Video Conferencing Tools: Comparative Study of the Experiences of Screen Reader Users and the development of more Inclusive Design Guidelines

Since the first lockdown in 2020, video conferencing tools have become increasingly important for employment, education, and social interaction, making them essential tools in everyday life. This study investigates the accessibility and usability of the desktop and mobile versions of three popular video conferencing tools, Zoom, Google Meet and MS Teams, for visually impaired people interacting via screen readers and keyboard or gestures. This involved two inspection evaluations to test the most important features of the desktop and mobile device versions and two surveys of visually impaired users to obtain information about the accessibility of the selected video conferencing tools. 65 and 94 people answered the surveys for desktop and mobile platforms respectively. The results showed that Zoom was preferred to Google Meet and MS Teams, but that none of the tools was fully accessible via screen reader and keyboard or gestures. Finally, the results of this empirical study were used to develop a set of guidelines for designers of video conferencing tools and assistive technology.

Submission Template for ACM Papers

The results presented here were obtained from an experimental study of blind people's experiences on two routes with very different characteristics. They are intended to answer three research questions on how blind people identify environmental features while travelling and use environmental information to form spatial representations, and the implications for the design of electronic travel aids to better support mental mapping of space. The results include detailed discussions of the mainly tactile and auditory information used by blind people to identify objects, as well as the different combinations of sensory information used in forming mental maps, the approaches participants used to do this, and the sensory modalities involved. They also provide a categorisation of the main features in participants’ descriptions of the two routes. The answers to the three questions include a discussion of the relationship between the sensory information used in route descriptions and mental maps, and the implications of the results for the design of electronic travel aids to support mental mapping, including suggestions for new types of aids and guidelines for aid design.

Wearable Travel Aids for Blind and Partially Sighted People: A Review with a Focus on Design Issues

The ability to travel (independently) is very important for participation in education, work, leisure activities, and all other aspects of modern life. Blind and partially sighted people experience a number of barriers to travel, including inaccessible information and environments, and consequently require support from technology or other people to overcome them. Despite the potential of advanced technologies and the development of electronic travel aids, the long cane and guide dog remains the most commonly used solutions. Wearable technologies are becoming increasingly popular. They have the particular advantage of keeping the hands free, thereby facilitating the use of a long cane, guide dog or another device at the same time. They also have the potential to change the ways in which users interact with the environment. The main contributions of this paper are surveying the current state-of-the-art of travel aids from a design perspective and investigating the following issues: (1) The important design issues in wearable travel aids and the extent to which they are taken into account in different devices; (2) The relationship, if any, between where and how travel aids are worn and their design, features and functions; (3) Limitations of existing devices, gaps in provision and future research directions, particularly with regard to meeting potential users' needs.

Panel Discussion: Covid-19, Technology and Ethics

The Covid-19 pandemic has led to considerable disruption and raised a number of issues for both individuals and society as a whole. Many of these issues have both technology and ethics dimensions. Several of them are discussed in this paper. In the session the authors will be making brief presentations from their perspectives and the experiences of Covid-19 in their different countries. This will be followed by a comment/question and answer session and final summing up by the authors.

Tacsac: A Wearable Haptic Device with Capacitive Touch-Sensing Capability for Tactile Display

This paper presents a dual-function wearable device (Tacsac) with capacitive tactile sensing and integrated tactile feedback capability to enable communication among deafblind people. Tacsac has a skin contactor which enhances localized vibrotactile stimulation of the skin as a means of feedback to the user. It comprises two main modules—the touch-sensing module and the vibrotactile module; both stacked and integrated as a single device. The vibrotactile module is an electromagnetic actuator that employs a flexible coil and a permanent magnet assembled in soft poly (dimethylsiloxane) (PDMS), while the touch-sensing module is a planar capacitive metal-insulator-metal (MIM) structure. The flexible coil was fabricated on a 50 µm polyimide (PI) sheet using Lithographie Galvanoformung Abformung (LIGA) micromoulding technique. The Tacsac device has been tested for independent sensing and actuation as well as dual sensing-actuation mode. The measured vibration profiles of the actuator showed a synchronous response to external stimulus for a wide range of frequencies (10 Hz to 200 Hz) within the perceivable tactile frequency thresholds of the human hand. The resonance vibration frequency of the actuator is in the range of 60–70 Hz with an observed maximum off-plane displacement of 0.377 mm at coil current of 180 mA. The capacitive touch-sensitive layer was able to respond to touch with minimal noise both when actuator vibration is ON and OFF. A mobile application was also developed to demonstrate the application of Tacsac for communication between deafblind person wearing the device and a mobile phone user who is not deafblind. This advances existing tactile displays by providing efficient two-way communication through the use of a single device for both localized haptic feedback and touch-sensing.

Mental Maps and the Use of Sensory Information by Blind and Partially Sighted People

This article aims to fill an important gap in the literature by reporting on blind and partially sighted people's use of spatial representations (mental maps) from their perspective and when travelling on real routes. The results presented here were obtained from semi-structured interviews with 100 blind and partially sighted people in five different countries. They are intended to answer three questions about the representation of space by blind and partially sighted people, how these representations are used to support travel, and the implications for the design of travel aids and orientation and mobility training. They show that blind and partially sighted people do have spatial representations and that a number of them explicitly use the term mental map. This article discusses the variety of approaches to spatial representations, including the sensory modalities used, the use of global or local representations, and the applications to support travel. The conclusions summarize the answers to the three questions and include a two-level preliminary classification of the spatial representations of blind and partially sighted people.

Wearable Assistive Tactile Communication Interface Based on Integrated Touch Sensors and Actuators

This paper presents the design and fabrication of a wearable tactile communication interface with vibrotactile feedback for assistive communication. The interface is based on finger Braille, which is a simple and efficient tactile communication method used by deafblind people. It consists of a flexible piezoresistive sensor and a vibrotactile actuator integrated together and positioned at the index, middle and ring fingers of both hands to represent the six dots of Braille. The sensors were made using flexible piezoresistive material whereas the actuator utilizes electromagnetic principle by means of a flexible coil and a tiny NdFeB permanent magnet. Both were integrated to realize a Bluetooth-enabled tactile communication glove which enables deafblind people to communicate using Braille codes. The evaluation with 20 end-users (10 deafblind and 10 sighted and hearing person) of the tactile interface under standardized conditions demonstrated that users can feel and distinguish the vibration at frequencies ranging from 10Hz to 200Hz which is within the perceivable frequency range for the FA-II receptors. The results show that it took non-experts in Braille within 25s and 55s to send and receive words like "BEST" and "JOURNAL", with an accuracy of ~75% and 68% respectively.

Barriers and enablers of inclusion for young autistic learners: lessons from the Polish experiences of teachers and related professionals

Purpose

The purpose of this paper is to present new empirical data on the experiences of 120 teachers and professionals working with autistic children and young people across different settings in Poland where autism research on inclusive education is scarce. It explores the relationship of inclusive education to the social and neurodiversity models of disability. It makes evidence-based recommendations for good practice and modelling and evaluating future education and inclusion practices.

Design/methodology/approach

It uses a survey approach involving a combination of qualitative and quantitative data collection and embeds practical findings in theory, including the relationship of inclusive education to the social and neurodiversity models of disability.

Findings

The findings include the barriers teachers and related professionals experience in facilitating inclusive teaching and learning and how the following would be useful to autistic students: opportunities to exercise responsibilities and take leadership roles; social as well as educational inclusion; provision of a safe environment; regular funded autism training in work time; and appropriate use of additional classroom teachers.

Research limitations/implications

A survey-based approach has limitations.

Practical implications

Opportunities to exercise responsibilities and take leadership roles; social as well as educational inclusion; provision of a safe environment; regular funded autism training in work time; and appropriate use of additional classroom teachers.

Social implications

This study can be useful in the development of social skills and communication, social and educational inclusion.

Originality/value

Polish teachers’ attitudes, experiences and support needs, including some previously overlooked issues, are related to the broader international context beyond Poland. Analysis of the findings is used to derive evidence-based recommendations for good practice and modelling, and evaluating future education and inclusion practices.

Mobile Recommender Apps with Privacy Management for Accessible and Usable Technologies

The paper presents the preliminary results of an ongoing survey of the use of computers and mobile devices, interest in recommender apps and knowledge and concerns about privacy issues amongst English and Italian speaking disabled people. Participants were found to be regular users of computers and mobile devices for a range of applications. They were interested in recommender apps for household items, computer software and apps that met their accessibility and other requirements. They showed greater concerns about controlling access to personal data of different types than this data being retained by the computer or mobile device. They were also willing to make tradeoffs to improve device performance.

A Self-Assessment Framework for Inclusive Schools Supporting Assistive Technology Users

In order to support schools to assess their performance in supporting children with disabilities in their ICT and ICT-AT needs, a self-assessment framework was developed by a task force of partners and associate partners of the ENTELIS project. The self-assessment tool aims to help educational establishments that welcome learners with disabilities to assess their current outcomes and to plan improvements in supporting these students in increasing digital literacy and developing digital skills. This includes the use of mainstream Information and Communication Technology (ICT) and specially designed digital Assistive Technologies (ICT-AT). This can only successfully happen if schools fully embrace an inclusive approach to education. In this paper the authors describe the development of the framework and the further steps for its use.

Overcoming Barriers and Increasing Independence – Service Robots for Elderly and Disabled People

The paper discusses the potential of assistive service robots to support disabled and elderly people. It shows that they have considerable untapped potential in this area, but also that inappropriate implementations could increase isolation, reduce independence and lead to users feeling as though they are under surveillance. The main body of the paper presents an overview of existing applications and discusses their benefits and potential problems. This is organized by an extension of the common classification into socially and physically assistive robots by the two categories of sensory assistive and mixed assistance robots. Another more detailed classification is also presented. This discussion is introduced by an overview of many of the technological components of smart mobile robots. It is followed by a discussion of user acceptance. The problems of existing models based on either solely positive or solely negative factors are noted and a model containing both types of factors is proposed. The need for continuing research is noted and various proposals are made.

Development of a Portable Two-Way Communication and Information Device for Deafblind People

This paper presents research on the development of a wearable two-way communication and information device for deafblind people who use tactile communications methods, namely the British deafblind manual alphabet and/or Braille. The device has two components: a glove worn by the deafblind person and a handheld display with keypad to be used by their hearing and sighted communication partner. Users can send messages using pressure sensors embedded in the glove and receive them by means of vibration on the palm. The two components are linked by Bluetooth and the use of Bluetooth to communicate with computers, mobile phones and other Bluetooth enabled devices is being investigated. The design was informed by feedback obtained from a survey of deafblind people and interviews with staff in two organisations for deafblind people. Research and development of the device is still ongoing.

ICT Learning Technologies for Disabled People: Recommendations for Good Practice

The use of ICT in education is becoming increasingly important and has potential advantages to disabled learners if the technologies are appropriately designed, including for accessibility and usability, and used. This paper presents the first sets of recommendations for learning technologies for disabled people aimed at disabled learners, teachers, developers and educational institutions respectively. They were developed as part of the work of the Enable Network for ICT Learning for Disabled People and involved input from both experts and end-users. The concise format facilitates production in a variety of formats and languages for accessibility and wide distribution. The paper discusses the recommendations and their relationship to existing guidelines.

Deafblind people, communication, independence, and isolation

This paper discusses issues related to communication, independence, and isolation for an understudied group of deaf people who also have visual impairments. The discussion is based on the experiences of 28 deafblind people in 6 different countries, obtained from interviews that were carried out as part of a larger research project on travel issues. However, the similarities in experiences between countries were stronger than the differences. In particular, barriers to communication and inadequate support, with resulting problems of isolation and depression, were found in all the countries. Equally, deafblind people in all the countries were interested in being involved in and contributing to society and supporting other people, particularly through organizations of blind and deafblind people. This runs counter to the tendency to present deafblind and other disabled people purely as recipients of support rather than also as active participants in society. However, there were some differences in the support available in the different countries.

Investigating road safety issues and deaf people in the United kingdom: an empirical study and recommendations for good practice

Very little research has been carried out in the United Kingdom or other countries on the views and experiences of deaf people on road safety and other aspects of travel. Historically, there has been little specific attention to either the issue of road safety for deaf people or more general travel issues affecting deaf people. Deaf-specific support, guidance, or advice on road safety from the police or other agencies has been sparse. This has led to a situation where support for deaf pedestrians, drivers, and other deaf road users has been developed on an ad-hoc basis, and available measures have not been uniformly adopted across the United Kingdom. Furthermore, although the United Kingdom police force has aimed to provide some support to deaf and hard of hearing people, this has mainly concentrated on communications support in the form of note-taking, interpreters, and video-based information. This article aims to fill the gap in knowledge of road safety issues for deaf and hard of hearing people by reporting empirical research carried out with deaf people in the United Kingdom and making recommendations to improve their road safety.

Thrombotic microangiographic hemolytic anemia in systemic lupus erythematosus

Thrombotic microangiopathic hemolytic anemia (TMHA) is characterized by thrombocytopenia, microangiopathic hemolytic anemia, fever, neurological symptoms, and kidney involvement. It presents as thrombotic thrombocytopenic purpura (TTP) or hemolytic uremic syndrome (HUS). TMHA has been considered to occur only rarely in systemic lupus erythematosus (SLE). However, there has been an increase in the reporting of this association in recent years, and autopsy studies have suggested that TMHA may be underdiagnosed in SLE because of the similarity in symptoms. We report four patients with SLE-related TMHA and describe 24 more patients from a literature review. All patients were women, 50% had active SLE, 89% presented as TTP, and 11% presented as HUS. Those patients with active SLE had low complement levels. Antiphospholipid antibodies or lupus anticoagulant were positive in 5 of 8 cases. Patients treated with plasma infusions or plasmapheresis had a lower mortality rate at 25% compared with 57% mortality in patients who were not treated with plasma infusions or plasmapheresis. It is suggested that TMHA should be considered in any SLE patient presenting with neurological symptoms or renal failure associated with fever, hemolytic anemia, and thrombocytopenia. Early recognition and appropriate therapy with plasmapheresis may improve prognosis.

An estimate of the prevalence of asthma and wheezing among inner-city children

OBJECTIVE

To estimate the prevalence of asthma and wheezing unassociated with a diagnosis of asthma among inner-city children.

DESIGN

Cross-sectional survey of a sample of Bronx households.

METHODS

Random digit dialing telephone survey using parental report.

SETTING

Bronx County, NY.

PARTICIPANTS

662 self-designated heads-of-household who reported for all children 0 through 17 years of age living in their households.

MEASUREMENTS

Questions from the Child Health Supplement to the 1988 National Health Interview Survey and the International Union Against Tuberculosis and Lung Disease Bronchial Symptoms Questionnaire were used to estimate the prevalence of asthma and wheezing-related illness.

RESULTS

Information was gathered on 1285 children. Of this sample, 184 (14.3%) were reported to have ever had asthma (cumulative prevalence) and 111 (8.6%) were reported to have asthma in the last 12 months (period prevalence). The asthma period prevalence rate among Bronx children was twice the United States rate (4.3%). Among children 0 through 11 years of age, the prevalence rate was similar for boys and girls, although among children 12 through 17 years of age, asthma was significantly more prevalent among boys. Fifty-four children (4.2%) were reported to have had wheezing in the past 12 months unassociated with a diagnosis of asthma (wheeze only). The cumulative, but not the period, prevalence rate of asthma differed significantly by income and race/ethnicity. The cumulative prevalence was significantly higher among Hispanics and children from the lowest income families. The prevalence of wheeze only (no reported history of asthma) was higher among whites (6.4%) and blacks (5.8%) than Hispanics (2.9%) (P < .1). The reported number of wheezing attacks and the average number of nights per week that sleep was disturbed by wheezing during the past year were similar for those with asthma and those with wheeze only, although severe attacks (wheezing severe enough to limit speech) were significantly more likely among those reported to have asthma (P < .001). The total asthma prevalence (period prevalence of asthma plus wheeze only) was 12.8% and was quite consistent across subgroups.

CONCLUSIONS

These data suggest that the prevalence of asthma among inner-city children may be substantially higher than the rates for this group estimated from national survey data. Some proportion of the wheeze only group may represent undiagnosed, and thereby undertreated, asthma. Public health efforts directed at reducing asthma morbidity and mortality need to address the possibility that asthma prevalence is higher within inner cities and that a large number of children with asthma may be inadequately diagnosed and treated.

Language in differential diagnosis of a teenage schizophrenic girl with aspects of multiple personality

Diagnosis of a teenage schizophrenic girl showed many features of her language and behavior mimicked the presentation of a Dissociative Personality Disorder. These aspects were secondary to the primary schizophrenic disorder and treated via a multimodal approach combining pharmacotherapy, individual, family, and milieu therapy. Implications are drawn for tailoring verbal interventions to such overdetermined conditions.

A rare bone tumor in an unusual location: osteoblastoma of the vertebral body

Most osteoblastomas involve the posterior elements alone, or both the posterior elements and the vertebral bodies. Osteoblastomas confined in the body of the vertebrae are very rare. Spinal osteoblastomas are associated with localized pain in about 80% of cases and neurological deficits in 25% to 50% of cases. Nearly half of lumbar and thoracic osteoblastomas demonstrate coexistent scoliosis with the convex side away from the involved side of the vertebrae.

Phase I trial of echinomycin (NSC 526417), a bifunctional intercalating agent, administered by 24-hour continuous infusion

Echinomycin was administered to 43 patients with advanced cancer in escalating doses ranging from 60 to 2128 mcg/m2. The dose-limiting toxicity of echinomycin administered as a 24-h continuous infusion every 28 days was nausea and vomiting beginning at the end of the 24 h infusion and lasting from 3 to 8 days. Other toxicities included sporadic thrombocytopenia and biochemical evidence of liver dysfunction characterized by elevations in SGOT. Peripheral vein phlebitis was noted in 100% of patients, and watery diarrhea of 24-48-h duration was noted in 7% of patients. The maximally tolerated dose of echinomycin was 2128 mcg/m2. The recommended dose for phase II trials utilizing the 24-h continuous infusion schedule is 1600 mcg/m2 repeated every 28 days with pretreatment antiemetics.

A phase I and pharmacokinetic comparison of hepatic arterial and peripheral vein infusions of bisantrene for liver cancer

Bisantrene (NSC-337766) was administered to five patients with cancer of the liver (one case of hepatocellular carcinoma, two of metastatic carcinoma of unknown primary, two of metastatic colorectal carcinoma). Under fluoroscopic guidance, percutaneous hepatic venous catheters were placed in five patients and percutaneous hepatic arterial catheters in four. A fifth patient's hepatic arterial catheter was implanted at laparotomy. Hepatic plasma flow was estimated by the Fick principle using peripheral vein indocyanine green infusion. On the first day of treatment, patients received a 2- or 4 h hepatic arterial infusion of bisantrene (130 mg/m2); peripheral venous, hepatic arterial, and hepatic venous timed blood samples were drawn during and for 18 h after drug infusion. On the second day of treatment, 2- or 4 h peripheral vein infusion of bisantrene (130 mg/m2) was followed by the same blood sampling schedule. Patients were followed weekly for toxicity. Four patients received only one course of treatment, while a fifth received two courses. All patients experienced leukopenia (median nadir 2400/mm3; range 1400-2700/mm3). Two patients developed fever after drug infusion. No antitumor responses were observed. Plasma bisantrene concentrations were measured by HPLC. Pharmacokinetic analyses are reported for four patients. The hepatic extraction ratio ranged from 15% to 49%, hepatic plasma clearances were 0.029-0.353 1/min/m2; peripheral vein areas under the concentration-time curve during hepatic arterial infusion ranged from 35% to 50% of peripheral vein areas under the curve during peripheral vein infusion. We conclude that hepatic arterial bisantrene infusion offers only modest pharmacokinetic advantage to the target organ or to the systemic circulation over peripheral vein infusion.

Effects on human peripheral lymphocytes of in vivo administration of 9-beta-D-arabinofuranosyl-2-fluoroadenine-5'-monophosphate (NSC 312887), a new purine antimetabolite

9-beta-D-Arabinofuranosyl-2-fluoroadenine-5'-monophosphate (NSC 312887) (2-F-ara-AMP) is a new purine antimetabolite with documented preclinical activity against a number of animal tumors. Data from in vitro studies and preclinical animal toxicology trials indicated that 2-F-ara-AMP might be lymphocytotoxic. We studied effects of 2-F-ara-AMP on peripheral lymphocytes of patients receiving the agent in a Phase I clinical trial. Eleven patients received 13 courses given by i.v. bolus daily for 5 days. Mononuclear cells were isolated, and lymphocyte subsets were quantitated by immunofluorescence and flow cytometry 1 day before treatment and 4 hr after the final infusion. Lymphocytopenia developed rapidly (median time to nadir, 6 days) and was reversible. Standard leukocyte counts, differential counts, and percentages of isolated mononuclear cells reactive with monoclonal antibodies were used to calculate numbers of peripheral cells in each major lymphocyte subpopulation. Total T-lymphocyte counts fell during all treatment courses, with calculated mean absolute T-cell counts decreasing by 90%. Decreases were observed in all major T-lymphocyte subsets. By contrast, calculated B-lymphocyte counts decreased an average of 50% and were noted to increase during two treatment cycles. We also compared in vitro recoveries of cells from each major lymphocyte subpopulation before and after administration of 2-F-ara-AMP. Recoveries of total mononuclear cells, total T-cells, and non-T-, non-B-cells all were reduced substantially by 2-F-ara-AMP, but B-cell recovery was not reduced. These in vivo data, the first in human subjects, are in agreement with in vitro studies of halopurine nucleotide analogues which have demonstrated that T-cells are more sensitive than are B-cells to the cytotoxic effects of these compounds.

Lead poisoning in a West Bank Arab Village

Eleven patients from the West Bank village of Es-Sawiyeh were admitted with lead poisoning to two Jerusalem hospitals between November 1982 and January 1983. They all belonged to several households of a single large family. Colicky abdominal pains were present in five patients, weakness in four, behavioral changes ranging from irritability to frank psychosis in four, and paralysis in one. Anemia of various degrees was seen in all patients. Basophilic stippling and reticulocytosis were encountered in all patients with moderate to severe anemia. Therapy with edetate disodium calcium and penicillamine resulted in clinical improvement in all patients. A preliminary survey of 270 subjects in the same village disclosed 84 subjects with abnormally elevated blood lead levels, 17 of whom had grade IV lead burden according to the Centers for Disease Control risk classification. Contamination of homemade flour by lead used for stabilizing the metal parts of stone mills was the source of poisoning. As the method of milling in many West Bank villages is similar, these findings may have important implications to the well being of a large section of the rural West Bank population.

Phase I clinical investigation of 9-beta-D-arabinofuranosyl-2-fluoroadenine 5'-monophosphate (NSC 312887), a new purine antimetabolite

9-beta-D-Arabinofuranosyl-2-fluoroadenine 5'-monophosphate (NSC 312887) is a new purine antimetabolite that has been evaluated in a Phase I clinical trial. The schedule of administration consisted of a single i.v. infusion over a period of 30 min once each day for 5 consecutive days, repeated at 4-week intervals. Thirteen patients received 30 courses of the drug in a dose range of 18 to 40 mg/sq m/day. Granulocytopenia and thrombocytopenia were dose limiting. Repeated courses produced similar degrees of granulocytopenia, but in 7 of 7 patients receiving 2 or more courses, the degree of thrombocytopenia was less severe during the first than during subsequent courses. Myelosuppression in humans was more severe than predicted from the mouse model. Lymphopenia was profound at all dose levels, but reversed within 3 weeks. Somnolence occurred during infusion in 8 of 13 patients, but quickly cleared after the infusion was completed. The infused drug was rapidly dephosphorylated in plasma and then cleared so there was no cumulation of drug in plasma when it was rapidly infused once each day in these doses. Phase II studies of 9-beta-D-arabinofuranosyl-2-fluoroadenine 5'-monophosphate are planned at a starting dose of 18 mg/ sq m/day for patients with prior chemotherapy or radiotherapy and 25 mg/sq m/day for those without prior therapy, as a single dose on each of 5 consecutive days repeated at 21- to 28-day intervals.