Theories, models and frameworks to understand barriers to the provision of mobility-assistive technologies: a scoping review.

Objectives: There is strong evidence that mobility-assistive technologies improve occupational performance, social participation, educational and employment access and overall quality of life in people with disabilities. However, people with disabilities still face barriers in accessing mobility products and related services. This review aims to summarise and synthesise: (1) theories, models and frameworks that have been used to understand mobility-assistive technology access, (2) determinants of access and (3) gaps in knowledge.

HERA-lding More Integration in Health? Examining the Discursive Legitimation of the European Commission's New Health Emergency Preparedness and Response Authority.

Context: Since COVID-19, the European Commission (EC) has sought to expand its activities in health through the development of a European Health Union and within it the Health Emergencies Preparedness and Response Authority (HERA).

Methods: The authors applied a discourse analysis to documents establishing HERA to investigate how the EC legitimated the creation of this institution. They focused on how it framed health emergencies, how it framed the added value of HERA, and how it linked HERA to existing EU activities and priorities.

Participatory policy analysis in health policy and systems research: reflections from a study in Nepal.

Background: Participatory policy analysis (PPA) as a method in health policy and system research remains underexplored. Using our experiences of conducting PPA workshops in Nepal to explore the impact of the country's move to federalism on its health system, we reflect on the method's strengths and challenges. We provide an account of the study context, the design and implementation of the workshops, and our reflections on the approach's strengths and challenges.

The impact of decentralisation on health systems: a systematic review of reviews.

Background: Decentralisation is a common mechanism for health system reform; yet, evidence of how it impacts health systems remains fragmented. Despite published findings from primary and secondary research illustrating range of impacts, a comprehensive and clear understanding is currently lacking. This review synthesised the existing evidence to assess how decentralisation (by devolution) impacts each of the six WHO building blocks, and the health system.

Overcoming the challenges facing Nepal's health system during federalisation: an analysis of health system building blocks.

Introduction: Nepal's move to a federal system was a major constitutional and political change, with significant devolution of power and resources from the central government to seven newly created provinces and 753 local governments. Nepal's health system is in the process of adapting to federalism, which is a challenging, yet potentially rewarding, task. This research is a part of broader study that aims to explore the opportunities and challenges facing Nepal's health system as it adapts to federalisation.

Retinotopic connectivity maps of human visual cortex with unconstrained eye movements.

Human visual cortex contains topographic visual field maps whose organization can be revealed with retinotopic mapping. Unfortunately, constraints posed by standard mapping hinder its use in patients, atypical subject groups, and individuals at either end of the lifespan. This severely limits the conclusions we can draw about visual processing in such individuals.

Gender and caste inequalities in primary healthcare usage by under-5 children in rural Nepal: an iterative qualitative study into provider perspectives and the potential role of implicit bias.

Objective: This study explored provider perspectives on: (1) why inequalities in health service usage persist; and (2) their knowledge and understanding of the role of patient experience and implicit bias (also referred to as unconscious bias).

Design: A three stage, iterative qualitative study was conducted involving two rounds of in-depth interviews and a training session with healthcare staff. Interview transcripts were analysed using a reflexive thematic approach in relation to the study's aims.

Determinants affecting utilisation of health services and treatment for children under-5 in rural Nepali health centres: a cross-sectional study.

Background: Large inequalities in child health remain in Nepal, with caste, ethnicity and sex being major determinants of deprivation and negative outcomes. The purpose of this study was to explore whether key demographics of under 5s were associated with health seeking behaviours, utilisation of health care, and treatment received.

Methods: Data came from Integrated Management of Neonatal & Childhood Illness (IMNCI) records of 23 health centres across five districts.

Processes of assistive technology service delivery in Bangladesh, India and Nepal: a critical reflection.

Purpose: This paper critically reviews and reflects on the processes for providing Assistive Technology (AT) services to Persons with Disabilities (PWD) in Bangladesh, India and Nepal. The aim is to investigate the AT service delivery systems in these countries and suggest improvements where weaknesses are identified.

Materials And Methods: We carried out a descriptive qualitative exploratory study in Bangladesh, India and Nepal by conducting key informant interviews with policymakers (5), AT service providers (22) and mobility and hearing related AT service users (21).

Further Evidence That People Rely on Egocentric Information to Guide a Cursor to a Visible Target.

Everyday movements are guided by objects' positions relative to other items in the scene (allocentric information) as well as by objects' positions relative to oneself (egocentric information). Allocentric information can guide movements to the remembered positions of hidden objects, but is it also used when the object remains visible? To stimulate the use of allocentric information, the of the participant's finger controlled the of a cursor that they used to intercept moving targets, so there was no one-to-one mapping between egocentric positions of the hand and cursor. We evaluated whether participants relied on allocentric information by shifting all task-relevant items simultaneously leaving their allocentric relationships unchanged.

Visual stress responses to static images are associated with symptoms of Persistent Postural Perceptual Dizziness (PPPD).

Background: Images that deviate from natural scene statistics in terms of spatial frequency and orientation content can produce visual stress (also known as visual discomfort), especially for migraine sufferers. These images appear to over-activate the visual cortex.

Objective: To connect the literature on visual discomfort with a common chronic condition presenting in neuro-otology clinics known as persistent postural perceptual dizziness (PPPD).

Re-examining critiques of resilience policy: evidence from Barpak after the 2015 earthquake in Nepal.

This paper examines three common critiques of 'resilience': (i) that it is a 'top-down' policy discourse that pays too little regard to local specificities; (ii) that resilience policy represents a neoliberal shift towards the responsibilisation of communities and a retreat of the state from its role in providing protection; and (iii) that the focus on resilience tends to divert attention from the underlying causes of vulnerability. Using data collected after the 2015 earthquake in Nepal, the paper argues that these critiques have mixed salience in this context, but that (i) and (iii) in particular point to important problems in how the central government and its international partners have approached enhancing the resilience of communities. While there are benefits to considering resilience at the local level, it is important to recognise the inequalities within communities, how these might be reflected in differential degrees of vulnerability, and how they might be reinforced through resilience-building programmes.

Access to assistive technology for persons with disabilities: a critical review from Nepal, India and Bangladesh.

Purpose: The purpose of this paper is to analyse and critically reflect on access to Assistive Technology (AT) for persons with disabilities (PWD) in Nepal, India and Bangladesh. This analysis aims to guide the development of a contextualised generic AT service delivery model suitable for these countries, based on the best practices identified.

Materials And Methods: This paper is based on a comprehensive study conducted in Nepal, India and Bangladesh, observing mobility and hearing-related AT service delivery centres run by the government, as well as private and nongovernmental organisations, and interviews with key informants: policymakers (5), AT service providers (20) and AT service users (20) between December 2019 to February 2020.

Detection of scene-relative object movement and optic flow parsing across the adult lifespan.

Moving around safely relies critically on our ability to detect object movement. This is made difficult because retinal motion can arise from object movement or our own movement. Here we investigate ability to detect scene-relative object movement using a neural mechanism called optic flow parsing.

Choosing not to weaponize healthcare: politics and health service delivery during Nepal's civil war, 1996-2006.

Healthcare has often been 'weaponized' during armed conflicts, with parties to the conflict interfering with or violently attacking health facilities and personnel for their own strategic ends. In this exploratory study of the civil war in Nepal (1996-2006), by contrast, we look at a case in which both sides (with some exceptions) came to see it as in their interests to avoid targeting health facilities or deliberately disrupting healthcare delivery. Drawing on key informant interviews and documentary analysis, we identify four factors that appear to have contributed to the two sides making this choice: i) their interest in the continued functioning of the health systems (specifically, the need of the Maoists to access government-run facilities for treatment of their cadres, and the fact that Maoist healthcare provision ensured that at least some service delivery continued in areas under their control; ii) the fact that healthcare did not become an important 'ideological battleground' in the conflict; iii) the roles played by humanitarian and development organizations in shaping the behaviour of both the warring sides; and iv) the part played by health professionals in navigating the pressures on them and quickly mobilizing to resist more sustained attempts at interference with healthcare.

Visually-induced dizziness is associated with sensitivity and avoidance across all senses.

Background: Persistent postural perceptual dizziness (PPPD) is a common chronic condition presenting in neurology and neuro-otology clinics. Symptoms lie on a spectrum in the general population. The cause is unknown and thought to involve interactions between visual and vestibular systems, but symptoms also correlate with anxiety and migraine.

Persistent postural perceptual dizziness is on a spectrum in the general population.

Objective: To examine the idea that symptoms of persistent postural perceptual dizziness (PPPD) are more common than previously assumed and lie on a spectrum in the general population, thus challenging current theories that PPPD is only a consequence of a vestibular insult.

Methods: We collected 2 common clinical questionnaires of PPPD (Visual Vertigo Analogue Scale [VVAS] and Situational Characteristics Questionnaire [SCQ]) in 4 cohorts: community research volunteers (n = 1941 for VVAS, n = 1,474 for SCQ); paid online participants (n = 190 for VVAS, n = 125 for SCQ); students (n = 204, VVAS only); and patients diagnosed with PPPD (n = 25).

Results: We found that around 9%, 4%, and 11%, respectively, of the 3 nonclinical cohorts scored above the 25th percentile patient score on 1 PPPD measure (VVAS) and 49% and 54% scored above the 25th percentile patient score on the other measure (SCQ).

The role of time perception in temporal binding: Impaired temporal resolution in causal sequences.

Causality affects our perception of time; events that appear as causally related are perceived as closer together in time than unrelated events. This effect is known as temporal binding. One potential explanation of this effect is that causality slows an "internal clock" that is used in interval estimation.

The predictability of a target's motion influences gaze, head, and hand movements when trying to intercept it.

Does the predictability of a target's movement and of the interception location influence how the target is intercepted? In a first experiment, we manipulated the predictability of the interception location. A target moved along a haphazardly curved path, and subjects attempted to tap on it when it entered a hitting zone. The hitting zone was either a large ring surrounding the target's starting position (ring condition) or a small disk that became visible before the target appeared (disk condition).

Lateral visual occlusion does not change walking trajectories.

Difficulties with walking are often reported following brain damage that causes a lateralized loss of awareness on one side. Whether lateralized loss of awareness has a direct causal impact on walking is unknown. A review of the literature on visually guided walking suggests several reasons why a lateralized loss of visual awareness might be expected to lead to difficulties walking.

Ability to identify scene-relative object movement is not limited by, or yoked to, ability to perceive heading.

During locomotion humans can judge where they are heading relative to the scene and the movement of objects within the scene. Both judgments rely on identifying global components of optic flow. What is the relationship between the perception of heading, and the identification of object movement during self-movement? Do they rely on a shared mechanism? One way to address these questions is to compare performance on the two tasks.