A revaluation of the cultural dimension of disability policy in the European Union: The impact of digitization and web accessibility

Reflecting the commitments undertaken by the EU through the conclusion of the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), the European Disability Strategy 2010–2020 not only gives a prominent position to accessibility, broadly interpreted, but also suggests an examination of the obligations for access to cultural goods and services. The European Disability Strategy 2010–2020 expressly acknowledges that EU action will support national activities to make sports, leisure, cultural and recreational organizations and activities accessible, and use the possibilities for copyright exceptions in the Directive 2001/29/EC (Infosoc Directive). This article discusses to what extent the EU has realized the principle of accessibility and the right to access cultural goods and services envisaged in the UNCRPD. Previous research has yet to explore how web accessibility and digitization interact with the cultural dimension of disability policy in the European Union. This examination attempts to fill this gap by discussing to what extent the European Union has put this cultural dimension into effect and how web accessibility policies and the digitization of cultural materials influence these efforts

Improving Oral Hygiene Skills by Computer-Based Training: A Randomized Controlled Comparison of the Modified Bass and the Fones Techniques

Background: Gingivitis and other plaque-associated diseases have a high prevalence in western communities even though the majority of adults report daily oral hygiene. This indicates a lack of oral hygiene skills. Currently, there is no clear evidence as to which brushing technique would bring about the best oral hygiene skills. While the modified Bass technique is often recommended by dentists and in textbooks, the Fones technique is often recommended in patient brochures. Still, standardized comparisons of the effectiveness of teaching these techniques are lacking. Methodology/Principal Findings: In a final sample of n=56 students, this multidisciplinary, randomized, examiner-blinded, controlled study compared the effects of parallel and standardized interactive computer presentations teaching either the Fones or the modified Bass technique. A control group was taught the basics of tooth brushing alone. Oral hygiene skills (remaining plaque after thorough oral hygiene) and gingivitis were assessed at baseline and 6, 12, and 28 weeks after the intervention. We found a significant group×time interaction for gingivitis (F(4/102)=3.267; p=0.016; e=0.957; ?2=0.114) and a significant main effect of group for oral hygiene skills (F(2/51)=7.088; p=0.002; ?2=0.218). Fones was superior to Bass; Bass did not differ from the control group. Group differences were most prominent after 6 and 12 weeks. Conclusions/Significance: The present trial indicates an advantage of teaching the Fones as compared to the modified Bass technique with respect to oral hygiene skills and gingivitis. Future studies are needed to analyze whether the disadvantage of teaching the Bass technique observed here is restricted to the teaching method employed. Trial Registration: German Clinical Trials Register http://www.drks.de/DRKS0000348

Mundhygienefertigkeiten bei jungen Erwachsenen Status quo und Möglichkeiten der Verbesserung

Die Prävalenz von plaqueassoziierten Parodontalerkrankungen wie Gingivitis und Parodontitis ist weltweit sehr hoch, obwohl die Motivation zur Putzhäufigkeit ebenfalls hoch zu sein scheint. Ursache für diesen Befund könnte eine mangelnde Motivation zur Hygienegründlichkeit sein, aber auch ein Mangel an Hygienefertigkeiten. Tatsächlich weisen Studien auf erhebliche Fertigkeitendefizite hin. Eine wichtige Aufgabe in der Prävention von Parodontalerkrankungen ist es demnach, die Mundygienefertigkeiten zu verbessern. Allerdings gibt es keine Evidenzen, die für oder gegen eine spezielle Bürsttechnik für ein Mundhygienetraining sprächen. Ziel der vorliegenden Studie ist es daher, die Auswirkungen einer standardisierten Vermittlung verschiedener Zahnbürsttechniken vergleichend zu untersuchen. Neben zahnmedizinisch-klinischen Parametern finden dabei auch psychologische Parameter Berücksichtigung, die Rückschlüsse auf die Motivation zur Putzgründlichkeit zulassen: Selbstwirksamkeitser-wartungen und Entscheidungsbalance56 Probanden wurden randomisiert und stratifiziert nach Geschlecht, Händigkeit und Mundhygienefertigkeiten drei Gruppen zugeordnet. Die Gruppen erhielten entweder nur ein Training der Grundlagen des Zähneputzens (Kontrollgruppe) oder dieses Grundlagentraining gemeinsam mit dem Training von einer von zwei Bürsttechniken (Bass-Technik vs. Fones-Technik). Die klinischen Parameter (Mundhygienefertigkeiten, Mundhygiene und Mundgesundheit) wurden zur Baseline und zwei, sechs, zwölf und 28 Wochen nach einer Professionellen Zahnreinigung und der Mundhygieneinstruktion erhoben. Die psychologischen Parameter wurden mittels Fragebögen getrennt für Zähnebürsten und Approximalhygiene erhoben und zwar zur Baseline, zwölf und 28 Wochen nach der Intervention. Zum Schluss wurde die Adhärenz zur Verwendung der Techniken mit einem Fragebogen erhoben.Die Gruppen unterscheiden sich hinsichtlich der Mundhygienefertigkeiten, der Mundhygiene und Mundgesundheit, wobei die Fonesgruppe der Bassgruppe überlegen ist. Allerdings zeigen sich die Unterschiede bei der Mundhygiene und der Mundgesundheit erst in den späteren Untersuchungsterminen. Auffällig ist, dass die Fertigkeiten nach zwölf Wochen stagnieren. Bei den psychologischen Parametern zeigen sich nur hinsichtlich des Zahnbürstens Gruppenunterschiede bei den Selbstwirksamkeitserwartungen und bei den wahrgenommenen Nachteilen beim zwölf-Wochentermin. Auch hier weist die Fonesgruppe bessere Werte auf als die Bassgruppe. Die meisten Vorteile nimmt sowohl beim zwölf als auch beim 28-Wochentermin die Kontrollgruppe wahr. Bei der Adhärenz zeigt sich, dass die meisten Nicht Adhärenten in der Bassgruppe anzutreffen waren. Die vorliegende Studie zeigt, dass bei einer standardisierten Vermittlung die Fones-Technik der Bass-Technik in den klinischen Parametern überlegen ist. Auch hinsichtlich der psychologischen Parameter ergeben sich Vorteile für die Fonesgruppe, in der Bassgruppe zeichnet sich eine deutliche Verschlechterung der Putzmotivation nach der Intervention ab. Mit den Daten gelingt erstmals in einem standardisierten randomisierten Vergleich der Nachweis eines Vorteils des Trainings der Fones- gegenüber der Bass-Technik. Dieser Befund ist insofern besonders bemerkenswert, als die Bass-Technik in der klinischen Praxis häufig gelehrt und für überlegen gehalten wird. Die Aufgabe zukünftiger Studien besteht darin, die Ursachen für die relative Unterlegenheit der Bass-Technik weiter zu verfolgen und Methoden zu entwickeln, Hygienefertigkeiten noch über das in dieser Studie erreichte Niveau zu verbessern.Prevalence of periodontal diseases (i.e. gingivitis and periodontitis) is pretty high all over the world, although motivation of brushing frequency is high as well. A reason for this finding could be a lack of motivation in thoroughness of brushing as well as a lack of brushing skills. Actually, studies indicate a considerable lack of brushing skills. Improvement of brushing skills is therefore an important part of prevention of periodontal diseases. However, there is no evidence for or against a specific brushing technique for on oral hygiene training. Aim of the present study is to compare the effects of a standardized training of different brushing techniques. In addition to the assessment of clinical parameters, psychological parameters are taken into account as well to allow conclusions concerning motivation of thoroughness of brushing: self-efficacy and decisional balance.56 participants were randomized and stratified by gender, handedness and oral hygiene skills to one of three groups. The groups receive either only a training in basics of tooth brushing (control group) or the training of basics of tooth brushing followed by a training of one of the two brushing techniques (Bass-technique vs. Fones-technique). Clinical parameters (oral hygiene skills, oral hygiene and oral health) were assessed at baseline, two, six, twelve and 28 weeks after professional tooth cleaning and oral hygiene training. The psychological parameters were assessed via questionnaires separately for brushing and interdental hygiene at the baseline, twelve and 28 weeks after intervention. At the end participants filled in a questionnaire about adherence of the brushing techniques. The groups differed concerning oral hygiene skills, oral hygiene and oral health, whereby the Fonesgroup is superior to the Bassgroup. However, the differences appeared in oral hygiene and oral health at the later examinations. Of particular note is that the skills remain static twelve weeks after intervention. In the psychological parameters the groups differed only with respect to tooth brushing in self-efficacy and perceived barriers at twelve weeks after Intervention, whereby the Fonesgroup is again superior to the Bassgroup. The most benefits are perceived by the control group twelve and 28 weeks after intervention. In the Bassgroup most people report that they were non-adherent.The present study shows, that after a standardized training of brushing techniques the Fones-technique is superior to the Bass-technique concerning clinical parameters. With regard to psychological parameters the Fonesgroup show advantages and in the Bassgroup a clearly decline concerning brushing motivation occur after intervention. The data of this first randomized controlled comparison showed evidence for a superiority of the Fones-technique compared with the Bass-technique. This result is remarkable, because in clinical practice the Bass-technique is taught quite often and is considered to be superior. The task of future studies is, to further investigate the causes of the inferiority of the Bass-technique and to develop methods to improve oral hygiene skills beyond the level that was reached in this study

Disability and Capability: Exploring the Usefulness of Martha Nussbaum's Capabilities Approach for the UN Disability Rights Convention

The United Nations Convention on the Rights of Persons with Disabilities (CRPD) aims at empowering people with disabilities by granting them a number of civil and political, but also economic, social, and cultural rights. This is a groundbreaking agreement for all persons with disabilities, especially because it is the first human rights agreement for disabled people, and it is legally binding. For those states who signed it, it also brings various governmental obligations. Implementing the CRPD will clearly be politically challenging and also very expensive for all states, but even more so for poor ones.</jats:p

From Human Nature to Moral Judgments : Reframing Debates about Disability and Enhancement

My goal in my dissertation is to develop an account of how a theory of human nature should be integrated into bioethics and to show what bioethics can gain from using this account. I explore the relevance of human nature for moral argumentation, and especially for bioethics. Thereby, I focus on debates about enhancement and disability. Bioethics is in need of a discussion of conceptions of human nature, as I argue, to better justify and to understand moral judgments in bioethics. I begin the development of the theoretical framework in by identifying the very different conceptions of the human being implicit in discussions of ‘human nature.’ Once one distinguishes between naturalistic, metaphysical, and normative conceptions of the human being, it becomes clear that one cannot simply choose one of these conceptions to employ in a moral argument. These conceptions are not directly comparable to each other, because they are not simply alternatives for each other. I also show that conceptions of the human being can—and, in effect, do—play a role in moral arguments. These roles go beyond the much-criticized idea that approaches to human nature can serve as a sufficient basis for making moral judgments. In particular, as I show, there are several indirect argumentative functions for conceptions of human nature in moral arguments. Next, the theoretical framework is applied to three debates about disability and enhancement. These chapters assess the extent to which employing my framework improves the moral debate in question or allows better arguments to be made. The applications clarify the meaning, relevance, and implications for bioethical debates of the theoretical distinctions and insights developed in the theoretical framework. I start with a real-life case in which a decision has to be made concerning the treatment of an individual. This case concerns Ashley, a severely disabled girl. She received a controversial medical intervention to keep her child-sized and to restrict her female bodily development, with the intention of improving her long-term quality of life. The next chapter challenges the common assumption in debates about disability, which is that as soon as we know what the correct ‘model of disability’ is, we have an answer to the question of what justice for disabled people entails. Models of disability are taken to have strong normative implications. Lastly, I discuss a more general moral debate: the fascinating debate about designer babies. By discussing these three case studies, I show how my theoretical framework can help to illuminate three debates in bioethics, how it clarifies misunderstandings between scholars holding different positions in those debates, and how it is necessary to understand the arguments put forward in the debates. The choice of a particular account of human nature makes a difference when dealing with practical moral issues. We need such an account to make sensible moral judgments, but also to understand discussions properly and to understand disagreements about moral issues at all