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This dissertation addresses issues related to teaching and learning middle-school mathematical graphing concepts and provides an in-depth analysis on the impact of introducing a new assistive technology in a visually impaired classroom. The motivation, design, implementation, and deployment of the Graph and Number line Input and Exploration (GNIE) software, an auditory graphing tool that enables students with visual impairment to navigate and interact with a coordinate plane or number line graph is presented. Results include a discussion about how a computer-based auditory graphing software can be a beneficial supplement to aiding teachers and students with vision impairment with middle-school based graphing principles. This work also demonstrates that auditory graphing software support collaboration between students of different levels of vision loss and that bone-conduction headphones can be used with software to perform concurrent think aloud protocols without degradation of qualitative data.

This research introduces, develops and applies the concept of using student perceptions to measure opportunity-to-learn, in order to evaluate regular and special educational provision. A qualitative investigation into services for the education of learners with vision impairment identified the common aim of giving students equal access to the curriculum as their sighted peers. It also elicited potential determinants of need that affect caseload allocation decisions. Opportunity-to-learn was identified as a concept in the research literature, which has evolved from a measure of content coverage into a potential indicator of school effectiveness, measured almost exclusively from the teachers' perception. This research drew on the growing body of research that asks the students, to shift the focus from the teacher to the students themselves. An instrument was developed, based on the Essential Skills of the New Zealand curriculum, that measures opportunity-to-learn from the perspective of the students. This was used to collect baseline data on 1300 students, with no identified special needs, from twenty secondary schools throughout New Zealand. Analysis of the baseline data demonstrated the validity of the approach, and its potential to aid in research on the educational process, using this set of intermediate indicators. Results showed differences between schools and between girls and boys. The mean index scores for the schools were not strongly related to the socio-economic background of the schools, but did reflect independent measures of school quality. The instrument was then used to measure opportunity-to-learn for fifty learners with vision impairment in regular high schools. Comprehensive data on these learners was gathered from regular and specialist teachers, parents, schools and the individuals themselves. This data was analysed to evaluate the services and the opportunity-to-learn for the learners with vision impairment. Results showed that on average these students had opportunity-to-learn at least as good as for their sighted peers. Areas of weakness and strength within the service were identified. The instrument proved effective in the evaluation process.

The purpose of the study was to investigate the prevalence and effects of vision impairment co-existing with other comorbid conditions. Utilizing the 2008 National Health Interview Survey, the most recent nationally representative data including expanded vision, health conditions, and activity questions, this study examined the effect of vision impairment co-existing with selected comorbid conditions among non-institutionalized older adults age ≥ 55 years. Specifically, this study compared 4 groups: (a) older adults with neither vison impairment nor comorbid conditions, (b) older adults with vision impairment only, (c) older adults with comorbid conditions only, and (d) older adults with both vision impairment and each of the comorbid conditions to examine the prevalence and effect of vision impairment and comorbid conditions on selected mobility and vision activity limitations, and participation restrictions. Using complex sample techniques to conduct frequency analyses and logistic regression procedures, this study compared these groups of older adults to document the likelihood of experiencing mobility and vision activity limitations, and participatory restrictions. These results suggest that older adults reporting vision impairments are a heterogeneous population, overwhelmingly use corrective lenses, and experience substantial mobility and vision activity limitations, and participatory restrictions; however, relatively few report using low vision aids or rehabilitation services. In addition, these results revealed, even when controlling for age, sex, race/ethnicity, marital status, region of residence, and health status, older adults with vision impairment and any of the selected comorbid conditions were statistically significantly more likely to report mobility and vision activity limitations, and participation restrictions. Moreover, when comparing older adults reporting vision impairment co-existing with comorbid conditions older adults reporting either vision impairment only or a comorbid condition only, the results suggest vision impairment had the largest statistically significant effect on the likelihood of mobility or vision activity limitations, or participatory restriction in 29 of the 44 logistic regression analyses. These findings are significant as vision impairment is framed as a public health concern, and can inform improvements in programs and services for older adults. Finally, these findings highlight the need for expanded research examining the effect of specific eye diseases and comorbid conditions among older adults.

Immigrants are an important part of Canada and Canadian culture. Despite a large number of immigrants in Canada relatively few studies have focused on disability and immigrants. Even less research has been conducted on immigrants with visual impairments. The first paper uses the Participation Activity Limitation Survey (PALS) from 2006 to examine the prevalence of vision impairment in immigrants compared to non-immigrants, 50 years of age and over. First, descriptive statistics were used to determine the prevalence rate of vision impairment. Then, multivariate logistic regression was utilized to examine differences in providers of support and characteristics of individuals who receive support. Results disclosed that there was no difference in the prevalence rates of adult immigrants and non-immigrants over 50 years of age when controlling for age and gender. Results confirmed that there is a relationship between having a vision impairment and living in a low income household. Results also showed that receiving support is linked to severity of impairment. The second paper used qualitative analysis to examine visually impaired immigrants’ perception of vision impairment and disability and if perception influenced utilization of care. Qualitative semi-structured interviews were conducted with 8 clients of the Canadian National Institute for the Blind (CNIB). Results showed that immigrants’ employ three different views when explaining their impairment, these were; the medical view, social view and theological/ traditional view. All participants used two or more views interchangeably demonstrating that all views are important in understanding how immigrants perceive and navigate their impairment on an everyday basis. Results also suggested that negative perceptions did not keep most immigrants from accessing services; however, traditional barriers such as not being eligible to receive services and transportation were main barriers. / Thesis / Master of Arts (MA)

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Background: Social exclusion of people with vision impairments is an ongoing issue. Since social inclusion emphasizes social and emotional aspects as distinct from academic ones and the aspects concerning opportunities, the focus is turned on the domain of social interactions and friendships. Adolescence is the time point when youth feels mostly the need to ‘fit in’ in social circles and groups and the social life and friendships are important aspects of young people’s well-being and development. Aim: The aim of this study is to review the existing literature on the social interactions and friendships of adolescents with visual impairments from their own perspective and investigate the interventions designed to improve their social interactions and friendships. Method: A literature search on the databases of ERIC, CINAHL and PsycINFO and a hand search on the reference lists of the relevant articles was conducted. The search was limited to recent peer reviewed studies published in English, reporting perspectives of adolescents (13-18 years old) with visual impairments on their social interactions and friendships and intervention studies aimed to support them in the aforementioned domain. Results: In the 18 included studies, adolescents with vision impairments engaged more in passive activities that were not highly interactive. They reported being satisfied with their networks and friends, however contradictions existed in the perceived quality of friendships and the feeling of loneliness. The context of school was presented often as problematic compared to other contexts, and friendships in schools were rare. According to adolescents’ voices, friendships helped to cope with the impairment, friends had a meaningful role in their life and they made school life more enjoyable. In comparison to their sighted peers, adolescents with vision impairments had smaller networks and less friends with whom they had different type of relationships. Lastly even though several barriers and facilitators were identified, which belong to domains of Body functions and structures and Physical, Attitudinal and Social environment, there was a lack of interventions aiming to support the social interactions and friendships of adolescents with vision impairments. Conclusions: Considering the importance of social interactions and friendships in adolescents’ life for them to learn, develop and enjoy, more interventions with social focus need to be designed in respect to the challenges that exist. A plethora of barriers and facilitators impacting the social interactions and friendships of adolescents with vision impairments were identified that need to be taken into consideration for future research and interventions since the existing literature provided so far is limited. Adolescents need to be engaged in this process so that their interests, preferences and their views are prioritized.

abstract: Traveling is one of the most enriching and fulfilling activities for most people. Yet factors such as crowded airports, long waiting queues, and inaccessible features of airports and airplanes often make traveling stressful for many individuals including those with disabilities. This qualitative phenomenological research study examined the underexplored area of traveling with a vision disability. Framed around a Co-cultural theoretical perspective, the study examined the lived experiences of vision impaired individuals with regard to receiving disability assistance services during air travel. The study specifically explored the communication strategies that vision impaired individuals employed to manage their assistance-related air travel needs. The study used in-depth interviews for data collection, and a combination of thematic analysis techniques for data analysis. Findings indicated four categories of assistance-related issues that vision impaired participants frequently experienced in their travel: personnel training issues, system issues, policy issues, and physical accessibility issues. The study also identified four Co-cultural communication orientations that participants used in navigating air travel: assertive accommodation, aggressive accommodation, assertive assimilation, and nonassertive assimilation. In addition, the study identified a new Co-cultural communication practice - normalizing for self. Findings of this research conclude that despite three decades since the passage of United States legislation to protect the rights of disabled people, vision impaired travelers still frequently experience inequitable air travel practices. The study offers recommendations on pressing issues concerning policies and regulations that can inform airline executives and federal legislators in facilitating a more equitable and pleasurable air travel experience for those with vision disabilities. / Dissertation/Thesis / Doctoral Dissertation Communication 2020

The commission on radiological protection through publication 118 decided to recommend a change to the eye dose limit in 2011. ICRP recommendations made in publications, especially ‘publication 60’ and its subsequent update ‘publication 103’ has served as standards for regulatory authorities worldwide in limiting ionizing radiation exposure both to workers and members of the public. For example in Canada, the Canadian Nuclear Safety Commission (CNSC) generally directly adopts recommendations from ICRP. The previous dose limit for the lens of the eye was 150 mSv year-1, based on Publication 60 and 103. Regulatory agencies worldwide have been using this value and subsequently nuclear facilities, hospitals and universities have designed their radiation protection program based on this dose limit for several decades. The new revised eye dose limit now being equivalent to the whole body dose limit will pose significant challenges for sectors where the eye exposure was not characterized as the limit was previously five times over the whole body exposure. A two-step approach was used in conducting this study, firstly a through literature search was conducted on the effects of ionizing radiation to the eye, its radiobiology, fundamentals in established both dose limits was analyzed. Secondly, the authors spent time researching institutions that use ionizing radiation and interviewed engineers, medical physicists, radiation safety officers and regulators from a wide array of fields and industries. Based on the ICRP publications, the review of the literature and the interviews conducted with the nuclear industry, there is consensus in Canada and among IAEA member states that the dose limit for the lens of the eye should be reduced from the original proposed limit of 150 mSv per year. However not to the recommendations suggested by ICRP 118, but, to a standard reasonable and an achievable limit that is 50 mSv per year. / Thesis / Master of Science (MSc) / The International Commission on Radiological Protection (“ICRP”), the independent governing body responsible for radiation protection, since the early 1950s has been issuing recommendations that are widely used as radiological protection standards by regulatory agencies worldwide, primarily UN member states. Since its inception in 1928, the ICRP has served as the basis for radiation protection and value based judgements in protecting both human and non-human biota. In 2011, the commission published (ICRP Pub. 118) its review of epidemiological studies and decided to recommend a change to the previously established eye dose limit. Based on the review of the literature and the research conducted within the academic, veterinary, nuclear and medical industry, there is general consensus in Canada and among IAEA members states that the dose limit for the lens of the eye should be reduced from the original proposed limit, but not to the recommendations suggested by ICRP 118.

Low vision impacts on Quality of Life (QoL). Thus, low vision services are essential to enhance the QoL of people with functional low vision. However, of the estimated 70 out of the 124 million people with low vision who require services, approximately 5-10% has access to services. The demands for low vision services will continue to grow due to the emerging global trends in ageing populations and changes in the epidemiology of vision impairment. While critical data and information are available for other forms of vision impairment, there is a paucity of information on the distribution, needs, and priorities for improving low vision service delivery at the national, regional, and global levels. / This thesis addressed the problem by first developing and distributing a survey to Vision 2020 contacts, government, and non government organisations in 195 countries during 2006-2008 to assess the current situation of low vision services globally. The survey was first pilot tested leading to improvements in the length, layout, and content of its form. Specifically, the survey topics included: epidemiology, policies, human resources, service provision, barriers, equipment, and monitoring and evaluation. / The Classification Analysis and Regression Tree (CART), logistic regression methodology and grounded theory analysis were used to present the findings and identify the critical success factors of low vision service coverage. The qualitative component consisted of case studies in three countries (India, Ghana, and Cameroon) during November 2007 and 2008. A total of 101 interviews were carried out. The case studies provided an overview and historical perspective of services, effectiveness, cost, efficiency, acceptability, access, equity, sustainability, and ideal situations as recommended by interviewees. Qualitative findings from the case studies were produced with the assistance of the NVivo software. / The primary results are that the majority (80%) of countries have poor (≤10%) coverage. Key issues pertinent to the current situation of service coverage are: human resources (number and combination of disciplines), funding (sustainability and arrangements), type of services provided (comprehensive and multidisciplinary) and its locations (NGOs or government facilities), and the sociodemographic and economic barriers (costs, awareness, and rural areas) to accessing services. / The critical success factors found in this research are represented by the ‘FRAME’: Funding (sustainable source, public and private mix), Rehabilitation workers (e.g., adequate numbers of multidisciplinary personnel), Access to low vision devices, Multidisciplinary services; and External contextual influences in which low vision services operate in. The case studies identified seven major themes that further build on the FRAME: sustainability, governance, advocacy, human resources, access, awareness, and service delivery. / The conclusion of the thesis is that a global picture of the current situation of low vision services was acquired and it is now known which countries have poor (≤10%) and better (>10%) coverage. It also found the critical success factors that will assist the WHO Low Vision Working Group and Vision 2020 to improve the current models of service delivery, future planning, training curriculum development, and priorities setting. Specifically, these need to be achieved through three areas of action: human resources development, sustainability, and advocacy.