Academic literature on the topic 'Classification des handicaps'
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Journal articles on the topic "Classification des handicaps":
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Nordenfelt, Lennart. "On the General Concepts of Action and Ability: A Philosophical Introduction to the Theory of Handicaps." International Journal of Technology Assessment in Health Care 11, no. 2 (1995): 144–52. http://dx.doi.org/10.1017/s0266462300006796.
Abstract:
AbstarctThe main task of this paper is to contribute to the theory of disabilities and handicaps, in particular their characterization and classification. It presents an analysis of the conditions for the successful performance of actions. By this procedure a list of reasons for failure of action, i.e., for disability and handicap, is obtained. This list can be used for a detailed classification of disabilities and handicaps. Some theories in modern philosophical action theory serve as platforms for the analysis.
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Janik, Sophie. "Thésaurus : Personne handicapée, outil de coordination des services documentaires spécialisés." Documentation et bibliothèques 33, no. 1 (October 15, 2018): 11–17. http://dx.doi.org/10.7202/1052593ar.
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Ce texte vise à présenter le Thésaurus : Personne handicapée qui vient d’être publié par l’Office des personnes handicapées du Québec (OPHQ). Ses 3 697 descripteurs avec leurs équivalents en anglais répartis en 95 schémas fléchés et environ 2 000 non-descripteurs précisent le langage spécialisé concernant les personnes handicapées et l’enfance en difficulté. Le Thésaurus propose une terminologie qui correspond à la nouvelle conception de la situation des personnes handicapées, fruit d’une réflexion à laquelle a largement contribué l’OPHQ ces dernières années. Il se base également sur la classification de l’Organisation mondiale de la santé concernant les déficiences, incapacités et handicaps.
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Lespinet-Najib, Véronique, and Christian Belio. "Classification des handicaps : enjeux et controverses." Hermès 66, no. 2 (2013): 104. http://dx.doi.org/10.4267/2042/51561.
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Roussel, Pascale. "L’apport de la Classification Internationale des Handicaps." Gérontologie et société 16 / n° 65, no. 2 (October 1, 1993): 50–57. http://dx.doi.org/10.3917/gs.065.0050.
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Rahman, Toshiba. "Case Report of a Child with Developmental Delay." Pulse 8, no. 1 (June 6, 2016): 73–76. http://dx.doi.org/10.3329/pulse.v8i1.28106.
Abstract:
The cerebral palsies are a group of conditions due to non progressive damage to the brain before, during or after birth. There are many causes. Although the brain damage itself doesnt change nor is it curable, the symptoms may change with time. Classifications vary in different clinics and countries. usually there is the spastic, the athetoid and the ataxic type. The diagnostic classification may not play a direct role in the therapy plans. Diagnostic types are based on the predominant symptoms and there may be symptoms of the other types Although the motor delay and dysfunctions are the main problems in the cerebral palsies there is the possibility of other handicaps. The brain damage itself can be diffuse enough to affect speech and hearing, vision, perceptual function, mental ability and general behaviour. Epilepsy may occur. There may also be other associated handicaps which are due to lack of motor experiences in physically disabled children. Lack of motor exploration affects development of sensation perceptions, mental abilities and speech, emotional and social skills are also hampered. Parent-Child interaction is not always easy and may create emotional problems. Early therapy is advisable to minimize the degree of motor handicap and of the secondary development handicaps.Pulse Vol.8 January-December 2015 p.73-76
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Robinson, David. "The International Classification of Impairments, Disabilities, and Handicaps." International Rehabilitation Medicine 7, no. 2 (January 1985): 60. http://dx.doi.org/10.3109/03790798509166118.
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Einarsson, G., and G. Grimby. "Disability and handicap in late poliomyelitis." Journal of Rehabilitation Medicine 22, no. 2 (May 11, 2020): 113–21. http://dx.doi.org/10.2340/165019779022113121.
Abstract:
The impact of long-standing polio sequelae in terms of disability and handicap was studied in 41 patients (17 men and 24 women, mean age 54 years). Twenty-nine (71%) of these met the criteria for post-polio syndrome. The Katz' ADL index, the Functional Status Questionnaire (FSQ), selected questions concerning social needs and support and the WHO ICIDH-Classification of handicaps were used. A substantial impact on intermediate (secondary or instrumental) ADL was a consistent finding, most severely affecting the quality of mobility. This emphasizes needs for individual rehabilitation services including transportation, walking and domestic aids.
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Fougeyrollas, Patrick. "Le Processus De Production Des Handicaps: Vers Un Cadre Conceptuel Renouvele." Canadian Journal of Community Mental Health 9, no. 2 (September 1, 1990): 151–62. http://dx.doi.org/10.7870/cjcmh-1990-0025.
Abstract:
Since the mid-1970s the development of a specific conceptual framework for the consequences of disease and trauma has been occurring at the international level. A growing awareness among health professionals of the chronic physical, intellectual, and emotional problems which are reducing the abilities and social autonomy of a large percentage of the population have led the World Health Organization (WHO) to work on this matter. In this paper, the author explains the conceptual evolution of the field of disabilities. He defines the challenges and potential uses of an international classification of consequences of disease and trauma. This article proposes an interactive conceptual framework for the identification of handicaps and directions for the revision of the WHO's International Classification of Impairments, Disabilities, and Handicaps (ICIDH). It is an invitation for the Canadian mental-health field to express points of view on the present process of the harmonization of terminology and concepts on the Canadian and international scenes. The English version of the proposal to revise the third level of the ICIDH (handicaps) can be obtained from the Canadian Society for the ICIDH, 1399, rue Thibodeau, Lac St-Charles, Québec GOA 2H0, Canada.
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McFarlane, Alexander C. "The International Classification of Impairments, Disabilities and Handicaps: Its Usefulness in Classifying and Understanding Biopsychosocial Phenomena." Australian & New Zealand Journal of Psychiatry 22, no. 1 (March 1988): 31–42. http://dx.doi.org/10.1080/00048678809158942.
Abstract:
The International Classification of Impairments, Disabilities and Handicaps (ICIDH) was devetoped because of the growing awareness that ICD-9 failed to reflect many of the problems that people bring to health care systems. The ICIDH was designed to classify the consequences of disease such as the disruption of daily activity and the social disadvantage that accompany illness. However, since its introduction, the ICIDH has largely been ignored by psychiatry, despite its conceptual strength. In particular, it provides a framework for applying the biopsychosocial model and studying the phenomena of mental illness. The latter is an important issue because of clinical psychiatry's inherent weakness in distinguishing between symptoms of disease and the psychosociat consequences, a particular inadequacy of the DSM-III diagnostic criteria. The utility of the ICIDH is shown in the study of the phenomena of panic disorder and agoraphobia, where I conclude that agoraphobia should be classified as a disability/handicap and not a disorder.
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Minaire, Pierre. "Espérance de vie en santé : apport conceptuel et pratique de la Classification internationale des déficiences, incapacités, handicaps (CIDIH)." Articles 20, no. 2 (March 25, 2004): 237–51. http://dx.doi.org/10.7202/010085ar.
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RÉSUMÉ Le calcul de l'espérance de vie en santé s'appuie sur les mesures de la mortalité et sur celles de l'incapacité. La notion d'incapacité est liée aux définitions modernes de la santé, c'est-à-dire de l'adaptation de la personne ou du groupe à l'environnement. La Classification internationale des déficiences, incapacités, handicaps (CIDIH) permet l'analyse globale des incapacités et des handicaps. Il est possible d'envisager ainsi des définitions communes de la santé et de l'incapacité pour la mise au point d'instruments adaptés aux calculs de l'espérance de vie sans incapacité ou espérance de vie en santé. Il est indispensable que ce travail conceptuel soit effectué au niveau international avant l'établissement de comparaisons entre les données chiffrées d'espérance de vie en santé. De telles comparaisons ne sont licites que si les concepts et les définitions de base sont identiques.
Dissertations / Theses on the topic "Classification des handicaps":
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Denoux, Armelle. "Le handicap du petit enfant et le problème de sa prise en charge initiale." Caen, 1990. http://www.theses.fr/1990CAEN3119.
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Rossignol, Christian. "Inadaptation, handicap, invalidation ? : Histoire et étude critique des notions, de la terminologie et des pratiques dans le champ professionnel de l'Education spéciale." Université Louis Pasteur (Strasbourg) (1971-2008), 1999. http://www.theses.fr/1999STR1PS04.
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Bas, Jérôme. "Contester la fatalité du handicap : mobilisations de personnes handicapées et institution d’une catégorie d’action publique (XXe siècle – France)." Electronic Thesis or Diss., Paris 8, 2021. http://www.theses.fr/2021PA080098.
Abstract:
Cette thèse porte sur le processus d’unification de la catégorie de handicap en France au XXe siècle. Unification au sens de l’agrégation de groupes sociaux rassemblés sous ce terme, mais aussi du développement d’institutions de plus en plus spécialisées dans leur prise en charge, de pratiques qui les ciblent, de représentations et de connaissances sur ces per-sonnes, ou encore de mobilisations pour porter leur parole dans l’espace public. À partir d'archives, de nombreux journaux et imprimés, de documents audiovisuels et de plusieurs entretiens biographiques avec des acteurs de cette histoire, elle met en relation la multipli-cité des agents engagés dans la représentation des personnes handicapées, resitue leurs prises de position au sein d’un champ de luttes et identifie les principaux enjeux de ce champ : définir la catégorie des « personnes handicapées » et prescrire ce qu’il faut faire, ou ne pas faire, pour leur bien. La thèse met au jour le rôle structurant des mobilisations d’étudiants handicapés dans la dynamique de ce champ, car ils ont été les mieux placés à différentes étapes de son histoire pour en subvertir l’ordre dominant. Elle met également en évidence le rôle crucial de certaines épidémies (tuberculose et poliomyélite) dans l’autonomisation de ce champ et celui des sciences sociales comme ressource pour distin-guer le handicap de la maladie dans ce processus. Enfin, cette thèse n’isole pas le champ du handicap des transformations du champ de la protection sociale, du champ médical et du champ politique. Elle propose donc une sociologie historique et politique d’un groupe so-cial de mieux en mieux connu des sciences sociales, mais rarement approché d’une manière relationnelle comme un champ et de manière processuelle comme un enjeu de luttesThis doctoral thesis studies the unification of the category “disability” in France during the twentieth century. By unification, I mean the aggregation of various social groups under the term “disabled” accompanied by the development of institutions and practices increasingly specialized in the support of the disabled. This process also came about through the growth in the representation and knowledge on disabled persons as well as their increasing pres-ence in the public sphere. Based on archives, newspapers and other published material, audiovisual documents and personal interviews with key historical figures, this doctoral thesis analyses the numerous participants engaged in the representation of disabled peo-ple, establishes their position in this social field and identifies the issues at stake within it : establishing a definition of the category “disabled persons” and recommending what needs to be done, or not done, for the well-being of this segment of the population. The thesis brings into light the structural role of the activism lead by disabled students, who through-out the different stages of this field’s history have been suitably placed to subvert the domi-nant social order. The thesis also highlights the central role of epidemics such as tuberculo-sis and poliomyelitis in the empowerment of these people and examines the ways in which the social sciences contributed to distinguishing disabilities from illnesses. This thesis takes into account the transformation of the medical field and political arena when analyzing the constitution of the “disabled” category. Thus, this work develops a historical and political sociology of a social group which, while increasingly considered by the social sciences, has rarely been studied through a relational and process-oriented approach. In other words, analyzed as a field structured through by a power dynamics
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Brun, Gaspard. "L’expérience de soi à l’épreuve des normes : Eléments pour une philosophie du handicap." Thesis, Aix-Marseille, 2013. http://www.theses.fr/2013AIXM3089.
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L’interrogation première de cette thèse est issue de questionnements liés à notre activité professionnelle au sein de dispositifs dédiés à l’insertion professionnelle et au maintien en emploi des personnes handicapées. Comment mener des politiques spécifiquement destinées à ce public alors même que la définition de ce qui caractérisait les personnes handicapées n’était pas encore formalisée ? Après avoir fait porter nos analyses sur les limites des classifications actuelles du handicap, sur l’impossibilité de définir le handicap avec la rigueur des classifications scientifiques ou de le définir par le seul recours à la médecine, nous avons envisagé de concevoir le handicap comme une relation singulière entre normes sociales et expérience individuelle. En cela le recours aux premières œuvres de Foucault et à des écrits, pour une bonne part inédits, de Canguilhem nous était d’un grand secours. Ces auteurs nous permettaient de préparer notre formalisation du concept de handicap qui repose sur l’idée centrale de « corps-soi » empruntée à Yves Schwartz. Le handicap est alors considéré comme une expérience singulière du corps-soi à l’épreuve de normes sociales antagoniques. Notre thèse principale était alors la suivante : le concept de handicap peut servir de prisme pour renouveler l’analyse de pratiques humaines et de formes discursives théoriques. Nous l'avons alors soumis à trois procédures de test dans des domaines d’activité et des corpus théoriques pourtant bien connus. Notre thèse ainsi renforcée, nous avons pour finir tenté de proposer un réinvestissement de nos analyses dans les politiques publiques destinées aux personnes handicapéesThe original question this thesis started with arose in the context of our professional activities within organizations dealing with the integration of disabled people in the world of work. How could policies specifically addressed to this public be enforced when the very definition of what characterized disabled people had not yet been formulated? After focusing our analyses on the limits of the current classifications of disabilities, on the impossibility to define disability with the exactness of scientific classifications or by only resorting to medicine, we thought of conceiving disability as a singular relationship between social norms and individual experience. In so doing, Foucault’s first works and mostly unpublished writings by Canguilhem were a great help. These authors allowed us to prepare our formulation of the concept of disability which is based on Yves Schwartz’s central idea of “corps-soi” (body and self together). A disability is then considered as a singular experience of the “body and self” in the face of antagonistic social norms. This view of what disability is lead us then to present our main thesis: disability, considered as a concept, can be used as a prism to renew the analysis of human practices and of theoretical discourse. We then submitted our thesis to three different test procedures, so as to check if, with disability as a starting point, we could renew our understanding of activities and theoretical corpuses, well-known though they may be. We felt the process tended to validate our reflection and eventually made suggestions as to how public policies for the disabled could benefit from our thesis
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Ben, Saad Helmi. "De la fonction à l'activité : de la spirométrie au test de marche de six minutes." Montpellier 1, 2008. http://www.theses.fr/2008MON1T037.
Abstract:
Objectif : surmonter les difficultés d'application de la classification internationale du fonctionnement, du handicap et de la santé (CIF) dans le domaine des explorations fonctionnelles respiratoires. Questions posées. A. Étude du "fonctionnement et des structures corporelles". 1) Chez un tabagique réalisant une pléthysmographie, quelle définition faut-il utiliser pour définir un déficit ventilatoire obstructif (DVO)? 2) Chez un tabagique ayant un DVO, quelle définition faut-il utiliser pour interpréter le test de réversibilité? 3) Comment se présente le profil spirométrique des fumeurs de narguilé? B. Étude de l'activité au niveau de l'individu : quelle norme faut-il utiliser pour interpréter la distance de marche de six minutes (Dm6) mesurée lors du test de marche de six minutes (TM6)? Méthodes. A. Étude du "fonctionnement et des structures corporelles" : mesures pléthysmographiques avant/après la prise d'un broncho-dilatateur chez des fumeurs de cigarettes et chez les fumeurs de narguilé. B. Étude de l'activité au niveau de l'individu : pratique de deux TM6 chez des enfants et des adultes sains, après évaluation de la parité, de la puberté et des données anthropométriques, socioéconomiques et spirométriques. Résultats. A. Étude du "fonctionnement et des structures corporelles". 1) La définition du DVO est recommandation dépendante. En effet, le pourcentage des fumeurs ayant un DVO varie de 45% à 56%. 2) La définition du test de réversibilité de l'obstruction bronchique est recommandation dépendante. En effet, le pourcentage des fumeurs ayant un DVO réversible varie de 24% à 50%. De même, la capacité vitale forcée (CVF), un simple paramètre mesuré pendant la même manoeuvre déterminant le volume expiré maximal à la première seconde (VEMS) recommandé par l'ATS/ERS mais "ignoré" par GOLD, est plus "réactive" que le VEMS et détecte plus de patients que le "VEMS seul". 3) 6% des fumeurs de narguilé ont un DVO proximal, 14% ont un DVO distal, 14% ont un déficit ventilatoire restrictif et 36% ont une hyperinflation alvéolaire statique. De même, la consommation du narguilé accélère le vieillissement pulmonaire. B. Étude de l'activité au niveau de l'individu : les normes de la Dm6 publiées ne sont pas applicables sur la population Nord africaine. Les normes établies sur la population locale expliquent 77% et 60% des variances de la Dm6, respectivement des adultes et des enfants Nord africains. Conclusion. A. Les divergences dans les définition du DVO et du test de réversibilité de l'obstruction bronchique sont un obstacle majeur au diagnostic précoce de la broncho-pneumopathie chronique obstructive, affecte les décisions de santé publique, et fausse les stratégies de planification. L'étude du narguilé fournit aux autorités sanitaires publiques des arguments valides pour lutter contre ce fléau. B. Les équations locales de référence de la Dm6, en enrichissant la banque mondiale des normes, dans laquelle le spécialiste pourra choisir en fonction de l'ethnie de son patient, permettent de surmonter les obstacles d'interprétation de l'incapacité.
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Adam, Charles-Eric. "Le processus de classification en handisport : sociologie d’un polyptyque évolutif." Thesis, Paris 10, 2014. http://www.theses.fr/2014PA100192.
Abstract:
Dans les coulisses des compétitions handisports de haut-niveau se déroule une épreuve inaccessible au regard du public : le processus de classification. L’expertise, impérative pour attribuer une classe à chaque sportif se matérialise par une série d’opérations effectuées aussi bien par les classificateurs que par les principaux protagonistes : observer, mesurer, quantifier, qualifier, comparer, protester, délibérer… Cette quête d’objectivité s’organise dans plusieurs arènes (vestiaires, Bureau Exécutif du Comité International Paralympique, Commission de Classification, laboratoires). Mais l’impression de stabilité du dispositif contraste avec les témoignages et les observations visant les protocoles d’examen des corps. Les dirigeants cherchent donc à entretenir l’intérêt de la compétition pour les pratiquants et les spectateurs. La complexité du processus apparaît comme un polyptyque évolutif dans lequel les acteurs tentent de mettre de l’ordre et dont le sociologue s’attache à rassembler les pièces éparpillées, tel un commissaire d’exposition.La recherche du langage sociologique le plus approprié permet d’analyser l’adoption, l’entretien, ou l’abandon de la croyance dans l’efficacité du dispositif dont l’enjeu final est la crédibilité des Jeux Paralympiques. Comment est rendue possible et acceptable la mise en équivalence de sportifs aux corps uniques ? Comment les acteurs œuvrent à transformer ou à maintenir en l’état un dispositif qui sépare des individus en même temps qu’il les regroupe? L’enquête permet de comprendre les conditions d’existence du handisport et du sport adapté de compétition et contribue à la réflexion sur les frontières entre les individusBackstage of disabled sports competitions high-level event takes place an inaccessible trial to public sight : the classification process. Expertise, imperative to assign a class to each athlete is materialized by a series of operations performed by both classifiers and the main protagonists: observe, measure, quantify, qualify, compare, protest, deliberate ... This quest for objectivity is organized in several arenas (locker rooms, the Executive Board of the International Paralympic Committee, Committee on Classification, laboratories). But the impression of stability of the device contrast with testimonies and observations criticizing the review body protocols. Therefore, institutional leaders are seeking to maintain the interest of competition for practitioners and spectators. The complexity of the process appears to be an evolving polyptych in which actors attempt to bring order and that sociologist try to reassemble the pieces scattered, like a curator. The search for the most appropriate sociological language use to analyze the adoption, maintenance, or abandonment of the belief in the effectiveness of the device whose final issue is the credibility of the Paralympic Games. How is possible and acceptable equity with so unique sports body? How actors work to transform or maintain a device that separate or aggregate individuals in the same time? The survey allows us to understand the conditions of disable sport and adapted sport competition and contributes to the debate on the boundaries between individuals
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Amadou, Kountché Djibrilla. "Localisation dans les bâtiments des personnes handicapées et classification automatique de données par fourmis artificielles." Thesis, Tours, 2013. http://www.theses.fr/2013TOUR4021/document.
Abstract:
Le concept du « smart » envahit de plus en plus notre vie quotidienne. L’exemple type est sans doute le smartphone. Celui-ci est devenu au fil des ans un appareil incontournable. Bientôt, c’est la ville, la voiture, la maison qui seront « intelligentes ». L’intelligence se manifeste par une capacité d’interaction et de prise de décision entre l’environnement et l’utilisateur. Ceci nécessite des informations sur les changements d’états survenus des deux côtés. Les réseaux de capteurs permettent de collecter ces données, de leur appliquer des pré-traitements et de les transmettre aux applications. Ces réseaux de par certaines de leurs caractéristiques se rapprochent de l’intelligence collective, dans le sens, où des entités de faibles capacités se coordonnent automatiquement, sans intervention humaine, de façon décentralisée et distribuée pour accomplir des tâches complexes. Ces méthodes bio-inspirées ont servi à la résolution de plusieurs problèmes, surtout l’optimisation, ce qui nous a encouragé à étudier la possibilité de les utiliser pour les problèmes liés à l’Ambient Assisted Living ou AAL et à la classification automatique de données. L’AAL est un sous-domaine des services dits basés sur le contexte, et a pour objectifs de faciliter la vie des personnes âgées et handicapées dans leurs défis quotidiens. Pour ce faire, il détermine le contexte et, sur cette base, propose divers services. Deux éléments du contexte nous ont intéressé : le handicap et la position. Bien que la détermination de la position (localisation, positionnement) se fasse à l’extérieur des bâtiments avec des précisions très satisfaisantes, elle rencontre plusieurs difficultés à l’intérieur des bâtiments, liées à la propagation des ondes électromagnétiques dans les milieux difficiles, aux coûts des systèmes, à l’interopérabilité, etc. Nos travaux se sont intéressés au positionnement des personnes handicapées à l’intérieur de bâtiments en utilisant un réseau de capteurs afin de déterminer les caractéristiques de l’onde électromagnétique (puissance, temps, angle) pour estimer la position par méthodes géométriques (triangulation, latération), méthodes de fingerprinting (k plus proches voisins), par des filtres baysiens (filtre de Kalman). L’application est d’offrir des services types AAL tel que la navigation. Nous avons élargi la notion de réseau de capteurs pour prendre en compte tout appareil capable d’émettre et de recevoir une onde électromagnétique et se trouvant dans l’environnement. Nous avons aussi appliqué l’algorithme API sur la classification automatique de données. Enfin, nous avons proposé une architecture à middleware pour la localisation indoorThe concept of « smart » invades more and more our daily life. A typical example is the smartphone, which becames by years an essential device. Soon, it’s the city, the car and the home which will become « smart ». The intelligence is manifested by the ability for the environment to interact and to take decisons in its relationships with users and other environments. This needs information on state changes occurred on both sides. Sensor networks allow to collect these data, to apply on them some pre-processings and to transmit them. Sensor network, towards some of their caracteristics are closed to Swarm Intelligence in the sense that small entities with reduced capababilities can cooperate automatically, in unattended, decentralised and distributed manner in order to accomplish complex tasks. These bio-inspired methods have served as basis for the resolution of many problems, mostly optimization and this insipired us to apply them on problems met in Ambient Assisted Living and on the data clustering problem. AAL is a sub-field of context-aware services, and its goals are to facilitate the everyday life of elderly and disable people. These systems determine the context and then propose different kind of services. We have used two important elements of the context : the position and the disabilty. Although positioning has very good precision outdoor, it faces many challenges in indoor environments due to the electromagnetic wave propagation in harsh conditions, the cost of systems, interoperabilty, etc. Our works have been involved in positioning disabled people in indoor environment by using wireless sensor network for determining the caracteristics of the electromagnetic wave (signal strenght, time, angle) for estimating the position by geometric methods (triangulation, lateration), fingerprinting methods (k-nearest neighbours), baysiens filters (Kalman filter). The application is to offer AAL services like navigation. Therefore we extend the definition of sensor node to take into account any device, in the environment, capable of emiting and receiving a signal. Also, we have studied the possibility of using Pachycondylla Apicalis for data clustering and for indoor localization by casting this last problem as data clustering problem. Finally we have proposed a system based on a middleware architecture
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Gacem, Amina. "Méthodologie d’évaluation de performances basée sur l’identification de modèles de comportements : applications à différentes situations de handicap." Versailles-St Quentin en Yvelines, 2013. http://www.theses.fr/2013VERS0053.
Abstract:
L'évaluation de performance est un processus important pour identifier les capacités d'une personne et ses limites. L'évaluation, à l'heure actuelle, repose sur l'intervention subjective d'une personne experte (médecin, ergothérapeute, etc. ) qui doit effectuer des analyses et des tests différents pour aboutir à une décision. Dans la littérature, plusieurs travaux proposent différentes méthodes d'évaluation plus objectives reposant sur des critères et des indicateurs de performance : il s'agit d'une évaluation quantitative. Ce type d'évaluation est basé généralement sur des analyses statistiques. Le travail effectué dans cette thèse consiste à proposer une nouvelle méthodologie d'évaluation de performance basée sur l'identification de modèles de comportement. La démarche, que nous adoptons, permet de déterminer, à partir d'indicateurs de performance, des comportements de référence généralement issus de l'évaluation fonctionnelle de personnes expérimentées dans le domaine. Ces comportements serviront ensuite de références pour l'évaluation d'autres personnes. L'identification de comportements de référence est donc un élément essentiel de notre travail. Il est basé sur des méthodes de classification. Dans le cadre de ce travail, nous avons testé deux méthodes différentes. La première est la méthode de "Fuzzy C-means" qui permet une recherche approfondie de comportements de référence mais ceux-ci sont représentés par des indicateurs représentatifs. La deuxième est la méthode de "Hidden Markov Models". Celle-ci permet de représenter un comportement par sa variation dans le temps mais elle nécessite une phase d'apprentissage coûteuse permettant de modéliser les comportements de référence. Cette méthodologie d'évaluation a été testée dans le cadre d'applications de différentes fonctions d'interface de commande : la conduite de fauteuil roulant électrique, la conduite d'automobile et l'utilisation des interfaces de pointage bureautiques. Dans chaque application, un protocole et une mise en situation écologique sont définis pour évaluer les participants sur des plateformes fonctionnelles faisant intervenir des interfaces de commande variées (joystick, souris, volant, etc. ). Ensuite, des outils statistiques sont utilisés afin d'analyser les données et de fournir ainsi une première interprétation des comportements. L'application de notre méthodologie dans chacune des situations étudiées permet d'identifier automatiquement différents comportements de référence. Ensuite, l'évaluation fonctionnelle des personnes, effectuée par comparaison aux comportements de références identifiés, a permis d'identifier différents niveaux d'expertise. Le processus d'évaluation permet d'illustrer l'évolution de l'apprentissage durant l'évaluation et de détecter la stabilité de la personne. La méthodologie d'évaluation proposée est un processus itératif permettant d'enrichir la population de personnes d'expérimentées par les personnes devenues stables à l'issue de l'évaluation. Ceci permet donc la recherche de nouveaux comportements de référenceThe performance assessment is an important process to identify the abilities and the limits of a person. Currently, the assessment requires the mediation of a specialist (doctor, therapist, etc. ) which must performs analysis and tests to reach a subjective decision. In the literature, several works propose assessment methods based on performance criteria: it is a quantitative evaluation which is objective. This type of evaluation is usually based on statistical analysis. In this work, a new methodology of performance assessment is proposed. It is based on the identification of reference behaviours. Those behaviours are then used as references for the evaluation of other people. The identification of reference behaviours is an essential element of our work. It is based on classification methods. In our work, we have tested two different methods. The first one is the "Fuzzy C-means" which allows a thorough search of reference behaviours. However, behaviours are represented by proxy criteria. The second method is the "Hidden Markov Models". It offers a time series analysis based on the temporal behaviour variation. However, it is not easy to determine the training phase of this method. This assessment methodology has been applied in the context of different applications designed for disabled people: driving electric wheelchair, driving an automobile and the use of pointing devices (mouse, trackball, joystick, etc. ). In each application, a protocol and an ecological situation are defined in order to evaluate participants on different platforms involving functional control interfaces (joystick, mouse, steering wheel, etc. ). Then, statistical tools are used to analyze the data and provide a first interpretation of behaviours. The application of our methodology identifies different reference behaviours and the assessment by comparing behaviours let to identify different levels of expertise. In each of the studied applications, our methodology identifies automatically different reference behaviours. Then, the assessment of people, carried out by comparing to the reference behaviours, let identify different levels of expertise and illustrate the evolution of learning during the assessment. The proposed evaluation methodology is an iterative process. So that, the population of experienced people can be enriched by adding people who become stable after assessment. Therefore, this allows the search for new reference behaviours
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Mereuta, Alina. "Smart web accessibility platform : dichromacy compensation and web page structure improvement." Thesis, Tours, 2014. http://www.theses.fr/2014TOUR4032/document.
Abstract:
Dans ces travaux, nous nous concentrons sur l’amélioration de l’accessibilité web pourdes utilisateurs handicapés visuels à travers d’outils s’intègrant dans la plateforme SmartWeb Accessibility Platform (SWAP). Après une synthèse sur l’accessibilité, un panoramade SWAP est présenté. Notre première contribution concerne la compensation de la pertede contraste textuel dans les pages web pour les daltoniens tout en maintenant les intentionsde l’auteur retranscrites par les couleurs. Ce problème est modélisé sous la forme d’unproblème de minimisation d’une fonction numérique dépendante des couleurs initiales, desrelations entre les couleurs de la page et des couleurs modifiées. L’intérêt et l’efficacité detrois méthodes d’optimisation (mass-spring system, CMA-ES, API) ont été évaluées surdeux jeux de données (réel, artificiel). Notre deuxième contribution cherche à améliorer lastructure de pages web pour des utilisateurs de lecteurs d’écran afin de compenser la perted’information due à la linéarisation du contenu. Grâce à l’utilisation d’heuristiques et detechnique d’apprentissage, les zones caractéristiques de la page sont identifiées. La pageest complétée en utilisant des liens supplémentaires et les marqueurs ARIA afin de permettreune meilleure identification des zones par les lecteurs d’écran. Nos expérimentationsmontrent l’efficacité de notre propositionThis thesis works are focused on enhancing web accessibility for users with visual disabilities using tools integrated within the SmartWeb Accessibility Platform (SWAP). After a synthesis on accessibility, SWAP is presented. Our first contribution consists in reducing the contrast loss for textual information in web pages for dichromat users while maintaining the author’s intentions conveyed by colors. The contrast compensation problem is reduced at minimizing a fitness function which depends on the original colors and the relationships between them. The interest and efficiency of three methods (mass-spring system, CMA-ES, API) are assessed on two datasets (real and artificial). The second contribution focuses on enhancing web page structure for screen reader users in order to overcome the effect of contents’linearization. Using heuristics and machine learning techniques, the main zones of the page are identified. The page structure can be enhanced using ARIA statements and access links to improve zone identification by screen readers
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Fontaine, Benoît. "La connaissance taxonomique des espèces rares : outil ou handicap pour la conservation de la biodiversité ?" Paris, Muséum national d'histoire naturelle, 2006. http://www.theses.fr/2006MNHN0028.
Abstract:
Une des caractéristiques essentielles de la biodiversité est la dominance des espèces rares et petites dans les communautés. Ces espèces sont également les moins étudiées. Par ailleurs, environ 1,75 million d’espèces sont connues, mais le nombre total d’espèces vivantes dépasse sans doute 10 millions, peut-être bien davantage. Enfin, il est maintenant établi que nous vivons une crise d’extinction majeure dans l’histoire de la vie. La documentation de la biodiversité est donc urgente, ne serait-ce que pour pouvoir mieux la préserver. C’est aux taxonomistes que revient cette tâche, puisque ce sont eux qui découvrent et décrivent les espèces, mais leur discipline souffre d’un grave manque de main-d’oeuvre et d’infrastructures. Face à ce triple constat (lacunes des connaissances sur la biodiversité, crise d’extinction, handicap taxonomique), nous nous interrogeons sur le rôle que peuvent jouer les taxonomistes pour la conservation. Le coeur du travail du taxonomiste est constitué de deux grandes étapes : discriminer les espèces, puis les nommer. La discrimination des espèces les unes par rapport aux autres, avant de les nommer, permet de dégager rapidement les caractéristiques des communautés sur la richesse spécifique, la rareté et la taille des espèces et peut aider au choix des sites à protéger. Lorsque les espèces sont nommées, il est possible d’évaluer l’endémisme et les statuts de menace, afin d’orienter les actions de conservation. Nous illustrons ces contributions de l’apport des taxonomistes à la conservation par des articles issus d’inventaires des mollusques terrestres au Gabon et en Polynésie française. Enfin, l’analyse de la base de données Fauna Europaea, compilée par des taxonomistes, est l’occasion de montrer que les indicateurs habituellement utilisés pour mesurer l’état de la biodiversité font l’impasse sur la majorité des espèces, et ne remplissent donc que partiellement leur rôle. La dernière partie de cette thèse aborde l’intérêt et la faisabilité d’une nomenclature scientifique française pour les mollusques de France, pour favoriser la conservation de ces espèces méconnues à forte valeur patrimoniale. Pour les espèces les plus nombreuses et les moins connues, les taxonomistes sont les seuls à pouvoir apporter des informations sur la richesse spécifique ou les patrons d’endémisme. Ils permettent donc de prendre en considération l’ensemble de la biodiversité, et non uniquement les grands vertébrés et les plantes supérieures. Dans ce contexte, avec les biologistes des populations, les généticiens et les écologues, ils ont un rôle de premier plan à jouer dans la conservation de la biodiversitéThe abundance of rare and small species is a characteristic of biodiversity, and these species are the least known. Moreover, ca. 1. 75 million species are known, but the global magnitude of biodiversity is probably over 10 million species, maybe many more. Last but not least, we are experiencing a major extinction crisis. Documenting biodiversity is thus a priority, if only to preserve it. Taxonomists are responsible for this documentation, as these are the ones who discover and describe species, but they suffer from a lack of manpower and infrastructure. Considering these facts (lack of knowledge on biodiversity, extinction crisis, taxonomic impediment), we examine the role taxonomists could play in conservation. The core of taxonomical work is double: discriminating species, and naming them. Discriminating species, before naming, gives data on species richness, rarity and size patterns, and could help the choice of conservation areas. When species are named, assessing endemism and threat status is possible, which also allows to orientate conservation actions. We illustrate these contributions to conservation with papers presenting results of terrestrial mollusc inventories in Gabon and French Polynesia. We then analyze the Fauna Europaea database, compiled by taxonomists, which shows that the indicators usually used to measure the state of biodiversity are missing most species and give a partial image of the situation. This thesis ends with an assessment of the interest and possibility of having a French scientific nomenclature for the molluscs of France, to facilitate conservation of poorly-known threatened species. Only taxonomists can deliver data on specific richness and patterns of endemism for the most numerous and least known species. Their contribution allows to take into account all biodiversity, and not only large vertebrates and flowering plants. In this framework, their role is crucial in conservation biology, together with population biologists, geneticists and ecologists
Books on the topic "Classification des handicaps":
1
Organization, World Health, and World Health Assembly, (29th : 1976), eds. International classification of impairments, disabilities, and handicaps: A manual of classification relating to theconsequences of disease. Geneva: World Health Organization, 1993.
2
Alaszewski, Andy. Institutional care and the mentally handicapped: The mental handicap hospital. London: Croom Helm, 1986.
3
Classification internationale des handicaps: Déficiences, incapacités et désavantages : un manuel de classification des conséquences des maladies. Paris: INSERM, 1988.
4
Classification internationale des handicaps: Deficiences, incapacites et desavantages : Un manuel de classification des consequences des maladies (Publications du CTNERHI). Diffusion P.U.F, 1988.
5
Chapireau, Fran<135>ois. The Conceptual Framework of the Internatinal Classification of Impairments, Disabilities and Handicaps (Icidh) (Health). Food & Agriculture Organization of the United Nations (FAO), 1992.
6
Minaire, Pierre. The Use of the International Classification of Impairments, Disabilities and Handicaps (ICIDH) in Rehabilitation. Council of Europe Publishing, 1989.
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Europe, Council of, and Durk Wiersma. The Use of the International Classification of Impairments, Disabilities and Handicaps (Icidh) in Mental Health. Manhattan Pub. Co., 1991.
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Gardent, Henriette. Use of the International Classification of Impairments, Disabilities and Handicaps (ICIDH) in Relation to Elderly People. Council of Europe Publishing, 1997.
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Use of the International Classification of Impairments, Disabilities and Handicaps (Icidh) in the Field of Mental Retardation. Manhattan Pub. Co., 1993.
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Europe, Council of, and Albert Tricot. Use of the International Classification of Impairments, Disabilities and Handicaps (Icidh) in the Assessment of Technical AIDS. Manhattan Pub. Co., 1992.
Book chapters on the topic "Classification des handicaps":
1
Wood, P. H. N. "The International Classification of Impairments, Disabilities and Handicaps of the World Health Organization." In Health Systems Research, 83–101. Berlin, Heidelberg: Springer Berlin Heidelberg, 1990. http://dx.doi.org/10.1007/978-3-642-75593-4_7.
2
Rosine, Jean-Marie, Colin Mathers,, and Nicolas Brouard. "Trends and Differentials in Disability-Free Life Expectancy: Concepts, Methods, and Findings." In Health and Mortality Among Elderly Populations, 182–201. Oxford University PressOxford, 1996. http://dx.doi.org/10.1093/oso/9780198233374.003.0009.
Abstract:
Abstract In the introduction to the International Classification of Impairments, Disabilities, and Handicaps (ICIDH), the World Health Organization (WHO) has argued that the classical medical model (of aetiology-pathology-manifestation) is incomplete ‘because it stops short of the consequences of disease. It is the latter, particularly, that intrude upon everyday life ... this is especially true for chronic and progressive or irreversible disorders ‘. More generally, WHO has thus proposed the following model: disease-impairment-disability-handicap.
3
Phillips, Margaret F., and Jean Mathieu. "Physical disability in myotonic dystrophy." In Myotonic dystrophy: present management, future therapy, 68–82. Oxford University PressOxford, 2004. http://dx.doi.org/10.1093/oso/9780198527824.003.0006.
Abstract:
Abstract The concept of impairment, disability and handicap was originally defined by the World Health Organization (WHO) in 1980 as the International Classification of Impairments, Disabilities and Handicaps (ICIDH) (World Health Organization 1980). In that model, an impairment was defined as ‘any physiological, anatomical or histological anomaly or alteration’ and a disability as ‘any disturbance resulting from an impairment in the capacity to perform a physical or mental activity considered normal for a human being (depending on his/her biological characteristics)’.
4
"International Classification of Impairment, Disabilities and Handicaps." In Handbook of Disease Burdens and Quality of Life Measures, 4240. New York, NY: Springer New York, 2010. http://dx.doi.org/10.1007/978-0-387-78665-0_5936.
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"Learning disability." In Oxford Handbook of Psychiatry, edited by David Semple and Roger Smyth, 725–74. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199693887.003.0018.
Abstract:
Introduction Historical perspective Classification Impairments, disabilities, and handicaps Aetiology Establishing the cause The process of assessment Considering management choices Treatment methods Down’s syndrome Deletion and duplication syndromes Autosomal dominant syndromes Autosomal recessive syndromes X-linked dominant syndromes X-linked recessive syndromes Sex chromosome disorders Non-genetic causes of learning disability...
6
Ebrahim, Shah. "Severity." In The Clinical Epidemiology of Stroke, 83–91. Oxford University PressNew York, NY, 1990. http://dx.doi.org/10.1093/oso/9780192617491.003.0005.
Abstract:
Abstract Is it a bad stroke? The severity of disease can be described in many different ways, ranging from the patient’s perception, the degree of physiological disturbance, the consequent disability, and handicap caused, to the burden on society (Stein et al. 1987). The severity of a stroke may be assessed in terms of the amount of brain damaged, the size of the lesion(s) demonstrated on CT scanning, or the number and severity of the neurological impairments. At the level of disability, the severity of a stroke may be measured by ability to walk, the ability to climb stairs, or the ability for self-care. At the level of handicap, severity may be measured by impact on work, enjoyment of usual sex life, or social engagement. The aetiological and pathogenetic differences between types of stroke, together with the wide range of possible consequences, make a simple classification of severity difficult.
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Wallace, Daniel J., and Janice Brock Wallace. "Work and Disability." In All About Fibromyalgia. Oxford University Press, 2002. http://dx.doi.org/10.1093/oso/9780195147537.003.0035.
Abstract:
Most of us have to work for a living. There are bills to pay and families to provide for. Since fibromyalgia patients do not usually look ill and on superficial examination appear strong, complaints of difficulty performing the job can be hard to believe. This chapter will review definitions as they apply to disability, impairments reported in fibromyalgia patients, and constructive approaches that allow individuals with the syndrome to work most effectively. The World Health Organization defines disability as a limitation of function that compromises the ability to perform an activity within a range considered normal. Efforts to manage work disabilities considers issues such as age, sex, level of education, psychological profile, past attainments, motivation, retraining prospects, and social support systems. Additionally, work disability issues take into account work-related self-esteem, motivation, stress, fatigue, personal value systems, and availability of financial compensation. An impairment is an anatomic, physiologic, or psychological loss that leads to disability. Impairments include pain from work activities (e.g., heavy lifting), emotional stress (e.g., working in a complaint department), or muscle dysfunction (e.g., cerebral palsy). A handicap is a job limitation or something that cannot be done (e.g., deafness). Patients with a disability can be permanently, totally disabled and thus potentially eligible for Social Security Disability and Medicare health benefits. Other classifications include being permanently, partially disabled, whereby vocational rehabilitation, occupational therapy, and psychological or ergonomic evaluations can address impairments or handicaps to optimize employment retraining possibilities. Temporary, partial disability allows one to work with restrictions (e.g., no lifting more than ten pounds) while treatment is in progress. Temporary, total disability involves a leave of absence from employment while undergoing treatment so that one can return to work. Subjective factors of disability include symptoms such as pain or fatigue, while objective factors of disability are physical signs such as a heart murmur or a swollen joint. One can be disabled from a work category and granted disability even if employment is ongoing in a different work category. Work categories are rated as sedentary, light work, light medium work, medium work, heavy work, or very heavy work, each defined by how much exertion is used over a time interval.
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Harris, James C. "The Classification of Intellectual Disability." In Intellectual Disability. Oxford University Press, 2005. http://dx.doi.org/10.1093/oso/9780195178852.003.0006.
Abstract:
Although intellectual disability has been recognized since antiquity, interest in its classification did not develop until the nineteenth century, when it became apparent that intellectual disability is not one homogeneous category, as was previously thought, but has many causes. Moreover, it became apparent that intervention could be beneficial and that interventions might be tailored for specific disorders. Early authors prepared the way for modern efforts to differentiate specific conditions that differ in both etiology and pathology, yet all result in intellectual disability. Some attempts were misguided. J. Langdon Hayden Down, in his ethnic classification (1866; Jordan, 2000), sought to classify based on the physical appearance of the individuals he examined. His goal was to absolve parents of self-blame for the handicap by emphasizing a constitutional basis for their child’s disorder. He proposed an “ethnic classification,” suggesting that the various forms of intellectual disability represented regressions to stereotypical racial forms (e.g., mongoloid, Aztec). Although he later abandoned this unfortunate idea, he continues to be known for it. Still, he is credited with drawing scientific attention to the syndrome bearing his name (Jordan, 2000) and for suggesting that the best classification is one based on etiology. Subsequently, he anticipated current efforts at classification by describing three major groups: (1) congenital, which included microcephalic, macrocephalic, hydrocephalic, epileptic, and paralytic types; (2) developmental, with a vulnerability to mental breakdown with stress during a developmental crisis; and (3) accidental (caused by injury or illness). Later, William Weatherspoon Ireland (1877), in his textbook on intellectual disability, suggested 10 subdivisions. Among these are genetous (congential), microcephalic, epileptic, eclamptic, hydrocephalic, paralytic, traumatic, inflammatory, cretinism, and idiocy by social and physical deprivation. In 1880, tuberous sclerosis complex was identified by Désiré-Maglione Bourneville (1880), who established that intellectual disability might result from brain pathology. Subsequently, many other intellectual disability syndromes were recognized. Thus began a new era, with investigators searching for clearly defined disorders associated with intellectual disability; these were commonly named after their discoverers. It was an era when intellectual disability syndromes were beginning to be recognized, but medicine had little to offer therapeutically.
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Harris, James C. "Introduction." In Intellectual Disability. Oxford University Press, 2005. http://dx.doi.org/10.1093/oso/9780195178852.003.0004.
Abstract:
The aim of this book is to provide professionals with the latest and most reliable information on intellectual disability and associated impairments. It utilizes a developmental perspective and reviews the various types of intellectual disability, discusses approaches to classification, diagnosis, and appropriate interventions, and provides information on resources that may offer additional help. The term “intellectual disability” is used throughout this book instead of “mental retardation” to reflect current perspectives. Intellectual disability refers to impairments in both cognitive functioning and adaptive skills whose onset is during the developmental period. It is a developmental, intellectual, and cognitive disability. Although the term “mental retardation” continues to be used in the International Classification of Diseases (ICD-10) and DSM-IVTR, the continued use of this designation has been questioned because it implies a static, unchanging condition rather than one that can change over time. Other terms, such as “mental handicap” and “learning disability,” have also been used. These variations in terminology are derived from long-standing concerns about the stigma of applying the term “mental retardation” to individuals. A more general term applied to individuals with intellectual disability is “mental disability.” The World Health Organization and the United Nations generally use the term “mental disability” as a broad descriptor, and the U.S. Supreme Court, in the Olmstead decision emphasizing the importance of community living, also used the term “mental disability.” The definition of “mental retardation” has changed nine times over the past 100 hundred years in the United States. Such changes in nomenclature come about with the acquisition of new knowledge regarding causes and efforts to preserve the dignity of persons who are intellectually disabled. Reflecting this new knowledge and concerns about the stigma sometimes associated with the term, on July 25, 2003, the name of the federal advisory committee, the President’s Committee on Mental Retardation (PCMR), was changed to the President’s Committee for People with Intellectual Disabilities (PCPID). Because the name designates the committee that advises the Secretary of Health and Human Services and the President on federal policy regarding programs and services, the change is noteworthy.
Conference papers on the topic "Classification des handicaps":
1
COOPER, JOHN E. "INTERNATIONAL CLASSIFICATION OF IMPAIRMENTS, DISABILITIES AND HANDICAPS: (ICIDH-1980): SUGGESTIONS FOR REVISION." In IX World Congress of Psychiatry. WORLD SCIENTIFIC, 1994. http://dx.doi.org/10.1142/9789814440912_0030.
2
Masankaran, Lawana, Waraporn Viyanon, and Visan Mahasittiwat. "Classification of Benign Paroxysmal Positioning Vertigo Types from Dizziness Handicap Inventory using Machine Learning Techniques." In 2018 International Conference on Intelligent Informatics and Biomedical Sciences (ICIIBMS). IEEE, 2018. http://dx.doi.org/10.1109/iciibms.2018.8550002.
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BOUMAZOUZA, Nassima. "CONCEPTUAL DEVELOPMENT OF SPECIAL NEEDS THROUGH THE SYMBOLISM OF ABUSE AND BULLYING TARGETING." In International Research Congress of Contemporary Studies in Social Sciences (Rimar Congress 2). Rimar Academy, 2021. http://dx.doi.org/10.47832/rimarcongress2-6.
Abstract:
The World Health Organization (WHO) states on its website, the one dedicated to the regional office of the Middle East, that there are more than 1000 million disabled people across the globe, which represents approximately 15% of the entire world population i.e. nearly 1 in every 7 people is disabled. It also indicates that the number of the people who suffer from a handicap is on a continuous rise, mainly because of the aging population as well as the exacerbation of chronic illnesses. Moreover, the same organization informs that although this matter is of an extreme seriousness, there is in fact a severe lack of awareness and an unavailability of the necessary scientific information related to this topic. As a matter of fact, there is only a small number of documents that display collections of studies about the policies and responses that the countries have put in place in order to meet the needs of people with disabilities. The data related to disabilities and disabled people points out to an evident lack of concern, on a global scale, when it comes to this particular group that happens to include millions of people all throughout the world. However, and despite the efforts and resources dedicated to accommodate and rehabilitate handicapped people, we still, unfortunately, have a long way to go before we can reach this desired goal. So, does it mean that all these efforts were in vain? In this communication, we will attempt to answer this question through a presentation of the historical evolution of opinions about the meaning of disability and special needs in light of the recent scientific advancements and its impact on the social perception, by shedding the light on the symbolism of the phenomenon of abuse and bullying targeting individuals with special needs. This historical examination shows a clear quantum leap when it comes to the treatment and attitude towards people with special needs, a leap that coincides with the advancement that the scientific research and the pathological classification in the psychology have witnessed in the beginning of the twentieth century. Following these classifications, a number of legal renewals took place, which provided disabled people with several rights that guarantee their protection. Therefore, we can determine that there is indeed a tangible change, albeit the fact that there is definitely and undoubtedly more room for improvement in this regard. Consequently, the denunciations we witness today regarding the abuse and mistreatment of people with disabilities is in fact a product of the collective awareness and the public acknowledgment of the radical shift regarding the conceptual and practical notion of disability. Which in turn, predicts a better and a more prosperous future for a group of people who are in dire need of change.