The study, led by Mizanur Rahman and colleagues, is notable for its sheer scale. The National Survey on Persons with Disabilities was designed to provide population-level estimates rather than the small clinic-based or district-level samples that have dominated the literature on disability in South Asia. By analysing data across individual, household, and community levels, the researchers were able to apply multilevel mixed-effects logistic regression, a statistical approach that accounts for the fact that people are nested within households and communities and that risk factors operate at each of these layers simultaneously. Crucially, they stratified their models by age, analysing children aged 0 to 17 years separately from adults aged 18 to 95, because the biology and social context of disability differ profoundly between these groups.

The headline number, a national disability prevalence of 2.79 percent with a 95 percent confidence interval of 2.69 to 2.91, is lower than estimates from some international organisations, which have suggested that roughly 15 percent of the world’s population lives with some form of disability. That gap almost certainly reflects differences in definition and measurement rather than any genuine scarcity of impairment in Bangladesh. Survey instruments that rely on self-report or household reporting tend to capture moderate and severe functional limitations while missing many milder impairments, and stigma can suppress disclosure, particularly for intellectual and psychosocial disabilities. Even so, the survey’s consistency and size make the 2.79 percent figure an important benchmark, and the patterns within it are arguably more informative than the headline rate itself.

Physical disability dominated the profile, accounting for 42.44 percent of reported cases, followed by visual impairment at 14.11 percent. Notably, 11.60 percent of people with disabilities reported multiple disabilities, a detail with significant implications for service design. A person with both a physical impairment and a visual one faces compounded barriers to education, employment, and health care, and rehabilitation programmes built around a single impairment category may fail such individuals entirely. The prominence of physical and visual disabilities also points toward preventable causes, including injuries, untreated infections, and age-related conditions, that could be addressed through stronger primary care, occupational safety, and eye health services.

One of the most striking findings concerns sex. Overall, disability was more prevalent among males, but this aggregate picture concealed sharply divergent patterns by age. Among children, girls had 31 percent higher adjusted odds of disability than boys, with an adjusted odds ratio of 1.31 and a confidence interval of 1.13 to 1.52. Among adults, however, no significant sex difference emerged, with an adjusted odds ratio of 1.06 and a confidence interval spanning 0.95 to 1.19. The childhood pattern is particularly concerning in a country where daughters have historically faced disadvantages in nutrition, health care utilisation, and educational investment. Higher odds of reported disability among girls may reflect genuine biological or perinatal differences, but they may also signal that families are more likely to identify and report disability in girls in certain contexts, or conversely that girls with disabilities face compounded neglect. Disentangling these mechanisms is a priority for follow-up research.

Perhaps the most counterintuitive result is the relationship between socioeconomic status and disability. In both age groups, the odds of reporting disability increased with years of schooling and household wealth, the opposite of what a purely causal reading of poverty and impairment might predict. Among adults, community-level literacy was likewise associated with higher odds of disability, while among children the association was reversed, with higher community literacy linked to lower odds. The most plausible explanation is detection bias: wealthier, better-educated households are more aware of what constitutes a disability, more willing to report it to surveyors, and more likely to have accessed diagnostic services, while stigma and limited awareness suppress reporting in poorer and less literate communities. If that interpretation is correct, the true burden of disability in Bangladesh’s most disadvantaged communities is likely substantially higher than the survey suggests, and the observed socioeconomic gradient is a map of underreporting rather than of genuine protection.

Occupational patterns among adults reinforce this interpretive caution. Housewives, students, and blue-collar workers all showed higher adjusted odds of disability than agriculture workers, the reference category. Each of these comparisons can be read in multiple ways. Blue-collar workers may face genuinely elevated risk through hazardous working conditions and injuries, a finding consistent with occupational health research across South Asia. Housewives and students, by contrast, are categories whose composition differs systematically by wealth and education, so the elevated odds may partly reflect reporting behaviour rather than causation. Agriculture workers, who form the reference group, are often among the poorest and least educated, meaning that unmeasured impairment in this group could deflate the apparent risk elsewhere. The authors’ call for caution in interpreting these associations is well founded.

The policy implications of the study are concrete. Rahman and colleagues argue for strengthening community-based disability identification and referral through Bangladesh’s existing primary health-care infrastructure, with particular attention to underserved populations and geographic areas where detection is likely weakest. Bangladesh has an extensive network of community clinics and frontline health workers, and embedding disability screening within routine maternal, child health, and general primary care contacts could dramatically improve case finding without requiring new infrastructure. The researchers also highlight the potential of better coordination between the Ministry of Health and Family Welfare, which controls health services, and the Department of Social Services, which administers disability allowances, rehabilitation programmes, and assistive-device distribution. In practice, many Bangladeshis who are identified with a disability never connect to the social protection schemes designed for them, and the study suggests that closing this administrative gap could deliver immediate benefits.

For a country that has made significant progress on poverty reduction, immunisation, and maternal mortality, the persistence of an invisible disability burden represents both a challenge and an opportunity. The 2021 National Survey on Persons with Disabilities provides the statistical foundation that advocates, planners, and researchers have long lacked, and its stratified, multilevel design offers a template for other low- and middle-income countries attempting similar measurement exercises. The paradoxes it documents, from higher reported disability among wealthier households to the reversal of the literacy association between children and adults, are not statistical curiosities. They are warnings that the data we see are shaped by who gets counted, and that the children and adults least likely to appear in disability statistics may be those most in need of services. Turning a 2.79 percent snapshot into a genuinely inclusive national response will require Bangladesh to treat detection itself as a public health intervention.

Subject of Research: National prevalence and sociodemographic correlates of disability in Bangladesh based on the 2021 National Survey on Persons with Disabilities

Article Title: National burden of disabilities in Bangladesh and its socio-demographic correlates: A 2021 cross-sectional analysis

Article References: National burden of disabilities in Bangladesh and its socio-demographic correlates: A 2021 cross-sectional analysis. (n.d.). https://doi.org/10.1371/journal.pgph.0007463

Image Credits: AI Generated

DOI: 10.1371/journal.pgph.0007463

Keywords: disability, Bangladesh, public health, prevalence, cross-sectional study, multilevel regression, health equity, primary health care, social protection, visual impairment, physical disability, LMICs

The research, published in BMC Health Services Research, was conducted by a team led by Ravi Dhar Bhandari of Dhangadhi Netralaya Eye Hospital together with colleagues from the Tilganga Institute of Ophthalmology in Kathmandu. Their focus was a specific behavior known in the health services literature as cost-related non-adherence, abbreviated CRNA. The concept is deceptively simple: a patient is considered cost-related non-adherent if, within a defined period, they engaged in at least one cost-saving behavior related to their medication. That might mean skipping doses to make a bottle last longer, taking drops less frequently than prescribed, delaying a refill until money becomes available, or using a cheaper substitute without medical guidance. Each of these behaviors may seem minor in isolation, but in a disease where sustained intraocular pressure control is the only proven way to preserve vision, even intermittent lapses can translate into permanent nerve damage.

To measure how often this happens, the researchers designed a cross-sectional study running from 1 October 2023 to 31 March 2024 at Dhangadhi Netralaya, a major eye hospital serving Sudurpaschim Province. They enrolled consecutive patients aged eighteen or older who had been receiving topical glaucoma medication for at least six months, a threshold chosen to ensure that participants had enough experience with their treatment regimen to report on it meaningfully. Data came from two sources: a structured questionnaire capturing sociodemographic information and medication-related behaviors, and a review of medical records for clinical details such as diagnosis, visual acuity, and the number of medication bottles prescribed. The study received ethics approval from the Ethical Review Committee of the Nepal Health Research Council under protocol reference number 54, and every participant provided written informed consent before enrollment, in accordance with the Declaration of Helsinki.

The final cohort comprised 132 patients, of whom 60.6 percent were male, with a mean age of 60.1 years and a standard deviation of 12.6 years. Primary open-angle glaucoma, the most common form of the disease worldwide, accounted for 65.9 percent of diagnoses, with angle-closure variants and secondary glaucomas making up the remainder. The burden of visual loss in this group was striking even before adherence was considered: 53.0 percent of participants already had some degree of visual impairment, and 15.2 percent were blind. These figures underscore a broader reality of glaucoma care in low-resource settings, where patients frequently present late in the disease course, when much of the damage cannot be undone. Against this backdrop, any additional barrier to effective treatment, including cost, becomes a matter of profound consequence.

The headline finding was that 14 of the 132 participants reported at least one cost-saving behavior with their glaucoma medications in the preceding six months, yielding a prevalence of cost-related non-adherence of 10.6 percent, with a 95 percent confidence interval ranging from 6.1 to 17.5 percent. In other words, roughly one in ten patients in this cohort was compromising their glaucoma therapy for financial reasons. The authors are careful to frame this as a conservative estimate for a single hospital population, but the proportion is clinically meaningful: every one of those ten percent represents a person whose optic nerve is exposed to pressure fluctuations that could accelerate vision loss. The confidence interval also indicates genuine statistical uncertainty inherent in a sample of this size, a limitation the researchers acknowledge by presenting the estimate transparently rather than overstating its precision.

Perhaps the most technically interesting part of the study lies in its analysis of which patients were most at risk. The team first performed bivariate analyses examining the raw associations between cost-related non-adherence and a range of potential predictors, then moved to multivariable logistic regression to adjust for confounding variables and isolate independent risk factors. Three factors emerged with statistical significance at the conventional threshold of a p-value below 0.05. Patients with systemic comorbidities, meaning coexisting conditions such as diabetes, hypertension, or other chronic illnesses requiring their own treatment expenses, had dramatically higher odds of cost-related non-adherence, with an adjusted odds ratio of 23.05 and a 95 percent confidence interval spanning 2.32 to 374.36. The very width of that interval reflects the small number of affected patients, but the direction and magnitude of the association tell a coherent story: households juggling multiple chronic diseases face compounding out-of-pocket costs, and when budgets are stretched, eye drops that produce no felt benefit are among the first expenses to be cut.

The second independent predictor was the number of glaucoma medication bottles prescribed. Most participants, 62.9 percent, were prescribed a single bottle, while 28.8 percent were prescribed two and 8.3 percent were prescribed three. Each additional bottle multiplied both the direct cost and the logistical complexity of the regimen, and patients on multi-bottle therapy had an adjusted odds ratio of 6.76 for cost-related non-adherence, with a confidence interval of 2.31 to 25.73. This finding aligns with a well-established principle in adherence research: regimen complexity is one of the most reliable predictors of non-adherence across virtually every chronic disease, from HIV to hypertension to glaucoma. Every additional medication adds a set of instructions, a schedule, and a price tag, and in a setting where patients typically pay out of pocket, the financial gradient is steep.

The third finding was more counterintuitive. Male sex was associated with significantly lower odds of cost-related non-adherence, with an adjusted odds ratio of 0.11 and a confidence interval of 0.02 to 0.55. Given that men made up the majority of the cohort, this suggests that women in this population face disproportionate financial barriers to sustaining their glaucoma therapy. The authors do not over-interpret this result, but it resonates with a substantial body of literature from South Asia documenting gender inequities in healthcare access and expenditure, where women’s health needs are often deprioritized within household spending decisions. Whether the mechanism in Sudurpaschim Province reflects income disparities, decision-making dynamics, or other factors is a question the study raises but cannot fully resolve, and it is precisely the kind of question that deserves targeted follow-up research.

It is worth pausing on why these findings matter beyond Nepal. Glaucoma is the leading cause of irreversible blindness globally, and the World Health Organization has projected that the burden of blinding eye disease will grow as populations age. In high-income countries, cost-related non-adherence to glaucoma drops is also documented, but insurance coverage, generic options, and pharmaceutical assistance programs provide buffers that simply do not exist in many low- and middle-income settings. In far-western Nepal, where geographic isolation, limited transportation infrastructure, and low household incomes compound the challenge, the out-of-pocket cost of a bottle of topical medication can represent a substantial fraction of a family’s monthly budget. The study’s finding that more than half of enrolled patients already had visual impairment, and one in seven was blind, paints a picture of a population arriving at care late and then struggling to sustain it.

The authors conclude with a set of practical implications that follow directly from their data. Because cost-related non-adherence affected approximately one in ten patients, and because the strongest risk factors were systemic comorbidities and multi-bottle regimens, interventions can be targeted with reasonable precision. Strategies to reduce out-of-pocket costs, whether through subsidized medication supply, inclusion of glaucoma drops in essential drug programs, or tiered pricing at charitable eye hospitals, would address the financial barrier at its root. Simplifying treatment regimens where clinically feasible, for example by favoring combination drops that consolidate multiple medications into a single bottle, would simultaneously lower cost and reduce complexity. Clinicians could also screen for cost-related non-adherence proactively, asking patients directly whether they have stretched or skipped drops for financial reasons, since patients rarely volunteer this information unprompted. As a modifiable barrier, medication cost stands apart from demographic risk factors that cannot be changed, which is what makes this modest study of 132 patients in far-western Nepal a small but genuinely actionable piece of the global effort to prevent avoidable blindness.

Subject of Research: Cost-related non-adherence to topical glaucoma medication among patients in far-western Nepal

Article Title: Cost-related non-adherence to glaucoma medical therapy: a hospital based study in Sudurpaschim Province of Nepal

Article References: Bhandari, R. D., Bist, J., Poudel, M., Pant, O. P., & Pant, B. P. (2026). Cost-related non-adherence to glaucoma medical therapy: a hospital based study in Sudurpaschim Province of Nepal. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15788-1

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15788-1

Keywords: glaucoma, cost-related non-adherence, medication adherence, Nepal, eye health, ophthalmology, health services research, out-of-pocket costs, visual impairment, primary open-angle glaucoma, treatment regimen complexity, low-resource settings

The research, led by Seifemichael Tsegaye Kassa of Wollo University and Mengistu Awlachew of Dessie College of Teachers Education, examined every student with visual impairment enrolled in Grades 7 and 8 across the five governmental middle schools in Dessie that operate inclusive education programs. That came to exactly 50 students, and rather than sampling from them, the researchers used a census approach, including the entire accessible population. The participants completed standardized questionnaires measuring perceived social support and self-esteem, while their academic performance was drawn from official school examination records across eight subjects, from Amharic and English to General Science and Information Technology.

The numbers are compelling. Perceived social support correlated with academic performance at r = .49, and self-esteem at r = .54, both statistically significant at the p < .01 level. When the two variables were entered together in a multiple regression model, they accounted for 39.7 percent of the variance in examination scores—a substantial share for any two predictors in educational research. The overall model was highly significant, F(2, 47) = 15.48, p < .001. Notably, self-esteem carried the stronger standardized weight (β = 0.42) compared with perceived social support (β = 0.34), suggesting that a student’s internal sense of worth may be the more immediate psychological engine of achievement, even though both factors contributed independently.

The theoretical backbone of the study is Sociometer Theory, the influential idea proposed by psychologist Mark Leary that self-esteem functions as an internal gauge of social acceptance. According to this view, when students with visual impairment perceive meaningful emotional, informational, and practical assistance from parents, teachers, and peers, that support signals relational value, which is then reflected in stronger self-esteem. Conversely, stigma, isolation, or thin support networks register as signs of low acceptance and gradually erode self-worth. In the Dessie data, perceived social support and self-esteem were themselves moderately correlated at r = .46, consistent with the idea that external relational inclusion shapes internal self-evaluation.

The researchers layered three additional frameworks onto this foundation. Socioecological Theory situates the student within nested systems of family, peers, and school, each shaping development. Self-Determination Theory emphasizes that relatedness and competence feed intrinsic motivation, the fuel of persistence in difficult academic tasks. Social Capital Theory explains how interpersonal networks supply tangible resources—help navigating barriers, information, encouragement—that facilitate educational success. Together, these perspectives converge on a single proposition: academic performance among students with visual impairment is not merely a product of cognitive capacity or instructional quality, but is deeply embedded in the psychosocial and structural contexts in which learning occurs.

Context matters enormously here, and the Ethiopian setting is distinctive. In collectivist cultures such as Ethiopia’s, self-worth is tied more strongly to group membership, family approval, and social inclusion than in individualist Western contexts. Strong family interconnectedness and community-based support systems may therefore amplify the association between social support and achievement. At the same time, resource constraints, lingering stigma around disability, and the early stages of inclusive education policy implementation mean that psychosocial resources may carry extra weight: where structural supports are thin, students lean more heavily on relationships and self-belief to navigate academic challenges. The authors argue that this may explain why the observed associations were relatively strong in their sample.

The methodological care behind the study deserves attention. Because all participants had visual impairments, the standard written questionnaires could not simply be handed out. Trained research assistants read every item aloud, individually or in small groups, using neutral delivery without inflection, and recorded verbal responses; enlarged-print versions were available for students with partial vision. The Amharic-adapted Multidimensional Scale of Perceived Social Support showed excellent internal consistency (Cronbach’s alpha = 0.870), and the adapted Rosenberg Self-Esteem Scale performed even better (alpha = 0.884). The instruments were translated forward and backward, reviewed by bilingual experts, and piloted with 12 visually impaired students at a separate school.

The team also took deliberate steps to guard against common method bias and social desirability. Crucially, the outcome variable—academic performance—came from official school examination records rather than self-reports, creating methodological separation between predictors and outcome. Students were assured confidentiality and told their answers would not affect their academic standing or be disclosed to teachers or parents. Regression diagnostics were clean: variance inflation factors of 1.27 indicated no multicollinearity, the Durbin–Watson statistic of 1.65 fell within the acceptable range, and tests of residual normality were satisfied.

Still, the authors are candid about limits. The cross-sectional design captures associations at a single point in time and cannot establish causation—it remains possible that high-performing students feel better supported and more confident, rather than the reverse. The sample of 50, while a complete census of the local population, is small and drawn from one city, limiting generalizability to private schools, rural settings, or other regions. Roughly sixty percent of the variance in performance remains unexplained, likely reflecting instructional quality, access to assistive technology, socioeconomic status, disability severity, and other factors outside the model. Longitudinal studies and larger, more geographically diverse samples are the clear next step.

Even so, the practical implications are immediate. The findings suggest that schools should foster self-esteem development programs, build peer mentoring and teacher-led emotional support systems, and embed counseling alongside instructional accommodations in inclusive education policy. For Ethiopia’s growing inclusive education framework—and for educators across Sub-Saharan Africa facing similar conditions—the message is that braille, screen readers, and accessible curricula are necessary but not sufficient. The relationships surrounding a student, and the self-worth those relationships cultivate, appear to be among the most powerful predictors of whether that student succeeds.

Subject of Research: Psychosocial predictors of academic performance among middle school students with visual impairment in Ethiopia

Article Title: Perceived social support, self-esteem, and academic performance among students with visual impairment in Ethiopian middle schools

Article References: Kassa, S. T., & Awlachew, M. (2026). Perceived social support, self-esteem, and academic performance among students with visual impairment in Ethiopian middle schools. Discover Education, 5(1), Article 1082. https://doi.org/10.1007/s44217-026-02223-0

Image Credits: AI Generated

DOI: 10.1007/s44217-026-02223-0

Keywords: visual impairment, self-esteem, social support, academic performance, inclusive education, Ethiopia, middle school, Sociometer Theory, school psychology, disability, cross-sectional study, psychosocial factors

The study, led by Jenberu Mekurianew Kelkay of Debark University with colleagues from Debre Tabor University and the University of Gondar, focused on the university’s Maraki Campus, one of five campuses of one of Ethiopia’s oldest and largest public universities. The researchers employed a qualitative case study design, conducting ten individual in-depth interviews and two focus group discussions with six participants each. The participants, 17 males and 5 females, were drawn from Social Work, Sociology, Psychology, and Law programs spanning all four years of undergraduate study. Interviews and discussions were conducted in Amharic, audio-recorded with permission, transcribed verbatim, translated into English, and analyzed thematically through manual coding and categorization. The research team continued collecting data until saturation was reached, meaning no new themes emerged from subsequent conversations.

The scale of the underlying problem is considerable. According to the World Health Organization, approximately 2.2 billion people worldwide live with some form of vision impairment or blindness, and at least one billion of those cases could have been prevented or remain unaddressed due to inadequate access to eye care. In the Amhara region specifically, a study of 784 clients at the University of Gondar teaching hospital found prevalence rates of visual impairment and blindness of 15.3 percent and 14.4 percent respectively. Against this backdrop, the number of visually impaired students reaching higher education in Ethiopia remains small, and the support systems available to those who do are stretched thin.

The study’s first major theme was economic. Participants described financial hardship as a defining feature of their academic lives, not merely because of general poverty but because visual impairment generates additional costs that sighted students never face. Many students depend on paid sighted readers to access printed materials, review documents, and complete practical assignments that require visual ability. One male participant explained that he could not independently review documents or finish certain assignments, so he had to hire readers who demanded payment. Existing financial support mechanisms, including the Mastercard Foundation Scholarship, were perceived as helpful but insufficient and not fully inclusive of disability-related expenses such as accessible learning materials, academic assistance, and personal support needs. The result, the researchers found, is a system in which students’ independence is compromised and their academic participation is constrained by costs their peers do not bear.

Access to assistive learning resources emerged as a second critical gap. Participants reported inadequate availability of Braille books, computers equipped with screen-reading software, and other assistive technologies. Although computers existed in some university settings, many lacked the accessibility features required for independent use by blind or low-vision students. One participant noted that undergraduate education demands individual effort and that students are expected to work with computers and Braille books, yet these resources were simply not accessible to them. The shortage of materials in accessible formats, whether Braille, audio, or compatible digital files, forced students into dependence on others for basic academic tasks such as reading lecture materials and completing coursework, undermining the self-directed learning that university study presupposes.

The third cluster of findings concerned social and psychosocial barriers, and these proved among the most troubling. Participants described stigma and negative attitudes from some instructors, including doubts about whether visually impaired students could learn as effectively as their sighted peers. Some teachers refused to permit audio recording of lectures, eliminating a crucial accessible learning channel and leaving students unable to review course content independently after class. Participants also reported difficulty securing reliable volunteer assistance, particularly during examinations when informal peer support networks proved least dependable. Most seriously, some female participants described deception and unwanted sexual advances from sighted students who initially presented themselves as academic supporters, revealing how dependence on unregulated informal support networks can expose vulnerable students to exploitation and harm.

Yet the study deliberately moves beyond a deficit narrative, guided by the Strengths Perspective, a framework in disability research that emphasizes individuals’ capacities, resilience, and adaptive strategies rather than their limitations. The students in this study were not passive recipients of hardship. They described hope and determination as sustaining forces, with one participant declaring that although he faced many challenges, he believed he could overcome everything. Others cultivated deliberate social connectedness, building relationships across the university community to secure assistance when needed. Emotional coping strategies ranged from listening to music to spiritual practices, and participants drew on these personal, social, and emotional resources to persist in their studies despite barriers that would defeat many. The researchers interpret this resilience as evidence that students with visual impairment are active agents in their own education, not merely subjects of charity or accommodation.

The contrast with better-resourced contexts is instructive. The study notes that South African universities have, in many cases, provided accessible learning materials, examination readers, dedicated examination rooms, and structured academic support services for visually impaired students. Ethiopian institutions, by comparison, continue to grapple with limited resources, inadequate accessibility arrangements, and gaps between inclusive education policy and its practical implementation. Previous research at Addis Ababa University similarly documented failures to implement building accessibility accommodations for blind students, suggesting the problems identified at Gondar reflect systemic national challenges rather than the failings of a single institution.

From their lived experience, the participants themselves proposed concrete interventions, and their recommendations form perhaps the most actionable component of the research. They called for expanded access to assistive technologies, including Braille books, screen readers such as JAWS, and adapted computers, but crucially they emphasized that access alone is insufficient without training in how to use these tools effectively. They demanded improvements in campus infrastructure, including accessible examination rooms, water facilities, cafeterias, roads, and toilets, designed according to universal design principles that support safe and independent mobility. They urged awareness campaigns and staff training to dismantle stigma and foster positive attitudes among teachers and students. And they called for strengthened counseling and psychosocial support services, alongside inclusive financial support mechanisms that account for the genuine additional costs of studying with a visual impairment.

The study’s broader significance lies in its reframing of disability inclusion as a comprehensive institutional responsibility rather than a matter of individual accommodation. The authors argue that equitable participation requires supportive policies, accessible learning environments, and institutional systems spanning university administration, disability support offices, academic departments, libraries, information technology units, and student affairs. Internationally, the findings resonate with obligations under the United Nations Convention on the Rights of Persons with Disabilities and Sustainable Development Goal 4, which commits governments to inclusive and equitable quality education for all. The persistent gap between such commitments and the daily reality of students at Gondar underscores a global truth: inclusion is not achieved by admitting students with disabilities through the door, but by rebuilding the institution so that the door, the corridor beyond it, the lecture hall, the examination room, and the cafeteria all work for everyone. For the resilient students of Maraki Campus, that transformation cannot come soon enough.

Subject of Research: Barriers and support mechanisms for undergraduate students with visual impairment in Ethiopian higher education

Article Title: Challenges and intervention mechanisms for students with visual impairment at the University of Gondar Ethiopia

Article References: Kelkay, J. M., Mihret, B. G., Tegegne, K. T., Asgai, A. S., Kidie, D. M., & Anteneh, D. S. (2026). Challenges and intervention mechanisms for students with visual impairment at the University of Gondar Ethiopia. Discover Education, 5(1), Article 1072. https://doi.org/10.1007/s44217-026-02165-7

Image Credits: AI Generated

DOI: 10.1007/s44217-026-02165-7

Keywords: visual impairment, inclusive education, higher education, Ethiopia, University of Gondar, assistive technology, disability studies, Braille, screen readers, resilience, stigma, qualitative research

The research took the form of a cross-sectional survey, a design in which data are gathered from participants at a single point in time. Zemedkun recruited 105 trainees with visual impairment through comprehensive sampling, meaning that every eligible trainee in the six purposively selected teacher education colleges was invited to take part rather than a random subset being drawn. This approach maximizes statistical power in settings where the population of interest is small and scattered, a common challenge in disability research across sub-Saharan Africa. Structured questionnaires were used to measure three things: resilience, perceived social support, and life satisfaction, the last of which is widely treated in psychology as a cognitive component of subjective well-being, reflecting how people evaluate their lives as a whole rather than how they feel moment to moment.

The statistical analysis proceeded in two stages, and both stages told a consistent story. First, Pearson’s correlation coefficients were computed to assess the strength and direction of the relationships between the variables. Resilience showed a strong positive correlation with life satisfaction, with a coefficient of r = .574, statistically significant at p < .001. Perceived social support also correlated positively with life satisfaction, though more modestly, at r = .349, likewise significant at p < .001. In plain terms, trainees who reported greater resilience and stronger perceived support tended to report markedly higher life satisfaction, and neither relationship could plausibly be attributed to chance given the sample size.

Correlation alone, however, cannot disentangle the contributions of two variables that are themselves likely to be related, and this is where multiple regression analysis came in. This technique allows researchers to estimate the unique effect of each predictor while holding the other constant. The results were decisive. Resilience emerged as a powerful predictor of life satisfaction, with an unstandardized coefficient of B = 0.899, significant at p < .001. Perceived social support also remained a significant predictor, with B = 0.142, but its contribution was considerably smaller. Together, the two variables explained 37.3 percent of the variance in life satisfaction, a substantial share for research on subjective well-being, where single studies often account for far less.

The decomposition of that shared variance is perhaps the most striking technical detail in the study. Of the 37.3 percent explained, resilience alone accounted for 33 percent, while perceived social support contributed just 4.3 percent. That asymmetry suggests that for these trainees, an internal psychological resource does far more work than an external one in shaping how satisfied they feel with their lives. It does not mean social support is irrelevant; the regression confirmed it retains a significant independent effect even after resilience is taken into account. But it does mean that the dominant driver of well-being in this population appears to be what trainees carry within them rather than what surrounds them.

Why would resilience loom so large? The psychology literature offers several converging explanations. Resilience is generally understood as a dynamic process encompassing the ability to bounce back from setbacks, to regulate emotion under stress, and to find meaning in difficulty. For students with visual impairment pursuing professional training in a resource-constrained educational system, daily life involves navigating inaccessible materials, transportation challenges, and social attitudes that can range from supportive to dismissive. A trainee with a well-developed capacity for adaptation may experience these obstacles as surmountable challenges, whereas the same obstacles may erode the life satisfaction of someone with fewer internal coping resources. Perceived social support, by contrast, depends partly on circumstances outside the individual’s control, such as family proximity, peer attitudes, and institutional culture, which may explain why its measured contribution is smaller even though it matters.

The study’s setting gives the findings particular weight. The Amhara Region is one of Ethiopia’s major educational hubs, and its teacher education colleges train the instructors who will staff classrooms across the region. Trainees with visual impairment who complete these programs enter a profession where their success has ripple effects on hundreds of future students. Yet research on the psychosocial well-being of people with disabilities in Ethiopia has historically been sparse, and interventions are often designed on the basis of assumptions imported from high-income countries. By grounding the analysis in the lived context of Amhara colleges, the study provides locally relevant evidence that can inform policy in a way that generic international findings cannot.

The methodological choices deserve attention as well. Comprehensive sampling eliminates the sampling error that can arise when a small subgroup is randomly sampled, ensuring that the 105 participants represent the full population of visually impaired trainees in the selected colleges. The use of structured questionnaires allows standardized measurement, though it also means the data reflect self-reports, which can be shaped by social desirability and by how participants interpret questionnaire items. The cross-sectional design, meanwhile, establishes association but not causation: it is possible that higher life satisfaction itself fosters resilience, or that a third factor, such as financial security or health status, influences both. Longitudinal follow-up would be needed to confirm the direction of the relationships, and the author’s recommendation for intervention programs is framed as an association-based inference rather than a proven causal effect.

Ethical safeguards were notably thorough. The study received approval from the Institutional Ethics Committee of Dessie College of Teachers Education under reference number IECDCTE/1-1042/2025, and procedures followed the principles of the Declaration of Helsinki. Permission was obtained from the deans and registrar offices of all six colleges, and informed consent was secured in writing from every participant. Because many participants could not read standard print consent forms, the forms were read aloud and explained thoroughly before signing, a practical accommodation that reflects both ethical rigor and sensitivity to the population being studied. Participation was voluntary, and trainees were told they could withdraw at any time without penalty.

The practical implications are straightforward and potentially transformative. The study concludes that resilience and perceived social support are important psychosocial resources associated with higher life satisfaction among trainees with visual impairment, and it recommends that teacher education colleges implement programs to foster resilience and strengthen social support networks. In practice, that could mean embedding coping-skills training and peer mentoring into teacher preparation, training staff to recognize and respond to psychological distress, and building campus cultures in which students with disabilities receive consistent academic and social backing. Given that resilience explains roughly eight times more of the variance in life satisfaction than social support in this sample, investments in students’ internal coping capacities may yield the greatest returns, while support networks remain a meaningful complementary lever. For a group of future teachers whose own well-being will shape the classrooms of the next generation, the message from this Ethiopian study is clear: helping students build resilience may be the single most effective thing their colleges can do.

Subject of Research: The influence of resilience and perceived social support on life satisfaction among teacher trainees with visual impairment in Ethiopia

Article Title: The influence of resilience and perceived social support on life satisfaction among teacher trainees with visual impairment in selected teacher education colleges of the Amhara Region, Ethiopia

Article References: Zemedkun, M. A. (2026). The influence of resilience and perceived social support on life satisfaction among teacher trainees with visual impairment in selected teacher education colleges of the Amhara Region, Ethiopia. Discover Psychology, 6(1), Article 264. https://doi.org/10.1007/s44202-026-00904-3

Image Credits: AI Generated

DOI: 10.1007/s44202-026-00904-3

Keywords: resilience, perceived social support, life satisfaction, visual impairment, teacher education, Ethiopia, Amhara Region, subjective well-being, positive psychology, disability and education, cross-sectional survey, multiple regression

The research, led by Chun-Wei Chang of Monash University together with Ming-De Chen of Kaohsiung Medical University, Nikos Thomacos and Aislinn F. Lalor, followed up on a tailored physical activity programme previously delivered at the Kaohsiung Rehabilitation Centre for the Visually Impaired in Taiwan. The programme consisted of ten 90-minute mat exercise sessions held weekly between March and June 2023, designed specifically to address participation barriers faced by people with visual impairment. Its group format deliberately fostered peer support and social interaction, while accessible facilities and instructor guidance helped participants engage safely. Rather than measuring immediate fitness gains, the team wanted to know what happened to participants’ lives once the sessions stopped.

To answer that question, the researchers conducted an exploratory qualitative study involving semi-structured interviews with eleven of the twelve programme participants. Each participant was interviewed twice — once two months and once four months after the programme concluded, in September and November 2023. The interviews, conducted in Taiwanese and/or Mandarin Chinese according to participant preference, lasted roughly an hour each and drew on the Occupational Performance History Interview-II, a validated tool for exploring a person’s occupational life history. Questions probed changes in daily routines, occupational roles, motivation, and the personal meaning of both the programme and the changes participants noticed. All interviews were audio-recorded, transcribed, translated into English and analysed using reflexive thematic analysis following Braun and Clarke’s six-phase approach, with coding performed in NVivo 14.

The eleven respondents included three men and eight women aged between 28 and 64, all legally classified as having severe visual impairment, with the duration of their vision loss ranging from two to 55 years. Ten lived with family members, while one lived alone and relied on long-term care services for some household tasks. Three worked as masseurs; the remainder were unemployed. This diversity of circumstances allowed the researchers to trace how improved health rippled through very different life contexts — from paid work and parenting to household management and friendship.

Three overarching themes emerged from the analysis: ‘I have a healthier body and mind’, ‘I perform better in my day-to-day life’, and ‘My connection with others is growing’. The first theme captured perceived gains in physical and mental health. At the two-month mark, many participants described firmer muscles, greater flexibility, more energy and improved body shape. One participant, Chong, reflected that his legs felt stronger and he had more stamina when hiking. By four months, several reported that their stronger bodies were actively preventing injury, with fewer muscle strains, less fatigue at work and a reduced risk of falls. Mental health improvements followed a parallel trajectory: better mood, better emotional regulation, and — by the second interview — a more positive mindset and greater courage to try new things, such as walking unfamiliar routes. One participant, Chun, even applied the breathing techniques learned in the programme to manage stress and anxiety in daily life.

The second theme revealed how these health gains translated into occupational performance. Most participants reported walking more easily and confidently, which made shopping, transportation and social outings less daunting. At four months, some described walking longer distances with greater agility and less fear of uneven pavements or poor lighting. Exercise itself became embedded in routines: some continued with mat exercises at home or in similar courses elsewhere, while others joined yoga classes or running groups, guided by audio recordings from the programme. For the masseurs, the programme had direct economic consequences. Improved strength and endurance allowed them to work longer with less fatigue, and techniques such as adjusted breathing and body positioning made their work easier — changes they linked to longer careers and higher earnings. Several participants also described a shift from being cared for to caring for others: managing household tasks independently, easing their families’ worries, and even taking on parenting duties they had previously avoided.

The third theme charted expanding social worlds. The group format had created friendships that outlasted the programme itself, with participants coordinating meet-ups through the messaging app LINE and inviting one another to other activities. One participant, Wen, said the course gave him the chance to interact with people of different personalities, helping him build friendships beyond the programme. For the working masseurs, newly acquired knowledge about stretching and muscle strengthening enriched conversations with clients and deepened rapport. Family relationships strengthened too: participants shared class experiences over dinner, asked relatives for help refining exercise positions, and — as confidence and stamina grew — planned outings and independent visits they would previously have avoided. Several participants even became advocates, encouraging others who did not exercise to give it a try.

The researchers interpreted these cascading changes through the Do-Live-Well framework, an occupation-focused health promotion model that frames participation in meaningful activity as a chain of interconnected outcomes. In this view, physical activity improves health; better health supports engagement in daily occupations; and continued occupational engagement further reinforces health and well-being. The study’s two follow-up time points allowed the team to observe this dynamic in action: improvements reported at two months deepened and broadened by four months, with participants moving from simply noticing benefits to actively building lives around them. While earlier research had documented short-term physical and psychosocial gains from physical activity programmes for people with visual impairment, this study extends the evidence by showing that those gains can become progressively more pronounced over time.

The authors are careful to acknowledge the study’s limitations. The small, non-random sample consisted of service users of a single rehabilitation centre who were already relatively engaged with welfare organisations, so the findings may not generalise to socially isolated individuals with visual impairment. Reliance on self-reflection may have introduced response bias, with participants inclined to emphasise positive change, and the primary investigator’s dual role as programme instructor and interviewer — while fostering rapport and rich data — required careful reflexive management, including team discussions, member checking, a detailed audit trail and bilingual verification of transcripts. Participants were also free to engage in other physical activity during the follow-up period, and the programme involved only mat-based exercise from a single provider, leaving open questions about other formats and contexts.

Even so, the study carries a clear message for rehabilitation practice: physical activity should be promoted within occupational therapy as a health management strategy for people with visual impairment, and its outcomes should be evaluated over the long term rather than judged solely on immediate results. Most participants transitioned from structured mat exercise into alternative forms of activity — yoga, running, increased daily walking — even when home practice lapsed, suggesting that a well-designed programme can seed a durable, self-sustaining active lifestyle. For a population in which loneliness, falls and sedentary behaviour pose serious threats to well-being, the evidence that ten weeks of accessible, social, group-based exercise can keep paying dividends months later is a compelling argument for making such programmes a routine part of services for people with vision loss.

Subject of Research: Long-term life changes in adults with visual impairment after a group-based physical activity programme

Article Title: Life changes of people with visual impairment post participating in a group-based physical activity programme

Article References: Chang, C.-W., Chen, M.-D., Thomacos, N., & Lalor, A. F. (2025). Life changes of people with visual impairment post participating in a group-based physical activity programme. Scandinavian Journal of Occupational Therapy, 32(1), 1-14. https://doi.org/10.1080/11038128.2026.2619340

Image Credits: AI Generated

DOI: 10.1080/11038128.2026.2619340

Keywords: visual impairment, physical activity, occupational therapy, group exercise, long-term outcomes, qualitative research, social participation, well-being, mat exercise, Taiwan, Do-Live-Well framework, daily living

The research team, led by Abdelrahman Abu Osba of Dalhousie University in Halifax alongside collaborators from the University of Calgary, the University of Manitoba and Dalhousie’s department of ophthalmology, set out to answer a deceptively simple question with rigorous methods: does poor eyesight predict delirium? They systematically searched MEDLINE, Embase and the Cochrane Central Register of Controlled Trials from their inception through September 2025, and screened and extracted data with two independent reviewers, a design intended to guard against the subjective drift that can plague narrative reviews. The review was prospectively registered with PROSPERO, the international registry of systematic review protocols, before the data were examined.

The studies that made the cut spanned the full geography of acute care. Some followed older patients undergoing hip fracture surgery, where postoperative delirium is notoriously common. Others enrolled medical inpatients, intensive care unit patients, stroke survivors, oncology patients, emergency department visitors and elderly patients in sub-intensive and palliative care. Visual impairment was defined in various ways, from measured acuity deficits to documented eye disease or self-reported difficulty seeing, and delirium was identified through a patchwork of diagnostic criteria and screening instruments. That heterogeneity, the authors acknowledge, is one of the central challenges of interpreting the pooled result.

When the researchers ran their primary analysis, they were deliberately conservative. They restricted it to the 16 studies that reported multivariable-adjusted estimates, meaning statistical models that already accounted for other delirium risk factors such as age, dementia, illness severity and medications. Even after that adjustment, visual impairment remained firmly associated with delirium: the pooled odds ratio was 2.02, with a 95 percent confidence interval of 1.29 to 3.16. In plain terms, patients whose vision was impaired had about double the odds of delirium compared with similar patients whose vision was intact, a difference that would be hard to dismiss as statistical noise.

The secondary analysis, which pooled all available estimates including those unadjusted for confounders, produced an even larger association: an odds ratio of 2.40, with a confidence interval of 1.81 to 3.18. That the adjusted figure is somewhat smaller is exactly what one would expect if some of the apparent link in raw data flows through correlated factors, but the persistence of a doubled risk after adjustment is the analysis’s most consequential finding. Both pooled estimates, however, came with substantial statistical heterogeneity, with I-squared values above 82 percent, signaling that individual studies varied considerably in the magnitude of the association they observed, likely reflecting their different populations, settings, definitions and analytic choices.

One might have expected the association to be far stronger in some settings than others, for example in surgical wards where sensory inputs are already disrupted by anesthesia and unfamiliar environments, or in the intensive care unit where delirium rates can exceed 50 percent. Interestingly, meta-regression across clinical settings did not detect statistically significant differences in the strength of the association by setting. The signal, in other words, appears remarkably portable, rising in hospitals, ICUs, emergency rooms and palliative units alike, which strengthens the case that the relationship reflects a genuine phenomenon rather than an artifact of any single care environment.

Why would failing eyesight prime the brain for acute confusion? The authors and the broader literature they cite point to several plausible and not mutually exclusive mechanisms. Sensory deprivation is a long-recognized trigger of psychotic-like and confusional experiences, and vision supplies the brain with a dominant stream of information for orienting to reality. When that stream degrades, the brain loses grounding cues, and in a vulnerable, often older and medically ill patient, the result may be the disorganized perception and attention that define delirium. There is also the shared-pathology argument: the vascular and neurodegenerative processes that damage the eye and optic pathways frequently damage the brain as well, meaning poor vision may partly act as a marker of a fragile, delirium-prone nervous system rather than a cause of it. Reduced visual input may further diminish engagement, worsen sleep-wake disruption and limit a patient’s ability to use clocks, calendars, glasses and familiar faces, all staples of multicomponent delirium prevention programs such as the Hospital Elder Life Program.

The authors are careful, and refreshingly so, about what their evidence can and cannot say. Because all of the included studies are observational, the certainty of the evidence, evaluated with the GRADE framework, was rated low, with uncertainty stemming primarily from the substantial between-study heterogeneity. Risk of bias was assessed using the Quality in Prognosis Studies tool, and the analysis itself was conducted according to PRISMA 2020 reporting standards. The verdict the team offers is precise: visual impairment should be regarded as a prognostic factor for delirium, a flag that identifies higher-risk patients, rather than an established modifiable cause. Whether correcting vision, with new glasses, cataract surgery or other ophthalmic care, actually lowers delirium incidence was not evaluated by any of the included studies and remains an open question that will require testing in a causal framework, ideally randomized trials.

Even with that caveat, the clinical implications are difficult to ignore. Visual impairment is extraordinarily common in aging populations; prevalence studies using the National Health and Aging Trends Study data suggest that a large fraction of Americans over 71 have some form of vision loss, and projections indicate the burden will grow substantially in the coming decades. Delirium is equally common, affecting a large share of hospitalized older adults, yet it is frequently missed and its risk factors incompletely addressed. If a simple assessment of vision at admission, paired with low-cost interventions such as ensuring patients have their correct glasses, adequate lighting and orientation aids, could contribute to delirium prevention, the public health payoff could be enormous. This meta-analysis does not prove that such measures will work, but it elevates the eye from an organ routinely ignored in delirium risk models to one that clinicians, researchers and hospital designers can no longer afford to overlook. The next chapter, testing whether restoring sight restores clarity of mind, is now an urgent priority.

Subject of Research: The association between visual impairment and delirium risk in adults

Article Title: The Association Between Visual Impairment and Delirium: A Systematic Review and Meta-Analysis

Article References: Abu Osba, A., Bondok, M., Ibrahim, A., Ahmad, S., Al-Ani, A., Mishra, A., & Benard-Seguin, E. (2026). The Association Between Visual Impairment and Delirium: A Systematic Review and Meta-Analysis. Journal of General Internal Medicine. https://doi.org/10.1007/s11606-026-10804-w

Image Credits: AI Generated

DOI: 10.1007/s11606-026-10804-w

Keywords: delirium, visual impairment, systematic review, meta-analysis, older adults, ophthalmology, risk factors, hospitalized patients, sensory deprivation, geriatric medicine, delirium prevention, vision loss