6th International Conference on Disability and Development: Disability and COVID-19

We invite you to join the 6th International Conference on Disability and Development

The Conference will be hosted by the International Centre for Evidence in Disability

Date: 14 - 17 March 2022
Time: 10am – 12pm GMT each day
Venue: Virtual

COVID-19 has dominated global discourse for the last 18 months as the pandemic impacts everyone, everywhere. There is growing evidence that people with disabilities and their families are particularly at risk during the pandemic, in terms of:

1. Increased risk of death and hospitalization;
2. Exclusion from the COVID-19 response actions (e.g. information, vaccination);
3. Adverse consequences of COVID-19 control activities (e.g. lockdown and social distancing);
4. Negative impacts on health (e.g. reduction in rehabilitation care).

The Conference seeks to bring together people to discuss and debate Disability and COVID-19. The focus will be on new research findings, methodologies and tools and implications of evidence for policy and practice. The focus will include both low-, middle- and high-income settings as well as humanitarian contexts.

Who should attend? All those with a strong interest in disability and COVID-19 are very welcome to attend, and this may include researchers, policy activists, decision- makers and practitioners. People with disabilities are particularly encouraged to submit abstracts and attend.

Please visit our event page for more information 
and for more details about abstract submission.

Deadline for submissions: 10th February 2022

International sign language interpreters and live captioning will be available at the event. 

If other access needs are required, please email disabilitycentre AT lshtm.ac.uk.

Four forms of Recovery? Hodges' model and the Political Domain

individual

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INTERPERSONAL : SCIENCES

humanistic --------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

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group

Recovery?	Recovery?
Recovery?

Five forms in fact including the spiritual...

See also:
Jones P. (2014) Using a conceptual framework to explore the dimensions of recovery and their relationship to service user choice and self-determination. International Journal of Person Centered Medicine. Vol 3, No 4, (2013) pp.305-311.

Hodges' model - Integrating the five vignettes?

Some reading while working on my research proposal:


Vignette methodologies for studying clinicians’ decision-making: Validity, utility, and application in ICD-11 field studies

Abstract

Vignette-based methodologies are frequently used to examine judgments and decision-making processes, including clinical judgments made by health professionals. Concerns are sometimes raised that vignettes do not accurately reflect “real world” phenomena, and that this affects the validity of results and conclusions of these studies. This article provides an overview of the defining features, design variations, strengths, and weaknesses of vignette studies as a way of examining how health professionals form clinical judgments (e.g., assigning diagnoses, selecting treatments). As a “hybrid” of traditional survey and experimental methods, vignette studies can offer aspects of both the high internal validity of experiments and the high external validity of survey research in order to disentangle multiple predictors of clinician behavior. When vignette studies are well designed to test specific questions about judgments and decision-making, they can be highly generalizable to “real life” behavior, while overcoming the ethical, practical, and scientific limitations associated with alternative methods (e.g., observation, self-report, standardized patients, archival analysis). We conclude with methodological recommendations and a description of how vignette methodologies are being used to investigate clinicians’ diagnostic decisions in case-controlled field studies for the ICD-11 classification of mental and behavioural disorders, and how these studies illustrate the preceding concepts and recommendations.

Evans, Roberts, Keeley, Blossom, Amaro, Garcia, . . . Reed. (2015). Vignette methodologies for studying clinicians’ decision-making: Validity, utility, and application in ICD-11 field studies. International Journal of Clinical and Health Psychology, 15(2), 160-170. DOI: 10.1016/j.ijchp.2014.12.001 

Abstract

Vignette studies use short descriptions of situations or persons (vignettes) that are usually shown to respondents within surveys in order to elicit their judgments about these scenarios. By systematically varying the levels of theoretically important vignette characteristics a large population of different vignettes is typically available – too large to be presented to each respondent. Therefore, each respondent gets only a subset of vignettes. These subsets may either be randomly selected in following the tradition of the factorial survey or systematically selected according to an experimental design. We show that these strategies in selecting vignette sets have strong implications for the analysis and interpretation of vignette data. Random selection strategies result in a random confounding of effects and heavily rely on the assumption of no interaction effects. In contrast, experimental strategies systematically confound interaction effects with main or set effects, thereby preserving a meaningful interpretation of main and important interaction effects. Using a pilot study on attitudes toward immigrants we demonstrate the implementation and analysis of a confounded factorial design.

Atzmüller, C., & Steiner, P. (2010). Experimental Vignette Studies in Survey Research. Methodology: European Journal of Research Methods for the Behavioral and Social Sciences, 6(3), 128-138. DOI: 10.1027/1614-2241/a000014 

"Values in Advanced Directives" mapped to Hodges' model

Hechter, et al. (1999) consider values in respect of advanced directives and medical treatment. The authors discuss an old debate in social science that still divides objectivists and subjectivists. Below, with my emphasis the four designated values are mapped to Hodge' model:

individual
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INTERPERSONAL : SCIENCES
humanistic ---------------------------------------  mechanistic
SOCIOLOGY : POLITICAL
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group

(ii) self-concept values involving feelings of dignity, self-control, and/or physical capacity (designated as function);	(i) hedonic values about pain, aversive physical states, chances for recovery to some minimally satisfactory level, and so forth (designated hereafter as pain);
(iii) allocentric values referring to concerns with creating an emotional burden for family and/or loved ones (designated as burden)	(iv) financial considerations (designated as cost) (p.409).

Since 1999 and considering the above I have added the following additions to reflect elements of change and a more generic view:

identity, self-expression (of needs), consistency in expressed wishes, intentionality, mood, alternative-adaptive forms of communication, time - active listening	distance, logistics (family, friends), what telecare might offer in terms of communication, evidence-based interventions, measures, assessment
independent advocacy, standards of social care, 'appropriate' placement for ongoing care, social - life history;	legislation - mental capacity, advocacy, evidence-based care - policy, pension, safeguarding;

While the focus of Hechter, et al. is specific these values also apply in a more generic sense. As students and lifelong learners engage with patients, carers and public they must learn to have due regard for the totality of values that might be encountered.

Hechter, M., Ranger-Moore, J., Jasso, G., & Horne, C. (1999). Do Values Matter? An Analysis of Advance Directives for Medical Treatment. European Sociological Review, 15(4), 405-430. 
 

Student's intellectual and ethical development (Gyurko, 2011)

I need to trace out a theoretical basis for Hodges' model. The paper in this post provides a piece of the jig-saw. Hodges' model is a conceptual framework that can act as a starting grid for the ongoing intellectual, ethical and professional development of all students.

In a post to follow I have also found some insights to underpin the objective and subjective within Hodges' model...

individual
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INTERPERSONAL : SCIENCES
humanistic --------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
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group

relativism	duality
multiplicity	commitment

Perry identifies themes or stages of experience, which cluster around nine positions that are classified into four broad categories: duality, multiplicity, relativism, and commitment (Billings et al., 1998). Duality views the world dichotomously as good–bad, right–wrong, or black–white. Those who make meaning from a dichotomous point of view do so with the belief that right answers exist for everything. With regard to learning, in this stage students simply seek the right answer. With multiplicity, students learn to honor “diverse views when the answers are not yet known” (Evans et al., 1998, p. 131). As students advance toward relativism, they begin to recognize that right and wrong and good and bad are not enough to deal with the situations of real life. In this stage, students learn how to look at specific situations in an abstract view and weigh information by problem solving (Evans et al., 1998). Finally, the movement to commitment occurs when “ethical development,” involving choices, decisions, and affirmations, is incorporated in one's lifestyle (Evans et al., 1998, p.133). (p.508)

Gyurko, C. (2011) A synthesis of Vroom's model with other social theories: An application to nursing education. Nurse Education Today, 31(5), 506-510. doi:10.1016/j.nedt.2010.08.010

Hodges' model: Across the Humanities and Sciences Respond - React

individual

INTERPERSONAL : SCIENCES

humanistic ------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

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...to respond   is to let relationship  predominate.	To react is to let the facts   predominate;

Source:
Tillmanns, Maria daVenza, (2015) The Need To Move Beyond Homo Faber, Philosophy Now, February/March. 106: p.14.

Five Days at Memorial by Sheri Fink: Book

INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL

individual

Five Days at Memorial by Sheri Fink

group - population

Five Days at Memorial by Sheri Fink: The Indepedent - Review

Image source: http://www.barnesandnoble.com/w/five-days-at-memorial-sheri-fink/1114975091?ean=9780804128094

Study on attitudes to epistemic uncertainty in safety - Call for participants

From: Eugenio Alberdi, e.alberdi AT CSR.CITY.AC.UK
To: SOCIOTECH AT JISCMAIL.AC.UK
Sent: Tuesday, 17 September 2013, 19:57
Subject: Study on attitudes to epistemic uncertainty in safety - Call for participants

The Centre of Software Reliability and the Department of Psychology at City University London are running a study on reactions to epistemic uncertainty in decision problems about safety.

Perceived errors in such decisions are often debated hotly after the fact, but there is still a need to study how the input to the decision maker can help or hinder correct decisions.

If you are involved in any capacity with probabilistic reasoning about safety and risk, we would be grateful if you take the survey at:

...

This study arises from research project UnCoDe -
(UNcertainty and COnfidence in safety arguments: effect on expert DEcision makers).

All participants will have the opportunity to read the final report from the study and the other project outputs.

Regards,

_eugenio

Dr. Eugenio Alberdi

Research Fellow, Centre for Software Reliability,

City University, London, Northampton Square, London EC1V 0HB

Beware Reflex Moves and the Triple Whammy

In the past working as a community mental health nurse, I had several referrals in which a house move proved a key contributing factor to mental health problems. I'm surprised that moving residence is not ranked higher in terms of most stressful life events. For older people though an often initial trigger to ensuing chaos is bereavement and the degree of stress this causes is obvious and well documented. It was Simmel the sociologist who highlighted the vulnerability of the dyad - the couple:

"for its life, the dyad depends on both its members; but for its death, the dyad depends upon only one"

Whether marital partners or not, we often take this relationship for granted. Key really is the word of choice here, because listening to the 'patient' tell their story you really wonder what prompts such a vulnerable person to put their keys on the market and re-locate? Often still in grief and depressed they are certainly not able to think clearly and make effective decisions.

If you work in health and social care this scenario will not be news to you. Whatever your employment status though you may (sadly) have personal experience when a parent has died leaving your mother or father alone. For many decades now families are tending to live further and further apart, fifty miles or more - transcontinental even.

Following bereavement the cry goes up “come and live near us, we’ll look after you!” Usually for reasons of longevity that call is to 'mum'. Statutory services don’t hear about the instances when this move is the best thing since sliced-bread, but they certainly do when it goes wrong. We can describe it in many ways, but the importance of place, space, geography, community, in short - home has repeatedly been stressed.

Helping pick up the pieces on many occasions three features stood out:

1. The changing demographic – ageing population
2. The highly personal, subjective, narrative, and qualitative content that arose in session
3. The special circumstances of the older person and their capacity to negotiate this critical conjunction

Plus: my need in 1997 to learn HTML.

Given population trends surely this problem will become more common? What do we know about this dislocation? How frequent does it happen, what are the time-scales, personal and family outcomes, what are the socioeconomic consequences?

Surely it is nothing other than pure sentimentality to say:

"I miss the squeaky garden gate, the GP (family doctor) I knew for twenty years, the people who stopped and chatted on the front, even that nuisance-dog-next-door-but-one?"

Is there a double whammy effect? 1. People previously very well medically for their age suffer acute anxiety and depression. Suddenly pathological age = chronological age; and the negative impacts this can bring. 2. While people who may have had stable longer-term chronic conditions develop additional emotional problems, possibly resulting in hospital admission?

Could there be a triple whammy? [Surely not. Enough already!]

Well, that re-location also means of course that it is a new health and social care team who must help this person and their family make sense of the situation and find their feet again. This 3rd whammy will have its own subtleties. The former doctor-patient relationship may not previously have been tested to this extent. The situation can also impact the health of other relatives. The case for electronic health records also comes to the fore.

All this resulted in the [former] website ‘Beware Reflex Moves'. The title announced itself and captures the situation precisely. Creating the site helped me learn HTML and check out the use of frames. It is not maintained, although I really would like to follow this up!

Being able to air this pet research question at the Ideas Factory in October, other people were certainly interested. Their research questions concerned the quality of care and support that follows 'sudden' versus 'anticipated' deaths in palliative, primary care and related care environments.

I must do a Hodges' matrix. One aspect to highlight would be INTERPERSONAL: counselling, psychotherapy POLITICAL: access to counselling services for >65s. Can anyone help out? Any tutors with a class of students who could take the existing website content and do an update - re-design?

At this time of year loved ones and the rest of humanity are always in our thoughts. Take care and beware those reflex moves ....