Incomes, functionings and capabilities: the well-being of disabled people in Britain

The central objective of this thesis is to explore whether the capability approach can be operationalised, using the well-being of disabled people in Britain as a case study. The capability approach proposes a shift away from measuring utility and income poverty towards identifying functionings (the states of being and activities which individuals achieve), and capabilities (the different combinations of functionings which individuals have the opportunity to achieve). To date there have been few empirical applications and many concerns about the usefulness of the approach remain. Disabled people are an interesting case study for the capability approach because of the challenge to conventional measures of well-being issued by the social model of disability: that we should move away from measuring individual deficits towards focusing on the barriers individuals with impairments experience in attempting to lead the lives they want to lead. The capability approach has the potential, in theory, to meet this challenge. In addition to providing in-depth analysis of the position of disabled people in society, the thesis makes three contributions, one theoretical and two methodological. The theoretical development is the distinction between capability as opportunity and capability as autonomy, that is, the distinction between an approach which treats preferences as exogenous and one which takes seriously the problem of conditioned expectations. The innovative methodologies are, firstly, the extension of techniques of equivalisation of income to take account of variations in needs due to disability, and, secondly, quantifying whether a particular functioning is within an individual's capability set. The thesis concludes that relatively straightforward adjustments to conventional poverty measures improve their validity. For fuller application of the capability approach, although there is a trade-off between conceptual soundness and complexity of data requirements, informative measures of opportunity and autonomy can be derived from existing survey data

Methods, systems, and devices for pairing vagus nerve stimulation with motor therapy in stroke patients

A method of treating motor deficits in a stroke patient, comprising assessing a patient's motor deficits, determining therapeutic goals for the patient, based on the patient's motor deficits, selecting therapeutic tasks based on the therapeutic goals, performing each of the selected therapeutic tasks repetitively, observing the performance of the therapeutic tasks, initiating the stimulation of the vagus nerve manually at approximately a predetermined moment during the performance of the therapeutic tasks, stimulating the vagus nerve of the patient during the performance of the selected therapeutic tasks, and improving the patient's motor deficits.Board of Regents, University of Texas Syste

Factors related to braille acquisition among adult and senior learners : establishing evidence-based practice

Les difficultés de lecture sont les raisons les plus fréquentes pour lesquelles des personnes sont orientées vers un service de réadaptation visuelle. Bien qu’il existe une base historique solide à propos de l’enseignement du braille chez les enfants aveugles, il existe très peu de données probantes concernant l’apprentissage du braille chez les personnes en âge de travailler et les personnes âgées. De surcroît, bien qu’il soit clair que le vieillissement est associé à un déclin des capacités tactiles, motrices et cognitives, on sait peu de choses sur la manière dont ces variables peuvent influencer les résultats de la lecture du braille. Pour examiner cette problématique, une étude en quatre phases a été conceptualisée. Dans la première phase, une étude de la portée a été menée afin de synthétiser les connaissances existantes concernant la relation entre le déclin des capacités lié au vieillissement et la performance de la lecture en braille. La seconde a voulu étudier les obstacles et les facilitateurs rencontrés par les adultes qui suivent une formation en braille. La troisième a exploré les variables qui sont en corrélation avec la performance de lecture en braille à l’âge adulte. Enfin, la dernière phase a voulu se pencher sur l’influence du support de lecture sur la performance de lecture des adultes ayant une sensibilité tactile réduite. Les preuves antérieures concernant le braille et le vieillissement restent rares. Il existe une variété de facteurs personnels, sociaux et institutionnels qui façonnent le processus d’apprentissage du braille chez les adultes, incluant la stigmatisation envers le braille et le vieillissement perçue par certains praticiens, des services inadéquats et des difficultés à l’accès aux équipements brailles. Des données soulignent la nécessité de commencer l’apprentissage du braille le plus tôt possible, d’évaluer des mesures objectives de l’acuité tactile tout en considérant le rôle de la fonction du toucher, de fournir une formation accrue en matière de perception tactile et d’envisager une plus grande intégration d’appareils braille. Les résultats font également ressortir la nécessité d’augmenter le financement et les services ; de définir des critères d’éligibilité qui tiennent compte des réalités uniques des clients âgés et l’accès au braille ; et d’étudier plus avant le rôle de la stigmatisation vis-à-vis du braille et du vieillissement. En somme, tous ces éléments réunis peuvent influencer à la fois les décisions cliniques et les résultats d’apprentissage.Reading difficulties are the most common reasons for referral to vision rehabilitation. Though there is a strong historical basis for the provision of braille instruction among blind children, there is little evidence-based research on the needs of working-age and older adults. Aging is associated with declines in tactile, motor and cognitive capacities. Moreover, learning in adulthood is distinct from childhood learning, owing to differences in cortical plasticity and development. Little is known about how these variables may influence braille reading outcomes, but such knowledge is needed to inform the design of evidence-based strategies. For example, low-cost braille devices incorporate dots of greater height and density, but the extent to which such approaches may enhance reading performance for older adults with reduced tactile sensitivity remains unexplored. These questions are especially imperative as the prevalence of age-related vision loss continues to increase. A four-phase study was devised to synthesize prior evidence on the interrelationship between factors known to decline with age and braille reading performance; to investigate the barriers and facilitators encountered by working-age and older adults who pursue braille training; to identify variables that correlate with braille reading performance in adulthood; and to explore the influence of reading medium on the reading performance of adults with reduced tactile sensitivity. This thesis confirms that prior evidence on braille and aging remains scant, heightening the imperative for further research in this domain. Moreover, there are a variety of personal, social and institutional factors which shape the adult braille learning process, including perceived stigma towards braille and aging among some practitioners, inadequate services and access to braille devices. Braille learning age, frequency of usage, and measures of active tactile acuity emerged as significant correlates of braille reading speed. Preliminary evidence suggests that using braille displays with greater dot height enhances performance for those with reduced tactile sensitivity, while also enabling immediate access to relevant reading content. Collectively, these findings point to the need for rehabilitation practitioners to introduce braille as early as possible, evaluate objective measures of tactile acuity while also considering the role of functional touch, provide increased training in tactile perception, and consider a wider integration of braille devices. Findings also highlight the need for increased funding and services, eligibility criteria which takes into account the unique realities of older braille clients, and the need to further explore the role of stigma towards braille and aging which may influence both clinical decisions and learning outcomes

Malandragem and Ginga: Socio-cultural constraints on the development of expertise and skills in Brazilian football

In an ecological dynamics rationale, the development of expertise in sports is shaped by interactions of personal, task and environmental constraints. A notable outcome of this process is the distinctive performance styles of athletes shaped by socio-cultural-historical constraints. To understand this process, we examined the role of socio-cultural constraints shaping the development of skill in Brazilian football players at the macrosystem level. A range of data sources were inductively generated and analysed through the qualitative interpretative paradigm, including historical contextual analysis, participant observation, and unstructured interviews. Malandragem (i.e., cunning) emerged as a major focus and our findings suggested that behavioural characteristics, such as mischief and deception, are common attributes valued by many elite Brazilian footballers. Our analysis suggests how the value system of Malandragem is a product of the socio-cultural constraints primarily influenced by the Mulattos’ cultural traditions, historically interacting with particular socio-economic conditions. In Brazil, Malandragem can manifest itself through the Ginga (i.e., body sway) playing style in which footballers move deceptively to gain competitive advantages over opponents. Whilst the theatrical antics of contemporary Malandros (i.e., tricksters and/or streetwise persons), such as Neymar Junior, are frowned upon by many football critics, we argue that some aspects of being Malandro may be contributing to the development of a high level of perceptual-motor and cognitive functioning that has underpinned the Ginga playing style in Brazilian football for many decades