Getting It: The ADA After Thirty Years

On the thirtieth anniversary of the Americans with Disabilities Act (ADA), this essay examines the vital role that attitudes have played — and will play — in the success of this pathbreaking civil rights law. Drawing on the legacy of the late disability philosopher and bioethicist Adrienne Asch, the essay argues that the law alone cannot bring about the change that’s needed in the United States to realize the ADA’s promise. Attitudes to disability need to change. More people need to “get it” with regard to disability. The essay puts forward an updated account of what it means to get it and charts a path for shaping attitudes through law and other means in the years ahead

The use of health economics in the early evaluation of regenerative medicine therapies

The aim of this thesis is to help the RM industry avoid misguidedly investing in technologies that are unlikely to be cost-effective and reimbursed by healthcare providers. Health economics provides the tools to demonstrate value for money. These tools are typically used by healthcare providers to drive demand side decisions. However, they can be used by manufacturers to inform the supply side. I propose a simple approach, termed the headroom method. This ‘back of the envelope’ calculation is based on estimates of effectiveness of the proposed treatment towards the upper end of the plausible range. The method can be used either to inform an intuitive decision to continue or abandon development, or as a screening test to decide if more elaborate models are justified. One problem I encountered was the development of technologies without clearly defining the clinical problem. In particular, the marginal gain in benefit over alternative treatments is frequently overlooked. A large part of this thesis is therefore concerned with the clinical epidemiology of the conditions at which treatment is targeted. In this way, it was found, for example, the headroom for health gain from new treatment for inguinal hernia was much smaller than that for incisional hernias.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Doctor of Philosophy

dissertationAcquiring a physical disability can be a traumatic event accompanied by a plethora of physical and psychosocial challenges. Despite these challenges, many people who have endured traumatic events also report experiences of positive psychological change, known as posttraumatic growth (PTG). This dissertation sought to understand the phenomenon of PTG amongst para sport athletes with acquired disability, and how their para sport participation may have facilitated these experiences. By conducting semistructured interviews with 14 elite paratriathletes with experiences of PTG, the first study sought to examine the relevance of theoretical tenets of the organismic valuing theory of growth through adversity (OVT) in understanding PTG. Directed content analysis revealed themes largely consistent with the main tenets of OVT. Specifically, paratriathlon participation facilitated PTG by providing experiences of social connection, competence, empowerment, and identity development. The second study sought to understand the cognitive processing that occurs in relation to a disabling life event among para sport athletes, as well as the role of para sport participation in shaping these cognitions, and subsequent perceptions of PTG or distress. Seventy-five para sport athletes completed questionnaires concerning disruption to core beliefs in the aftermath of acquiring a disability, cognitive processing, and perceptions of PTG and distress. A serial multiple mediation analysis revealed that PTG can be achieved through several unique sequences of cognitive processing. Furthermore, these indirect paths revealed the value of purposefully trying to make sense of a trauma. Informed by study 1's findings demonstrating the importance of psychological needs satisfaction and study 2's findings of the role of cognitive processing in achieving PTG, study 3 sought to examine how deliberate rumination and psychological need satisfaction interact to facilitate PTG for para sport athletes with acquired disability. Seventy para sport athletes completed a survey similar to that of study 2, with the addition of a measure assessing needs satisfaction afforded through para sport participation. Though deliberate rumination and needs satisfaction were both independently associated with PTG, moderated mediation analyses revealed that the interaction between the two constructs was not as hypothesized. Findings from the studies are discussed in terms of their theoretical and practical implications

A critical analysis of ethical consideration in environmental management: social, economic and ecological perspectives

Everyone is an environmental manager, whether they alter or maintain their personal socio-ecological space, or command the operations of a major production company or infrastructure developments. Historically the social impacts of organisation have been more insidious than the ecological impacts, but now there is much less of a definition between social and ecological impact - they are most often bound together. At the end of the 20th century, technological and 'scientific' developments, personal goals and aspirations, and a psychological separation from nature and its 'laws' means that impacts of individual or collective decisions on socio-ecological integrity have burgeoned. Gravitation towards managing and exploiting our socio-ecological environment has not been matched by a growth in our ability to predict the impacts of our actions. The greater the impact potential, the greater is the need for ethical consideration in environmental management. Yet deliberate and default benignity in actions has been eroded as fast as impact potential has grown. The fundamental belief in personal gain, and the arrogant psychological and expressed independence from our biological dependence on nature, have severed any accord between many sections of human society and the rest of nature. This dualistic outlook can be explained, especially as social and infrastructural developments reinforce destructive and divisive lifestyles, however a watershed of socio-environmental and ethical issue awareness brings with it the possibility of reinstating an accord with our surroundings. Reformist responses to calls for socio-environmental responsibility have brought about improvements, and ethical consideration is either explicit or implicit in this. But even the most prestigious responses such as environmental economics offer, at best, short term partial protection from further socio-ecological degradation, and are of questionable utility for procedural and principle based reasons. At worst they offer piecemeal, delayed, and inadequate reactions geared towards staying, questioning or denying responses and issues, or to resolving symptoms of problems and consciences. However there are several linked frameworks offering potential for the ecologisation of society, for rectifying indifference to social and environmental decay. Deep, social and transpersonal ecologies, and education from non-industrial societies, provide outlook frameworks which can assist in the reorientation of development patterns towards community organicisation and the redressing socio-ecological discord

Meissen Porcelain: Precision, Presentation, and Preservation. How Artistic and Technological Significance Influence Conservation Protocol

invention of Meissen porcelain and how these factors impact certain restoration and conservation protocol. The diversity and range of objects produced at the Meissen studio paired with the artistic genius of their design repositioned European ceramics as a superior craft form among its pottery-producing competitors. The ware\u27s enthusiastic reception amongst upper-class European society established the pieces as being highly-valued and prompted their widespread recognition. What resulted was an efflorescence of creativity, artistic and technical accomplishments, and an original aesthetic quality that initiated a new conceptual reframing of how ceramic media could be presented. Throughout the past three centuries, Meissen porcelain has continued to be coveted, collected, and exhibited. As a result, the work requires the aid of conservation science in order to preserve its cultural and material integrity.;For a body of work so steeped in precision, presentation, and material science, certain attributes that are crucial to Meissen porcelain\u27s identity must be taken into account prior to the assembly of an appropriate conservation protocol. By considering these factors, conservators, museum professionals, and historians are able to devise more informed and appropriate decisions involving the direction of a conservation route for an individual object. For the purposes of this argument, three case studies are observed: ceramic riveting, material substitution and/or object replacement, and a condition assessment of the Furstenzug mural in Dresden, Germany. All three situations present some of the most visually-intrusive and structurally-jeopardizing tactics pertaining to conservation methodologies. The historical, artistic, and technological attributes of Meissen porcelain are assessed in an attempt to devise proper treatment plans for all three case studies.;The purpose of this paper is not to discredit or undermine alternative porcelain media and the restorations applied to their framework. Instead, its objective is to bring an individuality to Meissen porcelain and the restorative processes applied in its conservation. This, in turn, contributes to and expands upon preexisting conservation methodologies involving the restoration of porcelain media. The main goal is to educate and inform art historians, museum professionals, and conservators alike about the particularities of specific clay media and the significance of their individual attributes within ceramic art

Changing Mindsets? Evolution of a Rehabilitation Programme for Chemically Dependent Male Street Adolescents in a Major Indian City.

I have worked in Mumbai supporting street boys since 1982 (full-time since 1986). This thesis began with the question, “How can we improve the educational experiences of the most vulnerable children in India?” Thus began a research journey in which I have systematically examined my practice, with my colleagues and with the vulnerable boys themselves. During the process, the operation has become more reflexive and self-sustaining. There is no magic for these boys, just a long painstaking process of support which has enabled some to turn their lives around. As a practitioner researcher, my experience has prompted me to question the thinking and the mindsets of these male street adolescents and evaluate my practice. My account connects my personal experience to the cultural, placing myself within the social context of the street adolescent (Reed-Danahay, 1997). I wish to identify effective practice, and to share and develop this with colleagues on whom the future of the work depends. The phenomenon of street youth is a visible manifestation of a disrupted political and socioeconomic society. The forces that lead growing numbers of youth to the street are numerous and complex. In developing countries, few social services exist for the youth who have lived or worked on the streets. It is important to understand not only who these youth are but also how they function, as such insights will provide a better understanding of their needs which in turn will provide them with the opportunity to be included in decision-making processes pertinent to their future as contributing members of society (Tudoric′- Ghemo, 2005). -- [excerpt taken from Introduction and Context

Defensive Realism and Chinese Maritime Strategy

The development and recent operations of the People’s Liberation Army Navy (PLAN) is one of the most pressing issues in the security structure of Asia. Discussions of both the Chinese Navy and China’s rise generally continue to be dominated by offensive realist thinking. This theory sees China as a state seeking power, and eventually hegemony, in its region. However, defensive realism is a more nuanced explanation of China’s rise and the operations of its navy. Defensive realism sees states as seeking security rather than power, valuing what they have more than what they desire. The PLAN itself was founded in 1949 and has evolved in its focus throughout its existence. First the PLAN was focused on defending against attacks from Taiwan, then defending against a possible attack by the Soviet Union. After the cementing of the US-Sino relationship towards the end of the Cold War, and the rise of Deng Xiaoping and his economic liberalisation, the PLAN lost much of its purpose and funding which had always been minimal. The Taiwan Strait crisis in 1995, along with other conflicts like the first Gulf War and the Kosovo War, reprioritised the navy and the need to defend against possible US intervention. This turn to the navy was heightened by economic, resource, energy and regime motivations. This has lead to an effort to modernise a PLAN fleet which was aging and incapable of what was now required of it. This modernisation is ongoing, and it is still to produce a navy which is an entirely modern and near the capability of other comparable forces. The development of para-military maritime forces is one of the most telling aspects of China’s maritime development. China’s navy has engaged in two operations overseas in the past decade; anti-piracy patrols in the Gulf of Aden since 2005, and assisting in the evacuation of Chinese nationals from Libya in 2012. These two operations are not indicative of a new global role, and are instead born of the unique circumstances of the two situations. More telling are the exercises that the PLAN has engaged in since 2010, these show the PLAN’s developing ability to defend territorial claims, such as the South China Sea and Taiwan. There have also been a series of incidents at sea between China and other disputant states over maritime territory. These incidents take a different shape based on the military capabilities of the other state. South Korea and Japan can monitor these areas with large militaries, and so actions by China are low key. In comparison, claimant states in the South China Sea have ships harassed, primarily by the ships of paramilitary maritime organisations. This harassment is a strategy by China to ensure a secure claim to these areas under international law by asserting jurisdiction. Such a strategy serves to defend China’s claim and prevent a negotiated settlement on anything but its own terms. Thus China’s maritime strategy is based on defensive realist principles of defending territory and ensuring security, rather than seeking power

Inclusive Inquiry. 14th Annual Research Week: Event Proceedings

Presentations of completed and ongoing research activity conducted by graduate and undergraduate students and faculty at University of the Incarnate Word. Coordinated and presented by the Office of Research and Graduate Studies