LIVING IN THIS BODY: HEARING THE VOICES OF WOMEN WITH DISABILITIES

This research explored factors associated with self-determination among university-educated women with physical disabilities. Autoethnography and case study methods were employed. Participants were the researcher and five other women. Semi- structured interviews were conducted and the researcher also responded to the interview questions. Interviews were transcribed verbatim and transcripts were analyzed using a content analysis procedure. Journal entries by the researcher were analyzed as part of the autoethnographic data. Themes from the researcher data were compared to themes from the participant data at four levels: identical themes, similar themes, overlapping themes and unique theme. Themes were also compared to available literature concerning the experiences ofpeople with disabilities. Implications for educators and counsellors were presented

Older people’s use of mobility aids in the built environment

The world population is ageing, by both number and share of older people (WHO 2013), leading to ageing issues being increasingly discussed within transport and mobility fields (Murray 2016; Schwanen & Paez, 2010). As those over 70 are the group most likely to have mobility and accessibility issues, there is a need to look at the wider relationship between mobility and ageing in relation to health and well-being (Musselwhite 2016). The social model of disability and resulting accessibility legislation has heralded a great deal of improvement for the inclusion of those with disabilities, but there seems to be little attention paid to emotional or psychological needs of people with physical impairments (Oliver, 2013), or disability and mobility aid use by older people (Jönson & Taghizadeh Larsson, 2009; Minkler & Fadem, 2002; Phillips, Ajrouch, & Hillcoat-Nallétamby, 2010; Raymond, Grenier, & Hanley, 2014). From the perspective of mobility aid provision, outcomes are measured in terms of independence for user, without considering the impact of this functionality on mobility aid user or carer, family or social life (Hammel et al, 2013). This study has taken an ethnographic grounded theory approach using observation, sound recording, photography, storytelling and discussion as methods for data collection. People who use mobility aids (n=11) were recruited to give accounts of mobility aid use during daily routine activities, along with the accounts of some of their family members and carers (n=6). Constant comparative analysis through coding and revisiting the field on an iterative basis was employed to describe and begin to understand mobility aid use by older people in the built environment. A complex and interlinking array of experiences and obstacles to inclusion was found for this group of people on individual, relational and infrastructural levels, with themes of identity, relationships and infrastructure and interlinking systems emerging from the data. The findings contribute information regarding a complex relationship between mobility aid use and ageing. The impact of reduced mobility and mobility aid use on identity and relationships is exacerbated by ineffective or inconsistent policies and systems. Social, psychological, emotional and physical costs of unequal access are being met by older mobility aid users and their carers. The implications of these findings are that this area requires more attention from both research and policy and planning arenas to ensure older people who use mobility aids are appropriately accommodated in the built environment. Policy and planning are found to not consistently provide a cohesively supportive environment for older people who use mobility aids to effectively participate socially

Work and care in double front carer families. A qualitative comparison of care arrangements in Finland, France, Italy, Portugal and the UK

The first main result of our research is that in double front carer families the emphasis is on the elder care, whereas the care of children is in general described as less problematic and more "natural". Not only does this latter one seem to involve less fatigue and stress but also, it has been presented as a resource to recover from the main burden of eldercare. These results are grounded in our data. They do not derive from a bias in the interviews but do really express the views of the carers.European Commissio

Patch Life: Army Wives Behind the Wire

In 2014, one hundred and eighty-four female civilian women moved overseas with the British Army for a tour lasting three years. Known by the collective ‘Army Wives’ and ‘Dependents,’ these women faced multiple dislocations as they sought to make a life for themselves, bounded by British military jurisdiction in a South-Eastern corner of the European Union. Using a free association qualitative interview methodology, twenty-nine women married to serving soldiers and officers of the British Army were interviewed during a six-month fieldwork period at an overseas British military garrison. In addition to their individual narratives, this thesis draws on participant observation and field diary extracts and, based on a range of sociological and feminist theories, it reveals these women’s negotiation of, and reflections upon, their time as incorporated overseas army wives. Attuned to the wives’ voices, Patch Life, Army Wives Behind the Wire accompanies them as they learn the complex unwritten rules of the overseas garrison, becoming physically and ontologically bounded into the hierarchical and patriarchal system of their husbands’ employer. It explores how women become incorporated and institutionalised, investigating how they negotiate and experience their associated positioning within and parallel to the ranked boundaries of the overseas military garrison. It considers what shapes and governs and influences their incorporation (or not) into their military marriage. This thesis probes how these women (re)create their identity within the socio-spaces of the garrison through the bonds of friendship and community living in a geographically remote location. Lying at the heart of this research is how these civilian women respond to their socially constructed appellation of ‘army wife’, whether they embraced its traditions and expectations or, if in their refutation, they were able to find an alternative sense of self located for three years overseas living a patch life behind the wire

Sustainability and Perceptions of Fair Water Resources Management: a case study of the Lark Valley, Suffolk

As socially and naturally imposed limits place water resources under greater pressure, the frequency of resource disputes will intensify. The emerging regulatory challenge is to mediate competing claims to water while taking account of conflicting decision criteria within the sustainability discourse. This thesis set out to explore the extent to which the objectives of sustainable and just water resource management strategies can be informed by an understanding of different perceptions of fairness among water abstractors, other interests groups and the environmental regulator. The normative dimensions of resource problems and solutions are underrepresented in the literature on water resources management and most work on equity and water operates with a predetermined position regarding the meaning of equitable allocation and management. There exists, therefore, a need for an understanding of local fairness norms for water, and fairness judgements held by stakeholders themselves. The main objective of the research was thus to determine what is fair water resources management, and to what extent are perceptions of fairness important in advancing sustainable water resources management? A qualitative and quantitative stakeholder analysis and catchment case study were employed to map competing claims on water in a small, rural water stressed catchment in East Anglia. The empirical study is contextualised in the drought events, regulatory change and new discourses influencing water management of 1989-1995. Analysis of attitudes to the regulator and to management strategies and support for different principles of water justice reveals the differing views of fair water management and expectations for water regulation which frame conflict and cooperation in the catchment. The thesis shows that as the environment has become a major player in water resource management: the notion of fairness as 'balance' (implicit in the regulation of water abstraction) has become contested, and the expectations for regulation more diverse

Developing a measure of informed choice in cancer screening

The principle of informed choice has recently become incorporated into cancer screening policy. However, there has been limited empirical or theoretical work on informed choice in this particular context. The main aim of this thesis is to develop an instrument/approach that could be used to measure informed choice in both research and service settings. The principal research question is, 'What are the key domains of informed choice in cancer screening, and how best can they be measured?'Systematic reviews were undertaken to identify the relevant qualitative and quantitative studies. A qualitative study (nine focus groups and 15 individual interviews) was undertaken with people who had different experiences of screening (for breast, cervical or colorectal cancer). The purpose of the study was to identify the key domains of informed choice. Data from the qualitative study were used to define the items in the questionnaire. The questionnaire was piloted initially by sending it to a sample of 150 screening invitees and 54 replied (36%). It was then further refined and sent to 1292 people who had been invited to participate in one of the three types of screening. Of these, 553 returned a completed questionnaire (43%).Findings from the systematic reviews suggested that lay people define and conceptualise informed choice differently from researchers and policy makers. These findings were substantiated in the data from the qualitative study. The study also found that information on the disease was as important to people as information on the risks and limitations of screening. However, information may have little part to play in the choices people make. It may have more impact on outcomes such as satisfaction and anxiety. Analysis of the questionnaire data found that people had limited knowledge of the risks and consequences of screening. In addition, perceived informedness was strongly predicted by attitudes rather than the knowledge of the risk and benefits. High levels of knowledge were not a predictor of the level of choice people had.The main policy reason for promoting informed choice is to enhance autonomy and to prevent people being deceived or coerced. However, this research shows that the provision of evidence-based information alone does not necessarily mean that an informed choice is made. People may not read, want, or understand the information, and, additionally, people may not be able to carry out their intended choice. For example, people may feel that they do not have the choice to refuse screening, even though they might wish to do so. Moreover, there may be personal barriers, such as physical or mental health problems and language, or organisational barriers, such as the availability of the service/intervention and access. This research identifies the complexity of the relationship between information and choice, revealing a number of reasons why the concept of 'informed choice' requires more subtle understanding in the context of cancer screening

Beyond Clinical Reduction: Levinas, the Ethics of Wonder and the Practice of Autoethnography in Community Mental Health Care

Abstract The central claim of this thesis is that wonder has the capacity to interrupt the institutional entrancement of the clinician to exert a gravitational pull on her awareness. This can “awaken” her from the normalized perspective of clinical praxis, and a clinical environment that defiles the vulnerable help seeker while contributing to the clinician’s moral disengagement or paralysis. In making this claim, our inquiry revisits many well-rehearsed ethical questions about the therapeutic relationship, the construct of mental illness and its care, the politics of power within the institution of community mental health care, and the supposed and real dangers of emotional intimacy in the clinical relationship. These questions also point uncomfortably—devastatingly—back to why and how the ethics of educated and dedicated clinicians can be diluted, for which the possible “cure” of wonder is being sought here. Wonder represents but one aspect of our ethical analysis in this interdisciplinary study. We turn in equal measure to an emerging strand of moral research, called autoethnography, and to the radical ethical vision of Emmanuel Levinas who informs our final understanding of wonder. In this inquiry, autoethnography takes the form of a short story in chapter 2 and as a series of personal epiphanic vignettes thereafter. Autoethnography affectively illuminates the theory being presented here and evokes the horrifying imperative of our ethical quest that calls for radical institutional change, albeit enigmatically. It is in Levinas’ ethical vision, however, that the clinician may discover the astonishing holiness and relationality at the heart of the clinical relationship and all this implies. This perfection, apprehended through the stunning approach of the vulnerable help seeker, extends an ethical invitation to the beleaguered clinician that she can hardly resist, but that she will almost inevitably fail to answer