'Organising objects': support for legal capacity in adult safeguarding and Article 12 of the UN Convention on the Rights of Persons with Disabilities

This thesis explores social workers’ practice and understanding of support for the exercise of legal capacity in adult safeguarding. The impetus for this study was the ‘revolution’ of article 12 of the UN Convention on the Rights of Persons with Disabilities, which questioned fundamental and long-held legal positions on the rights of people with mental impairments to make decisions about their lives. This shift is a fundamental one, but there is very little existing empirical evidence of how such a revolutionary change in legal frameworks might actually work in practice, and what the challenges may be. Thus, this thesis aimed to empirically examine existing practice, to explore what the baseline of understanding was, and the difficulties that social workers encountered in using support mechanisms. An ethnographic approach was taken, with participant observation of an adult safeguarding team over a 17 week period, followed by interviews with 7 of the social workers who had been closely observed. The importance of this study is that the focus of the debate on article 12 has been on restoring legal capacity to individuals who had previously been denied it on the basis of their lack of mental capacity. While this is important, and is discussed in this thesis, the empirical work that forms the basis of this study demonstrates that denial of legal capacity affects a much wider group. In this context, ‘support’ may be less about supporting decisions in the particular instance, but rather supporting the individual to effect the decision that they have made, or to continue to be able to make decisions in the future. Using a theoretical framework of relational autonomy and universal vulnerability, the analysis shows that social workers the individual framing of mental capacity in the law means that they struggle accommodate the possibility of support for that mental capacity from a third party. Adults who have mental capacity but are considered ‘vulnerable’ are also significantly disempowered in the safeguarding framework. The social workers see the concept of mental capacity as overly limiting, and that vulnerable adults who are not captured by the Mental Capacity Act 2005 may still lack what this thesis terms ‘relational capacity’. A link made between vulnerability and a lack of relational capacity results in individuals being disempowered, kept as ‘objects to be organised’, rather than agentive subjects. The conclusion of this thesis is that the potential for undue influence in the exercise of support under article 12 is very possible. The data shows that we must consider carefully how we respond to this, building a universally enabling environment, rather than one which reduces agency and legal capacity

Disentangling the influence of livestock vs. farm density on livestock disease epidemics

Susceptible host density is a key factor that influences the success of invading pathogens. However, for diseases affecting livestock, there are two aspects of host density: livestock and farm density, which are seldom considered independently. Traditional approaches of simulating disease outbreaks on real‐world farm data make dissecting the relative importance of farm and livestock density difficult owing to their inherent correlation in many farming regions. We took steps to disentangle these densities and study their relative influences on epidemic size by simulating foot‐and‐mouth disease outbreaks on factorial combinations of cattle and farm populations in artificial county areas, resulting in 50 unique cattle/farm density combinations. In these simulations, increasing cattle density always resulted in larger epidemics, regardless of farm density. Alternatively, increasing farm density only led to larger epidemics in scenarios of high cattle density. We compared these results with simulations performed on real‐world farm data from the United States, where we initiated outbreaks in U.S. counties that varied in county‐level cattle density and farm density. We found a similar, but weaker relationship between cattle density and epidemic size in the U.S. simulations. We tested the sensitivity of these outcomes to variation in pathogen dispersal and farm‐level susceptibility model parameters and found that although variation in these parameters quantitatively influenced the size of the epidemic, they did not qualitatively change the relative influence of cattle vs. farm density in factorial simulations. By reducing the correlation between farm and livestock density in factorial simulations, we were able to clearly demonstrate the increase in epidemic size that occurred as farm sizes grew larger (i.e., through increasing county‐level cattle populations), across levels of farm density. These results suggest livestock production trends in many industrialized countries that concentrate livestock on fewer, but larger farms have the potential to facilitate larger livestock epidemics

Engaging Engineering Teams Through Moral Imagination: A Bottom-Up Approach for Responsible Innovation and Ethical Culture Change in Technology Companies

We propose a "Moral Imagination" methodology to facilitate a culture of responsible innovation for engineering and product teams in technology companies. Our approach has been operationalized over the past two years at Google, where we have conducted over 50 workshops with teams across the organization. We argue that our approach is a crucial complement to existing formal and informal initiatives for fostering a culture of ethical awareness, deliberation, and decision-making in technology design such as company principles, ethics and privacy review procedures, and compliance controls. We characterize some of the distinctive benefits of our methodology for the technology sector in particular.Comment: 16 pages, 1 figur

Indeterminate and discrepant rapid HIV test results in couples' HIV testing and counselling centres in Africa

<p>Abstract</p> <p>Background</p> <p>Many HIV voluntary testing and counselling centres in Africa use rapid antibody tests, in parallel or in sequence, to establish same-day HIV status. The interpretation of indeterminate or discrepant results between different rapid tests on one sample poses a challenge. We investigated the use of an algorithm using three serial rapid HIV tests in cohabiting couples to resolve unclear serostatuses.</p> <p>Methods</p> <p>Heterosexual couples visited the Rwanda Zambia HIV Research Group testing centres in Kigali, Rwanda, and Lusaka, Zambia, to assess HIV infection status. Individuals with unclear HIV rapid antibody test results (indeterminate) or discrepant results were asked to return for repeat testing to resolve HIV status. If either partner of a couple tested positive or indeterminate with the screening test, both partners were tested with a confirmatory test. Individuals with indeterminate or discrepant results were further tested with a tie-breaker and monthly retesting. HIV-RNA viral load was determined when HIV status was not resolved by follow-up rapid testing. Individuals were classified based on two of three initial tests as "Positive", "Negative" or "Other". Follow-up testing and/or HIV-RNA viral load testing determined them as "Infected", "Uninfected" or "Unresolved".</p> <p>Results</p> <p>Of 45,820 individuals tested as couples, 2.3% (4.1% of couples) had at least one discrepant or indeterminate rapid result. A total of 65% of those individuals had follow-up testing and of those individuals initially classified as "Negative" by three initial rapid tests, less than 1% were resolved as "Infected". In contrast, of those individuals with at least one discrepant or indeterminate result who were initially classified as "Positive", only 46% were resolved as "Infected", while the remainder was resolved as "Uninfected" (46%) or "Unresolved" (8%). A positive HIV serostatus of one of the partners was a strong predictor of infection in the other partner as 48% of individuals who resolved as "Infected" had an HIV-infected spouse.</p> <p>Conclusions</p> <p>In more than 45,000 individuals counselled and tested as couples, only 5% of individuals with indeterminate or discrepant rapid HIV test results were HIV infected. This represented only 0.1% of all individuals tested. Thus, algorithms using screening, confirmatory and tie-breaker rapid tests are reliable with two of three tests negative, but not when two of three tests are positive. False positive antibody tests may persist. HIV-positive partner serostatus should prompt repeat testing.</p

Engaging Engineering Teams Through Moral Imagination: A Bottom-Up Approach for Responsible Innovation and Ethical Culture Change in Technology Companies

We propose a ‘Moral Imagination’ methodology to facilitate a culture of responsible innovation for engineering and product teams in technology companies. Our approach has been operationalized over the past two years at Google, where we have conducted over 50 workshops with teams from across the organization. We argue that our approach is a crucial complement to existing formal and informal initiatives for fostering a culture of ethical awareness, deliberation, and decision-making in technology design such as company principles, ethics and privacy review procedures, and compliance controls. We characterize some distinctive benefits of our methodology for the technology sector in particular

Mixed Chamber Ensembles

Kennesaw State University School of Music presents Mixed Chamber Ensembles, 6:00 p.m. performance.https://digitalcommons.kennesaw.edu/musicprograms/1429/thumbnail.jp

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

The CTSA Consortium's Catalog of Assets for Translational and Clinical Health Research (CATCHR)

The 61 CTSA Consortium sites are home to valuable programs and infrastructure supporting translational science and all are charged with ensuring that such investments translate quickly to improved clinical care. Catalog of Assets for Translational and Clinical Health Research (CATCHR) is the Consortium's effort to collect and make available information on programs and resources to maximize efficiency and facilitate collaborations. By capturing information on a broad range of assets supporting the entire clinical and translational research spectrum, CATCHR aims to provide the necessary infrastructure and processes to establish and maintain an open‐access, searchable database of consortium resources to support multisite clinical and translational research studies. Data are collected using rigorous, defined methods, with the resulting information made visible through an integrated, searchable Web‐based tool. Additional easy‐to‐use Web tools assist resource owners in validating and updating resource information over time. In this paper, we discuss the design and scope of the project, data collection methods, current results, and future plans for development and sustainability. With increasing pressure on research programs to avoid redundancy, CATCHR aims to make available information on programs and core facilities to maximize efficient use of resources.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106893/1/cts12144.pd

A mechanistic spatio-temporal framework for modelling individual-to-individual transmission—With an application to the 2014-2015 West Africa Ebola outbreak

In recent years there has been growing availability of individual-level spatio-temporal disease data, particularly due to the use of modern communicating devices with GPS tracking functionality. These detailed data have been proven useful for inferring disease transmission to a more refined level than previously. However, there remains a lack of statistically sound frameworks to model the underlying transmission dynamic in a mechanistic manner. Such a development is particularly crucial for enabling a general epidemic predictive framework at the individual level. In this paper we propose a new statistical framework for mechanistically modelling individual-to-individual disease transmission in a landscape with heterogeneous population density. Our methodology is first tested using simulated datasets, validating our inferential machinery. The methodology is subsequently applied to data that describes a regional Ebola outbreak in Western Africa (2014-2015). Our results show that the methods are able to obtain estimates of key epidemiological parameters that are broadly consistent with the literature, while revealing a significantly shorter distance of transmission. More importantly, in contrast to existing approaches, we are able to perform a more general model prediction that takes into account the susceptible population. Finally, our results show that, given reasonable scenarios, the framework can be an effective surrogate for susceptible-explicit individual models which are often computationally challenging