Employing Disability Simulations and Virtual Reality Technology to Foster Cognitive and Affective Empathy Towards Individuals With Disabilities

The chapter will begin by defining empathy and theory of mind (ToM), key constructs for showcasing the importance of simulations and immersive experiences to help typical children better understand the lived experiences of individuals with disabilities. The authors will delineate strengths and limitations associated with Autism, ADHD, Visual, Hearing and Physical Impairment. Next, the chapter will introduce Affect/Effort Theory to demonstrate how formulating positive expectancies of individuals with disabilities will be critical to interest typical children in their peers with disabilities. Moreover, the chapter will highlight the strengths, limitations and best practices for optimizing VRT and disability simulations to enhance typical children's knowledge, intentions and attitudes towards peers with disabilities. Finally, the authors will share qualitative data from a pilot disability simulation of eight children in third through sixth grade from a Camp in Liberty, NY. The results will be discussed in light of future possibilities for effective VRT-based disability simulations.

They See Me Rollin’, They Hatin’

Aubrey Graham, more commonly known as hip-hop performer Drake, presents himself as a man of contradiction—a lover and a fighter, sensitive but hard, successful but humble. Despite this subjective work, designed to present a complex embodiment of an artistic and financial success, the discourse of Graham online is often underpinned by suspicion and derision that seeks to redefine him as a pretender who is unworthy of the status he claims. Nowhere is this more evident than in the “Wheelchair Drake” memetic cluster, which uses an old Degrassi: The Next Generation promotional image of Graham sitting on a wheelchair, combined with humorous juxtaposition of rap lyrics, to critique Graham’s status as both a performer and a Black man. In various Wheelchair Drake memes, physical impairment becomes a living metaphor for a spoiled identity; the memes argue that, just like ableist imaginations of physically disabled people, Graham is doomed to a life of impotence and dependency. Built upon a sample of 583 user-generated images, coded into 9 thematic groups, this article excavates the latticed discourses of masculinity, disability and race that animate the Wheelchair Drake meme and consider the ways that this memetic cluster subjects Aubrey Graham to the strictures of ableist hegemonic masculinity.

Toward a Multidimensional Understanding of Later Life Disability: A Latent Profile Analysis

Disability is difficult to define succinctly. Current literature on disability has primarily focused on physical functional limitations. However, relying on a single dimension or index cannot accurately represent disability as the experience of disability is nuanced and complex. To address these gaps, this study aims to understand the multidimensional nature of disability among retired, community-dwelling older adults. Using a sample of 414 older adults between the ages of 72 and 106 years (M=84.84, SD=4.56), latent profile analysis was employed to identify classes based on five indicators of disability across three domains. The five indicators of disability included difficulties with activities of daily living (ADLs), cognitive impairment, physical impairment, sensory impairment, and participation restrictions. Three classes were found to represent the data best. The most favorable and highly functioning group comprised the highest number of participants (n=242, 59.5%). The next group, class 2 (n=157, 37.9%), was characterized by high physical impairment and ADL-difficulty. The smallest group, class 3 (n=15, 3.6%), had the highest ADL-difficulty and participation restrictions but drastically lower cognitive and sensory impairment. Multinomial logistic regression revealed that class membership was related to sociodemographic characteristics. Finally, class membership predicted several mental health outcomes such as depressive symptoms, positive affect, and life satisfaction in the expected direction. If supported by future work, these findings could inform practitioners in developing more specific interventions relevant to older adults based on their disability profiles. Understanding various combinations of disablement has potential implications for services and interventions to be tailored to individuals’ distinct disability-related needs.

Persisting neuroendocrine abnormalities and their association with physical impairment 5 years after critical illness

Background Critical illness is hallmarked by neuroendocrine alterations throughout ICU stay. We investigated whether the neuroendocrine axes recover after ICU discharge and whether any residual abnormalities associate with physical functional impairments assessed 5 years after critical illness. Methods In this preplanned secondary analysis of the EPaNIC randomized controlled trial, we compared serum concentrations of hormones and binding proteins of the thyroid axis, the somatotropic axis and the adrenal axis in 436 adult patients who participated in the prospective 5-year clinical follow-up and who provided a blood sample with those in 50 demographically matched controls. We investigated independent associations between any long-term hormonal abnormalities and physical functional impairments (handgrip strength, 6-min walk distance, and physical health-related quality-of-life) with use of multivariable linear regression analyses. Results At 5-year follow-up, patients and controls had comparable serum concentrations of thyroid-stimulating hormone, thyroxine (T4), triiodothyronine (T3) and thyroxine-binding globulin, whereas patients had higher reverse T3 (rT3, p = 0.0002) and lower T3/rT3 (p = 0.0012) than controls. Patients had comparable concentrations of growth hormone, insulin-like growth factor-I (IGF-I) and IGF-binding protein 1 (IGFBP1), but higher IGFBP3 (p = 0.030) than controls. Total and free cortisol, cortisol-binding globulin and albumin concentrations were comparable for patients and controls. A lower T3/rT3 was independently associated with lower handgrip strength and shorter 6-min walk distance (p ≤ 0.036), and a higher IGFBP3 was independently associated with higher handgrip strength (p = 0.031). Conclusions Five years after ICU admission, most hormones and binding proteins of the thyroid, somatotropic and adrenal axes had recovered. The residual long-term abnormality within the thyroid axis was identified as risk factor for long-term physical impairment, whereas that within the somatotropic axis may be a compensatory protective response. Whether targeting of the residual abnormality in the thyroid axis may improve long-term physical outcome of the patients remains to be investigated. Trial registration ClinicalTrials.gov: NCT00512122, registered on July 31, 2007 (https://www.clinicaltrials.gov/ct2/show/NCT00512122). Graphical Abstract

How Should Self-Esteem Be Considered in Cancer Patients?

Numerous studies showed that cancer significantly increases the risk of developing depressive and anxious symptoms. It has been shown that self-esteem is an important psychological resource and is associated with many health behaviors. Furthermore, the vulnerability model of low self-esteem, which has received strong empirical support, highlights that low self-esteem is a real risk factor in the development of depressive disorders. This article aims at providing an overview of the involvement of self-esteem in the psychological adjustment to cancer. After briefly reviewing the literature, we suggest that its implication in the development of depressive disorders and its association with coping strategies and social support in cancer patients justify the consideration of self-esteem in oncology psychological care, especially in young adult patients and those with significant physical impairment following treatment.

Long-term pain relief after groin hernia repair for sports groin: A nationwide cohort study

Background: The groin is a complex anatomical area with multiple structures that can be injured and cause pain. One condition with groin pain is the so-called “sports groin,” which can be treated with a groin hernia repair even though no hernia is present. The aim of this study was to assess the prevalence of chronic groin pain several years after a groin hernia repair performed in patients with a sports groin. Methods: This nationwide cohort study included adults who had a groin hernia repair for a sports groin through the years 1998–2011. The patients were identified through the Danish Hernia Database and in surgical records. Patients were asked to fill out four questionnaires several years after the repair: a visual analogue scale, the Activity Assessment Scale, the Inguinal Pain Questionnaire, and a questionnaire about treatment satisfaction. Results: Of 118 contacted patients, 71 gave informed consent and were included in the study (60%), and of these the response rate was 100%. The questionnaires were filled out median 14 years after surgery. Most of the patients were pain-free in the operated groin (87%), and only a few had physical impairment caused by groin pain (20%). Prior to surgery, 79% had groin pain that they could not ignore. Overall, 90% of the patients were satisfied with the treatment. Conclusions: Most patients were pain-free and without physical impairment several years after groin hernia repair for a sports groin and with high satisfaction rate.

Embodied difference in manhood : A sociological analysis of the intersection of visible physical impairments and manhood among Xhosa men in the Eastern Cape

In this thesis, I outline possible answers to the question of what it means to be a Xhosa man living with a visible physical impairment. Drawing on 17 one-on-one in-depth interviews and through an interpretive phenomenological thematic analysis, this thesis explores the intersection of physical disabilities and manhood masculinity in Xhosa men in selected rural areas in the Eastern Cape, South Africa. The intention for this study is to better our understanding concerning the creation, negotiation, maintenance, and recreation of manhood identities by traditionally circumcised Xhosa men in the Eastern Cape who by birth, accident, or illness find themselves at the intersections of masculinity and physical disability. Research notes that the bodies of men with disabilities serve as a continual reminder that they are at odds with the expectations of the dominant manhood cultures. The main argument from this area of research is that men with disabilities are outside the hegemony because they undermine the normative role and shape of the body in Western cultures. However, this line of argumentation stands in sharp contrast to arguments that the hegemony in Xhosa manhood masculinity is primarily and conclusively achieved by having a traditionally circumcised penis without any consideration of the full embodiments of men. Therefore, this study, in the first instance, seeks to bring embodiment into the analyses of manhood by focusing on physical disability amongst traditionally circumcised Xhosa men. Through an embodied theoretical approach to their disabilities that accounts for the corporeal experience of impairment, and theories of masculinity that centre the context, this thesis establishes, in the first instance, the significance of embodiment in doing Xhosa manhood. Concerning the research aims and objectives, this study sheds light on what it means to be a Xhosa man living with visible physical impairment. In this regard, the original findings are classified according to each research aims and objective, as outlined below. Concerning the first research aim, I found that the participants struggle to speak about their bodies outside of physical labour/work despite their impairments. I explain their inability to talk about their disabled bodies by looking at traditional Xhosa initiation as a grantor of equality and sameness. Secondly, I argue that there is a higher premium on social bodies rather than physical bodies in this context, thus their inability to speak about their conditions. Lastly, I make connections between the participants’ inabilities to talk about their bodies and the lasting impact of colonial and apartheid histories. Concerning the second research aim, I explore ways and strategies they employ to respond to and negotiate Xhosa manhood masculinity's dominant cultural demands. In this regard, I note that the participants who acquired their impairments after initiation consider their disability as a second initiation because they see it as having set them back to square one regarding their manhood responsibilities. In contrast, the participants who acquired their disabilities post-initiation saw initiation as a gateway to a more respectable personhood status. I also note that there is an emergence of alternative Xhosa manhood masculinities. Lastly, I also found that contrary to western scholarship on disability and manhood, the participants distinguish between threatened manhood identity versus threatened status as a man. I outline how they arrive at this distinction. In terms of researching the last research aim, this thesis explores how the participants negotiate their ‘embodied difference’ in mundane everyday living. I explore their taken-for-granted routines in doing and being disabled Xhosa men every day. In this regard, this study presents original and interesting findings regarding sex and intimacy, social interactions and sociability, and everyday home living.