'It's a delicate topic': Stigma, capabilities and young people's mental health in post-conflict Colombia.

Young people in Colombia present high rates of mental health problems, to which the country's history of armed internal conflict contributes in complex ways. Mental health services in Colombia are fragmented, inadequate, and difficult to access for many. Young people's help-seeking is often hindered by mental health stigma and/or poor experiences with services. This paper presents a thematic analysis of qualitative data from a mixed-methods study aimed at developing and testing a mental health intervention for Colombian youths. We draw upon theoretical lenses from scholarly work on stigma and Sen's 'capabilities approach' to inform our analysis of interviews and group discussions with staff and young people involved in the state-funded human capital building programme 'Jovenes en Acción' (JeA). By illustrating how study participants talked about stigma, vulnerability, mental health services organisation, and the challenges of discussing mental health topics in a learning environment, we illuminate aspects of mental health support and anti-stigma interventions that might need enhancing. In particular, we suggest that more emphasis on 'community competencies' as complementary to and interrelated with individual competencies would strengthen young people's individual and collective resources for mental wellbeing while being in line with the sociocritical principles of existing human capital-enhancing programmes.

Machine Ethics in Care: Could a Moral Avatar Enhance the Autonomy of Care-Dependent Persons?

It is a common view that artificial systems could play an important role in dealing with the shortage of caregivers due to demographic change. One argument to show that this is also in the interest of care-dependent persons is that artificial systems might significantly enhance user autonomy since they might stay longer in their homes. This argument presupposes that the artificial systems in question do not require permanent supervision and control by human caregivers. For this reason, they need the capacity for some degree of moral decision-making and agency to cope with morally relevant situations (artificial morality). Machine ethics provides the theoretical and ethical framework for artificial morality. This article scrutinizes the question how artificial moral agents that enhance user autonomy could look like. It discusses, in particular, the suggestion that they should be designed as moral avatars of their users to enhance user autonomy in a substantial sense.

The Life and Death of Freya the Walrus: Human and Wild Animal Interactions in the Anthropocene Era.

Freya the Walrus, who often climbed onto docked boats to sunbathe and frolic, was euthanized by the Norwegian Department of Fisheries in the Oslo fjord in August 2022, sparking international outrage and media attention. Since walruses are social animals, and since the Anthropocene era of climate change has displaced animals from their Arctic homes, forcing them to migrate, we can expect more human-animal interactions at such places as marinas, where Freya met her end. This paper asks and attempts to answer how we can make such interactions just going forward? In cases such as Freya's, we need to reconcile three competing interests: the animal's interest in living a flourishing life as best they can in a changing climate; the public's interest in a safe and fulfilling wildlife encounter with an animal they have come to know intimately enough to name and follow devotedly on social media; and interests in maintaining private property. Examining these interests through the philosophical lenses of co-sovereignty, capability, and individuality, however, will yield more just results for animals in similar situations of conflict and co-existence with humans in urban spaces. We argue that, going forward, state resources should be expended to safeguard the public from marina access if safety is a genuine concern, while private money should be spent by marinas to enact safe animal removal with a no-kill policy.

Human capabilities of South African parents who have children with developmental disabilities.

Background: Parenting a child with a developmental disability (DD) has a substantial influence on the lives of the parents or caregivers, as well as on how the family operates. This is frequently because of the adjustments in some daily practices that are crucial for parents' or caregivers' human capabilities to provide for childcare. There is not enough research done on human capabilities of parents or children with DD in South Africa. Objectives: This study investigated the available support in improving the human capabilities of parents or caregivers with children with DD and the bodily health and bodily integrity human capabilities of parents or caregivers with children with DD. Method: Qualitative interviews were conducted with 11 parents or caregivers of children aged between 1 and 8 years old with DD. This study used snowball sampling. Thematic data analysis was chosen to analyse the data collected. Results: The results of the study indicate that participants have difficulties bringing up their children because of the emotional strain that goes along with parenting a child with DD. In addition, participants were not able to afford decent and satisfactory shelter and had limited access to good quality food because they could not afford it. Conclusion: A lack of social support and care burden influences parents' or caregivers' ability to raise their child with developmental disability. Contribution: The study contains helpful information about families of children with DD in under-resourced locations. The information may be of significance to policymakers who are accountable for designing and executing policies that are targeted at assisting parents or caregivers of children with DD.

The economics of the wellbeing economy: Understanding heterodox economics for health-in-all-policies and co-benefits.

ISSUE ADDRESSED: The "wellbeing economy" represents a significant departure from the orthodox, neoclassical economic model of rational, utility-maximising individuals embedded in a growth economy. Emerging approaches to the wellbeing economy draw heavily upon insights from a range of heterodox schools of economic thought; these schools differ in many respects, but all share the central common insight that the economy is best conceived as a social provisioning system for humanity's needs. METHODS: This narrative review introduces and summarises key dimensions of a number of these heterodox economic approaches, all of which have had or are likely to have significant implications for wellbeing economics. Their relationship with wellbeing and their resulting approaches to public policy and the Health-in-All Policies (HiAP) approach is described and explored. RESULTS: The schools of heterodox economic thought which have had the most impact on the development of approaches to the "wellbeing economy" include ecological economics (including both post-growth and degrowth economics), feminist economics, and modern monetary theory. Recent developments in the economics of inequality and institutional economics have also been of significance. Yet HiAP approaches represent an attempt to incorporate consideration of health consequences within public policy processes inside the neoclassical economics paradigm, reflecting the reality that social and economic forces are typically the most important determinants of health. WHO's new Health For All approach draws much more directly on the heterodox economics that underpins wellbeing economy thinking. CONCLUSIONS: Wellbeing economics offers many attractive features for HiAP-but may not achieve its full potential within conventional economic policy paradigms. Calls to replace cost-benefit analysis with "co-benefit" analysis are attractive, but face strong practical obstacles. Meanwhile, strong countervailing forces and interests might still thwart achieving the broader goals of wellbeing economics. SO WHAT?: Operationalising "wellbeing economy" thinking requires a clear understanding of heterodox economics, and how they can be incorporated into more formal economic analysis. It remains to be seen if HiAP is the right tool by which to implement the new Health For All approach.

Water struggles and contested use: A capabilities assessment of household water security in marginalized communities.

In this study, we apply a capabilities approach to analyze a water consolidation project and water security outcomes following a severe drought in East Porterville, California. By combining hydro-social theory with the capabilities approach, we provide a holistic approach to household water security that is historically situated, considers residents' needs, and accounts for areas of life beyond hydration and domestic use. In addition, we offer a critical analysis of water system consolidation, a process of combining water systems physically and/or managerially as a solution to water insecurity in small towns. Drawing on interviews with residents, local experts, and government officials as well as archival research and participant observation, we find that the water consolidation project has mixed results for the East Porterville community, with beneficial, limiting, and contested effects on residents' social, cultural, and economic life. Although residents now have a consistent source of water in their homes, they find themselves limited in their ability to use water for drinking and cultural and economic purposes. Water negotiations and contestations also affected property values, independence, and livability. Through this empirical application of the capabilities approach, we demonstrate the need to expand the concept of water security and consolidation outcomes through needs-based perspectives. Furthermore, we show how the coupling of capabilities approach with a hydro-social framework provides descriptive, analytical, and explanatory tools for understanding and addressing household water security.

Anent the theoretical justification of a sex doula program.

The Human Condition is neither a well-defined nor well-described concept-nevertheless, it is generally agreed that human sexuality is a fundamental and constituent part of it. For most able-bodied persons, accessing and expressing one's sexuality is a (relatively) trouble-free process. However, many disabled persons experience difficulty in accessing their sexuality, while others experience such significant barriers that they are often precluded from sexual citizenship altogether. Recognising the barriers to the sexual citizenship of disabled persons, the concept of a Welfare-Funded Sex Doula Program has been advanced - a program specifically aimed at meeting the various (and often complex) sexual needs of disabled people. Below we show how that program can be justified within at least two different moral frameworks, the capabilities approach and liberal utilitarianism, and consider and repudiate arguments against it.

Psychometric properties of the measure of achieved capabilities in homeless services.

BACKGROUND: Purposeful participation in personally meaningful life tasks, enjoyment of positive reciprocal relationships, and opportunities to realize one's potential are growth-related aspects of a meaningful life that should be considered important dimensions of recovery from homelessness. The extent to which homeless services support individuals to achieve the capabilities they need to become who they want to be and do what they want to do is, in turn, an important indicator of their effectiveness. In this study, we developed a measure of achieved capabilities (MACHS) for use in homeless services settings, and assessed its construct and concurrent validity. METHODS: We analysed data collected from homeless services users at two time points in eight European countries to assess the factor structure and psychometric properties of the new measure. Participants were adults engaged with either Housing First (n = 245) or treatment as usual (n = 320). RESULTS: Exploratory and confirmatory factor analyses yielded a four-factor structure of the capabilities measure: community integration, optimism, safety, and self-determination. We obtained evidence for construct validity through observed correlations between achieved capabilities and recovery, working alliance and satisfaction with services. Moreover, we obtained evidence of the measure's concurrent validity from its positive association between HF and personal recovery, which was fully mediated by achieved capabilities. CONCLUSIONS: Findings demonstrate that the MACHS is a valid and reliable measure that may be used to assess the extent to which homeless services support their clients to develop capabilities needed for growth-related recovery. Implications for practice and future research directions are discussed.

Learning while earning: Barriers and pedagogies toward Sustainable Development Goal 4, "quality education" for child street-sellers in Siem Reap, Cambodia.

BACKGROUND: For children living in a village near Angkor Wat, Siem Reap, Cambodia, selling low cost goods to tourists supplements family incomes and progresses familial social and educational aspirations. However, the Cambodian Government has legislated to remove children selling on the streets in order to project a modern, orderly society. Simultaneously, the tourist campaigns of local non-governmental organisations (NGOs) discourage tourists from purchasing goods from children, based on the premise that work prevents school attendance. OBJECTIVE: To explore the lived experiences of street-selling children focusing particularly on formal and non-formal education within a human development framework and compare and contrast this to the positions of the Cambodian Government and local NGOs. PARTICIPANTS AND SETTING: The research participants comprised 22 Cambodian street-sellers aged 8-15 years in central Siem Reap, Cambodia. METHOD: Rights-based, participatory research was conducted over two periods totalling five months, between 2013 and 2015. RESULTS: The child street-sellers were initially able to work and attend school with their selling financing their schooling costs. During the research, 14 participants (64%) were forced from their selling activities and unable to pay schooling costs, subsequently left school. However, the successful child street-sellers devised strategies to continue selling, remain in school, learn English through tourist interactions and fulfil their familial and cultural obligations. CONCLUSION: Contrary to Government policy and NGO campaigns, many child streets-sellers in Siem Reap work to finance their own schooling and progress their own human development and are adversely impacted and have their rights violated when removed from the street.

Activity and participation experiences of people with disabilities in Ethiopia.

Background: Ethiopia, as a State Party to the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), has committed to upholding the rights of people with disabilities in Ethiopia. There is little evidence, however, reflecting the impact of this commitment on the lived experiences of people with disabilities in Ethiopia. Objectives: This study sought to uncover how the experiences of participation and activity shape the enactment of rights for Ethiopians with disabilities as enshrined in the UNCRPD. Method: Analysis of 25 qualitative interviews with people with disabilities and family members living in Ethiopia used a reflexive thematic analysis approach to arrive at central themes. Results: People with disabilities in Ethiopia experience marginalisation, distress and practical challenges in both routine daily activities and participation in broader social roles and opportunities. These experiences affect their ability to claim many of the rights afforded by the UNCRPD. Conclusion: Despite legislative efforts to bring about change in Ethiopia, people with disabilities continue to live on the social margins. A meaningful change will require substantial allocation of needed resources by the Ethiopian government to support national-level programmes and policy change. It is critical that people with disabilities and their families are engaged in receiving relevant support, and serve as change leaders. Contribution: This study illustrates how marginalisation, distress and practical challenges in daily activities and social participation arise and are sustained for people with disabilities in Ethiopia. The findings can help to inform the country's efforts to enact the rights of Ethiopians with disabilities as enshrined in the United Nations Convention on the Rights of Persons with Disabilities.

'In most supermarkets food does not cost £3 per day ' The impact of the school food voucher scheme during COVID-19.

Households with children eligible for Free School Meals are at risk of food insecurity. This paper reports on a rapid-response study that investigated the impact of the school food voucher scheme during the COVID-19 crisis on young people, families and schools. It pays close attention to the reliance of the state on the goodwill of society and its citizens in feeding those most in need. The Capabilities Approach is used to highlight factors that inhibited and restricted the use of the vouchers to produce the capability of having good nutrition for children in need of Free School Meals. The approach moves towards creating a society where children and young people are able to lead a life of their own choice and contribute to key policy decisions. This qualitative study funded by the British Education Research Association was conducted between September 2020 and March 2021. The study posed two research questions: (1) how have schools responded to COVID-19 in relation to food during holiday provision; and (2) what have families identified as barriers to accessing the school food voucher scheme? Data collection involved online interviews with young people, schools and organisations (i.e. public health, director from the food industry. etc.). The findings highlight the difficulties with accessing and using the school food voucher and implications for future policy directions. Owing to this being a small-scale study, it is not generalisable to the wider population but does highlight localised issues.

The "Ambassadorial" Journalist: Twitter as a Performative Platform for Ultra-Orthodox Journalists during the COVID-19 Pandemic.

Journalists can play a pivotal role in promoting a population's security amid a health crisis such as a global pandemic. This role becomes of enhanced importance for marginalized populations as they face a compounded threat due to preexisting social inequalities and exclusion. This study focuses on the utilization of Twitter by ultra-Orthodox journalists during the early months of the COVID-19 pandemic in Israel. The study applies a thematic analysis of 23,110 tweets from the 20 most popular ultra-Orthodox journalists on Twitter. Findings reveal that ultra-Orthodox journalists utilized Twitter in an "ambassadorial" role to advocate their community's security through six strategies: (1) explaining the challenges endangering ultra-Orthodox Jews during COVID-19, (2) dispelling COVID-19 accusations directed against ultra-Orthodox Jews, (3) encouraging social distancing and health guidelines, (4) highlighting the social contributions of ultra-Orthodox Jews to the general public during the pandemic, (5) criticizing wrongdoers who violated the health guidelines, and (6) calling out acts of hatred and bigotry that have been directed toward ultra-Orthodox Jews. These findings reveal the professional ethos of ultra-Orthodox journalists and their aspiration to protect their community. Furthermore, these findings shed light on the vital role Twitter can play in journalistic work through inter-social interactivity and the enablement of capabilities, particularly the capability "to be secure." Lastly, this study expands the understanding of the social media resource contributing to policymakers tasked with formulating its fair distribution in society in accordance with the capabilities approach and its objective of promoting well-being.

The Achieved Capabilities Questionnaire for Community Mental Health (ACQ-CMH): A consumer-based measure for the evaluation of community mental health interventions.

The capabilities approach offers a multidimensional, ecological, and agent-centered framework that may inspire models of intervention and evaluation. A growing number of measures grounded on the capabilities approach for outcome measurement are appearing. Regarding community mental health, new consumer-valued measures-constructed in collaboration with consumers-are here considered crucial for a transformative shift. Meanwhile, new measurements need to provide psychometric evidence to enable proper choice and application. The Achieved Capabilities Questionnaire for Community Mental Health (ACQ-CMH) was developed in collaboration with consumers of community mental health services. It aims to assess consumers' capabilities achieved through program support. The present paper shows advancements in the measure validation through a confirmatory factor analysis within a sample of community mental health consumers (N = 225). Reliability and construct-related validity were also observed. A structural solution composed of five factors and 43 items revealed a better model fit than that obtained in a previous exploratory study. Findings support the reliability, sensibility, and both convergent and discriminant validity of using the ACQ-CMH in the evaluation of community mental health interventions. The ACQ-CMH offers a consumer-valued framework with specific dimensions and indicators of capabilities for use in a routine service evaluation setting.

Socio-technical system analysis of responsible data sharing in water systems as critical infrastructure.

Attention is increasingly focused on the protection of water systems as critical infrastructure, including subsystems of supply, sanitation, hygiene, and management. Similarly increasing consideration is paid to the growing role and impact of data on water systems and management. We explore key challenges associated with data-driven water systems as critical infrastructure. First, we describe the status of water infrastructure as a part of national critical infrastructure. Second, as this infrastructure increasingly relies on the constant flow of data from a huge variety, quality, and complexity of sensors, we provide a descriptive framework to map in detail the particular expertise needed across data-driven water management, applied to the UK water infrastructure as our use case. Third, through the framework of Capabilities Approach (CA) we analyze the specific challenges of data-driven water management, and argue that the current predominant narratives in the water infrastructure discourse have difficulties to effectively convey existing and emerging challenges. Fourth, we further demonstrate the widening gap between infrastructure services and consumer goods, arguing for increased convergence of the utilization of consumer data, and developing open data ecosystems.

Activity and participation experiences of people with disabilities in Ethiopia

Ethiopia, as a State Party to the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), has committed to upholding the rights of people with disabilities in Ethiopia. There is little evidence, however, reflecting the impact of this commitment on the lived experiences of people with disabilities in Ethiopia. Objectives: This study sought to uncover how the experiences of participation and activity shape the enactment of rights for Ethiopians with disabilities as enshrined in the UNCRPD. Method: Analysis of 25 qualitative interviews with people with disabilities and family members living in Ethiopia used a reflexive thematic analysis approach to arrive at central themes. Results: People with disabilities in Ethiopia experience marginalization, distress and practical challenges in both routine daily activities and participation in broader social roles and opportunities. These experiences affect their ability to claim many of the rights afforded by the UNCRPD. Conclusion: Despite legislative efforts to bring about change in Ethiopia, people with disabilities continue to live on the social margins. A meaningful change will require substantial allocation of needed resources by the Ethiopian government to support national-level programs and policy change. It is critical that people with disabilities and their families are engaged in receiving relevant support and serve as change leaders. Contribution: This study illustrates how marginalization, distress and practical challenges in daily activities and social participation arise and are sustained for people with disabilities in Ethiopia. The findings can help to inform the country's efforts to enact the rights of Ethiopians with disabilities as enshrined in the United Nations Convention on the Rights of Persons with Disabilities

Activity and participation experiences of people with disabilities in Ethiopia

Ethiopia, as a State Party to the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), has committed to upholding the rights of people with disabilities in Ethiopia. There is little evidence, however, reflecting the impact of this commitment on the lived experiences of people with disabilities in Ethiopia. Objectives: This study sought to uncover how the experiences of participation and activity shape the enactment of rights for Ethiopians with disabilities as enshrined in the UNCRPD. Method: Analysis of 25 qualitative interviews with people with disabilities and family members living in Ethiopia used a reflexive thematic analysis approach to arrive at central themes. Results: People with disabilities in Ethiopia experience marginalisation, distress and practical challenges in both routine daily activities and participation in broader social roles and opportunities. These experiences affect their ability to claim many of the rights afforded by the UNCRPD. Conclusion: Despite legislative efforts to bring about change in Ethiopia, people with disabilities continue to live on the social margins. A meaningful change will require substantial allocation of needed resources by the Ethiopian government to support national-level programmes and policy change. It is critical that people with disabilities and their families are engaged in receiving relevant support and serve as change leaders. Contribution: This study illustrates how marginalisation, distress and practical challenges in daily activities and social participation arise and are sustained for people with disabilities in Ethiopia. The findings can help to inform the country's efforts to enact the rights of Ethiopians with disabilities as enshrined in the United Nations Convention on the Rights of Persons with Disabilities

Aligning Patient's Ideas of a Good Life with Medically Indicated Therapies in Geriatric Rehabilitation Using Smart Sensors.

New technologies such as smart sensors improve rehabilitation processes and thereby increase older adults' capabilities to participate in social life, leading to direct physical and mental health benefits. Wearable smart sensors for home use have the additional advantage of monitoring day-to-day activities and thereby identifying rehabilitation progress and needs. However, identifying and selecting rehabilitation priorities is ethically challenging because physicians, therapists, and caregivers may impose their own personal values leading to paternalism. Therefore, we develop a discussion template consisting of a series of adaptable questions for the patient-physician encounter based on the capability approach. The goal is to improve geriatric rehabilitation and thereby increase participation in social life and well-being. To achieve this goal, we first analyzed what is considered important for participation on basis of the capability approach, human rights, and ethics of care. Second, we conducted an ethical analysis of each of the four identified dimensions of participation: political, economic, socio-cultural, and care. To improve compliance with rehabilitation measures, health professionals must align rehabilitation measures in an open dialogue with the patient's aspiration for participation in each dimension. A discussion template based on the capability approach allows for a proactive approach in patient information and stimulates a critical assessment of treatment alternatives while reducing the risk of imposing personal values.

Education of students with intellectual disabilities at Technical Vocational Education and Training institutions in Botswana: Inclusion or exclusion?

BACKGROUND: Despite a commitment to achieving inclusion for all by the Botswana government, the enrolment of students with disabilities in Botswana's Technical and Vocational Education and Training (TVET) institutions is still fraught with confusion as reflected by its practice and implementation. Exclusionary rather than inclusive practices remain prevalent. OBJECTIVE: This study explores students with mild intellectual disabilities' experiences of inclusion or exclusion in TVET institutions using key concepts of the Capability Approach. METHOD: A phenomenological interpretive qualitative design was adopted. One government, technical vocational institution, offering programmes for students with disabilities in Botswana was conveniently selected. Fourteen students were purposefully selected from this institution based on the criterion that they were students with mild intellectual disabilities. Individual interviews served as the data collection method to enable participants to voice their experiences of inclusion or exclusion at the TVET institution. Thematic content analysis was utilised to analyse the data. RESULTS: It was found that whilst students with mild intellectual disabilities are offered an opportunity to enrol at TVET institutions, they are faced with social and epistemological exclusion, deliberate marginalisation, labelling and emotional abuses. CONCLUSION: These negative experiences hinder students' achievement by limiting their capabilities.

One slope does not fit all: longitudinal trajectories of quality of life in older adulthood.

PURPOSE: Maintaining or improving quality of life (QoL) in later life has become a major policy objective. Yet we currently know little about how QoL develops at older ages. The few studies that have modelled QoL change across time for older adults have used 'averaged' trajectories. However, this ignores the variations in the way QoL develops between groups of older adults. METHODS: We took a theoretically informed 'capabilities approach' to measuring QoL. We used four waves of data, covering 6 years, from the New Zealand Health, Work and Retirement Study (NZHWR) (N = 3223) to explore whether distinct QoL trajectories existed. NZHWR is a nationally representative longitudinal study of community-dwelling adults aged 50 + in New Zealand. Growth mixture modelling was applied to identify trajectories over time and multinomial regressions were calculated to test baseline differences in demographic variables (including age, gender, ethnicity, education and economic living standards). RESULTS: We found five QoL trajectories: (1) high and stable (51.94%); (2) average and declining (22.74%); (3) low and increasing (9.62%); (4) low and declining (10.61%); (5) low and stable (5.09%). Several differences across profiles in baseline demographic factors were identified, with economic living standards differentiating between all profiles. CONCLUSIONS: The trajectory profiles demonstrate that both maintaining and even improving QoL in later life is possible. This has implications for our capacity to develop nuanced policies for diverse groups of older adults.