Journal articles on the topic 'Women with disabilities – Zimbabwe – Social conditions'

Women with longterm or lifelong disabilities are invisible in Australian statistics on disabilities or ageing. Current literature indicates unrecognised and untreated secondary conditions may lead to increased disability. Definitions of disability are explored for their relevance to the experience of women with disabilities and for health promotion within this group. A Victorian study included anecdotal accounts by some women with disabilities which identified both a knowledge of the wider meaning of health, and specific social issues which prevented their achievement of maximum wellbeing. Strategies are suggested for enabling women with disabilities to age more healthily.

Using a random sample of 1,876 individuals with disabilities, this study examines relationships between victimization as a result of violence, substance abuse, disability, and gender. Multivariate analyses reveal that women with disabilities are more likely to be victims of substance abuserelated violence than are male counterparts. Some disability conditions such as disability onset, multiple disabilities and chronic pain – are significantly associated with violence for both men and women with disabilities. For people with disabilities, this study finds that victims of substance abuse-related violence are more likely to have their own substance abuse problems than are those who have not been victimized. The authors discuss several issues relevant to a better understanding of violence, substance abuse, disability and gender.

Social inclusion of women with disabilities is currently an extremely complex challenge, an educational emergency, which mainly involves Special Education. The development of the international normative framework did not help the majority of women with disabilities, who are still socially underprivileged and are often victims of multi-discrimination, which is part of an extensive process of feminization of poverty.  Starting from the above mentioned daunting overview, the article aims at contributing to the debate on the need to reinforce a theoretical and methodological framework of interpretation. Such framework should be able to link the conditions of gender and disability together, thus pursuing an emancipating perspective. The article aspires to reflect on potential perspectives of social development, combining and balancing social protection elements with educational and employment opportunities through empowerment processes designed for women with disabilities. Such reflection will move its steps from the case-study on a journey of social and employment inclusion embraced by women with disabilities living in the difficult context of Gaza Strip

There is a growing literature on the conditions of Zimbabwean women working as migrant workers in South Africa, specifically in cities like Johannesburg. Based on in-depth interviews and documentary analysis, this empirical research paper contributes to scholarship examining the conditions of migrant women workers from Zimbabwe employed as precarious workers in Johannesburg by zooming in on specific causes of migration to Johannesburg, the journey undertaken by the migrant women to Johannesburg, challenges of documentation, use of networks to survive in Johannesburg, employment of the women in precarious work, and challenges in the workplace. Rape and sexual violence are threats that face the women interviewed during migration to Johannesburg and even when in Johannesburg. The police who are supposed to uphold and protect the law are often found to be perpetrators involved in various forms of violence against women. In the workplace, the women earn starvation wages and work under poor working conditions. Human rights organizations and trade unions are unable to reach the many migrant women because of the sheer volume of violations against workers’ rights and human rights.

This paper explores Tsitsi Dangarembga’s debut novel, Nervous Conditions, from a political perspective. It has been read as portraying of gender relationships, social hierarchies and oppression of African women. This paper takes a different route as it analyses the role of masculinities through a political perspective. The conflict and struggle between genders in the text can be read through a political and historical perspective. This particular reading is permitted through a close analysis of the male characters in the novel. The research argues that male characters resemble or behave in away similar to white colonizers in their treatment of African women. Reading the novel through a political perspective provides the reader with the benefit of understanding the changes that occur in the characters and the role of gender conflict in the text. The triumph of Tambu and Nyasha at the end underscores the failure of colonial power to colonize Zimbabwe.

The attitudes held by 60 students and 60 managers toward four hypothetical secretaries were investigated. Performance evaluations of the secretaries were completed also. Though women raters and raters who had worked with or supervised workers with disabilities reported more positive attitudes toward persons with diSabilities, no difference was found between evaluations of workers with and without disabilities. A social psychological model for changing racial stereotypes was modified and extended to include conditions necessary for changing stereotypes toward workers with disabilities.

Compensation is an essential benefit provided by the Department of Veterans Affairs (VA) for veterans with service connected conditions, which are illnesses or injuries incurred or aggravated during military service. The purpose of this paper is to inform beneficiaries, program administrators, policy makers, and the general public about key developments in the VA compensation program. Based on findings from publicly available data as well as recently published papers, this paper identifies key topics that have future implications for veterans receiving compensation for service connected conditions. These topics include (a) increases in the number of veterans, the combined rating for service connected conditions, and expenditures for compensation, (b) increases in the number of women veterans with service connected conditions, (c) service connected mental health conditions, (d) the use of VA health care by veterans with service connected conditions, (e) premature death in veterans with service connected conditions, and (f) veterans with a combined 100% rating. We hope these questions will be considered by all parties who value this critical program for veterans with service connected conditions.

The onset of puberty, periods and sexual relationships can be difficult for adolescents and parents. Adolescents with disabilities face a wide range of additional challenges (physical, mental, social and intellectual), which may impact the quality of their lives and those of their families and carers. Research on the use of contraception in young women with disabilities is limited, and clinicians have little practical guidance for best practice. This review article aims to summarise and assess the evidence and guidance for the use of contraception in this group, particularly with regard to management of menstrual and cyclical problems. Multidisciplinary teamwork is important for recognising and addressing the concerns of patients and their carers effectively. The legal and ethical considerations are also highlighted here, as this group of adolescents is highly vulnerable to sexual exploitation and abuse.

In the study of disability, an extremely important role is played by issues related to identity changes occurring under the influence of experiences which alter the current course of life and force the adoption of new roles and the adaptation of previously fulfilled roles. This is the nature of a disability acquired in adulthood. It is a turning point that transforms the identities of women who must redefine themselves and their places in a reality that is new to them. The main goal of the article will be to show the changes that affect the identities of women who, as a result of an accident, acquired disability in adulthood. The study is based on autobiographical narrative interviews. This method allowed me to reconstruct the trajectory of the lives of the respondents, showing the process-like nature of the identities they shape, which have undergone changes under the influence of the need to adapt to the conditions resulting from the acquired disability. Six women – diversified in terms of age, education, professional position, and family situation, all of which influenced their roles and social positions – were surveyed.

Background Non-communicable disease (NCD) risk factors can co-exist with disability and cause a greater burden on the health status of adults with disabilities. A lack of egalitarian social policies in China may result in gender disparities in the NCD risk factors of adults with disabilities. However, little is known about the gender disparities in the association between socio-demographics and NCD risk factors among adults with disabilities in China; consequently, we examined this association among adults with disabilities in Shanghai, China. Methods We used the health examination data of 44,896 adults with disabilities in Shanghai in 2014. Descriptive analyses and logistic regression models were conducted to estimate gender disparities in the association between socio-demographics, disability characteristics, and four selected NCD risk factors among adults with disabilities—including high blood pressure, high blood glucose, high blood lipids, and being overweight. We estimated marginal effects (MEs) on NCD risk factors between gender and other confounders. Results Women with disabilities were about 11.6 percentage points more likely to suffer from high blood lipids and less likely to develop the other three risk factors than men were. The association of age group, residence permit, education level, marital status, and disability type with health outcomes varied by gender among adults with disabilities. The difference in age effects between men and women was more pronounced in older age groups. Urban residence was associated with less risk of high blood pressure risk among women (ΔME = − 0.035, p < 0.01), but no significant difference in other NCD risk factors. Education remained a major protective factor against high blood pressure, high blood glucose and being overweight among women with disabilities (MEs < 0, p < 0.05); however, this did not hold for men. The difference in marriage effects between men and women was observed in high blood lipids (ΔME = − 0.048 for the married group and −0.054 for the divorced or widowed group) and overweight individuals (ΔME = − 0.091 for the married group and −0.114 for the divorced or widowed group). Women with intellectual disabilities or mental disabilities reported worse health conditions than men did. Discussion Preventive strategies and interventions on NCD risk factors for adults with disabilities should take into account gender disparities in these socio-demographic effects. Rural women or poorly educated women with disabilities can be a vulnerable population that requires more health education and promotion strategies. Health education for caregivers of women with intellectual or mental disabilities may also play a vital role in preventing their NCD risk factors.

SummaryThis essay explores how gender and generational dynamics in peasant communities in colonial Zimbabwe were reshaped between 1930 and 1965 by factors introduced by colonization. British rule brought dramatically greater market opportunities and access to new agricultural tools. Some peasants readily adopted ploughs, combining these new tools with indigenous methods of production and environmental management to increase output and market sales while developing new hybrid ways of working the land. These options allowed some young men to evade the demands of, and obligations to, their fathers, while the new methods often increased women’s workloads, exacerbating gender tensions. In the wake of World War II, Rhodesian state agricultural programmes sought to reshape African farming practices dramatically, initiatives that were justified as protecting the environment and modernizing the peasant sector. These measures permanently allocated and demarcated peasant land, imposed onerous environmental protection measures, and encouraged peasants to follow labour-intensive production methods based on European techniques. These conditions restricted young men’s access to land and imposed intense demands on women of all ages; in practice, however, these changes led to a renegotiation of gender and generational dynamics, most obviously in a wave of protests that threatened state control of the countryside.

The relevance of the research is related to the fact that the psychological safety of persons with disabilities is the leading characteristic that determines its developmental nature. The research objective was to study students’ opinions about the capabilities and abilities of citizens with disabilities and to form a tolerant attitude towards them, and hence their social and psychological safety. The research was carried out on the basis of the Voronezh State Industrial and Humanitarian College (Russian Federation), in which 1,000 people took part (among them 38% were boys and 62% were girls). Methods: survey, Spearman correlation analysis, principal component analysis, and semantic analysis. At the stage of the ascertaining experiment, the problem of the psychological safety of persons with disabilities is partially covered. The analysis of experimental data obtained from the survey showed that at the time of the survey, 51.5% of the respondents by gender (23% – men, 28.5% – women) treated persons with disabilities as ordinary, recognising their skills, dignity, and abilities. The results of the factor analysis revealed the main factor "tolerant attitude towards persons with disabilities", which does not depend on age, gender, and place of residence. As a rule, this attitude is formed as a result of communication with them. All respondents intend to "treat persons with disabilities as people with (special) needs, not with disabilities, and create all conditions for their psychological and social safety".

AbstractAimsWomen show higher frequency of most painful disorders. This is usually explained that endogenous pain modulation pathways, which affect incoming nociceptive signals, act differently in women and men, but psycho-social factors are likelytoinfluence as well. Ghanaian women suffer different disabilities that may lead to severe pain. The hard climatic conditions and the hard physical toil in work exert untold injuries. How do women in Ghana cope with painful disorders, and do they show certain behavioural pattern during diagnosis and treatments?MethodsThe study used in-depth interviews with health care providers to accomplish its aim. The “snowball effect” was added by which those interviewed aided us to find other prospective interviewee. In qualitative methodology, such an approach can be adopted to enable the researcher acquire relevant data with help from respondents.Practitioners were askedtoreflectontheir experiences from meeting women with severe pain as their patients. Seven practitioners, four female and three male, were interviewed.ResultsBy talking spontaneously about pain, women cope with painful disorders. This ensures easy diagnoses and treatments. The majority of women report their severe pain disabilities freely as against a smaller group who behave differently.The other group has explored other practitioners and have been unsuccessful. They are afraid to reveal their situations openly. Others test the skills of the practitioners whether they could perform efficient diagnoses. This strengthens patients’ faith and ability to be cured. In behavioural terms, inability to report severe pain stem from comorbid depressive symptoms (timidity-shyness, over-worried/confusion, distraction), lack of trust-expectant faith, thought of practitioner’s omniscient power, threat of practitioner’s knowledge (patient’s wrongs and evil thoughts), religious affiliation-constraints, etc. Women cope and show more positive attitudes than men; they expect practitioners to be in careful control.ConclusionsGhanaian women deal with their severe pains in meaningful manner by talking spontaneously about them. They show their willingness to be helped during diagnosis. Only few patients are not spontaneous, and are due to the condition of the mind and uncertainty with previous treatment encounters.

Gender threat triggers compensatory mechanisms and motivation to restore and reaffirm gender identity. The aim of the present research is to verify whether gender threat will influence social distance toward homosexual people, refugees, and disabled people. It was predicted that men in gender threat conditions would manifest higher social distance toward groups when compared with the control condition. Due to the exploratory nature of the study, no hypotheses were formulated for women. Sixty-six individuals (30 men and 36 women) aged from 18 to 24 participated in the experiment. After completing the Masculinity and Femininity Scale, participants in the gender threat condition found out that they possess high levels of feminine attributes (men) or high levels of masculine traits (women). Participants in the control group did not receive feedback about the levels of their femininity and masculinity.The analyses showed that both men and women, after receiving the information that their psychological gender was incompatible with their biological sex, declared stronger social distance and colder feelings toward the majority of the groups, including people with disabilities. At the same time, women, regardless of the research condition, declared warmer feelings toward these groups than men. The results of the study indicate that gender threat may be a potential mechanism which explains prejudices toward other groups. However, the results obtained among females require replication in future studies.

Abstract Objectives This qualitative study explored risk and protective factors affecting employment and health among low-income older women with chronic health conditions or physical disabilities. Methods The authors conducted a secondary data analysis of 14 intensive interviews with low-income older women with chronic health conditions who had participated in a federally funded training and employment program for workers aged 55 and older. Qualitative data were analyzed using thematic analysis. Results The physical nature of the work and discrimination were risk factors, with unaccommodating work environments, ageism, and/or ableism, and internalized ageism identified as subthemes of discrimination. Protective factors, namely institutional supports (e.g., access to retraining, time management flexibility) enhanced health and self-confidence. Occupational demands matched with the capacity of the individual resulted in continued employment and improved health. Discussion Working conditions can degrade health through exposure to mental and physical health risks, or support health through access to financial and interpersonal resources. Institutional supports such as workplace flexibility and retraining are crucial to obtaining a good fit between occupational demands and the capacity of individuals, enabling a positive relationship between employment and health. Legislation designed to prevent discrimination, enhance opportunities for lifelong learning, and encourage flexible work arrangements among low-income women with chronic health conditions may facilitate healthier working lives.

Sexuality represents one of the basic dimensions of human existence, which is channelled through sexual and gender identification and role, sexual orientation, eroticism, emotional commitment, satisfaction, and reproduction. Sexuality is also linked to many significant health problems, especially in the area of reproductive and sexual health. Sexual health is the condition of physical, emotional, mental, and social wellbeing that is linked with sexuality. Knowledge about sexual health, contraception and selection of contraceptives, and the risk of sexually transmittable diseases is not only relevant for individuals? sexuality; it?s also important for encouraging the use of health services and other forms of support that are necessary to protect youth from sexually transmittable diseases and the maintenance of sexual and re-productive health. When it comes to sexuality and care of reproductive and sexual health, some groups are especially vulnerable. Bearing in mind the specific conditions women with disabilities grow up in and their dependence on assistance and support from other people, satisfying their needs for partnership, sexuality, and parenthood becomes unattainable for many, or it takes place under the control of professionals or family members. In this context, people with visual impairments are part of a vulnerable group, acknowledging that visual impairment leads to limitations in everyday life, autonomy, and quality of life to its full potential. The purpose of this article is to describe the phenomena of sexuality and sexual health among people with visual impairments, and to point out the existing international and national normative frameworks relevant to the sexual health of people with disabilities. Existing legislative acts acknowledge the right to a normal sexual life, as well as to the care and maintenance of the sexual health of people with disabilities. However, there are many obstacles and limitations that hamper the practical application of these rights: health issues, communication problems, lack of privacy, people?s acceptance of the inhibition of their own sexuality, or their acceptance of the labelling and normalisation of their situation. Even considering the existence of the regulation, the system of support for maintaining and improving the sexual and reproductive health of women with disabilities is not developed enough. The lack of literature relating to this topic shows that its importance is not recognised enough among the relevant actors, including organisations that advocate for people with disabilities. Realising the existing general legal framework requires the will of policymakers, who could enact and implement specific bylaw regulations, as well as activating the societal actors relevant to this field.

A perusal of the criminal laws and personal laws reveal that laws adopt a protectionist and paternalistic approach for empowering and providing autonomy to women. This paper initiates a discussion on issues at the core of gender justice. It questions the man-woman dichotomy and asserts that if men and women are fundamentally different as categories, then a single yardstick for measuring justice is wrong. And, if they are not class wise different, and evince only personal traits, then the whole idea of gender justice based on the dichotomy is flawed. This paper further argues that social conditioning restricts the possibility of autonomous decisions. In conclusion, it is argued that laws need to create just social conditions and institutions that guarantee freedom from socially imposed disabilities, and subsequently, strengthen autonomy in decision making.

ObjectivesTo investigate the prevalence of multimorbidity in adults with intellectual disabilities with and without Down syndrome.DesignLarge, population-based cross-sectional study.SettingThe geographical area of one Health Board, Scotland.ParticipantsAll adults (aged 16+ years) known to general practitioners to have intellectual disabilities and adults receiving services provided or paid by intellectual disabilities health or social work services. 1023/1562 potential participants took part (65.5%); 562 (54.9%) men and 461 (45.1%) women, aged 43.9 years (16–83 years). 186 had Down syndrome and 837 did not.Main outcome measuresThe prevalence of International Statistical Classification of Diseases, 10th revision, physical health conditions and multimorbidity detected at a comprehensive health assessment.ResultsThe mean number of physical health conditions/participant was 11.04, and 98.7% had multimorbidity. The most prevalent conditions are painful and/or disabling and, in some cases, life threatening. The five most prevalent were visual impairment, obesity, epilepsy, constipation and ataxic/gait disorders. The pattern of multimorbidity differs from that seen in the general population and is spread across the entire adult life course. The extent of multimorbidity in the adults with Down syndrome was similar to that of the adults without Down syndrome, while the prevalence of individual conditions differed.ConclusionsThis robustly designed study with a large population found an extremely high prevalence of multimorbidity in adults with intellectual disabilities across the entire adult life course. This increases complexity of medical management that secondary healthcare services and medical education are not yet geared towards, as these tend to focus on single conditions. This is in addition to complexity due to limitations in communication and understanding. As the physical conditions within their multimorbidity also differ from that seen in the older general population, urgent attention is needed to develop the care pathways and guidelines that are required to inform and so improve their healthcare.

Introduction: Community Based Rehabilitation (CBR) is a strategy within community development for rehabilitation, equalizes opportunities and social integration of incapacitated people. This is a comprehensivestrategy of involving people with disabilities in their communities through the development program. CBR system provides for the people with disabilities equal access to treatment and rehabilitation, education, promotes health and healthy living, and also indicates the existence of other features that make these people become full members of society and the community in which they live and is currently used in over 90 countries around the world.Methods: Research was conducted in two CBRs (CBR-Kumrovec and CBR-Saraj Polje) in the department of physical medicine and rehabilitation in the Sarajevo Canton. The study included and statistically treated 97patients during the period from 01.01.2008 to 31.12.2008 year.Results: In a study from the total number of respondents 65% were women, 35% male respondents, and the most represented were respondents of age group from 71-80 years - 40%. Of all diseases, the most represented were respondents with ICV, 43%.Conclusion: This type of treatment in the home conditions is providing necessary medical rehabilitation services by qualified physical therapists through a sufficiently long period for successful medical rehabilitation inthe natural environment of patients (home conditions), and the presence of family members who we can also educate for the enforcement of basic physical procedures and instruct them on the condition of the patientand his perspective.

Greater numbers of persons will enter retirement outside of marriage or with a checkered marital history. Given the traditional health benefits of marriage, these changes in the population's marital life course may foretell changing demands for eldercare in addition to adverse health consequences. Here, the authors provide new evidence on the specific aspects of health associated with marriage for a nationally representative survey of retirement age adults. An important aspect of the authors' analysis is the assessment of whether the benefits of marriage hold equally for women and men, major race/ethnic groups, and persons with different marital histories. Data from the Health and Retirement Survey are used to evaluate how marriage is associated with major chronic illnesses, functional limitations, and disability. Findings document that marriage benefits health across a broad spectrum of fatal and nonfatal chronic disease conditions, functioning problems, and disabilities. Moreover, benefits of marriage are widely shared across demographic groups.

HIV and AIDS is an urgent housing and human settlements issue, especially among women and children living in poverty and suffering from poor housing conditions in urban slums in the South. The link between poverty and HIV prevalence is well established, and the fact that inadequate shelter increases the vulnerability of the urban poor to HIV and AIDS is increasingly recognised. Since 2003, Rooftops Canada and their partners in Kenya, Tanzania, Cameroon, Zimbabwe, South Africa, and more recently Uganda, have been working on strategies and developing programmes to respond to the AIDS crisis in these countries. Related programmes link shelter to poverty reduction through sustainable economic and social development, environmental protection, respect for human rights, democratisation and gender equality. This paper compiles the experiences of the partner housing organisations and resource groups in Sub-Saharan Africa responding to HIV and AIDS among their constituent stakeholders. The community-based responses focus on promoting social sustainability, enhancing operational capacity and improving financial sustainability. Community-based responses relate to issues of stigma and discrimination, reducing the impact of housing rights violations and responding to the specific vulnerability of children, women and youth. Social sustainability deals with the impact of HIV and AIDS on the social viability of communities. Operational capacity analyses housing groups' responses to the organ-isational impact of HIV and AIDS - including loss of staff, leadership and institutional memory, decreased productivity and capacity - and the experience of including HIV and AIDS within the core organisational mandate. Financial sustainability explores the challenges of reconciling related financial and social goals.

Turner Syndrome (TS) is a sex chromosome aneuploidy (45,X) associated with social skill difficulties. Recent clinical care guidelines recommend that the Program for the Education and Enrichment of Relational Skills (PEERS) social skills intervention programme be trialled in this population. PEERS has been successfully used in adolescents with autism spectrum conditions without intellectual disabilities. The PEERS program will be piloted with adolescents and young women with TS aged 16-20 using an uncontrolled study trial with a multiple-case series design. The program will be delivered face to face and online. The assessment battery is designed to measure social skills comprehensively from diverse informants (parent, teacher young person). It includes measures of social performance, social knowledge and social cognition. Parents and young people taking part in the intervention will also feedback on the acceptability and feasibility of the pilot. The outcomes of this small scale pilot (n=6-10) will be used to adapt the programme based on feedback and estimate the sample for a future randomised controlled trial.

Turner Syndrome (TS) is a sex chromosome aneuploidy (45,X) associated with social skill difficulties. Recent clinical care guidelines recommend that the Program for the Education and Enrichment of Relational Skills (PEERS) social skills intervention programme be trialled in this population. PEERS has been successfully used in adolescents with autism spectrum conditions without intellectual disabilities. The PEERS program will be piloted with adolescents and young women with TS aged 16-20 using an uncontrolled study trial with a multiple-case series design. The program will be delivered face to face and online. The assessment battery is designed to measure social skills comprehensively from diverse informants (parent, teacher young person). It includes measures of social performance, social knowledge and social cognition. Parents and young people taking part in the intervention will also feedback on the acceptability and feasibility of the pilot. The outcomes of this small scale pilot (n=6-10) will be used to adapt the programme based on feedback and estimate the sample for a future randomised controlled trial.

IntroductionSexual impulsivity (SI) has been associated with conditions that have substantial public health costs, such as sexually transmitted infections and unintended pregnancies. However, SI has not been examined systematically with respect to its relationships to psychopathology. The literature regarding associations between SI and history of different types of trauma also scarce.AimsWe aimed to deepen the understanding of the roots of SI, both through the prism of history of trauma and through the prism of psychopathology as an explanation for SI.ObjectivesWe intended to investigate associations between SI and psychopathology, and between SI and personal history of trauma of different types, including gender-related differences.MethodsWe performed a secondary data analysis of Wave-2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a national sample of 34,653 adults in the United States. DSM-IV based diagnoses of mood; anxiety, drug and personality disorders were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Scheduled DSM-IV Version.ResultsFor both women and men, SI was positively associated with most Axis-I and Axis-II psychiatric disorders. Significant gender-related differences (GRD) were observed. Among women as compared to men, SI was more strongly associated with social phobia, alcohol abuse/dependence and most personality disorders. As for trauma, SI was positively associated with any trauma for both women and men. Among women as compared to men, SI was more strongly associated with sexual assault and kidnapping.Disclosure of interestThe authors have not supplied their declaration of competing interest.

This study examines the seventy-five suicide cases Dr. Jack Kevorkian acknowledged assisting during the period between 1990 and 1997. Although these cases represent a range of regional and occupational backgrounds, a significant majority are women. Most of these individuals had a disabling, chronic, nonterminal-stage illness. In five female cases, the medical examiner found no evidence of disease whatsoever. About half of the women were between the ages of forty-one and sixty, and another third were older adults. In contrast, men were almost as likely to be middle-aged as to be older adults. Men's conditions were somewhat less likely than women's to be chronic and nonterminal-stage. The main reasons for the hastened death mentioned by both the person and their significant others were having disabilities, being in pain, and fear of being a burden. The predominance of women among Kevorkian's assisted suicides contrasts with national trends in suicide mortality, where men are a clear majority. It is possible that individuals whose death was hastened by Kevorkian are not representative of physician-assisted suicide cases around the country, because of Kevorkian's unique approach. Alternatively, the preponderance of women among Kevorkian's assisted suicides may represent a real phenomenon. One possibility is that, in the United States, assisted suicide is particularly acceptable for women. Individual, interpersonal, social, economic, and cultural factors encouraging assisted suicide in women are examined.

The right to equal access to health care is a fundamental irrevocable right for every person which should be guaranteed in every legal system. It is clear from the established international standards in the field of health that the right of access to healthcare guarantees universal access on an equal basis to really available quality and acceptable health services and health facilities. According to the World Health Organization, access to health services also includes health promotion and disease prevention. In regard to people with disabilities and disadvantaged people, ensuring effective access to healthcare is extremely important, in mind their vulnerability and increased need for moral, social and financial support. The international community has always paid serious attention to the protection of the fundamental rights and freedoms of people with disabilities, especially their health care rights. Evidence for this positive policy is the many legal acts adopted within the United Nations system and within the European Union.The most important of these acts are the Universal Declaration of Human Rights, the International Covenant on Economic, Social and Cultural Rights, the International Convention on the Elimination of All Forms of Racial Discrimination, the Convention on the Elimination of All Forms of Discrimination against Women, the Convention on the Rights of the Child, the Convention on the Rights of Persons with Disabilities, all adopted by the United Nations, as well as the Charter of Fundamental Rights of the European Union, the European Disability Strategy and other European acts. The listed legal instruments proclaim the right of every person to the highest attainable standard of health and as an element of it is protected and the right to equal access to quality health care for all persons.At the same time with creating an appropriate legal framework to protect the health rights of people with disabilities, specialized bodies have been set up within the United Nations system and within the European Union to monitor and control the implementation of international treaties. This approach of the international community deserves support, as only the introduction of comprehensive and adequate measures could provide for a sufficiently high level of protection of the rights of persons with disabilities, who as full citizens of society should have equal and appropriate conditions for full exercising their subjective health rights, without discrimination on the basis of their disability.

The article uses the theoretical and methodological standpoint of Gilbert Durand’s theory of archetypes to interpret ethnic archetypes of Ukrainians, which are manifested in the set of value dispositions of students attending educational and rehabilitation institutions. The authors substantiate the idea that the influence of archetypal determinants in children is manifested primarily in value dispositions that act as potentials for their future behaviour; they are the projection of the collective unconscious influence on the social morality of a particular society and the formation of universal prototypes that determine the living environment of each individual and the entire community, eventually affecting the construction of social reality. Based on the survey conducted among senior students of educational and rehabilitation institutions of Ukraine, it is empirically shown that the value structure of student youth is formed mostly regardless of their gender, reflecting the main national archetypes (freedom-loving Cossack society, cordocentrism, the concept of “fertile land”, peasantry character, the image of Goddess-Mother) and includes such traits of national character as democratic nature, opulence, thrift, diligence, religiosity and respect for women. The article demonstrates the analytical and interpretative value of the conceptual trichotomy “diurnal – dramatic nocturnal – mystical nocturnal” introduced by G. Durand for understanding the archetypal pre-conditions of students’ choices of priority values. The authors analyse the specific features of the value sphere of students with disabilities: when compared to children without disabilities, they show lower indicators for almost all value points. It is suggested that these differences are evidence of the lesser manifestation of archetypes and national character traits due to preferential focusing on health issues, the need to monitor and control physical condition increasingly, coordination of movements, etc. Because of this, in students with disabilities, the postural reflex, which belongs to the sphere of the diurnal influence, retains its activity after reaching physical maturity and often manifests itself in the unprecedented psychological vitality of people belonging to this category.

Respect for the elderly has always been a prevalent social norm in Pakistani society. Retired People in Pakistan have recently become visible due to changing social values. Karachi is the mega city of Sindh province. It is occupied with peculiar issues that need to be addressed at local, provincial and federal level. The aim of this study is to highlight the salient features on the life of the retired personnel in Pakistan. Retirement is often the first major transition faced by the older people. The objective of this study is to explore different aspects of retired people. Two hundred retired persons both male and female are interviewed by questionnaire method. The results were tabulated and analyzed by simple frequency and chi-square method. Results show that Pakistan is one of such countries where retired ageing people are becoming apparent. The old age affects males and females differently in terms of social adjustment at this stage of life. In old age, they are more likely to suffer from disabilities and multiple health problems. Family structure and living conditions influence the lives of elderly people. The present situation for elderly women is also quite poor. There is needed to make gender specific policies and programmes that can encourage and facilitate the elderly to have more involvement in activities of life through greater social and economic participation.

Scholars have noted deplorable conditions of female migrant workers who suffer several types of citizenship disabilities as most countries do not extend equal citizenship rights and protections to migrant workers. In addition to this, they are unable to take full advantage of the rights available to them in the host countries because of low cultural and social capital. Further, studies have emphasized how the breakdown of the traditional economy and the penetration of the market in developing societies have forced people, especially from rural areas, to seek low-paying dead-end jobs in the global labor market. Examining Nepali domestic workers in New Delhi, while this research agrees with the existing studies, we also bring to notice the fact that migrant female workers are not always passive victims and that they exercise considerable choice and agency. The case of Nepali domestic workers in New Delhi offers fresh insight into the ways in which migrant women attempt to actively influence and control the work conditions and immediate labour market outcomes. This paper also shows that even if Nepali migrant workers gain in a limited way, they actively collude with their employers to marginalize native domestic workers. In the end, traditional power relations and inequality are reproduced unchallenged.

ABSTRACTBackground:As populations age, psychological distress in late life will become of increasing public health and social importance. This study seeks to bridge the gap in information that exists about psychological distress in late life, by exploring the prevalence of psychological distress among a very large sample of older adults to determine the impact of age and gender, and the modifying effect of these factors on the associations between measures of psychological distress and sociodemographic and comorbid conditions.Methods:We analyzed self-reported data from 236,508 men and women in the New South Wales 45 and Up Study, to determine the impact of age and gender, and the modifying effects of these factors on associations between psychological distress and sociodemographic and comorbid conditions.Results:Higher education, married status, and higher income were associated with lower risk of psychological distress. Although overall prevalence of psychological distress is lower at older ages, this increases after age 80, and is particularly associated with physical disabilities. Some older people (such as those requiring help because of disability and those with multiple comorbid health conditions) are at increased risk of psychological distress.Conclusion:These findings have implications for both healthcare providers and policy-makers in identifying and responding to the needs of older people in our aging society.

Our study aims to find how disability affected human health in historical time through an examination of individuals' mortality risks and death causes. Swedish parish registers digitized by the Demographic Data Base (DDB) enable us to account for a relatively high number of persons reported to have disabilities, and to compare them with a group of non-disabled cases. The findings concern a 19th-century population of 35,610 individuals in the Sundsvall region, Sweden, and show that disability increased the premature mortality risk substantially. Disability seems to have jeopardized men’s survival in particular, and perhaps due to gendered expectations concerning the type of work men and women became less able to perform when disabled. Our study of death causes indicates that their deaths were less characterized by infectious diseases than among the non-disabled group, as a possible consequence of lower exposure to infections due to the way in which disability could impede opportunities for interaction with peers in the community. In all, our mortality findings suggest that disability was associated with poor living conditions and limited possibilities to participate in work and social life, which further tend to have accumulated across life and resulted in ill health indicated by premature death.

BackgroundShort stature in adult life, a possible consequence of poor perinatal conditions, is associated with higher risk of mortality and social disabilities. We aimed to determine whether low-income, overweight/obese, short-stature (SS) women show alterations in body composition, self-body-image perception, and biochemical profile compared to their non-short (NS) counterparts.MethodsA cross-sectional study was conducted with women living in shantytowns and mother or relatives to undernourished children treated in a center for recuperation and nutritional education. Inclusion criteria were: (1) age, 19–45 years; (2) stature < 152.3 cm or > 158.7 cm; and (3) body mass index > 25 kg/m2. Socioeconomic, anthropometric, biochemical, and body image data were collected. We analyzed 56 SS and 57 NS women.ResultsThe SS group showed a higher waist-to-height ratio (WHtR) (mean: 0.63; standard deviation: 0.06 for SS and mean: 0.60; standard deviation: 0.07 for the NS group; p = 0.02), and, in the adjusted analysis, showed lower fat-free mass (Estimated Marginal Mean for the SS group: 45.7 kg 95% confidence intervals (CI) (45.2–46.2) and for the NS group: 46.9 kg 95% CI (46.4–47.4); p < 0.01) and higher fat mass (Estimated Marginal Mean for the SS group: 32.5 95% CI (31.9–33.0) and for the NS group: 31.4 kg 95% CI (30.9–31.9); p < 0.01). Body mass index was a better predictor of current self-body-image perception for NS women. The SS coefficient values were β = 0.141,SE= 0.059, and R2-Nagelkerke = 0.107, and the NS coefficients values were β = 0.307,SE= 0.058, and R2-Nagelkerke = 0.491 (Z= 2.006; p < 0.05). Considering the obese subgroup, six out of 32 (18.8%) SS women and 14 out of 33 (42.4%) NS women perceived themselves as obese (χ2= 4.27; p = 0.03). This difference remained significant even after adjustment by age, schooling, and number of children (p = 0.04). Only the total thyroxin showed significant differences between groups, lower in SS women (p = 0.04).DiscussionOverweight/obese, low-income SS women have more central adiposity and impaired self-body image perception, and the body mass index is a weaker predictor of it, compared to NS women. Misperception about body size may be linked with an overestimation of health and underestimation of risk, which may lead to a lower utilization of the health care system and inadequate physician counseling. These features may account, at least partially, for the higher mortality risk seen in SS adults.

Abstract Objective: The objective of this study is to analyze the factors that aggravate everyday life, health status, living conditions, economic coping, medical rehabilitation, and training needs of people with diabetes. Materials and Methods: In 2001, in cooperation with the Ministry of Social Affairs of the Republic of Estonia and the Institute for European Studies, the Estonian Chamber for Disabled People conducted a survey among people with different disabilities. The survey also included people living with diabetes. A total of 974 people were surveyed; 86 of them had diabetes. The data were analyzed using frequency tables. The results reflect the subjective opinions of the people surveyed. Results: There are more women (64%) among people with diabetes than men. The disease is more frequent among the older population (74% in the age group of 26-45 years). Persons living with diabetes display a variety of health complaints (vision problems, high blood pressure, osteoporosis, tooth decay, etc.). Of the people surveyed, 75% are satisfied with the medical care they have received. Of the people with diabetes, 63% were hospitalized for 6-30 days during the past year. The need for a helper was often (63%) cited as something that would facilitate coping with everyday life. Catering services are especially important for persons living with diabetes (30%), but the need for a conversation partner was also highlighted (21%). Conclusions: The efficiency of the impact of adjustment courses should be considered more. There is an apparent contradiction - although they are of working age, not everyone can find work. People with diabetes rarely have the courage to talk about the difficulties they are faced with in their everyday life. Help and financial support from the state are needed to solve the problems. The organization itself could do a lot more favorable conditions for its activities, which were established.

Purpose The purpose of this paper is to present a review of diversity management research published in hospitality and tourism-specific and business discipline-based journals. The study objectives include attempting to assess the progress of diversity management research in hospitality and tourism, identifying gaps between the general business diversity management literature and the hospitality and tourism literature and providing hospitality and tourism scholars with suggestions to advance knowledge in diversity management. Design/methodology/approach The study is a critical review of the existing diversity management literature in the general business and hospitality and tourism disciplines in an attempt to identify gaps and make suggestions for expanding this knowledge in the hospitality and tourism fields. Findings There are significant gaps between the diversity management scholarship conducted in hospitality and tourism disciplines and the general business field. Diversity management research in general business is far more in-depth and uses sociological and social psychological theoretical frameworks. Research limitations/implications There are lessons to be learned from the general business literature that uses strong theoretical foundations deeply grounded in sociological, psychological, social-psychological and management theories. The general management literature also explores the conditions under which diversity management adds value or creates challenges for organizations. Practical implications The hospitality and tourism industry has employed large numbers of ethnic minorities, women and members of the lesbian, gay, bisexual and transgender community for decades. As such, it is critical that scholars explore the implications of such a diverse workforce not only on organizational outcomes, but also on individual and group performance. The general business diversity management research suggests that workgroup composition can influence individual and group performance, as well as the quality of co-worker relationships. Given the team-oriented, interdependent nature of work in the hospitality and tourism industry, it is imperative that researchers conduct studies that help practitioners understand the most effective perspectives and approaches to diversity management. Social implications The critical literature review demonstrated that there is extremely scarce research on diversity management focusing on employees with disabilities. It is imperative to shed more light on best diversity management practices, workplace etiquette of this under-represented group of employees and their interaction with their co-workers. Originality/value This study’s results provide insight into areas of exploration that can significantly enhance the scholarship on diversity management in the hospitality and tourism literature.

Topicality. The guiding vision of a stable market economy in Ukraine is accelerating the transition to the introduction of the principle of inclusiveness in market conditions, which, in the context of broadening the overall employment of the population, is an increase in access to education, entrepreneurship, services for young people, women, people in less developed regions and those with disabilities. Implementation of the country's strategic priorities for the transition to sustainable development should take place by ensuring inclusiveness, in particular through agricultural land use. An important task of promoting the principles of inclusiveness is to assess its impact on specific target groups.The introduction of inclusiveness in terms of economic development has a long-term perspective, covering social interests and the rational use of resources. The main focus is on productive employment as a means of reducing the stratification of society by income and raising the standard of living of less well-off people.Aim and tasks. The purpose of the article is to analyze the definition of the inclusiveness of nature use as an economic category in the context of land use, namely the development of inclusive activity. Disclosure of the characteristics of the inclusive approach to land use and outline its benefits. Formulation of the intrinsic features and objectives of the inclusive economy, in particular inclusive agricultural land use. Justification of the scientific principles of the implementation of the principles of organizing the inclusion of land use in agricultural activities.Research results. The concept of inclusiveness in the context of nature use in generalized form and in accordance with land use is developed in the part of expanding the attraction of as many members of society as possible. Improved conceptual-categorical apparatus of the study of "inclusiveness", in particular inclusive growth, inclusive economy, inclusive activity in the context of land use, inclusive ecological agriculture. The relationship between these categories is determined. Formed general scientific principles of inclusive development, principles of inclusive agricultural land use: systematic and complex, adequacy and flexibility, objectivity and accuracy, efficiency, purposefulness, scientific, priority of economic interests of the state. The principles of inclusive agricultural land use are determined on the basis of generally accepted conditions that form the basis of inclusive development and determine its directions and priorities. The advantages of creating ecologically clean lands and conducting ecologically oriented agriculture as one of the directions of development of inclusive nature management in Ukraine are grounded.Conclusion. It is substantiated that, despite a number of literature and discussion of this topic, there is no single definition of the concept of inclusive growth. In the article the genesis of inclusiveness is investigated and the preconditions of the emergence of "inclusive economy" are determined. It is determined that the basic principles under the influence of which the concept of "inclusiveness" was formed are from the theoretical and methodological foundations of sustainable development, "green economy", social economy, and innovation economics. The market component of inclusive land use has been identified and theoretically grounded, which is to involve individual and individual peasant farms in order to organize activities and processes of rational land use, which includes individuals from all walks of life and psychophysical possibilities, through the expansion of: access to land resources; possibilities of land use grouping; the availability of special technical equipment for all individuals; opportunities for obtaining or improving qualifications in the field of ecologically oriented agriculture.

Las úlceras por presión (UPP), forman parte de los grandes síndromes geriátricos, son un problema de la práctica médica cotidiana, que afecta a toda la población, aunque se presentan con mayor frecuencia, en ancianos con diferentes discapacidades, o en etapa terminal. El objetivo es prevenir las causas de úlceras por presión en sus diferentes formas de aparición en pacientes geriátricos, para poder mejorar su calidad de vida. La metodología utilizada es cualitativa, descriptiva; que permitió conocer cómo se manifiesta este problema en términos frecuencia, características, condiciones, incidencia y prevalencia. Se aplicaron métodos teóricos y empíricos como análisis documental, encuestas y entrevista para verificar las insuficiencias en el manejo y cuidado de las lesiones por esta enfermedad, que tiene una predominancia en pacientes que consta en un rango de edad entre los 61 a 70 años, con un porcentaje de 41,3% en usuarias de género femenino, en un porcentaje de 63,6% siendo estos los casos de usuarios que han sufrido traumatismo, fracturas, se encuentran encamados en un 27,5 % o ensillados en un 26,5%. La forma de prevenir las ulceras por presión es de vital importancia ya que se podrá demostrar las causas, diferentes estadios, evolución de la enfermedad; proporcionar formación y educación a los cuidadores, desarrollar una continuidad de servicios sociales y de salud que sean asequibles, accesibles, de gran calidad y respetuosos con la edad, y que tengan en cuenta las necesidades y los derechos de las mujeres y los hombres a medida que envejecen.Palabras claves: prevención, pacientes, geriátricos, ulceras por presiónABSTRACTPressure ulcers (UPP), are part of the biggest geriatric syndromes, they’re a problem of everyday medical practice, this affect to all population, although they occur more frequently, in elderly with different disabilities, or terminal stage. The aim is to determine the causes of pressure ulcers in their different forms of appearance in geriatric patients, in order to improve their quality of life. The methodology used is qualitative, descriptive, and it allowed to know how this problem manifests in terms of frequency, characteristics, conditions, incidence and prevalence. Theoretical and empirical methods were applied such as documentary analysis, surveys and interviews to verify the insufficiencies in the management and care of the lesions due to this disease, it has a predominance in patients ranging from 61 to 70 years old, with a percentage of 41.3% in female users, in a percentage of 63.6%, these being the cases of users who have suffered trauma, fractures, are bedridden in 27.5% or saddled in a 26.5% %. The way to prevent pressure ulcers is of vital importance since it will be possible to demonstrate the causes, different stages, evolution of the disease; provide education to keepers, develop a continuity of social and health services that are possible, accessible, of high quality and respectful with age, and the women and men consider their need according as the years go by.Keywords: prevention, patients, geriatric, ulcers, pressure

The birth of a child normally brings joy and celebration to the family. On the other hand, the birth of a disabled child brings a number of challenges to the family. This article resulted from a qualitative study aimed at describing the experiences of mothers of children with disabilities in Zimbabwe. Data were collected using focus group discussions (FGDs). The composition of the focus groups was based on age. The first group comprised women in the 18–24-year age group; the second group was made up of 25–30-year olds; the third one was of those between the ages of 31–35 years; the fourth group comprised 36–43 year olds; and the fifth group was made up of women of 44 years and older. The study found that mothers of children with disabilities face a plethora of psychological, social and economic challenges, some of which seem to escape the attention of policy makers and development practitioners. Witchcraft accusation was identified in this study as the greatest challenge that mothers of children with disabilities face. As a result these mothers do not get support from family members and the community. In the absence of family and community support, government and non-governmental organisations have to come up with initiatives to support mothers of children with disabilities.

The paper explores the role of the play titled She No Longer Weeps by Tsitsi Dangarembga in interrogating the prevailing status quo of, what the paper refers to as, the “scenarios.” In this paper, we focus on how the play facilitates and shapes social change in independent Zimbabwe in the 1980s. Whereas it is undeniable that social change occurs at various levels in society, we concentrate on the change that occurs in the domestic space of the family and/or home, and specifically in gender power relations, as this is the play’s main focus. The paper argues that She No Longer Weeps represents a discussion about ways in which characters attempt to change and/or resist the transformation of the Zimbabwean society. Relying on textual analysis and the historical and material conditions that informed the dramatist’s vision, the paper concludes that gender power relations, as in Zimbabwe in the 1980s, need to be rethought and transformed, but we also question the dramatist’s wholesale acceptance of radical feminism. We conclude by rejecting radical and/or Western feminism in favour of Africana womanism as the latter encourages co-existence and understanding between men and women within the family institution.

Іn the article deals, that the creation of an inclusive environment is an important priority of modern public policy, which considers the issues of accessibility, protection of the rights of people with disabilities and equal opportunities in accordance with the Sustainable Development Goals until 2030. It has been proved that for the implementation of organizational measures for physical disability, it is necessary to ensure the implementation of the concept of universal design and reasonable adaptation, transport accessibility, and the implementation of new building codes. Local authorities should adopt special programs and create an inclusive environment for everyone, including children, women, the elderly, representatives of other groups, realizing their rights to individual adaptation, assistive devices, and a comfortable public space. It is noted that an important area that covers a significant range of organizational issues is economic inclusion. Economic inclusion means providing conditions and opportunities for employment, obtaining financing for entrepreneurship, developing social entrepreneurship, and vocational rehabilitation for all groups of citizens. It has been established that in a pandemic, more attention should be paid to organizing vocational rehabilitation for persons who have lost contact with the labor market or persons who need additional protection in the labor market. The importance of information inclusion and the development of appropriate state standards of social services for the translation of sign speech, accompanying persons with visual impairments, accompanying people with disabilities in employment and social and labor adaptation has been substantiated.The conditions for the development of rehabilitation services in accordance with the requirements of the Convention on the Rights of Persons with Disabilities are considered. It is proved that the main directions of development of the system of rehabilitation services in Ukraine require an integrated approach in connection with the medical reform in the country. To implement organizational measures, public authorities need to constantly monitor compliance with the standards of accessibility. It is necessary to reform the legislation on the employment of people with disabilities and strengthen the work of state bodies in the field of employment.

Empowerment implies equal conditions to girls. It supplies more significant access to know-how as well as sources, greater liberty in decision making, higher potential to consider their lifestyles and flexibility from the irons troubled all of them through personalized, view and also technique becoming conscious of their own condition and setting, setting their personal schedules, developing area on their own, obtaining skill-sets, developing positive self-image, addressing problems, and developing self-reliance. It is actually certainly not merely a social as well as a political method, yet a personal one too - as well as it is not simply a procedure however a result too. Empowerment of girls creates them much more powerful to encounter the challenges of lifestyle, to beat the disabilities, handicaps, and inequalities. It makes it possible for ladies to discover their total identification and powers in all realms of life. The study is actually generally concentrated on the efficiency of SWOT aspects on the total assessment of Women Self Help Groups product in Chennai Metropolitan area

The article opens the publications which are relevant to the problems research in the penitentiary system. The main problems in the legislation developing process, disadvantages of the current system are critically described so that to fulfill the international standards of the penal policy. According to the provisions enshrined in international legal standards, the decision on the distribution of convicted prisoners between penal institutions should not create difficulties for convicts and their families. For social rehabilitation, convicts should be detained in penitentiary institutions close to their residence or at a distance as close as possible to him. In this regard, the author notes with satisfaction the efforts of international organizations that contribute to the development of women's rights in Central Asia. For example, at the First Regional Meeting in Astana, the Representation of the International Prison Reform in Central Asia presented a project to improve the access of vulnerable categories of convicts to justice, where the vulnerable categories were noted as including not only people with disabilities, the elderly, the sick, those sentenced to death penalty, but also women. The present penal reforms in Uzbekistan lead to the discussion to recognize and implement those standards as the main policy on legislative level.

Abstract Objectives This study examines total life expectancies (TLE) for both healthy and diabetic US-born populations and two measures capturing quality of life: 1) the proportion of remaining life to be spent without either other chronic conditions or ADL disabilities (ADLs), and 2) the proportion of remaining life to be spent with ADLs for US-born diabetic populations by race/ethnicity and educational attainment. Methods Using the 1998-2014 waves of the Health and Retirement Study (n=16,983), we apply a Bayesian multistate life table method to calculate these quantities from the constructed life tables. Results TLE at age 50 is shorter for diabetic individuals than healthy individuals, for non-Hispanic Blacks than members of other racial/ethnic groups, and for less-educated individuals. Gaps in TLE at age 50 between healthy and diabetic populations range from 6.3 to 8.8 years across sex-race combinations, and 5.6 to 9.2 years across sex-education combinations. Among the diabetic population, those with at least a college degree on average have a higher proportion of remaining life to be spent without either other chronic conditions or ADLs. Hispanics and those without a college degree have a particularly high proportion of remaining life to be spent with ADLs. Although diabetic women on average live longer than men, their quality of life tends to be lower. Discussion The impact of diabetes on population health varies across racial/ethnic and educational groups. The findings support targeted interventions for vulnerable groups, such as people of color, women, and less-educated individuals.

<p>A "hidden disability," one unapparent to outside observers, defies the outward social construction of disability. A narrative research approach is used to understand the process of personal identification (or lack thereof) with being "disabled." Self-narratives were elicited from three men and three women, ranging in age from 21 to 53 years who have had a hidden physical disability since before age thirteen. The conditions represented are: Juvenile Diabetes, Asthma, Juvenile Rheumatoid Arthritis, Epilepsy, Muscular Dystrophy, and Celiac Disease.</p> <p>While persons with hidden disabilities are afforded a sense of anonymity, they must contend with different challenges, including learning strategic self-disclosure and impression management; when to disclose and make disability visible and when to "pass" and give society the impression of "able-bodiedness." The choice, to be or not to be disabled, has important implications for the way we conceptualize disability, and the concept of identity as a whole.</p>

There has been an unprecedented increase in population ageing resulting in the increase in prevalence of various health conditions, including disability and associated risk factors. This study aimed to investigate the prevalence and predictors of functional status and disability amongst older South Africans. Little is known about disability amongst older South Africans because most previous health research has focused on younger individuals and infectious diseases. We conducted a national population-based cross-sectional study with a sample of 3840 subjects aged 50 years or older in South Africa. Multivariable regression analysis was performed in order to assess the association of social factors, health variables and functional disability. Overall, 37.2% of the respondents had moderate or severe and/or very severe functional disability, this being higher amongst women. The highest disability was found for the mobility, cognition and participation domains. In all domains, except for the self-care domain, women had a higher disability prevalence. Multivariable analysis amongst men revealed that older age, having some or primary education, being from Indian or Asian race, having chronic conditions, physical inactivity and a lower quality of life were associated with functional disability. Amongst women, older age, as well as having chronic conditions and a lower quality of life, were associated with functional disability. This study has implications for health-sector strategic plans aimed at preventing disabilities, ensuring access to curative and rehabilitative care. This study forms an evidence base upon which future policies and health care management systems can be based.Daar was ’n ongekende toename in bevolkingsveroudering, wat ’n toename in die voorkoms van verskeie gesondheidstoestande tot gevolg gehad het, insluitende gestremdheid en gepaardgaande faktore. Die studie was daarop gemik om die voorkoms en voorspelbaarheid van die funksionele status en gestremdheid onder ouer Suid-Afrikaners te ondersoek. Daar is min bekennis oor gestremdheid onder ouer Suid-Afrikaners omdat vorige gesondheidsnavorsing meestal op jonger individue en oordraagbare siektes ingestel was. Ons het ’n nasionale bevokings-gebaseerde kruis-seksionele ondersoek uitgevoer op ’n studiemonster van 3840 Suid-Afrikaners, 50-jaar en ouer. Om die verband tussen sosiale faktore, gesondheidsveranderlikes en funksionele gestremdheid te bepaal, is veelvuldig veranderlike regressie-analise uitgevoer. In die algemeen het 37.2% van die respondente matig of ernstige funksionele gestremdheid ervaar wat hoer was onder vroue. Die hoogste vorm van gestremdheid was op die gebiede van beweeglikehid, waarneming en deelname. Die voorkoms van gestremdheid was op alle gebiede hoër in vroue, behalwe op die gebied van selfsorg. Multi-veranderlike ontledings onder mans het getoon dat funksionele gestremdheid geassosieer word met ouderdom, met ’n mate van primêre onderwys, met die Indiese of Asiatiese bevolkingsgroep, en met diegene wat ly aan kroniese toestande (beroerte, slaapprobleme snags), fisiese onaktiwiteit en ’n laer lewenskwaliteit. Die studie het implikasies vir strategiese planne in die gesondheidsektor wat daarop gemik is om gestremdheid te voorkom en om toegang tot genesende en rehabiliterende sorg te verseker. Hierdie studie verskaf ’n grondslag van bewyse waarop beleid- en gesondheidsorg-bestuurstelsels in die toekoms gebaseer kan word.

In 2012, World Health Organization published the first ever Neglected Tropical Diseases (NTD) Roadmap, entitled “Accelerating Work to Overcome the Global Impact of Neglected Tropical Diseases: A Roadmap for Implementation.” This report brought international attention to Chagas and other NTDs and provided a framework to guide implementation of policies and strategies set out in the Global Plan to Combat Neglected Tropical Diseases 2008-2015. Chagas disease, endemic to Bolivia, is considered the third most common parasitic disease globally, after malaria and schistosomiasis. It is estimated that six to seven million persons are infected worldwide. [1] Bolivia has the highest rate of endemic Chagas disease in the Americas. Chagas disease is both a disease of poverty and, like other neglected tropical diseases, poverty promoting. [2] Chagas disease is associated with multiple social and environmental determinants in communities marked by poverty. Salient among the main determinants are poor-quality dwellings, social instability, the combined presence of certain environmental factors, such as the Chagas vectors, mammals that serve as reservoirs of the disease and human exposure, creating the conditions for perpetuating the effective transmission of the infection and its endemicity. These challenges put pregnant women, young children and children with disabilities at especially high risk for contracting Chagas disease. Left untreated, Chagas disease can lead to serious heart, digestive and neurological conditions.

Abstract Background A recent Royal Commission into the treatment of Australians living with disabilities has underscored the considerable exposure to violence and harm in this population. Yet, little is known about exposure to violence among Aboriginal and Torres Strait Islander people living with disabilities. The objective of this paper was to examine the prevalence, disability correlates and aspects of violence and threats reported by Aboriginal and Torres Strait Islander people living with disabilities. Methods Data from the 2014–15 National Aboriginal and Torres Strait Islander Social Survey were used to measure physical violence, violent threats and disability. Multivariable logistic and ordinal logistic regression models adjusted for complex survey design were used to examine the association between measures of disability and exposure to violence and violent threats. Results In 2014–15, 17% of Aboriginal and Torres Strait Islander people aged 15–64 with disability experienced an instance of physical violence compared with 13% of those with no disability. Approximately 22% of those with a profound or severe disability reported experiencing the threat of physical violence. After adjusting for a comprehensive set of confounding factors and accounting for complex survey design, presence of a disability was associated with a 1.5 odds increase in exposure to physical violence (OR = 1.54 p < 0.001), violence with harm (OR = 1.55 p < 0.001), more frequent experience of violence (OR = 1.55 p < 0.001) and a 2.1 odds increase (OR = 2.13 p < 0.001) in exposure to violent threats. Severity of disability, higher numbers of disabling conditions as well as specific disability types (e.g., psychological or intellectual) were associated with increased odds of both physical violence and threats beyond this level. Independent of these effects, removal from one’s natural family was strongly associated with experiences of physical violence and violent threats. Aboriginal and Torres Strait Islander women, regardless of disability status, were more likely to report partner or family violence, whereas men were more likely to report violence from other known individuals. Conclusion Aboriginal and Torres Strait Islander people with disability are at heightened risk of physical violence and threats compared to Aboriginal and Torres Strait Islander people without disability, with increased exposure for people with multiple, severe or specific disabilities.

The article considers the accessibility of the urban environment from the point of view of ensuring the mobility of citizens.One of the tools createdto solve this problem is a universal design.Its main purpose is to adapt the artificial environment to human needs. A “barrier-free” environment is understood to mean the conditions in which unhindered access to social infrastructure facilities and free comfortable movement in urban areas are possible.Persons with reduced mobility are people who have difficulties in movement, orientation in space, and obtaining information or services. They include people with disabilities, elderly people, people with temporary health problems, pregnant women, people with baby strollers. The means providing mobility on the example of ramps, standards for their production and the compliance of devices in use with the specified standardsare analyzed.A special attention is paid to the various types of ramps: stationary, removable, folding.The task of the ramps is to ensure the accessibility and to ease the movement of wheel mechanisms, for example, strollers and wheelchairs.Based onthe normative documents a comparative table “Parameters of ramps for persons with reduced mobility”has been compiled. The average dimensions for the ramps were derived.Several control points were selected where the parameters of the ramps installed in the transitions were measured.Based on the measurements obtained, a table of the actual parameters of the ramps measured in the Moscow metrowas compiled.Deviations in most of the ramps under study from satisfactory values which can significantly complicate the re-movement of persons with reduced mobilitywere revealed.

With growing pressure from an ageing population on social and health-care expenditure, it is of policy importance to analyze the reasons for admission to long-term institutional care at older ages. Although there is increasing evidence that cognitive and functional disabilities are not the only major risk factors, and that the social situation and the lack of family members play an important role in explaining admissions, further research is needed. There is a lack of evidence on the effects of a spouse’s death, and previous findings on how income is associated with institutional care are inconsistent, and results on poor housing are seldom available. Furthermore, there is little systematic evidence showing how chronic medical conditions other than dementia affect the risk of admission in the general older population. This study used population-based register data on Finnish older adults aged 65 and over (n=280,722) to analyse individual-level determinants of admission to long-term institutional care from January 1998 to September 2003. The main focus was on how chronic medical conditions, household income and other socio-economic factors, living with a spouse, and the death of a spouse were associated with admissions. The results of the study indicated that dementia, Parkinson’s disease, stroke, depressive symptoms, other mental-health problems, hip fracture, and diabetes were strongly associated with an increased risk of admission when socio-demographic confounders and co-morbid conditions were controlled for. It was also shown that older men and women in the lowest household-income quintile group were more likely to be admitted to institutional care than those in the highest group, when age, first language, and area characteristics were accounted for. Controlling further for living arrangements and other socio-economic and chronic medical conditions markedly reduced these income differences in admission, but they still remained significant. Poorly equipped housing and being a renter were associated with an increased risk of admission, and the possession of a car and living in a detached house with a decreased risk in these same multivariate models. Having a lift in an apartment house was not associated with admission. The results further showed that the lower risk of admission among those living with a spouse compared to those living alone or with others was only partly attributable to and mediated through favorable socio-economic, housing and medical conditions. Moreover, this study was the first to establish that the death of a spouse strongly increases the risk of admission, the excess risk being highest during the first month following the death and decreasing over time in both genders. The findings in this study imply that the future need for institutional care will depend not only on the increasing numbers of older people but also on the development of the prevalence and severity of chronic medical conditions associated with admission, and on older people’s income, housing conditions and access to informal care from their spouse.

Introduction The scientific validity of climate change claims, how to intervene (if at all) in environmental, economic, political and social consequences of climate change, and the adaptation and mitigation needed with any given climate change scenario, are contested areas of public, policy and academic discourses. For marginalised populations, the climate discourses around adaptation, mitigation, vulnerability and resilience are of particular importance. This paper considers the silence around disabled people in these discourses. Marci Roth of the Spinal Cord Injury Association testified before Congress in regards to the Katrina disaster: [On August 29] Susan Daniels called me to enlist my help because her sister in-law, a quadriplegic woman in New Orleans, had been unsuccessfully trying to evacuate to the Superdome for two days. […] It was clear that this woman, Benilda Caixetta, was not being evacuated. I stayed on the phone with Benilda, for the most part of the day. […] She kept telling me she’d been calling for a ride to the Superdome since Saturday; but, despite promises, no one came. The very same paratransit system that people can’t rely on in good weather is what was being relied on in the evacuation. […] I was on the phone with Benilda when she told me, with panic in her voice “the water is rushing in.” And then her phone went dead. We learned five days later that she had been found in her apartment dead, floating next to her wheelchair. […] Benilda did not have to drown. (National Council on Disability, emphasis added) According to the Intergovernmental Panel on Climate Change (IPCC), adaptation is the “Adjustment in natural or human systems in response to actual or expected climatic stimuli or their effects, which moderates harm or exploits beneficial opportunities” (IPCC, Climate Change 2007). Adaptations can be anticipatory or reactive, and depending on their degree of spontaneity they can be autonomous or planned (IPCC, Fourth Assessment Report). Adaptations can be private or public (IPCC, Fourth Assessment Report), technological, behavioural, managerial and structural (National Research Council of Canada). Adaptation, in the context of human dimensions of global change, usually refers to a process, action or outcome in a system (household, community, group, sector, region, country) in order for that system to better cope with, manage or adjust to some changing condition, stress, hazard, risk or opportunity (Smit and Wandel). Adaptation can encompass national or regional strategies as well as practical steps taken at the community level or by individuals. According to Smit et al, a framework for systematically defining adaptations is based on three questions: (i) adaptation to what; (ii) who or what adapts; and (iii) how does adaptation occur? These are essential questions that have to be looked at from many angles including cultural and anthropological lenses as well as lenses of marginalised and highly vulnerable populations. Mitigation (to reduce or prevent changes in the climate system), vulnerability (the degree to which a system is susceptible to, and unable to cope with, the adverse effects of climate change), and resilience (the amount of change a system can undergo without changing state), are other important concepts within the climate change discourse. Non-climate stresses can increase vulnerability to climate change by reducing resilience and can also reduce adaptive capacity because of resource deployment to competing needs. Extending this to the context of disabled people, ableism (sentiment to expect certain abilities within humans) (Wolbring, “Is there an end to out-able?”) and disablism (the unwillingness to accommodate different needs) (Miller, Parker and Gillinson) are two concepts that will thus play themselves out in climate discourses. The “Summary for Policymakers” of the IPCC 2007 report, Climate Change 2007: Impacts, Adaptation and Vulnerability, states: “Poor communities can be especially vulnerable, in particular those concentrated in high-risk areas. They tend to have more limited adaptive capacities, and are more dependent on climate-sensitive resources such as local water and food supplies.” From this quote one can conclude that disabled people are particularly impacted, as the majority of disabled people live in poverty (Elwan). For instance, CARE International, a humanitarian organisation fighting global poverty, the UN Office for the Coordination of Humanitarian Affairs, and Maplecroft, a company that specialises in the calculation, analysis and visualisation of global risks, conclude: “The degree of vulnerability is determined by underlying natural, human, social, physical and financial factors and is a major reason why poor people—especially those in marginalised social groups like women, children, the elderly and people with disabilities—are most affected by disasters” (CARE International). The purpose of this paper is to expose the reader to (a) how disabled people are situated in the culture of the climate, adaptation, mitigation and resilience discourse; (b) how one would answer the three questions, (i) adaptation to what, (ii) who or what adapts, and (iii) how does adaptation occur (Smit et al), using a disabled people lens; and (c) what that reality of the involvement of disabled people within the climate change discourse might herald for other groups in the future. The paper contends that there is a pressing need for the climate discourse to be more inclusive and to develop a new social contract to modify existing dynamics of ableism and disablism so as to avoid the uneven distribution of evident burdens already linked to climate change. A Culture of Neglect: The Situation of Disabled People As climates changes, environmental events that are classified as natural disasters are expected to be more frequent. In the face of recent disaster responses, how effective have these efforts been as they relate to the needs and challenges faced by disabled people? Almost immediately after Hurricane Katrina devastated the Gulf Coast, the National Council on Disability (NCD) in the United States estimated that 155,000 people with disabilities lived in the three cities hardest hit by the hurricane (about 25 per cent of the cities’ populations). The NCD urged emergency managers and government officials to recognise that the need for basic necessities by hurricane survivors with disabilities was “compounded by chronic health conditions and functional impairments … [which include] people who are blind, people who are deaf, people who use wheelchairs, canes, walkers, crutches, people with service animals, and people with mental health needs.” The NCD estimated that a disproportionate number of fatalities were people with disabilities. They cited one statistic from the American Association of Retired Persons (AARP): “73 per cent of Hurricane Katrina-related deaths in New Orleans area were among persons age 60 and over, although they comprised only 15 per cent of the population in New Orleans.” As the NCD stated, “most of those individuals had medical conditions and functional or sensory disabilities that made them more vulnerable. Many more people with disabilities under the age of 60 died or were otherwise impacted by the hurricanes.” As these numbers are very likely linked to the impaired status of the elderly, it seems reasonable to assume similar numbers for non-elderly disabled people. Hurricane Katrina is but one example of how disabled people are neglected in a disaster (Hemingway and Priestley; Fjord and Manderson). Disabled people were also disproportionately impacted in other disasters, such as the 1995 Great Hanshin Earthquake in Japan (Nakamura) or the 2003 heatwave in France, where 63 per cent of heat-related deaths occurred in institutions, with a quarter of these in nursing homes (Holstein et al.). A review of 18 US heatwave response plans revealed that although people with mental or chronic illnesses and the homeless constitute a significant proportion of the victims in recent heatwaves, only one plan emphasised outreach to disabled persons, and only two addressed the shelter and water needs of the homeless (Ebi and Meehl; Bernhard and McGeehin). Presence of Disabled People in Climate Discourse Although climate change will disproportionately impact disabled people, despite the less than stellar record of disaster adaptation and mitigation efforts towards disabled people, and despite the fact that other social groups (such as women, children, ‘the poor’, indigenous people, farmers and displaced people) are mentioned in climate-related reports such as the IPCC reports and the Human Development Report 2007/2008, the same reports do not mention disabled people. Even worse, the majority of the material generated by, and physically set up for, discourses on climate, is inaccessible for many disabled people (Australian Human Rights Commission). For instance, the IPCC report, Climate Change 2007: Impacts, Adaptation and Vulnerability, contains Box 8.2: Gender and natural disasters, makes the following points: (a) “men and women are affected differently in all phases of a disaster, from exposure to risk and risk perception; to preparedness behaviour, warning communication and response; physical, psychological, social and economic impacts; emergency response; and ultimately to recovery and reconstruction”; (b) “natural disasters have been shown to result in increased domestic violence against, and post-traumatic stress disorders in, women”; and (c) “women make an important contribution to disaster reduction, often informally through participating in disaster management and acting as agents of social change. Their resilience and their networks are critical in household and community recovery.” The content of Box 8.2 acknowledges the existence of different perspectives and contributions to the climate discourse, and that it is beneficial to explore these differences. It seems reasonable to assume that differences in perspectives, contributions and impact may well also exist between people with and without disabilities, and that it may be likewise beneficial to explore these differences. Disabled people are differently affected in all phases of a disaster, from exposure to risk and risk perception; to preparedness behaviour, warning communication and response; physical, psychological, social and economic impacts; emergency response; and ultimately to recovery and reconstruction. Disabled people could also make an important contribution to disaster reduction, often informally through participating in disaster management and acting as agents of social change. Their resilience and their networks are critical in household and community recovery, important as distributors of relief efforts and in reconstruction design. The Bonn Declaration from the 2007 international conference, Disasters are always Inclusive: Persons with Disabilities in Humanitarian Emergency Situations, highlighted many problems disabled people are facing and gives recommendations for inclusive disaster preparedness planning, for inclusive response in acute emergency situations and immediate rehabilitation measures, and for inclusive post-disaster reconstruction and development measures. Many workshops were initiated by disabled people groups, such as Rehabilitation International. However, the disabled people disaster adaptation and mitigation discourse is not mainstreamed. Advocacy by people with disability for accessible transport and universal or “life-cycle” housing (among other things) shows how they can contribute significantly to more effective social systems and public facilities. These benefit everyone and help to shift public expectations towards accessible and flexible amenities and services—for example, emergency response and evacuation procedures are much easier for all if such facilities are universally accessible. Most suggestions by disabled people for a more integrative, accessible physical environment and societal attitude benefit everyone, and gain special importance with the ever-increasing proportion of elderly people in society. The IPCC Fourth Assessment Report is intended to be a balanced assessment of current knowledge on climate change mitigation. However, none of the 2007 IPCC reports mention disabled people. Does that mean that disabled people are not impacted by, or impact, climate change? Does no knowledge of adaptation, mitigation and adaptation capacity from a disabled people lens exist, or does the knowledge not reach the IPCC, or does the IPCC judge this knowledge as irrelevant? This culture of neglect and unbalanced assessment of knowledge evident in the IPCC reports was recognised before for rise of a ‘global’ climate discourse. For instance, a 2001 Canadian government document asked that research agendas be developed with the involvement of, among others, disabled people (Health Canada). The 2009 Nairobi Declaration on Africa’s response to climate change (paragraph 36) also asks for the involvement of disabled people (African Ministerial Conference on the Environment). However, so far nothing has trickled up to the international bodies, like the IPCC, or leading conferences such as the United Nations Climate Change Conference Copenhagen 2009. Where Will It End? In his essay, “We do not need climate change apartheid in adaptation”, in the Human Development Report 2007/2008, Archbishop Desmond Tutu suggests that we are drifting into a situation of global adaptation apartheid—that adaptation becomes a euphemism for social injustice on a global scale (United Nations Development Programme). He uses the term “adaptation apartheid” to highlight the inequality of support for adaptation capacity between high and low income countries: “Inequality in capacity to adapt to climate change is emerging as a potential driver of wider disparities in wealth, security and opportunities for human development”. I submit that “adaptation apartheid” also exists in regard to disabled people, with the invisibility of disabled people in the climate discourse being just one facet. The unwillingness to accommodate, to help the “other,” is nothing new for disabled people. The ableism that favours species-typical bodily functioning (Wolbring, “Is there an end to out-able?”; Wolbring, “Why NBIC?”) and disablism (Miller, Parker, and Gillinson)—the lack of accommodation enthusiasm for the needs of people with ‘below’ species-typical body abilities and the unwillingness to adapt to the needs of “others”—is a form of “adaptation apartheid,” of accommodation apartheid, of adaptation disablism that has been battled by disabled people for a long time. In a 2009 online survey of 2000 British people, 38 per cent believed that most people in British society see disabled people as a “drain on resources” (Scope). A majority of human geneticist concluded in a survey in 1999 that disabled people will never be given the support they need (Nippert and Wolff). Adaptation disablism is visible in the literature and studies around other disasters. The 1988 British Medical Association discussion document, Selection of casualties for treatment after nuclear attack, stated “casualties whose injuries were likely to lead to a permanent disability would receive lower priority than those expected to fully recover” (Sunday Morning Herald). Famine is seen to lead to increased infanticide, increased competitiveness and decreased collaboration (Participants of the Nuclear Winter: The Anthropology of Human Survival Session). Ableism and disablism notions experienced by disabled people can now be extended to include those challenges expected to arise from the need to adapt to climate change. It is reasonable to expect that ableism will prevail, expecting people to cope with certain forms of climate change, and that disablism will be extended, with the ones less affected being unwilling to accommodate the ones more affected beyond a certain point. This ableism/disablism will not only play itself out between high and low income countries, as Desmond Tutu described, but also within high income countries, as not every need will be accommodated. The disaster experience of disabled people is just one example. And there might be climate change consequences that one can only mitigate through high tech bodily adaptations that will not be available to many of the ones who are so far accommodated in high income countries. Desmond Tutu submits that adaptation apartheid might work for the fortunate ones in the short term, but will be destructive for them in the long term (United Nations Development Programme). Disability studies scholar Erik Leipoldt proposed that the disability perspective of interdependence is a practical guide from the margins for making new choices that may lead to a just and sustainable world—a concept that reduces the distance between each other and our environment (Leipoldt). This perspective rejects ableism and disablism as it plays itself out today, including adaptation apartheid. Planned adaptation involves four basic steps: information development and awareness-raising; planning and design; implementation; and monitoring and evaluation (Smit et al). Disabled people have important knowledge to contribute to these four basic steps that goes far beyond their community. Their understanding and acceptance of, for example, the concept of interdependence, is just one major contribution. Including the concept of interdependence within the set of tools that inform the four basic steps of adaptation and other facets of climate discourse has the potential to lead to a decrease of adaptation apartheid, and to increase the utility of the climate discourse for the global community as a whole. References African Ministerial Conference on the Environment. Nairobi Declaration on the African Process for Combating Climate Change. 2009. 26 Aug. 2009 ‹ http://www.unep.org/roa/Amcen/Amcen_Events/3rd_ss/Docs/nairobi-Decration-2009.pdf ›. American Association of Retired Persons. We Can Do Better: Lessons Learned for Protecting Older Persons in Disasters. 2009. 26 Aug. 2009 ‹ http://assets.aarp.org/rgcenter/il/better.pdf ›. Australian Human Rights Commission. “Climate Change Secretariat Excludes People with Disabilities.” 2008. 26 Aug. 2009 ‹ http://www.hreoc.gov.au/about/media/media_releases/2008/95_08.html ›. Bernhard, S., and M. McGeehin. “Municipal Heatwave Response Plans.” American Journal of Public Health 94 (2004): 1520-21. CARE International, the UN Office for the Coordination of Humanitarian Affairs, and Maplecroft. Humanitarian Implications of Climate Change: Mapping Emerging Trends and Risk Hotspots for Humanitarian Actors. CARE International, 2008. 26 Aug. 2009 ‹ http://www.careclimatechange.org/files/reports/Human_Implications_PolicyBrief.pdf ›, ‹ http://www.careclimatechange.org/files/reports/CARE_Human_Implications.pdf ›. "Disasters Are Always Inclusive: Persons with Disabilities in Humanitarian Emergency Situations." Bonn Declaration from the International Conference: Disasters Are Always Inclusive: Persons with Disabilities in Humanitarian Emergency Situations. 2007. 26 Aug. 2009 ‹ http://www.disabilityfunders.org/webfm_send/6, http://www.disabilityfunders.org/emergency_preparedness ›, ‹ http://bezev.de/bezev/aktuelles/index.htm ›. Ebi, K., and G. Meehl. Heatwaves and Global Climate Change: The Heat Is On: Climate Change and Heatwaves in the Midwest. 2007. 26 Aug. 2009 ‹ www.pewclimate.org/docUploads/Regional-Impacts-Midwest.pdf ›. Elwan, A. Poverty and Disability: A Survey of the Literature. Worldbank, Social Protection Discussion Paper Series (1999): 9932. 26 Aug. 2009 ‹ http://siteresources.worldbank.org/DISABILITY/Resources/Poverty/Poverty_and_Disability_A_Survey_of_the_Literature.pdf ›. Fjord, L., and L. Manderson. “Anthropological Perspectives on Disasters and Disability: An Introduction.” Human Organisation 68.1 (2009): 64-72. Health Canada. First Annual National Health and Climate Change Science and Policy Research Consensus Conference: How Will Climate Change Affect Priorities for Your Health Science and Policy Research? Health Canada, 2001. 26 Aug. 2009 ‹ http://www.hc-sc.gc.ca/ewh-semt/pubs/climat/research-agenda-recherche/population-eng.php ›. Hemingway, L., and M. Priestley. “Natural Hazards, Human Vulnerability and Disabling Societies: A Disaster for Disabled People?” The Review of Disability Studies (2006). 26 Aug. 2009 ‹ http://www.rds.hawaii.edu/counter/count.php?id=13 ›. Holstein, J., et al. “Were Less Disabled Patients the Most Affected by the 2003 Heatwave in Nursing Homes in Paris, France?” Journal of Public Health Advance 27.4 (2005): 359-65. Intergovernmental Panel on Climate Change. Climate Change 2007: Impacts, Adaptation and Vulnerability. 2007. 26 Aug. 2009 ‹ http://www.ipcc.ch/publications_and_data/publications_ipcc_fourth_assessment_report_wg2_report_impacts_adaptation_and_vulnerability.htm ›. Intergovernmental Panel on Climate Change. “Summary for Policymakers.” Eds. O. F. Canziani, J. P. Palutikof, P. J. van der Linden, C. E. Hanson, and M.L.Parry. Cambridge, UK: Cambridge University Press, 2007. 7-22. 26 Aug. 2009 ‹ http://www.ipcc.ch/pdf/assessment-report/ar4/wg2/ar4-wg2-spm.pdf ›. Intergovernmental Panel on Climate Change. IPCC Fourth Assessment Report Working Group III Report: Mitigation of Climate Change Glossary. 2007. 26 Aug. 2009 ‹ http://www.ipcc.ch/ipccreports/ar4-wg3.htm, http://www.ipcc.ch/pdf/assessment-report/ar4/wg3/ar4-wg3-annex1.pdf ›. Leipoldt, E. “Disability Experience: A Contribution from the Margins. Towards a Sustainable Future.” Journal of Futures Studies 10 (2006): 3-15. Miller, P., S. Parker and S. Gillinson. “Disablism: How to Tackle the Last Prejudice.” Demos, 2004. 26 Aug. 2009 ‹ http://www.demos.co.uk/files/disablism.pdf ›. Nakamura, K. “Disability, Destitution, and Disaster: Surviving the 1995 Great Hanshin Earthquake in Japan.” Human Organisation 68.1 (2009): 82-88. National Council on Disability, National Council on Independent Living, National Organization on Disability, and National Spinal Cord Injury Association and the Paralyzed Veterans of America. Emergency Management and People with Disabilities: before, during and after Congressional Briefing, 10 November 2005. 26 Aug. 2009 ‹ http://www.ncd.gov/newsroom/publications/2005/transcript_emergencymgt.htm ›. National Council on Disability. National Council on Disability on Hurricane Katrina Affected Areas. 2005. 26 Aug. 2009 ‹ http://www.ncd.gov/newsroom/publications/2005/katrina2.htm ›. National Research Council of Canada. From Impacts to Adaptation: Canada in a Changing Climate 2007. 26 Aug. 2009 ‹ http://adaptation.nrcan.gc.ca/assess/2007/pdf/full-complet_e.pdf ›. Nippert, I. and G. Wolff. “Ethik und Genetik: Ergebnisse der Umfrage zu Problemaspekten angewandter Humangenetik 1994-1996, 37 Länder.” Medgen 11 (1999): 53-61. Participants of the Nuclear Winter: The Anthropology of Human Survival Session. Proceedings of the 84th American Anthropological Association's Annual Meeting. Washington, D.C., 6 Dec. 1985. 26 Aug. 2009 ‹ http://www.fas.org/sgp/othergov/doe/lanl/lib-www/la-pubs/00173165.pdf ›. Scope. “Most Britons Think Others View Disabled People ‘As Inferior’.” 2009. 26 Aug. 2009 ‹ http://www.scope.org.uk/cgi-bin/np/viewnews.cgi?id=1244379033, http://www.comres.co.uk/resources/7/Social%20Polls/Scope%20PublicPoll%20Results%20May09.pdf ›. Smit, B., et al. “The Science of Adaptation: A Framework for Assessment.” Mitigation and Adaptation Strategies for Global Change 4 (1999): 199-213. Smit, B., and J. Wandel. “Adaptation, Adaptive Capacity and Vulnerability.” Global Environmental Change 16 (2006): 282-92. Sunday Morning Herald. “Who Lives and Dies in Britain after the Bomb.” Sunday Morning Herald 1988. 26 Aug. 2009 ‹ http://news.google.com/newspapers?nid=1301&dat=19880511&id=wFYVAAAAIBAJ&sjid=kOQDAAAAIBAJ&pg=3909,113100 ›. United Nations Development Programme. Human Development Report 2007/2008: Fighting Climate Change – Human Solidarity in a Divided World. 2008. 26 Aug. 2009 ‹ http://hdr.undp.org/en/media/HDR_20072008_EN_Complete.pdf ›. Wolbring, Gregor. “Is There an End to Out-Able? Is There an End to the Rat Race for Abilities?” M/C Journal 11.3 (2008). 26 Aug. 2009 ‹ http://journal.media-culture.org.au/index.php/mcjournal/article/viewArticle/57 ›. Wolbring, Gregor. “Why NBIC? Why Human Performance Enhancement?” Innovation: The European Journal of Social Science Research 21.1 (2008): 25-40.

Critique of Ability In July 2008, we could be on the eve of an enormously important shift in disability in Australia. One sign of change is the entry into force on 3 May 2008 of the United Nations convention on the Rights of Persons with Disabilities, which will now be adopted by the Rudd Labor government. Through this, and other proposed measures, the Rudd government has indicated its desire for a seachange in the area of disability. Bill Shorten MP, the new Parliamentary Secretary for Disabilities and Children’s Services has been at pains to underline his commitment to a rights-based approach to disability. In this inaugural speech to Parliament, Senator Shorten declared: I believe the challenge for government is not to fit people with disabilities around programs but for programs to fit the lives, needs and ambitions of people with disabilities. The challenge for all of us is to abolish once and for all the second-class status that too often accompanies Australians living with disabilities. (Shorten, “Address in reply”; see also Shorten, ”Speaking up”) Yet if we listen to the voices of people with disability, we face fundamental issues of justice, democracy, equality and how we understand the deepest aspects of ourselves and our community. This is a situation that remains dire and palpably unjust, as many people with disabilities have attested. Elsewhere I have argued (Goggin and Newell) that disability constitutes a systemic form of exclusion and othering tantamount to a “social apartheid” . While there have been improvements and small gains since then, the system that reigns in Australia is still fundamentally oppressive. Nonetheless, I would suggest that through the rise of the many stranded movements of disability, the demographic, economic and social changes concerning impairment, we are seeing significant changes in how we understand impairment and ability (Barnes, Oliver and Barton; Goggin and Newell, Disability in Australia; Snyder, Brueggemann, and Garland-Thomson; Shakespeare; Stiker). There is now considerable, if still incomplete, recognition of disability as a category that is constituted through social, cultural, and political logics, as well as through complex facets of impairment, bodies (Corker and Shakespeare), experiences, discourses (Fulcher), and modes of materiality and subjectivity (Butler), identity and government (Tremain). Also there is growing awareness of the imbrication of disability and other categories such as sex and gender (Fine and Asch; Thomas), race, age, culture, class and distribution of wealth (Carrier; Cole; Davis, Bending over Backwards, and Enforcing Normalcy; Oliver; Rosenblum and Travis), ecology and war (Bourke; Gerber; Muir). There are rich and wide-ranging debates that offer fundamental challenges to the suffocating grip of the dominant biomedical model of disability (that conceives disability as individual deficit — for early critiques see: Borsay; Walker), as well as the still influential and important (if at times limiting) social model of disability (Oliver; Barnes and Mercer; Shakespeare). All in all,there have been many efforts to transform the social and political relations of disability. If disability has been subject to considerable examination, there has not yet been an extended, concomitant critique of ability. Nor have we witnessed a thoroughgoing recognition of unmarked, yet powerful operations of ability in our lives and thought, and the potential implications of challenging these. Certainly there have been important attempts to reframe the relationship between “ability” and “disability” (for example, see Jones and Mark). And we are all familiar with the mocking response to some neologisms that seek to capture this, such as the awkward yet pointed “differently-abled.” Despite such efforts we lack still a profound critique of ability, an exploration of “able”, the topic that this special issue invites us to consider. If we think of the impact and significance of “whiteness”, as a way to open up space for how to critically think about and change concepts of race; or of “masculinity” as a project for thinking about gender and sexuality — we can see that this interrogation of the unmarked category of “able” and “ability” is much needed (for one such attempt, see White). In this paper I would like to make a small contribution to such a critique of ability, by considering what the concept of innovation and its contemporary rhetorics have to offer for reframing disability. Innovation is an important discourse in contemporary life. It offers interesting possibilities for rethinking ability — and indeed disability. And it is this relatively unexplored prospect that this paper seeks to explore. Beyond Access, Equity & Diversity In this scene of disability, there is attention being given to making long over-due reforms. Yet the framing of many of these reforms, such as the strengthening of national and international legal frameworks, for instance, also carry with them considerable problems. Disability is too often still seen as something in need of remediation, or special treatment. Access, equity, and anti-discrimination frameworks offer important resources for challenging this “special” treatment, so too do the diversity approaches which have supplemented or supplanted them (Goggin and Newell, “Diversity as if Disability Mattered”). In what new ways can we approach disability and policies relevant to it? In a surprisingly wide range of areas, innovation has featured as a new, cross-sectoral approach. Innovation has been a long-standing topic in science, technology and economics. However, its emergence as master-theme comes from its ability to straddle and yoke together previously diverse fields. Current discussions of innovation bring together and extend work on the information society, the knowledge economy, and the relationships between science and technology. We are now familiar for instance with arguments about how digital networked information and communications technologies and their consumption are creating new forms of innovation (Benkler; McPherson; Passiante, Elia, and Massari). Innovation discourse has extended to many other unfamiliar realms too, notably the area of social and community development, where a new concept of social innovation is now proposed (Mulgan), often aligned with new ideas of social entrepreneurship that go beyond earlier accounts of corporate social responsibility. We can see the importance of innovation in the ‘creative industries’ discourses and initiatives which have emerged since the 1990s. Here previously distinct endeavours of arts and culture have become reframed in a way that puts their central achievement of creativity to the fore, and recognises its importance across all sorts of service and manufacturing industries, in particular. More recently, theorists of creative industries, such as Cunningham, have begun to talk about “social network markets,” as a way to understand the new hybrid of creativity, innovation, digital technology, and new economic logics now being constituted (Cunningham and Potts). Innovation is being regarded as a cardinal priority for societies and their governments. Accordingly, the Australian government has commissioned a Review of The National Innovation System, led by Dr Terry Cutler, due to report in the second half of 2008. The Cutler review is especially focussed upon gaps and weaknesses in the Australian innovation system. Disability has the potential to figure very strongly in this innovation talk, however there has been little discussion of disability in the innovation discourse to date. The significance of disability in relation to innovation was touched upon some years ago, in a report on Disablism from the UK Demos Foundation (Miller, Parker and Gillinson). In a chapter entitled “The engine of difference: disability, innovation and creativity,” the authors discuss the area of inclusive design, and make the argument for the “involvement of disabled people to create a stronger model of user design”:Disabled people represented a market of 8.6 million customers at the last count and their experiences aren’t yet feeding through into processes of innovation. But the role of disabled people as innovators can and should be more active; we should include disabled people in the design process because they are good at it. (57) There are two reasons given for this expertise of disabled people in design. Firstly, “disabled people are often outstanding problem solvers because they have to be … life for disabled people at the moment is a series of challenges to be overcome” (57). Secondly, “innovative ideas are more likely to come from those who have a new or different angle on old problems” (57). The paradox in this argument is that as life becomes more equitable for people with disabilities, then these ‘advantages’ should disappear” (58). Accordingly, Miller et al. make a qualified argument, namely that “greater participation of disabled people in innovation in the short term may just be the necessary trigger for creating an altogether different, and better, system of innovation for everyone in the future” (58). The Demos Disablism report was written at a time when rhetorics of innovation were just beginning to become more generalized and mainstream. This was also at a time in the UK, when there was hope that new critical approaches to disability would see it become embraced as a part of the diverse society that Blair’s New Labor Britain had been indicating. The argument Disablism offers about disability and innovation is in some ways a more formalized version of vernacular theory (McLaughlin, 1996). In the disability movement we often hear, with good reason, that people with disability, by dint of their experience and knowledge are well positioned to develop and offer particular kinds of expertise. However, Miller et al. also gesture towards a more generalized account of disability and innovation, one that would intersect with the emerging frameworks around innovation. It is this possibility that I wish to take up and briefly explore here. I want to consider the prospects for a fully-fledged encounter between disability and innovation. I would like to have a better sense of whether this is worth pursuing, and what it would add to our understanding of both disability and innovation? Would the disability perspective be integrated as a long-term part of our systems of innovation rather than, as Miller et al. imply, deployed temporarily to develop better innovation systems? What pitfalls might be bound up with, or indeed be the conditions of, such a union between disability and innovation? The All-Too-Able User A leading area where disability figures profoundly in innovation is in the field of technology — especially digital technology. There is now a considerable literature and body of practice on disability and digital technology (Annable, Goggin, and Stienstra; Goggin and Newell, Digital Disability; National Council on Disability), however for my purposes here I would like to focus upon the user, the abilities ascribed to various kinds of users, and the user with disability in particular. Digital technologies are replete with challenges and opportunities; they are multi-layered, multi-media, and global in their manifestation and function. In Australia, Britain, Canada, the US, and Europe, there have been some significant digital technology initiatives which have resulted in improved accessibility for many users and populations (Annable, Goggin, and Stienstra; National Council on Disability) . There are a range of examples of ways in which users with disability are intervening and making a difference in design. There is also a substantial body of literature that clarifies why we need to include the perspective of the disabled if we are to be truly innovative in our design practices (Annable, Goggin and Stienstra; Goggin and Newell, “Disability, Identity and Interdependence”). I want to propose, however, that there is merit in going beyond recognition of the role of people with disability in technology design (vital and overlooked as it remains), to consider how disability can enrich contemporary discourses on innovation. There is a very desirable cross-over to be promoted between the emphasis on the user-as-expert in the sphere of disability and technology, and on the integral role of disability groups in the design process, on the one hand, and the rise of the user in digital culture generally, on the other. Surprisingly, such connections are nowhere near as widespread and systematic as they should be. It may be that contemporary debates about the user, and about the user as co-creator, or producer, of technology (Haddon et al.; von Hippel) actually reinstate particular notions of ability, and the able user, understood with reference to notions of disability. The current emphasis on the productive user, based as it is on changing understandings of ability and disability, provides rich material for critical revision of the field and those assumptions surrounding ability. It opens up possibilities for engaging more fully with disability and incorporating disability into the new forms and relations of digital technology that celebrate the user (Goggin and Newell, Digital Disability). While a more detailed consideration of these possibilities require more time than this essay allows, let us consider for a moment the idea of a genuine encounter between the activated user springing from the disability movement, and the much feted user in contemporary digital culture and theories of innovation. People with disability are using these technologies in innovative ways, so have much to contribute to wider discussions of digital technology (Annable, Goggin and Stienstra). The Innovation Turn Innovation policy, the argument goes, is important because it stands to increase productivity, which in turn leads to greater international competitiveness and economic benefit. Especially with the emergence of capitalism (Gleeson), productivity has strong links to particular notions of which types of production and produce are valued. Productivity is also strongly conditioned by how we understand ability and, last in a long chain of strong associations, how we as a society understand and value those kinds of people and bodies believed to contain and exercise the ordained and rewarded types of ability, produce, and productivity. Disability is often seen as antithetical to productivity (a revealing text on the contradictions of disability and productivity is the 2004 Productivity Commission Review of the Disability Discrimination Act). When we think about the history of disability, we quickly realize that productivity, and by extension, innovation, are strongly ideological. Ideological, that is, in the sense that these fields of human endeavour and our understanding of them are shaped by power relations, and are built upon implicit ‘ableist’ assumptions about productivity. In this case, the power relations of disability go right to the heart of the matter, highlighting who and what are perceived to be of value, contributing economically and in other ways to society, and who and what are considered as liabilities, as less valued and uneconomical. A stark recent example of this is the Howard government workplace and welfare reforms, which further disenfranchised, controlled, and impoverished people with disability. If we need to rethink our ideas of productivity and ability in the light of new notions of disability, then so too do we need to rethink our ideas about innovation and disability. Here the new discourses of innovation may actually be useful, but also contain limited formulations and assumptions about ability and disability that need to be challenged. The existing problems of a fresh approach to disability and innovation can be clearly observed in the touchstones of national science and technology “success.” Beyond One-Sided Innovation Disability does actually feature quite prominently in the annals of innovation. Take, for instance, the celebrated case of the so-called “bionic ear” (or cochlear implant) hailed as one of Australia’s great scientific inventions of the past few decades. This is something we can find on display in the Powerhouse Museum of Technology and Design, in Sydney. Yet the politics of the cochlear implant are highly controversial, not least as it is seen by many (for instance, large parts of the Deaf community) as not involving people with disabilities, nor being informed by their desires (Campbell, also see “Social and Ethical Aspects of Cochlear Implants”). A key problem with the cochlear implant and many other technologies is that they are premised on the abolition or overcoming of disability — rather than being shaped as technology that acknowledges and is informed by disabled users in their diverse guises. The failure to learn the lessons of the cochlear implant for disability and innovation can be seen in the fact that we are being urged now to band together to support the design of a “bionic eye” by the year 2020, as a mark of distinction of achieving a great nation (2020 Summit Initial Report). Again, there is no doubting the innovation and achievement in these artefacts and their technological systems. But their development has been marked by a distinct lack of consultation and engagement with people with disabilities; or rather the involvement has been limited to a framework that positions them as passive users of technology, rather than as “producer/users”. Further, what notions of disability and ability are inscribed in these technological systems, and what do they represent and symbolize in the wider political and social field? Unfortunately, such technologies have the effect of reproducing an ableist framework, “enforcing normalcy” (Davis), rather than building in, creating and contributing to new modes of living, which embrace difference and diversity. I would argue that this represents a one-sided logic of innovation. A two-sided logic of innovation, indeed what we might call a double helix (at least) of innovation would be the sustained, genuine interaction between different users, different notions of ability, disability and impairment, and the processes of design. If such a two-sided (or indeed many-sided logic) is to emerge there is good reason to think it could more easily do so in the field of digital cultures and technologies, than say, biotechnology. The reason for this is the emphasis in digital communication technologies on decentralized, participatory, user-determined governance and design, coming from many sources. Certainly this productive, democratic, participatory conception of the user is prevalent in Internet cultures. Innovation here is being reshaped to harness the contribution and knowledge of users, and could easily be extended to embrace pioneering efforts in disability. Innovating with Disability In this paper I have tried to indicate why it is productive for discourses of innovation to consider disability; the relationship between disability and innovation is rich and complex, deserving careful elaboration and interrogation. In suggesting this, I am aware that there are also fundamental problems that innovation raises in its new policy forms. There are the issues of what is at stake when the state is redefining its traditional obligations towards citizens through innovation frameworks and discourses. And there is the troubling question of whether particular forms of activity are normatively judged to be innovative — whereas other less valued forms are not seen as innovative. By way of conclusion, however, I would note that there are now quite basic, and increasingly accepted ways, to embed innovation in design frameworks, and while they certainly have been adopted in the disability and technology area, there is much greater scope for this. However, a few things do need to change before this potential for disability to enrich innovation is adequately realized. Firstly, we need further research and theorization to clarify the contribution of disability to innovation, work that should be undertaken and directed by people with disability themselves. Secondly, there is a lack of resources for supporting disability and technology organisations, and the development of training and expertise in this area (especially to provide viable career paths for experts with disability to enter the field and sustain their work). If this is addressed, the economic benefits stand to be considerable, not to mention the implications for innovation and productivity. Thirdly, we need to think about how we can intensify existing systems of participatory design, or, better still, introduce new user-driven approaches into strategically important places in the design processes of ICTs (and indeed in the national innovation system). Finally, there is an opportunity for new approaches to governance in ICTs at a general level, informed by disability. New modes of organising, networking, and governance associated with digital technology have attracted much attention, also featuring recently in the Australia 2020 Summit. Less well recognised are new ideas about governance that come from the disability community, such as the work of Queensland Advocacy Incorporated, Rhonda Galbally’s Our Community, disability theorists such as Christopher Newell (Newell), or the Canadian DIS-IT alliance (see, for instance, Stienstra). The combination of new ideas in governance from digital culture, new ideas from the disability movement and disability studies, and new approaches to innovation could be a very powerful cocktail indeed.Dedication This paper is dedicated to my beloved friend and collaborator, Professor Christopher Newell AM (1964-2008), whose extraordinary legacy will inspire us all to continue exploring and questioning the idea of able. 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