Disability and participation in the professions: examples from higher and medical education

Learners with disabilities remain under-represented in higher education and courses, such as medicine, that grant access to ‘the professions’. National and professional legislation, policy and guidance have changed over the last few decades in response to reforms in the way disability is viewed and valued by society. Principles of equal rights and equality of opportunity inform the negotiation of widened participation in the professions. However, drawing on the example of medical education, it is possible to see that widening participation agendas may be insensitive to the needs of learners with disabilities. Analysing the development of practice and policy from a participation perspective suggests that tokenism may have played a role in deprioritising the voices of individuals with disabilities, rendering policy disconnected from the needs of marginalised groups. The concept of participatory parity may provide an opportunity to readdress this misrepresentation.     

Welfare to Well-Being Transition

Welfare to well-being leads to better qualityof life for families and communities. Around the world, societies are experimenting and shifting policies that address welfare to well-being for families and communities. In the U.S., the greatest shift in several decades has occurred with thewelfare reform policies. These shifts haveplaced at issue the extent to which individualsand families and governments contribute toself-sufficiency and sustainability of theirmembers and the collective whole in society. The paper addresses: a framework for thinkingabout sustaining well-being in the context ofmaking transitions from welfare for the few towell-being for the many; a researchillustration of focus group findings on themeaning of self-sufficiency for families whoare currently receiving one type of welfare(food stamps); and the opportunities emergingin the context of the interaction of the familyand society at the community, state, nationaland global level that allows for a wholisticresponse to issues around well-being andquality of life studies.     

Judgments about Risk and Perceived Invulnerability in Adolescents and Young Adults

This study examined age differences in risk judgments and perceptions of invulnerability, by surveying 577 adolescents (grades 5, 7, and 9) and young adults (ages 20 to 30 years) for their judgments concerning natural hazards and behavior–linked risks. Adolescents were less likely than were young adults to see themselves as invulnerable, and only a small minority of adolescents evidenced such perceptions. Moreover, individuals’ perceptions about the magnitude of their personal risk for experiencing negative outcomes showed an inverse relation to age. Most participants were inaccurate and significantly overestimated risks; this was especially true of adolescents. These patterns of age differences were consistent across different types of risks and sociodemographic configurations. The results pose a challenge to conventional wisdom concerning adolescents’ perceptions of risk and have important implications for theory, programs, and policies related to adolescents.     

Everglades Restoration: Interactions of Population and Environment

The Everglades system has suffered drastic changes to its life-blood, water. Dramatic population increases and intensive drainage efforts have significantly altered water quantity, quality, timing, and distribution through the system. This paper reviews water management alterations to the Everglades system and changes in the region's population and demography documenting the interconnectivity of the human and natural system. Specific ramifications of population and economic growth on land use, water use, and flood control are examined as a backdrop for discussion of the Comprehensive Everglades Restoration efforts now underway. Through discussion of these ramifications and restoration efforts, challenges and opportunities for successful Everglades restoration are identified.     

Governmentality by Network in English Primary Healthcare

In England, the quality of clinical work is being regulated in new ways following recent developments in “clinical governance” policy and apparent failures in the previous system of medical self‐regulation. Using multiple case studies, this paper examines how these changes are affecting professional governmentality and discipline in general practice. Formal organizational structures play little role in clinical governance there. Clinical quality is managed largely through semi‐formal networks, relying on medical self‐surveillance. Compliance is achieved largely by discursive appeals to the legitimacy of clinical governance, but local GPs’ leaders also argue that governments might otherwise regulate medical practice more actively. As yet the effects of clinical governance activity on service delivery are slight. Professional self‐regulation is replacing permissive exception management with more collegial, directive methods.     

Identifying the barriers and challenges to voting by residents in nursing homes and assisted living settings

To ascertain the need for and to inform development of guidelines for voting in long-term care settings, we conducted a telephone survey of Philadelphia nursing (n = 31) and assisted living (n = 20) settings following the 2003 election. Substantial variability existed in procedures used for registration and voting, in staff attitudes, and in the estimated proportion of residents who voted (29%+/-28, range 0-100%). Residents who wanted to vote were unable to do so at nearly one-third of sites, largely due to procedural problems. Nearly two-thirds of facilities indicated they assessed residents' voting capacity before the election. However, methods differed and may have disenfranchised residents who were actually competent to vote. Current procedures in many facilities fail to protect voting rights. These data suggest that rights might be better protected if election officials took charge of registration, filing absentee ballot requests, ballot completion, and trained LTC facility staff on voters' rights and reasonable accommodations.     

Eagle soaring: the power of the resilient self

Adversity can be an opportunity to focus on strengths and nurture resiliency. Cultural understanding and awareness can be easily incorporated into therapy through empathic listening, a therapeutic alliance, and supportive understanding. Patients should not subscribe to "victim" labels. Resilience should be celebrated.