From Navas to Kaltoft: The European Court of Justice’s evolving definition of disability and the implications for HIV-positive individuals

This article will examine the definition of disability developed by the European Court of Justice for the purposes of the Employment Equality Directive and examine whether it is sufficient for the purpose of bringing People Living with HIV/AIDS within its scope. The article will argue that in order to adequately protect People Living with HIV/AIDS within the EU from discrimination, the European Court of Justice needs to ensure that a coherent EU wide definition of disability, based fully upon the social model of disability, is adopted. This is necessary in order to ensure adequate protection not only for People Living with HIV/AIDS but for all individuals with disabilities from discrimination throughout the EU. In addition to this central argument, this paper will argue that the lack of a coherent definition of disability grounded in the social model fragments protection for People Living with HIV/AIDS across the EU leading to a number of possible unintended consequences

'Caught Between a Rock and a Hard Place': Anti-discrimination Legislation in the Liberal State and the Fate of the Australian Disability Discrimination Act

This article offers a critical analysis of some of the practical implications for disabled people of the Disability Discrimination Act of 1992. Specifically, it raises questions about politics and the role of the law as an instrument of social change?taking greater account of the interests of disabled people?on the one hand, and of the reliance of the social model of disability on a strategy based upon legal rights on the other. The article also suggests that the constraining effects of Australia's constitutional protections of rights and its federal system of government hinder the mildly progressive elements of the Disability Discrimination Act. To illustrate this, the paper employs empirical evidence to suggest that these effects have been exacerbated by the passage of the Human Rights Legislation Amendment Act in 1999

Priorities and strategies for improving disabled women's access to maternity services when they are affected by domestic abuse:a multi-method study using concept maps

BACKGROUND: Domestic abuse is a significant public health issue. It occurs more frequently among disabled women than those without a disability and evidence suggests that a great deal of domestic abuse begins or worsens during pregnancy. All women and their infants are entitled to equal access to high quality maternity care. However, research has shown that disabled women who experience domestic abuse face numerous barriers to accessing care. The aim of the study was to identify the priority areas for improving access to maternity services for this group of women; develop strategies for improved access and utilisation; and explore the feasibility of implementing the identified strategies. METHODS: This multi-method study was the third and final part of a larger study conducted in the UK between 2012 and 2014. The study used a modified concept mapping approach and was theoretically underpinned by Andersen’s model of healthcare use. Seven focus group interviews were conducted with a range of maternity care professionals (n = 45), incorporating quantitative and qualitative components. Participants ranked perceived barriers to women’s access and utilisation of maternity services in order of priority using a 5-point Likert scale. Quantitative data exploration used descriptive and non-parametric analyses. In the qualitative component of each focus group, participants discussed the barriers and identified potential improvement strategies (and feasibility of implementing these). Qualitative data were analysed inductively using a framework analysis approach. RESULTS: The three most highly ranked barriers to women’s access and utilisation of maternity services identified in the quantitative component were: 1) staff being unaware and not asking about domestic abuse and disability; 2) the impact of domestic abuse on women; 3) women’s fear of disclosure. The top two priority strategies were: providing information about domestic abuse to all women and promoting non-judgemental staff attitude. These were also considered very feasible. The qualitative analysis identified a range of psychosocial and environmental barriers experienced by this group of women in accessing maternity care. Congruent with the quantitative results, the main themes were lack of awareness and fear of disclosure. Key strategies were identified as demystifying disclosure and creating physical spaces to facilitate disclosure. CONCLUSIONS: The study supports findings of previous research regarding the barriers that women face in accessing and utilising maternity services, particularly regarding the issue of disclosure. But the study provides new evidence on the perceived importance and feasibility of strategies to address such barriers. This is an important step in ensuring practice-based acceptability and ease with which improvement strategies might be implemented in maternity care settings

Improving understanding of service-user involvement and identity : collaborative research traversing disability, activism and the academy

This article focuses on collaborative research traversing disability, activism and the academy to improve understanding of service-user involvement and identity. The project was undertaken by an organisation of disabled people, some of whom are, and some of whom are not, employed by academic institutions. It is an example of research fusion between disabled people’s activism and their work within the academy. The project aimed to identify meaningful ways of promoting involvement in the development of public services. Power relationships which shape the reality of disabled people’s participation in decision-making processes within services are critiqued. We explore ways in which disabled service users and our representative organisations can drive a form of political activism within services and through the academy to improve the lives of disabled people according to the priorities of disabled people themselves. This is not simply an academic project; we identify strategies for activism and change

The Diagnosis and Context of a Facial Deformity from an Anglo-Saxon Cemetery at Spofforth, North Yorkshire

An individual aged between 6 and 7years at death from a 7th to 9th century cemetery at Village Farm, Spofforth, North Yorkshire, presented significant pathological swelling to the left facial bones. The ectocranial surface was bulbous and uneven, and the expanded diploë was densely packed with a mass of thick trabeculae. Radiographic and histological analysis, in combination with the macroscopically observed pathological changes, supported the differential diagnosis of fibrous dysplasia. The skeletal changes to the left face and jaw would have resulted in a significant facial deformity. Examples of individuals with physical impairments or disfigurements from Anglo-Saxon cemeteries are rare. Nevertheless, it seems that a significant proportion are afforded unusual burial practices more often associated with deviancy, for example, at the edge of cemeteries or on a reversed orientation, seemingly indicating that their diminished physical capabilities or altered physical appearance had a detrimental effect on their social status. The child from Spofforth was, however, buried in a normative manner, extended, supine and in a plain earth-cut grave, with no indication that their facial deformity had prompted unusual funerary provision. This example of facial disfigurement contributes to a growing corpus of potentially disabled individuals from early medieval England. © 2011 John Wiley & Sons, Ltd

Co-research with adults with Intellectual Disability: a systematic review

Background. Co-research with people with intellectual disability (ID) is a distinct form of patient and public involvement (PPI). This systematic review summarises published studies and protocols to report on the process of co-research in social and health care research. Method. Relevant studies were identified using electronic searches on ASSIA, PsycInfo and MedLine. Study quality was assessed and information relevant to the process of working with co-researchers was extracted and thematically analysed. Results. Thirteen studies were retrieved. Data are reported under three themes: 1) challenges of co-research; 2) facilitators of co-research; 3) benefits of co-research. Best practice is presented as a model of co-research. Content analysis on 12 research protocols identified four themes related to PPI. Conclusions. All stakeholders involved in co-research with people with ID can benefit, providing there is adequate infrastructure to accommodate and empower the co-researchers. Many current ID research projects still lack systematic involvement of PPI members

Disabled children and the child protection system : a cause for concern

Disabled children are more likely to be abused than their non-disabled peers. Despite this heightened risk, the abuse of disabled children goes undetected and under-reported. This qualitative study investigated the specific issues faced by practitioners in Scotland in supporting disabled children at risk of significant harm. Interviews were held with participants from six local authority areas and across five different services and five focus groups with Child Protection Committees (total 61 participants). There were positive messages about putting the child at the very heart of child protection assessment and intervention, regardless of any impairment a child may have. However, there was also concern that practice was at times parent-centred. Some participants appeared to be ‘muddling through’ in practice and many practitioners lacked confidence when working with disabled children. Data from this study suggests that thresholds for disabled children may be higher than for non-disabled children. Participants reported high levels of interagency working and saw this as inherently positive, although they recognised some failings and tensions. There is widespread commitment across the child protection system to putting the child at the centre. However, getting it right for every child does not mean treating every child the same