From warfare to welfare: veterans, military charities and the blurred spatiality of post-service welfare in the United Kingdom

The military offers a form of welfare-for-work but when personnel leave they lose this safety net, a loss exacerbated by the rollback neoliberalism of the contemporary welfare state. Increasingly the third sector has stepped in to address veterans’ welfare needs through operating within and across military/civilian and state/market/community spaces and cultures. In this paper we use both veterans’ and military charities’ experiences to analyse the complex politics that govern the liminal boundary zone of post-military welfare. Through exploring ‘crossing’ and ‘bridging’ we conceptualise military charities as ‘boundary subjects’, active yet dependent on the continuation of the civilian-military binary, and argue that the latter is better understood as a multidirectional, multiscalar and contextual continuum. Post-military welfare emerges as a competitive, confused and confusing assemblage that needs to be made more navigable in order to better support the ‘heroic poor’.

Heritage property, tourism and the UK Disability Discrimination Act

Heritage tourism depends on a physical resource based primarily on listed buildings and scheduled monuments. Visiting or staying in a historic building provides a rich tourism experience, but historic environments date from eras when access for disabled people was not a consideration. Current UK Government policy now promotes social inclusion via an array of equal opportunities, widening participation and anti-discrimination policies. Historic environments enjoy considerable legislative protection from adverse change, but now need to balance conservation with public access for all. This paper discusses the basis of research being undertaken by The College of Estate Management funded by the Mercers Company of London and the Harold Samuel Trust. It assesses how the 1995 Disability Discrimination Act has changed the legal obligations of owners/operators in managing access to listed buildings in tourism use. It also examines the key stakeholders and power structures in the management of historic buildings and distinguishes other important players in the management process.

Children's sociospatial (re)production of disability within primary school playgrounds

There is a contemporary shift in the institutional context of 'disabled' children's education in the United Kingdom from segregated special to mainstream schools. This change is tied to wider deinstitutionalised or reinstitutionalised geographies of disabled people, fragile globalised educational 'inclusion' agendas, and broader concerns about social cohesiveness. Although coeducating children is expected to transform negative representations of (dis)ability in future society, there are few detailed explorations of how children's everyday sociospatial practices (re)produce or transform dominant representations of (dis)ability. With this in mind, children's contextual and shifting performances of (dis)ability in two case study school playground (recreational) spaces are explored. The findings demonstrate that children with mind-body differences are variously (dis)abled, in comparison with sociospatially shifting norms of ability, which have body, learning, and emotional-social facets. The discussion therefore places an emphasis on the need to incorporate 'intellectual' and 'emotional' differences more fully into geographical studies of disability and identity. The paper has wider resonance for transformative expectations placed on colocating children with a variety of 'axes of difference' (such as gender, 'race, ethnicity, and social class) in schools.

Children's caring roles and responsibilities within the family in Africa

In many Sub-Saharan African countries, the care of chronically ill, disabled or elderly relatives is usually regarded as the responsibility of family members, within a broader landscape of often overburdened healthcare systems, the expense of medical fees, very limited access to social protection and policies that emphasise home-based care. Recent studies have demonstrated that children and youth, particularly girls and young women, take on considerable caring roles for chronically ill and elderly relatives in Africa. This article reviews the available research on young people’s caring roles and responsibilities within families affected by chronic illness and disability in Sub-Saharan Africa. I discuss how children’s caring roles challenge global and local constructions of childhood and suggest ways of conceptualising the socio-spatial and embodied dimensions of children’s everyday care work within diverse household forms. I analyse evidence on outcomes of care and children’s resilience in managing their caring responsibilities and examine the complex array of processes that influence whether children take on caring roles within the family. I argue that relational, intergenerational and lifecourse approaches to researching children’s caring responsibilities within the family have considerable potential for future geographical research and could provide further insights into the ways that care is embedded in social relations, cultural norms and structural inequalities operating in different configurations in particular places.

EQUAL: New horizons for ageing research

The Engineering and Physical Sciences Research Council (EPSRC) extending quality of life (EQUAL) initiative, specifically supports interdisciplinary user-focused design, engineering and technology research concerned with enhancing the independence and quality of life of older and disabled people. This paper briefly describes a recent programme to encourage the adoption of a broader perspective on the lives and needs of older people that have been pursued by EPSRC through its extending quality life (EQUAL) initiative. EPSRC is the principle supporter design, engineering and technology research in UK universities. The paper illustrates the scope of EQUAL.

The contribution of building research to the independence and quality of life of older people

Many nations are experiencing rapid rises in the life expectancy of their citizens. The implications of this major demographic shift are considerable offering opportunities as well as challenges to reconsider how people should spend their later years. A key task is enhancing the quality of life of older people through enabling them to continue to live independently even though illness, accident or frailty may have severely reduced their physical and sensory abilities and, possibly, mental health. Yet the needs of older people and disabled people have been largely ignored in the design of everyday consumer products, the home, transport systems and the built environment in general. Whilst the need for designers, engineers and technologists to provide products, environments and systems which are inclusive of all members of society is widely accepted, there is little understanding of how this can be achieved. In 1998 the UK Engineering and Physical Sciences Research Council established its EQUAL Initiative. This has encouraged design, engineering and technology researchers in universities to join with their colleagues from the social, medical and health sciences to investigate a wide range of issues experienced by older and disabled people and to propose solutions. Their research, which directly involves older and disabled people and, for example, social housing providers, social services departments, charities, engineering and architectural consultants, and transport firms, has been extremely successful. In a very short time it has influenced government policy on housing, long-term care, and building standards, and findings have been taken up by architects, designers, health-care professionals and bodies which represent older and disabled people.

The children that time forgot: Reframing housing standards to incorporate children's needs

This paper presents the findings from a recent study funded by the Joseph Rowntree Foundation examining the housing and neighbourhood needs of 44 visually impaired children. Our research found that disabled people’s needs have been too narrowly based on ‘accessibility’ criteria, which do not take into account the health and safety issues so important for children. Indeed, the home environment is the main site of accidental death or injury for young children under 4 years, and children from low income families are particularly susceptible to burns, scalds, falls, swallowing foreign objects or poisonous substances within it (CRDU 1994). As disabled children are statistically more likely to be in low income families, this places them at high risk. If ‘accessibility’ is to be reconceived as design for usability throughout the lifecourse, this challenges us to move beyond the pragmatic but limited application of design prescriptions for disabled people as a separate and adult group, and to re-think all of the dimensions of the housing quality framework in the light of this expanded approach.

Regulation and innovation: Rethinking 'inclusive' housing design

The Lifetime Homes (LTH) concept initiated in 1989 by the Helen Hamlyn Trust, and subsequently promoted by the Joseph Rowntree Foundation, emerged at a point when there was growing awareness of the decline of both private and public sector housing quality, especially in relation to floorspace standards (Karn & Sheridan, 1994). LTH were intended to offset the concerns of first, the house buying public of the appearance and affordability of homes suitable for successive generations, second, the private house building industry of the cost and marketability of incorporating 'inclusive' design features, and third, Registered Social Landlords (RSLs), who had to balance cost constraints with addressing the needs of a growing number of households with older and/or disabled people. Approved Document Part M of the building regulations was extended in 1999, from public buildings to private dwellings, and currently requires that all new housing meet minimal 'visitability' criteria. Indeed, although the signs are that Part M will be incrementally extended to comprise LTH principles, the paper argues that in their existing form they are insufficient to act as a key component of the government's 'new agenda for British housing'. This paper therefore explores how they might usefully be expanded from an approach, largely based on compromise, to one that inspires innovative, flexible and inclusive house forms, which also challenge design conventions.

Young people with intellectual disabilities attending mainstream and segregated schooling: perceived stigma, social comparison and future aspirations

Mainstream schooling is a key policy in the promotion of social inclusion of young people with learning disabilities. Yet there is limited evidence about the school experience of young people about to leave mainstream as compared with segregated education, and how it impacts on their relative view of self and future aspirations. Sixty young people with mild to moderate intellectual disabilities in their final year of secondary school participated in this study. Twenty-eight individuals came from mainstream schools and 32 attended segregated school. They completed a series of self-report measures on perceptions of stigma, social comparison to a more disabled and non-disabled peer and the likelihood involved in attaining their future goals. The majority of participants from both groups reported experiencing stigmatized treatment in the local area where they lived. The mainstream group reported significant additional stigma at school. In terms of social comparisons, both groups compared themselves positively with a more disabled peer and with a non-disabled peer. While the mainstream pupils had more ambitious work-related aspirations, both groups felt it equally likely that they would attain their future goals. Although the participants from segregated schools came from significantly more deprived areas and had lower scores on tests of cognitive functioning, neither of these factors appeared to have an impact on their experience of stigma, social comparisons or future aspirations. Irrespective of schooling environment, the young people appeared to be able to cope with the threats to their identities and retained a sense of optimism about their future. Nevertheless, negative treatment reported by the children was a serious source of concern and there is a need for schools to promote the emotional well-being of pupils with intellectual disabilities.

Who knows best? Awareness of divided attention difficulty in a neurological rehabilitation setting

Objective: To explore whether patients relearning to walk after acquired brain injury and showing cognitive-motor interference were aware of divided attention difficulty; whether their perceptions concurred with those of treating staff. Design: Patients and neurophysiotherapists (from rehabilitation and disabled wards) completed questionnaires. Factor analyses were applied to responses. Correlations between responses, clinical measures and experimental decrements were examined. Results: Patient/staff responses showed some agreement; staff reported higher levels of perceived difficulty; responses conformed to two factors. One factor (staff/patients alike) reflected expectations about functional/motor status and did not correlate with decrements. The other factor (patients) correlated significantly with dual-task motor decrement, suggesting some genuine awareness of difficulty (cognitive performance prioritized over motor control). The other factor (staff) correlated significantly with cognitive decrement (gait prioritized over sustained attention). Conclusions: Despite some inaccurate estimation of susceptibility; patients and staff do exhibit awareness of divided attention difficulty, but with a limited degree of concurrence. In fact, our results suggest that patients and staff may be sensitive to different aspects of the deficit. Rather than 'Who knows best?', it is a question of 'Who knows what?.

Virtual reality Post Traumatic Stress Disorder (PTSD) exposure therapy results with active duty Iraq war combatants

Post Traumatic Stress Disorder (PTSD) is reported to be caused by traumatic events that are outside the range of usual human experience including (but not limited to) military combat, violent personal assault, being kidnapped or taken hostage and terrorist attacks. Initial data suggests that at least 1 out of 6 Iraq War veterans are exhibiting symptoms of depression, anxiety and PTSD. Virtual Reality (VR) delivered exposure therapy for PTSD has been used with reports of positive outcomes. The aim of the current paper is to present the rationale and brief description of a Virtual Iraq PTSD VR therapy application and present initial findings from its use with PTSD patients. Thus far, Virtual Iraq consists of a series of customizable virtual scenarios designed to represent relevant Middle Eastern VR contexts for exposure therapy, including a city and desert road convoy environment. User-centered design feedback needed to iteratively evolve the system was gathered from returning Iraq War veterans in the USA and from a system deployed in Iraq and tested by an Army Combat Stress Control Team. Results from an open clinical trial at San Diego Naval Medical Center of the first 18 treatment completers indicate that 14 no longer meet PTSD diagnostic criteria at post-treatment, with only one not maintaining treatment gains at 3 month follow-up. Clinical tests are also currently underway at Ft. Lewis, Emory University, Weill Cornell Medical College, Walter Reed Army Medical Center and 10 other sites. Other sites are preparing to use the application for a variety of PTSD and VR research purposes.

Iron and zinc status in multiple sclerosis patients with pressure sores

Measurements of weighted dietary intakes and plasma determinations of albumin, iron, zinc, ascorbic acid and TIBC were carried out on twenty female multiple sclerosis patients in a long-stay hospital for disabled people. The group included ten patients with a recent history of pressure sores, closely matched with ten patients without pressure sores. Mean daily intake of carbohydrate was found to be higher in the non-pressure sore group whilst intake of zinc was lower in this group. Intakes of all other nutrients were comparable between the two groups. For both groups, intakes of energy, folate, vitamin D, iron and zinc were less than recommended values. Mean plasma levels of albumin and iron were towards the lower limit of the normal range, whilst that for zinc was considerably less than the normal range. Plasma TIBC was slightly above the normal range. Levels of plasma iron and zinc were significantly lower in the pressure sore group. The data indicate that severely disabled hospitalized patients with multiple sclerosis may be at risk of poor nutritional status. The results suggest that in the presence of pressure sores, there are increased requirements for specific nutrients, notably zinc and iron. Consideration is given to the possible value of supplementation of these individuals.

Virtual reality Post Traumatic Stress Disorder (PTSD) exposure therapy results with active duty OIF/OEF service members

Posttraumatic stress disorder (PTSD) is reported to be caused by exposure to traumatic events including (but not limited to) military combat, violent personal assault, being kidnapped or taken hostage and terrorist attacks. Initial data suggest that at least 1 out of 6 Iraq War veterans are exhibiting symptoms of depression, anxiety and PTSD. Virtual reality (VR) delivered exposure therapy for PTSD has been used with reports of positive outcomes. The aim of the current paper, is to present the rationale and brief description of a Virtual Iraq/Afghanistan PTSD VR therapy application and present initial findings from its use with PTSD patients. Thus far, Virtual Iraq/Afghanistan consists of a series of customizable virtual scenarios designed to represent relevant Middle Eastern VR contexts for exposure therapy, including a city and desert road convoy environment. User-centered design feedback, needed to iteratively evolve the system, was gathered from returning Iraq War veterans in the USA and from a system deployed in Iraq and tested by an Army Combat Stress Control Team. Results from an open clinical trial at San Diego Naval Medical Center of the first 20 treatment completers indicate that 16 no longer met PTSD screening criteria at post-treatment, with only one not maintaining treatment gains at 3 month follow-up.

Drama, disability and education

This book explores the question, what can society learn about disability through the way it is portrayed in TV, films and plays? The text examines and analyses the way disability is portrayed in drama, and how that portrayal may be interpreted by young audiences. Investigating how disabilities have been represented on stage in the past, this book discusses what may be inferred from plays which feature disabled characters through a variety of critical approaches. The book provides an annotated chronology that traces the history of plays that have featured disabled characters. It analyses how disability is used as a dramatic metaphor and considers the ethics of dramatising a disabled character. Critical accounts of units of work in mainstream school seeking to raise disability awareness through engagement with practical drama and dramatic texts are given along with detailed discussions of the issues underpinning two previously unpublished playscripts written for young audiences and description and evaluation of a drama project in a special school. In tackling questions and issues that have not, hitherto, been well covered, Drama, Disability and Education will be of enormous interest to drama students, teachers, researchers and pedagogues who work with disabled people or are concerned with raising awareness and understanding of disability.