Medicines information sources and services for consumers : A special focus on the Internet and people with depression

The range of consumer health and medicines information sources has diversified along with the increased use of the Internet. This has led to a drive to develop medicines information services and to better incorporate the Internet and e-mail into routine practice in health care and in community pharmacies. To support the development of such services more information is needed about the use of online information by consumers, particularly of those who may be the most likely to use and to benefit from the new sources and modes of medicines communication. This study explored the role and utilization of the Internet-based medicines information and information services in the context of a wider network of information sources accessible to the public in Finland. The overall aim was to gather information to develop better and more accessible sources of information for consumers and services to better meet the needs of consumers. Special focus was on the needs and information behavior among people with depression and using antidepressant medicines. This study applied both qualitative and quantitative methods. Consumer medicines information needs and sources were identified by analyzing the utilization of the University Pharmacy operated national drug information call center (Study I) and surveying Finnish adults (n=2348) use of the different medicines information sources (Study II). The utilization of the Internet as a source of antidepressant information among people with depression was explored by focus group discussions among people with depression and with current or past use of the antidepressant(s) (n=29, Studies III & IV). Pharmacy response to the needs of consumers in term of providing e-mail counseling was assessed by conducting a virtual pseudo customer study among the Finnish community pharmacies (n=161, Study V). Physicians and pharmacists were the primary sources of medicines information. People with mental disorders were more frequent users of telephone- and Internet-based medicines information sources and patient information leaflets than people without mental disorders. These sources were used to complement rather than replace information provided face-to-face by health professionals. People with depression used the Internet to seek facts about antidepressants, to share experiences with peers, and for the curiosity. They described that the access to online drug information was empowering. Some people reported lacking the skills necessary to assess the quality of online information. E-mail medication counseling services provided by community pharmacies were rare and varied in quality. Study results suggest that rather than discouraging the use of the Internet, health professionals should direct patients to use accurate and reliable sources of online medicines information. Health care providers, including community pharmacies should also seek to develop new ways of communicating information about medicines with consumers. This study determined that people with depression and using antidepressants need services enabling interactive communication not only with health care professionals, but also with peers. Further research should be focused on developing medicines information service facilitating communication among different patient and consumer groups.

Konstrukcija mnimosti : K poètike "Voskovoj persony" Ju. Tynjanova

The subject of this work is the poetics of «The Wax Effigy», a short novel or novella by Jurii Tynianov, Russian writer, literary critic, historian of literature and prominent literary theoretician. The plot structure of the novel is based upon a real event, the creation by Bartolomeo Carlo Rastrelli in 1725 of a wax sculpture of the first Russian emperor, Peter the Great. «Construction of the Sham» consists of three chapters, an introduction and a conclusion. Due to the fact that Tynianov was at the same time a prose writer and theoretician of literature it seemed important to consider the reception of his prose and his works on literary theory in relationship to each other. The introduction is devoted to this task. The first chapter is about the history of the creation of the novel and its reception. Tynianov stopped writing one short story in order to write the novel; these two works have some common traits. It seems almost obvious that his work on the first text was a real step toward the creation of the second. In the first story there is an opposition of dead/alive which is semantic prefiguring of a central motif in «The Wax Effigy». An analysis of the reception of the novel demonstrated that almost every critic writing about the novel has described it as nonsense. Critics considered Tynianov's work in terms of «devices» and «content» and could not understand how devices are related to the content of the novel: the novel was thought as a signifier without any signified. Implicitly, critics thought the signified of the novel as a traditional one of the historical novel, as the historiosophical «idea», embodied in the system of literary devices. In this case literature becomes something instrumental, a kind of expression of extraliterary content. In contradistinction to that Tynianov considered literary semantics as an effect of the literary structure. From his point of view the literary sense is immanent to the process of signification accomplished inside the literary text. The second chapter is devoted to a rhetorical analysis of the opposition dead/alive. Tynianov systematically compares both terms of the opposition. As a result of this strategy the wax effigy of the dead emperor becomes «as if» alive and the world of living people «as if» dead. The qualifier «as if» refers to the fact that Tynianov creates an ambiguous semantic system. This rhetoric is related to European Romanticism and his «fantastic literature» (Merimé, Hoffmann, Maupassant etc.). But Tynianov demonstrates a linguistic origin of the strange fantoms created by romantics; he demystifies these idols by parodying the fantastic literature, that is, showing «how it was done». At the same time, the opposition mentioned above refers to his idea of «incongruity» which plays a prominent role in Tynianov s theory but has never been conceptualised. The incongruity is a inner collision of the literary text; from Tynianov's point of view the meaning of the work of literature is always a dynamic collision of semantically heterogeneous elements struggling with each other. In «The Wax Effigy» Tynianov creates a metalevel of the work demonstrating the process of creation of the literary sense. The third chapter is a reconstruction of Tynianov's conception of the historical prose, specifically of the mechanisms by which historical facts are transformed into literary events. Tynianov thought that the task of the historical novelist is to depict his hero as an actor, to demonstrate that as a wearer of many masks he is a creator of appearances, ambiguities. Here, in the «figure of fiction» (Andrei Belyi), the very idea of the historical prose and rhetoric employed in «The Wax Effigy», history and literature meet each other. In his last theoretical work, «On parody» Tynianov writes about the so-called sham structure of parody. In his opinion every parody is a text about other texts and «serious» work which could be read at the same time as a text about «reality». This twofold structure of parody is that of «The Wax Effigy»: that text speaks about ambiguities of the history and about ambiguities of the literary sense, about social reality of the past and - about the working of the literature itself. «The Wax Effigy» is written as a autoreflective text, as an experiment in literary semantics, as a system of literary ambiguities - of hero, rhetoric and the text itself. The meaning of the novel is created not by the embodiment extraliterary idea, but by the process of signification accomplished inside the work of literature. In this sense Tynianov's novel is parody, a break with the tradition of the historical novel preceding «The Wax Effigy».

Genetic Options for Drought Management in Groundnut

Groundnut is one of the principal oilseeds in the world. It is cultivated on 24.8 million ha with a total production of 32.8 million t and an average productivity of 1.32 t ha-'. Developing countries account for 96.9% of the world groundnut area and 93.8% of total production. Production is concentrated in Asia (56.8% area and 66.5% production of the world) and Africa (38.0% area and 24.7% production). The groundnut productivity in Africa is only 0.86 t ha-' compared with 1.55 t hx1 of Asia. The world groundnut economy-facts, trends and outlook are desaibed in detail by Freeman et al., 1999. Briefly, in medium-term (i.e. up to 2010), 'groundnut production and consumption is likely to shift increasingly to developing countries; production will grow in all regions but most rapidly in Asia, slowly in sub-Saharan Africa and decline in Latin America; and utilizationwill continue to shift away from groundnut oil toward groundnut meal, specially confectionery products'.

Pedagogical tools designed to promote engagement and active learning in the biomedical sciences and allied health disciplines

Perceiving students, science students especially, as mere consumers of facts and information belies the importance of a need to engage them with the principles underlying those facts and is counter-intuitive to the facilitation of knowledge and understanding. Traditional didactic lecture approaches need a re-think if student classroom engagement and active learning are to be valued over fact memorisation and fact recall. In our undergraduate biomedical science programs across Years 1, 2 and 3 in the Faculty of Health at QUT, we have developed an authentic learning model with an embedded suite of pedagogical strategies that foster classroom engagement and allow for active learning in the sub-discipline area of medical bacteriology. The suite of pedagogical tools we have developed have been designed to enable their translation, with appropriate fine-tuning, to most biomedical and allied health discipline teaching and learning contexts. Indeed, aspects of the pedagogy have been successfully translated to the nursing microbiology study stream at QUT. The aims underpinning the pedagogy are for our students to: (1) Connect scientific theory with scientific practice in a more direct and authentic way, (2) Construct factual knowledge and facilitate a deeper understanding, and (3) Develop and refine their higher order flexible thinking and problem solving skills, both semi-independently and independently. The mindset and role of the teaching staff is critical to this approach since for the strategy to be successful tertiary teachers need to abandon traditional instructional modalities based on one-way information delivery. Face-to-face classroom interactions between students and lecturer enable realisation of pedagogical aims (1), (2) and (3). The strategy we have adopted encourages teachers to view themselves more as expert guides in what is very much a student-focused process of scientific exploration and learning. Specific pedagogical strategies embedded in the authentic learning model we have developed include: (i) interactive lecture-tutorial hybrids or lectorials featuring teacher role-plays as well as class-level question-and-answer sessions, (ii) inclusion of “dry” laboratory activities during lectorials to prepare students for the wet laboratory to follow, (iii) real-world problem-solving exercises conducted during both lectorials and wet laboratory sessions, and (iv) designing class activities and formative assessments that probe a student’s higher order flexible thinking skills. Flexible thinking in this context encompasses analytical, critical, deductive, scientific and professional thinking modes. The strategic approach outlined above is designed to provide multiple opportunities for students to apply principles flexibly according to a given situation or context, to adapt methods of inquiry strategically, to go beyond mechanical application of formulaic approaches, and to as much as possible self-appraise their own thinking and problem solving. The pedagogical tools have been developed within both workplace (real world) and theoretical frameworks. The philosophical core of the pedagogy is a coherent pathway of teaching and learning which we, and many of our students, believe is more conducive to student engagement and active learning in the classroom. Qualitative and quantitative data derived from online and hardcopy evaluations, solicited and unsolicited student and graduate feedback, anecdotal evidence as well as peer review indicate that: (i) our students are engaging with the pedagogy, (ii) a constructivist, authentic-learning approach promotes active learning, and (iii) students are better prepared for workplace transition.

Space in Musical Semiosis : An Abductive Theory of the Musical Composition Process

Space in musical semiosis is a study of musical meaning, spatiality and composition. Earlier studies on musical composition have not adequately treated the problems of musical signification. Here, composition is considered an epitomic process of musical signification. Hence the core problems of composition theory are core problems of musical semiotics. The study employs a framework of naturalist pragmatism, based on C. S. Peirce’s philosophy. It operates on concepts such as subject, experience, mind and inquiry, and incorporates relevant ideas of Aristotle, Peirce and John Dewey into a synthetic view of esthetic, practic, and semiotic for the benefit of grasping musical signification process as a case of semiosis in general. Based on expert accounts, music is depicted as real, communicative, representational, useful, embodied and non-arbitrary. These describe how music and the musical composition process are mental processes. Peirce’s theories are combined with current morphological theories of cognition into a view of mind, in which space is central. This requires an analysis of space, and the acceptance of a relativist understanding of spatiality. This approach to signification suggests that mental processes are spatially embodied, by virtue of hard facts of the world, literal representations of objects, as well as primary and complex metaphors each sharing identities of spatial structures. Consequently, music and the musical composition process are spatially embodied. Composing music appears as a process of constructing metaphors—as a praxis of shaping and reshaping features of sound, representable from simple quality dimensions to complex domains. In principle, any conceptual space, metaphorical or literal, may set off and steer elaboration, depending on the practical bearings on the habits of feeling, thinking and action, induced in musical communication. In this sense, it is evident that music helps us to reorganize our habits of feeling, thinking, and action. These habits, in turn, constitute our existence. The combination of Peirce and morphological approaches to cognition serves well for understanding musical and general signification. It appears both possible and worthwhile to address a variety of issues central to musicological inquiry in the framework of naturalist pragmatism. The study may also contribute to the development of Peircean semiotics.

From council dog catcher to critical scholar

Carol and I just missed each other in the early 1990s: Carol left Manchester for Australia in 1990, while I an·iv·ed in Manchester from Australia in 1993. Sixteen years later and on the very opposite side of the world, we found ourselves sharing an adjacent room during the 2009 Agri-Food Research Network conference in Auckland. Carol was already an accomplished sociologist; I was a newbie PhD student, presenting on a thesis topic that was only just starting to take shape...

Uskonto ilman uskontoa : Radikaalin postmodernin uskonnonfilosofian haaste

Religion without religion. The challenge of radical postmodern philosophy of religion. The aim of this study is to examine the central ideas of Mark C. Taylor, Don Cupitt, and Grace Jantzen on the subject of the philosophy of religion. The method is a qualitative, systematic analysis of the works of the aforementioned philosophers. The purpose is to present, analyze, identify, find connections, and to gain an understanding of the original texts. This thesis shows that radical postmodern religion is “religion without religion”. God is “dead” and the concept of God is seen as “writing”, an ideal, a relationship of meanings or a language. In ethics, there are no objective values or principles. People must create their own morality. Reality is each person´s concept of reality. Language is universal in that language and reality cannot be considered separately. The human subject is contingent and formed in the linguistic and social context. According to postmodern feminism, the ideas that men present as facts are often degrading to women, distort reality and support the power of men. For this reason, we should create a new kind of philosophy of religion and a new language that takes women into consideration. Finally, we will study some philosophers, who have used postmodern ideas in a more moderate manner. In this way, we will look for a balanced solution between modernism and postmodernism. This study shows that the postmodern idea of religion is very different from classical Christianity. Ethics becomes subjective, anarchistic and nihilistic. Epistemology is relativistic and the human being becomes the measure of all things. Objective reality becomes blurry. Language is seen to be game-like, and it has no relation to reality. The moral responsibility of a subject becomes problematic. Science and rationality come into question without the permanent core provided by our consciousness. Women are not in an epistemologically privileged position. The truth claims by either men or women must each be evaluated one at a time. Many postmodern ideas can successfully be made of use if used in moderate manner.

Luonto, tiede ja teknologia : Kansanvalistuksen Suomi-kuva 1870-1920

Nature, science and technology. The image of Finland through popular enlightenment texts 1870-1920 This doctoral thesis looks at how Finnish popular enlightenment texts published between 1870 and 1920 took part in the process of forming a genuine Finnish national identity. The same process was occurring in other Nordic countries at the time and the process in Finland was in many ways influenced by them, particularly Sweden. In Finland the political realities under Russian rule especially during the Russification years, and the fact that its history was considered to be short compared to other European countries, made this nation-building process unique. The undertaking was led by members of the national elite, influential in the cultural, academic as well as political arenas, who were keen to support the foundation of a modern Finnish identity. The political realities and national philosophy of history necessitated a search for elements of identity in nature and the Finnish landscape, which were considered to have special national importance: Finland was very much determined as a political entity on the basis of its geography and nature. Nature was also used as means of taking a cultural or political view in terms of, for example, geographical facts such as the nation s borders or the country s geographical connections to Western Europe. In the building of a proper national identity the concept of nature was not, however, static, but was more or less affected by political and economic progress in society. This meant that nature, or the image of the national landscape, was no longer seen only as a visual image of the national identity, but also as a source of science, technology and a prosperous future. The role of technology in this process was very much connected to the ability to harness natural resources to serve national interests. The major change in this respect had occurred by the early 20th century, when indisputable scientific progress altered the relationship between nature and technology. Concerning technology, the thesis is mainly interested in the large and at the time modern technological manifestations, such as railways, factories and industrial areas in Finland. Despite the fact that the symbiosis between national nature and international but successfully localized technology was in Finnish popular enlightenment literature depicted mostly as a national success story, concerns began to arise already in last years of the 19th century. It was argued that the emerging technology would eventually destroy Finland s natural environment, and therefore the basis of its national identity. The question was not how to preserve nature through natural science, but more how to conserve such natural resources and images that were considered to be the basis of national identity and thus of the national history. National parks, isolated from technology, and distant enough so as to have no economic value, were considered the solution to the problem. Methodologically the thesis belongs to the genre of science and technology studies, and offers new viewpoints with regard to both the study of Finnish popular enlightenment literature and the national development process as a whole.

Phase transition in ammonium aluminium and ammonium chromium alums-A high pressure EPR study

An investigation of the phase transitions at high pressures in the alums mentioned in the title has been carried out using EPR of the Cr3+ ion (at the trivalent metal ion site). It is observed that at ambient as well as at high pressures there is a change of slope in the linear variations of the zero field splitting with temperature and that the low temperature phase is characterised by a large number of lines in the EPR spectra. The transition temperature shows a large positive shift with pressure, for both the alums. All these facts are explained in terms of our model of the origin of the trigonal field at the trivalent metal ion site as well as the details of the motion of NH4+ ion.

Kognitiva system i namngivningen av finländska handelsfartyg 1838-1938

This dissertation is an onomastic study of Finland s stock of ship names (nautonomasticon) recorded over the period 1838 1938. The primary material investigated consists of 2 066 examples of ship names from the fleets of coastal towns, distributed over five sample years. The material is supplemented with two bodies of comparative data; one that consists of 2 535 examples of boat names from the archipelago area at the corresponding time, and another that comprises 482 examples of eighteenth century Finnish ship names. This study clarifies the categories of names that appear the frequency of the names, formation, morphology, linguistic origin, functions, and semantic qualities. By comparing the material with boat names from previous centuries, and from other countries, the characteristics of Finnish vessel names are further highlighted. Additional clarification is brought to the chronological, regional, and social variations, and to the emergence of various forms of systematic naming. This dissertation builds on older research from other countries, and uses traditional onomastic methods alongside a more modern methodology. The approach is interdisciplinary, meaning that the names are explored using facts not only from nautical history, but also from a range of other historical disciplines such as economics, culture, art, and literature. In addition, the approach is socio-onomastic, i.e. that the variations in names are studied in a societal context. Using a synchronised perspective, cognitive linguistic theories have provided the tools for this exploration into the metaphorical and the prototypical meaning of the names, and the semantic domains that the names create. The quantitative analysis has revealed the overall picture of Finnish boat names. Personal names, names from mythology, and place names, emerge as significant categories, alongside nonproprial names in Swedish and Finnish. The interdisciplinary perspective has made it possible to explain certain trends in the stock of boat names, for example, the predisposition towards names from classical mythology, the breakthrough of names taken from the national epos Kalevala, names in the Finnish language from around the middle of the nineteenth century, and the continuing rise of place names during the latter part of the period 1838 1938. The socio-onomastic perspective has also identified clear differences between those ship names used in towns, and those ship names used in the archipelago, and it has clarified how naming conventions tend to spread from town centres to peripheral areas. The cognitive linguistic methods have revealed that the greater part of the vessel names can be interpreted as metaphors, in particular personifications, and that many names are related in their content and also form semantic networks and cognitive systems. The results indicate that there is a mental nautonomasticon that consists of a standard set of traditional ship names, but they also reveal the existence of conscious or unconscious cognitive systems (rules and conventions) that guide the naming of boats.

"Ei vittu, mennään röökille" : tutkimus sitaattien tehtävistä ja tekemisestä kaunokirjallis-journalistisissa lehtijutuissa

This research deals with direct speech quotations in magazine articles through two questions: As my major research question, I study the functions of speech quotations based on a data consisting of six literary-journalistic magazine articles. My minor research question builds on the fact that there is no absolute relation between the sound waves of the spoken language and the graphemes of the written one. Hence, I study the general thoughts on how utterances should be arranged in the written form based on a large review of literature and textbooks on journalistic writing as well as interviews I have made with magazine writers and editors, and the Council of Mass Media in Finland. To support my main research questions, I also examine the reference system of the Finnish language, define the aspects of the literary-journalistic article and study vernacular cues in written speech quotations. FUNCTIONS OF QUOTATIONS. I demonstrate the results of my analysis with a six-pointed apparatus. It is a continuum which extends from the structural level of text, all the way through the explicit functions, to the implicit functions of the quotation. The explicit functions deal with the question of what is the content, whereas the implicit ones base mainly on the question how the content is presented. 1. The speech quotation is an distinctive element in the structure of the magazine article. Thereby it creates a rhythm for the text, such as episodes, paragraphs and clauses. 2. All stories are told through a plot, and in magazine articles, the speech quotations are one of the narrative elements that propel the plot forward. 3. The speech quotations create and intensify the location written in the story. This location can be a physical one but also a social one, in which case it describes the atmosphere and mood in the physical environment and of the story characters. 4. The quotations enhance the plausibility of the facts and assumptions presented in the article, and moreover, when a text is placed between quotation marks, the reader can be assured that the text has been reproduced in the authentic verbatim way. 5. Speech quotations tell about the speaker's unique way of using language and the first-hand experiences of the person quoted. 6. The sixth function of speech quotations is probably the most essential one: the quotations characterize the quoted speaker. In other words, in addition to the propositional content of the utterance, the way in which it has been said transmits a lot of the speaker's character (e.g. nature, generation, behaviour, education, attitudes etc.). It is important to notice, that these six functions of my speech quotation apparatus do not exlude one another. It means that every speech quotation basically includes all of the functions discussed above. However, in practice one or more of them have a principal role, while the others play a subsidiary role. HOW TO MAKE QUOTATIONS? It is not suprising that the field of journalism (textbooks, literature and interviews) holds heterogeneous and unestablished thoughts on how the spoken language should be arranged in written quotations, which is my minor research question. However, the most frequent and distinctive aspects can be depicted in a couple of words: serve the reader and respect the target person. Very common advice on how to arrange the quotations is − firstly, to delete such vernacular cues (e.g. repetitions and ”expletives”) that are common in spoken communication, but purposeless in the written language. − secondly, to complete the phonetic word forms of the spoken language into a more reader-friendly form (esim. punanen → punainen, 'red'), and − thirdly, to enhance the independence of clauses from the (authentic) context and to toughen reciprocal links between them. According to the knowledge of the journalistic field, utterances recorded in different points in time of an interview or a data-collecting session can be transferred as consecutive quotations or even merged together. However, if there is any temporal-spatial location written in the story, the dialogue of the story characters should also be situated in an authentic context – chronologically in the right place in the continuum of the events. To summarize, the way in which the utterances should be arranged into written speech quotations is always situationally-specific − and it is strongly based on the author's discretion.

Nuorisokodista maailmalle : Kokemuksia nuorisokodissa elämisestä ja aikuisiässä selviytymisestä

This thesis studies the experiences of women who have lived in a youth home as girls. There are two main themes: 1) experiences of living in a youth home, and 2) experiences of coping as an adult. Data on the first theme is purely subjective; it derives from personal, recalled experiences. Data on the second theme is partly based on experiences and partly on facts about the current life situation of the research participants. A third theme of the thesis is concerned with the question of how the research participants’ placement in a youth home influenced their later life. The thesis contributes valuable knowledge concerning the experiences of young people who have been raised in substitute care, a topic that is rare in the literature. The empirical data of the study consists of responses to an initial inquiry and subsequent interviews. The inquiry was sent to 116 former inhabitants of a youth home. 62 altogether returned the inquiry, and 34 participated in the interview. The purpose of the inquiry was to produce an overview of the life situations of the research participants and to invite them to participate in the interview. In addition, the inquiry sought to produce an overview of how the participants enjoyed living in a youth home and how they saw its significance in terms of their later lives. The interviews concentrated on the research participants’ experiences concerning the processes of getting into a youth home, living there, and coping independently in life afterwards. The most central result relating to the first main theme was that the experiences were both shared and non-shared. Living in a youth home was characterized by six general sentiments: “wonderful, real home”, “new world!”, “safe haven”, “place to live”, “penal institution”, and “nightmare”. These sentiments seemed to be related first and foremost to whether one’s own, individual needs and expectations had been met in the youth home. The strongest and most common needs, as experienced, were the needs for safety, belongingness and respect. On the basis of the experiences, meeting these needs can be considered as the most important task of a youth home. The results relating to the second main theme of the study were examined in two different ways. Comparisons with the general female population (education, situation in working life and financial circumstances) showed that research participants had coped less well. Differences were also found to exist in family structures: nuclear families and single mother families were more unusual among research participants, and stepfamilies more common, than in the general population. More of the participants’ children than of the general population’s lived with somebody other than their parent. However, the experience of coping well was common among research participants, although the beginning of independent living had been generally experienced as difficult: feelings of loneliness, insecurity and restlessness were dominant. Later, a sense of life control developed and strengthened through joining with others (family, work, friends), through accepting one’s own life history and through creating one’s own model of living. As the most significant explanation of their coping, the research participants identified their own (innate) strength and will to cope. The majority of the research participants felt that the youth home had a positive influence on their later lives. Positive influences can be grouped in three “levels”: I) getting out of the home, II) having good experiences and learning useful things, and III) the essential effect on one’s own way of thinking and living. The second level’s influence includes strengthened self-esteem, increased social understanding and new knowledge and skills. Some research participants did not think the youth home had any significance in terms of their later lives, and some thought it had negative significance.

The Eligibility Definition Used in the Social Security Administration’s Disability Programs Needs to be Changed

In its October 2003 report on the definition of disability used by the Social Security Administration’s (SSA’s) disability programs [i.e., Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) for people with disabilities], the Social Security Advisory Board raises the issue of whether this definition is at odds with the concept of disability embodied in the Americans with Disabilities Act (ADA) and, more importantly, with the aspirations of people with disabilities to be full participants in mainstream social activities and lead fulfilling, productive lives. The Board declares that “the Nation must face up to the contradictions created by the existing definition of disability.” I wholeheartedly agree. Further, I have concluded that we have to make fundamental, conceptual changes to both how we define eligibility for economic security benefits, and how we provide those benefits, if we are ever to fulfill the promise of the ADA. To convince you of that proposition, I will begin by relating a number of facts that paint a very bleak picture – a picture of deterioration in the economic security of the population that the disability programs are intended to serve; a picture of programs that purport to provide economic security, but are themselves financially insecure and subject to cycles of expansion and cuts that undermine their purpose; a picture of programs that are facing their biggest expenditure crisis ever; and a picture of an eligibility determination process that is inefficient and inequitable -- one that rations benefits by imposing high application costs on applicants in an arbitrary fashion. I will then argue that the fundamental reason for this bleak picture is the conceptual definition of eligibility that these programs use – one rooted in a disability paradigm that social scientists, people with disabilities, and, to a substantial extent, the public have rejected as being flawed, most emphatically through the passage of the ADA. Current law requires eligibility rules to be based on the premise that disability is medically determinable. That’s wrong because, as the ADA recognizes, a person’s environment matters. I will further argue that programs relying on this eligibility definition must inevitably: reward people if they do not try to help themselves, but not if they do; push the people they serve out of society’s mainstream, fostering a culture of isolation and dependency; relegate many to a lifetime of poverty; and undermine their promise of economic security because of the periodic “reforms” that are necessary to maintain taxpayer support. I conclude by pointing out that to change the conceptual definition for program eligibility, we also must change our whole approach to providing for the economic security of people with disabilities. We need to replace our current “caretaker” approach with one that emphasizes helping people with disabilities help themselves. I will briefly describe features that such a program might require, and point out the most significant challenges we would face in making the transition.

Work Study and Supplemental Security Income (SSI)

This Just the Facts Series details Work Study and Supplemental Security Income.

When are SSDI/SSI Benefits Paid Pending Appeal?

This Just the Facts Series details when SSDI/SSI benefits are paid pending appeal.