자연주의적 탐구조사(Naturalistic Inquiry)

The present report is submitted in response to General Assembly resolution 61/106, by which the Assembly adopted the Convention on the Rights of Persons with Disabilities and the Optional Protocol thereto. As requested by the Assembly, a brief overview of the status of the Convention as at 3 August 2007 is presented. The report also contains a brief description of technical arrangements on staff and facilities made necessary for the effective performance of the functions of the Conference of States Parties and the Committee under the Convention and the Optional Protocol, and a description on the progressive implementation of standards and guidelines for the accessibility of facilities and services of the United Nations system. Recent efforts of the United Nations and agencies to disseminate information on the Convention and the Optional Protocol are also described.

わかりやすい障害者の権利条約 : 知的障害のある人の権利のために = Convention on the rights of persons with disabilities

Symposium Review: 25th Anniversary of Moral Boundaries by Joan Tronto

A significant and core text in occupational therapy for more than 8 years, Dr Ann Wilcock's revolutionary "An Occupational Perspective of Health" has been updated and enhanced into a much-anticipated Second Edition This unique text that examines the relationship between occupation, health, and ill-health explores the occupational experience within populations and offers more information critical to the practice of occupational therapy Based on extensive studies of human history and occupation, Dr Wilcock takes a holistic approach of health in line with that of the World Health Organization, examining the necessity for occupational therapists and their role in promoting health and well-being for all people "An Occupational Perspective of Health" uncovers a different way to understand health by exploring the physical, social, mental, environmental, and spiritual dimensions that lead to or result from occupation Dr Wilcock takes a global perspective by approaching health from this angle, rather than just considering medical or social factors The text considers the growth, development, and enhancement potential of involvement This valuable resource supports and explains the historical and rational foundations of the advancing field of occupational therapy, by showing the link between occupation and existence Addressed in this edition are: a conceptualization of health in the past, present, and future; the role of occupation in human life, health, and survival; occupation as a positive or negative influence on well-being; the potential contribution of occupational therapy to current WHO public/population health objectives; and possible action for OTs to become recognized as health-promoting professionals at population levels Clinicians and students of occupational therapy, as well as other professionals working in public health, will benefit from and relate to this admired and essential text

An Occupational Perspective of Health

Moral Boundaries: A Political Argument for an Ethic of Care

This challenging and innovative book explores the political aspects of occupational therapy practice, developing this concept from the implications of occupational justice, and expanding on some of the ideas originally set out in OCCUPATIONAL THERAPY WITHOUT BORDERS. The book discusses how practitioners may develop political awareness in order to achieve goals in community development, or towards occupational goals, and is supported by twelve chapters of practice examples from the UK, US, Georgia and Australia as well as an important history of the profession as an agency for social change. Contents include significant theoretical chapters on gender, class and disability, challenges to holism, occupational literacy, and a discussion of political competence.

A Political Practice of Occupational Therapy

Human sexuality has been medicalized and largely reduced to its physical components. This has led to a focus on the performative part of sexuality, and to a lack of interest in its social component. Men with spinal cord injury often report an unsatisfying sexual life, with limited chances to express their sexuality. This study shows that sociocultural barriers may be as disabling as physical impairment. The participants of this qualitative study felt that several barriers compromised their right to a satisfying sexual life, including certain social beliefs and attitudes (e.g. social disapproval and exclusive notion of sexuality), lack of employment, inappropriate personal assistance and inaccessibility among others. Impairment per se was not viewed as a barrier, since the new situation assumed status of normality. It is suggested that changes in education as well as the removal of physical barriers may positively influence societal attitudes and make sexuality more “accessible” to disabled people.

If not the Disability, then what? Barriers to Reclaiming Sexuality Following Spinal Cord Injury

The new Sustainable Development Goals (SDGs) to 2030 aim to reduce maternal mortality and provide equitable access to maternal healthcare. Compromised access to maternal health facilities in low-income countries, and specifically in Africa, contribute to the increased prevalence of maternal mortality. We conducted a systematic review to investigate access barriers to maternal health in low-income countries in Africa since 2015, from the perspective of both community members and health providers. The findings show that the most important barriers to maternal health are transportation barriers to health facilities, economic factors, and cultural beliefs, in addition to lack of family support and poor quality of care. Further research is required to guide policymakers towards firm multi-sectoral action to ensure appropriate and equitable access to maternal health in line with the SDGs to 2030.

https://www.mdpi.com/1660-4601/17/12/4292/pdf

Barriers to Accessing Maternal Care in Low Income Countries in Africa: A Systematic Review

Neoliberal reforms lead to deep changes in healthcare systems around the world, on account of their emphasis on free market rather than the right to health. People with disabilities can be particularly disadvantaged by such reforms, due to their increased healthcare needs and lower socioeconomic status. In this article, we analyse the impacts of neoliberal reforms on access to healthcare for disabled people. This article is based on a critical analytical review of the literature and on two case studies, Chile and Greece. Chile was among the first countries to introduce neoliberal reforms in the health sector, which led to health inequalities and stratification of healthcare services. Greece is one of the most recent examples of countries that have carried out extensive changes in healthcare, which have resulted in a deterioration of the quality of healthcare services. Through a review of the policies performed in these two countries, we propose that the pathways that affect access to healthcare for disabled people include: a) Policies directly or indirectly targeting healthcare, affecting the entire population, including disabled people; and b) Policies affecting socioeconomic determinants, directly or indirectly targeting disabled people, and indirectly impacting access to healthcare. The power differentials produced through neoliberal policies that focus on economic rather than human rights indicators, can lead to a category of disempowered people, whose health needs are subordinated to the markets. The effects of this range from catastrophic out-of-pocket payments to compromised access to healthcare. Neoliberal reforms can be seen as a form of structural violence, disproportionately affecting the most vulnerable parts of the population – such as people with disabilities – and curtailing access to basic rights, such as healthcare.

/pdf/the-effects-of-neoliberal-policies-on-access-to-healthcare-5f23i1ccc3.pdf

The effects of neoliberal policies on access to healthcare for people with disabilities.

Objectives: The aim of this study was to investigate differences in access to health care between people with and without disabilities in the UK. The hypotheses were that: a) people with disabilities would be more likely to have unmet health care needs; and b) there would be gender differences, with women more likely to report unmet needs. Setting and Participants: We performed secondary analysis, using logistic regressions, of de-identified cross-sectional data from the European Health Interview Survey, Wave 2. The sample included 12,840 community-dwelling people over the age of 16 from across the UK, 5,236 of whom had a disability. The survey method involved face-to-face and telephone interviews. Outcome measures: Unmet need for health care due to long waiting lists, or distance or transportation problems; not being able to afford medical examination, treatment, mental health care, or prescribed medicines. All measures were self-reported. Results: Adjusting for age, sex, and other factors, people with a severe disability had higher odds of facing unmet needs. The largest gap was in ‘unmet need for mental health care due to cost’, where people with a severe disability were 4.5 times (CI 95%: 2.2-9.2) more likely to face a problem, as well as in ‘unmet need due to cost of prescribed medicine’, where people with a mild disability had 3.6 (CI 95%: 2.2-5.9) higher odds of facing a difficulty. Women with a disability were 7.2 times (CI 95%: 2.7-19.4) more likely to have unmet needs due to cost of care or medication, compared to men with no disability. Conclusions: People with disabilities reported worse access to health care, with transportation, cost, and long waiting lists being the main barriers. These findings are worrying as they illustrate that a section of the population, who may have higher health care needs, faces increased barriers in accessing services.

https://bmjopen.bmj.com/content/bmjopen/7/8/e016614.full.pdf

Dikaios Sakellariou

Papers

A Political Practice of Occupational Therapy

If not the Disability, then what? Barriers to Reclaiming Sexuality Following Spinal Cord Injury

Barriers to Accessing Maternal Care in Low Income Countries in Africa: A Systematic Review

The effects of neoliberal policies on access to healthcare for people with disabilities.

Access to healthcare for men and women with disabilities in the UK: secondary analysis of cross-sectional data