16 results
Head and Neck Cancer: United Kingdom National Multidisciplinary Guidelines, Sixth Edition
- Jarrod J Homer, Stuart C Winter, Elizabeth C Abbey, Hiba Aga, Reshma Agrawal, Derfel ap Dafydd, Takhar Arunjit, Patrick Axon, Eleanor Aynsley, Izhar N Bagwan, Arun Batra, Donna Begg, Jonathan M Bernstein, Guy Betts, Colin Bicknell, Brian Bisase, Grainne C Brady, Peter Brennan, Aina Brunet, Val Bryant, Linda Cantwell, Ashish Chandra, Preetha Chengot, Melvin L K Chua, Peter Clarke, Gemma Clunie, Margaret Coffey, Clare Conlon, David I Conway, Florence Cook, Matthew R Cooper, Declan Costello, Ben Cosway, Neil J A Cozens, Grant Creaney, Daljit K Gahir, Stephen Damato, Joe Davies, Katharine S Davies, Alina D Dragan, Yong Du, Mark R D Edmond, Stefano Fedele, Harriet Finze, Jason C Fleming, Bernadette H Foran, Beth Fordham, Mohammed M A S Foridi, Lesley Freeman, Katherine E Frew, Pallavi Gaitonde, Victoria Gallyer, Fraser W Gibb, Sinclair M Gore, Mark Gormley, Roganie Govender, J Greedy, Teresa Guerrero Urbano, Dorothy Gujral, David W Hamilton, John C Hardman, Kevin Harrington, Samantha Holmes, Jarrod J Homer, Deborah Howland, Gerald Humphris, Keith D Hunter, Kate Ingarfield, Richard Irving, Kristina Isand, Yatin Jain, Sachin Jauhar, Sarra Jawad, Glyndwr W Jenkins, Anastasios Kanatas, Stephen Keohane, Cyrus J Kerawala, William Keys, Emma V King, Anthony Kong, Fiona Lalloo, Kirsten Laws, Samuel C Leong, Shane Lester, Miles Levy, Ken Lingley, Gitta Madani, Navin Mani, Paolo L Matteucci, Catriona R Mayland, James McCaul, Lorna K McCaul, Pádraig McDonnell, Andrew McPartlin, Valeria Mercadante, Zoe Merchant, Radu Mihai, Mufaddal T Moonim, John Moore, Paul Nankivell, Sonali Natu, A Nelson, Pablo Nenclares, Kate Newbold, Carrie Newland, Ailsa J Nicol, Iain J Nixon, Rupert Obholzer, James T O'Hara, S Orr, Vinidh Paleri, James Palmer, Rachel S Parry, Claire Paterson, Gillian Patterson, Joanne M Patterson, Miranda Payne, L Pearson, David N Poller, Jonathan Pollock, Stephen Ross Porter, Matthew Potter, Robin J D Prestwich, Ruth Price, Mani Ragbir, Meena S Ranka, Max Robinson, Justin W G Roe, Tom Roques, Aleix Rovira, Sajid Sainuddin, I J Salmon, Ann Sandison, Andy Scarsbrook, Andrew G Schache, A Scott, Diane Sellstrom, Cherith J Semple, Jagrit Shah, Praveen Sharma, Richard J Shaw, Somiah Siddiq, Priyamal Silva, Ricard Simo, Rabin P Singh, Maria Smith, Rebekah Smith, Toby Oliver Smith, Sanjai Sood, Francis W Stafford, Neil Steven, Kay Stewart, Lisa Stoner, Steve Sweeney, Andrew Sykes, Carly L Taylor, Selvam Thavaraj, David J Thomson, Jane Thornton, Neil S Tolley, Nancy Turnbull, Sriram Vaidyanathan, Leandros Vassiliou, John Waas, Kelly Wade-McBane, Donna Wakefield, Amy Ward, Laura Warner, Laura-Jayne Watson, H Watts, Christina Wilson, Stuart C Winter, Winson Wong, Chui-Yan Yip, Kent Yip
-
- Journal:
- The Journal of Laryngology & Otology / Volume 138 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 14 March 2024, pp. S1-S224
- Print publication:
- April 2024
-
- Article
-
- You have access Access
- Open access
- HTML
- Export citation
four - Living with medicine
- Sonali Shah, University of Birmingham, Mark Priestley, University of Leeds
-
- Book:
- Disability and Social Change
- Published by:
- Bristol University Press
- Published online:
- 01 September 2022
- Print publication:
- 23 March 2011, pp 69-92
-
- Chapter
- Export citation
-
Summary
The examples in Chapters Two and Three drew attention to claims about the influence of public medicine in the private lives of young people with physical impairments. The stories suggested at least three kinds of influence. Medical diagnosis and opinion appeared to frame future life expectations or trajectories, even from birth. Medical treatment regimes appeared to shape early life experiences, particularly in relation to hospital stays. Medical authority appeared to be significant at key turning points, particularly in choosing schools. The stories also raised interesting questions about medicine and social change. To what extent have life expectations been shaped by medical knowledge? Have challenges to medical authority altered power-knowledge relationships between health professions and disabled people? How have developments in medical technologies and health care institutions affected young people's life chances and choices? The chapter examines these kinds of questions by examining the influence of health professionals, policies and institutions on the life expectations and life pathways of the three generations.
The role of medicine in society was increasingly scrutinised and debated during the second half of the 20th century. Its role in disabling social relations has been much asserted in the critical disability studies literature (for example, Barnes and Mercer, 1996; Thomas, 2007) and there are frequent references to the ‘medical model’ of disability. Although such references are often juxtaposed with discussions of the ‘social model’ this misses an important point. For the original exponents of social model analysis, medicine played its role within a larger scheme. As Oliver (1996, p 31) put it:
The individual model for me encompassed a whole range of issues and was underpinned by what I called the personal tragedy theory of disability. But it also included psychological and medical aspects of disability. … In short, for me, there is no such thing as the medical model of disability, there is instead, an individual model of disability of which medicalisation is one significant component.
Numerous writings have credited medicine with policing normalcy and constraining life expectations for disabled people. For example, American functionalist sociology in the 1950s appeared to characterise impairment, along with illness, as a form of ‘deviance’ from social norms that required correction.
Contents
- Sonali Shah, University of Birmingham, Mark Priestley, University of Leeds
-
- Book:
- Disability and Social Change
- Published by:
- Bristol University Press
- Published online:
- 01 September 2022
- Print publication:
- 23 March 2011, pp iii-iv
-
- Chapter
- Export citation
five - Learning about life
- Sonali Shah, University of Birmingham, Mark Priestley, University of Leeds
-
- Book:
- Disability and Social Change
- Published by:
- Bristol University Press
- Published online:
- 01 September 2022
- Print publication:
- 23 March 2011, pp 93-118
-
- Chapter
- Export citation
-
Summary
This chapter examines experiences of education, particularly schooling. The main focus, as in other chapters, is to examine the impact of public policies on private lives in the context of change over time. The stories in Chapter Two, the accounts of family life in Chapter Three and the discussion of medicalisation in Chapter Four all drew attention to the significance of educational policies and practices in young people’s private lives. Across the three generations, the separation of children from their families and friends was perhaps the most obvious example. The complex policy relationship between health and educational provision highlighted the extent of medical authority in educational settings (for example, in determining choice of school and in daily school routines). There were also strong suggestions in the stories that low academic expectations for disabled children had impacted on life course trajectories and later opportunities in adulthood.
School and college experiences frame peer cultures, role models and identity construction (discussed in Chapter Seven). Successful participation in education is also an important enabler of social and economic inclusion for adult life (this is very relevant to the discussion of employment in Chapter Six). The examples in this chapter focus on some key issues at the interface between private lives and public education policies – on the personal and policy factors that influenced choice of school and college, the ways in which institutional provision shaped those choices, on the social experience of educational settings and on academic expectations and achievements.
Selecting pupils, choosing schools
Within the stories, choices and decisions about sending a child to special school featured prominently as key biographical turning points. These decision points illustrated much about the interaction between public policies and private lives. They were often points at which individual agency and familial resources collided with professional authority or with institutional barriers to inclusion. They established life course trajectories that would persist into adulthood, or marked turning points towards alternative biographies and life chances. There were both similarities and differences in the experience of those from the three generations.
Professional authority in selection
Those of the oldest generation were born into a rapidly changing policy context.
eight - Conclusion
- Sonali Shah, University of Birmingham, Mark Priestley, University of Leeds
-
- Book:
- Disability and Social Change
- Published by:
- Bristol University Press
- Published online:
- 01 September 2022
- Print publication:
- 23 March 2011, pp 175-184
-
- Chapter
- Export citation
-
Summary
The preceding seven chapters have covered a wide-ranging exploration of the ways in which changes in public policies and institutions, coupled with changes in civil society, have impacted on the private lives of young people with physical impairments since the 1940s. This exploration was intimately informed by a critical engagement with biographical narratives generated from life history interviews with people from three generational cohorts, who experienced childhood and the transition to adulthood in different historical times. The method of analysis sought to engage with these narratives as a stimulus to pose questions about parallel developments in public policies and institutions. This final part of the book reviews these developments, drawing on key findings from the substantive chapters, and returns to the questions outlined at the beginning. It also reflects on the utility of using biographical evidence to tell histories of disability.
Reflections on biography
Activist and academic discourse within the social model paradigm has emphasised the commonality of disability as oppression and institutionalised discrimination. This is fundamental to a social understanding of disability in contemporary societies and to the mobilisation of a cohesive social movement. Disability, like patriarchy and racism, is also something that affects people in their private lives, both materially and psycho-emotionally. The personal experience so evident in biographical accounts conveys the diversity of individual lives. It is not surprising then that the ‘biographical turn’ in social science (see Rustin, 2000) has drawn much inspiration from post-structural critiques of grand theory but, as feminist thought has long reminded us, the ‘personal’ is also ‘political’ and the boundaries between public and private are often fractured or blurred. Disability studies, like feminist studies, have shown repeatedly how public policies and institutions arising from unequal social relations can reach deep into people's private lives and relationships. The lives of young disabled people have been particularly marked by this kind of public reach – making intimate lives very public and constraining private life decisions.
Stories demonstrate the very real ways in which policies (for example, policies for the provision of public health and social care, education, housing or transport) impact on everyday life and close personal relationships.
one - Policy, history and biography
- Sonali Shah, University of Birmingham, Mark Priestley, University of Leeds
-
- Book:
- Disability and Social Change
- Published by:
- Bristol University Press
- Published online:
- 01 September 2022
- Print publication:
- 23 March 2011, pp 5-22
-
- Chapter
- Export citation
-
Summary
This chapter sets the scene for the book's main themes, by examining the challenge of linking biography with history in terms of disability policy in 20th-century Britain. As explained in the Introduction, some of the key areas of policy that have affected people's personal lives are explored in more detail in subsequent chapters, including areas such as the provision of public health care, education and employment. The main purpose of this chapter is to provide a context for reading the individual biographical experiences related in Chapter Two.
The chapter begins by briefly outlining some of the key change dimensions in public policy since the 1940s, comparing the current state of the art with past policy developments and policy claims arising from the disabled people's movement. The second part moves to a more detailed discussion of how individual biography can be used to reveal, and raise questions about, these social changes.
Changing policies and claims
The disability studies and policy literature has provided much evidence that people with impairments are disadvantaged in important areas of social life, such as education, employment, family life, political participation, cultural representation; or in access to public goods and services, like transport, housing, access to information, and so on (for example, Topliss, 1975; Barnes, 1991; Prime Minister's Strategy Unit, 2005; Williams et al, 2008). The challenge is to explain how and why this happens but also to gauge the extent to which the situation changes over time and whether changes in public policies have real impacts on people's lives.
Alongside continuing concerns about the considerable inequalities and barriers that face disabled people in Britain there has also been mounting evidence of change in the treatment of disability as a public issue (in public attitudes towards disability; in the emergence of the disabled people's movement; in the shift from welfare-based to rights-based social policies; in technological developments; and in labour market opportunities, for example). While we do not share the unguarded optimism of some policy makers, it is our hypothesis that young disabled people in 21st-century Britain are making life choices in a different opportunity structure from their recent predecessors.
Introduction
- Sonali Shah, University of Birmingham, Mark Priestley, University of Leeds
-
- Book:
- Disability and Social Change
- Published by:
- Bristol University Press
- Published online:
- 01 September 2022
- Print publication:
- 23 March 2011, pp 1-4
-
- Chapter
- Export citation
-
Summary
The second half of the 20th century, perhaps more than any other period, produced great changes in how we think about and respond to disability as a public issue in Britain. Not only was there a proliferation of new public policies but also an awakening of political consciousness about disability. But what of those who lived their lives through this period? How do the lives of young disabled people today compare with those who grew up in previous generations? In short, has life changed? This book seeks answers to these questions by using a combination of biographical experiences and historical policy analysis.
The source material came from a three-year empirical research project conducted at the University of Leeds and funded by the Nuffield Foundation. In particular, the biographical narratives used for illustration are drawn from a selection of 50 life history interviews with three generations of women and men (born in the 1940s, 1960s and 1980s) who grew up in England. Each of these generational cohorts grew up in changing times. The oldest generation were born during, or shortly after, the Second World War and grew up with attempts to more systematically address disability in British social policy (and the emergence of the post-war welfare state). The second generation, born in the 1960s, experienced childhood and early adulthood at a time when assumptions about the social exclusion of disabled people were coming under scrutiny (for example, in critiques of segregated care and special schools, and in the rise of the early disabled people's movement). The youngest cohort, born in the 1980s, are the first generation to reach early adulthood in an era of non-discrimination and human rights legislation affecting all aspects of their lives.
The book focuses on the stories of those who were diagnosed or labelled with physical impairments prior to compulsory school age (that is, from birth or infancy) and includes people who grew up in Northern, Southern, urban and rural parts of England (although one participant had attended school in Scotland before moving to England). This selection includes 15 people representing the oldest generation, 19 from the middle generation, and 16 from the youngest generation (a total of 50 out of 60 interviews).
six - Working for a living
- Sonali Shah, University of Birmingham, Mark Priestley, University of Leeds
-
- Book:
- Disability and Social Change
- Published by:
- Bristol University Press
- Published online:
- 01 September 2022
- Print publication:
- 23 March 2011, pp 119-146
-
- Chapter
- Export citation
-
Summary
The preceding chapters have emphasised life choices and chances in childhood. They also illustrated how childhood transitions can establish trajectories that affect adult careers. This chapter turns to work and employment as a key factor in transitions to adulthood, and as a key preoccupation of disability policies since the 1940s. It is perhaps worth noting at the outset that few in the youngest generation (born in the 1980s) had yet entered the adult labour market, either because they were still in full-time education or because they had not found paid employment. Conversely, the long work experience of some in the older generations provided useful insights into the changes they had witnessed up to the present day.
Work and employment have been viewed as central to inclusion in adult life, by disability activists and policy makers alike (Priestley, 2000). For example, those who pioneered the development of social model thinking in the 1970s and 1980s asserted a strong structural relationship between employment and social inclusion, arguing that:
the struggle to achieve integration into ordinary employment is the most vital part of the struggle to change the organisation of society so that physically impaired people are no longer impoverished through exclusion from full participation.… All the other situations from which physically impaired people are excluded are linked, in the final analysis, with the basic exclusion from employment. (UPIAS/Disability Alliance, 1976, pp 15–16)
Like education, employment is an expansive theme and it would be impossible to cover the full range of issues arising from the stories here. As with the previous chapters, the main emphasis is on relationships between public policies and people's private lives. The examples focus on three themes arising from the stories. The first section looks at the kinds of help people drew upon to look for work in changing labour markets. The second section considers barriers to employment and the impact of changing policies. The final section addresses the substitution of meaningful employment with alternative occupation.
Help in looking for work
The experiences of looking for work in the life stories revealed much about the strategies that people used to navigate their way into the labour market, and the kinds of public and private help they received.
Frontmatter
- Sonali Shah, University of Birmingham, Mark Priestley, University of Leeds
-
- Book:
- Disability and Social Change
- Published by:
- Bristol University Press
- Published online:
- 01 September 2022
- Print publication:
- 23 March 2011, pp i-ii
-
- Chapter
- Export citation
two - Telling stories
- Sonali Shah, University of Birmingham, Mark Priestley, University of Leeds
-
- Book:
- Disability and Social Change
- Published by:
- Bristol University Press
- Published online:
- 01 September 2022
- Print publication:
- 23 March 2011, pp 23-46
-
- Chapter
- Export citation
-
Summary
As explained in Chapter One, this book examines how life has changed for young people with physical impairments in England over three generations, and how public policies have affected this. However, as (Priestley, 2001, p 240) points out, ‘life can be a complex, often messy, business and people's life experiences do not fit neatly into academic disciplines or theoretical models’. The focus here is on those real lives rather than the constructed boundaries of policy making. The chapter introduces the three generational cohorts of disabled people who contributed their life stories. These are illustrated by six vignettes (summary life stories), which were agreed and validated by those who told their stories at much greater length. After each pair of vignettes (two from each generation) there is discussion of the issues they raise. These are then explored in more detail in the thematic chapters that follow.
The examples provide a flavour of the experiences and remembrances explored in the interviews. It is not the intention here to produce definitive biographies or case studies, or to tell the ‘whole story’, but to illustrate the range of experiences and to prompt questions about relationships between private lives and public policies. For example, the stories illustrate connections between medical treatment, education, employment, family relationships, self-identity and disability politics.
Children of the 1940s
Those in the oldest generation were born around the time of Second World War or shortly after and grew up with the first attempts to address disability more systematically in British social policy. In particular, they and their families negotiated experiences of disability during the emergence of the post-war welfare state (for example, in relation to radical new legislation on employment, education and health services in the wake of the Beveridge Report, as highlighted in Chapter One).
Florence
Florence was born in the late 1940s, the daughter of a single parent, but when doctors diagnosed that she would never walk, her birth mother left her. At the age of one, she spent a year in a hospital before being placed in a children's home and with foster families. However, they were unable to cope with a child with physical impairments, and Florence was picked on in the children's home, so she was sent back to hospital ‘because there was nowhere else’.
three - Keeping it in the family
- Sonali Shah, University of Birmingham, Mark Priestley, University of Leeds
-
- Book:
- Disability and Social Change
- Published by:
- Bristol University Press
- Published online:
- 01 September 2022
- Print publication:
- 23 March 2011, pp 47-68
-
- Chapter
- Export citation
-
Summary
The stories summarised in Chapter Two showed just how important it was for people to be able to draw on the resilience or resources of those closest to them at key turning points in their lives. The same stories showed what can happen to people's lives in the absence of such support. This chapter examines experiences of family life, using examples from the three generations to illustrate how social trends and public policies have affected choices and opportunities for young disabled people to develop and sustain kinship relationships. The discussion identifies a broad distinction between two competing life trajectories – inclusion in the private life of the family and exclusion from family life in public institutions.
This first section deals mainly with family relationships in the private domain. The examples highlight the importance attached to family as a site for acceptance and social inclusion. They also illustrate how people sometimes attribute disruptions in family relationships to disability issues. The discussion draws attention to gendered divisions of emotional and caring labour between birth parents, including the significance attributed to maternal advocacy and paternal abandonment. However, it also points to the positive influence of extended family resources, such as step-parenting and grandparenting. These experiences are set in the context of policy developments and changing family patterns during the 20th century and their implications for disabled children.
The second section focuses on childhood experiences of separation from family life arising from institutional segregation for the purposes of medical treatment or schooling (these contexts are then addressed in more detail in Chapters Four and Five, respectively). The examples illustrate, often graphically, how public policies and institutions can create real barriers to family life with sometimes lifelong implications. They also point to some of the important changes that have taken place since the 1940s.
Life at home – acceptance and rejection
The life stories collected for this book conveyed much about intimate family relationships between mothers, fathers and disabled children but they also revealed traces of wider social changes since the Second World War. These included changes in public policies affecting disabled families and demographic patterns of change in the structure of families more generally.
Acknowledgements
- Sonali Shah, University of Birmingham, Mark Priestley, University of Leeds
-
- Book:
- Disability and Social Change
- Published by:
- Bristol University Press
- Published online:
- 01 September 2022
- Print publication:
- 23 March 2011, pp v-vi
-
- Chapter
- Export citation
![](http://static.cambridge.org/content/id/urn:cambridge.org:id:book:9781847427885/resource/name/9781847427885i.jpg)
Disability and Social Change
- Private Lives and Public Policies
- Sonali Shah, Mark Priestley
-
- Published by:
- Bristol University Press
- Published online:
- 01 September 2022
- Print publication:
- 23 March 2011
-
This book provides a socio-historical account of the changing treatment of disabled people in Britain from the 1940s to the present day. It asks whether life has really changed for disabled people and shows the value of using biographical methods in new and critical ways to examine social and historical change over time.
References
- Sonali Shah, University of Birmingham, Mark Priestley, University of Leeds
-
- Book:
- Disability and Social Change
- Published by:
- Bristol University Press
- Published online:
- 01 September 2022
- Print publication:
- 23 March 2011, pp 185-208
-
- Chapter
- Export citation
seven - Living with ‘disability’
- Sonali Shah, University of Birmingham, Mark Priestley, University of Leeds
-
- Book:
- Disability and Social Change
- Published by:
- Bristol University Press
- Published online:
- 01 September 2022
- Print publication:
- 23 March 2011, pp 147-174
-
- Chapter
- Export citation
-
Summary
Throughout this book the main focus has been to show how interactions with changing public policies and institutions affected people's private lives, and how individuals and their families navigated life choices in policy contexts. The two preceding chapters illustrated specific developments with reference to education and employment. This final chapter takes a step back to review, more holistically, how disability revealed itself in people's lives over time and how this impacted on the negotiation of personal identity. It shows how public policies and institutions play an important part in structuring the social spaces, relationships and life course expectations that come to define who is seen as ‘disabled’. The discussion considers the extent to which opportunities to ‘come out’ as disabled have changed over time.
The examples show how encounters with public policies contributed to processes of making disability known in public spaces (for example, where disability status was marked out by labelling, differential treatment or physical segregation). They also show how public spaces framed a sense of disability in private worlds. It is equally important to appreciate changes over time in the kinds of cultural resources and role models available to young people as they seek to make sense of tensions between the public and private. Looking at the work of identity construction in this way helps to demonstrate some of the significant social changes that have taken place since the 1940s (not least in the development of a new disability culture and politics within civil society). The chapter deals first with the kinds of identity scripts and resources that were available to people, and then with the ways in which public and private spaces framed the construction of disability identities.
Intergenerational learning
It is generally assumed within cohort studies that different generations find themselves exposed to ‘different rights, duties, statuses, roles, privileges, disenfranchisments’ (Foner, 1988, p 176). However, it is also acknowledged that successive generations co-exist alongside each other and that cultural ideas and norms are transmitted from one to the next (Manheim, 1952). This assumption raises some questions in the case of young disabled people, the majority of whom are born to non-disabled parents and some of whom have been socially segregated by public institutions.
Index
- Sonali Shah, University of Birmingham, Mark Priestley, University of Leeds
-
- Book:
- Disability and Social Change
- Published by:
- Bristol University Press
- Published online:
- 01 September 2022
- Print publication:
- 23 March 2011, pp 209-217
-
- Chapter
- Export citation
![](/core/cambridge-core/public/images/lazy-loader.gif)