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Prior to 1970 help for disabled people and their families was really only available through the health service (medical social workers) or voluntary organisations such as the Invalid Children’s Aid Association and the Spastics Society. A few local authority health departments set up professional social work services in the 1950s, staffed mainly by medical social workers and in some cases occupational therapists as well. Welfare departments in the pre-Seebohm days also offered services to disabled people, but as most did not employ trained social workers little was done beyond material help and information-giving, while some provision was made for residential care. However, the Seebohm Report, local government reorganisation and the Chronically Sick and Disabled Persons Act 1970 was supposed to change all that and usher in a new era. Following this a number of other developments and reorganisations of social welfare, in particular the community care ‘reforms’ of the 1990s through the National Health Service and Community Care Act 1990 but also the Disabled Persons (Services, Consultation and Representation) Act 1986, the Children Act 1989 and the more recent Community Care (Direct Payments) Act 1996 have transformed the organisation of the statutory social services. Just what this has meant as far as social work with disabled people is concerned will thus be a major theme of this book.

This final chapter will attempt to bring together some of the issues thrown up by attempting to apply the social model of disability to social work as an organised professional activity. It will begin by considering some of the professional aspects of the matter by asking questions about the nature of the professional task: Who should do it? What kinds of qualifications and training are needed? Consideration will then be given to the organisational context in which social work with disabled people actually takes place and the constraints this may impose upon professional activity. Finally, implications for the future will be considered.

“Next, please,” and in came a spry, fit looking, silver haired man. In answer to the usual question, “What can I do for you?” he replied, “I am not complaining of anything. There is nothing wrong with me.” There was no letter from his general practitioner. Why not? “Because there was no point in troubling him, so I came straight to you because you are the consultant for outpatients.” There was open access in the general medical outpatients department in the Royal Infirmary of …

If a patient with coronary disease already drinks a glass of wine and eats a piece of fruit daily, eats fish several times a week, dresses salads with olive oil, exercises regularly, and takes …

Reductions in levels of the hunger-stimulating hormone ghrelin have been proposed to mediate part of the effects of vertical sleeve gastrectomy (VSG) and Roux-en-Y gastric bypass surgeries for obesity. We studied circulating levels of acyl and desacyl ghrelin in rats after these surgeries. We found that blood levels of ghrelin were reduced after VSG, but not after Roux-en-Y gastric bypass, based on enzyme-linked immunosorbent assay and mass-spectrometry analyses. We compared the effects of VSG in ghrelin-deficient mice and wild-type mice on food intake, body weight, dietary fat preference, and glucose tolerance. We found that VSG produced comparable outcomes in each strain. Reduced ghrelin signaling therefore does not appear to be required for these effects of VSG.

As one of the originators of discussions about disability models, it is important that I clarify some of the issues I intended to raise when I began to write about the individual and social models of disability as I saw them (Oliver 1983). Before so doing, it is necessary to state at the outset however, that in claiming parental rights to disability models, I am not seeking personal aggrandizement nor indeed to deny the very real contribution that other disabled people have made to opening up the issue, notably Finkelstein (1980).

The original version of this chapter was written in response to an invitation to Gerry Zarb and myself to present some findings of research we had recently completed on ageing with a spinal injury at an international conference in Denver, Colorado. Initially we were to do a joint presentation but subsequently we were asked to present separate papers which took into account theoretical developments and policy contexts.

One of the functions of welfare provision in general, and education in particular, is to ensure the integration of individuals into society. And, citizenship is a shorthand device for talking about the relationship between individuals and society. Then it is not surprising that the National Curriculum Council can affirm that the twin aims of education are to teach all children about the rights and responsibilities of citizenship.

This chapter is a further consideration of the welfare state and an attempt to identify some of the reasons why it has failed disabled people among others. There is one further influence that is relevant to the discussions herein and that is my own commitment to collective welfare provision and my concern that within the political left, there has been a dearth in recent theorising about state welfare. As it is sometimes said in respect of religion that the devil has all the best tunes, in recent years it is the right that has had the best theories about welfare.

This final chapter is completely new and is an attempt to make sense of my own experience in, and relationship to, the disability movement. It is neither a statement of what I think my position in this relationship is or should be but an attempt to open up the issue of the role of individuals in collective movements. In discussing this, I use the word intellectual not in the bourgeois sense of the term but to describe all individuals who think critically about their lives. Not all disabled people do of course: some think the only problem is non-disabled people; some think the problems they face are their own fault; some think disabled people should accept the hand-outs they are given and be grateful. What unites disabled people within the movement is that not only do we think our lives could be better, we know they should be. Intellectual work is but one path to achieving the social transformation necessary to make it so.

This chapter is an attempt to combine two separate but related issues. The first of those is an attempt to, at the very least, provide an outline sketch of the conditions under which disabled people live throughout the world. The second, related issue concerns my puzzlement as to why disabled people, wherever they live, experience conditions of life far worse than their non-disabled counterparts.

This opening chapter will be an attempt for me to understand retrospectively the development of my own personal and political consciousness. Unlike later chapters, this has been specially written for this book, though earlier versions of my own thinking about role models and my professional career have appeared elsewhere. It is rooted in my own personal biography which I briefly outline. A more detailed description of my life may appear as an autobiography once I retire or, if my pension proves inadequate, as a thinly disguised novel.

This chapter will return to the relationship between the personal and political, originally discussed in Chapter 1. Its main focus will be on collective empowerment and this will be discussed in relation to the rise of the disability movement in Britain. The discussion will draw upon the recent reintroduction of the idea of citizenship, heralded by the publication of the Citizen’s Charter. It will also attempt to deal with some of the rejoinders that have been made since I originally published my claim that the disability movement was a political movement with more in common with the newly emerging social movements than either corporatist interest group politics or humanitarian, charitable and voluntary organisation responses.

In the previous chapter I discussed the influence the social model has had not simply on the consciousness of disabled people but also on welfare provision and professional practice. In this chapter I shall focus on another ‘big idea’, that of citizenship. I shall consider it in the context of the re-structuring of state welfare that is currently going on and consider its problems and potential in respect of disabled peoples’ struggles to live independently.

The purpose of giving this chapter a similar title to the Fundamental Principles document is because it is deliberately derivative of it. I, and many other disabled people, openly acknowledge our debt to the document in the way it shaped our own understanding of disability. The document has never been widely available and with the demise of the Union in 1991, it will become increasingly difficult to obtain.

The first principle of the lipid hypothesis is that raised plasma cholesterol concentrations are associated with a high incidence of atherosclerosis and an increased risk of coronary heart disease. That assertion no longer stirs argument in medical circles. But the second principle—that both this risk and total mortality can be reduced by lowering plasma cholesterol concentrations—remains controversial. Polarisation of views has led over the past 20 years to the emergence of enthusiasts for whom cholesterol lowering and the prevention of coronary heart disease are almost synonymous and sceptics who attribute to lipid reduction more harm than good. This lack of consensus has been widely publicised by the media, and many people believe that the case for treating raised cholesterol concentrations is flawed and can be disregarded. The publication in 1994 of the results of several new trials has shown that this attitude is no longer tenable for one clearly defined category of patients—those who have already developed coronary heart disease. Clinical decisions are rarely black or white. More often than not they are made with incomplete knowledge. This is certainly true in the prevention of cardiovascular disease. No one would challenge a policy aimed at reducing cigarette smoking, even in the absence of formal evidence from trials of a positive effect on the incidence of coronary …

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Non-invasive optical analysis of molecular targets inside living animals has become an important tool for disease progression and treatment assessment. One of the essential elements of molecular imaging is the development of specific, sensitive imaging contrast agents to investigate these biological processes. The use of longer wavelength dyes, i.e. near-infrared (NIR) dyes, presents distinct advantages over inherently fluorescent protein tags, including reduced autofluorescence background and increased sensitivity in imaging small animals. In addition, the adoption of efficient and specific labeling techniques is a key step in the generation of protein-based fluorescent imaging agents. In the present study, we explore the versatility of a self-labeling protein termed SNAP-tag, derived from human O6-alkylguanine-DNA alkyltransferase, in tagging polypeptides with a near-infrared dye, IRDye® 800CW. In cell-based assays, an IRDye 800CW conjugated SNAP-tag successfully labeled cells transiently transfected with a pSNAP-ADRB2 plasmid. For in vivo experiments, a synthetic epidermal growth factor receptor (EGFR)-binding ligand was used to construct an IRDye 800CW-EGFR-SNAP-tag. Following injection of the agent into nude mice bearing EGFR-overexpressing A431 xenografts, tumors were clearly visualized with a Pearl® Imaging system. Furthermore, the specificity of binding was demonstrated in competition experiments with unlabeled EGF. Similar probes labeled with visible fluorophores were used to image EGFR-expressing cultured cells by confocal microscopy. This fluorescent imaging system using a self-labeling protein tag and highly sensitive organic dyes provides versatile tools for cancer research, drug discovery and small animal imaging. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4952.

Is the original thinker encouraged in medicine any more? How do young and excited potential clinical scientists get going? We have no reason to think that there is any paucity of original ideas, and many young medical students and doctors will still be thinking about unresolved medical and scientific problems. But now the odds are stacked against them. Fifty and more years ago it was possible to embark on a research project with advice from one’s seniors and without much, if any, peer review interference, bureaucratic resistance, or obligatory referral to various ethics committees. There are many other reasons now why opportunities for initiating new ideas are limited. Perhaps the chief is cost, although the initial cost of many of the key discoveries (sympathin (adrenaline), insulin, penicillin, fibrates, lipoprotein receptors) in the last century was not high. Now universities cannot afford to initiate a new project unless funded by a charity or government, and most research developments are undertaken by the big pharmaceutical consortiums. Without the infusion of …

Many older people, often retired, are summoned by their general practitioner for an annual health check. They may feel reasonably well, but the NHS does not always permit such euphoria. They may be told that they have hypertension or diabetes or high cholesterol concentrations; that they are obese; that they take too little exercise, eat unhealthily, and drink too much. The quality and outcomes framework (QoF), the scheme that rewards NHS general practitioners for good performance, awards points, with related payments, for each documentation. Many of these patients are told to have more investigations. Eventually, most are started on pills. Few seem to be considered not at risk for something. Thus, of those who thought themselves healthy, a number will return home as patients. And they may be scared and no longer comfortably aging. What kind of medicine is this? It is politics taking preference over professionalism, obsession with government targets superseding common sense, paternalism replacing personal advice. It seems that many Western governments regard all people aged over 75 as patients. This trend has many causes. These include overenthusiastic and uncritical interpretation of various guidelines, the payment of GPs by NHS trusts for …