ICF bridges the gulf between the social and medical models of disability.

I have recently been involved in helping to set up an assessment tool for children with mobility difficulties requiring postural support in their wheelchairs. These children usually have neurological and orthopaedic problems which means they require a lot more than just an ordinary wheelchair.
This has led us to thinking about the models of disability adopted by different health professionals and how this influences their practice. Since the 80s in the UK, there have been two quite opposed approaches, the medical vs. the social model. As a quick summary, the social model says that the person is not disabled but it is their environment that disables them. The medical model is said to want to “cure” the individual and wants them to fit in and adapt to their environment so that the onus rests on the individual. What is emerging from the research in this area is that this divergence in approaches is not helpful to this client group (Crow 1996, Shakespeare and Watson 2002, Shakespeare 2006). The social model does not acknowledge issues which are related to impairment. Although our society must continue to improve access and inclusion, it is indeed very difficult to participate in the activities which matter to you if you are in pain or need surgery (Fauconnier et al 2009).
Liz Crow and Tom Shakespeare, both disabled themselves, have analysed this dichotomy which appears to be unique to Britain, where the social model has been adopted in an extreme manner, and feel it is high time to bring the two aspects together so that all aspects of life can be included in any approach involving people with disabilities.
This has been at the heart of our assessment process, and one of the most useful tool available to us is the WHO International Classification of Functioning, Disability and Health (ICF and ICF-CY for young people). This classification includes all aspects of an individual’s personal circumstances, starting with the body structures and their functions and leading on to the individual’s environment and activities in all spheres of life. It establishes a “common language for understanding and investigating health and health-related states” ( McDonald et al 2004). By doing this it “bridges the ... gulf between the medical and social models of disability” (Shakespeare 2006). By using the ICF-CY, we have been able to draw up an assessment tool (still being developed) which truly takes into consideration all aspects of a child’s life which are relevant to their use of mobility aids; hopefully this gives them access to the product which best helps their physical as well as their social and emotional needs, whilst providing them the best postural support in seating. This also makes use of professional expertise and experience, in order to make available to the user and their families all the necessary information to make an informed choice.


Crow L. (1996) Including all of our lives: renewing the social model of disability in Disability and Illness: exploring the divide, Disability Press
Fauconnier J. Et al. (2009) Participation in life situations of 8-12 year old children with cerebral palsy: cross sectional European study BMJ 338: 1548 (on line)
McDonald, R., Surtees, R. And Wirz, S. (2004) The International Classidfication of Functioning, Disability and Health provides a model for adaptive seating interventions for children with cerebral palsy British Journal of Occupational Therapy 67(7) 293-305
Shakespeare, T. And Watson, N. (2002) The social model of disability: an outdated ideology? Research in Social Science and Disability 2: 9-28
Shakespeare, T. (2006) Disability Rights and Wrongs, Routledge, Oxford
WHO (2007) International classification of Functioning, Disability and Health – Children and Youth Version

Why we need to be concerned about ocean acidification.

Image: http://www.pmel.noaa.gov/co2/OA/OA1.jpg

Text from EPOCA- European Project on OCean Acidification
A glossary of terms can be found at the end of the article.



Ocean acidification – The process by which carbon dioxide dissolves in seawater, giving rise to a decrease in pH and other changes in ocean carbonate chemistry

The consequences of man's use of fossil fuels (coal, oil and natural gas) in terms of global warming have not escaped anyone’s attention. Ocean acidification is another, and much less known, result of the approximately 79 million tons of carbon dioxide (CO2) released into the atmosphere every day, not only as a result of fossil fuel burning but also of deforestation and production of cement. Since the beginning of the industrial revolution, about one third of the CO2 released in the atmosphere by anthropogenic (human-caused) activities has been absorbed by the world’s oceans, which play a key role in moderating climate change. Without this capacity of the oceans, the CO2 content in the atmosphere would have been much higher and global warming and its consequences more dramatic. The impacts of ocean acidification on marine ecosystems are still poorly known but one of the most likely consequences is the slower growth of organisms forming calcareous skeletons or shells, such as corals and molluscs.

The world's oceans play a fundamental role in the exchange of CO2 with the atmosphere and constitute an important sink for atmospheric CO2. Once dissolved in sea water, carbon dioxide is subject to two possible fates. It can either be used by photosynthesis or other physiological processes, or remain free in its different dissolved forms in the water. The latter leads to ocean acidification.

The chemical process of ocean acidification
There is a constant exchange between the upper layers of the oceans and the atmosphere. Nature strives towards equilibrium, and thus for the ocean and the atmosphere to contain equal concentrations of CO2. Carbon dioxide in the atmosphere therefore dissolves in the surface waters of the oceans in order to establish a concentration inequilibrium with that of the atmosphere. As CO2 dissolves in the ocean it generates dramatic changes in sea water chemistry. CO2 reacts with water molecules (H2O) and forms the weak acid H2CO3 (carbonic acid). Most of this acid dissociates into hydrogen ions (H+) and bicarbonate ions (HCO3-). The increase in H+ ions reduces pH (measure of acidity) and the oceans acidify, that is they become more acidic or rather less alkaline since although the ocean is acidifying, its pH is still greater than 7 (that of water with a neutral pH). The average pH of today's surface waters is 8.1, which is approximately 0.1 pH units less than the estimated pre-industrial value 200 years ago.

Projections of future changes
Modelling demonstrates that if CO2 continues to be released on current trends, ocean average pH will reach 7.8 by the end of this century, corresponding to 0.5 units below the pre-industrial level, a pH level that has not been experienced for several millions of years. A change of 0.5 units might not sound as a very big change, but the pH scale is logarithmic meaning that such a change is equivalent to a threefold increase in H+ concentration. All this is happening at a speed 100 times greater than has ever been observed during the geological past. Several marine species, communities and ecosystems might not have the time to acclimate or adapt to these fast changes in ocean chemistry.

Possible consequences on marine organisms
The dissolution of carbon dioxide in sea water not only provokes an increase in hydrogen ions and thus a decline in pH, but also a decrease in a very important form of inorganic carbon: the carbonate ion (CO32-). Numerous marine organisms such as corals, molluscs, crustaceans and sea urchins rely on carbonate ions to form their calcareous shells or skeletons in a process known as calcification. The concentration of carbonate ions in the ocean largely determines whether there is dissolution or precipitation of aragonite and calcite, the two natural polymorphs of calcium carbonate (CaCO3), secreted in the form of shells or skeletons by these organisms. Today, surface waters are super saturated with respect to aragonite and calcite, meaning that carbonate ions are abundant. This super saturation is essential, not only for calcifying organisms to produce their skeletons or shells, but also to keep these structures intact. Existing shells and skeletons might dissolve if pH reach lower values, and the oceans turn corrosive for these organisms. Consequently, the results of the decrease in carbonate ions might be catastrophic for calcifying organisms which play an important role in the food chain and form diverse habitats helping the maintenance of biodiversity.


The magnitude of ocean acidification can be predicted with a high level of confidence since the ocean chemistry is well known. But the impacts of the acidification on marine organisms and their ecosystems is much less predictable. Not only calcifying organisms are potentially affected by ocean acidification. Other main physiological processes such as reproduction, growth and photosynthesis are susceptible to be impacted, possibly resulting in an important loss in marine biodiversity. But it is also possible that some species, like sea grasses that use CO2 for photosynthesis, are positively influenced by ocean acidification. Ocean acidification research is still in its infancy and more studies are required to answer the numerous questions related to its biological and biogeochemical consequences.

Glossary

Acclimate - To accustom or become accustomed to a new environment or situation.

Aragonite - An orthorhombic (system of crystallization characterized by three unequal axes at right angles to each other) mineral form of crystalline calcium carbonate, dimorphous with calcite

Biosphere – The living organisms and their environment

Calcite - A common crystalline form of natural calcium carbonate, CaCO3, that is the basic constituent of limestone, marble, and chalk. Also called calcspar.

Inorganic - Involving neither organic life nor the products of organic life

Ocean acidification – The process by which carbon dioxide dissolves in seawater, giving rise to a decrease in pH and other changes in ocean carbonate chemistry

Organic - Of, relating to, or derived from living organisms

pH – Measure of acidity (pH= -log[H+])

Photosynthesis - The process in green plants and certain other organisms by which carbohydrates are synthesized from carbon dioxide and water using light as an energy source. Most forms of photosynthesis release oxygen as a byproduct.

Phytoplankton - Minute, free-floating aquatic plants (algae, protists, and cyanobacteria).

Polymorph – Chemistry: A specific crystalline form of a compound that can crystallize in different forms.

Menai Translations

Thank you for visiting my blog. Menai Translations is taking its first steps into the world of blogs!

As a translation service focusing mostly on the environment and ecology, this blog will try and discuss some aspects of our environment which may be new or unfamiliar to you, and occasionally provide a short glossary of related terms in French and English.