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Chronic disease management strategies are largely based on single disease models, yet patients often need to manage multiple conditions. This study uses the concepts of 'chronic illness trajectory' and 'biographical disruption' to examine how patients self-manage multiple chronic conditions and especially how they prioritize which condition(s) will receive the greatest attention. Fifty-three people with multiple chronic illnesses participated in one of 6 focus groups. The results suggest that people who were disrupted tended to be younger than 60, lived on their own, cared for other family members, or other barriers. Many participants anticipated subsequent illnesses given their age and prior experience with illness. In order to cope with their multiple illnesses most felt it was necessary to prioritize their 'main' illness. Their reasons for prioritizing a particular illness included: (1) the unpredictable nature of the disease; (2) the condition could not be controlled by tablets; and (3) the condition tended to set off the rest of their health problems. Social context played a key role in shaping patients' biography and chronic illness trajectory.

Faculty and staff with disabilities are significantly underrepresented within academia and experience alarming rates of discrimination, social exclusion and marginalization. This review aimed to understand the experiences and impact of disability discrimination (ableism) among faculty and staff. We conducted a systematic review while searching six international databases that identified 33 studies meeting our inclusion criteria. Of the 33 studies that were included in our review, they involved 1996 participants across six countries, over a 25-year period. The studies highlighted faculty and staff experiences of ableism in academia, which focused on disclosure (i.e., choosing to disclose or not), accommodations (i.e., lack of workplace accommodations and the difficult process for obtaining them) and negative attitudes (i.e., stigma, ableism and exclusion). Twenty-one studies explained the impact of ableism in academia, including a negative effect on physical and mental health, and career development. Coping mechanisms and strategies to address ableism in academia were also described. There is a critical need for more research and attention to the lived experiences of ableism among faculty and staff in academia and the impact that ableism has on their health and well-being.

Background: Although employment is a right of citizenship, people with disabilities remain underrepresented
in the workforce. Employment is especially important for people with disabilities because it can
alleviate financial hardship, social isolation, improve confidence and quality of life. Most research exploring
employers' views of hiring employees with disabilities has focused on adults while little is known about employers'
experience of working with youth with disabilities. The purpose of this study was to explore supervisors'
views of working with an adolescent with disabilities as a part of an employment training program.
Method: The sample was drawn from the supervisors of youth taking part in an employment training program,
run through children's rehabilitation hospital in a large urban centre. A descriptive questionnaire was
sent to all supervisors who worked with a adolescent with disabilities as part of an employment training
program. Thirty-six questionnaires were completed with a response rate of 92%. Results: Our findings
show that most supervisors felt prepared when youth arrived and that supervising them did not take up
much extra time. Some supervisors had a few initial concerns about workplace accommodations and workload
but these were quickly resolved. Most supervisors who worked with youth with disabilities reported a
positive experience and that having them in the workplace also had the added benefit of challenging some
of their assumptions about people with disabilities. Conclusions: Our findings emphasize the importance
of supervisors having an opportunity to work with a person with disabilities because it can help to break
down negative attitudes and stereotypes.

The project that we report here provided free home computers and a one-year broadband subscription to a sample of 108 older people diagnosed with coronary heart disease. The sample was divided at random and the experimental group had 'facilitated learning', based on access to a dedicated website, while controls did not. The results suggest that many participants needed to overcome their fear of new technology before they could learn how to use it effectively. Significant differences in computer skills were found between the experimental and control groups after six months of being involved in the project.

PurposeMany employers struggle with how to have a disability disclosure discussion with their employees and job candidates. The primary purpose of this study was to identify issues relevant to disability disclosure discussions. In addition, we explored how simulations, as an educational tool, may help employers and managers.Design/methodology/approachSeven participants (four employers and three human resource professionals) took part in this study. We used a qualitative design that involved two focus group discussions to understand participants' experiences of building a simulation training scenario that focused on how to have a disability disclosure discussion. The simulation sessions were audio-recorded and analyzed using an open-coding thematic approach.FindingsFour main themes emerged from our analysis. Three themes focused on issues that participants identified as relevant to the disability disclosure process, including: (1) creating a comfortable and safe space for employees to disclose, (2) how to ask employees or job candidates about disability and (3) how to respond to employees disability disclosure. A fourth theme focused on how simulations could be relevant as an educational tool.Originality/valueDeveloping a simulation on disability disclosure discussions is a novel approach to educating employers and managers that has the potential to help enhance diversity and inclusion in the workplace. Further, the process that we followed can be used as a model for other researchers seeking to develop educational training scenarios on sensitive diversity and inclusion topics.

The White Paper Choosing health acknowledges that there is no lack of information in the system about healthy lifestyles, but the manner of communication of risk and the level of support for lifestyle change need improvement. Action also has to be taken to address inequalities in health and to focus on securing better access to healthier choices for people in disadvantaged groups or areas. Accordingly, this randomized controlled trial examined whether access to a purpose-built health portal for heart disease could enable patients to manage better their heart conditions. We recruited 108 men and women aged 50—74 from coronary heart disease registries from a deprived area of Greater Manchester. Every participant received a new computer and one-year broadband subscription; however, only the experimental group received access to the Hearts of Salford health portal. Our results indicate that the experimental group changed their diet significantly. Specifically, they reported eating `bad foods' (such as chips, sweets, crisps, fried foods, ready meals and cakes/biscuits) significantly less often compared to the controls.

PurposeMany employers lack disability confidence regarding how to include people with disabilities in the workforce, which can lead to stigma and discrimination. The purpose of this paper is to explore the concept of disability confidence from two perspectives, employers who hire people with a disability and employees with a disability.Design/methodology/approachA qualitative thematic analysis was conducted using 35 semi-structured interviews (18 employers who hire people with disabilities; 17 employees with a disability).FindingsThemes included the following categories: disability discomfort (i.e. lack of experience, stigma and discrimination); reaching beyond comfort zone (i.e. disability awareness training, business case, shared lived experiences); broadened perspectives (i.e. challenging stigma and stereotypes, minimizing bias and focusing on abilities); and disability confidence (i.e. supportive and inclusive culture and leading and modeling social change). The results highlight that disability confidence among employers is critical for enhancing the social inclusion of people with disabilities.Originality/valueThe study addresses an important gap in the literature by developing a better understanding of the concept of disability from the perspectives of employers who hire people with disabilities and also employees with a disability.