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A Sociological Perspective

The allied health professions have gained legitimacy through the pursuit of research evidence and the standardisation of practice. Yet there remains very little analysis or understanding of these professions.

Adopting theory from the sociology of health professions, this unique text explores the sociological, economic, political and philosophical pressures that have shaped the professions. Drawing on case studies and examples from occupations including optometrists, occupational therapists and physiotherapists to emerging vocations, including pedorthists and allied health assistants, this book offers an innovative comparison of allied health professions in Australia and Britain.

By telling the story of their past, this original book prepares the allied health professions for a new and different future.

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Practical Tools for Improving Teaching, Research, and Scholarship

Despite progress, the Western higher education system is still largely dominated by scholars from the privileged classes of the Global North. This book presents examples of efforts to diversify points of view, include previously excluded people, and decolonize curricula.

What has worked? What hasn’t? What further visions do we need? How can we bring about a more democratic and just academic life for all?

Written by scholars from different disciplines, countries, and backgrounds, this book offers an internationally relevant, practical guide to ‘doing diversity’ in the social sciences and humanities and decolonising higher education as a whole.

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Uncovering Men’s Participation in Low-Income Family Life

Anna Tarrant’s revealing research explores the dynamics of men’s caring responsibilities in low-income families’ lives.

The book draws on pioneering multigenerational research to examine men’s involvement in care for their families. It interrogates how this is affected by the resources available and the constraints upon them, considering intersections of gender, generation and work, as well as the impact of austerity and welfare support.

Illuminating aspects of care within economic hardship that often go unseen, it deepens our understanding of masculinities and family life and the policies and practices that support or undermine men’s participation.

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Development and well-being

This much-needed new textbook introduces readers to the development of China’s welfare polices since its conception of an open-door policy in 1978. Setting out basic concepts and issues, including key terms and the process of policy making, it overcomes a major barrier to understanding Chinese social policy.

The book explores in detail the five key policy areas of employment, social security, health, education and housing. Each is examined using a human well-being framework comprising both qualitative and quantitative data and eight dimensions: physical and psychological well-being, social integration, fulfilment of caring duties, human learning and development, self-determination, equal value and just polity. This enables the authors to provide not only factual information on policies but also an in-depth understanding of the impact of welfare changes on the quality of life of Chinese people over the past three decades.

A major strength of the book lies in its use of primary Chinese language sources, including relevant White Papers, central and local government policy documents, academic research studies and newspapers for each policy area. There are very few books in English on social policy in China, and this book will be welcomed both by academics and students of China and East Asian studies and comparative social policy and by those who want to know more about China’s social development.

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International Perspectives on Childhood and Youth in Hard Times

Bringing together new, multidisciplinary research, this book explores how children and young people across Europe, Asia, Africa and the Americas experience and cope with situations of poverty and precarity.

It looks at the impact of neoliberalism, austerity and global economic crisis, evidencing the multiple harms and inequalities caused. It also examines the different ways that children, young people and families ‘get by’ under these challenging circumstances, showing how they care for one another and envisage more hopeful socio-political futures.

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Key Issues in Corrections critically analyzes the most important challenges affecting the correctional system in the USA, offering a no-nonsense explanation of the problems of correctional officers, correctional managers, prisoners, and the public.

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This chapter examines the concept of allied health as a collective comprised of constituent professional groupings. Here, we describe the development of the allied health professions over the past century from the perspective of both the development of individual professions and the emergence of allied health under medical hegemony. Concepts that will be explored include considerations around a heterogeneous group of occupations attempting to work together to achieve a single professional project. We also examine the international health and social care organisational and policy contexts and the importance of the various regulatory frameworks.

The allied health professions are distinct from the medical and nursing professions in numerous ways. Collectively, allied health professions comprise approximately one third of the total health workforce. Due to large jurisdictional variations in inclusion in the allied health collective, as well as challenges in capturing allied health workforce data, the exact numbers and scale of the allied health professions vary widely and are difficult to determine accurately (Olson, 2012; Nancarrow et al, 2017).

Unlike medicine and nursing, which have strong brand recognition, large individual professional size, internal hierarchies, recognised specialisms and, importantly, a strong political voice, the allied health professions are a confederation of independent disciplines, each of varying size and focusing on a niche area of practice. Allied health professions face the dual challenge of negotiating their discrete professional territory within the boundaries of the allied health collective, while attempting to achieve recognition and a voice alongside their larger medical and nursing counterparts.

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The allied health professions, and indeed all contemporary Western professions, have been shaped by a set of distinct social forces and contexts that were a product of their formative era. The Industrial Revolution saw the rapid organisation of labour at a time when social class, British colonialism and paternalism were dominant themes in much of the Western world. For the professions, the consequences have included a highly organised, hierarchical and strongly gender-differentiated workforce. Social policies have evolved over the past half-century to try to explicitly reduce gender and racial inequalities in education, the workplace and health service delivery, with varying levels of success in allied health.

This context is important for understanding both the evolution of the professions through a sociological lens, and also their contemporary context. In many ways, the world has moved on but the professions (particularly the highly structured and gendered health professions) are relics of their post-industrial era formation. At the start of the 21st century, the stereotypical allied health profession is still predominantly female, middle-class and white. The narrow analysis of any areas of diversity from an allied health perspective means that this is a limited field; however, there are dominant paradigms in the literature on the sociology of the professions that are important for diversity. Gender is the obvious position; however, ethnicity and socio-economic status are also important considerations.

Intersectionality recognises that social differences and divisions do not operate separately, but rather intersect. Examining diversity from an intersectional perspective enables us to consider that several classification systems coexist and interact – such as gender, ethnicity/race, sexuality, socio-economic status and even professional status – without reducing them to singular positions (Styhre and Eriksson-Zetterquist, 2008).

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The largest recognised group of allied health professionals is comprised of the established state- and self-regulated professions. These professions have claimed clear philosophies and sometimes anatomical domains and scopes of practice that differentiate them from each other, and other emerging disciplines. This chapter draws on the examples of optometry and radiography, one of which was established prior to the advent of the era of medical dominance, and the other during it. It thus illustrates the way allied health professions responded to the challenge posed by medicine in defining the new health division of labour that took hold in the early 20th century. It also illustrates the different ways in which these professions later identified with other allied health professions: one as part of the broader collective; the other remaining separate from it (Larkin, 1983; Boyce, 2001, 2006). As was explained in Chapter 2, and should be borne in mind when considering the context of the account that follows, they also serve as useful exemplars of the contrasting gender divide within the allied health professions. Radiography became a primarily female profession, and optometry remained a mainly male profession (though, interestingly, the former remains stable but the latter is becoming more feminised) (Register, 2010; Healy et al, 2015).

Those allied health professions with a long pre-modern history – that is, the groups that emerged prior to the period in which medical dominance became firmly established – experienced medical opposition and resistance in their bid for recognition and state registration during the early to mid-20th century (Larkin, 1981, 1983, 2002).

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The health professions are in a constant state of growth and evolution, with new professions continuing to emerge, many in response to new techniques and technologies, and being included under the umbrella of allied health. This chapter explores the emergent allied health occupations, that is, those groups that have recently achieved a level of consistency of title and organisation to then pursue professionalism.

Examples of occupations that have professionalised since the middle of the 20th century include exercise physiologists, rehabilitation counsellors, ODPs, DEs, genetic counsellors, perfusionists and sonographers. In 2020, AHPA introduced affiliate membership for a range of professions, including some emerging ones, for example, lymphoedema therapists, counsellors, diabetes educators, hand therapists, dermal clinicians, hearing aid audiologists, myotherapists, pedorthists, psychotherapists and spiritual counsellors. Not all these professions are recognised allied health professions in all jurisdictions.

A notable exception to the recognition of new allied health professions is the NHS. When the Professions Supplementary to Medicine Act 1960 was introduced, 12 professions were recognised. At the start of 2020, the NHS formally recognised 14 allied health professions: arts therapy, chiropody (now podiatry), dietetics, dramatherapy, medical laboratory sciences, music therapy, occupational therapy, orthoptics, physiotherapy, radiography, prosthetics and orthotics, speech and language therapy, clinical sciences, and paramedics (Larkin, ). Since 2005, just after the formation of the HPC, the recognised allied health professions in the UK have remained relatively stable. An important contribution of this chapter is the way that regulatory frameworks and funding structures influence the development of new professions.

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