Socially constructed ‘value’ and vocational experiences following neurological injury

Purpose: Paid work is seen as a key outcome in rehabilitation. However, research demonstrates that because of normative expectations in the job market and workplace, experiences of disability can be intensified in a work context. We sought to explore this issue in more depth by analysing the effects of societal constructions of worker ‘value’ within individual case studies of people with acquired neurological injury. Method: Instrumental case study of four heterogeneous participants, employing a discourse analysis approach. Results: Participants described a perpetuation of discourses in which a disabled body or mind itself is seen to qualify, disqualify or limit a person’s value in employment. Nevertheless, interviews also highlighted discourses that constructed other worker identities: based on pre-injury identities, life experiences and other aspects of self. The contrasts between individuals illustrated how worker identities, when situated within broader societal discourses of worker ‘value’, can either constrain or expand the vocational opportunities available to individuals who experience disability. However, current and historical interactions about worker ‘value’ shaped the identities genuinely available to each individual. Conclusion: Understanding how societal discourses enable and constrain worker identities may be vital to (a) facilitating valid opportunities and (b) navigating situations that could unintentionally hinder vocational possibilities.Implications for RehabilitationThis study shows how worker identities, situated within societal discourses of worker ‘value’, can constrain or broaden vocational opportunities available to individuals who experience disability.Barriers to gaining, maintaining and developing in employment could be re-envisaged in terms of what is limiting a person’s ability to embody an enabling identity.A knowledge of both societal discourses and individuals’ interactions with them may be vital to facilitating opportunities that users of rehabilitation services experience as valid options. This knowledge can also provide information with which to navigate situations that could potentially (sometimes unintentionally) constrain vocational possibilities

Foucault, the Subject and the Research Interview: A Critique of Methods

Research interviews are a widely used method in qualitative health research and have been adapted to suit a range of methodologies. Just as it is valuable that new approaches are explored, it is also important to continue to examine their appropriate use. In this article, we question the suitability of research interviews for 'history of the present' studies informed by the work of Michel Foucault - a form of qualitative research that is being increasingly employed in the analysis of healthcare systems and processes. We argue that several aspects of research interviewing produce philosophical and methodological complications that can interfere with achieving the aims of the analysis in this type of study. The article comprises an introduction to these tensions and examination of them in relation to key aspects of a Foucauldian philosophical position, and discussion of where this might position researchers when it comes to designing a study

Re/creating entrepreneurs of the self: Discourses of worker/employee ‘value’ and current vocational rehabilitation practices

Vocational rehabilitation for people experiencing work disability is a social practice often situated within health services, but the social and political drivers and effects of this practice are rarely critically analysed in health research or policy. In this study we used a Foucauldian theoretical perspective to analyse the ways in which current vocational rehabilitation practices in New Zealand re/produce notions of worker and employee ‘value’, and how different approaches to vocational rehabilitation deploy current discourses about value. We also consider the subject positions produced through these different approaches and the identities and actions they make possible for people experiencing work disability. The analysis showed that notions about the importance of worker and employee value in a job market are pervasive in vocational rehabilitation, and reflect wider societal discourses. However, the deployment of those discourses in different approaches to vocational rehabilitation practice are diverse, producing different opportunities and constraints for people experiencing disability. We argue that an examination of these various opportunities and constraints at the level of practice approaches is important, as considerable time and resources are allocated to developing solutions to help those who do not thrive in the current systems, yet we rarely critique the premises on which the systems are based

PENGARUH KOMPETENSI DAN DISIPLIN KERJA TERHADAP KINERJA GURU DI SMP WARINGIN BANDUNG

ABSTRAK Pendidikan merupakan media yang sangat strategis dalam meningkatkan kualitas sumber daya manusia yang merupakan faktor determinan pembangunan. Pendidikan adalah usaha sadar untuk menyiapkan peserta didik melalui kegiatan bimbingan, pengajaran, dan atau latihan bagi peranannya di masa yang akan datang. Institusi pendidikan yang baik selalu didukung kinerja guru-gurunya yang baik pula. Penelitian ini bertujuan untuk mengetahui seberapa besar pengaruh kompetensi dan disiplin kerja terhadap kinerja guru di SMP Waringin Bandung baik secara parsial maupun simultan. Metode penelitian yang digunakan adalah deskriptif dan verifikatif. Jumlah populasi dalam penelitian ini adalah 30 orang guru yang mengajar di SMP Waringin Bandung dengan menggunakan metode sensus dimana seluruh populasi dipilih sebagai responden. Teknik pengumpulan data yang digunakan adalah observasi, wawancara dan menyebarkan kuesioner. Metode analisis yang digunakan adalah regresi linier ganda, korelasi ganda, uji F, uji T dan koefisien determinasi. Hasil penelitian menunjukan bahwa kompetensi, disiplin kerja dan kinerja guru pada SMP Waringin Bandung dapat dikatakan sudah baik. Kompetensi dan disiplin kerja memberikan pengaruh kurang kuat terhadap peningkatan kinerja guru yaitu sebesar 51,8%. Pengaruh variabel yang kuat adalah kompetensi dengan koefisien sebesar 29,9%. Sedangkan disiplin kerja koefisiennya sebesar 21,87%. Kata Kunci : Kompetensi, Disiplin Kerja dan Kinerja Gur

Development of a new measure of work-ability for injured workers

Background: Work-ability is often assessed as part of the vocational rehabilitation process for injured workers. However, research highlights a concern among therapists who carry out vocational assessments that there is a lack of consistency with regard to quality and comprehensiveness using current methods of assessment. One of the reasons for this is that there are no standardized measures of work-ability available that are designed to be used for the purpose of facilitating rehabilitation. The Participation And Work-ability Support Scale (PAWSS) is a new measure, conceptualized and initially developed by Professors Lynne Turner-Stokes and Kathryn McPherson, that was designed to address this gap. Design and Methods: This research was designed to develop the PAWSS measure to the point where it had face validity, and was complete enough to be formally psychometrically tested. The design of the research involved three parts. Firstly, a comprehensive review of the literature was undertaken. This was done to identify all the aspects of work functioning that are considered to contribute to work-ability, and then consider currently available work-ability measures in relation to their suitability for assessing vocational support needs. Secondly, in phase one of the research, qualitative focus groups and interviews with stakeholders in the return-to-work process were undertaken. The purpose of this phase was to check the content of the measure against stakeholder experiences, and determine the most appropriate administration context and procedures. Interviews and focus groups were analysed using descriptive analysis, and findings were used to inform revisions to the measure. Finally, phase two of the research involved pilot testing the measure. This was carried out by contracting experienced occupational therapists to test the new measure with consenting workplace assessment clients. Feedback from assessors and injured workers, assessor testing notes and scoring were analysed to examine feasibility and acceptability of the PAWSS, and revisions to the measure were made in accordance with findings.Results: The qualitative interviews and focus groups (phase one) provided feedback and comments that informed adaptations to the measure to bring it more in line with stakeholders’ experiences of work-ability. Furthermore, this phase provided information about the context in which the measure should be administered, and this was adopted for the pilot testing. Pilot testing of the measure (phase two) showed that the measure was acceptable to both the assessors and the injured workers, and that it was feasible to administer as part of a workplace assessment. Revisions to the measure and training procedures at this stage were primarily made to enhance clarity of item descriptions and scoring decisions. Conclusions and implications for practice: Findings from the research confirmed the need for a standardized measure of work-ability that can be used to plan vocational supports and interventions. Furthermore, the PAWSS was shown to be feasible and acceptable as a comprehensive tool for assessment of the work-ability of injured workers. Further research is needed to test the reliability and validity of the PAWSS before it can be used in practice

Facilitating return to work through early specialist health-based interventions (FRESH): protocol for a feasibility randomised controlled trial

Background Over one million people sustain traumatic brain injury each year in the UK and more than 10 % of these are moderate or severe injuries, resulting in cognitive and psychological problems that affect the ability to work. Returning to work is a primary rehabilitation goal but fewer than half of traumatic brain injury survivors achieve this. Work is a recognised health service outcome, yet UK service provision varies widely and there is little robust evidence to inform rehabilitation practice. A single-centre cohort comparison suggested better work outcomes may be achieved through early occupational therapy targeted at job retention. This study aims to determine whether this intervention can be delivered in three new trauma centres and to conduct a feasibility, randomised controlled trial to determine whether its effects and cost effectiveness can be measured to inform a definitive trial. Methods/design Mixed methods study, including feasibility randomised controlled trial, embedded qualitative studies and feasibility economic evaluation will recruit 102 people with traumatic brain injury and their nominated carers from three English UK National Health Service (NHS) trauma centres. Participants will be randomised to receive either usual NHS rehabilitation or usual rehabilitation plus early specialist traumatic brain injury vocational rehabilitation delivered by an occupational therapist. The primary objective is to assess the feasibility of conducting a definitive trial; secondary objectives include measurement of protocol integrity (inclusion/exclusion criteria, intervention adherence, reasons for non-adherence) recruitment rate, the proportion of eligible patients recruited, reasons for non-recruitment, spectrum of TBI severity, proportion of and reasons for loss to follow-up, completeness of data collection, gains in face-to-face Vs postal data collection and the most appropriate methods of measuring primary outcomes (return to work, retention) to determine the sample size for a larger trial. Discussion To our knowledge, this is the first feasibility randomised controlled trial of a vocational rehabilitation health intervention specific to traumatic brain injury. The results will inform the design of a definitive trial

Sistema de monitoramento da qualidade do ar utilizando uma rede LPWAN

In this research work, a hardware and software system that uses low-cost wireless sensors to monitor some pollutants in the air and variables such as temperature, air humidity and geographic coordinates in order to monitor air quality from a particular location was developed. LoRa technology with an average range of 5km in urban areas and 10km in rural areas was used to perform this monitoring. The developed system has a web Internet of Things (IoT) platform in which a dashboard that receives the variables being monitored in real time and displays them in an intuitive way for the user is configured. Tests were performed in different parts of the city to validate the measurements of the developed system. The measurements obtained were compared to the standards of the world health organization to assess the possible health risks of air pollution in the chosen locations. The viability of the developed system proves the possibility of having mobile air quality monitoring stations, with low cost for large-scale monitoring in the future.Foi desenvolvido neste trabalho de pesquisa, um sistema de hardware e software que utiliza sensores sem fio e de baixo custo para monitorar alguns poluentes no ar e variáveis como a temperatura, a umidade do ar e as coordenadas geográficas com objetivo de monitorar a qualidade do ar de um determinado local. Para isso, foi utilizada a tecnologia LoRa com alcance médio de 5km nas zonas urbanas e 10km nas zonas rurais. O sistema desenvolvido conta com uma plataforma para Internet of Things (IoT) Web na qual é configurado um dashboard que recebe em tempo real aas variáveis que estão sendo monitoradas e as exibe de forma intuitiva para o usuário. Foram realizados testes em diferentes pontos da cidade para validar as medições do sistema desenvolvido. As medições obtidas foram confrontadas com os padrões da organização mundial da saúde para levantar os possíveis riscos sobre a saúde da poluição do ar nos locais escolhidos. A viabilidade do sistema desenvolvido comprova a possibilidade de ter estações móveis de monitoramento da qualidade do ar, com baixo custo para um monitoramento a grande escala no futuro.4Nã

I hvilken grad er personsentrert praksis forenlig med aktiveringspolitikk for arbeidslivet? Personsentrert tilnærming i arbeidsrettede tiltak for innvandrere som søker arbeid i Norge

Increased migration to OECD countries has made unemployed foreignborn immigrants a new target population for ‘activation’ policies to reintroduce people into the labour market. As populations receiving employment activation interventions became more diverse, individualisation of activation measures was introduced into guidelines for welfare and employment agencies. While a person-centred approach in employment-oriented social work is gaining popularity, there is little research relating to how such approaches fit the frameworks of relatively aggressive activation. This study presents a qualitative instrumental case study exploring interactions between activation policy and person-centred employment interventions with immigrant jobseekers in Norway. Data analysis applied critical orientation towards data and employed directed content analysis. Research questions include: (1) How well do person-centred principles fit with the policy of activation? (2) How do person-centred practice and activation measures interact, and what are the congruencies and tensions? (3) What are the effects and practical implications of these congruencies and tensions? Findings from the present case study indicate the policy of activation strongly affects opportunities to implement person-centred practice in vocational counselling. Further, the political agenda of activation is inconsistent with the intentions of supported employment implementation to make vocational services jobseeker-centred or jobseeker-driven.Økt innvandring til OECD-landene har ført til at arbeidsledige innvandrere er blitt en ny målgruppe for “aktiverings”-tiltak som skal hjelpe mennesker tilbake inn på jobbmarkedet. Etter hvert som stadig flere typer befolkningsgrupper blir gjenstand for aktiveringstiltak, har man i retningslinjene for velferds- og arbeidskontorer innført individualisering av aktiveringstiltak. Mens personsentrert tilnærming innen arbeidsrettede sosialt arbeid blir stadig mer populært, finnes det lite forskning på hvordan slike tilnærmingsmetoder passer inn i rammeverkene for den forholdsvis dramatiske aktiveringen som finner sted. Denne studien presenterer en kvalitativ instrumentell casestudie som utforsker samhandlingen mellom aktiveringspolitikk og personsentrerte tiltak for utenlandske jobbsøkere i Norge. Det er anvendt dataanalyse ved kritisk orientering overfor data og direkte innholdsanalyse. Følgende spørsmål ble stilt ved undersøkelsen: 1) Hvor forenlige er personsentrerte prinsipper med aktiveringspolitikken? 2) På hvilke områder samhandler personsentrert praksis og personsentrerte aktiveringstiltak? På hvilke måter stemmer de overens, og hvor ligger spenningsforholdene? 3) Hva er virkningene og de praktiske implikasjonene av disse overensstemmelsene og spenningsforholdene? Funn fra denne casestudien tyder på at aktiveringspolitikken har sterk innvirkning på mulighetene for å implementere en personsentrert praksis ved yrkesrådgivning. Dessuten er det ikke samsvar mellom den politiske agendaen for aktivering og hensikten med støttet sysselsetting, som er å gjøre arbeidsformidlingstjenestene mer sentrert omkring jobbsøkeren.This study was supported by the Norwegian Research Council [grant number 272852] and the Norwegian Labour and Welfare Administration, case number 17/1146.publishedVersio

ニッケルアレルギー惹起相におけるセマフォリン７Aの効果

Background: Metal allergy is caused by many factors, including cells, cytokines, chemokines, or the environment. Recent studies suggested semaphorin7A (Sema7A), expressed on activated T cells, is crucial to produce inflammation through α1β1 integrin on monocytes and macrophages. However, the role of Sema7A on keratinocytes in metal allergy is still unclear. In this study, we focused on keratinocytes since they are known as an important player for skin immunity, and analyzed the effect of Sema7A expressed on keratinocytes in the development of metal allergy. Materials and Methods: Mouse keratinocyte line PAM2.12 cells were treated with NiCl2 to analyze the expression of Sema7A. Ni allergy was induced in female C57BL/6J mice (6-8 weeks old) with or without Sema7A suppression to confirm if Sema7A is necessary to produce allergic reactions to NiCl2. Results: NiCl2 enhanced the expression of Sema7A in a dose and time-dependent manner after 72 hours of stimulation. PAM 2.12 produced TNF-α in response to NiCl2, and this secretion was reduced by Sema7A inhibition. In a mouse model, ear thickness, at 48 hours after NiCl2 injection, was significantly decreased by Sema7A siRNA administration. Conclusions: Sema7A is essential to produce an allergic reaction to NiCl2, especially during the effector phase. Since the interaction between Sema7A and α1β1 integrin enhances inflammation in many skin diseases, this interaction may also have possibilities to be a therapeutic target for metal allergy