Interpretative accounts of work capacity assessment policy for young adults with disabilities

Young adults with disabilities are a specific target of the welfare-to-work policy introduced by many OECD countries over the past decade. The implementation of these policies is a significant concern for service delivery organisations and advocates in Australia and internationally due to complex intersecting structural barriers that persist for many young adults with disabilities. A particular focus of this article is work capacity assessments. Drawing on socio-political theories and interpretive policy analysis, the 22 in-depth interviews with personnel from service delivery organisations and advocacy organisations reveal how the deemed capacity to work process is not only interpreted as flawed, but the current policy approach disables young adults, perpetuates stigma, and creates division between service users and service providers. The accounts reinforce the need to contest such assessments and instead turn towards a rights-based capability approach permitting young adults with disability self-determination over their education-to-employment pathway.     

Are fire services ‘extremely gendered’ organizations? Examining the Country Fire Authority (CFA) in Australia

Emergency management organizations often have military‐based histories and continue to maintain militaristic styles of operation. Similar to the military, these organizations tend to be male dominated and culturally masculinized. The militarization and masculinization of rural fire services in Australia are generally unrecognized but highly important elements defining these organizations, and the example of the Country Fire Authority (CFA) is considered here. Using a cultural artefacts approach, historical and contemporary elements of the CFA's structure and practice are analysed using the concept of an ‘extremely gendered’ organization, with a focus on how the CFA is structurally and culturally gendered. We argue there is value in expanding the notion of ‘extremely gendered’ institutions beyond the military, to include other militarized organizations. Doing so not only helps to better understand and address resistance to change and gender equality measures, it also draws attention to the important role that such organizations play in the greater patriarchal order.     

Women and homelessness,a complex multidimensional issue: findings from a scoping review

Homelessness is an increasingly prevalent issue worldwide. Women represent the fastest growing segment of the homeless population and have differing needs to men. These differences need to be considered by service providers and other stakeholders working with homeless women. A scoping review was conducted to address the question “What is known about issues relating to homeless women in the existing literature?” PubMed, PsycInfo, Embase, CINAHL, Scopus and Web of Science were searched up until March 2018 with no date limits. The final sample of articles included in this scoping study was 232 from which six themes were extracted: (1) pathways into homelessness, (2) trauma, victimization and adverse childhood experiences, (3) mental and physical health issues, (4) barriers to accessing treatment and experiences with service providers, (5) social support and life satisfaction and (6) strengths, hopes and leaving homelessness. This review suggests a strengths-based approach to addressing women’s homelessness. This approach emphasizes people’s self-determination and strengths and views clients as resilient to problems they encounter in their lives. Future research and service provision should take into account the complexities in the lives of homeless women and recognize the autonomy of women to move out of homelessness.     

Gendered uncertainty and variation in physicians' decisions for coronary heart disease: the double-edged sword of "atypical symptoms"

Nonmedical factors and diagnostic certainty contribute to variation in clinical decision making, but the process by which this occurs remains unclear. We examine how physicians' interpretations of patient sex-gender affect diagnostic certainty and, in turn, decision making for coronary heart disease. Data are from a factorial experiment of 256 physicians who viewed 1 of 16 video vignettes with different patient-actors presenting the same symptoms of coronary heart disease. Physician participants completed a structured interview and provided a narrative about their decision-making processes. Quantitative analysis showed that diagnostic uncertainty reduces the likelihood that physicians will order tests and medications appropriate for an urgent cardiac condition in particular. Qualitative analysis revealed that a subset of physicians applied knowledge that women have "atypical symptoms" as a generalization, which engendered uncertainty for some. Findings are discussed in relation to social-psychological processes that underlie clinical decision making and the social framing of medical knowledge.     

Using process evaluation to determine effectiveness of participatory ergonomics training interventions in construction

The construction industry continues to experience high rates of musculoskeletal injuries despite the widespread promotion of ergonomic solutions. Participatory ergonomics (PE) has been suggested as one approach to engage workers and employers for reducing physical exposures from work tasks but a systematic review of participatory ergonomics programs showed inconclusive results.. A process evaluation is used to monitor and document the implementation of a program and can aid in understanding the relationship between the program elements and the program outcomes. The purpose of this project is to describe a proposed process evaluation for use in a participatory ergonomic training program in construction workers and to evaluate its utility in a demonstration project among floor layers.     

Deriving Daily Purpose Through Daily Events and Role Fulfillment Among Asian American Youth

Establishing life purpose is a key developmental task; however, how it is linked to adolescents’ everyday family, school, extracurricular, and leisure experiences remains unclear. Using daily diary data from 180 Asian American ninth and tenth graders (50% ninth; 58% female; 25% first generation), daily purpose was positively related to daily family assistance. Leisure time was negatively associated with purpose, especially for first‐generation adolescents. Social role fulfillment (e.g., feeling like a good son or daughter) also contributed to daily purpose. Implications extended into daily affect, with positive associations with happiness, and negative associations with distress and anxiety. Results suggest that promoting social connectedness and activities that allow adolescents to feel like a valued family member may best foster youth purpose development.     

How can occupational health services in Sweden contribute to work ability?

Occupational health service in Sweden is often described as an important and strategic resource to reduce work-related diseases, improve work ability and successfully assess improvement of the workplace. However, not much research has been done on how OHS contribute to reduced absence due to work-related illness or improvement of the work ability of employees. In our study, the ambition has been to describe how OHS can contribute and give effects in client companies. Fifteen companies considered to be good examples were selected in cooperation with the social partners. Semi-structured interviews were carried out with representatives of the company and OHS. The results show that efficient collaboration depend strongly on the relationship between the OHS and the company, and were highly correlated with a continuously dialogue and contact. Good occupational safety and health management at company level was a key factor for effective use of OHS. The strategic collaborations also often led to that OHSs contribution was gradually shifted from a reactive or medical focus to a more proactive approach. Several of the interviewed OHSs also held this strategy to work more with prevention, and focusing on "treating the organization", not the individual, leaving the executive measures to the company.     

Using human factors engineering to improve patient safety in the cardiovascular operating room

Despite significant medical advances, cardiac surgery remains a high risk procedure. Sub-optimal work system design characteristics can contribute to the risks associated with cardiac surgery. However, hazards due to work system characteristics have not been identified in the cardiovascular operating room (CVOR) in sufficient detail to guide improvement efforts. The purpose of this study was to identify and categorize hazards (anything that has the potential to cause a preventable adverse patient safety event) in the CVOR. An interdisciplinary research team used prospective hazard identification methods including direct observations, contextual inquiry, and photographing to collect data in 5 hospitals for a total 22 cardiac surgeries. We performed thematic analysis of the qualitative data guided by a work system model. 60 categories of hazards such as practice variations, high workload, non-compliance with evidence-based guidelines, not including clinicians' in medical device purchasing decisions were found. Results indicated that hazards are common in cardiac surgery and should be eliminated or mitigated to improve patient safety. To improve patient safety in the CVOR, efforts should focus on creating a culture of safety, increasing compliance with evidence based infection control practices, improving communication and teamwork, and designing better tools and technologies through partnership among all stakeholders.