Suchergebnisse

For millions of disabled people around the world the wheelchair has been one of the most important technological innovations of the twentieth century. From its inception as a relatively cumbersome, heavy machine, designed principally for indoor use, the wheelchair has evolved into a sophisticated and highly technical mode of transport. Wheelchairs are, at least in the Global North, relatively widely used and universally recognizable – so recognizable that they have become the cultural symbol to represent all disabled people. Wheelchairs are often viewed with trepidation: as machines that disable, confine, and deprive their occupant of independence – as medical devices that doctors prescribe only to the sick, the wounded or the elderly. Such definitions and perceptions infiltrate the public lives of wheelchair users, cause considerable macro and micro political difficulties, and consequently disable users in a myriad of different ways.

Co-production is now an established part of public service delivery. Despite its popularity, there is only a limited understanding about how co-production works in practice, particularly with marginalised groups. This paper identifies and explores insights from three case studies of a successful co-productive approach in Glasgow, Scotland. Operation Modulus is a criminal justice initiative involving public and third sector partners in the co-production of services with marginalised young people to reduce their involvement in crime and antisocial behaviour. The data highlighted the importance of leadership, the role of public service professionals and the process of working with marginalised young people; these are explored, all within the context of the authorising environment created at the level of a collaborative governance body. The findings underscore, first, the importance of distributed leadership and process in developing trust amongst partners and in turn in the relationships of partners with young people. Second, the essential role of effective co-management amongst service providers in creating the requisite conditions for meaningful co-production with marginalised citizens. Third, the potential for and importance of shared management to facilitate changes in professional relationships and ways of working, even if these do not lead to organisational systems change. Fourth, the significance of public service professionals having the authority and agency to explore collaborative ways of working.

In April 2014, the Social Care (Self Directed Support) Act 2013 (SDS) was implemented in Scotland. This marked a major shift in how social care is delivered and organised for both users and professionals across the country. Whilst it emerged through the personalisation agenda - which has dominated international social care systems over recent years - SDS represented a significant shift in thinking for service provision in Scotland. In this article, we review the initial stages of policy implementation. Drawing on two Freedom of Information requests from 2015 and 2016 and a series of interviews with local authority practitioners, we argue that, to date, SDS has yet to produce radical transformative change. We explore the reasons behind this through four key themes. Firstly, we highlight the challenges of promoting the principles of coproduction in policy and suggest that in reality, this has been compromised through SDS implementation. Secondly, we suggest that SDS has been caught up in a policy overload and ultimately overshadowed by new legislation for health and social care integration. In looking at the impact of this relationship, our third theme questions the role of new partnership working. Finally we argue that the timing of SDS in a period of acute austerity in social care has resulted in disabled people being offered limited choice rather than increased opportunities for independent living.

In April 2014, the Social Care (Self-directed Support) (Scotland) Act 2013 (SDS Act) was implemented in Scotland. This marked a major shift in how social care is delivered and organized for both users and professionals across the country. Whilst it emerged through the personalization agenda—which has dominated international social care systems over recent years—self-directed support (SDS) represented a significant shift in thinking for service provision in Scotland. In this article, we review the initial stages of policy implementation. Drawing on two Freedom of Information requests from 2015 and 2016 and a series of interviews with local authority practitioners, we argue that, to date, SDS has yet to produce radical transformative change. We explore the reasons behind this through four key themes. First, we highlight the challenges of promoting the principles of co-production in policy and suggest that, in reality, this has been compromised through SDS implementation. Second, we suggest that SDS has been caught up in a policy overload and ultimately overshadowed by new legislation for health and social care integration. In looking at the impact of this relationship, our third theme questions the role of new partnership working. Lastly, we argue that the timing of SDS in a period of acute austerity in social care has resulted in disabled people being offered limited choice rather than increased opportunities for independent living.

AbstractIn April 2014, the Social Care (Self‐directed Support) (Scotland) Act 2013 (SDS Act) was implemented in Scotland. This marked a major shift in how social care is delivered and organized for both users and professionals across the country. Whilst it emerged through the personalization agenda—which has dominated international social care systems over recent years—self‐directed support (SDS) represented a significant shift in thinking for service provision in Scotland. In this article, we review the initial stages of policy implementation. Drawing on two Freedom of Information requests from 2015 and 2016 and a series of interviews with local authority practitioners, we argue that, to date, SDS has yet to produce radical transformative change. We explore the reasons behind this through four key themes. First, we highlight the challenges of promoting the principles of co‐production in policy and suggest that, in reality, this has been compromised through SDS implementation. Second, we suggest that SDS has been caught up in a policy overload and ultimately overshadowed by new legislation for health and social care integration. In looking at the impact of this relationship, our third theme questions the role of new partnership working. Lastly, we argue that the timing of SDS in a period of acute austerity in social care has resulted in disabled people being offered limited choice rather than increased opportunities for independent living.

The biopsychosocial model (BPS) of mental distress, originally conceived by American psychiatrist George Engel in the 1970s and commonly used in psychiatry and psychology, has been adapted by Gordon Waddell and Mansel Aylward to form the theoretical basis for current UK government thinking on disability. Most importantly, the Waddell and Aylward version of the BPS has played a key role as the government has sought to reform spending on out-of-work disability benefits. This article critiques Waddell and Aylward's model, examining its origins, its claims and the evidence it employs. We argue that its potential for genuine interdisciplinary cooperation and the holistic and humanistic benefits for disabled people as envisaged by Engel are not now, if they ever have been, fully realised. Any potential benefit it may have offered has been eclipsed by its role in Coalition/Conservative government social welfare policies that have blamed the victim and justified restriction of entitlements.

The biopsychosocial model (BPS) of mental distress, originally conceived by American psychiatrist George Engel in the 1970s and commonly used in psychiatry and psychology, has been adapted by Gordon Waddell and Mansel Aylward to form the theoretical basis for current UK government thinking on disability. Most importantly, the Waddell and Aylward version of the BPS has played a key role as the government has sought to reform spending on out-of-work disability benefits. This article critiques Waddell and Aylward's model, examining its origins, its claims and the evidence it employs. We argue that its potential for genuine interdisciplinary cooperation and the holistic and humanistic benefits for disabled people as envisaged by Engel are not now, if they ever have been, fully realised. Any potential benefit it may have offered has been eclipsed by its role in Coalition/Conservative government social welfare policies that have blamed the victim and justified restriction of entitlements.

Personalisation has dominated social care across OECD countries over the past 20 years. UK policy evolved from the efforts of disabled peoples' organisations (DPOs) to secure the availability of cash payments as part of a wider drive to enable independent living. Implementation of personalisation across the UK has seen significant divergence in how governments have developed their own responses, but in each country the DPOs' role and impact has shifted from campaigning and promoting the voices of disabled people to a more muted focus on service provision and limited policy engagement. This article draws on a series of interviews with DPOs and leading disabled activists. It highlights concerns raised related to themes around austerity, changing relationships with local government and the role of co-production in developing policy. We conclude the article by discussing the future directions for personalisation and developments in light of the COVID-19 pandemic.

This article explores the third sector's role during the COVID-19 pandemic and its impact on the experiences of disabled people in England and Scotland. It draws on semi-structured longitudinal interviews with 71 disabled people and 31 key informants, primarily from disabled people's organisations. The third sector's nimble response, supporting people in myriad innovative ways, emerged as a key finding. In contrast, statutory services were experienced by many as a barrier rather than an enabler, posing doubts about the state's ability to respond to the crisis. Our findings raise questions about the role of the state and the third sector. We employ and critique Young's typology of sector–state relations, concluding that the state needs to engage with the third sector as an equal and strategic partner, recognising its civil society credentials. Further, we raise questions about the appropriateness of using supply and demand models to understand the third sector's societal role.

The effect of different drying methods i.e., oven (OD), vacuum (VD), and heat pump assisted (HPD) drying on lemon myrtle leaf (LML) as well as the retention of volatiles in the dried product was investigated. Following a constant rate period, each method entered the falling rate period, whereby drying was governed by internal diffusion. The moisture diffusivity (Deff), calculated using Fick's second law, was found to fall in the range of 8.07 × 10-10 to 4.35 × 10-9 m2/s across the varying drying methods and conditions. The activation energy (Ea), calculated using the Arrhenius equation, was 13.42, 45.41, and 72.85 kJ/mol for HPD, VD, and OD, respectively. Essential oils (EO) were obtained from dried LML through the simultaneous distillation and extraction (SDE) method, and thereafter, the EO was analysed using gas chromatography-mass spectrometry (GC-MS). Citral, an important volatile in LML, was among the EO components identified. Commonly found in its cis- and trans- forms, citral retention differed between the drying methods. The highest retention of volatiles was observed in the HPD method, followed by VD and OD. As high citral content is indicative of successful post-harvest processing, and given its ability to retain such volatiles in dried LML, HPD is therefore the most suitable drying method for LML drying. HPD can also be applied for the preservation of various agricultural products especially heat-sensitive herbs. The waste heat recovery ability attracts agropreneurs' attention on adapting HPD into their industry. The versatile feature of this controlled dryer not only ensures good quality herb products, but is also economical, efficient, and time-saving.

Background: Outcomes for children who have been received into state care due to maltreatment or neglect are very poor in comparison to the general population. A mental health focussed intervention is being trialled in the UK which seeks to improve outcomes for such children. Although the main study is concerned with outcome evaluation (child mental health measures), a robust process evaluation adds nuance to the findings by examining the relationship between the interventions, the participants and the context-thereby determining what works, for whom and in what context. This paper sets out the protocol for that process evaluation. Methods: The process evaluation is embedded within a Randomised Control Trial and uses Realist Evaluation as its theoretical framework. It sets out the mechanisms of change that are used to effect positive outcomes and outlines the various aspects of the context (including service provision and the legal system that provides the statutory basis for involvement with families). Data collection is primarily qualitative and takes place with a large group of stakeholders. The analysis of the interplay between context, mechanisms and outcomes will provide a richer understanding of the main trial outcomes. Discussion: The nature of the interaction between the social, legal and practice context is complex. The use of a variety of methods including case studies, focus groups and analysis of routine data are justified and it is argued that they will provide for greater understanding of the nature of the interactions within such a challenging context.

Digital technologies are being used as part of international efforts to revolutionize healthcare in order to meet increasing demands such as the rising burden of chronic disease and ageing populations. In Scotland there is a government push towards a national service (Living It Up) as a single point of reference where citizens can access information, products and services to support their health and wellbeing. The aim of the study is to examine implementation issues including the challenges or facilitators which can help to sustain this intervention. We gathered data in three ways: a) participant observation to gain an understanding of LiU (N=16); b) in-depth interviews (N=21) with stakeholders involved in the process; and c) analysis of documentary evidence about the progress of the implementation (N=45). Barriers included the need to "work at risk" due to delays in financing, inadequate infrastructure and skill-set deficiencies, whilst facilitators included trusted relationships, champions and a push towards normalisation. The findings suggest that a Scottish ehealth service is achievable but identifies key considerations for future large scale initiatives.

Digital technologies are being used as part of international efforts to revolutionize healthcare in order to meet increasing demands such as the rising burden of chronic disease and ageing populations. In Scotland there is a government push towards a national service (Living It Up) as a single point of reference where citizens can access information, products and services to support their health and wellbeing. The aim of the study is to examine implementation issues including the challenges or facilitators which can help to sustain this intervention. We gathered data in three ways: a) participant observation to gain an understanding of LiU (N=16); b) in-depth interviews (N=21) with stakeholders involved in the process; and c) analysis of documentary evidence about the progress of the implementation (N=45). Barriers included the need to "work at risk" due to delays in financing, inadequate infrastructure and skill-set deficiencies, whilst facilitators included trusted relationships, champions and a push towards normalisation. The findings suggest that a Scottish ehealth service is achievable but identifies key considerations for future large scale initiatives.