Experiences of workers with post-COVID-19 symptoms can signpost suitable workplace accommodations

The prevalence and multi-system nature of post-COVID-19 symptoms warrants clearer understanding of their work ability implications within the working age population. An exploratory survey was undertaken to provide empirical evidence of the work-relevant experiences of workers recovering from COVID-19. A bespoke online survey based on a biopsychosocial framework ran between December 2020 and February 2021. It collected quantitative ratings of work ability and return-to-work status, qualitative responses about return-to-work experiences, obstacles and recommendations, along with views on employer benefits for making accommodations. A sample of 145 UK workers recovering from COVID-19 was recruited via social media, professional networks and industry contacts. Qualitative data was subject to thematic analysis. Participants were mainly from health/social care (50%) and educational settings (14%). Findings – Just over 90% indicated that they had experienced at least some post-COVID-19 symptoms, notably fatigue and cognitive effects. For 55%, symptoms lasted longer than six months. Only 15% had managed a full return-to-work. Of the 88 who provided workability ratings, just 13 and 18% respectively rated their physical and mental workability as good or very good. Difficulties in resuming work were attributed to symptom unpredictability, their interaction with job demands, managing symptoms and demands in parallel, unhelpful attitudes and expectations. Manager and peer support was reported as variable. Workplace health management characterised by flexible long-term collaborative return-to-work planning, supported bymoreCOVID-centric absence policies and organisational cultures, appear pivotal for sustaining the return-to-work of the large segments of the global workforce affected by post-COVID-19 symptoms

Transcriptome Analysis of the Vernalization Response in Barley (Hordeum vulgare) Seedlings

Temperate cereals, such as wheat (Triticum spp.) and barley (Hordeum vulgare), respond to prolonged cold by becoming more tolerant of freezing (cold acclimation) and by becoming competent to flower (vernalization). These responses occur concomitantly during winter, but vernalization continues to influence development during spring. Previous studies identified VERNALIZATION1 (VRN1) as a master regulator of the vernalization response in cereals. The extent to which other genes contribute to this process is unclear. In this study the Barley1 Affymetrix chip was used to assay gene expression in barley seedlings during short or prolonged cold treatment. Gene expression was also assayed in the leaves of plants after prolonged cold treatment, in order to identify genes that show lasting responses to prolonged cold, which might contribute to vernalization-induced flowering. Many genes showed altered expression in response to short or prolonged cold treatment, but these responses differed markedly. A limited number of genes showed lasting responses to prolonged cold treatment. These include genes known to be regulated by vernalization, such as VRN1 and ODDSOC2, and also contigs encoding a calcium binding protein, 23-KD jasmonate induced proteins, an RNase S-like protein, a PR17d secretory protein and a serine acetyltransferase. Some contigs that were up-regulated by short term cold also showed lasting changes in expression after prolonged cold treatment. These include COLD REGULATED 14B (COR14B) and the barley homologue of WHEAT COLD SPECIFIC 19 (WSC19), which were expressed at elevated levels after prolonged cold. Conversely, two C-REPEAT BINDING FACTOR (CBF) genes showed reduced expression after prolonged cold. Overall, these data show that a limited number of barley genes exhibit lasting changes in expression after prolonged cold treatment, highlighting the central role of VRN1 in the vernalization response in cereals

Do workers with long-term health conditions need self-management support at work?

BACKGROUNG. Due to an ageing population and longer working lives, long-term health conditions are an increasing global burden and particularly among people of working age. A long-term health condition (LTC) can affect people’s workability and lead to premature work exit. Supporting a worker’s self-management of LTCs has the potential to minimise adverse effects through enhanced health and work outcomes. Evidence suggests that self-activation, self-efficacy, empowerment and support from others can promote LTC self-management in general and that psychosocial factors interact to influence health, but little is known about workers’ support needs. No data exists on employers’ perspectives of what self-management support workers with LTCs require. Utilising self-efficacy theory, the Patient Activation® concept and a psychosocial framework, this project aimed to understand if workers with LTCs need workplace self-management support. METHOD. The project adopted a mixed methods approach with four inter-related studies. Participants completed a cross-sectional online survey questionnaire (Study 1) measuring demographic and LTC characteristics, activation, self-efficacy, quality of life (QoL), wellbeing, workability and working conditions (stressors). For the survey, 736 workers including 327 with mental health, musculoskeletal (MSK) and other LTCs were recruited from across industries. In order to establish a longitudinal picture of changes and patterns in workers LTCs, self-management and work characteristics a sub-sample (n = 67) participated in a 10 week online diary study (Study 2). Participants’ LTC information, perceived control of an LTC, self-management activities, LTC and work interactions, received support, support satisfaction and work engagement were measured. The exploration of employers’ views on worker’s LTC self-management (Study 3) involved recruiting 15 participants with responsibilities for health and wellbeing, who participated in a semi-structured interview about self-management and support. Lastly, 14 workers participated in a narrative interview (Study 4) exploring their experiences of self-managing an LTC at work. Data were analysed using quantitative statistics for the survey and online diary (ANCOVAs, t-tests, chi-square tests, regression and multi-level modelling) and qualitative techniques for the interview studies (content, thematic, narrative thematic and narrative structural analyses). RESULTS. Of 736 participants completing the Study 1 survey, 327 reported a diagnosed LTC including mental health n = 119, MSK n = 94 and other n = 114 conditions. Participants without LTCs (n = 409) reported more people to turn to at work for support [F(1, 730) = 9.67, p = 0.002], better manager [F(1, 729) = 14.2, p = 0.001] and peer support [F(1, 729) = 12.1, p = 0.001], better current workability [F(1, 730) = 58.9, p = 0.001] and less stress about control [F(1, 729) = 5.21, p = 0.023] and change [F(1, 729) = 5.18, p = 0.009]. When compared to workers with MSK and other LTCs, workers with mental health conditions reported reduced current workability (p = 0.014), manager support (p = 0.008) and wellbeing (p = 0.001) and increased stress about change (p = 0.028) and role (p = 0.049). Differences in activation (p = 0.006) but not self-efficacy (p = 0.158) emerged between mental health and all other LTCs suggesting workplace support is important. Increased activation scores were associated with increased self-efficacy (p = 0.001), wellbeing (p = 0.001) and current workability (p = 0.001). Workers who had not disclosed an LTC (mainly mental health) reported less workplace support (p = 0.001) and were non-significantly more activated and self-efficacious. Increasing LTC severity was associated with reduced self-efficacy (p = 0.001), wellbeing (p = 0.001) and current workability (p = 0.001). Increasing age was associated with higher activation and self-efficacy together with current and future workability. Significant variability in the change of participants self-management confidence over time was revealed (B = 1.43, SE = 0.62, p = 0.02). Interactions between self-management confidence and support satisfaction and time were not significant (p = 0.61), nor between self-management confidence, LTC control and time (p = 0.62). However, interactions between self-management confidence and work engagement were significant [F(1, 54) = 1.69, p = 0.027]. Qualitative data from studies 3 and 4 provide insight into workplace LTC self-management. Data from the survey and diary study suggest that support in respect of flexibility, leeway, openness and reasonable job demands will be helpful. This was reinforced by the narrative interview data that work-modifications, disclosure, low levels of stigma, and relational support from managers and colleagues was important to workers. The employer interview study findings suggest that self-management support is not purposely provided to workers with LTCs and that managers have a main support role. Employers made it clear that workers are expected to disclose an LTC for support to be offered and recognised that obstacles to support include poor manager behaviour, stigma and work demands.CONCLUSION. This research examined if workers with LTCs need workplace self-management support. The findings from the studies reported in this thesis lead to the conclusion that workers do. This has important implications for employers. Psychosocial factors interact to affect workers ability to fit self-managing around work. Findings suggest that workers confidence and empowerment to self-manage rests largely on managers supporting flexibility, leeway and autonomy. Yet, employers lack awareness and self-management support is not purposely provided. Whilst employers and managers might not realise the control they exert on workers LTC self-management, they have an important role to play and need guidance in the principles and practice of supporting self-management. This research identifies support needs specific to the workplace and proposes a model for psychosocial LTC self-management support. This can be used to generate discussions about obstacles and support needs to guide workers and employers. Potentially, the model can inform the design of a LTC self-management support tool for managers and update existing self-management support models.</div

Using the patient activation measure to examine the self-management support needs of a population of UK workers with long-term health conditions

Objectives To examine differences in patient activation and self-management support needs in a population of UK workers with long-term health conditions. Methods Demographic, health and activation information were taken from the data of participants with long-term conditions, collected via an online cross-sectional survey of workers. The 13-item British patient activation measure measured workers knowledge, skills and confidence towards self-managing. Results Three hundred and seven workers with mental health, musculoskeletal and other conditions completed the patient activation measure. Mental health conditions were most prevalent (36.8%). Workers were higher activated, however workers with mental health conditions were significantly less activated (p = 0.006). Differences in activation by condition severity and age were revealed. Discussion This study provides insight to the activation of UK workers with long-term conditions. Whilst workers with mental health conditions need more training and education to self-manage, workers are variably activated indicating broader support needs. There is a gap for workplace self-management support. The patient activation measure is used in healthcare to improve people’s self-management and should be considered to be included in the workplace, and could form part of interventions to support workers self-management. More rigorous studies, including the patient activation measure, are needed to identify the best approaches to identifying workers self-management support needs.</p

Editors' Report

We have now almost completed our third year as editors – which will be our last full year as we will be handing over to new editors at some point in 2017. As observant readers will note, we have had a slight change of editorial team. Carina Girvan joined the new editorial team of BJET (the British Journal of Educational Technology), which is also in the BERA portfolio. In her place, we have been lucky enough to be joined by two colleagues – William Baker (a sociologist of education whose work focuses broadly on educational inequality, culture, social class and aspirations) and Peter Hemming (a sociologist and human geographer with interests in schooling, faith-based education, childhood/youth, identity and citizenship and qualitative research methods).We have really enjoyed editing BERJ – it gives a wonderful opportunity to appreciate and shape (albeit in a small way) the wide field of educational research. We continue to be impressed by the scholarship and imagination of many of the articles submitted and hope we have provided you with an interesting diet. We have tried to ensure that we have included a spectrum of excellent research which covers different phases (from pre-school to higher and adult education), different disciplines and methodological approaches. We also try to ensure that every article speaks to issues that are of international concern.One of the issues that is facing the educational research community is the ongoing debate about the ‘usefulness’ of our research for policy-makers and practitioners. Last year's volume of BERJ concluded with Professor Gemma Moss's excellent BERA Presidential Address. Through a compelling analysis of the development of literacy policy in England, she maps out the complex terrain of the ‘knowledge landscape’. She argues that we need to find more profitable ways of working across the current division of labour epitomised by the policy-research-practice relationship – but in ways which do not compromise the complexity of the research process and research findings.We believe that BERJ (and BERA) has an important role to play in contributing to debates in this areas – and are confident that the research we disseminate in this Journal is both complex and ?useful'. As the following sections outlines, BERJ continues to increase its influence and reach.</p

What workers can tell us about post-COVID workability

BACKGROUND: The apparent functional impact of post-COVID-19 syndrome has workability implications for large segments of the working-age population. AIMS: To understand obstacles and enablers around self-reported workability of workers following COVID-19, to better guide sustainable workplace accommodations. METHODS: An exploratory online survey comprising quantitative and qualitative questions was disseminated via social media and industry networks between December 2020 and February 2021, yielding usable responses from 145 workers. Qualitative data were subjected to content analysis. RESULTS: Over half of the sample (64%) were from the health, social care, and education sectors. Just under 15% had returned to work, and 53% and 50% reported their physical and psychological workability respectively as moderate at best. Leading workability obstacles were multi-level, comprising fatigue, the interaction between symptoms and job, lack of control over job pressures, inappropriate sickness absence management policies, and lack of COVID-aware organizational cultures. Self-management support, modified work, flexible co-developed graded return-to-work planning, and improved line management competency were advocated as key enablers. CONCLUSIONS: Assuming appropriate medical management of any pathophysiological complications of COVID-19, maintaining or regaining post-COVID workability might reasonably follow a typical biopsychosocial framework enhanced to cater to the fluctuating nature of the symptoms. This should entail flexible, regularly reviewed and longer-term return-to-work planning addressing multi-level workability obstacles, co-developed between workers and line managers, with support from human resources, occupational health professionals (OHP’s), and a COVID-aware organizational culture

Sustaining work ability amongst female professional workers with long COVID

Background: Long COVID (LC) compromises work ability (WA). Female worker WA has been more adversely impacted than men. Exploration of their lived experiences could elucidate the WA support required. Aims: To explore the working conditions and circumstances experienced as affecting sustained WA amongst female workers with LC, to help mitigate worklessness risks. Methods: Online semi-structured qualitative interviews were conducted with 10 female workers self-reporting or formally diagnosed with LC who had made some attempt to return-to-work (RTW). Interviews were analysed using template analysis to map themes informing WA enablers and obstacles onto a biopsychosocial model of rehabilitation. Results. All participants were professionals working in an employed or self-employed capacity. Key themes reflecting circumstances that afforded sustained WA included the autonomy over where, when and how to work indicated as afforded by a professional role, rapid healthcare access, predominantly sedentary work, competent colleagues able to cover for transient reduced WA, a strong interface between specialist health and management support, and accessible organisational policies that steer health management according to equity rather than equality. Highly flexible, iterative, co-produced RTW planning, tolerant of fluctuating symptom expression appears vital. In return for providing such flexibility, participants felt that employers’ workforce diversity and competence would be protected, and that workers would need to reciprocate flexibility. Conclusions. These qualitatively derived findings of worker’s lived experiences add to existing guidance on supporting WA for people struggling with LC. Moreover, the same principles seem appropriate for tackling worklessness amongst working age adults with complex long-term health conditions

Employer perspectives concerning the self-management support needs of workers with long-term health conditions

Design: The exploration of employers’ views involved recruiting 15 participants with responsibilities for workplace health, wellbeing and safety, who participated in a semistructured interview about self-management and support. Data were analysed using a qualitative six-stage thematic analysis technique.Purpose: Long-term health conditions are a significant occupational and global burden and can undermine people’s ability to work. Workplace support for self-management of long-term conditions has the potential to minimise adverse work effects, by enhancing health and work outcomes. No data exists about employers’ views concerning supporting workers with long-term conditions to self-manage.Findings: Self-management support is not purposely provided to workers with longterm conditions. Support in any form rests on workers disclosing a condition, and on their relationship with their line-manager. While employers have considerable control over people’s ability to self-manage, they consider that workers are responsible for selfmanagement at work. Stigma, work demands, and line-manager behaviours are potential obstacles to workers’ self-management and support.Practical implications: Workplace discussions about self-managing long-term conditions at work should be encouraged and opened up, to improve health and work outcomes and aligned with return-to-work and rehabilitation approaches. A wider biopsychosocial culture could help ensure workplaces are regarded as settings in which long-term conditions can be self-managed. Originality: This study highlights that employer self-management support is not provided to workers with long-term conditions in a purposeful way. Workplace support depends on an employer knowing what needs to be supported which, in turn, depends on aspects of disclosure, stigma, work demands and line management. </div