Occupation, citizenship and participation

Occupational therapy is a health profession which centres on the significance of doing. It is a well understood principle that doing things can be good for your health. The treatment medium for many occupational therapists is activity. Occupational therapy uses the word ‘occupation’ in the broader sense of being occupied, rather than the narrower connection with work and employment. Many people assume that occupational therapy is linked to occupational health and so is primarily vocational. Occupational therapists rarely work in occupational health. The significance of doing and activity is that this is how people interconnect with others and the environment around them. It is the basis for individual and social engagement, for a participative society in which people experience health through a social exchange, which might be expressed as forms of citizenship. Through doing things in the world people gain experiences and develop the substance of their life narratives. Every day events are the basis of social interaction and give people the sense of belonging to a community. Health is not merely physical and mental health, but is expressed in a social context of experiences. People may be ill or dying, but they may still enjoy healthy participation in life through occupation, through opportunities to express themselves or be part of a community. The quality of health, participation and citizenship depend on a number of social determinants of health such as poverty, experience of relative inequality and of the institutional aspects of the health system, all of which contribute to the production of health inequities. This presentation will explore a couple of case studies which illustrate how issues of citizenship and rights are challenged by everyday experiences which impact on health, the experience of literacy and of accessing health services. It is based on work from the European Network of Occupational Therapy in Europe (ENOTHE) Citizenship Working Group which has been exploring the concept of “participatory citizenship” (Hoskins & Kerr, 2012) since the European Year of the Citizen in 2013

Meaningful occupation as a fundamental principle of health and citizenship

Introduction : Occupational therapists are concerned with fostering abilities and opportunities towards meaningful participation. This aim is conceived in health terms, but implies that health is connected to enacting citizenship, since participation goals are social, transactional and depend on interaction and reciprocal exchange. Objectives: To present a critical discussion of the significance of occupation for health and transformative citizenship. Approach Restriction in participation is also a restriction of citizenship. Practice-based vignettes will serve as examples of how dis-citizenship is generated through marginalisation with negative impacts on health outcomes. Secondly, we will frame exercising citizenship as social participation. This approach of participatory citizenship brings forth the potential of social transformation both individually and collectively based on new collective understandings and mutual recognition. Practice implications Approaching citizenship and health as interrelated and embodied rather than abstract, takes into account the ways in which social and cultural backgrounds as well as material circumstances affect people's lives as citizens. Health conditions are generated or maintained by social conditions such as poverty and limited access to resources and affected by cultural factors such as difference. The implication of critical occupation-based practise is that it offers a possibility to question and challenge these limitations and create particular spaces of action where in everyday life people negotiate rights and possibilities, belonging and participation. Conclusion Citizenship as an occupational practice of participation has valuable potential as the basis for the understanding of processes of participation and health as for the promotion of social transformation and more inclusive communitie

Educational materials on citizenship from an occupational perspective

Sarah Kantartzis - ORCID: 0000-0001-5191-015X https://orcid.org/0000-0001-5191-015XThis booklet presents educational materials for teachers or educators and students of occupational therapy in higher education programmes. The materials can also be applied in interprofessional programmes, to enable an occupation-based approach to citizenship to be negotiated in the inter-curricula context. In addition, they will be useful for the continuing professional development of people working in health and social fields and in community development programmes. The general aim is to facilitate and highlight addressing issues of citizenship in the contemporary education of occupational therapists. The purpose is to bring the co-creation of knowledge, skills and values of participatory citizenship together with strategic political, cultural and critical thinking into education, particularly at the Diploma/Bachelor or pre-registration levels. The booklet is written in three sections, which present: Section 1: An introduction to the concept of citizenship and particularly of participatory citizenship (Chapter 2). Section 2: A discussion of competences and learning outcomes, as well as of the theoretical approaches that underpin these educational materials (Chapters 3 and 4). Section 3: A range of educational materials, enabling flexible, contextualised, approaches, for the exploration, understanding and development of knowledge regarding participatory citizenship (Chapter 5).This booklet has been published with the support from a grant of the European Network of Occupational Therapy in Higher Education (ENOTHE) for the Project: “Citizenship II”.https://doi.org/10.17979/spudc.9788497498142pubpu

The occupation of accessing healthcare and processes of (dis)citizenship in UK Somali migrants: Sheffield case study

** From Crossref via Jisc Publications Router.In the UK free access to healthcare is regarded as a fundamental right accorded to all citizens, but there are significant health inequities experienced by ethnic minority populations. Accessing healthcare is an everyday occupation which can be made complicated by language issues and the design of communication systems. The example of people of Somali origin living in Sheffield is used to explore the occupational dimensions of access to healthcare as part of the participatory process of citizenship. Occupational analysis of healthcare access could contribute to better service provision.sch_occ75pub5238public

Participatory citizenship: critical perspectives on client-centred occupational therapy

Background/aims: This article aims to discuss client-centred practice, the current dominant approach within occupational therapy, in relation to participatory citizenship. Occupational therapists work within structures and policies that set boundaries on their engagement with clients, while working with complex, multidimensional social realities. Methods: The authors present a critical discussion shaped by their research, including a survey, discussions at workshops at international conferences, and critical engagement with the literature on occupational therapy, occupation, and citizenship. Conclusion: A focus on citizenship suggests reframing professional development based on the participation in public life of people as citizens of their society. While occupational therapists often refer to clients in the context of communities, groups, families, and wider society, the term client centred practice typically represents a particular view of the individual and may sometimes be too limited in application for a more systemic and societal approach. Significance: The authors question the individual focus which has, until recently, been typical of client-centred occupational therapy. Placing citizenship at the core of intervention is a transformative process that assumes all people are citizens and conceives of health as a collective issue, influencing the way we educate, do research, and practise. Key words: Collective, dis-citizenship, inequalities, professional development, participation, paradigms, occupational justice</p

Targeting Toll-like receptor 7/8 enhances uptake of apoptotic leukemic cells by monocyte-derived dendritic cells but interferes with subsequent cytokine-induced maturation

Therapeutic vaccination with dendritic cells (DC) is an emerging investigational therapy for eradication of minimal residual disease in acute myeloid leukemia. Various strategies are being explored in manufacturing DC vaccines ex vivo, e.g., monocyte-derived DC (MoDC) loaded with leukemia-associated antigens (LAA). However, the optimal source of LAA and the choice of DC-activating stimuli are still not well defined. Here, loading with leukemic cell preparations (harboring both unknown and known LAA) was explored in combination with a DC maturation-inducing cytokine cocktail (CC; IL-1β, IL-6, TNF-α, and PGE2) and Toll-like receptor ligands (TLR-L) to optimize uptake. Since heat shock induced apoptotic blasts were more efficiently taken up than lysates, we focused on uptake of apoptotic leukemic cells. Uptake of apoptotic blast was further enhanced by the TLR7/8-L R848 (20–30%); in contrast, CC-induced maturation inhibited uptake. CC, and to a lesser extent R848, enhanced the ability of MoDC to migrate and stimulate T cells. Furthermore, class II-associated invariant chain peptide expression was down-modulated after R848- or CC-induced maturation, indicating enhanced processing and presentation of antigenic peptides. To improve both uptake and maturation, leukemic cells and MoDC were co-incubated with R848 for 24 h followed by addition of CC. However, this approach interfered with CC-mediated MoDC maturation as indicated by diminished migratory and T cell stimulatory capacity, and the absence of IL-12 production. Taken together, our data demonstrate that even though R848 improved uptake of apoptotic leukemic cells, the sequential use of R848 and CC is counter-indicated due to its adverse effects on MoDC maturation