Werk, werkloosheid en het vacuüm tussen burger en gemeente

Werkloosheid vormt een van de grootste problemen van de westerse samenleving, maar is tegelijkertijd moeilijk met behulp van theorieën te verklaren. Dit artikel behandelt in dit verband de noodzaak tot institutionele vernieuwing in buurten, wijken en eventueel deelgemeenten. De volgende vraag staat hierbij centraal: wat is de mogelijke bijdrage van de kringorganisatiemethode aan de analyse en mogelijke oplossing van het werkloosheidsvraagstuk? In het kader van deze vraag worden de mogelijkheden onderzocht om de lokale institutionele infrastructuur te vernieuwen met behulp van de principes van kringorganiseren die zijn ontwikkeld door de Rotterdamse ingenieur Gerard Endenburg. Deze benadering is met name interessant omdat het huidige werkgelegenheidsbeleid is gebaseerd op de veronderstelling dat er ontwerpfouten in de relatie tussen de markteconomie en het sociale zekerheidssysteem zitten, waardoor de afstemming tussen vraag en aanbod op de arbeidsmarkt verstoord raakt. Een gedetailleerde analyse van deze ontwerpfouten ontbreekt echter in de literatuur, waardoor ook beleid gericht op het herstellen van deze dieperliggende oorzaak van het werkloosheidsprobleem achterwege blijft. We bespreken eerst het huidige werkgelegenheidsbeleid van het kabinet Kok. Daarna worden de begrippen ''werk'' en ''werkloosheid'' in een historisch perspectief geplaatst. Vervolgens gaan we na hoe diverse ontwikkelingen de scheiding tussen werk en werkloosheid, en daarmee samenhangende scheiding tussen werk- en niet-werksfeer, ondermijnen. Deze problematiek hangt nauw samen met het ontstaan van een zogenaamd institutioneel vacuüm tussen individuele burger en gemeente, waardoor op dit niveau een dynamische sociaal-politieke structuur ontbreekt. Dit vacuüm kan worden gezien als een fundamentele constructiefout van de westerse samenleving die zichtbaar wordt in het probleem van structurele werkloosheid. De principes van kringorganiseren kunnen worden gebruikt om genoemd vacuüm in te vullen. Deze weg van lokale institutionele vernieuwing is in hoge mate complementair aan het werkgelegenheidsbeleid van de huidige regering.public economics ;

Beyond command and control:tensions arising from empowerment initiatives

In this study, we explore how empowerment initiatives can be understood by drawing on key notions from the power literature. By conceptualizing empowerment as the transformation toward ‘power to’ by actively using ‘power over’, we uncover power-related dynamics and tensions arising from empowerment initiatives in ways that go beyond prior work. Our in-depth case study of an empowerment initiative in a military organization highlights the complex challenges that powerful actors face when attempting to enhance the power to act elsewhere in the organization. Our findings demonstrate how power-related tensions arise between and within actors, as actors combine and shift between different power practices. We find that power tensions are not merely relational in nature (i.e., between actors), but also arise when individual cognition differs from action. By showing how the interplay of different power practices may result in major tensions, our findings provide a new perspective on why organizational empowerment initiatives may produce unintended outcomes or even completely fail. Moreover, while power-over, power-to and transformative power practices are typically explored separately, this study is one of the first to shed light on the complex relation between these power practices, thereby examining them together. Finally, this study demonstrates how cross-fertilization between the empowerment and power discourses may advance both fields

Madness decolonized?: Madness as transnational identity in Gail Hornstein’s Agnes’s Jacket

The US psychologist Gail Hornstein’s monograph Agnes’s Jacket: A Psychologist’s Search for the Meanings of Madness (2009) is an important intervention in the identity politics of the mad movement. Hornstein offers a resignified vision of mad identity that embroiders the central trope of an “anti-colonial” struggle to reclaim the experiential world “colonized” by psychiatry. A series of literal and figurative appeals make recourse to the inner world and (corresponding) cultural world of the mad, as well as to the ethno-symbolic cultural materials of dormant nationhood. This rhetoric is augmented by a model in which the mad comprise a diaspora without an origin, coalescing into a single transnational community. The mad are also depicted as persons displaced from their metaphorical homeland, the “inner” world “colonized” by the psychiatric regime. There are a number of difficulties with Hornstein’s rhetoric, however. Her “ethnicity-and-rights” response to the oppression of the mad is symptomatic of Western parochialism, while her proposed transmutation of putative psychopathology from limit upon identity to parameter of successful identity is open to contestation. Moreover, unless one accepts Hornstein’s porous vision of mad identity, her self-ascribed insider status in relation to the mad community may present a problematic “re-colonization” of mad experience

Making sense of voices: a case series

The current evidence-base for the psychological treatment of distressing voices indicates the need for further clinical development. The Maastricht approach (also known as Making Sense of Voices) is popular within sections of the Hearing Voices Movement, but its clinical effectiveness has not been systematically evaluated. The aim of the approach is to develop a better understanding of the role of the voice, in part through opening a dialogue between the voice hearer and the voice. The current study was a (N=15) case series adopting a concurrent multiple baseline design. The Maastricht approach was offered for up to 9-months. The main outcome, weekly voice-related distress ratings, was not statistically significant during intervention or follow-up, although the effect size was in the moderate range. The PSYRATS Hallucination scale was associated with a large effect size both at the end of treatment, and after a 3-month follow-up period, although again the effect did not reach statistical significance. The results suggest further evaluation of the approach is warranted. However, given the large variance in individual participant outcome, it may be that a better understanding of response profiles is required before conducting a definitive randomised controlled trial

“That little doorway where I could suddenly start shouting out”: barriers and enablers to the disclosure of distressing voices

Hearing distressing voices is a key feature of psychosis. The time between voice onset and disclosure may be crucial as voices can grow in complexity. This study investigated barriers and enablers to early voice disclosure. Interviews with 20 voice hearers underwent Thematic Analysis. Beliefs about the effect of disclosure on self and others acted as a barrier and enabler to voices being discussed. Voice hearing awareness should be increased amongst young people, the public and care services. To support earlier disclosure measures need to increase skill amongst those likely to be disclosed to

Working with consumers who hear voices: The experience of early career nurses in mental health services in Australia

© 2018 Australian College of Mental Health Nurses Inc. Mental health consumers who hear voices frequently experience distress and express a desire to discuss their voice-hearing experience. Nurses do not regularly demonstrate a willingness to engage in such discussions. With the introduction of educational strategies that develop empathy and an understanding of voice-hearing experiences, it is anticipated that early career nurses will be able to translate such understanding into their professional nursing practice. To explore early career nurses’ understanding of providing care to mental health consumers who hear voices, a qualitative exploratory descriptive study was conducted in which nine early career Registered Nurses were interviewed regarding their experiences of caring for people who hear voices. Thematic analysis was employed to analyse the data and generate themes. Participants reported difficulty in developing relationships with consumers who hear voices, due to a workplace culture that was focussed on risk and lacking professional support. Nurses need specific education to develop the skills necessary to respond to consumers who hear voices and engage in dialogue that assists consumers to relate to the voices in a meaningful way. However, for this to succeed in practice, changes need to be supported by addressing the cultural barriers, such as risk-focussed environments, that prevent nurses implementing best practice

Future Dominance by Quaking Aspen Expected Following Short-Interval, Compounded Disturbance Interaction

The spatial overlap of multiple ecological disturbances in close succession has the capacity to alter trajectories of ecosystem recovery. Widespread bark beetle outbreaks and wildfire have affected many forests in western North America in the past two decades in areas of important habitat for native ungulates. Bark beetle outbreaks prior to fire may deplete seed supply of the host species, and differences in fire‐related regeneration strategies among species may shift the species composition and structure of the initial forest trajectory. Subsequent browsing of postfire tree regeneration by large ungulates, such as elk (Cervus canadensis), may limit the capacity for regeneration to grow above the browse zone to form the next forest canopy. Five stand‐replacing wildfires burned ~60,000 ha of subalpine forest that had previously been affected by severe ( \u3e90% mortality) outbreaks of spruce beetle (SB, Dendroctonus rufipennis) in Engelmann spruce (Picea engelmannii) in 2012–2013 in southwestern Colorado. Here we examine the drivers of variability in abundance of newly established conifer tree seedlings [spruce and subalpine fir (Abies lasiocarpa)] and resprouts of quaking aspen (Populus tremuloides) following the short‐interval sequence of SB outbreaks and wildfire (2–8 yr between SB outbreak and fire) at sites where we previously reconstructed severities of SB and fire. We then examine the implications of ungulate browsing for forest recovery. We found that abundances of postfire spruce seedling establishment decreased substantially in areas of severe SB outbreak. Prolific aspen resprouting in stands with live aspen prior to fire will favor an initial postfire forest trajectory dominated by aspen. However, preferential browsing of postfire aspen resprouts by ungulates will likely slow the rate of canopy recovery but browsing is unlikely to alter the species composition of the future forest canopy. Collectively, our results show that SB outbreak prior to fire increases the vulnerability of spruce–fir forests to shifts in forest type (conifer to aspen) and physiognomic community type (conifer forest to non‐forest). By identifying where compounded disturbance interactions are likely to limit recovery of forests or tree species, our findings are useful for developing adaptive management strategies in the context of warming climate and shifting disturbance regimes

A framework to develop semiautomated surveillance of surgical site infections: An international multicenter study

Objective: Automated surveillance of healthcare-associated infections reduces workload and improves standardization, but it has not yet been adopted widely. In this study, we assessed the performance and feasibility of an easy implementable framework to develop algorithms for semiautomated surveillance of deep incisional and organ-space surgical site infections (SSIs) after orthopedic, cardiac, and colon surgeries. Design: Retrospective cohort study in multiple countries. Methods: European hospitals were recruited and selected based on the availability of manual SSI surveillance data from 2012 onward (reference standard) and on the ability to extract relevant data from electronic health records. A questionnaire on local manual surveillance and clinical practices was administered to participating hospitals, and the information collected was used to pre-emptively design semiautomated surveillance algorithms standardized for multiple hospitals and for center-specific application. Algorithm sensitivity, positive predictive value, and reduction of manual charts requiring review were calculated. Reasons for misclassification were explored using discrepancy analyses. Results: The study included 3 hospitals, in the Netherlands, France, and Spain. Classification algorithms were developed to indicate procedures with a high probability of SSI. Components concerned microbiology, prolonged length of stay or readmission, and reinterventions. Antibiotics and radiology ordering were optional. In total, 4,770 orthopedic procedures, 5,047 cardiac procedures, and 3,906 colon procedures were analyzed. Across hospitals, standardized algorithm sensitivity ranged between 82% and 100% for orthopedic surgery, between 67% and 100% for cardiac surgery, and between 84% and 100% for colon surgery, with 72%-98% workload reduction. Center-specific algorithms had lower sensitivity. Conclusions: Using this framework, algorithms for semiautomated surveillance of SSI can be successfully developed. The high performance of standardized algorithms holds promise for large-scale standardization