Individual-level and plant-level predictors of acute, traumatic occupational injuries in a manufacturing cohort

Objectives: Workplace and contextual factors that may affect risk for worker injury are not well described. This study used results from an employee job satisfaction survey to construct aggregate indicators of the work environment and estimate the relative contribution of those factors to injury rates in a manufacturing cohort. Methods: Principal components analysis was used to construct four plant-level factors from responses to a 32 question survey of the entire workforce, administered in 2006. Multilevel Poisson regression was used to evaluate the relationship between injury rate, individual-level and plant-level risk factors, unionisation and plant type. Results: Plant-level ‘work stress’ (incident rate ratio (IRR)=0.50, 95% CI 0.28 to 0.90) was significant in the multilevel model, indicating the rate of injury for an average individual in that plant was halved (conditional on plant) when job stress decreased by a tertile. ‘Overall satisfaction’, ‘work environment’ and ‘perception of supervisor’ showed the same trend but were not significant. Unionisation was protective (IRR=0.40, 95% CI 0.17 to 0.95) as was any plant type compared with smelter. Conclusions: We demonstrated utility of data from a human resources survey to construct indicators of the work environment. Our research suggests that aspects of the work environment, particularly work stress and unionisation, may have a significant effect on risk for occupational injury, emphasising the need for further multilevel studies. Our work would suggest monitoring of employee perceptions of job stress and the possible inclusion of stress management as a component of risk reduction programmes

O dispositivo da idade, a produção da velhice e regimes de subjetivação: rastreamentos genealógicos

Este artículo problematiza la producción histórica de la vejez a partir del dispositivo de la edad. Se delinea un rastreo genealógico que busca apuntar algunas líneas que fueron configurando enunciados sobre la vejez a partir de diversas correlaciones de fuerzas, especialmente en contextos biopolíticos. Se destaca como los discursos de verdad que enuncian la vejez producen regímenes de subjetivación y constituyen sujetos a partir de referenciales normalizadores y masificadores. A partir de la deconstrucción de discursos relativos a la vejez, se apunta para la posibilidad de considerar las experiencias de la vejez para más allá de formas de tutela y de gestiones calculistas de la vida.This paper discusses the historical production of the old age considering the dispositif of age. A genealogical tracking is outlined in order to point out some lines that have configured statements about the old age, especially in biopolitical contexts. It is emphasized how the discourses of truth about the old age do produce regimes of subjectification and constitute subjects from normalizing and generalizing references. Starting from the deconstructing of discourses regarding the old age, it is indicated the possibility of considering the experiences of the old age aside from the forms of tutelage and from the forms of calculated management of life.Cet article met en question la production historique de la vieillesse en partant du dispositif de l'âge. Un traçage généalogique est fait afin de signaler quelques lignes qui édifient des énoncés sur la vieillesse à partir de plusieurs correlations de forces, en particulier dans des contextes biopolitiques. On souligne comment les discours de vérité qui énoncent la vieillesse produisent des régimes de subjectivation et constituent des sujets selon des référentiels normalisateurs et massificateurs. À partir de la déconstruction des discours liés à la vieillesse, on signale la possibilité de considérer les expériences de vieillesse au-delà des formes de tutelle et de gestions calculatrices de la vie.Este artigo problematiza a produção histórica da velhice a partir do dispositivo da idade. Traça-se um rastreio genealógico que visa apontar algumas linhas que foram configurando enunciados sobre a velhice a partir de diversas correlações de forças, especialmente em contextos biopolíticos. Destaca-se como os discursos de verdade que enunciam a velhice produzem regimes de subjetivação e constituem sujeitos a partir de referenciais normalizadores e massificadores. A partir da desconstrução dos discursos relativos à velhice, aponta-se para a possibilidade de considerar as experiências das velhices para além das formas de tutela e de gestões calculistas da vida

The COVID-19 pandemic: local to global implications as perceived by urban ecologists

From Springer Nature via Jisc Publications RouterHistory: received 2020-07-27, registration 2020-08-27, accepted 2020-08-27, pub-print 2020-09, pub-electronic 2020-09-11, online 2020-09-11Publication status: PublishedAbstract: The global COVID-19 pandemic is affecting everyone, but in many different ways, stimulating contrasting reactions and responses: opportunities for some, difficulties for many. A simple survey of how individual workers in urban ecology have been coping with COVID-19 constraints found divergent responses to COVID-19 on people’s activities, both within countries and between continents. Many academics felt frustrated at being unable to do fieldwork, but several saw opportunities to change ways of working and review their engagement with the natural world. Some engaging with social groups found new ways of sharing ideas and developing aspirations without face-to-face contact. Practitioners creating and managing urban greenspaces had to devise ways to work and travel while maintaining social distancing. Many feared severe funding impacts from changed local government priorities. Around the world, the COVID-19 pandemic has amplified issues, such as environmental injustice, disaster preparation and food security, that have been endemic in most countries across the global south in modern times. However, developing and sustaining the strong community spirit shown in many places will speed economic recovery and make cities more resilient against future geophysical and people-made disasters. Significantly, top-down responses and one-size-fits-all solutions, however good the modelling on which they are based, are unlikely to succeed without the insights that local knowledge and community understanding can bring. We all will have to look at disaster preparation in a more comprehensive, caring and consistent way in future

Synergies, Strengths and Challenges: Findings on Community Capability from a Systematic Health Systems Research Literature Review

Background: Community capability is the combined influence of a community’s social systems and collective resources that can address community problems and broaden community opportunities. We frame it as consisting of three domains that together support community empowerment: what communities have; how communities act; and for whom communities act. We sought to further understand these domains through a secondary analysis of a previous systematic review on community participation in health systems interventions in low and middle income countries (LMICs). Methods: We searched for journal articles published between 2000 and 2012 related to the concepts of “community”, “capability/participation”, “health systems research” and “LMIC.” We identified 64 with rich accounts of community participation involving service delivery and governance in health systems research for thematic analysis following the three domains framing community capability. Results: When considering what communities have, articles reported external linkages as the most frequently gained resource, especially when partnerships resulted in more community power over the intervention. In contrast, financial assets were the least mentioned, despite their importance for sustainability. With how communities act, articles discussed challenges of ensuring inclusive participation and detailed strategies to improve inclusiveness. Very little was reported about strengthening community cohesiveness and collective efficacy despite their importance in community initiatives. When reviewing for whom communities act, the importance of strong local leadership was mentioned frequently, while conflict resolution strategies and skills were rarely discussed. Synergies were found across these elements of community capability, with tangible success in one area leading to positive changes in another. Access to information and opportunities to develop skills were crucial to community participation, critical thinking, problem solving and ownership. Although there are many quantitative scales measuring community capability, health systems research engaged with community participation has rarely made use of these tools or the concepts informing them. Overall, the amount of information related to elements of community capability reported by these articles was low and often of poor quality. Conclusions: Strengthening community capability is critical to ensuring that community participation leads to genuine empowerment. Our simpler framework to define community capability may help researchers better recognize, support and assess it

Sustainable supply chain management towards disruption and organizational ambidexterity:A data driven analysis

Balancing sustainability and disruption of supply chains requires organizational ambidexterity. Sustainable supply chains prioritize efficiency and economies of scale and may not have sufficient redundancy to withstand disruptive events. There is a developing body of literature that attempts to reconcile these two aspects. This study gives a data-driven literature review of sustainable supply chain management trends toward ambidexterity and disruption. The critical review reveals temporal trends and geographic distribution of literature. A hybrid of data-driven analysis approach based on content and bibliometric analyses, fuzzy Delphi method, entropy weight method, and fuzzy decision-making trial and evaluation laboratory is used on 273 keywords and 22 indicators obtained based on the experts’ evaluation. The most important indicators are identified as supply chain agility, supply chain coordination, supply chain finance, supply chain flexibility, supply chain resilience, and sustainability. The regions show different tendencies compared with others. Asia and Oceania, Latin America and the Caribbean, and Africa are the regions needs improvement, while Europe and North America show distinct apprehensions on supply chain network design. The main contribution of this review is the identification of the knowledge frontier, which then leads to a discussion of prospects for future studies and practical industry implementation

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension