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AbstractPurposeMethodResultsConclusion\nIMPLICATIONS FOR REHABILITATIONChildren with congenital upper limb difference (CULD) in India have limited access to treatment with conventional prostheses. 3D printed prosthetic devices (3DPP) can function as transitional prostheses for growing children with congenital transverse deficiency. They are low-cost and the designs are easily customized. However, functional outcomes, access, and acceptability are still unexplored in many clinical settings. This qualitative study sought perspectives from Indian mothers of children with CULD using 3DPP for the first time. The objective was to enhance understanding of 3DPP acceptability and to explore how their children utilized these devices.Semi-structured interviews were conducted with seven mothers of children aged 3 to 11 years with varying levels of CULD who had been fitted with a 3DPP for at least 1 month prior. The interviews aimed to gather insights into the children’s daily experiences with the devices and the mothers’ perceptions of 3DPP. Thematic analysis was carried out using an inductive approach.Four major themes were identified through thematic analysis. They were: 1. Design and functionality of 3DPP, 2. Adaptation patterns, 3. Social attitudes and perceptions, and 4. Access to the Center for congenital hand differences: location and its services.Our study explores the early-stage use and acceptance of 3DPP in India. Mothers reported several reasons for prosthesis abandonment including functional limitations, pain, and unmet expectations. The acceptability of 3DPP was moderate among close family, but social stigmatization was still a barrier to continued use. Addressing these issues and offering tailored solutions could be important to achieve successful 3DPP adaptation.3D printed prostheses (3DPP) offer affordability and customizability. The current study explores their use and acceptability in a low-income setting in India.Specialized and individualized 3DPP design is essential. Given the identified limitations in functionality, prioritizing the patient’s needs for specific applications in daily activities or sports with improved grip is critical for optimal performance.Enhanced communication and collaboration among all stakeholders (parents, child, surgeon, and engineers) are necessary to prevent disappointment and improve overall usage rates of 3DPP.Implementing 3DPP in rehabilitation should account for local socioeconomic barriers and develop strategies to overcome these obstacles to achieve effective and functional outcomes.3D printed prostheses (3DPP) offer affordability and customizability. The current study explores their use and acceptability in a low-income setting in India.Specialized and individualized 3DPP design is essential. Given the identified limitations in functionality, prioritizing the patient’s needs for specific applications in daily activities or sports with improved grip is critical for optimal performance.Enhanced communication and collaboration among all stakeholders (parents, child, surgeon, and engineers) are necessary to prevent disappointment and improve overall usage rates of 3DPP.Implementing 3DPP in rehabilitation should account for local socioeconomic barriers and develop strategies to overcome these obstacles to achieve effective and functional outcomes. [ABSTRACT FROM AUTHOR]

Organizations offer activities and programmes to improve their employees' health. These workplace health promotion (WHP) activities usually have an individualized and top-down focus, a low uptake among employees, and are perceived to be out of line with employees' experiences and definitions of health. This paper follows up on studies that have broadened the focus of WHP by including social relations and delves deeper into how daily practices and experiences of (un)belonging at work relate to workplace health. Based on ethnographic research in two companies in the Netherlands, this paper analyses how (un)belonging is expressed and experienced by employees. The paper shows that employees define health at work as a social practice. It also demonstrates how dynamics at work shape different dimensions of (un)belonging that, in turn, affect employees' perceived health at work. These findings indicate the importance of including (un)belonging in the workplace as an ingredient of WHP. [ABSTRACT FROM AUTHOR]

The tradition of intergenerational care and support exchanges in Indian families is assumed to be disturbed because of changes in family structure brought on by modern life, which is mainly based on studies investigating experiences of older adults regarding the impact of socio-economic change on their care arrangement. However, there is a large gap in understanding the experiences of adult children from a larger relational perspective, more than just care provision to their older relatives. Drawing on 26 in-depth interviews with adult children living in modern and traditional living arrangements from South India, the study explores their experiences with their parents with regard to reciprocity of care and support, the challenges they experience and strategies they adopt to overcome those challenges. The analysis shows adult children perceive the increased demands of modern work life and their older kin's preferences to be heard, lack of flexibility and related extra domestic work and costs, do cause a bigger burden for them in both living arrangements. However, adult children strive to uphold the traditional values of caring for their older kin and sharing emotional bonding with them. This inspiration helps them to employ strategies to accept their older relatives as they are, focus their attention on the benefits they receive from them and distribute care tasks with other relatives to overcome the challenges. [ABSTRACT FROM AUTHOR]

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1467-9566.2007.01009.x Byline: Agnes Meershoek (1), Anja Krumeich (1), Rein Vos (1) Keywords: ethnography; objectifying procedures; expert decision-making; sickness certification; accountability Abstract: Abstract The gate-keeping function that physicians perform in determining clients' physical and mental incapacities is widely assumed to be the main reason for the rising numbers of disabled people. The sharp rise in the number of disabled has led many to claim that the disability benefits schemes are untenable. In order to regain public control and to make disabled eligibility procedures more transparent guidelines have been introduced in which medical evaluations are conceptualised as formal rational decisions. It is, however, questionable whether such measures are helpful in achieving their stated aims. This paper is based on ethnographic research on the ways physicians evaluate the eligibility of clients for disability benefits. It argues that assessing incapacity involves much more than formal rational decision-making. Doctors' reasoning is contextual and deliberative in character, and thus their assessment of a client's incapacity is less a technical matter than a normative one. Instead of generating transparency, guidelines based on formal rationality make the complex deliberations on which such judgments are based invisible, because they deny the normative dimension of medical expert decision-making. Therefore, different measures have to be developed that allow this normative dimension to be articulated, since insight into this normative dimension is a necessary pre-condition to be able to criticise disability judgments at all. Author Affiliation: (1)Department of Health, Ethics and Philosophy, Maastricht University Article note: Address for correspondence: Agnes Meershoek, Department of Health Ethics and Philosophy, Maastricht University, The Netherlands, PO Box 616, 6200 MD Maastricht, The Netherlands, e-mail: a.meershoek@ZW.unimaas.nl

Persons with disabilities in rural India do not have the opportunity to lead a self-determined life and be included in their community as required by the convention on the rights of persons with disabilities. To investigate their experience of living everyday life and the amount of agency they are able to exercise, in-depth interviews were undertaken. The Capability Approach (CA) was used to analyse the situation that was seen in terms of outcome of the interplay between internal and external factors resulting in loss of agency. The results show that the dependency they experience due to lack of adequate support to undertake activities and being completely dependent on the family places them in a vicious circle of 'self-worthlessness'. Reducing the dependency disabled people face and changing perceptions of the community towards disability may break this circle. In rural India persons with disabilities are unable to live a self- determined life and to participate in home and community activities. The research shows that the interaction between personal, social and environmental factors makes it difficult for persons with disabilities to live a self-determined life and increase dependency. The dependency encountered, coupled with the negative attitude of the community towards disability, places the persons with disabilities in a vicious circle of 'worthlessness'. The recommendations suggest reducing the dependency of persons with disabilities on their families, improving the perception of disability in the community and increasing self-esteem of persons with disabilities. [ABSTRACT FROM AUTHOR]