Gobelet, C; Luthi, F; Al-Khodairy, A T; Chamberlain, M A
Vocational rehabilitation is by definition a multidisciplinary intervention in a process linked to the facilitation of return to work or to the prevention of loss of the work. Clinical staff in contact with a person who has lost his job (general practitioner, specialized physician) must promote vocational rehabilitation. Medical rehabilitation for those with disabilities, whether new or old, has to be followed without delay by vocational rehabilitation. It is even better if these two intertwined processes are overlapping. They involve many professionals including physiotherapists, occupational therapists, psychologists, vocational trainers, job counsellors, teachers, case-managers, job placement agencies. Vocational rehabilitation has a financial cost, borne by many state organizations (security, social system, social affairs) as well as by employers and private insurances, which are in case of accident, concerned by this process. However, the evidence suggests that this is recouped 2- to 10-fold as suggested by the British Society of Rehabilitation Medicine.
Ipsen, Catherine; Swicegood, Grant
Purpose: To examine rural and urban differences in Vocational Rehabilitation (VR) case mix, delivery practices, and employment outcomes. Methods: Rehabilitation Services Administration 911 (RSA-911) case data do not include location indicators that allow for rural analyses. We compiled RSA-911 data with county and ZIP code information from 47 VR…
Wihlman, Ulla; Lundborg, Cecilia Stålsby; Holmström, Inger; Axelsson, Runo
This study describes and analysis five years of experiences from organising an interorganisational project on vocational rehabilitation. A qualitative case study approach was used based on interviews, focus group discussions and documents. The aim was to analyse how and why the project was organised in the way it was in relation to theories of integration, organisational change and learning. The results show that the vocational rehabilitation project was initiated mainly for financial reasons. It was organised as a mechanistic system with the aim of producing different activities, where financial control and support from all the levels of the organisations involved was important. A new bureaucracy between the different authorities involved was built up, where the vertical (top-down) integration was more important than the horizontal. The result was scattered islands of interprofessional work in different teams, but without contacts between them. The project did not influence the processes or workflows of the organisations involved in the project, which would be important from a service-user perspective. It may therefore be questionnable to organise the development of interorganisational integration for vocational rehabilitation in a separate project organisation. Instead, interorganisational networks with focus on interconnections of processes and workflows may be more flexible and adaptable. Copyright © 2010 John Wiley & Sons, Ltd.
Chiu, Chung-Yi; Tansey, Timothy N.; Chan, Fong; Strauser, David; Frain, Michael P.; Arora, Simran
Objectives: To examine the effect of rehabilitation technology interventions on the employment or job retention outcomes of individuals with multiple sclerosis (MS) served by the state-federal vocational rehabilitation program using a case-control study design. Participants: Data for this study were extracted from the Rehabilitation Services…
Lindstrom, Lauren E.; Flannery, K. Brigid; Benz, Michael R.; Olszewski, Brandon; Slovic, Roz
This article examined the implementation of an occupational skills training partnership developed between the Oregon Office of Vocational Rehabilitation Services and four local community colleges. Case study methods were used to describe the pattern of services provided to rehabilitation consumers and document the resulting changes in the…
About Us > Business Enterprise Program Business Enterprise Program The Division of Vocational Rehabilitation's (DVR) Business Enterprise Program (BEP) provides employment opportunities to people who experience contact their DVR counselor or the BEP coordinator. List of Business Enterprise Program Vendors BEP Policy
Glässel, Andrea; Rauch, Alexandra; Selb, Melissa; Emmenegger, Karl; Lückenkemper, Miriam; Escorpizo, Reuben
Vocational rehabilitation (VR) plays a key role in bringing persons with acquired disabilities back to work, while encouraging employment participation. The purpose of this case study is to illustrate the systematic application of International Classification of Functioning, Disability, and Health (ICF)-based documentation tools by using ICF Core Sets in VR shown with a case example of a client with traumatic spinal cord injury (SCI). The client was a 26-year-old male with paraplegia (7th thoracic level), working in the past as a mover. This case study describes the integration of the ICF Core Sets for VR into an interdisciplinary rehabilitation program by using ICF-based documentation tools. Improvements in the client's impairments, activity limitations, and participation restrictions were observed following rehabilitation. Goals in different areas of functioning were achieved. The use of the ICF Core Sets in VR allows a comprehensive assessment of the client's level of functioning and intervention planning. Specifically, the Brief ICF Core Set in VR can provide domains for intervention relevant to each member of an interdisciplinary team and hence, can facilitate the VR management process in a SCI center in Switzerland.
Harpster, Anna M.; Byers, Katherine L.; Harris, LaKeisha L.
This study examines 137 state vocational rehabilitation (VR) counselors' perceptions of the value of having the Certified Rehabilitation Counselor (CRC) credential. While almost 53% of this sample included persons who were certified, the majority who were not indicated that the two major reasons for not currently having this designation were: (a)…
Nijboer, I.D.; Wevers, C.J.
The paper presents a summary of a study of the vocational rehabilitation of young adults with a disability of one hand or arm. It demonstrates the importance of labor research in vocational rehabilitation. The success of vocational rehabilitation depends in large measure on the suitability of the
Høgelund, Jan; Holm, Anders
Previous studies find that vocational rehabilitation in terms of education has no or even a negative effect on long-term sick-listed employees’ probability of returning to work. This paper extends previous analyses by assessing the employment effect, using both a return-to-work measure and a meas......Previous studies find that vocational rehabilitation in terms of education has no or even a negative effect on long-term sick-listed employees’ probability of returning to work. This paper extends previous analyses by assessing the employment effect, using both a return-to-work measure...
Knaeps, J.; Neyens, I.; Donceel, P.; van Weeghel, J.; Van Audenhove, C.
Vocational rehabilitation (VR) counselors do not always focus on competitive employment for people with severe mental illness (SMI). Based on the Theory of Planned Behavior (TPB), this study examines how three types of VR counselors (i.e., gatekeepers, case managers, and specialists) vary in their
Alverson, Charlotte Y.; Yamamoto, Scott H.
Research has consistently documented poor employment outcomes for young adults with autism spectrum disorder (ASD). Vocational rehabilitation (VR) services provide substantial federal and state commitments to individuals with disabilities to obtain and maintain employment. To date, little research has examined the relationship between VR services…
Elliott, Timothy R.
Describes a six-session psychoeducational program for training vocational rehabilitation counselors in group dynamics. Presents evaluation of program by counselors (N=15) in which leadership styles, conflict management, and typology of group tasks concepts were rated as most beneficial. (Author/ABL)
Reviews theoretical and empirical work in labor economics and the sociology of work relating to the segmentation of the labor market into a primary and a secondary sector and examines the implications for vocational rehabilitation. Transition into primary sector employment is explored as an important aspect of career development for individuals…
In the rehabilitation workshop there is insufficient attention to job development oriented to the current and future needs of industry. Many types of work which were done in vocational workshops in contract from industrial firms are now done by automation. Semiskilled labor is thus in diminished demand. There is a twenty year lag in the industrial…
Chan, Jacob Yui-Chung; Keegan, John P.; Ditchman, Nicole; Gonzalez, Rene; Zheng, Lisa Xi; Chan, Fong
Objective: To determine whether employment outcomes of people with disabilities can be predicted by the social-cognitive/attribution theory of stigmatization. Design: Ex post facto design using data mining technique and logistic regression analysis. Participants: Data from 40,585 vocational rehabilitation (VR) consumers were extracted from the…
Lewis, Darrell R.; Johnson, David R.; Scholl, Steven R.
This paper reports the use of multi-attribute utility analysis for evaluating the goals and services of a state vocational rehabilitation agency. Uses included: (1) identification and clarification of agency goals and services; (2) engagement of stakeholders in the determination of measurable attributes of these goals; and (3) use of…
... workshop or rehabilitation facility may be an institutional, on-job, or combination course which has been... sheltered workshop or rehabilitation facility. 21.144 Section 21.144 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation...
Under the law on enhancing growth and employment (Wachstums- und Beschäftigungsförderungsgesetz-WFG), the legal entitlement to vocational rehabilitation hitherto stipulated in the employment promotion act (Arbeitsförderungsgesetz-AFG), has been restricted to a narrowly defined population; and pension insurance scheme spending in the entire rehabilitation field been "capped" to the 1993 level minus some 600 million DM. Moreover, the transitional allowance applicable for pension insurance rehabilitees will be lowered. In addition, economies amounting to some 500 million DM have been imposed on the federal employment service Bundesanstalt für Arbeit. These measures are placing persons with disability at a disadvantage, accept exclusion of entire groups of disabled persons, and endanger the very existence of numerous rehabilitation facilities previously established with significant amounts of public funding. A blind eye is being turned on the high level of demand for qualification measures, on the overall economic benefits of rehabilitation measures, and on the fact that measures of this kind are disabled persons' only chance to hold their own in the face of labour market competitiveness. Also, poor awareness seems to exist of the fact that, in the longer run, meaningful contributions to greater economy will more likely be generated by structural adjustment, increased effectiveness, and greater flexibility. The future of vocational rehabilitation is being placed at risk--notwithstanding that vocational rehabilitation for the future is imperative.
... we do for veterans pursuing institutional training or rehabilitation. Thus, veterans pursuing... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 21 RIN 2900-AO10 Vocational Rehabilitation and... August 1, 2011, that affect payment of vocational rehabilitation benefits for certain service-disabled...
The Assistant Secretary for Special Education and Rehabilitative Services announces a priority under the Rehabilitation Training program to establish a Job-Driven Vocational Rehabilitation Technical Assistance Center (JDVRTAC). The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2014 and later years. We take this action to focus on training in an area of national need. Specifically, this priority responds to the Presidential Memorandum to Federal agencies directing them to take action to address job-driven training for the Nation's workers. The JDVRTAC will provide technical assistance (TA) to State vocational rehabilitation (VR) agencies to help them develop for individuals with disabilities training and employment opportunities that meet the needs of today's employers.
Arling, V; Slavchova, V; Knispel, J; Spijkers, W
The Main purpose of vocational rehabilitation is occupational reintegration of clients into the job market who have lost their job or whose job is threatened because of a handicap or chronicl illness. With regard to existing evidence for the relevance of personality factors for work performance and job achievement, the present study investigated the influence of participants' personality factors on a successful reintegration after a retraining program in a vocational training center over 2 years. A central research objective was to identify prognostic personality factors for successful vocational integration. In this longitudinal study 15 vocational training centers participated at 3 time points of measurement (T1, T2 and T3). Data gathering was based on rehabilitants' self-reports (standardized questionnaires: SVF, BSW, SPR, CSES) about personality aspects. First data collection started at the beginning (T1) and a second survey was conducted at the end of the training 2 years later (T2). Based on the data at measurement points T1 and T2, 4 prognostic models were computed (binary logistic regression analysis) and evaluated, examining the differenzial influence of several scales and items on direct reintegration after completing the vocational retraining and reintegration status 6 months later (T3). As expected, different variables turned out to be relevant for occupational integration at the end of the training program and 6 months later. Correspondingly other variables appeared to be relevant for occupational reintegration at T1 and at T2. At the end of the vocational training program, approximately 24% of the participants had a job. With respect to direct reintegration, regression analysis revealed that vocational self-efficacy (R(2)=0,175) and self-evaluation were relevant (R(2)=0,383). Approximately 70% of the participants had gotten a job 6 months later. Several stress coping strategies (R(2)=0,170), estimation of the own reintegration prognosis and aspects
Phelps, William R.
This training guide is prepared primarily for the Vocational Rehabilitation practitioner, although academicians may also find it of value. Sixteen specific areas are covered, including common abbreviations, prefixes and suffixes, root words, general terms, operative terminology, special senses and body systems, general medical examination, medical…
... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Loan Guaranty, Education and Vocational Rehabilitation and Counseling Programs. 853.271 Section 853.271 Federal Acquisition... Guaranty, Education and Vocational Rehabilitation and Counseling Programs. ...
Phelps, William R.
This paper presents information helpful to the vocational rehabilitation counselor and can be utilized in training programs for the newly employed untrained vocational rehabilitation practitioner. Areas covered include medical terminology, common prefixes and suffixes, speciality boards; paramedic professions, and medical education. Undergraduate…
Reneman, M. F.; Beemster, T. T.; Edelaar, M. J. A.; van Velzen, J. M.; van Bennekom, C.; Escorpizo, R.
Background For clinical use and research of pain within the context of vocational rehabilitation, a specific core set of measurements is needed. The recommendations of the International Classification of Functioning, Disability and Health (ICF) brief Core Set for Vocational Rehabilitation (VR) and
Huang, I-Chun; Holzbauer, Jerome J; Lee, Eun-Jeong; Chronister, Julie; Chan, Fong; O'Neil, John
The aim of this study was to examine the relationship between vocational rehabilitation services provided and work outcomes among people with cerebral palsy (CP), taking in to account demographic characteristics. From the US Department of Education Rehabilitation Service Administration Case Service Report (RSA-911) database, data from 3162 individuals with CP (1820 males [57.6%] and 1342 females [42.4% age range 16-54 y) whose cases were closed in 2009, were used in this study. A total of 1567 cases (49.6%) were closed with clients being categorized as 'successful employment' and 1595 cases (50.4%) were closed with clients being classified as unemployed. Multivariate logistic regression was used to examine the relationship between services provided and work outcomes with regard to demographic characteristics. Males aged between 26 and 54 years old with higher education attainment were more likely to be employed. Individuals receiving disability benefits were less likely to be employed. After controlling for the effect of demographic and work disincentive variables, five vocational rehabilitation services significantly predicted employment outcomes (pemployability, to address their much needed work adjustment skills, to establish independent living, and to eventually reach their full potential in participation in society. © 2013 Mac Keith Press.
This document amends the vocational rehabilitation and employment regulations of the Department of Veterans Affairs (VA) concerning self-employment for individuals with qualifying disabilities. We are making changes to conform VA's regulations for self-employment programs for veterans, and for servicemembers awaiting discharge, to statutory provisions, including provisions limiting eligibility for certain supplies, equipment, stock, and license fees to individuals with the most severe service-connected disabilities. We are also making related changes in VA's regulations affecting eligibility for such assistance for certain veterans' children with birth defects in self-employment programs. In addition, we are amending our regulations regarding the approval authority for self-employment plans to make certain requirements less restrictive and less burdensome, to remove a vague and overly broad requirement, to make changes to reflect longstanding VA policy, and to make nonsubstantive clarifying changes.
Parker, M. Wayne; Oswalt, Jesse H.
There is still resistance to employment of the handicapped and the cost of modifying equipment will make the employement even less attractive. This is an area where close coordination between vocational rehabilitation placement personnel and prospective employers is required. (Author)
Full Text Available Solveig Vindholmen,1 Rune Høigaard,2 Geir Arild Espnes,3 Stephen Seiler41Department of Psychosocial Health, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway; 2Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway; 3Research Centre for Health Promotion and Resources, Department of Social Work and Health Science, Norwegian University of Science and Technology, Trondheim, Norway; 4Faculty of Health and Sport Sciences, University of Agder, Kristiansand, NorwayPurpose: Mindfulness has become an important construct in return-to-work (RTW rehabilitation. The aim of this study was to investigate whether mindfulness is a predictor for RTW, and to examine the indirect effect of mindfulness on RTW and work ability through quality of life (QOL.Methods: A retrospective study was conducted among 80 former participants (71 females and seven males from age 24 to 66, in a multidisciplinary vocational rehabilitation program (MVRP. Self-report questionnaires were used to measure work status, work ability, QOL, and mindfulness. Demographic data were also collected.Results: In the current sample, 47% of participants reported having returned to ordinary work. The majority of the non-working sub-sample reported being in work-related activity or education. A bias-corrected bootstrapping technique was used to examine indirect effects. Results revealed that mindfulness was indirectly related to both RTW and work ability through QOL. There was no significant total effect of mindfulness on work ability or RTW. Logistic regression analysis was performed to assess the impact of mindfulness on the likelihood that respondents returned to work. None of the independent mindfulness variables (observe, describe, act aware, non-judge, non-react made a unique statistically significant contribution to the model. The covariates work ability and education level significantly
Nitsch, Kristian P; Pedersen, Jessica; Miliotto, Alexandra; Petersen, Brett; Robbins, Samantha; Garcia, Ana; Hoisington, Molly Ansel; The, Kimberly J; Smiley, Jill; Janikowski, Timothy
This case report provides an overview of the psychometric properties and clinical utility of the My Vocational Situation (MVS) instrument. The accompanying hypothetical case description illustrates how clinicians could use the MVS to evaluate vocational preferences and outcomes and how the MVS can be used to inform treatment planning and rehabilitation decision making. The information contained in this report is intended to familiarize clinicians with the administration and scoring of the MVS, the psychometric information necessary to interpret results obtained from the MVS, and how the results could be used to provide comprehensive, patient-centered care. It is important to note that the information provided represents only a sample of the available research literature on the MVS. Copyright © 2017 by the American Occupational Therapy Association, Inc.
Taheri-Araghi, M.; Hendren, G.
Statistical analysis of 10 personal (client) variables and four program variables related to 76 people who became blind from retinitis pigmentosa revealed that 6 variables predicted clients' rehabilitation outcomes: age, gender, race, work status, amount of case-service money spent on the client's behalf, and number of changes in career objectives…
...) Number: 84.250C] AGENCY: Rehabilitation Services Administration, Office of Special Education and...), provide vocational rehabilitation services to American Indians with disabilities who reside on or near... documents published by the Department. Dated: September 20, 2012. Melody Musgrove, Director of Special...
Wihlman, Ulla; Lundborg, Cecilia Stålsby; Axelsson, Runo; Holmström, Inger
A project of vocational rehabilitation was studied in Sweden between 1999 and 2002. The project included four public organisations: the social insurance office, the local health services, the municipal social service and the office of the state employment service. The aim of this paper was to analyse perceived barriers in the development of inter-organisational integration. Theories of inter-professional and inter-organisational integration, and theories on organisational change. In total, 51 semi-structured interviews and 14 focus group discussions were performed with actors within the project between 1999 and 2002. A thematic approach was used for the analysis of the data. THREE DIFFERENT MAIN THEMES OF BARRIERS EMERGED FROM THE DATA: A Uncertainty, B Prioritising own organisation and C Lack of communication. The themes are interconnected in an intricate web and hence not mutually exclusive. The barriers found are all related partly to organisational change in general and partly to the specific development of organisational integration. Prioritising of own organisation led to flaws in communication, which in turn led to a high degree of uncertainty within the project. This can be seen as a circular relationship, since uncertainty might increase focus on own organisation and lack of communication. A way to overcome these barriers would be to take the needs of the clients as a point of departure in the development of joint services and to also involve them in the development of inter-organisational integration.
Reneman, M F; Beemster, T T; Edelaar, M J A; van Velzen, J M; van Bennekom, C; Escorpizo, R
For clinical use and research of pain within the context of vocational rehabilitation, a specific core set of measurements is needed. The recommendations of the International Classification of Functioning, Disability and Health (ICF) brief Core Set for Vocational Rehabilitation (VR) and those of Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) cover two broad areas. These two sources can be integrated when made applicable to vocational rehabilitation and pain. Objective To develop a core set of diagnostic and evaluative measures specifically for vocational rehabilitation of patients with subacute and chronic musculoskeletal pain, while using the brief ICF core set for VR as the reference framework in VR, and the IMMPACT recommendations in the outcome measurements around pain. Three main steps were taken. The first step was to remove irrelevant and duplicate domains of the brief ICF Core Set for Vocational Rehabilitation and the IMMPACT recommendations around pain. The second step was to match the remaining domains with existing instruments or measures. Instruments were proposed based on availability and its proven use in Dutch practice and based on proof of sufficient clinimetric properties. In step 3, the preliminary VR-Pain core set was presented to 3 expert panels: proposed users, Dutch pain rehabilitation experts, and international VR experts. Experts agreed with the majority of the proposed domains and instruments. The final VR-Pain Core Set consists of 18 domains measured with 12 instruments. All instruments possessed basic clinimetric properties. An agreed-upon VR-Pain Core Set with content that covers relevant domains for pain and VR and validated instruments measuring these domains has been developed. The VR-Pain Core Set may be used for regular clinical purposes and research in the field of vocational rehabilitation and pain, but adaptations should be considered for use outside the Netherlands.
Catalano, Denise; Pereira, Ana Paula; Wu, Ming-Yi; Ho, Hanson; Chan, Fong
This study analyzed the Rehabilitation Services Administration (RSA) case service report (RSA-911) data for fiscal year 2004 to examine effects of demographic characteristics, work disincentives, and vocational rehabilitation services patterns on employment outcomes of persons with traumatic brain injuries (TBI). The results indicated that European Americans (53%) had appreciably higher competitive employment rates than Native American (50%), Asian Americans (44%), African Americans (42%), and Hispanic/Latino Americans (41%). Clients without co-occurring psychiatric disabilities had a higher employment rate (51%) than those with psychiatric disabilities (45%). Clients without work disincentives showed better employment outcomes (58%) than those with disincentives (45%). An important finding from this analysis was the central role of job search assistance, job placement assistance, and on-the-job support services for persons with TBI in predicting employment outcomes. A data mining technique, the exhaustive CHAID analysis, was used to examine the interaction effects of race, gender, work disincentives and service variables on employment outcomes. The results indicated that the TBI clients in this study could be segmented into 29 homogeneous subgroups with employment rates ranging from a low of 11% to a high of 82%, and these differences can be explained by differences in work disincentives, race, and rehabilitation service patterns.
Sosulski, Marya R; Donnell, Chandra; Kim, Woo Jong
Studies indicate positive effects of the U.S. Vocational Rehabilitation Services (VRS) in assisting people with disabilities to find independent employment. Underemployment continues to impact access to adequate health care and other benefits. Workers with disabilities receive fewer benefits, overall. With data from the Longitudinal Study of Vocational Rehabilitation Services Program (LSVRSP), the authors compare the rates of receipt of 6 types of benefits for people with physical, mental, and sensory impairments. Although those with physical disabilities are most likely to receive benefits, all groups lack adequate access to health care, sick leave, and vacation. The authors discuss implications for services provision in the current job market.
Lustig, Daniel C.; Strauser, David R.
Access to health insurance is one of the critical aspects of securing employment for people with disabilities. This study investigated whether vocational rehabilitation consumers secured employment with an employer who offered health insurance at similar rates to workers in the general population. In general, the results show that vocational…
Koletsi, Marsha; Niersman, Astrid; van Busschbach, Jooske T.; Catty, Jocelyn; Becker, Thomas; Burns, Tom; Fioritti, Angelo; Kalkan, Rana; Lauber, Christoph; Roessler, Wulf; Tomov, Toma; Wiersma, Durk
Background Although the effectiveness of individual placement and support (IPS) has been well established, little is known about clients' perceptions of the model compared to usual vocational rehabilitation, nor about their experiences of searching for and returning to work with this kind of
Bullis, Michael; Foss, Gilbert
Conducted a national survey of vocational rehabilitation agencies (N=42) to determine the present status of cooperative work study programs serving mentally retarded secondary students. Results documented a decrease both in formal programs and number of students served. (Author/JAC)
... Employment Program--Self-Employment AGENCY: Department of Veterans Affairs. ACTION: Final rule. SUMMARY: This document amends the vocational rehabilitation and employment regulations of the Department of Veterans Affairs (VA) concerning self-employment for individuals with qualifying disabilities. We are making...
Martin, Frank H.
Numerous studies have indicated racial and ethnic disparities in the vocational rehabilitation (VR) system, including differences in acceptance, services provided, closure types, and employment outcomes. Few of these studies, however, have used advanced multivariate techniques or latent constructs to measure quality of employment outcomes (QEO) or…
Falkum, Erik; Klungsøyr, Ole; Lystad, June Ullevoldsæter; Bull, Helen Christine; Evensen, Stig; Martinsen, Egil W; Friis, Svein; Ueland, Torill
This study examined the outcomes of a vocational rehabilitation program (The Job Management Program, JUMP) for persons with psychotic disorders based on close collaboration between health and welfare services. Participants (N = 148) with broad schizophrenia spectrum disorders (age 18-65) were recruited from six counties in Norway. Three counties were randomized to vocational rehabilitation augmented with cognitive behaviour therapy (CBT), while the remaining three counties were randomized to vocational rehabilitation augmented with cognitive remediation (CR). This paper compares the vocational activity of the total group of JUMP participants with a treatment as usual group (N = 341), and further examines differences between the two JUMP interventions. Employment status (working/not working) was registered at the time of inclusion and at the end of the intervention period. The total number of JUMP participants in any kind of vocational activity increased from 17 to 77% during the intervention. Of these, 8% had competitive employment, 36% had work placements in ordinary workplaces with social security benefits as their income, and 33% had sheltered work. The total number of working participants in the TAU group increased from 15.5 to 18.2%. The JUMP group showed significant improvements of positive (t = -2.33, p = 0.02) and general (t = -2.75, p = 0.007) symptoms of psychosis. Significant differences between the CBT and CR interventions were not demonstrated. The study supports existing evidence that the majority of persons with broad schizophrenia spectrum disorders can cope with some kind of work, given that internal and external barriers are reduced. Those who wish to work should be offered vocational rehabilitation. ClinicalTrials.gov Identifier: NCT01139502 . Registered on 6 February 2010.
Mateer, Catherine A; Sira, Claire S
The effects of a traumatic brain injury on vocational outcome can be predicted on the basis of several factors. Environmental factors such as a supportive work environment, and person specific factors, including the client's age, premorbid occupation, injury variables, level of awareness, psychosocial adjustment, coping skills, and cognitive deficits have all been found to predict return to work following a traumatic brain injury. Some of these factors are amenable to treatment, and clinicians can impact clients' likelihood of returning to work by intervening in various ways. Through case studies and a literature review on the effectiveness of cognitive rehabilitation interventions, we have outlined specific strategies and recommendations for interventions. Cognitive rehabilitation strategies that address attention, memory and executive deficits can improve clients' abilities to manage workplace tasks and demands. Many clients continue to experience problems with social and emotional adjustment following a brain injury that impact return to work. Cognitive behavioural therapy is well suited for improving coping skills, helping clients to manage cognitive difficulties, and addressing more generalized anxiety and depression in the context of a brain injury.
Peltier, James W; Scovotti, Carol
The purpose of vocational rehabilitation (VR) is to provide disabled individuals with the training and support services needed to assimilate into the workforce. This study incorporates concepts developed in the relationship marketing and internal marketing literature to determine the factors that influence overall satisfaction of vocational training services. Results underscore the importance of social and structural bonds that develop among the multiple stakeholders involved in the VR process. Satisfaction is also influenced by the design and equipment used in the facilities and the efficiency of initiating VR services. A highly reliable instrument to measure VR participant satisfaction is presented.
Burstrom, Bo; Nylen, Lotta; Clayton, Stephen; Whitehead, Margaret
Under the national framework law in Sweden, all eligible people should have equal chances of receiving vocational rehabilitation. We aimed to review the evidence on (1) whether access to vocational rehabilitation is equitable in practice and (2) whether the outcomes vary for different groups in the population. Systematic review of studies in Sweden that reported diagnostic or socio-demographic characteristics of people offered or taking up rehabilitation programmes and outcomes of such programmes for different diagnostic and socio-demographic groups. Searches of 11 relevant electronic databases, 15 organisational websites, citation searching and contact with experts in the field, for the period 1990-2009. A total of 11 studies were included in the final review, six of which addressed review question (1) and seven addressed review question (2). All the six observational studies of access reported biased selection into vocational rehabilitation: greater likelihood for men, younger people, those with longer-term sick leave, those with lower income, employed rather than unemployed people and those with musculoskeletal and mental disorders or alcohol abuse. Having had a rehabilitation investigation also increased the likelihood of receiving vocational rehabilitation. Differential outcome of rehabilitation was reported in seven studies: outcomes were better for men, younger people, employed individuals, those with shorter sick leave and those with higher income. Selection into vocational rehabilitation was perceived as important for successful outcomes, but success also depended on the state of the local labour market. There is evidence of socio-demographic differences in access to and outcomes of vocational rehabilitation in Sweden, even though the national framework law is meant to apply to everyone. Few studies have deliberately measured differential access or outcomes, and there is a need for this kind of equity analysis of population-wide policies. Studies
Ståhl, Christian; Andersén, Åsa; Anderzén, Ingrid; Larsson, Kjerstin
This study analyzes the process of establishing and developing a cooperative vocational rehabilitation project with special focus on organizational and professional aspects. In the project, officials from the Swedish Social Insurance Agency and the Swedish Public Employment Service worked cooperatively with participants on long-term sick leave, youths with disability benefits, and people receiving social allowances. The officials used Motivational Interviewing (MI) as a method when meeting participants, and were able to offer flexible and tailored case management. The goal was to improve work ability and promote self-sufficiency. The process evaluation was carried out through continuous data collection throughout the project (2012-2014), resulting in a total of 28 individual interviews and 17 focus groups with officials and managers. The material was categorized through an inductive content analysis, and analyzed using social capital as a theoretical frame. The evaluation points to how issues related to design, organization and management contributed to the project not reaching its goals, e.g. problems with recruitment of participants, the funding structure, and staffing problems on the managerial level. Still, officials reported positive effects of close cooperation, which was perceived as facilitating the case management by fostering a mutual understanding and access to resources and rehabilitation measures from more than one authority. Cooperative work combined with the use of MI and flexible case management seem to promote an increased trust between officials from different authorities and participants, which in the study is conceptualized as bonding and bridging social capital (between officials) and linking social capital (between officials and participants). The organizational problems combined with the relatively large differences in approaches between the project and regular practice obstructed implementation, where the authorities involved did not appear
Full Text Available Abstract Background This study analyzes the process of establishing and developing a cooperative vocational rehabilitation project with special focus on organizational and professional aspects. In the project, officials from the Swedish Social Insurance Agency and the Swedish Public Employment Service worked cooperatively with participants on long-term sick leave, youths with disability benefits, and people receiving social allowances. The officials used Motivational Interviewing (MI as a method when meeting participants, and were able to offer flexible and tailored case management. The goal was to improve work ability and promote self-sufficiency. Methods The process evaluation was carried out through continuous data collection throughout the project (2012–2014, resulting in a total of 28 individual interviews and 17 focus groups with officials and managers. The material was categorized through an inductive content analysis, and analyzed using social capital as a theoretical frame. Results The evaluation points to how issues related to design, organization and management contributed to the project not reaching its goals, e.g. problems with recruitment of participants, the funding structure, and staffing problems on the managerial level. Still, officials reported positive effects of close cooperation, which was perceived as facilitating the case management by fostering a mutual understanding and access to resources and rehabilitation measures from more than one authority. Conclusions Cooperative work combined with the use of MI and flexible case management seem to promote an increased trust between officials from different authorities and participants, which in the study is conceptualized as bonding and bridging social capital (between officials and linking social capital (between officials and participants. The organizational problems combined with the relatively large differences in approaches between the project and regular practice
Radford, Kathryn; Grant, Mary; Terry, Jane
Purpose: This study aimed to clarify the existing service provision of stroke-specific vocational rehabilitation (VR) in one English county, in order to facilitate future service development. Method: Using soft systems methodology, services in Health, Social Care, Department of Work and Pensions, the voluntary and private sectors, which were identified as supporting return to work after stroke, were mapped using a mixed-methodology approach. Results: A lack of a sanctioned VR pathway meant access to support relied on brokered provision and tacit knowledge. The timing of an intervention was complex and there was a substantial degree of unmet need for mild stroke patients. VR was seen as “non-essential” due to competing commissioning priorities. Service providers from all sectors lacked training and cross-sector partnerships were tenuous and provider roles unclear. Conclusions: Stroke-specific VR should be delivered by an integrated, cross-sector multi-disciplinary team and integrated commissioning between health and other sectors is necessary. Although early intervention is important, support later on in the recovery process is also necessary. Service providers need adequate training to meet the needs of stroke survivors wishing to return to work and better awareness of best practice guidelines. Business cases which demonstrate the efficacy and cost-effectiveness of VR are vital. Implications for Rehabilitation The timeliness of a vocational rehabilitation (VR) intervention is complex; services need to be responsive to the changing needs of the stroke survivor throughout their recovery process and have better mechanisms to ensure re-entry into the stroke pathway is possible. Return to work is a recognised health outcome; health services need to develop better mechanisms for interagency/cross sector working and liaison with employers and not assume that VR is beyond their remit. Therapists and non-health service providers should receive sufficient training to
Sinclair, Emma; Radford, Kathryn; Grant, Mary; Terry, Jane
This study aimed to clarify the existing service provision of stroke-specific vocational rehabilitation (VR) in one English county, in order to facilitate future service development. Using soft systems methodology, services in Health, Social Care, Department of Work and Pensions, the voluntary and private sectors, which were identified as supporting return to work after stroke, were mapped using a mixed-methodology approach. A lack of a sanctioned VR pathway meant access to support relied on brokered provision and tacit knowledge. The timing of an intervention was complex and there was a substantial degree of unmet need for mild stroke patients. VR was seen as "non-essential" due to competing commissioning priorities. Service providers from all sectors lacked training and cross-sector partnerships were tenuous and provider roles unclear. Stroke-specific VR should be delivered by an integrated, cross-sector multi-disciplinary team and integrated commissioning between health and other sectors is necessary. Although early intervention is important, support later on in the recovery process is also necessary. Service providers need adequate training to meet the needs of stroke survivors wishing to return to work and better awareness of best practice guidelines. Business cases which demonstrate the efficacy and cost-effectiveness of VR are vital. Implications for Rehabilitation The timeliness of a vocational rehabilitation (VR) intervention is complex; services need to be responsive to the changing needs of the stroke survivor throughout their recovery process and have better mechanisms to ensure re-entry into the stroke pathway is possible. Return to work is a recognised health outcome; health services need to develop better mechanisms for interagency/cross sector working and liaison with employers and not assume that VR is beyond their remit. Therapists and non-health service providers should receive sufficient training to meet the needs of stroke survivors wishing to
... vocational courses outside a State if the case manager determines that such training is in the best interest... vocational courses outside the United States. 21.130 Section 21.130 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation...
Matthews, Lynda R; Hanley, Francine; Lewis, Virginia; Howe, Caroline
With social and economic costs of workplace injury on the increase, efficient payment models that deliver quality rehabilitation outcomes are of increasing interest. This paper provides a perspective on the issue informed by both refereed literature and published research material not available commercially (gray literature). A review of payment models, workers' compensation and compensable injury identified relevant peer-reviewed and gray literature that informed our discussion. Fee-for-service and performance-based payment models dominate the health and rehabilitation literature, each described as having benefits and challenges to achieving quality outcomes for consumers. There appears to be a movement toward performance-based payments in compensable workplace injury settings as they are perceived to promote time-efficient services and support innovation in rehabilitation practice. However, it appears that the challenges that arise for workplace-based rehabilitation providers and professionals when working under the various payment models, such as staff retention and quality of client-practitioner relationship, are absent from the literature and this could lead to flawed policy decisions. Robust evidence of the benefits and costs associated with different payment models - from the perspectives of clients/consumers, funders and service providers - is needed to inform best practice in rehabilitation of compensable workplace injuries. Available but limited evidence suggests that payment models providing financial incentives for stakeholder-agreed vocational rehabilitation outcomes tend to improve service effectiveness in workers' compensation settings, although there is little evidence of service quality or client satisfaction. Working in a system that identifies payments for stakeholder-agreed outcomes may be more satisfying for rehabilitation practitioners in workers' compensation settings by allowing more clinical autonomy and innovative practice. Researchers
Moore, Corey L.; Wang, Ningning; Washington, Janique Tynez
Purpose: This study assessed and demonstrated the efficacy of two select empirical forecast models (i.e., autoregressive integrated moving average [ARIMA] model vs. grey model [GM]) in accurately predicting state vocational rehabilitation agency (SVRA) rehabilitation success rate trends across six different racial and ethnic population cohorts…
Lukasczik, M; Löffler, S; Gerlich, C; Wolf, H-D; Neuderth, S
Vocational orientation in medical rehabilitation has become an important issue in rehabilitation science and practice in Germany. Although a variety of vocationally oriented interventions has been developed in recent years, there is still a lack of consensus with regard to the definition of specific types of interventions as well as relevant criteria (e. g., methods; instruments; duration/frequency; patient groups). Building on preliminary definitions, basic types of vocationally oriented measures/interventions were conceptually modified and refined in the context of a consensual process. 39 experts of various professions were contacted during a 2-stage Delphi survey to evaluate existing definitions of vocationally oriented interventions using key questions. Standardized descriptions of 5 vocationally oriented basic interventions were specified in cooperation with an interdisciplinary panel of experts. Descriptions were published in a workbook and a homepage for researchers and clinicians, which also contain information on the implementation of measures into rehabilitative care as well as good practice examples. The media developed in this project may contribute to the transfer of research results on vocationally oriented rehabilitation into health care practice. © Georg Thieme Verlag KG Stuttgart · New York.
Fadyl, Joanna; McPherson, Kathryn; Nicholls, David
Vocational rehabilitation for people experiencing work disability is a social practice often situated within health services, but the social and political drivers and effects of this practice are rarely critically analysed in health research or policy. In this study we used a Foucauldian theoretical perspective to analyse the ways in which current vocational rehabilitation practices in New Zealand re/produce notions of worker and employee 'value', and how different approaches to vocational rehabilitation deploy current discourses about value. We also consider the subject positions produced through these different approaches and the identities and actions they make possible for people experiencing work disability. The analysis showed that notions about the importance of worker and employee value in a job market are pervasive in vocational rehabilitation, and reflect wider societal discourses. However, the deployment of those discourses in different approaches to vocational rehabilitation practice are diverse, producing different opportunities and constraints for people experiencing disability. We argue that an examination of these various opportunities and constraints at the level of practice approaches is important, as considerable time and resources are allocated to developing solutions to help those who do not thrive in the current systems, yet we rarely critique the premises on which the systems are based. © 2015 The Authors. Sociology of Health & Illness © 2015 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.
Saltychev, Mikhail; Kinnunen, Aila; Laimi, Katri
To identify the most frequent functional limitations according to the International Classification of Functioning, Disability, and Health (ICF) obtained by unstandardised clinical assessment of patients with chronic musculoskeletal disorders who underwent vocational rehabilitation evaluation; and to compare the obtained list with simplified versions of ICF. The descriptions of functional limitations were retrospectively identified for 32 patients. The original vocational rehabilitation evaluation was conducted by a multi-professional team in an out-patient clinic of a university hospital. The obtained descriptions were converted to ICF codes, the most frequent being compared with the ICF Checklist of the World Health Organization (WHO) and the ICF Comprehensive and Brief Core Sets suggested by the ICF Research Branch. In the study population (53 % women), 141 ICF codes were identified with a preciseness of three or more digits, the average being 21 codes/subject (median 20.0, range 9-40). When truncated to three digits, 84 ICF codes remained (average 18 codes/subject, range 9-25), 45 of which appeared in over 10 % of the study population, 24 also being found in the ICF Comprehensive, 5 in the ICF Brief Core Sets, and 33 in the WHO ICF Checklist. The list of most frequent ICF codes retrospectively obtained in this study from unstandardised records showed a similarity with ICF Comprehensive and Brief Core Sets by ICF Research Branch and the ICF Checklist by WHO, but with a bias towards the identification of body structures and functions. The results support the use of ICF in vocational rehabilitation evaluation to ensure comprehensiveness of evaluation. The ICF Comprehensive Core Set seems to be the most useful for the needs of multiprofessional team when assessing functioning of patients.
Millet, Patrick B; Vaittinen, Pauli
This study has had two main aims, the first to investigate and gather knowledge of the major job functions of Swedish rehabilitation workers, the second to study the frequency of use of these functions in the VR process. Structured questionnaires were sent to Swedish rehabilitation workers from public and private sectors. To identify the major dimensions of Swedish rehabilitation workers' job in the vocational rehabilitation (VR) process, a principal component factor analysis was performed. Results revealed that there are four main factors (dimensions) that comprised the VR process in Sweden. The four factors (dimensions) are job development and career counselling; assessment and counselling interventions; workplace adjustment and employer consultation and client support, personnel development and public relations. The VR process in Sweden is limited in both its scope and depth. This when one compares with the results of studies carried out in the USA, who found seven and six dimensions, respectively. It is argued that it cannot be excluded that the negative trend of extensive sick leave and early pensions are attributable to the limitations in the VR process that have been found. Suggested is the urgent need to put resources in place that would support the further advancement of the knowledge and competencies of the VR services in Sweden.
Saperstein, Alice M; Fiszdon, Joanna M; Bell, Morris D
Intrinsic motivation is a construct commonly used in explaining goal-directed behavior. In people with schizophrenia, intrinsic motivation is usually subsumed as a feature of negative symptoms or underlying neurocognitive dysfunction. A growing literature reflects an interest in defining and measuring motivational impairment in schizophrenia and in delineating the specific role of intrinsic motivation as both an independent predictor and a mediator of psychosocial functioning. This cross-sectional study examined intrinsic motivation as a predictor of vocational outcomes for 145 individuals with schizophrenia and schizoaffective disorder participating in a 6-month work rehabilitation trial. Correlation and mediation analyses examined baseline intrinsic motivation and negative symptoms in relation to work hours and work performance. Data support a significant relationship between intrinsic motivation and negative symptoms and significant correlations with outcome variables, such that lower negative symptoms and greater intrinsic motivation were associated with better work functioning. Moreover, in this sample, intrinsic motivation fully mediated the relationships between negative symptoms, work productivity, and work performance. These results have significant implications on the design of work rehabilitation interventions for people with schizophrenia and support a role for targeting intrinsic motivation directly to influence vocational functioning. Future directions for research and intervention are discussed.
... social and electronic media, especially as it relates to confidentiality and appropriateness of the use... Counselor Certification Code of Professional Ethics; (2) VR services to transition-age youth; (3... Rehabilitation Act, as amended, and the Social Security Act and their accompanying regulations; (5) basic...
Braathen, Tore; Veiersted, Kaj Bo; Heggenes, Jan
Objective: To evaluate a vocational multidisciplinary rehabilitation programme for patients on long-term sick leave with respect to their work ability and return to work. Methods: A multidisciplinary rehabilitation programme was administered to an intervention group of 183 patients on long-term sick leave (mean 12.2 months). Effects of the treatment were compared with a control group (n = 96) recruited from the national sickness insurance record of patients on sick leave of 6??2 month...
Stefan Watzke; Anja Galvao
Vocational rehabilitation represents an important element within the mental health care system. To ensure the success of rehabilitation, programs of varying degrees of complexity are needed in order to meet patients’ abilities and needs. Rehabilitation success must be examined multidimensionally and not be reduced to the mere integration into competitive employment. Success is also represented by progress in the level of vocational integration, strengthening of work capabilities, the improvem...
Malec, J F; Buffington, A L; Moessner, A M; Degiorgio, L
To evaluate initial placement and 1-year employment outcomes of a Medical/Vocational Case Coordination System (MVCCS) for persons with brain injury (BI) that provides: (1) early case identification and coordination, (2) appropriate medical and vocational rehabilitation interventions, (3) work trials, and (4) supported employment interventions including job coaching. One hundred fourteen Minnesota residents, ages 18 to 65 years, with acquired BI. Five levels of Vocational Independence Scale (VIS). Preinjury employment status (VIS) and years of education, severity of initial injury, time since injury, current impairment/disability as measured by the Rasch-analyzed Staff Mayo-Portland Adaptability Inventory (MPAI), and impaired self-awareness measured by staff rating and the difference between Staff MPAI and Survivor MPAI. At placement, 46% in independent work; 25% in transitional placements; 9% in long-term supported employment; 10% in sheltered work; and 10% not placed. At 1-year follow-up (n = 101), 53% in independent work; 19% in transitional placement; 9% in supported work; 6% in sheltered work; and 13% unemployed. Regression analyses showed time since injury and Rasch Staff MPAI predicted VIS at placement; only VIS at placement independently predicted VIS at 1-year follow-up; Rasch Staff MPAI and preinjury education level predicted time to placement. The MVCCS optimized vocational outcome after BI. Time since injury and impairment/disability best predicted vocational placement. Level of initial placement best predicted employment status at follow-up. Persons with greater disability required more extended time and more extensive rehabilitation services before placement.
Alade, Eunice B.
This article discusses the community-based vocational rehabilitation (CBVR) of persons with disabilities. In 1991, a pilot project was instituted by the International Labour Organisation and the United Nations Development Programme in conjunction with Oyo State Government in Nigeria. The aim was to facilitate the reintegration of persons with…
Outside agencies such as vocational rehabilitation agencies are designed to help provide services such as job coaching, mental health services, tuition assistance, and life-skills training for students with disabilities during and after high school so that they may obtain postsecondary success (Gil, 2007). This study examined the perceived…
Sung, Connie; Sánchez, Jennifer; Kuo, Hung-Jen; Wang, Chia-Chiang; Leahy, Michael J.
As males and females with autism spectrum disorder (ASD) experience different symptomology, their needs for vocational rehabilitation (VR) are unique as they transition into adulthood. This study examined the effects of gender differences in VR service predictors on employment outcomes for transition-aged individuals with ASD. A total of 1696…
This document is intended to assist agencies in formulating and initiating a financially realistic public relations plan specifically designed for their community-based vocational rehabilitation organizations. The document consists of 6 chapters, a 43-item bibliography, a glossary, and information about the author. Chapter 1 defines public…
Phillips, Brian N; Kaseroff, Ashley A; Fleming, Allison R; Huck, Garrett E
Social skills play an important role in employment. This study provides a qualitative analysis of salient work related social skills and interventions for addressing social skills in public vocational rehabilitation (VR). A modified consensual qualitative research (CQR) approach was taken to understand the elements and influence of work related social skills in public VR. Thirty-five counselors, supervisors, and administrators participated in semistructured interviews to provide their perspectives of work related social skills and the interventions they use for addressing these skills. Multiple aspects of work-related social skills were described as being important for VR consumer success. The most common work related social skills across all participants were nonverbal communication and the ability to connect with others. Primary social interventions included informal social skills training (SST), systems collaboration, and creating an appropriate job match. Public rehabilitation agency staff, constantly faced with addressing work related social skills, possess many insights about salient skills and interventions that can benefit future research and practice. Agencies currently address social skills deficits by providing interventions to both person and environment. The research provides directions for future research related to identification of social skills and interventions to address related deficits. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
Iqbal M. KHAN
Full Text Available The aim of this research is to explore the prospect of teaching Entrepreneurship Education to those who acquire vocational skills at Punjab Vocational Training Council (PVTC. It is also to explore whether PVTC has promoted entrepreneurship through its vocational training institutes located all over Punjab. This study also deals with the concept of utilization of ‘Zakat' for the purpose of vocational education as a mode for possible replication. The research objective has been to follow the progress of this institution. It has also been to record the successes of this model of a public-private ownership, a model of utilizing the ‘Zakat' to fund education projects, a value based organization, a learning organization and a highly innovative institution. The other objective is to explore the evidence of entrepreneurship education and its effectiveness in PVTC. Literature has been reviewed on vocational training and entrepreneurship education. It also reviews experience and evidence of such practice prevailing in other environment. Combined with this is the review and conceptualization of a model based on ‘zakat'. Research Methodology used is basically qualitative; data has been collected through semi structured intensive interviews and from focus groups of stakeholders. The strategies adopted to collect data in this study are “survey”, “case study” and “grounded theory.” The data collected from semi structured interviews were concluded by thematic analysis, analyzing technique of writing reports from data. NVivo software was utilized for triangulation to reduce the data bias and increase validity by comparing primary and secondary data. The findings of this research have been that the pedagogical skills offered by PVTC's are not effective for entrepreneurial potential development. Work is required for entrepreneurial curriculum development and training of PVTCs' instructors, students and practitioners. The research also reveals
Campolieti, Michele; Gunderson, Morley K. L.; Smith, Jeffrey A.
We estimate the effects of the vocational rehabilitation (VR) program run by the Canada Pension Plan Disability Program using administrative data. Identification relies on "selection on observed variables" plus careful comparison group selection and institutional knowledge regarding sources of conditional variation in participation. We employ several matching and weighting estimators and emphasize flexible conditioning on variables suggested by theory, the institutional setup and the literatu...
Escorpizo, Reuben; Reneman, Michiel F; Ekholm, Jan; Fritz, Julie; Krupa, Terry; Marnetoft, Sven-Uno; Maroun, Claude E; Guzman, Julietta Rodriguez; Suzuki, Yoshiko; Stucki, Gerold; Chan, Chetwyn C H
The International Classification of Functioning, Disability and Health (ICF) is a conceptual framework and classification system by the World Health Organization (WHO) to understand functioning. The objective of this discussion paper is to offer a conceptual definition for vocational rehabilitation (VR) based on the ICF. We presented the ICF as a model for application in VR and the rationale for the integration of the ICF. We also briefly reviewed other work disability models. Five essential elements of foci were found towards a conceptual definition of VR: an engagement or re-engagement to work, along a work continuum, involved health conditions or events leading to work disability, patient-centered and evidence-based, and is multi-professional or multidisciplinary. VR refers to a multi-professional approach that is provided to individuals of working age with health-related impairments, limitations, or restrictions with work functioning and whose primary aim is to optimize work participation. We propose that the ICF and VR interface be explored further using empirical and qualitative works and encouraging stakeholders' participation.
Full Text Available Introduction: Collaboration between welfare organizations is an important strategy for integrating different health and welfare services. This article reports a review of the international literature on vocational rehabilitation, focusing on different organizational models of collaboration as well as different barriers and facilitating factors. Methods: The review was based on an extensive search in scientific journals from 1995 to 2010, which generated more than 13 000 articles. The number of articles was reduced in different steps through a group procedure based on the abstracts. Finally, 205 articles were read in full text and 62 were included for content analysis. Results: Seven basic models of collaboration were identified in the literature. They had different degrees of complexity, intensity and formalization. They could also be combined in different ways. Several barriers and facilitators of collaboration were also identified. Most of these were related to factors as communication, trust and commitment.Conclusion: There is no optimal model of collaboration to be applied everywhere, but one model could be more appropriate than others in a certain context. More research is needed to compare different models and to see whether they are applicable also in other fields of collaboration inside or outside the welfare system.
Full Text Available Introduction: Collaboration between welfare organizations is an important strategy for integrating different health and welfare services. This article reports a review of the international literature on vocational rehabilitation, focusing on different organizational models of collaboration as well as different barriers and facilitating factors. Methods: The review was based on an extensive search in scientific journals from 1995 to 2010, which generated more than 13 000 articles. The number of articles was reduced in different steps through a group procedure based on the abstracts. Finally, 205 articles were read in full text and 62 were included for content analysis. Results: Seven basic models of collaboration were identified in the literature. They had different degrees of complexity, intensity and formalization. They could also be combined in different ways. Several barriers and facilitators of collaboration were also identified. Most of these were related to factors as communication, trust and commitment. Conclusion: There is no optimal model of collaboration to be applied everywhere, but one model could be more appropriate than others in a certain context. More research is needed to compare different models and to see whether they are applicable also in other fields of collaboration inside or outside the welfare system.
Full Text Available Work is important for one’s self-esteem, social standing and ability to participate in the community as well as for the material advantages it brings to individuals and their families. The evidence suggests that the benefits of employment outweigh the risks of work and are greater than the risks of long-term unemployment or sickness absence. Individuals may be born with physical or intellectual disadvantages (e.g., cerebral palsy, or they may be acquired during childhood or adult life. Some progressive conditions may present in childhood or adolescence (e.g., some muscular dystrophies and these need to be distinguished from those presenting later in life (e.g., trauma, stroke. Vocational rehabilitation (VR thus takes three forms: preparing those with a disability, health or mental health condition for the world of work, job retention for those in work and assisting those out of work into new work. Important components of VR consist of the attributes of the individual, the skills/knowledge of their health professionals, the knowledge and attitudes of actual or potential employers and the assistance that is provided by the state or other insurance facility. Charities are playing an increasing role.
Finger, Monika; de Bie, Robert; Selb, Melissa; Escorpizo, Reuben
In the last few years the International Classification of Functioning, Disability and Health (ICF) has become a widely known and useful reference classification in vocational rehabilitation. It would be equally important to know which aspects of work-related health information cannot be assigned to distinct ICF categories. The objective of this study is to examine the concepts derived from three studies conducted within the ICF Core Set for vocational rehabilitation project, which could not be linked to distinct ICF codes in order to complement the current understanding of functioning in vocational rehabilitation. Secondary data analysis of the concepts from the systematic literature review, expert survey and patient focus group study of the ICF Core Set for vocational rehabilitation project that were marked as nd = not definable, nc = not covered or pf = personal factor. Nd-concepts were assigned to the biopsychosocial model of the ICF; additional ICF categories were formulated where needed. Nc-concepts were grouped into common themes not covered by the ICF. Pf-categories were linked to a proposed personal factors classification. 1093 nd-concepts were matched to overarching terms in the ICF, and "other specified"-categories were detailed. 1924 pf-concepts were linked to 31 second level categories of a proposed personal factors classification. 441 nc-concepts were grouped into six themes including the concept of well-being and attributes related to processes and time. With concepts that emerged from the secondary analysis of data gathered during the vocational rehabilitation ICF Core Set project, we have enriched the ICF model with constructs specific to vocational rehabilitation. However, additional research is needed to further explore personal factors specific to vocational rehabilitation. The influence of themes complementary to the ICF such as well-being and quality of life on return-to-work should be further investigated.
Poulsen, Rie; Hoff, Andreas; Fisker, Jonas
have depression and/or anxiety. There is no clear evidence that treatment alone will provide sufficient support for vocational recovery in this group. Integrated vocational and health care services have shown good effects on return to work in other, similar welfare contexts. The purpose of the IBBIS...... (Integrated Mental Health Care and Vocational Rehabilitation to Individuals on Sick Leave Due to Anxiety and Depression) interventions is to improve and hasten the process of return to employment for people in Denmark on sick leave because of depression and anxiety. METHODS/DESIGN: This three-arm, parallel......-group, randomized superiority trial has been set up to investigate the effectiveness of the IBBIS mental health care intervention and the integrated IBBIS mental health care and IBBIS vocational rehabilitation intervention for people on sick leave because of depression and/or anxiety in Denmark. The trial has...
Cost-effectiveness of 40-hour versus 100-hour vocational rehabilitation on work participation for workers on sick leave due to subacute or chronic musculoskeletal pain: study protocol for a randomized controlled trial
Beemster, Timo T.; van Velzen, Judith M.; van Bennekom, Coen A. M.; Frings-Dresen, Monique H. W.; Reneman, Michiel F.
Although vocational rehabilitation is a widely advocated intervention for workers on sick leave due to subacute or chronic nonspecific musculoskeletal pain, the optimal dosage of effective and cost-effective vocational rehabilitation remains unknown. The objective of this paper is to describe the
Cost-effectiveness of 40-hour versus 100-hour vocational rehabilitation on work participation for workers on sick leave due to subacute or chronic musculoskeletal pain : study protocol for a randomized controlled trial
Beemster, Timo T.; van Velzen, Judith M.; van Bennekom, Coen A. M.; Frings-Dresen, Monique H. W.; Reneman, Michiel F.
Background: Although vocational rehabilitation is a widely advocated intervention for workers on sick leave due to subacute or chronic nonspecific musculoskeletal pain, the optimal dosage of effective and cost-effective vocational rehabilitation remains unknown. The objective of this paper is to
Escorpizo, Reuben; Reneman, Michiel F.; Ekholm, Jan; Fritz, Julie; Krupa, Terry; Marnetoft, Sven-Uno; Maroun, Claude E.; Guzman, Julietta Rodriguez; Suzuki, Yoshiko; Stucki, Gerold; Chan, Chetwyn C. H.
Background The International Classification of Functioning, Disability and Health (ICF) is a conceptual framework and classification system by the World Health Organization (WHO) to understand functioning. The objective of this discussion paper is to offer a conceptual definition for vocational
Employment is an important factor in recovery for individuals with schizophrenia. The illness is, however, associated with consistently high unemployment rates. The high unemployment in this group is found to be associated with a number of both illness-related barriers and system-related barriers to employment. The main aim of this thesis was to further investigate the barriers to employment in participants with broad schizophrenia spectrum disorders in Norway, a high-income Scandinavian w...
Andersén, Åsa; Ståhl, Christian; Anderzén, Ingrid; Kristiansson, Per; Larsson, Kjerstin
The process of returning to work after long-term sick leave can sometimes be complex. Many factors, (e.g. cooperation between different authorities and the individual as well as individual factors such as health, emotional well-being and self-efficacy) may have an impact on an individual's ability to work. The aim of this study was to investigate clients' experiences with an individually tailored vocational rehabilitation, the Dirigo project, and encounters with professionals working on it. The Dirigo project was based on collaboration between rehabilitation authorities, individually tailored interventions and a motivational interviewing approach. A descriptive qualitative design was used with data collected through interviews. Fourteen individuals on long-term sick leave took part in individual semi-structured interviews. The interviews were analysed using content analysis. The analysis showed overall positive experience of methods and encounters with professionals in a vocational rehabilitation project. The positive experiences were based on four key factors: 1. Opportunities for receiving various dimensions of support. 2. Good overall treatment by the professionals. 3. Satisfaction with the working methods of the project, and 4. Opportunities for personal development. The main result showed that the clients had an overall positive experience of a vocational rehabilitation project and encounters with professionals who used motivational interviewing as a communication method. The overall positive experience indicated that their interactions with the different professionals may have affected their self-efficacy in general and in relation to transition to work. The knowledge is essential for the professionals working in the area of vocational rehabilitation. However, vocational rehabilitation interventions also need a societal approach to be able to offer clients opportunities for job training and real jobs.
Full Text Available Abstract Background The process of returning to work after long-term sick leave can sometimes be complex. Many factors, (e.g. cooperation between different authorities and the individual as well as individual factors such as health, emotional well-being and self-efficacy may have an impact on an individual’s ability to work. The aim of this study was to investigate clients’ experiences with an individually tailored vocational rehabilitation, the Dirigo project, and encounters with professionals working on it. The Dirigo project was based on collaboration between rehabilitation authorities, individually tailored interventions and a motivational interviewing approach. Methods A descriptive qualitative design was used with data collected through interviews. Fourteen individuals on long-term sick leave took part in individual semi-structured interviews. The interviews were analysed using content analysis. Results The analysis showed overall positive experience of methods and encounters with professionals in a vocational rehabilitation project. The positive experiences were based on four key factors: 1. Opportunities for receiving various dimensions of support. 2. Good overall treatment by the professionals. 3. Satisfaction with the working methods of the project, and 4. Opportunities for personal development. Conclusions The main result showed that the clients had an overall positive experience of a vocational rehabilitation project and encounters with professionals who used motivational interviewing as a communication method. The overall positive experience indicated that their interactions with the different professionals may have affected their self-efficacy in general and in relation to transition to work. The knowledge is essential for the professionals working in the area of vocational rehabilitation. However, vocational rehabilitation interventions also need a societal approach to be able to offer clients opportunities for job training
Knaeps, Jeroen; Neyens, Inge; van Weeghel, Jaap; Van Audenhove, Chantal
Although the evidence-based Individual Placement and Support programme highlights the importance of the vocational rehabilitation (VR) counsellors' focus on competitive employment during career counselling, studies have shown that counsellors do not always target such jobs. This study examines which determinants affect the counsellors' intentions…
Ferdiana, A.; Post, M. W. M.; Finger, M.; Bultmann, U.; Escorpizo, R.
Background. Health-related quality of life (HRQOL) has been frequently used as an outcome measure in disability-related studies, yet little is known about HRQOL in vocational rehabilitation (VR). Aim. To evaluate HRQOL in VR clients and identify factors associated with their HRQOL Design, setting
van Dongen, Caroline H.; Goossens, Paulien H.; van Zee, Inge E.; Verpoort, Kirsten N.; Vliet Vlieland, Thea P. M.; van Velzen, Judith M.
Purpose To describe short-term and long-term work status after a vocational rehabilitation (VR) program in patients with acquired brain injury (ABI) in the Netherlands. Methods Patients with ABI who participated in a VR program between 2007 and 2010 were included in this study. The 4-month VR
Sutherland, Jason Murray; Walker, Jan
Case mix classification systems have been adopted in many countries as a method to manage and finance healthcare in acute care settings; the most popular systems are based on diagnosis related groups. The most successful of those case mix systems differentiate patient types by reflecting both the intensity of resources consumed and patient acuity. Case mix systems for use with non-acute hospital activity have not been as wide-spread; other than in the United States, little attention has been directed towards case mix classification for rehabilitation activity. In a province with over 13 million inhabitants with 2496 rehabilitation beds, inpatient rehabilitation is an important component of hospital care in Ontario, Canada, and consists of the spectrum of intensive rehabilitation activities intended to restore function. Although case mix adjusted activity has been the currency in Ontario's Integrated Population Based Allocation hospital funding formula, rehabilitation activity has not been subjected to case mix measurement. A project to examine case mix classification for adult inpatient rehabilitation activity was initiated by the Ontario Ministry of Health and Long-Term Care whose outcome was a case mix system and associated cost weights that would result in rehabilitation activity being incorporated into the hospital funding formula. The process described in this study provides Ontario's provincial government with a case mix classification system for adult inpatient rehabilitation activity although there remain areas for improvement.
Full Text Available Diastematomyelia (split cord malformation is a rare dysraphic lesion in which a part of the spinal cord is split in the sagittal plane into two hemicords, a bony, cartilagenous or fibrous spur projecting through the dura mater is visible in 33% of cases. Vertebral anomalies (spina bifida are common. It occurs usually between D9 and S1. Classificatin includes two types: type 1 with a duplicated dural sac, with common midline spur, usually symptomatic, and type 2 with a single dural sac and usually less symptomatic. The majority of patients are presenting with tethered cord syndrome (neurologic deficits in the lower limbs and perineum. MRI is the modality of choice for diagnosis. In symptomatic cases, surgical release of the cord and resection of spur with repair of dura are performed, with good results. We present a case of a pauci-symptomatic type 1 dyastematomyelia, manifested by intermittent and resistant lumbar pain, in which physiotherapy during rehabilitation program have shown to improve pain intensity.
Tansey, Timothy N.
Assessment represents a foundational component of rehabilitation counseling services. The revised Council on Rehabilitation Education (CORE) standards implemented in 2004 resulted in the redesign of the knowledge and outcomes under the Assessment standard. The author reviews the current CORE standard for training in assessment within the context…
Bell, Morris D; Laws, Holly; Pittman, Brian; Johannesen, Jason K
Cognitive remediation performed in a cognitive laboratory was compared with a sham control using portable brain games to study effects on vocational, neurocognitive, and functional outcomes for participants with psychotic disorders in vocational rehabilitation (VR). Seventy-seven participants (61% schizophrenia, 39% other psychosis) in transitional (45.5%) or supported employment (54.5%) were randomly assigned to 6 months of portable cognitive-games (CG) or cognitive remediation (CR) plus a weekly goal-setting group, and evaluated during training, post-training and at 12 months. Overall rates of employment did not differ significantly at 12-month follow-up; however, VR + CG attained employment more rapidly during training. A significant time by condition interaction favored VR + CR on Quality of Life Total Score and Instrumental Functioning over 12 months. Neurocognitive outcomes favored VR + CR, particularly on attention. Training hours related significantly to neurocognitive improvement regardless of condition. No differences were found in training adherence despite portability for VR + CG. Results indicate that VR + CR had significantly greater effect than VR + CG on neurocognition and community functioning, but not on employment outcome. Job attainment rates during the training period revealed a potential advantage for portable training raising new questions concerning how cognitive remediation can be most effectively integrated with VR.
... AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation and Employment Under... the veteran's preference for a particular training or rehabilitation facility but VA has final...
Full Text Available Abstract Background Musculoskeletal disorders are common and costly disorders to workers compensation and motor accident insurance systems and are a leading contributor to the burden of ill-health. In Australia, vocational rehabilitation is provided to workers to assist them to stay in, or return to work. Self-management training may be an innovative addition to improve health and employment outcomes from vocational rehabilitation. Methods/Design The research plan contains mixed methodology consisting of a single blind randomised controlled trial, an economic evaluation and qualitative research. Participants (n = 366 are volunteers with compensated musculoskeletal disorders of 3 months to 3 years in duration who were working at the time of the injury/onset of the chronic disorder. The trial tests the effectiveness of usual vocational rehabilitation plus the Chronic Disease Self-Management Program (CDSMP to which two additional and newly-developed modules have been added, against vocational rehabilitation alone (control The modules added to the CDSMP focus on how to navigate through compensation systems and manage the return to work process, and aim to be relevant to those in a vocational rehabilitation setting. The primary outcome of this study is readiness for return to work which will be evaluated using the Readiness for Return-to-Work scale. Secondary outcomes include return to work status, health efficacy (heiQ™ questionnaire and general health status (SF-12v2® Health Survey. Measures will be taken at baseline, immediately post-intervention and at 6- and 12- months post-intervention by an independent assessor. An economic evaluation will compare the costs and outcomes between the intervention and control groups in terms of cost-effectiveness and a partial cost-benefit or cost analysis. The impact of the intervention will also be evaluated qualitatively, in terms of its acceptability to stakeholders. Discussion This article describes the
Hilton, G; Unsworth, C A; Murphy, G C; Browne, M; Olver, J
Longitudinal cohort design. First, to explore the longitudinal outcomes for people who received early intervention vocational rehabilitation (EIVR); second, to examine the nature and extent of relationships between contextual factors and employment outcomes over time. Both inpatient and community-based clients of a Spinal Community Integration Service (SCIS). People of workforce age undergoing inpatient rehabilitation for traumatic spinal cord injury were invited to participate in EIVR as part of SCIS. Data were collected at the following three time points: discharge and at 1 year and 2+ years post discharge. Measures included the spinal cord independence measure, hospital anxiety and depression scale, impact on participation and autonomy scale, numerical pain-rating scale and personal wellbeing index. A range of chi square, correlation and regression tests were undertaken to look for relationships between employment outcomes and demographic, emotional and physical characteristics. Ninety-seven participants were recruited and 60 were available at the final time point where 33% (95% confidence interval (CI): 24-42%) had achieved an employment outcome. Greater social participation was strongly correlated with wellbeing (ρ=0.692), and reduced anxiety (ρ=-0.522), depression (ρ=-0.643) and pain (ρ=-0.427) at the final time point. In a generalised linear mixed effect model, education status, relationship status and subjective wellbeing increased significantly the odds of being employed at the final time point. Tertiary education prior to injury was associated with eight times increased odds of being in employment at the final time point; being in a relationship at the time of injury was associated with increased odds of being in employment of more than 3.5; subjective wellbeing, while being the least powerful predictor was still associated with increased odds (1.8 times) of being employed at the final time point. EIVR shows promise in delivering similar return
Hammond, A; O'Brien, R; Woodbridge, S; Bradshaw, L; Prior, Y; Radford, K; Culley, J; Whitham, D; Pulikottil-Jacob, R
Background Inflammatory arthritis leads to work disability, absenteeism and presenteeism (i.e. at-work productivity loss) at high cost to individuals, employers and society. A trial of job retention vocational rehabilitation (VR) in the United States identified this helped people keep working. The effectiveness of this VR in countries with different socioeconomic policies and conditions, and its impact on absenteeism, presenteeism and health, are unknown. This feasibility study tested the acc...
Iwanaga, Kanako; Chan, Fong; Tansey, Timothy N; Strauser, David; Ritter, Ellen; Bishop, Malachy; Brooks, Jessica
Purpose Working alliance is one of the most important common factors for successful counseling/psychotherapy outcomes. Based on the empirical literature about working alliance, it seems that self-determination and self-efficacy theory (SDT/SET) can potentially be used as a motivational model to explain the relationship between working alliance and vocational rehabilitation (VR) outcomes. The purpose of this study is to evaluate three primary SDT/SET constructs, autonomous motivation, expectancy and engagement, as mediators for the relationship between working alliance and stages of change (SOC) for employment. Methods A serial multiple mediation analysis (SMMA) was computed to evaluate autonomy, outcome expectancy, and VR engagement as mediators of the relationship between working alliance and SOC for employment in a sample of 277 people with chronic illness and disability (CID) receiving services from state VR agencies in the United States. Results The SMMA results indicated that working alliance was positively associated with SOC for employment (total effect), while the direct effect between working alliance and SOC for employment was not significant after controlling for the effects of the mediators, indicating significant mediation effects. The mediation effects were estimates of the indirect effects for working alliance on SOC for employment through (a) autonomous motivation, (b) outcome expectancy, (c) VR engagement, and (d) autonomous motivation, outcome expectancy and VR engagement together. Conclusions The results indicated that a strong working alliance has the benefit of helping consumers develop autonomous motivation to work and increasing their vocational outcome expectancy and engagement in VR services, leading to employment.
... Program; Proposed Waivers and Extensions of the Project Periods AGENCY: Office of Special Education and... rehabilitation services to American Indians with disabilities who reside on or near Federal or State reservations... documents published by the Department. Dated: July 19, 2012. Alexa Posny, Assistant Secretary for Special...
Chen, June L.; Sung, Connie; Pi, Sukyeong
Young adults with autism spectrum disorders (ASD) often experience employment difficulties. Using Rehabilitation Service Administration data (RSA-911), this study investigated the service patterns and factors related to the employment outcomes of individuals with ASD in different age groups. Hierarchical logistic regression analyses were conducted…
... is retroactively inducted into a rehabilitation program, VA may authorize payment of tuition, fees... aggregate, or by the private sector, of $100 million or more (adjusted annually for inflation) in any year. This final rule will have no such effect on State, local, and Tribal governments, or on the private...
Seyed J Sadrossadat
Full Text Available Rehabilitation is the ongoing management of injuries and disabilities after an accident. It will help people to maximize the individuals` recovery through the relearning of skills or teaching of strategies to compensate for changed abilities. Self-esteem may be one major factor related to the manner in which people with Spinal Cord Injury (SCI respond to rehabilitation. Following a short discussion on related concepts this article will report a study and conclude that, pertaining to vulnerabilities in self-esteem, the second year following SCI may be just as critical a time period as the initial one after the injury. If replicated, this finding is of potential importance in the rehabilitation field. For example, the majority of psychological services are currently available at the acute stage of injury. People with SCI are most often discharged from hospital when they are physiologically stable and physically deemed ready for the discharge. It is precisely at this point, however, that people with new SCI may have many questions and concerns their new role in the community. The current study suggests that perhaps practitioners need to make a more concerted effort in dealing with the psychological effects of SCI when difficulties may arise in the community.
Full Text Available A classic philosopher in the Bildung tradition, Humboldt argued that general Bildung was the opposite of specialist training (vocational education. This has been a matter of contention and the aim here is to revisit the issue through an empirical case study. In the vocational education biography of craft master Wolfgang B. he speaks about aspects of his education that have much in common with Humboldt’s ideal of general Bildung but transposed into the context of vocational education and training (VET. The concept of vocationalism (Beruflichkeit provides context to the present argument which is that the contrast Humboldt made is relevant but not in the sense of there being two categories of education (general and vocational but rather two expressions of pedagogy: one expansive and one exclusive. Furthermore, there are two versions of general or expansive Bildung present in the case. The conclusions are that empirical studies of vocational Bildung expand on the concept of Bildung, increase our understanding of how VET contains affordances of Bildung and of the curriculum-patterns related to this.
Escorpizo, Reuben; Finger, Monika E; Glässel, Andrea; Gradinger, Felix; Lückenkemper, Miriam; Cieza, Alarcos
Vocational rehabilitation (VR) is aimed at engaging or re-engaging individuals with work participation and employment. The International Classification of Functioning, Disability and Health (ICF) by the World Health Organization can be operationalized in the context of VR. The objective of this study is to review the literature to identify outcomes or measures being used in VR using a systematic review methodology and link those measures to the ICF. We applied a structured search strategy using multiple databases. Items or constructs of the measures or outcomes identified were linked to the ICF by two trained individuals. We have identified 648 measures which contained 10,582 concepts that were linked to the ICF which resulted in 87 second-level ICF categories. Out of the 87 categories, 31 (35.6%) were related to body functions, 43 (49.4%) were related to activities and participation, and 13 (14.9%) were related to environmental factors. No category was related to body structures. Our review found great diversity in the ICF contents of the measures used in different VR settings and study populations, which indicates the complexity of VR. This systematic review has provided a list of ICF categories which could be considered towards a successful VR.
Bönisch, A; Dorn, M; Ehlebracht-König, I
To analyze the short-term efficacy of the Vocational Perspective programme for patients identified as having extensive work-related problems during rheumatology or orthopaedic inpatient rehabilitation. The primary objectives of the programme on patient level are to convey information about the legal provisions regarding earning incapacity and occupational reintegration, to suggest strategies for dealing with one's own occupational situation, and to strengthen the motivation to stay employed. The programme is explicitly designed for patients who wish to retire or have applied for a pension. On the systemic level, the main goals are to facilitate doctor-patient communication and to increase rehabilitation teams' awareness of occupational problems. In a controlled quasi-experimental design, 359 subjects were consecutively assigned to either the control group (CG, n=177) or the intervention group (IG, n=182). The control group received standard care only, whereas the intervention group additionally participated in the 5-part Vocational Perspective programme. Evaluation criteria were assessed by questionnaire at the beginning (t1) and at end of rehabilitation (t2). Survey participation was 92.2% at t2. The socio-medically relevant knowledge status was objectively documented using a specially designed knowledge questionnaire. Aspects of treatment satisfaction were evaluated using individual items, and the subjective prognosis of gainful employment was assessed using the Subjective Prognosis of Gainful Employment (SPE) scale. Facilitation of communication between doctor and patient was operationalized at patient level in terms of patient satisfaction with medical care, and increased awareness of the rehabilitation team was operationalized in terms of the rate of recommendations to apply for vocational reintegration (LTA) services at discharge. Emotional and functional parameters were exploratively analyzed (anxiety and depression using the IRES 3.1 scales, and
Høffding, Louise.K.Enggaard; Nielsen, Maria Haahr; Rasmussen, Morten Arendt
as a work placement program including supported employment. Furthermore, the intervention will include a family intervention program followed up by support to one individual family caregiver. The primary outcomes are increased work or study rate at six-month follow-up. Moreover, a budget impact analysis...... and possibly a cost-utility analysis of the intervention will be performed. DISCUSSION: This study consists of a comprehensive multidiciplinary VR intervention involving several parties such as the municipalities, a specialized rehabilitation team, and patients' own family caregivers. If this intervention...
Miotto, Eliane Correa
A number of memory rehabilitation techniques have targeted people with various degrees of memory impairments. However, few studies have shown the contribution of preserved non-declarative memory capacity and errorless learning in the treatment of amnesic patients. The current case report describes the memory rehabilitation of a 44-year-old man with amnesia following viral encephalitis. The patient's procedural memory capacity had an important role in the use of a motor imagery strategy to remember people's names. It was further demonstrated that the application of a verbal learning technique was helpful in recalling new verbal information. These different memory rehabilitation techniques are discussed in terms of alternative possibilities in the rehabilitation of amnesic patients.
Jain, Sumeet; Maru, Kavita; Shukla, Jyotsana
Facial defects resulting from neoplasm, congenital malformation or trauma can be restored with facial prosthesis using different materials and retention methods to achieve life-like look and function. A nasal prosthesis can re-establish esthetic form and anatomic contours for mid-facial defects...... the non-surgical rehabilitation, with polymethyl meth-acrylate resin, nasal prosthesis for a patient who received partial rhinectomy as a result of squamous cell carcinoma of the nose. The prosthesis was made to restore the esthetic appearance of the patient with a mechanical retained design using...
Loschi, T M; Cinacchi, M P R G; Baccan, M D T A; Marques, F; Pedroso, P T; Meira Filho, S P; Scacchetti, T; Pavão, D N
Multivisceral transplantation is the treatment for multiple abdominal organ failure. The patient experiences reduced food intake and absorption of nutrients, contributing to weight loss and decreased muscle mass, reducing functional capacity. A physical and nutritional rehabilitation program based on adequate caloric intake associated with supervised physical exercise seems to support a gain of muscle mass, re-establishing its capacity and functional independence. A rehabilitation program was carried out, consisting of low-intensity aerobic exercise on treadmill, exercises of global strengthening (50% of 1 maximum repetition [1RM], with progressive increase), and nutritional monitoring (oral hypercaloric diet, hyperproteic supplementation daily and after exercise). Initial and final evaluation included weight, muscle mass index, brachial circumference (BC), tricipital cutaneous fold (TCF), hand grip strength (HGS), 6-minute walk test (6MWT), 1RM, vital capacity (VC), and respiratory muscle strength. After the program, functional capacity was evaluated through the 6MWT (92%), 1RM test, VC (55%), respiratory muscle strength, HGS at 5 kg, weight gain (4.75%), increase of BC in 2 cm, and TCF in 2 mm. The program contributed to functional independence, improved quality of life, and social reintegration, suggesting the importance of a supervised physical activity program associated with adequate nutritional intake after multivisceral transplantation. Copyright © 2018 Elsevier Inc. All rights reserved.
... settings, including the community, rehabilitation service- delivery institutions, vocational rehabilitation...) Vocational rehabilitation (VR) practices that contribute to improved employment outcomes for individuals with... or more priorities, we designate the type of each priority as absolute, competitive preference, or...
Rommes, E.W.M.; Faulkner, W.; Slooten, I. van
Women-only vocational courses in technology, which became popular across Western Europe during the 1980s, had fallen from fashion by 2000. Yet the need for such courses remains, at least in certain circumstances. Drawing on case studies of two women-only courses in information and communications
Madsen, Erik Skov
, a framework of skills related to process tasks is developed. The paper and the presentation conclude that much more focus is needed on the development of vocational education and vocational skills in Denmark, the U.K, and in the U.S. and in China for employees to be able to handle future automated......Abstract: This paper and presentation is based on case studies in China, Mexico and Denmark. The paper identifies challenges posed to production companies by a lack of vocational skills and vocational education. The study is focusing on different types of production systems i.e. on manual, complex...... and automated production. The paper highlights how both China and Denmark have focused on theoretical rather than vocational education for more than a decade. Based on a combination of a literature review and field studies of cases, including studies of mass production and unmanned and automated production...
... seeking to employ individuals with disabilities. (5) In the case of any small business enterprise operated..., including enterprises established under the Randolph-Sheppard program, management services and supervision... and improve small business enterprises operated by individuals with significant disabilities...
Integrated mental health care and vocational rehabilitation to improve return to work rates for people on sick leave because of depression and anxiety (the Danish IBBIS trial): study protocol for a randomized controlled trial.
Poulsen, Rie; Hoff, Andreas; Fisker, Jonas; Hjorthøj, Carsten; Eplov, Lene Falgaard
Depression and anxiety are among the largest contributors to the global burden of disease and have negative effects on both the individual and society. Depression and anxiety are very likely to influence the individual's work ability, and up to 40% of the people on sick leave in Denmark have depression and/or anxiety. There is no clear evidence that treatment alone will provide sufficient support for vocational recovery in this group. Integrated vocational and health care services have shown good effects on return to work in other, similar welfare contexts. The purpose of the IBBIS (Integrated Mental Health Care and Vocational Rehabilitation to Individuals on Sick Leave Due to Anxiety and Depression) interventions is to improve and hasten the process of return to employment for people in Denmark on sick leave because of depression and anxiety. This three-arm, parallel-group, randomized superiority trial has been set up to investigate the effectiveness of the IBBIS mental health care intervention and the integrated IBBIS mental health care and IBBIS vocational rehabilitation intervention for people on sick leave because of depression and/or anxiety in Denmark. The trial has an investigator-initiated multicenter design. A total of 603 patients will be recruited from Danish job centers in 4 municipalities and randomly assigned to one of 3 groups: (1) IBBIS mental health care integrated with IBBIS vocational rehabilitation, (2) IBBIS mental health care and standard vocational rehabilitation, and (3) standard mental health care and standard vocational rehabilitation. The primary outcome is register-based return to work at 12 months. The secondary outcome measures are self-assessed level of depression (Beck Depression Inventory II), anxiety (Beck Anxiety Inventory), stress symptoms (Four-Dimensional Symptom Questionnaire), work and social functioning (Work and Social Adjustment Scale), and register-based recurrent sickness absence. This study will provide new knowledge
Integrated mental health care and vocational rehabilitation to improve return to work rates for people on sick leave because of exhaustion disorder, adjustment disorder, and distress (the Danish IBBIS trial): study protocol for a randomized controlled trial.
Poulsen, Rie; Fisker, Jonas; Hoff, Andreas; Hjorthøj, Carsten; Eplov, Lene Falgaard
Common mental disorders are important contributors to the global burden of disease and cause negative effects on both the individual and society. Stress-related disorders influence the individual's workability and cause early retirement pensions in Denmark. There is no clear evidence that mental health care alone will provide sufficient support for vocational recovery for this group. Integrated vocational and health care services have shown good effects on return to work in other similar welfare contexts. The purpose of the Danish IBBIS (Integreret Behandlings- og BeskæftigelsesIndsats til Sygemeldte) study is to examine the efficacy of (1) a stepped mental health care intervention with individual stress coaching and/or group-based MBSR and (2) an integrated stepped mental health care with individual stress coaching and/or group-based MBSR and vocational rehabilitation intervention for people on sick leave because of exhaustion disorder, adjustment disorder or distress in Denmark. This three-armed, parallel-group, randomized superiority trial is set up to investigate the effectiveness of a stepped mental health care intervention and an integrated mental health care and vocational rehabilitation intervention for people on sick leave because of exhaustion disorder, adjustment disorder or distress in Denmark. The trial has an investigator-initiated multicenter design. Six hundred and three patients will be recruited from Danish vocational rehabilitation centers in four municipalities and randomly assigned into three groups: (1) IBBIS mental health care integrated with IBBIS vocational rehabilitation, (2) IBBIS mental health care and standard vocational rehabilitation, and (3) standard mental health care and standard vocational rehabilitation. The primary outcome is register-based return to work at 12 months. The secondary outcome measures are self-assessed level of depression (BDI), anxiety (BAI), distress symptoms (4DSQ), work- and social functioning (WSAS), and
Full Text Available Vocational rehabilitation represents an important element within the mental health care system. To ensure the success of rehabilitation, programs of varying degrees of complexity are needed in order to meet patients’ abilities and needs. Rehabilitation success must be examined multidimensionally and not be reduced to the mere integration into competitive employment. Success is also represented by progress in the level of vocational integration, strengthening of work capabilities, the improvement of the functional level, and in a better quality of life. The patient’s need for rehabilitation has to be recognized as early as possible to shorten the duration of the patient’s disintegration and to avoid stagnation periods. Rehabilitation needs to start in the clinic; with psychiatric help sustained during the rehabilitation process to prevent illness exacerbation and premature program termination. The patient’s development regarding his or her functional level, work capability, and subjective wellbeing needs to be evaluated throughout the program to consistently monitor the patient’s individual needs and abilities and to ensure appropriate support. Training for cognition and social skills should be integrated into rehabilitation programs to compensate individual deficits.La rehabilitación vocacional representa un importante elemento dentro del sistema del cuidado de la salud mental. Con el fin de asegurar el éxito de la rehabilitación y para satisfacer las necesidades y habilidades de los pacientes hacen falta programas de diversos grados de complejidad. El resultado de la rehabilitación debe examinarse de manera multidimensional y no reducirse tan sólo a la integración al empleo competitivo, pues el éxito se ve reflejado asimismo por el avance en el nivel de integración vocacional, el fortalecimiento de las capacidades para el trabajo, la mejora del nivel de funcionamiento y una mejor calidad de vida. Las necesidades de
Hammond, Alison; O'Brien, Rachel; Woodbridge, Sarah; Bradshaw, Lucy; Prior, Yeliz; Radford, Kate; Culley, June; Whitham, Diane; Ruth Pulikottil-Jacob
Inflammatory arthritis leads to work disability, absenteeism and presenteeism (i.e. at-work productivity loss) at high cost to individuals, employers and society. A trial of job retention vocational rehabilitation (VR) in the United States identified this helped people keep working. The effectiveness of this VR in countries with different socioeconomic policies and conditions, and its impact on absenteeism, presenteeism and health, are unknown. This feasibility study tested the acceptability of this VR, modified for the United Kingdom, compared to written advice about managing work problems. To help plan a randomized controlled trial, we tested screening, recruitment, intervention delivery, response rates, applicability of the control intervention and identified the relevant primary outcome. A feasibility randomized controlled trial with rheumatoid, psoriatic or inflammatory arthritis patients randomized to receive either job retention VR or written information only (the WORK-IA trial). Following three days VR training, rheumatology occupational therapists provided individualised VR on a one to one basis. VR included work assessment, activity diaries and action planning, and (as applicable) arthritis self-management in the workplace, ergonomics, fatigue and stress management, orthoses, employment rights and support services, assistive technology, work modifications, psychological and disclosure support, workplace visits and employer liaison. Fifty five (10%) people were recruited from 539 screened. Follow-up response rates were acceptable at 80%. VR was delivered with fidelity. VR was more acceptable than written advice only (7.8 versus 6.7). VR took on average 4 h at a cost of £135 per person. Outcome assessment indicated VR was better than written advice in reducing presenteeism (Work Limitations Questionnaire (WLQ) change score mean: VR = -12.4 (SD 13.2); control = -2.5 (SD 15.9), absenteeism, perceived risk of job loss and improving pain and health status
Ullah, Mohammad Mosayed; Sarker, Amit; Chowdhury, Suman Kanti
Returning to work after spinal cord injury (SCI) is a complex process due to the nature of injury and its devastating effect on all aspects of patients. This case study report is based on a spinal cord injury centre of Bangladesh. The evaluation examined vocational assessment process and vocational interest of persons with SCI undergoing rehabilitation program in the center. Occupational Therapists were interviewed to understand the existing vocational assessment services. This study also used data from 183 vocational assessment forms to find out the association of vocational interests and other demographic factors. The vocational assessment conducted to gathered information on the physical capacity of the patient and physical environment of patients living area only. The most preferred vocational interest was shop management 39%, and returning to previous job 38%. Vocational trades with the lowest level of interest were computer (2%) and electronics (3%), and 10% of patients at the time of assessment were undecided. A statistically significant association between interest to return to previous job and gender, age, occupation before injury and living area were found. Patients go through a complex process to adapt to a new life after experiencing SCI which is significantly influenced by the rehabilitation professionals around him/her. A comprehensive assessment including psychosocial information and therapist's expertise on facilitations making vocational decision based on the variables can optimize the rehabilitation outcome.
Full Text Available Cognitive impairment is one of the most common neurological disorders in neuro-oncological patients, linked with morbidity, disability, and poor quality of life. As pharmacologic interventions have not yet proven effective in the treatment of cognitive deficits, cognitive rehabilitation could represent an alternative approach. This paper presents three case studies, describing the cognitive intervention and discussing its effectiveness in the light of current evidence.
Laures-Gore, Jacqueline; McCusker, Tiffany; Hartley, Leila L
Descriptions of speech-language interventions addressing the unique aspects of aphasia in adolescence appear to be nonexistent. The current paper presents the case of a male adolescent who experienced a stroke with resultant aphasia and the speech and language therapy he received. Furthermore, we discuss the issues that are unique to an adolescent with aphasia and how they were addressed with this particular patient. Traditional language and apraxia therapy was provided to this patient with inclusion of technology and academic topics. The patient demonstrated improvements in his speech and language abilities, most notably his reading comprehension and speech production. Age-related issues, including academic needs, group treatment, socialization, adherence/compliance, independence and family involvement, emerged during intervention. Although aphasia therapy for adolescents may be similar in many aspects to selected interventions for adults, it is necessary for the clinician to be mindful of age-related issues throughout the course of therapy. Goals and interventions should be selected based on factors salient to an adolescent as well as the potential long-term impact of therapy. Implications for Research Aphasia and its treatment in adolescence need to be further explored. Academics and technology are important aspects of aphasia treatment in adolescence. Issues specific to adolescence such as socialization, adherence/compliance, and independence are important to address in speech-language therapy.
Improving Vocational Rehabilitation Access and Return to Work and Career Outcomes among African American Wounded Warriors, Gulf War, and Vietnam War Era Veterans with Disabilities: A White Paper Series
Moore, Corey L., Ed.: Johnson, Jean E., Ed.; Washington, Andre L., Ed.
The purpose of this monograph is to present documents that discuss issues related to improving access to vocational rehabilitation services and return to work rates of African American Wounded Warriors, Gulf War and Vietnam War Era veterans with disabilities. This monograph also includes a review of relevant literature on barriers to employment…
Al Servicio del Diabetico no Vidente o Discapacitado Visual: Guia de Recursos para Consejeros Vocacionales de Rehabilitacion (Serving Individuals with Diabetes Who Are Blind or Visually Impaired: A Resource Guide for Vocational Rehabilitation Counselors).
Bryant, Ed, Ed.
Designed for Spanish-speaking vocational rehabilitation counselors, this book provides information about diabetes and treating diabetes. Much of the material previously appeared as articles in "Voice of the Diabetic" and is written not just by doctors and diabetes professionals, but also by members of the National Federation of the Blind…
Kim, Bill W S; Peskin, Robert M
Intravenous sedation is frequently provided by anesthesiologists for phobic patients undergoing elective dental treatment in outpatient settings. Propofol is one of the most commonly used anesthetic agents that can result in apnea and respiratory depression, thereby posing potential difficulties with perioperative airway management. Dexmedetomidine has been utilized successfully in intravenous sedation for a wide variety of procedures and holds potential as an alternative to propofol in outpatient dental settings. However, as a single agent, it may not provide adequate depth of sedation and analgesia for oral rehabilitation. In this case report we demonstrate an effective alternative intravenous deep-sedation technique for an adult phobic patient undergoing oral rehabilitation utilizing 3 agents in combination: dexmedetomidine, ketamine, and midazolam. This combination of agents may be especially useful for those patients with a history of substance abuse, where administration of opioids may be undesirable or contraindicated.
... the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES... disabilities who reside on Federal or State reservations, consistent with their individual strengths, resources...
Cler, Gabriel J; Mittelman, Talia; Braden, Maia N; Woodnorth, Geralyn Harvey; Stepp, Cara E
Video games provide a promising platform for rehabilitation of speech disorders. Although video games have been used to train speech perception in foreign language learners and have been proposed for aural rehabilitation, their use in speech therapy has been limited thus far. We present feasibility results from at-home use in a case series of children with velopharyngeal dysfunction (VPD) using an interactive video game that provided real-time biofeedback to facilitate appropriate nasalization. Five participants were recruited across a range of ages, VPD severities, and VPD etiologies. Participants completed multiple weeks of individual game play with a video game that provides feedback on nasalization measured via nasal accelerometry. Nasalization was assessed before and after training by using nasometry, aerodynamic measures, and expert perceptual judgments. Four participants used the game at home or school, with the remaining participant unwilling to have the nasal accelerometer secured to his nasal skin, perhaps due to his young age. The remaining participants showed a tendency toward decreased nasalization after training, particularly for the words explicitly trained in the video game. Results suggest that video game-based systems may provide a useful rehabilitation platform for providing real-time feedback of speech nasalization in VPD. https://doi.org/10.23641/asha.5116828.
Mittelman, Talia; Braden, Maia N.; Woodnorth, Geralyn Harvey; Stepp, Cara E.
Purpose Video games provide a promising platform for rehabilitation of speech disorders. Although video games have been used to train speech perception in foreign language learners and have been proposed for aural rehabilitation, their use in speech therapy has been limited thus far. We present feasibility results from at-home use in a case series of children with velopharyngeal dysfunction (VPD) using an interactive video game that provided real-time biofeedback to facilitate appropriate nasalization. Method Five participants were recruited across a range of ages, VPD severities, and VPD etiologies. Participants completed multiple weeks of individual game play with a video game that provides feedback on nasalization measured via nasal accelerometry. Nasalization was assessed before and after training by using nasometry, aerodynamic measures, and expert perceptual judgments. Results Four participants used the game at home or school, with the remaining participant unwilling to have the nasal accelerometer secured to his nasal skin, perhaps due to his young age. The remaining participants showed a tendency toward decreased nasalization after training, particularly for the words explicitly trained in the video game. Conclusion Results suggest that video game–based systems may provide a useful rehabilitation platform for providing real-time feedback of speech nasalization in VPD. Supplemental Material https://doi.org/10.23641/asha.5116828 PMID:28655049
Full Text Available Responding to rural poverty associated with the declining fishery, the rise of industrial capitalism, and the impact of the Great Depression, the Sisters of Charity, Halifax, implemented a vocational training program in weaving and carpentry in the small community of Terence Bay, Nova Scotia in 1938. Senator William Dennis, a proponent of the New Democracy Movement, financed the program. Because the Sisters based their claims to success on observed behavioural changes among the residents of Terence Bay, the program can be seen as an example of liberal therapeutics in education, a model that placed emphasis on achieving social goals rather than transferring discrete skills and capacities to pupils. Focusing on the years 1938-43, this paper outlines the rehabilitation efforts at Terence Bay, describes the programs the Sisters implemented, and evaluates the definitions of success ascribed to their training school just a few years later.
Andersén, Åsa; Larsson, Kjerstin; Lytsy, Per; Berglund, Erik; Kristiansson, Per; Anderzén, Ingrid
Purpose To investigate the effects of two vocational rehabilitation interventions on self-efficacy, for women on long-term sick leave ≥ 1 year due to chronic pain and/or mental illness. Methods This study uses data from a randomised controlled trial consisting of two phases and comprising 401 women on long-term sick leave. They were allocated to either (1) a multidisciplinary team assessment and multimodal intervention (TEAM), (2) acceptance and commitment therapy (ACT), or (3) control group. Data were collected through repeated measurements from self-reported questionnaires before intervention, 6 and 12 months later and registry data. Data from measurements of general self-efficacy, sociodemographics, anxiety and depression were analysed with linear regression analyses. Results During the intervention period, the women in the TEAM group's self-efficacy mean increased from 2.29 to 2.74. The adjusted linear regression model, which included group allocation, sociodemographics, self-efficacy pre-treatment, anxiety and depression showed increased self-efficacy for those in the TEAM intervention at 12 months (B = 0.25, 95% CI 0.10-0.41). ACT intervention had no effect on self-efficacy at 12 months (B = 0.02, 95% CI - 0.16 to 0.19). The results in the adjusted model also showed that higher self-efficacy at pre-treatment was associated with a higher level of self-efficacy at 12 months (B = 0.68, 95% CI 0.54-0.81). Conclusion A multidisciplinary team assessment and multimodal intervention increased self-efficacy in women on sick leave for an extremely long time (mean 7.8 years) who had a low mean level of self-efficacy prior to inclusion. Thus, self-efficacy needs to be addressed in vocational rehabilitation.
García Sánchez, José Elías
Commercial cinema is both narrative art and a widely-used mass medium that is built upon human stories. Among the contents of these stories there are many vocational aspects. Taking advantage of these circumstances we will proceed to analyze health vocations through eight films. Patch Adams allows us to approach the fulfillment of vocation, which has not been an easy task for women, as we can see in Allá en el setenta y tantos. Vocational fulfillment is at the core of the plot in The Citadel. Something the Lord Made is a good example to illustrate an unfulfilled vocation, in the same way as Awakenings and Arrowsmith represent the fulfillment of an unexpected vocation and a long pursued one. Finally, vocation can demand great sacrifices, which is made crystal clear in Korczak, and when vocation is not strictly followed it might lead to the greatest abominations, which is the case in "The Fugitive. "
Caswell, Dorte; Høybye-Mortensen, Matilde; Dall, Tanja
Rehabilitering som både begreb og indsats har været genstand for stigende fokus i de seneste år, på både politisk, organisatorisk og praksis-niveau. Fra januar 2013 træder en større reform af førtidspension og fleksjob i kraft, og med reformen etableres ’rehabilitering’ som både mål og middel i...
Mishra, Arun K.
Education has a place of high priority on India's development agenda. The technical/vocational education (TVE) system is multisectoral with each ministry responsible for labor force development in that sector. The TVE programs in the formal education system are either state delivered or financed. The higher secondary vocational education program…
Integrated mental health care and vocational rehabilitation to improve return to work rates for people on sick leave because of exhaustion disorder, adjustment disorder, and distress (the Danish IBBIS trial)
Poulsen, Rie; Fisker, Jonas; Hoff, Andreas
that mental health care alone will provide sufficient support for vocational recovery for this group. Integrated vocational and health care services have shown good effects on return to work in other similar welfare contexts. The purpose of the Danish IBBIS (Integreret Behandlings- og Beskæftigelses...... of the current organizational separation of health care interventions and vocational rehabilitation regarding the individual's process of returning to work after sick leave because of exhaustion disorder, adjustment disorder or distress. If the effect on return to work, symptom level, and recurrent sick leave...... is different in the intervention groups, this study can contribute with new knowledge on shared care models and the potential for preventing deterioration in stress symptoms, prolonged sick leave, and recurrent sick leave. TRIAL REGISTRATION: ClinicalTrials.gov, registration number: NCT02885519...
van Twillert, Sacha; Postema, Klaas; Geertzen, Jan H. B.; Hemminga, Titia; Lettinga, Ant T.
Objective: To contribute to the discussion on the research-practice gap by illustrating obstacles and opportunities that arise in an evidence-informed improvement process of prosthetic rehabilitation in a local setting. Setting: Dutch rehabilitation centre. Presupposition: The improvement process
Sousa, Nariana Mattos Figueiredo
The term amnesia refers to a pathological state of mind in which memory and learning are affected to a greater extent than other cognitive functions in a patient without altered level of consciousness. The aim of the current study was to describe a case of severe amnesia in a patient during neurological rehabilitation and to report the importance of preserved cognitive functions to compensate for the mnemonic deficit. VJA presented a clinical condition suggestive of encephalopathy due to caloric-protein malnutrition following several abdominal surgical procedures for complicated choledocholithiasis. A descriptive analysis of the results was carried out to outline the goals attained and the factors limiting implementation of memory aids. After the intervention program, consisting of individual and group activities, VJA showed improvement in level of recall with repetition of tasks, but still required constant external monitoring. Longitudinal follow-up is necessary to obtain more consistent results.
Nariana Mattos Figueiredo Sousa
Full Text Available ABSTRACT The term amnesia refers to a pathological state of mind in which memory and learning are affected to a greater extent than other cognitive functions in a patient without altered level of consciousness. The aim of the current study was to describe a case of severe amnesia in a patient during neurological rehabilitation and to report the importance of preserved cognitive functions to compensate for the mnemonic deficit. VJA presented a clinical condition suggestive of encephalopathy due to caloric-protein malnutrition following several abdominal surgical procedures for complicated choledocholithiasis. A descriptive analysis of the results was carried out to outline the goals attained and the factors limiting implementation of memory aids. After the intervention program, consisting of individual and group activities, VJA showed improvement in level of recall with repetition of tasks, but still required constant external monitoring. Longitudinal follow-up is necessary to obtain more consistent results.
Arnold, Nancy; Seekins, Tom; Ipsen, Catherine; Colling, Kyle
Recommends a research-based process for rehabilitation agencies assisting clients with self-employment. Steps include counselor-client dialog about self-employment, use of assessment tools and resources, education/training, development of a business plan, start-up funding from the agency and other sources, business start-up, and evaluation of…
Khasawneh, Samer; Omari, Aieman; Abu-Tineh, Abdullah M.
The purpose of this article is to determine the relationship between transformational leadership of vocational school principals on vocational teachers-organizational commitment. A random sample of 340 vocational teachers responded to a three-part instrument (the transformational leadership questionnaire, the organizational commitment…
Brown, Ben; Fadillah, Ratna; Nurdin, Yusran; Soulsby, Iona; Ahmad, Rio
While successful examples of large-scale (5 000-10 000 ha) ecological wetland/mangrove rehabilitation projects exist worldwide, mangrove rehabilitation efforts in Indonesia, both large and small, have mainly failed. The majority of projects (both government programs and non-government initiatives) have oversimplified the technical processes of mangrove rehabilitation, favouring the direct planting of a restricted subset of mangrove species (from the family Rhizophoracea), commonly in the lowe...
Ferdiana, A; Post, M W; Finger, M; Bültmann, U; Escorpizo, R
Health-related quality of life (HRQOL) has been frequently used as an outcome measure in disability-related studies, yet little is known about HRQOL in vocational rehabilitation (VR). To evaluate HRQOL in VR clients and identify factors associated with their HRQOL DESIGN, SETTING AND POPULATION: Cross-sectional study of 149 clients from 5 VR centers in Switzerland and Germany HRQOL was measured by 8 dimensions of the Medical Outcomes Study 36-item Short Form Health Survey (SF-36) and compared with sex-matched German population norms. Multiple regression analyses were conducted to identify whether VR-related variables (VR duration and type, sick leave duration) and depressive symptoms were associated with HRQOL dimensions independent of sociodemographics (age, sex, education) and clinical characteristics (type of disorders, number of comorbidities) HRQOL in VR clients was significantly lower in all dimensions measured by the SF-36 compared to the general population. Returning to the former workplace and being oriented to a new job were associated with less functional limitation due to physical problems, less pain and better mental health. Being oriented to a new job was also associated with better vitality. Presence of depressive symptoms was negatively related with all dimensions of HRQOL. Overall, the regression models explained 10%-25% variance of the physical HRQOL domain and 18%-27% variance of the mental HRQOL domain. Multiple dimensions of HRQOL were significantly decreased in VR clients. Depressive symptoms were prevalent and contributed significantly to poorer HRQOL, thus should be considered in the VR process. Further research is needed to ascertain the effect of different VR types to HRQOL and to elaborate the role of depressive symptoms in HRQOL over time. Rehabilitation professionals should be informed of the level of HRQOL in VR clients in order to tailor effective interventions to improve HRQOL by not only focusing on functional ability but also the
Le Tallec, H; Lassalle, A; Khenioui, H; Durufle, A; Plassat, R; Gallien, P
Ehlers-Danlos syndrome is rare and little known. It comprises a heterogeneous group of heritable connective tissue disorders characterized by articular hypermobility, skin extensibility and tissue fragility. Diagnosis may be difficult and often delayed. Here we describe 2 cases of women with Ehlers-Danlos syndrome. The first had scoliosis with back pain and joint hypermobility. The second presented with hypermobility and joint dislocation, which increased during pregnancy. In these 2 cases, rehabilitation management produced clinical improvement. Orthopaedic complications such joint pain, joint swelling, joint dislocation, back pain, with walking and hand function disability are the main problems in Ehlers-Danos syndrome. Surgery may be necessary to correct dislocated joints but is often not sufficient to resolve the handicap, and physical therapy has an important place in management. Ehlers-Danlos syndrome is an evolving disease that can lead to great impairment. Thus, physicians must be aware of this syndrome to offer the best management, with the appropriate use of orthotic devices, specific strengthening routines, education in proper body mechanics and assistive devices, to prevent joint dislocation and subluxations responsible for pain and handicap.
Full Text Available Introduction: The locked-in syndrome is a neurological condition which occurs most often as a result of brainstem stroke, characterized by the presence of sustained eye opening, aphonia or severe hypophonia, quadriplegia or quadriparesis, preserved cognitive functioning, and a primary and elementary code of communication using vertical eye movements or blinking. This illness leads to complete physical disability of the person, accompanied with fully retained mental capability. Case study: The goal of the hereby work is to present a description of a case of a person with the locked-in syndrome, caused by ischemic stroke of the pons and left cerebellar hemisphere. The prognosis of improvement in LIS is bad. The patient has to adapt to the new, difficult situation that will probably accompany him for whole life. The article presents the therapeutic process from the onset through physical rehabilitation, speech therapy and psychological therapy until return home. The process requires patience from the patient and therapists and family members. Conclusion: Research in this area is supposed to help in planning of cooperation the entire medical team of doctors, nurses, physiotherapists, social workers, speech therapists and neuropsychologists. Interdisciplinary proceedings can greatly help to achieve even a minimal degree of independence and autonomy.
This case study presents the epidemiology, etiology, diagnostic criteria, and therapeutic interventions for a common clinical condition - gastrocnemius injury. A 44-year old male presented with acute calf pain with a palpable defect, loss of range of motion, and loss of strength after sustaining a soft tissue injury to the lower leg. The differential diagnosis of tear of the medial head of the gastrocnemius was confirmed by physical examination and diagnostic ultrasound imaging. The patient was treated over a 6 week period. Initially, rehabilitation was approached using the PRICE principles for symptomatic relief, followed by stretching, strengthening, proprioception, and conditioning exercises. At 9-month follow-up post injury, there was no residual impairment in the gastrocnemius muscle function. This case demonstrates the importance of epidemiology, clinical assessment, and the use of diagnostic ultrasound and MRI imaging in the diagnosis of a tear of the medial head of the gastrocnemius muscle. With an accurate diagnosis and comprehension of classification of muscle injuries, management of gastrocnemius tears is straightforward.
Fleming, Allison R.; Boeltzig-Brown, Heike; Foley, Susan M.
Purpose: We describe a modified Delphi method used to select effective state vocational rehabilitation agency practices to prioritize rehabilitation services for individuals with most significant disabilities within the context of Order of Selection, an area where there is little known and published. Specifically, we describe how we applied the…
de Buck, Petronella D M; le Cessie, Saskia; van den Hout, Wilbert B; Peeters, Andreas J; Ronday, Herman K; Westedt, Marie-Louise; Breedveld, Ferdinand C; Vliet Vlieland, Theodora P M
Work disability is a major consequence of inflammatory rheumatic conditions. Evidence regarding the effectiveness of interventions aimed at the prevention or reduction of work disability in rheumatic diseases is limited. We conducted a randomized controlled trial to investigate the effectiveness of a multidisciplinary job-retention vocational rehabilitation (VR) program in patients with a rheumatic condition who were at risk for job loss. A total of 140 patients with a chronic rheumatic condition were randomly assigned to either a multidisciplinary job-retention VR program (n = 74) or usual outpatient care (UC) (n = 66). Patients in the VR group were assessed and guided by a multidisciplinary team, whereas patients in the UC group received care as initiated by their rheumatologist, supplemented with written information. The main outcome measure was the occurrence of job loss (complete work disability or unemployment); additional outcome measures included job satisfaction, pain, functional status, emotional status, and quality of life. There was no difference between the 2 groups regarding the proportion of patients having lost their job at any time point, with 24% and 23% of the patients in the VR and UC groups, respectively, having lost their job after 24 months. Over the total period of 24 months, patients in the VR group had a significantly greater improvement of the fatigue visual analog scale and of emotional status (all P values job-retention VR program did not reduce the risk of job loss but improved fatigue and mental health in patients with chronic rheumatic diseases at risk for job loss.
Bouwmeester, Lies; van de Wege, Anja; Haaxma, Rob; Snoek, Jos W.
This paper describes the rehabilitation process of a patient with severe topographical disorientation. The study demonstrates the sustained effects of a tailor-made, meticulous rehabilitation programme based on the gradual development of compensatory strategies. The patient (RB) had a memory
This paper starts with the real-life issues pertaining to the educational, economic and socio-cultural vulnerability of young Cambodians; and the latter in turn has called for greater integrated stance in vocational education. A multiple-case study of nine educational NGOs located in four cities was conducted, whereby what constitutes an…
Few studies have tracked youth transition beyond the immediate post-school period or have looked at the longer-term outcomes of post-school programs. This study reports the findings of a case study investigating links between an industry-specific school vocational education and training (VET) program and subsequent work transitions to the building…
Albiol-Pérez, S; Forcano-García, M; Muñoz-Tomás, M T; Manzano-Fernández, P; Solsona-Hernández, S; Mashat, M A; Gil-Gómez, J A
This article is part of the Focus Theme of Methods of Information in Medicine on "New Methodologies for Patients Rehabilitation". For Guillain-Barré patients, motor rehabilitation programs are helpful at the onset to prevent the complications of paralysis and in cases of persistent motor impairment. Traditional motor rehabilitation programs may be tedious and monotonous, resulting in low adherence to the treatments. A Virtual Motor Rehabilitation system has been tested in Guillain-Barré patients to increase patient adherence and to improve clinical results. Two people with Guillain-Barré performed 20 rehabilitation sessions. We tested a novel system based on Motor Virtual Rehabilitation in three periods of time (baseline evaluation, final evaluation, and follow-up. In the training program, the participants carried out a specific treatment using the Active Balance Rehabilitation system (ABAR). The system is composed of customizable virtual games to perform static and dynamic balance rehabilitation. Significant improvements in clinical results were obtained by both participants, with significant results in the static balance clinical test of the Anterior Reach test in the standing position and unipedal stance time. Other significant results were found in dynamic balance clinical tests in the Berg Balance Scale test and the 30-second Sit-to-Stand test. With regard to acceptance of the system, both patients enjoyed the experience, and both patients thought that this system was helpful for their rehabilitation. The results show that Virtual Motor Rehabilitation for Guillain-Barré patients provides clinical improvements in an entertaining way.
Madsen, Erik Skov
Through case studies in China, Mexico and Denmark, this paper identifies challenges posed to production companies by a lack of vocational skills and vocational education. The study includes manual, complex and automated production procedures. The paper highlights how both China and Denmark have...... focused on theoretical rather than vocational education for more than a decade. Based on a combination of a literature review and field studies of cases, including studies of mass production and unmanned and automated production, a framework of skills related to process tasks is developed. The paper...... concludes that much more focus on the development of vocational education and vocational skills is needed in Denmark, the U.K, the U.S. and in China for employees to be equipped to handle future automated and advanced production systems....
Tosetto, Thaís; Orsi, Flávia Giuntini
Among the indicators of Decent Work in Brazil, the one referring to the "Safe Working Environment" was the only which had no improvement in the time series analyzed by the International Labor Organisation. There is an increased number of accidents with significant economic and social impacts. Given that many of these accidents involve the hands and cause functional sequels, this paper presents an integration between the approaches of Hand Therapy and Ergonomics in order to facilitate the process of rehabilitation and reintegration, as well as acting to prevent further accidents, thus contributing to the promotion of Decent Work in the country, particularly with regard to safety and health at work and equal opportunities.
.e., the same type of issues that newly enrolled students at the vocational college are facing. Our article is based on empirical data from a long-term, qualitative study of the Diploma of Vocational Pedagogy programme. It examines the learning trajectories of vocational teachers who choose to come back as VET...... their pedagogical education as teachers, i.e., transitional coherence, are not the same. The empirical data from the cases were collected via qualitative and ethnography-inspired methods, i.e., observations, focus group interviews, interviews and analyses of diploma projects from the programme......., vocational field at a specific type of college. Due to these factors, the individual teachers will experience different ‘learning trajectories’ (Lave, 2011), depending on vocational field and place of employment. They will gather different experiences, including the experience of going back to school, i...
Hee, Tieng Fok
The economic profile of Malaysia has changed from an economy mainly based on agriculture and the production of tin ore to a more balanced economy with continuing growth in the manufacturing and industrial sectors. Educational programs need to be upgraded and improved, particularly the direction and development of technical and vocational education…
Huang, Hsun-I; Lee, Cheng-Fei
Higher technical and vocational education institutions in Taiwan face the pressure of an oversupply of student places and fierce competition from domestic and international institutions. To cope with these challenges, higher technical and vocational education institutions that are better equipped to respond to market requirements are expected to…
Park, Chong Myung
The purpose of this study is to develop an understanding of the ways in which educational experiences might differ between a regional vocational technical high school (RVTH) and short-term career-training programs. A particular regional vocational technical high school was selected for its outstanding academic records and placement rates, and a…
Gupta, Anupam; Patil, Maitreyi; Khanna, Meeka; Krishnan, Rashmi; Taly, Arun B.
We report three females who developed Guillain–Barre Syndrome in postpartum period (within 6 weeks of delivery) and were admitted in the Neurological Rehabilitation Department for rehabilitation after the initial diagnosis and treatment in the Department of Neurology. The first case, axonal variant (acute motor axonal neuropathy [AMAN]) had worst presentation at the time of admission, recovered well by the time of discharge. The second case, acute motor sensory axonal neuropathy variant and t...
... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Rehabilitation facilities... Vocational Rehabilitation and Employment Service 871.208 Rehabilitation facilities. Charges by rehabilitation facilities for the rehabilitation services provided under 38 U.S.C. Chapter 31 are paid in the same manner as...
Full Text Available Hamstring injuries and its rehabilitation in competitive events such as football targets safe and early return to play. This is because hamstring injuries are more related to prolonged recovery time and high rate of re-injury. In this case study, Zakeer Mundampara, 26-year-old footballer of Chennaiyin FC team (Indian super league tournament, who was rehabilitated for Grade 2 hamstring strain was briefed. To describe the importance of conservative rehabilitation in hamstring injuries and report on player's rehabilitation program and clinical outcome. Zakeer Mundampara was conservatively treated with active release technique for 2 weeks duration. Data collected includes passive knee extension test range of motion and verbal rating score. After 2 weeks of rehabilitation, Zakeer Mundampara had nearly full range of pain-free movement, normal gait and trained to run safely. By the 3rd week, he started to perform all sports specific drills. He was rehabilitated and set fit to play after 4 weeks from the date of injury. Active release technique is effective in hamstring injuries. In this case study, rehabilitation program with an emphasis on active release technique is found to be effective in returning the footballer back to play.
Dr. Bertha Vallejo; Dr. S. Bolhuis; Prof. dr. Perry den Brok; Drs. Kennedy Aquilino Tielman
Abstract This research presents a descriptive study regarding collaborative learning in a multicultural classroom at a vocational education school in The Netherlands. The study bridges two domains of research: research on culturally diverse learning environments - which has mostly concerned primary
Sailer, Herman F.; Tarawneh, Fadi; Fourkas, Panagiotis; Antoniades, Dimitrios Z.; Athanasiou, Athanasios E.
This case report describes the combined surgical, orthodontic and prosthodontic rehabilitation of an adult female patient with a previous history of follicular ameloblastoma, which was treated through partial mandibulectomy and an immediate replacement of missing bone with an autologous calvarial bone graft. Orthodontic treatment was undertaken in order to restore occlusal disturbances and obtain sufficient space for two dental implants and an optimum prosthodontic rehabilitation. PMID:20396452
Full Text Available "nFabrication of dental prosthesis for patients with microstomia has long been a problem for dentists. Microstomia is defined as an abnormally small oral orifice. Prosthetic rehabilitation of microstomia patients presents difficulties at all stages, from the preliminary impressions to fabrication of prosthesis. This study described a method for making impressions for patients with limited opening of the oral cavity which the use of a full-size impression tray was not possible.
Cogné, M; Wiart, L; Simion, A; Dehail, P; Mazaux, J-M
Social and vocational reintegration of persons with brain injury is an important element in their rehabilitation. To evaluate the 5-year outcome of persons with brain injury included in 2008 in the Aquitaine Unit for Evaluation, Training and Social and Vocational Counselling programme (UEROS). 57 persons with brain injury were recruited from those who completed the 2008 UEROS programme. Five years later, an interview was done to assess family and vocational status, autonomy and life satisfaction. These results were compared with those from persons completing the 1997-1999 programme. The typical person entered the 2008 UEROS programme 6 years after a severe brain injury (42%) and was male, single and 35 years. At the 5-year follow-up, more persons lived with a partner (+23%) and lived in their own home (+21%). 47% were working vs 11% on entering the programme. Approximately half were satisfied or very satisfied with their quality of life. Having a job in 2013 was associated with a high education level, less cognitive sequelae, having a job in 2008 and no health condition. The UEROS programme is effective with regard to return-to-work and improvement of autonomy in persons with brain injury, irrespective of length of time from injury.
... employers, vocational rehabilitation (VR) practitioners, and policy makers. Grantees also must collaborate... vocational rehabilitation agencies. (b) Increased knowledge about how these practices relate to employer... of each priority as absolute, competitive preference, or invitational through a notice in the Federal...
..., vocational rehabilitation (VR) practitioners, individuals with disabilities, and other stakeholders need to... vocational rehabilitation (VR) practitioners. The Center must work in partnership with organizations... or more priorities, we designate the type of each priority as absolute, competitive preference, or...
Full Text Available Abstract Background Due to improvements in cancer survival the number of people of working age living with cancer across Europe is likely to increase. UK governments have made commitments to reduce the number of working days lost to ill-health and to improve access to vocational rehabilitation (VR services. Return to work for people with cancer has been identified as a priority. However, there are few services to support people to remain in or return to work after cancer and no associated trials to assess their impact. A pilot randomised controlled trial among women with breast cancer has been designed to assess the feasibility of a larger definitive trial of VR services for people with cancer. Methods Patients are being recruited from three clinical sites in two Scottish National Health Service (NHS Boards for 6 months. Eligible patients are all women who are: (1 aged between 18 and 65 years; (2 in paid employment or self-employed; (3 living or working in Lothian or Tayside, Scotland, UK; (4 diagnosed with an invasive breast cancer tumour; (5 treated first with surgery. Patients are randomly allocated to receive referral to a VR service or usual care, which involves no formal employment support. The primary outcome measure is self-reported sickness absence in the first 6 months following surgery. Secondary outcome measures include changes in quality of life (FACT-B, fatigue (FACIT-Fatigue and employment status between baseline and 6- and 12-months post-surgery. A post-trial evaluation will be conducted to assess the acceptability of the intervention among participants and the feasibility of a larger, more definitive, trial with patients with lung and prostate cancer. Discussion To our knowledge this is the first study to determine the feasibility of a randomised controlled trial of the effectiveness of VR services to enable people with cancer to remain in or return to employment. The study will provide evidence to assess the relevance and
De Vroege, L.; Khasho, D.; Foruz, A.; Van Der Feltz-cornelis, C.M.; Walla, P.
Cognitive rehabilitation treatment (CRT) has been described in patients with brain injury, but it has not been attempted in cases of cognitive dysfunction without organic cause. This case report describes CRT of neurocognitive impairment in a 54-year-old female patient with conversion disorder (CD).
Full Text Available Oral submucous fibrosis (OSF is an insidious chronic condition characterized by restricted mouth opening. Prosthetic rehabilitation is challenging for OSF patients as obtaining a good impression requires adequate mouth opening. The aim of the present review is to systematically present the data from case reports published in the English-language literature.A comprehensive search of the literature databases (PubMed, Medline, SCOPUS, Web of Science and Google Scholar along with the references of published articles on prosthetic rehabilitation in OSF patients published to date was conducted. Keywords included a combination of 'Oral submucous fibrosis', 'prosthesis', 'dentures' and/or 'restricted mouth opening'. Citations from selected references and bibliographic linkages taken from similar cases were included in this review. The inclusion criteria selected for case reports on prosthetic rehabilitation in OSF patients, and cases of restricted mouth opening due to causes other than OSF were excluded from the study.A total of 21 cases were identified and analysed from 17 papers published in the English-language literature. Of these, 9 cases employed the sectional denture technique, 4 cases emphasized the need-based treatment approach in which conventional methods were modified, and 4 cases used mouth exercising devices. Finally, 1 case each involved, flexible denture, oral screen prosthesis, oral stents, surgery in conjunction with dentures.Prosthetic rehabilitation in OSF patients is a multifaceted approach and should be patient specific, although sectional dentures have achieved the best results.
Patil, Shankargouda; Sarode, Sachin Chakradhar; Sarode, Gargi S; Bhandi, Shilpa; Awan, Kamran Habib; Ferrari, Marco
Oral submucous fibrosis (OSF) is an insidious chronic condition characterized by restricted mouth opening. Prosthetic rehabilitation is challenging for OSF patients as obtaining a good impression requires adequate mouth opening. The aim of the present review is to systematically present the data from case reports published in the English-language literature. A comprehensive search of the literature databases (PubMed, Medline, SCOPUS, Web of Science and Google Scholar) along with the references of published articles on prosthetic rehabilitation in OSF patients published to date was conducted. Keywords included a combination of 'Oral submucous fibrosis', 'prosthesis', 'dentures' and/or 'restricted mouth opening'. Citations from selected references and bibliographic linkages taken from similar cases were included in this review. The inclusion criteria selected for case reports on prosthetic rehabilitation in OSF patients, and cases of restricted mouth opening due to causes other than OSF were excluded from the study. A total of 21 cases were identified and analysed from 17 papers published in the English-language literature. Of these, 9 cases employed the sectional denture technique, 4 cases emphasized the need-based treatment approach in which conventional methods were modified, and 4 cases used mouth exercising devices. Finally, 1 case each involved, flexible denture, oral screen prosthesis, oral stents, surgery in conjunction with dentures. Prosthetic rehabilitation in OSF patients is a multifaceted approach and should be patient specific, although sectional dentures have achieved the best results.
Page-Karjian, Annie; Norton, Terry M; Harms, Craig; Mader, Doug; Herbst, Larry H; Stedman, Nancy; Gottdenker, Nicole L
Fibropapillomatosis (FP) is a debilitating neoplastic disease that affects all species of hard-shelled sea turtles, including loggerhead turtles Caretta caretta. FP can represent an important clinical concern in rehabilitating turtles, since managing these infectious lesions often requires special husbandry provisions including quarantine, and FP may affect clinical progression, extend rehabilitation duration, and complicate prognoses. Here we describe cases of rehabilitating loggerhead turtles with FP (designated FP+). Medical records of FP+ loggerhead cases from 3 sea turtle rehabilitation facilities in the southeastern USA were reviewed. Between 2001 and 2014, FP was observed in 8 of 818 rehabilitating loggerhead turtles (0.98% overall prevalence in admitted patients). FP+ loggerhead size classes represented were large juvenile (straight carapace length, SCL: 58.1-80 cm; n=7) and adult (SCL>87 cm; n=1). Three turtles presented with FP, and 5 developed tumors during rehabilitation within a range of 45 to 319 d. Sites of new tumor growth included the eyes, sites of trauma, neck, and glottis. FP+ turtles were scored as mildly (3/8), moderately (4/8), or heavily (1/8) afflicted. The mean total time in rehabilitation was 476±355 d (SD) (range: 52-1159 d). Six turtles were released without visible evidence of FP, 1 turtle was released with mild FP, and 1 turtle with internal FP was euthanized. Clinical decision-making for FP+ loggerhead patients can be aided by such information as time to tumor development, anatomic locations to monitor for new tumor growth, husbandry considerations, diagnostic and treatment options, and comparisons to FP in rehabilitating green turtles Chelonia mydas.
Volpato, Luiz Evaristo Ricci; Caldas, Lorena Frange; Castro, Paulo Henrique de Souza; de Carvalhosa, Artur Aburad; Volpato, Maria Carmen Palma Faria; Bandéca, Matheus Coelho; Borges, Álvaro Henrique
Adenoid cystic carcinoma is a cancer of the salivary gland that primarily affects the parotid, submandibular, and accessory salivary glands. Its growth is slow and it has infiltrative nature. A 46-year-old female patient coming from the rural area presented a lesion on the palate and reported pain in the region for three years. After incisional biopsy, and histopathological diagnosis of adenoid cystic carcinoma of the cribriform type of minor salivary gland, superior hemimaxillectomy and adjuvant treatment with radiotherapy and maxillofacial prosthetic rehabilitation were performed. PMID:25709844
Luiz Evaristo Ricci Volpato
Full Text Available Adenoid cystic carcinoma is a cancer of the salivary gland that primarily affects the parotid, submandibular, and accessory salivary glands. Its growth is slow and it has infiltrative nature. A 46-year-old female patient coming from the rural area presented a lesion on the palate and reported pain in the region for three years. After incisional biopsy, and histopathological diagnosis of adenoid cystic carcinoma of the cribriform type of minor salivary gland, superior hemimaxillectomy and adjuvant treatment with radiotherapy and maxillofacial prosthetic rehabilitation were performed.
Gupta, Anupam; Patil, Maitreyi; Khanna, Meeka; Krishnan, Rashmi; Taly, Arun B
We report three females who developed Guillain-Barre Syndrome in postpartum period (within 6 weeks of delivery) and were admitted in the Neurological Rehabilitation Department for rehabilitation after the initial diagnosis and treatment in the Department of Neurology. The first case, axonal variant (acute motor axonal neuropathy [AMAN]) had worst presentation at the time of admission, recovered well by the time of discharge. The second case, acute motor sensory axonal neuropathy variant and the third case, AMAN variant presented at the late postpartum period. Medical treatment was sought much later due to various reasons and both the patients had an incomplete recovery at discharge. Apart from their presentations, rehabilitation management is also discussed in some detail.
Gupta, Anupam; Patil, Maitreyi; Khanna, Meeka; Krishnan, Rashmi; Taly, Arun B.
We report three females who developed Guillain–Barre Syndrome in postpartum period (within 6 weeks of delivery) and were admitted in the Neurological Rehabilitation Department for rehabilitation after the initial diagnosis and treatment in the Department of Neurology. The first case, axonal variant (acute motor axonal neuropathy [AMAN]) had worst presentation at the time of admission, recovered well by the time of discharge. The second case, acute motor sensory axonal neuropathy variant and the third case, AMAN variant presented at the late postpartum period. Medical treatment was sought much later due to various reasons and both the patients had an incomplete recovery at discharge. Apart from their presentations, rehabilitation management is also discussed in some detail. PMID:28694640
Full Text Available We report three females who developed Guillain–Barre Syndrome in postpartum period (within 6 weeks of delivery and were admitted in the Neurological Rehabilitation Department for rehabilitation after the initial diagnosis and treatment in the Department of Neurology. The first case, axonal variant (acute motor axonal neuropathy [AMAN] had worst presentation at the time of admission, recovered well by the time of discharge. The second case, acute motor sensory axonal neuropathy variant and the third case, AMAN variant presented at the late postpartum period. Medical treatment was sought much later due to various reasons and both the patients had an incomplete recovery at discharge. Apart from their presentations, rehabilitation management is also discussed in some detail.
Mountain Debbie A
Full Text Available Abstract Background At any time, about 1% of people with severe and enduring mental illness such as schizophrenia require in-patient psychiatric rehabilitation. In-patient rehabilitation enables individuals with the most challenging difficulties to be discharged to successful and stable community living. However, the length of rehabilitation admission that is required is highly variable and the reasons for this are poorly understood. There are very few case-control studies of predictors of outcome following hospitalisation. None have been carried out for in-patient rehabilitation. We aimed to identify the factors that are associated with achieving discharge from in-patient rehabilitation by carrying out a case-control study. Methods We compared two groups: 34 people who were admitted to the Rehabilitation Service at the Royal Edinburgh Hospital and discharged within a six year study period, and 31 people who were admitted in the same period, but not discharged. We compared the groups on demographic, illness, treatment and risk variables that were present at the point of their admission to rehabilitation. We used independent t tests and Pearson Chi-Square tests to compare the two groups. Results We found that serious self harm and suicide attempts, treatment with high dose antipsychotics, antipsychotic polypharmacy and previous care in forensic psychiatric services were all significantly associated with non-discharge. The non-discharged group were admitted significantly later in the six year study period and had already spent significantly longer in hospital. People who were admitted to rehabilitation within the first ten years of developing psychosis were more likely to have achieved discharge. Conclusions People admitted later in the study period required longer rehabilitation admissions and had higher rates of serious self harm and treatment resistant illness. They were also more likely to have had previous contact with forensic services. This
Pierella, Camilla; Abdollahi, Farnaz; Farshchiansadegh, Ali; Pedersen, Jessica; Chen, David; Mussa-Ivaldi, Ferdinando A; Casadio, Maura
High-level spinal cord injury (SCI) survivors face every day two related problems: recovering motor skills and regaining functional independence. Body machine interfaces (BoMIs) empower people with sever motor disabilities with the ability to control an external device, but they also offer the opportunity to focus concurrently on achieving rehabilitative goals. In this study we developed a portable, and low-cost BoMI that addresses both problems. The BoMI remaps the user's residual upper body mobility to the two coordinates of a cursor on a computer monitor. By controlling the cursor, the user can perform functional tasks, such as entering text and playing games. This framework also allows the mapping between the body and the cursor space to be modified, gradually challenging the user to exercise more impaired movements. With this approach, we were able to change the behavior of our SCI subject, who initially used almost exclusively his less impaired degrees of freedom - on the left side - for controlling the BoMI. At the end of the few practice sessions he had restored symmetry between left and right side of the body, with an increase of mobility and strength of all the degrees of freedom involved in the control of the interface. This is the first proof of concept that our BoMI can be used to control assistive devices and reach specific rehabilitative goals simultaneously.
Agbara, Rowland; Goetze, Elizabeth; Koch, Felix; Wagner, Wilfred
The functional and esthetic rehabilitation of patients with atrophic maxilla or posterior maxillary defect is often challenging. The aim of this study was to determine patient demographics, indications, success rate, and complications following the use of zygoma implants. All patients who had zygoma implant placement in our clinic between 1998 and 2013 were retrospectively assessed for implant outcome. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 16 and Microsoft Excel 2007 test for significance (ρ) using Pearson's Chi-square (χ 2 ) set at 0.05. A total of 28 patients consisting of 22 females (78.6%) and 6 males (21.4%) were treated, and their age ranged from 41 years to 83 years with a mean age of 60.3 ± 10.6 years. The main indication for zygoma implant placement was atrophic maxilla 12 (42.9%). In the prosthetic rehabilitation of the patients, 2 had epithetic prostheses, and 2 had obturators while 18 patients had conventional removable dental prostheses. Four patients (14.3%) had perimplantitis and one implant was accidentally placed into the maxillary sinus. A cumulative success rate of 88.1% was obtained from this retrospective analysis. A cumulative success rate of 88.1% reported in this study is lower than the reports from other studies. The difference in success rates may be related to different criteria for assessment of zygoma implant success and to the difference in inclusion criteria and follow-up period.
Full Text Available Surgical resection of neoplasms or malformations of the face may result in defects that are not amenable to immediate surgical reconstruction. Such defects can have a severe adverse effect on patient perceptions of body image and self-esteem. In these cases, the use of an interim removable facial prosthesis can offer a rapid alternative treatment solution. The patient may then resume social interactions more comfortably while permitting easy access to the facial defect to observe tissue healing while awaiting definitive rehabilitation. This article presents a case report describing the use of interim nasal prostheses to provide rapid patient rehabilitation of facial defects.
Tannure, P N; Moraes, G G; Borba, McU; Abrahão, A; Andrade, Mtrc; Fidalgo, Tks
The aim of this case report is to describe the treatment planning of a young child with severe early childhood caries (S-ECC) as well as the prosthetic rehabilitation technique. A 3-year-old female child was referred to the pediatric dentistry clinic with the chief complaint of tooth pain, difficulty in eating and recurrent hospitalizations caused by dental infections. The mother reported intermittent episodes of fever and recurrent swelling of child's face. The girl presented angular cheilitis and was referred to a dietitian. The treatment plain consisted on a behavior changes in oral hygiene habits, exodontias of all primary teeth and oral rehabilitation with a prosthesis. The extracted teeth with periapical lesions were submitted to histopathologic analysis (hematoxilin and eosin staining) and revealed an inflammatory infiltrate. The aesthetic requirement of children with S-ECC has been a challenge to pediatric dentists. In the present case, the oral rehabilitation provided for the children better aesthetic, nutrition, phonation, and functional conditions.
Burchert, Joanna; Hoeve, Aimée; Kämäräinen, Pekka
This article focuses on two examples of interactive research (IR) in vocational education and training. IR is a process which brings together practitioners and researchers with the aim to implement an innovation. This innovation in the first project meant to create a hybrid learning environment; in the second it supported introducing digital media…
Tielman, K.A.; Brok, den P.J.; Bolhuis, S.M; Vallejo, B.
This research presents a descriptive study regarding collaborative learning in a multicultural classroom at a vocational education school in The Netherlands. The study bridges two domains of research: research on culturally diverse learning environments – which has mostly concerned primary and
Stadler, Adriano; Smith, Anne M. J.
Vocational entrepreneurship education is associated with specific techniques and teaching methods, including face-to-face student contact and knowledge alignment with labour market needs. The authors argue that entrepreneurship education provides particular benefits in different educational conditions and modes because it allows students to…
Saunders, Murray; Sambili, Helen
A survey of Kenyan school leavers (200 responses) and 34 interviews show that the exchange value of school-leaving exams is predominant and the use value of vocational programs has little impact. Apparently, 80% of school effort has actual exchange value for only 20% of school leavers, whereas 20% of effort directed at self-employment has…
Full Text Available Background. Individuals with traumatic brain injury (TBI face many challenges when attempting to return to work (RTW. Vocational evaluation (VE is a systematic process that involves assessment and appraisal of an individual’s current work-related characteristics and abilities. Objective. The aims of this study are to (1 examine demographic and employment characteristics of vocational rehabilitation providers (VRPs, (2 identify the specific evaluation methods that are used in the VE of individuals with TBI, and (3 examine the differences in assessment method practices based upon evaluator assessment preferences. Methods. This exploratory case study used a forty-six-item online survey which was distributed to VRPs. Results. One hundred and nine VRPs accessed the survey. Of these, 74 completed the survey. A majority of respondents were female (79.7%, Caucasian (71.6%, and holding a master’s degree (74.3%, and more than half (56.8% were employed as state vocational rehabilitation counselors (VRCs. In addition, over two-thirds (67.6% were certified rehabilitation counselors (CRCs. Respondents reported using several specific tools and assessments during the VE process. Conclusions. Study findings reveal differences in use of and rationales for specific assessments amongst VRPs. Understanding VRP assessment practices and use of an evidence-based framework for VE following TBI may inform and improve VE practice.
Dillahunt-Aspillaga, Christina; Jorgensen Smith, Tammy; Hanson, Ardis; Ehlke, Sarah; Stergiou-Kita, Mary; Dixon, Charlotte G; Quichocho, Davina
Individuals with traumatic brain injury (TBI) face many challenges when attempting to return to work (RTW). Vocational evaluation (VE) is a systematic process that involves assessment and appraisal of an individual's current work-related characteristics and abilities. The aims of this study are to (1) examine demographic and employment characteristics of vocational rehabilitation providers (VRPs), (2) identify the specific evaluation methods that are used in the VE of individuals with TBI, and (3) examine the differences in assessment method practices based upon evaluator assessment preferences. This exploratory case study used a forty-six-item online survey which was distributed to VRPs. One hundred and nine VRPs accessed the survey. Of these, 74 completed the survey. A majority of respondents were female (79.7%), Caucasian (71.6%), and holding a master's degree (74.3%), and more than half (56.8%) were employed as state vocational rehabilitation counselors (VRCs). In addition, over two-thirds (67.6%) were certified rehabilitation counselors (CRCs). Respondents reported using several specific tools and assessments during the VE process. Study findings reveal differences in use of and rationales for specific assessments amongst VRPs. Understanding VRP assessment practices and use of an evidence-based framework for VE following TBI may inform and improve VE practice.
Full Text Available Inflammation of oral mucosa induced by anti neoplastic drugs is an important, dose limiting and costly side effect of cancer therapy. Here is presented an exacerbated case of oral mucositis associated with renal failure in a patient who underwent bone marrow transplantation. The clinical aspects and an integrated rehabilitation program are discussed below.
Jade PY Ho
Full Text Available We present a case of chronic acromioclavicular joint dislocation (Rockwood type 5 in which the choice of acromioclavicular reconstruction using autogenous semitendinosus tendon graft was made due to its superiority in anatomical reconstruction of the coracoclavicular ligaments, and the impact of postoperative rehabilitation on the recovery of this patient. We also discuss the rationale behind this.
Cornelius, Floyd C.; Muth, Kenneth M.; Kenyon, Roger
Native lake trout (Salvelinus namaycush) once thrived in the deep waters of eastern Lake Erie. The impact of nearly 70 years of unregulated exploitation and over 100 years of progressively severe cultural eutrophication resulted in the elimination of lake trout stocks by 1950. Early attempts to restore lake trout by stocking were unsuccessful in establishing a self-sustaining population. In the early 1980s, New York's Department of Environmental Conservation, Pennsylvania's Fish and Boat Commission, and the U.S. Fish and Wildlife Service entered into a cooperative program to rehabilitate lake trout in the eastern basin of Lake Erie. After 11 years of stocking selected strains of lake trout in U.S. waters, followed by effective sea lamprey control, lake trout appear to be successfully recolonizing their native habitat. Adult stocks have built up significantly and are expanding their range in the lake. Preliminary investigations suggest that lake trout reproductive habitat is still adequate for natural reproduction, but natural recruitment has not been documented. Future assessments will be directed toward evaluation of spawning success and tracking age-class cohorts as they move through the fishery.
Salvatore, Serena; Librando, Aloisa; Esposito, Mariacristina; Vingolo, Enzo M
To evaluate the usefulness of acoustic biofeedback by means of Mozart's Sonata for Two Pianos in D Major K. 448 to maintain and/or restore visual performance in a patient with macular pucker and glaucoma. A 74-year-old patient with open angle glaucoma in both eyes and macular pucker in the right eye (RE) underwent visual rehabilitation with acoustic biofeedback by means of the MAIA™ Vision Training Module (Centervue, Padova, Italy) 10 minutes each eye once a week for 5 weeks. The patient was asked to move his eyes according to a sound which changed into Mozart's Sonata for Two Pianos when the patient locked the fixation target. Best-corrected visual acuity improved in his right eye (RE) and was stable in the left eye (LE). Fixation stability improved in both eyes, and retinal sensitivity decreased in the RE and improved in the LE. The characteristic of the macular pucker did not change during the training as demonstrated with optical coherence tomography. The patient was very satisfied with the training, as demonstrated by a 25-item questionnaire (National Eye Institute - Visual Functioning Questionnaire, NEI-VFQ-25). The patient's reading speed and the character size which he was able to read improved in his RE. Music could enhance synaptic plasticity and affect neural learning and fixation training by means of MAIA vision training. Therefore it can improve visual performance in patients with macular pucker, postpone the surgical time, and assure a better quality of life for the patient.
Full Text Available Hemorrhagic transformation (HT may occur as a part of the natural history of acute ischemic stroke, with incidence between 13-43% in computer-tomography (CT studies. Detection of HT in a patient with ischemic stroke is important in establishing treatment in the acute phase in assessing prognosis and in taking therapeutical decisions for secondary stroke prevention. There were controversies regarding optimal treatment in acute ischemic stroke with HT, especially if the patient needs further anticoagulant or antiplatelet treatment. Rehabilitation treatment needs to be continued for post-stroke patients who developed HT, because HT does not decrease rehabilitation outcome. We present rehabilitation treatment and prognosis in a case of hemorrhagic transformation after an embolic ischemic stroke treated with anticoagulants, which required reinitiation of anticoagulant treatment.
Roxana Oana Darabont
Full Text Available Romania has one of the highest mortality rates in Europe for ischemic heart disease and, especially, for cerebrovascular disease. Taking into account the actual prevalence of cardiovascular diseases, an augmentation of the demand for specialized medical services is expected. As this paper argues, this situation can have an important impact on medical tourism. We analyze original data on the case study of a hospital, specialized in cardiovascular treatment, in the Romanian county of Covasna, which is offering specific balneal procedures, such as CO2 .hydrotherapy, alongside regular rehabilitation programs. The aim of our study is to evaluate the demographic characteristics, and the pathology of the hospitalized patients, as well as the specific rehabilitation procedures. Our findings suggest that the interest of patients, with cardiovascular diseases, for medical tourism can be influenced by accessibility, by some particularities of the location, but also by the holistic nature of the rehabilitation procedures.
Landi, Luca; Piccinelli, Stefano; Raia, Roberto; Marinotti, Fabio; Manicone, Paolo Francesco
Treatment of complex perioprosthetic cases is one of the clinical challenges of everyday practice. Only a complete and thorough diagnostic setup may allow the clinician to formulate a realistic prognosis to select the abutments to support prosthetic rehabilitation. Clinical, radiographic, or laboratory parameters used separately are useless to correctly assign a reliable prognosis to single teeth except in the case of a clearly hopeless tooth. Therefore, it is crucial to gather the greatest quantity of data to determine the role that every single element can play in the prosthetic rehabilitation of the case. The following report deals with the management of a multidisciplinary periodontally compromised case in which a treatment strategy and chronology were designed to reach clinical predictability while reducing the duration of the therapy.
Full Text Available Treatment of complex perioprosthetic cases is one of the clinical challenges of everyday practice. Only a complete and thorough diagnostic setup may allow the clinician to formulate a realistic prognosis to select the abutments to support prosthetic rehabilitation. Clinical, radiographic, or laboratory parameters used separately are useless to correctly assign a reliable prognosis to single teeth except in the case of a clearly hopeless tooth. Therefore, it is crucial to gather the greatest quantity of data to determine the role that every single element can play in the prosthetic rehabilitation of the case. The following report deals with the management of a multidisciplinary periodontally compromised case in which a treatment strategy and chronology were designed to reach clinical predictability while reducing the duration of the therapy.
Pajaczkowski, Jason A
Objective To present the epidemiology, etiology, diagnostic criteria and therapeutic interventions for an important clinical entity – tibiofibular syndesmosis or “high ankle” sprains. Clinical Features The most common mechanism of injury is forced external rotation in a dorsiflexed foot. Pain is located anteriorly over the anterior tibiofibular ligament, and is elicited through a variety of tests designed to stress this articulation through diastatic forces. Pain with ambulation is typical, and is usually present during the push-off phase of gait. Radiographs may be useful in determining the extent of this injury, as syndesmotic sprains with malleolar fractures are more common than those without. Intervention and Outcome Convalescence is generally protracted compared with a lateral ankle sprain, and care must be taken to avoid stressing the supporting ligaments during the early course of therapy. Initial treatment is aimed at reducing pain and inflammation using modalities such as microcurrent, electroacupuncture and P.R.I.C.E. principles. Treatment over subsequent weeks involves progressive resistance exercises, proprioceptive challenges, plyometric exercises and sport-specific agility drills, while maintaining cardiovascular fitness. Conclusion The practitioner should also be cognizant of the indolent nature of this injury and possibility for sequelae. Anterior ankle pain and pain with a deep squat or during the push-off phase of gait are typical of this injury. Radiographs to rule out fracture and evaluate the extent of the injury may be warranted. Conservative therapy involving rehabilitation and tissue injury care is appropriate for Grade I and II injuries, while Grade III injuries require a surgical intervention. PMID:17657290
Full Text Available Serena Salvatore, Aloisa Librando, Mariacristina Esposito, Enzo M VingoloDepartment of Ophthalmology, University La Sapienza, Polo Pontino, Alfredo Fiorini Hospital, Terracina, ItalyPurpose: To evaluate the usefulness of acoustic biofeedback by means of Mozart’s Sonata for Two Pianos in D Major K. 448 to maintain and/or restore visual performance in a patient with macular pucker and glaucoma.Methods: A 74-year-old patient with open angle glaucoma in both eyes and macular pucker in the right eye (RE underwent visual rehabilitation with acoustic biofeedback by means of the MAIA™ Vision Training Module (Centervue, Padova, Italy 10 minutes each eye once a week for 5 weeks. The patient was asked to move his eyes according to a sound which changed into Mozart’s Sonata for Two Pianos when the patient locked the fixation target.Results: Best-corrected visual acuity improved in his right eye (RE and was stable in the left eye (LE. Fixation stability improved in both eyes, and retinal sensitivity decreased in the RE and improved in the LE. The characteristic of the macular pucker did not change during the training as demonstrated with optical coherence tomography. The patient was very satisfied with the training, as demonstrated by a 25-item questionnaire (National Eye Institute – Visual Functioning Questionnaire, NEI-VFQ-25. The patient’s reading speed and the character size which he was able to read improved in his RE.Conclusion: Music could enhance synaptic plasticity and affect neural learning and fixation training by means of MAIA vision training. Therefore it can improve visual performance in patients with macular pucker, postpone the surgical time, and assure a better quality of life for the patient.Keywords: glaucoma, macular cellophane, music, vision training
Evensen, Stig; Ueland, Torill; Lystad, June Ullevoldsæter; Bull, Helen; Klungsøyr, Ole; Martinsen, Egil W; Falkum, Erik
Employment is an important part of recovery for individuals with schizophrenia. The employment rate for this group is as low as 10% in Norway, and major system related barriers to employment are evident. This study reports the competitive employment outcome at 2-year follow-up of a vocational rehabilitation study augmented with cognitive remediation (CR) or elements from cognitive behaviour therapy (CBT) for individuals with schizophrenia spectrum disorders. It also investigates if global functioning, self-esteem, and depression at baseline predicts employment outcome, and if change in these variables during the intervention period is associated with employment outcome. One hundred and forty-eight participants with schizophrenia spectrum disorders in six Norwegian counties received 10 months vocational rehabilitation augmented with either CBT (n = 84) or CR (n = 64). Both competitive and sheltered workplaces were used. Participants were assessed at baseline, at the end of the intervention period, and at 2-year follow-up. At 2-year follow-up, 21.2% had obtained competitive employment. A further 25.3% had work placements in competitive workplaces. Significant improvements were found in global functioning, self-esteem, and depression during the intervention period, but no significant differences between the two intervention groups. High baseline global functioning and self-esteem, as well as positive change in these variables during the intervention period, were significantly associated with higher competitive employment outcome at 2-year follow-up. The results add to existing evidence that competitive employment is attainable for individuals with schizophrenia. High global functioning and self-esteem were strongly associated with competitive employment outcome.
Blackstone Valley Regional Vocational School District, Upton, MA.
A project was conducted to bridge the gap between the coneptualized model of vocational evaluation within a rehabilitation framework and the needs of a changing career development model within an educational setting. The project focus was on ascertaining the state of the art of vocational assessment of special needs individuals, then building a…
Guilbert, Alma; Clément, Sylvain; Moroni, Christine
Two major limitations of unilateral spatial neglect (USN) rehabilitation methods are actually reported: a lack of long-term efficiency and a lack of generalization to daily life. The aim of our case study was to underline how a multisensory method-music practice-could avoid these limitations. Mrs BV suffered from a chronic severe USN. She had rehabilitation sessions of music practice over 8 weeks. An improvement of her USN was found on paper-pencil tests but also in daily activities. Benefits subsisted 4 months after rehabilitation. Music practice seemed to avoid the major limitations of USN rehabilitations and could represent a promising tool.
... absolute priorities, one competitive preference priority, and one invitational priority. In order to... priority and Absolute Priority 1. This priority is: Partnership with the State Vocational Rehabilitation... knowledge of students of the role and responsibilities of the vocational rehabilitation (VR) counselor and...
This work presents results obtained from a case study conducted on M’kam neighborhood (600 housing social city) in Laghouat, Algeria. The bloc (J) in this location, suffering from damages that are attributed to the expansive clayey soil interaction with sewage disposal under foundations was the subject of rehabilitation in this study. The principal causes of observed structural damages were studied through diagnostic expertise (inspection-evaluation process) of the cracks and sewage dispo...
Raeburn, Toby; Schmied, Virginia; Hungerford, Catherine; Cleary, Michelle
Psychosocial Clubhouses provide recovery-focused psychosocial rehabilitation to people with serious mental illness at over 300 sites in more than 30 countries worldwide. To deliver the services involved, Clubhouses employ a complex mix of theory, programs and relationships, with this complexity presenting a number of challenges to those undertaking Clubhouse research. This paper provides an overview of the usefulness of case study designs for Clubhouse researchers; and suggests ways in which the evaluation of Clubhouse models can be facilitated. The paper begins by providing a brief explanation of the Clubhouse model of psychosocial rehabilitation, and the need for ongoing evaluation of the services delivered. This explanation is followed by an introduction to case study design, with consideration given to the way in which case studies have been used in past Clubhouse research. It is posited that case study design provides a methodological framework that supports the analysis of either quantitative, qualitative or a mixture of both types of data to investigate complex phenomena in their everyday contexts, and thereby support the development of theory. As such, case study approaches to research are well suited to the Clubhouse environment. The paper concludes with recommendations for future Clubhouse researchers who choose to employ a case study design. While the quality of case study research that explores Clubhouses has been variable in the past, if applied in a diligent manner, case study design has a valuable contribution to make in future Clubhouse research.
Wang, Jie; Xu, Fenghua
Using the Wuling Mountain area as a case study, the authors discuss the significance as well as five problems of developing information technology for vocational education in contiguous destitute areas. Recommendations are provided at the end of the article. [Translated by Michelle LeSourd.
Goh, Adeline Yuen Sze
This article about workplace learning examines the learning of individuals in becoming a Vocational and Technical Education (VTE) teacher in Brunei. Drawing on research findings from a group of student teachers, it presents case study accounts of three individuals to illustrate the importance of social relationships in learning to become a VTE…
Schreiber, Martin J.
The purpose of this case study explores the impact of an immersion experience to a least developed country on the vocation of lay teacher leaders in American Jesuit High Schools. Nine lay teacher leaders engaged in a four stage process of immersion from November 2009 to August 2010. The study employed the conceptual framework of Edward…
Case management in oncology rehabilitation (CAMON: The effect of case management on the quality of life in patients with cancer after one year of ambulant rehabilitation. A study protocol for a randomized controlled clinical trial in oncology rehabilitation
Full Text Available Abstract Background Cancer diseases and their therapies have negative effects on the quality of life. The aim of this study is to assess the effectiveness of case management in a sample of oncological outpatients with the intent of rehabilitation after cancer treatment. Case management wants to support the complex information needs of the patients in addition to the segmented structure of the health care system. Emphasis is put on support for self-management in order to enhance health - conscious behaviour, learning to deal with the burden of the illness and providing the opportunity for regular contacts with care providers. We present a study protocol to investigate the efficacy of a case management in patients following oncology rehabilitation after cancer treatment. Methods The trial is a multicentre, two-arm randomised controlled study. Patients are randomised parallel in either 'usual care' plus case management or 'usual care' alone. Patients with all types of cancer can be included in the study, if they have completed the therapy with chemo- and/or radiotherapy/surgery with curative intention and are expected to have a survival time >1 year. To determine the health-related quality of life the general questionnaire FACT G is used. The direct correlation between self-management and perceived self-efficacy is measured with the Jerusalem & Schwarzer questionnaire. Patients satisfaction with the care received is measured using the Patient Assessment of Chronic Illness Care 5 As (PACIC-5A. Data are collected at the beginning of the trial and after 3, 6 and 12 months. The power analysis revealed a sample size of 102 patients. The recruitment of the centres began in 2009. The inclusion of patients began in May 2010. Discussion Case management has proved to be effective regarding quality of life of patients with chronic diseases. When it comes to oncology, case management is mainly used in cancer treatment, but it is not yet common in the
Full Text Available Vertigo and dizziness are common symptoms in the general population. While the clinical picture is well known and widely described, there are different interpretations of Benign Paroxysmal Positional Vertigo. The purpose of this case report was to describe the treatment of a 56 year old woman with complains of positional vertigo for 35 consecutive years. She suffered from a sudden onset of rotatory, unilateral horizontal canal type benign paroxysmal positional vertigo (BPPV. The symtoms started a day after falling from a bus, where she injured her head. Otherwise her medical history was unremarkable. She was treated with an individualized home exercise program of eye movement exercises, Brandt/Daroff exercises, and general conditioning exercises (i.e., laying on the left side from sitting on the bed, while the head rotated 45 degrees to the right, waiting for about one minue; twice a day on gradual basis, not laying on the side all the way, but to use enough pillows to lay about at 60 degrees. Four weeks from the start of physical therapy, the patient was free of symptoms, even when her neck was in the extended position.
Dianna Ramírez Prada
Full Text Available Case: The objective is to present the successful experience of multidisciplinary management of a patient with short bowel syndrome and intestinal failure with progression to intestinal adaptation. This is a newly born premature with intestinal atresia type IV with multiple intestinal atresia who evolved to intestinal failure and required managed with prolonged parenteral nutritional support, multiple antibiotic schemes, prebiotics, multivitamins, enteral nutrition with elemental formula to achieve their adaptation intestinal until lead to a normal diet. The evolution of these patients intestinal failure is a challenge for the health team, as it not only involves the surgical management of your condition if not basic nutritional support, fluid and electrolyte balance, hepatic dysfunction cholestasis associated infections etc. Discussion: Short bowel syndrome with progression to intestinal failure in children is a condition whose prevalence is increasing worldwide, thanks to advances in neonatal intensive care, neonatal surgery, and nutritional support of patients with conditions such as gastroschisis, omphalocele and necrotizing enterocolitis. Despite the limitations of our health system, it is possible to offer a multidisciplinary and integrated to lead to intestinal adaptation treatment.
Full Text Available A 32-year-old male diagnosed with transverse myelitis in 2013 came to our clinic in 2015 with complaints of paraplegia, sensory disturbances, pain, exertional dyspnea, poor quality of sleep, emotional instability, and depression. This was a recurrent attack that had been exacerbated by post-traumatic stress. Owing to pain and functional disabilities, he was struggling to actively participate in the treatment modalities offered at our center. A modified protocol of electroacupuncture was planned for a period of 21 days, every day, with each session lasting for 30 minutes. Assessments based on the brief version of World Health Organization Brief Quality of Life (WHO Brief QOL questionnaire, Pittsburgh sleep quality index, visual analog scale, and a disease-specific physical examination showed momentous improvement in functional health status as well as mental well-being. The quality of life showed significant improvement particularly in the physical and psychological dimensions of WHO Brief QOL. The patient reported a reduction in pain, dyspnea, and fatigue accompanied by an improvement in the quality of sleep and mood. This case report suggests that acupuncture can play a vital role in amelioration of symptoms, thereby improving the health status in patients with transverse myelitis.
Full Text Available Objective: to present the effectiveness of pulmonary rehabilitation programs in the treatment of a patient with asthma. Case: this is the case of a young Caucasian girl —17 years old— with severe asthma diagnosis, with symptoms since she was eight years old, 10th grade student. She was referred to the program of Pulmonary Rehabilitation after three hospitalizations during the last year due to asthmatic crises, dyspnoea in activities of daily living, and intolerance to physical exercise. In the initial evaluation, a patient with non-controlled asthma was found; she was receiving short-acting medication admitting that she was not complying with regular use and with a prescribed dose of the pharmacological treatment and that she ignored the importance of this commitment for optimal evolution. The patient expressed concern about the progressive deterioration at her respiratory and functional level during the last year and her fear and anxiety for not being able to breathe during activities befitting her age. One month after receiving bronchodilators and long-acting steroids permanently and complying with recommendations about regular use and adequate inhalatory technique, the patient was included in a three-timesa-week program of pulmonary rehabilitation during eight weeks for upper and lower extremity endurance and resistance training. This intervention showed significant changes in the patient at functional level and a greater social participation.
Full Text Available Background: Prosthetic reconstruction of partial maxillectomy defects is a challenging procedure that requires multidisciplinary expertise to achieve an acceptable function, speech and esthetics. This procedure improves the quality of life for the patient as a normal individual. Obturation of the defect depends on its volume and position of remaining hard and soft tissues which determine the retention, stability and support for the prosthesis. The prosthesis should be simple to handle, easy to maintain, biocompatible, light in weight and convenient for future adjustments. This case report describes a clinical case of partial maxillectomy which was successfully rehabilitated with a definitive closed hollow bulb obturator and cast metal denture base.
Sprong, Matthew Evan; Dallas, Bryan; Paul, Erina; Xia, Michelle
The primary goal of the study was to evaluate how the use of rehabilitation technology impacted closure status for consumers receiving services in fiscal year (FY) 2014. Rehabilitation Service Administration (RSA-911) Case Service Report FY 2014 archival dataset was obtained from the U.S. Department of Education (2014) and secondary analyses was performed for this study. RSA-911 archival data is updated on an annual basis and consists of all state-federal rehabilitation consumers who were served in the specific fiscal year. The dataset contains information related to each consumer's demographic information (e.g. age, gender, race) and other supplemental information (e.g. weekly earnings at closure, cause of disability, services provided). A multiple logistic regression analysis was utilized and revealed that white consumers receiving rehabilitation technology (RT) services have significantly higher closure rate than consumers of other races, RT services differ by the employment status at application, RT services differ by the type of disability, educational level at application for people receiving RT services did predict closure status (i.e. exiting with an employment outcome), IEP status did not predict closure status, weekly earnings at application did predict closure status and the interaction effect between IEP and RT services is statistically significant. The odds ratio (ORs) were presented at the 95% confidence interval (CI). Vocational rehabilitation counselors needs training to correctly identify appropriate RT services for consumers, so that the likelihood of exiting with an employment outcome is obtained. Implications for Rehabilitation RT services significantly improved their chances of successful employment compared to those who did not receive RT services. Education at closure would also have some significant impact on employment outcomes. Training in Assistive Technology (AT) for Vocational Rehabilitation counselors will assist in the proper
Reid, Christine; Riddick-Grisham, Susan
Abstract INTRODUCTION: The importance of work or productive activity for the well-being, community integration, and quality of life of people living with disabilities is addressed, with implications for life care planning and case management. BACKGROUND: The role of work or productive activity in our society, and consequences of deprivation if rehabilitation services do not address vocational effects of disabilities, is explored. A continuum of productivity options is introduced; types of vocational rehabilitation assessment processes and interventions are described. PURPOSE: The role of vocational rehabilitation services in life care planning and case management is discussed, focusing on quality of life for people living with disabilities. CONCLUSION: Rehabilitation and health care professionals should understand the importance of work or other productive activity, and support the development of appropriate plans to address those needs among people who have disabilities. PMID:26409330
Reid, Christine; Riddick-Grisham, Susan
The importance of work or productive activity for the well-being, community integration, and quality of life of people living with disabilities is addressed, with implications for life care planning and case management. The role of work or productive activity in our society, and consequences of deprivation if rehabilitation services do not address vocational effects of disabilities, is explored. A continuum of productivity options is introduced; types of vocational rehabilitation assessment processes and interventions are described. The role of vocational rehabilitation services in life care planning and case management is discussed, focusing on quality of life for people living with disabilities. Rehabilitation and health care professionals should understand the importance of work or other productive activity, and support the development of appropriate plans to address those needs among people who have disabilities.
Wu, Juan; Cheng, Shuiping; Li, Zhu; Guo, Weijie; Zhong, Fei; Yin, Daqiang
In the past three decades, the fast development of economy and urbanization has caused increasingly severe pollutions of urban water bodies in China. Consequently, eutrophication and deterioration of aquatic ecosystem, which is especially significant for aquatic vegetation, inevitably became a pervasive problem across the Yangtze River Basin. To rehabilitate the degraded urban water bodies, vegetation replanting is an important issue to improve water quality and to rehabilitate ecosystem. As a case study, a representative polluted urban river, Nanfeihe River, in Hefei City, Anhui Province, was chosen to be a rehabilitation target. In October 2009 and May 2010, 13 species of indigenous and prevalent macrophytes, including seven species emergent, one species floating leaved, and five species submersed macrophytes, were planted along the bank slopes and in the river. Through 1.5 years' replanting practice, the water quality and biodiversity of the river had been improved. The concentrations of total nitrogen (TN), total phosphorus (TP), and ammonia nitrogen (NH4 (+)-N) declined by 46.0, 39.5, and 60.4 %, respectively. The species of macrophytes increased from 14 to 60, and the biodiversity of phytoplankton rose significantly in the river (purban waters restoration in the middle-downstream area of Yangtze River Base.
Full Text Available This paper explores the relationship between the indicators and different factors that “rating systems for green projects” concentrates on, and principles and factors considered in the rehabilitation of historical buildings. In recent years, different methods and systems concerned and improved for assessing environmental sustainability. LEED (Leadership in Energy and Environmental Design and BREEAM (Building Research Establishment (BRE Environmental Assessment Method are two most commonly used rating systems, established in U.S and UK. These systems comprise some categories and different factors to achieve environmentally responsible design. Firstly, this study focuses on the list of rating systems indicators and criteria. Secondly this paper investigates a historical rehabilitated building in the site of Tabriz Art University, as a case study and has tried to compile its green design elements. Finally, this work intends to compare mentioned elements with indicators and factors of building rating systems. Findings of the study revealed that “Materials and Resources”, “indoor environmental quality” and also “Sustainable Sites” ,the most significant indicator of rating systems, had major and important role in the rehabilitation of the building. Beyond this materials’ life cycle was considerable in construction.
Angleena Y Daniel
Full Text Available The surgical management of maxillary pathosis results in direct communication between the oral and nasal cavity, imposing problems such as nasal regurgitation, unintelligent speech, difficulty in deglutition and compromised esthetics. A restoration of these defects is not always possible surgically, but prosthetic rehabilitation is an established treatment modality. Early rehabilitation can improve the quality of life and reduce the psychological trauma caused by surgical excision. Surgical and interim obturators placed during the initial phase can improve the outcome of the definitive prosthesis. This article presents a case report of a patient with partial maxillectomy who has been rehabilitated with a delayed surgical and an interim obturator.
Quintanilha, Luís Eduardo Lavigne Paranhos; Carneiro-Campos, Luís Eduardo; Antunes, Lívia Azeredo Alves; Antunes, Leonardo Santos; Fernandes, Claudio Pinheiro; Abreu, Fernanda Volpe
Hypohidrotic ectodermal dysplasia (HED) is a rare ectodermal disease with a systemic expression. Oral abnormalities are common and may include hypodontia and shape irregularities in the primary and permanent dentitions. Rehabilitation of the dental arches in pediatric patients with HED is a challenge because HED is a multifactorial disease that demands a complicated treatment approach and most dentists have limited experience or training in the necessary treatment. In addition, pediatric patients often lack the patience or ability to cooperate with complex prosthetic treatment. This case report describes a simplified technique used to fabricate complete dentures for a 4-year-old HED patient in 4 sessions.
... Employment Under 38 U.S.C. Chapter 31 Rehabilitation Research and Special Projects § 21.390 Rehabilitation... purpose of advancing the knowledge, methods, techniques, and resources available for use in rehabilitation...(b)) (c) Research by Vocational Rehabilitation and Employment (VR&E) staff members. VA will encourage...
... Vocational Rehabilation Panel, determine whether such a course is in the best interest of the eligible person... interest. (3) Both the counseling psychologist and the Vocational Rehabilitation Panel will assist in... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Specialized vocational...
Stodden, Robert A.
The present state of the art of vocational evaluation is largely manifested within the field of vocational rehabilitation, and as a result, the concepts, instrumentation, and strategies do not lend themselves readily to an educational setting. This project attempted to bridge the gap between the conceptualized model of vocational evaluation within…
Systematic co-operation between employer, occupational health service and social insurance office: a 6-year follow-up of vocational rehabilitation for people on sick-leave, including economic benefits.
Kärrholm, Jenny; Ekholm, Karolina; Ekholm, Jan; Bergroth, Alf; Ekholm, Kristina Schüldt
To evaluate the effects of systematic co-operation among municipal employees on the number of sick-leave days per month and the type of benefit granted by the Social Insurance Office. A further aim was to evaluate the economic consequences for society. A 6-year follow-up study with a matched-pairs design. Days on sick-leave were calculated for each subject one year before the intervention started and yearly for the following 6-year period. Statistical mixed-model analysis was used. The economic benefit of the intervention was estimated as the increased production stemming from fewer days on sick-leave. Sixty-four employees on long-term sick-leave were individually matched with controls from another Social Insurance Office in a county with a socioeconomic structure similar to that of the study group. The study group had 5.7 fewer days on sick-leave per month and person over the 6-year period (p=0.003). The estimated average economic benefit of the intervention was euro36,600 per person over the 6-year period. In conclusion, those who received systematic co-operation in vocational rehabilitation had fewer days on sick-leave than their "treatment-as-usual" peers. This effect persisted over 6 years, generating substantial net economic gains for society.
Kukla, Marina; Whitesel, Frankie; Lysaker, Paul H
This case study illustrates the use of a long-term integrative psychotherapy approach with a middle- aged man with chronic schizophrenia and a mood disorder. The case of "Holst" describes a man with a history of insecure attachment and trauma who later went on to contract a serious chronic illness, precipitating the onset of psychotic symptoms, depression, and chronic suicidal ideation, resulting in multiple hospitalizations. Combining metacognition-oriented therapy with elements of cognitive behavioral therapy and psychiatric rehabilitation, this approach fostered significantly improved community functioning and attainment of personal goals over time. Through the journey of therapy, the patient also developed a more coherent narrative about his life, established a stable sense of self, and became an active agent in the world. This case illustration demonstrates that these three different approaches can be used in a sequential and complementary fashion to foster recovery in the midst of serious physical and mental illness. © 2015 Wiley Periodicals, Inc.
Thalji, Ghadeer N; Cooper, Lyndon F
Dental agenesis is a common developmental anomaly among human populations. It presents with varying degrees of severity. Oligodontia present in the permanent dentition may have significant esthetic, psychosocial, as well as functional implications. A case of oligodontia in an adolescent patient treated with conventional overdentures is presented in this article. A thorough medical and dental history were taken. Comprehensive clinical and radiographic examinations were made. Diagnostic casts were mounted. The prosthetic denture teeth were set and followed by esthetic and phonetic evaluation. Following approval by the patient, the overdentures were processed in heat cure resin using the conventional techniques. Good esthetic results were achieved. Patient was satisfied with the final prostheses. Simple prosthodontic solutions can be utilized to aid patients with dental agenesis. These have great implications for the patient's self image. Oligodontias are common. The literature frequently addresses esthetic rehabilitation using fixed prostheses and dental implants. This case report illustrates the value of removable prosthodontic procedures as one approach to fulfilling the requirements of esthetic rehabilitation of a young oligodontia patient.
Oliveira, Leandro Benetti de; Gabrielli, Marisa Aparecida Cabrini; Gabrielli, Mario Francisco Real; Pereira-Filho, Valfrido Antonio Pereira
The objective of this article is to present options of rehabilitation with dental implants in two cases of severely atrophic mandibles (fractures. Two patients who sustained fractures in severely atrophic mandibles with less than 10 mm of bone height were treated by open reduction and internal fixation through a transcervical access. Internal fixation was obtained with 2.4-mm locking reconstruction plates. The first patient presented satisfactory bone height at the area between the mental foramens and after 2 years, received flapless guided implants in the anterior mandible and an immediate protocol prosthesis. The second patient received a tent pole iliac crest autogenous graft after 2 years of fracture treatment and immediate implants. After 5 months, a protocol prosthesis was installed in the second patient. In both cases, the internal fixation followed AO principles for load-bearing osteosynthesis. Both prosthetic devices were Branemark protocol prosthesis. The mandibular reconstruction plates were not removed. Both patients are rehabilitated without complications and satisfied with esthetic and functional results. With the current techniques of internal fixation, grafting, and guided implants, the treatment of atrophic mandible fractures can achieve very good results, which were previously not possible.
Huang, Chun-Hao; Schroeder, E Todd; Powers, Christopher
Patients who have undergone unicompartmental knee arthroplasty (UKA) have been reported to exhibit altered gait 19-25 months post-surgery. The most common gait impairment in this population is inadequate knee flexion and a corresponding decrease in the knee extensor moment during loading response (i.e., quadriceps avoidance). The purpose of this case series was to determine whether incorporation of antigravity treadmill training into a standard physical therapy program can eliminate quadriceps avoidance gait during the early rehabilitation phase following UKA. Four females who underwent UKA were recruited for this study. Participants completed antigravity treadmill training three times per week for 12 weeks in addition to their standard physical therapy program. Instrumented gait analysis was performed at baseline (pre-intervention), week 6 (mid-intervention), and week 12 (post-intervention). We found that peak knee flexion and the peak knee extensor moment during the weight acceptance phase of gait increased to normal values following the 12-week intervention period (14.1 ± 6.5° to 20.6 ± 1.5° and 0.4 ± 0.3 to 0.7 ± 0.2 Nm/kg respectively). The findings of this case series suggest that a standard physical therapy program that incorporates early gait training using an antigravity treadmill may be beneficial in eliminating "quadriceps avoidance" during the early rehabilitation phase following UKA.
Gumieiro, Emne Hammoud; Dib, Luciano Lauria; Jahn, Ricardo Schmitutz; Santos Junior, João Ferreira dos; Nannmark, Ulf; Granström, Gösta; Abrahão, Márcio
Osseointegrated implants have acquired an important role in the prosthetic rehabilitation of patients with craniofacial defects. The main indications are lack of local tissue for autogenous reconstruction, previous reconstruction failure and selection of this technique by the patient. This paper presents a clinical case and discusses indications and advantages of the osseointegrated implant technique for retention of auricular prostheses. Case report, Universidade Federal de São Paulo (UNIFESP). A female patient received three auricular implants after surgical resection of a hemangioma in her left ear. The time taken for osseointegration of the temporal bone was three months. After fabrication of the implant-retained auricular prosthesis, the patient was monitored for 12 months. The clinical parameters evaluated showed good postoperative healing, healthy peri-implant tissue, good hygiene and no loss of implants. Good hygiene combined with thin and immobile peri-implant soft tissues resulted in minimal complications. Craniofacial implant integration appears to be site-dependent; increasing age affects osseointegration in the temporal bone. The frequency of adverse skin reactions in peri-implant tissues is generally low. The surgical technique for rehabilitation using implant-retained auricular prostheses seems to be simple. It is associated with low rates of adverse skin reactions and long-term complications. Prostheses anchored by osseointegrated implants seem to provide better retention than do prostheses supported on spectacle frames, less risk of discoloration through the use of adhesives and better esthetic results than do prostheses anchored in the surgical cavity.
Kellett, David; Mpofu, Elias; Madden, Richard
This study describes a case formulation approach applying a prospective ICF derived clinical tool to assess rehabilitation needs for a community dwelling stroke survivor with care from an outpatient rehabilitation medicine clinic. Case history data on the person were assessed for rehabilitation management planning using a prospective tool to interlink current with projected future functional status in everyday settings. Implicit assessment with reflective action informed decision points at each stage of the rehabilitation process. As a result of reflective action using the prospective tool, rehabilitation management led to significant changes in client participation after limitations to mobility and self care were mapped to the living conditions of the stroke survivor. The context sensitive rehabilitative plan resulted in higher subjective health-related quality of life in the stroke survivor and significant other and enhanced their capacity for participation. Reflective action informed assessment applying ICF concepts to clinical problem solving resulted in positive gains in health-related quality of life in a stroke survivor.
Özçakar, L; Franchignoni, F; Frontera, W; Negrini, S
Case reports (CR) have led to the description and discovery of new diseases, syndromes, therapeutic complications or side-effects, and previously unknown potential benefits of pharmacologic agents. CRs may also be used as an effective training strategy for novice authors to develop the skills needed for medical writing. Yet, too often, CRs do not follow standards for excellence in scientific writing. Therefore, in this article, the American Journal of Physical Medicine and Rehabilitation (AJPMR) and the European Journal of Physical and Rehabilitation Medicine (EJPRM) collaborate with the purpose of providing guidance to authors in selecting CRs that might be appropriate for publication. In addition, we discuss different aspects of the preparation of a well-written CR in accordance with the mission and editorial views of both journals.
Ozçakar, Levent; Franchignoni, Franco; Negrini, Stefano; Frontera, Walter
Case reports (CRs) have led to the description and discovery of new diseases, syndromes, therapeutic complications or side effects, and previously unknown potential benefits of pharmacologic agents. CRs may also be used as an effective training strategy for novice authors to develop the skills needed for medical writing. However, too often, CRs do not follow standards for excellence in scientific writing. Therefore, in this article, the American Journal of Physical Medicine & Rehabilitation and the European Journal of Physical and Rehabilitation Medicine collaborate with the purpose of providing guidance to authors in selecting CRs that might be appropriate for publication. In addition, the authors discuss different aspects of the preparation of a well written CR in accordance with the mission and editorial views of both journals.
Lynch, C D
There are reports in the literature of the various dental features of hypophosphatasia, especially where it affects the deciduous dentition. The descriptions include both the manifestations of the disorder and the subsequent patterns of tooth loss. There are fewer descriptions of the effects of hypophosphatasia on the permanent dentition and little information on the subsequent prosthodontic management of these patients, particularly in relation to the use of dental implants. The aim of this paper was to review the literature on the dental effects of hypophosphatasia, present two cases and describe how one of those patients, a young adult, was successfully rehabilitated using dental implants. That latter patient\\'s pattern of tooth loss as well as some histological and scanning electron microscopic findings of root cementum from the other case is also described.
Approaches and Obstacles to the Evaluation of Investment in Continuing Vocational Training: Discussion and Case Studies from Six Member States of the European Union. CEDEFOP Panorama. Discussion Paper/Case Studies.
Grunewald, Uwe; Moraal, Dick; Sorensen, John Houman; Luttringer, Jean-Marie; Pasco, Nicolas; Kohler, Alexander; Barrett, Alan; O'Connell, Philip; Garibaldo, Francesco; Lorenzoni, Stefan; Mandl, Dieter
This report summarizes six case studies on different aspects of the issue of evaluating investing in continuing vocational training (CVT). Part 1 (chapters 1-2) contains "Conceptual Introduction" (Jean-Marie Luttringer), which explores practical problems in considering training expenses as an investment, and "Methodological…
Meena Kumari Mishra
Full Text Available Case description: A 60 year old female patient presented to Department of Prosthodontics, CODS, BPKIHS, Dharan with a chief complain of loose obturator. History revealed that patient had undergone partial maxillectomy for squamous cell carcinoma 7 years back. The patient also has been wearing obturator which was loose when the patient reported to the department. On examination, the site of surgery was the maxillary right buccal sulcus area and a part of the hard palate including teeth number 11, 12, 13, 14, 15, 16, 17. The presented defect situation corresponded to a Class I situation (resection performed along the palatalmidline according to the Aramany classification of defects. The surgical site showed complete healing. A hollow-bulb obturator was fabricated for rehabilitation of the defect. Conclusion: The extensive surgical procedures necessary to eradicate cancer of the head and neck and to prevent local recurrence or regional metastasis often leave extremely large physical defects which present almost insurmountable surgical difficulties in restoring acceptable function or esthetics. The prosthesis rehabilitated the patient in terms of function by providing better masticatory efficiency, phonetics by adding resonance to the voice, hence improving the clarity of speech and also improved the esthetics of the patient. DOI: http://dx.doi.org/10.3126/jcmsn.v10i4.12976 JCMS Nepal 2014; 10(4:32-36
de Souza-e-Silva, Cíntia Maria; Parisotto, Thaís Manzano; Steiner-Oliveira, Carolina; Gavião, Maria Beatriz Duarte; Nobre-Dos-Santos, Marinês
The purpose of the case report was to describe the treatment of a 4(1/2)-year-old boy with amelogenesis imperfect (AI) in the primary dentition. AI is a hereditary condition that affects the development of enamel, causing quantity, structural, and compositional anomalies involving all dentitions. Consequently, the effects can extend to both the primary and secondary dentitions. A 4(1/2)-year-old boy was brought to the dental clinic complaining of tooth hypersensitivity during meals. The medical history and clinical examination were used to arrive at the diagnosis of amelogenesis imperfecta. The treatment was oral rehabilitation of the primary molars with stainless steel crowns and resin-filled celluloid forms of both maxillary and mandibular primary incisors and canines. Improvements in the patient's psychological behavior and the elimination of tooth sensitiveness were observed, and the reestablishment of a normal occlusion resulted in improved eating habits. The child was monitored in the Pediatric Dentistry Clinic at four-month intervals until the mixed dentition stage. The oral rehabilitation of young children with AI is necessary to reestablish the stomatognathic system function, so important for a child's systemic health. An adequate medical history and a careful clinical examination were essential for a correct diagnosis. Treatment was rendered that was appropriate for the child's age and clinical/psychological characteristics. Cost-effective restorative techniques involving stainless steel and composite-resin crowns are shown for the restoration of a young patient with amelogensis imperfecta.
Full Text Available Background: psychological interventions in Cardiac Rehabilitation (CR programs appear relevant in as much they significantly contribute to achieve the goals of rehabilitation, to reduce the risk of relapses and to improve patients’ adherence to therapy. To this aim, Motivational Interviewing (MI has shown promising results in improving motivation to change and individuals’ confidence in their ability to do so. Objective: the purpose of this article is to integrate theory with practice by describing a 3-session case scenario. It illustrates how the use of MI’s skills and strategies can be used to enhance health. MI may be synergistic with other treatment approaches and it is used here in conjunction with Brief Strategic Therapy (BST. Conclusions: by the use of Motivational Interviewing principles and technique, the patient reported an increase in his motivation and ability to change, developing a post discharge plan that incorporates self-care behaviors. Clinical Implications: Motivational Interviewing may be effective in motivating and facilitating health behavior change in patients suffering from heart failure.
Nanninga, Christa S; Postema, Klaas; Schönherr, Marleen C; van Twillert, Sacha; Lettinga, Ant T
There is growing awareness that the poor uptake of evidence in health care is not a knowledge-transfer problem but rather one of knowledge production. This issue calls for re-examination of the evidence produced and assumptions that underpin existing knowledge-to-action (KTA) activities. Accordingly, it has been advocated that KTA studies should treat research knowledge and local practical knowledge with analytical impartiality. The purpose of this case report is to illustrate the complexities in an evidence-informed improvement process of organized stroke care in a local rehabilitation setting. A participatory action approach was used to co-create knowledge and engage local therapists in a 2-way knowledge translation and multidirectional learning process. Evidence regarding rehabilitation stroke units was applied in a straightforward manner, as the setting met the criteria articulated in stroke unit reviews. Evidence on early supported discharge (ESD) could not be directly applied because of differences in target group and implementation environment between the local and reviewed settings. Early supported discharge was tailored to the needs of patients severely affected by stroke admitted to the local rehabilitation stroke unit by combining clinical and home rehabilitation (CCHR). Local therapists welcomed CCHR because it helped them make their task-specific training truly context specific. Key barriers to implementation were travel time, logistical problems, partitioning walls between financing streams, and legislative procedures. Improving local settings with available evidence is not a straightforward application process but rather a matter of searching, logical reasoning, and creatively working with heterogeneous knowledge sources in partnership with different stakeholders. Multiple organizational levels need to be addressed rather than focusing on therapists as sole site of change. © 2015 American Physical Therapy Association.
Sayers, Stephen P.; LaFontaine, Tom; Scheussler, Scott
Background: Complete rupture of the distal tendon of the biceps brachii is relatively rare and there is little information to guide therapists in rehabilitation after this injury. The purposes of this case report are to review the rehabilitation concepts used for treating such an injury, and discuss how to modify exercises during rehabilitation based on patient progression while adhering to physician recommended guidelines and standard treatment protocols. Case Presentation: The patient was an active 38‐year old male experienced in weight‐training. He presented with a surgically repaired right distal biceps tendon following an accident on a trampoline adapted with a bungee suspension harness. The intervention focused on restoring range of motion and strengthening of the supporting muscles of the upper extremity without placing undue stress on the biceps brachii. Outcomes: The patient was able to progress from a moderate restriction in ROM to full AROM two weeks ahead of the physician's post‐operative orders and initiate a re‐strengthening protocol by the eighth week of rehabilitation. At the eighth post‐operative week the patient reported no deficits in functional abilities throughout his normal daily activities with his affected upper extremity. Discussion: The results of this case report strengthen current knowledge regarding physical therapy treatment for a distal biceps tendon repair while at the same time providing new insights for future protocol considerations in active individuals. Most current protocols do not advocate aggressive stretching, AROM, or strengthening of a surgically repaired biceps tendon early in the rehabilitation process due to the fear of a re‐rupture. In the opinion of the authors, if full AROM can be achieved before the 6th week of rehabilitation, initiating a slow transition into light strengthening of the biceps brachii may be possible. Level of evidence: 4‐Single Case report PMID:23316429
Legge, C.; Schwartz, J. [JRS Enginerring LTd., Burnaby, (Canada)
Paloma Cooperative consists of two wood-frame multi-unit residential buildings located in the Commercial Drive area of Vancouver, British Columbia. In 2006, investigations showed that the balconies were severely deteriorated due to water ingress. The complex was deemed to have suffered from a premature building failure. A complete building envelope remediation was necessary. This paper presented the challenges of incorporating energy efficient and sustainable design upgrades during a rehabilitation project, using the Paloma Cooperative as a case study. The various design options, the technical limitations, the financial analysis, the modelling assumptions and the involvement of third party lenders were presented. Initial air-leakage rates were measured and an energy modeling was completed using RETScreen software. Three scenarios were modeled to determine what effect different energy upgrades would have on the energy savings. This paper showed that cost was the biggest challenge faced by the Paloma Cooperative energy upgrade.
Campbell, Karen M
The purpose of this case report was to describe oral findings and outline challenges and considerations for general anesthetic (GA) and dental management of 4-year-old female craniopagus (cranially conjoined) twins, at high risk for medical comorbidity, who presented for treatment of severe early childhood caries. This hospital-based procedure required good interdisciplinary communication, cooperation, and presurgical planning to address unique challenges and ensure positive postoperative outcomes. Two separate anesthesia teams delivered GA simultaneously to each twin. To minimize anesthetic exposure, two pediatric dental teams completed dental care concurrently. Extensive plaque accumulation and unusual "mirror-image" caries distribution were attributed to frequency and postural pooling during feeding. The rehabilitation objective was to provide definitive dental management, minimizing future need for dental retreatment under GA. Two-month follow-up revealed intact dental restorations, good oral hygiene, and weight gain. For these unique twins however, the challenge of long-term oral health maintenance remains.
Full Text Available Objective. The effectiveness of an individualized and everyday approach to cognitive rehabilitation for schizophrenia was examined in a case study. Method. After cognitive and functional assessment, concrete objectives were targeted for the person’s everyday complaints. Strategies were constructed based on an analysis of the cognitive profile, daily life functioning, and processes involved in activities. They included a memory strategy for reading, a diary to compensate memory difficulties, and working memory exercises to improve immediate processing of information when reading and following conversations. Efficacy was assessed with outcome measures. Results. The program had beneficial effects on the person’s cognitive and everyday functioning, which persisted at a 3-year follow-up. Conclusion. Findings provide suggestive evidence that an individualized and everyday approach may be a useful alternative in order to obtain a meaningfully lasting transfer of training to daily life, compared to the nomothetic ones which dominate the field.
Moura, Carmem Dolores Vilarinho Soares de; Pontes, Alessandra Silva; Lopes, Teresinha Soares Pereira; Moura, Lúcia Fátima Almeida de Deus; Lima, Marina Deus Moura de
Amelogenesis imperfecta (AI) is a tooth disorder characterized by the abnormal development of the enamel in response to mutations in the genes involved in amelogenesis. The objective of this article is to present the clinical case of a child with AI in the primary dentition phase. A 4-year-old boy was presented to a clinic by his mother, who complained that her son's smile esthetics were compromised by "weak and yellow teeth." All the teeth showed yellowish discoloration as well as crumbling or missing enamel. Due to the absence of carious lesions and the presence of normal pulp in the teeth, it was decided to restore the dentition with indirect crowns of ceramic-optimized polymer, also known as ceromer. No preparations were performed on the teeth. For this patient, indirect ceromer restorations presented a good treatment option for the rehabilitation of primary teeth affected by AI.
Tarigan, A. P. M.; Rahmad, D.; Sembiring, R. A.; Iskandar, R.
This paper illustrates an application of Analytical Hierarchy Process (AHP) as a potential decision-making method in water resource management related to drainage rehabilitation. The prioritization problem of urban drainage rehabilitation in Medan City due to limited budget is used as a study case. A hierarchical structure is formed for the prioritization criteria and the alternative drainages to be rehabilitated. Based on the AHP, the prioritization criteria are ranked and a descending-order list of drainage is made in order to select the most favorable drainages to have rehabilitation. A sensitivity analysis is then conducted to check the consistency of the final decisions in case of minor changes in judgements. The results of AHP computed manually are compared with that using the software Expert Choice. It is observed that the top three ranked drainages are consistent, and both results of the AHP methods, calculated manually and performed using Expert Choice, are in agreement. It is hoped that the application of the AHP will help the decision-making process by the city government in the problem of urban drainage rehabilitation.
Leticia María Lemus Cruz
Full Text Available Se presenta un caso de un paciente rehabilitado en la consulta de Implantología de la Facultad de Estomatología de Ciudad de La Habana. La historia de la implantología moderna se remonta a principios de los años 60, cuando Per-Ingvar Branemark sienta las bases de la osteointegración y describe los primeros implantes de titanio con forma de tornillo. Aunque antigua, es la prótesis más moderna. Si la meticulosidad es obligada en la elaboración de todo tipo de prótesis, en los trabajos de implantes no se admite el más mínimo fallo, desde la planificación del caso hasta la implantación de la prótesis en boca. Para obtener buenos resultados, las técnicas y los procesos han de observarse escrupulosamente. En nuestra Facultad se ha creado el Grupo de Implantología, que es el encargado de la colocación de implantes y la rehabilitación prótesica de estos. Para ello han sido utilizado diferentes tipos de implantes comercializados y patentizados al nivel mundial. Se reafirma que la rehabilitación sobre implantes mejora la calidad estética y funcional de los pacientes.A case of rehabilitation patient is presented seen in Implantation Science consulting room of Stomatology Faculty of Havana City. History of implantation science dates back to at the beginning of 60s, when Per-Ingvar Branemark creates the bases of bone-integration and to describe the firsts titanium implants in a screw form. Although ancient, it is the more modern prosthesis. If meticulousness if mandatory in elaboration of all type of prosthesis, in implants works it inadmissible the minimum of failure, from the case planning until prosthesis implantation in mouth. To achieve good results, techniques and processes has to be scrupulously observed. In our Faculty it has been created a group of Implantation Science, which is in charge of implants placement, and of the prosthetic rehabilitation of these. Thus, we used different types of marketed and showed at world level. It
Connell, Louise A; McMahon, Naoimh E; Tyson, Sarah F; Watkins, Caroline L; Eng, Janice J
Current approaches to upper limb rehabilitation are not sufficient to drive neural reorganization and maximize recovery after stroke. To address this evidence-practice gap, a knowledge translation intervention using the Behaviour Change Wheel was developed. The intervention involves collaboratively working with stroke therapy teams to change their practice and increase therapy intensity by therapists prescribing supplementary self-directed arm exercise. The purposes of this case series are: (1) to provide an illustrative example of how a research-informed process changed clinical practice and (2) to report on staff members' and patients' perceptions of the utility of the developed intervention. A participatory action research approach was used in 3 stroke rehabilitation units in the United Kingdom. The intervention aimed to change 4 therapist-level behaviors: (1) screening patients for suitability for supplementary self-directed arm exercise, (2) provision of exercises, (3) involving family and caregivers in assisting with exercises, and (4) monitoring and progressing exercises. Data on changes in practice were collected by therapy teams using a bespoke audit tool. Utility of the intervention was explored in qualitative interviews with patients and staff. Components of the intervention were successfully embedded in 2 of the 3 stroke units. At these sites, almost all admitted patients were screened for suitability for supplementary self-directed exercise. Exercises were provided to 77%, 70%, and 88% of suitable patients across the 3 sites. Involving family and caregivers and monitoring and progressing exercises were not performed consistently. This case series is an example of how a rigorous research-informed knowledge translation process resulted in practice change. Research is needed to demonstrate that these changes can translate into increased intensity of upper limb exercise and affect patient outcomes. © 2016 American Physical Therapy Association.
Talaminos-Barroso, Alejandro; Estudillo-Valderrama, Miguel A; Roa, Laura M; Reina-Tosina, Javier; Ortega-Ruiz, Francisco
M2M (Machine-to-Machine) communications represent one of the main pillars of the new paradigm of the Internet of Things (IoT), and is making possible new opportunities for the eHealth business. Nevertheless, the large number of M2M protocols currently available hinders the election of a suitable solution that satisfies the requirements that can demand eHealth applications. In the first place, to develop a tool that provides a benchmarking analysis in order to objectively select among the most relevant M2M protocols for eHealth solutions. In the second place, to validate the tool with a particular use case: the respiratory rehabilitation. A software tool, called Distributed Computing Framework (DFC), has been designed and developed to execute the benchmarking tests and facilitate the deployment in environments with a large number of machines, with independence of the protocol and performance metrics selected. DDS, MQTT, CoAP, JMS, AMQP and XMPP protocols were evaluated considering different specific performance metrics, including CPU usage, memory usage, bandwidth consumption, latency and jitter. The results obtained allowed to validate a case of use: respiratory rehabilitation of chronic obstructive pulmonary disease (COPD) patients in two scenarios with different types of requirement: Home-Based and Ambulatory. The results of the benchmark comparison can guide eHealth developers in the choice of M2M technologies. In this regard, the framework presented is a simple and powerful tool for the deployment of benchmark tests under specific environments and conditions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Emne Hammoud Gumieiro
Full Text Available CONTEXT AND OBJECTIVE: Osseointegrated implants have acquired an important role in the prosthetic rehabilitation of patients with craniofacial defects. The main indications are lack of local tissue for autogenous reconstruction, previous reconstruction failure and selection of this technique by the patient. This paper presents a clinical case and discusses indications and advantages of the osseointegrated implant technique for retention of auricular prostheses. TYPE OF STUDY: Case report, Universidade Federal de São Paulo (UNIFESP. METHODS: A female patient received three auricular implants after surgical resection of a hemangioma in her left ear. The time taken for osseointegration of the temporal bone was three months. After fabrication of the implant-retained auricular prosthesis, the patient was monitored for 12 months. RESULTS: The clinical parameters evaluated showed good postoperative healing, healthy peri-implant tissue, good hygiene and no loss of implants. Good hygiene combined with thin and immobile peri-implant soft tissues resulted in minimal complications. Craniofacial implant integration appears to be site-dependent; increasing age affects osseointegration in the temporal bone. The frequency of adverse skin reactions in peri-implant tissues is generally low. CONCLUSION: The surgical technique for rehabilitation using implant-retained auricular prostheses seems to be simple. It is associated with low rates of adverse skin reactions and long-term complications. Prostheses anchored by osseointegrated implants seem to provide better retention than do prostheses supported on spectacle frames, less risk of discoloration through the use of adhesives and better esthetic results than do prostheses anchored in the surgical cavity
Rubin, Stanford E.; Farley, Roy C.
This guide is the case study manual for the first in a series of instructor-assisted training modules for rehabilitation counselors, supervisors, and graduate students. This typescript manual for the first module focuses on basic intake interviewing skills consisting of: (1) systematic interview programming including attracting, planning and…
Dillon, Laura; Colling, Kyle
This case study of the Therapeutic Community Program at Montana Women's Prison investigates the relationship between inmate reading levels and the self-help materials used for rehabilitative purposes within prison settings. The Therapeutic Community Handbook, published by the Montana Department of Corrections, is used as the primary method of…
Glintborg, Chalotte; Hansen, Tia G B
A severe mental illness like Post Traumatic Stress Disorder (PTSD) is known to have psychosocial consequences that can lead to a decreased quality of life. Research in Animal-Assisted Therapy (AAT) has revealed that the presence of a dog can have a positive effect on health, e.g., increase quality of life and lessen depression and anxiety. However, canine companionship is not a catch-all solution. Previous research has revealed methodological limitations that prohibit any clear conclusions, as well as a sparsity of critical reflection in anecdotal reports and case studies, which means that more research is needed to contextualize the findings. There has been an increasing interest in animal-assisted intervention in Denmark in recent years. Previously, authorities could only grant service dogs to adults with physical disabilities, but now this has been extended to adults with mental illnesses. Therefore, it has become important to explore how these service dogs are incorporated into rehabilitation practices in mental health, and how rehabilitation professionals react to the use of service dogs. This paper is a case study of a person who suffers from PTSD. This study examines how the person describes the significance of having a dog during her rehabilitation process, and how this is integrated with existing rehabilitation. The case study has been developed based on a semi-structured interview. A Thematic Content analysis was used to reveal dominant patterns and categories. This study revealed a lack of communication and collaboration between public administration (social service), service dog providers, health rehabilitation services, and providers of psychological treatment. It also revealed limited access for the dog to public services, limited success in incorporating the dog into goal-directed treatment and rehabilitation procedures, a strongly felt emotional support from the dog, and a perceived stigma by having the dog wearing a vest with he words "mentally ill
case is to emphasize the fact that rehabilitation programs using physical-kinetic therapeutic methods are the only way to limit functional deficit, playing an important role in the long-term management and care of the patient. The particularity of this case consists of the fact that the patient is young, without a known personal pathological history, and symptoms occurred two years after orthopedic surgery, with sudden motor deficit in the lower limbs. The regular follow-up of the patient and his inclusion in complex medical rehabilitation programs in order to limit the functional deficit, increase the autonomy and improve the quality of life of this patient are important. Key words: paraparesis, rehabilitation, spinal meningitis
Balan, I; Calcaterra, R; Lauritano, D; Grecchi, E; Carinci, F
Spiral dental implant (SDI) is an implant with a conical internal helix that confers the characteristic of self-drilling, self-tapping, and self-bone condensing. These proprieties offer better control during insertion of SDI giving a high primary stabilization, even in poor quality bone. A shorter diameter of SDI results in reduced drilling during insertion and consequently less trauma and minimal bone loss. To address the research purpose, the investigators designed a retrospective cohort study. The study population was composed of 25 patients, 11 males and 14 females that have been treated by Dr. Balan with 187 SDI positioned in mandible and into maxilla bone. The implants were placed during the years 2013 to 2014 in Dr. Balan clinic. All patients underwent the same surgical protocol. Several variables are investigated: demographic (age and gender), anatomic (upper/lower jaws and tooth site), implant (length and diameter and type) variables, edentulism (partial or total), and comorbid status of health (i.e.: hypothyroidism, parodontitis, hypertension, diabetes, presence of cancer, heart disease, hepatitis and rheumatologic disease). Pearson Chi-Square test was used to investigate variables and p < 0.05 was considered statistically significant. Statistically it has been shown that females have a higher possibility of unsuccessful respect of male, with a "p value" of 0.014. Another important impact factor for success of implant insertion has been represented by concomitants pathologies: cancer represents the most negative high factor risk with a percentage of unsuccessful of 50%, followed by heart disease (15%), and diabetes (3.7%). SDIs are reliable tools for difficult cases of oral rehabilitation. They have a higher success and survival rate, which means stable results over time. No differences were detected among SDI lengths, implant/crown ratio. In addition, the insertion of SDIs in banked bone can be performed without adverse effects. Finally, flapless and
Miettinen, Sari; Ashorn, Ulla; Lehto, Juhani; Viitanen, Elina
The main purpose of this article is to analyse the institutional and political structures of the Finnish rehabilitation entity and the governmental efforts to improve the governance of the rehabilitation policy. Rehabilitation in Finland is a complex welfare system which has undergone several coordination attempts during the last two decades. The centrality of the coordination of this welfare system is obvious. Based on the content analysis of three Government's rehabilitation reports from 1994 to 2002 and their background papers, this article provides two main findings. First, the rehabilitation entity seems to be based on different funding strategies, different governing and different coordination models between the rehabilitation subsystems. Second, the governance discourse in the reports seems to be unchanging with a predominantly hierarchical mode. The article concludes with a discussion on the challenges to coordinate this kind of a complex welfare system as an entity and also how to overcome those challenges. Copyright © 2010 John Wiley & Sons, Ltd.
Vimal Kantilal Munot
Full Text Available The restoration of normal function and esthetic appearance with a dental prosthesis is a major challenge in the rehabilitation of patients who have lost their teeth and surrounding bone because of surgery for oral cyst or tumor. Rehabilitation with fixed or removable prosthesis is even more challenging when the edentulous span is long and the ridge is defective. Anatomic deformities and unfavorable biomechanics encountered in the region of resection add to the misery. In such situation, a fixed-removable prosthesis allows favorable biomechanical stress distribution along with restoration of esthetics, phonetics, comfort, hygiene, and better postoperative care and maintenance. This article describes rehabilitation of two cases with mandibular defects with an attachment-retained fixed-removable hybrid prosthesis.
Munot, Vimal Kantilal; Nayakar, Ramesh P; Patil, Raghunath
The restoration of normal function and esthetic appearance with a dental prosthesis is a major challenge in the rehabilitation of patients who have lost their teeth and surrounding bone because of surgery for oral cyst or tumor. Rehabilitation with fixed or removable prosthesis is even more challenging when the edentulous span is long and the ridge is defective. Anatomic deformities and unfavorable biomechanics encountered in the region of resection add to the misery. In such situation, a fixed-removable prosthesis allows favorable biomechanical stress distribution along with restoration of esthetics, phonetics, comfort, hygiene, and better postoperative care and maintenance. This article describes rehabilitation of two cases with mandibular defects with an attachment-retained fixed-removable hybrid prosthesis.
Alqahtani, Abdulmuhsen Ayedh; Almutairi, Yousef B.
The purpose of the current study is to examine, in retrospect, trainees' perceptions of the reasons some of their peers dropped out of the vocational education at the Industrial Institute-Shuwaikh (IIS), Kuwait. Using the descriptive-analytical method, a reliable questionnaire was developed to achieve this purpose. Results show that: (a) the…
Chadderton, Charlotte; Edmonds, Casey
This small-scale, highly original study connects themes which are rarely explored in relation to each other, particularly in a European context: vocational education and training (VET), refugees and race equality in order to explore how VET policies impact on racial equality, and the ways racial structures in Europe impact on VET. It begins to…
Mustapha, Ramlee B.
Research has documented that vocational education and training (VET) is critical to Malaysia's industrial development. Rapid technological changes and increased global competition have exacerbated the challenges associated with delivery of quality VET in Malaysia. The barriers to improving VET in Malaysia and ways of overcoming those barriers,…
Mustapha, Ramlee B.; Ali, Manisah Mohd; Bari, Safani; Amat, Salleh
In the era of globalization, Malaysia's ability to remain economically competitive depends on the skills of its workforce. The policies and practices of Malaysia's vocational education system must be revised to do more to give the country's disabled citizens the training they need to find employment and become taxpayers. More concerted efforts are…
Lo, Yi-Hsuan Gloria
A curriculum is a form of politics (Apple, 1993). The politics of a curriculum defines what is legitimate and valued and what is not. In Taiwan, the objectives of vocational high school (VHS) education are to prepare students to acquire relevant professional knowledge and practical skills and to integrate them into their future career development.…
Mažgon, Jasna; Šebart, Mojca Kovac; Štefanc, Damijan
In the paper some issues and problems regarding the implementation of ICT in initial vocational education and training in Slovenia are discussed. After the brief analysis of the main theoretical characteristics of ICT and e-materials, the key findings from the recent EU survey on the ICT in schools are presented and some conclusions on the basis…
... VOCATIONAL REHABILITATION SERVICE PROJECTS What Conditions Must Be Met by a Grantee? § 369.44 What wage and... hour standards must be observed in projects carried out in community rehabilitation programs...
Krause, James S; Ricks, Jillian M
To identify the stability of vocational interests first assessed during inpatient rehabilitation for spinal cord injury and again an average of 834.9 days postinjury to determine the extent to which stability of interest varies as a function of race and sex. Longitudinal. Data were collected at a specialty hospital. At enrollment, participants were a minimum of 16 years of age, were currently hospitalized for inpatient rehabilitation, were less than 6 months postinjury, had residual impairment after traumatic spinal cord injury, and were either white or black, and non-Hispanic. Participants (N=304) were assessed an average ± SD of 50±26.6 days after injury and again an average ± SD of 834.9±192.7 days postinjury (averaged 785.1 d between assessments). Not applicable. The Strong Interest Inventory, a 317-item vocational interests measure. A repeated-measures general linear model was used with 4 groups based on a combination of race and sex. Significant cohort by time interactions were observed on 4 general occupational themes (investigative, artistic, enterprising, and conventional). In nearly all cases, black women showed decreases in average interest scores compared with the other groups. There was a clear pattern of change in the direction of greater homogeneity of interests over time as measured by the range of theme scores between cohorts based on sex and race. Although changes in mean interest profiles varied as a function of sex and race, less consistent differences were observed when stability coefficients were the measure of change. The direction and degree of change in mean scores for vocational interests was related to sex and race. With the exception of black women, vocational interests increased from baseline to follow-up. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Full Text Available Introduction. Ankylosing spondylitis (AS/Morbus Bechterew is a chronic inflammatory rheumatoid disease. The temporomandibular joint (TMJ dysfunction is involved in 4–35% of AS cases, and is correlated to the severity and extension of AS. Even though AS-caused TMJ ankylosis is exceptional, one should have high index of suspicion of TMJ ankylosis in AS for an early detection, because it is an extremely serious and disabling condition that causes problems with mastication, swallowing, digestion, speech, appearance and poor oral hygiene with heavy caries. Case report. A 54-year-old male patient sought medical attention at the Department of Periodontology and Oral Medicine, Clinic for Dentistry at the Military Medical Academy, Belgrade, Serbia, with the chief complaint of pain in the area of the upper left canine in the presence of limited mouth opening. The treatment plan consisted of upper left canine management and rehabilitation of the remaining teeth in the frontal and the premolar region in both, the upper and lower jaw. Even though molar region needed to be treated, unfortunately it was not in the treatment plan because ankylosis of TMJ made the treatment impossible. Conclusions. The patients with AS-caused TMJ ankylosis are considered a diagnostic challenge to routine dentistry. Accent should be given to early diagnosis and multidisciplinary approach in the treatment of the AS patients towards the favorable disease course and outcome.
Bower, Janeen; Catroppa, Cathy; Grocke, Denise; Shoemark, Helen
The primary aim of this case study was to explore the behavioural changes of a paediatric patient in post-traumatic amnesia (PTA) during a music therapy session. A secondary objective was to measure the effect of the music therapy intervention on agitation. Video data from pre, during and post-music therapy sessions were collected and analysed using video micro-analysis and the Agitated Behaviour Scale. The participant displayed four discrete categories of behaviours: Neutral, Acceptance, Recruitment and Rejection. Further analysis revealed brief but consistent and repeated periods of awareness and responsiveness to the live singing of familiar songs, which were classified as Islands of Awareness. Song offered an Environment of Potential to maximise these periods of emerging consciousness. The quantitative data analysis yielded inconclusive results in determining if music therapy was effective in reducing agitation during and immediately post the music therapy sessions. The process of micro-analysis illuminated four discrete participant behaviours not apparent in the immediate clinical setting. The results of this case suggest that the use of familiar song as a music therapy intervention may harness early patient responsiveness to foster cognitive rehabilitation in the early acute phase post-TBI.
Economia solidária e reabilitação vocacional no campo da drogadição: possibilidades e limites das práticas atuais Cooperative work and vocational rehabilitation in the drug addiction treatment: opportunities and limitations of current practices
Alessandra Nagamine Bonadio
Full Text Available Este artigo visa a contribuir ao debate sobre as potencialidades do trabalho no processo de recuperação de dependentes químicos. Consideramos nesta análise os princípios subjacentes à reabilitação vocacional praticada no contexto internacional, seguido da descrição das diretrizes brasileiras para a inclusão social de dependentes químicos por meio do trabalho. Por fim, procedemos a uma análise comparativa das matrizes conceituais, dos conceitos de saúde subjacentes e do potencial emancipatório em ambas as perspectivas. O material consultado foi levantado por meio de revisão bibliográfica em bases de dados da área da saúde. Já as informações sobre as diretrizes brasileiras foram coletadas nas publicações oficiais disponibilizadas on-line pelo Ministério da Saúde e Ministério do Trabalho e do Emprego do Brasil. A análise do material permitiu-nos verificar que a reabilitação vocacional praticada em países da América do Norte e da Europa destina-se a usuários de serviços de saúde mental, procedendo à inclusão pelo viés da doença. Enfatiza a recolocação no mercado formal de trabalho, por meio de programas voltados ao treinamento de habilidades para obter e manter um posto de trabalho conquistado. Já as diretrizes do governo brasileiro estão pautadas nos princípios do cooperativismo e da economia solidária. Privilegia o ser humano como sujeito e finalidade maior da atividade econômica, focalizando as potencialidades e recursos do trabalho, em detrimento das limitações impostas pela doença ou pela condição socioeconômica que tenha gerado a situação de exclusão.This paper contributes to the debate on the potencial of work in the recovery process of addicts. The vocational rehabilitation principles are analyzed and compared to the Brazilian guidelines for the work rehabilitation of this population. In this analysis we compare the underlying concept of health and the emancipatory potential in both
Full Text Available Objective: The purpose of this presentation is to show the difficulty in prosthetization of a clinical case with a pronounced atrophy of the upper jaw and the various types and nature of restrictions imposed by the requirements of the patient. Methods: The clinical analysis, surgical protocol and prosthetic solution are presented in the treatment of 72 year-old woman with a pronounced atrophy of the upper jaw. OPG, standard CT of the upper jaw was used in the planning and a special surgical template was fabricated, helping us to find intraoperatively the exact locations of implants. The preliminary analysis of the number, height and diameter of intraossal implants helped us to find the exact prosthetic solution in this clinical case. The preparation of the implant bed was done by conical osteotomy in order to expand and condense the existing bone, which allowed us to use endoossal implants with a possible maximum size in a very limited maxillary volume and the reluctance of the patient to use other methods and surgical techniques. Conical threaded and self-tapping intraossal implants were used, placed according to a classic two-stage methodology with a flap and a long-term functional loading after a period of four months.Results and Conclusion: The applied surgical and prosthetic solution allowed us to achieve a good functional and aesthetic rehabilitation in this case of severe atrophy of the upper jaw, following a number of restrictions imposed on us by the reluctance of the patient to use other surgical solutions. This shows that in the case of severe atrophy of the upper jaw, a good clinical result can be achieved. For this reason, the use of CT,a well-planned surgical template, sufficient preparation ,the maximum use of available bone volume and the choice of a good prosthetic solution is very important.
Wales, Coralie; Matthews, Lynda R; Donelly, Michelle
In Australia, evidence of an ageing population and a skills shortage are imminent challenges for employers [5,50]. A further concern arises from the work injury and motor accident compensation schemes, where many claims for soft tissue injuries result in permanent impairment depriving the community of otherwise productive workers . In many cases, it is chronic pain that becomes the major barrier to a return to productive work. This study will review the operation of rehabilitation within Australian Workers' and Motor Accidents compensation systems in order to identify values and attitudes underpinning the vocational rehabilitation ethos. The models underlying current practice will also be identified. A comprehensive review of published literature and policy documents was undertaken. We identified a variety of contextual factors that influenced progress back into the workforce for people living with persistent pain. The conceptual models underpinning these factors within rehabilitation systems were explored. They were all driven by a strong focus on early return to work and at the same time the sustainability of rehabilitation as a profitable industry. Implications of these findings on the relationship between the rehabilitation provider and the person in pain are discussed. Rehabilitation professionals are influenced by and in turn influence the context in which chronic pain is experienced. Empirical data about the experiences of vocational rehabilitation professionals in Australian personal injury rehabilitation systems is lacking, yet the implications of the cost of chronic pain to the nation are significant. It is recommended that rehabilitation providers increase their awareness of the perhaps unforeseen traps within the various practice models they might be using on the goal of sustainable return to work for people living with pain.
Turner-Stokes, Lynne; Poppleton, Rob; Williams, Heather; Schoewenaars, Katie; Badwan, Derar
A key challenge for providers and commissioners of rehabilitation services is to find optimal balance between service costs and outcomes. This article presents a "real-life" application of the UK Rehabilitation Outcomes Collaborative (UKROC) dataset. We undertook a comparative cohort analysis of case-episode data (n = 173) from two specialist neurological rehabilitation units (A and B), to compare the cost-efficiency of two service models. (i) Demographics, casemix and levels of functional dependency on admission and discharge were broadly similar for the two units. (ii) The mean length of stay for Unit A was 1.5 times longer than Unit B, which had 85% higher levels of therapy staffing in relation to occupied bed days so despite higher bed-day costs, Unit B was 20% more cost-efficient overall, for similar gain. (iii) Following analysis, engagement with service commissioners led to successful negotiation of a business plan for service reconfiguration with increased staffing levels for Unit A and further development of local community rehabilitation services. (i) Lower front-end service costs do not always signify optimal cost-efficiency. (ii) Analysis of routinely collected clinical data can be used to engage commissioners and to make the case for resources to maximise efficiency and improve patient care.
Full Text Available Stroke is one of the leading causes of permanent disability in adults. The literature suggests that rehabilitation is key to early motor recovery. However, conventional therapy is labor and cost intensive. Robotic and functional electrical stimulation (FES devices can provide a high dose of repetitions and as such may provide an alternative, or an adjunct, to conventional rehabilitation therapy. Brain-computer interfaces (BCI could augment neuroplasticity by introducing mental training. However, mental training alone is not enough; but combining mental with physical training could boost outcomes. In the current case study, a portable rehabilitative platform and goal-oriented supporting training protocols were introduced and tested with a chronic stroke participant. A novel training method was introduced with the proposed rehabilitative platform. A 37-year old individual with chronic stroke participated in 6-weeks of training (18 sessions in total, 3 sessions a week, and 1 h per session. In this case study, we show that an individual with chronic stroke can tolerate a 6-week training bout with our system and protocol. The participant was actively engaged throughout the training. Changes in the Wolf Motor Function Test (WMFT suggest that the training positively affected arm motor function (12% improvement in WMFT score.
Farrell, Elizabeth; Naber, Erin; Geigle, Paula
This case describes the outcomes of a multifaceted rehabilitation program including body weight-supported overground gait training (BWSOGT) in a nonambulatory child with cerebral palsy (CP) and the impact of this treatment on the child's functional mobility. The patient is a nonambulatory 10-year-old female with CP who during an inpatient rehabilitation stay participated in direct, physical therapy 6 days per week for 5 weeks. Physical therapy interventions included stretching of her bilateral lower extremities, transfer training, bed mobility training, balance training, kinesiotaping, supported standing in a prone stander, two trials of partial weight-supported treadmill training, and for 4 weeks, three to five times per week, engaged in 30 minutes of BWSOGT using the Up n' go gait trainer, Lite Gait Walkable, and Rifton Pacer gait trainer. Following the multifaceted rehabilitation program, the patient demonstrated increased step initiation, increased weight bearing through bilateral lower extremities, improved bed mobility, and increased participation in transfers. The child's Gross Motor Functional Measure (GMFM) scores increased across four dimensions and her Physical Abilities and Mobility Scale (PAMS) increased significantly. This case report illustrates that a multifaceted rehabilitation program including BWSOGT was an effective intervention strategy to improve functional mobility in this nonambulatory child with CP.
Duncan, Clare; Primavera, Jurgenne H; Pettorelli, Nathalie; Thompson, Julian R; Loma, Rona Joy A; Koldewey, Heather J
Mangroves provide vital climate change mitigation and adaptation (CCMA) ecosystem services (ES), yet have suffered extensive tropics-wide declines. To mitigate losses, rehabilitation is high on the conservation agenda. However, the relative functionality and ES delivery of rehabilitated mangroves in different intertidal locations is rarely assessed. In a case study from Panay Island, Philippines, using field- and satellite-derived methods, we assess carbon stocks and coastal protection potential of rehabilitated low-intertidal seafront and mid- to upper-intertidal abandoned (leased) fishpond areas, against reference natural mangroves. Due to large sizes and appropriate site conditions, targeted abandoned fishpond reversion to former mangrove was found to be favourable for enhancing CCMA in the coastal zone. In a municipality-specific case study, 96.7% of abandoned fishponds with high potential for effective greenbelt rehabilitation had favourable tenure status for reversion. These findings have implications for coastal zone management in Asia in the face of climate change. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.
Arteriosclerosis is a disease effecting large elastic, elastic muscular and large muscular arteries. The primary pathological changes are found inside the arteries. Salient feature is atherosclerotic plaque. The main purpose of this paper is to determine whether early kinesitherapy with verticalization and mobilization can give better rehabilitation results with patients after lower extremities operation, in comparison to patients which were not mobilized early in this stage. In this paper we have analyzed two groups of 40 patients that were operatively treated for circulation obstruction to lower extremities. The first, tested group was treated with early kinesiotherapy with early verticalization and mobilization. The second, controlled group was treated with kinesitherapy in bed. All the patients were analyzed according to their gender, age, primary diagnosis, postoperative complications, as well as capabilities for everyday activities. For the evaluation of the everyday life activities we used the Barthel index at hospital admission and discharge. Both groups of patients were equable in gender and age. The most common age group within the tested groups was between 61-70 for males and 51-60 for woman.The most common type of obstruction in both groups was occlusion of femoral artery. The complications which occurred among the tested patients were thrombosis, ileus and contracture in 7.5% of cases, while 85% of patients did not have any complications. Within the controlled group, decubitus occurred in 7.5% of cases, as well as gangrene and ileus. Ulcus occurred in 5% of patients, thrombosis in 10%, and contracture in 4% of cases. 40% of patients in this group were without complications. Based on the results stated above we can conclude that early kinesitherapy with verticalization and mobilization of patients in postoperative phase after the treatment of lower extremities obstruction, have shown much better results in comparison to the patients which were only
Andreasen, Karen Egedal; Duch, Henriette
as other contextual factors. Our concern is adult vocational teachers attending a pedagogical course and teaching at vocational colleges. The aim of the paper is to discuss different models and develop a model concerning teachers at vocational colleges based on empirical data in a specific context......, vocational teacher-training course in Denmark. By offering a basis and concepts for analysis of practice such model is meant to support the development of vocational teachers’ professionalism at courses and in organizational contexts in general....
Annoni, J M; Vuagnat, H; Frischknecht, R; Uebelhart, D
This study reports the cases of six patients with severe chronic neurological disability and swallowing difficulties due to traumatic brain injury (TBI), anoxia and multiple sclerosis (MS). The patients required nutritional supplement through percutaneous endoscopic gastrostomy (PEG). Their clinical follow-up showed a decrease of intercurrent medical complications, especially pressure sores. In addition, an improvement of oropharyngeal function was observed in some patients, also accompanied by slightly better basic psychomotor functions such as vigilance, sustained attention and tone or motor control. However, not every patient did improve with this procedure. The two MS patients benefited most, while the improvement was less homogenous in the three TBI patients. The advantages of PEG over nasogastric tube on oropharyngeal function can be related to the absence of pharyngeal irritation and its role in overall recovery could be due to an increase in social activities, a control of infections, a better rehabilitation schedule and a long-term effect on brain function due to better nutritional support.
Full Text Available The term post-polio syndrome (PPS was introduced in 1985 by Halstead. It is characterized by sudden or progressive muscle weakness, new muscular atrophy, muscle pain, fatigue, functional impotence, cold intolerance, after a period of at least 15 years from acute polio virus infection, a period of neurological and functional stability, in the absence of other medical explanation . The reported prevalence of PPS is between 15% and 80% of all patients with previous polio virus infections [2, 3]. Poliomyelitis continues to be a public health problem, because the consequences of the disease last throughout life. In Europe, there are about 700,000 persons who survived the infection and are still alive. Non-randomized studies with kinesitherapy programs with a duration between 6 weeks and 7 months, involving isokinetic and isometric endurance muscle training, have demonstrated an increase of muscle strength in the case of patients with mild or moderate muscle weakness, and a reduction of muscle fatigue [7, 8, 9]. The differential diagnosis of PPS can be difficult because of the need to exclude both neurological and non-neurological conditions that aggravate the pre-existing motor deficit. Rehabilitation programs using therapeutic means: kinesitherapy, thermotherapy, hydrothermotherapy, occupational therapy represent the only way to limit functional deficit and to improve pain, playing an important role in the long-term management and care of patients.
Briand, Catherine; Sablier, Juliette; Therrien, Julie-Anne; Charbonneau, Karine; Pelletier, Jean-François; Weiss-Lambrou, Rhoda
This study aimed to test the feasibility of using a mobile device (Apple technology: iPodTouch®, iPhone® or iPad®) among people with severe mental illness (SMI) in a rehabilitation and recovery process and to document the parameters to be taken into account and the issues involved in implementing this technology in living environments and mental health care settings. A qualitative multiple case study design and multiple data sources were used to understand each case in depth. A clinical and comprehensive analysis of 11 cases was conducted with exploratory and descriptive aims (and the beginnings of explanation building). The multiple-case analysis brought out four typical profiles to illustrate the extent of integration of a personal digital assistant (PDA) as a tool to support mental health rehabilitation and recovery. Each profile highlights four categories of variables identified as determining factors in this process: (1) state of health and related difficulties (cognitive or functional); (2) relationship between comfort level with technology, motivation and personal effort deployed; (3) relationship between support required and support received; and (4) the living environment and follow-up context. This study allowed us to consider the contexts and conditions to be put in place for the successful integration of mobile technology in a mental health rehabilitation and recovery process.
Di Pietro, G.
It is often suggested that vocational education and training (VET) could be key to cut youth unemployment. VET programmes may provide young people with specific professional qualifications that enable them to successfully compete in the labour market. However, despite the great emphasis placed by governments and other institutions on these programmes, VET appears to be far from reaching its full potential in many countries. One barrier preventing students from pursuing this type of education ...
Full Text Available With the increasing average life expectancy of human beings, the need to cater geriatric patients is ever increasing. Complete dentures are an indispensable tool in this regard. The loose and unstable lower complete denture owing to residual ridge resorption is one of the most common problems faced by edentulous patients. Dental implant retained overdentures have emerged as an efficient treatment modality for such patients. Though useful, not every patient is a suitable candidate to go for conventional implant-borne prosthesis, limitation being the available bone width. In such cases, mini implants may be used for augmenting the retention of the dentures and improving the quality of life of patients. In this case series, rehabilitation of three compromised cases with mini implant retained overdentures have been described wherein patients are experiencing instability of lower denture due to thin resorbed mandibular ridges. In one of the cases, three mini implants placed in A, C, and E position were splinted using a cemented bar to retain the mandibular denture. The other two cases were rehabilitated using unsplinted ball type one piece mini implants placed in A, C, and E position in one case and B and D position in another case. Though splinted bar design should be preferred but the lack of available vertical space precluded the utilization of bar in other two cases. The results were found to be satisfactory with no complications reported during a follow-up period of over 3 years in all the cases.
Full Text Available Chih-Lan Kuo1, Sui-Foon Lo1,2, Chun-Lin Liu3, Chia-Hui Chou4, Li-Wei Chou1,2,5¹Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan; ²School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; 3Department of Neurosurgery, China Medical University Hospital, Taichung, Taiwan; 4Department of Infectious disease, China Medical University Hospital, Taichung, Taiwan; 5Department of Physical Therapy, China Medical University, Taichung, TaiwanAbstract: There are few reports in the literature of tuberculous brain abscess. Tuberculous brain abscess usually occurs in an immunocompromised host. Almost all previously documented cases have involved acquired immune deficiency syndrome. We encountered a 53-year-old right-handed immunocompetent male who was initially suspected of having a cerebrovascular accident due to acute-onset right hemiparesis and paresthesia. A tentative diagnosis of brain tumor versus brain abscess was made on imaging studies. The patient was finally diagnosed with a tuberculous brain abscess based upon deterioration on imaging and a positive tuberculosis culture. The tuberculous brain abscess was located in the left parietal lobe, which resulted in Gerstmann's syndrome and right-sided apraxia. Stereotactic surgery was performed. He was also given antituberculosis chemotherapy and comprehensive rehabilitation. Considerable improvement was noted after rehabilitation. The patient even returned to a normal life and work. Our case demonstrates that an aggressive intensive inpatient rehabilitation program combined with stereotactic surgery and effective antituberculosis therapy play an important role in improving the outcome for patients with tuberculous brain abscess, Gerstmann's syndrome, and right-sided apraxia.Keywords: tuberculous brain abscess, Gerstmann's syndrome, rehabilitation
Chishtie, Jawad; Chishtie, Farrukh; Yoshida, Karen; Balogh, Robert
The 2005 South Asian earthquake led to large-scale injuries and disabilities in northern Pakistan, which were dealt with using various approaches. In this regard, a community-based rehabilitation approach was initiated in the Muzaffarabad district of Pakistan in early 2006, focused on preventing complications among persons with Spinal Cord Injury. This case study briefly describes its development, aims and service provision components, in addition to the distribution of injuries from the disaster. Pressure ulcer prevention education, its recall and decrease in prevalence over a year are presented as key outcomes and illuminate the process of implementing rehabilitation in this context. This case study presents findings from a larger internal program evaluation in 2010-11. The study design was cross-sectional, to elicit recall of education components and the resulting prevalence of pressure ulcers over the year, in 33 randomly selected persons with Spinal Cord Injury. Outcomes included retention of knowledge about pressure ulcer prevention, practices and reduction in the prevalence of pressure ulcers over the last year. We also conducted a narrative literature review on the types of injuries and complications in the Spinal Cord population from Northern Pakistan. Hospital cohort studies reported "spine" injuries at 5%, while persons with spinal cord injury were identified as the most underserved needing rehabilitation services after the quake. Results from the evaluation of prevention education revealed that all 33 respondents were trained in detection of pressure ulcers, while 32 recalled "danger signs" for which they would seek immediate help. All correctly recalled postural change timings, however, their actual practices differed. Twenty-seven respondents (82%) reported no pressure ulcers over the last year. The decrease in pressure ulcer prevalence over the last year in persons with spinal cord injury highlights the strengths of the community-based rehabilitation
Duval, J; Coyette, F; Seron, X
This paper describes and evaluates a programme of neuropsychological rehabilitation which aims to improve three sub-components of the working memory central executive: processing load, updating and dual-task monitoring, by the acquisition of three re-organisation strategies (double coding, serial processing and speed reduction). Our programme has two stages: cognitive rehabilitation (graduated exercises subdivided into three sub-programmes each corresponding to a sub-component) which enables the patient to acquire the three specific strategies; and an ecological rehabilitation, including analyses of scenarios and simulations of real-life situations, which aims to transfer the strategies learned to everyday life. The programme also includes information meetings. It was applied to a single case who had working memory deficits after a surgical operation for a cerebral tumour on his left internal temporal ganglioglioma. Multiple baseline tests were used to measure the effectiveness of the rehabilitation. The programme proved to be effective for all three working memory components; a generalisation of its effects to everyday life was observed, and the effects were undiminished three months later.
Wakabayashi, Hidetaka; Uwano, Rimiko
Sarcopenic dysphagia is characterized by the loss of swallowing muscle mass and function associated with generalized loss of skeletal muscle mass and function. In this report, the authors describe a patient with possible sarcopenic dysphagia after lung cancer surgery and was treated subsequently by rehabilitation nutrition. A 71-year-old man with lung cancer experienced complications of an acute myocardial infarction and pneumonia after surgery. He was ventilated artificially, and a tracheotomy was performed. The patient received diagnoses of malnutrition, severe sarcopenia, and possible sarcopenic dysphagia. His dysphagia was improved by a combination of dysphagia rehabilitation including physical and speech therapy and an improvement in nutrition initiated by a nutrition support team. Finally, he no longer had dysphagia and malnutrition. Sarcopenic dysphagia should be considered in patients with sarcopenia and dysphagia. Rehabilitation nutrition using a combination of both rehabilitation and nutritional care management is presumptively useful for treating sarcopenic dysphagia.
Kumpanya, P; Matshumba, M; Sekele, I B; Mayunga, M; Lutula, P S; Ntumba, M K
The authors describe the ectodermal Capdepont syndrome as an anomaly characterized by anhidrosis, hypotrichosis and anodontia diagnosed in a 22 year-old adult. In front of this anodontia, oral prosthetic rehabilitation remains the only solution.
Riakhovskiĭ, A N
Clinical case of prosthetic rehabilitation of patient (female) with generalized parodontitis complicated by defects and deformations of dentitions was offered. Using 3D-technologies position of teeth was corrected with the help of a series of temporary transparent splints-modifiers with subsequent guy splintage and esthetic 3D-planning of front teeth forms. Teeth forms correction was made by composite using preliminary prepared templet.
Glintborg, Chalotte; Hansen, Tia G. B.
Simple Summary The use of service dogs for adults with mental illnesses has become generally accepted. With reference to a single case study of a client with Post Traumatic Stress (PTSD), this study illustrates some of the potential advantages, but also note an important concern that appears to have gone unnoticed. The provision of service animals/therapy animals for adults with mental illnesses must be sufficiently informed by relevant knowledge and integrated with concurrent rehabilitation ...
Full Text Available Patient is a 24 year .old male with valvular heart disease, severe mitral & aortic & tricuspid valve stenosis and regurgitation. After MVR & AVR & tricuspid surgical repair, he has undergone cardiac rehabilitation for 8 weeks (24 sittings. After completion of a cardiac rehabilitation, review of cardiovascular tests showed obvious improvement in the functional capacity, blood pressure and heart rate. Physically and mentally patient feels very comfortable and hopeful of a good healthy life.
... Disabilities Act, or individuals with disabilities who are eligible for the vocational rehabilitation program... vocational rehabilitation (VR) programs, or other programs serving transition-age youth with disabilities. (b... preference, or invitational through a notice in the Federal Register. The effect of each type of priority...
Skidmore, Elizabeth R; Holm, Margo B; Whyte, Ellen M; Dew, Mary Amanda; Dawson, Deirdre; Becker, James T
Meta-cognitive strategy training may be used to augment inpatient rehabilitation to promote active engagement and subsequent benefit for individuals with cognitive impairments after stroke. We examined the feasibility of administering a form of meta-cognitive strategy training, Cognitive Orientation to daily Occupational Performance (CO-OP), during inpatient rehabilitation. We trained an individual with cognitive impairments after right hemisphere stroke to identify performance problems, set self-selected goals, develop plans to address goals, and evaluate performance improvements. To assess feasibility, we examined the number of meta-cognitive training sessions attended, the number of self-selected goals, and changes in goal-related performance. We also examined changes in rehabilitation engagement and disability. The participant used the meta-cognitive strategy to set eight goals addressing physically oriented, instrumental, and work-related activities. Mean improvement in Canadian Occupational Performance Measure Performance Scale scores was 6.1. Pittsburgh Rehabilitation Participation Scale scores (measuring rehabilitation engagement) improved from 3.2 at admission to 4.9 at discharge. Functional Independence Measure scores (measuring disability) improved from 68 at admission, to 97 at discharge. Performance Assessment of Self-Care Skills scores improved from 1.1 at admission to 2.9 at discharge. The results indicate that meta-cognitive strategy training was feasible during inpatient rehabilitation and warrants further evaluation to determine its effectiveness.
Full Text Available Background: Cognitive decline in Multiple Sclerosis (MS negatively impacts patients’ everyday functioning and quality of life. Since symptomatic pharmacological treatment is not yet available alternative treatment strategies such as cognitive rehabilitation are of particular interest. Objectives: To analyse the ways in which MS patients respond to cognitive training, by combining behavioural and fMRI data in a case-based triangulation approach.Methods: Ten relapsing-remitting (RR MS patients aged between 39 and 58 years and between one and eight years post MS diagnosis were included. EDSS ranged from 1 to 3.5. Participants had normal to high intelligence levels. Six patients were assigned to the training group (TG and four to the control group (CG without intervention. The training group received a 4-weeks computerized working memory (WM training, consisting of 16 training sessions of 45 minutes duration each. Before and after the training a neuropsychological examination and fMRI investigation by using an N-Back task of different complexity was applied. Results: Patients in the TG responded differently to cognitive training. Four participants did not meet the triangulation criteria for being treatment responders. The two responders showed two distinct changes regarding activation patterns after training: I decreased brain activation associated with increased processing speed and II increased brain activation associated with higher processing speed and WM performance. Conclusion: The occurrence of different and opposed response patterns after the same training indicates a risk in applying classical group statistics. Different and especially opposed patterns within the same sample may distort results of classical statistical comparisons. Thus, underlying processes may not be discovered and lead to misinterpretation of results.
Prashant G Bhat
Full Text Available BACKGROUND: Severe acute malnutrition (SAM is the most serious form of malnutrition affecting children under-five and is associated with many infectious diseases including Tuberculosis (TB. In India, nutritional rehabilitation centres (NRCs have been recently established for the management of SAM including TB. The National TB Programme (NTP in India has introduced a revised algorithm for diagnosing paediatric TB. We aimed to examine whether NRCs adhered to these guidelines in diagnosing TB among SAM children. METHODS: A cross-sectional study involving review of records of all SAM children identified by health workers during 2012 in six tehsils (sub-districts with NRCs (population: 1.8 million of Karnataka, India. RESULTS: Of 1927 identified SAM children, 1632 (85% reached NRCs. Of them, 1173 (72% were evaluated for TB and 19(2% were diagnosed as TB. Of 1173, diagnostic algorithm was followed in 460 (37%. Among remaining 763 not evaluated as per algorithm, tuberculin skin test alone was conducted in 307 (41%, chest radiography alone in 99 (13% and no investigations in 337 (45%. The yield of TB was higher among children evaluated as per algorithm (4% as compared to those who were not (0.3% (OR: 15.3 [95%CI: 3.5-66.3]. Several operational challenges including non-availability of a full-time paediatrician, non-functioning X-ray machine due to frequent power cuts, use of tuberculin with suboptimal strength and difficulties in adhering to a complex diagnostic algorithm were observed. CONCLUSION: This study showed that TB screening in NRCs was sub-optimal in Karnataka. Some children did not reach the NRC, while many of those who did were either not or sub-optimally evaluated for TB. This study pointed to a number of operational issues that need to be addressed if this collaborative strategy is to identify more TB cases amongst malnourished children in India.
Lahav, Orly; Schloerb, David W; Srinivasan, Mandayam A
This paper presents a virtual reality system (the BlindAid) developed for orientation and mobility training of people who are newly blind. The BlindAid allows users to interact with different virtual structures and objects via auditory and haptic feedback. This case study aims to examine if and how the BlindAid, in conjunction with a traditional rehabilitation programme, can help people who are newly blind develop new orientation and mobility methods. Follow-up research based on this study, with a large experiment and control group, could contribute to the area of orientation and mobility rehabilitation training for the newly blind. The case study research focused on A., a woman who is newly blind, for 17 virtual sessions spanning ten weeks, during the 12 weeks of her traditional orientation and mobility rehabilitation programme. The research was implemented by using virtual environment (VE) exploration and orientation tasks in VE and physical spaces. The research methodology used both qualitative and quantitative methods, including interviews, questionnaire, videotape recording, and user computer logs. The results of this study helped elucidate several issues concerning the contribution of the BlindAid system to the exploration strategies and learning processes experienced by the participant in her encounters with familiar and unfamiliar physical surroundings. [Box: see text].
Kii, Y; Mizuma, M
We report our experience with a case of attempted suicidal hanging presenting with dysphagia, in which rehabilitation approaches resulted in improvement. A 36-year-old man was discovered collapsed at home. From the finding of a broken cord nearby, attempted suicide by hanging was suspected. He was transported to hospital after 40 minutes, and regained consciousness after emergency treatment. There were no noteworthy findings on brain magnetic resonance imaging, cervical spine computed tomography, or vocal cord examination. There were no noteworthy psychiatric disorders or cognitive abnormalities. On hospital day 10, he showed signs of dysphagia. Videofluoroscopic examination of swallowing revealed piriform sinuses residue and aspiration after ingestion of jelly in any posture. Rehabilitation approaches were started based on the diagnosis of dysphagia due to impaired transit through the piriform sinuses. The patient achieved independent oral intake by 40 days after the injury. In this case, dysphagia was considered attributable to compression of the vagus nerves running along the lateral aspects of the neck by the cord used in the hanging. If compression is brief, full functional recovery can be expected. Implementation of rehabilitation approaches is also important in this situation.
Malandraki, Georgia A; Rajappa, Akila; Kantarcigil, Cagla; Wagner, Elise; Ivey, Chandra; Youse, Kathleen
To examine the effects of the Intensive Dysphagia Rehabilitation approach on physiological and functional swallowing outcomes in adults with neurogenic dysphagia. Intervention study; before-after trial with 4-week follow-up through an online survey. Outpatient university clinics. A consecutive sample of subjects (N=10) recruited from outpatient university clinics. All subjects were diagnosed with adult-onset neurologic injury or disease. Dysphagia diagnosis was confirmed through clinical and endoscopic swallowing evaluations. No subjects withdrew from the study. Participants completed the 4-week Intensive Dysphagia Rehabilitation protocol, including 2 oropharyngeal exercise regimens, a targeted swallowing routine using salient stimuli, and caregiver participation. Treatment included hourly sessions twice per week and home practice for approximately 45 min/d. Outcome measures assessed pre- and posttreatment included airway safety using an 8-point Penetration Aspiration Scale, lingual isometric pressures, self-reported swallowing-related quality of life (QOL), and level of oral intake. Also, patients were monitored for adverse dysphagia-related effects. QOL and adverse effects were also assessed at the 4-week follow-up (online survey). The Intensive Dysphagia Rehabilitation approach was effective in improving maximum and mean Penetration Aspiration Scale scores (PDysphagia Rehabilitation approach was safe and improved physiological and some functional swallowing outcomes in our sample; however, further investigation is needed before it can be widely applied. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
The extent of the implementation of the International Classification of Functioning, Disability and Health (ICF), developed by the WHO, in rehabilitation units and in physical therapy (PT) departments is unknown. The study aims to describe the extent to which the ICF has been implemented in PT services within rehabilitation units in Israel. To update data on ICF implementation since its inception. An online semi-structured survey was administered to 25 physiotherapists in charge of PT departments in all rehabilitation units throughout Israel. Rehabilitation units were grouped into three categories: general, geriatric and pediatric. The questionnaire included items regarding the ICF implementation, its strengths, and weaknesses. Twenty two physiotherapists (88%) completed the questionnaire. The majority was familiar with the ICF and nearly two thirds reported partial implementation in their units. Implementation focused mostly on adopting the biopsychosocial concepts and using ICF terms. The ICF was not used either for evaluating patients, or for reporting or encoding patient information. Physiotherapists, directors of most Israeli PT departments in rehabilitation units are familiar with the ICF; however, its clinical implementation is very limited. There is need for further research into the processes of knowledge transfer and implementation of the ICF, in order to better understand the factors that facilitate and those that impede ICF implementation.
Bolton, Brian; Sugent, Elaine
Validity of the Attitudes Toward Work and Money Questionnaire as a predictor of vocational adjustment for mentally retarded adults who were clients of an intensive rehabilitation program was assessed. (Author/RC)
Yip, Kevin Hak-Kong; Chow, Tak W; Chu, Frederick C S
Tooth tissue loss from bruxism has been demonstrated to be associated with various dental problems such as tooth sensitivity, excessive reduction of clinical crown height, and possible changes of occlusal relationship. A literature search revealed a number of treatment modalities, with an emphasis on prevention and rehabilitation with adhesive techniques. Rehabilitating a patient with bruxism-associated tooth tissue loss to an acceptable standard of oral health is clinically demanding and requires careful diagnosis and proper treatment planning. This article describes the management of excessive tooth tissue loss in a 43-year-old woman with a history of bruxism. The occlusal vertical dimension of the patient was re-established with the use of an acrylic maxillary occlusal splint, followed by resin composite build-up. Full-mouth oral rehabilitation ultimately involved constructing multiple porcelain veneers, adhesive gold onlays, ceramo-metal crowns, and fixed partial dentures.
Utama, D. N.; Triana, Y. S.; Iqbal, M. M.; Iksal, M.; Fikri, I.; Dharmawan, T.
Mosque, for Muslim, is not only a place for daily worshipping, however as a center of culture as well. It is an important and valuable building to be well managed. For a responsible department or institution (such as Religion or Plan Department in Indonesia), to practically manage a lot of mosques is not simple task to handle. The challenge is in relation to data number and characteristic problems tackled. Specifically for renovating and rehabilitating the damaged mosques, a decision to determine the first damaged mosque priority to be renovated and rehabilitated is problematic. Through two types of optimization method, simulated-annealing and hill-climbing, a decision support model for mosque renovation and rehabilitation was systematically constructed. The method fuzzy-logic was also operated to establish the priority of eleven selected parameters. The constructed model is able to simulate an efficiency comparison between two optimization methods used and suggest the most objective decision coming from 196 generated alternatives.
Full Text Available Henry SR Kao,1 Stewart PW Lam,2 Tin Tin Kao3,4 1Calligraphy Therapy Laboratory, Shenzhen Institute of Neuroscience, Shenzhen, China; 2Research and Development Division, Calli-Health Society, 3Department of Geography, 4Department of Psychology, University of Hong Kong, Hong Kong Introduction: This study investigated the efficacy of Chinese calligraphy handwriting (CCH for the awakening of patients under a vegetative state after stroke. The theories, the instrument, and the treatment protocols were reported. A single case of a severe stroke patient who was in a coma state for 2 years is presented in this study. The objectives were to apply finger writing as a new method to awaken a stroke patient in a coma state and to test the effect of this method in improving the patient’s vegetative states over time. Case presentation: A 55-year-old man suffered a severe stroke in 2004 which left him in a coma for 2 years without any systematic rehabilitation. A culture-based finger-writing method of visual-spatial intervention was then applied to improve his condition. The writing tasks involved aided viewing and finger tracing of sets of innovative characters with enriched visual-spatial and movement characteristics. Following regular treatment protocols involving diverse movement and sensory feedback, the patient was awakened after 12 months. As a consequence, the patient showed significant behavioral changes favoring enhanced focusing, alertness, visual scan, visual span, and quickened visual and motor responses. The treatment continued for another 12 months. As the treatment progressed, we gradually observed improvements in his attention span and mental concentration. His eye ball movements – the left eye in particular – were quickened and showed wider visual angularity in his focal vision. Currently, the patient can now watch television, engage in improved visual sighting, and focus on visual-spatial and cognitive-linguistic materials. Conclusion
Full Text Available Amelogenesis imperfecta (AI has been defined as a group of hereditary enamel defects. It can be characterized by enamel hypoplasia, hypomaturation, or hypocalcification of the teeth. AI may be associated with some other dental and skeletal developmental defects. Restoration for patients with this condition should be oriented toward the functional and esthetic rehabilitation. This clinical report describes the oral rehabilitation of a young patient diagnosed with the hypoplastic type of AI in posterior teeth and hypomatured type of AI in anterior teeth.
Iwanaga, Kanako; Umucu, Emre; Wu, Jia-Rung; Yaghmaian, Rana; Lee, Hui-Ling; Fitzgerald, Sandra; Chan, Fong
Self-determination theory (SDT) and self-efficacy theory (SET) can be used to conceptualize self-determined motivation to engage in mental health and vocational rehabilitation (VR) services and to predict recovery. To incorporate SDT and SET as a framework for vocational recovery, developing and validating SDT/SET measures in vocational rehabilitation is warranted. Outcome expectancy is an important SDT/SET variable affecting rehabilitation engagement and recovery. The purpose of this study was to validate the Vocational Outcome Expectancy Scale (VOES) for use within the SDT/SET vocational recovery framework. One hundred and twenty-four individuals with serious mental illness (SMI) participated in this study. Measurement structure of the VOES was evaluated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Both EFA and CFA results supported a two-factor structure: (a) positive outcome expectancy, and (b) negative outcome expectancy. The internal consistency reliability coefficients for both factors were acceptable. In addition, positive outcome expectancy correlated stronger than negative outcome expectancy with other SDT/SET constructs in the expected directions. The VOES is a brief, reliable and valid instrument for assessing vocational outcome expectancy in individuals with SMI that can be integrated into SDT/SET as a vocational rehabilitation engagement and recovery model in psychiatric rehabilitation.
Full Text Available Background: Segmental mandibulectomy is most often performed as part of resection of advanced squamous cell carcinoma, which involves the mandible by extension from intraoral tissues and is usually followed by reconstruction of the mandible. However, not all mandibular defects can be surgically reconstructed, due to local or systemic factors. Oral rehabilitation with conventional removable dentures is often insufficient. In order to provide predictable support and denture retention, especially in the non-reconstructed cases of segmental mandibulectomy, dental implants are indicated.Case report: The authors describe oral rehabilitation with implant-supported overdenture in two non-reconstructed patients with similar mandibular defect, but different etiology, as well as different denture design and different outcome in terms of success and patient satisfaction. In the first case, the defect was caused by surgical treatment of cancer, which was followed by radiotherapy and prosthodontic treatment with an implant-supported mandibular overdenture anchored with a bar. In another case, the damage was due to a suicide attempt. This was initially followed by the surgical treatment of the injury. Afterwards, the prosthodontic treatment with an implant-supported and conical–crown-anchored mandibular overdenture was performed.Conclusions: The success of the prosthodontic oral rehabilitation of patients with segmental mandibulectomy depends on many factors. The size of the defect and the condition of the remaining hard and soft tissues, which are affected by radiotherapy, are crucial. The etiology of the defect, the opposing jaw status, maxillomandibular relationships, the consistency of mandibular movement and the denture design play an important role as well.
Levinger, Pazit; Zeina, Daniel; Teshome, Assefa K; Skinner, Elizabeth; Begg, Rezaul; Abbott, John Haxby
This study aimed to develop a low-cost real-time biofeedback system to assist with rehabilitation for patients following total knee replacement (TKR) and to assess its feasibility of use in a post-TKR patient case study design with a comparison group. The biofeedback system consisted of Microsoft Kinect(TM) and Nintendo Wii balance board with a dedicated software. A six-week inpatient rehabilitation program was augmented by biofeedback and tested in a single patient following TKR. Three patients underwent a six weeks standard rehabilitation with no biofeedback and served as a control group. Gait, function and pain were assessed and compared before and after the rehabilitation. The biofeedback software incorporated real time visual feedback to correct limb alignment, movement pattern and weight distribution. Improvements in pain, function and quality of life were observed in both groups. The strong improvement in the knee moment pattern demonstrated in the case study indicates feasibility of the biofeedback-augmented intervention. This novel biofeedback software has used simple commercially accessible equipment that can be feasibly incorporated to augment a post-TKR rehabilitation program. Our preliminary results indicate the potential of this biofeedback-assisted rehabilitation to improve knee function during gait. Research is required to test this hypothesis. Implications for Rehabilitation The real-time biofeedback system developed integrated custom-made software and simple low-cost commercially accessible equipment such as Kinect and Wii board to provide augmented information during rehabilitation following TKR. The software incorporated key rehabilitation principles and visual feedback to correct alignment of the lower legs, pelvic and trunk as well as providing feedback on limbs weight distribution. The case study patient demonstrated greater improvement in their knee function where a more normal biphasic knee moment was achieved following the six
Wallace, Sarah E.; Purdy, Mary; Skidmore, Elizabeth
BACKGROUND Communication is essential for successful rehabilitation, yet few aphasia treatments have been investigated during the acute stroke phase. Alternative modality use including gesturing, writing, or drawing has been shown to increase communicative effectiveness in people with chronic aphasia. Instruction in alternative modality use during acute stroke may increase patient communication and participation, therefore resulting in fewer adverse situations and improved rehabilitation outcomes. OBJECTIVE The study purpose was to explore a multimodal communication program for aphasia (MCPA) implemented during acute stroke rehabilitation. MCPA aims to improve communication modality production, and to facilitate switching among modalities to resolve communication breakdowns. METHODS Two adults with severe aphasia completed MCPA beginning at 2 and 3 weeks post onset a single left-hemisphere stroke. Probes completed during each session allowed for evaluation of modality production and modality switching accuracy. RESULTS Participants completed MCPA (10 and 14 treatment sessions respectively) and their performance on probes suggested increased accuracy in the production of various alternate communication modalities. However, increased switching to an alternate modality was noted for only one participant. CONCLUSIONS Further investigation of multimodal treatment during inpatient rehabilitation is warranted. In particular, comparisons between multimodal and standard treatments would help determine appropriate interventions for this setting. PMID:25227547
Wallace, Sarah E; Purdy, Mary; Skidmore, Elizabeth
Communication is essential for successful rehabilitation, yet few aphasia treatments have been investigated during the acute stroke phase. Alternative modality use including gesturing, writing, or drawing has been shown to increase communicative effectiveness in people with chronic aphasia. Instruction in alternative modality use during acute stroke may increase patient communication and participation, therefore resulting in fewer adverse situations and improved rehabilitation outcomes. The study purpose was to explore a multimodal communication program for aphasia (MCPA) implemented during acute stroke rehabilitation. MCPA aims to improve communication modality production, and to facilitate switching among modalities to resolve communication breakdowns. Two adults with severe aphasia completed MCPA beginning at 2 and 3 weeks post onset a single left-hemisphere stroke. Probes completed during each session allowed for evaluation of modality production and modality switching accuracy. Participants completed MCPA (10 and 14 treatment sessions respectively) and their performance on probes suggested increased accuracy in the production of various alternate communication modalities. However, increased switching to an alternate modality was noted for only one participant. Further investigation of multimodal treatment during inpatient rehabilitation is warranted. In particular, comparisons between multimodal and standard treatments would help determine appropriate interventions for this setting.
Kiran, Swathi; Iakupova, Regina
The goal of this study was to address the relationship between language proficiency, language impairment and rehabilitation in bilingual Russian-English individuals with aphasia. As a first step, we examined two Russian-English patients' pre-stroke language proficiency using a detailed and comprehensive language use and history questionnaire and…
Rea Ventures Group, LLC, partnered with Southface Energy Institute (Southface), a member of the U.S. Department of Energy's Partnership for Home Innovation Building America research team, to develop a prescriptive approach for rehabilitating a portfolio of rural multifamily rental properties in Georgia, which was funded by the U.S. Department of Agriculture (USDA).
The transfer of NASA technolgy to rehabilitative applications of artificial limbs is studied. Human factors engineering activities range from orthotic manipulators to tiny dc motors and transducers to detect and transmit voluntary control signals. It is found that bicarbon implant devices are suitable for medical equipment and artificial limbs because of their biological compatibility with human body fluids and tissues.
Wolfert, Hendrik Pieter
Integrated spatial planning for river rehabilitation requires insight in the geomorphology of river systems. Procedures are elaborated to implement a functional-geographical approach in geomorphology, in which a view of rivers as four-dimensional systems and the use of a process-based hierarchy of
Pedersen, Malene; Bundgaard, Tina H; Zeeman, Peter; Jørgensen, Jørgen R; Sørensen, Peter M B; Berro, Hamza M; Larsson, Bodil W
Chronic stroke patients are primarily referred to general rehabilitation, rather than to specific neurorehabilitation. Currently, there are no Danish clinical guidelines for chronic stroke, but recent research in neuroplasticity has contributed to possible rehabilitation interventions for these patients. The purpose of this project is to describe the use of a specialized neuroplastic approach in combination with an already existing training program. The project is designed as an action research project concerning four participants with chronic stroke. Through ten intervention, a neuroplastic focus has been added to their group training program including daily home training. Participants were tested before and after the intervention with MAS, DGI, 6MWT, SSQLS. All four participants improved their functional levels and their quality of life following the intervention. This report indicates that a specific neuroplastic focus in combination with action research has an impact on the participants with chronic stroke. However, there is still no clarity regarding what type of rehabilitation methods can be considered the most efficacious in promoting neuroplasticity. This case report serves as a pilot project for further studies of how to implement neuroplasticity in physical therapy.
Vining, Robert D; Gosselin, Donna M; Thurmond, Jeb; Case, Kimberlee; Bruch, Frederick R
This report describes interdisciplinary rehabilitation for a 51-year-old male recovering from incomplete cervical spinal cord injury (SCI) and multiple comorbidities following an automobile accident. The patient was admitted to a rehabilitation specialty hospital approximately 2 months post SCI and 2 separate surgical fusion procedures (C3-C6). Clinical presentation at the rehabilitation hospital included moderate to severe motor strength loss in both upper and lower extremities, a percutaneous endoscopic gastronomy tube (PEG), dysphagia, bowel/bladder incontinence, dependence on a mechanical lift and tilting wheelchair due to severe orthostatic hypotension, and pre-existing shoulder pain from bilateral joint degeneration. The interdisciplinary team formally coordinated rehabilitative care from multiple disciplines. Internal medicine managed medications, determined PEG removal, monitored co-morbid conditions, and overall progress. Chiropractic care focused on alleviating shoulder and thoracic pain and improving spinal and extremity mobility. Physical therapy addressed upright tolerance, transfer, gait, and strength training. Occupational therapy focused on hand coordination and feeding/dressing activities. Psychology assisted with coping strategies. Nursing ensured medication adherence, nutrient intake, wound prevention, and incontinence management, whereas physiatry addressed abnormal muscle tone. Eleven months post-admission the patient's progress allowed discharge to a long-term care facility. At this time he was without dysphagia or need for a PEG. Orthostatic hypotension and bilateral shoulder pain symptoms were also resolved while bowel/bladder incontinence and upper and lower extremity motor strength loss remained. He was largely independent in transferring from bed to wheelchair and in upper body dressing. Lower body dressing/bathing required maximal assistance. Gait with a 2-wheeled walker was possible up to 150 feet with verbal cues and occasional
Full Text Available This paper presents an empirical investigation to study the effects of knowledge management on organizational learning. The study is held in headquarter of technical and vocational training organization in city of Tehran, Iran. The proposed study measures the effects of concept of management, management, knowledge tools, measurement, change management and knowledge content on organizational learning. The study designs a questionnaire in Likert scale and selects a sample of 313 people randomly from 1680 people who work for this organization in city of Tehran, Iran. Using structural equation modeling, the study has detected a positive and meaningful relationship with knowledge management on organizational learning. In our survey, knowledge content is the most important factor followed by change management.
Biefang, S; Potthoff, P
Diagnostics and evaluation in medical rehabilitation should be based on methods that are as objective as possible. In this context quantitative methods are an important precondition. We conducted for the German Pensions Insurance Institutions (which are in charge of the medical and vocational rehabilitation of workers and employees) a survey on assessment methods for rehabilitation which included an evaluation of American literature, with the aim to indicate procedures that can be considered for adaptation in Germany and to define further research requirements. The survey identified: (1) standardized procedures and instrumented tests for the assessment of musculoskeletal, cardiopulmonary and neurophysiological function; (2) personality, intelligence, achievement, neuropsychological and alcoholism screening tests for the assessment of mental or cognitive function; (3) rating scales and self-administered questionnaires for the assessment of Activities of Daily Living and Instrumental Activities of Daily Living (ADL/IADL Scales); (4) generic profiles and indexes as well as disease-specific measures for the assessment of health-related quality of life and health status; and (5) rating scales for vocational assessment. German equivalents or German versions exist only for a part of the procedures identified. Translation and testing of Anglo-Saxon procedures should have priority over the development of new German methods. The following procedures will be taken into account: (a) instrumented tests for physical function, (b) IADL Scales, (c) generic indexes of health-related quality of life, (d) specific quality of life and health status measures for disorders of the circulatory system, metabolic system, digestive organs, respiratory tract and for cancer, and (e) vocational rating scales.
Tonga, Johanne Bjoernstad; Arnevik, Espen Ajo; Werheid, Katja; Ulstein, Ingun Dina
There is a growing attention worldwide to young-onset dementia (YOD) and this group's special challenges and needs. The literature on psychosocial interventions for this population is scarce, and little is known about the specific challenges and benefits of working therapeutically with this group of patients. The aim of this study was to explore if a manual-based structured cognitive behavioral/cognitive rehabilitation program would be beneficial for these patients. One case, a 63-year-old woman with YOD, is presented to illustrate how this intervention can be applied to individual patients to manage depressive symptoms in YOD.
Elif Bahar Tuna
Full Text Available Traumatic injuries may cause anatomic deficiencies in soft and hard tissues. These defects often result in the loss of attached mucosa and alveolar processes, which might reduce potential prosthesis support and require bone and skin grafting. As a result of major maxillofacial trauma, complete or partial avulsion of the palate may require extensive surgical and prosthodontic rehabilitation. The appropriate treatment for the maxillary defect demands a multidisciplinary approach by a team which consists of various fields of dentistry and medicine. The planning prostheses should replace not only missing teeth but also lost soft tissues and bone, and they should include the hard palate, residual alveolar ridges, and, in some instances, the soft palate. This paper describes the treatment procedures including plastic surgery operation procedures and prosthetic rehabilitation in a 19-year-old woman after her severe bicycle accident.
Vailati, Francesca; Vaglio, Giovanna; Belser, Urs Christoph
Dental erosion is increasing, and only recently are clinicians starting to acknowledge the problem. A prospective clinical trial investigating which therapeutic approach must be undertaken to treat erosion and when is under way at the University of Geneva (Geneva Erosion Study). All patients affected by dental erosion who present with signs of dentin exposure are immediately treated using only adhesive techniques. In this article, the full-mouth adhesive rehabilitation of one of these patients affected by severe dental erosion (ACE class IV) is illustrated. By the end of the therapy, a very pleasing esthetic outcome had been achieved (esthetic success), all of the patient's teeth maintained their vitality, and the amount of tooth structure sacrificed to complete the adhesive full-mouth rehabilitation was negligible (biological success).
Putanikar, Nagaraj Y.; Patil, Anandkumar G.; Shetty, Pavithra K.; Nagaral, Suresh; Mithaiwala, Hatimali I.
Severe physical and psychological distress occurs due to disfigurement caused by loss of eye. Ocular prosthesis is the only mode of rehabilitation for the missing eye. There are different materials and techniques used for the fabrication of the same. Resin proved to be the better among the available materials. Either using the stock eye or using customized ocular prosthesis has their own advantages and disadvantages. Through our clinical report, we have fabricated a semi-customized ocular pro...
Roche, Aidan Dominic; Vujaklija, Ivan; Amsüss, Sebastian; Sturma, Agnes; Göbel, Peter; Farina, Dario; Aszmann, Oskar C.
Advances in robotic systems have resulted in prostheses for the upper limb that can produce multifunctional movements. However, these sophisticated systems require upper limb amputees to learn complex control schemes. Humans have the ability to learn new movements through imitation and other learning strategies. This protocol describes a structured rehabilitation method, which includes imitation, repetition, and reinforcement learning, and aims to assess if this method can improve multifuncti...
Brock, Kim A; Vale, Stephen J; Cotton, Susan M
To compare resource use of, and outcomes for, rehabilitation for severe stroke before and after the implementation of the Casemix and Rehabilitation Funding Tree case-mix-based funding model. Prospective, observational cohort study. Eight inpatient rehabilitation centers in Australia. Consecutive sample of 609 patients with severe stroke. Not applicable. Rehabilitation length of stay (LOS), discharge destination, and FIM instrument motor score at discharge. The average rehabilitation LOS changed significantly between the preimplementation year and the implementation year (Mann-Whitney U, P=.001). There were no significant differences in discharge destination. FIM motor score at discharge showed significant reduction in improvement (Mann-Whitney U, P=.001) between the preimplementation year and the implementation year. There were no significant correlations between LOS in rehabilitation and gain in function for either the preimplementation year (Spearman rho, P=.07) or the implementation year (P=.15). The change in funding model was associated with a decrease in inpatient costs and with an associated increase in disability at discharge. Our results suggest that the rate of improvement in severe stroke is variable; also, they support the use of funding models for stroke rehabilitation that allow flexibility in resource allocation.
Full Text Available Wave energy and storm surges threaten coastal ecology and nearshore infrastructures. Although coastal structures are conventionally constructed to dampen the wave energy, they introduce tremendous damage to the ecology of the coast. To minimize environmental impact, ecofriendly coastal protection schemes should be introduced. In this paper, we discuss an example of an innovative mangrove rehabilitation attempt to restore the endangered mangroves on Carey Island, Malaysia. A submerged detached breakwater system was constructed to dampen the energy of wave and trap the sediments behind the structure. Further, a large number of mangrove seedlings were planted using different techniques. Further, we assess the possibility of success for a future mangrove rehabilitation project at the site in the context of sedimentology, bathymetry, and hydrogeochemistry. The assessment showed an increase in the amount of silt and clay, and the seabed was noticeably elevated. The nutrient concentration, the pH value, and the salinity index demonstrate that the site is conducive in establishing mangrove seedlings. As a result, we conclude that the site is now ready for attempts to rehabilitate the lost mangrove forest.
Pombo Castro, María; Luaces Rey, Ramón; Arenaz Búa, Jorge; Santana-Mora, Urbano; López-Cedrún Cembranos, José Luís
Oral manifestations in ectodermal dysplasia include oligodontia, alveolar ridges hypoplasia, and others. Due to the special conditions in terms of unhealthy teeth and lack of bone, implant-supported rehabilitation seems to offer the most satisfactory outcome. A 27-year-old male diagnosed with ectodermal dysplasia was referred to our department for oral rehabilitation. Oral manifestations included oligodontia, maxillary and mandibular atrophy, mandibular alveolar ridge with knife-edge morphology, and conical teeth. Treatment planning consisted of a Le Fort I osteotomy with interpositional grafts, bilateral sinus lift, and placement of maxillary and mandibular inlay and onlay corticocancellous grafts, using autologous iliac crest bone. In the second surgery, all remaining teeth were removed and 11 endosteal implants were placed. Six months after implant placement, a bimaxillary fixed implant-supported prosthesis was delivered, maintaining a satisfactory esthetic and functional result after a 2-year follow-up. The use of combined preprosthetic techniques allows the placement of endosteal implants and a fixed implant-supported prosthesis in patients with oligodontia and ectodermal dysplasia, providing an esthetic and functional oral rehabilitation.
Motamedi, Shervin; Hashim, Roslan; Zakaria, Rozainah; Song, Ki-Il; Sofawi, Bakrin
Wave energy and storm surges threaten coastal ecology and nearshore infrastructures. Although coastal structures are conventionally constructed to dampen the wave energy, they introduce tremendous damage to the ecology of the coast. To minimize environmental impact, ecofriendly coastal protection schemes should be introduced. In this paper, we discuss an example of an innovative mangrove rehabilitation attempt to restore the endangered mangroves on Carey Island, Malaysia. A submerged detached breakwater system was constructed to dampen the energy of wave and trap the sediments behind the structure. Further, a large number of mangrove seedlings were planted using different techniques. Further, we assess the possibility of success for a future mangrove rehabilitation project at the site in the context of sedimentology, bathymetry, and hydrogeochemistry. The assessment showed an increase in the amount of silt and clay, and the seabed was noticeably elevated. The nutrient concentration, the pH value, and the salinity index demonstrate that the site is conducive in establishing mangrove seedlings. As a result, we conclude that the site is now ready for attempts to rehabilitate the lost mangrove forest. PMID:25097894
Rumbach, Anna F; Cremer, Rebecca; Chatwood, Astra; Fink, Sari; Haider, Sadaf; Yee, Michelle
Dysphagia is common sequelae of chemical ingestion injury, resulting from damage to critical swallowing structures. From a speech-language pathology perspective, this study outlines the physiological deficits in 2 individuals with severe injury (1 woman, acid; 1 man, alkali) and the pattern of dysphagia rehabilitation and recovery. A retrospective chart review of clinical and instrumental assessments was conducted to examine swallow characteristics and speech-language pathology management (compensatory and rehabilitation strategies) at multiple time points. Chemical ingestion injury resulted in severe pharyngeal dysphagia for both participants, warranting speech-language pathology management. Dysphagia was characterized by poor base of tongue mobility and reduced laryngeal excursion. Decreased airway patency and protection, secondary to mucosal sloughing, widespread edema, and structural deficits necessitated tracheostomy. Recovery was complicated by physical alterations of pharyngeal and laryngeal structures (e.g., interarytenoid adhesions) and esophageal strictures. Participant 1 was discharged (Day 135) consuming a texture-modified diet; Participant 2 remained nil by mouth (Day 329). Dysphagia recovery subsequent to chemical ingestion is protracted and complex. Clinical outcomes may be improved through individualized and intensive rehabilitation by speech-language pathologists.
Kaplan, Lee D.; Musto, Tony; Gaunaurd, Ignacio A.; Gailey, Robert S.; Kelley, William P.; Alemi, Timothy J.; Espinosa, Braulio; Mandler, Eli; Scavo, Vincent A.; West, Dustin C.
ABSTRACT Background and Purpose Multiple rehabilitation factors including overall wellness need to be considered when an athlete returns to sport after an injury. The purpose of this case report is to describe a multidisciplinary approach for return to sport of a Division I collegiate football player following a traumatic ankle fracture requiring surgical repair. The assessment and treatment approach included the use of a performance-based physical therapy outcome measure, self-reported functional abilities, body composition assessments, and nutritional counseling. Case Description A 21 year-old running back fractured his lateral malleolus due to a mechanism of injury of excessive eversion with external rotation of the ankle. Surgical intervention included an open reduction internal fixation (ORIF) of the fibula and syndesmosis. In addition to six months of rehabilitation, the patient received consultations from the team sports nutritionist specialist to provide dietary counseling and body composition testing. The Comprehensive High-level Activity Mobility Predictor-Sport (CHAMP-S), a performance-based outcome measure, self-report on the Foot and Ankle Disability Index (FADI-ADL, FADI-S), and body composition testing using whole body densitometry (BOD POD®), were administered throughout rehabilitation. Outcomes The subject was successfully rehabilitated, returned to his starting role, and subsequently was drafted by a National Football League (NFL) franchise. High-level mobility returned to above pre-injury values, achieving 105% of his preseason CHAMP-S score at discharge. Self-reported function on the FADI-ADL and FADI-Sport improved to 100% at discharge. Body fat percentages decreased (13.3% to 11.9%) and fat mass decreased (12.0 kg to 11.0kg). Lean body mass (78.1 kg to 81.5 kg) and lbm/in increased (1.14 kg/in to 1.19 kg/in). His BMI changed from 29.8 kg/m2 to 30.6 kg/m2. Discussion This case report illustrates the positive effects of a
Khabbache, Hicham; Jebbar, Abdelhak; Rania, Nadia; Doucet, Marie-Chantal; Watfa, Ali Assad; Candau, Joël; Martini, Mariano; Siri, Anna; Brigo, Francesco; Bragazzi, Nicola Luigi
Mental, neurological and substance use (MNS) disorders represent a major source of disability and premature mortality worldwide. However, in developing countries patients with MNS disorders are often poorly managed and treated, particularly in marginalized, impoverished areas where the mental health gap and the treatment gap can reach 90%. Efforts should be made in promoting help by making mental health care more accessible. In this article, we address the challenges that psychological and psychiatric services have to face in a low-resource context, taking our experience at a Moroccan rehabilitation center as a case study. A sample of 60 patients were interviewed using a semi-structured questionnaire during the period of 2014-2015. The questionnaire investigated the reactions and feelings of the patients to the rehabilitation program, and their perceived psychological status and mental improvement, if any. Interviews were then transcribed and processed using ATLAS.ti V.7.0 qualitative analysis software. Frequencies and co-occurrence analyses were carried out. Despite approximately 30 million inhabitants within the working age group, Morocco suffers from a shortage of specialized health workers. Our ethnographic observations show that psychiatric treatment can be ensured, notwithstanding these hurdles, if a public health perspective is assumed. In resource-limited settings, working in the field of mental health means putting oneself on the line, exposing oneself to new experiences, and reorganizing one's own skills and expertise. In the present article, we have used our clinical experience at a rehabilitation center in Fes as a case study and we have shown how to use peer therapy to overcome the drawbacks that we are encountered daily in a setting of limited resources.
Lund, Henrik Hautop; Jensen, Line Steiness Dejnbjerg; Ssessanga, Yusuf
By the development of a mHealth tablet app together with modular interactive tiles for rehabilitation, we intend to facilitate the co-design, adaptation, demonstration and validation of modular ICT solutions for rehabilitation in deep rural sub-Saharan Africa. This results in highly mobile, modular...... community-based rehabilitation. Thereby, we investigate the adaptation, contextualisation and implementation in different rehabilitation methods and centres, including hospitals both in a city centres and in a rural area, NGO’s performing community based rehabilitation, and rehabilitation centres. Together...
Cristian Jorge GARCÍA MARCOS
Full Text Available The article is concerned with the instructional design process used to elaborate an educational media developing the Web Applications module curriculum of Microcomputer Systems and Networks Intermediate Level Training Cycle, which belongs to the professional family of Computing and Communications within the studies of Vocational Education and Training. A backward model is followed as instructional design to create the educational media, starting with the learning outcomes and ending with the contents, in a reverse way to the procedure used in other instructional designs. The educational media has been designed based on constructivism as pedagogical principle and it has been used to create projects for the student to be actively involved in the development of their knowledge. The result is an open educational resource composed of six didactic sequences, where the student is expected to achieve higher order thinking skills. In addition to openness in access, use, adaptation and redistribution of material, the article provides a detailed view of the process that has been followed in each phase of instructional design. In this way, the educational resource evolves from being not only open in its content, but also in its design, so that the latter becomes accessible, reusable, adapted and redistributed by others. The full open educational resource can be found at the following link: http://www.cristiangarcia.org/WebAppsProject/index.html
Full Text Available The purpose of this paper is to determine the current status of mobile device usage and mobile learning adoption in vocational education and training (VET secondary schools in three European Union countries (Austria, the Czech Republic, and Germany. The research focused on exploring students’ mobile device usage habits, their attitudes toward education in the context of mobile application support, and preferences regarding mobile learning features. The research confirmed a high level of mobile device usage among secondary school students on a daily basis; smartphones and laptops were the most commonly used devices. The vast majority of participants perceived themselves to be advanced mobile device users, but reported a deficit of ICT-assisted mobile learning experience. However, the majority of respondents with prior ICT-assisted education experience described it as a positive or very positive experience. In addition, study participants tended to agree that mobile learning will play a significant role in education in the future. The paper also explored the reported differences among the students in the three countries and suggested several implications for understanding students’ views of mobile learning. The findings provide insights into possibilities of m-learning implementation while creating a framework for m-learning application development in the VET secondary school environment.
Full Text Available According to the official data, Romania has more than 600 companies involved in the automotive industry, with more than 203,600 employees. However the automotive industry is facing a real problem when it comes to finding skilled work force. In the west part of the country, the unemployment rate is negative and companies are forced to find solutions for their lack of personnel. This study presents the solutions that were taken by Germany in order to solve the matter. A dual education system was implemented which combines trainings in a company with vocational education. This kind of system is practiced in countries such as: Germany, Austria, Switzerland and South Korea. As of 2005 young German people can learn one of 356 apprenticeship occupations through this program. In France, dual education has gained a lot of popularity since the 1990s. In order to gain more experience and have multilateral development, in Germany the students are also send to workshops run by guilds or chamber of commerce. The advantages of the dual training system are numerous and this program can help the industry by providing skilled workers with flexible qualifications, solution which may as well be suitable for the Romanian Automotive Industry.
Feigenbaum, Luis A; Kaplan, Lee D; Musto, Tony; Gaunaurd, Ignacio A; Gailey, Robert S; Kelley, William P; Alemi, Timothy J; Espinosa, Braulio; Mandler, Eli; Scavo, Vincent A; West, Dustin C
Multiple rehabilitation factors including overall wellness need to be considered when an athlete returns to sport after an injury. The purpose of this case report is to describe a multidisciplinary approach for return to sport of a Division I collegiate football player following a traumatic ankle fracture requiring surgical repair. The assessment and treatment approach included the use of a performance-based physical therapy outcome measure, self-reported functional abilities, body composition assessments, and nutritional counseling. A 21 year-old running back fractured his lateral malleolus due to a mechanism of injury of excessive eversion with external rotation of the ankle. Surgical intervention included an open reduction internal fixation (ORIF) of the fibula and syndesmosis. In addition to six months of rehabilitation, the patient received consultations from the team sports nutritionist specialist to provide dietary counseling and body composition testing. The Comprehensive High-level Activity Mobility Predictor-Sport (CHAMP-S), a performance-based outcome measure, self-report on the Foot and Ankle Disability Index (FADI-ADL, FADI-S), and body composition testing using whole body densitometry (BOD POD®), were administered throughout rehabilitation. The subject was successfully rehabilitated, returned to his starting role, and subsequently was drafted by a National Football League (NFL) franchise. High-level mobility returned to above pre-injury values, achieving 105% of his preseason CHAMP-S score at discharge. Self-reported function on the FADI-ADL and FADI-Sport improved to 100% at discharge. Body fat percentages decreased (13.3% to 11.9%) and fat mass decreased (12.0 kg to 11.0kg). Lean body mass (78.1 kg to 81.5 kg) and lbm/in increased (1.14 kg/in to 1.19 kg/in). His BMI changed from 29.8 kg/m(2) to 30.6 kg/m(2). This case report illustrates the positive effects of a multidisciplinary approach where combining physical therapy and
Day, Sherman R.; McCane, Mel R.
Vocational education programs in America's correctional institutions have been financially handicapped, since security demands the greatest portion of resource allocations. Four eras in the development of the correctional system are generally identified: era of punishment and retribution, era of restraint or reform, era of rehabilitation and…
Uche, Greg N.
Components of a treatment model are diagnosis of offenders' work history and training needs, in relation to labor market requirements; provision of appropriate job and entrepreneurial skills; and after care services. Focus is on vocational adjustment to ensure successful rehabilitation. (SK)
Ofluoglu, Duygu; Altin, Nazli; Yaman, Elif; Tuna İnce, Elif Bahar; Aytepe, Zeynep; Tanyeri, Hakki
Hereditary sensory and autonomic neuropathies (HSAN) are rare genetic syndromes of unknown etiology. They are seen in early childhood and are categorized into six different types by their symptoms. HSAN type 4 demonstrates autosomal recessive transmission pattern, with such major characteristics as loss of sense of pain, self-mutilation, anhydrosis and mental retardation. Sympathetic innervations are deficient despite the existence of sweat glands. Sufferers are hypotonic without any tendon reflexes, and neuro-motor development is retarded. In some cases tactile sensation and vibration may be intact. Biting injuries due to lack of pain sensation cause laceration, ulceration and scarring of the tongue, lips and other parts of oral mucosa. Tooth luxation and severe dental attrition have been observed. This case report presents oral and dental findings, surgical treatments and prosthetic rehabilitation of an 11- year-old boy with HSAN type 4.
Full Text Available Hereditary sensory and autonomic neuropathies (HSAN are rare genetic syndromes of unknown etiology. They are seen in early childhood and are categorized into six different types by their symptoms. HSAN type 4 demonstrates autosomal recessive transmission pattern, with such major characteristics as loss of sense of pain, self-mutilation, anhydrosis and mental retardation. Sympathetic innervations are deficient despite the existence of sweat glands. Sufferers are hypotonic without any tendon reflexes, and neuro-motor development is retarded. In some cases tactile sensation and vibration may be intact. Biting injuries due to lack of pain sensation cause laceration, ulceration and scarring of the tongue, lips and other parts of oral mucosa. Tooth luxation and severe dental attrition have been observed. This case report presents oral and dental findings, surgical treatments and prosthetic rehabilitation of an 11- year-old boy with HSAN type 4.
Megarbane, Jean-Marie; Freiha, Cécile; Mokbel, Nadim
Mucous membrane pemphigoid (MMP) refers to a group of chronic autoimmune subepithelial diseases distinguished by erosive lesions of the mucous membranes and skin. Its treatment consists of inhibition of the inflammatory reaction by means of corticosteroids and symptomatic medication. This is a report of a patient suffering from a combination of MMP and severe generalized chronic periodontitis. The patient has been treated with oral corticosteroids, initial phase therapy, extraction with immediate implant placement, and periodontal surgery where the prognosis was questionable. The case has been followed up for 15 years. Periodontal therapy with immediate implant placement was determined to be a viable modality to achieve a total rehabilitation of a case suffering from MMP combined with severe generalized chronic periodontitis.
A single storied building was constructed on strip foundation system—on a subsoil, with high expansivity, without taking necessary precautions and it suffered extensive cracks and damages in roof slab, beams, columns and brick walls, subsidence /upheavals in floors etc. within 2/3 years of its construction and consequently it had to be abandoned. The study examines the reasons for the severe damages, cracks etc. and also suggests remediation by ground improvement and other necessary measures that were actually taken up, to rehabilitate the highly distressed and abandoned building within a reasonably short period of time—at a reasonable cost.
Mirzayanto; Yulian Gressando
Gampong Jawa dumpsite was established in 1994 as part of Banda Aceh Municipality (BAM) efforts to participate in Adipura Award for the category of clean and green city. The 12 ha area was a dumpsite for most of wastes from BAM and Aceh Besar District. When earthquake/tsunami hit Banda Aceh in December 2004, it was completely destroyed and all the wastes were swept away. This paper is aimed to present the lessons of how a dumpsite is rehabilitated to a landfill. Some issues and ...
In this paper I analyze Russian direct address forms, both the distinct truncated vocative and nominative-case direct address forms. I contrast the formal and functional restrictions on the truncated vocative with vocatives in other languages (e.g. Czech and Polish), and I compare the interpolation of Russian direct address forms in an utterance to the situation in English. While similarities are found both in the form and the usage of Russian direct address forms with those in other language...
The aim of the study was to investigate the relationship between vocational ... Modified Bakare Vocational interest inventory, the instrument on counselling, .... family influences the vocational preference of youths. .... Theories of Personality.
Yang, Si-Dong; Ning, Sheng-Hua; Zhang, Li-Hong; Zhang, Ying-Ze; Ding, Wen-Yuan; Yang, Da-Long
The purpose of this study was to explore the effect of lower limb rehabilitation gymnastics on postoperative rehabilitation in elderly patients with femoral shaft fracture after undergoing intramedullary nail fixation surgery.We collected medical records of elderly patients aged ≥ 60 years with femoral shaft fracture between 03/2010 and 03/2015 in Longyao County Hospital. Totally, 160 patients were identified and divided into the intervention group (n = 80) and the control group (n = 80). During the postoperative period, the intervention group received lower limb rehabilitation gymnastics treatment for 3 months, but the control group did not. All patients were routinely asked to return hospital for a check in the 1st postoperative week, as well as the 2nd week, the 1st month, and the 3rd month, after surgery. The clinical rehabilitation effect was evaluated by checking lower limb action ability, detecting the lower limb deep venous thrombosis (DVT), scoring muscle strength of quadriceps and visual analog scale (VAS) score, and performing satisfaction survey.At the 1st week and 2nd week after surgery, the clinical rehabilitation effect in the intervention group was better regarding lower limb action ability, lower limb DVT, muscle strength of quadriceps, VAS score, and patient satisfaction, as compared with the control group. However, there was no significant difference at the 1st month and the 3rd month after surgery when comparing the intervention group to the control group.In the early postoperative stage, lower limb rehabilitation gymnastics can effectively improve the recovery of lower limb function, beneficial to reducing postoperative complications such as lower limb DVT and muscle atrophy, and increasing patient satisfaction rate.
Parisotto, Thaís Manzano; de Souza-E-Silva, Cintia Maria; Steiner-Oliveira, Carolina; Nobre-dos-Santos, Marinês; Gavião, Maria Beatriz Duarte
The purpose of this case report was to describe the oral rehabilitation of a 4-year-old girl presenting early childhood caries (ECC). ECC is highly prevalent in developing countries and its severity increases with age. This disease implies serious consequences for the development of the stomatognathic system and for the child's quality of life. As young children are usually anxious about dental treatment, their level of co-operation is limited, leading to a challenging situation. A 4-year-old girl was brought by her mother for dental treatment with the complaint of pain. The clinical examination revealed extensive carious coronary destructions. After preventive and curative measures, the oral rehabilitation was performed; it included the use of stainless steel crowns, resin filled celluloid crowns with previous cementation of glass post pins when necessary, an amalgam restoration, orthodontic treatment, and a partial removable prosthesis. The child has been monitored in the Pediatric Dentistry Clinic at 4-monthly intervals. The oral rehabilitation was able to reestablish the oral health in the primary arches mutilated by early childhood caries. This is important for the establishment of an adequate mixed and permanent dentition, for proper facial and maxillary growth, and to the child's psychological and social development. The full management, including preventive, psychological, and curative measures of a young child with severe ECC was found successful after 8 months of follow up. This result can encourage the clinicians to seek a cost-effective technique such as stainless steel crowns, resin filled celluloid crowns, and partial removable prosthesis to reestablish the oral functions and improve the child's psycho-social development.
Miller, Juliet V.; Vetter, Louise
A study examined the relevance of vocational information and guidance for the equal access of girls and women to technical/vocational education in the following countries: Argentina; India; Mexico; Republic of Korea; South Africa; Spain; Sweden; Turkey; United Arab Emirates; and Zambia. Case studies were conducted by using a multiple-strategy…
Rea Ventures Group, LLC, (Rea Ventures) partnered with Southface Energy Institute (Southface) on the rehabilitation of 418 low-income rental multifamily apartments located at 14 different properties in Georgia (Climate Zones 2-4). These 22-year old, individually-metered units were arranged in rowhouse or townhouse style units. Rehabilitation plans were developed using a process prescribed by the US Department of Agriculture (USDA) Rural Development program, who partially funded the building upgrades. The USDA is responsible for building, upgrading, and subsidizing housing in rural areas nationwide. In 2012, over $100 million was allocated in grants and loans. Due to the unique financing mechanism as well as long-term ownership requirements, property owners are especially motivated to invest in upgrades that will increase durability and tenant retention. These buildings represent a large stock of rural affordable housing that have the potential for significant energy and cost savings for property owners and tenants. Southface analyzed the energy upgrade potential of one stereotypical property in the Rea Ventures portfolio. This study will provide insight into the most cost-effective, implementable energy efficiency and durability upgrades for this age multifamily housing, having an enormous impact not only on the portfolio of Rea Ventures but on the vast USDA and larger Federal portfolio. Additionally, Southface will identify gaps in the current capital needs assessment process, examine available audit and simulation tools and protocols, and evaluate additional auditor training or certification needs.
Hashida, Nao; Shamoto, Hiroshi; Maeda, Keisuke; Wakabayashi, Hidetaka; Suzuki, Motoyuki; Fujii, Takashi
Swallowing dysfunction is related to long-term weight loss and reduced body mass index in patients with head and neck cancer. We describe a 76-y-old woman who had severe sarcopenic dysphagia and atrophy of the reconstructed tongue for 17 mo after subtotal glossectomy due to tongue cancer and lost 14 kg during that period. Upon admission, the patient received diagnoses of malnutrition in the context of social or environmental circumstances with insufficient energy intake, loss of muscle mass, localized fluid accumulation, weight loss, and sarcopenia due to reduced skeletal muscle mass (skeletal muscle index protein intake to 70.3 g/d by supplying sufficient excess energy, and provided physical therapy and dysphagia rehabilitation to improve sarcopenia, atrophy of the reconstructed tongue, and dysphagia. After 20 mo of treatment, she was considered to be no longer malnourished (11 kg weight gain) and without sarcopenia (skeletal muscle index 4.01 cm 2 /m 2 ), and the volume of the reconstructed tongue was increased. Sarcopenia and atrophy of the reconstructed tongue may cause dysphagia after glossectomy due to tongue cancer. Additionally, nutritional support and rehabilitation could improve such dysphagia. Copyright © 2016 Elsevier Inc. All rights reserved.
Irimia, Danut C; Cho, Woosang; Ortner, Rupert; Allison, Brendan Z; Ignat, Bogdan E; Edlinger, Guenter; Guger, Christoph
Conventional therapies do not provide paralyzed patients with closed-loop sensorimotor integration for motor rehabilitation. This work presents the recoveriX system, a hardware and software platform that combines a motor imagery (MI)-based brain-computer interface (BCI), functional electrical stimulation (FES), and visual feedback technologies for a complete sensorimotor closed-loop therapy system for poststroke rehabilitation. The proposed system was tested on two chronic stroke patients in a clinical environment. The patients were instructed to imagine the movement of either the left or right hand in random order. During these two MI tasks, two types of feedback were provided: a bar extending to the left or right side of a monitor as visual feedback and passive hand opening stimulated from FES as proprioceptive feedback. Both types of feedback relied on the BCI classification result achieved using common spatial patterns and a linear discriminant analysis classifier. After 10 sessions of recoveriX training, one patient partially regained control of wrist extension in her paretic wrist and the other patient increased the range of middle finger movement by 1 cm. A controlled group study is planned with a new version of the recoveriX system, which will have several improvements. © 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.
Tasaduq, N.; Saleem, M.; Rehman, S.S.U.; Saleem, M.
Objective: To determine the role of intra-articular corticosteroid injections in pain management during physical rehabilitation of moderate to severe cases of knee osteoarthritis. Study Design: Randomized control trial (RCT). Place and Duration of Study: Department of Rheumatology and Rehabilitation, Fauji Foundation Hospital Rawalpindi during June 2011 to February 2012. Patients and Methods: Sixty patients with moderate to severe knee osteoarthritis were randomly selected by using probability simple random sampling technique, and randomly placed into two groups A and B through flip a coin method. The intra-articular corticosteroid injections were administered into 30 patients, including 22 female and 08 male, followed by a 2 weeks physical rehabilitation program. In group B all 30 patients, 19 female and 11 male, underwent through a 2 weeks physical rehabilitation program. The visual analog scale (VAS) was used to assess the intensity of pain and was measured at the start and at completion of the 2 week treatment program. Results: There were 60 cases in the study; 30 in each treatment groups A and B, and no drop outs. Mean age of the patients in group A was 56.25 and group B it was 58.75 years. Majority of patients in both the groups were between 44 - 77 years of age. The pain intensity was calculated in group A (p-value=0.007) and group B (p-value=0.009) at baseline. The patients in group A was treated by intra-articular corticosteroid injections followed by physical rehabilitation and group B was treated only with physical rehabilitation for two months. The pain intensity was measured at the completion of treatment for group A (p - value = 0.006) and B (p - value 0.271). Conclusion: The study concluded that intra-articular corticosteroid injections combined with physical therapy management are more effective in pain management during physical rehabilitation of moderate to severe cases of knee osteoarthritis as compare with physical therapy alone. (author)
Bowman, Mary H; Taub, Edward; Uswatte, Gitendra; Delgado, Adriana; Bryson, Camille; Morris, David M; McKay, Staci; Mark, Victor W
Constraint-Induced Movement therapy (CI therapy) is a recognized rehabilitation approach for persons having stroke with mild to moderately severe motor upper extremity deficits. To date, no rehabilitation treatment protocol has been proven effective that addresses both motor performance and spontaneous upper extremity use in the life situation for chronic stroke participants having severe upper extremity impairment with no active finger extension or thumb abduction. This case report describes treatment of a chronic stroke participant with a plegic hand using a CI therapy protocol that combines CI therapy with selected occupational and physical therapy techniques. Treatment consisted of six sessions of adaptive equipment and upper extremity orthotics training followed by a three-week, six-hour daily intervention of CI therapy plus neurodevelopmental treatment. Outcome measures included the Motor Activity Log for very low functioning patients (Grade 5 MAL), upper extremity portion of the Fugl-Meyer Motor Assessment, Graded Wolf Motor Function Test - for very low functioning patients (gWMFT- Grade 5), and Modified Ashworth Scale. The participant showed improvement on each outcome measure with the largest improvement on the Grade 5 MAL. In follow-up, the participant had good retention of his gains in motor performance and use of his more affected arm for real world activities after 3 months; after a one-week brush-up at 3 months, and at one year post-treatment.
Hélder Fonseca Mendes
Full Text Available Introduction: The education and promotion of health she make guaranteeing knowledge, aptitudes and opportunities to the people so that they can make decisions and to have attitudes that improve your conditions of health. The training for promotion of patients' health with sequels of BIRD (it Alters Vascular Encefálico and patients' caretakers with sequels of BIRD, it can contribute to improve the life quality and to promote the solemnity-care. Methods: They were made case studies with five patient and your respective caretakers. The patients answered to the Functional Index of Barthel and the caretakers to a questionnaire of knowledge regarding the pathology and they participated of weekly encounters in the Regional Hospital of Planaltina, where they were answered your doubts, they received training and orientations in agreement with the theme proposed for each meeting and the patients' main needs. Results: Four patients concluded the study. We observed that all had it gets better in your functional state. The Index of medium initial Barthel was of 52,5 and the end of 85,0 points. The caretakers were shown disposed to participate in the process of the patients' rehabilitation in spite of they have not previous knowledge regarding the disease. Conclusion: We concluded that the presented data showthe relevance of the education and of the promotion of health as strategies for the patients' rehabilitation with sequel of BIRD.
Guo, Yao-Hong; Kuan, Ta-Shen; Hsieh, Pei-Chun; Lien, Wei-Chih; Chang, Chun-Kai; Lin, Yu-Ching
Anti-N-methyl-d-aspartate (anti-NMDA) receptor encephalitis is a newly recognized, potentially fatal, but treatable autoimmune disease. Good outcome predictors include milder severity of symptoms, no need for intensive care unit admission, early aggressive immunotherapy, and prompt tumor removal. We report a case of a young girl aged 3 years 2 months and diagnosed as recalcitrant anti-NMDA receptor encephalitis without any underlying neoplasm. The patient had initial symptoms of behavioral changes that progressed to generalized choreoathetosis and orofacial dyskinesia, which resulted in 6 months of hospitalization in the pediatric intensive care unit. One year after initial onset of the disease, she had only achieved the developmental age of an infant aged 6–8 months in terms of gross and fine motor skills, but she resumed total independence in activities of daily living after receiving extensive immunotherapy and 28 months of rehabilitation. Our brief review will help clinical practitioners become more familiar with this disease and the unique rehabilitation programs. PMID:25473290
Juliana Feltrin de Souza
Full Text Available Case Report. An 8-year-old girl with amelogenesis imperfecta (AI reported unsatisfactory aesthetics, difficulty in mastication, and dental hypersensitivity. The intraoral examination observed mixed dentition, malocclusion in anteroposterior relationships, anterior open bite, and dental asymmetry. A hypoplastic form of AI was diagnosed in the permanent dentition. A multidisciplinary planning was performed and divided into preventive, orthopedic, and rehabilitation stages. Initially, preventive treatment was implemented, with fluoride varnish applications, in order to protect the fragile enamel and reduce the dental sensitivity. In the second stage, the patient received an interceptive orthopedic treatment to improve cross-relationship of the arches during six months. Finally, the rehabilitation treatment was executed to establish the vertical dimension. In the posterior teeth, indirect composite resin crowns were performed with minimally invasive dental preparation. Direct composite resin restorations were used to improve the appearance of anterior teeth. Follow-Up. The follow-up was carried out after 3, 6, 12, and 18 months. After 18 months of follow-up, The restoration of integrity, oral hygiene, and patient satisfaction were observed . Conclusion. Successful reduction of the dental hypersensitivity and improvement of the aesthetic and functional aspects as well as quality of life were observed.
Fisher, Steve R; Wiggs, Laura L; Ivanhoe, Cindy B
Broadly defined, forced-use therapy uses specific techniques designed to engage the patient with brain injury in activities that disallow overcompensation with the noninvolved or less involved body segments while forcing the use of the more involved segments. Some applications may involve placing the patient's hemiparetic extremity in a closed-chain weight-bearing activity with therapist support. We describe 2 cases of gastrocnemius muscle tears that occurred during inpatient neurologic rehabilitation that may be attributed to forced use of the hemiplegic lower extremity. Each presented with signs and symptoms indicative of deep vein thrombosis of the calf but was later confirmed with magnetic resonance imaging to be muscle tears. Some closed-chain, forced-use activities may be ill advised in the early stages of rehabilitation or if force generation of the muscle is inadequate to provide a protective response to overstretching. Gastroc-soleus tears should also be considered in the differential diagnosis of unilateral or even bilateral lower-extremity swelling and pain in neurologically impaired patients who are undergoing forced-use therapy.
de Souza, Juliana Feltrin; Fragelli, Camila Maria Bullio; Paschoal, Marco Aurélio Benini; Campos, Edson Alves; Cunha, Leonardo Fernandes; Losso, Estela Maris; Cordeiro, Rita de Cássia Loiola
Case Report. An 8-year-old girl with amelogenesis imperfecta (AI) reported unsatisfactory aesthetics, difficulty in mastication, and dental hypersensitivity. The intraoral examination observed mixed dentition, malocclusion in anteroposterior relationships, anterior open bite, and dental asymmetry. A hypoplastic form of AI was diagnosed in the permanent dentition. A multidisciplinary planning was performed and divided into preventive, orthopedic, and rehabilitation stages. Initially, preventive treatment was implemented, with fluoride varnish applications, in order to protect the fragile enamel and reduce the dental sensitivity. In the second stage, the patient received an interceptive orthopedic treatment to improve cross-relationship of the arches during six months. Finally, the rehabilitation treatment was executed to establish the vertical dimension. In the posterior teeth, indirect composite resin crowns were performed with minimally invasive dental preparation. Direct composite resin restorations were used to improve the appearance of anterior teeth. Follow-Up. The follow-up was carried out after 3, 6, 12, and 18 months. After 18 months of follow-up, The restoration of integrity, oral hygiene, and patient satisfaction were observed . Conclusion. Successful reduction of the dental hypersensitivity and improvement of the aesthetic and functional aspects as well as quality of life were observed.
The successful implementation of an integrated care pathway (ICP) for any given condition is a challenge. Even more challenging is successful ICP implementation for individuals who have multiple co-morbidities. This is further compounded when there are dual mental health and physical disabilities that require integrated working across multiple disciplines, specialties, institutions and organisations. Anti-NMDA-Receptor encephalitis (aNMDARe) is a relatively new diagnostic entity with patients typically presenting with significant psychiatric symptoms followed by progressive neurological deterioration. In this case series, we describe 3 cases of females with aNMDARe who were referred for complex specialist rehabilitation (CSR) to The National Rehabilitation Hospital. CSR is the total active care of patients with a disabling condition, and their families, by a multi-professional team who have undergone recognised specialist training in rehabilitation, led \\/supported by a consultant trained and accredited in rehabilitation medicine (RM). These services provide for patients with highly complex rehabilitation needs that are beyond the scope of local services. In these cases, referral to CSR resulted in the construction of a bespoke integrated care pathway (ICP) that transcended the barriers between primary, secondary and tertiary care and across the boundaries of physical and mental health. A care pathway is a complex intervention for the mutual decision-making and organisation of care processes Rehabilitation services acted as the coordinator of services in these cases to ensure implementation of the care plan and to ensure successful transitions of care and supported local specialist and general teams in the management of these complex cases.
The case of higher education provision in further education: leadership in the evolution of higher education in the post leaving certificate sector of the city of Dublin vocational education committee.
The case of Higher Education provision in Further Education: Leadership in the evolution of Higher Education in the Post Leaving Certificate sector of the City of Dublin Vocational Education Committee. (Denis Murray, BA, MBS.) This research investigates evolutionary change in Further Education (FE) within the Post Leaving Certificate (PLC) sector with a particular emphasis on the development of Higher Education (HE) courses within the CDVEC. The objective of the study is to understand what...
Full Text Available Zygomatic implants have been used for dental rehabilitation in patients with insufficient bone in the posterior upper jaw, due to, for example, tumor resection, trauma, or atrophy. Zygomatic implants are an alternative to complex free or vascularized bone grafting and distraction osteogenesis. A 42-year-old male patient with a severe defect in the right posterior maxilla, starting from the first canine region, which had occurred after tumor resection 3 years earlier, was referred to our department. One zygomatic implant (Brenemark System, Nobel Biocare, Goteborg, Sweden to the zygoma and one dental implant to the canine region were placed. After a 5-month osseointegration period, a fixed denture was fabricated and adapted to the implants. Although the surgical and prosthetic procedures for zygoma implants are not easy, the final outcomes can be successful with appropriate planning.
Full Text Available Abstract Introduction: Recovery and maintenance of patients suffering from heart and respiratory diseases using the cardiopulmonary rehabilitation program (CPRP help maintain their functionality and improve the activities of daily living (ADLs carried out according to their functional limitations. Objective: To investigate the efficacy of a CPRP in a patient with cardiopulmonary disease, following a 5-month training program. Methods: A 66-year-old female patient, body weight 78 kg, height 1.55 m, diagnosed with acute myocardial infarction and bronchial asthma underwent a six-minute walk test (6MWT to measure exercise tolerance; the Wells Bench was used to measure the flexibility of the posterior chain and lower limbs (LL, and a hand-held dynamometer (HHD was used to measure upper limb strength (ULS.Vital sign measurements include blood pressure (BP, heart rate (HR, respiratory rate (RR, oxygen saturation (SpO2 as well as dyspnea and LL fatigue (modified Borg scale at rest, during and after 5-month CPRP. Results: An increase of 145 meters during the cardiopulmonary rehabilitation program i.e. 30% of walk distance (WD in the 6MWT (pre = 345, post = 490m. There was an increase of 32% in flexibility (pre = 13, post = 19cm; in right upper limb (pre = 26, post = 60 kgf and left lower limb strength (pre = 28, post = 72kgf, there was an increase of 57% and 61%, respectively. Conclusion: The CPRP proved to be effective in increasing exercise capacity, upper limb strength and flexibility of the posterior chain and lower limbs.
Gussenhoven, A.H.M.; Singh, A.S.; Goverts, S.T.; van Til, M.; Anema, J.R.; Kramer, S.E.
A multidisciplinary vocational rehabilitation programme, the Vocational Enablement Protocol (VEP) was developed to address the specific needs of employees with hearing difficulties. In the current study we evaluated the process of implementing the VEP in audiologic care among employees with hearing
Full Text Available The maxillofacial region is one of the most injury-prone areas during road traffic accidents, personal violence, falls and sports. Maxillofacial trauma can lead to breakage or avulsion of upper anterior teeth, which may cause significant aesthetic and functional problems. There are many treatment options available for rehabilitation including removable partial dentures, fixed partial dentures, crown and bridges and implant-supported prostheses.Herein, two cases are presented where implant placement was done for upper anterior teeth, which were traumatized or avulsed following maxillofacial trauma. Both patients demonstrated a history of maxillofacial trauma and had undergone open reduction and internal fixation. The first patient had a severe maxillary alveolar defect treated via autogenous bone grafting and a six-month period was given for proper integration of the bone graft. The second patient was a smoker with very poor oral hygiene and a deep bite. Thus, implant placement was not initially justified.
Full Text Available Dentin dysplasia is an exceptionally rare, autosomal-dominant, hereditary condition, primarily characterized by defective dentin formation affecting both the deciduous and permanent dentitions. The etiology remains imprecise to date, in spite of the numerous hypotheses put forward and the constant updates on this condition. This case report of type I dentin dysplasia exhibits radiographic findings that are unique and diverse from the classical findings of various subtypes of this disease reported to date. This article also depicts the implant-based oral rehabilitation of the young patient diagnosed with this variant model of dentin dysplasia type I. Early diagnosis and implementation of this preventive and curative therapy is vital for avoiding premature exfoliation of deciduous and permanent dentition and the associated residual ridge resorption, thereby overcoming functional and esthetic deficits and ensuring protection of the remaining dentition from further harm.
Kentucky State Dept. of Education, Frankfort.
This document is a catalog of reviews of computer software suitable for use in vocational agriculture programs. The reviews were made by vocational agriculture teachers in Kentucky. The reviews cover software on the following topics: farm management, crop production, livestock production, horticulture, agricultural mechanics, general agriculture,…
... achieving a vocational goal. 21.53 Section 21.53 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF... achieving a vocational goal. (a) Requirement. The Department of Veterans Affairs shall determine the reasonable feasibility of achieving a vocational goal in each case in which a veteran has either: (1) An...
Shibata, S; Taguchi, Cmc; Gondo, R; Stolf, S C; Baratieri, L N
The aim of this article is to present two case reports for the treatment of patients affected with amelogenesis imperfecta. One case was treated with composite resin and the other case with ceramic veneers. Esthetic and functional results were achieved using both treatments, and a review of advantages and disadvantages is presented.
The Mode Reform of Cultivating Marketing Talents in Agricultural Vocational Colleges Based on the Perspective of Agricultural Enterprises——A Case Study of Wenzhou Vocational College of Science and Technology
We conduct survey on the characteristics of demand of agricultural enterprises for agricultural marketing talents from the following 6 aspects:the professional marketing talents needed urgently by the agricultural enterprises,the amount of demand of agricultural enterprises for the marketing talents,the jobs offered by the agricultural enterprises,the educational background of agricultural marketing talents favored by the agricultural enterprises,the requirements posed by the agricultural enterprises on the work experience of agricultural marketing talents,and the quality requirements posed by the agricultural enterprises on the agricultural marketing talents.We analyse the problems existing in the cultivation mode of marketing talents in agricultural vocational colleges as follows:the feature of major is not outstanding;the contradiction between supply and demand is prominent;it is disconnected with the practical needs of agricultural enterprises;the cultivation form of practical ability is simple.On the basis of this,taking Wenzhou Vocational College of Science and Technology as an example,we advance the new mode of cultivating inter-disciplinary talents integrating "marketing technique+technique marketing",and establish characteristic agricultural course combo system on the basis of vocational position orientation.In the meantime,we propose that we should conduct close college-enterprise cooperation with the local leading agricultural enterprises.This cultivation mode reform of talents is favorable for the agricultural enterprises,especially small and medium-sized agricultural enterprises to foster "marketable" agricultural marketing talents,elevate the comprehensive competitiveness of small and medium-sized agricultural enterprises,serve the local economy,and promote the development of modern agriculture,and China’s agriculture,farmer,and countryside.
Full Text Available In Bangladesh, a majority of individuals with spinal cord injuries (SCI are either poor or very poor. In most cases, their families undergo extreme hardship as they lose the income of the only or main earning member, and are unable to bear costs of rehabilitation.Purpose: This mixed method study explored perspectives of individuals with SCI regarding financial aid in the form of interest-free loans for their treatment and rehabilitation at the Centre for the Rehabilitation of the Paralysed (CRP.Method: In the first part of the study, 10 semi-structured face-to-face interviews were conducted. In the second part of the study, 40 persons with SCI were surveyed. The qualitative method involved selection of respondents according to their age, sex and severity of disability. Quantitative interviews were conducted with all persons with SCI in the final stage of hospital rehabilitation, in the third quarter of 2008. Results: Though CRP provides financial support depending on the individual’s economic status, many persons with SCI needed additional funding from multiple sources, such as savings (42.5%, mortgaging assets (12.5%, selling assets (45%, receiving loans (37.5%, begging for money (42.5%, and receiving donations from relatives (47.5% or the community (30%, to meet the direct and indirect costs of rehabilitation. Majority (85% of those interviewed wanted to receive financial aid in the form of interest-free loans. 76.4% of them wanted the loans to be disbursed in two phases; initially, to offset some of their costs during rehabilitation at CRP, and thereafter, for economic reintegration in their community. The remaining 23.6% wanted the loan only for vocational reintegration. 70.59% of those interviewed proposed repayment in monthly instalments, while 17.64% suggested quarterly instalments and 11.76% favoured annual instalments. Over half of the participants (55.88% wanted to have vocational training, and the rest wanted vocational training for
Stam, Daniel; Fernandez, Jennifer
Diffuse axonal injury is a prominent cause of disablement post-traumatic brain injury. Utilization of the rapid expansion of our current scientific knowledge base combined with greater access to neurological and assistive technology as adjuncts to providing sensorimotor experience may yield innovative new approaches to rehabilitation based upon a dynamic model of brain response following injury. A 24-year-old female who sustained a traumatic brain injury, bilateral subdural hemorrhage, subarachnoid hemorrhage and severe diffuse axonal injury secondary to a motor vehicle collision. Evidence-based appraisal of present literature suggests a link between graded intensity of aerobic activity to facilitation of neuro-plastic change and up-regulation of neurotrophins essential to functional recovery post-diffuse axonal injury. Following resolution of paroxysmal autonomic instability with dystonia, aggressive early mobilization techniques were progressed utilizing robotic assistive gait technology in combination with conventional therapy. This approach allowed for arguably greater repetition and cardiovascular demands across a six-month inpatient rehabilitation stay. Outcomes in this case suggest that the use of assistive technology to adjunct higher level and intensity rehabilitation strategies may be a safe and effective means towards reduction of disablement following severe traumatic brain and neurological injury. Implications for Rehabilitation Functional recovery and neuroplasticity following diffuse neurological injury involves a complex process determined by the sensorimotor experience provided by rehabilitation clinicians. This process is in part modulated by intrinsic brain biochemical processes correlated to cardiovascular intensity of the activity provided. It is important that rehabilitation professionals monitor physiological response to higher intensity activities to provide an adaptive versus maladaptive response of central nervous system plasticity with
Margaretha M. Visser
Full Text Available Background: Case studies are core constructs used in information management research. A persistent challenge for business, information management and social science researchers is how to select a representative sample of cases among a population with diverse characteristics when convenient or purposive sampling is not considered rigorous enough. The context of the study is post-school education, and it involves an investigation of quantitative methods of clustering the population of public technical and vocational education and training (TVET colleges in South Africa into groups with a similar level of maturity in terms of their information systems. Objectives: The aim of the study was to propose an evidence-based quantitative method for the selection of cases for case study research and to demonstrate the use and usefulness thereof by clustering public TVET colleges. Method: The clustering method was based on the use of a representative characteristic of the context, as a proxy. In this context of management information systems (MISs, website maturity was used as a proxy and website maturity model theory was used in the development of an evaluation questionnaire. The questionnaire was used for capturing data on website characteristics, which was used to determine website maturity. The websites of the 50 public TVET colleges were evaluated by nine evaluators. Multiple statistical techniques were applied to establish inter-rater reliability and to produce clusters of colleges. Results: The analyses revealed three clusters of public TVET colleges based on their website maturity levels. The first cluster includes three colleges with no websites or websites at a low maturity level. The second cluster consists of 30 colleges with websites at an average maturity level. The third cluster contains 17 colleges with websites at a high maturity level. Conclusion: The main contribution to the knowledge domain is an innovative quantitative method employing a
Pressman, Helaine Tobey
Traumatic brain injury (TBI) cases are medically complex, involving the physical, cognitive, behavioral, social, and emotional aspects of the survivor. Often catastrophic, these cases require substantial financial resources not only for the patient's survival but to achieve the optimal outcome of a functional life with return to family and work responsibilities for the long term. TBI cases involve the injured person, the family, medical professionals such as treating physicians, therapists, attorneys, the employer, community resources, and the funding source, usually an insurance company. Case management is required to facilitate achievement of an optimal result by collaborating with all parties involved, assessing priorities and options, coordinating services, and educating and communicating with all concerned.
Gay-Escoda, C; Pérez-Álvarez, D; Camps-Font, O; Figueiredo, R
The existing information on oral rehabilitations with dental implants in VIH-positive patients is scarce and of poor quality. Moreover, no long-term follow-up studies are available. Hence, the aims of this study were to describe the long-term survival and success rates of dental implants in a group of HIV-positive patients and to identify the most common postoperative complications, including peri-implant diseases. A retrospective case series of HIV-positive subjects treated with dental implants at the School of Dentistry of the University of Barcelona (Spain) was studied. Several clinical parameters were registered, including CD4 cell count, viral load and surgical complications. Additionally, the patients were assessed for implant survival and success rates and for the prevalence of peri-implant diseases. A descriptive statistical analysis of the data was performed. Nine participants (57 implants) were included. The patients' median age was 42 years (IQR=13.5 years). The implant survival and success rates were 98.3% and 68.4%, respectively, with a mean follow-up of 77.5 months (SD=16.1 months). The patient-based prevalence of peri-implant mucositis and peri-implantitis were 22.2% and 44.4% respectively at the last appointment. Patients that attended regular periodontal maintenance visits had significantly less mean bone loss than non-compliant patients (1.3 mm and 3.9 mm respectively). Oral rehabilitation with dental implants in HIV-positive patients seems to provide satisfactory results. In order to reduce the considerably high prevalence of peri-implant diseases, strict maintenance programmes must be implemented.
... by the veteran in a course at the secondary school level under § 21.4235 before December 31, 1989, or... requires the approval of the counseling psychologist and concurrence of the Vocational Rehabilitation and...
... experience working with vocational rehabilitation agencies. (b) Increased knowledge about how these practices... or more priorities, we designate the type of each priority as absolute, competitive preference, or...)(3)). Competitive preference priority: Under a competitive preference priority, we give competitive...
Vincenzo Luca Zizzari
Full Text Available The aim of this case report is to describe the surgical and prosthetic procedures to achieve maxillary and mandibular implant-supported PMMA monolithic full-arch rehabilitation (PMFR with surgical computer-planned guide and immediate provisional. In such cases, the correct planning of dental implants’ position, length, and diameter and the prosthetic phases via computer-aided design are very important to achieve good aesthetic and functional long-lasting results.
Zizzari, Vincenzo Luca; Tacconelli, Gianmarco
The aim of this case report is to describe the surgical and prosthetic procedures to achieve maxillary and mandibular implant-supported PMMA monolithic full-arch rehabilitation (PMFR) with surgical computer-planned guide and immediate provisional. In such cases, the correct planning of dental implants’ position, length, and diameter and the prosthetic phases via computer-aided design are very important to achieve good aesthetic and functional long-lasting results.
... in nonrural areas (U.S. Census Bureau, 2011b), and rural vocational rehabilitation clients with... priorities, we designate the type of each priority as absolute, competitive preference, or invitational...)). Competitive preference priority: Under a competitive preference priority, we give competitive preference to an...
Farley, Roy C.
Examined the effects of a psychoeducational program on employability enhancement of 23 rehabilitation clients. The program had a significant, positive impact on clients' thinking, feeling, acting, and vocational outcome and reduced task-interfering beliefs, thoughts, emotions, and problem behavior. Participants had a lower vocational training…
...: One commenter noted that the priority requires the Center to actively engage ``vocational... with disabilities, employers, policy makers, and vocational rehabilitation (VR) practitioners. The... preference, or invitational through a notice in the Federal Register. The effect of each type of priority...
Young, A E; Russell, J
Occupational stress is a significant problem and is of particular concern for educational organizations. It was the aim of the current project to identify variables that could predict return-to-work outcomes in a group of teachers who had taken leave for a work-related stress condition. Demographic, psychometric, and case progression data were collected for 119 teachers who had taken Workers' Compensation Leave and were participating in a rehabilitation program. The participants' return to work outcomes were followed-up at least 12 months after they initially left their workplace. Hierarchical discriminant function analysis indicated that 84.62% of the cases could be correctly classified as either "returning to work" or "not returning to work due to illness." The main predictor variables were: if the individual had attempted to return to work within 505 days of injury, the individual's health behaviors, the sex of the individual, and the type of school in which he or she was employed (primary or secondary). It is suggested that the derived model could be further developed and used to predict return to work from stress-related illnesses.
Full Text Available This paper examines the entrepreneurial inclinations of young people who achieved excellence in vocational occupations. We propose a three-capital approach to the study of entrepreneurship. Relying on the existing theories and original qualitative and quantitative data analyses, findings from interviews with 30 entrepreneurial and 10 non-entrepreneurial WorldSkills competitors show that psychological capital, social capital and human capital can be combined to explore how young people who excel in vocational occupations develop entrepreneurial mindsets. We show that training for and participation in the largest vocational skills event globally - WorldSkills competition - develops selected aspects of three capitals. However, we also discover that the entrepreneurial motivation precedes competitors' involvement with WorldSkills.
Camacho, MariaCruz; Hernández, Jose Manuel; Lima-Barbero, Jose Francisco; Höfle, Ursula
More than 70% of new human pathogens are zoonotic and many originate from the wildlife reservoir. Wildlife rehabilitation centres (WRC) are an easily accessible source for sample and data collection for preventive surveillance, but data collected this way may be biased. We use white storks (Ciconia ciconia) as a model to compare pathogen prevalence obtained in the field and WRC. We address factors that may affect disease prevalence data like origin, the age group and the "diseased" state of WRC admissions. In this study we compared prevalence of Escherichia coli and Salmonella spp. in the digestive tract; antibodies against West Nile virus, avian influenza and Newcastle disease virus, and antimicrobial resistance patterns of E. coli between nestling and adult wild storks established in different habitats (n=90) and storks admitted to two different WRC (n=30) in the same region. When age groups and colonies of origin were disregarded, the mean enterobacteria (E. coli, Salmonella) and viral antibody prevalence of the wild population (n=90) were similar to prevalence observed in the individuals admitted to WRC (n=30). However, in fledgling juvenile storks admitted to WRC, the prevalence of Salmonella spp. (13.3%), E. coli showing resistance to cefotaxime (37.9%) and against two antimicrobials at once (41.4%) were more similar to the prevalence in stork nestlings from landfill-associated colonies (7.9%, 37.1% and 48.6%, respectively for prevalence of Salmonella spp. and E. coli displaying, cefotaxime resistance and resistance against two antimicrobials), and significantly higher than in colonies located in natural habitats (0%; 10.5% and 15.8%, respectively). Thus, pathogen surveillance in individuals from an abundant species admitted to WRC is useful to monitor overall mean prevalence, but for certain pathogens may not be sufficient to detect differences between local populations. In addition, the ecology of the tested species and the specific temporal, spatial and
McAleer, Stephen S; Lippie, Ed; Norman, Darcy; Riepenhof, Helge
Study Design Case series. Background Pubic bone stress (PBS) is a common acute or chronic response of the pelvis in sports where sprinting, kicking, twisting, and cutting are the dominant movements. There are few nonoperative rehabilitation strategies for the condition reported in the literature, and the outcome of conservative treatment has not been documented. Case Description Five professional and academy soccer players complaining of pubic symphysis pain, confirmed as PBS on magnetic resonance imaging and objective assessment, were treated with a nonoperative rehabilitation program that featured functional and clinical objective markers as progression criteria. Interventions in the acute phase included pharmacological and physical therapeutic modalities to reduce pain initially. Rehabilitation management focused on improving range of motion at the hips and thorax, adductor strengthening, trunk and lumbopelvic stability, gym-based strength training, and field-based rehabilitation and conditioning. Clinical follow-up was performed at least 8 months following return to play. Outcomes All players demonstrated reduced or resolved pain, increased adductor squeeze strength, and return to pain-free training and match play. Return-to-training time averaged 40.6 days (range, 30-60 days) and return to play averaged 49.4 days (range, 38-72 days) within the 5 players. At final follow-up (mean, 29.6 months; range, 16-33 months), there had been no recurrences. Discussion This report of 5 cases suggests that a nonoperative protocol, using clinical and functional progression criteria, may be successful in rehabilitating athletes with PBS for return to sport within 11 weeks. Level of Evidence Therapy, level 4. J Orthop Sports Phys Ther 2017;47(9):683-690. Epub 3 Aug 2017. doi:10.2519/jospt.2017.7314.
Full Text Available Hicham Khabbache,1 Abdelhak Jebbar,2,* Nadia Rania,3,* Marie-Chantal Doucet,4 Ali Assad Watfa,5 Joël Candau,6 Mariano Martini,7 Anna Siri,8,* Francesco Brigo,9,10,* Nicola Luigi Bragazzi1,2,4–8,11,* 1Faculty of Literature and Humanistic Studies, Sais, Sidi Mohamed Ben Abdellah University, Fez, 2Faculty of Art and Humanities, Sultan Moulay Slimane University, Beni-Mellal, Morocco; 3School of Social Sciences, Department of Education Sciences, University of Genoa, Genova, Italy; 4Faculty of Human Sciences, School of Social Work, University of Québec-Montréal, Montreal, QC, Canada; 5Faculty of Education, Kuwait University, Kuwait City, Kuwait; 6Laboratory of Anthropology and Cognitive and Social Psychology, University of Nice Sophia Antipolis, Nice, France; 7Department of Health Sciences (DISSAL, Section of Bioethics, University of Genoa, 8UNESCO Chair “Health Anthropology, Biosphere and Healing Systems”, Genova, 9Department of Neurology, Franz Tappeiner Hospital, Merano, 10Department of Neurological, Biomedical, and Movement Sciences, University of Verona, Verona, 11School of Public Health, Department of Health Sciences (DISSAL, University of Genoa, Genova, Italy *These authors contributed equally to this work Abstract: Mental, neurological and substance use (MNS disorders represent a major source of disability and premature mortality worldwide. However, in developing countries patients with MNS disorders are often poorly managed and treated, particularly in marginalized, impoverished areas where the mental health gap and the treatment gap can reach 90%. Efforts should be made in promoting help by making mental health care more accessible. In this article, we address the challenges that psychological and psychiatric services have to face in a low-resource context, taking our experience at a Moroccan rehabilitation center as a case study. A sample of 60 patients were interviewed using a semi-structured questionnaire during the period of
Khan, M H; Ashrafuzzaman, S M; Taib, A N; Alam, M T; Khan, S H; Goldstein, S K; Rahman, R
People with rare hypertrichosis syndromes became crowd-drawing money-making phenomena in many 19th century sideshow acts. These individuals have been referred to as dog-men, hair-men, and werewolves. In 1993, Baumister et al. described congenital hypertrichosis lanuginose or Ambras syndrome: a distinct form of congenital hypertrichosis characterized by excessive hair growth over the body and face associated with facial and occasional dental anomalies. Much is not known about this syndrome since fewer than 50 cases have been documented worldwide. In this case report, a nine year old girl presented with excessive hair growth throughout her body that was denser along her midline. Furthermore, her face displayed the typical dysmorphic features characteristic of Ambras syndrome: a round tip nose, thickened nasal cartilage, antiverted nares, prominent philtrum with deep groove, and a trapezoid mouth. Oral examination revealed normal oral mucosa with completely missing and unerupted decidious and permanent teeth. Panoramic radiographs confirmed unerupted deciduous teeth. Previous case reports have mentioned the presence of occasional dental anomalies such as retarded first and second dentition and absence of some teeth. However, this is the first reported case of Ambras syndrome presenting with complete anodontia. Prior cytogenetic studies performed on persons with Ambras syndrome have implicated a balanced pericentric inversion of chromosome 8. However, it is likely that dental anomalies are likely a result of a different genetic rearrangement. Further studies are needed to explore the cause of this rare phenotype of Ambras syndrome with complete unerupted dentition.
Kim, Sun-Hyun; Kim, Min-Young; Lee, Jae-Hyuk; Chun, Sae-il
This case report discusses the potential for art therapy to aid in the recovery of early-chronic stroke patients. The patient was diagnosed with having a subarachnoid hemorrhage from a cerebral aneurysm rupture 1 year prior to hospitalization. Therapies used as part of the patient's treatment included 10 weeks of art therapy conducted twice a…
Roessler, R T
The person/environment or ecological perspective on vocational evaluation provides a comprehensive assessment strategy for people with multiple sclerosis. The ecological model requires assessment of both personal variables such as rehabilitation outlook and MS symptoms and environmental variables such as barriers to workplace accessibility and performance of essential job functions. Measures of person and environment constructs are presented as are applications of the resulting information in vocational counseling and disability management services.
Full Text Available Stroke is a significant cause of long-term disability world-wide. The post-stroke disabilities are due to loss of locomotion, activity of daily living, cognition and communication skills. Rehabilitation is an integral part of medical management and continues longitudinally through acute care, post-acute care and community reintegration. The objectives of stroke rehabilitation are to maximize the functional independence, minimize the disabilities, reintegrate back into the home and community and improve the self-esteem of patient. A comprehensive stroke rehabilitation service should provide early assessment of impairments and disabilities, management and prevention of complications and well-organized rehabilitation program in both in-patient and out-patient settings. A multidisciplinary or interdisciplinary team approach is necessary to reduce the post-stroke disabilities. It has many members, including physicians, physical therapists, occupational therapists, speech and language pathologists, orthotist, psychotherapists, social workers, vocational rehabilitation therapists, rehabilitation nurse, patients, families and other caregivers. Physicians caring for patients with stroke during rehabilitation must be aware of potential medical complications, as well as a number of special problems that may complicate recovery, including cognitive deficits, aphasia, dysphagia, urinary incontinence, shoulder pain, spasticity, falls and depression. Involvement of patient and caregivers in the rehabilitation process is essential. This article outlines the salient features of the early comprehensive rehabilitation after stroke.
Full Text Available The aim of this review is to discuss the basic forms of neuropsychological rehabilitation for patients with traumatic brain injury (TBI. More broadly, we discussed cognitive rehabilitation therapy (CRT which constitutes a fundamental component in therapeutic interaction at many centres worldwide. Equally presented is a comprehensive model of rehabilitation, the fundamental component of which is CRT. It should be noted that the principles of this approach first arose in Poland in the 1970s, in other words, several decades before their appearance in other programmemes. Taken into consideration are four factors conditioning the effectiveness of such a process: comprehensiveness, earlier interaction, universality and its individualized character. A comprehensive programmeme of rehabilitation covers: cognitive rehabilitation, individual and group rehabilitation with the application of a therapeutic environment, specialist vocational rehabilitation, as well as family psychotherapy. These training programmemes are conducted within the scope of the ‘Academy of Life,’ which provides support for the patients in their efforts and shows them the means by which they can overcome existing difficulties. Equally emphasized is the close cooperation of the whole team of specialists, as well as the active participation of the family as an essential condition for the effectiveness of rehabilitation and, in effect, a return of the patient to a relatively normal life. Also presented are newly developing neurothechnologies and the neuromarkers of brain injuries. This enables a correct diagnosis to be made and, as a result, the selection of appropriate methods for neuropsychological rehabilitation, including neurotherapy.
Galvin Arribas, J. Manuel
This article analyses moves towards good multilevel governance approaches in Vocational Education and Training (VET) as an effective way to improve VET policy making in transition and developing countries, focusing on the Southern Neighbourhood of the EU (ENPI South). The centralised approaches in public administration and to VET governance still…
Copa, George H.
Discusses the application of continuous quality improvement principles in the Department of Vocational and Technical Education at the University of Minnesota. Reviews the processes that the department incorporated to implement this program and lists future steps and categories of action. (Author)
Hippach-Schneider, Ute; Weigel, Tanja; Brown, Alan; Gonon, Philipp
The German and Swiss economies value skilled work highly and initial vocational education and training (IVET) has been the predominant traditional pathway into such work. However, concerns about a more "knowledge-based society" and the "academic shift in the labour market" are starting to undermine the status associated with…
Rajadurai, Jegatheesan; Sapuan, Noraina Mazuin; Daud, Salina; Abidin, Nurazariah
Technical, Vocational Education and Training has been viewed as a means of developing a nation. The marketability of technical graduates is reliant on whether these graduates possess the attributes demanded by their respective industries. Hence, this study aims to investigate the gap between the key attributes of Higher Education Institutions'…
Ramadan, Abdelmoiz; Chen, Xiaohui; Hudson, Laura L.
Information and communication technology (ICT) elicited rapidly dissemination over the world. For its impact in Sudan, the national government has been energized the institutions to implement ICT in every sector. This study examined the Sudanese teachers' skills and ICT integration in technical and vocational education and training TVET in…
Factors influencing effective learning in instructional skill training for vocational instructors : learning for change : a case of Training Institute for Technical Instruction (TITI), Bhaktapur, Nepal
This study was based on Instructional Skills (IS) training module which was imparted by Training Institute for Technical Instruction (TITI) Nepal to improve the performance of vocational instructors. Instructional skill training is a three months training course split in to three modules; each
Chankseliani, Maia; Relly, Susan James
This paper examines the entrepreneurial inclinations of young people who achieved excellence in vocational occupations. We propose a three-capital approach to the study of entrepreneurship. Relying on the existing theories and original qualitative and quantitative data analyses, findings from interviews with 30 entrepreneurial and 10…
Perry den Brok; dr.ir. Quinta Kools; Kennedy Tielman
This research presents a descriptive study on regarding the use of a research-based approach by teachers to clarify problems they encountered in multicultural classrooms. It analyses the outcomes of a training in which seven teachers from a Dutch Senior Secondary Vocational Education school
Blakely, D [Alberta Environment, Edmonton, AB (Canada)
Alberta Environment Water Management Operations (WMO) owns and operates 46 dams and 800 kilometres of canals in Alberta. The WMO consists of 120 staff and several contract operators to take care of this infrastructure. Most of the infrastructure supplies water for irrigation use, which adds 5 billion dollars to the provincial economy annually. Other water uses include stock watering, domestic use, municipal use, recreational use and habitat. Alberta Environment's weir safety program was also discussed along with options for rehabilitation to improve public safety. A case study of Calgary's Weir Dam on the Bow River was highlighted. A brief history of the dam was offered and safety programs around provincially-owned weirs were discussed. Photographs were included to illustrate some of the additional safety measures at the Calgary weir, such as suspended safety buoys upstream of the boom directing paddlers to the portage trail, and signage on the river that can be activated when the boom is out. Typical river users on the Calgary Bow River and safety history at the Calgary Weir were discussed along with other topics such as the Calgary Bow River weir project criteria; project design progress; pre-feasibility options; scale modelling; final design analysis; construction funding; and proposed changes to the safety program for the new weir configuration. figs.
Maia Nogueira, Renato Luiz; Osterne, Rafael Lima Verde; Cavalcante, Roberta Barroso; Abreu, Ricardo Teixeira
Although pharmacologic treatments for central giant cell lesions have gained much emphasis, these treatment modalities do not always have successful outcomes, and surgical treatment may be necessary. The purpose of the present study was to report a case of aggressive central giant cell lesion initially treated by nonsurgical methods without satisfactory results, necessitating segmental mandibular resection for definitive treatment and oral rehabilitation. A 20-year-old woman was diagnosed with an aggressive central giant cell lesion in the mandible. The patient was first treated with intralesional corticosteroid injections. Subsequently, the lesion increased in size. Therefore, a second pharmacologic treatment was proposed with salmon calcitonin nasal spray, but no signs of a treatment response were noted. Because of the lack of response, surgical excision was performed, and a mandibular reconstruction plate was installed. At 12 months after surgical resection, the patient underwent mandibular reconstruction with bone grafts. After 6 months, 7 dental implants were installed, and fixed prostheses were made. After installation of the prostheses, the patient experienced persistent mandibular laterognathism, and a mandibular orthognathic surgery was performed to correct the laterognathia. The follow-up examination 4 years after orthognathic surgery showed no signs of recurrence and good facial symmetry. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Hayward, Kathryn S; Neibling, Bridee A; Barker, Ruth N
This single-case, mixed-method study explored the feasibility of self-administered, home-based SMART (sensorimotor active rehabilitation training) Arm training for a 57-yr-old man with severe upper-limb disability after a right frontoparietal hemorrhagic stroke 9 mo earlier. Over 4 wk of self-administered, home-based SMART Arm training, the participant completed 2,100 repetitions unassisted. His wife provided support for equipment set-up and training progressions. Clinically meaningful improvements in arm impairment (strength), activity (arm and hand tasks), and participation (use of arm in everyday tasks) occurred after training (at 4 wk) and at follow-up (at 16 wk). Areas for refinement of SMART Arm training derived from thematic analysis of the participant's and researchers' journals focused on enabling independence, ensuring home and user friendliness, maintaining the motivation to persevere, progressing toward everyday tasks, and integrating practice into daily routine. These findings suggest that further investigation of self-administered, home-based SMART Arm training is warranted for people with stroke who have severe upper-limb disability. Copyright © 2015 by the American Occupational Therapy Association, Inc.
de Carvalho, Cynthia Paes
This article discusses the relationship of students with learning and the university in the context of current challenges to vocational education and economic development. Inspired by the research of Pierre Bourdieu, this case study focuses on the relationship of students to learning and the university in Brazil. The survey gathered elements that…
Lopez, Frederick G.
Describes a case study in which a paradoxical intervention was effectively used in treating a vocationally indecisive college student and his overly involved father. The quality of the father-son interaction improved as the student's anxiety decreased. Implications for the use of paradox in other situations are discussed. (Author/JAC)
Short, Steven M; Anloague, Philip A; Strack, Donald S
Study Design Case report. Background Acute traumatic avulsion of the rectus abdominis and adductor longus is rare. Chronic groin injuries, often falling under the athletic pubalgia spectrum, have been reported to be more common. There is limited evidence detailing the comprehensive rehabilitation and return to sport of an athlete following surgical or conservative treatment of avulsion injuries of the pubis or other sports-related groin pathologies. Case Description A 29-year-old National Basketball Association player sustained a contact injury during a professional basketball game. This case report describes a unique clinical situation specific to professional sport, in which a surgical repair of an avulsed rectus abdominis and adductor longus was combined with a multimodal impairment- and outcomes-based rehabilitation program. Outcomes The patient returned to in-season competition at 5 weeks postoperation. Objective measures were tracked throughout rehabilitation and compared to baseline assessments. Measures such as the Copenhagen Hip and Groin Outcome Score and numeric pain-rating scale revealed progress beyond the minimal important difference. Discussion This case report details the clinical reasoning and evidence-informed interventions involved in the return to elite sport. Detailed programming and objective assessment may assist in achieving desired outcomes ahead of previously established timelines. Level of Evidence Therapy, level 4. J Orthop Sports Phys Ther 2016;46(8):697-706. Epub 3 Jul 2016. doi:10.2519/jospt.2016.6352.
Rasmussen, Kurt; Andersen, Johan H
There appears to be a lack of evidence concerning the effect of rehabilitation programmes for the long-term sick. More focus in this area would supplement an approach that has been directed toward process evaluation of rehabilitation programmes. It was the purpose of this study to shed light...... on sick leave or social benefits at this time. Individual background variables, as well as psychological well-being, mental health, pain level, and pain coping, seemed to have little effect on the outcome of rehabilitation, whilst clients' own evaluations of competence and ability of the involved health...
M Naveen Kumar
Full Text Available Ectodermal dysplasia is a hereditary disorder characterized by developmental dystrophies of ectodermal derivatives- It is characterized by triad of signs comprising sparse hair, abnormal or missing teeth and inability to sweat. This case of 12-year-old boy with hypohidrotic ectodermal dysplasia and complete anodontia of both primary and permanent dentition is presented. Owing to the need for treatment at an early age for anodontia and due to the ill-formed maxillary and mandibular residual ridges, the prosthetic management can be difficult. Complete dentures with soft liners and hollow maxillary denture were provided to encourage normal psychological development and to improve the function of the stomatognathic system.
Ivan Chenchev; Radka Cholakova; Cvetan Cvetanov; Ir. Mitarcheva
Objective: The purpose of this presentation is to show the difficulty in prosthetization of a clinical case with a pronounced atrophy of the upper jaw and the various types and nature of restrictions imposed by the requirements of the patient. Methods: The clinical analysis, surgical protocol and prosthetic solution are presented in the treatment of 72 year-old woman with a pronounced atrophy of the upper jaw. OPG, standard CT of the upper jaw was used in the planning and a special surgical t...
Full Text Available Amelogenesis imperfecta is a genetic condition affecting the teeth resulting in aberrations of the structure and clinical appearance of enamel. The treatment of amelogenesis imperfecta involves a multidisciplinary treatment approach requiring a comprehensive examination, diagnosis, and effective treatment planning strategy along with satisfaction of patient-related factors. The clinical case described here involves judicious involvement of different disciplines to formulate a treatment plan best suitable to confirm with the patient's needs and expectations, at the same time maintaining the integrity and harmony of associated hard and soft tissues.
Yavuz, Ferdi; Balaban, Birol
Diagnosis of Adult Idiopathic Toe Walking (AITW) is very rare in clinical practice. High quality studies regarding AITW and its treatment options have not been conducted previously. A 28-year-old male patient complaining of lower leg pain was referred to outpatient rehabilitation clinic. Physical examination revealed a gait abnormality of insufficient heel strike at initial contact. The aetiology was investigated and the patient’s walking parameters were assessed using a computerized gait analysis system. The AITW was diagnosed. Botulinum toxin-A (Dysport®) was injected to the bilateral gastrocnemius muscles. A combined 10-days rehabilitation program was designed, including a daily one-hour physiotherapist supervised exercise program, ankle dorsiflexion exercises using an EMG-biofeedback unit assisted virtual rehabilitation system (Biometrics) and virtual gait training (Rehawalk) every other day. After treatment, the patient was able to heel strike at the initiation of the stance phase of the gait. Ankle dorsiflexion range of motions increased. The most prominent improvement was seen in maximum pressure and heel force. In addition center of pressure evaluations were also improved. To the best of our knowledge this is the first case, of AITW treated with combined botulinum toxin, exercise and virtual rehabilitation systems. This short report demonstrates the rapid effect of this 10-days combined therapy. PMID:27504395
Erieta Nikolikj Dimitrova
CONCLUSION: Rehabilitation is integral part of multidisciplinary treatment of renal transplant recipient after total hip arthroplasty. Regular exercise training of these patients is very important for improving of their long-term outcome.
Fouad A. Al-Omari
Full Text Available Parkinson’s disease is usually seen in adults in their middle and late ages. Most people with this disease are less likely to opt for dental treatments unless it is an acute condition. Tremors caused by Parkinson’s disease can make dental appointments, especially prolonged treatments, a challenge. The case presented here was successfully treated with an immediate denture for the partially edentulous maxillary and mandibular arches. Early morning brief appointments were given for the procedure. Patient was instructed to take the prescribed parkinsonism medications 60 to 90 minutes before the appointment to utilize the advantage of its peak response. Sympathetic and caring approach towards the patient was employed to reduce his anxiety during the procedures. Some modification of technics and materials was adopted to suit the special situation.
Full Text Available Gingival enlargements are quite common and may be either inflammatory, noninflammatory, or a combination of both. Gingival hyperplasia is a bizarre condition causing esthetic, functional, psychological, and masticatory disturbances of the oral cavity. Causes of gingival enlargement can be due to plaque accumulation, due to poor oral hygiene, inadequate nutrition, or systemic hormonal stimulation (Bakaeen and Scully, 1998. It can occur as an isolated disease or as part of a syndrome or chromosomal abnormality. A progressive fibrous enlargement of the gingiva is a facet of idiopathic fibrous hyperplasia of the gingiva (Carranza and Hogan, 2002; Gorlin et al., 1976. It is described variously as fibromatosis gingivae, gingivostomatitis, hereditary gingival fibromatosis, idiopathic fibromatosis, familial elephantiasis, and diffuse fibroma. We present a case of idiopathic gingival fibromatosis with its multidisciplinary approach of management.
Gandy, Gerald L.
Investigated birth order differences and the vocational interests of 150 male college students, making use of the Strong Vocational Interest Blank. Sibling sex and interaction effects were also investigated. (DP)
Morse, Chelsea L; Schultheis, Maria T; McKeever, Joshua D; Leist, Thomas
To examine associations between multitasking ability defined by performance on a complex task integrating multiple cognitive domains and vocational functioning in multiple sclerosis (MS). Survey data collection. Laboratory with referrals from an outpatient clinic. Community-dwelling individuals with MS (N=30) referred between October 2011 and June 2012. Not applicable. The modified Six Elements Test (SET) to measure multitasking ability, Fatigue Severity Scale to measure fatigue, several neuropsychological measures of executive functioning, and vocational status. Among the sample, 60% of individuals have reduced their work hours because of MS symptoms (cutback employment group) and 40% had maintained their work hours. Among both groups, SET performance was significantly associated with performance on several measures of neuropsychological functioning. Individuals in the cutback employment group demonstrated significantly worse overall performance on the SET (P=.041). Logistic regression was used to evaluate associations between SET performance and vocational status, while accounting for neuropsychological performance and fatigue. The overall model was significant (χ(2)3=8.65, P=.032), with fatigue [Exp(B)=.83, P=.01] and multitasking ability [Exp(B)=.60, P=.043] retained as significant predictors. Multitasking ability may play an important role in performance at work for individuals with MS. Given that multitasking was associated with vocational functioning, future efforts should assess the usefulness of incorporating multitasking ability into rehabilitation planning. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Skidmore, Elizabeth R.; Holm, Margo B.; Whyte, Ellen M.; Dew, Mary Amanda; Dawson, Deirdre; Becker, James T.
Meta-cognitive strategy training may be used to augment inpatient rehabilitation to promote active engagement and subsequent benefit for individuals with cognitive impairments after stroke. We examined the feasibility of administering a form of meta-cognitive strategy training, Cognitive Orientation to daily Occupational Performance, during inpatient rehabilitation. We trained an individual with cognitive impairments after right hemisphere stroke to identify performance problems, set self-selected goals, develop plans to address goals, and evaluate performance improvements. To assess feasibility, we examined the number of meta-cognitive training sessions attended, the number of self-selected goals, and changes in goal-related performance. We also examined changes in rehabilitation engagement and disability. The participant used the meta-cognitive strategy to set 8 goals addressing physically-oriented, instrumental, and work-related activities. Mean improvement in Canadian Occupational Performance Measure Performance Scale scores was 6.1. Pittsburgh Rehabilitation Participation Scale scores (measuring rehabilitation engagement) improved from 3.2 at admission to 4.9 at discharge. Functional Independence Measure scores (measuring disability) improved from 68 at admission, to 97 at discharge. Performance Assessment of Self-care Skills scores improved from 1.1 at admission to 2.9 at discharge. The results indicate that meta-cognitive strategy training was feasible during inpatient rehabilitation and warrants further evaluation to determine its effectiveness. PMID:21391121
Washington, Andre Lamont
This study examined how desktop virtual reality environment training (DVRET) affected state anxiety and vocational identity of vocational rehabilitation services consumers during job placement/job readiness activities. It utilized a quantitative research model with a quasi-experimental pretest-posttest design plus some qualitative descriptive…
Stodden, Robert A.; And Others
A project was conducted to bridge the gap between the conceptualized model of vocational evaluation within a rehabilitation framework and the needs of a changing career development model within an educational setting. The project focus was on ascertaining the state of the art of vocational assessment of special needs individuals, then building a…
Candiasa I Made
Full Text Available Test for measuring vocational aptitude has been formulated and validated. There are three main constructs involved in vocational aptitude test, which are individual characteristics, activities that are likely to be selected, and professions that tend to be idolized. Individual characteristics indicate the individuals talents, whereas the activity that tends to be chosen leads to student interest in the activity, and the intended profession gives clues about the capability of themselves to pursue the profession. Content validity test with Lawse technique yields content validity ratio (CVR for all items are in the range 0.82-0.94 and content validity index (CVI = 0.88. The construct validity test yields comparative fit index (CFI = 0.918 and chi square coefficient (χ2 = 5.85 with significance (p = 0.002. These findings indicate that the test is valid either by content or construct. Furthermore, the reliability test with Alpha Cronbach found the alpha coefficient (α = 0.82. Finally, it can be concluded that vocational aptitude test can be utilized for early identification of student vocational aptitude. The hope, the test can help students to choose the appropriate vocational school, in order to obtain the better learning outcomes.
Full Text Available Thayla Hellen Nunes Gouveia, Jéssica Dias Theobaldo, Waldemir Francisco Vieira-Junior, Débora Alves Nunes Leite Lima, Flávio Henrique Baggio Aguiar Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Campinas, SP, Brazil Background: In daily clinical practice, esthetics of anterior teeth is a common presenting complaint of patients.Objective: This case report discusses the management of asymmetric smile associated with unsatisfactory extensive composite restorations and describes a clinical protocol using the direct composite resin for smile enhancement to restore the dental harmony of anterior teeth.Methods: The treatment planning was based on a diagnostic wax-up and cosmetic mock-up. After clinical and patient approvals were obtained, the patient was subjected to direct and indirect restorative treatment.Conclusion: Nanocomposites are an effective alternative for anterior teeth restorations. Additionally, good planning enables satisfactory esthetic results, leading to the correction of an inappropriate axial inclination of incisors. Keywords: composite, adhesive, smile, esthetic, restoration
Full Text Available Yao-Hong Guo,1 Ta-Shen Kuan,1,2 Pei-Chun Hsieh,1 Wei-Chih Lien,1 Chun-Kai Chang,1 Yu-Ching Lin1–3 1Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 2Department of Physical Medicine and Rehabilitation, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 3Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan Abstract: Anti-N-methyl-d-aspartate (anti-NMDA receptor encephalitis is a newly recognized, potentially fatal, but treatable autoimmune disease. Good outcome predictors include milder severity of symptoms, no need for intensive care unit admission, early aggressive immunotherapy, and prompt tumor removal. We report a case of a young girl aged 3 years 2 months and diagnosed as recalcitrant anti-NMDA receptor encephalitis without any underlying neoplasm. The patient had initial symptoms of behavioral changes that progressed to generalized choreoathetosis and orofacial dyskinesia, which resulted in 6 months of hospitalization in the pediatric intensive care unit. One year after initial onset of the disease, she had only achieved the developmental age of an infant aged 6–8 months in terms of gross and fine motor skills, but she resumed total independence in activities of daily living after receiving extensive immunotherapy and 28 months of rehabilitation. Our brief review will help clinical practitioners become more familiar with this disease and the unique rehabilitation programs. Keywords: anti-NMDA receptor encephalitis, autoimmune encephalitis, rehabilitation, cognition deficits
This paper examines the entrepreneurial inclinations of young people who achieved excellence in vocational occupations. We propose a three-capital approach to the study of entrepreneurship. Relying on the existing theories and original qualitative and quantitative data analyses, findings from interviews with 30 entrepreneurial and 10 non-entrepreneurial WorldSkills competitors show that psychological capital, social capital and human capital can be combined to explore how young people who exc...
Chankseliani, Maia; James Relly, Susan
This paper examines the entrepreneurial inclinations of young people who achieved excellence in vocational occupations. We propose a three-capital approach to the study of entrepreneurship. Relying on the existing theories and original qualitative and quantitative data analyses, findings from interviews with 30 entrepreneurial and 10 non-entrepreneurial WorldSkills competitors show that psychological capital, social capital and human capital can be combined to explore how young people who exc...
Muschalla, Beate; Bengel, Jürgen; Morfeld, Matthias; Worringen, Ulrike
Mental disorders (such as recurrent mood disorders, personality disorders, or psychotic disorders) come along with enduring impairment in daily life activities. Therefore psychotherapeutic actions in inpatient or outpatient settings require a life-span and participation-oriented treatment perspective. Participation-oriented treatment aims at social and vocational integration in general life despite enduringly recurring or resting symptoms. According to the model of health problems offered by the International Classification of Functioning, Disability and Health, ICF (WHO, 2001), disability can be defined as context-dependent activity impairment due to illness. Disability is not the person̓s illness itself, but depends on the interaction of health status and contextual conditions. This context-dependent impairment shall be overcome with the help of treatment. In psychotherapy, the perspective of participation over the life-span has always been of great importance. However, it has until now hardly been mentioned explicitly.For practical handling of the ICF philosophy, its bio-psycho-social model of health problem-description is useful. Psychotherapists should gain knowledge on medical, vocational, and social rehabilitation treatment aims, institutions and the health care system. Psychotherapists may serve, similar to family physicians, as a case manager of illness processes. They do not only aim reducing mental illness symptoms, but focus on life-span management of the mental disorder. The aim is mainly to improve patients̓ daily life participation. © Georg Thieme Verlag KG Stuttgart · New York.
Marklund, Staffan; Lundh, Göran; Gustafsson, Klas; Linder, Jürgen; Svedberg, Pia; Alexanderson, Kristina
The purpose of this article is to investigate actions taken by the Social Insurance Agency (SIA) for long-term sickness absentees and possible associations of this with future sick leave or disability pension. For 384 long-term sickness absentees who had had a multidisciplinary medical assessment (MMA) during 2001-2006, three types of data were obtained: (1) case file information about SIA actions, (2) suggested rehabilitation measures from the MMA and (3) sickness absence and disability pension data. Most individuals had been subject to a range of actions by the SIA. Sixty percent had been invited to a coordination meeting, and half of those who assessed by the MMA for vocational rehabilitation were approved to get it by the SIA. Few SIA actions were associated with full or partial return to work. Although the studied individuals had been on sick leave for a long time, the number of SIA actions related to vocational rehabilitation was limited and came late in the sick-leave spell. The information from the MMA was often not used as a basis for further SIA action and seldom resulted in return to work. The positive MMA views on the potential of vocational rehabilitation were not met by SIA actions. Suggestions on vocational rehabilitation from a medical assessment was in many cases not used by the social insurance agency in relationship to long-term sickness absentees. Active rehabilitation measures by the social insurance agency were few and came late in the sickness absence process. Few of the activities taken by the social insurance agency enhanced return to work.
... vocational rehabilitation agencies. In addition, this RRTC must collaborate with relevant Rehabilitation... designate the type of each priority as absolute, competitive preference, or invitational through a notice in... preference priority: Under a competitive preference priority, we give competitive preference to an...
... outcomes in the vocational rehabilitation process. Section 21 of the Rehabilitation Act specifically... priorities, we designate the type of each priority as absolute, competitive preference, or invitational...)). Competitive preference priority: Under a competitive preference priority, we give competitive preference to an...
... communication or language preference. Interpreter means individuals, both hearing and deaf, who provide... vocational rehabilitation (VR) agencies), VR State coordinators for the deaf, rehabilitation counselors for... preferences within the deaf, hard of hearing, and deaf-blind communities through strands of specialized...
Sendelbaugh, Joseph; Bullis, Michael
The national survey to determine what state level transition provisions exist between special education and rehabilitation services for hearing-impaired students found that half of the vocational rehabilitation and one-fourth of the special education agencies have a formal state-level transition plan in place. (DB)
Fluet, Gerard G; Patel, Jigna; Qiu, Qinyin; Yarossi, Matthew; Massood, Supriya; Adamovich, Sergei V; Tunik, Eugene; Merians, Alma S
The complexity of upper extremity (UE) behavior requires recovery of near normal neuromuscular function to minimize residual disability following a stroke. This requirement places a premium on spontaneous recovery and neuroplastic adaptation to rehabilitation by the lesioned hemisphere. Motor skill learning is frequently cited as a requirement for neuroplasticity. Studies examining the links between training, motor learning, neuroplasticity, and improvements in hand motor function are indicated. This case study describes a patient with slow recovering hand and finger movement (Total Upper Extremity Fugl-Meyer examination score = 25/66, Wrist and Hand items = 2/24 on poststroke day 37) following a stroke. The patient received an intensive eight-session intervention utilizing simulated activities that focused on the recovery of finger extension, finger individuation, and pinch-grasp force modulation. Over the eight sessions, the patient demonstrated improvements on untrained transfer tasks, which suggest that motor learning had occurred, as well a dramatic increase in hand function and corresponding expansion of the cortical motor map area representing several key muscles of the paretic hand. Recovery of hand function and motor map expansion continued after discharge through the three-month retention testing. This case study describes a neuroplasticity based intervention for UE hemiparesis and a model for examining the relationship between training, motor skill acquisition, neuroplasticity, and motor function changes. Implications for rehabilitation Intensive hand and finger rehabilitation activities can be added to an in-patient rehabilitation program for persons with subacute stroke. Targeted training of the thumb may have an impact on activity level function in persons with upper extremity hemiparesis. Untrained transfer tasks can be utilized to confirm that training tasks have elicited motor learning. Changes in cortical motor maps can be used to document
Korupolu, Radha; Ngo, Thien; Hack, Nawaz; Escott, Edward; Salles, Sara
A 5-year old female presented with acute tetraparesis and areflexia. Initial imaging and cerebrospinal fluid analysis were suggestive of acute disseminated encephalomyelitis (ADEM). Minimal clinical response with intravenous steroids prompted further work up. Limited nerve conduction studies suggested possible acute motor-sensory axonal neuropathy, a rare variant of Guillain-Barré syndrome (GBS). Repeat imaging was compatible with polyradiculopathy indicating concomitance of ADEM and GBS. The patient suffered severe motor deficits and neuropathic pain. Slow but significant functional recovery was noted after intensive inpatient rehabilitation followed by continued rehabilitation via home health services.
Rasmussen, K.; Andersen, JH
care professionals were found important for a positive outcome of the programme. Especially stable relations to a single General Practitioner (GP), who took good care of the patient in the form of giving good information about health and social possibilities, and an empathic attitude toward these hard...... than 1 year. The remainder had been transferred to receiving social benefits after having exceeded the time limit for being sick-listed. A plan of action for active rehabilitation, which was made at the end of the 8-week rehabilitation programme, was only poorly fulfilled after 9 months, 48% were still...
Full Text Available Intracerebral hemorrhage (ICH, a form of brain bleeding and minor subtype of stroke, leads to significant mortality and long-term disability. There are currently no validated approaches to promote functional recovery after ICH. Research in stroke recovery and rehabilitation has largely focused on ischemic stroke, but given the stark differences in the pathophysiology between ischemic and hemorrhagic stroke, it is possible that strategies to rehabilitate the brain in distinct stroke subtypes will be different. Here, we review our current understanding of recovery after primary intracerebral hemorrhage with the intent to provide a framework to promote novel, stroke-subtype specific approaches.
Langhorne, Peter; Bernhardt, Julie; Kwakkel, Gert
Stroke is a common, serious, and disabling global health-care problem, and rehabilitation is a major part of patient care. There is evidence to support rehabilitation in well coordinated multidisciplinary stroke units or through provision of early supported provision of discharge teams. Potentially beneficial treatment options for motor recovery of the arm include constraint-induced movement therapy and robotics. Promising interventions that could be beneficial to improve aspects of gait include fitness training, high-intensity therapy, and repetitive-task training. Repetitive-task training might also improve transfer functions. Occupational therapy can improve activities of daily living; however, information about the clinical effect of various strategies of cognitive rehabilitation and strategies for aphasia and dysarthria is scarce. Several large trials of rehabilitation practice and of novel therapies (eg, stem-cell therapy, repetitive transcranial magnetic stimulation, virtual reality, robotic therapies, and drug augmentation) are underway to inform future practice. Copyright © 2011 Elsevier Ltd. All rights reserved.
... rehab; Heart failure - cardiac rehab References Anderson L, Taylor RS. Cardiac rehabilitation for people with heart disease: ... of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed ...
Belagaje, Samir R
Rehabilitation is an important aspect of the continuum of care in stroke. With advances in the acute treatment of stroke, more patients will survive stroke with varying degrees of disability. Research in the past decade has expanded our understanding of the mechanisms underlying stroke recovery and has led to the development of new treatment modalities. This article reviews and summarizes the key concepts related to poststroke recovery. Good data now exist by which one can predict recovery, especially motor recovery, very soon after stroke onset. Recent trials have not demonstrated a clear benefit associated with very early initiation of rehabilitative therapy after stroke in terms of improvement in poststroke outcomes. However, growing evidence suggests that shorter and more frequent sessions of therapy can be safely started in the first 24 to 48 hours after a stroke. The optimal amount or dose of therapy for stroke remains undetermined, as more intensive treatments have not been associated with better outcomes compared to standard intensities of therapy. Poststroke depression adversely affects recovery across a variety of measures and is an important target for therapy. Additionally, the use of selective serotonin reuptake inhibitors (SSRIs) appears to benefit motor recovery through pleiotropic mechanisms beyond their antidepressant effect. Other pharmacologic approaches also appear to have a benefit in stroke rehabilitation. A comprehensive rehabilitation program is essential to optimize poststroke outcomes. Rehabilitation is a process that uses three major principles of recovery: adaptation, restitution, and neuroplasticity. Based on these principles, multiple different approaches, both pharmacologic and nonpharmacologic, exist to enhance rehabilitation. In addition to neurologists, a variety of health care professionals are involved in stroke rehabilitation. Successful rehabilitation involves understanding the natural history of stroke recovery and a
Krause, James S; Saunders, Lee L; Staten, David; Rohe, Daniel E
To compare vocational interests as a function of sex and race among persons with recent spinal cord injury (SCI), because previous research used almost exclusively white men. Limited research from nearly 2 decades ago suggested SCI selectively occurs to men whose vocational interests are consistent with the Realistic theme of the Holland typology, indicative of a preference for activities and occupations requiring physical strength and dexterity. The Strong Interest Inventory (SII) was completed an average of 50 days after SCI onset. Data were collected at a specialty hospital and analyzed at a medical university. Adults with traumatic SCI (N=500) were assessed during inpatient rehabilitation. Not applicable. The SII, a 317-item measure of vocational interests. Although the findings for white men were consistent with elevation of the Realistic theme when compared with the reference group, the interests of women and black participants were substantially different. Women scored highest on Social, Enterprising, and Conventional themes compared with the reference group. Black participants reported significantly higher elevations than whites on 5 themes (all except Realistic), with elevations on the Social, Enterprising, and Conventional themes exceeding standardized norms. The Artistic and Investigative themes were least descriptive of the overall sample. Rehabilitation professionals should be aware of likely differences in patterns of vocational interests as a function of race and sex, and use vocational interests as a means of facilitating postinjury adaptation. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Full Text Available The paper presents the mathematical modelling of some Fin Ray-type mechanism, destined for the wrist-rehabilitation equipment, its driving being made by a pneumatic muscle. The validity of the mathematical modelling of Fin Ray mechanism is verified by threedimensional mechanism made in Pro/Engineer.
Full Text Available Retimax Vision Trainer is a device that has the purpose to improve visual function by means of the detection of a visual evoked potential associated with a sound feedback. We evaluated the effectiveness of rehabilitative treatment in two patients with Acquired Brain Injury (ABI. Results, subjectively appreciated, are objectively confirmed by the improvement of visual function.
Full Text Available Slovenia has a high burden of head and neck cancer. Patients are mostly treated with surgery followed by radiation therapy. Advanced surgical and prosthodontic techniques have expanded the rehabilitation options. The aim of the study was to review the outcome of implant-prosthetic treatment after radiation therapy.
Krebs, H I; Volpe, B T
This chapter focuses on rehabilitation robotics which can be used to augment the clinician's toolbox in order to deliver meaningful restorative therapy for an aging population, as well as on advances in orthotics to augment an individual's functional abilities beyond neurorestoration potential. The interest in rehabilitation robotics and orthotics is increasing steadily with marked growth in the last 10 years. This growth is understandable in view of the increased demand for caregivers and rehabilitation services escalating apace with the graying of the population. We provide an overview on improving function in people with a weak limb due to a neurological disorder who cannot properly control it to interact with the environment (orthotics); we then focus on tools to assist the clinician in promoting rehabilitation of an individual so that s/he can interact with the environment unassisted (rehabilitation robotics). We present a few clinical results occurring immediately poststroke as well as during the chronic phase that demonstrate superior gains for the upper extremity when employing rehabilitation robotics instead of usual care. These include the landmark VA-ROBOTICS multisite, randomized clinical study which demonstrates clinical gains for chronic stroke that go beyond usual care at no additional cost. Copyright © 2013 Elsevier B.V. All rights reserved.
Stezar, I C; Pizzol, L; Critto, A; Ozunu, A; Marcomini, A
Brownfield rehabilitation is an essential step for sustainable land-use planning and management in the European Union. In brownfield regeneration processes, the legacy contamination plays a significant role, firstly because of the persistent contaminants in soil or groundwater which extends the existing hazards and risks well into the future; and secondly, problems from historical contamination are often more difficult to manage than contamination caused by new activities. Due to the complexity associated with the management of brownfield site rehabilitation, Decision Support Systems (DSSs) have been developed to support problem holders and stakeholders in the decision-making process encompassing all phases of the rehabilitation. This paper presents a comparative study between two DSSs, namely SADA (Spatial Analysis and Decision Assistance) and DESYRE (Decision Support System for the Requalification of Contaminated Sites), with the main objective of showing the benefits of using DSSs to introduce and process data and then to disseminate results to different stakeholders involved in the decision-making process. For this purpose, a former car manufacturing plant located in the Brasov area, Central Romania, contaminated chiefly by heavy metals and total petroleum hydrocarbons, has been selected as a case study to apply the two examined DSSs. Major results presented here concern the analysis of the functionalities of the two DSSs in order to identify similarities, differences and complementarities and, thus, to provide an indication of the most suitable integration options. Copyright © 2013 Elsevier Ltd. All rights reserved.
Romney, Wendy; Salbach, Nancy; Parrott, James Scott; Deutsch, Judith E
Little is known about the process of engaging key stakeholders to select and design a knowledge translation (KT) intervention to increase the use of an outcome measure using audit and feedback. The purpose of this case report was to describe the development of a KT intervention designed with organizational support to increase physical therapists' (PTs) use of a selected outcome measure in an inpatient sub-acute rehabilitation hospital. Eleven PTs who worked at a sub-acute rehabilitation hospital participated. After determining organizational support, a mixed methods barrier assessment including a chart audit, questionnaire, and a focus group with audit and feedback was used to select an outcome measure and design a locally tailored intervention. The intervention was mapped using the Theoretical Domains Framework (TDF). One investigator acted as knowledge broker and co-designed the intervention with clinician and supervisor support. The 4-m walk test was selected through a group discussion facilitated by the knowledge broker. Support from the facility and input from the key stakeholders guided the design of a tailored KT intervention to increase use of gait speed. The intervention design included an interactive educational meeting, with documentation and environmental changes. Input from the clinicians on the educational meeting, documentation changes and placement of tracks, and support from the supervisor were used to design and locally adapt a KT intervention to change assessment practice among PTs in an inpatient sub-acute rehabilitation hospital. Implementation and evaluation of the intervention is underway.
Strauser, David R.
This study examines the sex differences in the perception of working alliance and the perceptions of optimism regarding future employment and job satisfaction with adult cancer survivors receiving vocational rehabilitation services. No significant differences were found between males and females in terms of the three components of the working…
Guldager, Rikke; Poulsen, Ingrid
OBJECTIVES: The overall Ph.d.-study aims to investigate rehabilitation trajectories in adult patients with traumatic brain injury (TBI) and stroke, and to describe mechanisms behind the institutionalized (health care) part of inequality in health with emphasis on interfaces and critical transitions...... from time of accident to twelve month follow-up. The case study aims to explore the process of rehabilitation in a high status patient, related to professions in healthcare. The focus is on how a high status patient is perceived and handled in organizations and among professions, and strategies applied...... by the patient and relatives. METHODS: Observation and qualitative interview has been conducted of one patient following the patients’ trajectories though different phases of the rehabilitation process during admission at Traumatic Brain Unit. Interdisciplinary meetings are regarded as key elements...
Full Text Available Since 2013, the university degree is free for everyone in Estonia. Vocational education has always been for free. University degrees have been valued as more academical, and vocational education because of the practical skills gained. There is a new trend in Estonia to enter into a vocational school after the university degree; and/or after one vocational education in to another vocational school. Study eagerness is always nice, but the question here is about the reason(s – is this kind of behaviour rather the sign of lifelong learning, or of wrong choices? In this question the research problem is included also – in case of wrong choices the waste of resources can be considered (from the point of view of society. In 2016, the National Audit Office of Estonia studied the progress of adults aged 25 and over, who had started acquiring vocational education (from 2010/2011 to 2014/2015 academic years before and during their studies, and in working life after the completion of their studies. The focus was on adults, because the decreasing number of young people in the state means that adults are and will remain an important target group for vocational education. The aim of this research is to analyze the background of the fact that many adults in Estonia with vocational education (36% or higher education (20% have started acquiring vocational education alongside adults without any professional education (44%. The subjects/respondents of this research were people who decided to influence the quality of their life through education. The object of the research were shcolars’ opinions about the type of education. In this research I focus on the opinion of students about university and/or vocational education. As an illustration, I discuss one case study of a highly educated person with two master degrees, who is going to start studying in a vocational school. The research question: which background impulses influence the choice of educational
Jørgensen, Christian Helms
For the last ten years drop out of vocational education has increased strongly in Denmark. Only half of the students, who take up a vocational programme on upper secondary level, complete it. Like in other European countries the low completion rates has caused considerable alarm on the political...... level (Lamb and Markussen 2011). Continuing high dropout rates will make it very hard for the government to reach its target for educational completion, and the government has launched a series of measures to increase retention including the obligation for all colleges to make plans for retention...... and monitor the progress in achieving the goals. The questions addressed in this paper are why and how dropout in VET takes place. The objective is to provide more detailed and qualified knowledge of the complex processes of dropping out....
Evangelos Mavrommatis; Maria Menegaki
Mine rehabilitation is nowadays an essential part of the mine life-cycle. Nevertheless, due to the inadequate legislative framework and the lack of appropriate financial instruments in the past, abandoned mined land is present in almost all regions with a mining history. Especially in times of fiscal and financial belt tightening, where direct funding is almost impossible, the restoration of abandoned mines becomes a difficult task and, consequently, prioritization of the restoration projects...
Full Text Available The purpose of this study was to clarify the safety and feasibility of a 6-day protocol of bilateral repetitive transcranial magnetic stimulation (rTMS combined with intensive swallowing rehabilitation for chronic poststroke dysphagia. In-hospital treatment was provided to 4 poststroke patients (age at treatment: 56-80 years; interval between onset of stroke and treatment: 24-37 months with dysphagia. Over 6 consecutive days, each patient received 10 sessions of rTMS at 3 Hz applied to the pharyngeal motor cortex bilaterally, followed by 20 min of intensive swallowing rehabilitation exercise. The swallowing function was evaluated by the Penetration Aspiration Scale (PAS, Modified Mann Assessment of Swallowing Ability (MMASA, Functional Oral Intake Scale (FOIS, laryngeal elevation delay time (LEDT and Repetitive Saliva-Swallowing Test (RSST on admission and at discharge. All patients completed the 6-day treatment protocol and none showed any adverse reactions throughout the treatment. The combination treatment improved laryngeal elevation delay time in all patients. Our proposed protocol of rTMS plus swallowing rehabilitation exercise seems to be safe and feasible for chronic stroke dysphagia, although its efficacy needs to be confirmed in a large number of patients.
The purpose of the study was to assess the value of combining occupational therapy (OT) with physical therapy (PT) for the rehabilitation of complex regional pain syndrome (CRPS) and to measure its effectiveness on activities of daily life. Sixty patients with CRPS type 1 were recruited and interviewed between September 1, 2014 and February 1, 2015. Thirty patients had undergone PT and thirty had undergone PT+OT. They were administered the short-form of the "Assessment of Life Habits" questionnaire (v.3.0 LIFE-H) created in Canada. This questionnaire consists of 16 items exploring activities of daily living, which were used to compare the effectiveness of the two rehabilitation protocols. The results of each test were submitted to the Wilcoxon test. After confirming the complexity of CRPS in terms of its etiology, clinical signs and progression, rehabilitation was effective, especially for pain. The patients who received PT+OT had on average 10% better dressing and undressing function, 25% better for meal preparation, and 20% better on personal care than those who underwent PT only. In CRPS, OT combined with PT brings a real benefit in restoring the essential activities of daily life. This strategy could be implemented as soon the diagnosis confirmed and continued for a very long time. It helps to avoid the risk of dependence on third parties. Copyright © 2016 SFCM. Published by Elsevier Masson SAS. All rights reserved.
Stengler, K; Rauschenbach, J; Riedel-Heller, S G; Becker, T; Steinhart, I; Gerlinger, G; Hauth, I
Working and living for persons with mental illnesses are a major concern of rehabilitative psychiatry. In Germany the definition of rehabilitation for persons with mental illnesses is closely linked to different sectors of social welfare and to the strongly organized supply chain of prevention, acute treatment, rehabilitation and care. In successfully supporting people with mental health problems in terms of vocational integration, professionals face various obstacles. Besides finding the correct content, structural and organizational difficulties can also arise. The welfare system with its specific institutions and settings is complicated which often leads to delays in the onset of rehabilitation. Some essential reasons are insufficient knowledge about established options of rehabilitative treatment and about responsibilities related to participation in specialized training and further education for professional caregivers. Also information and (positive) experiences from pilot projects working in an inclusive, cross-sectional way and across different settings are practically unavailable in Germany. The presented compass of participation from the German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN) for vocational integration of persons with mental illnesses starts at this point: it provides guidelines for psychiatric and psychotherapeutic practitioners, general practitioners as well as for physicians working in residential or day care institutions with a psychiatric and psychotherapeutic background. Both the paper and planned online versions should help professionals to help people, particularly those with severe mental illnesses to navigate the system of services for vocational integration in Germany.
The development of higher vocational education in China embodies a global trend of vocationalism that values skills and skilled workers, which is opposite, in some ways, to the Confucian tradition in Chinese education that values theoretical knowledge related to good governance. As the cultural trend supporting the development of higher vocational…
Han, Ji-Deuk; Cho, Seong-Ho; Jang, Kuk-Won; Kim, Seong-Gwang; Kim, Jung-Han; Kim, Bok-Joo; Kim, Chul-Hun
This case series study demonstrates the possibility of successful implant rehabilitation without bone augmentation in the atrophic posterior maxilla with cystic lesion in the sinus. Sinus lift without bone graft using the lateral approach was performed. In one patient, the cyst was aspirated and simultaneous implantation under local anesthesia was performed, whereas the other cyst was removed under general anesthesia, and the sinus membrane was elevated in a second process, followed by implantation. In both cases, tapered 11.5-mm-long implants were utilized. With all of the implants, good stability and appropriate bone height were achieved. The mean bone level gain was 5.73 mm; adequate bone augmentation around the implants was shown, the sinus floor was moved apically, and the cyst was no longer radiologically detected. Completion of all of the treatments required an average of 12.5 months. The present study showed that sufficient bone formation and stable implantation in a maxilla of insufficient bone volume are possible through sinus lift without bone materials. The results serve to demonstrate, moreover, that surgical treatment of mucous retention cyst can facilitate rehabilitation. These techniques can reduce the risk of complications related to bone grafts, save money, and successfully treat antral cyst.
Ferrari, S; Monticone, M
Many musculoskeletal disorders are work-related. For the success of treatment, it is essential to promptly recognize these cases and introduce a specific intervention able to act on the causes. In Literature many activities predisposing workers to incorrect posture and long maintained attitudes are highlighted. The professionals involved in dental hygiene are among these. For these patients it is not sufficient to just reduce pain, but it is necessary to have a broader approach to rehabilitation, which can also act on neuromuscular imbalances induced by work. The article describes the case of a dental hygienist with upper quadrant disorders treated by physiotherapy and education. Particular importance during treatment was given to postural re-education. The treatment lasted two months (8 sessions, 1 session per week). The outcomes introduced were Visual Analogue Scale, VAS (70/100 at the beginning and 0/100 at the end of treatment) and Neck Pain and Disability Scale, NPDS (62.5/100 at the beginning and 3/100 at the end of treatment); at 12-month follow-up, VAS was 10/100 and NPDS was 19/100. A multimodal rehabilitation, with emphasis to musculoskeletal imbalance correction, proved to be useful in a patient who maintained prolonged flexion and rotation of the spine, front shoulder closure, and arm suspension due to occupational daily activities. The improvements lasted over time.
Full Text Available Entrepreneurial characteristics, in fact, are the entrepreneur’s behavioral outputs in different conditions. The behavior, which can be increasingly changed during the times, is a function of acquired and inherent factors. Emotional intelligence as a set of teachable and acquisitive behaviors, can affect the entrepreneurs’ behavioral characteristics. This paper tried to study the relationship between emotional intelligence and entrepreneurial behavioral characteristics among the Iran Technical and vocational Training Organization (TVTO’s Instructors. The statistical sample population in this research is 105 instructors from all over the Iran. Two standardized questionnaires including; Measurement Instrument of Personality characteristics of Iranian’s Entrepreneurs and “Bar- On” Test for assessing the Emotional Intelligence has been used for data collection after testing their validity and reliability. Results from data analysis using descriptive and inferential statistical techniques showed that there is a significant positive relationship between entrepreneurial characteristics and emotional intelligence among Iran TVTO’s instructors.
Kessemeier, Franziska; Stöckler, Christiane; Petermann, Franz; Bassler, Markus; Pfeiffer, Wolfgang; Kobelt, Axel
Aim of this study Apart from the reduction of symptoms and the restoration of working ability, return to work is a long-term goal of medical rehabilitation. The aim of this study is to analyze the influence of work motivation on the outcome of rehabilitation. Methods The data basis consists of N=998 patients at the psychosomatic department of the Oberharz Rehabilitation Center as well as data from insurance accounts. Using multiple linear regression analysis the predictive power of work motivation on rehabilitation outcome as well as different facets of work motivation in their function as predictors are analyzed. Results Only minor statistical relations could be found between work motivation and rehabilitation success when also taking employment status of the previous year and subjective vocational disability into account. A small predictive power can be attributed to work motivation as a factor in rehabilitation success in the sense of a reduction of symptoms. Particular facets of work motivation are suitable to predict rehabilitation success. Patients with a work motivation risk profile differ from patients with a normal work motivation profile as regards their capacity to work in the year following rehabilitation treatment. Conclusion Work motivation represents a relevant construct in rehabilitation success but is strongly influenced by individual factors. During rehabilitation, individual problems which influence work motivation should be taken into account more strongly. © Georg Thieme Verlag KG Stuttgart · New York.
Kubo, Arthur S [BDM Corp., VA (United States); [Bikini Atoll Rehabilitation Committee, Berkeley, CA (United States)
The costs of radioactivity contamination control and other matters relating to the resettlement of Bikin atoll were reviewed for Bikini Atoll Rehabilitation Committee by a panel of engineers which met in Berkeley, California on January 22-24, 1986. This Appendix presents the cost estimates.
Kubo, Arthur S.
The costs of radioactivity contamination control and other matters relating to the resettlement of Bikin atoll were reviewed for Bikini Atoll Rehabilitation Committee by a panel of engineers which met in Berkeley, California on January 22-24, 1986. This Appendix presents the cost estimates
Laffont, F; Engelmajer, L; Vourc'h, G; Nahas, G
From 1974 to 1979, the rehabilitation centers of the association "Le Patriarche" located in the country side of southern France, have received 446 chronic polydrugs users who has consumed at one time or an other cannabis (marihuana, hashish) (87 p. cent), LSD (66 p. cent) and other hallucinogens (35 p. cent), psychodepressants (55 p. cent), psychostimulants (amphetamines, 85 p. cent; cocaïne, 50 p. cent) and opium and its derivatives (brown sugar, 47 p. cent; opiates, 67 p. cent; heroin, 50 p. cent). The dominant addictive drug was heroin and opiates, 52 p. cent, psychodepressants (barbitutiques and benzodiazepines, 33 p. cent, psychostimulants, 15 p. cent. Males were twice as numerous as female. Average age was 21 (range 14-38). Mean duration of drug abuse was 7 years. All these drug abusers display at entrance withdrawal symptoms. These were treated successfully by a drug free, psycho-physiological regimen comprising: 1. An elimination of all psychoactive drugs, including coffee, and alcohol. Tobacco was permitted. 2. Physical therapy (bath, exercise, massage) and forced fluid diuresis. 3. A supportive psychotherapy dispensed by rehabilitated addicts who had undergone successfully a similar regimen. This non-pharmacological method of treating withdrawal symptoms associated with opium, barbiturate and amphetamine addiction, was successful, and was not associated with any major clinical symptoms threatening the vital signs. Mean duration of detoxification was 5 days for opiates, 6 days for amphetamines and 10 days for barbiturates. 78 p. cent of these subjects remained in the centers from 3 months to 2 years, partaking in physical occupational and physiological rehabilitation paograms which allowed then to adopt a drug free life style and prepared them for social reinsertion.
Bogetoft, Peter; Wittrup, Jesper
. This makes it difficult to compare the resources used, since some programmes by their nature require more classroom time and equipment than others. It is also far from straightforward to compare college effects with respect to grades, since the various programmes apply very different forms of assessment....... In addition to these conceptual challenges, analyses of vocational colleges present problems with respect to data. It is difficult in many cases to be certain of the correspondences between resources used and student-related factors, since students are registered at a college level, while resources used...... are recorded at a higher level, i.e. that of umbrella institutions administering programmes at several colleges. In this study paper, analyses are restricted to around 40 vocational colleges where it was possible to be certain of the correspondence between resource use and student-related achievement. We...
Explores the more purely theoretical side of the legal scholar's vocation, using Max Weber's text on the scholar's role titled "Science as a Vocation." Discusses the consequences of the tension between law schools' generalist "pretensions" and increasingly specialist character, and Weber's fact/value distinction. (EV)
South Carolina State Dept. of Education, Columbia. Office of Vocational Education.
This handbook on teaching reading in vocational education is designed to provide vocational education teachers with a resource to use in helping students to develop sound reading skills. Provided in the handbook are information sheets, self-checks, practice activities, and suggestions for further reading dealing with the following topics:…
Erickson, Richard C.
Challenges to vocational teacher education include technological change that is sending large numbers of adults back to school; increasing numbers of women, minorities, and handicapped individuals who are seeking employment in nontraditional occupations; vocational preparation for jobs in the information economy; teacher recruitment; and creative…
Practical information is provided on sexual harassment within the vocational education context. A definition of sexual harassment is followed by examples of practices or behaviors that may be used to determine sexual harassment, including both physical conduct and communication. Possible impacts of sexual harassment in a vocational training…
Krause, James S; Clark, Jillian M R
We sought to identify the stability of vocational interests among persons with spinal cord injury (SCI) first assessed during inpatient rehabilitation. Initial assessments were completed during inpatient rehabilitation an average of 50 days after SCI onset (n = 521). Follow-up measures, collected by mail, were obtained an average of 16.6 months postinjury (n = 190) and 29.1 months postinjury (n = 296). Participants (n = 135) completed all 3 assessments. Participants completed the 1994 Strong Interest Inventory (Campbell, 1971; Harmon, Hansen, Borgen, & Hammer, 1994), Form T317, a 317-item measure of vocational interests. Comparison of scale means across 3 times of measurement indicated significant changes in 2 of 6 general occupational themes (GOT), 8 basic interest scales (BIS), and 2 special scales (leadership style, risk taking/adventure). With 1 exception, a linear trend indicating an increase in reported interests accounted for observed relationships. An age by time interaction occurred with 1 GOT and 3 BIS. The average stability coefficient was 0.61 for the GOT, 0.59 for the BIS, and 0.70 for the special scales. The average coefficients were somewhat lower for the oldest participants. Interests do not appear to be static when first measured during inpatient rehabilitation after SCI. Rather, they evolve with average increases on select themes more compatible with the limitations of SCI. Stability coefficients suggest that interests are likely to change more than indicated in earlier studies.
. The case presented here is four vocational colleges where the teachers attend a teacher training course. The study is based on documentary analyses, focus group interviews and observations. Using Evetts’ concept of professionalism, the analyses show different logics at vocational colleges. Managers...
Idialu, Ethel E.
Vocational education emphasises skill acquisition. Quality assurance in vocational education is a concept that is concerned with high performance involving activities with vocational education such as teaching, learning, infrastructures, students' behaviour and the entire academic process. Quality vocational education refers to input and output of…
This literature review attempts to profile specific areas of cognition that have shown unique and consistent evidence of dysfunction among people with schizophrenia. In addition, their impact on vocational functioning is illustrated, so as to highlight the importance of managing these cognitive difficulties in vocational rehabilitation. Literature search was carried out on seven key cognitive domains identified by the National Institute of Mental Health in the USA. Their impact on vocational function was also reviewed. It is found that attention, declarative and working memory, reasoning, problem-solving and social cognition are areas of impairment that have great impact on vocational functioning. Attention and memory problems affect learning of new work tasks. Executive function is particularly crucial in determining supported and open employment outcomes, as executive dysfunction cannot be easily compensated. Lastly, social cognition plays a major role in determining the success of workplace social exchanges. Occupational therapists need to have a good understanding of the profile of cognitive problems among people with schizophrenia, in order to tailor our intervention according to their cognitive strengths and difficulties. Several cognitive remediation strategies and programs have been designed specifically for people with mental illness. Equipping ourselves with skills in conducting such programs will augment our expertise in vocational rehabilitation.
Doig, Emmah; Kuipers, Pim; Prescott, Sarah; Cornwell, Petrea; Fleming, Jennifer
OBJECTIVE. We examined participation in goal planning and development of self-awareness for people with impaired self-awareness after traumatic brain injury. METHOD. We performed a mixed-methods study of 8 participants recently discharged from inpatient rehabilitation. Self-awareness was measured using discrepancy between self and significant other ratings on the Mayo-Portland Adaptability Index (MPAI-4) at four time points. We calculated effect size to evaluate the change in MPAI-4 discrepancy over time. RESULTS. Seven participants identified their own goals. We found a large reduction in mean MPAI-4 discrepancy (M = 8.57, SD = 6.59, N = 7, d = 1.08) in the first 6 wk and a further small reduction (M = 5.33, SD = 9.09, N = 6, d = 0.45) in the second 6 wk of intervention. Case data indicated that 7 participants demonstrated some growth in self-awareness. CONCLUSION. Engagement in occupation-based, goal-directed rehabilitation appeared to foster awareness of injury-related changes to varying extents. Copyright © 2014 by the American Occupational Therapy Association, Inc.
Full Text Available Hereditary ectodermal dysplasia is a rare group of inherited disorders characterized by aplasia or dysplasia of two or more tissues of ectodermal origin such as hair, nails, teeth, and skin. The dental characteristics of this syndrome include anodontia or hypodontia of the primary and/or permanent teeth, hypoplastic conical teeth, and underdevelopment of the alveolar ridges. The options for a definitive treatment plan include fixed, removable or implant-supported prostheses, singly or in combination. This clinical report describes the prosthetic rehabilitation of an 11-year-old boy with hereditary ectodermal dysplasia. Maxillary flexible removable partial denture and mandibular conventional complete denture were fabricated to establish an acceptable masticatory function, speech, and esthetics for the patient.
De Tommaso, Barbara; Piedimonte, Alessandro; Caglio, Marcella M; D'Agata, Federico; Campagnoli, Marcello; Orsi, Laura; Raimondo, Simona; Vighetti, Sergio; Mortara, Paolo; Massazza, Giuseppe; Pinessi, Lorenzo
In this paper we report the effect of a combined transcranial direct current stimulation (tDCS) and speech language therapy on linguistic deficits following left brain damage in a stroke case. We show that simultaneous electrical excitatory stimulation to the left and inhibitory stimulation to the right parietal regions (dual-tDCS) affected writing and reading rehabilitation, enhancing speech therapy outcomes. The results of a comparison with healthy controls showed that application of dual-tDCS could improve, in particular, sub-lexical transcoding and, specifically, the reading of non-words with increasing length and complexity. Positive repercussions on patient's quality of functional communication were also ascertained. Significant changes were also found in other language and cognitive tasks not directly treated (comprehension and constructive apraxia).
Rehabilitation is concerned with lessening the impact of disabling conditions. These are particularly common in older people and considerable health gain can be achieved by successful rehabilitation. Hospital doctors and general practitioners should be aware of the core principles of rehabilitation, be able to recognise rehabilitation need in their patients, and have sufficient knowledge of their local rehabilitation services to trigger the referral process.
Full Text Available Objectives: Conservative treatments for anterior cruciate ligament (ACL tears may have just as good an outcome as invasive treatments. These include muscle strengthening and neuromuscular proprioceptive exercises to improve joint stability and restore motion to the knee. The Purpose of the current work presents was to examine the feasibility of a novel non-invasive biomechanical treatment to improve the rehabilitation process following an ACL tear. This is a single case report that presents the effect of this therapy in a patient with a complete ACL rupture who chose not to undergo reconstructive surgery. Methods: A 29-year old female athlete with an acute indirect injury to the knee who chose not to undergo surgery was monitored. Two days after injury the patient began AposTherapy. A unique biomechanical device was specially calibrated to the patient’s feet. The therapy program was initiated, which included carrying out her daily routine while wearing the device. The subject underwent a gait analysis at baseline and follow-up gait analyses at weeks 1, 2, 4, 8, 12 and 26. Results: A severe abnormal gait was seen immediately after injury, including a substantial decrease in gait velocity, step length and single limb support. In addition, limb symmetry was substantially compromised following the injury. After 4 weeks of treatment, patient had returned to normal gait values and limbs asymmetry reached the normal range. Conclusions: The results of this case report suggest that this conservative biomechanical therapy may have helped this patient in her rehabilitation process. Further research is needed in order to determine the effect of this therapy for patients post ACL injuries.
Hetzel, C; Streibelt, M
Background: Studies about the impact of the labour market on return to work (RTW) after vocational retraining are contradictory. We examined if (1) RTW after vocational retraining depends on regional labour markets and if (2) the regional labour markets variance affects the influence of personal characteristics on RTW. Methods: The data consisted of the scientific use file (completed rehabilitation in the course of health insurance 2002-2009) of the German Federal Pension Insurance (51 626 persons of 7 year cohorts) and regional economic data (412 districts). Multilevel logistic regression models were used. Results: At the context level the logarithmic unemployment rate was the most relevant predictor. The RTW rate decreased with increasing unemployment rate, saturating at an unemployment rate of around 15%. Significant differences between the intervention types (integration, 1-year and 2-year vocational retraining programs) were observed. The effects of individual predictors were clearer with higher unemployment, e. g. education, individual unemployment, income and further vocational interventions prior to vocational retraining. Conclusion: We demonstrate that the success of vocational retraining depends on the regional labour market. Furthermore individual predictors show stronger effects on success with the context of "poor" labour markets. In addition to the existing evidence the regional unemployment rate should be taken into consideration in effectiveness research studies and benchmarking processes in quality assurance. © Georg Thieme Verlag KG Stuttgart · New York.
Löbner, Margrit; Luppa, Melanie; Konnopka, Alexander; Meisel, Hans J; Günther, Lutz; Meixensberger, Jürgen; Stengler, Katarina; Angermeyer, Matthias C; König, Hans-Helmut; Riedel-Heller, Steffi G
To examine rehabilitation preferences, participation and determinants for the choice of a certain rehabilitation setting (inpatient vs. outpatient) and setting-specific rehabilitation outcomes. The longitudinal observational study referred to 534 consecutive disc surgery patients (18-55 years). Face-to-face baseline interviews took place about 3.6 days after disc surgery during acute hospital stay. 486 patients also participated in a follow-up interview via telephone three months later (dropout-rate: 9%). The following instruments were used: depression and anxiety (Hospital Anxiety and Depression Scale), pain intensity (numeric analog scale), health-related quality of life (Short Form 36 Health Survey), subjective prognosis of gainful employment (SPE-scale) as well as questions on rehabilitation attendance, return to work, and amount of sick leave days. The vast majority of patients undergoing surgery for a herniated disc attended a post-hospital rehabilitation treatment program (93%). Thereby two-thirds of these patients took part in an inpatient rehabilitation program (67.9%). Physical, psychological, vocational and health-related quality of life characteristics differed widely before as well as after rehabilitation depending on the setting. Inpatient rehabilitees were significantly older, reported more pain, worse physical quality of life, more anxiety and depression and a worse subjective prognosis of gainful employment before rehabilitation. Pre-rehabilitation differences remained significant after rehabilitation. More than half of the outpatient rehabilitees (56%) compared to only one third of the inpatient rehabilitees (33%) returned to work three months after disc surgery (p<.001). The results suggest a "pre-selection" of patients with better health status in outpatient rehabilitation. Gaining better knowledge about setting-specific selection processes may help optimizing rehabilitation allocation procedures and improve rehabilitation effects such as return
Löbner, Margrit; Luppa, Melanie; Konnopka, Alexander; Meisel, Hans J.; Günther, Lutz; Meixensberger, Jürgen; Stengler, Katarina; Angermeyer, Matthias C.; König, Hans-Helmut; Riedel-Heller, Steffi G.
Objective To examine rehabilitation preferences, participation and determinants for the choice of a certain rehabilitation setting (inpatient vs. outpatient) and setting-specific rehabilitation outcomes. Methods The longitudinal observational study referred to 534 consecutive disc surgery patients (18–55 years). Face-to-face baseline interviews took place about 3.6 days after disc surgery during acute hospital stay. 486 patients also participated in a follow-up interview via telephone three months later (dropout-rate: 9%). The following instruments were used: depression and anxiety (Hospital Anxiety and Depression Scale), pain intensity (numeric analog scale), health-related quality of life (Short Form 36 Health Survey), subjective prognosis of gainful employment (SPE-scale) as well as questions on rehabilitation attendance, return to work, and amount of sick leave days. Results The vast majority of patients undergoing surgery for a herniated disc attended a post-hospital rehabilitation treatment program (93%). Thereby two-thirds of these patients took part in an inpatient rehabilitation program (67.9%). Physical, psychological, vocational and health-related quality of life characteristics differed widely before as well as after rehabilitation depending on the setting. Inpatient rehabilitees were significantly older, reported more pain, worse physical quality of life, more anxiety and depression and a worse subjective prognosis of gainful employment before rehabilitation. Pre-rehabilitation differences remained significant after rehabilitation. More than half of the outpatient rehabilitees (56%) compared to only one third of the inpatient rehabilitees (33%) returned to work three months after disc surgery (p<.001). Conclusion The results suggest a “pre-selection” of patients with better health status in outpatient rehabilitation. Gaining better knowledge about setting-specific selection processes may help optimizing rehabilitation allocation procedures and
Full Text Available OBJECTIVE: To examine rehabilitation preferences, participation and determinants for the choice of a certain rehabilitation setting (inpatient vs. outpatient and setting-specific rehabilitation outcomes. METHODS: The longitudinal observational study referred to 534 consecutive disc surgery patients (18-55 years. Face-to-face baseline interviews took place about 3.6 days after disc surgery during acute hospital stay. 486 patients also participated in a follow-up interview via telephone three months later (dropout-rate: 9%. The following instruments were used: depression and anxiety (Hospital Anxiety and Depression Scale, pain intensity (numeric analog scale, health-related quality of life (Short Form 36 Health Survey, subjective prognosis of gainful employment (SPE-scale as well as questions on rehabilitation attendance, return to work, and amount of sick leave days. RESULTS: The vast majority of patients undergoing surgery for a herniated disc attended a post-hospital rehabilitation treatment program (93%. Thereby two-thirds of these patients took part in an inpatient rehabilitation program (67.9%. Physical, psychological, vocational and health-related quality of life characteristics differed widely before as well as after rehabilitation depending on the setting. Inpatient rehabilitees were significantly older, reported more pain, worse physical quality of life, more anxiety and depression and a worse subjective prognosis of gainful employment before rehabilitation. Pre-rehabilitation differences remained significant after rehabilitation. More than half of the outpatient rehabilitees (56% compared to only one third of the inpatient rehabilitees (33% returned to work three months after disc surgery (p<.001. CONCLUSION: The results suggest a "pre-selection" of patients with better health status in outpatient rehabilitation. Gaining better knowledge about setting-specific selection processes may help optimizing rehabilitation allocation procedures
The connection between vocational college education and vocational training is a new way for vocational colleges and enterprises to develop together. At present, vocational college education focusing on the education level of talent training, however, it ignores the needs of workers’ vocational training based on enterprise development planning and training of professional career development. Therefore, we should strengthen the connection between vocational training and vocational education. For the establishment of modern vocational education system, we should enhance the value of human capital of workers in order to adapt to the new economic norm with important practical signifi cance.
N. V. Galtseva
Full Text Available At the present time effectiveness of rehabilitation programs after heart surgery, myocardial infarction, and in some cases for coronary artery disease (CAD is undeniable. According to the researches, physical exercises, which underlie cardio rehabilitation of patients with CAD, reduce cardiac mortality. In the review accumulated scientific data about modern approaches to cardio rehabilitation is discussed: goals, indications, contraindications, its organization, advantages. Controlled training in patients with CAD, making a complex program of cardio rehabilitation, kinds of control during cardio training are described in details. In this review the second phase of physical rehabilitation after cardiac surgery – a stationary phase, protocols of which are subjective and often contested, is considered. More frequently physical rehabilitation after coronary artery bypass surgery is doing breathing exercises, as there is data that physical exercises, in which tangential force vector in or around the sternum appears, should be avoided for at least 3 months after surgery. On the other hand, avoiding of heaving during the first weeks after surgery leads to more pronounced atrophy of the chest muscles. But there is data, according to which, early beginning of an adapted program of cardio rehabilitation (1–2 weeks after surgery is safely, it accelerates recovery and does not increase problems with the sternum. In this review the following idea is suggested: in order to follow the stages of rehabilitation after cardiac surgery it is necessary to start it on the stationary stage, and control of load rehabilitation programs must be carried out using hemodynamic changes during exercises, energy, SF-36 questionnaire.
Hansen, Agnete Meldgaard
Care work for elderly people has been characterised as dirty work, owing to its proximity to the (dys)functions and discharges of aged bodies and the notions of disease, decay and death associated with the idea of ‘old age’. However, a wave of reform programmes in Danish municipalities promoting...... units, this article analyses how rehabilitative care practices, drawing on a narrative of the third age, provide an optimistic and anti-ageist framing of homecare work that informs the development of new occupational identities for care workers as coaches rather than carers in relation to citizens...
Williams, Jamie C.; Powell, Ronald
The authors address the need for instruction in entrepreneurship within the vocational agriculture curriculum. They list various competencies and skills needed by agricultural entrepreneurs and discucss available curriculum materials. (CH)
Millennium Challenge Corporation — The impact evaluation of the Vocational Training Grant Fund (VTGF) subactivity in Namibia used a random assignment design to determine the effects of VTGF-funded...
Joosen, Margot C. W.; Frings-Dresen, Monique H. W.; Sluiter, Judith K.
To gain insight into fatigued workers' perspectives regarding work experience before and after receiving vocational rehabilitation (VR) treatments. A qualitative survey was conducted using semi-structured interviews with 21 fatigued workers who attended an outpatient multi-component VR treatment.
In India, several efforts have been made for the development of skilled manpower during the last twenty years since the launch of formal technical vocational education at school. A huge education infrastructure has developed in India. However, 45~50 percent of the population of India is still illiterate. To solve the mismatch between education and employment, a revolution in education is really needed. Additionally, there is a need for a system of National Vocational Qualifications in India a...
Flinn, Nancy A; Smith, Jennifer L; Tripp, Christopher J; White, Matthew W
The objective of the study was to examine the results of robotic therapy in a single client. A 48-year-old female client 15 months post-stroke, with right hemiparesis, received robotic therapy as an outpatient in a large Midwestern rehabilitation hospital. Robotic therapy was provided three times a week for 6 weeks. Robotic therapy consisted of goal-directed, robotic-aided reaching tasks to exercise the hemiparetic shoulder and elbow. No other therapeutic intervention for the affected upper extremity was provided during the study or 3 months follow-up period. The outcome measures included the Fugl-Meyer, graded Wolf motor function test (GWMFT), motor activity log, active range of motion and Canadian occupational performance measure. The participant made gains in active movement; performance; and satisfaction of functional tasks, GWMFT and functional use. Limitations involved in this study relate to the generalizability of the sample size, effect of medications, expense of robotic technologies and the impact of aphasia. Future research should incorporate functional use training along with robotic therapy.
Full Text Available Traumatic lesions in primary teeth are frequent in pediatric patients and can cause problems both to the deciduous tooth and permanent successor. The impact strength on deciduous tooth can reach the growing permanent tooth, affecting its morphology, structure and position, or even hampering its proper development. This report describes an aesthetic-functional rehabilitation process in an 8 year 10 month old boy during a multidisciplinary treatment held at the Clinical Center of Dental Trauma in Primary Teeth of the Pediatric Dentistry of Dental College of University of São Paulo, Brazil. The patient presented bilateral posterior cross bite and the permanent left upper central incisor with ectopic eruption and enamel hypoplasy, preceded by avulsion of element 61, occurred when the patient was 1.6 years old. After diagnosis and treatment planning, a quick expansion of jaws was recommended with Hass-type rapid expander and orthodontic leveling with fixed braces. Due to the ectopic eruption, the gingival contour had been altered and hypertrophia was found, compromising aesthetics and avoiding local hygienic procedures. Gingivoplasty was carried out with high-intensity Diode Laser, followed by aesthetic restoration with compound resin. It was concluded that after deciduous teeth traumatism it is important that the patient undergoes clinic and radiographic assistance until the permanent teeth erupt so that an adequate multidisciplinary treatment can be offered to the patient.
Ina, G; Eto, F; Furuichi, T; Suzuki, H; Shibuya, K
An 81-year-old man with Parkinson's disease was admitted to our hospital with impaired function of all extremities. Four weeks before his symptoms developed, he had tripped on the steps, fallen and bruised his jaw. Following this episode he experienced a few more falls inside his house. On examination his greatest weakness was in the hands and wrists. He was hyper-reflexic in all extremities and had bilateral Babinski's sign. He could not walk and needed physical assistance in most of his daily living activities. X-ray films of the cervical spine showed significant degenerative changes. The magnetic resonance images suggested central cervical cord damage at the level of the C6 vertebral body. After three months' rehabilitation treatment, he became able to walk with a cane and became independent in all the basic activities of daily living except for bathing. He never regained skillful function of his hands despite later levodopa treatment of Parkinson's disease. His clinical features were consistent with the central cervical cord syndrome, described by Schnneider and co-workers in 1954. This syndrome may occur as a result of hyperextension neck injury, occasionally associated with an accidental fall in the elderly with cervical spondylosis. Thirteen patients with cervical spinal cord injury above 65 of age were admitted to our department from 1983 to 1993. Six of them presented with the central cervical cord syndrome, and all patients had a history of accidental injuries related to falling.
Zafiropoulos, Gregory-George; Hoffmann, Oliver
Various implant-supported restorations have been used successfully for several decades to rehabilitate edentulous patients. Telescopic crowns are a common treatment modality used to connect dentures to natural teeth. Although previous findings indicate that telescopic crowns can be placed successfully on implants to support overdentures, only limited data are available on this treatment approach. Eight months after extraction of all nonsalvageable teeth and socket preservation, 11 implants were inserted into the mandible and maxillae of one patient. These implants were restored 4 months later using telescopic crown-supported dentures. Bleeding on probing (BOP), plaque index (PI), clinical attachment (PAL), and radiographic bone level were evaluated over 5 years. All implants remained in function over the 5-year evaluation period. Radiography showed stable bone levels for all implants. No changes in BOP or PI (range, 2%-4% for both parameters) were observed over this time. The PAL deteriorated by 1.5 mm during the first 3 years, with no subsequent changes. We conclude that telescopic crowns can be used successfully as attachments for overdentures supported by implants in regenerated bone.
Handberg, Charlotte; Thorne, Sally; Maribo, Thomas
To analyze and describe health professionals' attitudes and perspectives on the complexities of cancer survivorship and rehabilitation needs assessment in a shared cancer care context. The design and methodology for this study was Interpretive Description and the analysis was informed by Symbolic Interactionism as the theoretical framework. Between April and December 2015 an ethnographic fieldwork was carried out by the first author in haematological wards at two Danish hospitals and in two primary care settings conducting cancer survivorship care programs. Participants were 41 health professionals working with needs assessment. The findings revealed an understanding of the health professionals' attitudes and perspectives and were distinguishable in relation to three structural conditions associated with the dimensions of survivorship care: Patient Context, Workplace Priorities and Practice Culture. Despite shared beliefs that needs assessment was essential to ensure survivorship care, the differential conditions surrounding the hospital and the primary care settting impeded the wider idea of formalized needs assessment, creating barriers to a seamless link between the sectors. Meaningful resolution of these disjunctures will require broad solutions, recognizing that the organization of healthcare into disconnected systems, with their different conditions, history, habits and traditions, will certainly plague the "transition" problems in healthcare unless a wider perspective is taken. Thoughtful and informed clinicians working with decision makers and those who know the evidence and can interpret systems in context can certainly bring better options to light in order to develop high quality survivorship care that will support patients throughout their cancer trajectory. Copyright © 2018 Elsevier Ltd. All rights reserved.
José Fernando Scarelli LOPES
Full Text Available A 43-year-old woman with a unilateral cleft lip and palate, presenting a totally edentulous maxilla and mandible with marked maxillomandibular discrepancy, attended the Prosthodontics section of the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo for treatment. She could not close her mouth and was dissatisfied with her complete dentures. Treatment planning comprised placement of six implants in the maxilla, four in the mandible followed by prostheses installation and orthognathic surgery. The mandibular full arch prosthesis guided the occlusion for orthognathic positioning of the maxilla. The maxillary complete prosthesis was designed to assist the orthognathic surgery with a provisional prosthesis (no metal framework, allowing reverse treatment planning. Maxillary and mandibular realignment was performed. Three months later, a relapse in the position of the maxilla was observed, which was offset with a new maxillary prosthesis. This isa complex interdisciplinary treatment and two-year follow-up is presented and discussed. It should be considered that this type of treatment could also be applied in non-cleft patients.
Full Text Available Mine rehabilitation is nowadays an essential part of the mine life-cycle. Nevertheless, due to the inadequate legislative framework and the lack of appropriate financial instruments in the past, abandoned mined land is present in almost all regions with a mining history. Especially in times of fiscal and financial belt tightening, where direct funding is almost impossible, the restoration of abandoned mines becomes a difficult task and, consequently, prioritization of the restoration projects is necessitated. So far, several models have been developed for that purpose. The existing models, however, usually underestimate that, especially for non-reclaimed mines located close to populated areas, landscape degradation generated by surface mining is a critical factor. To this end, this paper presents, through an illustrative example, a new approach providing the means for prioritizing mine restoration projects based on the visibility of surface mines with regard to the neighboring areas of interest. The proposed approach can be utilized as an additional module in existing prioritization models, or it can be used standalone when considering a group of surface mines where what distinguishes them from each other is primarily the disturbance of the landscape.
Full Text Available The purpose of this study is to develop a deeper understanding of the teaching qualities of effective lecturers that vocational students desire, students assessment preferences and preferred learning environments. This study gives a voice to higher vocational students as it is important for vocational educators to learn what attracts students to effective learning. Due to the inquiry’s exploratory nature, an interpretivist approach was used, and a constructivist grounded approach using qualitative data was adopted. A purposive approach to multiple case study selection was used where the unit of analysis was a higher vocational student. The perceptions and expectations of vocational undergraduate (EQF level 6 students in two disciplines (applied science and engineering were explored, to identify what may constitute good practice. A total of ten participants from two different institutes within the vocational university college agreed to be interviewed. Semi-structured and photo-elicitation interviews were applied. In addition, the Powerful Learning Environments (PLEs Framework was used as a preliminary tool to aid in the decision-making process for data collection. Iterative analysis was used for the semi- structured interviews, whilst a constant-comparative method was used for the photo- elicitation image analysis. Overall, the expectations and preferences between both groups were very similar. Results show that students expect to be taught by interactive lectures that relate theory to practice that will prepare them for the job. Formal lectures including presentations were the least favoured. Regarding teaching qualities, students expect approachable and understanding lecturers who provide concrete industrial examples. Assessment preferences included home based assignments and research projects. The preferred learning environment is in line with most characteristics of the Powerful Learning Environment. Evidence shows that there is no
Modern chest hospitals offer favourable conditions for the rehabilitation of asthmatic patients. In the Central Hospital for Heart- and Lung Diseases at Bad Berka 421 patients with asthma were rehabilitated under clinical conditions in 1972 and 1973. Their rehabilitation was based on individualized long-term plans for treatment taking in consideration environmental factors which might have triggered the attacks. We report on experiences with diagnostic and therapeutic procedures and the results of vocational rehabilitation. 284 patients (67.4%) could return to their work, 4.5% were disabled, 16.5% remained invalids and 11.6% were old-age pensioners or children. The results depended on age, on the type of asthma, on the severity of cardio-pulmonary impairment, on certain concomitant diseases and on the patients cooperation. Possibilities for elimination of factors starting an attack sometimes proved decisive. For the maintenance of rehabilitatory success subsequent ambulatory long-term care by a specialist is provided.
Hanning, Brian; Predl, Nicolle
Traditional overnight rehabilitation payment models in the private sector are not based on a rigorous classification system and vary greatly between contracts with no consideration of patient complexity. The payment rates are not based on relative cost and the length-of-stay (LOS) point at which a reduced rate applies (step downs) varies markedly. The rehabilitation Australian National Sub-Acute and Non-Acute Patient (AN-SNAP) model (RAM), which has been in place for over 2 years in some private hospitals, bases payment on a rigorous classification system, relative cost and industry LOS. RAM is in the process of being rolled out more widely. This paper compares and contrasts RAM with traditional overnight rehabilitation payment models. It considers the advantages of RAM for hospitals and Australian Health Service Alliance. It also considers payment model changes in the context of maintaining industry consistency with Electronic Claims Lodgement and Information Processing System Environment (ECLIPSE) and health reform generally.
Using the case of North Central Geo-Political Zone of Nigeria, this study interrogates the nexus between vocational and technical education (VTE) and sustainable development. Specific attention is put on provision and attainment of basic skills on one hand and job creation, self-employment, utilization of locally available ...
Laine, Kati; Hämäläinen, Raija
There is a growing demand to enhance entrepreneurship. This study aims at producing knowledge that can assist teachers in designing and supporting collaborative learning of entrepreneurship in vocational education. A qualitative case study approach was adopted. The outcome of this study provides a better understanding of the factors that hinder…
Full Text Available Severely eroded lands of southern Guam are referred to as BadLands. These are actively eroding areas of very deep, well–drained saprolite derived from tuff and tuff breccia. These badlands are exposed to overland flow, wind and rain causing sever erosion as the result of rapid runoff from the pitted, sloping sites void of vegetation. Through soil removal or sediment transport, erosion also alters the inherent physical and chemical properties of these soils. This alteration resulted in degradation, in turn affecting the environment as well as water quality in the down stream. The on-site damage from erosion is indeed a problem to environmental ecosystem of the island. Sediment lost due to erosion clogs rivers, lakes, and waterways. It reduces the water storage capacity of reservoirs and canals and increases flooding.The challenge facing soil and environmental scientists is to develop conservation and restoration strategies at the farm as well as at the watershed level that address crop production and natural resources protection needs, within a framework of increasing environmental and financial constraints. In our soil conservation program at the College of Natural and Applied Sciences of the University of Guam we have adopted integrated approaches to evaluate a variety of strategies, including the effect of conservation tillage and residue management, crop rotation with leguminous plants (sunnhemp as green manure as well as the use of composted organic wastes as soil amendment for organic matter build up, all for soil rehabilitation and restoration of the badlands in southern Guam. In a companion study we are evaluating the effectiveness of Vetiver technology as a sediment trap to mitigate sediment transport in a typical watershed basin in southern Guam. This paper discusses the methodology as well as up to date data that shows the effect of Vetiver technology on sediment trapping at the watershed level.
Sozzi, Davide; Novelli, Giorgio; Silva, Rebeka; Connelly, Stephen T; Tartaglia, Gianluca M
To determine the dental implant and prostheses success rate in a cohort of patients who underwent a vascularized fibula-free flap (FFF) for maxillary or mandibular reconstruction. The investigators implemented a retrospective cohort study composed of patients who had undergone primary or secondary FFF reconstruction jaw surgery plus placement of 2-6 implants in the reconstructed arch, which were restored with an implant-supported prosthesis. The sample was composed of all patients who underwent FFF surgery between 1998 and 2012 and had either simultaneous or secondary dental implant placement. A total of 28 patients met inclusion criteria. Of these, 22 patients participated in the retrospective review. Patients were examined by an independent observer between January-December 2015. In addition, all patients completed a questionnaire to access satisfaction with the implant-supported prosthesis. The patient cohort consisted of 12 males and 10 females, age 12-70 years. A total of 100 implants were placed, 92 implants in fibular bone and 8 implants in native bone. In the maxilla, 35 implants were placed into fibular bone and 4 into native bone (11 in irradiated patients and 28 in non-irradiated patients). In the mandible, 57 implants were placed into fibular bone and 4 into native bone (15 in irradiated patients and 46 in non-irradiated patients). The mean follow-up after implant loading was 7.8 years (range 1.3-17.5 years). The implant survival rate was 98% (95% CI: 92.2%-99.5%). No statistically significant difference was found in implant success between maxillary and mandibular implants, or between radiated and non-radiated bone. The prostheses success rate, determined by clinical exam and patient satisfaction, was 100%. The results of this study suggest that implant survival is high and implant-supported prostheses are a reliable rehabilitation option in patients whose jaws have been reconstruction with a FFF. Copyright © 2017. Published by Elsevier Ltd.
Tanggaard, Lene; Nielsen, Klaus; Helms Jørgensen, Christian
Since 2007, it has been mandatory for all vocational schools in Denmark to assess the prior qualifications of all students when they begin at the school and to use this assessment to divide students into different ability-based courses (streaming) with the aim of increasing the retention of stude......Since 2007, it has been mandatory for all vocational schools in Denmark to assess the prior qualifications of all students when they begin at the school and to use this assessment to divide students into different ability-based courses (streaming) with the aim of increasing the retention...... of students. The purpose of this paper is to explore students’ experiences of being placed on a low-ability course by using case studies of two classes from separate vocational schools in Denmark with different practices regarding the streaming of students....
Weill-Chounlamountry, A; Soyez-Gayout, L; Tessier, C; Pradat-Diehl, P
The cognitive model of music processing has a modular architecture with two main pathways (a melody pathway and a time pathway) for processing the musical "message" and thus enabling music recognition. It also features a music-specific module for tonal encoding of pitch which stands apart from all other known cognitive systems (including language processing). To the best of our knowledge, rehabilitation therapy for amusia has not yet been reported. We developed a therapeutic method (inspired by work on word deafness) in order to determine whether specific rehabilitation based on melody discrimination could prompt the regression of amusia. We report the case of a patient having developed receptive, acquired amusia four years previously. His tone deafness disorder was assessed using the Montreal Battery of Evaluation of Amusia (MBEA), which revealed impairment of the melody pathway but no deficiency in the time pathway. A computer-assisted rehabilitation method was implemented; it used melody discrimination tasks and an errorless learning paradigm with progressively fading visual cues. After therapy, we noted an improvement in the overall MBEA score and its component subscores which could not be explained by spontaneous recovery (in view of the number of years since the neurological accident). The improvement was maintained at seven months post-therapy. Although post-therapy improvement in daily life was not systematically assessed, the patient started listening to his favourite music again. Specific amusia therapy has shown efficacy.
Wiggins, J. D.; Weslander, Darrell
Expressed vocational choices were more predictive of employment status four years after high school graduation for males than were scores on either the Vocational Preference Inventory or the Kuder Preference Record--Vocational. Predictions for males were more accurate than for females on all measures. (Author)
Hahmann, H W
patient. Cardiac rehabilitation is already focusing on older, sicker and polymorbid patients; this will become ever more the case in the future. There is still a need for future clinical research for these patients.
Irritable bowel syndrome and vocational stress: individual psychotherapy: research. ... The goal of this study was to provide individualised psychotherapy for a sample suffering from IBS and vocational stress. ... AJOL African Journals Online.
This article traces the EC vocational training policy historically and describes the discursive alignments which brought the policy from a ‘common vocational training policy' as laid down in Article 128, in the Treaty of Rome to the Lisbon Lifelong Learning strategy. The argument is that vocational...... EC vocational training policy (Ball, What is policy? Texts, trajectories and toolboxes. Discourse, 13(2), 1993)....
The article analyses a contradiction between vocational teacher ability to plan his/her career and requirements for the teacher professional development set by the system of education. It aims at providing theoretical and empirical justification for vocational teacher need to develop career planning skills and identify problems. The concept and objectives of vocational teacher career planning as well as career planning skills that vocational teachers should develop are defined in the article.
Full Text Available The paper deals with the linguistic and cultural elements of vocative texts and the techniques used in translating them by giving some examples of texts that are typically vocative (i.e. advertisements and instructions for use. Semantic and communicative strategies are popular in translation studies and each of them has its own advantages and disadvantages in translating vocative texts. The advantage of semantic translation is that it takes more account of the aesthetic value of the SL text, while communicative translation attempts to render the exact contextual meaning of the original text in such a way that both content and language are readily acceptable and comprehensible to the readership. Focus is laid on the strategies used in translating vocative texts, strategies that highlight and introduce a cultural context to the target audience, in order to achieve their overall purpose, that is to sell or persuade the reader to behave in a certain way. Thus, in order to do that, a number of advertisements from the field of cosmetics industry and electronic gadgets were selected for analysis. The aim is to gather insights into vocative text translation and to create new perspectives on this field of research, now considered a process of innovation and diversion, especially in areas as important as economy and marketing.
Full Text Available for MIS maturity. The method can be applied in quantitative, qualitative and mixed methods research, to group a population and thereby simplify the process of sample selection of cases for further in-depth investigation....
Ministry of Social Affairs and Public Health, Amsterdam (Netherlands).
THE NETHERLANDS GOVERNMENT HAS TAKEN OVER ADULT VOCATIONAL TRAINING TO MAKE UP FOR THE ARREARS IN VOCATIONAL TRAINING CAUSED DURING WORLD WAR II AND TO ACHIEVE A SWITCHOVER OF WORKERS FROM TRADES WITH A LABOR SURPLUS TO TRADES WITH A LABOR SHORTAGE. IT HAS ESTABLISHED A NUMBER OF VOCATIONAL TRAINING CENTERS FOR THE INITIAL TRAINING OF PERSONS FOR…
Horowitz, Benjamin; Feinberg, Walter
Examines the concepts of equality of opportunity and equality of educational opportunity and their relationship to vocational education. Traces the history of vocational education. Delineates the distinction between training and education as enumerated in Aristotelian philosophy. Discusses the role vocational education can play in the educative…
Gade, Eldon M.; Goodman, Ronald E.
This study was designed to examine the vocational interests of daughters of alcoholics. Mixed support was provided for the assumption that their vocational choices are nonperson oriented. Data did support the prediction of high scores on the realistic and intellectual scales of Holland's Vocational Preference Inventory. (SJL)
Muncrief, Martha Crawford
To investigate work adjustment of vocational education teachers, a nation-wide study was conducted focusing on vocational needs, job satisfaction, and job success. The study involved 180 secondary teachers from three vocational areas, business, home economics, and industrial education. A multistage sampling process was utilized to select…
The focus of the thesis is an exploration into students’ vocational knowledge in the context of Dutch vocational education and training (VET). The reason students’ vocational knowledge requires exploration is because there is no consensus among scholars in the field of VET about how to theorise the
Sissa Mara Nicodemo Sanches
Full Text Available A equoterapia é uma das técnicas de reabilitação utilizada para pacientes com disfunções neurológicas. Os movimentos provocados pelo cavalo no corpo do paciente podem interferir positivamente em seu controle postural, melhorando a mobilidade geral e o desempenho motor funcional. O objetivo deste estudo foi verificar o efeito da equoterapia no equilíbrio, coordenação motora e funcionalidade de uma criança com meningoencefalocele. Uma menina de 3 anos e 6 meses foi submetida a 18 sessões de equoterapia (em três fases - alimentação, escovação e montaria realizadas uma vez por semana. Para a avaliação foram utilizadas as escalas de equilíbrio de Berg e Tinneti e o Inventário de avaliação pediátrica de incapacidade (PEDI para habilidades motoras gerais e funcionais, aplicados antes e após o período de terapia; e uma reavaliação foi feita oito semanas (sem intervenção depois. A equoterapia melhorou de maneira significativa o equilíbrio e a coordenação motora da criança, o que se refletiu no controle de movimentos funcionais básicos para a realização de atividades de vida diária. O ganho funcional também foi percebido pela mãe da criança. Esse estudo oferece uma nova perspectiva sobre o uso da equoterapia como modalidade fisioterapêutica na reabilitação motora e funcional de criança com meningoencefalocele.Hippotherapy is one among techniques used in rehabilitation of patients with neurological dysfunctions. The patient body's reactions to horse movements are known to have positive effects on patients' postural control, thus improving general mobility and motor functional performance. The purpose of this paper was to assess the effects of hippotherapy on balance, motor coordination, and functionality of a child with meningoencephalocele. A 3-and-a-half year-old girl with meningoencephalocele was submitted to 18 hippotherapy sessions (in a three- phase procedure - feeding, brushing, and riding once a week
Bolton, Brian; Akridge, Robert L.
Summarized the results of 15 experimental studies of 10 small-group skills training interventions developed for use with vocational rehabilitation clients. Concluded that the typical participant in skills training interventions received substantial benefit from the activity. Skills training programs should be implemented more widely with clients…