Issues in evaluating vocational rehabilitation programs.

Addresses issues in the evaluation of vocational rehabilitation (VR) programs for the disabled and discusses examples of 10 common evaluation problems typically encountered in assessing VR services. The usefulness of conducting an initial evaluability assessment is emphasized to identify and deal with potential obstacles to evaluation and to prevent a premature evaluation effort. It is concluded that, in spite of the complexity of carrying out evaluation research, the improvement of VR and other rehabilitation services depends on this program-monitoring and budget-justifying activity. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Vaccination project for vocational students

As part of a North-Rhine-Westphalian state project the district of Unna developed a vaccination programme for continuation schools in 1996. The reason for this programme realized for the first time in a vocational school, was a considerable lack of protection by vaccination in ninth year classes. The present results from the first vocational school show a significant lack of standard vaccination as well as boosters. To improve the current situation it will be necessary to authorize and enable the Public Health Services to carry out even more standard and indication vaccinations at secondary and vocational schools as well as at institutions for the handicapped.     

Problems of occupational therapy and vocational rehabilitation in psychiatry

The authors discuss the rehabilitative measures of occupational therapy, slight work and protected work with reference to their practical performance and optimum application. Critical remarks on the partly ineffective practical application of rehabilitative measures are followed by hints on laws, which show their objectives and possibilities.     

Psychosocial factors affecting the employment of former vocational rehabilitation clients.

Analyzed questionnaires completed by 211 former vocational rehabilitation (VR) clients (aged 15–61 yrs) 2 yrs after case closure for a clarification of the psychosocial factors that affect vocational adjustment. Questionnaires assessed employment status and problems, sources of income/financial status, health, and job satisfaction (for employed Ss only). WAIS Full Scale IQs were available for 195 Ss, and 120 Ss had completed the 16PF—Form E. Results show that the primary criteria of vocational adjustment (employment, job satisfaction, and persistence in looking for work) were associated with better self-appraised physical and mental health, greater perceived family support in seeking employment, more optimism about employment prospects, and attribution of the problem source to the environment. These variables suggest useful points for intervention by VR practitioners. (5 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison of adult learning disability subtypes in the vocational rehabilitation system.

Objective: To examine the personal adjustment and vocational outcomes of adults with different subtypes of specific learning disabilities. Design: Cluster analysis was used to derive subtypes from a vocational rehabilitation population, and nonparametric tests were used to test hypotheses. Participants: Three hundred Sixty-one successfully employed persons were compared with 252 unsuccessfully employed persons. Main Outcome Measures: Rates of secondary psychiatric disorders, type of training, and category of vocational attainment were the outcome measures. Results: Subtype was associated with vocational outcome and training but not with prevalence of secondary psychiatric diagnosis. Conclusions: Subtypes of specific learning disabilities exist in the vocational rehabilitation population and are associated with differences in vocational training, success rates, and occupational placement. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Motivation and employee-supervisor discrepancies in a psychiatric vocational rehabilitation setting.

Examined both employee and supervisor reports of motivational and work adjustment variables, in the context of a psychiatric rehabilitation program, as correlates of program participation and independent ratings of readiness for competitive employment. Ss were 80 employees (aged 21–75 yrs) in a sheltered workshop and transitional employment program affiliated with a state psychiatric hospital. Program participation and work-readiness were associated with both employee and supervisor ratings of motivation after controlling for employee benefit plan, residential status, and social adjustment. Additionally, the degree of supervisor–employee discrepancy in these ratings was negatively correlated with program participation, work-readiness, and estimates of premorbid social competence. The role of motivational factors in vocational rehabilitation and the dynamics of supervisor and employee perceptions of work motivation and adjustment are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Quantification of biographical data for predicting vocational rehabilitation success.

To devise an instrument based on biographical data to classify applicants for State vocational rehabilitation services in terms of success and to construct expectancy charts to indicate probability of success of future applicants. The Ss were 200 clients closed in fiscal year 1960 as being employed and 200 closed in fiscal year 1960 as being unemployed, as well as 40 in each category closed during fiscal year 1961. 86 items of personal data were obtained for key K1 and 20 selected items were obtained for key K2. Results were: variance between criterion subgroups could be maximized for classification, scores could be derived to classify clients, scores could be combined to establish expectancy charts, and K2 predicted expectancies better than K1. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Supported work: An innovative approach to the vocational rehabilitation of persons who are psychiatrically disabled.

Presents a model for the vocational rehabilitation of persons with severe psychiatric disability (SPD) that helps clients find private-sector jobs and provides support to both client and employer. Preliminary data on a supported work program in which 152 Ss with SPD participated suggest that the model is effective in returning individuals with SPD to competitive employment. Close monitoring of a subset of 34 Ss during the 1st yr of the program revealed that Ss whose disabilities were identified in adolescence (age 19 yrs or younger) were almost twice as likely to be employed as those with an adult onset. Clinical stability and level of motivation also appeared to affect program outcome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of depressive symptoms during short-term rehabilitation: An attempted replication of the DOUR project.

Objective: To replicate and extend P. A. Lichtenberg and colleagues' (1996) cross-disciplinary intervention to improve physical and mental health among older adults. Participants: 14 depressed older adults (6 treatment, 8 control). Setting: The short-term rehabilitation unit of an urban nursing home. Intervention: Occupational therapists were trained to treat depression using pleasant events and cognitive-behavioral therapies. Outcome Measures: Geriatric Depression Scale, the Short Form-12, and the Multi-Level Assessment Instrument: Activities of Daily Living. Results: No significant group differences were found in physical or mental health. However, more control group members (75%) than treatment group members (33%) were depressed at study completion. Conclusions: The treatment of depressive symptoms can be integrated with a nonmental health treatment modality. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Generalization of the WAIS—R factor structure with a vocational rehabilitation sample.

Investigated the robustness of the WAIS—R factor structure with a generalization sample of 85 psychiatric and medical patients (mean age 35.38 yrs) receiving vocational rehabilitation services at a VA medical center. A principal factor analysis followed by varimax rotation identified the Verbal Comprehension and Perceptual Organization factors. Coefficients of congruence indicate that the results are highly consistent with those reported by A. B. Silverstein (1982) for the standardization sample and provide added justification for specific interpretation of the WAIS—R Verbal and Performance IQs in this clinical group. (4 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The evaluation of the organization of vocational rehabilitation for convalescents in the health workshop of an industrial enterprise

A patient with myasthenia gravis and a thymoma did not respond to thymectomy. He was submitted to radiotherapy concurrent with steroid therapy followed by an alkylating based chemotherapy. Four years later, he developed an otherwise typical Philadelphia chromosome/BCR-ABL positive chronic myelogenous leukemia (CML) that quickly evolved to a blast crisis. We discuss the possible cause-effect mechanism between the previous treatment and CML, and suggest that a distinct mechanism, albeit unknown, could be involved in the development and progression of secondary CML.     

What makes vocational rehabilitation effective? Program characteristics versus employment outcomes nationally in VA.

With the focus on well-defined models for rehabilitation of people with mental illness, there is interest in program elements that predict successful outcomes. Data on programmatic elements from 92 Veterans Affairs Compensated Work Therapy (CWT) programs were merged with 6,891 individual records. General estimation equation analyses were used to identify correlates of 3 dependent variables representing successful outcomes. Community-based work at the individual level was positively associated with all 3 measures of success. Program emphasis on assertive outreach was positively associated with competitive employment and achievement of constructive activity. Greater amounts of assertive outreach and less integration of mental health and vocational staff were associated with a greater likelihood of constructive activity. These results suggest that the best outcomes are achieved by community-oriented programs incorporating assertive outreach. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Age differences in a sample of state vocational rehabilitation clients with traumatic brain injury.

Objective: To examine the relations among age, neuropsychological functioning, and vocational rehabilitation following traumatic brain injury (TBI). Study Design and Participants: Prospective study of 78 adults (18-57 years) who qualified for services with the Missouri Division of Vocational Rehabilitation (DVR), based on a history of TBI followed from enrollment to case closure. Group differences based on age were examined for neuropsychological and vocational outcome with multivariate analysis of variance and nonparametric methods. Main Outcome Measures: Neuropsychological test data and DVR data regarding vocational placement. Results: Age-related differences were present for a measure of mental flexibility, isolated demographic characteristics, and 1 DVR service category. Contrary to hypotheses, there were no age-related differences in vocational outcome. Conclusions: In contrast to hospital-based samples, age does not appear to be a negative indicator for individuals admitted to a state DVR program. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Occupational and vocational rehabilitation of psychiatric patients: a control and attribution theory approach to examining the effect of working conditions

The expression of N-cadherin mRNA was mapped in the brain of mice between embryonic day 12 (E12) and the adult stage by in situ hybridization of digoxigenin-labeled riboprobe. Two phases of N-cadherin expression can be distinguished. During the first phase (about E12 to E16), expression is ubiquitous throughout the brain and most prominent in the proliferative neuroepithelium. During the second phase (about E16 to postnatal day 6), N-cadherin expression is restricted to particular nuclei or laminae that share common functional features and neuroanatomical connections. Several of the N-cadherin-positive structures receive direct afferents from retinal ganglion cells or from the superior colliculus. Others belong to the reticular system and to the limbic system of the brain. In neocortex, N-cadherin is expressed by deeper layer cells. In the adult brain, only low levels of N-cadherin expression remain in very few types of cells, for example in the Purkinje cells of the cerebellum. These results are similar to data from chicken brain and suggest that the generalized expression of N-cadherin during the early phase and the restriction expression of this molecule in particular functional systems during the later phase is, at least in part, phylogenetically conserved between chicken and mouse. Moreover, the results show that N-cadherin expression extends to phylogenetically newer structures, e.g., the mammalian neocortex.     

适应职业岗位需求的高职高专康复治疗技术专业的人才培养模式构建与实践

新型的人才培养模式已经成为高职院校教育改革的一项重要任务,康复治疗技术专业作为一个新兴专业应紧紧围绕康复治疗技术职业岗位需求,在人才培养定位、教学体系设置、实训基地建设、人才培养方案上凸显职业岗位的特点.