Hasil untuk "Vocational rehabilitation. Employment of people with disabilities"

Franco Mascayano, Sarah Swanson, A. Florence et al.

Implementing evidence-based practices has become a standard policy in U.S. behavioral health care. However, current penetration remains inadequate, and longitudinal studies of scaling up these practices are rare. This article examined the steady, 3-decade growth of individual placement and support (IPS), the evidence-based model of employment services for people with psychiatric disabilities. The number of IPS programs in the United States has increased to >1,000. Nevertheless, coverage remains limited, and challenges to further growth are substantial. Facilitators of IPS growth over the past few decades include client demand, scientific evidence, initial financial support from foundations, subsequent federal agency support, state leadership in behavioral health and vocational rehabilitation, standardized training and quality assurance methods, an international learning community, and the collection of national data to establish benchmarks. Challenges to further expansion of IPS include the complexity of multiple partial funding sources; the increasing use of information technology for training, implementation, and quality assurance; extension to new populations and settings; outreach to historically marginalized groups (e.g., young adults not engaged in the mental health system); employer partnerships; and adaptations related to cultural, workforce, and workplace changes. Developing reliable research methods to assess and compare scaling-up strategies is also critical.

Jerome P. Fredericks, Surona Visagie, Lana van Niekerk

Background: Accessible transport is essential for achieving the sustainable development goals. Persons with disabilities often struggle to access public transport with different impairments leading to unique access barriers. Wheelchair users face physical and attitudinal challenges when accessing minibus taxis, a common mode of public transport in Africa. Objectives: The objective of this review was to explore the barriers and facilitators that wheelchair users in African countries experience when using minibus taxi services. Method: The scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines for reporting on scoping reviews as well as the Joanna Briggs Institute scoping review guidelines. Eight databases were searched. Two reviewers screened articles in Rayyan. Data were analysed and synergised through a convergent integrated approach. Results: The literature search yielded 236 titles, of which 20 were included after further review. Studies were from four African countries, mostly South Africa (n = 14), Ghana (n = 4), Sierra Leone (n = 1) and Zimbabwe (n = 1). Key findings such as structural (obstructed sidewalks, potholes), mechanical (vehicle design), economic (paying for wheelchairs and carers), attitudinal (impatience, rudeness) and institutional (ableism, lack of political will) barriers and facilitators were identified. Conclusion: Despite minibuses having evolved into a cheap mode of public transport in most African countries, their design and operating practices still prevent wheelchair users from using them with ease and dignity. Contribution: This review presents barriers and facilitators that wheelchair users experience when using minibus taxi services. Future research should focus on reconfiguring transport services offered by minibus taxis to provide equal access for wheelchair users in Africa and beyond.

Mahmoud M. Abdelwahab, Khamis A. Al-Karawi, H. E. Semary

The dedication to enhancing the inclusion of students with disabilities has led to the growing prevalence of assistive technology (AT) in education. The present paper aims to systematically review studies on the effects of AT on the inclusion of students with impairments. A review of pertinent empirical studies published from 2009 to 2022 was conducted across four databases: Web of Science, Scopus, ERIC, and PsycINFO. The sample comprises 32 papers that fulfilled the inclusion criteria of this review, from a total of 218 papers identified. The results highlight that advanced AT markedly enhances accessibility and active involvement for students with mobility impairments, improving their academic engagement and social integration. Nonetheless, the analysis also highlights obstacles to efficient AT adoption, including inadequate teacher training, restricted awareness of AT possibilities, and difficulties related to availability and cost. The study closes with recommendations for governmental support, enhanced financing, and specialized teacher training to use advanced AT to create more inclusive educational settings for kids with significant mobility impairments.

Nokulunga Shabalala

No abstract available.

Dr. Hiba Saeed, Dr. Sana Akram, Dr Hussain Ahmad Saeed et al.

Background: Hamstring strain injuries commonly affect athletes particularly those engaging in activities that involve frequent high velocity and quick changes in direction. Such injuries cause severe pain, limitation of motion, and reduction in trunk muscular endurance and thus require longer time to rehabilitation. Objective: To determine the effects of multimodal intervention on pain, range of motion and trunk endurance in patients with hamstring strain injury. Methodology: A randomized controlled trial (RCT) was conducted with 60 participants (aged 18-30) divided into two groups: a control group receiving conventional physical therapy (CPT) and an intervention group receiving a multimodal intervention over six weeks. Data was collected using visual analogue scale, goniometer and trunk endurance test. Data was analyzed using SPSS 25. Results: Both groups showed significant improvements (p < 0.001). By the 6th week, Group B achieved superior outcomes, with knee flexion increasing from 90.08° to 127.31° (p = 0.002), hip extension rising from 4.28° to 10.17° (p < 0.001), pain levels decreasing from 9.06 to 4.67 (p < 0.001), and trunk endurance improving from 2.17 to 3.72 (p = 0.045). In comparison, Group A showed improvements in knee flexion (89.89° to 118.31°), hip extension (3.81° to 7.78°), pain (8.31 to 5.78), and trunk endurance (1.78 to 3.22), but with less significant differences. Conclusion: Multimodal intervention significantly improves pain levels, ROM, and trunk endurance in patients with hamstring strain injury, offering a comprehensive approach to rehabilitation. Keywords: Hamstring muscles, muscle stretching exercises, pain management, ROM

Manel Abid, Roseline Galipeau, Mariem Gaddour et al.

Background: Cerebral palsy (CP) represents the most common and disabling motor disorder in childhood. It can lead to chronic pain and reduced quality of life (QOL). These challenges can also affect mothers, who are typically the primary caregivers, contributing to physical and psychosocial strain. Objectives: This study explored the associations between motor impairment, chronic pain, and QOL in children with CP, as well as maternal stress and pain intensity, and examined their mediating roles. Method: A cross-sectional study was conducted with 132 mother–child dyads in Tunisia. Children were aged 4 to 12 years. The Gross Motor Function Classification System, the Cerebral Palsy Quality of Life Questionnaire, the Visual Analogue Scale, and the Perceived Stress Scale were used to assess motor impairment, quality of life, and chronic pain intensity in children with CP, as well as maternal pain intensity and stress. Results: Motor impairment was significantly associated with lower child QOL (β = −0.671; SE = 0.657, p  0.001) and higher pain intensity (β = 0.5; SE = 1.213, p  0.001). Maternal stress partially mediated the relationship between motor impairment and child QOL (Sobel test = −4.073; p  0.001). Maternal pain also partially mediated the relationship between motor impairment and child pain (Sobel test = 2.505; p = 0.012). Conclusion: These findings highlight the significant impact of motor impairment on QOL and chronic pain intensity in children with CP. Contribution: This study emphasises the mediating roles of maternal stress and pain intensity, suggesting that interventions should address both the physical symptoms of CP and the psychosocial well-being of children and their mothers.

Rentia A. Maart, Dawn V. Ernstzen, Gubela Mji et al.

Background: The need for rehabilitation in South Africa has doubled between 1990 and 2017 and is expected to increase in the coming years. However, the rehabilitation needs of South Africans (and globally) remain largely unmet. Establishing a common understanding of the value of rehabilitation can inform clinical practice and policymaking to achieve Universal Health Coverage (UHC). Objectives: This study aims to explore the value of rehabilitation services in South Africa’s public healthcare sector by gathering perspectives from stakeholders. The goal is to inform policy decisions related to the implementation of National Health Insurance (NHI) in South Africa. Method: The study used a phenomenological approach and interpretivist paradigm. Semi-structured interviews were conducted face-to-face, online, or telephonically with 12 stakeholders from various rehabilitation sectors. The value of rehabilitation was analysed and categorised into five main categories: context, service delivery, patient outcomes, economic and financial components, and collaboration within and between sectors. Results: The value of rehabilitation was found to be multifaceted, because of the varying health, economic, and social challenges faced by many South Africans. Conclusion: The study identified components of value-based rehabilitation that should be prioritised in the proposed NHI of South Africa. Future research should explore all stakeholder perspectives, including patients, and provide empirical evidence of rehabilitation’s economic and societal value. Contribution: We highlight priority areas that are central to the value of rehabilitation in South Africa and other low- and middle-income countries (LMICs). Tailoring rehabilitation services to patient and community needs is crucial for achieving value-based care. Given South Africa’s commitment to the United Nations Convention on the Rights of Persons with Disabilities, prioritising rehabilitation remains essential.

Jana York, Jan Jochmaring

This paper examines the German system of vocational rehabilitation and participation from a system- and innovation-theoretical perspective. The German system of vocational rehabilitation and participation, with its established special systems for participation in the labor market, is facing a - long overdue - reorientation. The article presents central instruments of the vocational rehabilitation system based on legal foundations, official labor market statistics, and current research findings. The authors compare the legal requirements for an inclusive work environment with the actual employment situation of people with disabilities and highlight a central dilemma of inclusion. Two modes of innovation and exnovation in the vocational rehabilitation system are proposed and critically discussed to resolve the dilemma.

Zahra Valitabar Kerati, Morteza Farazi, Atieh Ashtari et al.

Objectives: The mother’s knowledge and attitude about the child’s developmental norms can affect their practice and the quality of parent-child interaction. The quality of a child’s development in the early years significantly impacts their personality and future success. Therefore, this study aims to develop and investigate the psychometric characteristics of the Iranian mother’s knowledge, attitude, and practice (KAP) questionnaire about the development of communication, language, speech, and swallowing of Persian-speaking children aged 18 to 36 months and comparing them. Methods: This study was a descriptive-analytical and cross-sectional study conducted on 280 mothers with typically developed children aged 18 to 36 months from different provinces of Iran. Due to the COVID-19 pandemic with the implementation of the study, the participants were selected as available, and then the snowball completed the questionnaire in both face-to-face and online methods. To check the validity of the questionnaire, face validity was calculated using the opinion of speech therapy experts and ten mothers, and content validity was calculated using the Lawshe method. To check the reliability of the questionnaire, the test re-test method was used in a two-week interval. Results: The results indicated that this questionnaire has high validity (content validity index [CVI] >0.79) and reliability (intraclass correlation coefficient [ICC]=0.90). The multiple linear regression model showed that only the mother’s age has a significant positive relationship with knowledge ([B=0.082] P=0.04) about the development of communication, language, speech, and swallowing of children aged 18 to 36 months. Socioeconomic status and the mother’s education had no significant relationship with the mother’s KAP. Also, this study showed that the mother’s knowledge, attitude, and practice about a child’s development were high (mean=16.5), positive (mean=56.44), and good (mean=60.27). Discussion: This study showed that the designed questionnaire is a valid and reliable tool that can be used to investigate the mother’s KAP about the development of communication, language, speech, and swallowing of Persian-speaking children aged 18 to 36 months. On the other hand, speech and language pathologists can use this questionnaire in related studies and clinical evaluations to have better and more knowledge of the child’s environment and the factors affecting it in Persian-speaking society. Coresponding author: Morteza Farazi, E-mail: mfarazi80@gmail.com You can also search for this author in: PubMed, Google Scholar

Hadeel Alsolai, Fahd N. Al-Wesabi, Abdelwahed Motwakel et al.

Anomaly detection in pedestrian walkways of visually impaired people (VIP) is a vital research area that utilizes remote sensing and aids to optimize pedestrian traffic and improve flow. Researchers and engineers can formulate effective tools and methods with the power of machine learning (ML) and computer vision (CV) to identifying anomalies (i.e. vehicles) and mitigate potential safety hazards in pedestrian walkways. With recent advancements in ML and deep learning (DL) areas, authors have found that the image recognition problem ought to be devised as a two-class classification problem. Therefore, this manuscript presents a new sine cosine algorithm with deep learning-based anomaly detection in pedestrian walkways (SCADL-ADPW) algorithm. The proposed SCADL-ADPW technique identifies the presence of anomalies in the pedestrian walkways on remote sensing images. The SCADL-ADPW techniques focus on the identification and classification of anomalies, i.e. vehicles in the pedestrian walkways of VIP. To accomplish this, the SCADL-ADPW technique uses the VGG-16 model for feature vector generation. In addition, the SCA approach is designed for the optimal hyperparameter tuning process. For anomaly detection, the long short-term memory (LSTM) method can be exploited. The experimental results of the SCADL-ADPW technique are studied on the UCSD anomaly detection dataset. The comparative outcomes stated the improved anomaly detection results of the SCADL-ADPW technique.

Khalid Alluhydan, Md Irfanul Haque Siddiqui, Hesham Elkanani

This literature review on the design of amputated lower limbs has covered various aspects related to prosthetic limb design. It has highlighted the need for continuous improvement and innovation in order to enhance user satisfaction, mobility, and overall quality of life. Biomechanical factors such as gait analysis, joint range of motion, force distribution, and energy efficiency were identified as crucial considerations in amputated lower-limb design. Socket design principles, focusing on comfort and proper load distribution, were found to be essential for achieving a well-fitting and functional prosthetic limb. Emerging technologies, including advanced materials, robotics, neural interfaces, and sensor technology, were explored as potential avenues for improvement. These technologies showed promise in enhancing functionality, control, and sensory feedback in prosthetic limbs. A user-centric approach was emphasized, involving users in the design process and incorporating their feedback and preferences. Affordability and accessibility were highlighted as significant concerns, calling for the development of cost-effective solutions. Long-term performance and durability were also emphasized, stressing the need for robust materials and quality control processes. The integration of neural interfaces and sensory feedback posed opportunities and challenges for achieving more natural limb control and sensation. To sum up, this literature review has furnished valuable perspectives on amputated lower-limb design, underscoring the significance of refining design principles, accounting for biomechanical variables, embracing emerging technologies, and integrating user input. Future directions include addressing affordability, long-term performance, and neural integration while leveraging advancements in materials, technology, and user-centered design.

Claire Hutchinson, Kiri Lay, June Alexander et al.

BACKGROUND: Microenterprise is emerging as an employment pathway for people with intellectual disabilities, but there is little published research in this area. OBJECTIVE: To identify the facilitators, barriers and outcomes from microenterprises owned by people with intellectual disabilities from several stakeholder perspectives. METHODS: Semi-structured interviews were conducted with seven business owners and 22 other stakeholders with data analysed using content analysis. RESULTS: A key facilitator for successful microenterprise was the availability of, and continued access to, three pillars of formal support (microenterprise consultant, personal assistant, and an enterprise management group). Key barriers identified were funding limitations, role confusion between supports, and problems recruiting supports with business skills. Outcomes for business owners included personal/emotional growth, skills development, autonomy, having a meaningful role, and contributing to their communities. Other stakeholders experienced personal rewards and an increased expectation of the capacities of people with intellectual disabilities. Income generation and cessation of benefits was not the goal of the model or noted as a main consideration by stakeholders. CONCLUSIONS: Microenterprise can provide people with intellectual disabilities with an employment pathway highly tailored to their goals, capacities and interests. With consistent formal support, people with intellectual disabilities can run businesses over many years.

Nichole Tichy, K. Hergenrather, Bárbara Rodrigues Alvernaz dos Santos et al.

The first case of COVID-19 was reported in the United States in January 2020. To date, the U.S. reports more than 87 million confirmed cases and more than 1 million related deaths. In the U.S., published research suggests that COVID-19 transmission and prevention practices presented challenges for people with disabilities regarding job status and access to services. To explore the impact of COVID-19 on employment and service provision for persons with disabilities (PWD), the authors performed a systematic review of published quantitative and qualitative studies conducted in the U.S. from January 2020 through December 2021. From the 19 identified studies, findings were grouped into three themes: employment, quality of life, and coping. The impact of COVID-19 and other adverse events (e.g., global pandemic, supply chain issues, financial recession, hurricanes, flooding, wildfires) on the provision of vocational rehabilitation services and employment outcomes for persons with disabilities should be further explored. Based on review findings, the COVID-19 Lived Experiences Scale for Persons with Disabilities (CLES-PWD) was created to understand the experiences of PWD in terms of their employment, quality of life, and coping. The CLES-PWD can serve as a tool for vocational rehabilitation professionals when providing employment planning to enhance employment outcomes.

Mıchalıs Varkas

Social inclusion and employment prospects of young students with disabilities depend not only on positive attitudes but also on appropriate vocational training. There is an urgent need to implement effective intervention strategies to alleviate barriers and facilitate successful outcomes for the employment of young people with disabilities, and at the same time there is growing evidence that helping them gain early work experiences leads to better long-term results of vocational rehabilitation. There are many social groups that can influence employment opportunities and outcomes for students with disabilities (e.g., parents, employers, employment counsellors, etc.) but teachers are of primary importance. They have at their disposal a wealth of knowledge about the advantages and needs associated with the school to employment transition of young people with disabilities, and at the same time they understand the extent to which existing school activities are effective in strengthening them. Our literature review shows that teachers’ attitudes have a significant impact on job opportunities and the transition to work for students with disabilities. Negative attitudes can limit the type of education services provided and the potential for their successful training. Teachers play a predominant and essential role in removing social exclusion, initially supporting their students' stay at school and later providing immediate training to improve employment outcomes. Ultimately, they affect their employability because their attitudes have a direct impact on the structure, content, implementation and promotion of school to employment transition programs.

Muhammad Ahmad , Aleem Liaqat , Nabeela Kanwal et al.

Objectives: to find out the effectiveness of stretching exercises and baclofen alone and combined in spastic cerebral palsy children on spasticity, fluid and calorie intake. Material & Methods: A single-blinded, randomized control trial was conducted at Allama Iqbal Hospital, and Idrees Teaching Hospital. The participants between 5-15 years, having spasticity score of 2 or more on Modified Ashworth Scale (MAS). The participants were randomly divided into three treatment groups i.e. group A received baclofen, group B received stretching and group C received both baclofen and sustained stretching. Data were collected by Performa / Questionnaire, which calculated basic demographics, BMI, fluid and calorie intake, and Modified Ashworth Scale (MAS). Results: The result showed significant difference (p<0.05) among group with large effect size while comparing mean differences of Fluid intake {F(df)=2,57(988.603), η2 =0.972, p<0.001} and Calories intake {F(df)= 2,57(166.877), η2 =0.854, p<0.001}. While there was no significant difference in mean difference of spasticity {F(df)= 2,57(2.119), p=0.130}. Conclusion: baclofen along with stretching exercises significantly improved fluid, calorie intake and spasticity.

Budiman, Sri Garnewi

Objectives: The present study aimed to determine the effect of diaphragmatic breathing exercises on the degree of breathlessness among patients with Chronic Obstructive Pulmonary Disease (COPD) in West Java Province, Indonesia. Methods: This was a quasi-experimental study with a pretest-posttest and no control group design. In total, 33 patients with COPD participated in this study using a consecutive sampling technique. The Modified Medical Research Council was used to measure the degree of breathlessness. A portable spirometer was used to assess Forced Expiratory Volume in one second (FEV1) and Forced Vital Capacity (FVC). Results: The Mean±SD age of the study subjects was 44.5±3.17 years; 54.4% of the study participants were male, with healthy a body mass index. Approximately 42.4% of the studied patients experienced the fourth degree of breathlessness before the intervention. There was a reduction in the Mean±SD score of breathlessness from 3.42±0.53 to 1.64±0.13 after the intervention (P=0.001). There were improvements in the breathing frequency (Mean±SD: 11.8±4.9 vs 9.5±1.6), oxygen saturation (93.39±3.20 vs 95.47±4.21), and FEV1/FVC (0.5±0.12 vs 0.3±0.45) in the study subjects. Discussion: It is expected for the hospital, educational institutions, nurses, and patients to be able to apply diaphragmatic breathing exercises as one form of nursing care measure. This is because it is proven effective to reduce the degree of breathlessness.

Carmen María Salvador-Ferrer

En este estudio se pretende conocer la calidad de vida que tienen los trabajadores con discapacidad respecto a la inclusión social, así como si los problemas existentes en el trabajo (conflicto de rol) consideran que son determinantes en dicha inclusión. Además, proponemos un modelo donde se plantea que la autodeterminación tiene un efecto mediador entre el conflicto de rol y la inclusión social. El trabajo se ha realizado con un total de 51 trabajadores con discapacidad pertenecientes a un Centro Especial de Empleo que prestan un servicio de limpieza en la Administración Pública. Los resultados indican que los trabajadores valoran la inclusión social y que el conflicto de rol puede afectar a su inclusión social. Además, los hallazgos respaldan el modelo propuesto, ofreciendo una orientación para conseguir la inclusión social del colectivo con discapacidad. Al final planteamos las implicaciones prácticas del presente trabajo y, también, se debate en torno al relevante papel que desempeña el trabajo en la inclusión social.

Masoud Gharib, Roshanak Vameghi, Mohsen Fallahi

Beaulieu-Boycott-Innes syndrome (BBIS), an autosomal recessive disorder, is characterized by dysmorphic facial features and developmental delay. In this case study, we used the age and stages questionnaire 2 (ASQ-2) to assess the developmental status of an Iranian 20-month-old girl displaying a complex BBIS phenotype. Rehabilitation interventions were designed and performed focusing on neurodevelopmental delay. Because she had a severe developmental delay and her scores in all five domains of ASQ-2 were below the cut-off points available for Iranian children, the effectiveness of rehabilitation interventions was slower than expected. It seems that early rehabilitation and close follow-up should be considered for these children. We can assume that early and properly sensory-motor and cognitive interventions in these children may lead to growth development and prevent secondary complications.

Ioanna Papavassiliou-Alexiou, Maria Fotiadou

BACKGROUND: This paper draws upon a broader empirical qualitative research about the educational and vocational (re-)integration of people with acquired physical disabilities in Greece. OBJECTIVE: Perceived motives and barriers, under the shadow of recession, coping mechanisms as well as the contribution of state, rehabilitation specialists and significant others on the return to the labor market of people with acquired physical disabilities in Greece of crisis are investigated. METHODS: The research was carried out using a focus group with 6 persons and focused semi-structured interviews with 20 persons, members of the Greek Association of Paraplegics and the Greek Company of Multiple Sclerosis. RESULTS: According to the main findings work makes people with acquired physical disabilities (PwAPD) feel useful and creative contributing to their physical and psychological rehabilitation. Despite the significant barriers they encounter, additionally burdened by the recession, e.g. no job offer, limited accessibility, discrimination, educational deficiencies, PwAPD succeeded in developing strategies to overcome their vocational (re-)integration barriers mainly via education, resistance to discriminatory attitudes and the support of the significant others. CONCLUSION: Despite of the existing barriers, affected by the financial crisis, PwAPD, still fight for their re-inclusion to social life, being equipped with a positive attitude. Still, the Greek State along with rehabilitation and relevant services should become more active and flexible to effectively support and empower this right fight.

Seyyed Mohammad hossein Javadi, Lotfollah Mohseni, Iraj Esmaili et al.

Objectives: Delinquency is one of the severe social problems. Today, changing criminal behavior and reducing the way and method of delinquency is one of the most important challenges in the juvenile justice system. Methods: Based on the cognitive-behavioral approach, this study used three principles of Red Cross and Red Crescent fundamental principles, three skills of basic life skills, and first aid skill. A group intervention in 13 sessions was designed for changing the attitudes of juveniles in conflict with the law and was implemented in juvenile detention centers in 5 provinces. Then, the efficiency of the model was evaluated. In this quasi-experimental study, two groups were compared as the pre-test, and then post-test. The statistical sample contained 127 boys with the age range of 12 to 19 years, who were randomly selected among delinquent juveniles in the mentioned centers. The reliability and validity of the researcher-made and normalized questionnaires were examined and confirmed by the opinions of experts and statistical methods. Results: There were significant differences between the experimental and control groups in humanity, impartiality, and voluntary services as well as the sum of fundamental principles and first aid skills, self-awareness, problem-solving, and anger management scores. These significant differences suggest that the model can develop these scores. Discussion: This model is effective in improving knowledge and skills and changing the attitude of delinquent juveniles. Based on the findings of this study, a model was designed, using three principles of the Red Cross society, basic life skills, and first aid skills that can be effective in changing the attitudes and behavior of people in the juvenile detention centers. This finding is consistent with the studies and similar experiences at this level and requires additional longitudinal studies to investigate its effects on the frequency of recidivism, arrest, trial, and return to the center or imprisonment.