scholarly journals Implementation of a novel return-to-work approach for persons with affective disorders in a traditional vocational rehabilitation context: a case study

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Suzanne Johanson ◽  
Urban Markström ◽  
Maria E. Larsson ◽  
Ulrika Bejerholm
Keyword(s):  
Return To Work ◽  
Vocational Rehabilitation ◽  
Affective Disorders ◽  
Supported Employment ◽  
Mental Healthcare ◽  
Healthcare Services ◽  
Model Fit ◽  
Essential Components ◽  
Employment Specialists

Abstract Background The person-centred Individual Enabling and Support (IES) model is a novel return-to-work (RTW) intervention for people with affective disorders that was developed from evidence-based supported employment for persons with severe mental illness. Typically, supported employment is integrated into mental healthcare and provides a network around the service user and close collaboration with employment and insurance services and employers. Introducing integrated models into a highly sectored welfare system that includes traditional mental healthcare and vocational rehabilitation is challenging. Greater knowledge is needed to understand how facilitating or hindering factors influence this introduction. The aim of this study was to investigate essential components in implementation of the IES model. Methods A case-study was conducted and included four mental healthcare services. Data collection was comprised of semi-structured interviews with 19 key informants, documentation from meetings, and reflection notes. Analyses were performed according to directed content analysis, using the components of the Consolidated Framework of Implementation Research (CFIR) as a guiding tool. Fidelity assessments were performed at 6 and 12 months. Results Anticipating RTW support for the target group, and building collaborative relationships and a network with employment specialists that engaged staff in every organization were components that resulted in the greatest facilitation if IES implementation. Barriers consisted of difficulty in integrating employment specialists into the mental healthcare teams, insufficient engagement of first line managers, reorganization and differing perceptions of the IES model fit into a traditional vocational context. Delivery of the IES model had good fidelity. Conclusions The IES model can be implemented with good fidelity, several model advantages, and context adaptation. Team integration difficulties and negative perceptions of model fit in a traditional vocational rehabilitation context can be overcome to a certain degree, but this is insufficient for sustainable implementation on a larger scale. Policy and guidelines need to promote integrative and person-centred RTW approaches rather than a segregated stepwise approach. Further implementation studies in the traditional vocational rehabilitation context are needed.

scholarly journals Integrating vocational rehabilitation and mental healthcare to improve the return-to-work process for people on sick leave with depression or anxiety: results from a three-arm, parallel randomised trial

2021 ◽  
pp. oemed-2021-107894
Author(s):  
Andreas Hoff ◽  
Rie Mandrup Poulsen ◽  
Jonas Fisker ◽  
Carsten Hjorthøj ◽  
Nicole Rosenberg ◽  
...  
Keyword(s):  
Sick Leave ◽  
Return To Work ◽  
Vocational Rehabilitation ◽  
Primary Outcome ◽  
Randomised Trial ◽  
Mental Healthcare ◽  
Stress Symptoms ◽  
Registration Number ◽  
Anxiety Depression

ObjectiveThe aim of this study was to investigate an integrated mental healthcare and vocational rehabilitation intervention to improve and hasten the process of return-to-work of people on sick leave with anxiety and depression.MethodsIn this three-arm, randomised trial, participants were assigned to (1) integrated intervention (INT), (2) improved mental healthcare (MHC) or (3) service as usual (SAU). The primary outcome was time to return-to-work measured at 12-month follow-up. The secondary outcomes were time to return-to-work measured at 6-month follow-up; levels of anxiety, depression, stress symptoms, and social and occupational functioning at 6 months; and return-to-work measured as proportion in work at 12 months.Results631 individuals were randomised. INT yielded a higher proportion in work compared with both MHC (56.2% vs 43.7%, p=0.012) and SAU (56.2% vs 45%, p=0.029) at 12-month follow-up. We found no differences in return-to-work in terms of sick leave duration at either 6-month or 12-month follow-up, with the latter being the primary outcome. No differences in anxiety, depression or functioning between INT, MHC and SAU were identified, but INT and MHC showed lower scores on Cohen’s Perceived Stress Scale compared with SAU at 12-month follow-up.ConclusionsAlthough INT did not hasten the process of return-to-work, it yielded better outcome with regard to proportion in work compared with MHC and SAU. The findings suggest that INT compared with SAU is associated with a few, minor health benefits. Overall, INT yielded slightly better vocational and health outcomes, but the clinical significance of the health advantage is questionable.Trial registration numberNCT02872051.

scholarly journals Appraising psychotherapy case studies in practice-based evidence: introducing Case Study Evaluation-tool (CaSE)

2021 ◽  
Vol 34 (1) ◽  
Author(s):  
Greta Kaluzeviciute
Keyword(s):  
Case Studies ◽  
Evaluation Criteria ◽  
Internal Validity ◽  
Knowledge Generation ◽  
Evaluation Tool ◽  
Third Way ◽  
Study Evaluation ◽  
Essential Components ◽  
Randomised Controlled

AbstractSystematic case studies are often placed at the low end of evidence-based practice (EBP) due to lack of critical appraisal. This paper seeks to attend to this research gap by introducing a novel Case Study Evaluation-tool (CaSE). First, issues around knowledge generation and validity are assessed in both EBP and practice-based evidence (PBE) paradigms. Although systematic case studies are more aligned with PBE paradigm, the paper argues for a complimentary, third way approach between the two paradigms and their ‘exemplary’ methodologies: case studies and randomised controlled trials (RCTs). Second, the paper argues that all forms of research can produce ‘valid evidence’ but the validity itself needs to be assessed against each specific research method and purpose. Existing appraisal tools for qualitative research (JBI, CASP, ETQS) are shown to have limited relevance for the appraisal of systematic case studies through a comparative tool assessment. Third, the paper develops purpose-oriented evaluation criteria for systematic case studies through CaSE Checklist for Essential Components in Systematic Case Studies and CaSE Purpose-based Evaluative Framework for Systematic Case Studies. The checklist approach aids reviewers in assessing the presence or absence of essential case study components (internal validity). The framework approach aims to assess the effectiveness of each case against its set out research objectives and aims (external validity), based on different systematic case study purposes in psychotherapy. Finally, the paper demonstrates the application of the tool with a case example and notes further research trajectories for the development of CaSE tool.

scholarly journals Good fences make good neighbors: Collaborating with families to create employment opportunity

2021 ◽  
pp. 1-5
Author(s):  
Bethany Chase
Keyword(s):  
Parent Involvement ◽  
Developmental Disabilities ◽  
Supported Employment ◽  
Employment Opportunity ◽  
Job Seekers ◽  
Employment Success ◽  
Job Match ◽  
Employment Supports ◽  
Job Coaches ◽  
Employment Specialists

BACKGROUND: Collaboration between supported employment providers and parents/guardians of job seekers with intellectual and/or developmental disabilities is key to employment success. However, parents are often concerned about the efficacy of employment supports or the capacity of the professionals providing the service. Likewise, job coaches may consider certain kinds of parent involvement as detrimental to a successful job match. OBJECTIVE: This article provides context for why parents/guardians may be distrustful of the employment process, as well as why employment specialists may struggle to build strong partnerships with parents/guardians. METHODS: This article will discuss how to implement practices that not only welcome the critical input of families, but also maintain healthy and well-defined boundaries that affirm the autonomy, professionalism, and competence of the worker.

Evaluations for New Healthcare Environment Commissioning and Operational Decision Making Using Simulation and Human Factors: A Case Study of an Interventional Trauma Operating Room

2021 ◽  
pp. 193758672199966
Author(s):  
Mirette Dubé ◽  
Jason Laberge ◽  
Elaine Sigalet ◽  
Jonas Shultz ◽  
Christine Vis ◽  
...  
Keyword(s):  
Decision Making ◽  
Human Factors ◽  
Operating Room ◽  
Healthcare Services ◽  
Healthcare Team ◽  
Healthcare Environment ◽  
New Process ◽  
Timely Access ◽  
Operational Decision Making

Purpose: The aim of this article is to provide a case study example of the preopening phase of an interventional trauma operating room (ITOR) using systems-focused simulation and human factor evaluations for healthcare environment commissioning. Background: Systems-focused simulation, underpinned by human factors science, is increasingly being used as a quality improvement tool to test and evaluate healthcare spaces with the stakeholders that use them. Purposeful real-to-life simulated events are rehearsed to allow healthcare teams opportunity to identify what is working well and what needs improvement within the work system such as tasks, environments, and processes that support the delivery of healthcare services. This project highlights salient evaluation objectives and methods used within the clinical commissioning phase of one of the first ITORs in Canada. Methods: A multistaged evaluation project to support clinical commissioning was facilitated engaging 24 stakeholder groups. Key evaluation objectives highlighted include the evaluation of two transport routes, switching of operating room (OR) tabletops, the use of the C-arm, and timely access to lead in the OR. Multiple evaluation methods were used including observation, debriefing, time-based metrics, distance wheel metrics, equipment adjustment counts, and other transport route considerations. Results: The evaluation resulted in several types of data that allowed for informed decision making for the most effective, efficient, and safest transport route for an exsanguinating trauma patient and healthcare team; improved efficiencies in use of the C-arm, significantly reduced the time to access lead; and uncovered a new process for switching OR tabletop due to safety threats identified.

Consumer perspectives of vocational rehabilitation and return to work following acquired brain injury

2021 ◽  
pp. 1-21
Author(s):  
Kerrin Watter ◽  
Areti Kennedy ◽  
Vanette McLennan ◽  
Jessica Vogler ◽  
Sarah Jeffery ◽  
...  
Keyword(s):  
Brain Injury ◽  
Return To Work ◽  
Vocational Rehabilitation ◽  
Acquired Brain Injury ◽  
System Level ◽  
Structured Interviews ◽  
Post Injury ◽  
Vocational Rehabilitation Services ◽  
Workplace Supports ◽  
Vocational Goals

Abstract Introduction: Following acquired brain injury, the goal of return to work is common. While return to work is supported through different rehabilitation models and services, access to vocational rehabilitation varies within and between countries, and global rates of employment post-injury remain low. The literature identifies outcomes from vocational programs and experiences with return to work, yet little is known about individuals’ perceptions and experiences regarding rehabilitation to support their vocational goals and experiences in attempting to return to work. Method: This qualitative study investigated the experiences of community-living adults with acquired brain injury (n = 8; mean age 45 years; mean time post-injury of 5.5 years) regarding their vocational rehabilitation and return to work. Focus groups and semi-structured interviews were conducted, with data analyzed via thematic analysis. Results: Participants identified negative and positive experiences with vocational rehabilitation and return to work. Five overarching themes were identified: addressing vocational rehabilitation in rehabilitation; facilitators of recovery and return to work; the importance and experience of working again; acquired brain injury and identity; and services, systems and policies. Participants also identified five key areas for early vocational rehabilitation services: education; service provision; employer liaison; workplace supports; and peer mentors. Study findings inform current and future practice and service delivery, at a clinical, service and system level.

scholarly journals Machine Learning and LPWAN Based Internet of Things Applications in Healthcare Sector during COVID-19 Pandemic

Electronics ◽  
2021 ◽  
Vol 10 (14) ◽  
pp. 1615
Author(s):  
Zeeshan Ali Khan ◽  
Ubaid Abbasi ◽  
Sung Won Kim
Keyword(s):  
Machine Learning ◽  
Internet Of Things ◽  
Healthcare Services ◽  
Healthcare Sector ◽  
K Nearest Neighbors ◽  
Iot Applications ◽  
Processing Resources ◽  
Multiple Services ◽  
Applications Of Machine Learning

Low power wide area networks (LPWAN) are comprised of small devices having restricted processing resources and limited energy budget. These devices are connected with each other using communication protocols. Considering their available resources, these devices can be used in a number of different Internet of Things (IoT) applications. Another interesting paradigm is machine learning, which can also be integrated with LPWAN technology to embed intelligence into these IoT applications. These machine learning-based applications combine intelligence with LPWAN and prove to be a useful tool. One such IoT application is in the medical field, where they can be used to provide multiple services. In the scenario of the COVID-19 pandemic, the importance of LPWAN-based medical services has gained particular attention. This article describes various COVID-19-related healthcare services, using the the applications of machine learning and LPWAN in improving the medical domain during the current COVID-19 pandemic. We validate our idea with the help of a case study that describes a way to reduce the spread of any pandemic using LPWAN technology and machine learning. The case study compares k-Nearest Neighbors (KNN) and trust-based algorithms for mitigating the flow of virus spread. The simulation results show the effectiveness of KNN for curtailing the COVID-19 spread.

scholarly journals Simultaneous Parameters Identifiability and Estimation of anE. coliMetabolic Network Model

2015 ◽  
Vol 2015 ◽  
pp. 1-21 ◽  
Author(s):  
Kese Pontes Freitas Alberton ◽  
André Luís Alberton ◽  
Jimena Andrea Di Maggio ◽  
Vanina Gisela Estrada ◽  
María Soledad Díaz ◽  
...  
Keyword(s):  
Experimental Data ◽  
Escherichia Coli ◽  
Metabolic Networks ◽  
Initial Conditions ◽  
Model Fit ◽  
Real Problem ◽  
Kinetic Rates ◽  
K 12 ◽  
Procedure Model

This work proposes a procedure for simultaneous parameters identifiability and estimation in metabolic networks in order to overcome difficulties associated with lack of experimental data and large number of parameters, a common scenario in the modeling of such systems. As case study, the complex real problem of parameters identifiability of theEscherichia coliK-12 W3110 dynamic model was investigated, composed by 18 differential ordinary equations and 35 kinetic rates, containing 125 parameters. With the procedure, model fit was improved for most of the measured metabolites, achieving 58 parameters estimated, including 5 unknown initial conditions. The results indicate that simultaneous parameters identifiability and estimation approach in metabolic networks is appealing, since model fit to the most of measured metabolites was possible even when important measures of intracellular metabolites and good initial estimates of parameters are not available.

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