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PubMed2000

Support and faculty mentoring programmes for medical students in Germany, Switzerland and Austria.

OBJECTIVES: To study what is being done at German-speaking universities regarding the counselling and tutoring of students, we carried out a survey among the deans of medical faculties in Germany, Austria and Switzerland. Our main concern was if any such projects were already available to the medical student or whether efforts to this purpose were under way. DESIGN: We focused in particular on faculty mentoring programmes, a continuous tutoring by designated members of the faculty on a person-to-person basis. SETTING: German, Austrian and Swiss medical faculties. SUBJECTS: Medical faculty deans. RESULTS: The return rate was 80%. While general student counselling is, if required, available at nearly all of the faculties, faculty mentoring programmes are offered by only 36.1% of the medical schools, and individualized career counselling by 30.6%. CONCLUSIONS: Compared to other countries, such as the United Kingdom or the United States, counselling and tutoring programmes, e.g. career planning or faculty mentoring, are not generally available to the German medical student. Regional differences are evident, which can be attributed to differences in the universities' legal and financial situation. The medical faculties at German-speaking universities should make it their priority to offer these services to the student on a permanent basis.

Austria↗
PubMed2003

Health career promotion in the New England area of New South Wales: a program to support high school career advisers.

OBJECTIVE: To facilitate the area's high school careers advisers' ability to effectively promote health careers to students. DESIGN: Three cross sectional evaluation surveys at the end of each one-day workshop. SETTING: Conference rooms in three regional centres (Armidale, Moree and Tamworth, New South Wales). SUBJECTS: Twenty-two high school careers advisers. INTERVENTION: One-day workshop. MAIN OUTCOME MEASURES: High school careers advisers' self-rated assessment in terms of the effective delivery of appropriate information and opportunities to network. RESULTS: Participants agreed that the workshop conveyed relevant information (3.8), were of high standard (3.5) and enabled them to identify students wanting to pursue health careers (2.9). Networking between health professionals and career advisers was rated as the most beneficial aspect by a majority of participants (60%). The scenario was rated as a useful tool to educate advisers about health careers (3.8). CONCLUSION: Collaborative workshops between advisers and health professionals are useful in facilitating networks to promote health careers in high schools in rural areas. The use of a farm injury scenario as a learning tool was effective in educating advisers about health careers. WHAT IS ALREADY KNOWN: Previous research carried out in the USA6 and Australia demonstrated that high school careers advisers needed to target high school students earlier in their studies before senior subjects were decided and that about a quarter of careers advisers indicated poor knowledge about health careers.10 WHAT THIS STUDY ADDS: Provision of practical support to high school careers advisers, such as distributing a mentorship directory and up-to-date health career kits as well as facilitating networking with health professionals constitute effective means to promote health careers to high school students.

Career Choice↗
PubMedDate not supplied

Nothing is going to stop me now: obstacles perceived by low-income women as they become self-sufficient.

As low-income women struggle to become self-sufficient, they encounter many obstacles. The literature identifies physical and mental health problems, inadequate childcare, inadequate occupational skills, lack of transportation, criminal histories, and limited educational abilities as major barriers to be overcome in this transition. Qualitative data collected from low-income women attending Innovative Alternatives for Women, an occupational skills and health information training center which was developed and implemented by a nurse, refutes several of the previously identified obstacles. Inadequate childcare and transportation were not seen as barriers to success by the program participants, but were viewed as socially acceptable reasons for not working. Eight obstacles were identified by the program participants as being the real reasons for their lack of success. The identified obstacles included the following: lack of self-esteem, especially relating to school; "bad" relationships with men; lack of support from family and friends; limited life options; lack of training for nonwelfare recipients; lack of quality programs; criminal histories; and fear of success.

Anecdotes as Topic↗
PubMed2001

[Pathways leading to work--the Hamburg integration specialty service].

A model project of the Federal Ministry of Labour and Social Affairs, the Hamburg Integrationsfachdienst zur Eingliederung Schwerbehinderter (IFD Hamburg, selective placement and support agency for occupational integration of persons with severe disablement) has been active since 1998 in placing people with sensory or physical handicap in the open labour market, based on cooperative partnership between Adecco Dienstleistungen, a market-oriented temporary staff business, and the vocational retraining centre Berufsförderungswerk Hamburg, provider of training programmes for vocational rehabilitation. The IFD combines social competence with business considerations (counselling employers, clarification of wage subsidies or grants, in-depth job analysis, preliminary selection of suitable job seekers). A proactive customer orientation vis-a-vis the prospective employer is the clear message of the IFD's consultants, which hence acts as a professional staff service for severely disabled job seekers in its dealings with the prospective customers, in their majority company decision-makers from small and medium scale firms. Counselling and support offered to the disabled clients are based on a case-management approach, in partnership with the IFD's principals, i.e., employment office, pension insurance fund, industrial injuries insurance institutes, and sometimes also health insurance funds.

Adult↗
PubMed2001

[Occupational choice and biography - biographical diagnostics as an approach to accessing the individual's perceptual horizons and resources in the context of vocational rehabilitation].

This contribution is focused on the core tenet that the process of choice of occupation must encompass in its everyday routines the disabled person's biography, his or her life experiences, biographical self-appraisals as well as action orientations. Unless this is achieved, its professional strategies and interventions will remain prone to missing, or even counteracting, the biographical resources as well as thinking and perceptions of its clients. Biographical Diagnostics is presented here as a method seeking to access the individual in the process of choice of occupation in an understanding manner. It constitutes a new concept in terms of a biography-based, hermeneutic case approach conceived for implementation in the everyday routines of vocational rehabilitation. Two case examples serve to explicate the method of Biographical Diagnostics and set out the relevancy of a biographical orientation in the process of occupational choice.

Adult↗
PubMed2002

[Regional networking of medical and vocational rehabilitation-- the bad Krozingen model].

Regional networking facilitates flexible and individual integration of vocational programmes in medical rehabilitation. We present a pilot project of Theresienklinik II in cooperation with the Education centre for occupation and health (Bildungszentrum Beruf und Gesundheit) in Bad Krozingen. Orthopaedic and cardiac patients who are in danger to lose their capacity to work, participate in an integrated vocational reorientation programme during extended medical rehabilitation. The aim of the pilot project is an early assessment of motivation, work hardening, aptitude and interest, in order to accelerate vocational retraining and reintegration. Within one year 30 patients participated in the programme. Presented are the contents and course of the pilot project. First results show a high patient satisfaction with the programme.

Adult↗
PubMed2003

[Occupationally Orientated Medical Rehabilitation (BOR) for disabilities caused by orthopedic diseases].

Low back pain and arthrosis are influencing the quality of life of people concerned and are leading to high expenses for the health and social system. A merely medical rehabilitation is often insufficient in case the person concerned is unable to fulfil the requirement at work. But vocational rehabilitation is often connected with long processing and waiting times. To counteract these, cooperative approaches have been developed between rehabilitation clinics and vocational retraining centres (Berufsförderungswerke, BFW) over the last few years. The Bad Eilsen rehabilitation centre of the LVA Hannover has worked with the Bad Pyrmont BFW since 1998. According to this project, "Occupationally Orientated Medical Rehabilitation" (Berufsorientierte medizinische Rehabilitation, BOR), the participants are extensively informed and tested in the retraining centre, they can also perform occupation-specific tasks. The aim of the study was to compare processing and waiting times with and without BOR. The results available so far show that a majority of the participants of the BOR measures could be occupationally reintegrated. In many cases work promotion measures were introduced earlier. BOR measures not only lead to a considerable acceleration of procedures, they also improve the occupational reintegration of the insured to a high degree.

Adult↗
PubMed2003

[Aptitude statements after head injury].

In an exemplary way the case study of M. S. shows that the statements concerning aptitude, which are based on intelligence structure tests, lead to false positive judgements under certain preconditions. Particularly if you postulate learning disorder and partial amnesia, the standard status diagnosis via intelligence and achievement tests has to be supplemented by a method of testing by which the dynamics of cognitive processes can be recorded. In the individual case study of M. S., learning disorder and partial amnesia have been disclosed via the dynamic learning test by Seitz (1998). They did not become manifest when only the routine diagnostic methods were applied. Against the background of socio-legal implications of the specific case some demands on psychological diagnosis and valuation are being discussed from the practician's point of view. They subsequently lead to certain demands concerning academic research. This applies above all to the dynamic learning test which is described above. It states as a result a linear relationship between the effort put into learning and the quantity of learning (the slope is interpreted as an individual constant). The dynamic learning test is also likely to be interesting in respect to pure research in general psychology and the formation of theories.

Adult↗
PubMed2003

[Vocational rehabilitation in German vocational retraining centres and results of Berufsförderungswerk Heidelberg gGmbH].

The article focuses on the results of vocational integration over the last two decades and on actual results from client-surveys as presented by the Arbeitsgemeinschaft Deutscher Berufsförderungswerke (ADB) (working group of the German vocational retraining centres) and the Berufsförderungswerk Heidelberg (BFW Heidelberg, the vocational retraining centre in Heidelberg). Process quality of vocational rehabilitation can be indicated by data like the number of persons dropping out of their training - the ratio to be found in the vocational retraining centres is on a lower level than in other institutions of vocational training. Clients have changed: during the last decade the average age of the clients in the BFW Heidelberg has increased by 3 years, there is a higher proportion of women, but there also are more clients with psychological disorders. A new group of clients is growing - non-handicapped persons who pay for their training themselves. Process quality has improved, with graduates of the BFW Heidelberg saying significantly more often that they can use much or very much of the training courses' contents within their later occupational activities -- the proportion increases with the level of training they had undergone. Additionally the proportion of those is growing who see themselves in an -- according to their training -- adequate occupational situation. These are certainly positive results referring to the indicators of process quality. Concerning outcome quality one has to take the levels of occupational integration into account. Compared with the results of German vocational retraining centres overall, graduates of the Heidelberg centre constantly had a higher level of vocational integration over the last 20 years, one of the reasons being that the vocational training offered in Heidelberg reaches up to the level of degree of a university of applied sciences. The situation on the job market strongly influences occupational integration: it is evident that a high rate of unemployment will extend the time span necessary for placement. But in the long run occupational integration proves to be amazingly high. Variables that influence the results are: level of disability, sex, age and marital status. The level of vocational qualification is a characteristic with high evidence: integration of graduates at the level of "Fachschule" (highly skilled technician or the like) is 10 % higher and that of graduates at the level of "Fachhochschule" (university of applied sciences) another 10 %. Participation in vocational rehabilitation generally is highly estimated -- estimation as given two years after the training increases with the level of qualification. In the Heidelberg centre progress is seen in expanding the proportions of special target groups (which of course is politically aimed at): women now account for some 30 %, there are more elderly clients and for example also more clients with psychological disorders. The vocational integration of these various groups has to be regarded under different aspects. For example, the situation of severely disabled clients is quite ambivalent: their proportion is falling and their rate of occupational integration is relatively low -- yet there are effects that may compensate. So the importance of the disability decreases with a rising level of vocational training. The data presented may permit the conclusion that vocational rehabilitation at the Heidelberg centre has become more successful over the last decade.

Adult↗
PubMed1995

Helping to solve problems associated with spina bifida: 1. Presentation of the TRS Project: organizing services for low frequency diagnostic groups and 2. Cognitive deficits often seen in young adults with spina bifida: effects in the school and work place.

1. A Presentation of the TRS Project: Counselling and (Re)habilitation Center. A Model Project in Organizing Services for Low Frequency Diagnostic Groups. Persons with low frequency disabilities often require services from a number of professions. The patient organizations claim that the patients themselves often have to coordinate their own treatment. The TRS project has been established as one of the initiatives under the Norwegian Government's Plan of Action for the Disabled. The project is one of three national projects designed to develop models for the coordination of services for persons with low frequency congenital disabilities. The TRS project deals with the following five diagnoses: Marfan syndrome, arthrogryphosis multiplex congenita, myelomeningocele/spina bifida, osteogenesis imperfecta and congenital limb deficiency. The project is based on patient (user) participation. The five patient organizations are represented on the board where they are in the majority. Patients along with professionals give lectures during group stays. The project offers its services to persons with the diagnosis from all parts of Norway (4.3 mill. inhabitants). Persons with spina bifida over 16 years are included in the project, as well as persons with the other diagnoses at all ages. We present the organization of the project and the repertoire of services that are on offer. 2. Cognitive Deficits Often Seen in Young Adults with Spina Bifida: Effects in the School and Work Place. As survival rates continue to increase with the use of shunting procedures for persons with spina bifida (SB), the need for improved educational and vocational planning also increases. Orbeck and Schanke reported that the cognitive deficits of young adults with SB have not received enough attention in educational and vocational planning. A thorough description of these deficits will aid in developing more effective individualized planning. With improved planning, insight into alternative methods for improving support may also then be investigated. The purpose of this study is to better define and describe the cognitive deficits often encountered while planning support in the school and work place for this group. Neuropsychological examinations are the basis for this description of observed cognitive deficits. The study included 46 young adults with SB aged 15 to 38 living in Norway. All persons were given a neuropsychological test battery which included tests for attention, memory, speed of information processing, visual perception and visual constructive function, arithmetic, fine motor coordination, and verbal functioning. The results indicated deficits in fine motor coordination, speed of information processing, and a slow learning curve. The consequences of these deficits in educational and vocational planning are discussed and guidelines for further studies are suggested.

Abnormalities, Multiple↗
PubMed1990

Strategies for managing the merger. Helping the staff adjust.

A strong reason why many mergers fail is the corporation's neglect of the human side of the venture; the resulting high turnover of personnel naturally takes its toll on the young conglomerate. While keeping everyone satisfied is obviously not easy (or even possible), there are concrete strategies for leading your staff through the transition.

Adaptation, Psychological↗