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PubMed1981

[The present situation with regard to the practical handling of the blind in South Africa].

Frankness in explaining the visual handicap helps the individual and his parents in accepting and coping with the impairment. Early reference of the visually handicapped to the relevant schools is important for pre-school guidance and counselling. Special aids and appliances facilitate rehabilitation and adjustment, and training in orientation and mobility skills leads to greater independence. Braille, touch-typing, large print, low-vision aids, closed-circuit TV reading apparatus, cassettes and the Optacon are means of reading and communication. The visually handicapped can take part in ordinary forms of recreation as well as in specially organized sports and entertainment. All visually impaired individuals who may qualify should be encouraged to have themselves registered as blind persons for personal, research and statistical purposes. There are ten special schools for the visually handicapped in South Africa with academically and vocationally directed courses. Tertiary training at standard training centres is possible and special study bursaries as well as bursaries for special aids and appliances are available. Modern electronic aids open up new job possibilities for the visually handicapped and special sheltered workshop are available for the multiple-handicapped visually impaired.

Blindness↗
PubMed1986

Bifocal wearing and VDU operation: A review and graphical analysis.

There has been a lack of expert guidance regarding the visual capabilities of VDU operators who wear bifocal spectacles. The authors have developed a general framework as a basis for analysing the problem. A schematic diagram has been constructed which facilitates the integration of the variables of lens dimensions, range of clear vision and a standard VDU workstation. The analysis of the diagram established that the majority of bifocal wearers are able to operate a VDU efficiently without special optical considerations. However, a prima facie case was found to exist for some VDU operators wearing bifocal spectacles and experiencing problems. These operators are most likely over 50 years of age, usually over 55 years of age and, in principle, comprise a small proportion of the workforce. Vocational prescribing for this group must be viewed sympathetically in order to avoid the increased risk of bodily injury.

Journal Article↗
PubMed2002

The Cornell Leadership Program for Veterinary Students.

Cornell University hosts a summer program for veterinary students who aspire to research careers. The program features independent, faculty-guided research; vocational counseling; and professional enrichment activities that seek to build teamwork skills and to foster critical thinking and effective communication. A total of 255 students from 49 veterinary colleges worldwide have taken part in the program since 1990. Among those who have completed their veterinary education, approximately half have followed career trajectories of the kind envisioned by the program. While this outcome is gratifying, it was also learned that some program graduates subsequently withdrew from a research-oriented academic track after many years of graduate study. That disquieting outcome underscores the need to inform aspiring veterinary scientists about the realities of a research career; to structure their graduate studies in a manner that will maximize their prospects of success; to provide them with ongoing guidance and assistance; and to reward them at a level that will ensure that they remain in training for a period sufficient to realize their career expectations.

Animals↗
PubMed1994

[Psychosocial disintegration].

Among the patients referred for rehabilitation in the latter half of their working life, many are notable due to considerable discrepancies between their objectively ascertainable performance and its subjectively perceived decline. In these cases, the "substantial threat to earning capacity" cannot be explained by measurable organ deficiencies. Similarly, treatment efforts focussed solely at improved somatic functioning remain inefficient in terms of stabilization of earning capacity, because they do not bring about changes in the cause of subjective performance deterioration. The author in these circumstances assumes the presence of an independent syndrome, called "psychosocial disintegration". He describes the full picture of this disease entity, and suggests causal mechanisms as well as potential for remedial intervention. On account of the considerable social dimension of the disorder outlined, early identification of these gradually developing changes as well as qualified care of the insurants are indispensable. All those involved in treatment and care of the patients or working in some branch of the social security system should be familiar with this psychosocial disintegration syndrome in order to avoid the guidance and counselling mistakes that are frequently the case. As rehabilitation is impossible in case of inhibiting personal attitudes of an insurant, it is advisable to verify the individual's readiness for rehabilitation and/or to strengthen it by appropriate measures before engaging in costly in-patient service provision. If the needed motivation is to be achieved during participation in a rehabilitation measure, extended service provision will invariably be required.

Disability Evaluation↗
PubMed1997

Epilepsy and employment: the Americans with Disabilities Act and its protections against employment discrimination.

People with epilepsy often encounter discrimination. Some cultures have established prohibitive laws limiting access to employment, restricting marriage, and denying driving privileges. It is not enough to repeal such laws. Legislation, such as the Americans with Disabilities Act (ADA), is needed to provide protections against discriminatory practices. The definitions and standards of the law provide clear guidance to employers and workers with disabilities regarding their rights and responsibilities in the workplace. The ADA is proving to be an effective means of addressing allegations of employment discrimination brought forward by people with seizure disorders, although it has not increased the number of people with disabilities who are employed. However, in combination with rehabilitation counseling and employer education, legislative protection can assist people with epilepsy to be more successful in their pursuit of employment opportunities.

Persons with Disabilities↗
PubMed1989

[Patient education and counseling responsibilities of an organization for handicapped patients in the field of rehabilitation].

Organizations of the disabled do not see their information and counselling activities as competing against those of the financially responsible administrations but as complementary ones. Crucial to their work are the provision of guidance through the structured social protection system, familiarization of disabled persons with rehabilitation as well as their motivation and support, with the aim of rendering the disabled individual an equal partner in the process of rehabilitation. The area of social rehabilitation is a major focus in the counselling of disabled people. As specific institutional responsibilities for social rehabilitation do not exist, information and counselling activities in these matters are also directed at administrations and industry.

Combined Modality Therapy↗
PubMed1992

A man-machine vision interface for sensing the environment.

This study describes a computer vision approach for sensing the environment with the intent of helping people with a visual impairment. The principal goal in applying computer vision is to exploit, in an optimal fashion, the information acquired by the camera(s) to yield useful descriptions of the viewed environment. The objective is to seek efficient and reliable guidance cues in order to improve the mobility needs of individuals with a visual impairment. In this research direction, the following problems are identified and addressed: 1) the vision system design; 2) establishment of the mapping principles between the two-dimensional (2-D) camera images and the three-dimensional (3-D) real world; 3) development of appropriate imaging techniques for the interpretation of the 2-D images; and, 4) establishment of a communication link between the vision system and the user. The soundness of this research direction is assessed by means of a theoretical framework and experimental evaluations.

Algorithms↗
PubMed2001

Occupational health guidelines for the management of low back pain at work: evidence review.

There is increasing demand for evidence-based health care. Back pain is one of the most common and difficult occupational health problems, but there has been no readily available evidence base or guidance on management. There are well-established clinical guidelines for the management of low back pain, but these provide limited guidance on the occupational aspects. Occupational Health Guidelines for the Management of Low Back Pain at Work were launched by the Faculty of Occupational Medicine in March 2000. These are the first national occupational health guidelines in the UK and, as far as we are aware, the first truly evidence-linked occupational health guidelines for back pain in the world. They were based on an extensive, systematic review of the scientific literature predominantly from occupational settings or concerning occupational outcomes. The full evidence review is on the Faculty web site (www.facoccmed.ac.uk), but an abridged version is presented here to aid its dissemination.

Disability Evaluation↗
PubMed1992

Experience, skill and knowledge gained by newly qualified dentists during their first year of general practice.

This study was commissioned by the Department of Health in 1988 for the assessment of the preparation of newly qualified dentists for general practice and the effect of the Vocational Training Schemes on their development. Newly qualified dentists working either as VTS trainees or associates were assessed in three ways. During the third and the twelfth months of practice they were asked to keep a one-week clinical diary record. They were also asked to complete a questionnaire to give a subjective assessment of their skill and knowledge related to general practice. Similar questionnaires were completed by their trainers or principals in order to provide an objective assessment. An indication of the volume of treatment they provided was also obtained from DPB records. The results showed that associates saw more patients and provided more treatment than VTS trainees during their first year. The difference between the two groups was greater at 3 months than at 12 months; however, wide variations were found, especially in the VTS group. The results from the questionnaires suggest that, with the exception of practice administration, oral surgery, orthodontics, anaesthesia and sedation, the undergraduate course provides adequate preparation for the initial demands of general practice. However, initially both groups were judged to be unprepared for independent practice. The results suggest that during the first year of practice the support and guidance of a more experienced colleague is essential, together with the provision of adequate and varied clinical experience.

Clinical Clerkship↗
PubMed2002

Return to work after foot and ankle injury.

A surgeon faces important issues when returning a patient to the workplace, including workers' compensation issues and the need for physician guidance. These patients deserve appropriate diagnosis and treatment protocols, and the other members of the workers compensation treatment team can help maximize the effects of careful guidance by a physician. The speediest possible return to the workplace is usually best for all concerned, the injured worker, the employer and the physician. The treatment team within the workers' compensation system assists in the facilitation and coordination of the medical care and assists in bringing the patient back to work. The team includes the nurse case manager, the insurer, and physical and occupational therapists. Appropriate use of work hardening programs or functional capacity evaluations can be valuable in the return-to-work effort. Physicians who make use of these resources may find it easier to guide this process efficiently to achieve the desired outcome of return to work of the injured worker.

Accidents, Occupational↗
PubMed2004

Clients' experiences of a work rehabilitation process.

PURPOSE: The aim of this study was to describe clients' experiences of a work rehabilitation process. METHOD: Ten clients who had participated in work-related rehabilitation at a rehabilitation centre in the northern parts of Sweden were interviewed using a narrative approach. The interviews were analysed using qualitative content analysis focusing on clients' descriptions of the goals, contents and results of the work rehabilitation process. RESULTS: At the beginning of the rehabilitation the goal was often to confirm a diagnosis, to become healthy and able to return to work. It was hard to be forced to change the goals. When fortunate the rehabilitation provided more profound guidance and function assessment. It resulted in changes varying from practical alterations to important insights into life. It was important to get support and understanding. When the rehabilitation was not adjusted to clients' needs, feelings of disappointment emerged and life became a struggle with various authorities in order to gain understanding and other forms of rehabilitation. CONCLUSIONS: This study shows the need to develop truly client-centred practice. Therefore, we emphasized, based on this study, the importance of professionals involved in rehabilitation working on different levels and in various settings having regular discussions about what the term client-centred practice means to them. Integrating individual perceptions is essential to advancing a multidimensional approach in return-to-work research.

Adult↗
PubMed1986

The disabled adolescent guidance unit.

The disabled adolescent guidance unit is a panel which comprises representatives of various health professions, sheltered employment workshops and government instrumentalities associated with employment, social security and education. The aim of the panel is to advise disabled school leavers on the various options available to them. This includes recommendations on employment, leisure activities, and, when, necessary, on housing. In the years 1978 to 1984, 114 young people were seen. Average age at referral was 17 years. 66% of the disabilities were caused by neurological problems, including cerebral palsy, epilepsy, and spina bifida. Trauma accounted for 10%. A simple questionnaire was used to evaluate the usefulness of the panel. 58 of the 114 clients replied, 78% of the clients had followed the panel's recommendations, the work situation of the clients was as follows: 7% in open employment, 21% in sheltered employment, 22% undertaking further education, 10% doing voluntary work and 38% unemployed.

Adolescent↗
PubMed2006

Patients' complaints about doctors in surgical training.

AIM: Research looking at the effect of complaints on senior medical staff has shown that while there is important information to be gained from patient criticisms of medical care, they are often not well received by doctors. There is no information on the effects of complaints on junior medical staff and those undergoing vocational training in New Zealand. The aim of this study is to assess the impact of complaints on trainees in general surgery. METHOD: A questionnaire was devised and sent to all advanced general surgical trainees in New Zealand. There were four sections to the questionnaire covering background, professional life, family life, and personal health. The scale was semantically anchored at not applicable, strongly agree, agree, neither, disagree, and strongly disagree. RESULTS: Following electronic mailings of the questionnaire at three different times, 35 of 58 (60%) questionnaires were returned of which 21 (60%) of the respondents had received at least one major complaint; 10 (29%) indicated they had experienced one complaint; 4 (11%) reported 2 complaints; 3 (9%) had received 3 complaints; and 1 (3%) reported 4 complaints. None of the respondents believed that the complaint had improved their surgical training. Thirty-one (86%) respondents believed that the complaint had made them practice more defensively; 13 (38%) felt that the complaint had a negative effect of future doctor-patient relationships; and 15 (43%) felt a lack of trust with such relationships. Twenty-three (67%) felt decreased enjoyment with their training and 18 (53%) felt the complaint had a negative effect on their family. Twenty-seven (78%) felt depressed over the complaint, with 18 (52%) feeling a lack of support and being alone with the experience. CONCLUSION: Trainees receiving complaints find them difficult to deal with; they incur an emotional cost on the doctor and possible future doctor patient relationships. Thus it is important that trainee doctors receive support and guidance throughout this difficult and stressful event.

Attitude of Health Personnel↗
PubMed2003

Reducing long term sickness absence by an activating intervention in adjustment disorders: a cluster randomised controlled design.

AIMS: To compare an innovative activating intervention with "care as usual" (control group) for the guidance of employees on sickness leave because of an adjustment disorder. It was hypothesised that the intervention would be more effective than care as usual in lowering the intensity of symptoms, increasing psychological resources, and decreasing sickness leave duration. METHODS: A prospective, cluster randomised controlled trial was carried out with 192 patients on first sickness leave for an adjustment disorder. Symptom intensity, sickness duration, and return to work rates were measured at 3 months and 12 months. Analyses were performed on an intention to treat basis. RESULTS: At 3 months, significantly more patients in the intervention group had returned to work compared with the control group. At 12 months all patients had returned to work, but sickness leave was shorter in the intervention group than in the control group. The recurrence rate was lower in the intervention group. There were no differences between the two study groups with regard to the decrease of symptoms. At baseline, symptom intensity was higher in the patients than in a normal reference population, but decreased over time in a similar manner in both groups to approximately normal levels. CONCLUSION: The experimental intervention for adjustment disorders was successful in shortening sick leave duration, mainly by decreasing long term absenteeism.

Absenteeism↗