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PubMed2003

Predictors of success for state vocational rehabilitation clients with traumatic brain injury.

OBJECTIVES: To determine the characteristics of individuals with traumatic brain injury (TBI) who request state vocational rehabilitation services and to determine the best predictors of their successful vocational outcomes. DESIGN: Observational study. SETTING: Vocational services data from the Missouri Division of Vocational Rehabilitation (DVR). PARTICIPANTS: Seventy-eight individuals with TBI who requested services from the Missouri DVR. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Demographic, injury severity, neuropsychologic variables, vocational services offered, and vocational status at time of case closure (successful, unsuccessful, services interrupted, no services provided). RESULTS: Individuals requesting DVR services were primarily men (71%), white (82%), single (47%), of low average intelligence (Wechsler Adult Intelligence Scales-III full scale IQ score, 84.8), and of limited education (11.8 y). The majority experienced a significant TBI (ie, 66% were hospitalized after their TBI; 56% reported loss of consciousness; 37% reported posttraumatic amnesia; 32% reported multiple TBIs; avg time since injury, 9.2 y). At DVR case closure, 17% were rated as being successfully employed, with nearly all working in industrial, service, or clerical positions (2 in a sheltered workshop, 1 in a professional position). Stepwise logistic regressions indicated that delivery of DVR services (ie, vocational guidance and counseling, on-the-job training) predicted vocational outcome and demographic, injury severity, and neuropsychologic variables did not. CONCLUSIONS: DVR clients have multiple impairments that affect them several years postinjury; the provision of DVR services may be more important in determining vocational outcomes than traditional medical, psychologic, and demographic variables.

Adult↗
PubMed1992

A comparison of the diagnoses of a graphologist with results of psychological tests. 1941.

A class of twenty-four students who had previously been given intelligence, interest, and personality tests wrote to a newspaper graphologist for vocational guidance, their university connection being disguised and the requests being staggered over a period of more than one week. The vocational recommendations and the diagnoses of personality traits were then compared with the test scores. It was found that: 1. Assuming that a certain minimum intelligence is necessary for a given occupation, the occupations recommended by the graphologist showed no more than a change relationship with the recommendations which a psychologist would have made on the basis of intelligence tests. 2. Assuming that a certain pattern of interests is desirable for adjustment in an occupation, the occupation recommended by the graphologist were quite different from those which a psychologist would have recommended on the basis of an interest inventory, certain unsuitable occupations being recommended with more than chance frequency by the graphologist. 3. The graphologist's estimates of the students' personality traits showed no more than a chance agreement with those made by a psychologist on the basis of personality inventories in the case of four traits, and in the case of the two others were worse than change, again revealing a constant error. 4. There was reason for ascribing these constant errors to a belief in the existence of opportunities in certain areas rather than to poor diagnosis alone, and to the use of clues to personality traits not intrinsic in handwriting. 5. It was pointed out that, with certain graphological principles gaining acceptance in scientific circles, it is still important to check the activities of persons who claim to use these newer principles.

Adult↗
PubMed1995

[Occupational rehabilitation of psychiatric patients in the Michaelshoven/Cologne vocational training center--an integrated overall concept].

Vocational retraining centres, sui generis, belong to those vocational rehabilitation facilities where disabled adults are afforded an opportunity for comprehensive occupational reorientation, facilities that operate on the principle of "dual training under one roof", i.e. combine practical and theoretical contents, which documents their close linkage with the mainstream vocational education system practiced in Germany. An essential modification has for some years now been introduced at the Michaelshoven/Cologne vocational retraining centre: the traditional conveyance of skills and knowledge (i.e., acquisition of technical competence) has been replaced by attainment of occupational action competence as the focus of rehabilitative efforts. Hand in hand with this concept rooted in the principle of client-concentration, comes implementation of the principles of integration and holistic approach. Integration means that rehabilitees with mental illness participate in the rehabilitation programmes alongside rehabilitees without mental illness. The holistic approach is expressed in a number of closely coordinated elements ensuring that the specific configuration of persons with mental illness and their way of life are taken into consideration from the very beginning of their stay in the Michaelshoven/Cologne vocational retraining centre. Along with in-depth talks at entry and specific vocational guidance for individuals with mental illness, these elements inter alia include: pre-rehabilitation adjustment, pre-rehabilitation course, an extramural industrial practical, action-oriented training methods throughout, and systematic placement assistance and support--in line with the vocational retraining centre's motto of "picking up our rehabilitees right where they stand".

Adolescent↗
PubMed1983

[School and occupational history of 30 patients with Klinefelter's syndrome. Significance of early diagnosis].

Thirty men aged 17-48 years with pure 47,XXY Klinefelter syndrome have been studied. The group was a positive selection diagnosed not on account of behavior problems but infertility or hypogonadism. Interviews and additional information revealed, almost without exception, the characteristic personality traits of XXY patients. At school, problems arose early, particularly in relation to language. Routine administrative acts such as 15 class repetitions had predominantly negative effects, thus increasing the patients' tendency towards social isolation. In manually oriented professions the patients were quite successful, but in apprenticeship several had to drop out due to problems in theoretical courses, especially foreign languages and mathematics. The diagnosis could nearly always have been suspected by pediatricians, school doctors or school psychologists when the patients were aged 4-8. Early diagnosis is crucial for counselling of parents and teachers, for vocational guidance and for timely testosterone replacement therapy. Patients, and their parents, could thus be spared much unnecessary suffering.

Adolescent↗
PubMed1992

[Special problems of young rheumatic patients with occupational placement].

In a study initiated by the German League against Rheumatism, 433 young patients with rheumatic disorders (mean age 27 years, disease duration 7.5 years, 60% female, 40% male) were questioned in 1989 for the first time to ascertain disease-related problems encountered at school or during professional training. Their self-reported diagnoses were 68.2% chronic arthritis and 23.6% Ankylosing spondylitis (definite or probable diagnosis). From 181 patients who had been affected at school age, 84.5% reported the following main problems: absence related to illness, exclusion from excursions and school-related activities. Nevertheless, a majority of the patients (60.5%) reached a qualified graduation. 25.3% of the study sample was still attending school, 50.3% were employed, 8.6% were unemployed, and 4.5% had been retired early. Only 37.7% of the Arthritis patients and 22.3% of the Spondylitis patients had sought advice and help from the labour exchange services; 26.9% of the arthritis patients and 21.9% of the Spondylitis patients assessed this advice to be helpful. Regarding vocational guidance, the patients main criticism was a lack of knowledge about rheumatic disorders. There is a demand for an adjustment of the individual physical abilities and the requirements of the respective jobs, and continuous supervision by a rheumatologist is necessary.

Adolescent↗
PubMed1992

[Principles of medical expert testimony regarding adolescents' capacity for practical vocational training and work].

The presented approach to adolescents' vocational guidance is based on the ILO principle that work should conform to psychophysical conditions of the worker which should be evaluated before the beginning of work. In the paper the main health problems influencing the work capability have been discussed. It is suggested that the student, his parents and tutor should be informed about his health impairments, the degree of disability and therapeutic possibilities. The psychophysical features characteristic of the adolescence justify the health protection against occupational exposure to harmful agents as well as the activities, for health education and health promotion at school.

Adolescent↗
PubMedDate not supplied

[Coping with illness by chronically ill adolescents and young adults--an empirical study].

From June 1990 to January 1991 86 chronically ill adolescents and young adults who had come to the vocational assessment unit of the rehabilitation center or for vocational guidance to the rehabilitation hospital, both in Neckargemünd/Germany, were examined with regard to their coping with their illnesses. The Freiburg questionnaire for coping with illness was applied, and the Trait-instruction was given because persons with inborn disabilities were part of the sample. Also, the type of illness or disability and motorial handicap as well as the non-verbal intelligence were included. The results of three different medical diagnosis groups don't show any differences in the coping with illness. Persons with motorial handicaps are able to cope with their disabilities as well as persons without motorial handicaps. Adolescents and young adults with inborn or early acquired illness/handicap show a greater loss of confidence in the medical doctors than persons who were taken ill at the age of 6 or later.

Adaptation, Psychological↗
PubMed1993

Patterns of performance on the verbal and performance subtests of the Wechsler Adult Intelligence Scale-Revised: some Australian data.

The pattern of performance of 345 vocational guidance clients on the WAIS-R was examined in relation to previous studies of client populations. An exploratory principal axis factor analysis was conducted, and two factors that accounted for 89% of the total variance were selected. These comprised a general factor on which the Verbal subtests loaded most highly and a smaller Performance subtest factor. A hypothesis-testing approach was undertaken as a second step, using multiple group analysis. Two factors (which correlated .58) accounted for 65% of the total variance. The first factor (51%) was also a general factor on which all subtests, but moreso the Verbal tests, loaded highly. The second factor was dominated by Performance subtests. Implications for special client samples and intellectual assessment are discussed.

Adolescent↗
PubMed1985

Modern management of rheumatoid arthritis.

The management of rheumatoid arthritis can be challenging even to the most experienced and astute physician. The rheumatoid inflammatory process can be profound, ravaging, and unremitting, and the illness is notorious for its protean manifestations and capricious course. Moreover, the response to therapy is unpredictable, although it can be quite successful in many cases. Nevertheless, the intense pain, profound disability, progressive destructive arthropathy, and negative psychological milieu that haunt patients demand that something be done therapeutically. Rheumatoid arthritis responds best to a symphony of therapeutic modalities including drugs, rehabilitation, joint surgery, and attention to psychosocial issues. The foundation of any successful therapeutic venture is an educational program designed, however simply, to imbue the patient and family with an understanding of the disease and its course and treatment, and with realistic expectations. Drug therapy is often polypharmaceutical, employing analgesics, nonsteroidal anti-inflammatory agents, both local and systemic corticosteroids, and remission-inducing drugs. Pacing of lifestyle, physical and/or occupational therapy, vocational guidance, psychological and sexual counseling, and social intervention are as much a part of modern management in rheumatoid arthritis as are drugs. The extra-articular (systemic) manifestations are addressed in a variety of ways depending upon the type and severity of involvement. Although most patients can be treated by their primary care physician, some may require the expertise provided by a specialist. Finally, despite the lack of a cure for rheumatoid arthritis, most patients respond well to treatment and return to their desired activities of daily living.

Adrenal Cortex Hormones↗