Vocational Rehabilitation in Spinal Cord Injury: What Vocational Service Activities Are Associated with Employment Program Outcome?

Background:

Designing effective vocational programs for persons with spinal cord injury (SCI) is essential for improving return to work outcome following injury. The relationship between specific vocational services and positive employment outcome has not been empirically studied.

Objective:

To examine the association of specific vocational service activities as predictors of employment.

Method:

Secondary analysis of a randomized, controlled trial of evidence-based supported employment (EBSE) with 12-month follow-up data among 81 Veteran participants with SCI.

Results:

Primary activities recorded were vocational counseling (23.9%) and vocational case management (23.8%). As expected, job development and employment supports were the most time-consuming activities per appointment. Though the amount of time spent in weekly appointments did not differ by employment outcome, participants obtaining competitive employment averaged significantly more individual activities per appointment. Further, for these participants, job development or placement and employment follow-along or supports were more likely to occur and vocational counseling was less likely to occur. Community-based employment services, including job development or placement and employment follow-along or supports as part of a supported employment model, were associated with competitive employment outcomes. Office-based vocational counseling services, which are common to general models of vocational rehabilitation, were associated with a lack of employment.

Conclusions:

Vocational services that actively engage Veterans with SCI in job seeking and acquisition and that provide on-the-job support are more likely to lead to employment than general vocational counseling that involves only job preparation.     

A Review of OIE Country Status Recovery Using Vaccinate‐to‐Live Versus Vaccinate‐to‐Die Foot‐and‐Mouth Disease Response Policies II: Waiting Periods After Emergency Vaccination in FMD Free Countries

For countries with OIE status, FMD free country where vaccination is not practised, vaccinate‐to‐live policies have a significant economic disincentive as the trade restriction waiting period is double that of vaccinate‐to‐die policies. The disposal of healthy vaccinated animals strictly for the purpose of regaining markets with debatable scientific justification is a global concern. The feasibility of aligning the waiting periods to facilitate vaccinate‐to‐live is explored. The first article of this two‐part review (Barnett et al., 2015) explored the qualities of higher potency Foot‐and‐Mouth Disease (FMD) vaccines, performance of differentiating infected from vaccinated animals (DIVA) diagnostic assays particularly in vaccinates and carriers, as well as aspects of current limitations of post‐outbreak surveillance. Here, the history behind the OIE waiting periods for FMD free status is reviewed as well as whether the risk of vaccinated animals and their subsequent products differ appreciably at 3 versus 6 months. It is concluded that alignment is feasible for vaccinate‐to‐live using higher potency FMD vaccines within the current OIE waiting period framework of 3 and 6 months blocks of time. These waiting periods reflect precedence, historical practicalities and considered expert opinion rather than a specific scientific rationale. The future lies in updated epidemiological and diagnostic technology to establish an acceptable level of statistical certainty for surveillance or target probability of freedom of FMDV (infection or circulation) not time restricted waiting periods. The OIE Terrestrial Code limits trade from a FMD free country where vaccination is not practiced to animal products and live non‐vaccinated animals. The risk of FMDV in products derived from higher potency vaccinated animals is appreciably less than for countries with infected FMD status or even from a FMD free country where vaccination is practised for which the Code has Articles with guidelines for safe trade with time restrictions of 3 months or less. All these presume that key requirements in the implementation of emergency vaccination including appropriate vaccine match, vaccine application, susceptible population coverage, etc. are addressed.     

医学高职课堂小演讲与学生综合能力培养的研究与思考

培养探索与创新等综合能力是医学高职教育的核心任务,课堂小演讲是训练综合素质的重要方式,以讲授为主的教学法为对照,将“小演讲”引入助产专业《医学遗传与优生》课程教学,经笔试、总结和教学反馈等方式评价显示教学效果显著,小演讲是学生综合能力培养的重要方法。     

前次剖宫产史瘢痕子宫产妇应用气囊助产术辅助阴道分娩对产程及妊娠结局的影响

目的 分析前次剖宫产史瘢痕子宫产妇应用气囊助产术辅助阴道分娩对产程及妊娠结局的影响,以期为前次剖宫产史瘢痕子宫产妇的临床分娩提供参考依据。方法 对照组开展常规阴道分娩,观察组在对照组基础上应用气囊助产术辅助阴道分娩;比较两组分娩方式、产程及妊娠结局。结果 两组分娩方式、妊娠结局比较差异均无统计学意义(P＞0.05);但观察组第一产程时间、第二产程时间及总产程时间均显著低于对照组(P＜0.05)。结论 前次剖宫产史瘢痕子宫产妇应用气囊助产术辅助阴道分娩可有效缩短产程,且不增加中转剖宫产、产钳助产及不良妊娠结局风险,值得临床推广。     

Asian Pacific Journal of Tropical Medicine

正Aims Scope Asian Pacific Journal of Tropical Medicine(APJTM),aims to set up and provide an academic communicating platform for international physicians,medical scientists,allied health scientists and public     

叙事教学法在培训新入产房助产士助产职业能力的应用

目的 探讨叙事教学法在培训新入产房助产士助产职业能力的应用效果。方法 选取2016年5月～2019年8月入我院工作的30名新入产房助产士,按照不同的教学方法分为观察组和对照组,每组15人;观察组采用叙事教学法,对照组采用传统教学法。教学结束后对两组助产士进行妇产科学教材理论知识,实践考核成绩,产妇对两组助产士满意度及投诉情况,助产士对教学法的效果评价和教师对助产士综合能力评价调查。结果 观察组的理论知识和实践综合考核高于对照组,差异有统计学意义(P0.05);观察组产妇对助产士满意度高于对照组,投诉情况低于对照组,差异有统计学意义(P0.05);观察组带教老师对助产士综合能力评价高于对照组,差异有统计学意义(P0.05);观察组剖宫产、产后出血、新生儿窒息低于对照组,差异有统计学意义(P0.05)。结论叙事教学法有助于培养助产士对妇产科学理论知识及操作的学习积极性,提高助产士的理论知识和助产技能,提升了专科职业能力。     

高等医学院校学评教过程误差分析及对策探讨

学评教即学生对教师的课堂教学效果进行评价。对高等医学院校而言,学评教的范围包括校本部、临床医学院及教学医院,涵盖范围广,涉及人员多,从而使得学评教结果受到各种因素的影响而造成误差。文章在高等医学院校的视角下,以首都医科大学为例,就学评教过程中产生误差的原因进行分析,并针对误差原因进行对策探讨。     

高年级与低年级医学生批判性思维能力的比较

通过高年级与低年级医学生批判性思维能力差异的比较,探讨目前医学教育对学生批判性思维能力的影响。通过批判性思维能力倾向量表检测暨南大学五年级和一年级临床医学专业学生的批判性思维能力。结果表明五年级和一年级临床医学专业学生批判性思维能力的得分在总体上没有显著性差异(P>0.05),都属于意义不明确批判性思维倾向。进而对批判性思维的7个特性进行比较,即在寻找真相、开放思想、分析能力、系统化能力、自信心、求知欲和认知成熟度方面也没有显著性差异(P>0.05)。在认知成熟度方面,五年级和一年级学生均为正性批判性思维倾向,其余6个方面都属于意义不明确批判性思维倾向。低年级和高年级临床医学专业医学生的批判性思维能力普遍偏弱,在医学教育中应当特别加强学生批判性思维能力的培养。