This study evaluated the specialized housing, transportation, and resource needs and barriers of adults with MS. Information pertaining to barriers and barrier removal strategies related to housing and transportation issues for adults with MS was gathered as part of a national survey of a randomly selected and representative sample of 5082 adults with MS, in cooperation with affiliate chapters of the National Multiple Sclerosis Society (NMSS) and the North American Research Committee on Multiple Sclerosis (NARCOMS). This article presents a qualitative analysis of participants' responses to questions addressing: (a) barriers to obtaining specialized housing and adapted transportation for individuals with MS, (b) factors contributing to maintenance of an independent lifestyle, and (c) information and referral resources pertinent to obtaining specialized housing and adapted transportation. The results provide the first assessment of these issues on a national scale and underscore the need for increased access to professional consultation, financial resources, and housing modification information and resources to enable persons with MS to obtain the specialized housing needed to maintain maximal independent lifestyles.

BACKGROUND:

Individuals with different impairments are working in the formal and/or informal market despite physical and attitudinal barriers. To date, few studies have addressed this situation from the perspective of the individuals.

OBJECTIVE:

Apprehend factors that restrict work performance in the perspective of workers with impairments and identify the strategies employed and the difficulties faced.

PARTICIPANTS:

Individuals with impairment who exercised paid activities.

METHODS:

Thirty semi-structured interviews and eleven observations of individuals in work activities.

RESULTS:

Limitations stemming from participants' disability and health status had an influence over their execution of tasks, but did not compromise work performance. Environmental factors that impacted as facilitators or barriers were: lack of preparation of colleagues, employers, education and rehabilitation systems; attitudes and coexistence; accessibility, implementation of land use policies, urban structures and transportation; products and technology; and distributive policies. Personal factors (upbringing, self-esteem, good mood, outgoingness, communicability, willpower, age and how the disability was acquired) also influenced participation at work. Important strategies included recognizing and sharing capabilities and needs, which minimized or eliminated difficulties at work.

CONCLUSIONS:

Workers with impairments developed effective strategies for dealing with adverse situations, which remained in the individual realm. Working with impairments is a complex experience that demands overcoming old paradigms.

BACKGROUND:

Participation in the workforce is one of the main social evaluations all individuals are subject to in modern society. Public policies supporting social justice for persons with disabilities have gained prominence in several nations in the last decades and it is critical to ensure that those who want to work are afforded the opportunity to do so. Meanwhile they remain under represented in the labor market within the contemporary world.

OBJECTIVE:

The purpose of this study was to identify facilitators or barriers faced by people with disability within the workforce.

PARTICIPANTS:

Ten workers with disabilities from various companies and performing diverse professional job functions participated in semi-structured interviews.

METHOD:

The Discourse of the Collective Subject method was employed as a means to organize and analyze qualitative data of a verbal nature.

RESULTS:

Reasonable work conditions, adjustments, and accommodations facilitate performance and job retention. Social participation through employment leads to social recognition and the feeling of citizenship. On the other hand prejudice, unequal opportunities, workers' low educational attainment, and lack of training opportunities lead to employment exclusion.

CONCLUSION:

To include people with disabilities in the workforce, it is necessary to focus on attaining equal levels of education, an unbiased and inclusive process for entering the labor market, and continued management of disability issues within the workplace. Together, these elements create equal opportunities for workers with disabilities to advance in their careers, which in turn enables participation, social recognition and guaranties their rights as citizens.

BACKGROUND:

Studies involving the therapeutic nature of the work done by chemically dependent individuals undergoing treatment in therapeutic communities are scarce, not only in Brazil, but also in the international literature.

OBJECTIVE:

To clarify the therapeutic nature of work for persons with chemical dependency who are undergoing treatment in a therapeutic community setting in Brazil. Clients are free to choose their occupations during treatment, that exercise their creativity [10].

METHOD:

The Biographical Method was employed in two case studies.

CONCLUSIONS:

The approach adopted by the community enabled clients to recognize how they became chemically dependent, as well as their possibilities for recovery. Clients expanded their interests and their daily activities that were once exclusively directed towards the consumption of drugs. Their personal development improved through their contact with reality through work activities, in the context of a therapeutic community. From there, clients were increasingly able to plan and execute life projects aimed at their full recovery.

BACKGROUND:

Emergency room (ER) work includes dealing with situations of conflict and aggression. The diversity and unpredictability of these situations and the lack of pre-established procedures to guide workers in dealing with these phenomena affect and weaken their physical and mental health.

OBJECTIVE:

The purpose of the article is to learn about conflict and aggression at work and its impact on the workers in a hospital emergency room.

METHOD:

The method is a transversal, exploratory, descriptive and observational study, carried out from September to November 2008, using direct observation procedures and interviews.

PARTICIPANTS:

Two hundred and eighty emergency room workers participated in the observations and eleven interviews were carried out with workers from several professional categories.

RESULTS:

The work process is marked by overload, individualization of responsibilities, time pressures and deadlines for making decision, little space for exchange and sharing, lack of support or guidance. The strong pressure to provide care quickly causes conflict and aggression among users and the different professional teams. These situations arise from problems in work organization and users in excess of the ER service capacity.

CONCLUSION:

The article recommends changes in the work process that can simultaneously improve both the quality of care for patients and provide protective measures for workers.

OBJECTIVE:

To investigate factors associated with work ability among nursing professionals.

PARTICIPANTS:

They comprised 514 nursing professionals (83.8% of the total number of workers) from a hospital in São Paulo, Brazil.

METHODS:

In 2009, we conducted a cross-sectional study that was a part of a 5-year planned cohort study initiated in 2008. We administered a comprehensive questionnaire to the participants in order to obtain data on their sociodemographic characteristics, lifestyles, and working conditions. The questionnaire also contained the Brazilian versions of the following: the Job Stress Scale (JSS), Effort-Reward Imbalance (ERI) Questionnaire, Work-Related Activities That May Contribute To Job-Related Pain and/or Injury (WRAPI), and Work Ability Index (WAI). The results were analyzed using descriptive, bivariate, and multivariate linear regression analyses.

RESULTS:

On the WAI, 74.9% of the workers obtained a score of over 40 points (score range 7-49); the mean score was 42.3 points (SD=4.5). The final multivariate model showed that lower WAI scores were related to the work-related outcome, which was work injury, and the following individual characteristics and working conditions: body mass index (p=0.001), sex (female; p=0.002), sedentariness (p < 0.001), time in the profession (p=0.005), social support at work (p=0.003), effort-reward ratio (p=0.001), violence at work (p=0.005), WRAPI score (p < 0.001), and work injuries (yes; p=0.001).

CONCLUSIONS:

Various factors were associated with work ability. The results showed that a number of variables should be considered when planning and implementing actions to maintain or improve work ability among nursing professionals.

Mental health claims in the workplace are rising, particularly those due to depression. Associated with this is an increase in disability costs for the employer and the disability insurer, but even more important is the human suffering that results.While treatments are availablefor the depression there is a gap in interventions that specifically target return-to-work preparation. This paper presents cognitive work hardening, a treatment intervention that can bridge this gap by addressing the unique functional issues inherent in depression with a view to increasing return-to-work success. Cognitive work hardening applies the proven principles of classical work hardening (which has typically been applied to people with physical injuries) to the mental health domain. This paper explains how the occupational therapy principle of occupation and the core competency, enablement, are utilized and applied in cognitive work hardening. Key skillsof the occupational therapist are also discussed. In addition, the paper considers the relationship of cognitive work hardening to recovery and mental illness, and the roleit plays among workplace-based return-to-work interventions in the current movement toward non-clinical return-to-work interventions.

BACKGROUND:

Designers and ergonomists occasionally must produce anthropometric models of workstations with only summary percentile data available regarding the intended users. Until now the only option available was adding or subtracting percentiles of the anthropometric elements, e.g. heights and widths, used in the model, despite the known resultant errors in the estimate of the percent of users accommodated. This paper introduces a new method, the Median Correlation Method (MCM) that reduces the error.

OBJECTIVE:

Compare the relative accuracy of MCM to combining percentiles for anthropometric models comprised of all possible pairs of five anthropometric elements. Describe the mathematical basis of the greater accuracy of MCM.

METHODS:

MCM is described. 95th percentile accommodation percentiles are calculated for the sums and differences of all combinations of five anthropometric elements by combining percentiles and using MCM. The resulting estimates are compared with empirical values of the 95th percentiles, and the relative errors are reported.

RESULTS:

The MCM method is shown to be significantly more accurate than adding percentiles. MCM is demonstrated to have a mathematical advantage estimating accommodation relative to adding or subtracting percentiles.

CONCLUSIONS:

The MCM method should be used in preference to adding or subtracting percentiles when limited data prevent more sophisticated anthropometric models.

Structural Equation Modeling (SEM) is a collection of statistical techniques used to determine the degree to which a proposed theoretical model is supported by data. SEM has been growing in various disciplines as well as in rehabilitation research. It is the goal of this introduction to provide a conceptual overview of SEM. This statistical technique can facilitate a better understanding of large data sets involving theoretical models that have become more frequent in this discipline.