The art and science of teamwork: enacting a transdisciplinary approach in work rehabilitation

Teamwork, collaboration and interprofessional care are becoming the new standard in health care, and service delivery in work practice is no exception. Most rehabilitation professionals believe that they intuitively know how to work collaboratively with others such as workers, employers, insurers and other professionals. However, little information is available that can assist rehabilitation professionals in enacting authentic transdisciplinary approaches in work practice contexts. A qualitative study was designed using a grounded theory approach, comprised of observations and interviews, to understand the social processes among team members in enacting a transdisciplinary approach in a work rehabilitation clinic. Findings suggest that team members consciously attended to a team approach through nurturing consensus, nurturing professional synergy, and nurturing a learning culture. These processes enabled this team to work in concert with clients who had chronic disabilities in achieving solution focused goals for returning to work and improving functioning. Implications for achieving greater collaborative synergies among stakeholders in return to work settings and in the training of new rehabilitation professionals are explored.     

The empowerment of people with disabilities through qualitative research

The purpose of this article is to explore the use of qualitative research in vocational rehabilitation as a means of empowering people with disabilities to (a) take greater control of their lives and (b) directly inform public policy and vocational rehabilitation service delivery. After exploring various definitions of the construct empowerment, we provide a rationale for the use of qualitative research as an empowerment mechanism based on (a) philosophies espoused by leaders of the independent living movement, (b) disability legislation, and (c) a multi-constituency call for more consumer involvement in research. We then describe empirical properties of various qualitative methodologies that lend themselves to consumer empowerment. The article concludes with several examples of qualitative approaches to scientific inquiry from the rehabilitation literature that include many of the empowerment aspects described herein.     

A clinical consultation model for child welfare supervisors

This article presents findings from a consultation project conducted by faculty from six schools of social work with approximately 150 child welfare supervisors over a two-year period. The purpose of the program was to assist supervisors with their roles as educators, mentors, and coaches for casework staff, specifically in relationship to case practice decisions. The consultation model, the development of the curriculum, the project implementation, and the results of the initial assessment are described.     

Is nonsmoking dangerous to the health of restaurants? The effect of California's indoor smoking ban on restaurant revenues

The state of California passed the Smoke-Free Workplace Act on January 1, 1995. This legislation effectively banned indoor smoking in all public and private workplaces including restaurants. Many restaurant owners, especially owners of restaurants that served alcohol, opposed the ban for fear that their businesses would be affected adversely because of the loss of patrons who smoked. Using an interrupted times-series autoregressive integrative moving average study design, the authors assess the effect of California's indoor smoking ban on revenue rates for all restaurants, for non-alcohol-serving restaurants, and for alcohol-serving restaurants. Results showed that revenues for alcohol-serving restaurants dropped by about 4% immediately following the establishment of the indoor smoking ban. However, this reduction was temporary because revenues for alcohol-serving restaurants quickly returned to normal levels. Findings also revealed that the indoor smoking ban had little observable impact on the revenue rate for restaurants overall and for non-alcohol-serving restaurants.     

Spatial and temporal aspects of alcohol-related crime in a college town

OBJECTIVE: The authors aimed to clarify crime "movement" through the city of Madison to focus efforts to address consequences of student drinking. The authors examined all crime reported by police during the 2003 year. METHODS: Using geographical information system (GIS) mapping and 2003 crime data from the University of Wisconsin-Madison and the city of Madison, the authors investigated the relationships among high-density alcohol outlets and various city neighborhoods. RESULTS: Different categories of crime showed different temporal and spatial patterns: Serious crimes peaked between 2 and 3AM, coinciding with bar closing time. Less serious crimes peaked between 11PM and midnight. Reports of vandalism peaked in the morning and afternoon. "Hotspots" for different crimes moved throughout the downtown. Results were consistent with problems associated with high-risk student drinking in college communities. CONCLUSION: These results and maps generated by GIS led directly to changes made by city and university officials to address high-risk drinking.     

Antimicrobial resistance of urinary tract isolates in acute uncomplicated cystitis among college-aged women: choosing a first-line therapy

OBJECTIVE AND PARTICIPANTS: The authors of this retrospective case study focused on antimicrobial susceptibility of urinary tract isolates in cases of acute uncomplicated cystitis in college-aged women, aged 18 to 24 years, diagnosed at a major south-central university student health center. METHODS: The authors obtained pertinent data from patient medical and laboratory records, including, diagnoses, urine culture, and susceptibility results. RESULTS: Of 179 isolates, 161 (90%) were Escherichia coli (E. Coli) isolates, of which 23% were resistant to trimethoprimsulfamethoxazole, <1% were resistant to Ciprofloxacin, and <1% were resistant to nitrofurantoin. Sixty-eight (42%) E. Coli isolates were multidrug resistant. There were 18 isolates cultured in the study group that were significant organisms other than E. coli. For all organisms in the study group, there was a combined resistance rate of 22% to trimethoprim-sulfamethoxazole, <1.0% for Ciprofloxacin, and 7% for nitrofurantoin. CONCLUSIONS: The findings suggest that both Ciprofloxacin and Nitrofurantoin are acceptable choices for empiric therapy of acute uncomplicated urinary tract infection in this study population, keeping in mind the potential for rising resistance rates to Ciprofloxacin in the community setting.     

Behavioral management of command hallucinations to harm in schizophrenia

The study objective was to evaluate changes in prevalence of command hallucinations to harm self or others, characteristics and intensity of auditory hallucinations, and levels of anxiety and depression after attendance at a 10-session course teaching behavioral strategies for managing persistent auditory hallucinations to adult outpatients with schizophrenia. Prevalence of command hallucinations to harm self or others was measured at baseline, end of course, and 1-year post-course. Pre-course scores on the Characteristics of Auditory Hallucinations Questionnaire, Unpleasant Voices Scale, tension-anxiety subscale of Profile of Mood States, and Beck Depression Inventory-II were compared with scores immediately post-course and 1 year later. The prevalence rate of command hallucinations to harm self of 44% at baseline decreased to 24% immediately after attending the 10-session course and remained at 24% 1-year post-course. The prevalence rate for command hallucinations to harm others of 21% at baseline decreased to 16% at end of course and 17% 1-year post-course. People who attended the course perceived it as helpful, and improvement was seen in all seven characteristics of auditory hallucinations, intensity of auditory hallucinations, and anxiety and depression immediately after the course and 1-year post-course.     

Personal assistance in Sweden

This article provides an overview of the Swedish personal assistance program for persons with severe impairments, introduced in 1994. The personal assistance program makes it financially possible for people with severe disabilities to appoint a personal assistant, by themselves or through a provider, to create support adapted to the individual and to optimize the person's influence over how the support is arranged. The article describes how the reform has increased the opportunity for people with severe disabilities to choose their own way of living. Overall, the personal assistance has enhanced the quality of life for people with severe disabilities and their families.