Utilizing research in professional practice

A review of the rehabilitation, disability studies, and allied health literature suggests the presence of numerous factors that impede the utilization of research by practitioners. The purpose of this article is to describe these factors and offer potential solutions that could enable rehabilitation professionals to integrate research findings into their practice. Specifically, the authors recommend strategies to (a) contextualize research throughout pre-service curricula, (b) establish researcher-stakeholder partnerships, (c) increase the accessibility of research to practitioners, and (d) establish professional and peer support for implementing research in field practice.     

Dependence maps: Local dependence in practice

There is often more structure in the way two random variables are associated than a single scalar dependence measure, such as correlation, can reflect. Local dependence functions such as that of Holland and Wang (1987) are, therefore, useful. However, it can be argued that estimated local dependence functions convey information that is too detailed to be easily interpretable. We seek to remedy this difficulty, and hence make local dependence a more readily interpretable practical tool, by introducing dependence maps. Via local permutation testing, dependence maps simplify the estimated local dependence structure between two variables by identifying regions of (significant) positive, (not significant) zero and (significant) negative local dependence. When viewed in conjunction with an estimate of the joint density, a comprehensive picture of the joint behaviour of the variables is provided. A little theory, many implementational details and several examples are given.     

Disability and job stress: Implications for vocational rehabilitation planning

Because people with disabilities often experience an increased risk for physical and psychological complications of job stress, vocational rehabilitation professionals must be able to (a) identify individual and work-environmental risk factors for job stress and (b) design appropriate interventions to minimize those risk factors. The purpose of this article is to (a) present two models of occupational stress, (b) examine factors common to each of these models that are associated with employee health and well-being, and (c) suggest implications for rehabilitation planning.     

College students and tattoos. Influence of image,identity, family,and friends

Tattoos are popular among many groups of people. College students from a large university in the southwestern United States were queried using the 134-item Armstrong Team Tattoo Attitude Survey. Findings documents a progressive increase in tattooing and reflect significant support for tattoos, even from non-tattooed students. Similar and positive demographic characteristics were present in individuals who were both non-tattooed and tattooed. In addition, tattooed people were viewed positively, even among non-tattooed respondents. Friends significantly affected procurement and possession of tattoos, whereas of all family members, the sister was the only significant influence. Overall, friends, identity, and image seem to be the major influences for obtaining tattoos.     

Recreational planning: an important component of career counseling for people with disabilities

Participation in recreational activities is a critical component of the career development process, providing opportunities for individuals to explore their interests and to develop work-related skills. Recreational participation also offers a healthy outlet for dealing with job-related and other life stressors. People with disabilities are often excluded from participation in recreational activities because of a multitude of barriers. This exclusion can seriously impede the career development of these individuals. This article explores the importance of recreational planning as part of the vocational rehabilitation process. The authors define inclusive recreation and discuss the implications of recreational planning in the various phases of rehabilitation.     

An ecological approach to facilitate successful employment outcomes among people with multiple chemical sensitivity

Many adults with multiple chemical sensitivity (MCS) must prematurely exit the workforce because of the severity of their MCS symptoms, the resulting disability stigma, and their unmet needs for on-the-job accommodations. To help individuals with MCS continue working or re-enter employment, rehabilitation professionals must understand the barriers resulting in unemployment and implement interventions to reduce or remove those barriers. In this article, the Ecological Model of Career Development is presented as a scheme for identifying barriers and implementing rehabilitation interventions to improve the employment outcomes among people with MCS.     

Multiple chemical sensitivity and workplace discrimination: the national EEOC ADA research project

Information from the Integrated Mission System of the United States Equal Employment Opportunity Commission (EEOC) was used to investigate the employment discrimination experiences of Americans with multiple chemical sensitivity (MCS) in comparison to Americans in a general disability group with allergies, asthma, HIV, gastrointestinal impairment, cumulative trauma disorder and tuberculosis. Specifically, the researchers examined demographic characteristics of the charging parties; the industry designation, location, and size of employers against whom allegations were filed; the nature of discrimination (i.e., type of adverse action) alleged to occur; and the legal outcomes or resolutions of these allegations. Findings indicate that persons with MCS were, on average, older than the comparison group and comparatively overrepresented by Caucasians and women. People with MCS were proportionally more likely than the comparison group to allege discrimination related to reasonable accommodations. People with MCS were proportionally more likely than the comparison group to file allegations against employers in the manufacturing and public administration industries, employers with 201-500 workers, and employers in the Western Census region. People with MCS were proportionally more likely than the comparison group to receive non-merit resolutions as a result of the EEOC's Americans with Disabilities Act Title I investigatory process. Implications for policy and advocacy are addressed.     

Addressing the disproportionate representation of children of color: a collaborative community approach

The state of Indiana recommended a committee be formed to address the disproportional representation of black youth in out-of-home placements. In response, the Indiana Disproportionality Committee (IDC) was established. This article presents the development, objectives and future of the IDC. One of the objectives, research, will be offered as an example of the committee's collaborative strategies. The IDC, in partnership with another organization, has begun exploring relationships between ethnicity, risk factors and treatment outcomes. The results of this research effort have examined disproportion and disparity, leading the IDC to identify needs for change within the state. Barriers and successes of the IDC will be shared, so that others can use these efforts to guide their own strategies to reduce disproportionality.     

The use of focus groups in rehabilitation research

In this article, the authors explore the applications of focus groups to rehabilitation and disability research. Key issues in designing focus group research (e.g., methodological considerations, strategies for conducting focus groups, data analysis procedures) are highlighted. The authors then discuss specific considerations for conducting focus groups with people with disabilities. The article concludes with a review of three research studies in rehabilitation that used a focus group methodology.     

Analyzing multiple endpoints in a confirmatory randomized clinical trial—an approach that addresses stratification,missing values,baseline imbalance and multiplicity for strictly ordinal outcomes

Confirmatory randomized clinical trials with a stratified design may have ordinal response outcomes, ie, either ordered categories or continuous determinations that are not compatible with an interval scale. Also, multiple endpoints are often collected when 1 single endpoint does not represent the overall efficacy of the treatment. In addition, random baseline imbalances and missing values can add another layer of difficulty in the analysis plan. Therefore, the development of an approach that provides a consolidated strategy to all issues collectively is essential. For a real case example that is from a clinical trial comparing a test treatment and a control for the pain management for patients with osteoarthritis, which has all aforementioned issues, multivariate Mann‐Whitney estimators with stratification adjustment are applicable to the strictly ordinal responses with stratified design. Randomization based nonparametric analysis of covariance is applied to account for the possible baseline imbalances. Several approaches that handle missing values are provided. A global test followed by a closed testing procedure controls the family wise error rate in the strong sense for the analysis of multiple endpoints. Four outcomes indicating joint pain, stiffness, and functional status were analyzed collectively and also individually through the procedures. Treatment efficacy was observed in the combined endpoint as well as in the individual endpoints. The proposed approach is effective in addressing the aforementioned problems simultaneously and straightforward to implement.