A general and scalable solution for heterogeneous workflow invocation and nesting

Several widely utilized, grid workflow management systems emerged in the last decade. These systems were developed by different scientific communities for various purposes. Enhancing these systems with the capability of invoking and nesting the workflows of other systems within their native workflows makes these communities to be able to carry out cross-organizational experiments and share non-native workflows. The novel solution described in this paper allows the integration of different workflow engines and makes them accessible for workflow systems in order to achieve this goal. The solution is based on an application repository and submitter, which exposes different workflow engines and executes them using the computational resources of the grid. In contrast with other approaches, our solution is scalable in terms of both number of workflows and amount of data, easily extendable in the sense that the integration of a new workflow engine does not require code re-engineering, and general, since it can be adopted by numerous workflow systems

Barriers and Facilitators to Work Success for Veterans in Supported Employment: A Nationwide Provider Survey

bjective: Veterans with mental illness are at serious risk of poor work outcomes and career stagnation. Supported employment (SE) is an evidence-based model of vocational services that assists persons with mental illness to obtain competitive employment. The purpose of this study was to gain a rich understanding of barriers and facilitators related to competitive work success from the perspective of a nationwide sample of U.S. Department of Veterans Affairs (VA) SE staff, supervisors, and managers. Methods: This study utilized a mixed-methods approach in which 114 VA SE personnel completed an online questionnaire consisting of a survey of work barriers and facilitators; open-ended questions elicited additional factors affecting work success. Descriptive statistics characterized factors affecting work success, and an emergent, open-coding approach identified qualitative themes describing other key elements influencing employment. Results: The most prominent work facilitators were perceived veteran motivation, job match, the assistance of SE services, and veteran self-confidence. The highest rated barriers were psychological stress and a range of health-related problems. Qualitative findings revealed additional areas affecting work success, notably, the availability of resources, the capacity of frontline staff to form strong relationships with veterans and employers, the ability of staff to adapt and meet the multifaceted demands of the SE job, and the need for additional staff and supervisor training. The impact of employer stigma was also emphasized. Conclusions: An array of elements influencing work success at the level of the veteran, staff, SE program, and employer was recognized, suggesting several implications for VA services

Mixed methods study examining work reintegration experiences from perspectives of Veterans with mental health disorders

Recent findings have demonstrated that reintegration for Veterans is often challenging. One difficult aspect of reintegration—transitioning into the civilian workplace—has not been fully explored in the literature. To address this gap and examine work reintegration, this mixed methods study examined the perspectives of Veterans with mental health disorders receiving Department of Veterans Affairs healthcare. Forty Veterans rated factors that affect work success; participants also provided narratives on their most and least successful work experiences. We used t-tests and qualitative analysis to compare participants who did and did not serve in combat. Several themes relevant to work reintegration emerged in the narratives, particularly for Veterans who served in combat. An array of work difficulties were reported in the months following military discharge. In addition, Veterans who served in combat reported significantly more work barriers than Veterans who did not serve in combat, particularly health-related barriers. In conclusion, Veterans with mental health disorders who served in combat experienced more work reintegration difficulty than their counterparts who did not serve in combat. The role of being a Veteran affected how combat Veterans formed their self-concept, which also shaped their work success and community reintegration, especially during the early transition period

Factors impacting work success in Veterans with mental health disorders: A Veteran-focused mixed methods pilot study

BACKGROUND: Veterans with mental illness often have poor employment outcomes. OBJECTIVE: This mixed-methods study sought to understand and describe Veteran perspectives of factors that impact their work success. METHODS: A sample of 40 employed and unemployed Veterans with post-traumatic stress disorder (PTSD) or other severe mental illness (SMI) completed a survey of factors that impact vocational functioning and provided narrative accounts of their most successful and challenging work experiences. RESULTS: Personal motivation, self-efficacy, work skills, interpersonal issues, health, and cognitive problems were rated as most impactful on work. There were no significant differences on ratings of work factors based on employment status. Veterans with PTSD reported significantly more barriers to work success compared with Veterans with SMI, notably, cognitive problems, physical health, and psychological stress. Veterans with SMI were more likely to receive VA vocational services and rated this assistance as beneficial to work success. Narrative findings corroborated the survey results, and yielded additional factors, including economic factors, person/job fit, and Veteran-specific issues. CONCLUSIONS: Several factors substantially impact work success in Veterans with mental illness. Veterans with PTSD and SMI experience a distinct set of barriers and facilitators, suggesting the need for tailoring clinical and rehabilitative services

Patients’ understanding of shared decision-making in a mental health setting: The importance of the patient-provider relationship

Shared decision making is a fundamental component of patient-centered care and has been linked to positive health outcomes. Increasingly, researchers are turning their attention to shared decision making in mental health; however, few studies have explored decision making in these settings from patients’ perspectives. We examined patients’ accounts and understanding of shared decision making. We analyzed interviews from 54 veterans receiving outpatient mental health care at a Department of Veterans Affairs Medical Center in the United States. Although patients’ understanding of shared decision making was consistent with accounts published in the literature, participants reported that shared decision making goes well beyond these components. They identified the patient–provider relationship as the bedrock of shared decision making and highlighted several factors that interfere with shared decision making. Our findings highlight the importance of the patient–provider relationship as a fundamental element of shared decision making and point to areas for potential improvement

Factors influencing patients’ preferences and perceived involvement in shared decision making in mental health care

Background: Although research has suggested that patients desire to participate in shared decision-making, recent studies show that most patients take a passive role in their treatment decisions. The discrepancy between patients’ expressed desire and actual behaviors underscores the need to better understand how patients perceive shared decision-making and what factors influence their participation. Aims: To investigate patients’ preferences and appraisals of their involvement in treatment decisions. Methods: Fifty-four qualitative interviews were conducted with veterans receiving outpatient mental health care at a U.S. Veterans Affairs Medical Center. Interviews were analyzed using thematic analysis. Results: Participants outlined several factors that influence their preferences and involvement in treatment decisions. These include the patient–provider relationship, fear of being judged, perceived inadequacy, and a history of substance abuse. Conclusion: Patients’ preferences and willingness to engage in shared decision-making fluctuate over time and are context dependent. A better understanding of these factors and a strong patient–provider relationship will facilitate better measurement and implementation of shared decision-making

Role of combined prenatal and postnatal paracetamol exposure on asthma development: the Czech ELSPAC study

Background: Prenatal and postnatal paracetamol exposure has been previously associated with asthma development in childhood in Western populations. We explore the association between prenatal and postnatal paracetamol exposure and asthma development in a Central European sample of Czech children, suggesting possible additive effect of the both exposures. Furthermore, since aspirin had been used more widely during study data collection in Central Europe, we also compared asthma development for those exposed to paracetamol and aspirin. Methods: We used data from 3329 children born in the 1990s as members of the prospective Czech European Longitudinal Study of Pregnancy and Childhood. Data about prenatal and postnatal paracetamol and aspirin exposure, and potential covariates were obtained from questionnaires completed by mothers. Data about incident asthma were obtained from paediatrician health records. Results: 60.9% of children received paracetamol only postnatally, 1.5% only prenatally and 4.9% of children were exposed both during pregnancy and infancy. Prevalence of asthma in following population was 5% at 11 years. Being exposed to paracetamol both in prenatal and postnatal period was associated with asthma development (unadjusted OR 1.98, 95% CI 1.02 to 3.87). Being exposed only in the postnatal period was also significantly associated with increased risk of asthma. No association between prenatal exposure only and outcome was found. A higher but non-significant risk of asthma was observed for those whose mothers used paracetamol during pregnancy compared with those who used aspirin. Conclusions: The main findings of this prospective birth cohort study add to previous observations linking prenatal and early postnatal paracetamol exposure to asthma development. However, the magnitude of effect is relatively modest, and therefore, we recommend paracetamol to remain the analgesic and antipyretic of choice throughout pregnancy and early childhood

Correlates of attendance in mental health services for individuals with psychotic disorders: A critical review

Low attendance to mental health care results in loss of time, money, and treatment gains. No prior review in this area has taken into account the quality of studies or varying definitions of attendance. The current review provides a critical evaluation of variables associated with attendance in consumers with psychotic symptoms participating in outpatient mental health services, with a focus on study quality and operationalization of attendance. EMBASE, MEDLINE, PsycINFO, CINAHL, and the Cochrane Library were searched for empirical articles relevant to attendance to mental health services by individuals diagnosed with a psychotic disorder. Eligible articles were rated for quality by two coauthors; high-quality articles were reviewed in-depth. Twenty-eight articles were eligible; 11 articles qualified for in-depth review. Four attendance outcome types were identified, including the prediction of dropout, time engaged, categorical attendance, and continuous attendance. Ongoing substance use during treatment was consistently associated with lower attendance in high-quality articles. More high-quality research using systematically defined outcome types is needed to identify reliable associations with attendance. Commonly tested variables such as demographics show little utility in predicting attendance. Future research in this area should expand upon current findings focusing on clinically and theoretically relevant variables

A randomized controlled trial of Illness Management and Recovery with an active control condition

Objective The purpose of the study was to rigorously test Illness Management and Recovery (IMR) against an active control group in a sample that included veterans. Methods A total of 118 participants with schizophrenia spectrum disorders, 56 of whom were veterans, were recruited from a Department of Veterans Affairs medical center and a community mental health center in the same city and were randomly assigned to an IMR group (N=60) or a weekly problem-solving group intervention (N=58). Groups met weekly for nine months. Blinded assessments were conducted at baseline, nine months, and 18 months on measures of symptoms, functioning, illness self-management, medication adherence, subjective recovery experiences, and service utilization. Results No significant differences were found between IMR and problem-solving groups. Participants in both groups improved significantly over time in symptom severity, illness management, and quality of life and had fewer emergency department visits. Participation rates in both interventions were low. Only 28% of consumers assigned to IMR and 17% of those assigned to the problem-solving group participated in more than half the scheduled groups, and 23% and 34%, respectively, attended no sessions. Conclusions This is the first randomized controlled trial of IMR to report negative findings. Given the inclusion of an active control group and the low participation rates, further research is needed to understand factors affecting IMR effectiveness. Increased attention may need to be paid to facilitate more active participation in IMR, such as individual follow-up with consumers and the integration of IMR with ongoing treatment

Subjective Experiences of the Benefits and Key Elements of a Cognitive Behavioral Intervention Focused on Community Work Outcomes in Persons With Mental Illness

New research suggests that group-based cognitive behavioral therapy (CBT) may help improve employment outcomes in persons with mental illness, yet the effects and potential key elements facilitating change in such interventions are unclear. Using a mixed methods approach, this study examined the perspectives of persons with mental illness after participating in a pilot study of the “CBT for Work Success” intervention. Findings demonstrate that participants valued the intervention and perceived that it assisted them in achieving work goals. Therapeutic effects included improved self-efficacy, work motivation, enhanced sense of self as workers, and increased beliefs that work success is attainable. CBT for Work Success elements perceived to be important in facilitating work goals included cognitive restructuring, behavioral coping strategies, problem solving work barriers, meaningful reflection on oneself as a worker, and important factors associated with the group process. The authors discuss the implications of these findings and future research directions