Development of work participation in young adults with cerebral palsy: A longitudinal study

Objective: To document the development of work participation in young adults with cerebral palsy who are transitioning into adulthood, examine associated characteristics, and investigate work limitations and barriers among employed persons.Design: Observational longitudinal cohort study.Subjects: Seventy-four young adults with cerebral palsy of average intelligence, aged 16-20 years at baseline.Methods: Work participation in 3 categories (employed, unemployed, studying) was assessed at baseline, 2-year and 4-year follow-ups using structured interviews. At 4-year follow-up, associations of work participation with demographic and clinical characteristics were examined using multinomial logistic regression. Work limitations and barriers among employed persons were evaluated using questionnaires.Results: From age range 16-20 years to age range 20-24 years the proportions of subjects who were employed and unemployed increased from 12% to 49% and 3% to 17%, respectively; the proportion who were students decreased from 85% to 34%. In the age range 20-24 years, the employment rate of young adults with cerebral palsy was lower and the unemployment rate higher, than that of the general population. A lower level of gross motor function and younger age were associated with unemployment. Employed persons experienced few work limitations; 28% experienced situational or health barriers.Conclusion: Young adults with cerebral palsy and average intelligence are at risk of experiencing unfavourable developments in work participation. Rehabilitation services should offer support to prevent unemployment and occupational disability

Do soldiers seek more mental health care after deployment? Analysis of mental health consultations in the Netherlands Armed Forces following deployment to Afghanistan

Background: Military deployment to combat zones puts military personnel to a number of physical and mental challenges that may adversely affect mental health. Until now, few studies have been performed in Europe on mental health utilization after military deployment. Objective: We compared the incidence of mental health consultations with the Military Mental Health Service (MMHS) of military deployed to Afghanistan to that of non-deployed military personnel. Method: We assessed utilization of the MMHS by the full cohort of the Netherlands Armed Forces enlisted between 2008 and 2010 through linkage of mental health and human resource information systems. Results: The total population consisted of 50,508 military (18,233 deployed, 32,275 non-deployed), who accounted for 1,906 new consultations with the MMHS. The follow-up was limited to the first 2 years following deployment. We observed higher mental health care utilization in deployed vs. non-deployed military personnel; hazard ratio (HR), adjusted for sex, military branch and time in service, 1.84 [95% CI 1.61–2.11] in the first and 1.28 [1.09–1.49] in the second year after deployment. An increased risk of adjustment disorders (HR 2.59 [2.02–3.32] and 1.74 [1.30–2.32]) and of anxiety disorders (2.22 [1.52–3.25] and 2.28 [1.50–3.45]) including posttraumatic stress disorder (5.15 [2.55–10.40] and 5.28 [2.42–11.50]), but not of mood disorders (1.33 [0.90–1.97] and 1.11 [0.68–1.82]), was observed in deployed personnel in the first- and second-year post-deployment, respectively. Military personnel deployed in a unit with a higher risk of confrontation with potentially traumatic events had a higher HR (2.13 [1.84–2.47] and 1.40 [1.18–1.67]). Conclusions: Though absolute risk was low, in the first and second year following deployment to Afghanistan there was an 80 and 30% higher risk for mental health problems resulting in a consultation with the Dutch MMHS compared to military never deployed to Afghanistan. These observations underscore the need for an adequate mental health infrastructure for those returning from deployment

Effectiveness of an Interactive Website Aimed at Empowerment of Disability Benefit Claimants: Results of a Pragmatic Randomized Controlled Trial

Introduction The aim of this study was to investigate the effectiveness of an interactive website aimed at empowerment of disability claimants, prior to the assessment of disability by an insurance physician. Methods A randomized controlled trial was conducted. Claimants applying for a work disability pension after being sick-listed for 104 weeks, were randomized into either an intervention group or control group. Participants who were randomized into the intervention group were able to logon to the website www.wiagesprek.nl, which mainly consisted of five interactive modules aimed at increasing knowledge, self-awareness, expectations, self-efficacy, and active participation. Participants from the control group were directed to a ‘sham’ website with commonly available information only. The primary outcome was empowerment. Secondary outcomes included coping, knowledge, claimant satisfaction, perceived justice, and physician satisfaction. Outcomes were assessed at baseline, 2 days before the disability assessment, as well as 1 day after, 6 weeks, and 4 months after the disability assessment. Results Claimants were randomly assigned to the intervention group (n = 123) or a control group (n = 119). The intervention had no significant short- and long-term effects on empowerment, but the intervention increased claimants’ knowledge significantly compared to the control group. Claimant satisfaction with the disability assessment interview and claimant perceived justice on the outcome of the assessment were lower in the intervention group (statistically not significant). Furthermore, the intervention had a significant negative effect on claimants perceived procedural justice. Conclusion Although knowledge increased significantly, the intervention www.wiagesprek.nl was not successful in reaching its primary target, that is, to increase levels of empowerment among disability claimants, prior to the assessment of disability

Type D Personality, Temperament, and Mental Health in Military Personnel Awaiting Deployment

Type D personality, temperament, and mental health in military personnel awaitin

A theoretical framework to describe communication processes during medical disability assessment interviews

BACKGROUND: Research in different fields of medicine suggests that communication is important in physician-patient encounters and influences satisfaction with these encounters. It is argued that this also applies to the non-curative tasks that physicians perform, such as sickness certification and medical disability assessments. However, there is no conceptualised theoretical framework that can be used to describe intentions with regard to communication behaviour, communication behaviour itself, and satisfaction with communication behaviour in a medical disability assessment context. OBJECTIVE: The objective of this paper is to describe the conceptualization of a model for the communication behaviour of physicians performing medical disability assessments in a social insurance context and of their claimants, in face-to-face encounters during medical disability assessment interviews and the preparation thereof. CONCEPTUALIzATION: The behavioural model, based on the Theory of Planned Behaviour (TPB), is conceptualised for the communication behaviour of social insurance physicians and claimants separately, but also combined during the assessment interview. Other important concepts in the model are the evaluation of communication behaviour (satisfaction), intentions, attitudes, skills, and barriers for communication. CONCLUSION: The conceptualization of the TPB-based behavioural model will help to provide insight into the communication behaviour of social insurance physicians and claimants during disability assessment interviews. After empirical testing of the relationships in the model, it can be used in other studies to obtain more insight into communication behaviour in non-curative medicine, and it could help social insurance physicians to adapt their communication behaviour to their task when performing disability assessment

Methodological developments in violence research

Über Jahrzehnte wurde Gewalt durch Interviews mit Betroffenen oder Tätern, durch teilnehmende Beobachtung oder Gewaltstatistiken untersucht, meist unter Verwendung entweder qualitativer oder quantitativer Analysemethoden. Seit der Jahrhundertwende stehen Forschenden eine Reihe neuer Ansätze zur Verfügung: Es gibt immer mehr Videoaufnahmen von gewaltsamen Ereignissen, Mixed Methods-Ansätze werden stetig weiterentwickelt und durch Computational Social Sciences finden Big Data-Ansätze Einzug in immer mehr Forschungsfelder. Diese drei Entwicklungen bieten großes Potenzial für die quantitative und qualitative Gewaltforschung. Der vorliegende Beitrag diskutiert Videodatenanalyse, Triangulation und Mixed Methods-Ansätze sowie Big Data und bespricht den gegenwärtigen und zukünftigen Einfluss der genannten Entwicklungen auf das Forschungsfeld. Das Augenmerk liegt besonders darauf, (1) wie neuere Videodaten genutzt werden können, um Gewalt zu untersuchen und wo ihre Vor- und Nachteile liegen, (2) wie Triangulation und Mixed Methods-Ansätze umfassendere Analysen und theoretische Verknüpfungen in der Gewaltforschung ermöglichen und (3) wo Anwendungen von Big Data und Computational Social Science in der Gewaltforschung liegen können.For decades violence research has relied on interviews with victims and perpetrators, on participant observation, and on survey methods, and most studies focused on either qualitative or quantitative analytic strategies. Since the turn of the millennium, researchers can draw on a range of new approaches: there are increasing amounts of video data of violent incidents, triangulation and mixed methods approaches become ever more sophisticated, and computational social sciences introduce big data analysis to more and more research fields. These three developments hold great potential for quantitative and qualitative violence research. This paper discusses video data analysis, mixed methods, and big data in the context of current and future violence research. Specific focus lies on (1) potentials and challenges of new video data for studying violence; (2) the role of triangulation and mixed methods in enabling more comprehensive violence research from multiple theoretical perspectives, and (3) what potential uses of big data and computational social science in violence research may look like