Placement Assistance Research Articles

Application of Robotic Stereotactic Assistance (ROSA) for spontaneous intracerebral hematoma aspiration and thrombolytic catheter placement

BackgroundSpontaneous intracerebral hemorrhage (ICH) accounts for up to 20% of all strokes and results in 40% mortality at 30 days. Although conservative medical management is still the standard treatment for ICH patients with small hematoma, patients with residual hematoma ≤15 mL after surgery are associated with better functional outcomes and survival rates. This study reported our clinical experience with using Robotic Stereotactic Assistance (ROSA) as a safe and effective approach for stereotactic ICH aspiration and intra-clot catheter placement. MethodsA retrospective analysis was conducted of patients with spontaneous ICH who underwent ROSA-guided ICH aspiration surgery. ROSA-guided ICH surgical techniques, an aspiration and intra-clot catheter placement protocol, and a specific operative workflow (pre-operative protocol, intraoperative procedure and postoperative management) were employed to aspirate ICH using the ROSA One Brain, and appropriate follow-up care was provided. ResultsFrom September 14, 2021 to May 4, 2022, a total of 7 patients were included in the study. Based on our workflow design, ROSA-guided stereotactic ICH aspiration effectively aspirated more than 50% of hematoma volume (or more than 30 mL for massive hematomas), thereby reducing the residual hematoma to less than 15 mL. The mean operative time of entire surgical procedure was 1.3 ± 0.3 h, with very little perioperative blood loss and no perioperative complications. No patients required catheter replacement and all patients’ functional status improved. ConclusionsWithin our clinical practice ROSA-guided ICH aspiration, using our established protocol and workflow, was safe and effective for reducing hematoma volume, with positive functional outcomes.

COLLEGE PLACEMENT ASSISTANCE FOR SAPKAL KNOWLEDGE HUB

The college placement assistance project is a web-based application that aims to facilitate the placement process of students and companies in an efficient and convenient way. The project consists of three modules: student, company, and admin. The student module allows the students to register, login, update their profile and academic details, view and apply for various job and internship opportunities posted by the companies, view their status and offer letters, and get placement assistance from the admin. The company module allows the companies to register, login, post their job and internship requirements, view and select the eligible candidates, and send offer letters. The admin module allows the admin to manage the users and companies, provide placement assistance to the students by uploading training documents, and view the statistics and graphs of the placement process. The project uses Python as the programming language, Django as the web framework, MySQL as the database, and HTML, CSS, and JavaScript as the front-end technologies. The project aims to reduce the manual work and errors involved in the placement process, and provide a platform for students and companies to connect and communicate easily. Key Words: Placement, Companies, HR, TPO, Admin, Assistance.

Demographic covariates and vocational rehabilitation services as predictors of employment outcomes of people with physical disabilities: a hierarchical logistic regression analysis

Purpose Stable employment is essential for the health, psychosocial, and financial well-being of people with physical disabilities (PwPD). Unfortunately, the low employment rate for PwPD in the U.S. exposes them to adverse effects of unemployment, including depression, anxiety, low self-esteem, and physical pain. Helping PwPD find gainful employment will improve their general health and well-being. However, few empirical studies examine factors affecting the employment outcomes of PwPD. This study aims to examine the relationship between demographic covariates, vocational rehabilitation (VR) services, and employment outcomes of PwPD. Materials and Methods This secondary data analysis study includes 17,598 PwPD from the U.S. Department of Education’s Rehabilitation Services Administration’s Case Service Report (RSA-911) dataset. Our analysical approach was hierarchical logistic regression analysis. Results For VR services, workplace support, technology support, job placement assistance, and VR counseling significantly contribute to predicting employment outcomes for PwPD. Even after entering VR services, the demographic variables (age, race, education, referral sources, low-income, long-term unemployment, and disability significancy) were still significant predictors of employment. Conclusions Findings from this study can be used by state VR counselors and other disability service providers to plan and select effective employment-related interventions to improve the employment outcomes of PwPD.

State-Federal Vocational Rehabilitation Services, Demographic Characteristics and Employment Outcomes for Native Americans with Mental Illnesses.

There were 9.7 million Native Americans (American Indian, Alaska Native-AI/AN- these acronyms will be used interchangeably with Native Americans throughout the paper) in 2019 comprising 2.9% of the U.S. population. Native American populations have disproportionately higher rates of mental illnesses compared to other racial groups in the U.S. Mental health is a significant public health concern for this population, impacting different areas of their lives including employment. Additionally, Native Americans continue to experience significant disparities in access to Vocational Rehabilitation (VR) services and have poor employment outcomes. However, little is known about the relationships among demographic factors, vocational rehabilitation services, and employment outcomes of Native Americans with mental illness. Consequently, the current study examined how demographic factors and VR services are related to successful employment outcomes for Native American VR clients with mental illnesses using data from the Rehabilitation Services Administration (RSA) program year (2019) Case Service Report (9-11). Both descriptive analysis and data mining approaches were used to answer the research questions. Chi-square Automatic Interaction Detector (CHAID) analysis was used to determine which of the VR services could best predict the successful employment outcome of Native Americans with mental illness. The findings of the data mining approach revealed that among all the vocational rehabilitation services, job placement assistance was the strongest predictor of successful employment among Native American clients with mental illnesses. The second most important service predicting successful employment for those who received job placement assistance was shown to be maintenance. Implications for rehabilitation counselors and future research are discussed.

Comparison between two types of grids for placement of mini-screw implant in posterior maxillary segment

Use of mini-screw implants is in vogue. It has brought about a drastic change in day to day practise for orthodontists. Despite being the most popular source of anchorage, it is not easy for newer clinicians to perfectly figure out the site of implant placement and the accuracy by which it should be placed to avoid failure. A customised grid or mesh is the simplest way to gain assistance for placement of miniscrew implants. This article focuses on comparison of two types of grids for placement of implant accurately and to guide the clinician in such a way that minimises all the possible errors.

A Tracer Study on the Bachelor of Secondary Education Graduates of St. Paul University Surigao A. Y. 2017-2022

A tracer study is a research method commonly used in the field of education to assess the outcomes and impact of an educational program or institution on its graduates. It involves tracking and gathering data on the employment status, career paths, and overall experiences of program graduates over a specific period after they have completed their studies. The tracer study titled “A Tracer Study on the Bachelor of Secondary Education Graduates of St. Paul University Surigao A.Y. 2017-2022″examined the employability of graduates and assessed the effectiveness of the teacher education program outcomes. Data was collected from a sample of 35 graduates using an adapted-modified questionnaire and analyzed using various statistical tools. The study revealed that the majority of participants were females aged 22 to 25, with a bachelor’s degree as their highest educational attainment. English was the most specialized area, and most respondents graduated in 2017. Within six months of graduation, approximately 51.43% were employed and 48.57% were unemployed, with employed graduates occupying teaching positions at different levels and others pursuing various occupations. Competencies learned in college, such as communication, critical thinking, and problem-solving skills, were deemed useful in their first jobs. The study also identified attributes acquired during undergraduate studies, including communication, critical thinking, research, problem-solving, social and ethical responsibility, productivity, accountability, leadership, teamwork, and pursuit of academic excellence. Graduates rated the teacher education program outcomes and their knowledge in teaching, global competence, reading proficiency, effective communication, pedagogical competence, technological proficiency, knowledge integration, transformative education, assessment competence, ethical responsibility, creativity, empathy, and lifelong learning as very effective. The study concluded by recommending targeted support and preparation for challenging areas of licensure examinations, measures to enhance employability and job placement assistance, and efforts to bridge the education-employment gap. Additionally, specific programs, resources, mentorship initiatives, and curriculum improvements were proposed to support graduates’ success and professional growth. Regular assessment, collaboration with industry professionals, continuous learning promotion, and partnerships with stakeholders were suggested to ensure program effectiveness and foster innovation in teaching and learning.

Interventions for work participation of unemployed or work-disabled cancer survivors: a systematic review

Background: Supporting unemployed or work-disabled cancer survivors in their work participation can have extensive individual and societal benefits. We aimed to identify and summarise interventions for work participation of unemployed or work-disabled cancer survivors. Methods: Five databases (Medline, Embase, PsycINFO, CINAHL and Cochrane Library) were systematically searched for quantitative studies on interventions aimed at enhancing work participation of unemployed or work-disabled cancer survivors. Work participation refers to participation in the workforce, fulfilling one’s work role. Manual and automatic screening (with ASReview software) were performed on titles and abstracts, followed by manual full-text screening. Data were extracted regarding study, patient and intervention characteristics, and work participation outcomes. Risk of bias (RoB) was assessed using the Cochrane RoB2 and QUIPS tools. Results: We identified 10,771 articles, of which we included two randomised controlled trials (RCTs), of which one feasibility RCT, and three cohort studies. In total, 1862 cancer survivors were included, with predominantly breast cancer. Work participation was mainly measured as time to return to work (RTW) and RTW rate. Interventions included components of coaching (e.g., psychological or rehabilitation), training (e.g., building confidence and managing fatigue) and self-management. Two RCTs with unclear RoB did not show an effect of multicomponent interventions compared to care as usual. One cohort study found a significant effect of a psycho-educational intervention on RTW rates, with moderate RoB. The other two cohort studies, with moderate RoB, reported significant associations between components including job search and placement assistance, and work participation. Discussion: Only few interventions aimed at enhancing work participation of unemployed or work-disabled cancer survivors, have been evaluated. In two cohort studies, promising components for future multicomponent interventions were identified. However, findings suggest that more evidence is necessary on such multicomponent interventions, in which elements explicitly directed at work and including the workplace should be included.

Orthopedic Robot-Assisted Femoral Neck System in the Treatment of Femoral Neck Fracture.

Cannulated screw fixation is the main therapy for femoral neck fractures, especially in young patients. The traditional surgical procedure uses C-arm fluoroscopy to place the screw freehand and requires several guide wire adjustments, which increases the operation time and radiation exposure. Repeated drilling can also cause damage to the blood supply and bone quality of the femoral neck, which can be followed by complications such as screw loosening, nonunion, and femoral head necrosis. In order to make fixation more precise and reduce the incidence of complications, our team applied robot-assisted orthopedic surgery for screw placement using the femoral neck system to modify the traditional procedure. This protocol introduces how to import a patient's X-ray information into the system, how to perform screw path planning in software, and how the robotic arm assists in screw placement. Using this method, the surgeons can place the screw successfully the first time, improve the accuracy of the procedure, and avoid radiation exposure. The whole protocol includes the diagnosis of femoral neck fracture; the collection of intraoperative X-ray images; screw path planning in the software; precise placement of the screw under the assistance of the robotic arm by the surgeon; and verification of the implant placement.

Improve the Completion Rate of ECMO Placement Assistance for Nurses in the NICU

The extracorporeal membrane oxygenation (ECMO) system can provide cardiopulmonary support to and reduce the mortality rate in severely ill newborns. According to our investigation, completion rate of the care process among staff nurses was only 63.5% in our ward. We assumed that the reasons for the above problems included: lack of care awareness, unfamiliarity with the ECMO operation process, inadequate instruments preparation, improper ECMO pipeline fixation, lack of designated space in the unit for placing ECMO supplies, lack of specialty care guidelines, lack of a regular inspection system, and lack of regular on-the-job education. Improve awareness related to assisting ECMO placement among nurses in the neonatal intensive care unit and the completeness of care. 1. Create a care process guidebook describing the procedures for ECMO system placement in newborns to help nurse accomplish proper placement. 2. Establish the ECMO system consumables checklist and install an ECMO system-specialized toolbox to reduce the preparation time and smooth the process. 3. Regularly organize comprehensive nurse training and develop performance indicators to enhance ECMO system placement awareness and skills. The cognitive accuracy rate for the assisted placement of ECMO among nurses in the neonatal intensive care unit increased from 51.9% before improvement to 89.9% afterward. Also, the complete care rate of ECMO placement increased from 63.5% before improvement to 100% afterward. This project effectively improved the accuracy rate of nurses involved in assisting with ECMO placement, made the ECMO system placement process easier to implement, improved the care process completion rate, and improved newborn care quality.

The Determinants of Unemployment Insurance Participation: An Application of Theory Of Planned Behaviour

Unemployment is one of the economic disorders that affect the economic growth rate. In addition, the recent pandemic outbreak has turned the medical crisis into a global financial downturn, threatening the health and employment of people around the world. Unemployment insurance is intended to assist workers with partial and momentary income replacement, access to skill training, and job placement assistance during their unemployment period. The scheme was launched in Indonesia on March 2021. This study analyzed the intention effect toward participation and the effect of attitude, subjective norms, and perceived behavioral control towards the intention to participate using the Theory of Planned Behaviour. The total number of registered companies in DKI Jakarta Regional is 111.855, while the registered workers are 5.853.717. The quantity of samples based on the minimum sample calculation findings with the minimum number of samples obtained is 170 respondents. There were 200 participants of BPJS Ketenagakerjaan in the DKI Jakarta regional office who participated as respondents during the research period. SEM analysis methods are used in this study. The result showed that attitude toward behavior, subjective norms, and perceived behavioral control positively and significantly influence the intention to participate. Subjective norm is significant as an intervening variable between attitude and perceived behavioral control toward the intention to participate. Thus, strategies focusing on these factors can increase participation in the unemployment insurance scheme. Keywords: attitude toward behavior, participation intention, perceived behavioral control, subjective norm, unemployment insurance

Potential benefits of intraoperative ultrasound in neurosurgery.

Computed tomography and magnetic resonance imaging are the most popular diagnostic tools to visualize intracranial pathology and help surgical planning in the neurosurgical practice. However, these preoperative techniques need to be supplemented with intraoperative methods, if the lesion size may increase or preoperative anatomy may change after the primary imaging due to rapid progression of the underlying intracranial disease. In such situations intraoperative ultrasound could be a valuable technique in real-time imaging of intracranial pathologic processes, real-time control of surgical procedure, assistance in drain or catheter placement, and real-time assessment of residual tumor or hematoma volume during neurosurgical interventions.

Customized employment as a pathway to competitive integrated employment: An analysis of RSA 911 data of state vocational rehabilitation agencies with the highest use of this intervention

BACKGROUND: Customized employment (CE) is a highly relevant but underused strategy for individuals with significant disabilities. It is important to examine how CE has been utilized in state vocational rehabilitation agencies (SVRAs). OBJECTIVE: The purpose of this study is to identify SVRAs’ CE service patterns and outcomes from 2017 to 2020. METHODS: Descriptive analysis, chi-square, and t-test comprised data analysis. RESULTS: 78% of the consumers receiving CE were associated with 10 SVRAs. This sample (N = 1,779) was 57.4% male and 42.6% female and had a mean age of 31.61 years. 77% were White. The frequent services provided with CE were VR counseling and guidance, assessment, and job placement assistance. Based on the service provision pattern, the agencies were separated into Group A, using co-occurring services other than supported employment (SE), and Group B, using SE along with CE. Consumers served by Group B are more likely to have cognitive impairment, intellectual disability, and the most significant disability. Group A is associated with lower employment, higher weekly earnings, and weekly hours worked. CONCLUSION: VR agencies and providers should consider these findings to refine and improve their service delivery and policies/procedures particularly for customized employment.

Cirq® robotic assistance for thoracolumbar pedicle screw placement – feasibility, accuracy, and safety

IntroductionNew technologies providing higher degree of precision, less risk for damage and less harmful exposure to radiation are necessary for correct transpedicular screw trajectory, but their efficacy should be evaluated. Research QuestionEvaluate the feasibility, accuracy and safety of Brainlab Cirq® navigated robotic arm assistance for pedicle screw placement in comparison to fluoroscopic guidance. Material and MethodsGroup I “Cirq® robotic-assisted group” – 97 screws in 21 prospectively analyzed patients. Group II “Fluoroscopy-guided group” – 98 screws in 16 consecutive patients analyzed retrospectively. Comparative evaluations included screw accuracy on Gertzbein-Robbins’s scale and fluoroscopy time. Time per screw and subjective mental workload (MWL) measured with the raw NASA task load index tool were assessed for Group I. Results195 screws were evaluated. Group I: 93 screws grade A (95.88%); 4 grade B (4.12%). In Group II, 87 screws grade A (88.78%); 9 grade B (9.18%); 1 grade C (1.02%); 1 grade D (1.02%). While the screws placed using the Cirq® system were more accurate overall, there was no statistical significance between the two groups, p=0.3714. There was no significant difference in operation length or radiation exposure between the two groups, however with the Cirq® system the radiation exposure for the surgeon was limited. Reduction in time per screw (p<0.0001) and in the MWL (p=0.0024) correlated with the surgeon’s experience with Cirq®. Discussion and ConclusionThe initial experience suggests that navigated, passive robotic arm assistance is feasible, at least as accurate as fluoroscopic guidance, and safe for pedicle screw placement.

Use of Customized Employment in State Vocational Rehabilitation Programs: A Retrospective Study 2017–2020

The purpose of this study was to examine the outcomes of customized employment via an analysis using the U.S. Rehabilitation Services Administration Case Service Report (RSA-911) from Federal Fiscal Years of 2017 through 2020. The independent variables were demographics, barriers to employment, and types of state vocational rehabilitation agency (SVRA) services, and the dependent variables were competitive integrated employment status and weekly earnings at exit. Descriptive analyses, multiple logistic regression, and hierarchical multiple regression comprised data analysis. The study sample ( N = 2,280) was 57.9% male and 42.1% female and had a mean age of 32.69 years ( SD = 12.83). Seventy-seven percent identified themselves as White and 46.7% had a cognitive disability. The results of this study indicated that consumers who have cognitive disability and cultural barriers; are migrant farmworkers and/or dependents; and receive job placement assistance, short-term job supports, maintenance services, benefits counseling, and supported employment are more likely to get competitive integrated employment at exit ( R2 = .34). Multiple variables were found to be significantly related to weekly earnings at exit and explained 24% of the variance. Rehabilitation counselors should take into consideration the findings of this study to determine from which supports consumers may benefit to attain successful employment goals, particularly for customized employment.

The key factors contributing to the persistence of homelessness

ABSTRACT Homelessness is a long-standing social problem in many countries. People who work and volunteer in homeless shelters struggle with the question of how to help homeless people lead an independent life. We sought to answer this question using insights obtained from Google Scholar literature searches and personal experiences with homeless people. In this brief research, we explored the main causes of homelessness in the United States for children, youth, adults, elderly, women, and veterans, over the past decade. The results showed that the three leading causes of homelessness were substance abuse, domestic violence, and mental illness. These problems lead to the initial homelessness, and in turn, homelessness further exacerbates these problems. Preventing and reducing homelessness requires effective policies and community interventions, such as rehabilitation facilities for people with substance abuse, job placement assistance and accommodation for homeless people, and homeless camps in designated areas to serve as bases to help homeless people rebuild their lives. Solving the issue of homelessness will contribute to achieving the UN’s Sustainable Development Goals.

İŞTEN ÇIKARILANLARA DESTEK HİZMETİ (OUTPLACEMENT) ÜZERİNE NİTEL BİR ARAŞTIRMA

İşten Çıkarılanlara Destek Hizmeti (İÇDH), küçülme, birleşme, yeniden yapılanma gibi kurum kaynaklı veya performans düşüklüğü gibi bireysel sebeplerle işten personel çıkaran işletmeler tarafından, bu zor sürecin olumsuz etkilerini en aza indirmek için sürdürülmektedir. Bu kapsamda kariyer danışmanlığı, işe yerleştirme yardımı, mülakat koçluğu gibi hizmetler sunulmaktadır. Bu çalışmada, Türkiye’de işten çıkarılanlara destek hizmetini kendi bünyesinde veya danışmanlık firmalarından sağlayarak sunan 6 işletmenin üst düzey insan kaynakları yöneticileri ile görüşmeler yapılmış ve toplanan işletme düzeyinde veriler literatüre dayanarak tema analizi ve betimsel analiz ile tartışılmıştır. Araştırma sonucunda, bu uygulamanın katılımcıların yarısı tarafından rutin bir İK sürecine dönüştüğü, kalanı tarafından ise ekonomik kriz dönemlerindeki toplu işten çıkarmalar sırasında sistematik uygulandığı saptanmıştır. Hem iç hem dış paydaşlar açısından kurumsal imajı olumlu etkilediği görülen hizmetin süresi danışmanlık firmalarından alındığında artan maliyet sebebiyle daha sınırlı tutulmaktadır.

Abstract No. 270 Safety and performance of the EPIONE robotic assistance for CT-guided percutaneous needle placement in the abdomen: pre-clinical study in pigs

Abstract No. 270 Safety and performance of the EPIONE robotic assistance for CT-guided percutaneous needle placement in the abdomen: pre-clinical study in pigs

Practice Patterns of Ventriculoperitoneal Shunt Placement in Academic and Community Settings: A National Survey of Practicing Neurosurgeons

We sought to assess the practice patterns of ventriculoperitoneal shunt (VPS) placement by neurosurgeons at academic, community, and government-based institutions. Using the American Association of Neurological Surgeons directory, a total of 3673 practicing neurosurgeons were contacted. The survey received 495 responses (57% academic, 41% community, 3% other/government based). The survey consisted of 9 questions to assess the frequency of general surgery assistance for distal VPS placement and the use of cranial neuronavigation for proximal placement and to assess subjective beliefs of personal practice pattern and the influence on shunt failure rates. Almost half of the respondents reported using general surgery less than half of the time for distal VPS placement. Regardless of personal practice patterns, roughly one third of respondents reported that general surgery assistance is a common or somewhat common practice at their institution. The most common reasons for recruiting general surgery assistance were cases of higher complexity. Although commonly used, almost 40% of respondents believe that general surgery assistance does not decrease shunt failure rates. Cranial neuronavigation is used less than half of the time, and the most common reason was for improved accuracy. Almost half of the respondents believe navigation does decrease shunt failure rates. General surgery assistance for distal placement and neuronavigation for the proximal placement of VPS catheters are both commonly used by neurosurgeons in academic, community, and other practice locations. This survey provides the first assessment of practice patterns nationally. The results demonstrate that roughly half of the practicing neurosurgeons use general surgery assistance and neuronavigation, particularly for complex or high-risk cases.

Jig-assisted modified Harrington reconstruction for metastatic bone destruction of the acetabulum.

We developed a technique using an indigenously designed jig to assist pin placement in producing a stable and long-lasting construct to augment the acetabulum combined with a cemented hip replacement in cases of metastatic destruction of the acetabulum. We describe our novel modified Harrington technique and retrospectively assess our cohort's clinical outcomes and complications. Between 2006 and 2019, 27 patients with a median age of 69 (49-81) years and a median ASA grade of III (II-IV) were managed using our modified 'Harrington' technique. We assessed outcomes on the following criteria: mechanical complications, post-surgery mobility, and functional outcome using Musculoskeletal Tumour Society Score (MSTS). At the last follow-up, ten patients were alive with disease [median follow-up of 26months (12-74)], and 17 patients died of their oncological disease [median follow-up of 15months (9-22)]. There were no perioperative deaths or intra-operative complications in our series. In total, ten complications were noted in nine patients (33%). Mobility-wise, 13 patients (48%) mobilised unaided, ten patients (37%) required a stick or crutch, two patients (7%) required a frame and two patients (7%) were wheel chair-dependent. The median MSTS score of all patients during their latest follow-up was 18 (8-26). Our jig-aided modified Harrington reconstruction technique assists in safe placement of antegrade pins in acetabulum during surgery and offers a long-lasting solution to these high-risk patients. The use of large diameter pins, appropriate patient selection, and cage used during construction in the acetabulum demonstrated relief of pain, improved mobility, and favorable functional outcomes with minimal complication rates.

Correlates of vocational outcomes of youth with co-occurring mental illness and substance use disorders: Evidence from a vocational rehabilitation program

AbstractYouth with co-occurring mental illness and substance use disorders are at higher risk for vocational rehabilitation exclusion. This study aimed to (a) explore the personal factors associated with vocational outcomes of youth with co-occurring mental illness and substance use disorders and (b) highlight services that have shown the greatest promise for this population in the state-federal rehabilitation program in the United States. Our analytic sample was extracted from the Rehabilitation Services Administration’s Case Service Report data set for 2013, 2014, and 2015 fiscal years. Multiple regression analyses results identified personal factors such as gender, race/ethnicity, level of education, and severity of disability as predictors of the achievement of competitive employment, hours worked, and income. The receipt of vocational rehabilitation services such as job search support, job placement assistance, vocational training, and on-the-job support are significantly associated with the achievement of competitive employment, higher work hours, and income. These finding have implications for vocational rehabilitation practice as they highlight who is at higher risk for poor outcomes, effective services, and additional factors to consider when working with youth with co-occurring mental illness and substance use disorders.