Reducing Driving Risk Factors in Adolescents with Attention Deficit Hyperactivity Disorder (ADHD): Insights from EEG and Eye-Tracking Analysis.

Adolescents with attention deficit hyperactivity disorder (ADHD) face significant driving challenges due to deficits in attention and executive functioning, elevating their road risks. Previous interventions targeting driving safety among this cohort have typically addressed isolated aspects (e.g., cognitive or behavioral factors) or relied on uniform solutions. However, these approaches often overlook this population's diverse needs. This study introduces the "Drive-Fun" innovative intervention (DFI), aimed at enhancing driving skills among this vulnerable population. The intervention was tested in a pilot study including 30 adolescents aged 15-18, comparing three groups: DFI, an educational intervention, and a control group with no treatment. Assessments included a driving simulator, EEG, and Tobii Pro Glasses 2. Evaluation was conducted pre- and post-intervention and at a 3-month follow-up. Results indicated that the DFI group significantly improved in the simulated driving performance, attentional effort, and focused gaze time. The findings underscore that holistic strategies with personalized, comprehensive approaches for adolescents with ADHD are particularly effective in improving driving performance. These outcomes not only affirm the feasibility of the DFI but also highlight the critical role of sensor technologies in accurately measuring and enhancing simulator driving performance in adolescents with ADHD. Outcomes suggest a promising direction for future research and application.

Employment barriers questionnaire: Development and determination of its reliability and validity.

BACKGROUND: The high unemployment rate among people with disabilities (PWDs) can be attributed to barriers found in the work environment and demands of the job itself. Given the lack of comprehensive tools to identify these barriers, we developed the Employment Barriers Questionnaire (EBQ). OBJECTIVE: The objective of this study was to develop and examine the EBQ's reliability and validity for detecting employment barriers and possible modifications to overcome them. METHODS: Two stages were conducted: stage I was a cross-sectional design. Stage II included a cross-sectional and prospective design. Thirty-nine people with physical disabilities (mean age 47.21±10.78 years) were recruited, 51% of which were employed during data collection. During stage I, we developed a first version of the EBQ (EBQ.I) and evaluated its internal reliability. The EBQ.I was filled twice, one week apart to assess test-re-test reliability. Predictive validity was tested using a regression model to predict the employment status of stage II based on EBQ.I's results from stage I. In stage II, we generated a second version (EBQ.II) and tested its internal-reliability and known-groups validity, by comparing the EBQ.II's results between employed and unemployed subjects. RESULTS: The results showed that the EBQ.II has a high internal-reliability (α= 0.79-0.97) and a medium-large known-groups validity (-3.95≤Z≤-2.26, p < 0.05). Additionally, the EBQ.I has a high test re-test reliability (ICC = 0.85-0.94, p < 0.001) and predictive validity (ß= 0.861, p = 0.033). CONCLUSION: This study has illustrated that the EBQ.II is a unique, reliable and valid tool for identifying employment barriers and modifications to address them, expected to improve vocational rehabilitation efforts.

Effects of aquatic exercise program versus on-land exercise program on cancer-related fatigue, neuropathy, activity and participation, quality of life, and return to work for cancer patients: study protocol for a randomized controlled trial.

BACKGROUND: Exercise has shown positive effects on fatigue, exhaustion, neuropathy, and quality of life in cancer patients. While on-land exercises have been studied, the aquatic environment offers unique advantages. Water's density and viscosity provide resistance, enhancing muscle strength, while hydrostatic pressure improves venous return. This trial aims to investigate the effect of aquatic exercises on time to return to work, work hours, work-related difficulties, daily life activity and participation, quality of life, exhaustion, fatigue, and neuropathy among cancer patients, compared to on-land exercise intervention group and a non-exercise group. METHODS: This randomized controlled trial will include 150 cancer patients aged 18-65 years with stage III colon cancer or breast cancer patients with lymph node involvement. Participants in the aquatic exercise intervention group will undergo an 8-week, twice-weekly group-based Ai-Chi program, while the on-land exercise group will perform identical exercise. The control group will not engage in any exercise. The primary outcome will be assessed using an employment barriers questionnaire, capturing return to work date and working hours and daily life participation and activity and quality of life. Secondary outcomes include exhaustion, fatigue, and neuropathy. Data will be collected at baseline, post-intervention (8 weeks), and at 3,12, and 24 months. Mixed variance analyses will explore relationships among groups and over time for independent variables, with separate analyses for each dependent variable. DISCUSSION: The potential benefits include an earlier return to work for patients, reducing their need for social and economic support. The study's implications on socio-economic policies are noteworthy, as a successful intervention could offer a cost-effective and non-invasive solution, improving patients' quality of life and increasing their participation in daily activities. This, in turn, could lead to a faster return to work, contributing to both personal well-being and broader societal interests by reducing reliance on social services. TRIAL REGISTRATION: The trial is registered at ClinicalTrials.gov NCT05427344 (22 June 2022).

Simulator Driving Abilities, Executive Functions, and Adaptive Behavior Among Adolescents With Complex Attention Deficit Hyperactivity Disorder.

OBJECTIVE: To examines the driving skills, executive functions, and adaptive behavior of adolescents diagnosed with Attention-deficit/hyperactivity disorder (ADHD) combined with emotional difficulties and/or learning disabilities (complex ADHD), compared to adolescents without ADHD. METHOD: A cross-sectional study including 30 adolescents with complex ADHD and 33 adolescents without ADHD aged 15 to 18 years. Driving skills on a simulator, executive functions, and adaptive behavior were evaluated. RESULTS: Adolescents without ADHD demonstrated significantly higher total scores on the driving simulator, indicating better driving performance compared to adolescents with complex ADHD. In the complex ADHD group, after controlling for different Conners Comprehensive Behavior Rating Scale-Self Report scales, driving simulator scores were partially correlated with executive functions. CONCLUSION: These findings emphasize the unique needs of adolescents with complex ADHD. Given the significance of driving in today's society, it is crucial to consider the development of intervention programs to support this population's driving skills.

Optimal Duration of In-Vehicle Data Recorder Monitoring to Assess Bus Driver Behavior.

This study examined the optimal sampling durations for in-vehicle data recorder (IVDR) data analysis, focusing on professional bus drivers. Vision-based technology (VBT) from Mobileye Inc. is an emerging technology for monitoring driver behavior and enhancing safety in advanced driver assistance systems (ADASs) and autonomous driving. VBT detects hazardous driving events by assessing distances to vehicles. This naturalistic study of 77 male bus drivers aimed to determine the optimal duration for monitoring professional bus driving patterns and the stabilization point in risky driving events over time using VBT and G-sensor-equipped buses. Of the initial cohort, 61 drivers' VBT data and 66 drivers' G-sensor data were suitable for analysis. Findings indicated that achieving a stable driving pattern required approximately 130 h of VBT data and 170 h of G-sensor data with an expected 10% error rate. Deviating downward from these durations led to higher error rates or unreliable data. The study found that VBT and G-sensor data are both valuable tools for driving assessment. Moreover, it underscored the effective application of VBT technology in driving behavior analysis as a way of assessing interventions and refining autonomous vehicle algorithms. These results provide practical recommendations for IVDR researchers, stressing the importance of adequate monitoring durations for reliable and accurate outcomes.

Reliability and validity of the Hebrew version of the International Spinal Cord Injury Activities and Participation Basic Data Set.

BACKGROUND: The International Spinal Cord Injury (SCI) Activities and Participation Basic Data Set (APBDS) was created to facilitate comparisons of levels of function and disability in SCI individuals worldwide. AIM: Evaluating the reliability and validity of the APBDS's Hebrew translation was our goal. DESIGN: Observational, cross-sectional study. SETTING: University and Outpatient Rehabilitation Department of a Medical Center. POPULATION: Individuals with spinal cord injury (SCI). METHODS: The APBDS's Hebrew version was administered to fifty individuals with SCI. Reliability was evaluated through Cronbach Alpha Test and a test-retest method. Validity was determined by testing for convergence with the World Health Organization Disability Assessment Scale (WHODAS) 2.0 and the Medical Outcomes Short Form Health Survey (SF-12). RESULTS: The Hebrew APBDS had a high test-retest reliability (ICC=0.792) and an adequate Cronbach alpha test (α=0.792). Significant convergent validity was partial with both the WHODAS 2.0 (strong in the self-care objective (r=-0.648) and subjective (r=-0.666), moderate in the total objective (r=-0.640) and subjective (r=-0.570) domains of the APBDS) and the SF-12 (moderate between the total objective domain and the Physical composite score (r=0.378), poor with the Mental composite score (r=0.310)). CONCLUSIONS: Although the Hebrew APBDS's moderate reliability and validity warrants further research, it opens new vistas regarding assessment of SCI individuals' satisfaction, activity, and participation. CLINICAL REHABILITATION IMPACT: We feel that this data set may be used in the long-term follow-up of SCI individuals in the Sheba SCI rehabilitation registry.

Upper Limb Kinematics of Handwriting among Children with and without Developmental Coordination Disorder.

Background: Children with developmental coordination disorder (DCD) often experience difficulties with handwriting legibility and speed. This study investigates the relationship between handwriting and upper limb kinematics to characterize movement patterns of children with DCD and typically developing (TD) children. Methods: 30 children with and without DCD matched for age, gender, and parent education were compared across handwriting abilities using a standardized handwriting assessment of both copied and dictated tasks (A-A Handwriting). The 3D motion capture system (Qualysis) was used to analyze upper limb kinematics and characterize movement patterns during handwriting and contrasted with written output. Results: Children with DCD wrote fewer legible letters in both copying and dictation. Children with DCD also showed poor automatization of key writing concepts. Atypical wrist postures were associated with reduced legibility for children with DCD (F (1,27) 4.71, p = 0.04, p-η2 = 0.15); whereas for TD children, better legibility was associated with greater variations in movement speed, particularly of the wrist (rho = −0.578, p < 0.05). Conclusion: Results reflect different movement parameters influencing handwriting in children with DCD. An improved understanding of the movement characteristics during handwriting of these children may assist intervention design.

Convergent validity of vision based technology (VBT) among professional bus drivers.

INTRODUCTION: Due to the relative rarity of crashes, researchers use traffic offenses, police records, public complaints, and In-Vehicle Data Recorder (IVDR) data as proxies for assessing crash risk. In this study, a unique IVDR system, called Vision-Based Technology [(VBT), (Mobileye Inc.)] was used to monitor perilous naturalistic driving events, such as insufficient distance from other vehicles and pedestrian or bicycle rider near-misses. The study aimed to test the convergent validity of VBT as an indicator of crash involvement risk. METHODS: Data from 61 professional drivers working for a large bus company were analyzed (16 of 77 in the original data cohort were excluded for insufficient VBT data). Data included: recorded VBT data, objective data collected from official records (crash records provided by the bus company, and public complaints of reckless driving), self-report data regarding crash involvement, and police tickets. The correlation between VBT, objective and self-reported data was analyzed. Binary-logistic regression modeling (BLM) was used to calculate the odds ratio (OR) for participants involved in a car crash. RESULTS: Correlations were found between the total VBT risk score and official crash records, public complaints, and self-reports of crash involvement. The BLM correctly classified 90% of those who were involved in a crash (sensitivity) and 60% of those who were "crash-free" (specificity). The VBT total risk score was the only significant contributing factor to crash risk, and for each point of increase, the odds of being involved in a crash increased by a factor of 1.55. CONCLUSIONS: It is the first study to provide empirical evidence validating the VBT as an indicator of crash involvement and driver safety among professional bus drivers. PRACTICAL APPLICATIONS: VBT technology can provide researchers and clinicians a better understanding of bus drivers' risky driving behaviors- a valuable contribution to road safety interventions for this target group.

Transition to Labor Market among Young Adults with Serious Mental Illness.

Background: The research on job attainment and retention among young adults with serious mental illness (SMI) is limited. The objective of this study was to investigate the contributions of emotional, cognitive, motor, demographic, and work-related factors to the transition into supported employment (SE) and retention. Methods: This cross-sectional study included young adults with SMI involved in prevocational (N = 21) services or those who have transferred to SE (N = 21) following prevocational services. Work-related self-efficacy, executive functions, and motor skills were approached with standard and well-established tools. Results: There was a significant difference between groups in most dimensions of work-related self-efficacy, job history and experience, cognitive strategies, and general independence in daily life. The multivariate analysis demonstrates that holding a profession, experiencing self-efficacy in general work skills, cognitive strategies, and independence in living situations explained the between-group differences (χ2(4) = 34.62, p < 0.001; correct classification−90.2%). Conclusions: The study identifies the factors contributing to a sustainable transition to employment among young adults with SMI, suggesting the importance of a comprehensive approach to address a range of personal factors in an integrative way. The augmentation of prevocational training with continued employment support may be beneficial to meet the unique needs of young adults with SMI.

Correlations between body postures and musculoskeletal pain in guitar players.

BACKGROUND: The guitar-playing community is the largest group at risk of developing playing related musculoskeletal disorders. A thorough investigation of the relationships between the various risk factors and players' report on musculoskeletal pain using objective and accurate means of assessment has yet to be reported. PURPOSE: (a) to explore the correlations between demographic characteristics, anthropometric measurements, playing habits, and personal habits of guitar player and their complaints of musculoskeletal pain, (b) explore the correlations between the upper body kinematics of guitar players during playing the guitar and their complaints of musculoskeletal pain, and (c) compare the upper body kinematics of guitar players during playing the guitar while sitting versus standing. METHODS: Twenty-five guitar players (27.5±4.6 years old) filled out questionnaires regarding their guitar-playing habits, and the Standardized Nordic Questionnaires for the analysis of musculoskeletal symptoms. Kinematics of their torso and upper limbs were tracked while they played a tune twice, once while sitting and once while standing. RESULTS: We found moderate correlations between the number of painful joints in the last year and factors, such as physical comfort while playing, years of playing, and position during playing. During standing, lower back pain severity correlated with the rotation range of the torso, while during sitting, it moderately correlated with the average radial-ulnar deviation of the right wrist. During sitting, we found higher anterior and right tilt of the torso, combined with greater abduction of the right shoulder, higher flexion in the left shoulder and higher radial deviation in the left wrist. CONCLUSION: Our results point to several risk factors, related both to playing habits but also to playing posture, which should be considered by the guitar players in order to prevent playing-related musculoskeletal disorders.

Effects of Ai-Chi Practice on Balance and Left Cerebellar Activation during High Working Memory Load Task in Older People: A Controlled Pilot Trial.

BACKGROUND: Normal aging is associated with balance and working memory decline. From a neurobiological standpoint, changes in cerebellar functional plasticity may mediate the decline in balance and working memory for older adults. Mounting evidence suggests that physical activity is beneficial for decreasing aging effects. Previous studies have focused on land-based physical activity and research concerning the aquatic environment is scarce. This study investigated the effectiveness of Ai-Chi on balance abilities and cerebral activation during a high working memory load task among community-dwelling older people. METHODS: A total of 19 people aged 65-86 years were allocated to receive Ai-Chi practice (n = 6), structured on-land Ai-Chi practice (n = 7) or guided-imagery of Ai-Chi practice (n = 6) for a bi-weekly, 30-min exercise session for 12 weeks. Balance was measured by the Tinetti balance sub-test and working memory was measured by the N-back test during functional-MRI scan. RESULTS: The Ai-Chi practice group presented a significant change in balance between pre and post intervention (balance t = -4.8, p < 0.01). In the whole-brain analysis, during high working memory load task, the Ai-Chi practice group presented a decrease in left cerebellar activation. Region of interest analyses yielded similar results by which pre-cerebellar activation was higher than post-intervention (t = 2.77, p < 0.05). CONCLUSIONS: Ai-Chi is an available, non-invasive intervention method that may serve as a tool to improve cerebellar activation that in turn might improve balance. In addition, our findings may provide new insights into the neuronal mechanisms that underlie both motor and cognitive abilities.

The Effects of an In-vehicle Collision Warning System on Older Drivers' On-road Head Movements at Intersections.

With age might come a decline in crucial driving skills. The effect of a collision warning system (CWS) on older drivers' head movements behavior at intersections was examined. Methods: Twenty-six old-adults, between 55 and 64 years of age, and 16 Older drivers between 65 and 83 years of age, participated in the study. A CWS (Mobileye Inc.) and a front-back in-vehicle camera (IVC) were installed in each of the participants' own vehicles for 6 months. The CWS was utilized to identify unsafe events during naturalistic driving situations, and the IVC was used to capture head direction at intersections. The experimental design was conducted in three phases (baseline, intervention, and carryover), 2 months each. Unsafe events were recorded by the CWS during all phases of the study. In the second phase, the CWS feedback was activated to examine its effect on drivers' head movement' behavior at intersections. Results: Older drivers (65+) drove significantly more hours in total during the intervention phase (M = 79.1 h, SE = 10) than the baseline phase (M = 39.1 h, SE = 5.3) and the carryover phase (M = 37.7 h, SE = 5.4). The study revealed no significant differences between the head movements of older and old-adult drivers at intersections. For intersection on the left direction, a significant improvement in drivers' head movements' behavior was found at T-junctions, turns and four-way intersections from phase 1 to phase 3 (p < 0.01), however, two intersection types presented a decrease along the study phases. The head movements' behavior at roundabouts and merges was better at phase 1 compared to phase 3 (p < 0.01). There was no significant reduction of the mean number of CWS unsafe events across the study phases. Conclusions: The immediate feedback provided by the CWS was effective in terms of participants' head movements at certain intersections but was harmful in others. However, older drivers drove many more hours during the active feedback phase, implying that they trusted the system. Therefore, in the light of this complex picture, using the technological feedback with older drivers should be followed with an additional mediation or follow-up to ensure safety.

Maze test score time adjustments when using nondominant hand in fitness-to-drive assessments.

Drivers with medical conditions may need to demonstrate their fitness by participating in clinical and on-road assessments. Scores from the clinic-based occupational therapy-drive home maze test (OT-DHMT) can contribute to fitness-to-drive recommendations. The OT-DHMT is a short, timed test that has previously been shown to be valid and reliable, and norms are available for completion with a driver's dominant hand. Following stroke or trauma, many drivers need to complete assessments and resume driving using their nondominant hand. The validity of a person's OT-DHMT score when completed with a nondominant hand is unknown. This study investigated if a person's OT-DHMT score time requires adjustment when completed with a nondominant hand. The OT-DHMT was administered with a convenience sample of 148 community-dwelling participants, aged 21-81 years (M = 48.6, SD = 19.38) using both their dominant and nondominant hands, in a random order. OT-DHMT score times were significantly faster when using dominant (M = 15.73) compared with nondominant (M = 17.64) hand, d = 1.91 [confidence interval (CI) 1.13, 2.69], t = 4.84, P < 0.01. Employing a generalized weighted least squares regression model indicated that multiplying a driver's nondominant hand time by 0.833 s for drivers aged ≤60, and by 0.929 s for drivers aged 61+ can approximate dominant hand completion times. The OT-DHMT has been validated for use with people using their nondominant hand. Time adjustments are required for people using their nondominant hand when completing the OT-DHMT, and a larger adjustment is required for people aged ≤60 reinforcing previous findings that younger people have faster OT-DHMT completion times.

Performance of Everyday Occupations and Perceived Health of Spouses of Men With Spinal Cord Injury at Discharge and 6 Months Later.

STUDY DESIGN: An exploratory longitudinal study. OBJECTIVES: (a) Compare the occupational performance, and life satisfaction of spouses of men with SCI with those of spouses of healthy men, (b) compare the occupational performance, perceived health, and life satisfaction of spouses of men with SCI at discharge from inpatient rehabilitation and 6 months postdischarge; and (c) assess whether the functioning levels of men with SCI and the perceived mental health of the spouse, correlate with her occupational performance. SUMMARY OF BACKGROUND DATA: Spouses of men with spinal cord injury (SCI) report having symptoms of depression and anxiety. However, their ability to choose everyday occupations and perform them satisfactorily (occupational performance) was less studied. METHODS: Fifteen women spouses of men with SCI and 15 women spouses of healthy men participated. Study measures included four self-report questionnaires and the Occupational Performance History Interview that was analyzed quantitatively and measured occupational performance by three components: occupational identity, competence, and settings. RESULTS: Occupational performance and life satisfaction of caregivers were lower than those of spouses of healthy men and did not significantly change over 6 months. However, they had higher scores on physical, mental, and general health 6 months postdischarge than at discharge. Mental health of the spouse correlated with her occupational identity. CONCLUSION: It is recommended that rehabilitation intervention focus not only on patients with SCI, but also on their healthy spouses to promote their occupational performance, health, and well-being. LEVEL OF EVIDENCE: 3.

Returning to work after a hand injury: Does ethnicity matter?

BACKGROUND: Hand injuries (HI) are common and may limit participation in work. The objective of this study is to examine the effect of ethnicity and other prognostic variables on return-to-work (RTW) among male manual workers after acute HI. METHODS: A cohort of 178 subjects (90 Arabs, 88 Jews) aged 22 to 65 was studied. Trained bilingual occupational therapists evaluated and interviewed the subjects, using structured validated questionnaires for evaluating personal and environmental factors, body function and structure, and activity limitation and participation restrictions. Employment status 3 months post injury was assessed by a telephone interview. To establish a predictive model for RTW, ethnicity and certain variables of the four domains mentioned above were analyzed using logistic regression analysis. RESULTS: A significant difference in the rate of RTW between Jews and Arabs was found (45.5% for Jews, 28.9% for Arabs, p = 0.03) three months post HI. In the univariate regression analysis, ethnicity was associated with RTW (OR = 2.05; CI: 1.10-3.81) for Jews vs. Arabs. Using a multivariate analysis, only legal counseling, educational attainment, and the severity of disability were significantly associated with RTW. CONCLUSION: RTW three months post HI among manual workers is directly related to variables such as education and legal counseling and only indirectly related to ethnicity. Patients with a lower level of education and those who were engaged in legal counseling need special attention and close guidance in the process of RTW.

Effects of aquatic physical intervention on fall risk, working memory and hazard-perception as pedestrians in older people: a pilot trial.

BACKGROUND: Normal aging is associated with balance, mobility and working memory decline that increase fall risk and influence activity of daily living functions. Mounting evidence suggests that physical activity is beneficial for decreasing aging effects. Previous studies have focused on land-based physical activity. Research concerning the aquatic environment is scarce. The primary objectives of this three arm intervention pilot study were to examine the effects of an aquatic physical intervention program on balance, gait, fall risk and working memory among community-dwelling older individuals. The secondary objective was to examine the effects of an aquatic physical intervention program on safety of street-crossing among community-dwelling older individuals. METHODS: Forty-two healthy participants aged 65 or older were enrolled into one of three intervention groups: aquatic physical intervention (API) (N = 13), on-land physical intervention (OLPI) (N = 14) or non-physical intervention (NPI) (N = 15). The intervention took place from 2018 until 2019 at Tel-Aviv University, Sheba medical center and Reich Center. The protocol included 30-min sessions twice a week for 12 weeks. Balance, gait and fall risk were assessed by the Tinneti test, working memory abilities were assessed by digit span and Corsi blocks tests and simulated safe streets-crossing was assessed by the hazard perception test for pedestrians. Testing and data collection was conducted at baseline, after six weeks and 12 weeks of intervention. All members of the professional team involved in evaluating participants were blind to the intervention group to which participants were allocated. RESULTS: The differences in Tinetti balance (F (2, 39)=10.03, p < 0.01), fall risk (F (2, 39)=5.62, p0 > .05), digit span forward (F (2, 39)=8.85, p < 0.01) and Corsi blocks forward (F (2, 39)=3.54, p < 0.05) and backward (F (2, 39)=6.50, p < 0.05) scores after 12 weeks between the groups were significant. The API group showed improved scores. The differences in hazard perception test for pedestrians scores after 12 weeks of intervention between the groups were marginally significant (F (2, 39)=3.13, p = 0.055). The API group showed improved scores. CONCLUSIONS: These findings may affect experts working with the elderly population when making decisions concerning therapeutic prevention interventions for the deficiencies of elderly patients. Older adults practicing aquatic physical activity could contribute to their increased safety. TRIAL REGISTRATION: Trial registration number: ClinicalTrials.gov Registry NCT03510377. Date of registration: 10/31/2017.

Comparing executive functioning and clinical and sociodemographic characteristics of people with schizophrenia who hold a driver's license to those who do not.

BACKGROUND.: Community engagement requires driving. However, there is paucity of research focusing on the potential to drive for people with schizophrenia. PURPOSE.: This study aimed to characterize people with schizophrenia by comparing clinical signs, executive functions (EF), and sociodemographic aspects of those holding a driver's license to those without one. METHOD.: This cross-sectional study used convenience sampling to select 60 ambulatory individuals to participate: 31 with a driver's license and 29 without one. They completed the Wisconsin Card Sorting Test (WCST) for evaluation of EF and the Positive and Negative Syndrome Scale (PANSS) for symptoms severity evaluation. Data were analyzed using multivariate analyses of covariance and logistic regression models. FINDINGS.: Participants with a license had less severe negative symptoms and general psychopathology and better EF and sociodemographic aspects compared to those without a license. Logistic regression revealed significant odds ratios (OR) in general psychopathology (PANSS; OR = 0.963, p = .011) and in the WCST (OR = 0.504, p = .027). IMPLICATIONS.: This study offers occupational therapists a data-driven perspective on evaluating potential fitness to drive to enable participation in daily life and well-being of people with schizophrenia.

Motor skills, cognition, and work performance of people with severe mental illness.

PURPOSE: Employment offers many benefits to people with mental illness, yet their employment rate is much lower than that of the general population. We investigated the effect of work-related motor skills, neurocognition, and job attitudes on the work performance of people with mental illness, comparing those working in sheltered workshops, with controls working in similar jobs. METHODS: Twenty-nine adults with severe mental illness and 27 controls matched by gender and age were enrolled into the study using convenience sampling. They were assessed for gross and fine motor hand functioning, job attitudes, work performance, and cognition. RESULTS: People with mental illness scored lower on work performance, cognitive functioning, and hand dexterity while sitting and working with tools. They were assigned lower job loads than were controls, and perceived the physical environment at work as more constraining than did controls. Assembling motor skills significantly explained the work performance of people with mental illness. CONCLUSIONS: The results expand our understanding of the complexities involved in the employment of people with severe mental illness, and point to new paths for improving vocational outcomes of people with severe mental illness, taking into account their motor skills and job attitudes. Implications for rehabilitation Therapists should be aware that employed people with severe mental illness may have various unmet needs, affecting their work performance and experience of stress. This study results demonstrate importance of motor skills and perception of the work environment for the promotion of vocational outcomes among individuals with severe mental illness. Employment of people with severe mental illness should be viewed from holistic perspective as with general population, rather than focused on traditionally illness-related factors.

Return-to-Work Barriers Among Manual Workers After Hand Injuries: 1-Year Follow-up Cohort Study.

OBJECTIVE: To determine time of return to work (TRTW) in relation to multivariable predictors among male manual workers after hand injury (HI) over a 12-month follow-up. DESIGN: A cohort study with baseline medical information, functional evaluation, and 3-, 6-, 9-, and 12-month follow-up telephone interviews. SETTING: Seven physical rehabilitation community occupational therapy clinics. PARTICIPANTS: Participants (N=178) with acute HI aged 22-65. Two participants were lost to follow-up. INTERVENTION: Not applicable. MAIN OUTCOME MEASURE: The dependent variable was TRTW. The independent variables originated from 4 domains: personal factors, environmental factors, body function and structure, and activity limitation and participation restriction. The proportion of return to work (RTW) at each time point was calculated. Multiple Cox regressions established a predictive model for TRTW. RESULTS: At the end of the study, 75.3% participants returned to work. The median TRTW was 94 days. In the final model, only compensation factors and education contributed significantly to overall RTW, but when separate analyses were performed, decreased level of self-efficacy, higher workplace demands, level of pain, level of emotional response to trauma, reduced physical capability of the hand, and higher level of disability were significantly associated with delayed TRTW. CONCLUSIONS: TRTW was determined by the physical capability of the hand, pain, and psychosocial factors, but it was also affected by legal factors. Participants who did not return to work during the first 9 months are at risk for long-term disability. Developing treatment programs for those who are at risk for not returning to work, taking into consideration these factors, is recommended.

The correlation between upper extremity musculoskeletal symptoms and joint kinematics, playing habits and hand span during playing among piano students.

OBJECTIVE: We aimed to investigate the correlations between Upper Extremity Musculoskeletal Symptoms (MSD) and joint kinematics while playing the piano, as well as correlations between MSD and psychosocial, professional and personal habits, and bio-demographic risk factors of piano students. METHOD: This cross-sectional study included 15 piano students. The research tools included 3D motion capture, anthropometric measurements, and questionnaires for obtaining data about MSD, psychological, and personal factors. RESULTS: The piano students recruited for this study experienced a variety of MSD during the past 12 months, with a particularly high prevalence of neck pain (80%). Extreme wrist extension and/or elbow flexion while playing the piano also correlated with MSD. Additionally, this study identified correlations between MSD and hand span (r = -.69, p≤.004) and number of playing hours per week (r = .58, p≤.024). CONCLUSIONS: Anthropometric factors and playing patterns should be considered together with well-known MSD risk factors, like extreme and repetitive movements. However, considering each joint singularly might not be sufficient to prevent the development of MSD when instructing the piano player; accordingly, joint synchronization should also be considered.