RESUMEN
Job performance and production related issues are important not only to successful vocational training and ultimate job placement for individuals with cognitive disabilities, but also for their ability to have expanded vocational options. This study hypothesized that the application of Kaizen philosophy, and poka-yoke techniques in particular, could create job opportunities and improve productivity of individuals with cognitive disabilities. Poka-yoke or error-proofing techniques are part of the collection of Kaizen techniques. Kaizen refers to continuous improvement in performance, cost/effectiveness, and quality. Kaizen strives to empower the worker, increase worker satisfaction, facilitate a sense of accomplishment, and thereby create pride-of-work. These techniques typically reduce the physical and cognitive demands of a task and thereby render the task more accessible. The job was a fuel clamp assembly. A redesigned assembly fixture was the poka-yoke intervention. Consistent with poka-yoke principles, the intervention improved the productivity of everyone attempting the assembly. In particular, the workers in this study showed an 80% increase in productivity and an average percent error drop from 52% to about 1% after the process redesign. Furthermore, the workers showed improved morale, self-esteem, and pride-of-work. Prior to the process redesign, only the higher functioning workers could successfully perform the assembly. After the redesign a greater number of workers could successfully perform the assembly. These results not only validated the study hypothesis, but demonstrated that the success facilitated by applying Kaizen techniques had similar results with individuals with cognitive disabilities as with nondisabled workers.
Asunto(s)
Personas con Discapacidad , Empleo , Discapacidad Intelectual , Sistemas Hombre-Máquina , Análisis y Desempeño de Tareas , Adolescente , Adulto , Diseño de Equipo , HumanosRESUMEN
While twin concordances for schizophrenia have been used to estimate heritability and to develop genetic models, concordances in subtypes of monozygotic (MZ) twins can also be used to investigate the influence of prenatal development in the etiology of mental illness. We used within-pair variability and mirroring of fingerprints to estimate retrospectively the placentation status of concordant and discordant MZ twins. The results indicate that concordant MZ pairs were more likely to have been monochorionic (MC) and to have shared a single placenta, whereas discordant MZ pairs appear more likely to have been dichorionic (DC) with separate placentas. Pairwise concordances for MZ twins without MC markers averaged 10.7 percent. In contrast, concordances for MZ twins with one or more MC markers averaged 60 percent. This suggests that simple MZ concordance rates may overestimate schizophrenia heritability and that prenatal development may also be important in the etiology of schizophrenia. Because MC (but not DC) twins usually share fetal blood circulation and hence are likely to share infections, these results are consistent with the hypothesis that fetal infections may be a significant etiological factor in schizophrenia.
Asunto(s)
Enfermedades en Gemelos/genética , Efectos Tardíos de la Exposición Prenatal , Esquizofrenia/genética , Psicología del Esquizofrénico , Gemelos Monocigóticos/genética , Dermatoglifia , Enfermedades en Gemelos/psicología , Femenino , Marcadores Genéticos/genética , Humanos , Masculino , Modelos Genéticos , Fenotipo , Placentación/genética , Embarazo , Factores de Riesgo , Gemelos Monocigóticos/psicologíaRESUMEN
High concordance for schizophrenia in monozygotic (MZ) twins is often cited as evidence for the etiological influence of genetics; however, even if twins are separated at birth, MZ twin concordance is influenced by the shared prenatal environment. Study of the placentation status of MZ twins provides a way to investigate some prenatal influences, including the possible role of viral infections. The probability of shared infections is likely to be greater in monochorionic MZ twin pairs than in dichorionic pairs because of shared fetal circulation in the monochorionic pairs. We drew from published twin studies and used reported concordance for handedness as a retrospective marker of placentation status. We found that MZ twin pairs with opposite-hand preferences were concordant for psychosis in 9 of 15 cases (60%), while only 18 of 56 twin pairs (32%) with same-hand preferences were concordant for psychosis. These results suggest that shared prenatal viral infection may account for much of the high concordance for schizophrenia in identical twins.
Asunto(s)
Enfermedades en Gemelos/genética , Efectos Tardíos de la Exposición Prenatal , Esquizofrenia/genética , Psicología del Esquizofrénico , Femenino , Lateralidad Funcional/genética , Humanos , Masculino , Placentación/genética , Embarazo , Factores de Riesgo , Esquizofrenia/diagnóstico , Esquizofrenia/etiología , Medio Social , Gemelos Monocigóticos/genética , Gemelos Monocigóticos/psicologíaRESUMEN
Thirty-four surgical procedures were performed over a 12-year period on a select population of severely multiply handicapped individuals. Heel cord lengthening, hamstring and adductor releases, as well as selected osteotomies, tenotomies, and arthrodeses (both wrist and foot) were performed. The objectives were improvement in sitting posture, care, and comfort. Independent evaluations of active function, passive function, cosmesis, self-esteem, limb posture, and ease of dressing and hygiene were assessed. Significant improvement was generally noted. No patient was made worse. Selected procedures in the severely multiply handicapped individual have a definite place in patient management.