Limitations of system integration in providing employment services for persons with mental illness

Collaboration in the context of supporting people with mental health and addiction issues into employment: A scoping review

BACKGROUND: People with mental health and addiction issues have significantly lower levels of labor force participation than the general population. How organizations collaborate, particularly employment and health services, influence this disparity. Whilst collaboration has been examined, investigation of the role of collaboration context is limited. OBJECTIVE: To identify what affects collaboration to support people with mental health and addiction issues into employment. METHODS: A review and synthesis of the collaborative healthcare literature identified important a priori factors at macro, meso, and micro levels. A targeted scoping review of vocational rehabilitation literature identified the collaboration factors most relevant to supporting people with mental health and addiction issues into employment. RESULTS: Twenty articles met the inclusion criteria for the scoping review. Whilst some factors effecting collaboration aligned across these different contexts, there were notable differences. The vocational rehabilitation literature emphasized roles and responsibilities, contracting, training and technical assistance, sharing information, relationship continuity and practitioner value alignment. There was less emphasis in the vocational rehabilitation literature on practitioners’ beliefs about collaboration, how agencies work together around the person, and on infrastructure support. CONCLUSIONS: Collaboration in the context of supporting people with mental health and addiction issues into employment needs planning and support. Whilst many factors known to enable collaboration remain important, the collaboration context matters.

The Gut Microbiota-Produced Indole-3-Propionic Acid Confers the Antihyperlipidemic Effect of Mulberry-Derived 1-Deoxynojirimycin

Hyperlipidemia is a worldwide epidemic with an obvious gender disparity in incidence. Modulations on gut microbiota by traditional Chinese medicines (TCM) are emerging as a potential rationale governing the profitable effects of drugs on hyperlipidemia. However, it is unclear how gut microbes regulate the progression of hyperlipidemia. Here, we found that mulberry leaf extract (MLE) and its active component 1-deoxynojirimycin (DNJ) diminished hyperglycemia and hypertriglyceridemia with similar efficacy in male and female mice but preferentially alleviated hypercholesterolemia in female mice. Further investigations showed that DNJ sex-specifically downregulated the expression of lipogenic genes, especially cholesterol-biosynthetic genes. Oral administration of DNJ imposed more profound modulation on gut microbiota in female mice than in male ones, as estimated by 16S rRNA metatranscriptomic analysis. DNJ markedly enriched Akkermansia and Clostridium group XIVa and promoted the production of indole-3-propionic acid (IPA) in a sexually dimorphic way. Importantly, IPA tightly associates with the antihyperlipidemic effect of DNJ and exhibited a potent lipid-lowering effect both in vitro and in vivo Together, our results have established a regulatory mechanism by which DNJ sex-specifically improves hyperlipidemia, offering an in-depth theoretical basis for therapeutic exploitation of DNJ as a sex-specific intervention against hyperlipidemia.IMPORTANCE Hyperlipidemia has been intensively focused on by researchers around the world owing to its major contribution to cardiovascular diseases. Various evidence reveals that women are more susceptible than male counterparts to dyslipidemia, making sex-dependent therapeutic strategies and drugs urgently needed. In the present work, we demonstrate that DNJ, the main active component of mulberry leaves, exerts an obvious female-preferential antihyperlipidemic effect through specifically enriching Akkermansia and Clostridium XIVa and elevating an active microbial metabolite, indole-3-propionic acid (IPA), in female mice. Moreover, we have corroborated the potent lipid-lowering efficacy of IPA both in vitro and in vivo These findings not only indicate a potential mechanism by which gut microbes and their metabolites confer the beneficial role of DNJ in ameliorating hyperlipidemia but also provide an in-depth theoretical basis for therapeutic exploitation of DNJ as a female-specific intervention against hyperlipidemia.

Client, Contextual and Program Elements Influencing Supported Employment: A Literature Review

Supported employment is an evidence-based practice with a well-established research base. Most studies track such outcomes as employment rates, time to employment and wages earned. Few studies address client and contextual factors that impact outcomes or consider program elements beyond those that comprise the individual placement and support model. This paper reviews existing literature to shed light on the following questions: (1) What impact do labour market trends have on the effectiveness of SE? (2) How lasting are the effects of SE and what factors influence longevity of SE effects? (3) What levels and types of employment are targeted by SE? (4) What are the characteristics of people who benefit from SE? (5) What is the role of peer support in SE? and (6) What are the barriers to effective SE implementation? Research findings are synthesized and suggestions for service enhancements are offered so that the model can continue to evolve.

Aspectos psicológicos e reabilitação profissional: revisão de literatura

As doenças ocupacionais podem gerar prejuízos para a saúde mental dos trabalhadores, o que resulta em incapacidade laboral. A partir dos programas de reabilitação profissional, esses trabalhadores podem voltar a exercer uma atividade laborativa. Este artigo tem como objetivo realizar um levantamento bibliográfico a respeito da reabilitação profissional e dos aspectos psicológicos relacionados. Realizou-se rastreamento nas bases de dados nacionais e internacionais, o que resultou em um total de 70 artigos, posteriormente organizados nas categorias conceitos e políticas de reabilitação profissional, aspectos psicológicos em reabilitação profissional e processos de intervenção em reabilitação profissional. Estudos no campo da reabilitação profissional envolvendo aspectos da saúde mental são recentes, e observou-se um aumento nas publicações a partir da década de 2000. Aponta-se a necessidade da realização de estudos nessa área, a fim de ampliar a produção sobre os aspectos da saúde mental em reabilitação profissional.