Assessment Of Work Capacity Research Articles

Implications of a twelve-week aerobic exercise on functional work capacity in HIV positive clients on antiretroviral therapy

The implications of aerobic exercise on functional work capacity of Human Immunodeficiency Virus (HIV) positive clients on antiretroviral therapy (ART) in Uganda have been established. ART and the efforts to scale it up have significantly improved the value of life and life’s hope of among PLHIV. Despite the presence of ART HIV disease is still seen in wards and a significant loss of life due to AIDS. This study provides useful information to the Ministry of Health of Uganda on the implications of aerobic exercises on functional work capacity as a clinical outcome to HIV positive clients in Uganda. This helps in refining the existing information on aerobic exercises and their relevancy in management of HIV positive clients. An experimental study was conducted among HIV positive clients who had been on treatment for at least 12 months prior to the study. Volunteers were randomly assigned to a control group (Group 1), where no treatment was administered, and an experimental group (Group 2), where a twelve-week moderate intensity aerobic exercise was administered. Assessment of functional work capacity was done as a pre-test and post-test for both groups. The results showed that aerobic exercises significantly improved both heart rate and VO2max with p-values of

The Use of Basketball Variations in Ukrainian General Secondary Education Institutions for Enhancing High School Students' Physical Capacity

Amidst the ongoing reforms in Ukraine's educational sector, prioritizing students' health and improving their physical prowess has become imperative. This study explores the feasibility and effectiveness of integrating diverse forms of traditional basketball into high school physical education lessons to enhance the work capacity of students. The research cohort comprised 29 male 11th-grade students. The assessment of physical work capacity focused on the Harvard Step Test (HST), utilizing its metrics to measure students' development. Univariate analysis was employed for data analysis. Results indicated a satisfactory level of physical fitness among students, slightly below the established norm. These findings emphasize the need to incorporate various basketball derivatives, including streetball, korfball, netball, rezball, ringball, slamball, and cestoball, into the general secondary education physical education curriculum. The comprehensive adoption of these variations not only improves high school students' functional capabilities and enhances their enthusiasm for physical activities but also deepens their understanding of the objectives of physical culture, contributing to the broader objectives of the educational sphere. Future research should focus on defining a set of informative indicators and developing comprehensive means of enhancing motor skills and proficiency in basketball. This approach is expected to boost high school students' work capacity and foster increased interest in basketball and its derivatives. Keywords: physical capacity, basketball variations, high school students, physical education lesson.

Вплив тривоги і депресії на психічний стан здобувачів медичної освіти під час воєнного стану

Actuality. Long-term exposure to stressors associated with martial law hurts the mental state of the country's population. One of the risk groups is education seekers, for whom it is possible to sum up the stressful impact of education and other zonal factors. Earlier, in the example of countries in Africa, the Middle East and Kosovo, it was proven that the symptoms of anxiety and depressive disorders increased during military conflicts, particularly among medical students. The work aimed to study the symptoms of anxiety and depression in students of higher medical education at the Dnipro State Medical University and to determine their impact on the mental component of quality of life. Materials and methods: a four-fold one-moment cross-sectional survey questionnaire was conducted on the Google Forms platform. We interviewed 193 medical students of the Dnipro State Medical University. Data were collected after one, three, ten months and one year from the beginning of martial law. The level of anxiety was assessed using the generalized anxiety disorder scale (GAD-7), depression was assessed using the Patient Health Questionnaire (PHQ-9), and the mental component of quality of life was assessed using a self-administered questionnaire based on the VAS. Results. The median level of anxiety symptoms according to GAD-7 at the first stage of the study was 8 [5; 14] points with further reduction in the fourth stage to 5.5 [3.5; 7.5] points. The median level of depressive symptoms determined by PHQ-9 varies from 11 [6; 14] points after 1 month to 7.5 [4; 10] points 1 year after the start of martial law. Subjective assessment of working capacity in the subjects was 4 [3; 7] points for VAS with dynamics from 6 [4; 8] after 1 month of martial law, to 4.5 [4; 6] points after 1 year. According to the results of the correlation analysis, a relationship between indicators of anxiety, depression and the mental component of the quality of life was revealed. The correlation between anxiety and depression persisted as the duration of martial law increased, as did the relationship between anxiety and the mental component of quality of life at 1, 3, and 10 months of martial law. But after 12 months of martial law, anxiety ceases to affect the quality of life of the surveyed education seekers. Conclusions. Univariate and multiple logistic analyses were used to explore the psychometric characteristics that correlated with achieving a sufficient level of the mental component of quality of life. The combination of GAD-7 ≥ 10 and PHQ-9 ≥ 10 had the best predictive ability among the constructed models, for which the AUC was 0.777 (95% CI 0.711 – 0.834). By incorporating the ability to work into the model, we enhance its predictive power, resulting in an AUC of 0.844 (95% CI 0.785 – 0.892), which signifies its exceptional predictive capabilities. Thus, the presence of anxiety for GAD-7 more than 10 points increases the chances of not achieving quality of life by 2.885 (95% CI 1.167 – 7.133) times, the presence of depression for PHQ-9 more than 10 points – by 2.689 (95% CI 1.182 – 6.117) times, and subjectively reduced ability to work – 1.434 (95% CI 1.193 – 1.725) times.

Comprehensive Physical Work Capacity Evaluations for Korean Farmers Assessed in Healthy Volunteers.

To establish the lower limits of normative values of the physical work capacity for Korean farmers in healthy working individual. We developed a comprehensive set of physical work capacity evaluation items that encompass common farming tasks. These items include measurements of trunk flexion/extension angles, strength (hand grip, trunk flexion/extension, leg/back lifting, and pushing/pulling), and positional tolerances. We calculated the normative values for the items and defined the normal range in 124 healthy volunteers aged 20-79 years. We calculated the intraclass correlation coefficient (ICC) to validate the test-retest reliability of the measurements protocol. The normal values for each measurement item were as follows: trunk flexion and extension angle (65.3°±11.6° and 29.6°±6.6°), dominant hand grip strength (32.2±10.5 kgf), trunk flexion and extension strength (288.4±119.0 N and 297.3±129.9 N), leg and back lifting strength (452.9±233.5 N and 349.2±166.7 N), pushing and pulling strength (214.7±75.1 N and 221.7±63.3 N), and positional tolerance time (squat: 76.8±9.0 seconds, front: 73.8±7.7 seconds, twist: 82.2±8.8 seconds, upward: 71.9±11.3 seconds). Regarding test-retest reliability, all strength measurements demonstrated excellent absolute agreement (ICC, 0.91-0.96). However, positional tolerance showed poor-to-moderate absolute agreement (ICC, 0.37-0.58). We conducted measurements of muscle strength and positional tolerance in healthy participants of various ages, focusing on tasks commonly performed by Korean farmers. The outcomes hold significant value as they offer a pertinent instrument for assessing the appropriateness of workers, thereby carrying implications for rehabilitation objectives, legal evaluations, and work capacity assessments within the agricultural domain.

Towards a ‘Social Model’ of Mental Capacity for Social Work

Abstract The statutory social work role in England and Wales regularly involves assessment and ‘best interests’ decision making under the Mental Capacity Act (MCA) 2005. Legal frameworks that permit substitute decision making have, however, been challenged as a contravention of the human rights of people with disabilities. This article aims to answer the question: ‘Can mental capacity be theorised for social work assessment in England and Wales in a way that is compatible with social work ethics and values?’ Findings are that mental capacity is a complex and disputed concept best described using a constructivist ‘social model’ which situates it as a property of an individual’s relationships. Such a model suggests that assessments are a joint endeavour and that the quality of the relationship between assessor and assessed is crucial. The present legal framework disincentivises but does not prevent capacity assessment based on a social model. The existing literature suggests that further research might identify ways in which social work capacity assessment could enhance rather than diminish the autonomy of the people involved. These findings have implications for social work research, education and post qualification training.

Anthropometric features and functional state of the cardiovascular system in qualified athletes of various sports

Aim. To assess the anthropometric characteristics and functional state of the cardiovascular system in qualified athletes of various sports.Material and methods. A total of 136 male athletes were examined. Qualified athletes (n=116) (age, 22,07±4,10 years, sports experience 9,56±3,08 years) were divided into groups: I (n=30) — wrestling, judo, II (n=27) — cross-country skiing, biathlon, III (n=33) — powerlifting, IV (n=26) — volleyball. Control group (n=20) consisted of those training less than 3 years. We performed anthropometry with assessment of body height and weight, chest circumference, body surface area, body mass index (BMI), Pignet index, Erisman index, grip and back strength test. Echocardiography, cycle ergometry with assessment of physical working capacity (PWC170) and maximum oxygen consumption (MOC). The relationship between traits was assessed using the Spearman rank correlation coefficient (rs). Critical significance level was p=0,05.Results. According to echocardiography, qualified athletes had significant differences in structural parameters. Group II was characterized by an increase in left ventricular (LV) volumetric dimensions and identified correlations of BMI and body surface area with end-diastolic dimension (r=0,602), end-diastolic volume (r=0,591), end-systolic volume (ESV) (r=0,429), stroke volume (r=0,597), PWC170 (r=0,550). Groups I and III were characterized by an increase in LV posterior wall (LVPWT) and interventricular septal (IVST) thickness. In group I, there was a relationship between body surface area and LVPWT (r=0,413); Pignet index with MOC (r=0,623); PWC170 with Erisman index (r=0,573), strength of the right (r=0,610) and left hand (r=0,515), back muscles (r=0,445). Group III had the highest BMI and body surface area, while relationships were identified with LVPWT (r=0,426), IVST (r=0,409), LV mass (LVM) (r=0,453), and back muscle strength (r=0,464); the Erisman index correlated with LVM index (r=0,359). In group IV, the parameters of height, body weight and body surface area are interrelated with LVM (r=0,731), LVPWT (r=0,523), IVST (r=0,399), ESV (r=0,504), end-systolic dimension (r=0,467), right hand strength (r=0,583).Conclusion. The relationships established by correlation analysis showed that anthropometric features are important components and criteria for assessing cardiac hemodynamics function in qualified athletes, depending on the type of sport and the duration of training, which must be taken into account when achieving sports results.

Short-term functional outcome of distal femur fracture treated with locking compression plate

Abstract Background: Common modes of trauma for distal femur fractures are falls, sports injuries, and road traffic accidents, especially in older patients. Locking plates are a commonly used surgical intervention for these fractures, as they provide stability and promote fracture healing, allowing patients to regain function and early mobility. Compared with traditional compression plates, locking plates provide better construct and more excellent stability than screws locked and provide fixed angled construct. Aims and Objectives: To analyze the short-term outcome of distal femur fractures regarding pain relief, range of motion (ROM) at the knee joint, and radiological outcome after treatment with a locking compression plate. Materials and Methods: This prospective study involves 20 cases of fractures of the distal femur aged 18–80 years. All patients underwent open reduction and internal fixation using a locking plate. Functional and radiological outcomes were assessed using nominal effective exchange rate’s (NEER) scoring system as patients were followed up for 6 months. NEER’s scoring system evaluation includes pain, motion, walking capacity, work capacity, anatomy, and radiological assessment. Results: Radiological union was seen at the mean time of 18 weeks. On the final follow-up at 6 months, we noted ROM of more than 110° in 5 patients, 90°–100° in 11 patients, and 60°–90° in 4 patients. According to the NEER’s scoring system, patients with excellent results were 11 and satisfactory results were 6, whereas two patients went in failure in our study. Conclusion: Locking plate is an excellent option for treating the distal femoral fractures of both the articular and extra-articular types. Locking plates show an excellent outcome regarding fracture healing and patient satisfaction. However, potential complications such as infection, implant failure, malunion, and nonunion should be carefully considered and monitored.

Residual Work Capacity and (In)Ability to Work Fulltime Among a Year-Cohort of Disability Benefit Applicants Diagnosed with Mental and Behavioural Disorders.

Residual work capacity and inability to work fulltime are important outcomes in disability benefit assessment for workers with mental and behavioural disorders. The aim of this study is to gain insight into the prevalence and associations of socio-demographic and disease-related factors of these outcomes across different mental and behavioural diagnoses groups. A year cohort of anonymized register-data of patients diagnosed with a mental or behavioural disorder who claim a work disability benefit after two years of sick-leave was used (n = 12,325, age 44.5 ± 10.9, 55.5% female). Limitations in mental and physical functioning caused by disease are indicated according to the Functional Ability List (FAL). No residual work capacity was defined as having no possibilities to work, whereas inability to work fulltime was defined as being able to work less than 8h per day. The majority (77.5%) of the applicants were assessed with residual work capacity, of these 58.6% had an ability to work fulltime. Applicants diagnosed with (post-traumatic) stress, mood affective and delusional disorders showed significant higher odds for no residual work capacity and for inability to work fulltime, while other diagnoses groups, like adjustment and anxiety disorders, showed decreased odds for both assessment outcomes. The type of mental and behavioural disorder seems important in the assessment of residual work capacity and inability to work fulltime, as the associations differ significantly between the specific diagnoses groups.

Development of the core of an ICF-based instrument for the assessment of work capacity and guidance in return to work of employees on sick leave: a multidisciplinary modified Delphi study

BackgroundSeveral occupational health disciplines are involved in return to work guidance, implying that good interdisciplinary collaboration is important. A shared conceptual framework and a common language for the assessment of work capacity and guidance in return to work is expected to be at the benefit of appropriate and sustainable employability of sick employees. The International Classification of Functioning, Disability and Health (ICF) can be considered a shared conceptual framework and is also promising in terms of a common language. The purpose of the current study is to reach multidisciplinary consensus among occupational health professionals on the content of an ICF-based instrument for the assessment of work capacity and guidance in return to work.MethodsTo obtain multidisciplinary consensus we conducted a modified Delphi study among twelve occupational health experts, including four occupational physicians, four insurance physicians and four labour experts. The study included two e-mail rounds and two virtual meetings. In the consecutive rounds the experts assessed ICF items as well as a list of non-ICF-based work-related environmental factors on their relevance for the assessment of the work capacity and guidance in return to work together with their interpretability.ResultsThe four consecutive Delphi rounds resulted in 20 items that are minimally needed for the assessment of the work capacity and return to work possibilities of employees on sick leave. The final list included six items on personal functioning, seven items on social functioning and seven items on physical functioning.ConclusionsThis set of items forms the core of an ICF-based instrument, which is expected to facilitate interdisciplinary and intradisciplinary communication because of the use of a shared conceptual framework. As such, it should be of help in the guidance in return to work of employees on sick leave and contribute to appropriate and sustainable employability.

Linking of the 'Integration von Menschen mit Behinderungen in die Arbeitswelt' (IMBA) to the 'International Classification of Functioning, Disability and Health' (ICF).

The assessment of work capacity, workable work and the need for a common language is challenging in labour market policy. Being a specific instrument to facilitate Return To Work (RTW), the Integration von Menschen mit Behinderungen in die Arbeitswelt (IMBA) might facilitate the documentation of the individual's work capacity, the job-related workload and the match between these two elements. Since the International Classification of Functioning, Disability and Health (ICF) is worldwide recognized as frame of reference in RTW, this paper presents the linking of IMBA to the ICF, since this is assumed to be beneficial to support RTW. The establishment of the IMBA-ICF linking in order to study 1) the relationship between IMBA and ICF; 2) the content comparison of IMBA with work-related ICF core sets; and 3) the extent to which the linking addresses the challenges in RTW policy. A content comparison of IMBA and ICF was conducted, using a 7- step linking methodology in which the Delphi and Nominal Group Technique are integrated in the implementation of the ICF linking rules. An explorative conversion of the scoring systems of IMBA and ICF was established based on expert opinions. In the main 70 IMBA items, 107 concepts have been identified of which 94 were linked to 87 different ICF categories. Body functions and activities and participation are the most presented ICF components in contrast to the environmental factors. IMBA items regarding occupational safety and work organization are respectively 'not covered' and 'not defined' in ICF. An integration of IMBA and ICF addresses the challenges in RTW policy in the assessment of work capacity, workable work and the need for a common language. In order to do so, extension of ICF terminology regarding 'occupational safety' and 'work organization' is priority. In depth quantitative research is necessary to support the conversion of both scoring systems.

Oncologists' experiences of and prerequisites for sickness certification tasks: A nationwide questionnaire study.

To investigate oncologists' experiences of organisational prerequisites for SC tasks, and if lack of resources was related to experiencing SC as problematic. Questionnaire data from 342 oncologists in Sweden were used for descriptive statistics and to calculate odds ratios (OR) with 95% confidence intervals (CI). The majority (92.2%) had SC consultations weekly; 17.8% of the oncologists experienced such consultations as problematic weekly. About a third appreciated the national guidelines for SC (34.5%) and had joint routines/policies regarding SC at their clinic (29.7%). Experiencing SC consultations as problematic was associated with stating not having enough resources for such work (OR 3.47; 95% CI 1.92-6.25). Lack of resources was associated with: experiencing lack of competence in insurance medicine (3.34; 1.92-5.82), conflicts with patients regarding SC (4.22; 1.96-9.07), finding it problematic to manage the two roles as medical expert and as the patient's treating physician (3.31; 2.04-5.34), or to assess work capacity (2.28; 1.46-3.56). Although oncologists often had SC tasks, most did not experience them as problematic weekly. However, lack of resources for SC tasks was associated with experiencing SC as problematic.

Evidence needs, training demands, and opportunities for knowledge translation in social security and insurance medicine: A European survey.

ObjectiveTo perform a European survey of the evidence needs and training demands of insurance medicine professionals related to professional tasks and evidence-based practice.DesignInternational survey.SubjectsProfessionals working in insurance medicine.MethodsExperts designed an online questionnaire including 26 questions related to 4 themes: evidence needs; training demands; evidence-seeking behaviour; and attitudes towards evidence-based medicine. Descriptive statistics were presented by country/conference and the total sample.ResultsA total of 782 participants responded. Three-quarter of participants experienced evidence needs at least once a week, related to mental disorders (79%), musculoskeletal disorders (67%) and occupational health (65%). Guidelines (76%) and systematic reviews (60%) were the preferred types of evidence and were requested for assessment of work capacity (64%) and prognosis of return-to-work (51%). Evidence-based medicine was thought to facilitate decision-making in insurance medicine (95%). Fifty-two percent of participants felt comfortable finding, reading, interpreting, and applying evidence. Countries expressed similar needs for reviews on typical topics.ConclusionThis study reveals evidence gaps in key areas of insurance medicine, supporting the need for further research, guidelines and training in evidence-based insurance medicine. Importantly, insurance medicine professionals should recognize that evidence-based practice is crucial in producing high-quality assessments.LAY ABSTRACTEvidence-based medicine (EBM) means the consideration of research findings when taking decisions in clinical medicine. This approach has become standard in health and social care. Since it is less clear to what degree EBM is applied in insurance medicine, European insurance physicians performed a joint survey among colleagues in 8 countries and 2 conferences. More than 700 professionals participated. Half of respondents experienced a need at least once a week to look for guidelines and systematic reviews about work capacity assessments related to mental or musculoskeletal disorders. Almost all thought that EBM would facilitate decision-making. Not all felt competent in finding, reading, interpreting, and applying research evidence. Overall, findings were similar across countries. These results illustrate important evidence gaps in insurance medicine, supporting the need for further research and guidelines. Importantly, professionals should recognize that evidence-based practice is crucial in producing high-quality assessments.

Increased body mass index: what is the influence on ventilatory muscular strength?

Introduction: Ventilatory muscle strength (VMS) and anatomical/biological factors are important in the functioning and maintenance of body homeostasis. Thus, the study of respiratory mechanics and conditions that can alter them is fundamental. Studies indicate that obesity decreases the Maximum Inspiratory Pressure (MIP) and Maximum Expiratory Pressure (MEP), however, these studies are contradictory in their results. Objective: To verify if there is a difference between the VMS of obese and eutrophic individuals. Methods: Comparative observational study, in which 40 individuals of both sexes were evaluated, divided into two groups: 20 individuals with grade I obesity and 20 eutrophic individuals. Abdominal circumference was considered to be > 102 cm for men and 88 cm for women. Two-way unpaired Student's t-test was applied to compare the Maximum Inspiratory Pressure (MIP) and Maximum Expiratory Pressure (MEP) of the evaluated groups. The BioEstat 5.0 program was used and a p ˂ 0.05 was adopted as significant. Results: The mean MIP for obese and eutrophic individuals was 147 ± 73 vs 145 ± 70 cmH2O, respectively (p = 0.91). For MEP, the mean for the obese and eutrophic group was 133 ± 28 vs 135 ± 27 cmH2O, respectively (p = 0.93). Conclusion: Sedentary individuals with grade I obesity associated with increased waist circumference do not differ in MIP and MEP when compared to eutrophic individuals.Keywords: obesity, work capacity assessment, functional physical performance.

Work capacity assessments and efforts to achieve a job match for claimants in a social security setting: an international inventory

Purpose Many high-income countries are witnessing a shift of focus on eligibility for disability benefits towards promotion of work reintegration. However, little is known about how countries assess work capacity, and how a job match is then obtained. The current study aims to compare work capacity assessments and available efforts to achieve a job match in eight high-income OECD countries. Methods A survey was conducted among key stakeholders concerning organization of work capacity assessments in social security settings, and efforts made to obtain a job, across eight OECD countries: Australia, Denmark, Finland, Iceland, Sweden, the Netherlands, the United Kingdom and the United States. Results In most countries, work capacity is assessed at several time points, with variations in moments and in information used for job matching. In countries obtaining information on personal and work levels, the search to find a job match usually begins with the persons who have disabilities. Conclusion Although a shift towards a holistic focus in work capacity assessment has been recognized, medical factors still prevail. Limited emphasis is placed on the implications of functional limitations for the possibilities of work. A holistic approach to assessment needs to be coupled with holistic support measures through provision of coordinated and high quality job matching services. IMPLICATIONS FOR REHABILITATION Besides determining eligibility for benefits the outcome of the work capacity assessment can also be used for other purposes such as reintegration and should not result in a static description of work capacity but also deliver insight in support needs. Involving multiple institutions and disciplines in work capacity assessments may result in a broader overview of the claimants’ capacities, however this places high demands on cooperation and data sharing of all those involved. Incorporating the claimants own perspective on work capacity and possibilities to work might improve the legitimacy of the process and reasonably also the achievement of a good and sustainable job match. This can be achieved by using self reported questionnaires and interviews in the assessments.

A Thirteen-Year-Old Girl with Cornelia de Lange Syndrome – The First Case Described in Litigation

AIM: The aim of this paper is to accentuate importance of the expert witness role, occupational medicine specialist, in litigation. The OM specialist proved his importance in broad spectrum of administrative court proceedings, assessment of working capacity, and different type of claims.
 CASE REPORT: Here is presented a case of a 13-year-old girl suffering Cornelia de Langue syndrome. The occupational medicine specialist concludes that the girl’s claim toward the Ministry of Demography, Family and Social Affairs is legitimate. Expert witness representing the above ministry came to conclusion that the patient is not heavily disabled due to her mobility and regular school attendance. Due to hearing aid her hearing is satisfactory and she is capable of dressing and feeding herself. In 2012, the girl was diagnosed with Langer-Giedion syndrome 8q23.3-q24.13 deletions and due to the development of molecular diagnosis only in 2015 RAD 21 gene deletion was discovered and she was correctly diagnosed. On examination, occupational medicine specialist found the patient suffering heavy deformations of locomotor system, small hands and feet, genua valga, and flat feet. The hearing is severely impaired in right and moderately in her left ear. Her mother states that she stopped soiling bed at the age of 8 and at present when going to toilette during night she becomes disoriented, sleeps badly, and screams. In the morning, she is not capable of preparing her own food. The patient needs to be examined by endocrinologist, her body is covered in exostoses and she heavily depends on other people.
 CONCLUSION: The patient is heavily disabled and in need of help for essential functioning at least until completion of secondary education.

Content Validation of a Practice-Based Work Capacity Assessment Instrument Using ICF Core Sets

PurposeA shift from providing long-term disability benefits to promoting work reintegration of people with remaining work capacity in many countries requires new instruments for work capacity assessments. Recently, a practice-based instrument addressing biopsychosocial aspects of functioning, the Social Medical Work Capacity instrument (SMWC), was developed. Our aim was to examine the content validity of the SMWC using ICF core sets.MethodsFirst, we conducted a systematic search to identify relevant ICF core sets for the working age population. Second the content of these core sets were mapped to assess the relevance and comprehensiveness of the SMWC. Next, we compared the content of the SMWC with the ICF-core sets.ResultsTwo work-related core sets and 31 disease-specific core sets were identified. The SMWC and the two work-related core sets overlap on 47 categories. Compared to the work-related core sets, the Body Functions and Activities and Participation are well represented in the new instrument, while the component Environmental factors is under-represented. Compared to the disease-specific core sets, items related to the social and domestic environmental factors are under-represented, while the SMWC included work-related factors complementary to the ICF.ConclusionThe SMWC content seems relevant, but could be more comprehensive for the purpose of individual work capacity assessments. To improve assessing relevant biopsychosocial aspects, it is recommended to extend the instrument by adding personal and environmental (work- and social-related) factors as well as a more tailored use of the SMWC for assessing work capacity of persons with specific diseases or underlying illness.

Assessing work capacity \u2013 reviewing the what and how of physicians\u2019 clinical practice

BackgroundAlthough a main task in the sickness certification process, physicians’ clinical practice when assessing work capacity has not been thoroughly described. Increased knowledge on the matter is needed to better understand and support the certification process. In this review, we aimed to synthesise existing qualitative evidence to provide a clearer description of the assessment of work capacity as practiced by physicians.MethodSeven electronic databases were searched systematically for qualitative studies examining what and how physicians do when they assess work capacity. Data was analysed and integrated using thematic synthesis.ResultsTwelve articles were included. Results show that physicians seek to form a knowledge base including understanding the condition, the patient and the patient’s workplace. They consider both medical and non-medical aspects to affect work capacity. To acquire and process the information they use various skills, methods and resources. Medical competence is an important basis, but not enough. Time, trust, intuition and reasoning are also used to assess the patient’s claims and to translate the findings into a final assessment. The depth and focus of the information seeking and processing vary depending on several factors.ConclusionThe assessment of work capacity is a complex task where physicians rely on their non-medical skills to a higher degree than in ordinary clinical work. These skills are highly relevant but need to be complemented with access to appropriate resources such as understanding of the associations between health, work and social security, enough time in daily work for the assessment and ways to better understand the patient’s work place. Also, the notion of an “objective” evaluation is questioned, calling for a greater appreciation of the complexity of the assessment and the role of professional judgement.

Work capacity assessments – reviewing the what and how of physicians’ clinical practice

Abstract Background Although a main task in the sickness certification process, physicians’ clinical practice when assessing work capacity has not been thoroughly described. Increased knowledge on the matter is needed to support a better and more reliable certification process. In this review, we aimed to synthesise existing evidence to provide a clearer description of the work capacity assessment as practiced by physicians. Methods Seven electronic databases were searched systematically for qualitative studies examining what and how physicians do when they assess work capacity. Data was analysed and synthesised using qualitative manifest content analysis. Results Twelve articles were included in the review. Results show that physicians seek to form a knowledge base including understanding the condition, the patient and the patient’s workplace. They consider both medical and non-medical aspects to affect work capacity. Accordingly, to acquire and process the information they use both medical and non-medical skills, methods and resources. Medical competence is an important basis, but not enough. Time, trust, intuition and reasoning are also used to assess the patient’s claims and to translate the findings into a final decision. The depth and focus of the information seeking and processing vary depending on several factors. Conclusions The work capacity assessment is a complex task where physicians rely on their non-medical skills to a higher degree than in ordinary clinical work. These skills are highly relevant but need to be complemented with methods to better understand the patient’s work place, as well as theoretical knowledge regarding the intricate associations between health, work and social security. This would further enhance physicians’ competence and confidence, and promote better experiences and practices of the work capacity assessment. Key messages In the complex task of assessing work capacity physicians rely on their non-medical skills to a higher degree than in ordinary clinical work. A better understanding of the patient’s work situation and the intricate associations between health, work and social security would enhance physicians’ competence and promote better assessments.

Creating national guidelines for assessing functional and work capacity of recently settled persons

Abstract Problem The measurement of functioning in clinical practice should be systematic and comprehensive. However, different versions of the same functioning measure are used e.g. by physicians, psychologists, physiotherapists and occupational therapists. The TOIMIA network of experts aims to harmonize and develop the measuring of functioning in Finland. Description of the problem With increasing immigration to Finland, a specific need for guidelines on how to assess functional and work capacity of recently settled persons was identified. Led by the National Institute for Health and Welfare (mobiTARMO-project, 2017-2020), guidelines for assessing functional and work capacity in the integration phase are in preparation. Results The guidelines on assessing functional and work capacity in the integration phase include four principles: Functional and work capacity assessment should be done with culturally and linguistically appropriate methods.Assessment should be based on shared expertise of the professional and the client.Assessment should be comprehensive, and take into consideration physical, psychological, social and cognitive functional capacity, activities of daily living, and environmental factors.Assessment should be systematic and lead to further actions and necessary services.The national guidelines will be disseminated as free online access material in the Terveysportti health portal to professionals in clinical practice and research. Lessons There are specificities to the cross-cultural assessment of functional and work capacity of recently settled persons. National guidelines can be created through broad collaboration of different organizations, as in the TOIMIA network of experts in Finland. Key messages Jointly agreed principles on how to assess functional and work capacity in the integration phase benefit professionals and clients. National guidelines can be created, disseminated and taken into practice through broad collaboration.

The results of medical and psychophysiological examination performed during an arctic world oceanic international flight

Background: The development of the Arctic region is connected with extreme and strenuous work conditions and transmeridian shifts. The resulting stress changes the functional state of involved professionals irrespective of their age. Successful performance of job tasks depends on individual adaptation, which is an urgent issue to be studied with modern research methods.
 Aims: The study was a complex research project on adaptation and changes of cardiovascular and psychophysiological functioning in response to long-term stress associated with rapid climate changes and transmeridian shifts experienced by the participants of the Arctic World Oceanic International Flight Sever Vash.
 Materials and methods: The participants of Sever Vash expedition, which took place in July and August 2018, were examined. According to the design of the study, they underwent a complex laboratory and instrumental assessment before the start and immediately on the finish. Blood parameters, level of DNA damage in blood cells, cardiovascular parameters (heart rate, brachial and aortic blood pressure (BP), subendocardial blood flow etc.), allostatic load index (ALI), and data of psychophysiological tests with work capacity assessment were analyzed.
 Results: All participants (7 males, 3969 y.o.) completed the planned route. The actual duration of the flight was 43 days. Comparative pairwise analysis on the finish revealed an increase of total blood protein (p0.000), creatinine (p0.000), bilirubine (p=0.038) and AcAT (p=0.031), and glucose (p0.000) levels, and shifts in peripheral blood parameters, which are typical for the process of adaptation to the Polar conditions and transmeridian shifts. An increase of DNA damage in white blood cells was found. Average values of hemodynamic parameters were in a normal range; heart rate increased (p0.000); mean brachial BP (p=0.003) and systolic aortic BP (p=0.001) decreased. Average values of pulse BP and subendocardial blood flow did not change (p0.05). ALI increased in four pilots; in others, no ALI dynamic was observed. Psychophysiological potential decreased after the flight. The number of errors and omissions of target signal (р0.000) increased, attention span and emotional stability deteriorated. Along with this, the mood parameter increased to a maximum level, and risk tolerance level decreased (р0.001).
 Conclusions: Working in Arctic conditions is connected with stress factors and leads to multiple and deep changes required for urgent adaptation. Allostatic load index, which is an integral parameter of strained functioning in extreme conditions, can be a marker of individual adaptation. The achieved functional stability of body systems, particularly the cardiovascular system, ensures an acceptable level of work capacity in the considered conditions.