Reduced Work Capacity Research Articles

Lessons Learned by Rehabilitation Counselors and Physicians in Services to COVID-19 Long-Haulers: A Qualitative Study

Coronavirus disease (COVID-19) may cause long-lasting adverse consequences after acute recovery, including functional limitations and reduced work capacity. Individuals with long-lasting complications of COVID-19 are known as long-haulers. There is a knowledge gap on how COVID-19 complications affect return-to-work (RTW) efforts. We aimed to describe the challenges that long-haulers encounter when returning to work from the perspectives of rehabilitation professionals. In this study, four certified rehabilitation counselors and four rehabilitation physicians in U.S. outpatient rehabilitation centers participated in focus groups. Participants discussed challenges in working with long-haulers, including personal attributes, post–COVID-19 symptoms and complications, uncertain recovery and unpredictable outcomes, limited health care accessibility and support, and unsupportive work environments. Participants provide individualized services to meet long-haulers’ diverse needs as they do for all persons with disabilities, although they expressed uncertainty due to the variable disease course and risk of infection. Modifying workplace policies, especially gradual RTW, were frequently mentioned accommodations. The findings highlight the RTW issues of long-haulers. We provide recommendations on increasing awareness of the challenges and job accommodations of long-haulers.

Exercise-Based Cardiac Rehabilitation: Secondary Data Analyses of Mortality and Working Capacity in Germany, 2010\u20132017

BackgroundExercise-based cardiac rehabilitation is safe and implemented in international cardiac rehabilitation guidelines. Evidence for long-term health effects is scarce and rare for health care service research.ObjectiveThe aim of this study is to evaluate the effectiveness of exercise-based phase III cardiac rehabilitation programs in improving mortality and working capacity outcomes.MethodsThe present analyses used claims data of the German pension fund from 2010 to 2017. Overall, 54,163 patients with coronary heart disease (ICD10 I20.–I25.) were included and followed up for exercise-based cardiac rehabilitation participation (mean 4.3 ± 1.9 years). All patients were categorized according to participation duration (long: ≥ 90 days, short: < 90 days, no). The effectiveness of exercise-based rehabilitation was analyzed by calculating adjusted hazard ratios for mortality and reduced working capacity in relation to program participation.ResultsOf all the cardiac patients, 57.6% received medical recommendations for exercise-based phase III rehabilitation, and 16.8% participated in this rehabilitation. In total, 1776 (3.3%) patients died during the study period, and 3050 (5.5%) received reduced earning capacity pensions. Mortality risk was nearly doubled for those who did not participate in exercise-based cardiac rehabilitation compared to those who participated for a long duration (HR 1.97, 95% CI 1.60–2.43) and 44% higher compared to a short participation (HR 1.44, 95% CI 1.03–2.01). Furthermore, the risk of reduced working capacity was higher for those who did not participate compared to those who participated for a short duration (HR 1.24, 95% CI 1.00–1.54).ConclusionExercise-based phase III cardiac rehabilitation is independently associated with reduced mortality and reduced loss in working capacity. Strong efforts should be made to increase participation rates to improve cardiac patients care.

Lumbar spinal fusion surgery outcomes in a cohort of injured workers in the Victorian workers' compensation system.

Lumbar spinal fusion (LSF) outcomes for workers' compensation patients are worse than for the general population. The objectives were to examine the long-term work capacity, opioid prescription and mental health outcomes of injured workers who have undergone LSF surgery in Victoria, Australia, and to identify demographic and pre- and post-operative characteristics associated with these outcomes. Retrospective study of 874 injured workers receiving elective LSF from 2008 to 2016 in the Victorian workers' compensation system. WorkSafe Victoria's claims data were used to infer outcomes for recovery. Association of demographics, pre-surgery and surgery variables with outcomes were modelled using multivariate multinomial logistic regression analyses. Twenty-four months after LSF surgery, 282 (32.3%) of the 874 injured workers had substantial work capacity, 388 (44.4%) were prescribed opioids, and 330 (37.8%) were receiving mental health treatment. Opioid prescription and limited work capacity before surgery were independent strong predictors of opioid prescription, reduced work capacity and mental health treatment 24 months after LSF. Pre-operative mental health treatment was associated with the use of mental health treatment at 24 months. Other predictors for poor outcomes included a greater than 12-month duration from injury to surgery, LSF re-operation and common law or impairment benefit lodgement before surgery. An association between pre-operative factors and post-operative outcomes after LSF in a Victorian workers' compensation population was identified, suggesting that pre-operative status may influence outcomes and should be considered in LSF decisions. The high opioid use indicates that opioid management before and after surgery needs urgent review.

A Cross-Provider Healthcare Management Program for Musculoskeletal Disorders: Results of a Randomized Controlled Trial in 22 German Companies.

Musculoskeletal disorders (MSDs) are among the most common cause for reduced work capacity and sick leave. Workplace health promotion programs are often neither tailored to the workplace nor the individual needs of the employees. To counteract lacking intersectional care, this four-year randomized controlled trial (RCT) aimed to investigate the effects of modular coordinating case management (treatment group) compared to supported self-management (control group) on MSD specific sick leave days (routine data), workability (WAI), self-efficacy (self-efficacy scale), and pain (German pain questionnaire, GPQ). The study network comprised 22 companies, 15 company health insurance funds, and 12 pension funds in Germany. Overall, 852 participants (Module A/early intervention: n = 651, Module B/rehabilitation: n = 190, Module C/reintegration: n = 10) participated. Both groups achieved fewer sick leave days, higher workability, and less pain (p < 0.0001) at follow-up compared to baseline. At follow-up, the coordinating case management group showed fewer disability days (GPQ), lower disability scores (GPQ), and lower pain intensities (GPQ) than the supported self-management group (p < 0.05), but no superiority regarding MSD specific sick leave days, workability, nor self-efficacy. Module A showed more comprehensive differences. The accompanying process evaluation shows barriers and facilitators for the implementation of the program, especially in a RCT setting.

Managers’ experience-based understanding of capacity to work in workers with common mental disorders

Abstract Background The capacity to work among workers with common mental disorders (CMD) is important to understand but scarcely explored from a manager perspective, even though their views could add essential knowledge. The aim of this study was to explore and describe managers' experience-based understanding of capacity to work in individuals with CMD. Methods This qualitative focus group study used inductive manifest content analysis as analytic technique. First-line managers with experiences of employees with CMDs were recruited via organizations and networks. Eight focus group interviews with altogether 31 participants were performed. Results The analysis resulted in five categories of managers' experience-based understanding of occupational functioning in workers with CMDs: (1) The capacity to mentally focus on work tasks decreases or disappears, with negative consequences for work output. (2) The capacity to commit to continuous and coherent tasks changes, making tasks that span over longer periods of time difficult. (3) The capacity to independently adapt to the needs of the situation decreases, causing the worker to need more guidance and instructions than usual. (4) The capacity to keep up professional appearances is reduced, meaning that the worker struggle with the professional role. Finally, (5) the ability to interact socially and professionally decreases, which potentially causes conflicts at the workplace. Conclusions This study shows managers' experience-based understanding of CMDs in workers as severe changes and reductions of employees' capacities needed for occupational functioning. These findings add to the understanding of the construction of the capacity at the workplace. A deeper understanding of reduced work capacity is also needed to adapt workplaces and our findings can facilitate work accommodations for employees with CMDs. Key messages This study adds a manager perspective to the increasing knowledge about how capacity to work is influenced by CMD. This study shows that managers experience that CMD in workers severely change and reduce employees’ capacities needed for occupational functioning.

Investigation of the reduction in the disability after fractures in children and adolescents

The student accident insurance has been part of the German Statutory Accident Insurance (Deutsche Gesetzliche Unfallversicherung, DGUV) for 50years. In order to assess the reduction in working capacity (Minderung der Erwerbsfähigkeit, MdE) in the event of permanent consequences of accidents and injuries, the recommendation to treat the affected child or adolescent "as an average adult" is currently still valid. The present work deals with the everyday practice of the MdE assessment in children and adolescents and their weaknesses through the transfer of the principles from adulthood. In addition, proposals for the adaptation of the assessment principles for the growth age are drawn up.

ГЕОЭКОЛОГИЧЕСКАЯ ОЦЕНКА РИСКА БИОЛОГИЧЕСКОГО ЗАГРЯЗНЕНИЯ ТЕРРИТОРИИ РЕСПУБЛИКИ БАШКОРТОСТАН ПО ПРИРОДНО-ОЧАГОВЫМ ФАКТОРАМ

The high significance of the problem of hemorrhagic fever with renal syndrome (HFRS) is associated with the scale of spread, damage to persons of active age, a long period of reduced working capacity and high economic damage. The work presents an assessment of biological contamination by natural - focal viral infection - HFRS in the Re-public of Bashkortostan (RB). The most active foci are associated with linden forests, which prevail in the republic. The work shows the dynamics and features of infection. Analysis of the geoecological state of the territory according to HFRS showed that in the territory of most regions of the republic there are natural-focal infections of HFRS. There is an increase in infection of rodents with the HFRS virus, so in 2016 it was 5.0 %, and in 2019 - 16.2 %. The increase in the incidence of the population has characteristic epidemiological signs for the territory of RB, and the increase in high-risk areas indicates trends in the expansion and activation of foci of infection in them. At the same time, there is an increase in incidence, and infection in 50 % of cases occurs when visiting forests. In the capital of Bashkortostan - the city of Ufa, which is located in the natural zone, the incidence of HFRS is almost 50 % of the entire territory of the republic. In connection with climate changes, the diversity of environmental aspects of natural-focal infection of HFRS should be more widely assessed to counter their spread and measures to reduce this dangerous disease in the RB should be significantly strengthened.

The essence and problems of the motivation system at the stage of formation of modern specialists of humane professions

Annotation. The article is devoted to the problems of motivation of modern specialists of humane professions at the stage of their formation. The most humane profession of humanity is the profession of a doctor. Therefore, the purpose of the article was to study the essence of motivation of medical staff of medical institutions of Ukraine, to determine the problem of managing the system of incentive of medical staff, to generalize and systematize the stages of designing stimulation of medical workers of medical institutions. Materials and methods of research were the analysis of domestic and foreign scientific sources, logical-theoretical procedure; method of system analysis and union; method of generalization (to study the quality of work of medical staff and identify problematic aspects of increasing work motivation). An anonymous survey on the motivation of professional activity of medical workers according to the method of K. Zamfir in the modification of A. Rean and a study on the practice of A. Leonov, S. Velichkovska on the differential assessment of the reduced working capacity of medical workers. Thus, the essence of motivation of medical staff of medical institutions of Ukraine was investigating, problems of management of system of inducement of medical staff are defined, stages of designing of stimulation of medical staff of medical institutions are generalized and systematized. To ensure quality management of motivation of medical staff of the medical institution, the manager must identify and eliminate the causes that negatively affect the reduction of stimulation for successful activities of medical staff and make timely and informed management decisions.

Особливості ураження підшлункової залози на фоні гастродуоденальної патології, асоційованої з H.pylori-інфекцією

Актуальність. Останнім часом з’явились публікації про можливий вплив Нelicobacter pylori (Н.pylori) не лише на слизову оболонку шлунка чи дванадцятипалої кишки, а й на підшлункову залозу. Такий зв’язок теоретично можливий, зважаючи на тісні взаємозв’язки між шлунком, дванадцятипалою кишкою та підшлунковою залозою. Мета дослідження. Визначити частоту й особливості поєднаного ураження підшлункової залози та верхніх відділів шлунково-кишкового тракту, асоційованого з H.рylori-інфекцією у дітей. Матеріали та методи. Проведено ретроспективний аналіз медичної документації 684 дітей, які перебували на стаціонарному лікуванні в гастроентерологічному відділенні Чернівецької обласної дитячої клінічної лікарні в період 2010–2016 рр. Комплексне обстеження включало ультразвукове дослідження органів черевної порожнини, фіброгастродуоденоскопію, визначення активності α-амілази сироватки крові, діастази сечі, оцінку копрограми. Для діагностики H.pylori використано тест-систему «ХЕЛИК-тест» «АМА» (Росія, м. Санкт-Петербург) та гістологічний метод (забирали біоптати з фундального та антрального відділів слизової оболонки шлунка, після забарвлення за методом Гімзи гістологічних зрізів проводили візуалізацію H.рylori за допомогою світлової мікроскопії). Використовували методи описової статистики при параметричному розподілі з оцінкою середнього значення показників і стандартного відхилення (М ± SD). Вірогідність відмінностей оцінювали за допомогою t-критерію Стьюдента для незалежних вибірок. Результати. Серед обстежених дітей було 310 (45,3 %) хлопчиків і 374 (54,7 %) дівчинки віком від 6 до 18 років. Найбільш часто серед обстежених дітей реєструвався діагноз хронічного гастродуоденіту (420 осіб з 684 проаналізованих, 61,4 %). При цьому достатньо високою залишається кількість дітей, які мають ерозивно-виразкові ураження шлунка і дванадцятипалої кишки (157 осіб з 684 обстежених, 22,9 %). Інфікування H.pylori серед групи обстежених дітей у середньому становило 64,5 %. Найбільш часто H.pylori виявлялася у дітей, хворих на виразково-ерозивні ураження верхніх відділів шлунково-кишкового тракту (121 особа із 157 проаналізованих, 77,1 %). Більше ніж у половини пацієнтів (352 із 684 обстежених, 51,5 %) із гастродуоденальною патологією в патологічний процес додатково була залучена підшлункова залоза. У 56,8 % осіб, які мали поєднане ураження, виявлено позитивний тест на H.pylorі. Найбільш часто H.pylorі виявлялася у пацієнтів з ерозивно-виразковими ураженнями верхніх відділів шлунково-кишкового тракту та ураженнями підшлункової залози (92 особи із 119 проаналізованих, 77,9 %). Інтенсивніший больовий синдром спостерігався в пацієнтів із H.pylori-позитивним тестом і становив 5,1 ± 1,2 бала, тоді як при негативному тесті на H.pylori середній бал болю становив 2,8 ± 1,0 (при р &lt; 0,05). Прояви церебрастенічного синдрому (головокружіння, втома, сонливість, порушення сну, зниження працездатності, загальна слабкість) переважали в дітей, у яких виявили H.pylori. Збільшення розмірів підшлункової залози було у третини хворих, змінена ехогенність — у 28,8 %, нечіткість контурів залози — у 23,6 % осіб. Підвищення активності α-амілази сироватки крові було виявлено у 44,8 % хворих. Змінений рівень діастази сечі спостерігався у 90 (45,4 %) інфікованих пацієнтів та у 36 (23,3 %) неінфікованих (р &lt; 0,01). За результатами копрологічного дослідження виявлено зміни у 130 із 352 дітей (36,9 %), а саме: стеаторея відзначена у 27,4 %, креаторея — у 22,6 %, крохмаль у великій кількості — у 12,9 %, слиз — у 9,6 %, йодофільну та грибкову флору виявлено відповідно у 16,1 та 18,5 % дітей. Висновки. Понад половину дітей із гастродуоденальною патологією, за даними ретроспективного аналізу, мають порушення екзокринної функції підшлункової залози, що виявляються при застосуванні загальноприйнятих клініко-лабораторних та інструментальних методів дослідження. При H.рylori-асоційованій патології верхніх відділів шлунково-кишкового тракту такі порушення реєструються частіше, у клінічній картині переважає больовий та церебрастенічний синдроми, особливо при ерозивно-виразкових ураженнях слизової оболонки гастродуоденальної зони. Це диктує необхідність поглибленого вивчення функції підшлункової залози у дітей із H.рylori-асоційованою патологією гастродуоденальної зони.

Heterogeneous Impacts of Body Mass Index on Work Hours.

This study examined how higher body mass index (BMI) affects the work hours of men and women and how the impact varies by gender and the value of BMI. Using a longitudinal dataset of 1603 British adults (men: n = 775; women: n = 828) and a panel threshold regression model, this study estimated that BMI has significant impacts on work hours but the pattern is different by gender and BMI groups. BMI is positively associated with work hours up to the estimated BMI threshold of 30, which corresponds to the clinical cutoff point of obesity; above this point, additional increases in BMI is associated with reduced work hours. The asymmetric nonlinear relationship between BMI and work hours was more evident among women, particularly female low-skilled workers. The results imply reduced work capacity and lower labor income for women with a higher BMI above an obesity threshold, highlighting a practical role of BMI’s obesity cutoff value. The findings of this study provide a new perspective regarding the economic burden of workplace obesity and point out the need to design gender-specific and BMI-based strategies to tackle productivity loss from obesity.

Worker protection at the intersection of the COVID-19 pandemic and climate change: lessons learned through industry partnership

BACKGROUND AND AIM: The Center for Health, Work &amp; Environment began a collaborative project to address Total Worker Health® (TWH) with a Latin American sugarcane agribusiness. TWH is an approach which integrates hazard protection with promotion of injury and illness prevention. TWH strategies are especially relevant when addressing a complex mix of occupational, environmental, social, and personal risk factors that impact health, such as those related to climate change. Climate change has increased the risk to workers’ health and safety. Workers are at increased risk of heat-related disorders, occupational injuries and illnesses, and reduced work capacity. METHODS: The CHWE conducted a TWH needs assessment across all levels of the organization, in Guatemala, Nicaragua and Mexico. The assessment was conducted through in person and online Employee Health and Safety Culture surveys, Employee Health Risk Assessments, a Leadership Self-Assessment, as well as through semi-structured interviews and focus groups with top leaders and managers at the company. RESULTS:We will present preliminary results of the needs assessment. The priority areas identified were 1) chronic disease prevention &amp; management, 2) sleep hygiene, and 3) stress management and mental health. This collaboration aimed to address climate-related hazards such as heat stress and dehydration, while also evaluating and addressing other risks including chronic disease, fatigue, stress and mental health that have been further exacerbated by the COVID-19 pandemic. CONCLUSIONS:This project represents one of the first examples of international TWH in practice within the agricultural industry. Workers face both new and existing risks that require an integrated approach to protect health, safety and well-being to address the dual crisis of climate change and a global pandemic. TWH programs, policies and practices can be utilized and adapted by employers to meet the health, safety and well-being needs of workers. KEYWORDS: Climate, Occupational exposures, International collaboration, Health co-benefits, Mental health outcomes

Effects of ambient temperature on maternal behaviour and health-related functioning in Burkina Faso

BACKGROUND AND AIM: High ambient temperature is associated with reduced work capacity, disrupted sleep, and increased anxiety, which may impact on maternal caregiving behaviours and health-related functioning. We explored the effects of heat on normal daily activities and wellbeing in a cohort of pregnant and postpartum women in southern Burkina Faso. METHODS: We undertook secondary analysis of data collected during structured interviews with 868 pregnant and postpartum women (aged 14–47 years), on 3 occasions (between November 2013 and November 2014), in the commune of Bobo-Dioulasso. Temperature data for Bobo-Dioulasso were obtained from Tutiempo.net. Multilevel linear regression models were used to estimate the effects of daily mean temperature on women’s sleeping behaviour, mental health (Kessler Psychological Distress Scale), and time spent (minutes per typical day) on professional, household, social, and caregiving activities. Models were stratified by residential area (urban/rural), and controlled for season, pregnancy history, marital status, number of infants born, infant status (alive, absent, dead) and/or age, where appropriate. RESULTS:The population experienced year-round high temperatures (intra-annual range: 23.2℃ - 33.7℃). With every 1℃ increase in daily mean temperature, exclusive breastfeeding decreased by 2.0 minutes per day (95% CI -4.3 to 0.3), family care decreased by 1.9 minutes per day (-4.1 to 0.2), and childcare increased by 0.5 minutes per day (-0.04 to 1.0). Associations were statistically significant at the 10% level. We found no evidence of association between temperature and time spent on professional or social activities, housework, sleeping, or mental health. Temperature-outcome associations did not differ between urban and rural settings. CONCLUSIONS:This study suggests that very high temperatures may not limit work-related behaviours when individuals have little option to rest. As infants become thirstier in hot weather, it is concerning that they may be breastfed for a shorter duration when temperatures rise. KEYWORDS: Temperature, Female, Outcomes, Mental health outcomes

Complaints and clinical findings six months after COVID-19: outpatient follow-up at the University Medical Center Freiburg

Increasing evidence suggests that some patients suffer from persistent symptoms for months after recovery from acute COVID-19. However, the clinical phenotype and its pathogenesis remain unclear. We here present data on complaints and results of a diagnostic workup of patients presenting to the post-COVID clinic at the University Medical Center Freiburg. Retrospective data analysis of persistently symptomatic patients presenting to our clinic at least 6 months after onset of acute COVID-19. All patients were assessed by a doctor and routine laboratory analysis was carried out. Quality of life was assessed using SF-36 questionnaire. In case of specific persisting symptoms, further organ-specific diagnostic evaluation was performed, and patients were referred to respective departments/specialists. 132 Patients (58 male, 74 female; mean age 53.8years) presented to our clinic at least 6 months after COVID-19. 79 (60 %) had been treated as outpatients and 53 (40 %) as inpatients. Most common complaints were persistent fatigue (82 %) and dyspnea on exertion (61 %). Further common complaints were impairments of concentration (54 %), insomnia (43 %), and impairments of smell or taste (35 %). Quality of life was reduced in all sections of the SF-36 questionnaire, yielding a reduced working capacity. Significant pathological findings in laboratory, echocardiographic and radiological work-up were rare. Impairments in lung function tests were more common in previously hospitalized patients. Patients presenting 6 months after onset of acute COVID-19 suffer from a diverse spectrum of symptoms with impaired quality of life, also referred to as Long COVID or Post-Acute Sequelae of SARS-CoV-2 infection (PASC). Further research is needed to determine the frequency of these post-COVID syndromes and their pathogenesis, natural course and treatment options. Evaluation and management should be multi-disciplinary.

Factors Associated with Work Ability in a Population of Dock Workers

Background: Work ability consists in the balance between employee’s capabilities and work demands. It can be measured by the Work Ability Index, a validated questionnaire that has been used in Europe since 1980s. This study is the first evaluating work ability among dock workers, a workforce which carries out complex activities requiring physical and mental engagement (night shifts, irregular shifts, constant demand for attention and concentration and significant physical effort). Objective: It was hypothized that the high strain level affecting this peculiar job may lead to a decrease in work ability. The aim of the study was to assess work ability and investigate if and how much not work-related factors, such as psycho-emotional state, lifestyle, health conditions and socio-demographic aspects, can interfere with it. Psycho-diagnostic protocol consisted of 6 questionnaires, chosen because of fast and effective data collection aiming to worker compliance and simple interpretation of results. Method: A total of 105 workers was engaged in different companies involved in port services. A protocol consisting of 6 questionnaires has been applied individually before the work shift: Work Ability Index (WAI), Effort-reward imbalance questionnaire (ERI), Beck Depression Inventory-II (BDI-II), Hamilton Rating Scale for Anxiety (HAM-A), Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI). Results: Work ability resulted excellent in 60 subjects and good in 37. No significant correlation between individual characteristics and work ability was found. Our results indicated that work ability was negatively related with emotional states, particularly with anxiety. Univariate and multivariate linear regression model for work ability, have shown a statistically significant correlation with BDI, HAM-A and ERI questionnaires’ results. Conclusion: Our results showed that WAI is a useful tool for routine occupational health surveillance. The association of work ability with psychosocial factors suggests that actions at the workplace adopted by occupational physicians in order to prevent a reduction in working capacity, should have a multidimensional approach evaluating not only individual lifestyle, but also mood states.

PILOT STUDY ON THE INCIDENCE OF BREAST CANCER AMONG THE POPULATION OF THE NORTH EAST REGION OF BULGARIA

Purpose: According to the Bulgarian National Cancer Registry of 2017, breast cancer accounted for 26.8% of all malignancies among women. The actual incidence rate was 108.1 per 100 000. Materials/ Methods: An observational retrospective study was conducted among breast cancer patients diagnosed and treated at Dr Marko Markov Specialised Hospital for Treatment of Oncologic Diseases (SHTOD) - Varna, between 2016 and 2019. Descriptive statistics and collected data included demographic characteristics, clinical data (survival rates) and type of pharmacotherapy. Results: In terms of gender distribution, significantly more women were affected, accounting for approximately 99.05%. Patients from cities were almost 7 times more than those from villages. Patients aged between 61 and 70 represented the largest number, which accounted for 28.04% of all included in the study. Conclusion: Taking into consideration not only the efficiency but also the cost-effectiveness of available treatment strategies can lead to considerably better therapeutic outcomes. There is no pharmacoeconomic data analysis in Bulgaria. A further study of all direct and indirect costs is required in order to estimate the cost of premature death, reduced working capacity and disability.

Differential diagnosis of states of operability in young people who have had COVID-19 infection

AIM: to assess the peculiarity of the state of working capacity in the process of rehabilitation in young people after suffering COVID-19 infection.&#x0D; MATERIALS AND METHODS: We examined 62 convalescents who underwent COVID-19 (men aged 22.83 0.37 years) 90 days after discharge from the hospital. The main clinical forms (CF) of COVID-19 in this study were inapparent form (20 people 32.25%), acute respiratory viral infection (22 people 35.49%), pneumonia without respiratory failure (20 people 32.25%). The diagnostics of all clinical cases of COVID-19, examination, treatment and discharge of patients from the hospital were carried out in accordance with the regulatory documents. The psychodiagnostic study was carried out according to the Questionnaire Differential Diagnosis of Conditions of Decreased Performance by A.B. Leonova and S.B. Velichkovskaya. All surveyed received voluntary informed consent to participate in the study.&#x0D; RESULTS: In most cases, in all groups, the degree of severity of states of working capacity is regarded as low, which is probably due to asthenic syndrome after a previous illness, and psychological fatigue, due, in particular, to the presence of post-traumatic stress disorder syndrome.&#x0D; CONCLUSION: The states of reduced working capacity and the effectiveness of professional activity are very diverse, therefore, the peculiarities of the mental state can be understood only on the basis of identifying really acting motives of activity, which are manifested in reflexive assessments of the real situation and the behavior of the individual, taking into account their emotional coloring. Therefore, in order to substantiate corrective and rehabilitation measures in the case of a state of reduced working capacity and the effectiveness of professional activity, a differentiated assessment of these conditions is required, which requires the work of a multidisciplinary rehabilitation team (2 tables, bibliography: 32 refs).

Work productivity trajectories of Australians living with multiple sclerosis: A group-based modelling approach

BackgroundStudies have documented reduced work capacity and work productivity loss in multiple sclerosis (MS). Little is known about the longitudinal trajectories of work productivity in MS. ObjectivesTo examine trajectories of work productivity in people living with multiple sclerosis (PwMS) and the factors associated with the trajectories. MethodsStudy participants were employed participants of the Australian MS Longitudinal Study (AMSLS) followed from 2015 to 2019 with at least two repeated measures (n=2121). We used group-based trajectory modelling to identify unique work productivity trajectories in PwMS. ResultsWe identified three distinct trajectories of work productivity: ‘moderately reduced’ (17.0% of participants) with a mean work productivity level of 47.6% in 2015 (slope -0.97% per year (p= 0.22)), ‘mildly reduced’ (46.7%) with a mean work productivity of 86.3% in 2015 (slope 0.70% per year (p=0.12)), and ‘full’ (36.3%) with a mean work productivity of 99.7% in 2015 (slope 0.29% per year (p= 0.30)). Higher education level, higher disability, and higher MS symptom severity are associated with increased probability of being in a worse work productivity trajectory. ConclusionWe identified three distinct work productivity trajectories in PwMS which were stable over time and differentiated by their baseline level of work productivity.

Self-reported changes in work situation \u2013 a cross-sectional study of patients 7\u2009years after treatment for stress-related exhaustion

BackgroundExhaustion disorder (ED) is a common cause of sick leave in Sweden, and patients often have long-lasting symptoms and reduced work capacity. The aim of this study was to explore whether patients with ED had made any changes in their work situation from the period of treatment and up to 7 years later.MethodsIn this cross-sectional study, patients diagnosed with ED at a specialist outpatient clinic were followed up after 7 years (n = 217). They received questionnaires at baseline covering sex, age, marital status, level of education, and symptoms of burnout, depression, and anxiety measured with the Shirom-Melamed Burnout Questionnaire and the Hospital Anxiety and Depression Scale. After 7 years, they were sent a follow-up questionnaire asking about their work situation and work-related stressors both before they fell sick and at the 7-year follow-up. There were three questions on work situation (change of workplace, change of work tasks, and change of working hours), and 155 patients responded to all three.ResultsAfter 7 years, the majority of the patients (63%; n = 98/155) reported that they had made some kind of change at work. Women were more likely than men to report decreased working hours (p = 0.001), and work-related stressors such as conflicts at work, reorganization, deficient leadership, and general discontent with the work situation were significantly more common at baseline in the group who had made changes at work. Patients who made no changes at work experienced more work-related stress due to quantitative demands in the 7-year follow-up.ConclusionThe majority of the patients with ED made some kind of change in their work situation, and gender differences were found for changes of work tasks and working hours. Work-related stressors might be decisive for making changes at work.

A CLINICAL STUDY TO EVALUATE THE EFFECT OF SPHATIKAYUKTHA RASA SINDOORA WITH LODHRA KASHAYA IN DYSFUNCTIONAL UTERINE BLEEDING

Dysfunctional Uterine Bleeding is defined as a state of abnormal uterine bleeding without any clinically detectable organic, systemic and iatrogenic cause. The prevalence varies widely but an incidence of 10% amongst new patients attending the outpatient seems logical. Along with increased susceptibility to iron deficiency, heavy menstrual bleeding can negatively impact physical, emotional and social quality of life and reduce work capacity of females. Objective: A clinical study was conducted to evaluate the effect of Sphatikayuktha Rasa Sindoora with Lodhra Kashaya in Dysfunctional Uterine Bleeding. Design: This pre-post interventional study was conducted among 20 females in the age group 20-45 years who had the symptoms of Dysfunctional Uterine Bleeding for the past 3 cycles. Drug administration started on the 3rd day of menstruation and was continued till bleeding stopped or upto a maximum of 7 days for 3 consecutive cycles. Follow up was done in the next cycle. The condition of the patient after drug administration in the first, second and third months were separately compared with the condition of the patient before treatment. Outcome measures: Outcome variables were change in the amount, duration and frequency of bleeding. Results and Discussion: Results were analysed statistically using Wilcoxon signed rank test and Paired t-test. The treatment was effective in reducing the amount of bleeding during treatment period and the follow up period. It was effective in reducing the duration of bleeding during the treatment period as compared to the follow up period and in controlling the cycle interval during the treatment period.

2021/11 Expiration of leave only with prior information from the employer, even if the employee was not able to take the leave due to illness, a reduction of work capacity or an incapacity for work? (GE)

2021/11 Expiration of leave only with prior information from the employer, even if the employee was not able to take the leave due to illness, a reduction of work capacity or an incapacity for work? (GE)