Assessment Of Work Ability Research Articles

Explaining variations in general practitioners’ experiences of doing medically based assessments of work ability in disability benefit claims. A survey-based analysis

AbstractPurpose: Assessing patients’ work ability is a task that many general practitioners consider challenging. Increase of mental and musculoskeletal disorders further complicate the assessments. The purpose of this paper is to explain variation between general practitioners related to how they experience the assessment of work ability in disability cases. Methods: Combining data from an original postal survey among all general practitioners in Norway (N = 1,466; response rate = 32.5%) with characteristics of the municipality where they work, we use multilevel logistic regression to estimate the relationship between a set of dependent variables measuring how confident general practitioners feel when assessing patients’ work ability in disability cases, physician-related characteristics and structural factors. Results: A main finding is that length of service explains most of the variation between general practitioners (B = 0.492 [0.015, 0.970]–2.127 [1.457, 2.798]); in most of the regressions, this var...

Return to work after stroke: Importantaspects shared and contrasted byfivestakeholder groups.

Poor co-operation between the various stakeholders underscores the need for reviewing important factors that facilitate return to work (RTW) after stroke. To explore and describe important aspects expressed by Swedish stakeholders in the RTW process for persons post stroke and to contrast the stakeholders' aspects exploring different perspectives that may influence optimal RTW. Data from seven focus group interviews with the stakeholders were analyzed using qualitative content analysis. Three main categories made up the findings; the prolonged RTW process, the need for extended knowledge, and the assessment of work ability in the RTW process. Despite the stakeholders' agreement on these important aspects, they presented divergent views of the categories, representing their diverse agendas. A stroke coordinator may remediate the stakeholders' divergent perspectives. The coordinator should be versed in stroke specific knowledge and in a person centered approach to inform the decision process regarding RTW, while finding optimal solutions within regulatory boundary conditions. A coordinator could increase collaboration of the various stakeholders, provide support and coordinate services for the client with stroke and the employer throughout the whole process facilitating RTW after stroke. Future studies are needed to confirm this proposal.

ADAPTATION OF RUFFIER’S TEST FOR ASSESSMENT OF HEART WORKABILITY OF STUDENTS WITH HEALTH PROBLEMS

Purpose: to check up experimentally adapted test for assessment of heart workability of students with heath problems. Material: in the research girl students and boy students of 18-20 years age (n=487) participated. The procedure of test was as follows: during 45 seconds students fulfilled torso rising from lying on back position. During this procedure pulse was measured three times. Total time of test fulfillment was 2 minutes. For working out the scale for the received results’ interpretation we assessed new version of Ruffier’s test for validity. For this purpose 487 absolutely healthy tested students fulfilled, first, adapted test. Then, after complete recreation (in 20 minutes) they fulfilled commonly accepted test with squatting. Results: it was found that with the help of adapted test it is possible to objectively assess heart workability of students. Correlation analysis of the received results showed average correlation (r=0.73). Conclusions: application of adapted Ruffier’s test permits to assess heart workability of students with health problems.

Strength and Workability Assessment of Ordinary Concrete and Self-Compacting Concrete using Tandur Stone Slurry Powder – A comparison

Strength and Workability Assessment of Ordinary Concrete and Self-Compacting Concrete using Tandur Stone Slurry Powder – A comparison

Work Ability Score (WAS) as a Suitable Instrument to Assess Work Ability Among Iranian Workers

Background: The high item numbers is one of the Work Ability Index (WAI) limitations that make it difficult to be completed by the workers. Using the single-item Work Ability Score (WAS) as a simple is one of the proposed solutions which is valid and suitable measure for work ability. Objectives: The present study aimed to assess work ability using WAI and WAS instruments and to compare their results among Iranian workers. Methods: This cross-sectional study was done on 1579 workers from eleven different work sectors located in different geographical areas in Iran. Work ability was measured by the full Persian version of WAI. Data were analyzed using univariate tests, Pearson product moment correlation, Gamma test, and multiple liner regression analysis. Results: The mean scores of the WAI and WAS were 39.95 ± 6.1 (range 15 - 49) and 8.1 ± 1.8 (range 0 - 10), respectively. Both the WAI and WAS showed the similar patterns of associations with the assessed independent variable. There was a strong correlation between the mean scores of WAI and WAS. In addition, the Gamma test showed that the categories of WAI were strongly correlated with the categories of WAS. Conclusions: The WAS could be used for reliable assessment of work ability among Iranian workers. To improve the worker’s work ability, interventional programs should focus on the alteration and correction of work schedule, and increasing the supervisor’s support for the young workers.

Phosphate-amended sand/Ca-bentonite mixtures as slurry trench wall backfills: Assessment of workability, compressibility and hydraulic conductivity

In regions and countries where sodium bentonite is scarce, the resourceful calcium bentonite can be considered as an alternative material for soil-bentonite slurry trench walls. However, the lower swelling capacity of calcium bentonite as compared to Na-bentonite may result in the unacceptable high hydraulic conductivity of the sand/calcium bentonite backfills, and, therefore, amendment of calcium bentonite is necessary. However, studies on the feasibility of using amended calcium bentonite for soil bentonite backfills are limited. This study investigates the feasibility of using sodium hexametaphosphate amended calcium bentonite for the backfill material through a comprehensive laboratory investigation. First, a series of viscosity, density and filtrate loss tests are conducted using bentonite-tap water slurries with different amounts of phosphate to determine the optimal amendment dosage. Subsequently, the Atterberg limits and free swell index are evaluated for the amended/un-amended calcium bentonite and backfills, which consist of sand and amended/un-amended calcium bentonite. Finally, slump, oedometer tests and flexible-wall hydraulic conductivity tests are conducted on the backfills. The results indicate that the slurry with 20% calcium bentonite amended by 2% phosphate results in the target slurry, and the optimum phosphate dosage for amended calcium bentonite is found to be 2%. The phosphate amendment causes an increase of 1.21 times in the liquid limit, and an increase of 1.40 times in the free swell index of the amended bentonite relative to those of the un-amended bentonite. The sand/calcium bentonite backfill changes from non-plasticity to plasticity after the amendment. The amended backfill displays two times higher swell index value and one order of magnitude lower consolidation coefficient value than the un-amended backfill. The hydraulic conductivity of un-amended backfills containing 15% to 25% un-amended bentonite is greater than the commonly targeted value of 10−9m/s for slurry trench walls. In contrast, the hydraulic conductivity of the amended backfill with 15% to 25% amended bentonite varies from 8.3×10−10m/s to 2.7×10−10m/s, which is lower than 10−9m/s. In addition, the amended backfills containing 20% and 25% amended calcium bentonite have nearly the same magnitude of hydraulic conductivity as the conventional sand/sodium bentonite backfill. This study demonstrates that phosphate is a promising amendment for achieving low hydraulic conductivity of sand/calcium bentonite backfills for soil-bentonite slurry trench walls.

Work disabilities and unmet needs for health care and rehabilitation among jobseekers: a community-level investigation using multidimensional work ability assessments

Objective: Comprehensive understanding of the prevalence and quality of work disabilities and unmet needs for health care and rehabilitation to support return to work (RTW) among jobseekers.Design: Community-level, cross-sectional analysis with multidimensional clinical work ability assessments.Setting: Paltamo, Finland.Participants: Unemployed citizens either participating in the Full-Employment Project or long-term unemployed (n = 230, 81%).Main outcome measures: Based on data from theme interviews, patient records, supervisors’ observations of work performance and clinical examinations, a physician concluded the individual’s work ability, categorised into four groups: good work ability, good work ability expected after RTW support, able to transitional work only or unable to work. These groups were cross tabulated with primary diagnoses, types of plans to support RTW, as well as categories of social functioning and motivation, for which sensitivity and specificity scores in detecting work disability were calculated.Results: Only about half of the jobseekers had good work ability, 27% were found unable to work in the open labour market and 15% even eligible for a disability pension. For 20%, care or rehabilitation was seen necessary to enable RTW. Poor supervisor- and self-rated performance at work or poor social functioning appeared as sensitive measures in detecting work disability.Conclusions: Work disabilities and unmet needs for health care and rehabilitation are highly prevalent among jobseekers, as depicted using a multidimensional work ability assessment procedure inspired by the International Classification of Functioning (ICF). Further development of work ability assessment practices is clearly needed.KEY POINTSAlthough the association of unemployment with poor health is well known, evidence on the work ability of the unemployed remains scarce.Work disabilities are common among the unemployed.Multidimensional work ability assessment among the unemployed reveals unmet needs for care and rehabilitation to support return to work.Context sensitivity may add to the accuracy of the doctor’s conclusions on work ability.

“Dis-able bodied” or “dis-able minded”: stakeholders’ return-to-work experiences compared between physical and mental health conditions

Purpose: This study aimed to explore if and why the return-to-work (RTW) experiences of various workplace stakeholders in the Netherlands and Denmark differ between physical and mental health conditions, and to understand the consequences of potentially different experiences for the RTW process in both health conditions.Methods: We studied 21 cases of long-term sickness absence, and held a total of 61 semi-structured interviews with the various actors involved in these cases.Results: Physical cases were seen as “easy” and mental cases as “difficult” to manage, based on the visibility and predictability of health complaints. On this ground, assessing work ability and following required RTW actions were perceived as more urgent in mental than in physical cases. Despite these perceptions, in practice, the assessment of work ability seemed to impair the RTW process in mental cases (but not in physical ones), and the (non-)uptake of RTW actions appeared to have similar results in both mental and physical cases.Conclusions: With these outcomes, the effectiveness of a differential approach is questioned, and the relevance of a bidirectional dialog on work ability and a phased RTW plan is highlighted, regardless of the absence cause. Our study also demonstrates how policymakers need to strike a balance between obligatory and permissive legislation to better involve workplaces in RTW issues.Implications for rehabilitationBoth physically and mentally sick-listed employees could benefit from a bidirectional dialog on work ability as well as from a phased RTW plan.A greater role for employers in the RTW process should be accompanied with a support for sick-listed employees, in both physical and mental sickness absence cases.Dutch and Danish RTW legislation could be improved by carefully balancing obligatory and permissive rules and regulations to involve workplaces in RTW matters.

The impact of menopause on work ability in women with severe menopausal symptoms

ObjectiveTo measure the impact of menopause on work ability in women with severe menopausal symptoms. Study designThis cross-sectional study compared the work ability of a sample of otherwise healthy employed Dutch women (n=205) with that of a sample of first-time attendees of a menopause clinic (n=60); both groups were aged 44–60 years. Self-reported questionnaire data assessing work ability (Work Ability Index; WAI) and menopausal symptoms (Greene Climacteric Scale; GCS) were used. Main outcome measuresLogistic regression analyses were used to examine whether women with severe menopausal symptoms were more likely to have low work ability (defined as a score <37.0 points on the WAI) than were women in the reference group, after adjustment for individual and lifestyle factors. ResultsSymptomatic women had significantly higher total GCS scores (mean 26.7 vs 14.2, t=10.8, P<0.001) and significantly lower WAI scores (median 32.0 vs 40.0, U=2380, P<0.001) than the reference group. They were 8.4 times more likely to report low work ability than their healthy counterparts: 76.7% versus 30.2% (OR 8.4, 95% CI 4.1–17.2). ConclusionsOver three-quarters of symptomatic menopausal women report serious problems in dealing with the physical and mental demands of their work (recorded here as low work ability); hence these women might be at risk of prolonged sickness absence from work.

Impact of Steel Fibers on Workability and Properties of UHPC

This paper is focused on properties of fresh and hardened cement-based composite Ultra-High Performance Concrete with regard to different volume fraction of short brass coated steel fibers BASF MASTERFIBER® 482. Workability of fresh concrete and basic mechanical properties (tensile strength in bending, compressive strength) of hardened UHPC were found out. The workability of fresh concrete was measured by small mortar Haegermann cone. Percentage differences at cost were obtained at hardened concrete, too. The aim of the first experimental part of the research was the impact of volume fraction of steel fibers according to workability of fresh concrete and also according to mechanical properties of hardened UHPC with the same volume fraction of each component of the mixture, only the volume fraction of the steel fibers was different at each mixture. The mixture design of UHPC was changed to maintaining the workability of fresh concrete at the second part of the research. The workability at mixture with dosage of steel fibers of 300 kg/m3 measured by Haegermann cone was around 300 mm. In the framework of grant project GAČR 15-05791S the basic mechanical properties of hardened fine-grained cementitious composite material UHPC at small beams size of 160/40/40 mm and beams size 300/70/70 mm were determined. The aim of the research project was not only the determination of basic mechanical properties for each mixture design but also workability assessment and costs linked with higher amount of the volume fracture of steel fibers.

Is it a Case of “Work-Anxiety” When Patients Report Bad Workplace Characteristics and Low Work Ability?

Aims Work-anxiety may produce overly negative views of the workplace that impair provider efforts to assess work ability from patient self-report. This study explores the empirical relationships between patient-reported workplace characteristics, work-anxiety, and subjective and objective work ability measures. Methods 125 patients in medical rehabilitation before vocational reintegration were interviewed concerning their vocational situation, and filled in a questionnaire on work-anxiety, subjective mental work ability and perceived workplace characteristics. Treating physicians gave independent socio-medical judgments concerning the patients' work ability and impairment, and need for supportive means for vocational reintegration. Results Patients with high work-anxiety reported more negative workplace characteristics. Low judgments of work ability were correlated with problematic workplace characteristics. When controlled for work-anxiety, subjective work ability remained related only with social workplace characteristics and with work achievement demands, but independent from situational or task characteristics. Sick leave duration and physicians' judgment of work ability were not significantly related to patient-reported workplace characteristics. Conclusions In socio-medical work ability assessments, patients with high work-anxiety may over-report negative workplace characteristics that can confound provider estimates of work ability. Assessing work-anxiety may be important to assess readiness for returning to work and initiating work-directed treatments.

Factors related to the physician and the employer influencing successful return to work in Korea: results from the first panel study of workers' compensation insurance (PSWCI).

ObjectivesThis study aims to investigate associated factors including the physician and the employer of successful return to work (RTW) in occupationally injured workers.MethodsThis study is based on the first panel study of workers’ compensation insurance (PSWCI), published in June 2014. The PSWCI is a sample survey of occupationally injured workers who completed medical care in 2012 (89,921 people). A total of 2000 subjects were sampled based on sex, age, nine metropolitan-based regions, disability ratings, duration of rehabilitation, and whether vocational rehabilitation service was used. We divided the study population into two groups: return to work (RTW) group (job retention, reemployment, unpaid family worker, and self-employment), and non-RTW group (joblessness and economical inactivity). The odds ratios (ORs) and 95 % confidence intervals (CI) related to differences in basic characteristics, part of physician and employer-related factors between those who succeeded to RTW and those who did not were measured using multivariable logistic regression model.ResultsThe success of RTW is 70.6 % (n = 1412) among participants. The ORs (95 % CI) of the participants belonging to RTW who received periodic recovery assessment from the medical care institution and the physician are 1.51 (1.07–2.13). The ORs (95 % CI) are 1.68 (1.05–2.69) for the RTW group who received work ability assessment and referral for vocational return. When the employer maintains the relationship with the occupationally injured worker, the worker has 1.39 times higher odds (95 % CI: 1.41–2.26) of the RTW group compared to the non-RTW group.ConclusionsThe physician and the employer have a significant impact on the RTW.

Characteristics of functional tension of qualified skiers when passing rises of different difficulty

Purpose: studying of main functional changes in organism of qualified female skiers when passing rises of different difficulty. Materials: 12 female skiers of combined team of Ukraine of 21-34 years’ age were tested. Pedagogic observation included: speed metering (system of GPS- navigation), pulse metering (telemetric register of heart beats rate Polar RS800). In process of ski track passing we registered content of exhaled air (radio-telemetric gas-analytic complex MetaMax 3B, Cortex). Sportswomen fulfilled control passing of competition 6 km distance (2 circles, 3 km each) in classic style on ski rollers. Ski track was determined by coach. In the course of track’s passing we registered indicators of speed and track profile with discreteness 1 sec. Assessment of special workability and realization of functional potentials was determined by characteristics of external breathing at the end of each rise. Results: it was found that the highest correlation belonged to the following indicators: frequency of breathing (r = 0.38); oxygen consumption (r = 0.29); ventilation equivalent by О 2(r = 0.68). We detected high interconnection between length of distance and ventilation equivalent by СО 2 (r=0.61). It was determined that factors of organism’s anaerobic efficiency change according to relief of track. They increase on rises and reduce on descends. With it increase on long rises is much higher than on middle size rises. Conclusions: effectiveness of different difficulty rises’ overcoming depends on potentials of anaerobic mechanisms and their realization that, to certain extent, influence on sport efficiency.

Assessment of Workability and Different Strengths of Lime Stone Aggregate Concrete

Assessment of Workability and Different Strengths of Lime Stone Aggregate Concrete

Prospective Cohort Analysis of the Predictive Validity of a Screening Instrument for Severe Restrictions of Work Ability in Patients with Musculoskeletal Disorders.

The aim of this study was to determine whether the Screening-Instrument zur Feststellung des Bedarfs an medizinisch-beruflich orientierter Rehabilitation (SIMBO) screening instrument can identify persons with a high work disability risk. Patients with chronic musculoskeletal disorders and participation in a rehabilitation program were included in the analysis. Data were collected by questionnaires at admission and at the 6-mo follow-up. Failed return to work (RTW; i.e., unemployment or active employment with sick leave of >12 wks in the follow-up) was the primary outcome. Additional outcome data were obtained from the physician's discharge form (e.g., assessment of work ability). Receiver operating characteristic analyses and logistic regression models were used to analyze the data. Valid data were available for 1755 participants. Of these, 25% reported failed RTW. The area under the curve of the SIMBO score predicting failed RTW was 0.81 (0.79-0.83). The optimal cutoff to identify failed RTW was 23 points (of 100). The odds of failed RTW, unemployment, and sick leave of more than 12 wks were increased 12, 11, and 10 times for the persons with a SIMBO score of 23 points or greater compared with the persons with lower SIMBO scores. The odds of reduced work time capacity were increased 21 times. The SIMBO predicts work disability in patients with chronic musculoskeletal disorders. Further research should focus on its predictive validity in patients with other disorders and within other rehabilitation systems.

Effect of Adalimumab on Work Ability Assessed in Rheumatoid Arthritis Disease Patients in Saudi Arabia (AWARDS).

Objectives : Rheumatoid arthritis (RA) is a chronic disabling disease that can jeopardize the ability of affected individuals to participate in paid work. Our objective was to evaluate the effectiveness of a 6-month course of tumor necrosis factor (TNF) antagonist (adalimumab) on work ability, overall health, and fatigue in RA patients.Methods : Between October 2012 and February 2014, this prospective, observational study enrolled 63 consecutive patients with established adult RA at outpatient clinics in Makkah, Jeddah, Riyadh and Abha (Saudi Arabia). Patients received subcutaneous injections of adalimumab (40 mg every 2 weeks). Outcomes were measured at baseline and 6 months using the following tools: Work Productivity and Activity Impairment (WPAI), Health Assessment Questionnaire Disability Index (HAQ-DI), Fatigue Severity Scale (FSS), Visual Analog Scale for Fatigue (VAS-F), and work disability self-assessment.Results : All outcomes showed improvements after 6 months of adalimumab therapy. Significant improvements from baseline were observed in absenteeism (64% ± 11.62 to 11.60% ± 11.17 [p<0.0001]), presenteeism (62.15% ± 20.11 to 34.92% ± 20.61 [p<0.0001]), overall work impairment (69.08% ± 18.86 to 40.73% ± 22.29 [p<0.0001]), overall activity impairment (68.46% ± 18.58 to 36.46% ± 20.79 [p<0.0001]), HAQ score (1.69 ± 0.57 to 0.81 ± 0.61 [p<0.0001]), and FSS score (47.08 ± 9.55 to 27.86 ± 13.43 [p<0.0001]).Conclusion : A 6-month course of adalimumab improved work ability, fatigue, and overall health assessments in patients with established RA. Our findings encourage randomized controlled trials investigating the cost-effectiveness and long-term effects of TNF inhibitors on work disability.

How do physiotherapists perceive their role in work ability assessments? A prospective focus group study

Background: Work ability and work ability assessments have become important both in health care and in relation to granting sick leave. There are different interpretations of work ability among the different professionals involved, and there is no consensus on how work ability should be assessed. Aim: The aim was to analyse how a group of experienced and specially trained physiotherapists (PTs) in primary health care (PHC) perceived their professional role in work ability assessments during 14 months. Methods: We conducted a prospective focus group study and applied qualitative content analysis to the data. Findings: There was a need to emphasise the PTs’ role both within PHC and also in relation to others involved. The PHC organisation was not really prepared to direct work-disabled patients to PTs before physicians. In addition, the PTs themselves needed to reorganise to better meet the requirements. The PTs underlined the advantage of their frequent and extended meetings with patients. This made it possible to assess, follow and facilitate work ability and to determine patients’ resources. The PTs believed that they could contribute to structured assessments, which was positive for themselves and also in their communication with physicians and patients. The PTs later took more initiatives in work ability questions and believed that they could be responsible for work ability assessments to a greater extent. They found it most valuable to have had the opportunity to reflect on work ability, while working in the focus groups, and also to have been the subjects for further education. This made them more prepared to handle work ability questions when compared with other colleagues.

Clinical utility of the worker role interview: a survey study among Swedish users

Background: Work ability assessments are used to guide interventions designed to reduce or eliminate work disability and facilitate work participation. The clinical utility of assessments concerns the extent to which the assessment results support clinical decision-making. Aim: The aim was to investigate how users perceive the clinical utility of the Swedish version of the Worker Role Interview (WRI-S). An additional aim was to investigate differences in clinical utility related to the users’ level of WRI-S experience, attendance at courses on WRI-S application, and knowledge of the Model of Human Occupation. Material and methods: Data are based on 187 respondents’ answers to a web-based questionnaire and analysed through descriptive and inferential statistics. Results: In total, the respondents performed 12 000 WRI-S assessments. The respondents were mainly satisfied with the clinical utility of the WRI-S and experienced the assessment as supporting clinical practice. The main hindrance affecting clinical utility was the amount of time needed for conducting a WRI-S assessment. Experienced users and users with very good knowledge of MOHO conduct WRI-S assessments in a more time-effective manner. Conclusion: This study contributes to further development of the clinical utility of the Swedish version of the WRI-S, mainly focusing on time consumption.

Fracture mechanics defect assessment diagram on pipe from steel P264GH with a notch

The design for a pipeline component is considered a tough challenge once defects in the base material develop. To address this issue, we present a gouge defect located in a pipe submitted to internal pressure. This problem is often encountered in the field of pipeline network and boiler components because of structural imperfection. To simulate the activity of such pressurized pipeline, a longitudinal cylindrical shell under pressure from a material of steel P264GH were involved in the research. Secondly, by this paper we propose a safety methodology to detect the boundary of failure assessment diagram (FAD), as a new solution to predict the service life of pipeline products. The methodology is connected to the modified FAD approach, whereas the specific parameters were settled using the Volumetric Method calculation, based on the notch Stress Intensity Factor, determined in the elasto-plastic field. This new modified FAD methodology entails an accurate solution, suitable to be used as expert tool for the assessment of workability and reliability of pipes network, in the case of corrosion defects presence.

Factors associated with inadequate work ability among women in the clothing industry

Work ability depends on a balance between individual resources and work demands. This study evaluated factors that are associated with inadequate work ability among workers in the clothing industry. We conducted a cross-sectional observational study of 306 workers in 40 small and medium-sized enterprises. We assessed work ability, individual resources, physical and psychosocial demands, and aspects of life outside work using a binary logistic regression model with hierarchical data entry. The mean work ability was 42.5 (SD=3.5); when adjusted for age, only 11% of the workers showed inadequate work ability. The final model revealed that smoking, high isometric physical load, and poor physical environmental conditions were the most significant predictors of inadequate work ability. Good working conditions and worker education must be implemented to eliminate factors that can be changed and that have a negative impact on work ability. These initiatives include anti-smoking measures, improved postures at work, and better physical environmental conditions.