Functional capacity after hip arthroplasty: A comparison between evaluation with three standard instruments and a personal interview

The aim of the present study was to compare the information obtained from three standard instruments used in physiotherapy and occupational therapy and with information acquired from an unstructured interview. Ten patients with osteoarthritis of the hip were consecutively picked from the waiting list at an orthopedic clinic. All were examined before and six months after arthroplasty. The study layout is a mixture of quantitative and qualitative evaluation. The three instruments used were SF-36 (self-reported health-related quality of life), FAS (an instrument for evaluation of lower extremity dysfunction), and the COPM (for evaluation of self-experienced activity level). All patients were also interviewed in a free, unstructured interview, and data were analyzed with a phenomenological approach. All methods could describe function and activity status of the patients very well, and they were also responsive to postoperative improvement. Together the three instruments gave such good information that almost no extra information was obtained through the interviews. On the other hand, the interviews served as powerful validation of the three instruments. The information in the three separate instruments is qualitatively different, and one instrument cannot replace another. They cannot be replaced by the interview either, because the instruments provide the therapist with specific and structured information that is important for further treatment planning and follow-up.     

A conceptual framework of functional capacity evaluation for occupational therapy in work rehabilitation

Functional capacity evaluation (FCE) is commonly used in work rehabilitation to assess the capacity of the injured worker for return to work. Occupational therapists are major providers of FCE, especially in Australia. Despite a history of involvement in the functional assessment of clients for work, occupational therapy has few theoretical models for work assessment in general, and for FCE in particular. This may account for some of the confusion that exists about the conceptual basis of FCE in occupational therapy practice. This paper presents a framework for FCE that parallels occupational therapy's occupational performance model and the World Health Organisation's International Classification of Functioning, Disability and Health. The framework is used to clarify some of the confusions that exist in FCE research and practice, particularly the issue of measuring a client's function versus impairment. A redefinition of FCE for occupational therapy practice in the work assessment continuum is presented that supports occupational therapy practice and research in the area.     

Functional capacity evaluation: Rationale,procedure, utility of the kinesiophysical approach

The return to work process of an injured worker is dependent upon matching the physical abilities of the worker with physical demands of work tasks. Functional work movements and tasks are complex. Machines, equipment and isolated musculoskeletal testing have not produced data that is broad enough to project multi-faceted work ability. Functional capacity evaluations, which are sets of dynamic work tests, have seen a growing acceptance because of their whole-worker approach. The basic items of functional evaluations (lifting, carrying, bending, reaching, climbing) are compiled into a comprehensive test which results in information about the whole of work and overall ability of the worker. Projections into an eight-hour day and comparison to physical demands of the job are included in outcome of a functional capacity evaluation. The Kinesiophysical design approach also produces information on safety, compliance, movement characteristics and physical reasons behind work limitations. Utility of functional evaluation is exemplified when employers, and physicians use it as a basis for safe work return of the employee.     

Functional capacity after hip arthroplasty: a comparison between evaluation with three standard instruments and a personal interview

The aim of the present study was to compare the information obtained from three standard instruments used in physiotherapy and occupational therapy and with information acquired from an unstructured interview. Ten patients with osteoarthritis of the hip were consecutively picked from the waiting list at an orthopedic clinic. All were examined before and six months after arthroplasty. The study layout is a mixture of quantitative and qualitative evaluation. The three instruments used were SF-36 (self-reported health-related quality of life), FAS (an instrument for evaluation of lower extremity dysfunction), and the COPM (for evaluation of self-experienced activity level). All patients were also interviewed in a free, unstructured interview, and data were analyzed with a phenomenological approach. All methods could describe function and activity status of the patients very well, and they were also responsive to postoperative improvement. Together the three instruments gave such good information that almost no extra information was obtained through the interviews. On the other hand, the interviews served as powerful validation of the three instruments. The information in the three separate instruments is qualitatively different, and one instrument cannot replace another. They cannot be replaced by the interview either, because the instruments provide the therapist with specific and structured information that is important for further treatment planning and follow-up.     

The utility of Functional Capacity Evaluation: the opinion of physicians and other experts in the field of return to work and disability claims

Objectives: This qualitative study explored how Dutch experts perceive the utility of functional capacity evaluation (FCE) for return to work (RTW) and disability claim (DC) assessment purposes. Methods: Twenty-one RTW case managers and 29 DC experts were interviewed by telephone using a semi-structured interview schedule. Results: The RTW case managers valued the utility of FCE on a scale of 0–10. Their mean valuation was 6.5 (SD 1.5). The average valuation for DC experts was 4.8 (SD 2.2). Arguments in favor of FCE were (1) its ability to confirm own opinions and (2) the objectivity of its measurement method. Arguments against FCE were (1) the redundancy of the information it provides and (2) the lack of objectivity. Indications for FCE were musculoskeletal disorders, a positive patient self-perception of ability to work, and the presence of an actual job. Contraindications for FCE were medically unexplained disorders, a negative patient self-perception of ability to work, and the existence of disputes and legal procedures. Conclusions: The responding RTW case managers perceived FCE to be more useful than the responding DC experts. The question of whether the arguments presented for and against the utility of FCE are valid is one that should be addressed in a future study.     

A framework for systematically improving occupational therapy expert opinions on work capacity

Aim:  To present an evidence-based framework to improve the quality of occupational therapy expert opinions on work capacity for litigation, compensation and insurance purposes.
Methods:  Grounded theory methodology was used to collect and analyse data from a sample of 31 participants, comprising 19 occupational therapists, 6 medical specialists and 6 lawyers. A focused semistructured interview was completed with each participant. In addition, 20 participants verified the key findings.
Results:  The framework is contextualised within a medicolegal system requiring increasing expertise. The framework consists of (i) broad professional development strategies and principles, and (ii) specific strategies and principles for improving opinions through reporting and assessment practices.
Conclusions:  The synthesis of the participants' recommendations provides systematic guidelines for improving occupational therapy expert opinion on work capacity.     

Job control, substantive complexity, and risk for low birth weight and preterm delivery: an analysis from a state birth registry

BACKGROUND: Indices of job strain have demonstrated a variable relationship to low birth weight (LBW) and prematurity, with conflicting study results. This study sought to examine the associations of psychosocial work environment characteristics with adverse pregnancy outcomes using and comparing the demand-control model and job attributes derived from the O*NET. METHODS: Job characteristics were imputed to maternal occupation recorded in the 2000 Connecticut state birth registry for 26,408 singleton births, using scores for psychological job demands, control, and physical demands derived from the Job Content Questionnaire, and for substantive complexity of work and physical demands using variables derived from O*NET job attributes. Odds ratios for LBW and preterm delivery were estimated while controlling for relevant covariates. RESULTS: High psychological demands were not associated with pregnancy outcomes, while high physical demand scores from the O*NET were associated with LBW. Associations of term- and all-LBW with both low control and low substantive complexity were attenuated by adjustment for educational and demographic covariates. A gradient with lower scores was seen for term LBW and substantive complexity, and for prematurity and control. Both constructs were correlated with maternal education. CONCLUSIONS: These results suggest that low maternal job control and substantive complexity may be modestly associated with LBW and, to a lesser extent, prematurity. A greater association with control may explain why a weak link of birth outcomes to high-strain work has been noted in past studies. Observed associations with occupational are reduced after adjustment for relevant confounding variables, in particular educational level and race/ethnicity.     

英文期刊内容差异性测度和分析

【目的】 从差异性视角提出期刊区分度(Journal Discriminative Capacity,JDC)测算方法,并对期刊内容的差异性进行定量测算及分析,以探测不同期刊个体之间的区分性特征及不同学科期刊总体的差异化程度。【方法】 以2015—2017年SCI、SSCI、A&HCI收录期刊的题录信息为数据源,首先通过层次聚类和JDC测算对LIS学科23种期刊内容的差异性进行深入分析;然后通过计算不同学科的JDC并结合多维尺度降维分析法来探测学科间期刊的差异性特征,同时利用学科期刊个体的JDC均值来探讨不同学科期刊的差异性。【结果】 LIS学科期刊的区分性出现明显分层,图书馆类期刊的区分性最强,评价与评述类期刊的区分性最弱;不同学科期刊具有鲜明的学科性特征,SCI收录期刊的区分性最为显著,SSCI收录期刊次之,A&HCI收录期刊的区分性最弱。【结论】 在单学科中区分度越低的期刊,其综合性特征越显著;而在多学科中,理工类期刊的内容差异性更为显著,其学科特色较人文社科类期刊更为突出。     

A comparative analysis of treatment costs for home-based care and hospital-based care in enteral nutrition patients: A retrospective analysis of claims data

Objective

To explore the differences in mean treatment costs between home-based care and hospital-based care in enteral nutrition patients in Japan.

Health promotion activities in annual reports of local governments: 'Health for All' targets as a tool for content analysis

BACKGROUND: This article presents an instrument to study the annual reporting of health promotion activities in local governments within the three intervention municipalities of the Stockholm Diabetes Prevention Program (SDPP). The content of health promotion activities are described and the strengths, weaknesses and relevance of the method to health promotion discussed. METHOD: A content analysis of local governmental reports from 1995-2000 in three Swedish municipalities. A matrix with WHO's 38 'Health for All' (HFA) targets from 1991 was used when coding the local health promotion activities. RESULTS: There are many public health initiatives within the local governmental structure even if they are not always addressed as health promotion. The main focuses in the local governmental reports were environmental issues, unemployment, social care and welfare. CONCLUSIONS: Local governmental reports were found to be a useful source of information that could provide knowledge about the priorities and organizational capacities for health promotion within local authorities. Additionally the HFA targets were an effective tool to identify and categorize systematically local health promotion activities in the annual reports of local governments. Identifying local health promotion initiatives by local authorities may ease the development of a health perspective and joint actions within the existing political and administrative structure. This paper provides a complementary method of attaining and structuring information about the local community for developments in health promotion.     

Strengthening community-based care for vulnerable children in Ethiopia: A mixed-method evaluation of program reach and community capacity development

Ethiopian children face serious challenges resulting from the HIV/AIDS pandemic. In response to these challenges, the Positive Change: Children, Communities and Care (PC3) program mobilized local communities to address them in seven regions of Ethiopia. This study aims to evaluate the PC3 program reach including the scale of services provided and the extent to which the provided care corresponded to the identified needs. It also assesses whether and how the program enhanced the capacity of local community-based organizations (CBOs) to respond to the needs of vulnerable children. The study team employed a mixed-method approach, assessing program reach through record review of services provided to children (n = 247,461), and assessing community capacity development through 11 in-depth, semi-structured interviews with leaders from four randomly selected local nongovernmental organizations (NGOs) and seven CBOs. Of all children included in the program, 88% needed at least one service and 97% of these children received at least one, whereas 55% had at least one un-met need. Further, 29% of children received services for needs which were not identified. Interviews indicated that the PC3 program mobilized and transformed local communities to address multiple needs of children. Community involvement and ownership of the program helped leverage partner resources to meet the needs of children in their communities. The PC3 program can provide a model for other communities in Sub-Saharan African countries with similar challenges. The impact of the PC3 program may have been understated due to underreporting. The research indicated that the program underutilized program data for the purposes of program management, assessment, and improvement. Improvement in this area would have enhanced this highly effective community mobilization model.     

Analysis of a whole diet in terms of phenolic content and antioxidant capacity: effects of a simulated gastrointestinal digestion

This work compares the phenolic contents and the total antioxidant capacity of the 36 most popular Brazilian foods submitted to aqueous extraction or in vitro digestion. The purpose was to evaluate the extent by which digestion differs from the simple aqueous extraction procedures of several food matrices. After in vitro digestion, cereals, legumes, vegetables, tuberous vegetables, chocolates and fruits showed higher phenolic contents and higher antioxidant activities than those obtained by aqueous extraction. Contrarily, the digestion caused a reduction in the phenolic contents and antioxidant activities of beverages (red wine, coffee and yerba mate). Our results suggest that the phenolics of food groups with solid and complex matrix are protected against enzymatic action and alteration in pH during the digestion, what does not occur in liquid food matrices such as the beverages. This fact would overestimate the antioxidant activities of beverages submitted solely to aqueous extraction.     

Development and Validation of a Short-Form Functional Capacity Evaluation for Use in Claimants with Low Back Disorders

Objectives: Functional Capacity Evaluations (FCE) are used for making return-to-work decisions, yet FCE's modest predictive ability is currently outweighed by the administrative burden of testing. We attempted to develop a short-form FCE while maintaining comparable predictive ability. Methods: Three databases previously created for evaluating FCE predictive validity were used. Subjects were compensation claimants with low back disorders. FCE measures included items in the Isernhagen Work Systems’ FCE. Days until benefit suspension served as an indicator of return-to-work. Analysis included Cox regression. Results: Three items, floor-to-waist lift, crouching, and standing, were maintained in the short-form FCE. The short-form FCE was found to predict comparably to the entire FCE protocol in two validation cohorts (R ² difference<3%). Subjects meeting job demands on all three items consistently experienced faster benefit suspension. Conclusion: A short-form FCE for determining future work status in claimants with low back disorders was developed. A substantially abbreviated FCE may offer an efficient alternative.     

Publication trends in telesupervision: A content analysis study

Thirty-five empirical studies from 25 peer-reviewed journals and one book chapter were analyzed through a content analysis for trends in publication, methodological, and research foci in telesupervision between 1990 and 2016. The most significant increase in publications occurred in the past decade. Methodological trends revealed that video-conferencing, webcam, and cybersupervision were frequent terminologies used to describe telesupervision. Studies were focused on supervisee experiences, used an individual supervision method, a videoconferencing medium of supervision delivery, and a qualitative methodology with both male-female samples. Studies examined three topics: effectiveness of telesupervision, counselor development, and supervisory relationship. Implications and future research directions are discussed.     

Analysis of industrial tasks as a tool for the inclusion of people with disabilities in the work market

This article describes the application of a model for analyzing industrial tasks that was developed to identify jobs that could potentially be filled by people with disabilities (DP) and to serve as a guideline for a company hiring policy. In Brazil, Law No. 8213/91 makes it obligatory to hire DP based on quotas that are established according to the number of employees in a public and private company. Using a set of methods and techniques based on ergonomic work analysis and on occupational therapy, we sought to build a model to indicate the skills required to perform industrial tasks. The model was applied at 19 workstations at a Brazilian aircraft manufacturer in 2002. The task supervisor and the operator performing the task were interviewed, the work activity was filmed, a kinesiological analysis was done, the task was observed and a checklist was applied to help recognize and systematize the skills involved in performing the job task. The last step consisted of correlating the skills required to perform the task to the potential skills of the various types of disability. It was found that 100% of the jobs could be filled by workers with low-level paraplegia, 89% by workers with general paraplegia, 0% with low-level tetraplegia, 47% with auditory impairment, 42% with hemiplegia, 68% with upper limb amputees wearing adequate prostheses, and 89% handicapped wheelchair users. The company hired 14 DP based on the results of this model. The model proved adequate for analyzing industrial tasks with a view to the inclusion of DP, and it can be applied to other sectors of industrial production.     

Venue-level correlates of female sex worker registration status: A multilevel analysis of bars in Tijuana,Mexico

Abstract

In Tijuana, Mexico, sex work is regulated by the municipal government, through registration cards issued to female sex workers (FSWs) for an annual fee. Registration has been associated with decreased drug use and increase condom use and HIV testing. Previously, it was demonstrated that FSWs operating in bars were more likely than street-based FSWs to be registered. This implies that certain venues may be more accessible to local authorities for the enforcement of this type of programme. Taking a novel multilevel approach, we examined whether venue characteristics of bars reflecting greater organised management and visibility affect registration status of FSWs. In an analysis of venue-level characteristics, predictors of being registered were availability of free condoms at work and distance to the main sex strip; however, these were not independently associated after inclusion of FSWs' income, illicit drug use and history of HIV testing. Our findings suggest that sex work regulations may inadvertently exclude venues in which the more vulnerable and less visible FSWs, such as injection drug users and those with limited financial resources, are situated. Efforts to revise or reconsider sex work regulations to ensure that they best promote FSWs' health, human and labour rights are recommended.     

Psychosocial work characteristics of personal care and service occupations: a process for developing meaningful measures for a multiethnic workforce

Background and objectives. Despite their rapid increase in number, workers in personal care and service occupations are underrepresented in research on psychosocial work characteristics and occupational health. Some of the research challenges stem from the high proportion of immigrants in these occupations. Language barriers, low literacy, and cultural differences as well as their nontraditional work setting (i.e., providing service for one person in his/her home) make generic questionnaire measures inadequate for capturing salient aspects of personal care and service work. This study presents strategies for (1) identifying psychosocial work characteristics of home care workers that may affect their occupational safety and health and (2) creating survey measures that overcome barriers posed by language, low literacy, and cultural differences.

Design and results. We pursued these aims in four phases: (Phase 1) Six focus groups to identify the psychosocial work characteristics affecting the home care workers' occupational safety and health; (Phase 2) Selection of questionnaire items (i.e., questions or statements to assess the target construct) and first round of cognitive interviews (n = 30) to refine the items in an iterative process; (Phase 3) Item revision and second round of cognitive interviews (n = 11); (Phase 4) Quantitative pilot test to ensure the scales' reliability and validity across three language groups (English, Spanish, and Chinese; total n = 404). Analysis of the data from each phase informed the nature of subsequent phases. This iterative process ensured that survey measures not only met the reliability and validity criteria across groups, but were also meaningful to home care workers.

Conclusion. This complex process is necessary when conducting research with nontraditional and multilingual worker populations.     

Complementary value of functional capacity evaluation for physicians in assessing the physical work ability of workers with musculoskeletal disorders

Objective  To study the complementary value of information from functional capacity evaluation (FCE) for insurance physicians (IPs) who assess the physical work ability of claimants with long-term musculoskeletal disorders (MSD). Method  A post-test only design was used in the context of disability claims. Twenty-eight IPs participated in the study. Claimants with MSD formed the patient population. For each IP, the first claimant who agreed to participate was included in the study, and underwent FCE in addition to the regular disability claim assessment. Firstly, the IP performed the statutory disability claim assessment. Secondly, the FCE assessment took place. Finally, a self-formulated questionnaire was presented to the IPs after they viewed the FCE report. IPs were asked whether they perceived FCE information to be of complementary value to their judgment of the claimant’s physical work ability investigated. We considered FCE information to be of complementary value if more than 66% of the IPs indicated as such. IPs were also asked whether FCE information led them to change their initial judgment about the claimant’s physical work ability, and whether they felt this information made them more confident about their ultimate judgement. Finally, they were asked whether they planned to include FCE information in future disability claims and for what type of claimants. Differences between IPs who did or did not experience complementary value were explored. Results  Of the 28, 19 (nearly 68%) IPs considered FCE information to be of complementary value for their assessment of claimants with MSD. Half of the IPs stated that FCE information reinforced their judgment. All but four IPs changed their assessment after reading the FCE report. Sixteen IPs intended to involve FCE information in future disability claim assessments. There were no observed differences between the IPs who did or did not consider the FCE information to be of complementary value. Conclusion  FCE information was found to have complementary value at present and in the future according to most IPs in the assessment of the physical work ability of claimants with MSD. Half of the IPs felt that this information reinforces their judgment in this context.