Work - Volume 26, issue 4

Article Type: Other

Citation: Work, vol. 26, no. 4, pp. 333-333, 2006

Authors: Shechtman, Orit | Anton, Stephen D. | Kanasky Jr., William F. | Robinson, Michael E.

Article Type: Research Article

Abstract: The coefficient of variation (CV) is used to determine sincerity of effort of strength measurements. However, there is a controversy in the literature concerning its validity and effectiveness. We used a meta-analytic approach and calculated the effect size between maximal and submaximal efforts for the CV of grip, elbow flexion and knee extension. We summarized findings concerning stability, sensitivity and specificity of the CV. We found large effect sizes (d ⩾ 0.8) for all comparisons indicating …that submaximal efforts were more variable than maximal efforts. We also found large error rates and low stability of the CV. The error rates and stability values of the CV are unacceptable from both a clinical and a medico-legal standpoint. Therefore, the use of the CV for assessing sincerity of effort needs to be questioned. Show more

Keywords: Grip strength, meta-analysis, coefficient of variation, sincerity of effort

Citation: Work, vol. 26, no. 4, pp. 335-341, 2006

Authors: Andersson, Lena | Nyman, Carin Staland | Spak, Fredrik | Hensing, Gunnel

Article Type: Research Article

Abstract: Regional differences in Sweden in the prevalence of disability pension with a psychiatric diagnosis are unexplained, in spite of the significant impact on the population's health, rehabilitation systems, and the health care system. The purpose of this study was to describe the pattern of disability pensions with a psychiatric diagnosis and to analyze the impact of age and gender. We examined the incidence rates in one urban and one semi-rural region and compared these to national …rates. The study sample was drawn from employed persons between 16–64 years of age who, because of their sickness insurance coverage, would be eligible to access disability pensions should it be necessary. Analysis of annual incidences and standardized morbidity ratios were made for 1980, 1985, 1990, 1995, and 1998. Data on disability pension cases were collected from the National Social Insurance registers. In the urban region we found that the proportion of men and women clearly outnumbered the national average: approximately twice the number of persons between 16–64 years of age with a psychiatric diagnosis were receiving a disability pension. In the semi-rural region there were fewer men overall on disability pensions with psychiatric disorders, but in 1980, 1985, and 1995 women clearly outnumbered men. Access to psychiatric care, unemployment, alcohol dependence, and previous sickness absence are suggested as possible factors that might affect the rates of disability pension in different geographical settings. Show more

Keywords: Swedish mental health system, psychiatric diagnosis, regional differences, disability pensions

Citation: Work, vol. 26, no. 4, pp. 343-353, 2006

Authors: Hall, Allison Cohen | Timmons, Allison Cohen | Boeltzig, Heike | Hamner, Doris | Fesko, Sheila

Article Type: Research Article

Abstract: The Workforce Investment Act of 1998 (USA) mandates that partners in the One-Stop Career Center system be prepared to serve a diverse customer base. Effective service delivery depends in part on a focus on human resources and professional development. This article presents innovative strategies for One-Stop Career Center staff training related to serving customers with disabilities. Findings from case study research conducted in several One-Stops across the country revealed that staff struggled with both knowledge and …attitudes around disability issues. To address these concerns, local leaders developed practices that provided opportunities to gain practical skills and put acquired knowledge to use. These included a formalized curriculum focused on disability issues; informal support and consultation from a disability specialist; and exposure and learning through internships for students with disabilities. Implications are offered to stimulate thinking and creativity in local One-Stops regarding the most effective ways to facilitate staff learning and, in turn, improve services for customers with disabilities. Show more

Citation: Work, vol. 26, no. 4, pp. 355-367, 2006

Authors: Hultberg, Eva-Lisa | Lönnroth, Knut | Allebeck, Peter | Hensing, Gunnel

Article Type: Research Article

Abstract: Aims: The aim of the study was to assess if health care centres with a co-financing model for collaborative rehabilitation between primary health care, sickness insurance offices and social welfare offices reduced sick leave among persons with musculoskeletal disorders compared to health centres with conventional rehabilitation structures. Method: A comparative prospective study was conducted. Consecutive patients aged 16–64 with musculoskeletal disorders attending the health care centres with (n=107) and without (n=31) co-financing model were …interviewed. In addition, we collected register data about patients' allowances for sick leave days for totally 18 months. Results: The intervention group had an average of 94 days and the controls 87 days on sick leave during the 12-months period after inclusion in the study. At 12 months the proportion of patients sick listed was 31% in the intervention group and 32% in the control group. Conclusion: The study could not show that the co-financing model reduced the numbers of sick leave days among patients with musculoskeletal disorders. A possible explanation for the lack of positive impact on patients' health or work ability might be that the working procedure has in fact not really been changed and the tool mix lack solid evidence. The study identifies some methodological problems addressed in future research trying to link organisational changes with patient outcomes. Show more

Keywords: Collaboration, sick leave, musculoskeletal disorder, co-financing, interdisciplinary

Citation: Work, vol. 26, no. 4, pp. 369-377, 2006

Authors: Sandqvist, Jan L. | Törnquist, Kristina B. | Henriksson, Chris M.

Article Type: Research Article

Abstract: Adequate work assessments are a matter of importance both for individuals and society [5,29,31,38,40,46,52]. However, there is a lack of adequate and reliable instruments for use in work rehabilitation [14,15,20,21,31,44]. The purpose of this study was to develop and evaluate an observation instrument for assessing work performance, the AWP (Assessment of Work Performance). The purpose of the 14-item instrument is to assess the individual's observable working skills in three different areas: motor skills, …process skills, and communication and interaction skills. This article describes the development and results of preliminary testing of the AWP. The testing indicates a satisfactory face validity and utility for the AWP and supports further research and testing of the instrument. Show more

Keywords: Occupational therapy, measurement, instrument development, skills, MOHO

Citation: Work, vol. 26, no. 4, pp. 379-387, 2006

Authors: Cheng, P.L. | Dumas, G.A. | Smith, J.T. | Leger, A. | Plamondon, A. | McGrath, M.J. | Tranmer, J.E.

Article Type: Research Article

Abstract: The objective of this study was to evaluate the reproducibility of a Task Description Questionnaire that was designed to investigate exposures to, and influential factors for, problematic tasks experienced by working pregnant women. The questionnaire comprised questions concerning 22 task components (covering working posture, manual material handling, work pace, prolonged postures and others), eight influential factors contributing to problematic tasks, discomfort (measured using a body map) and level of effort to perform …the tasks. Reproducibility of the questionnaire was assessed by interviewing participants on two occasions one week apart for interviews at both 20 and 34 weeks of pregnancy. Eleven and 13 problematic tasks were reported by 21 working pregnant women at 20 and 34 weeks of pregnancy, respectively. These tasks were surveyed using the Task Description Questionnaire. Kappa statistics and correlation coefficients (supplemented by paired t-tests) were used to examine the reproducibility of responses to the questionnaire. The results showed that most of the variables were measured with very good or satisfactory reproducibility. The reproducibility of exposure to work posture was higher than that of exposure to manual material handling. There was no significant difference between test and retest means for the discomfort scores measured on the body map, except for the maximum discomfort score for the whole body in the 34 weeks survey. The study suggests that the questionnaire can be reliably used in the study of problematic tasks experienced by pregnant women. But an initial preview of the questions by the subjects and explanation of the questions given to the subjects by the interviewer may help to produce more reliable results. Show more

Keywords: Reproducibility, reliability, task analysis, pregnant women, risk factors

Citation: Work, vol. 26, no. 4, pp. 389-397, 2006

Authors: Osmotherly, Peter | Attia, John

Article Type: Research Article

Abstract: Background: The healthy worker survival effect is a complex and poorly controlled bias affecting occupational studies. Little is known about its behaviour in samples of computer based workers. This descriptive study examined the healthy worker effect in relation to muscle performance and neck pain in call-centre operators. Methods: 28 call-centre workers were examined for postural muscle performance. Neck pain was measured using a validated questionnaire. Analysis was by multivariate regression of the cohort, stratified …by years of employment. Results: Analysis using the entire sample failed to display any relationship between neck pain and muscle performance. Further examination revealed survival/secondary selection within the sample, with pain and poor muscle performance reduced after 6 years employment. Stratified analysis demonstrated that deep flexor muscle performance and posture were statistically significantly associated with neck pain. Each stratum explained a greater percentage of the variance in questionnaire scores, increasing from 42.3% for the entire sample to 95.1% for the 4 years employed subgroup. Conclusion: The healthy worker survival effect is demonstrable in occupations with lower physical demands. It should be considered in analysis since it may obscure causal associations. There is no single method for controlling this bias and greater understanding of its components is required. Show more

Keywords: Effect modifiers, neck pain, occupational health, selection bias

Citation: Work, vol. 26, no. 4, pp. 399-406, 2006

Authors: Blitz, Cynthia L. | Mechanic, David

Article Type: Research Article

Abstract: Unemployment rates remain high among individuals with psychiatric disabilities despite growing evidence that supported employment programs (SEPs) can help such individuals to obtain and retain competitive employment. A complete understanding of factors that may facilitate or hinder the success of such supported employment efforts is urgently needed to increase the efficacy of SEPs and move more individuals with psychiatric disabilities from welfare to work. This exploratory study provides insight into potential facilitators and …barriers to employment among individuals with psychiatric disabilities from the perspective of job coaches. Twenty-eight job coaches from 14 SEPs in a Northeastern state reported on their experience with four recent clients, two who were successful in obtaining employment and two who failed, through a semi-structured mail survey. Findings suggest that job coaches use similar strategies to assist clients, but in each case try to tailor specific strategies to client's needs and characteristics. Factors that influence successful job placement and research and policy implications are discussed. Show more

Keywords: Supported employment, vocational rehabilitation, mental illness

Citation: Work, vol. 26, no. 4, pp. 407-419, 2006

Authors: Borg, K. | Goine, H. | Söderberg, E. | Marnetoft, S.-U. | Alexanderson, K.

Article Type: Research Article

Abstract: The objective was to compare the applicability of and results provided by the two measures of sickness absence used most often within the Swedish social insurance administration (that is, unadjusted sick-leave rate and adjusted sick-leave rate) and five measures suggested by epidemiological researchers. Data consisted of four cross-sectional data sets of registry sick-leave data covering four separate years (1997–2000) in three counties. In total 454,000 persons qualified for sickness insurance and aged …20–64 years were included. The two measures used within the social insurance administration and three of the five measures suggested by epidemiological researchers revealed sex-related dissimilarities in absence patterns that indicated that women had more sickness absence than men. However, in marked contrast to those results, two of the epidemiologically based measures (i.e., length of sickness absence and duration of sickness absence) instead showed highly comparable rates of sick leave for men and women, and such information is seldom obtained, albeit definitely of importance, when trying to make a correct assessment of sickness absence. The measure of sickness absence that is used influences the findings and should therefore be chosen with care. Complementing the measures used in the social insurance administration by five measures suggested by epidemiological researchers provided a more informative and comprehensive picture of sickness absence in a population. Further investigations into the effect of using different measures is needed, as well as international consensus on what to call different measures. Show more

Citation: Work, vol. 26, no. 4, pp. 421-428, 2006