Biomedical subjects
Publications and source records attributed to P Malm.
Educating staff, performing billing audits, and appealing claim denials can help agencies ensure compliance with Medicare regulations and prevent loss of revenue. By preparing in advance, agencies ensure a smoother ride through (what are quite often) turbulent investigations.
This study was performed in order to evaluate how individual characteristics, as well as ergonomic, organizational and psychosocial factors in the work situation are associated with early symptoms in the neck and shoulder area. Nine hundred randomly drawn subjects of the working population in a semi-rural community in Sweden were mailed a questionnaire comprising the Nordic questionnaire on musculoskeletal symptoms, questions on ergonomic, organizational and psychosocial work conditions, life style factors, and background factors. The total response rate was 73% (n = 637). Questions on ergonomic work conditions and on organizational and psychosocial work conditions provided the measures of exposure. Prevalence ratios (PR) were calculated for symptoms in the neck and shoulder area as reported by 303 subjects. Significant determinants for early symptoms were being a female and being an immigrant, as were repetitive movements demanding precision. High work pace, low work content and work role ambiguity were significant organizational risk factors while life style characteristics did not appear as risk factors. The results suggest that symptoms are signals not only of ergonomic deficiencies in the work situation, but in particular of work organizational conditions. Special attention should be given to the work conditions of women and immigrants in preventive interventions.
Explore the source record for details and available documents.
OBJECTIVE: To evaluate the effects of an early, active, and multidisciplinary rehabilitation programme for neck and shoulder disorders. METHODS: Primary health care and industrial health care of a nonrandomised, controlled, cohort was followed up over two years in a geographically defined area. The cohort consisted of working people who consulted a physician about disorders of the neck or shoulders from 1 August 1988 to 31 October 1989. Criteria for acceptance; not chronic symptoms, patients had sick leave of no more than four weeks. Disorders were not caused by trauma, infections, malignancy, rheumatic diseases, abuse, or pregnancy. 107 people qualified for the study, 87% were followed up for two years. They were divided into two groups. One group obtained active, multidisciplinary rehabilitation for eight weeks that comprised physical training, information, education, social interaction, and work place visits. Controls were given traditional treatment; physiotherapy, medication, rest, and sick leave. The main outcome measures were: average number of days of sick leave for the two years after rehabilitation, subjective pain on a visual analogue scale, and ratings on seven subscales of the sickness impact profile. RESULTS: At 12 and 24 months of follow up effects of the active rehabilitation programme did not differ from traditional treatment in any of the outcome measures. New work task (P < 0.05) or changed work place (P < 0.001) during the follow up period were associated with decreased sick leave, independent of treatment. CONCLUSIONS: Active, multidisciplinary rehabilitation of neck and shoulder disorders was not more effective than traditional treatment. Changed work conditions were associated with decreased sick leave, independent of type of treatment provided.
A case-control study was performed to elucidate the strength of the relation between musculoskeletal disorders in the neck and shoulders and physical, organisational, and psychosocial aspects of the work environment. Cases were identified as those persons who consulted a physician in a community in southern Sweden for new musculoskeletal disorders in the neck and shoulders during a study period from August 1988 to the end of October 1989. One hundred and nine cases were collected and clinically examined. The cases also answered the Nordic questionnaire on symptoms as well as a questionnaire on work conditions and background factors. Controls were drawn as a random sample of the working population in the community where the cases appeared. A total of 637 controls answered the same questionnaires as the cases. Odds ratios (ORs) were calculated by logistic regression. The odds ratios were 11.4 for women, 4.9 for immigrant background, and 3.7 for current smoking. To exercise rarely, compared with often, appeared as a preventive factor with an OR of 0.3. The ORs for various determinants of physical work load were 7.5 for repetitive movements demanding precision, 13.6 for light lifting, 3.6 for uncomfortable sitting positions, 4.8 for work with lifted arms, and 3.5 for a rushed work pace. Regarding work organisational determinants, the ORs were 16.5 for ambiguity of work role (uncertainty whether the person could manage the work) 2.6 for low quality work, and 3.8 for high demands on attention. Several of the determinants showed a significant dose-response relation with disease. It seems that work organisation and psychosocial work conditions are as important determinants for disease in the neck and shoulders as are the physical work conditions.
Explore the source record for details and available documents.