Uproar at Oxford as suspended professor returns to work.
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The history, physical characteristics and fitness status of 60 persons who had sustained a spinal cord injury at least 3 years previously were considered in relation to current occupation. All subjects had completed their education, 39 being gainfully employed and 21 unemployed. The general characteristics of the sample, mainly beneficiaries of the Quebec Automobile Insurance Plan, were typical of spinal cord injured individuals in North America. The working group had a significantly higher current level of education than those who were unemployed (p less than .01). In terms of physical fitness, the workers were lighter, with a lower body mass index and a higher aerobic power (p less than .05). Isokinetic testing suggested a trend toward a higher peak torque in the workers. The total work performed (Nm.kg-1) during an isokinetic endurance test (25 biphasic contraction at 180 degrees.sec-1) was significantly higher in the workers, suggesting that such muscular endurance might be even more useful than greater peak isokinetic strength during vocational activities. However, the likelihood of employment was unrelated to habitual patterns of either aerobic exercise or overall physical activity. No significant differences of physical fitness or physical activity habits were found between workers holding sedentary versus physically demanding jobs. The results verified the positive relationship between physical fitness (body composition, aerobic power, muscular endurance) and the gainful employment of paraplegics, but failed to show any significant relationship between physical fitness and the acceptance of physically demanding work by such individuals.
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Intra-articular fractures of the calcaneus typically occur in individuals working on ladders, scaffolding or roofs. Male individuals in their productive age are most at risk. The functional problems that frequently persist are a well-known risk since they may obstruct a safe resumption of the former job. According to the data of the National Institute for Sickness and Invalidity Insurance the number of calcaneal fractures in Belgium have stabilised over the last ten years. These figures indicate the necessity for a better prevention policy. Scientific literature about the problem of impairment and disability in these cases is rare and lacks uniformity. A retrospective study was therefore performed on 65 private insurance compensation patients who were treated for intra-articular calcaneal fractures. The mean period of work incapacity was 260.5 days and the mean percentage of impairment was 12.3%. A large group (86.2%) were able to resume their former activities including the height workers. More than half of the patients (57%) needed a supportive device. Working at heights and falls from a height were a significant risk factor for long-term work incapacity. The figures are compared with the limited literature and further discussed.
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OBJECTIVE: To provide a detailed description of post-herniorrhaphy convalescence. DESIGN: Prospective, descriptive, consecutive questionnaire case series. SETTING: Public university hospital, Denmark. PATIENTS: 100 consecutive patients treated for inguinal hernia. INTERVENTION: Elective open inguinal herniorrhaphy under local anaesthesia. One day convalescence for light/moderate and three weeks for strenuous physical activity was recommended. MAIN OUTCOME MEASURE: Duration of absence from work or main recreational activity. RESULTS: Overall median absence (including the day of operation) was 6 days (interquartile range 1-16). For unemployed patients it was 1 day (0-7), for patients with a light or moderate workload 6 days (3-12), and for those with a heavy workload 25 days (21-37). Among the 64 patients, who did not follow the recommendations, pain was contributory in 33 and advice from the general practitioner in 12. Pain was the main cause of impairment of activities of daily living. CONCLUSION: Well-defined recommendations for convalescence may, together with improved management of postoperative pain, shorten convalescence; they are essential in the evaluation of effects of different surgical techniques of herniorrhaphy on convalescence.
OBJECTIVES: To determine the views of organizations of and for disabled people in order to inform the writing of the British Society of Research Medicines policy document "Vocational Rehabilitation--The Way Forward". PATIENTS/ORGANIZATIONS: A single mailing was sent to 98 disability organizations within the UK. DESIGN: A semi-structured postal questionnaire focused on factors (i) within the National Health Service; (ii) external to it, mainly in the workplace, making it difficult for people to stay in work in the presence of disease/disability, or to find work after losing their job (within the last 6 months). RESULTS: A 30% response rate, with many incomplete questionnaires, was obtained so that 24 complete questionnaires were analysed. The dominant findings concerning the National Health Service were, overwhelmingly, that it was perceived as impacting deleteriously on the work of disabled people with delays to consultation, investigation and rehabilitation and a lack of appreciation of workplace issues. Employers were seen as unresponsive to the needs of workers, with negative attitudes to disability. The changes required in both areas were closely related to these findings. CONCLUSION: Though the organizations surveyed were not representative, nevertheless there was considerable agreement about the need for both the National Health Service and employers to be more responsive to the workplace needs of disabled people.
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The authors propose a dynamic 'man-work system' model, centered around the bodily strain, which is determined jointly by the momentary efficiency of the organism and the sum of stresses acting at a given point of time, i.e. integrated along various durations. With regard to stresses, they call attention to the heuristic significance of a separate subgroup, that of physiological stresses and also to the necessity of the distinction of a physiological subclass in the class of information stresses. The 'man-work system' is completed by positive and negative feedback from the strain and the components of efficiency, thereby providing the basis of successful or unsuccessful adaptation of the organism to the short- and long-term challenges. The authors are of the opinion that the system offers a sounder foundation for rehabilitative as well as preventive cardiology.
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