The feasibility of a web-based counselling program for occupational physicians and employees on sick leave due to back or neck pain

BACKGROUND: The objective of this feasibility study was to gain insight into occupational physicians' (OPs) and employees' use of, and attitudes towards, 'Snelbeter' (Get Well Fast), a new web-based counselling program for employees on sick leave due to non-specific back or neck pain and their OPs. METHODS: Registered user information was collected from the website to get insight in the use of the program by employees (n = 24). Qualitative information was obtained through semi-structured in-depth interviews with 19 OPs and nine employees in order to get insight in the actual use of the provided information, the attitudes towards the program and possible improvements of the program. RESULTS: Actual use of the program among OPs was low. The majority of OPs, eight out of 11 (73%), never or only occasionally signed in. The greatest obstacle for OPs to use the program was the low number of eligible employees involved. Employees appreciated the program but their use was moderate. A small majority of the employees who used the program, 14 out of 24 (58%), opened 50% to 100% of the provided documents, a majority of the interviewed employees, seven out of nine (78%), used the provided information sometimes or regularly. The absence of personal contact was found to be a major barrier towards use of the program by employees. CONCLUSION: Although both OPs and employees appreciated the idea of the program and employees appreciated using it, program utilization was moderate to low. The discussion section reveals that before implementation can be started to any extent, the program will need adaptations that make it more attractive to use. The program should be considered for both return to work (RTW) and the prevention of sick leave. Adding personal contact (e.g. involving physiotherapists) to the program may also be promisin

Generating FAIR research data in experimental tribology

Solutions for the generation of FAIR (Findable, Accessible, Interoperable, and Reusable) data and metadata in experimental tribology are currently lacking. Nonetheless, FAIR data production is a promising path for implementing scalable data science techniques in tribology, which can lead to a deeper understanding of the phenomena that govern friction and wear. Missing community-wide data standards, and the reliance on custom workflows and equipment are some of the main challenges when it comes to adopting FAIR data practices. This paper, first, outlines a sample framework for scalable generation of FAIR data, and second, delivers a showcase FAIR data package for a pin-on-disk tribological experiment. The resulting curated data, consisting of 2,008 key-value pairs and 1,696 logical axioms, is the result of (1) the close collaboration with developers of a virtual research environment, (2) crowd-sourced controlled vocabulary, (3) ontology building, and (4) numerous – seemingly – small-scale digital tools. Thereby, this paper demonstrates a collection of scalable non-intrusive techniques that extend the life, reliability, and reusability of experimental tribological data beyond typical publication practices

Effectiveness of physical training for self-employed persons with musculoskeletal disorders: a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Despite the fact that the population of self-employed persons is still growing and at risk for long term disability due to a number of risk factors, there is still a lack of information on the effectiveness of interventions for this specific group.</p> <p>Methods</p> <p>To determine the effectiveness of physical training without a cognitive behavioral component and workplace specific exercises (PT) and physical training with a cognitive behavioral component and workplace specific exercises (PTCBWE), we conducted a pragmatic Randomized Controlled Trial, stratified into two groups. Self-employed persons with a new work disability claim because of musculoskeletal disorders were randomized to PT (n = 53) or PTCBWE (n = 76), or to a corresponding usual care group (n = 50 and n = 75 respectively). Both types of training consisted of cardiovascular training, strengthening, relaxation and posture exercises and took place two or three times a week, for 1–1.5 hours, during three months, also if someone had already returned to work full-time. The primary outcome measure was claim duration (in days) during 12 months follow-up. Pain severity and functional status were secondary outcome measures. All data were assessed at baseline and at 6 and 12 months follow-up. The data with regard to claim duration were analyzed by survival analysis and Cox regression analysis. Secondary outcome measures were analyzed by means of linear regression analysis.</p> <p>Results</p> <p>After 12 months of follow-up there was no difference in claim duration between PT and usual care (Hazard Ratio 0.7; 95%CI, 0.4–1.1; p = 0.12) or PTCBWE and usual care (Hazard Ratio 0.9; 95%CI, 0.6–1.4; p = 0.72). Both types of physical training and usual care improved in pain and functional status over time, but there was only a statistically significant difference in favor of PT on pain improvement at 6 months.</p> <p>Conclusion</p> <p>In this study, physical training with and without a cognitive behavioral component and workplace specific exercises for self-employed persons with musculoskeletal disorders was not shown to be effective on claim duration, pain severity and functional status at 12 months follow-up.</p> <p>Trial registration</p> <p>Current Controlled Trials ISRCTN67766245.</p

Managed Care in der Schweiz: Eine Literaturanalyse zu Kostenunterschieden zwischen traditioneller Versorgung und Managed Care unter Einbezug der Qualität

Die vorliegende Arbeit untersucht auf Basis einer Literaturanalyse den aktuellen Wissensstand über die Unterschiede zwischen einer traditionellen Versorgung und einer integrierten Versorgung (Managed Care) in der Schweiz mit Fokus auf die Kosten. Studien zu Qualitätsunterschieden wurden in direktem Zusammenhang mit Untersuchungen zu Kostenunterschieden berücksichtigt. Die Versorgung in Managed Care erweist sich – bei Berücksichtigung der Morbidität – als kostengünstiger im Vergleich zur traditionellen Versorgung. Die Faktoren, die zu diesen Unterschieden führen, wurden von keiner bekannten Studie untersucht. Für die Erklärung der Ursachen besteht Forschungsbedarf. Die Verknüpfung von Kostenunterschieden und Qualitätsunterschieden wurde nur in einer Studie vollzogen. Auch hier besteht weiterer Forschungsbedarf

[Software-Based Evaluation of Optimization Potential for Clinical MRI Scanners in Radiology].

OBJECTIVE  The aim of the study was to use a software application to analyze the examination times and changeover times of two clinically highly applied MRI scanners at a university hospital for radiology and to evaluate whether this could result in optimization potential for examination planning in the daily clinical routine of MRI diagnostics. MATERIALS AND METHODS  Based on the newly developed software application "Teamplay Usage" (Siemens Healthineers, Germany), the examinations carried out on two MRI scanners (1.5 T and 3 T) were investigated within an analysis period of 12 months with regard to the type of examination and its duration. In addition, compliance with the previously defined planning time (30, 45, 60 min.) was checked and deviations were analyzed. In addition, the changeover times between the examinations were determined and a possible influence due to the exchange of MRI coils was investigated for a selection of change combinations. RESULTS  For the total of 7184 (1.5T: 3740; 3T: 3444) examinations included in the study, the median examination time was 43:02 minutes (1.5T: 43:17 min.; 3T: 42:45 min.). The ten most frequent types of examinations per MRI scanner were completed within the predefined plan time of 54.5 % (1.5 T) and 51.9 % (3 T), taking into account a previously defined preparation and post-processing time of 9 minutes per examination. Overall, more time was spent on examinations with a planned time of 30 minutes, whereas the majority of the examinations planned with 45 minutes were also completed within this time. Examinations with a planned time of 60 minutes usually took less time. A comparison between the planned time and the determined examination duration of the most common types of examinations showed overall a slight potential for optimization. Coil exchanges between two examinations had a small, but statistically not significant effect on the median changeover time (p = 0.062). CONCLUSION  Utilizing a software-based analysis, a detailed overview of the type of examination, examination duration, and changeover times of frequently used clinical MRI scanners could be obtained. In the clinic examined, there was little potential for optimization of examination planning. An exchange of MRI coils necessary for different types of examination only had a small effect on the changeover times