The Michigan Disability Prevention Study: Research Highlights

This 3-year collaborative research project was designed to provide empirical evidence to substantiate the impact of various employer policies and practices on the prevention and management of workplace disability. It studied a random sample of 220 Michigan establishments with more than 100 employees from seven different industries who responded to a mail survey in the first half of 1991. The study correlates differences in employer-reported levels of achievement on policy and practice dimensions with performance on disability outcome measures, while controlling for a set of establishment characteristics in a multivariate regression analysis. There are three sets of policy and practice interventions evaluated here. First is safety intervention, that is, the attempt to prevent injuries from happening at all (measured as Safety Diligence, Ergonomic Solutions, and Safety Training). Second is disability management, the set of strategies to minimize the disability consequences of a given injury or disease arising from the workplace (measured as Disability Case Monitoring and Proactive Return-to-Work Program). Third is health promotion, which represents an attempt to intervene directly with individuals to encourage more healthy lifestyles, in the expectation that this will reduce the likelihood of a workplace accident or disease, or reduce the lost worktime resulting from a given injury or disease (measured as Wellness Orientation). In addition, a fourth dimension was included to capture the general environment of the firm and the orientation of its management in areas relevant to the study (measured as People Oriented Culture and Active Safety Leadership). These interventions and the general environment of the firm were scored on this set of eight variables which represent self-rated firm achievement of the policy and practice dimensions. The marginal effect of these interventions is determined by comparing firm performance on the incidence of work-related disability (Lost Workday Cases and Workers' Compensation Wage-Loss Claims), the duration of disability (Lost Workdays per Case), and overall disability prevention and management performance (Total Lost Workdays). Our results show that a higher self-rating on Safety Diligence is strongly associated with better performance on disability outcomes, varying with the specific measure. Higher self-rating on Proactive Return-to-Work Programs is also strongly associated with better performance outcomes. Safety Training and Active Safety Leadership is shown to have significant effects on the number of Lost Workday Cases. For example, on the summary measure of total Lost Workdays per 100 Employees, 10 percent better self-rating on Safety Diligence translates into 17 percent fewer lost workdays, and 10 percent better self-rating on Proactive Return-to-Work Programs translates into 7 percent fewer lost workdays. Thus, the twin strategies of trying to prevent injuries in the first place, and working to ameliorate their disability effects through disability management techniques, are both shown to be productive in reducing workplace disability in those establishments that have implemented them rigorously. Disability Case Monitoring could not be shown to have significant effects; in fact, Disability Case Monitoring had negative impacts in some cases. This probably reflects the controlling aspects of Disability Case Monitoring, as we speculate that these practices can be viewed by the employees as negative and interfering if they do not emanate from a supportive company human resource climate. Ergonomic Solutions and Wellness Orientation generally do not perform significantly, and this is attributed to their indirect connection to the performance outcomes used here or ineffective measurement of these dimensions in the study. Site visits were made to a subsample of 32 firms selected from the larger, random sample in order to confirm the quantitative survey findings and gain operational understanding of successful policies and practices contributing to low disability rates. Companies were generally found to be most advanced in their safety efforts, very active in injury management, and had implemented at least some form of return-to-work. Health promotion strategies to prevent specific work injuries have not yet been fully developed. The disability prevention efforts of successful firms use data effectively to measure performance, identify problems, guide actions taken, and motivate active support and participation of management, supervisors and line employees. Successful firms rigorously investigate injuries and communicate their commitment by immediately responding to risks when they are identified. In these low-disability firms, safety and disability management are viewed as components of quality, productivity and financial stability. Working relationships have been developed with responsive health care providers to assure effective injury management, but firms also maintain an active role in case management themselves. Their return-to-work process is systematic, yet flexible to respond to individual needs. Innovative firms have also implemented ergonomic principles to prevent risks. Nearly all companies visited reported increasing incidence and costs due to cumulative trauma and repetitive motion disorders. Additional strategies are needed to resolve and prevent these disabilities. This study demonstrates that many employers have moved aggressively to policies and practices designed to reduce the incidence and the costs of disability in their workplace. The project concludes that disability can be prevented and managed; and those who do it well can expect to be rewarded with lower disability costs, more satisfied workers, higher productivity and, ultimately, higher profits.disability, workers', compensation, Michigan, Hunt, Habeck

Disability Prevention Among Michigan Employers

This chapter briefly discusses the magnitude of the problem of disability in the workplace. It also presents an overview of the three and one-half year research project for which this Final Report is the product. It highlights the origins of the project and the major design elements that are reflected in this report. It concludes with a discussion of the remaining limitations of the research

Stochastic models for atomic clocks

For the atomic clocks used in the National Bureau of Standards Time Scales, an adequate model is the superposition of white FM, random walk FM, and linear frequency drift for times longer than about one minute. The model was tested on several clocks using maximum likelihood techniques for parameter estimation and the residuals were acceptably random. Conventional diagnostics indicate that additional model elements contribute no significant improvement to the model even at the expense of the added model complexity

Spatially Indirect Exciton Condensation in Superconductor Bilayers

We look at the possibility of spatially indirect exciton condensation in electrically isolated superconducting bilayers. We find that in a mean-field approximation bilayers can have superconducting and excitonic order simultaneously if repulsive interactions between layers are sufficiently strong. The excitonic order implies interlayer phase coherence, and can be conveniently studied in a representation of symmetric and antisymmetric bilayer states. When both orders are present we find several solutions of the mean-field equations with different values of the the symmetric and antisymmetric state pair amplitudes. The mixed state necessarily has non-zero pair amplitudes for electrons in different layers in spite of the repulsive interlayer interactions, and these are responsible for spatially indirect Andreev reflection processes in which an incoming electron in one layer can be reflected as a hole in the opposite layer. We evaluate layer diagonal and off-diagonal current-voltage relationships that can be used to identify this state experimentally

Employer Factors in the Incidence and Cost of Workers\u27 Compensation Claims

Examines the correlates of workers\u27 compensation claims incidence and costs for a select sample of Michigan employers in 198

Beam alignment techniques based on the current multiplication effect in photoconductors Third summary technical progress report, 15 Nov. 1966 - 15 Oct. 1967

Beam alignment techniques developed for infrared sensitive single crystal germanium to study multiplication effect in photoconductor

Uptake of advanced clinical practice roles in the health service in England: perspectives at the micro level

Health care organisations in many countries are developing advanced clinical practitioner roles to address workforce shortages and growing demand for services. Even in countries where advanced practice roles are more established there are low numbers, clustered in a limited range of professions, mostly nursing specialities. Successful implementation of national policies encouraging increased advanced practice roles and from a broader range of professions, requires attention to all levels of the health system. There is a lack of evidence as to the motivation to take-up these roles at the micro, individual actor level. This study explored the motivations important at the micro level in influencing a range of health professionals to undertake advanced practice roles. The study used an interpretive methodology with thematic analysis and was framed by theories of motivational domains in the work environment. Semi-structured interviews were undertaken with eighteen advanced clinical practitioners working in health care organisations in England. The motivators for role take-up were found to be predominantly intrinsic reflecting participants’ desires for advancement, both personal and for their profession, and improved efficiency of patient care. Participants described experiencing limited organisational support and sometimes discouragement from other professionals. There is potential for health organisations at the meso level of health care systems to support national growth of advanced practice roles by giving attention to the motivations of diverse health professionals. We propose a new theoretical framework of motivators for advanced clinical practice role uptake at the micro level

Path-integral calculation of the third virial coefficient of quantum gases at low temperatures

We derive path-integral expressions for the second and third virial coefficients of monatomic quantum gases. Unlike previous work that considered only Boltzmann statistics, we include exchange effects (Bose-Einstein or Fermi-Dirac statistics). We use state-of-the-art pair and three-body potentials to calculate the third virial coefficient of 3He and 4He in the temperature range 2.6-24.5561 K. We obtain uncertainties smaller than those of the limited experimental data. Inclusion of exchange effects is necessary to obtain accurate results below about 7 K.Comment: The following article has been accepted by The Journal of Chemical Physics. After it is published, it will be found at http://jcp.aip.org/ Version 2 includes the corrections detailed in the Erratu

Noise spectroscopy and interlayer phase-coherence in bilayer quantum Hall systems

Bilayer quantum Hall systems develop strong interlayer phase-coherence when the distance between layers is comparable to the typical distance between electrons within a layer. The phase-coherent state has until now been investigated primarily via transport measurements. We argue here that interlayer current and charge-imbalance noise studies in these systems will be able to address some of the key experimental questions. We show that the characteristic frequency of current-noise is that of the zero wavevector collective mode, which is sensitive to the degree of order in the system. Local electric potential noise measured in a plane above the bilayer system on the other hand is sensitive to finite-wavevector collective modes and hence to the soft-magnetoroton picture of the order-disorder phase transition.Comment: 5 pages, 2 figure

Are advanced clinical practice roles in England’s National Health Service a remedy for workforce problems? A qualitative study of senior staff perspectives

Objective: A major issue facing all health systems is improving population health while at the same time responding to both growing patient numbers and needs and developing and retaining the health care workforce. One policy response to workforce shortages has been the development of advanced clinical practice roles. In the context of an English national policy promoting such roles in the health service, we explored senior managers’ and senior clinicians’ perceptions of factors at the organization level that support or inhibit the introduction of advanced clinical practice roles. The investigation was framed by theories of the diffusion of innovation and the system of professions. Methods: We conducted a qualitative interview study of 39 senior manager and clinicians in 19 National Health Service acute, community, mental health and ambulance organizations across a metropolitan area in 2019. Results: Small numbers of advanced clinical practice roles were reported, often in single services. Four main influences were identified in the development of advanced clinical practice roles: staff shortages (particularly of doctors in training grades) combined with rising patient demand, the desire to retain individual experienced staff, external commissioners or purchasers of services looking to shape services in line with national policy, and commissioner-funded new roles in new ambulatory care services and primary care. Three factors were reported as enabling the roles: finance for substantive posts, evidence of value of the posts, and structural support within the organization. Three factors were perceived as inhibiting developing the roles: confusion and lack of knowledge amongst clinicians and managers, the availability of finance for the roles, and a nervousness (sometimes resistance) to introducing the new roles. Conclusions: While the national policy was to promote advanced clinical practice roles, the evidence suggested there was and would continue to be limited implementation at the operational level. Development scenarios that introduced new monies for such roles reduced some of the inhibiting factors. However, where the introduction of roles required funding to move from one part of a service to another, and potentially from one staff group to another, the growth of these roles was and is likely to be contested. In such scenarios, research and business evidence of relative advantage will be important, as too will be supporters in powerful positions. The paucity of publicly available evidence on the effectiveness of advanced clinical practice roles across the specialties and professions in the context requires urgent attention