A Community-Focused Health & Work Service (HWS)

We recommend establishment of a community-focused Health & Work Service (HWS) dedicated to responding rapidly to new health-related work absence among working people due to potentially disabling conditions. The first few days and weeks after onset are an especially critical period during which the likelihood of a good long-term outcome is being influenced, either favorably or unfavorably, by some simple things that either do or do not happen during that interval. It is the optimal window of opportunity to improve outcomes by simultaneously attending to the worker’s basic needs and concerns as well as coordinating the medical, functional restoration, and occupational aspects of the situation in a coordinated fashion

Developing an Intervention Toolbox for the Common Health Problems in the Workplace

Development of the Health ↔ Work Toolbox is described. The toolbox aims to reduce the workplace impact of common health problems (musculoskeletal, mental health, and stress complaints) by focusing on tackling work-relevant symptoms. Based on biopsychosocial principles this toolbox supplements current approaches by occupying the zone between primary prevention and healthcare. It provides a set of evidence-informed principles and processes (knowledge + tools) for tackling work-relevant common health problems. The toolbox comprises a proactive element aimed at empowering line managers to create good jobs, and a ‘just in time’ responsive element for supporting individuals struggling with a work-relevant health problem. The key intention is helping people with common health problems to maintain work participation. The extensive conceptual and practical development process, including a comprehensive evidence review, produced a functional prototype toolbox that is evidence based and flexible in its use. End-user feedback was mostly positive. Moving the prototype to a fully-fledged internet resource requires specialist design expertise. The Health ↔ Work Toolbox appears to have potential to contribute to the goal of augmenting existing primary prevention strategies and healthcare delivery by providing a more comprehensive workplace approach to constraining sickness absence

EuroSpine Task Force on Research: support for spine researchers

In recognition of the value of research to the practice of spine care, Federico Balagué and Ferran Pellisé, at the time President and Secretary for EuroSpine, asked Margareta Nordin to set up a Task Force on Research (TFR) for EuroSpine during summer 2011. The concept was to stimulate and facilitate a research community within the society, through two main functions: (1) distribution of EuroSpine funds to researchers; (2) develop and deliver research training/education courses. What has the EuroSpine TFR accomplished since its inception

System influences on work disability due to low back pain: an international evidence synthesis

Work disability due to low back pain is a significant global health concern. Current policy and practice aimed at tackling this problem is largely informed by the biopsychosocial model. Resultant interventions have demonstrated some small-scale success, but they have not created a widespread decrease in work disability. This may be explained by the under-representation of the less measurable aspects in the biopsychosocial evidence base; namely the influence of relevant systems. Thus, a ‘best-evidence’ synthesis was conducted to collate the evidence on how compensatory (worker’s compensation and disability benefits), healthcare and family systems (spouse/partner/close others) can act as obstacles to work participation for those with low back pain. Systematic searches of several scientific and grey literature sources were conducted, resulting in 1,762 records. Following a systematic exclusion process, 57 articles were selected and the evidence was assessed using a system adapted from previous large-scale policy reviews conducted in this field. Results indicated how specific features of relevant systems could act as obstacles to individual efforts/interventions aimed at tackling work disability due to LBP. These findings reinforce the need for a ‘whole-systems’ approach, with all key players onside and have implications for the revision of current biopsychosocial-informed policy and practice

Riding against the wind: a review of competition cycling aerodynamics

Aerodynamics has such a profound impact on cycling performance at the elite level that it has infiltrated almost every aspect of the sport from riding position and styles, equipment design and selection, race tactics and training regimes, governing rules and regulations to even the design of new velodromes. This paper presents a review of the aspects of aerodynamics that are critical to understanding flows around cyclists under racing conditions, and the methods used to evaluate and improve aerodynamic performance at the elite level. The fundamental flow physics of bluff body aerodynamics and the mechanisms by which the aerodynamic forces are imparted on cyclists are described. Both experimental and numerical techniques used to investigate cycling aerodynamic performance and the constraints on implementing aerodynamic saving measures at the elite level are also discussed. The review reveals that the nature of cycling flow fields are complex and multi-faceted as a result of the highly three-dimensional and variable geometry of the human form, the unsteady racing environment flow field, and the non-linear interactions that are inherent to all cycling flows. Current findings in this field have and will continue to evolve the sport of elite cycling while also posing a multitude of potentially fruitful areas of research for further gains in cycling performance

The Bell Laboratories (13)CO Survey: Longitude-Velocity Maps

A survey is presented of the Galactic plane in the J=1-0 transition of (13)CO. About 73,000 spectra were obtained with the 7 m telescope at Bell Laboratories over a ten-year period. The coverage of survey is (l, b) = (-5 to 117, -1 to +1), or 244 square degrees, with a grid spacing of 3' for |b| < 0.5, and a grid spacing of 6' for |b| > 0.5. The data presented here have been resampled onto a 3' grid. For 0.68 km/s channels, the rms noise level of the survey is 0.1 K on the $T_R^*$ scale. The raw data have been transformed into FITS format, and all the reduction processes, such as correcting for emission in the reference positions, baseline removal and interpolation were conducted within IRAF using the FCRAO task package and additional programs. The reduced data are presented here in the form of longitude-velocity color maps at each latitude. These data allow identification and classification of molecular clouds with masses in excess of ~ 1,000 solar masses throughout the first quadrant of the Galaxy. Spiral structure is manifested by the locations of the largest and brightest molecular clouds.Comment: 23 pages, 7 figures, ApJS submitted (out of 41 frames of Figure4, only one is included becaue of size limit

The costs and benefits of active case management and rehabilitation for musculoskeletal disorders

The burden of musculoskeletal disorders (MSDs) to employers and workplaces is significant; and the most important cost to employers and society is lost time from work. ‘Case management’ is a goal-oriented approach to keeping employees at work and facilitating an early return to work. There is good scientific evidence that case management methods are costeffective through reducing time off work and lost productivity, and reducing healthcare costs. There is even stronger evidence that best-practice rehabilitation approaches have the very important potential to significantly reduce the burden of long-term sickness absence due to MSDs. The combination of case management with suitable rehabilitation principles is currently being used effectively in multiple settings throughout the UK, and there is growth within the case management sector. Current providers vary widely in quality and experience. There is limited professional regulation, although localised standards of practice have recently become available. Many of the factors influencing the adoption of cost-effective case management and rehabilitation approaches rest with employers, and funders/commissioners of healthcare. It may be easier to integrate these practices into large and medium-sized workplaces, but there is no reason why the same principles cannot be applied to small businesses and the self-employed. It appears to be very timely for the distribution of information to employers and other key players about how effective case management and suitable rehabilitation approaches can be, and how applicable they are to UK settings. To this end, an integrated model specific to the UK has been developed. An evidence-based model for managing those with MSDs was developed that is widely applicable to all types of industry and business in the UK. It describes the principles to apply in order to integrate case management and rehabilitation with the workplace. It was derived from high quality scientific studies, and research conducted into views on the applicability and effectiveness within the UK. It is recommended that HSE distribute guidance based on this model

Experiences of workers with post-COVID-19 symptoms can signpost suitable workplace accommodations

The prevalence and multi-system nature of post-COVID-19 symptoms warrants clearer understanding of their work ability implications within the working age population. An exploratory survey was undertaken to provide empirical evidence of the work-relevant experiences of workers recovering from COVID-19. A bespoke online survey based on a biopsychosocial framework ran between December 2020 and February 2021. It collected quantitative ratings of work ability and return-to-work status, qualitative responses about return-to-work experiences, obstacles and recommendations, along with views on employer benefits for making accommodations. A sample of 145 UK workers recovering from COVID-19 was recruited via social media, professional networks and industry contacts. Qualitative data was subject to thematic analysis. Participants were mainly from health/social care (50%) and educational settings (14%). Findings – Just over 90% indicated that they had experienced at least some post-COVID-19 symptoms, notably fatigue and cognitive effects. For 55%, symptoms lasted longer than six months. Only 15% had managed a full return-to-work. Of the 88 who provided workability ratings, just 13 and 18% respectively rated their physical and mental workability as good or very good. Difficulties in resuming work were attributed to symptom unpredictability, their interaction with job demands, managing symptoms and demands in parallel, unhelpful attitudes and expectations. Manager and peer support was reported as variable. Workplace health management characterised by flexible long-term collaborative return-to-work planning, supported bymoreCOVID-centric absence policies and organisational cultures, appear pivotal for sustaining the return-to-work of the large segments of the global workforce affected by post-COVID-19 symptoms

Complementary vertices and adjacency testing in polytopes

Our main theoretical result is that, if a simple polytope has a pair of complementary vertices (i.e., two vertices with no facets in common), then it has at least two such pairs, which can be chosen to be disjoint. Using this result, we improve adjacency testing for vertices in both simple and non-simple polytopes: given a polytope in the standard form {x \in R^n | Ax = b and x \geq 0} and a list of its V vertices, we describe an O(n) test to identify whether any two given vertices are adjacent. For simple polytopes this test is perfect; for non-simple polytopes it may be indeterminate, and instead acts as a filter to identify non-adjacent pairs. Our test requires an O(n^2 V + n V^2) precomputation, which is acceptable in settings such as all-pairs adjacency testing. These results improve upon the more general O(nV) combinatorial and O(n^3) algebraic adjacency tests from the literature.Comment: 14 pages, 5 figures. v1: published in COCOON 2012. v2: full journal version, which strengthens and extends the results in Section 2 (see p1 of the paper for details