This article presents a case of severe burn injury at work involving 80 % of body surface area and patient treatment and rehabilitation, which resulted in preserved working ability. The worker was ...injured by hot water and steam. After initial treatment in the intensive care unit, he underwent comprehensive clinical and outpatient rehabilitation that took 92 weeks, after which he returned to work. His working disability was 100 % after the initial treatment in the intensive care unit, but rehabilitation improved it to 50 %. It should always be kept in mind that even patients with serious or life-threatening injuries can be reintegrated into the workforce if patients, physicians, occupational physicians, and employers all work together.
Ovaj članak prikazuje slučaj teške ozljede na radu uslijed opekline koja je zahvatila 80 % površine tijela bolesnika, njegovo liječenje i rehabilitaciju, kojima se uspio očuvati dio radne sposobnosti. Opeklinu je izazvala vrela voda i para. Nakon početnoga liječenja u jedinici intenzivne skrbi, bolesnik je bio na kliničkoj i ambulantnoj rehabilitaciji od 92 tjedna, nakon koje se vratio na posao. Nakon početnoga liječenja bolesnik je bio potpuno nesposoban za rad, da bi se nakon rehabilitacije radna sposobnost vratila na 50 %. Uvijek valja imati na umu da se čak i bolesnici s teškim i po život opasnim ozljedama mogu vratiti u radnu zajednicu ako surađuju zajedno s liječnicima, specijalistima medicine rada i poslodavcima.
Schlaf und Arbeitsleben Klösch, G.; Holzinger, B.; Estrella, R. ...
Somnologie : Schlafforschung und Schlafmedizin = Somnology : sleep research and sleep medicine,
03/2010, Letnik:
14, Številka:
1
Journal Article
Recenzirano
Zusammenfassung
Hintergrund
Gestörter und nichterholsamer Nachtschlaf beeinträchtigt die Arbeitsleistung und die Stresstoleranz und gilt als einer der Risikofaktoren für Burn-out. Eine weitere Folge ...ist vermehrte Tagesmüdigkeit, die neben einer verminderten Aufmerksamkeits- und Konzentrationsleistung auch als eine Ursache für Arbeits- und Verkehrsunfälle angesehen wird.
Methode
In der vorliegenden Studie werden die Daten einer Umfrage der Bundesarbeitskammer Österreich an 4214 Arbeitnehmern (BAK-Studie) in Hinblick auf Schlafprobleme (des Ein- und Durchschlafens) und arbeitsbedingte Müdigkeit untersucht. Geklärt werden soll, wie sich gestörter Schlaf auf den allgemeinen Gesundheitszustand, die Arbeitsfähigkeit und die Arbeitszufriedenheit auswirkt.
Ergebnisse
Rund 23% der Befragten gaben an, mehrmals pro Woche an Schwierigkeiten beim Ein- und Durchschlafen zu leiden, mit signifikant negativen Auswirkungen auf den allgemeinen Gesundheitszustand, die Arbeitsfähigkeit und arbeitsbedingte Müdigkeit. Alter und Geschlecht spielen dabei ebenfalls eine wesentliche Rolle, nicht jedoch der Beruf, die Branche, der familiäre Status und die Arbeitszufriedenheit.
Schlussfolgerung
Ein gestörter Nachtschlaf ist ein Grund für Tagesmüdigkeit und beeinträchtigt sowohl die allgemeine Gesundheit als auch die Arbeitsfähigkeit. Im öffentlichen Diskurs muss den Konsequenzen von nichterholsamem Schlaf für die Rahmenbedingungen der Arbeitswelt deutlich mehr Aufmerksamkeit geschenkt werden.
Zusammenfassung
Die vorliegende Studie untersucht die Arbeitsfähigkeit bei Rettungsdienstpersonal in Abhängigkeit von verschiedenen Einflussvariablen. In einer Querschnittstudie wurden 545 ...Einsatzkräfte im Rettungsdienst in Deutschland mittels standardisierten Fragebogen (Copenhagen Psychosocial Questionnaire (COPSOQ, dt. Version), Work Ability Index (WAI)) befragt. Wie die Ergebnisse zeigen, haben über 75% des Gesamtkollektivs der Einsatzkräfte einen guten bis sehr guten Work Ability Index. Dabei ist die Arbeitsfähigkeit abhängig vom allgemeinen Gesundheitszustand und vom Maß der körperlichen und seelischen Erschöpfung (Burnout). Einfluss auf die Arbeitsfähigkeit und den Gesundheitszustand der Einsätzkräfte haben sowohl das Alter als auch die Beschäftigungsdauer im Rettungsdienst. Mit zunehmendem Alter und mit steigender Beschäftigungsdauer nehmen die Arbeitsfähigkeit und der Gesundheitszustand signifikant ab. Burnout wird dagegen eher vom Einsatzgebiet und von der Einsatzfrequenz determiniert. Die Ergebnisse verdeutlichen die Notwendigkeit sowohl für Maßnahmen der betrieblichen Gesundheitsförderung im Setting Rettungsdienst als auch für nachhaltige Verhältnis- und Verhaltensprävention, um die Arbeitsfähigkeit der Einsatzkräfte im Rettungsdienst zu erhöhen. Zudem ist es notwendig, die Konzepte der Gesundheitsförderung und Prävention, als reguläre Ausbildungsinhalte, in die Lehrpläne der Berufsausbildung zum staatlich geprüften Rettungsassistenten aufzunehmen.
Definitions of so-called older age often are based on a chronological age of 65 years and over, although by some authors aging is the process that starts after the 30th year of life. At the beginning ...occur changes in the organ functions, followed by anatomical changes as well. Some organs age faster, some slower. For example, kidneys decrease for one third, lungs do not change, liver shrinks a little, prostate increases twice. In some cross-sectional studies, muscle mass in men aged 65 is on average 12 kg less than in the so-called middle age, and in women it is approximately 5 kg less. In the heart the amount of connective tissue increases, lipofuscin is deposited in cardiac muscle, the strength of which is decreasing. In the respiratory tract the number of pathways cilia decreases, along with the alveolar surface, muscles involved in breathing change, lung elasticity is also diminished. But, in regard with the previous body capacity, "physiological aging" can be divided into three types of elderly: the "older" elderly have the highest functional capacity of 2-3 MET (MET--metabolic unit, i.e. the oxygen consumption of 3.5 ml/kg body mass in a minute), the "younger" elderly are the persons of older age having maximal functional capacity of 5-7 MET, while the "sport" elderly have the functional capacity of 9-10 MET, disregarding chronological age. The brain weight diminishes for approximately 7% compared to younger age. In temporal gyrus and area striata even 20-40% of cells are being lost, vacuolar and neuroaxonal degeneration occurs, lipofuscin is being accumulated. The brain blood flow, which is in normal conditions 50-60 ml/min/100 g of tissue, with the increase of biological age decreases to about 40 ml/min/100 g of tissue. However, this usually is not the consequence of biological age but of disease. A chronological age of 65 for the beginning of "elder hood" is a sociopolitical construct developed by social security systems and government organizations to decide an arbitrary age at which benefits should be paid. Thus, it neither a border nor do changes designating old age occurs exactly with that "age border". The changes in the organism during the so-called aging are individual. So, the functional capacity of an organism, both physical and intellectual, must be evaluated individually, having in mind biological age.
Sarcoidosis is a multisystemic granulomatous disease of unknown etiology which affects most frequently the hilar lymph nodes and lungs. Symptomatic involvement of the central nervous system may ...develop in patients diagnosed with sarcoidosis or it may be the initial manifestation of the disease. This is a case report of 48-year old female patient admitted to our clinic for evaluation of working ability. The patient had a total of 24 years of service and occupational exposure and she has been employed as supplies procurement officer. On admission, she complained of the following discomforts: eye-lid pain, intellectual fatigue, psychic uneasiness, forgetfulness, dyspnea and productive cough. Neurological findings indicated the presence of the right eye ophthalmoplegia, psychoorganic syndrome and neurosarcoidosis. Ophthalmological examination evidenced bilateral ptosis and presence of anisocoria. Magnetic resonance imaging revealed discrete focal lesions of the pons (paracentral left) and parietal corona radiata of the left hemisphere. Based on performed examinations and diagnostics procedures, final evaluation of patient's working ability concluded that the patient was not capable of psychic strains and jobs associated with material accountability.
Radars are the eye and ear of military equipment. The continuous working ability of a radar is to the key to guaranteeing combat effectiveness. This work proposes an assessment model of continuous ...working ability (CWA), based on minimal order statistics, to ensure the stability and reliability of a radar. The relationship between CWA and mean time between failure (MTBF) is analyzed to reduce the time and cost of reliability testing. Maintainability and testability are developed in expanded CWA models. Using the models, the CWA of a radar is verified considering its maintainability or testability. Finally, the relationship between CWA design, basic reliability, maintainability, and testability is examined. Methods for improvement of CWA are also introduced.
Within the disability evaluation process, three different and potentially conflicting roles for the clinician become clear: patient advocate, provider of information, and medical adjudicator. It is ...important to understand the requirements of each of these roles so that the patient can best be served. The working ability evaluation is a process of numerous examinations, measurements and estimates that are done by a team of medical and other experts. It is utterly unacceptable to think that the opinion about someone’s working ability is given by some individual specialist of any expert domain especially regarding the invalids category since this can lead to either confusion or undesired conflicts between the patient and those who are professionally and legally qualified to evaluate his working ability. In order to carry out the medical part of the expertise for evaluating the working ability it is necessary have an accurate diagnosis of particular disease, an opinion whether the process is define or can be improved by and adequate therapy in addition to the state of morphology and function of all the organs and systems essential for responding to the biological requirements of the working operations at a given job as well as the estimate of the functional ability of the organs or system. The practical evaluation of the working ability also has to include the professional utilization factor, that is, it is necessary to determine the working operations requirements as well as the conditions in which they are performed at a given job. Within the working ability it is necessary to take into consideration the psychosocial structure of the sick person, years of age, qualification and professional degree as well as the society’s position to accept the proposal made by the medical and other experts. In judging the working ability of the patients having a cardiac disease it is indispensable to view every case separately since it always implies its own factors. The evaluation must be done in specially-qualified institutions having an adequate team of experts including a specialist of occupational medicine, a cardiologist, a safety at work expert, a technologist, a psychologist, a social worker and other medical and non medical staff.
The rheumatic diseases are present to a high percentage in the working - active population. There is a great number of professional causes of the diseases as well as specific job's requirements that ...can unfavorably affect the emergence and the evolution of the rheumatic diseases. The evaluation of the working ability is a procedure that correlates and brings into accord the job's requirements with the morphological- functional state of the engaged systems and of the organs of the exposed worker. This is a very delicate and responsible task aiming at placing the worker at such a job that most corresponds to his psycho-physical characteristics, that is, at a job at which he will best carry out his assigned duties without violating his health. The proper attitude in evaluating the working ability of the rheumatic patients is an important step to be taken in order to prevent the rheumatic disease complications. The removal of the sick worker from the job at which there are some potential professional disease causes as well as the requirements that unfavorably affect the bone-joint, muscular and vascular system of the exposed worker represents an important therapeutic and preventive measure since it can slow down the disease's evolution and thus ease the workers' troubles. The recognition of the professional disease, of the bodily damage and of the right to the care and aid represents an important assistance to the sick worker thus helping him to exert his right concerning the medical, social and disabled protection.
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