Functional testing: Approaches and injury management integration

Functional Capacity Evaluations (FCEs) have become the standard for identifying an individual's physical abilities and/or limitations following injury or illness. While philosophies and approaches differ, the focus of most FCE systems is to identify the individual's maximum capabilities. This article will discuss the usefulness of the FCE information and how FCEs are impacted by multiple factors including APTA guidelines, machine based testing, therapist expertise, medical legal credibility and court testimony, IMEs and FCE, and return to work/return to function.     

Work hardening: Outdated fad or effective intervention?

OBJECTIVES: The purpose of this outcome measurement study was to determine the effectiveness of a work hardening program as measured by the participants' work status at three months after program completion. Predictors of successful return to work were explored. STUDY DESIGN: The sequential case series design was employed, and data were gathered at three points: the initial work hardening assessment, the discharge assessment, and three months post-discharge from the work hardening program. Seventy-nine participants were included. RESULTS: Eighty-two percent (82%) of the clients who completed a work hardening program reported that they were working in some capacity three months after program completion. They listed their employment status in 5 sub-categories. Significant predictors of employment included "single" marital status, lower perceived disability scores at program entry, reduction in reported pain during program duration, and funding source. CONCLUSION: Work hardening remains an effective treatment strategy which promotes successful return to the workplace. Ongoing analyses of these programs is imperative.     

Research on Domestic Violence in the 1990s: Making Distinctions

This review of the family literature on domestic violence suggests that two broad themes of the 1990s provide the most promising directions for the future. The first is the importance of distinctions among types or contexts of violence. Some distinctions are central to the theoretical and practical understanding of the nature of partner violence, others provide important contexts for developing more sensitive and comprehensive theories, and others may simply force us to question our tendency to generalize carelessly from one context to another. Second, issues of control, although most visible in the feminist literature that focuses on men using violence to control “their” women, also arise in other contexts, calling for more general analyses of the interplay of violence, power, and control in relationships. In addition to these two general themes, our review covers literature on coping with violence, the effects on victims and their children, and the social effects of partner violence.

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Book Reviews

This article examines some difficulties associated with the Haynes–Stone model and attempts to clarify how the model can be justified as representing the hypothesis that “quantity is demand determined and price is supply determined.” It also argues that the applications of such a model as was done by Haynes and Stone might not have resolved the controversies related to the Phillips curve and the supply function of exports (or imports).     

Extension of the Application of Conway‐Maxwell‐Poisson Models: Analyzing Traffic Crash Data Exhibiting Underdispersion

The objective of this article is to evaluate the performance of the COM‐Poisson GLM for analyzing crash data exhibiting underdispersion (when conditional on the mean). The COM‐Poisson distribution, originally developed in 1962, has recently been reintroduced by statisticians for analyzing count data subjected to either over‐ or underdispersion. Over the last year, the COM‐Poisson GLM has been evaluated in the context of crash data analysis and it has been shown that the model performs as well as the Poisson‐gamma model for crash data exhibiting overdispersion. To accomplish the objective of this study, several COM‐Poisson models were estimated using crash data collected at 162 railway‐highway crossings in South Korea between 1998 and 2002. This data set has been shown to exhibit underdispersion when models linking crash data to various explanatory variables are estimated. The modeling results were compared to those produced from the Poisson and gamma probability models documented in a previous published study. The results of this research show that the COM‐Poisson GLM can handle crash data when the modeling output shows signs of underdispersion. Finally, they also show that the model proposed in this study provides better statistical performance than the gamma probability and the traditional Poisson models, at least for this data set.     

The potential impact of discrimination fears of older gays, lesbians, bisexuals and transgender individuals living in small- to moderate-sized cities on long-term health care

As an exploration of the potential impact of fears of discrimination against GLBTs in long-term health care settings, this study compared perceptions of GLBT persons and heterosexuals. A total of 132 GLBT persons and 187 heterosexuals living in Eastern Washington completed a survey that contained demographic questions and perceptions of discrimination in long-term care settings. Most respondents suspected that staff and residents of care facilities discriminate against GLBTs. GLBT respondents who believed that residents of care facilities are victims of discrimination were more likely to believe that they would have to hide their sexual orientation if admitted to a care facility. GLBT respondents were more likely than heterosexual respondents to believe that GLBTs do not have equal access to health care and social services, that GLBTs residents of care facilities are victims of discrimination, that GLBT sensitivity training programs would benefit staff and residents of care facilities, and that GLBT retirement facilities would be a positive development for older GLBTs. This study is offered as a preliminary investigation of concerns about GLBT discrimination in health care settings, how concerns are expressed, and the implications of those concerns for health care needs.     

Complaining Our Way to Quality: Complaints, Contracts and the Voluntary Sector

The research on which this paper is based is part of a wider study of quality assurance and the voluntary sector. The focus of this paper is on complaints procedures, as part of quality assurance mechanisms, where voluntary agencies are the contracted service providers. The authors argue that, with the introduction of contracting and particularly with its further development, the way in which complaints mechanisms currently operate will need to be revised if they are to be an effective part of the quality assurance process.