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Speakers
Elmi Zwaan
Sophie Giles
Donny Kreuger
Elena Syurina
Forbidden Territory: On ideology in science
There are no sacred cows or dogmas in science. Real scientists follow the path of facts, wherever it leads. At least, that is the theory.
In reality, scientists are also just people, prone to ideological blind spots and self-deception. That in itself is not an insurmountable problem, if there is sufficient diversity in science. In this way, scientists correct each other\'s blind spots and biases, and the truth eventually emerges. But if everyone is of roughly the same political and ideological persuasion, things can go badly wrong.
Unfortunately, we see this in more and more fields of science, from sociology to biology, from climate science to psychology. Some hypotheses are taboo because they go against a prevailing ideology. Some questions become “off limits. A form of unitary thinking that has little to do with science is creeping into some disciplines. If we want to combat this ideological contamination of science, we need more diversity, and above all diversity of ideas.
The Accident Compensation Corporation
The Accident Compensation Corporation (ACC) is a New Zealand Government body founded in 1974 to provide universal, compulsory cover for work and non-work-related injuries on a no-faults basis, resulting in the abolition of the right to sue for wrongful injury.
ACC has the legislated task of treating and rehabilitating all injured persons to the greatest extent possible. It also provides earnings related compensation at 80% of the worker’s salary at the time of injury until the worker returns to work. There are some interesting drivers of claims to ACC by persons with certain medical disabling conditions such as low back pain and cerebral palsy, which will be discussed in the presentation.
ACC has progressively developed a large investment fund that fully covers future predicted costs of all severe injuries currently identified. ACC treatment and compensation is funded through a modest tax on salary that is less than one dollar per hundred dollars earned for workers, and through other taxation mechanisms for non-workers. Overall, it appears to run in a cost-effective manner, funding many interesting initiatives aimed at best outcomes for various types of accidental injury.
While there are certain criticisms of the ACC scheme, in many respects it has been transformative in helping many injured New Zealanders return to work, school or to normal life.
Artificial Intelligence
Symptom and performance validity assessment: Developments, state of the art, and problems to solve
Neuropsychological approaches to validity assessment can be considered a success story as it has stimulated the development of new diagnostic approaches and paved the way to conceptual developments enabling clinicians and forensic workers to more reliably distinguish genuine symptoms from noncredible presentations. After a brief summary on basics, research trends and practice recommendations of the last few years are reviewed. The proper selection and use of validity tests and the adequate interpretation of their results continue to be the core problem of forensic assessments.
Evidence and ethics in health decision making - reflections into insurance medicine
An update on concussion and chronic traumatic encephalopathy
Assessment and treatment of concussion (also known as mild traumatic brain injury) remains a confusing area for many clinicians. Despite its apparent mild nature, many people have persistent symptoms lasting months or years. There are also difficulties with the diagnosis of this condition, particularly in the sports arena. However, there is significant progress in the clinical medicine of concussion treatment, particularly with the use of patient education and a multi-disciplinary team approach, tailored to the symptom picture of the patient.
The workshop will help to clarify what the current best evidence is. In addition, we will discuss the concerns that many people, particularly sportspeople, have about the potential to develop chronic traumatic encephalopathy (CTE), and how concussion clinics are struggling to manage those concerns given the unclear clinical syndrome of CTE.
Experiences in integrating ethics in HTA and decision making
Enhancing Support for Clients experiencing Autistic Burnout
Autistic burnout (AB) is a serious condition affecting a significant proportion of autistic population. There is however limited research on the topic. Our study looked into the prevalence of AB, factors increasing risk of AB and real life experiences of people with AB. We discovered that identifying as female, being older, having higher educational attainment and receiving autism diagnosis later in life increase the risk of AB. We discuss the symptoms of AB, possible causes contributing to severity of AB and the pathways to rehabilitation.
An update on concussion and chronic traumatic encephalopathy
Assessment and treatment of concussion (also known as mild traumatic brain injury) remains a confusing area for many clinicians. Despite its apparent mild nature, many people have persistent symptoms lasting months or years. There are also difficulties with the diagnosis of this condition, particularly in the sports arena. However, there is significant progress in the clinical medicine of concussion treatment, particularly with the use of patient education and a multi-disciplinary team approach, tailored to the symptom picture of the patient. The workshop will help to clarify what the current best evidence is. In addition, we will discuss the concerns that many people, particularly sportspeople, have about the potential to develop chronic traumatic encephalopathy (CTE), and how concussion clinics are struggling to manage those concerns given the unclear clinical syndrome of CTE.
Experiences in integrating ethics in HTA and decision making
Standards, challenges and difficulties assessing sequelae of mild traumatic brain injury: A neuropsychological perspective
Forensic examinations of patients with the effects of mild traumatic brain injury (mTBI) are often more difficult and complex than those of moderate and severe brain injuries. Clinical diagnoses are often inaccurate and not based on a thorough review of diagnostic criteria. Compliance with the revised guidelines is strongly recommended (American Congress of Rehabilitation Medicine, 2023). One of the major problems is that mTBI patients often report more severe persistent symptoms than patients after moderate and severe brain injury; also, the time course of symptomatology is often incompatible with the condition in question. Forensic reports should include a thorough and explicit analysis of consistency and plausibility, and neuropsychological evaluations should include a current validity assessment.
Enhancing Support for Clients experiencing Autistic Burnout
Autistic burnout (AB) is a serious condition affecting a significant proportion of autistic population. There is however limited research on the topic. Our study looked into the prevalence of AB, factors increasing risk of AB and real life experiences of people with AB. We discovered that identifying as female, being older, having higher educational attainment and receiving autism diagnosis later in life increase the risk of AB. We discuss the symptoms of AB, possible causes contributing to severity of AB and the pathways to rehabilitation.
Long Covid - how to treat and manage and vocational issues.
Professor Faux will outline the theories on the mechanism aswell the evidence based rehabilitation approaches to treatment. The course of the disease will be discussed and some of the more salient features such as cognitive impairments (brain fog), fatigue and loss of smell/taste which has affected those workers in the hospitality and emergency sectors. Prevention in the workplace and issues to do with employer responsibility and return to work programs will be discussed and cases presented.
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What about the causer? Investigating injury causation
What is it like to have caused injury to someone else? How do you relate to the victim? What do you notice about the settlement of the personal injury claim? And what else does the accident bring about?
Femke Ruitenbeek interviewed those who caused injuries about their personal experiences. She presents the key findings from the question: "What can we learn from these experiences?"
Influence of estrogen on mental health
Estrogen has many receptors in the brain and interacts with virtually all neurotransmitters. Not surprisingly, the level of this hormone b y many women affects mental health. The level in a woman's life can fluctuate greatly. During pregnancy, estrogen is extremely high and there is also variation in the level of this hormone during a menstrual cycle. Around menopause, there is a sharp drop. There is still little knowledge about these variations and how to deal with them in clinical practice. In this lecture, I will lift a corner of the veil on the correlations between hormone fluctuations and mental health. Wish I had lifted the whole veil, but there is still much that is unknown about these interactions.
How is it possible that so many people can no longer keep up?
As a psychiatrist, I am trained to help people suffering from syndromes such as major depression or psychotic disorders. But in my consultation, I see more and more people who do not have an illness of that nature, but who still report that they are stuck. They are physically and mentally exhausted.
How is it possible that so many people can no longer keep up? That they come to specialists with indeterminate physical and psychological complaints, and there receive the answer that medicine can offer no explanation and no solution to their problem? Could it be that the resilience meant for a lifetime is used up too quickly? Or have we forgotten to listen to our bodies when they signal that they are nearing exhaustion?
In my book The Stressed Society, I explore these questions. The book takes a critical look not only at our drive for medication and other quick fixes, but also at the way the mental health system deals with these problems. I argue for a fundamental change, in which skills like mildness and self-knowledge have a role to play, and we look at our bodies, our carrying capacity, our desires and ambitions with a different perspective. Thinking about this together can take us a long way.
Effectiveness and cost-effectiveness of innovative techniques in low back pain
Acute and chronic low back pain are common in society. Even though these complaints are often seen as a harmless condition, they constitute one of the biggest causes of absenteeism and therefore one of the biggest costs for society. Due to the wide variety of causes of back pain, there is often no single therapy available.
In recent decades, innovation in modern equipment and new approaches to the back, has led to new treatment options by the pain specialist and surgeon, among others. During this presentation, the latest techniques will be reviewed, as well as their scientifically based added value.
Ethical questions around measurement and knowledge
Personalized medicine has been a widely shared vision of the future in biomedical research for some time. Initially, the central idea behind it was that the use of molecular data would help make diagnoses more precise and earlier, and better tailor treatment to the characteristics of the person in question. This vision has since inspired the collection of more and more types of data, not only about bodily processes, but also about a person's behavior and environment.
By analyzing all that data with Artificiële Intelligence, we seem to be increasingly able to predict how a person's health and disease will develop in the future. Care for health is thus increasingly becoming care for the future. Such predictive knowledge is of particular interest to insurance medicine, as it can help in assessing a person's taxability.
But all this measuring and knowing also raises ethical questions: is predictive knowledge always desirable, and if so, how should we deal with such knowledge? Can you expect a client to cooperate with intensive home monitoring? What effect does predictive knowledge have on the person in question, and how to weigh positive and negative effects? How does the availability of predictive knowledge affect physician and client responsibilities?
In this lecture, we will give an impression of the new technological possibilities for generating predictive knowledge about a person's health and disease, and discuss the difficult ethical questions involved.
Determinants of work participation and disability benefit: an integrative look at the health of gastrointestinal-liver patients
Chronic gastrointestinal-liver patients experience problems in all areas of life that may not always be included in the specialist's treatment. It is unclear exactly what problems they experience and how perceived problems affect work participation and disability.
The aim of this study is to gain insight into the integral health of the chronic gastrointestinal liver patient according to the concept of Positive Health and to assess which dimensions are related to work participation and receiving disability benefits.
Opportunities, challenges and conditions for data-driven work and use of (generative) AI in insurance medicine
The shortage of insurance physicians causes longer waiting times, prolonged sick leave and reduced labor participation. A possible solution lies in data-driven work and (generative) AI language models, which support reporting and case summarization, which can alleviate administrative burdens.
This research focuses on the opportunities, challenges and preconditions for the application of AI in insurance medicine, with the needs of stakeholders at its core. However, acceptance by users and cliëners is not self-evident, but essential. The project is being developed in collaboration with policy and practice, with a focus on the feasibility of AI applications.
Feasibility of the BAR tool and guidance for interprofessional collaboration during the reintegration process
The feasibility study examined the comprehensibility, applicability and satisfaction of professionals with the BAR tool and guide to interprofessional collaboration during reintegration. Through interviews, case discussions and focus groups with occupational physicians, insurance physicians and labor experts, it was found that the tool was well received.
Professionals appreciate the scientific foundation and the bio-psychosocial perspective. The tool promotes thinking in terms of possibilities and supports both professionals and employees and employers in the reintegration process, with positive feedback on its practicality.
Interprofessional learning and collaboration for insurance physicians, occupational physicians and labor experts: development of a methodology for interprofessional case discussion
Joint case review is a form of interprofessional learning in which professionals encounter alternative approaches to a case, can broaden their understanding and perspective, connect with each other and learn from each other. Therefore, we are developing a methodology for interprofessional case discussion for occupational physicians, insurance physicians and labor experts in the context of reintegration of sick employees.
During the VG days, professionals are cordially invited to contribute to the design of this methodology. In an interactive workshop, participants can give their input on the design of the methodology and indicate how they want to apply the methodology in their own practice.
More WIA Assessments with Task Delegation!
Previous research indicated that a protocolled approach in task delegation for WIA assessments is practically feasible with good customer and employee satisfaction. We investigated how many end-of-waiting-time WIA assessments the VA can perform when tasks are delegated in a protocolled manner to a socio-medical nurse (SMV).
Presented are the number of assessments that the SMV and VA consider achievable and actually achieve in practice. Also discussed are the employee satisfaction and perceived quality of the assessment.
Value-driven insurance medicine: learn, improve and steer using client-relevant outcomes.
Value-driven care focuses or maximizing client value and minimizing inefficiencies within the healthcare system. This lecture will outline how the Value-Driven Care concept, as originally developed for curative care, can help us add value for our clients in the practice of insurance medicine.
During this lecture, you will learn more about the importance of measuring client-relevant outcomes in insurance medicine and how this information can be leveraged. In doing so, you will be introduced to the Value@WORK outcome set; a client-reported questionnaire that questions the most important work-focused outcomes for the client with cardiovascular disease.
Psychosocial factors in feigning health complaints
Feuding is difficult to recognize and even more difficult to demonstrate. Deliberate feigning (malingering) is different from exaggeration or feigning as unconscious reactive behavior. Understanding the client's psychosocial situation can put an aberrant symptom presentation in context. Scientific research shows that several factors can be influential, including debt problems and psychological symptoms. We also discuss several scientifically based tools that may promote recognition of feigning.
With this study, we would like to open the conversation about what can be categorized under the various forms of feigning and how it can be dealt with appropriately.
De haalbaarheid van het Progressive Goal Attainment Program volgens werkenden met gezondheidsproblemen
Cognitions and perceptions of workers with long-term health conditions, such as catastrophizing thoughts and fear-avoiding beliefs, can negatively impact work participation. Insurance physicians should therefore consider these impeding factors when providing social medical counseling and assessing functional capacity.
The Progressive Goal Attainment Program (PGAP) is an intervention developed in Canada to reduce impeding cognitions and perceptions and encourage work participation. This presentation presents the results of the feasibility of deploying PGAP in the Netherlands.
Patient wishes good cooperation between social medicine and orthopedic surgeon after arthroplasty during return to work
Total knee replacements (TKR) and total hip replacements (THR) are being placed on a daily basis in increasingly younger patients within working age. Outcomes including quality of life, patientënt satisfaction and return to work (RTW) are becoming more important and influencing clinical (recovery) pathways, among others. However, insight into the experiences and expectations of patientsënt regarding RTW lags behind. The aim of this study is to gain insight into the vision, experiences and expectations of patients regarding the current arranged recovery pathway after a TKR or THR.
Current use of validity tests
Through a survey, insurance physicians working at Uitvoeringsinstituut Werknemersverzekeringen (UWV) were asked about current use of validity tests and opinions about future in-house use. Responses indicated that insurance physicians use observation of inconsistencies and often consider it sufficient to accurately recognize overreporting and disguising of complaints. However, it is also indicated that being able to apply validity tests oneself could be contributory in practice. This would require more attention to the subject during education and through practical training.
Support needs for return to work among self-employed workers: a focus group study
Support during sick leave and return to work (RTW) differs between self-employed workers and workers in paid employment. Legislation is currently drafted for compulsory insurance for self-employed workers that should ultimately lead to improved support during sick leave and RTW. However, studies on how to support self-employed workers during their RTW are lacking. Therefore, in this focus group study we explored facilitators, barriers and support needs of self-employed workers when returning to work.
The Parkinson's pandemic: what do we know and where do we stand?
Hotel Almere is located alongside the highway A6, near the cities Amsterdam, Utrecht and Hilversum.
Almere Parkwijk and Almere Centrum train stations are only a few minutes away by car from the hotel. From these stations you can travel to the hotel by bus or taxi. From both Almere Parkwijk and Almere Centrum Stations you can take bus M5 and get off at bus stop Walt Disneyplantsoen. From this stop it is about a 10-minute walk to Hotel Almere.
From the A27 towards Hilversum/Huizen, take exit 36 towards Almere Stad. At the end of the exit, turn left towards Almere Haven/Almere Stad (N305). Just before Almere you drive under the viaduct of the A6 motorway, still in the direction of Almere Stad. The road is now called Veluwedreef. At the 2nd traffic light, turn left onto the Veluwezoom. You will find Hotel Almere on your right.
From the A1 in the direction of Amersfoort, take the A6 in the direction of Almere. On the A6, take exit 5 (Almere Stad). At the end of the exit, turn left towards Almere Stad (S103 Veluwedreef). At the 2nd traffic light, turn left onto the Veluwezoom. You will find Hotel Almere on your right.
From the A6 towards Almere, take exit 5 (Almere Stad). At the end of the exit, turn left at the traffic light in the direction of Almere Stad (S103 Veluwedreef). At the 1st traffic light, turn left onto the Veluwezoom. You will find Hotel Almere on your right.
