Work and health play an entirely different role in the life course than before, necessitating new models. A definition and model of sustainable employability is presented based on Amartya Sen's capability approach, challenging researchers, policy-makers and practitioners to look for what is important and valuable in a given (work) context and whether people are able and enabled to realize this. Affiliation 71Discussion paper Scand J Work Environ Health 2016;42(1):71-79. doi:10.5271/sjweh.3531 Sustainable employability -definition, conceptualization, and implications: A perspective based on the capability approach By Jac JL van der Klink, PhD,1, 2 Ute Bültmann, PhD, 2 Alex Burdorf, PhD,3 Wilmar B Schaufeli, PhD,4,5 Fred RH Zijlstra, PhD,6 Femke I Abma, PhD, 2 Sandra Brouwer, PhD, 2 Gert Jan van der Wilt, PhD 7 Van der Klink JJL, Bültmann U, Burdorf A, Schaufeli WB, Zijlstra FRH, Abma FI, Brouwer S, Van der Wilt GJ. Sustainable employability -definition, conceptualization, and implications: A perspective based on the capability approach. Scand J Work Environ Health 2016;42(1):71-79. doi:10.5271/sjweh.3531Objectives The aim of this paper is to propose a new model of sustainable employability based on the capability approach, encompassing the complexity of contemporary work, and placing particular emphasis on work-related values.Methods Having evaluated existing conceptual models of work, health, and employability, we concluded that prevailing models lack an emphasis on important work-related values. Amartya Sen's capability approach (CA) provides a framework that incorporates a focus on values and reflects the complexity of sustainable employability.Results We developed a model of sustainable employability based on the CA. This model can be used as starting point for developing an assessment tool to investigate sustainable employability.Conclusions A fundamental premise of the CA is that work should create value for the organization as well as the worker. This approach challenges researchers, policy-makers, and practitioners to investigate what people find important and valuable -what they would like to achieve in a given (work) context -and moreover to ascertain whether people are able and enabled to do so. According to this approach, it is not only the individual who is responsible for achieving this; the work context is also important. Rather than merely describing relationships between variables, as existing descriptive models often do, the CA depicts a valuable goal: a set of capabilities that constitute valuable work. Moreover, the CA fits well with recent conceptions of health and modern insights into work, in which the individual works towards his or her own goals that s/he has to achieve within the broader goals of the organization. Correspondence to JJL van der Klink, Tilburg University, Tilburg School of Social and Behavioral Sciences, Tranzo, Scientific Center for Care and Welfare, PO Box 90153, 5000 LE Tilburg. The Netherlands. [E-mail: j.j.l.vdrklink@uvt.nl] In his recent book, The Strength...

This study demonstrates that it is pointless to claim low or high prevalence of primary aldosteronism based on published reports. Because of the significant impact of a diagnosis of primary aldosteronism on health care resources and the necessary facilities, our findings urge for a prevalence study whose design takes into account the factors identified in the meta-regression analysis.

Purpose:Implementation of novel genetic diagnostic tests is generally driven by technological advances because they promise shorter turnaround times and/or higher diagnostic yields. Other aspects, including impact on clinical management or cost-effectiveness, are often not assessed in detail prior to implementation.Methods:We studied the clinical utility of whole-exome sequencing (WES) in complex pediatric neurology in terms of diagnostic yield and costs. We analyzed 150 patients (and their parents) presenting with complex neurological disorders of suspected genetic origin. In a parallel study, all patients received both the standard diagnostic workup (e.g., cerebral imaging, muscle biopsies or lumbar punctures, and sequential gene-by-gene–based testing) and WES simultaneously.Results:Our unique study design allowed direct comparison of diagnostic yield of both trajectories and provided insight into the economic implications of implementing WES in this diagnostic trajectory. We showed that WES identified significantly more conclusive diagnoses (29.3%) than the standard care pathway (7.3%) without incurring higher costs. Exploratory analysis of WES as a first-tier diagnostic test indicates that WES may even be cost-saving, depending on the extent of other tests being omitted.Conclusion:Our data support such a use of WES in pediatric neurology for disorders of presumed genetic origin.Genet Med advance online publication 23 March 2017

The newly developed questionnaire to measure the capability set for work is unique because the items go beyond the valued aspects of work by incorporating whether a worker is able to achieve what he/she values in his/her work. The results show that the capability for work questionnaire can serve as a proxy measure of sustainable employability.

Priority setting of health interventions is generally considered as a valuable approach to support low- and middle-income countries (LMICs) in their strive for universal health coverage (UHC). However, present initiatives on priority setting are mainly geared towards the development of more cost-effectiveness information, and this evidence does not sufficiently support countries to make optimal choices. The reason is that priority setting is in reality a value-laden political process in which multiple criteria beyond cost-effectiveness are important, and stakeholders often justifiably disagree about the relative importance of these criteria. Here, we propose the use of ‘evidence-informed deliberative processes’ as an approach that does explicitly recognise priority setting as a political process and an intrinsically complex task. In these processes, deliberation between stakeholders is crucial to identify, reflect and learn about the meaning and importance of values, informed by evidence on these values. Such processes then result in the use of a broader range of explicit criteria that can be seen as the product of both international learning (‘core’ criteria, which include eg, cost-effectiveness, priority to the worse off, and financial protection) and learning among local stakeholders (‘contextual’ criteria). We believe that, with these evidence-informed deliberative processes in place, priority setting can provide a more meaningful contribution to achieving UHC.