miller Health Occupational Health and Fitness

Index

4. SAPS NOVEMBER 2008

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John Miller conducted a Health Management program for The Group in November 2008.

74 people, 61 men and 13 women completed the following profiles: -

■ Health, Fitness and Wellbeing

■ Elite force fitness

■ Elite force musculo-skeletal risk

■ Diet

■ Chemical intake

■ Stress risk

■ Career satisfaction

The results are presented in graphic format, with commentary.

Click here to read what the assessments are all about

HEALTH, FITNESS AND WELLBEING PROFILE

The Health, Fitness and Wellbeing profile provides people with a very good idea of how well the various systems of the body are functioning, particularly the

• the mind

• autonomic nervous system

• immune system

• digestive system

• circulatory system

• elimination system

• musculo-skeletal system.

	Symptom	None		Not much			A fair bit			A lot
1.	Headaches including migraines	0	1	2	3	4	5	6	7	8	9	10
2.	Lack of energy and vitality	0	1	2	3	4	5	6	7	8	9	10
3.	Candida - jock itch, thrush, tinea ...	0	1	2	3	4	5	6	7	8	9	10
4.	Poor sleep. If on tablets score 10	0	1	2	3	4	5	6	7	8	9	10
5.	Snoring &/or sleep apnoea. Score 10 if using a mask	0	1	2	3	4	5	6	7	8	9	10
6.	Crook back, stiff neck, sore shoulders, dicky knee RSI ...	0	1	2	3	4	5	6	7	8	9	10
7.	Frequent colds, flu, sinus	0	1	2	3	4	5	6	7	8	9	10
8.	Unsettled stomach, reflux (Score 10 if on medication)	0	1	2	3	4	5	6	7	8	9	10
9.	Overweight - 1 point for every 2Kg	0	1	2	3	4	5	6	7	8	9	10
10.	Irritable bowel, constipation	0	1	2	3	4	5	6	7	8	9	10
11.	Asthma	0	1	2	3	4	5	6	7	8	9	10
12.	Low level of aerobic fitness	0	1	2	3	4	5	6	7	8	9	10
13.	Chest pain, palpitations	0	1	2	3	4	5	6	7	8	9	10
14.	Rashes, itchiness, skin outbreaks, psoriasis ...	0	1	2	3	4	5	6	7	8	9	10
15.	Mouth ulcers, cold sores	0	1	2	3	4	5	6	7	8	9	10
16.	Elevated blood pressure. Score 0 on pills	0	1	2	3	4	5	6	7	8	9	10
17.	Elevated blood cholesterol. Score o if on pills	0	1	2	3	4	5	6	7	8	9	10
18.	Elevated blood glucose. Score 0 if on medication	0	1	2	3	4	5	6	7	8	9	10
19.	Shakes, nervous ticks, mannerisms	0	1	2	3	4	5	6	7	8	9	10
20.	Grinding teeth	0	1	2	3	4	5	6	7	8	9	10
21.	Alcoholic drinks per day (2 pts/drink)	0	1	2	3	4	5	6	7	8	9	10
22.	Smoking. (1 pt/cigarette/day)	0	1	2	3	4	5	6	7	8	9	10
23.	Caffeine (1 pt/cup per day)	0	1	2	3	4	5	6	7	8	9	10
24.	Anxious about life, insecure, apprehensive	0	1	2	3	4	5	6	7	8	9	10
25.	Sad or depressed (On medication, score 0)	0	1	2	3	4	5	6	7	8	9	10
26.	In wrong job for now	0	1	2	3	4	5	6	7	8	9	10
27.	Under-appreciated at work	0	1	2	3	4	5	6	7	8	9	10
28.	Have poor work/life balance	0	1	2	3	4	5	6	7	8	9	10
29.	Unhappy with family life	0	1	2	3	4	5	6	7	8	9	10
30.	Unhappy with financial status	0	1	2	3	4	5	6	7	8	9	10

Score

The score of a normal, fit and healthy human being is less than 20

Higher scores are symptomatic of dysfunction of one or more body systems.

People with high levels of stress usually score well over 100.

For people with a score of more than 80, the ‘background noise’ of their life is becoming louder and louder. It is hard to concentrate on your work when body systems are dysfunctional.

We know a fit and healthy group when we see the majority of scores below 40. This was not the case with this group. By and large higher scores are usually a reflection of

• low levels of fitness

• an inability to deal with what life and work are serving up to people.

Remember, it is not what happens, but how we deal with what happens that determines our level of stress.

Classification of average scores: Excellent - less than 40. Good - 41 - 50. Fair 51-60. Poor - over 60.

This profile is described as fair. The average score was 52. Anyone scoring more than 80 is putting up with a lot of 'background noise'.

HEALTH CLIMATE SURVEY

Based on scores received in the Health, Fitness and Wellbeing profile we've compiled a Health Climate Survey. Scores on each item have ranked - the higher the score the worse the problem.

We registered those scores of 5 and over as being a symptom, issue or concern, the most pressing of which have been highlighted. We added the scores for each item. The results appear in the table below.

Symptoms/ issues / concerns	% of people scoring over 5
Overweight	52	13
Crook back, sore shoulders	35
Low level of fitness	35
Lack of Energy	22
Poor sleep	22
Snoring, sleep apnoea	20
Elevated blood pressure	20	13
Caffeine	20
Work-life balance	19
Under appreciated at work	17
Financial status	16
Depressed	14	5
Reflux, unsettled stomach	13
Alcohol	13
Anxious	13
Grinding teeth	10
Wrong job	10
Frequent colds, flu, sinus	9
Irritable bowel, constipation etc	9
Unhappy family life	9
Smoking	9	6
Headaches	7
Candida	6
Elevated cholesterol	6
Elevated glucose	4	2
Shakes, nervous mannerisms	4
Itchy, rashes, psoriasis	3
Mouth ulcers	3
Chest pain, palpitations	1
Shortness of breath from asthma	0

Compared with other groups we've surveyed the number of symptoms/issues/concerns over 20% (highlighted) is not high and revolve principally around issues relating to fitness - metabolic dysfunction (high blood pressure, lack of energy, snoring and being over weight) and musculo-skeletal dysfunction.

Perception

Based on people's perception (where they gave a particular symptom a score of 5 or more, and backed up by objective scores) the key issues are

•	Obesity 52% of people said they were more than 10Kg over weight. 20% were more than 20Kg overweight. It's a symptom of metabolic dysfunction and relates to high energy diets and low energy lifestyles. It's suggestive of elevated levels of insulin floating around the body, which is a precursor of all manner of body system dysfunctions - elevated blood pressure, elevated cholesterol, elevated blood glucose. The recommendation, 25% of people need to get more exercise at lunch time and eat from the top of the Hourglass.

•	Snoring 20% of people said they snored loudly enough for it to be a problem. The recipe for a good snore is to be male, be unfit and at least 20Kg over weight, to have high blood pressure, have a few drinks every night, be stressed out of their brain and sleep on their back.

•	Lack of energy 22% of people said they lacked energy. Low levels of energy come from many sources, including: - - lack of a good aerobic fitness training program - a diet high in wheat flour and sugar - dullness - ...

•	Fitness 35% said they were unfit. We recommend staff be given the greatest encouragement to maintain an acceptable level of fitness. For a start they'll feel better. Fitness has a significant bearing on the scores for low levels of energy, poor sleep, snoring, depression and headaches.

•	Musculo-skeletal dysfunction 35% of people said they had some sort of musculo-skeletal dysfunction. Musculo-skeletal dysfunction goes with low levels of strength and flexibility. Those at greatest risk need encouragement to attend a strength and flexibility training program several times a week.

•	Under-appreciation at work 17% said they were under-appreciated at work. Compared with other groups this is a good result. Whilst it is not a great cause for concern, managers need to take note and put in train a series of measures to improve this score in say, 3 months time. This factor certainly needs addressing in more detail and re-evaluation.

•	Being in the wrong job Only 10% of people said they were in the wrong job. Compared with other groups this is a good result. Whilst there is usually a high and positive correlation between people being in the wrong job and people saying they are under-appreciated at work, this was not the case with this group.

•	Diet A diet high in flour and sugar and low in fruit, vegetables and fibre leads to irritable and bowel, reflux.

•	Depression and anxiety There is an epidemic of depression in our community and we encourage all organisations to target depression. 14 people gave themselves a score of 5 or more on the depression question. 5 people were on anti-depressant medication. There is a significant core of depression that relates to poor health generally. All body systems are connected. The epidemic of depression will continue to escalate at the same rate as the epidemic of all other body system dysfunctions. People need to be given encouragement to exercise regularly and vigorous, eat less flour and sugar and imbibe less of the culturally chemicals - particularly nicotine, caffeine and alcohol. Because of the relationship of depression to fitness and diet there is a chance that some people have been misdiagnosed. Some aspects of depression relate to psychologically generated issues. It is important that these people be encouraged to have regular counselling - through the EAP or other counsellors - The best book about depression I've read, and what you can do about it, and one that I recommend highly is by psychiatrist, David Servan-Schreiber, Healing Without Freud or Prozac.

•	Blood pressure 13 people indicated they were on blood pressure medication. This is a very high percentage of people (20%). Blood pressure is a symptom of body system dysfunction relating directly to - lack of aerobic fitness - being over weight - being stressed.

•	Smoking There were 6 confirmed smokers. This is a good result over a group of 74 people. Now lets move heaven and earth to assist these people to give it away altogether.

•	Alcohol intake 13% of people indicated a higher than acceptable level of alcohol consumption. For too many people it is culturally acceptable to drink half a dozen cans of beer a night. Not only does willpower dissolve in alcohol but it increases the size of the waist.

FITNESS

The fitness profile is comprised of a mix of 10 objective and subjective assessments.

• Are you keeping yourself fit and healthy to the best of your ability?

• What was your score on the Health, Fitness and Wellbeing profile?

• Are you about your ideal weight?

• Aerobic fitness test

• Abdominal strength test

• Upper body strength test

• Flexibility test

• Mobility test

• Aerobic activity training behaviour

• Level of energy and vitality.

A reasonable score is over 70%.

Those receiving less than 70 are not training with sufficient vigour or intensity on a regular and systematic basis to keep themselves fit and healthy.


As a group this is a poor profile. 20% were on blood pressure medication.		Another poor profile - 20% on medication.

Patchy.		As a group this is a poor result. 52% were 10 or more kilos over their ideal weight. Being overweight greatly compromises mobility. This is not an elite force score.

Patchy.		This is a poor result. Most people couldn't do 40 situps with their feet held. This means that the strength of the muscles on the front of their body is not sufficient to keep their pelvis and spinal column in good alignment.

This is a poor result. 21 people couldn't touch their toes at all. Too many people have tight muscles along the back side of their body - calves, hamstrings, buttock and back. It's caused by two things - sitting down and not having a flexibility program. There is a high risk of lower back and neck dysfunction.		This is a poor result. Most people could not do 40 pressups. They are leaving themselves open to upper back, shoulder and arm dysfunction.

A poor result. Most people are having difficulty getting down on the floor and back up again. Being overweight and having a game leg, bung hip and a crook back dramatically reduces mobility.		This is a poor result. This is not the score of an elite force group. It is a symptom of metabolic dysfunction, or under-training.

As a group overall fitness - aerobic, strength and flexibility - is not good. 60% of participants failed the test.

Overall the fitness scores was 56.

PLATINUM CHALLENGE

The PLATINUM FITNESS CHALLENGE is the highest elite force fitness award. It involves 4 key measures of fitness.

1.	Aerobic fitness - number of 20m laps in 5 minutes

2.	Situps - maximum consecutive number in 90 seconds - feet held, fingers clasped behind ears, coming up so elbows touch alternate knees, shoulders (not head) hitting the floor.

3.	Pressups - maximum consecutive number in 60 seconds - men on toes, women on knees.

4.	Functional mobility - sit down (legs straight out) and standup (straight) in 30 seconds, multiplied by 4.

SCORING

To achieve a particular standard participants needed to complete the required number of repetitions as listed below. Their award depends on the lowest of your scores.

Award	20m Laps	Situps	Pressups	Functional Mobility x 4
10. Platinum	60	60	60	60
9. Diamond	55	55	55	55
8. Gold	50	50	50	50
7. Silver	45	45	45	45
6. Bronze	40	40	40	40
5. Tin	35	35	35	35
4. Plastic	30	30	30	30
3. Wood	25	25	25	25
2. Cardboard	20	20	20	20
1. Paper	15	15	15	15
0. String	<15	<15	<15	<15

It was a disappointing result. A large number of staff scored zero on one of more of the items. People in modest shape can reach the 40 point level with ease. This was not a highly tuned group by any means.

MUSCULO-SKELETAL RISK

Our musculo-skeletal risk factor profile looked at a range of parameters including mobility, strength and flexibility and whether people are training to keep themselves strong and flexible.

The musculo-skeletal risk factor profile is comprised of a mix of 7 objective and 3 subjective assessments.

• Current musculo-skeletal condition

• Abdominal strength test

• Upper body strength test

• Flexibility

• Functional mobility – the ability to sit down and stand up with ease.

• Shoulder function

• Dominant hand grip

• Non-dominant hand grip

• Flexibility training behaviour

• Strength training behaviour

A score of 70% is attainable by those who have a regular and systematic training program.

Those scoring less than 70 are not doing sufficient in the way of strength and flexibility exercises. They are therefore exposing themselves to a high risk of musculo-skeletal dysfunction. (It would be bizarre for a workplace to offer to pay the rehabilitation costs of people who were not keeping themselves strong enough or flexible enough to do their job without succumbing to musculo-skeletal dysfunction, wouldn't it?)


A mediocre result. Too many people are experiencing some pain and discomfort. Those scoring less the 6 are encouraged to attend a prehab/rehab program, for their own benefit and that of the organisation.		As a group this is a poor result. 52% were 10 or more kilos over their ideal weight. Being overweight greatly compromises mobility. This is not an elite force score.

Generally speaking a good result. However, 5 people couldn't do a squat, for a variety of reasons - dicky knees, bung hips, crook backs and excess weight.		This is a poor result. Most people couldn't do 40 situps with their feet held. This means that the strength of the muscles on the front of their body is not sufficient to keep their pelvis and spinal column in good alignment.

This is a poor result. 21 people couldn't touch their toes at all. Too many people have tight muscles along the back side of their body - calves, hamstrings, buttock and back. It's caused by two things - sitting down and not having a flexibility program. There is a high risk of lower back and neck dysfunction.		This is a poor result. Most people could not do 40 pressups. They are leaving themselves open to upper back, shoulder and arm dysfunction.

A poor result. Most people are having difficulty getting down on the floor and back up again. Being overweight and having a game leg, bung hip and a crook back dramatically reduces mobility.		A mediocre result. Close to 40% of people had some form of shoulder dysfunction.

Its always the case, few people have a regular strength and flexibility program.

Average score: 49. Not good. These people are not in particularly good shape. The risk of musculo-skeletal dysfunction is high due to low levels of strength and flexibility. Those who scored less than 60 are encouraged to take part in a regular strength and flexibility training program .

By far and away a high proportion of people do not have a strength and flexibility program. As a result they are getting weaker and tighter by the week, thereby exposing themselves and the organisation to risk.

In our opinion musculo-skeletal dysfunction caused by lack of a regular and systematic strength and flexibility program cannot be classified as an injury.

We recommend a range of strength and flexibility classes that are readily available Australia-wide: -

•	Posture and Flexibility
•	Yoga
•	Crookback Clinic
•	Tai Chi
•	Pontius Pilates

The lack of strength and flexibility training coupled with poor abdominal strength, upper body strength, flexibility and shoulder function is a cause for concern and needs the attention of individual staff and managers.

Recommendation

We strongly recommend that the people who are in current poor musculo-skeletal condition, and who lack abdominal strength, upper body strength, flexibility, shoulder function and functional mobility, in particular those who scored less than 60 on the profile, to attend regular strength and flexibility classes.

DIET PROFILE

The diet profile is designed to assist participants to check out whether they are eating wisely and also one which has appropriate amounts of carbohydrate, protein and fat. It also looks at various eating habits, eg eating too much, eating for comfort ...

• Closeness to ideal weight?

• Do you eat a decent breakfast?

• Do you eat a high fat diet?

• Do you eat a high starch diet?

• Do you eat from the top of the Diet Hourglass?

• How much water do you during each day?

• Do you supplement your diet with essential micro-nutrients – vitamins,

minerals, essential fats (omega 3) and glyco-proteins - and

nutraceuticals - ginko, aloe vera, Echinacea ...?

• Do you eat too much?

• Are you ruled by your addictions to fat, sugar and starch?

• Does the back end of your system work like a charm?

We use the Hourglass Diet as out eating model.

Low scores are usually symptomatic of high fat, high starch, low fibre diets. The results: - people become over fat and constipated.


	Being over weight is a symptom of metabolic dysfunction. 52% of people were more than 10Kg overweight, 10 people were more than 20Kg over weight.	Too many people filling themselves up on flour and sugar at breakfast time. This is due to the Kellogification of our diets. The 'fat police' have just about stripped a decent cooked breakfast out of existence.

	If you're over weight you've either got a fat guts ...	or a starch guts, or a sugar guts or a beer guts ...

	The nature of our culture is that it's too easy to eat junk food.	Some people are not drinking enough water. We're too affluent - we can afford to drink coffee, fruit juice and carbonated drinks to slake our thirst; every thing but water. 'Water, water every where ...' but no-one wants to drink it!

	Unless you eat the perfect diet, there is a good case for supplementing one's diet. Our food lacks vitamins minerals and essential fats.	Not only do I fail to eat from the top of the Hourglass, But I eat too much. It's hard to satisfy the inner hunger by eating.

	There's an epidemic of food addiction, particularly to chocolate, cola drinks, cake, biscuits, ice-cream ...	Back end function depends on eating less fat, flour and sugar and more fruit, vegetables and fibre. Psyllium husk works a treat.
Patchy. Total score 62. A very average score. It's too easy to eat a high energy dense diet of manufactured food - particularly foods containing large amounts of fat, flour and sugar - food that comes in packets, tins, cans, bottles, cardboard boxes and plastic bags. This is a group that needs to design strategies to get more fruit, vegetables and water down their throat.

Australia is in a grip of an obesity and body system dysfunction epidemic generated by too much of the wrong food on the one hand, and too little of the right food on the other. It is my opinion that diets high in refined, cereal-based carbohydrates and sugar (the garbohydrates) are the suspects. Too few people seem to be aware that their level of body fat is affected by the amount of flour and sugar they take in each day. The high starch diet has replaced the high fat diet, with the same consequences. The garbohydrate diet stimulates insulin production which leads to fat gain, and all manner of metabolic dysfunctions.

Many people are unaware that they may be allergic or intolerant of some foods, particularly wheat flour, milk, deadly nightshades, chocolate, alcohol, caffeine, preservatives ...

Most people have a flour and sugar breakfast, attributed to the kelloggification of the Australian diet. You don't eat biscuits for lunch and dinner so why are you eating them for breakfast? The breakfast eating behaviour of Australians is dreadful. Few people have fruit. Even fewer have vegetables, or adequate protein and fat.

Few people take vitamin and mineral supplements. I believe there are good reasons to do so. If you don't believe me, I recommend you buy the book, What Your Doctor Doesn't Know About Nutrition May Be Killing You, by Ray Strand, MD.

By their own recognition a small number of people said they over-ate and were ruled by their addictions to junk food.

The operation of the back end of the system was only fair – low scores being reflective of a diet that lacks sufficient fibre.

CHEMICAL INTAKE PROFILE

The chemical profile focuses principally on the mix of culturally acceptable stimulants and depressants.

• Do you smoke?

• How many alcoholic drinks do you have a week?

• How much caffeine do you drink each day?

• Do you persistently feed a sweet tooth?

• Do you persistently feed a salt tooth?

• How many hours a week do you spend watching TV?

• Do you have a high intake of food additives?

• How do you rate your reliance on headache and pain-killing tablets?

• Are you on sleeping tablets or anti-depressants?

• Are you on diabetes or blood pressure mediation?


	6 people smoked.	Overall a good result (except for the 3 of people who have more than 20 drinks a week). As people become fitter the need for alcohol declines.

	Less is good.	Time to stop putting sugar in tea and coffee.

	Bones out of alignment are the main cause of anti-inflammatory tablet usage.	Headaches are not caused by a lack of Panadol!

	A good result. 1 person regularly taking sleeping medication. Poor sleep is not caused by a lack of Stilnox! The first causality of anxiety is poor sleep. Find out the cause of the problem. Exercise more, drink less.	5 people were on anti-depressant medication. These people need a twice daily aerobic fitness training program, omega 3 fat supplementation, and regular counselling. They need to take their holidays and long service leave.

	Elevated blood pressure is another indication of metabolic dysfunction. It is not caused by a lack of Avpro! 14 people are on blood pressure medication. This is an exceptionally high proportion of people and may be related to the job. More likely it is personally generated by a lack of fitness. It is a principal symptom of metabolic dysfunction.	2 people were on diabetes medication. Diabetes is not caused by a lack of Metformin. On the contrary it is another symptom of metabolic dysfunction caused by a diet high in flour and sugar and a serious lack of regular and vigorous physical activity.

Average score: 85. A fair result. A good score on this profile is over 80. Scores below that are a cause for concern.

It is usually the case that fit and healthy people don’t drink to any great degree. In fact they only have one or two drinks per week.

However, we’ve well and truly entered the junk medical age when the medical priesthood is encouraging their clients to wash down an Aspro each day with a couple of glasses of claret, all in the name of good health! The people we see who are fittest and healthiest also have very low, or zero intakes of alcohol, caffeine and Aspro.

STRESS RISK PROFILE

Participants completed a simple stress and relaxation profile designed to assist them in making an assessment of how they were affected by stress. It is based on the habits of unstressed people.

If you do what unstressed people do you are less at risk of becoming stressed. I’m yet to see someone who said they were highly stressed or depressed who got a high score on this profile. A good score is over 70.

• How would you rate your current stress level

• Do you get a good night’s sleep?

• Do you take your holidays?

• Are you keeping yourself fit and healthy?

• Is there balance in your life?

• Do you take time off at lunch time?

• How many hours a week do you work?

• Are you good at giving back to your Self?

• Do you meditate?

• Are you happy with your family (and romantic) life?

The matter of stress always needs to be addressed by organisations as part of a personal development thrust, and aimed at all staff. If stress management type programs are to be conducted, all staff need to be involved, otherwise those at most risk and those who are currently most stressed (and too wrapped up in their own busyness) will not attend.

For those who spend long hours at work, I often wonder whether the behaviour is externally or internally driven. I suspect the latter. No body on their death bed ever said 'I wish I'd spent more time at the office.'

A few people are struggling with their family life. This is another fertile area for personal development and counseling programs. It's hard to concentrate at work when your home life is in turmoil

SCORING GUIDELINES

Excellent, scoring 8 or more

Good, scoring 7 or more

Fair, scoring 5 or 6

Poor, scoring less than 5

‘Pass mark’ on all parameters 7/10.


	With some exception, this is a reasonable result.	This is a reasonable result. 28% of the group don't sleep well. The first casualty of anxiety and low levels of fitness is sleep. The first causality of anxiety is poor sleep. Find out the cause of the problem. Exercise more, drink less.

	A poor result. Paul Pearsal in his book Superimmunity' said you need a 21 day away from home holiday every year.	Not a good result. Too many people are not keeping themselves in the shape they'd like to be in - and which they need to be in.

	With some exceptions this is a reasonable result.	A poor result. Too many people don't take time off to switch off and get outside in the fresh air. This is a reflection of poor management - personal and organisational

	This is a poor result. Too many people are working extra ;long hours. No one on their death bed ever said 'I wish I'd spent more time at the office.' The people working the longest hours may be women with young children who have a shift before work, a shift at work, a shift after work and the graveyard shift as well.	Too many people are too busy to look after and nurture their Self.

	Very few people meditate. The reasons to do so are compelling.	Family life satisfaction is good for most people, but not for a few. The tail suggests the organisation could encourage staff with family problems to go to the employee assistance program for advice and support.

Average score: 56. This is indeed an average sort of a score. People could do more to look after their Self. I recommend that people scoring less that 50 spend time with a counselor or life coach, or go to a personal development weekend to get themselves centred and grounded on looking after their Self - start doing the things unstressed people do to avoid becoming stressed.

CAREER SATISFACTION PROFILE

The parameters in the profile relate to a mix of factors influences by the participant, management and their colleagues.

• How close are you to doing the job you’d really like to be doing?

• Are you in the right job for now?

• Is work giving you life or sucking life out of you?

• Are you focused on your career options?

• Do you get good feedback from your manager?

• Do you receive an appropriate financial reward?

• Do you feel you and your work are valued and appreciated?

• Do you work for an organisation that cares about people?

• Do you enjoy the company of the people you work with?

• What’s the level of morale like in your work group?

Normally, when results on the overall career profile are less than 70/100, people agree that they’re not in the right job. Certainly those scoring less than 60 have sufficient issues relating to career management as to seriously consider going somewhere else.