Flexibilisierung von Entgeltsystemen : Voraussetzung für ein systematisches Beschäftigungsmangement

Im Rahmen eines interdisziplinären Projektverbunds des Zentrums für Europäische Wirtschaftsforschung in Mannheim und der Universität Mannheim wurden im Zeitraum von Mitte April bis Mitte Mai 1998 in Form von Fallstudien die Entgeltsysteme von drei Großunternehmen aus dem Rhein-Neckar-Raum untersucht. Ziel war es zum einen, die Flexibilisierungsnotwendigkeiten sowie die den einzelnen Unternehmen zur Verfügung stehenden Flexibilisierungsspielräume bei der Gestaltung ihrer Entgeltsysteme zu analysieren. Zum anderen sollten die externen und internen Determinanten dieser Gestaltungsspielräume ermittelt werden. Schließlich war es das Anliegen, zu untersuchen, inwieweit durch die identifizierten Flexibilisierungsmöglichkeiten Beschäftigungswirkungen erreicht werden können. Der vorliegende Bericht dokumentiert die Untersuchungsergebnisse und geht dabei auch auf die konzeptionelle Grundlage der Untersuchung ein

Flexibilisierung von Entgeltsystemen: Voraussetzung für ein systematisches Beschäftigungsmanagement ; Ergebnisse aus qualitativen Fallstudien

Im Rahmen eines interdisziplinären Projektverbunds des Zentrums für Europäische Wirtschaftsforschung in Mannheim und der Universität Mannheim wurden im Zeitraum von Mitte April bis Mitte Mai 1998 in Form von Fallstudien die Entgeltsysteme von drei Großunternehmen aus dem Rhein-Neckar-Raum untersucht. Ziel war es zum einen, die Flexibilisierungsnotwendigkeiten sowie die den einzelnen Unternehmen zur Verfugung stehenden Flexibilisierungsspielräume bei der Gestaltung ihrer Entgeltsysteme zu analysieren. Zum anderen sollten die externen und internen Determinanten dieser Gestaltungsspielräume ermittelt werden. Schließlich war es das Anliegen, zu untersuchen, inwieweit durch die identifizierten Flexibilisierungsmöglichkeiten Beschäftigungswirkungen erreicht werden können. Der vorliegende Bericht dokumentiert die Untersuchungsergebnisse und geht dabei auch auf die konzeptionelle Grundlage der Untersuchung ein. ; The basic objective of the research project described in this article is to analyze the necessity for flexibility in compensation systems in major German industries. The range of flexibility in compensation systems is determined to a great extent by collective bargaining regulations. Since collective agreements differ very much among industries they have an impact on the possibilities of flexible compensation systems. Companies in three different industries (construction, chemical and software) were analyzed according to their needs for flexible compensation systems and to their possibilities as determined by collective agreements. The results indicate that different degrees of flexibility of compensation systems influence labor markets. Inflexible systems such as in the construction industry lead to lay offs where there is a reduction in demand or bad wheather, whereas flexible systems in the software industry allow reductions in performance based components instead of dismissals. Collective agreements in Germany should provide more flexibility in order to reach stable employment. --

Effect of Ultraviolet Irradiation on Biosynthesis of Dna in Guinea-Pig Skin in Vivo

The molecular and metabolic alterations preceding the clinical manifestation of a photobiologic process, the erythematous or sunburn reaction, were investigated in mammalian skin in vivo. The effect of a moderate (2.5–3 times the minimal erythema dose [MED]) and a large (6–8 times MED) dose of ultraviolet radiation (290–320 nm) on the incorporation of [Me-3H]-thymidine into epidermal cell DNA of guinea pigs was studied. The epilated half of the back of each animal was irradiated with various doses of ultraviolet light, and the other half served as the nonirradiated control. The amount of intraperitoneally injected [Me-3H]-thymidine incorporated into the DNA was determined by the isolation of DNA at various time intervals and the measurement of its radioactivity. Significant inhibition of the biosynthesis of DNA (64% of the control) immediately after ultraviolet irradiation was observed. The duration of this inhibition is related to the total dose of ultraviolet light delivered and to the degree of the erythema reaction (i.e., the degree of cellular damage) and can persist from 2.24hr. With a moderate dose, the biosynthesis of new DNA occurs 2hr after irradiation

Exercise recommendations for people with bone metastases: Expert consensus for healthcare providers and clinical exercise professionals

Purpose: Exercise has been underutilized in people with advanced or incurable cancer despite the potential to improve physical function and reduce psychosocial morbidity, especially for people with bone metastases because of concerns over skeletal complications. The International Bone Metastases Exercise Working Group (IBMEWG) was formed to develop best practice recommendations for exercise programming for people with bone metastases on the basis of published research, clinical experience, and expert opinion. Methods: The IBMEWG undertook sequential steps to inform the recommendations: (1) modified Delphi survey, (2) systematic review, (3) cross-sectional survey to physicians and nurse practitioners, (4) in-person meeting of IBMEWG to review evidence from steps 1-3 to develop draft recommendations, and (5) stakeholder engagement. Results: Recommendations emerged from the contributing evidence and IBMEWG discussion for pre-exercise screening, exercise testing, exercise prescription, and monitoring of exercise response. Identification of individuals who are potentially at higher risk of exercise-related skeletal complication is a complex interplay of these factors: (1) lesion-related, (2) cancer and cancer treatment–related, and (3) the person-related. Exercise assessment and prescription requires consideration of the location and presentation of bone lesion(s) and should be delivered by qualified exercise professionals with oncology education and exercise prescription experience. Emphasis on postural alignment, controlled movement, and proper technique is essential. Conclusion: Ultimately, the perceived risk of skeletal complications should be weighed against potential health benefits on the basis of consultation between the person, health care team, and exercise professionals. These recommendations provide an initial framework to improve the integration of exercise programming into clinical care for people with bone metastases

Exercise for individuals with bone metastases: A systematic review

Background Exercise has the potential to improve physical function and quality of life in individuals with bone metastases but is often avoided due to safety concerns. This systematic review summarizes the safety, feasibility and efficacy of exercise in controlled trials that include individuals with bone metastases. Methods MEDLINE, Embase, Pubmed, CINAHL, PEDro and CENTRAL databases were searched up to July 16, 2020. Results A total of 17 trials were included incorporating aerobic exercise, resistance exercise or soccer interventions. Few (n=4, 0.5%) serious adverse events were attributed to exercise participation, with none related to bone metastases. Mixed efficacy results were found, with exercise eliciting positive changes or no change. The majority of trials included an element of supervised exercise instruction (n=16, 94%) and were delivered by qualified exercise professionals (n=13, 76%). Conclusions Exercise appears safe and feasible for individuals with bone metastases when it includes an element of supervised exercise instruction

Moderators of Exercise Effects on Cancer-related Fatigue:A Meta-analysis of Individual Patient Data

PURPOSE: Fatigue is a common and potentially disabling symptom in patients with cancer. It can often be effectively reduced by exercise. Yet, effects of exercise interventions might differ across subgroups. We conducted a meta-analysis using individual patient data of randomized controlled trials (RCT) to investigate moderators of exercise intervention effects on cancer-related fatigue. METHODS: We used individual patient data from 31 exercise RCT worldwide, representing 4366 patients, of whom 3846 had complete fatigue data. We performed a one-step individual patient data meta-analysis, using linear mixed-effect models to analyze the effects of exercise interventions on fatigue (z score) and to identify demographic, clinical, intervention- and exercise-related moderators. Models were adjusted for baseline fatigue and included a random intercept on study level to account for clustering of patients within studies. We identified potential moderators by testing their interaction with group allocation, using a likelihood ratio test. RESULTS: Exercise interventions had statistically significant beneficial effects on fatigue (β = -0.17; 95% confidence interval [CI], -0.22 to -0.12). There was no evidence of moderation by demographic or clinical characteristics. Supervised exercise interventions had significantly larger effects on fatigue than unsupervised exercise interventions (βdifference = -0.18; 95% CI -0.28 to -0.08). Supervised interventions with a duration ≤12 wk showed larger effects on fatigue (β = -0.29; 95% CI, -0.39 to -0.20) than supervised interventions with a longer duration. CONCLUSIONS: In this individual patient data meta-analysis, we found statistically significant beneficial effects of exercise interventions on fatigue, irrespective of demographic and clinical characteristics. These findings support a role for exercise, preferably supervised exercise interventions, in clinical practice. Reasons for differential effects in duration require further exploration

Design of the EXercise Intervention after Stem cell Transplantation (EXIST) study: a randomized controlled trial to evaluate the effectiveness and cost-effectiveness of an individualized high intensity physical exercise program on fitness and fatigue in patients with multiple myeloma or (non-) Hodgkin's lymphoma treated with high dose chemotherapy and autologous stem cell transplantation

<p>Abstract</p> <p>Background</p> <p>The use of high-dose chemotherapy combined with autologous stem cell transplantation has improved the outcome of hematologic malignancies. Nevertheless, this treatment can cause persistent fatigue and a reduced global quality of life, role and physical function. Physical exercise interventions may be beneficial for physical fitness, fatigue and quality of life. However, the trials conducted so far to test the effects of physical exercise interventions in this group of patients were of poor to moderate methodological quality and economic evaluations are lacking. Hence there is need for a rigorous, appropriately controlled assessment of the effectiveness of exercise programs in these patients. The aims of the present study are (1) to determine the effectiveness of an individualized high intensity strength and interval training program with respect to physiological and psychological health status in patients with multiple myeloma or (non-)Hodgkin's lymphoma who have recently undergone high dose chemotherapy followed by autologous stem cell transplantation; and (2) to evaluate the cost-effectiveness of this program.</p> <p>Methods</p> <p>A multicenter, prospective, single blind randomized controlled trial will be performed. We aim to recruit 120 patients within an inclusion period of 2 years at 7 hospitals in the Netherlands. The patients will be randomly assigned to one of two groups: (1) intervention plus usual care; or (2) usual care. The intervention consists of an 18-week individualized supervised high-intensity exercise program and counselling. The primary outcomes (cardiorespiratory fitness, muscle strength and fatigue) and secondary outcomes are assessed at baseline, at completion of the intervention and at 12 months follow-up.</p> <p>Discussion</p> <p>The strengths of this study include the solid trial design with clearly defined research groups and standardized outcome measures, the inclusion of an economic evaluation and the inclusion of both resistance and endurance exercise in the intervention program.</p> <p>Trial registration</p> <p>This study is registered at the Netherlands Trial Register (NTR2341)</p

Targeting exercise interventions to patients with cancer in need:An individual patient data meta-analysis

Background: Exercise effects in cancer patients often appear modest, possibly because interventions rarely target patients most in need. This study investigated the moderator effects of baseline values on the exercise outcomes of fatigue, aerobic fitness, muscle strength, quality of life (QoL), and self-reported physical function (PF) in cancer patients during and post-treatment. Methods: Individual patient data from 34 randomized exercise trials (n = 4519) were pooled. Linear mixed-effect models were used to study moderator effects of baseline values on exercise intervention outcomes and to determine whether these moderator effects differed by intervention timing (during vs post-treatment). All statistical tests were two-sided. Results: Moderator effects of baseline fatigue and PF were consistent across intervention timing, with greater effects in patients with worse fatigue (Pinteraction = .05) and worse PF (Pinteraction = .003). Moderator effects of baseline aerobic fitness, muscle strength, and QoL differed by intervention timing. During treatment, effects on aerobic fitness were greater for patients with better baseline aerobic fitness (Pinteraction = .002). Post-treatment, effects on upper (Pinteraction &lt; .001) and lower (Pinteraction = .01) body muscle strength and QoL (Pinteraction &lt; .001) were greater in patients with worse baseline values. Conclusion: Although exercise should be encouraged for most cancer patients during and post-treatments, targeting specific subgroups may be especially beneficial and cost effective. For fatigue and PF, interventions during and post-treatment should target patients with high fatigue and low PF. During treatment, patients experience benefit for muscle strength and QoL regardless of baseline values; however, only patients with low baseline values benefit post-treatment. For aerobic fitness, patients with low baseline values do not appear to benefit from exercise during treatment