Collaborative case management to aid return to work after long-term sickness absence: a pilot randomised controlled trial

Background: Despite high levels of employment among working-age adults in the UK, there is still a significant minority who are off work with ill health at any one time (so-called ‘sickness absence’). Long-term sickness absence results in significant costs to the individual, to the employer and to wider society. Objective: The overall objective of the intervention was to improve employee well-being with a view to aiding return to work. To meet this aim, a collaborative case management intervention was adapted to the needs of UK employees who were entering or experiencing long-term sickness absence. Design: A pilot randomised controlled trial, using permuted block randomisation. Recruitment of patients with long-term conditions in settings such as primary care was achieved by screening of routine records, followed by mass mailing of invitations to participants. However, the proportion of patients responding to such invitations can be low, raising concerns about external validity. Recruitment in the Case Management to Enhance Occupational Support (CAMEOS) study used this method to test whether or not it would transfer to a population with long-term sickness absence in the context of occupational health (OH). Participants: Employed people on long-term sickness absence (between 4 weeks and 12 months). The pilot was run with two different collaborators: a large organisation that provided OH services for a number of clients and a non-profit community-based organisation. Intervention: Collaborative case management was delivered by specially trained case managers from the host organisations. Sessions were delivered by telephone and supported use of a self-help handbook. The comparator was usual care as provided by participants’ general practitioner (GP) or OH provider. This varied for participants according to the services available to them. Neither participants nor the research team were blind to randomisation

Analysing sustainable transport packaging solutions for the home delivery of dry groceries: A case study at PostNL

Logistics plays an import role in e-commerce and so in the online grocery market. This research analysed different transport packaging solutions for the home delivery of dry groceries. Insights into the effects of several transport packaging have been gained. A case study has been applied to PostNL, to find the best alternative for the delivery of dry groceries in their supply chain. Sustainability plays an important role in this research. The Triple Bottom Line of social, economic and environmental sustainability are the fundamentals for the criteria on which the alternatives have been evaluated. Also, constraints of the systems in which the transport packaging must function in have been established. The criteria are important aspects like environmental impact, costs, food safety, ergonomics and logistics performance. Weights have been identified to show the relative importance of the criteria. The identification of the importance of the weights has been done by conducting a questionnaire to actors in the food delivery supply chain of PostNL. The method which has been used for the determination of the weights is called the Best-Worst Method (BWM). The alternatives have been assessed on the criteria and compared to each other. This has been done conducting a Multi-Criteria Analysis (MCA). The scoring of the alternatives on the criteria has been done using interviews, questionnaires, calculations models and experiments. One of the calculations models is a Life Cycle Assessment (LCA) in which the environmental impact of the alternatives has been determined. A useful methodology, combining MCA, LCA and BWM, has been developed for the assessment of sustainable transport packaging solutions.Transport, Infrastructure and Logistic

Effectiveness of a minimal psychological intervention to reduce mild to moderate depression and chronic fatigue in a working population: the design of a randomized controlled trial

Abstract Background In a working population, common mental complaints like depressed mood and chronic fatigue are highly prevalent and often result in further deterioration of mental health and consequently absence from work. In a large occupational health setting, we will evaluate the (cost-) effectiveness of a Minimal Psychological Intervention (MPI), in reducing symptoms of depression and chronic fatigue in a working population. The MPI is also evaluated regarding its appreciation by worker, nurse, and occupational health physician (process evaluation). The tailor-made intervention is administered by nurses, who are trained in the principles of cognitive behavioural therapy and self-management. Methods/design The presented WoPaCoM study (Work Participation of Workers with Common Mental complaints) is a two-armed randomized controlled trial, comparing MPI with usual care. A total number of 124 workers suffering from (chronic) mental fatigue or mild to moderate depression will be included. A stratified and block randomization will be applied, stratifying by customer organisation, income, and gender, using a block size of four. It will include a baseline measurement and subsequently follow up measurements after 4, 6 and 12 months. The primary outcome measures are symptoms of either fatigue (using the Checklist Individual Strength) and/or depression (using the Beck Depression Inventory) and secondary outcome measures include sickness absence, self efficacy, costs and quality of life. Analysis will include both univariate and multivariate techniques and data will be analysed according to the intention to treat principle. Discussion Patient recruitment in an occupational setting proves to be complicated and time consuming. Shift work for instance proved to be an obstacle for making appointments for consultation with the nurse. Furthermore, economic developments might have created job insecurity which negatively influenced participation in the study, with workers being anxious to be detected as having psychological problems. Additionally, long-term follow-up in a working population is time-consuming and continuously engages occupational health staff and administrative personnel to control the process of data gathering. However, if the intervention proves to be effective, occupational medicine will have a manageable option for treatment of workers who are at risk of loss of productivity or sickness absence. Trial registration Nederlands Trialregister NTR3162</p

Flood Safety Durban

Durban is the biggest city of the KwaZulu-Natal province located at the East coast of South-Africa. In South Africa nation wide millions of Rands of damage occur along with tens of casualties as a result of urban flooding. These floods are usually the result of heavy rainfall. In Durban other factors that may contribute to floods are blockage or siltation of the drainage system. The blockage of the rainage system is a result of bad waste management. The continuously rising sea level in combination with a blocked urban drainage system could pose a serious threat. This results in the following main goal of this project: obtain insight in the effects of combined sea storm and high rain/river events on stakeholders and existing transport systems, for regular and more severe events. The scope of the project is the area of Durban from the port up until the Umgeni Business park and from the coast until the hill ridge. This report contains four parts. Part I: Analysis, Part II: Elaboration on Modelling Approach, Part III: Acquiring Results and Part IV: Solutions. In the first part are analysed: stakeholders, the transport network, the storm water network and hydraulic and hydrological aspects. In the stakeholder analysis several stakeholders are identified that either have a significant interest, or significant power to influence any decisions that will have to be made regarding floods. From the traffic analysis the most important roads and bottlenecks were identified. The only interesting network is the road network, since other infrastructure is not used by many people. The stormwater network analysis showed that in several locations such as the Central Business District (CBD) the tide penetrates far into the network and several outfalls are completely underwater during spring tide. This shows the possible vulnerability of the network to a high water level from the sea. The analysis also showed that external factors such as blockage of the manholes by waste could also affect the functionality of the system. The hydraulic & hydrological parameters that were analysed were rainfall and river discharge from the land side and the water level from the sea side. In the second part different maps are created which together reveal the most critical areas with respect to flooding. The most critical areas with respect to stakeholders and the traffic network were identified and mapped. Also the drainage model PCSWMM, which has been used to model the urban drainage system of the study area has been described. In the third part the stakeholder and transport map are combined with a flood map resulting from PCSWMM. The flood scenarios, which are used as input for PCSWMM are based on the likeliness of the combination of occurrence of the sea and land based hydraulic parameters. By the combination of these maps, the consequences of the floods have been evaluated. Because of inaccuracies in the flood map for some regions the focus was laid upon the Central Business District. The consequences of the floods are divided in capital, social and economic costs. Several main roads could get flooded in the CBD which will require the traffic to use other main roads. The exit- and entry ramps of these other roads however are not designed for such an increase in intensity and therefore congestion will arise at these locations. This will cause severe travel time delay and will result in economic costs. With respect to stakeholders, property owners and small businesses will be most affected in some parts whereas in other parts of the area insurance companies will be most affected because of the houses of middle or upper class residents and also business who are all insured for damages caused by floods. The last part contains four proposed solution strategies which can be used as a starting point in treating floods. Floods can be seen as a risk which consists of the combination of probability and consequences. Therefore four general risk treating strategies are used: Accept, Avoid, Mitigate and Transfer. Four global solutions to deal with floods are constructed each based on these different strategy. The four strategies were evaluated using a Multi Criteria analysis. This showed that all strategies are better than the 0-hypothesis (Accept) but none of the strategies proved to be the most suitable. Finally some recommendations are given for further research and to improve the PCSWMM model.Civil Engineering and GeosciencesMultidisciplinary Project CIE4061-0