The assessment of efforts to return to work in the European Union

Background: Assessment of efforts to promote return-to-work (RTW) includes all efforts (vocational and non-vocational) designed to improve the work ability of the sick-listed employee and increase the chance to return to work. Aim of the study was to investigate whether in 13 European countries these RTW efforts are assessed and to compare the procedures by means of six criteria. METHODS: Data were gathered in the taxonomy project of the European Union of Medicine in Assurance and Social Security and by means of an additional questionnaire. RESULTS: In seven countries RTW efforts are subject of the assessment in relation to the application for disability benefits. Description of RTW efforts is a prerequisite in five countries. Guidelines on the assessment of RTW efforts are only available in the Netherlands and no countries report the use of the ICF model. Based on the results of the additional questionnaire, the assessor is a social scientist or a physician. The information used to assess RTW efforts differs, from a report on the RTW process to medical information. A negative outcome of the assessment leads to delay of the application for disability benefits or to application for rehabilitation subsidy. Conclusion: RTW efforts are assessed in half of the participating European countries. When compared, the characteristics of the assessment of RTW efforts in the participating European countries show both similarities and differences. This study may facilitate the gathering and exchange of knowledge and experience between countries on the assessment of RTW efforts

Quadrupole deformation of deuterons and final state interaction in 2H⃗(e,e′p)^2 \vec H (e,e'p) scattering on tensor polarized deuterons at CEBAF energies

The strength of final state interaction (FSI) between struck proton and spectator neutron in $^2\vec{H}(e,e'p)$ scattering depends on the alignment of the deuteron. We study the resulting FSI effects in the tensor analyzing power in detail and find substantial FSI effects starting at still low missing momentum p_m \gsim 0.9 fm^{-1}. At larger p_m \gsim 1.5 fm^{-1}, FSI completely dominates both missing momentum distribution and tensor analyzing power. We find that to a large extent FSI masks the sensitivity of the tensor analyzing power to models of the deuteron wave function. For the transversely polarized deuterons the FSI induced forward-backward asymmetry of the missing momentum distribution is shown to have a node at precisely the same value of $p_m$ as the PWIA missing momentum distribution. The position of this node is not affected by FSI and can be a tool to distinguish experimentally between different models for the deuteron wave function.Comment: 24 pages, figures available from the authors on reques

Spin dependence in high pT2p^{2}_{T} elastic pp and np scattering

Using the polarized proton capability of the Argonne ZGS the authors recently made 90 degrees /sub cm/ measurements of elastic pp scattering from 6 to 11.75 GeV/c, determining the parallel and anti- parallel pure initial spin state cross sections and the associated spin-spin parameter A/sub nn/ with the spins normal to the scattering plane. They find that the parallel to anti-parallel cross section ratio rises dramatically from 1.2+or-.06 at p/sub t//sup 2/=3.3 (GeV /c)/sup 2/ to 3.2+or-.4 at 4.8 (GeV/c)/sup 2/, similar to the p/sub T //sup 2/ dependence previously observed at the fixed laboratory momentum of 11.75 GeV/c. They have also extended the measurements at 6 GeV/c and find that A/sub nn/ has a small but sharp rise at 90 degrees /sub cm/. In addition a month of 12 GeV/c polarized deuteron acceleration in the ZGS enabled them to measure two A/sub nn/ at two points at 6 GeV/c for np elastic scattering: A/sub nn/=-.17+or-.04 at p/sub T//sup 2/=.8, A/sub nn/=-.19+or-.05 at P/sub T//sup 2/=1.0. These values are opposite in sign from the pp results at the same momentum. (4 refs)

Femtometer Toroidal Structures in Nuclei

The two-nucleon density distributions in states with isospin $T=0$, spin $S$=1 and projection $M_S$=0 and $\pm$1 are studied in $^2$H, $^{3,4}$He, $^{6,7}$Li and $^{16}$O. The equidensity surfaces for $M_S$=0 distributions are found to be toroidal in shape, while those of $M_S$=$\pm$1 have dumbbell shapes at large density. The dumbbell shapes are generated by rotating tori. The toroidal shapes indicate that the tensor correlations have near maximal strength at $r<2$ fm in all these nuclei. They provide new insights and simple explanations of the structure and electromagnetic form factors of the deuteron, the quasi-deuteron model, and the $dp$, $dd$ and $\alpha d$ $L$=2 ($D$-wave) components in $^3$He, $^4$He and $^6$Li. The toroidal distribution has a maximum-density diameter of $\sim$1 fm and a half-maximum density thickness of $\sim$0.9 fm. Many realistic models of nuclear forces predict these values, which are supported by the observed electromagnetic form factors of the deuteron, and also predicted by classical Skyrme effective Lagrangians, related to QCD in the limit of infinite colors. Due to the rather small size of this structure, it could have a revealing relation to certain aspects of QCD.Comment: 35 pages in REVTeX, 25 PostScript figure

Effect of Myostatin Depletion on Weight Gain, Hyperglycemia, and Hepatic Steatosis during Five Months of High-Fat Feeding in Mice

The marked hypermuscularity in mice with constitutive myostatin deficiency reduces fat accumulation and hyperglycemia induced by high-fat feeding, but it is unclear whether the smaller increase in muscle mass caused by postdevelopmental loss of myostatin activity has beneficial metabolic effects during high-fat feeding. We therefore examined how postdevelopmental myostatin knockout influenced effects of high-fat feeding. Male mice with ubiquitous expression of tamoxifen-inducible Cre recombinase were fed tamoxifen for 2 weeks at 4 months of age. This depleted myostatin in mice with floxed myostatin genes, but not in control mice with normal myostatin genes. Some mice were fed a high-fat diet (60% of energy) for 22 weeks, starting 2 weeks after cessation of tamoxifen feeding. Myostatin depletion increased skeletal muscle mass ∼30%. Hypermuscular mice had ∼50% less weight gain than control mice over the first 8 weeks of high-fat feeding. During the subsequent 3 months of high-fat feeding, additional weight gain was similar in control and myostatin-deficient mice. After 5 months of high-fat feeding, the mass of epididymal and retroperitoneal fat pads was similar in control and myostatin-deficient mice even though myostatin depletion reduced the weight gain attributable to the high-fat diet (mean weight with high-fat diet minus mean weight with low-fat diet: 19.9 g in control mice, 14.1 g in myostatin-deficient mice). Myostatin depletion did not alter fasting blood glucose levels after 3 or 5 months of high-fat feeding, but reduced glucose levels measured 90 min after intraperitoneal glucose injection. Myostatin depletion also attenuated hepatic steatosis and accumulation of fat in muscle tissue. We conclude that blocking myostatin signaling after maturity can attenuate some of the adverse effects of a high-fat diet

The risk factor profile of women with secondary infertility: an unmatched case-control study in Kigali, Rwanda

<p>Abstract</p> <p>Background</p> <p>Secondary infertility is a common, preventable but neglected reproductive health problem in resource-poor countries. This study examines the association of past sexually transmitted infections (STIs) including HIV, bacterial vaginosis (BV) and factors in the obstetric history with secondary infertility and their relative contributions to secondary infertility.</p> <p>Methods</p> <p>Between November 2007 and May 2009 a research infertility clinic was set up at the Kigali University Teaching Hospital in Rwanda. Cases were defined as sexually-active women aged 21-45 years presenting with secondary infertility (n = 177), and controls as multiparous women in the same age groups who recently delivered (n = 219). Participants were interviewed about socio-demographic characteristics and obstetric history using structured questionnaires, and were tested for HIV and reproductive tract infections (RTIs).</p> <p>Results</p> <p>Risk factors in the obstetric history for secondary infertility were lack of prenatal care in the last pregnancy, the first pregnancy before the age of 21 years, a history of unwanted pregnancy, a pregnancy with other than current partner, an adverse pregnancy outcome, stillbirth, postpartum infection and curettage. Presence of HIV, herpes simplex virus type 2 (HSV-2), or <it>Treponema pallidum </it>antibodies, and bacterial vaginosis (BV), were significantly more common in women in secondary infertile relationships than those in fertile relationships. The population attributable fractions (PAF%) for obstetric events, HIV, other (STIs), and BV were 25%, 30%, 27%, and 14% respectively.</p> <p>Conclusions</p> <p>The main finding of this study is that obstetric events, HIV and other STIs contribute approximately equally to secondary infertility in Rwanda. Scaling up of HIV/STI prevention, increased access to family planning services, improvement of prenatal and obstetric care and reduction of stillbirth and infant mortality rates are all likely to decrease secondary infertility in sub-Saharan Africa.</p

Simultaneous measurement of 2 and 3 spins in proton proton elastic scattering at 6 GeV/c

The elastic cross section for proton proton scattering at 6 GeV/c was measured using a 70% polarized beam and a 75% polarized target at the Argonne ZGS. In the range P[perpendicular]2 = 0.5 --> 2.0(GeV/c)2 we obtained small error measurements for the [short up arrow][short up arrow], [downwards arrow][downwards arrow] and [short up arrow][downwards arrow] initial spin states perpendicular to the scattering plane. At P[perpendicular]2 = 0.5 we also measured the recoil spin and found that the 5 different cross sections were very unequal.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/22271/1/0000710.pd

Improving the Nurse-Family Partnership in Community Practice

Evidence-based preventive interventions are rarely final products. They have reached a stage of development that warrant public investment but require additional research and development to strengthen their effects. The Nurse-Family Partnership (NFP), a program of nurse home visiting, is grounded in findings from replicated randomized controlled trials