Inability to Work Fulltime, Prevalence and Associated Factors Among Applicants for Work Disability Benefit

Purpose Inability to work fulltime is an important outcome in the assessment of workers applying for a disability benefit. However, limited knowledge is available about the prevalence and degree of the inability to work fulltime, the associations between disease-related and socio-demographic factors with inability to work fulltime and whether the prevalence and the associations differ across disease groups. Methods Anonymized register data on assessments of workers with residual work capacity (n = 30,177, age 48.8 +/- 11.0, 53.9% female) applying for a work disability benefit in 2016 were used. Inability to work fulltime was defined as being able to work less than 8 h per day. Results The prevalence of inability to work fulltime was 39.4%, of these 62.5% could work up to 4 h per day. Higher age (OR 1.01, 95% CI 1.01-1.01), female gender (OR 1.45, 95% CI 1.37-1.52), higher education (OR 1.44, 95% CI 1.33-1.55) and multimorbidity (OR 1.06, 95% CI 1.01-1.11) showed higher odds for inability to work fulltime. Highest odds for inability to work fulltime were found for diseases of the blood, neoplasms and diseases of the respiratory system. Within specific disease groups, different associations were identified between disease-related and socio-demographic factors. Conclusion The prevalence and degree of inability to work fulltime in work disability benefit assessments is high. Specific chronic diseases are found to have higher odds for inability to work fulltime, and associated factors differ per disease group

The perseverance time of informal carers for people with dementia: Results of a two-year longitudinal follow-up study

Background: Given the projected increase of people with dementia over the next few decades and the related demand for informal care, an important question for health policy makers is to what extent and for how long informal carers can be expected to provide care in a sustainable way. This study aimed to investigate the perseverance time of informal carers for people with dementia. Methods: A 2-year longitudinal cohort study was conducted. Questionnaires were used to collect data about the care situation, the impact of caregiving on carers and their need for support, and the anticipated and realized perseverance time of informal carers for people with dementia living at home. The data were analysed using bivariate and multivariate analyses. Results: Two hundred twenty-three carers for people with dementia were included in the study and 25 (11.2 %) dropped out during the follow-up. The results show that after 1 year, 74 (37.4 %) of 198 patients were still living at home, and after 2 years, 44 (22.2 %) patients were still living at home. The variables that were associated with this outcome were identified. When informal carers anticipated that their perseverance time would be less than 1 year, this was indicative of their actual perseverance time. Conclusions: Anticipated perseverance time provides a fair indication of the actual duration of informal care. It is most accurate when carers anticipate a limited rather than an unlimited perseverance time. Although further research is required to support these findings, the concept of perseverance time may be considered a useful additional instrument in health policy and clinical practice for monitoring carers' need for support and for planning the transition of care from home to a nursing home

Residual work capacity and (in)ability to work fulltime among a year cohort of cancer survivors who claim a disability benefit

PURPOSE: Residual work capacity (RWC) and inability to work fulltime (IWF) are important outcomes in disability benefit assessments for workers diagnosed with cancer. The aim of this study is to gain insight into the prevalence of both outcomes, the associations of disease-related and socio-demographic factors and if these differ across cancer diagnosis groups.METHODS: A year cohort of anonymized register data of cancer survivors who claim a disability benefit after 2 years of sick leave (n = 3690, age 53.3 ± 8.8, 60.4% female) was used. Having no RWC was defined as having no possibilities to perform any work at all, whereas IWF was defined as being able to work less than 8 h per day.RESULTS: The prevalence of being assessed with no RWC was 42.6%. Of the applicants with RWC (57.4%), 69.8% were assessed with IWF. Cancers of the respiratory organs showed the highest odds for having no RWC, whereas lymphoid and haematopoietic cancers showed the highest odds for IWF. Within specific cancer diagnosis groups, different associations were identified for both outcomes.CONCLUSION: The prevalence of no RWC and IWF in applicants of work disability benefits diagnosed with cancer is high compared to the prevalence in other diagnoses. The odds for no RWC, IWF, and associated factors differ per cancer diagnosis group.IMPLICATIONS FOR CANCER SURVIVORS: Being diagnosed with cancer has an enormous impact on work (dis)ability. Our results show that 2 years after being diagnosed with cancer, the majority of the disability benefit applicants are assessed with RWC; however, only 15% of all applicants with cancer had a normal ability to work fulltime, and therefore, it is of great importance to accompany them in their return to work.</p

Solving the Thermal Challenge in Power-Dense CubeSats with Water Heat Pipes

This paper describes the results of a project researching the application of water heat pipes in CubeSats. Heat pipes are proposed to solve for the increase in CubeSat power density, being one of the main thermal challenges appearing in high-performance missions. Commercial off the shelve water heat pipes have been tested and a proof-of-concept design has been made showing the flexibility of heat pipe integration. Thermal tests reflecting a common hot- and cold case experienced in low-Earth orbit, have been carried out. These tests have proven that the water heat pipe is capable of keeping a single component generating a continuous heat dissipation of 10W, within a reasonable temperature range and successfully start-up from a frozen state before temperature limits are breached. The outcome of this research has shown that water heat pipes can be the thermal solution for high performance CubeSat missions

Gustatory responses in primates to the sweetener aspartame and their phylogenetic implications

Two-bottle preference tests have been applied to 70 (sub-) species of the order of Primates and, for comparison, to the tree shrew (Tupaia belangeri) to determine their responses to aspartame (APM), the first known sweet-tasting dipeptide which has to man a sweetness potency of about 200 times that of sucrose. It was found that only the Cercopithecidae, the Hylobatidae and the Pongidae respond like man to this dipeptide and prefer it to water. The other primates tested to date, show no response to this sweetener. From a phylogenetic point of view, we note that APM shows species specificity similar to thaumatin. Thus, a clear dichotomy exists within the order of Primates with respect to both thaumatin and APM. The results here illustrate once more the gustatory diversity among primates and are a compelling argument for the existence of different sweet taste receptors or recognition sites in primate specie

Pediatric Brain Tumors:Narrating Suffering and End-of-Life Decisionmaking

When talking about decisionmaking for children with a life-threatening condition, the death of children with brain tumors deserves special attention. The last days of the lives of these children can be particularly harsh for bystanders, and raise questions about the suffering of these children themselves. In the Netherlands, these children are part of the group for whom a wide range of end-of-life decisions are discussed, and questions raised. What does the end-of-life for these children look like, and what motivates physicians and parents to make decisions that may affect the life and death of these children? This article highlights the story of the parents of the sisters Roos and Noor. When both their daughters were diagnosed with a hereditary brain tumor, they had to make similar decisions twice. Their story sheds light on the suffering of children in the terminal phase, and how this suffering may motivate parents and physicians to make decisions that influence the end of life of these children's lives.We argue that complete knowledge about suffering in the terminal phase of children with brain tumors is impossible. However, by collecting experiences like those of Roos and Noor, we can move toward an experienced-based understanding and better guide parents and physicians through these hardest of decisions

Genome-wide Association Study Identifies Genetic Variants Associated With Early and Sustained Response to (Pegylated) Interferon in Chronic Hepatitis B Patients: The GIANT-B Study

Background. (Pegylated) Interferon ([Peg]IFN) therapy leads to response in a minority of chronic hepatitis B (CHB) patients. Host genetic determinants of response are therefore in demand. Methods. In this genome-wide association study (GWAS), CHB patients, treated with (Peg)IFN for at least 12 weeks ± nucleos(t)ide analogues within randomized trials or as standard of care, were recruited at 21 centers from Europe, Asia, and North America. Response at 24 weeks after (Peg)IFN treatment was defined as combined hepatitis B e antigen (HBeAg) loss with hepatitis B virus (HBV) DNA <2000 IU/mL, or an HBV DNA <2000 IU/mL for HBeAg-negative patients. Results. Of 1144 patients, 1058 (92%) patients were included in the GWAS analysis. In total, 282 (31%) patients achieved the response and 4% hepatitis B surface antigen (HBsAg) loss. GWAS analysis stratified by HBeAg status, adjusted for age, sex, and the 4 ancestry components identified PRELID2 rs371991 (B= −0.74, standard error [SE] = 0.16, P = 3.44 ×10–6) for HBeAg-positive patients. Importantly, PRELID2 was cross-validated for long-term response in HBeAg-negative patients. G3BP2 rs3821977 (B = 1.13, SE = 0.24, P = 2.46 × 10–6) was associated with response in HBeAg-negative patients. G3BP2 has a role in the interferon pathway and was further examined in peripheral blood mononuclear cells of healthy controls stimulated with IFNα and TLR8. After stimulation, less production of IP-10 and interleukin (IL)-10 proteins and more production of IL-8 were observed with the G3BP2 G-allele. Conclusions. Although no genome-wide significant hits were found, the current GWAS identified genetic variants associated with (Peg)IFN response in CHB. The current findings could pave the way for gene polymorphism-guided clinical counseling, both in the setting of (Peg)IFN and the natural history, and possibly for new immune-modulating therapies

Development and Validation of an On-Line Water Toxicity Sensor with Immobilized Luminescent Bacteria for On-Line Surface Water Monitoring.

Surface water used for drinking water production is frequently monitored in The Netherlands using whole organism biomonitors, with for exampleDaphnia magnaorDreissenamussels, which respond to changes in the water quality. However, not all human-relevant toxic compounds can be detected by these biomonitors. Therefore, a new on-line biosensor has been developed, containing immobilized genetically modified bacteria, which respond to genotoxicity in the water by emitting luminescence. The performance of this sensor was tested under laboratory conditions, as well as under field conditions at a monitoring station along the river Meuse in The Netherlands. The sensor was robust and easy to clean, with inert materials, temperature control and nutrient feed for the reporter organisms. The bacteria were immobilized in sol-gel on either an optical fiber or a glass slide and then continuously exposed to water. Since the glass slide was more sensitive and robust, only this setup was used in the field. The sensor responded to spikes of genotoxic compounds in the water with a minimal detectable concentration of 0.01 mg/L mitomycin C in the laboratory and 0.1 mg/L mitomycin C in the field. With further optimization, which should include a reduction in daily maintenance, the sensor has the potential to become a useful addition to the currently available biomonitors

Baseline predictors of response and discontinuation of tumor necrosis factor-alpha blocking therapy in ankylosing spondylitis: a prospective longitudinal observational cohort study

Contains fulltext : 96669.pdf (publisher's version ) (Open Access)INTRODUCTION: Identifying ankylosing spondylitis (AS) patients who are likely to benefit from tumor necrosis factor-alpha (TNF-alpha) blocking therapy is important, especially in view of the costs and potential side effects of these agents. Recently, the AS Disease Activity Score (ASDAS) has been developed to assess both subjective and objective aspects of AS disease activity. However, data about the predictive value of the ASDAS with respect to clinical response to TNF-alpha blocking therapy are lacking. The aim of the present study was to identify baseline predictors of response and discontinuation of TNF-alpha blocking therapy in AS patients in daily clinical practice. METHODS: AS outpatients who started TNF-alpha blocking therapy were included in the Groningen Leeuwarden Ankylosing Spondylitis (GLAS) study, an ongoing prospective longitudinal observational cohort study with follow-up visits according to a fixed protocol. For the present analysis, patients were excluded if they had previously received anti-TNF-alpha treatment. Predictor analyses of response and treatment discontinuation were performed using logistic and Cox regression models, respectively. RESULTS: Between November 2004 and April 2010, 220 patients started treatment with infliximab (n = 32), etanercept (n = 137), or adalimumab (n = 51). At three and six months, 68% and 63% of patients were Assessments in Ankylosing Spondylitis (ASAS)20 responders, 49% and 46% ASAS40 responders, and 49% and 50% Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)50 responders, respectively. Baseline predictors of response were younger age, male gender, higher ASDAS score, higher erythrocyte sedimentation rate (ESR) level, higher C-reactive protein (CRP) level, presence of peripheral arthritis, higher patient's global assessment of disease activity, and lower modified Schober test. In August 2010, 64% of patients were still using their TNF-alpha blocking agent with a median follow-up of 33.1 months (range 2.4 to 68.2). Baseline predictors of discontinuation of TNF-alpha blocking therapy were female gender, absence of peripheral arthritis, higher BASDAI, lower ESR level, and lower CRP level. CONCLUSIONS: Besides younger age and male gender, objective variables such as higher inflammatory markers or ASDAS score were identified as independent baseline predictors of response and/or continuation of TNF-alpha blocking therapy. In contrast, higher baseline BASDAI score was independently associated with treatment discontinuation. Based on these results, it seems clinically relevant to include more objective variables in the evaluation of anti-TNF-alpha treatment