Phasing Into Retirement

Employers have been launching phased retirement programs to help workers navigate the transition from work to retirement more effectively. This paper examines the experience of the phased retirement system for tenured faculty in the University of North Carolina system. After phased retirement was introduced, there was a sizable increase in the overall separation rate in the system. A multinomial logit model of the retirement decision as a function of pension incentives, employee performance, demographics, and campus characteristics is developed. The key empirical result is that the odds of entering phased retirement are strongly and inversely related to employee performance, as measured by recent pay increases.

Sylvie Schweitzer, Les Inspectrices du Travail, 1878-1974. Le genre de la fonction publique

Le parcours professionnel des femmes qui sont entrées à l’Inspection du travail entre 1878 et 1974 est l’objet du dernier ouvrage de Sylvie Schweitzer. Après avoir écrit Les femmes ont toujours travaillé : une histoire des femmes aux XIXe et XXe siècles (2000) et Femmes au pouvoir : une histoire de l’égalité professionnelle en Europe, xixe et xxe siècles (2010), Sylvie Schweitzer s’intéresse ici à un groupe de fonctionnaires françaises employées à l’un des postes de responsabilité qu’elle évo..

Sylvie Schweitzer, Femmes de pouvoir. Une histoire de l’égalité professionnelle en Europe (XIXe-XXIe siècle)

Cette étude de l’histoire des femmes européennes qui ont eu une vie professionnelle du milieu du XIXe siècle à nos jours est une précieuse synthèse et une belle introduction à l’historiographie récente. Sylvie Schweitzer s’intéresse surtout aux femmes françaises, mais elle apporte de nombreux éléments qui permettent de les comparer à leurs collègues d’autres pays en Europe occidentale, voire de quelques pays de l’Europe de l’Est. Un thème central du livre est l’histoire de la résistance à l’é..

Structural validity and reliability of the patient experience measure: A new approach to assessing psychosocial experience of upper limb prosthesis users

Recent advances in upper limb prosthetics include sensory restoration techniques and osseointegration technology that introduce additional risks, higher costs, and longer periods of rehabilitation. To inform regulatory and clinical decision making, validated patient reported outcome measures are required to understand the relative benefits of these interventions. The Patient Experience Measure (PEM) was developed to quantify psychosocial outcomes for research studies on sensory-enabled upper limb prostheses. While the PEM was responsive to changes in prosthesis experience in prior studies, its psychometric properties had not been assessed. Here, the PEM was examined for structural validity and reliability across a large sample of people with upper limb loss (n = 677). The PEM was modified and tested in three phases: initial refinement and cognitive testing, pilot testing, and field testing. Exploratory factor analysis (EFA) was used to discover the underlying factor structure of the PEM items and confirmatory factor analysis (CFA) verified the structure. Rasch partial credit modeling evaluated monotonicity, fit, and magnitude of differential item functioning by age, sex, and prosthesis use for all scales. EFA resulted in a seven-factor solution that was reduced to the following six scales after CFA: social interaction, self-efficacy, embodiment, intuitiveness, wellbeing, and self-consciousness. After removal of two items during Rasch analyses, the overall model fit was acceptable (CFI = 0.973, TLI = 0.979, RMSEA = 0.038). The social interaction, self-efficacy and embodiment scales had strong person reliability (0.81, 0.80 and 0.77), Cronbach\u27s alpha (0.90, 0.80 and 0.71), and intraclass correlation coefficients (0.82, 0.85 and 0.74), respectively. The large sample size and use of contemporary measurement methods enabled identification of unidimensional constructs, differential item functioning by participant characteristics, and the rank ordering of the difficulty of each item in the scales. The PEM enables quantification of critical psychosocial impacts of advanced prosthetic technologies and provides a rigorous foundation for future studies of clinical and prosthetic interventions

The Nutrition Education Initiative Resource Guide: Examining Effectiveness with Middle School Students and Perceptions of Science Teachers

Background and Purpose: With obesity in children and youth continuing to be a major health problem in the U.S., schools are considered an important setting to implement programs to address the issue but few have focused on middle school students. The purposes of this study were to: 1) determine the effectiveness of a school-based nutrition education program, the Nutrition Education Initiative (NEI) Resource Guide, in improving school lunch eating behaviors of middle school students, and 2) identify science teachers’ perceptions of the materials. Implementation: The project was implemented by 16 middle school science teachers and 309 seventh grade students in a medium-sized north Florida community. The NEI Guide included three conceptual areas (Build a Healthy Base, Choose Sensibly and Aim for Fitness), major concepts, objectives, narrative information, and teaching strategies. Evaluation: Using a pre-/post without control group design, the study involved collecting data via food recall surveys with students, and surveys and interviews with teachers. Data were analyzed using descriptive statistics and paired t-tests. Results: During lunch time, a higher proportion of students met the recommended dietary servings for dairy, meat, vegetables, fruit, juice and grains from pre-test to post-test. Students also significantly increased dietary intake of meat (p< .01), fruit (p< .01) and fruit/juice combined (p< .05); and significantly decreased intake of fried vegetables (p< .001), with decreased fat intake approaching significance (p< .06). Differences in dietary patterns were noted between the two schools studied. Science teachers perceived the NEI Guide as effective; yet they also identified challenges including lack of adequate training, lack of time to implement the materials, and lack of collaboration with the project team. Conclusion: The project outcomes suggest that middle school science teachers can positively impact school lunch eating behaviors of middle school students in selected schools by incorporating nutrition education in their curricula

Reducing Stress after Trauma (ReSeT): Study Protocol for a Randomized, Controlled Trial of an Online Psychoeducational Program and Video Therapy Sessions for Children Hospitalized after Trauma

BACKGROUND: Post-traumatic stress symptoms develop in a quarter to half of injured children affecting their longer-term psychologic and physical health. Evidence-based care exists for post-traumatic stress; however, it is not readily available in some communities. We have developed an eHealth program consisting of online, interactive educational modules and telehealth therapist support based in trauma-focused cognitive behavioral therapy, the Reducing Stress after Trauma (ReSeT) program. We hypothesize that children with post-traumatic stress who participate in ReSeT will have fewer symptoms compared to the usual care control group. METHODS: This is a randomized controlled trial to test the effectiveness of the ReSeT intervention in reducing symptoms of post-traumatic stress compared to a usual care control group. One hundred and six children ages 8-17 years, who were admitted to hospital following an injury, with post-traumatic stress symptoms at 4 weeks post-injury, will be recruited and randomized from the four participating trauma centers. The outcomes compared across groups will be post-traumatic stress symptoms at 10 weeks (primary outcome) controlling for baseline symptoms and at 6 months post-randomization (secondary outcome). DISCUSSION: ReSeT is an evidence-based program designed to reduce post-traumatic stress symptoms among injured children using an eHealth platform. Currently, the American College of Surgeons standards suggest that trauma programs identify and treat patients at high risk for mental health needs in the trauma system. If effectiveness is demonstrated, ReSeT could help increase access to evidence-based care for children with post-traumatic stress within the trauma system

Integration of systems biology with organs-on-chips to humanize therapeutic development

"Mice are not little people" - a refrain becoming louder as the gaps between animal models and human disease become more apparent. At the same time, three emerging approaches are headed toward integration: powerful systems biology analysis of cell-cell and intracellular signaling networks in patient-derived samples; 3D tissue engineered models of human organ systems, often made from stem cells; and micro-fluidic and meso-fluidic devices that enable living systems to be sustained, perturbed and analyzed for weeks in culture. Integration of these rapidly moving fields has the potential to revolutionize development of therapeutics for complex, chronic diseases, including those that have weak genetic bases and substantial contributions from gene-environment interactions. Technical challenges in modeling complex diseases with "organs on chips" approaches include the need for relatively large tissue masses and organ-organ cross talk to capture systemic effects, such that current microfluidic formats often fail to capture the required scale and complexity for interconnected systems. These constraints drive development of new strategies for designing in vitro models, including perfusing organ models, as well as "mesofluidic" pumping and circulation in platforms connecting several organ systems, to achieve the appropriate physiological relevance. Keywords: organs-on-chips; 3D liver culture; perfusion; drug development; inflammation; organ crosstalk; tissue chip; intestineUnited States. Defense Advanced Research Projects Agency (Award W911NF-12-2- 0039))National Institutes of Health (U.S.) (Grant UH3TR000496

Risk Factors for Delirium after Vascular Surgery:A Systematic Review and Meta-Analysis

Background: Vascular surgery is considered a risk factor for the development of postoperative delirium (POD). In this systematic review we provide a report on the incidence and risk-factors of POD after vascular surgery. Methods: A systematic literature search was conducted using Pubmed with the MeSH terms and key words "delirium" or "confusion", "vascular surgery procedures" and "risk factors or "risk assessment". Studies were selected for review after meeting the following inclusion cr iter ia: vascular surgery, POD diagnosed using validated screening tools, and DSM-derived criteria to assess delirium. A meta-analysis was performed for each endpoint if at least two studies could be combined. Results: Sixteen articles met the abovementioned cr iter ia. The incidence of delir ium ranged from 5% to 39%. Various preoperative risk factors were identified that is, age (Random MD 3.96, CI 2.57-5.35), hypertension (Fixed OR 1.30, CI 1.05-1.59), diabetes mellitus (Random OR 2.15, CI 1.30-3.56), hearing impairment (Fixed OR 1.89, CI 1.28-2.81), history of cerebrovascular incident or transient ischemic attack (Fixed OR 2.20, CI 1.68-2.88), renal failure (Fixed OR 1.61, CI 1.19-2.17), and pre-operative low haemoglobin level (fixed MD-0.76, CI-1.04 to-0.47). Intra-operative risk factors were duration of surgery (Random MD 15.68; CI 2.79-28.57), open aneurysm repair (Fixed OR 4.99, CI 3.10-8.03), aortic cross clamping time (fixed MD 7.99, CI 2.56-13.42), amputation surgery (random OR 3.77, CI 2.13-6.67), emergency surgery (Fixed OR 4.84, CI 2.81-8.32) and total blood loss (Random MD 496.5, CI 84.51-908.44) and need for blood transfusion (Random OR 3.72, CI 1.57-8.80). Regional anesthesia on the other hand, had a protective effect. Delirium was associated with longer ICU and hospital length of stay, and more frequent discharge to a care facility. Conclusions: POD after vascular surgery is a frequent complication and effect-size pooling supports the concept that delirium is a heterogeneous disorder. The risk factors identified can be used to either design a validated risk factor model or individual preventive strategies for high-risk patients