Work conditions and occupational morbidity in Latvia

Copyright: Copyright 2012 Elsevier B.V., All rights reserved.The aim of study was to analyse work conditions and occupational morbidity in Latvia during a 15-year period for recommendations to employment policy programmes. The study included the analysis of the database of occupational risk factor measurements in more than 7000 enterprises and companies performed in period 1995-2010 by the Laboratory of Hygiene and Occupational Diseases of the Institute of Occupational Safety and Environmental Health of Riga Stradins University. The analysis of registered occupational diseases according to the data from the Latvian State Registry of Occupational diseases run by the Centre of Occupational and Radiation Medicine of Pauls Stradins Clinical University Hospital for the same period was performed. Occupational diseases in Latvia are diagnosed and coded in accordance with the International Classification of Diseases. Results of measurements showed that for one third of measured occupational risk factors values exceeded recommended limits. The traditional work risk factors (chemical, physical, biological etc.) have been partly replaced by new risks (ergonomic and psychosocial factors). The results of the study indicated that the following enterprises form a major risk group of non-compliance with legislation regarding occupational health and safety: small enterprises; enterprises of private and non-governmental sectors; enterprises of different industries (construction, metal processing and wood processing). The number of firstly diagnosed occupational diseases and patients has gradually increased. The total number of firstly diagnosed and registered occupational patients per 100,000 employees was 11.2 in 1995 and 140.5 in 2009. The structure of occupational diseases shows musculoskeletal diseases (46.1%) as the leading group of diseases followed by diseases of the nervous system and organs of sense (29.3%), traumatic disorders and intoxications (11.7%).publishersversionPeer reviewe

A ∼\sim15 kpc outflow cone piercing through the halo of the blue compact metal-poor galaxy SBS0335-052

Context: Outflows from low-mass star-forming galaxies are a fundamental ingredient for models of galaxy evolution and cosmology. Aims: The onset of kpc-scale ionised filaments in the halo of the metal-poor compact dwarf SBS 0335-052E was previously not linked to an outflow. We here we investigate whether these filaments provide evidence for an outflow. Methods: We obtained new VLT/MUSE WFM and deep NRAO/VLA B-configuration 21cm data of the galaxy. The MUSE data provide morphology, kinematics, and emission line ratios H$\beta$/H$\alpha$ and [\ion{O}{iii}]$\lambda5007$/H$\alpha$ of the low surface-brightness filaments, while the VLA data deliver morphology and kinematics of the neutral gas in and around the system. Both datasets are used in concert for comparisons between the ionised and the neutral phase. Results: We report the prolongation of a lacy filamentary ionised structure up to a projected distance of 16 kpc at $\mathrm{SB}_\mathrm{H\alpha} = 1.5\times10^{-18}$erg s$^{-1}$ cm$^{-2}$arcsec$^{-2}$. The filaments exhibit unusual low H$\alpha$/H$\beta \approx 2.4$ and low [\ion{O}{iii}]/H$\alpha \sim 0.4 - 0.6$ typical of diffuse ionised gas. They are spectrally narrow ($\sim 20$ km s$^{-1}$) and exhibit no velocity sub-structure. The filaments extend outwards of the elongated \ion{H}{I} halo. On small scales the $N_\mathrm{HI}$ peak is offset from the main star-forming sites. Morphology and kinematics of \ion{H}{I} and \ion{H}{II} reveal how star-formation driven feedback interacts differently with the ionised and the neutral phase. Conclusions: We reason that the filaments are a large scale manifestation of star-formation driven feedback, namely limb-brightened edges of a giant outflow cone that protrudes through the halo of this gas-rich system. A simple toy model of such a conical-structure is found to be commensurable with the observations.Comment: Accepted version in A&A after language editing. 22 pages, 24 figure

HLA‐A23/HLA‐A24 serotypes and dementia interaction in the elderly: Association with increased soluble HLA class I molecules in plasma

MHC class I molecules regulate brain development and plasticity in mice and HLA class I molecules are associated with brain disorders in humans. We investigated the relationship between plasma-derived soluble human HLA class I molecules (sHLA class I), HLA class I serotypes and dementia. A cohort of HLA class I serotyped elderly subjects with no dementia/predementia (NpD, n = 28), or with dementia (D, n = 28) was studied. Multivariate analysis was used to examine the influence of dementia and HLA class I serotype on sHLA class I levels, and to compare sHLA class I within four groups according to the presence or absence of HLA-A23/A24 and dementia. HLA-A23/A24 and dementia, but not age, significantly influenced the level of sHLA class I. Importantly, the concurrent presence of HLA-A23/A24 and dementia was associated with higher levels of sHLA class I (p < 0.001). This study has shown that the simultaneous presence of HLA-A23/HLA-A24 and dementia is associated with high levels of serum sHLA class I molecules. Thus, sHLA class I could be considered a biomarker of neurodegeneration in certain HLA class I carriers.info:eu-repo/semantics/publishedVersio

What research agenda could be generated from the European General Practice Research Network concept of Multimorbidity in Family Practice?

This is the final version of the article. Available from the publisher via the DOI in this record.BACKGROUND: Multimorbidity is an intuitively appealing, yet challenging, concept for Family Medicine (FM). An EGPRN working group has published a comprehensive definition of the concept based on a systematic review of the literature which is closely linked to patient complexity and to the biopsychosocial model. This concept was identified by European Family Physicians (FPs) throughout Europe using 13 qualitative surveys. To further our understanding of the issues around multimorbidity, we needed to do innovative research to clarify this concept. The research question for this survey was: what research agenda could be generated for Family Medicine from the EGPRN concept of Multimorbidity? METHODS: Nominal group design with a purposive panel of experts in the field of multimorbidity. The nominal group worked through four phases: ideas generation phase, ideas recording phase, evaluation and analysis phase and a prioritization phase. RESULTS: Fifteen international experts participated. A research agenda was established, featuring 6 topics and 11 themes with their corresponding study designs. The highest priorities were given to the following topics: measuring multimorbidity and the impact of multimorbidity. In addition the experts stressed that the concept should be simplified. This would be best achieved by working in reverse: starting with the outcomes and working back to find the useful variables within the concept. CONCLUSION: The highest priority for future research on multimorbidity should be given to measuring multimorbidity and to simplifying the EGPRN model, using a pragmatic approach to determine the useful variables within the concept from its outcomes.The study had a Grant of 8000 Euros from the EGPRN

Which DSM validated tools for diagnosing depression are usable in primary care research? A systematic literature review

IntroductionDepression occurs frequently in primary care. Its broad clinical variability makes it difficult to diagnose. This makes it essential that family practitioner (FP) researchers have validated tools to minimize bias in studies of everyday practice. Which tools validated against psychiatric examination, according to the major depression criteria of DSM-IV or 5, can be used for research purposes

Observatoire régional du pneumocoque en région Pays de la Loire : résistance de Streptococcus pneumoniae aux antibiotiques en 2007

But de l’étudeEntre le 1er janvier et le 31 décembre 2007, les 20 laboratoires participant à l’observatoire régional du pneumocoque (ORP) Pays de la Loire ont collecté 331 souches invasives de Streptococcus pneumoniae afin d’étudier leur sensibilité aux antibiotiques et la répartition des sérogroupes/sérotypes. Méthode Les concentrations minimales inhibitrices (CMI) de la pénicilline G, de l’amoxicilline et du céfotaxime ont été déterminées par le centre coordinateur, par la méthode de référence de diffusion en milieu gélosé. Les résultats ont été interprétés selon les recommandations du CA-SFM. Les sensibilités à d’autres antibiotiques ont été étudiées et les typages des souches réalisées par le centre coordinateur. Résultats Trois cent trente et une souches ont été isolées en 2007. Elles provenaient de 30 liquides céphalorachidiens, 239 hémocultures, 53 pus d’otites moyennes aiguës et neuf liquides pleuraux. Le pourcentage de pneumocoques de sensibilité diminuée à la pénicilline G (PSDP) était de 39 % et restait plus élevé chez l’enfant (51 %) que chez l’adulte (35 %). Les PSDP étaient souvent multirésistants, avec en particulier un pourcentage élevé de résistance à l’érythromycine (87,6 % contre 8,4 % pour les pneumocoques sensibles à la pénicilline). Enfin, le sérogroupe majoritairement rencontré était le sérogroupe 19 (29,6 % des isolats). Conclusion Une diminution des PSDP a été observée depuis 2001 et les souches de haut niveau de résistance aux β-lactamines restent rares. Le pourcentage de PSDP observés en ORP Pays de la Loire demeure dans la moyenne nationale

Defining Feasibility and Pilot Studies in Preparation for Randomised Controlled Trials: Development of a Conceptual Framework

We describe a framework for defining pilot and feasibility studies focusing on studies conducted in preparation for a randomised controlled trial. To develop the framework, we undertook a Delphi survey; ran an open meeting at a trial methodology conference; conducted a review of definitions outside the health research context; consulted experts at an international consensus meeting; and reviewed 27 empirical pilot or feasibility studies. We initially adopted mutually exclusive definitions of pilot and feasibility studies. However, some Delphi survey respondents and the majority of open meeting attendees disagreed with the idea of mutually exclusive definitions. Their viewpoint was supported by definitions outside the health research context, the use of the terms ‘pilot’ and ‘feasibility’ in the literature, and participants at the international consensus meeting. In our framework, pilot studies are a subset of feasibility studies, rather than the two being mutually exclusive. A feasibility study asks whether something can be done, should we proceed with it, and if so, how. A pilot study asks the same questions but also has a specific design feature: in a pilot study a future study, or part of a future study, is conducted on a smaller scale. We suggest that to facilitate their identification, these studies should be clearly identified using the terms ‘feasibility’ or ‘pilot’ as appropriate. This should include feasibility studies that are largely qualitative; we found these difficult to identify in electronic searches because researchers rarely used the term ‘feasibility’ in the title or abstract of such studies. Investigators should also report appropriate objectives and methods related to feasibility; and give clear confirmation that their study is in preparation for a future randomised controlled trial designed to assess the effect of an intervention

Harmonized definition of occupational burnout : A systematic review, semantic analysis, and Delphi consensus in 29 countries

Funding Information: This study was supported by the University of Lausanne and European Cooperation in Science and Technology, Action CA 16216 "Network on the Coordination and Harmonisation of European Occupational Cohorts” (OMEGA-NET). Publisher Copyright: © 2021, Nordic Association of Occupational Safety and Health. All rights reserved.Objective A consensual definition of occupational burnout is currently lacking. We aimed to harmonize the definition of occupational burnout as a health outcome in medical research and reach a consensus on this definition within the Network on the Coordination and Harmonisation of European Occupational Cohorts (OMEGA-NET). Methods First, we performed a systematic review in MEDLINE, PsycINFO and Embase (January 1990 to August 2018) and a semantic analysis of the available definitions. We used the definitions of burnout and burnout-related concepts from the Systematized Nomenclature of Medicine Clinical Terms (SNOMED-CT) to formulate a consistent harmonized definition of the concept. Second, we sought to obtain the Delphi consensus on the proposed definition. Results We identified 88 unique definitions of burnout and assigned each of them to 1 of the 11 original definitions. The semantic analysis yielded a first proposal, further reformulated according to SNOMED-CT and the panelists` comments as follows: "In a worker, occupational burnout or occupational physical AND emotional exhaustion state is an exhaustion due to prolonged exposure to work-related problems". A panel of 50 experts (researchers and healthcare professionals with an interest for occupational burnout) reached consensus on this proposal at the second round of the Delphi, with 82% of experts agreeing on it. Conclusion This study resulted in a harmonized definition of occupational burnout approved by experts from 29 countries within OMEGA-NET. Future research should address the reproducibility of the Delphi consensus in a larger panel of experts, representing more countries, and examine the practicability of the definition.Peer reviewe

The contribution of musculoskeletal disorders in multimorbidity: Implications for practice and policy

People frequently live for many years with multiple chronic conditions (multimorbidity) that impair health outcomes and are expensive to manage. Multimorbidity has been shown to reduce quality of life and increase mortality. People with multimorbidity also rely more heavily on health and care services and have poorer work outcomes. Musculoskeletal disorders (MSDs) are ubiquitous in multimorbidity because of their high prevalence, shared risk factors, and shared pathogenic processes amongst other long-term conditions. Additionally, these conditions significantly contribute to the total impact of multimorbidity, having been shown to reduce quality of life, increase work disability, and increase treatment burden and healthcare costs. For people living with multimorbidity, MSDs could impair the ability to cope and maintain health and independence, leading to precipitous physical and social decline. Recognition, by health professionals, policymakers, non-profit organisations, and research funders, of the impact of musculoskeletal health in multimorbidity is essential when planning support for people living with multimorbidity