Empowering employees with chronic diseases; development of an intervention aimed at job retention and design of a randomised controlled trial

<p>Abstract</p> <p>Background</p> <p>Persons with a chronic disease are less often employed than healthy persons. If employed, many of them experience problems at work. Therefore, we developed a training programme aimed at job retention. The objective of this paper is to describe this intervention and to present the design of a study to evaluate its effectiveness.</p> <p>Development and description of intervention</p> <p>A systematic review, a needs assessment and discussions with Dutch experts led to a pilot group training, tested in a pilot study. The evaluation resulted in the development of a seven-session group training combined with three individual counselling sessions. The training is based on an empowerment perspective that aims to help individuals enhance knowledge, skills and self-awareness. These advances are deemed necessary for problem solving in three stages: exploration and clarification of work related problems, communication at the workplace, and development and implementation of solutions. Seven themes are discussed and practised in the group sessions: 1) Consequences of a chronic disease in the workplace, 2) Insight into feelings and thoughts about having a chronic disease, 3) Communication in daily work situations, 4) Facilities for disabled employees and work disability legislation, 5) How to stand up for oneself, 6) A plan to solve problems, 7) Follow-up.</p> <p>Methods</p> <p>Participants are recruited via occupational health services, patient organisations, employers, and a yearly national conference on chronic diseases. They are eligible when they have a chronic physical medical condition, have a paid job, and experience problems at work. Workers on long-term, 100% sick leave that is expected to continue during the training are excluded. After filling in the baseline questionnaire, the participants are randomised to either the control or the intervention group. The control group will receive no care or care as usual. Post-test mail questionnaires will be sent after 4, 8, 12 and 24 months. Primary outcome measures are job retention, self efficacy, fatigue and work pleasure. Secondary outcome measures are work-related problems, sick leave, quality of life, acquired work accommodations, burnout, and several quality of work measures. A process evaluation will be conducted and satisfaction with the training, its components and the training methods will be assessed.</p> <p>Discussion</p> <p>Many employees with a chronic condition experience problems in performing tasks and in managing social relations at work. We developed an innovative intervention that addresses practical as well as psychosocial problems. The results of the study will be relevant for employees, employers, occupational health professionals and human resource professionals (HRM).</p> <p>Trial registration</p> <p>ISRCTN77240155</p

Scalar dissipation rate and scales in swirling turbulent premixed flames

© 2016 by The Combustion Institute. Published by Elsevier Inc. Simultaneous Rayleigh scattering and OH LIF imaging measurements of temperature and OH were used to investigate the properties of turbulent premixed flames, including the nature of the 2D thermal structures and scalar dissipation rate in the Cambridge/Sandia swirling bluff body stabilized flames, with and without the effect of swirl. Swirl creates enhanced turbulence as well as outer flow entrainment, and disrupts the pre-flame zone significantly, whilst the high temperature reaction zone as marked by OH remains relatively intact. In particular, the temperature at the location of maximum OH gradient shows very low variance across the flame region. The 2D image analysis of OH and temperature shows that the corresponding 2D gradients are aligned up to a distance of half the laminar flame thickness away from the flame front, deviating significantly in the case of swirling flames beyond that region. As in previous investigations in diffusion flames, the mean width of the observed thermal structures increases from 300 to 600 μm near the flame, with a main mode around the laminar flame thermal width in the unswirled case. The correlation between 2D thermal dissipation and variance of the reaction progress variable extracted from the images shows a direct proportionality, with a slope which agrees well with theory in the region of high turbulence away from the base. At the base of the flame where turbulence is low, the local scalar dissipation becomes a function of the local temperature via the thermal diffusivity

Regional variations in ex-vivo diffusion tensor anisotropy are associated with cardiomyocyte remodeling in rats after left ventricular pressure overload

Background Pressure overload left ventricular (LV) hypertrophy is characterized by increased cardiomyocyte width and ventricle wall thickness, however the regional variation of this remodeling is unclear. Cardiovascular magnetic resonance (CMR) diffusion tensor imaging (DTI) may provide a non-invasive, comprehensive, and geometrically accurate method to detect regional differences in structural remodeling in hypertrophy. We hypothesized that DTI parameters, such as fractional and planar anisotropy, would reflect myocyte remodeling due to pressure overload in a regionally-dependent manner. Methods We investigated the regional distributions of myocyte remodeling in rats with or without transverse aortic constriction (TAC) via direct measurement of myocyte dimensions with confocal imaging of thick tissue sections, and correlated myocyte cross-sectional area and other geometric features with parameters of diffusivity from ex-vivo DTI in the same regions of the same hearts. Results We observed regional differences in several parameters from DTI between TAC hearts and SHAM controls. Consistent with previous studies, helix angles from DTI correlated strongly with those measured directly from histological sections (p < 0.001, R2 = 0.71). There was a transmural gradient in myocyte cross-sectional area in SHAM hearts that was diminished in the TAC group. We also found several regions of significantly altered DTI parameters in TAC LV compared to SHAM, especially in myocyte sheet angle dispersion and planar anisotropy. Among others, these parameters correlated significantly with directly measured myocyte aspect ratios. Conclusions These results show that structural remodeling in pressure overload LV hypertrophy is regionally heterogeneous, especially transmurally, with a greater degree of remodeling in the sub-endocardium compared to the sub-epicardium. Additionally, several parameters derived from DTI correlated significantly with measurements of myocyte geometry from direct measurement in histological sections. We suggest that DTI may provide a non-invasive, comprehensive method to detect regional structural myocyte LV remodeling during disease

Facilitating job retention for chronically ill employees: perspectives of line managers and human resource managers

<p>Abstract</p> <p>Background</p> <p>Chronic diseases are a leading contributor to work disability and job loss in Europe. Recent EU policies aim to improve job retention among chronically ill employees. Disability and occupational health researchers argue that this requires a coordinated and pro-active approach at the workplace by occupational health professionals, line managers (LMs) and human resource managers (HRM). Little is known about the perspectives of LMs an HRM on what is needed to facilitate job retention among chronically ill employees. The aim of this qualitative study was to explore and compare the perspectives of Dutch LMs and HRM on this issue.</p> <p>Methods</p> <p>Concept mapping methodology was used to elicit and map statements (ideas) from 10 LMs and 17 HRM about what is needed to ensure continued employment for chronically ill employees. Study participants were recruited through a higher education and an occupational health services organization.</p> <p>Results</p> <p>Participants generated 35 statements. Each group (LMs and HRM) sorted these statements into six thematic clusters. LMs and HRM identified four similar clusters: LMs and HRM must be knowledgeable about the impact of chronic disease on the employee; employees must accept responsibility for work retention; work adaptations must be implemented; and clear company policy. Thematic clusters identified only by LMs were: good manager/employee cooperation and knowledge transfer within the company. Unique clusters identified by HRM were: company culture and organizational support.</p> <p>Conclusions</p> <p>There were both similarities and differences between the views of LMs and HRM on what may facilitate job retention for chronically ill employees. LMs perceived manager/employee cooperation as the most important mechanism for enabling continued employment for these employees. HRM perceived organizational policy and culture as the most important mechanism. The findings provide information about topics that occupational health researchers and planners should address in developing job retention programs for chronically ill workers.</p

Developing customized NIRS-EEG for infant sleep research: methodological considerations

Significance: Studies using simultaneous functional near-infrared spectroscopy (fNIRS)-electroencephalography (EEG) during natural sleep in infancy are rare. Developments for combined fNIRS-EEG for sleep research that ensure optimal comfort as well as good coupling and data quality are needed. // Aim: We describe the steps toward developing a comfortable, wearable NIRS-EEG headgear adapted specifically for sleeping infants ages 5 to 9 months and present the experimental procedures and data quality to conduct infant sleep research using combined fNIRS-EEG. // Approach: N = 49 5- to 9-month-old infants participated. In phase 1, N = 26 (10 = slept) participated using the non-wearable version of the NIRS-EEG headgear with 13-channel-wearable EEG and 39-channel fiber-based NIRS. In phase 2, N = 23 infants (21 = slept) participated with the wireless version of the headgear with 20-channel-wearable EEG and 47-channel wearable NIRS. We used QT-NIRS to assess the NIRS data quality based on the good time window percentage, included channels, nap duration, and valid EEG percentage. // Results: The infant nap rate during phase 1 was ∼40 % (45% valid EEG data) and increased to 90% during phase 2 (100% valid EEG data). Infants slept significantly longer with the wearable system than the non-wearable system. However, there were more included good channels based on QT-NIRS in study phase 1 (61%) than phase 2 (50%), though this difference was not statistically significant. // Conclusions: We demonstrated the usability of an integrated NIRS-EEG headgear during natural infant sleep with both non-wearable and wearable NIRS systems. The wearable NIRS-EEG headgear represents a good compromise between data quality, opportunities of applications (home visits and toddlers), and experiment success (infants’ comfort, longer sleep duration, and opportunities for caregiver–child interaction)

Distress or no distress, that's the question: A cutoff point for distress in a working population

Background. The objective of the present study is to establish an optimal cutoff point for distress measured with the corresponding scale of the 4DSQ, using the prediction of sickness absence as a criterion. The cutoff point should result in a measure that can be used as a credible selection instrument for sickness absence in occupational health practice and in future studies on distress and mental disorders. Methods. Distress is measured using the Four Dimensional Symptom Questionnaire (4DSQ), a 50-item self-report questionnaire, in a working population with and without sickness absence due to distress. Sensitivity and specificity were compared for various potential cutoff points, and a receiver operating characteristics analysis was conducted. Results and conclusion. A distress cutoff point of 11 was defined. The choice was based on a challenging specificity and negative predictive value and indicates a distress level at which an employee is presumably at risk for subsequent sick leave on psychological grounds. The defined distress cutoff point is appropriate for use in occupational health practice and in studies of distress in working populations

The association between Colombian medical students' healthy personal habits and a positive attitude toward preventive counseling: cross-sectional analyses

<p>Abstract</p> <p>Background</p> <p>Physician-delivered preventive counseling is important for the prevention and management of chronic diseases. Data from the U.S. indicates that medical students with healthy personal habits have a better attitude towards preventive counseling. However, this association and its correlates have not been addressed in rapidly urbanized settings where chronic disease prevention strategies constitute a top public health priority. This study examines the association between personal health practices and attitudes toward preventive counseling among first and fifth-year students from 8 medical schools in Bogotá, Colombia.</p> <p>Methods</p> <p>During 2006, a total of 661 first- and fifth-year medical students completed a culturally adapted Spanish version of the "Healthy Doctor = Healthy Patient" survey (response rate = 78%). Logistic regression analyses were used to assess the association between overall personal practices on physical activity, nutrition, weight control, smoking, alcohol use (main exposure variable) and student attitudes toward preventive counseling on these issues (main outcome variable), stratified by year of training and adjusting by gender and medical training-related factors (basic knowledge, perceived adequacy of training and perception of the school's promotion on each healthy habit).</p> <p>Results</p> <p>The median age and percentage of females for the first- and fifth-year students were 21 years and 59.5% and 25 years and 65%, respectively. After controlling for gender and medical training-related factors, consumption of ≥ 5 daily servings of fruits and/or vegetables, not being a smoker or binge drinker were associated with a positive attitude toward counseling on nutrition (<it>OR </it>= 4.71; CI = 1.6–14.1; <it>p </it>= 0.006 smoking (<it>OR </it>= 2.62; CI = 1.1–5.9; <it>p </it>= 0.022), and alcohol consumption (<it>OR </it>= 2.61; CI = 1.3–5.4; <it>p </it>= 0.009), respectively.</p> <p>Conclusion</p> <p>As for U.S. physician and medical students, a positive association was found between the personal health habits of Colombian medical students and their corresponding attitudes toward preventive counseling, independent of gender and medial training-related factors. Our findings, the first relating to this association in medical students in developing regions, also suggest that within the medical school context, interventions focused on promoting healthy student lifestyles can potentially improve future physician's attitudes toward preventive counseling.</p

Top pair Asymmetries at Hadron colliders with general Z′Z' couplings

Recently it has been shown that measurement of charge asymmetry of top pair production at LHC excludes any flavor violating $Z'$ vector gauge boson that could explain Tevatron forward-backward asymmetry (FBA). We consider the general form of a $Z'$ gauge boson including left-handed, right-handed vector and tensor couplings to examine FBA and charge asymmetry. To evaluate top pair asymmetries at Tevatron and LHC, we consider $B^0_q$ mixing constraints on flavor changing $Z'$ couplings and show that this model still explain forward-backward asymmetry at Tevatron and charge asymmetry can not exclude it in part of parameters space.Comment: 18 pages, 7 figure

A cross validation of Consumer-Based Brand Equity (CBBE) with Private Labels in Spain

Molinillo,S., Ekinci, Y., Japutra, A. (2014)'A cross validation of Consumer-Based Brand Equity (CBBE) with Private Labels in Spain'. in Martínez-López, Gázquez-Abad, J.C. and Sethuraman, R. J.A. (eds.) Advances in National Brand and Private Label Marketing. Second International Conference, 2015. Springer Proceedings in Business and Economics, pp. 113-125In recent years a number of Consumer-Based Brand Equity (CBBE) models and measurement scales have been introduced in the branding literature. However, examinations of brand equity in Private Labels (PL) are rather limited. This study aims to compare the validity of the two prominent CBBE models those introduced by Yoo and Donthu (2001) and Nam et al. (2011). In order to test the models and make this comparison, the study collected data from 236 respondents who rated private labels in Spain. A list of 30 different fashion and sportswear PL was introduced to respondents. These brands do not make any reference to the retail store in which they are sold. Research findings suggest that the extended CBBE model introduced by Nam et al. (2011) and Ciftci et al. (2014) is more reliable and valid than Yoo and Donthu’s model for assessing PL. Theoretical contributions and managerial implications are discussed.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech