A Community-Focused Health & Work Service (HWS)

We recommend establishment of a community-focused Health & Work Service (HWS) dedicated to responding rapidly to new health-related work absence among working people due to potentially disabling conditions. The first few days and weeks after onset are an especially critical period during which the likelihood of a good long-term outcome is being influenced, either favorably or unfavorably, by some simple things that either do or do not happen during that interval. It is the optimal window of opportunity to improve outcomes by simultaneously attending to the worker’s basic needs and concerns as well as coordinating the medical, functional restoration, and occupational aspects of the situation in a coordinated fashion

Developing an Intervention Toolbox for the Common Health Problems in the Workplace

Development of the Health ↔ Work Toolbox is described. The toolbox aims to reduce the workplace impact of common health problems (musculoskeletal, mental health, and stress complaints) by focusing on tackling work-relevant symptoms. Based on biopsychosocial principles this toolbox supplements current approaches by occupying the zone between primary prevention and healthcare. It provides a set of evidence-informed principles and processes (knowledge + tools) for tackling work-relevant common health problems. The toolbox comprises a proactive element aimed at empowering line managers to create good jobs, and a ‘just in time’ responsive element for supporting individuals struggling with a work-relevant health problem. The key intention is helping people with common health problems to maintain work participation. The extensive conceptual and practical development process, including a comprehensive evidence review, produced a functional prototype toolbox that is evidence based and flexible in its use. End-user feedback was mostly positive. Moving the prototype to a fully-fledged internet resource requires specialist design expertise. The Health ↔ Work Toolbox appears to have potential to contribute to the goal of augmenting existing primary prevention strategies and healthcare delivery by providing a more comprehensive workplace approach to constraining sickness absence

EuroSpine Task Force on Research: support for spine researchers

In recognition of the value of research to the practice of spine care, Federico Balagué and Ferran Pellisé, at the time President and Secretary for EuroSpine, asked Margareta Nordin to set up a Task Force on Research (TFR) for EuroSpine during summer 2011. The concept was to stimulate and facilitate a research community within the society, through two main functions: (1) distribution of EuroSpine funds to researchers; (2) develop and deliver research training/education courses. What has the EuroSpine TFR accomplished since its inception

Will Tennessee Soybean Producers Support a Biodiesel Cooperative?

Adding value to agriculture products to create jobs is one means to achieve rural development. Tennessee soybean growers\u27 views on both biodiesel and the formation of a biodiesel cooperative are evaluated. Results from a mail survey suggest considerable interest from farmers in selling their soybeans to a biodiesel production plant. Some producers are willing to provide funding and purchase shares in a cooperative. This study provides Tennessee Extension agents a means to evaluate farmers\u27 perceptions of the development of a new generation cooperative and to help provide advice on cooperatives and how this might affect the farmer\u27s bottom line

A Most Unusual Zeolite Templating: Cage to Cage Connection of One Guest Molecule

An unusual case of a diquaternary ammonium dication, with large bulky end groups built from the tropane moiety and connected by a C4 methylene chain, is found to reside in zeolite SSZ-35 (STF). The structure of the guest/host product is such that the tropane bicylic entities reside in the shallow cavities of the cages of the STF structure and the C4 methylene chain runs through the 10-ring (~5.5 Å) window that connects the cages. This is a most unusual (and energy-intensive) templating of a zeolite structure with the guest molecule spanning two unit cells. The unusual result was found by single crystal studies with the addition of the use of the SQUEEZE program to show a consistent fit for the guest molecule following from measured electron densities in the crystal structure work. These analyses were followed with MAS NMR studies to confirm the integrity of the diquaternary guest molecule in the host sieve. A few comparative diquaternary guest molecules in MFI zeolite are also studied

System influences on work disability due to low back pain: an international evidence synthesis

Work disability due to low back pain is a significant global health concern. Current policy and practice aimed at tackling this problem is largely informed by the biopsychosocial model. Resultant interventions have demonstrated some small-scale success, but they have not created a widespread decrease in work disability. This may be explained by the under-representation of the less measurable aspects in the biopsychosocial evidence base; namely the influence of relevant systems. Thus, a ‘best-evidence’ synthesis was conducted to collate the evidence on how compensatory (worker’s compensation and disability benefits), healthcare and family systems (spouse/partner/close others) can act as obstacles to work participation for those with low back pain. Systematic searches of several scientific and grey literature sources were conducted, resulting in 1,762 records. Following a systematic exclusion process, 57 articles were selected and the evidence was assessed using a system adapted from previous large-scale policy reviews conducted in this field. Results indicated how specific features of relevant systems could act as obstacles to individual efforts/interventions aimed at tackling work disability due to LBP. These findings reinforce the need for a ‘whole-systems’ approach, with all key players onside and have implications for the revision of current biopsychosocial-informed policy and practice

Rehabilitation following surgery for lumbar spinal stenosis: a Cochrane review

Study Design A systematic review of randomised controlled trials (RCTs) Objective To determine the effects of active rehabilitation on functional outcome following lumbar spinal stenosis surgery when compared with 'usual postoperative care'. Summary of background data Surgery rates for lumbar spinal stenosis have risen, yet outcomes remain suboptimal. Post-operative rehabilitation has been suggested as a tool to improve post-operative function but, to date, there is limited evidence to support its use. Methods CENTRAL (The Cochrane Library), the Cochrane Back Review Group Trials Register, MEDLINE, EMBASE, CINAHL and PEDro electronic databases were searched. Randomised controlled trials (RCTs) comparing the effectiveness of active rehabilitation with usual care in adults with lumbar spinal stenosis who had undergone primary spinal decompression surgery were included. Two authors independently selected studies, assessed the risk of bias, and extracted the data in line with the recommendations of the Cochrane Back Review Group. Study results were pooled in a meta-analysis when appropriate using functional status as the primary outcome, with secondary outcomes including measures of leg pain, low back pain, and global improvement/general health. The GRADE approach was used to assess the quality of the evidence. Results Our searches yielded 1,726 articles, of which three studies (N = 373 participants) were suitable for inclusion in meta-analysis. All included studies were deemed to have low risk of bias; no study had unacceptably high dropout rates. There was moderate evidence suggesting that active rehabilitation was more effective than usual care in improving both short- and long-term functional status following surgery. Similar findings were noted for secondary outcomes, including short-term improvement in low back pain and long-term improvement in both low back pain and leg pain. Conclusions We obtained moderate-quality evidence indicating that postoperative active rehabilitation after decompression surgery for lumbar spinal stenosis is more effective than usual care. Further work is required particularly with respect to the cost effectiveness of such interventions

Developing an intervention toolbox for common health problems in the workplace

The project brief was to develop the content for an intervention toolbox for common health problems in the workplace - musculoskeletal, mental health and stress complaints. The intention was to develop a prototype toolbox that can be taken forward to (1) minimise the occurrence of work-relevant common health problems (CHPs) and (2) reduce avoidable sickness absence, healthcare use and long-term disability for CHP complaints that inevitably occur in the workplac