Trends in mortality by labour market position around retirement ages in three European countries with different welfare regimes

<p>Objectives: In the face of economic downturn and increasing life expectancy, many industrial nations are adopting a policy of postponing the retirement age. However, questions still remain around the consequence of working longer into old age. We examine mortality by work status around retirement ages in countries with different welfare regimes; Finland (social democratic), Turin (Italy; conservative), and England and Wales (liberal).</p> <p>Methods: Death rates and rate ratios (RRs) (reference rates = ‘in-work’), 1970 s–2000 s, were estimated for those aged 45–64 years using the England and Wales longitudinal study, Turin longitudinal study, and the Finnish linked register study.</p> <p>Results: Mortality of the not-in-work was consistently higher than the in-work. Death rates for the not-in-work were lowest in Turin and highest in Finland. Rate ratios were smallest in Turin (RR men 1972–76 1.73; 2002–06 1.63; women 1.22; 1.68) and largest in Finland (RR men 1991–95 3.03; 2001–05 3.80; women 3.62; 4.11). Unlike RRs for men, RRs for women increased in every country (greatest in Finland).</p> <p>Conclusions: These findings signal that overall, employment in later life is associated with lower mortality, regardless of welfare regime.</p&gt

The Analysis of Multijet Events Produced at High Energy Hadron Colliders

We define and discuss a set of (4N - 4) parameters that can be used to analyse events in which N jets have been produced in high energy hadron-hadron collisions. These multijet variables are the multijet mass and (4N - 5) independent dimensionless parameters. To illustrate the use of the variables QCD predictions are presented for events with up to five jets produced at the Fermilab Tevatron Proton-Antiproton Collider. These QCD predictions are compared with the predictions of a model in which multijet events uniformly populate the N-body phase-space

Extraspinal articular tuberculosis: An 11-year retrospective study of demographic features and clinical outcomes in East London

OBJECTIVES: To describe demographic features, clinical outcomes and diagnostic delay amongst patients with extra-spinal articular tuberculosis (TB) in a low-incidence setting. METHODS: Cases of TB treated at our institution between 2004 and 2014 were identified via the London TB register (LTBR). Demographic features of extra-spinal articular TB cases were compared to controls with TB at all other sites. For articular cases (excluding individuals <16 years or with spinal TB without peripheral joint involvement) clinical data were retrospectively collected. RESULTS: 6,146 TB patients were identified over the study period; 146 (2.4%) cases had extra-spinal articular infection. There was no difference in median age between extra-spinal articular TB cases and controls with TB at other sites (31 vs 32 years, p = 0.57). Articular cases were more likely to be male (70.6% vs 59.5%, p = 0.007), Bangladeshi (28.7% vs 18.0%) or Pakistani (24.0% vs 16.1%) and were less likely to be Black-African (9.5% vs 19.8%) (p < 0.001). 93 cases were included in the case series; 85 (88.5%) were migrants and 83 (89.2%) were South Asian. Knee and elbow joints were affected in 22 (23.7%) and 18 (19.4%) cases respectively. The median durations of pre-healthcare and healthcare associated delay were 16 and 6 weeks respectively. Where mycobacterial culture was performed, 57/75 (76%) were positive for Mycobacterium tuberculosis. 86 (92.5%) cases received standard quadruple therapy for a median of 6 months (IQR 6–9). Recurrence of TB infection occurred in 4 (4.3%) cases and there were no TB related deaths. Seven (7.6%) cases required surgical intervention. CONCLUSIONS: Extra-spinal articular TB more commonly affected men and people of South Asian ethnicity. Significant diagnostic delays were identified, including avoidable healthcare-associated delays

Exploring a combined biomarker for tuberculosis treatment response: protocol for a prospective observational cohort study.

INTRODUCTION: An improved understanding of factors explaining tuberculosis (TB) treatment response is urgently needed to help clinicians optimise and personalise treatment and assist scientists undertaking novel treatment regimen trials. Promising outcome proxy measures, including sputum bacillary load and host immune response, are widely reported with variable results. However, they have not been studied together in combination with antibiotic exposure. The aim of this observational cohort study is to investigate which antibiotic exposures correlate with sputum bacillary load and which with the host immune response. Subsequently, we will explore if these correlations can be used to inform a candidate combined biomarker predicting cure. METHODS AND ANALYSIS: All patients aged ≥ 18, diagnosed with drug-sensitive pulmonary TB (culture or molecular test), eligible for standard anti-TB treatment, at selected London, UK TB Services, will be invited to participate in this observational cohort study (target sample size=210). Patients will be asked to give blood for host transcriptomics and antibiotic plasma exposure, in addition to standard of care sputum samples for bacillary load. Antibiotic plasma concentrations will be quantified using a validated liquid chromatograph triple quadrupole mass spectrometer (LC-MS/MS) assay and sputum bacillary load by mycobacterial growth incubator tube time to positivity. Expression from a total of 35 prespecified host blood genes will be quantified using NanoString®. Antibiotic exposure, sputum bacillary load and host blood transcriptomic time series data will be analysed using nonlinear mixed-effects models. Correlations between combinations of longitudinal biomarkers and microbiological cure at the end of treatment and remaining relapse free for 1 year thereafter will be analysed using logistic regression and Cox proportional hazard models. ETHICS AND DISSEMINATION: The observational cohort study has been approved by the UK's HRA REC (20/SW/0007). Written informed consent will be obtained. Results will be disseminated via publication, presentation and through engagement with institutes/companies developing novel anti-TB treatment combinations

Single Top Quark Production as a Probe for Anomalous Moments at Hadron Colliders

Single production of top quarks at hadron colliders via $gW$ fusion is examined as a probe of possible anomalous chromomagnetic and/or chromoelectric moment type couplings between the top and gluons. We find that this channel is far less sensitive to the existence of anomalous couplings of this kind than is the usual production of top pairs by $gg$ or $q\bar q$ fusion. This result is found to hold at both the Tevatron as well as the LHC although somewhat greater sensitivity for anomalous couplings in this channel is found at the higher energy machine.Comment: New discussion and 10 new figures added. uuencoded postscript fil

Aggression and violence, posttraumatic stress, and absenteeism among employees in penitentiaries

On the basis of the Labour Conditions Act of 18 March 1999, employers are obliged to take care of their employees’ safety and health, and to pursue a policy aimed at creating the best possible labour conditions. The prevention of aggression towards employees falls under this obligation. In November 2005, the Scientific Research and Documentation Centre (WODC) carried out a large-scale study into the prevalence of aggressive behaviour targeting employees of penitentiaries during their work, which was commissioned by the Judicial Penitentiary Service (DJI) (Bogaerts & Den Hartogh, 2006). One of the remarkable findings of this study was that ‘aggression and violence among employees’ is a frequently occurring phenomenon within the prison system; of the 5,750 responding employees, no less than 641 reported to have fallen victim to one or more forms of aggression and violence among employees in the course of the previous twelve months. In this context, the term ‘aggression and violence among employees’ includes experienced unwanted sexual attention, intimidation, and physical violence. Aggression and violence among employees consists either of incidents between staff members, or of incidents between executive staff members and ordinary staff members. A substantial part of prison personnel is comprised of penitentiary workers (in Dutch, so-called ‘PIW-ers’). In order to improve the safety of penitentiary workers, the Ministry of Social Affairs and Employment, the DJI, and the unions have reached an agreement about a reduction of aggression and violence among employees, laid down in the ‘Arboplus Covenant Judicial Penitentiary Service on the Policy on Absenteeism, Integral Personal Safety, and the Career Perspective of Executive Personnel’2. The goal was for this reduction to be brought about halfway through 20073. To enable itself to successfully act upon the agreement, in addition to many actions and measures, the Sector Directorate of the Prison System asked the WODC to conduct an in-depth study on aggression and violence among employees within the penitentiaries. It was decided to examine only personal factors in this study. Organisational and economic factors and the institutional features of organisations that, without any doubt, play an important role in both the prevention and the occurrence of aggression and violence among employees were not studied. Framing mechanisms, for instance, which occur in every organisation, were not included in the study, the importance of this and other concepts notwithstanding. In his book ’Frame analysis: An essay on the organization of experience’, Goffman writes: “The concept of framing is taken to label schemata of interpretation that allows individuals or groups to locate, perceive, identify, and label events and occurrences, thus rendering meaning, organizing experiences, and guiding actions.” (Goffman, 1974, p. 21) The study ‘Benchmark Penitentiaries’, which will start in the autumn of 2007, will include institutional, organisational, and economic characteristics as well, besides the personal indicators, in order to assess the quality of the penitentiaries. In this way, aggression and violence among employees will not only be linked to personal factors, but will also be related to institutional factors and characteristics specific to the organisation. Another correlation not included in the present study is that between domestic violence (partner violence), violence at work, absenteeism, and the economic costs, even though this correlation is regularly established in the literature (e.g. Reeves & O’Leary-Kelly, 2007; Swanberg, Macke, & Logan, 2007). With this study, the aim of the Judicial Penitentiary Service is to gain insight into the possible effects of aggression and violence among employees and in the factors which are at the roots of it. The DJI is especially interested in absenteeism as a possible effect of aggression and violence among employees, and in the psychosocial factors that play a role. In the present report, we will present the findings of this study. It is set up as follows. In chapter 2, we will examine the potential effects of aggression and violence among employees and the factors at their source, such as can be assumed to exist when we base ourselves on the literature. Next, we will take these findings as the basis for our hypothetical model presented in chapter 3, which will be the starting point for the empirical part of the study. We will also discuss how this model was tested. In chapter 4, we will present de results of this test and we will examine whether it is necessary to break down the model into sub-models. In chapter 5, we will subsequently formulate twelve specific research questions, which deserve further exploration in the researchers’ view, both on the basis of the literature study and of the hypothetical model derived from it. All these questions are in logical keeping with the formulated hypothetical model. Again, we will indicate how these questions were tested. Finally, chapter 6 will provide a summary of the study. In this chapter we will present some conclusions as well

Fluoroquinolones and isoniazid-resistant tuberculosis: implications for the 2018 WHO guidance.

INTRODUCTION: 2018 World Health Organization (WHO) guidelines for the treatment of isoniazid (H)-resistant (Hr) tuberculosis recommend a four-drug regimen: rifampicin (R), ethambutol (E), pyrazinamide (Z) and levofloxacin (Lfx), with or without H ([H]RZE-Lfx). This is used once Hr is known, such that patients complete 6 months of Lfx (≥6[H]RZE-6Lfx). This cohort study assessed the impact of fluoroquinolones (Fq) on treatment effectiveness, accounting for Hr mutations and degree of phenotypic resistance. METHODS: This was a retrospective cohort study of 626 Hr tuberculosis patients notified in London, 2009-2013. Regimens were described and logistic regression undertaken of the association between regimen and negative regimen-specific outcomes (broadly, death due to tuberculosis, treatment failure or disease recurrence). RESULTS: Of 594 individuals with regimen information, 330 (55.6%) were treated with (H)RfZE (Rf=rifamycins) and 211 (35.5%) with (H)RfZE-Fq. The median overall treatment period was 11.9 months and median Z duration 2.1 months. In a univariable logistic regression model comparing (H)RfZE with and without Fqs, there was no difference in the odds of a negative regimen-specific outcome (baseline (H)RfZE, cluster-specific odds ratio 1.05 (95% CI 0.60-1.82), p=0.87; cluster NHS trust). Results varied minimally in a multivariable model. This odds ratio dropped (0.57, 95% CI 0.14-2.28) when Hr genotype was included, but this analysis lacked power (p=0.42). CONCLUSIONS: In a high-income setting, we found a 12-month (H)RfZE regimen with a short Z duration to be similarly effective for Hr tuberculosis with or without a Fq. This regimen may result in fewer adverse events than the WHO recommendations