Exploring Employer Perspectives on Their Supportive Role in Accommodating Workers with Disabilities to Promote Sustainable RTW: A Qualitative Study

Purpose: Employers play an important role in facilitating sustainable return to work (RTW) by workers with disabilities. The aim of this qualitative study was to explore how employers who were successful in retaining workers with disabilities at work fulfilled their supportive role, and which facilitators were essential to support these workers throughout the RTW process. Methods: We conducted a semi-structured interview study among 27 employers who had experience in retaining workers with disabilities within their organization. We explored the different phases of RTW, from the onset of sick leave until the period, after 2-years of sick-leave, and when they can apply for disability benefit. We analyzed data by means of thematic analysis. Results: We identified three types of employer support: (1) instrumental (offering work accommodations), (2) emotional (encouragement, empathy, understanding) and (3) informational (providing information, setting boundaries). We identified three facilitators of employer support (at organizational and supervisor levels): (1) good collaboration, including (in)formal contact and (in)formal networks; (2) employer characteristics, including supportive organizational culture and leadership skills; and (3) worker characteristics, including flexibility and self-control. Conclusions: Employers described three different possible types of support for the worker with disabilities: instrumental, emotional, and informational. The type and intensity of employer support varies during the different phases, which is a finding that should be further investigated. Good collaboration and flexibility of both employer and worker were reported as facilitators of optimal supervisor/worker interaction during the RTW process, which may show that sick-listed workers and their supervisors have a joint responsibility for the RTW process. More insight is needed on how this supervisor/worker interaction develops during the RTW process

Glucosuria as an early marker of late-onset sepsis in preterms:a prospective cohort study

Background: Early and accurate diagnosis of late-onset sepsis (LONS) in preterm infants is difficult since presenting signs are subtle and non-specific. Because neonatal sepsis may be accompanied by glucose intolerance and glucosuria, we hypothesized that glucosuria may be associated with LONS in preterms, in an early stage. We aim to evaluate the association of glucosuria and late-onset neonatal sepsis (LONS) in preterm infants, in an attempt to improve early and accurate diagnosis of LONS. Methods: We performed a prospective observational cohort study in 316 preterms ( Results: Glucosuria was found in 65.8 % of 316 preterm patients, and sepsis was suspected 157 times in 123 patients. LONS was found in 47.1 % of 157 suspected episodes. The presence of glucosuria was associated with LONS (OR 2.59, 95 % CI 1.24-5.43, p = 0.012) with sensitivity 69.0 % and specificity 53.8 % (Likelihoodratio 1.49). After adjustment for gestational age, birth weight, and postnatal age, this association weakened and was no longer significant (adjusted OR 2.16; 95 % CI 0.99-1.85, p = 0.055). An increase in glucosuria 48-24 h before onset of symptoms was not associated with LONS. Conclusion: In preterms glucosuria is associated with LONS within 24 h, however this association is too weak to be of diagnostic value

Resumption of pituitary and ovarian activity post-partum: endocrine and ultrasonic observations in bromocriptine-treated women

The resumption of pituitary and ovarian activity was investigated by hormonal measurements and ultrasound scanning in 45 healthy post-partum women who were treated with bromocriptine. Bromocriptine, 50 mg (Parlodel LAR) was administered within 24 h post-partum. Plasma luteinizing hormone, follicle stimulating hormone, oestradiol, progesterone and prolactin concentrations were measured repeatedly and correlated with ultrasound measurements. Forty-one of the 45 women completed the study. A prompt fall in prolactin levels to normal (non-pregnant) values was observed within 24 h post-partum. Hereafter, a rapid return of the normal menstrual cycle was observed. Endocrine evidence of ovulation was obtained in 19/41 women within 1 month post-partum. Ultrasound measurements started at day 10 and were repeated regularly in 40 women. Ultrasound evidence of ovulation was found in 25/40 women. Ultrasound findings appeared not to correspond with the hormonal measurements. It is concluded that the resumption of pituitary and ovarian secretory functions post-partum is not always paralleled by a concomitant recovery of normal follicular growth and ovulation. Application of a progesterone threshold to judge resumption of ovulation post-partum should be reconsidere

Factsheet Groene re-integratiepraktijken voor mensen met psychische problemen

Gemeenten zijn per 1 januari 2015 verantwoordelijk voor uitvoering van de Jeugdwet, Wmo en de Participatiewet. De invoering van de Participatiewet leidt tot de toestroom van een nieuwe doelgroep waaronder veel mensen met psychische problemen die behoefte hebben aan langdurige ondersteuning.De decentralisaties vormen een grote uitdaging voor gemeenten. Niet alleen komen er nieuwe taken op gemeenten af, maar er wordt ook flink bezuinigd. Gemeenten moeten dus meer doen met minder geld. Maar er zijn ook kansen.Voor het eerst krijgt één partij, de gemeente, zeggenschap over praktisch het hele sociale domein. De decentralisaties maken dwarsverbanden tussen de Wmo/Awbz, de jeugdzorg en het domein van werk en inkomen mogelijk. Werkplekken waar mensen vanuit de participatiewet, WMO en jeugdzorg terecht kunnen hebben daarom de aandacht van gemeenten.Deze factsheet gaat over de mogelijkheden die het groen biedt voor re-integratie van mensen met psychische problemen. Interessante voorbeelden van re-integratie initiatieven zijn stadslandbouwbedrijven, landschapsonderhoud,zorgboerderijen, groenonderhoud en groene wijkinitiatieven.De factsheet is gebaseerd op literatuuronderzoek, interviews en groepsgesprekken met initiatiefnemers, mensen met psychische problemen die werken in het groen (deelnemers) en betrokken beleidsmedewerkers van verschillende groene re-integratie initiatieven. In deze factsheet komen de volgende thema’s aan bod:• Welke vormen van groene re-integratie bestaan er in Nederland?• Wat is de mogelijke theoretische onderbouwing en wat zijn de werkzame elementen van groene re-integratie?• Wat zijn de randvoorwaarden van groene re-integratie? En wat is er nodig om deze vorm van re-integratie verder inte bedden en op te schalen

The prognosis of kidney transplant recipients with aorto-iliac calcification: a systematic review and meta-analysis

The prognosis of kidney transplant recipients (KTR) with vascular calcification (VC) in the aorto-iliac arteries is unclear. We performed a systematic review and meta-analysis to investigate their survival outcomes. Studies from January 1st, 2000 until March 5th, 2019 were included. Outcomes for meta-analysis were patient survival, (death-censored) graft survival and delayed graft function (DGF). Twenty-one studies were identified, eight provided data for meta-analysis. KTR with VC had a significantly increased mortality risk [1-year: risk ratio (RR) 2.19 (1.39–3.44), 5-year: RR 2.28 (1.86–2.79)]. The risk of 1-year graft loss was three times higher in recipients with VC [RR 3.15 (1.30–7.64)]. The risk of graft loss censored for death [1-year: RR 2.26 (0.58–2.73), 3-year: RR 2.19 (0.49–9.82)] and the risk of DGF (RR 1.24, 95% CI 0.98–1.58) were not statistically different. The quality of the evidence was rated as very low. To conclude, the presence of VC was associated with an increased mortality risk and risk of graft loss. In this small sample size, no statistical significant association between VC and DGF or risk of death-censored graft loss could be demonstrated. For interpretation of the outcomes, the quality and sample size of the evidence should be taken into consideration

Learning from sustainable development: education in the light of public issues

Education for sustainable development (ESD) is increasingly affecting environmental education policy and practice. In this article we show how sustainable development is mainly seen as a problem that can be tackled by applying the proper learning processes and how this perspective translates sustainability issues into learning problems of individuals. We present a different perspective on education in the context of sustainable development based on novel ways of thinking about citizenship education and emphasizing the importance of presenting issues of sustainable development as ‘public issues’, as matters of public concern. From this point of view, the focus is no longer on the competences that citizens must achieve, but on the democratic nature of the spaces and practices in which participation and citizenship can develop

Mutations in SCG10 Are Not Involved in Hirschsprung Disease

Hirschsprung disease (HSCR) is a congenital malformation characterized by the absence of enteric neurons in the distal part of the colon. Several genes have been implicated in the development of this disease that together account for 20% of all cases, implying that other genes are involved. Since HSCR is frequently associated with other congenital malformations, the functional characterization of the proteins encoded by the genes involved in these syndromes can provide insights into the protein-network involved in HSCR development. Recently, we found that KBP, encoded by the gene involved in a HSCR- associated syndrome called Goldberg-Shprintzen syndrome, interacts with SCG10, a stathmin-like protein. To determine if SCG10 is involved in the etiology of HSCR, we determined SCG10 expression levels during development and screened 85 HSCR patients for SCG10 mutations. We showed that SCG10 expression increases during development but no germline mutation was found in any of these patients. In conclusion, this study shows that SCG10 is not directly implicated in HSCR development. However, an indirect involvement of SCG10 cannot be ruled out as this can be due to a secondary effect caused by its direct interactors

Assessing the impact of beach nourishment on the intertidal food web through the development of a mechanistic-envelope model

1. Beach nourishment, the placement of sand onto a sediment-starved stretch of coast, is widely applied as a soft coastal protection measure because of its reduced ecological impact relative to hard coastal protection. In order to predict effects on the intertidal sandy beach ecosystem, we developed a simulation model that integrates species envelope-based projections for the dominant macrobenthos species and mechanistic food web modules for higher trophic levels. 2. Species envelopes were estimated by using Bayesian inference of species’ biomass relationships according to the three determining abiotic variables: intertidal elevation, median grain size and total organic matter, obtained from multiple sampling campaigns along the Belgian coast. Maximum potential abundance of higher trophic levels represented by birds, shrimp and flatfish were estimated based on their derived trophic relationship with macrobenthos. 3. After validation, we demonstrated that unlike nourishment slope, sediment grain size strongly determines beach-level species richness and production, with strong deterioration in species richness after nourishment with coarse sediment (>300 lm). Patterns for higher trophic levels do not follow the changes in macrobenthos abundance and biomass. 4. Synthesis and applications. The optimal grain size range for nourishment of fine-grained beaches is 200–300 lm. This modelling approach shows that the impact assessment of beach nourishment needs to include the evaluation of different species richness and biomass variables. Focusing solely on the potential abundance of species from higher trophic levels might lead to deceptive conclusions due to the dominance of opportunistic prey species