Healing a Vulnerable Self:Exploring Return to Work for Women With Mental Health Problems

Mental health problems (MHPs) such as stress and depression are among the leading causes of work disability. In this article we explore how women with MHPs experience sickness absence and subsequent return to work. We conducted 16 semistructured interviews and employed constructivist grounded theory for the analysis. We found that whereas sickness absence constituted a major threat to positive self-images, the experience had potential as a personal growth experience: Although some women felt handicapped, others became stronger and more self-confident. The core of the experience was not the return to work but a process of healing a vulnerable self-the ability both to refocus attention from symptoms to other life goals and to maintain or reconstruct a positive self-image. Supportive health care and acknowledgment from others facilitated the healing process

Health, work, and personal-related predictors of time to return to work among employees with mental health problems

Purpose: To identify health-, personal- and work-related factors predictive of return to work (RTW) in employees sick-listed due to common mental health problems, such as, stress, depression, burnout, and anxiety. Methods: We distributed a baseline questionnaire to employees applying for sickness absence benefits at a large Danish welfare Department (n = 721). A total of 298 employees returned the questionnaire containing information on possible predictors of RTW. We followed up all baseline responders for a maximum of one year in a national registry of social transfer payments, including sickness absence benefits. Results: At baseline, about 9% of respondents had quit their job, 10% were dismissed and the remaining 82% were still working for the same employer. The mean time to RTW, measured from the first day of absence, was 25 weeks (median = 21) and at the end of follow-up (52 weeks) 85% had returned to work. In the fitted Cox model we found that fulfilling the DSM-IV criteria for depression predicted a longer time to RTW (HR: 0.61, CI: 0.45-0.84), whereas a better self-rated health predicted a shorter time to RTW (HR: 1.18, CI: 1.03-1.34). Employees working in the municipal (HR: 0.62, CI: 0.41-0.94) and private sector (HR: 0.65, CI: 0.44-0.96) returned to work slower compared to employees working in the governmental sector. Gender, education, cohabitation, size of workplace, low-back and upper-neck pain and employment at baseline did not predict RTW. Conclusion: Our results indicate that time to RTW is determined by both health- and work-related factors

Workplace sexual harassment and depressive symptoms:A cross-sectional multilevel analysis comparing harassment from clients or customers to harassment from other employees amongst 7603 Danish employees from 1041 organizations

Abstract Background Previous research has reported that sexual harassment can lead to reduced mental health. Few studies have focused on sexual harassment conducted by clients or customers, which might occur in person-related occupations such as eldercare work, social work or customer service work. This study examined the cross-sectional association between sexual harassment by clients or customers and depressive symptoms. We also examined if this association was different compared to sexual harassment conducted by a colleague, supervisor or subordinate. Further, we investigated if psychosocial workplace initiatives modified the association between sexual harassment by clients or customers and level of depressive symptoms. Methods We used data from the Work Environment and Health in Denmark cohort study (WEHD) and the Work Environment Activities in Danish Workplaces Study (WEADW) collected in 2012. WEHD is based on a random sample of employed individuals aged 18–64. In WEADW, organizational supervisors or employee representatives provided information on workplace characteristics. By combining WEHD and WEADW we included self-reported information on working conditions and health from 7603 employees and supervisors in 1041 organizations within 5 occupations. Data were analyzed using multilevel regression and analyses adjusted for gender, age, occupation and socioeconomic position. Results Exposure to workplace sexual harassment from clients or customers was statistically significantly associated with a higher level of depressive symptoms (2.05; 95% CI: 0.98–3.12) compared to no exposure. Employees harassed by colleagues, supervisors or subordinates had a higher mean level of depressive symptoms (2.45; 95% CI: 0.57–4.34) than employees harassed by clients or customers. We observed no statistically significant interactions between harassment from clients and customers and any of the examined psychosocial workplace initiatives (all p > 0.05). Conclusions The association between sexual harassment and depressive symptoms differed for employees harassed by clients or customers and those harassed by colleagues, supervisors or subordinates. The results underline the importance of investigating sexual harassment from clients or customers and sexual harassment by colleagues, supervisors or subordinates as distinct types of harassment. We found no modification of the association between sexual harassment by clients or customers and depressive symptoms by any of the examined psychosocial workplace initiatives

Non-essential genes form the hubs of genome scale protein function and environmental gene expression networks in Salmonella enterica serovar Typhimurium

Background Salmonella Typhimurium is an important pathogen of human and animals. It shows a broad growth range and survives in harsh conditions. The aim of this study was to analyze transcriptional responses to a number of growth and stress conditions as well as the relationship of metabolic pathways and/or cell functions at the genome-scale-level by network analysis, and further to explore whether highly connected genes (hubs) in these networks were essential for growth, stress adaptation and virulence. Results De novo generated as well as published transcriptional data for 425 selected genes under a number of growth and stress conditions were used to construct a bipartite network connecting culture conditions and significantly regulated genes (transcriptional network). Also, a genome scale network was constructed for strain LT2. The latter connected genes with metabolic pathways and cellular functions. Both networks were shown to belong to the family of scale-free networks characterized by the presence of highly connected nodes or hubs which are genes whose transcription is regulated when responding to many of the assayed culture conditions or genes encoding products involved in a high number of metabolic pathways and cell functions. The five genes with most connections in the transcriptional network (wraB, ygaU, uspA, cbpA and osmC) and in the genome scale network (ychN, siiF (STM4262), yajD, ybeB and dcoC) were selected for mutations, however mutagenesis of ygaU and ybeB proved unsuccessful. No difference between mutants and the wild type strain was observed during growth at unfavorable temperatures, pH values, NaCl concentrations and in the presence of H2O2. Eight mutants were evaluated for virulence in C57/BL6 mice and none differed from the wild type strain. Notably, however, deviations of phenotypes with respect to the wild type were observed when combinations of these genes were deleted. Conclusion Network analysis revealed the presence of hubs in both transcriptional and functional networks of S. Typhimurium. Hubs theoretically confer higher resistance to random mutation but a greater susceptibility to directed attacks, however, we found that genes that formed hubs were dispensable for growth, stress adaptation and virulence, suggesting that evolution favors non-essential genes as main connectors in cellular networks

The NBS1-Treacle complex controls ribosomal RNA transcription in response to DNA damage

Chromosome breakage elicits transient silencing of ribosomal RNA synthesis, but the mechanisms involved remained elusive. Here we discover an in trans signalling mechanism that triggers pan-nuclear silencing of rRNA transcription in response to DNA damage. This is associated with transient recruitment of the Nijmegen breakage syndrome protein 1 (NBS1), a central regulator of DNA damage responses, into the nucleoli. We further identify TCOF1 (also known as Treacle), a nucleolar factor implicated in ribosome biogenesis and mutated in Treacher Collins syndrome, as an interaction partner of NBS1, and demonstrate that NBS1 translocation and accumulation in the nucleoli is Treacle dependent. Finally, we provide evidence that Treacle-mediated NBS1 recruitment into the nucleoli regulates rRNA silencing in trans in the presence of distant chromosome breaks

Return to work among employees with common mental disorders: Study design and baseline findings from a mixed-method follow-up study

Aims: Most research on return-to-work (RTW) has focused on musculoskeletal disorders. To study RTW in employees sick-listed with common mental disorders (CMD), e.g., stress, depression, and anxiety, the National Research Centre for the Working Environment initiated a study on ''Common Mental Disorders, Return-to-work, and Long-term Sickness Absence'' (CORSA). The aim of the study is (1) to identify predictors of RTW from the environmental, the individual, and the health-related domain and (2) to explore the RTW process based on study participants' experiences. The purpose of this paper is to present the study design and the characteristics of the participants, including analyses on non-response and the prevalence of major depression. Methods: CORSA is a mixed-method follow-up study encompassing quantitative and qualitative analyses in a cohort of employees sick-listed with CMD. Participants were all employees who suffered from CMD and whose applications for sickness absence benefits were processed by the Job Centre Copenhagen (a subunit of the municipality) between July and December 2007 (n = 721). Data on predictors for RTW were collected from (1) administrative application forms filled out by all participants when applying for benefits (n = 721), and (2) baseline questionnaires sent to all participants (responders: n = 298). Data on RTW was retrieved from a national sickness absence registry and from 6-month follow-up questionnaires (n = 226). To explore the RTW process we will primarily use data from in-depth interviews with selected participants (n = 16) supplemented with data from the two questionnaires. Conclusions: The mixed method design allows for a more comprehensive understanding of RTW by triangulating qualitative and quantitative methods