Work ability of Dutch employees with rheumatoid arthritis

OBJECTIVES: To (i) examine the association between fatigue, psychosocial work characteristics (job control, support, participation in decision making, psychological job demands), and physical work requirements on the one hand and work ability of employees with rheumatoid arthritis (RA) on the other, and (ii) determine the advice that health care professionals give to employees with RA on how to maintain their work ability. METHODS: Data were gathered from 78 employees with early RA (response = 99%) by telephone interviews and self-report questionnaires. RESULTS: Fatigue, lack of autonomy, low coworker/supervisor support, low participation in decision making, and high physical work requirements (i.e. using manual force) predicted low work ability. High psychological job demands, however, did not predict low work ability. The rheumatologist, occupational physician, occupational therapist, physiotherapist, and psychologist gave advice on how to cope with RA at work to 36, 30, 27, 26, and 17% of the employees, respectively. Advice was directed mainly at factors intrinsic to the employee. Employees expressed a positive attitude towards this advice. CONCLUSIONS: Fatigue, lack of support, lack of autonomy, lack of participation in decision making, and using manual force at work (e.g. pushing and pulling) threaten the work ability of employees with RA. According to the employees with RA, involvement of health care professionals from different disciplines and the implementation of organizational and technical interventions would help them to tackle these threat

Evolutionary social and biogeophysical changes in the Amazon, Ganges–Brahmaputra–Meghna and Mekong deltas

Policy-making in social-ecological systems increasingly looks to iterative, evolutionary approaches that can address the inherent complexity of interactions between human wellbeing, provision of goods, and the maintenance of ecosystem services. Here, we show how the analysis of available time-series in tropical delta regions over past decades can provide important insight into the social-ecological system dynamics in deltaic regions. The paper provides an exploratory analysis of the recent changes that have occurred in the major elements of three tropical deltaic social-ecological systems, such as demography, economy, health, climate, food, and water. Time-series data from official statistics, monitoring programmes, and Earth observation data are analysed to explore possible trends, slow and fast variables, and observed drivers of change in the Amazon, Ganges–Brahmaputra–Meghna and Mekong deltas. In the Ganges–Brahmaputra–Meghna delta zone, increasing gross domestic product and per capita income levels since the 1980s mirror rising levels of food and inland fish production. In contrast, non-food ecosystem services, such as water availability, water quality, and land stability appear to be deteriorating. In the Amazon delta, natural and anthropogenic perturbations are continuously degrading key ecosystem services, such as carbon storage in biomass and soils, the regulation of water balance, and the modulation of regional climate patterns. In the Mekong delta, rapid economic development, changing land-use practices, and salinity intrusion are progressively putting more pressure on the delivery of important provisioning services, such as rice and inland aquaculture production, which are key sources of staple food, farm incomes, and export revenue. Observed changes in many key indicators of ecosystem services point to a changing dynamic state and increased probability of systemic threshold transformations in the near future