Self-reported health problems and obesity predict sickness absence during a 12-month follow-up : a prospective cohort study in 21 608 employees from different industries

Objectives To study whether self-reported health problems predict sickness absence (SA) from work in employees from different industries. Methods The results of a health risk appraisal (HRA) were combined with archival data of SA of 21 608 employees (59% female, 56% clerical). Exposure variables were self-reported health problems, labelled as ' work disability (WD) risk factors' in the HRA, presence of problems with occupational well-being and obesity. Age, socioeconomic grading and the number of SA days 12 months before the survey were treated as confounders. The outcome measure was accumulated SA days during 12-month follow-up. Data were analysed separately for males and females. A Hurdle model with negative binomial response was used to analyse zero-inflated count data of SA. Results The HRA results predicted the number of accumulated SA days during the 12-month follow-up, regardless of occupational group and gender. The ratio of means of SA days varied between 2.7 and 4.0 among those with ' WD risk factors' and the reference category with no findings, depending on gender and occupational group. The lower limit of the 95% CI was at the lowest 2.0. In the Hurdle model, ' WD risk factors', SA days prior to the HRA and obesity were additive predictors for SA and/or the accumulated SA days in all occupational groups. Conclusion Self-reported health problems and obesity predict a higher total count of SA days in an additive fashion. These findings have implications for both management and the healthcare system in the prevention of WD. © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.Peer reviewe

Novel tools and best practices for education about invasive alien species

Increasing public awareness is a prerequisite for successful management of invasive alien species (IAS). Environmental education can play an important role in this process by providing relevant learning outcomes and experiences for youth and students, as well as professionals in different sectors associated with introduction pathways or who are involved in mitigation and eradication of IAS. This paper responds to the urgent call for the inclusion of the IAS topic in education through the development, implementation and evaluation of novel and user-friendly educational materials. The aim of this paper is to describe best practices in IAS education and to share the lessons learned from eight educational projects from seven different countries. We discuss four challenges for IAS education, related to (1) inconsistent and ambiguous terminology, (2) communicating risk, (3) implementation of education materials, and (4) evaluation of learning effects. Examples of best practices are the use of smartphone applications and gaming elements, place-based education and exhibitions. We also note the importance of open access publishing of education materials to make them easily available. We intend this discussion to serve as a source of inspiration to researchers, science communicators and teachers and to spur the development of new teaching materials worldwide.Peer reviewe

Sixth Åland Island Conference on von Willebrand disease

Introduction The sixth angstrom land Islands Conference on von Willebrand disease (VWD) on the angstrom land Islands, Finland, was held from 20 to 22 September 2018. Aim The meeting brought together experts in the field of VWD from around the world to share the latest advances and knowledge in VWD. Results and discussion The topics covered both clinical aspects of disease management, and biochemical and laboratory insights into the disease. The clinical topics discussed included epidemiology, diagnosis and treatment of VWD in different countries, management of children with VWD, bleeding control during surgery, specific considerations for the management of type 3 VWD and bleeding control in women with VWD. Current approaches to the management of acquired von Willebrand syndrome were also discussed. Despite significant advances in the understanding and therapeutic options for VWD, there remain many challenges to be overcome in order to optimise patient care. In comparison with haemophilia A, there are very few registries of VWD patients, which would be a valuable source of data on the condition and its management. VWD is still underdiagnosed, and many patients suffer recurrent or severe bleeding that could be prevented. Awareness of VWD among healthcare practitioners, including non-haematologists, should be improved to allow timely diagnosis and intervention. Diagnosis remains challenging, and the development of fast, simple assays may help to facilitate accurate and rapid diagnosis of VWD.Peer reviewe

Sustainable management of migratory European ducks: finding model species

Eurasian migratory duck species represent a natural resource shared between European countries. As is evident throughout human harvest history, lack of coordinated management and monitoring at appropriate levels often leads to 'the tragedy of the commons', where shared populations suffer overexploitation. Effective management can also be hampered by poor understanding of the factors that limit and regulate migratory populations throughout their flyways, and over time. Following decades of population increase, some European duck populations now show signs of levelling off or even decline, underlining the need for more active and effective management. In Europe, the existing mechanisms for delivering effective management of duck populations are limited, despite the need and enthusiasm for establishing adaptive management (AM) schemes for wildlife populations. Existing international legal agreements already oblige European countries to sustainably manage migratory waterbirds. Although the lack of coordinated demographic and hunting data remains a challenge to sustainable management planning, AM provides a robust decision-making framework even in the presence of uncertainty regarding demographic and other information. In this paper we investigate the research and monitoring needs in Europe to successfully apply AM to ducks, and search for possible model species, focusing on freshwater species (in contrast to sea duck species) in the East Atlantic flyway. Based on current knowledge, we suggest that common teal Anas crecca, Eurasian wigeon Mareca penelope and common goldeneye Bucephala clangula represent the best species for testing the application of an AM muddling approach to duck populations in Europe. Applying AM to huntable species with relatively good population data as models for broader implementation represents a cost effective way of starting to develop AM on a European flyway scale for ducks, and potentially other waterbirds in the future

Alleviating Surgeons’ Stress through Listening to Natural Sounds in a Half-Encapsulated Rest Space after an Operation: A Pilot, Longitudinal Field Study

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Clinical practice selectively follows acute appendicitis guidelines

Peer reviewe

Adolescents' health and health behaviour as predictors of injury death. A prospective cohort follow-up of 652,530 person-years

<p>Abstract</p> <p>Background</p> <p>Injuries represent an important cause of mortality among young adults. Longitudinal studies on risk factors are scarce. We studied associations between adolescents' perceived health and health behaviour and injury death.</p> <p>Methods</p> <p>A prospective cohort of 57,407 Finns aged 14 to 18 years was followed for an average of 11.4 years. The end-point of study was injury death or termination of follow-up in 2001. The relationships of eight health and health behaviour characteristics with injury death were studied with adjusted Cox's proportional hazard model.</p> <p>Results</p> <p>We identified 298 (0.5%) injury deaths, 232 (0.9%) in men and 66 (0.2%) in women. The mean age at death was 23.8 years. In the models adjusted for age, sex and socioeconomic background, the strongest risk factors for injury death were recurring drunkenness (HR 2.1; 95% CI: 1.4–3.1) and daily smoking (HR 1.7; 95% CI: 1.3–2.2). Poor health did not predict injury death. Unintentional and intentional injury deaths had similar health and health behavioural risk factors.</p> <p>Conclusion</p> <p>Health compromising behaviour adopted at adolescence has a clear impact on the risk of injury death in adulthood independent from socioeconomic background. On the other hand, poor health as such is not a significant predictor of injury death. Promotion of healthy lifestyle among adolescents as part of public health programmes would seem an appropriate way to contribute to adolescent injury prevention.</p