The Cognitive Symptom Checklist-Work in cancer patients is related with work functioning, fatigue and depressive symptoms: a validation study

The study objectives are to translate the 21-item Cognitive Symptom Checklist-Work (CSC-W21) to Dutch (CSC-W DV) and to validate the CSC-W DV in working cancer patients. The CSC-W21 was cross-culturally translated and adapted to a Dutch version. In this 19-item version, the dichotomous response option was changed to an ordinal five-point scale. A validation study of the CSC-W DV was conducted among cancer patients who had returned to work during or following cancer treatment. Internal consistency (Cronbach's alpha), structural validity (exploratory factor analysis) and construct validity (hypothesis testing) were evaluated. In a cohort of 364 cancer patients, 341 (94 %) completed the CSC-W DV (aged 50.6 +/- 8.6 years, 60 % women). Exploratory factor analysis revealed two subscales 'working memory' and 'executive function'. The internal consistency of the total scale and subscales was high (Cronbach's alpha = 0.93-0.95). Hypothesis testing showed that self-reported cognitive limitations at work were related to work functioning (P <0.001), fatigue (P = 0.001) and depressive symptoms (P <0.001), but not to self-rated health (P = 0.14). The CSC-W DV showed high internal consistency and reasonable construct validity for measuring work-specific cognitive symptoms in cancer patients. The CSC-W DV was associated in expected ways with work functioning, fatigue and depressive symptoms. It is important to enhance knowledge about cognitive symptoms at work in cancer patients, to guide and support cancer patients as good as possible when they are back at work and to improve their work functioning over time

К численному решению задач о деформации анизотропных пластин с отверстием

Представлен подход к расчету напряженно-деформированного состояния пластин с отверстием, основанный на численной параметризации двусвязной области, сведении исходной нелинейной краевой задачи к последовательности линейных двухмерных и интегрировании последних устойчивым численным методом. Исследуется влияние формы и месторасположения отверстия на напряженно-деформированное состояние квадратной пластины.Представлено підхід до розрахунку напружено-деформованого стану пластин, що послаблені отвором. Підхід базується на числовій параметризації двозв’язної області, зведенні вихідної нелінійної задачі до послідовності лінійних двомірних та останніх до одномірних, інтегрування яких проводиться стійким числовим методом. Досліджується вплив форми та місцезнаходження отвору на напружено-деформований стан квадратної пластини.The study presents an approach to stressed-state analysis of plates with apertures which is based on the numerical parameterization of a doubly-connected area, reduction of the initial nonlinear boundary-value problem to a sequence of linear two-dimensional problems and integrating the latter by the stable numerical method. The effect of form and place of an aperture on stressed state of a square plate has been analyzed

Ochratoxin A affects oocyte maturation and subsequent embryo developmental dynamics in the juvenile sheep model

The genotoxic and nephrotoxic mycotoxin Ochratoxin A (OTA) has also been reported to have adverse effects on oocyte maturation and embryo development. Previous studies on the effects of OTA on female fertility have used micromolar concentrations, but no information is available to date on effects in a more relevant nanomolar range. This study used a juvenile sheep model to evaluate the effects of oocyte exposure to low levels of OTA on maturation, fertilization, and embryo development. Further, it was investigated whether different mechanisms of action of OTA could be responsible for varying toxic effects at different levels of exposure. Cumulus-oocyte-complexes (COCs) were exposed to 10&nbsp;μmol/L–0.1&nbsp;nmol/L OTA during in vitro maturation and evaluated for cumulus viability, oocyte maturation, and bioenergetic/oxidative status. COCs were subjected to in vitro fertilization, embryo culture, and embryo quality assessment via morphology, viability, bioenergetic/oxidative status, and time-lapse monitoring. At micromolar concentrations, OTA induced cytotoxic effects, by reducing cumulus expansion and oocyte maturation. OTA altered temporospatial dynamics of zygote pronuclear formation and embryo morphokinetics. Blastocysts, even morphologically normal, were found to undergo collapse events, which were probably related to boosted blastocyst mitochondrial activity. At nanomolar concentrations, OTA did not affect COC morpho-functional parameters, but impaired oocyte ability to prevent polyspermy and increased blastocyst apoptosis. In conclusion, in the female germ cell, cytotoxic nonspecific effects characterize OTA-induced toxicity at high exposure levels, whereas fine tuning-mode effects, not associated with altered cell viability and integrity, characterize OTA toxic action at low levels

Poor Children in Rich Households and Vice Versa: A Blurred Picture or Hidden Realities?

An expanding evidence base suggests that children experiencing monetary and multidimensional poverty are not the same. This article breaks new ground by providing a unique mixed methods investigation of drivers of child poverty mismatch in Ethiopia and Vietnam, considering the role of measurement error and individualistic and structural factors. The analysis capitalises on large-scale secondary quantitative panel data and combines this with purposively collected primary qualitative data in both countries. It finds that factors at the household and structural level can mediate the effects of monetary poverty in terms of multidimensional poverty and vice versa, but that the size and sign of these effects are specific to place and time. The policy mix aiming to reduce all forms of child poverty need to be targeted on the basis of a multidimensional assessment of poverty and reflect the complex and contextspecific interactions between determinants of child poverty

Synchronous online CPD: empirical support for the value of webinars in career settings

The careers profession in England is facing unprecedented challenges. Initiatives to improve service delivery while keeping costs low are attractive and online training holds the promise of high impact at low cost. The present study employs a qualitative methodology to evaluate a series of online ‘webinars’ conducted with 15 careers advisers. Results showed that the technology itself could impede learning, and participants missed out on the peer-to-peer interaction that takes place in a ‘bricks and mortar’ setting, but overall participants found that access to relevant, good quality training from the convenience of their workplace more than compensated for the challenges. The article offers conceptual support for the viability of online learning through the theory of equivalency, andragogy and transactional distance theory, and makes recommendations for practice

Cancer Survivors’ Social Context in the Return to Work Process:Narrative Accounts of Social Support and Social Comparison Information

Purpose: Returning to work is a process that is intertwined with the social aspects of one’s life, which can influence the way in which that person manages their return to work and also determines the support available to them. This study aimed to explore cancer patients’ perceptions of the role of their social context in relation to returning to work following treatment. Methods: Twenty-three patients who had received a diagnosis of either urological, breast, gynaecological, or bowel cancer participated in semi-structured interviews examining general perceptions of cancer, work values and perceptions of the potential impact of their cancer diagnosis and treatment on work. Interviews were analysed using the iterative process of Framework Analysis. Results: Two superordinate themes emerged as influential in the return to work process: Social support as a facilitator of return to work (e.g. co-workers’ support and support outside of the workplace) and Social comparison as an appraisal of readiness to return to work (e.g. comparisons with other cancer patients, colleagues, and employees in other organisations or professions). Conclusions: Two functions of the social context of returning to work after cancer were apparent in the participants’ narrative: the importance of social support as a facilitator of returning to work and the utilisation of social comparison information in order to appraise one’s readiness to return to work. The role of social context in returning to work has largely been absent from the research literature to date. The findings of this study suggest that social support and social comparison mechanisms may have a significant impact on an individual’s successful return to the workplace

The Contribution of High Levels of Somatic Symptom Severity to Sickness Absence Duration, Disability and Discharge

Introduction: The primary objectives were to compare the duration of sickness absence in employees with high levels of somatic symptom severity (HLSSS) with employees with lower levels of somatic symptom severity, and to establish the long-term outcomes concerning return to work (RTW), disability and discharge. Secondary objective was to evaluate determinants of the duration of sickness absence in employees with HLSSS. Methods: 489 sick-listed employees registered with five Occupational Health Physician (OHP) group practices were included in this study. We measured their baseline scores for somatic symptoms severity, depressive disorders, anxiety disorders, health anxiety, distress and functional impairment. The OHPs filled in a questionnaire on their diagnosis. A prospective 2-year follow-up was carried out to assess the long-term outcomes concerning sickness absence, and retrospective information was gathered with regard to sickness absence during the 12 months before the employees were sick-listed. Results: The median duration of sickness absence was 78 days longer for employees with HLSSS. They more often remained disabled and were discharged more often, especially due to problems in the relationship between the employer and the employee. HLSSS, health anxiety and older age contributed to a longer duration of sickness absence of employees. Conclusion: High levels of somatic symptom severity are a determinant of prolonged sickness absence, enduring disabilities and health-related job loss. Occupational health physicians should identify employees who are at risk and adhere to guidelines for medically unexplained somatic symptoms

Exploring working conditions as determinants of job satisfaction: an empirical test among Catalonia service workers

Job satisfaction is particularly important in the service industry since it involves direct contact with customers and thus has a direct influence on company performance. We analyzed the impact of ten working conditions on job satisfaction by means of structural equation modelling in a representative stratified random sample of 1553 service sector employees in Catalonia (Spain). We found significant effects in social aspects (recognition of a job well done and social support), followed by psychological loads (emotional demands and job insecurity) and by task contents (development & meaning and predictability). These variables explained 50% of the variance in job satisfaction

Severe MUPS in a sick-listed population: a cross-sectional study on prevalence, recognition, psychiatric co-morbidity and impairment

Background: Medically unexplained physical symptoms (MUPS) have a high prevalence in the general population and are associated with psychiatric morbidity. There are indications that MUPS are an important determinant of frequent and long-term disability. The primary objective was to assess the prevalence of MUPS in sick-listed-employees and its associations with depressive disorders, anxiety disorders, health anxiety, distress and functional impairment. Secondary objectives were to investigate the classification of the occupational health physicians (OHPs), their opinions about the causes as well as the attributions of the employee. Methods: In a cross- sectional study of 489 sick-listed employees from 5 OHP group practices, MUPS, depressive disorders, anxiety disorders, health anxiety, distress and functional impairment were assessed with the Patient Health Questionnaire (PHQ), the Whitely Index (WI), the Four-Dimensional Symptom Questionnaire (4DSQ) and the Short-Form 36 Health Survey (SF-36). We used a cut off score of 15 on the PHQ for the categorisation of severe MUPS. The opinions of the OHPs were evaluated by means of a separate questionnaire with regard to the presence of employees physical symptoms, and the symptoms attributions, and the diagnoses of the OHPs. Results: Severe MUPS had a prevalence of 15.1% in this population of sick-listed employees. These employees had 4-6 times more depressive and anxiety disorders, and were more impaired. Female gender and PHQ-9 scores were determinants of severe MUPS. Most of the time the OHPs diagnosed employees with severe MUPS as having a mental disorder. The employees attributed their physical symptoms in 66% to mental or to both mental and physical causes. Conclusion: The prevalence of severe MUPS is higher in long-term sick-listed employees than in the non-sick-listed working population and at least equals the prevalence in the general practice population. Severe MUPS are associated with psychiatric morbidity and functional impairment and must therefore be specifically recognised as such. Validated questionnaires, such as the PHQ-15, are useful instruments in order to help OHPs to recognise severe MUPS

Gender and age differences in the recurrence of sickness absence due to common mental disorders: a longitudinal study

Background: Common mental disorders (CMDs) are an important cause of sickness absence and long-term work disability. Although CMDs are known to have high recurrence rates, little is known about the recurrence of sickness absence due to CMDs. The aim of this study was to investigate the recurrence of sickness absence due to CMDs, including distress, adjustment disorders, depressive disorders and anxiety disorders, according to age, in male and female employees in the Netherlands. Methods: Data on sickness absence episodes due to CMDs were obtained for 137,172 employees working in the Dutch Post and Telecommunication companies between 2001 and 2007. The incidence density (ID) and recurrence density (RD) of sickness absence due to CMDs was calculated per 1000 person-years in men and women in the age-groups of < 35 years, 35-44 years, 45-54 years, and >= 55 years. Results: The ID of one episode of CMDs sickness absence was 25.0 per 1000 person-years, and the RD was 76.7 per 1000 person-years. Sickness absence due to psychiatric disorders (anxiety and depression) does not have a higher recurrence density of sickness absence due to any CMDs as compared to stress-related disorders (distress and adjustment disorders): 81.6 versus 76.0 per 1000 person-years. The ID of sickness absence due to CMDs was higher in women than in men, but the RD was similar. Recurrences were more frequent in women < 35 years and in women between 35 and 44 years of age. We observed no differences between age groups in men. Recurrences among employees with recurrent episodes occurred within 3 years in 90% of cases and the median time-to-onset of recurrence was 11 (10-13) months in men and 10 (9-12) months in women. Conclusions: Employees who have been absent from work due to CMDs are at increased risk of recurrent sickness absence due to CMDs and should be monitored after they return to work. The RD was similar in men and in women. In women < 45 years the RD was higher than in women >= 45 years. In men no age differences were observed