Multicentre validation of frequent sickness absence predictions

A prediction model including age, self-rated health (SRH) and prior sickness absence (SA) has previously been found to predict frequent SA.To further validate the model and develop it for clinical use.A multicentre study of care of the elderly workers employed at one of 14 centres in Aarhus (Denmark). SA episodes recorded in the year prior to baseline and both age and SRH at baseline were included in a prediction model for frequent (three or more) SA episodes during a 1-year follow-up period. The prediction model was developed in the largest centre. Risk predictions and discrimination between high- and low-risk workers were investigated in the other centres. The prediction rule 'SRH-prior SA' was derived from the prediction model and prognostic properties of the prediction rule were investigated for each centre, using score &lt;0 as cut-off.Of 2562 workers, 1930 had complete data for analysis. Predictions were accurate in 4 of 13 centres; discrimination was good in five and fair in another five centres. Prediction rule scores &lt;0 identified workers at risk of frequent SA with sensitivities of 0.17-0.54, specificities of 0.86-0.96 and positive predictive values of 0.54-0.87 across centres.The prediction model discriminated between workers at high and low risk of frequent SA in the majority of centres. The prediction rule 'SRH-prior SA' can be used in clinical practice specifically to identify workers at high risk of frequent SA.</p

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

Sickness absence frequency among women working in hospital care

Background Frequent short sickness absences result in understaffing and interfere with work processes. We need more knowledge about factors associated with this type of absence. Aims To investigate associations between the frequency of previous sickness absence and self-reported perceptions of health and work. Methods Cross-sectional study of female hospital care workers in which health, work characteristics and coping styles were assessed by questionnaire and linked to the number of sickness absence episodes recorded in the preceding 5 years using negative binomial regression analysis for counts distinguishing between short (1-7 days) and long (>7 days) episodes of absence after adjusting for age and duration of employment in December 2007 and hours worked between 2003 and 2007. Results Of 350 women employed for at least 5 years, 237 (68%) answered the questionnaire. The hours worked over the 5 year period [rate ratio (RR) = 1.2] and problem solving coping style score (RR = 1.1) were positively associated with the number of short sickness absence episodes. Age (RR = 0.8) and good general health (RR = 0.7) were inversely related to the number of both short and long episodes. Self-reported mental health and work characteristics were not shown to be related to the frequency of sickness absence. Conclusions Hours worked, problem-solving coping style, age and general health showed associations with the frequency of previous sickness absence among women who had worked at least 5 years in health care. Future prospective studies on the frequency of sickness absence should consider the impact of these factors further

Validation of the Work Role Functioning Questionnaire 2.0 in cancer patients

Objective The Work Role Functioning Questionnaire 2.0 (WRFQ), measuring the percentage of time a worker has difficulties in meeting the work demands for a given health state, has shown strong reliability and validity in various populations with different chronic conditions. The present study aims to validate the WRFQ in working cancer patients. Methods A validation study of the WRFQ 2.0 was conducted, using baseline data from the longitudinal Work Life after Cancer study. Structural validity (Confirmatory Factor Analysis, CFA), internal consistency (Cronbach's alpha) and discriminant validity (hypothesis testing) were evaluated. Results 352 working cancer patients, most of them diagnosed with breast cancer (48%) and 58% in a job with mainly non-manual tasks, showed a mean WRFQ score of 78.6 (SD = 17.1), which means that they had on average difficulties for 78.6% of the time they spent working. Good internal consistency (alpha = 0.96) and acceptable to good fit for both the four and five-factor model (CFA) was found. The WRFQ distinguished between cancer patients reporting good vs. poor health (80.3 vs. 73.0, p = 0.001), low vs. high fatigue (82.0 vs. 72.2, p <0.001), no vs. clinical depression (80.4 vs. 58.8, p <0.001) and low vs. high cognitive symptoms (86.1 vs. 64.7, p <0.001). Conclusions The WRFQ 2.0 is a reliable and valid instrument to measure work functioning in working cancer patients. Further psychometric research on responsiveness is needed to support its use in health practice

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

Parametric hazard rate models for long-term sickness absence

PURPOSE: In research on the time to onset of sickness absence and the duration of sickness absence episodes, Cox proportional hazard models are in common use. However, parametric models are to be preferred when time in itself is considered as independent variable. This study compares parametric hazard rate models for the onset of long-term sickness absence and return to work. METHOD: Prospective cohort study on sickness absence with four follow-up years of 53,830 employees working in the private sector in the Netherlands. The time to onset of long-term (>6 weeks) sickness absence and return to work were modelled by parametric hazard rate models. RESULTS: The exponential parametric model with a constant hazard rate most accurately described the time to onset of long-term sickness absence. Gompertz-Makeham models with monotonically declining hazard rates best described return to work. CONCLUSIONS: Parametric models offer more possibilities than commonly used models for time-dependent processes as sickness absence and return to work. However, the advantages of parametric models above Cox models apply mainly for return to work and less for onset of long-term sickness absence

Sperm DNA damage causes genomic instability in early embryonic development

Genomic instability is common in human embryos, but the underlying causes are largely unknown. Here, we examined the consequences of sperm DNA damage on the embryonic genome by single-cell whole-genome sequencing of individual blastomeres from bovine embryos produced with sperm damaged by γ-radiation. Sperm DNA damage primarily leads to fragmentation of the paternal chromosomes followed by random distribution of the chromosomal fragments over the two sister cells in the first cell division. An unexpected secondary effect of sperm DNA damage is the induction of direct unequal cleavages, which include the poorly understood heterogoneic cell divisions. As a result, chaotic mosaicism is common in embryos derived from fertilizations with damaged sperm. The mosaic aneuploidies, uniparental disomies, and de novo structural variation induced by sperm DNA damage may compromise fertility and lead to rare congenital disorders when embryos escape developmental arrest

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

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

Breast Cancer, Sickness Absence, Income and Marital Status. A Study on Life Situation 1 Year Prior Diagnosis Compared to 3 and 5 Years after Diagnosis

Background: Improved cancer survival poses important questions about future life conditions of the survivor. We examined the possible influence of a breast cancer diagnosis on subsequent working and marital status, sickness absence and income. Materials: We conducted a matched cohort study including 4,761 women 40–59 years of age and registered with primary breast cancer in a Swedish population-based clinical register during 1993–2003, and 2,3805 women without breast cancer. Information on socioeconomic standing was obtained from a social database 1 year prior and 3 and 5 years following the diagnosis. In Conditional Poisson Regression models, risk ratios (RRs) and 95 % confidence intervals (CIs) were estimated to assess the impact of a breast cancer diagnosis. Findings: Three years after diagnosis, women who had had breast cancer more often had received sickness benefits (RR = 1.49, 95 % CI 1.40–1.58) or disability pension (RR = 1.47, 95 % CI 1.37–1.58) than had women without breast cancer. W