The impact of CFS/ME on employment and productivity in the UK: a cross-sectional study based on the CFS/ME national outcomes database

<p>Abstract</p> <p>Background</p> <p>Few studies have investigated factors associated with discontinuation of employment in patients with CFS/ME or quantified its impact on productivity.</p> <p>Methods</p> <p>We used patient-level data from five NHS CFS/ME services during the period 01/04/2006-31/03/2010 collated in the UK CFS/ME National Outcomes Database. We used logistic regression to identify factors associated with discontinuation of employment. We estimated UK-wide productivity costs using patient-level data on duration of illness before assessment by a CFS/ME service, duration of unemployment, age, sex and numbers of patients, in conjunction with Office for National Statistics income and population data.</p> <p>Results</p> <p>Data were available for 2,170 patients, of whom 1,669 (76.9%) were women. Current employment status was recorded for 1,991 patients (91.8%), of whom 811 patients (40.7%) were currently employed and 998 (50.1%) had discontinued their employment "because of fatigue-related symptoms". Older age, male sex, disability, fatigue, pain, and duration of illness were associated with cessation of employment. In a multivariable model, age, male sex, and disability remained as independent predictors. Total productivity costs among the 2,170 patients due to discontinuation of employment in the years preceding assessment by a specialist CFS/ME service (median duration of illness = 36 months) were £49.2 million. Our sample was equivalent to 4,424 UK adults accessing specialist services each year, representing productivity costs to the UK economy of £102.2 million. Sensitivity analyses suggested a range between £75.5-£128.9 million.</p> <p>Conclusions</p> <p>CFS/ME incurs huge productivity costs amongst the small fraction of adults with CFS/ME who access specialist services.</p

Web-Based Task Design Supporting Students’ Construction of Alternative Proofs

This is the author accepted manuscript. The final version is available from Springer via the DOI in this recordThis study explores how a proving task with technology can be designed to develop students’ strategic knowledge of how to construct alternative proofs to the same problem, and how the designed task enriched their strategic knowledge in proving in the context of geometrical proof. The designed task had three components; open problem with flow-chart proofs, learning environment with web-based proof learning support system, and process of expressing strategic knowledge of how to reconstruct proofs. By analyzing experimental lessons with a grade 8 class (students aged 13-14), we found that these task components, and their interactions, contributed to developing students’ strategic knowledge. Using open problems with flow-chart proofs in a web-based proof learning support system enabled students to find alternative proofs to the same problem, and promoted the process of them expressing their strategic knowledge of how to reconstruct proofs.This research was supported by the Grant-in-Aid for Scientific Research, Ministry of Education, Culture, Sports, Science, and Technology, Japan

Analyzing effective communication in mathematics group work : the role of visual mediators and technical terms.

Analyzing and designing productive group work and effective communication constitute ongoing research interests in mathematics education. In this article we contribute to this research by using and developing a newly introduced analytical approach for examining effective communication within group work in mathematics education. By using data from 12-13-year old students playing a dice game as well as from a group of university students working with a proof by induction, the article shows how the link between visual mediators and technical terms are crucial in students’ attempts to communicate effectively. The critical evaluation of visual mediators and technical terms, and of links between them, is useful for researchers interested in analyzing effective communication and designing environments providing opportunities for students to learn mathematics.The original publication is available at www.springerlink.com</p

“Employment and arthritis: making it work” a randomized controlled trial evaluating an online program to help people with inflammatory arthritis maintain employment (study protocol)

Background: Arthritis and musculoskeletal conditions are the leading cause of long-term work disability (WD), an outcome with a major impact on quality of life and a high cost to society. The importance of decreased at-work productivity has also recently been recognized. Despite the importance of these problems, few interventions have been developed to reduce the impact of arthritis on employment. We have developed a novel intervention called “Making It Work”, a program to help people with inflammatory arthritis (IA) deal with employment issues, prevent WD and improve at-work productivity. After favorable results in a proof-of-concept study, we converted the program to a web-based format for broader dissemination and improved accessibility. The objectives of this study are: 1) to evaluate in a randomized controlled trial (RCT) the effectiveness of the program at preventing work cessation and improving at-work productivity; 2) to perform a cost-utility analysis of the intervention. Methods/Design 526 participants with IA will be recruited from British Columbia, Alberta, and Ontario in Canada. The intervention consists of a) 5 online group sessions; b) 5 web-based e-learning modules; c) consultations with an occupational therapist for an ergonomic work assessment and a vocational rehabilitation counselor. Questionnaires will be administered online at baseline and every 6 months to collect information about demographics, disease measures, costs, work-related risk factors for WD, quality of life, and work outcomes. Primary outcomes include at-work productivity and time to work cessation of > 6 months for any reason. Secondary outcomes include temporary work cessation, number of days missed from work per year, reduction in hours worked per week, quality adjusted life year for the cost utility analysis, and changes from baseline in employment risk factors. Analysis of Variance will evaluate the intervention’s effect on at-work productivity, and multivariable Cox regression models will estimate the risk of work cessation associated with the intervention after controlling for risk factors for WD and other important predictors imbalanced at baseline. Discussion This program fills an important gap in arthritis health services and addresses an important and costly problem. Knowledge gained from the RCT will be useful to health care professionals, policy planners and arthritis stakeholders. Trial registration ClinicalTrials.gov NCT01852851 ; registered April 13, 2012; first participant randomized on July 6, 2013.Medicine, Department ofOccupational Science and Occupational Therapy, Department ofPhysical Therapy, Department ofPopulation and Public Health (SPPH), School ofRheumatology, Division ofNon UBCMedicine, Faculty ofReviewedFacult