39 research outputs found
Are environmental characteristics in the municipal eldercare, more closely associated with frequent short sick leave spells among employees than with total sick leave: a cross-sectional study
Background: It has been suggested that frequent-, short-term sick leave is associated with work environment
factors, whereas long-term sick leave is associated mainly with health factors. However, studies of the hypothesis of
an association between a poor working environment and frequent short spells of sick leave are few and results are
inconsistent. Therefore, we aimed to explore associations between self-reported psychosocial work factors and
workplace-registered frequency and length of sick leave in the eldercare sector.
Methods: Employees from the municipal eldercare in Aarhus (N = 2,534) were included. In 2005, they responded to
a work environment questionnaire. Sick leave records from 2005 were dichotomised into total sick leave days (0–14
and above 14 days) and into spell patterns (0–2 short, 3–9 short, and mixed spells and 1–3 long spells). Logistic
regression models were used to analyse associations; adjusted for age, gender, occupation, and number of spells or
sick leave length.
Results: The response rate was 76%; 96% of the respondents were women. Unfavourable mean scores in work
pace, demands for hiding emotions, poor quality of leadership and bullying were best indicated by more than 14
sick leave days compared with 0–14 sick leave days. For work pace, the best indicator was a long-term sick leave
pattern compared with a non-frequent short-term pattern. A frequent short-term sick leave pattern was a better
indicator of emotional demands (1.62; 95% CI: 1.1-2.5) and role conflict (1.50; 95% CI: 1.2-1.9) than a short-term
non-frequent pattern.
Age (= 40 years) statistically significantly modified the association between the 1–3 long-term sick leave
spell pattern and commitment to the workplace compared with the 3–9 frequent short-term pattern.
Conclusions: Total sick leave length and a long-term sick leave spell pattern were just as good or even better
indicators of unfavourable work factor scores than a frequent short-term sick leave pattern. Scores in commitment
to the workplace and quality of leadership varied with sick leave pattern and age. Thus, different sick leave
measures seem to be associated with different work environment factors. Further studies on these associations may
inform interventions to improve occupational health care
Rationale, design and methods of the Study of Work and Pain (SWAP): a cluster randomised controlled trial testing the addition of a vocational advice service to best current primary care for patients with musculoskeletal pain (ISRCTN 52269669)
Background
Musculoskeletal pain is a major contributor to short and long term work absence. Patients
seek care from their general practitioner (GP) and yet GPs often feel ill-equipped to deal with
work issues. Providing a vocational case management service in primary care, to support
patients with musculoskeletal problems to remain at or return to work, is one potential
solution but requires robust evaluation to test clinical and cost-effectiveness.
Methods/Design
This protocol describes a cluster randomised controlled trial, with linked qualitative
interviews, to investigate the effect of introducing a vocational advice service into general
practice, to provide a structured approach to managing work related issues in primary care
patients with musculoskeletal pain who are absent from work or struggling to remain in work.
General practices (n = 6) will be randomised to offer best current care or best current care
plus a vocational advice service. Adults of working age who are absent from or struggling to
remain in work due to a musculoskeletal pain problem will be invited to participate and 330
participants will be recruited. Data collection will be through patient completed
questionnaires at baseline, 4 and 12 months. The primary outcome is self-reported work
absence at 4 months. Incremental cost-utility analysis will be undertaken to calculate the cost
per additional QALY gained and incremental net benefits. A linked interview study will
explore the experiences of the vocational advice service from the perspectives of GPs, nurse
practitioners (NPs), patients and vocational advisors.
Discussion
This paper presents the rationale, design, and methods of the Study of Work And Pain
(SWAP) trial. The results of this trial will provide evidence to inform primary care practice
and guide the development of services to provide support for musculoskeletal pain patients
with work-related issues.
Trial registration
Current Controlled Trials ISRCTN52269669
Dusty Planetary Systems
Extensive photometric stellar surveys show that many main sequence stars show
emission at infrared and longer wavelengths that is in excess of the stellar
photosphere; this emission is thought to arise from circumstellar dust. The
presence of dust disks is confirmed by spatially resolved imaging at infrared
to millimeter wavelengths (tracing the dust thermal emission), and at optical
to near infrared wavelengths (tracing the dust scattered light). Because the
expected lifetime of these dust particles is much shorter than the age of the
stars (>10 Myr), it is inferred that this solid material not primordial, i.e.
the remaining from the placental cloud of gas and dust where the star was born,
but instead is replenished by dust-producing planetesimals. These planetesimals
are analogous to the asteroids, comets and Kuiper Belt objects (KBOs) in our
Solar system that produce the interplanetary dust that gives rise to the
zodiacal light (tracing the inner component of the Solar system debris disk).
The presence of these "debris disks" around stars with a wide range of masses,
luminosities, and metallicities, with and without binary companions, is
evidence that planetesimal formation is a robust process that can take place
under a wide range of conditions. This chapter is divided in two parts. Part I
discusses how the study of the Solar system debris disk and the study of debris
disks around other stars can help us learn about the formation, evolution and
diversity of planetary systems by shedding light on the frequency and timing of
planetesimal formation, the location and physical properties of the
planetesimals, the presence of long-period planets, and the dynamical and
collisional evolution of the system. Part II reviews the physical processes
that affect dust particles in the gas-free environment of a debris disk and
their effect on the dust particle size and spatial distribution.Comment: 68 pages, 25 figures. To be published in "Solar and Planetary
Systems" (P. Kalas and L. French, Eds.), Volume 3 of the series "Planets,
Stars and Stellar Systems" (T.D. Oswalt, Editor-in-chief), Springer 201
Epithelial to mesenchymal transition and breast cancer
Epithelial-mesenchymal plasticity in breast carcinoma encompasses the phenotypic spectrum whereby epithelial carcinoma cells within a primary tumor acquire mesenchymal features and re-epithelialize to form a cohesive secondary mass at a metastatic site. Such plasticity has implications in progression of breast carcinoma to metastasis, and will likely influence response to therapy. The transcriptional and epigenetic regulation of molecular and cellular processes that underlie breast cancer and result in characteristic changes in cell behavior can be monitored using an increasing array of marker proteins. Amongst these markers exists the potential for emergent prognostic, predictive and therapeutic targeting
Bypassing cellular EGF receptor dependence through epithelial-to-mesenchymal-like transitions
Over 90% of all cancers are carcinomas, malignancies derived from cells of epithelial origin. As carcinomas progress, these tumors may lose epithelial morphology and acquire mesenchymal characteristics which contribute to metastatic potential. An epithelial-to-mesenchymal transition (EMT) similar to the process critical for embryonic development is thought to be an important mechanism for promoting cancer invasion and metastasis. Epithelial-to-mesenchymal transitions have been induced in vitro by transient or unregulated activation of receptor tyrosine kinase signaling pathways, oncogene signaling and disruption of homotypic cell adhesion. These cellular models attempt to mimic the complexity of human carcinomas which respond to autocrine and paracrine signals from both the tumor and its microenvironment. Activation of the epidermal growth factor receptor (EGFR) has been implicated in the neoplastic transformation of solid tumors and overexpression of EGFR has been shown to correlate with poor survival. Notably, epithelial tumor cells have been shown to be significantly more sensitive to EGFR inhibitors than tumor cells which have undergone an EMT-like transition and acquired mesenchymal characteristics, including non-small cell lung (NSCLC), head and neck (HN), bladder, colorectal, pancreas and breast carcinomas. EGFR blockade has also been shown to inhibit cellular migration, suggesting a role for EGFR inhibitors in the control of metastasis. The interaction between EGFR and the multiple signaling nodes which regulate EMT suggest that the combination of an EGFR inhibitor and other molecular targeted agents may offer a novel approach to controlling metastasis