A participatory physical and psychosocial intervention for balancing the demands and resources among industrial workers (PIPPI): study protocol of a cluster-randomized controlled trial

Background: Need for recovery and work ability are strongly associated with high employee turnover, well-being and sickness absence. However, scientific knowledge on effective interventions to improve work ability and decrease need for recovery is scarce. Thus, the present study aims to describe the background, design and protocol of a cluster randomized controlled trial evaluating the effectiveness of an intervention to reduce need for recovery and improve work ability among industrial workers. Methods/Design: A two-year cluster randomized controlled design will be utilized, in which controls will also receive the intervention in year two. More than 400 workers from three companies in Denmark will be aimed to be cluster randomized into intervention and control groups with at least 200 workers (at least 9 work teams) in each group. An organizational resources audit and subsequent action planning workshop will be carried out to map the existing resources and act upon initiatives not functioning as intended. Workshops will be conducted to train leaders and health and safety representatives in supporting and facilitating the intervention activities. Group and individual level participatory visual mapping sessions will be carried out allowing team members to discuss current physical and psychosocial work demands and resources, and develop action plans to minimize strain and if possible, optimize the resources. At all levels, the intervention will be integrated into the existing organization of work schedules. An extensive process and effect evaluation on need for recovery and work ability will be carried out via questionnaires, observations, interviews and organizational data assessed at several time points throughout the intervention period. Discussion: This study primarily aims to develop, implement and evaluate an intervention based on the abovementioned features which may improve the work environment, available resources and health of industrial workers, and hence their need for recovery and work ability

Reliability and validity of the Thai version of the PHQ-9

<p>Abstract</p> <p>Background</p> <p>Most depression screening tools in Thailand are lengthy. The long process makes them impractical for routine use in primary care. This study aims to examine the reliability and validity of a Thai version Patient Health Questionnaire (PHQ-9) as a screening tool for major depression in primary care patients.</p> <p>Methods</p> <p>The English language PHQ-9 was translated into Thai. The process involved back-translation, cross-cultural adaptation, field testing of the pre-final version, as well as final adjustments. The PHQ-9 was then administered among 1,000 patients in family practice clinic. Of these 1,000 patients, 300 were further assessed by the Thai version of the Mini International Neuropsychiatric Interview (MINI) and the Thai version of the Hamilton Rating Scale for Depression (HAM-D). These tools served as gold-standards for diagnosing depression and for assessing symptom severity, respectively. In the assessment, reliability and validity analyses, and receiver operating characteristic curve analysis were performed.</p> <p>Results</p> <p>Complete data were obtained from 924 participants and 279 interviewed respondents. The mean age of the participants was 45.0 years (SD = 14.3) and 73.7% of them were females. The mean PHQ-9 score was 4.93 (SD = 3.75). The Thai version of the PHQ-9 had satisfactory internal consistency (Cronbach's alpha = 0.79) and showed moderate convergent validity with the HAM-D (r = 0.56; P < 0.001). The categorical algorithm of the PHQ-9 had low sensitivity (0.53) but very high specificity (0.98) and positive likelihood ratio (27.37). Used as a continuous measure, the optimal cut-off score of PHQ-9 ≥ 9 revealed a sensitivity of 0.84, specificity of 0.77, positive predictive value (PPV) of 0.21, negative predictive value (NPV) of 0.99, and positive likelihood ratio of 3.71. The area under the curve (AUC) in this study was 0.89 (SD = 0.05, 95% CI 0.85 to 0.92).</p> <p>Conclusion</p> <p>The Thai version of the PHQ-9 has acceptable psychometric properties for screening for major depression in general practice with a recommended cut-off score of nine or greater.</p

Wellbeing and resilience:Mechanisms of transmission of health and risk in parents with complex mental health problems and their offspring—The WARM Study

The WARM study is a longitudinal cohort study following infants of mothers with schizophrenia, bipolar disorder, depression and control from pregnancy to infant 1 year of age. Background: Children of parents diagnosed with complex mental health problems including schizophrenia, bipolar disorder and depression, are at increased risk of developing mental health problems compared to the general population. Little is known regarding the early developmental trajectories of infants who are at ultra-high risk and in particular the balance of risk and protective factors expressed in the quality of early caregiver-interaction. Methods/Design: We are establishing a cohort of pregnant women with a lifetime diagnosis of schizophrenia, bipolar disorder, major depressive disorder and a non-psychiatric control group. Factors in the parents, the infant and the social environment will be evaluated at 1, 4, 16 and 52 weeks in terms of evolution of very early indicators of developmental risk and resilience focusing on three possible environmental transmission mechanisms: stress, maternal caregiver representation, and caregiver-infant interaction. Discussion: The study will provide data on very early risk developmental status and associated psychosocial risk factors, which will be important for developing targeted preventive interventions for infants of parents with severe mental disorder

Maternal fat intake during pregnancy and offspring metabolic health – a prospective study with 20 years of follow-up

Maternal fat intake during pregnancy in relation to offspring metabolic outcomes has been studied primarily in animal models, yet little is known about the association in humans. The aim of this study was to examine the association of total and subtype of fat consumption in pregnancy with anthropometric measures and biomarkers of adiposity and glucose metabolism in the offspring. Methods: A source population was 965 Danish pregnant women recruited in 1988e1989 with offspring follow-up at 20 years. Information on fat intake was collected in the 30th week of gestation, and we subdivided fat according to saturated (SFA), monounsaturated (MUFA), and polyunsaturated (PUFA) fat. Offspring body mass index (BMI) and waist circumference (WC) were recorded at follow-up (n ¼ 670678), and biomarkers were quantified in a subset (n ¼ 443) of participants. Multivariable linear and log-binomial regression were used to calculate effect estimates and 95% CI for a 1:1%energy substitution of carbohydrates for fat. Results: The mean (standard deviation) BMI was 22.1 (3.3) and 22.8 (2.9) kg/m2 in female and male offspring, respectively. The median (10th to 90th percentile) of maternal fat intake was 31% of energy [23,39]. We found no overall associations for maternal fat intake with female offspring anthropometry. However, for male offspring higher intake of MUFA during pregnancy was associated with higher insulin levels at 20 years (Q4 vs. Q1: %D: 37, 95% CI: 1, 86) accompanied by a non-significant 3.6 (95% CI: 1.1, 8.2) cm increase in WC. High maternal total fat intake (>¼35% energy) was also associated with higher BMI (0.9, 95% CI: 0.2, 1.6) and WC (4.0, 95% CI: 1.6, 2.3) among male offspring. Conclusions: A high fat diet during pregnancy may increase adiposity in adult male offspring. We surmise that maternal MUFA intake during this time included both MUFA and trans fat misclassified as MUFA, and that the associations observed may be more reflective of the latter exposure

Temporal trends of lipophilic persistent organic pollutants in serum from Danish nulliparous pregnant women 2011–2013

© 2017, Springer-Verlag Berlin Heidelberg. The use of the lipophilic persistent organic pollutants (POPs) including polychlorinated biphenyls (PCBs) and several organochlorine pesticides (OCPs) has been prohibited for more than 30 years. In this study, we present the temporal trends of the lipophilic POP serum concentrations in Danish nulliparous pregnant women between 2011 and 2013. We randomly selected 197 pregnant women (gestational age 11–13) from the Aarhus Birth Cohort. The concentrations of the lipophilic POPs in the serum samples were analyzed using gas chromatography. The concentrations were corrected for total serum lipids. The statistical analysis was performed by regression analysis with adjustment for age, BMI, gestational age at blood draw, and smoking status. The serum concentrations of PCB 118, 138, 153, 156, 170, 180, 187, and hexachlorobenzen, trans-nonachlor, β-hexachlorocyclohexane (β-HCH), and p,p’-dichlorodiphenyldichloroethylene were lower in 2013 than in 2011. However, the oxychlordane concentration was lowest in 2011. The serum levels of most lipophilic POPs followed downward trends during the study period, which was expected, as these compounds has been banned for many years. The upward trend of oxychlordane was unexpected and presumably a chance finding