Empowering employees with chronic diseases: process evaluation of an intervention aimed at job retention

Purpose Employees with a chronic disease may experience work-related problems that contribute to the risk of job loss. We developed a group-based intervention programme aimed at clarifying problems, making these a subject of discussion at work, and realizing solutions. This process evaluation investigates the intervention's feasibility and the satisfaction of 64 participants in eight groups. Methods Data were collected through process evaluation forms and self-report questionnaires. Results The recruitment of participants was time-consuming. Highly educated women working in the service sector were overrepresented. The programme was administered as planned, although components were sometimes only discussed briefly, due to lack of time. Satisfaction with the overall programme among participants was high; it was perceived as effective and there were only three dropouts. In particular, the focus on feelings and thoughts about having a chronic disease was highly valued, as were the exchange of experiences and role-playing directed at more assertive communication. Conclusions A vocational rehabilitation programme aimed at job retention is feasible and is perceived to be effective. Such a programme should address psychosocial aspects of working with a chronic disease beside practical problems. The recruitment of participants is time-consuming. Cooperation with outpatient clinics is necessary in order to reach all groups of employees with a chronic disease that might benefit from job retention programmes. Trial registration: ISRCTN77240155

Across-arc geochemical variations in the Southern Volcanic Zone, Chile (34.5- 38.0°S): Constraints on Mantle Wedge and Input Compositions

Crustal assimilation (e.g. Hildreth and Moorbath, 1988) and/or subduction erosion (e.g. Stern, 1991; Kay et al., 2005) are believed to control the geochemical variations along the northern portion of the Chilean Southern Volcanic Zone. In order to evaluate these hypotheses, we present a comprehensive geochemical data set (major and trace elements and O-Sr-Nd-Hf-Pb isotopes) from Holocene primarily olivine-bearing volcanic rocks across the arc between 34.5-38.0°S, including volcanic front centers from Tinguiririca to Callaqui, the rear arc centers of Infernillo Volcanic Field, Laguna del Maule and Copahue, and extending 300 km into the backarc. We also present an equivalent data set for Chile Trench sediments outboard of this profile. The volcanic arc (including volcanic front and rear arc) samples primarily range from basalt to andesite/trachyandesite, whereas the backarc rocks are low-silica alkali basalts and trachybasalts. All samples show some characteristic subduction zone trace element enrichments and depletions, but the backarc samples show the least. Backarc basalts have higher Ce/Pb, Nb/U, Nb/Zr, and Ta/Hf, and lower Ba/Nb and Ba/La, consistent with less of a slab-derived component in the backarc and, consequently, lower degrees of mantle melting. The mantle-like δ18O in olivine and plagioclase phenocrysts (volcanic arc = 4.9-5.6 and backarc = 5.0-5.4 per mil) and lack of correlation between δ18O and indices of differentiation and other isotope ratios, argue against significant crustal assimilation. Volcanic arc and backarc samples almost completely overlap in Sr and Nd isotopic composition. High precision (double-spike) Pb isotope ratios are tightly correlated, precluding significant assimilation of older sialic crust but indicating mixing between a South Atlantic Mid Ocean-Ridge Basalt (MORB) source and a slab component derived from subducted sediments and altered oceanic crust. Hf-Nd isotope ratios define separate linear arrays for the volcanic arc and backarc, neither of which trend toward subducting sediment, possibly reflecting a primarily asthenospheric mantle array for the volcanic arc and involvement of enriched Proterozoic lithospheric mantle in the backarc. We propose a quantitative mixing model between a mixed-source, slab-derived melt and a heterogeneous mantle beneath the volcanic arc. The model is consistent with local geodynamic parameters, assuming water-saturated conditions within the slab

Effects of work ability and health promoting interventions for women with musculoskeletal symptoms: A 9-month prospective study

<p>Abstract</p> <p>Background</p> <p>Women working in the public human service sector in 'overstrained' situations run the risk of musculoskeletal symptoms and long-term sick leave. In order to maintain the level of health and work ability and strengthen the potential resources for health, it is important that employees gain greater control over decisions and actions affecting their health – a process associated with the concept of self-efficacy. The aim of this study was to describe the effects of a self-efficacy intervention and an ergonomic education intervention for women with musculoskeletal symptoms, employed in the public sector.</p> <p>Methods</p> <p>The design of the study was a 9-month prospective study describing the effects of two interventions, a comprehensive self-efficacy intervention (<it>n </it>= 21) and an ergonomic education intervention (<it>n </it>= 21). Data were obtained by a self-report questionnaire on health- and work ability-related factors at baseline, and at ten weeks and nine months follow-up. Within-group differences over time were analysed.</p> <p>Results</p> <p>Over the time period studied there were small magnitudes of improvements within each group. Within the self-efficacy intervention group positive effects in perceived work ability were shown. The ergonomic education group showed increased positive beliefs about future work ability and a more frequent use of pain coping strategies.</p> <p>Conclusion</p> <p>Both interventions showed positive effects on women with musculoskeletal symptoms, but in different ways. Future research in this area should tailor interventions to participants' motivation and readiness to change.</p

Geochemical variations in the Central Southern Volcanic Zone, Chile (38-43°S): The role of fluids in generating arc magmas

We present new Sr-Nd-Pb-Hf-O isotope data from the volcanic arc (VA, volcanic front and rear arc) in Chile and the backarc (BA) in Argentina of the Central Southern Volcanic Zone in Chile (CSVZ; 38-43°S). Compared to the Transitional (T) SVZ (34.5-38°S; Jacques et al., 2013), the CSVZ VA has erupted greater volumes over shorter time intervals (Völker et al., 2011) and produced more tholeiitic melts. Although the CSVZ VA monogenetic cones are similar to the TSVZ VA samples, the CSVZ VA stratovolcanoes have higher ratios of highly fluid-mobile to less fluid-mobile trace elements (e.g. U/Th, Pb/Ce, Ba/Nb) and lower more- to less-incompatible fluid-immobile element ratios (e.g. La/Yb, La/Sm, Th/Yb, Nb/Yb), consistent with an overall higher fluid flux and greater degree of flux melting beneath the CSVZ stratovolcanoes compared to the CSVZ monogenetic centers and the TSVZ VA. The CSVZ monogenetic centers overlap the TSVZ in Sr and Nd isotopes, but the stratovolcanoes are shifted to higher Sr and/or Nd isotope ratios. The Pb isotopic composition of the CSVZ overlaps the TSVZ, which is clearly dominated by the composition of the trench sediments, but the CSVZ monogenetic samples extend to less radiogenic Pb isotope ratios. δ18Omelt from the CSVZ stratovolcano samples are below the MORB range, whereas the CSVZ monogenetic and the TSVZ samples fall within and slightly above the MORB range. The Nd and Hf isotopic ratios of the CSVZ VA extend to more radiogenic compositions than found in the TSVZ VA, indicating a greater contribution from a more depleted source. These correlations are interpreted to reflect derivation of fluids from hydrothermally altered oceanic crust and/or serpentinized upper mantle of the subducting plate. CSVZ BA basalts largely overlap TSVZ BA basalts, displaying less or no subduction influence compared to the VA, but some CSVZ BA basalts tap more enriched mantle, possibly subcontinental lithosphere, with distinctively lower Nd and Hf and elevated 207Pb/204Pb and 208Pb/204Pb isotope ratios