Omgaan met gezondheidsrisico's op de werkvloer: Effectiviteit van beïnvloeding tot veiliger werken

Samenvatting Over de uitvoering van arbeidsomstandighedenbeleid in de dagelijkse praktijk is relatief weinig bekend. Om deze reden is onderzocht hoe uitvoerend en leidinggevend personeel van twee in Nederland gevestigde bedrijven op de werkvloer omgaan met gezondheidsrisico’s. Allereerst is gebleken dat leidinggevenden niet alleen meer belang hechten aan veilige en gezonde arbeidsomstandigheden dan uitvoerend personeel, maar dat zij zich hiervoor ook meer inspannen. Ten tweede is aangetoond dat medewerkers de manier waarop zij proberen om anderen meer rekening te laten houden met veiligheid en gezondheid, afstemmen op het vertrouwen dat zij in hun doelwit hebben. Ze zijn geneigd om te dwingen als ze hier geen vertrouwen in hebben; uit te leggen bij gedeeltelijk vertrouwen (dat wil zeggen wanneer ze menen dat hun doelwit hiertoe wel bereid, maar niet in staat zijn) en te overleggen bij volledig vertrouwen. Ten derde is aangetoond dat de effectiviteit van deze drie strategieën afhangt van de mate waarin ze aansluiten bij het zelfbeeld van de medewerker die het doelwit is van de beïnvloedingspoging. In de Nederlandse verhoudingen wordt echter een overleggende of uitleggende strategie geprefereerd, ook wanneer een dwingende benadering de voorkeur heeft. Daarom moeten met name in Nederland culturele en structurele belemmeringen worden weggenomen tegen het hard aanpakken van bedrijven die niet van zins zijn om te werken aan het verbeteren van de arbeidsomstandigheden

Design and Fabrication of Cell-laden Gelatin Methacrylated Hydrogel Scaffold for Improving Biotransportation

One of the main goals of Tissue Engineering (TE), which has been developed rapidly over the recent years, is to re-create organs or tissues in vitro or in vivo with mimicked the anatomy and functions of body systems. Nowadays, replacing damaged tissues or organs has been a main focus in this field for addressing a significant shortage of donor tissues. Vascularisation plays a crucial role in supplying cells and tissue with essential oxygen and nutrients and removing waste products from the engineered tissue constructs. Any issue in nutrient perfusion and mass transport could significantly restrict construct development to dimensions smaller than clinically useful size, thus limiting the ability for in vivo integration. The main objectives of this study are to develop a novel framework for computational design using topology optimisation and microfabrication of 3D scaffolds using gelatin-based hydrogels (GelMa), allowing artificial vascularisation in vitro for testing if the framework is valid through the investigation into cellular viability inside the construct. In this thesis, computational models were first generated to simulate oxygen transport through solving the diffusion equation. The diffusion models are then used to optimise scaffold topology. By means of microfabrication technologies, hydrogel-based constructs were fabricated to prototype the sophisticated scaffolds. Cellular viability study was also performed to validate computational simulations and design. The results showed a higher cellular survival rate in optimally patterned constructs than the control. In summary, the work presented here is not only technically simple and cost-effective, but also establishes an effective approach to the design and fabrication of a vascularised biodegradable and scaffold-free constructs. The proposed methodology will be of considerable implication for engineering bulk tissue constructs which require sufficient ongoing vascularization in the future

Adaptability and learning Intraprofessional collaboration of residents during the COVID-19 pandemic

CONTEXT: The COVID-19 pandemic created a worldwide public health emergency, in which hospitals created new COVID departments and doctors from different disciplines had to work together. In the Netherlands, a large proportion of doctors in these departments were residents. With knowledge of the disease developing only gradually, the influx of COVID-19 patients called for adaptability, innovative work behavior, and intraprofessional collaboration (intraPC) between residents and between residents and medical specialists. RESEARCH GOAL: This study investigates how the delivery of COVID-19 care in hospital settings altered the way residents develop their sense of adaptability and intraPC during their training. METHODS: Sixteen semi-structured interviews were conducted with residents and medical specialists from various disciplines who worked at a COVID department or Intensive Care Unit (ICU) during the COVID pandemic in the Netherlands, focusing on adaptability and intraPC learning. Transcripts were analyzed using (thematic) template analysis. RESULTS: Four themes that influenced learning during COVID care were identified: collective uncertainty, social cohesion and a sense of safety, the need for adaptive performance and intraPC learning. During the first wave, collective uncertainty about the unknown disease and the continuation of the crisis urged residents to adapt in order to take care of patients with a disease that was as yet unknown. The combination of collective uncertainty, social cohesion and a sense of safety, and the presence of different disciplines in one department promoted residents’ intraPC learning. However, intraPC learning was not always the matter of course due to the scope of the crisis and the huge numbers of new patients. CONCLUSION: Collective uncertainty affected the residents’ adaptability. The combination of collective uncertainty, social cohesion, and the presence of different disciplines in one department promoted the residents’ intraPC learning. An important facilitating factor for both adaptability and intraPC learning is a high level of social cohesion and safety. The physical and psychological proximity of supervisors is an important factor contributing to a safe learning environment. This study provides implications for practice for learning during postgraduate training in non-crisis settings. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12909-022-03868-9

Risk factors for ulnar nerve compression at the elbow: a case control study

Background. Ulnar nerve compression at the elbow is frequently encountered as the second most common compression neuropathy in the arm. As dexterity may be severely affected, the disease entity can seriously interfere with daily life and work. However, epidemiological research considering the risk factors is rarely performed

Nested case-control study of occupational chemical exposures and prostate cancer in aerospace and radiation workers

Background To date, little is known about the potential contributions of occupational exposure to chemicals to the etiology of prostate cancer. Previous studies examining associations suffered from limitations including the reliance on mortality data and inadequate exposure assessment. Methods We conducted a nested case-control study of 362 cases and 1,805 matched controls to examine the association between occupational chemical exposures and prostate cancer incidence. Workers were employed between 1950 and 1992 at a nuclear energy and rocket engine-testing facility in Southern California. We obtained cancer-incidence data from the California Cancer Registry and seven other state cancer registries. Data from company records were used to construct a job exposure matrix (JEM) for occupational exposures to hydrazine, trichloroethylene (TCE), polycyclic aromatic hydrocarbons (PAHs), benzene and mineral oil. Associations between chemical exposures and prostate cancer incidence were assessed in conditional logistic regression models. Results With adjustment for occupational confounders, including socioeconomic status, occupational physical activity, and exposure to the other chemicals evaluated, the odds ratio for low/moderate TCE exposure was 1.3; 95%CI = 0.8 to 2.1, and for high TCE exposure was 2.1; 95%CI = 1.2 to 3.9. Furthermore, we noted a positive trend between increasing levels of TCE exposure and prostate cancer ( P -value for trend = 0.02). Conclusion Our results suggest that high levels of TCE exposure are associated with prostate cancer among workers in our study population. Am. J. Ind. Med. 50:383–390, 2007. © 2007 Wiley-Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/56006/1/20458_ftp.pd

“My Lung Disease Won’t Go Away, it’s There to Stay”: Profiles of Adaptation to Functional Limitations in Workers with Asthma and COPD

Purpose Earlier research has shown that adaptation (i.e., the way in which employees cope with limitations resulting from their disease) is associated with sick leave. Our aim was to investigate signs of adequate or inadequate adaptation in employees with asthma and COPD. Methods A Q-methodological study was carried out among 34 workers with asthma or COPD. Results Four adaptation profiles were distinguished: the eager, the adjusted, the cautious, and the worried workers. The adaptation profiles provide insight into the different ways in which workers with asthma and COPD cope with their illness at work. Conclusions The adaptation profiles serve as a starting point for the design of appropriate (occupational) care. The eager workers experience little difficulties at work; the cautious workers may need assistance in learning how to accept their disease; the worried workers need reassurance, and may need reactivation; the adjusted workers deserve extra attention, and, when necessary, advice on how to live with their asthma or COPD

Striking increase in incidence of prostate cancer in men aged < 60 years without improvement in prognosis

Increased awareness and improved diagnostic techniques have led to earlier diagnosis of prostate cancer and increased detection of subclinical cases, resulting in improved prognosis. We postulated that the considerable increase in incidence under age 60 is not attributable only to increased detection. To test this hypothesis, we studied incidence, mortality and relative survival among middle-aged patients diagnosed in south-east Netherlands and East Anglia (UK) between 1971 and 1994. Prostate-specific antigen (PSA) testing did not occur before 1990. Between 1971 and 1989, the age-standardized incidence at ages40–59 increased from 8.8 to 12.5 per 105 in The Netherlands and from 7.0 to 11.6 per 105 in East Anglia.Five-year relative survival did not improve in East Anglia and even declined in south-east Netherlands from 65% [95% confidence interval (CI) 47–83) in 1975–79 to 48% (CI 34–62) in 1985–89. Mortality due to prostate cancer among men aged 45–64 years increased by 50% in south-east Netherlands and by 61% in East Anglia between 1971 and 1989, but decreased slightly in the 1990s. Because other factors adversely influencing the prognosis are unlikely, our results indicate an increase in the incidence of fatal prostate cancer among younger men in the era preceding PSA testing. © 1999 Cancer Research Campaig

Modelling the Dynamics of Feral Alfalfa Populations and Its Management Implications

BACKGROUND: Feral populations of cultivated crops can pose challenges to novel trait confinement within agricultural landscapes. Simulation models can be helpful in investigating the underlying dynamics of feral populations and determining suitable management options. METHODOLOGY/PRINCIPAL FINDINGS: We developed a stage-structured matrix population model for roadside feral alfalfa populations occurring in southern Manitoba, Canada. The model accounted for the existence of density-dependence and recruitment subsidy in feral populations. We used the model to investigate the long-term dynamics of feral alfalfa populations, and to evaluate the effectiveness of simulated management strategies such as herbicide application and mowing in controlling feral alfalfa. Results suggest that alfalfa populations occurring in roadside habitats can be persistent and less likely to go extinct under current roadverge management scenarios. Management attempts focused on controlling adult plants alone can be counterproductive due to the presence of density-dependent effects. Targeted herbicide application, which can achieve complete control of seedlings, rosettes and established plants, will be an effective strategy, but the seedbank population may contribute to new recruits. In regions where roadside mowing is regularly practiced, devising a timely mowing strategy (early- to mid-August for southern Manitoba), one that can totally prevent seed production, will be a feasible option for managing feral alfalfa populations. CONCLUSIONS/SIGNIFICANCE: Feral alfalfa populations can be persistent in roadside habitats. Timely mowing or regular targeted herbicide application will be effective in managing feral alfalfa populations and limit feral-population-mediated gene flow in alfalfa. However, in the context of novel trait confinement, the extent to which feral alfalfa populations need to be managed will be dictated by the tolerance levels established by specific production systems for specific traits. The modelling framework outlined in this paper could be applied to other perennial herbaceous plants with similar life-history characteristics