Work ability meetings-a survey of Finnish occupational physicians

Background Work ability meetings (WAMs) are planned discussions between an employee, a manager and an occupational physician (OP) to support work ability and return to work (RTW). During the last decade, WAMs become a popular intervention in Finnish occupational healthcare, although research on their content is lacking. Aims To describe the practice of WAMs in Finland. Methods We sent an internet survey by e-mail to members of the Finnish Society of Occupational Health Physicians in August 2014. We asked them to describe the last WAM they had attended, the employee the meeting concerned, the reason why it was convened, the content of the meeting and the action plan developed. Results A total of 303 of 1304 OPs responded (24%) to the survey. The meetings were most often arranged for employees in manual or clerical work (71%). There were several overlapping reasons for convening a WAM, including a worker's reduced work ability (57%), functional ability (42%) or long-term sickness absence (38%). The meetings consisted of RTW planning, clarification of the situation and a dialogue between the three parties. In half of the cases, the action plans dealt with modifications of work tasks. A third of cases were forwarded to vocational rehabilitation, while permanent disability pension was considered in 6% of cases. Conclusions The focus of WAMs was on workplace adjustments to support workers to remain at work. The WAMs dealt mostly with early interventions for RTW: work modifications, adjustments and vocational rehabilitation.Peer reviewe

Pharmacological interventions for sleepiness and sleep disturbances caused by shift work

BACKGROUND: Shift work results in sleep-wake disturbances, which cause sleepiness during night shifts and reduce sleep length and quality in daytime sleep after the night shift. In its serious form it is also called shift work sleep disorder. Various pharmacological products are used to ameliorate symptoms of sleepiness or poor sleep length and quality. OBJECTIVES: To evaluate the effects of pharmacological interventions to reduce sleepiness or to improve alertness at work and decrease sleep disturbances whilst of work, or both, in workers undertaking shift work. METHODS: Search methods: We searched CENTRAL, MEDLINE, EMBASE, PubMed and PsycINFO up to 20 September 2013 and ClinicalTrials.gov up to July 2013. We also screened reference lists of included trials and relevant reviews. Selection criteria: We included all eligible randomised controlled trials (RCTs), including cross-over RCTs, of pharmacological products among workers who were engaged in shift work (including night shifts) in their present jobs and who may or may not have had sleep problems. Primary outcomes were sleep length and sleep quality while of work, alertness and sleepiness, or fatigue at work. Data collection and analysis: Two authors independently selected studies, extracted data and assessed risk of bias in included trials. We performed meta-analyses where appropriate. MAIN RESULTS: We included 15 randomised placebo-controlled trials with 718 participants. Nine trials evaluated the effect of melatonin and two the effect of hypnotics for improving sleep problems. One trial assessed the effect of modafinil, two of armodafinil and one examined cafeine plus naps to decrease sleepiness or to increase alertness

Does the autecology of core species reflect the synecology of functional groups during the assembly of vegetation in abandoned extracted peatlands?

The combined autecology of individual species is expected to reflect the synecology of their respective functional groups and vice versa, but this assumption has been rarely assessed. We estimated this similarity in limiting ecological filters using vegetation survey data from 64 abandoned extracted peatlands in Estonia, which form a 50-year chronosequence of secondary succession. Partial overlap was found between filters predicting the occurrence of individual core species and richness in their respective functional groups. These overlapping filters were microtopographical form (flats, margins, ditches), time since abandonment, and various properties of peat. At the functional group level, time since abandonment and habitat properties showed clear interactions with microform type. Bog species and acidophilous bilocals successfully established on flats and ditch margins when residual peat was acidic and poorly decayed, while species of fens and mineral soils preferentially established in ditches of large extraction fields, where residual peat had higher pH and higher mineral content. We also detected some effects of landscape-level (patch area and forest neighbourhood) and regional filters (continentality); however, their limiting role was inconsistent. Many ecological filters also were shared between functional groups at the species level, but the optimal levels of these filters differed between groups. We conclude that even in species-poor habitats, both the autecology of individual species and the synecology of functional groups should be considered during habitat restoration. In peatland restoration, the following management strategies are advised to direct a faster and more successful trajectory: controlling the depth of peat extraction, partial filling of ditches, introducing plant propagules and managing mineral dust pollution

Hedging against biodiversity loss : forest herbs’ performance in hedgerows across temperate Europe

Questions: How do contrasting environmental conditions among forests and hedgerows affect the vegetative and reproductive performance of understorey forest herbs in both habitats? Can hedgerows support reproductive source populations of forest herbs, thus potentially allowing progressive dispersal of successive generations along these linear habitats? Location: Hedgerows and deciduous forest patches in agricultural landscapes across the European temperate biome. Methods: First, we assessed differences in environmental conditions among forests and hedgerows. Next, we quantified plant performance based on a set of functional life‐history traits for four forest herbs (Anemone nemorosa, Ficaria verna, Geum urbanum, Poa nemoralis) with contrasting flowering phenology and colonisation capacity in paired combinations of forests and hedgerows, and compared these traits among both habitats. Finally, we assessed relationships between plant performance and environmental conditions in both habitats. Results: All study species showed a higher above‐ground biomass in hedgerows than in forests. For Poa nemoralis and Geum urbanum, we also found a higher reproductive output in hedgerows, which was mainly correlated to the higher sub‐canopy temperatures therein. The “ancient forest herb” Anemone nemorosa, however, appeared to have a lower reproductive output in hedgerows than in forests, while for Ficaria verna no reproductive differences were found between the two habitats. Conclusions: This is the first study on such a broad geographical scale to provide evidence of reproductive source populations of forest herbs in hedgerows. Our findings provide key information on strategies by which forest plants grow, reproduce and disperse in hedgerow environments, which is imperative to better understand the dispersal corridor function of these wooded linear structures. Finally, we highlight the urgent need to develop guidelines for preserving, managing and establishing hedgerows in intensive agricultural landscapes, given their potential to contribute to the long‐term conservation and migration of forest herbs in the face of global environmental change

Dissemination of clinical practice guidelines: A content analysis of patient versions

Background. Clinical practice guidelines (CPGs) are typically written for health care professionals but are meant to assist patients with health care decisions. A number of guideline producers have started to develop patient versions of CPGs to reach this audience. Objective. To describe the content and purpose of patient versions of CPGs and compare with patient and public views of CPGs. Design. A descriptive qualitative study with a directed content analysis of a sample of patient versions of CPGs published and freely available in English from 2012 to 2014. Results. We included 34 patient versions of CPGs from 17 guideline producers. Over half of the patient versions were in dedicated patient sections of national/professional agency websites. There was essentially no information about how to manage care in the health care system. The most common purpose was to equip people with information about disease, tests or treatments, and recommendations, but few provided quantitative data about benefits and harms of treatments. Information about beliefs, values and preferences, accessibility, costs, or feasibility of the interventions was rarely addressed. Few provided personal stories or scenarios to personalize the information. Three versions described the strength of the recommendation or the level of evidence. Limitations. Our search for key institutions that produce patient versions of guidelines was comprehensive, but we only included English and freely available versions. Future work will include other languages. Conclusions. This review describes the current landscape of patient versions of CPGs and suggests that these versions may not address the needs of their targeted audience. Research is needed about how to personalize information, provide information about factors contributing to the recommendations, and provide access

The influence of psychosocial factors at work and life style on health and work ability among professional workers

OBJECTIVES: The purpose of this article is to explore the associations of psychosocial factors at work, life style, and stressful life events on health and work ability among white-collar workers. METHODS: A cross-sectional survey was conducted among workers in commercial services (n = 1141). The main outcome variables were work ability, measured by the work ability index (WAI), and mental and physical health, measured by the Short-Form Health Survey (SF-12). Individual characteristics, psychosocial factors at work, stressful life events, and lifestyle factors were determined by a questionnaire. Maximum oxygen uptake, weight, height, and biceps strength were measured during a physical examination. RESULTS: Work ability of white-collar workers in commercial services industry was strongly associated with psychosocial factors at work such as teamwork, stress handling, and self-development and, to a lesser extent, with stressful life events, lack of physical activity, and obesity. Determinants of mental health were very similar to those of work ability, whereas physical health was influenced primarily by life style factors. With respect to work ability, the influence of unhealthy life style seems more important for older workers, than for their younger colleagues. CONCLUSION: Among white-collar workers mental and physical health were of equal importance to work ability, but only mental health and work ability shared the same determinants. The strong associations between psychosocial factors at work and mental health and work ability suggest that in this study population health promotion should address working conditions rather than individual life style factors

Sensitivity to habitat fragmentation across European landscapes in three temperate forest herbs

Context Evidence for effects of habitat loss and fragmentation on the viability of temperate forest herb populations in agricultural landscapes is so far based on population genetic studies of single species in single landscapes. However, forest herbs differ in their life histories, and landscapes have different environments, structures and histories, making generalizations difficult. Objectives We compare the response of three slow-colonizing forest herbs to habitat loss and fragmentation and set this in relation to differences in life-history traits, in particular their mating system and associated pollinators. Methods We analysed the herbs' landscape-scale population genetic structure based on microsatellite markers from replicate forest fragments across seven European agricultural landscapes. Results All species responded to reductions in population size with a decrease in allelic richness and an increase in genetic differentiation among populations. Genetic differentiation also increased with enhanced spatial isolation. In addition, each species showed unique responses. Heterozygosity in the self-compatible Oxalis acetosella was reduced in smaller populations. The genetic diversity of Anemone nemorosa, whose main pollinators are less mobile, decreased with increasing spatial isolation, but not that of the bumblebee-pollinated Polygonatum multiflorum. Conclusions Our study indicates that habitat loss and fragmentation compromise the long-term viability of slow-colonizing forest herbs despite their ability to persist for many decades by clonal propagation. The distinct responses of the three species studied within the same landscapes confirm the need of multi-species approaches. The mobility of associated pollinators should be considered an important determinant of forest herbs' sensitivity to habitat loss and fragmentation

The European Forest Plant Species List (EuForPlant): Concept and applications

Question When evaluating forests in terms of their biodiversity, distinctiveness and naturalness, the affinity of the constituent species to forests is a crucial parameter. Here we ask to what extent are vascular plant species associated with forests, and does species' affinity to forests vary between European regions? Location Temperate and boreal forest biome of Northwestern and Central Europe. Methods We compiled EuForPlant, a new extensive list of forest vascular plant species in 24 regions spread across 13 European countries using vegetation databases and expert knowledge. Species were region-specifically classified into four categories reflecting the degree of their affinity to forest habitats: 1.1, species of forest interiors; 1.2, species of forest edges and forest openings; 2.1, species that can be found in forest as well as open vegetation; and 2.2, species that can be found partly in forest, but mainly in open vegetation. An additional "O" category was distinguished, covering species typical for non-forest vegetation. Results EuForPlant comprises 1,726 species, including 1,437 herb-layer species, 159 shrubs, 107 trees, 19 lianas and 4 epiphytic parasites. Across regions, generalist forest species (with 450 and 777 species classified as 2.1 and 2.2, respectively) significantly outnumbered specialist forest species (with 250 and 137 species classified as 1.1 and 1.2, respectively). Even though the degree of shifting between the categories of forest affinity among regions was relatively low (on average, 17.5%), about one-third of the forest species (especially 1.2 and 2.2) swapped categories in at least one of the study regions. Conclusions The proposed list can be used widely in vegetation science and global change ecology related to forest biodiversity and community dynamics. Shifting of forest affinity among regions emphasizes the importance of a continental-scale forest plant species list with regional specificity