495 research outputs found
Strong association of physical job demands with functional limitations among active people: a population-based study in North-eastern France.: Job and functional limitations
International audiencePURPOSE: To assess the association between physical job demands (PJD) and physical/cognitive functional limitations, and the role of adverse health behaviours, obesity, and socio-demographic factors as confounders of those associations. METHODS: The sample included 3,368 active subjects aged 18-64 years, randomly selected from North-eastern France. Subjects completed a post-mailed questionnaire. PJD score was defined as the product of years of employment with the cumulative number of a wide range of high job demands. Data were analysed through the logistic regression models. RESULTS: The physical and cognitive functional limitations affected 16.9 and 28.6% of subjects, respectively. A strong relationship was found between PJD and physical functional limitation: significant odds ratios (OR) adjusted for all the factors studied 1.41 for PJD1-29, 1.72 for PJD30-99, and 2.57 for PJD >or=100 versus PJD0; and between PJD and cognitive functional limitation: OR 1.28 for PJD1-29, 1.60 for PJD30-99, and 2.00 for PJD >or=100 versus PJD0. Adverse health behaviours, obesity and job category were modest confounders of those associations. CONCLUSIONS: This study identified a wide range of job demands and individual characteristics related to physical/cognitive functional limitations. Prevention should aim at improving working conditions and adverse health behaviours
Lean Implementation Frameworks:The Challenges for SMEs
Implementation of lean manufacturing in any type of organizations can bring many benefits, such as reducing waste and improving operating efficiency. However, lean implementation is not a straightforward process. Although a number of frameworks have been presented, still many companies find it difficult to implement lean. Furthermore, most of these roadmaps are for large manufacturing companies, and not for small and medium enterprises. Unfortunately, there is not a recipe that if used can guarantee a successful implementation. Furthermore, unsuccessful implementation can have a great impact on organization's resources, but even more importantly, affect employees and their confidence in lean philosophy. In the present paper, the most prominent lean implementation frameworks will be discussed, under the prism of the needs of SMEs. The challenges for the SMEs in their lean journey are discussed
Job loss from poor health, smoking and obesity: a national prospective survey in France
Background and objectives: Health selection into unemployment may be either direct or operate by reference to health-related behaviours rather than health per se (indirect selection). Panel data are desirable to investigate selection effects, and the two types of selection processes may be concurrent. We examine jointly the roles of health and health-related behaviours as precursors of unemployment, in order to disentangle direct from indirect selection processes.
Design: The data of a multi-round nationally representative health survey in France were analysed longitudinally, based on three data collection rounds: 1992–5, 1996–8 and 2000–2. Following employees salaried in the private sector and aged 30–54 years at baseline, we explored through logistic regression the influence of non-optimal self-rated health, smoking and obesity on the risk of being found unemployed 4 years later.
Results: After adjustment for self-rated health, obesity was found to be a significant precursor of unemployment in women, and heavy smoking had that role in men. After adjustment for smoking and obesity, poor health at baseline was found to be a significant precursor of unemployment in both genders.
Conclusion: Those findings confirm the intrinsic role of poor health and of health-related behaviours as precursors of unemployment, with gender-specific patterns for the latter. Public policy prescriptions regarding employees’ protection from job insecurities should integrate appropriate accommodations of health limitations, and the personal factors underlying unfavourable work and health behaviours should be investigated, in order to thwart indirect selection phenomena.ou
The Implementation Process of a Closed Loop Marketing System in the Healthcare Industry: A Case Study Approach
Closed Loop Marketing (CLM) is a relatively new marketing information system that has received substantial attention in recent years. However, the pharmaceutical and medical device industry has been slow to adopt CLM, primarily because of the industry’s resistance to cultural and business process changes. Research is limited in the context of CLM and some issues have arisen with respect to leadership and mandatory versus volitional use of this system. Literature on other Management Information Systems (MIS) such as ERP and CRM (which face similar difficulties) reveals the need for a deeper understanding of the management of the implementation process of such systems. As CLM differs from ERP and CRM in certain respects, this research is grounded in the broader array of the implementation of strategic decisions in order to uncover the Critical Success Factors (CSFs) specific to CLM. Case study methodology is used to compare two CLM system implementations in the same medical device organization. The results delineate a chronological three-step process model that highlights the varying effects of CSFs throughout the implementation process. In addition, the research findings revealed Backing as a novel and important CSF in the context of MIS implementation. Backing consists of having efficient aggregate leadership activities and commitment driving the initiative forward across all levels of the organization. Finally, a mandatory versus volitional use environment did not seem to have a significant impact on implementation success. These findings align with previous research on both MIS implementation and strategic decisions’ implementation
Polymorphisms in the methylenetetrahydrofolate reductase (MTHFR) gene, intakes of folate and related B vitamins and colorectal cancer : a case-control study in a population with relatively low folate intake
Peer reviewedPublisher PD
Non-fatal injuries in three Central and Eastern European urban population samples: the HAPIEE study
Background: Despite high mortality from injuries and accidents, data on rates and distribution of non-fatal injuries in Central and Eastern European populations are scarce. Methods: Cross-sectional study of random population samples of 45–69-year-old men and women (n = 28 600) from Novosibirsk (Russia), Krakow (Poland) and six Czech towns, participating in the Health, Alcohol and Psychosocial factors In Eastern Europe (HAPIEE) study. Participants provided information on non-fatal injuries in the past 12 months, socio-economic characteristics, alcohol consumption and other covariates. Results: The period prevalence of non-fatal injuries in the last year among Czech, Russian and Polish men was 12.5, 9.4 and 5.3%, respectively; among women, the respective proportions were 9.9, 9.8 and 6.4%. Injury prevalence declined with age in men and increased with age in women. Higher injury prevalence was associated with being unmarried, material deprivation, higher drinking frequency and problem drinking. In the pooled data, the adjusted odds ratio (OR) for the highest versus lowest material deprivation category was 1.57 [95% confidence interval (CI) 1.38–1.79]; for problem drinking, the OR was 1.44 (95% CI 1.23–1.69). Alcohol did not mediate the link between socio-economic status and injury. Conclusion: Non-fatal injuries were associated with material deprivation, other socio-economic characteristics and with alcohol. These results not only underscore the universality of the inequality phenomenon, but also suggest that the mediating role of alcohol in social differentials in non-fatal injury remains an unresolved issue
Consanguinity and reproductive health among Arabs
Consanguineous marriages have been practiced since the early existence of modern humans. Until now consanguinity is widely practiced in several global communities with variable rates depending on religion, culture, and geography. Arab populations have a long tradition of consanguinity due to socio-cultural factors. Many Arab countries display some of the highest rates of consanguineous marriages in the world, and specifically first cousin marriages which may reach 25-30% of all marriages. In some countries like Qatar, Yemen, and UAE, consanguinity rates are increasing in the current generation. Research among Arabs and worldwide has indicated that consanguinity could have an effect on some reproductive health parameters such as postnatal mortality and rates of congenital malformations. The association of consanguinity with other reproductive health parameters, such as fertility and fetal wastage, is controversial. The main impact of consanguinity, however, is an increase in the rate of homozygotes for autosomal recessive genetic disorders. Worldwide, known dominant disorders are more numerous than known recessive disorders. However, data on genetic disorders in Arab populations as extracted from the Catalogue of Transmission Genetics in Arabs (CTGA) database indicate a relative abundance of recessive disorders in the region that is clearly associated with the practice of consanguinity
Consanguineous marriages and endemic malaria: can inbreeding increase population fitness?
<p>Abstract</p> <p>Background</p> <p>The practice of consanguineous marriages is widespread in countries with endemic malaria. In these regions, consanguinity increases the prevalence of α<sup>+</sup>-thalassemia, which is protective against malaria. However, it also causes an excessive mortality amongst the offspring due to an increase in homozygosis of recessive lethal alleles. The aim of this study was to explore the overall effects of inbreeding on the fitness of a population infested with malaria.</p> <p>Methods</p> <p>In a stochastic computer model of population growth, the sizes of inbred and outbred populations were compared. The model has been previously validated producing results for inbred populations that have agreed with analytical predictions. Survival likelihoods for different α<sup>+</sup>-thalassemia genotypes were obtained from the odds of severe forms of disease from a field study. Survivals were further estimated for different values of mortality from malaria.</p> <p>Results</p> <p>Inbreeding increases the frequency of α<sup>+</sup>-thalassemia allele and the loss of life due to homozygosis of recessive lethal alleles; both are proportional to the coefficient of inbreeding and the frequency of alleles in population. Inbreeding-mediated decrease in mortality from malaria (produced via enhanced α<sup>+</sup>-thalassemia frequency) mitigates inbreeding-related increases in fatality (produced via increased homozygosity of recessive lethals). When the death rate due to malaria is high, the net effect of inbreeding is a reduction in the overall mortality of the population.</p> <p>Conclusion</p> <p>Consanguineous marriages may increase the overall fitness of populations with endemic malaria.</p
Use of the life table to compare mortality in ethnic groups in Amsterdam, the Netherlands
High levels of postmigration HIV acquisition within nine European countries
OBJECTIVE: We aimed to estimate the proportion of post-migration HIV acquisition among HIV-positive migrants in Europe. DESIGN: To reach HIV positive migrants we designed a cross sectional study performed in HIV clinics. METHODS: The study was conducted from July 2013-July 2015 in 57 clinics (9 European countries, targeting individuals over 18 years diagnosed in the preceding 5 years and born abroad. Electronic questionnaires supplemented with clinical data were completed in any of 15 languages. Post-migration HIV acquisition was estimated through Bayesian approaches combining extensive information on migration and patients' characteristics. CD4 counts and HIV-RNA trajectories from seroconversion were estimated by bivariate linear mixed models fitted to natural history data. Post-migration acquisition risk factors were investigated with weighted logistic regression. RESULTS: Of 2009 participants, 46% were men who have sex with men (MSM) and a third originated from Sub-Saharan Africa (SSA) and Latin America & Caribbean (LAC), respectively. Median time in host countries was 8 years. Post-migration HIV acquisition was 63% (95% CI: 57%-67%); 72% among MSM, 58% and 51% in heterosexual men and women, respectively. Post-migration HIV acquisition was 71% for LAC migrants and 45% for people from SSA. Factors associated with post-migration HIV acquisition among heterosexual women and MSM were age at migration, length of stay in host country and HIV diagnosis year and among heterosexual men, length of stay in host country, and HIV diagnosis year. CONCLUSIONS: A substantial proportion of HIV-positive migrants living in Europe acquired HIV post-migration. This has important implications for European public health policies
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