Identifying work ability promoting factors for home care aides and assistant nurses

<p>Abstract</p> <p>Background</p> <p>In workplace health promotion, all potential resources needs to be taken into consideration, not only factors relating to the absence of injury and the physical health of the workers, but also psychological aspects. A dynamic balance between the resources of the individual employees and the demands of work is an important prerequisite. In the home care services, there is a noticeable trend towards increased psychosocial strain on employees at work. There are a high frequency of work-related musculoskeletal disorders and injuries, and a low prevalence of sustainable work ability. The aim of this research was to identify factors promoting work ability and self-efficacy in care aides and assistant nurses within home care services.</p> <p>Methods</p> <p>This study is based on cross-sectional data collected in a municipality in northern Sweden. Care aides (n = 58) and assistant nurses (n = 79) replied to a self-administered questionnaire (response rate 46%). Hierarchical multiple regression analyses were performed to assess the influence of several independent variables on self-efficacy (model 1) and work ability (model 2) for care aides and assistant nurses separately.</p> <p>Results</p> <p>Perceptions of personal safety, self-efficacy and musculoskeletal wellbeing contributed to work ability for assistant nurses (R²adj of 0.36, <it>p </it>< 0.001), while for care aides, the safety climate, seniority and age contributed to work ability (R²adj of 0.29, <it>p </it>= 0.001). Self-efficacy was associated with the safety climate and the physical demands of the job in both professions (R²adj of 0.24, <it>p </it>= 0.003 for care aides), and also by sex and age for the assistant nurses (R²adj of 0.31, <it>p </it>< 0.001).</p> <p>Conclusions</p> <p>The intermediate factors contributed differently to work ability in the two professions. Self-efficacy, personal safety and musculoskeletal wellbeing were important for the assistant nurses, while the work ability of the care aides was associated with the safety climate, but also with the non-changeable factors age and seniority. All these factors are important to acknowledge in practice and in further research. Proactive workplace interventions need to focus on potentially modifiable factors such as self-efficacy, safety climate, physical job demands and musculoskeletal wellbeing.</p

Long-term follow-up with Granulocyte and Monocyte Apheresis re-treatment in patients with chronically active inflammatory bowel disease

<p>Abstract</p> <p>Background</p> <p>Patients with IBD and chronic inflammation refractory to conventional therapy often demonstrate higher risk of serious complications. Combinations of immunosuppression and biological treatment as well as surgical intervention are often used in this patient group. Hence, there is need for additional treatment options. In this observational study, focused on re-treatment and long-term results, Granulocyte/Monocyte Adsorption (GMA, Adacolumn^®) treatment has been investigated to study efficacy, safety and quality of life in IBD-patients with chronic activity.</p> <p>Methods</p> <p>Fifteen patients with ulcerative colitis and 25 patients with Crohn's disease, both groups with chronically active inflammation refractory to conventional medication were included in this observational study. The patients received 5-10 GMA sessions, and the clinical activity was assessed at baseline, after each completed course, and at week 10 and 20 by disease activity index, endoscopy and quality of life evaluation. Relapsed patients were re-treated by GMA in this follow-up study up to 58 months.</p> <p>Results</p> <p>Clinical response was seen in 85% and complete remission in 65% of the patients. Ten patients in the UC-group (66%) and 16 patients in the CD-group (64%) maintained clinical and endoscopic remission for an average of 14 months. Fourteen patients who relapsed after showing initial remission were re-treated with GMA and 13 (93%) went into a second remission. Following further relapses, all of seven patients were successfully re-treated for the third time, all of three patients for the fourth time and one for a fifth time.</p> <p>Conclusions</p> <p>IBD-patients with chronic inflammation despite conventional therapy seem to benefit from GMA. Re-treatment of relapsing remission patients seems to be effective.</p

Mutations in the ELANE Gene are Associated with Development of Periodontitis in Patients with Severe Congenital Neutropenia

# The Author(s) 2011. This article is published with open access at Springerlink.com Background Patients with severe congenital neutropenia (SCN) often develop periodontitis despite standard medical and dental care. In light of previous findings that mutations in the neutrophil elastase gene, ELANE, are associated with more severe neutropenic phenotypes, we hypothesized an association between the genotype of SCN and development of periodontitis. Methods Fourteen Swedish patients with SCN or cyclic neutropenia harboring different genetic backgrounds were recruited for periodontal examination. Peripheral blood, gingival crevicular fluid (GCF), and subgingival bacterial Thomas Modéer and Katrin Pütsep have contributed equally to the study

A solid-state nuclear magnetic resonance study of post-plasma reactions in organosilicone microwave plasma-enhanced chemical vapor deposition (PECVD) coatings

Plasma-polymerized organosilicone coatings can be used to impart abrasion resistance and barrier properties to plastic substrates such as polycarbonate. Coating rates suitable for industrial-scale deposition, up to 100 nm/s, can be achieved through the use of microwave plasma-enhanced chemical vapor deposition (PECVD), with optimal process vapors such as tetramethyldisiloxane (TMDSO) and oxygen. However, it has been found that under certain deposition conditions, such coatings are subject to post-plasma changes; crazing or cracking can occur anytime from days to months after deposition. To understand the cause of the crazing and its dependence on processing plasma parameters, the effects of post-plasma reactions on the chemical bonding structure of coatings deposited with varying TMDSO-to-O2 ratios was studied with 29Si and 13C solid-state magic angle spinning nuclear magnetic resonance (MAS NMR) using both single-pulse and cross-polarization techniques. The coatings showed complex chemical compositions significantly altered from the parent monomer. 29Si MAS NMR spectra revealed four main groups of resonance lines, which correspond to four siloxane moieties (i.e., mono (M), di (D), tri (T), and quaternary (Q)) and how they are bound to oxygen. Quantitative measurements showed that the ratio of TMDSO to oxygen could shift the chemical structure of the coating from 39% to 55% in Q-type bonds and from 28% to 16% for D-type bonds. Post-plasma reactions were found to produce changes in relative intensities of 29Si resonance lines. The NMR data were complemented by Fourier transform infrared (FTIR) spectroscopy. Together, these techniques have shown that the bonding environment of Si is drastically altered by varying the TMDSO-to-O2 ratio during PECVD, and that post-plasma reactions increase the cross-link density of the silicon–oxygen network. It appears that Si–H and Si–OH chemical groups are the most susceptible to post-plasma reactions. Coatings produced at a low TMDSO-to-oxygen ratio had little to no singly substituted moieties, displayed a highly cross-linked structure, and showed less post-plasma reactions. However, these chemically more stable coatings are less compatible mechanically with plastic substrates, because of their high stiffness

A comparison of a priori threshold setting procedures for speaker verification in the CAVE project

The issue of a priori threshold setting in speaker verification is a key problem for field applications. In the context of the CAVE project, we compared several methods for estimating speaker-independent and speaker-dependent decision thresholds. Relevant parameters are estimated from development data only, i.e. without resorting to additional client data. The various approaches are tested on the Dutch SESP database

Admission rates in a general practitioner-based versus a hospital specialist based, hospital-at-home model: ACCESS, an open-labelled randomised clinical trial of effectiveness

Abstract Background Hospital at home (HaH) is an alternative to acute admission for elderly patients. It is unclear if should be cared for a primarily by a hospital intern specialist or by the patient’s own general practitioner (GP). The study assessed whether a GP based model was more effective than a hospital specialist based model at reducing number of hospital admissions without affecting the patient’s recovery or number of deaths. Methods Pragmatic, randomised, open-labelled multicentre parallel group trial with two arms in four municipalities, four emergency departments and 150 GPs in Southern Denmark, including + 65 years old patients with an acute medical condition that required acute hospital in-patient care. The patients were randomly assigned to hospital specialist based model or GP model of HaH care. Five physical and cognitive performance tests were performed at inclusion and after 7 days. Primary outcome was number of hospital admissions within 7 days. Secondary outcomes were number of admissions within 14, 21 and 30 days, deaths within 30 and 90 days and changes in performance tests. Results Sixty seven patients were enrolled in the GP model and 64 in the hospital specialist model. 45% in the hospital specialist arm versus 24% in the GP arm were admitted within 7 days (effect size 2.7, 95% CI 1.3–5.8; p = 0.01) and this remained significant within 30 days. No differences were found in death or changes in performance tests from day 0–7 days between the two groups. Conclusions The GP based HaH model was more effective than the hospital specialist model in avoiding hospital admissions within 7 days among elderly patients with an acute medical condition with no differences in mental or physical recovery rates or deaths between the two models. Registration No. NCT02422849 Registered 27 March 2015. Retrospectively registere

Solid-state static Cu-65 and P-31 CP/MAS NMR, and liquid-state EXAFS studies on copper(I) O,O '-dialkyldithiophosphate cluster compounds: Formation of the copper(I) O,O '-di-iso-amyldlthiophosphate cluster compound on the surface of synthetic chalcocite

Polycrystalline octa-miclear copper(l) O,O'-di-i-propyl- and O,O'-di-i-amyldithiophosphate cluster compounds, {Cu-8[S2P(OR)(2)](6)(mu(8)-S)} where R=Pr-i and Am-i, were synthesized and characterized by P-31 CP/MAS NMR at 8.46 T and static Cu-65 NMR at multiple magnetic field strengths (7.05, 9.4 and 14.1 T). The symmetries of the electronic environments around the P sites were estimated from the (31)p chemical shift anisotropy (CSA) parameters, delta(aniso) and eta. Analyses of the Cu-65 chemical shift and quadrupolar splitting parameters for these compounds are presented with the data being compared to those for the analogous octa-miclear cluster compounds with R = "Bu and Bu-i. The Cu-65 transverse relaxation for the copper sites in {Cu-8[S2P((OPr)-Pr-i)(2)](6)(mu(8)-S)} and {CU8[S2P((OAm)-Am-i)(2)](6)(mu(8)-S) I was found to be very different, with a relaxation time, T-2, of 590 mu s (Gaussian) and 90 mu s (exponential), respectively. The structures of {Cu-4[S2P((OPr)-Pr-i)(2)](4)} and {Cu-8[S2P((OPr)-Pr-i)(2)](6)(mu(8)-S)} cluster compounds in the liquid- and the solid-state were studied by Cu K-edge EXAFS. The disulfide, [S2P((OAm)-Am-i)(2)](2), was obtained and characterized by P-31 {H-1} NMR. The interactions of the disulfide and of the potassium O,O'-di-i-amyldithiophosphate salt with the surfaces of synthetic chalcocite (Cu2S) were probed using solid-state 3 T NMR spectroscopy and only the presence of copper(I) dithiophosphate species with the {Cu-8[S2P((OAm)-Am-i)(2)](6)(mu(8)-S)} structure was observed. (c) 2006 Elsevier Ltd. All rights reserved