Usual medical treatments or levonorgestrel-IUS for women with heavy menstrual bleeding:long-term randomised pragmatic trial in primary care

Background: Heavy menstrual bleeding (HMB) is a common, chronic problem affecting women and health services. However, long-term evidence on treatment in primary care is lacking. Aim: To assess the effectiveness of commencing the levonorgestrel-releasing intrauterine system (LNG-IUS) or usual medical treatments for women presenting with HMB in general practice. Design and setting: A pragmatic, multicentre, parallel, open-label, long term, randomised controlled trial in 63 primary care practices across the English Midlands. Method: In total, 571 women aged 25–50 years, with HMB were randomised to LNG-IUS or usual medical treatment (tranexamic/mefenamic acid, combined oestrogen–progestogen, or progesterone alone). The primary outcome was the patient reported Menorrhagia Multi-Attribute Scale (MMAS, measuring effect of HMB on practical difficulties, social life, psychological and physical health, and work and family life; scores from 0 to 100). Secondary outcomes included surgical intervention (endometrial ablation/hysterectomy), general quality of life, sexual activity, and safety. Results: At 5 years post-randomisation, 424 (74%) women provided data. While the difference between LNG-IUS and usual treatment groups was not significant (3.9 points; 95% confidence interval = −0.6 to 8.3; P = 0.09), MMAS scores improved significantly in both groups from baseline (mean increase, 44.9 and 43.4 points, respectively; P<0.001 for both comparisons). Rates of surgical intervention were low in both groups (surgery-free survival was 80% and 77%; hazard ratio 0.90; 95% CI = 0.62 to 1.31; P = 0.6). There was no difference in generic quality of life, sexual activity scores, or serious adverse events. Conclusion: Large improvements in symptom relief across both groups show treatment for HMB can be successfully initiated with long-term benefit and with only modest need for surgery.

Rhythms of life:antecedents and outcomes of work-family balance among employed parents

This study examined antecedents and outcomes of a fourfold taxonomy of work-family balance in terms of the direction of influence (work-family vs. family-work) and type of effect (conflict vs. facilitation). Respondents were full-time employed parents in India. Confirmatory factor analysis results provided evidence for the discriminant validity of M. R. Frone's (2003) fourfold taxonomy of work-family balance. Results of moderated regression analysis revealed that different processes underlie the conflict and facilitation components. Furthermore, gender had only a limited moderating influence on the relationships between the antecedents and the components of work-family balance. Last, work-family facilitation was related to the work outcomes of job satisfaction and organizational commitment.

Is there life in the old dogs yet? Making break-tests work on financial contagion

Many tests of financial contagion require a definition of the dates separating calm from crisis periods. We propose to use a battery of break search procedures for individual time series to objectively identify potential break dates in relationships between countries. Applied to the biggest European stock markets and combined with two well established tests for financial contagion, this approach results in break dates which correctly identify the timing of changes in cross-country transmission mechanisms. Application of break search procedures breathes new life into the established contagion tests, allowing for an objective, data-driven timing of crisis periods.

Personality across working life:the longitudinal and reciprocal influences of personality on work

Summary: This paper focuses on the role of personality at different stages of people's working lives. We begin by reviewing the research in industrial, work, and organizational (IWO) psychology regarding the longitudinal and dynamic influences of personality as an independent variable at different career stages, structuring our review around a framework of people's working lives and careers over time. Next, we review recent studies in the personality and developmental psychology domain regarding the influence of changing life roles on personality. In this domain, personality also serves as a dependent variable. By blending these two domains, it becomes clear that the study of reciprocal effects of work and personality might open a new angle in IWO psychology's long-standing tradition of personality research. To this end, we outline various implications for conceptual development (e.g., trait stability) and empirical research (e.g., personality and work incongruence). Finally, we discuss some methodological and statistical considerations for research in this new research domain. In the end, our review should enrich the way that IWO psychologists understand personality at work, focusing away from its unidirectional predictivist influence on job performance toward a more complex longitudinal reciprocal interplay of personality and working life. © 2013 John Wiley & Sons, Ltd.

Work-life balance benefits:employee attitudes and behaviors through the lens of social exchange theory

The question of what to provide employees in order that they reciprocate with desirable behaviors in the work place has resulted in a great amount of work in the area of social exchange. Although offering fair compensation, including salary or wages and employee benefits, has been extensively studied, the effects of offering specific types of benefits, such as work-life balance benefits, and the intangible rewards that such an offering inadvertently offers, has only been minimally explored. Utilizing past literature, this current research examined the offering of work-life balance benefits, the value employees place on those benefits, the communication of the benefits by the organization to employees, and their effect on employee attitudes and behaviors. The goal was to identify the effect on desirable outcomes when work-life balance benefits are offered to determine the usefulness to the organization of offering such benefits. To test these effects, a study of an organization known to offer a strong work-life balance benefits package was undertaken. This was accomplished through the distribution of questionnaires to identify the possible relationships involving 408 employee respondents and their 79 supervisors. This was followed with interviews of 12 individuals to ascertain the true reasons for links observed through analysis. Analysis of the data was accomplished through correlation analysis, multilevel analysis and regression analysis generated by SPSS. The results of the quantitative analysis showed support for a relationship between the offering of work-life balance benefits and perceived organizational support, perceived distributive justice, job satisfaction and OCBO. The analysis also showed a lack of support for a relationship between the offering of work-life balance benefits and organizational commitment, OCBI and IRB. The interviews offered possible reasons for the lack of support regarding the relationship between the offering of work-life balance benefits and organizational commitment as well as organizational citizenship behaviors (OCBI and IRB). The implications of these findings on future research, theory and practice in the offering of work-life balance benefits are discussed.