A systematic review of studies identifying predictors of poor return to work outcomes following workplace injury

BACKGROUND: Injuries occurring in the workplace can have serious implications for the health of the individual, the productivity of the employer and the overall economic community. OBJECTIVE: The objective of this paper is to increase the current state of understanding of individual demographic and psychosocial characteristics associated with extended absenteeism from the workforce due to a workplace injury. METHODS: Studies included in this systematic literature review tracked participants' return to work status over a minimum of three months, identified either demographic, psychosocial or general injury predictors of poor return to work outcomes and included a heterogeneous sample of workplace injuries. RESULTS: Identified predictors of poor return to work outcomes included older age, female gender, divorced marital status, two or more dependent family members, lower education levels, employment variables associated with reduced labour market desirability, severity or sensitive injury locations, negative attitudes and outcome perceptions of the participant. CONCLUSIONS: There is a need for clear and consistent definition and measurement of return to work outcomes and a holistic theoretical model integrating injury, psychosocial and demographic predictors of return to work. Through greater understanding of the nature of factors affecting return to work, improved outcomes could be achieved.

Promoting and maintaining physical activity in the transition to retirement: A systematic review of interventions for adults around retirement age

It has been argued that transition points in life, such as the approach towards, and early years of retirement present key opportunities for interventions to improve the health of the population. Research has also highlighted inequalities in health status in the retired population and in response to interventions which should be addressed. We aimed to conduct a systematic review to synthesise international evidence on the types and effectiveness of interventions to increase physical activity among people around the time of retirement. A systematic review of literature was carried out between February 2014 and April 2015. Searches were not limited by language or location, but were restricted by date to studies published from 1990 onwards. Methods for identification of relevant studies included electronic database searching, reference list checking, and citation searching. Systematic search of the literature identified 104 papers which described study populations as being older adults. However, we found only one paper which specifically referred to their participants as being around the time of retirement. The intervention approaches for older adults encompassed: training of health care professionals; counselling and advice giving; group sessions; individual training sessions; in-home exercise programmes; in-home computer-delivered programmes; in-home telephone support; in-home diet and exercise programmes; and community-wide initiatives. The majority of papers reported some intervention effect, with evidence of positive outcomes for all types of programmes. A wide range of different measures were used to evaluate effectiveness, many were self-reported and few studies included evaluation of sedentary time. While the retirement transition is considered a significant point of life change, little research has been conducted to assess whether physical activity interventions at this time may be effective in promoting or maintaining activity, or reducing health inequalities. We were unable to find any evidence that the transition to retirement period was, or was not a significant point for intervention. Studies in older adults more generally indicated that a range of interventions might be effective for people around retirement age.

Prevalence and incidence of shoulder and neck dysfunction after neck dissection: A systematic review

Background: Head and neck cancer is a debilitating disease. Not only can the primary tumour cause painful swallowing and speech difficulties, the treatments required to manage it can impact on neck and shoulder musculoskeletal function. In particular, those patients who undergo neck dissection surgery to remove lymph nodes from the neck can acquire accessory nerve injury during the procedure and a resultant loss of shoulder/neck motion, strength and function. Despite changes to surgical techniques that can protect the nerve, patients still report problems post-operatively.

Systematic variation in bond lengths of peptides

The lengths of the carbonyl as well as of the adjacent C-N and C-C bonds in peptides are shown to vary systematically with the central C-N bond length. Results of ab initio calculations on N-methylacetamide and its Li+, Na+ and Mg2+ complexes are also discussed.

Do Human Extraintestinal Escherichia coli Infections Resistant to Expanded-Spectrum Cephalosporins Originate From Food-Producing Animals? A Systematic Review

To find out whether food-producing animals (FPAs) are a source of extraintestinal expanded-spectrum cephalosporin-resistant Escherichia coli (ESCR-EC) infections in humans, Medline, Embase, and the Cochrane Database of Systematic Reviews were systematically reviewed. Thirty-four original, peer-reviewed publications were identified for inclusion. Six molecular epidemiology studies supported the transfer of resistance via whole bacterium transmission (WBT), which was best characterized among poultry in the Netherlands. Thirteen molecular epidemiology studies supported transmission of resistance via mobile genetic elements, which demonstrated greater diversity of geography and host FPA. Seventeen molecular epidemiology studies did not support WBT and two did not support mobile genetic element-mediated transmission. Four observational epidemiology studies were consistent with zoonotic transmission. Overall, there is evidence that a proportion of human extraintestinal ESCR-EC infections originate from FPAs. Poultry, in particular, is probably a source, but the quantitative and geographical extent of the problem is unclear and requires further investigation.

The use of neurocognitive methods in assessing health communication messages: A systematic review

We review 20 studies that examined persuasive processing and outcomes of health messages using neurocognitive measures. The results suggest that cognitive processes and neural activity in regions thought to reflect self-related processing may be more prominent in the persuasive process of self-relevant messages. Furthermore, activity in the medial prefrontal cortex (MPFC), the superior temporal gyrus, and the middle frontal gyrus were identified as predictors of message effectiveness, with the MPFC accounting for additional variance in behaviour change beyond that accounted for by self-report measures. Incorporating neurocognitive measures may provide a more comprehensive understanding of the processing and outcomes of health messages.

The effectiveness of the teach-back method on adherence and self-management in health education for people with chronic disease: A systematic review

- BACKGROUND Chronic diseases are increasing worldwide and have become a significant burden to those affected by those diseases. Disease-specific education programs have demonstrated improved outcomes, although people do forget information quickly or memorize it incorrectly. The teach-back method was introduced in an attempt to reinforce education to patients. To date, the evidence regarding the effectiveness of health education employing the teach-back method in improved care has not yet been reviewed systematically. - OBJECTIVES This systematic review examined the evidence on using the teach-back method in health education programs for improving adherence and self-management of people with chronic disease. - INCLUSION CRITERIA Types of participants: Adults aged 18 years and over with one or more than one chronic disease. Types of intervention: All types of interventions which included the teach-back method in an education program for people with chronic diseases. The comparator was chronic disease education programs that did not involve the teach-back method. Types of studies: Randomized and non-randomized controlled trials, cohort studies, before-after studies and case-control studies. Types of outcomes: The outcomes of interest were adherence, self-management, disease-specific knowledge, readmission, knowledge retention, self-efficacy and quality of life. - SEARCH STRATEGY Searches were conducted in CINAHL, MEDLINE, EMBASE, Cochrane CENTRAL, Web of Science, ProQuest Nursing and Allied Health Source, and Google Scholar databases. Search terms were combined by AND or OR in search strings. Reference lists of included articles were also searched for further potential references. - METHODOLOGICAL QUALITY Two reviewers conducted quality appraisal of papers using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument. - DATA EXTRACTION Data were extracted using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument data extraction instruments. - DATA SYNTHESIS There was significant heterogeneity in selected studies, hence a meta-analysis was not possible and the results were presented in narrative form. - RESULTS Of the 21 articles retrieved in full, 12 on the use of the teach-back method met the inclusion criteria and were selected for analysis. Four studies confirmed improved disease-specific knowledge in intervention participants. One study showed a statistically significant improvement in adherence to medication and diet among type 2 diabetics patients in the intervention group compared to the control group (p < 0.001). Two studies found statistically significant improvements in self-efficacy (p = 0.0026 and p < 0.001) in the intervention groups. One study examined quality of life in heart failure patients but the results did not improve from the intervention (p = 0.59). Five studies found a reduction in readmission rates and hospitalization but these were not always statistically significant. Two studies showed improvement in daily weighing among heart failure participants, and in adherence to diet, exercise and foot care among those with type 2 diabetes. - CONCLUSION Overall, the teach-back method showed positive effects in a wide range of health care outcomes although these were not always statistically significant. Studies in this systematic review revealed improved outcomes in disease-specific knowledge, adherence, self-efficacy and the inhaler technique. There was a positive but inconsistent trend also seen in improved self-care and reduction of hospital readmission rates. There was limited evidence on improvement in quality of life or disease related knowledge retention.

Systematic search for optical Barker codes with minimum length

A method that yields optical Barker codes of smallest known lengths for given discrimination is described.

Ambient temperature and risk of cardiovascular hospitalization: An updated systematic review and meta-analysis

The association between temperatures and risk of cardiovascular mortality has been recognized but the association drawn from previous meta-analysis was weak due to the lack of sufficient studies. This paper presented a review with updated reports in the literature about the risk of cardiovascular hospitalization in relation to different temperature exposures and examined the dose–response relationship of temperature-cardiovascular hospitalization by change in units of temperature, latitudes, and lag days. The pooled effect sizes were calculated for cold, heat, heatwave, and diurnal variation using random-effects meta-analysis, and the dose–response relationship of temperature-cardiovascular admission was modelled using random-effect meta-regression. The Cochrane Q-test and index of heterogeneity (I2) were used to evaluate heterogeneity, and Egger's test was used to evaluate publication bias. Sixty-four studies were included in meta-analysis. The pooled results suggest that for a change in temperature condition, the risk of cardiovascular hospitalization increased 2.8% (RR, 1.028; 95% CI, 1.021–1.035) for cold exposure, 2.2% (RR, 1.022; 95% CI, 1.006–1.039) for heatwave exposure, and 0.7% (RR, 1.007; 95% CI, 1.002–1.012) for an increase in diurnal temperature. However no association was observed for heat exposure. The significant dose–response relationship of temperature — cardiovascular admission was found with cold exposure and diurnal temperature. Increase in one-day lag caused a marginal reduction in risk of cardiovascular hospitalizations for cold exposure and diurnal variation, and increase in latitude was associated with a decrease in risk of cardiovascular hospitalizations for diurnal temperature only. There is a significant short-term effect of cold exposure, heatwave and diurnal variation on cardiovascular hospitalizations. Further research is needed to understand the temperature-cardiovascular relationship for different climate areas.

Confronting Confucian Understandings of the Christian Doctrine of Salvation : A systematic theological analysis of the basic problems in the Confucian-Christian dialogue

The aim of the present study is to analyze Confucian understandings of the Christian doctrine of salvation in order to find the basic problems in the Confucian-Christian dialogue. I will approach the task via a systematic theological analysis of four issues in order to limit the thesis to an appropriate size. They are analyzed in three chapters as follows: 1. The Confucian concept concerning the existence of God. Here I discuss mainly the issue of assimilation of the Christian concept of God to the concepts of Sovereign on High (Shangdi) and Heaven (Tian) in Confucianism. 2. The Confucian understanding of the object of salvation and its status in Christianity. 3. The Confucian understanding of the means of salvation in Christianity. Before beginning this analysis it is necessary to clarify the vast variety of controversies, arguments, ideas, opinions and comments expressed in the name of Confucianism; thus, clear distinctions among different schools of Confucianism are given in chapter 2. In the last chapter I will discuss the results of my research in this study by pointing out the basic problems that will appear in the analysis. The results of the present study provide conclusions in three related areas: the tacit differences in the ways of thinking between Confucians and Christians, the basic problems of the Confucian-Christian dialogue, and the affirmative elements in the dialogue. In addition to a summary, a bibliography and an index, there are also eight appendices, where I have introduced important background information for readers to understand the present study.

Käytännöt ja ajattelu Michel Foucault'n filosofiassa

Practices and Thought in Michel Foucault s Philosophy The present thesis examines Michel Foucault s (1926-1984) notion of practice and argues that it is an essential concept in his philosophy, especially in his analysis of knowledge, power and ethics. The thesis reveals a previously neglected chronological and methodological unity in Foucault s work. The first chapter clarifies Foucault s philosophy by outlining it according to four central themes. First, the main philosophical goal of his historical studies is to analyse how human subjects have become objects of their own thinking. Second, this goal calls for methodological precaution to avoid all anthropological universals. Third, Foucault s studies are directed towards fields of practices. Fourth, the analysis of practices is executed along three axes: knowledge, power and ethics. The second chapter concerns the notion of practice in Foucault s archaeological method. Foucault s archaeological analysis is not directed towards objects and subjects as such, but to the way that the rules of discursive practice form them in the discourse. Many commentators have neglected Foucault s concept of practice when discussing his ideas concerning rules of discourse and limits of knowledge. I argue that Foucault s analysis concerning the limits of knowledge relates to local and contingent rules of discursive practice, not to transcendental rules of thinking in general. The third chapter deals with power relations and practices. I clarify Foucault s concept of dispositif by defining it as a functional ensemble of practices, and argue that this concept is crucial to his understanding of power relations. I stress a conceptual definition, which separates relations of power from the practices of government and show that the latter is based on the idea that power relations are integrated into practices. This conceptual clarification also helps in understanding Foucault s critique concerning modern practices of power. The fourth chapter examines Foucault s way of perceiving ethics as a practice. He separates three essential dimensions in morals: moral codes, moral behaviour and practices of self. His ethics concern practices of self and he studies how these practices have constituted different relations that subjects have to themselves, to others and to their societies. I argue that Foucault s own ethical views can be found in the ideas on the importance of practices of self in the modern world, and emphasize that these ideas should be connected to his views concerning the tradition of the Enlightenment, and to his own political action.

Vedestä vai Hengestä? : Uuras Saarnivaaran kasteteologia

Of water or the Spirit? Uuras Saarnivaara s theology of baptism The aim of the study was to investigate PhD and ThD Uuras Saarnivaara s views on baptism as well as their possible changes and the reasons for them. Dr Saarnivaara said himself that he searched for the truth about the relationship between baptism and faith for decades, and had faltered in his views. The method of this research is systematic analysis. A close study of the source material shows that Dr Saarnivaara s views on baptism have most likely changed several times. Therefore, special attention was paid to the time periods defined by when his literary works were published. This resulted in revealing the different perspectives he had on baptism. The fact that Dr Saarnivaara worked on two continents Europe and North America added a challenge to the research process. At the beginning of the research, I described Dr Saarnivaara s phases of life and mapped out his vast literary production as well as presented his theological basis. Saarnivaara s theological view on the means of grace and their interrelation in the church was influenced by the Laestadian movement, which caused him to adopt the view that the Holy Spirit does not dwell in the means of grace, but in the believers. Thus the real presence of Christ in the means of grace is denied. God s word is divided into Biblical revelation and proclamation by believers through the means of grace. Also, the sacraments are overshadowed by the preached word. Because grace is received through the word of the gospel preached publicly or privately by a believer, the preacher s status gains importance at the expense of the actual means of grace. Saarnivaara was intrigued by the content of baptism from the time he was a student until the end of his life. As a young theologian, he would adopt the opinions of his teachers as well as the view of the Evangelical Lutheran Church of Finland, which at the time was dominated by the pietistic movement and the teachings of J. T. Beck. After Saarnivaara had converted to the Laestadian movement, moved to the United States and started his Luther research, he adopted a view on baptism which was to a great extent in accordance with Luther and the Lutheran Symbolical Books. Saarnivaara considered his former views on baptism unbiblical and publicly apologised for them. In the 1950s, after starting his ministry within the Finnish neopietistic movements, Saarnivaara adopted a Laestadian-neopietistic doctrine of baptism. During his Beckian-pietistic era, Saarnivaara based his baptism theology on the event of the disciples of Jesus being baptised by John the Baptist, the revival of Samaria in the Book of Acts and the conversion of Cornelius and his family, all cases where the receiving of the Holy Spirit and the baptism were two separate events in time. In order to defend the theological unity of the Bible, Saarnivaara had to interpret Jesus teachings on baptism in the Gospels and the teachings of the Apostles in the New Testament letters from a viewpoint based on the three events mentioned above. During his Beckian-pietistic era, the abovementioned basic hermeneutic choice caused Saarnivaara to separate baptism by water and baptism by the Holy Spirit in his salvation theology. Simultaneously, the faith of a small child is denied, and rebirth is divided into two parts, the objective and the subjective, the latter being moved from the moment of baptism to a possible spiritual break-through at an age when the person possesses a more mature understanding. During his Laestadian-Lutheran era, Saarnivaara s theology of baptism was biblically consistent and the same for all people regardless of the person s age. Small children receive faith in baptism through the presence of Christ. The task of other people s faith is limited to the act of bringing the child to the baptism so that the child may receive his/her own faith from Christ and be born again as a child of God. The doctrine of baptism during Saarnivaara s Laestadian-neopietistic era represents in many aspects the emphases he presented during his first era, although they were now partly more radical. Baptism offers grace; it is not a means of grace. Justification, rebirth and salvation would take place later on when a person had reached an age with a more mature understanding through the word of God. A small child cannot be born again in baptism because being born again requires personal faith, which is received through hearing and understanding the law and the gospel. Saarnivaara s views on baptism during his first and third era are, unlike during his second era, quite controversial. The question of the salvation of a small child goes unanswered, or it is even denied. The central question during both eras is the demand of conversion and personal faith at a mature age. The background for this demand is in Saarnivaara s anthropology, which accentuates man s relationship to God as an intellectual and mental matter requiring understanding, and which needs no material instruments. The two first theological eras regarding Saarnivaara s doctrine of baptism lasted around ten years. The third era lasted over 40 years until his death.

Prevention of foot ulcers in the at-risk patient with diabetes: A systematic review

Background Prevention of foot ulcers in patients with diabetes is extremely important to help reduce the enormous burden of foot ulceration on both patient and health resources. A comprehensive analysis of reported interventions is not currently available, but is needed to better inform caregivers about effective prevention. The aim of this systematic review is to investigate the effectiveness of interventions to prevent first and recurrent foot ulcers in persons with diabetes who are at risk for ulceration. Methods The available medical scientific literature in PubMed, EMBASE, CINAHL and the Cochrane database was searched for original research studies on preventative interventions. Both controlled and non-controlled studies were selected. Data from controlled studies were assessed for methodological quality by two independent reviewers. Results From the identified records, a total of 30 controlled studies (of which 19 RCTs) and another 44 non-controlled studies were assessed and described. Few controlled studies, of generally low to moderate quality, were identified on the prevention of a first foot ulcer. For the prevention of recurrent plantar foot ulcers, multiple RCTs with low risk of bias show the benefit for the use of daily foot skin temperature measurements and consequent preventative actions, as well as for therapeutic footwear that demonstrates to relieve plantar pressure and that is worn by the patient. To prevent recurrence, some evidence exists for integrated foot care when it includes a combination of professional foot treatment, therapeutic footwear and patient education; for just a single session of patient education, no evidence exists. Surgical interventions can be effective in selected patients, but the evidence base is small. Conclusion The evidence base to support the use of specific self-management and footwear interventions for the prevention of recurrent plantar foot ulcers is quite strong, but is small for the use of other, sometimes widely applied, interventions and is practically nonexistent for the prevention of a first foot ulcer and non-plantar foot ulcer.

Agreeable Agreement : An Examination into the Quest for a Solid Consensus in Light of Bilateral Doctrinal Dialogues among Anglicans, Lutherans and Roman Catholics

The purpose of this study is to analyse the development and understanding of the idea of consensus in bilateral dialogues among Anglicans, Lutherans and Roman Catholics. The source material consists of representative dialogue documents from the international, regional and national dialogues from the 1960s until 2006. In general, the dialogue documents argue for agreement/consensus based on commonality or compatibility. Each of the three dialogue processes has specific characteristics and formulates its argument in a unique way. The Lutheran-Roman Catholic dialogue has a particular interest in hermeneutical questions. In the early phases, the documents endeavoured to describe the interpretative principles that would allow the churches to together proclaim the Gospel and to identify the foundation on which the agreement in the church is based. This investigation ended up proposing a notion of basic consensus , which later developed into a form of consensus that seeks to embrace, not to dismiss differences (so-called differentiated consensus ). The Lutheran-Roman Catholic agreement is based on a perspectival understanding of doctrine. The Anglican-Roman Catholic dialogue emphasises the correctness of interpretations. The documents consciously look towards a common future , not the separated past. The dialogue s primary interpretative concept is koinonia. The texts develop a hermeneutics of authoritative teaching that has been described as the rule of communion . The Anglican-Lutheran dialogue is characterised by an instrumental understanding of doctrine. Doctrinal agreement is facilitated by the ideas of coherence, continuity and substantial emphasis in doctrine. The Anglican-Lutheran dialogue proposes a form of sufficient consensus that considers a wide set of doctrinal statements and liturgical practices to determine whether an agreement has been reached to the degree that, although not complete , is sufficient for concrete steps towards unity. Chapter V discusses the current challenges of consensus as an ecumenically viable concept. In this part, I argue that the acceptability of consensus as an ecumenical goal is based not only the understanding of the church but more importantly on the understanding of the nature and function of the doctrine. The understanding of doctrine has undergone significant changes during the time of the ecumenical dialogues. The major shift has been from a modern paradigm towards a postmodern paradigm. I conclude with proposals towards a way to construct a form of consensus that would survive philosophical criticism, would be theologically valid and ecumenically acceptable.

Early post-operative mortality after major lower limb amputation: A systematic review of population and regional based studies

OBJECTIVE: Lower limb amputation is often associated with a high risk of early post-operative mortality. Mortality rates are also increasingly being put forward as a possible benchmark for surgical performance. The primary aim of this systematic review is to investigate early post-operative mortality following a major lower limb amputation in population/regional based studies, and reported factors that might influence these mortality outcomes. METHODS: Embase, PubMed, Cinahl and Psycinfo were searched for publications in any language on 30 day or in hospital mortality after major lower limb amputation in population/regional based studies. PRISMA guidelines were followed. A self developed checklist was used to assess quality and susceptibility to bias. Summary data were extracted for the percentage of the population who died; pooling of quantitative results was not possible because of methodological differences between studies. RESULTS: Of the 9,082 publications identified, results were included from 21. The percentage of the population undergoing amputation who died within 30 days ranged from 7% to 22%, the in hospital equivalent was 4-20%. Transfemoral amputation and older age were found to have a higher proportion of early post-operative mortality, compared with transtibial and younger age, respectively. Other patient factors or surgical treatment choices related to increased early post-operative mortality varied between studies. CONCLUSIONS: Early post-operative mortality rates vary from 4% to 22%. There are very limited data presented for patient related factors (age, comorbidities) that influence mortality. Even less is known about factors related to surgical treatment choices, being limited to amputation level. More information is needed to allow comparison across studies or for any benchmarking of acceptable mortality rates. Agreement is needed on key factors to be reported.