Return to Work after Traumatic Hand Injuries: Medical, Personal and Work-related Factors

PURPOSE This study aimed to examine the work-related impact of open hand injuries, specifically, the amount of lost work days subsequent to the injury and factors associated with work-related rehabilitation. PATIENTS AND METHODS We retrospectivley included consecutive patients with acute hand injuries who were operated between 2008 and 2009 in the Division of Hand Surgery (n=435) at the Department of Orthopaedic, Plastic and Hand Surgery. Information was obtained from the medical records and via a self-reported questionnaire sent out in 2011. Patients younger than 18 or older than 65 years, as well as the unemployed were excluded from the study. Descriptive group analysis was used to establish statistical relationships between time off work (TOW) and possible influencing variables. Multiple linear regression was applied to analyse the impact of injury, personal and/or work-related factors on TOW. RESULTS The sample included 290 patients with a mean age of 38.9 (SD 13.2) years of whom 98.6% returned to work after a median absence of 45.5 days. Univariate analysis demonstrated an association of length of absence from work with socio-demographic, clinical and work-related factors. Multiple regression analysis indicated that the location of injury, the number of injured regions, the need for secondary surgery, age, and the type of occupation were independently associated with TOW. CONCLUSION Most factors associated with TOW after traumatic hand injuries could not be influenced. Possible interventions should probably target improved injury prevention, optimal clinical treatment and rehabilitation starting early after injury. Whether improvements in communication and enhancement of cooperation between the treatment teams, the workplace and the insurance carrier may support a staged and earlier return to work remains to be investigated.

How Cantonal Education Systems in Switzerland Promote Gender-Typical School-to-Work Transitions

The paper asks how cantonal education systems in Switzerland promote gender-typed school-to-work transitions and gender segregation at work. Data from the Swiss TREE youth panel study is used to analyse the impact of cantonal provision of vocational education and training (VET) on gender-typical educational trajectories. The findings show that education systems with higher VET rates have higher allocations of men in gender-(male-) typical occupational careers. The paper concludes that the pronounced and persistent gender segregation on the Swiss labor market is partly due to a prominent VET system, which urges early gender-typed occupational career decisions.

CT-guided infiltration saves surgical intervention and fastens return to work compared to anatomical landmark-guided infiltration in patients with lumbosciatica

BACKGROUND Infiltration procedures are a common treatment of lumbar radiculopathy. There is a wide variety of infiltration techniques without an established gold standard. Therefore, we compared the effectiveness of CT-guided transforaminal infiltrations versus anatomical landmark-guided transforaminal infiltrations at the lower lumbar spine in case of acute sciatica at L3-L5. METHODS A retrospective chart review was conducted of 107 outpatients treated between 2009 and 2011. All patients were diagnosed with lumbar radiculopathic pain secondary to disc herniation in L3-L5. A total of 52 patients received CT-guided transforaminal infiltrations; 55 patients received non-imaging-guided nerve root infiltrations. The therapeutic success was evaluated regarding number of physician contacts, duration of treatment, type of analgesics used and loss of work days. Defined endpoint was surgery at the lower lumbar spine. RESULTS In the CT group, patients needed significantly less oral analgesics (p < 0.001). Overall treatment duration and physician contacts were significantly lower in the CT group (p < 0.001 and 0.002) either. In the CT group, patients lost significant fewer work days due to incapacity (p < 0.001). Surgery had to be performed in 18.2 % of the non-imaging group patients (CT group: 1.9 %; p = 0.008). CONCLUSION This study shows that CT-guided periradicular infiltration in lumbosciatica caused by intervertebral disc herniation is significantly superior to non-imaging, anatomical landmark-guided infiltration, regarding the parameters investigated. The high number of treatment failures in the non-imaging group underlines the inferiority of this treatment concept.

Latent profiles of work motivation in adolescents in relation to work expectations, goal engagement, and changes in work experiences

Motivation plays a key role in successful entry into working life. Based on a cross-sectional and a one-year longitudinal study, we used a person-centered approach to explore work-related motivation (i.e., autonomous goals, positive affect, and occupational self-efficacy) among 577 students in 8th grade (Study 1) and 949 adolescents in vocational training (Study 2). Based on latent profile analysis, in both studies we identified four groups that were characterized by different levels of overall motivation and one group characterized by low positive affect and mean levels in autonomous goals and self-efficacy. Profiles characterized by high levels of motivation showed the highest levels of positive work expectations and goal engagement and the lowest levels of negative work expectations in Study 1 and the highest levels of person-job fit, work engagement, and job satisfaction in Study 2. Moreover, latent difference score analysis showed that motivational profiles predicted changes in person-job fit and work engagement across one year but not in job satisfaction. The results imply that career counselors should be aware of characteristic motivational patterns of clients that may require specific counseling approaches.

Chance Events and Career Decidedness: Latent Profiles in Relation to Work Motivation

Research has shown that chance events affect careers but has not established the nature of their effects. Moreover, the relationship between chance and career decidedness is not well understood. The present study used a person-centered approach with latent profile analysis to examine 312 Swiss adolescents in their first year of vocational training. We identified five qualitatively differing profiles according to levels of perceived chance events and career decidedness: balanced scorers, undecided with mean chance, undecided with high chance, decided with chance, and decided without chance. The groups differed significantly in work motivation (i.e., occupational self-efficacy beliefs, perceived person-job fit, and work engagement). Decided adolescents reported more favorable work motivation regardless of their level of perceived chance events. The results imply that promoting decidedness remains a valuable goal in career counseling despite the occurrence of unpredicted events.

Ability to Work and Employment Rates in Human Immunodeficiency Virus (HIV)-1-Infected Individuals Receiving Combination Antiretroviral Therapy: The Swiss HIV Cohort Study

Background.  Limited data exist on human immunodeficiency virus (HIV)-infected individuals' ability to work after receiving combination antiretroviral therapy (cART). We aimed to investigate predictors of regaining full ability to work at 1 year after starting cART. Methods.  Antiretroviral-naive HIV-infected individuals <60 years who started cART from January 1998 through December 2012 within the framework of the Swiss HIV Cohort Study were analyzed. Inability to work was defined as a medical judgment of the patient's ability to work as 0%. Results.  Of 5800 subjects, 4382 (75.6%) were fully able to work, 471 (8.1%) able to work part time, and 947 (16.3%) were unable to work at baseline. Of the 947 patients unable to work, 439 (46.3%) were able to work either full time or part time at 1 year of treatment. Predictors of recovering full ability to work were non-white ethnicity (odds ratio [OR], 2.06; 95% confidence interval [CI], 1.20-3.54), higher education (OR, 4.03; 95% CI, 2.47-7.48), and achieving HIV-ribonucleic acid <50 copies/mL (OR, 1.83; 95% CI, 1.20-2.80). Older age (OR, 0.55; 95% CI, .42-.72, per 10 years older) and psychiatric disorders (OR, 0.24; 95% CI, .13-.47) were associated with lower odds of ability to work. Recovering full ability to work at 1 year increased from 24.0% in 1998-2001 to 41.2% in 2009-2012, but the employment rates did not increase. Conclusions.  Regaining full ability to work depends primarily on achieving viral suppression, absence of psychiatric comorbidity, and favorable psychosocial factors. The discrepancy between patients' ability to work and employment rates indicates barriers to reintegration of persons infected with HIV.

The role of drug use in welfare to work: Evidence from Houston, Texas

The purpose of this study is to examine the prevalence of drug abuse among welfare recipients in Houston, TX and compare the work activities and employment barriers of drug abusers in order to better understand the potential effects of welfare reform for this population. Four hypotheses were tested comparing the work activities and employment barriers of drug abusers to others on welfare and the relative importance of drug abuse and employment barriers in predicting work activity. ^ This cross-sectional study examined the characteristics and work activities of 447 welfare recipients (81 drug abusers and 366 non-abusers) who were surveyed between October 1998 and April 1999 in Houston, TX. Subjects were introduced and recruited to participate in the study through a flyer, door to door visits, and peer driven recruitment/referral. ^ About 18% were found to be drug abusers, which is consistent with the national average (10–33%) among welfare recipients. Compared to others on welfare, drug abusers were less involved in work activities, and had more employment barriers. Employment barriers were found to be more predictive of welfare to work activities than drug abuse. The results suggest that alleviating employment barriers should be stressed in programs aimed at welfare recipients with drug abuse problems. ^

From school to work : Muslim youths' education and employment strategies in a community in Uttar Pradesh, India

India's Muslim community, which accounts for 14.4 percent of India’s vast population and is thus the largest of all religious minorities, has been the subject of considerable development discourse as Muslims have the lowest level of educational attainment and standard of living among socio-religious groups in the country. This study addresses the meaning of education and career opportunities for Muslim youths in relation to their educational credentials and social position in the hierarchy of Muslim class and caste groups, with particular reference to a community in Uttar Pradesh. The author contends that the career opportunities, possibilities, and strategies of Muslim youths in Indian society depend on multiple factors: social hierarchy, opportunities to utilize economic resources, social networks, cultural capital, and the wider structural disparities within which the Muslims are situated and wherein they question the value of higher education in gaining them admission to socially recognized and established employment sectors.

Putting ion channels to work: Mechanoelectrical transduction, adaptation, and amplification by hair cells

As in other excitable cells, the ion channels of sensory receptors produce electrical signals that constitute the cellular response to stimulation. In photoreceptors, olfactory neurons, and some gustatory receptors, these channels essentially report the results of antecedent events in a cascade of chemical reactions. The mechanoelectrical transduction channels of hair cells, by contrast, are coupled directly to the stimulus. As a consequence, the mechanical properties of these channels shape our hearing process from the outset of transduction. Channel gating introduces nonlinearities prominent enough to be measured and even heard. Channels provide a feedback signal that controls the transducer's adaptation to large stimuli. Finally, transduction channels participate in an amplificatory process that sensitizes and sharpens hearing.

An evolutionary approach to the delineation of functional areas based on travel-to-work flows

This paper presents a new approach to the delineation of local labor markets based on evolutionary computation. The aim of the exercise is the division of a given territory into functional regions based on travel-to-work flows. Such regions are defined so that a high degree of inter-regional separation and of intra-regional integration in both cases in terms of commuting flows is guaranteed. Additional requirements include the absence of overlap between delineated regions and the exhaustive coverage of the whole territory. The procedure is based on the maximization of a fitness function that measures aggregate intra-region interaction under constraints of inter-region separation and minimum size. In the experimentation stage, two variations of the fitness function are used, and the process is also applied as a final stage for the optimization of the results from one of the most successful existing methods, which are used by the British authorities for the delineation of travel-to-work areas (TTWAs). The empirical exercise is conducted using real data for a sufficiently large territory that is considered to be representative given the density and variety of travel-to-work patterns that it embraces. The paper includes the quantitative comparison with alternative traditional methods, the assessment of the performance of the set of operators which has been specifically designed to handle the regionalization problem and the evaluation of the convergence process. The robustness of the solutions, something crucial in a research and policy-making context, is also discussed in the paper.

Welfare state regimes and gender inequalities in the exposure to work-related psychosocial hazards

Background: Gender inequalities in the exposure to work-related psychosocial hazards are well established. However, little is known about how welfare state regimes influence these inequalities. Objectives: To examine the relationship between welfare state regimes and gender inequalities in the exposure to work-related psychosocial hazards in Europe, considering occupational social class. Methods: We used a sample of 27, 465 workers from 28 European countries. Dependent variables were high strain, iso-strain, and effort-reward imbalance, and the independent was gender. We calculated the prevalence and prevalence ratio separately for each welfare state regime and occupational social class, using multivariate logistic regression models. Results: More female than male managers/professionals were exposed to: high strain, iso-strain, and effort–reward imbalance in Scandinavian [adjusted prevalence ratio (aPR) = 2·26; 95% confidence interval (95% CI): 1·87–2·75; 2·12: 1·72–2·61; 1·41: 1·15–1·74; respectively] and Continental regimes (1·43: 1·23–1·54; 1·51: 1·23–1·84; 1·40: 1·17–1·67); and to high strain and iso-strain in Anglo-Saxon (1·92: 1·40–2·63; 1·85: 1·30–2·64; respectively), Southern (1·43: 1·14–1·79; 1·60: 1·18–2·18), and Eastern regimes (1·56: 1·35–1·81; 1·53: 1·28–1·83). Conclusion: Gender inequalities in the exposure to work-related psychosocial hazards were not lower in those welfare state regimes with higher levels of universal social protection policies.