Healthcare service utilization and work-related productivity in reflexology intervention for advanced breast cancer women.

PURPOSE: This project's purpose was to determine the effects of a home-based reflexology intervention on symptom-related use of health services and work-related productivity during the 11-week study. METHODS: A total of 256 patients were randomized to four weekly reflexology sessions (each lasting 30 min, delivered by lay caregivers who received two training sessions by a professional reflexologist) or attention control. The Conventional Health Service and Productivity Costs Form was used to collect information on health service utilization and out-of-pocket expenditure of symptom management. The Health and Work Performance Questionnaire was used to measure workplace performance for patients during the study period. We used weighted and unweighted logistic and linear regression analyses. RESULTS: Patients in the reflexology group were less likely to have hospital visits compared to the control group in the weighted unadjusted (odds ratio [OR] = 0.49; 95% confidence interval [CI] = [0.25, 0.97]), unweighted adjusted (OR = 0.35; 95% CI = [0.16, 0.75]), and weighted adjusted (OR = 0.30, 95% CI = [0.13, 0.66]) logistic regressions. Compared to attention control, patients in the reflexology group had lower relative absenteeism in the unweighted adjusted (- 0.32; 95% CI = [- 0.60, - 0.03]) linear regressions and less absolute presenteeism (15.42, 95% CI = [0.87, 29.98]) in the weighted unadjusted analysis. CONCLUSION: The reflexology intervention delivered by lay caregivers reduced hospital visits and increased workplace productivity in a short-term period, which has potential for cost saving for health care systems and employers. TRIAL REGISTRATION: NCT01582971.

Validez predictiva e impacto adverso de la entrevista conductual estructurada en el sector público / Predictive validity and adverse impact of the structured behavioral interview in the public sector

En este trabajo se estudia el papel de la entrevista conductual estructurada (ECE) en los procedimientos de selección del sector público, cuya legislación insta a comprobar si los procedimientos selectivos están vinculados con el desempeño y si se cumple el principio de igualdad de oportunidades entre sexos. Para ello se ha analizado en una muestra de 379 candidatos si existían diferencias de género en la puntuación de la entrevista. Por otro lado, se midió el desempeño de las 125 personas contratadas, lo que permitió estudiar la validez predictiva de la ECE. Los resultados son similares a los obtenidos por investigaciones precedentes -la ECE predice de manera significativa el desempeño y no produce impacto de género. Finalmente se discuten las implicaciones de estos resultados (AU)

This paper studies the role of the structured behavioral interview (SBI) in the selection procedures of the public sector. The Spanish legislation calls on to examine whether selection procedures are linked to performance and whether the principle of equal opportunities regarding gender is respected. Hence, it was analyzed if there were gender differences in the interview scores in a sample of 379 candidates. Furthermore, performance of 125 hired subjects was assessed, allowing us to measure the predictive validity of the SBI. Results are similar to those obtained by previous research -SBIs are a significant predictor of performance and they do not produce adverse gender impact. Finally, implications of these results are discussed (AU)

Post-retirement intentions of nurses and midwives living and working in the Northern Territory of Australia.

INTRODUCTION: Previous research undertaken in the Northern Territory of Australia has identified interest among nurses in engaging in the active workforce post-retirement. Relatively little is known about which nurses are interested in such engagement, and the types of work arrangements that might be of interest. This study aims to provide an enhanced understanding of the retirement plans and post-retirement employment intentions of nurses and midwives living and working in the Northern Territory (NT) of Australia. METHODS: An online survey was developed to examine retirement intentions, and investigate the types and facilitators significant for post-retirement engagement. RESULTS: The results indicated a strong interest among nurses and midwives in engaging in post-retirement work, with 73.2% of respondents (n=207) having considered continuing in the active workforce. The most preferred types of engagement included the gradual reduction of hours in current workplaces, part-year or seasonal employment, short-term placements, job-sharing or job-rotation, mentoring, research and policy development or acting as 'Northern Territory representatives' promoting jobs to prospective nurses and midwives elsewhere in Australia. A range of facilitators for post-retirement engagement was found, including for nurses who had not currently considered such engagement. The data collected from this research also identified barriers to post-retirement employment. The most favoured facilitators were financial incentives (90.0% of respondents identified it as a facilitator for post-retirement engagement), followed by support from line management (82.0%). Regardless of whether they had considered engaging post-retirement, the largest proportion of respondents intended to leave the NT for the time of their retirement (33.7%). The most prominent barrier to post-retirement engagement was that only a smaller proportion intended to retire in the NT (24.1%). Importantly, many nurses who had not currently considered post-retirement engagement were interested in some of the opportunities listed in the survey, and may therefore be tempted to consider continued engagement in the future. CONCLUSIONS: This study has provided an enhanced understanding of the retirement intentions of nurses and midwives living and working in the NT, and the significant types and facilitators of post-retirement engagement. The barriers arising from the inability of workplaces to cater to the needs of older workers potentially continuing their employment post-retirement are consistent with previous research. The types and facilitators of engagement presented in this study might assist in overcoming these barriers.

Social influences on trajectories of self-rated health: evidence from Britain, Germany, Denmark and the USA.

BACKGROUND: This study investigates social inequalities in self-rated health dynamics for working-aged adults in four nations, representing distinct welfare regime types. The aims are to describe average national trajectories of self-rated health over a 7-year period, identify social determinants of cross-sectional and longitudinal health and compare cross-national patterns. METHODS: Data are from national household panel surveys in Britain, Germany, Denmark and the USA. The self-rated health of working-age respondents is measured for the years 1995-2001. Social indicators include education, occupational class, employment status, income, age, gender, minority status and marital status. Latent growth curve models are used to estimate both individual change and average national trajectories of self-rated health, conditioned on the social indicators. RESULTS: Ageing-vector graphs reveal general declines in health as people age. They also show differential patterns of change for specific national cohorts. Older cohorts in Denmark had poorer health and young cohorts in the USA had better health in 2001 than 1995. Social covariates predicted baseline health in all four countries, in ways that were consistent with welfare regime theories. Once inequalities in baseline health were accounted for, the few determinants of mean health decline occurred mainly in the USA, again in line with theoretical expectations. Finally, trajectories of health for those in average and advantaged social circumstances were similar, but disadvantaged individuals had much poorer health trajectories than 'average' individuals. The differences were greatest in the countries with lower levels of public transfers. CONCLUSION: National differences in self-rated health trajectories and their social correlates may be attributed partly to welfare policies.

A screening questionnaire to predict no return to work within 3 months for low back pain claimants.

The objective of the present study was to develop a short prediction questionnaire for estimating the risk of no return to work (RTW) within 3 months of sick leave to facilitate triage and management of a patient population of subacute low-back pain (LBP) sufferers. We conducted a prospective study with a 3-month follow-up on 186 patients with LBP introducing a claim for sickness benefits to the largest sickness fund in Belgium. Patients completed a screening questionnaire within 2 weeks after claim submission. All patients were invited for clinical assessment, at 6-8 weeks of sick leave, by the medical adviser. Patients' work status was recorded by the sickness fund. About 20% of the patients did not resume work at 3 months' sick leave. They were more likely to experience pain below the knee, to have an own previous prediction of a 100% no RTW and to have a severe interference of pain on daily activities. The screening tool based on these three items correctly classified 73.7% of the non-resumers and 78.4% of the resumers at a cut-off score of 0.22. The findings of this study provide evidence of the utility of a short screening questionnaire for future use in intervention studies in a social security setting.

Intradiscal electrothermal treatment for chronic discogenic low back pain: a prospective outcome study with minimum 1-year follow-up.

STUDY DESIGN: Prospective case series. OBJECTIVE: To determine the outcome of patients with chronic low back pain whose symptoms did not improve with aggressive nonoperative care and who chose (intradiscal electrothermal anuloplasty) IDET as an alternative to chronic pain management or interbody fusion surgery. SUMMARY OF BACKGROUND DATA: Patients with unremitting chronic discogenic low back pain are faced with the choice of long-term pain management or fusion surgery. Intradiscal electrothermal anuloplasty (IDET) was developed as an alternative minimally invasive treatment. MATERIALS AND METHODS: Sixty-two patients from the author's practice who had chronic low back pain unresponsive to nonoperative care, no evidence of compressive radiculopathy, and concordant pain reproduction at one or more disc levels on provocative discography were enrolled in the study. Visual analog scale (VAS) pain scores and Short Form (SF)-36 Health Status Questionnaire Physical Function subscale and SF-36 Bodily Pain subscale scores were assessed at baseline and at least 1 year later. RESULTS: Mean follow-up was 16 months, and mean preoperative duration of symptoms was 60 months. Baseline and follow-up outcome measures demonstrated a mean change in VAS score of 3.0 (P < 0.001), mean change in SF-36 physical function of 20 (P < 0.001), and mean change in SF-36 bodily pain of 17 (P < 0.001). Symptoms improved in 44 (71%) of 62 of the study group on the SF-36 physical function subscale, in 46 (74%) of 62 on the SF-36 Bodily Pain subscale, and in 44 (71%) of 62 on the VAS scores. Twelve (19%) of 62 of the patients did not show improvement on any scale. CONCLUSION: A cohort of patients with chronic unremitting low back pain of discogenic origin whose symptoms had failed to improve with aggressive nonoperative care demonstrated a statistically significant and clinically meaningful improvement on the SF-36 and the VAS scores at a minimum follow-up of 1 year after IDET. The positive results should be validated with placebo-controlled randomized trials and studies that compare IDET with alternative treatments.-