Do work ability and life satisfaction matter for return to work? Predictive ability of the work ability index and life satisfaction questionnaire among women with long-term musculoskeletal pain.

BACKGROUND: Impaired work ability and reduced life satisfaction due to long-term musculoskeletal pain, particularly in neck, shoulders and back, are considered occupational health problems that can result in workers taking sick leave. The aim of the study was to determine whether work ability and life satisfaction predict return to work (RTW) among women with long-term neck/shoulder and/or back pain, and to assess the ability of the Work Ability Index (WAI) and the Life Satisfaction Questionnaire (LiSat-11) to discriminate between those who did RTW and those who did not RTW (NRTW). METHODS: This is a cohort study with 1-year follow-up. A survey was sent to 600 women receiving sick leave benefits from the Swedish Social Insurance Agency. In total, 208 women responded at baseline, and 141 at a 1-year follow-up. To identify whether work ability and life satisfaction predicted RTW, multiple logistic regression analyses were performed with and without adjustment for type of work and pain intensity. To assess the discriminative ability of the WAI and the LiSat-11 for women who did RTW and those who did NRTW, receiver operating characteristic curves were fitted. RESULTS: Work ability predicted RTW, and the results remained significant after adjusting for type of work and pain intensity (OR 1.12, 95% CI: 1.04-1.22). Life satisfaction was not significant. The WAI at baseline adequately discriminated between RTW and NRTW after 1 year (Area under curve 0.78, 95% CI: 0.70-0.86), but the LiSat-11 did not. CONCLUSIONS: This study supports a relationship between work ability and RTW among women on sick leave for long-term neck/shoulder and/or back pain. The results indicate that the WAI, but not the LiSat-11, can discriminate between RTW and NRTW in the population under study. Although the discriminative ability of the WAI needs to be verified in new samples before it can be recommended for use in rehabilitation settings, we suggest that healthcare professionals consider how women perceive their work ability in order to better support them in their RTW.

Are return to work beliefs, psychological well-being and perceived health related to return-to-work intentions among women on long-term sick leave for common mental disorders? A cross-sectional study based on the theory of planned behaviour.

BACKGROUND: Long-term sick leave due to common mental disorders (CMDs) is a great burden in society today, especially among women. A strong intention to return to work (RTW) as well as symptom relief may facilitate RTW in this group. However, there is a lack of knowledge regarding what constitutes a strong intention. The Theory of Planned Behaviour is well-suited to identifying underlying beliefs about intentions to perform a behaviour. By including psychological well-being and perceived health, a more comprehensive picture of determinants of RTW intention might be achieved. Thus, the aim of the present study was to identify associations between RTW beliefs, psychological well-being, perceived health and RTW intentions among women on long-term sick leave due to CMDs, and to do so based on the Theory of Planned Behaviour. METHODS: The study was cross-sectional. Between October 2019 and January 2020, 282 women on long-term sick leave (> 2 months) due to CMDs were included in the study. The questionnaires for data collection were: "RTW Beliefs Questionnaire", the "General Health Questionnaire -12" and the "EuroQol Visual Analogue Scale". Standard multiple regression analysis was performed both with and without adjustment for potential confounders. RESULTS: The results showed that a more positive attitude towards RTW, stronger social pressure to RTW, higher perceived control over RTW and higher psychological well-being were associated with stronger RTW intention. The adjusted analysis eliminated the importance of psychological well-being for RTW intention, but showed that women who reported that their employer had taken actions to facilitate their RTW had stronger RTW intention. CONCLUSION: The RTW beliefs, derived from the Theory of Planned Behaviour, were all important for a strong RTW intention, while psychological well-being and perceived health showed weaker associations. Furthermore, having an employer that take actions for facilitating RTW was associated with stronger RTW intentions. Though some caution is warranted regarding the representativeness of the sample, the results do improve our understanding of some important determinants of RTW intention among women on long-term sick leave for CMDs.

Beliefs About Return to Work Among Women During/After Long-Term Sick Leave for Common Mental Disorders: A Qualitative Study Based on the Theory of Planned Behaviour.

PURPOSE: Long-term sick leave due to common mental disorders (CMDs) is an increasing problem, especially among women. To help these women return to work (RTW) sustainably, we need to know more about their own beliefs about RTW. One applicable theory is the theory of planned behaviour (TPB). Thus, the present study aimed to describe, based on the TPB, women's beliefs about RTW during or after long-term sick leave for a CMD. METHODS: A qualitative approach was used. Twenty women were included during a long-term sick leave period due to a CMD. A deductive content analysis was conducted using predetermined factors from the TPB: behavioural beliefs (advantages-disadvantages of RTW), normative beliefs (supporters and non-supporters of RTW), and control beliefs (facilitators of-barriers to RTW). RESULTS: The women believed that RTW would give them meaning and balance in life, but also that it would be challenging to maintain balance after RTW. They believed they had several supporters of RTW, but that the support was sometimes perceived as stressful rather than encouraging. Furthermore, individual adaptation and high demands were the most mentioned facilitator and barrier, respectively. Workplace conditions and personal strategies were thought to be important aspects. CONCLUSIONS: By using the TPB, the present study was able to offer new findings on women's beliefs about RTW after long-term sick leave for a CMD. Based on the findings, we suggest that various RTW stakeholders should focus on striving to provide the tasks and work pace women need so they can maintain their professional competence and sense of meaning.

Living with a spouse with chronic illness - the challenge of balancing demands and resources.

BACKGROUND: The number of partners providing informal care for their chronically ill spouse is rising, and they describe their daily life as demanding. The aim of this paper was to describe the partners' experiences of living with a person with chronic illness and how they manage everyday life. METHODS: A descriptive design with a qualitative approach was used. A purposive sample of 16 Swedish partners with a chronically ill spouse were interviewed. The interviews were recorded, transcribed, and analyzed using qualitative content analysis. RESULTS: Four main themes were identified: 'Managing challenges in daily life,' 'Seeking support and use own capabilities to manage life,' 'Appreciating the good parts of life' and 'Adapting to constant changes and an uncertain future'. Their experiences of support from formal care providers varied; they expressed the need for more assistance from the health care sector. CONCLUSIONS: The partners experienced many challenges in everyday life when providing informal care for their chronically ill spouse. This affected both their physical and psychological health, as they had limited time for themselves. The partners seemed to receive more support from their informal network than from formal care providers. In handling daily life, the partners balanced demands and resources to identify possibilities to move forward and find meaning in life. This is congruent with theories by Antonovsky, and Folkman and Lazarus that describes meaningfulness and how to handle challenges in everyday life.

Coping mediates the relationship between sense of coherence and mental quality of life in patients with chronic illness: a cross-sectional study.

PURPOSE: The aim of the present study was to investigate relationships between sense of coherence, emotion-focused coping, problem-focused coping, coping efficiency, and mental quality of life (QoL) in patients with chronic illness. A model based on Lazarus' and Folkman's stress and coping theory tested the specific hypothesis: Sense of coherence has a direct and indirect effect on mental QoL mediated by emotion-focused coping, problem-focused coping, and coping efficiency in serial adjusted for age, gender, educational level, comorbidity, and economic status. METHODS: The study used a cross-sectional and correlational design. Patients (n = 292) with chronic diseases (chronic heart failure, end-stage renal disease, multiple sclerosis, stroke, and Parkinson) completed three questionnaires and provided background data. Data were collected in 2012, and a serial multiple mediator model was tested using PROCESS macro for SPSS. RESULTS: The test of the conceptual model confirmed the hypothesis. There was a significant direct and indirect effect of sense of coherence on mental QoL through the three mediators. The model explained 39% of the variance in mental QoL. CONCLUSIONS: Self-perceived effective coping strategies are the most important mediating factors between sense of coherence and QoL in patients with chronic illness, which supports Lazarus' and Folkman's stress and coping theory.

Factors related to work ability and well-being among women on sick leave due to long-term pain in the neck/shoulders and/or back: a cross-sectional study.

BACKGROUND: Musculoskeletal pain is one of the leading causes of sick leave, especially among women, in Western countries. The aim of the present study was to identify factors associated with work ability and well-being, respectively, among women on sick leave due to long-term pain in the neck/shoulders and/or back. METHODS: A cross-sectional study with a correlational design was conducted on women who were sick-listed due to long-term pain in the neck/shoulders and/or back. A total of 208 participants responded to a survey comprising eight instruments: Multidimensional Pain Inventory scale, General Self-Efficacy scale, Sense of Coherence scale, Coping Strategies Questionnaire, Demand-Control-Support Questionnaire, Hospital Anxiety and Depression Scale, Work Ability Index and Life Satisfaction questionnaire. Multiple linear regression analyses were performed to identify factors associated with work ability and well-being, respectively. RESULTS: Women who more strongly believed they would return to the same work had greater work ability (ß = 0.39, p < 0.001), whereas women with higher pain intensity (ß = - 0.30, p < 0.001) and higher job strain (ß = - 0.12, p < 0.05) had lower work ability. Women with higher self-efficacy rated greater well-being (ß = 0.14, p < 0.05). As the women's scores for depression increased, their well-being decreased by 48%, which was statistically significant (p < 0.001). The regression models for work ability and well-being were significant (p < 0.001), and their adjusted R- square values were 48% and 59%, respectively. CONCLUSIONS: The study suggests that the factors beliefs to be back at the same work, pain intensity and job strain are predictive of work ability. Moreover, the factors self-efficacy and depression seem to be predictive of well-being. The findings highlight factors that should be considered by health care professionals and policy-makers to guide attempts to reduce sick leave.

Nurse Anesthetists' Reflections on Caring for Patients With Previous Substance Dependence: Balancing Between Professionalism and Preconceptions.

PURPOSE: The study aim was to describe nurse anesthetists' reflections on the provision of perioperative care to patients with previous substance dependence. DESIGN: A qualitative approach with a descriptive design. METHODS: Semistructured interviews based on clinical vignettes were conducted with 10 nurse anesthetists. FINDINGS: The perioperative care provided to patients with previous substance dependence was perceived as balancing between professionalism and preconceptions for this specific patient group. The nurse anesthetists felt that anesthetizing this group of patients constituted a challenge with regard to knowledge, experience, and time. However, the nurses also had feelings of distrust and uncertainty because of lack of knowledge. CONCLUSIONS: The nurse anesthetists strove to uphold the principle that patients who are/have been substance dependent have the same right to adequate treatment and care as all patients. If guidelines were developed for this patient group, care could be made safer and nurses' sense of uncertainty minimized.

Garden greenery and the health of older people in residential care facilities: a multi-level cross-sectional study.

AIMS: To test the relationship between greenery in gardens at residential facilities for older people and the self-perceived health of residents, mediated by experiences of being away and fascination when in the garden and the frequency of visitation there. To examine how these indirect effects vary with the number of physical barriers to visiting the garden. BACKGROUND: Many older people in residential facilities suffer from complex health problems. Access to a green outdoor environment may enable psychological distance, engage effortless attention, encourage more frequent visitation and promote resident health. DESIGN: A multi-level, cross-sectional, correlational design. METHODS: Questionnaires were administered June-August, 2011 to convenience samples of residents at 72 facilities for older people with complex healthcare needs. One to 10 eligible residents were sampled during self-motivated garden visits at each facility (n = 290). They reported on their garden experiences and health. Facility staff reported on objective garden characteristics and barriers to access. A serial mediation model was tested with multiple linear regression analysis. RESULTS: The total indirect effect of greenery on self-perceived health was positive and significant. Garden greenery appears to affect health by enhancing a sense of being away, affording possibilities to experience the outdoor environment as interesting and encouraging visitation. Among residents in homes with multiple barriers, only fascination mediated the relationship between greenery and self-perceived health. CONCLUSION: Ample greenery in outdoor space at residential facilities for older people appears to promote experiences of being away and fascination, more frequent visitation and better health.

E-assessment and an e-training program among elderly care staff lacking formal competence: results of a mixed-methods intervention study.

BACKGROUND: Among staff working in elderly care, a considerable proportion lack formal competence for their work. Lack of formal competence, in turn, has been linked to higher staff ratings of stress symptoms, sleep disturbances and workload. OBJECTIVES: 1) To describe the strengths and weaknesses of an e-assessment and subsequent e-training program used among elderly care staff who lack formal competence and 2) to study the effects of an e-training program on staff members' working life (quality of care and psychological and structural empowerment) and well-being (job satisfaction and psychosomatic health). The hypothesis was that staff who had completed the e-assessment and the e-training program would rate greater improvements in working life and well-being than would staff who had only participated in the e-assessments. METHODS: An intervention study with a mixed-methods approach using quantitative (2010-2011) and qualitative data (2011) was conducted in Swedish elderly care. Participants included a total of 41 staff members. To describe the strengths and weaknesses of the e-assessment and the e-training program, qualitative data were gathered using semi-structured interviews together with a study-specific questionnaire. To study the effects of the intervention, quantitative data were collected using questionnaires on: job satisfaction, psychosomatic health, psychological empowerment, structural empowerment and quality of care in an intervention and a comparison group. RESULTS: Staff who completed the e-assessments and the e-training program primarily experienced strengths associated with this approach. The results were also in line with our hypotheses: Staff who completed the e-assessment and the e-training program rated improvements in their working life and well-being. CONCLUSION: Use of the e-assessments and e-training program employed in the present study could be one way to support elderly care staff who lack formal education by increasing their competence; increased competence, in turn, could improve their self-confidence, working life, and well-being.

Life memories and the ability to act: the meaning of autonomy and participation for older people when living with chronic illness.

There is a lack of knowledge about how older people living with chronic illness describe the meaning of autonomy and participation, indicating a risk for reduced autonomy and participation in their everyday life. The purpose of this study was to describe the meaning of autonomy and participation among older people living with chronic illness in accordance with their lived experience. The design was descriptive with a phenomenological approach guided by Giorgi's descriptive phenomenological psychological method. Purposive sampling was used, and 16 older people living with chronic illness who lived in an ordinary home participated in individual interviews. The findings showed that the meaning of autonomy and participation among the older people emerged when it was challenged and evoked emotional considerations of the lived experience of having a chronic illness. It involved living a life apart, yet still being someone who is able, trustworthy and given responsibility--still being seen and acknowledged. The meaning of autonomy and participation was derived through life memories and used by the older people in everyday life for adjustment or adaption to the present life and the future. Our conclusion is that autonomy and participation were considered in relation to older people's life memories in the past, in their present situation and also their future wishes. Ability or disability is of less importance than the meaning of everyday life among older people. We suggest using fewer labels for limitations in everyday life when caring for older people and more use of the phrase 'ability to act' in different ways, based on older people's descriptions of the meaning of autonomy and participation.

E-assessment of prior learning: a pilot study of interactive assessment of staff with no formal education who are working in Swedish elderly care.

BACKGROUND: The current paper presents a pilot study of interactive assessment using information and communication technology (ICT) to evaluate the knowledge, skills and abilities of staff with no formal education who are working in Swedish elderly care. METHODS: Theoretical and practical assessment methods were developed and used with simulated patients and computer-based tests to identify strengths and areas for personal development among staff with no formal education. RESULTS: Of the 157 staff with no formal education, 87 began the practical and/or theoretical assessments, and 63 completed both assessments. Several of the staff passed the practical assessments, except the morning hygiene assessment, where several failed. Other areas for staff development, i.e. where several failed (>50%), were the theoretical assessment of the learning objectives: Health, Oral care, Ergonomics, hygiene, esthetic, environmental, Rehabilitation, Assistive technology, Basic healthcare and Laws and organization. None of the staff passed all assessments. Number of years working in elderly care and staff age were not statistically significantly related to the total score of grades on the various learning objectives. CONCLUSION: The interactive assessments were useful in assessing staff members' practical and theoretical knowledge, skills, and abilities and in identifying areas in need of development. It is important that personnel who lack formal qualifications be clearly identified and given a chance to develop their competence through training, both theoretical and practical. The interactive e-assessment approach analyzed in the present pilot study could serve as a starting point.

Demographic and clinical factors associated with psychological wellbeing in people with chronic, non-specific musculoskeletal pain engaged in multimodal rehabilitation: -a cross-sectional study with a correlational design.

OBJECTIVES: To investigate which demographic and clinical factors were associated with psychological wellbeing in working-aged people in multimodal rehabilitation for musculoskeletal disorders. METHODS: 116 participants met the criteria for inclusion: persistent or intermittent pain for at least three months; pain that adversely impacts daily life; potential for active change despite pain; no co-morbidity or condition that will hinder participation in the rehabilitation program. Primary outcome was psychological wellbeing and independent measures were general, physical and mental health, pain intensity, limitations in daily life, depression and sleep. RESULTS: The results show decreased odds of psychological wellbeing for persons rating high on depression. The results remained significant after adjusting for sex and age. Being a woman increased the odds of high psychological wellbeing. Logistic regression showed that psychological wellbeing was not significantly associated with pain intensity; sleep; functional limitations; general, physical, or mental health. None of the other independent variables was significantly associated with high vs. low psychological wellbeing. CONCLUSIONS: Depression turned out to be significantly related to psychological wellbeing, contrary to pain and limitations in daily life. If further studies with larger, random samples can confirm these results, this knowledge may be important both in clinical settings and in future research.

Development and psychometric evaluation of a theory-based questionnaire measuring women's return-to-work beliefs after long-term sick leave for common mental disorders.

BACKGROUND: Common mental disorders (CMDs) are currently a major cause of long-term sick leave, with women being most affected. OBJECTIVE: Using the Theory of Planned Behaviour (TPB), we aimed to describe the development and psychometric evaluation of a new questionnaire to measure women's beliefs about return to work (RTW) after long-term sick leave for CMDs. METHODS: Data were collected in central Sweden from women on long-term sick leave (2- 24 months) for CMDs. The questionnaire was developed by conducting an elicitation study with 20 women and included both direct and indirect measures. Subsequently, 282 women participated in a psychometric evaluation and 35 of them in a test-retest procedure. Psychometric properties were evaluated by determining reliability (internal consistency [Cronbach's alpha] and test-retest stability [intraclass correlation coefficient]), construct validity (exploratory factor analysis) and content validity. RESULTS: The development resulted in 60 questionnaire items. Content validity assessment showed that the women overall found it easy to complete the questionnaire. Reliability analyses showed satisfactory results for both direct and indirect measures, with a few exceptions. Factor analyses of the indirect scales showed that items were generally in line with the TPB, but that items related to life as a whole/personal life and items related to work were separated into two different factors. CONCLUSION: The questionnaire, called the RTW Beliefs Questionnaire, showed promising results and can among women with CMDs be considered useful, especially the scales for direct measures. This questionnaire gives opportunity to identify new potential predictors for RTW.

Compensatory mutations in agrC partly restore fitness in vitro to peptide deformylase inhibitor-resistant Staphylococcus aureus.

OBJECTIVES: To determine how the fitness cost of deformylase inhibitor resistance conferred by fmt mutations can be genetically compensated. METHODS: Resistant mutants were isolated and characterized with regard to their growth rates in vitro and in neutropenic mice, MIC and DNA sequence. Faster-growing compensated mutants were isolated by serial passage in culture medium, and for a subset of the resistant and compensated mutants whole-genome sequencing was performed. RESULTS: Staphylococcus aureus mutants resistant to the peptide deformylase inhibitor actinonin had mutations in the fmt gene that conferred high-level actinonin resistance and reduced bacterial growth rate. Compensated mutants that remained fully resistant to actinonin and showed increased growth rates appeared within 30-60 generations of growth. Whole-genome sequencing and localized DNA sequencing of mutated candidate genes showed that alterations in the gene agrC were present in the majority of compensated strains. Resistant and compensated mutants grew at similar rates as the wild-type in a mouse thigh infection model. CONCLUSIONS: Resistance to deformylase inhibitors due to fmt mutations reduces bacterial growth rates, but these costs can be reduced by mutations in the agrC gene. Mutants defective in fmt (with or without compensatory agrC mutations) grew well in an animal model, implying that they can also cause infection in a host.

Living with systemic mastocytosis: Balancing between vulnerability and resilience: A qualitative study.

PURPOSE: Systemic mastocytosis is a rare group of haematological malignancies with heterogeneous symptoms from various organs, and an overall survival that ranges from normal for indolent SM (ISM) to 2-4 years for advanced SM subtypes (Adv SM). The purpose of this study was to describe the experiences of everyday life among persons diagnosed with ISM or Adv SM. METHODS: In this qualitative study, data were collected through purposive sampling and semi-structured interviews with 16 participants diagnosed with ISM (n = 9) or Adv SM (n = 7). Data were subsequently analysed with content analysis. RESULTS: Three main categories were identified. The persistent presence of the disease includes findings of how the symptoms affected the participants and how they handled its limitations and the adaptions and medication management required. Struggling against ignorance illustrates contacts with both healthcare professionals and strangers. The participants described being forced to be experts on SM due to a general lack of knowledge. An illness or wellness perspective encompasses the participants' feelings of vulnerability and alienation, but also how various strategies were used to gain emotional control. CONCLUSIONS: The disease has considerable impact on everyday life, with constant efforts required to manage symptoms and medication side effects. The complexity and rarity of the disease complicated relationships with healthcare professionals and contributed to feelings of marginalisation and alienation. The participants described feeling vulnerable, but used a multitude of strategies in their striving for resilience. Trusting relationships with healthcare professionals, family members and friends promoted a wellness perspective.

How persons with systemic mastocytosis describe the time between symptom onset and receiving diagnosis.

AIM: The aim of the study was to explore how persons with systemic mastocytosis (SM) described the time between the onset of symptoms and signs and getting the diagnosis. BACKGROUND: SM is a rare disease caused by the accumulation of clonal mast cells with abnormal function. The symptoms and signs of the disease are varied, often diffuse and affect individuals differently. Due to this complexity, a multi-disciplinary diagnostic approach is required, in which general practitioners play an important part in identifying and referring patients relevant for such investigations. METHODS: Sixteen persons with SM were interviewed about their experiences of the time before the diagnosis was received. Systematic text condensation was used in the analysis process. FINDINGS: The time between symptom and signs onset and diagnosis was perceived as difficult. SM often had a complex and unpredictable effect on a person's daily life, long before diagnosis. In the analysis, three themes were found. Having symptoms and signs with an unknown cause included the participants' descriptions of numerous symptoms and signs, often years before diagnosis. These could be severe and result in worries for both participants and their next-of-kin. Dealing with the symptoms and signs encompassed the different ways in which the participants coped with the symptoms and signs, and sought relief. Being a patient without a diagnosis underlined the lack of information and knowledge within healthcare, often resulting in a delayed or incorrect diagnosis. The study highlighted the importance of a person-centred approach and the need to increase knowledge of the disease within primary care, to shorten this stressful and vulnerable time.

Predictors of return to work and psychological well-being among women during/after long-term sick leave due to common mental disorders - a prospective cohort study based on the theory of planned behaviour.

Common mental disorders are associated with long-term sick leave, especially among women. There is a lack of theory-based research regarding the impact of personal factors on return to work and psychological well-being. Therefore, the aim of this study was to examine whether return-to-work beliefs and perceived health were predictors of return to work and psychological well-being among women during or after long-term sick leave for common mental disorders, based on the Theory of Planned Behaviour. This was a prospective cohort study with a 1-year follow-up. At baseline, women (n = 282) had been on full- or part-time sick leave for common mental disorders for 2-24 months. Data were collected in October 2019-January 2020 and October 2020-January 2021 in Sweden. The Social Insurance Agency identified the women at baseline. The Return-To-Work Beliefs Questionnaire, EuroQol Visual Analogue Scale and General Health Questionnaire-12 were used. Multiple logistic and linear regression analyses were conducted. The women were divided into two groups: full-time sick leave or part-time sick leave at baseline. The results showed that stronger return-to-work intention significantly predicted return to work among women on full-time sick leave at baseline. No significant predictors of return to work were found among women on part-time sick leave at baseline. Psychological well-being was predicted by stronger social pressure to return to work (full-time group) and a more positive attitude toward returning to work and better perceived health (part-time group). We concluded that the Theory of Planned Behaviour can be useful for understanding return to work among women on full-time sick leave, and what underlies psychological well-being in both groups. However, return to work and psychological well-being were predicted by different factors, indicating that a multifactorial approach should be used in supporting women to return to work after long-term sick leave for common mental disorders.

Evidence of the impacts of metal mining and the effectiveness of mining mitigation measures on social-ecological systems in Arctic and boreal regions: a systematic map.

Background: Mining can directly and indirectly affect social and environmental systems in a range of positive and negative ways, and may result in societal benefits, but may also cause conflicts, not least in relation to land use. Mining always affects the environment, whilst remediation and mitigation efforts may effectively ameliorate some negative environmental impacts. Social and environmental systems in Arctic and boreal regions are particularly sensitive to impacts from development for numerous reasons, not least of which are the reliance of Indigenous peoples on subsistence livelihoods and long recovery times of fragile ecosystems. With growing metal demand, mining in the Arctic is expected to increase, demanding a better understand its social and environmental impacts. We report here the results of a systematic mapping of research evidence of the impacts of metal mining in Arctic and boreal regions. Methods: We searched multiple bibliographic databases and organisational websites for relevant research using tested search strategies. We also collected evidence from stakeholders and rightsholders identified in the wider 3MK project (Mapping the impacts of Mining using Multiple Knowledges, https://osf.io/cvh3u). We screened articles at three stages (title, abstract, and full text) according to a predetermined set of inclusion criteria, with consistency checks between reviewers at each level. We extracted data relating to causal linkages between actions or impacts and measured outcomes, along with descriptive information about the articles and studies. We have produced an interactive database along with interactive visualisations, and identify knowledge gaps and clusters using heat maps. Review findings: Searches identified over 32,000 potentially relevant records, which resulted in a total of 585 articles being retained in the systematic map. This corresponded to 902 lines of data on impact or mitigation pathways. The evidence was relatively evenly spread across topics, but there was a bias towards research in Canada (35% of the evidence base). Research was focused on copper (23%), gold (18%), and zinc (16%) extraction as the top three minerals, and open pit mines were most commonly studied (33%). Research most commonly focused on operation stages, followed by abandonment and post-closure, with little evidence on early stages (prospecting, exploration, construction; 2%), expansion (0.2%), or decommissioning/closure (0.3%). Mitigation measures were not frequently studied (18% articles), with groundwater mitigation most frequently investigated (54% of mitigations), followed by soil quality (12%) and flora species groups (10%). Control-impact study designs were most common (68%) with reference sites as the most frequently used comparator (43%). Only 7 articles investigated social and environmental outcomes together. the most commonly reported system was biodiversity (39%), followed by water (34%), societies (20%), and soil/geology (6%), with air the least common (1%). Conclusions: The evidence found highlights a suite of potential knowledge gaps, namely: on early stages prior to operation; effectiveness of mitigation measures; stronger causal inference study designs; migration and demography; cumulative impacts; and impacts on local and Indigenous communities. We also tentatively suggest subtopics where the number of studies could allow systematic reviews: operation, post-closure, and abandonment stages; individual faunal species, surface water quality, water sediment quality; and, groundwater mitigation measure effectiveness. Supplementary Information: The online version contains supplementary material available at 10.1186/s13750-022-00282-y.

Error-prone initiation factor 2 mutations reduce the fitness cost of antibiotic resistance.

Mutations in the fmt gene (encoding formyl methionine transferase) that eliminate formylation of initiator tRNA (Met-tRNA(i)) confer resistance to the novel antibiotic class of peptide deformylase inhibitors (PDFIs) while concomitantly reducing bacterial fitness. Here we show in Salmonella typhimurium that novel mutations in initiation factor 2 (IF2) located outside the initiator tRNA binding domain can partly restore fitness of fmt mutants without loss of antibiotic resistance. Analysis of initiation of protein synthesis in vitro showed that with non-formylated Met-tRNA(i) IF2 mutants initiated much faster than wild-type IF2, whereas with formylated fMet-tRNA(i) the initiation rates were similar. Moreover, the increase in initiation rates with Met-tRNA(i) conferred by IF2 mutations in vitro correlated well with the increase in growth rate conferred by the same mutations in vivo, suggesting that the mutations in IF2 compensate formylation deficiency by increasing the rate of in vivo initiation with Met-tRNA(i). IF2 mutants had also a high propensity for erroneous initiation with elongator tRNAs in vitro, which could account for their reduced fitness in vivo in a formylation-proficient strain. More generally, our results suggest that bacterial protein synthesis is mRNA-limited and that compensatory mutations in IF2 could increase the persistence of PDFI-resistant bacteria in clinical settings.

Relationships between coping, coping resources and quality of life in patients with chronic illness: a pilot study.

OBJECTIVES: The original purpose of the study was to determine differences between two groups of patients with chronic illness (ESRD and CHF) regarding the following study variables: coping, sense of coherence (SOC), self-efficacy and quality of life (QOL). Following this, the aim was to explore the relationships between demographic variables (sex, age, educational level and living area) and QOL as well as between coping, SOC, self-efficacy and QOL for the combined sample of patients with ESRD and CHF. METHODS: A comparative and correlative design was used with a sample of 100 patients (n = 41 ESRD, n = 59 CHF). The data were collected during 2004, using four standardized questionnaires and regression analyses were conducted. RESULTS: No significant differences were found between the two groups. Positive correlations were identified between SOC, general self-efficacy and QOL, whereas negative correlations emerge between emotion-focused coping, SOC, general self-efficacy and QOL. SOC, general self-efficacy and emotion-focused coping explained 40% of the variance in QOL. Those with low SOC and general self-efficacy showed negative correlations between emotion-focused coping and QOL, whereas no such correlations were shown for those with high values on SOC and general self-efficacy. CONCLUSIONS: The present results on coping and QOL correspond with previous research regarding how other groups with chronic illness handled their daily life. Preliminary results indicate that how individuals tackle their present situation is more important than which chronic illness they have. Women used more emotion-focused coping than men, which constitute an important finding for further research.