BACKGROUND: The cost of sickness absence has major social, psychological and financial implications for individuals and organisations. Return-to-work (RTW) interventions that support good quality communication and contact with the workplace can reduce the length of sickness absence by between 15 and 30 days. However, initiatives promoting a sustainable return to work for workers with poor mental health on long-term sickness absence across small, medium and large enterprises (SMEs and LEs) are limited. This paper describes the protocol of a pilot randomised controlled trial (RCT) to test the feasibility of implementing a RTW intervention across SMEs and LEs across all sectors. METHODS AND DESIGN: A two-arm feasibility RCT with a 4-month intervention will be conducted in SMEs and LE enterprises from the Midlands region, UK. At least 8 organisations (4 controls and interventions), and at least 60 workers and/or managers, will be recruited and randomised into the intervention and control group (30 interventions, 30 controls). Workers on long-term sickness absence (LTSA) (between 8 and 50 days) and managers with a worker on LTSA will be eligible to participate. The intervention is a behavioural change programme, including a managers and workers RTW toolkit, focused on supporting sickness absence and RTW through the provision of knowledge, problem-solving, action planning, goal setting and positive communication that leads to a sustainable RTW. Organisations assigned to the control group will continue with their usual practice. Measurements of mental health, RTW, work outcomes, quality-of-life, workplace support and communication and other demographic data will be taken at baseline, 2 months and 4 months. Feasibility will be assessed based on recruitment, retention, attrition, completion of measures and intervention compliance for which specific process and research outcomes have been established. A process evaluation will explore the experiences and acceptability of the intervention components and evaluation measures. Exploratory economic evaluation will be conducted to further inform a definitive trial. DISCUSSION: This is a novel intervention using a worker-manager approach to promote a sustainable return to work of workers on long-term sick leave due to poor mental wellbeing. If this intervention is shown to be feasible, the outcomes will inform a larger scale randomised control trial. TRIAL REGISTRATION: ISRCTN90032009 (retrospectively registered, date registered 15th December 2020).
Land resources in developing countries are facing intense degradation due to deforestation and subsequent loss of organic matter from continuous tillage that causes soil erosion and gulley formation. The Ethiopian highlands are especially and severely affected. One of the land and water management practices to counteract this problem, fenced areas to prevent livestock access (called exclosures), has been in practice for the last few decades in the semi-arid highlands of Ethiopia but its effect on degraded landscapes has not been well researched -- especially in the sub-humid and humid highlands. The aim of this study is to evaluate the effects of exclosures on improving degraded landscapes in the sub-humid highlands. The research was carried out in the Ferenj Wuha watershed, in the northwestern sub-humid Ethiopian highlands, where land and water management practices were implemented starting in 2011. Vegetation was inventoried and aboveground biomass, carbon and nutrient stock determined for communal grazing land, exclosures and for other uses. In addition, soil samples were collected for nutrient analysis. Our results show that exclosures have a richer and more diverse set of plant species compared to communal grazing land. Establishment of an exclosure also enhanced organic carbon, total nitrogen and available phosphorus. Over a six-year period, aboveground biomass increased by 54 Mg ha-1 (or 81%) at the watershed scale because of the conversion of communal grazing land to exclosures. The improvement in soil nutrients due to exclosures, in turn, increased carbon and nutrient stock. The results support regeneration of degraded landscapes by restoring vegetation, soil fertility, carbon and nutrient stocks in the Northwestern highlands of Ethiopia. However, additional research is required to more accurately quantify these improvements because current research efforts that sample only the surface soils seem to indicate that the capacity of exclosures to increase soil carbon storage is decreasing when annual rainfall is increasing.
Carbon , Soil , Animals , Biomass , Ecosystem , Ethiopia , Nitrogen
