Purpose
A lack of social acceptance by non-disabled co-workers is often the reason why employees with disabilities fail to stay in regular organizations for sustained periods. The aim of the study is ...to present a coherent review of the extant literature on factors affecting the acceptance of people with disabilities in regular employment.
Method
We conducted a search of the electronic databases PsychINFO and Web of Science (period: 1996–2011) supplemented with a search for additional relevant articles by means of cross-referencing. In total 48 articles were selected, coded and analyzed by three coders into three overarching themes.
Results
The analysis of included articles shows that the acceptance of employees with disabilities is influenced by three main variable groups: characteristics of co-workers, of the persons with disabilities and of the employers/organizations. Most studies present factors that influence co-workers’ or employers’ attitudes toward employees with disabilities such as demographic variables.
Conclusion
Although, recent research has started to accumulate findings on factors that affect the acceptance of employees with disabilities, many gaps remain in the understanding of the concept of acceptance and its relation to the employment of people with disabilities.
Introduction
In many Western countries, a vast amount of interventions exist that aim to facilitate return to work (RTW) after sickness absence. These interventions are usually focused on specific ...target populations such as employees with low back pain, stress-related complaints or adjustment disorders. The aim of the present study is to detect and identify characteristics of RTW interventions that generally facilitate return to work (i.e. in multiple target populations and across interventions). This type of knowledge is highly relevant to policy makers and health practitioners who want to deliver evidence based care that supports the employee’s health and participation in labour.
Methods
We performed a keyword search (systematic literature review) in seven databases (period: 1994–2010). In total, 23 articles were included and assessed for their methodological quality. The characteristics of the interventions were evaluated as well.
Results
Early interventions, initiated in the first 6 weeks of the RTW process were scarce. These were effective to support RTW though. Multidisciplinary interventions appeared effective to support RTW in multiple target groups (e.g. back pain and adjustment disorders). Time contingent interventions in which activities followed a pre-defined schedule were effective in all physical complaints studied in this review. Activating interventions such as gradual RTW were effective in physical complaints. They have not been studied for people with psychological complaints.
Conclusions
Early- and multidisciplinary intervention and time-contingent-, activating interventions appear most effective to support RTW.
Objective To compare perinatal mortality and severe perinatal morbidity between planned home and planned hospital births, among low‐risk women who started their labour in primary care.
Design A ...nationwide cohort study.
Setting The entire Netherlands.
Population A total of 529 688 low‐risk women who were in primary midwife‐led care at the onset of labour. Of these, 321 307 (60.7%) intended to give birth at home, 163 261 (30.8%) planned to give birth in hospital and for 45 120 (8.5%), the intended place of birth was unknown.
Methods Analysis of national perinatal and neonatal registration data, over a period of 7 years. Logistic regression analysis was used to control for differences in baseline characteristics.
Main outcome measures Intrapartum death, intrapartum and neonatal death within 24 hours after birth, intrapartum and neonatal death within 7 days and neonatal admission to an intensive care unit.
Results No significant differences were found between planned home and planned hospital birth (adjusted relative risks and 95% confidence intervals: intrapartum death 0.97 (0.69 to 1.37), intrapartum death and neonatal death during the first 24 hours 1.02 (0.77 to 1.36), intrapartum death and neonatal death up to 7 days 1.00 (0.78 to 1.27), admission to neonatal intensive care unit 1.00 (0.86 to 1.16).
Conclusions This study shows that planning a home birth does not increase the risks of perinatal mortality and severe perinatal morbidity among low‐risk women, provided the maternity care system facilitates this choice through the availability of well‐trained midwives and through a good transportation and referral system.
Painful diabetic neuropathy (PDN) is a peripheral neuropathic pain condition that is often difficult to relieve. Spinal cord stimulation (SCS) is a proven effective therapy for various types of mixed ...neuropathic conditions, yet effectiveness of SCS treatment for PDN is not well established. To our knowledge, ours is the first multicentre randomized controlled trial investigating the effectiveness of SCS in patients with PDN. Sixty patients with PDN in the lower extremities refractory to conventional medical therapy were enrolled and followed for 6 months. They were randomized 2:1 to best conventional medical practice with (SCS group) or without (control group) additional SCS therapy, and both groups were assessed at regular intervals. At each follow-up visit, the EuroQoL 5D, the short form McGill Pain Questionnaire (SF-MPQ) and a visual analogue scale (VAS, ranging 0-100) to measure pain intensity were recorded. The average VAS score for pain intensity was 73 in the SCS group and 67 in the control group at baseline. After 6 months of treatment, the average VAS score was significantly reduced to 31 in the SCS group (P<.001) and remained 67 (P=.97) in the control group. The SF-MPQ and EuroQoL 5D questionnaires also showed that patients in the SCS group, unlike those in the control group, experienced reduced pain and improved health and quality of life after 6 months of treatment. In patients with refractory painful diabetic neuropathy, spinal cord stimulation therapy significantly reduced pain and improved quality of life.
Objective
To compare rates of adverse perinatal outcomes between planned home births versus planned hospital births.
Design
A nationwide cohort study.
Setting
The Netherlands.
Population
Low‐risk ...women in midwife‐led care at the onset of labour.
Methods
Analysis of national registration data.
Main outcome measures
Intrapartum and neonatal death, Apgar scores, and admission to a neonatal intensive care unit (NICU) within 28 days of birth.
Results
Of the total of 814 979 women, 466 112 had a planned home birth and 276 958 had a planned hospital birth. For 71 909 women, their planned place of birth was unknown. The combined intrapartum and neonatal death rates up to 28 days after birth, including cases with discrepancies in the registration of the moment of death, were: for nulliparous women, 1.02‰ for planned home births versus 1.09‰ for planned hospital births, adjusted odds ratio (aOR) 0.99, 95% confidence interval (95% CI) 0.79–1.24; and for parous women, 0.59‰ versus 0.58‰, aOR 1.16, 95% CI 0.87–1.55. The rates of NICU admissions and low Apgar scores did not significantly differ among nulliparous women (NICU admissions up to 28 days, 3.41‰ versus 3.61‰, aOR 1.05, 95% CI 0.92–1.18). Among parous women the rates of Apgar scores below seven and NICU admissions were significantly lower among planned home births (NICU admissions up to 28 days, 1.36 versus 1.95‰, aOR 0.79, 95% CI 0.66–0.93).
Conclusions
We found no increased risk of adverse perinatal outcomes for planned home births among low‐risk women. Our results may only apply to regions where home births are well integrated into the maternity care system.
Hubs within the neocortical structural network determined by graph theoretical analysis play a crucial role in brain function. We mapped neocortical hubs topographically, using a sample population of ...63 young adults. Subjects were imaged with high resolution structural and diffusion weighted magnetic resonance imaging techniques. Multiple network configurations were then constructed per subject, using random parcellations to define the nodes and using fibre tractography to determine the connectivity between the nodes. The networks were analysed with graph theoretical measures. Our results give reference maps of hub distribution measured with betweenness centrality and node degree. The loci of the hubs correspond with key areas from known overlapping cognitive networks. Several hubs were asymmetrically organized across hemispheres. Furthermore, females have hubs with higher betweenness centrality and males have hubs with higher node degree. Female networks have higher small-world indices.
Objective
To use data from routine sources to compare rates of obstetric intervention in Europe both overall and for subgroups at higher risk of intervention.
Design
Retrospective analysis of ...aggregated routine data.
Setting
Thirty‐one European countries or regions contributing data on mode of delivery to the Euro‐Peristat project.
Population
Births in participating countries in 2010.
Methods
Countries provided aggregated data about overall rates of obstetric intervention and about caesarean section rates for specified subgroups.
Main outcome measures
Mode of delivery.
Results
Rates of caesarean section ranged from 14.8% to 52.2% of all births and rates of instrumental vaginal delivery ranged from 0.5% to 16.4%. Overall, there was no association between rates of instrumental vaginal delivery and rates of caesarean section, but similarities were observed between some countries that are geographically close and may share common traditions of practice. Associations were observed between caesarean section rates for women with breech and vertex births and with singleton and multiple births but patterns of association for women who had and had not had previous caesarean sections were more complex.
Conclusions
The persisting wide variations in caesarean section and instrumental vaginal delivery rates point to a lack of consensus about practice and raise questions for further investigation. Further research is needed to explore the impact of differences in clinical guidelines, healthcare systems and their financing and parents’ and professionals’ attitudes to care at delivery.
Colloidal synthesis of nanocrystals (NC) followed by their attachment to a support and activation is a promising route to prepare model catalysts for research on structure-performance relationships. ...Here, we investigated the suitability of this method to prepare well-defined Co/TiO2 and Co/SiO2 catalysts for the Fischer–Tropsch (FT) synthesis with high control over the cobalt particle size. To this end, Co-NC of 3, 6, 9, and 12 nm with narrow size distributions were synthesized and attached uniformly on either TiO2 or SiO2 supports with comparable morphology and Co loadings of 2–10 wt %. After activation in H2, the FT activity of the TiO2-supported 6 and 12 nm Co-NC was similar to that of a Co/TiO2 catalyst prepared by impregnation, showing that full activation was achieved and relevant catalysts had been obtained; however, 3 nm Co-NC on TiO2 were less active than anticipated. Analysis after FT revealed that all Co-NC on TiO2 as well as 3 nm Co-NC on SiO2 had grown to ∼13 nm, while the sizes of the 6 and 9 nm Co-NC on SiO2 had remained stable. It was found that the 3 nm Co-NC on TiO2 already grew to 10 nm during activation in H2. Furthermore, substantial amounts of Co (up to 60%) migrated from the Co-NC to the support during activation on TiO2 against only 15% on SiO2. We showed that the stronger interaction between cobalt and TiO2 leads to enhanced catalyst restructuring as compared to SiO2. These findings demonstrate the potential of the NC-based method to produce relevant model catalysts to investigate phenomena that could not be studied using conventionally synthesized catalysts.
Introduction
Early return-to-work (RTW) after sick leave is considered to support employees’ quality of life. Successful RTW requires adequate cooperation between absent employees and their ...supervisors. This study assesses the effectiveness of an intervention for COoperation regarding RTW between Sick-listed employees and their Supervisors (COSS; i.e. ‘conversation roadmap’, monitoring of cooperation and, if necessary, extra occupational physician support).
Methods
In this field study, employees on sick leave for 2–10 weeks, aged 18 up to and including 60, and performing paid labour for at least 12 h per week were included. Terminally ill were excluded. Multivariate regression (correcting for baseline quality of life) was used to compare 6-months follow up data regarding quality of life between the groups. Using Cox regression analyses, time until first-, full-, and sustainable RTW was compared between groups.
Results
In total 64 employees received COSS or common practice. No significant group differences were found regarding all study outcomes. The COSS group had a higher chance of work resumption than the common practice group. The hazard ratio was 1.39 for first RTW (95 % CI 0.81–2.37), 1.12 for full RTW (95 % CI 0.65–1.93) and 1.10 for sustainable RTW (95 % CI 0.63–1.95).
Conclusions
COSS has no significant effects. Yet, the results regarding work resumption show a tendency towards effectiveness. Therefore, COSS can be further developed and applied in practice. Researchers should try to prevent some limitations of the present study in future research, for instance by finding a more common research setting.
Please cite this paper as: Schuit E, Kwee A, Westerhuis M, Van Dessel H, Graziosi G, Van Lith J, Nijhuis J, Oei S, Oosterbaan H, Schuitemaker N, Wouters M, Visser G, Mol B, Moons K, Groenwold R. A ...clinical prediction model to assess the risk of operative delivery. BJOG 2012;119:915–923.
Objective To predict instrumental vaginal delivery or caesarean section for suspected fetal distress or failure to progress.
Design Secondary analysis of a randomised trial.
Setting Three academic and six non‐academic teaching hospitals in the Netherlands.
Population 5667 labouring women with a singleton term pregnancy in cephalic presentation.
Methods We developed multinomial prediction models to assess the risk of operative delivery using both antepartum (model 1) and antepartum plus intrapartum characteristics (model 2). The models were validated by bootstrapping techniques and adjusted for overfitting. Predictive performance was assessed by calibration and discrimination (area under the receiver operating characteristic), and easy‐to‐use nomograms were developed.
Main outcome measures Incidence of instrumental vaginal delivery or caesarean section for fetal distress or failure to progress with respect to a spontaneous vaginal delivery (reference).
Results 375 (6.6%) and 212 (3.6%) women had an instrumental vaginal delivery or caesarean section due to fetal distress, and 433 (7.6%) and 571 (10.1%) due to failure to progress, respectively. Predictors were age, parity, previous caesarean section, diabetes, gestational age, gender, estimated birthweight (model 1) and induction of labour, oxytocin augmentation, intrapartum fever, prolonged rupture of membranes, meconium stained amniotic fluid, epidural anaesthesia, and use of ST‐analysis (model 2). Both models showed excellent calibration and the receiver operating characteristics areas were 0.70–0.78 and 0.73–0.81, respectively.
Conclusion In Dutch women with a singleton term pregnancy in cephalic presentation, antepartum and intrapartum characteristics can assist in the prediction of the need for an instrumental vaginal delivery or caesarean section for fetal distress or failure to progress.
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