Objectives This paper is the first multidisciplinary study into the impact of new skill requirements in the job on absenteeism. The aim of this study was to investigate whether economic skills obsolescence (ESO) increased both absence frequency and average duration mediated by burnout and/or work engagement.Methods A longitudinal study was conducted on data from the Dutch Study on Transitions in Employment, Ability and Motivation (N=4493). Structural equation modelling was used to test the specific direct and indirect effects of ESO on absence frequency and average duration, followed by bootstrapping to compute the confidence intervals.Results ESO at baseline had a positive relationship with burnout at follow-up. In turn, burnout was positively related to both absence frequency and average absence duration at follow-up. The bootstrap indirect effect test showed that ESO had a significant positive indirect effect, via burnout and (lower) work engagement, on absence frequency and average duration. Furthermore, ESO at baseline was negatively related to work engagement at follow-up. Work engagement, in turn, was negatively related to absence frequency and average duration at follow-up. The bootstrap test showed that ESO had a significant indirect effect, via work engagement, on absence frequency.Conclusion ESO is associated with subsequent absence frequency and average duration of workers, both mediated by burnout and decreased work engagement.
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OBJECTIVE: The aim of this study was to explore the longitudinal relationship between sitting time on a working day and vitality, work performance, presenteeism, and sickness absence.METHODS: At the start and end of a five-month intervention program at the workplace, as well as 10 months after the intervention, sitting time and work-related outcomes were measured using a standardized self-administered questionnaire and company records. Generalized linear mixed models were used to estimate the longitudinal relationship between sitting time and work-related outcomes, and possible interaction effects over time.RESULTS: A significant and sustainable decrease in sitting time on a working day was observed. Sitting less was significantly related to higher vitality scores, but this effect was marginal (b = -0.0006, P = 0.000).CONCLUSIONS: Our finding of significant though marginal associations between sitting time and important work-related outcomes justifies further research.
DOCUMENT
BackgroundFluid therapy is a common intervention in critically ill patients. It is increasingly recognised that deresuscitation is an essential part of fluid therapy and delayed deresuscitation is associated with longer invasive ventilation and length of intensive care unit (ICU) stay. However, optimal timing and rate of deresuscitation remain unclear. Lung ultrasound (LUS) may be used to identify fluid overload. We hypothesise that daily LUS-guided deresuscitation is superior to deresuscitation without LUS in critically ill patients expected to undergo invasive ventilation for more than 24 h in terms of ventilator free-days and being alive at day 28.MethodsThe “effect of lung ultrasound-guided fluid deresuscitation on duration of ventilation in intensive care unit patients” (CONFIDENCE) is a national, multicentre, open-label, randomised controlled trial (RCT) in adult critically ill patients that are expected to be invasively ventilated for at least 24 h. Patients with conditions that preclude a negative fluid balance or LUS examination are excluded. CONFIDENCE will operate in 10 ICUs in the Netherlands and enrol 1000 patients. After hemodynamic stabilisation, patients assigned to the intervention will receive daily LUS with fluid balance recommendations. Subjects in the control arm are deresuscitated at the physician’s discretion without the use of LUS. The primary endpoint is the number of ventilator-free days and being alive at day 28. Secondary endpoints include the duration of invasive ventilation; 28-day mortality; 90-day mortality; ICU, in hospital and total length of stay; cumulative fluid balance on days 1–7 after randomisation and on days 1–7 after start of LUS examination; mean serum lactate on days 1–7; the incidence of reintubations, chest drain placement, atrial fibrillation, kidney injury (KDIGO stadium ≥ 2) and hypernatremia; the use of invasive hemodynamic monitoring, and chest-X-ray; and quality of life at day 28.DiscussionThe CONFIDENCE trial is the first RCT comparing the effect of LUS-guided deresuscitation to routine care in invasively ventilated ICU patients. If proven effective, LUS-guided deresuscitation could improve outcomes in some of the most vulnerable and resource-intensive patients in a manner that is non-invasive, easy to perform, and well-implementable.Trial registrationClinicalTrials.gov NCT05188092. Registered since January 12, 2022
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