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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ABSTRACT It is unknown whether heterogeneity in effects of self-management interventions in patients with chronic obstructive pulmonary disease (COPD) can be explained by differences in programme characteristics. This study aimed to identify which characteristics of COPD self-management interventions are most effective. Systematic search in electronic databases identified randomised trials on self-management interventions conducted between 1985 and 2013. Individual patient data were requested for meta-analysis by generalised mixed effects models. 14 randomised trials were included (67% of eligible), representing 3282 patients (75% of eligible). Univariable analyses showed favourable effects on some outcomes for more planned contacts and longer duration of interventions, interventions with peer contact, without log keeping, without problem solving, and without support allocation. After adjusting for other programme characteristics in multivariable analyses, only the effects of duration on all-cause hospitalisation remained. Each month increase in intervention duration reduced risk of all-cause hospitalisation (time to event hazard ratios 0.98, 95% CI 0.97–0.99; risk ratio (RR) after 6 months follow-up 0.96, 95% CI 0.92–0.99; RR after 12 months follow-up 0.98, 95% CI 0.96–1.00). Our results showed that longer duration of self-management interventions conferred a reduction in allcause hospitalisations in COPD patients. Other characteristics are not consistently associated with differential effects of self-management interventions across clinically relevant outcomes.
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Background: Research into termination of long-term psychosocial treatment of mental disorders is scarce. Yearly 25% of people in Dutch mental health services receive long-term treatment. They account for many people, contacts, and costs. Although relevant in different health care systems, (dis)continuation is particularly problematic under universal health care coverage when secondary services lack a fixed (financially determined) endpoint. Substantial, unaccounted, differences in treatment duration exist between services. Understanding of underlying decisional processes may result in improved decision making, efficient allocation of scarce resources, and more personalized treatment.
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Injuries of runners reduce the ability to train and hinder competing. Literature shows that the relation between potential risk factors and injuries are not definitive, limited, and inconsistent. In team sports, workload derivatives were identified as risk factors. However, there is an absence of literature in running on workload derivatives. This study used the workload derivatives acute workload, chronic workload, and acute: chronic workload ratios to investigate the relation between workload and injury risk in running. Twenty-three competitive runners kept a daily training log for 24 months. The runners reported training duration, training intensity and injuries. One-week (acute) and 4-week (chronic) workloads were calculated as the average of training duration multiplied by training intensity. The acute:chronic workload ratio was determined dividing the acute and chronic workloads. Results show that a fortnightly low increase of the acute:chronic workload ratio (0.10-0.78) led to an increased risk of sustaining an injury (p<0.001). Besides, a low increase of the acute:chronic workload ratio (0.05-0.62) between the second week and third week before an injury showed an association with increased injury risk (p=0.013). These findings demonstrate that the acute:chronic workload ratio relates to injury risk.
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Background Wheelchair tennis, a globally popular sport, features a professional tour spanning 40 countries and over 160 tournaments. Despite its widespread appeal, information about the physical demands of wheelchair tennis is scattered across various studies, necessitating a comprehensive systematic review to synthesise available data. Objective The aim was to provide a detailed synthesis of the physical demands associated with wheelchair tennis, encompassing diverse factors such as court surfaces, performance levels, sport classes, and sexes. Methods We conducted comprehensive searches in the PubMed, Embase, CINAHL, and SPORTDiscus databases, covering articles from inception to March 1, 2023. Forward and backward citation tracking from the included articles was carried out using Scopus, and we established eligibility criteria following the Population, Exposure, Comparison, Outcome, and Study design (PECOS) framework. Our study focused on wheelchair tennis players participating at regional, national, or international levels, including both juniors and adults, and open and quad players. We analysed singles and doubles matches and considered sex (male, female), sport class (open, quad), and court surface type (hard, clay, grass) as key comparative points. The outcomes of interest encompassed play duration, on-court movement, stroke performance, and physiological match variables. The selected study designs included observational cross-sectional, longitudinal, and intervention studies (baseline data only). We calculated pooled means or mean differences with 95% confidence intervals (CIs) and employed a random-effects meta-analysis with robust variance estimation. We assessed heterogeneity using Cochrane Q and 95% prediction intervals. Results Our literature search retrieved 643 records, with 24 articles meeting our inclusion criteria. Most available information focused on international male wheelchair tennis players in the open division, primarily competing in singles on hard courts. Key findings (mean [95% CI]) for these players on hard courts were match duration 65.9 min [55.0–78.8], set duration 35.0 min [28.2–43.5], game duration 4.6 min [0.92–23.3], rally duration 6.1 s [3.7–10.2], effective playing time 19.8% [18.9–20.7], and work-to-rest ratio 1:4.1 [1:3.7–1:4.4]. Insufficient data were available to analyse play duration for female players. However, for the available data on hard court matches, the average set duration was 34.8 min [32.5–37.2]. International male players on hard court covered an average distance per match of 3859 m [1917–7768], with mean and peak average forward speeds of 1.06 m/s [0.85–1.32] and 3.55 m/s [2.92–4.31], respectively. These players executed an average of 365.9 [317.2–422.1] strokes per match, 200.6 [134.7–299.0] per set, 25.4 [16.7–38.7] per game, and 3.4 [2.6–4.6] per rally. Insufficient data were available for a meta-analysis of female players’ on-court movement and stroke performance. The average and peak heart rates of international male players on hard court were 134.3 [124.2–145.1] and 166.0 [132.7–207.6] beats per minute, and the average match heart rate expressed as a percentage of peak heart rate was 74.7% [46.4–100]. We found no studies concerning regional players or juniors, and only one study on doubles match play. Conclusions While we present a comprehensive overview of the physical demands of wheelchair tennis, our understanding predominantly centres around international male players competing on hard courts in the open division. To attain a more comprehensive insight into the sport’s physical requirements, future research should prioritise the inclusion of data on female and quad players, juniors, doubles, and matches played on clay and grass court surfaces. Such endeavours will facilitate the development of more tailored and effective training programmes for wheelchair tennis players and coaches.
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Objective: This study aims to assess the comparative effectiveness of a conventional splitting needle or a peelable cannula vs. the modified Seldinger technique (MST) by utilizing a dedicated micro-insertion kit across various clinically significant metrics, including insertion success, complications, and catheter-related infections. Methods: We conducted a retrospective observational cohort study using an anonymized data set spanning 3 years (2017-2019) in a large tertiary-level neonatal intensive care unit in Qatar. Results: A total of 1,445 peripherally inserted central catheter (PICC) insertion procedures were included in the analysis, of which 1,285 (89%) were successful. The primary indication for insertion was mainly determined by the planned therapy duration, with the saphenous vein being the most frequently selected blood vessel. The patients exposed to MST were generally younger (7 ± 15 days vs. 11 ± 26 days), but exhibited similar mean weights and gestational ages. Although not statistically significant, the MST demonstrated slightly higher overall and first-attempt insertion success rates compared to conventional methods (91 vs. 88%). However, patients undergoing conventional insertion techniques experienced a greater incidence of catheter-related complications (p < 0.001). There were 39 cases of catheter-related bloodstream infections (CLABSI) in the conventional group (3.45/1,000 catheter days) and eight cases in the MST group (1.06/1,000 catheter days), indicating a statistically significant difference (p < 0.001). Throughout the study period, there was a noticeable shift toward the utilization of the MST kit for PICC insertions. Conclusion: The study underscores the viability of MST facilitated by an all-in-one micro kit for neonatal PICC insertion. Utilized by adept and trained inserters, this approach is associated with improved first-attempt success rates, decreased catheter-related complications, and fewer incidences of CLABSI. However, while these findings are promising, it is imperative to recognize potential confounding factors. Therefore, additional prospective multicenter studies are recommended to substantiate these results and ascertain the comprehensive benefits of employing the all-in-one kit.
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Light enables us to see and perceive our environment but it also initiates effects beyond vision, such as alertness. Literature describes that at least six factors are relevant for initiating effects beyond vision. The exact relationship between these factors and alertness is not yet fully understood. In the current field study, personal lighting conditions of 62 Dutch office workers (aged 49.7 ± 11.4 years) were continuously measured and simultaneously self-reported activities and locations during the day were gathered via diaries. Each office worker participated 10 working days in spring 2017. Personal lighting conditions were interpreted based on four of the six factors (light quantity, spectrum, timing, and duration of light exposure). Large individual differences were found for the daily luminous exposures, illuminances, correlated colour temperatures, and irradiances measured with the blue sensor area of the dosimeter. The average illuminance (over all participants and all days) over the course of the day peaked three times. The analysis of the duration of light exposure demonstrated that the participants were on average only exposed to an illuminance above 1000 lx for 72 minutes per day. The interpretation of personal lighting conditions based on the four factors provides essential information since all of these factors may be relevant for initiating effects beyond vision. The findings in the current paper give first in-depth insight in the possibilities to interpret personal lighting conditions of office workers.
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Although bipolar disorder (BD) has been understood classically as a cyclic disease with full recovery between manic and depressive mood episodes, the long-term outcome has been associated with cognitive deficits, impaired psychosocial functioning, and premature death.1 Due to ageing of the population the absolute number of older persons with BD will rise in the next decades1 with substantial burden for their caregivers. 2. Acknowledging that recovery is defined more broadly than the absence of mood symptoms,3 insights regarding perspectives of recovery and expectations of mental health care (MHC) are urgently warranted to meet the needs of this growing complex patient group.
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Aim and method: To examine in obese people the potential effectiveness of a six-week, two times weekly aquajogging program on body composition, fitness, health-related quality of life and exercise beliefs. Fifteen otherwise healthy obese persons participated in a pilot study. Results: Total fat mass and waist circumference decreased 1.4 kg (p = .03) and 3.1 cm (p = .005) respectively. The distance in the Six-Minute Walk Test increased 41 meters (p = .001). Three scales of the Impact of Weight on Quality of Life-Lite questionnaire improved: physical function (p = .008), self-esteem (p = .004), and public distress (p = .04). Increased perceived exercise benefits (p = .02) and decreased embarrassment (p = .03) were observed. Conclusions: Aquajogging was associated with reduced body fat and waist circumference, and improved aerobic fitness and quality of life. These findings suggest the usefulness of conducting a randomized controlled trial with long-term outcome assessments.
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Mentor teachers need a versatile supervisory skills repertoire. Besides taking the prevalent role of daily advisor and instructor, mentor teachers should also be able to stimulate reflection in student teachers. Video recordings were analyzed of 60 mentoring dialogues, both before and after a mentor teacher training aiming at developing the encourager role. Mentor teachers' repertoires of supervisory skills were found to consist of an average of seven supervisory skills. After training, a shift was observed in the frequencies and duration with which supervisory skills were used. Although considerable inter-individual variability existed between mentor teachers, training positively affected the use of supervisory skills for stimulating reflection in student teachers.
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