Review of Irish Civil Service sickness absence referrals 2008-10

BACKGROUND

Long-term sickness absence can have negative consequences for individuals and for their employers. Occupational health has an important role in assisting workplace rehabilitation in such cases.

AIMS

To investigate long-term sickness absence referrals in the Irish Civil Service in terms of epidemiological profile, illness categories and eventual outcomes.

METHODS

A retrospective review of consecutive new long-term sickness absence cases referred between January 2008 and April 2008 and followed up to July 2010, using review of electronic and paper medical records and personnel department data to establish case outcomes.

RESULTS

Three hundred and one cases were available for analysis. There were more long-term sickness absence cases among older employees, with female employees and clerical officer grades more likely to be referred. The principal diagnostic groups were mental health issues (30%), musculoskeletal disorders (13%) and cancer (11%). The eventual outcomes were the following: return to work (83%) and ill-health retirement (8%); 2% were still on sick leave and the remaining 7% had left civil service employment for other reasons at the end of the study period.

CONCLUSIONS

The final outcome in a large majority of case referrals was to resume work, with only a small proportion retiring on ill-health grounds. Mental health disorders, musculoskeletal disorders and cancers were the principal reasons for absence.

The NF2 tumor suppressor regulates microtubule-based vesicle trafficking via a novel Rac, MLK and p38(SAPK) pathway

Neurofibromatosis Type 2 patients develop schwannomas, meningiomas and ependymomas resulting from mutations in the tumor suppressor gene, NF2, encoding a membrane-cytoskeleton adaptor protein called merlin. Merlin regulates contact inhibition of growth and controls the availability of growth factor receptors at the cell surface. We tested if microtubule-based vesicular trafficking might be a mechanism by which merlin acts. We found that schwannoma cells, containing merlin mutations and constitutive activation of the Rho/Rac family of GTPases, had decreased intracellular vesicular trafficking relative to normal human Schwann cells. In Nf2−/− mouse Schwann (SC4) cells, re-expression of merlin as well as inhibition of Rac or its effector kinases, MLK and p38^SAPK, each increased the velocity of Rab6 positive exocytic vesicles. Conversely, an activated Rac mutant decreased Rab6 vesicle velocity. Vesicle motility assays in isolated squid axoplasm further demonstrated that both mutant merlin and active Rac specifically reduce anterograde microtubule-based transport of vesicles dependent upon the activity of p38^SAPK kinase. Taken together, our data suggest loss of merlin results in the Rac dependent decrease of anterograde trafficking of exocytic vesicles, representing a possible mechanism controlling the concentration of growth factor receptors at the cell surface.

A new anti-depressive strategy for the elderly: ablation of FKBP5/FKBP51

The gene FKBP5 codes for FKBP51, a co-chaperone protein of the Hsp90 complex that increases with age. Through its association with Hsp90, FKBP51 regulates the glucocorticoid receptor (GR). Single nucleotide polymorphisms (SNPs) in the FKBP5 gene associate with increased recurrence of depressive episodes, increased susceptibility to post-traumatic stress disorder, bipolar disorder, attempt of suicide, and major depressive disorder in HIV patients. Variation in one of these SNPs correlates with increased levels of FKBP51. FKBP51 is also increased in HIV patients. Moreover, increases in FKBP51 in the amygdala produce an anxiety phenotype in mice. Therefore, we tested the behavioral consequences of FKBP5 deletion in aged mice. Similar to that of naïve animals treated with classical antidepressants FKBP5−/− mice showed antidepressant behavior without affecting cognition and other basic motor functions. Reduced corticosterone levels following stress accompanied these observed effects on depression. Age-dependent anxiety was also modulated by FKBP5 deletion. Therefore, drug discovery efforts focused on depleting FKBP51 levels may yield novel antidepressant therapies.

Wireless-based Monitoring of Body Movements Using Wearable Sensors

The world is becoming more health conscious and as a result healthcare is evolving in many ways. Wearable computing is assisting with this evolution, finding its place in many biomedical applications where real-time monitoring of general health indicators is required. However, the inconvenience of connecting sensors through wires, which not only incurs high maintenance, limits the freedom of the person therefore hampering a true reflection of the person's actions. By using sensors attached to wireless sensor nodes, this constraint is removed. Also in order to be “wearable” the sensors must be comfortable, a factor often overlooked by traditional sensors, where functionality and robustness are of higher importance. This work is focused on the use of foam-based pressure sensors and similar textile-based sensors for monitoring the ambulatory movements of the wearer. Characterization of the molecular nature of the materials and their environment are presented. We find these sensors to be successful in detecting the movement events without imposing on the daily activity of the wearer.

Comparison of contraceptive choices of rural and urban US adults aged 18-55 years: an analysis of 2004 behavioral risk factor surveillance survey data

INTRODUCTION

Although sexually active US adults wanting to prevent pregnancy have a wide variety of birth control methods readily available, there is little research that documents the contraceptive choices of rural adults in comparison to urban adults. This study compared the contraceptive choices of rural with urban adults. The comparative analysis joins the recent dialog in population health focused on assessing health related differences to detect if these are indicative of rural health disparities.

DESIGN

This was a cross-sectional study analyzing 2004 Behavioral Risk Factor Surveillance Survey (BRFSS) data. Place of residence was ascertained by re-coding the state/county FIPS code as either urban or rural, based on 2003 Rural-Urban Continuum Codes from the US Office of Management and Budget (setting: US households; participants: US adults 18-55 years).

MAIN OUTCOME MEASURES

characteristics and contraceptive method choice of rural adults using birth control.

RESULTS

A multivariate regression model performed with 'use of birth control' as the dependent variable yielded that rural in comparison with urban adults 18-55 years were more likely to use female or male sterilization, non-injectable and injectable hormones for birth control. They were less likely to use: condoms, a diaphragm or NuvaRing, emergency contraception, withdrawal or rhythm methods. Additionally, in comparison with urban adults, rural persons younger than 35 years, those who had children younger than 18 years living with them, those who were partnered, males and those living in households with an income of less than US$35,000 were more likely to report using some form of contraception.

CONCLUSION

There were differences in the contraception choices of urban and rural adults. How much primary care provider preferences explains the differences is not known and bears further exploration. These results should prove useful to healthcare providers as well as public health family planning programs.