Understanding the employment landscape in people with systemic sclerosis

OBJECTIVE

Systemic sclerosis (SSc) can restrict employment participation. Our objectives were to comparatively evaluate health factors, work factors and workplace accommodations between those who are employed and those who recently gave up employment.

METHODS

A cross-sectional study was conducted of employed and recently working, but now unemployed individuals with SSc. Demographics, employment sectors, health factors, flare frequency, work context, and information about the need, availability and use of workplace supports were collected.

RESULTS

Participants were 140 individuals (108 (77.1%) women, 32 (22.9%) men) where 110 (78.6%) were employed and 30 (21.4%) unemployed. Participants worked in Education/Health/Sciences/Arts (n=51, 36.4%), Sales/Retail (n=23, 16.5%), Banking/Insurance/Business/Technology (n=22, 15.7%), Government (n=15, 10.7%), Construction/Utilities (n=10, 7.1%), and Manufacturing/Agriculture/Mining/ Logging (n=10, 7.1%). Employed participants had a lower mean age (48.4 versus 54.3 years), and higher level of education (77.3% with post-secondary education versus 22.7% without). Those who had no flares were most frequently employed (41.7%), compared to those who had 1-2 flares (35.2%) and ≥3 flares (23.1%). The availability of workplace accommodations differed significantly between the employed and unemployed: flexible hours (75.2% versus 41.4%, p=0.005), more rest periods (81.8% versus 46.7%, p=0.0001), special equipment (87.5% versus 50.0%, p=0.0001), and alternative work-schedule flexibility (70.2% versus 38.8%, p=0.003).

CONCLUSION

Health factors alone do not differentiate those who are employed and those who gave up employment. This study lays the groundwork for where SSc-specific efforts in workplace policies/practices should be directed, especially workplace support.

First record of a new member of Anopheles Hyrcanus Group from Iran: molecular identification, diagnosis, phylogeny, status of kdr resistance and Plasmodium infection

The current study aimed to provide further evidence on the status of species composition, insecticide resistance, and vectorial capacity within the members of Anopheles (Anopheles) Hyrcanus Group in Ardebil, Giulan, and Khuzestan provinces of Iran. Sequencing the internal transcribed spacer 2 (ITS2) of ribosomal DNA gene led to identification of two members of Hyrcanus complex: Anopheles hyrcanus Pallas and a new species/form, hereafter called Anopheles hyrcanus sp(IR) as a world record. Furthermore, we identified and compared partial sequences of exons I and II and the whole intron I region of insecticide resistance-related voltage-gated sodium channel (vgsc) gene in populations of Hyrcanus Group and other main old world Anopheles species. The ITS2 and vgsc sequences in members of Hyrcanus Group and other Anopheles species were used for construction of phylogenetic tree, which demonstrated the evolutionary relatedness among Western and Eastern Palearctic taxa within the Hyrcanus Group. A nested polymerase chain reaction assay for detection of Plasmodium species revealed the infection of Plasmodium falciparum within An. hyrcanus collected from Fooman district in Guilan province. The data from this study led to the introduction of a new member/form within the Hyrcanus Group, identification and definition of the status of knockdown resistance related to pyrethroids and DDT in their vgsc gene, detection of Plasmodium infection, and further evidence on genetic relatedness within these taxa. The overall results may suggest reconsidering the role ofAn. hyrcanus in malaria transmission, which would be useful for implementation and evaluation of malaria control programs in Western Palearctic region.