Implementation of a disability management policy in a large healthcare employer: a quasi-experimental, mixed-method evaluation

Objective: This study describes the process and outcomes of the implementation of a strengthened disability management policy in a large Canadian healthcare employer. Key elements of the strengthened policy included an emphasis on early contact, the training of supervisors and the integration of union representatives in return-to-work (RTW) planning. Design: The study applied mixed methods, combining a process evaluation within the employer and a quasi-experimental outcome evaluation between employers for a 3-year period prior to and following policy implementation in January 2012. Participants: Staff in the implementation organisation (n=4000) and staff in a peer group of 29 large hospitals (n=1 19 000). Outcomes: Work disability episode incidence and duration. Results: Both qualitative and quantitative measures of the implementation process were predominantly positive. Over the 6-year observation period, there were 624 work disability episodes in the organisation and 8604 in the comparison group of 29 large hospitals. The annual per cent change in episode incidence in the organisation was −5.6 (95% CI −9.9 to −1.1) comparable to the annual per cent change in the comparison group: −6.2 (-7.2 to –5.3). Disability episode durations also declined in the organisation, from a mean of 19.4 days (16.5, 22.3) in the preintervention period to 10.9 days (8.7, 13.2) in the postintervention period. Reductions in disability durations were also observed in the comparison group: from a mean of 13.5 days (12.9, 14.1) in the 2009–2011 period to 10.5 days (9.9, 11.1) in the 2012–2014 period. Conclusion: The incidence of work disability episodes and the durations of work disability declined strongly in this hospital sector over the 6-year observation period. The implementation of the organisation’s RTW policy was associated with larger reductions in disability durations than observed in the comparison group

Implementation of a disability management policy in a large healthcare employer: a quasi-experimental, mixed-method evaluation

Objective: This study describes the process and outcomes of the implementation of a strengthened disability management policy in a large Canadian healthcare employer. Key elements of the strengthened policy included an emphasis on early contact, the training of supervisors and the integration of union representatives in return-to-work (RTW) planning. Design: The study applied mixed methods, combining a process evaluation within the employer and a quasi-experimental outcome evaluation between employers for a 3-year period prior to and following policy implementation in January 2012. Participants: Staff in the implementation organisation (n=4000) and staff in a peer group of 29 large hospitals (n=1 19 000). Outcomes: Work disability episode incidence and duration. Results: Both qualitative and quantitative measures of the implementation process were predominantly positive. Over the 6-year observation period, there were 624 work disability episodes in the organisation and 8604 in the comparison group of 29 large hospitals. The annual per cent change in episode incidence in the organisation was −5.6 (95% CI −9.9 to −1.1) comparable to the annual per cent change in the comparison group: −6.2 (-7.2 to –5.3). Disability episode durations also declined in the organisation, from a mean of 19.4 days (16.5, 22.3) in the preintervention period to 10.9 days (8.7, 13.2) in the postintervention period. Reductions in disability durations were also observed in the comparison group: from a mean of 13.5 days (12.9, 14.1) in the 2009–2011 period to 10.5 days (9.9, 11.1) in the 2012–2014 period. Conclusion: The incidence of work disability episodes and the durations of work disability declined strongly in this hospital sector over the 6-year observation period. The implementation of the organisation’s RTW policy was associated with larger reductions in disability durations than observed in the comparison group

Anomalous Aharonov--Bohm gap oscillations in carbon nanotubes

The gap oscillations caused by a magnetic flux penetrating a carbon nanotube represent one of the most spectacular observation of the Aharonov-Bohm effect at the nano--scale. Our understanding of this effect is, however, based on the assumption that the electrons are strictly confined on the tube surface, on trajectories that are not modified by curvature effects. Using an ab-initio approach based on Density Functional Theory we show that this assumption fails at the nano-scale inducing important corrections to the physics of the Aharonov-Bohm effect. Curvature effects and electronic density spilled out of the nanotube surface are shown to break the periodicity of the gap oscillations. We predict the key phenomenological features of this anomalous Aharonov-Bohm effect in semi-conductive and metallic tubes and the existence of a large metallic phase in the low flux regime of Multi-walled nanotubes, also suggesting possible experiments to validate our results.Comment: 7 figure

Fluorescently labeled circular DNA molecules for DNA topology and topoisomerases

DNA topology plays essential roles in several fundamental biological processes, such as DNA replication, recombination, and transcription. Typically agarose gel electrophoresis is employed to study DNA topology. Since gel electrophoresis is time-consuming and labor intensive, it is desirable to develop other methods, such as fluorescence-based methods, for such studies. In this paper we report the synthesis of a type of unique fluorescence-labeled DNA molecules that can be used to study DNA topology and topoisomerases by fluorescence resonance energy transfer (FRET). Specifically, we inserted an 82 nt. synthetic DNA oligomer FL905 carrying a 42 nt. AT sequence with fluorescein and dabcyl labels into a gapped DNA molecule to generate relaxed and supercoiled pAB1_FL905. Since the fluorescence intensity of pAB1_FL905 is dependent on its supercoiling status, pAB1_FL905 is a powerful tool to study DNA topology and topoisomerases by FRET. pAB1_FL905 can also be developed into rapid and efficient high-throughput screening assays to identify inhibitors that target various DNA topoisomerases

Stable sulforaphane protects against gait anomalies and modifies bone microarchitecture in the spontaneous STR/Ort model of osteoarthritis

Osteoarthritis (OA), affecting joints and bone, causes physical gait disability with huge socio-economic burden; treatment remains palliative. Roles for antioxidants in protecting against such chronic disorders have been examined previously. Sulforaphane is a naturally occurring antioxidant. Herein, we explore whether SFX-01®, a stable synthetic form of sulforaphane, modifies gait, bone architecture and slows/reverses articular cartilage destruction in a spontaneous OA model in STR/Ort mice. Sixteen mice (n = 8/group) were orally treated for 3 months with either 100 mg/kg SFX-01® or vehicle. Gait was recorded, tibiae were microCT scanned and analysed. OA lesion severity was graded histologically. The effect of SFX-01® on bone turnover markers in vivo was complemented by in vitro bone formation and resorption assays. Analysis revealed development of OA-related gait asymmetry in vehicle-treated STR/Ort mice, which did not emerge in SFX-01®-treated mice. We found significant improvements in trabecular and cortical bone. Despite these marked improvements, we found that histologically-graded OA severity in articular cartilage was unmodified in treated mice. These changes are also reflected in anabolic and anti-catabolic actions of SFX-01® treatment as reflected by alteration in serum markers as well as changes in primary osteoblast and osteoclast-like cells in vitro. We report that SFX-01® improves bone microarchitecture in vivo, produces corresponding changes in bone cell behaviour in vitro and leads to greater symmetry in gait, without marked effects on cartilage lesion severity in STR/Ort osteoarthritic mice. Our findings support both osteotrophic roles and novel beneficial gait effects for SFX-01® in this model of spontaneous OA

NATIONAL SOVEREIGNTY V REGIONALISM; TOWARD A COMMON FISHERIES POLICY FOR CARICOM

The hypothesis which guides this thesis is that successful integration cannot be achieved so long as member states of a regional grouping are unwilling to subordinate the individual interest to the collective interest. The Caribbean Community (CARICOM) – which is the second oldest regional institution in the Western Hemisphere – is the central focus of the work. In order to assess this hypothesis, the study first discusses the relevant integration literature, and then addresses the issue of individual vs. collective interests in CARICOM overall. Next it examines the specific functional area of fisheries which effectively illustrates the complexity of this dilemma. For nine years, member states have tried unsuccessfully to forge a Common Fisheries Policy and Regime to more effectively manage the region’s maritime resources. However, such an arrangement carries implications regarding perceived loss of sovereignty over portions of their Exclusive Economic Zones and this, inter alia, has kept member states from being able to unite on this issue. Boundary delimitation challenges, diverging national positions regarding the right of access to third party vessels and the lack of willingness to grant necessary powers to the implementing agency have also been shown to contribute to the lack of progress. In April 2011, an agreement on a common fisheries policy was finally established. However, given the considerably reduced reach of this agreement, the study concludes that CARICOM has continued to function as a regional group of independent states, in which maintenance of national sovereignty takes precedence over collective interest. Therefore, while committed in principle to deepening integration, the political leadership maintains a state-centric view that has compromised CARICOM’s effectiveness as a regional entity

Chemistry in Infrared Dark Cloud Clumps: a Molecular Line Survey at 3 mm

We have observed 37 Infrared Dark Clouds (IRDCs), containing a total of 159 clumps, in high-density molecular tracers at 3 mm using the 22-meter ATNF Mopra Telescope located in Australia. After determining kinematic distances, we eliminated clumps that are not located in IRDCs and clumps with a separation between them of less than one Mopra beam. Our final sample consists of 92 IRDC clumps. The most commonly detected molecular lines are (detection rates higher than 8%): N2H+, HNC, HN13C, HCO+, H13CO+, HCN, C2H, HC3N, HNCO, and SiO. We investigate the behavior of the different molecular tracers and look for chemical variations as a function of an evolutionary sequence based on Spitzer IRAC and MIPS emission. We find that the molecular tracers behave differently through the evolutionary sequence and some of them can be used to yield useful relative age information. The presence of HNC and N2H+ lines do not depend on the star formation activity. On the other hand, HC3N, HNCO, and SiO are predominantly detected in later stages of evolution. Optical depth calculations show that in IRDC clumps the N2H+ line is optically thin, the C2H line is moderately optically thick, and HNC and HCO+ are optically thick. The HCN hyperfine transitions are blended, and, in addition, show self-absorbed line profiles and extended wing emission. These factors combined prevent the use of HCN hyperfine transitions for the calculation of physical parameters. Total column densities of the different molecules, except C2H, increase with the evolutionary stage of the clumps. Molecular abundances increase with the evolutionary stage for N2H+ and HCO+. The N2H+/HCO+ and N2H+/HNC abudance ratios act as chemical clocks, increasing with the evolution of the clumps.Comment: Accepted to ApJ. 29 page

Forming Jupiter, Saturn, Uranus and Neptune in Few Million Years by Core Accretion

Giant planet formation process is still not completely understood. The current most accepted paradigm, the core instability model, explains several observed properties of the solar system's giant planets but, to date, has faced difficulties to account for a formation time shorter than the observational estimates of protoplanetary disks' lifetimes, especially for the cases of Uranus and Neptune. In the context of this model, and considering a recently proposed primordial solar system orbital structure, we performed numerical calculations of giant planet formation. Our results show that if accreted planetesimals follow a size distribution in which most of the mass lies in 30-100 meter sized bodies, Jupiter, Saturn, Uranus and Neptune may have formed according to the nucleated instability scenario. The formation of each planet occurs within the time constraints and they end up with core masses in good agreement with present estimations.Comment: 11 pages, 3 figures, in press (Icarus

Sprouty2 mediated tuning of signalling is essential for somite myogenesis

Background: Negative regulators of signal transduction cascades play critical roles in controlling different aspects of normal embryonic development. Sprouty2 (Spry2) negatively regulates receptor tyrosine kinases (RTK) and FGF signalling and is important in differentiation, cell migration and proliferation. In vertebrate embryos, Spry2 is expressed in paraxial mesoderm and in forming somites. Expression is maintained in the myotome until late stages of somite differentiation. However, its role and mode of action during somite myogenesis is still unclear. Results: Here, we analysed chick Spry2 expression and showed that it overlaps with that of myogenic regulatory factors MyoD and Mgn. Targeted mis-expression of Spry2 led to inhibition of myogenesis, whilst its C-terminal domain led to an increased number of myogenic cells by stimulating cell proliferation. Conclusions: Spry2 is expressed in somite myotomes and its expression overlaps with myogenic regulatory factors. Overexpression and dominant-negative interference showed that Spry2 plays a crucial role in regulating chick myogenesis by fine tuning of FGF signaling through a negative feedback loop. We also propose that mir-23, mir-27 and mir-128 could be part of the negative feedback loop mechanism. Our analysis is the first to shed some light on in vivo Spry2 function during chick somite myogenesis