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OBJECTIV: e This study evaluated a psychoeducational intervention that aimed to facilitate return to work., Methods: The randomized-controlled study trial was established at three psychiatric hospitals. The status of permanent employment in an age group of 18 to 60 served as main inclusion criterion. The intervention consisted of 5 sessions and covered topics such as disclosure of the diagnosis to colleagues and supervisors or legal frameworks in the return-to-work process. Participants of the control group received treatment as usual., Results: The informative value of the comparisons was decreased by strong differences between the groups at baseline due to an allocation bias. However, participants of the intervention group felt more secure and prepared regarding their return to the workplace. In addition, participants developed a higher level of understanding regarding their rights within the legal frameworks when returning to work. More participants of the control group returned to work within 3 months. The decisive factor for a successful return to work was the intention of the participants to return at baseline., Conclusion: The psychoeducational program was well accepted among participants and appeared to be a useful addition to individual counseling by social workers. However,the program did not increase the likelihood to return to work within three months., Competing Interests: Johannes Hamann erhielt in den vergangenen 3 Jahren Vortragshonorare und Forschungsbeihilfe von Janssen Cilag, Ely Lilly und Otsuka., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background: Work-related stress has become a major challenge for social security and health care systems, employers and employees across Europe. In Sweden, sickness absence particularly due to stress-related disorders has increased excessively in recent years, and the issue of how to improve sustainable return to work in affected employees is high up on the political agenda. The literature on interventions for return to work in patients with common mental disorders is still inconclusive. This randomized controlled trial (RCT) aims to contribute with knowledge about how physicians and rehabilitation coordinators in primary health care can involve the employer in the rehabilitation of patients with stress-related disorders. The objective is to evaluate whether the early involvement of the patient's employer can reduce the time for return to work compared to treatment as usual. A process study will complete the RCT with information about what prerequisites primary health caregivers need to succeed with this endeavor., Methods: Twenty-two primary care centers were randomized to either intervention or control group. At the intervention centers, physicians and rehabilitation coordinators underwent training, providing them with both knowledge and practical tools to involve the employer in rehabilitation. At the patient level, employed patients with an ICD-10 F43 diagnosis were eligible for participation (n=132). Difference in proportion of patients on full- or part-time sick leave at three, six and 12 months after inclusion will be investigated. Register data, logbooks and interviews with coordinators and physicians at both intervention and control centers will be used for process evaluation., Discussion: Although the issue of how to tackle work-related stress can be recognized all across Europe, Sweden face an urgent need to curb the disproportional increase of stress-related disorders in the sick-leave statistics. Since physicians are limited by time constraints, the rehabilitation coordinator may be a helpful resource to take this contact. The current study will contribute to knowledge about how this collaboration can be organized to facilitate employer involvement and reduce time to return to work among patients suffering from work related stress., Trial Registration: Registered on 1 November 2016, ClinicalTrials.gov, NCT03022760 .

The Texas Supreme Court blocked a challenge to liability protections for physicians employed by state medical schools, a legal victory for TMA. Thanks to the court's decision, physicians employed by a government institution, like a publicly funded medical school, still can perform clinical duties at a non-government facility, like a private hospital, without giving up immunity from lawsuits.

Purpose: The purpose of this study is to explore experiences of persons in Nepal using lower-limb prostheses, in relation to specific articles in the Convention on the Rights of Persons with Disabilities that consider mobility, education, health, rehabilitation, and work and employment., Method: Qualitative interviews were conducted with 16 persons using lower limb prostheses. Content analysis was applied to the data., Results: Six themes emerged: The lower-limb prosthesis is essential for mobility and daily life; Limited mobility in challenging terrain and request for reduced pain when using prosthesis; Difficulties in finding and sustaining employment emphasized the importance of vocational training; Appreciation of comprehensive rehabilitation together with other persons with amputations, but covering related costs is a struggle; Satisfied with health care, but concerned that it creates debt and dependence upon others; and finally, Limited ability creates negative self-image and varied attitudes in other people., Conclusion: Persons with lower-limb amputations were restricted by poverty and wanted increased independence. Rehabilitation and prosthetic services in Nepal need to increase proportionally as they contribute to enabling those persons to a better daily life. Prostheses were essential but more advanced technology was requested. Access to education and vocational training has the potential to improve the socio-economic status of those with lower-limb amputations due lack of employment not requiring physical effort. Implications for rehabilitation To increase access for persons with lower-limb amputations in Nepal to rehabilitation services, these services need to increase proportionally, and the policy for financial compensation to enable those persons to afford transportation to the rehabilitation center should be implemented. The design and manufacture of the low-cost polypropylene technology for prostheses used in Nepal needs to be improved, directed towards increasing the ability to ambulate on uneven surfaces and hilly terrain, and the ability to walk long distances. Adjustments of employment for persons with physical disabilities in Nepal have the potential to strengthen their socio-economic status. Vocational training programs and educational opportunities for persons with physical disabilities have the potential to improve income-generating employment and need to increase proportionally in Nepal. The policies developed in accordance with the Convention on the Rights of Persons with Disabilities need to be further implemented to decrease existing barriers to access to general health care and rehabilitation and prosthetic services for persons with disabilities in Nepal.

Background: Parents with small children constitute a vulnerable group as they have an increased risk of sick leave due to stress-related disorders compared to adults without children. It has been shown that mothers and fathers to small children together spend more time in paid work than any other group, which could create negative stress and an experience of low occupational balance., Aim: The aim of this study was to examine associations between organisational factors and occupational balance among parents with small children in Sweden., Methods: Data were collected by a survey including questions about occupational balance, organisational factors and age, sex, employment rate, work position, monthly household income, number of children at home, separation/divorce last five years and overtime. The total number of parents included in this study was 718 (490 mothers and 228 fathers). Logistic regression models were applied to examine the odds ratios for occupational balance in relation to organisational factors., Results: Parents who experienced positive attitudes towards parenthood and parental leave among colleagues and managers were more likely to experience high occupational balance than parents who experienced negative or neutral attitudes. Having a clear structure for handover when absent from work was also strongly associated with high occupational balance., Conclusions: The result of the present study indicates that some organisational factors could be important for the occupational balance of parents with small children.

Purpose: To provide an international analysis of employees' views of the influence of disability management (DM) on the workplace., Methodology: An international research team with representation from Australia, Canada, China, and Switzerland collected survey data from employees in public and private companies in their respective regions. Due to lack of availability of current measures, a research team-created survey was used and a total of 1201 respondents were collected across the four countries., Analysis: Multiple linear (enter) regression was also employed to predict DM's influence on job satisfaction, physical health, mental health, workplace morale and reduced sickness absence, from respondents' perceptions of whether their company provided disability prevention, stay-at-work, and return-to-work initiatives within their organization. One-way ANOVA comparisons were used to examine differences on demographic variables including company status (public versus private), union status (union versus nonunion), and gender., Results: The perceived influence of DM programs was related to perceptions of job satisfaction; whereas, relationships with mental health, physical health, morale, and sickness absence were variable according to type of DM program and whether the response was related to self or others. Difference analyses (ANOVA) revealed significantly more positive perceptions for private and nonunion organizations; no gender effects were found., Conclusions: There is perceived value of DM from the perspective of employees, especially with respect to its value for coworkers. Implications for Rehabilitation Rehabilitation efforts should continue to focus attention on the value of disability management (DM). In particular, DM that is fully committed to the biopsychosocial model would be supported by this research. Employees reported the most value in the psychosocial variables addressed by DM, such that rehabilitation professionals could focus on these valued aspects to improve buy-in from employees. The interest in coworker value may provide another avenue for rehabilitation efforts to increase uptake, by highlighting the value of intervention efforts for employee coworkers. Rehabilitation professionals in union environments may need to be particularly cognizant of the need for encouraging psychosocial and coworker value potentially seen by employees in order to increase acceptance and participation for organizational DM efforts.

Payments for ecosystem services programs have become common tools but most have failed to achieve wide-ranging conservation outcomes. The capacity for scale and impact increases when PES programs are designed through the lens of the potential participants, yet this has received little attention in research or practice. Our work with small-scale marine fisheries integrates the social science of PES programs and provides a framework for designing programs that focus a priori on scaling. In addition to payments, desirable non-monetary program attributes and ecological feedbacks attract a wider range of potential participants into PES programs, including those who have more negative attitudes and lower trust. Designing programs that draw individuals into participating in PES programs is likely the most strategic path to reaching scale. Research should engage in new models of participatory research to understand these dynamics and to design programs that explicitly integrate a broad range of needs, values, and modes of implementation.

The trafficking of persons is one of the most egregious violations of human rights in modern society. Given the disproportionate effects across demographic categories of age and gender, as well as concentrated impacts within the developing world, there is a strong need for research and literature on program effectiveness and appropriate aftercare efforts for those persons whose lives and livelihoods have been impacted by trafficking. The purpose of this article is to provide a scoping review of what is known about effectively helping survivors of human trafficking experiencing lack of economic opportunity and the implications for practice and future research regarding the absence of literature. From over 14,000 initial search results, this article focuses on those initiatives (N = 16) that support economic development of the individual or family after being trafficked. Implications arising from the review for trafficking policy, areas for further research, and implications for practitioners are highlighted and discussed.

Background: There is limited evidence of the impact of policies to promote work-family balance on family health. Exploiting the introduction of the UK Flexible Working Act (2003), we examined whether a policy that grants parents the right to request flexible work influences their health and well-being., Methods: Using the UK Millennium Cohort Study, we focus on 6424 mothers employed in 2001-2002, when the cohort child was 9 months old, until their child's seventh birthday. We used a difference-in-differences (DiD) approach to compare changes in outcomes before and after the policy among mothers most likely to benefit and mothers unlikely to benefit from the policy., Results: Flexible working increased in a small group of mothers (n=548) whose employer did not offer work flexibility before the reform (treatment group). By contrast, among mothers whose employer already offered flexible work before the reform (control group, n=5810), there was little change or a slight decline in flexible working. DiD estimates suggest that the policy was associated with an increase in flexible working (37.5 percentage points, 95% CI 32.9 to 41.6), but it had no impact on self-rated health (-1.6 percentage points, 95% CI -4.4 to 1.1), long-term illness (-1.87 percentage points, 95% CI -4.3 to 0.5) or life satisfaction scores (β=0.04, 95% CI -0.08 to 0.16)., Conclusion: The Flexible Working Act increased flexible working only among a small group of mothers who had not yet the right to request work flexibility, but it had no impact on their health and well-being. Policies promoting work flexibility may require stronger incentives for both parents and employers., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Objective: To analyze the associations between fixed-term employment and health (work ability and mental health) and behaviors (engagement and performance). Psychological contract fulfilment (PCF) and breach (PCB) are investigated as potential mediators of these associations., Methods: Seven hundred workers employed on fixed-term contracts from a broad range of organizations participated in the study. The Structural Equation Model was performed to analyze the data., Results: Mediation analyses revealed that good physical and mental health and productivity are more likely to be achieved by those workers who perform non-manual work and (to some extent) accept their contracts because they experience high levels of PCF and low levels of PCB., Conclusions: Apart from the lack of physical workload, psychological contract fulfilment has been revealed as yet another significant mediator between a higher socioeconomic position and good health and productivity of fixed-term workers.

As the U.S. population ages, the number of people needing personal assistance in the home care setting is increasing dramatically. Personal care aides and home health workers are currently adding more jobs to the economy than any other single occupation. Home health workers face physically and emotionally challenging, and at times unsafe, work conditions, with turnover rates ranging from 44 percent to 65 percent annually. As part of a mixed-method, longitudinal study in Maine examining turnover, interviews with 252 home care aides were analyzed thematically. Responses to interview questions regarding the job's impact on health and safety, the adequacy of training, and the level of agency responsiveness were examined. Emergent themes, indicating some contradictory perspectives on workplace safety, quality of training, and agency support, were compared across three variables: job termination, occupational injury, and age. Implications for increasing occupational safety and job retention are discussed.

The working conditions, relative wages, and social standing of care occupations are the result of diverse causes that can worsen, improve, or neutralize the labor disadvantages usually found in care occupations. This article seeks to provide a perspective on the factors underlying care workers' working conditions in Argentina. It presents a comparative analysis of three highly feminized occupations-early education teachers, nurses, and domestic workers. After highlighting the different working conditions among these occupations, the paper focuses on the critically important role that unionization and state policies have played in defining each labor context in Argentina. The analysis shows how workers' evaluation of their occupation and working conditions are fundamentally shaped by these two variables.

Based on policy analysis and individual interviews, the author analyzes the care workers' precarious situations in home-based elder care in Slovenia, a post-socialist, European Union country characterized by a rapidly aging population and delays in adapting a long-term care system to this new social risk. Employment and quasi-employment positions which coexist in home-based care can be sorted along two continuums: between public and market service; between formal and informal work. The author argues that working conditions in home-based care differ according to the position of the care worker on these two continuums, that is, being employed in public services, being self-employed, working in informal care markets, holding a status of family assistant, or being an informal family caregiver. Although the working conditions in public services are deteriorating, the analysis shows that precarity is more severe in market and informal care, while formalization and socialization of care bring about less precarious conditions.

Background: Despite the importance of inclusive employment, described in Goal 8 of the Sustainable Development Goals (SDGs), employment of persons with psychiatric disabilities in Africa is lower than among the general population., Objective: The aim of this scoping review is to explore evidence related to the barriers to and facilitators of employment of persons with psychiatric disabilities in Africa., Methods: A literature search was conducted using six relevant electronic databases of articles published between 1990 and 2017., Results: Eight studies were identified and analysed regarding barriers and facilitators of employment of persons with psychiatric disabilities. The dynamic adaptation of the bio-psycho-social model was used as an analytical framework. Identified barriers include ill health, (anticipated) psychiatric illness, social stigma and discrimination, negative attitudes among employers and the lack of social support and government welfare. Facilitators of employment include stability of mental illness, heightened self-esteem, a personal decision to work despite stigma, competitive and supported employment, reduction in social barriers/stigma and workplace accommodations., Conclusion: Employment of persons with psychiatric disabilities is essential, yet there is dearth of scientific evidence to identify contextual models that might be useful in African countries and other low-and middle countries (LMICs). This gap in information would benefit from further research to improve the employment rates of persons with psychiatric disabilities in Africa.

Background: Many people living with mental illness want paid work, but finding and maintaining mainstream employment remains challenging. In recent decades, social enterprises have emerged as one alternative site for paid employment. Existing research has examined the experiences of people with mental illness working in social enterprises, but less is known about the organizational character of these workplaces., Objective: The objective of this paper is to develop a better understanding of social enterprises as organizational contexts for workers with mental illness., Methods: The research employed a qualitative methodology, conducting semi-structured interviews with executive directors and managers at 42 organizations operating 67 social enterprises across CanadaRESULTS:While there are strong similarities in organizational mandate to create meaningful employment there are also important variations between social enterprises. These include variations in size, economic activity and organizational structure, as well as differences in hours of work, rates of pay and the nature and extent of workplace accommodation. These variations reflect both immediate organizational contexts as well as broader economic constraints that enterprises confront., Conclusions: Understanding the varied nature of social enterprises is important for thinking about future enterprise development, and the capacity of such organizations to create meaningful employment for people living with mental illness.

Objective: There's a lot of literature about teachers' work conditions and the effects of such conditions on them. The goal of this research focuses on the analysis of the effects derived from the type of labour relationship with the University on the psycho-social dimensions of satisfaction, stress and perceived health., Methods: Quasi-experimental study on a sample of 145 university professors from the seven public universities from Catalonia (Spain). The data was obtained in April 2014, by means of ISTAS21 questionnaire, intermediate version, in Spanish. From the 21 subscales in the instrument, only seven were used for data-gathering since they encompassed the dimensions of interest. A series of ANOVA analyses were performed, taking the three psycho-social dimensions as dependent variables and work stability and dedication (e.g. full- vs. partial-time) as independent variables., Results: Professors with full-time work and unstable contracts showed worse health (both physical and mental) despite being the youngest, as well as larger symptoms of stress and lower job-satisfaction, compared with full-time professors with stable contracts and even compared part-time-jobs professors., Conclusion: Job-stability seems to be a central variable in work-quality and health for the professors whose labour situation is unstable, something that influences both their teaching and research quality.

Background: The intersection between health, disability and transport has significant practical challenges for people with a disability living in low- and middle-income countries (LMICs), where road infrastructure is poor and travel unsafe. Lack of transport access to health, education, employment and other services impedes achievement of the Sustainable Development Goals and affects quality of life. The Journey Access Tool (JAT) combines access audit and road safety audit approaches to identify barriers to transport on journeys taken by people with a disability. To be useful and effective, it must fit the expectations of people with a disability (be acceptable) and be feasible for use in different settings (adoptable). Accordingly, a formative evaluation process was undertaken in Phnom Penh, Cambodia., Objectives: To undertake a formative evaluation of the JAT using an iterative process to tailor the tool, pilot its use by people with a disability, and develop a template for its implementation in other LMICs., Methods: An iterative process of consultation and three pilots was undertaken. Participants were people with a disability who undertook journeys with a public transport component accompanied by assistants. Focus groups were held after each pilot, and results were integrated into JAT revisions., Results: Issues of terminology were resolved early, as were process issues related to the length of time taken to complete the JAT. Interpersonal issues were more difficult to address, with assistants tending to exceed their role and record their own comments. Use of the tool provided rich information on barriers., Conclusions: The JAT was both acceptable and adoptable for people with a disability and other stakeholders, and the experience gained will facilitate adaptation of the tool to new settings. The tool has significant potential to shape and support advocacy for change and engagement with transport services and also health, education, employment and other services.

Background: The increasing number of people with chronic diseases challenges workforce capacity. Type 2 diabetes (T2D) can have work-related consequences, such as early retirement. Laws of most high-income countries require workplaces to provide accommodations to enable people with chronic disabilities to manage their condition at work. A barrier to successful implementation of such accommodations can be lack of co-workers' willingness to support people with T2D. This study aimed to examine the willingness to pay (WTP) of people with and without T2D for five workplace initiatives that help individuals with type 2 diabetes manage their diabetes at work., Methods: Three samples with employed Danish participants were drawn from existing online panels: a general population sample (n = 600), a T2D sample (n = 693), and a matched sample of people without diabetes (n = 539). Participants completed discrete choice experiments eliciting their WTP (reduction in monthly salary, €/month) for five hypothetical workplace initiatives: part-time job, customized work, extra breaks with pay, and time off for medical consultations with and without pay. WTP was estimated by conditional logits models. Bootstrapping was used to estimate confidence intervals for WTP., Results: There was an overall WTP for all initiatives. Average WTP for all attributes was 34 €/month (95% confidence interval [CI]: 27-43] in the general population sample, 32 €/month (95% CI: 26-38) in the T2D sample, and 55 €/month (95% CI: 43-71) in the matched sample. WTP for additional breaks with pay was considerably lower than for the other initiatives in all samples. People with T2D had significantly lower WTP than people without diabetes for part-time work, customized work, and time off without pay, but not for extra breaks or time off with pay., Conclusions: For people with and without T2D, WTP was present for initiatives that could improve management of diabetes at the workplace. WTP was lowest among people with T2D. Implementation of these initiatives seems feasible and may help unnecessary exclusion of people with T2D from work.

Background: Research has shown that perceived unfairness contributes to higher rates of sickness absence. While shorter, but more frequent periods of sickness absence might be a possibility for the individual to get relief from high strain, long-term sickness absence might be a sign of more serious health problems. The Uncertainty Management Model suggests that justice is particularly important in times of uncertainty, e.g. perceived job insecurity. The present study investigated the association between interpersonal and informational justice at work with long and frequent sickness absence respectively, under conditions of job insecurity., Methods: Data were derived from the 2010, 2012, and 2014 biennial waves of the Swedish Longitudinal Occupational Survey of Health (SLOSH). The final analytic sample consisted of 19,493 individuals. We applied repeated measures regression analyses through generalized estimating equations (GEE), a method for longitudinal data that simultaneously analyses variables at different time points. We calculated risk of long and frequent sickness absence, respectively in relation to interpersonal and informational justice taking perceptions of job insecurity into account., Results: We found informational and interpersonal justice to be associated with risk of long and frequent sickness absence independently of job insecurity and demographic variables. Results from autoregressive GEE provided some support for a causal relationship between justice perceptions and sickness absence. Contrary to expectations, we found no interaction between justice and job insecurity., Conclusions: Our results underline the need for fair and just treatment of employees irrespective of perceived job insecurity in order to keep the workforce healthy and to minimize lost work days due to sickness absence.

Purpose To explore the patient's perspective on the involvement of employers into rehabilitation. Methods 8 participants of a work-related medical rehabilitation were interviewed by telephone 4 weeks after discharge. Qualitative content analysis was used to analyze generated data. Results Beside a poor employer-involvement, the interviews revealed that the process of returning to work was characterized and hampered by unused measures of supporting vocational reintegration during rehabilitation, intersection problems in the health care and social security system, and a strategy of waiting by all involved actors. Conclusion Beside an improved employer-involvement, systematic intersection management and full usage of existing measures are demanded to support vocational reintegration., Competing Interests: Interessenkonflikt: Timo Specht ist Chefarzt und Ärztlicher Direktor der Rehabilitationseinrichtung, in der die an der Studie teilnehmenden Betroffenen rekrutiert wurden. Die Autoren geben an, dass kein weiterer Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

Aims: Alcohol is one of the leading causes of ill health and premature death in the world. Several studies indicate that working life might influence employees' alcohol consumption and drinking patterns. The aim of this study was to explore work-related drinking situations, with a special focus on answering who initiates and organises these situations., Methods: Data were collected through semi-structured group interviews in six Norwegian companies from the private ( n=4) and public sectors ( n=2), employing a total of 3850 employees. The informants ( n=43) were representatives from management and local unions, safety officers, advisers from the social insurance office and human-resource personnel, health, safety and environment personnel, and members from the occupational environment committee. Both qualitative and quantitative content analyses were applied in the analyses of the material., Results: Three different initiators and organisers were discovered: the employer, employees and external organisers. External organisers included customers, suppliers, collaborators, sponsors, subcontractors, different unions and employers' organisations. The employer organised more than half of the situations; external organisers were responsible for more than a quarter. The differences between companies were mostly due to the extent of external organisers., Conclusions: The employer initiates and organises most situations for work-related alcohol use. However, exposure to such situations seems to depend on how many external relations the company has. These aspects should be taken into account when workplace health-promotion initiatives are planned.

Purpose The purpose of this paper is to make a case for novel and innovative reentry programs focused on women of color and to describe policy recommendations that are necessary to support the sustainability of these programs and in turn the success of the women who participate in them. Design/methodology/approach A review and analysis of the literature that described job-training opportunities specifically targeted to women exiting jail and the impact on recidivism provided limited information. The authors developed, implemented, and evaluated doula training program for low-income and women of color to determine if birth work could provide stable income and decrease recidivism. Findings Training low-income formerly incarcerated women to become birth doulas is an innovative strategy to solve employment barriers faced by women reentering communities from jail. Realigning women within communities via birth support to other women also provides culturally relevant and appropriate members of the healthcare team for traditionally vulnerable populations. Doulas are important members of the healthcare workforce and can improve birth outcomes. The authors' work testing doula training, as a reentry vocational program has been successful in producing 16 culturally relevant and appropriate doulas of color that experienced no re-arrests and to date no program participant has experienced recidivism. Originality/value To be successful, the intersections of race, gender, and poverty, for women of color should be considered in the design of reentry programs for individuals exiting jail. The authors' work provided formerly incarcerated and low-income women of color with vocational skills that provide consistent income, serve as a gateway to the health professions, and increase the numbers of well-trained people of color who serve as providers of care.

This paper explores the content and extent of the burden of caregiving for Chinese families in transition. It sets out to understand how Chinese families manage to balance family caregiving responsibilities with employment, the impact of the existing social institutions on family caregiving practices, and the risks that caregivers have to face. Data were collected from a sample of 214 workers from 14 manufacturing companies in an industrialized city in central China in 2013. Analysis revealed that common types of eldercare were assisting with activities of daily living and medical related care; middle aged employed respondents were most likely to be the caregivers to older family members; financial and time demands of care were challenging for caregivers, but women with more education and a secure job responded to the pressure of care giving better than those with less education and insecure jobs. An absence of workplace policies to support family caregivers was reported to create insecure employment conditions among middle aged workers. The findings imply an urgent need for legislative action and workplace policy that support family caregiving in China.

This article considers recent changes in the incidence of caring among people aged 50-64 in England and the policy context in which these have occurred. After introducing the topic, research questions addressed and methods used, it outlines findings from other research on how older workers experience and manage caring roles. It then sets out relevant public policy developments since carers were first accorded rights to recognition and services in 1995, focusing on workplace support, local services and financial help for people who reduce or quit their paid work to care. The article presents new analyses of the population censuses conducted in England in 2001 and 2011, focusing on people aged 50-64 and especially on those aged 60-64, the group in which the largest changes were seen. Theses show growth in caring at higher levels of intensity for older workers, and increases in the incidence of caring alongside paid work. To deepen understanding of these changes, the analysis also draws on data from a government survey of carers conducted in 2009-10. The concluding discussion argues that although the modest policy changes implemented since 1995 have provided some support to older workers managing work and care, more policy attention needs to be given following the sharp increase in the incidence of caring seen among people aged 50-64 in England between 2001 and 2011.

There is inconsistent evidence that deliberate attempts to improve job design realise improvements in well-being. We investigated the role of other employment practices, either as instruments for job redesign or as instruments that augment job redesign. Our primary outcome was well-being. Where studies also assessed performance, we considered performance as an outcome. We reviewed 33 intervention studies. We found that well-being and performance may be improved by: training workers to improve their own jobs; training coupled with job redesign; and system wide approaches that simultaneously enhance job design and a range of other employment practices. We found insufficient evidence to make any firm conclusions concerning the effects of training managers in job redesign and that participatory approaches to improving job design have mixed effects. Successful implementation of interventions was associated with worker involvement and engagement with interventions, managerial commitment to interventions and integration of interventions with other organisational systems. Practitioner Summary: Improvements in well-being and performance may be associated with system-wide approaches that simultaneously enhance job design, introduce a range of other employment practices and focus on worker welfare. Training may have a role in initiating job redesign or augmenting the effects of job design on well-being.

Objectives Psychosocial rehabilitation, particularly work integration, is currently a public health preoccupation, as evidenced by recent publications on this topic and the development of new professional insertion program. This article aims to present a French health facility focused on psychosocial rehabilitation of persons in state of psychic disability, in order to highlight its specific programs of professional insertion.Methods After a brief remind about the theoretical foundations of psychosocial rehabilitation, psychic disability and recovery, we present the means used by our healthcare facility, illustrating our remarks with 2 case studies.Results Our rehabilitation programs demonstrate the need of a multidisciplinary in interventions, the need for multiplicity in proposals of activities, the importance of self-determination, of healthcare professionals in management of the public admitted in our healthcare facility, and the importance of fighting the stigma caused by mental disorders.Conclusion Our programs need to be placed in the French context, in which persist stigmatization towards persons with psychiatric disorders, and huge barriers to employment.

Objectives: The aims of this article are to (1) determine whether and to what extent general perceived health and quality of supervision predict voluntary early retirement pension (VERP) and (2) assess whether quality of supervision modifies the association between general perceived health and VERP., Methods: Employees aged 49-64 years who participated in the Danish Work Environment Cohort Study in 2000 were selected. Their questionnaire data about health and work were linked to register data on social transfer payments, among others VERP, from 2001 to 2012 in the Danish Register for Evaluation of Marginalization ( N=1167). Cox proportional hazards analyses were performed to identify the prospective association of general perceived health and quality of supervision on VERP. Relative excess risks due to interaction (RERIs) were calculated to assess whether quality of supervision modified the association between health and VERP., Results: Employees with poor health at baseline had an increased risk of VERP during follow-up (hazard ratio [HR]=1.23; 95% confidence interval [CI] 1.02-1.49). Quality of supervision at baseline was not associated to VERP during follow-up (HR=1.04; 95% CI 0.90-1.21). There was no statistically significant interaction of poor health and poor quality of supervision with regard to risk of VERP (RERI=-0.33; 95% CI -1.79 to 1.14)., Conclusions: This study did not support the notion that quality of supervision buffers the association between poor health and VERP. Future research is needed to determine whether other aspects of supervision, for example supervisors' opportunities to effectuate workplace adjustments, may modify the association of poor health and VERP.

This study assesses the long-term impact of the Nursing Graduate Guarantee (NGG) initiative using the concept of "stickiness" to examine the employment trends of young nurses in Ontario and evaluate the effect of employers' participation in the NGG on the full-time (FT) employment patterns of young nurses and whether this effect varies by category of nurse and sector of employment. A quantitative analysis of a de-identified linked subset of the College of Nurses of Ontario nursing registration database for years 2000-2014 and data collected from the NGG employment portal for years 2007-2014 was performed. One-year and two-year transition matrixes were generated to examine the stickiness trends of young nurses across the sectors of employment and the effect of the employing organization's participation level on those trends. The NGG initiative contributed to an improved FT employment and stickiness of the young nurses in hospitals and the young RPNs in LTC institutions. A higher participation level in the NGG initiative contributed to an enhanced full time employment of the young nursing graduates only in the hospitals sector. The effect of employer participation on the stickiness of young RNs and RPNs in FT jobs in the Community sector requires further investigation., (Copyright © 2017. Published by Elsevier B.V.)

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., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Background: Adults with disabilities are employed at a significantly lower rate than adults without disabilities. Of adults with disabilities in the workforce, more individuals work in a facility setting rather than a community setting, despite efforts to improve community inclusion. Choice-making has been proposed as a predictive factor for employment for individuals with disabilities., Aims: The purpose of this research was to examine the current state of employment for three groups of adults with intellectual disability (ID): individuals with autism spectrum disorder (ASD), individuals with Down syndrome (DS), and individuals with idiopathic ID. Choice-making and its relation to improved employment outcomes was explored., Methods: This study used National Core Indicator's Adult Consumer Survey datasets from years 2011-2012 and 2012-2013. Factor analyses revealed latent variables from six choice-making questions in the Adult Consumer Survey. Ordinal logistic regression was used to identify factors related to employment status., Results: Adults with DS had the highest rates of paid community jobs, but adults with ID had the highest rates of choice-making. ID severity level and short-term choice-making had the greatest effects on employment status in all three groups., Conclusions: Employment rates remain low despite national efforts to find jobs for people with disabilities. Choice-making is a unique factor that was found to be associated with employment status and provides a target for interventions to increase employability., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Purpose To study the effectiveness of a multifaceted strategy to implement the participatory approach (PA) for supervisors to increase their self-efficacy in addressing risk of sick leave of employees. Methods Supervisors from three organizations were invited to participate. Randomization was performed at department level. Supervisors (n = 61) in the intervention departments received the implementation strategy consisting of a working group meeting, supervisor training in PA application, and optional supervisor coaching. Supervisors in the control departments (n = 55) received written information on PA. The primary outcome was supervisors' self-efficacy to apply the PA, measured at baseline and 6 months' follow-up. The number of employees with whom supervisors discussed work functioning problems or (risk of) sick leave was also assessed. Effects were tested using multilevel analyses. Results The strategy did not increase self-efficacy to apply the PA. Subgroup analyses showed that self-efficacy increased for supervisors who at baseline reported to have discussed (risk of) sick leave with less than three employees during the last 6 months (B = 1.42, 95 % CI 0.34-2.50). Furthermore, the implementation strategy increased the number of employees with whom supervisors discussed work functioning problems or risk of sick leave (B = 1.26, 95 % CI 0.04-2.48). Conclusion Although the implementation strategy cannot be recommended for all supervisors, for supervisors who less frequently discuss (risk of) sick leave with employees the implementation strategy might be helpful. Trial registration NTR3733.

Purpose Workers with musculoskeletal pain (MSP) often continue to work despite their condition. Understanding the factors that enable them to remain at work provides insights into the development of appropriate workplace accommodations. This qualitative study aims to explore the strategies utilised by female Malaysian office workers with MSP to maintain productive employment. Methods A qualitative approach using thematic analysis was used. Individual semi-structured interviews were conducted with 13 female Malaysian office workers with MSP. Initial codes were identified and refined through iterative discussion to further develop the emerging codes and modify the coding framework. A further stage of coding was undertaken to eliminate redundant codes and establish analytic connections between distinct themes. Results Two major themes were identified: managing the demands of work and maintaining employment with persistent musculoskeletal pain. Participants reported developing strategies to assist them to remain at work, but most focused on individually initiated adaptations or peer support, rather than systemic changes to work systems or practices. A combination of the patriarchal and hierarchical cultural occupational context emerged as a critical factor in the finding of individual or peer based adaptations rather than organizational accommodations. Conclusions It is recommended that supervisors be educated in the benefits of maintaining and retaining employees with MSP, and encouraged to challenge cultural norms and develop appropriate flexible workplace accommodations through consultation and negotiation with these workers.

Introduction: Restructuring is the corporate management term for the act of reorganizing the legal, operational, or other structures of a company for the purpose of making it more profitable or better organized for its present needs. However, preparing an organization to accept and welcome any change is crucial. There is concern though over poor service delivery, untimely payment of workers, top management structure which is thought to be top heavy and employee costs taking (58%) of total expenditure., Methods: A descriptive cross sectional study was carried out. A cost benefit analysis was used to assess the cost and benefits of the proposed retrenchment exercise. A descriptive cross sectional study survey was conducted to assess the workers' perceptions towards the proposed restructuring exercise. A pretested self-administered questionnaire was used for data collection and data were analysed using EpiInfoTM (CDC 2012).Written informed consent was obtained from all study participants., Results: Sixty nine percent of the respondents were males. The median years working for the organisation was 8 years (Q1=1; Q3=17). The total income was surpassed by expenditure with USD$11 000 and 52% of expenditures was going towards employment costs. A midyear financial review showed that 1% was channeled towards capital expenditure 2% on repairs and maintenance and employee costs accounting to 58% of all incurred expenditure. Current departmental salary budget amounted to USD 3,3million dollars. Estimated salary costs for the proposed departmental structures amount to USD 3,8 million dollars. Comparison of the current and proposed structure showed that the proposed structure costs USD$486 000 more. Projected benefits of the proposed structure aims to improve service delivery from 60%-85% . Unlike managers, lower levels workers did not want the exercise to be carried out., Conclusion: The proposed structure has higher costs than the current structure but with more benefits in terms of service delivery. Generally workers perceived restructuring negatively and did not want it done.

Previous studies suggest that providing employment services to individuals with serious mental illnesses can help them obtain competitive, real-world employment. However, these services are still not easily accessible to this population. This paper provides a brief summary of recent federal initiatives that may influence widespread implementation of employment services. While there is an increasing recognition of the need to remove barriers and provide supported employment services to individuals with mental illnesses, a wide-spread coordination across Federal polices, financing and regulatory changes are necessary to promote measurable and lasting effects on the broad availability of employment services among this population.

Background/aim: This study explored how occupational therapists in private practice developed the business skills needed to operate a successful private practice. The literature shows that many small-business owner-managers have poorly developed business skills, and some experience high rates of failure. This indicates that to be successful in private practice, occupational therapists need to gain mastery of management competencies in addition to their professional clinical competencies., Methods: A qualitative study, using in-depth interviews, collected data from twenty-six self-employed occupational therapists on their experiences of becoming a small-business owner-manager. A narrative analysis built an understanding about how these therapists developed their business competencies., Results: Analysis revealed the factors affecting the development of business competencies were interactions between the initial motivations for start-up, growth aspirations and engagement with external business environments. Business competencies developed through a combination of formal learning prior to starting their businesses, and informal learning once their businesses were in operation. Lower level learning occurred in the routine and operational processes, with higher level learning through discontinuous events resulting in a transformation in the therapists' understanding about themselves as business owner-managers., Conclusions: Findings led to a proposition that occupational therapists make the transition to becoming successful small-business owner-manager through management learning that includes elements of self-reflection, identifying environmental opportunities and risks, developing capabilities, and strategic planning for growth and development. It provides insights on what occupational therapists need to consider to become successful small-business owner-managers., (© 2016 Occupational Therapy Australia.)

Background: Colorectal cancer affects a wide range of working-age people. Little is known about the consequent work limitations., Objective: The aim of this study was to understand the extent and changing nature of work-related limitations of middle-aged (45-64 years) people over the first 12 months of colorectal cancer., Methods: Surveys were administered to participants recruited via the Queensland Cancer Registry, at 6 and 12 months after diagnosis. Among those who returned to work, the Work Limitations Questionnaire measured 4 job performance domains (time management, physical, mental-interpersonal, and output demands) and an overall productivity score. Open-ended questions supplemented the Work Limitations Questionnaire, and responses were thematically analyzed., Results: Of 239 participants, 8% did not continue in the study, and 20% left employment by 12 months, leaving 171 participants eligible for this analysis. Open-ended responses for why participants stopped work included bowel problems and stoma, loss of strength, and medication adverse effects. At 12 months, 22% to 39% of participants reported work limitations, but there was no overall significant change in work limitations between 6 and 12 months. Qualitative data highlighted the key work-related issues were changes in work functioning, attitudes of employers and colleagues, financial pressures, and emotional responses., Conclusions: While a significant proportion left work because of treatment-related problems, and the majority of participants did not experience workplace limitations, some reported considerable work-related challenges., Implications for Practice: Discussions with health professionals about the possible impact of treatment adverse effects on employment, good communication with employers, and workplace flexibility may facilitate return to work for this population.

Aim: Explore the potential of a part-time work option for nurses as a strategy for managing domestic markets in Jordan by examining perceptions of working nurses and nursing students in the context of current social and cultural variables., Background: Unemployment among Jordanian nurses has become a reality in recent years. However, labor markets literature in nursing rarely studies what kind of policy responses should occur during a surplus of nurses., Methods: A cross-sectional design structured the study. The perceptions of nurses and students were measured through a questionnaire developed specifically for the purpose of this exploratory study., Results: Both nurses (n = 51) and students (n = 56) supported the introduction of the new suggested part-time option. However, students were more willing to start working or transfer into part-time work, take payment on hourly basis, and support colleagues to transfer into part-time work. Different solutions were also suggested by participants., Discussion: The results were useful for providing the foundational data to further study the viability of a part-time work option for Jordanian nurses. The results show how optimistic current and future Jordanian nurses are regarding this employment option. For countries that may need to diversify their employment models due to excess supply of nurses and to address gender imbalances, this work may help inform policy development., Implications for Nurses: Both employed and unemployed nurses will benefit if health care managers consider its application. The flexibility of this option may help improve the quality of life of many nurses., Implications for Health Policy: The results of this study provide nursing leaders and managers with foundational evidence that may be applicable in the Jordanian health sector. Although further studies are recommended, nursing leaders and policy makers should consider such a solution., (© 2016 International Council of Nurses.)

Background: Promoting walking for the journey to and from work (commuter walking) is a potential strategy for increasing physical activity. Understanding the factors influencing commuter walking is important for identifying target groups and designing effective interventions. This study aimed to examine individual, employment-related and psychosocial factors associated with commuter walking and to discuss the implications for targeting and future design of interventions., Methods: 1,544 employees completed a baseline survey as part of the 'Walking Works' intervention project (33.4% male; 36.3% aged <30 years). Multivariate logistic regression was used to examine the associations of individual (age, ethnic group, educational qualifications, number of children <16 and car ownership), employment-related (distance lived from work, free car parking at work, working hours, working pattern and occupation) and psychosocial factors (perceived behavioural control, intention, social norms and social support from work colleagues) with commuter walking., Results: Almost half of respondents (n = 587, 49%) were classified as commuter walkers. Those who were aged <30 years, did not have a car, had no free car parking at work, were confident of including some walking or intended to walk to or from work on a regular basis, and had support from colleagues for walking were more likely to be commuter walkers. Those who perceived they lived too far away from work to walk, thought walking was less convenient than using a car for commuting, did not have time to walk, needed a car for work or had always travelled the same way were less likely to be commuter walkers., Conclusions: A number of individual, employment-related and psychosocial factors were associated with commuter walking. Target groups for interventions to promote walking to and from work may include those in older age groups and those who own or have access to a car. Multi-level interventions targeting individual level behaviour change, social support within the workplace and organisational level travel policies may be required in order to promote commuter walking., Competing Interests: The authors have declared that no competing interests exist.

The Where are the Radiation Professionals (WARP)? statement issued by the National Council on Radiation Protection and Measurements estimates that in 10 y, there will be a human capital crisis across the radiation safety community. The ability to respond to this shortage will be amplified by the fact that many radiation protection (health physics) academic programs will find it difficult to justify their continued existence since they are low-volume programs, both in terms of enrollment and research funding, compared to the research funding return and visibility of more highly subscribed and highly funded academic disciplines. In addition, across the national laboratory complex, radiation protection research groups have been disbanded or dramatically reduced in size. The loss of both of these national resources is being accelerated by low and uncertain government funding priorities. The most effective solution to this problem would be to form a consortium that would bring together the radiation protection research, academic, and training communities. The goal of such a consortium would be to engage in research, education, and training of the next generation of radiation protection professionals. Furthermore, the consortium could bring together the strengths of different universities, national laboratory programs, and other entities in a strategic manner to accomplish a multifaceted research, educational, and training agenda. This vision would forge a working and funded relationship between major research universities, national laboratories, 4-y degree institutions, technical colleges, and other partners.

The National Council on Radiation Protection and Measurements (NCRP) believes that the most critical need for the nation in radiation protection is to train, engage, and retain radiation professionals for the future. Not only is the pipeline shrinking, but for some areas there is no longer a pipe! When the call comes to respond, there may be no one to answer the phone! The NCRP "Where are the Radiation Professionals?" initiative, Council Committee (CC) 2, and this year's annual meeting are to focus our efforts to find solutions and not just reiterate the problems. Our next major initiative is CC 1, where the NCRP is making recommendations for the United States on all things dealing with radiation protection. Our last publication was NCRP Report No. 116, Limitation of Exposure to Ionizing Radiation, in 1993-time for an update. NCRP has seven active Program Area Committees on biology and epidemiology, operational concerns, emergency response and preparedness, medicine, environmental issues and waste management, dosimetry, and communications. A major scientific research initiative is the Million Person Study of Low Dose Radiation Health Effects. It includes workers from the Manhattan Project, nuclear weapons test participants (atomic veterans), industrial radiographers, and early medical workers such as radiologists and technologists. This research will answer the one major gap in radiation risk evaluation: what are the health effects when the exposure occurs gradually over time? Other cutting edge initiatives include a re-evaluation of science behind recommendations for lens of the eye dose limits, recommendations for emergency responders on dosimetry after a major radiological incident, guidance to the National Aeronautics and Space Administration with regard to possible central nervous system effects from galactic cosmic rays (the high energy, high mass particles bounding through space), re-evaluating the population exposure to medical radiation (NCRP Report No. 160, Ionizing Radiation Exposure of the Population of the United States, is over 10 y old, and computed tomography exams have increased substantially since then), and concerning whether the linear no-, threshold model is still the best available for purposes of radiation protection (not for risk assessment). We believe evaluation of heart disease and cerebral vascular disease following low-dose and dose-rate exposure is important for assessments of possible detriment from such exposures. We continue to seek the necessary resources to follow our quest to improve radiation protection for the public!

Aim: To assess whether or not a sample of PGY-1 doctors in the Waikato region remained satisfied with the ACE system for employment 12 years after its inception., Method: An anonymous paper-based survey was completed by a cohort (n=60) of 2015 and 2016 PGY-1 doctors based at the Waikato DHB. Questions were based around reasons for selecting the DHB, satisfaction with the ACE process and future career intentions., Results: Overall satisfaction with the ACE selection process was reasonable (63%). Over 60% of the 2015 and 2016 cohorts chose Waikato as their first choice DHB, and of those, over 90% intended to carry on through to at least PGY2 level at the DHB. An overwhelming majority (93-96%) intended to continue practicing in New Zealand., Conclusions: Consistent trends were observed across the two cohorts in regards to their reasons for selecting the DHB, satisfaction with ACE and future intentions, with some differences observed with familial background and interest in pursuing hospital-based specialties. Our findings suggest that ACE remains a satisfactory recruiting system for postgraduate junior doctors, however, motives around initial DHB selection and future vocational intentions remain unclear and warrant further investigation.

Context:  Academic and medical models are emerging as alternatives to the athletics model, which is the more predominant model in the collegiate athletic training setting. Little is known about athletic trainers' (ATs') perceptions of these models., Objective:  To investigate the perceived benefits of and barriers in the medical and academic models., Design:  Qualitative study., Setting:  National Collegiate Athletic Association Divisions I, II, and III., Patients or Other Participants:  A total of 16 full-time ATs (10 men, 6 women; age = 32 ± 6 years, experience = 10 ± 6 years) working in the medical (n = 8) or academic (n = 8) models., Data Collection and Analysis:  We conducted semistructured telephone interviews and evaluated the qualitative data using a general inductive approach. Multiple-analyst triangulation and peer review were completed to satisfy data credibility., Results:  In the medical model, role congruency and work-life balance emerged as benefits, whereas role conflict, specifically intersender conflict with coaches, was a barrier. In the academic model, role congruency emerged as a benefit, and barriers were role strain and work-life conflict. Subscales of role strain included role conflict and role ambiguity for new employees. Role conflict stemmed from intersender conflict with coaches and athletics administrative personnel and interrole conflict with fulfilling multiple overlapping roles (academic, clinical, administrative)., Conclusions:  The infrastructure in which ATs provide medical care needs to be evaluated. We found that the medical model can support better alignment for both patient care and the wellbeing of ATs. Whereas the academic model has perceived benefits, role incongruence exists, mostly because of the role complexity associated with balancing teaching, patient-care, and administrative duties.

Background: What a stroke means for working-age persons has not been sufficiently studied from a sociological perspective., Objective: This article uses the empirical material of a larger study to describe and analyze how institutional practices and discourses influence attempts to return to work after a stroke., Methods: Semi-structured interviews were conducted with ten persons who have had a stroke and ten civil servants and professionals from the Swedish Public Employment Service, the Social Insurance Agency, and different health care institutions. The qualitative analysis was inspired by institutional ethnography., Results: The analysis shows how persons who have had a stroke and civil servants and professionals in welfare organizations share the same goal: a return to working life for the former. The persons in this study related to, translated, and put into practice discourses of normality and employability in this process. However, there were, at times, conflicting institutional practices between the different organizations., Conclusions: Conflicting institutional practices connected to the discourses of normality and employability contribute to the difficulties that persons who have had a stroke face when trying to return to work after recovery.

Arrangements between those who perform work and those who provide jobs come in many different forms. Standard work arrangements now exist alongside several nonstandard arrangements: agency work, contract work, and gig work. While standard work arrangements are still the most prevalent types, the rise of nonstandard work arrangements, especially temporary agency, contract, and "gig" arrangements, and the potential effects of these new arrangements on worker health and safety have captured the attention of government, business, labor, and academia. This article describes the major work arrangements in use today, profiles the nonstandard workforce, discusses several legal questions about how established principles of labor and employment law apply to nonstandard work arrangements, summarizes findings published in the past 20 years about the health and safety risks for workers in nonstandard work arrangements, and outlines current research efforts in the area of healthy work design and worker well-being. Am. J. Ind. Med. 60:1-10, 2017. © 2016 Wiley Periodicals, Inc., (© 2016 Wiley Periodicals, Inc.)

The present study aimed to survey systems in Japanese companies for supporting workers returning to work from sickness absence due to mental illness. A questionnaire survey was mailed to 3,545 companies. Support systems for return to work, sick leave, and multiple sick-listed (MSL) workers were examined. A total of 161 companies responded to the survey (response rate: 4.5%). About 80% of the companies expressed difficulty in dealing with workers with mental health problems. About half of all companies reported having reset period and financial compensation systems, as well as gradual resumption and trial attendance systems. Most large companies tended to have reset period and trial attendance systems. No association was found between company size and MSL rates. The most frequent diagnosis among workers was depression, and the mean number of sick leave days was 275.3. Although there might have been a selection bias due to the low response rate, the results of this study are expected to be useful for companies when formulating employment systems.

Introduction Many disability prevention strategies are focused on acute injuries and brief illness episodes, but there will be growing challenges for employers to manage circumstances of recurrent, chronic, or fluctuating symptoms in an aging workforce. The goal of this article is to summarize existing peer-review research in this area, compare this with employer discourse in the grey literature, and recommend future research priorities. Methods The authors participated in a year-long sponsored collaboration that ultimately led to an invited 3-day conference, "Improving Research of Employer Practices to Prevent Disability", held October 14-16, 2015, in Hopkinton, Massachusetts, USA. The collaboration included a topical review of the scientific and industry literature, group discussion to identify key areas and challenges, drafting of initial documents, and feedback from peer researchers and a special panel of experts with employer experience. Results Cancer and mental illness were chosen as examples of chronic or recurring conditions that might challenge conventional workplace return-to-work practices. Workplace problems identified in the literature included fatigue, emotional exhaustion, poor supervisor and co-worker support, stigma, discrimination, and difficulties finding appropriate accommodations. Workplace intervention research is generally lacking, but there is preliminary support for improving workplace self-management strategies, collaborative problem-solving, and providing checklists and other tools for job accommodation, ideas echoed in the literature directed toward employers. Research might be improved by following workers from an earlier stage of developing workplace concerns. Conclusions Future research of work disability should focus on earlier identification of at-risk workers with chronic conditions, the use of more innovative and flexible accommodation strategies matched to specific functional losses, stronger integration of the workplace into on-going rehabilitation efforts, and a better understanding of stigma and other social factors at work., Competing Interests: Glenn Pransky, Elyssa Besen, Peter Blanck, Kirsten Ekberg, Jean-Baptise Fassier, Michael Feuerstein, and Fehmidah Munir declare that they have no conflict of interest. Ethical approval This article does not contain any studies with human participants or animals performed by any of the authors.

Background: "Doing gender" plays an important role in nursing interactions in long-term care settings., Aim: The aim of this article is to focus on the experiences of staff and management in a long-term care setting on the social categorization of gender and to reflect and discuss these findings against already existing research., Material and Methods: Within a qualitative study, one to one interviews and group discussions with a total of 28 participants were conducted., Results and Conclusion: The results show how "doing gender" as a social practice effects interactions with residents, within the working team and in the context of management and hierarchy in the long-term care setting. In interactions with residents, gender-specific behavior can be observed. Within the working team gender-specific differences with respect to division of labor and working hours are reported. Concerning management and hierarchy it can be observed that male executives react more strongly in correspondence with the expectations of their gender role whereas female executives show more discrepancies between the expectations towards their position and gender role.