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Ziekteverzuim en arbeidsongeschiktheid zijn binnen de A&G-psychologie belangrijke thema’s. De reden is dat het gaat om de gevolgen van gezondheidsproblemen van werk-nemers die vertaald worden in het niet meer kunnen verrichten van werk. Vaak zijn dat kortdurende perioden van afwezigheid, maar het kan ook gaan om langdurige afwezig-heid of zelfs helemaal niet meer terug kunnen keren naar het werk. Ziekteverzuim wordt ook wel tijdelijke arbeidsongeschiktheid genoemd. Onder ziekteverzuim en arbeidson-geschiktheid verstaan we in dit hoofdstuk minder uren of dagen werken dan contractu-eel overeengekomen, vanwege ziekte, ongeval of andere gezondheidsredenen, en waarbij normaal zwangerschapsverlof niet als ziekteverzuim wordt opgevat. De afb akening tussen ziekte, ziekteverzuim en arbeidsongeschiktheid is niet eendui-dig. Ook is de grens tussen ziek en gezond niet scherp te trekken. Vooral niet als we, in navolging van de Wereldgezondheidsorganisatie (WHO), een ruime defi nitie van gezondheid hanteren: namelijk een toestand van lichamelijk, psychisch en sociaal wel-zijn. Deze omschrijving geeft aan dat niet gezond zijn nog niet betekent dat iemand ziek is. Ziekte en gezondheid moeten worden opgevat als twee uitersten van een continuüm, waarbij de meeste mensen zich ergens tussen die twee uitersten bevinden. Ook betekent ziekte niet automatisch dat er sprake is van ziekteverzuim. Ziekte verwijst naar ziek-zijn in de medische zin van het woord. Verzuim daarentegen ver-wijst naar je ziek melden als vorm van gedrag. In veel gevallen voelt de werknemer zich ziek en ervaart hij subjectieve gezondheidsklachten, die soms moeilijk objectiveerbaar kunnen zijn. Het is niet altijd evident dat de werknemer niet meer kan werken. In dat geval heeft de werknemer (afh ankelijk van de ernst van de klachten) een zekere mate van beslissingsvrijheid om zich al dan niet ziek te melden. Hierbij dient ook bedacht te worden dat vergelijkbare gezondheidsproblemen (bijv. een verstuikte enkel) in de ene arbeidssituatie (werk in de bouw) wel reden kunnen zijn voor een ziekmelding, terwijl in een andere arbeidssituatie (kantoorwerk) verzuim niet noodzakelijk is. Het antwoord op de vraag of een aandoening of ziekte leidt tot verzuim is dus afh ankelijk van de aard van het werk dat iemand verricht.

Young children are vulnerable to extreme temperatures due to their physiological and anatomical characteristics and behavioural dependability. The latter is a relatively unexplored area. Therefore, the current study investigated the skin temperature as a proxy of the thermal state of children and care providers in day-care centers, the ability of the care providers to estimate the thermal state of the children and their knowledge on this topic. Results from 104 children ( 0.05). Furthermore, many care providers had difficulties naming symptoms of heat illness and the care providers with ≤5 years work experience had a lower knowledge level of thermoregulation than care providers with >5 years work experience. It is recommended to train care providers in thermal assessment, in particular novice care providers that have less knowledge on this topic.

COVID-19 healthcare personnel (HCP) use personal protective equipment (PPE; ie, isolation gowns, eye protection, facemasks and respirators) to safely perform their medical duties. However, PPE creates a microenvironment around the skin due to a higher thermal resistance and lower water vapour permeability of the materials being used compared with the normal clothing ensemble of HCP.1 Consequently, heat loss capacity via the skin surface is greatly reduced. The metabolic energy expenditure from regular working activities could, therefore, not be completely lost to the surrounding environment, leading to heat strain, thermal discomfort, excessive sweating, faster dehydration and an increased cardiovascular strain. To accommodate heat loss, blood redistribution from central organs and skeletal muscle to the skin occurs, which will further exacerbate the physiological strain, ultimately leading to shorter work tolerance times and a reduced physical and cognitive performance.1 2 The most common recommendation for working in PPE is to adjust the work/rest schedule and incorporate more and longer breaks in order to alleviate heat strain. However, this recommendation is not always feasible in clinical settings as hospitals are often understaffed during the COVID-19 pandemic.

In dit hoofdstuk staan psychische aandoeningen en klachten centraal die ontstaan door of tijdens het werk, of die worden verergerd door of tijdens het werk. Deze aandoenin-gen en klachten worden in dit hoofdstuk op een specifi eke wijze belicht: vanuit de epi-demiologie. Epidemiologie kan worden omschreven als de (medische) statistiek van de grote aantallen. Zij beschrijft het vóórkomen en de verspreiding van, en de ontwikkeling in (epidemische) ziekten. Naast beschrijvend kan de epidemiologie ook toetsend of voorspellend zijn. In de medische wetenschap hebben allerhande problemen vaak een dichotoom karakter: een werknemer is wel of niet blootgesteld aan een bepaald risico, wel of niet ziek, of is wel of niet arbeidsongeschikt. Dit vertaalt zich ook in de wijze waarop de epi-demiologie toetsingsresultaten weergeeft , namelijk als de kans om een bepaald gezond-heidsprobleem te hebben na te zijn blootgesteld aan één of meer risico’s, of de kansen op werkhervatting bij bijvoorbeeld wel of geen werkdruk. In tegenstelling tot de medi-sche wetenschap gaan we er in de A&G-psychologie in het algemeen van uit dat een gezondheidsprobleem een lineair ofwel continu karakter heeft . Anders gezegd: een der-gelijk probleem kan iets meer, gemiddeld, of juist iets minder aanwezig zijn. Zo kan een werknemer veel, weinig of geen psychische klachten hebben, en kunnen arbeidsrisico’s in meer of mindere mate bijdragen aan een gezondheidsprobleem, ziekteverzuim of arbeidsongeschiktheid.

In dit hoofdstuk staan psychische aandoeningen en klachten centraal die ontstaan door of tijdens het werk, of die worden verergerd door of tijdens het werk. Deze aandoenin-gen en klachten worden in dit hoofdstuk op een specifi eke wijze belicht: vanuit de epi-demiologie. Epidemiologie kan worden omschreven als de (medische) statistiek van de grote aantallen. Zij beschrijft het vóórkomen en de verspreiding van, en de ontwikkeling in (epidemische) ziekten. Naast beschrijvend kan de epidemiologie ook toetsend of voorspellend zijn. In de medische wetenschap hebben allerhande problemen vaak een dichotoom karakter: een werknemer is wel of niet blootgesteld aan een bepaald risico, wel of niet ziek, of is wel of niet arbeidsongeschikt. Dit vertaalt zich ook in de wijze waarop de epi-demiologie toetsingsresultaten weergeeft , namelijk als de kans om een bepaald gezond-heidsprobleem te hebben na te zijn blootgesteld aan één of meer risico’s, of de kansen op werkhervatting bij bijvoorbeeld wel of geen werkdruk. In tegenstelling tot de medi-sche wetenschap gaan we er in de A&G-psychologie in het algemeen van uit dat een gezondheidsprobleem een lineair ofwel continu karakter heeft . Anders gezegd: een der-gelijk probleem kan iets meer, gemiddeld, of juist iets minder aanwezig zijn. Zo kan een werknemer veel, weinig of geen psychische klachten hebben, en kunnen arbeidsrisico’s in meer of mindere mate bijdragen aan een gezondheidsprobleem, ziekteverzuim of arbeidsongeschiktheid.

This study investigates the hypotheses that during passive heat stress, the change in perception of time and change in accuracy of a timed decision task relate to changes in thermophysiological variables gastrointestinal temperature and heart rate (HR), as well as subjective measures of cognitive load and thermal perception. Young adult males (N = 29) participated in two 60-min head-out water immersion conditions (36.5°C-neutral and 38.0°C-warm). Cognitive task measurements included accuracy (judgment task), response time (judgment ask), and time estimation (interval timing task). Physiological measurements included gastrointestinal temperature and heart rate. Subjective measurements included cognitive task load (NASA-TLX), rate of perceived exertion, thermal sensation, and thermal comfort. Gastrointestinal temperature and HR were significantly higher in warm versus neutral condition (gastrointestinal temperature: 38.4 ± 0.2°C vs. 37.2 ± 0.2°C, p < 0.01; HR: 105 ± 8 BPM vs. 83 ± 9 BPM, p < 0.01). The change in accuracy was significantly associated with the change in gastrointestinal temperature, and attenuated by change in thermal sensation and change in HR (r2=0.40, p< 0.01). Change in response time was significantly associated with the change in gastrointestinal temperature (r2=0.26, p< 0.002), and change in time estimation was best explained by a change in thermal discomfort (r2=0.18, p< 0.01). Changes in cognitive performance during passive thermal stress are significantly associated with changes in thermophysiological variables and thermal perception. Although explained variance is low (

This study investigates the hypotheses that during passive heat stress, the change in perception of time and change in accuracy of a timed decision task relate to changes in thermophysiological variables gastrointestinal temperature and heart rate (HR), as well as subjective measures of cognitive load and thermal perception. Young adult males (N = 29) participated in two 60-min head-out water immersion conditions (36.5°C-neutral and 38.0°C-warm). Cognitive task measurements included accuracy (judgment task), response time (judgment ask), and time estimation (interval timing task). Physiological measurements included gastrointestinal temperature and heart rate. Subjective measurements included cognitive task load (NASA-TLX), rate of perceived exertion, thermal sensation, and thermal comfort. Gastrointestinal temperature and HR were significantly higher in warm versus neutral condition (gastrointestinal temperature: 38.4 ± 0.2°C vs. 37.2 ± 0.2°C, p < 0.01; HR: 105 ± 8 BPM vs. 83 ± 9 BPM, p < 0.01). The change in accuracy was significantly associated with the change in gastrointestinal temperature, and attenuated by change in thermal sensation and change in HR (r2=0.40, p< 0.01). Change in response time was significantly associated with the change in gastrointestinal temperature (r2=0.26, p< 0.002), and change in time estimation was best explained by a change in thermal discomfort (r2=0.18, p< 0.01). Changes in cognitive performance during passive thermal stress are significantly associated with changes in thermophysiological variables and thermal perception. Although explained variance is low (

Young children are vulnerable to extreme temperatures due to their physiological and anatomical characteristics and behavioural dependability. The latter is a relatively unexplored area. Therefore, the current study investigated the skin temperature as a proxy of the thermal state of children and care providers in day-care centers, the ability of the care providers to estimate the thermal state of the children and their knowledge on this topic. Results from 104 children ( 0.05). Furthermore, many care providers had difficulties naming symptoms of heat illness and the care providers with ≤5 years work experience had a lower knowledge level of thermoregulation than care providers with >5 years work experience. It is recommended to train care providers in thermal assessment, in particular novice care providers that have less knowledge on this topic.

Ziekteverzuim en arbeidsongeschiktheid zijn binnen de A&G-psychologie belangrijke thema’s. De reden is dat het gaat om de gevolgen van gezondheidsproblemen van werk-nemers die vertaald worden in het niet meer kunnen verrichten van werk. Vaak zijn dat kortdurende perioden van afwezigheid, maar het kan ook gaan om langdurige afwezig-heid of zelfs helemaal niet meer terug kunnen keren naar het werk. Ziekteverzuim wordt ook wel tijdelijke arbeidsongeschiktheid genoemd. Onder ziekteverzuim en arbeidson-geschiktheid verstaan we in dit hoofdstuk minder uren of dagen werken dan contractu-eel overeengekomen, vanwege ziekte, ongeval of andere gezondheidsredenen, en waarbij normaal zwangerschapsverlof niet als ziekteverzuim wordt opgevat. De afb akening tussen ziekte, ziekteverzuim en arbeidsongeschiktheid is niet eendui-dig. Ook is de grens tussen ziek en gezond niet scherp te trekken. Vooral niet als we, in navolging van de Wereldgezondheidsorganisatie (WHO), een ruime defi nitie van gezondheid hanteren: namelijk een toestand van lichamelijk, psychisch en sociaal wel-zijn. Deze omschrijving geeft aan dat niet gezond zijn nog niet betekent dat iemand ziek is. Ziekte en gezondheid moeten worden opgevat als twee uitersten van een continuüm, waarbij de meeste mensen zich ergens tussen die twee uitersten bevinden. Ook betekent ziekte niet automatisch dat er sprake is van ziekteverzuim. Ziekte verwijst naar ziek-zijn in de medische zin van het woord. Verzuim daarentegen ver-wijst naar je ziek melden als vorm van gedrag. In veel gevallen voelt de werknemer zich ziek en ervaart hij subjectieve gezondheidsklachten, die soms moeilijk objectiveerbaar kunnen zijn. Het is niet altijd evident dat de werknemer niet meer kan werken. In dat geval heeft de werknemer (afh ankelijk van de ernst van de klachten) een zekere mate van beslissingsvrijheid om zich al dan niet ziek te melden. Hierbij dient ook bedacht te worden dat vergelijkbare gezondheidsproblemen (bijv. een verstuikte enkel) in de ene arbeidssituatie (werk in de bouw) wel reden kunnen zijn voor een ziekmelding, terwijl in een andere arbeidssituatie (kantoorwerk) verzuim niet noodzakelijk is. Het antwoord op de vraag of een aandoening of ziekte leidt tot verzuim is dus afh ankelijk van de aard van het werk dat iemand verricht.

De Nederlandse beroepsbevolking wordt gemiddeld steeds ouder en verlaat op steeds hogere leeftijd het arbeidsproces. Dat geldt ook voor ambtenaren. De gemiddelde leeftijd van werknemers in het openbaar bestuur is in de periode 2004-2014 opgelopen van 41,6 tot ruim 44,6 jaar (CBS, 2016). Die vergrijzing zet druk op ons sociale stelsel en heeft er onder andere al toe geleid dat de AOW-leeftijd in Nederland is verhoogd en dat vervroegde uittrederoutes zijn afgesloten. Oók voor ambtenaren. Langer gezond, gemotiveerd, competent en productief aan het werk blijven, is dus vereist.

De Nederlandse beroepsbevolking wordt gemiddeld steeds ouder en verlaat op steeds hogere leeftijd het arbeidsproces. Dat geldt ook voor ambtenaren. De gemiddelde leeftijd van werknemers in het openbaar bestuur is in de periode 2004-2014 opgelopen van 41,6 tot ruim 44,6 jaar (CBS, 2016). Die vergrijzing zet druk op ons sociale stelsel en heeft er onder andere al toe geleid dat de AOW-leeftijd in Nederland is verhoogd en dat vervroegde uittrederoutes zijn afgesloten. Oók voor ambtenaren. Langer gezond, gemotiveerd, competent en productief aan het werk blijven, is dus vereist.

Background: Health, safety, and well-being (HSW) at work represent important values in themselves. It seems, however, that other values can contribute to HSW. This is to some extent reflected in the scientific literature in the attention paid to values like trust or justice. However, an overview of what values are important for HSW was not available. Our central research question was: what organizational values are supportive of health, safety, and well-being at work? Methods: The literature was explored via the snowball approach to identify values and value-laden factors that support HSW. Twenty-nine factors were identified as relevant, including synonyms. In the next step, these were clustered around seven core values. Finally, these core values were structured into three main clusters. Results: The first value cluster is characterized by a positive attitude toward people and their “being”; it comprises the core values of interconnectedness, participation, and trust. The second value cluster is relevant for the organizational and individual “doing”, for actions planned or undertaken, and comprises justice and responsibility. The third value cluster is relevant for “becoming” and is characterized by the alignment of personal and organizational development; it comprises the values of growth and resilience. Conclusion: The three clusters of core values identified can be regarded as “basic value assumptions” that underlie both organizational culture and prevention culture. The core values identified form a natural and perhaps necessary aspect of a prevention culture, complementary to the focus on rational and informed behavior when dealing with HSW risks.

OBJECTIVE: To assess problem behavior in adolescents with Down syndrome and examine the association with sex and severity of intellectual disability. STUDY DESIGN: Cross-sectional data of a Dutch nationwide cohort of Down syndrome children aged 16-19 years were collected using a written parental questionnaire. Problem behavior was measured using the Child Behavior Checklist and compared with normative data. The degree of intellectual disability was determined using the Dutch Social competence rating scale. RESULTS: The response rate was 62.8% (322/513), and the mean age 18.3 years (SD ± 0.8). The total score for problem behavior was higher in adolescents with Down syndrome than in adolescents without Down syndrome (26.8 vs 16.5; P < .001). Overall, 51% of adolescents with Down syndrome had problem scores in the clinical or borderline range on 1 or more Child Behavior Checklist subscales; this is more than twice as high as adolescents without Down syndrome. Adolescents with Down syndrome had more internalizing problems than their counterparts without Down syndrome (14% and 9%, respectively, in the clinical range); the percentages for externalizing problems were almost equal (7% and 9%, respectively, in the clinical range). The highest problem scores in adolescents with Down syndrome were observed on the social problems and thought problems subscales (large to very large standardized differences). Male sex and/or more severe mental disabilities were associated with more behavioral problems. CONCLUSIONS: Serious problem behavior is more prevalent in adolescents with Down syndrome. This demonstrates the need for a focus on general behavior improvement and on the detection and treatment of specific psychopathology in individuals with Down syndrome.

Contains fulltext : 119785.pdf (Publisher’s version ) (Closed access) Incidence rates of third party workplace violence in Europe have increased, but little is known about the causes thereof. It has been suggested that the growth of the service sector and the intensification of work could be responsible for the increase. This study aimed to identify trends in the prevalence of physical workplace violence across Europe, as well as to uncover factors explaining these trends. Three cross-sectional waves (1995, 2000, and 2005) of the European Working Conditions Survey were used, involving 58,520 workers and covering 15 European member states. Logistic regression analyses were performed to investigate associations between work characteristics and violence prevalence. Workplace violence increased significantly during the study interval. Although violence was clearly related to specific characteristics of the labour market (gender, age, sector, etc.) and the work environment (client contact frequency, time pressure, control, and computer work), recent changes in the European labour market composition and work environment could not explain the increase in violence. In jobs characterized by high levels of computer work in particular, violence appears to be an emerging risk. Our results suggest that the nature (and perhaps quality) of client contact is changing, leading to higher violence risks. 13 p.

OBJECTIVE: To investigate the associations between body mass index (BMI) and sick leave, and the mediating role of emotional exhaustion. METHODS: Data were collected from a large survey among Dutch employees (n = 35,022). The causal pathway approach consisting of four regression analyses was applied. RESULTS: In women, moderate overweight and obesity were associated with higher sick leave; in men, obesity, but not moderate overweight, was associated with higher sick leave. Obese workers were at increased risk for emotional exhaustion. Emotional exhaustion was also associated with higher sick leave rates. Adjustment for emotional exhaustion in the association between BMI and sick leave hardly changed the effect size and significance remained. CONCLUSIONS: The association between BMI status and sick leave can be explained partially by the presence of emotional exhaustion. Workplace health promotion initiatives should take this into account. Copyright © 2013 by American College of Occupational and Environmental Medicine.

Background: The majority of Dutch F-16 pilots experience in-flight oxygen mask related nasal discomfort and injury. We aimed to analyze the fit of the oxygen mask. Methods: We successfully scanned 35 pilots with a 3D scanner to measure the distance between the contact area on the nose and the oxygen mask in seven points, and the difference (Δ) in angle between the nose and the mask relative to the facial midline. Ill fit was defined as ≥ 4 mm distance, or Δ ≥ 4o angle. Intraclass correlation coefficients were used to objectify the reproducibility of the measurements. Results: There were 35 pilots who had ≥ 4 mm distance between the nasal dorsum and the mask and 14 pilots had Δ ≥ 4o angle. Reproducibility of the distance measurements was excellent (R ≥ 0.93, CI 95% 0.86-0.96) and of the angle measurements was good (R = 0.72, CI 95% 0.5-0.8). Conclusion: The room for displacement that we found may be a contributor to the discomfort. It is indicative of an ill fit of the oxygen mask, since all subjects had complaints. We recommend evaluating whether improved fixation of the mask and simultaneous reduction of the pressure on the nose will improve comfort.

Purpose The aims of this study are: (1) to describe the prevalence of needed and implemented work adjustments in a representative sample of Dutch employees with a chronic disease; and (2) to assess the effects of needed and implemented work adjustments on sick leave. Methods The prevalence of work adjustments was assessed in employees with a chronic disease, aged between 15 and 65 years (n = 7,687) from the 2007 Netherlands Working Conditions Survey (NWCS). Of these, N = 2,631 employees participated in the Netherlands Working Conditions Cohort Study (NWCCS) measurements in 2008 and 2009. The NWCCS data were used to investigate the effects of work adjustments on sick leave. All data were self-reported. A repeated measures ANOVA was performed to analyse differences in sick leave in 2007, 2008 and 2009 between employees with and without a need for work adjustments, for those who reported an implemented work adjustment and those who did not. Results In 2007, the prevalence of implemented work adjustments among Dutch employees with a chronic disease was 22 %, while 30 % reported the need of a work adjustment. In employees with and without a need for work adjustments in 2007, a work adjustment in 2008 was significantly associated with a decrease in sick leave from 2007 to 2009. Conclusion The need for work adjustments is higher than the implementation of work adjustments. Work adjustments should be considered more often for employees with chronic diseases, because implementation of a work adjustment is associated with a decrease in sick leave. © 2013 Springer Science+Business Media New York.

De JGZ kan voorlichting geven over zindelijkheid aan ouders en kinderen en zindelijkheidsproblemen signaleren en begeleiden. Doel van deze richtlijn is het uniform, tijdig en correct signaleren, verwijzen en begeleiden van kinderen met zindelijkheidsproblemen door de JGZ. Ook kan de JGZ een rol spelen in de voorlichting aan de omgeving van het kind, zoals school en kinderopvang.

Summary Photosensitivity is characteristic of systemic lupus erythematosus (SLE). Upon ultraviolet B (UVB) exposure, patients develop inflammatory skin lesions in the vicinity of sunburn cells (SBCs). High mobility group box 1 (HMGB1) is released from apoptotic and activated cells and exerts inflammatory actions through ligation to its receptors. Methods Eleven SLE patients and 10 healthy controls (HCs) were exposed to UVB. Skin biopsies were taken before and at one, three and 10 days after irradiation. Sections were stained for SBC, HMGB1, CD3, CD68, interferon-induced protein MxA and cleaved caspase 3. In vitro experiments with UVB-irradiated keratinocytes were also performed. Higher numbers of cells that had released HMGB1 were seen in the skin of SLE patients compared to HCs before and after irradiation. HMGB1-negative nuclei correlated with the presence of SBCs, and with the number of cleaved caspase 3 positive cells in lupus skin. Results HMGB1 release is increased in the skin of SLE patients compared to HCs. Upon UVB exposure, HMGB1 release further increases in SLE patients and is related to the number of apoptotic cells. Our data suggest that HMGB1, probably released from apoptotic keratinocytes, contributes to the development of inflammatory lesions in the skin of SLE patients upon UVB exposure.

Uncertainty plays a significant role in evaluating climate policy, and fat-tailed uncertainty may dominate policy advice. Should we make our utmost effort to prevent the arbitrarily large impacts of climate change under deep uncertainty? In order to answer to this question, we propose a new way of investigating the impact of (fat-tailed) uncertainty on optimal climate policy: the curvature of the optimal carbon tax against the uncertainty. We find that the optimal carbon tax increases as the uncertainty about climate sensitivity increases, but it does not accelerate as implied by Weitzman's Dismal Theorem. We find the same result in a wide variety of sensitivity analyses. These results emphasize the importance of balancing the costs of climate change against its benefits, also under deep uncertainty. © 2013 Springer Science+Business Media Dordrecht.

Objectives Asians have a smaller muscle mass and a larger fat mass at the same body mass index (BMI) than most other ethnic groups. Due to a resulting higher cardiometabolic risk, the BMI cut-offs for overweight and obesity were lowered for adults. For Asian children universal criteria apply. The objectives of this study were to determine the normal BMI distribution and assess the BMI class distribution in a reference cohort of affluent South Asian children born before the obesity epidemic and to assess the influence of the obesity epidemic on the distributions. Methods Historical cohort study with 4350 measurements of height and weight of two cohorts (born 1974–1976 and 1991–1993) of Surinamese South Asian children living in The Netherlands, analysed with WHO Child Growth References and International Obesity Task Force (IOTF) BMI cut-offs. Results The reference cohort 1974–1976 was significantly lighter (BMI Z-score=−0.63; 95% CI −0.69 to −0.58) and more variable (SD=1.19) than WHO reference. Total thinness prevalence was exceptionally high, both in cohort 1974–1976 (WHO 38.3%; IOTF 36.4%) and 1991–1993 (WHO 23.6%; IOTF 23.9%). Overweight and obesity prevalences were low in the reference cohort (WHO respectively 6.0% and 2.1%; IOTF 5.3%, 0.9%), but much higher in cohort 1991–1993 (WHO 13.6%, 9.1%; IOTF 11.7%, 6.0%). Conclusions The low mean BMI Z-score and high prevalence of thinness are likely expressions of the characteristic body composition of South Asians. Universal BMI cut-offs should be applied carefully in South Asian populations as thinness prevalence is likely to be overestimated and obesity underestimated. The development of ethnic specific cut-offs is recommended.

Objective This study aims to evaluate the effectiveness of a draft occupational health guideline, aimed at preventing weight gain, on employees' body weight-related outcomes, cardiovascular disease (CVD) risk factors, and quality of life. Methods In a cluster randomized controlled trial including 16 occupational physicians (OP) and 523 employees, guideline-based care was compared to usual care by OP between 2009-2011 in the Netherlands. Guideline-based care consisted of (i) providing advice to employers on how to assess and intervene on the obesogenic work environment, (ii) conducting five face-to-face behavioral change counseling sessions with employees to improve their lifestyles, and (iii) evaluating the outcome and maintaining sections i and ii. Data were collected at baseline and 6, 12, and 18-months follow-up. To evaluate the effects of the intervention, multilevel analyses were performed. Results No significant differences were found between the intervention and control group on waist circumference [β 1.2 cm, 95% confidence interval (95% CI) -0.6-2.9], body weight (β 0.3 kg, 95% CI -1.0-1.6), body mass index (β 0.1 kg/m2, 95% CI -0.3-0.5), systolic blood pressure (β 1.7 mmHG, 95% CI -2.4-5.8), diastolic blood pressure (β 0.3 mmHG, 95% CI -1.0-0.6), cholesterol (β 0 mmol/l, 95% CI -0.2-0.2), or quality of life indicators after 18-months follow-up. Stratified analyses showed an increase in waist circumference among men (β 2.5 cm, 95% CI 0.5-4.5) and obese intervention participants (β 2.7 cm, 95% CI 0.6-4.7) compared to control participants. Conclusion The draft occupational health guideline was not more effective than usual care. Therefore, the guideline in its current form cannot be recommended for implementation. This work is licensed under a Creative Commons Attribution 4.0 International License.

Objective: Previous research has focused mostly on abstainer and/or general drinker prototypes. The present studies examined an abstainer, moderate drinker and heavy drinker prototype in relation to drinking behaviour. Design: Two studies among young adults aged 18–25 (paper-and-pencil, cross-sectional, N = 140; online, prospective, N = 451) assessed prototype favourability and participants’ perceived similarity to the prototypes. Participants were also categorised into abstainers, moderate, and heavy drinkers. Results: Similarity and favourability had similar sequences in both studies: the moderate drinker and abstainer prototypes were evaluated most favourable and felt similar to; the heavy drinker prototype was rated the least favourable and felt similar to. Importantly, heavy drinking participants felt most similar to the moderate drinker prototype and rated the heavy drinker least desirable. The results suggest a need for research to include other prototypes, such as the moderate drinker, besides the abstainer and heavy drinker. Conclusion: The studies provide insights into the contribution of alternative prototypes (i.e. moderate drinker) into the relationship between prototype perceptions and drinking behaviour. The results suggest tailoring prototype-based interventions according to drinking behaviour. Importantly, realistic perceived similarity to the more favourable moderate drinker prototype may therefore need to be encouraged only after appropriate reductions in heavy drinkers’ alcohol consumption.

In deze ‘Proloog en epiloog’ vatten we eerst de hoofdlijnen van de zeven artikelen uit dit themanummer samen. Daarna proberen we een aantal conclusies te formuleren.

Item does not contain fulltext AIM: The purpose of this study was to assess the relation of perinatal risk factors with later development of specific language impairment (SLI). METHOD: In a case-control study, 179 children attending special needs schools for SLI were matched with non-affected children attending mainstream schools. Both groups consisted of 134 males and 45 females (age range 4-13y; mean age 9y, SD 2y 4mo). Data on duration of pregnancy, birthweight, delivery complications, birth characteristics, and Apgar scores were collected from the Preventive Child Health Care files of the Municipal Health Service. RESULTS: The gestational age of the children with SLI (mean 39.6wks, SD 0.1wk) and for the comparison group (mean 39.4wks, SD 0.1wk) and the birthweight of children with SLI (mean 3330.4g; SD 41.4g) and for the comparison group (mean 3388.1g; SD 39.8g) were not statistically different; neither were other pregnancy and birth characteristics, with the exception of the Apgar scores (effect of group for Apgar score after 1min p=0.045; after 5min p=0.001). The difference in Apgar scores was larger for females than for males (effect of group x sex for Apgar score after 1min p=0.049; after 5min p=0.043). INTERPRETATION: The relation between Apgar scores and SLI together with the influence of sex may be meaningful for predicting modelling and for understanding the causal pathway for SLI.

A new and promising area of research has recently emerged in the field of career development: career competencies. The present article provides a framework of career competencies that integrates several perspectives from the literature. The framework distinguishes between reflective, communicative, and behavioral career competencies. Six career competencies are discerned: reflection on motivation, reflection on qualities, networking, self-profiling, work exploration, and career control. Based on this framework, we developed the Career Competencies Questionnaire (CCQ) and preliminarily validated it in two samples of young employees between 16 and 30 years of age. The results provided initial support for the content, factorial, discriminant, and incremental validity of the CCQ. We hope to stimulate further discussion, research, and development of interventions in the area of career development. Implications for theory and practice are also discussed. © Curators of the University of Missouri 2012.

Contains fulltext : 128459.pdf (Publisher’s version ) (Closed access) Background: There are concerns about the Dutch maternity care system, characterized by a strict role division between primary and secondary care. The objective of this study was to describe trends in referrals and in perinatal outcomes among labors that started in primary midwife-led care. Methods: We performed a descriptive study of all 789,795 labors that started in primary midwife-led care during 2000 to 2008 in The Netherlands. Referrals to obstetrician-led care or pediatrician were classified as urgent or nonurgent. Perinatal safety was described by perinatal mortality (intrapartum or neonatal 0–7 days), admission to neonatal intensive care unit 0–7 days, and Apgar score < 7 at 5 minutes. Results: The proportion of referrals during labor or after birth declined from 52.6 to 42.6 percent for nulliparous women and from 83.2 to 76.7 percent for multiparous women. Especially nonurgent referrals during the first stage increased, for nulliparous women from 28.7 to 40.7 percent and for multiparous women from 10.5 to 16.5 percent. Referrals were less frequent in planned home births. Perinatal mortality was 0.9 per thousand births for nulliparous women, and 0.6 per thousand for multiparous women. A low Apgar score was registered in 8.6 per thousand births for nulliparous women, and 4.1 per thousand for multiparous women. Conclusions: There was a considerable rise in nonurgent referrals to obstetrician-led care in primary midwife-led care during labor. Perinatal safety did not improve significantly over time. The persisting rise in referrals challenges the sustainability of the current strict role division between primary and secondary maternity care in The Netherlands. 10 p.

Road networks are becoming more vulnerable to incidents as a result of the increasing level of congestion. An innovative empirical method is proposed and applied to analyze the delays caused by about 490,000 incidents that occurred in the Netherlands in the period 2007 to 2009. The method was applied to the motorway network of the Netherlands for which detailed loop detector data were available and for which incidents were registered. The method contributes to the existing literature by explaining how delays that are caused by incidents can be computed by selecting a reference day and by tracing the effects of incidents. The method considers upstream delays on the road where the incident occurred, spillback effects to other roads, and rubbernecking effects. The method provides insight for the locations that are most vulnerable to incidents and a basis for taking robustness measures and understanding the potential benefits of these measures.

Background Due to the aging of the population and subsequent higher pressure on public finances, there is a need for employees in many European countries to extend their working lives. One way in which this can be achieved is by employees refraining from retiring early. Factors predicting early retirement have been identified in quantitative research, but little is known on why and how these factors influence early retirement. The present qualitative study investigated which non-health related factors influence early retirement, and why and how these factors influence early retirement. Methods A qualitative study among 30 Dutch employees (60–64 years) who retired early, i.e. before the age of 65, was performed by means of face-to-face interviews. Participants were selected from the cohort Study on Transitions in Employment, Ability and Motivation (STREAM). Results For most employees, a combination of factors played a role in the transition from work to early retirement, and the specific factors involved differed between individuals. Participants reported various factors that pushed towards early retirement (‘push factors’), including organizational changes at work, conflicts at work, high work pressure, high physical job demands, and insufficient use of their skills and knowledge by others in the organization. Employees who reported such push factors towards early retirement often felt unable to find another job. Factors attracting towards early retirement (‘pull factors’) included the wish to do other things outside of work, enjoy life, have more flexibility, spend more time with a spouse or grandchildren, and care for others. In addition, the financial opportunity to retire early played an important role. Factors influenced early retirement via changes in the motivation, ability and opportunity to continue working or retire early. Conclusion To support the prolongation of working life, it seems important to improve the fit between the physical and psychosocial job characteristics on the one hand, and the abilities and wishes of the employee on the other hand. Alongside improvements in the work environment that enable and motivate employees to prolong their careers, a continuous dialogue between the employer and employee on the (future) person-job fit and tailored interventions might be helpful.

Purpose The goal of this qualitative study was to gain insight into how older employees remain productive at work in spite of health problems. Methods Twenty-six semi-structured telephone interviews were conducted with older employees, 46-63 years of age, who reported a poor health in the Study on Transitions in Employment, Ability, and Motivation. Demographic, health, and work information was gathered, followed by information on adjustments made in response to health problems. Inductive and deductive analyses were done independently by two researchers. Results Four pathways through which poor health could influence productivity were identified: (1) poor health did not influence productivity; (2) poor health created a temporary imbalance in demands and external and internal resources after which adjustments were made and productivity was maintained; (3) adjustments were made in response to an imbalance, but productivity remained reduced; and (4) no adjustments were made and productivity was reduced. Whether and which adjustments occurred was influenced by factors in various domains, such as: visibility of the problem (health), autonomy (work-related), support (relational), and the ability to ask for help (personal). Sustainable productivity was influenced by internal factors that enhanced or hindered the creation of a balance, and by whether appropriate adjustments were made. Conclusions The influence that health can have on productivity depends on the individuals' unique imbalance and personal disposition. Helpful a priori work place characteristics and personal well-being should be promoted so that a balance between demands and resources can be found in times of poor health. © 2012 Springer Science+Business Media New York.

Recent research highlights the superior influence of affect over cognition in health decision making. The present study examined the independent and combined effects of 2 message characteristics that are thought to tap into the cognition affect distinction: message format (rhetorical vs. testimonial) and argument type (instrumental vs. affective). In this 2 × 2 experiment, 81 college students were randomly assigned to 1 of 4 health messages discouraging binge drinking. The results indicated that messages containing affective arguments were judged more positively and perceived as more effective than were messages containing instrumental arguments. The results further revealed an interaction effect between message format and argument type. Testimonials were more persuasive when they contained affective arguments than when they contained instrumental arguments. Type of arguments did not influence the efficacy of rhetorical messages. Mediation analyses revealed that instrumental arguments reduce the efficacy of testimonials because they prevent individuals from being transported into the story, and increase psychological reactance. In conclusion, testimonial messages more effectively discourage binge drinking among college students when they contain affective, as opposed to instrumental, arguments. Health communication has traditionally focused on conveying reason-based messages.

Objectives Having condoms available has been shown to be an important predictor of condom use. We examined whether or not personal norm and goal enjoyment contribute to predicting having condoms available in the context of cognition specified by the theory of planned behaviour (TPB). Design Prospective survey study, with a baseline and follow-up measurement (at 3 months). Methods Data were gathered using an online survey. In total 282 adolescents (mean age = 15.6, 74% female adolescents) completed both questionnaires. At baseline, demographics, sexual experience, condom use, TPB variables, descriptive norm, personal norm, and enjoyment towards having condoms available were measured. At T2 (3 months later) having condoms available was measured. Direct and moderating effects of personal norm and goal enjoyment were examined by means of hierarchical linear regression analyses. Results Regression analyses yielded a direct effect of self-efficacy and personal norm on condom availability. In addition, moderation of the intention-behaviour relation by goal enjoyment added to the variance explained. The final model explained approximately 35% of the variance in condom availability. Conclusions Personal norm and goal enjoyment add to the predictive utility of a TPB model of having condoms available and may be useful intervention targets. Statement of contribution What is already known about this subject? Having condoms available is an important prerequisite for actual condom use. The theory of planned behaviour has successfully been applied to explain condom availability behaviour. The theory of planned behaviour has been criticized for not adequately taking into account affective motivation. What does this study add? Personal norm and goal enjoyment add to the predictive utility of the model. Personal norm explains condom availability directly, enjoyment increases intention enactment. Personal norm and goal enjoyment therefore are useful intervention targets. © 2012 The British Psychological Society.

Purpose – This paper aims to provide an empirical test of theories proposed in the literature stating that turnover and retirement (two kinds of work withdrawal) involve different employee decisions. It also aims to provide a more general theoretical framework understanding turnover and retirement intentions integrating insights from different theories. Design/methodology/approach – Research hypotheses are tested using the Study on Transitions in Employment, Ability and Motivation (STREAM). This dataset includes information from approximately 15,000 respondents in The Netherlands. Respondents between the age of 45 and 64 were the target group in order to model transitions in the labor market for older workers. This dataset provides a unique opportunity to test turnover and retirement intentions. Findings – First, the results show that personal characteristics such as income, age or health, add more to the explanation of retirement intentions compared to turnover intentions and that work characteristics provide a better explanation of the turnover intention compared to retirement intention. Second, by focusing more closely on retirement intentions, the results show that organizational motivators can increase older workers' labor market participation. Research limitations/implications – First, it is acknowledged that the study investigates intentions rather than actual behavior. Second, given that the data are cross sectional, we cannot make claims about causality. Finally, some of the measures can be improved in future studies. Originality/value – This paper aims at integrating different perspectives on two kinds of work withdrawal (turnover and retirement) into one theoretical model.

Transport congestion and the quality of the air in cities is a persistent concern for urban planners, and in this context Park and Ride (P. +. R) facilities have been proposed as an element of urban sustainability strategies in many cities in Europe. In 2008 a European Commission directive aimed at improving local air quality has been introduced, the Directive on air quality and cleaner air for Europe. It seems reasonable to suggest that increased regulatory measures at European level may have spurred interest in developing potential sustainable transport (policy) innovations such as P. +. R.We test this hypothesis through a survey among 25 cities in North-West Europe. We find that by 2010 perceived regulatory pressure for P. +. R has indeed increased compared to 2005, although it remains weak and is still not a significant motivation for P. +. R development. Furthermore, it was found that perceived community pressure has become a significant motivation, possibly because of increased public awareness and attention for global warming and sustainability. Overall we find that framing of P. +. R among urban planners as well as the cities' engagement levels have not evolved significantly from 2005 levels and thus that air quality concerns are an increasing but currently not strong motivation for local authorities in North-West Europe to develop P + R. © 2013 Elsevier Ltd.

A worksite lifestyle intervention aiming to improve lifestyle behaviors could be an effective tool to keep older workers vital, and thereby prolong their labor participation. Therefore, this study evaluates the effectiveness of such an intervention on vitality, work engagement, productivity and sick leave.In a randomized controlled trial design, 367 workers (control group: N=363) received a 6-month intervention, which included two weekly guided group sessions: one yoga and one workout, as well as one weekly session of aerobic exercising, without face-to-face instruction, and three individual coach visits aimed at changing workers' lifestyle behavior by goal setting, feedback, and problem-solving strategies. Furthermore, free fruit was provided at the guided sessions. Data on work-related vitality (UWES vitality scale), general vitality (RAND-36 vitality scale), work engagement (UWES), productivity (single item scoring 0-10), and sick leave (yes/no past 3 months) were collected using questionnaires at baseline (N=730), and at 6- (N=575) and 12-months (N=500) follow-up. Effects were analyzed according to the intention-to-treat principle with complete cases (N=500) and imputed data (N=730).There were no significant differences in vitality, work engagement, productivity, and sick leave between the intervention and control group workers after either 6- and 12-months follow-up. Yoga and workout subgroup analyses showed a 12-month favorable effect on work-related vitality [β=0.14, 95% confidence interval (95% CI) 0.04-0.28] and general vitality (β=2.9, 95% CI 0.02-5.9) among high yoga compliers. For high workout compliers, this positive trend was also seen, but it was not statistically significant.Implementation of worksite yoga facilities could be a useful strategy to promote vitality-related work outcomes, but only if high compliance can be maximized. Therefore, impeding factors for participation should be investigated in more detail in future research.

Purpose Cold-induced vasodilatation (CIVD) is a cyclic regulation of blood flow during prolonged cooling of protruding body parts. It is generally considered to be a protective mechanism against local cold injuries and cold intolerance after peripheral nerve injury. The aim of this study was to determine the role of the sympathetic system in initiating a CIVD response. Methods Eight rats were operated according to the spared nerve injury (SNI) model, eight underwent a complete sciatic lesion (CSL) and six underwent a sham operation. Prior to operation, 3, 6 and 9 weeks postoperatively, both hind limbs were cooled and the skin temperature was recorded to evaluate the presence of CIVD reactions. Cold intolerance was determined using the cold plate test and mechanical hypersensitivity measured using the Von Frey test. Results No significant difference in CIVD was found comparing the lateral operated hind limb for time (preoperatively and 3, 6 and 9 weeks postoperatively; p = 0.397) and for group (SNI, CSL and Sham; p = 0.695). SNI and CSL rats developed cold intolerance and mechanical hypersensitivity. Conclusion Our data show that the underlying mechanisms that initiate a CIVD reaction are not affected by damage to a peripheral nerve that includes the sympathetic fibres. We conclude that the sympathetic system does not play a major role in the initiation of CIVD in the hind limb of a rat. Clinical relevance No substantial changes in the CIVD reaction after peripheral nerve injury imply that the origin of cold intolerance after a traumatic nerve injury is initiated by local factors and has a more neurological cause. This is an important finding for future developing treatments for this common problem, as treatment focussing on vaso-regulation may not help diminish symptoms of cold-intolerant patients. © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

In het Terneuzen Onderzoek naar Preventie zijn overgewicht en cardiometabole risicofactoren op jongvolwassen leeftijd bestudeerd in relatie tot de veranderingen in body mass index (BMI) tussen de geboorte en 18-jarige leeftijd. Deze studie is gebaseerd op het Terneuzen Geboorte Cohort, waarbij prospectief verkregen gegevens zijn verkregen via de jeugdgezondheidszorg (JGZ) van GGD Zeeland. Bij de analyses is gebruik gemaakt van de brokenstickmethode en van lineaire en logistische regressieanalyses. Het leeftijdsinterval 2-6 jaar was het meest voorspellend voor overgewicht en de meeste cardiometabole uitkomsten op jongvolwassen leeftijd. Deze resultaten vragen speciale aandacht van de JGZ voor een stijgende BMI-standaarddeviatiescore (SDS) gedurende het leeftijdsinterval 2-6 jaar, ook als er nog geen sprake is van overgewicht. Hierbij kunnen predictie-instrumenten nuttig zijn. Het monitoren en stabiliseren van de BMI SDS gedurende dit leeftijdsinterval draagt waarschijnlijk niet alleen bij aan de preventie van overgewicht op jongvolwassen leeftijd, maar ook aan een goede cardiometabole gezondheidstoestand op latere leeftijd.