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If people with episodic mental-health conditions lose their job due to an episode of their mental illness, they often experience personal negative consequences. Therefore, reintegration after sick leave is critical to avoid unfavorable courses of disease, longer inability to work, long payment of sickness benefits, and unemployment. Existing return-to-work (RTW) programs have mainly focused on “common mental disorders” and often used very elaborate and costly interventions without yielding convincing effects. It was the aim of the RETURN study to evaluate an easy-to-implement RTW intervention specifically addressing persons with mental illnesses being so severe that they require inpatient treatment.
The RETURN study was a multi-center, cluster-randomized controlled trial in acute psychiatric wards addressing inpatients suffering from a psychiatric disorder. In intervention wards, case managers (RTW experts) were introduced who supported patients in their RTW process, while in control wards treatment, as usual, was continued.
A total of 268 patients were recruited for the trial. Patients in the intervention group had more often returned to their workplace at 6 and 12 months, which was also mirrored in more days at work. These group differences were statistically significant at 6 months. However, for the main outcome (days at work at 12 months), differences were no longer statistically significant (p = 0.14). Intervention patients returned to their workplace earlier than patients in the control group (p = 0.040).
The RETURN intervention has shown the potential of case-management interventions when addressing RTW. Further analyses, especially the qualitative ones, may help to better understand limitations and potential areas for improvement.
This discussion paper by a group of scholars across the fields of health, economics and labour relations argues that COVID-19 is an unprecedented humanitarian crisis from which there can be no return to the ‘old normal’. The pandemic’s disastrous worldwide health impacts have been exacerbated by, and have compounded, the unsustainability of economic globalisation based on the neoliberal dismantling of state capabilities in favour of markets. Flow-on economic impacts have simultaneously created major supply and demand disruptions, and highlighted the growing within-country inequalities and precarity generated by neoliberal regimes of labour market regulation. Taking an Australian and international perspective, we examine these economic and labour market impacts, paying particular attention to differential impacts on First Nations people, developing countries, women, immigrants and young people. Evaluating policy responses in a political climate of national and international leadership very different from those in which major twentieth century crises were addressed, we argue the need for a national and international conversation to develop a new pathway out of crisis.
Despite the importance of secondary dormancy for plant life cycle timing and survival, there is insufficient knowledge about the (epigenetic) regulation of this trait at the molecular level. Our aim was to determine the role of (epi)genetic processes in the regulation of secondary seed dormancy using natural genotypes of the widely distributed Capsella bursa-pastoris. Seeds of nine ecotypes were exposed to control conditions or histone deacetylase inhibitors [trichostatin A (TSA), valproic acid] during imbibition to study the effects of hyper-acetylation on secondary seed dormancy induction and germination. Valproic acid increased secondary dormancy and both compounds caused a delay of t50 for germination (radicle emergence) but not of t50 for testa rupture, demonstrating that they reduced speed of germination. Transcriptome analysis of one accession exposed to valproic acid versus water showed mixed regulation of ABA, negative regulation of GAs, BRs and auxins, as well as up-regulation of SNL genes, which might explain the observed delay in germination and increase in secondary dormancy. In addition, two accessions differing in secondary dormancy depth (deep vs non-deep) were studied using RNA-seq to reveal the potential regulatory processes underlying this trait. Phytohormone synthesis or signalling was generally up-regulated for ABA (e.g. NCED6, NCED2, ABCG40, ABI3) and down-regulated for GAs (GA20ox1, GA20ox2, bHLH93), ethylene (ACO1, ERF4-LIKE, ERF105, ERF109-LIKE), BRs (BIA1, CYP708A2-LIKE, probable WRKY46, BAK1, BEN1, BES1, BRI1) and auxin (GH3.3, GH3.6, ABCB19, TGG4, AUX1, PIN6, WAT1). Epigenetic candidates for variation in secondary dormancy depth include SNL genes, histone deacetylases and associated genes (HDA14, HDA6-LIKE, HDA-LIKE, ING2, JMJ30), as well as sequences linked to histone acetyltransferases (bZIP11, ARID1A-LIKE), or to gene silencing through histone methylation (SUVH7, SUVH9, CLF). Together, these results show that phytohormones and epigenetic regulation play an important role in controlling differences in secondary dormancy depth between accessions.
Bacterial survival on, and interactions with, human skin may explain the epidemiological success of MRSA strains. We evaluated the bacterial counts for 27 epidemic and 31 sporadic MRSA strains on 3D epidermal models based on N/TERT cells (NEMs) after 1, 2 and 8 days. In addition, the expression of antimicrobial peptides (hBD-2, RNase 7), inflammatory cytokines (IL-1β, IL-6) and chemokine IL-8 by NEMs was assessed using immunoassays and the expression of 43 S. aureus virulence factors was determined by a multiplex competitive Luminex assay. To explore donor variation, bacterial counts for five epidemic and seven sporadic MRSA strains were determined on 3D primary keratinocyte models (LEMs) from three human donors. Bacterial survival was comparable on NEMs between the two groups, but on LEMs, sporadic strains showed significantly lower survival numbers compared to epidemic strains. Both groups triggered the expression of immune factors. Upon interaction with NEMs, only the epidemic MRSA strains expressed pore-forming toxins, including alpha-hemolysin (Hla), gamma-hemolysin (HlgB), Panton-Valentine leucocidin (LukS) and LukED. Together, these data indicate that the outcome of the interaction between MRSA and human skin mimics, depends on the unique combination of bacterial strain and host factors.
Animals are highly vulnerable in war. However, they are only incidentally protected by international humanitarian law, namely as mere objects (or property), as specially protected objects, as part of the environment, as endangered species, as war weapons, or as means of medical transport, search and rescue. They are neither treated as ‘subjects of protection’ nor are they granted any rights. The research has revealed that the few international humanitarian law provisions that could potentially apply to animals have rarely been enforced or effectively implemented by international courts and tribunals. In light of these general observations, the concluding chapter summarises the key findings of the study. It highlights the main legal challenges that an agenda of protection of animals during warfare faces. It then formulates recommendations for addressing these challenges with a view to strengthening and developing the legal framework.
After recalling the context and purposes of the research, the chapter introduces the main challenges raised by the legal protection of animals during warfare: the silence of international humanitarian law on the issue, the difficulty in identifying which animals should be safeguarded, the inaptitude of international humanitarian law to adequately protect animals, and the ambivalent nature of the violence inflicted upon animals in wartime. The chapter then introduces the principal paradigms on which the legal protection of animals is grounded: animal species conservation regimes, animal welfare norms and animal rights. It subsequently emphasises three specific difficulties posed for animals by the current state of international law: the animal welfare gap in international law, the tension between species conservation and concern for individual animal welfare, and the fact that notably international trade and financial law has stymied animal welfare and protection efforts. The chapter then explores options to face these challenges while making best use of the legal strategies available within the existing normative framework. Potential new directions for developing international law on armed conflict are finally identified.
Animals are the unknown victims of armed conflicts. Wildlife populations usually decline during warfare, with disastrous repercussions on the food chain, on fragile ecosystems and precarious habitats. Belligerents take advantage of the chaos of war for poaching and trafficking of animal products. Livestock, companion, and zoo animals, highly dependent on human care, are direct victims of hostilities. The book is the first legal analysis of these issues. It maps the framework of international humanitarian law, examining which and how the concepts, principles, and rationales can be applied and adapted for a better protection of animals. The contributions inter alia discuss precautions for animal civilians, problems of animal combatants and prisoners, a specific status for veterinarian personnel, the recognition of biodiversity hotspots as specially protected zones, and the potential of enforcement mechanisms. The concluding chapter draws together novel interpretations and reform proposals.