Using the Work Behaviour Inventory and Work Environment Impact Scale to measure employment sustainability for people with severe mental illness in a vocational rehabilitation program.

OBJECTIVE: People with severe mental illness often have difficulty sustaining employment. Work Behaviour Inventory and Work Environment Impact Scale are vocational assessments used by occupational therapists to evaluate the facilitators and barriers of work performance and work environment respectively. These factors may have an impact on job tenure and can inform occupational therapy practice. METHODS: This study analysed retrospective data of 85 clients who attended a 3-month Employment Internship Program from August 2016 to August 2017. Scores from Work Behaviour Inventory and Work Environment Impact Scale were analysed for associations with job tenure. Repeated measures were used to determine significant changes in Work Behaviour Inventory composite scores across the 3 months. RESULTS: One-month Work Behaviour Inventory composite scores, three Work Behaviour Inventory domains (cooperativeness, work habits, work quality), and three Work Environment Impact Scale domains (time demands, supervisor interaction, architecture) were significantly associated with job tenure. Significant differences in mean job tenure were also found between participants of different internship status. However, these factors did not predict job tenure in regression analysis. There were significant improvements in Work behaviour Inventory composite scores from the first to third month. CONCLUSIONS: Work behaviours such as cooperativeness, work habits, and work quality as well as work characteristics such as time demands, supervisor interaction, and workplace architecture may play a role in influencing job tenure. Occupational therapists may consider such factors and provide more targeted interventions to effectively sustain employment.

Effect of adherence on daytime sleepiness, fatigue, depression and sleep quality in the obstructive sleep apnea/hypopnea syndrome patients undertaking nasal continuous positive airway pressure therapy.

OBJECTIVES: The aims of this study were to describe changes in day- and nighttime symptoms and the adherence to nasal continuous positive airway pressure (nCPAP) during the first 3-month nCPAP therapy among newly diagnosed patients with obstructive sleep apnea/hypopnea syndrome (OSAS) and to identify the effect of adherence on the changes in day- and nighttime symptoms during the first 3 months. METHODS: Newly diagnosed OSAS patients were consecutively recruited from March to August 2013. Baseline clinical information and measures of the Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), Zung's Self-Rating Depression Scale (SDS) and the Pittsburgh Sleep Quality Index (PSQI) at baseline and the end of 3rd, 6th, 9th and 12th week of therapy were collected. Twelve weeks' adherence was calculated as the average of each 3-week period. Mixed model was used to explore the effect of adherence to nCPAP therapy on ESS, FSS, SDS and PSQI in each 3-week phase. RESULTS: Seventy-six patients completed the 12-week follow-up. The mixed-effects models showed that under the control of therapy phase adherence in the range of <4 hours per night, using nCPAP could independently improve daytime sleepiness, in terms of ESS (coefficient, [95% confidence interval] unit; -4.49 [-5.62, -3.36]). Adherence at 4-6 hours per night could independently improve all variables of day- and nighttime symptoms included in this study, namely ESS -6.69 (-7.40, -5.99), FSS -6.02 (-7.14, -4.91), SDS -2.40 (-2.95, -1.85) and PSQI -0.20 (-0.52, -0.12). Further improvement in symptoms could be achieved at ≥6 hours per night using nCPAP, which was ESS -8.35 (-9.26, -7.44), FSS -10.30 (-11.78, -8.83), SDS -4.42 (-5.15, -3.68) and PSQI -0.40 (-0.82, -0.02). The interaction between adherence level and therapy phase was not significant in day- and nighttime symptoms. CONCLUSION: The effect of adherence on the above-mentioned symptoms is stable through the first 3 months. Under the control of therapy phase, the nCPAP therapy effectively improves day- and nighttime symptoms with ≥4 hours adherence, and the patients can achieve a further improvement with ≥6 hours adherence.

IL-27 alleviates the bleomycin-induced pulmonary fibrosis by regulating the Th17 cell differentiation.

BACKGROUND: Interleukin-27 (IL-27) is a multifunctional cytokine with both pro-inflammatory and immunoregulatory functions. At present, the role of IL-27 in pulmonary fibrosis remains unknown. METHODS: In this study, we observed the expression of IL-27/IL-27R in a mouse model of bleomycin (BLM)-induced pulmonary fibrosis. We verified the role of IL-27 using hematoxylin and eosin as well as Masson's staining methods and measuring the content of hydroxyproline as well as collagen I and III. We assessed the differentiation of T lymphocytes in the spleen and measured the concentration of cytokines in bronchoalveolar lavage fluid (BALF) and the expression level of relevant proteins in the JAK/STAT and TGF-ß/Smad signaling pathways in lung tissue. RESULTS: Increased IL-27 expression in BLM-induced pulmonary fibrosis was noted. IL-27 treatment may alleviate pulmonary fibrosis and increase the survival of mice. IL-27 inhibited the development of CD4(+) IL-17(+), CD4(+) IL-4(+) T, and CD4(+) Foxp3(+) cells and the secretion of IL-17, IL-4, IL-6, and TGF-ß. IL-27 induced the production of CD4(+) IL-10(+) and CD4(+) INF-γ(+) T cells. IL-27 decreased the levels of phosphorylated STAT1, STAT3, STAT5, Smad1, and Smad3 but increased the level of SOCS3. CONCLUSIONS: This study demonstrates that IL-27 potentially attenuates BLM-induced pulmonary fibrosis by regulating Th17 differentiation and cytokine secretion.