Need for recovery and different types of early labour force exit: a prospective cohort study among older workers.

PURPOSE: This study examines the relationship between need for recovery (NFR) and labour force exit (LFE) among older workers. Different types of LFE (early retirement, work disability and unemployment) are considered, and the role of potential confounding and modifying factors, including the availability of early LFE schemes, is examined. Also, associations between NFR and the intention and ability to prolong one's working life, which are known determinants of LFE, are assessed. METHODS: A subsample of older workers from the Maastricht Cohort Study was examined (n = 2312). The relationship between NFR and LFE was investigated by means of Cox regression analyses. Logistic regression analyses were performed to investigate cross-sectional associations between NFR and the intention and ability to prolong working life. RESULTS: Elevated NFR was associated with a higher risk of overall LFE during a 4-year follow-up period (HR 1.39, 95% CI 1.09-1.78), and specifically with a higher risk of leaving the labour force through early retirement and work disability. When early retirement schemes were available, strong and significant associations between NFR and LFE were observed (HR 2.79, 95% CI 1.29-6.02), whereas no significant associations were found when such schemes were unavailable. Older workers with a higher NFR also had earlier retirement intentions and lower self-assessed abilities (both physical and mental) to prolong their working life until the mandatory retirement age. CONCLUSIONS: Because this study shows that NFR is a precursor of LFE among older workers, monitoring NFR is important for timely interventions aimed at reducing NFR to facilitate extended labour participation.

Need for recovery across work careers: the impact of work, health and personal characteristics.

PURPOSE: Employees experiencing a high need for recovery (NFR) are at risk of long-term adverse effects in both their health and labour participation. So far, the determinants of NFR across age categories remain unknown. The aim of this study is to investigate the determinants of the NFR among employees in three age categories (30-44, 45-54 and 55-65 years), for men and women separately. METHODS: The study was based on data from the prospective Maastricht Cohort Study. Wave T3 (May 1999) was chosen as article baseline (n = 7,900). The follow-up period of 20 months included five follow-up waves. Cox regression analyses were performed to investigate the determinants, which originated from the work environment, health and lifestyle and personal domain of employees, of NFR across age categories over time. RESULTS: Cross-sectional results demonstrated substantial differences in mean scores and proportion of cases of NFR across age categories. Longitudinal analyses demonstrated risk factors in the multifactorial aetiology of NFR that played a role in all age categories, but also showed several age-specific risk factors, e.g. low decision latitude appeared to be a risk factor only in the oldest age category. CONCLUSIONS: Although selection effects may have occurred, this study shows that the risk factors for a high NFR were different among the age categories. To prevent and reduce a high NFR among employees, it is important to develop preventive measures that target age-specific risk factors.

An unusual cutaneous presentation of Hodgkin's disease.

Hodgkin's disease is a neoplasm of lymphoid tissue defined histopathologically by the presence of Reed-Sternberg cells in an appropriate cellular background. Hodgkin's disease extends only rarely into the skin. Sinus and fistula formation has been reported in very occasional cases. We now report a case of a 34-year-old woman presenting with a cutaneous lesion surrounding a discharging blind-ending sinus in the neck, subsequently diagnosed as Hodgkin's disease. To our knowledge this form of presentation of Hodgkin's disease has not been reported in the English literature before, and at the same time we would like to outline the difficulties in diagnosis encountered with these cutaneous lymphoid lesions.

Expression of glial antigens in mouse astrocytes: species differences and regulation in vitro.

Expression of developmentally regulated antigens was used to characterize glial cells in cultures from embryonic mouse cerebral cortex. Over 90% of the cells had a flat morphology, and about 50% of these flat cells also expressed the ganglioside GD3. Up to 40% of all the GD3 expressing cells also expressed A2B5 antigen. Flat cells expressing either glial fibrillary acidic protein (GFAP), or GD3 or both were present at all times in vitro. These three populations of flat cells could not be further distinguished on the basis of NG2 or fibronectin expression, or with respect to their responses to the mitogens FGF-2, PDGF, or EGF. The glial cultures also contain a small number (approximately 5%) of process bearing cells with the morphological and immunocytochemical characteristics of oligodendrocyte precursors. The expression of GD3 by flat cells changed with time in culture as the fraction of flat cells expressing only GD3 declined and the fraction of cells expressing GFAP (with or without GD3) increased. The data are consistent with those flat cells expressing only GD3 being astrocyte precursors. Furthermore, between 1 and 3 weeks in vitro GD3/GFAP cells lose GD3 while retaining GFAP. Cells expressing only GFAP could be induced to express GD3 and A2B5 by treatment with FGF-2. The widespread and regulated expression of GD3 and A2B5 by murine glia is different from the restricted pattern of expression previously reported for these antigens in rat brain cell cultures. These results demonstrate that expression of GD3 and A2B5 by murine astrocytes depends on both culture age and extracellular signals and that these gangliosides are not markers for cell lineage in the mouse.