Description: Introduction Increasing employment among older workers is a policy priority given the increase in life expectancy and the drop in labour force participation after the age of 50. Reasons for this drop are complex but include poor health, age discrimination, inadequate skills/qualifications and caring roles; however, limited evidence exists on how best to support this group back to work. The Work Programme is the UK Government's flagship policy to facilitate return to work (RTW) among those at risk of long-term unemployment. ‘Supporting Older People Into Employment’ (SOPIE) is a mixed-methods longitudinal study involving a collaboration between academics and a major Work Programme provider (Ingeus). The study will investigate the relationship between health, worklessness and the RTW process for the over 50s. Methods and analysis There are three main study components. Embedded fieldwork will document the data routinely collected by Ingeus and the key interventions/activities delivered. The quantitative study investigates approximately 14 000 individuals (aged 16–64 years, with 20% aged over 50) who entered the Ingeus Work Programme (referred to as ‘clients’) in a 16-month period in Scotland and were followed up for 2 years. Employment outcomes (including progression towards work) and how they differ by client characteristics (including health), intervention components received and external factors will be investigated. The qualitative component will explore the experiences of clients and Ingeus staff, to better understand the interactions between health and (un)employment, Work Programme delivery, and how employment services can be better tailored to the needs of the over 50s. Ethics and dissemination Ethical approval was received from the University of Glasgow College of Social Sciences Research Ethics Committee (application number 400140186). Results Results will be disseminated through journal articles, national and international conferences. Findings will inform current and future welfare-to-work and job retention initiatives to extend healthy working lives.

Description: Objective To summarise the available scientific evidence on the health effects of exposure to working beyond the limit number of hours established by the European Working Time Directive (EWTD) on physicians. Design A systematic literature search was conducted in PubMed and EMBASE. Study selection, quality appraisal and data extraction were carried out by independent pairs of researchers using pre-established criteria. Setting Physicians of any medical, surgical or community specialty, working in any possible setting (hospitals, primary healthcare, etc), as well as trainees, residents, junior house officers or postgraduate interns, were included. Participants The total number of participants was 14 338. Primary and secondary outcome measures Health effects classified under the International Classification of Diseases (ICD-10). Results Over 3000 citations and 110 full articles were reviewed. From these, 11 studies of high or intermediate quality carried out in North America, Europe and Japan met the inclusion criteria. Six studies included medical residents, junior doctors or house officers and the five others included medical specialists or consultants, medical, dental, and general practitioners and hospital physicians. Evidence of an association was found between percutaneous injuries and road traffic accidents with extended long working hours (LWH)/days or very LWH/weeks. The evidence was insufficient for mood disorders and general health. No studies on other health outcomes were identified. Conclusions LWH could increase the risk of percutaneous injuries and road traffic accidents, and possibly other incidents at work through the same pathway. While associations are clear, the existing evidence does not allow for an established causal or ‘dose–response’ relationship between LWH and incidents at work, or for a threshold number of extended hours above which there is a significantly higher risk and the hours physicians could work and remain safe and healthy. Policymakers should consider safety issues when working on relaxing EWTD for doctors.

Description: Objectives Sickness absence (SA) among healthcare workers is associated with occupational and non-occupational risk factors and impacts employee health, healthcare delivery and patient health. At the same time, healthcare is one of the employment sectors with the highest rates of work-related ill health in the UK. Musculoskeletal (MSK) and mental health (MH) issues are leading causes of SA, but there is a lack of research on how certain MSK/MH conditions impact on SA duration. The study aim is to determine differences in SA duration by MH and MSK disorders in healthcare employees. Methods Survival analyses were used to estimate SA duration due to MSK and MH problems over 6 years, and Cox’s proportional hazards models to determine the HRs of returning to work, using a bespoke Scottish health board database with over 53 000 SA events. SA duration and time to return-to-work (RTW) were estimated for employees by age, gender, job and health conditions. Results MSK and MH conditions accounted for 27% and 6% of all SA events and 23.7% and 19.5% of all days lost, respectively. Average SA duration was 43.5 days for MSK and 53.9 days for MH conditions. For MSK conditions, employees with low back or neck pain had the fastest RTW (median P 50 : 7 days), whereas employees absent due to depression took the longest (P 50 : 54 days). The most influential sociodemographic variables affecting RTW were age, gender and job category. Conclusions Using a unique and rich database, we found significant differences in SA duration by presenting condition in healthcare workers. MH conditions, and depression specifically, accounted for the most working days’ absence. Significant variations in duration were also observed for MSK conditions. Our findings can inform public health practitioners and healthcare managers of the most significant factors impacting MSK-related and MH-related SA to develop and implement tailored and targeted workplace interventions.

Description: Objectives The competencies required of occupational physicians (OPs) and occupational health nurses (OHNs) separately have been studied in various countries but little research has made direct comparisons between these two key occupational health (OH) professional groups. The aim of this study was to compare current competency priorities between UK OPs and OHNs. Methods A modified Delphi study conducted among professional organisations and networks of UK OPs and OHNs. This formed part of a larger Delphi, including international OPs. It was undertaken in two rounds (round 1—‘rating’, round 2—‘ranking’), using a questionnaire based on available OH competency guidance, the literature, expert panel reviews and conference discussions. Results In each round (rating/ranking), 57/49 and 48/54 responses were received for OPs and OHNs respectively. The principle domain (PD) competency ranks were very highly correlated (Spearman’s r=0.972) with the same PDs featuring in the top four and bottom three positions. OPs and OHNs ranked identically for the top two PDs (good clinical care and general principles of assessment and management of occupational hazards to health). Research methods was ranked lowest by both groups. Conclusions This study has observed a high level of agreement among UK OPs and OHNs on current competency priorities. The ‘clinically focused’ competency priorities likely reflect that although OH practice will broaden in response to various factors, traditional ‘core’ OH activities will still be required. These mutually identified priorities can serve to strengthen collaboration between these groups, develop joint education/training programmes and identify common professional development opportunities.

Description: Long-term trends in iodine and selenium retention in soil, and uptake by herbage, were investigated in archived samples from the Park Grass Experiment, initiated in 1856 at Rothamsted, UK. Soil (0–23 cm) and herbage samples from plots receiving various mineral fertilizers and organic manures, with and without lime, were analysed for selenium (Se) and iodine (I) to assess the effect of soil amendments, annual rainfall, crop yield and changes in soil chemistry from 1876 to 2008. Comparing soil from limed and unlimed control (unfertilized) plots, TMAH-extractable Se and I concentrations both diverged, with time, with greater retention in unlimed plots; differences in concentration amounted to 92 and 1660  μ g/kg for Se and I, respectively, after 105 yr. These differences were broadly consistent with estimated additions from rainfall and dry deposition. Offtake of both elements in herbage was negligible compared to soil concentrations and annual inputs (〈0.003% of total soil I and 〈0.006% of total soil Se). A positive correlation was observed between I and Se concentrations in herbage, suggesting some common factors controlling bioavailability. A growth-dilution effect for I and Se was suggested by the positive correlation between growing season rainfall (GSR) and herbage yield together with soil-to-plant transfer factors decreasing with yield. Phosphate and sulphate fertilizers reduced I and Se herbage concentrations, both through ion competition and increased herbage yield. Results suggest that in intensive agriculture with soil pH control, the I requirement of grazing animals is not likely to be met by herbage alone.

Description: Background Immigrants may be at a higher risk of adverse drug reactions, in that poor language proficiency reduces individuals understanding of drug label instructions. Additionally, there are reports of severe or fatal toxicity due to CYP2D6 ultrarapid hepatic metabolism of codeine to morphine among some ethnic groups, especially those from Eastern Africa. Methods Between 2002 and 2012 we conducted a population-based cohort study among residents of Ontario, Canada. We used administrative health databases that linked immigrants and Canadian-born individuals to both prescription medication use and emergency department visits and hospital admissions. The primary composite outcome was the risk of drug overdose or all-cause mortality within 30 days of codeine prescription, comparing patients from various world regions to Canadian-born individuals. A secondary analysis stratified by codeine dose and ability to speak English and/or French. Results There were 553 504 individuals exclusively prescribed codeine. Relative to an incidence rate of 57.1/100 000 person-days among Canadian-born codeine recipients, those who migrated from various world regions were at a lower risk of drug overdose or death. For example, Eastern Africans had an adjusted HR of 0.60 (95% CI 0.31 to 1.17) on controlling for potential confounders such as age, sex, income and physician visits. Patients unable to speak English or French who were prescribed codeine were at a lower risk of the composite outcome relative to those proficient in either language (adjusted HR 0.63, 95% CI 0.54 to 0.74). Interpretation Overdose and death following the institution of codeine therapy are not more commonly observed among immigrants from world regions with a high prevalence of ultrarapid CYP2D6 status relative to those born in Canada. Lower proficiency in English or French also did not appear to heighten the risk.

Description: Large grain angles in timber can have a negative effect on wood quality by reducing dimensional stability, strength properties and performance, and causing twisting and warping in sawn timber and poles. In this study, we assessed the impact of tree spacing and site exposure on grain angle, based on the measurements from 360 discs cut from Sitka spruce ( Picea sitchensis (Bong.) Carr.) trees from Northern Britain (Scotland and Northern England). The results show that planting on sites exposed to strong prevailing winds, planting at wider spacing or undertaking heavy thinning can significantly increase spiral grain angle. Using the mixed-effect model, we found that between-tree variation ranged from 3.6 to 33.3 per cent, variation due to disc position within the tree ranged from 5.7 to 47.8 per cent; and between-ring variations within discs ranged from 0 to 38.5 per cent. Residual variation ranged from 25.7 to 64.8 per cent. Grain angles are greater at the juvenile stage than at the mature stage of wood development. A non-linear model, developed to predict grain angle, explained only 16 per cent of total variation in grain angle, despite the inclusion of several stand covariates into the model. Although the mixed-effect model improved the root mean square error (RMSE) by 26 per cent, and the coefficient of determination ( R 2 ) rose to 53 per cent, its usage requires that a sample of grain angle measurements be made on the particular site for model calibration. The silvicultural response to reduced grain angle would be to plant at closer spacing and delay thinning or thin lightly, or to avoid planting Sitka spruce on very exposed sites. Given that grain angle is highly heritable, a further option is to reduce grain angle through selective breeding.

Description: Objectives The competencies required of occupational physicians (OPs) have been the subject of peer-reviewed research in Europe and individual countries around the world. In the European Union (EU), there has been development of guidance on training and common competencies, but little research has extended beyond this. The aim of this study was to obtain consensus on and identify the common core competencies required of OPs around the world. Methods A modified Delphi study was carried out among representative organisations and networks of OPs in a range of countries around the world. It was conducted in 2 rounds using a questionnaire based on the specialist training syllabus of a number of countries, expert panel reviews and conference discussions. Results Responses were received from 51 countries around the world, with the majority from Europe (60%; 59%) and North and South America (24%; 32%) in rounds 1 and 2, respectively. General principles of assessment and management of occupational hazards to health and good clinical care were jointly considered most important in ranking when compared with the other topic areas. Assessment of disability and fitness for work, communication skills and legal and ethical issues completed the top five. In both rounds, research methods and teaching and educational supervision were considered least important. Conclusions This study has established the current priorities among OPs across 51 countries of the common competencies required for occupational health (OH) practice. These findings can serve as a platform for the development of common core competencies/qualifications within specific geographical regions or internationally. This is particularly pertinent with globalisation of commerce and free movement within the EU.

Description: Because wood density is an important indicator of the end-use mechanical properties of sawn timber, detailed knowledge of its variation is important for optimizing value in processing. The aim of this study was to develop a model for predicting wood density variation in plantation-grown Scots pine ( Pinus sylvestris L.) using position in the stem and radial growth increment as independent variables. Seventy trees, ranging in age at 1.3 m from 9 to 99 years, were sampled from 12 even-aged Scots pine stands in Scotland, UK. Pith-to-bark density profiles were obtained on 193 radial samples using scanning X-ray densitometry. We developed a mixed-effects model of average ring density (expressed as basic specific gravity) based on an exponential function of cambial age, height along the stem and annual ring width. Basic specific gravity ranged from 0.274 to 0.697, with a mean of 0.423, and increased rapidly from the pith until approximately rings 20–30, before stabilizing. In addition, there was a weak negative relationship between basic specific gravity and annual ring width, and for a given cambial age, basic specific gravity decreased with sampling height. The fixed effects of the final model were able to explain ~57 per cent of the within-stem variation in wood density (78 per cent if random effects were included). The final model is intended for integration into a growth, yield and wood quality simulation system.