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BackgroundIn the present study the effect of a workplace-oriented intervention for persons on long-term sick leave for clinical burnout, aimed at facilitating return to work (RTW) by job-person match through patient-supervisor communication, was evaluated. We hypothesised that the intervention group would show a more successful RTW than a control group.MethodsIn a prospective controlled study, subjects were identified by the regional social insurance office 2-6 months after the first day on sick leave. The intervention group (n = 74) was compared to a control group who had declined participation, being matched by length of sick leave (n = 74). The RTW was followed up, using sick-listing register data, until 1.5 years after the time of intervention.ResultsThere was a linear increase of RTW in the intervention group during the 1.5-year follow-up period, and 89% of subjects had returned to work to some extent at the end of the follow-up period. The increase in RTW in the control group came to a halt after six months, and only 73% had returned to work to some extent at the end of the 1.5-year follow-up.ConclusionsWe conclude that the present study demonstrated an improvement of long-term RTW after a workplace-oriented intervention for patients on long-term sick leave due to burnout.Trial registrationCurrent Controlled Trials NCT01039168.

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Individuals with a dismissing-avoidant pattern of attachment are assumed to repress anxiety-related signals, a disposition hypothesized to interfere with facial mimicry and emotional contagion. Further, they are assumed to have one internal working model associated with anxiety, operating out of awareness at early, automatic stages of information processing, and another positive model operating at later, cognitively controlled stages of processing. The main aim of the present investigation was to compare facial mimicry in dismissing-avoidant and non-dismissing subjects at different levels of information processing. Pictures of happy and angry faces were exposed to 61 subjects at three different exposure times (17, 56, and 2,350 ms) in order to elicit facial muscle reactions, first at automatic levels and then at a more controlled levels. Corrugator activity ("frowning muscles") represented negative emotions and zygomaticus activity ("smiling muscles") positive emotions. The dismissing-avoidant subjects scored significantly lower on emotional empathy than the non-dismissing subjects. At the automatic level the dismissing-avoidant subjects showed "normal" corrugator responses (negative emotions) upon exposure to angry faces. At the cognitively controlled level of processing (2,350 ms) a significant interaction effect was shown between Faces x Muscles x Attachment pattern. The dismissing-avoidant subjects showed no corrugator response and an increased zygomaticus response ("smiling reaction") to the angry face, whereas the non-dismissing subjects reacted with a significant mimicking reaction. The dismissing-avoidant subjects' tendency to "smiling" in response to the angry face at the controlled level (2,350 ms) may be interpreted as a repression of their earlier, automatically evoked (56 ms) negative emotional reaction.

This study revealed musculoskeletal disorders in a majority of laparoscopists. The laparoscopic technique often requires static and tiring work positions, sometimes extreme, which can explain musculoskeletal disorders among general surgeons and gynecologist.

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