Discussions on policy and management initiatives to facilitate individuals throughout working careers take place without sufficient insight into how career paths are changing, how these changes are related to a modernization of life course biographies, and whether this leads to increased labour market transitions. This paper asks how new, flexible labour market patterns can best be analyzed using an empirical, quantitative approach. The data used are from the career module of the Panel Study of Belgian Households (PSBH). This module, completed by almost 4500 respondents consists of retrospective questions tracing lengthy and even entire working life histories. To establish any changes in career patterns over such extended periods of time, we compare two evolving methodologies: Optimal Matching Analysis (OMA) and Latent Class Regression Analysis (LCA). The analyses demonstrate that both methods show promising potential in discerning working life typologies and analyzing sequence trajectories. However, particularities of the methods demonstrate that not all research questions are suitable for each method. The OMA methodology is appropriate when the analysis concentrates on the labour market statuses and is well equipped to make clear and interpretable differentiations if there is relative stability in career paths during the period of observation but not if careers become less stable. Latent Class has the strength of adopting covariates in the clustering allowing for more historically connected types than the other methodology. The clustering is denser and the technique allows for more detailed model fitting controls than OMA. However, when incorporating covariates in a typology, the possibilities of using the typology in later, causal, analyses is somewhat reduced.
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I will examine the ways in which a hidden crisis can be exposed from a communications point of view. Therefore, this examination of the concept of crisis entrepreneurship is also relevant tot communication professionals. The article is in the form of proto-research and will shed light on the dilemmas experienced by crisis entrepreneurs and the interactional solutions they apply to cope with such dilemmas
Background: Patient education, home-based exercise therapy, and advice on returning to normal activities are established physiotherapeutic treatment options for patients with nonspecific low back pain (LBP). However, the effectiveness of physiotherapy interventions on health-related outcomes largely depends on patient self-management and adherence to exercise and physical activity recommendations. e-Exercise LBP is a recently developed stratified blended care intervention comprising a smartphone app integrated with face-to-face physiotherapy treatment. Following the promising effects of web-based applications on patients’ self-management skills and adherence to exercise and physical activity recommendations, it is hypothesized that e-Exercise LBP will improve patients’ physical functioning. Objective: This study aims to investigate the short-term (3 months) effectiveness of stratified blended physiotherapy (e-Exercise LBP) on physical functioning in comparison with face-to-face physiotherapy in patients with nonspecific LBP. Methods The study design was a multicenter cluster randomized controlled trial with intention-to-treat analysis. Patients with nonspecific LBP aged ≥18 years were asked to participate in the study. The patients were treated with either stratified blended physiotherapy or face-to-face physiotherapy. Both interventions were conducted according to the Dutch physiotherapy guidelines for nonspecific LBP. Blended physiotherapy was stratified according to the patients’ risk of developing persistent LBP using the Keele STarT Back Screening Tool. The primary outcome was physical functioning (Oswestry Disability Index, range 0-100). Secondary outcomes included pain intensity, fear-avoidance beliefs, and self-reported adherence. Measurements were taken at baseline and at the 3-month follow-up. Results: Both the stratified blended physiotherapy group (104/208, 50%) and the face-to-face physiotherapy group (104/208, 50%) had improved clinically relevant and statistically significant physical functioning; however, there was no statistically significant or clinically relevant between-group difference (mean difference −1.96, 95% CI −4.47 to 0.55). For the secondary outcomes, stratified blended physiotherapy showed statistically significant between-group differences in fear-avoidance beliefs and self-reported adherence. In patients with a high risk of developing persistent LBP (13/208, 6.3%), stratified blended physiotherapy showed statistically significant between-group differences in physical functioning (mean difference −16.39, 95% CI −27.98 to −4.79) and several secondary outcomes. Conclusions: The stratified blended physiotherapy intervention e-Exercise LBP is not more effective than face-to-face physiotherapy in patients with nonspecific LBP in improving physical functioning in the short term. For both stratified blended physiotherapy and face-to-face physiotherapy, within-group improvements were clinically relevant. To be able to decide whether e-Exercise LBP should be implemented in daily physiotherapy practice, future research should focus on the long-term cost-effectiveness and determine which patients benefit most from stratified blended physiotherapy.
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