The aim of the study was to evaluate the outcome 6 years after completing a multiprofessional 8-week rehabilitation programme regarding the following objectives: (1) return to work, (2) level of activity and (3) pain intensity. Of 149 patients attending a rehabilitation programme, 122 were followed up after 6 years, through a structured telephone interview, and their present work situation, level of activity, sleeping habits, their estimated pain intensity and consumption of analgesics were recorded. The questions presented were the same as they had answered before entering the programme. The return-to-work rate was compared to 79 patients in a control group. At the 6-year follow-up, compared to before entering the programme, 52% had returned to work (P
In a long-term series analysis the study had the aim of detecting how the used socioeconomic variables were related to the caries status development in the year group leaving the organised dental care. The study included caries epidemiological records of individuals at the Public Dental Service of Göteborg, leaving the organised dental care during 1986-2000. The City of Göteborg was divided into four districts. One incidence and one prevalence caries index was used, each presented in two subgroups: individuals with no caries record and patients with 20% of the highest index values. The socio-economical variable was individuals 18-64 years of age, seeking employment, as a percentage of the corresponding group of all inhabitants. The registered values were divided into three time sections of five years each. In the first, the socio-economic value curves were almost horizontal, in the second they showed a considerable increasing and in the third a declining tendency. The result curves for the caries-free patient groups and for patients with 20% of the highest caries index values compared to the three socioeconomical time sector results, showed an almost horizontal level concerning the incidence index values, and for the prevalence index values an inclined curve structure to the incidence curves. The result curves for the incidence index with respect to the caries-free patient group showed an almost horizontal structure, while the prevalence curves inclined towards the incidence curves during the study period. The linear structure of these curves deviated considerably from the result curves for the socio-economic time series. No correlation existed between the socio-economic data and the studied caries index values. The need for determining the time length concerning caries index observations was discussed. It must be of special interest to maintain the dental health of the studied patient group and the individuals' relation to regular dental care, when as adults they meet the dental care economy.
The Commission on the Future of Health Care in Canada asked whether Medicare is sustainable in its present form. Well, Medicare is not sustainable for at least six reasons. Given a long list of factors, such as Canada's changing dependency ratio, the phenomenon of diminishing returns from increased taxation, competing provincial expenditure needs, low labour and technological productivity in government-funded healthcare, the expectations held by baby boomers, and the evolving value sets of Canadians--Medicare will impoverish Canada within the next couple of decades if not seriously recast. As distasteful as parallel private-pay, private-choice healthcare may be to some policy makers and providers who grew up in the 1960s, the reality of the 2020s will dictate its necessity as a pragmatic solution to a systemic problem.
The aim of the present study was to investigate absence from work in Denmark due to occupational and non-occupational accidents.
Since the beginning of the last decade, political focus has been placed on the population's working capacity and the scope of absence due to illness. Absence from work is estimated at between 3% and 6% of working hours in the EU and costs are estimated at approximately 2.5% of GNP.
Victims of accidents treated at two emergency departments were interviewed regarding absence for the injured, the family and others. All answers were linked to the hospital information on the injury, so that it was possible to examine the relation between absence and injury type, and cause of the accident.
In total, 1,479 injured persons were interviewed. 36% of these reported absence from work by themselves or others. In mean, an injury caused 3.21 days of absence. Based on this the total absence due to injuries in Denmark was estimated to 1,822,000 workdays, corresponding to approximately 6% of the total absence from work due to all types of illness. Non-occupational injuries resulted in more absence than did occupational injuries.
Absence due to accidents contributed to a considerable part of the total absence from work, and non-occupational accidents caused more absence than did occupational accidents.
To investigate whether abstainers fare worse than non-abstainers on the labour market because a subset of the abstainers are ex-drinkers with alcohol problems.
In the cross-sectional population survey 'health 2000 in Finland' (n = 10 000) carried out in 2000, alcohol dependency was measured using the DSM-IV diagnostic criteria for alcohol dependence. The CIDI (composite international diagnostic interview) was applied to ascertain lifetime DSM-IV diagnoses for substance abuse diagnoses, including alcohol dependence. Individuals were considered to be employed if they were working part-time or full-time.
Male abstainers have on average 9.5 percentage points lower employment probability than non-abstainers. However, abstainers who have never drunk alcohol do not have lower employment probability than non-abstainers. Abstainers who are diagnosed as alcohol dependent have 27 percentage points lower employment probability than non-abstainers.
The underperformance of abstainers in a labour market sense is almost entirely due to the fact that some abstainers are ex-drinkers who in our study are identified as alcohol-dependent. Otherwise abstaining does not decrease employment probability.
The aim of this study was to assess the acceptability of human immunodeficiency virus (HIV) testing among migrants in Finland and the factors contributing to non-acceptance.
The Finnish Migrant Health and Wellbeing Study 'Maamu' was the first national population-based Health Interview and Examination Survey (HIS/HES) among migrants in Finland. A total of 386 Kurdish, Russian and Somali immigrants in Helsinki participated in the study.
Despite the participants' different sociodemographic backgrounds, a high rate of test acceptability (92%, 95% CI 90-95) was achieved. HIV test acceptance was associated with pretest counselling, ability to understand spoken Finnish or Swedish and employment status. No participants tested positive for HIV.
The results imply that a universal HIV testing strategy is well accepted in a low-HIV prevalence immigrant population and can be included in a general health examination in immigrant population-based surveys.
There is limited knowledge about what happens to people after long-term sick leave. The aim of this report was to conduct a prospective study of individuals who were on prolonged sick leave during a particular year, considering their activities and sources of income during subsequent years. To enable comparison of different time periods, we used three cohorts of individuals with different starting years.
Using data from national registers, three separate cohorts were constructed that included all people living in Sweden who were 20-64 years of age (>5 million) in the years 1995, 2000 and 2005, respectively. The individual members of the cohorts were classified into the following groups based on their main source of income and activity in 1995-2008: on long-term sick leave, employed, old-age pensioner, long-term unemployed, disability pensioner, on parental leave, social assistance recipient, student allowance recipient, deceased, or emigrated.
Most individuals on long-term (> 6 months) sick leave in 1995 were not employed 13 years later. Only 11% of the women and 13% of the men were primarily in employment after 13 years. Instead, a wide range of alternatives existed, for example, many had been granted disability pension, and about 10% of the women and 17% of the men had died during the follow-up period. A larger proportion of those with long-term sick leave were back in employment when 2005 was the starting year for the follow-up.
The low future employment rates for people on long-term sick leave may seem surprising. There are several possible explanations for the finding: The disorders these people may have, might have entailed longstanding difficulties on the labor market. Besides, long-term absence from work, no matter what its causes were, might have worsen the chances of further employment. The economic cycles may also have been of importance. The improving labor market during later years seems to have improved the chances for employment among those earlier on long-term sick leave.
Cites: J Epidemiol Community Health. 2009 Jan;63(1):50-519039005
Cites: Eur J Public Health. 2008 Jun;18(3):224-3118245150
To investigate longitudinally the effect of alcohol consumption and related acute alcohol-related dysfunction on employment status.
A total of 1143 men aged 25-55 years in regular paid employment and resident in the city of Izhevsk, Russia were interviewed between 2003-06 and then re-interviewed (2008-09) and their employment status ascertained.
Exposures of interest were baseline alcohol intake (yearly total volume of ethanol consumed and non-beverage alcohols) and alcohol-related dysfunction, measured by a latent variable defined in terms of frequency of alcohol-related dysfunctional behaviours and by one or more episodes of zapoi (a period of continuous drunkenness lasting 2 or more days). The outcome of interest was whether or not men were still in regular paid employment at follow-up. The inter-relationship between these variables was investigated using structural equation modelling.
Total volume of ethanol consumed had no substantive effect on future employment status; however, taking into account education and other socio-demographic factors, there was strong evidence that loss of regular paid employment at follow-up was influenced by non-beverage alcohol consumption [odds ratio?=?2.30 for non-beverage drinkers compared with beverage-only drinkers, 95% confidence interval (CI)?=?1.21, 4.40)], latent acute alcohol-related dysfunction (odds ratio?=?1.50 per standard deviation increase in dysfunction score, 95% CI?=?1.20, 1.88) and zapoi (odds ratio?=?3.08, 95% CI?=?1.71, 5.55). Acute alcohol-related dysfunction was an important mediator of the relationship between non-beverage alcohol use and employment status.
Acute alcohol-related dysfunction is an important factor in determining whether men remain in employment and an important mediator of the effects of alcohol intake.
Cites: Annu Rev Psychol. 2012;63:369-9621721936
Cites: Am J Epidemiol. 2012 Oct 1;176(7):608-1222956513
Employment is commonly upheld as an important outcome of addiction treatment. To explore this attribution, we assessed whether treatment enrollment predicts employment initiation among participants enrolled in a community-recruited Canadian cohort of people who inject drugs (IDU; N = 1,579). Survival analysis initially found no association between addiction treatment enrollment and employment initiation. However, when methadone maintenance therapy (MMT) was separated from other treatment modalities, non-MMT treatment positively predicted employment transitions, whereas MMT was negatively associated with employment initiation. Subanalyses examining transitions into temporary, informal, and under-the-table income generation echo these results. Findings suggest that individual factors impacting employment transitions may systematically apply to MMT clients and that, in this setting, the impact of treatment on employment outcomes is contingent on treatment type and design. Treatment-specific differences underscore the need to expand low-threshold MMT, explore MMT alternatives, and evaluate the impact of treatment design on the social and economic activity of IDU.
Cites: Can J Public Health. 2004 Mar-Apr;95(2):104-915074899
Cites: Arch Gen Psychiatry. 1973 Aug;29(2):237-414741515
The few available studies on early-onset depression and future earnings offer ambiguous findings, and potential sources of heterogeneity are poorly understood. We examined the differences in adult earnings of males and females with and without a history of depressive disorder in adolescence, with specific focuses on (1) future earnings in clinical subtypes of adolescent depression; (2) the growth and distribution of earnings over time within these subgroups and (3) the mediating role of subsequent depressive episodes occurring in early adulthood.
Data were drawn from the Uppsala Longitudinal Adolescent Depression Study, a community-based cohort study initiated in Uppsala, Sweden, in the early 1990s. Comprehensive diagnostic assessments were conducted at age 16-17 and in follow-up interviews 15 years later, while consecutive data on earnings for the years 1996 to 2016 (ages 20-40) were drawn from population-based registries. The current study included participants with a history of persistent depressive disorder (PDD) (n = 175), episodic major depressive disorder (MDD) (n = 82), subthreshold depression (n = 64) or no depression (n = 218) in adolescence. The association of adolescent depression with earnings in adulthood was analysed using generalised estimating equations. Estimates were adjusted for major child and adolescent psychiatric comorbidities and parental socioeconomic status. The indirect (mediated) effect of depression in early adulthood (ages 19-30) on earnings in mid-adulthood (31-40) was estimated in mediation analysis. The study followed the 'STrengthening the Reporting of OBservational studies in Epidemiology' (STROBE) guidelines.
Earnings across early to middle adulthood were lower for participants with a history of a PDD in adolescence than for their non-depressed peers, with an adjusted ratio of mean earnings of 0.85 (0.77-0.95) for females and 0.76 (0.60-0.95) for males. The differences were consistent over time, and more pronounced in the lower percentiles of the earnings distributions. The association was partially mediated by recurrent depression in early adulthood (48% in total; 61% for females, 29% for males). No reduction in earnings was observed among participants with episodic MDD in adolescence, while results for subthreshold depression were inconclusive.
Our findings suggest that future earnings of adolescents with depressive disorders are contingent on the duration and natural long-term course of early-onset depression, emphasising the need for timely and effective interventions to avoid loss of human capital.