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Background: Women with breast cancer face many barriers to return to work (RTW) after their cancer. The main objective of the FASTRACS-RCT is to evaluate the impact of the FASTRACS (Facilitate and Sustain Return to Work after Breast Cancer) intervention on the sustainable RTW of breast cancer patients, 12 months after the end of active treatment. Methods: FASTRACS-RCT is a prospective, national, multicentre, randomized, controlled and open-label study. A total of 420 patients with early breast cancer scheduled for surgery and (neo)adjuvant chemotherapy, will be randomly assigned (1:1 ratio) to: (i) the intervention arm comprising four steps over 6 months : Handing over the intervention tools; transitional medical consultation with the general practitioner (GP); pre-RTW visit with the company's occupational physician (OP); catch-up visit with a hospital-based RTW expert (if sick leave > 10 months) (ii) the control arm to receive usual care. The design of the FASTRACS intervention was informed by intervention mapping for complex interventions in health promotion planning, and involved patients and representatives of relevant stakeholders. Specific tools were developed to bridge the gap between the hospital, the GP, the OP and the workplace: a toolkit for breast cancer patients comprising a theory-based guide; specific checklists for the GP and the OP, respectively; and a theory-based guide for workplace actors (employer, manager, colleagues). The primary endpoint will associate sustainable RTW (full-time or part-time work at 50% or more of working time, for at least 28 consecutive days) and days off work. It will be assessed at 4, 8 and 12 months after the end of active oncological treatment. Secondary endpoints will include quality of life, anxiety, depression, RTW self-efficacy, physical activity, social support, job accommodations, work productivity, job status, and the usefulness and acceptability of the intervention's tools. Discussion: FASTRACS-RCT will be supplemented by a realist evaluation approach aimed at understanding the influence of context in activating the intervention's mechanisms and effects. If the expected impact of the intervention is confirmed, the intervention will be adapted and scaled-up for other cancers and chronic diseases to better integrate healthcare and work disability prevention. Trial registration: NCT04846972 ; April 15, 2021. [ABSTRACT FROM AUTHOR]

Background: Most studies about accidents and about PTSD, respectively, have been conducted either on blue-collar workers, or on the entire working population. There are very few such studies on white-collar workers. Aim: To examine diagnosis-specific sickness absence (SA) and disability pension (DP) after a work accident or PTSD, respectively, among white-collar workers in the private retail and wholesale industry. Methods: A prospective population-based cohort study of all 192,077 such workers aged 18–67 (44% women) in Sweden in 2012, using linked microdata from nationwide registers. We identified individuals who had secondary healthcare due to work-related accidents (n = 1114; 31% women) or to PTSD (n = 216; 79% women) in 2012–2016. Their average number of net days of diagnosis-specific SA (in SA spells > 14 days) and DP were calculated for 365 days before and 365 days after the healthcare visit. Results: 35% of the women and 24% of the men had at least one new SA spell during the 365 days after healthcare due to work accidents. Among women, the average number of SA/DP days increased from 14 in the year before the visit to 31 days the year after; among men from 9 to 21 days. SA days due to fractures and other injuries increased most, while SA days due to mental diagnoses increased somewhat. 73% of women and 64% of men who had healthcare due to PTSD had at least one new SA spell in the next year. Women increased from 121 to 157 SA/DP days and men from 112 to 174. SA due to stress-related disorders and other mental diagnoses increased the most, while DP due to stress-related diagnoses and SA due to musculoskeletal diagnoses increased slightly. Conclusions: About a quarter of those who had secondary healthcare due to work accidents, and the majority of those with such healthcare due PTSD, had new SA in the following year. SA due to injury and mental diagnoses, respectively, increased most, however, SA/DP due to other diagnoses also increased slightly. More knowledge is needed on factors associated with having or not having SA/DP in different diagnoses after work accidents and among people with PTSD. [ABSTRACT FROM AUTHOR]

This document provides a summary of various studies and cases related to dermatological issues and occupational skin diseases. The studies cover topics such as contact allergies among hairdressers, chronic hand eczema, tattoo ink hazards, and the autoimmune nature of atopic dermatitis. The cases discuss allergies to specific substances found in cosmetic products and the importance of patch testing. The document also includes a study on the presence of hidden formaldehyde in cosmetics and the potential risks for individuals with formaldehyde allergy. Overall, these summaries provide valuable information for library patrons conducting research on dermatological conditions and occupational skin diseases. [Extracted from the article]

This document is a collection of summaries of various research articles related to dermatology. The first article focuses on occupational contact dermatitis (OCD) among professional cleaners, highlighting the prevalence, risk factors, and prevention methods. The second article discusses allergic contact dermatitis (ACD) caused by topical antibacterials/antiseptics, examining the demographic and clinical characteristics of patients in Turkey. The third article explores changes in sensitization patterns in chronic actinic dermatitis (CAD) and the frequency of positive patch testing in CAD patients. The fourth article presents a systematic review and meta-analysis of hand eczema (HE) in healthcare workers, providing an overview of the prevalence and incidence of HE, as well as the severity of the condition. The final article focuses on a genome-wide association study of HE, identifying a genetic locus associated with the condition and exploring the genetic overlap between HE and atopic dermatitis (AD). This collection of abstracts includes studies on various topics related to dermatology and skin sensitization. [Extracted from the article]

Exercise interventions show promise in the treatment of anxiety disorders, but effects on health-related quality of life (HR-QoL), work ability, and sick leave are little studied. We investigated these outcomes in a 12-week randomized controlled trial with a 1-year follow-up. Patients aged 18–65 (n = 222) with anxiety disorders from primary care centers in Gothenburg were randomized to a control group or one of two 12-week exercise intervention groups (low-intensity, [LI] and moderate/high-intensity, [HI]); 148 were evaluated at 12-weeks and 113 completed the 1-year follow-up. The EuroQol 5D (EQ5D; index and the visual analogue scale [VAS]), work ability score (WAS), presenteeism, and self-reported sick leave were assessed at baseline, 12 weeks, and 1 year. Improvements were defined by binary cut-offs for each scale. Binary logistic regression with odds ratios (OR) and 95 % confidence intervals (CI) were reported. There were improved scores for EQ5D and WAS in the HI group compared to controls after 12 weeks (EQ5D index: 4.74 [1.91–11.7], EQ5D-VAS 4.00, [1.65–9.72], WAS 3.41 [1.24–7.37]) and 1 year (EQ5D index: 3.05 [1.05–8.81], EQ5D-VAS 3.20 [1.16–8.84], WAS 5.50 [1.85–16.3]). Post-hoc analysis showed higher ORs in participants on antidepressants (n = 75) (12-week EQ5D index: OR 9.95 [2.85–34.8]) and significant improvements in EQ5D scores for both intervention groups after 1 year. There were no between-group differences for presenteeism or sick leave. Discontinuation was high, mostly early after randomization (n = 74), as is common for anxiety interventions. HI Exercise improves HR-QoL and work ability in anxiety patients, especially when combined with antidepressants. • High-intensity exercise improves health-related quality of life and work ability with long-lasting effects after 1 year. • There were trends suggesting a dose-response effect of exercise on health-related quality of life and work ability. • Exercise effects are greater in patients with antidepressant medication. • There were no between-group differences for presenteeism or sick leave. [ABSTRACT FROM AUTHOR]

Objectives: To investigate whether intensified cooperation between general practitioner (GP), care manager and rehabilitation coordinator (RC) for patients sick-listed for stress-related mental disorder, combined with a person-centred dialogue meeting with employer, could reduce sick-leave days compared with usual care manager contact. Design: Pragmatic cluster-randomised controlled trial, randomisation at primary care centre (PCC) level. Setting: PCCs in Region Västra Götaland, Sweden, with care manager organisation. Participants: Of 30 invited PCCs, 28 (93%) accepted the invitation and recruited 258 patients newly sick-listed due to stress-related mental disorder (n = 142 intervention, n = 116 control PCCs). Intervention: Cooperation between GP, care manager and rehabilitation coordinator from start of illness notification plus a person-centred dialogue meeting between patient and employer within 3 months. Regular contact with care manager was continued at the control PCCs. Main outcome measures: 12-months net and gross number of sick-leave days. Secondary outcomes: Symptoms of stress, depression, anxiety; work ability and health related quality of life (EQ-5D) over 12 months. Results: There were no significant differences between intervention and control groups after 12 months: days on sick-leave (12-months net sick-leave days, intervention, mean = 110.7 days (95% confidence interval (CI) 82.6 − 138.8); control, mean = 99.1 days (95% CI 73.9 − 124.3)), stress, depression, or anxiety symptoms, work ability or EQ-5D. There were no significant differences between intervention and control groups concerning proportion on sick-leave after 3, 6, 12 months. At 3 months 64.8% were on sick-leave in intervention group vs 54.3% in control group; 6 months 38% vs 32.8%, and12 months 16.9% vs 15.5%. Conclusion: Increased cooperation at the PCC between GP, care manager and RC for stress-related mental disorder coupled with an early workplace contact in the form of a person-centred dialogue meeting does not reduce days of sick-leave or speed up rehabilitation. Trial registration: ClinicalTrials.gov Identifier: NCT03250026 CO-WORK-CARE First Posted: August 15, 2017. Recruitment of PCCs: September 2017. Inclusion of patients from December 2017 [ABSTRACT FROM AUTHOR]

Rationale: To ensure optimal patient care based on evidence, it is crucial to understand how to implement new methods in practice. However, intervention studies often overlook parts of the implementation process. A comprehensive process evaluation is necessary to understand why interventions succeed or fail in specific contexts and to integrate new knowledge into daily practice. This evaluation examines the full implementation of the Co‐Work‐Care model in Swedish primary healthcare to identify strengths and weaknesses. Aim: This study aimed to evaluate the process of implementing the CO‐WORK‐CARE model that focuses on close collaboration and the use of a person‐centred dialogue meeting in primary healthcare for patients on sick leave due to common mental disorders. Method: The CO‐WORK‐CARE model emphasises collaboration among the GP, rehabilitation coordinator and care manager, along with person‐centred dialogue meetings involving employers. Following UK Medical Research Council guidelines, we conducted a process evaluation. Data from previous studies were reanalysed. We also analysed field notes and meeting notes using Malterud's qualitative method. Results: The evaluation identified key facilitators for model implementation, including regular visits by facilitators and guidance from the research physician. Peer support meetings also bolstered implementation. However, challenges emerged due to conflicts with existing structures and limitations in person‐centred dialogue meetings. Conclusion: Adapting the CO‐WORK‐CARE model to Swedish primary care is feasible and beneficial, with collaboration among the care manager, rehabilitation coordinator and GP and person‐centred dialogue meetings. Thorough preparations, ongoing facilitator and peer support and integrated information enhanced implementation efficiency, despite challenges posed by existing structures. [ABSTRACT FROM AUTHOR]

Purpose: Return-to-work coordinators (RTWCs) give people on sick leave individualized support and coordinate between different stakeholders, including physicians. The aim of this study was to explore physicians' experience of RTWCs and investigate factors that influence how much physicians collaborate with RTWCs, or refer patients to them, in primary, orthopaedic, and psychiatric care clinics. Materials and methods: Of the 1229 physicians responding to a questionnaire, 629 physicians who had access to a RTWC in their clinic answered to questions about collaborating with RTWCs. Results: Among physicians who had access to a RTWC, 29.0% collaborated with a RTWC at least once a week. Physicians with a more favourable experience of RTWCs reported more frequent collaboration (adjusted OR 2.92, 95% CI 2.06–4.15). Physicians also collaborated more often with RTWCs if they reported to often deal with problematic sick-leave cases, patients with multiple diagnoses affecting work ability, and conflicts with patients over sickness certification. Conclusions: Physicians who had more problematic sick-leave cases to handle and a favourable experience of RTWCs, also reported collaborating more often with RTWCs. The results indicate that RTWCs' facilitation of contacts with RTW stakeholders and improvements in the sickness certification process may be of importance for physicians. IMPLICATIONS FOR REHABILITATION: This study of physicians' experience of collaborating with return-to-work coordinators (RTWCs) observes that physicians reported more collaboration with or referrals to coordinators if they had a favourable experience of coordinators. The results indicate that physicians report more collaboration with or referrals to RTWCs if they had more problematic sick-leave cases to handle in the clinic. These findings imply that it might be possible to increase the collaboration between physicians and RTWCs in clinical settings by managing factors of importance. [ABSTRACT FROM AUTHOR]

Over 30 million U.S. working adults use tobacco, and tobacco use varies by occupation. Limited information is available on employment characteristics and tobacco use prevalence. The purpose of this study was to describe the prevalence of current tobacco use by employment characteristics and occupation group among U.S. working adults. This cross-sectional study used 2021 National Health Interview Survey data for currently working adults (n=16,461) analyzed in 2023. Multivariable logistic regression was used to estimate adjusted odds of tobacco use by employment characteristics and occupation group. In 2021, 20.0% of working adults used tobacco. Any tobacco use was significantly lower among workers who were offered workplace health insurance (AOR=0.86, 95% CI=0.77–0.97), had paid sick leave (AOR=0.81, 95% CI=0.73–0.91), and government versus private employment (AOR=0.61, 95% CI=0.52–0.70). Any tobacco use was significantly higher among workers who usually worked ≥35 hours per week versus did not usually work ≥35 hours per week (AOR=1.21, 95% CI=1.06–1.39), worked a rotating or "some other" shift versus daytime shift (AOR=1.19, 95% CI=1.02–1.38), experienced schedule instability (AOR=1.17, 95% CI=1.03–1.31), and worked while physically ill in the past 3 months (AOR=1.25, 95% CI=1.11–1.41). Tobacco use by employment characteristics also varied by occupation group. Current tobacco use varied according to employment characteristics and occupation group. Findings from this study could inform workplace tobacco cessation interventions and policies (e.g., access to paid sick leave or insurance coverage) to better support tobacco cessation and overall worker health. [ABSTRACT FROM AUTHOR]

Purpose: For clients to understand social insurance decisions and processes, information from authorities needs to be comprehensible, and clients need sufficient individual abilities. These dimensions are captured by the concept social insurance literacy, which has been operationalized into a measure, the Social Insurance Literacy Questionnaire (SILQ). The aim of this study was to describe the development of the SILQ and evaluate its psychometric properties using Rasch measurement theory. Methods: The development of the SILQ included a Delphi study and cognitive interviews. A preliminary version, divided on four scales corresponding to the domains of the concept (obtaining information, understanding information, acting on information, and system comprehensibility) was psychometrically evaluated according to Rasch measurement theory, in a survey to a stratified random sample of people on sick leave (n = 1151) sent out in the fall of 2020. Results: Overall, the items in the final version of the SILQ demonstrated good fit to the Rasch model, and the response scale worked as intended. Unidimensionality was supported for all scales, but minor problems with local dependency was detected for three items. The person separation was 0.80 for the Obtain scale, 0.82 for the Understand scale, 0.68 for the Act scale, and 0.81 for the System scale. Corresponding ordinal alpha values were 0.91, 0.91, 0.86, and 0.91, respectively. Conclusion: This study is a first step toward exploring literacy in the social insurance field. The SILQ covers individual abilities and systems' comprehensibility, and the results show that it has acceptable psychometric properties. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to explore the perspectives of self-employed workers with a physically demanding job on work participation. Methods: We interviewed self-employed workers with a physically demanding job, using semi-structured interviews, which were audio recorded. The main topic addressed was the workers' health in relation with their work participation, work demands, and preventive measures. The interviews were transcribed verbatim and coded by three team members of the research team in several steps. We used the consolidated criteria for reporting qualitative research (COREQ) checklist to report our findings. Results: We interviewed 18 self-employed workers: 83% male, 49 years (SD 7), self-employed for 18 years (SD 9) and the majority (n = 14) worked in the construction sector. Thematic analysis revealed facilitators and barriers for work participation across three main themes: personal factors, work factors, and healthcare. Personal factors compassed sub-themes such as health and financial consequences. Work factors included sub-themes related to work demands and adaptations and healthcare encompassed sub-themes associated with work-related care and medication. Conclusion: To our knowledge, this is the first qualitative study that investigated the perspectives of self-employed workers in physically demanding jobs regarding work participation. While most facilitators and barriers were consistent with those described in the literature for employees, certain factors, such as financial consequences of ceasing work, emerged important factors for work participation among self-employed workers. [ABSTRACT FROM AUTHOR]

AbstractObjectivesMethodsResultsConclusionsHair cortisol concentration (HCC) indicates chronic stress exposure, which is a risk factor in the pathogenesis of burnout and depression. However, findings on HCC are inconsistent. Similarly, intervention studies show mixed effects on HCC. The present study aimed to shed light on these inconsistencies, by additionally considering also hair cortisone.Twenty-five patients with a burnout-related depressive disorder receiving a multimodal inpatient treatment for clinical burnout and 17 matched healthy controls participated in this study. All participants provided 1 cm long hair samples at the beginning and end of the treatment. HCC and hair cortisone levels (HCNC) were determined. Meteorological data and duration of sick leave were considered as potential covariates. Burnout and depression were assessed with self-ratings, the latter also with examiner ratings.There were no significant group differences in glucocorticoid levels. Treatment led to a decrease in both depression severity and hair glucocorticoid concentration in inpatients, while lower HCNC in particular predicted a greater reduction in depression severity. Moreover, meteorological data and the duration of sick leave were also found to have an effect on hair glucocorticoid concentrations.These results suggest that multimodal inpatient treatment of clinical burnout considerably reduced stress on both a psychological and biological level. In parallel, hair glucocorticoids appear to be sensitive biomarkers for the evaluation of treatment success and prediction. Examining both HCC and HCNC in intervention studies may provide clearer results than the usual examination of HCC alone. [ABSTRACT FROM AUTHOR]

Background: Loiasis is a disease of relevance in endemic populations and there has been advocacy for its inclusion on the World Health Organization's neglected tropical diseases list. As loiasis-related healthcare-seeking behaviors and related costs are unknown, we aimed to evaluate these aspects in a population residing in an endemic region in Gabon. Methods: Data were collected during a community-based, cross-sectional study assessing the disease burden due to loiasis. Diagnostics for microfilaremia were performed and a history of eyeworm was obtained. In addition, a standardized questionnaire about type of healthcare resources and frequency of use, as well as respective associated costs was administered to each participant. Loiasis related healthcare-seeking behaviors were evaluated, and the associated monetary burden was estimated as a secondary outcome of the study. Findings: Individuals diagnosed with loiasis more frequently reported any healthcare-seeking (OR 1.52 (95%CI: 1.21–1.91)), self-medicating (OR 1.62 (1.26–2.08)), inability to work (OR 1.86 (1.47–2.35)), and consulting with traditional healers (logOdds 1.03 (0.52–1.53)), compared to loiasis negative individuals. The most frequently reported treatment for the eyeworm was traditional herbs. The estimated healthcare associated costs, per positive individual, was US-$ 58 (95% CI: 21–101) per year, which would correspond to 3.5% of the reported mean household income. Extrapolation to the rural population of Gabon (n = 204,000), resulted in an annual monetary burden estimate of US-$ 3,206,000 (1,150,000–5,577,000). Interpretation: Loiasis patients have demonstrated healthcare needs, often consulted traditional healers, and used traditional treatments for disease specific symptoms. Further, loiasis seems to be associated with substantial direct and indirect costs for individuals and thus may cause a relevant economic burden for endemic populations and economies of affected countries. Author summary: Loiasis has long been considered a negligible infection, however disease perception is changing as more data on significant disease-associated morbidity and mortality are being published. Still, many important aspects of the disease, such as the socioeconomic impact, are unknown. This study was part of a larger project on loiasis associated disease burden and aimed to evaluate healthcare seeking behaviors and estimate associated costs in individuals with loiasis living in a highly endemic region. We found that loiasis is associated with healthcare consultation, self-medicating, and sick leave. Self-medicating for treatment of disease specific symptoms was frequent. Traditional treatments and pain medication were most frequently used. Based on these data, we estimated loiasis related direct healthcare costs and indirect costs due to sickness, resulting in a monetary burden of US-$ 58 (95% CI: 21–101) per loiasis positive individual per year. Extrapolating these numbers to the rural population of Gabon (n = 204,000) would correspond to a monetary burden of US-$ 3,206,000 (95% CI: 1,150,000–5,577,000). Thus, loiasis is not only associated with morbidity and mortality but also with healthcare-seeking and may cause a relevant socioeconomic burden on affected populations. Therefore, considering loiasis a negligible disease is not appropriate anymore. [ABSTRACT FROM AUTHOR]

Background: Returning to work after long-term sick leave can be challenging, particularly in small- and medium-sized enterprises (SMEs) where support may be limited. Recognizing the responsibilities and challenges of SME employers, a web-based intervention (hereafter the SME tool) has been developed. The SME tool aims to enhance the employer's intention and ability to support the sick-listed employee. Based on the Self-Determination Theory, it is hypothesized that this intention is enhanced by intervening in the employer's autonomy, competences, and relatedness targeted at, e.g., communication with sick-listed employee, involvement of other stakeholders, and practical support. This is achieved by means of providing templates, communication videos, and information on legislation. This article describes the design of an effect and process evaluation of the SME tool. Methods: A randomized controlled trial (RCT) with a 6-month follow-up will be conducted with a parallel-group design with two arms: an intervention group and a control group. Sick-listed employees (≤ 8 weeks) of SMEs (≤ 250 employees) at risk of long-term sick leave and their employers will be recruited and randomly allocated as a dyad (1:1). Employers randomized to the intervention group receive unlimited access to the SME tool, while those in the control group will receive care as usual. The primary outcome is the satisfaction of the employee with the return to work (RTW) support provided by their employer. Secondary outcomes include social support, work performance, and quality of work life at the employee level and self-efficacy in providing RTW support at the employer level. Outcomes will be assessed using questionnaires at baseline and 1, 3, and 6 months of follow-up. Process evaluation measures include, e.g., recruitment and use of and perceived usefulness of the SME tool. Additionally, semi-structured interviews with employers, employees, and occupational physicians will explore the interpretation of the RCT results and strategies for the national implementation of the SME tool. Discussion: The SME tool is hypothesized to be valuable in addition to usual care helping employers to effectively support the RTW of their long-term sick-listed employees, by improving the employers' intention and ability to support. Trial registration: ClinicalTrials.gov, NCT06330415. Registered on February 14, 2024. [ABSTRACT FROM AUTHOR]

Background: Persistent pain is a frequent cause of sick leave and work disability in Norway. A return-to-work intervention featuring supported work placements, developed in the UK, demonstrated feasibility, and a return-to-work rate of 20% within 6 months was observed in the sample. We sought to adapt the intervention for delivery in Norway and to confirm feasibility prior to a full-scale trial. Methods: In this internal pilot, we used a pragmatic cohort randomised controlled approach with national recruitment in Norway. We recruited people who were unemployed (for at least 1 month), having persistent pain (for at least 3 months), aged between 18 and 64, and wanting to return to work. We initially recruited people to an observational cohort study of the impact of being unemployed with persistent pain. After baseline measurement, we randomly sub-sampled participants to whom we offered the intervention, which featured individual case management and support, work-familiarisation sessions, and the offer of a 6-week part-time unpaid work placement. We assessed recruitment rates (aiming to recruit 66, and sub-sample 17 within 6 months); optimal recruitment pathways; intervention acceptance rates; the feasibility of data collection; using video links for work-familiarisation sessions and remote case manager support. Results: The pilot ran from June to November 2022. Of 168 people expressing interest, 94 consented. Recruitment posts on Facebook yielded the most 'expressions of interest' (66%, n = 111). After screening for eligibility, we included 55 participants. Of these, 19 were randomised to be offered the intervention. Of these, less than half (n = 8) consented to intervention participation. Remote case manager and work-familiarisation sessions appeared feasible. Following a delay in identifying placements, three participants received offers of work placements, with one starting and completing during the pilot period. Data collection methods were feasible, and no adverse events were reported. Conclusions: Recruitment and logistical processes, such as remote management by video link, are feasible. However, delivery of the intervention is challenging. In particular, sourcing placements and the time required for identifying appropriate placements was more challenging than anticipated. A full-scale trial is feasible but will require improvements to the placement identification processes. Trial registration: ISRCTN85437524 (Referring to the ReISE trial, of which this internal pilot was a part), Registered 31 of May 2022 https://doi.org/10.1186/ISRCTN85437524 Trial funding: Norwegian Research Council. [ABSTRACT FROM AUTHOR]

In today's dynamic business world, organizations are increasingly relying on innovative technologies to improve the efficiency and effectiveness of their human resource (HR) management. Our study uses historical time and attendance data collected with the MojeUre time and attendance system to predict employee absenteeism, including sick and vacation leave, using machine learning methods. We integrate employee demographic data and the absence profiles on timesheets showing daily attendance patterns as fundamental elements for our analysis. We also convert the absence data into a feature-based format suitable for the machine learning methods used. Our primary goal in this paper is to evaluate how well we can predict sick leave and vacation leave over short- and long-term intervals using tree-based machine learning methods based on the predictive clustering paradigm. This paper compares the effectiveness of these methods in different learning settings and discusses their impact on improving HR decision-making processes. [ABSTRACT FROM AUTHOR]

This corrigendum addresses errors in an article titled "The relationship between perceived organizational support and insomnia in Chinese nurses: the serial multiple mediation analysis." It corrects mistakes in the author list, article citation, copyright statement, and author contributions. It also rectifies errors in the text regarding questionnaire issuance dates, number of questionnaires issued, response rate, and grammar in the Results and Discussion sections. The corrigendum ensures the accuracy of the original article. Another corrigendum corrects errors related to the COVID-19 pandemic, funding statement, and a table in the article. These corrections do not alter the scientific conclusions of the study. [Extracted from the article]

Background: Economic relief programs are strategies designed to sustain societal welfare and population health during a regional or global scale infectious disease outbreak. While economic relief programmes are considered essential during a regional or global health crisis, there is no clear consensus in the literature about their health and non-health benefits and their impact on promoting equity. Methods: We conducted a scoping review, searching eight electronic databases from January 01, 2001, to April 3, 2023, using text words and subject headings for recent pathogens (coronavirus (COVID-19), Ebola, Influenza, Middle East Respiratory Syndrome (MERS), severe acute respiratory syndrome (SARS), HIV, West Nile, and Zika), and economic relief programs; but restricted eligibility to high-income countries and selected diseases due to volume. Title and abstract screening were conducted by trained reviewers and Distiller AI software. Data were extracted in duplicates by two trained reviewers using a pretested form, and key findings were charted using a narrative approach. Results: We identified 27,263 de-duplicated records, of which 50 were eligible. Included studies were on COVID-19 and Influenza, published between 2014 and 2023. Zero eligible studies were on MERS, SARS, Zika, Ebola, or West Nile Virus. We identified seven program types of which cash transfer (n = 12) and vaccination or testing incentive (n = 9) were most common. Individual-level economic relief programs were reported to have varying degrees of impact on public health measures, and sometimes affected population health outcomes. Expanding paid sick leave programs had the highest number of studies reporting health-related outcomes and positively impacted public health measures (isolation, vaccination uptake) and health outcomes (case counts and the utilization of healthcare services). Equity impact was most often reported for cash transfer programs and incentive for vaccination programs. Positive effects on general well-being and non-health outcomes included improved mental well-being and quality of life, food security, financial resilience, and job security. Conclusions: Our findings suggest that individual-level economic relief programs can have significant impacts on public health measures, population health outcomes and equity. As countries prepare for future pandemics, our findings provide evidence to stakeholders to recognize health equity as a fundamental public health goal when designing pandemic preparedness policies. [ABSTRACT FROM AUTHOR]

Although multisite pain can markedly reduce work ability, the relevance of the bodily pain distribution as a predictor of long-term sick leave is still unknown. This study aimed to investigate the association between musculoskeletal pain distributions and long-term sick leave in the general working population of Denmark and included 66,177 currently employed wage earners without long-term sick leave during the prior 52 weeks. Participants reported whether they had pain in the lower extremity (hips/knees), upper extremity (neck/shoulders), or the low back. The analysis controlled for age, sex, year of survey reply, educational level, occupational group, psychosocial work factors, body max index, smoking, leisure-time physical activity, and mental health confounders. The results demonstrated that the risk of long-term sick leave increased with the number of pain sites. Compared with no pain, localized pain in any body region increased the risk/hazard by 25% to 29% (HR [95% CI]: 1.29 [1.07-1.54] for pain only in the low back), whereas pain in 2 regions increased the risk by 39% to 44% (HR [95% CI]: 1.41 [1.18-1.69] for pain in the low back 1 hips/knees). Workers reporting pain in all 3 regions experienced a 72% increased risk (HR [95% CI]: 1.72 [1.55-1.91]). Thus, the number of pain regions seems to matter more than the exact pain location. The spatial extension of musculoskeletal pain in workers functions as a gradient system, where pain spread throughout the body is an independent indicator of the high risk of long-term sick leave. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the body of evidence of the effects of work-directed interventions on return-to-work for people on sick leave due to common mental disorders (i.e., mild to moderate depression, anxiety, adjustment disorders and reactions to severe stress). Methods: The systematic review was conducted in accordance with an a priori developed and registered protocol (Prospero CRD42021235586). The certainty of evidence was assessed by two independent reviewers using the Grading of Recommendations, Assessment, Development and Evaluations. Results: We reviewed 14,794 records published between 2015 and 2021. Of these, eight RCTs published in eleven articles were included in the analysis. Population: Working age adults (18 to 64 years), on sick leave due to mild to moderate depression, anxiety, adjustment disorders or reactions to severe stress. Intervention: Work-directed interventions. Comparator: No comparator, Standard care, or other measures. Outcome: return to work, number of days on sick leave, income. Overall, the effects of work-focused CBT and work-focused team-based support on RTW resulted in increased or faster return-to-work compared with standard care or no intervention (low certainty of evidence). The effects of Individual Placement and Support showed no difference in RTW compared with standard care (very low certainty of evidence). Conclusion: Interventions involving the workplace could increase the probability of RTW. Areas in need of improvement in the included studies, for example methodological issues, are discussed. Further, suggestions are made for improving methodological rigor when conducting large scale trials. [ABSTRACT FROM AUTHOR]

To examine joint associations of leisure-time physical activity (LTPA) and screen sitting time with subsequent sickness absence among the adult population. Registry linked follow-up study. A representative sample of Finnish adults (n = 10,300) were asked to fill out a questionnaire for the FinHealth 2017 survey. Self-reported LTPA was classified into three groups: inactive, moderately active, and active, and screen sitting time into two groups: 3 h or less and over three hours a day, yielding a six-category variable for the joint analyses. Questionnaire data were linked to the Finnish Social Insurance Institution's register data on sickness benefits (over 9 days), including diagnoses (follow-up 2.9 years). The analytical samples were restricted to working age (18–64 years), which included 5098 participants. Associations were examined using logistic regression analysis adjusting for covariates with SPSS 29. The inactive and high sitting time had a higher risk for sickness absence due to mental disorders (OR 2.07, 95% CI 1.03–4.18) compared with the physically active, low-sitting time group. Additionally, the inactive and low sitting time (OR 1.69 95% CI 1.12–2.55) and the moderately active and high-sitting time groups (OR 2.06 95% CI 1.15–3.67) had a higher risk. No significant associations were found for all-cause and musculoskeletal diseases sickness absence. Employers and policymakers could support reducing sitting in front of a screen and increase LTPA outside working hours to prevent mental health problems and related sickness absences. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: Restraining and secluding health consumers for safety reasons continue to be used in psychiatric inpatient facilities even though they have no therapeutic value and have negative effects on consumers, families and staff.Six Core Strategies (6CS) for reducing seclusion and restraint have been developed to address this problem but there are very few effectiveness studies in inpatient adolescent psychiatric facilities. What the paper adds to existing knowledge: We used a mixed methods approach to evaluate the implementation of 6CS in an adolescent psychiatric facility. The implementation was successful. It eliminated the use of seclusion, substantially reduced the use of restraints and significantly reduced staff absenteeism.Using thematic analysis on feedback surveys, we identified five dominant themes that described consumers' and carers' experiences during their stay at the facility: communication, service delivery, flexibility, consistency and internal feeling states. What are the implications for practice: This study provides support for the feasibility of a comprehensive and broad‐based intervention program such as 6CS to reduce seclusion and restraint practices in inpatient mental health facilities.This study also demonstrates the value of using surveys to gather consumer and carer feedback and improve outcomes for service users. Introduction: Seclusion and restraint practices are routinely used in psychiatric facilities but are controversial for ethical, legal and safety reasons, and can cause significant harm to consumers, staff and organisations. Six Core Strategies (6CS) for reducing seclusion and restraint were developed to address this problem but very few studies have examined their effectiveness in adolescent settings. Aim/Question: To evaluate the implementation of 6CS in an adolescent inpatient psychiatric facility. Method: We retrieved archival data from an acute adolescent psychiatric ward that implemented the 6CS. Using a mixed methods approach, we evaluated outcomes on the use of seclusion and restraint, nursing staff sick leave and feedback surveys. Results: Findings showed an elimination of seclusion, and a significant reduction in restraint use and staff absenteeism in the 12 months after project implementation. Thematic analysis of feedback survey responses identified communication, service delivery, flexibility, consistency and internal feeling states as dominant themes in consumers' and carers' experience on the unit. Discussion: The 6CS is feasible and may be effective in reducing seclusion and restraint, which in turn may have a positive impact on staff wellbeing. Implications for Practice: Implementation of the 6CS with executive support, combined with staff and programmatic changes at a local level is recommended. [ABSTRACT FROM AUTHOR]

Aim: The inclusion of production losses in health care priority setting is extensively debated. However, few studies allow for a comparison of these losses across relevant clinical and demographic categories. Our objective was to provide comprehensive estimates of Norwegian production losses from morbidity and mortality by age, sex and disease category. Methods: National registries, tax records, labour force surveys, household and population statistics and data from the Global Burden of Disease were combined to estimate production losses for 12 disease categories, 38 age and sex groups and four causes of production loss. The production losses were estimated via lost wages in accordance with a human capital approach for 2019. Results: The main causes of production losses in 2019 were mental and substance use disorders, totalling NOK121.6bn (32.7% of total production losses). This was followed by musculoskeletal disorders, neurological disorders, injuries, and neoplasms, which accounted for 25.2%, 7.4%, 7.4% and 6.5% of total production losses, respectively. Production losses due to sick leave, disability insurance and work assessment allowance were higher for females than for males, whereas production losses due to premature mortality were higher for males. The latter was related to neoplasms, cardiovascular disease and injuries. Across age categories, non-fatal conditions with a high prevalence among working populations caused the largest production losses. Conclusions: The inclusion of production losses in health care priority debates in Norway could result in an emphasis on chronic diseases that occur among younger populations at the expense of fatal diseases among older age groups. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to examine the association between gender composition in the workplace and sickness absence days during a one-year period. Methods: The study population was drawn from the Northern Swedish Cohort (wave 3; 2007) by Statistics Sweden and consisted of all participants belonging to a specific workplace (n =837) as well as all co-workers at the workplace of the participants (n =132,464; 67,839 women and 64,625 men). Exposure was the gender composition of the workplace, and outcome was cumulative sickness absence days (⩾ 90 days or not) during 2007, provided through a link to the Database for Health Insurance and Labour Marked Studies of Statistics Sweden. Covariates were gender, age, educational level and branch of industry from the same data source. We performed descriptive analyses and multivariable regression analyses. Results: Workers in extremely female-dominated workplaces had a significantly higher risk of cumulative sickness absence days (⩾90 days) compared with gender-equal workplaces (fully adjusted odds ratio (OR)=1.27; 95% confidence interval (CI) 1.09–1.48), whereas those working in extremely and moderately male-dominated workplaces had a significantly lower sickness absence risk (OR=0.62 and 0.66, respectively). Stratified by gender, the higher absence risk at female-dominated workplaces was fully explained by variation in branches of industry. Women working in extremely male-dominated workplaces had a significantly lower absence risk (OR=0.75), as did men working in moderately male-dominated workplaces (OR=0.78). Conclusions: Workplaces dominated by women had a significantly higher risk of days lost to sickness absence compared to gender-equal workplaces. Stratified by gender, this higher risk was explained by branch of industry. [ABSTRACT FROM AUTHOR]

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BACKGROUND: People seeking care at primary healthcare centres may be exposed to work-related stress, increasing the risk of future sick leave. Thus, it is important to identify work-related stress, and to explore how stress relates to work ability and health. OBJECTIVE: To investigate the association between work-related stress and a) work ability, and b) self-rated health, among working women and men seeking care for physical or mental health complaints. METHODS: This cross-sectional study analyzed baseline data (n = 232) from a randomized controlled trial investigating the effects of a brief intervention to prevent sick leave. Data regarding work-related stress, work ability and self-rated health were analyzed using binary logistic regression models. RESULTS: In models adjusted for age, gender and education, high work-related stress measured by the Work Stress Questionnaire was significantly associated with low work ability. The highest odds ratio (OR 3.27, 95% CI 1.66–6.42) was found between the domain "interference between work and leisure time" and work ability, suggesting a more than three times higher odds for low work ability when perceiving that work interferes with leisure time. No significant association was found between work-related stress and self-rated health. CONCLUSION: Health professionals should explore patients' work-related stress when they seek care for physical or mental complaints in primary healthcare. Patients' perceived balance between work and leisure time seems particularly important to address. Increased awareness might facilitate timely, relevant strategies to reduce stress and promote work ability. [ABSTRACT FROM AUTHOR]

Objective: To explore frontline employees' experiences of how to create a purposeful sick leave and rehabilitation process (SRP) with the best interest of patients' long-term health in focus. Methods: Qualitative design based on focus group interviews in a primary care context in Region Västra Götaland, Sweden. Strategically selected professionals from different SRP organizations discussed sick leave outcomes and the rehabilitation process. Analysis was performed with Systematic text condensation. Subjects: General practitioners (n = 6), rehabilitation coordinators and/or healthcare professionals from primary healthcare (n = 13), caseworkers from the Social Insurance Agency, the Employment Agency, and Social Services (n = 12). Results: The outcome of the SRP was described to depend upon the extent to which the process meets patients' bio-psycho-social needs. Aspects considered crucial were: 1) early bio-psycho-social assessments, including medical specialist consultations when needed, 2) long-term realistic planning of sick leave and rehabilitation alongside medical treatment, 3) access to a wide range of early rehabilitative and supportive interventions, including situation-based, non-medical practical problem solving, and 4) trusting relationships over time for all involved professions and roles to maximize process quality and person-centeredness. A gap between the desired scope of the SRP and existing guidelines was identified. Conclusion: Interviewees perceived that successful outcomes from the sick leave and rehabilitation process in a primary care context depend on consensus, person-centeredness, and relationship continuity for all involved professions. An extended process scope and relationship continuity for all involved professionals were suggested to improve process outcomes. [ABSTRACT FROM AUTHOR]

AbstractObjectiveDesignSubjectsMethodsResultsConclusion\nKEY POINTSTo investigate whether mental and work-related stress predicts a one-year incidence of sick leave in a cohort of middle-aged working women.The 2016/17 survey was part of the Population Study of Women in Gothenburg, Sweden, with registry data information on sick leave during one year pre- and post-baseline.A cohort of women aged 38 and 50 in 2016/17 (n = 573; 68% participation), of which 504 women were gainfully employed and not on sick leave ± 2 weeks around baseline examination; 493 women had complete data on stress exposure.We studied associations between self-assessed mental and work-related stress and incident sick leave of >14 days during the year following the baseline examination. We used multiple logistic regression, adjusting for age and previous sick leave, and additionally for sleep quality, well-being, and physical activity.Overall, 75 women (16%) experienced at least one period of sick leave after baseline. Permanent stress during the last five years almost tripled the risk for incident sick leave, OR = 2.8 (95% CI 1.2–6.3), independent of previous sick leave, OR = 2.3 (95% CI 1.3–4.2). Among 21 specific work-related problems, conflicts at work, OR = 2.2 (95% CI 1.3–3.6), and low decision latitude, OR = 1.7 (95% CI 1.0–2.9), were associated with incident sick leave. The association with conflicts at work remained upon further covariate adjustment.Low decision latitude and conflicts at work are risk factors for incident sick leave among working women. The impact of conflicts at work, irrespective of own involvement, may indicate a specific vulnerability among women of interest for future interventions.About 75% of around 500 middle-aged women reported mental stress in 2016/17. Low decision latitude and conflicts at work predicted incident sick leave independent of general mental stress and previous periods of sick leave. Efforts to improve the work environment may be essential for interventions aiming to reduce absenteeism among working women. [ABSTRACT FROM AUTHOR]

Introduction: Stress-related ill-health like pain and exhaustion are demanding public health problems in Europe. In Sweden, women are particularly at risk to develop stress-related ill-health during a period in life that coincides with child-rearing years. When entering motherhood, Swedish women’s sick leave substantially increases. Yet, motherhood is rarely acknowledged in clinical encounters concerning pain and exhaustion although women suffer from these ailments more often than men. To incorporate motherhood as an existential dimension of health in the care of women living with pain and exhaustion might alleviate women’s suffering. But knowledge on women’s experiences of motherhood and health is scarce. Therefore, the aim of the study is to reach a deeper understanding of how women suffering from long-lasting pain and exhaustion experience their health in relation to motherhood. Methods: Ricoeur’s interpretation theory has been applied to analyze 27 phenomenological interviews with 14 mothers suffering from long-lasting pain and exhaustion. Results: These women’s experiences shed light on how closely motherhood is interwoven with the experience of their health and suffering: The women’s suffering seems to be rooted in a relational vulnerability that has been uncovered during motherhood. Further, the women suffer from a burden of difficult life experiences and inner conflicts. Reconciliation with life is possible when women find an existential shelter, which offers ways to relate to their suffering making the own suffering more bearable. [ABSTRACT FROM AUTHOR]

Background: Stress-induced exhaustion disorder (SED) is the most common reason for long-term sick leave in Sweden and the recovery process may be long and troublesome. This study explores the symptoms of burnout, depression and anxiety among patients with SED 10 years after termination of a multimodal rehabilitation program. Another aim of the study was to investigate work situation, work functioning, and any remaining exhaustion and sleeping disorders among those who were gainfully employed at the 10-year follow-up. Methods: This longitudinal study included 107 patients (91 women and 16 men), who had been diagnosed with SED 10 years prior to the study. After establishing the diagnosis they all underwent and completed an multimodal rehabilitation program. Data on symptoms of burnout, anxiety and depression were collected before and after the multimodal rehabilitation program, and at follow-ups after additional 1 year and an additional 10 years. At the 10-year follow-up, work situation, work functioning, and symptoms of exhaustion and sleep disorders were assessed in those who were gainfully employed (89 patients). Results: Symptoms of burnout, anxiety, and depression remained stable from the 1- to the 10-year follow-up after completed rehabilitation. Among participants who were gainfully employed, 73% had changed workplaces, and 31.5% had reduced their working hours. Common reasons for these changes were lack of energy or because they had chosen to prioritise their lives differently. Work functioning was rated as moderate, one third self-reported SED to some extent, and one fifth reported moderate-to-severe insomnia. Conclusion: A relatively large proportion of former patients with SED have residual health problems 10 years after rehabilitation and some have not been able to return to full-time work. Preventive and early rehabilitative interventions with adjustments and measures at the organisational level are probably needed to achieve a more sustainable working life. [ABSTRACT FROM AUTHOR]

AbstractObjectivesDesignSettingParticipantsMain Outcome MeasuresResultsConclusionThis study compares the demographics, diagnoses, re-admission rates, sick leaves, and prescribed medications of patients accessing digital general practitioner (GP) visits with those of patients opting for traditional face-to-face appointments in a primary health care setting.The study adopted a retrospective analysis of patient record data collected in 2019, comparing visits to a digital primary health center with traditional health center visits.Primary health care.The data encompassed patients who utilized the digital clinic and those who visited public health centers for primary health care services.The study assessed demographics, health diagnoses, prescribed medications, sick leave recommendations, re-admission rates, and differences in costs between digital clinic and face-to-face visits. Secondary outcomes included a comparative analysis of medication categories, resolution rates for health problems, and potential impacts on health care utilization.Digital clinic users were typically younger, more educated, and predominantly female compared with health centre users. Digital visits were well-suited for uncomplicated infections, while health centre appointments were associated with a higher prevalence of chronic conditions. Medication patterns differed between the two modalities, with digital clinic users receiving generic over-the-counter drugs and antibiotics, whereas health centre visits commonly involved cardiac and antihypertensive medications. Sick leave recommendations were slightly higher in the digital clinic, but the difference was not significant. Approximately 70% of health problems addressed in the digital clinic were successfully resolved, and the cost of digital visits was about 50,3% of face-to-face appointments.Digital health care services offer a cost-efficient alternative for specific health problems, appealing to younger, educated individuals, when compared to the users of public health center, and may enable improvement of cost-effectiveness combined with acceptable demand management and patient segmentation practices. The results highlight the potential benefits of digital clinics, particularly for uncomplicated cases, while also emphasizing the importance of suitable referral mechanisms for in-person consultations. [ABSTRACT FROM AUTHOR]

ObjectiveMethodsResultsConclusionStepped care models are frameworks for mental health care systems in several countries. According to Norwegian guidelines, individuals with mental health problems of mild severity should be treated in community mental health services, moderate severity in specialist mental health services, while complex/severe problems are often a shared responsibility. This study investigated whether patients are allocated as intended.In a cross-sectional study, 4061 outpatients recruited from community- and specialist mental health services reported demographic variables, symptoms of anxiety/depression, functional impairment, health status, and sick leave status. The community sample consisted of two subsamples: mild/moderate problems and complex problems.There was substantial overlap (80%–99%) of symptoms, impairment, and health between community- and specialist mental health services. More impairment, worse health, lower age, and being male were associated with treatment at specialist level compared to community mild/moderate. Better health, being in a relationship, and lower age were associated with specialized treatment compared to community complex group.The limited association between treatment level and symptoms and functional impairment reveals inconsistencies between treatment guidelines and clinical practice. How the existing organization affects patient outcomes and satisfaction should be investigated further. [ABSTRACT FROM AUTHOR]

With the overall objective of providing implication for clinical and research practices regarding the identification and measurement of modifiable predicting factors for return to work (RTW) in people with musculoskeletal disorders (MSDs) and common mental disorders (CMDs), this study 1) systematically examined and synthetized the research evidence available in the literature on the topic, and 2) critically evaluated the tools used to measure each identified factor. A systematic search of prognostic studies was conducted, considering four groups of keywords: 1) population (i.e., MSDs or CMDs), 2) study design (prospective), 3) modifiable factors, 4) outcomes of interest (i.e., RTW). Studies showing high risk of bias were eliminated. Tools used to measure prognostic factors were assessed using psychometric and usability criteria. From the 78 studies that met inclusion criteria, 19 (for MSDs) and 5 (for CMDs) factors reaching moderate or strong evidence were extracted. These factors included work accommodations, RTW expectations, job demands (physical), job demands (psychological), job strain, work ability, RTW self-efficacy, expectations of recovery, locus of control, referred pain (back pain), activities as assessed with disability questionnaires, pain catastrophizing, coping strategies, fears, illness behaviours, mental vitality, a positive health change, sleep quality, and participation. Measurement tools ranged from single-item tools to multi-item standardized questionnaires or subscales. The former generally showed low psychometric properties but excellent usability, whereas the later showed good to excellent psychometric properties and variable usability. The rigorous approach to the selection of eligible studies allowed the identification of a relatively small set of prognostic factors, but with a higher level of certainty. For each factor, the present tool assessment allows an informed choice to balance psychometric and usability criteria. [ABSTRACT FROM AUTHOR]

Background: Sickness absence has been linked to short and long, as well as poor, sleep in a few studies. Such studies have started from a baseline measurement and followed up on subsequent sickness absence. In the present study, however, we focused on the change in biennial reports of sickness absence and sleep measures (using work-related variables as possible modifiers). We also searched for an interaction between predictors and gender since women report more sleep problems. Methods: A total of 5377 individuals (random sample from the Swedish working population) participated across five biennial points of measurement. Data were analyzed using mixed-model logistic regression. Results: The multivariable analysis of variation across the five time points showed that the significant sleep-related predictors of sickness absence (at least one occurrence during the preceding year) were sleep duration during days off (OR = 1.16, 95% Cl = 1.08;1.24) and sleep problems (OR = 1.42, 95% CI = 1.33;1.51). These also remained significant after the addition of psychosocial work factors. Sensitivity analyses indicated that a 9 h sleep duration during days off may represent a critical level in terms of increased sickness absence and that late rising contributed to the association between sickness absence and long sleep duration during days off. Women reported a higher sickness absence than men (OR = 2.16, 95% CI = 1.74;2.68) and had a higher probability of sickness absence for long sleep during days off and during the workweek than men. Conclusions: It was concluded that increases in sleep problems and sleep duration during days off are longitudinally associated with changes in sickness absence and that women have a closer link between the two. This suggests that treatment for sleep problems may reduce the risk of sickness absence. [ABSTRACT FROM AUTHOR]

Background: Due to changes in testing policy and increased use of rapid tests, other indicators for SARS-CoV-2 infections are needed to monitor vaccine effectiveness (VE). We aimed to estimate VE against COVID-19 sick leave (> 3 days, certified by a medical professional) among employed individuals (25–64-years-old) in Norway. Methods: We performed a nationwide cohort study by collating data from the Emergency preparedness register for COVID-19. We used adjusted Cox proportional hazard models with vaccine status as a time-varying covariate and presented results as adjusted hazard ratios (aHRs) with corresponding 95% confidence intervals. Separate models were run against sick leave and against SARS-CoV-2 infections during the Delta period (June-December 2021), and against sick leave during the Omicron period (January-December 2022) when SARS-CoV-2 PCR-testing was replaced by rapid self-tests and infections were underreported. Results: We included 2,236,419 individuals during the Delta period, of whom 73,776 (3.3%) had a reported infection and 54,334 (2.4%) were registered with sick leave. Of the 2,206,952 included individuals in the Omicron period, 300,140 (13.6%) were registered with sick leave. During the Delta period, 55% (26,611) of individuals who had registered sick leave also had a positive test, compared to 32% (96,445) during the Omicron period. The VE against sick leave during the Delta period followed a similar waning pattern to that against SARS-CoV-2 infections. After the second and third dose, the lowest aHRs were estimated for 2–7 days after vaccination for both sick leave (0.25; 95%CI 0.24–0.26 and 0.26; 95% CI 0.24–0.29) and infection (0.16; 95% CI 0.15–0.17 and 0.18; 95% CI 0.16–0.19) respectively. During the Omicron period, aHRs for sick leave were higher than during the Delta period, but the lowest aHRs were still found in 2–7 weeks after receiving the second (0.61; 95% CI 0.59–0.64) or third dose (0.63; 95% CI 0.62–0.64). Conclusion: Our results showed that sick leave could be a relevant indicator for VE in the surveillance of COVID-19 and a finding that may be important in the surveillance of other respiratory infection. [ABSTRACT FROM AUTHOR]

Background: In addition to several sequelae of post-COVID-19, individuals also experience significant limitations in work ability, resulting in negative consequences for the return-to-work (RTW) process. This systematic review and meta-analysis were conducted to assess the impact of post-COVID-19 on work ability and RTW of individuals previously infected with SARS-CoV-2. Methods: Studies on the work ability and RTW of patients with post-COVID-19 (more than 12 weeks after an acute SARS-CoV-2 infection) were regarded eligible for inclusion. Systematic search of literature was performed up to March 2023 using five databases (MEDLINE, EMBASE, CINAHL, CENTRAL and WHO COVID 19). Study selection followed the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) Statement. A meta-analysis estimated the overall success rate of RTW. The risk of bias of the included studies was evaluated with the Newcastle Ottawa Scale (NOS). Results: 19 relevant studies, published between 2021 and 2023, were included in the systematic review, involving 21.155 patients from 14 different countries. The findings indicate that a significant proportion of individuals with post-COVID-19 experience persistent symptoms and functional impairments, with fatigue being the most prominent symptom. These persistent symptoms can have a considerable (negative) impact on individuals' physical and psychological capacity to participate in work-related activities, leading to lower work ability and increased absenteeism. The RTW for post-COVID-19 patients is complex, with approximately 60.9% of patients successfully returning to work after 12 or more weeks following SARS-CoV-2 infection. Among those who successfully returning to work, a considerable number need modifications in their work duties or hours to cope with residual impairments. Factors such as workplace accommodations, supportive policies, and occupational rehabilitation programs play a crucial role in facilitating successful RTW. Conclusions: The systematic review underscores the substantial impact of post-COVID-19 on work-related outcomes. The implications of this research highlight the need for healthcare providers, employers, and policymakers to collaborate in creating inclusive work environments and implementing tailored rehabilitation programs to support individuals recovering from post-COVID-19. Further research should focus on long-term follow-up studies with mixed methods to gain a more comprehensive understanding of the long-term consequences of post-COVID-19 on work ability and RTW outcomes. PROSPERO registration number: CRD42023385436. [ABSTRACT FROM AUTHOR]

Over recent decades, sickness absence due to common mental disorders has increased among young workers. The phenomenon is mostly understood on the basis of epidemiological research, and knowledge regarding the viewpoints of young workers themselves is lacking. Our study explored the explanations for mental health‐related sickness absence in the narrative accounts of young workers in high‐risk health and social care occupations. Semi‐structured narrative interviews were conducted with 23 Finnish young workers (aged 21–34), with self‐reported sickness absence related to common mental disorders over the previous year. Our analysis identified three narrative explanations for the onset of mental health problems leading to sick leave: work as the sole cause, work as an additional cause and work as a trigger. These findings indicate that mental health‐related sickness absences form a complex phenomenon related to various life and work‐related circumstances. More comprehensive preventive measures are needed in the health and social care sector to help tackle mental health problems among young workers. [ABSTRACT FROM AUTHOR]

As disasters increase due to climate change, population density, epidemics, and technology, information is needed about postdisaster consequences for people's mental health and how stress-related mental disorders affect multiple spheres of life, including labor-market attachment. We tested the causal hypothesis that individuals who developed stress-related mental disorders as a consequence of their disaster exposure experienced subsequent weak labor-market attachment and poor work-related outcomes. We leveraged a natural experiment in an instrumental variables model, studying a 2004 fireworks factory explosion disaster that precipitated the onset of stress-related disorders (posttraumatic stress disorder, anxiety, and depression) among individuals in the local community (N = 86,726). We measured labor-market outcomes using longitudinal population-level administrative data: sick leave, unemployment benefits, early retirement pension, and income from wages from 2007 to 2010. We found that individuals who developed a stress-related disorder after the disaster were likely to go on sickness benefit, both in the short-and long-term, were likely to use unemployment benefits and to lose wage income in the long term. Stress-related disorders did not increase the likelihood of early retirement. The natural experiment design minimized the possibility that omitted confounders biased these effects of mental health on work outcomes. Addressing the mental health and employment needs of survivors after a traumatic experience may improve their labor-market outcomes and their nations' economic outputs. [ABSTRACT FROM AUTHOR]

This article discusses the complexities of treating posttraumatic stress disorder (PTSD) and the importance of tailoring therapy to individual patients. The author presents a case study of a man named John who experiences acute stress disorder (ASD) and later develops PTSD after the sudden death of his fiancée. The therapist uses a combination of psychoeducation, cognitive restructuring, and exposure therapy to help John process his guilt and traumatic memories. The article emphasizes the need for therapists to listen to their patients, adapt treatment plans, and acknowledge their own limitations. [Extracted from the article]

Women and workers over 50 disproportionately provide care for aging family members worldwide, including the 101 million who are care-dependent. Paid leave for adult health needs, which temporarily replaces employment income for workers providing care, can critically support both caregivers' economic outcomes and care recipients' wellbeing. We created quantitatively comparable data on paid leave policies that can be used to meet adult family members' health needs in all United Nations member states. Globally, 112 countries fail to provide any paid leave that can be used to meet the serious health needs of an aging parent, spouse, or adult child. These gaps have profound consequences for older workers providing care as well as care access by aging, ill, and disabled adults. [ABSTRACT FROM AUTHOR]

This article, published in the American Journal of Psychiatry, explores the topics of affective disorders, pharmacogenomics, and psychiatric illness-related cardiometabolic problems. It discusses the use of pharmacogenomic tools in treating depression and examines the genetics of affective disorders and bipolar disorder. The article also investigates the connection between antidepressant use and the induction of hypomania/mania in bipolar depression, as well as the relationship between alterations in stress responsivity and the pathophysiology of depression. Additionally, it assesses the risk of developing cardiometabolic problems in various psychiatric illnesses. The findings provide valuable insights into the genetics, pathophysiology, and treatment of affective disorders, as well as the associations between different psychiatric disorders and the development of cardiometabolic problems. The article discusses the results of a study on patients with major depression, which revealed abnormal brain activity in mood regulation networks and blunted stress-related cortisol levels. The study also found decreased GABA levels in a specific brain region and a negative correlation between cortisol reactivity and brain activity in depressed patients. The authors suggest that these findings indicate faulty regulation and abnormal associations between brain activity and stress response in depressed individuals. Another study examined the relationship between psychiatric disorders and cardiometabolic problems, finding that individuals with psychiatric diagnoses had an increased risk of developing cardiovascular disorders and metabolic syndrome. The authors concluded that a general psychopathology factor contributes to this increased risk. [Extracted from the article]

Objective: Many but not all persons with bipolar disorder require hospital care because of severe mood episodes. Likewise, some but not all patients experience long-term occupational dysfunction that extends beyond acute mood episodes. It is not known whether these dissimilar outcomes of bipolar disorder are driven by different polygenic profiles. Here, polygenic scores (PGSs) for major psychiatric disorders and educational attainment were assessed for associations with occupational functioning and psychiatric hospital admissions in bipolar disorder. Methods: A total of 4,782 patients with bipolar disorder and 2,963 control subjects were genotyped and linked to Swedish national registers. Longitudinal measures from at least 10 years of registry data were used to derive percentage of years without employment, percentage of years with long-term sick leave, and mean number of psychiatric hospital admissions per year. Ordinal regression was used to test associations between outcomes and PGSs for bipolar disorder, schizophrenia, major depressive disorder, attention deficit hyperactivity disorder (ADHD), and educational attainment. Replication analyses of hospital admissions were conducted with data from the Bipolar Disorder Research Network cohort (N=4,219). Results: Long-term sick leave and unemployment in bipolar disorder were significantly associated with PGSs for schizophrenia, ADHD, major depressive disorder, and educational attainment, but not with the PGS for bipolar disorder. By contrast, the number of hospital admissions per year was associated with higher PGSs for bipolar disorder and schizophrenia, but not with the other PGSs. Conclusions: Bipolar disorder severity (indexed by hospital admissions) was associated with a different polygenic profile than long-term occupational dysfunction. These findings have clinical implications, suggesting that mitigating occupational dysfunction requires interventions other than those deployed to prevent mood episodes. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to investigate the age-varying mortality risk associated with different labour market status categories. Methods: Data from a population-based survey carried out among adults aged 30–62 years in Finnmark in 1987/1988 were linked to the Norwegian Cause of Death Registry to identify all deaths occurring by December 2017. We used flexible parametric survival models to examine the age-varying associations between different labour market status categories (no paid work/homemaker, part-time work, full-time work, unemployment benefits, sick leave/rehabilitation allowance, and disability pension) and mortality. Results: Men with part-time work, unemployment benefits, sick leave/rehabilitation allowance, or disability pension had an increased mortality risk compared with men with full-time work; however, these findings were restricted to ages below 60–70 years, varying with labour market status category. For women, excess mortality was linked to disability pension in the younger age groups; in older age groups it was linked to the labour market status category no paid work/homemaker. Non-employment was associated with low education level compared with full-time employment. Conclusions: The study showed increased mortality risk for some non-employment categories, with decreasing relative risk with age. Our findings suggest that the increased mortality risk is partly explained by health, pre-existing illnesses, and health-related behaviour and partly by other factors, such as social network and economic factors. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to compare the sickness absence (SA; over 10 days) rates of migrant and non-migrant care workers in Finland. Methods: Two cohorts were randomly sampled from nationwide registers and analysed together in a three-year follow-up design (2011–2013, 2014–2016). The pooled data consisted of 78,476 care workers, of whom 5% had a migrant background. Statistical methods included cross-tabulations and Poisson regression modelling. Results: Thirty-five percent of the Finnish-born care workers had at least one SA during the follow-up. Care workers from the post-2004 EU countries (30%, at least one SA), Russia, the Former Soviet Union and the Balkan states (25%) and the Global South and East (21%) had fewer episodes of SA than the Finnish-born care workers. The two latter groups also had lower SA rates after we controlled for occupation, gender, age, income and region of residence. Care workers from Western Europe and the Global North (36%) had higher SA rates than the Finnish-born care workers. Conclusions: The following explanations were discussed: population-level health differences – migrants from lower-income non-EU countries are generally healthier than the Finnish-born population (due to, e.g., the 'healthy migrant effect'); discrimination in recruitment and employment – migrants from lower-income non-EU countries need to be healthier than Finnish-born jobseekers to gain employment (in the care sector or more broadly); and sickness presenteeism – migrants from lower-income non-EU countries underuse their right to sickness allowance (due to, e.g., job insecurity). It is likely that these mechanisms affect migrants differently depending on, for example, their countries of origin and social status in Finland. [ABSTRACT FROM AUTHOR]

Few studies have investigated how remote work influences personality trait–performance linkages over time in heterogeneous work populations. Hence, the aim of this study was twofold: (1) to explore the predictive validity personality traits have on work behaviour (work engagement and innovative work behaviour) and occupational health outcomes (general health and sick leave); (2) to explore how remote work potentially moderates the trait–performance linkage. Panel survey data from a Norwegian work–life barometer panel research project was employed, and the time lag was one year. The results indicated that the Big Five was consistently related to work behaviour and occupational health outcomes. Extraversion had the strongest positive association with work engagement (0.25), innovative work behaviour (0.26) and general health (0.17), while neuroticism had the strongest negative association with work engagement (−0.16), general health (−0.21), and sick leave (−0.23). Agreeableness increases the risk of sick leave (0.11), while intellect/imagination increases innovative work behaviour (0.13). Remote work reduces the influence extraversion has on work engagement, while remote work five days a week also reduces the effect conscientiousness has on general health. Remote work did not moderate trait–performance linkages associated with intellect/imagination, agreeableness or neuroticism. This study provides updated knowledge on trait–performance linkages post-COVID-19 and demonstrates that remote work can reduce the positive influence of extraversion and conscientiousness. [ABSTRACT FROM AUTHOR]

Sick pay systems are critical in balancing the economic and health costs of infectious diseases, especially in workplaces, where uncontrolled disease spread can lead to significant economic losses. Surprisingly, most research on sick‐pay reforms does not rely on variation in worker exposure to disease when investigating absences from work. This paper studies the effects of exposure to influenza outbreaks on absences from work when a nation‐wide policy canceled health‐insurance coverage for the first 3 days of illness. We explore geographic variation in the prevalence of infectious diseases, primarily the seasonal flu, to identify corresponding variations in the need for sickness insurance. Estimates based on the Czech Structure of Earnings Survey imply that when sickness insurance was canceled for the first 3 days of an illness, the total hours of work missed were not affected, but employees relied on paid and unpaid leave instead of sick‐leave to stay home. The substitution effects are heterogeneous across occupations and socio‐demographic characteristics of employees, and suggest that workers did not increase the spread of infectious illness in workplaces due to a lack of insurance coverage for the first 3 days of an illness. [ABSTRACT FROM AUTHOR]