Self-reported health problems in a health risk appraisal predict permanent work disability : a prospective cohort study of 22,023 employees from different sectors in Finland with up to 6-year follow-up

Purpose Work disability (WD) as a medico-legal concept refers to disability benefits (DB) that are granted due to diseases that permanently reduce work ability. We studied whether an occupational healthcare instrument for the prediction of sickness absence (SA) risk-a health risk appraisal (HRA)-also predicts permanent WD. Methods HRA results were combined with registry data on DB of 22,023 employees from different industry sectors. We analysed how the HRA risk categories predict DB and considered occupational group, gender, age, and prior SA as confounding variables. Cumulative incidence function illustrates the difference between the HRA risk categories, and the Fine-Gray model estimates the predictors of WD during 6-year follow-up. Results The most common primary reasons for permanent WD were musculoskeletal (39%) and mental disorders (21%). Self-reported health problems in the HRA, labelled as "WD risk factors", predicted DB when controlling for age and prior SA. Hazard ratios were 10.9 or over with the lower limit of the 95% confidence interval 3.3 or over among those with two simultaneous WD risk factors. 14% of the females and 17% of the males with three or more simultaneous WD risk factors had received a DB, whereas the respective figures among those without findings were 1.9% and 0.3%. Conclusions Self-reported health problems in the HRA, especially multiple simultaneous WD risk factors, predict permanent WD among both genders across occupational groups. Screening WD risk with a self-administered questionnaire is a potential means for identifying high-risk employees for targeting occupational healthcare actions.Peer reviewe

Subjective cognitive complaints and permanent work disability : a prospective cohort study

Purpose Work disability (WD) is a medico-legal concept that refers to disability benefits (DB) granted due to diseases. We assessed whether subjective cognitive complaints (SCC)-presenting as self-rated difficulties of concentration, memory, clear thinking, and decision making-predict permanent WD in knowledge-intensive occupations. Methods In this prospective cohort study with up to 7-year follow-up, we combined the SCC questionnaire results with reliable registry data on the DBs of 7161 professional/managerial employees (46% females). We excluded employees who were on long-term sickness absence (SA) or had received a DB at baseline. The exposure variable was the presence of SCC. Age and SA before the questionnaire as a proxy measure of general health were treated as confounders and the analyses were conducted by gender. The outcome variable was a granted DB. The cumulative incidence function illustrates the difference between SCC categories, and the Fine-Gray model estimates the predictors of WD during the 8-year follow-up. Results The annual incidence of DB was 0.15% in the entire cohort: 0.18% among the females, and 0.12% among the males (p = 0.795). The most common primary reasons for permanent WD were mental (36%) and musculoskeletal (20%) disorders. SCC predicted DB in both genders when controlling for age and prior SA. Hazard ratios were 2.9 with a 95% confidence interval 1.4-6.0 for the females and 3.7 (1.8-7.9) for the males. Conclusion Subjective cognitive complaints predict permanent WD in knowledge-intensive occupations. This finding has implications for supporting work ability and preventing work disability among employees with cognitively demanding tasks.Peer reviewe

Using pharmacokinetics for tailoring prophylaxis in people with hemophilia switching between clotting factor products: A scoping review

Abstract The objective of this scoping review is to summarize the current use of pharmacokinetics for tailoring prophylaxis in hemophilia patients switching between clotting factor products. Patients with hemophilia may require switching of clotting factor concentrates due to a variety of factors, but there have been perceived risks associated with switching, such as inhibitor development or suboptimal protection due to inadequate dosing while titrating treatment. Studies that look at patients switching from one clotting factor concentrate to another are categorized in terms of their primary and/or secondary objectives, notably biosimilarity and comparative pharmacokinetic studies and inhibitor development studies. Research on how best to switch concentrates with respect to dosing regimen are lacking, and currently a trial-and-error approach is used for dosing the new factor concentrate. In the future, studies looking at the predictability of pharmacokinetics (PK) of a new factor concentrate based on individual PK knowledge of the original factor concentrate may offer clinical benefit by providing a safer switching approach and protocol.Peer reviewe

Lasten primaariset pahanlaatuiset aivokasvaimet : mitä olemme oppineet?

publishedVersionPeer reviewe

Pienentynyt ferritiinipitoisuus lapsella: Niukat rautavarastot ilman anemiaa

Laadukas tutkimusnäyttö puuttuu rautalisän hyödystä lapsille, joilla ei ole raudanpuuteanemiaa.Lapsia ei tulisi seuloa raudanpuutteen varalta, eikä diagnoosia tehdä yksin seerumin ferritiinipitoisuuden perusteella.Jos lapsella on raudanpuutteeseen sopivia oireita ja ferritiinipitoisuus on pienempi kuin 15 µg/l, suun kautta otettavan rautalisän voi aloittaa, mikäli lapsella ei ole raudan kertymiselle altistavaa sairautta. Hoidon vastetta tulee seurata.Lapselle suoneen annosteltavan rautalääkityksen tarpeen arvioiminen ja toteutus kuuluvat erikoissairaanhoitoon

Pre-and postdiagnosis growth failure, adult short stature, and untreated growth hormone deficiency in radiotherapy-treated long-term survivors of childhood brain tumor

Peer reviewe

Motor Performance in Children Diagnosed with Cancer: A Longitudinal Observational Study

Children with cancer are dealing with different side and long-term effects caused by cancer and its treatments, like vinca-alkaloids, which may have negative effects on motor performance. However, the affected areas of motor performance (aiming and catching, balance, manual dexterity) and the differences in these areas between boys and girls and diagnoses are not frequently reported in a longitudinal design. Therefore, the aim of this study was to investigate how motor performance changes over the course of cancer treatment. The study was conducted with 3-to 16-year-old children with cancer (N = 36) in 2013-2017. The five assessment points were 0, 2, 6, 12 and 30 months from diagnosis. Movement-ABC2 was used to assess motor performance. We found that aiming and catching skills decreased significantly during the follow-up (p p p p p p < 0.05, respectively). Individual monitoring of motor performance with standardized tests and physical activity/exercise programs during and after treatment are needed. </p

Lapsena syövän sairastaneiden myöhäisseurannassa yhtenäinen perusta

Lapsena ja nuorena syövän sairastaneiden myöhäisvaikutusten seurannan pohjaksi on luotu kolmiportainen riskiluokitus. Sen mukainen myöhäisseuranta on käynnistetty jokaisessa yliopistosairaalassa