The influence of psychiatric morbidity on return to paid work after stroke in younger adults: The auckland regional community stroke (ARCOS) study, 2002 to 2003

BACKGROUND AND PURPOSE-: Few data exist on the determinants of return to paid work after stroke, yet participation in employment is vital to a person's mental well-being and role in society. This study aimed to determine the frequency and determinants of return to work, in particular the effect of early psychiatric morbidity, in a population-based study of stroke survivors. METHODS-: The third Auckland Regional Community Stroke (ARCOS) study was a prospective, population-based, stroke incidence study undertaken in Auckland, New Zealand during 2002 to 2003. After a baseline assessment early after stroke, data were collected on all survivors at 1 and 6 months follow-up. Multiple variable logistic regression was used to determine predictors of return to paid work. Data are reported with odds ratios (OR) and 95% confidence intervals (CI). RESULTS-: Among 1423 patients registered with first-ever strokes, there were 210 previously in paid employment who survived to 6 months, of whom 155 (74%) completed the GHQ-28 and 112 (53%) had returned to paid work. Among those cognitively competent, psychiatric morbidity at 28 days was a strong independent predictor of not returning to work (Odds Ratio 0.39; 95% CI 0.22 to 0.80). Non-New Zealand European ethnicity (OR 0.40; 95% CI 0.17 to 0.91), prior part-time, as opposed to full-time, employment 0.36 (0.15 to 0.89), and not being functionally independent soon after the stroke 0.28 (0.13 to 0.59) were the other independent age- and gender-adjusted predictors of not successfully returning to paid work. CONCLUSIONS-: About half of previously employed people return to paid employment after stroke, with psychiatric morbidity and physical disability being independent, yet potentially treatable, determinants of this outcome. Appropriate management of both emotional and physical sequelae would appear necessary for optimizing recovery and return to work in younger adults after stroke

The increasing cost of happiness.

A fundamental question for society is how much happiness does a dollar buy? The accepted view among economists and psychologists is that income has diminishing marginal returns on happiness: money and happiness increase together up to a point after which there is relatively little further gain. In this paper we estimate the relationship between income and subjective wellbeing over a 19-year period focusing on where the greatest change in the marginal return on income occurs and whether this change point has shifted over time. We formally test for the presence of a change point as well as temporal changes in the relationship between income and affective wellbeing (happiness), and income and cognitive wellbeing (life satisfaction), using household economic data from Australia between 2001 and 2019. The results indicate that the change point between affective wellbeing and income has increased over those 19 years faster than inflation (i.e., cost of living). This suggests that inequalities in income may be driving increasing inequities in happiness between the rich and the poor, with implications for health and recent government policy-goals to monitor and improve wellbeing

Scottish Identity in Australia: The Case of Old Sydneians in the Boer War, 1899–1902

Thirteen Old Sydneians lost their lives fighting in South Africa (the Boer War), 1899–1902. Eleven of them are honoured on a memorial board at Sydney Grammar School. The best known of them was Keith Kinnaird Mackellar, killed in 1900. His letters to his sister, Dorothea (the famous poet), are a reminder of the youthful enthusiasm that drove so many young men into the conflic. Another old boy of the School was the famous bush poet, Andrew ‘Banjo’ Paterson, who went to South Africa as a war correspondent. Both men had Scots ancestry and they were among a large contingent of Old Sydneians for whom some form of Scottish identity was meaningful. Altogether, over 150 Old Sydneians fought in South Africa—an unusually high number of volunteers from one school. This paper explores the meaning of Scottish identity for the Grammar old boys who fought and died in South Africa