Is There an Association between Long-Term Sick Leave and Disability Pension and Unemployment beyond the Effect of Health Status? – A Cohort Study

Background: Studies have shown that long-term sick leave is a strong predictor of disability pension. However, few have aimed to disentangle the effect of sick leave and of health status. The objective of this study was to investigate whether there is an association between long-term sick leave and disability pension and unemployment, when taking health status into account. Methods/Principal Findings: The study was based on the Stockholm Public Health Cohort, restricted to 13,027 employed individuals (45.9 % men) aged 18–59 in 2002 and followed until 2007. Hazard ratios (HR) with 95 % Confidence Interval (CI) were estimated by Cox regression models adjusting for socio-demographic factors and five measures of health status. Having been on long-term sick leave increased the risk of disability pension (HR 4.01; 95 % CI 3.19–5.05) and longterm unemployment (HR 1.45; 95 % CI 1.05–2.00), after adjustment for health status. The analyses of long-term sick leave due to specific illness showed that the increased risk for long-term unemployment was confined to the group on sick leave due to musculoskeletal (HR 1.70 95 % CI 1.00–2.89) and mental illness (HR 1.80 95 % CI 1.13–2.88) and further that there was an increased risk for short-term unemployment in the group on sick leave due to mental illness (HR1.57 95%CI 1.09–2.26). Conclusions/Significance: Long-term sick leave increases the risks of both disability pension and unemployment even when taking health status into account. The results support the hypothesis that long-term sick leave may start a process o

PREDICTING CROSS COUNTRY SKIING PERFORMANCE: A COMPARISSON OF TWO DIFFERENT UPPER BODY POWER EGOMETERS

L. Hultin, W. Zhu, K.A. Pribanic, J.L.Terry, D.P. Heil FACSM Montana State University, Bozeman, MT Development of upper body power (UBP) has become an integral part of the training process for competitive cross-country (XC) skiers. Many researchers have found that measures of UBP correlate highly with distance and sprint XC skiing performance. To date, there are two types of ergometers commonly used in research and training settings to measure UBP: 1) A custom-modified rowing ergometer that uses ski poles, and 2) a commercially available ergometer that does not use ski poles. However, no previous study has compared UBP measures from these two types of ergometers to determine whether one correlates better with XC performance. PURPOSE: The purpose of this study was to evaluate the correlational relationships between measures of UBP from two different types of UBP ergometers with distance and sprint cross country ski performance in collegiate and regionally competitive cross country skiers. METHODS: Twenty-two XC skiers (Mean±SD: 10 women, 21±3 yrs, 55.8±4.9 ml/kg/min VO2MAX; 12 men, 20±2 yrs, 67.7±4.4 ml/kg/min VO2MAX) from the Montana State University (MSU) Nordic Ski Team and Bridger Ski Foundation were recruited. The subjects completed four separate tests of UBP on two UBP-specific ergometers on two separate lab visits in random order. Two UBP tests used a custom-modified rowing ergometer developed in the MSU Movement Science/Human Performance Lab (MSL) that incorporates the use of ski poles for 10 s (UBP10MSL) and 60 s (UBP60MSL). The other UBP tests were performed on a commercially available skiing ergometer (SE) for 20 s (UBP20SE)and 60 s (UBP60SE) that did not use ski poles. Lastly, subjects participated in five different ski races: three classic events (1.3 km sprint; 10/15 km distance; 10 km time trail) and two skate events (1.5 km sprint; 10/15 km distance race) from which race speed (RS) was computed. The RS for each race was correlated with all four UBP measures (0.05 alpha). RESULTS: RS correlated highly with all UBP tests (r =0.86-0.95, UBP10MSL; r= 0.83-0.95, UBP60MSL; r= 0.88-0.98, UBP20SE; r= 0.90-0.97, UBP60SE) and all were statistically significant (P \u3c 0.01). CONCLUSION: Upper body power (UBP) measures from both UBP ergometers (i.e., one with poles and another without poles) correlated highly with distance and sprint XC skiing performance in collegiate and regionally competitive XC skiers. When comparing UBP measures from the two different UBP ergometers, no statistical differences were found between the two. Therefore, this study concludes that both ergometers have similar abilities to predict distance and sprint XC skiing performance in a group of collegiate and competitive skiers. Equipment donation from Concept2 CTS, Inc. (Morrisville, VT USA)

Determinants for return to work among sickness certified patients in general practice

<p>Abstract</p> <p>Background</p> <p>Long-term sickness absence is one of the main risk factors for permanent exit out of the labour market. Early identification of the condition is essential to facilitate return to work. The aim of this study was to analyse possible determinants of return to work and their relative impact.</p> <p>Methods</p> <p>All 943 subjects aged 18 to 63 years, sickness certified at a Primary Health Care Centre in Sweden from 1 January until 31 August 2004, were followed up for three years. Baseline information on sex, age, sick leave diagnosis, employment status, extent of sick leave, and sickness absence during the year before baseline was obtained, as was information on all compensated days of sick leave, disability pension and death during follow-up.</p> <p>Results</p> <p>Slightly more than half the subjects were women, mean age was 39 years. Half of the study population returned to work within 14 days after baseline, and after three years only 15 subjects were still on sick leave. In multivariate proportional hazards regression analysis the extent of previous sick leave, age, being on part-time sick leave, and having a psychiatric, musculoskeletal, cardiovascular, nervous disease, digestive system, or injury or poisoning diagnosis decreased the return to work rate, while being employed increased it. Marital status, sex, being born in Sweden, citizenship, and annual salary had no influence. In logistic regression analyses across follow-up time these variables altogether explained 88-90% of return to work variation.</p> <p>Conclusions</p> <p>Return to work was positively or negatively associated by a number of variables easily accessible in the GP’s office. Track record data in the form of previous sick leave was the most influential variable.</p