The role of individual and contextual factors in paid employment of workers with a chronic disease

Workers with chronic diseases are at an increased risk of early exit from paid employment. The aim of this thesis was to examine individual and contextual risk factors in early exit from paid employment among workers with common chronic diseases in the Dutch workforce. The results of this thesis show that it is important to not only focus on the disease itself, but to also take unhealthy behaviour and possible other chronic diseases into account. In addition, results show that an unfavourable work or living environment can increase the risk of early exit from paid employment, especially into unemployment and work disability. The findings also suggest that the impact of the psychosocial work environment on early exit from paid employment is rather similar for workers with and without chronic diseases, but differs for workers with depression. Workers with depression do not benefit from more job resources to deal with high job demands at work. Lastly, results of prediction models indicate that risk factors for early exit from paid employment are better examined at the population level rather than at the individual level. Altogether, the results in this thesis support the need for more tailored approaches in supporting workers with chronic diseases at work. This can ultimately contribute to sustainability of the social security system

Simply Swivel Seat - Assistive Device

Poster is of the Simply Swivel Seat - Assistive Device that allows you to sit while entering and exiting the bathtub safely. The seat sits over the edge of the tub and rotates as you lift your legs into or out of the bathtub. The device provides support and minimizes the fear of falling.https://jdc.jefferson.edu/id/1001/thumbnail.jp

La fenomenología de la comorbilidad del trauma y la psicosis

A lo largo de este artículo queremos reflejar cómo la psicosis y el trastorno por estrés postraumático (TEPT) no son entidades tan distintas ni separadas, sino que con frecuencia confluyen y se solapan. Muchas investigaciones nos indican que la prevalencia vital de TEPT en pacientes mentales graves es muy superior a la de la población general. Algunos autores concluyen que algunas personas con sintomatología psicótica desarrollan TEPT como resultado de la propia experiencia psicótica. Durante muchos años los investigadores se han centrado preferentemente en la relación del trauma con síndromes no psicóticos. No obstante, en los últimos años se ha producido un gran interés sobre cómo el trauma puede precipitar o favorecer la aparición de cuadros psicóticos. Por otro lado, parece existir evidencia empírica que señala la existencia de un subtipo TEPT con síntomas psicóticos. Por último, Morrison, Frame y Larkin (2003) plantean, que tanto la psicosis como el TEPT, representan un continuo de respuestas del individuo sometido a un evento traumático. Las similitudes entre ambos trastornos indican que podrían formar parte del mismo espectro de respuestas ante un acontecimiento traumático. No obstante, es preciso indagar el por qué el trauma da lugar un tipo de síntomas u otros. Visto todo lo anterior, el objetivo de este artículo es examinar la naturaleza de las distintas relaciones entre la psicosis y el trauma. Así como, recomendar encarecidamente que se introduzcan protocolos específicos y preguntas rutinarias para detectar y tratar el abuso sexual y físico en pacientes con trastornos psicóticos.Throughout this article we have attempted to show how psychotic disorders and posttraumatic stress disorder (PTSD) are not such distinct or apart entities, on the contrary they frequently come together and overlap. A lot of research has indicated that the vital prevalence of PTSD in severe mental illness is quite superior to that of the general population. Some authors has concluded that some people with psychotic symptoms develop PTSD due to their own psychotic experience. During many years researches have focused on the relation of trauma with non psychotic syndromes. Nonetheless, in recent years a great interest has been raised on how trauma might precipitate the onset of psychosis. Moreover, there is empirical evidence that points out to the existence of PTSD subtype with psychotic symptomatology. Finally, Morrison, Frame y Larkin (2003) proposed that psychosis as well as PTSD represent a continuum of responses of an individual exposed to a traumatic event. The similarities among both disorders indicate that they could form part of a spectrum of post-traumatic responses. However, it is necessary to ascertain why trauma produces a type of symptom or the other. Consequently, the aim of the article is to examine the nature of the different relations between psychosis and trauma. Additionally, it is to recommend earnestly the introduction of specific protocols and routine inquiries to detect and treat sexual and physical abuse for persons with psychotic disorders

Reading or Listening to a Gain- or Loss-Framed Health Message:Effects of Message Framing and Communication Mode in the Context of Fruit and Vegetable Intake

Gain-framed health messages are found to be more effective when targeting prevention behaviors. However, framing research has only minimally investigated the role of communication mode, another important factor in health communication. This study explored the role of communication mode in interaction with message framing, and the influence of two individual differences related to involvement as conditions under which gain framing can lead to health behavior change. Participants (N = 258) were exposed to either an auditory or written health message concerning fruit and vegetable intake, with either gain- or loss-framed arguments. In addition, the online experiment consisted of baseline and posttest measures, among which intention to consume sufficient fruit and vegetables. Moderating effects of perceived baseline fruit and vegetable consumption and baseline intention were assessed. A significant interaction between message framing and communication mode was observed: In case of a gain-framed message, an auditory message resulted in a higher intention than a written message. This pattern was most explicitly found among those with a lower perceived fruit and vegetable intake at baseline. Although further research is warranted in health persuasion research, the findings can possibly be used to target health interventions better at specific groups of people who behave less healthy

Multimorbidity and exit from paid employment:the effect of specific combinations of chronic health conditions

Background This study aimed to assess the association between multimorbidity and exit from paid employment, and which combinations of chronic health conditions (CHCs) have the strongest association with exit from paid employment. Methods Data from 111 208 workers aged 18-64 years from Lifelines were enriched with monthly employment data from Statistics Netherlands. Exit from paid employment during follow-up was defined as a change from paid employment to unemployment, disability benefits, economic inactivity or early retirement. CHCs included cardiovascular diseases (CVD), chronic obstructive pulmonary disease (COPD), rheumatoid arthritis (RA), type 2 diabetes (T2DM) and depression. Cox-proportional hazards models were used to examine the impact of multimorbidity and combinations of CHCs on exit from paid employment. Results Multimorbidity increased the risk of exiting paid employment compared with workers without CHCs (hazard ratio (HR): 1.52; 95% confidence interval (CI): 1.35-1.71) or one CHC (HR: 1.14; 95% CI: 1.01-1.28). The risk for exit from paid employment increased among workers with COPD if they additionally had CVD (HR: 1.39; 95% CI: 1.03-1.88), depression (HR: 1.46; 95% CI: 1.10-1.93) or RA (HR: 1.44; 95% CI: 1.08-1.91), for workers with T2DM if they additionally had CVD (HR: 1.43; 95% CI: 1.07-1.91) or depression (HR: 2.09; 95% CI: 1.51-2.91) and for workers with depression who also had T2DM (HR: 1.68; 95% CI: 1.21-2.32). Conclusion This study showed that workers with multimorbidity, especially having a combination of COPD and depression or T2DM and depression, have a higher risk for early exit from paid employment and, therefore, may need tailored support at the workplace

Influence of changing working conditions on exit from paid employment among workers with a chronic disease

Objectives To investigate the relation between changes in working conditions and exit from paid employment among workers with a chronic disease. Methods Six waves from the longitudinal Study on Transitions in Employment, Ability and Motivation (2010–2016), enriched with tax-based employment information from Statistics Netherlands (2011–2017), were available for 4820 chronically ill workers aged 45–63 years (mean 55.3 years, SD 5.1). A change in working conditions (physical workload, psychological job demands, job autonomy, emotional job demands and social support) was defined as an increase or decrease between two consecutive waves of at least one SD. Discrete-time survival models with repeated measurements were used to estimate the relative risk (RR) of a change in working conditions on exiting paid employment in the following year compared with no change and consecutive favourable working conditions. Results A favourable change in physical workload lowered the risk to exit paid employment (RR 0.46, 95% CI 0.22 to 0.94). An adverse change in psychosocial working conditions, especially a decrease in social support (RR 2.07, 95% CI 1.52 to 2.81), increased the likelihood to exit paid employment. In contrast, a favourable change in psychological job demands increased the risk to exit paid employment (RR 1.57, 95% CI 1.09 to 2.24). Multiple adverse changes increased the risk to exit paid employment up to six times (RR 6.06, 95% CI 2.83 to 12.98). Conclusions Changes in working conditions among workers with chronic diseases influence exit from paid employment. Ensuring that working conditions can be adapted to the needs of workers with a chronic disease may help to extend working life

The influence of unhealthy behaviours on early exit from paid employment among workers with a chronic disease:a prospective study using the Lifelines cohort

OBJECTIVES: This study examined the risk of unhealthy behaviours and the additive effects of multiple unhealthy behaviours on exit from paid employment among workers with a chronic disease and investigated effect modification by gender and educational level. METHODS: Data from the Lifelines cohort, collected between 2006 and 2013, were enriched with registry data from Statistics Netherlands with up to 11 years follow-up. Workers with a chronic disease were selected (n=11,467). The influence of unhealthy behaviours (physical inactivity, smoking, unhealthy diet, high alcohol intake, and obesity) on exit from paid employment (unemployment, disability benefits, early retirement, and economic inactivity) was examined using competing risk models. To examine effect modification by gender and educational level, interaction terms were added. RESULTS: Smoking and low fruit intake increased the risk to exit paid employment through unemployment and disability benefits. Low vegetable intake increased the risk of unemployment, obesity the risk of receiving disability benefits, and high alcohol intake the risk of early retirement. Physical inactivity was not associated with any exit from paid employment. Having multiple unhealthy behaviours increased the risk of both unemployment and of receiving disability. No consistent effect modification for gender or educational level was found. CONCLUSIONS: Unhealthy behaviours increased the risk to exit paid employment through unemployment and disability benefits among workers with a chronic disease, and this risk increased when having multiple unhealthy behaviours. Health promotion to support workers with chronic diseases to make healthier choices may help to extend their working life

Associations of within-individual changes in working conditions, health behaviour and BMI with work ability and self-rated health:a fixed effects analysis among Dutch workers

OBJECTIVES: This study assessed the associations of (1) within-individual improvements and (2) within-individual deteriorations in working conditions, health behaviour and body mass index (BMI) with changes in work ability and self-rated health among workers. DESIGN: Prospective cohort study. SETTING: The Netherlands. PARTICIPANTS: Persons in paid employment, aged 45-64 years, who participated in the Dutch Study on Transitions in Employment, Ability and Motivation (STREAM) between 2010 and 2017, and improved or deteriorated at least once with respect to working conditions (psychological and emotional job demands, autonomy, social support, physical workload), health behaviour (moderate and vigorous physical activity, smoking status), or BMI between any of two consecutive measurements during the 7-year follow-up. PRIMARY AND SECONDARY OUTCOME MEASURES: Changes in self-reported work ability on a scale from 0 to 10 (1st item of the work ability index) and self-rated health on a scale from 1 to 5 (SF-12). RESULTS: Of the 21 856 STREAM participants, ultimately 14 159 workers were included in the fixed effects analyses on improvements (N=14 045) and deteriorations (N=14 066). Workers with deteriorated working conditions decreased in work ability (β's: -0.21 (95% CI: -0.25 to -0.18) to -0.28 (95% CI: -0.33 to -0.24)) and health (β's: -0.07 (95% CI: -0.09 to -0.06) to -0.10 (95% CI: -0.12 to -0.08)), whereas improvements were to a lesser extent associated with increased work ability (β's: 0.06 (95% CI: 0.02 to 0.09) to 0.11 (95% CI: 0.06 to 0.16)) and health (β's: 0.02 (95% CI: 0.00 to 0.03) to 0.04 (95% CI: 0.02 to 0.06)). Workers with increased BMI or decreased physical activity reduced in work ability and health. Likewise, decreased BMI or increased vigorous physical activity was associated with improved health. An increase in moderate or vigorous physical activity was modestly associated with a reduced work ability. Quitting smoking was associated with reduced work ability and health. CONCLUSIONS: Compared with improvements, preventing deteriorations in working conditions, health behaviour and BMI, might be more beneficial for work ability and workers' health

A capital-based approach to better understand health inequalities: Theoretical and empirical explorations

Background: The persistence of health inequalities may be driven by differences in education and income, but also by other economic and non-economic factors. Our aim was to explore how the association between single-dimensional health and socioeconomic status (SES) changes when including health-related person capital, economic capital, social capital, cultural capital and attractiveness and personality capital. Methods: We used a capital-based approach to understand health inequalities. It presumes intertwined relationships between broadly measured health (‘health-related person capital’) and embodied resources (‘attractiveness and personality capital’) on the one hand, and ESC capital, i.e., economic, social, and cultural resources on the other. We used cross-sectional data on 152,592 participants from the Dutch Lifelines cohort study and estimated correlations using partial least squares structural equation modelling. Results: The correlation between SES and health-related person capital (r = 0.15) was stronger than the correlations between SES and single-dimensional health (physical and mental health; r = 0.12 and r = 0.04, respectively). ESC capital, combining economic, social and cultural capital, showed a correlation of 0.34 with health-related person capital. This was stronger than the correlation between health-related person capital and economic capital alone (r = 0.19). Lastly, the correlation between health-related person capital and ESC capital increased when health related, attractiveness and personality resources were combined into a single person capital construct (from r = 0.34 to r = 0.49). Conclusions: This exploratory study shows the empirical interconnectedness of various types of resources, and their potential role in the persistence of health inequalities. Our findings corroborate the idea of considering health as a multidimensional concept, and to extend conventional SES indicators to a broader measurement of economic and non-economic resources

Influence of changing working conditions on exit from paid employment among workers with a chronic disease

Objectives: To investigate the relation between changes in working conditions and exit from paid employment among workers with a chronic disease. Methods: Six waves from the longitudinal Study on Transitions in Employment, Ability and Motivation (2010-2016), enriched with tax-based employment information from Statistics Netherlands (2011-2017), were available for 4820 chronically ill workers aged 45-63 years (mean 55.3 years, SD 5.1). A change in working conditions (physical workload, psychological job demands, job autonomy, emotional job demands and social support) was defined as an increase or decrease between two consecutive waves of at least one SD. Discrete-time survival models with repeated measurements were used to estimate