Distribution and labour market incentives in the welfare state – Danish experiences

In recent years, Denmark has been successful in ensuring and maintaining a low unemployment rate. However, almost one third of the working-age population remains dependent on public transfers, a fact which poses questions on both social inclusion and financial pressures on the welfare state. In this paper, we consider more closely the interaction between the social safety net and the need and scope for maintaining a high employment rate in a welfare state of the Scandinavian type. The focus is on the basic dilemma between ambitious distributional goals on the one hand and work incentives on the other. The paper discusses policy issues related to minimizing welfare dependence that improve the transition from welfare to work. We consider these issues in a life cycle perspective considering entry into the labour market, maintenance of labour market contact, and exit from the labour market. Finally, we consider some recent reform proposals and initiatives in Denmark.Incentives to work; Social safety net; Distribution

Risk of being granted disability pension among incident cancer patients before and after a structural pension reform:A Danish population-based, matched cohort study

OBJECTIVE: This study aimed to examine the risk of being granted a disability pension (DP) among incident cancer patients up to five years after diagnosis compared to a match control group, before and after the structural reform of the Danish Disability Pension Act in 2013. METHODS: All 20–60-year-old incident cancer-diagnosed individuals from 2000 to 2015 were identified in the Danish Cancer Registry. A control group, not previously diagnosed with cancer, was identified in Statistics Denmark matched by gender, age, education, and household income. Risk differences (RD) in cumulative incidence proportions of being granted a DP between cancer patients and controls were analyzed before and after the reform. RESULTS: In total, 111 773 incident cancer patients and 506 904 controls were included in the study. Before reform 10 561 cancer patients and 11 231 controls were granted DP; and 2570 cancer patients and 2646 controls were granted DP after the reform. The adjusted RD of being granted DP was significantly higher for cancer patients versus controls at all time points before the reform. The RD increased the most during the first (RD 3.6, 95% CI 3.5–3.7) and second (RD 7.2, 95% CI 7.0–7.4) follow-up year and levelled off the remaining three years. After the reform, the adjusted RD were lower for all 1–5 follow-up years compared to before the reform (RD range 2.8–7.7, 95% CI 2.6–8.1). CONCLUSION: The 2013 reform of the Disability Pension Act reduced the risk of cancer patients being granted DP. The impact on a personal level should be further explored

Structural accommodation of ribonucleotide incorporation by the DNA repair enzyme polymerase Mu

While most DNA polymerases discriminate against ribonucleotide triphosphate (rNTP) incorporation very effectively, the Family X member DNA polymerase μ (Pol μ) incorporates rNTPs almost as efficiently as deoxyribonucleotides. To gain insight into how this occurs, here we have used X-ray crystallography to describe the structures of pre- and post-catalytic complexes of Pol μ with a ribonucleotide bound at the active site. These structures reveal that Pol μ binds and incorporates a rNTP with normal active site geometry and no distortion of the DNA substrate or nucleotide. Moreover, a comparison of rNTP incorporation kinetics by wildtype and mutant Pol μ indicates that rNTP accommodation involves synergistic interactions with multiple active site residues not found in polymerases with greater discrimination. Together, the results are consistent with the hypothesis that rNTP incorporation by Pol μ is advantageous in gap-filling synthesis during DNA double strand break repair by nonhomologous end joining, particularly in nonreplicating cells containing very low deoxyribonucleotide concentrations

Long-Term Prognostic Importance of Diabetes After a Myocardial Infarction Depends on Left Ventricular Systolic Function

Objective: This study was performed to understand how left ventricular function modulates the prognostic importance of diabetes after myocardial infarction (MI). Research Design and Methods: Consecutively hospitalized MI patients screened for three clinical trials were followed for a median of 7 years. Multivariable Cox regression models were used to assess the risk of mortality associated with diabetes, and the importance of diabetes was examined independently within defined left ventricular ejection fraction (LVEF) subgroups. Results: A total of 16,912 patients were included; 1,819 (11%) had diabetes. Diabetes and 15% unit depression in LVEF were of similar prognostic importance: hazard ratios (HRs) were 1.45 (95% CI 1.37–1.54) and 1.41 (1.37–1.45) for diabetes and LVEF depression, respectively. LVEF modified the outcomes associated with diabetes, with HRs being 1.29 (1.19–1.40) and 1.61 (1.49–1.74) in patients with LVEF <40% and LVEF ≥40%, respectively (P = 0.03). Conclusions: Patients within the higher LVEF categories have a greater mortality risk attributable to diabetes than patients within the lower LVEF categories

Return to the workforce following first hospitalization for heart failure: a Danish nationwide cohort study

Background: Return to work is important financially, as a marker of functional status and for self-esteem in patients developing chronic illness. We examined return to work after first heart failure (HF) hospitalization. Methods: By individual-level linkage of nationwide Danish registries, we identified 21455 patients of working age (18-60 years) with a first HF hospitalization in the period of 1997-2012. Of these 11880 (55%) were in the workforce prior to HF hospitalization and comprised the study population. We applied logistic regression to estimate odds ratios (OR) for associations between age, sex, length of hospital stay, level of education, income, comorbidity and return to work. Results: One year after first HF hospitalization, 8040 (67.7%) returned to the workforce, 2981 (25.1%) did not, 805 (6.7%) died and 54 (0.5%) emigrated. Predictors of return to work included younger age (18-30 vs. 51-60 years, OR 3.12; 95% CI 2.42-4.03), male sex (OR 1.22 [1.18-1.34]) and level of education (long-higher vs. basic school OR 2.06 [1.63-2.60]). Conversely, hospital stay &gt;7 days (OR 0.56 [0.51-0.62]) and comorbidity including history of stroke (OR 0.55 [0.45-0.69]), chronic kidney disease (OR 0.46 [0.36-0.59]), chronic obstructive pulmonary disease (OR 0.62 [0.52-0.75]), diabetes (OR 0.76 [0.68-0.85]) and cancer (OR 0.49 [0.40-0.61]) were all significantly associated with lower chance of return to work. Conclusions: Patients in the workforce prior to HF hospitalization had low mortality but high risk of detachment from the workforce one year later. Young age, male sex, and higher level of education were predictors of return to work

Implementation of neck/shoulder exercises for pain relief among industrial workers: A randomized controlled trial

BACKGROUND: Although leisure-time physical activity is important for health, adherence to regular exercise is challenging for many adults. The workplace may provide an optimal setting to reach a large proportion of the adult population needing regular physical exercise. This study evaluates the effect of implementing strength training at the workplace on non-specific neck and shoulder pain among industrial workers. METHODS: Cluster-randomized controlled trial involving 537 adults from occupations with high prevalence of neck and shoulder pain (industrial production units). Participants were randomized to 20 weeks of high-intensity strength training for the neck and shoulders three times a week (n = 282) or a control group receiving advice to stay physically active (n = 255). The strength training program followed principles of progressive overload and periodization. The primary outcome was changes in self-reported neck and shoulder pain intensity (scale 0-9). RESULTS: 85% of the participants followed the strength training program on a weekly basis. In the training group compared with the control group, neck pain intensity decreased significantly (-0.6, 95% CI -1.0 to -0.1) and shoulder pain intensity tended to decrease (-0.2, 95% CI -0.5 to 0.1, P = 0.07). For pain-cases at baseline (pain intensity > = 3) the odds ratio - in the training group compared with the control group - for being a non-case at follow-up (pain intensity < 3) was 2.0 (95% CI 1.0 to 4.2) for the neck and 3.9 (95% CI 1.7 to 9.4) for the shoulders. CONCLUSION: High-intensity strength training relying on principles of progressive overload can be successfully implemented at industrial workplaces, and results in significant reductions of neck and shoulder pain. TRIAL REGISTRATION: NCT01071980

Amyloid-β and α-Synuclein Decrease the Level of Metal-Catalyzed Reactive Oxygen Species by Radical Scavenging and Redox Silencing.

The formation of reactive oxygen species (ROS) is linked to the pathogenesis of neurodegenerative diseases. Here we have investigated the effect of soluble and aggregated amyloid-β (Aβ) and α-synuclein (αS), associated with Alzheimer's and Parkinson's diseases, respectively, on the Cu(2+)-catalyzed formation of ROS in vitro in the presence of a biological reductant. We find that the levels of ROS, and the rate by which ROS is generated, are significantly reduced when Cu(2+) is bound to Aβ or αS, particularly when they are in their oligomeric or fibrillar forms. This effect is attributed to a combination of radical scavenging and redox silencing mechanisms. Our findings suggest that the increase in ROS associated with the accumulation of aggregated Aβ or αS does not result from a particularly ROS-active form of these peptides, but rather from either a local increase of Cu(2+) and other ROS-active metal ions in the aggregates or as a downstream consequence of the formation of the pathological amyloid structures.This work was supported by the Villum Foundation (J.T.P., L.H.), the Lundbeck Foundation (J.T.P., K.T.), the Agency for Science, Technology and Research, Singapore (S.W.C.), The Wellcome Trust (C.M.D.) and the Spanish Ministry of Economy and Competitiveness through the Ramon y Cajal ́ program (N.C.).This is the final version of the article. It first appeared from the American Chemical Society via http://dx.doi.org/10.1021/jacs.5b1357