Differences in sickness absence between self-employed and employed doctors: a cross-sectional study on national sample of Norwegian doctors in 2010

Background Doctors have a low prevalence of sickness absence. Employment status is a determinant in the multifactorial background of sickness absence. The effect of doctors’ employment status on sickness absence is unexplored. The study compares the number of sickness absence days during the last 12 months and the impact of employment status, psychosocial work stress, self-rated health and demographics on sickness absence between self-employed practitioners and employed hospital doctors in Norway. Methods The study population consisted of a representative sample of 521 employed interns and consultants and 313 self-employed GPs and private practice specialists in Norway, who received postal questionnaires in 2010. The questionnaires contained items on sickness absence days during the last 12 months, employment status, demographics, self-rated health, professional autonomy and psychosocial work stress. Results 84% (95% CI 80 to 88%) of self-employed and 60% (95% CI 55 to 64%) of employed doctors reported no absence at all last year. In three multivariate logistic regression models with sickness absence as response variable, employment category was a highly significant predictor for absence vs. no absence, 1 to 3 days of absence vs. no absence and 4 to 99 days of absence vs. no absence), while in a model with 100 or more days of absence vs. no absence, there was no difference between employment categories, suggesting that serious chronic disease or injury is less dependent on employment category. Average or poor self-rated health and low professional autonomy, were also significant predictors of sickness absence, while psychosocial work stress, age and gender were not. Conclusion Self-employed GPs and private practice specialist reported lower sickness absence than employed hospital doctors. Differences in sickness compensation, and organisational and individual factors may to a certain extent explain this finding

Understanding the relationship between subjective health complaints and satisfaction with life for people in prevocational training in Norway

publishedVersio

Understanding the relationship between subjective health complaints and satisfaction with life for people in prevocational training in Norway

Background and aim: In Norway, a large part of the population is dependent on disability benefits. The main reasons for this are related to long-term musculoskeletal pain and psychological complaints. Prevocational rehabilitation, aimed at increasing participation in working life, targets people in need of a sheltered vocational environment. This group has been found to report a very high level of health complaints. Therefore, a better understanding of the psychological mechanisms affecting satisfaction with life for people who experience subjective health complaints could be important for tailoring more optimal vocational rehabilitation initiatives for these individuals. This study aimed to investigate the possible mediator role of basic psychological need satisfaction, described in self-determination theory, in the relationship between subjective health complaints and satisfaction with life. Methods: A total of 201 adult participants attending prevocational training on care farms in Norway answered a questionnaire, including demographic questions and standardised instruments on subjective health complaints, basic psychological need satisfaction and satisfaction with life. Analyses were conducted using a structural equation model. Results: Most of the participants had been out of work for more than one year, had a high prevalence of subjective health complaints and a low level of satisfaction with life. The structural equation model showed that basic psychological need satisfaction mediated the negative association between psychological health complaints and satisfaction with life. Conclusion: The results indicate that even though health complaints remain, prevocational programs can counteract some of the negative associations between subjective health complaints and satisfaction with life by creating contexts that support basic psychological needs that are important for well-being and functioning. Providing clients with understanding, guidance, positive feedback, meaningful tasks and a close, supportive social community, has been found to facilitate satisfaction of basic psychological needs in prevocational training on care farmspublishedVersio

Scenarios for biodegradable solid waste management and energy recovery in the 'A' Ward in Mumbai, India

Introduction. Mumbai is one of the most highly-populated cities in the world and the commercial capital of India. Every day, about 6500 tons of municipal solid waste (MSW) and 2500 tons of construction and demolition waste are generated. The collection efficiency in Mumbai is relatively high for an Indian city, but there is a paucity of space for landfilling.. With the introduction of the Municipal Solid Waste (Management & Handling) Rules, 2000, biodegradable wastes could not be landfilled without prior processing.. To find a solution to this, the Municipal Corporation of Greater Mumbai (MCGM) entrusted a consultancy with the task of determining solutions to the city's waste treatment challenges in the short-, medium-, and long-term. The report, which was readied in year- 2006 recommended the capping of the currently-operating landfills accompanied by landfill-gas (methane) capture, financed through the clean development mechanism. Further, it advised the MCGM to compost 6000 tons of mixed MSW and subject 500 tons of separately-collected market and restaurant wastes to biomethanation daily. The latter solution originates from the MSW rules which state that this fraction should be separately collected and used. This solution would also incur the lowest tipping fees.. Thus, centralised solutions can be beneficial and also more economical. The reaction to there recommendation has been from many that the civil societies role in waste handling have been rejected and that decentralised solutions are more beneficiary and cheaper. Objectives. This study has therefore focused on decentralised and on-site treatment solutions of biodegradable solid wastes, in preference to the conventional, in-vogue centralised solution. The peninsular tip of the city which is an affluent area of Mumbai – the A ward – was selected as the study area. If treatment of waste could be commercially viable, was the driver behind the study. Methods. Material flow analysis of the flow of biodegradable waste has been applied as a basis for this study. Material flow cost accounting has also been carried out. A stakeholder analysis has been performed in order to understand how the system would be influenced by differing perceptions and interests of the stakeholders associated with it. Scenario for treating all the waste of 'A' ward onsite, decentralised and centralised was compared to the current situation. Results. Commercial and institutions were the largest generators in the 'A' ward, and was closely followed by the residences. The generators of waste were the primary stakeholders and the waste managers were the secondary. If all the waste were to be treated on-site of generation, the net cost of SWM services would almost be eliminated. Decentralised and centralised solution had almost the same net cost. On-site or decentralised treatment would require 0.3% of the total area of 'A' ward. Conclusion. The MSW rules which came into force in year-2000 address the health, hygiene and environmental goals quite satisfactorily and degree of compliance to these rules is a good proxy for the level of hygiene and environmental upkeep. In a low-income country, cost-efficiency of SWM services is crucial. Were labour is cheap, costs could also serve as indicator of resource conservation. It should also be mentioned that resource recovery also has several economic, environmental and social side-benefits as well. Tools of industrial ecology like material flow analysis are important for decision support regarding this, however in depth study of the objectives and context of the study should be conducted before deciding on the method

Klimagassutslipp i skogbruket : tiltak og allokeringsmodeller

Klimagassutslipp fra norsk skogbruk har tidligere blitt beregnet av Timmermann og Dibdiakova (2013). Skogindustriens kunder etterspør i økende grad om miljødokumentasjon for produktene de kjøper, for eksempel miljødeklarasjoner (EPDer). Det er derfor viktig at oppdaterte data for klimautslipp er tilgjengelige for alle treslag og materialkvaliteter som industrien benytter som råstoff (dvs. tømmersortimenter), og at det gjennomføres beregninger med alle aktuelle metoder for allokering av utslipp. I studien beregnes og allokeres utslipp for fem relevante problemstillinger: I) Produktspesifikke beregninger for enkeltår, II) Produktspesifikke beregninger for en periode, III) Produktspesifikke beregninger basert på historiske data, IV) Produktspesifikke utslipp av gjødsling av skog og V) Produktspesifikke utslipp på regionalt nivå. Beregningene viser at beregnede klimagassutslipp kan variere betydelig (opptil 30%) avhengig av valg av

Klimagassutslipp i skogbruket : tiltak og allokeringsmodeller

Klimagassutslipp fra norsk skogbruk har tidligere blitt beregnet av Timmermann og Dibdiakova (2013). Skogindustriens kunder etterspør i økende grad om miljødokumentasjon for produktene de kjøper, for eksempel miljødeklarasjoner (EPDer). Det er derfor viktig at oppdaterte data for klimautslipp er tilgjengelige for alle treslag og materialkvaliteter som industrien benytter som råstoff (dvs. tømmersortimenter), og at det gjennomføres beregninger med alle aktuelle metoder for allokering av utslipp. I studien beregnes og allokeres utslipp for fem relevante problemstillinger: I) Produktspesifikke beregninger for enkeltår, II) Produktspesifikke beregninger for en periode, III) Produktspesifikke beregninger basert på historiske data, IV) Produktspesifikke utslipp av gjødsling av skog og V) Produktspesifikke utslipp på regionalt nivå. Beregningene viser at beregnede klimagassutslipp kan variere betydelig (opptil 30%) avhengig av valg av.Climate gas emissions from Norwegian forestry have previously been estimated by Timmermann og Dibdiakova (2013). The Norwegian forest industry is increasingly being requested for environmental documentation by it´s customers, e.g. Environmental Product Declarations (EPDs). It is therefore important that data on climate gas emissions are available for all industrial wood species consumed by the domestic industry. Methods for allocation of climate gas emissions to wood products can be improved. In the study, emissions of estimates for five relevant scenarios are presented: I) Estimations based on data from single years, II) Estimations based on calculated averages, III) Estimates based on data from when measures actually took place, IV) Sensitivity analysis on effects of fertilization, and V) Estimates based on regional data. The estimates indicate that results from the five scenarios differ by up to 30 % for single products