scholarly journals Disability insurance benefit application in Switzerland: an analysis of linked administrative and survey data

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Szilvia Altwicker-Hámori
Keyword(s):  
Social Protection ◽  
Disability Insurance ◽  
P Value ◽  
Related Phenomenon ◽  
Related Activity ◽  
Gainful Employment ◽  
Adverse Health Effects ◽  
Insurance Benefit ◽  
Health Related

Abstract Background The guiding principle of disability insurance in Switzerland is ‘rehabilitation before pension’. Access to rehabilitation measures to restore, maintain or improve the earning capacity of individuals with disabilities is essential. Gainful employment enables them to be an active part of society, improves their quality of life, and may mitigate the adverse health effects of disability pension receipt. The aim of this study was therefore to identify factors for disability insurance benefit application in Switzerland. Methods A novel dataset was created linking the 2010 Social Protection and Labour Market cross-section with administrative register data on disability insurance benefit application (2009–2018). Multiple logistic regression was employed to examine the associations between long-term health-related activity limitation, region of residence, demographic and socioeconomic characteristics and disability insurance benefit application in adults aged 18–55 (N = 18,448). Sensitivity analysis based on age was performed in individuals aged 18 to retirement age and aged 25 to 55. Results The regression results showed higher odds of disability insurance benefit application for individuals suffering from long-term health-related activity limitations (OR 2.88; 95% CI 1.29–6.44; p-value 0.010); born outside of Switzerland (OR 1.75; 95% CI 1.32–2.32; p-value 0.000); living without a working partner (OR 1.54; 95% CI 1.17–2.02; p-value 0.002); living without a child aged 0–14 years (OR 1.70; 95% CI 1.29–2.26; p-value 0.000); aged 18–39 (OR 1.41; 95% CI 1.09–1.83; p-value 0.009); with a learnt occupation in ‘Manufacturing’ (OR 2.75; 95% CI 1.68–4.50; p-value 0.000), ‘Construction and mining’ (OR 2.03; 95% CI 1.13–3.66; p-value 0.018), ‘Trade and transport’ (OR 2.12; 95% CI 1.30–3.45; p-value 0.003), ‘Business and administration’ (OR 1.68; 95% CI 1.03–2.72; p-value 0.036), and ‘Health, teaching, culture and science’ (OR 1.55; 95% CI 1.05–2.29; p-value 0.026); and renters (OR 1.44; 95% CI 1.00–1.94; p-value 0.016). The results were robust to alternative samples defined by age – albeit with some differences in regional and learnt occupational patterns. Conclusions The results suggested that disability insurance benefit application is more than a health-related phenomenon in Switzerland. However, the results provided a less consistent picture on the role of marginalization in application than in other European countries.

736 PL11.04 HEALTH-RELATED QUALITY OF LIFE OF PATIENTS WITH ESOPHAGEAL CANCER FOLLOWING ESOPHAGECTOMY TREATED WITH NEOADJUVANT CHEMORADIOTHERAPY OR CHEMOTHERAPY: EUROPEAN MULTICENTER STUDY

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Nannet Schuring ◽  
Sheraz Markar ◽  
Eliza R C Hagens ◽  
Egle Jezerskyte ◽  
Mirjam A G Sprangers ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Neoadjuvant Chemoradiotherapy ◽  
P Value ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Mean ◽  
Eortc Qlq

Abstract   Curative treatment for patients with esophageal cancer consists of neoadjuvant treatment and radical surgical resection. Two different strategies exist; patients can either be treated with perioperative chemotherapy (CT) or neoadjuvant chemoradiotherapy (CRT). Both strategies improve 5-year survival rates, it is however not known if these treatments affect long-term Health-Related Quality of Life (HR-QoL) differently. The aim of this study was to compare HR-QoL between patients following CT and CRT followed by esophagectomy for esophageal cancer. Methods The LASER study database comprises data of a multicenter European study, with focus on HR-QoL among disease-free patients at least one year following an esophagectomy for esophageal or junctional cancer. Included patients completed the LASER, EORTC-QLQ-C30 and EORTC-QLQ-OG25 questionnaires. From this database we extracted patients either treated with CT or CRT for analysis. The primary endpoint was the mean difference in all long-term HR-QoL domains and LASER key symptom scores, using univariable and multivariable logistic regression analysis. The secondary endpoint was to compare the reported HR-QoL domain scores in the study population to the reference values of the general population. Results Among the 565 included patients, 349 (61.8%) received CRT, and 216 (38.2%) were treated with CT. The mean age was 63.7 years (±SD 8.6), and mean time since surgery was 4.3 years (±SD 1.7). After multivariable analysis, patients treated with CT reported worse outcomes on ‘Social Functioning’ (∆means 4.56, p-value<0.05), more symptomatology on domains ‘Insomnia’ (∆means 5.65 p-value<0.05) and ‘Diarrhea’ (∆means 5.93 p-value<0.05) of the QLQ-C30 questionnaire, and more symptomatology on domains ‘Reflux’ (∆means 7.40, p-value<0.05), ‘Odynophagia’(∆means 4.66 p-value<0.05) and ‘Pain and discomfort’(∆means 4.34, p-value<0.05) of the QLQ-OG25 questionnaire. No differences were observed for the LASER key symptoms. Conclusion Significant differences in favor of CRT were observed in several long-term HR-QoL domains for patients following esophagectomy for cancer. However, none of the observed differences in the reported long-term HR-QoL domains between patients treated with CT or with CRT, were clinically relevant (∆means≠ ≥ 10 points). Selection of neoadjuvant therapy should therefore be based on patient characteristics.

scholarly journals Evolution of the health-related activity of the trade unions of Galicia in the early-XIX XX centuries

2021 ◽  
Vol 26 (3) ◽  
pp. 197-204
Author(s):  
I.R. Berest ◽  
R.Ya. Berest ◽  
M.S. Pasichnyk ◽  
S.M. Pasichnyk ◽  
H.M. Savchuk ◽  
...  
Keyword(s):  
Trade Unions ◽  
Social Protection ◽  
Professional Organization ◽  
Practical Significance ◽  
Medical Society ◽  
Related Activity ◽  
Systematic Analysis ◽  
Trade Union Movement ◽  
Health Related ◽  
History Of

Based on the prin­ciple of historicism, systematic analysis, scientific and objective approach, the article analyzes the evolution and shows the activities of the Galician trade unions in health-related activity. The current state and development of historiography of the issue is shown, the history of the medical and trade union movement is studied, it is proved that common problems for all segments of the population became the main event among the trade unions of the early-XIX XX centuries. These issues provide significant material for the scientific study of other key issues of the complex history of Galicia in the Austro-Hungarian period, in particular: the organization of health care, medical education, governance, economic and social development, the rise of the Ukrainian national movement and the like. In the conditions of building democratic institutions of independent Ukraine, the analysis and accumulation of historical experience have not only scientific, but also cognitive, ideological-political and especially applied, practical significance. Almost any professional organization has tried to protect its members in some way. In early 1867, doctors in Lviv recognized the need to create their own professional association to organize social protection, to create a fund to support sick, infirm and impoverished colleagues, as well as their widows and orphans. Thus, it was decided to establish a separate Medical Society. In accordance with the provisions of the statute, the purpose of the Society of Galician Physicians was to work together on the development of medicine, primarily in the direction of its practical application, taking into account the relations of the population as a whole; promoting a spirit of cohesion and friendship between health professionals to jointly oversee medical affairs; providing material assistance to impoverished colleagues, families of deceased colleagues. Similar tasks were set by the societies of printers, weavers, and oil refiners. All of them were united by the medical and health-improving activity.

scholarly journals Data Visualization to Promote Understanding of the Community Health Impact of the Flint Water Crisis

2021 ◽  
Vol 10 (3) ◽  
Author(s):  
Annika Nikhar ◽  
Daniel Kruger
Keyword(s):  
Water Quality ◽  
Tap Water ◽  
Water Source ◽  
Health Impact ◽  
Water Crisis ◽  
Adverse Health Effects ◽  
Health Related ◽  
Tap Water Quality ◽  
The Times

Between 2014 to 2015, the city of Flint suffered from critically contaminated water that caused long-term adverse health effects for many of its residents. In 2017, the “Speak to Your Health!” Community Survey assessed various aspects of adult Flint residents’ health. In addition to the health-related assessments, there were also questions about residents’ tap water quality, including during the times of Flint’s water crisis. This project used results from the survey on how water turbidity levels affected the number of days when poor mental and physical health interfered with daily activities. Diagramming software was used to create images representing this relationship in intuitive formats. These data visualizations are intended to boost data literacy among non-researchers, particularly the people and policymakers of Flint. Given that the crisis ensued after Flint’s water source was switched without proper infrastructure in place to ensure appropriate water quality, causing the population to suffer long term health, social, and economic complications, it is hoped that these results will be used to empower the population of Flint to advocate for continued investment in remediation and prevent future similar health crises.  

scholarly journals Shiftwork Organization

2020 ◽  
pp. 403-412
Author(s):  
Giovanni Costa ◽  
Eleonora Tommasi ◽  
Leonardo Giovannini ◽  
Nicola Mucci
Keyword(s):  
Circadian Rhythm ◽  
Cardiovascular Diseases ◽  
Shift Work ◽  
Well Being ◽  
Adverse Health Effects ◽  
Patient Health ◽  
Health Related ◽  
And Performance ◽  
Health And Well Being

AbstractIn healthcare companies, shiftwork organization is fundamental to ensure continuous 24-h patient care. This chapter gives an overview of health-related problems associated with shift work and the preventative actions that can be taken to protect workers’ health and well-being. Shift work, in particular night work, results in a disruption of biological circadian rhythms with serious social and psychophysical ramifications for the worker. The adverse health effects of shift work can be both in the short-term (sleep, digestive, mental, and menstrual disorders) and in the medium- to long-term (increased gastrointestinal, neuropsychic, metabolic, and cardiovascular diseases). In 2007, the IARC classified shift work as “probable carcinogen” for humans due to the destructive effects on the circadian rhythm. The modification of the sleep/wake cycle also negatively influences worker’s vigilance and performance (“jet-lag syndrome”) leading to a consequently greater risk of accidents and errors. Shift work can be harmful to the safety of both the worker and the patient. Appropriate shift scheduling that respects ergonomic criteria is important to protect worker and patient health and well-being. Medical residents should be conscious of the legislation and rights regarding shift work to ensure they provide appropriate assistance to patients and to preserve their own social and psychophysical well-being.

Isolated Liner Revision for Total Knee Arthroplasty Instability: A Road That Should Remain Less Taken

2020 ◽  
Author(s):  
Jason D. Tegethoff ◽  
Rafael Walker-Santiago ◽  
William M. Ralston ◽  
James A. Keeney
Keyword(s):  
Total Knee Arthroplasty ◽  
Femoral Component ◽  
Knee Arthroplasty ◽  
Primary Total Knee Arthroplasty ◽  
P Value ◽  
Surgical Morbidity ◽  
Exact Test ◽  
Total Knee ◽  
Component Revision

AbstractIsolated polyethylene liner exchange (IPLE) is infrequently selected as a treatment approach for patients with primary total knee arthroplasty (TKA) prosthetic joint instability. Potential advantages of less immediate surgical morbidity, faster recovery, and lower procedural cost need to be measured against reoperation and re-revision risk. Few published studies have directly compared IPLE with combined tibial and femoral component revision to treat patients with primary TKA instability. After obtaining institutional review board (IRB) approval, we performed a retrospective comparison of 20 patients treated with IPLE and 126 patients treated with tibial and femoral component revisions at a single institution between 2011 and 2018. Patient demographic characteristics, medical comorbidities, time to initial revision TKA, and reoperation (90 days, <2 years, and >2 years) were assessed using paired Student's t-test or Fisher's exact test with a p-value <0.01 used to determine significance. Patients undergoing IPLE were more likely to undergo reoperation (60.0 vs. 17.5%, p = 0.001), component revision surgery (45.0 vs. 8.7%, p = 0.002), and component revision within 2 years (30.0 vs. 1.6%, p < 0.0001). Differences in 90-day reoperation (p = 0.14) and revision >2 years (p = 0.19) were not significant. Reoperation for instability (30.0 vs. 4.0%, p < 0.001) and infection (20.0 vs. 1.6%, p < 0.01) were both higher in the IPLE group. IPLE does not provide consistent benefits for patients undergoing TKA revision for instability. Considerations for lower immediate postoperative morbidity and cost need to be carefully measured against long-term consequences of reoperation, delayed component revision, and increased long-term costs of multiple surgical procedures. This is a level III, case–control study.

Historical and medical aspects of the organization of medical and social services for the elderly and senile people in Russia in the late XX — early XXI centuries

2020 ◽  
pp. 49-57
Author(s):  
Lyudmila Kaspruk
Keyword(s):  
Health Care ◽  
Social Services ◽  
Social Protection ◽  
The Elderly ◽  
Primary Role ◽  
Primary Health ◽  
Geriatric Service ◽  
Delivery Of Medical Care ◽  
Older Citizens

When analyzing the historical and medical aspects of the organization of medical and social services for the elderly and senile people in Russia in the late XX — early XXI centuries not only obvious achievements in this sphere, but also a number of problems requiring solution were identified. The primary role in the delivery of medical care to geriatric patients is assigned to the primary health care sector. However the work of the geriatric service in the format of a single system for the provision of long-term medical and social care based on the continuity of patient management between differ- ent levels of the health care system and between the health and social protection services is not well organized. There is no clear coordination and interaction between health care and social protection institutions, functions of which include providing care to older citizens, and it significantly reduces the effectiveness of the provision of both medical and social services.

Thrombopoietin Receptor Agonists in Children with Immune Thrombocytopenia: A New Therapeutic Era

2020 ◽  
Vol 20 ◽  
Author(s):  
Giuseppe Lassandro ◽  
Valentina Palladino ◽  
Giovanni Carlo Del Vecchioa ◽  
Viviana Valeria Palmieri ◽  
Paola Carmela Corallo ◽  
...  
Keyword(s):  
Immune Thrombocytopenia ◽  
Treatment Options ◽  
Thrombopoietin Receptor Agonists ◽  
Receptor Agonists ◽  
Thrombopoietin Receptor ◽  
Related Quality ◽  
Health Related

Background and Objective: Immune thrombocytopenia (ITP) is a common bleeding disorder in childhood. The management of ITP in children is controversial, requiring personalized assessment of patients and therapeutic choices. Thrombopoietin receptor agonists (TPO-RAs), eltrombopag and romiplostim, have been shown to be safety and effective for the treatment of pediatric ITP. The aim of our research is defining the role of thrombopoietin receptor agonists in the management of pediatric ITP. Method: This review focuses on the use of TPO-RAs in pediatric ITP, in randomized trials and in clinical routine, highlighting their key role in management of the disease. Results: Eltrombopag and romiplostim appear effective treatment options for children with ITP. Several clinical studies have assessed that the use of TPO-RAs increases platelet count, decreases bleeding symptoms and improves health-related quality of life. Moreover, TPO-RAs are well tolerated with minor side effects. Conclusion: Although TPO-RAs long term efficacy and safety still require further investigations, their use is gradually expanding in clinical practice of children with ITP.

scholarly journals The impact of lymphedema on health-related quality of life up to 10 years after breast cancer treatment

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Mads G. Jørgensen ◽  
Navid M. Toyserkani ◽  
Frederik G. Hansen ◽  
Anette Bygum ◽  
Jens A. Sørensen
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Treatment ◽  
Breast Cancer Treatment ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Impact

AbstractThe impact of breast cancer-related lymphedema (BCRL) on long-term quality of life is unknown. The aim of this study was to investigate the impact of BCRL on health-related quality of life (HRQoL) up to 10 years after breast cancer treatment. This regional population-based study enrolled patients treated for breast cancer with axillary lymph node dissection between January 1st 2007 and December 31th 2017. Follow up and assessments of the included patients were conducted between January 2019 and May 2020. The study outcome was HRQoL, evaluated with the Lymphedema Functioning, Disability and Health Questionnaire, the Disabilities of the Arm, Shoulder and Hand Questionnaire and the Short Form (36) Health Survey Questionnaire. Multivariate linear logistic regression models adjusted for confounders provided mean score differences (MDs) with 95% confidence intervals in each HRQoL scale and item. This study enrolled 244 patients with BCRL and 823 patients without BCRL. Patients with BCRL had significantly poorer HRQoL than patients without BCRL in 16 out of 18 HRQoL subscales, for example, in physical function (MDs 27, 95%CI: 24; 30), mental health (MDs 24, 95%CI: 21; 27) and social role functioning (MDs 20, 95%CI: 17; 23). Age, BMI, BCRL severity, hand and dominant arm affection had only minor impact on HRQoL (MDs < 5), suggesting a high degree of inter-individual variation in coping with lymphedema. This study showed that BCRL is associated with long-term impairments in HRQoL, especially affecting the physical and psychosocial domains. Surprisingly, BCRL diagnosis rather than clinical severity drove the largest impairments in HRQoL.

Repeated Occupational Exposure to Low-level Blast in the Canadian Armed Forces: Effects on Hearing, Balance, and Ataxia

2021 ◽  
Author(s):  
Ann Nakashima ◽  
Oshin Vartanian ◽  
Shawn G Rhind ◽  
Kristen King ◽  
Catherine Tenn ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Occupational Exposure ◽  
Armed Forces ◽  
Cross Sectional ◽  
Low Level ◽  
Additional Information ◽  
Adverse Health Effects ◽  
Blast Overpressure ◽  
Blast Exposure

ABSTRACT Introduction Recently, there has been increasing concern about the adverse health effects of long-term occupational exposure to low-level blast in military personnel. Occupational blast exposure occurs routinely in garrison through use of armaments and controlled blast detonations. In the current study, we focused on a population of breaching instructors and range staff. Breaching is a tactical technique that is used to gain entry into closed spaces, often through the use of explosives. Materials and Methods Initial measurements of blast overpressure collected during breaching courses found that up to 10% of the blasts for range staff and up to 32% of the blasts for instructors exceeded the recommended 3 psi exposure limit. Using a cross-sectional design, we used tests of balance, ataxia, and hearing to compare a sample of breachers (n = 19) to age-and sex-matched military controls (n = 19). Results There were no significant differences between the two groups on the balance and ataxia tests, although the average scores of both groups were lower than would be expected in a normative population. The prevalence of hearing loss was low in the breacher group (4 of 19), and hearing thresholds were not significantly different from the controls. However, the prevalence of self-reported tinnitus was significantly higher in the breacher group (12 of 19) compared with the controls (4 of 19), and all breachers who were identified as having hearing loss also reported tinnitus. Conclusions Our results suggest that basic tests of balance, ataxia, and hearing on their own were not sensitive to the effects of long-term occupational exposure to low-level blast. Some of the blast exposure levels exceeded limits, and there was a significant association of exposure with tinnitus. Future studies should supplement with additional information including exposure history and functional hearing assessments. These findings should be considered in the design of future acute and longitudinal studies of low-level blast exposure.

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