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      Employment and Chronic Diseases: Suggested Actions for The Implementation of Inclusive Policies for The Participation of People with Chronic Diseases in the Labour Market

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          Abstract

          In recent decades, the number of people living with one or more chronic diseases has increased dramatically, affecting all sectors of society, particularly the labour market. Such an increase of people with chronic diseases combined with the aging of working population affects income levels and job opportunities, careers, social inclusion and working conditions. Both legislation and company regulations should take into account the difficulties that workers experiencing chronic diseases may face in order to be able to formulate innovative and person-centred responses to effectively manage this workforce while simultaneously ensuring employee wellbeing and continued employer productivity. The European Joint Action “CHRODIS PLUS: Implementing good practices for Chronic Diseases” supports European Union Member States in the implementation of new and innovative policies and practices for health promotion, diseases prevention and for promoting participation of people with chronic diseases in labour market. Therefore, a Toolbox for employment and chronic conditions has been developed and its aim is to improve work access and participation of people with chronic diseases and to support employers in implementing health promotion and chronic disease prevention activities in the workplace. The Toolbox consists of two independent instruments: the Training tool for managers and the Toolkit for workplaces that have been tested in different medium and large companies and working sectors in several European countries.

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          The effectiveness of workplace health promotion interventions on physical and mental health outcomes – a systematic review of reviews

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            Chronic Diseases and Employment: Which Interventions Support the Maintenance of Work and Return to Work among Workers with Chronic Illnesses? A Systematic Review

            The increase of chronic diseases worldwide impact quality of life, cause economic and medical costs, and make it necessary to look for strategies and solutions that allow people with chronic diseases (PwCDs) to lead an active working life. As part of the CHRODIS Plus Joint European Action project, a systematic review was conducted to identify studies of interventions that support the maintenance of work and return to work (RTW) among workers with chronic illnesses. These interventions should target employees with the following conditions: diabetes, cardiovascular diseases, metabolic vascular syndrome, respiratory diseases, musculoskeletal disorders, mental disorders, and neurological disorders. An extensive search was performed in PubMed, EMBASE, and PsycINFO for English language studies. Included in this review were 15 randomized controlled trials (RCT) for adult employees (aged 18+). We found that workplace-oriented and multidisciplinary programs are the most supportive to RTW and reducing the absence due to illness. In addition, cognitive behavioral therapies achieve positive results on RTW and sick leave. Finally, coaching is effective for the self-management of chronic disease and significantly improved perceptions of working capacity and fatigue.
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              Return to Work Interventions for Cancer Survivors: A Systematic Review and a Methodological Critique

              Cancer patients are more at risk of being unemployed or having difficulties to return to work (RTW) compared to individuals without health concerns, and is thus a major public health issue. The aim of this systematic review is to identify and describe the interventions developed specifically to help cancer patients to RTW after treatment. Two researchers independently screened the articles for inclusion and Critical Appraisal Skills Program (CASP) checklists were used to assess the methodology of the included studies. Ten manuscripts met the inclusion criteria. The type of studies were three quasi-experimental studies, three longitudinal studies, three randomized controlled trials (RCTs) and a qualitative study. RTW interventions were conducted in or outside the hospital (n = 6 and 3 respectively), or both (n = 1). Improvements in RTW were only observed in quasi-experimental studies. No improvement in RTW was noted in RCTs, nor in other measures (e.g., quality of life, fatigue). Lack of statistically significant improvement does not necessarily reflect reality, but may be attributed to non-adapted research methods. This systematic review underscores the need for researches in the RTW field to reach a consensus on RTW criteria and their assessment. Recommendations to this effect are suggested.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                28 January 2020
                February 2020
                : 17
                : 3
                : 820
                Affiliations
                [1 ]Neurologia, Salute Pubblica, Disabilità, Fondazione Irccs Istituto Neurologico Carlo Besta, 20133 Milan, Italy; michela.eigenmann@ 123456istituto-besta.it (M.E.); chiara.scaratti@ 123456istituto-besta.it (C.S.); erika.guastafierro@ 123456istituto-besta.it (E.G.); claudia.toppo@ 123456istituto-besta.it (C.T.); matilde.leonardi@ 123456istituto-besta.it (M.L.)
                [2 ]Finnish Institute for Health and Welfare, 00271 Helsinki, Finland; jaana.lindstrom@ 123456thl.fi (J.L.); eeva.rantala@ 123456thl.fi (E.R.)
                [3 ]Instituto de Salud Carlos III—“Carlos III” Institute for Health, 28029 Madrid, Spain; imaz@ 123456isciii.es
                [4 ]REDISSEC, Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Instituto de Salud Carlos III, 28029 Madrid, Spain
                [5 ]EuroHealthNet, 1000 Brussels, Belgium; a.barnfield@ 123456eurohealthnet.eu (A.B.); a.maassen@ 123456eurohealthnet.eu (A.M.)
                Author notes
                [* ]Correspondence: fabiola.silvaggi@ 123456istituto-besta.it ; Tel.: +390-2394-2188
                Author information
                https://orcid.org/0000-0003-3745-632X
                https://orcid.org/0000-0001-8512-6638
                https://orcid.org/0000-0002-7864-4194
                https://orcid.org/0000-0003-0552-8923
                Article
                ijerph-17-00820
                10.3390/ijerph17030820
                7037802
                32013004
                fa10bd3f-0974-4d6e-b575-54b73b071cbb
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 20 December 2019
                : 23 January 2020
                Categories
                Article

                Public health
                chronic disease,employment,toolbox,policy dialogue,inclusion,public health
                Public health
                chronic disease, employment, toolbox, policy dialogue, inclusion, public health

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