Resilience by solidary ties

This article considers an empirical approach to the relationships among three well known concepts: “Benevolence” (Schwartz), Solidarity and Resilience ("Subjective wellbeing scale" - SWB). The first concept refers to cultural values, the second one to social networks and the third to the ability to recover from crisis. The measurement of solidarity has been done from the point of view of supportive ties. The baseline hypothesis considers that the presence of a high value in Benevolence contributes to the involvements in solidarity networks. Participation in supportive relationships facilitates recovery from personal crisis. Using data from the European Social Survey (ESS6), we conclude from this structural analysis that the resilience reflected in a society is partly a consequence of the supportive networks shaped by the presence of benevolence values.

Maguk urai – a magyar vállalkozó lelkialkata (A magyarországi kisvállalkozók értékvilágának néhány jellemzője) Their own bosses – The character of the Hungarian entrepreneur (Some aspects of the value system of small entrepreneurs in Hungary)

The study uses the value test developed by Shalom Schwartz to examine the value system of Hungarian entrepreneurs. First, the dataset of the last wave of the European Social Survey is used to define those value orientations which generally distinguish entrepreneurs from the rest of society in Europe. Second, the prevalence of these ‘entrepreneurial values’ in the general populations of various countries, and Hungary in particular, is explored. Third, using compatible data from a survey of 300 Hungarian small entrepreneurs, the value orientations that distinguish them from other European entrepreneurs and Hungarian non-entrepreneurs are examined. Multivariate regression analyses allow us to draw a nuanced value-portrait of the typical Hungarian entrepreneur. The main conclusion is that although Hungarian small entrepreneurs share the ’core values’ of entrepreneurs in Europe, they are less adventurous and less materialist, but held personal freedom and human relations especially dear.

A gyermekvállalás időzítésével kapcsolatos lakossági attitűdök egyes bizonytalansági tényezők tükrében

A fiatalok felnőtté válásának folyamata napjainkban nemcsak egyre későbbi életkorra tolódik ki, de sokszor a mérföldkövek hagyományos sorrendje is felborul. Az egyének maguk építhetik fel ugyan életútjukat, de a döntés és a következményekért történő felelősségvállalás szintén rájuk hárul. Ezzel párhuzamosan a globalizáció által generált gazdasági és társadalmi változások a bizonytalanság növekedését eredményezik az állami, a piaci és az egyéni szereplők szintjén egyaránt. A fiataloknak nemcsak hogy nem állnak rendelkezésükre minták, de az életüket hosszú távra meghatározó döntéseiket ebben a megváltozott, bizonytalan térben kell meghozniuk. Válaszul sokszor elhalasztják a fiatal felnőttkor egyes életeseményeit. Tanulmányunkban a társadalmi gondolkodás oldaláról vizsgáltuk meg a szülővé válás időzítését. A European Social Survey 2008. évi adatai segítségével megmutatjuk egyrészt, mi befolyásolja az egyének elképzeléseit a gyermekvállalás "ideális" életkori normájáról. Másrészt, hogy a közvélemény mely tényezőkben látja a "késői" gyermekvállalás fő okait, s a vélemények miként változnak az alapvető társadalmi és demográfiai ismérvek szerint. Elemzéseinkben kiemelt figyelmet fordítunk a munkanélküliség és az általános bizonytalanság hatására, valamint a szülővé válásra legesélyesebb 26–35 éves korcsoportra.

A gazdasági válság hatásai a férfiak és a nők munkaerő-piaci helyzetére Kelet-Közép-Európában

Tanulmányunkban azt vizsgáljuk, hogyan hatott a 2008-as gazdasági válság a nemek munkaerő-piaci helyzetére Kelet-Közép-Európában. Amellett érvelünk, hogy bár a vizsgált régióban a foglalkozási szegregáció jobban megvédte a női, mint a férfi munkaerőt, azonban a fejlettebb gazdaságokkal szemben itt csökkent a női foglalkoztatás, emelkedett a nők szegénységi rátája. A nemek szerinti különbségek a válság hatásának percepciójában is tetten érhetők voltak. Elemzésünkhöz a European Social Survey 2010-es adatfelvételét és az EU SILC adatait használtuk.

A recessionary debate: who suffered more? A study of sectoral well-being and economic insecurity in Ireland

The aim of this thesis is to identify the relationship between subjective well-being and economic insecurity for public and private sector workers in Ireland using the European Social Survey 2010-2012. Life satisfaction and job satisfaction are the indicators used to measure subjective well-being. Economic insecurity is approximated by regional unemployment rates and self-perceived job insecurity. Potential sample selection bias and endogeneity bias are accounted for. It is traditionally believed that public sector workers are relatively more protected against insecurity due to very institution of public sector employment. The institution of public sector employment is made up of stricter dismissal practices (Luechinger et al., 2010a) and less volatile employment (Freeman, 1987) where workers are subsequently less likely to be affected by business cycle downturns (Clark and Postal-Vinay, 2009). It is found in the literature that economic insecurity depresses the well-being of public sector workers to a lesser degree than private sector workers (Luechinger et al., 2010a; Artz and Kaya, 2014). These studies provide the rationale for this thesis in testing for similar relationships in an Irish context. Sample selection bias arises when a selection into a particular category is not random (Heckman, 1979). An example of this is non-random selection into public sector employment based on personal characteristics (Heckman, 1979; Luechinger et al., 2010b). If selection into public sector employment is not corrected for this can lead to biased and inconsistent estimators (Gujarati, 2009). Selection bias of public sector employment is corrected for by using a standard Two-Step Heckman Probit OLS estimation method. Following Luechinger et al. (2010b), the propensity for individuals to select into public sector employment is estimated by a binomial probit model with the inclusion of the additional regressor Irish citizenship. Job satisfaction is then estimated by Ordinary Least Squares (OLS) with the inclusion of a sample correction term similar as is done in Clark (1997). Endogeneity is where an independent variable included in the model is determined within in the context of the model (Chenhall and Moers, 2007). The econometric definition states that an endogenous independent variable is one that is correlated with the error term (Wooldridge, 2010). Endogeneity is expected to be present due to a simultaneous relationship between job insecurity and job satisfaction whereby both variables are jointly determined (Theodossiou and Vasileiou, 2007). Simultaneity, as an instigator of endogeneity, is corrected for using Instrumental Variables (IV) techniques. Limited Information Methods and Full Information Methods of estimation of simultaneous equations models are assed and compared. The general results show that job insecurity depresses the subjective well-being of all workers in both the public and private sectors in Ireland. The magnitude of this effect differs among sectoral workers. The subjective well-being of private sector workers is more adversely affected by job insecurity than the subjective well-being of public sector workers. This is observed in basic ordered probit estimations of both a life satisfaction equation and a job satisfaction equation. The marginal effects from the ordered probit estimation of a basic job satisfaction equation show that as job insecurity increases the probability of reporting a 9 on a 10-point job satisfaction scale significantly decreases by 3.4% for the whole sample of workers, 2.8% for public sector workers and 4.0% for private sector workers. Artz and Kaya (2014) explain that as a result of many austerity policies implemented to reduce government expenditure during the economic recession, workers in the public sector may for the first time face worsening perceptions of job security which can have significant implications for their well-being (Artz and Kaya, 2014). This can be observed in the marginal effects where job insecurity negatively impacts the well-being of public sector workers in Ireland. However, in accordance with Luechinger et al. (2010a) the results show that private sector workers are more adversely impacted by economic insecurity than public sector workers. This suggests that in a time of high economic volatility, the institution of public sector employment held and was able to protect workers against some of the well-being consequences of rising insecurity. In estimating the relationship between subjective well-being and economic insecurity advanced econometric issues arise. The results show that when selection bias is corrected for, any statistically significant relationship between job insecurity and job satisfaction disappears for public sector workers. Additionally, in order to correct for endogeneity bias the simultaneous equations model for job satisfaction and job insecurity is estimated by Limited Information and Full Information Methods. The results from two different estimators classified as Limited Information Methods support the general findings of this research. Moreover, the magnitude of the endogeneity-corrected estimates are twice as large as those not corrected for endogeneity bias which is similarly found in Geishecker (2010, 2012). As part of the analysis into the effect of economic insecurity on subjective well-being, the effects of other socioeconomic variables and work-related variables are examined for public and private sector workers in Ireland.

Party Members’ Preferences and the Changing Nature of Party Representation: Does Representation Change when Parties become Mini-Republics?

Giovanni Sartori famously wrote that political parties do not need to be mini-republics, yet today parties in many parliamentary democracies are moving in this direction by giving their members direct votes over important decisions, including selecting party leaders and settling policy issues. This paper explores some of the implications of these changes. It asks whether the addition of membership rights affects the types of members who are attracted: do we find a bigger gap between the preferences of party members and of party voters in parties that are more plebiscitary, as literature on members' motivations might lead us to expect? The paper examines this question both cross-sectionally and longitudinally using opinion data from the European Social Survey and newly-available party organizational data from the Political Party Database project.

Modelling and classification with quantile-based distributions

In this work, we explore and demonstrate the potential for modeling and classification using quantile-based distributions, which are random variables defined by their quantile function. In the first part we formalize a least squares estimation framework for the class of linear quantile functions, leading to unbiased and asymptotically normal estimators. Among the distributions with a linear quantile function, we focus on the flattened generalized logistic distribution (fgld), which offers a wide range of distributional shapes. A novel naïve-Bayes classifier is proposed that utilizes the fgld estimated via least squares, and through simulations and applications, we demonstrate its competitiveness against state-of-the-art alternatives. In the second part we consider the Bayesian estimation of quantile-based distributions. We introduce a factor model with independent latent variables, which are distributed according to the fgld. Similar to the independent factor analysis model, this approach accommodates flexible factor distributions while using fewer parameters. The model is presented within a Bayesian framework, an MCMC algorithm for its estimation is developed, and its effectiveness is illustrated with data coming from the European Social Survey. The third part focuses on depth functions, which extend the concept of quantiles to multivariate data by imposing a center-outward ordering in the multivariate space. We investigate the recently introduced integrated rank-weighted (IRW) depth function, which is based on the distribution of random spherical projections of the multivariate data. This depth function proves to be computationally efficient and to increase its flexibility we propose different methods to explicitly model the projected univariate distributions. Its usefulness is shown in classification tasks: the maximum depth classifier based on the IRW depth is proven to be asymptotically optimal under certain conditions, and classifiers based on the IRW depth are shown to perform well in simulated and real data experiments.

The significant effect of endometriosis on physical, mental and social wellbeing: results from an international cross-sectional survey.

STUDY QUESTION To what extent do the management of endometriosis and the symptoms that remain after treatment affect the quality of life in women with the disease? SUMMARY ANSWER Many women with endometriosis had impaired quality of life and continued to suffer from endometriosis-associated symptoms even though their endometriosis has been managed in tertiary care centres. WHAT IS KNOWN ALREADY The existing literature indicates that quality of life and work productivity is reduced in women with endometriosis. However, most studies have small sample sizes, are treatment related or examine newly diagnosed patients only. STUDY DESIGN, SIZE, DURATION A cross-sectional questionnaire-based survey among 931 women with endometriosis treated in 12 tertiary care centres in 10 countries. PARTICIPANTS/MATERIALS, SETTING, METHODS Women diagnosed with endometriosis who had at least one contact related to endometriosis-associated symptoms during 2008 with a participating centre were enrolled into the study. The study investigated the effect of endometriosis on education, work and social wellbeing, endometriosis-associated symptoms and health-related quality of life, by using questions obtained from the World Endometriosis Research Foundation (WERF) GSWH instrument (designed and validated for the WERF Global Study on Women's Health) and the Short Form 36 version 2 (SF-36v2). MAIN RESULTS AND THE ROLE OF CHANCE Of 3216 women invited to participate in the study, 1450 (45%) provided informed consent and out of these, 931 (931/3216 = 29%) returned the questionnaires. Endometriosis had affected work in 51% of the women and affected relationships in 50% of the women at some time during their life. Dysmenorrhoea was reported by 59%, dyspareunia by 56% and chronic pelvic pain by 60% of women. Quality of life was decreased in all eight dimensions of the SF-36v2 compared with norm-based scores from a general US population (all P < 0.01). Multivariate regression analysis showed that number of co-morbidities, chronic pain and dyspareunia had an independent negative effect on both the physical and mental component of the SF-36v2. LIMITATIONS, REASONS FOR CAUTION The fact that women were enrolled in tertiary care centres could lead to a possible over-representation of women with moderate-to-severe endometriosis, because the participating centres typically treat more complex and referred cases of endometriosis. The response rate was relatively low. Since there was no Institute Review Board approval to do a non-responder investigation on basic characteristics, some uncertainty remains regarding the representativeness of the investigated population. WIDER IMPLICATIONS OF THE FINDINGS This international multicentre survey represents a large group of women with endometriosis, in all phases of the disease, which increases the generalizability of the data. Women still suffer from frequent symptoms, despite tertiary care management, in particular chronic pain and dyspareunia. As a result their quality of life is significantly decreased. A patient-centred approach with extensive collaboration across disciplines, such as pain specialists, psychologists, sexologists and social workers, may be a valuable strategy to improve the long-term care of women with endometriosis. STUDY FUNDING/COMPETING INTEREST(S) The WERF EndoCost study is funded by the World Endometriosis Research Foundation (WERF) through grants received from Bayer Schering Pharma AG, Takeda Italia Farmaceutici SpA, Pfizer Ltd and the European Society of Human Reproduction and Embryology. The sponsors did not have a role in the design and conduct of the study; collection, management, analysis and interpretation of the data; and preparation, review or approval of the manuscript. L.H. is the chief executive and T.D. was a board member of WERF at the time of funding. T.D. holds the Merck-Serono Chair in Reproductive Medicine and Surgery, and the Ferring Chair in Reproductive Medicine at the Katholieke Universiteit Leuven in Belgium and has served as consultant/research collaborator for Merck-Serono, Schering-Plough, Astellas and Arresto.

Self reported physical activity, public health, and perceived environment: results from a comparative European study

The focus of physical activity promotion is moving from methods for increasing health enhancing physical activity on the individual level to higher level strategies including environmental and policy approaches. Scientific inquiry, traditionally related to individual-based strategies, requires adaptation and refinement when environmental and policy changes become more relevant. The objective of this study is to investigate the significance for behaviour and health of community-based environments that encourage physical activity. DESIGN AND SETTING The article presents data and results from a cross sectional comparative survey of the general population in six European countries (Belgium, Finland, Germany (East and West), Netherlands, Spain, Switzerland). Specifically, the relation between perceived community-based opportunities for physical activity, self reported physical activity, and self rated health status is investigated. PARTICIPANTS Representative samples of general populations (adults 18 years or older). Overall response rate: 53.5%. Sample sizes realised: Belgium: n=389; Finland: n=400; Germany (East): n = 913; Germany (West): n=489; Netherlands: n=366; Spain: n=380; Switzerland: n=406. MAIN RESULTS Analyses show that best opportunities are reported by people who are lightly to moderately physically active. People's self rated health is moderately, but significantly associated with both perceived opportunities, and physical activity itself. These predictors interact in that especially for women, the health impact of physical activity is more pronounced in case of good opportunities. CONCLUSIONS The paper shows the potential of opportunities within residential and community environments with regard to physical activity, both for behaviour and health. Opportunities may enable the population, especially women, to develop an active lifestyle, and thus improve their health. Future studies with objective indicators for physical activity related environments should test the findings that are based on perceptions.

Practices of pediatric oncology and hematology providers regarding fertility issues: A European survey.

BACKGROUND Fertility is impaired in many survivors of childhood cancer following treatment. Preservation of fertility after cancer has become a central survivorship concern. Nevertheless, several doctors, patients, and families do not discuss fertility and recommendations for fertility preservation in pediatrics are still lacking. Recommendations based on scientific evidence are needed and before their development we wanted to assess the practice patterns of fertility preservation in Europe. PROCEDURES On behalf of the PanCare network, we sent a questionnaire to pediatric onco-hematology institutions across Europe. The survey consisted of 21 questions assessing their usual practices around fertility preservation. RESULTS One hundred ninety-eight institutional representatives across Europe received the survey and 68 (response rate 34.3%) responded. Pre-treatment fertility counseling was offered by 64 institutions. Counseling was done by a pediatric onco-hematologist in 52% (33/64) and in 32% (20/64) by a team. The majority of institutions (53%) lacked recommendations for fertility preservation. All 64 centers offered sperm banking; eight offered testicular tissue cryopreservation for pre-pubertal males. For females, the possibility of preserving ovarian tissue was offered by 40 institutions. CONCLUSIONS There is a high level of interest in fertility preservation among European centers responding to our survey. However, while most recommended sperm cryopreservation, many also recommended technologies whose efficacy has not been shown. There is an urgent need for evidence-based European recommendations for fertility preservation to help survivors deal with the stressful topic of fertility. Pediatr Blood Cancer 2014;9999:1-5. © 2014 Wiley Periodicals, Inc.

Disclosing and reporting medical errors: Cross-sectional survey of Swiss anaesthesiologists.

BACKGROUND There is limited research on anaesthesiologists' attitudes and experiences regarding medical error communication, particularly concerning disclosing errors to patients. OBJECTIVE To characterise anaesthesiologists' attitudes and experiences regarding disclosing errors to patients and reporting errors within the hospital, and to examine factors influencing their willingness to disclose or report errors. DESIGN Cross-sectional survey. SETTING Switzerland's five university hospitals' departments of anaesthesia in 2012/2013. PARTICIPANTS Two hundred and eighty-one clinically active anaesthesiologists. MAIN OUTCOME MEASURES Anaesthesiologists' attitudes and experiences regarding medical error communication. RESULTS The overall response rate of the survey was 52% (281/542). Respondents broadly endorsed disclosing harmful errors to patients (100% serious, 77% minor errors, 19% near misses), but also reported factors that might make them less likely to actually disclose such errors. Only 12% of respondents had previously received training on how to disclose errors to patients, although 93% were interested in receiving training. Overall, 97% of respondents agreed that serious errors should be reported, but willingness to report minor errors (74%) and near misses (59%) was lower. Respondents were more likely to strongly agree that serious errors should be reported if they also thought that their hospital would implement systematic changes after errors were reported [(odds ratio, 2.097 (95% confidence interval, 1.16 to 3.81)]. Significant differences in attitudes between departments regarding error disclosure and reporting were noted. CONCLUSION Willingness to disclose or report errors varied widely between hospitals. Thus, heads of department and hospital chiefs need to be aware of the importance of local culture when it comes to error communication. Error disclosure training and improving feedback on how error reports are being used to improve patient safety may also be important steps in increasing anaesthesiologists' communication of errors.

Política(s) de saúde no trabalho : um inquérito sociológico às empresas portuguesas

Resumo Política(s) de saúde no trabalho: um inquérito sociológico às empresas portuguesas A literatura portuguesa sobre políticas, programas e actividades de Segurança, Higiene e Saúde no Trabalho (abreviadamente, SH&ST) é ainda escassa. Com este projecto de investigação pretende-se (i) colmatar essa lacuna, (ii) melhorar o conhecimento dos sistemas de gestão da saúde e segurança no trabalho e (iii) contribuir para a protecção e a promoção da saúde dos trabalhadores. Foi construída uma tipologia com cinco grupos principais de políticas, programas e actividades: A (Higiene & Segurança no Trabalho / Melhoria do ambiente físico de trabalho); B (Avaliação de saúde / Vigilância médica / Prestação de cuidados de saúde); C (Prevenção de comportamentos de risco/ Promoção de estilos de vida saudáveis); D (Intervenções a nível organizacional / Melhoria do ambiente psicossocial de trabalho); E (Actividades e programas sociais e de bem-estar). Havia uma lista de mais de 60 actividades possíveis, correspondendo a um índice de realização de 100%. Foi concebido e desenhado, para ser auto-administrado, um questionário sobre Política de Saúde no Local de Trabalho. Foram efectuados dois mailings, e um follow-up telefónico. O trabalho de campo decorreu entre a primavera de 1997 e o verão de 1998. A amostra (n=259) é considerada representativa das duas mil maiores empresas do país. Uma em cada quatro é uma multinacional. A taxa de sindicalização rondava os 30% da população trabalhadora, mas apenas 16% dos respondentes assinalou a existência de representantes dos trabalhadores eleitos para a SH&ST. A hipótese de investigação principal era a de que as empresas com um sistema integrado de gestão da SH&ST seriam também as empresas com um (i) maior número de políticas, programas e actividades de saúde; (ii) maior índice de saúde; (iii) maior índice de realização; e (iv) maior percentagem dos encargos com a SH&ST no total da massa salarial. As actividades de tipo A e B, tradicionalmente associadas à SH&ST, representavam, só por si, mais de 57% do total. Os resultados, correspondentes às respostas da Secção C do questionário, apontam, para (i) a hipervalorização dos exames de medicina do trabalho; e por outro para (ii) o subaproveitamento de um vasto conjunto de actividades (nomeadamente as de tipo D e E), que são correntemente levadas a cabo pelas empresas e que nunca ou raramente são pensadas em termos de protecção e promoção da saúde dos trabalhadores. As actividades e os programas de tipo C (Prevenção de comportamentos de risco/Promoção de estilos de vida saudáveis), ainda eram as menos frequentes entre nós, a seguir aos Programas sociais e de bem-estar (E). É a existência de sistemas de gestão integrados de SH&ST, e não o tamanho da empresa ou outra característica sociodemográfica ou técnico-organizacional, que permite predizer a frequência de políticas de saúde mais activas e mais inovadores. Os três principais motivos ou razões que levam as empresas portuguesas a investir na protecção e promoção da saúde dos seus trabalhadores eram, por ordem de frequência, (i) o absentismo em geral; (ii) a produtividade, qualidade e/ou competitividade, e (iii) a filosofia de gestão ou cultura organizacional. Quanto aos três principais benefícios que são reportados, surge em primeiro lugar (i) a melhoria da saúde dos trabalhadores, seguida da (ii) melhoria do ambiente do ambiente de trabalho e, por fim, (iii) a melhoria da produtividade, qualidade e/ou competitividade.Quanto aos três principais obstáculos que se põem, em geral, ao desenvolvimento das iniciativas de saúde, eles seriam os seguintes, na percepção dos respondentes: (i) a falta de empenho dos trabalhadores; (ii) a falta de tempo; e (iii) os problemas de articulação/ comunicação a nível interno. Por fim, (i) o empenho das estruturas hierárquicas; (ii) a cultura organizacional propícia; e (iii) o sentido de responsabilidade social surgem, destacadamente, como os três principais factores facilitadores do desenvolvimento da política de saúde no trabalho. Tantos estes factores como os obstáculos são de natureza endógena, susceptíveis portanto de controlo por parte dos gestores. Na sua generalidade, os resultados deste trabalho põem em evidência a fraqueza teóricometodológica de grande parte das iniciativas de saúde, realizadas na década de 1990. Muitas delas seriam medidas avulsas, que se inserem na gestão corrente das nossas empresas, e que dificilmente poderão ser tomadas como expressão de uma política de saúde no local de trabalho, (i) definida e assumida pela gestão de topo, (ii) socialmente concertada, (iii) coerente, (iv) baseada na avaliação de necessidades e expectativas de saúde dos trabalhadores, (v) divulgada, conhecida e partilhada por todos, (vi) contingencial, flexível e integrada, e, por fim, (vii) orientada por custos e resultados. Segundo a Declaração do Luxemburgo (1997), a promoção da saúde engloba o esforço conjunto dos empregadores, dos trabalhadores, do Estado e da sociedade civil para melhorar a segurança, a saúde e o bem-estar no trabalho, objectivo isso que pode ser conseguido através da (i) melhoria da organização e das demais condições de trabalho, da (ii) participação efectiva e concreta dos trabalhadores bem como do seu (iii) desenvolvimento pessoal. Abstract Health at work policies: a sociological inquiry into Portuguese corporations Portuguese literature on workplace health policies, programs and activities is still scarce. With this research project the author intends (i) to improve knowledge on the Occupational Health and Safety (shortly thereafter, OSH) management systems and (ii) contribute to the development of health promotion initiatives at a corporate level. Five categories of workplace health initiatives have been identified: (i) Occupational Hygiene and Safety / Improvement of Physical Working Environment (type A programs); (ii) Health Screening, Medical Surveillance and Other Occupational Health Care Provision (type B programs); (iii) Preventing Risk Behaviours / Promoting Healthy Life Styles (type C programs); (iv) Organisational Change / Improvement of Psycho-Social Working Environment (type D programs); and (v) Industrial and Social Welfare (type E programs). A mail questionnaire was sent to the Chief Executive Officer of the 1500 largest Portuguese companies, operating in the primary and secondary sectors (≥ 100 employees) or tertiary sector (≥ 75 employees). Response rate has reached about 20% (259 respondents, representing about 300 companies). Carried out between Spring 1997 and Summer 1998, the fieldwork has encompassed two direct mailings and one phone follow-up. Sample is considered to be representative of the two thousand largest companies. One in four is a multinational. Union membership rate is about 30%, but only 16% has reported the existence of a workers’ health and safety representative. The most frequent workplace health initiatives were those under the traditional scope of the OSH field (type A and B programs) (57% of total) (e.g., Periodical Medical Examinations; Individual Protective Equipment; Assessment of Working Ability). In SMEs (< 250) it was less likely to find out some time-consuming and expensive activities (e.g., Training on OSH knowledge and skills, Improvement of environmental parameters as ventilation, lighting, heating).There were significant differences in SMEs, when compared with the larger ones (≥ 250) concerning type B programs such as Periodical medical examinations, GP consultation, Nursing care, Other medical and non-medical specialities (e.g., psychiatrist, psychologist, ergonomist, physiotherapist, occupational social worker). With regard to type C programs, there were a greater percentage of programs centred on Substance abuse (tobacco, alcohol, and drug) than on Other health risk behaviours. SMEs representatives reported very few prevention- oriented programs in the field of Drug abuse, Nutrition, Physical activity, Off- job accidents, Blood pressure or Weight control. Frequency of type D programs included Training on Human Resources Management, Training on Organisational Behaviour, Total Quality Management, Job Design/Ergonomics, and Workplace rehabilitation. In general, implementation of this type of programs (Organisational Change / Improvement of Psychosocial Working Environment) is not largely driven by health considerations. Concerning Industrial and Social Welfare (Type E programs), the larger employers are in a better position than SMEs to offer to their employees a large spectrum of health resources and facilities (e.g., Restaurant, Canteen, Resting room, Transport, Infra-structures for physical activity, Surgery, Complementary social protection, Support to recreational and cultural activities, Magazine or newsletter, Intranet). Other workplace health promotion programs like Training on Stress Management, Employee Assistance Programs, or Self-help groups are uncommon in the Portuguese worksites. The existence of integrated OSH management systems, not the company size, is the main variable explaining the implementation of more active and innovative workplace health policies in Portugal. The three main prompting factors reported by employers for health protection and promotion initiatives are: (i) Employee absenteeism; (ii) Productivity, quality and/or competitiveness; and (iii) Corporate culture/management philosophy. On the other hand, (i) Improved staff’s health, (ii) Improved working environment and (iii) Improved productivity, quality and/or competitiveness were the three main benefits reported by companies’ representatives, as a result of successful implementation of workplace health initiatives. (i) Lack of staff commitment; (ii) Lack of time; and (iii) Problems of co-operation and communication within company or establishment (iii) are perceived to be the main barriers companies must cope with. Asked about the main facilitating factors, these companies have pointed out the following ones: (i) Top management commitment; (ii) Corporate culture; and (iii) Sense of social responsibility. This sociological research report shows the methodological weaknesses of workplace health initiatives, carried out by Portuguese companies during the last ‘90s. In many cases, these programs and actions were not part of a corporate health strategy and policy, (i) based on the assessment of workers’ health needs and expectancies, (ii) advocated by the employer or the chief executive officer, (ii) planned and implemented with the staff consultation and participation or (iv) evaluated according to a cost-benefit analysis. In short, corporate health policy and action were still rather based on more traditional OSH approaches and should be reoriented towards Workplace Health Promotion (WHP) approach. According to the Luxembourg Declaration of Workplace Health Promotion in the European Union (1997), WHP is “a combination of: (i) improving the work organisation and environment; (ii) promoting active participation; (iii) encouraging personal development”.Résumée Politique(s) de santé au travail: une enquête sociologique aux entreprises portugaises Au Portugal on ne sait presque rien des politiques de santé au travail, adoptés par les entreprises. Avec ce projet de recherche, on veut (i) améliorer la connaissance sur les systèmes de gestion de la santé et de la sécurité au travail et, au même temps, (ii) contribuer au développement de la promotion de la santé des travailleurs. Une typologie a été usée pour identifier les politiques, programmes et actions de santé au travail: A. Amélioration des conditions de travail / Sécurité au travail; B. Médecine du travail /Santé au travail; C. Prévention des comportements de risque / Promotion de styles de vie sains; D. Interventions organisationnelles / Amélioration des facteurs psychosociaux au travail; E. Gestion de personnel et bien-être social. Un questionnaire postal a été envoyé au représentant maximum des grandes entreprises portugaises, industrielles (≥ 100 employés) ou des services (≥ 75 employés). Le taux de réponse a été environ 20% (259 répondants, concernant trois centaines d’entreprises et d’établissements). La recherche de champ, conduite du printemps 1997 à l’été 1998, a compris deux enquêtes postales et un follow-up téléphonique. L´échantillon est représentatif de la population des deux miles plus grandes entreprises. Un quart sont des multinationales. Le taux de syndicalisation est d’environ 30%. Toutefois, il y a seulement 16% de lieux de travail avec des représentants du personnel pour la santé et sécurité au travail. Les initiatives de santé au travail les plus communes sont celles concernant le domaine plus traditionnel (types A et B) (57% du total): par exemple, les examens de médecine du travail, l’équipement de protection individuelle, les tests d’aptitude au travail. En ce qui concerne les programmes de type C, les plus fréquents sont le contrôle et la prévention des addictions (tabac, alcool, drogue). Les interventions dans le domaine de du système technique et organisationnelle du travail peuvent comprendre les courses de formation en gestion de ressources humaines ou en psychosociologie des organisations, l’ergonomie, le travail posté ou la gestion de la qualité totale. En général, la protection et la promotion de la santé des travailleurs ne sont pas prises en considération dans l’implémentation des initiatives de type D. Il y a des différences quand on compare les grandes entreprises et les moyennes en matière de politique de gestion du personnel e du bien-être (programmes de type E, y compris l’allocation de ressources humaines ou logistiques comme, par exemple, restaurant, journal d’entreprise, transports, installations et équipements sportifs). D’autres activités de promotion de la santé au travail comme la formation en gestion du stress, les programmes d’ assistance aux employés, ou les groupes de soutien et d’auto-aide sont encore très peu fréquents dans les entreprises portugaises. C’est le système intégré de gestion de la santé et de la sécurité au travail, et non pas la taille de l’entreprise, qui aide à prédire l’existence de politiques actives et innovatrices dans ce domaine. Les trois facteurs principaux qui encouragent les actions de santé (prompting factors, en anglais) sont (i) l’absentéisme (y compris la maladie), (ii) les problèmes liés à la productivité, qualité et/ou la compétitivité, et aussi (iii) la culture de l’entreprise/philosophie de gestion. Du coté des bénéfices, on a obtenu surtout l’amélioration (i) de la santé du personnel, (ii) des conditions de travail, et (iii) de la productivité, qualité et/ou compétitivité.Les facteurs qui facilitent les actions de santé au travail sont (i) l’engagement de la direction, (ii) la culture de l’entreprise, et (iii) le sens de responsabilité sociale. Par contre, les obstacles à surmonter, selon les organisations qui ont répondu au questionnaire, seraient surtout (i) le manque d’engagement des travailleurs et de leur représentants, (ii) le temps insuffisant, et (iii) les problèmes de articulation/communication au niveau interne de l’entreprise/établissement. Ce travail de recherche sociologique montre la faiblesse méthodologique des services et activités de santé et sécurité au travail, mis en place par les entreprises portugaises dans les années de 1990, à la suite des accords de concertation sociale de 1991. Dans beaucoup de cas, (i) ces politiques de santé ne font pas partie encore d’un système intégré de gestion, (ii) il n’a pas d’évaluation des besoins et des expectatives des travailleurs, (iii) c’est très bas ou inexistant le niveau de participation du personnel, (iv) on ne fait pas d’analyse coût-bénéfice. On peut conclure que les politiques de santé au travail sont plus proches de la médecine du travail et de la sécurité au travail que de la promotion de la santé des travailleurs. Selon la Déclaration du Luxembourg sur la Promotion de la Santé au Lieu de Travail dans la Communauté Européenne (1997), celle-ci « comprend toutes les mesures des employeurs, des employés et de la société pour améliorer l'état de santé et le bien être des travailleurs » e « ceci peut être obtenu par la concentration des efforts dans les domaines suivants: (i) amélioration de l'organisation du travail et des conditions de travail ; (ii) promotion d'une participation active des collaborateurs ; (iii) renforcement des compétences personnelles ».

IPH response to European Review of the Social Determinants of Health and the Health Divide

IPH welcomes this European Review conducted by the Marmot Review Team which aims to inform action on social determinants of health and health equity within the forthcoming health policy for the European region, Health 2020. IPH calls for clear mandates supporting whole-of-government approaches to address social determinants and outlines some of the specific challenges and opportunities within the current Ireland and Northern Ireland policy landscape.

Health Survey Northern Ireland: First Results 2013/14

This report presents results from the 2013/14 Health Survey Northern Ireland. It includes information on general health, mental health and wellbeing, diet and nutrition, physical activity, obesity, smoking, drinking and sexual health. Differences reported are those that are statistically significant at the 95% confidence level. The fieldwork for this survey was conducted from April 2013 to March 2014. Results are based on responses of 4,509 individuals, with a response rate of 66% achieved. åÊ