BackgroundThe concept of health promotion rests on aspirations aiming at enabling people to increase control over and improve their health. Health promotion action is facilitated in settings such as schools, homes and work places. As a contribution to the promotion of healthy lifestyles, we have further developed the setting approach in an effort to harmonise it with contemporary realities (and complexities) of health promotion and public health action. The paper introduces a modified concept, the supersetting approach, which builds on the optimised use of diverse and valuable resources embedded in local community settings and on the strengths of social interaction and local ownership as drivers of change processes. Interventions based on a supersetting approach are first and foremost characterised by being integrated, but also participatory, empowering, context-sensitive and knowledge-based. Based on a presentation of “Health and Local Community”, a supersetting initiative addressing the prevention of lifestyle diseases in a Danish municipality, the paper discusses the potentials and challenges of supporting local community interventions using the supersetting approach.DiscussionThe supersetting approach is a further development of the setting approach in which the significance of integrated and coordinated actions together with a participatory approach are emphasised and important principles are specified, all of which contribute to the attainment of synergistic effects and sustainable impact of supersetting initiatives. The supersetting approach is an ecological approach, which places the individual in a social, environmental and cultural context, and calls for a holistic perspective to change potentials and developmental processes with a starting point in the circumstances of people’s everyday life. The supersetting approach argues for optimised effectiveness of health promotion action through integrated efforts and long-lasting partnerships involving a diverse range of actors in public institutions, private enterprises, non-governmental organisations and civil society.SummaryThe supersetting approach is a relevant and useful conceptual framework for developing intervention-based initiatives for sustainable impact in community health promotion. It strives to attain synergistic effects from activities that are carried out in multiple settings in a coordinated manner. The supersetting approach is based on ecological and whole-systems thinking, and stipulates important principles and values of integration, participation, empowerment, context and knowledge-based development.
The study suggests a potential for preventing people from leaving physically heavy occupations by improving the physical and psychosocial work environment.
The presence of a central venous catheter is an important risk factor, and hyponatremia and anemia are associated with the development of hospital-acquired SAB. Furthermore, hospital-acquired SAB in itself increases mortality.
Background The aim was to assess the rate at which waste collectors and municipal workers leave their job, to establish the outcome and to identify associated risk factors within work environment, health, lifestyle and marital status. Methods A questionnaire‐based survey among a cohort of 2,918 waste collectors and municipal workers was performed in 1994, with follow‐up 2.5 years later. Results Twenty‐five percent had left the job at follow‐up. Of these, 31% had changed jobs (associated with low decision authority), 16% were unemployed (associated with low skill discretion, pushing heavy loads and extreme bending of back), 10% received Disability Pension/long‐term sick leave (associated with low skill discretion, prevalent diseases, underweight and smoking), and 12% received Early Retirement Pension (associated with extreme bending of back and marital status). Conclusions The study suggests a potential for preventing people from leaving physically heavy occupations by improving the physical and psychosocial work environment. Am. J. Ind. Med. 40:161–169, 2001. © 2001 Wiley‐Liss, Inc.
ObjectivesThe rise in prevalence of diabetes is alarming and research ascribes most of the increase to lifestyle. However, little knowledge exists about the influence of occupational factors on the risk for developing diabetes. This study estimates the importance of work and lifestyle as risk factors for developing diabetes mellitus among healthcare workers and explores the association of work factors and obesity, which is a risk factor for diabetes.MethodsQuestionnaire-based prospective cohort study among 7,305 health care workers followed for seven years in the Danish National Diabetes Register. We used bivariate comparisons to give an unadjusted estimate of associations, followed by adjusted survival analysis and logistic regression models to estimate the influences of potential risk factors related to job, health and lifestyle on diabetes and obesity.ResultsDuring seven years of follow up, 3.5% of participants developed diabetes, associated with obesity (HR = 6.53; 95% CI 4.68–9.10), overweight (HR = 2.89; CI 2.11–3.96) age 50–69 y (HR = 2.27; 95% CI 1.57–3.43) and high quality of leadership (HR = 1.60; CI 1.19–2.16). Obesity at baseline was most common among the youngest employees, and was mainly associated with developing diabetes (OR = 3.84; CI 2.85–5.17), impaired physical capacity and physical inactivity. In the occupational setting, obesity was associated with shift work, severe musculoskeletal pain, low influence, but also by good management, fewer role conflicts and a positive work-life balance. Looking only at non-smokers, removed the influence of age and pain. However, non-smokers also had higher depression scores and more role conflicts.ConclusionsConfirming obesity as the strongest risk factor for developing diabetes, the present study identified few occupational risk factors. However, obesity, the key risk factor for diabetes, had a more variable relation with work than did diabetes.
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