Le Health-Sickness Rating Scale (HSRS; Luborsky, 1962) permet d’évaluer empiriquement la santé mentale. Plusieurs recherches ont permit d’établir ses qualités psychométriques (Armelius, Gerin, Luborsky & Alexander, 1991; Luborsky, 1962, 1975;Luborsky & Bachrach, 1974; Harty, Cerney, Colson, Coyne, Frieswyk, Johnson &Mortimer, 1981). Cette recherche se divise en deux parties. Dans la première, elle vise une traduction du HSRS, une évaluation de sa validité et de sa fidélité interjuges auprès d’intervenants québécois en santé mentale ainsi qu’une nouvelle validation internationale de l’instrument. Trente et un professionnels ont participé à cette partie de l’étude. Les résultats montrent une fidélité interjuges forte (ICC de 0.78) entre l’ensemble des intervenants québécois, une validité concurrente très forte (ICC de 0.97). Le nouvel indice de validité internationale calculé auprès des professionnels de quatre pays (Etats-Unis, France, Québec et Suisse) est également très fort (ICC de 0.98). La deuxième partie de cette recherche vise l’élaboration et la validation la forme auto-révélée du HSRS. Trente-cinq sujets ont participé à l’étude. Les résultats indiquent une corrélation forte (ICC de 0.79) entre la forme auto-révélée du HSRS et la version originale. La fidélité interjuges est également élevée (ICC de 0.83).

African horse sickness (AHS) is a non-contagious viral disease transmitted by an arthropod vector and is endemic to sub-Saharan Africa. The disease affects all equine species, but is more severe in horses and other equid species not native to Africa. Vaccination is the only demonstrated means of its prevention. The horse-owning public provides much anecdotal evidence of prophylactic strategies, such as repellents, stabling, alternate hosts, traps, paraffin, blankets, smoke or fans. The present study investigated the relationship of these strategies to the incidence of AHS, and evaluated alternate hosts, wind speed and repellents on the activity of males and females of the different Culicoides species.. Cypermethrin and citronella-containing repellents repelled the most female midges. Sheep and cattle offer an alternate blood meal to gravid and nulliparous female midges. Fans are very effective in keeping midges away from horses. Methods are summarised for the horse owner to implement in addition to vaccination to prevent AHS. / Thesis (M.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2008.

African horse sickness virus causes a non-contagious, infectious disease of equids. It is epizootic to sub-Saharan Africa and parts of the Middle East. The epizootics caused by the virus have caused widespread devastation amongst equids worldwide. Fortunately no epizootic has lasted more than 5 years outside of sub- Saharan Africa. It is vectored by species of Culicoides midges (Diptera: Ceratopogonidae) and most importantly by the two Avarita species of C. imicola Keiffer and C. bolitinos Meiswinkel. The literature pertaining to the study and research of the virus, the disease and the vectors is reviewed. Models allowing prediction of future possible outbreaks as well as details of control strategies and findings of researchers are presented and discussed. The virus needs a long term reservoir host in which to overwinter and various theories are discussed. Control measures in South Africa are suggested so that outbreaks of the disease can be reduced. / Thesis (M.Sc.)-University of KwaZulu-Natal, Pietermarizburg, 2008.

Analysis of work incapacity in the Czech Republic: trends and determinants Abstract The thesis addresses trends of work incapacity in the Czech Republic after the establishment of the independent Czech state on 1st January 1993 up to the present. In the theoretical part it focuses on the legislative changes affecting work incapacity during the period under study. Furthermore, it describes work incapacity using demographic indicators of work incapacity and focuses on the structure of work incapacity according to the international classification of diseases (MKN-10), according to the age, region, seasonal trends and occupational classification (CZ-ISCO). This part mainly shows the development of the average percentage of incapacity for work, terminated cases of incapacity for work per 100 000 insured people and the analysis of the average length of incapacity for work. The next chapter is based on the advanced data analysis of the Labor Force Survey. The last chapter is dedicated to the international comparison of work incapacity. Keywords: temporary incapacity for work, terminated cases of incapacity for work, Czech Republic, sickness insurance, sickness rate, sickness benefit

<p>This thesis consists of a summary and four papers. The first two concerns health care and sickness absence, and the last two pharmaceutical costs and prices.</p><p>Paper [I] presents an economic federation model which resembles the situation in, for example, Sweden. In the model the state governments provide health care, the fed-eral government provides a sickness benefit and both levels tax labor income. The re-sults show that the states can have either an incentive to under- or over-provide health care. The federal government can, by introducing an intergovernmental transfer, in-duce the state governments to provide the socially optimal amount of health care.</p><p>In Paper [II] the effect of aggregated public health care expenditure on absence from work due to sickness or disability was estimated. The analysis was based on data from a panel of the Swedish municipalities for the period 1993-2004. Public health care expenditure was found to have no statistically significant effect on absence and the standard errors were small enough to rule out all but a minimal effect. The result held when separate estimations were conducted for women and men, and for absence due to sickness and disability.</p><p>The purpose of Paper [III] was to study the effects of the introduction of fixed pharmaceutical budgets for two health centers in Västerbotten, Sweden. Estimation results using propensity score matching methods show that there are no systematic differences for either price or quantity per prescription between health centers using fixed and open-ended budgets. The analysis was based on individual prescription data from the two health centers and a control group both before and after the introduction of fixed budgets.</p><p>In Paper [IV] the introduction of the Swedish substitution reform in October 2002 was used as a natural experiment to examine the effects of increased consumer infor-mation on pharmaceutical prices. Using monthly data on individual pharmaceutical prices, the average reduction of prices due to the reform was estimated to four percent for both brand name and generic pharmaceuticals during the first four years after the reform. The results also show that the price adjustment was not instant.</p>

This thesis consists of a summary and four papers. The first two concerns health care and sickness absence, and the last two pharmaceutical costs and prices. Paper [I] presents an economic federation model which resembles the situation in, for example, Sweden. In the model the state governments provide health care, the fed-eral government provides a sickness benefit and both levels tax labor income. The re-sults show that the states can have either an incentive to under- or over-provide health care. The federal government can, by introducing an intergovernmental transfer, in-duce the state governments to provide the socially optimal amount of health care. In Paper [II] the effect of aggregated public health care expenditure on absence from work due to sickness or disability was estimated. The analysis was based on data from a panel of the Swedish municipalities for the period 1993-2004. Public health care expenditure was found to have no statistically significant effect on absence and the standard errors were small enough to rule out all but a minimal effect. The result held when separate estimations were conducted for women and men, and for absence due to sickness and disability. The purpose of Paper [III] was to study the effects of the introduction of fixed pharmaceutical budgets for two health centers in Västerbotten, Sweden. Estimation results using propensity score matching methods show that there are no systematic differences for either price or quantity per prescription between health centers using fixed and open-ended budgets. The analysis was based on individual prescription data from the two health centers and a control group both before and after the introduction of fixed budgets. In Paper [IV] the introduction of the Swedish substitution reform in October 2002 was used as a natural experiment to examine the effects of increased consumer infor-mation on pharmaceutical prices. Using monthly data on individual pharmaceutical prices, the average reduction of prices due to the reform was estimated to four percent for both brand name and generic pharmaceuticals during the first four years after the reform. The results also show that the price adjustment was not instant.

published_or_final_version / abstract / toc / Medicine / Master / Doctor of Medicine

Background. In Sweden 10 percent (550,000) of the labour force, aged 18 to 65 years are disability pensioners and about four percent are on sick leave. The knowledge of the course from healthy individual to disability pensioner is not well known and was the theme of this thesis. Objectives, Material and Methods. The aims of the thesis were to follow the study population regarding sickness absence, health care utilisation, quality of life, and survival. Population based data including 14,538 women and men from three cities in Sweden were used, of whom 1,952 were granted a disability pension at baseline or received one during follow up. Register data, including sickness spells, health care utilisation, and mortality data during 30 years of follow up, and questionnaire data including socio-economic and quality of life data were used. Results. The most powerful determinant for being granted a disability pension was cumulative annual sick leave days, more powerful than all other tested determinants together. The degree of explanation for all determinants combined was 96%. Health care utilisation among disability pensioners continued to be high also after disability pension, 2.3 times higher for hospital admissions and 8 times higher for primary health case appointments than among referents. Disability pensioners had lower quality of life than non-pensioners and old age pensioners. For those who became disability pensioners after the baseline measurements quality of life measures decreased progressively until disability pension was granted and were then stabilised on a low level. During follow up 525 (7.6%) subjects died. Compared with subjects who did not become disability pensioners the hazards ratio was 2.78 among women and 3.43 among men, even when the effect of a number of other outcome affecting variables were taken into account. The mortality differences were not explained by underlying disease. Conclusions. The risk of disability pension may be predicted but only late in the course of events. Disability pensioners continue to have a high level of health care utilisation, and have a worse quality of life development and a higher mortality rate than non-pensioners. Given the unfavourable outcome of disability pension, other means of managing the reduced work capacity might be considered.

This thesis examines the reforms of Sickness Insurance that have been realized in chosen countries of European Union. I've focused myself on Belgium, Netherlands, United Kingdom and Finland and every single reform step that have been taken in between 2003 -- 2005 in these countries. I've investigated how the situation in each country was before the reform came true and explored the main reasons that I believe have led to these reforms. I've also stated which impacts these reforms were supposed to have and after that I've studied the real impacts and consequences that were brought by this change in each country. You can see these in multiple graphs followed by my explanation whether and why I think the reform step was succesful. Judging by the succes that was noted in examinated countries I've decided which path is best to follow as far as the reform in Sickness Insurance is concerned. Thanks to previous examination of reforms that differs from each another I was at the end able to recommned which steps should be taken in Czech Republic since some kind of Sickness Insurance reform is needed as well. I believe comparing foreign Sickness Insurance reforms and my suggestions can help to improve Sickness Insurance system in CR and lead to the solution of various problems Czech Republic hasn't coped with yet.

The theme of this thesis is draft of measures body related with changes in sick benefit system. The goal of this thesis is the analysis of impact of changes in sick benefit system on employer and the draft of measures for the subject. There is a description of sick benefit system used in CR and in other countries EU in this thesis. There is a describtion of the changes and the impacts on employer are analysed. The last part of the thesis is composed by draft of measures related with these changes.