Presentation of speakers

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1 Presentation of speakers Keynote speaker: Professor Sir Michael Marmot, MBBS, MPH, PhD, FRCP, FFPHM, FMedSci. Director of the International Institute for Society and Health. MRC Research Professor of Epidemiology and Public Health, University College, London. Michael Marmot has led a research group on health inequalities for the past 30 years. He is Principal Investigator of the Whitehall Studies of British civil servants, investigating explanations for the striking inverse social gradient in morbidity and mortality. He leads the English Longitudinal Study of Ageing (ELSA) and is engaged in several international research efforts on the social determinants of health. He chairs the Department of Health Scientific Reference Group on tackling health inequalities. He was a member of the Royal Commission on Environmental Pollution for six years and is an honorary fellow of the British Academy. In 2000 he was knighted by Her Majesty The Queen for services to Epidemiology and understanding health inequalities. Internationally acclaimed, Professor Marmot is a Vice President of the Academia Europaea, a Foreign Associate Member of the Institute of Medicine (IOM), and the Chair of the Commission on Social Determinants of Health set up by the World Health Organization in He won the Balzan Prize for Epidemiology in 2004, gave the Harveian Oration in 2006 and won the William B. Graham Prize for Health Services Research in Speakers, May 7 th Gunnel Hensing, professor. Inger Haukenes, educated in physiotherapy and philosophy, PhD in social epidemiology from the University of Bergen, and currently affiliated to the Norwegian Institute of Public Health as a post doctor. My field of research is predictors for disability pension and sickness absence, addressing particularly the role of gender and occupational social class. I am also engaged in a research project at Umeå University in Sweden, examining equality in health care and selection to pain rehabilitation across gender and socioeconomic class. In my presentation I will reflect on social stratification and gender as producers of differential conflicts between health and work, differential use of primary and specialist health care services and finally, differential exclusion from working life due to sickness absence and disability pension.

2 Tiina Pensola, PhD. I am particularly interested in the possibilities and means by which we can enhance health, work ability and wellbeing, and decrease social inequalities in health. My studies include topics on determinants of health, work ability of various population groups such as those unemployed and the ageing working population, the incidence of disability pensions, occupational mortality differences and the allocation of vocational rehabilitation. Recently, I have been interested in factors that affect maintenance of good work ability of those with multisite pain. Thus, only few of my research topics have directly focused on the rehabilitation but looking at the large perspective they have covered the areas that are related to the need of rehabilitation. In our session the focus is on the factors that affect, on the one hand the demand and applying for rehabilitation, and on the other hand granting it. Anne Lamminpää, MD, PhD, chief physician Pohjola Insurance ltd, senior lecturer, Helsinki University. Rehabilitation is an investment for future, not an expense. Successful rehabilitation is an economic investment for the provider such as insurance institution. For a patient the process of rehabilitation can mean better social, physical, mental or economic well- being. Key words of my research of relevance for this conference are work, ability early rehabilitation, vocational and multimodal rehabilitation, leadership and epidemiology. There are two types of relevance: scientific relevance, where a study increases our understanding of a disease or a process, and societal relevance, where society directly benefits as a result of this increased understanding. The heading of my presentation is Effect and evidence of vocational rehabilitation. The aim of vocational rehabilitation is to influence on work ability and functional capacity. Rehabilitation can be defined as measures that are needed for coping with consequences of a disease, defect or trauma. The effects of vocational rehabilitation among person at working age can be measured by length of absenteeism, return to work and decreased number of early retirement. In my presentation I will tell You about the vocational rehabilitation in Finland as well as the results of our systematic review and other studies concerning vocational rehabilitation. Therese Hellman, registered occupational therapist and PhD. She completed her PhD in February 2012 and the title of her PhD thesis was Rehabilitation and everyday life in people with stress- related ill health. Currently, she has a post doc position at the Institute of Environmental Medicine, Unit of Intervention and Implementation Research at Karolinska Institutet and the focus on her research is on multimodal rehabilitation and return to work in people with non- specific pain. The project is based both on interview and questionnaire data from rehabilitation professionals and on index data of sick leave rates for persons with long- tern non- specific pain.

3 Christian Ståhl, PhD, assistant professor. I have a broad interest in welfare and social insurance issues and have conducted studies on stakeholder cooperation in return to work and labor market reintegration and written on ethical issues in the work disability prevention field. I also have an interest in implementation issues, both concerning application of research- based knowledge in practice, and policy development. The presentation expands on the topic of ethics in work disability prevention, which includes theoretical frameworks from medical, social administration and business ethics, which is related to broader ethical theories, and to the implications of applying different theories in practice. Speakers, May 8 th Ulrik Gensby, PhD. Nina Nevala, professor. Ida Seing, PhD candidate at the National Centre for Work and Rehabilitation at Linköping University with a background in political science. Her thesis project puts focus on the Swedish social security system by analyzing the Social Insurance Agency s and employers roles in the return to work process of workers on sick leave. The presentation concerns the employers activities and role in return to work in the context of early- return- to- work policy and intensity of modern working life. Eva Ladekjær Larsen, assistant professor, PhD, and Kirsten S. Petersen, researcher, MSc, OT, PhD. Co- workers and work place relations in the return to work process: In this workshop we will be focusing on how workplaces are re- integrating a returning employee who has been absent from work due to illness or injuries. A workplace can be perceived as a social organization having its own work routines and norms and in which each workplace actor has a distinctive social role. Our approach is that long term illness and the following return to work process is breaking the work routine as well as the social balance in the work team, causing challenges for all work place actors i.e. co- workers, the sick listed employee and the work leader. Based on results from fieldwork conducted at four different workplaces we first present those challenges and how they are handled by the returning employee, his/her colleagues, and the work leader. Secondly we invite to group sessions where workshop participants will be discussing challenges in the return to work process and if and how these challenges can be solved. The workshop will be concluded with a joint discussion Aage Indahl, professor.

4 Jónína Waagfjörð, MSc in Physiotherapy and International Health Policy and Health Economics. VIRK Vocational Rehabilitation Fund in Iceland (VIRK Starfsendurhæfingarsjóður). Research relevance: Evaluating the effect of assisting workplaces in constructing, implementing and using absence management tools to affect short- and long- term absences in the workplace with the goal of affecting long- term absences and disability; change attitudes towards employees returning to the work place after long- term illnesses, in reduced capacity employments; active workplace employers view on return to work. Presentation: In 2011, VIRK Vocational Rehabilitation Fund initiated an extensive developmental project on welfare, absences and return to work after accidents or illnesses. Companies and work places were recruited with the final number of participating employees accounting for about 1% of the work force in Iceland. The main objective of the project was to assess and bring about change in attitude in the work place and among employees in the sense that everybody has a role in the work place even though they have a reduced capacity to work. Participating work places were assisted in forming and introducing absence management policies and procedures to handle short- and long- term absences, using them as a preventative measure both to identify workers that are missing work because of difficult work condition and also pave the way for their successful return to work after long- term illnesses. The presentation will also summarise the participating employers view on accepting employees back to work after long- term illnesses into reduced capacity in relation to barriers to entry, both generally and also in relation to labour market agreements. Kari- Pekka Martimo MD, PhD. Specialist in Occupational Health and Occupational Medicine, works as Chief Medical Officer at the Finnish Institute of Occupational Health (FIOH) in Helsinki. He is also the Director of the Thematic Area Effective Occupational Health Services (OHS) with the main task is to initiate and coordinate OHS research and development at FIOH. Earlier he has developed OHS both in a large international company and in one of the major private providers of OHS in Finland. He has long experience as occupational physician in various organisations in addition to working in Estonia as the leader of an EU funded project on developing OHS. He has written articles and given lectures on quality, ethics and effectiveness of OHS, as well as he has consulted workplaces in issues related to OHS, disability management, and well- being at work. Musculoskeletal disorders, disability and work was the topic of his academic dissertation in In his presentation, Kari- Pekka Martimo will give an overview of the features of Occupational Health Services (OHS), which give OHS a position as a bridge- builder between health care and workplaces in issues related to work disability prevention. The professionals working in OHS have a close collaboration with the workplaces, and, therefore, they can help to find solutions that are suitable for both the individual worker with disability and the workplace with its organisational goals. Supporting return to work and work retention is not only a medical problem, but a challenge that requires a biopsychosocial approach. OHS have the capacity to meet even this demand, based on their multiprofessional nature.

5 Irene Jensen, professor in corporate health and Head of the Division of Intervention and Implementation Research, Institute of environmental medicine, Karolinska Institutet. Has mainly pursued research in the area of back pain, rehabilitation, work place interventions concerning cost effective interventions and implementation of evidence- based measures. Is currently developing a new research program with the focus of intervention and implementation research within occupational health services/corporate health and workers health. To facilitate the translation of research into practice the research programme is developing an organisational model for research based on partnership with employers, occupational health services and university. She has served as a an expert in several advisory boards concerning rehabilitation and workers health to the Swedish government and has since 2010 evaluated the governmental initiative to enhance evidence based rehabilitation nationwide. Pirjo Juvonen- Posti, Senior Specialist, Finnish Institute of Occupational Health. MD and PD (Professional Development Degree) on Rehabilitation Science and Special Competence on Rehabilitation. I have had the possibility to work with work ability, disability and rehabilitation issues from 1989 on. And already from the very beginning there was the demand for better RTW outcomes though which I got interested on research work of this field, too. The discussion of effects and effectiveness not only of rehabilitation but also of OHS is going on in Finland, and not least of the economic situation we are facing at the moment in Finland. My resent research work relevance for the conference are: We have just reported (2014) in Finnish Work (Dis)Ability Management supervised collaboration at the workplace, the case study research of management and leadership procedures in co- operation with OHS in Job Retention and Return to Work in one public in- house enterprise. During the spring 2014 we are reporting (in Finnish) The effects of the early intervention for prolonged sickness absence an evaluation study of the new legislation in Finland.. The large developmental and evaluation project, which is ran by SII in Finland, The co- operative work related rehabilitation, and where we study the role and tasks of OHS, will be reported till the end of this year. In addition to the research work I work as the (one out of four) Secretary on the National Board of Rehabilitation at the Ministry of Social Affairs and Health, responsible of Vocational and Occupational Rehabilitation issues. Liv Haugli. Thomas Lund. Ingibjorg Loftsdottir.

6 Speakers, May 9 th Kristiina Härkäpää, professor of rehabilitation science at the University of Lapland and docent in health psychology at the University of Helsinki. Her previous post was RD manager at the Rehabilitation Research and Development Centre of the Rehabilitation Foundation in Helsinki. Her main research interests focus on the evaluation of processes and outcomes of vocational and medical rehabilitation, the role of personal mastery, optimism and motivation in rehabilitation, and collaboration, shared agency and empowerment issues in rehabilitation. Ása Dóra Konráðsdóttir, Director of vocational rehabilitation,virk. Kerstin Ekberg, professor, has for many years performed research on return to work after sick leave, using epidemiological and qualitative study designs. During recent years work ability and employability have become central concepts in several studies, focus lies in particular on the work place and the welfare system as important stakeholders in the sick leave and rehabilitation process, and possible sources for inequalities in this process. She is also a research leader at the Helix Vinn Excellence Centre at Linköping University, performing multidisciplinary research on health in working life. In her presentation she will attempt to give an overview of the sick leave and rehabilitation process and aspects of inequalities in this process.

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