Estimating and mapping the population at risk of sleeping sickness.

PubMed

Simarro, Pere P; Cecchi, Giuliano; Franco, José R; Paone, Massimo; Diarra, Abdoulaye; Ruiz-Postigo, José Antonio; Fèvre, Eric M; Mattioli, Raffaele C; Jannin, Jean G

2012-01-01

Human African trypanosomiasis (HAT), also known as sleeping sickness, persists as a public health problem in several sub-Saharan countries. Evidence-based, spatially explicit estimates of population at risk are needed to inform planning and implementation of field interventions, monitor disease trends, raise awareness and support advocacy. Comprehensive, geo-referenced epidemiological records from HAT-affected countries were combined with human population layers to map five categories of risk, ranging from "very high" to "very low," and to estimate the corresponding at-risk population. Approximately 70 million people distributed over a surface of 1.55 million km(2) are estimated to be at different levels of risk of contracting HAT. Trypanosoma brucei gambiense accounts for 82.2% of the population at risk, the remaining 17.8% being at risk of infection from T. b. rhodesiense. Twenty-one million people live in areas classified as moderate to very high risk, where more than 1 HAT case per 10,000 inhabitants per annum is reported. Updated estimates of the population at risk of sleeping sickness were made, based on quantitative information on the reported cases and the geographic distribution of human population. Due to substantial methodological differences, it is not possible to make direct comparisons with previous figures for at-risk population. By contrast, it will be possible to explore trends in the future. The presented maps of different HAT risk levels will help to develop site-specific strategies for control and surveillance, and to monitor progress achieved by ongoing efforts aimed at the elimination of sleeping sickness.

Secreted proteases of Trypanosoma brucei gambiense: possible targets for sleeping sickness control?

PubMed

Bossard, Géraldine; Cuny, Gérard; Geiger, Anne

2013-01-01

Human African trypanosomiasis (HAT) is caused by trypanosomes of the species Trypanosoma brucei and belongs to the neglected tropical diseases. Presently, WHO has listed 36 countries as being endemic for sleeping sickness. No vaccine is available, and disease treatment is difficult and has life-threatening side effects. Therefore, there is a crucial need to search for new therapeutic targets against the parasite. Trypanosome excreted-secreted proteins could be promising targets, as the total secretome was shown to inhibit, in vitro, host dendritic cell maturation and their ability to induce lymphocytic allogenic responses. The secretome was found surprisingly rich in various proteins and unexpectedly rich in diverse peptidases, covering more than ten peptidase families or subfamilies. Given their abundance, one may speculate that they would play a genuine role not only in classical "housekeeping" tasks but also in pathogenesis. The paper reviews the deleterious role of proteases from trypanosomes, owing to their capacity to degrade host circulating or structural proteins, as well as proteic hormones, causing severe damage and preventing host immune response. In addition, proteases account for a number of drug targets, such drugs being used to treat severe diseases such AIDS. This review underlines the importance of secreted proteins and especially of secreted proteases as potential targets in HAT-fighting strategies. It points out the need to conduct further investigations on the specific role of each of these various proteases in order to identify those playing a central role in sleeping sickness and would be suitable for drug targeting. Copyright © 2013 International Union of Biochemistry and Molecular Biology, Inc.

Quercetin induces apoptosis of Trypanosoma brucei gambiense and decreases the proinflammatory response of human macrophages.

PubMed

Mamani-Matsuda, Maria; Rambert, Jérôme; Malvy, Denis; Lejoly-Boisseau, Hélène; Daulouède, Sylvie; Thiolat, Denis; Coves, Sara; Courtois, Pierrette; Vincendeau, Philippe; Mossalayi, M Djavad

2004-03-01

In addition to parasite spread, the severity of disease observed in cases of human African trypanosomiasis (HAT), or sleeping sickness, is associated with increased levels of inflammatory mediators, including tumor necrosis factor (TNF)-alpha and nitric oxide derivatives. In the present study, quercetin (3,3',4',5,7-pentahydroxyflavone), a potent immunomodulating flavonoid, was shown to directly induce the death of Trypanosoma brucei gambiense, the causative agent of HAT, without affecting normal human cell viability. Quercetin directly promoted T. b. gambiense death by apoptosis as shown by Annexin V binding. In addition to microbicidal activity, quercetin induced dose-dependent decreases in the levels of TNF-alpha and nitric oxide produced by activated human macrophages. These results highlight the potential use of quercetin as an antimicrobial and anti-inflammatory agent for the treatment of African trypanomiasis.

Quercetin Induces Apoptosis of Trypanosoma brucei gambiense and Decreases the Proinflammatory Response of Human Macrophages

PubMed Central

Mamani-Matsuda, Maria; Rambert, Jérôme; Malvy, Denis; Lejoly-Boisseau, Hélène; Daulouède, Sylvie; Thiolat, Denis; Coves, Sara; Courtois, Pierrette; Vincendeau, Philippe; Djavad Mossalayi, M.

2004-01-01

In addition to parasite spread, the severity of disease observed in cases of human African trypanosomiasis (HAT), or sleeping sickness, is associated with increased levels of inflammatory mediators, including tumor necrosis factor (TNF)-α and nitric oxide derivatives. In the present study, quercetin (3,3′,4′,5,7-pentahydroxyflavone), a potent immunomodulating flavonoid, was shown to directly induce the death of Trypanosoma brucei gambiense, the causative agent of HAT, without affecting normal human cell viability. Quercetin directly promoted T. b. gambiense death by apoptosis as shown by Annexin V binding. In addition to microbicidal activity, quercetin induced dose-dependent decreases in the levels of TNF-α and nitric oxide produced by activated human macrophages. These results highlight the potential use of quercetin as an antimicrobial and anti-inflammatory agent for the treatment of African trypanomiasis. PMID:14982785

Trypanosoma brucei gambiense: HMI-9 medium containing methylcellulose and human serum supports the continuous axenic in vitro propagation of the bloodstream form.

PubMed

Van Reet, N; Pyana, P P; Deborggraeve, S; Büscher, P; Claes, F

2011-07-01

Trypanosoma brucei (T.b.) gambiense causes the chronic form of human African trypanosomiasis or sleeping sickness. One of the major problems with studying T.b. gambiense is the difficulty to isolate it from its original host and the difficult adaptation to in vivo and in vitro mass propagation. The objective of this study was to evaluate if an established method for axenic culture of pleomorphic bloodstream form T.b. brucei strains, based on methylcellulose containing HMI-9 medium, also facilitated the continuous in vitro propagation of other bloodstream form Trypanozoon strains, in particular of T.b. gambiense. Bloodstream form trypanosomes from one T.b. brucei, two T.b. rhodesiense, one T. evansi and seven T.b. gambiense strains were isolated from mouse blood and each was concurrently cultivated in liquid and methylcellulose-containing HMI-9 based medium, either with or without additional human serum supplementation, for over 10 consecutive sub passages. Although HMI-9 based medium supplemented with 1.1% (w/v) methylcellulose supported the continuous cultivation of all non-gambiense strains better than liquid media could, the in vitro cultivation of all gambiense strains was only achieved in HMI-9 based medium containing 1.1% (w/v) methylcellulose, 15% (v/v) fetal calf serum and 5% (v/v) heat-inactivated human serum. Copyright © 2011 Elsevier Inc. All rights reserved.

The continuing problem of human African trypanosomiasis (sleeping sickness).

PubMed

Kennedy, Peter G E

2008-08-01

Human African trypanosomiasis, also known as sleeping sickness, is a neglected disease, and it continues to pose a major threat to 60 million people in 36 countries in sub-Saharan Africa. Transmitted by the bite of the tsetse fly, the disease is caused by protozoan parasites of the genus Trypanosoma and comes in two types: East African human African trypanosomiasis caused by Trypanosoma brucei rhodesiense and the West African form caused by Trypanosoma brucei gambiense. There is an early or hemolymphatic stage and a late or encephalitic stage, when the parasites cross the blood-brain barrier to invade the central nervous system. Two critical current issues are disease staging and drug therapy, especially for late-stage disease. Lumbar puncture to analyze cerebrospinal fluid will remain the only method of disease staging until reliable noninvasive methods are developed, but there is no widespread consensus as to what exactly defines biologically central nervous system disease or what specific cerebrospinal fluid findings should justify drug therapy for late-stage involvement. All four main drugs used for human African trypanosomiasis are toxic, and melarsoprol, the only drug that is effective for both types of central nervous system disease, is so toxic that it kills 5% of patients who receive it. Eflornithine, alone or combined with nifurtimox, is being used increasingly as first-line therapy for gambiense disease. There is a pressing need for an effective, safe oral drug for both stages of the disease, but this will require a significant increase in investment for new drug discovery from Western governments and the pharmaceutical industry.

Challenges towards the elimination of Human African Trypanosomiasis in the sleeping sickness focus of Campo in southern Cameroon.

PubMed

Simo, Gustave; Mbida Mbida, Jean Arthur; Ebo'o Eyenga, Vincent; Asonganyi, Tazoacha; Njiokou, Flobert; Grébaut, Pascal

2014-08-16

The sleeping sickness focus of Campo lies along the Atlantic coast and extends along the Ntem River, which constitutes the Cameroonian and Equatorial Guinean border. It is a hypo-endemic focus with the disease prevalence varying from 0.3 to 0.86% during the last few decades. Investigations on animal reservoirs revealed a prevalence of Trypanosoma brucei gambiense of 0.6% in wild animals and 4.83% in domestic animals of this focus. From 2001 to 2012, about 19 931 tsetse were collected in this focus and five tsetse species including Glossina palpalis palpalis, G. pallicera, G. nigrofusca, G. tabaniformis and G. caliginea were identified. The analysis of blood meals of these flies showed that they feed on human, pig, goat, sheep, and wild animals such as antelope, duiker, wild pig, turtle and snake. The percentage of blood meals taken on these hosts varies according to sampling periods. For instance, 6.8% of blood meals from pig were reported in 2004 and 22% in 2008. This variation is subjected to considerable evolutions because the Campo HAT focus is submitted to socio-economic mutations including the reopening of a new wood company, the construction of autonomous port at "Kribi" as well as the dam at "Memve ele". These activities will bring more that 3000 inhabitants around Campo and induce the deforestation for the implementation of farmlands as well as breeding of domestic animals. Such mutations have impacts on the transmission and the epidemiology of sleeping sickness due to the modification of the fauna composition, the nutritional behavior of tsetse, the zoophilic/anthropophilic index. To achieve the elimination goal in the sleeping sickness focus of Campo, we report in this paper the current epidemiological situation of the disease, the research findings of the last decades notably on the population genetics of trypanosomes, the modifications of nutritional behavior of tsetse, the prevalence of T. b. gambiense in humans, domestic and wild animals. An overview

Survey on Trypanosoma spp. infection of dogs in Gabon and its epidemiological implications for sleeping sickness.

PubMed

Watier-Grillot, S; Herder, S; Marié, J-L; Bourry, O; Cuny, G; Davoust, B

2016-05-01

This survey screened native dogs (Canis familiaris) in Gabon (Africa) for trypanosome infection. A total of 376 apparently healthy dogs, divided into two populations, were examined. The first group included 252 semi-domesticated dogs inhabiting 16 villages of the Ogooué-Ivindo Province, a rural inland area in northeast Gabon, and the second group 124 dogs belonging to protection companies or families from Libreville (n = 113) and Port-Gentil (n = 11), in the coastal area of Gabon. Both study areas include active or former foci of sleeping sickness in Gabon. Molecular testing (polymerase chain reaction) was performed on blood samples from dogs in both groups. All dogs were negative for T. congolense ("savanna type" and "forest type"). Eighteen dogs (4.7%), however, tested positive for T. brucei s.l.: 3% (8/252) were from the Ogooué-Ivindo Province, and 8% (10/124) from the coastal area. These animals may be potential reservoirs of the parasite T. brucei gambiense, responsible for human African trypanosomiasis. This hypothesis, as well as the role of the dog as a sentinel of human infection by T. brucei gambiense, should be investigated in further studies.

A mechanism for sickness sleep: lessons from invertebrates.

PubMed

Davis, Kristen C; Raizen, David M

2017-08-15

During health, animal sleep is regulated by an internal clock and by the duration of prior wakefulness. During sickness, sleep is regulated by cytokines released from either peripheral cells or from cells within the nervous system. These cytokines regulate central nervous system neurons to induce sleep. Recent research in the invertebrates Caenorhabditis elegans and Drosophila melanogaster has led to new insights into the mechanism of sleep during sickness. Sickness is triggered by exposure to environments such as infection, heat, or ultraviolet light irradiation, all of which cause cellular stress. Epidermal growth factor is released from stressed cells and signals to activate central neuroendocrine cell(s). These neuron(s) release neuropeptides including those containing an amidated arginine(R)-phenylalanine(F) motif at their C-termini (RFamide peptides). Importantly, mechanisms regulating sickness sleep are partially distinct from those regulating healthy sleep. We will here review key findings that have elucidated the central neuroendocrine mechanism of sleep during sickness. Adaptive mechanisms employed in the control of sickness sleep may play a role in correcting cellular homeostasis after various insults. We speculate that these mechanisms may play a maladaptive role in human pathological conditions such as in the fatigue and anorexia associated with autoimmune diseases, with major depression, and with unexplained chronic fatigue. © 2016 The Authors. The Journal of Physiology © 2016 The Physiological Society.

Identification of different trypanosome species in the mid-guts of tsetse flies of the Malanga (Kimpese) sleeping sickness focus of the Democratic Republic of Congo.

PubMed

Simo, Gustave; Silatsa, Barberine; Flobert, Njiokou; Lutumba, Pascal; Mansinsa, Philemon; Madinga, Joule; Manzambi, Emile; De Deken, Reginald; Asonganyi, Tazoacha

2012-09-19

The Malanga sleeping sickness focus of the Democratic Republic of Congo has shown an epidemic evolution of disease during the last century. However, following case detection and treatment, the prevalence of the disease decreased considerably. No active survey has been undertaken in this focus for a couple of years. To understand the current epidemiological status of sleeping sickness as well as the animal African trypanosomiasis in the Malanga focus, we undertook the identification of tsetse blood meals as well as different trypanosome species in flies trapped in this focus. Pyramidal traps were use to trap tsetse flies. All flies caught were identified and live flies were dissected and their mid-guts collected. Fly mid-gut was used for the molecular identification of the blood meal source, as well as for the presence of different trypanosome species. About 949 Glossina palpalis palpalis were trapped; 296 (31.2%) of which were dissected, 60 (20.3%) blood meals collected and 57 (19.3%) trypanosome infections identified. The infection rates were 13.4%, 5.1%, 3.5% and 0.4% for Trypanosoma congolense savannah type, Trypanosoma brucei s.l., Trypanosoma congolense forest type and Trypanosoma vivax, respectively. Three mixed infections including Trypanosoma brucei s.l. and Trypanosoma congolense savannah type, and one mixed infection of Trypanosoma vivax and Trypanosoma congolense savannah type were identified. Eleven Trypanosoma brucei gambiense infections were identified; indicating an active circulation of this trypanosome subspecies. Of all the identified blood meals, about 58.3% were identified as being taken on pigs, while 33.3% and 8.3% were from man and other mammals, respectively. The presence of Trypanosoma brucei in tsetse mid-guts associated with human blood meals is indicative of an active transmission of this parasite between tsetse and man. The considerable number of pig blood meals combined with the circulation of Trypanosoma brucei gambiense in this focus

Xenomonitoring of sleeping sickness transmission in Campo (Cameroon).

PubMed

Grébaut, Pascal; Melachio, Trésor; Nyangmang, Simplice; Eyenga, Vincent Ebo'o; Njitchouang, Guy-Roger; Ofon, Elvis; Njiokou, Flobert; Simo, Gustave

2016-04-12

The sleeping sickness focus of Campo in South Cameroon is still active, at a low endemic level, for more than a century, despite a regular medical surveillance. The present study focuses on the spatial distribution of xenomonitoring information obtained from an entomological survey performed in the dry season 2012. It appears that humans constitute a third of the blood meals and that the flies' densities were coherent with those classically observed in the different biotopes. Paradoxically, the epicenter of the focus is the place where the risk indicators are the lowest ones. Particular attention was paid to the entomological device so that it covered the main part of human activities in the study area. One hundred and sixty-two pyramidal traps were used to catch tsetse flies twice a day that were identified, counted, dissected. Molecular analysis using classical and specific molecular markers was conducted to determine the importance of trypanosome infections and the nature of the feeding hosts. This information was used to calculate a Transmission Risk Index and to define a gradient of risk that was projected into a Geographical Information System. Conventional entomological indicators such as species identification of tsetse flies or the Apparent Density per Trap per day, show that Glossina palpalis palpalis is the main species in the campo area which is classically distributed into the different biotopes of the study area. Molecular analysis reveals that humans constitute a third of the blood feeding hosts and that 20 % of the dissected flies were infected with trypanosomes, principally with Nannomonas. Nevertheless, one fly was carrying Trypanosoma brucei gambiense, the pathogen agent of sleeping sickness, showing that the reservoir is still active in the epicenter of the focus. Paradoxically, the Transmission Risk Index is not important in the epicenter, demonstrating that endemic events are not only depending on the man/vector contact. Xenomonitoring

Sensitivity and specificity of HAT Sero-K-SeT, a rapid diagnostic test for serodiagnosis of sleeping sickness caused by Trypanosoma brucei gambiense: a case-control study.

PubMed

Büscher, Philippe; Mertens, Pascal; Leclipteux, Thierry; Gilleman, Quentin; Jacquet, Diane; Mumba-Ngoyi, Dieudonné; Pyana, Patient Pati; Boelaert, Marleen; Lejon, Veerle

2014-06-01

Human African trypanosomiasis (HAT) is a life-threatening infection affecting rural populations in sub-Saharan Africa. Large-scale population screening by antibody detection with the Card Agglutination Test for Trypanosomiasis (CATT)/Trypanosoma brucei (T b) gambiense helped reduce the number of reported cases of gambiense HAT to fewer than 10 000 in 2011. Because low case numbers lead to decreased cost-effectiveness of such active screening, we aimed to assess diagnostic accuracy of a rapid serodiagnostic test (HAT Sero-K-SeT) applicable in primary health-care centres. In our case-control study, we assessed participants older than 11 years who presented for HAT Sero-K-SeT and CATT/T b gambiense at primary care centres or to mobile teams (and existing patients with confirmed disease status at these centres) in Bandundu Province, DR Congo. We defined cases as patients with trypanosomes that had been identified in lymph node aspirate, blood, or cerebrospinal fluid. During screening, we recruited controls without previous history of HAT or detectable trypanosomes in blood or lymph who resided in the same area as the cases. We assessed diagnostic accuracy of three antibody detection tests for gambiense HAT: HAT Sero-K-SeT and CATT/T b gambiense (done with venous blood at the primary care centres) and immune trypanolysis (done with plasma at the Institute of Tropical Medicine, Antwerp, Belgium). Between June 6, 2012, and Feb 25, 2013, we included 134 cases and 356 controls. HAT Sero-K-SeT had a sensitivity of 0·985 (132 true positives, 95% CI 0·947-0·996) and a specificity of 0·986 (351 true negatives, 0·968-0·994), which did not differ significantly from CATT/T b gambiense (sensitivity 95% CI 0·955, 95% CI 0·906-0·979 [128 true positives] and specificity 0·972, 0·949-0·985 [346 true negatives]) or immune trypanolysis (sensitivity 0·985, 0·947-0·996 [132 true positives] and specificity 0·980, 0·960-0·990 [349 true negatives]). The diagnostic accuracy

Sleep problems and sickness absence among middle-aged employees.

PubMed

Rahkonen, Ossi; Lallukka, Tea; Kronholm, Erkki; Vahtera, Jussi; Lahelma, Eero; Laaksonen, Mikko

2012-01-01

The aim of this study was to examine whether sleep problems predict subsequent sickness absence among middle-aged public sector employees. The data included 5391 female and 1454 male employees of the City of Helsinki from questionnaire surveys at baseline in 2000-2002. These data were prospectively linked to the employer's sickness absence register data, with a mean follow-up time of 4.1 years. Using Poisson regression analysis, we examined associations between sleep problems (none, rare, occasional, and frequent), as indicated by the Jenkins Sleep Questionnaire, and self-certified short (1-3 days) and medically confirmed intermediate (4-14 days) and long (≥15 days) sickness absence spells. Sociodemographic factors, working conditions, work-family interface, health behaviors, and health status were obtained from the baseline surveys. At baseline, 21% of women and 17% of men reported frequent sleep problems. Frequent sleep problems were associated with subsequent sickness absence spells irrespective of length of absence among both women and men after adjusting for age. After full adjustment for all covariates, the associations attenuated but remained for self-certified sickness absence [risk ratio (RR) for women 1.40, 95% confidence interval (95% CI) 1.25-1.56 and RR 1.59, 95% CI 1.24-2.03 for men], and medically confirmed intermediate (RR 1.34, 95% CI 1.17-1.52 and RR 1.35, 95% CI 1.02-1.77, for women and men, respectively) and long (RR 1.58, 95% CI 1.29-1.94 and RR 1.44, 95% CI 0.93-2.21, for women and men, respectively) sickness absence spells. Occasional sleep problems were also associated with sickness absence, but the associations were somewhat weaker. In occupational healthcare, sleep problems should be addressed to prevent their occurrence and subsequent ill-health and sickness absence.

Sleep and Sickness Absence: A Nationally Representative Register-Based Follow-Up Study

PubMed Central

Lallukka, Tea; Kaikkonen, Risto; Härkänen, Tommi; Kronholm, Erkki; Partonen, Timo; Rahkonen, Ossi; Koskinen, Seppo

2014-01-01

Study Objectives: We aimed to examine various sleep measures as determinants of sickness absence while considering confounders. Design: Nationally representative Health 2000 Survey linked with sickness absence data from the Finnish Social Insurance Institution. Setting: Finland. Participants: Working-aged women (n = 1,875) and men (n = 1,885). Interventions: N/A. Measurements and Results: Insomnia-related symptoms, early morning awakenings, being more tired during daytime than other people of same age, use of sleeping pills, excessive daytime sleepiness, probable sleep apnea (4 items about snoring/apnea), and reporting that sleep duration varies between different seasons were examined as determinants of sickness absence over a 7.2 year follow-up. Poisson and gamma regression models were fitted. After adjusting age, all examined sleep disturbances except excessive daytime sleepiness were associated with sickness absence among men (RRs 1.3-2.5). Among women, after adjusting for age, insomnia-related symptoms, early morning awakenings, being more tired than others, and use of sleeping pills were associated with sickness absence (RRs 1.4-1.8). After further adjustments for education, working conditions, health behaviors, and objectively measured mental and somatic health, the associations somewhat attenuated but mainly remained. The optimal sleep duration with the lowest risk of sickness absence was 7.6 hours for women and 7.8 hours for men. Although persistence of other health problems could affect the estimates, direct costs due to sickness absence could decrease by up to 28% if sleep disturbances could be fully addressed. Conclusions: This study highlights the need for prevention of sleep disturbances and promotion of optimal sleep length to prevent sickness absence. Citation: Lallukka T, Kaikkonen R, Härkänen T, Kronholm E, Partonen T, Rahkonen O, Koskinen S. Sleep and sickness absence: a nationally representative register-based follow-up study. SLEEP 2014

Sleep and sickness absence: a nationally representative register-based follow-up study.

PubMed

Lallukka, Tea; Kaikkonen, Risto; Härkänen, Tommi; Kronholm, Erkki; Partonen, Timo; Rahkonen, Ossi; Koskinen, Seppo

2014-09-01

We aimed to examine various sleep measures as determinants of sickness absence while considering confounders. Nationally representative Health 2000 Survey linked with sickness absence data from the Finnish Social Insurance Institution. Finland. Working-aged women (n = 1,875) and men (n = 1,885). N/A. Insomnia-related symptoms, early morning awakenings, being more tired during daytime than other people of same age, use of sleeping pills, excessive daytime sleepiness, probable sleep apnea (4 items about snoring/apnea), and reporting that sleep duration varies between different seasons were examined as determinants of sickness absence over a 7.2 year follow-up. Poisson and gamma regression models were fitted. After adjusting age, all examined sleep disturbances except excessive daytime sleepiness were associated with sickness absence among men (RRs 1.3-2.5). Among women, after adjusting for age, insomnia-related symptoms, early morning awakenings, being more tired than others, and use of sleeping pills were associated with sickness absence (RRs 1.4-1.8). After further adjustments for education, working conditions, health behaviors, and objectively measured mental and somatic health, the associations somewhat attenuated but mainly remained. The optimal sleep duration with the lowest risk of sickness absence was 7.6 hours for women and 7.8 hours for men. Although persistence of other health problems could affect the estimates, direct costs due to sickness absence could decrease by up to 28% if sleep disturbances could be fully addressed. This study highlights the need for prevention of sleep disturbances and promotion of optimal sleep length to prevent sickness absence. © 2014 Associated Professional Sleep Societies, LLC.

Sleeping sickness in Uganda: revisiting current and historical distributions.

PubMed

Berrang-Ford, Lea; Odiit, Martin; Maiso, Faustin; Waltner-Toews, David; McDermott, John

2006-12-01

Sleeping sickness is a parasitic, vector-borne disease, carried by the tsetse fly and prevalent in sub-Saharan Africa. The disease continues to pose a public health burden in Uganda, which experienced a widespread outbreak in 1900-1920, and a more recent outbreak in 1976-1989. The disease continues to spread to uninfected districts. This paper compares the spatial distributions of sleeping in Uganda for the 1900-1920 outbreak period with current disease foci, and discusses information gaps and implications arising for future research, prevention and control. Population census records for 1911 and sleeping sickness records from Medical and Sanitary Reports of the Ugandan Protectorate for 1905-1936 were extracted from the Uganda Archives. Current sleeping sickness distribution data were provided by the Ministry of Health, Uganda. These were used to develop sleeping sickness distribution maps for comparison between the early 1900s and the early 2000s. The distribution of sleeping sickness from 1905-1920 shows notable differences compared to the current distribution of disease. In particular, archival cases were recorded in south-west and central Uganda, areas currently free of disease. The disease focus has moved from lakeshore Buganda (1905-1920) to the Busoga and south-east districts. Archival sleeping sickness distributions indicate the potential for a much wider area of disease risk than indicated by current disease foci. This is compounded by an absence of tsetse distribution data, continued political instability in north-central Uganda, continued spread of disease into new districts, and evidence of the role of livestock movements in spreading the parasite. These results support concerns as to the potential mergence of the two disease foci in the south-east and north-west of the country.

Sickness absenteeism is associated with sleep problems independent of sleep disorders: results of the 2016 Sleep Health Foundation national survey.

PubMed

Reynolds, Amy C; Appleton, Sarah L; Gill, Tiffany K; Taylor, Anne W; McEvoy, R Douglas; Ferguson, Sally A; Adams, Robert J

2017-10-01

Sleep disorders are associated with sickness absenteeism (SA), at significant economic cost. Correlates of absenteeism are less well described in nonclinical samples. We determined the relationship between markers of inadequate sleep and SA in a sample of 551 working adults aged ≥18 years across Australia. We considered diagnosed obstructive sleep apnea (OSA) and insomnia symptoms, daytime symptoms, and sleepiness with respect to sickness absenteeism (missing ≥1 day of work in the past 28 days because of problems with physical or mental health). Sickness absenteeism was reported by 27.0% of participants and was more frequent in younger participants, university graduates, and those experiencing financial stress. Sickness absenteeism was independently associated with insomnia (odds ratio [OR]=2.5, confidence interval [CI]=1.5-4.0], OSA (OR=9.8, CI=4.7-20.7), sleep aid use (OR=3.0, CI=1.9-4.7), and daytime symptoms (OR=3.0, CI=2.0-4.6) and inversely associated with perception of getting adequate sleep (OR=0.6, CI=0.4-0.9). Associations persisted in the population free of insomnia and/or OSA. In adults without clinical sleep disorders, sleep behaviors are contributing to sickness absenteeism. An increased focus at an organizational level on improvement of sleep hygiene is important to reduce lost work performance. Copyright © 2017 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

Sleep structure: a new diagnostic tool for stage determination in sleeping sickness.

PubMed

Buguet, Alain; Bisser, Sylvie; Josenando, Théophile; Chapotot, Florian; Cespuglio, Raymond

2005-01-01

Human African trypanosomiasis (HAT), due to the transmission of Trypanosoma brucei (T. b.) gambiense and T. b. rhodesiense by tsetse flies, is re-emerging in inter-tropical Africa. It evolves from the hemolymphatic Stage I to the meningo-encephalitic Stage II. The latter is generally treated with melarsoprol, an arseniate provoking often a deadly encephalopathy. A precise determination of the HAT evolution stage is therefore crucial. Stage II patients show: (i) a deregulation of the 24-h distribution of the sleep-wake alternation; (ii) an alteration of the sleep structure, with frequent sleep onset rapid eye movement (REM) periods (SOREMPs). Gambian HAT was diagnosed in eight patients (four, Stage II; three, Stage I; one, "intermediate" case) at the trypanosomiasis clinic at Viana (Angola). Continuous 48-h polysomnography was recorded on Oxford Medilog 9000-II portable systems before and after treatment with melarsoprol (Stage II) or pentamidine (Stage I and "intermediate" stage). Sleep traces were visually analyzed in 20-s epochs using the PRANA software. Stage II patients showed the complete sleep-wake syndrome, partly reversed by melarsoprol 1 month later. Two Stage I patients did not experience any of these alterations. However, the "intermediate" and one Stage I patients exhibited sleep disruptions and/or SOREMPs, persistent after pentamidine treatment. Polysomnography may represent a diagnostic tool to distinguish the two stages of HAT. Especially, SOREMPs appear shortly after the central nervous system invasion by trypanosomes. The reversibility of the sleep-wake cycle and sleep structure alterations after appropriate treatment constitutes the basis of an evaluation of the healing process.

Civil conflict and sleeping sickness in Africa in general and Uganda in particular.

PubMed

Berrang Ford, Lea

2007-03-29

Conflict and war have long been recognized as determinants of infectious disease risk. Re-emergence of epidemic sleeping sickness in sub-Saharan Africa since the 1970s has coincided with extensive civil conflict in affected regions. Sleeping sickness incidence has placed increasing pressure on the health resources of countries already burdened by malaria, HIV/AIDS, and tuberculosis. In areas of Sudan, the Democratic Republic of the Congo, and Angola, sleeping sickness occurs in epidemic proportions, and is the first or second greatest cause of mortality in some areas, ahead of HIV/AIDS. In Uganda, there is evidence of increasing spread and establishment of new foci in central districts. Conflict is an important determinant of sleeping sickness outbreaks, and has contributed to disease resurgence. This paper presents a review and characterization of the processes by which conflict has contributed to the occurrence of sleeping sickness in Africa. Conflict contributes to disease risk by affecting the transmission potential of sleeping sickness via economic impacts, degradation of health systems and services, internal displacement of populations, regional insecurity, and reduced access for humanitarian support. Particular focus is given to the case of sleeping sickness in south-eastern Uganda, where incidence increase is expected to continue. Disease intervention is constrained in regions with high insecurity; in these areas, political stabilization, localized deployment of health resources, increased administrative integration and national capacity are required to mitigate incidence. Conflict-related variables should be explicitly integrated into risk mapping and prioritization of targeted sleeping sickness research and mitigation initiatives.

Civil conflict and sleeping sickness in Africa in general and Uganda in particular

PubMed Central

Berrang Ford, Lea

2007-01-01

Conflict and war have long been recognized as determinants of infectious disease risk. Re-emergence of epidemic sleeping sickness in sub-Saharan Africa since the 1970s has coincided with extensive civil conflict in affected regions. Sleeping sickness incidence has placed increasing pressure on the health resources of countries already burdened by malaria, HIV/AIDS, and tuberculosis. In areas of Sudan, the Democratic Republic of the Congo, and Angola, sleeping sickness occurs in epidemic proportions, and is the first or second greatest cause of mortality in some areas, ahead of HIV/AIDS. In Uganda, there is evidence of increasing spread and establishment of new foci in central districts. Conflict is an important determinant of sleeping sickness outbreaks, and has contributed to disease resurgence. This paper presents a review and characterization of the processes by which conflict has contributed to the occurrence of sleeping sickness in Africa. Conflict contributes to disease risk by affecting the transmission potential of sleeping sickness via economic impacts, degradation of health systems and services, internal displacement of populations, regional insecurity, and reduced access for humanitarian support. Particular focus is given to the case of sleeping sickness in south-eastern Uganda, where incidence increase is expected to continue. Disease intervention is constrained in regions with high insecurity; in these areas, political stabilization, localized deployment of health resources, increased administrative integration and national capacity are required to mitigate incidence. Conflict-related variables should be explicitly integrated into risk mapping and prioritization of targeted sleeping sickness research and mitigation initiatives. PMID:17411421

Trypanosoma brucei gambiense trypanosomiasis in Terego county, northern Uganda, 1996: a lot quality assurance sampling survey.

PubMed

Hutin, Yvan J F; Legros, Dominique; Owini, Vincent; Brown, Vincent; Lee, Evan; Mbulamberi, Dawson; Paquet, Christophe

2004-04-01

We estimated the pre-intervention prevalence of Trypanosoma brucei gambiense (Tbg) trypanosomiasis using the lot quality assurance sampling (LQAS) methods in 14 parishes of Terego County in northern Uganda. A total of 826 participants were included in the survey sample in 1996. The prevalence of laboratory confirmed Tbg trypanosomiasis adjusted for parish population sizes was 2.2% (95% confidence interval =1.1-3.2). This estimate was consistent with the 1.1% period prevalence calculated on the basis of cases identified through passive and active screening in 1996-1999. Ranking of parishes in four categories according to LQAS analysis of the 1996 survey predicted the prevalences observed during the first round of active screening in the population in 1997-1998 (P < 0.0001, by chi-square test). Overall prevalence and ranking of parishes obtained with LQAS were validated by the results of the population screening, suggesting that these survey methods may be useful in the pre-intervention phase of sleeping sickness control programs.

The dispersal ecology of Rhodesian sleeping sickness following its introduction to a new area.

PubMed

Wardrop, Nicola A; Fèvre, Eric M; Atkinson, Peter M; Welburn, Susan C

2013-01-01

Tsetse-transmitted human and animal trypanosomiasis are constraints to both human and animal health in sub-Saharan Africa, and although these diseases have been known for over a century, there is little recent evidence demonstrating how the parasites circulate in natural hosts and ecosystems. The spread of Rhodesian sleeping sickness (caused by Trypanosoma brucei rhodesiense) within Uganda over the past 15 years has been linked to the movement of infected, untreated livestock (the predominant reservoir) from endemic areas. However, despite an understanding of the environmental dependencies of sleeping sickness, little research has focused on the environmental factors controlling transmission establishment or the spatially heterogeneous dispersal of disease following a new introduction. In the current study, an annually stratified case-control study of Rhodesian sleeping sickness cases from Serere District, Uganda was used to allow the temporal assessment of correlations between the spatial distribution of sleeping sickness and landscape factors. Significant relationships were detected between Rhodesian sleeping sickness and selected factors, including elevation and the proportion of land which was "seasonally flooding grassland" or "woodlands and dense savannah." Temporal trends in these relationships were detected, illustrating the dispersal of Rhodesian sleeping sickness into more 'suitable' areas over time, with diminishing dependence on the point of introduction in concurrence with an increasing dependence on environmental and landscape factors. These results provide a novel insight into the ecology of Rhodesian sleeping sickness dispersal and may contribute towards the implementation of evidence-based control measures to prevent its further spread.

Challenges in the diagnosis and management of sleeping sickness in Tanzania: a case report.

PubMed

Sindato, C; Kibona, S N; Nkya, G M; Mbilu, T J N K; Manga, C; Kaboya, J S; Rawille, F

2008-07-01

In Tanzania sleeping sickness presents a serious threat to human health with a country-wide average of 400 cases reported annually. Both wild and domestic animals have been found to play a significant role in the epidemiology of sleeping sickness. Serengeti National Park in northern Tanzania, has experienced a number of sleeping sickness epidemics since 1922. The epidemics were associated with abundant game animals in the areas and Glossina swynnertoni was incriminated as the main vector. However since 2001 there has been no case of sleeping sickness reported from the park. This case report highlights on the possibility of resurgence and challenges in the diagnosis and management of sleeping sickness in Serengeti. A 38 years old Tanzanian man working in the Serengeti National Park who had experienced various tsetse bites was presented with a febrile condition and history of unsuccessful case management at different health facilities. Blood and cerebrospinal fluid (CSF) samples were examined for the presence oftrypanosomes using wet film, Field's stain and concentration techniques. Typanosoma brucei rhodesiense were detected in both the blood and CSF samples. The patient was treated successfully with melarsoprol. The results of this case study highlight the possibility of resurgence of sleeping sickness in the park hence calls for the need to create more awareness among the community and clinicians. There is need for early reporting to health facility and strengthening the diagnostic capacity of healthcare facilities in and around national parks endemic for sleeping sickness.

Late stage infection in sleeping sickness.

PubMed

Wolburg, Hartwig; Mogk, Stefan; Acker, Sven; Frey, Claudia; Meinert, Monika; Schönfeld, Caroline; Lazarus, Michael; Urade, Yoshihiro; Kubata, Bruno Kilunga; Duszenko, Michael

2012-01-01

At the turn of the 19(th) century, trypanosomes were identified as the causative agent of sleeping sickness and their presence within the cerebrospinal fluid of late stage sleeping sickness patients was described. However, no definitive proof of how the parasites reach the brain has been presented so far. Analyzing electron micrographs prepared from rodent brains more than 20 days after infection, we present here conclusive evidence that the parasites first enter the brain via the choroid plexus from where they penetrate the epithelial cell layer to reach the ventricular system. Adversely, no trypanosomes were observed within the parenchyma outside blood vessels. We also show that brain infection depends on the formation of long slender trypanosomes and that the cerebrospinal fluid as well as the stroma of the choroid plexus is a hostile environment for the survival of trypanosomes, which enter the pial space including the Virchow-Robin space via the subarachnoid space to escape degradation. Our data suggest that trypanosomes do not intend to colonize the brain but reside near or within the glia limitans, from where they can re-populate blood vessels and disrupt the sleep wake cycles.

Sleeping sickness in southeastern Uganda: a spatio-temporal analysis of disease risk, 1970-2003.

PubMed

Berrang-Ford, Lea; Berke, Olaf; Sweeney, Sean; Abdelrahman, Lubowa

2010-12-01

Sleeping sickness is a major threat to human health in sub-Saharan Africa. Southeastern Uganda has experienced a number of significant epidemics in the past 100 years, most recently from 1976 to 1989. Recent and continued spread of the disease has highlighted gaps in the ability of current research to explain and predict the distribution of infection. Vegetation cover and changes in vegetation may be important determinants of transmission and disease risk because of the habitat preferences of the tsetse fly vector. This study examines the determinants of sleeping sickness distribution and incidence in southeastern Uganda from 1970 to 2003, spanning the full epidemic region and cycle, and focusing in particular on vegetation cover and change. Sleeping sickness data were collected from records of the Ugandan Ministry of Health, individual sleeping sickness treatment centers, and interviews with public health officials. Vegetation data were acquired from satellite imagery for four dates spanning the epidemic period, 1973, 1986, 1995, and 2001. Zero-inflated regression models were used to model predictors of disease presence and magnitude. Correlations between disease incidence and the normalized difference vegetation index (NDVI) at the subcounty level were evaluated. Results indicate that sleeping sickness infection is predominantly associated with proximity to water and spatial location, while disease incidence is highest in subcounties with moderate to high NDVI. The vegetation density (NDVI) at which sleeping sickness incidence peaked differed throughout the study period. The optimal vegetation density capable of supporting sleeping sickness transmission may be lower than indicated by data from endemic regions, indicating increased potential for disease spread under suitable conditions.

Including refugees in disease elimination: challenges observed from a sleeping sickness programme in Uganda.

PubMed

Palmer, Jennifer J; Robert, Okello; Kansiime, Freddie

2017-01-01

Ensuring equity between forcibly-displaced and host area populations is a key challenge for global elimination programmes. We studied Uganda's response to the recent refugee influx from South Sudan to identify key governance and operational lessons for national sleeping sickness programmes working with displaced populations today. A refugee policy which favours integration of primary healthcare services for refugee and host populations and the availability of rapid diagnostic tests (RDTs) to detect sleeping sickness at this health system level makes Uganda well-placed to include refugees in sleeping sickness surveillance. Using ethnographic observations of coordination meetings, review of programme data, interviews with sleeping sickness and refugee authorities and group discussions with health staff and refugees (2013-2016), we nevertheless identified some key challenges to equitably integrating refugees into government sleeping sickness surveillance. Despite fears that refugees were at risk of disease and posed a threat to elimination, six months into the response, programme coordinators progressed to a sentinel surveillance strategy in districts hosting the highest concentrations of refugees. This meant that RDTs, the programme's primary surveillance tool, were removed from most refugee-serving facilities, exacerbating existing inequitable access to surveillance and leading refugees to claim that their access to sleeping sickness tests had been better in South Sudan. This was not intentionally done to exclude refugees from care, rather, four key governance challenges made it difficult for the programme to recognise and correct inequities affecting refugees: (a) perceived donor pressure to reduce the sleeping sickness programme's scope without clear international elimination guidance on surveillance quality; (b) a problematic history of programme relations with refugee-hosting districts which strained supervision of surveillance quality; (c) difficulties that

Sleeping Sickness in the 'Omics Era.

PubMed

Tiberti, Natalia; Sanchez, Jean-Charles

2018-03-08

Sleeping sickness is a neglected tropical disease caused by Trypanosoma brucei parasites, affecting the poorest communities in sub-Saharan Africa. The great efforts done by the scientific community, local governments, and non-governmental organizations (NGOs) via active patients' screening, vector control, and introduction of improved treatment regimens have significantly contributed to the reduction of human African trypanosomiasis (HAT) incidence during the last 15 years. Consequently, the WHO has announced the objective of HAT elimination as a public health problem by 2020. Studies at both parasite and host levels have improved our understanding of the parasite biology and the mechanisms of parasite interaction with its mammalian host. In this review, the impact that 'omics studies have had on sleeping sickness by revealing novel properties of parasite's subcellular organelles are summarized, by highlighting changes induced in the host during the infection and by proposing potential disease markers and therapeutic targets. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Reducing Human-Tsetse Contact Significantly Enhances the Efficacy of Sleeping Sickness Active Screening Campaigns: A Promising Result in the Context of Elimination.

PubMed

Courtin, Fabrice; Camara, Mamadou; Rayaisse, Jean-Baptiste; Kagbadouno, Moise; Dama, Emilie; Camara, Oumou; Traoré, Ibrahima S; Rouamba, Jérémi; Peylhard, Moana; Somda, Martin B; Leno, Mamadou; Lehane, Mike J; Torr, Steve J; Solano, Philippe; Jamonneau, Vincent; Bucheton, Bruno

2015-01-01

Control of gambiense sleeping sickness, a neglected tropical disease targeted for elimination by 2020, relies mainly on mass screening of populations at risk and treatment of cases. This strategy is however challenged by the existence of undetected reservoirs of parasites that contribute to the maintenance of transmission. In this study, performed in the Boffa disease focus of Guinea, we evaluated the value of adding vector control to medical surveys and measured its impact on disease burden. The focus was divided into two parts (screen and treat in the western part; screen and treat plus vector control in the eastern part) separated by the Rio Pongo river. Population census and baseline entomological data were collected from the entire focus at the beginning of the study and insecticide impregnated targets were deployed on the eastern bank only. Medical surveys were performed in both areas in 2012 and 2013. In the vector control area, there was an 80% decrease in tsetse density, resulting in a significant decrease of human tsetse contacts, and a decrease of disease prevalence (from 0.3% to 0.1%; p=0.01), and an almost nil incidence of new infections (<0.1%). In contrast, incidence was 10 times higher in the area without vector control (>1%, p<0.0001) with a disease prevalence increasing slightly (from 0.5 to 0.7%, p=0.34). Combining medical and vector control was decisive in reducing T. b. gambiense transmission and in speeding up progress towards elimination. Similar strategies could be applied in other foci.

Sleeping sickness in Buikwe South Health sub-district: Neuroinfection situation report.

PubMed

Dobrodenkova, Silvia

2013-09-01

The aim of this paper is to describe the incidence of Trypanosoma brucei rhodesiense sleeping sickness in the last functioning treatment centre in Buikwe South HSD in Southeast Uganda, in Mukono District, for a 19-year period (1989-2008). This is a report on the treatment outcome, structure of population affected, comparison with the published data on general incidence of T. b rhodesiensae in Uganda and functioning of sleeping sickness control program. Cross-sectional sleeping sickness data from 1989 to 2008 were collected retrospectively in 2009 at Buikwe Sleeping Sickness Center to identify case counts and measures of disease magnitude per sub-county per year. Data were collected from all available records of sleeping sickness patients. Case counts from the Buikwe South sub-counties, and even some neighboring sub-counties for 19 years (1989-2008) were collected and analyzed by Microsoft Excel and EpiInfo program. In the period from 1989 to 2008, 372 cases of sleeping sickness were diagnosed and treated. Children under 5 years were 12 (3.22%) - males 6, females 6, patients in the age from 6 to 15 years were 51 (13.7%) - males 30, females 21, and patients above 15 were 309 (83.06%) - males 176, females 133. In the category 5-15 years and above 15 years there was a significant gender difference closely connected to the professional exposure. The oldest patient was 80 years old, the youngest was 3 moths old. The average age of the patients was 30.8 years. From all 372 patients with trypanosomiasis 30 had died - 10 females and 20 males, which means 8% case fatality. The case fatality rate in the late stage of the disease was 14%. From this group 6 patients (20%) had negative BS. The average interval between the diagnosis and death was 14.4 days, in 10 patients the exact date of death was not recorded. Average age of the patients that died was 30.6 years. Sleeping sickness still remains a serious public health problem. Since the preventive and educational activities

Sleep disturbances and fatigue: independent predictors of sickness absence? A prospective study among 6538 employees.

PubMed

Bültmann, Ute; Nielsen, Maj Britt D; Madsen, Ida E H; Burr, Hermann; Rugulies, Reiner

2013-02-01

Although sleep disturbances and fatigue are common conditions, frequently shown to be associated with sickness absence, only a few studies have prospectively investigated their independent effects on sickness absence, while adjusting for depressive symptoms. This study aims (i) to examine whether sleep disturbances and fatigue are independently related to the onset of register-based sickness absence of ≥ 3 weeks during a 1-year follow-up in a representative sample of the Danish workforce and (ii) to determine if possible associations are gender-specific. Data were used from the Danish Work Environment Cohort Study and linked with sickness absence data from the Danish National Register of Social Transfer Payments. A total of 6538 employees, 3178 men and 3360 women, were included in the analyses. Sleep disturbances predicted risk of sickness absence after adjustment for covariates, but lost statistical significance after further adjustment for depressive symptoms. Fatigue among men predicted risk of sickness absence [Hazard ratio (HR) = 1.25, 95% confidence intervals (CI) 1.00-1.56] after adjustment for covariates, depressive symptoms and sleep disturbances. Sleep disturbances in both genders and fatigue in women did not predict sickness absence after depressive symptoms were taken into account. In men, fatigue was significantly related to future sickness absence, also when adjusted for depressive symptoms and sleep disturbances. Further prospective studies are needed to explore the pathways from fatigue to sickness absence in more detail. The study suggests that early detection and treatment of fatigue in men should be high on the stakeholder's agenda.

Joint associations of sleep duration and insomnia symptoms with subsequent sickness absence: the Helsinki Health Study.

PubMed

Lallukka, Tea; Haaramo, Peija; Rahkonen, Ossi; Sivertsen, Børge

2013-07-01

We aimed to examine the joint associations of sleep duration and insomnia symptoms with subsequent sickness absence of various lengths while considering several covariates. Baseline surveys among 40-60-year-old employees of the City of Helsinki, Finland, (N = 6535) were prospectively linked with employer's personnel register data comprising short self-certified (1-3 days), medically-certified intermediate (4-14 days) and long (15 days or more) sickness absence spells. Average follow-up time was 4.1 years. Sleep duration, insomnia symptoms, sociodemographics, working conditions, health behaviours and health were self-reported in the surveys. Poisson regression analysis was used. Insomnia symptoms were associated with sickness absence at all levels of sleep duration. Adjusting for gender and age, U-shaped associations regarding sleep hours were found. Thus, those reporting short or long sleep and reporting insomnia symptoms had a higher risk for medically-certified intermediate and long sickness absence as compared to those reporting 7 hours of sleep without insomnia symptoms. Also, those reporting 6, 7, and 8 hours of sleep had a higher risk for such sickness absence, if they reported insomnia. Weak associations were also found for self-certified sickness absence, and for those reporting short and long sleep without insomnia. Adjustments attenuated the associations, but they mainly remained. These results suggest primacy of the effects of insomnia symptoms over sleep duration on sickness absence. Although insomnia dominated the joint association, U-shaped associations suggest that both sleep duration and insomnia symptoms need to be considered to promote work ability.

Knowledge, attitudes and practices on tsetse and sleeping sickness among communities living in and around Serengeti National Park, Tanzania.

PubMed

Kinung'hi, S M; Malele, I I; Kibona, S N; Matemba, L E; Sahani, J K; Kishamawe, C; Mlengeya, T D K

2006-09-01

A study was undertaken to investigate knowledge, attitudes and practices about sleeping sickness (human African trypanosomiasis) among communities living in and around Serengeti National Park (SENAPA). Structured questionnaires were administered to a total of 1490 consenting participants. Of the respondents, 924 (62%) knew sleeping sickness, and 807 (87.3%) knew the right place to seek healthcare. Of 924 who knew sleeping sickness, 386 (42%) said the disease was present in the areas they live. Most respondents (85.4%) knew that sleeping sickness infections were acquired in the bush and forest. The most common (69.3%) sources of information about sleeping sickness were relatives and friends. Symptoms of sleeping sickness mentioned included abnormal sleep (45.2%), fever (35.3%), body malaise (14.5%), headache (7.6%) and lymph node enlargement (6.1%). Of 1490 people interviewed 90.4% knew tsetse flies and 89.8% had been bitten by tsetse flies. The majority (86.6%) of the respondents knew that sleeping sickness is transmitted through a tsetse bite. Activities that exposed people to tsetse bites included working in tsetse infested bushes/forests, grazing livestock in tsetse infested areas and hunting game animals. In conclusion, communities living in and around SENAPA were knowledgeable about tsetse and sleeping sickness. The communities can thus understand and support community based tsetse and sleeping sickness control programmes to ensure success.

Non-invasive Positive Pressure Ventilation during Sleep at 3800m: relationship to Acute Mountain Sickness and sleeping oxyhemoglobin saturation

PubMed Central

Johnson, PL; Popa, DA; Prisk, GK; Sullivan, CE; Edwards, N

2014-01-01

Background and objectives Ascent to high altitude results in hypobaric hypoxia and some individuals will develop Acute Mountain Sickness, which has been shown to be associated with low oxyhemoglobin saturation during sleep. Previous research has shown that positive end-expiratory pressure by use of expiratory valves in a face mask while awake, results in a reduction in AMS symptoms and higher oxyhemoglobin saturation. We aimed to test whether pressure ventilation during sleep would prevent AMS by keeping oxyhaemoglobin higher during sleep. Methods We compared sleeping oxyhemoglobin saturation and the incidence and severity of Acute Mountain Sickness in seven subjects sleeping for two consecutive nights at 3800m above sea level using either non-invasive positive pressure ventilation that delivered positive inspiratory and expiratory airway pressure via a face mask, or sleeping without assisted ventilation. The presence and severity of Acute Mountain Sickness was assessed by administration of the Lake Louise questionnaire. Results We found significant increases in the mean and minimum sleeping oxyhemoglobin saturation and decreases in AMS symptoms in subjects who used positive pressure ventilation during sleep. Mean and minimum sleeping SaO2 was lower in subjects who developed AMS after the night spent without positive pressure ventilation. Conclusion The use of positive pressure ventilation during sleep at 3800m significantly increased the sleeping oxygen saturation; we suggest that the marked reduction in symptoms of AMS is due to this higher sleeping SaO2. We agree with the findings from previous studies that the development of AMS is associated with a lower sleeping oxygen saturation. PMID:20051046

Sleeping sickness is a circadian disorder.

PubMed

Rijo-Ferreira, Filipa; Carvalho, Tânia; Afonso, Cristina; Sanches-Vaz, Margarida; Costa, Rui M; Figueiredo, Luísa M; Takahashi, Joseph S

2018-01-04

Sleeping sickness is a fatal disease caused by Trypanosoma brucei, a unicellular parasite that lives in the bloodstream and interstitial spaces of peripheral tissues and the brain. Patients have altered sleep/wake cycles, body temperature, and endocrine profiles, but the underlying causes are unknown. Here, we show that the robust circadian rhythms of mice become phase advanced upon infection, with abnormal activity occurring during the rest phase. This advanced phase is caused by shortening of the circadian period both at the behavioral level as well as at the tissue and cell level. Period shortening is T. brucei specific and independent of the host immune response, as co-culturing parasites with explants or fibroblasts also shortens the clock period, whereas malaria infection does not. We propose that T. brucei causes an advanced circadian rhythm disorder, previously associated only with mutations in clock genes, which leads to changes in the timing of sleep.

Work-Related Sleep Disturbances and Sickness Absence in the Swedish Working Population, 1993–1999

PubMed Central

Westerlund, Hugo; Alexanderson, Kristina; Åkerstedt, Torbjörn; Hanson, Linda Magnusson; Theorell, Töres; Kivimäki, Mika

2008-01-01

Study Objectives: To examine secular trends in work-related sleep disturbances and their association with sickness absence in the Swedish working population. Design. Nationally representative cross-sectional samples of the Swedish working population aged 16–64 (the biennial Swedish Work Environment Survey) in 1993, 1995, and 1999 respectively. Questionnaire data on work-related sleep disturbances were linked to records of medically-certified sick-leave spells exceeding 14 days obtained from national registers. Setting: All Sweden. Participants: A total of 28,424 individuals aged 16–65 with complete data (5162/5173 women/men in 1993; 4635/4764 in 1995; and 4422/4268 in 1999). Interventions: N/A. Measurements and Results: The age-adjusted proportion of women with work-related sleep disturbances at least once a week increased from 12.3% in 1993 to 21.7% in 1999 (P < 0.001). The corresponding figures for men were 12.5% to 18.6% (P < 0.001). There was a strong cross-sectional association between work-related sleep disturbances and sickness absence in both genders and in each studied year. Using binary logistic regressions and adjusting for age, supervisory position, and geographical region, the odds ratios for sickness absence for those who reported work-related sleep disturbances every day, compared with those who answered “not at all/seldom last 3 months” varied between 3.22 (1.88–5.50) and 4.26 (2.56–7.19), with the strongest associations seen in 1999. Adjustment for health indicators, especially depressive symptoms, attenuated the relationship substantially. Conclusions: Self-reported sleep disturbances attributed to work-related causes were on the rise in Sweden and were associated with medically-certified sickness absence. Most of this association seems to be accounted for by depressive symptoms. Citation: Westerlund H; Alexanderson K; Åkerstedt T; Hanson LM; Theorell T; Kivimäki M. Work-related sleep disturbances and sickness absence in the swedish

Molecular epidemiology of African sleeping sickness.

PubMed

Hide, G; Tait, A

2009-10-01

Human sleeping sickness in Africa, caused by Trypanosoma brucei spp. raises a number of questions. Despite the widespread distribution of the tsetse vectors and animal trypanosomiasis, human disease is only found in discrete foci which periodically give rise to epidemics followed by periods of endemicity A key to unravelling this puzzle is a detailed knowledge of the aetiological agents responsible for different patterns of disease--knowledge that is difficult to achieve using traditional microscopy. The science of molecular epidemiology has developed a range of tools which have enabled us to accurately identify taxonomic groups at all levels (species, subspecies, populations, strains and isolates). Using these tools, we can now investigate the genetic interactions within and between populations of Trypanosoma brucei and gain an understanding of the distinction between human- and nonhuman-infective subspecies. In this review, we discuss the development of these tools, their advantages and disadvantages and describe how they have been used to understand parasite genetic diversity, the origin of epidemics, the role of reservoir hosts and the population structure. Using the specific case of T.b. rhodesiense in Uganda, we illustrate how molecular epidemiology has enabled us to construct a more detailed understanding of the origins, generation and dynamics of sleeping sickness epidemics.

Tsetse elimination: its interest and feasibility in the historical sleeping sickness focus of Loos islands, Guinea.

PubMed

Kagbadouno, M; Camara, M; Bouyer, J; Hervouet, J P; Courtin, F; Jamonneau, V; Morifaso, O; Kaba, D; Solano, P

2009-03-01

Guinea is the West African country which is currently the most prevalent for sleeping sickness. The littoral area is the region where most of the recent sleeping sickness cases have been described, especially the mangrove sleeping sickness foci of Dubreka and Boffa where Glossina palpalis gambiensis is the vector. Loos islands constitute a small archipelago 5 km apart from the capital, Conakry. Medical, animal, and entomological surveys were implemented in these islands in Oct-Nov 2006. No pathogenic trypanosomes were found in these surveys. The locally very high tsetse densities (up to more than 100 tsetse/trap/day) linked to pig rearing, constitute a high potential risk for humans (taking into account populations movements with neighboring active sleeping sickness foci of the Guinea littoral, and the history of sleeping sickness on these islands), and for the economically important pig rearing, as well as a danger for tourism. This situation, associated to the possibility of elimination of these tsetse populations due to low possibility of reinvasion, led the National Control Program to launch a tsetse elimination project following an "area wide" strategy for the first time in West Africa, which participates in the global objective of the PATTEC (Pan African Tsetse and Trypanosomosis Eradication Campaign).

Sleep disturbances predict future sickness absence among individuals with lower back or neck-shoulder pain: a 5-year prospective study.

PubMed

Aili, Katarina; Nyman, Teresia; Hillert, Lena; Svartengren, Magnus

2015-05-01

Musculoskeletal pain is one of the most common causes of sickness absence. Sleep disturbances are often co-occurring with pain, but the relationship between sleep and pain is complex. Little is known about the importance of self-reported sleep, when predicting sickness absence among persons with musculoskeletal pain. This study aims to study the association between self-reported sleep quality and sickness absence 5 years later, among individuals stratified by presence of lower back pain (LBP) and neck and shoulder pain (NSP). The cohort (n = 2286) in this 5-year prospective study (using data from the MUSIC-Norrtälje study) was stratified by self-reported pain into three groups: no LBP or NSP, solely LBP or NSP, and concurrent LBP and NSP. Odds ratios (ORs) for the effect of self-reported sleep disturbances at baseline on sickness absence (> 14 consecutive days), 5 years later, were calculated. Within all three pain strata, individuals reporting the most sleep problems showed a significantly higher OR for all-cause sickness absence, 5 years later. The group with the most pronounced sleep problems within the concurrent LBP and NSP stratum had a significantly higher OR (OR 2.00; CI 1.09-3.67) also for long-term sickness absence (> 90 days) 5 years later, compared to the group with the best sleep. CONCLUSIONS Sleep disturbances predict sickness absence among individuals regardless of co-existing features of LBP and/or NSP. The clinical evaluation of patients should take possible sleep disturbances into account in the planning of treatments. © 2015 the Nordic Societies of Public Health.

[Sleeping sickness: one hundred years of control strategy evolution].

PubMed

Louis, F J; Simarro, P P; Lucas, P

2002-12-01

Sleeping sickness has been known since the fifteenth century but the real progress in the knowledge of the disease occurred in the nineteenth century with the development of microscopy. From 1841 to 1901 the parasites and their vectors have been identified, the symptomatology and the epidemiology have been described. However, due to absence of any effective cure, the campaign against the disease was still based on the isolation of the patients and the transfer of exposed populations. The discovery of atoxyl in 1905 provided doctors with their first therapeutic weapon and, in 1910, the first action of vector control was undertaken with success in the Island of Principe. Between the two world conflicts, Jamot published the rules to fight against major outbreaks. Their application in Oubangui-Chari, in Cameroon and in French Occidental Africa brought tremendous results and signed the triumph of the mobile unit concept. Success which will not be denied until the sixties when the disease was believed to be eradicated. From the sixties to the nineties, the concept of the integration of prevention and care added to the exclusion of any vertical system will result in a progressive reniewed outbreak of the sleeping sickness in the known foci. As a paradox, it is a time rich in discovery as regards diagnosis, treatment and entomology. In 1994, the World Health Organisation got concerned with the situation of the disease in Central Africa where the outbreak of the disease reinforced. A second paradox appeared; it is the next to total disinterest from the politics and fund raisers which will save the disease. Today, sleeping sickness is the typical example of the orphan disease, a show case brandished by all the good souls. In 2001, an agreement between the WHO and the pharmaceutical industry brings back the financial funds required to fight the disease. Basically, it is a matter of resuming the action by using what is still existing and by creating new strategies considering

The influence of sleep deprivation and oscillating motion on sleepiness, motion sickness, and cognitive and motor performance.

PubMed

Kaplan, Janna; Ventura, Joel; Bakshi, Avijit; Pierobon, Alberto; Lackner, James R; DiZio, Paul

2017-01-01

Our goal was to determine how sleep deprivation, nauseogenic motion, and a combination of motion and sleep deprivation affect cognitive vigilance, visual-spatial perception, motor learning and retention, and balance. We exposed four groups of subjects to different combinations of normal 8h sleep or 4h sleep for two nights combined with testing under stationary conditions or during 0.28Hz horizontal linear oscillation. On the two days following controlled sleep, all subjects underwent four test sessions per day that included evaluations of fatigue, motion sickness, vigilance, perceptual discrimination, perceptual learning, motor performance and learning, and balance. Sleep loss and exposure to linear oscillation had additive or multiplicative relationships to sleepiness, motion sickness severity, decreases in vigilance and in perceptual discrimination and learning. Sleep loss also decelerated the rate of adaptation to motion sickness over repeated sessions. Sleep loss degraded the capacity to compensate for novel robotically induced perturbations of reaching movements but did not adversely affect adaptive recovery of accurate reaching. Overall, tasks requiring substantial attention to cognitive and motor demands were degraded more than tasks that were more automatic. Our findings indicate that predicting performance needs to take into account in addition to sleep loss, the attentional demands and novelty of tasks, the motion environment in which individuals will be performing and their prior susceptibility to motion sickness during exposure to provocative motion stimulation. Copyright © 2016 Elsevier B.V. All rights reserved.

Joint association of sleep problems and psychosocial working conditions with registered long-term sickness absence. A Danish cohort study.

PubMed

Madsen, Ida Eh; Larsen, Ann D; Thorsen, Sannie V; Pejtersen, Jan H; Rugulies, Reiner; Sivertsen, Børge

2016-07-01

Sleep problems and adverse psychosocial working conditions are associated with increased risk of long-term sickness absence. Because sleep problems affect role functioning they may also exacerbate any effects of psychosocial working conditions and vice versa. We examined whether sleep problems and psychosocial working conditions interact in their associations with long-term sickness absence. We linked questionnaire data from participants to two surveys of random samples of the Danish working population (N=10 752) with registries on long-term sick leave during five years after questionnaire response. We defined sleep problems by self-reported symptoms and/or register data on hypnotics purchases of hypnotics. Psychosocial working conditions included quantitative and emotional demands, influence, supervisor recognition and social support, leadership quality, and social support from colleagues. Using time-to-event models, we calculated hazard ratios (HR) and differences and examined interaction as departure from multiplicativity and additivity. During 40 165 person-years of follow-up, we identified 2313 episodes of long-terms sickness absence. Sleep problems predicted risk of long-term sickness absence [HR 1.54, 95% confidence interval (95% CI) 1.38-1.73]. This association was statistically significantly stronger among participants with high quantitative demands and weaker among those with high supervisor recognition (P<0.0001). High quantitative demands exacerbated the association of sleep problems with risk of long-term sickness absence whereas high supervisor recognition buffered this association. To prevent long-term sickness absence among employees with sleep problems, workplace modifications focusing on quantitative demands and supervisor recognition may be considered. Workplace interventions for these factors may more effectively prevent sickness absence when targeted at this group. The efficacy and effectiveness of such interventions needs to be established in

Epidemiology of Sleeping Sickness in Boffa (Guinea): Where Are the Trypanosomes?

PubMed Central

Kagbadouno, Moise Saa; Camara, Mamadou; Rouamba, Jeremi; Rayaisse, Jean-Baptiste; Traoré, Ibrahima Sory; Camara, Oumou; Onikoyamou, Mory Fassou; Courtin, Fabrice; Ravel, Sophie; de Meeûs, Thierry; Bucheton, Bruno; Jamonneau, Vincent; Solano, Philippe

2012-01-01

Human African Trypanosomiasis (HAT) in West Africa is a lethal, neglected disease caused by Trypanosoma brucei gambiense transmitted by the tsetse Glossina palpalis gambiensis. Although the littoral part of Guinea with its typical mangrove habitat is the most prevalent area in West Africa, very few data are available on the epidemiology of the disease in such biotopes. As part of a HAT elimination project in Guinea, we carried a cross-sectional study of the distribution and abundance of people, livestock, tsetse and trypanosomes in the focus of Boffa. An exhaustive census of the human population was done, together with spatial mapping of the area. Entomological data were collected, a human medical survey was organized together with a survey in domestic animals. In total, 45 HAT cases were detected out of 14445 people who attended the survey, these latter representing 50.9% of the total population. Potential additional carriers of T. b. gambiense were also identified by the trypanolysis test (14 human subjects and two domestic animals). No trypanosome pathogenic to animals were found, neither in the 874 tsetse dissected nor in the 300 domestic animals sampled. High densities of tsetse were found in places frequented by humans, such as pirogue jetties, narrow mangrove channels and watering points. The prevalence of T. b. gambiense in humans, combined to low attendance of the population at risk to medical surveys, and to an additional proportion of human and animal carriers of T. b. gambiense who are not treated, highlights the limits of strategies targeting HAT patients only. In order to stop T. b. gambiense transmission, vector control should be added to the current strategy of case detection and treatment. Such an integrated strategy will combine medical surveillance to find and treat cases, and vector control activities to protect people from the infective bites of tsetse. PMID:23272259

[History of an epidemiological route between Ivory Coast and Burkina Faso: the case of the Koudougou sleeping sickness foci].

PubMed

Kiendrébéogo, D; Kambiré, R; Jamonneau, V; Lingué, K; Solano, P; Courtin, F

2012-11-01

In the first half of the XXth century, while Upper-Volta (now Burkina Faso) was suffering a terrible epidemic of sleeping sickness, the French colonial administration encouraged the movement of people from Upper-Volta to Ivory Coast to meet their demands for labour. This led to the establishment of Mossi villages, such as those of Koudougou, in the Ivorian forest with populations originating from areas of Upper-Volta that were not only densely populated but also severely affected by sleeping sickness. Since 2000, most cases of sleeping sickness in the Koudougou district of Burkina Faso have been in people originally from Ivory Coast. Who are they? Where did they settle in Burkina Faso? Where do they come from in Ivory Coast? After having retraced the epidemiological history of Koudougou villages in Burkina Faso and Ivory Coast, the history of ten cases of sleeping sickness detected passively at Koudougou hospital since 2000 were analysed. All cases originated from the forest area of Ivory Coast. Understanding the spread of sleeping sickness between Burkina Faso and Ivory Coast will assist in the identification of areas of disease risk.

Cattle movements and trypanosomes: restocking efforts and the spread of Trypanosoma brucei rhodesiense sleeping sickness in post-conflict Uganda.

PubMed

Selby, Richard; Bardosh, Kevin; Picozzi, Kim; Waiswa, Charles; Welburn, Susan C

2013-09-27

The northwards spread of acute T. b. rhodesiense sleeping sickness in Uganda has been linked to cattle movements associated with restocking following the end to military conflict in 2006. This study examined the number of cattle traded from T. b. rhodesiense endemic districts, the prevalence of the parasite in cattle being traded and the level of trypanocidal treatment at livestock markets. Between 2008 and 2009 interviews were carried out with government veterinarians from 20 districts in Uganda, 18 restocking organisations and numerous livestock traders and veterinarians. Direct observations, a review of movement permit records (2006 to 2008) and blood sampling of cattle (n = 1758) for detection of parasites were also conducted at 10 livestock markets in T. b. rhodesiense endemic districts. Records available from 8 out of 47 identified markets showed that 39.5% (5,238/13,267) of the inter-district cattle trade between mid-2006 and mid-2008 involved movement from endemic areas to pathogen-free districts. PCR analysis showed a prevalence of 17.5% T. brucei s.l. (n = 307/1758 [95% CI: 15.7-19.2]) and 1.5% T. b. rhodesiense (n = 26/1758 [95% CI: 0.9-2.0]) from these same markets. In a two-year period, between late-2006 to late-2008, an estimated 72,321 to 86,785 cattle (57, 857 by 18 restocking organisations and 10,214 to 24,679 by private traders) were imported into seven pathogen-free northern districts, including districts that were endemic for T. b. gambiense. Between 281 and 1,302 of these cattle were likely to have carried T. b. rhodesiense. While governmental organisations predominantly adhered to trypanocidal treatment, most Non-Governmental Organisations (NGOs) and private traders did not. Inadequate market infrastructure, poor awareness, the need for payment for drug treatments, and the difficulty in enforcing a policy of treatment at point of sale contributed to non-compliance. With increasing private trade, preventing the spread of Rhodesian sleeping

Cattle movements and trypanosomes: restocking efforts and the spread of Trypanosoma brucei rhodesiense sleeping sickness in post-conflict Uganda

PubMed Central

2013-01-01

Background The northwards spread of acute T. b. rhodesiense sleeping sickness in Uganda has been linked to cattle movements associated with restocking following the end to military conflict in 2006. This study examined the number of cattle traded from T. b. rhodesiense endemic districts, the prevalence of the parasite in cattle being traded and the level of trypanocidal treatment at livestock markets. Methods Between 2008 and 2009 interviews were carried out with government veterinarians from 20 districts in Uganda, 18 restocking organisations and numerous livestock traders and veterinarians. Direct observations, a review of movement permit records (2006 to 2008) and blood sampling of cattle (n = 1758) for detection of parasites were also conducted at 10 livestock markets in T. b. rhodesiense endemic districts. Results Records available from 8 out of 47 identified markets showed that 39.5% (5,238/13,267) of the inter-district cattle trade between mid-2006 and mid-2008 involved movement from endemic areas to pathogen-free districts. PCR analysis showed a prevalence of 17.5% T. brucei s.l. (n = 307/1758 [95% CI: 15.7-19.2]) and 1.5% T. b. rhodesiense (n = 26/1758 [95% CI: 0.9-2.0]) from these same markets. In a two-year period, between late-2006 to late-2008, an estimated 72,321 to 86,785 cattle (57, 857 by 18 restocking organisations and 10,214 to 24,679 by private traders) were imported into seven pathogen-free northern districts, including districts that were endemic for T. b. gambiense. Between 281 and 1,302 of these cattle were likely to have carried T. b. rhodesiense. While governmental organisations predominantly adhered to trypanocidal treatment, most Non-Governmental Organisations (NGOs) and private traders did not. Inadequate market infrastructure, poor awareness, the need for payment for drug treatments, and the difficulty in enforcing a policy of treatment at point of sale contributed to non-compliance. Conclusion With increasing private trade, preventing

Neglected disease - african sleeping sickness: recent synthetic and modeling advances.

PubMed

Paliwal, Sarvesh K; Verma, Ankita Narayan; Paliwal, Shailendra

2011-01-01

Human African Trypanosomiasis (HAT) also called sleeping sickness is caused by subspecies of the parasitic hemoflagellate Trypanosoma brucei that mostly occurs in sub-Saharan Africa. The current chemotherapy of the human trypanosomiases relies on only six drugs, five of which have been developed more than 30 years ago, have undesirable toxic side effects and most of them show drug-resistance. Though development of new anti-trypanosomal drugs seems to be a priority area research in this area has lagged far behind. The given review mainly focus upon the recent synthetic and computer based approaches made by various research groups for the development of newer anti-trypanosomal analogues which may have improved efficacy and oral bioavailability than the present ones. The given paper also attempts to investigate the relationship between the various physiochemical parameters and anti-trypanosomal activity that may be helpful in development of potent anti-trypanosomal agents against sleeping sickness.

The role of poor sleep in the relation between workplace bullying/unwanted sexual attention and long-term sickness absence.

PubMed

Nabe-Nielsen, Kirsten; Grynderup, Matias Brødsgaard; Lange, Theis; Andersen, Johan Hviid; Bonde, Jens Peter; Conway, Paul Maurice; Garde, Anne Helene; Høgh, Annie; Kaerlev, Linda; Rugulies, Reiner; Hansen, Åse Marie

2016-08-01

While exposure to bullying and unwanted sexual attention was previously found to increase the risk of sickness absence, the underlying mechanisms are largely unknown. Poor sleep can be a consequence of stressful exposures and a cause of poor health, and poor sleep is also a determinant of insufficient recovery. Therefore, the present study investigated whether poor sleep mediates and/or moderates the association between bullying and unwanted sexual attention, on the one hand, and long-term sickness absence (LTSA), on the other hand. We used questionnaire data from 7650 individuals contributing with 15,040 2-year observation periods. Workplace bullying, unwanted sexual attention, disturbed sleep, and difficulties awakening were measured at three time points, and participants were followed in registers to measure the occurrence of LTSA, defined as ≥30 consecutive days of sickness absence during the subsequent 2 years. The odds of LTSA were significantly increased by workplace bullying (OR 1.77; 95 % CI 1.50-2.12) and unwanted sexual attention (OR 1.55; 95 % CI 1.06-2.29). Together, disturbed sleep and difficulties awakening mediated 12.8 % (95 % CI 8.1-19.8) of the association between bullying and long-term sickness absence, and 8.5 % (95 % CI -0.45 to 37.1) of the association between unwanted sexual attention and long-term sickness absence in the fully adjusted model. Neither disturbed sleep nor difficulties awakening moderated these associations. As expected, bullying and unwanted sexual attention were prospectively associated with long-term sickness absence. Only a small part of this association was mediated by poor sleep.

We Remember… Elders' Memories and Perceptions of Sleeping Sickness Control Interventions in West Nile, Uganda.

PubMed

Kovacic, Vanja; Tirados, Inaki; Esterhuizen, Johan; Mangwiro, Clement T N; Lehane, Michael J; Torr, Stephen J; Smith, Helen

2016-06-01

The traditional role of African elders and their connection with the community make them important stakeholders in community-based disease control programmes. We explored elders' memories related to interventions against sleeping sickness to assess whether or not past interventions created any trauma which might hamper future control operations. Using a qualitative research framework, we conducted and analysed twenty-four in-depth interviews with Lugbara elders from north-western Uganda. Participants were selected from the villages inside and outside known historical sleeping sickness foci. Elders' memories ranged from examinations of lymph nodes conducted in colonial times to more recent active screening and treatment campaigns. Some negative memories dating from the 1990s were associated with diagnostic procedures, treatment duration and treatment side effects, and were combined with memories of negative impacts related to sleeping sickness epidemics particularly in HAT foci. More positive observations from the recent treatment campaigns were reported, especially improvements in treatment. Sleeping sickness interventions in our research area did not create any permanent traumatic memories, but memories remained flexible and open to change. This study however identified that details related to medical procedures can remain captured in a community's collective memory for decades. We recommend more emphasis on communication between disease control programme planners and communities using detailed and transparent information distribution, which is not one directional but rather a dialogue between both parties.

Adding tsetse control to medical activities contributes to decreasing transmission of sleeping sickness in the Mandoul focus (Chad)

PubMed Central

Mahamat, Mahamat Hissene; Peka, Mallaye; Rayaisse, Jean-Baptiste; Rock, Kat S.; Toko, Mahamat Abdelrahim; Darnas, Justin; Brahim, Guihini Mollo; Yoni, Wilfrid; Tirados, Inaki; Courtin, Fabrice; Brand, Samuel P. C.; Nersy, Cyrus; Alfaroukh, Idriss Oumar; Torr, Steve J.; Lehane, Mike J.; Solano, Philippe

2017-01-01

Background Gambian sleeping sickness or HAT (human African trypanosomiasis) is a neglected tropical disease caused by Trypanosoma brucei gambiense transmitted by riverine species of tsetse. A global programme aims to eliminate the disease as a public health problem by 2020 and stop transmission by 2030. In the South of Chad, the Mandoul area is a persistent focus of Gambian sleeping sickness where around 100 HAT cases were still diagnosed and treated annually until 2013. Pre-2014, control of HAT relied solely on case detection and treatment, which lead to a gradual decrease in the number of cases of HAT due to annual screening of the population. Methods Because of the persistence of transmission and detection of new cases, we assessed whether the addition of vector control to case detection and treatment could further reduce transmission and consequently, reduce annual incidence of HAT in Mandoul. In particular, we investigated the impact of deploying ‘tiny targets’ which attract and kill tsetse. Before tsetse control commenced, a census of the human population was conducted and their settlements mapped. A pre-intervention survey of tsetse distribution and abundance was implemented in November 2013 and 2600 targets were deployed in the riverine habitats of tsetse in early 2014, 2015 and 2016. Impact on tsetse and on the incidence of sleeping sickness was assessed through nine tsetse monitoring surveys and four medical surveys of the human population in 2014 and 2015. Mathematical modelling was used to assess the relative impact of tsetse control on incidence compared to active and passive screening. Findings The census indicated that a population of 38674 inhabitants lived in the vicinity of the Mandoul focus. Within this focus in November 2013, the vector is Glossina fuscipes fuscipes and the mean catch of tsetse from traps was 0.7 flies/trap/day (range, 0–26). The catch of tsetse from 44 sentinel biconical traps declined after target deployment with only

Adding tsetse control to medical activities contributes to decreasing transmission of sleeping sickness in the Mandoul focus (Chad).

PubMed

Mahamat, Mahamat Hissene; Peka, Mallaye; Rayaisse, Jean-Baptiste; Rock, Kat S; Toko, Mahamat Abdelrahim; Darnas, Justin; Brahim, Guihini Mollo; Alkatib, Ali Bachar; Yoni, Wilfrid; Tirados, Inaki; Courtin, Fabrice; Brand, Samuel P C; Nersy, Cyrus; Alfaroukh, Idriss Oumar; Torr, Steve J; Lehane, Mike J; Solano, Philippe

2017-07-01

Gambian sleeping sickness or HAT (human African trypanosomiasis) is a neglected tropical disease caused by Trypanosoma brucei gambiense transmitted by riverine species of tsetse. A global programme aims to eliminate the disease as a public health problem by 2020 and stop transmission by 2030. In the South of Chad, the Mandoul area is a persistent focus of Gambian sleeping sickness where around 100 HAT cases were still diagnosed and treated annually until 2013. Pre-2014, control of HAT relied solely on case detection and treatment, which lead to a gradual decrease in the number of cases of HAT due to annual screening of the population. Because of the persistence of transmission and detection of new cases, we assessed whether the addition of vector control to case detection and treatment could further reduce transmission and consequently, reduce annual incidence of HAT in Mandoul. In particular, we investigated the impact of deploying 'tiny targets' which attract and kill tsetse. Before tsetse control commenced, a census of the human population was conducted and their settlements mapped. A pre-intervention survey of tsetse distribution and abundance was implemented in November 2013 and 2600 targets were deployed in the riverine habitats of tsetse in early 2014, 2015 and 2016. Impact on tsetse and on the incidence of sleeping sickness was assessed through nine tsetse monitoring surveys and four medical surveys of the human population in 2014 and 2015. Mathematical modelling was used to assess the relative impact of tsetse control on incidence compared to active and passive screening. The census indicated that a population of 38674 inhabitants lived in the vicinity of the Mandoul focus. Within this focus in November 2013, the vector is Glossina fuscipes fuscipes and the mean catch of tsetse from traps was 0.7 flies/trap/day (range, 0-26). The catch of tsetse from 44 sentinel biconical traps declined after target deployment with only five tsetse being caught in nine

Unhealthy lifestyle and sleep problems as risk factors for increased direct employers' cost of short-term sickness absence.

PubMed

Kanerva, Noora; Pietiläinen, Olli; Lallukka, Tea; Rahkonen, Ossi; Lahti, Jouni

2018-03-01

Objectives Unhealthy lifestyle (eg, smoking) as well as sleep problems are associated with increased risk of sickness absence, but the financial impact of these associations beyond risk ratios is not well known. We aimed to estimate the additive contribution of lifestyle and sleep problems (risk factors) to direct costs of short-term (<15 days) sickness absence. Methods The Helsinki Health Study is a longitudinal cohort of employees of the City of Helsinki, Finland (N=8960, response rate 67%). During 2000-2002 the participants were mailed a survey questionnaire that gathered information on their lifestyle and sleep. A sum of the risk factors was calculated: participants received one point for being a smoker; high alcohol user (>7 servings/week for women and >14 servings/week for men); physically inactive [<14 metabolic equivalents (MET) hours/week]; having low fruit and vegetable consumption (<1 times/day); or suffering from frequent insomnia symptoms. Sickness absence, salary, and time of employment were followed through the employer's register between 2002-2016. Individual salary data were used to calculate the direct costs of short-term sickness absence. Data were analyzed using a two-part model. Results Direct costs of short-term sickness absences were on average €9057 (standard deviation €11 858) per employee over the follow-up. Those with ≥3 risk factors had €3266 [95% confidence interval (95% CI) €2114-4417] higher direct costs for the employer over the follow-up compared to those without any risk factors. Conclusions Unhealthy lifestyle and sleep problems may increase the costs of short-term sickness absence to the employer by 10-30%. Consequently, programs addressing lifestyle and sleep may yield to significant savings.

How sleep problems contribute to simulator sickness: Preliminary results from a realistic driving scenario.

PubMed

Altena, Ellemarije; Daviaux, Yannick; Sanz-Arigita, Ernesto; Bonhomme, Emilien; de Sevin, Étienne; Micoulaud-Franchi, Jean-Arthur; Bioulac, Stéphanie; Philip, Pierre

2018-04-17

Virtual reality and simulation tools enable us to assess daytime functioning in environments that simulate real life as close as possible. Simulator sickness, however, poses a problem in the application of these tools, and has been related to pre-existing health problems. How sleep problems contribute to simulator sickness has not yet been investigated. In the current study, 20 female chronic insomnia patients and 32 female age-matched controls drove in a driving simulator covering realistic city, country and highway scenes. Fifty percent of the insomnia patients as opposed to 12.5% of controls reported excessive simulator sickness leading to experiment withdrawal. In the remaining participants, patients with insomnia showed overall increased levels of oculomotor symptoms even before driving, while nausea symptoms further increased after driving. These results, as well as the realistic simulation paradigm developed, give more insight on how vestibular and oculomotor functions as well as interoceptive functions are affected in insomnia. Importantly, our results have direct implications for both the actual driving experience and the wider context of deploying simulation techniques to mimic real life functioning, in particular in those professions often exposed to sleep problems. © 2018 European Sleep Research Society.

Loop-Mediated Isothermal Amplification Test for Trypanosoma gambiense Group 1 with Stem Primers: A Molecular Xenomonitoring Test for Sleeping Sickness.

PubMed

Njiru, Zablon K; Mbae, Cecilia K; Mburugu, Gitonga N

2017-01-01

The World Health Organization has targeted Human African Trypanosomiasis (HAT) for elimination by 2020 with zero incidence by 2030. To achieve and sustain this goal, accurate and easy-to-deploy diagnostic tests for Gambian trypanosomiasis which accounts for over 98% of reported cases will play a crucial role. Most needed will be tools for surveillance of pathogen in vectors (xenomonitoring) since population screening tests are readily available. The development of new tests is expensive and takes a long time while incremental improvement of existing technologies that have potential for xenomonitoring may offer a shorter pathway to tools for HAT surveillance. We have investigated the effect of including a second set of reaction accelerating primers (stem primers) to the standard T. brucei gambiense LAMP test format. The new test format was analyzed with and without outer primers. Amplification was carried out using Rotorgene 6000 and the portable ESE Quant amplification unit capable of real-time data output. The stem LAMP formats indicated shorter time to results (~8 min), were 10-100-fold more sensitive, and indicated higher diagnostic sensitivity and accuracy compared to the standard LAMP test. It was possible to confirm the predicted product using ESE melt curves demonstrating the potential of combining LAMP and real-time technologies as possible tool for HAT molecular xenomonitoring.

Should I get screened for sleeping sickness? A qualitative study in Kasai province, Democratic Republic of Congo.

PubMed

Mpanya, Alain; Hendrickx, David; Vuna, Mimy; Kanyinda, Albert; Lumbala, Crispin; Tshilombo, Valéry; Mitashi, Patrick; Luboya, Oscar; Kande, Victor; Boelaert, Marleen; Lefèvre, Pierre; Lutumba, Pascal

2012-01-01

Control of human African trypanosomiasis (sleeping sickness) in the Democratic Republic of Congo is based on mass population active screening by mobile teams. Although generally considered a successful strategy, the community participation rates in these screening activities and ensuing treatment remain low in the Kasai-Oriental province. A better understanding of the reasons behind this observation is necessary to improve regional control activities. Thirteen focus group discussions were held in five health zones of the Kasai-Oriental province to gain insights in the regional perceptions regarding sleeping sickness and the national control programme's activities. Sleeping sickness is well known among the population and is considered a serious and life-threatening disease. The disease is acknowledged to have severe implications for the individual (e.g., persistence of manic periods and trembling hands, even after treatment), at the family level (e.g., income loss, conflicts, separations) and for communities (e.g., disruption of community life and activities). Several important barriers to screening and treatment were identified. Fear of drug toxicity, lack of confidentiality during screening procedures, financial barriers and a lack of communication between the mobile teams and local communities were described. Additionally, a number of regionally accepted prohibitions related to sleeping sickness treatment were described that were found to be a strong impediment to disease screening and treatment. These prohibitions, which do not seem to have a rational basis, have far-reaching socio-economic repercussions and severely restrict the participation in day-to-day life. A mobile screening calendar more adapted to the local conditions with more respect for privacy, the use of less toxic drugs, and a better understanding of the origin as well as better communication about the prohibitions related to treatment would facilitate higher participation rates among the Kasai

Characterization of sleeping sickness transmission sites in rural and periurban areas of Kinshasa (République Démocratique du Congo).

PubMed

Grébaut, Pascal; Bena, Jean-Marie; Manzambi, Emile Zola; Mansinsa, Philémon; Khande, Victor; Ollivier, Gaelle; Cuny, Gérard; Simo, Gustave

2009-12-01

To characterize the potential transmission sites of sleeping sickness in Kinshasa, two entomologic surveys were carried out during the dry and the rainy seasons in rural and periurban areas of Kinshasa in 2005. About 610 pyramidal traps were set up, and 897 Glossina fuscipes quanzensis were captured. Environmental and biologic factors were reported, and relationships between these factors were evaluated using logistic regression and multiple correspondence analysis. The biologic factors (the presence of tsetse flies, human blood meals, and teneral flies) were progressively accumulated at each capture site to permit the characterization of the sleeping sickness transmission risk. The dry season was found to be a more favorable period for the disease transmission than the rainy season. Moreover, the landscapes characterized by the presence of argillaceous soils, raised ground cover with forest residues and rivers, were identified as types of environments with greater risk of sleeping sickness transmission. Pig breeding appeared as an important factor increasing the disease transmission. If vector control is continuously performed along rivers segments at high risk, the transmission of sleeping sickness in rural and periurban areas of Kinshasa will considerably decrease.

New discoveries in the transmission biology of sleeping sickness parasites: applying the basics.

PubMed

MacGregor, Paula; Matthews, Keith R

2010-09-01

The sleeping sickness parasite, Trypanosoma brucei, must differentiate in response to the changing environments that it encounters during its complex life cycle. One developmental form, the bloodstream stumpy stage, plays an important role in infection dynamics and transmission of the parasite. Recent advances have shed light on the molecular mechanisms by which these stumpy forms differentiate as they are transmitted from the mammalian host to the insect vector of sleeping sickness, tsetse flies. These molecular advances now provide improved experimental tools for the study of stumpy formation and function within the mammalian bloodstream. They also offer new routes to therapy via high-throughput screens for agents that accelerate parasite development. Here, we shall discuss the recent advances that have been made and the prospects for future research now available.

Characterization of recombinant Trypanosoma brucei gambiense Translationally Controlled Tumor Protein (rTbgTCTP) and its interaction with Glossina midgut bacteria.

PubMed

Bossard, Géraldine; Bartoli, Manon; Fardeau, Marie-Laure; Holzmuller, Philippe; Ollivier, Bernard; Geiger, Anne

2017-09-03

In humans, sleeping sickness (i.e. Human African Trypanosomiasis) is caused by the protozoan parasites Trypanosoma brucei gambiense (Tbg) in West and Central Africa, and T. b. rhodesiense in East Africa. We previously showed in vitro that Tbg is able to excrete/secrete a large number of proteins, including Translationally Controlled Tumor Protein (TCTP). Moreover, the tctp gene was described previously to be expressed in Tbg-infected flies. Aside from its involvement in diverse cellular processes, we have investigated a possible alternative role within the interactions occurring between the trypanosome parasite, its tsetse fly vector, and the associated midgut bacteria. In this context, the Tbg tctp gene was synthesized and cloned into the baculovirus vector pAcGHLT-A, and the corresponding protein was produced using the baculovirus Spodoptera frugicola (strain 9) / insect cell system. The purified recombinant protein rTbgTCTP was incubated together with bacteria isolated from the gut of tsetse flies, and was shown to bind to 24 out of the 39 tested bacteria strains belonging to several genera. Furthermore, it was shown to affect the growth of the majority of these bacteria, especially when cultivated under microaerobiosis and anaerobiosis. Finally, we discuss the potential for TCTP to modulate the fly microbiome composition toward favoring trypanosome survival.

Human African Trypanosomiasis Transmission, Kinshasa, Democratic Republic of Congo

PubMed Central

Diabakana, Philemon Mansinsa; Mesu, Victor Kande Betu Ku; Manzambi, Emile Zola; Ollivier, Gaelle; Asonganyi, Tazoacha; Cuny, Gerard; Grébaut, Pascal

2006-01-01

To investigate the epidemiology of human African trypanosomiasis (sleeping sickness) in Kinshasa, Democratic Republic of Congo, 2 entomologic surveys were conducted in 2005. Trypanosoma brucei gambiense and human-blood meals were found in tsetse fly midguts, which suggested active disease transmission. Vector control should be used to improve human African trypanosomiasis control efforts. PMID:17326955

Impact of Sleeping Altitude on Symptoms of Acute Mountain Sickness on Mt. Fuji.

PubMed

Horiuchi, Masahiro; Uno, Tadashi; Endo, Junko; Handa, Yoko; Hasegawa, Tatsuya

2018-05-09

Horiuchi, Masahiro, Tadashi Uno, Junko Endo, Yoko Handa, and Tatsuya Hasegawa. Impact of sleeping altitude on symptoms of acute mountain sickness on Mt. Fuji. High Alt Med Biol. 00:000-000, 2018. We sought to investigate the factors influencing acute mountain sickness (AMS) on Mt. Fuji in Japan, in particular, to assess the effects of sleeping altitude, by means of a questionnaire survey. This study involved 1932 participants who climbed Mt. Fuji, and obtained information regarding sex, age, and whether participants stayed at the mountain lodges. The AMS survey excluded the perceived sleep difficulties assessed with the Lake Louise Scoring (LLS) system for all climbers. The overall prevalence of AMS was 31.6% for all participants (LLS score ≥3 with headache, excluding sleep difficulties). A univariate analysis revealed that overnight stay at Mt. Fuji was associated with an increased prevalence of AMS, but that sex and age were not. For overnight lodgers, the mean sleeping altitude in participants with AMS was slightly higher than that in participants without AMS (p < 0.05). Moreover, participants who stayed above 2870 m were more likely to experience AMS than those who stayed below 2815 m (p < 0.001), but sex and age were not significantly associated with the probability of experiencing AMS. Staying overnight at a mountain lodge, especially one above 2870 m, may be associated with an increased prevalence of AMS on Mt. Fuji.

Recommendations for control of East african sleeping sickness in Uganda.

PubMed

Kotlyar, Simon

2010-01-01

East African sleeping sickness, caused by Trypanosoma brucei rhodesiense, is prominent in Uganda and poses a serious public health challenge in the region. This publication attempts to provide key components for designing a strategy for a nationwide initiative to provide insecticide-treatment of the animal reservoir to control T. b. rhodesiense. The contents of this article will focus on insecticide-based vector control strategies, monitoring and evaluation framework, and knowledge gaps required for future initiatives.

The role of cytokines in the pathogenesis and staging of Trypanosoma brucei rhodesiense sleeping sickness.

PubMed

Kato, Charles D; Matovu, Enock; Mugasa, Claire M; Nanteza, Ann; Alibu, Vincent P

2016-01-01

Human African trypanosomiasis due to Trypanosoma brucei rhodesiense is invariably fatal if untreated with up to 12.3 million people at a risk of developing the disease in Sub-Saharan Africa. The disease is characterized by a wide spectrum of clinical presentation coupled with differences in disease progression and severity. While the factors determining this varied response have not been clearly characterized, inflammatory cytokines have been partially implicated as key players. In this review, we consolidate available literature on the role of specific cytokines in the pathogenesis of T. b. rhodesiense sleeping sickness and further discuss their potential as stage biomarkers. Such information would guide upcoming research on the immunology of sleeping sickness and further assist in the selection and evaluation of cytokines as disease stage or diagnostic biomarkers.

Differentiation of Trypanosoma brucei, T. rhodesiense, and T. gambiense by the indirect fluorescent antibody test

PubMed Central

Latif, B. M. A.; Adam, Katherine M. G.

1973-01-01

Epidemiological studies, if they are to lead to appropriate preventive procedures, require knowledge of the host distribution of the parasite. Progress in the epidemiology of African trypanosomiasis is restricted by the lack of a reliable and simple method of differentiating Trypanosoma brucei, T. rhodesiense, and T. gambiense. The recently introduced blood inoculation infectivity test promises to fulfil this need by distinguishing T. brucei from T. rhodesiense, but it would not be suitable for separating T. brucei from T. gambiense, since rats and mice are frequently refractory to infection by fresh isolates of T. gambiense. Previous studies had indicated that the indirect fluorescent antibody test might differentiate not only the subgenera of the salivarian trypanosome species but also members of the subgenus Trypanozoon. A method of performing the test is described that enables T. brucei, T. rhodesiense, and T. gambiense to be differentiated by the titre of the sera. The method might be used in conjunction with the blood inoculation infectivity test to distinguish between new isolates of the subgenus Trypanozoon in East Africa, and also to search for possible animal reservoirs of T. gambiense in West Africa. PMID:4587481

Identification of Trypanosome Proteins in Plasma from African Sleeping Sickness Patients Infected with T. b. rhodesiense

PubMed Central

Enyaru, John C.; Carr, Steven A.; Pearson, Terry W.

2013-01-01

Control of human African sleeping sickness, caused by subspecies of the protozoan parasite Trypanosoma brucei, is based on preventing transmission by elimination of the tsetse vector and by active diagnostic screening and treatment of infected patients. To identify trypanosome proteins that have potential as biomarkers for detection and monitoring of African sleeping sickness, we have used a ‘deep-mining” proteomics approach to identify trypanosome proteins in human plasma. Abundant human plasma proteins were removed by immunodepletion. Depleted plasma samples were then digested to peptides with trypsin, fractionated by basic reversed phase and each fraction analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). This sample processing and analysis method enabled identification of low levels of trypanosome proteins in pooled plasma from late stage sleeping sickness patients infected with Trypanosoma brucei rhodesiense. A total of 254 trypanosome proteins were confidently identified. Many of the parasite proteins identified were of unknown function, although metabolic enzymes, chaperones, proteases and ubiquitin-related/acting proteins were found. This approach to the identification of conserved, soluble trypanosome proteins in human plasma offers a possible route to improved disease diagnosis and monitoring, since these molecules are potential biomarkers for the development of a new generation of antigen-detection assays. The combined immuno-depletion/mass spectrometric approach can be applied to a variety of infectious diseases for unbiased biomarker identification. PMID:23951171

Identification of Trypanosome proteins in plasma from African sleeping sickness patients infected with T. b. rhodesiense.

PubMed

Eyford, Brett A; Ahmad, Rushdy; Enyaru, John C; Carr, Steven A; Pearson, Terry W

2013-01-01

Control of human African sleeping sickness, caused by subspecies of the protozoan parasite Trypanosoma brucei, is based on preventing transmission by elimination of the tsetse vector and by active diagnostic screening and treatment of infected patients. To identify trypanosome proteins that have potential as biomarkers for detection and monitoring of African sleeping sickness, we have used a 'deep-mining" proteomics approach to identify trypanosome proteins in human plasma. Abundant human plasma proteins were removed by immunodepletion. Depleted plasma samples were then digested to peptides with trypsin, fractionated by basic reversed phase and each fraction analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). This sample processing and analysis method enabled identification of low levels of trypanosome proteins in pooled plasma from late stage sleeping sickness patients infected with Trypanosoma brucei rhodesiense. A total of 254 trypanosome proteins were confidently identified. Many of the parasite proteins identified were of unknown function, although metabolic enzymes, chaperones, proteases and ubiquitin-related/acting proteins were found. This approach to the identification of conserved, soluble trypanosome proteins in human plasma offers a possible route to improved disease diagnosis and monitoring, since these molecules are potential biomarkers for the development of a new generation of antigen-detection assays. The combined immuno-depletion/mass spectrometric approach can be applied to a variety of infectious diseases for unbiased biomarker identification.

[Ivory Coast uprising and returning Burkinabe immigrants: evaluation of the risk for reemergence of sleeping sickness in Burkina Faso].

PubMed

Courtin, F; Jamonneau, V; Kambiré, R; Solano, P

2010-12-01

Following the sociopolitical unrest that occurred in Ivory Coast in 2002, 360,000 Burkinabe immigrants returned to Burkina Faso that was the epicenter of sleeping sickness last century and is now thought to be free of autochthonous transmission. The purpose of this study was to determine if the massive return of immigrants from human African trypanosomiasis (HAT) endemic areas of Ivory Coast to areas in Burkina Faso where the vector (tsetse fly) is currently present could lead to re-emergence of the disease. Risk areas for re-emergence were identified taking into account the number of returning immigrants, history of the disease, and presence of tsetse flies. Based on these criteria, study was focused on two villages, i.e., Folonzo and Gbalara, located in southern Burkina Faso near the Ivory Coast border. Study in these two villages consisted of characterization of the population (repatriates or not, origin, ...) and medical surveys to assess the presence/absence of the disease. Departure of some returning immigrants from areas including sleeping sickness foci in Ivory Coast (e.g. center west) confirmed the potential risk of re-emergence of the disease. Although no case of sleeping sickness was diagnosed, several serologically positive people were identified and will be followed up. This study failed to demonstrate a clear-cut correlation between massive population movements due to war and reemergence of sleeping sickness. However, this study may have been timed too soon after the return of immigrants to detect reemergence of HAT that could require several years.

African Trypanosomiasis

DTIC Science & Technology

2011-06-01

trypanosomes in the blood of a patient with Gambia fever and named the organisms T. gambiense. Two years later, Castellani found identical organisms...trypanosomes, and that Gambia fever and sleeping sickness were 2 stages of the same disease.5 In 1910, Stephens and Fantham identified trypanosomes in the...which parasites disseminate through the lymph nodes, lymphatic system, and bloodstream. Symptoms include fever , malaise, generalized rash, headache

The identification of Trypanosoma brucei gambiense in Liberian pigs and dogs by isoenzymes and by resistance to human plasma.

PubMed

Gibson, W; Mehlitz, D; Lanham, S M; Godfrey, D G

1978-09-01

29 Trypanozoon stocks from Liberian pigs and dogs were screened for human plasma resistance and electrophoretic isoenzyme patterns of eleven enzymes. Two stocks from pigs were found both to be resistant to human plasma and to have an isoenzyme marker, a slow alanine aminotransferase (ALAT) pattern, previously found only in Trypanosoma brucei gambiense from man. This constitutes evidence that the pig is a reservoir of human trypanosomiasis in West Africa. The T.b.gambiense ALAT was also found in stocks from 5 other pigs and a dog, but none of these stocks was resistant to human plasma; conversely, 9 further isolations from pigs and 2 from dogs were plasma resistant but did not have the T.b.gambiense ALAT. The lack of correspondence between the two characteristics is discussed. A T.b.gambiense stock from man in Zaire had the ALAT pattern characteristic of T.b.gambiense from Senegal and Nigeria, together with the ASAT triplet found in most T.b.gambiense stocks. Peptidase polymorphism was shown in trypanosomes for the first time.

Drug development against sleeping sickness: old wine in new bottles?

PubMed

Stein, J; Mogk, S; Mudogo, C N; Sommer, B P; Scholze, M; Meiwes, A; Huber, M; Gray, A; Duszenko, M

2014-01-01

Atoxyl, the first medicinal drug against human African trypanosomiasis (HAT), also known as sleeping sickness, was applied more than 100 years ago. Ever since, the search for more effective, more specific and less toxic drugs continued, leading to a set of compounds currently in use against this devastating disease. Unfortunately, none of these medicines fulfill modern pharmaceutical requirements and may be considered as therapeutic ultima ratio due to the many, often severe side effects. Starting with a historic overview on drug development against HAT, we present a selection of trypanosome specific pathways and enzymes considered as highly potent druggable targets. In addition, we describe cellular mechanisms the parasite uses for differentiation and cell density regulation and present our considerations how interference with these steps, elementary for life cycle progression and infection, may lead to new aspects of drug development. Finally we refer to our recent work about CNS infection that offers novel insights in how trypanosomes hide in an immune privileged area to establish a chronic state of the disease, thereby considering new ways for drug application. Depressingly, HAT specific drug development has failed over the last 30 years to produce better suited medicine. However, unraveling of parasite-specific pathways and cellular behavior together with the ability to produce high resolution structures of essential parasite proteins by X-ray crystallography, leads us to the optimistic view that development of an ultimate drug to eradicate sleeping sickness from the globe might just be around the corner.

Alterations of orexinergic and melanin-concentrating hormone neurons in experimental sleeping sickness.

PubMed

Palomba, M; Seke-Etet, P F; Laperchia, C; Tiberio, L; Xu, Y-Z; Colavito, V; Grassi-Zucconi, G; Bentivoglio, M

2015-04-02

Human African trypanosomiasis or sleeping sickness is a severe, neglected tropical disease caused by the extracellular parasite Trypanosoma brucei. The disease, which leads to chronic neuroinflammation, is characterized by sleep and wake disturbances, documented also in rodent models. In rats and mice infected with Trypanosoma brucei brucei, we here tested the hypothesis that the disease could target neurons of the lateral hypothalamus (LH) containing orexin (OX)-A or melanin-concentrating hormone (MCH), implicated in sleep/wake regulation. In the cerebrospinal fluid of infected rats, the OX-A level was significantly decreased early after parasite neuroinvasion, and returned to the control level at an advanced disease stage. The number of immunohistochemically characterized OX-A and MCH neurons decreased significantly in infected rats during disease progression and in infected mice at an advanced disease stage. A marked reduction of the complexity of dendritic arborizations of OX-A neurons was documented in infected mice. The evaluation of NeuN-immunoreactive neurons did not reveal significant neuronal loss in the LH of infected mice, thus suggesting a potential selective vulnerability of OX-A and MCH neurons. Immunophenotyping and quantitative analysis showed in infected mice marked activation of microglial cells surrounding OX-A neurons. Day/night oscillation of c-Fos baseline expression was used as marker of OX-A neuron activity in mice. In control animals Fos was expressed in a higher proportion of OX-A neurons in the night (activity) phase than in the day (rest) phase. Interestingly, in infected mice the diurnal spontaneous Fos oscillation was reversed, with a proportion of OX-A/Fos neurons significantly higher at daytime than at nighttime. Altogether the findings reveal a progressive decrease of OX-A and MCH neurons and dysregulation of OX-A neuron diurnal activity in rodent models of sleeping sickness. The data point to the involvement of these peptidergic

Population genetics of Trypanosoma brucei gambiense in sleeping sickness patients with treatment failures in the focus of Mbuji-Mayi, Democratic Republic of the Congo.

PubMed

Pyana, Patient Pati; Sere, Modou; Kaboré, Jacques; De Meeûs, Thierry; MacLeod, Annette; Bucheton, Bruno; Van Reet, Nick; Büscher, Philippe; Belem, Adrien Marie Gaston; Jamonneau, Vincent

2015-03-01

Human African trypanosomiasis (HAT) in the Democratic Republic of the Congo (DRC) is caused by the protozoan Trypanosoma brucei gambiense. Until recently, all patients in the second or neurological stage of the disease were treated with melarsoprol. At the end of the past and the beginning of the present century, alarmingly high relapse rates in patients treated with melarsoprol were reported in isolated HAT foci. In the Mbuji-Mayi focus of DRC, a particular mutation that confers cross resistance for pentamidine and melarsoprol was recently found for all strains studied. Nevertheless, treatment successfully cured a significant proportion of patients. To check for the existence of other possible genetic factors of the parasites, we genotyped trypanosomes isolated from patients before and after treatment (relapsing patients) with eight microsatellite markers. We found no evidence of any genetic correlation between parasite genotype and treatment outcome and we concluded that relapse or cure probably depend more on patients' factors such as disease progression, nutritional or immunological status or co-infections with other pathogens. The existence of a melarsoprol and pentamidine resistance associated mutation at such high rates highlights an increasing problem, even for other drugs, especially those using the same transporters as melarsoprol and pentamidine. Copyright © 2014 Elsevier B.V. All rights reserved.

Non-invasive positive pressure ventilation during sleep at 3800 m: Relationship to acute mountain sickness and sleeping oxyhaemoglobin saturation.

PubMed

Johnson, Pamela L; Popa, Daniel A; Prisk, G Kim; Edwards, Natalie; Sullivan, Colin E

2010-02-01

Overnight oxyhaemoglobin desaturation is related to AMS. AMS can be debilitating and may require descent. Positive pressure ventilation during sleep at high altitude may prevent AMS and therefore be useful in people travelling to high altitude, who are known to suffer from AMS. Ascent to high altitude results in hypobaric hypoxia and some individuals will develop acute mountain sickness (AMS), which has been shown to be associated with low oxyhaemoglobin saturation during sleep. Previous research has shown that positive end-expiratory pressure by use of expiratory valves in a face mask while awake results in a reduction in AMS symptoms and higher oxyhaemoglobin saturation. We aimed to determine whether positive pressure ventilation would prevent AMS by increasing oxygenation during sleep. We compared sleeping oxyhaemoglobin saturation and the incidence and severity of AMS in seven subjects sleeping for two consecutive nights at 3800 m above sea level using either non-invasive positive pressure ventilation that delivered positive inspiratory and expiratory airway pressure via a face mask, or sleeping without assisted ventilation. The presence and severity of AMS were assessed by administration of the Lake Louise questionnaire. We found significant increases in the mean and minimum sleeping oxyhaemoglobin saturation and decreases in AMS symptoms in subjects who used positive pressure ventilation during sleep. Mean and minimum sleeping SaO2 was lower in subjects who developed AMS after the night spent without positive pressure ventilation. The use of positive pressure ventilation during sleep at 3800 m significantly increased the sleeping oxygen saturation; we suggest that the marked reduction in symptoms of AMS is due to this higher sleeping SaO2. We agree with the findings from previous studies that the development of AMS is associated with a lower sleeping oxygen saturation.

RNA-seq de novo Assembly Reveals Differential Gene Expression in Glossina palpalis gambiensis Infected with Trypanosoma brucei gambiense vs. Non-Infected and Self-Cured Flies

PubMed Central

Hamidou Soumana, Illiassou; Klopp, Christophe; Ravel, Sophie; Nabihoudine, Ibouniyamine; Tchicaya, Bernadette; Parrinello, Hugues; Abate, Luc; Rialle, Stéphanie; Geiger, Anne

2015-01-01

Trypanosoma brucei gambiense (Tbg), causing the sleeping sickness chronic form, completes its developmental cycle within the tsetse fly vector Glossina palpalis gambiensis (Gpg) before its transmission to humans. Within the framework of an anti-vector disease control strategy, a global gene expression profiling of trypanosome infected (susceptible), non-infected, and self-cured (refractory) tsetse flies was performed, on their midguts, to determine differential genes expression resulting from in vivo trypanosomes, tsetse flies (and their microbiome) interactions. An RNAseq de novo assembly was achieved. The assembled transcripts were mapped to reference sequences for functional annotation. Twenty-four percent of the 16,936 contigs could not be annotated, possibly representing untranslated mRNA regions, or Gpg- or Tbg-specific ORFs. The remaining contigs were classified into 65 functional groups. Only a few transposable elements were present in the Gpg midgut transcriptome, which may represent active transpositions and play regulatory roles. One thousand three hundred and seventy three genes differentially expressed (DEGs) between stimulated and non-stimulated flies were identified at day-3 post-feeding; 52 and 1025 between infected and self-cured flies at 10 and 20 days post-feeding, respectively. The possible roles of several DEGs regarding fly susceptibility and refractoriness are discussed. The results provide new means to decipher fly infection mechanisms, crucial to develop anti-vector control strategies. PMID:26617594

Quantifying the association between bovine and human trypanosomiasis in newly affected sleeping sickness areas of Uganda.

PubMed

von Wissmann, Beatrix; Fyfe, Jenna; Picozzi, Kim; Hamill, Louise; Waiswa, Charles; Welburn, Susan C

2014-06-01

Uganda has active foci of both chronic and acute HAT with the acute zoonotic form of disease classically considered to be restricted to southeast Uganda, while the focus of the chronic form of HAT was confined to the northwest of the country. Acute HAT has however been migrating from its traditional disease focus, spreading rapidly to new districts, a spread linked to movement of infected cattle following restocking. Cattle act as long-term reservoirs of human infective T. b. rhodesiense showing few signs of morbidity, yet posing a significant risk to human health. It is important to understand the relationship between infected cattle and infected individuals so that an appropriate response can be made to the risk posed to the community from animals infected with human pathogens in a village setting. This paper examines the relationship between human T. b. rhodesiense infection and human infective and non-human T. brucei s.l. circulating in cattle at village level in Kaberamaido and Dokolo Districts, Uganda. The study was undertaken in villages that had reported a case of sleeping sickness in the six months prior to sample collection and those villages that had never reported a case of sleeping sickness. The sleeping sickness status of the villages had a significant effect with higher odds of infection in cattle from case than from non-case villages for T. brucei s.l. (OR: 2.94, 95%CI: 1.38-6.24). Cattle age had a significant effect (p<0.001) on the likelihood of T. brucei s.l. infection within cattle: cattle between 18-36 months (OR: 3.51, 95%CI: 1.63-7.51) and cattle over 36 months (OR: 4.20, 95%CI: 2.08-8.67) had significantly higher odds of T. brucei s. l. infection than cattle under 18 months of age. Furthermore, village human sleeping sickness status had a significant effect (p<0.05) on the detection of T. b. rhodesiense in the village cattle herd, with significantly higher likelihood of T. b. rhodesiense in the village cattle of case villages (OR: 25, 95%CI

Clinical profiles, disease outcome and co-morbidities among T. b. rhodesiense sleeping sickness patients in Uganda.

PubMed

Kato, Charles D; Nanteza, Ann; Mugasa, Claire; Edyelu, Andrew; Matovu, Enock; Alibu, Vincent P

2015-01-01

The acute form of Human African Trypanosomiasis (HAT, also known as Sleeping sickness) caused by Trypanosoma brucei rhodesiense has been shown to have a wide spectrum of focus specific clinical presentation and severity in East and Southern Africa. Indeed HAT occurs in regions endemic for other tropical diseases, however data on how these co-morbidities might complicate the clinical picture and affect disease outcome remains largely scanty. We here describe the clinical presentation, presence of co-infections, and how the latter impact on HAT prognosis. We carried out a retrospective analysis of clinical data from 258 sleeping sickness patients reporting to Lwala hospital between 2005 and 2012. The mean patient age was 28.6 years with a significant number of cases below 18 years (p< 0.0001). About 93.4% of the cases were diagnosed as late stage (p< 0.0001). The case fatality rate was 10.5% with post treatment reactive encephalopathys reported in 7.9% of the cases, of whom 36.8% eventually died. Fever was significantly (p = 0.045) higher in patients under 18 years. Of the early stage patients, 26.7% and 6.7% presented with late stage signs of sleep disorder and mental confusion respectively. Among the co-infections, malaria was significantly more prevalent (28.9%; p< 0.0001) followed by urinary tract infections (4.2%). Co-infections were present in 14.3% of in-hospital deaths, 38.5% of which were recorded as Malaria. Malaria was significantly more common in patients under 18 years (45.5%; p< 0.02), and was reported in 60% of the fatal cases in this age group. We show a wide spectrum of sleeping sickness clinical presentation and disease outcome that was apparently not significantly influenced by concurrent infections. It would thus be interesting to determine the host and/or parasite factors that might be responsible for the observed diverse clinical presentation.

Population genetics of Glossina palpalis palpalis from central African sleeping sickness foci.

PubMed

Melachio, Trésor Tito Tanekou T T; Simo, Gustave; Ravel, Sophie; De Meeûs, Thierry; Causse, Sandrine; Solano, Philippe; Lutumba, Pascal; Asonganyi, Tazoacha; Njiokou, Flobert

2011-07-18

Glossina palpalis palpalis (Diptera: Glossinidae) is widespread in west Africa, and is the main vector of sleeping sickness in Cameroon as well as in the Bas Congo Province of the Democratic Republic of Congo. However, little is known on the structure of its populations. We investigated G. p. palpalis population genetic structure in five sleeping sickness foci (four in Cameroon, one in Democratic Republic of Congo) using eight microsatellite DNA markers. A strong isolation by distance explains most of the population structure observed in our sampling sites of Cameroon and DRC. The populations here are composed of panmictic subpopulations occupying fairly wide zones with a very strong isolation by distance. Effective population sizes are probably between 20 and 300 individuals and if we assume densities between 120 and 2000 individuals per km2, dispersal distance between reproducing adults and their parents extends between 60 and 300 meters. This first investigation of population genetic structure of G. p. palpalis in Central Africa has evidenced random mating subpopulations over fairly large areas and is thus at variance with that found in West African populations of G. p. palpalis. This study brings new information on the isolation by distance at a macrogeographic scale which in turn brings useful information on how to organise regional tsetse control. Future investigations should be directed at temporal sampling to have more accurate measures of demographic parameters in order to help vector control decision.

Estimating the burden of rhodesiense sleeping sickness during an outbreak in Serere, eastern Uganda

PubMed Central

Fèvre, Eric M; Odiit, Martin; Coleman, Paul G; Woolhouse, Mark EJ; Welburn, Susan C

2008-01-01

Background Zoonotic sleeping sickness, or HAT (Human African Trypanosomiasis), caused by infection with Trypanosoma brucei rhodesiense, is an under-reported and neglected tropical disease. Previous assessments of the disease burden expressed as Disability-Adjusted Life Years (DALYs) for this infection have not distinguished T.b. rhodesiense from infection with the related, but clinically distinct Trypanosoma brucei gambiense form. T.b. rhodesiense occurs focally, and it is important to assess the burden at the scale at which resource-allocation decisions are made. Methods The burden of T.b. rhodesiense was estimated during an outbreak of HAT in Serere, Uganda. We identified the unique characteristics affecting the burden of rhodesiense HAT such as age, severity, level of under-reporting and duration of hospitalisation, and use field data and empirical estimates of these to model the burden imposed by this and other important diseases in this study population. While we modelled DALYs using standard methods, we also modelled uncertainty of our parameter estimates through a simulation approach. We distinguish between early and late stage HAT morbidity, and used disability weightings appropriate for the T.b. rhodesiense form of HAT. We also use a model of under-reporting of HAT to estimate the contribution of un-reported mortality to the overall disease burden in this community, and estimate the cost-effectiveness of hospital-based HAT control. Results Under-reporting accounts for 93% of the DALY estimate of rhodesiense HAT. The ratio of reported malaria cases to reported HAT cases in the same health unit was 133:1, however, the ratio of DALYs was 3:1. The age productive function curve had a close correspondence with the HAT case distribution, and HAT cases occupied more patient admission time in Serere during 1999 than all other infectious diseases other than malaria. The DALY estimate for HAT in Serere shows that the burden is much greater than might be expected from

Sleep disordered breathing, hypoxia and inflammation: associations with sickness behaviour in community dwelling elderly with and without cardiovascular disease.

PubMed

Johansson, Peter; Svensson, Erland; Alehagen, Urban; Dahlström, Ulf; Jaarsma, Tiny; Broström, Anders

2015-03-01

Inflammation can induce a cluster of symptoms, referred to as sickness behaviour (e.g., depressive symptoms, sleep disturbances, pain and fatigue). Cardiovascular disease (CVD) and sleep disordered breathing (SDB) are common in older adults. CVD is associated with an increased inflammatory activity and in SDB, hypoxia can also increase inflammation. The purpose of this study is to explore if SDB-related hypoxia is associated differently with inflammation and the presence of sickness behaviour in older adults with and without CVD. Three hundred and thirty-one older adults, whose mean age is 78 years, underwent one-night polygraphic recording to measure SDB and hypoxia. CVD was established by a clinical investigation. Questionnaires were used to measure sickness behaviour and depressive symptoms. High sensitivity C-reactive protein was used as a marker of inflammation. Structural Equation Modelling showed that SDB-related hypoxia was associated with inflammation (β > 0.40) which mediated indirect associations with sickness behaviour (β = 0.19) and depressive symptoms (β = 0.11), but only in those with CVD (n = 119). In this model, inflammation had a direct effect on sickness behaviour (β = 0.43) and an indirect effect on depressive symptoms (β = 0.24). Hypoxia had the strongest effect (i.e., β = 0.41; significant) on inflammation, whereas the AHI or ODI had weak and non-significant effects (β = 0.03 and β = 0.15). Older adults with CVD and SDB are at a particular risk of developing sickness behaviour and depressive symptoms. The effect of SDB was mainly caused by hypoxia, suggesting that hypoxia is an important marker of SDB severity in older adults with CVD.

Sleep disturbances in long-term immigrants with chronic mountain sickness: a comparison with healthy immigrants at high altitude.

PubMed

Guan, Wei; Ga, Qin; Li, Rong; Bai, Zhen-Zhong; Wuren, Tana; Wang, Jin; Yang, Ying-Zhong; Li, Yu-Hong; Ge, Ri-Li

2015-01-15

The aim of this study was to examine sleep disturbances in patients with chronic mountain sickness (CMS). The sleep of 14 patients with CMS and 11 healthy controls with or without sleep disorders (control N: without sleep disorders; control D: with sleep disorders) was studied by polysomnography. Hypopnea was the sleep disorder most commonly suffered by CMS patients and control D subjects. No major differences were observed in sleep structure between CMS and control groups, with the exception of shorter rapid eye movement latency in controls and increased deep non-rapid eye movement in the control N group. Periodic breathing was observed in only two study participants, one each in the CMS and control D groups. The level of saturated oxygen was significantly lower in the CMS group during sleep than the control groups (P<0.05). CMS scores were positively correlated with the apnea-hypopnea index, and negatively correlated with saturated oxygen levels. These results demonstrate that sleep disorders and nocturnal hypoxia are important in the development of CMS. Copyright © 2014 Elsevier B.V. All rights reserved.

Tsetse ecology in a Liberian rain-forest focus of Gambian sleeping sickness.

PubMed

Kaminsky, R

1987-07-01

Investigations on tsetse ecology were undertaken in Bong County of Liberia during the dry season, October 1981 to February 1982, around villages where the human infection rate with Trypanosoma brucei gambiense Dutton was about 2%. Most tsetse captured in biconical traps were Glossina palpalis Robineau-Desvoidy and G. pallicera Bigot, with relatively few G. fusca Walker and G. nigrofusca Newstead. Swamps and water-gathering places were predominant habitats of all four species, but tsetse were also found in coffee and cocoa plantations. Breeding-places of G. palpalis were found in the leaf axils of oilpalm trees (Elaeis guineensis Jacquin), especially beside paths where people would risk being bitten. Bloodmeals of twenty-nine wild-caught G. palpalis were identified as mostly from man (fifteen) and bushbuck (Tragelaphus scriptus (Pallas] or other wild ruminants (eleven), plus three from reptiles. It is concluded that man may be the principal host of tsetse in the area, while man or bushbuck could be the main reservoir to T.b. gambiense infection. Most of the activity of G. palpalis occurs in the early afternoon from noon to 16.00 hours. Mean life-span of G. palpalis and G. pallicera, estimated from wing-fray age-groups, was consistent with the females, and to a lesser degree the males, having vector potential.

Agrochemicals against malaria, sleeping sickness, leishmaniasis and Chagas disease.

PubMed

Witschel, Matthias; Rottmann, Matthias; Kaiser, Marcel; Brun, Reto

2012-01-01

In tropical regions, protozoan parasites can cause severe diseases with malaria, leishmaniasis, sleeping sickness, and Chagas disease standing in the forefront. Many of the drugs currently being used to treat these diseases have been developed more than 50 years ago and can cause severe adverse effects. Above all, resistance to existing drugs is widespread and has become a serious problem threatening the success of control measures. In order to identify new antiprotozoal agents, more than 600 commercial agrochemicals have been tested on the pathogens causing the above mentioned diseases. For all of the pathogens, compounds were identified with similar or even higher activities than the currently used drugs in applied in vitro assays. Furthermore, in vivo activity was observed for the fungicide/oomyceticide azoxystrobin, and the insecticide hydramethylnon in the Plasmodium berghei mouse model, and for the oomyceticide zoxamide in the Trypanosoma brucei rhodesiense STIB900 mouse model, respectively.

Agrochemicals against Malaria, Sleeping Sickness, Leishmaniasis and Chagas Disease

PubMed Central

Witschel, Matthias; Rottmann, Matthias; Kaiser, Marcel; Brun, Reto

2012-01-01

In tropical regions, protozoan parasites can cause severe diseases with malaria, leishmaniasis, sleeping sickness, and Chagas disease standing in the forefront. Many of the drugs currently being used to treat these diseases have been developed more than 50 years ago and can cause severe adverse effects. Above all, resistance to existing drugs is widespread and has become a serious problem threatening the success of control measures. In order to identify new antiprotozoal agents, more than 600 commercial agrochemicals have been tested on the pathogens causing the above mentioned diseases. For all of the pathogens, compounds were identified with similar or even higher activities than the currently used drugs in applied in vitro assays. Furthermore, in vivo activity was observed for the fungicide/oomyceticide azoxystrobin, and the insecticide hydramethylnon in the Plasmodium berghei mouse model, and for the oomyceticide zoxamide in the Trypanosoma brucei rhodesiense STIB900 mouse model, respectively. PMID:23145187

A neglected aspect of the epidemiology of sleeping sickness: the propensity of the tsetse fly vector to enter houses.

PubMed

Vale, Glyn A; Chamisa, Andrew; Mangwiro, Clement; Torr, Stephen J

2013-01-01

When taking a bloodmeal from humans, tsetse flies can transmit the trypanosomes responsible for sleeping sickness, or human African trypanosomiasis. While it is commonly assumed that humans must enter the normal woodland habitat of the tsetse in order to have much chance of contacting the flies, recent studies suggested that important contact can occur due to tsetse entering buildings. Hence, we need to know more about tsetse in buildings, and to understand why, when and how they enter such places. Buildings studied were single storied and comprised a large house with a thatched roof and smaller houses with roofs of metal or asbestos. Each building was unoccupied except for the few minutes of its inspection every two hours, so focusing on the responses of tsetse to the house itself, rather than to humans inside. The composition, and physiological condition of catches of tsetse flies, Glossina morsitans morsitans and G. pallidipes, in the houses and the diurnal and seasonal pattern of catches, were intermediate between these aspects of the catches from artificial refuges and a host-like trap. Several times more tsetse were caught in the large house, as against the smaller structures. Doors and windows seemed about equally effective as entry points. Many of the tsetse in houses were old enough to be potential vectors of sleeping sickness, and some of the flies alighted on the humans that inspected the houses. Houses are attractive in themselves. Some of the tsetse attracted seem to be in a host-seeking phase of behavior and others appear to be looking for shelter from high temperatures outside. The risk of contracting sleeping sickness in houses varies according to house design.

Interleukin (IL)-6 and IL-10 Are Up Regulated in Late Stage Trypanosoma brucei rhodesiense Sleeping Sickness.

PubMed

Kato, Charles D; Alibu, Vincent P; Nanteza, Ann; Mugasa, Claire M; Matovu, Enock

2015-06-01

Sleeping sickness due to Trypanosoma brucei rhodesiense has a wide spectrum of clinical presentations coupled with differences in disease progression and severity across East and Southern Africa. The disease progresses from an early (hemo-lymphatic) stage to the late (meningoencephalitic) stage characterized by presence of parasites in the central nervous system. We hypothesized that disease progression and severity of the neurological response is modulated by cytokines. A total of 55 sleeping sickness cases and 41 healthy controls were recruited passively at Lwala hospital, in Northern Uganda. A panel of six cytokines (IFN-γ, IL1-β, TNF-α, IL-6, TGF-β and IL-10) were assayed from paired plasma and cerebrospinal fluid (CSF) samples. Cytokine concentrations were analyzed in relation to disease progression, clinical presentation and severity of neurological responses. Median plasma levels (pg/ml) of IFN-γ (46.3), IL-6 (61.7), TGF-β (8755) and IL-10 (256.6) were significantly higher in cases compared to controls (p< 0.0001). When early stage and late stage CSF cytokines were compared, IL-10 and IL-6 were up regulated in late stage patients and were associated with a reduction in tremors and cranioneuropathy. IL-10 had a higher staging accuracy with a sensitivity of 85.7% (95% CI, 63.7%-97%) and a specificity of 100% (95% CI, 39.8%-100%) while for IL-6, a specificity of 100% (95% CI, 47.8%-100%) gave a sensitivity of 83.3% (95% CI, 62.2%-95.3%). Our study demonstrates the role of host inflammatory cytokines in modulating the progression and severity of neurological responses in sleeping sickness. We demonstrate here an up-regulation of IL-6 and IL-10 during the late stage with a potential as adjunct stage biomarkers. Given that both cytokines could potentially be elevated by other CNS infections, our findings should be further validated in a large cohort of patients including those with other inflammatory diseases such as cerebral malaria.

A Neglected Aspect of the Epidemiology of Sleeping Sickness: The Propensity of the Tsetse Fly Vector to Enter Houses

PubMed Central

Vale, Glyn A.; Chamisa, Andrew; Mangwiro, Clement; Torr, Stephen J.

2013-01-01

Background When taking a bloodmeal from humans, tsetse flies can transmit the trypanosomes responsible for sleeping sickness, or human African trypanosomiasis. While it is commonly assumed that humans must enter the normal woodland habitat of the tsetse in order to have much chance of contacting the flies, recent studies suggested that important contact can occur due to tsetse entering buildings. Hence, we need to know more about tsetse in buildings, and to understand why, when and how they enter such places. Methodology/Principal Findings Buildings studied were single storied and comprised a large house with a thatched roof and smaller houses with roofs of metal or asbestos. Each building was unoccupied except for the few minutes of its inspection every two hours, so focusing on the responses of tsetse to the house itself, rather than to humans inside. The composition, and physiological condition of catches of tsetse flies, Glossina morsitans morsitans and G. pallidipes, in the houses and the diurnal and seasonal pattern of catches, were intermediate between these aspects of the catches from artificial refuges and a host-like trap. Several times more tsetse were caught in the large house, as against the smaller structures. Doors and windows seemed about equally effective as entry points. Many of the tsetse in houses were old enough to be potential vectors of sleeping sickness, and some of the flies alighted on the humans that inspected the houses. Conclusion/Significance Houses are attractive in themselves. Some of the tsetse attracted seem to be in a host-seeking phase of behavior and others appear to be looking for shelter from high temperatures outside. The risk of contracting sleeping sickness in houses varies according to house design. PMID:23469309

[Integration of demographic factors in the characterization of risk areas for sleeping sickness in Côte d'Ivoire].

PubMed

Fournet, F; Kone, A; Meda, A H; Traore, S; Hervouet, J P

2001-01-01

The purpose of this study was to classify the risk for transmission of African human trypanosomiasis (sleeping sickness) according to population and settlement densities in four different areas of Zoukougbeu, Cote d'Ivoire, where the exact location of cases reported since 1990 is known. Epidemiological risk indexes were calculated from entomological data obtained from three surveys and analyzed with respect to presence of patients and occupancy rate in each area. Results indicated that there was a risk of transmission near the village of Bahigbeu II where the population density is between 30 and 40 inhabitants per km2 and settlement density is 4 per km2. There was also a risk in less inhabited areas such as Ouatigbeu where the population density is less than 30 inhabitants per km2 and dwelling density less than 4 per km2. In fact, cases are regularly reported in Ouatigbeu but never in Bahigbeu II. Based on these findings, we conclude that, while land occupancy can be considered as a risk factor for sleeping sickness, other factors such as human mobility must be taken into account to characterize risk areas and predict outbreaks.

Association of Amplitude and Stability of Circadian Rhythm, Sleep Quality, and Occupational Stress with Sickness Absence among a Gas Company Employees-A Cross Sectional Study from Iran.

PubMed

Zare, Rezvan; Choobineh, Alireza; Keshavarzi, Sareh

2017-09-01

The present study was carried out to assess the relationship between sickness absence and occupational stress, sleep quality, and amplitude and stability of circadian rhythm as well as to determine contributing factors of sickness absence. This cross sectional study was conducted on 400 randomly selected employees of an Iranian gas company. The data were collected using Pittsburgh sleep quality index, Karolinska sleepiness scale, circadian type inventory, and Osipow occupational stress questionnaires. The mean age and job tenure of the participants were 33.18 ± 5.64 years and 6.06 ± 4.99 years, respectively. Also, the participants had been absent from work on average 2.16 days a year. According to the results, 209 participants had no absences, 129 participants had short-term absences, and 62 participants had long-term absences. The results showed a significant relationship between short-term absenteeism and amplitude of circadian rhythm [odds ratio (OR) = 6.13], sleep quality (OR = 14.46), sleepiness (OR = 2.08), role boundary (OR = 6.45), and responsibility (OR = 5.23). Long-term absenteeism was also significantly associated with amplitude of circadian rhythm (OR = 2.42), sleep quality (OR = 21.56), sleepiness (OR = 6.44), role overload (OR = 4.84), role boundary (OR = 4.27), and responsibility (OR = 3.72). The results revealed that poor sleep quality, amplitude of circadian rhythm, and occupational stress were the contributing factors for sickness absence in the study population.

Trypanosome infection rates in tsetse flies in the "silent" sleeping sickness focus of Bafia in the Centre Region in Cameroon.

PubMed

Simo, Gustave; Fongho, Pierre; Farikou, Oumarou; Ndjeuto-Tchouli, Prosper Innocent Ndjeuto; Tchouomene-Labou, Judith; Njiokou, Flobert; Asonganyi, Tazoacha

2015-10-12

The Bafia sleeping sickness focus of Cameroon is considered as "silent" with no case reported for about 20 years despite medical surveys performed during the last decades. In this focus, all epidemiological factors that can contribute to trypanosomes transmission are present. To update our knowledge on the current risks of Human and Animal African trypanosomiases, different trypanosome species were identified in midguts of tsetse flies captured in the Bafia focus. Tsetse flies were trapped using pyramidal traps. Each tsetse fly was identified and live flies were dissected and their midguts collected. DNA was extracted from each midgut and thereafter, blood meals and different trypanosome species were identified with molecular tools. The biological data were transported onto maps in order to have their distribution. Of the 98 traps set up, 461 Glossina palpalis palpalis were captured; 322 (69.8 %) tsetse flies were dissected and 49 (15.2 %) teneral flies identified. The average apparent density of tsetse flies per day was 1.18. Of the 35 (10.9 %) blood meals collected, 82 % were taken on pigs and 17.6 % on humans. Eighty two (25.5 %) trypanosome infections were identified: 56 (17.4 %) T. congolense savannah, 17 (5.3 %) T. congolense forest, 5 (1.6 %) T. vivax and 4 (1.2 %) T. brucei s.l. No infection of T. simiae and T. b. gambiense was identified. Sixty seven (81.7 %) infections were single and 15 (18.3 %) mixed involving one triple infection (T. congolense forest, T. brucei and T. vivax) and 14 double infections: 11 T. congolense forest and T. congolense savannah, two T. congolense savannah and T. brucei, and one of T. brucei and T. vivax. The generated maps show the distribution of tsetse flies and trypanosome infections across the focus. This study has shown that animal trypanosomes remain an important problem in this region. Meanwhile, it is very likely that HAT does not seem anymore to be a public health problem in this focus. The generated maps

N-Myristoyltransferase inhibitors as new leads to treat sleeping sickness

PubMed Central

Frearson, Julie A.; Brand, Stephen; McElroy, Stuart P.; Cleghorn, Laura A.T.; Smid, Ondrej; Stojanovski, Laste; Price, Helen P.; Guther, M. Lucia S.; Torrie, Leah S.; Robinson, David A.; Hallyburton, Irene; Mpamhanga, Chidochangu P.; Brannigan, James A.; Wilkinson, Anthony J.; Hodgkinson, Michael; Hui, Raymond; Qiu, Wei; Raimi, Olawale G.; van Aalten, Daan M. F.; Brenk, Ruth; Gilbert, Ian H.; Read, Kevin D.; Fairlamb, Alan H.; Ferguson, Michael A. J.; Smith, Deborah F.; Wyatt, Paul G.

2010-01-01

African sleeping sickness or human African trypanosomiasis (HAT), caused by Trypanosoma brucei spp., is responsible for ~30,000 deaths each year. Available treatments for this neglected disease are poor, with unacceptable efficacy and safety profiles, particularly in the late stage of the disease, when the parasite has infected the central nervous system. Here, we report the validation of a molecular target and discovery of associated lead compounds with potential to address this unmet need. Inhibition of this target, T. brucei N-myristoyltransferase (TbNMT), leads to rapid killing of trypanosomes both in vitro and in vivo and cures trypanosomiasis in mice. These high affinity inhibitors bind into the peptide substrate pocket of the enzyme and inhibit protein N-myristoylation in trypanosomes. The compounds identified have very promising pharmaceutical properties and represent an exciting opportunity to develop oral drugs to treat this devastating disease. Our studies validate TbNMT as a promising therapeutic target for HAT. PMID:20360736

N-myristoyltransferase inhibitors as new leads to treat sleeping sickness

DOE Office of Scientific and Technical Information (OSTI.GOV)

Frearson, Julie A.; Brand, Stephen; McElroy, Stuart P.

2010-11-05

African sleeping sickness or human African trypanosomiasis, caused by Trypanosoma brucei spp., is responsible for {approx}30,000 deaths each year. Available treatments for this disease are poor, with unacceptable efficacy and safety profiles, particularly in the late stage of the disease when the parasite has infected the central nervous system. Here we report the validation of a molecular target and the discovery of associated lead compounds with the potential to address this lack of suitable treatments. Inhibition of this target - T. brucei N-myristoyltransferase - leads to rapid killing of trypanosomes both in vitro and in vivo and cures trypanosomiasis inmore » mice. These high-affinity inhibitors bind into the peptide substrate pocket of the enzyme and inhibit protein N-myristoylation in trypanosomes. The compounds identified have promising pharmaceutical properties and represent an opportunity to develop oral drugs to treat this devastating disease. Our studies validate T. brucei N-myristoyltransferase as a promising therapeutic target for human African trypanosomiasis.« less

[Risk factors for absenteeism due to sick leave in the petroleum industry].

PubMed

Oenning, Nágila Soares Xavier; Carvalho, Fernando Martins; Lima, Veronica Maria Cadena

2014-02-01

To identify risk factors for absenteeism among workers with sick leave in an oil company. A case-control study (120 cases and 656 controls) nested in a retrospective cohort study following up all employees of an oil company in the North-Northeast of Brazil from 2007 to 2009. The response variable used to represent absenteeism with sick leave was the average incidence of sick leave, defined as the ratio between total sick days and potential working days in the period. Logistic regression techniques were used to investigate the association between average incidence of sick leave > 5.0% over the period and the variables sex, position, age, time at work, shift work, smoking, arterial hypertension, body mass index, physical activity, coronary risk, sleep, glycemia, non-managed diabetes, cardiovascular, digestive, musculoskeletal, neurological and neoplastic diseases, straining body positioning during work, satisfaction at work, relationship with management, and concentrated attention at work. Average incidence of sick leave higher than 5.0% in the cohort period was 15.5%. The logistic model revealed that workers with average incidence of sick leave higher than 5.0% were 2.6 times more likely to be female; 2.0 time more likely to be smokers; 1.8 time more likely to be former smokers; 2.2 times more likely to report abnormal sleep and 10.5 times more likely to report dissatisfaction with their than workers with average incidence of sick leave ≤ 5.0% in the period. In this population, female gender, being a smoker or a former smoker, reporting dissatisfaction with the job and reporting abnormal sleep are good predictors of occupational absenteeism with sick leave. To identify risk factors for absenteeism among workers with sick leave in an oil company. A case-control study (120 cases and 656 controls) nested in a retrospective cohort study following up all employees of an oil company in the North-Northeast of Brazil from 2007 to 2009. The response variable used to

Prevalence and Types of Coinfections in Sleeping Sickness Patients in Kenya (2000/2009)

PubMed Central

Kagira, J. M.; Maina, N.; Njenga, J.; Karanja, S. M.; Karori, S. M.; Ngotho, J. M.

2011-01-01

The occurrence of coinfections in human African trypanosomiasis (HAT) patients was investigated using a retrospective data of hospital records at the National Sleeping Sickness Referral Hospital in Alupe, Kenya. A total of 31 patients, 19 males and 12 females, were diagnosed with HAT between the years 2000 and 2009. The observed co-infections included malaria (100%), helminthosis (64.5%), typhoid (22.5%), urinary tract infections (16.1%), HIV (12.9%), and tuberculosis (3.2%). The species of helminthes observed included Ancylostoma duodenale (38.7%), Ascaris lumbricoides (45.7%), Strongyloides stercoralis (9.7%), and Taenia spp. (3.2%). The patients were also infected with Entamoeba spp. (32.3%) and Trichomonas hominis (22.6%) protozoan parasites. The main clinical signs observed at the point of admission included headache (74.2%), fever (48.4%), sleep disorders (45.2%), and general body pain (41.9%). The HAT patients were treated with suramin (early stage, 9/31) and melarsoprol (late stage, 22/31). In conclusion, the study has shown that HAT patients have multiple co-infections which may influence the disease pathogenesis and complicate management of HAT. PMID:21915184

Efficacy and Safety of Pafuramidine versus Pentamidine Maleate for Treatment of First Stage Sleeping Sickness in a Randomized, Comparator-Controlled, International Phase 3 Clinical Trial.

PubMed

Pohlig, Gabriele; Bernhard, Sonja C; Blum, Johannes; Burri, Christian; Mpanya, Alain; Lubaki, Jean-Pierre Fina; Mpoto, Alfred Mpoo; Munungu, Blaise Fungula; N'tombe, Patrick Mangoni; Deo, Gratias Kambau Manesa; Mutantu, Pierre Nsele; Kuikumbi, Florent Mbo; Mintwo, Alain Fukinsia; Munungi, Augustin Kayeye; Dala, Amadeu; Macharia, Stephen; Bilenge, Constantin Miaka Mia; Mesu, Victor Kande Betu Ku; Franco, Jose Ramon; Dituvanga, Ndinga Dieyi; Tidwell, Richard R; Olson, Carol A

2016-02-01

Sleeping sickness (human African trypanosomiasis [HAT]) is a neglected tropical disease with limited treatment options that currently require parenteral administration. In previous studies, orally administered pafuramidine was well tolerated in healthy patients (for up to 21 days) and stage 1 HAT patients (for up to 10 days), and demonstrated efficacy comparable to pentamidine. This was a Phase 3, multi-center, randomized, open-label, parallel-group, active control study where 273 male and female patients with first stage Trypanosoma brucei gambiense HAT were treated at six sites: one trypanosomiasis reference center in Angola, one hospital in South Sudan, and four hospitals in the Democratic Republic of the Congo between August 2005 and September 2009 to support the registration of pafuramidine for treatment of first stage HAT in collaboration with the United States Food and Drug Administration. Patients were treated with either 100 mg of pafuramidine orally twice a day for 10 days or 4 mg/kg pentamidine intramuscularly once daily for 7 days to assess the efficacy and safety of pafuramidine versus pentamidine. Pregnant and lactating women as well as adolescents were included. The primary efficacy endpoint was the combined rate of clinical and parasitological cure at 12 months. The primary safety outcome was the frequency and severity of adverse events. The study was registered on the International Clinical Trials Registry Platform at www.clinicaltrials.gov with the number ISRCTN85534673. The overall cure rate at 12 months was 89% in the pafuramidine group and 95% in the pentamidine group; pafuramidine was non-inferior to pentamidine as the upper bound of the 95% confidence interval did not exceed 15%. The safety profile of pafuramidine was superior to pentamidine; however, 3 patients in the pafuramidine group had glomerulonephritis or nephropathy approximately 8 weeks post-treatment. Two of these events were judged as possibly related to pafuramidine. Despite good

Paratransgenesis applied for control of tsetse transmitted sleeping sickness.

PubMed

Aksoy, Serap; Weiss, Brian; Attardo, Geoffrey

2008-01-01

African trypanosomiasis (sleeping sickness) is a major cause of morbidity and mortality in Subsaharan Africa for human and animal health. In the absence of effective vaccines and efficacious drugs, vector control is an alternative intervention tool to break the disease cycle. This chapter describes the vectorial and symbiotic biology of tsetse with emphasis on the current knowledge on tsetse symbiont genomics and functional biology, and tsetse's trypanosome transmission capability. The ability to culture one of tsetse's commensal symbiotic microbes, Sodalis in vitro has allowed for the development of a genetic transformation system for this organism. Tsetse can be repopulated with the modified Sodalis symbiont, which can express foreign gene products (an approach we refer to as paratransgenic expression system). Expanding knowledge on tsetse immunity effectors, on genomics of tsetse symbionts and on tsetse's parasite transmission biology stands to enhance the development and potential application of paratransgenesis as a new vector-control strategy. We describe the hallmarks of the paratransgenic transformation technology where the modified symbionts expressing trypanocidal compounds can be used to manipulate host functions and lead to the control of trypanosomiasis by blocking trypanosome transmission in the tsetse vector.

Work health determinants in employees without sickness absence.

PubMed

Schell, E; Theorell, T; Nilsson, B; Saraste, H

2013-01-01

Working ability is known to be related to good physical condition, clear work tasks, positive feedback and other occupational, organizational and psychosocial factors. In Sweden, high levels of sickness absence are due to stress-related disorders and musculoskeletal pain. To identify work health characteristics in a working population with a large variety of professional skills and occupational tasks. Employers' data on occupation, sickness absence, age and gender in a working population of 11 occupational groups and questionnaire responses regarding work-organization, environment, work stress, pain, health, and socio-demographic factors were collected. Employees with no history of sick-leave were compared with those with a history of sick-leave (1-182 days, mean 25 days). Of 2641 employees, 1961 participated. Those with no history of sick-leave reported less work-related pain, work-related stress, sleep disturbances, worry about their health, 'sick-presenteeism', monotonous work, bent and twisted working positions and exposure to disturbing noise than those with a history of sick-leave (P < 0.001). They also reported better health, support from superiors, having influence on their working hours and evening and week-end working, longer working hours per week (P < 0.001) and more regular physical training (P < 0.01). Socio-demographic factors were less important than gender, and differences in responses between occupational groups were also found. Workers without a history of sick-leave experienced less stress, sleep disturbances, worry about their own health and less neck, shoulder and back pain and more support from their superiors and influence on their working hours.

[Settlements, landscapes, and risks of sleeping sickness at the mouth of the Rio Pongo in Guinea-Conakry].

PubMed

Rouamba, J; Bruneau, J C; Sory, I; Kagbadouno, M; Coulibaly, B; Jamonneau, V; Solano, P; Rayaisse, J B; Camara, M; Courtin, F

2013-05-01

Seeking to understand how humans, by the settlements they create (among other means), influence the operation of the pathogen system of sleeping sickness, the authors performed a diachronic analysis of the landscape and settlement dynamics by comparing topographic maps from 1957, a satellite image from 2004, and georeferenced censuses from 2009 and 2001. It appears that the extreme mobility of the population between the continent and the islands is the principal cause for the continuation of this disease at the mouth of the Rio Pongo.

Risk factors for absenteeism due to sick leave in the petroleum industry

PubMed Central

Oenning, Nágila Soares Xavier; Carvalho, Fernando Martins; Lima, Veronica Maria Cadena

2014-01-01

OBJECTIVE To identify risk factors for absenteeism among workers with sick leave in an oil company. METHODS A case-control study (120 cases and 656 controls) nested in a retrospective cohort study following up all employees of an oil company in the North-Northeast of Brazil from 2007 to 2009. The response variable used to represent absenteeism with sick leave was the average incidence of sick leave, defined as the ratio between total sick days and potential working days in the period. Logistic regression techniques were used to investigate the association between average incidence of sick leave > 5.0% over the period and the variables sex, position, age, time at work, shift work, smoking, arterial hypertension, body mass index, physical activity, coronary risk, sleep, glycemia, non-managed diabetes, cardiovascular, digestive, musculoskeletal, neurological and neoplastic diseases, straining body positioning during work, satisfaction at work, relationship with management, and concentrated attention at work. RESULTS Average incidence of sick leave higher than 5.0% in the cohort period was 15.5%. The logistic model revealed that workers with average incidence of sick leave higher than 5.0% were 2.6 times more likely to be female; 2.0 time more likely to be smokers; 1.8 time more likely to be former smokers; 2.2 times more likely to report abnormal sleep and 10.5 times more likely to report dissatisfaction with their than workers with average incidence of sick leave ≤ 5.0% in the period. CONCLUSIONS In this population, female gender, being a smoker or a former smoker, reporting dissatisfaction with the job and reporting abnormal sleep are good predictors of occupational absenteeism with sick leave. PMID:24789643

Transmission Dynamics of Rhodesian Sleeping Sickness at the Interface of Wildlife and Livestock Areas.

PubMed

Auty, Harriet; Morrison, Liam J; Torr, Stephen J; Lord, Jennifer

2016-08-01

Many wilderness areas of East and Southern Africa are foci for Rhodesian sleeping sickness, a fatal zoonotic disease caused by trypanosomes transmitted by tsetse flies. Although transmission in these foci is traditionally driven by wildlife reservoirs, rising human and livestock populations may increase the role of livestock in transmission cycles. Deciphering transmission dynamics at wildlife and livestock interface areas is key to developing appropriate control. Data are lacking for key parameters, including host distributions, tsetse density, and mortality rates, and the relative roles of livestock and wildlife as hosts in fragmented habitats, limiting the development of meaningful models to assist in the assessment and implementation of control strategies. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effect of repeated normobaric hypoxia exposures during sleep on acute mountain sickness, exercise performance, and sleep during exposure to terrestrial altitude.

PubMed

Fulco, Charles S; Muza, Stephen R; Beidleman, Beth A; Demes, Robby; Staab, Janet E; Jones, Juli E; Cymerman, Allen

2011-02-01

There is an expectation that repeated daily exposures to normobaric hypoxia (NH) will induce ventilatory acclimatization and lessen acute mountain sickness (AMS) and the exercise performance decrement during subsequent hypobaric hypoxia (HH) exposure. However, this notion has not been tested objectively. Healthy, unacclimatized sea-level (SL) residents slept for 7.5 h each night for 7 consecutive nights in hypoxia rooms under NH [n = 14, 24 ± 5 (SD) yr] or "sham" (n = 9, 25 ± 6 yr) conditions. The ambient percent O(2) for the NH group was progressively reduced by 0.3% [150 m equivalent (equiv)] each night from 16.2% (2,200 m equiv) on night 1 to 14.4% (3,100 m equiv) on night 7, while that for the ventilatory- and exercise-matched sham group remained at 20.9%. Beginning at 25 h after sham or NH treatment, all subjects ascended and lived for 5 days at HH (4,300 m). End-tidal Pco(2), O(2) saturation (Sa(O(2))), AMS, and heart rate were measured repeatedly during daytime rest, sleep, or exercise (11.3-km treadmill time trial). From pre- to posttreatment at SL, resting end-tidal Pco(2) decreased (P < 0.01) for the NH (from 39 ± 3 to 35 ± 3 mmHg), but not for the sham (from 39 ± 2 to 38 ± 3 mmHg), group. Throughout HH, only sleep Sa(O(2)) was higher (80 ± 1 vs. 76 ± 1%, P < 0.05) and only AMS upon awakening was lower (0.34 ± 0.12 vs. 0.83 ± 0.14, P < 0.02) in the NH than the sham group; no other between-group rest, sleep, or exercise differences were observed at HH. These results indicate that the ventilatory acclimatization induced by NH sleep was primarily expressed during HH sleep. Under HH conditions, the higher sleep Sa(O(2)) may have contributed to a lessening of AMS upon awakening but had no impact on AMS or exercise performance for the remainder of each day.

Drug discovery for the treatment of leishmaniasis, African sleeping sickness and Chagas disease.

PubMed

2013-10-01

The trypanosomatid protozoa Leishmania, Trypanosoma brucei and Trypanosoma cruzi are the caustive agents of the human diseases respectively, leishmaniasis, African sleeping sickness and Chagas disease. Among the 17 'neglected tropical diseases' highlighted by WHO, progress towards the treatment of these diseases has improved in recent decades, as a result of increased awareness, the emergence of public-private research partnerships and advances in drug-discovery technologies and techniques. Despite this, the current therapies for these diseases have serious shortcomings and, as such, the need to develop novel drugs, improve diagnosis and control the spread of disease is of paramount importance. Future Medicinal Chemistry invited leading experts in the field to share their thoughts and opinions on the changing face of drug discovery in the pursuit of treatments for trypanosomatid-based diseases.

Sleep Duration in Rough Sea Conditions.

PubMed

Matsangas, Panagiotis; Shattuck, Nita L; McCauley, Michael E

2015-10-01

Environmental motion can affect shipboard sleep of crewmembers. Slamming and similar harsh motion may interfere with sleep, whereas mild motion and sopite syndrome may enhance sleep. If sleep needs vary by sea condition, this factor should be considered when assessing human performance at sea. The goal of this study was to assess sleep duration in different sea conditions. Crewmembers (N = 52) from a U.S. Navy vessel participated in the study while performing their normal daily schedule of duties. Sleep was assessed with wrist-worn actigraphy. Motion sickness and sopite syndrome were assessed using standardized questionnaires. In rough sea conditions, crewmembers experienced increased severity of motion sickness and sopite syndrome compared to their ratings during calmer sea conditions. Crewmembers slept significantly longer during sea state 5-6 compared to sleep on days with sea state 4 (25% increase) and sea state 3-4 (30% increase). Specifically, daily sleep increased from 6.97 ± 1.24 h in sea state 3-4, to 7.23 ± 1.65 h in sea state 4, to 9.04 ± 2.90 h in sea state 5-6. Although the duration of sleep in rough seas increased significantly compared to calmer sea conditions, causal factors are inconclusive. Accumulated sleep debt, motion-induced fatigue, and sopite syndrome all may have contributed, but results suggest that motion sickness and sopite syndrome were the predominant stressors. If sleep needs increase in severe motion environments, this factor should be taken into account when developing daily activity schedules or when modeling manning requirements on modern ships.

The study of trypanosome species circulating in domestic animals in two human African trypanosomiasis foci of Côte d'Ivoire identifies pigs and cattle as potential reservoirs of Trypanosoma brucei gambiense

PubMed Central

N’Djetchi, Martial Kassi; Ilboudo, Hamidou; Koffi, Mathurin; Kaboré, Jacques; Kaboré, Justin Windingoudi; Kaba, Dramane; Courtin, Fabrice; Coulibaly, Bamoro; Fauret, Pierre; Kouakou, Lingué; Ravel, Sophie; Deborggraeve, Stijn; Solano, Philippe; De Meeûs, Thierry; Bucheton, Bruno

2017-01-01

Background Important control efforts have led to a significant reduction of the prevalence of human African trypanosomiasis (HAT) in Côte d’Ivoire, but the disease is still present in several foci. The existence of an animal reservoir of Trypanosoma brucei gambiense may explain disease persistence in these foci where animal breeding is an important source of income but where the prevalence of animal African trypanosomiasis (AAT) is unknown. The aim of this study was to identify the trypanosome species circulating in domestic animals in both Bonon and Sinfra HAT endemic foci. Methodology/Principal findings 552 domestic animals (goats, pigs, cattle and sheep) were included. Blood samples were tested for trypanosomes by microscopic observation, species-specific PCR for T. brucei sl, T. congolense, T. vivax and subspecies-specific PCR for T. b. gambiense and T. b. gambiense immune trypanolysis (TL). Infection rates varied significantly between animal species and were by far the highest in pigs (30%). T. brucei s.l was the most prevalent trypanosome species (13.7%) followed by T. congolense. No T. b. gambiense was identified by PCR while high TL positivity rates were observed using T. b. gambiense specific variants (up to 27.6% for pigs in the Bonon focus). Conclusion This study shows that domestic animals are highly infected by trypanosomes in the studied foci. This was particularly true for pigs, possibly due to a higher exposure of these animals to tsetse flies. Whereas T. brucei s.l. was the most prevalent species, discordant results were obtained between PCR and TL regarding T. b. gambiense identification. It is therefore crucial to develop better tools to study the epidemiological role of potential animal reservoir for T. b. gambiense. Our study illustrates the importance of “one health” approaches to reach HAT elimination and contribute to AAT control in the studied foci. PMID:29045405

Proteasome inhibition for treatment of leishmaniasis, Chagas disease and sleeping sickness

PubMed Central

Khare, Shilpi; Nagle, Advait S.; Biggart, Agnes; Lai, Yin H.; Liang, Fang; Davis, Lauren C.; Barnes, S. Whitney; Mathison, Casey J. N.; Myburgh, Elmarie; Gao, Mu-Yun; Gillespie, J. Robert; Liu, Xianzhong; Tan, Jocelyn L.; Stinson, Monique; Rivera, Ianne C.; Ballard, Jaime; Yeh, Vince; Groessl, Todd; Federe, Glenn; Koh, Hazel X. Y.; Venable, John D.; Bursulaya, Badry; Shapiro, Michael; Mishra, Pranab K.; Spraggon, Glen; Brock, Ansgar; Mottram, Jeremy C.; Buckner, Frederick S.; Rao, Srinivasa P. S.; Wen, Ben G.; Walker, John R.; Tuntland, Tove; Molteni, Valentina; Glynne, Richard J.; Supek, Frantisek

2016-01-01

Chagas disease, leishmaniasis, and sleeping sickness affect 20 million people worldwide and lead to more than 50,000 deaths annually1. The diseases are caused by infection with the kinetoplastid parasites Trypanosoma cruzi, Leishmania spp. and Trypanosoma brucei spp., respectively. These parasites have similar biology and genomic sequence, suggesting that all three diseases could be cured with drug(s) modulating the activity of a conserved parasite target2. However, no such molecular targets or broad spectrum drugs have been identified to date. Here we describe a selective inhibitor of the kinetoplastid proteasome (GNF6702) with unprecedented in vivo efficacy, which cleared parasites from mice in all three models of infection. GNF6702 inhibits the kinetoplastid proteasome through a non-competitive mechanism, does not inhibit the mammalian proteasome or growth of mammalian cells, and is well-tolerated in mice. Our data provide genetic and chemical validation of the parasite proteasome as a promising therapeutic target for treatment of kinetoplastid infections, and underscore the possibility of developing a single class of drugs for these neglected diseases. PMID:27501246

Proteasome inhibition for treatment of leishmaniasis, Chagas disease and sleeping sickness.

PubMed

Khare, Shilpi; Nagle, Advait S; Biggart, Agnes; Lai, Yin H; Liang, Fang; Davis, Lauren C; Barnes, S Whitney; Mathison, Casey J N; Myburgh, Elmarie; Gao, Mu-Yun; Gillespie, J Robert; Liu, Xianzhong; Tan, Jocelyn L; Stinson, Monique; Rivera, Ianne C; Ballard, Jaime; Yeh, Vince; Groessl, Todd; Federe, Glenn; Koh, Hazel X Y; Venable, John D; Bursulaya, Badry; Shapiro, Michael; Mishra, Pranab K; Spraggon, Glen; Brock, Ansgar; Mottram, Jeremy C; Buckner, Frederick S; Rao, Srinivasa P S; Wen, Ben G; Walker, John R; Tuntland, Tove; Molteni, Valentina; Glynne, Richard J; Supek, Frantisek

2016-09-08

Chagas disease, leishmaniasis and sleeping sickness affect 20 million people worldwide and lead to more than 50,000 deaths annually. The diseases are caused by infection with the kinetoplastid parasites Trypanosoma cruzi, Leishmania spp. and Trypanosoma brucei spp., respectively. These parasites have similar biology and genomic sequence, suggesting that all three diseases could be cured with drugs that modulate the activity of a conserved parasite target. However, no such molecular targets or broad spectrum drugs have been identified to date. Here we describe a selective inhibitor of the kinetoplastid proteasome (GNF6702) with unprecedented in vivo efficacy, which cleared parasites from mice in all three models of infection. GNF6702 inhibits the kinetoplastid proteasome through a non-competitive mechanism, does not inhibit the mammalian proteasome or growth of mammalian cells, and is well-tolerated in mice. Our data provide genetic and chemical validation of the parasite proteasome as a promising therapeutic target for treatment of kinetoplastid infections, and underscore the possibility of developing a single class of drugs for these neglected diseases.

Prevention and control of malaria and sleeping sickness in Africa: where are we and where are we going?

PubMed

Corbel, Vincent; Henry, Marie-Claire

2011-03-16

The International Symposium on Malaria and Human African Trypanosomiasis: New Strategies for their Prevention & Control was held 7-8 October, 2010 in Cotonou, Benin with about 250 participants from 20 countries. This scientific event aimed at identifying the gaps and research priorities in the prevention and control of malaria and sleeping sickness in Africa and to promote exchange between North and South in the fields of medical entomology, epidemiology, immunology and parasitology. A broad range of influential partners from academia (scientists), stakeholders, public health workers and industry attempted the meeting and about 40 oral communications and 20 posters were presented by phD students and internationally-recognized scientists from the North and the South. Finally, a special award ceremony was held to recognize efforts in pioneer work conducted by staff involved in the diagnostic of the Sleeping illness in West Africa with partnership and assistance from WHO and Sanofi-Aventis group.

Plasma soluble erythropoietin receptor is decreased during sleep in Andean highlanders with Chronic Mountain Sickness

PubMed Central

Corante, Noemí; Anza-Ramírez, Cecilia; Figueroa-Mujíca, Rómulo; Vizcardo-Galindo, Gustavo; Mercado, Andy; Macarlupú, José Luis; León-Velarde, Fabiola

2016-01-01

Excessive erythrocytosis (EE) is the main sign of Chronic Mountain Sickness (CMS), a highly prevalent syndrome in Andean highlanders. Low pulse O2 saturation (SpO2) during sleep and serum androgens have been suggested to contribute to EE in CMS patients. However, whether these factors have a significant impact on the erythropoietin (Epo) system leading to EE is still unclear. We have recently shown that morning soluble Epo receptor (sEpoR), an endogenous Epo antagonist, is decreased in CMS patients suggesting increased Epo availability (increased Epo/sEpoR). The present study aimed to characterize the nocturnal concentration profile of sEpoR and Epo and their relationship with SpO2, Hct, and serum testosterone in healthy highlanders (HH) and CMS patients. Epo and sEpoR concentrations were evaluated every 4 h (6 PM to 6 AM) and nighttime SpO2 was continuously monitored (10 PM to 6 AM) in 39 male participants (CMS, n = 23; HH, n = 16) aged 21-65 yr from Cerro de Pasco, Peru (4,340 m). CMS patients showed higher serum Epo concentrations throughout the night and lower sEpoR from 10 PM to 6 AM. Consequently, Epo/sEpoR was significantly higher in the CMS group at every time point. Mean sleep-time SpO2 was lower in CMS patients compared with HH, while the percentage of sleep time spent with SpO2 < 80% was higher. Multiple-regression analysis showed mean sleep-time SpO2 and Epo/sEpoR as significant predictors of hematocrit corrected for potential confounders (age, body mass index, and testosterone). Testosterone levels were associated neither with Hct nor with erythropoietic factors. In conclusion, our results show sustained erythropoietic stimulus driven by the Epo system in CMS patients, further enhanced by a continuous exposure to accentuated nocturnal hypoxemia. PMID:27125843

Trypanosoma brucei gambiense adaptation to different mammalian sera is associated with VSG expression site plasticity.

PubMed

Cordon-Obras, Carlos; Cano, Jorge; González-Pacanowska, Dolores; Benito, Agustin; Navarro, Miguel; Bart, Jean-Mathieu

2013-01-01

Trypanosoma brucei gambiense infection is widely considered an anthroponosis, although it has also been found in wild and domestic animals. Thus, fauna could act as reservoir, constraining the elimination of the parasite in hypo-endemic foci. To better understand the possible maintenance of T. b. gambiense in local fauna and investigate the molecular mechanisms underlying adaptation, we generated adapted cells lines (ACLs) by in vitro culture of the parasites in different mammalian sera. Using specific antibodies against the Variant Surface Glycoproteins (VSGs) we found that serum ACLs exhibited different VSG variants when maintained in pig, goat or human sera. Although newly detected VSGs were independent of the sera used, the consistent appearance of different VSGs suggested remodelling of the co-transcribed genes at the telomeric Expression Site (VSG-ES). Thus, Expression Site Associated Genes (ESAGs) sequences were analysed to investigate possible polymorphism selection. ESAGs 6 and 7 genotypes, encoding the transferrin receptor (TfR), expressed in different ACLs were characterised. In addition, we quantified the ESAG6/7 mRNA levels and analysed transferrin (Tf) uptake. Interestingly, the best growth occurred in pig and human serum ACLs, which consistently exhibited a predominant ESAG7 genotype and higher Tf uptake than those obtained in calf and goat sera. We also detected an apparent selection of specific ESAG3 genotypes in the pig and human serum ACLs, suggesting that other ESAGs could be involved in the host adaptation processes. Altogether, these results suggest a model whereby VSG-ES remodelling allows the parasite to express a specific set of ESAGs to provide selective advantages in different hosts. Finally, pig serum ACLs display phenotypic adaptation parameters closely related to human serum ACLs but distinct to parasites grown in calf and goat sera. These results suggest a better suitability of swine to maintain T. b. gambiense infection supporting

Using Repeated Measures of Sleep Disturbances to Predict Future Diagnosis-Specific Work Disability: A Cohort Study

PubMed Central

Salo, Paula; Vahtera, Jussi; Hall, Martica; Rod, Naja Hulvej; Virtanen, Marianna; Pentti, Jaana; Sjösten, Noora; Oksanen, Tuula; Kivimäki, Mika

2012-01-01

Context: It is unknown whether or not measuring sleep disturbances repeatedly, rather than at only one point in time, improves prediction of work disability. Study Objective: o examine sleep disturbance patterns over time as a risk marker for diagnosis-specific work disability. Design: rospective cohort study linking repeatedly measured self-reported sleep disturbances with records of physician-certified work disability (sickness absence) from a national register. Participants responded to surveys in 2000–2002, and 2004, and were followed up for 12 mo. Setting: Public sector employees in Finland. Participants: 25,639 participants (mean age 45.6 yr, 82% female). Main Outcome Measure: Incident diagnosis-specific sickness absence of > 9 days. Results: During a mean follow-up of 323 days, 4,975 employees (19%) had a new episode of sickness absence. In multivariable-adjusted models corrected for multiple testing, stable severe sleep disturbances, in comparison with no sleep disturbances, were associated with an increased risk of sickness absence due to diseases of the musculoskeletal system (hazard ratio (HR) 1.68, 95% confidence interval (CI) 1.45–1.95), and injuries and poisonings (HR 1.64, 95% CI 1.23–2.18). Increases in sleep disturbances predicted subsequent sickness absence due to mental disorders (HR 1.59, 95% CI 1.32–1.91), and diseases of the musculoskeletal system (HR 1.44, 95% CI 1.27–1.64) According to net reclassification improvement analyses, measurement of sleep disturbance patterns rather than the level of sleep disturbances at one point in time improved prediction of all-cause sickness absence by 14%, and diagnosis-specific sickness absences up to 17% (P for improvement < 0.001). Conclusions: Increasing and severe chronic sleep disturbances mark an increased risk of diagnosis-specific work disability. Citation: Salo P; Vahtera J; Hall M; Rod NH; Virtanen M; Pentti J; Sjösten N; Oksanen T; Kivimäki M. Using repeated measures of sleep

New treatment option for second-stage African sleeping sickness: in vitro and in vivo efficacy of aza analogs of DB289.

PubMed

Wenzler, Tanja; Boykin, David W; Ismail, Mohamed A; Hall, James Edwin; Tidwell, Richard R; Brun, Reto

2009-10-01

African sleeping sickness is a fatal parasitic disease, and all drugs currently in use for treatment have strong liabilities. It is essential to find new, effective, and less toxic drugs, ideally with oral application, to control the disease. In this study, the aromatic diamidine DB75 (furamidine) and two aza analogs, DB820 and DB829 (CPD-0801), as well as their methoxyamidine prodrugs and amidoxime metabolites, were evaluated against African trypanosomes. The active parent diamidines showed similar in vitro profiles against different Trypanosoma brucei strains, melarsoprol- and pentamidine-resistant lines, and a P2 transporter knockout strain (AT1KO), with DB75 as the most trypanocidal molecule. In the T. b. rhodesiense strain STIB900 acute mouse model, the aza analogs DB820 and DB829 demonstrated activities superior to that of DB75. The aza prodrugs DB844 and DB868, as well as two metabolites of DB844, were orally more potent in the T. b. brucei strain GVR35 mouse central nervous system (CNS) model than DB289 (pafuramidine maleate). Unexpectedly, the parent diamidine DB829 showed high activity in the mouse CNS model by the intraperitoneal route. In conclusion, DB868 with oral and DB829 with parenteral application are potential candidates for further development of a second-stage African sleeping sickness drug.

Getting Enough Sleep

MedlinePlus

... enough sleep: Feeling angry or depressed Having trouble learning, remembering, and thinking clearly Having more accidents, including when driving or using machines Getting sick more often Feeling less motivated Possibly ...

Sleep disordered breathing and acute mountain sickness in workers rapidly transported to the South Pole (2835 m).

PubMed

Anderson, P J; Wiste, H J; Ostby, S A; Miller, A D; Ceridon, M L; Johnson, B D

2015-05-01

Sleep disordered breathing may be a risk factor for high altitude illness. Past Antarctic sleep studies suggest that rapid transport from sea level (SL) to the Amundsen Scott South Pole Station (SP, 2835 m) increases risk of Acute Mountain Sickness (AMS). We analyzed sleep studies in 38 healthy polar workers to explore the association between sleep disordered breathing and AMS after rapid transport to the South Pole. Subjects completed a baseline questionnaire, performed basic physiology tests, and were evaluated for AMS and medication use using an extended Lake Louise Questionnaire (LLQ) during their first week at the South Pole. Participants were included in this study if they took no medications and underwent polysomnography on their first nights at Sea Level and the South Pole using the Vivometrics LifeShirt(®). Within group changes were assessed with Wilcoxon signed rank tests and between group differences were assessed with Kruskal-Wallis rank sum tests. Overall, 21/38 subjects met criteria for AMS at some time on or prior to the third morning at the South Pole. Subjective poor sleep quality was reported by both AMS (65%) and no AMS (41%) groups. The Apnea Hypopnea Index (AHI) increased significantly in both the AMS and no AMS groups, but the difference in the increase between the two groups was not statistically significant. Increased AHI was not associated with increased AMS symptoms. Previous altitude illness (p=0.06) and residence at low altitudes (p = 0.02) were risk factors for AMS. AMS was not significantly associated with sleep architecture changes or increased AHI. However, AHI sharply increased at South Pole (19/38 participants) primarily due to central apneas. Those developing AMS were more likely to have experienced previous problems at altitude and reported living at lowland altitudes within the 3 months prior to rapid transport to the South Pole than those without AMS. Copyright © 2015 Elsevier B.V. All rights reserved.

Epidemiology of human African trypanosomiasis

PubMed Central

Franco, Jose R; Simarro, Pere P; Diarra, Abdoulaye; Jannin, Jean G

2014-01-01

Human African trypanosomiasis (HAT), or sleeping sickness, is caused by Trypanosoma brucei gambiense, which is a chronic form of the disease present in western and central Africa, and by Trypanosoma brucei rhodesiense, which is an acute disease located in eastern and southern Africa. The rhodesiense form is a zoonosis, with the occasional infection of humans, but in the gambiense form, the human being is regarded as the main reservoir that plays a key role in the transmission cycle of the disease. The gambiense form currently assumes that 98% of the cases are declared; the Democratic Republic of the Congo is the most affected country, with more than 75% of the gambiense cases declared. The epidemiology of the disease is mediated by the interaction of the parasite (trypanosome) with the vectors (tsetse flies), as well as with the human and animal hosts within a particular environment. Related to these interactions, the disease is confined in spatially limited areas called “foci”, which are located in Sub-Saharan Africa, mainly in remote rural areas. The risk of contracting HAT is, therefore, determined by the possibility of contact of a human being with an infected tsetse fly. Epidemics of HAT were described at the beginning of the 20th century; intensive activities have been set up to confront the disease, and it was under control in the 1960s, with fewer than 5,000 cases reported in the whole continent. The disease resurged at the end of the 1990s, but renewed efforts from endemic countries, cooperation agencies, and nongovernmental organizations led by the World Health Organization succeeded to raise awareness and resources, while reinforcing national programs, reversing the trend of the cases reported, and bringing the disease under control again. In this context, sustainable elimination of the gambiense HAT, defined as the interruption of the transmission of the disease, was considered as a feasible target for 2030. Since rhodesiense HAT is a zoonosis

Fever and sickness behavior: Friend or foe?

PubMed

Harden, L M; Kent, S; Pittman, Q J; Roth, J

2015-11-01

Fever has been recognized as an important symptom of disease since ancient times. For many years, fever was treated as a putative life-threatening phenomenon. More recently, it has been recognized as an important part of the body's defense mechanisms; indeed at times it has even been used as a therapeutic agent. The knowledge of the functional role of the central nervous system in the genesis of fever has greatly improved over the last decade. It is clear that the febrile process, which develops in the sick individual, is just one of many brain-controlled sickness symptoms. Not only will the sick individual appear "feverish" but they may also display a range of behavioral changes, such as anorexia, fatigue, loss of interest in usual daily activities, social withdrawal, listlessness or malaise, hyperalgesia, sleep disturbances and cognitive dysfunction, collectively termed "sickness behavior". In this review we consider the issue of whether fever and sickness behaviors are friend or foe during: a critical illness, the common cold or influenza, in pregnancy and in the newborn. Deciding whether these sickness responses are beneficial or harmful will very much shape our approach to the use of antipyretics during illness. Copyright © 2015 Elsevier Inc. All rights reserved.

Structure-based design of pteridine reductase inhibitors targeting African sleeping sickness and the leishmaniases.

PubMed

Tulloch, Lindsay B; Martini, Viviane P; Iulek, Jorge; Huggan, Judith K; Lee, Jeong Hwan; Gibson, Colin L; Smith, Terry K; Suckling, Colin J; Hunter, William N

2010-01-14

Pteridine reductase (PTR1) is a target for drug development against Trypanosoma and Leishmania species, parasites that cause serious tropical diseases and for which therapies are inadequate. We adopted a structure-based approach to the design of novel PTR1 inhibitors based on three molecular scaffolds. A series of compounds, most newly synthesized, were identified as inhibitors with PTR1-species specific properties explained by structural differences between the T. brucei and L. major enzymes. The most potent inhibitors target T. brucei PTR1, and two compounds displayed antiparasite activity against the bloodstream form of the parasite. PTR1 contributes to antifolate drug resistance by providing a molecular bypass of dihydrofolate reductase (DHFR) inhibition. Therefore, combining PTR1 and DHFR inhibitors might improve therapeutic efficacy. We tested two new compounds with known DHFR inhibitors. A synergistic effect was observed for one particular combination highlighting the potential of such an approach for treatment of African sleeping sickness.

Plasma soluble erythropoietin receptor is decreased during sleep in Andean highlanders with Chronic Mountain Sickness.

PubMed

Villafuerte, Francisco C; Corante, Noemí; Anza-Ramírez, Cecilia; Figueroa-Mujíca, Rómulo; Vizcardo-Galindo, Gustavo; Mercado, Andy; Macarlupú, José Luis; León-Velarde, Fabiola

2016-07-01

Excessive erythrocytosis (EE) is the main sign of Chronic Mountain Sickness (CMS), a highly prevalent syndrome in Andean highlanders. Low pulse O2 saturation (SpO2) during sleep and serum androgens have been suggested to contribute to EE in CMS patients. However, whether these factors have a significant impact on the erythropoietin (Epo) system leading to EE is still unclear. We have recently shown that morning soluble Epo receptor (sEpoR), an endogenous Epo antagonist, is decreased in CMS patients suggesting increased Epo availability (increased Epo/sEpoR). The present study aimed to characterize the nocturnal concentration profile of sEpoR and Epo and their relationship with SpO2, Hct, and serum testosterone in healthy highlanders (HH) and CMS patients. Epo and sEpoR concentrations were evaluated every 4 h (6 PM to 6 AM) and nighttime SpO2 was continuously monitored (10 PM to 6 AM) in 39 male participants (CMS, n = 23; HH, n = 16) aged 21-65 yr from Cerro de Pasco, Peru (4,340 m). CMS patients showed higher serum Epo concentrations throughout the night and lower sEpoR from 10 PM to 6 AM. Consequently, Epo/sEpoR was significantly higher in the CMS group at every time point. Mean sleep-time SpO2 was lower in CMS patients compared with HH, while the percentage of sleep time spent with SpO2 < 80% was higher. Multiple-regression analysis showed mean sleep-time SpO2 and Epo/sEpoR as significant predictors of hematocrit corrected for potential confounders (age, body mass index, and testosterone). Testosterone levels were associated neither with Hct nor with erythropoietic factors. In conclusion, our results show sustained erythropoietic stimulus driven by the Epo system in CMS patients, further enhanced by a continuous exposure to accentuated nocturnal hypoxemia. Copyright © 2016 the American Physiological Society.

Relationship between Comorbid Health Problems and Musculoskeletal Disorders Resulting in Musculoskeletal Complaints and Musculoskeletal Sickness Absence among Employees in Korea.

PubMed

Baek, Ji Hye; Kim, Young Sun; Yi, Kwan Hyung

2015-06-01

To investigate the relationship between musculoskeletal disorders and comorbid health problems, including depression/anxiety disorder, insomnia/sleep disorder, fatigue, and injury by accident, and to determine whether certain physical and psychological factors reduce comorbid health problems. In total, 29,711 employees were selected from respondents of the Third Korean Working Conditions Survey and categorized into two groups: Musculoskeletal Complaints or Musculoskeletal Sickness Absence. Four self-reported health indicators (overall fatigue, depression/anxiety, insomnia/sleep disorder, and injury by accident) were selected as outcomes, based on their high prevalence in Korea. We used multiple logistic regression analysis to determine the relationship between comorbid health problems, musculoskeletal complaints, and sickness absence. The prevalence of musculoskeletal complaints and musculoskeletal sickness absence due to muscular pain was 32.26% and 0.59%, respectively. Compared to the reference group, depression/anxiety disorder and overall fatigue were 5.2-6.1 times more prevalent in the Musculoskeletal Complaints Group and insomnia/sleep disorder and injury by accident were 7.6-11.0 times more prevalent in the Sickness Absence Group. When adjusted for individual and work-related physical factors, prevalence of all four comorbid health problems were slightly decreased in both groups. Increases in overall fatigue and depression/anxiety disorder were observed in the Musculoskeletal Complaints Group, while increases in insomnia/sleep disorder and injury by accident were observed in the Sickness Absence Group. For management of musculoskeletal complaints and sickness absence in the workplace, differences in health problems between employees with musculoskeletal complaints and those with sickness absence as well as the physical and psychological risk factors should be considered.

Health-related effects of early part-time sick leave due to musculoskeletal disorders: a randomized controlled trial.

PubMed

Shiri, Rahman; Kausto, Johanna; Martimo, Kari-Pekka; Kaila-Kangas, Leena; Takala, Esa-Pekka; Viikari-Juntura, Eira

2013-01-01

Previously we reported that early part-time sick leave enhances return to work (RTW) among employees with musculoskeletal disorders (MSD). This paper assesses the health-related effects of this intervention. Patients aged 18-60 years who were unable to perform their regular work due to MSD were randomized to part- or full-time sick leave groups. In the former, workload was reduced by halving working time. Using validated questionnaires, we assessed pain intensity and interference with work and sleep, region-specific disability due to MSD, self-rated general health, health-related quality of life (measured via EuroQol), productivity loss, depression, and sleep disturbance at baseline, 1, 3, 8, 12, and 52 weeks. We analyzed the repeated measures data (171-356 observations) with the generalized estimating equation approach. The intervention (part-time sick leave) and control (full-time sick leave) groups did not differ with regard to pain intensity, pain interference with work and sleep, region-specific disability, productivity loss, depression, or sleep disturbance. The intervention group reported better self-rated general health (adjusted P=0.07) and health-related quality of life (adjusted P=0.02) than the control group. In subgroup analyses, the intervention was more effective among the patients whose current problem began occurring <6 weeks before baseline and those with ≤30% productivity loss at baseline. Our findings showed that part-time sick leave did not exacerbate pain-related symptoms and functional disability, but improved self-rated general health and health-related quality of life in the early stage of work disability due to MSD.

Deadly Flies, Poor Profits, and Veterinary Pharmaceuticals: Sustaining the Control of Sleeping Sickness in Uganda.

PubMed

Bardosh, Kevin Louis

2016-01-01

Efforts to control neglected tropical diseases have increasingly focused on questions of implementation. But how should we conceptualize the implementation process? Drawing on ethnographic fieldwork between 2010 and 2012, in this article I explore efforts by a small-scale public-private partnership to use private veterinarians to sustainably control zoonotic sleeping sickness in Uganda. With a fundamental tension between business incentives and vector control, I show how divergences in knowledge, power, values, and social norms shaped project implementation and community responses. Reflecting more widely on the relationships between project plans and local realities, I argue that these encounters reveal the heuristic value in approaching global health interventions as evolving 'social experiments.' This metaphor reveals the uncertainty inherent to dominant narratives and models, the role of available expertise in defining the limits of action, and the need for continuous adaption to synchronize with emergent social and institutional topographies.

Carbohydrate-Binding Non-Peptidic Pradimicins for the Treatment of Acute Sleeping Sickness in Murine Models.

PubMed

Castillo-Acosta, Víctor M; Ruiz-Pérez, Luis M; Etxebarria, Juan; Reichardt, Niels C; Navarro, Miguel; Igarashi, Yasuhiro; Liekens, Sandra; Balzarini, Jan; González-Pacanowska, Dolores

2016-09-01

Current treatments available for African sleeping sickness or human African trypanosomiasis (HAT) are limited, with poor efficacy and unacceptable safety profiles. Here, we report a new approach to address treatment of this disease based on the use of compounds that bind to parasite surface glycans leading to rapid killing of trypanosomes. Pradimicin and its derivatives are non-peptidic carbohydrate-binding agents that adhere to the carbohydrate moiety of the parasite surface glycoproteins inducing parasite lysis in vitro. Notably, pradimicin S has good pharmaceutical properties and enables cure of an acute form of the disease in mice. By inducing resistance in vitro we have established that the composition of the sugars attached to the variant surface glycoproteins are critical to the mode of action of pradimicins and play an important role in infectivity. The compounds identified represent a novel approach to develop drugs to treat HAT.

Carbohydrate-Binding Non-Peptidic Pradimicins for the Treatment of Acute Sleeping Sickness in Murine Models

PubMed Central

Castillo-Acosta, Víctor M.; Ruiz-Pérez, Luis M.; Reichardt, Niels C.; Igarashi, Yasuhiro; Liekens, Sandra; Balzarini, Jan

2016-01-01

Current treatments available for African sleeping sickness or human African trypanosomiasis (HAT) are limited, with poor efficacy and unacceptable safety profiles. Here, we report a new approach to address treatment of this disease based on the use of compounds that bind to parasite surface glycans leading to rapid killing of trypanosomes. Pradimicin and its derivatives are non-peptidic carbohydrate-binding agents that adhere to the carbohydrate moiety of the parasite surface glycoproteins inducing parasite lysis in vitro. Notably, pradimicin S has good pharmaceutical properties and enables cure of an acute form of the disease in mice. By inducing resistance in vitro we have established that the composition of the sugars attached to the variant surface glycoproteins are critical to the mode of action of pradimicins and play an important role in infectivity. The compounds identified represent a novel approach to develop drugs to treat HAT. PMID:27662652

Fluorine walk: The impact of fluorine in quinolone amides on their activity against African sleeping sickness.

PubMed

Berninger, Michael; Erk, Christine; Fuß, Antje; Skaf, Joseph; Al-Momani, Ehab; Israel, Ina; Raschig, Martina; Güntzel, Paul; Samnick, Samuel; Holzgrabe, Ulrike

2018-05-25

Human African Trypanosomiasis, also known as African sleeping sickness, is caused by the parasitic protozoa of the genus Trypanosoma. If there is no pharmacological intervention, the parasites can cross the blood-brain barrier (BBB), inevitably leading to death of the patients. Previous investigation identified the quinolone amide GHQ168 as a promising lead compound having a nanomolar activity against T. b. brucei. Here, the role of a fluorine substitution at different positions was investigated in regard to toxicity, pharmacokinetics, and antitrypanosomal activity. This 'fluorine walk' led to new compounds with improved metabolic stability and consistent activity against T. b. brucei. The ability of the new quinolone amides to cross the BBB was confirmed using an 18 F-labelled quinolone amide derivative by means of ex vivo autoradiography of a murine brain. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Caregiving-Related Sleep Problems and Their Relationship to Mental Health and Daytime Function in Female Veterans.

PubMed

Song, Yeonsu; Washington, Donna L; Yano, Elizabeth M; McCurry, Susan M; Fung, Constance H; Dzierzewski, Joseph M; Rodriguez, Juan Carlos; Jouldjian, Stella; Mitchell, Michael N; Alessi, Cathy A; Martin, Jennifer L

2018-01-01

To identify caregiving-related sleep problems and their relationship to mental health and daytime function in female Veterans. Female Veterans (N = 1,477) from cross-sectional, nationwide, postal survey data. The survey respondent characteristics included demographics, comorbidity, physical activity, health, use of sleep medications, and history of sleep apnea. They self-identified caregiving- related sleep problems (i.e., those who had trouble sleeping because of caring for a sick adult, an infant/child, or other respondents). Patient Health Questionnaire (PHQ-4) was used to assess mental health, and daytime function was measured using 11 items of International Classification of Sleep Disorders-2 (ICSD-2). Female Veterans with self-identified sleep problems due to caring for a sick adult (n = 59) experienced significantly more symptoms of depression and anxiety (p < 0.001) and impairment in daytime function (e.g., fatigue, daytime sleepiness, loss of concentration, p < 0.001) than those with self-identified sleep problems due to caring for an infant or child (n = 95) or all other respondents (n = 1,323) after controlling for the respondent characteristics. Healthcare providers should pay attention to assessing sleep characteristics of female Veterans with caregiving responsibilities, particularly those caregiving for a sick adult.

Normative data on the diurnal pattern of the Karolinska Sleepiness Scale ratings and its relation to age, sex, work, stress, sleep quality and sickness absence/illness in a large sample of daytime workers.

PubMed

Åkerstedt, Torbjorn; Hallvig, David; Kecklund, Göran

2017-10-01

Self-rated sleepiness responds to sleep loss, time of day and work schedules. There is, however, a lack of a normative reference showing the diurnal pattern during a normal working day, compared with a day off, as well as differences depending on stress, sleep quality, sex, age and being sick listed. The present study sought to provide such data for the Karolinska Sleepiness Scale. Participants were 431 individuals working in medium-sized public service units. Sleepiness (Karolinska Sleepiness Scale, scale 1-9) was rated at six times a day for a working week and 2 days off (>90.000 ratings). The results show a clear circadian pattern, with high values during the morning (4.5 at 07:00 hours) and evening (6.0 at 22:00 hours), and with low values (3-4) during the 10:00-16:00 hours span. Women had significantly higher (0.5 units) Karolinska Sleepiness Scale values than men, as did younger individuals (0.3 units), those with stress (1.3 units above the low-stress group) and those with poor sleep quality (1.0 units above those with qood sleep quality). Days off showed reduced sleepiness (0.7 units), while being sick listed was associated with an increased sleepiness (0.8 units). Multiple regression analysis of mean sleepiness during the working week yielded mean daytime stress, mean sleep quality, age, and sex as predictors (not sleep duration). Improved sleep quality accounted for the reduced sleepiness during days off, but reduced stress was a second factor. Similar results were obtained in a longitudinal mixed-model regression analysis across the 7 days of the week. The percentage of ratings at Karolinska Sleepiness Scale risk levels (8 + 9) was 6.6%, but most of these were obtained at 22:00 hours. It was concluded that sleepiness ratings are strongly associated with time of day, sleep quality, stress, work day/day off, being ill, age, and sex. © 2017 European Sleep Research Society.

Gene fusion analysis in the battle against the African endemic sleeping sickness.

PubMed

Trimpalis, Philip; Koumandou, Vassiliki Lila; Pliakou, Evangelia; Anagnou, Nicholas P; Kossida, Sophia

2013-01-01

The protozoan Trypanosoma brucei causes African Trypanosomiasis or sleeping sickness in humans, which can be lethal if untreated. Most available pharmacological treatments for the disease have severe side-effects. The purpose of this analysis was to detect novel protein-protein interactions (PPIs), vital for the parasite, which could lead to the development of drugs against this disease to block the specific interactions. In this work, the Domain Fusion Analysis (Rosetta Stone method) was used to identify novel PPIs, by comparing T. brucei to 19 organisms covering all major lineages of the tree of life. Overall, 49 possible protein-protein interactions were detected, and classified based on (a) statistical significance (BLAST e-value, domain length etc.), (b) their involvement in crucial metabolic pathways, and (c) their evolutionary history, particularly focusing on whether a protein pair is split in T. brucei and fused in the human host. We also evaluated fusion events including hypothetical proteins, and suggest a possible molecular function or involvement in a certain biological process. This work has produced valuable results which could be further studied through structural biology or other experimental approaches so as to validate the protein-protein interactions proposed here. The evolutionary analysis of the proteins involved showed that, gene fusion or gene fission events can happen in all organisms, while some protein domains are more prone to fusion and fission events and present complex evolutionary patterns.

The 2018 Lake Louise Acute Mountain Sickness Score.

PubMed

Roach, Robert C; Hackett, Peter H; Oelz, Oswald; Bärtsch, Peter; Luks, Andrew M; MacInnis, Martin J; Baillie, J Kenneth

2018-03-01

Roach, Robert C., Peter H. Hackett, Oswald Oelz, Peter Bärtsch, Andrew M. Luks, Martin J. MacInnis, J. Kenneth Baillie, and The Lake Louise AMS Score Consensus Committee. The 2018 Lake Louise Acute Mountain Sickness Score. High Alt Med Biol 19:1-4, 2018.- The Lake Louise Acute Mountain Sickness (AMS) scoring system has been a useful research tool since first published in 1991. Recent studies have shown that disturbed sleep at altitude, one of the five symptoms scored for AMS, is more likely due to altitude hypoxia per se, and is not closely related to AMS. To address this issue, and also to evaluate the Lake Louise AMS score in light of decades of experience, experts in high altitude research undertook to revise the score. We here present an international consensus statement resulting from online discussions and meetings at the International Society of Mountain Medicine World Congress in Bolzano, Italy, in May 2014 and at the International Hypoxia Symposium in Lake Louise, Canada, in February 2015. The consensus group has revised the score to eliminate disturbed sleep as a questionnaire item, and has updated instructions for use of the score.

Simulating the elimination of sleeping sickness with an agent-based model.

PubMed

Grébaut, Pascal; Girardin, Killian; Fédérico, Valentine; Bousquet, François

2016-01-01

Although Human African Trypanosomiasis is largely considered to be in the process of extinction today, the persistence of human and animal reservoirs, as well as the vector, necessitates a laborious elimination process. In this context, modeling could be an effective tool to evaluate the ability of different public health interventions to control the disease. Using the Cormas ® system, we developed HATSim, an agent-based model capable of simulating the possible endemic evolutions of sleeping sickness and the ability of National Control Programs to eliminate the disease. This model takes into account the analysis of epidemiological, entomological, and ecological data from field studies conducted during the last decade, making it possible to predict the evolution of the disease within this area over a 5-year span. In this article, we first present HATSim according to the Overview, Design concepts, and Details (ODD) protocol that is classically used to describe agent-based models, then, in a second part, we present predictive results concerning the evolution of Human African Trypanosomiasis in the village of Lambi (Cameroon), in order to illustrate the interest of such a tool. Our results are consistent with what was observed in the field by the Cameroonian National Control Program (CNCP). Our simulations also revealed that regular screening can be sufficient, although vector control applied to all areas with human activities could be significantly more efficient. Our results indicate that the current model can already help decision-makers in planning the elimination of the disease in foci. © P. Grébaut et al., published by EDP Sciences, 2016.

Occupation-specific screening for future sickness absence: criterion validity of the trucker strain monitor (TSM).

PubMed

De Croon, Einar M; Blonk, Roland W B; Sluiter, Judith K; Frings-Dresen, Monique H W

2005-02-01

Monitoring psychological job strain may help occupational physicians to take preventive action at the appropriate time. For this purpose, the 10-item trucker strain monitor (TSM) assessing work-related fatigue and sleeping problems in truck drivers was developed. This study examined (1) test-retest reliability, (2) criterion validity of the TSM with respect to future sickness absence due to psychological health complaints and (3) usefulness of the TSM two-scales structure. The TSM and self-administered questionnaires, providing information about stressful working conditions (job control and job demands) and sickness absence, were sent to a random sample of 2000 drivers in 1998. Of the 1123 responders, 820 returned a completed questionnaire 2 years later (response: 72%). The TSM work-related fatigue scale, the TSM sleeping problems scale and the TSM composite scale showed satisfactory 2-year test-retest reliability (coefficient r=0.62, 0.66 and 0.67, respectively). The work-related fatigue, sleeping problems scale and composite scale had sensitivities of 61, 65 and 61%, respectively in identifying drivers with future sickness absence due to psychological health complaints. The specificity and positive predictive value of the TSM composite scale were 77 and 11%, respectively. The work-related fatigue scale and the sleeping problems scale were moderately strong correlated (r=0.62). However, stressful working conditions were differentially associated with the two scales. The results support the test-retest reliability, criterion validity and two-factor structure of the TSM. In general, the results suggest that the use of occupation-specific psychological job strain questionnaires is fruitful.

Tsetse Control and Gambian Sleeping Sickness; Implications for Control Strategy.

PubMed

Tirados, Inaki; Esterhuizen, Johan; Kovacic, Vanja; Mangwiro, T N Clement; Vale, Glyn A; Hastings, Ian; Solano, Philippe; Lehane, Michael J; Torr, Steve J

2015-01-01

Gambian sleeping sickness (human African trypanosomiasis, HAT) outbreaks are brought under control by case detection and treatment although it is recognised that this typically only reaches about 75% of the population. Vector control is capable of completely interrupting HAT transmission but is not used because it is considered too expensive and difficult to organise in resource-poor settings. We conducted a full scale field trial of a refined vector control technology to determine its utility in control of Gambian HAT. The major vector of Gambian HAT is the tsetse fly Glossina fuscipes which lives in the humid zone immediately adjacent to water bodies. From a series of preliminary trials we determined the number of tiny targets required to reduce G. fuscipes populations by more than 90%. Using these data for model calibration we predicted we needed a target density of 20 per linear km of river in riverine savannah to achieve >90% tsetse control. We then carried out a full scale, 500 km2 field trial covering two HAT foci in Northern Uganda to determine the efficacy of tiny targets (overall target density 5.7/km2). In 12 months, tsetse populations declined by more than 90%. As a guide we used a published HAT transmission model and calculated that a 72% reduction in tsetse population is required to stop transmission in those settings. The Ugandan census suggests population density in the HAT foci is approximately 500 per km2. The estimated cost for a single round of active case detection (excluding treatment), covering 80% of the population, is US$433,333 (WHO figures). One year of vector control organised within the country, which can completely stop HAT transmission, would cost US$42,700. The case for adding this method of vector control to case detection and treatment is strong. We outline how such a component could be organised.

In silico drug re-purposing against African sleeping sickness using GlcNAc-PI de-N-acetylase as an experimental target.

PubMed

Rashmi, Mayank; Swati, D

2015-12-01

Trypanosoma brucei is a protozoan that causes African sleeping sickness in humans. Many glycoconjugate compounds are present on the entire cell surface of Trypanosoma brucei to control the infectivity and survival of this pathogen. These gycoconjugates are anchored to the plasma membrane with the help of glycosyl phosphatidyl inositol (GPI) anchors. This type of anchor is much more common in protozoans than in other eukaryotes. The second step of glycosyl phosphatidyl inositol (GPI) anchor biosynthesis is catalyzed by an enzyme, which is GlcNAc-PI de-N-acetylase. GlcNAc-PI de-N-acetylase has a conserved GPI domain, which is responsible for the functionality of this enzyme. In this study, the three-dimensional structure of the target is modelled by I-TASSER and the ligand is modelled by PRODRG server. It is found that the predicted active site residues of the GPI domain are ultra-conserved for the Trypanosomatidae family. The predicted active site residues are His41, Pro42, Asp43, Asp44, Met47, Phe48, Ser74, Arg80, His103, Val144, Ser145, His147 and His150. Two hydrogen bond acceptors and four hydrogen bond donors are found in the modelled pharmacophore. All compounds of the Drugbank database and twenty three known inhibitors have been considered for structure based virtual screening. This work is focused on approved drugs because they are already tested for safety and effectiveness in humans. After the structure-based virtual screening, seventeen approved drugs and two inhibitors are found, which interact with the ligand on the basis of the designed pharmacophore. The docking has been performed for the resultant seventeen approved drugs and two known inhibitors. Two approved drugs have negative binding energy and their pKa values are similar to the selected known inhibitors. The result of this study suggests that the approved drugs Ethambutol (DB00330) and Metaraminol (DB00610) may prove useful in the treatment of African sleeping sickness. Copyright © 2015

Syndromic Algorithms for Detection of Gambiense Human African Trypanosomiasis in South Sudan

PubMed Central

Palmer, Jennifer J.; Surur, Elizeous I.; Goch, Garang W.; Mayen, Mangar A.; Lindner, Andreas K.; Pittet, Anne; Kasparian, Serena; Checchi, Francesco; Whitty, Christopher J. M.

2013-01-01

Background Active screening by mobile teams is considered the best method for detecting human African trypanosomiasis (HAT) caused by Trypanosoma brucei gambiense but the current funding context in many post-conflict countries limits this approach. As an alternative, non-specialist health care workers (HCWs) in peripheral health facilities could be trained to identify potential cases who need testing based on their symptoms. We explored the predictive value of syndromic referral algorithms to identify symptomatic cases of HAT among a treatment-seeking population in Nimule, South Sudan. Methodology/Principal Findings Symptom data from 462 patients (27 cases) presenting for a HAT test via passive screening over a 7 month period were collected to construct and evaluate over 14,000 four item syndromic algorithms considered simple enough to be used by peripheral HCWs. For comparison, algorithms developed in other settings were also tested on our data, and a panel of expert HAT clinicians were asked to make referral decisions based on the symptom dataset. The best performing algorithms consisted of three core symptoms (sleep problems, neurological problems and weight loss), with or without a history of oedema, cervical adenopathy or proximity to livestock. They had a sensitivity of 88.9–92.6%, a negative predictive value of up to 98.8% and a positive predictive value in this context of 8.4–8.7%. In terms of sensitivity, these out-performed more complex algorithms identified in other studies, as well as the expert panel. The best-performing algorithm is predicted to identify about 9/10 treatment-seeking HAT cases, though only 1/10 patients referred would test positive. Conclusions/Significance In the absence of regular active screening, improving referrals of HAT patients through other means is essential. Systematic use of syndromic algorithms by peripheral HCWs has the potential to increase case detection and would increase their participation in HAT programmes. The

Self-reported sleep lengths ≥ 9 hours among Swedish patients with stress-related exhaustion: Associations with depression, quality of sleep and levels of fatigue.

PubMed

Grossi, Giorgio; Jeding, Kerstin; Söderström, Marie; Osika, Walter; Levander, Maria; Perski, Aleksander

2015-05-01

Insomnia-type sleep disturbances are frequent among patients suffering from stress-related exhaustion disorder. However, clinical observations indicate that a subgroup suffer from sleep lengths frequently exceeding 9 hours, coupled with great daytime sleepiness. The aim of the present study was to investigate differences in socio-demographic variables, use of medications, sleep parameters, anxiety, depression and fatigue, between individuals with varying sleep lengths, in a sample of 420 Swedish patients (mean age 42 ± 9 years; 77% women) referred to treatment for exhaustion disorder. Patients were allocated to the groups: "never/seldom ≥ 9 hours" (n = 248), "sometimes ≥ 9 hours" (n = 115) and "mostly/always ≥ 9 hours" (n = 57), based on their self-rated frequency of sleep lengths ≥ 9 hours. The design was cross-sectional and data was collected by means of questionnaires at pre-treatment. Univariate analyses showed that patients in the "mostly/always ≥ 9 hours" group were more often on sick leave, and reported more depression and fatigue, better sleep quality and more daytime sleepiness, than patients in the other groups. Multivariate analyses showed that these patients scored higher on measures of fatigue than the rest of the sample independently of gender, use of antidepressants, sick leave, depression and quality of sleep. Patients suffering from exhaustion disorder and reporting excessive sleep seem to have a generally poorer clinical picture but better quality of sleep than their counterparts with shorter sleep lengths. The mechanisms underlying these differences, together with their prognostic value and implications for treatment remain to be elucidated in future studies.

How (and why) the immune system makes us sleep.

PubMed

Imeri, Luca; Opp, Mark R

2009-03-01

Good sleep is necessary for physical and mental health. For example, sleep loss impairs immune function, and sleep is altered during infection. Immune signalling molecules are present in the healthy brain, where they interact with neurochemical systems to contribute to the regulation of normal sleep. Animal studies have shown that interactions between immune signalling molecules (such as the cytokine interleukin 1) and brain neurochemical systems (such as the serotonin system) are amplified during infection, indicating that these interactions might underlie the changes in sleep that occur during infection. Why should the immune system cause us to sleep differently when we are sick? We propose that the alterations in sleep architecture during infection are exquisitely tailored to support the generation of fever, which in turn imparts survival value.

The Marine Sponge, Diacarnus bismarckensis, as a Source of Peroxiterpene Inhibitors of Trypanosoma brucei, the Causative Agent of Sleeping Sickness

PubMed Central

Rubio, Brent K.; Tenney, Karen; Ang, Kean-Hooi; Abdulla, Maha; Arkin, Michelle; McKerrow, James H.; Crews, Phillip

2009-01-01

Human African trypanosomiasis (HAT), also known as African sleeping sickness, is a neglected tropical disease with inadequate therapeutic options. We have launched a collaborative new lead discovery venture using our repository of extracts and natural product compounds as input into our growth inhibition primary screen against Trypanosoma brucei. Careful evaluation of the spectral data of the natural products and derivatives allowed for the elucidation of the absolute configuration (using the modified Mosher’s method) of two new peroxiterpenes: (+)-muqubilone B (1a) and (−)-ent-muqubilone (3a). Five known compounds were also isolated: (+)-sigmosceptrellin A (4a), (+)-sigmosceptrellin A methyl ester (4b), (−)-sigmosceptrellin B (5), (+)-epi-muqubillin A (6) and (−)-epi-nuapapuin B methyl ester (7). The isolated peroxiterpenes demonstrated activities in the range from IC50 = 0.2 – 2 μg/mL. PMID:19159277

Diagnostic Accuracy and Feasibility of Serological Tests on Filter Paper Samples for Outbreak Detection of T.b. gambiense Human African Trypanosomiasis

PubMed Central

Hasker, Epco; Lutumba, Pascal; Mumba, Dieudonné; Lejon, Veerle; Büscher, Phillipe; Kande, Victor; Muyembe, Jean Jacques; Menten, Joris; Robays, Jo; Boelaert, Marleen

2010-01-01

Control of human African trypanosomiasis (HAT) in the Democratic Republic of Congo is based on mass population screening by mobile teams; a costly and labor-intensive approach. We hypothesized that blood samples collected on filter paper by village health workers and processed in a central laboratory might be a cost-effective alternative. We estimated sensitivity and specificity of micro-card agglutination test for trypanosomiasis (micro-CATT) and enzyme-linked immunosorbent assay (ELISA)/T.b. gambiense on filter paper samples compared with parasitology-based case classification and used the results in a Monte Carlo simulation of a lot quality assurance sampling (LQAS) approach. Micro-CATT and ELISA/T.b. gambiense showed acceptable sensitivity (92.7% [95% CI 87.4–98.0%] and 82.2% [95% CI 75.3–90.4%]) and very high specificity (99.4% [95% CI 99.0–99.9%] and 99.8% [95% CI 99.5–100%]), respectively. Conditional on high sample size per lot (≥ 60%), both tests could reliably distinguish a 2% from a zero prevalence at village level. Alternatively, these tests could be used to identify individual HAT suspects for subsequent confirmation. PMID:20682885

Tsetse Control and Gambian Sleeping Sickness; Implications for Control Strategy

PubMed Central

Kovacic, Vanja; Mangwiro, T. N. Clement; Vale, Glyn A.; Hastings, Ian; Solano, Philippe; Lehane, Michael J.; Torr, Steve J.

2015-01-01

Background Gambian sleeping sickness (human African trypanosomiasis, HAT) outbreaks are brought under control by case detection and treatment although it is recognised that this typically only reaches about 75% of the population. Vector control is capable of completely interrupting HAT transmission but is not used because it is considered too expensive and difficult to organise in resource-poor settings. We conducted a full scale field trial of a refined vector control technology to determine its utility in control of Gambian HAT. Methods and Findings The major vector of Gambian HAT is the tsetse fly Glossina fuscipes which lives in the humid zone immediately adjacent to water bodies. From a series of preliminary trials we determined the number of tiny targets required to reduce G. fuscipes populations by more than 90%. Using these data for model calibration we predicted we needed a target density of 20 per linear km of river in riverine savannah to achieve >90% tsetse control. We then carried out a full scale, 500 km2 field trial covering two HAT foci in Northern Uganda to determine the efficacy of tiny targets (overall target density 5.7/km2). In 12 months, tsetse populations declined by more than 90%. As a guide we used a published HAT transmission model and calculated that a 72% reduction in tsetse population is required to stop transmission in those settings. Interpretation The Ugandan census suggests population density in the HAT foci is approximately 500 per km2. The estimated cost for a single round of active case detection (excluding treatment), covering 80% of the population, is US$433,333 (WHO figures). One year of vector control organised within the country, which can completely stop HAT transmission, would cost US$42,700. The case for adding this method of vector control to case detection and treatment is strong. We outline how such a component could be organised. PMID:26267814

How (and why) the immune system makes us sleep

PubMed Central

Imeri, Luca; Opp, Mark R.

2010-01-01

Good sleep is necessary for physical and mental health. For example, sleep loss impairs immune function, and sleep is altered during infection. Immune signalling molecules are present in the healthy brain, where they interact with neurochemical systems to contribute to the regulation of normal sleep. Animal studies have shown that interactions between immune signalling molecules (such as the cytokine interleukin 1) and brain neurochemical systems (such as the serotonin system) are amplified during infection, indicating that these interactions might underlie the changes in sleep that occur during infection. Why should the immune system cause us to sleep differently when we are sick? We propose that the alterations in sleep architecture during infection are exquisitely tailored to support the generation of fever, which in turn imparts survival value. PMID:19209176

The interaction of an antiparasitic peptide active against African sleeping sickness with cell membrane models.

PubMed

Pascholati, Cauê P; Lopera, Esteban Parra; Pavinatto, Felippe J; Caseli, Luciano; Nobre, Thatyane M; Zaniquelli, Maria E D; Viitala, Tapani; D'Silva, Claudius; Oliveira, Osvaldo N

2009-12-01

Zwitterionic peptides with trypanocidal activity are promising lead compounds for the treatment of African Sleeping Sickness, and have motivated research into the design of compounds capable of disrupting the protozoan membrane. In this study, we use the Langmuir monolayer technique to investigate the surface properties of an antiparasitic peptide, namely S-(2,4-dinitrophenyl)glutathione di-2-propyl ester, and its interaction with a model membrane comprising a phospholipid monolayer. The drug formed stable Langmuir monolayers, whose main feature was a phase transition accompanied by a negative surface elasticity. This was attributed to aggregation upon compression due to intermolecular bond associations of the molecules, inferred from surface pressure and surface potential isotherms, Brewster angle microscopy (BAM) images, infrared spectroscopy and dynamic elasticity measurements. When co-spread with dipalmitoyl phosphatidyl choline (DPPC), the drug affected both the surface pressure and the monolayer morphology, even at high surface pressures and with low amounts of the drug. The results were interpreted by assuming a repulsive, cooperative interaction between the drug and DPPC molecules. Such repulsive interaction and the large changes in fluidity arising from drug aggregation may be related to the disruption of the membrane, which is key for the parasite killing property.

External quality assessment of Giemsa-stained blood film microscopy for the diagnosis of malaria and sleeping sickness in the Democratic Republic of the Congo

PubMed Central

Mukadi, Pierre; Gillet, Philippe; Lukuka, Albert; Atua, Benjamin; Sheshe, Nicole; Kanza, Albert; Mayunda, Jean Bosco; Mongita, Briston; Senga, Raphaël; Ngoyi, John; Muyembe, Jean-Jacques; Jacobs, Jan

2013-01-01

Abstract Objective To report the findings of a second external quality assessment of Giemsa-stained blood film microscopy in the Democratic Republic of the Congo, performed one year after the first. Methods A panel of four slides was delivered to diagnostic laboratories in all provinces of the country. The slides contained: (i) Plasmodium falciparum gametocytes; (ii) P. falciparum trophozoites (reference density: 113 530 per µl); (iii) Trypanosoma brucei subspecies; and (iv) no parasites. Findings Of 356 laboratories contacted, 277 (77.8%) responded. Overall, 35.0% of the laboratories reported all four slides correctly but 14.1% reported correct results for 1 or 0 slides. Major errors included not diagnosing trypanosomiasis (50.4%), not recognizing P. falciparum gametocytes (17.5%) and diagnosing malaria from the slide with no parasites (19.0%). The frequency of serious errors in assessing parasite density and in reporting false-positive results was lower than in the previous external quality assessment: 17.2% and 52.3%, respectively, (P < 0.001) for parasite density and 19.0% and 33.3%, respectively, (P < 0.001) for false-positive results. Laboratories that participated in the previous quality assessment performed better than first-time participants and laboratories in provinces with a high number of sleeping sickness cases recognized trypanosomes more frequently (57.0% versus 31.2%, P < 0.001). Malaria rapid diagnostic tests were used by 44.3% of laboratories, almost double the proportion observed in the previous quality assessment. Conclusion The overall quality of blood film microscopy was poor but was improved by participation in external quality assessments. The failure to recognize trypanosomes in a country where sleeping sickness is endemic is a concern. PMID:24052681

Conflict of interest: use of pyrethroids and amidines against tsetse and ticks in zoonotic sleeping sickness endemic areas of Uganda.

PubMed

Bardosh, Kevin; Waiswa, Charles; Welburn, Susan C

2013-07-10

Caused by trypanosomes and transmitted by tsetse flies, Human African Trypanosomiasis and bovine trypanosomiasis remain endemic across much of rural Uganda where the major reservoir of acute human infection is cattle. Following elimination of trypanosomes by mass trypanocidal treatment, it is crucial that farmers regularly apply pyrethroid-based insecticides to cattle to sustain parasite reductions, which also protect against tick-borne diseases. The private veterinary market is divided between products only effective against ticks (amidines) and those effective against both ticks and tsetse (pyrethroids). This study explored insecticide sales, demand and use in four districts of Uganda where mass cattle treatments have been undertaken by the 'Stamp Out Sleeping Sickness' programme. A mixed-methods study was undertaken in Dokolo, Kaberamaido, Serere and Soroti districts of Uganda between September 2011 and February 2012. This included: focus groups in 40 villages, a livestock keeper survey (n = 495), a veterinary drug shop questionnaire (n = 74), participatory methods in six villages and numerous semi-structured interviews. Although 70.5% of livestock keepers reportedly used insecticide each month during the rainy season, due to a variety of perceptions and practices nearly half used products only effective against ticks and not tsetse. Between 640 and 740 litres of insecticide were being sold monthly, covering an average of 53.7 cattle/km(2). Sales were roughly divided between seven pyrethroid-based products and five products only effective against ticks. In the high-risk HAT district of Kaberamaido, almost double the volume of non-tsetse effective insecticide was being sold. Factors influencing insecticide choice included: disease knowledge, brand recognition, product price, half-life and mode of product action, product availability, and dissemination of information. Stakeholders considered market restriction of non-tsetse effective products the most

Serum sickness

MedlinePlus

Drug allergy - serum sickness; Allergic reaction - serum sickness; Allergy - serum sickness ... Unlike other drug allergies , which occur very soon after receiving the medicine, serum sickness develops 7 to 21 days after the first exposure ...

Attenuation of the Influenza Virus Sickness Behavior in Mice Deficient in Toll-like Receptor 3

PubMed Central

Majde, Jeannine A.; Kapás, Levente; Bohnet, Stewart G.; De, Alok; Krueger, James M.

2009-01-01

Certain sickness behaviors occur consistently in influenza-infected humans and mice. These include body temperature changes, somnolence, and anorexia. Several cytokines serve as mediators of the influenza acute phase response (APR), including these sickness behaviors, and one likely inducer of these cytokines is dsRNA produced during viral replication. TLR3 is known to be one of the host cellular components capable of recognizing dsRNA and activating cytokine synthesis. To determine the role of TLR3-detected viral dsRNA in the causation of viral symptoms, TLR3-deficient mice (TLR3 knockouts, or KOs) were infected with a marginally lethal dose of mouse-adapted X-31 influenza virus. TLR3 KOs and their wild-type (WT) controls were monitored for baseline body temperature, locomotor activity, and sleep profiles prior to infection. Both mouse strains were then infected and monitored for changes in these sickness behaviors plus body weight changes and mortality for up to 14 days post-infection. Consistent with the observations that influenza pathology is reduced in TLR3 KOs, we showed that hypothermia after post-infection day 5 and the total loss of body weight were attenuated in the TLR3 KOs. Sleep changes characteristic of this infection model [particularly increased non-rapid-eye-movement sleep (NREMS)] were also attenuated in TLR3 KOs and returned to baseline values more rapidly. Locomotor activity suppression was similar in both strains. Therefore virus-associated dsRNA detected by TLR3 appears to play a substantial role in mediating several aspects of the influenza syndrome in mice. PMID:19861156

Trypanosoma brucei Invasion and T-Cell Infiltration of the Brain Parenchyma in Experimental Sleeping Sickness: Timing and Correlation with Functional Changes.

PubMed

Laperchia, Claudia; Palomba, Maria; Seke Etet, Paul F; Rodgers, Jean; Bradley, Barbara; Montague, Paul; Grassi-Zucconi, Gigliola; Kennedy, Peter G E; Bentivoglio, Marina

2016-12-01

The timing of Trypanosoma brucei entry into the brain parenchyma to initiate the second, meningoencephalitic stage of human African trypanosomiasis or sleeping sickness is currently debated and even parasite invasion of the neuropil has been recently questioned. Furthermore, the relationship between neurological features and disease stage are unclear, despite the important diagnostic and therapeutic implications. Using a rat model of chronic Trypanosoma brucei brucei infection we determined the timing of parasite and T-cell neuropil infiltration and its correlation with functional changes. Parasite DNA was detected using trypanosome-specific PCR. Body weight and sleep structure alterations represented by sleep-onset rapid eye movement (SOREM) periods, reported in human and experimental African trypanosomiasis, were monitored. The presence of parasites, as well as CD4+ and CD8+ T-cells in the neuropil was assessed over time in the brain of the same animals by immunocytochemistry and quantitative analyses. Trypanosome DNA was present in the brain at day 6 post-infection and increased more than 15-fold by day 21. Parasites and T-cells were observed in the parenchyma from day 9 onwards. Parasites traversing blood vessel walls were observed in the hypothalamus and other brain regions. Body weight gain was reduced from day 7 onwards. SOREM episodes started in most cases early after infection, with an increase in number and duration after parasite neuroinvasion. These findings demonstrate invasion of the neuropil over time, after an initial interval, by parasites and lymphocytes crossing the blood-brain barrier, and show that neurological features can precede this event. The data thus challenge the current clinical and cerebrospinal fluid criteria of disease staging.

Trypanosoma brucei Invasion and T-Cell Infiltration of the Brain Parenchyma in Experimental Sleeping Sickness: Timing and Correlation with Functional Changes

PubMed Central

Laperchia, Claudia; Palomba, Maria; Seke Etet, Paul F.; Rodgers, Jean; Bradley, Barbara; Montague, Paul; Grassi-Zucconi, Gigliola; Bentivoglio, Marina

2016-01-01

Background The timing of Trypanosoma brucei entry into the brain parenchyma to initiate the second, meningoencephalitic stage of human African trypanosomiasis or sleeping sickness is currently debated and even parasite invasion of the neuropil has been recently questioned. Furthermore, the relationship between neurological features and disease stage are unclear, despite the important diagnostic and therapeutic implications. Methodology Using a rat model of chronic Trypanosoma brucei brucei infection we determined the timing of parasite and T-cell neuropil infiltration and its correlation with functional changes. Parasite DNA was detected using trypanosome-specific PCR. Body weight and sleep structure alterations represented by sleep-onset rapid eye movement (SOREM) periods, reported in human and experimental African trypanosomiasis, were monitored. The presence of parasites, as well as CD4+ and CD8+ T-cells in the neuropil was assessed over time in the brain of the same animals by immunocytochemistry and quantitative analyses. Principal findings Trypanosome DNA was present in the brain at day 6 post-infection and increased more than 15-fold by day 21. Parasites and T-cells were observed in the parenchyma from day 9 onwards. Parasites traversing blood vessel walls were observed in the hypothalamus and other brain regions. Body weight gain was reduced from day 7 onwards. SOREM episodes started in most cases early after infection, with an increase in number and duration after parasite neuroinvasion. Conclusion These findings demonstrate invasion of the neuropil over time, after an initial interval, by parasites and lymphocytes crossing the blood-brain barrier, and show that neurological features can precede this event. The data thus challenge the current clinical and cerebrospinal fluid criteria of disease staging. PMID:28002454

Sleeping in moderate hypoxia at home for prevention of acute mountain sickness (AMS): a placebo-controlled, randomized double-blind study.

PubMed

Dehnert, Christoph; Böhm, Astrid; Grigoriev, Igor; Menold, Elmar; Bärtsch, Peter

2014-09-01

Acclimatization at natural altitude effectively prevents acute mountain sickness (AMS). It is, however, unknown whether prevention of AMS is also possible by only sleeping in normobaric hypoxia. In a placebo-controlled, double-blind study 76 healthy unacclimatized male subjects, aged 18 to 50 years, slept for 14 consecutive nights at either a fractional inspired oxygen (Fio2) of 0.14 to 0.15 (average target altitude 3043 m; treatment group) or 0.209 (control group). Four days later, AMS scores and incidence of AMS were assessed during a 20-hour exposure in normobaric hypoxia at Fio2 = 0.12 (equivalent to 4500 m). Because of technical problems with the nitrogen generators, target altitude was not achieved in the tents and only 21 of 37 subjects slept at an average altitude considered sufficient for acclimatization (>2200 m; average, 2600 m). Therefore, in a subgroup analysis these subjects were compared with the 21 subjects of the control group with the lowest sleeping altitude. This analysis showed a significantly lower AMS-C score (0.38; 95% CI, 0.21 to 0.54) vs 1.10; 95% CI, 0.57 to 1.62; P = .04) and lower Lake Louise Score (3.1; 95% CI, 2.2 to 4.1 vs 5.1; 95% CI, 3.6 to 6.6; P = .07) for the treatment subgroup. The incidence of AMS defined as an AMS-C score greater than 0.70 was also significantly lower (14% vs 52%; P < .01). Sleeping 14 consecutive nights in normobaric hypoxia (equivalent to 2600 m) reduced symptoms and incidence of AMS 4 days later on exposure to 4500 m. Copyright © 2014 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

Detection of trypanosomes in small ruminants and pigs in western Kenya: important reservoirs in the epidemiology of sleeping sickness?

PubMed Central

Ng'ayo, Musa O; Njiru, Zablon K; Kenya, Eucharia U; Muluvi, Geoffrey M; Osir, Ellie O; Masiga, Daniel K

2005-01-01

Background Trypanosomosis is a major impediment to livestock farming in sub-Saharan Africa and limits the full potential of agricultural development in the 36 countries where it is endemic. In man, sleeping sickness is fatal if untreated and causes severe morbidity. This study was undertaken in western Kenya, an area that is endemic for both human and livestock trypanosomosis. While trypanosomosis in livestock is present at high levels of endemicity, sleeping sickness occurs at low levels over long periods, interspersed with epidemics, underscoring the complexity of the disease epidemiology. In this study, we sought to investigate the prevalence of trypanosomes in small ruminants and pigs, and the potential of these livestock as reservoirs of potentially human-infective trypanosomes. The study was undertaken in 5 villages, to address two key questions: i) are small ruminants and pigs important in the transmission dynamics of trypanosomosis? and ii), do they harbour potentially human infective trypanosomes? Answers to these questions are important in developing strategies for the control of both livestock and human trypanosomosis. Results Eighty-six animals, representing 21.3% of the 402 sampled in the 5 villages, were detected as positive by PCR using a panel of primers that identify trypanosomes to the level of the species and sub-species. These were categorised as 23 (5.7%) infections of T. vivax, 22 (5.5%) of T. simiae, 21 (5.2%) of the T. congolense clade and 20 (5.0%) of T. brucei ssp. The sheep was more susceptible to trypanosome infection as compared to goats and pigs. The 20 T. brucei positive samples were evaluated by PCR for the presence of the Serum Resistance Associated (SRA) gene, which has been linked to human infectivity in T. b. rhodesiense. Three samples (one pig, one sheep and one goat) were found to have the SRA gene. These results suggest that sheep, goats and pigs, which are kept alongside cattle, may harbour human-infective trypanosomes

Evaluating long-term effectiveness of sleeping sickness control measures in Guinea.

PubMed

Pandey, Abhishek; Atkins, Katherine E; Bucheton, Bruno; Camara, Mamadou; Aksoy, Serap; Galvani, Alison P; Ndeffo-Mbah, Martial L

2015-10-22

Human African Trypanosomiasis threatens human health across Africa. The subspecies T.b. gambiense is responsible for the vast majority of reported HAT cases. Over the past decade, expanded control efforts accomplished a substantial reduction in HAT transmission, spurring the WHO to include Gambian HAT on its roadmap for 2020 elimination. To inform the implementation of this elimination goal, we evaluated the likelihood that current control interventions will achieve the 2020 target in Boffa prefecture in Guinea, which has one of the highest prevalences for HAT in the country, and where vector control measures have been implemented in combination with the traditional screen and treat strategy. We developed a three-species mathematical model of HAT and used a Bayesian melding approach to calibrate the model to epidemiological and entomological data from Boffa. From the calibrated model, we generated the probabilistic predictions regarding the likelihood that the current HAT control programs could achieve elimination by 2020 in Boffa. Our model projections indicate that if annual vector control is implemented in combination with annual or biennial active case detection and treatment, the probability of eliminating HAT as public health problem in Boffa by 2020 is over 90%. Annual implementation of vector control alone has a significant impact but a decreased chance of reaching the objective (77%). However, if the ongoing control efforts are interrupted, HAT will continue to remain a public health problem. In the presence of a non-human animal transmission reservoir, intervention strategies must be maintained at high coverage, even after 2020 elimination, to prevent HAT reemerging as a public health problem. Complementing active screening and treatment with vector control has the potential to achieve the elimination target before 2020 in the Boffa focus. However, surveillance must continue after elimination to prevent reemergence.

Influence of sleep on symptom improvement and return to work in clinical burnout.

PubMed

Sonnenschein, Mieke; Sorbi, Marjolijn J; Verbraak, Marc J P M; Schaufeli, Wilmar B; Maas, Cora J M; van Doornen, Lorenz J P

2008-02-01

The current study examined the extent to which symptom improvement and full return to work occurs among clinically burnt-out employees and what the influence of concurring sleep problems is with respect to health recovery. Fifty-nine burnt-out employees on extended sick leave assessed their symptoms for 2 weeks using an electronic diary. After 6 months, the measurements were repeated. Symptom levels were compared with those of a healthy reference group that was assessed only once. After 6 months, all burnout symptoms had decreased significantly, and full return to work was achieved by 37% of the burnt-out individuals. The symptom levels at 6 months of follow-up among those who had fully returned to work were similar to healthy levels and significantly lower than the levels of those still on sick leave. The persons who benefited poorly from sleep at baseline had higher exhaustion levels at follow-up than those who benefited from sleep. Trouble falling asleep and less refreshing sleep at baseline hampered eventual full work resumption. The results show that a significant number of clinically burnt-out employees is able to recover in a 6-month period and that sleep plays an important role both in symptom improvement and in return to work.

Sick leave during pregnancy: a longitudinal study of rates and risk factors in a Norwegian population.

PubMed

Dørheim, S K; Bjorvatn, B; Eberhard-Gran, M

2013-04-01

To describe the prevalence of, reasons given for, and factors associated with sick leave during pregnancy. Longitudinal, population-based descriptive study. Akershus University Hospital, Norway. All women scheduled to give birth at the hospital (November 2008 to April 2010). Consenting women were handed a questionnaire at the routine ultrasound check at 17 weeks of gestation. Women returning this questionnaire received a second questionnaire at 32 weeks of gestation. Multiple logistic regression analyses were performed to examine associations with somatic, psychiatric and social factors. Rates and duration of sick leave. By 32 weeks of gestation, 63.2% of the 2918 women included were on sick leave, and 75.3% had been on sick leave at some point during their pregnancy. Pelvic girdle pain and fatigue/sleep problems were the main reasons given for sick leave. Being on sick leave in all trimesters was strongly associated with hyperemesis, exercising less than weekly, chronic pain before or during pregnancy, infertility treatment (all P < 0.001); younger maternal age, conflicts in the workplace (both P < 0.01); multiparity, previous depression, insomnia and lower education (all P < 0.05). Sick leave was associated with elective caesarean section and higher infant birthweight (P < 0.01). Adjustment of the work situation was associated with 1 week shorter duration of sick leave. Most women receive sick leave during pregnancy, but sick leave might not be caused by pregnancy alone. Previous medical and psychiatric history, work conditions and socio-economic factors need to be addressed to understand sick leave during pregnancy. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

Sick and tired: how molecular regulators of human sleep schedules and duration impact immune function.

PubMed

Kurien, Philip A; Chong, S Y Christin; Ptáček, Louis J; Fu, Ying-Hui

2013-10-01

Why do we need to sleep? What regulates when we sleep? And what dictates the number of hours we require? These are often viewed as three separate biological questions. Here, we propose they share molecular etiologies, whereby regulators of sleep schedules and sleep duration also govern the physiological purposes of sleep. To support our hypothesis, we review Mendelian human genetic variants sufficient to advance sleep-wake onset (PER2) and shorten sleep length (DEC2), and evaluate their emerging roles in immune responses that may rely on a sound night of slumber. Copyright © 2013 Elsevier Ltd. All rights reserved.

Enhanced passive screening and diagnosis for gambiense human African trypanosomiasis in north-western Uganda – Moving towards elimination

PubMed Central

Bessell, Paul Richard; Ndung’u, Joseph Mathu

2017-01-01

Introduction The incidence of gambiense human African trypanosomiasis (gHAT) in Uganda has been declining, from 198 cases in 2008, to only 20 in 2012. Interruption of transmission of the disease by early diagnosis and treatment is core to the control and eventual elimination of gHAT. Until recently, the format of available screening tests had restricted screening and diagnosis to central health facilities (passive screening). We describe a novel strategy that is contributing to elimination of gHAT in Uganda through expansion of passive screening to the entire population at risk. Methodology / Principal findings In this strategy, patients who are clinically suspected of having gHAT at primary health facilities are screened using a rapid diagnostic test (RDT), followed by parasitological confirmation at strategically located microscopy centres. For patients who are positive with the RDT and negative by microscopy, blood samples undergo further testing using loop-mediated isothermal amplification (LAMP), a molecular test that detects parasite DNA. LAMP positive patients are considered strong suspects, and are re-evaluated by microscopy. Location and upgrading of facilities to perform microscopy and LAMP was informed by results of georeferencing and characterization of all public healthcare facilities in the 7 gHAT endemic districts in Uganda. Three facilities were upgraded to perform RDTs, microscopy and LAMP, 9 to perform RDTs and microscopy, and 200 to screen patients with RDTs. This reduced the distance that a sick person must travel to be screened for gHAT to a median distance of 2.5km compared to 23km previously. In this strategy, 9 gHAT cases were diagnosed in 2014, and 4 in 2015. Conclusions This enhanced passive screening strategy for gHAT has enabled full coverage of the population at risk, and is being replicated in other gHAT endemic countries. The improvement in case detection is making elimination of the disease in Uganda an imminent possibility. PMID

Network Analysis Reveals Distinct Clinical Syndromes Underlying Acute Mountain Sickness

PubMed Central

Hall, David P.; MacCormick, Ian J. C.; Phythian-Adams, Alex T.; Rzechorzek, Nina M.; Hope-Jones, David; Cosens, Sorrel; Jackson, Stewart; Bates, Matthew G. D.; Collier, David J.; Hume, David A.; Freeman, Thomas; Thompson, A. A. Roger; Baillie, John Kenneth

2014-01-01

Acute mountain sickness (AMS) is a common problem among visitors at high altitude, and may progress to life-threatening pulmonary and cerebral oedema in a minority of cases. International consensus defines AMS as a constellation of subjective, non-specific symptoms. Specifically, headache, sleep disturbance, fatigue and dizziness are given equal diagnostic weighting. Different pathophysiological mechanisms are now thought to underlie headache and sleep disturbance during acute exposure to high altitude. Hence, these symptoms may not belong together as a single syndrome. Using a novel visual analogue scale (VAS), we sought to undertake a systematic exploration of the symptomatology of AMS using an unbiased, data-driven approach originally designed for analysis of gene expression. Symptom scores were collected from 292 subjects during 1110 subject-days at altitudes between 3650 m and 5200 m on Apex expeditions to Bolivia and Kilimanjaro. Three distinct patterns of symptoms were consistently identified. Although fatigue is a ubiquitous finding, sleep disturbance and headache are each commonly reported without the other. The commonest pattern of symptoms was sleep disturbance and fatigue, with little or no headache. In subjects reporting severe headache, 40% did not report sleep disturbance. Sleep disturbance correlates poorly with other symptoms of AMS (Mean Spearman correlation 0.25). These results challenge the accepted paradigm that AMS is a single disease process and describe at least two distinct syndromes following acute ascent to high altitude. This approach to analysing symptom patterns has potential utility in other clinical syndromes. PMID:24465370

Validation of sick leave measures: self-reported sick leave and sickness benefit data from a Danish national register compared to multiple workplace-registered sick leave spells in a Danish municipality

PubMed Central

2012-01-01

Background Previous validation studies of sick leave measures have focused on self-reports. Register-based sick leave data are considered to be valid; however methodological problems may be associated with such data. A Danish national register on sickness benefit (DREAM) has been widely used in sick leave research. On the basis of sick leave records from 3,554 and 2,311 eldercare workers in 14 different workplaces, the aim of this study was to: 1) validate registered sickness benefit data from DREAM against workplace-registered sick leave spells of at least 15 days; 2) validate self-reported sick leave days during one year against workplace-registered sick leave. Methods Agreement between workplace-registered sick leave and DREAM-registered sickness benefit was reported as sensitivities, specificities and positive predictive values. A receiver-operating characteristic curve and a Bland-Altman plot were used to study the concordance with sick leave duration of the first spell. By means of an analysis of agreement between self-reported and workplace-registered sick leave sensitivity and specificity was calculated. Ninety-five percent confidence intervals (95% CI) were used. Results The probability that registered DREAM data on sickness benefit agrees with workplace-registered sick leave of at least 15 days was 96.7% (95% CI: 95.6-97.6). Specificity was close to 100% (95% CI: 98.3-100). The registered DREAM data on sickness benefit overestimated the duration of sick leave spells by an average of 1.4 (SD: 3.9) weeks. Separate analysis on pregnancy-related sick leave revealed a maximum sensitivity of 20% (95% CI: 4.3-48.1). The sensitivity of self-reporting at least one or at least 56 sick leave day/s was 94.5 (95% CI: 93.4 – 95.5) % and 58.5 (95% CI: 51.1 – 65.6) % respectively. The corresponding specificities were 85.3 (95% CI: 81.4 – 88.6) % and 98.9 (95% CI: 98.3 – 99.3) %. Conclusions The DREAM register offered valid measures of sick leave spells of at

Validation of sick leave measures: self-reported sick leave and sickness benefit data from a Danish national register compared to multiple workplace-registered sick leave spells in a Danish municipality.

PubMed

Stapelfeldt, Christina Malmose; Jensen, Chris; Andersen, Niels Trolle; Fleten, Nils; Nielsen, Claus Vinther

2012-08-15

Previous validation studies of sick leave measures have focused on self-reports. Register-based sick leave data are considered to be valid; however methodological problems may be associated with such data. A Danish national register on sickness benefit (DREAM) has been widely used in sick leave research. On the basis of sick leave records from 3,554 and 2,311 eldercare workers in 14 different workplaces, the aim of this study was to: 1) validate registered sickness benefit data from DREAM against workplace-registered sick leave spells of at least 15 days; 2) validate self-reported sick leave days during one year against workplace-registered sick leave. Agreement between workplace-registered sick leave and DREAM-registered sickness benefit was reported as sensitivities, specificities and positive predictive values. A receiver-operating characteristic curve and a Bland-Altman plot were used to study the concordance with sick leave duration of the first spell. By means of an analysis of agreement between self-reported and workplace-registered sick leave sensitivity and specificity was calculated. Ninety-five percent confidence intervals (95% CI) were used. The probability that registered DREAM data on sickness benefit agrees with workplace-registered sick leave of at least 15 days was 96.7% (95% CI: 95.6-97.6). Specificity was close to 100% (95% CI: 98.3-100). The registered DREAM data on sickness benefit overestimated the duration of sick leave spells by an average of 1.4 (SD: 3.9) weeks. Separate analysis on pregnancy-related sick leave revealed a maximum sensitivity of 20% (95% CI: 4.3-48.1).The sensitivity of self-reporting at least one or at least 56 sick leave day/s was 94.5 (95% CI: 93.4 - 95.5) % and 58.5 (95% CI: 51.1 - 65.6) % respectively. The corresponding specificities were 85.3 (95% CI: 81.4 - 88.6) % and 98.9 (95% CI: 98.3 - 99.3) %. The DREAM register offered valid measures of sick leave spells of at least 15 days among eldercare employees. Pregnancy

The phosphoproteome of bloodstream form Trypanosoma brucei, causative agent of African sleeping sickness.

PubMed

Nett, Isabelle R E; Martin, David M A; Miranda-Saavedra, Diego; Lamont, Douglas; Barber, Jonathan D; Mehlert, Angela; Ferguson, Michael A J

2009-07-01

The protozoan parasite Trypanosoma brucei is the causative agent of human African sleeping sickness and related animal diseases, and it has over 170 predicted protein kinases. Protein phosphorylation is a key regulatory mechanism for cellular function that, thus far, has been studied in T.brucei principally through putative kinase mRNA knockdown and observation of the resulting phenotype. However, despite the relatively large kinome of this organism and the demonstrated essentiality of several T. brucei kinases, very few specific phosphorylation sites have been determined in this organism. Using a gel-free, phosphopeptide enrichment-based proteomics approach we performed the first large scale phosphorylation site analyses for T.brucei. Serine, threonine, and tyrosine phosphorylation sites were determined for a cytosolic protein fraction of the bloodstream form of the parasite, resulting in the identification of 491 phosphoproteins based on the identification of 852 unique phosphopeptides and 1204 phosphorylation sites. The phosphoproteins detected in this study are predicted from their genome annotations to participate in a wide variety of biological processes, including signal transduction, processing of DNA and RNA, protein synthesis, and degradation and to a minor extent in metabolic pathways. The analysis of phosphopeptides and phosphorylation sites was facilitated by in-house developed software, and this automated approach was validated by manual annotation of spectra of the kinase subset of proteins. Analysis of the cytosolic bloodstream form T. brucei kinome revealed the presence of 44 phosphorylated protein kinases in our data set that could be classified into the major eukaryotic protein kinase groups by applying a multilevel hidden Markov model library of the kinase catalytic domain. Identification of the kinase phosphorylation sites showed conserved phosphorylation sequence motifs in several kinase activation segments, supporting the view that

Sleep-Disordered Breathing and Vascular Function in Patients With Chronic Mountain Sickness and Healthy High-Altitude Dwellers.

PubMed

Rexhaj, Emrush; Rimoldi, Stefano F; Pratali, Lorenza; Brenner, Roman; Andries, Daniela; Soria, Rodrigo; Salinas, Carlos; Villena, Mercedes; Romero, Catherine; Allemann, Yves; Lovis, Alban; Heinzer, Raphaël; Sartori, Claudio; Scherrer, Urs

2016-04-01

Chronic mountain sickness (CMS) is often associated with vascular dysfunction, but the underlying mechanism is unknown. Sleep-disordered breathing (SDB) frequently occurs at high altitude. At low altitude, SDB causes vascular dysfunction. Moreover, in SDB, transient elevations of right-sided cardiac pressure may cause right-to-left shunting in the presence of a patent foramen ovale (PFO) and, in turn, further aggravate hypoxemia and pulmonary hypertension. We speculated that SDB and nocturnal hypoxemia are more pronounced in patients with CMS compared with healthy high-altitude dwellers, and are related to vascular dysfunction. We performed overnight sleep recordings, and measured systemic and pulmonary artery pressure in 23 patients with CMS (mean ± SD age, 52.8 ± 9.8 y) and 12 healthy control subjects (47.8 ± 7.8 y) at 3,600 m. In a subgroup of 15 subjects with SDB, we assessed the presence of a PFO with transesophageal echocardiography. The major new findings were that in patients with CMS, (1) SDB and nocturnal hypoxemia was more severe (P < .01) than in control subjects (apnea-hypopnea index [AHI], 38.9 ± 25.5 vs 14.3 ± 7.8 number of events per hour [nb/h]; arterial oxygen saturation, 80.2% ± 3.6% vs 86.8% ± 1.7%, CMS vs control group), and (2) AHI was directly correlated with systemic blood pressure (r = 0.5216; P = .001) and pulmonary artery pressure (r = 0.4497; P = .024). PFO was associated with more severe SDB (AHI, 48.8 ± 24.7 vs 14.8 ± 7.3 nb/h; P = .013, PFO vs no PFO) and hypoxemia. SDB and nocturnal hypoxemia are more severe in patients with CMS than in control subjects and are associated with systemic and pulmonary vascular dysfunction. The presence of a PFO appeared to further aggravate SDB. Closure of the PFO may improve SDB, hypoxemia, and vascular dysfunction in patients with CMS. ClinicalTrials.gov; No.: NCT01182792; URL: www.clinicaltrials.gov. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All

Global Profiling and Inhibition of Protein Lipidation in Vector and Host Stages of the Sleeping Sickness Parasite Trypanosoma brucei.

PubMed

Wright, Megan H; Paape, Daniel; Price, Helen P; Smith, Deborah F; Tate, Edward W

2016-06-10

The enzyme N-myristoyltransferase (NMT) catalyzes the essential fatty acylation of substrate proteins with myristic acid in eukaryotes and is a validated drug target in the parasite Trypanosoma brucei , the causative agent of African trypanosomiasis (sleeping sickness). N-Myristoylation typically mediates membrane localization of proteins and is essential to the function of many. However, only a handful of proteins are experimentally validated as N-myristoylated in T. brucei . Here, we perform metabolic labeling with an alkyne-tagged myristic acid analogue, enabling the capture of lipidated proteins in insect and host life stages of T. brucei . We further compare this with a longer chain palmitate analogue to explore the chain length-specific incorporation of fatty acids into proteins. Finally, we combine the alkynyl-myristate analogue with NMT inhibitors and quantitative chemical proteomics to globally define N-myristoylated proteins in the clinically relevant bloodstream form parasites. This analysis reveals five ARF family small GTPases, calpain-like proteins, phosphatases, and many uncharacterized proteins as substrates of NMT in the parasite, providing a global view of the scope of this important protein modification and further evidence for the crucial and pleiotropic role of NMT in the cell.

Return to work after early part-time sick leave due to musculoskeletal disorders: a randomized controlled trial.

PubMed

Viikari-Juntura, Eira; Kausto, Johanna; Shiri, Rahman; Kaila-Kangas, Leena; Takala, Esa-Pekka; Karppinen, Jaro; Miranda, Helena; Luukkonen, Ritva; Martimo, Kari-Pekka

2012-03-01

The purpose of this study was to assess the effects of early part-time sick leave on return to work (RTW) and sickness absence among patients with musculoskeletal disorders. A randomized controlled trial was conducted in six occupational health units of medium- and large-size enterprises. Patients aged 18-60 years with musculoskeletal disorders (N=63) unable to perform their regular work were randomly allocated to part- or full-time sick leave. In the former group, workload was reduced by restricting work time by about a half. Remaining work tasks were modified when necessary, as specified in a "fit note" from the physician. The main outcomes were time to return to regular work activities and sickness absence during 12-month follow-up. Time to RTW sustained for ≥4 weeks was shorter in the intervention group (median 12 versus 20 days, P=0.10). Hazard ratio of RTW adjusted for age was 1.60 [95% confidence interval (95% CI) 0.98-2.63] and 1.76 (95% CI 1.21-2.56) after further adjustment for pain interference with sleep and previous sickness absence at baseline. Total sickness absence during the 12-month follow-up was about 20% lower in the intervention than the control group. Compliance with the intervention was high with no discontinuations of part-time sick leave due to musculoskeletal reasons. Early part-time sick leave may provide a faster and more sustainable return to regular duties than full-time sick leave among patients with musculoskeletal disorders. This is the first study to show that work participation can be safely increased with early part-time sick leave.

[Income reduction due to sickness benefits--when does sickness make you poor?].

PubMed

Mielck, A; Huber, C A

2005-01-01

When absent from work due to sickness, most employees in Germany receive continued pay from their employer for six weeks. After this period, sick employees receive sickness benefits from their Statutory Sickness Fund. These sickness benefits are calculated in a rather complicated way as a percentage of gross and net salary. The paper focuses on two questions that have rarely been studied: which income groups show a particularly large difference between net salary and net sickness benefits? Which income groups move below the poverty line after receiving sickness benefits? We calculated how much sickness benefit is actually paid to the insured, for different income and tax groups. The definition for the poverty line is outlined as well. Due to methodological difficulties, the comparison between sickness benefits and poverty must be confined to single-person households. In the income groups chosen here (gross salary up to 4000 Euro per month), net sickness benefits amount to about 77 % of net salary, for all insured. Financial problems can mainly be expected for the lower and the upper income groups. Expressed in absolute terms, the upper income groups experience a large reduction in net income. The lower income groups come close to the poverty line or fall below it. Sickness benefits provide income in case of sickness; this is an important achievement of social policy. However, we should study the financial burden which sickness benefits could have for the insured. More in-depth analyses would require data that are not yet available (e. g. on the number of insured per income group and the income of other household members). The analyses presented here already show that sickness benefits could lead to severe financial problems for at least some insured. They point to the need for more studies in this neglected field.

Sick but yet at work. An empirical study of sickness presenteeism.

PubMed

Aronsson, G; Gustafsson, K; Dallner, M

2000-07-01

The study is an empirical investigation of sickness presenteeism in relation to occupation, irreplaceability, ill health, sickness absenteeism, personal income, and slimmed down organisation. Cross sectional design. Swedish workforce. The study group comprised a stratified subsample of 3801 employed persons working at the time of the survey, interviewed by telephone in conjunction with Statistics Sweden's labour market surveys of August and September 1997. The response rate was 87 per cent. A third of the persons in the total material reported that they had gone to work two or more times during the preceding year despite the feeling that, in the light of their perceived state of health, they should have taken sick leave. The highest presenteeism is largely to be found in the care and welfare and education sectors (nursing and midwifery professionals, registered nurses, nursing home aides, compulsory school teachers and preschool/primary educationalists. All these groups work in sectors that have faced personnel cutbacks during the 1990s). The risk ratio (odds ratio (OR)) for sickness presenteeism in the group that has to re-do work remaining after a period of absence through sickness is 2.29 (95% CI 1.79, 2.93). High proportions of persons with upper back/neck pain and fatigue/slightly depressed are among those with high presenteeism (p< 0.001). Occupational groups with high sickness presenteeism show high sickness absenteeism (rho = 0. 38; p<.01) and the hypothesis on level of pay and sickness presenteeism is also supported (rho = -0.22; p<0.01). Members of occupational groups whose everyday tasks are to provide care or welfare services, or teach or instruct, have a substantially increased risk of being at work when sick. The link between difficulties in replacement or finding a stand in and sickness presenteeism is confirmed by study results. The categories with high sickness presenteeism experience symptoms more often than those without presenteeism. The most

Association of Cognitive Performance with Time at Altitude, Sleep Quality, and Acute Mountain Sickness Symptoms.

PubMed

Issa, Amine N; Herman, Nicole M; Wentz, Robert J; Taylor, Bryan J; Summerfield, Doug C; Johnson, Bruce D

2016-09-01

It is well documented that cognitive performance may be altered with ascent to altitude, but the association of various cognitive performance tests with symptoms of acute mountain sickness (AMS) is not well understood. Our objective was to assess and compare cognitive performance during a high-altitude expedition using several tests and to report the association of each test with AMS, headache, and quality of sleep. During an expedition to Mount Everest, 3 cognitive tests (Stroop, Trail Making, and the real-time cognitive assessment tool, an in-house developed motor accuracy test) were used along with a questionnaire to assess health and AMS. Eight team members were assessed pre-expedition, postexpedition, and at several time points during the expedition. There were no significant differences (P >.05) found among scores taken at 3 time points at base camp and the postexpedition scores for all 3 tests. Changes in the Stroop test scores were significantly associated with the odds of AMS (P <.05). The logistic regression results show that the percent change from baseline for Stroop score (β = -5.637; P = .032) and Stroop attempts (β = -5.269; P = .049) are significantly associated with the odds of meeting the criteria for AMS. No significant changes were found in overall cognitive performance at altitude, but a significant relationship was found between symptoms of AMS and performance in certain cognitive tests. This research shows the need for more investigation of objective physiologic assessments to associate with self-perceived metrics of AMS to gauge effect on cognitive performance. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

Positive welfare state dynamics? Sickness benefits and sickness absence in Europe 1997-2011.

PubMed

Sjöberg, Ola

2017-03-01

Sickness absence is associated with great costs for individuals, companies and society at large. Influenced by neo-classical economic theory, policy advice has emphasized the role of sickness benefit programs for reducing sickness absence rates: too generous benefits without proper control will increase the number of recipients and prolong absence spells as well as possibly cause negative dynamic effects in the long term. This study provides an alternative interpretation of the relationship between sickness benefits and sickness absence. By combining an epidemiological approach to sickness absence and a resource-based approach to welfare, we argue that sickness benefits might be viewed as a "collective resource" that, by providing economic support during times of ill-health, might have positive health effects. Statistical analysis of short-term sickness absence using innovative methodological approaches and combined micro- and macro-level data for 21 EU countries over the period of 1992-2011 indicates that the long run effects of relatively generous sickness benefits is rather to reduce sickness absence. This result also has implications for sickness benefit reform: whereas benefit cuts to some extent may reduce absence in the short run, in the longer run such reforms may actually increase sickness absence rates. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Towards the control of the endemic of sleeping sickness in Nola-Bilolo focus, Central African Republic].

PubMed

Mbelesso, P; Mbadingaï, S; Laghoe Nguembe, G L S

2011-12-01

Sleeping sickness is more prevalent in three historical regions of Central African Republic. Control measures were organized by the colonial authorities through health services to fight against this disease and other major diseases. Multivariate analysis and the government helped in controlling the disease in the focus of Nola-Bilolo, which was formerly hyperendemic. The authors report the results of the control measures that resulted in the extinction of the disease in this outbreak. This is a retrospective study from 1991 to 2008, and the data were collected from the National Program to fight against human African trypanosomiasis in Bangui and in the diagnostic and treatment center of Nola. It was highly endemic, with more than 300 cases recorded in the year 1991. The average number of cases was 200.8 per year between 1992 and 1998. Less than 50 cases per year were recorded from 2000 to 2006, and no cases have been detected since 2007. 69.35% of the patients were actively screened. 5,000 conical deltamethrin-impregnated traps (Gouteux and Lancien) had been used in 15 districts in the city of Nola and 46 surrounding villages by 20 trappers fully supported by the program. This is an example of regular active mass screening. Systematic treatment of detected cases and well-conducted vector control measures give hope to the affected populations to live peacefully in order to contribute to the development of their country.

Inhaled budesonide and oral dexamethasone prevent acute mountain sickness.

PubMed

Zheng, Cheng-Rong; Chen, Guo-Zhu; Yu, Jie; Qin, Jun; Song, Pan; Bian, Shi-Zhu; Xu, Bai-Da; Tang, Xu-Gang; Huang, Yong-Tao; Liang, Xiao; Yang, Jie; Huang, Lan

2014-10-01

This double-blind, randomized controlled trial aimed to investigate inhaled budesonide and oral dexamethasone compared with placebo for their prophylactic efficacy against acute mountain sickness after acute high-altitude exposure. There were 138 healthy young male lowland residents recruited and randomly assigned to receive inhaled budesonide (200 μg, twice a day [bid]), oral dexamethasone (4 mg, bid), or placebo (46 in each group). They traveled to 3900 m altitude from 400 m by car. Medication started 1 day before high-altitude exposure and continued until the third day of exposure. Primary outcome measure was the incidence of acute mountain sickness after exposure. One hundred twenty-four subjects completed the study (42, 39, and 43 in the budesonide, dexamethasone, and placebo groups, respectively). Demographic characteristics were comparable among the 3 groups. After high-altitude exposure, significantly fewer participants in the budesonide (23.81%) and dexamethasone (30.77%) groups developed acute mountain sickness compared with participants receiving placebo (60.46%) (P = .0006 and P = .0071, respectively). Both the budesonide and dexamethasone groups had lower heart rate and higher pulse oxygen saturation (SpO2) than the placebo group at altitude. Only the budesonide group demonstrated less deterioration in forced vital capacity and sleep quality than the placebo group. Four subjects in the dexamethasone group reported adverse reactions. Both inhaled budesonide (200 μg, bid) and oral dexamethasone (4 mg, bid) were effective for the prevention of acute mountain sickness, especially its severe form, compared with placebo. Budesonide caused fewer adverse reactions than dexamethasone. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

When healthcare workers get sick: exploring sickness absenteeism in British Columbia, Canada.

PubMed

Gorman, Erin; Yu, Shicheng; Alamgir, Hasanat

2010-01-01

To determine the demographic and work characteristics of healthcare workers who were more likely to take sickness absences from work in British Columbia, Canada. Payroll data were analyzed for three health regions. Sickness absence rates were determined per person-year and then compared across demographic and work characteristics using multivariate Poisson regression models. The direct costs to the employer due to sickness absences were also estimated. Female, older, full-time workers, long-term care workers and those with a lower hourly wage were more likely to take sickness absences and had similar trends with respect to the costs due to sickness absence. For occupations, licensed practical nurses, care aides and facility support workers had higher rates of sickness absence. Registered nurses, and those workers paid high hourly wages were associated with highest sickness related costs. It is important to understand the demographic and work characteristics of those workers who are more likely to take sickness absences in order to make sure that they are not experiencing additional hazards at work or facing detrimental workplace conditions. Policy makers need to establish healthy, safe and in turn more productive workplaces. Further research is needed on how interventions can reduce sickness absence.

PubMed Central

Jannin, J.; Moulia-Pelat, J. P.; Chanfreau, B.; Penchenier, L.; Louis, J. P.; Nzaba, P.; de La Baume, F. E.; Eozenou, P.; Cattand, P.

1993-01-01

A case-control study was carried out in the Congo to define a scoring system based on a number of clinical and epidemiological criteria of African trypanosomiasis due to Trypanosoma brucei gambiense which could be used by peripheral health services to establish a diagnosis. The survey comprised 163 cases and 326 controls. Clinical signs and symptoms were fever, headache, pruritus and skin lesions due to scratching, diarrhoea, oedema, cervical adenopathies, sleep rhythm disturbances, changes in appetite, amenorrhoea or impotence, mental confusion, neurological signs, and other minor clinical disturbances. Other criteria were a history of previous trypanosomiasis and the presence of domestic animals in the home environment. Analysis of the results showed that neither a single criterion nor a group of criteria is pathognomonic for the disease. The selected criteria do not allow discrimination of sleeping sickness patients among suspected individuals who present themselves. A scoring system is therefore of little use at the peripheral level of health services, particularly when considering the additional workload involved. The low diagnostic value of these clinical signs and symptoms and other indicators in African trypanosomiasis stresses the difficulty in developing an early warning tool for an integrated control strategy in primary health care. PMID:8490985

The use of EEG to measure cerebral changes during computer-based motion-sickness-inducing tasks

NASA Astrophysics Data System (ADS)

Strychacz, Christopher; Viirre, Erik; Wing, Shawn

2005-05-01

Motion sickness (MS) is a stressor commonly attributed with causing serious navigational and performance errors. The distinct nature of MS suggests this state may have distinct neural markers distinguishable from other states known to affect performance (e.g., stress, fatigue, sleep deprivation, high workload). This pilot study used new high-resolution electro-encephalograph (EEG) technologies to identify distinct neuronal activation changes that occur during MS. Brain EEG activity was monitored while subjects performed a ball-tracking task and viewed stimuli on a projection screen intended to induce motion sickness/spatial disorientation. Results show the presence of EEG spectral changes in all subjects who developed motion sickness when compared to baseline levels. These changes included: 1) low frequency (1 to 10 Hz) changes that may reflect oculomotor movements rather than intra-cerebral sources; 2) increased spectral power across all frequencies (attributable to increased scalp conductivity related to sweating), 3) local increases of power spectra in the 20-50 Hz range (likely attributable to external muscles on the skull) and; 4) a central posterior (occipital) independent component that shows suppression of a 20 Hz peak in the MS condition when compared to baseline. Further research is necessary to refine neural markers, characterize their origin and physiology, to distinguish between motion sickness and other states and to enable markers to be used for operator state monitoring and the designing of interventions for motion sickness.

Fexinidazole--a new oral nitroimidazole drug candidate entering clinical development for the treatment of sleeping sickness.

PubMed

Torreele, Els; Bourdin Trunz, Bernadette; Tweats, David; Kaiser, Marcel; Brun, Reto; Mazué, Guy; Bray, Michael A; Pécoul, Bernard

2010-12-21

Human African trypanosomiasis (HAT), also known as sleeping sickness, is a fatal parasitic disease caused by trypanosomes. Current treatment options for HAT are scarce, toxic, no longer effective, or very difficult to administer, in particular for the advanced, fatal stage of the disease (stage 2, chronic HAT). New safe, effective and easy-to-use treatments are urgently needed. Here it is shown that fexinidazole, a 2-substituted 5-nitroimidazole rediscovered by the Drugs for Neglected Diseases initiative (DNDi) after extensive compound mining efforts of more than 700 new and existing nitroheterocycles, could be a short-course, safe and effective oral treatment curing both acute and chronic HAT and that could be implemented at the primary health care level. To complete the preclinical development and meet the regulatory requirements before initiating human trials, the anti-parasitic properties and the pharmacokinetic, metabolic and toxicological profile of fexinidazole have been assessed. Standard in vitro and in vivo anti-parasitic activity assays were conducted to assess drug efficacy in experimental models for HAT. In parallel, a full range of preclinical pharmacology and safety studies, as required by international regulatory guidelines before initiating human studies, have been conducted. Fexinidazole is moderately active in vitro against African trypanosomes (IC₅₀ against laboratory strains and recent clinical isolates ranged between 0.16 and 0.93 µg/mL) and oral administration of fexinidazole at doses of 100 mg/kg/day for 4 days or 200 mg/kg/day for 5 days cured mice with acute and chronic infection respectively, the latter being a model for the advanced and fatal stage of the disease when parasites have disseminated into the brain. In laboratory animals, fexinidazole is well absorbed after oral administration and readily distributes throughout the body, including the brain. The absolute bioavailability of oral fexinidazole was 41% in mice, 30% in rats

A Countermeasure for Space Motion Sickness

NASA Technical Reports Server (NTRS)

Reschke, M. F.; Somers, J. T.; Leigh, R. J.; Jones, G. Melvill

2006-01-01

Overall, the results obtained in both the U.S. and the Russian space programs indicate that most space crews will experience some symptoms of motion sickness (MS) causing significant impact on the operational objectives that must be accomplished to assure mission success. At this time the primary countermeasure for MS requires the administration of Promethazine. Promethazine is not a benign drug, and is most frequently administered just prior to the sleep cycle to prevent its side effects from further compromising mission objectives. Clearly other countermeasures for SMS must be developed. Currently the primary focus is on two different technologies: (1) developing new and different pharmacological compounds with less significant side effects, (2) preflight training. The primary problem with all of these methods for controlling MS is time. New drugs that may be beneficial are years from testing and development, and preflight training requires a significant investment of crew time during an already intensive pre-launch schedule. Granted, motion sickness symptoms can be minimized with either of the two methods detailed above, however, it may be possible to develop a countermeasure that does not require either extensive adaptation time or exposure to motion sickness. Approximately 25 years ago Professor Geoffrey Melvill Jones presented his work on adaptation of the vestibuloocular reflex (VOR) using optically reversed vision (left-right prisms) during head rotations in the horizontal plane. It was of no surprise that most subjects experienced motion sickness while wearing the optically reversing prisms. However, a serendipitous finding emerged during this research showing that the same subjects did not experience motion sickness symptoms when wearing the reversing prisms under stroboscopic illumination. The mechanism, by which this side-effect was believed to have occurred, is not clearly understood. However, the fact that no motion sickness was ever noted, suggests

Workplace accidents, absenteeism and productivity in patients with sleep apnea.

PubMed

Jurado-Gámez, Bernabé; Guglielmi, Ottavia; Gude, Francisco; Buela-Casal, Gualberto

2015-05-01

Obstructive sleep apnea-hypopnea syndrome (OSAHS) has health-related outcomes, but the impact of OSAHS on occupational health has been scarcely studied. The aim of this study was to evaluate the effect of OSAHS on workplace accidents, absenteeism and productivity. One hundred eighty-two OSAHS patients and 71 healthy subjects completed the Epworth Sleepiness Scale, the Pittsburgh Sleep Quality Index and the Spanish IMPALA (Impact of Disease on Work Productivity) index and answered various questions on workplace accidents and sick leave. Participants were classified to an OSAHS group or a non-OSAHS group according to polysomnography results. Patients with OSAHS had more sick leave lasting longer than 30days (16.6% vs. 7%, P=.049) and lower productivity (63.80% vs. 83.20%, P=.000) than subjects without OSAHS, although the rate of workplace accidents was similar in both groups (27.4% vs 25.4%; P>.050). None of the OSAHS-related variables was associated with workplace accidents. A diagnosis of OSAHS was related with absenteeism. Psychological distress and OSAHS were related with productivity. OSAHS causes limitations in the working lives of patients and leads to a higher incidence of sick leave and lower productivity. A diagnosis of OSAHS was the variable with most influence on the working lives of patients. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

Spatial predictions of Rhodesian Human African Trypanosomiasis (sleeping sickness) prevalence in Kaberamaido and Dokolo, two newly affected districts of Uganda.

PubMed

Batchelor, Nicola A; Atkinson, Peter M; Gething, Peter W; Picozzi, Kim; Fèvre, Eric M; Kakembo, Abbas S L; Welburn, Susan C

2009-12-15

The continued northwards spread of Rhodesian sleeping sickness or Human African Trypanosomiasis (HAT) within Uganda is raising concerns of overlap with the Gambian form of the disease. Disease convergence would result in compromised diagnosis and treatment for HAT. Spatial determinants for HAT are poorly understood across small areas. This study examines the relationships between Rhodesian HAT and several environmental, climatic and social factors in two newly affected districts, Kaberamaido and Dokolo. A one-step logistic regression analysis of HAT prevalence and a two-step logistic regression method permitted separate analysis of both HAT occurrence and HAT prevalence. Both the occurrence and prevalence of HAT were negatively correlated with distance to the closest livestock market in all models. The significance of distance to the closest livestock market strongly indicates that HAT may have been introduced to this previously unaffected area via the movement of infected, untreated livestock from endemic areas. This illustrates the importance of the animal reservoir in disease transmission, and highlights the need for trypanosomiasis control in livestock and the stringent implementation of regulations requiring the treatment of cattle prior to sale at livestock markets to prevent any further spread of Rhodesian HAT within Uganda.

Motion sickness in ancient China: Seasickness and cart-sickness.

PubMed

Brandt, Thomas; Bauer, Matthias; Benson, Judy; Huppert, Doreen

2016-07-19

To find and analyze descriptions of motion sickness in Chinese historical sources. Databases and dictionaries were searched for various terms for seasickness and travel sickness, which were then entered into databases of full texts allowing selection of relevant passages from about the third to the 19th century ad. Already in 300 ad the Chinese differentiated cart-sickness, particularly experienced by persons from the arid north of China, from a ship-illness experienced by persons from the south, where rivers were important for transportation and travel. In the Middle Ages, a third form of motion sickness was called litter-influence experienced by persons transported in a bed suspended between 2 long poles. The ancient Chinese recognized the particular susceptibility of children to motion sickness. Therapeutic recommendations include drinking the urine of young boys, swallowing white sand-syrup, collecting water drops from a bamboo stick, or hiding some earth from the middle of the kitchen hearth under the hair. The Chinese medical classics distinguished several forms of travel sickness, all of which had their own written characters. The pathophysiologic mechanism was explained by the medicine of correspondences, which was based on malfunctions within the body, its invasion by external pathogens like wind, or the deficit or surfeit of certain bodily substances such as the life force Qi. The concept of motion as the trigger of sickness initially appeared in a chapter on warding off the influence of demons and corpses, e.g., ancient magic and beliefs. © 2016 American Academy of Neurology.

Automated electroencephalography system and electroencephalographic correlates of space motion sickness, part 2. [sleep characteristics

NASA Technical Reports Server (NTRS)

Frost, J. D., Jr.

1976-01-01

Sleep pattern alterations were detected in two subjects by electroencephalographic, electrographic, and electromyographic monitoring before, during and after a 28 day bed rest. Standardized criteria were used for data analysis. During the second half of the bed-rest period, sleep latency and stage 3 increased, while total sleep time, stage 2, and REM latency decreased. In addition, during bed rest both subjects showed an increase in the number of REM periods and a slight increase in stage REM amount. No major alterations were seen in the recovery period. Of the alterations found to be associated with bed rest, only one, the increase in stage 3 sleep, was also seen consistently during Skylab. Conversely, none of the postflight changes seen following Skylab were observed during the post-bed-rest recovery period.

Changing landscapes, changing practice: negotiating access to sleeping sickness services in a post-conflict society.

PubMed

Palmer, Jennifer J; Kelly, Ann H; Surur, Elizeous I; Checchi, Francesco; Jones, Caroline

2014-11-01

For several decades, control programmes for human African trypanosomiasis (HAT, or sleeping sickness) in South Sudan have been delivered almost entirely as humanitarian interventions: large, well-organised, externally-funded but short-term programmes with a strategic focus on active screening. When attempts to hand over these programmes to local partners fail, resident populations must actively seek and negotiate access to tests at hospitals via passive screening. However, little is known about the social impact of such humanitarian interventions or the consequences of withdrawal on access to and utilisation of remaining services by local populations. Based on qualitative and quantitative fieldwork in Nimule, South Sudan (2008-2010), where passive screening necessarily became the predominant strategy, this paper investigates the reasons why, among two ethnic groups (Madi returnees and Dinka displaced populations), service uptake was so much higher among the latter. HAT tests were the only form of clinical care for which displaced Dinka populations could self-refer; access to all other services was negotiated through indigenous area workers. Because of the long history of conflict, these encounters were often morally and politically fraught. An open-door policy to screening supported Dinka people to 'try' HAT tests in the normal course of treatment-seeking, thereby empowering them to use HAT services more actively. This paper argues that in a context like South Sudan, where HAT control increasingly depends upon patient-led approaches to case-detection, it is imperative to understand the cultural values and political histories associated with the practice of testing and how medical humanitarian programmes shape this landscape of care, even after they have been scaled down. Copyright © 2014 Elsevier Ltd. All rights reserved.

Factors associated with sleep quality among operating engineers.

PubMed

Choi, Seung Hee; Terrell, Jeffrey E; Pohl, Joanne M; Redman, Richard W; Duffy, Sonia A

2013-06-01

Blue collar workers generally report high job stress and are exposed to loud noises at work and engage in many of risky health behavioral factors, all of which have been associated with poor sleep quality. However, sleep quality of blue collar workers has not been studied extensively, and no studies have focused Operating Engineers (heavy equipment operators) among whom daytime fatigue would place them at high risk for accidents. Therefore, the purpose of this study was to determine variables associated with sleep quality among Operating Engineers. This was a cross-sectional survey design with a dependent variable of sleep quality and independent variables of personal and related health behavioral factors. A convenience sample of 498 Operating Engineers was recruited from approximately 16,000 Operating Engineers from entire State of Michigan in 2008. Linear regression was used to determine personal and related health behavior factors associated with sleep quality. Multivariate analyses showed that personal factors related to poor sleep quality were younger age, female sex, higher pain, more medical comorbidities and depressive symptoms and behavioral factors related to poor sleep quality were nicotine dependence. While sleep scores were similar to population norms, approximately 34 % (n = 143) showed interest in health services for sleep problems. While many personal factors are not changeable, interventions to improve sleep hygiene as well as interventions to treat pain, depression and smoking may improve sleep quality resulting in less absenteeism, fatal work accidents, use of sick leave, work disability, medical comorbidities, as well as subsequent mortality.

Factors Associated With Sleep Quality Among Operating Engineers

PubMed Central

Choi, Seung Hee; Terrell, Jeffrey E.; Pohl, Joanne M.; Redman, Richard W.

2016-01-01

Blue collar workers generally report high job stress and are exposed to loud noises at work and engage in many of the health behavioral factors, all of which have been associated with poor sleep quality. However, sleep quality of blue collar workers has not been studied extensively, and no studies have focused Operating Engineers (heavy equipment operators) among whom daytime fatigue would place them at high risk for accidents. Therefore, the purpose of this study was to determine variables associated with sleep quality among Operating Engineers. This was a cross-sectional survey design with a dependent variable of sleep quality and independent variables of personal and related health behavioral factors. A convenience sample of 498 Operating Engineers was recruited from approximately 16,000 Operating Engineers from entire State of Michigan in 2008. Linear regression was used to determine personal and related health behavior factors associated with sleep quality. Multivariate analyses showed that personal factors related to poor sleep quality were younger age, female sex, higher pain, more medical comorbidities and depressive symptoms and behavioral factors related to poor sleep quality were nicotine dependence. While sleep scores were similar to population norms, approximately 34% (n=143) showed interest in health services for sleep problems. While many personal factors are not changeable, interventions to improve sleep hygiene as well as interventions to treat pain, depression and smoking may improve sleep quality resulting in less absenteeism, fatal work accidents, use of sick leave, work disability, medical comorbidities, as well as subsequent mortality. PMID:23393021

Coping and sickness absence.

PubMed

van Rhenen, Willem; Schaufeli, Wilmar B; van Dijk, Frank J H; Blonk, Roland W B

2008-02-01

The aim of this study is to examine the role of coping styles in sickness absence. In line with findings that contrast the reactive-passive focused strategies, problem-solving strategies are generally associated with positive results in terms of well-being and overall health outcomes; our hypothesis is that such strategies are positively related to a low frequency of sickness absence and with short lengths (total number of days absent) and durations (mean duration per spell). Using a prospective design, employees' (N = 3,628) responses on a self-report coping inventory are used to predict future registered sickness absence (i.e. frequency, length, duration, and median time before the onset of a new sick leave period). In accordance with our hypothesis, and after adjustment for potential confounders, employees with an active problem-solving coping strategy are less likely to drop out because of sickness absence in terms of frequency, length (longer than 14 days), and duration (more than 7 days) of sickness absence. This positive effect is observed in the case of seeking social support only for the duration of sickness absence and in the case of palliative reaction only for the length and frequency of absence. In contrast, an avoidant coping style, representing a reactive-passive strategy, increases the likelihood of frequent absences significantly, as well as the length and duration of sickness absence. Expression of emotions, representing another reactive-passive strategy, has no effect on future sickness absenteeism. The median time before the onset of a new episode of absenteeism is significantly extended for active problem-solving and reduced for avoidance and for a palliative response. The results of the present study support the notion that problem-solving coping and reactive-passive strategies are inextricably connected to frequency, duration, length and onset of sickness absence. Especially, active problem-solving decreases the chance of future sickness

Escaping Deleterious Immune Response in Their Hosts: Lessons from Trypanosomatids

PubMed Central

Geiger, Anne; Bossard, Géraldine; Sereno, Denis; Pissarra, Joana; Lemesre, Jean-Loup; Vincendeau, Philippe; Holzmuller, Philippe

2016-01-01

The Trypanosomatidae family includes the genera Trypanosoma and Leishmania, protozoan parasites displaying complex digenetic life cycles requiring a vertebrate host and an insect vector. Trypanosoma brucei gambiense, Trypanosoma cruzi, and Leishmania spp. are important human pathogens causing human African trypanosomiasis (HAT or sleeping sickness), Chagas’ disease, and various clinical forms of Leishmaniasis, respectively. They are transmitted to humans by tsetse flies, triatomine bugs, or sandflies, and affect millions of people worldwide. In humans, extracellular African trypanosomes (T. brucei) evade the hosts’ immune defenses, allowing their transmission to the next host, via the tsetse vector. By contrast, T. cruzi and Leishmania sp. have developed a complex intracellular lifestyle, also preventing several mechanisms to circumvent the host’s immune response. This review seeks to set out the immune evasion strategies developed by the different trypanosomatids resulting from parasite–host interactions and will focus on: clinical and epidemiological importance of diseases; life cycles: parasites–hosts–vectors; innate immunity: key steps for trypanosomatids in invading hosts; deregulation of antigen-presenting cells; disruption of efficient specific immunity; and the immune responses used for parasite proliferation. PMID:27303406

Transcriptomes of Trypanosoma brucei rhodesiense from sleeping sickness patients, rodents and culture: Effects of strain, growth conditions and RNA preparation methods

PubMed Central

Mulindwa, Julius; Leiss, Kevin; Ibberson, David; Kamanyi Marucha, Kevin; Helbig, Claudia; Melo do Nascimento, Larissa; Silvester, Eleanor; Matthews, Keith; Matovu, Enock; Enyaru, John

2018-01-01

All of our current knowledge of African trypanosome metabolism is based on results from trypanosomes grown in culture or in rodents. Drugs against sleeping sickness must however treat trypanosomes in humans. We here compare the transcriptomes of Trypanosoma brucei rhodesiense from the blood and cerebrospinal fluid of human patients with those of trypanosomes from culture and rodents. The data were aligned and analysed using new user-friendly applications designed for Kinetoplastid RNA-Seq data. The transcriptomes of trypanosomes from human blood and cerebrospinal fluid did not predict major metabolic differences that might affect drug susceptibility. Usefully, there were relatively few differences between the transcriptomes of trypanosomes from patients and those of similar trypanosomes grown in rats. Transcriptomes of monomorphic laboratory-adapted parasites grown in in vitro culture closely resembled those of the human parasites, but some differences were seen. In poly(A)-selected mRNA transcriptomes, mRNAs encoding some protein kinases and RNA-binding proteins were under-represented relative to mRNA that had not been poly(A) selected; further investigation revealed that the selection tends to result in loss of longer mRNAs. PMID:29474390

Transcriptomes of Trypanosoma brucei rhodesiense from sleeping sickness patients, rodents and culture: Effects of strain, growth conditions and RNA preparation methods.

PubMed

Mulindwa, Julius; Leiss, Kevin; Ibberson, David; Kamanyi Marucha, Kevin; Helbig, Claudia; Melo do Nascimento, Larissa; Silvester, Eleanor; Matthews, Keith; Matovu, Enock; Enyaru, John; Clayton, Christine

2018-02-01

All of our current knowledge of African trypanosome metabolism is based on results from trypanosomes grown in culture or in rodents. Drugs against sleeping sickness must however treat trypanosomes in humans. We here compare the transcriptomes of Trypanosoma brucei rhodesiense from the blood and cerebrospinal fluid of human patients with those of trypanosomes from culture and rodents. The data were aligned and analysed using new user-friendly applications designed for Kinetoplastid RNA-Seq data. The transcriptomes of trypanosomes from human blood and cerebrospinal fluid did not predict major metabolic differences that might affect drug susceptibility. Usefully, there were relatively few differences between the transcriptomes of trypanosomes from patients and those of similar trypanosomes grown in rats. Transcriptomes of monomorphic laboratory-adapted parasites grown in in vitro culture closely resembled those of the human parasites, but some differences were seen. In poly(A)-selected mRNA transcriptomes, mRNAs encoding some protein kinases and RNA-binding proteins were under-represented relative to mRNA that had not been poly(A) selected; further investigation revealed that the selection tends to result in loss of longer mRNAs.

Sleeping sickness and its relationship with development and biodiversity conservation in the Luangwa Valley, Zambia.

PubMed

Anderson, Neil E; Mubanga, Joseph; Machila, Noreen; Atkinson, Peter M; Dzingirai, Vupenyu; Welburn, Susan C

2015-04-15

The Luangwa Valley has a long historical association with Human African Trypanosomiasis (HAT) and is a recognised geographical focus of this disease. It is also internationally acclaimed for its high biodiversity and contains many valuable habitats. Local inhabitants of the valley have developed sustainable land use systems in co-existence with wildlife over centuries, based on non-livestock keeping practices largely due to the threat from African Animal Trypanosomiasis. Historical epidemics of human sleeping sickness have influenced how and where communities have settled and have had a profound impact on development in the Valley. Historical attempts to control trypanosomiasis have also had a negative impact on conservation of biodiversity.Centralised control over wildlife utilisation has marginalised local communities from managing the wildlife resource. To some extent this has been reversed by the implementation of community based natural resource management programmes in the latter half of the 20(th) century and the Luangwa Valley provides some of the earliest examples of such programmes. More recently, there has been significant uncontrolled migration of people into the mid-Luangwa Valley driven by pressure on resources in the eastern plateau region, encouragement from local chiefs and economic development in the tourist centre of Mfuwe. This has brought changing land-use patterns, most notably agricultural development through livestock keeping and cotton production. These changes threaten to alter the endemically stable patterns of HAT transmission and could have significant impacts on ecosystem health and ecosystem services.In this paper we review the history of HAT in the context of conservation and development and consider the impacts current changes may have on this complex social-ecological system. We conclude that improved understanding is required to identify specific circumstances where win-win trade-offs can be achieved between the conservation of

Virtual reality sickness questionnaire (VRSQ): Motion sickness measurement index in a virtual reality environment.

PubMed

Kim, Hyun K; Park, Jaehyun; Choi, Yeongcheol; Choe, Mungyeong

2018-05-01

This study aims to develop a motion sickness measurement index in a virtual reality (VR) environment. The VR market is in an early stage of market formation and technological development, and thus, research on the side effects of VR devices such as simulator motion sickness is lacking. In this study, we used the simulator sickness questionnaire (SSQ), which has been traditionally used for simulator motion sickness measurement. To measure the motion sickness in a VR environment, 24 users performed target selection tasks using a VR device. The SSQ was administered immediately after each task, and the order of work was determined using the Latin square design. The existing SSQ was revised to develop a VR sickness questionnaire, which is used as the measurement index in a VR environment. In addition, the target selection method and button size were found to be significant factors that affect motion sickness in a VR environment. The results of this study are expected to be used for measuring and designing simulator sickness using VR devices in future studies. Copyright © 2018 Elsevier Ltd. All rights reserved.

Coping and sickness absence

PubMed Central

Schaufeli, Wilmar B.; van Dijk, Frank J. H.; Blonk, Roland W. B.

2007-01-01

Objectives The aim of this study is to examine the role of coping styles in sickness absence. In line with findings that contrast the reactive–passive focused strategies, problem-solving strategies are generally associated with positive results in terms of well-being and overall health outcomes; our hypothesis is that such strategies are positively related to a low frequency of sickness absence and with short lengths (total number of days absent) and durations (mean duration per spell). Methods Using a prospective design, employees’ (N = 3,628) responses on a self-report coping inventory are used to predict future registered sickness absence (i.e. frequency, length, duration, and median time before the onset of a new sick leave period). Results and conclusions In accordance with our hypothesis, and after adjustment for potential confounders, employees with an active problem-solving coping strategy are less likely to drop out because of sickness absence in terms of frequency, length (longer than 14 days), and duration (more than 7 days) of sickness absence. This positive effect is observed in the case of seeking social support only for the duration of sickness absence and in the case of palliative reaction only for the length and frequency of absence. In contrast, an avoidant coping style, representing a reactive–passive strategy, increases the likelihood of frequent absences significantly, as well as the length and duration of sickness absence. Expression of emotions, representing another reactive–passive strategy, has no effect on future sickness absenteeism. The median time before the onset of a new episode of absenteeism is significantly extended for active problem-solving and reduced for avoidance and for a palliative response. The results of the present study support the notion that problem-solving coping and reactive–passive strategies are inextricably connected to frequency, duration, length and onset of sickness absence. Especially, active

Genotoxicity profile of fexinidazole--a drug candidate in clinical development for human African trypanomiasis (sleeping sickness).

PubMed

Tweats, David; Bourdin Trunz, Bernadette; Torreele, Els

2012-09-01

The parasitic disease human African trypanomiasis (HAT), also known as sleeping sickness, is a highly neglected fatal condition endemic in sub-Saharan Africa, which is poorly treated with medicines that are toxic, no longer effective or very difficult to administer. New, safe, effective and easy-to-use treatments are urgently needed. Many nitroimidazoles possess antibacterial and antiprotozoal activity and examples such as tinidazole are used to treat trichomoniasis and guardiasis, but concerns about toxicity including genotoxicity limit their usefulness. Fexinidazole, a 2-substituted 5-nitroimidazole rediscovered by the Drugs for Neglected Diseases initiative (DNDi) after extensive compound mining of public and pharmaceutical company databases, has the potential to become a short-course, safe and effective oral treatment, curing both acute and chronic HAT. This paper describes the genotoxicity profile of fexinidazole and its two active metabolites, the sulfoxide and sulfone derivatives. All the three compounds are mutagenic in the Salmonella/Ames test; however, mutagenicity is either attenuated or lost in Ames Salmonella strains that lack one or more nitroreductase(s). It is known that these enzymes can nitroreduce compounds with low redox potentials, whereas their mammalian cell counterparts cannot, under normal conditions. Fexinidazole and its metabolites have low redox potentials and all mammalian cell assays to detect genetic toxicity, conducted for this study either in vitro (micronucleus test in human lymphocytes) or in vivo (ex vivo unscheduled DNA synthesis in rats; bone marrow micronucleus test in mice), were negative. Thus, fexinidazole does not pose a genotoxic hazard to patients and represents a promising drug candidate for HAT. Fexinidazole is expected to enter Phase II clinical trials in 2012.

Acute mountain sickness

MedlinePlus

High altitude cerebral edema; Altitude anoxia; Altitude sickness; Mountain sickness; High altitude pulmonary edema ... If you have fluid in your lungs (pulmonary edema), treatment may include: Oxygen A high blood pressure ...

Space motion sickness

NASA Technical Reports Server (NTRS)

Homick, J. L.

1979-01-01

Research on the etiology, prediction, treatment and prevention of space motion sickness, designed to minimize the impact of this syndrome which was experienced frequently and with severity by individuals on the Skylab missions, on Space Shuttle crews is reviewed. Theories of the cause of space motion sickness currently under investigation by NASA include sensory conflict, which argues that motion sickness symptoms result from a mismatch between the total pattern of information from the spatial senses and that stored from previous experiences, and fluid shift, based upon the redistribution of bodily fluids that occurs upon continued exposure to weightlessness. Attempts are underway to correlate space motion sickness susceptibility to different provocative environments, vestibular and nonvestibular responses, and the rate of acquisition and length of retention of sensory adaptation. Space motion sickness countermeasures under investigation include various drug combinations, of which the equal combination of promethazine and ephedrine has been found to be as effective as the scopolomine and dexedrine combination, and vestibular adaptation and biofeedback training and autogenic therapy.

The association between pelvic girdle pain and sick leave during pregnancy; a retrospective study of a Norwegian population.

PubMed

Malmqvist, Stefan; Kjaermann, Inger; Andersen, Knut; Økland, Inger; Larsen, Jan Petter; Brønnick, Kolbjørn

2015-10-05

The incidence of pelvic girdle pain (PGP) in pregnancy is wide ranged depending on definition, the utilised diagnostic means, and the design of the studies. PGP during pregnancy has negative effects on activities of daily living and causes long sick leave, which makes it a major public health issue. Our objectives were to explore the frequency of sick leave in pregnancy due to PGP, assess the relationship between different types of pain-related activities of daily living, examine physical workload, type of work in relation to sick leave, and to explore factors that make women less likely to take sick leave for PGP. All women giving birth at the maternity ward of Stavanger University Hospital, Norway, were asked to participate and complete a questionnaire on demographic features, PGP, pain-related activities of daily living, sick leave in general and for PGP, frequency of exercising before and during pregnancy. Drawings of pelvic girdle and low back area were used for the localization of pain. PGP intensity was then rated retrospectively on a numerical rating scale. Non-parametric tests, multinomial logistic regression and sequential linear regression analysis were used in the statistical analysis. PGP is a frequent and major cause of sick leave during pregnancy among Norwegian women, which is also reflected in activities of daily living as measured with scores on all Oswestry disability index items. In the multivariate analysis of factors related to sick leave and PGP we found that work satisfaction, problems with lifting and sleeping, and pain intensity were risk factors for sick leave. In addition, women with longer education, higher work satisfaction and fewer problems with sitting, walking and standing, were less likely to take sick leave in pregnancy, despite the same pain intensity as women being on sick leave. A coping factor in pregnant women with PGP was discovered, most likely dependant on education, associated with work situation and/or work posture

Gender differences in motion sickness history and susceptibility to optokinetic rotation-induced motion sickness.

PubMed

Park, A H; Hu, S

1999-11-01

The present study investigated gender differences in motion sickness history and susceptibility to optokinetic rotation-induced motion sickness. The study included two phases. In Phase 1, 485 subjects filled out a survey of previous incidence of motion sickness. Results indicated that women reported significantly greater incidence of feeling motion sickness than did men on buses, on trains, on planes, in cars, and on amusement rides before the age of 12 yr; and on buses, on trains, on planes, in boats, on ships, in cars, on amusement rides, and on swings between the ages of 12 and 25 yr. Women also reported significantly higher incidence of being actually sick than did men on buses before the age of 12 yr and on buses, on ships, and in cars between the ages of 12 and 25 yr. In Phase 2, each of the 47 subjects viewed an optokinetic rotating-drum for 16 min. Subjects' subjective symptoms of motion sickness (SSMS) were obtained during drum rotation. The results showed that there were no significant differences on SSMS scores between men and women. Although women reported greater incidence in motion sickness history, women did not differ from men in severity of symptoms of motion sickness while viewing a rotating optokinetic drum.

Spacelab experiments on space motion sickness

NASA Technical Reports Server (NTRS)

Oman, C. M.

1987-01-01

Recent research results from ground and flight experiments on motion sickness and space sickness conducted by the Man Vehicle Laboratory are reviewed. New tools developed include a mathematical model for motion sickness, a method for quantitative measurements of skin pallor and blush in ambulatory subjects, and a magnitude estimation technique for ratio scaling of nausea or discomfort. These have been used to experimentally study the time course of skin pallor and subjective symptoms in laboratory motion sickness. In prolonged sickness, subjects become hypersensitive to nauseogenic stimuli. Results of a Spacelab-1 flight experiment are described in which four observers documented the stimulus factors for and the symptoms/signs of space sickness. The clinical character of space sickness differs somewhat from acute laboratory motion sickness. However SL-1 findings support the view that space sickness is fundamentally a motion sickness. Symptoms were subjectively alleviated by head movement restriction, maintenance of a familiar orientation with respect to the visual environment, and wedging between or strapping onto surfaces which provided broad contact cues confirming the absence of body motion.

Spacelab experiments on space motion sickness

NASA Technical Reports Server (NTRS)

Oman, C. M.

1985-01-01

Recent research results from ground and flight experiments on motion sickness and space sickness conducted by the Man Vehicle Laboratory are reviewed. New tools developed include a mathematical model for motion sickness, a method for quantitative measurement of skin pallor and blush in ambulatory subjects, and a magnitude estimation technique for ratio scaling of nausea or discomfort. These have been used to experimentally study the time course of skin pallor and subjective symptoms in laboratory motion sickness. In prolonged sickness, subjects become hypersensitive to nauseogenic stimuli. Results of a Spacelab-1 flight experiment are described in which 4 observers documented the stimulus factors for and the symptoms/signs of space sickness. The clinical character of space sickness differs somewhat from acute laboratory motion sickness. However SL-1 findings support the view that space sickness is fundamentally a motion sickness. Symptoms were subjectively alleviated by head movement restriction, maintenance of a familiar orientation with respect to the visual environment, and wedging between or strapping onto surfaces which provided broad contact cues confirming the absence of body motion.

Spacelab experiments on space motion sickness.

PubMed

Oman, C M

1987-01-01

Recent research results from ground and flight experiments on motion sickness and space sickness conducted by the Man Vehicle Laboratory are reviewed. New tools developed include a mathematical model for motion sickness, a method for quantitative measurements of skin pallor and blush in ambulatory subjects, and a magnitude estimation technique for ratio scaling of nausea or discomfort. These have been used to experimentally study the time course of skin pallor and subjective symptoms in laboratory motion sickness. In prolonged sickness, subjects become hypersensitive to nauseogenic stimuli. Results of a Spacelab-1 flight experiment are described in which four observers documented the stimulus factors for and the symptoms/signs of space sickness. The clinical character of space sickness differs somewhat from acute laboratory motion sickness. However SL-1 findings support the view that space sickness is fundamentally a motion sickness. Symptoms were subjectively alleviated by head movement restriction, maintenance of a familiar orientation with respect to the visual environment, and wedging between or strapping onto surfaces which provided broad contact cues confirming the absence of body motion.

20 CFR 218.28 - Sick pay.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Sick pay. 218.28 Section 218.28 Employees... Beginning Date § 218.28 Sick pay. (a) From railroad employer. If the employee is carried on the payroll while sick, the annuity can begin no earlier than the day after the last day of sick pay. However, sick...

Biological Rhythms Modelisation of Vigilance and Sleep in Microgravity State with COSINOR and Volterra's Kernels Methods

NASA Astrophysics Data System (ADS)

Gaudeua de Gerlicz, C.; Golding, J. G.; Bobola, Ph.; Moutarde, C.; Naji, S.

2008-06-01

The spaceflight under microgravity cause basically biological and physiological imbalance in human being. Lot of study has been yet release on this topic especially about sleep disturbances and on the circadian rhythms (alternation vigilance-sleep, body, temperature...). Factors like space motion sickness, noise, or excitement can cause severe sleep disturbances. For a stay of longer than four months in space, gradual increases in the planned duration of sleep were reported. [1] The average sleep in orbit was more than 1.5 hours shorter than the during control periods on earth, where sleep averaged 7.9 hours. [2] Alertness and calmness were unregistered yield clear circadian pattern of 24h but with a phase delay of 4h.The calmness showed a biphasic component (12h) mean sleep duration was 6.4 structured by 3-5 non REM/REM cycles. Modelisations of neurophysiologic mechanisms of stress and interactions between various physiological and psychological variables of rhythms have can be yet release with the COSINOR method. [3

A new transmission risk index for human African trypanosomiasis and its application in the identification of sites of high transmission of sleeping sickness in the Fontem focus of southwest Cameroon.

PubMed

Njitchouang, G R; Njiokou, F; Nana-Djeunga, H; Asonganyi, T; Fewou-Moundipa, P; Cuny, G; Simo, G

2011-09-01

A new index for the risk for transmission of human African trypanosomiasis was developed from an earlier index by adding terms for the proportion of tsetse infected with Trypanosoma brucei gambiense group 1 and the contribution of animals to tsetse diet. The validity of the new index was then assessed in the Fontem focus of southwest Cameroon. Averages of 0.66 and 4.85 Glossina palpalis palpalis (Diptera: Glossinidae) were caught per trap/day at the end of one rainy season (November) and the start of the next (April), respectively. Of 1596 tsetse flies examined, 4.7% were positive for Trypanosoma brucei s.l. midgut infections and 0.6% for T. b. gambiense group 1. Among 184 bloodmeals identified, 55.1% were from pigs, 25.2% from humans, 17.6% from wild animals and 1.2% from goats. Of the meals taken from humans, 81.5% were taken at sites distant from pigsties. At the end of the rainy season, catches were low and similar between biotopes distant from and close to pigsties, but the risk for transmission was greatest at sites distant from the sties, suggesting that the presence of pigs reduced the risk to humans. At the beginning of the rainy season, catches of tsetse and risk for transmission were greatest close to the sties. In all seasons, there was a strong correlation between the old and new indices, suggesting that both can be used to estimate the level of transmission, but as the new index is the more comprehensive, it may be more accurate. © 2010 The Authors. Medical and Veterinary Entomology © 2010 The Royal Entomological Society.

Sleep patterns at an altitude of 3500 metres

NASA Astrophysics Data System (ADS)

Selvamurthy, W.; Raju, V. R. K.; Ranganathan, S.; Hegde, K. S.; Ray, U. S.

1986-06-01

Alterations in sleep pattern during acclimatisation at an altitude of 3500 m were studied on 27 healthy men (20 30 years of age). Of these, 15 were sojourners (SJ), 6 were acclimatised lowlanders (AL) and 6 were high altitude natives (HAN). Baseline sleep profile of SJ was electrophysiologically monitored, initially at Delhi (260 m) and later at 3500 m altitude in Western Himalayas for 2 weeks. At high altitude (HA) the sleep patterns of AL and HAN were also monitored for comparison. There were 4 cases of acute mountain sickness (AMS) among SJ, whose sleep profiles were also recorded. The state of autonomic arousal was assessed by a battery of indices, while the psychological arousal was measured by the anxiety scales. On completion of studies at HA, the SJ were flown back to the plains and re-tested within one week of return. SJ showed curtailment of slow wave sleep (SWS) and frequent short episodes of arousal during sleep at HA. AL and HAN also had lesser amounts of SWS; however, the arousals and awakenings during sleep were less frequent. Subjects who experienced AMS had normal amounts of SWS at HA. There was sympathetic hyperactivity and slight increase in anxiety level in SJ, while HAN and AL had relatively reduced level of sympathetic activity. The curtailment of SWS and frequent arousals observed in SJ during the initial phase of acclimatisation at HA, appear to be adaptive features to prevent the accentuation of arterial hypoxemia due to sleep hypoventilation.

Clinical and pathological aspects of human African trypanosomiasis (T. b. gambiense) with particular reference to reactive arsenical encephalopathy.

PubMed

Haller, L; Adams, H; Merouze, F; Dago, A

1986-01-01

Fourteen of 330 patients treated with melarsoprol (Mel B) for human African trypanosomiasis (HAT) developed a severe reactive arsenical encephalopathy (RAE). Six of these cases were fatal and postmortem examination was performed on 5 patients. Symptoms of "sleeping sickness" were compared with symptoms after treatment with arsenicals and the subsequent onset of RAE. There are 3 characteristic syndromes of RAE: convulsive status associated with acute cerebral edema, rapidly progressive coma without convulsions, and acute nonlethal mental disturbances without neurological signs. Three subjects revealed hypoxic brain damage with acute cerebral edema, and multiple hemorrhages of brain stem in those comatose. The pathology of the underlying HAT (chronic perivascular inflammation and plasma cytic infiltration of the brain) and the pathology of the RAE (characterized by acute vasculitis) are distinct. RAE occurs in the first as well as in the second stage (CNS involvement) of trypanosomiasis but the reason for this is unclear; an exclusive toxicity of the drug, or a Herxheimer reaction are possible but seem unlikely. Both clinical and laboratory findings point rather to a drug-related, delayed immune response.

Analysis of risk factors for T. brucei rhodesiense sleeping sickness within villages in south-east Uganda

PubMed Central

Zoller, Thomas; Fèvre, Eric M; Welburn, Susan C; Odiit, Martin; Coleman, Paul G

2008-01-01

Background Sleeping sickness (HAT) caused by T.b. rhodesiense is a major veterinary and human public health problem in Uganda. Previous studies have investigated spatial risk factors for T.b. rhodesiense at large geographic scales, but none have properly investigated such risk factors at small scales, i.e. within affected villages. In the present work, we use a case-control methodology to analyse both behavioural and spatial risk factors for HAT in an endemic area. Methods The present study investigates behavioural and occupational risk factors for infection with HAT within villages using a questionnaire-based case-control study conducted in 17 villages endemic for HAT in SE Uganda, and spatial risk factors in 4 high risk villages. For the spatial analysis, the location of homesteads with one or more cases of HAT up to three years prior to the beginning of the study was compared to all non-case homesteads. Analysing spatial associations with respect to irregularly shaped geographical objects required the development of a new approach to geographical analysis in combination with a logistic regression model. Results The study was able to identify, among other behavioural risk factors, having a family member with a history of HAT (p = 0.001) as well as proximity of a homestead to a nearby wetland area (p < 0.001) as strong risk factors for infection. The novel method of analysing complex spatial interactions used in the study can be applied to a range of other diseases. Conclusion Spatial risk factors for HAT are maintained across geographical scales; this consistency is useful in the design of decision support tools for intervention and prevention of the disease. Familial aggregation of cases was confirmed for T. b. rhodesiense HAT in the study and probably results from shared behavioural and spatial risk factors amongmembers of a household. PMID:18590541

Inhibitors incorporating zinc-binding groups target the GlcNAc-PI de-N-acetylase in Trypanosoma brucei, the causative agent of African sleeping sickness.

PubMed

Abdelwahab, Nuha Z; Crossman, Arthur T; Sullivan, Lauren; Ferguson, Michael A J; Urbaniak, Michael D

2012-03-01

Disruption of glycosylphosphatidylinositol biosynthesis is genetically and chemically validated as a drug target against the protozoan parasite Trypanosoma brucei, the causative agent of African sleeping sickness. The N-acetylglucosamine-phosphatidylinositol de-N-acetylase (deNAc) is a zinc metalloenzyme responsible for the second step of glycosylphosphatidylinositol biosynthesis. We recently reported the synthesis of eight deoxy-2-C-branched monosaccharides containing carboxylic acid, hydroxamic acid, or N-hydroxyurea substituents at the C2 position that may act as zinc-binding groups. Here, we describe the synthesis of a glucocyclitol-phospholipid incorporating a hydroxamic acid moiety and report the biochemical evaluation of the monosaccharides and the glucocyclitol-phospholipid as inhibitors of the trypanosome deNAc in the cell-free system and against recombinant enzyme. Monosaccharides with carboxylic acid or hydroxamic acid substituents were found to be the inhibitors of the trypanosome deNAc with IC(50) values 0.1-1.5mM and the glucocyclitol-phospholipid was found to be a dual inhibitor of the deNAc and the α1-4-mannose transferase with an apparent IC(50)= 19±0.5μm. © 2011 John Wiley & Sons A/S.

The challenging problem of disease staging in human African trypanosomiasis (sleeping sickness): a new approach to a circular question.

PubMed

Njamnshi, Alfred K; Gettinby, George; Kennedy, Peter G E

2017-05-01

Human African trypanosomiasis (HAT), also known as sleeping sickness, puts millions of people at risk in sub-Saharan Africa and is a neglected parasitic disease that is almost always fatal if untreated or inadequately treated. HAT manifests itself in two stages that are difficult to distinguish clinically. The problem of staging in HAT is extremely important since treatment options, some of which are highly toxic, are directly linked to the disease stage. Several suggested investigations for disease staging have been problematic because of the lack of an existing gold standard with which to compare new clinical staging markers. The somewhat arbitrary current criteria based on the cerebrospinal fluid (CSF) white blood cell (WBC) count have been widely used, but the new potential biomarkers are generally compared with these, thereby making the problem somewhat circular in nature. We propose an alternative 'reverse' approach to address this problem, conceptualised as using appropriate statistical methods to test the performance of combinations of established laboratory variables as staging biomarkers to correlate with the CSF WBC/trypanosomes and clinical features of HAT. This approach could lead to the use of established laboratory staging markers, potentially leading to a gold standard for staging and clinical follow-up of HAT. © The Author 2017. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Statistical prediction of space motion sickness

NASA Technical Reports Server (NTRS)

Reschke, Millard F.

1990-01-01

Studies designed to empirically examine the etiology of motion sickness to develop a foundation for enhancing its prediction are discussed. Topics addressed include early attempts to predict space motion sickness, multiple test data base that uses provocative and vestibular function tests, and data base subjects; reliability of provocative tests of motion sickness susceptibility; prediction of space motion sickness using linear discriminate analysis; and prediction of space motion sickness susceptibility using the logistic model.

[Sleep disorders among physicians on shift work].

PubMed

Schlafer, O; Wenzel, V; Högl, B

2014-11-01

Sleep disorders in physicians who perform shift work can result in increased risks of health problems that negatively impact performance and patient safety. Even those who cope well with shift work are likely to suffer from sleep disorders. The aim of this manuscript is to discuss possible causes, contributing factors and consequences of sleep disorders in physicians and to identify measures that can improve adaptation to shift work and treatment strategies for shift work-associated sleep disorders. The risk factors that influence the development of sleep disorders in physicians are numerous and include genetic factors (15 % of the population), age (> 50 years), undiagnosed sleep apnea,, alcohol abuse as well as multiple stress factors inherent in clinical duties (including shift work), research, teaching and family obligations. Several studies have reported an increased risk for medical errors in sleep-deprived physicians. Shift workers have an increased risk for psychiatric and cardiovascular diseases and shift work may also be a contributing factor to cancer. A relationship has been reported not only with sleep deprivation and changes in food intake but also with diabetes mellitus, obesity, hypertension and coronary heart disease. Nicotine and alcohol consumption are more frequent among shift workers. Increased sickness and accident rates among physicians when commuting (especially after night shifts) have a socioeconomic impact. In order to reduce fatigue and to improve performance, short naps during shiftwork or naps plus caffeine, have been proposed as coping strategies; however, napping during adverse circadian phases is less effective, if not impossible when unable to fall asleep. Bright and blue light supports alertness during a night shift. After shiftwork, direct sunlight exposure to the retina can be avoided by using dark sunglasses or glasses with orange lenses for commuting home. The home environment for daytime sleeping after a night shift should be

Workers not Paid for Sick Leave after Implementation of the New York City Paid Sick Leave Law.

PubMed

Hall, Gerod Sharper; Walters, Sarah; Wimer, Christopher; Levanon Seligson, Amber; Maury, Matthew; Waldfogel, Jane; Gould, L Hannah; Lim, Sungwoo

2018-02-01

This study examined factors associated with being paid for sick leave after implementation of the New York City (NYC) paid sick leave law. A random sample of NYC residents was surveyed by telephone multiple times over a 2-year period. Participants (n = 1195) reported socio-demographics, awareness of the law, income, work hours per week, and payment for sick time off work. In the year after implementation of the law, part-time workers were significantly more likely to attend work while sick than full-time workers (relative risk = 1.25, 95% CI = 1.1, 1.4). Seventy percent of workers who missed work due to illness (n = 249) were paid for sick leave. Part-time workers, respondents not aware of the benefit (30% of workers), and workers without a college degree were the least likely to be paid for sick days. More than one third (37%) of persons not paid for sick leave worked in retail, food service, or health care. Although 70% of respondents were paid for sick leave after implementation of the law, part-time workers and workers with low education were least likely to access the benefit and more likely to work while sick. The disparity in paid sick leave may have public health consequences as many persons not paid for sick leave had occupations that carry a high risk of disease transmission to others.

Actigraphy in Human African Trypanosomiasis as a Tool for Objective Clinical Evaluation and Monitoring: A Pilot Study

PubMed Central

Njamnshi, Alfred K.; Seke Etet, Paul F.; Perrig, Stephen; Acho, Alphonse; Funsah, Julius Y.; Mumba, Dieudonné; Muyembe, Jean-Jacques; Kristensson, Krister; Bentivoglio, Marina

2012-01-01

Background Human African trypanosomiasis (HAT) or sleeping sickness leads to a complex neuropsychiatric syndrome with characteristic sleep alterations. Current division into a first, hemolymphatic stage and second, meningoencephalitic stage is primarily based on the detection of white blood cells and/or trypanosomes in the cerebrospinal fluid. The validity of this criterion is, however, debated, and novel laboratory biomarkers are under study. Objective clinical HAT evaluation and monitoring is therefore needed. Polysomnography has effectively documented sleep-wake disturbances during HAT, but could be difficult to apply as routine technology in field work. The non-invasive, cost-effective technique of actigraphy has been widely validated as a tool for the ambulatory evaluation of sleep disturbances. In this pilot study, actigraphy was applied to the clinical assessment of HAT patients. Methods/Principal Findings Actigraphy was recorded in patients infected by Trypanosoma brucei gambiense, and age- and sex-matched control subjects. Simultaneous nocturnal polysomnography was also performed in the patients. Nine patients, including one child, were analyzed at admission and two of them also during specific treatment. Parameters, analyzed with user-friendly software, included sleep time evaluated from rest-activity signals, rest-activity rhythm waveform and characteristics. The findings showed sleep-wake alterations of various degrees of severity, which in some patients did not parallel white blood cell counts in the cerebrospinal fluid. Actigraphic recording also showed improvement of the analyzed parameters after treatment initiation. Nocturnal polysomnography showed alterations of sleep time closely corresponding to those derived from actigraphy. Conclusions/Significance The data indicate that actigraphy can be an interesting tool for HAT evaluation, providing valuable clinical information through simple technology, well suited also for long-term follow

[Workplace bullying and sickness absenteeism].

PubMed

Campanini, Paolo; Conway, Paul Maurice; Neri, Luca; Punzi, Silvia; Camerino, Donatella; Costa, Giovanni

2013-01-01

To assess the relationship between workplace bullying and sickness absenteeism in a large sample of Italian workers. A cross-sectional study conducted by means of questionnaires. In all, 8,992 subjects filled in a questionnaire to detect workplace bullying, the presence of work stress factors and days of sickness absence in the last year. Workplace bullying and psychosocial stressor were measured by the means of the CDL 2.0 questionnaire. Days of sickness absence reported by the subjects. On average, days of sickness absence were 7.4, and 7.2% of the respondents were defined as bullied. Results from logistic regression analyses showed that a workplace bullying was associated with more days of sickness absence after controlling for gender, age, professional qualification, company sector and juridical nature and other psychosocial factors (men: OR =1.62; women: OR =2.15). The present study confirms that workers exposed to a workplace bullying reported higher sickness absenteeism as compared with non-exposed subjects, also when a potentially highly stressful work environment is considered. The results of the present study support that workplace bullying may be viewed as an extreme stressful condition. Interventions to avoid workplace bullying not only favoure workers' health, but also avoid the company costs associated with workers' sickness absenteeism.

Theory of antimotion sickness drug mechanisms.

NASA Technical Reports Server (NTRS)

Wood, D. C.; Graybiel, A.

1972-01-01

The results of a series of antimotion sickness drug evaluations indicates that drugs with central anticholinergic actions and drugs that increase central sympathetic activity are effective against motion sickness. The combination of these actions produces a synergistic effect against motion sickness. The effect of these medications on central acetylcholine or on norepinephrine could alter a balance between the neurons in the vestibular and reticular areas which influence motion sickness and also sympathetic and parasympathetic reactions. It is suggested that this could be their mechanism of action in preventing motion sickness.

Sick Leave and Factors Influencing Sick Leave in Adult Patients with Atopic Dermatitis: A Cross-Sectional Study.

PubMed

van Os-Medendorp, Harmieke; Appelman-Noordermeer, Simone; Bruijnzeel-Koomen, Carla; de Bruin-Weller, Marjolein

2015-03-27

Little is known about the prevalence of sick leave due to atopic dermatitis (AD). The current literature on factors influencing sick leave is mostly derived from other chronic inflammatory diseases. This study aimed to determine the prevalence of sick leave due to AD and to identify influencing factors. A cross-sectional study was carried out in adult patients with AD. sick leave during the two-week and one-year periods, socio-demographic characteristics, disease severity, quality of life and socio-occupational factors. Logistic regression analyses were used to determine influencing factors on sick leave over the two-week period. In total, 253 patients were included; 12% of the patients had to take sick leave in the last two weeks due to AD and 42% in the past year. A higher level of symptom interference (OR 1.26; 95% CI 1.13-1.40) or perfectionism/diligence (OR 0.90; 95% CI 0.83-0.96) may respectively increase or decrease the number of sick leave days. Sick leave in patients with AD is a common problem and symptom interference and perfectionism/diligence appeared to influence it. Novel approaches are needed to deal with symptoms at work or school to reduce the amount of sick leave due to AD.

Sickness absence and sickness attendance--what people with neck or back pain think.

PubMed

Hansson, Margareta; Boström, Carina; Harms-Ringdahl, Karin

2006-05-01

This study explores the decision of 33 men and women to be sick-listed from work for neck pain or low-back pain. Qualitative interviews with the subjects, who lived in a city or a sparsely populated area of Sweden, were tape-recorded, transcribed and analysed in the interpretive tradition by the three authors. New, intense and threatening pain quickly made persons report sick. For other pain, sickness absence, its timing and duration, were negotiated on the basis of the subjects' self-image, work-duty norms, organisational and extra-organisational work factors. Thirty-one people aimed to return to work, but spine-related pain was a hindrance. Five strategies to avoid, delay or shorten sickness absence were identified. Concepts of the illness flexibility model well described how the workers balanced the factors driving them from work and those forcing them or attracting them to remain. The conclusion is that reporting sick is neither undertaken lightly nor for short-term reasons only. Instead, personal history and anticipated future, spine-related pain, workplace and labour market factors are also important considerations.

Prediction of helicopter simulator sickness

DOE Office of Scientific and Technical Information (OSTI.GOV)

Horn, R.D.; Birdwell, J.D.; Allgood, G.O.

1990-01-01

Machine learning methods from artificial intelligence are used to identify information in sampled accelerometer signals and associative behavioral patterns which correlates pilot simulator sickness with helicopter simulator dynamics. These simulators are used to train pilots in fundamental procedures, tactics, and response to emergency conditions. Simulator sickness induced by these systems represents a risk factor to both the pilot and manufacturer. Simulator sickness symptoms are closely aligned with those of motion sickness. Previous studies have been performed by behavioral psychologists using information gathered with surveys and motor skills performance measures; however, the results are constrained by the limited information which ismore » accessible in this manner. In this work, accelerometers were installed in the simulator cab, enabling a complete record of flight dynamics and the pilot's control response as a function of time. Given the results of performance measures administered to detect simulator sickness symptoms, the problem was then to find functions of the recorded data which could be used to help predict the simulator sickness level and susceptibility. Methods based upon inductive inference were used, which yield decision trees whose leaves indicate the degree of simulator-induced sickness. The long-term goal is to develop a gauge'' which can provide an on-line prediction of simulator sickness level, given a pilot's associative behavioral patterns (learned expectations). This will allow informed decisions to be made on when to terminate a hop and provide an effective basis for determining training and flight restrictions placed upon the pilot after simulator use. 6 refs., 6 figs.« less

Motion sickness: Can it be controlled

NASA Technical Reports Server (NTRS)

Carnes, David

1988-01-01

NASA is one of the few research centers concerned with motion sickness. Since the physiology of man has been developed in the one-gravity field Earth, the changes experienced by man in space are unique, and often result in symptoms that resemble motion sickness on Earth. NASA is concerned with motion sickness because it is very uncomfortable for the astronauts. Another concern of NASA is the possibility of a motion sickness astronaut regurgitating while he or she is sealed in an airtight space suit. This could be fatal. Motivated by these reasons, NASA spent thousands of dollars in research and development for a drug or technique for combating motion sickness. Several different treatments were developed for this disorder. Three of the most effective ways of combatting motion sickness are discussed.

Sick Leave and Factors Influencing Sick Leave in Adult Patients with Atopic Dermatitis: A Cross-Sectional Study

PubMed Central

van Os-Medendorp, Harmieke; Appelman-Noordermeer, Simone; Bruijnzeel-Koomen, Carla; de Bruin-Weller, Marjolein

2015-01-01

Background: Little is known about the prevalence of sick leave due to atopic dermatitis (AD). The current literature on factors influencing sick leave is mostly derived from other chronic inflammatory diseases. This study aimed to determine the prevalence of sick leave due to AD and to identify influencing factors. Methods: A cross-sectional study was carried out in adult patients with AD. Outcome measures: sick leave during the two-week and one-year periods, socio-demographic characteristics, disease severity, quality of life and socio-occupational factors. Logistic regression analyses were used to determine influencing factors on sick leave over the two-week period. Results: In total, 253 patients were included; 12% of the patients had to take sick leave in the last two weeks due to AD and 42% in the past year. A higher level of symptom interference (OR 1.26; 95% CI 1.13–1.40) or perfectionism/diligence (OR 0.90; 95% CI 0.83–0.96) may respectively increase or decrease the number of sick leave days. Conclusion: Sick leave in patients with AD is a common problem and symptom interference and perfectionism/diligence appeared to influence it. Novel approaches are needed to deal with symptoms at work or school to reduce the amount of sick leave due to AD. PMID:26239345

Advances in Pharmacotherapeutics of Space Motion Sickness

NASA Technical Reports Server (NTRS)

Putcha, Lakshmi

2006-01-01

Space Motion Sickness (SMS) is common occurrence in the U.S. manned space flight program and nearly 2/3 of Shuttle crewmembers experience SMS. Several drugs have been prescribed for therapeutic management of SMS. Typically, orally-administered SMS medications (scopolamine, promethazine) have poor bioavailability and often have detrimental neurocognitive side effects at recommended doses. Intramuscularly administered promethazine (PMZ) is perceived to have optimal efficacy with minimal side effects in space. However, intramuscular injections are painful and the sedating neurocognitive side effects of promethazine, significant in controlled ground testing, may be masked in orbit because injections are usually given prior to crew sleep. Currently, EVAs cannot be performed by symptomatic crew or prior to flight day three due to the lack of a consistently efficacious drug, concern about neurocognitive side effects, and because an in-suit vomiting episode is potentially fatal. NASA has long sought a fast acting, consistently effective anti-motion sickness medication which has only minor neurocognitive side effects. Development of intranasal formulations of scopolamine and promethazine, the two commonly used SMS drugs at NASA for both space and reduced gravity environment medical operations, appears to be a logical alternative to current treatment modalities for SMS. The advantages are expected to be fast absorption, reliable and high bioavailability, and probably reduced neurocognitive side effects owing to dose reduction. Results from clinical trials with intranasal scopolamine gel formulation and pre-clinical testing of a prototype microcapsule intranasal gel dosage form of PMZ (INPMZ) will be discussed. These formulations are expected to offer a dependable and effective noninvasive treatment option for SMS.

Study Looking at End Expiratory Pressure for Altitude Illness Decrease (SLEEP-AID).

PubMed

Lipman, Grant S; Kanaan, Nicholas C; Phillips, Caleb; Pomeranz, Dave; Cain, Patrick; Fontes, Kristin; Higbee, Becky; Meyer, Carolyn; Shaheen, Michael; Wentworth, Sean; Walsh, Diane

2015-06-01

Lipman, Grant S., Nicholas C. Kanaan, Caleb Phillips, Dave Pomeranz, Patrick Cain, Kristin Fontes, Becky Higbee, Carolyn Meyer, Michael Shaheen, Sean Wentworth, and Diane Walsh. Study Looking at End Expiratory Pressure for Altitude Illness Decrease (SLEEP-AID). High Alt Med Biol 16:154-161, 2015.--Acute mountain sickness (AMS) affects 25%-70% of the tens of millions of high altitude travelers annually, with hypoxia and nocturnal desaturations as major contributing factors. This is the first double blind randomized placebo controlled trial to assess expiratory positive airway pressure (EPAP) for AMS prevention and nocturnal hypoxic events. Healthy adult participants trekking in the Khumbu region of the Himalayas were randomized to a single-use EPAP nasal strip, or a visually identical sham device (placebo) prior to first night sleeping between 4371-4530 m (14,340-14,800 ft). The primary outcome was AMS incidence, measured by Lake Louise Questionnaire (LLQ), with secondary outcomes of AMS severity (by LLQ) and physiologic sleep indices measured by continuous sleep monitor. Intent-to-treat analysis included 219 participants with comparable demographic characteristics, of which 115 received EPAP and 104 placebo. There was no decrease in AMS with EPAP intervention (14% EPAP vs. 17% placebo; p=0.65; risk difference (-)3.15%, 95% CI (-)12.85%-6.56%). While overall AMS severity was not different between groups, EPAP reported decreased incidence of headache (64% vs. 76%; p<0.05, OR 0.51, 95% CI 0.27-0.95) and dizziness (81% vs. 98%; p<0.03, OR 0.29, 95% CI 0.09-0.78). During sleep, EPAP resulted in significant improvements in average peripheral oxygenation (Spo(2)) (80% versus 78%; p<0.01, mean difference=2, 95% CI 0.58-3.63) and a reduced percentage of time below 80% Spo(2) (31% vs. 46%; p<0.03, median difference=16, 95% CI 2.22-28.18). This lightweight and inexpensive EPAP device did not prevent acute mountain sickness, but did reduce the subgroup incidence of

Predicting motion sickness during parabolic flight

NASA Technical Reports Server (NTRS)

Harm, Deborah L.; Schlegel, Todd T.

2002-01-01

BACKGROUND: There are large individual differences in susceptibility to motion sickness. Attempts to predict who will become motion sick have had limited success. In the present study, we examined gender differences in resting levels of salivary amylase and total protein, cardiac interbeat intervals (R-R intervals), and a sympathovagal index and evaluated their potential to correctly classify individuals into two motion sickness severity groups. METHODS: Sixteen subjects (10 men and 6 women) flew four sets of 10 parabolas aboard NASA's KC-135 aircraft. Saliva samples for amylase and total protein were collected preflight on the day of the flight and motion sickness symptoms were recorded during each parabola. Cardiovascular parameters were collected in the supine position 1-5 days before the flight. RESULTS: There were no significant gender differences in sickness severity or any of the other variables mentioned above. Discriminant analysis using salivary amylase, R-R intervals and the sympathovagal index produced a significant Wilks' lambda coefficient of 0.36, p=0.006. The analysis correctly classified 87% of the subjects into the none-mild sickness or the moderate-severe sickness group. CONCLUSIONS: The linear combination of resting levels of salivary amylase, high-frequency R-R interval levels, and a sympathovagal index may be useful in predicting motion sickness severity.

Predicting Motion Sickness During Parabolic Flight

NASA Technical Reports Server (NTRS)

Harm, Deborah L.; Schlegel, Todd T.

2002-01-01

Background: There are large individual differences in susceptibility to motion sickness. Attempts to predict who will become motion sick have had limited success. In the present study we examined gender differences in resting levels of salivary amylase and total protein, cardiac interbeat intervals (R-R intervals), and a sympathovagal index and evaluated their potential to correctly classify individuals into two motion sickness severity groups. Methods: Sixteen subjects (10 men and 6 women) flew 4 sets of 10 parabolas aboard NASA's KC-135 aircraft. Saliva samples for amylase and total protein were collected preflight on the day of the flight and motion sickness symptoms were recorded during each parabola. Cardiovascular parameters were collected in the supine position 1-5 days prior to the flight. Results: There were no significant gender differences in sickness severity or any of the other variables mentioned above. Discriminant analysis using salivary amylase, R-R intervals and the sympathovagal index produced a significant Wilks' lambda coefficient of 0.36, p= 0.006. The analysis correctly classified 87% of the subjects into the none-mild sickness or the moderate-severe sickness group. Conclusions: The linear combination of resting levels of salivary amylase, high frequency R-R interval levels, and a sympathovagal index may be useful in predicting motion sickness severity.

Self-Motion Perception and Motion Sickness

NASA Technical Reports Server (NTRS)

Fox, Robert A.

1991-01-01

Motion sickness typically is considered a bothersome artifact of exposure to passive motion in vehicles of conveyance. This condition seldom has significant impact on the health of individuals because it is of brief duration, it usually can be prevented by simply avoiding the eliciting condition and, when the conditions that produce it are unavoidable, sickness dissipates with continued exposure. The studies conducted examined several aspects of motion sickness in animal models. A principle objective of these studies was to investigate the neuroanatomy that is important in motion sickness with the objectives of examining both the utility of putative models and defining neural mechanisms that are important in motion sickness.

Treatment of severe motion sickness with antimotion sickness drug injections

NASA Technical Reports Server (NTRS)

Graybiel, Ashton; Lackner, James R.

1987-01-01

This report concerns the use of intramuscular injections of scopolamine, promethazine, and dramamine to treat severely motion sick individuals participating in parabolic flight experiments. The findings indicate that a majority of individuals received benefit from 50-mg injections of promethazine or 0.5 mg-injections of scopolamine. By contrast, 50-mg injections of dramamine and 25-mg injections of promethazine were nonbeneficial. The use of antimotion drug injections for treating space motion sickness is discussed.

Office design's impact on sick leave rates.

PubMed

Bodin Danielsson, Christina; Chungkham, Holendro Singh; Wulff, Cornelia; Westerlund, Hugo

2014-01-01

The effect of office type on sickness absence among office employees was studied prospectively in 1852 employees working in (1) cell-offices; (2) shared-room offices; (3) small, (4) medium-sized and (5) large open-plan offices; (6) flex-offices and (7) combi-offices. Sick leaves were self-reported two years later as number of (a) short and (b) long (medically certified) sick leave spells as well as (c) total number of sick leave days. Multivariate logistic regression analysis was used, with adjustment for background factors. A significant excess risk for sickness absence was found only in terms of short sick leave spells in the three open-plan offices. In the gender separate analysis, this remained for women, whereas men had a significantly increased risk in flex-offices. For long sick leave spells, a significantly higher risk was found among women in large open-plan offices and for total number of sick days among men in flex-offices. A prospective study of the office environment's effect on employees is motivated by the high rates of sick leaves in the workforce. The results indicate differences between office types, depending on the number of people sharing workspace and the opportunity to exert personal control as influenced by the features that define the office types.

Effect of lipopolysaccharide on sickness behaviour in hens kept in cage and free range environments.

PubMed

Gregory, N G; Payne, S R; Devine, C D; Cook, C J

2009-08-01

The aim of this study was to assess whether environmental enrichment and environmental conditions can influence the expression of sickness behaviour. The behaviour in response to injection of lipopolysaccharide or saline was examined in a total of 96 62-weeks old hatchmate hens kept in a free range or cage environment. There were eight experimental treatments, each with 12 birds. Half the birds were sourced from a commercial cage layer unit (C/-) and half from a commercial free range unit (FR/-). After intraperitoneal injection with either lipopolysaccharide or saline (as a control), the hens were placed in either a cage (-/C) or free range (-/FR) environment. Lipopolysaccharide caused greater suppression of activity in free range (FR/FR) than in caged hens, including less walking (53% reduction), roosting (-86%) and preening (-60%) (p<0.05). Those responses were not observed in caged birds released into free range, nor in free range birds introduced to cages, suggesting that both the presence of and the familiarity with an environment affected sickness behaviour patterns. Increased sleeping was the most consistent response (+147%; p<0.001), and it was least influenced by environment. It was concluded that free range layer hens can express a greater range of sickness behaviours than caged hens, and this may make it more difficult to recognise disease expression in the caged environment.

Preventing recurrence of severe morning sickness

PubMed Central

Koren, Gideon; Maltepe, Caroline

2006-01-01

QUESTION A recent Motherisk article showed that initiating antinauseants even before symptoms start could prevent recurrence of severe morning sickness. In the study described, however, different physicians used different drugs. How can one be sure which drugs work? ANSWER The study of 26 women who had had severe morning sickness during previous pregnancies showed that using antiemetics before symptoms of morning sickness started appeared to prevent recurrence of severe morning sickness in subsequent pregnancies. Physicians in the United States used various antinauseant drugs. Physicians in Canada administered only one drug, the combination of doxylamine-pyridoxine (Diclectin®), to 12 women. Subanalysis of these 12 women revealed that pre-emptive use of doxylamine-pyridoxine significantly decreased the likelihood that severe morning sickness would recur. PMID:17279232

Preventing recurrence of severe morning sickness.

PubMed

Koren, Gideon; Maltepe, Caroline

2006-12-01

A recent Motherisk article showed that initiating antinauseants even before symptoms start could prevent recurrence of severe morning sickness. In the study described, however, different physicians used different drugs. How can one be sure which drugs work? The study of 26 women who had had severe morning sickness during previous pregnancies showed that using antiemetics before symptoms of morning sickness started appeared to prevent recurrence of severe morning sickness in subsequent pregnancies. Physicians in the United States used various antinauseant drugs. Physicians in Canada administered only one drug, the combination of doxylamine-pyridoxine (Diclectin), to 12 women. Subanalysis of these 12 women revealed that pre-emptive use of doxylamine-pyridoxine significantly decreased the likelihood that severe morning sickness would recur.

20 CFR 335.4 - Filing statement of sickness and claim for sickness benefits.

Code of Federal Regulations, 2012 CFR

2012-04-01

... RAILROAD UNEMPLOYMENT INSURANCE ACT SICKNESS BENEFITS § 335.4 Filing statement of sickness and claim for... circumstances beyond the employee's control; or (4) The employee mistakenly registered for unemployment benefits... unemployment benefits were denied; or (5) Notwithstanding the foregoing, any claim that is not filed within two...

20 CFR 335.4 - Filing statement of sickness and claim for sickness benefits.

Code of Federal Regulations, 2011 CFR

2011-04-01

... RAILROAD UNEMPLOYMENT INSURANCE ACT SICKNESS BENEFITS § 335.4 Filing statement of sickness and claim for... circumstances beyond the employee's control; or (4) The employee mistakenly registered for unemployment benefits... unemployment benefits were denied; or (5) Notwithstanding the foregoing, any claim that is not filed within two...

20 CFR 335.4 - Filing statement of sickness and claim for sickness benefits.

Code of Federal Regulations, 2014 CFR

2014-04-01

... RAILROAD UNEMPLOYMENT INSURANCE ACT SICKNESS BENEFITS § 335.4 Filing statement of sickness and claim for... circumstances beyond the employee's control; or (4) The employee mistakenly registered for unemployment benefits... unemployment benefits were denied; or (5) Notwithstanding the foregoing, any claim that is not filed within two...

20 CFR 335.4 - Filing statement of sickness and claim for sickness benefits.

Code of Federal Regulations, 2013 CFR

2013-04-01

... RAILROAD UNEMPLOYMENT INSURANCE ACT SICKNESS BENEFITS § 335.4 Filing statement of sickness and claim for... circumstances beyond the employee's control; or (4) The employee mistakenly registered for unemployment benefits... unemployment benefits were denied; or (5) Notwithstanding the foregoing, any claim that is not filed within two...

Animal models in motion sickness research

NASA Technical Reports Server (NTRS)

Daunton, Nancy G.

1990-01-01

Practical information on candidate animal models for motion sickness research and on methods used to elicit and detect motion sickness in these models is provided. Four good potential models for use in motion sickness experiments include the dog, cat, squirrel monkey, and rat. It is concluded that the appropriate use of the animal models, combined with exploitation of state-of-the-art biomedical techniques, should generate a great step forward in the understanding of motion sickness mechanisms and in the development of efficient and effective approaches to its prevention and treatment in humans.

Sickness absence at a young age and later sickness absence, disability pension, death, unemployment and income in native Swedes and immigrants.

PubMed

Helgesson, Magnus; Johansson, Bo; Nordqvist, Tobias; Lundberg, Ingvar; Vingård, Eva

2015-08-01

Sickness absence with cash benefits from the sickness insurance gives an opportunity to be relieved from work without losing financial security. There are, however, downsides to taking sickness absence. Periods of sickness absence, even short ones, can increase the risk for future spells of sickness absence and unemployment. The sickness period may in itself have a detrimental effect on health. The aim of the study was to investigate if there is an association between exposure to sickness absence at a young age and later sickness absence, disability pension, death, unemployment and income from work. Our cohort consisted of all immigrants aged 21-25 years in Sweden in 1993 (N = 38 207) and a control group of native Swedes in the same age group (N = 225 977). We measured exposure to sickness absence in 1993 with a follow-up period of 15 years. We conducted separate analyses for men and women, and for immigrants and native Swedes. Exposure to ≥60 days of sickness absence in 1993 increased the risk of sickness absence [hazard ratio (HR) 1.6-11.4], unemployment (HR 1.1-1.2), disability pension (HR 1.2-5.3) and death (HR 1.2-3.5). The income from work, during the follow-up period, among individuals with spells of sick leave for ≥60 days in 1993 was around two-thirds of that of the working population who did not take sick leave. Individuals on sickness absence had an increased risk for work absence, death and lower future income. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association.

Self Motion Perception and Motion Sickness

NASA Technical Reports Server (NTRS)

Fox, Robert A. (Principal Investigator)

1991-01-01

The studies conducted in this research project examined several aspects of motion sickness in animal models. A principle objective of these studies was to investigate the neuroanatomy that is important in motion sickness with the objectives of examining both the utility of putative models and defining neural mechanisms that are important in motion sickness.

Targeting the HSP60/10 chaperonin systems of Trypanosoma brucei as a strategy for treating African sleeping sickness.

PubMed

Abdeen, Sanofar; Salim, Nilshad; Mammadova, Najiba; Summers, Corey M; Goldsmith-Pestana, Karen; McMahon-Pratt, Diane; Schultz, Peter G; Horwich, Arthur L; Chapman, Eli; Johnson, Steven M

2016-11-01

Trypanosoma brucei are protozoan parasites that cause African sleeping sickness in humans (also known as Human African Trypanosomiasis-HAT). Without treatment, T. brucei infections are fatal. There is an urgent need for new therapeutic strategies as current drugs are toxic, have complex treatment regimens, and are becoming less effective owing to rising antibiotic resistance in parasites. We hypothesize that targeting the HSP60/10 chaperonin systems in T. brucei is a viable anti-trypanosomal strategy as parasites rely on these stress response elements for their development and survival. We recently discovered several hundred inhibitors of the prototypical HSP60/10 chaperonin system from Escherichia coli, termed GroEL/ES. One of the most potent GroEL/ES inhibitors we discovered was compound 1. While examining the PubChem database, we found that a related analog, 2e-p, exhibited cytotoxicity to Leishmania major promastigotes, which are trypanosomatids highly related to Trypanosoma brucei. Through initial counter-screening, we found that compounds 1 and 2e-p were also cytotoxic to Trypanosoma brucei parasites (EC 50 =7.9 and 3.1μM, respectively). These encouraging initial results prompted us to develop a library of inhibitor analogs and examine their anti-parasitic potential in vitro. Of the 49 new chaperonin inhibitors developed, 39% exhibit greater cytotoxicity to T. brucei parasites than parent compound 1. While many analogs exhibit moderate cytotoxicity to human liver and kidney cells, we identified molecular substructures to pursue for further medicinal chemistry optimization to increase the therapeutic windows of this novel class of chaperonin-targeting anti-parasitic candidates. An intriguing finding from this study is that suramin, the first-line drug for treating early stage T. brucei infections, is also a potent inhibitor of GroEL/ES and HSP60/10 chaperonin systems. Copyright © 2016 Elsevier Ltd. All rights reserved.

Relationship of airflow limitation severity with work productivity reduction and sick leave in a Japanese working population.

PubMed

Onoue, Ayumi; Omori, Hisamitsu; Katoh, Takahiko; Kubota, Kenichi; Nonami, Yoshio; Ogata, Yasuhiro; Inoue, Hiromasa

2016-01-01

The aim of this study was to reveal the association between airflow limitation (AL) severity and reduction with work productivity as well as use of sick leave among Japanese workers. This cross-sectional study included 1,378 workers who underwent a lung function test during a health checkup at the Japanese Red Cross Kumamoto Health Care Center. AL was defined as forced expiratory volume in 1 second/forced vital capacity of <0.7. Workers completed a questionnaire on productivity loss at work and sick leave. The quality and quantity of productivity loss at work were measured on a ten-point scale indicating how much work was actually performed on the previous workday. Participants were asked how many days in the past 12 months they were unable to work because of health problems. Logistic regression analysis was used to assess the associations between AL severity and the quality and quantity of productivity loss at work as well as use of sick leave. Compared with workers without AL, workers with moderate-to-severe AL showed a significant productivity loss (quality: odds ratio [OR] =2.04, 95% confidence interval [CI]: 1.12-3.71, P=0.02 and quantity: OR =2.19, 95% CI: 1.20-4.00, P=0.011) and use of sick leave (OR =2.69, 95% CI: 1.33-5.44, P=0.006) after adjusting for sex, age, body mass index, smoking status, hypertension, hyperglycemia, dyslipidemia, sleep duration, work hours per day, and workplace smoking environment. AL severity was significantly associated with work productivity loss and use of sick leave. Our findings suggested that early intervention in the subjects with AL at the workforce might be beneficial for promoting work ability.

Morning Sickness: Nausea and Vomiting of Pregnancy

MedlinePlus

... About ACOG Morning Sickness: Nausea and Vomiting of Pregnancy Home For Patients Search FAQs Morning Sickness: Nausea ... PDF Format Morning Sickness: Nausea and Vomiting of Pregnancy Pregnancy How common is nausea and vomiting of ...

Diabetes - when you are sick

MedlinePlus

... gov/ency/patientinstructions/000079.htm Diabetes - when you are sick To use the sharing features on this ... call or see your provider. Eating When you are Sick When you have an upset stomach, try ...

Effect of short-term acclimatization to high altitude on sleep and nocturnal breathing.

PubMed

Nussbaumer-Ochsner, Yvonne; Ursprung, Justyna; Siebenmann, Christoph; Maggiorini, Marco; Bloch, Konrad E

2012-03-01

Objective physiologic data on sleep and nocturnal breathing at initial exposure and during acclimatization to high altitude are scant. We tested the hypothesis that acute exposure to high altitude induces quantitative and qualitative changes in sleep and that these changes are partially reversed with acclimatization. Prospective observation. One night in a sleep laboratory at 490 meters, the first and the third night in a mountain hut at 4559 meters. Sixteen healthy mountaineers. Altitude exposure. Polysomnography, questionnaire evaluation of sleep and acute mountain sickness. Compared to 490 m, median nocturnal oxygen saturation decreased during the 1st night at 4559 m from 96% to 67%, minute ventilation increased from 4.4 to 6.3 L/min, and the apnea-hypopnea index increased from 0.1 to 60.9/h; correspondingly, sleep efficiency decreased from 93% to 69%, and slow wave sleep from 18% to 6% (P < 0.05, all instances). During the 3rd night at 4559 m, oxygen saturation was 71%, slow wave sleep 11% (P < 0.05 vs. 1st night, both instances) and the apnea/hypopnea index was 86.5/h (P = NS vs. 1st night). Symptoms of AMS and of disturbed sleep were significantly reduced in the morning after the 3rd vs. the 1st night at 4559 m. In healthy mountaineers ascending rapidly to high altitude, sleep quality is initially impaired but improves with acclimatization in association with improved oxygen saturation, while periodic breathing persists. Therefore, high altitude sleep disturbances seem to be related predominantly to hypoxemia rather than to periodic breathing.

The RFamide receptor DMSR-1 regulates stress-induced sleep in C. elegans.

PubMed

Iannacone, Michael J; Beets, Isabel; Lopes, Lindsey E; Churgin, Matthew A; Fang-Yen, Christopher; Nelson, Matthew D; Schoofs, Liliane; Raizen, David M

2017-01-17

In response to environments that cause cellular stress, animals engage in sleep behavior that facilitates recovery from the stress. In Caenorhabditis elegans , stress-induced sleep(SIS) is regulated by cytokine activation of the ALA neuron, which releases FLP-13 neuropeptides characterized by an amidated arginine-phenylalanine (RFamide) C-terminus motif. By performing an unbiased genetic screen for mutants that impair the somnogenic effects of FLP-13 neuropeptides, we identified the gene dmsr-1 , which encodes a G-protein coupled receptor similar to an insect RFamide receptor. DMSR-1 is activated by FLP-13 peptides in cell culture, is required for SIS in vivo , is expressed non-synaptically in several wake-promoting neurons, and likely couples to a Gi/o heterotrimeric G-protein. Our data expand our understanding of how a single neuroendocrine cell coordinates an organism-wide behavioral response, and suggest that similar signaling principles may function in other organisms to regulate sleep during sickness.

Prevalence of acute mountain sickness on Mount Fuji: A pilot study.

PubMed

Horiuchi, Masahiro; Endo, Junko; Akatsuka, Shin; Uno, Tadashi; Jones, Thomas E

2016-04-01

Few studies have investigated climbing-related acute mountain sickness (AMS) on Mt Fuji. Although several studies of AMS have been conducted elsewhere, Mt Fuji is unique because there are many mountain lodges between the fifth station (a common starting point for climbers at an altitude of 2305 m) and the summit (3776 m), and many climbers commonly sleep overnight at mountain lodges during their ascents. This study surveyed the prevalence of AMS among climbers on Mt Fuji to determine which factors, if any, were related to the risk of developing AMS. This study collected data from 345 participants who climbed Mt Fuji in August 2013, including information regarding age, sex, climbing experience and whether the climber stayed at a mountain lodge (n = 239). AMS was surveyed using the Lake Louise Score (LLS) questionnaire. The item on perceived sleep quality was excluded for those who did not stay at a mountain lodge (n = 106). The overall prevalence of AMS was 29.5% (≥ 3 LLS with headache). According to a univariate analysis, AMS was not associated with sex (male vs female), age group (20-29, 30-39, 40-49 or >50 years) or stay at a mountain lodge (single day vs overnight stay). Conversely, prior experience climbing Mt Fuji (no prior attempts vs one or more prior attempts) was related to the risk of AMS. In addition, there was a significant deviation in the number of participants reporting poor sleep, and total sleep time was significantly shorter in participants with AMS. These preliminary findings suggest that no single factor can explain the risk for developing AMS while climbing Mt Fuji. In addition, impaired perceived sleep quality was associated with the severity of AMS in climbers who stayed overnight at a mountain lodge. © International Society of Travel Medicine, 2016. All rights reserved. Published by Oxford University Press. For permissions, please e-mail: journals.permissions@oup.com.

Influenza in workplaces: transmission, workers’ adherence to sick leave advice and European sick leave recommendations

PubMed Central

Tomba, Gianpaolo Scalia; de Blasio, Birgitte Freiesleben

2016-01-01

Background: Knowledge about influenza transmission in the workplace and whether staying home from work when experiencing influenza-like illness can reduce the spread of influenza is crucial for the design of efficient public health initiatives. Aim: This review synthesizes current literature on sickness presenteeism and influenza transmission in the workplace and provides an overview of sick leave recommendations in Europe for influenza. Methods: A search was performed on Medline, Embase, PsychINFO, Cinahl, Web of Science, Scopus and SweMed to identify studies related to workplace contacts, -transmission, -interventions and compliance with recommendations to take sick leave. A web-based survey on national recommendations and policies for sick leave during influenza was issued to 31 European countries. Results: Twenty-two articles (9 surveys; 13 modelling articles) were eligible for this review. Results from social mixing studies suggest that 20–25% of weekly contacts are made in the workplace, while modelling studies suggest that on average 16% (range 9–33%) of influenza transmission occurs in the workplace. The effectiveness of interventions to reduce workplace presenteeism is largely unknown. Finally, estimates from studies reporting expected compliance with sick leave recommendations ranged from 71 to 95%. Overall, 18 countries participated in the survey of which nine (50%) had issued recommendations encouraging sick employees to stay at home during the 2009 A(H1N1) pandemic, while only one country had official recommendations for seasonal influenza. Conclusions: During the 2009 A(H1N1) pandemic, many European countries recommended ill employees to take sick leave. Further research is warranted to quantify the effect of reduced presenteeism during influenza illness. PMID:27060594

Influenza in workplaces: transmission, workers' adherence to sick leave advice and European sick leave recommendations.

PubMed

Edwards, Christina Hansen; Tomba, Gianpaolo Scalia; de Blasio, Birgitte Freiesleben

2016-06-01

Knowledge about influenza transmission in the workplace and whether staying home from work when experiencing influenza-like illness can reduce the spread of influenza is crucial for the design of efficient public health initiatives. This review synthesizes current literature on sickness presenteeism and influenza transmission in the workplace and provides an overview of sick leave recommendations in Europe for influenza. A search was performed on Medline, Embase, PsychINFO, Cinahl, Web of Science, Scopus and SweMed to identify studies related to workplace contacts, -transmission, -interventions and compliance with recommendations to take sick leave. A web-based survey on national recommendations and policies for sick leave during influenza was issued to 31 European countries. Twenty-two articles (9 surveys; 13 modelling articles) were eligible for this review. Results from social mixing studies suggest that 20-25% of weekly contacts are made in the workplace, while modelling studies suggest that on average 16% (range 9-33%) of influenza transmission occurs in the workplace. The effectiveness of interventions to reduce workplace presenteeism is largely unknown. Finally, estimates from studies reporting expected compliance with sick leave recommendations ranged from 71 to 95%. Overall, 18 countries participated in the survey of which nine (50%) had issued recommendations encouraging sick employees to stay at home during the 2009 A(H1N1) pandemic, while only one country had official recommendations for seasonal influenza. During the 2009 A(H1N1) pandemic, many European countries recommended ill employees to take sick leave. Further research is warranted to quantify the effect of reduced presenteeism during influenza illness. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association.

Motion sickness: a negative reinforcement model.

PubMed

Bowins, Brad

2010-01-15

Theories pertaining to the "why" of motion sickness are in short supply relative to those detailing the "how." Considering the profoundly disturbing and dysfunctional symptoms of motion sickness, it is difficult to conceive of why this condition is so strongly biologically based in humans and most other mammalian and primate species. It is posited that motion sickness evolved as a potent negative reinforcement system designed to terminate motion involving sensory conflict or postural instability. During our evolution and that of many other species, motion of this type would have impaired evolutionary fitness via injury and/or signaling weakness and vulnerability to predators. The symptoms of motion sickness strongly motivate the individual to terminate the offending motion by early avoidance, cessation of movement, or removal of oneself from the source. The motion sickness negative reinforcement mechanism functions much like pain to strongly motivate evolutionary fitness preserving behavior. Alternative why theories focusing on the elimination of neurotoxins and the discouragement of motion programs yielding vestibular conflict suffer from several problems, foremost that neither can account for the rarity of motion sickness in infants and toddlers. The negative reinforcement model proposed here readily accounts for the absence of motion sickness in infants and toddlers, in that providing strong motivation to terminate aberrant motion does not make sense until a child is old enough to act on this motivation.

Examining paid sickness absence by shift workers.

PubMed

Catano, V M; Bissonnette, A B

2014-06-01

Shift workers are at greater risk than day workers with respect to psychological and physical health, yet little research has linked shift work to increased sickness absence. To investigate the relationship between shift work and sickness absence while controlling for organizational and individual characteristics and shift work attributes that have confounded previous research. The study used archive data collected from three national surveys in Canada, each involving over 20000 employees and 6000 private-sector firms in 14 different occupational groups. The employees reported the number of paid sickness absence days in the past 12 months. Data were analysed using both chi-squared statistics and hierarchical regressions. Contrary to previous research, shift workers took less paid sickness absence than day workers. There were no differences in the length of the sickness absence between both groups or in sickness absence taken by female and male workers whether working days or shifts. Only job tenure, the presence of a union in the workplace and working rotating shifts predicted sickness absence in shift workers. The results were consistent across all three samples. In general, shift work does not seem to be linked to increased sickness absence. However, such associations may be true for specific industries. Male and female workers did not differ in the amount of sickness absence taken. Rotating shifts, regardless of industry, predicted sickness absence among shift workers. Consideration should be given to implementing scheduled time off between shift changes. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Sickness absence trends after loss control management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tabaluyan, T.; Kuswadji, S.

1996-12-31

To assess the influence of loss control management programs applied in an oil and gas company to sickness absence trends. After the implementation of loss control management programs in 1990, sickness absence records in 1991, 1992 and 1993 were studied. International Safety Rating System (ISRS) management elements were audited each year. Absence parameter used were sickness frequency, mean sickness days examined by employee group age, length of service, work schedule and work location. Although frequency of sickness absences remain unchanged, there was a marked decrease of mean days per absence for certain worker groups. The effects were true among agemore » group 40-49 years, service group 15-19 years, service group 20-24 years and office workers. Shorter sickness absences among certain group of employees was noted following implementation of loss control management programs.« less

Absence and leave; sick leave. Final rule.

PubMed

2010-12-03

The U.S. Office of Personnel Management is issuing final regulations on the use of sick leave and advanced sick leave for serious communicable diseases, including pandemic influenza when appropriate. We are also permitting employees to substitute up to 26 weeks of accrued or accumulated sick leave for unpaid Family and Medical Leave Act (FMLA) leave to care for a seriously injured or ill covered servicemember, as authorized under the National Defense Authorization Act for Fiscal Year 2008, including up to 30 days of advanced sick leave for this purpose. Finally, we are reorganizing the existing sick leave regulations to enhance reader understanding and administration of the program.

Parental availability for the care of sick children.

PubMed

Heymann, S J; Earle, A; Egleston, B

1996-08-01

Parents have always played a critical role in the care of sick children. Although parents' roles remain crucial to children's health, parental availability has declined during the past half century. The percentage of women with preschool children who work has risen almost fivefold in 45 years from 12% in 1947 to 58% in 1992. The percentage of women in the paid work force with school-aged children has almost tripled in the same period, from 27.3% to 75.9%. Research has examined the effects of a variety of parental work conditions on children. However, past research has not examined how working conditions affect the ability of parents to care for their sick children. In this article, we examine how often the children of working parents get sick and whether parents receive enough paid leave to care for their sick children. This analysis makes use of two national surveys, which provide complementary information regarding the care of sick children. The National Longitudinal Survey of Youth is a longitudinal survey of a nationally representative probability sample of 12,686 men and women; the National Medical Expenditure Survey is a panel survey of 34,459 people. First, we estimated the family illness burden. Second, we looked in detail at the number of days of sick leave mothers had. Third, we examined whether mothers who had sick leave had it consistently during a 5-year period. Finally, we conducted a logistic regression to determine what factors were significant predictors of both lacking sick leave. More than one in three families faced a family illness burden of 2 weeks or more each year. Yet, 28% of mothers had sick leave none of the time they were employed between 1985 and 1990. Employed mothers of children with chronic conditions had less sick leave than other employed mothers. Thirty-six percent of mothers whose children had chronic conditions had sick leave none of the time they were employed. Although 20% of working parents who did not live in poverty lacked

Neural mechanisms of motion sickness

NASA Technical Reports Server (NTRS)

Crampton, G. H.; Daunton, N. G.

1983-01-01

The possibility that there might be a neuro-homoral cerebrospinal fluid link in motion sickness was directly tested by blocking the flow of CSF from the third into the fourth ventricle in cats. Evidence obtained thus far is consistent with the hypothesis. Cats with demonstrably sound plugs did not vomit in response to an accelerative motion sickness stimulus, whereas cats with imperfect 'leaky' plugs vomited with little or no delay in latency. Althoough there are several putative candidates, the identification of a humoral motion sickness substance is a matter of conjecture.

Conflict of interest: use of pyrethroids and amidines against tsetse and ticks in zoonotic sleeping sickness endemic areas of Uganda

PubMed Central

2013-01-01

-tsetse effective products the most effective way to increase pyrethroid use. Conclusions Conflicts of interest between veterinary business and vector control were found to constrain sleeping sickness control. While a variety of strategies could increase pyrethroid use, regulation of the insecticide market could effectively double the number of treated cattle with little cost to government, donors or farmers. Such regulation is entirely consistent with the role of the state in a privatised veterinary system and should include a mitigation strategy against the potential development of tick resistance. PMID:23841963

[The sick individual as a concept].

PubMed

Tejerizo López, Luis Carlos

2011-01-01

We start from the premise, shared by some current philosophical movements and by the author, which states that philosophy is not contemplation, or reflection, or introspection or communication. Philosophy is the art of shaping, inventing and creating concepts. It is an explicit way of introducing new differences in life, a different reading level, a specific jargon, which may imply revealing the flip side of the coin, or a dissimilar view of the side facing us. The philosopher is the friend of the concept, he holds it in his power, which means, basically and in all honesty, that philosophy is the discipline of creating concepts. Let us remember the brilliant idea of the Russian director Tarkovsky, who announced his greatest ambition as an artist: "To capture time". At the same time, we must recall one of the sayings of this director: "Every film I have directed and I intend to direct is always tied to characters who have something to overcome". The healthy individual lives in a specific time, with precise coordinates, aware that his life consists only of living that time. That is, living as defined by Josep María Esquirol: "Then we could also see that the best way of living the present is not to run after the fleeing time, but to see and live the opportunity that appears before us". One of the many circumstances that can intercept the way we see and live the opportunity that appears before us is sickness, one of those inescapable experiences we have not been taught how to pay an adequate attention to, and the meaning of which can, in a way, go unnoticed. As "time" goes by, the circumstance that we consider to be the basis on which existence is founded, sickness can appear, thus introducing a new dimension in the time of the healthy individual. For this reason we, as doctors and professionals, know that sickness "is tied to characters who have something to overcome". In view of the fact that a sickness invades a healthy individual and transforms him into a sick one

Assessment of Psychophysiological Responses During Motion Sickness Testing

NASA Technical Reports Server (NTRS)

Stoud, Cynthia S.; Toscano, William B.; Cowings, Patricia; Freidman, Gary

1994-01-01

The purpose of this investigation is to evaluate a methodology designed to accurately trace the temporal progression of motion sickness and space motion sickness symptoms. With this method, subjects continuously monitor their own motion sickness symptoms during exposure to a provocative stimulus as symptoms occur, in contrast to previous methods during which subjects report symptoms verbally at discrete time intervals. This method not only is comparable to previous methods in the type of symptoms that subjects report, but subjects report symptoms more frequently. Frequent reporting of motion sickness symptoms allows researchers to detail the waxing and waning of motion sickness symptoms for each individual. Previous research has shown that physiological responses to motion sickness stimuli are characterized by unique individual differences in response patterns. By improving our assessment of motion sickness symptoms with continuous monitoring of symptoms, the relationship between specific physiological responses and sickness levels can be more accurately determined for each individual. Results from this study show significant positive relationships between skin conductance levels and symptom levels for ten individuals; a significant positive relationship between temperature and symptom levels for 5 of 10 individuals; and both positive and negative relationships between respiration, heart rate, blood volume pulse and symptom levels. Continuous monitoring of motion sickness symptoms can be used to more accurately assess motion sickness to aid in the evaluation of countermeasures. In addition, recognition of the onset of symptoms that are strongly related to specific physiological responses could be used as cues to initiate procedures (e.g., Autogenic Feedback Training) to prevent the development of severe motion sickness symptoms.

Management of vibration sickness in coal mines by hyperbaric oxygenation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Soboleva, N.P.

1985-02-01

Clinical trials were conducted with hyperbaric oxygenation in the management of vibration sickness in 30 coal miners, 42 to 47 years of age. Assessment of the results of symptomatology and objective laboratory criteria (tetrapolar finger rheography, occulsion plethysmography) demonstrate market improvements in the treated subjects. Headaches disappeared or diminished in intensity, irritability, and fatigability became less pronounced, sleep improved, and the emotional status of the workers provided additional confirmation of the salubrious effects. Among the more pronounced objective findings were the increase in the filling volume and in the blood flow of the peripheral vasculature, and a three-fold decrease inmore » peripheral vascular resistance (from 97 + or 18.2 mm/m1/100 g/min in untreated controls, to 29.0 + or - 6.4 mm/ml/100 g/min in the treated subjects).« less

Managerial leadership is associated with self-reported sickness absence and sickness presenteeism among Swedish men and women.

PubMed

Nyberg, Anna; Westerlund, Hugo; Magnusson Hanson, Linda L; Theorell, Töres

2008-11-01

The objective of this study was to investigate the relationship between managerial leadership and self-reported sickness absence/presenteeism among Swedish men and women. Five thousand one hundred and forty-one Swedish employees, 56% of the participants in a nationally representative sample of the Swedish working population, were included in this cross-sectional questionnaire study. The leadership dimensions measured were five subscales of a standardized leadership questionnaire (Global Leadership and Organizational Behaviour Effectiveness Programme): Integrity, Team integration, Inspirational leadership, Autocratic leadership, and Self-centred leadership. Multiple logistic regression analyses were conducted, adjusting for factors in private life, employment category, labour-market sector, working conditions, self-reported general health, and satisfaction with life in general. Inspirational leadership was associated with a lower rate of short spells of sickness absence (<1 week) for both men and women. Autocratic leadership was related to a greater amount of total sick days taken by men. Sometimes showing integrity was associated with higher rate of sickness absence >1 week among men, and seldom showing integrity was associated with more sickness presenteeism among women. Managers performing Team integration were sometimes associated with women taking fewer short (<1 week) and long (>1 week) spells of sickness absence. Adjustment for self-reported general health did not alter these associations for men, but did so to some extent for women. Managerial leadership was found to be relevant for the understanding of sickness absence in the Swedish working population. There were distinctive gender differences.

Effect of Short-Term Acclimatization to High Altitude on Sleep and Nocturnal Breathing

PubMed Central

Nussbaumer-Ochsner, Yvonne; Ursprung, Justyna; Siebenmann, Christoph; Maggiorini, Marco; Bloch, Konrad E.

2012-01-01

Study Objective: Objective physiologic data on sleep and nocturnal breathing at initial exposure and during acclimatization to high altitude are scant. We tested the hypothesis that acute exposure to high altitude induces quantitative and qualitative changes in sleep and that these changes are partially reversed with acclimatization. Design: Prospective observation. Setting: One night in a sleep laboratory at 490 meters, the first and the third night in a mountain hut at 4559 meters. Participants: Sixteen healthy mountaineers. Intervention: Altitude exposure. Measurements: Polysomnography, questionnaire evaluation of sleep and acute mountain sickness. Results: Compared to 490 m, median nocturnal oxygen saturation decreased during the 1st night at 4559 m from 96% to 67%, minute ventilation increased from 4.4 to 6.3 L/min, and the apnea-hypopnea index increased from 0.1 to 60.9/h; correspondingly, sleep efficiency decreased from 93% to 69%, and slow wave sleep from 18% to 6% (P < 0.05, all instances). During the 3rd night at 4559 m, oxygen saturation was 71%, slow wave sleep 11% (P < 0.05 vs. 1st night, both instances) and the apnea/hypopnea index was 86.5/h (P = NS vs. 1st night). Symptoms of AMS and of disturbed sleep were significantly reduced in the morning after the 3rd vs. the 1st night at 4559 m. Conclusions: In healthy mountaineers ascending rapidly to high altitude, sleep quality is initially impaired but improves with acclimatization in association with improved oxygen saturation, while periodic breathing persists. Therefore, high altitude sleep disturbances seem to be related predominantly to hypoxemia rather than to periodic breathing. Citation: Nussbaumer-Ochsner Y; Ursprung J; Siebenmann C; Maggiorini M; Bloch KE. Effect of short-term acclimatization to high altitude on sleep and nocturnal breathing. SLEEP 2012;35(3):419-423. PMID:22379248

Bacteriotherapy of acute radiation sickness

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mal'tsev, V.N.; Korshunov, V.M.; Strel'nikov, V.A.

1979-04-01

Acute sickness is associated with intestinal dysbacteriosis; there is a radical decrease in number of microorganisms of lactic fermentation (bifidobacterium, lactobacillus) and an increase in E. coli proteus, enterococcus, and clostridium. Extensive use is made of live microorganisms in the treatment of various diseases associated with intestinal dysbacteriosis; in the case of acute radiation sickness, yeast, colibacterin, and E. coli have been used. In a number of cases, such therapy increased survival and life expectancy of irradiated animals. In this study, microorganisms of lactic fermentation (lactobacillus, bifidobacterium) and colibacterin were used for treatment of acute radiation sickness.

Cinerama sickness and postural instability.

PubMed

Bos, Jelte E; Ledegang, Wietse D; Lubeck, Astrid J A; Stins, John F

2013-01-01

Motion sickness symptoms and increased postural instability induced by motion pictures have been reported in a laboratory, but not in a real cinema. We, therefore, carried out an observational study recording sickness severity and postural instability in 19 subjects before, immediately and 45 min after watching a 1 h 3D aviation documentary in a cinema. Sickness was significantly larger right after the movie than before, and in a lesser extent still so after 45 min. The average standard deviation of the lateral centre of pressure excursions was significantly larger only right afterwards. When low-pass filtered at 0.1 Hz, lateral and for-aft excursions were both significantly larger right after the movie, while for-aft excursions then remained larger even after 45 min. Speculating on previous findings, we predict more sickness and postural instability in 3D than in 2D movies, also suggesting a possible, but yet unknown risk for work-related activities and vehicle operation. Watching motion pictures may be sickening and posturally destabilising, but effects in a cinema are unknown. We, therefore, carried out an observational study showing that sickness then is mainly an issue during the exposure while postural instability is an issue afterwards.

Sick-visit immunizations and delayed well-baby visits.

PubMed

Robison, Steve G

2013-07-01

Giving recommended immunizations during sick visits for minor and acute illness such as acute otitis media has long been an American Academy of Pediatrics/Advisory Committee on Immunization Practice recommendation. An addition to the American Academy of Pediatrics policy in 2010 advised considering whether giving immunizations at the sick visit would discourage making up missed well-baby visits. This study quantifies the potential tradeoff between sick-visit immunizations and well-baby visits. This study was a retrospective cohort analysis with a case-control component of sick visits for acute otitis media that supplanted normal well-baby visits at age 2, 4, or 6 months. Infants were stratified for sick-visit immunization, no sick-visit immunization but quick makeup well-baby visits, or no sick-visit immunizations or quick makeup visits. Immunization rates and well-baby visit rates were assessed through 24 months of age. For 1060 study cases, no significant difference was detected in immunization rates or well-baby visits through 24 months of age between those with or without sick-visit immunizations. Thirty-nine percent of infants without a sick-visit shot failed to return for a quick makeup well-baby visit; this delayed group was significantly less likely to be up-to-date for immunizations (relative risk: 0.66) and had fewer well-baby visits (mean: 3.8) from 2 through 24 months of age compared with those with sick-visit shots (mean: 4.7). The substantial risk that infants will not return for a timely makeup well-baby visit after a sick visit should be included in any consideration of whether to delay immunizations.

Motion sickness prevalence in school children.

PubMed

Henriques, Isadora Ferreira; Douglas de Oliveira, Dhelfeson Willya; Oliveira-Ferreira, Fernanda; Andrade, Peterson M O

2014-11-01

This study aimed to determine the prevalence of motion sickness in schoolchildren and related the finding to the postural balance and quality of life. A population-based cross-sectional study was carried out with 831 children aged 7 to 12 years. The frequency of motion sickness was evaluated based on the Motion Sickness Susceptibility Questionnaire-Short (MSSQ-short). Postural balance was assessed using the Romberg test under different sensory conditions. The Dizziness Handicap Inventory was used in order to assess the quality of life. The statistical analyses were performed using the chi-square, Kruskal-Wallis, Mann-Whitney, and Spearman correlation tests. The prevalence of motion sickness was 43.4 % in car, 43.2 % on bus, 11.7 % on park swing, and 11.6 % on Ferris wheel. Mean unadjusted scores on the MSSQ-short ranged from 5.0 (SE = 0.5) for 10-year-olds to 6.8 (SE = 0.5) for 9-year-olds. The most prevalent symptoms following the balance tests were dizziness (89.2 %), vertigo (54.9 %), headache (10.6 %), and nausea (8.2 %). Significant correlations were found between the MSSQ-short score and all postural balance tests. Significant correlations were found between the MSSQ and modified DHI (Dizziness Handicap Inventory) at all ages. The prevalence of motion sickness in schoolchildren is greater when in a car or on a bus. An association was found between motion sickness and postural balance tests and motion sickness and quality of life.

Paid Sick Leave and Nonfatal Occupational Injuries

PubMed Central

Pana-Cryan, Regina; Rosa, Roger

2012-01-01

Objectives. We examined the association between US workers’ access to paid sick leave and the incidence of nonfatal occupational injuries from the employer’s perspective. We also examined this association in different industries and occupations. Methods. We developed a theoretical framework to examine the business value of offering paid sick leave. Data from the National Health Interview Survey were used to test the hypothesis that offering paid sick leave is associated with a reduced incidence of occupational injuries. We used data on approximately 38 000 working adults to estimate a multivariate model. Results. With all other variables held constant, workers with access to paid sick leave were 28% (95% confidence interval = 0.52, 0.99) less likely than workers without access to paid sick leave to be injured. The association between the availability of paid sick leave and the incidence of occupational injuries varied across sectors and occupations, with the greatest differences occurring in high-risk sectors and occupations. Conclusions. Our findings suggest that, similar to other investments in worker safety and health, introducing or expanding paid sick leave programs might help businesses reduce the incidence of nonfatal occupational injuries, particularly in high-risk sectors and occupations. PMID:22720767

Health problems and disability in long-term sickness absence: ICF coding of medical certificates.

PubMed

Morgell, Roland; Backlund, Lars G; Arrelöv, Britt; Strender, Lars-Erik; Nilsson, Gunnar H

2011-11-11

The purpose of this study was to test the feasibility of International Classification of Functioning, Disability and Health (ICF) and to explore the distribution, including gender differences, of health problems and disabilities as reflected in long-term sickness absence certificates. A total of 433 patients with long sick-listing periods, 267 women and 166 men, were included in the study. All certificates exceeding 28 days of sick-listing sent to the local office of the Swedish Social Insurance Administration of a municipality in the Stockholm area were collected during four weeks in 2004-2005. ICD-10 medical diagnosis codes in the certificates were retrieved and free text information on disabilities in body function, body structure or activity and participation were coded according to ICF short version. In 89.8% of the certificates there were descriptions of disabilities that readily could be classified according to ICF. In a reliability test 123/131 (94%) items of randomly chosen free text information were identically classified by two of the authors. On average 2.4 disability categories (range 0-9) were found per patient; the most frequent were 'Sensation of pain' (35.1% of the patients), 'Emotional functions' (34.1%), 'Energy and drive functions' (22.4%), and 'Sleep functions' (16.9%). The dominating ICD-10 diagnostic groups were 'Mental and behavioural disorders' (34.4%) and 'Diseases of the musculoskeletal system and connective tissue' (32.8%). 'Reaction to severe stress and adjustment disorders' (14.7%), and 'Depressive episode' (11.5%) were the most frequent diagnostic codes. Disabilities in mental functions and activity/participation were more commonly described among women, while disabilities related to the musculoskeletal system were more frequent among men. Both ICD-10 diagnoses and ICF categories were dominated by mental and musculoskeletal health problems, but there seems to be gender differences, and ICF classification as a complement to ICD-10

Sleep and breathing in high altitude pulmonary edema susceptible subjects at 4,559 meters.

PubMed

Nussbaumer-Ochsner, Yvonne; Schuepfer, Nicole; Ursprung, Justyna; Siebenmann, Christoph; Maggiorini, Marco; Bloch, Konrad E

2012-10-01

Susceptible subjects ascending rapidly to high altitude develop pulmonary edema (HAPE). We evaluated whether HAPE leads to sleep and breathing disturbances that are alleviated by dexamethasone. Double-blind, randomized, placebo-controlled trial with open-label extension. One night in sleep laboratory at 490 m, 2 nights in mountain hut at 4,559 m. 21 HAPE susceptibles. Dexamethasone 2 × 8 mg/d, either 24 h prior to ascent and at 4,559 m (dex-early), or started on day 2 at 4,559 m only (dex-late). Polysomnography, questionnaires on sleep and acute mountain sickness. Polysomnographies at 490 m were normal. In dex-late (n = 12) at 4,559 m, night 1 and 3, median oxygen saturation was 71% and 80%, apnea/hypopnea index 91.3/h and 9.6/h. In dex-early (n = 9), corresponding values were 78% and 79%, and 85.3/h and 52.3/h (P < 0.05 vs. 490 m, all instances). In dex-late, ascending from 490 m to 4,559 m (night 1), sleep efficiency decreased from 91% to 65%, slow wave sleep from 20% to 8% (P < 0.05, both instances). In dex-early, corresponding sleep efficiencies were 96% and 95%, slow wave sleep 18% and 9% (P < 0.05). From night 1 to 3, sleep efficiency remained unchanged in both groups while slow wave sleep increased to 20% in dex-late (P < 0.01). Compared to dex-early, initial AMS scores in dex-late were higher but improved during stay at altitude. HAPE susceptibles ascending rapidly to high altitude experience pronounced nocturnal hypoxemia, and reduced sleep efficiency and deep sleep. Dexamethasone taken before ascent prevents severe hypoxemia and sleep disturbances, while dexamethasone taken 24 h after arrival at 4,559 m increases oxygenation and deep sleep.

Long-term sickness absence due to adjustment disorder.

PubMed

Catalina-Romero, C; Pastrana-Jiménez, J I; Tenas-López, M J; Martínez-Muñoz, P; Ruiz-Moraga, M; Fernández-Labandera, C; Calvo-Bonacho, E

2012-07-01

Although adjustment disorder is frequently reported in clinical settings, scientific evidence is scarce regarding its impact on sickness absence and the variables associated with sickness absence duration. To report sickness absence duration and to identify predictors of long-term sickness absence in patients with adjustment disorder. This observational, prospective study included subjects with non-work-related sickness absence (>15 days) after a diagnosis of adjustment disorder. A stepwise logistic regression analysis was conducted to identify the best predictors of long-term sickness absence (≥ 6 months). There were 1182 subjects in the final analysis. The median duration of sickness absence due to adjustment disorder was 91 days. Twenty-two per cent of the subjects reported long-term sickness absence. After multivariate analysis, comorbidity (OR = 2.23, 95% CI 1.43-3.49), age (25-34 years old versus <25 years old: OR = 2.78, 95% CI 1.27-6.07; 35-44 years old versus <25 years old: OR = 3.70, 95% CI 1.71-7.99; 45-54 years old versus <25 years old: OR = 3.58, 95% CI 1.60-8.02; ≥ 55 years old versus <25 years old: OR = 6.35, 95% CI 2.64-15.31) and occupational level (blue collar versus white collar: OR = 1.52, 95% CI 1.10-2.09) remained significantly associated with long-term sickness absence. Comorbidity was the strongest predictor. It is possible to predict long-term sickness absence due to adjustment disorder on the basis of demographic, work-related and clinical information available during the basic assessment of the patient.

Prediction of sickness absenteeism, disability pension and sickness presenteeism among employees with back pain.

PubMed

Bergström, Gunnar; Hagberg, Jan; Busch, Hillevi; Jensen, Irene; Björklund, Christina

2014-06-01

The primary aim of this study was to evaluate the predictive ability of the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) concerning long-term sick leave, sickness presenteeism and disability pension during a follow-up period of 2 years. The study group consisted of 195 employees visiting the occupational health service (OHS) due to back pain. Using receiver operating characteristic (ROC) curves, the area under the curve (AUC) varied from 0.67 to 0.93, which was from less accurate for sickness presenteeism to highly accurate for the prediction of disability pension. For registered sick leave during 6 months following the baseline the AUC from the ROC analyses was moderately accurate (0.81) and a cut off score of 90 rendered a high sensitivity of 0.89 but a low specificity of 0.46 whereas a cut off score of 105 improves the specificity substantially but at the cost of some sensitivity. The predictive ability appears to decrease with time. Several workplace factors beyond those included in the ÖMPSQ were considered but only social support at the workplace was significantly related to future long-term sick leave besides the total score of the ÖMPSQ. The results of this study extend and confirm the findings of earlier research on the ÖMPSQ. Assessment of psychosocial risk factors among employees seeking help for back pain at the OHS could be helpful in the prevention of work disabling problems.

Shift and Day Work: A Comparison of Sickness Absence, Lateness, and other Absence Behaviour at an Oil Refinery from 1962 to 1965

PubMed Central

Taylor, P. J.

1967-01-01

Despite the increasing use of continuous process shift work in modern industry, few studies on the medical aspects of shift work can be found in recent literature of occupational health. Physiologists have shown that the ability of the body to adjust its circadian rhythms to alteration in hours of work or sleep can take up to a month. The usual type of shift work in industry involves weekly changes of hours, and thus on theoretical grounds at least this may not be the most suitable frequency for shift changes. Sickness absence of male refinery workers has been studied over a four-year period. The figures show that continuous three-cycle shift workers have consistently and significantly lower rates of sickness than day workers in similar occupations. The annual inception rate (spells) standardized for age was 108% for shift workers and 182% for day workers, and the average annual duration per man was 11 days for shift workers and 18 days for day workers, although the average length of spell was slightly longer among shift workers. As far as is known, such a difference has not been described before in detail. Age-related lateness and absenteeism have been measured and show similar wide differences between the two groups. Although both types of worker are largely self-selected, the difference is not due to medical selection or to an excess of any one type of disease in day workers. Over three-quarters of 150 shift workers interviewed stated that they preferred shift work hours and that sleeping difficulties were not common. It is suggested that the main reasons for the difference between shift and day workers' sickness absence lie in the degree of personal involvement in the work and in the social structure of the working group. PMID:6023084

Job satisfaction and sickness absence: a questionnaire survey.

PubMed

Roelen, Corné A M; Koopmans, Petra C; Notenbomer, Annette; Groothoff, Johan W

2008-12-01

When dissatisfaction with work precedes sickness absence, screening for satisfaction levels might usefully detect workers at risk of sickness absence. To investigate whether job satisfaction was associated with subsequent sickness absence days or episodes. A sample of workers was randomly drawn from a population of employees who had an episode of absence between January and April 2003. Job satisfaction was measured using a validated single question with a Likert-type scale ranging from 1 (very dissatisfied) to 7 (very satisfied). Job satisfaction levels were linked to the number of recorded sickness absence days and episodes in 2003, distinguishing between short (1-7 days) episodes and long (>7 days) episodes. Of 898 questionnaires distributed, 518 (58%) were returned. The mean+/-standard deviation job satisfaction level was 5.1+/-1.4 and negatively related to the number of sickness absence days. Job satisfaction was also negatively related to the number of short episodes and long episodes of absence, but these associations were not significant. Job satisfaction was significantly related to total sickness absence duration. The association with the number of sickness absence episodes was weak and just below the level of statistical significance. Assessing work satisfaction levels might usefully identify those workers most likely to have the greatest sickness absence duration.

General Automatic Components of Motion Sickness

NASA Technical Reports Server (NTRS)

Suter, S.; Toscano, W. B.; Kamiya, J.; Naifeh, K.

1985-01-01

A body of investigations performed in support of experiments aboard the space shuttle, and designed to counteract the symptoms of Space Adaptation Syndrome, which resemble those of motion sickness on Earth is reviewed. For these supporting studies, the automatic manifestations of earth-based motion sickness was examined. Heart rate, respiration rate, finger pulse volume and basal skin resistance were measured on 127 men and women before, during and after exposure to nauseogenic rotating chair tests. Significant changes in all autonomic responses were observed across the tests. Significant differences in autonomic responses among groups divided according to motion sickness susceptibility were also observed. Results suggest that the examination of autonomic responses as an objective indicator of motion sickness malaise is warranted and may contribute to the overall understanding of the syndrome on Earth and in Space.

[Motion sickness in motion: from carsickness to cybersickness].

PubMed

Bos, J E; van Leeuwen, R B; Bruintjes, T D

2018-01-01

- Motion sickness is not a disorder, but a normal response to a non-normal situation in which movement plays a central role, such as car travel, sailing, flying, or virtual reality.- Almost anyone can suffer from motion sickness, as long as at least one of the organs of balance functions. If neither of the organs of balance functions the individual will not suffer from carsickness, seasickness, airsickness, nor from cybersickness. - 'Cybersickness' is a form of motion sickness that is stimulated by artificial moving images such as in videogames. Because we are now exposed more often and for longer periods of time to increasingly realistic artificial images, doctors will also encounter cases of motion sickness more often. - The basis for motion sickness is the vestibular system, which can be modulated by visual-vestibular conflicts, i.e. when the movements seen by the eyes are not the same as those experienced by the organs of balance.- Antihistamines can be effective against motion sickness in everyday situations such as car travel if taken before departure, but the effectiveness of medication for motion sickness is limited.

System for analysing sickness absenteeism in Poland.

PubMed

Indulski, J A; Szubert, Z

1997-01-01

The National System of Sickness Absenteeism Statistics has been functioning in Poland since 1977, as the part of the national health statistics. The system is based on a 15-percent random sample of copies of certificates of temporary incapacity for work issued by all health care units and authorised private medical practitioners. A certificate of temporary incapacity for work is received by every insured employee who is compelled to stop working due to sickness, accident, or due to the necessity to care for a sick member of his/her family. The certificate is required on the first day of sickness. Analyses of disease- and accident-related sickness absenteeism carried out each year in Poland within the statistical system lead to the main conclusions: 1. Diseases of the musculoskeletal and peripheral nervous systems accounting, when combined, for 1/3 of the total sickness absenteeism, are a major health problem of the working population in Poland. During the past five years, incapacity for work caused by these diseases in males increased 2.5 times. 2. Circulatory diseases, and arterial hypertension and ischaemic heart disease in particular (41% and 27% of sickness days, respectively), create an essential health problem among males at productive age, especially, in the 40 and older age group. Absenteeism due to these diseases has increased in males more than two times.

Therapeutic effects of antimotion sickness medications on the secondary symptoms of motion sickness

NASA Technical Reports Server (NTRS)

Wood, C. D.; Stewart, J. J.; Wood, M. J.; Manno, J. E.; Manno, B. R.

1990-01-01

In addition to nausea and vomiting, motion sickness involves slowing of brain waves, loss of performance, inhibition of gastric motility and the Sopite Syndrome. The therapeutic effects of antimotion sickness drugs on these reactions were evaluated. The subjects were rotated to the M-III end-point of motion sickness. Intramuscular (IM) medications were then administered. Side effects before and after rotation were reported on the Cornell Medical Index. Brain waves were recorded on a Grass Model 6 Electroencephalograph (EEG), and gastric emptying was studied after an oral dose of 1 mCi Technetium 99m DTPA in 10 oz. isotonic saline. An increase in dizziness and drowsiness was reported with placebo after rotation. This was not prevented by IM scopolamine 0.1 mg or ephedrine 25 mg. EEG recordings indicated a slowing of alpha waves with some thea and delta waves from the frontal areas after rotation. IM ephedine and dimenhydrinate counteracted the slowing while 0.3 mg scopolamine had an additive effect. Alterations of performance on the pursuit meter correlated with the brain wave changes. Gastric emptying was restored by IM metoclopramide. Ephedrine IM but not scopolamine is effective for some of the secondary effects of motion sickness after it is established.

A literature review of economic evaluations for a neglected tropical disease: human African trypanosomiasis ("sleeping sickness").

PubMed

Sutherland, C Simone; Yukich, Joshua; Goeree, Ron; Tediosi, Fabrizio

2015-02-01

Human African trypanosomiasis (HAT) is a disease caused by infection with the parasite Trypanosoma brucei gambiense or T. b. rhodesiense. It is transmitted to humans via the tsetse fly. Approximately 70 million people worldwide were at risk of infection in 1995, and approximately 20,000 people across Africa are infected with HAT. The objective of this review was to identify existing economic evaluations in order to summarise cost-effective interventions to reduce, control, or eliminate the burden of HAT. The studies included in the review were compared and critically appraised in order to determine if there were existing standardised methods that could be used for economic evaluation of HAT interventions or if innovative methodological approaches are warranted. A search strategy was developed using keywords and was implemented in January 2014 in several databases. The search returned a total of 2,283 articles. After two levels of screening, a total of seven economic evaluations were included and underwent critical appraisal using the Scottish Intercollegiate Guidelines Network (SIGN) Methodology Checklist 6: Economic Evaluations. Results from the existing studies focused on the cost-effectiveness of interventions for the control and reduction of disease transmission. Modelling was a common method to forecast long-term results, and publications focused on interventions by category, such as case detection, diagnostics, drug treatments, and vector control. Most interventions were considered cost-effective based on the thresholds described; however, the current treatment, nifurtomix-eflornithine combination therapy (NECT), has not been evaluated for cost-effectiveness, and considerations for cost-effective strategies for elimination have yet to be completed. Overall, the current evidence highlights the main components that play a role in control; however, economic evaluations of HAT elimination strategies are needed to assist national decision makers, stakeholders, and

Using an innovative multiple regression procedure in a cancer population (Part II): fever, depressive affect, and mobility problems clarify an influential symptom pair (pain-fatigue/weakness) and cluster (pain-fatigue/weakness-sleep problems).

PubMed

Francoeur, Richard B

2015-01-01

Most patients with advanced cancer experience symptom pairs or clusters among pain, fatigue, and insomnia. However, only combinations where symptoms are mutually influential hold potential for identifying patient subgroups at greater risk, and in some contexts, interventions with "cross-over" (multisymptom) effects. Improved methods to detect and interpret interactions among symptoms, signs, or biomarkers are needed to reveal these influential pairs and clusters. I recently created sequential residual centering (SRC) to reduce multicollinearity in moderated regression, which enhances sensitivity to detect these interactions. I applied SRC to moderated regressions of single-item symptoms that interact to predict outcomes from 268 palliative radiation outpatients. I investigated: 1) the hypothesis that the interaction, pain × fatigue/weakness × sleep problems, predicts depressive affect only when fever presents, and 2) an exploratory analysis, when fever is absent, that the interaction, pain × fatigue/weakness × sleep problems × depressive affect, predicts mobility problems. In the fever context, three-way interactions (and derivative terms) of the four symptoms (pain, fatigue/weakness, fever, sleep problems) are tested individually and simultaneously; in the non-fever context, a single four-way interaction (and derivative terms) is tested. Fever interacts separately with fatigue/weakness and sleep problems; these comoderators each magnify the pain-depressive affect relationship along the upper or full range of pain values. In non-fever contexts, fatigue/weakness, sleep problems, and depressive affect comagnify the relationship between pain and mobility problems. Different mechanisms contribute to the pain × fatigue/weakness × sleep problems interaction, but all depend on the presence of fever, a sign/biomarker/symptom of proinflammatory sickness behavior. In non-fever contexts, depressive affect is no longer an outcome representing malaise from the physical

The RFamide receptor DMSR-1 regulates stress-induced sleep in C. elegans

PubMed Central

Iannacone, Michael J; Beets, Isabel; Lopes, Lindsey E; Churgin, Matthew A; Fang-Yen, Christopher; Nelson, Matthew D; Schoofs, Liliane; Raizen, David M

2017-01-01

In response to environments that cause cellular stress, animals engage in sleep behavior that facilitates recovery from the stress. In Caenorhabditis elegans, stress-induced sleep(SIS) is regulated by cytokine activation of the ALA neuron, which releases FLP-13 neuropeptides characterized by an amidated arginine-phenylalanine (RFamide) C-terminus motif. By performing an unbiased genetic screen for mutants that impair the somnogenic effects of FLP-13 neuropeptides, we identified the gene dmsr-1, which encodes a G-protein coupled receptor similar to an insect RFamide receptor. DMSR-1 is activated by FLP-13 peptides in cell culture, is required for SIS in vivo, is expressed non-synaptically in several wake-promoting neurons, and likely couples to a Gi/o heterotrimeric G-protein. Our data expand our understanding of how a single neuroendocrine cell coordinates an organism-wide behavioral response, and suggest that similar signaling principles may function in other organisms to regulate sleep during sickness. DOI: http://dx.doi.org/10.7554/eLife.19837.001 PMID:28094002

Mechanisms of antimotion sickness drugs

NASA Technical Reports Server (NTRS)

Wood, C. D.; Manno, J. E.; Wood, M. J.; Manno, B. R.; Redetzki, H. M.

1987-01-01

Eight subjects, male and female, were rotated using the step method to progressively increase the speed of rotation (+2 rpm) after every 40 head movements to a maximum of 35 rpm. The end point for motion sickness was the Graybiel Malaise III total of symptoms short of frank nausea. The drug treatments were placebo, scopolamine 0.6 mg and 1 mg, scopolamine 0.6 mg/d-amphetamine 10 mg, scopolamine 1 mg/d-amphetamine 10 mg, and amphetamine 10 mg. Scopolamine increased tolerated head movements over placebo level by + 81; scopolamine 1 mg + 183; d-amphetamine by + 118; scopolamine 0.6/d-amphetamine by + 165; and scopolamine 1 mg/d-amphetamine 10 mg by + 201. The drugs effective in preventing motion sickness are considered to be divided into those with central acetylcholine blocking activity and those which enhance norepinephrine activity. A combination of both of these actions produces the most effective antimotion sickness medications. It is concluded that the balance between the acetylcholine and norepinephrine activity in the CNS appears to be responsible for motion sickness.

[Teacher sick leave: Prevalence, duration, reasons and covariates].

PubMed

Vercambre-Jacquot, M-N; Gilbert, F; Billaudeau, N

2018-02-01

Absences from work have considerable social and economic impact. In the education sector, the phenomenon is particularly worrying since teacher sick leave has an impact on the overall performance of the education system. Yet, available data are scarce. In April-June 2013, 2653 teachers responded to a population-based postal survey on their quality of life (enquête Qualité de vie des enseignants, MGEN Foundation/Ministry of education, response rate 53 %). Besides questions on work environment and health, teachers were asked to describe their eventual sick leave(s) since the beginning of the school year: duration, type and medical reasons. Self-reported information was reinforced by administrative data from ministerial databases and weighted to be extrapolated to all French teachers. Tobit models adjusted for individual factors of a private nature were used to investigate different occupational risk factors of teacher sick leave, taking into account both the estimated effect on the probability of sick leave and the length of it. More than one in three teachers (36 %) reported having had at least one day of sick leave since the beginning of the school year. Respiratory/ENT diseases were the leading reason for sick leave (37 %). However, and because sick leave duration depended on the underlying health problem, such diseases came in third place among justifications of sick leave days (14 %), far behind musculoskeletal problems (27 %) and neurological and psychological disorders (25 %). Tobit models suggested that some occupational factors significantly associated with the risk of sick leave may represent promising preventive targets, including high psychological demand, workplace violence and unfavorable socio-environmental context. Our study provides objective evidence about the issue of sick leave among French teachers, highlighting the usefulness of implementing actions to minimize its weight. To this end, the study findings point-out the importance of

Relative deprivation and sickness absence in Sweden.

PubMed

Helgertz, Jonas; Hess, Wolfgang; Scott, Kirk

2013-08-29

A high prevalence of sickness absence in many countries, at a substantial societal cost, underlines the importance to understand its determining mechanisms. This study focuses on the link between relative deprivation and the probability of sickness absence. 184,000 men and women in Sweden were followed between 1982 and 2001. The sample consists of working individuals between the ages of 19 and 65. The outcome is defined as experiencing more than 14 days of sickness absence during a year. Based on the complete Swedish population, an individual's degree of relative deprivation is measured through income compared to individuals of the same age, sex, educational level and type. In accounting for the possibility that sickness absence and socioeconomic status are determined by common factors, discrete-time duration models were estimated, accounting for unobserved heterogeneity through random effects. The results confirm that the failure to account for the dynamics of the individual's career biases the influence from socioeconomic characteristics. Results consistently suggest a major influence from relative deprivation, with a consistently lower risk of sickness absence among the highly educated. Altering individual's health behavior through education appears more efficient in reducing the reliance on sickness absence, rather than redistributive policies.

Endocrine correlates of susceptibility to motion sickness

NASA Technical Reports Server (NTRS)

Kohl, R. L.

1985-01-01

Motion sickness releases ACTH, epinerphrine, and norepinephrine. The endocrine responses to motion sickness, adaptive responses leading to the resolution of the syndrome, and the way in which antimotion-sickness drugs influence the endocrine responses were studied. Susceptible or insusceptible subjects were administered antimotion-sickness drugs prior to stressful stimulation. Insusceptible subjects displayed more pronounced elevations of ACTH, epinephrine, and norepinephrine after stressful motion. Predrug levels of ACTH were higher in insusceptible subjects (p less than 0.01). Acute blockade of hormone responses to stressful motion or alteration of levels of ACTH by drugs were not correlated with individual susceptibility. No correlation was apparent between epinephrine and ACTH release. These endocrine differences may represent neurochemical markers for susceptibility to motion, stress, or general adaptability, and it may be that the chronic modulation of their levels might be more effective in preventing motion sickness than the acute blockage or stimulation of specific receptors.

Sickness benefit cuts mainly affect blue-collar workers.

PubMed

Aaviksoo, E; Kiivet, R-A

2014-08-01

To analyse the impact of sick-pay cuts on the use of sickness absence by employees of different socioeconomic groups. In 2009 cuts in sick pay were implemented in reaction to an economic crisis in Estonia. Nationwide health survey data from the years 2004, 2006, 2008, and 2010 were used to evaluate sickness absence among blue-collar and white-collar workers. The dataset comprised 7,449 employees of 20-64 years of age. Difference in prevalence of absentees before and after the reform was assessed using the chi-squared test. Odds ratios (OR) for sickness absence were calculated in a multivariate logistic regression model. After the reform, the proportion of blue-collar workers who had been on sick leave decreased from 51% to 40% (p<0.001) and among white-collar employees from 45% to 41% (p=0.026). This reduction had a similar pattern in all the subgroups of blue-collar employees as stratified according to gender, age, self-rated health, and presence of chronic disease, especially among those with low incomes; in white-collar employees it reached statistical significance only in those with good self-rated health (p=0.033). In a multivariate model the odds of having lower sickness absence were highly significant only in blue-collar employees (OR 0.63; 95% confidence interval 0.51-0.77, p<0.001). The cuts in sickness benefits had a major impact on the use of sickness absence by blue-collar employees with low salaries. This indicates that lower income was a major factor hindering the use of sick leave as these employees are most vulnerable to the loss of income. © 2014 the Nordic Societies of Public Health.

Motion Sickness

MedlinePlus

... sickness from certain visual activities, such as playing video games or watching spinning objects. Symptoms can strike without ... of your body. For example, when playing a video game, your eyes may sense that you are moving ...

[Work ability and gender--physicians' assessment of sick-listed patients].

PubMed

Brage, S; Reiso, H

1999-10-20

Medical assessments might be influenced by the patient's gender and work situation. This article explorers the relationship between physicians' assessments of work ability in sick-listed patients, and gender of the sick-listed and the physicians. We conducted a questionnaire survey among 52 primary care physicians and 442 of their sick-listed full-time employed patients in Aust-Agder county. The relationship between physician assessment of the patients' work ability and gender were analysed by full/part-time sick-leave, new/extended sick-leave, patient's workload, and the physician's gender. Multivariate analyses were done in two-level logistic regression models. 60% of sick-listed women were assessed as having "very much" or "much" reduced work ability, against 71% of sick-listed men (p < 0.01). Women received part-time sickness certification more often than men, 27% vs. 11% (p < 0.001). These relationships were only found for extended sick-leaves, and were significant also after adjustment for physician's gender and patient work-load. Male physicians assessed work ability as more reduced among sick-listed men than among sick-listed women. Primary care physicians assessed work ability as less reduced among women than men. Women more often received part-time sickness certification. Possibly, the physicians' gender influenced their assessment of work ability, but this should be confirmed by more studies.

Towards an Early Warning System for Rhodesian Sleeping Sickness in Savannah Areas: Man-Like Traps for Tsetse Flies

PubMed Central

Vale, Glyn A.; Hall, David R.; Chamisa, Andrew; Torr, Stephen J.

2012-01-01

Background In the savannahs of East and Southern Africa, tsetse flies (Glossina spp.) transmit Trypanosoma brucei rhodesiense which causes Rhodesian sleeping sickness, the zoonotic form of human African trypanosomiasis. The flies feed mainly on wild and domestic animals and are usually repelled by humans. However, this innate aversion to humans can be undermined by environmental stresses on tsetse populations, so increasing disease risk. To monitor changes in risk, we need traps designed specifically to quantify the responsiveness of savannah tsetse to humans, but the traps currently available are designed to simulate other hosts. Methodology/Principal Findings In Zimbabwe, two approaches were made towards developing a man-like trap for savannah tsetse: either modifying an ox-like trap or creating new designs. Tsetse catches from a standard ox-like trap used with and without artificial ox odor were reduced by two men standing nearby, by an average of 34% for Glossina morsitans morsitans and 56% for G. pallidipes, thus giving catches more like those made by hand-nets from men. Sampling by electrocuting devices suggested that the men stopped flies arriving near the trap and discouraged trap-entering responses. Most of human repellence was olfactory, as evidenced by the reduction in catches when the trap was used with the odor of hidden men. Geranyl acetone, known to occur in human odor, and dispensed at 0.2 mg/h, was about as repellent as human odor but not as powerfully repellent as wood smoke. New traps looking and smelling like men gave catches like those from men. Conclusion/Significance Catches from the completely new man-like traps seem too small to give reliable indices of human repellence. Better indications would be provided by comparing the catches of an ox-like trap either with or without artificial human odor. The chemistry and practical applications of the repellence of human odor and smoke deserve further study. PMID:23301107

Motion sickness and postural sway in console video games.

PubMed

Stoffregen, Thomas A; Faugloire, Elise; Yoshida, Ken; Flanagan, Moira B; Merhi, Omar

2008-04-01

We tested the hypotheses that (a) participants might develop motion sickness while playing "off-the-shelf" console video games and (b) postural motion would differ between sick and well participants, prior to the onset of motion sickness. There have been many anecdotal reports of motion sickness among people who play console video games (e.g., Xbox, PlayStation). Participants (40 undergraduate students) played a game continuously for up to 50 min while standing or sitting. We varied the distance to the display screen (and, consequently, the visual angle of the display). Across conditions, the incidence of motion sickness ranged from 42% to 56%; incidence did not differ across conditions. During game play, head and torso motion differed between sick and well participants prior to the onset of subjective symptoms of motion sickness. The results indicate that console video games carry a significant risk of motion sickness. Potential applications of this research include changes in the design of console video games and recommendations for how such systems should be used.

The impact of physical activity on sickness absence.

PubMed

Lahti, J; Laaksonen, M; Lahelma, E; Rahkonen, O

2010-04-01

The aim of this study was to examine whether the volume and intensity of physical activity are associated with subsequent sickness absence spells of different lengths, and how much of these associations can be explained by socioeconomic position, body mass index (BMI) and physical health functioning. Baseline data were collected by questionnaire surveys in 2000-2002 among 40-60-year-old employees of Helsinki City (n=6465, 79% women). Sickness absence data were derived from the employer's registers (mean follow-up time 3.9 years). Associations of physical activity with shorter (< or =14 days) and longer (>14 days) sickness absence spells were examined, using Poisson's regression analysis. The volume of physical activity was weakly and somewhat inconsistently associated with sickness absence. However, men and women who were vigorously active systematically had reduced risk of sickness absence, whereas the same volume of moderately intensive physical activity did not reduce the risk of sickness absence. Adjusting for BMI and in particular physical health functioning attenuated these associations, after which the associations lost statistical significance. The results suggest that vigorous physical activity is associated with sickness absence and may contribute to better work ability.

Sleep and Breathing in High Altitude Pulmonary Edema Susceptible Subjects at 4,559 Meters

PubMed Central

Nussbaumer-Ochsner, Yvonne; Schuepfer, Nicole; Ursprung, Justyna; Siebenmann, Christoph; Maggiorini, Marco; Bloch, Konrad E.

2012-01-01

Study objectives: Susceptible subjects ascending rapidly to high altitude develop pulmonary edema (HAPE). We evaluated whether HAPE leads to sleep and breathing disturbances that are alleviated by dexamethasone. Design: Double-blind, randomized, placebo-controlled trial with open-label extension. Setting: One night in sleep laboratory at 490 m, 2 nights in mountain hut at 4,559 m. Participants: 21 HAPE susceptibles. Intervention: Dexamethasone 2 × 8 mg/d, either 24 h prior to ascent and at 4,559 m (dex-early), or started on day 2 at 4,559 m only (dex-late). Measurements: Polysomnography, questionnaires on sleep and acute mountain sickness. Results: Polysomnographies at 490 m were normal. In dex-late (n = 12) at 4,559 m, night 1 and 3, median oxygen saturation was 71% and 80%, apnea/hypopnea index 91.3/h and 9.6/h. In dex-early (n = 9), corresponding values were 78% and 79%, and 85.3/h and 52.3/h (P < 0.05 vs. 490 m, all instances). In dex-late, ascending from 490 m to 4,559 m (night 1), sleep efficiency decreased from 91% to 65%, slow wave sleep from 20% to 8% (P < 0.05, both instances). In dex-early, corresponding sleep efficiencies were 96% and 95%, slow wave sleep 18% and 9% (P < 0.05). From night 1 to 3, sleep efficiency remained unchanged in both groups while slow wave sleep increased to 20% in dex-late (P < 0.01). Compared to dex-early, initial AMS scores in dex-late were higher but improved during stay at altitude. Conclusions: HAPE susceptibles ascending rapidly to high altitude experience pronounced nocturnal hypoxemia, and reduced sleep efficiency and deep sleep. Dexamethasone taken before ascent prevents severe hypoxemia and sleep disturbances, while dexamethasone taken 24 h after arrival at 4,559 m increases oxygenation and deep sleep. Citation: Nussbaumer-Ochsner Y; Schuepfer N; Ursprung J; Siebenmann C; Maggiorini M; Bloch KE. Sleep and breathing in high altitude pulmonary edema susceptible subjects at 4,559 meters. SLEEP 2012;35(10):1413-1421. PMID

20 CFR 335.6 - Payment of sickness benefits.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true Payment of sickness benefits. 335.6 Section 335.6 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT SICKNESS BENEFITS § 335.6 Payment of sickness benefits. (a) General rule. Except as provided...

20 CFR 335.6 - Payment of sickness benefits.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true Payment of sickness benefits. 335.6 Section 335.6 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT SICKNESS BENEFITS § 335.6 Payment of sickness benefits. (a) General rule. Except as provided...

20 CFR 335.6 - Payment of sickness benefits.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false Payment of sickness benefits. 335.6 Section 335.6 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT SICKNESS BENEFITS § 335.6 Payment of sickness benefits. (a) General rule. Except as provided...

20 CFR 335.6 - Payment of sickness benefits.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Payment of sickness benefits. 335.6 Section 335.6 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT SICKNESS BENEFITS § 335.6 Payment of sickness benefits. (a) General rule. Except as provided...

Determinants of sick-leave duration: a tool for managers?

PubMed

Flach, Peter A; Krol, Boudien; Groothoff, Johan W

2008-09-01

To provide managers with tools to manage episodes of sick-leave of their employees, the influence of factors such as age, gender, duration of tenure, working full-time or part-time, cause and history of sick-leave, salary and education on sick-leave duration was studied. In a cross-sectional study, data derived from the 2005 sick-leave files of a Dutch university were examined. Odds ratios of the single risk factors were calculated for short spells (or=91 days) of sick-leave. Next, these factors were studied in multiple regression models. Age, gender, duration of employment, cause and history of sick-leave, salary and membership of scientific staff, studied as single factors, have a significant influence on sick-leave duration. In multiple models, this influence remains for gender, salary, age, and history and cause of sick-leave. Only in medium or long spells and regarding the risk for a long or an extended spell do the predictive values of models consisting of psychological factors, work-related factors, salary and gender become reasonable. The predictive value of the risk factors used in this study is limited, and varies with the duration of the sick-leave spell. Only the risk for an extended spell of sick-leave as compared to a medium or long spell is reasonably predicted. Factors contributing to this risk may be used as tools in decision-making.

Metals: In Sickness and in Health

MedlinePlus

... Science > Metals: In Sickness and in Health Inside Life Science View All Articles | Inside Life Science Home Page Metals: In Sickness and in Health ... Do Fats Do in the Body? This Inside Life Science article also appears on LiveScience . Learn about related ...

Sleeping sickness

MedlinePlus

... to confirm the diagnosis. Tests include the following: Blood smear to check for parasites Cerebrospinal fluid tests (fluid from your spinal cord) Complete blood count (CBC) Lymph node aspiration Treatment Medicines used ...

Measures of work-family conflict predict sickness absence from work.

PubMed

Clays, Els; Kittel, France; Godin, Isabelle; Bacquer, Dirk De; Backer, Guy De

2009-08-01

To examine the relation between work-family conflict and sickness absence. The BELSTRESS III study comprised 2983 middle-aged workers. Strain-based work-home interference (WHI) and home-work interference (HWI) were assessed by means of self-administered questionnaires. Prospective data of registered sickness absence during 12-months follow-up were collected. Multiple logistic regression analysis was conducted. HWI was positively and significantly related to high sickness absence duration (at least 10 sick leave days) and high sickness absence frequency (at least 3 sick leave episodes) in men and women, also after adjustments were made for sociodemographic variables, health indicators, and environmental psychosocial factors. In multivariate analysis, no association between WHI and sickness absence was found. HWI was positively and significantly related to high sickness absence duration and frequency during 12-months follow-up in male and female workers.

Do work-place initiated measures reduce sickness absence? Preventive measures and sickness absence among older workers in Norway.

PubMed

Midtsundstad, Tove I; Nielsen, Roy A

2014-03-01

The article examines whether preventive measures and work adjustments at the establishment level affects sickness absence among workers aged 50 years and older. We combine survey data from a representative sample of 713 Norwegian companies, mapping the prevalence of preventive health measures in the work place in 2005, with register data on sickness absence and demographic variables for workers aged 50 years or older in 2001 and 2007. By means of a difference-in-differences approach, we compare changes and differences in the likelihood of sickness absence among the sample group, with and without the various measures/ instruments in 2005 respectively. In general, work-place preventive measures at the establishment level have not contributed to reducing the probability for sickness absence among workers aged 50 years and older. However, analyses comparing differences between industries find that the work-place measures have had a positive effect on public administration employees. Whether work-place preventive initiatives influence levels of sickness absence seems to be contingent on sector and industry. Therefore, work-place measures may be more effective in the public administration sector where most employees have office jobs compared to sectors such as manufacturing, construction and transportation, where many employees have manual work and more physical demanding jobs. Work-place initiatives thus seem to have less effect on preventing sickness absence in sectors dominated by manual labour.

Relative Deprivation and Sickness Absence in Sweden

PubMed Central

Helgertz, Jonas; Hess, Wolfgang; Scott, Kirk

2013-01-01

Background: A high prevalence of sickness absence in many countries, at a substantial societal cost, underlines the importance to understand its determining mechanisms. This study focuses on the link between relative deprivation and the probability of sickness absence. Methods: 184,000 men and women in Sweden were followed between 1982 and 2001. The sample consists of working individuals between the ages of 19 and 65. The outcome is defined as experiencing more than 14 days of sickness absence during a year. Based on the complete Swedish population, an individual’s degree of relative deprivation is measured through income compared to individuals of the same age, sex, educational level and type. In accounting for the possibility that sickness absence and socioeconomic status are determined by common factors, discrete-time duration models were estimated, accounting for unobserved heterogeneity through random effects. Results: The results confirm that the failure to account for the dynamics of the individual’s career biases the influence from socioeconomic characteristics. Results consistently suggest a major influence from relative deprivation, with a consistently lower risk of sickness absence among the highly educated. Conclusions: Altering individual’s health behavior through education appears more efficient in reducing the reliance on sickness absence, rather than redistributive policies. PMID:23996012

Spatial task performance, sex differences, and motion sickness susceptibility.

PubMed

Levine, Max E; Stern, Robert M

2002-10-01

There are substantial individual differences in susceptibility to motion sickness, yet little is known about what mediates these differences. Spatial ability and sex have been suggested as possible factors in this relationship. 89 participants (57 women) were administered a Motion Sickness Questionnaire that assesses motion sickness susceptibility, a Water-level Task that gauges sensitivity to gravitational upright, and a Mental Rotation Task that tests an individual's awareness of how objects typically move in space. Significant sex differences were observed in performance of both the Water-level Task (p<.01), and the Mental Rotation Task (p<.005), with women performing less accurately than men. Women also had significantly higher scores on the Motion Sickness Questionnaire (p<.005). Among men, but not women, significant negative relationships were observed between Water-level Task performance and Motion Sickness Questionnaire score (p<.001) and between Mental Rotation Task performance and Motion Sickness Questionnaire score (p<.005). In conclusion, women performed significantly more poorly than men did on the spatial ability tasks and reported significantly more bouts of motion sickness. In addition, men showed a significant negative relationship between spatial ability and motion sickness susceptibility.

Molecular epidemiological studies on animal trypanosomiases in Ghana

PubMed Central

2012-01-01

Background African trypanosomes are extracellular protozoan parasites that are transmitted between mammalian hosts by the bite of an infected tsetse fly. Human African Trypanosomiasis (HAT) or sleeping sickness is caused by Trypanosoma brucei rhodesiense or T. brucei gambiense, while African Animal Trypanosomiasis (AAT) is caused mainly by T. vivax, T. congolense, T. simiae,T. evansi and T. brucei brucei. Trypanosomiasis is of public health importance in humans and is also the major constraint for livestock productivity in sub-Saharan African countries. Scanty information exists about the trypanosomiasis status in Ghana especially regarding molecular epidemiology. Therefore, this study intended to apply molecular tools to identify and characterize trypanosomes in Ghana. Methods A total of 219 tsetse flies, 248 pigs and 146 cattle blood samples were collected from Adidome and Koforidua regions in Ghana in 2010. Initial PCR assays were conducted using the internal transcribed spacer one (ITS1) of ribosomal DNA (rDNA) primers, which can detect most of the pathogenic trypanosome species and T. vivax-specific cathepsin L-like gene primers. In addition, species- or subgroup-specific PCRs were performed for T. b. rhodesiense, T. b. gambiense, T. evansi and three subgroups of T. congolense. Results The overall prevalence of trypanosomes were 17.4% (38/219), 57.5% (84/146) and 28.6% (71/248) in tsetse flies, cattle and pigs, respectively. T. congolense subgroup-specific PCR revealed that T. congolense Savannah (52.6%) and T. congolense Forest (66.0%) were the endemic subgroups in Ghana with 18.6% being mixed infections. T. evansi was detected in a single tsetse fly. Human infective trypanosomes were not detected in the tested samples. Conclusion Our results showed that there is a high prevalence of parasites in both tsetse flies and livestock in the study areas in Ghana. This enhances the need to strengthen control policies and institute measures that help prevent the

Motion sickness incidence during a round-the-world yacht race.

PubMed

Turner, M; Griffin, M J

1995-09-01

Motion sickness experiences were obtained from participants in a 9 month, round the world yacht race. Race participants completed questionnaires on their motion sickness experience 1 week prior to the start of the race, during the race, and following the race. Yacht headings, sea states, and wind directions were recorded throughout the race. Illness and the occurrence of vomiting were related to the duration at sea and yacht encounter directions relative to the prevailing wind. Individual crewmember characteristics, the use of anti-motion sickness drugs, activity while at sea, and after-effects of yacht motion were also examined with respect to sickness occurrence. Sickness was greatest among females and younger crewmembers, and among crewmembers who used anti-motion sickness drugs. Sickness varied as a function of drug type and activity while at sea. Crewmembers who reported after-effects of yacht motion also reported greater sickness while at sea. The primary determinants of motion sickness were the duration of time spent at sea and yacht encounter direction to the prevailing wind.

Sickness certification difficulties in Ireland--a GP focus group study.

PubMed

Foley, M; Thorley, K; Von Hout, M-C

2013-07-01

Sickness certification causes problems for general practitioners (GPs). Difficulty with the assessment of capacity to work, conflict with patients and other non-medical factors have been shown to influence GPs' decision-making. Inadequate leadership and management of certification issues add to GPs' difficulties. To explore problems associated with sickness certification, as part of a larger mixed method research project exploring GPs' experiences and perceptions of sickness certification in Ireland. A qualitative study in an urban region of Ireland. A focus group of four male and four female GPs explored problems encountered by GPs in certifying sickness absence. Thematic data analysis was used. Three major themes emerged: perception of the sickness certification system, organization of health care and cultural factors in sickness absence behaviour. Employment structures in public and private sectors and lack of communication with other health care providers and employers were identified as complicating sickness certification. GPs encounter a complexity of issues in sick certification and are dissatisfied with their role in certifying sickness absence. Our results open the debate for policy change and development in Ireland.

Obesity and sickness absence: results from the CHAP study.

PubMed

Harvey, S B; Glozier, N; Carlton, O; Mykletun, A; Henderson, M; Hotopf, M; Holland-Elliott, K

2010-08-01

Obesity is an increasing public health problem. A small number of studies have examined the relationship between obesity and sickness absence, with mixed results, particularly regarding short-term sickness absence. To determine if obesity is associated with short- and long-term sickness absence and to investigate the mechanisms that may underlie any association. Cross-sectional (n = 1489) and prospective (n = 625) analyses were conducted on staff from London Underground Ltd. All participants underwent regular clinical examinations that involved their height and weight being measured, obesity-related medical problems being diagnosed and psychiatric disorders being identified. The number of days taken for short- (<10 days in an episode) and long-term sickness absence were recorded by managers on an electronic database. There was a positive linear association between employees' body mass index (BMI) and the number of days' work missed due to sickness absence on both cross-sectional and prospective analyses (P < 0.001). Obesity was a risk factor for both short- and long-term sickness absence. Obese individuals typically took an extra 4 days sick leave every year. The majority of the increased risk for long-term sickness absence appeared to be mediated via co-morbid chronic medical conditions. The excess short-term sickness absence was not explained by obesity-related medical problems, psychiatric disorders or workplace factors. Obese employees take significantly more short- and long-term sickness absence than workers of a healthy weight. There is growing evidence to support employers becoming more involved in tackling obesity.

How physicians have learned to handle sickness-certification cases.

PubMed

Löfgren, Anna; Silén, Charlotte; Alexanderson, Kristina

2011-05-01

Sickness absence is a common ''prescription'' in health care in many Western countries. Despite the significance of sick-listing for the life situation of patients, physicians have limited training in how to handle sickness-certification cases and the research about sickness-certification practices is scarce. Gain knowledge on physicians' learning regarding management of sickness certification of patients in formal, informal, and non-formal learning situations, respectively, and possible changes in this from 2004 to 2008. Data from two comprehensive questionnaires to physicians in Sweden about their sickness-certification practice in 2004 (n = 7665) and 2008 (n = 36,898); response rates: 71% and 61%, respectively. Answers from all the physicians ≤64 years old and who had sickness certification tasks (n = 4019 and n = 14,210) were analysed. ratings of importance of different types of learning situations for their sickness-certification competence. Few physicians stated that formal learning situations had contributed to a large or fairly large extent to their competence in sickness certification, e.g. undergraduate studies had done that for 17%, internship for 37%, and resident training for 46%, respectively. Contacts with colleagues had been helpful for 65%. One-third was helped by training arranged by social insurance offices. There was a significant increase between 2004 and 2008 in all items related to formal and non-formal learning situations, while there were no changes regarding informal learning situations. This study of all physicians in Sweden shows that physicians primarily attain competence in sickness certification in their daily clinical practice; through contacts with colleagues and patients.

Motion sickness history, food neophobia, and sensation seeking.

PubMed

Alley, Thomas R; Willet, Kathleen A; Muth, Eric R

2006-06-01

Motion sickness is believed to be caused by conflicting sensory signals, a situation that mimics the effects of ingesting certain toxins. Thus, one might suspect that individuals who have experienced a relatively high frequency of motion sickness may be particularly vigilant about avoiding anything that produces nausea, induding potentially nauseating toxins. Consequently, they may be more resistant to trying new foods, i.e., be more food neophobic, since unfamiliar foods can have unexpected adverse effects due to toxins or allergens. Likewise, many highly stimulating experiences can trigger motion sickness, so individuals who are more susceptible may be more prone to avoid such experiences, i.e., be less sensation seeking. Finally, it was expected that food neophobia would be more frequent in individuals low on sensation seeking tendencies. Self-reported motion sickness history in 308 adults (M= 18.8 yr.; SD = 1.6) was correlated with scores on the Arnett Inventory of Sensation Seeking and the Food Neophobia Scale. As predicted, greater history of motion sickness was associated with lower Sensation Seeking scores. Food Neophobia was not correlated with motion sickness history but, as expected, was negatively correlated (r = -.42) with scores on Sensation Seeking. Further research is recommended that measures actual sensitivity to motion sickness.

The durations of past sickness absences predict future absence episodes.

PubMed

Laaksonen, Mikko; He, Liang; Pitkäniemi, Janne

2013-01-01

To determine whether preceding absence episodes increase the risk of future sickness absence, we examined recurrence of short (1 to 3 days), intermediate (4 to 14 days), and long (>2 weeks) sickness-absence episodes. Data from 6934 municipal employees of the City of Helsinki were analyzed using proportional hazards models. Preceding sickness absence increased the risk of new sickness-absence episodes. The association was stronger for longer sickness absence spells and for men. Shorter absence spells also predicted longer absence spells. Working conditions and health behaviors did not modify the associations. The risk of recurrent sickness absences is higher for longer sickness-absence spells, which are often recurrent in nature. In addition, short absence spells predict future longer spells, suggesting that short absences are not trivial for health.

Sickness and sickness absence of remaining employees in a time of economic crisis: a study among employees of municipalities in Iceland.

PubMed

Sigursteinsdóttir, Hjördís; Rafnsdóttir, Gudbjörg Linda

2015-05-01

This article focuses on sickness and sickness absence among employees of 20 municipalities in Iceland who remained at work after the economic crisis in October 2008. The aim was to examine the impact of economic crisis on sickness and sickness absence of "survivors" working within the educational system (primary school teachers and kindergarten teachers) and the care services (elderly care and care of disabled people) operated by the municipalities. The study was based on mixed methods research comprising a balanced panel data set and focus groups. An online survey conducted three times among 2356 employees of 20 municipalities and seven focus group interviews in two municipalities (39 participants). The generalized estimating equations (GEE) were used to analyze the quantitative data, and focused coding was used to analyze the qualitative data. The main finding showed that the economic crisis had negative health implications for the municipal employees. The negative effects grew stronger over time. Employee sickness and sickness absence increased substantially in both downsized and non-downsized workplaces. However, employees of downsized workplaces were more likely to be sick. Sickness and sickness absence were more common among younger than older employees, but no gender differences were observed. The study demonstrates the importance of protecting the health and well-being of all employees in the wake of an economic crisis, not only those who lose their jobs or work in downsized workplaces. This is important in the immediate aftermath of a crisis, but also for a significant time thereafter. This is of practical relevance for those responsible for occupational health and safety, as most Western countries periodically go through economic crises, resulting in strains on employees. Copyright © 2015 Elsevier Ltd. All rights reserved.

Motion sickness, console video games, and head-mounted displays.

PubMed

Merhi, Omar; Faugloire, Elise; Flanagan, Moira; Stoffregen, Thomas A

2007-10-01

We evaluated the nauseogenic properties of commercial console video games (i.e., games that are sold to the public) when presented through a head-mounted display. Anecdotal reports suggest that motion sickness may occur among players of contemporary commercial console video games. Participants played standard console video games using an Xbox game system. We varied the participants' posture (standing vs. sitting) and the game (two Xbox games). Participants played for up to 50 min and were asked to discontinue if they experienced any symptoms of motion sickness. Sickness occurred in all conditions, but it was more common during standing. During seated play there were significant differences in head motion between sick and well participants before the onset of motion sickness. The results indicate that commercial console video game systems can induce motion sickness when presented via a head-mounted display and support the hypothesis that motion sickness is preceded by instability in the control of seated posture. Potential applications of this research include changes in the design of console video games and recommendations for how such systems should be used.

Munchausen syndrome: Playing sick or sick player

PubMed Central

Prakash, Jyoti; Das, R. C.; Srivastava, K.; Patra, P.; Khan, S. A.; Shashikumar, R.

2014-01-01

Munchausen syndrome is rare factitious disorder which entails frequent hospitalization, pathological lying and intentional production of symptoms for sick role. Management requires collateral history taking, sound clinical approach, exclusion of organicity and addressing psychological issues. A case which presented with unusual symptoms of similar dimension is discussed here. The case brings out finer nuances in evaluation and management of this entity. PMID:25535450

Do sleep, stress, and illness explain daily variations in fatigue? A prospective study.

PubMed

Akerstedt, Torbjörn; Axelsson, John; Lekander, Mats; Orsini, Nicola; Kecklund, Göran

2014-04-01

Fatigue is related to a number of serious diseases, as well as to general well-being. It is also a major cause of sickness absence and use of health facilities. Still, the determinants of variations in fatigue are little investigated. The purpose of present study was to investigate the relationships between the daily variations of fatigue with sleep during the previous night, stress or disease symptoms during the same day - across 42 consecutive days of normal life. 50 individuals participated and gave diary reports and used an actigraph across the 42days. The data was analyzed using a multilevel approach with mixed model regression. The analyses showed that the day-to-day variation in fatigue was related to (poor) sleep quality (p<.001) and (reduced) sleep duration (p<.01) the previous night, as well as to higher stress (p<.05), and to the occurrence of a cold or fever (p<.001) during the same day as the fatigue rating. Fatigue was also strongly related to poorer subjective health (p<.001) and sleepiness (p<.001) during the same day. The results indicate that prior sleep (and sleepiness) as well as stress and illness are consistently connected to how fatigue is experienced during normal living conditions. Copyright © 2014 Elsevier Inc. All rights reserved.

Do lower vertebrates suffer from motion sickness?

NASA Astrophysics Data System (ADS)

Lychakov, Dmitri

The poster presents literature data and results of the author’s studies with the goal to find out whether the lower animals are susceptible to motion sickness (Lychakov, 2012). In our studies, fish and amphibians were tested for 2 h and more by using a rotating device (f = 0.24 Hz, a _{centrifugal} = 0.144 g) and a parallel swing (f = 0.2 Hz, a _{horizontal} = 0.059 g). The performed studies did not revealed in 4 fish species and in toads any characteristic reactions of the motion sickness (sopite syndrome, prodromal preparatory behavior, vomiting). At the same time, in toads there appeared characteristic stress reactions (escape response, an increase of the number of urinations, inhibition of appetite), as well as some other reactions not associated with motion sickness (regular head movements, eye retractions). In trout fry the used stimulation promoted division of the individuals into the groups differing by locomotor reaction to stress, as well as the individuals with the well-expressed compensatory reaction that we called the otolithotropic reaction. Analysis of results obtained by other authors confirms our conclusions. Thus, the lower vertebrates, unlike mammals, are immune to motion sickness either under the land conditions or under conditions of weightlessness. On the basis of available experimental data and theoretical concepts of mechanisms of development the motion sickness, formulated in several hypotheses (mismatch hypothesis, Traisman‘ s hypothesis, resonance hypothesis), there presented the synthetic hypothesis of motion sickness that has the conceptual significance. According to the hypothesis, the unusual stimulation producing sensor-motor or sensor-sensor conflict or an action of vestibular and visual stimuli of frequency of about 0.2 Hz is perceived by CNS as poisoning and causes the corresponding reactions. The motion sickness actually is a byproduct of technical evolution. It is suggested that in the lower vertebrates, unlike mammals

[Sickness absence associated with major life events].

PubMed

Markussen, Simen; Røgeberg, Ole

2012-05-29

Sickness absence in the Norwegian workplace doubled in the period 1993-2003. However, the extent to which the driving factors were medical or non-medical remains unclear, as does the extent to which the cause may be found in the composition of the workforce. A differences-in-differences regression model was used to estimate the added sickness absence associated with major life events such as separation, death of spouse and pregnancy in the period 1993-2005. The data were obtained from administrative registers covering the entire Norwegian population, and include all absence periods of 16 days' duration or more reported by a doctor's medical certificate. The primary outcome measures were incidence (the proportion of absentees in a given time window) and absence (the proportion of sick days in a given time window). The level of absence among employees exposed to the specified life events was compared to control groups matched for gender, age, education and income. In 1993, people in each of the three groups exposed to major life events had more frequent and longer periods of absence than people in the control groups. This added sickness absence increased between 1993 and 2005. The changes in added sickness absence were at times significant, particularly for pregnant women. While sickness absence among pregnant women in 1993 was 15.4 percentage points higher than in the control group, the difference had increased to 24.8 percentage points in 2005. We find it improbable for the increase in added sickness absence to be caused by changes in the medical impact of life events or alterations in the workforce composition. We believe the increase is caused by changing attitudes among the working population and in the medical profession towards sickness absence on grounds that are not strictly medical, combined with improved social acceptance and diagnosis of mental health issues, and/or a medicalisation of natural health variations (pregnancy) and emotional distress (grief).

Reducing sick leave of Dutch vocational school students: adaptation of a sick leave protocol using the intervention mapping process.

PubMed

de Kroon, Marlou L A; Bulthuis, Jozien; Mulder, Wico; Schaafsma, Frederieke G; Anema, Johannes R

2016-12-01

Since the extent of sick leave and the problems of vocational school students are relatively large, we aimed to tailor a sick leave protocol at Dutch lower secondary education schools to the particular context of vocational schools. Four steps of the iterative process of Intervention Mapping (IM) to adapt this protocol were carried out: (1) performing a needs assessment and defining a program objective, (2) determining the performance and change objectives, (3) identifying theory-based methods and practical strategies and (4) developing a program plan. Interviews with students using structured questionnaires, in-depth interviews with relevant stakeholders, a literature research and, finally, a pilot implementation were carried out. A sick leave protocol was developed that was feasible and acceptable for all stakeholders. The main barriers for widespread implementation are time constraints in both monitoring and acting upon sick leave by school and youth health care. The iterative process of IM has shown its merits in the adaptation of the manual 'A quick return to school is much better' to a sick leave protocol for vocational school students.

[Simulator sickness and its measurement with Simulator Sickness Questionnaire (SSQ)].

PubMed

Biernacki, Marcin P; Kennedy, Robert S; Dziuda, Łukasz

One of the most common methods for studying the simulator sickness issue is the Simulator Sickness Questionnaire (SSQ) (Kennedy et al., 1993). Despite the undoubted popularity of the SSQ, this questionnaire has not as yet been standardized and translated, which could allow us to use it in Poland for research purposes. The aim of our article is to introduce the SSQ to Polish readers, both researchers and practitioners. In the first part of this paper, the studies using the SSQ are discussed, whereas the second part consists of the description of the SSQ test procedure and the calculation method of sample results. Med Pr 2016;67(4):545-555. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

[Quality of sleep and periodic breathing in healthy individuals working at an altitude of 3700 meters].

PubMed

Pływaczewski, R; Pałasiewicz, G; Sarybaev, A S; Le Roux, J; Usupbaeva, D A; Nowiński, A; Mirrakhimov, M M; Zieliński, J

1999-02-01

We performed full polysomnography (PSG) in 7 healthy miners of Kyrghyz origin (mean age 25 +/- 6 years) working in 2 weeks shifts at Kumtor gold mines at the elevation of 4200 m. They slept in comfortable dormitories situated at 3700 m. To avoid acute mountain sickness all subjects received acetazolamide 3 x 0.25 daily during 2 days preceding ascent and during 2 days at altitude: PSG was performed three times: at 760 m (1) and on the 1st (2) and 7th night (3) after rapid ascent (aircraft) to high altitude using SomnoTrac 4250 sleep laboratory. We found that sleep efficiency was good at lowland and in the mountains averaging 81.79% and 84% respectively. Although there were no significant differences in percentage of sleep stages and of total sleep time between lowland and both nights at high altitude, arousals and awakenings were more frequent in the mountains. Episodes of periodic breathing (PB) appeared at high altitude. There was a large individual variability in PB on both nights at altitude. The time spent in PB ranged from 4 to 30 minutes during the first night at altitude and from 3 to 17 minutes during the second one. PB appeared mainly during non-REM sleep and aggravated arterial blood desaturation.

Morning sickness

MedlinePlus

... of fluids. Eat foods high in protein and complex carbohydrates, such as peanut butter on apple slices or celery; nuts; cheese; crackers; milk; cottage cheese; and yogurt; avoid foods high in fat and salt, but low in nutrition. Ginger products (proven effective against morning sickness) such ...

Countermeasures to Neurobehavioral Deficits from Cumulative Partial Sleep Deprivation During Space Flight

NASA Technical Reports Server (NTRS)

Dinges, David F.

1999-01-01

This project is concerned with identifying ways to prevent neurobehavioral and physical deterioration due to inadequate sleep in astronauts during long-duration manned space flight. The performance capability of astronauts during extended-duration space flight depends heavily on achieving recovery through adequate sleep. Even with appropriate circadian alignment, sleep loss can erode fundamental elements of human performance capability including vigilance, cognitive speed and accuracy, working memory, reaction time, and physiological alertness. Adequate sleep is essential during manned space flight not only to ensure high levels of safe and effective human performance, but also as a basic regulatory biology critical to healthy human functioning. There is now extensive objective evidence that astronaut sleep is frequently restricted in space flight to averages between 4 hr and 6.5 hr/day. Chronic sleep restriction during manned space flight can occur in response to endogenous disturbances of sleep (motion sickness, stress, circadian rhythms), environmental disruptions of sleep (noise, temperature, light), and curtailment of sleep due to the work demands and other activities that accompany extended space flight operations. The mechanism through which this risk emerges is the development of cumulative homeostatic pressure for sleep across consecutive days of inadequate sleep. Research has shown that the physiological sleepiness and performance deficits engendered by sleep debt can progressively worsen (i.e., accumulate) over consecutive days of sleep restriction, and that sleep limited to levels commonly experienced by astronauts (i.e., 4 - 6 hr per night) for as little as 1 week, can result in increased lapses of attention, degradation of response times, deficits in complex problem solving, reduced learning, mood disturbance, disruption of essential neuroendocrine, metabolic, and neuroimmune responses, and in some vulnerable persons, the emergence of uncontrolled

Job satisfaction and short-term sickness absence among Dutch workers.

PubMed

Notenbomer, Annette; Roelen, Corné A M; Groothoff, Johan W

2006-06-01

Sickness absence is a considerable economic and social problem. Short-term sickness absence is known to be associated with behavioural attitudes. The correlation between sickness absence and job satisfaction has been studied infrequently and with contradictory results. This study investigated the correlation between short-term sickness absence and both global and specific job satisfaction. We defined short-term sickness absence as spells of up to 42 days. A random sample of 898 Dutch workers from a variety of economic sectors and companies received a self-report questionnaire on their first day of sick leave. The questionnaire measured global and specific job satisfaction. In our regression analysis, we controlled for the confounding factors of age, gender, educational level, perceived workload, job autonomy and decision latitude. The duration of an absence spell was defined as the amount of calendar days between sick leave and return to work. Global job satisfaction did not correlate significantly with the duration of short-term sickness absence. While increasing physical job demands predicted longer absence, increasing job autonomy and educational level predicted shorter absence. Satisfaction with colleagues predicted longer duration absence. Global job satisfaction did not correlate with the duration of short-term absence spells, but specific satisfaction with colleagues was associated with longer sickness spells.

Chinese hyper-susceptibility to vection-induced motion sickness

NASA Technical Reports Server (NTRS)

Stern, Robert M.; Hu, Senqi; Leblanc, Ree; Koch, Kenneth L.

1993-01-01

Little is known about the factors that control individual differences in susceptible to motion sickness. A serendipitous observation in our laboratory that most Chinese subjects become motion sick prompted this study. We used a rotating optokinetic drum to provoke motion sickness and compared gastric responses and symptom reports of Chinese, European-American, and African-American subjects. There was no difference in the responses of European-American and African-American subjects; however, Chinese subjects showed significantly greater disturbances in gastric activity and reported significantly more severe symptoms. We suggest that this hypersusceptibility presents a natural model for the study of physiological mechanisms of nausea and other symptoms of motion sickness.

Self-reported and employer-recorded sickness absence in doctors.

PubMed

Murphy, I J

2014-09-01

Doctors' sickness absence reduces the quality and continuity of patient care and is financially costly. Doctors have lower rates of sickness absence than other healthcare workers. To compare self-reported with recorded sickness absence in doctors in a UK National Health Service hospital trust. A retrospective questionnaire study. The main outcome measures were self-reported and trust-recorded sickness absence episodes of 4 days or more in two consecutive 6-month periods. The response rate was 82% (607/736). Self-reported sickness absence rates were 1.2% compared with a rate of 0.6% from trust-recorded data. There were 38 matched pairs of self-reported (mean duration: 18 days, standard deviation: 22 days) and trust-recorded (mean duration: 10 days, standard deviation: 17 days) sickness absence episodes of 4 days or more in the 12 months studied. A matched pairs t-test determined that the difference between the two means was significant (t = 2.57, P < 0.05). Doctors' sickness absence was significantly under-recorded in this study population. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Various anti-motion sickness drugs and core body temperature changes.

PubMed

Cheung, Bob; Nakashima, Ann M; Hofer, Kevin D

2011-04-01

Blood flow changes and inactivity associated with motion sickness appear to exacerbate the rate of core temperature decrease during subsequent body cooling. We investigated the effects of various classes of anti-motion sickness drugs on core temperature changes. There were 12 healthy male and female subjects (20-35 yr old) who were given selected classes of anti-motion sickness drugs prior to vestibular Coriolis cross coupling induced by graded yaw rotation and periodic pitch-forward head movements in the sagittal plane. All subjects were then immersed in water at 18 degrees C for a maximum of 90 min or until their core temperature reached 35 degrees C. Double-blind randomized trials were administered, including a placebo, a non-immersion control with no drug, and six anti-motion sickness drugs: meclizine, dimenhydrinate, chlorpheniramine, promethazine + dexamphetamine, promethazine + caffeine, and scopolamine + dexamphetamine. A 7-d washout period was observed between trials. Core temperature and the severity of sickness were monitored throughout each trial. A repeated measures design was performed on the severity of sickness and core temperature changes prior to motion provocation, immediately after the motion sickness end point, and throughout the period of cold-water immersion. The most effective anti-motion sickness drugs, promethazine + dexamphetamine (with a sickness score/duration of 0.65 +/- 0.17) and scopolamine + dexamphetamine (with a sickness score/duration of 0.79 +/- 0.17), significantly attenuated the decrease in core temperature. The effect of this attenuation was lower in less effective drugs. Our results suggest that the two most effective anti-motion sickness drugs are also the most effective in attenuating the rate of core temperature decrease.

Are environmental characteristics in the municipal eldercare, more closely associated with frequent short sick leave spells among employees than with total sick leave: a cross-sectional study.

PubMed

Stapelfeldt, Christina Malmose; Nielsen, Claus Vinther; Andersen, Niels Trolle; Krane, Line; Fleten, Nils; Borg, Vilhelm; Jensen, Chris

2013-06-13

It has been suggested that frequent-, short-term sick leave is associated with work environment factors, whereas long-term sick leave is associated mainly with health factors. However, studies of the hypothesis of an association between a poor working environment and frequent short spells of sick leave are few and results are inconsistent. Therefore, we aimed to explore associations between self-reported psychosocial work factors and workplace-registered frequency and length of sick leave in the eldercare sector. Employees from the municipal eldercare in Aarhus (N = 2,534) were included. In 2005, they responded to a work environment questionnaire. Sick leave records from 2005 were dichotomised into total sick leave days (0-14 and above 14 days) and into spell patterns (0-2 short, 3-9 short, and mixed spells and 1-3 long spells). Logistic regression models were used to analyse associations; adjusted for age, gender, occupation, and number of spells or sick leave length. The response rate was 76%; 96% of the respondents were women. Unfavourable mean scores in work pace, demands for hiding emotions, poor quality of leadership and bullying were best indicated by more than 14 sick leave days compared with 0-14 sick leave days. For work pace, the best indicator was a long-term sick leave pattern compared with a non-frequent short-term pattern. A frequent short-term sick leave pattern was a better indicator of emotional demands (1.62; 95% CI: 1.1-2.5) and role conflict (1.50; 95% CI: 1.2-1.9) than a short-term non-frequent pattern.Age (= < 40 / >40 years) statistically significantly modified the association between the 1-3 long-term sick leave spell pattern and commitment to the workplace compared with the 3-9 frequent short-term pattern. Total sick leave length and a long-term sick leave spell pattern were just as good or even better indicators of unfavourable work factor scores than a frequent short-term sick leave pattern. Scores in commitment to the workplace and

20 CFR 335.2 - Manner of claiming sickness benefits.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true Manner of claiming sickness benefits. 335.2 Section 335.2 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT SICKNESS BENEFITS § 335.2 Manner of claiming sickness benefits. (a) Forms required for...

20 CFR 335.2 - Manner of claiming sickness benefits.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Manner of claiming sickness benefits. 335.2 Section 335.2 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT SICKNESS BENEFITS § 335.2 Manner of claiming sickness benefits. (a) Forms required for...

20 CFR 335.2 - Manner of claiming sickness benefits.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true Manner of claiming sickness benefits. 335.2 Section 335.2 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT SICKNESS BENEFITS § 335.2 Manner of claiming sickness benefits. (a) Forms required for...

20 CFR 335.2 - Manner of claiming sickness benefits.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false Manner of claiming sickness benefits. 335.2 Section 335.2 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT SICKNESS BENEFITS § 335.2 Manner of claiming sickness benefits. (a) Forms required for...

Autogenic feedback training experiment: A preventative method for space motion sickness

NASA Technical Reports Server (NTRS)

Cowings, Patricia S.

1993-01-01

Space motion sickness is a disorder which produces symptoms similar to those of motion sickness on Earth. This syndrome has affected approximately 50 percent of all astronauts and cosmonauts exposed to microgravity in space, but it differs from what is commonly known as motion sickness in a number of critical ways. There is currently no ground-based method for predicting susceptibility to motion sickness in space. Antimotion sickness drugs have had limited success in preventing or counteracting symptoms in space, and frequently caused debilitating side effects. The objectives were: (1) to evaluate the effectiveness of Autogenic-Feedback Training as a countermeasure for space motion sickness; (2) to compare physiological data and in-flight symptom reports to ground-based motion sickness data; and (3) to predict susceptibility to space motion sickness based on pre-flight data of each treatment group crew member.

General autonomic components of motion sickness

NASA Technical Reports Server (NTRS)

Cowings, Patricia S.; Suter, Steve; Toscano, William B.; Kamiya, Joe; Naifeh, Karen

1986-01-01

This report refers to a body of investigations directed toward the examination of autonomic nervous system responses to motion sickness. Heart rate, respiration rate, finger pulse volume, and basal skin resistance were measured on 127 men and women before, during, and after exposure to a nauseogenic rotating chair test. Significant changes in all autonomic responses were observed across the tests (p less than .05). Significant differences in autonomic responses among groups divided according to motion sickness susceptibility were also observed (p less than .05). Results suggest that the examination of autonomic responses as an objective indicator of motion sickness malaise is warranted and may contribute to the overall understanding of the syndrome.

Work-related sickness absence negotiations: GPs' qualitative perspectives.

PubMed

Money, Annemarie; Hussey, Louise; Thorley, Kevan; Turner, Susan; Agius, Raymond

2010-10-01

GPs can find their role as issuers of sickness certification problematic, particularly in trying to maintain a balance between certifying absence and preserving the doctor-patient relationship. Little research has been published on consultations in which sickness absence has been certified. To explore negotiations between GPs and patients in sickness absence certification, including how occupational health training may affect this process. A qualitative study was undertaken with GPs trained in occupational health who also participate in a UK wide surveillance scheme studying work-related ill-health. Telephone interviews were conducted with 31 GPs who had reported cases with associated sickness absence. Work-related sickness absence and patients' requests for a 'sick note' vary by diagnosis. Some GPs felt their role as patient advocate was of utmost importance, and issue certificates on a patient's request, whereas others offer more resistance through a greater understanding of issues surrounding work and health acquired through occupational health training. GPs felt that their training helped them to challenge beliefs about absence from work being beneficial to patients experiencing ill-health; they felt better equipped to consider patients' fitness for work, and issued fewer certificates as a result of this. Complex issues surround GPs' role in the sickness-certification process, particularly when determining the patient's ability to work while maintaining a healthy doctor-patient relationship. This study demonstrates the potential impact of occupational health training for GPs, particularly in light of changes to the medical statement introduced in 2010.

[Obstructive Sleep Apnea Syndrome (OSAS): The role model of the Occupational Health Physician in specific clinical cases.].

PubMed

Proietti, L; Sciacchitano, C; Strano, S; Scifo, N; Rapisarda, V

2010-01-01

Nowadays Sleeping disorders are a very interesting topic in Occupational medicine, they are involved in reduction of working performances and increased risk of work accidents (in work environment or while driving). Medical surveillance made from the Occupational Health Physician can be very helpful in early diagnosis of this kind of disease; during 2008 we fi nd out Obstructive Sleeping Apnea Disease (OSAS) in some Healthcare workers. We reported some clinical cases that show the role model of the occupational health physician in this kind of sickness. Our Experience shows the duty of Occupational health physician it's not limited to medical surveillance, but also to Health Promotion (as wrote in D.Lgs 81/08). This can be obtained by clinical and occupational solutions, like correct work shift planning and lifestyle changes; so the interest of the occupational physician have to be focused on introducing in medical surveillance also measures of health promotion regarding sleep disorders with the aim of preserving health condition in workers.

Changes in sick-leave diagnoses over eleven years in a cohort of young adults initially sick-listed due to low back, neck, or shoulder diagnoses.

PubMed

Festin, Karin; Alexanderson, Kristina

2009-05-01

To study future general and diagnoses-specific sickness absence and disability pension among young adults who were initially on long-term sick-leave due to back, neck, or shoulder diagnoses. Eleven-year prospective cohort study. All 213 adults in a Swedish municipality who, in 1985, were in the age range 25-34 years and had begun a spell of sick-leave lasting > or = 28 days with low back, neck, or shoulder diagnoses. For the time-period 1985-96, data regarding the dates and diagnoses for all periods of sick-leave, and the dates of disability pension, emigration, and death were obtained. Numbers of days of sick-leave and disability pension were analysed separately for each of the 11 years in relation to the number of days at risk for such benefits. The cohort members were on sick-leave or disability pension for 25% of all days at risk during the 11 years of follow-up. A large difference in the number of sick-leave days between the 22% of subjects who were later granted disability pension and the others was already apparent during the first 2 years. During the entire period, up to 21% of the sick-leave days for women and 24% for men entailed psychiatric diagnoses. This cohort of young adults, initially off sick for 4 weeks due to back, neck, or shoulder diagnoses, also had a high level of sickness absence in the subsequent 11 years with other diagnoses.

Sleep and rhythm changes at the time of Trypanosoma brucei invasion of the brain parenchyma in the rat.

PubMed

Seke Etet, Paul F; Palomba, Maria; Colavito, Valeria; Grassi-Zucconi, Gigliola; Bentivoglio, Marina; Bertini, Giuseppe

2012-05-01

Human African trypanosomiasis (HAT), or sleeping sickness, is a severe disease caused by Trypanosoma brucei (T.b.). The disease hallmark is sleep alterations. Brain involvement in HAT is a crucial pathogenetic step for disease diagnosis and therapy. In this study, a rat model of African trypanosomiasis was used to assess changes of sleep-wake, rest-activity, and body temperature rhythms in the time window previously shown as crucial for brain parenchyma invasion by T.b. to determine potential biomarkers of this event. Chronic radiotelemetric monitoring in Sprague-Dawley rats was used to continuously record electroencephalogram, electromyogram, rest-activity, and body temperature in the same animals before (baseline recording) and after infection. Rats were infected with T.b. brucei. Data were acquired from 1 to 20 d after infection (parasite neuroinvasion initiates at 11-13 d post-infection in this model), and were compared to baseline values. Sleep parameters were manually scored from electroencephalographic-electromyographic tracings. Circadian rhythms of sleep time, slow-wave activity, rest-activity, and body temperature were studied using cosinor rhythmometry. Results revealed alterations of most of the analyzed parameters. In particular, sleep pattern and sleep-wake organization plus rest-activity and body temperature rhythms exhibited early quantitative and qualitative alterations, which became marked around the time interval crucial for parasite neuroinvasion or shortly after. Data derived from actigrams showed close correspondence with those from hypnograms, suggesting that rest-activity could be useful to monitor sleep-wake alterations in African trypanosomiasis.

Early Effects of the San Francisco Paid Sick Leave Policy

PubMed Central

Colla, Carrie H.; Dow, William H.; Dube, Arindrajit; Lovell, Vicky

2014-01-01

Objectives. We examined employers’ responses to San Francisco, California’s 2007 Paid Sick Leave Ordinance. Methods. We used the 2009 Bay Area Employer Health Benefits Survey to describe sick leave policy changes and the policy’s effects on firm (n = 699) operations. Results. The proportion of firms offering paid sick leave in San Francisco grew from 73% in 2006 to 91% in 2009, with large firms (99%) more likely to offer sick leave than are small firms (86%) in 2009. Most firms (57%) did not make any changes to their sick leave policy, although 17% made a major change to sick leave policy to comply with the law. Firms beginning to offer sick leave reported reductions in other benefits (39%), worse profitability (32%), and increases in prices (18%) but better employee morale (17%) and high support for the policy (71%). Many employers (58%) reported some difficulty understanding legal requirements, complying administratively, or reassigning work responsibilities. Conclusions. There was a substantial increase in paid sick leave coverage after the mandate. Employers reported some difficulties in complying with the law but supported the policy overall. PMID:24432927

Costs Of Using “Tiny Targets” to Control Glossina fuscipes fuscipes, a Vector of Gambiense Sleeping Sickness in Arua District of Uganda

PubMed Central

Shaw, Alexandra P. M.; Tirados, Inaki; Mangwiro, Clement T. N.; Esterhuizen, Johan; Lehane, Michael J.; Torr, Stephen J.; Kovacic, Vanja

2015-01-01

Introduction To evaluate the relative effectiveness of tsetse control methods, their costs need to be analysed alongside their impact on tsetse populations. Very little has been published on the costs of methods specifically targeting human African trypanosomiasis Methodology/Principal Findings In northern Uganda, a 250 km2 field trial was undertaken using small (0.5 X 0.25 m) insecticide-treated targets (“tiny targets”). Detailed cost recording accompanied every phase of the work. Costs were calculated for this operation as if managed by the Ugandan vector control services: removing purely research components of the work and applying local salaries. This calculation assumed that all resources are fully used, with no spare capacity. The full cost of the operation was assessed at USD 85.4 per km2, of which USD 55.7 or 65.2% were field costs, made up of three component activities (target deployment: 34.5%, trap monitoring: 10.6% and target maintenance: 20.1%). The remaining USD 29.7 or 34.8% of the costs were for preliminary studies and administration (tsetse surveys: 6.0%, sensitisation of local populations: 18.6% and office support: 10.2%). Targets accounted for only 12.9% of the total cost, other important cost components were labour (24.1%) and transport (34.6%). Discussion Comparison with the updated cost of historical HAT vector control projects and recent estimates indicates that this work represents a major reduction in cost levels. This is attributed not just to the low unit cost of tiny targets but also to the organisation of delivery, using local labour with bicycles or motorcycles. Sensitivity analyses were undertaken, investigating key prices and assumptions. It is believed that these costs are generalizable to other HAT foci, although in more remote areas, with denser vegetation and fewer people, costs would increase, as would be the case for other tsetse control techniques. PMID:25811956

Sick Sinus Syndrome

MedlinePlus

... rhythm problems (arrhythmias) in which the heart's natural pacemaker (sinus node) doesn't work properly. The sinus ... people with sick sinus syndrome eventually need a pacemaker to keep the heart in a regular rhythm. ...

Effectiveness of early part-time sick leave in musculoskeletal disorders.

PubMed

Martimo, Kari-Pekka; Kaila-Kangas, Leena; Kausto, Johanna; Takala, Esa-Pekka; Ketola, Ritva; Riihimäki, Hilkka; Luukkonen, Ritva; Karppinen, Jaro; Miranda, Helena; Viikari-Juntura, Eira

2008-02-25

The importance of staying active instead of bed rest has been acknowledged in the management of musculoskeletal disorders (MSDs). This emphasizes the potential benefits of adjusting work to fit the employee's remaining work ability. Despite part-time sick leave being an official option in many countries, its effectiveness has not been studied yet. We have designed a randomized controlled study to assess the health effects of early part-time sick leave compared to conventional full-day sick leave. Our hypothesis is that if work time is temporarily reduced and work load adjusted at the early stages of disability, employees with MSDs will have less disability days and faster return to regular work duties than employees on a conventional sick leave. The study population will consist of 600 employees, who seek medical advice from an occupational physician due to musculoskeletal pain. The inclusion requires that they have not been on a sick leave for longer than 14 days prior to the visit. Based on the physician's judgement, the severity of the symptoms must indicate a need for conventional sick leave, but the employee is considered to be able to work part-time without any additional risk. Half of the employees are randomly allocated to part-time sick leave group and their work time is reduced by 40-60%, whereas in the control group work load is totally eliminated with conventional sick leave. The main outcomes are the number of days from the initial visit to return to regular work activities, and the total number of sick leave days during 12 and 24 months of follow-up. The costs and benefits as well as the feasibility of early part-time sick leave will also be evaluated. This is the first randomised trial to our knowledge on the effectiveness of early part-time sick leave compared to conventional full-time sick leave in the management of MSDs. The data collection continues until 2011, but preliminary results on the feasibility of part-time sick leave will be available

Mortality among workers with chronic radiation sickness

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shilnikova, N.S.; Koshurnikova, N.A.; Bolotnikova, M.G.

1996-07-01

This study is based on a registry containing medical and dosimetric data of the employees who began working at different plants of the Mayak nuclear complex between 1948 and 1958 who developed chronic radiation sickness. Mayak is the first nuclear weapons plutonium production enterprise built in Russia and includes nuclear reactors, a radiochemical plant for plutonium separation, and a plutonium production enterprise built in Russia and includes nuclear reactors, a radiochemical plant for plutonium separation, and a plutonium production plant.Workers whose employment began between 1948 and 1958 exhibited a 6-28% incidence of chronic radiation sickness at the different facilities. Theremore » were no cases of chronic radiation sickness among those who began working after 1958. Data on doses of external whole-body gamma-irradiation and mortality in workers with chronic radiation sickness are presented. 6 refs., 5 tabs.« less

Are environmental characteristics in the municipal eldercare, more closely associated with frequent short sick leave spells among employees than with total sick leave: a cross-sectional study

PubMed Central

2013-01-01

Background It has been suggested that frequent-, short-term sick leave is associated with work environment factors, whereas long-term sick leave is associated mainly with health factors. However, studies of the hypothesis of an association between a poor working environment and frequent short spells of sick leave are few and results are inconsistent. Therefore, we aimed to explore associations between self-reported psychosocial work factors and workplace-registered frequency and length of sick leave in the eldercare sector. Methods Employees from the municipal eldercare in Aarhus (N = 2,534) were included. In 2005, they responded to a work environment questionnaire. Sick leave records from 2005 were dichotomised into total sick leave days (0–14 and above 14 days) and into spell patterns (0–2 short, 3–9 short, and mixed spells and 1–3 long spells). Logistic regression models were used to analyse associations; adjusted for age, gender, occupation, and number of spells or sick leave length. Results The response rate was 76%; 96% of the respondents were women. Unfavourable mean scores in work pace, demands for hiding emotions, poor quality of leadership and bullying were best indicated by more than 14 sick leave days compared with 0–14 sick leave days. For work pace, the best indicator was a long-term sick leave pattern compared with a non-frequent short-term pattern. A frequent short-term sick leave pattern was a better indicator of emotional demands (1.62; 95% CI: 1.1-2.5) and role conflict (1.50; 95% CI: 1.2-1.9) than a short-term non-frequent pattern. Age (= < 40 / >40 years) statistically significantly modified the association between the 1–3 long-term sick leave spell pattern and commitment to the workplace compared with the 3–9 frequent short-term pattern. Conclusions Total sick leave length and a long-term sick leave spell pattern were just as good or even better indicators of unfavourable work factor scores than a frequent short

Work-related sickness absence negotiations: GPs' qualitative perspectives

PubMed Central

Money, Annemarie; Hussey, Louise; Thorley, Kevan; Turner, Susan; Agius, Raymond

2010-01-01

Background GPs can find their role as issuers of sickness certification problematic, particularly in trying to maintain a balance between certifying absence and preserving the doctor–patient relationship. Little research has been published on consultations in which sickness absence has been certified. Aim To explore negotiations between GPs and patients in sickness absence certification, including how occupational health training may affect this process. Method A qualitative study was undertaken with GPs trained in occupational health who also participate in a UKwide surveillance scheme studying work-related ill-health. Telephone interviews were conducted with 31 GPs who had reported cases with associated sickness absence. Results Work-related sickness absence and patients' requests for a ‘sick note’ vary by diagnosis. Some GPs felt their role as patient advocate was of utmost importance, and issue certificates on a patient’s request, whereas others offer more resistance through a greater understanding of issues surrounding work and health aquired through occupational health training. GPs felt that their training helped them to challenge beliefs about absence from work being beneficial to patients experiencing ill-health; they felt better equipped to consider patients’ fitness for work, and issued fewer certificates as a result of this. Conclusion Complex issues surround GPs' role in the sickness-certification process, particularly when determining the patient's ability to work while maintaining a healthy doctor–patient relationship. This study demonstrates the potential impact of occupational health training for GPs, particularly in light of changes to the medical statement introduced in 2010. PMID:20883621

Sick leave patterns as predictors of disability pension or long-term sick leave: a 6.75-year follow-up study in municipal eldercare workers

PubMed Central

Stapelfeldt, Christina Malmose; Nielsen, Claus Vinther; Andersen, Niels Trolle; Krane, Line; Borg, Vilhelm; Fleten, Nils; Jensen, Chris

2014-01-01

Objectives The aim was to study whether a workplace-registered frequent short-term sick leave spell pattern was an early indicator of future disability pension or future long-term sick leave among municipal eldercare workers. Setting The municipal healthcare sector in the city of Aarhus, which is the second largest city in Denmark. Participants All elder care employees who worked the entire year of 2004 in the municipality of Aarhus, Denmark (N=2774). The employees’ sick leave days during 2004 were categorised into: 0–2 and 3–17 short (1–7 days) spells, 2–13 mixed short and long (8+ days) spells and long spells only. Student workers (n=180), employees who were absent due to maternal/paternal leave (n=536) and employees who did not work the entire year of 2004 (n=1218) were not included. Primary outcome Disability pension and long-term sick leave (≥8 weeks) were subsequently identified in a National register. The cumulative incidence proportion as a function of follow-up weeks was estimated using the Kaplan-Meier curve. The relative cumulative incidence (RR) of experiencing events within 352 weeks was analysed in a generalised linear regression model using the pseudo values method adjusted for age, occupation, unfavourable work factors and sick leave length. Results A frequent short-term and a mixed sick leave pattern showed RRs of being granted a disability pension of 2.08 (95% CI 1.00 to 4.35) and 2.61 (95% CI 1.33 to 5.12) compared with 0–2 short spells. The risk of long-term sick leave was significantly increased for all sick leave patterns compared with 0–2 short spells. Adding sick leave length to the models attenuated all RRs and they became non-significant. Conclusions Sick leave length was a better indicator of future workability than spell frequency. Preventive actions should target employees engaged in homecare. The more sick leave days the greater the preventive potential seems, irrespective of spell frequency. PMID:24508850

Stroboscopic Vision as a Treatment Motion Sickness

NASA Technical Reports Server (NTRS)

Reschke, Millard F.; Somers, J. T.; Ford, G.; Krnavek, J. M.; Hwang, E. y.; Kornilova, L. N.; Leigh, R. J.

2006-01-01

Results obtained from space flight indicate that most space crews will experience some symptoms of motion sickness causing significant impact on the operational objectives that must be accomplished to assure mission success. Based on the initial work of Melvill-Jones, we have evaluated stroboscopic vision as a method of preventing motion sickness. Methods: Nineteen subjects read text while making +/-20deg head movements in the horizontal plane at 0.2 Hz while wearing left-right reversing prisms during exposure to 4 Hz stroboscopic or normal room illumination. Testing was repeated using LCD shutter glasses as the stroboscopic source with an additional 19 subjects. Results: With Strobe, motion sickness was significantly lower than with normal room illumination. Results with the LCD shutter glasses were analogous to those observed with environmental strobe. Conclusions: Stroboscopic illumination appears to be effective where retinal slip is a factor in eliciting motion sickness. Additional research is evaluating the glasses efficacy for, carsickness, sickness in parabolic flight and seasickness. There is evidence from pilot studies showing that the glasses reduce saccade velocity to visually presented targets by approximately half of the normal values. It is interesting to note that adaptation to space flight may also slow saccade velocity.

Sickness absence among Finnish special and general education teachers.

PubMed

Ervasti, J; Kivimäki, M; Pentti, J; Suominen, S; Vahtera, J; Virtanen, M

2011-10-01

Although teaching is considered a high-stress profession, research on stress-related outcomes among teachers, such as absence from work due to illness (i.e. sickness absence), remains scarce. It is possible that teachers are not a homogeneous group but include subgroups with particularly high risk of sickness absence, such as special education teachers. To examine differences in sickness absence rates between special and general education teachers in a large cohort of 2291 Finnish lower secondary school teachers. Register data on teachers' job titles, sociodemographic characteristics and sickness absence were obtained from 10 municipal employers' registers. Indices of sickness absence included rates of short-term (1-3 days) and long-term (>3 days) absence spells during 2003-05. With multi-level models adjusted for individual- and school-level covariates, we found that although the absolute level of sickness absence was higher among women than among men, male special education teachers were at a 1.36-fold (95% CI: 1.15-1.61) increased risk of short-term and a 1.33-fold (95% CI: 1.01-1.76) increased risk of long-term sickness absence compared with male teachers in general education. Among women, there were no differences in sickness absence between special and general education teachers. Compared to male teachers in general education, male teachers in special education appear to have an excess risk of absence from work due to illness. Future studies should examine the causes for this excess risk and determine the need for preventive interventions.

What Is Being Done to Control Motion Sickness?

NASA Technical Reports Server (NTRS)

Hall, Y. D.

1985-01-01

AFT (Autogenic Feedback Training) involves practicing a series of mental exercises to speed up or slow down the control of autonomic activity. This produces a reduced tendency for autonomic activity levels to diverge from baseline (at rest) under stressful motion-sickness-inducing conditions. Subjects conditions. Subjects engaged in applying AFT exercises are required to closely monitor their own bodily sensations during motion-sickness-eliciting tests. These tests include the Coriolis Sickness Susceptibility Index (CSSI), which consists of sitting a subject into a rotating chair that moves at various speeds while a visual background turns at differing speeds and directions, and the Vertical Acceleration Rotation Device (VARD) test, which involves the placing of a subject in a drum that moves in an upward and downward motion until he or she is sick, while simultaneously monitoring the subject's vital signs. These tests provide investigators with evidence of slight changes in autonomic activities such as increases in heart rate, skin temperature, and sweat. All of these symptoms occur in subjects that experience bodily weakness or discomfort with the onset of motion sickness.

Sick leave and medication use in pregnancy: a European web-based study

PubMed Central

Truong, Bich Thuy; Lupattelli, Angela; Kristensen, Petter; Nordeng, Hedvig

2017-01-01

Background and objective A comparison of sick leave in pregnancy between countries is difficult as most studies have been conducted in single countries in Scandinavia. The objective of this study was to explore patterns of and reasons for sick leave during pregnancy on a multinational level, focusing on medication use but also differences in sick leave policies. Design and setting Cross-sectional, web-based study in 12 European countries from October 2011 to February 2012. Data were collected via an electronic questionnaire. Participants Pregnant women and mothers of children under the age of 1 year. Primary outcome measure Sick leave prevalence in pregnancy. Results Of 6686 women included, 3385 (50.6%) had been on sick leave during pregnancy. The rates of sick leave varied across countries, ranging from 31.7%–34.8% in Sweden and the UK to 62.4%–71.3% in Norway, Serbia, Croatia and Poland. The most common reasons for being on sick leave were pregnancy complications (26.5%); pain in the neck, back or pelvic girdle (16.2%); and nausea and vomiting (NVP, 16.0%). Women using medications for acute illnesses were more likely to be on sick leave than their non-medicated counterparts, while an opposite trend was observed for women with chronic disorders, where non-medicated women were more likely to be on sick leave. Women from countries with ‘low’ sick leave policies were less likely to have extensions of sick leaves compared with women from countries with ‘medium’ policies (adjusted OR 0.63, 95% CI 0.49 to 0.82). Conclusion The rates of sick leave in pregnancy vary greatly across European countries. Women using medications were more likely to be on sick leave, especially for acute illnesses. The differences in sick leave patterns across countries only partially reflected differences in sick leave policies, which implies that sick leave in pregnancy is also affected by other national differences. PMID:28775180

Sick leave and medication use in pregnancy: a European web-based study.

PubMed

Truong, Bich Thuy; Lupattelli, Angela; Kristensen, Petter; Nordeng, Hedvig

2017-08-03

A comparison of sick leave in pregnancy between countries is difficult as most studies have been conducted in single countries in Scandinavia. The objective of this study was to explore patterns of and reasons for sick leave during pregnancy on a multinational level, focusing on medication use but also differences in sick leave policies. Cross-sectional, web-based study in 12 European countries from October 2011 to February 2012. Data were collected via an electronic questionnaire. Pregnant women and mothers of children under the age of 1 year. Sick leave prevalence in pregnancy. Of 6686 women included, 3385 (50.6%) had been on sick leave during pregnancy. The rates of sick leave varied across countries, ranging from 31.7%-34.8% in Sweden and the UK to 62.4%-71.3% in Norway, Serbia, Croatia and Poland. The most common reasons for being on sick leave were pregnancy complications (26.5%); pain in the neck, back or pelvic girdle (16.2%); and nausea and vomiting (NVP, 16.0%). Women using medications for acute illnesses were more likely to be on sick leave than their non-medicated counterparts, while an opposite trend was observed for women with chronic disorders, where non-medicated women were more likely to be on sick leave. Women from countries with 'low' sick leave policies were less likely to have extensions of sick leaves compared with women from countries with 'medium' policies (adjusted OR 0.63, 95% CI 0.49 to 0.82). The rates of sick leave in pregnancy vary greatly across European countries. Women using medications were more likely to be on sick leave, especially for acute illnesses. The differences in sick leave patterns across countries only partially reflected differences in sick leave policies, which implies that sick leave in pregnancy is also affected by other national differences. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise

The impact of downsizing on remaining workers' sickness absence.

PubMed

Østhus, Ståle; Mastekaasa, Arne

2010-10-01

It is generally assumed that organizational downsizing has considerable negative consequences, not only for workers that are laid off, but also for those who remain employed. The empirical evidence with regard to effects on sickness absence is, however, inconsistent. This study employs register data covering a major part of the total workforce in Norway over the period 2000-2003. The number of sickness absence episodes and the number of sickness absence days are analysed by means of Poisson regression. To control for both observed and unobserved stable individual characteristics, we use conditional (fixed effects) estimation. The analyses provide some weak indications that downsizing may lead to slightly less sickness absence, but the overall impression is that downsizing has few if any effects on the sickness absence of the remaining employees. Copyright © 2010 Elsevier Ltd. All rights reserved.

Decompression sickness in breath-hold divers: a review.

PubMed

Lemaitre, Frederic; Fahlman, Andreas; Gardette, Bernard; Kohshi, Kiyotaka

2009-12-01

Although it has been generally assumed that the risk of decompression sickness is virtually zero during a single breath-hold dive in humans, repeated dives may result in a cumulative increase in the tissue and blood nitrogen tension. Many species of marine mammals perform extensive foraging bouts with deep and long dives interspersed by a short surface interval, and some human divers regularly perform repeated dives to 30-40 m or a single dive to more than 200 m, all of which may result in nitrogen concentrations that elicit symptoms of decompression sickness. Neurological problems have been reported in humans after single or repeated dives and recent necropsy reports in stranded marine mammals were suggestive of decompression sickness-like symptoms. Modelling attempts have suggested that marine mammals may live permanently with elevated nitrogen concentrations and may be at risk when altering their dive behaviour. In humans, non-pathogenic bubbles have been recorded and symptoms of decompression sickness have been reported after repeated dives to modest depths. The mechanisms implicated in these accidents indicate that repeated breath-hold dives with short surface intervals are factors that predispose to decompression sickness. During deep diving, the effect of pulmonary shunts and/or lung collapse may play a major role in reducing the incidence of decompression sickness in humans and marine mammals.

Substance Use as a Risk Factor for Sleep Problems Among Adolescents Presenting to the Emergency Department.

PubMed

Zhabenko, Olena; Austic, Elizabeth; Conroy, Deirdre A; Ehrlich, Peter; Singh, Vijay; Epstein-Ngo, Quyen; Cunningham, Rebecca M; Walton, Maureen A

2016-01-01

To determine correlates of sleep problems among adolescents. Specifically, to assess the relative strength of associations between sleep problems and dating victimization, reasons for emergency department (ED) visit, depression, unhealthy alcohol use, and other drug use (marijuana, nonmedical use of prescription opioids, stimulants, and tranquilizers). A total of 1852 adolescents aged 14 to 20 years presenting for care to the University of Michigan Emergency Department, Ann Arbor, Michigan, during 2011-2012, self-administered a computerized health survey. Sleep problems were identified if any of the 4 items on the Sleep Problems Questionnaire were rated by a patient as greater than 3 on a 0 to 5 scale. Adolescents who were too sick to be screened in the ED were eligible to participate in the study during their inpatient stay. Exclusion criteria for baseline included insufficient cognitive orientation precluding informed consent, not having parent/guardian present if younger than 18 years, medical severity precluding participation, active suicidal/homicidal ideation, non-English-speaking, deaf/visually impaired, or already participated in this study on a prior visit. 23.5% of adolescents reported clinically significant sleep problems. Female gender, depression, dating victimization, tobacco use, nonmedical use of prescription medication, and an ED visit for medical reasons were each associated with sleep problems among adolescents, even while controlling for age, other types of drug use, receiving public assistance, and dropping out of school. These exploratory findings indicate that ED-based screening and brief intervention approaches addressing substance use and/or dating victimization may need to account for previously undiagnosed sleep problems.

Associations between work stress, alcohol consumption and sickness absence.

PubMed

Vasse, R M; Nijhuis, F J; Kok, G

1998-02-01

To test an interactional model on the associations between work stressors, perceived stress, alcohol consumption and sickness absence. Cross-sectional survey. The study was part of a Worksite Health Project including an Employee Assistance Programme and a Health Promotion Programme in the Netherlands. Participants were blue-collar workers from two Municipal Garbage Collecting Departments and white-collar workers from a Pharmaceutical Company (N = 471). Measurements included socio-demographic characteristics (gender, age, education, marital status), work stressors, perceived stress, alcohol consumption and sickness absence. Type of work-site (blue- or white-collar) and smoking behaviour were used as covariates. Regression analyses resulted in three major findings. First, in the presence of stress, abstinence increased the risk of sickness absence compared with moderate drinking. We failed to find a significant relationship between excessive drinking and sickness absence. Secondly, stress mediated the associations between stressor and alcohol consumption, and between stressor and sickness absence, although stressors also directly predicted sickness absence. The association between abstinence and sickness absence could reflect medical problems of abstainers or a lack of skills for coping with stress. The failure to find a significant detrimental effect of excessive drinking may have been due to use of a low threshold for excessive drinking and/or low power. Prospective studies are needed to gain insight in causal relationships between the variables concerned.

Quantitative EEG Monitoring of Vigilance: Effects of Sleep Deprivation, Circadian Phase and Sympathetic Activation

NASA Technical Reports Server (NTRS)

Dijk, Derk-Jan

1999-01-01

Shuttle astronauts typically sleep only 6 to 6.5 hours per day while in orbit. This sleep loss is related to recurrent sleep cycle shifting--due to mission-dependent orbital mechanics and mission duration requirements-- and associated circadian displacement of sleep, the operational demands of space flight, noise and space motion sickness. Such sleep schedules are known to produce poor subjective sleep quality, daytime sleepiness, reduced attention, negative mood, slower reaction times, and impaired daytime alertness. Countermeasures to allow crew members to obtain an adequate amount of sleep and maintain adequate levels of neurobehavioral performance are being developed and investigated. However, it is necessary to develop methods that allow effective and attainable in-flight monitoring of vigilance to evaluate the effectiveness of these countermeasures and to detect and predict online critical decrements in alertness/performance. There is growing evidence to indicate that sleep loss and associated decrements in neurobehavioral function are reflected in the spectral composition of the electroencephalogram (EEG) during wakefulness as well as in the incidence of slow eye movements recorded by the electro-oculogram (EOG). Further-more, our preliminary data indicated that these changes in the EEG during wakefulness are more pronounced when subjects are in a supine posture, which mimics some of the physiologic effects of microgravity. Therefore, we evaluate the following hypotheses: (1) that during a 40-hour period of wakefulness (i.e., one night of total sleep deprivation) neurobehavioral function deteriorates, the incidence of slow eye-movements and EEG power density in the theta frequencies increases especially in frontal areas of the brain; (2) that the sleep deprivation induced deterioration of neurobehavioral function and changes in the incidence of slow eye movements and the spectral composition of the EEG are more pronounced when subjects are in a supine

Go to work or report sick? A focus group study on decisions of sickness presence among offshore catering section workers.

PubMed

Krohne, Kariann; Magnussen, Liv Heide

2011-03-18

To identify and explore the factors promoting sickness presenteeism among offshore catering section workers. Twenty men and women, working in the offshore catering section onboard three offshore oil and gas production platforms on the Norwegian Continental Shelf, participated in three focus groups. Data from the focus groups were analysed according to a phenomenological approach, and supported by theories on presenteeism. The results show that the decision to attend work despite illness, first and foremost, was based on the severity of the health complaint. Other factors identified were; the individual's location once the health complaint occurred, job satisfaction, the norms of the team, and experiences of how company policies on sickness absenteeism were implemented by the catering section leaders. Offshore working conditions may promote sickness presenteeism. The factors promoting sickness presenteeism onboard the platforms reflected experiences of a healthy work environment.

Companionable sleep: Social regulation of sleep and co-sleeping in Egyptian families

PubMed Central

Worthman, Carol M.; Brown, Ryan A.

2013-01-01

This exploratory study examines family sleep patterns and quality in a setting of normative napping and co-sleeping. Participants comprised 78 members of 16 families from two locales in Egypt, Cairo and village. Each family member provided a history of sleeping arrangements, one week of continuous activity records, and details of each sleep event. Sleep records documented late-onset and dispersed sleep patterns with extensive co-sleeping. Of recorded sleep events, 69% involved co-sleeping, 24% included more than one co-sleeper, and only 21% were solitary. Mid-late afternoon napping occurred on 31% of days and night sleep onsets averaged after midnight. Age and gender structured sleep arrangements and together with locale, extensively explained sleep behavior (onset, duration, total) and quality. Co-sleepers had fewer night arousals, shorter and less variable night sleep duration, and less total sleep. Increased solitary sleep in adolescents and young adults was associated with increased sleep dysregulation, including exaggerated phase shifts in males and more nighttime arousals in females. Where normative, co-sleeping may provide psychosensory stimuli that moderate arousal and stabilize sleep. Such moderating features may address important self-regulatory developmental needs during adolescence. PMID:17371117

Sleep deprivation attenuates endotoxin-induced cytokine gene expression independent of day length and circulating cortisol in male Siberian hamsters (Phodopus sungorus).

PubMed

Ashley, Noah T; Walton, James C; Haim, Achikam; Zhang, Ning; Prince, Laura A; Fruchey, Allison M; Lieberman, Rebecca A; Weil, Zachary M; Magalang, Ulysses J; Nelson, Randy J

2013-07-15

Sleep is restorative, whereas reduced sleep leads to negative health outcomes, such as increased susceptibility to disease. Sleep deprivation tends to attenuate inflammatory responses triggered by infection or exposure to endotoxin, such as bacterial lipopolysaccharide (LPS). Previous studies have demonstrated that Siberian hamsters (Phodopus sungorus), photoperiodic rodents, attenuate LPS-induced fever, sickness behavior and upstream pro-inflammatory gene expression when adapted to short day lengths. Here, we tested whether manipulation of photoperiod alters the suppressive effects of sleep deprivation upon cytokine gene expression after LPS challenge. Male Siberian hamsters were adapted to long (16 h:8 h light:dark) or short (8 h:16 h light:dark) photoperiods for >10 weeks, and were deprived of sleep for 24 h using the multiple platform method or remained in their home cage. Hamsters received an intraperitoneal injection of LPS or saline (control) 18 h after starting the protocol, and were killed 6 h later. LPS increased liver and hypothalamic interleukin-1 (IL-1) and tumor necrosis factor-alpha (TNF) gene expression compared with vehicle. Among LPS-challenged hamsters, sleep deprivation reduced IL-1 mRNA levels in liver and hypothalamus, but not TNF. IL-1 attenuation was independent of circulating baseline cortisol, which did not increase after sleep deprivation. Conversely, photoperiod altered baseline cortisol, but not pro-inflammatory gene expression in sleep-deprived hamsters. These results suggest that neither photoperiod nor glucocorticoids influence the suppressive effect of sleep deprivation upon LPS-induced inflammation.

Profiling the U.S. Sick Leave Landscape: Presenteeism among Females.

PubMed

Susser, Philip; Ziebarth, Nicolas R

2016-12-01

To profile the sick leave landscape in the United States. The 2011 Leave Supplement of the American Time Use Survey. Bivariate and multivariate analyses to identify (i) employees without sick pay coverage and (ii) employees who attend work sick. Sixty-five percent of full-time employees have sick pay coverage. Coverage rates are below 20 percent for employees with hourly wages below $10, part-time employees, and employees in the hospitality and leisure industry. Each week, up to 3 million U.S. employees go to work sick. Females, low-income earners, and those aged 25 to 34 years have a significantly elevated risk of presenteeism behavior. © Health Research and Educational Trust.

Space motion sickness monitoring experiment - Spacelab 1

NASA Technical Reports Server (NTRS)

Oman, Charles M.; Lichtenberg, Byron K.; Money, Kenneth E.

1990-01-01

A detailed firsthand report on symptoms and signs of space motion sickness and fluid shift observed by four specially trained crewmembers during Shuttle/Spacelab 1, launched on November 28, 1983 is presented. Results show that three crewmen experienced persistent overall discomfort and vomited repeatedly. Symptom pattern was generally similar to that seen in the individuals preflight, except that prodromalnausea was brief or absent in some cases. Symptoms were clearly modulated by head movement, were exacerbated by unfamiliar visual cues, and could be reduced by physical restraint providing contact cues around the body. The results support the view that space sickness is a form of motion sickness.

The effect of occupational and workplace gender composition on sickness absence.

PubMed

Laaksonen, Mikko; Martikainen, Pekka; Rahkonen, Ossi; Lahelma, Eero

2012-02-01

To examine whether gender composition of the occupation or the workplace is associated with sickness absence, whether the gender composition accounts for the observed female excess in sickness absence, and whether gender composition explains variation in sickness absence rates between occupations and workplaces. Random effects models conducted among Helsinki employees (N = 36,395). Women and men working in women-dominated occupations and workplaces had more short-term (1 to 3 days') sickness absence. Gender composition of the occupation and the workplace partly explained gender differences in short-term but not in intermediate (4 to 14 days') and long-term (>2 weeks') absence. Gender composition also explained variation in short-term sickness absence among occupations and workplaces, but this was partly accounted for by social class, income, and job contract type. The results are consistent with the assumption that short-term sickness absence reflects cultures and norms shaping sickness absence behavior.

A polymorphism in the haptoglobin, haptoglobin related protein locus is associated with risk of human sleeping sickness within Cameroonian populations.

PubMed

Ofon, Elvis; Noyes, Harry; Mulindwa, Julius; Ilboudo, Hamidou; Simuunza, Martin; Ebo'o, Vincent; Njiokou, Flobert; Koffi, Mathurin; Bucheton, Bruno; Fogue, Pythagore; Hertz-Fowler, Christiane; MacLeod, Annette; Simo, Gustave

2017-10-01

Human African Trypanosomiasis (HAT) is a neglected disease targeted for elimination as a public health problem by 2020. Elimination requires a better understanding of the epidemiology and clinical evolution of HAT. In addition to the classical clinical evolution of HAT, asymptomatic carriers and spontaneous cure have been reported in West Africa. A genetic component to human susceptibility to HAT has been suggested to explain these newly observed responses to infection. In order to test for genetic associations with infection response, genetic polymorphism in 17 genes were tested (APOL1, IL1B, IL4, IL4R, IL6, IL8, IL12B, IL12RB1, IL10, TNFA, INFG, MIF, HLA-G, HLA-A, HP, HPR and CFH). A case-control study was performed on 180 blood samples collected from 56 cases and 124 controls from Cameroon. DNA was extracted from blood samples. After quality control, 25 samples (24 controls and 1 case) were eliminated. The genotyping undertaken on 155 individuals including 55 cases and 100 controls were investigated at 96 loci (88 SNPs and 8 indels) located on 17 genes. Associations between these loci and HAT were estimated via a case-control association test. Analyses of 64 SNPs and 4 indels out of 96 identified in the selected genes reveal that the minor allele (T) of rs8062041 in haptoglobin (HP) appeared to be protective against HAT (p = 0.0002395, OR 0.359 (CI95 [0.204-0.6319])); indicating higher frequency in cases compared to controls. This minor allele with adjusted p value of 0.0163 is associated with a lower risk (protective effect) of developing sleeping sickness. The haptoglobin related protein HPR and HP are tightly linked and both are duplicated in some people and may lead to higher activity. This increased production could be responsible of the protection associated with rs8062041 even though this SNP is within HP.

A polymorphism in the haptoglobin, haptoglobin related protein locus is associated with risk of human sleeping sickness within Cameroonian populations

PubMed Central

Ofon, Elvis; Noyes, Harry; Mulindwa, Julius; Ilboudo, Hamidou; Simuunza, Martin; Ebo’o, Vincent; Njiokou, Flobert; Koffi, Mathurin; Bucheton, Bruno; Fogue, Pythagore; Hertz-Fowler, Christiane; MacLeod, Annette

2017-01-01

Background Human African Trypanosomiasis (HAT) is a neglected disease targeted for elimination as a public health problem by 2020. Elimination requires a better understanding of the epidemiology and clinical evolution of HAT. In addition to the classical clinical evolution of HAT, asymptomatic carriers and spontaneous cure have been reported in West Africa. A genetic component to human susceptibility to HAT has been suggested to explain these newly observed responses to infection. In order to test for genetic associations with infection response, genetic polymorphism in 17 genes were tested (APOL1, IL1B, IL4, IL4R, IL6, IL8, IL12B, IL12RB1, IL10, TNFA, INFG, MIF, HLA-G, HLA-A, HP, HPR and CFH). Methodology A case-control study was performed on 180 blood samples collected from 56 cases and 124 controls from Cameroon. DNA was extracted from blood samples. After quality control, 25 samples (24 controls and 1 case) were eliminated. The genotyping undertaken on 155 individuals including 55 cases and 100 controls were investigated at 96 loci (88 SNPs and 8 indels) located on 17 genes. Associations between these loci and HAT were estimated via a case-control association test. Results Analyses of 64 SNPs and 4 indels out of 96 identified in the selected genes reveal that the minor allele (T) of rs8062041 in haptoglobin (HP) appeared to be protective against HAT (p = 0.0002395, OR 0.359 (CI95 [0.204–0.6319])); indicating higher frequency in cases compared to controls. This minor allele with adjusted p value of 0.0163 is associated with a lower risk (protective effect) of developing sleeping sickness. Conclusion The haptoglobin related protein HPR and HP are tightly linked and both are duplicated in some people and may lead to higher activity. This increased production could be responsible of the protection associated with rs8062041 even though this SNP is within HP. PMID:29077717

Prevalence of acute mountain sickness in the Swiss Alps.

PubMed Central

Maggiorini, M; Bühler, B; Walter, M; Oelz, O

1990-01-01

OBJECTIVE--To assess the prevalence of symptoms and signs of acute mountain sickness of the Swiss Alps. DESIGN--A study using an interview and clinical examination in a representative population of mountaineers. Positive symptoms and signs were assigned scores to quantify the severity of acute mountain sickness. SETTING--Four huts in the Swiss Alps at 2850 m, 3050 m, 3650 m, and 4559 m. SUBJECTS--466 Climbers, mostly recreational: 47 at 2850 m, 128 at 3050 m, 82 at 3650, and 209 at 4559 m. RESULTS--In all, 117 of the subjects were entirely free of symptoms and clinical signs of acute mountain sickness; 191 had one or two symptoms and signs; and 158 had more than two. Those with more than two symptoms and signs were defined as suffering from acute mountain sickness. At 4559 m 11 climbers presented with high altitude pulmonary oedema or cerebral oedema, or both. Men and women were equally affected. The prevalence of acute mountain sickness correlated with altitude: it was 9% at 2850 m, 13% at 3050 m, 34% at 3650 m, and 53% at 4559 m. The most frequent symptoms and signs were insomnia, headache, peripheral oedema, and scanty pulmonary rales. Severe headache, vomiting, dizziness, tachypnoea, and pronounced pulmonary rales were associated with other symptoms and signs and therefore characteristic of acute mountain sickness. CONCLUSION--Acute mountain sickness is not an uncommon disease at moderately high altitude--that is, above 2800 m. Severe headache, vomiting, dizziness, tachypnoea, and pronounced pulmonary rales indicate severe acute mountain sickness, and subjects who suffer these should immediately descend to lower altitudes. PMID:2282425

Stroboscopic Vision as a Treatment for Space Motion Sickness

NASA Technical Reports Server (NTRS)

Reschke, Millard F.; Somers, Jeffrey T.; Ford, George; Krnavek, Jody M.

2007-01-01

Results obtained from space flight indicate that most space crews will experience some symptoms of motion sickness causing significant impact on the operational objectives that must be accomplished to assure mission success. Based on the initial work of Melvill Jones we have evaluated stroboscopic vision as a method of preventing motion sickness. Given that the data presented by professor Melvill Jones were primarily post hoc results following a study not designed to investigate motion sickness, it is unclear how motion sickness results were actually determined. Building on these original results, we undertook a three part study that was designed to investigate the effect of stroboscopic vision (either with a strobe light or LCD shutter glasses) on motion sickness using: (1) visual field reversal, (2) Reading while riding in a car (with or without external vision present), and (3) making large pitch head movements during parabolic flight.

Motion sickness elicited by passive rotation in squirrel monkeys

NASA Technical Reports Server (NTRS)

Daunton, Nancy G.; Fox, Robert A.

1991-01-01

Current theory and recent evidence suggest that motion sickness occurs under conditions of sensory input in which the normal motor programs for producing eye, head, and body movements are not functionally effective, i.e. under conditions in which there are difficulties in maintaining posture and controlling eye movements. Conditions involving conflicting or inconsistent visual-vestibular (VV) stimulation should thus result in greater sickness rates since the existing motor programs do not produce effective control of eye-head-body movements under such conditions. It is felt that the relationship of postural control to motion sickness is an important one and one often overlooked. The results are reported which showed that when postural requirements were minimized by fully restraining squirrel monkeys during hypogravity parabolic flight, no animals became motion sick, but over 80 percent of the same 11 animals became sick if they were unrestrained and maintained control of their posture.

Increasing accuracy in the assessment of motion sickness: A construct methodology

NASA Technical Reports Server (NTRS)

Stout, Cynthia S.; Cowings, Patricia S.

1993-01-01

The purpose is to introduce a new methodology that should improve the accuracy of the assessment of motion sickness. This construct methodology utilizes both subjective reports of motion sickness and objective measures of physiological correlates to assess motion sickness. Current techniques and methods used in the framework of a construct methodology are inadequate. Current assessment techniques for diagnosing motion sickness and space motion sickness are reviewed, and attention is called to the problems with the current methods. Further, principles of psychophysiology that when applied will probably resolve some of these problems are described in detail.

Modafinil as a potential motion sickness countermeasure.

PubMed

Hoyt, Robert E; Lawson, Benton D; McGee, Heather A; Strompolis, Melissa L; McClellan, Molly A

2009-08-01

Motion sickness adversely affects military air and sea operations. Medications help prevent motion sickness but are frequently associated with side effects. Better medications or combinations of medications are needed. Dextroamphetamine has documented anti-motion sickness effects but also has a potential for abuse. Modafinil is a relatively new central nervous system stimulant that has none of the drawbacks of dextroamphetamine, but has not been evaluated for the treatment of motion sickness. This double-blind, placebo-controlled study evaluated the anti-motion sickness efficacy of modafinil, alone or in combination with oral scopolamine. Moderate nausea was induced via a Coriolis cross-coupling stimulus. There were 60 participants who were assigned randomly to 1 of 3 conditions: 1) 2 placebo pills (DP); 2) modafinil plus placebo (MP); or 3) modafinil plus oral scopolamine (MS). The primary measure of drug efficacy was the number of head tilts tolerated upon reaching moderate nausea for 1 min without abatement. The combination of modafinil and scopolamine (MS) allowed subjects to tolerate significantly more head tilts than placebo, but modafinil alone (MP) failed to differ significantly from placebo (DP). No significant cognitive performance decrements were observed among the three experimental conditions. Modafinil was not found to be more effective than placebo. Further testing is recommended to determine whether the potentially promising combination of modafinil and scopolamine provides better efficacy or fewer side effects than scopolamine administered alone.

Genetic Dissociation of Daily Sleep and Sleep Following Thermogenetic Sleep Deprivation in Drosophila

PubMed Central

Dubowy, Christine; Moravcevic, Katarina; Yue, Zhifeng; Wan, Joy Y.; Van Dongen, Hans P.A.; Sehgal, Amita

2016-01-01

Study Objectives: Sleep rebound—the increase in sleep that follows sleep deprivation—is a hallmark of homeostatic sleep regulation that is conserved across the animal kingdom. However, both the mechanisms that underlie sleep rebound and its relationship to habitual daily sleep remain unclear. To address this, we developed an efficient thermogenetic method of inducing sleep deprivation in Drosophila that produces a substantial rebound, and applied the newly developed method to assess sleep rebound in a screen of 1,741 mutated lines. We used data generated by this screen to identify lines with reduced sleep rebound following thermogenetic sleep deprivation, and to probe the relationship between habitual sleep amount and sleep following thermogenetic sleep deprivation in Drosophila. Methods: To develop a thermogenetic method of sleep deprivation suitable for screening, we thermogenetically stimulated different populations of wake-promoting neurons labeled by Gal4 drivers. Sleep rebound following thermogenetically-induced wakefulness varies across the different sets of wake-promoting neurons that were stimulated, from very little to quite substantial. Thermogenetic activation of neurons marked by the c584-Gal4 driver produces both strong sleep loss and a substantial rebound that is more consistent within genotypes than rebound following mechanical or caffeine-induced sleep deprivation. We therefore used this driver to induce sleep deprivation in a screen of 1,741 mutagenized lines generated by the Drosophila Gene Disruption Project. Flies were subjected to 9 h of sleep deprivation during the dark period and released from sleep deprivation 3 h before lights-on. Recovery was measured over the 15 h following sleep deprivation. Following identification of lines with reduced sleep rebound, we characterized baseline sleep and sleep depth before and after sleep deprivation for these hits. Results: We identified two lines that consistently exhibit a blunted increase in the

Genetic Dissociation of Daily Sleep and Sleep Following Thermogenetic Sleep Deprivation in Drosophila.

PubMed

Dubowy, Christine; Moravcevic, Katarina; Yue, Zhifeng; Wan, Joy Y; Van Dongen, Hans P A; Sehgal, Amita

2016-05-01

Sleep rebound-the increase in sleep that follows sleep deprivation-is a hallmark of homeostatic sleep regulation that is conserved across the animal kingdom. However, both the mechanisms that underlie sleep rebound and its relationship to habitual daily sleep remain unclear. To address this, we developed an efficient thermogenetic method of inducing sleep deprivation in Drosophila that produces a substantial rebound, and applied the newly developed method to assess sleep rebound in a screen of 1,741 mutated lines. We used data generated by this screen to identify lines with reduced sleep rebound following thermogenetic sleep deprivation, and to probe the relationship between habitual sleep amount and sleep following thermogenetic sleep deprivation in Drosophila. To develop a thermogenetic method of sleep deprivation suitable for screening, we thermogenetically stimulated different populations of wake-promoting neurons labeled by Gal4 drivers. Sleep rebound following thermogenetically-induced wakefulness varies across the different sets of wake-promoting neurons that were stimulated, from very little to quite substantial. Thermogenetic activation of neurons marked by the c584-Gal4 driver produces both strong sleep loss and a substantial rebound that is more consistent within genotypes than rebound following mechanical or caffeine-induced sleep deprivation. We therefore used this driver to induce sleep deprivation in a screen of 1,741 mutagenized lines generated by the Drosophila Gene Disruption Project. Flies were subjected to 9 h of sleep deprivation during the dark period and released from sleep deprivation 3 h before lights-on. Recovery was measured over the 15 h following sleep deprivation. Following identification of lines with reduced sleep rebound, we characterized baseline sleep and sleep depth before and after sleep deprivation for these hits. We identified two lines that consistently exhibit a blunted increase in the duration and depth of sleep after

State of the Art in African Trypanosome Drug Discovery

PubMed Central

Jacobs, Robert T.; Nare, Bakela; Phillips, Margaret A.

2011-01-01

African sleeping sickness is endemic in sub-Saharan Africa where the WHO estimates that 60 million people are at risk for the disease. Human African trypanosomiasis (HAT) is 100% fatal if untreated and the current drug therapies have significant limitations due to toxicity and difficult treatment regimes. No new chemical agents have been approved since eflornithine in 1990. The pentamidine analog DB289, which was in late stage clinical trials for the treatment of early stage HAT recently failed due to toxicity issues. A new protocol for the treatment of late-stage T. brucei gambiense that uses combination nifurtomox/eflornithine (NECT) was recently shown to have better safety and efficacy than eflornithine alone, while being easier to administer. This breakthrough represents the only new therapy for HAT since the approval of eflornithine. A number of research programs are on going to exploit the unusual biochemical pathways in the parasite to identify new targets for target based drug discovery programs. HTS efforts are also underway to discover new chemical entities through whole organism screening approaches. A number of inhibitors with anti-trypanosomal activity have been identified by both approaches, but none of the programs are yet at the stage of identifying a preclinical candidate. This dire situation underscores the need for continued effort to identify new chemical agents for the treatment of HAT. PMID:21401507

Reducing sound and light exposure to improve sleep on the adult intensive care unit: An inclusive narrative review.

PubMed

Bion, Victoria; Lowe, Alex Sw; Puthucheary, Zudin; Montgomery, Hugh

2018-05-01

Sleep disturbance is common in intensive care units. It is associated with detrimental psychological impacts and has potential to worsen outcome. Irregular exposure to sound and light may disrupt circadian rhythm and cause frequent arousals from sleep. We sought to review the efficacy of environmental interventions to reduce sound and light exposure with the aim of improving patient sleep on adult intensive care units. We searched both PubMed (1966-30 May 2017) and Embase (1974-30 May 2017) for all relevant human (adult) studies and meta-analyses published in English using search terms ((intensive care OR critical care), AND (sleep OR sleep disorders), AND (light OR noise OR sound)). Bibliographies were explored. Articles were included if reporting change in patient sleep in response to an intervention to reduce disruptive intensive care unit sound /light exposure. Fifteen studies were identified. Nine assessed mechanical interventions, four of which used polysomnography to assess sleep. Five studies looked at environmental measures to facilitate sleep and a further two (one already included as assessing a mechanical intervention) studied the use of sound to promote sleep. Most studies found a positive impact of the intervention on sleep. However, few studies used objective sleep assessments, sample sizes were small, methodologies sometimes imperfect and analysis limited. Data are substantially derived from specialist (neurosurgical, post-operative, cardiothoracic and cardiological) centres. Patients were often at the 'less sick' end of the spectrum in a variety of settings (open ward beds or side rooms). Simple measures to reduce intensive care unit patient sound/light exposure appear effective. However, larger and more inclusive high-quality studies are required in order to identify the measures most effective in different patient groups and any impacts on outcome.

Factors associated with self-reported need for treatment of sleeping difficulties: a survey of the general Swedish population.

PubMed

Sandlund, Christina; Westman, Jeanette; Hetta, Jerker

2016-06-01

This study aims to investigate factors associated with the self-reported need for treatment of sleeping difficulties in the general population. This study consisted of a cross-sectional telephone survey of 1550 people randomly selected from the total population of Sweden. The survey, conducted by the Swedish national statistics agency, Statistics Sweden, was completed by 1115 people aged 18-85 years. Participants were asked about sleep patterns, daytime symptoms, physical and mental health disorders, use of prescribed hypnotics, help-seeking behaviors, and sociodemographic characteristics. They were also asked whether they thought they needed treatment for sleeping difficulties. A total of 12.5% of the participants reported a need for treatment because of sleeping difficulties. Significantly more women than men reported such a need (OR 1.46, 95% CI 1.02-2.10). Additionally, in univariate analyses, older age (age 60-69), sick leave, retirement, and unemployment were associated with a self-reported need for treatment, as were several sleep complaints, daytime symptoms, and physical and mental health disorders. A logistic regression model showed that difficulty initiating sleep (OR 6.29, 95% CI 3.67-10.78) was the factor most strongly associated with a self-reported need for treatment for sleeping difficulties. Other important factors were nonrestorative sleep (OR 3.70, 95% CI 2.05-6.69), mental health disorders (OR 3.01, 95% CI 1.59-5.67), and fatigue (OR 2.95, 95% CI 1.53-5.68). There was considerable self-reported need for treatment for sleeping difficulties in the population. Difficulty initiating sleep was the factor most strongly associated with this need, followed by nonrestorative sleep, mental health disorders, and fatigue. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Sleep in lonely heroin-dependent patients receiving methadone maintenance treatment: longer sleep latency, shorter sleep duration, lower sleep efficiency, and poorer sleep quality.

PubMed

Li, Hong-Jie; Zhong, Bao-Liang; Xu, Yan-Min; Zhu, Jun-Hong; Lu, Jin

2017-10-24

Given the socially isolated status of Chinese heroin-dependent patients (HDPs) and the significant association between loneliness and sleep problem in the general population, the impact of loneliness on sleep of HDPs is potentially substantial. The study aimed to test whether loneliness is associated with poor sleep in terms of quantity and quality in a consecutive sample of Chinese HDPs receiving methadone maintenance treatment (MMT). The study participants were 603 HDPs of three MMT clinics in Wuhan, China. Data on socio-demographic and clinical characteristics were collected by a standardized self-administered questionnaire. Sleep outcomes included sleep latency, sleep duration, sleep efficiency, and sleep quality. We measured depressive symptoms, loneliness, and sleep quality by using Zung's Self-rating Depression Scale, the single-item self-report of loneliness, and the Pittsburgh Sleep Quality Index, respectively. Multiple linear regression was used to examine whether loneliness is independently associated with sleep measures. After controlling for the confounding effects of potential socio-demographic and clinical variables, loneliness was significantly associated with longer sleep latency, shorter sleep duration, lower sleep efficiency, and poorer sleep quality. Loneliness may exacerbate sleep disturbance in Chinese HDPs of MMT clinics. Psychosocial interventions aimed at reducing loneliness in MMT clinics would improve the sleep of HDPs.

Part-time sick leave as a treatment method for individuals with musculoskeletal disorders.

PubMed

Andrén, Daniela; Svensson, Mikael

2012-09-01

There is increasing evidence that staying active is an important part of a recovery process for individuals on sick leave due to musculoskeletal disorders (MSDs). It has been suggested that using part-time sick-leave rather than full-time sick leave will enhance the possibility of full recovery to the workforce, and several countries actively favor this policy. The aim of this paper is to examine if it is beneficial for individuals on sick leave due to MSDs to be on part-time sick leave compared to full-time sick leave. A sample of 1,170 employees from the RFV-LS (register) database of the Social Insurance Agency of Sweden is used. The effect of being on part-time sick leave compared to full-time sick leave is estimated for the probability of returning to work with full recovery of lost work capacity. A two-stage recursive bivariate probit model is used to deal with the endogeneity problem. The results indicate that employees assigned to part-time sick leave do recover to full work capacity with a higher probability than those assigned to full-time sick leave. The average treatment effect of part-time sick leave is 25 percentage points. Considering that part-time sick leave may also be less expensive than assigning individuals to full-time sick leave, this would imply efficiency improvements from assigning individuals, when possible, to part-time sick leave.

Go to work or report sick? A focus group study on decisions of sickness presence among offshore catering section workers

PubMed Central

2011-01-01

Background To identify and explore the factors promoting sickness presenteeism among offshore catering section workers. Methods Twenty men and women, working in the offshore catering section onboard three offshore oil and gas production platforms on the Norwegian Continental Shelf, participated in three focus groups. Data from the focus groups were analysed according to a phenomenological approach, and supported by theories on presenteeism. Results The results show that the decision to attend work despite illness, first and foremost, was based on the severity of the health complaint. Other factors identified were; the individual's location once the health complaint occurred, job satisfaction, the norms of the team, and experiences of how company policies on sickness absenteeism were implemented by the catering section leaders. Conclusions Offshore working conditions may promote sickness presenteeism. The factors promoting sickness presenteeism onboard the platforms reflected experiences of a healthy work environment. PMID:21418561

Space motion sickness medications: interference with biomedical parameters

NASA Technical Reports Server (NTRS)

Vernikos-Danellis, J.; Winget, C. M.; Leach, C. S.; Rosenblatt, L. S.; Lyman, J.; Beljan, J. R.

1977-01-01

The possibility that drugs administered to Skylab 3 (SL-3) and 4 (SL-4) crewmen for space motion sickness may have interfered with their biomedical evaluation in space was investigated. Healthy volunteers received combinations of Scopolamine/Dexedrine for four days in regimens similar to those used in these missions. Urine samples, heart rate, body temperature, mood and performance were analyzed for drug-related changes. Twenty-four hour urine samples were analyzed by the same procedures as those used to analyze the flight samples. Hormone concentrations determined included cortisol, epinephrine, norepinephrine, aldosterone and antidiuretic hormone (ADH). In addition, volume, specific gravity, osmolarity, sodium (Na), potassium (K), calcium (Ca), magnesium (Mg), chloride (Cl), inorganic phosphate, uric acid and creatinine were measured. Performance was not affected by the Scopolamine/Dexedrine. The drug combination increased daily mean heart rate (HR) significantly in all the subjects and daily mean rectal temperature (RT) in some of the subjects. A 2-4 hr phase shift in the HR circadian rhythm was also observed which indicates that internal circadian synchrony was disturbed by the drugs. Psychological and subjective evaluation indicated that the subjects could usually identify which days they were given the drugs by an increase in tension and anxiety, decreased patience, restlessness, decreased appetite, difficulty in sleeping and feelings of increased heart rate and body temperature. Urinary electrolytes were not changed significantly by the drug, but marked and significant changes occurred in urine volume and hormone excretion patterns. Scopolamine/Dexedrine caused consistent elevations in urinary cortisol and epinephrine and a transient elevation in ADH. Norepinephrine excretion was decreased, but there was no significant change in aldosterone excretion or in 24 hr urine volume. A comparison of these findings with the first four days of inflight data from the

Testosterone treatment diminishes sickness behavior in male songbirds.

PubMed

Ashley, Noah T; Hays, Quentin R; Bentley, George E; Wingfield, John C

2009-06-01

Males of many vertebrate species are typically more prone to disease and infection than female conspecifics, and this sexual difference is partially influenced by the immunosuppressive properties of testosterone (T) in males. T-induced immunosuppression has traditionally been viewed as a pleiotropic handicap, rather than an adaptation. Recently, it has been hypothesized that suppression of sickness behavior, or the symptoms of infection, may have adaptive value if sickness interferes with the expression of T-mediated behaviors important for male reproductive success. We conduct a classic hormone replacement experiment to examine if T suppresses sickness behavior in a seasonally-breeding songbird, Gambel's white-crowned sparrow (Zonotrichia leucophrys gambelii). Triggered experimentally by bacterial lipopolysaccharide (LPS), sickness behavior includes decreased activity, anorexia, and weight loss. Gonadectomized (GDX) males that were treated with silastic implants filled with T exhibited suppression of behavioral and physiological responses to LPS compared to GDX and sham-GDX controls given empty implants. Sickness responses of control groups were statistically indistinguishable. T-implanted birds had significantly higher plasma T than control groups and levels were within the range associated with aggressive interactions during male-to-male contests. These findings imply that suppression of sickness behavior could occur when T is elevated to socially-modulated levels. Alternatively, it is possible that this suppressive effect is mediated through a stress-induced mechanism, as corticosterone levels were elevated in T-implanted subjects compared to controls. We propose that males wounded and infected during contests may gain a brief selective advantage by suppressing sickness responses that would otherwise impair competitive performance. The cost of immunosuppression would be manifested in males through an increased susceptibility to disease, which is presumably

Entitlement to Sickness Benefits in Sweden: The Social Insurance Officers Experiences

PubMed Central

Söderberg, Elsy; Müssener, Ulrika

2008-01-01

Background: Social insurance offices (SIOs) handle a wide range of complex assessments of the entitlement to sickness benefits for an increasing number of clients on sick leave and consequently, the demands on the SIOs have increased considerably. Aim: To gain deeper knowledge of the problems experienced by the SIOs in their work associated with entitlement to sickness benefits. Method: A descriptive and explorative qualitative approach was used to analyse data from two focus-group interviews, including six participants in each group. Results: The participants discussed different dilemmas in regard to; physicians’ responsibility for issuing sickness certificates, interactions with the insured individuals, disclosure of decisions, communications with medical consultants, documentation of sickness benefit claims, threats in the workplace, as well as their own competence. The SIOs regarded incomplete information on sickness certificates as a main problem, because they frequently had to contact the client and the physicians who issued the certificates in order to obtain further details, leading to delays in the decision-making whether to grant sickness benefits. Conclusions: More knowledge regarding SIOs work is required to improve the methods used in the sickness insurance system and to ensure adequate training of new staff members. PMID:21572827

GPs' negotiation strategies regarding sick leave for subjective health complaints.

PubMed

Nilsen, Stein; Malterud, Kirsti; Werner, Erik L; Maeland, Silje; Magnussen, Liv Heide

2015-03-01

To explore general practitioners' (GPs') specific negotiation strategies regarding sick-leave issues with patients suffering from subjective health complaints. Focus-group study. Nine focus-group interviews in three cities in different regions of Norway. 48 GPs (31 men, 17 women; age 32-65), participating in a course dealing with diagnostic practice and assessment of sickness certificates related to patients with subjective health complaints. The GPs identified some specific strategies that they claimed to apply when dealing with the question of sick leave for patients with subjective health complaints. The first step would be to build an alliance with the patient by complying with the wish for sick leave, and at the same time searching for information to acquire the patient's perspective. This position would become the basis for the main goal: motivating the patient for a rapid return to work by pointing out the positive effects of staying at work, making legal and moral arguments, and warning against long-term sick leave. Additional solutions might also be applied, such as involving other stakeholders in this process to provide alternatives to sick leave. GPs seem to have a conscious approach to negotiations of sickness certification, as they report applying specific strategies to limit the duration of sick leave due to subjective health complaints. This give-and-take way of handling sick-leave negotiations has been suggested by others to enhance return to work, and should be further encouraged. However, specific effectiveness of this strategy is yet to be proven, and further investigation into the actual dealings between doctor and patients in these complex encounters is needed.

GPs’ negotiation strategies regarding sick leave for subjective health complaints

PubMed Central

Malterud, Kirsti; Werner, Erik L; Maeland, Silje; Magnussen, Liv Heide

2015-01-01

Abstract Objectives. To explore general practitioners’ (GPs’) specific negotiation strategies regarding sick-leave issues with patients suffering from subjective health complaints. Design. Focus-group study. Setting. Nine focus-group interviews in three cities in different regions of Norway. Participants. 48 GPs (31 men, 17 women; age 32–65), participating in a course dealing with diagnostic practice and assessment of sickness certificates related to patients with subjective health complaints. Results. The GPs identified some specific strategies that they claimed to apply when dealing with the question of sick leave for patients with subjective health complaints. The first step would be to build an alliance with the patient by complying with the wish for sick leave, and at the same time searching for information to acquire the patient's perspective. This position would become the basis for the main goal: motivating the patient for a rapid return to work by pointing out the positive effects of staying at work, making legal and moral arguments, and warning against long-term sick leave. Additional solutions might also be applied, such as involving other stakeholders in this process to provide alternatives to sick leave. Conclusions and implications. GPs seem to have a conscious approach to negotiations of sickness certification, as they report applying specific strategies to limit the duration of sick leave due to subjective health complaints. This give-and-take way of handling sick-leave negotiations has been suggested by others to enhance return to work, and should be further encouraged. However, specific effectiveness of this strategy is yet to be proven, and further investigation into the actual dealings between doctor and patients in these complex encounters is needed. PMID:25602364

Low back pain predict sickness absence among power plant workers

PubMed Central

Murtezani, Ardiana; Hundozi, Hajrije; Orovcanec, Nikola; Berisha, Merita; Meka, Vjollca

2010-01-01

Background: Low back pain (LBP) remains the predominant occupational health problem in most industrialized countries and low-income countries. Both work characteristics and individual factors have been identified as risk factors. More knowledge about the predictors of sickness absence from LBP in the industry will be valuable in determining strategies for prevention. Objectives: The aim of this longitudinal study was to investigate whether individual, work-related physical risk factors were involved in the occurrence of LBP sickness absence. Methods: A follow-up study was conducted among 489 workers, aged 18–65 years, at Kosovo Energetic Corporation in Kosovo. This cross-sectional study used a self-administered questionnaire to collect data on individual and work-related risk factors and the occurrence of LBP sickness absence. Logistic regression models were used to determine associations between risk factors and the occurrence of sickness absence due to LBP. Results: Individual factors did not influence sickness absence, whereas work-related physical factors showed strong associations with sickness absence. The main risk factors for sickness absence due to LBP among production workers were extreme trunk flexion (OR = 1.71, 95% CI = 1.05–2.78) as well as very extreme trunk flexion (OR = 6.04, 95% CI = 1.12–32.49) and exposure to whole-body vibration (OR = 1.75, 95% CI = 1.04–2.95). Conclusion: Reducing sickness absence from LBP among power plant workers requires focusing on the working conditions of blue-collar workers and risk factors for LBP. Increasing social support in the work environment may have effects in reducing sickness absence from LBP. PMID:21120081

Systematic review of active workplace interventions to reduce sickness absence.

PubMed

Odeen, M; Magnussen, L H; Maeland, S; Larun, L; Eriksen, H R; Tveito, T H

2013-01-01

The workplace is used as a setting for interventions to prevent and reduce sickness absence, regardless of the specific medical conditions and diagnoses. To give an overview of the general effectiveness of active workplace interventions aimed at preventing and reducing sickness absence. We systematically searched PubMed, Embase, Psych-info, and ISI web of knowledge on 27 December 2011. Inclusion criteria were (i) participants over 18 years old with an active role in the intervention, (ii) intervention done partly or fully at the workplace or at the initiative of the workplace and (iii) sickness absence reported. Two reviewers independently screened articles, extracted data and assessed risk of bias. A narrative synthesis was used. We identified 2036 articles of which, 93 were assessed in full text. Seventeen articles were included (2 with low and 15 with medium risk of bias), with a total of 24 comparisons. Five interventions from four articles significantly reduced sickness absence. We found moderate evidence that graded activity reduced sickness absence and limited evidence that the Sheerbrooke model (a comprehensive multidisciplinary intervention) and cognitive behavioural therapy (CBT) reduced sickness absence. There was moderate evidence that workplace education and physical exercise did not reduce sickness absence. For other interventions, the evidence was insufficient to draw conclusions. The review found limited evidence that active workplace interventions were not generally effective in reducing sickness absence, but there was moderate evidence of effect for graded activity and limited evidence for the effectiveness of the Sheerbrooke model and CBT.

Stroboscopic Goggles for Reduction of Motion Sickness

NASA Technical Reports Server (NTRS)

Reschke, M. F.; Somers, Jeffrey T.

2005-01-01

A device built around a pair of electronic shutters has been demonstrated to be effective as a prototype of stroboscopic goggles or eyeglasses for preventing or reducing motion sickness. The momentary opening of the shutters helps to suppress a phenomenon that is known in the art as retinal slip and is described more fully below. While a number of different environmental factors can induce motion sickness, a common factor associated with every known motion environment is sensory confusion or sensory mismatch. Motion sickness is a product of misinformation arriving at a central point in the nervous system from the senses from which one determines one s spatial orientation. When information from the eyes, ears, joints, and pressure receptors are all in agreement as to one s orientation, there is no motion sickness. When one or more sensory input(s) to the brain is not expected, or conflicts with what is anticipated, the end product is motion sickness. Normally, an observer s eye moves, compensating for the anticipated effect of motion, in such a manner that the image of an object moving relatively to an observer is held stationary on the retina. In almost every known environment that induces motion sickness, a change in the gain (in the signal-processing sense of gain ) of the vestibular system causes the motion of the eye to fail to hold images stationary on the retina, and the resulting motion of the images is termed retinal slip. The present concept of stroboscopic goggles or eyeglasses (see figure) is based on the proposition that prevention of retinal slip, and hence, the prevention of sensory mismatch, can be expected to reduce the tendency toward motion sickness. A device according to this concept helps to prevent retinal slip by providing snapshots of the visual environment through electronic shutters that are brief enough that each snapshot freezes the image on each retina. The exposure time for each snapshot is less than 5 ms. In the event that a higher

Methods of Reducing Sick Leave Abuse. An ERS Information Aid.

ERIC Educational Resources Information Center

Stemnock, Suzanne K.

A perennial concern to educational administrators is the abuse of sick leave by school employees. Numerous suggestions have been offered for reducing the abuse of sick leave both within education and industry. This publication reviews 12 research studies that evaluate plans for reducing sick leave abuse among various categories of employees. Also…

Proinflammatory cytokines, sickness behavior, and Alzheimer disease.

PubMed

Holmes, C; Cunningham, C; Zotova, E; Culliford, D; Perry, V H

2011-07-19

In Alzheimer disease (AD), systemic inflammation is known to give rise to a delirium. However, systemic inflammation also gives rise to other centrally mediated symptoms in the absence of a delirium, a concept known as sickness behavior. Systemic inflammation is characterized by the systemic production of the proinflammatory cytokines tumor necrosis factor-α (TNFα) and interleukin-6 (IL-6) that mediate immune to brain communication and the development of sickness behavior. To determine if raised serum TNFα or IL-6 are associated with the presence of sickness behavior symptoms, independent of the development of delirium, in a prospective cohort study of subjects with AD. A total of 300 subjects with mild to severe AD were cognitively assessed at baseline and a blood sample taken for inflammatory markers. Cognitive assessments, including assessments to detect the development of a delirium, and blood samples were repeated at 2, 4, and 6 months. The development of neuropsychiatric symptoms in the subject with AD over the 6-month follow-up period was assessed independently by carer interview at 2, 4, and 6 months. Raised serum TNFα and IL-6, but not CRP, were associated with an approximately 2-fold increased frequency of neuropsychiatric symptoms characteristic of sickness behavior. These relationships are independent of the development of delirium. Increased serum proinflammatory cytokines are associated with the presence of symptoms characteristic of sickness behavior, which are common neuropsychiatric features found in AD. This association was independent of the presence of delirium.

Travelers' Health: Motion Sickness

MedlinePlus

... Minute Travel Long-Term Travel Mass Gatherings Medical Tourism Mental Health Motion Sickness Natural Disasters Pregnant Travelers Road Safety Senior Citizens Sex Tourism STDs Sun Exposure Swimming and Diving Study Abroad ...

Cinnarizine for Sea Sickness During a Remote Pacific Ocean Rescue Mission.

PubMed

Lyon, Regan F; Rush, Stephen C; Roland, J Thomas; Jethanamest, Daniel; Schwan, Christopher P; Kharon, Chetan U

2015-01-01

Motion sickness can be a limiting factor for sea and air missions. We report the experience of a Pararescue (PJ) team on a Pacific Ocean rescue mission in which motion sickness was prevalent. Cinnarizine, an antagonist of H1-histamine receptors, was used to treat affected PJs. We also report findings of a survey of PJs regarding motion sickness. A family of four on a disabled sailboat 900 miles off the coast of Mexico sent out a distress call because their 1-year-old daughter became severely ill with fever and diarrhea. Four PJs were deployed on a C-130, performed a free-fall parachute insertion into the ocean, and boarded the sailboat. All four PJs experienced onset of motion sickness at some point during the early part of the mission and symptoms persisted through the first 24 hours. Three PJs experienced ongoing nausea, vomiting, dizziness, and sensory imbalances. The captain of the sailboat offered the three sick PJs approximately 18mg of cinnarizine two or three times a day with relief of symptoms and improvement on operational effectiveness. A new, anonymous, voluntary survey of Air National Guard PJs and combat rescue officers revealed that 78.4% of Operators have experienced motion sickness at sea. We discuss the current theories on motion sickness, the effect of motion sickness on operational effectiveness, and research on treatment of motion sickness, including the medication cinnarizine. 2015.

Per capita alcohol consumption and sickness absence in Norway.

PubMed

Norström, Thor; Moan, Inger Synnøve

2009-08-01

There is only one previous study addressing the relationship between population drinking and sickness absence. That study, based on Swedish time-series data, showed a statistically significant relationship between per capita alcohol consumption and the male sickness absence rate. Estimates suggested that a 1-l increase in consumption was associated with a 13% increase in sickness absence among men. In the present study, we aim at replicating and expanding the Swedish study on the basis of data for Norway. The outcome measure comprised annual data for Norway on registered sickness absence for manual employees covering the period 1957-2001. The unemployment rate was included as a control, as this factor may be correlated with alcohol as well as sickness absence. Alcohol consumption was gauged by sales of alcohol (total and beverage specific by beer, spirits and wine) per inhabitant 15 years and above. The data were analysed using the Box-Jenkins method for time-series analysis. The results suggested that a 1-l increase in total consumption was associated with a 13% increase in sickness absence among men (P < 0.05). This corresponds to an elasticity coefficient equal to 0.62. The alcohol effect was not significant for women. Unemployment was negatively associated with the outcome for men as well as for women (P < 0.05). In the beverage-specific analyses, spirits were statistically significant for men (P < 0.05), but not beer and wine. The present findings strengthen the conclusion from the Swedish study, that sickness absence may be added to the list of indicators of alcohol-related harm.

Prediction of sickness absence: development of a screening instrument

PubMed Central

Duijts, S F A; Kant, IJ; Landeweerd, J A; Swaen, G M H

2006-01-01

Objectives To develop a concise screening instrument for early identification of employees at risk for sickness absence due to psychosocial health complaints. Methods Data from the Maastricht Cohort Study on “Fatigue at Work” were used to identify items to be associated with an increased risk of sickness absence. The analytical procedures univariate logistic regression, backward stepwise linear regression, and multiple logistic regression were successively applied. For both men and women, sum scores were calculated, and sensitivity and specificity rates of different cut‐off points on the screening instrument were defined. Results In women, results suggested that feeling depressed, having a burnout, being tired, being less interested in work, experiencing obligatory change in working days, and living alone, were strong predictors of sickness absence due to psychosocial health complaints. In men, statistically significant predictors were having a history of sickness absence, compulsive thinking, being mentally fatigued, finding it hard to relax, lack of supervisor support, and having no hobbies. A potential cut‐off point of 10 on the screening instrument resulted in a sensitivity score of 41.7% for women and 38.9% for men, and a specificity score of 91.3% for women and 90.6% for men. Conclusions This study shows that it is possible to identify predictive factors for sickness absence and to develop an instrument for early identification of employees at risk for sickness absence. The results of this study increase the possibility for both employers and policymakers to implement interventions directed at the prevention of sickness absence. PMID:16698807

The susceptibility of rhesus monkeys to motion sickness

NASA Technical Reports Server (NTRS)

Corcoran, Meryl L.; Daunton, Nancy G.; Fox, Robert A.

1990-01-01

The susceptibility of rhesus monkeys to motion sickness was investigated using test conditions that are provocative for eliciting motion sickness in squirrel monkeys. Ten male rhesus monkeys and ten male Bolivian squirrel monkeys were rotated in the vertical axis at 150 deg/s for a maximum duration of 45 min. Each animal was tested in two conditions, continuous rotation and intermittent rotation. None of the rhesus monkeys vomited during the motion tests but all of the squirrel monkeys did. Differences were observed between the species in the amount of activity that occurred during motion test, with the squirrel monkeys being significantly more active than the rhesus monkeys. These results, while substantiating anecdotal reports of the resistance of rhesus monkeys to motion sickness, should be interpreted with caution because of the documented differences that exist between various species with regard to stimuli that are provocative for eliciting motion sickness.

Sickness absence, moral hazard, and the business cycle.

PubMed

Pichler, Stefan

2015-06-01

The procyclical nature of sickness absence has been documented by many scholars in literature. So far, explanations have been based on labor force composition and reduced moral hazard caused by fear of job loss during recessions. In this paper, we propose and test a third mechanism caused by reduced moral hazard during booms and infections. We suggest that the workload is higher during economic booms and thus employees have to go to work despite being sick. In a theoretical model focusing on infectious diseases, we show that this will provoke infections of coworkers leading to overall higher sickness absence during economic upturns. Using state-level aggregated data from 112 German public health insurance funds (out of 145 in total), we find that sickness absence due to infectious diseases shows the largest procyclical pattern, as predicted by our theoretical model. Copyright © 2014 John Wiley & Sons, Ltd.

Effects of Autonomic Conditioning on Motion Sickness Tolerance

NASA Technical Reports Server (NTRS)

Cowings, P. S.; Toscano, W. B.

1994-01-01

This paper presents case-studies of 9 shuttle crewmembers (prime and alternates) and one U.S. Navy F-18 pilot, as they participated in all preflight training and testing activities in support of a life sciences flight experiment aboard Spacelab-J, and Spacelab-3. The primary objective of the flight experiment was to determine if Autogenic-feedback training (AFT), a physiological self-regulation training technique would be an effective treatment for motion sickness and space motion sickness in these crewmembers. Additional objectives of this study involved the examining human Physiological- responses to motion sickness on Earth and in space, as well as developing predictive criteria for susceptibility to space motion sickness based on ground-based data. Comparisons of these crewmembers are made to a larger set of subjects from previous experiments (treatment and test-only controls subjects). This paper describes all preflight methods, results and proposed changes for future tests.

Human heart rate variability relation is unchanged during motion sickness

NASA Technical Reports Server (NTRS)

Mullen, T. J.; Berger, R. D.; Oman, C. M.; Cohen, R. J.

1998-01-01

In a study of 18 human subjects, we applied a new technique, estimation of the transfer function between instantaneous lung volume (ILV) and instantaneous heart rate (HR), to assess autonomic activity during motion sickness. Two control recordings of ILV and electrocardiogram (ECG) were made prior to the development of motion sickness. During the first, subjects were seated motionless, and during the second they were seated rotating sinusoidally about an earth vertical axis. Subjects then wore prism goggles that reverse the left-right visual field and performed manual tasks until they developed moderate motion sickness. Finally, ILV and ECG were recorded while subjects maintained a relatively constant level of sickness by intermittent eye closure during rotation with the goggles. Based on analyses of ILV to HR transfer functions from the three conditions, we were unable to demonstrate a change in autonomic control of heart rate due to rotation alone or due to motion sickness. These findings do not support the notion that moderate motion sickness is manifested as a generalized autonomic response.

Workplace bullying and sickness absence in hospital staff.

PubMed

Kivimäki, M; Elovainio, M; Vahtera, J

2000-10-01

In the past, evidence on the negative consequences of workplace bullying has been limited to cross sectional studies of self reported bullying. In this study, these consequences were examined prospectively by focusing on sickness absence in hospital staff. The Poisson regression analyses of medically certified spells (>/=4 days) and self certified spells (1-3 days) of sickness absence, relating to bullying and other predictors of health, were based on a cohort of 674 male and 4981 female hospital employees aged 19-63 years. Data on sickness absence were gathered from employers' registers. Bullying and other predictors of health were measured by a questionnaire survey. 302 (5%) of the employees reported being victims of bullying. They did not differ from the other employees in terms of sex, age, occupation, type of job contract, hours of work, income, smoking, alcohol consumption, or physical activity. Victims of bullying had higher body mass and prevalence of chronic disease, and their rates of medically and self certified spells of sickness absence were 1.5 (95% confidence interval (95% CI) 1.3 to 1.7) and 1.2 (1.1 to 1.4) times higher than those of the rest of the staff. The rate ratios remained significant after adjustment for demographic data, occupational background, behaviour involving risks to health, baseline health status, and sickness absence. Workplace bullying is associated with an increase in the sickness absenteeism of the hospital staff. Targets of bullying seem not to belong to any distinct group with certain demographic characteristics or occupational background.

Focus Group Study Exploring Factors Related to Frequent Sickness Absence

PubMed Central

van Rhenen, Willem

2016-01-01

Introduction Research investigating frequent sickness absence (3 or more episodes per year) is scarce and qualitative research from the perspective of frequent absentees themselves is lacking. The aim of the current study is to explore awareness, determinants of and solutions to frequent sickness absence from the perspective of frequent absentees themselves. Methods We performed a qualitative study of 3 focus group discussions involving a total of 15 frequent absentees. Focus group discussions were audiotaped and transcribed verbatim. Results were analyzed with the Graneheim method using the Job Demands Resources (JD–R) model as theoretical framework. Results Many participants were not aware of their frequent sickness absence and the risk of future long-term sickness absence. As determinants, participants mentioned job demands, job resources, home demands, poor health, chronic illness, unhealthy lifestyles, and diminished feeling of responsibility to attend work in cases of low job resources. Managing these factors and improving communication (skills) were regarded as solutions to reduce frequent sickness absence. Conclusions The JD–R model provided a framework for determinants of and solutions to frequent sickness absence. Additional determinants were poor health, chronic illness, unhealthy lifestyles, and diminished feeling of responsibility to attend work in cases of low job resources. Frequent sickness absence should be regarded as a signal that something is wrong. Managers, supervisors, and occupational health care providers should advise and support frequent absentees to accommodate job demands, increase both job and personal resources, and improve health rather than express disapproval of frequent sickness absence and apply pressure regarding work attendance. PMID:26872050

Systematic review of active workplace interventions to reduce sickness absence

PubMed Central

2013-01-01

Background The workplace is used as a setting for interventions to prevent and reduce sickness absence, regardless of the specific medical conditions and diagnoses. Aims To give an overview of the general effectiveness of active workplace interventions aimed at preventing and reducing sickness absence. Methods We systematically searched PubMed, Embase, Psych-info, and ISI web of knowledge on 27 December 2011. Inclusion criteria were (i) participants over 18 years old with an active role in the intervention, (ii) intervention done partly or fully at the workplace or at the initiative of the workplace and (iii) sickness absence reported. Two reviewers independently screened articles, extracted data and assessed risk of bias. A narrative synthesis was used. Results We identified 2036 articles of which, 93 were assessed in full text. Seventeen articles were included (2 with low and 15 with medium risk of bias), with a total of 24 comparisons. Five interventions from four articles significantly reduced sickness absence. We found moderate evidence that graded activity reduced sickness absence and limited evidence that the Sheerbrooke model (a comprehensive multidisciplinary intervention) and cognitive behavioural therapy (CBT) reduced sickness absence. There was moderate evidence that workplace education and physical exercise did not reduce sickness absence. For other interventions, the evidence was insufficient to draw conclusions. Conclusions The review found limited evidence that active workplace interventions were not generally effective in reducing sickness absence, but there was moderate evidence of effect for graded activity and limited evidence for the effectiveness of the Sheerbrooke model and CBT. PMID:23223750

Focus Group Study Exploring Factors Related to Frequent Sickness Absence.

PubMed

Notenbomer, Annette; Roelen, Corné A M; van Rhenen, Willem; Groothoff, Johan W

2016-01-01

Research investigating frequent sickness absence (3 or more episodes per year) is scarce and qualitative research from the perspective of frequent absentees themselves is lacking. The aim of the current study is to explore awareness, determinants of and solutions to frequent sickness absence from the perspective of frequent absentees themselves. We performed a qualitative study of 3 focus group discussions involving a total of 15 frequent absentees. Focus group discussions were audiotaped and transcribed verbatim. Results were analyzed with the Graneheim method using the Job Demands Resources (JD-R) model as theoretical framework. Many participants were not aware of their frequent sickness absence and the risk of future long-term sickness absence. As determinants, participants mentioned job demands, job resources, home demands, poor health, chronic illness, unhealthy lifestyles, and diminished feeling of responsibility to attend work in cases of low job resources. Managing these factors and improving communication (skills) were regarded as solutions to reduce frequent sickness absence. The JD-R model provided a framework for determinants of and solutions to frequent sickness absence. Additional determinants were poor health, chronic illness, unhealthy lifestyles, and diminished feeling of responsibility to attend work in cases of low job resources. Frequent sickness absence should be regarded as a signal that something is wrong. Managers, supervisors, and occupational health care providers should advise and support frequent absentees to accommodate job demands, increase both job and personal resources, and improve health rather than express disapproval of frequent sickness absence and apply pressure regarding work attendance.

75 FR 75363 - Absence and Leave; Sick Leave

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-03

... diseases, including pandemic influenza when appropriate. We are also permitting employees to substitute up..., including pandemic influenza when appropriate, by permitting the use of sick leave and advanced sick leave... and procedures developed in planning for a pandemic influenza and provided references to a substantial...

Prevalence, Predictors, and Prevention of Motion Sickness in Zero-G Parabolic Flights.

PubMed

Golding, John F; Paillard, Aurore C; Normand, Hervé; Besnard, Stéphane; Denise, Pierre

2017-01-01

Zero-G parabolic flight reproduces the weightlessness of space for short periods. However, motion sickness may affect some fliers. The aim was to assess the extent of this problem and to find possible predictors and modifying factors. Airbus zero-G flights consist of 31 parabolas performed in blocks. Each parabola consisted of 20 s of 0 g sandwiched by 20 s of hypergravity of 1.5-1.8 g. The survey covered N = 246 person-flights (193 men, 53 women), ages (M ± SD) 36.0 ± 11.3 yr. An anonymous questionnaire included motion sickness rating (1 = OK to 6 = vomiting), Motion Sickness Susceptibility Questionnaire (MSSQ), antimotion sickness medication, prior zero-G experience, anxiety level, and other characteristics. Participants had lower MSSQ percentile scores (27.4 ± 28.0) than the population norm of 50. Motion sickness was experienced by 33% and 12% vomited. Less motion sickness was predicted by older age, greater prior zero-G flight experience, medication with scopolamine, lower MSSQ scores, but not gender or anxiety. Sickness ratings in fliers pretreated with scopolamine (1.81 ± 1.58) were lower than for nonmedicated fliers (2.93 ± 2.16), and incidence of vomiting in fliers using scopolamine treatment was reduced by half to a third. Possible confounding factors including age, sex, flight experience, and MSSQ could not account for this. Motion sickness affected one-third of zero-G fliers despite being intrinsically less motion sickness susceptible compared to the general population. Susceptible individuals probably try to avoid such a provocative environment. Risk factors for motion sickness included younger age and higher MSSQ scores. Protective factors included prior zero-G flight experience (habituation) and antimotion sickness medication.Golding JF, Paillard AC, Normand H, Besnard S, Denise P. Prevalence, predictors, and prevention of motion sickness in zero-G parabolic flights. Aerosp Med Hum Perform. 2017; 88(1):3-9.

[Hospitals: place for the sick and other challenged persons].

PubMed

Ornellas, C P

1998-01-01

The hospitals were, since its source, a place of retirement and shelter of sick people. The Church, in Middle Age, founded hospitals in their monasteries, where sick people took care and a assistance, more religious than therapeutic. In the final of Middle Age the hospital became an exclusion's place for the crazy people, the leprous people, the bec people and the sick people were guided to. With de arisemens hospital became privilegious space where sick people could be observed and the art of care was consolidate. The apprehension of care practices by the capitalism way of production changed the welcoming character of the hospital that would be an instrument of work, productive space not only of treatment but, foremost, of values.

Pharmacological and neurophysiological aspects of space/motion sickness

NASA Technical Reports Server (NTRS)

Lucot, James B.; Crampton, George H.

1991-01-01

A motorized motion testing device modeled after a Ferris wheel was constructed to perform motion sickness tests on cats. Details of the testing are presented, and some of the topics covered include the following: xylazine-induced emesis; analysis of the constituents of the cerebrospinal fluid (CSF) during motion sickness; evaluation of serotonin-1A (5-HT sub 1A) agonists; other 5HT receptors; antimuscarinic mechanisms; and antihistaminergic mechanisms. The ability of the following drugs to reduce motion sickness in the cats was examined: amphetamines, adenosinergic drugs, opioid antagonists, peptides, cannabinoids, cognitive enhancers (nootropics), dextromethorphan/sigma ligands, scopolamine, and diphenhydramine.

Ducks Get Sick Too!

USGS Publications Warehouse

Windingstad, Ronald M.; Laitman, Cynthia J.

1988-01-01

When it comes to getting sick, wild waterfowl—which include ducks, geese, and swans—are a lot like people. We are all vulnerable to a wide variety of diseases.Some diseases that affect waterfowl, such as avian botulism, have been recognized for many decades as a major cause of death. Others, such as duck plague, are relative newcomers to the known roster of waterfowl diseases.Unfortunately, the number of waterfowl diseases as well as disease-breeding conditions are on the increase. As human development has expanded and encroached on wetlands, more and more waterfowl have been forced into less and less habitat. The resulting crowding can promote the spread of infectious disease caused by toxicants and other noninfectious agents.Although millions of waterfowl die of disease each year, it is often difficult to "see" the disease process occurring. Sick and dying birds usually seek cover to hide, and predators and scavengers eventually devour most of them. When disease becomes epidemic (a disease epidemic in animals is called an epizootic) and sick and dead birds become too numerous for predators and scavengers to eliminate, the disease process becomes far more noticeable.The diseases described in this booklet are among the most common causes of death in wild waterfowl, and include examples of those cause by bacteria, viruses, parasites, fungi, and toxic substances.

Role of orientation reference selection in motion sickness

NASA Technical Reports Server (NTRS)

Peterka, Robert J.; Black, F. Owen

1992-01-01

The overall objective of this proposal is to understand the relationship between human orientation control and motion sickness susceptibility. Three areas related to orientation control will be investigated. These three areas are (1) reflexes associated with the control of eye movements and posture, (2) the perception of body rotation and position with respect to gravity, and (3) the strategies used to resolve sensory conflict situations which arise when different sensory systems provide orientation cues which are not consistent with one another or with previous experience. Of particular interest is the possibility that a subject may be able to ignore an inaccurate sensory modality in favor of one or more other sensory modalities which do provide accurate orientation reference information. We refer to this process as sensory selection. This proposal will attempt to quantify subjects' sensory selection abilities and determine if this ability confers some immunity to the development of motion sickness symptoms. Measurements of reflexes, motion perception, sensory selection abilities, and motion sickness susceptibility will concentrate on pitch and roll motions since these seem most relevant to the space motion sickness problem. Vestibulo-ocular (VOR) and oculomotor reflexes will be measured using a unique two-axis rotation device developed in our laboratory over the last seven years. Posture control reflexes will be measured using a movable posture platform capable of independently altering proprioceptive and visual orientation cues. Motion perception will be quantified using closed loop feedback technique developed by Zacharias and Young (Exp Brain Res, 1981). This technique requires a subject to null out motions induced by the experimenter while being exposed to various confounding sensory orientation cues. A subject's sensory selection abilities will be measured by the magnitude and timing of his reactions to changes in sensory environments. Motion sickness

Neuroimmunologic aspects of sleep and sleep loss

NASA Technical Reports Server (NTRS)

Rogers, N. L.; Szuba, M. P.; Staab, J. P.; Evans, D. L.; Dinges, D. F.

2001-01-01

The complex and intimate interactions between the sleep and immune systems have been the focus of study for several years. Immune factors, particularly the interleukins, regulate sleep and in turn are altered by sleep and sleep deprivation. The sleep-wake cycle likewise regulates normal functioning of the immune system. Although a large number of studies have focused on the relationship between the immune system and sleep, relatively few studies have examined the effects of sleep deprivation on immune parameters. Studies of sleep deprivation's effects are important for several reasons. First, in the 21st century, various societal pressures require humans to work longer and sleep less. Sleep deprivation is becoming an occupational hazard in many industries. Second, to garner a greater understanding of the regulatory effects of sleep on the immune system, one must understand the consequences of sleep deprivation on the immune system. Significant detrimental effects on immune functioning can be seen after a few days of total sleep deprivation or even several days of partial sleep deprivation. Interestingly, not all of the changes in immune physiology that occur as a result of sleep deprivation appear to be negative. Numerous medical disorders involving the immune system are associated with changes in the sleep-wake physiology--either being caused by sleep dysfunction or being exacerbated by sleep disruption. These disorders include infectious diseases, fibromyalgia, cancers, and major depressive disorder. In this article, we will describe the relationships between sleep physiology and the immune system, in states of health and disease. Interspersed will be proposals for future research that may illuminate the clinical relevance of the relationships between sleeping, sleep loss and immune function in humans. Copyright 2001 by W.B. Saunders Company.

The work ability index and single-item question: associations with sick leave, symptoms, and health--a prospective study of women on long-term sick leave.

PubMed

Ahlstrom, Linda; Grimby-Ekman, Anna; Hagberg, Mats; Dellve, Lotta

2010-09-01

This study investigated the association between the work ability index (WAI) and the single-item question on work ability among women working in human service organizations (HSO) currently on long-term sick leave. It also examined the association between the WAI and the single-item question in relation to sick leave, symptoms, and health. Predictive values of the WAI, the changed WAI, the single-item question and the changed single-item question were investigated for degree of sick leave, symptoms, and health. This cohort study comprised 324 HSO female workers on long-term (>60 days) sick leave, with follow-ups at 6 and 12 months. Participants responded to questionnaires. Data on work ability, sick leave, health, and symptoms were analyzed with regard to associations and predictability. Spearman correlation and mixed-model analysis were performed for repeated measurements over time. The study showed a very strong association between the WAI and the single-item question among all participants. Both the WAI and the single-item question showed similar patterns of associations with sick leave, health, and symptoms. The predictive value for the degree of sick leave and health-related quality of life (HRQoL) was strong for both the WAI and the single-item question, and slightly less strong for vitality, neck pain, both self-rated general and mental health, and behavioral and current stress. This study suggests that the single-item question on work ability could be used as a simple indicator for assessing the status and progress of work ability among women on long-term sick leave.

The effect of social deprivation on local authority sickness absence rates.

PubMed

Wynn, P; Low, A

2008-06-01

There is an extensive body of research relating to the association between ergonomic and psychosocial factors on sickness absence rates. The impact of deprivation on health indices has also been extensively investigated. However, published research has not investigated the extent of any association between standard measures of deprivation and sickness absence and ill-health retirement rates. To establish if a relationship exists between standard measures of deprivation, used by the UK central government to determine regional health and social welfare funding, and sickness absence and ill-health early retirement rates in English local government employers. Local authority sickness absence rates for 2001-02 were regressed against the 2004 Indices of Multiple Deprivation in a multiple regression model that also included size and type of organization as independent variables. A second model using ill-health retirement as the dependent variable was also estimated. In the full regression models, organization size was not significant and reduced models with deprivation and organization type (depending on whether teachers were employed by the organization or not) were estimated. For the sickness absence model, the adjusted R(2) was 0.20, with 17% of the variation in sickness absence rates being explained by deprivation rank. Ill-health retirement showed a similar relationship with deprivation. In both models, the deprivation coefficients were highly significant: for sickness absence [t = -7.85 (P = 0.00)] and for ill-health retirement [t = -4.79 (P = 0.00)]. A significant proportion of variation in sickness absence and ill-health retirement rates in local government in England are associated with local measures of deprivation. Recognition of the impact of deprivation on sickness absence has implications for a number of different areas of work. These include target setting for Local Government Best Value Performance Indicators, history taking in sickness absence

Unemployment, labor force composition and sickness absence: a panel data study.

PubMed

Askildsen, Jan Erik; Bratberg, Espen; Nilsen, Oivind Anti

2005-11-01

Sickness absence tends to be negatively correlated with unemployment rates. In addition to pure health effects, this may be due to moral hazard behavior by workers who are fully insured against income loss during sickness and to physicians who meet demand for medical certificates. Alternatively, it may reflect changes in the composition of the labor force, with more sickness-prone workers entering the labor force in upturns. A panel of Norwegian register data is used to analyze long-term sickness absences. The unemployment rate is shown to be negatively associated with the probability of absence, and with the number of days of sick leave. Restricting the sample to workers who are present in the whole sample period, the negative relationship between absence and unemployment becomes clearer. This indicates that procyclical variations in sickness absence are caused by established workers and not by the composition of the labor force.

The relation of selenium to western duck sickness

USGS Publications Warehouse

Lakin, H.W.; Quortrup, E.R.; Hotchkiss, N.

1944-01-01

In 1936 Twomey and Twomey reported that 20-50 parts per million of selenium as sodium selenite in the drinking water produced poisoning in ducks in which the syndrome was identical with that produced by Clostridium botulinum type C, which had been considered the principal causative agent in western duck sickness (Kalmbach and Gunderson, 1934). In a more recent paper, Twomey, Twomey and Williams (1939) reported the analyses of a number of duck livers collected at various points near Great Salt Lake where the sickness is prevalent. These analyses show the presence of 7-148 p. p. m. of selenium, based on the oven-dried weight of the livers. In contrast, no selenium was found in duck livers obtained in Pennsylvania, where sickness has not been reported. As a result of these findings, a thorough investigation of the significance of selenium in outbreaks of western duck sickness was undertaken in the summer of 1940.

Sickness absence in Pertamina E.P. directorate

DOE Office of Scientific and Technical Information (OSTI.GOV)

Harjono, P.T.; Arief, N.

Pertamina is the only one state oil enterprise in the country has a strategic position in the national development, mainly in terms of foreign exchange and domestic ID energy supply. Hence human factor in the company productivity is very important. Workday loss by sickness in the last 4 years was 2.00{per_thousand} up to 3.00{per_thousand} and 0.88 days up to 1.12 days loss per worker annually. Workday loss by sickness was 96.86 % up to 99.12 % of total workday loss and the rest by work injuries, These relative low sickness absence figures achieved by multidisiplinary efforts in the company mainlymore » by health department. All sickness absence certificate even for one day off should be signed by company medical doctor. Health department conduct comprehensive health care including occupational health programme. Health & safety issues solved by multidisiplinary approach. Beside health department also organize employee assistance programme (counseling) mainly for healthy life style and psychosocial problems. The low workday loss is one of the basic important factors to support discipline and human productivity mainly since mostly oil reserve discoveries located in the remote areas inland as well as offshore.« less

Proinflammatory cytokines, sickness behavior, and Alzheimer disease

PubMed Central

Cunningham, C.; Zotova, E.; Culliford, D.; Perry, V.H.

2011-01-01

Background: In Alzheimer disease (AD), systemic inflammation is known to give rise to a delirium. However, systemic inflammation also gives rise to other centrally mediated symptoms in the absence of a delirium, a concept known as sickness behavior. Systemic inflammation is characterized by the systemic production of the proinflammatory cytokines tumor necrosis factor–α (TNFα) and interleukin-6 (IL-6) that mediate immune to brain communication and the development of sickness behavior. Objective: To determine if raised serum TNFα or IL-6 are associated with the presence of sickness behavior symptoms, independent of the development of delirium, in a prospective cohort study of subjects with AD. Methods: A total of 300 subjects with mild to severe AD were cognitively assessed at baseline and a blood sample taken for inflammatory markers. Cognitive assessments, including assessments to detect the development of a delirium, and blood samples were repeated at 2, 4, and 6 months. The development of neuropsychiatric symptoms in the subject with AD over the 6-month follow-up period was assessed independently by carer interview at 2, 4, and 6 months. Results: Raised serum TNFα and IL-6, but not CRP, were associated with an approximately 2-fold increased frequency of neuropsychiatric symptoms characteristic of sickness behavior. These relationships are independent of the development of delirium. Conclusions: Increased serum proinflammatory cytokines are associated with the presence of symptoms characteristic of sickness behavior, which are common neuropsychiatric features found in AD. This association was independent of the presence of delirium. PMID:21753171

Sleep Applications to Assess Sleep Quality.

PubMed

Fietze, Ingo

2016-12-01

This article highlights the potential uses that smartphone applications may have for helping those with sleep problems. Applications in smartphones offer the promised possibility of detection of sleep. From the author's own experience, one can also conclude that sleep applications are approximately as good as polysomnography in detection of sleep time, similar to the conventional wearable actimeters. In the future, sleep applications will help to further enhance awareness of sleep health and to distinguish those who actually poorly and only briefly sleep from those who suffer more likely from paradox insomnia. Copyright © 2016 Elsevier Inc. All rights reserved.

Analysis of sickness absence among employees of four NHS trusts

PubMed Central

Ritchie, K. A.; Macdonald, E. B.; Gilmour, W. H.; Murray, K. J.

1999-01-01

OBJECTIVES: To determine the value of using routinely collected sickness absence data as part of a health needs assessment of healthcare workers. METHOD: Sickness absence records of almost 12900 NHS staff for one calendar year were analysed. Three measures of absence, the absence rate, the absence frequency rate, and the mean duration of absence, were assessed for the population and comparisons made between men and women, full and part time and different occupational groups of staff. Also, the main causes of sickness absence were found. RESULTS: Almost 60% of the study population had no spells of sickness absence in the year of study and almost 20% had only one spell of sickness absence. Female staff were more likely to have experienced sickness absence than male staff. Although absence due to conditions related to pregnancy were included in the analysis, the incidence of these was not sufficient to account for the higher rates of absence among female staff. In general, full time staff had greater rates of sickness absence than part time staff. 71% of all absences were of < 1 week duration. The main known causes of sickness absence were respiratory disorders, digestive disorders, and musculoskeletal disorders. CONCLUSIONS: The transition from units managed directly from the health board to trusts with individual responsibility for personnel issues at the time of data collection resulted in variations in the quality of data available for analysis. This together with the use of "dump" codes has influenced the quality of the analysis. However, such data should be available for analysis to tailor occupational health care to the needs of the population.   PMID:10658551

Investigation of anti-motion sickness drugs in the squirrel monkey

NASA Technical Reports Server (NTRS)

Cheung, B. S.; Money, K. E.; Kohl, R. L.; Kinter, L. B.

1992-01-01

Early attempts to develop an animal model for anti-motion sickness drugs, using dogs and cats; were unsuccessful. Dogs did not show a beneficial effect of scopolamine (probably the best single anti-motion sickness drug for humans thus far) and the findings in cats were not definitive. The authors have developed an animal model using the squirrel monkey (Saimiri sciureus) of the Bolivian phenotype. Unrestrained monkeys in a small lucite cage were tested in an apparatus that induces motion sickness by combining vertical oscillation and horizontal rotation in a visually unrestricted laboratory environment. Signs of motion sickness were scored using a rating scale. Ten susceptible monkeys (weighing 800-1000 g) were given a total of five tests each, to establish the baseline susceptibility level. Based on the anticholinergic activity of scopolamine, the sensitivity of squirrel monkey to scopolamine was investigated, and the appropriate dose of scopolamine for this species was determined. Then various anti-motion sickness preparations were administered in subsequent tests: 100 ug scopolamine per monkey; 140 ug dexedrine; 50 ug scopolamine plus 70 ug dexedrine; 100 ug scopolamine plus 140 ug dexedrine; 3 mg promethazine; 3 mg promethazine plus 3 mg ephedrine. All these preparations were significantly effective in preventing motion sickness in the monkeys. Ephedrine, by itself, which is marginally effective in humans, was ineffective in the monkeys at the doses tried (0.3-6.0 mg). The squirrel monkey appears to be a good animal model for antimotion sickness drugs. Peripherally acting antihistamines such as astemizole and terfenadine were found to be ineffective, whereas flunarizine, and an arginine vasopressin V1 antagonist, showed significant activity in preventing motion sickness.