The negotiation of the sick role: general practitioners’ classification of patients with medically unexplained symptoms

PubMed Central

Mik-Meyer, Nanna; Obling, Anne Roelsgaard

2012-01-01

In encounters between general practitioners (GPs) and patients with medically unexplained symptoms (MUS), the negotiation of the sick role is a social process. In this process, GPs not only use traditional biomedical diagnostic tools but also rely on their own opinions and evaluations of a patient’s particular circumstances in deciding whether that patient is legitimately sick. The doctor is thus a gatekeeper of legitimacy. This article presents results from a qualitative interview study conducted in Denmark with GPs concerning their approach to patients with MUS. We employ a symbolic interaction approach that pays special attention to the external validation of the sick role, making GPs’ accounts of such patients particularly relevant. One of the article’s main findings is that GPs’ criteria for judging the legitimacy of claims by those patients that present with MUS are influenced by the extent to which GPs are able to constitute these patients as people with social problems and problematic personality traits. PMID:22384857

Role of the vestibular end organs in experimental motion sickness - A primate model

NASA Technical Reports Server (NTRS)

Igarashi, Makoto

1990-01-01

Experimental studies of the role of vestibular end organs in motion sickness experienced by squirrel monkeys are reviewed. The first experiments in motion-sickness-susceptible squirrel monkeys were performed under a free-moving condition with horizontal rotation and vertical oscillation. In the following experiments, the vestibular-visual conflict in the pitch plane was given to the chair-restrained (upright position) squirrel monkeys. Results of this study showed that the existence of otolith afferents, which continually signal the directional change of gravity and linear acceleration vectors, was necessary for the elicitation of emesis by the sensory conflict in pitch.

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

An appraisal of the value of vitamin B 12 in the prevention of motion sickness

NASA Astrophysics Data System (ADS)

Kohl, Randall L.; Lacey, Carol L.; Homick, Jerry L.

Unpublished reports have suggested that hydroxycobalamin (B 12, i.m.) prevents motion sickness. Some biomedical evidence supports this contention in that B 12 influences the metabolism of histidine and choline; dietary precursors to neurotransmitters with established roles in motion sickness. Susceptibility to motion sickness was evaluated after B 12 (1000 μg, i.m.). Subjects initially completed vestibular function and motion sickness susceptibility tests to establish normal vestibular function. The experimental motion stressor was a modified coriolis sickness susceptibility test. Subjects executed standardized head movements at successively higher RPM until a malaise III endpoint was reached. Following two baseline tests with this motion stressor, subjects received a B 12 injection, a second injection two weeks later, and a final motion sickness test three weeks later. No significant differences in susceptibility were noted after B 12. Hematological parameters revealed no B 12 deficiency before injection. The possibility that patients with B 12 deficiencies are more susceptible to motion sickness cannot be ruled out.

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 sick leave, 38% of parents who did live in poverty lacked sick leave. The problem is also more marked for nonwhite parents. Although 23% of working white parents lacked paid sick leave, 31% of nonwhite parents lacked sick leave. One in six families that lacked sick leave had to cover for more than 4 weeks of family illness during the year. In 1993, the US Congress passed the Family and Medical Leave Act (FMLA). However, by limiting the medical leave to the care of major illnesses, primarily those requiring hospitalization, the FMLA does not address the majority of children's sick care needs. For the common childhood illnesses that are not covered by the FMLA, employed parents often must rely on their sick leave if they are to care for their sick children themselves. Yet, we found that many employed parents lack sick leave. This is particularly true of parents of children with chronic conditions and poor and minority families.

Using an ICT Tool as a Solution for the Educational and Social Needs of Long-Term Sick Adolescents

ERIC Educational Resources Information Center

Zhu, Chang; Van Winkel, Lies

2015-01-01

This research investigates the role of an ICT tool for meeting the educational and social needs of long-term sick adolescents. Both surveys and interviews were conducted in this study. The participants of this study were sick school students between 12-19 years old. The interviewed participants had used the ICT-supporting tool for three months to…

An appraisal of the value of vitamin B12 in the prevention of motion sickness

NASA Technical Reports Server (NTRS)

Kohl, R. L.; Lacey, C. L.; Homick, J. L.

1983-01-01

It has been suggested that vitamin B12 given by intramuscular injection can significantly reduce the occurrence of motion sickness in susceptible individuals (Banks, 1980). Since it is known that B12 influences the metabolism of histidine and choline, dietary precursors to neurotransmitters with established roles in motion sickness, an experimental evaluation has been undertaken of the efficacy of B12 in the prevention of motion sickness induced by controlled coriolis simulation. Subjects executed standardized head movements at successively higher rpm until a malaise III endpoint was reached. Following two baseline tests with this motion stressor, subjects received a B12 injection, a second injection two weeks later, and a final motion sickness test three weeks later. No significant differences in the susceptibility to motion sickness were noted after B12.

A heuristic mathematical model for the dynamics of sensory conflict and motion sickness

NASA Technical Reports Server (NTRS)

Oman, C. M.

1982-01-01

The etiology of motion sickness is now usually explained in terms of a qualitatively formulated sensory conflict hypothesis. By consideration of the information processing task faced by the central nervous system in estimating body spatial orientation and in controlling active body movement using an internal model referenced control strategy, a mathematical model for sensory conflict generation is developed. The model postulates a major dynamic functional role for sensory conflict signals in movement control, as well as in sensory motor adaptation. It accounts for the role of active movement in creating motion sickness symptoms in some experimental circumstances, and in alleviating them in others. The relationship between motion sickness produced by sensory rearrangement and that resulting from external motion disturbances is explicitly defined. A nonlinear conflict averaging model describes dynamic aspects of experimentally observed subjective discomfort sensation, and suggests resulting behavior.

A heuristic mathematical model for the dynamics of sensory conflict and motion sickness

NASA Technical Reports Server (NTRS)

Oman, C. M.

1980-01-01

The etiology of motion sickness is explained in terms of a qualitatively formulated sensory conflict hypothesis. By consideration of the information processing task faced by the central nervous system in estimating body spatial orientation and in controlling active body movement using an internal model referenced control strategy, a mathematical model for sensory conflict generation is developed. The model postulates a major dynamic functional role for sensory conflict signals in movement control, as well as in sensory-motor adaptation. It accounts for the role of active movement in creating motion sickness symptoms in some experimental circumstances, and in alleviating them in others. The relationship between motion sickness produced by sensory rearrangement and that resulting from external motion disturbances is explicitly defined. A nonlinear conflict averaging model is proposed which describes dynamic aspects of experimentally observed subjective discomfort sensation, and suggests resulting behaviors.

[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.

The mediating role of psychophysic strain in the relationship between workaholism, job performance, and sickness absence: a longitudinal study.

PubMed

Falco, Alessandra; Girardi, Damiano; Kravina, Luca; Trifiletti, Elena; Bartolucci, Giovanni Battista; Capozza, Dora; De Carlo, Nicola A

2013-11-01

To test a theoretical model in which workaholism predicts both directly and indirectly, via psychophysic strain, job performance and sickness absences. A multimethod study was performed examining a sample of 322 workers in a private company. The study was articulated into two phases, over a time period of 15 months. Workaholism was assessed using a self-report measure (time 1). Psychophysic strain was measured by the occupational physician, performance by the supervisor, and data on sickness absences were collected from the company's database (time 2). Results highlighted a positive relationship between workaholism and psychophysic strain. Psychophysic strain was negatively associated with job performance and positively associated with sickness absences. In addition, workaholism predicted sickness absences. Workaholism negatively affects the health of workers. This is associated with lower working performance and greater sickness absences.

Structured functional assessments in general practice increased the use of part-time sick leave: a cluster randomised controlled trial.

PubMed

Osterås, Nina; Gulbrandsen, Pål; Kann, Inger Cathrine; Brage, Søren

2010-03-01

A method for structured functional assessments of persons with long-term sick leave was implemented in a cluster randomised controlled trial in general practice. The aim was to analyse intervention effects on general practitioner (GP) sick-listing practice and patient sick leave. 57 GPs were randomly assigned to an intervention or a control group. The intervention group GPs learned the method at a 1-day workshop including teamwork and role-playing. The control group GPs were requested to assess functional ability as usual during the 8 months intervention period in 2005. Outcome measures included duration of patient sick leave episodes, GP prescription of part-time sick leave, active sick leave, and vocational rehabilitation. This data was extracted from a national register. The GPs in the intervention group prescribed part-time sick leave more often (p < 0.01) and active sick leave less often (p = 0.04) than the control group GPs during the intervention period. There was no intervention effect on duration of patient sick leave episodes or on GP prescription of vocational rehabilitation. Implementing structured functional assessments in general practice made the GPs capable to assess functional ability of persons with long-term sick leave in a standardised and explicit manner. The intervention GPs' sick-listing practice was changed as they prescribed more part-time and less active sick leave compared to the control group GPs. As a result, more intervention GP patients returned to part-time work compared to control GP patients. No intervention effect was seen on duration of patient sick leave episodes or on prescription of vocational rehabilitation.

Experiences of participation in occupations of women on long-term sick leave.

PubMed

Johansson, Christina; Isaksson, Gunilla

2011-12-01

The majority of individuals on long-term sick leave experience negative effects in their lives associated with limitations on their participation, decreased income, and feelings of guilt. The aim was to describe the experiences that women on long-term sick leave have of participation in occupation. Unstructured interviews were used for the data collection, which involved eight women; a grounded theory approach was used. The results showed that the women's long-term sick leave changed their roles, daily habits, and routines, and their participation in occupations was negatively influenced. Their occupational performance also diminished, thereby having a negative influence on their social relationships. However, over time they came to find different strategies that contributed to a feeling of occupational competence and thence they started to rebuild their occupational identity. Through this began the process of occupational adaptation, which resulted in an increased experience of participating in occupation. As a conclusion, it should be noted that occupational therapy interventions should be directed at women on long-term sick leave at an early stage in the rehabilitation process to address the adaptation of their roles, habits, routines, and social environment.

The Role of Extra-Vestibular Inputs in Maintaining Spatial Orientation in Military Vehicles

DTIC Science & Technology

2003-02-01

flow contribute to spatial orientation. Disordered regulation of any of these factors can be identified in land based tests and allows us to study pre...adaptation disorders . 1,2 The sensory conflict theory of motion sickness states that motion sickness arises when one or several inputs from the body’s sensory...several episodes of severe motion sickness during an operational military assignment (usually aboard ship), but demonstrate no balance disorder or ear

[Regulations of sickness certification as a factor for increased health care utilization in Germany].

PubMed

Herrmann, Wolfram J; Haarmann, Alexander; Bærheim, Anders

2015-01-01

In Germany, utilization of ambulatory health care is high compared to other countries. Classical models of health care utilization cannot sufficiently explain these differences. The aim of this study was to explore relevant factors which can explain the higher health care utilization in Germany. In this article, we focus on regulations regarding sickness certification as a potential factor. An explorative qualitative study design. We conducted episodic interviews with 20 patients in Germany and 20 patients in Norway and participant observation in four primary care practices each. Additionally, we conducted a context analysis of relevant health care system related factors which emerged during the study. Qualitative data analysis was done by thematic coding in the framework of grounded theory. The need for a sickness certificate was an important reason for encounter in Germany, especially regarding minor illnesses. Sickness certification is a societal topic. GPs play a double role regarding sickness certification, both as the patients' advocate and as an expert witness for social security services. In Norway, longer periods of self-administered sickness certification and more differentiated possibilities of sickness certification have been introduced successfully. Our results point to regulations regarding sickness certification as a relevant factor for higher health care utilization in Germany. In pilot studies, the effect of extended self-certification of sickness and part-time sickness certification should be further assessed. Copyright © 2015. Published by Elsevier GmbH.

The Dying Role: Its Relevance to Improved Patient Care.

PubMed

Noyes, Russell; Clancy, John

2016-01-01

SOCIETY is failing to meet the obligation it has to its dying members. Persons with terminal illnesses suffer isolation and neglect in hospitals, receive overzealous treatment by physicians, and are kept in ignorance of their situation by families and medical personnel. Evidence for these statements has come from observers of the medical care system and from dying patients themselves (Kübler-Ross, 1969; Reynolds and Kalish, 1974; Sudnow, 1967). In the nineteenth century it was common for persons to die in the familiar environs of their homes, surrounded by grieving families from whom they parted in a meaningful manner (Blauner, 1966). Dying persons of today no longer fill a well-defined social role. Instead, the distinction between the roles of sick and dying persons has been lost and, in the resulting confusion, the care of dying people has suffered. The purpose of this article is to clarify the distinction between the dying and sick roles, identify the signs of existing role confusion, suggest ways in which this confusion may be corrected, and show how reestablishment of the dying role can result in improved care of dying people. The important part physicians play in defining sick and dying roles will be emphasized.

When Students Say School Makes Them Sick, Sometimes They're Right.

ERIC Educational Resources Information Center

Reecer, Marcia

1988-01-01

"Sick building syndrome" results mainly from tightly sealed, poorly ventilated buildings with low levels of airborne pollutants. This article describes the problem at a Pennsylvania elementary school, examines roles of specific contaminants, and discusses credibility problems, prescriptions, and preventive measures. Insets explain causes…

Role of otolith endorgans in the genesis of vestibular-visual conflict sickness (pitch) in the squirrel monkey (First report)

NASA Technical Reports Server (NTRS)

Igarashi, Makoto; Himi, Tetsuo; Kulecz, Walter B.; Kobayashi, Kazutoyo

1987-01-01

The effects of ablation of the macula utriculi and macula sacculi on vestibular-visual conflict emesis in squirrel monkeys are investigated. An optokinetic drum and a turntable were used for the direction conflict experiment. A significant difference between the preoperative condition and postunilateral and postbilateral utriculo-sacculectomy conditions is observed. It is detected that after unilateral sacculectomy the conflict sickness decreases and no emesis occurs; however, 4.5 months after sacculectomy, the animals regain their conflict sickness. The data reveal that macular afferents are important in the genesis of sensory conflict emesis and two submodalities may be needed to cause conflict sickness onset.

Is there a role for nonsedating antihistamines in motion sickness? Fallout from space research may soon benefit your patients

NASA Technical Reports Server (NTRS)

Kohl, R. L.

1991-01-01

The rotating chair test, a novel research technique for simulating motion sickness, is used to study the effect of nonsedating oral antihistamines in preventing or forestalling motion sickness. After receiving terfenadine, astemizole, doxepin, or placebo, four groups of male volunteers were rotated at accelerating speed, and they made head movements out of the axis of rotation until they perceived that vomiting would occur if additional head movements were made. Those pretreated with doxepin or terfenadine experienced a statistically significant prophylactic effect, as measured by increased tolerance to Coriolis stimulation. This suggests that selective peripheral H1 antihistamine action may protect against motion sickness.

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 quality of leadership varied with sick leave pattern and age. Thus, different sick leave measures seem to be associated with different work environment factors. Further studies on these associations may inform interventions to improve occupational health care.

Asymmetric otolith function and increased susceptibility to motion sickness during exposure to variations in gravitoinertial acceleration level

NASA Technical Reports Server (NTRS)

Lackner, James R.; Graybiel, Ashton; Johnson, Walter H.; Money, Kenneth E.

1987-01-01

Von Baumgarten and coworkers (1979, 1981) have suggested that asymmetries in otolith function between the left and right labyrinths may result from differences in otoconial mass and could play a role in space motion sickness. Such asymmetries would be centrally compensated for under terrestrial conditions, but on exposure to weightlessness the persisting central compensation would produce a central imbalance that could lead to motion sickness. In this work ocular counterrolling was used as a way of measuring the relative 'efficiency' of the left and right otoliths; the ocular counterrolling scores of individuals were compared with their susceptibility to motion sickness during passive exposure to variations in Gz in parabolic flight maneuvers. The experimental findings indicate that large asymmetries in counterrolling for leftward and rightward body tilts are associated with greater susceptibility to motion sickness in parabolic flight.

Reducing work related psychological ill health and sickness absence: a systematic literature review

PubMed Central

Michie, S; Williams, S

2003-01-01

A literature review revealed the following: key work factors associated with psychological ill health and sickness absence in staff were long hours worked, work overload and pressure, and the effects of these on personal lives; lack of control over work; lack of participation in decision making; poor social support; and unclear management and work role. There was some evidence that sickness absence was associated with poor management style. Successful interventions that improved psychological health and levels of sickness absence used training and organisational approaches to increase participation in decision making and problem solving, increase support and feedback, and improve communication. It is concluded that many of the work related variables associated with high levels of psychological ill health are potentially amenable to change. This is shown in intervention studies that have successfully improved psychological health and reduced sickness absence. PMID:12499449

Effect of working conditions on non-work-related sickness absence.

PubMed

Sampere, M; Gimeno, D; Serra, C; Plana, M; Martínez, J M; Delclos, G L; Benavides, F G

2012-01-01

There is limited evidence of the role of working conditions as prognostic factors for non-work-related sickness absence (i.e. absence due to injuries or diseases of non-occupational origin). To analyse the association between working conditions and time to return to work (RTW) in workers with long-term (>15 days) non-work-related sickness absence. We followed up a total of 655 workers, who completed a baseline questionnaire including physical and psychosocial work factors, until their non-work-related long-term sickness absence ended. Time to RTW was determined based on the health insurance company register. Cox proportional hazard models were constructed to evaluate the associations between working conditions and time to RTW. A self-perceived high level of physical activity at work and work with back twisted or bent were related to longer duration of sickness absence. We did not find any strong evidence of associations between psychosocial work factors and time to RTW, although higher job insecurity and low reward showed marginal statistical significance. Hazardous physical working conditions are associated with longer duration of non-work-related sickness absence. Workplace ergonomic interventions could conceivably shorten the length of sickness absence that has not originated at work.

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.

Leading during change: the effects of leader behavior on sickness absence in a Norwegian health trust.

PubMed

Bernstrøm, Vilde Hoff; Kjekshus, Lars Erik

2012-09-17

Organizational change often leads to negative employee outcomes such as increased absence. Because change is also often inevitable, it is important to know how these negative outcomes could be reduced. This study investigates how the line manager's behavior relates to sickness absence in a Norwegian health trust during major restructuring. Leader behavior was measured by questionnaire, where employees assessed their line manager's behavior (N = 1008; response rate 40%). Data on sickness absence were provided at department level (N = 35) and were measured at two times. Analyses were primarily conducted using linear regression; leader behavior was aggregated and weighted by department size. The results show a relationship between several leader behaviors and sickness absence. The line managers' display of loyalty to their superiors was related to higher sickness absence; whereas task monitoring was related to lower absence. Social support was related to higher sickness absence. However, the effect of social support was no longer significant when the line manager also displayed high levels of problem confrontation. The findings clearly support the line manager's importance for employee sickness absence during organizational change. We conclude that more awareness concerning the manager's role in change processes is needed.

Health care management of sickness certification tasks: results from two surveys to physicians

PubMed Central

2013-01-01

Background Health care in general and physicians in particular, play an important role in patients’ sickness certification processes. However, a lack of management within health care regarding how sickness certification is carried out has been identified in Sweden. A variety of interventions to increase the quality of sickness certification were introduced by the government and County Councils. Some of these measures were specifically aimed at strengthening health care management of sickness certification; e.g. policy making and management support. The aim was to describe to what extent physicians in different medical specialties had access to a joint policy regarding sickness certification in their clinical settings and experienced management support in carrying out sickness certification. Method A descriptive study, based on data from two cross-sectional questionnaires sent to all physicians in the Stockholm County regarding their sickness certification practice. Criteria for inclusion in this study were working in a clinical setting, being a board-certified specialist, <65 years of age, and having sickness certification consultations at least a few times a year. These criteria were met by 2497 physicians in 2004 and 2204 physicians in 2008. Proportions were calculated regarding access to policy and management support, stratified according to medical specialty. Results The proportions of physicians working in clinical settings with a well-established policy regarding sickness certification were generally low both in 2004 and 2008, but varied greatly between different types of medical specialties (from 6.1% to 46.9%). Also, reports of access to substantial management support regarding sickness certification varied greatly between medical specialties (from 10.5% to 48.8%). More than one third of the physicians reported having no such management support. Conclusions Most physicians did not work in a clinical setting with a well-established policy on sickness certification tasks, nor did they experience substantial support from their manager. The results indicate a need of strengthening health care management of sickness certification tasks in order to better support physicians in these tasks. PMID:23701711

Role of orientation reference selection in motion sickness

NASA Technical Reports Server (NTRS)

Peterka, Robert J.; Black, F. Owen

1987-01-01

The objectives of this proposal were developed to further explore and quantify the orientation reference selection abilities of subjects and the relation, if any, between motion sickness and orientation reference selection. The overall objectives of this proposal are to determine (1) if motion sickness susceptibility is related to sensory orientation reference selection abilities of subjects, (2) if abnormal vertical canal-otolith function is the source of these abnormal posture control strategies and if it can be quantified by vestibular and oculomotor reflex measurements, and (3) if quantifiable measures of perception of vestibular and visual motion cues can be related to motion sickness susceptibility and to orientation reference selection ability demonstrated by tests which systematically control the sensory imformation available for orientation.

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.

Neurochemical background and approaches in the understanding of motion sickness

NASA Technical Reports Server (NTRS)

Kohl, R. L.

1982-01-01

The problems and nature of space motion sickness were defined. The neurochemical and neurophysiological bases of vestibular system function and of the expression of motion sickness wre reviewed. Emphasis was given to the elucidation of the neuropharmacological mechanisms underlying the effects of scopolamine and amphetamine on motion sickness. Characterization of the ascending reticular activating system and the limbic system provided clues to the etiology of the side effects of scopolamine. The interrelationship between central cholinergic pathways and the peripheral (autonomic) expression of motion sickness was described. A correlation between the stress of excessive motion and a variety of hormonal responses to that stress was also detailed. The cholinergic system is involved in the efferent modulation of the vestibular hair cells, as an afferent modulator of the vestibular nuclei, in the activation of cortical and limbic structures, in the expression of motion sickness symptoms and most likely underscores a number of the hormonal changes that occur in stressful motion environments. The role of lecithin in the regulation of the levels of neurotransmitters was characterized as a possible means by which cholinergic neurochemistry can be modulated.

Role of orientation reference selection in motion sickness, supplement 2S

NASA Technical Reports Server (NTRS)

Peterka, Robert J.; Black, F. Owen

1987-01-01

Previous experiments with moving platform posturography have shown that different people have varying abilities to resolve conflicts among vestibular, visual, and proprioceptive sensory signals. The conceptual basis of the present proposal hinges on the similarities between the space motion sickness problem and the sensory orientation reference selection problems associated with benign paroxysmal positional vertigo (BPPV) syndrome. These similarities include both etiology related to abnormal vertical canal-otolith function, and motion sickness initiating events provoked by pitch and roll head movements. The objectives are to explore and quantify the orientation reference selection abilities of subjects and the relation of this selection to motion sickness in humans. The overall objectives are to determine: if motion sickness susceptibility is related to sensory orientation reference selection abilities of subjects; if abnormal vertical canal-otolith function is the source of abnormal posture control strategies and if it can be quantified by vestibular and oculomotor reflex measurements, and if it can be quantified by vestibular and oculomotor reflex measurements; and quantifiable measures of perception of vestibular and visual motion cues can be related to motion sickness susceptibility and to orientation reference selection ability.

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.

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-term sick leave pattern. Scores in commitment to the workplace and quality of leadership varied with sick leave pattern and age. Thus, different sick leave measures seem to be associated with different work environment factors. Further studies on these associations may inform interventions to improve occupational health care. PMID:23764253

Brainstem processing of vestibular sensory exafference: implications for motion sickness etiology

PubMed Central

Oman, Charles M.; Cullen, Kathleen E.

2014-01-01

The origin of the internal “sensory conflict” stimulus causing motion sickness has been debated for more than four decades. Recent studies show a subclass of neurons in the vestibular nuclei and deep cerebellar nuclei that respond preferentially to passive head movements. During active movement, the semicircular canal and otolith input (“reafference”) to these neurons is cancelled by a mechanism comparing the expected consequences of self-generated movement (estimated with an internal model-presumably located in the cerebellum) with the actual sensory feedback. The un-cancelled component (“exafference”) resulting from passive movement normally helps compensate for unexpected postural disturbances. Notably, the existence of such vestibular “sensory conflict” neurons had been postulated as early as 1982, but their existence and putative role in posture control, motion sickness has been long debated. Here we review the development of “sensory conflict” theories in relation to recent evidence for brainstem and cerebellar reafference cancellation, and identify some open research questions. We propose that conditions producing persistent activity of these neurons, or their targets, stimulates nearby brainstem emetic centers – via an as yet unidentified mechanism. We discuss how such a mechanism is consistent with the notable difference in motion sickness susceptibility of drivers as opposed to passengers, human immunity to normal self-generated movement, and why head restraint or lying horizontal confers relative immunity. Finally, we propose that fuller characterization of these mechanisms, and their potential role in motion sickness could lead to more effective, scientifically based prevention and treatment for motion sickness. PMID:24838552

Adult social position and sick leave: the mediating effect of physical workload.

PubMed

Corbett, Karina; Gran, Jon Michaeal; Kristensen, Petter; Mehlum, Ingrid Sivesind

2015-11-01

This study aimed to quantify how much of the adult social gradient in sick leave can be attributed to the mediating role of physical workload while accounting for the role of childhood and adolescent social position and neuroticism. Our sample consisted of 2099 women and 1229 men from a Norwegian birth cohort study (born 1967-1976) who participated in the Nord-Trøndelag Health Study (2006-2008) (HUNT3). Data on sick leave (defined as >16 calendar days; 2006-2009) and social position during childhood, adolescence, and adulthood were obtained from national registers. Study outcome was time-to-first sick leave spell. Physical workload and neuroticism were self-reported in HUNT3. Mediating effects through physical workload were estimated using a method based on the additive hazards survival model. A hypothetical change from highest to lowest group in adult social position was, for women, associated with 51.6 [95% confidence interval (95% CI) 24.7-78.5] additional spells per 100,000 person-days at risk, in a model adjusted for childhood and adolescent social position and neuroticism. The corresponding rate increase for men was 41.1 (95% CI 21.4-60.8). Of these additional spells, the proportion mediated through physical workload was 24% (95% CI 10-49) and 30% (95% CI 10-63) for women and men, respectively. The effect of adult social position on sick leave was partly mediated through physical workload, even while accounting for earlier life course factors. Our findings provide support that interventions aimed at reducing physical workload among those with lower adult social position could reduce sick leave risk.

Modulation of Excitability in the Temporoparietal Junction Relieves Virtual Reality Sickness.

PubMed

Takeuchi, Naoyuki; Mori, Takayuki; Suzukamo, Yoshimi; Izumi, Shin-Ichi

2018-06-01

Virtual reality (VR) immersion often provokes subjective discomfort and postural instability, so called VR sickness. The neural mechanism of VR sickness is speculated to be related to visual-vestibular information mismatch and/or postural instability. However, the approaches proposed to relieve VR sickness through modulation of brain activity are poorly understood. Using transcranial direct current stimulation (tDCS), we aimed to investigate whether VR sickness could be relieved by the modulation of cortical excitability in the temporoparietal junction (TPJ), which is known to be involved in processing of both vestibular and visual information. Twenty healthy subjects received tDCS over right TPJ before VR immersion. The order of the three types of tDCS (anodal, cathodal, and sham) was counterbalanced across subjects. We evaluated the subjective symptoms, heart rate, and center of pressure at baseline, after tDCS, and after VR immersion. VR immersion using head-mounted displays provoked subjective discomfort and postural instability. However, anodal tDCS over right TPJ ameliorated subjective disorientation symptoms and postural instability induced by VR immersion compared with sham condition. The amelioration of VR sickness by anodal tDCS over the right TPJ might result from relief of the sensory conflict and/or facilitation of vestibular function. Our result not only has potential clinical implications for the neuromodulation approach of VR sickness but also implies a causal role of the TPJ in VR sickness.

Factors Associated with Long-Term Sickness Absence Due to Mental Disorders: A Cohort Study of 7.112 Patients during the Spanish Economic Crisis.

PubMed

Real, Eva; Jover, Lluís; Verdaguer, Ricard; Griera, Antoni; Segalàs, Cinto; Alonso, Pino; Contreras, Fernando; Arteman, Antoni; Menchón, José M

2016-01-01

Mental health problems are very common and often lead to prolonged sickness absence, having serious economic repercussions for most European countries. Periods of economic crisis are important social phenomena that are assumed to increase sickness absence due to mental disorders, although research on this topic remains scarce. The aim of this study was to gather data on long-term sickness absence (and relapse) due to mental disorders in Spain during a period of considerable socio-economic crisis. Relationships were analyzed (using chi-squared tests and multivariate modelling via binary logistic regression) between clinical, social/employment-related and demographic factors associated and long-term sickness absence (>60 consecutive days) due to mental disorders in a cohort of 7112 Spanish patients during the period 2008-2012. Older age, severe mental disorders, being self-employed, having a non-permanent contract, and working in the real estate and construction sector were associated with an increased probability of long-term sickness absence (gender had a mediating role with respect to some of these variables). Relapses were associated with short-term sick leave (return to work due to 'improvement') and with working in the transport sector and public administration. Aside from medical factors, other social/employment-related and demographic factors have a significant influence on the duration of sickness absence due to mental disorders.

General practitioners' experiences with sickness certification: a comparison of survey data from Sweden and Norway

PubMed Central

2012-01-01

Background In most countries with sickness insurance systems, general practitioners (GPs) play a key role in the sickness-absence process. Previous studies have indicated that GPs experience several tasks and situations related to sickness certification consultations as problematic. The fact that the organization of primary health care and social insurance systems differ between countries may influence both GPs' experiences and certification. The aim of the present study was to gain more knowledge of GPs' experiences of sickness certification, by comparing data from Sweden and Norway, regarding frequencies and aspects of sickness certification found to be problematic. Methods Statistical analyses of cross-sectional survey data of sickness certification by GPs in Sweden and Norway. In Sweden, all GPs were included, with 3949 (60.6%) responding. In Norway, a representative sample of GPs was included, with 221 (66.5%) responding. Results Most GPs reported having consultations involving sickness certification at least once a week; 95% of the GPs in Sweden and 99% of the GPs in Norway. A majority found such tasks problematic; 60% of the GPs in Sweden and 53% in Norway. In a logistic regression, having a higher frequency of sickness certification consultations was associated with a higher risk of experiencing them as problematic, in both countries. A higher rate of GPs in Sweden than in Norway reported meeting patients wanting a sickness certification without a medical reason. GPs in Sweden found it more problematic to discuss the advantages and disadvantages of sick leave with patients and to issue a prolongation of a sick-leave period initiated by another physician. GPs in Norway more often worried that patients would go to another physician if they did not issue a certificate, and a higher proportion of Norwegian GPs found it problematic to handle situations where they and their patient disagreed on the need for sick leave. Conclusions The study confirms that many GPs experience sickness absence consultations as problematic. However, there were differences between the two countries in GPs' experiences, which may be linked to differences in social security regulations and the organization of GP services. Possible causes and consequences of national differences should be addressed in future studies. PMID:22375615

[Psychosocial workload, sick leave, and health-related well being: an empirical study from the perspective of gender research].

PubMed

Siegrist, K; Rödel, A; Hessel, A; Brähler, E

2006-01-01

The aim of this study was to test hypotheses on the consequences of gender role expectations with regard to the extent of work stress, selected health-related measures and their associations. Data on psychosocial workload (questionnaire of effort-reward imbalance), sick leave (self-reports of the duration of medically certified sick leave during the past two years) and health-related well being were collected in a representative sample of German full-time employees (n = 666). Hypotheses were tested using analyses of variance (ANOVA) and covariance (ANCOVA) and moderated linear regression analyses. Women reported lower health-related well-being as compared to men while effort-reward imbalance and sick leave did not differ between the sexes. Parents reported slightly longer durations of sick leave during the past two years than childless participants (not significant). The results of stratified linear regression analyses show stronger associations between effort-reward imbalance and both health-related measures for women with children than for men with children, while single men and women do not differ in this regard. Evidence of this kind can be useful for the purposeful planning and implementation of health promotion measures at work. Women with children would be a group deserving special attention. The findings also point to continuing differences in gender role expectations in the family context.

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 problem-solving decreases the chance of future sickness absence. PMID:17701200

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 absence.

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 consultations and the role of deprivation as a confounding factor in sickness absence intervention studies.

Leisure-time physical activity and absenteeism.

PubMed

Kerner, Ivana; Rakovac, Marija; Lazinica, Bruno

2017-09-26

Regular physical activity has a significant impact on health. There is scientific evidence for prescription of exercise in the treatment of at least 26 different chronic non-communicable diseases. Furthermore, it has an indirect role in the preservation of work capacity. The aim of this study was to review the published results of research on the relationship between leisure-time PA and absenteeism due to sickness. Medline database was searched using the keywords "leisuretime physical activity AND (sick leave OR sickness absence OR absenteeism)". Fifteen studies were included in the final analysis. A negative correlation between leisure-time PA and absenteeism due to sickness in working population was determined in 11 studies. The results support the inclusion of PA promotion in the programmes intended to reduce absenteeism prevalence, the latter being an important public health issue.

Leading during change: the effects of leader behavior on sickness absence in a Norwegian health trust

PubMed Central

2012-01-01

Background Organizational change often leads to negative employee outcomes such as increased absence. Because change is also often inevitable, it is important to know how these negative outcomes could be reduced. This study investigates how the line manager’s behavior relates to sickness absence in a Norwegian health trust during major restructuring. Methods Leader behavior was measured by questionnaire, where employees assessed their line manager’s behavior (N = 1008; response rate 40%). Data on sickness absence were provided at department level (N = 35) and were measured at two times. Analyses were primarily conducted using linear regression; leader behavior was aggregated and weighted by department size. Results The results show a relationship between several leader behaviors and sickness absence. The line managers’ display of loyalty to their superiors was related to higher sickness absence; whereas task monitoring was related to lower absence. Social support was related to higher sickness absence. However, the effect of social support was no longer significant when the line manager also displayed high levels of problem confrontation. Conclusions The findings clearly support the line manager’s importance for employee sickness absence during organizational change. We conclude that more awareness concerning the manager’s role in change processes is needed. PMID:22984817

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.

Leptin mediates seasonal variation in some but not all symptoms of sickness in Siberian hamsters

PubMed Central

Carlton, Elizabeth D.; Demas, Gregory E.

2014-01-01

Many seasonally breeding species, including Siberian hamsters (Phodopus sungorus), exhibit seasonal variation in sickness responses. One hypothesis regarding the mechanism of this variation is that sickness intensity tracks an animal's energetic state, such that sickness is attenuated in the season that an animal has the lowest fat stores. Energetic state may be signaled via leptin, an adipose hormone that provides a signal of fat stores. Siberian hamsters respond to extended housing in short, winter-like days by reducing fat stores and leptin levels, relative to those housed in long, summer-like days. Sickness responses are also attenuated in short-day hamsters as compared to long-day hamsters. We hypothesized that leptin provides a physiological signal by which seasonally breeding animals modulate sickness responses, such that animals with higher leptin levels show increased sickness intensity. To test this, we provided short-day hamsters with a long-day-like leptin signal and assessed their responses to lipopolysaccharide (LPS), a sickness-inducing antigen. We compared these responses to short-day vehicle-, long-day vehicle-, and long-day leptin-treated hamsters. Unexpectedly, LPS induced a hypothermic response (rather than fever) in all groups. Short-day vehicle-treated hamsters exhibited the greatest LPS-induced hypothermia, and leptin treatment attenuated this response, making hypothermia more long-day-like. Contrary to our hypothesis, short-day leptin-treated hamsters showed the least pronounced LPS-induced anorexia among all groups. These results suggest that leptin may mediate some but not all aspects of seasonal sickness variation in this species. Future studies should be targeted at determining roles of other energetic hormones in regulating seasonal sickness response variation. PMID:25461974

Organizational return to work support and sick leave duration: a cohort of Spanish workers with a long-term non-work-related sick leave episode.

PubMed

Sampere, Maite; Gimeno, David; Serra, Consol; Plana, Manel; Martínez, José Miguel; Delclos, George L; Benavides, Fernando G

2011-06-01

To analyze the association between organizational support and time to return to work (RTW) in workers with long-term non-work-related sick leave. Cohort participants were 571 workers, with a non-work-related sick leave episode of more than 15 days, recruited during the first visit in a health insurance company (mutua). Workers completed a baseline questionnaire regarding organizational RTW support measures and were followed until the end of the episodes. Return to work and time to RTW were established on the basis of the mutua's register. Multivariate Cox regression models were used. Workers in companies with an overall high organizational RTW support returned to work earlier. This effect was mainly due to workers in companies that provided specific RTW programs. Our findings suggest that companies play an important role in facilitating RTW for workers with long-term non-work-related sick leave episodes.

Gender differences in Reasons for Sickness Presenteeism - a study among GPs in a Swedish health care organization.

PubMed

Gustafsson Sendén, Marie; Schenck-Gustafsson, Karin; Fridner, Ann

2016-01-01

It is common that physicians go to work while sick and therefore it is important to understand the reasons behind. Previous research has shown that women and men differ in health and health related behavior. In this study, we examine gender differences among general practitioners who work while sick. General practitioners (GP's) working in outpatient care in a Swedish city participated in the study (n = 283; women = 63 %; response rate = 41 %). Data were obtained from a large web-based questionnaire about health and organization within primary care. Two questions about sickness presenteeism (going to work while sick) were included; life-long and during the past 12 months, and five questions about reasons. We controlled for general health, work-family conflict and demographic variables. Female physicians reported sickness presenteeism more often than male physicians. Work-family conflict mediated the association between gender and sickness presenteeism. Women reported reasons related with "concern for others" and "workload" more strongly than men. Men reported reasons related with "capacity" and "money" more strongly than women. These differences are likely effects of gender stereotyping and different family-responsibilities. Gender socialization and gender stereotypes may influence work and health-related behavior. Because sickness presenteeism is related with negative effects both on individuals and at organizational levels, it is important that managers of health organizations understand the reasons for this, and how gender roles may influence the prevalence of sickness presenteeism and the reasons that female and male GPs give for their behavior.

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

A heuristic mathematical model for the dynamics of sensory conflict and motion sickness

NASA Technical Reports Server (NTRS)

Oman, C. M.

1982-01-01

By consideration of the information processing task faced by the central nervous system in estimating body spatial orientation and in controlling active body movement using an internal model referenced control strategy, a mathematical model for sensory conflict generation is developed. The model postulates a major dynamic functional role for sensory conflict signals in movement control, as well as in sensory-motor adaptation. It accounts for the role of active movement in creating motion sickness symptoms in some experimental circumstance, and in alleviating them in others. The relationship between motion sickness produced by sensory rearrangement and that resulting from external motion disturbances is explicitly defined. A nonlinear conflict averaging model is proposed which describes dynamic aspects of experimentally observed subjective discomfort sensation, and suggests resulting behaviours. The model admits several possibilities for adaptive mechanisms which do not involve internal model updating. Further systematic efforts to experimentally refine and validate the model are indicated.

Stress amongst nurses working in a healthcare telephone-advice service: relationship with job satisfaction, intention to leave, sickness absence, and performance.

PubMed

Farquharson, Barbara; Allan, Julia; Johnston, Derek; Johnston, Marie; Choudhary, Carolyn; Jones, Martyn

2012-07-01

This paper is a report of a study, which assessed levels of stress amongst nurses working in a healthcare telephone-advice service. We explored whether stress related to performance, sickness absence, and intention to leave. Nurses report high levels of stress, as do call-centre workers. The emergence of telephone health advice services means many nurses now work in call-centres, doing work that differs markedly from traditional nursing roles. Stress associated with these roles could have implications for nurses, patients, and service provision. This paper reports cross-sectional survey results. The design of the overall study included longitudinal elements. A comprehensive study of stress was conducted amongst nurses working for a telephone-advice service in Scotland (2008-2010). All nurse-advisors were approached by letter and invited to participate. A total of 152 participants (33%) completed a questionnaire including General Health Questionnaire-12, Work Family Conflict Questionnaire, Job Satisfaction Scale and a measure of intention to leave the telephone-advice service and rated the perceived stress of 2 working shifts. Nurses' employers provided data on sickness absence and performance. Overall levels of psychological distress were similar to those found amongst Scottish women generally. In multiple regression, work-family conflict was identified as a significant predictor of job satisfaction and intention to leave, and significantly related to sickness absence. There were significant correlations between General Health Questionnaire scores and perceived stress of shifts and some performance measures. Work-family conflict is a significant predictor of job satisfaction, intention to leave, and sickness absence amongst telephone helpline nurses. Minimizing the impact of nurses' work on their home lives might reduce turnover and sickness absence. © 2012 Blackwell Publishing Ltd.

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.

Factors Associated with Long-Term Sickness Absence Due to Mental Disorders: A Cohort Study of 7.112 Patients during the Spanish Economic Crisis

PubMed Central

Real, Eva; Jover, Lluís; Verdaguer, Ricard; Griera, Antoni; Segalàs, Cinto; Alonso, Pino; Contreras, Fernando; Arteman, Antoni; Menchón, José M.

2016-01-01

Background Mental health problems are very common and often lead to prolonged sickness absence, having serious economic repercussions for most European countries. Periods of economic crisis are important social phenomena that are assumed to increase sickness absence due to mental disorders, although research on this topic remains scarce. The aim of this study was to gather data on long-term sickness absence (and relapse) due to mental disorders in Spain during a period of considerable socio-economic crisis. Methods Relationships were analyzed (using chi-squared tests and multivariate modelling via binary logistic regression) between clinical, social/employment-related and demographic factors associated and long-term sickness absence (>60 consecutive days) due to mental disorders in a cohort of 7112 Spanish patients during the period 2008–2012. Results Older age, severe mental disorders, being self-employed, having a non-permanent contract, and working in the real estate and construction sector were associated with an increased probability of long-term sickness absence (gender had a mediating role with respect to some of these variables). Relapses were associated with short-term sick leave (return to work due to ‘improvement’) and with working in the transport sector and public administration. Conclusions Aside from medical factors, other social/employment-related and demographic factors have a significant influence on the duration of sickness absence due to mental disorders. PMID:26730603

Sickness absence, marginality, and medically unexplained physical symptoms: a focus-group study of patients' experiences.

PubMed

Aamland, Aase; Werner, Erik L; Malterud, Kirsti

2013-06-01

Medically unexplained physical symptoms (MUPS) form a major cause of sickness absence. The purpose of this study was to explore factors which may influence further marginalization among patients with MUPS on long-term sickness absence. Two focus-group discussions were conducted with a purposive sample of 12 participants, six men and six women, aged 24-59 years. Their average duration of sickness absence was 10.5 months. Participants were invited to share stories about experiences from the process leading to the ongoing sickness absence, with a focus on the causes being medically unexplained. Systematic text condensation was applied for analysis. Inspired by theories of marginalization and coping, the authors searched for knowledge of how patients' positive resources can be mobilized to counteract processes of marginality. Analysis revealed how invisible symptoms and lack of objective findings were perceived as an additional burden to the sickness absence itself. Factors that could counteract further marginalization were a supportive social network, positive coping strategies such as keeping to the daily schedule and physical activity, and positive attention and confidence from professionals. Confidence from both personal and professional contacts is crucial. GPs have an important and appreciated role in this aspect.

Effect of Psychosocial Work Environment on Sickness Absence Among Patients Treated for Ischemic Heart Disease.

PubMed

Biering, Karin; Lund, Thomas; Andersen, Johan Hviid; Hjollund, Niels Henrik

2015-12-01

During the last decades mortality has declined in patients with coronary heart disease due to improvements in treatments and changes in life style, resulting in more people living with chronic heart disease. This implies that focus on rehabilitation and re-integration to the work-force becomes increasingly important. Previous studies among healthy workers suggest that the psychosocial working environment is associated with sickness absence. Whether the psychosocial working environment plays a role for patients with existing cardiovascular disease on return to work and sickness absence is less studied. A cohort of patients under 67 years and treated with percutaneous coronary intervention (PCI) was established in 2006. Three months after the procedure the patients (n = 625) answered a questionnaire about their psychosocial working environment. Patients were followed in registers for the following year. We examined the association between psychosocial working environment and sickness absence at 3 months, 1 year and new sick-listings during the first year with logistic regression. A total of 528 patients had returned to work 3 months after the PCI, while 97 was still sick-listed. After 1 year one was dead, 465 were working and 85 were receiving health related benefits, while 74 had left the workforce permanently. A number of 106 patients were sick-listed during the whole first year or had left the workforce permanently. After the initial return to work, 90 experienced a new sickness absence during the first year while the remaining 429 did not. High work pace, low commitment to the workplace, low recognition (rewards) and low job control were associated with sickness absence at 3 months, but not after 1 year. Low job control as well as job strain (combination of high demands and low control) was associated with new sick-listings. The psychosocial working environment was associated with sickness absence 3 months after the PCI, but not 1 year after.

[Socio-entomologic survey in human trypanosomiasis focus of Yamba (Peoples Republic of Congo)].

PubMed

Gouteux, J P; Malonga, J R

1985-01-01

A study carried out at villagers level in a focus infected by human trypanosomiasis (Yamba, Bouenza region, Congo, Mikengue ethnic group) revealed that modern medicin is recognized by them as the sole possibility to treat the sleeping sickness. The witch doctor, if he cannot transmit the sickness, is perfectly able to aggravate it. He is considered as the responsible for any fatal issue. Tsetse flies are charged of transmitting the sickness as well as other biting insects (black flies, ceratopogonidae). The elders give an historical role to pigs in spreading the sickness. Villagers seem very determined to assume themselves fighting against the tsetse fly by trapping, but impregnation of traps by an insecticide got some problems (technical know-how, equipment) which have been solved by a new model of trap designed by the ORSTOM Center in Brazzaville.

Why Do We Feel Sick When Infected—Can Altruism Play a Role?

PubMed Central

Shakhar, Keren; Shakhar, Guy

2015-01-01

When we contract an infection, we typically feel sick and behave accordingly. Symptoms of sickness behavior (SB) include anorexia, hypersomnia, depression, and reduced social interactions. SB affects species spanning from arthropods to vertebrates, is triggered nonspecifically by viruses, bacteria, and parasites, and is orchestrated by a complex network of cytokines and neuroendocrine pathways; clearly, it has been naturally selected. Nonetheless, SB seems evolutionarily costly: it promotes starvation and predation and reduces reproductive opportunities. How could SB persist? Former explanations focused on individual fitness, invoking improved resistance to pathogens. Could prevention of disease transmission, propagating in populations through kin selection, also contribute to SB? PMID:26474156

The vestibulo-ocular reflex and its possible roles in space motion sickness

NASA Technical Reports Server (NTRS)

Watt, Douglas G. D.

1987-01-01

Prolonged exposure to an inappropriate vestibulo-ocular reflex (VOR) will usually lead to motion sickness, and it has been predicted on theoretical grounds that VOR gain may be decreased in weightlessness. While experiments during parabolic flight in aircraft tend to confirm this prediction, experiments during orbital spaceflight have led to apparently contradictory results. It is suggested that VOR gain is reduced initially, but that rapid compensatory mechanisms restore it to normal within minutes of reaching weightlessness. However, even though this process may lead to the rapid return of functionally normal gaze stability, it may not protect against the development of motion sickness.

Role of Ionizing Radiation in Neurodegenerative Diseases

PubMed Central

Sharma, Neel K.; Sharma, Rupali; Mathur, Deepali; Sharad, Shashwat; Minhas, Gillipsie; Bhatia, Kulsajan; Anand, Akshay; Ghosh, Sanchita P.

2018-01-01

Ionizing radiation (IR) from terrestrial sources is continually an unprotected peril to human beings. However, the medical radiation and global radiation background are main contributors to human exposure and causes of radiation sickness. At high-dose exposures acute radiation sickness occurs, whereas chronic effects may persist for a number of years. Radiation can increase many circulatory, age related and neurodegenerative diseases. Neurodegenerative diseases occur a long time after exposure to radiation, as demonstrated in atomic bomb survivors, and are still controversial. This review discuss the role of IR in neurodegenerative diseases and proposes an association between neurodegenerative diseases and exposure to IR. PMID:29867445

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 future studies.

What physicians want to learn about sickness certification: analyses of questionnaire data from 4019 physicians

PubMed Central

2010-01-01

Background Sickness absence is a problem in many Western countries. Physicians have an essential role in sickness certification of patients, which is often recommended in health care but may have side effects. Despite the potentially harming impact of sickness absence, physicians have very limited training in insurance medicine, and there is little research on sickness certification practices. Our aim was to ascertain what knowledge and skills physicians in different clinical settings feel they need in order to improve their competence in sickness certification. Methods The data for analysis were collected in 2004 in Stockholm and Östergötland Counties, Sweden, by use of a comprehensive questionnaire about sickness certification issues, which was sent to 7,665 physicians aged ≤ 64 years. The response rate was 71% (n = 5455). Analyses of association and factor analysis were applied to the various aspects of competence to establish a skills index and a knowledge index, which were used to compare the results for physicians in different clinical settings. Results Most physicians stated they needed more knowledge and skills in handling sickness certification, e.g. regarding how to assess work capacity (44%) and optimal length and degree of sickness absence (50%), and information about aspects of the social insurance system (43-63%). Few (20%) reported needing to know more about issuing sickness certificates. The index scores varied substantially between different clinical settings, and this disparity remained after adjustment for sex, years in practice, workplace policy, and support from management. Scores on the skills index were significantly higher for physicians in primary care than for those working in other areas. Conclusions A majority of physicians in most types of clinics/practices, not only primary care, indicated the need for more knowledge and skills in handling sickness certification cases. Increased knowledge and skills are needed in order to protect both the health and equity of patients. However, few physicians stated that they needed more skills in filling out sickness certificates, which contradicts previous findings about such documents being of poor quality and suggests that factors other than mere knowledge and skills are involved. PMID:20144230

Consumer price sensitivity and social health insurer choice in Germany and The Netherlands.

PubMed

Schut, Frederik T; Gress, Stefan; Wasem, Juergen

2003-06-01

In this paper, we examine the effects of the introduction of free choice and price competition in social health insurance in Germany and the Netherlands. Using panel data at the sickness fund level we estimate the price elasticity of sickness fund choice in both countries. We find that the price elasticity in Germany is high and rapidly increasing. Consistent with findings of other studies on health plan choice, the price elasticity is much lower for elderly than for non-elderly. In the Netherlands, by contrast, the price elasticity of fund choice is negligible. Only when people were forced to choose a sickness fund, they were quite sensitive to premium differences. Key factors in explaining the observed differences in switching behavior between both countries are the degree of financial risk for sickness funds, the features of the risk-adjustment mechanism and the role of employers.

Lipopolysaccharide administration in the dominant mouse destabilizes social hierarchy.

PubMed

Cohn, Daniel Wagner Hamada; Gabanyi, Ilana; Kinoshita, Denise; de Sá-Rocha, Luiz Carlos

2012-09-01

Sickness behavior is a set of behavioral changes that are part of an adaptive strategy to overcome infection. Mice that interact with conspecifics displaying sickness behavior also show relevant behavioral changes. In this work we sought to determine the role of sickness behavior display by a dominant mouse as a promoter of hierarchy instability. We treated the dominant mouse within a dyad with lipopolysaccharide (LPS) (400 μg/kg, i.p.) for three consecutive days and assessed social dominance behavior. Since elder animals display increased inflammatory responses and the behaviors toward conspecifics are influenced by kinship we also assessed whether kinship and age, might influence sickness related hierarchy instability. Our results show that administration of LPS in the dominant mouse promotes social instability within a dyad, and indicates that this instability could be influenced by kinship and age. Copyright © 2012 Elsevier B.V. All rights reserved.

Immune trypanolysis test with blood spotted on filter paper for epidemiological surveillance of sleeping sickness.

PubMed

Camara, Oumou; Camara, Mamadou; Lejon, Veerle; Ilboudo, Hamidou; Sakande, Hassane; Léno, Mamadou; Büscher, Philippe; Bucheton, Bruno; Jamonneau, Vincent

2014-07-01

The immune trypanolysis test (TL) is an accurate sero-diagnostic tool increasingly implemented for sleeping sickness medical surveillance, but it is restricted to the reference laboratories. To facilitate storage and transport of the test specimen, we developed a protocol for the examination of blood spotted on filter paper (TL-fp) that can be stored and shipped at ambient temperature. We compared its performance with the classical TL on plasma (TL-pl) that needs to be kept frozen until use. The study was conducted in active foci of the Republic of Guinea. In total, 438 specimens from treated and untreated sleeping sickness patients and serological suspects were tested with both methods. TL-fp gave significantly less positive results than TL-pl, but all the confirmed sleeping sickness cases were positive with the TL-fp protocol. TL-fp appears to offer a good compromise between feasibility and sensitivity to detect currently infected subjects who play a role in the transmission of Trypanosoma brucei gambiense and is useful for contributing to the elimination of gambiense sleeping sickness. © 2014 John Wiley & Sons Ltd.

The regular general practitioner and sickness absence--a register-based study.

PubMed

Winde, Lee; Haukenes, Inger; Hetlevik, Øystein; Gjesdal, Sturla

2013-01-08

Undertaking research on the role of regular GPs with regard to rates of sickness absence is methodologically challenging, and existing results show a wide divergence. We investigated how long-term sickness absence is affected by the characteristics of doctors and their patient lists. The study encompassed all those vocationally active residents of Oslo and Bergen in 2005-2006 who had the same regular GP throughout 2006 (N = 298,039). Encrypted data on sickness absence for each individual in 2006, as well their age, gender and level of education were merged with data on the regular GPs (N = 568) and their patient lists, and subsequently analysed with the aid of logistic regression. The outcome variable was at least one period of sickness absence which had been paid for by the Norwegian Labour and Welfare Administration (NLWA). The explanatory variables included the age, gender, list length and list status (open/closed) of the regular GPs, as well as variables that characterised the composition of the patient lists. The analyses were stratified by gender and controlled for individual age and education. The age, gender and list length of the regular GPs were not associated with sickness absence paid for by the NLWA. The odds ratio for sickness absence > 16 days was reduced for both women and men when the list contained many highly educated patients, a high proportion of elderly people and few disability pensioners. Men on lists with a high proportion of men and lists with a high proportion of vocationally active patients also had lower odds rates for sickness absence > 16 days. Among women, the rate of sickness absence was lower for those on open lists than for those on closed lists. In addition to well-known individual factors, the study shows that the likelihood of sickness absence is affected by the socio-demographic composition of the patient list to which one belongs.

Sickness absence, marginality, and medically unexplained physical symptoms: A focus-group study of patients’ experiences

PubMed Central

2013-01-01

Abstract Purpose Medically unexplained physical symptoms (MUPS) form a major cause of sickness absence. The purpose of this study was to explore factors which may influence further marginalization among patients with MUPS on long-term sickness absence. Methods Two focus-group discussions were conducted with a purposive sample of 12 participants, six men and six women, aged 24–59 years. Their average duration of sickness absence was 10.5 months. Participants were invited to share stories about experiences from the process leading to the ongoing sickness absence, with a focus on the causes being medically unexplained. Systematic text condensation was applied for analysis. Inspired by theories of marginalization and coping, the authors searched for knowledge of how patients’ positive resources can be mobilized to counteract processes of marginality. Results Analysis revealed how invisible symptoms and lack of objective findings were perceived as an additional burden to the sickness absence itself. Factors that could counteract further marginalization were a supportive social network, positive coping strategies such as keeping to the daily schedule and physical activity, and positive attention and confidence from professionals. Conclusions Confidence from both personal and professional contacts is crucial. GPs have an important and appreciated role in this aspect. PMID:23659708

Motion sickness is linked to nystagmus-related trigeminal brain stem input: a new hypothesis.

PubMed

Gupta, Vinod Kumar

2005-01-01

Motion sickness is a common and distressing but poorly understood syndrome associated with nausea/vomiting and autonomic nervous system accompaniments that develops in the air or space as well as on sea or land. A bidirectional aetiologic link prevails between migraine and motion-sickness. Motion sickness provokes jerk nystagmus induced by both optokinetic and vestibular stimulation. Fixation of gaze or closure of eyes generally prevents motion sickness while vestibular otolithic function is eliminated in microgravity of space, indicating a predominant pathogenetic role for visuo-sensory input. Scopolamine, dimenhydrinate, and promethazine reduce motion-related nystagmus. Contraction of extraocular muscles generates proprioceptive neural traffic and can provoke an ocular hypertensive response. It is proposed that repetitive contractions of the extraocular muscles during motion-related jerk nystagmus rapidly augment brain stem afferent input by increasing proprioceptive neural traffic through connections of the oculomotor nerves with the ophthalmic nerve in the lateral wall of the cavernous sinus as well as by raising the intraocular pressure thereby stimulating anterior segment ocular trigeminal nerve fibers. This verifiable hypothesis defines the pathophysiological basis of individual susceptibility to motion sickness, elucidates the preventive mechanism of gaze fixation or ocular closure, advances the aetiologic link between MS and migraine, rationalizes the mechanism of known preventive drugs, and explores new therapeutic possibilities.

The influence of organizational commitment and health on sickness absenteeism: a longitudinal study.

PubMed

Schalk, René

2011-07-01

The prevention of sickness absenteeism of nurses is an important issue for organizations in health care as well as for nurses. The role of work-related attitudes, such as organizational commitment, as a cause of absenteeism is still unclear. To examine the influence over time of organizational commitment, health complaints, and visits to a general practitioner on sickness absenteeism. This was a longitudinal, three-wave study in two nursing homes in the Netherlands among 224 nurses. Questionnaire data (self reports of organizational commitment, health complaints, visits to a general practitioner), as well as absenteeism data retrieved from personnel files was used. Health complaints and visits to a general practitioner were found to predict absenteeism behaviour. Commitment was related to health complaints at the same point in time, but did not predict future sickness absenteeism. With respect to managing sickness absenteeism of nurses it should be acknowledged by managers that nurses call in sick when they perceive that there is a real health problem, not because of negative work attitudes. It is important, however, for managers to signal signs of decreasing organizational commitment because this is associated with increases in health complaints. This can eventually result in increases in absenteeism. © 2011 The Author. Journal compilation © 2011 Blackwell Publishing Ltd.

Short-term responses of the kidney to high altitude in mountain climbers

PubMed Central

Goldfarb-Rumyantzev, Alexander S.; Alper, Seth L.

2014-01-01

In high-altitude climbers, the kidneys play a crucial role in acclimatization and in mountain sickness syndromes [acute mountain sickness (AMS), high-altitude cerebral edema, high-altitude pulmonary edema] through their roles in regulating body fluids, electrolyte and acid–base homeostasis. Here, we discuss renal responses to several high-altitude-related stresses, including changes in systemic volume status, renal plasma flow and clearance, and altered acid–base and electrolyte status. Volume regulation is considered central both to high-altitude adaptation and to maladaptive development of mountain sickness. The rapid and powerful diuretic response to the hypobaric hypoxic stimulus of altitude integrates decreased circulating concentrations of antidiuretic hormone, renin and aldosterone, increased levels of natriuretic hormones, plasma and urinary epinephrine, norepinephrine, endothelin and urinary adrenomedullin, with increased insensible fluid losses and reduced fluid intake. The ventilatory and hormonal responses to hypoxia may predict susceptibility to AMS, also likely influenced by multiple genetic factors. The timing of altitude increases and adaptation also modifies the body's physiologic responses to altitude. While hypovolemia develops as part of the diuretic response to altitude, coincident vascular leak and extravascular fluid accumulation lead to syndromes of high-altitude sickness. Pharmacological interventions, such as diuretics, calcium blockers, steroids, phosphodiesterase inhibitors and β-agonists, may potentially be helpful in preventing or attenuating these syndromes. PMID:23525530

The attribution of work environment in explaining gender differences in long-term sickness absence: results from the prospective DREAM study.

PubMed

Labriola, Merete; Holte, Kari Anne; Christensen, Karl Bang; Feveile, Helene; Alexanderson, Kristina; Lund, Thomas

2011-09-01

To identify differences in risk of long-term sickness absence between female and male employees in Denmark and to examine to what extent differences could be explained by work environment factors. A cohort of 5026 employees (49.1% women, mean age 40.4years; 50.9% men, mean age 40.2years) was interviewed in 2000 regarding gender, age, family status, socio-economic position and psychosocial and physical work environment factors. The participants were followed for 18months in order to assess their incidence of long-term sickness absence exceeding 8 consecutive weeks. 298 workers (5.9%) received sickness absence compensation for 8weeks or more. Women had an excess risk of 37% compared to men, when adjusting for age, family status and socio-economic position. Physical work environment exposures could not explain this difference, whereas differences in psychosocial work environment exposures explained 32% of the differences in risk of long-term sickness absence between men and women, causing the effect of gender to become statistically insignificant. The combined effect of physical and psychosocial factors was similar, explaining 30% of the gender difference. Differences in psychosocial work environments in terms of emotional demands, reward at work, management quality and role conflicts, explained roughly 30% of women's excess long-term sickness absence risk. Assuming women and men had identical working conditions would leave the larger part of the gender difference in long-term sickness absence from work unexplained.

From sick role to narrative subject: An analytic memoir.

PubMed

Frank, Arthur W

2016-01-01

Questions of illness experience and identity are discussed, based on the analysis of a story told by the breast-cancer activist Audre Lorde. Displacing Parsons' conceptualization of illness as a sick role, I understand the ill person as a narrative subject, defined by discursive possibilities. Three discourses of illness are proposed: the medical institutional discourse, the discourse of illness experience, and the pink-ribbon discourse. Each has its preferred narratives. These discourses overlap and mutually affect each other. Problems with the Foucauldian conceptualization of the subject are considered, and a dialogical imagination of relations of governmentality is proposed. © The Author(s) 2015.

Interdependent and independent roles of type I interferons and IL-6 in innate immune, neuroinflammatory and sickness behaviour responses to systemic poly I:C

PubMed Central

Murray, Carol; Griffin, Éadaoin W.; O’Loughlin, Elaine; Lyons, Aoife; Sherwin, Eoin; Ahmed, Suaad; Stevenson, Nigel J; Harkin, Andrew; Cunningham, Colm

2015-01-01

Type I interferons (IFN-I) are expressed in the brain during many inflammatory and neurodegenerative conditions and have multiple effects on CNS function. IFN-I is readily induced in the brain by systemic administration of the viral mimetic, poly I:C (synthetic double-stranded RNA). We hypothesised that IFN-I contributes to systemically administered poly I:C-induced sickness behaviour, metabolic and neuroinflammatory changes. IFN-I receptor 1 deficient mice (IFNAR1−/−) displayed significantly attenuated poly I:C-induced hypothermia, hypoactivity and weight loss compared to WT C57BL/6 mice. This amelioration of sickness was associated with equivalent IL-1β and TNF-α responses but much reduced IL-6 responses in plasma, hypothalamus and hippocampus of IFNAR1−/− mice. IFN-β injection induced trivial IL-6 production and limited behavioural change and the poly I:C-induced IFN-β response did not preceed, and would not appear to mediate, IL-6 induction. Rather, IFNAR1−/− mice lack basal IFN-I activity, have lower STAT1 levels and show significantly lower levels of several inflammatory transcripts, including stat1. Basal IFN-I activity appears to play a facilitatory role in the full expression of the IL-6 response and activation of the tryptophan-kynurenine metabolism pathway. The deficient IL-6 response in IFNAR1−/− mice partially explains the observed incomplete sickness behaviour response. Reconstitution of circulating IL-6 revealed that the role of IFNAR in burrowing activity is mediated via IL-6, while IFN-I and IL-6 have additive effects on hypoactivity, but the role of IFN-I in anorexia is independent of IL-6. Hence, we have demonstrated both interdependent and independent roles for IFN-I and IL-6 in systemic inflammation-induced changes in brain function. PMID:25900439

Interdependent and independent roles of type I interferons and IL-6 in innate immune, neuroinflammatory and sickness behaviour responses to systemic poly I:C.

PubMed

Murray, Carol; Griffin, Éadaoin W; O'Loughlin, Elaine; Lyons, Aoife; Sherwin, Eoin; Ahmed, Suaad; Stevenson, Nigel J; Harkin, Andrew; Cunningham, Colm

2015-08-01

Type I interferons (IFN-I) are expressed in the brain during many inflammatory and neurodegenerative conditions and have multiple effects on CNS function. IFN-I is readily induced in the brain by systemic administration of the viral mimetic, poly I:C (synthetic double-stranded RNA). We hypothesised that IFN-I contributes to systemically administered poly I:C-induced sickness behaviour, metabolic and neuroinflammatory changes. IFN-I receptor 1 deficient mice (IFNAR1(-/-)) displayed significantly attenuated poly I:C-induced hypothermia, hypoactivity and weight loss compared to WT C57BL/6 mice. This amelioration of sickness was associated with equivalent IL-1β and TNF-α responses but much reduced IL-6 responses in plasma, hypothalamus and hippocampus of IFNAR1(-/-) mice. IFN-β injection induced trivial IL-6 production and limited behavioural change and the poly I:C-induced IFN-β response did not preceed, and would not appear to mediate, IL-6 induction. Rather, IFNAR1(-/-) mice lack basal IFN-I activity, have lower STAT1 levels and show significantly lower levels of several inflammatory transcripts, including stat1. Basal IFN-I activity appears to play a facilitatory role in the full expression of the IL-6 response and activation of the tryptophan-kynurenine metabolism pathway. The deficient IL-6 response in IFNAR1(-/-) mice partially explains the observed incomplete sickness behaviour response. Reconstitution of circulating IL-6 revealed that the role of IFNAR in burrowing activity is mediated via IL-6, while IFN-I and IL-6 have additive effects on hypoactivity, but the role of IFN-I in anorexia is independent of IL-6. Hence, we have demonstrated both interdependent and independent roles for IFN-I and IL-6 in systemic inflammation-induced changes in brain function. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

A new goldfish model to evaluate pharmacokinetic and pharmacodynamic effects of drugs used for motion sickness in different gravity loads

NASA Astrophysics Data System (ADS)

Lathers, Claire M.; Mukai, Chiaki; Smith, Cedric M.; Schraeder, Paul L.

2001-08-01

This paper proposes a new goldfish model to predict pharmacodynamic/pharmacokinetic effects of drugs used to treat motion sickness administered in differing gravity loads. The assumption of these experiments is that the vestibular system is dominant in producing motion sickness and that the visual system is secondary or of small import in the production of motion sickness. Studies will evaluate the parameter of gravity and the contribution of vision to the role of the neurovestibular system in the initiation of motion sickness with and without pharmacologic agents. Promethazine will be studied first. A comparison of data obtained in different groups of goldfish will be done (normal vs. acutely and chronically bilaterally blinded vs. sham operated). Some fish will be bilaterally blinded 10 months prior to initiation of the experiment (designated the chronically bilaterally blinded group of goldfish) to evaluate the neuroplasticity of the nervous system and the associated return of neurovestibular function. Data will be obtained under differing gravity loads with and without a pharmacological agent for motion sickness. Experiments will differentiate pharmacological effects on vision vs. neurovestibular input to motion sickness. Comparison of data obtained in the normal fish and in acutely and chronically bilaterally blinded fish with those obtained in fish with intact and denervated otoliths will differentiate if the visual or neurovestibular system is dominant in response to altered gravity and/or drugs. Experiments will contribute to validation of the goldfish as a model for humans since plasticity of the central nervous system allows astronauts to adapt to the altered visual stimulus conditions of 0-g. Space motion sickness may occur until such an adaptation is achieved.

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.

ANALYSIS OF ABSENTEEISM IN INDUSTRY

PubMed Central

Luongo, E. P.

1959-01-01

There are many nonmedical factors that contribute to employee absenteeism in industry. An employee's total life situation or total environment may be a causative factor in excessive “sick absenteeism.” In many instances the cure for “abnormal” sickness absenteeism is within the province of supervisory personnel, who should look upon abuse of sick leave benefits among employees as morale problems and as evidence of possible maladjustment to the demands of the job or the industry. There are, however, many problems in mental and physical health affecting absence rates in which preventive psychiatry and medicine can make greater contributions. Even truancy and malingering may sometimes be conditions requiring professional medical care. The role of a private physician in determining and certifying the true state of a patient's health is a most important one economically to industry and the community. The total problem of absenteeism for sickness, as it exists in industry today, points up the need for the most effective cooperation and communication possible between industrial and private physicians. Since no more than 25 per cent of the total work force is employed in industries having in-plant medical programs, the burden of responsibility for the control of absenteeism for sickness rests mainly with private practitioners. PMID:14418976

Psychosocial work factors and long sickness absence in Europe.

PubMed

Slany, Corinna; Schütte, Stefanie; Chastang, Jean-François; Parent-Thirion, Agnès; Vermeylen, Greet; Niedhammer, Isabelle

2014-01-01

Studies exploring a wide range of psychosocial work factors separately and together in association with long sickness absence are still lacking. The objective of this study was to explore the associations between psychosocial work factors measured following a comprehensive instrument (Copenhagen psychosocial questionnaire, COPSOQ) and long sickness absence (> 7 days/year) in European employees of 34 countries. An additional objective was to study the differences in these associations according to gender and countries. The study population consisted of 16 120 male and 16 588 female employees from the 2010 European working conditions survey. Twenty-five psychosocial work factors were explored. Statistical analysis was performed using multilevel logistic regression models and interaction testing. When studied together in the same model, factors related to job demands (quantitative demands and demands for hiding emotions), possibilities for development, social relationships (role conflicts, quality of leadership, social support, and sense of community), workplace violence (physical violence, bullying, and discrimination), shift work, and job promotion were associated with long sickness absence. Almost no difference was observed according to gender and country. Comprehensive prevention policies oriented to psychosocial work factors may be useful to prevent long sickness absence at European level.

Epstein-Barr virus (EBV)-encoded dUTPase and chronic restraint induce impaired learning and memory and sickness responses.

PubMed

Aubrecht, Taryn G; Weil, Zachary M; Ariza, Maria Eugenia; Williams, Marshall; Reader, Brenda F; Glaser, Ronald; Sheridan, John F; Nelson, Randy J

2014-10-01

Most adult humans have been infected with Epstein-Barr virus (EBV) and carry the latent virus. The EBV genome codes for several proteins that form an early antigen complex important for viral replication; one of these proteins is deoxyuridine triphosphate nucleotidohydrolase (dUTPase). The EBV-encoded dUTPase can induce sickness responses in mice. Because stress can increase latent virus reactivation, we hypothesized that chronic restraint would exacerbate sickness behaviors elicited by EBV-encoded dUTPase. Male Swiss-Webster mice were injected daily for 15 days with either saline or EBV-encoded dUTPase. Additionally, half of the mice from each condition were either restrained for 3h daily or left undisturbed. Restraint stress impaired learning and memory in the passive avoidance chamber; impaired learning and memory was due to EBV-encoded dUTPase injected into restrained mice. EBV-encoded dUTPase induced sickness responses and restraint stress interacts with EBV-encoded dUTPase to exacerbate the sickness response. These data support a role for EBV-encoded dUTPase and restraint stress in altering the pathophysiology of EBV independent of viral replication. Copyright © 2014 Elsevier Inc. All rights reserved.

Psychosocial work factors and long sickness absence in Europe

PubMed Central

Slany, Corinna; Schütte, Stefanie; Chastang, Jean-François; Parent-Thirion, Agnès; Vermeylen, Greet; Niedhammer, Isabelle

2014-01-01

Background: Studies exploring a wide range of psychosocial work factors separately and together in association with long sickness absence are still lacking. Objectives: The objective of this study was to explore the associations between psychosocial work factors measured following a comprehensive instrument (Copenhagen psychosocial questionnaire, COPSOQ) and long sickness absence (>7 days/year) in European employees of 34 countries. An additional objective was to study the differences in these associations according to gender and countries. Methods: The study population consisted of 16 120 male and 16 588 female employees from the 2010 European working conditions survey. Twenty-five psychosocial work factors were explored. Statistical analysis was performed using multilevel logistic regression models and interaction testing. Results: When studied together in the same model, factors related to job demands (quantitative demands and demands for hiding emotions), possibilities for development, social relationships (role conflicts, quality of leadership, social support, and sense of community), workplace violence (physical violence, bullying, and discrimination), shift work, and job promotion were associated with long sickness absence. Almost no difference was observed according to gender and country. Conclusions: Comprehensive prevention policies oriented to psychosocial work factors may be useful to prevent long sickness absence at European level. PMID:24176393

Mechanisms of selective attention and space motion sickness

NASA Technical Reports Server (NTRS)

Kohl, R. L.

1987-01-01

The neural mismatch theory of space motion sickness asserts that the central and peripheral autonomic sequelae of discordant sensory input arise from central integrative processes falling to reconcile patterns of incoming sensory information with existing memory. Stated differently, perceived novelty reaches a stress level as integrative mechanisms fail to return a sense of control to the individual in the new environment. Based on evidence summarized here, the severity of the neural mismatch may be dependent upon the relative amount of attention selectively afforded to each sensory input competing for control of behavior. Components of the limbic system may play important roles in match-mismatch operations, be therapeutically modulated by antimotion sickness drugs, and be optimally positioned to control autonomic output.

Arousal and stability - The effects of five new sympathomimetic drugs suggest a new principle for the prevention of space motion sickness

NASA Technical Reports Server (NTRS)

Kohl, R. L.; Calkins, D. S.; Mandell, A. J.

1986-01-01

Sympathomimetic agents are frequent components in antimotion-sickness drug combinations because of their usefulness in counteracting the sedation caused by stressful motion or resulting from the administration of other antimotion-sickness drugs. The noradrenergic neurochemistry of the brain's arousal-attentional systems prompted us to evaluate the efficacy of five new sympathomimetic drugs and to further define the role of arousal in susceptibility to motion. Subjects were orally administered methamphetamine (20 mg), phenmetrazine (25 mg), phentermine (37.5 mg), methylphenidate (20 mg), or pemoline (75 mg) 2 h prior to taking a Staircase Profile Test. All of the drugs increased resistance to stressful coriolis stimulation by 80-120 percent. Methylphenidate and pemoline showed fewer side effects. These findings, interpreted in conjunction with the documented inefficacy of most anticholinergic and antihistaminergic drugs tested to date, suggest that sympathomimetic drugs or a generalized state of arosusal can inhibit the development of motion sickness.

Determinants of Motion Sickness in Tilting Trains: Coriolis/Cross-Coupling Stimuli and Tilt Delay

PubMed Central

Bertolini, Giovanni; Durmaz, Meek Angela; Ferrari, Kim; Küffer, Alexander; Lambert, Charlotte; Straumann, Dominik

2017-01-01

Faster trains require tilting of the cars to counterbalance the centrifugal forces during curves. Motion sensitive passengers, however, complain of discomfort and overt motion sickness. A recent study comparing different control systems in a tilting train, suggested that the delay of car tilts relative to the curve of the track contributes to motion sickness. Other aspects of the motion stimuli, like the lateral accelerations and the car jitters, differed between the tested conditions and prevented a final conclusion on the role of tilt delay. Nineteen subjects were tested on a motorized 3D turntable that simulated the roll tilts during yaw rotations experienced on a tilting train, isolating them from other motion components. Each session was composed of two consecutive series of 12 ideal curves that were defined on the bases of recordings during an actual train ride. The simulated car tilts started either at the beginning of the curve acceleration phase (no-delay condition) or with 3 s of delay (delay condition). Motion sickness was self-assessed by each subject at the end of each series using an analog motion sickness scale. All subjects were tested in both conditions. Significant increases of motion sickness occurred after the first sequence of 12 curves in the delay condition, but not in the no-delay condition. This increase correlated with the sensitivity of motion sickness, which was self-assessed by each subject before the experiment. The second sequence of curve did not lead to a significant further increase of motion sickness in any condition. Our results demonstrate that, even if the speed and amplitude are as low as those experienced on tilting trains, a series of roll tilts with a delay relative to the horizontal rotations, isolated from other motion stimuli occurring during a travel, generate Coriolis/cross-coupling stimulations sufficient to rapidly induce motion sickness in sensitive individuals. The strength and the rapid onset of the motion sickness reported confirm that, even if the angular velocity involved are low, the Coriolis/cross-coupling resulting from the delay is a major factor in causing sickness that can be resolved by improving the tilt timing relative to the horizontal rotation originating from the curve. PMID:28555125

Role of the area postrema in three putative measures of motion sickness in the rat

NASA Technical Reports Server (NTRS)

Sutton, Richard L.; Fox, Robert A.; Daunton, Nancy G.

1991-01-01

After thermal cauterization of the area postrema in rats, the absence of conditioned taste aversion of sucrose paired with lithium chloride (0.15M, 3.3 ml/kg) was used as a pharmacologic/behavioral index of area postrema damage. In a subsequent experiment the effects of area postrema lesions on three measures proposed as species-relevant measures of motion sickness were studied, using off-vertical rotation at 150 deg/s for either 30 or 90 min. Lesions of area postrema did not alter postrotational suppression of drinking or amount of defecation during motion. The initial acquisition of conditioned taste aversion to a novel cider vinegar solution paired with motion was not affected by lesioning of the area postrema, but these taste aversions extinguished more slowly in lesioned rats than in sham-operates or intact controls. Results are discussed in terms of proposed humoral factors which may induce motion sickness and in light of recent data on the role of the area postrema in similar measures in species possessing the complete emetic reflex.

Work outcomes and their predictors in the Redesigning Daily Occupations (ReDO) rehabilitation programme for women with stress-related disorders.

PubMed

Eklund, Mona; Wästberg, Birgitta A; Erlandsson, Lena-Karin

2013-04-01

Previous research has shown that the Redesigning Daily Occupations programme reduced the degree of sick leave and increased return to work rates among women on sick leave for stress-related disorders when compared with "care as usual". To further investigate the Redesigning Daily Occupations intervention, this study explored changes in the work situation from baseline to a 12-month follow-up in the Redesigning Daily Occupations group compared with the "care as usual" group and analysed any predictors of change. A matched-control design was used and 84 women were recruited. Objective (return to work and sick leave) and subjective work outcomes (perceptions of the worker role and the work environment) were explored. Potential predictors were clinical and demographic variables and an anxiety-depression factor. In both groups, large positive effect sizes from baseline to follow-up were found regarding the objective outcomes, a moderate positive effect size was found for perceived work environment, whereas perceived worker role remained unaffected. Previous work rehabilitation predicted objective work outcomes in both groups. Higher education and older age were predictors of subjective outcomes in the Redesigning Daily Occupations group, whereas a more severe anxiety-depression rating was negative for work environment ratings in the "care as usual" group. Return to work seemed possible without a change in the women's perceptions of the worker role; rather they renegotiated their view of the work environment. The Redesigning Daily Occupations programme was found to be promising, with a positive effect on return to work and sick leave reduction. It seemed more suitable for the higher educated and older women. © 2012 The Authors Australian Occupational Therapy Journal © 2012 Occupational Therapy Australia.

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.

Maternity Leave and Mothers' Long-Term Sickness Absence: Evidence From West Germany.

PubMed

Guertzgen, Nicole; Hank, Karsten

2018-04-01

Exploiting unique German administrative data, we estimate the association between an expansion in maternity leave duration from two to six months in 1979 and mothers' postbirth long-term sickness absence over a period of three decades after childbirth. Adopting a difference-in-difference approach, we first assess the reform's labor market effects and, subsequently, prebirth and postbirth maternal long-term sickness absence, accounting for the potential role of the reform in mothers' selection into employment. Consistent with previous research, our estimates show that the leave extension caused mothers to significantly delay their return to work within the first year after childbirth. We then provide difference-in-difference estimates for the number and length of spells of long-term sickness absence among returned mothers. Our findings suggest that among those returned, mothers subject to the leave extension exhibit a higher incidence of long-term sickness absence compared with mothers who gave birth before the reform. This also holds true after we control for observable differences in prebirth illness histories. At the same time, we find no pronounced effects on mothers' medium-run labor market attachment following the short-run delay in return to work, which might rationalize a negative causal health effect. Breaking down the results by mothers' prebirth health status suggests that the higher incidence of long-term sickness absence among mothers subject to the reform may be explained by the fact that the reform facilitated the reentry of a negative health selection into the labor market.

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.

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.

Socioeconomic status is associated with symptom severity and sickness absence in people with infectious intestinal disease in the UK.

PubMed

Rose, Tanith C; Adams, Natalie L; Barr, Benjamin; Hawker, Jeremy; O'Brien, Sarah J; Violato, Mara; Whitehead, Margaret; Taylor-Robinson, David C

2017-06-23

The burden of infectious intestinal disease (IID) in the UK is substantial. Negative consequences including sickness absence are common, but little is known about the social patterning of these outcomes, or the extent to which they relate to disease severity. We performed a cross-sectional analysis using IID cases identified from a large population-based survey, to explore the association between socioeconomic status (SES) and symptom severity and sickness absence; and to assess the role of symptom severity on the relationship between SES and absence. Regression modelling was used to investigate these associations, whilst controlling for potential confounders such as age, sex and ethnicity. Among 1164 cases, those of lower SES versus high had twice the odds of experiencing severe symptoms (OR 2.2, 95%CI;1.66-2.87). Lower SES was associated with higher odds of sickness absence (OR 1.8, 95%CI;1.26-2.69), however this association was attenuated after adjusting for symptom severity (OR 1.4, 95%CI;0.92-2.07). In a large sample of IID cases, those of low SES versus high were more likely to report severe symptoms, and sickness absence; with greater severity largely explaining the higher absence. Public health interventions are needed to address the unequal consequences of IID identified.

Explaining educational differences in sickness absence: a population-based follow-up study.

PubMed

Kaikkonen, Risto; Härkänen, Tommi; Rahkonen, Ossi; Gould, Raija; Koskinen, Seppo

2015-07-01

There is a marked socioeconomic gradient in sickness absences, but the causes of this gradient are poorly understood. This study examined the role of health and work-related factors as determinants of educational differences in long-term sickness absence in an 8-year follow-up. The study comprised a population-based sample of 5835 Finns aged 30-64 years (participation 89%, N=3946) in a register-based 8-year follow-up. This is a novel method to predict the population average of sickness absence days per working year (DWY) based on the expected outcome values using Poisson and gamma regression models. The difference in the DWY between the lowest and highest educational level was clear among both men (3.2 days/year versus 8.0 days/year) and women (women 4.4 days/year versus 10.1 days/year). Adjusting for physical working conditions, health status and health behavior, and obesity attenuated the differences. Psychosocial working conditions had only a minor effect on the association. After adjusting for health and work-related factors, the difference attenuated by 1.8 days and 2.6 days among men and women, respectively. Our results suggest that improvements in physical working conditions and reducing smoking, particularly among employees with a low level of education, may markedly reduce educational differences in sickness absence.

Sick leave certification: a unique perspective on frequency and duration of episodes - a complete record of sickness certification in a defined population of employees in Malta.

PubMed

Soler, Jean Karl

2003-03-27

In Malta, sickness certificates are needed from the first day of illness, and are issued by family physicians (FPs) either employed by the government primary health care system, self-employed in private practice, or employed by an employer for this purpose alone. The latter system, when applied by the employer, is compulsory. In order to contribute to the debate on the role of the FP in this context, electronic data collected by a group of company-employed FPs was used to study the phenomenon of sickness certification. This database is a complete record of the selected employees' sick leave certification during the study period. Data collected by company-employed FPs from a defined population was used: all employees of selected Maltese companies served by a group of FPs. The database included episode-based data from home visits over three years (01/01/1997 - 31/12/1999), by 9 company-appointed FPs regarding 421 employees of five companies. 3015 episodes of sickness absenteeism, with an average duration of 2.9 days, were documented. Employees who did intensive manual work had relatively higher rates. Furthermore, a relatively higher incidence of work injury, sprains and strains, anxiety and depression and low back pain as found in manual workers, and in male workers. This trend was shown to be statistically significant. The frequency of sick-leave certification in Malta is comparable to that in other European countries, but the average duration of certificates is much less than reported in other studies that generally did not include data on short-term illness and certification. This has important implications on future research in the field. A number of common disorders were found to be significantly more prevalent causes of sickness certification in manual workers, amongst them anxiety and depression.

Organizational characteristics as predictors of work disability: a prospective study among sick employees of for-profit and not-for-profit organizations.

PubMed

Schröer, C A P; Janssen, M; van Amelsvoort, L G P M; Bosma, H; Swaen, G M H; Nijhuis, F J N; van Eijk, J

2005-09-01

This article reports a prospective study that focused on the influence of organizational structure and organizational culture on the outcome of sickness absence, return to work or work disability. Former studies of determinants of work disability hardly have given attention to organizational characteristics and, if so, not following a appropriate prospective design. The study population consisted of 455 employees of 45 for-profit and not-for-profit companies participating in the Maastricht Cohort Study on fatigue at work who were on sick leave for at least 6 weeks. Both independent variables which were type of company, size, centralization of decision making and organizational culture, and covariates, which were sex, age, educational level, fatigue, and chronic illness, were all measured before employees reported sick. The dependent variable outcome of the sickness absence, mainly return to work or work disability, was measured 15 months after reporting sick. Multilevel logistic regression analysis, with organizational characteristics as level 2 independent variables and demographic and health characteristics as covariates, suggested that the type of company (for-profit/private or not-for-profit/public) is predictive of the outcome of sickness absence (crude OR = 2.21; CI: 1.16-4.20), but this may be partially due to a higher proportion of fatigued and chronically ill employees in not-for-profit companies (adjusted OR = 2.09; CI: 0.93-4.37). Findings about the role of some other organizational characteristics, like organizational culture, were inconclusive. Organizational characteristics should next to health characteristics be included in the models of studies which aim at predicting which sick employees are at risk for work disability. To prevent work disability not-for-profit companies might be stimulated to more active return-to-work policy by charging them with the costs of it.

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.

"Inclusive Working Life" in Norway--experience from "Models of Good Practice" enterprises.

PubMed

Lie, Arve

2008-08-01

To determine whether enterprises belonging to the Bank of Models of Good Practice were more successful than average Norwegian enterprises in the reduction of sickness absence, promotion of early return to work, and prevention of early retirement. In 2004 we selected 86 enterprises with a total of approximately 90000 employees from the Inclusive Working Life (IWL) Bank of Models of Good Practice. One representative of workers and one of management from each enterprise received a questionnaire on the aims, organization, and the results of the IWL program by mail. Data on sickness absence, use of early retirement, and disability retirement in the 2000-2004 period were collected from the National Insurance Registry. Data on comparable enterprises were obtained from the National Bureau of Statistics. The response rate was 65%. Although the IWL campaign was directed at reducing sickness absence, preventing early retirement, and promoting employment of the functionally impaired, most attention was paid to reducing sickness absence. Sickness absence rate in Models of Good Practice enterprises (8.2%) was higher than in comparable enterprises that were not part of the Models of Good Practice (6.9%). Implementation of many IWL activities, empowerment and involvement of employees, and good cooperation with the occupational health service were associated with a lower rate of sickness absence. On average, 0.7% new employees per year received disability pension, which is a significantly lower percentage than expected on the basis of the rate of 1.3% per year in comparable enterprises. Frequent use of disability pensioning was associated with high rate of sickness absence and having many employees older than 50 years. On average, 0.4% employees per year received early retirement compensation, which was expected on the basis of national estimates. Frequent use of early retirement was associated with having many employees older than 50 years. Models of Good Practice enterprises had a higher than expected sickness absence rate. This indicates that it is difficult to identify Models of Good Practice enterprises and that they cannot be treated as role model enterprises. Good cooperation with the occupational health service and the empowerment and involvement of the employees is associated with a low sickness absence rate.

Role of orientation reference selection in motion sickness

NASA Technical Reports Server (NTRS)

Peterka, Robert J.; Black, F. Owen

1988-01-01

Previous experiments with moving platform posturography have shown that different people have varying abilities to resolve conflicts among vestibular, visual, and proprioceptive sensory signals used to control upright posture. In particular, there is one class of subjects with a vestibular disorder known as benign paroxysmal positional vertigo (BPPV) who often are particularly sensitive to inaccurate visual information. That is, they will use visual sensory information for the control of their posture even when that visual information is inaccurate and is in conflict with accurate proprioceptive and vestibular sensory signals. BPPV has been associated with disorders of both posterior semicircular canal function and possibly otolith function. The present proposal hopes to take advantage of the similarities between the space motion sickness problem and the sensory orientation reference selection problems associated with the BPPV syndrome. These similarities include both etiology related to abnormal vertical canal-otolith function, and motion sickness initiating events provoked by pitch and roll head movements. The objectives of this proposal are to explore and quantify the orientation reference selection abilities of subjects and the relation of this selection to motion sickness in humans.

New pharmacologic approaches to the prevention of space/motion sickness

NASA Technical Reports Server (NTRS)

Kohl, Randall L.; Macdonald, Scott

1991-01-01

Three fundamental approaches used in the selection of new agents for the evaluation in the prevention of space-motion sickness (SMS) are reviewed, with emphasis on drugs under investigation at the Johnson Space Center. These approaches are: (1) the selection of agents from drug classes that possess pharmacologic properties of established antimotion sickness agents, (2) the selection of drugs that are used to prevent emesis caused by means other than the exposure to motion, and (3) basic research that characterizes individual differences in susceptibility to SMS. In the latter type of studies, it was found that subjects who were more resistant to SMS had higher plasma AVP after severe nausea than subjects with lower resistance. The review details the experimental data collected on AVP and adrenocorticotropin. It is noted that data support interrelated roles for AVP and opioid peptides in SMS.

Hormonal responses of metoclopramide-treated subjects experiencing nausea or emesis during parabolic flight

NASA Technical Reports Server (NTRS)

Kohl, Randall L.

1987-01-01

The concentrations of adrenocorticotropic hormone (ACTH), vasopressin (AVP), epinephrine (EPI), and norepinephrine (NE) in 22 subjects administered 10 to 20 mg of metoclopramide prior to parabolic flight are measured. The effect of metoclopramide on motion sickness is examined. It is observed that metoclopramide is ineffective in the modulation of motion sickness due to stressful linear and angular acceleration and orbital flight, and it does not affect serum hormones prior to parabolic flight. It is detected that the serum level of AVP declines following emesis induced by parabolic flight and stressful angular acceleration; the serum levels of ACTH and EPI are elevated by parabolic flight and stressful angular acceleration; and serum NE is significantly elevated immediately following emesis. The possible roles of these hormones in the etiology of space motion sickness are discussed.

THE EFFECT OF IONIZING RADIATION OF THE PROGENY IN IRRADIATION OF ANIMALS DURING THE LAST DAYS OF PREGNANCY (in Russian)

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

Zuikova, E.A.; Chaikovskaya, M.Ya.; Petrosian, S.L.

1959-09-01

The result of investigations demonstrated that a total single irradiation of dogs in a dose of 500 r during the last days of pregnancy leads to the development of acute radiation sickness in newborn puppies and causes their death soon after birth. Radiation sickness in newborn puppies as distinct from adult animals in a number of cases was associated with necrotic lesions of the urinary bladder, atelectasis of the lungs, and cerebral edema. Hemodynamic disturbances of the central nervous system play an important role in the appearance of atelectasis and of the cerebral edema. The course of radiation sickness inmore » dogs irradiated during the last days of pregnancy was comparatively mild. Reaction of peripheral blood to irradiation was short and of peculiar nature. (auth)« less

Retrospectively assessed psychosocial working conditions as predictors of prospectively assessed sickness absence and disability pension among older workers.

PubMed

Sundstrup, Emil; Hansen, Åse Marie; Mortensen, Erik Lykke; Poulsen, Otto Melchior; Clausen, Thomas; Rugulies, Reiner; Møller, Anne; Andersen, Lars L

2018-01-17

The aim was to explore the association between retrospectively assessed psychosocial working conditions during working life and prospectively assessed risk of sickness absence and disability pension among older workers. The prospective risk of register-based long-term sickness absence (LTSA) and disability pension was estimated from exposure to 12 different psychosocial work characteristics during working life among 5076 older workers from the CAMB cohort (Copenhagen Aging and Midlife Biobank). Analyses were censored for competing events and adjusted for age, gender, physical work environment, lifestyle, education, and prior LTSA. LTSA was predicted by high levels of cognitive demands (HR 1.31 (95% CI 1.10-1.56)), high levels of emotional demands (HR 1.26 (95% CI 1.07-1.48)), low levels of influence at work (HR 1.30 (95% CI 1.03-1.64)), and high levels of role conflicts (HR 1.34 (95% CI 1.09-1.65)). Disability pension was predicted by low levels of influence at work (HR 2.73 (95% CI 1.49-5.00)) and low levels of recognition from management (HR 2.04 (95% CI 1.14-3.67)). This exploratory study found that retrospectively assessed high cognitive demands, high and medium emotional demands, low influence at work, low recognition from management, medium role clarity, and high role conflicts predicted LTSA and/or disability pension.

Acetazolamide or dexamethasone use versus placebo to prevent acute mountain sickness on Mount Rainier.

PubMed

Ellsworth, A J; Meyer, E F; Larson, E B

1991-03-01

Eighteen climbers actively ascended Mount Rainier (elevation 4,392 m) twice during a randomized, double-blind, concurrent, placebo-controlled, crossover trial comparing the use of acetazolamide, 250 mg, dexamethasone, 4 mg, and placebo every 8 hours as prophylaxis for acute mountain sickness. Each subject was randomly assigned to receive placebo during one ascent and one of the active medications during the other ascent. Assessment of acute mountain sickness was performed using the Environmental Symptoms Questionnaire and a clinical interview. At the summit or high point attained above base camp, the use of dexamethasone significantly reduced the incidence of acute mountain sickness and the severity of symptoms. Cerebral and respiratory symptom severity scores for subjects receiving dexamethasone (0.26 +/- 0.16 and 0.20 +/- 0.19, respectively) were significantly lower than similar scores for both acetazolamide (0.80 +/- 0.80 and 1.20 +/- 1.05; P = 0.25) and placebo (1.11 +/- 1.02 and 1.45 +/- 1.27; P = .025). Neither the use of dexamethasone nor that of acetazolamide measurably affected other physical or mental aspects. Compared with placebo, dexamethasone appears to be effective for prophylaxis of symptoms associated with acute mountain sickness accompanying rapid ascent. The precise role of dexamethasone for the prophylaxis of acute mountain sickness is not known, but it can be considered for persons without contraindications who are intolerant of acetazolamide, for whom acetazolamide is ineffective, or who must make forced, rapid ascent to high altitude for a short period of time with a guaranteed retreat route.

Acetazolamide or dexamethasone use versus placebo to prevent acute mountain sickness on Mount Rainier.

PubMed Central

Ellsworth, A. J.; Meyer, E. F.; Larson, E. B.

1991-01-01

Eighteen climbers actively ascended Mount Rainier (elevation 4,392 m) twice during a randomized, double-blind, concurrent, placebo-controlled, crossover trial comparing the use of acetazolamide, 250 mg, dexamethasone, 4 mg, and placebo every 8 hours as prophylaxis for acute mountain sickness. Each subject was randomly assigned to receive placebo during one ascent and one of the active medications during the other ascent. Assessment of acute mountain sickness was performed using the Environmental Symptoms Questionnaire and a clinical interview. At the summit or high point attained above base camp, the use of dexamethasone significantly reduced the incidence of acute mountain sickness and the severity of symptoms. Cerebral and respiratory symptom severity scores for subjects receiving dexamethasone (0.26 +/- 0.16 and 0.20 +/- 0.19, respectively) were significantly lower than similar scores for both acetazolamide (0.80 +/- 0.80 and 1.20 +/- 1.05; P = 0.25) and placebo (1.11 +/- 1.02 and 1.45 +/- 1.27; P = .025). Neither the use of dexamethasone nor that of acetazolamide measurably affected other physical or mental aspects. Compared with placebo, dexamethasone appears to be effective for prophylaxis of symptoms associated with acute mountain sickness accompanying rapid ascent. The precise role of dexamethasone for the prophylaxis of acute mountain sickness is not known, but it can be considered for persons without contraindications who are intolerant of acetazolamide, for whom acetazolamide is ineffective, or who must make forced, rapid ascent to high altitude for a short period of time with a guaranteed retreat route. PMID:2028586

Vestibular system and neural correlates of motion sickness

NASA Technical Reports Server (NTRS)

Miller, Alan D.

1986-01-01

Initial studies re-examine the role of certain central nervous system structures in the production of vestibular-induced vomiting and vomiting in general. All experiments were conducted using cats. Since these studies demonstrated that the essential role of various central structures in vestibular-induced vomiting is only poorly understood, efforts were re-directed to study the control of the effector muscles (diaphragm and abdominal muscles) that produce the pressure changes responsible for vomiting, with the goal of determining how this control mechanism is engaged during motion sickness. Experiments were conducted to localize the motoneurons that innervate the individual abdominal muscles and the portion of the diaphragm that surrounds the esophagus. A central question regarding respiratory muscle control during vomiting is whether these muscles are activated via the same brain stem pre-motor neurons that provide descending respiratory drive and/or by other descending input(s). In other experiments, the use of a combination of pitch and roll motions to produce motion sickness in unrestrained cats was evaluated. This stimulus combination can produce vomiting in only the most susceptible cats and is thus not as provacative a stimulus for cats as vertical linear acceleration.

Susceptibility of the squirrel monkey to different motion conditions

NASA Technical Reports Server (NTRS)

Fox, Robert A.; Daunton, Nancy G.; Coleman, J.

1991-01-01

The exact stimulus eliciting vomiting in animal studies of motion sickness is difficult to specify because the vestibular stimulation produced by many motion conditions is confounded by voluntary movements with animals. This is an important problem because experiments with animal models of motion sickness can provide useful information about antimotion sickness drugs or the role of neural mechanisms, only when animals are exposed to the same motion stimuli in each experimental session. A series of tests were conducted to determine the susceptibility of 15 adult squirrel monkeys to motion sickness in freely moving and restrained test conditions. Canal stimulation was varied by exposing the monkey in freely moving conditions to varying degrees of angular velocity (60, 90, 120, 150 deg/sec), and in restrained conditions to one angular velocity (150 deg/sec) and to cross-coupling effects of whole-body roll movements during rotation. Otolith stimulation was investigated by using sinusoidal vertical linear acceleration during free movement conditions, and off-vertical rotation and earth-horizontal (BBQ) rotation while restrained. The percentage of freely moving animal vomiting during vertical axis rotation was 27, 93, 86, and 92 for the angular velocities of 60, 90, 120, and 150 deg/sec respectively. None of the monkeys vomited during vertical axis rotation or cross-coupled rotation when restrained. Otolith stimulation appears to be a less provocative stimulus for the squirrel monkey as the percentage of animals vomiting were 13, 0, and 7 for the conditions of free movement during oscillation, restraint during off-vertical, and BBQ rotation respectively. Motion sickness to the point of vomiting occurred regularly only in conditions where self-motion was possible. Such effects could occur because voluntary movement during motion augments vestibular effects by producing self-inflicted cross-coupling, but the failure to elicit vomiting with experimenter-coupling cross-coupling argues against this interpretation. Alternatively, these results might imply that feedback from movement control mechanisms may play an important role in sensory conflict as suggested by Oman's sensory-motor conflict theory.

Developments in neonatal care and nursing responses.

PubMed

Healy, Patricia; Fallon, Anne

This article reviews the origins and evolution of neonatology and considers the role of the neonatal nurse within this specialty. Neonatal nurses are a vital part of the neonatal team that provides care for sick babies. The nursing care required by sick babies and their families on a neonatal unit can be variable and complex. The past century has seen significant changes in the role of the neonatal nurse. This has come about through dramatic technological developments on neonatal units, an increased understanding of neonatal physiology and pathology, changes in the education of neonatal nurses, and active and ongoing clinical research within the specialty. The resulting significant advances in neonatal care, including that provided by neonatal nurses, have made a crucial and steadfast contribution to marked improvements in neonatal outcomes.

Nature-Based Stress Management Course for Individuals at Risk of Adverse Health Effects from Work-Related Stress—Effects on Stress Related Symptoms, Workability and Sick Leave

PubMed Central

Sahlin, Eva; Ahlborg, Gunnar; Vega Matuszczyk, Josefa; Grahn, Patrik

2014-01-01

Sick leave due to stress-related disorders is increasing in Sweden after a period of decrease. To avoid that individuals living under heavy stress develop more severe stress-related disorders, different stress management interventions are offered. Self-assessed health, burnout-scores and well-being are commonly used as outcome measures. Few studies have used sick-leave to compare effects of stress interventions. A new approach is to use nature and garden in a multimodal stress management context. This study aimed to explore effects on burnout, work ability, stress-related health symptoms, and sick leave for 33 women participating in a 12-weeks nature based stress management course and to investigate how the nature/garden activities were experienced. A mixed method approach was used. Measures were taken at course start and three follow-ups. Results showed decreased burnout-scores and long-term sick leaves, and increased work ability; furthermore less stress-related symptoms were reported. Tools and strategies to better handle stress were achieved and were widely at use at all follow-ups. The garden and nature content played an important role for stress relief and for tools and strategies to develop. The results from this study points to beneficial effects of using garden activities and natural environments in a stress management intervention. PMID:25003175

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.

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.

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

Contemporary Obstetric Triage.

PubMed

Sandy, Edward Allen; Kaminski, Robert; Simhan, Hygriv; Beigi, Richard

2016-03-01

The role of obstetric triage in the care of pregnant women has expanded significantly. Factors driving this change include the Emergency Medical Treatment and Active Labor Act, improved methods of testing for fetal well-being, increasing litigation risk, and changes in resident duty hour guidelines. The contemporary obstetric triage facility must have processes in place to provide a medical screening examination that complies with regulatory statues while considering both the facility's maternal level of care and available resources. This review examines the history of the development of obstetric triage, current considerations in a contemporary obstetric triage paradigm, and future areas for consideration. An example of a contemporary obstetric triage program at an academic medical center is presented. A successful contemporary obstetric triage paradigm is one that addresses the questions of "sick or not sick" and "labor or no labor," for every obstetric patient that presents for care. Failure to do so risks poor patient outcome, poor patient satisfaction, adverse litigation outcome, regulatory scrutiny, and exclusion from federal payment programs. Understanding the role of contemporary obstetric triage in the current health care environment is important for both providers and health care leadership. This study is for obstetricians and gynecologists as well as family physicians. After completing this activity, the learner should be better able to understand the scope of a medical screening examination within the context of contemporary obstetric triage; understand how a facility's level of maternal care influences clinical decision making in a contemporary obstetric triage setting; and understand the considerations necessary for the systematic evaluation of the 2 basic contemporary obstetric questions, "sick or not sick?" and "labor or no labor?"

Differences in Regional Brain Responses to Food Ingestion After Roux-en-Y Gastric Bypass and the Role of Gut Peptides: A Neuroimaging Study.

PubMed

Hunt, Katharine F; Dunn, Joel T; le Roux, Carel W; Reed, Laurence J; Marsden, Paul K; Patel, Ameet G; Amiel, Stephanie A

2016-10-01

Improved appetite control, possibly mediated by exaggerated gut peptide responses to eating, may contribute to weight loss after Roux-en-Y gastric bypass (RYGB). This study compared brain responses to food ingestion between post-RYGB (RYGB), normal weight (NW), and obese (Ob) unoperated subjects and explored the role of gut peptide responses in RYGB. Neuroimaging with [(18)F]-fluorodeoxyglucose (FDG) positron emission tomography was performed in 12 NW, 21 Ob, and 9 RYGB (18 ± 13 months postsurgery) subjects after an overnight fast, once FED (400 kcal mixed meal), and once FASTED, in random order. RYGB subjects repeated the studies with somatostatin infusion and basal insulin replacement. Fullness, sickness, and postscan ad libitum meal consumption were measured. Regional brain FDG uptake was compared using statistical parametric mapping. RYGB subjects had higher overall fullness and food-induced sickness and lower ad libitum consumption. Brain responses to eating differed in the hypothalamus and pituitary (exaggerated activation in RYGB), left medial orbital cortex (OC) (activation in RYGB, deactivation in NW), right dorsolateral frontal cortex (deactivation in RYGB and NW, absent in Ob), and regions mapping to the default mode network (exaggerated deactivation in RYGB). Somatostatin in RYGB reduced postprandial gut peptide responses, sickness, and medial OC activation. RYGB induces weight loss by augmenting normal brain responses to eating in energy balance regions, restoring lost inhibitory control, and altering hedonic responses. Altered postprandial gut peptide responses primarily mediate changes in food-induced sickness and OC responses, likely to associate with food avoidance. © 2016 by the American Diabetes Association.

Neurophysiological responses to stressful motion and anti-motion sickness drugs as mediated by the limbic system

NASA Technical Reports Server (NTRS)

Kohl, R. L.; Odell, S.

1982-01-01

Performance is characterized in terms of attention and memory, categorizing extrinsic mechanism mediated by ACTH, norepinephrine and dopamine, and intrinsic mechanisms as cholinergic. The cholinergic role in memory and performance was viewed from within the limbic system and related to volitional influences of frontal cortical afferents and behavioral responses of hypothalamic and reticular system efferents. The inhibitory influence of the hippocampus on the autonomic and hormonal responses mediated through the hypothalamus, pituitary, and brain stem are correlated with the actions of such anti-motion sickness drugs as scopolamine and amphetamine. These drugs appear to exert their effects on motion sickness symptomatology through diverse though synergistic neurochemical mechanisms involving the septohippocampal pathway and other limbic system structures. The particular impact of the limbic system on an animal's behavioral and hormonal responses to stress is influenced by ACTH, cortisol, scopolamine, and amphetamine.

Effectiveness of a Multilevel Workplace Health Promotion Program on Vitality, Health, and Work-Related Outcomes

PubMed Central

Hendriksen, Ingrid J.M.; Snoijer, Mirjam; de Kok, Brenda P.H.; van Vilsteren, Jeroen; Hofstetter, Hedwig

2016-01-01

Objective: Evaluation of the effectiveness of a workplace health promotion program on employees’ vitality, health, and work-related outcomes, and exploring the influence of organizational support and the supervisors’ role on these outcomes. Methods: The 5-month intervention included activities at management, team, and individual level targeting self-management to perform healthy behaviors: a kick-off session, vitality training sessions, workshops, individual coaching, and intervision. Outcome measures were collected using questionnaires, health checks, and sickness absence data at baseline, after the intervention and at 10 months follow-up. For analysis linear and generalized mixed models were used. Results: Vitality, work performance, sickness absence, and self-management significantly improved. Good organizational support and involved supervisors were significantly associated with lower sickness absence. Conclusions: Including all organizational levels and focusing on increasing self-management provided promising results for improving vitality, health, and work-related outcomes. PMID:27136605

Effectiveness of a Multilevel Workplace Health Promotion Program on Vitality, Health, and Work-Related Outcomes.

PubMed

Hendriksen, Ingrid J M; Snoijer, Mirjam; de Kok, Brenda P H; van Vilsteren, Jeroen; Hofstetter, Hedwig

2016-06-01

Evaluation of the effectiveness of a workplace health promotion program on employees' vitality, health, and work-related outcomes, and exploring the influence of organizational support and the supervisors' role on these outcomes. The 5-month intervention included activities at management, team, and individual level targeting self-management to perform healthy behaviors: a kick-off session, vitality training sessions, workshops, individual coaching, and intervision. Outcome measures were collected using questionnaires, health checks, and sickness absence data at baseline, after the intervention and at 10 months follow-up. For analysis linear and generalized mixed models were used. Vitality, work performance, sickness absence, and self-management significantly improved. Good organizational support and involved supervisors were significantly associated with lower sickness absence. Including all organizational levels and focusing on increasing self-management provided promising results for improving vitality, health, and work-related outcomes.

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 susceptibility will be measured by the time required to induce characteristic changes in the pattern of electrogastrogram recordings while exposed to various sensory environments during posture and motion perception tests. The results of this work are relevant to NASA's interest in understanding the etiology of space motion sickness. If any of the reflex, perceptual, or sensory selection abilities of subjects are found to correlate with motion sickness susceptibility, this work may be an important step in suggesting a method of predicting motion sickness susceptibility. If sensory selection can provide a means to avoid sensory conflict, then further work may lead to training programs which could enhance a subject's sensory selection ability and therefore minimize motion sickness susceptibility.

Transforming Growth Factor-β1 T869C Gene Polymorphism Is Associated with Acquired Sick Sinus Syndrome via Linking a Higher Serum Protein Level

PubMed Central

Chen, Jan-Yow; Liu, Jiung-Hsiun; Wu, Hong-Dar Isaac; Lin, Kuo-Hung; Chang, Kuan-Cheng; Liou, Ying-Ming

2016-01-01

Background Familial sick sinus syndrome is associated with gene mutations and dysfunction of ion channels. In contrast, degenerative fibrosis of the sinus node tissue plays an important role in the pathogenesis of acquired sick sinus syndrome. There is a close relationship between transforming growth factor-β1 mediated cardiac fibrosis and acquired arrhythmia. It is of interest to examine whether transforming growth factor-β1 is involved in the pathogenesis of acquired sick sinus syndrome. Methods Overall, 110 patients with acquired SSS and 137 age/gender-matched controls were screened for transforming growth factor-β1 and cardiac sodium channel gene polymorphisms using gene sequencing or restriction fragment length polymorphism methods. An enzyme-linked immunosorbent assay was used to determine the serum level of transforming growth factor-β1. Results Two transforming growth factor-β1 gene polymorphisms (C-509T and T+869C) and one cardiac sodium channel gene polymorphism (H588R) have been identified. The C-dominant CC/CT genotype frequency of T869C was significantly higher in acquired sick sinus syndrome patients than in controls (OR 2.09, 95% CI 1.16–3.75, P = 0.01). Consistently, the level of serum transforming growth factor-β1 was also significantly greater in acquired sick sinus syndrome group than in controls (5.3±3.4 ng/ml vs. 3.7±2.4 ng/ml, P = 0.01). In addition, the CC/CT genotypes showed a higher transforming growth factor-β1 serum level than the TT genotype (4.25 ± 2.50 ng/ml vs. 2.71± 1.76 ng/ml, P = 0.028) in controls. Conclusion Transforming growth factor-β1 T869C polymorphism, correlated with high serum transforming growth factor-β1 levels, is associated with susceptibility to acquired sick sinus syndrome. PMID:27380173

Understanding long-term sick leave in female white-collar workers with burnout and stress-related diagnoses: a qualitative study.

PubMed

Sandmark, Hélène; Renstig, Monica

2010-04-26

Sick leave rates in Sweden have been significant since the end of the 1990s. In this paper we focus on individual female white-collar workers and explore various factors and setting-based sources of ill health in working life and in private life, in order to understand impaired work ability, leading ultimately to long-term sick leave. A qualitative methodology was chosen, and thematic, open-ended interviews were carried out with 16 women. The interviewees were strategically selected from a cohort of 300 women in full-time white-collar jobs in high-level positions, living in three urban areas in Sweden, and on long-term sick leave > or =90 days. A qualitative content analysis was carried out. The informants in the study were generally well educated, but a few had surprisingly little formal education considering their salary level and position on the labour market. The women were in professional positions more commonly held by men, either as specialists with some degree of managerial role or as executives with managerial responsibilities. Both external and internal stressors were identified. The analysis indicated that being in these gender-typed jobs could have induced sex discrimination and role conflicts. The women expressed strong agreement regarding success in working life, but emphasised the lack of competence matching in their present jobs. They also lacked the sense of having a rewarding job, saw leadership as weak, and disliked their present workplace and colleagues. Impaired health may have hindered them from changing jobs; conversely, their locked-in positions could have resulted in deterioration in their health status. The women displayed personal overcommitment, both at work and in private life, and had difficulties in setting limits. Factors in working life, as well as in private life, played an important role in the informants' deteriorated health and long-term sick leave. Job and workplace mismatching, problems in connection with company profitability, and poor leadership contributed to stress-related symptoms, resulting in reduced working capacity. On the basis of these findings, attention should be paid to identification of early indicators of exhaustion, and measures should be taken in work settings and in working life as a whole to promote retained work ability.

Understanding long-term sick leave in female white-collar workers with burnout and stress-related diagnoses: a qualitative study

PubMed Central

2010-01-01

Background Sick leave rates in Sweden have been significant since the end of the 1990s. In this paper we focus on individual female white-collar workers and explore various factors and setting-based sources of ill health in working life and in private life, in order to understand impaired work ability, leading ultimately to long-term sick leave. Methods A qualitative methodology was chosen, and thematic, open-ended interviews were carried out with 16 women. The interviewees were strategically selected from a cohort of 300 women in full-time white-collar jobs in high-level positions, living in three urban areas in Sweden, and on long-term sick leave ≥90 days. A qualitative content analysis was carried out. Results The informants in the study were generally well educated, but a few had surprisingly little formal education considering their salary level and position on the labour market. The women were in professional positions more commonly held by men, either as specialists with some degree of managerial role or as executives with managerial responsibilities. Both external and internal stressors were identified. The analysis indicated that being in these gender-typed jobs could have induced sex discrimination and role conflicts. The women expressed strong agreement regarding success in working life, but emphasised the lack of competence matching in their present jobs. They also lacked the sense of having a rewarding job, saw leadership as weak, and disliked their present workplace and colleagues. Impaired health may have hindered them from changing jobs; conversely, their locked-in positions could have resulted in deterioration in their health status. The women displayed personal overcommitment, both at work and in private life, and had difficulties in setting limits. Conclusions Factors in working life, as well as in private life, played an important role in the informants' deteriorated health and long-term sick leave. Job and workplace mismatching, problems in connection with company profitability, and poor leadership contributed to stress-related symptoms, resulting in reduced working capacity. On the basis of these findings, attention should be paid to identification of early indicators of exhaustion, and measures should be taken in work settings and in working life as a whole to promote retained work ability. PMID:20420702

Beta-endorphin and arginine vasopressin following stressful sensory stimuli in man

NASA Technical Reports Server (NTRS)

Kohl, Randall L.

1992-01-01

This experimentation partially defines, for the first time, the response of beta-endorphin (ENDO) in man during tests designed to elicit nausea and motion sickness. These responses are similar to those associated with arginine vasopressin (AVP) and adreno-corticotropin (ACTH) to the extent that all hormones rise in response to motion sickness (p less than 0.003). Repeated exposure diminished motion-induced release of ENDO (p less than 0.005) and AVP (p less than 0.004) despite a three-fold increase in resistance to motion stimuli. Higher post-stress levels of AVP (p less than 0.04) and ACTH (p less than 0.02) were correlated with greater resistance to motion sickness. These data support the hypothesis that release of AVP is a significant link between stressful motion and motion-induced nausea and other autonomic system changes. Further, resistant individual apparently can tolerate higher peripheral levels of AVP before nausea results. Peripheral release of ENDO and ACTH may follow release of AVP; however, given the extensive and complex functional interactions that exist between AVP and the opiate systems, it is not yet possible to define a clear role for ENDO in the etiology of motion sickness.

An explorative, population-based study of female disability pensioners: the role of childhood conditions and alcohol abuse/dependence.

PubMed

Upmark, Marianne; Thundal, Kajsa-Lena

2002-01-01

This study investigates the association in women between conditions during childhood and adolescence and alcohol dependence or abuse in adulthood on the one hand, and disability pensions and long-term sickness absence on the other. A stratified population-based sample of women in Göteborg was interviewed. For analyses in this study the following variables were selected from the interview protocol: childhood and adolescence, education, employment, social class, self-rated physical health and alcohol dependence or abuse (ADA), with diagnoses assessed according to DSM-III-R. Information on disability pension and sickness absence was obtained from the local Social Insurance Office. Unfavourable conditions during childhood and adolescence and school difficulties as well as early deviant behaviours predicted disability pension and long-term sickness absence in adulthood. For most risk factors ADA could explain only a minor part of the odds ratios found in crude and age-adjusted analyses. It is concluded that conditions early in life are predictors in women of disability pension and long-term incapacity to work. There are similarities in the pattern of early risk factors for later alcohol dependence or abuse and for disability pension/long-term sickness absence.

Cytokine polymorphisms have a synergistic effect on severity of the acute sickness response to infection.

PubMed

Vollmer-Conna, Uté; Piraino, Barbara F; Cameron, Barbara; Davenport, Tracey; Hickie, Ian; Wakefield, Denis; Lloyd, Andrew R

2008-12-01

Functional polymorphisms in immune response genes are increasingly recognized as important contributors to the marked individual differences in susceptibility to and outcomes of infectious disease. The acute sickness response is a stereotypical set of illness manifestations mediated by the proinflammatory cytokines induced by many different pathogens. The genetic determinants of severity of the acute sickness response have not previously been explored. We examined the impact of functional polymorphisms in cytokine genes with critical roles in the early immune response (tumor necrosis factor-alpha, interleukin-6, interleukin-10, and interferon-gamma) on the severity and duration of illness following acute infection with Epstein-Barr virus, Coxiella burnetii (the causative agent of Q fever), or Ross River virus. We found that the interferon-gamma +874T/A and the interleukin-10 -592C/A polymorphisms significantly affected illness severity, cytokine protein levels, and the duration of illness. These cytokine genotypes acted in synergy to potentiate their influence on disease outcomes. These findings suggest that genetically determined variations in the intensity of the inflammatory response underpin the severity of the acute sickness response and predict the recovery time across varied infections.

The role of gender in long-term sickness absence and transition to permanent disability benefits. Results from a multiregister based, prospective study in Norway 1990-1995.

PubMed

Gjesdal, Sturla; Bratberg, Espen

2002-09-01

The aim of the study was to identify predictors for the transition from long-term sickness absence into disability pension with a special focus on gender. The study used data from a national database containing a 10% random sample of the Norwegian adult population (The KIRUT database). The study population were all individuals in the database who on 1 January 1990 were eligible for sick pay from the Norwegian National Insurance System: 83,398 men and 75,586 women. Individuals below 60 years with long-term sickness absence starting in 1990 and 1991 were identified, 6,434 men and 8,233 women, and followed up for three years. Background data were used as independent variables in a logistic regression of the probability for receiving disability pension during follow-up. Annual cumulative incidence of long-term sickness absence was 6.5% for women and 4.9% for men. During follow-up, 12.4% of the women and 12.6% of the men received disability pension. Among full-time employed women only 10.3% had become disability pensioners, while the corresponding proportion for women working part-time was 15.5%. For men the figures were 12.1% (full-time) and 18.1% (part-time). In the logistic regression of the whole sample the female odds ratio was insignificant. The dominant predictive factors for disability pension were age and duration of the sickness spells. Working part-time also increased the risk. Higher levels of education and having children below 7 years reduced the probability for disability pension. Separate regressions for men and women showed that the 'protective' effect of having small children only remained for women.

The social negotiation of fitness for work: tensions in doctor-patient relationships over medical certification of chronic pain.

PubMed

Wainwright, Elaine; Wainwright, David; Keogh, Edmund; Eccleston, Christopher

2015-01-01

The UK government is promoting the health benefits of work, in order to change doctors' and patients' behaviour and reduce sickness absence. The rationale is that many people 'off sick' would have better outcomes by staying at work; but reducing the costs of health care and benefits is also an imperative. Replacement of the 'sick note' with the 'fit note' and a national educational programme are intended to reduce sickness-certification rates, but how will these initiatives impact on doctor-patient relationships and the existing tension between the doctor as patient advocate and gate-keeper to services and benefits? This tension is particularly acute for problems like chronic pain where diagnosis, prognosis and work capacity can be unclear. We interviewed 13 doctors and 30 chronic pain patients about their experiences of negotiating medical certification for work absence and their views of the new policies. Our findings highlight the limitations of naïve rationalist approaches to judgements of work absence and fitness for work for people with chronic pain. Moral, socio-cultural and practical factors are invoked by doctors and patients to contest decisions, and although both groups support the fit note's focus on capacity, they doubt it will overcome tensions in the consultation. Doctors value tacit skills of persuasion and negotiation that can change how patients conceptualise their illness and respond to it. Policy-makers increasingly recognise the role of this tacit knowledge and we conclude that sick-listing can be improved by further developing these skills and acknowledging the structural context within which protagonists negotiate sick-listing. © The Author(s) 2014.

The Association Between Self-Assessed Future Work Ability and Long-Term Sickness Absence, Disability Pension and Unemployment in a General Working Population: A 7-Year Follow-Up Study.

PubMed

Lundin, A; Kjellberg, K; Leijon, O; Punnett, L; Hemmingsson, T

2016-06-01

Purpose Work ability is commonly measured with self-assessments, in the form of indices or single items. The validity of these assessments lies in their predictive ability. Prospective studies have reported associations between work ability and sickness absence and disability pension, but few examined why these associations exist. Several correlates of work ability have been reported, but their mechanistic role is largely unknown. This study aims to investigate to what extent individual's own prognosis of work ability predicts labor market participation and whether this was due to individual characteristics and/or working conditions. Methods Self-assessed prognosis of work ability, 2 years from "now," in the Stockholm Public Health Questionnaire (2002-2003) was linked to national registers on sickness absence, disability pension and unemployment up to year 2010. Effects were studied with Cox regression models. Results Of a total of 12,064 individuals 1466 reported poor work ability. There were 299 cases of disability pension, 1466 long-term sickness absence cases and 765 long-term unemployed during follow-up. Poor work ability increased the risk of long-term sickness absence (HR 2.25, CI 95 % 1.97-2.56), disability pension (HR 5.19, CI 95 % 4.07-6.62), and long-term unemployment (HR 2.18, CI 95 % 1.83-2.60). These associations were partially explained by baseline health conditions, physical and (less strongly) psychosocial aspects of working conditions. Conclusions Self-assessed poor ability predicted future long-term sickness absence, disability pension and long-term unemployment. Self-assessed poor work ability seems to be an indicator of future labor market exclusion of different kinds, and can be used in public health monitoring.

Anti-inflammatory Effect of Astaxanthin on the Sickness Behavior Induced by Diabetes Mellitus.

PubMed

Ying, Chang-jiang; Zhang, Fang; Zhou, Xiao-yan; Hu, Xiao-tong; Chen, Jing; Wen, Xiang-ru; Sun, Ying; Zheng, Kui-yang; Tang, Ren-xian; Song, Yuan-jian

2015-10-01

Chronic inflammation appears to play a critical role in sickness behavior caused by diabetes mellitus. Astaxanthin has been used in treating diabetes mellitus and diabetic complications because of its neuroprotective and anti-inflammatory actions. However, whether astaxanthin can improve sickness behavior induced by diabetes and its potential mechanisms are still unknown. The aim of this study was to investigate the effects of astaxanthin on diabetes-elicited abnormal behavior in mice and its corresponding mechanisms. An experimental diabetic model was induced by streptozotocin (150 mg/kg) and astaxanthin (25 mg/kg/day) was provided orally for 10 weeks. Body weight and water consumption were measured, and the sickness behavior was evaluated by the open field test (OFT) and closed field test (CFT). The expression of glial fibrillary acidic protein (GFAP) was measured, and the frontal cortical cleaved caspase-3 positive cells, interleukin-6 (IL-6), and interleukin-1β (IL-1β) expression levels were also investigated. Furthermore, cystathionine β-synthase (CBS) in the frontal cortex was detected to determine whether the protective effect of astaxanthin on sickness behavior in diabetic mice is closely related to CBS. As expected, we observed that astaxanthin improved general symptoms and significantly increase horizontal distance and the number of crossings in the OFT and CFT. Furthermore, data showed that astaxanthin could decrease GFAP-positive cells in the brain and down-regulate the cleaved caspase-3, IL-6, and IL-1β, and up-regulate CBS in the frontal cortex. These results suggest that astaxanthin provides neuroprotection against diabetes-induced sickness behavior through inhibiting inflammation, and the protective effects may involve CBS expression in the brain.

Work problems due to low back pain: what do GPs do? A questionnaire survey.

PubMed

Coole, Carol; Watson, Paul J; Drummond, Avril

2010-02-01

Low back pain can affect work ability and remains a main cause of sickness absence. In the UK the GP is usually the first contact for patients seeking health care. The UK government intends that the GP will continue to be responsible for sickness certification and work advice. This role requires a considerable level of understanding of work rehabilitation, and effective communication between GPs, patients, employers and therapists. The aim of this study was to identify GPs' current practice in managing patients whose ability to work is affected by low back pain, and their perception of the support services required. A postal questionnaire of 441 GPs in the South Nottinghamshire area of the UK was carried out. Areas covered included referral patterns, sickness certification, and communication with therapists and employers. There was a 54.6% response rate. The majority of GPs (76.8%) reported that they did not take overall responsibility for managing the work problems of patients arising from low back pain. Few 'mainly agreed' that they initiated communication with employers (2.5%) and/or therapists (10.4%) regarding their patients' work. The results of this study demonstrate that most GPs do not readily engage in vocational rehabilitation and do not initiate contact with employers or other health care practitioners regarding patients' work problems. Thus the current government expectation that GPs are able to successfully manage this role may be unrealistic; considerable training and a change in the GPs' perception of their role will be required.

The role of stress in absenteeism: cortisol responsiveness among patients on long-term sick leave.

PubMed

Jacobsen, Henrik B; Bjørngaard, Johan Håkon; Hara, Karen W; Borchgrevink, Petter C; Woodhouse, Astrid; Landrø, Nils Inge; Harris, Anette; Stiles, Tore C

2014-01-01

This study aimed to (1) See whether increased or decreased variation relate to subjective reports of common somatic and psychological symptoms for a population on long-term sick leave; and (2) See if this pattern in variation is correlated with autonomic activation and psychological appraisal. Our participants (n = 87) were referred to a 3.5-week return-to-work rehabilitation program, and had been on paid sick leave >8 weeks due to musculoskeletal pain, fatigue and/or common mental disorders. An extensive survey was completed, addressing socio-demographics, somatic and psychological complaints. In addition, a physician and a psychologist examined the participants, determining baseline heart rate, medication use and SCID-I diagnoses. During the 3.5-week program, the participants completed the Trier Social Stress Test for Groups. Participants wore heart rate monitors and filled out Visual Analogue Scales during the TSST-G. Our participants presented a low cortisol variation, with mixed model analyses showing a maximal increase in free saliva cortisol of 26% (95% CI, 0.21-0.32). Simultaneously, the increase in heart rate and Visual Analogue Scales was substantial, indicating autonomic and psychological activation consistent with intense stress from the Trier Social Stress Test for Groups. The current findings are the first description of a blunted cortisol response in a heterogeneous group of patients on long-term sick leave. The results suggest lack of cortisol reactivity as a possible biological link involved in the pathway between stress, sustained activation and long-term sick leave.

Vection is the main contributor to motion sickness induced by visual yaw rotation: Implications for conflict and eye movement theories

PubMed Central

Pretto, Paolo; Oberfeld, Daniel; Hecht, Heiko; Bülthoff, Heinrich H.

2017-01-01

This study investigated the role of vection (i.e., a visually induced sense of self-motion), optokinetic nystagmus (OKN), and inadvertent head movements in visually induced motion sickness (VIMS), evoked by yaw rotation of the visual surround. These three elements have all been proposed as contributing factors in VIMS, as they can be linked to different motion sickness theories. However, a full understanding of the role of each factor is still lacking because independent manipulation has proven difficult in the past. We adopted an integrative approach to the problem by obtaining measures of potentially relevant parameters in four experimental conditions and subsequently combining them in a linear mixed regression model. To that end, participants were exposed to visual yaw rotation in four separate sessions. Using a full factorial design, the OKN was manipulated by a fixation target (present/absent), and vection strength by introducing a conflict in the motion direction of the central and peripheral field of view (present/absent). In all conditions, head movements were minimized as much as possible. Measured parameters included vection strength, vection variability, OKN slow phase velocity, OKN frequency, the number of inadvertent head movements, and inadvertent head tilt. Results show that VIMS increases with vection strength, but that this relation varies among participants (R2 = 0.48). Regression parameters for vection variability, head and eye movement parameters were not significant. These results may seem to be in line with the Sensory Conflict theory on motion sickness, but we argue that a more detailed definition of the exact nature of the conflict is required to fully appreciate the relationship between vection and VIMS. PMID:28380077

The effect of part-time sick leave for employees with mental disorders.

PubMed

Høgelund, Jan; Holm, Anders; Eplov, Lene Falgaard

2012-12-01

Part-time sick leave (PTSL) allows employees on full-time sick leave (FTSL) to resume work at reduced hours. When the partly absent employee's health improves, working hours are increased until the employee is able to work regular hours. Studies have found that PTSL is an effective instrument for reducing sick leave durations for employees with musculoskeletal disorders and for employees on sick leave in general. This is the first published article to document how PTSL affects sick leave durations for employees with mental disorders. The aim is to estimate the effect of PTSL on the duration until returning to regular working hours for employees with mental disorders. We compare this effect to that of PTSL for employees with non-mental disorders ('other disorders'). We use combined survey and register data about 226 employees on long-term sick leave with mental disorders and 638 employees with other disorders. These data contain information about type of disorder, PTSL and FTSL (full-time sick leave) durations, and various background characteristics. We use a mixed proportional hazard regression model that allows us to control for unobserved differences between employees on PTSL and those on FTSL. Our analyses show that PTSL has no effect on the duration until returning to regular working hours for employees with mental disorders. Furthermore, looking at specific disorders such as depression and stress-related conditions, we find no significant effects of PTSL. In contrast, in line with previous research, we find that PTSL significantly reduces the duration until returning to regular working hours for employees with other disorders. The analyses also illustrate the importance of controlling for unobserved differences between employees on PTSL and those on FTSL. Without this control, PTSL significantly reduces the duration until returning to regular working hours. When we control for unobserved characteristics, this effect decreases, and for employees with mental disorders the effect vanishes entirely. The lack of an effect of PTSL for employees with mental disorders needs replication in other studies. If subsequent studies confirm our findings, one should not necessarily conclude that PTSL is an ineffective intervention: PTSL may play a role in combination with other workplace interventions and in combination with person-centred interventions. The study is limited by self-reported data about disorders and a relatively small number of employees with mental disorders. Our findings suggest that while PTSL reduces sick leave durations for employees with other disorders, it does not affect sick leave durations for employees with mental disorders. These results may indicate that PTSL by itself is insufficient for promoting the return to work of employees with mental disorders. Future studies could benefit from larger data sets with disorder information based on medical assessments. In addition to quantitative effect studies, future studies could focus on qualitative workplace mechanisms that may counteract the potential positive effects of PTSL for employees on sick leave with mental disorders.

Early coordinated multidisciplinary intervention to prevent sickness absence and labour market exclusion in patients with low back pain: study protocol of a randomized controlled trial.

PubMed

Fisker, Annette; Langberg, Henning; Petersen, Tom; Mortensen, Ole Steen

2013-03-13

Musculoskeletal disorders account for one third of the long-term absenteeism in Denmark and the number of individuals sick listed for more than four weeks is increasing. Compared to other diagnoses, patients with musculoskeletal diseases, including low back pain, are less likely to return to work after a period of sick leave. It seems that a multidisciplinary intervention, including cooperation between the health sector, the social sector and in the work place, has a positive effect on days off work due to musculoskeletal disorders and particularly low back pain. It is a challenge to coordinate this type of intervention, and the implementation of a return-to-work (RTW)-coordinator is suggested as an effective strategy in this process. The purpose of this paper is to describe the study protocol and present a new type of intervention, where the physiotherapist both has the role as RTW-coordinator and treating the patient. A randomized controlled trial (RCT) is currently on-going. The RCT includes 770 patients with low back pain of minimum four weeks who are referred to an outpatient back centre. The study population consists of patients, who are sick-listed or at risk of sick-leave due to LBP. The control group is treated with usual care in a team of a physiotherapist, a chiropractor, a rheumatologist and a social worker employed at the centre. The Intervention group is treated with usual care and in addition intervention of a psychologist, an occupational physician, an ergonomist, a case manager from the municipal sickness benefit office, who has the authority in the actual case concerning sickness benefit payment and contact to the patients employer/work place. The treating physiotherapist is the RTW-coordinator. Outcome will be reported at the end of treatment as well as 6 and 12 months follow up. The primary outcome is number of days off work. Secondary outcomes are disability, pain, and quality of life. The study will follow the recommendations in CONSORT-statement in designing and reporting RCTs. This large RCT is testing the effectiveness of a preventive intervention targeting patients on short term sick leave or at risk being sick listed because of low back pain. We have developed a novel multidisciplinary team structure using the treating physiotherapist as the return to work coordinator, and having the case manager from the municipal sickness benefit office participating in team meetings. The study has the potential to contribute to the knowledge about how to target the challenges in the treatment of LBP. The aim is to prevent sickness absence and labour market exclusion--both on the individual level and economic costs at community level. Short term results will be available in 2014.This study is approved by the Danish Regional Ethics Committee (J.nr: H-C-2008-112) and is registered at ClinicalTrials.gov: NCT01690234.

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 least 15 days among eldercare employees. Pregnancy-related sick leave should be excluded in studies planning to use DREAM data on sickness benefit. Self-reported sick leave became more imprecise when number of absence days increased, but the sensitivity and specificity were acceptable for lengths not exceeding one week. PMID:22894644

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-related sick leave should be excluded in studies planning to use DREAM data on sickness benefit. Self-reported sick leave became more imprecise when number of absence days increased, but the sensitivity and specificity were acceptable for lengths not exceeding one week.

Concepts, Diagnosis and the History of Medicine: Historicising Ian Hacking and Munchausen Syndrome.

PubMed

Millard, Chris

2017-08-01

Concepts used by historians are as historical as the diagnoses or categories that are studied. The example of Munchausen syndrome (deceptive presentation of illness in order to adopt the 'sick role') is used to explore this. Like most psychiatric diagnoses, Munchausen syndrome is not thought applicable across time by social historians of medicine. It is historically specific, drawing upon twentieth-century anthropology and sociology to explain motivation through desire for the 'sick role'. Ian Hacking's concepts of 'making up people' and 'looping effects' are regularly utilised outside of the context in which they are formed. However, this context is precisely the same anthropological and sociological insight used to explain Munchausen syndrome. It remains correct to resist the projection of Munchausen syndrome into the past. However, it seems inconsistent to use Hacking's concepts to describe identity formation before the twentieth century as they are given meaning by an identical context.

A case of factitious pedophilia.

PubMed

Porter, Theresa M; Feldman, Marc D

2011-09-01

Factitious disorder involves feigning, exaggerating, or self-inducing physical and/or psychological ailments with the goal of assuming the "sick" or "patient" role. In turn, the sick role entitles the factitious disorder patient to care, nurturance, and protection; it also exempts one from usual responsibilities. In this paper, we present the first reported case of factitious pedophilia. Although it seems counterintuitive, this middle-aged man has falsely claimed or exaggerated sexual desire for minors ostensibly to remain in a state hospital; indeed, he has remained in the same inpatient facility for more than 20 years as a result of his deceptions. At times, his reports have included disconfirmed claims of bizarre accidents and other physical travails. This case enlarges the literature on factitious psychological disorders and shows that some individuals may falsify paraphilic behaviors, although clearly minimization of these behaviors remains more common. © 2011 American Academy of Forensic Sciences.

Relationship of area postrema to three putative measures of motion sickness

NASA Technical Reports Server (NTRS)

Sutton, R.; Fox, Robert A.; Daunton, Nancy G.

1991-01-01

Although the rat has an incomplete emetic reflex, several species-specific responses to motion were proposed as measures of 'motion sickness' in rats. The purpose was to determine the dependence of these responses on one of several neural structures known to be essential to motion-induced vomiting in species with a complete emetic reflex. The Area Postrema (AP) was shown to play an important role in the production of motion sickness in vomiting species. The effects of thermo-cautery ablations of the AP on three different responses supposedly reflecting motion sickness in the rat were compared: conditioned taste aversion (CTA); drinking suppression; and fecal boli. Efficacy of the ablations was determined by subjecting ablated, sham-operated, and unoperated control animals to a CTA test which is known to require a functional AP. Animals with AP ablations failed to form CTA when 0.15 M LiCl was paired with a 10 percent sucrose solution, while sham-operated control subjects conditioned as well as the unoperated control subjects. The extent of the ablations was evaluated histologically at the end of the experiment. To determine the effects of the ablations on the measures of motion sickness, all animals were subjected to rotation for 30 min or 90 min on a platform displaced 20 deg from earth horizontal. Results indicate that ablation of AP in the rat has no effect on the formation of CTA to a 4 percent solution of cider paired with motion, on the suppression of drinking immediately after exposure to motion, or on the frequency of fecal boli during exposure to motion. This failure of AP ablations to eliminate the effects of motion on any of these responses discourages their use as equivalents of motion-induced vomiting. The appropriateness of other suggested measures, e.g., pica, remains untested but the dependence of such measures on stimulation more severe than commonly used in motion sickness research and the absence of a demonstration of their dependence on neural structures essential to motion sickness in vomiting species, suggest caution in the use of such responses. Further, until more is known about the neural structures underlying these putative measures, the rat will remain a questionable subject in which to study motion sickness.

Neural Connectivity and Immunocytochemical Studies of Anatomical Sites Related to Nauseogenic and Emetic Reflexes

NASA Technical Reports Server (NTRS)

Fox, Robert A. (Principal Investigator)

1992-01-01

The studies conducted in this research project examined several aspects of neuroanatomical structures and neurochemical processes related to motion sickness in animal models. A principle objective of these studies was to investigate neurochemical changes in the central nervous system that are related to motion sickness with the objective of defining neural mechanisms important to this malady. For purposes of exposition, the studies and research finding have been classified into five categories. These are: immunoreactivity in the brainstem, vasopressin effects, lesion studies of area postrema, role of the vagus nerve, and central nervous system structure related to adaptation to microgravity.

Disease dynamics in a stochastic network game: a little empathy goes a long way in averting outbreaks

PubMed Central

Eksin, Ceyhun; Shamma, Jeff S.; Weitz, Joshua S.

2017-01-01

Individuals change their behavior during an epidemic in response to whether they and/or those they interact with are healthy or sick. Healthy individuals may utilize protective measures to avoid contracting a disease. Sick individuals may utilize preemptive measures to avoid spreading a disease. Yet, in practice both protective and preemptive changes in behavior come with costs. This paper proposes a stochastic network disease game model that captures the self-interests of individuals during the spread of a susceptible-infected-susceptible disease. In this model, individuals strategically modify their behavior based on current disease conditions. These reactions influence disease spread. We show that there is a critical level of concern, i.e., empathy, by the sick individuals above which disease is eradicated rapidly. Furthermore, we find that risk averse behavior by the healthy individuals cannot eradicate the disease without the preemptive measures of the sick individuals. Empathy is more effective than risk-aversion because when infectious individuals change behavior, they reduce all of their potential infections, whereas when healthy individuals change behavior, they reduce only a small portion of potential infections. This imbalance in the role played by the response of the infected versus the susceptible individuals on disease eradication affords critical policy insights. PMID:28290504

The critical role of velocity storage in production of motion sickness

NASA Technical Reports Server (NTRS)

Cohen, Bernard; Dai, Mingjia; Raphan, Theodore; Young, L. R. (Principal Investigator)

2003-01-01

We propose that motion sickness is mediated through the orientation properties of velocity storage in the vestibular system that tend to align eye velocity produced by the angular vestibulo-ocular reflex (aVOR) with gravito-inertial acceleration (GIA). (GIA is the sum of the linear accelerations acting on the head. In the absence of translational accelerations, gravity is the GIA.) We further postulate that motion sickness produced by cross-coupled vestibular stimulation can be characterized by a metric composed of the disparity between the axis of eye rotation and the GIA, the strength of the response to angular motion, and the response duration, as determined by the central vestibular time constant, that is, by the time constant of velocity storage. The nodulus and uvula of the vestibulocerebellum are likely to be the central sites where the disparity is sensed, where the vestibular time constants are habituated, and where links are made to the autonomic system to produce the symptoms and signs.

Do patients with psychogenic nonepileptic seizures have positive covert attitudes toward sickness?

PubMed

Testa, S Marc; Brandt, Jason

2010-11-01

Some individuals with psychogenic nonepileptic seizures (PNES) are seen as having adopted a "sick role" that relinquishes them of responsibility for meeting stressful life demands. Thus, patients with PNES may have positive, albeit unrecognized, attitudes toward seizures, or perhaps illness in general. Because such covert attitudes may not be amendable to self-report, the current study used the Implicit Association Test (IAT), a methodology by which attitudes toward illness and disability can be inferred from performance on an ostensibly neutral task. Individuals with PNES did not have a reduced interference effect when responding to sickness-related and pleasant words on the same response key. Exploratory analyses revealed that a pronounced somatic focus and higher extraversion were associated with more neutral attitudes toward illness among patients with PNES. This IAT methodology found little support for the notion that patients with PNES harbor positive attitudes toward illness. Limitations of the IAT methodology are reviewed and recommendations are provided. Published by Elsevier Inc.

Associations between partial sickness benefit and disability pensions: initial findings of a Finnish nationwide register study.

PubMed

Kausto, Johanna; Virta, Lauri; Luukkonen, Ritva; Viikari-Juntura, Eira

2010-06-23

Timely return to work after longterm sickness absence and the increased use of flexible work arrangements together with partial health-related benefits are tools intended to increase participation in work life. Although partial sickness benefit and partial disability pension are used in many countries, prospective studies on their use are largely lacking. Partial sickness benefit was introduced in Finland in 2007. This register study aimed to investigate the use of health-related benefits by subjects with prolonged sickness absence, initially on either partial or full sick leave. Representative population data (13 375 men and 16 052 women either on partial or full sick leave in 2007) were drawn from national registers and followed over an average of 18 months. The registers provided information on the study outcomes: diagnoses and days of payment for compensated sick leaves, and the occurrence of disability pension. Survival analysis and multinomial regression were carried out using sociodemographic variables and prior sickness absence as covariates. Approximately 60% of subjects on partial sick leave and 30% of those on full sick leave had at least one recurrent sick leave over the follow up. A larger proportion of those on partial sick leave (16%) compared to those on full sick leave (1%) had their first recurrent sick leave during the first month of follow up. The adjusted risks of the first recurrent sick leave were 1.8 and 1.7 for men and women, respectively, when subjects on partial sick leave were compared with those on full sick leave. There was no increased risk when those with their first recurrent sick leave in the first month were excluded from the analyses. The risks of a full disability pension were smaller and risks of a partial disability pension approximately two-fold among men and women initially on partial sick leave, compared to subjects on full sick leave. This is the first follow up study of the newly adopted partial sickness benefit in Finland. The results show that compared to full sick leave, partial sick leave - when not followed by lasting return to work - is more typically followed by partial disability pension and less frequently by full disability pension. It is anticipated that the use of partial benefits in connection with part-time participation in work life will have favourable effects on future disability pension rates in Finland.

General practitioners and sickness certification for injury in Australia.

PubMed

Mazza, Danielle; Brijnath, Bianca; Singh, Nabita; Kosny, Agnieszka; Ruseckaite, Rasa; Collie, Alex

2015-08-15

Strong evidence supports an early return to work after injury as a way to improve recovery. In Australia, General Practitioners (GPs) see about 96 % of injured workers, making them the main gatekeepers to workers' entitlements. Most people with compensable injuries in Australia are certified as "unfit to work" by their GP, with a minority of patients certified for modified work duties. The reasons for this apparent dissonance between evidence and practice remain unexplored. Little is known about the factors that influence GP sickness certification behaviour in Australia. The aim of this study is to describe the factors influencing Australian GPs certification practice through qualitative interviews with four key stakeholders. From September to December 2012, 93 semi-structured interviews were undertaken in Melbourne, Australia. Participants included GPs, injured workers, employers and compensation agents. Data were thematically analysed. Five themes describing factors influencing GP certification were identified: 1. Divergent stakeholder views about the GP's role in facilitating return to work; 2. Communication between the four stakeholder groups; 3. Conflict between the stakeholder groups; 4. Allegations of GPs and injured workers misusing the compensation system and 5. The layout and content of the sickness certificate itself. By exploring GP certification practice from the perspectives of four key stakeholders, this study suggests that certification is an administrative and clinical task underpinned by a host of social and systemic factors. The findings highlight opportunities such as practice guideline development and improvements to the sickness certificate itself that may be targeted to improve GP sickness certification behaviour and return to work outcomes in an Australian context.

Biopsychosocial function analyses changes the assessment of the ability to work in patients on long-term sick-leave due to chronic musculoskeletal pain: the role of undiagnosed mental health comorbidity.

PubMed

Olaya-Contreras, Patricia; Styf, Jorma

2013-05-01

To study the prevalence of somatic and mental health comorbidity and the use of opioid medication among patients on long-term sick-leave due to chronic musculoskeletal pain (CMP); to compare an orthopaedic-based assessment of ability to work with a team assessment; to investigate the relationship between intensity of pain and psychosocial characteristics in this group. A cross-sectional study was carried out with 174 consecutive patients on sick-leave for a mean of 21 months. All were referred from the Social Insurance Office for orthopaedic evaluation and assessment of the ability to work. Of them, only 83/174 patients were referred by the Office for psychiatric evaluation. Neck pain was the main cause of disability. Patients with neck pain often suffered pain in more than two sites, and greater intensity of pain. Thirty-four percent of all participants had been prescribed opioid medication before consultation. Degrees of disability, unemployment, low degree of education and to be an immigrant were related to intensity of pain. Unrecognized psychiatric disorders changed the main cause of inability to work in 69% of patients who underwent both orthopaedic and psychiatric evaluation. An evaluation based on biopsychosocial function is valuable in reaching an accurate assessment of the patient's diagnosis, and ability to work in CMP. Ability to work and degree of sick-leave in patients on long-term sick-leave is determined to a large extent by undiagnosed mental health comorbidities, and not solely somatic complaints.

Virtual Patients for Virtual Sick Call Medical Training

DTIC Science & Technology

2010-11-01

2007). A controlled clinical comparison of attention performance in children with ADHD in a virtual reality classroom compared to standard...traditional approaches rely upon a combination of classroom learning and role-playing lnterservice/Jndusrry Training, Simularion, and Education

POSSIBLE ROLE OF FUNGAL HEMOLYSINS IN SICK BUILDING SYNDROME

EPA Science Inventory

Many fungi produce proteinaceous hemolytic agents. Like bacterial hemolysins, fungal hemolysins create pores or holes in membranes. Depending on which membranes are damaged, fungal hemolysins can produce a variety of effects. Fungal hemolysins can cause histamine release from ...

Associations between partial sickness benefit and disability pensions: initial findings of a Finnish nationwide register study

PubMed Central

2010-01-01

Background Timely return to work after longterm sickness absence and the increased use of flexible work arrangements together with partial health-related benefits are tools intended to increase participation in work life. Although partial sickness benefit and partial disability pension are used in many countries, prospective studies on their use are largely lacking. Partial sickness benefit was introduced in Finland in 2007. This register study aimed to investigate the use of health-related benefits by subjects with prolonged sickness absence, initially on either partial or full sick leave. Methods Representative population data (13 375 men and 16 052 women either on partial or full sick leave in 2007) were drawn from national registers and followed over an average of 18 months. The registers provided information on the study outcomes: diagnoses and days of payment for compensated sick leaves, and the occurrence of disability pension. Survival analysis and multinomial regression were carried out using sociodemographic variables and prior sickness absence as covariates. Results Approximately 60% of subjects on partial sick leave and 30% of those on full sick leave had at least one recurrent sick leave over the follow up. A larger proportion of those on partial sick leave (16%) compared to those on full sick leave (1%) had their first recurrent sick leave during the first month of follow up. The adjusted risks of the first recurrent sick leave were 1.8 and 1.7 for men and women, respectively, when subjects on partial sick leave were compared with those on full sick leave. There was no increased risk when those with their first recurrent sick leave in the first month were excluded from the analyses. The risks of a full disability pension were smaller and risks of a partial disability pension approximately two-fold among men and women initially on partial sick leave, compared to subjects on full sick leave. Conclusions This is the first follow up study of the newly adopted partial sickness benefit in Finland. The results show that compared to full sick leave, partial sick leave - when not followed by lasting return to work - is more typically followed by partial disability pension and less frequently by full disability pension. It is anticipated that the use of partial benefits in connection with part-time participation in work life will have favourable effects on future disability pension rates in Finland. PMID:20573207

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.

The contribution of gender-role orientation, work factors and home stressors to psychological well-being and sickness absence in male- and female-dominated occupational groups.

PubMed

Evans, Olga; Steptoe, Andrew

2002-02-01

The associations of work stress, types of work and gender-role orientation with psychological well-being and sickness absence were investigated in a questionnaire survey of 588 male and female nurses and 387 male and female accountants. We hypothesised that health might be impaired among women working in the male-dominated occupation (accountancy), and men in the female-dominated occupation (nursing), but that effects might be moderated by job strain (perceptions of high demand and low control), work and home hassles, and traditional male (instrumentality) and female (expressivity) psychological characteristics. Responses were analysed from 172 female and 61 male nurses, and from 53 female and 81 male commercial accountants. Female accountants were more likely than other groups to have high anxiety scores on the Hospital Anxiety and Depression Scales, while male nurses had the highest rates of sickness absence. Male nurses and female accountants also reported more work-related hassles than did female nurses and male accountants. Men and women in the same occupation did not differ in job strain or job social support, but nurses reported greater job strain than accountants, due to higher ratings of demands and lower skill utilisation. After adjusting for age, sex, occupation, paid work hours and a measure of social desirability bias, risk of elevated anxiety was independently associated with higher job strain, lower job social support, more work hassles, more domestic responsibility, lower instrumentality and higher expressivity. The association between sex and anxiety was no longer significant after instrumentality had been entered into the regression model. Sickness absence of more than three days over the past 12 months was independently associated with higher job strain, more work hassles, lower instrumentality and higher expressivity. The results suggest that when men and women occupy jobs in which they are in the cultural and numerical minority, there may be adverse health effects that are gender-specific. Psychological traits related to socially constructed gender roles may also be relevant, and mediate in part the differences in psychological well-being between men and women.

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 ...

Blended E-health module on return to work embedded in collaborative occupational health care for common mental disorders: design of a cluster randomized controlled trial.

PubMed

Volker, Daniëlle; Vlasveld, Moniek C; Anema, Johannes R; Beekman, Aartjan Tf; Roijen, Leona Hakkaart-van; Brouwers, Evelien Pm; van Lomwel, A Gijsbert C; van der Feltz-Cornelis, Christina M

2013-01-01

Common mental disorders (CMD) have a major impact on both society and individual workers, so return to work (RTW) is an important issue. In The Netherlands, the occupational physician plays a central role in the guidance of sick-listed workers with respect to RTW. Evidence-based guidelines are available, but seem not to be effective in improving RTW in people with CMD. An intervention supporting the occupational physician in guidance of sick-listed workers combined with specific guidance regarding RTW is needed. A blended E-health module embedded in collaborative occupational health care is now available, and comprises a decision aid supporting the occupational physician and an E-health module, Return@Work, to support sick-listed workers in the RTW process. The cost-effectiveness of this intervention will be evaluated in this study and compared with that of care as usual. This study is a two-armed cluster randomized controlled trial, with randomization done at the level of occupational physicians. Two hundred workers with CMD on sickness absence for 4-26 weeks will be included in the study. Workers whose occupational physician is allocated to the intervention group will receive the collaborative occupational health care intervention. Occupational physicians allocated to the care as usual group will give conventional sickness guidance. Follow-up assessments will be done at 3, 6, 9, and 12 months after baseline. The primary outcome is duration until RTW. The secondary outcome is severity of symptoms of CMD. An economic evaluation will be performed as part of this trial. It is hypothesized that collaborative occupational health care intervention will be more (cost)-effective than care as usual. This intervention is innovative in its combination of a decision aid by email sent to the occupational physician and an E-health module aimed at RTW for the sick-listed worker.

Feasibility trial of GP and case-managed support for workplace sickness absence.

PubMed

Rannard, Anne; Gabbay, Mark; Sen, Dil; Riley, Richard; Britt, David

2014-07-01

Aim Our aim was to compare the return-to-work rates between individuals supported by their GP plus workplace health advisers (intervention group) and those supported by their GP alone. Workplace sickness absence places a significant cost burden on individuals and the wider economy. Previous research shows better outcomes for individuals if they are supported while still in employment, or have been on sick leave for four weeks or less. Those helped back to work at an early stage are more likely to remain at work. A non-medicalised case-managed approach appears to have the best outcomes and can prevent or reduce the slide onto out-of-work benefits, but UK literature on its effectiveness is sparse. The design was a feasibility-controlled trial in which participants were sickness absentees, or presentees in employment with work-related health problems. Individuals completed health status measures (SF-36; EQ-5D) and a Job Content Questionnaire at baseline and again at four-month follow-up. Findings In the intervention group, 29/60 participants completed both phases of the trial. GP practices referred two control patients, and, despite various attempts by the research team, GPs failed to engage with the trial. This finding is of concern, although not unique in primary care research. In earlier studies, GPs reported a lack of knowledge and confidence in dealing with workplace health issues. Despite this, we report interesting findings from the case-managed group, the majority of whom returned to work within a month. Age and length of sickness absence at recruitment were better predictors of return-to-work rates than the number of case-managed contacts. The traditional randomised controlled trial approach was unsuitable for this study. GPs showed low interest in workplace sickness absence, despite their pivotal role in the process. This study informed a larger Department for Work and Pensions study of case-managed support.

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...

[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.

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.

Evaluation of biological models using Spacelab

NASA Technical Reports Server (NTRS)

Tollinger, D.; Williams, B. A.

1980-01-01

Biological models of hypogravity effects are described, including the cardiovascular-fluid shift, musculoskeletal, embryological and space sickness models. These models predict such effects as loss of extracellular fluid and electrolytes, decrease in red blood cell mass, and the loss of muscle and bone mass in weight-bearing portions of the body. Experimentation in Spacelab by the use of implanted electromagnetic flow probes, by fertilizing frog eggs in hypogravity and fixing the eggs at various stages of early development and by assessing the role of the vestibulocular reflex arc in space sickness is suggested. It is concluded that the use of small animals eliminates the uncertainties caused by corrective or preventive measures employed with human subjects.

[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.

In the shadows of nursing history.

PubMed

Meehan, Therese C

2005-01-01

Often overshadowed in the history books by Florence Nightingale, the Irish Sisters of Mercy established, more than 150 years ago, a system of "careful nursing" and played a key role in ministering to the needs of sick and dying soldiers during the Crimean War.

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

Pattern and predictors of sick leave among users of antidepressants: a Danish retrospective register-based cohort study.

PubMed

Gasse, Christiane; Petersen, Liselotte; Chollet, Julien; Saragoussi, Delphine

2013-12-01

Depression is associated with work absenteeism, reduced productivity, and significant personal and societal economic burden. We describe patterns and determinants of sick leave among working Danish antidepressant users. Persons starting antidepressant treatment (January 1, 2004 through December 31, 2005) were identified from a representative 25% sample of the Danish population by linking Danish national registries. Inclusion criteria were age 18-64 years, being in the workforce the week prior to the first antidepressant prescription (index prescription, IP), and no antidepressant prescription in the year prior to the IP. Only sick leaves >2 weeks are centrally registered in Denmark and could be assessed. Cox regression analyses identified predictors of sick leave during the year following the IP, based on previous history of sick leave and clinical and socio-demographic baseline characteristics. In the cohort of 25,908 (59.7% women), sick leave prevalence increased from 37.5% (year prior to IP) to 45.3% (year after the IP); 30.7% were on sick leave for >8 weeks. Incidence peaked (35.5% of individuals) the week after the IP. Of persons with sick leave in the year before the IP, 62.7% were on sick leave the first week after the IP, vs 5.7% of those without previous sick leave. Predictors associated with increased risk of sick leave among those without previous sick leave were unemployment, female gender, age 25-54 years, couples with children, and vocational and higher intermediate education (including e.g. teachers and nurses). Reasons for sick leave, sick leaves of less than 14 days and the indications for antidepressant treatment were unknown. Sick leave was prevalent in persons starting new antidepressant use, often lasting >8 weeks. Previous sick leave was the strongest predictor of subsequent sick leave. © 2013 Elsevier B.V. All rights reserved.

Microbial Contamination on Touch Surfaces in Sick- and Well-Child Waiting Rooms in Pediatric Outpatient Facilities.

PubMed

Gudakova, Irina; Kim, JinYoung; Meredith, Jennifer F; Webb, Ginny

2017-12-01

Healthcare-associated infections are a significant public health burden resulting in approximately 1.7 million infections each year. Much work is done to study the contributing factors in inpatient settings; however, little has been done to study outpatient facilities and their roles in healthcare-associated infections. While many pediatric outpatient offices utilize separated waiting areas for sick and well children to decrease the spread of disease, research has not been done to determine whether this practice is of benefit. In this study, we aimed to determine whether there is a difference in microbial burden between sick- and well-child waiting areas and to identify surfaces with the highest levels of contamination. Touch surfaces in waiting rooms were swabbed and surveyed for total microbial growth, staphylococcal growth and Gram-negative enteric bacterial growth. Selected bacteria were identified to screen for pathogenic organisms. Surfaces sampled included seats, tables, children's tables, children's seats, magazines and books. We found seats, children's seats and children's books to have the highest microbial burden. No conclusions can be made on the differences in microbial contamination in sick- and well-child waiting areas because of high variation. Streptococcus pyogenes was isolated as were several opportunistic pathogens. This study suggests the need for better cleaning practices by pediatric outpatient facilities, to include the disinfection of additional surfaces as well as more frequent and thorough cleaning.

Demographic, clinical and treatment characteristics among Meuhedet sick fund mental health referrals.

PubMed

Mishkin, Arie; Cohen-Hadad, Gerard; Lang, Michal; Kofler, Esther; Vardi, Yoel; Schrira, Samuel; Heresco-Levy, Uriel

2003-01-01

The role of the sick funds in the delivery of mental health outpatient services is expected to increase in Israel in the near future. Consequently there is an urgent need for assessing relevant parameters of the patient populations and treatment patterns presently characterizing sick fund's mental health delivery frameworks. During a random census month all patients who referred to Kupat Holim Meuhedet mental health services in Jerusalem district completed structured questionnaires including demographic, medical and mental health history data, and the Symptom Checklist 90 (SCL-90). The professionals who performed the screening assessments filled in a structured questionnaire referring to clinical status parameters, diagnosis and treatment decisions. Eighty-three new referrals were screened during the period studied, out of which 54 (65%) were absorbed within the treatment framework of the sick fund. Women patients were twice as numerous as men. The sample was heterogeneous in terms of demographic characteristics and included relatively high rates of recent physical injury and medical hospitalization. Only approximately 10% of the patients had been referred by their family doctor and only approximately 3% had psychotic disorders. The symptom profile reported was characterized by mild to moderate severity and the most common DSM-IV diagnoses made were depressive, anxiety adjustment and personality disorders. About 50% of the sample was recommended individual psychotherapy and though not mutually exclusive approximately 40% psychotropic medication. Relatively small sample size and catchment area. Before generalization of the findings, larger scale studies are warranted. This pilot study offers a rigorous examination of the content of care of a small sick fund mental health delivery system. Our findings may be instrumental in the development of new services and adaptations to changes in mental health policies.

Expectation of sickness absence duration: a review on statements and methods used in guidelines in Europe and North America

PubMed Central

Mousavi, S. Mohsen; Delclos, George L.; Benavides, Fernando G.; Lorente, Mercedes; Kunz, Regina

2016-01-01

Background: Certifying physicians play a key role in the management of sickness absence and are often provided with guidelines. Some of these guidelines contain statements on expected sickness absence duration, according to diagnosis. We were interested in exploring the evidence base of these statements. Methods: We identified guidelines through a survey of EUMASS members and a literature search of the Internet and PubMed. We extracted the statements and methods from the guidelines. We compared: diagnoses that were addressed, expected durations and development processes followed. Next, we presented our findings to the developers, to afford them an opportunity to comment and/or correct any misinterpretations. Results: We identified 4 guidelines from social insurance institutions (France, Serbia, Spain and Sweden) and 4 guidelines from private organisations (1 Netherlands, 3 US). Guidelines addressed between 63 and some 63000 health conditions (ICD 10 codes). Health conditions overlapped among guidelines. Direct comparison is hampered by differences in coding (ICD 9 or 10) and level of aggregation (three or four digit, clustering of diseases and treatment situations). Expectations about duration are defined as minimum, maximum, and optimum or mean or median and percentile distribution, stratified to age and work requirements. In a sample of 5 diagnoses we found overlap in expected duration but also differences. Guidelines are developed differently, pragmatic expert consensus being used most, supplemented with data on sickness absence from different registers, other guidelines and non-systematic literature reviews. The effectiveness of these guidelines has not yet been formally evaluated. Conclusions: Expectations about duration of sickness absence by diagnosis are expressed in several guidelines. The expectations are difficult to compare, their evidence base is unclear and their effectiveness needs to be established. PMID:26705569

Therapeutic Work as a Facilitator for Return to Paid Work in Cancer Survivors.

PubMed

van Egmond, M P; Duijts, S F A; van Muijen, P; van der Beek, A J; Anema, J R

2017-03-01

Purpose The increase of flexible employment in European labour markets has contributed to workers' risk of job loss. For sick-listed workers with chronic illnesses, such as cancer, and especially those without an employment contract, participation in therapeutic work may be an important step towards paid employment. The purpose of this study was to determine the role of therapeutic employment as facilitator for return to paid work, in a cohort of sick-listed cancer survivors (CSs) with and without an employment contract. Methods In this longitudinal study, data were used from a cohort of Dutch CSs (N = 192), who applied for disability benefits after 2 years of sick leave. The primary outcome measure was return to paid work after 1 year. Logistic regression analysis was applied. Results Of the participating CSs (mean age 50.7 years, 33 % male), 69 % had an employment contract at baseline. CSs without an employment contract participated significantly less in therapeutic work (p < 0.001) and were less likely to return to paid work after 1 year (p = 0.001), than those with a contract. Participation in therapeutic work significantly increased the chance of return to paid work after 1 year (OR 6.97; 95 % CI 2.94-16.51), adjusted for age, gender, level of work disability and having an employment contract. Conclusions Participation in therapeutic work could be an important facilitator for return to paid work in sick-listed CSs. The effectiveness of therapeutic work as a means to return to paid employment for sick-listed workers should be studied in an experimental setting.

Longitudinal associations of experiences of adversity and socioeconomic disadvantage during childhood with labour force participation and exit in later adulthood.

PubMed

Fahy, A E; Stansfeld, S A; Smuk, M; Lain, D; van der Horst, M; Vickerstaff, S; Clark, C

2017-06-01

The Extending Working Lives (EWL) agenda seeks to sustain employment up to and beyond traditional retirement ages. This study examined the potential role of childhood factors in shaping labour force participation and exit among older adults, with a view to informing proactive interventions early in the life-course to enhance individuals' future capacity for extending their working lives. Childhood adversity and socioeconomic disadvantage have previously been linked to ill-health across the life-span and sickness benefit in early adulthood. This study builds upon previous research by examining associations between childhood adversity and self-reported labour force participation among older adults (aged 55). Data was from the National Child Development Study - a prospective cohort of all English, Scottish, & Welsh births in one week in 1958. There was evidence for associations between childhood adversity and increased risk of permanent sickness at 55 years - which were largely sustained after adjustment for educational disengagement and adulthood factors (mental/physical health, qualifications, socioeconomic disadvantage). Specifically, children who were abused or neglected were more likely to be permanently sick at 55 years. In addition, among males, those in care, those experiencing illness in the home, and those experiencing two or more childhood adversities were more likely to be permanently sick at 55 years. Childhood factors were also associated with part-time employment and retirement at 55 years. Severe childhood adversities may represent important distal predictors of labour force exit at 55 years, particularly via permanent sickness. Notably, some adversities show associations among males only, which may inform interventions designed to extend working lives. Copyright © 2017 Elsevier Ltd. All rights reserved.

Importance of Contextual Factors When Measuring Work Outcome in Ankylosing Spondylitis: A Systematic Review by the OMERACT Worker Productivity Group.

PubMed

Stolwijk, Carmen; Castillo-Ortiz, José-Dionisio; Gignac, Monique; Luime, Jolanda; Boonen, A

2015-09-01

To review the literature on contextual factors (CoFas) and their relationship to work outcomes in individuals with ankylosing spondylitis (AS). Articles that quantified the relationship between CoFas and employment status, sick leave, or presenteeism in individuals with AS were systematically identified. CoFas were classified into 5 domains for personal factors and 8 domains for environmental factors. We defined criteria for best-evidence synthesis for each CoFa domain based on the number of studies exploring that domain, and the quality of evidence of individual studies based on the risk of bias, adjustment of multivariable analyses for disease activity and physical function, and sample size. Twenty-five studies met our inclusion criteria: 20 addressed employment status, 6 examined sick leave, and 3 presenteeism. For employment, there was strong evidence for the role of age, moderate evidence for related skills/abilities, the absence of work accommodations, the nature of work and absence of workplace support, and poor evidence for the role of marital status. Evidence was insufficient for sex, education, and physical environment. For sick leave and presenteeism there were too few studies to perform a best-evidence synthesis for the role of CoFas. Using a newly proposed set of criteria for determining the best-evidence of the association between CoFa domains and work outcome, the following factors emerged: age, related skills/abilities, work accommodations, nature of work, and workplace support. In addition to disease-related variables, these CoFa domains seem important to include when designing and interpreting studies on work outcomes. © 2015, American College of Rheumatology.

Cumulative exposure to shift work and sickness absence: associations in a five-year historic cohort.

PubMed

van Drongelen, Alwin; Boot, Cécile R L; Hlobil, Hynek; van der Beek, Allard J; Smid, Tjabe

2017-01-11

Exposure to shift work has been associated with negative health consequences, although the association between shift work and sickness absence remains unclear. The aim of this study is to investigate associations between cumulative exposure to shift work and sickness absence among ground staff employees of an airline company. This study used data from the MORE (Monitoring Occupational Health Risks in Employees) cohort, which is a 5-year historic cohort. The population of the present study consisted of 7562 ground staff employees. For each employee, work schedules and sickness absence days between 2005 and 2009 were obtained from company records. For the exposure to different shift schedule types and to the cumulative number of night shifts, the association with long-term sickness absence (>7 consecutive sickness absence days) and the number of sickness absence episodes during 2009, was calculated using logistic and Poisson regression analyses. Socio-demographic variables, work-related variables, job classification variables, and previous sickness absence days were regarded as confounders. After adjusting for previous sickness absence and job classification variables, only the group of employees that switched into working in a three-shift schedule, showed a significantly increased risk for long-term sickness absence (OR = 1.31, 95%CI 1.02-1.69). Night shift exposure was not significantly associated with long-term sickness absence. Exposure to shift work was negatively associated with more sickness absence episodes. Employees who were exposed to more than 46 night shifts also showed a lower risk for more sickness absence episodes. Subgroup analyses showed that single employees and employees without children had an increased risk for long-term sickness absence when exposed to a three-shift schedule, and when they had changed between shift schedule types. Cumulative exposure to shift work proved to be negatively associated with more sickness absence episodes, and was not associated with more long-term sickness absence, although selection bias could not be ruled out. Future research should explore the influence of household composition, and take into account both previous sickness absence and psychosocial and physical work factors to obtain a better estimation of the association between shift work and sickness absence.

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.

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.

5-HT2A receptors control body temperature in mice during LPS-induced inflammation via regulation of NO production.

PubMed

Voronova, Irina P; Khramova, Galina M; Kulikova, Elizabeth A; Petrovskii, Dmitrii V; Bazovkina, Daria V; Kulikov, Alexander V

2016-01-01

G protein-coupled 5-HT2A receptors are involved in the regulation of numerous normal and pathological physiological functions. At the same time, its involvement in the regulation of body temperature (Tb) in normal conditions is obscure. Here we study the effect of the 5-HT2A receptor activation or blockade on Tb in sick animals. The experiments were carried out on adult C57BL/6 mouse males. Systemic inflammation and sickness were produced by lipopolysaccharide (LPS, 0.1mg/kg, ip), while the 5-HT2A receptor was stimulated or blocked through the administration of the receptor agonist DOI or antagonist ketanserin (1mg/kg), respectively. LPS, DOI or ketanserin alone produced no effect on Tb. However, administration of LPS together with a peripheral or central ketanserin injection reduced Tb (32.2°C). Ketanserin reversed the LPS-induced expression of inducible NO synthase in the brain. Consequently, an involvement of NO in the mechanism of the hypothermic effect of ketanserin in sick mice was hypothesized. Administration of LPS together with NO synthase inhibitor, l-nitro-arginine methyl ester (60mg/kg, ip) resulted in deep (28.5°C) and prolonged (8h) hypothermia, while administration of l-nitro-arginine methyl ester alone produced no effect on Tb. Thus, 5-HT2A receptors play a key role in Tb control in sick mice. Blockade of this GPCR produces hypothermia in mice with systemic inflammation via attenuation of LPS-induced NO production. These results indicate an unexpected role of 5-HT2A receptors in inflammation and NO production and have a considerable biological impact on understanding the mechanism of animal adaptation to pathogens and parasites. Moreover, adverse side effects of 5-HT2A receptor antagonists in patients with inflammation may be expected. Copyright © 2015 Elsevier Ltd. All rights reserved.

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.

12-year trends in occupational class differences in short sickness absence among young women.

PubMed

Hilla, Sumanen; Jouni, Lahti; Eero, Lahelma; Olli, Pietiläinen; Ossi, Rahkonen

2015-06-01

Socioeconomic differences in sickness absence are well established among middle-aged employees but poorly known among younger employees, in particular for shorter spells. We examined trends in occupational class differences in short sickness absence among young women. The data were obtained from the registers of the City of Helsinki, Finland, and included female employees aged 18-34 years from 2002 to 2013. Self-certified (1-3 days) sickness absence spells were examined. Occupational class was classified into four hierarchical categories. Joinpoint regression models were used to identify major changes in sickness absence trends. Short sickness absence increased until 2008, after which it decreased in all occupational classes except manual workers. Differences in sickness absence between occupational classes remained over time. Routine non-manuals had the highest amount of short sickness absence, while managers and professionals had the smallest amount. Manual workers had somewhat less short sickness absence than routine non-manuals and semi-professionals. The socioeconomic differences in short sickness absence were clear among young women but not fully consistent as routine non-manuals tended to have more sickness absence than manual workers. Preventive measures are needed to narrow socioeconomic differences in young women's sickness absence especially among routine non-manuals. © 2015 the Nordic Societies of Public Health.

Sensory and motor properties of the cerebellar uvula and modulus

NASA Technical Reports Server (NTRS)

Robinson, F. R.

1985-01-01

The uvula and nodulus (vermal lobules 9 and 10) of the vestibulocerebellum are implicated by behavioral evidence in the control of eye and head movements and in the production of motion sickness. The uvula and nodulus could play a role in these functions through known output pathways. Purkinje cells in both structures project via the fastigial and vestibular nuceli to the ventral horn of the cervical spin cord, to oculomotor neurons, and to the emetic region of the reticular formation (ablation of which abolishes susceptability to motion sickness). Uvula and nodulus Purkinje cells will be analyzed in cats trained to make controlled head movements. The activity of these neurons is expected to modulate well during head and/or eye movements because the uvula and nodulus receive heavy projections from sources of visual, vestibular and neck proprioceptive information. How neuron activity contributes to movement and how different sensory inputs converge to influence this contribution may be determined by characterizing movement related properties of these neurons. A population of neurons that modulates powerfully to the conflict between different head movement signals that can cause motion sickness may be identified.

Role of mammalian immune responses in vector-enhanced orbiviral transmission

USDA-ARS?s Scientific Manuscript database

Culicoides sonorensis biting midges are vectors of several emerging and re-emerging orbiviruses including bluetongue, epizootic hemorrhagic disease, and African horse sickness viruses. They feed primarily on domestic sheep and cattle, but opportunistically feed on a variety of wildlife and on humans...

POSSIBLE ROLES OF FUNGAL HEMOLYSINS IN SICK BUILDING SYNDROME

EPA Science Inventory

The World Health Organization (WHO) definition of SBS includes such symptoms in the occupants as headache, distraction, dizziness, fatigue, watery eyes, runny or blocked or bleeding nose, dry or sore throat and skin irritation. The WHO has set a criterion for a healthy building ...

Developmental Issues in the Treatment of Diabetic Women.

ERIC Educational Resources Information Center

Hartman-Stein, Paula; Reuter, Jeanette M.

1988-01-01

Reviews selected articles from medical and psychological literature that focus on special issues for diabetic woman during preadolescence, adolescence, and adulthood. Makes recommendations for behavioral interventions with diabetic women in regard to sick role adjustment, peer conformity pressures, eating disorders, sexuality, and pregnancy.…

Liver Transplant: Complications/Medications

MedlinePlus

... possible airborne fungal spores (e.g. avoiding smoking marijuana , certain occupational exposures), and avoiding contact with sick persons. You do not need to wear masks after you return home. Since the immune system also plays a role in fighting cancer, you will be at increased risk for developing ...

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.

Towards a Better Understanding of Sickness Absence in Adolescence: A Qualitative Study among Dutch Intermediate Vocational Education Students

PubMed Central

Feron, Frans J. M.; van Mook, Marlieke A. W.; de Rijk, Angelique

2017-01-01

An adequate approach to sickness absence can reduce school dropout which is a major problem in Intermediate Vocational Education (IVE). This practice-based study explores the sickness absence reasons and factors influencing reporting the sickness, from a student's perspective. Semistructured interviews were held until saturation. Data were collected and analysed by a multidisciplinary research team including youth health care physicians working with IVE students. The results show that, according to the students, reasons for sickness reporting were health-related or related to problems at home or in school. Students view their sickness absence as necessity, as asking for understanding, or as pardonable. Their views depended on (1) the perception of medical legitimacy, (2) feeling able to take their own responsibility, (3) feeling being taken seriously at school, and (4) the perception that the sickness reporting procedure at school is anonymous and easy. In conclusion, reporting sickness seems more a reaction to a necessity or opportunity than the result of a conscious decision-making process. Personalizing the sickness reporting procedures and demonstrating interest rather than control while discussing the sickness absence with the individual IVE student might very well affect their sickness absence levels. PMID:28573135

Towards a Better Understanding of Sickness Absence in Adolescence: A Qualitative Study among Dutch Intermediate Vocational Education Students.

PubMed

Vanneste, Yvonne T M; Feron, Frans J M; van Mook, Marlieke A W; de Rijk, Angelique

2017-01-01

An adequate approach to sickness absence can reduce school dropout which is a major problem in Intermediate Vocational Education (IVE). This practice-based study explores the sickness absence reasons and factors influencing reporting the sickness, from a student's perspective. Semistructured interviews were held until saturation. Data were collected and analysed by a multidisciplinary research team including youth health care physicians working with IVE students. The results show that, according to the students, reasons for sickness reporting were health-related or related to problems at home or in school. Students view their sickness absence as necessity, as asking for understanding, or as pardonable. Their views depended on (1) the perception of medical legitimacy, (2) feeling able to take their own responsibility, (3) feeling being taken seriously at school, and (4) the perception that the sickness reporting procedure at school is anonymous and easy. In conclusion, reporting sickness seems more a reaction to a necessity or opportunity than the result of a conscious decision-making process. Personalizing the sickness reporting procedures and demonstrating interest rather than control while discussing the sickness absence with the individual IVE student might very well affect their sickness absence levels.

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.

Indications of a Scarring Effect of Sickness Absence Periods in a Cohort of Higher Educated Self-Employed.

PubMed

Wijnvoord, Liesbeth E C; Brouwer, Sandra; Buitenhuis, Jan; van der Klink, Jac J L; de Boer, Michiel R

2016-01-01

Little is known regarding incidence and recurrence of sickness absence in self-employed. The primary aim of this study was to evaluate the influence of the number of prior episodes of sickness absence on the risk of subsequent periods of sickness absence in higher educated self-employed. In a historic register study based on the files of a Dutch private disability insurance company all sickness absence periods of 30 days or more were analysed. A total of 15,868 insured persons contributed 141,188 person years to the study. In total, 5608 periods of sickness absence occurred during follow-up. The hazard of experiencing a new period of sickness absence increased with every previous period, ranging from a hazard ratio of 2.83 in case of one previous period of sickness absence to a hazard ratio of 6.72 in case of four previous periods. This effect was found for both men and women and for all diagnostic categories of the first period of sickness absence. Our study shows that for all diagnostic categories the hazard of experiencing a recurrence of sickness absence is appreciably higher than for experiencing a first episode. This suggests that this increased hazard may be related to the occurrence of sickness absence itself rather than related to characteristics of the insured person or of the medical condition. These findings could indicate that sickness absence periods may have a scarring effect on the self-employed person experiencing the sickness absence.

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.

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 expressly granted.

[Sick leave during pregnancy: an analysis of French hospitals from 2005 until 2008 demonstrates the major importance for jobs with physical demands].

PubMed

Estryn-Behar, Madeleine; Amar, Emile; Choudat, Dominique

2013-06-01

sick-leave in the course of pregnancy play a role under estimated according to several studies.They bring to light the existence of risk factors concerning the physical load for contractions, sick-leave, hospitalizations and prematurity.The data obtained on the totality of the wage earners of the AP-HP allow to avoid all the possible bias and to determine the potential impact of a policy of reduction of the physical load The data of four years could be analyzed.The used database is PILOT RH, intranet application restoring information extracted from GIPSIE who was until 2008 the institutional software of management of the careers of all the workers of the AP-HP. In 2008,3 937 women having had a maternity leave (ML) accumulated 132 360 days of ordinary sick-leave (OL) (that is 33,6 days on average) without inclusion of the 15 days accepted for "pathological pregnancy" (PP) and "post pregnancy leave". Ordinary sick-leave of all the 53 132 women amounts to 11.5 days by agent. But, the set apart of the women having had a ML reduces the number of days of sick-leave to 9,7 days This difference weighs for 15.6 % of the total of the absenteeism OL. The results are similar on the four years. The analysis by occupational catégory, for 2008, shows that the average number of days of sick-leave, after exclusion of women having had a ML, decreases with the physical load of the posts estimated by the study PRESST-NEXT :ancillary staff 19.9 days, nursing aids 13.7 days, registered nurses 8.2 days, specialized nurses 7.7 days, medico - technical workers 5.7 days and head nurses 5.1 days. For the women having had a ML, the average number of days of ordinary sick-leave, is the most raised for nursing aids (41.9 days) followed by the ancillary staff (36 days) and the registered nurses (36 days) and slightly less for the specialized nurses (28.3 days). On the other hand, in the professions having least physical load the women have less than 25 days of ordinary sick-leave the year of their pregnancy :medico-technical workers 21.3 days, head nurses 23.1 days and administration staff 23.7 days.The results are similar on the four years. For the nurses, it is 25.5% of total ordinary sick-leave that are attributable to the women having had a pregnancy, and 34.4 % if we add OL and 15 days of official "pathological pregnancy". An intervention to reduce the physical load in test hospitals could be led.The reduction of sick-leave in the course of pregnancy can be a fast indicator of evaluation of the efficiency of the investments. The improvements will benefit to all the agents, in the medium term, with a reduction of the risks of musculoskeletal disorders. Such an action also allows to maintain the employability of the older employees and to integrate) persons into situation of handicap in a work which has for them a strong sense and which they do not want to give up.

What happens to work if you're unwell? Beliefs and attitudes of managers and employees with musculoskeletal pain in a public sector setting.

PubMed

Wynne-Jones, Gwenllian; Buck, Rhiannon; Porteous, Carol; Cooper, Lucy; Button, Lori A; Main, Chris J; Phillips, Ceri J

2011-03-01

Musculoskeletal complaints can impact on work in terms of productivity, sickness absence and long term incapacity for work. While employee attitudes and knowledge can drive absenteeism and presenteeism behaviour, managers also play an important role in influencing this via the quality of their relationships with employees and their role in implementing organisational policies and procedures. The aims of this study were to investigate the beliefs and attitudes of managers and employees with musculoskeletal pain about sickness absence, presenteeism, and return to work and to identify areas of consensus and conflict. 18 employees with musculoskeletal pain and 20 managers from two large public sector organisations in South Wales, UK, took part in individual face-to-face interviews. Data were analysed thematically using NVivo. Employees' and managers' reports indicated that there was a strong culture of presenteeism in these organisations. Establishing the legitimacy of complaints was a salient theme for both managers and employees, although their views were in conflict. Employees reported feeling that contact with employers was intrusive when sickness absence was legitimate. Managers were supportive of those who they felt were 'genuinely' unwell, but also cited examples of people 'working the system' and not reporting absences appropriately. These issues require careful consideration of the rights and responsibilities of both employees and employers, where strategies for improving communication, trust, and creating an environment conducive to successful return to work need to be investigated.

Exploring family-centered care for children living with HIV and AIDS in Nigeria.

PubMed

Achema, Godwin; Ncama, Busisiwe P

2016-04-01

To explored the role of family-centered care in supporting children living with HIV and AIDS in Nigeria. A qualitative research design was adopted for this study with a grounded theory approach. Children aged between 11 and 14 years living with HIV and AIDS, their caregivers, and nurse practitioners working in the HIV clinic were engaged in separate focus group discussions in two hospitals in Nigeria. The findings showed that the value African families place on children plays a significant role in identifying their care needs and providing their basic necessities; hence, people around the sick child tend to make him feel better, as attested by nurse practitioners and caregiver participants. Nurse practitioner participants cited unified families as providing care support and love to the children and the support needed to alleviate their sicknesses. Children participants confirmed that family members/relatives were always at their disposal to provide supportive care in terms of administrating antiretroviral medication as well as other psychological care; although a few participants indicated that disruption in family structures in resource-poor settings, isolation and withdrawal, and deprivation of care due to poverty threatened the care rendered to the children. The study highlighted the value attached to children in the African context as helping family members to identify the care needs of children living with HIV and AIDS; thereby providing succor to alleviate their sicknesses and enhance their quality of life. © 2016 Japan Academy of Nursing Science.

Does postponement of first pregnancy increase gender differences in sickness absence? A register based analysis of Norwegian employees in 1993-2007.

PubMed

Ariansen, Anja M S; Mykletun, Arnstein

2014-01-01

From 1970-2012, the average age at first delivery increased from 23.2-28.5 in Norway. Postponement of first pregnancy increases risks of medical complications both during and after pregnancy. Sickness absence during pregnancy has over the last two decades increased considerably more than in non-pregnant women. The aim of this paper is twofold: Firstly to investigate if postponement of pregnancy is related to increased sickness absence and thus contributing to the increased gender difference in sickness absence; and secondly, to estimate how much of the increased gender difference in sickness absence that can be accounted for by increased sickness absence amongst pregnant women. We employed registry-data to analyse sickness absence among all Norwegian employees with income equivalent to full-time work in the period 1993-2007. After control for age, education, and income, pregnant women's sickness absence (age 20-44) increased on average 0.94 percentage points each year, compared to 0.29 in non-pregnant women and 0.14 in men. In pregnant women aged 20-24, sickness absence during pregnancy increased by 0.96 percent points per calendar year, compared to 0.60 in age-group 30-34. Sickness absence during pregnancy accounted for 25% of the increased gender gap in sickness absence, accounting for changes in education, income and age. Postponement of first pregnancy does not explain the increase in pregnant women's sickness absence during the period 1993-2007 as both the highest level and increase in sickness absence is seen in the younger women. Reasons are poorly understood, but still important as it accounts for 25% of the increased gender gap in sickness absence.

Does Postponement of First Pregnancy Increase Gender Differences in Sickness Absence? A Register Based Analysis of Norwegian Employees in 1993–2007

PubMed Central

Ariansen, Anja M. S.; Mykletun, Arnstein

2014-01-01

Background From 1970–2012, the average age at first delivery increased from 23.2–28.5 in Norway. Postponement of first pregnancy increases risks of medical complications both during and after pregnancy. Sickness absence during pregnancy has over the last two decades increased considerably more than in non-pregnant women. The aim of this paper is twofold: Firstly to investigate if postponement of pregnancy is related to increased sickness absence and thus contributing to the increased gender difference in sickness absence; and secondly, to estimate how much of the increased gender difference in sickness absence that can be accounted for by increased sickness absence amongst pregnant women. Methods We employed registry-data to analyse sickness absence among all Norwegian employees with income equivalent to full-time work in the period 1993–2007. Results After control for age, education, and income, pregnant women's sickness absence (age 20–44) increased on average 0.94 percentage points each year, compared to 0.29 in non-pregnant women and 0.14 in men. In pregnant women aged 20–24, sickness absence during pregnancy increased by 0.96 percent points per calendar year, compared to 0.60 in age-group 30–34. Sickness absence during pregnancy accounted for 25% of the increased gender gap in sickness absence, accounting for changes in education, income and age. Conclusions Postponement of first pregnancy does not explain the increase in pregnant women's sickness absence during the period 1993–2007 as both the highest level and increase in sickness absence is seen in the younger women. Reasons are poorly understood, but still important as it accounts for 25% of the increased gender gap in sickness absence. PMID:24667483

Subjective health complaints, functional ability, fear avoidance beliefs, and days on sickness benefits after work rehabilitation - a mediation model.

PubMed

Øyeflaten, Irene; Opsahl, Jon; Eriksen, Hege R; Braathen, Tore Norendal; Lie, Stein Atle; Brage, Søren; Ihlebæk, Camilla M; Breivik, Kyrre

2016-05-23

Long-term sick leave and withdrawal from working life is a concern in western countries. In Norway, comprehensive inpatient work rehabilitation may be offered to sick listed individuals at risk of long-term absence from work. Knowledge about prognostic factors for work outcomes after long-term sick leave and work rehabilitation is still limited. The aim of this study was to test a mediation model for various hypothesized biopsychosocial predictors of continued sick leave after inpatient work rehabilitation. One thousand one hundred fifty-five participants on long-term sick leave from eight different work rehabilitation clinics answered comprehensive questionnaires at arrival to the clinic, and were followed with official register data on sickness benefits for 3 years. Structural equation models were conducted, with days on sickness benefits after work rehabilitation as the outcome. Fear avoidance beliefs for work mediated the relation between both musculoskeletal complaints and education on days on sickness benefits after work rehabilitation. The relation between musculoskeletal complaints and fear avoidance beliefs for work was furthermore fully mediated by poor physical function. Previous sick leave had a strong independent effect on continued sick leave after work rehabilitation. Fear avoidance beliefs for work did not mediate the small effect of pseudoneurological complaints on continued sick leave. Poor coping/interaction ability was neither related to continued sick leave nor fear avoidance beliefs for work. The mediation model was partly supported by the data, and provides some possible new insight into how fear avoidance beliefs for work and functional ability may intervene with subjective health complaints and days on sickness benefits after work rehabilitation.

Comparison of symptomatology and performance degradation for motion and radiation sickness. Technical report, 6 January 1984-31 March 1985

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

McClellan, G.E.; Wiker, S.F.

1985-05-31

This report quantifies for the first time the relationship between the signs and symptoms of acute radiation sickness and those of motion sickness. With this relationship, a quantitative comparison is made between data on human performance degradation during motion sickness and estimates of performance degradation during radiation sickness. The comparison validates estimates made by the Intermediate Dose Program on the performance degradation from acute radiation sickness.

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.

Simulators IV; Proceedings of the SCS Conference, Orlando, FL, Apr. 6-9, 1987

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

Fairchild, B.T.

1987-01-01

The conference presents papers on the applicability of AI techniques to simulation models, the simulation of a reentry vehicle on Simstar, simstar missile simulation, measurement issues associated with simulator sickness, and tracing the etiology of simulator sickness. Consideration is given to a simulator of a steam generator tube bundle response to a blowdown transient, the census of simulators for fossil fueled boiler and gas turbine plant operation training, and a new approach for flight simulator visual systems. Other topics include past and present simulated aircraft maintenance trainers, an AI-simulation based approach for aircraft maintenance training, simulator qualification using EPRI methodology,more » and the role of instinct in organizational dysfunction.« less

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.

Mood, anxiety, and alcohol use disorders and later cause-specific sick leave in young adult employees.

PubMed

Torvik, Fartein Ask; Reichborn-Kjennerud, Ted; Gjerde, Line C; Knudsen, Gun Peggy; Ystrom, Eivind; Tambs, Kristian; Røysamb, Espen; Østby, Kristian; Ørstavik, Ragnhild

2016-08-03

Mental disorders strongly influence work capability in young adults, but it is not clear which disorders that are most strongly associated with sick leave, and which diagnoses that are stated on the sick leave certificates. Better knowledge of the impairments associated with different mental disorders is needed for optimal planning of interventions and prioritization of health services. In the current study, we investigate the prospective associations between eight mood, anxiety, and alcohol use disorders, and later sick leave granted for mental, somatic, or any disorder. Lifetime mental disorders were assessed by structured diagnostic interviews in 2,178 young adults followed for eight years with registry data on sick leave. Relative risk ratios were estimated for the associations between each mental disorder and the different forms of sick leave. All included diagnoses were associated with later sick leave. In adjusted analyses, major depressive disorder and generalized anxiety disorder were the strongest predictors of sick leave granted for mental disorders, whereas social anxiety disorder and specific phobia were the strongest predictors of sick leave granted for somatic disorders. Specific phobia and major depressive disorder had the highest attributable fractions for all-cause sick leave. Mood and anxiety disorders constituted independent risk factors for all cause sick leave, whereas alcohol use disorders seemed to be of less importance in young adulthood. Disorders characterised by distress were most strongly associated with sick leave granted for mental disorders, whereas disorders characterised by fear primarily predicted sick leave granted for somatic conditions. A large part of all sick leave is related to specific phobia, due to the high prevalence of this disorder. The impairment associated with this common disorder may be under-acknowledged, and it could decrease work capacity among individuals with somatic disorders. This disorder has good treatment response and may be overlooked as a target for interventions aimed at prevention of sick leave.

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 common combination is low monthly income, high sickness absenteeism and high sickness presenteeism.

Workplace bullying and sickness absence: a systematic review and meta-analysis of the research literature.

PubMed

Nielsen, Morten Birkeland; Indregard, Anne-Marthe Rustad; Øverland, Simon

2016-09-01

The association between workplace bullying and sickness absence remains unclear. This paper presents a systematic review and meta-analysis of research on the association. We conducted a systematic review and meta-analysis of published primary studies on workplace bullying and sickness absence. Studies based on prospective design or registry data on sickness absence were included. Cross-sectional studies with self-reported sickness absence were excluded. Seventeen primary studies were included in the review, sixteen originated from the Nordic countries and fifteen included registry data on sickness absence. All but one study found that exposure to workplace bullying was associated with increased risk of sickness absence. A meta-analysis of ten independent studies showed that exposure to bullying increased the risk of sickness absence (odds ratio 1.58, 95% CI 1.39-1.79). Five studies included variables that moderated the association between bullying and absenteeism. None of the studies included mediating variables. No studies examined sickness absence as a risk factor for later exposure to bullying. Following the GRADE guidelines, the evidence for an association between bullying and sickness absence is moderate. Workplace bullying is a risk factor for sickness absence, but the mechanisms to explain this relationship are not sufficiently described. It is unclear whether sickness absence predicts later exposure to bullying. While, the methodological quality of the reviewed studies was high, the knowledge base is small. There is a need for more research on how and when bullying is related to sickness absence and the possible bidirectional relationships involved.

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.

Interaction of Physical Exposures and Occupational Factors on Sickness Absence in Automotive Industry Workers.

PubMed

Valirad, Fateme; Ghaffari, Mostafa; Abdi, Alireza; Attarchi, Mirsaeed; Mircheraghi, Seyed Farzin; Mohammadi, Saber

2015-04-23

Increased sickness absence in recent years has been a trouble making issue in industrial society. Identify the causes of sickness absence and its influencing factors, is an important step to control and reduce its associated complications and costs. The aim of this study was to evaluate main factors associated with the incidence of sickness absence. In 2012, a cross-sectional study on 758 employees of a car accessories producing company was applied and relevant information about the number of days and episodes of sickness absence, Disease resulting in absence from work, personal features, occupational factors and physical exposures were collected. To determine risk factors associated with sickness absence, Logistic regression analysis was used. The most common diseases leading to sickness absence in order of frequency were Respiratory diseases, musculoskeletal disorders, gastrointestinal diseases and injuries at work. Musculoskeletal disorders increased the danger of long term absence by 4/33 times. Blue collar and shift works were the most important occupational factors associated with the incidence of sickness absence. The main physical factors that affect incidence of sickness absence were frequent bending-twisting and heavy lifting. Identifying controllable factors of sickness absence and trying to prevent and modify them such as compliance of ergonomic principals to decrease physical can be effective in reducing sickness absence.

Factors associated with occupational strain among Chinese teachers: a cross-sectional study.

PubMed

Yang, X; Wang, L; Ge, C; Hu, B; Chi, T

2011-02-01

With the reform of the education system in China, teachers are suffering from more occupational strain, which is believed to impair their working state indirectly and affect their health. This study assessed occupational strain and explored the related factors among Chinese teachers. Cross-sectional with cluster sampling. The study population was composed of 3570 school teachers working in 64 primary and middle schools in Heping District in Shenyang, China. Data were collected using a self-administered questionnaire (the Chinese version of the Occupational Stress Inventory scale). Multivariate linear regression analyses were performed to study the factors related to occupational strain. The average score on the Personal Strain Questionnaire (PSQ) for the whole study population was 106.5 (107.5 in men and 106.3 in women). Teachers with chronic disease, a greater number of days of sick leave, recent experience of a stressful life event and divorced/separated/widowed status tended to suffer greater strain than their peers. Regression analyses showed that the PSQ score was significantly associated with role overload, role boundary, responsibility and physical environment, and inversely associated with recreation and rational coping. The most crucial predictors of occupational strain were chronic disease, days of sick leave, recent experience of a stressful life event and marital status. Being a class teacher was the strongest indicator of interpersonal strain. Self-care was associated with vocational strain and psychological strain, and inversely associated with physical strain. Most teachers in this study experienced a high degree of occupational strain. Chronic disease, days of sick leave, recent experience of a stressful life event and divorced/separated/widowed status played prominent roles in occupational strain. In addition, role overload, role boundary, responsibility and physical environment induce occupational strain, while recreation and rational coping have a positive effect on occupational strain. Interventions such as proper management of chronic diseases and establishment of a balanced work-family life are crucial to reduce occupational strain. Recreation and training in coping abilities are needed to enhance positive working environments and attenuate the occupational strain imposed on teachers. Copyright © 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Effort-reward imbalance, overcommitment and their associations with all-cause and mental disorder long-term sick leave - A case-control study of the Swedish working population.

PubMed

Lidwall, Ulrik

2016-11-18

To investigate if effort-reward imbalance (ERI) and overcommitment (OC) are associated with all-cause and mental disorder long-term sick leave (LS), and to identify differences in associations between genders, private versus public sector employees and socioeconomic status groups. The study uses a cross-sectional case-control design with a sample of 3477 persons on long-term sick leave of more than 59 days and a control group of 2078 in employment. Data on sick leave originate from social insurance registers, while data on health, working and living conditions were gathered through a survey. The binary logistic regression was used to test the multivariate associations. Effort-reward imbalance was associated with all-cause LS among the women (odds ratio (OR) = 1.58, 95% CI: 1.2-2.08), but not among the men. Associations for mental disorder LS were evident for both ERI and OC among both genders (ERI/OC: women OR = 2.76/2.82; men OR = 2.18/2.92). For the men these associations were driven by high effort, while for the women it was low job esteem in public sector and low job security in private sector. Among the highly educated women, ERI was strongly related to mental disorder LS (OR = 6.94, 95% CI: 3.2-15.04), while the highly educated men seemed to be strongly affected by OC for the same outcome (OR = 5.79, 95% CI: 1.48-22.57). The study confirmed the independent roles of ERI and OC for LS, with stronger associations among the women and for mental disorders. The ERI model is a promising tool that can contribute to understanding the prevailing gender gap in sick leave and increasing sick leave due to mental disorders. Int J Occup Med Environ Health 2016;29(6):973-989. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Involvement and structure: A qualitative study of organizational change and sickness absence among women in the public sector in Sweden

PubMed Central

2011-01-01

Background Organizational changes in modern corporate life have become increasingly common and there are indications that they often fail to achieve their ends. An earlier study of 24,036 employees showed that those who had repeatedly been exposed to large increases in staffing during 1991-1996 had an excess risk of both long-term sickness absence and hospital admission during 1997-1999, while moderate expansion appeared to be protective. The former was most salient among female public sector employees. We used qualitative interviews to explore work environment factors underlying the impact of organizational changes (moderate and large expansions in staffing) on sickness absence from an employee perspective. Method We interviewed 21 strategically selected women from the earlier study using semi-structured telephone interviews focusing on working conditions during the organizational changes. We identified 22 themes which could explain the association between organizational changes and sickness absence. We then used Qualitative Comparative Analysis (QCA) to reduce the number of themes and discover patterns of possible causation. Results The themes that most readily explained the outcomes were Well Planned Process of Change (a clear structure for involvement of the employees in the changes), Agent of Change (an active role in the implementation of the changes), Unregulated Work (a lack of clear limits and guidelines regarding work tasks from the management and among the employees), and Humiliating Position (feelings of low status or of not being wanted at the workplace), which had been salient throughout the analytic process, in combination with Multiple Contexts (working in several teams in parallel) and Already Ill (having already had a debilitating illness at the beginning of 1991), which may indicate degree of individual exposure and vulnerability. Well Planned Process of Change, Agent of Change and Multiple Contexts are themes that were associated with low sickness absence. Unregulated Work, Humiliating Position and Already Ill were associated with high sickness absence. Conclusions These findings suggest that promising areas for future research and improvement in change management could be the structured involvement of the employees in the planning of organizational changes, and the development of methods to avoid highly unregulated working conditions. PMID:21575180

Involvement and structure: a qualitative study of organizational change and sickness absence among women in the public sector in Sweden.

PubMed

Baltzer, Maria; Westerlund, Hugo; Backhans, Mona; Melinder, Karin

2011-05-16

Organizational changes in modern corporate life have become increasingly common and there are indications that they often fail to achieve their ends. An earlier study of 24,036 employees showed that those who had repeatedly been exposed to large increases in staffing during 1991-1996 had an excess risk of both long-term sickness absence and hospital admission during 1997-1999, while moderate expansion appeared to be protective. The former was most salient among female public sector employees. We used qualitative interviews to explore work environment factors underlying the impact of organizational changes (moderate and large expansions in staffing) on sickness absence from an employee perspective. We interviewed 21 strategically selected women from the earlier study using semi-structured telephone interviews focusing on working conditions during the organizational changes. We identified 22 themes which could explain the association between organizational changes and sickness absence. We then used Qualitative Comparative Analysis (QCA) to reduce the number of themes and discover patterns of possible causation. The themes that most readily explained the outcomes were Well Planned Process of Change (a clear structure for involvement of the employees in the changes), Agent of Change (an active role in the implementation of the changes), Unregulated Work (a lack of clear limits and guidelines regarding work tasks from the management and among the employees), and Humiliating Position (feelings of low status or of not being wanted at the workplace), which had been salient throughout the analytic process, in combination with Multiple Contexts (working in several teams in parallel) and Already Ill (having already had a debilitating illness at the beginning of 1991), which may indicate degree of individual exposure and vulnerability. Well Planned Process of Change, Agent of Change and Multiple Contexts are themes that were associated with low sickness absence. Unregulated Work, Humiliating Position and Already Ill were associated with high sickness absence. These findings suggest that promising areas for future research and improvement in change management could be the structured involvement of the employees in the planning of organizational changes, and the development of methods to avoid highly unregulated working conditions.

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.

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 ...

Impact of improved recording of work-relatedness in primary care visits at occupational health services on sickness absences: study protocol for a randomised controlled trial.

PubMed

Atkins, Salla; Ojajärvi, Ulla; Talola, Nina; Viljamaa, Mervi; Nevalainen, Jaakko; Uitti, Jukka

2017-07-26

Employment protects and fosters health. Occupational health services, particularly in Finland, have a central role in protecting employee health and preventing work ability problems. However, primary care within occupational health services is currently underused in informing preventive activities. This study was designed to assess whether the recording of work ability problems and improvement of follow-up of work-related primary care visits can reduce sickness absences and work disability pensions after 1 year. A pragmatic trial will be conducted using patient electronic registers and registers of the central pensions agency in Finland. Twenty-two occupational health centres will be randomised to intervention and control groups. Intervention units will receive training to improve recording of work ability illnesses in the primary care setting and improved follow-up procedures. The intervention impact will be assessed through examining rates of sickness absence across intervention and control clinics as well as before and after the intervention. The trial will develop knowledge of the intervention potential of primary care for preventing work disability pensions and sickness absence. The use of routine patient registers and pensions registers to assess the outcomes of a randomised controlled trial will bring forward trial methodology, particularly when using register-based data. If successful, the intervention will improve the quality of occupational health care primary care and contribute to reducing work disability. ISRCTN Registry reference number ISRCTN45728263 . Registered on 18 April 2016.

Chronic Pain Patients: Implications for Rehabilitation Counseling.

ERIC Educational Resources Information Center

Scott, Lori T.

Chronic pain syndrome appears to have certain dimensions which make it unique as a disabling condition. When pain persists, the resulting anxiety and depression, others' reactions to the patient's sick role behaviors, and situational variables such as disability benefits may all contribute to the pain syndrome and complicate the rehabilitation…

Sick leave patterns among 5-year cancer survivors: a registry-based retrospective cohort study.

PubMed

Torp, Steffen; Nielsen, Roy A; Gudbergsson, Sævar B; Fosså, Sophie D; Dahl, Alv A

2012-09-01

The aims of this study were to observe the sick leave rates of cancer survivors for five consecutive years following a first lifetime diagnosis of invasive cancer and to identify socio-demographic and clinical predictors of sick leave taken in the fifth year after diagnosis. This registry study comprised 2,008 Norwegian individuals (18-61 years old) with their first lifetime diagnosis of invasive cancer in 1999 and alive in 2004 and a cancer-free control group (n = 3,240) matched by sex, age, educational level, and employment status in 1998. Sick leave was defined as at least one sick leave period >16 days within the year in question. A total of 75 % of the long-term cancer survivors (LTCSs) took sick leave within the first 12 months after their diagnosis. The sick leave rate stabilized at a slightly higher level in the following 4 years compared to the year before diagnosis, with approximately 23 % of the male and 31 % of the female LTCSs taking sick leave. Being single with children, having low education, working in health and social work sector, or having taken sick leave the year before diagnosis (1998) predicted the sick leave taken 5 years after diagnosis (2004) among LTCSs. Compared to the controls, LTCSs with rectal, lymphogenic, breast, or "other" types of cancer had significantly higher sick leave rates 5 years after diagnosis. Socio-demographic factors explained more of the variance in sick leave than did clinical factors. Employed LTCSs struggle with their ability to work 5 years after diagnosis. More research is needed to identify factors that would promote LTCSs' health and ability. A socioeconomic and work environmental perspective seems necessary for achieving effective occupational rehabilitation and preventing sick leave among LTCSs.

Sickness absence due to otoaudiological diagnoses and risk of disability pension: a nationwide Swedish prospective cohort study.

PubMed

Friberg, Emilie; Jansson, Catarina; Mittendorfer-Rutz, Ellenor; Rosenhall, Ulf; Alexanderson, Kristina

2012-01-01

Hearing difficulties are a large public health problem. Knowledge is scarce regarding risk of disability pension among people who have been sickness absent due to these difficulties. A cohort including all 4,687,756 individuals living in Sweden in 2005, aged 20-64, and not on disability or old-age pension, was followed through 2009. Incidence rate ratios (RR) of disability pension with 95% confidence intervals (CI) were estimated using Cox proportional hazard models. In multivariable models, individuals who had a sick-leave spell due to otoaudiological diagnoses in 2005 had a 1.52-fold (95% CI: 1.43-1.62) increased risk of being granted a disability pension compared to individuals on sick leave due to other diagnoses. Hearing and tinnitus sick-leave diagnoses were associated with risk of disability pension: RR 3.38, 95% CI: 3.04-3.75, and 3.30, 95% CI: 2.95-3.68, respectively. No association was observed between sick leave due to vertigo diagnoses and disability pension whereas otological diagnoses and no sick leave were inversely associated with risk of disability pension compared to non-otoaudiological sick-leave diagnoses. Sick leave due to otoaudiological diagnoses was positively associated with risk of disability pension due to otoaudiological diagnoses and sick leave due to a tinnitus diagnosis was also associated with risk of disability pension due to mental diagnoses. The risk of disability pension among individuals with hearing or tinnitus sick-leave diagnoses was highest in the age group 35-44. Moreover, men had a slightly higher risk. This large cohort study suggests an increased risk of disability pension among those with sickness absence due to otoaudiological diagnoses, particularly hearing and tinnitus diagnoses, compared to those with sickness absence due to non-otoaudiological diagnoses.

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.

EEG-based learning system for online motion sickness level estimation in a dynamic vehicle environment.

PubMed

Lin, Chin-Teng; Tsai, Shu-Fang; Ko, Li-Wei

2013-10-01

Motion sickness is a common experience for many people. Several previous researches indicated that motion sickness has a negative effect on driving performance and sometimes leads to serious traffic accidents because of a decline in a person's ability to maintain self-control. This safety issue has motivated us to find a way to prevent vehicle accidents. Our target was to determine a set of valid motion sickness indicators that would predict the occurrence of a person's motion sickness as soon as possible. A successful method for the early detection of motion sickness will help us to construct a cognitive monitoring system. Such a monitoring system can alert people before they become sick and prevent them from being distracted by various motion sickness symptoms while driving or riding in a car. In our past researches, we investigated the physiological changes that occur during the transition of a passenger's cognitive state using electroencephalography (EEG) power spectrum analysis, and we found that the EEG power responses in the left and right motors, parietal, lateral occipital, and occipital midline brain areas were more highly correlated to subjective sickness levels than other brain areas. In this paper, we propose the use of a self-organizing neural fuzzy inference network (SONFIN) to estimate a driver's/passenger's sickness level based on EEG features that have been extracted online from five motion sickness-related brain areas, while either in real or virtual vehicle environments. The results show that our proposed learning system is capable of extracting a set of valid motion sickness indicators that originated from EEG dynamics, and through SONFIN, a neuro-fuzzy prediction model, we successfully translated the set of motion sickness indicators into motion sickness levels. The overall performance of this proposed EEG-based learning system can achieve an average prediction accuracy of ~82%.

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

Sick-leave decisions for patients with severe subjective health complaints presenting in primary care: A cross-sectional study in Norway, Sweden, and Denmark

PubMed Central

2013-01-01

Abstract Objectives The primary objective of this study was to explore whether general practitioners (GPs) in Norway, Sweden, and Denmark make similar or different decisions regarding sick leave for patients with severe subjective health complaints (SHC). The secondary objective was to investigate if patient diagnoses, the reasons attributed for patient complaints, and GP demographics could explain variations in sick leave decisions. Design A cross-sectional study. Method Video vignettes of GP consultations with nine different patients. Subjects 126 GPs in Norway, Sweden, and Denmark. Setting Primary care in Norway, Sweden, and Denmark. Main outcome measure Sick leave decisions made by GPs. Results “Psychological” diagnoses in Sweden were related to lower odds ratio (OR) of granting sick leave than in Norway (OR = 0.07; 95% CI = 0.01–0.83) Assessments of patient health, the risk of deterioration, and their ability to work predicted sick leave decisions. Specialists in general medicine grant significantly fewer sick leaves than non-specialists. Conclusion Sick-leave decisions made by GPs in the three countries were relatively similar. However, Swedish GPs were more reluctant to grant sick leave for patients with “psychological” diagnoses. Assessments regarding health-related factors were more important than diagnoses in sick-leave decisions. Specialist training may be of importance for sick-leave decisions. PMID:24164371

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.

The associations between workplace bullying, salivary cortisol, and long-term sickness absence: a longitudinal study.

PubMed

Grynderup, Matias Brødsgaard; Nabe-Nielsen, Kirsten; Lange, Theis; Conway, Paul Maurice; Bonde, Jens Peter; Garde, Anne Helene; Gullander, Maria; Kaerlev, Linda; Persson, Roger; Rugulies, Reiner; Vammen, Marianne Agergaard; Høgh, Annie; Hansen, Åse Marie

2017-09-16

Workplace stressors, such as bullying, are strongly related to subsequent long-term sickness absence, but little is known of the possible physiological mechanisms linking workplace stressors and sickness absence. The primary aim of this study was to investigate to what extent cortisol levels were associated with subsequent sickness absence and if cortisol mediated the association between workplace bullying and sickness absence. We additionally investigated possible bidirectional associations between bullying, cortisol, and long-term sickness absence. Participants came from two Danish cohort studies, the "Psychosocial RIsk factors for Stress and MEntal disease" (PRISME) cohort and the "Workplace Bullying and Harassment" (WBH) cohort (n = 5418). Information about exposure to workplace bullying and morning and evening salivary cortisol was collected at three time points with approximately two years in between. After each data collection, all participants were followed for two years in registers, and cases with long-term sickness absence lasting 30 or more consecutive days were identified. The association between cortisol levels and subsequent sickness absence was assessed by logistic regression, while the extent to which the association between bullying and sickness absence was mediated by cortisol was quantified through natural direct and indirect effects. High evening cortisol was associated with a decreased risk of sickness absence (OR = 0.82, 95% CI = 0.68-0.99), but we did not find that high morning cortisol levels (OR = 0.98, 95% CI = 0.81-1.18) or high morning-to-evening slope (OR = 0.99, 95% CI = 0.82-1.18) were associated with subsequent sickness absence. We also tested for reverse causation and found that long-term sickness absence, but not salivary cortisol, was a strong risk factor for subsequent workplace bullying. There was no indication that cortisol mediated the association between workplace bullying and sickness absence. We found no straightforward and simple association between cortisol and long-term sickness absence. Furthermore, the association between workplace bullying and long-term sickness absence was not mediated by cortisol.

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.

Explaining occupational class differences in sickness absence: results from middle-aged municipal employees.

PubMed

Laaksonen, M; Piha, K; Rahkonen, O; Martikainen, P; Lahelma, E

2010-09-01

Low socioeconomic position is consistently associated with higher rates of sickness absence. We aimed to examine whether working conditions, health-related behaviours and family-related factors explain occupational class differences in medically certified sickness absence. The study included 5470 women and 1464 men employees of the City of Helsinki, surveyed in 2000-2002. These data were prospectively linked to sickness absence records until the end of 2005, providing a mean follow-up time of 3.9 years. Poisson regression was used to examine the occurrence of medically certified sickness absence episodes lasting 4 days or more. Medically certified sickness absence was roughly three times more common among manual workers than among managers and professionals in both women and men. Physical working conditions were the strongest explanatory factors for occupational class differences in sickness absence, followed by smoking and relative weight. Work arrangements and family-related factors had very small effects only. The effects of psychosocial working conditions were heterogeneous: job control narrowed occupational class differences in sickness absence while mental strain and job demands tended to widened them. Overall, the findings were quite similar in women and men. Physical working conditions provided strongest explanations for occupational class differences in sickness absence. Smoking and relative weight, which are well-known determinants of health, also explained part of the excess sickness absence in lower occupational classes. Applying tailored work arrangements to employees on sick leave, reducing physically heavy working conditions and promoting healthy behaviours provide potential routes to narrow occupational class differences in sickness absence.

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.

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.

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.

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

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.

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.

GP consultations for common mental disorders and subsequent sickness certification: register-based study of the employed population in Norway

PubMed Central

Gjesdal, Sturla; Holmaas, Tor Helge; Monstad, Karin; Hetlevik, Øystein

2016-01-01

Background. Challenges related to work are in focus when employed people with common mental disorders (CMDs) consult their GPs. Many become sickness certified and remain on sick leave over time. Objectives. To investigate the frequency of new CMD episodes among employed patients in Norwegian general practice and subsequent sickness certification. Methods. Using a national claims register, employed persons with a new episode of CMD were included. Sickness certification, sick leave over 16 days and length of absences were identified. Patient- and GP-related predictors for the different outcomes were assessed by means of logistic regression. Results. During 1 year 2.6% of employed men and 4.2% of employed women consulted their GP with a new episode of CMD. Forty-five percent were sickness certified, and 24 percent were absent over 16 days. Thirty-eight percent had depression and 19% acute stress reaction, which carried the highest risk for initial sickness certification, 75%, though not for prolonged absence. Men and older patients had lower risk for sickness certification, but higher risk for long-term absence. Conclusion. Better knowledge of factors at the workplace detrimental to mental health, and better treatment for depression and stress reactions might contribute to timely return of sickness absentees. PMID:27535329

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.

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.

The influence of household work and of having children on sickness absence among publicly employed women in Sweden.

PubMed

Voss, Margaretha; Josephson, Malin; Stark, Stefan; Vaez, Marjan; Alexanderson, Kristina; Alfredsson, Lars; Vingård, Eva

2008-08-01

To investigate whether family obligations influence the risk of sickness absence among female municipal employees in Sweden. A 1-year prospective cohort study of 1464 female municipal employees <50 years of age in Sweden in 2000 was conducted using questionnaire responses and absence data from the employers' personnel records. The relative risk of having children <16 years of age in the home, marital status, household work, financial situation, working hours and work-family conflicts for repeated sick-leave spells (>or=4 spells) and long-term sickness absence (>or=28 days) were calculated by applying Poisson regression models. Women reporting financial strain or work-family conflicts were at elevated risk for long-term sickness absence. Having children was not a risk factor for repeated sick-leave spells or long-term sickness absence among married/cohabiting women. Single women with children had a two-fold greater risk of repeated sick-leave spells than single women without children. The findings suggest that the combination of gainful employment and children does not influence the risk of repeated sick-leave spells or long-term sickness absence among married/cohabiting publicly employed women. However, this was not true for single women with children, which indicates that their circumstances are particularly strained.

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.

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.

Sickness presenteeism: The prevalence of coming to work while ill among paediatric resident physicians in Canada.

PubMed

Mitchell, Kevin J; Vayalumkal, Joseph V

2017-05-01

Sickness presenteeism is defined as the act of attending one's job despite ill-health. Recently, physicians and other health care workers have become the focus of sickness presenteeism research, because presenteeism in this population can put patients at risk of infection. There are currently no data on this topic among physicians in Canada. The aim of this study was to investigate sickness presenteeism in paediatric resident physicians in Canada. We conducted an anonymous, online, cross-sectional survey study in which all paediatric residents in Canada were eligible. Outcomes of interest included prevalences of sickness presenteeism, sickness during the study period and voluntary self-appointed personal protective equipment use when engaging in sickness presenteeism. Response rate was 56.5% (N=323). During the previous 2 months, 61% (95% confidence interval [CI] 55.7 to 66.3) of respondents reported having experienced an illness and 59% (95% CI 53.7 to 64.5) of respondents had come to work sick. Of those who reported becoming ill during the study period, 97.0% (95% CI 94.6 to 99.4) reported coming to work while sick. There was no difference in prevalence when comparing across post-graduate year training levels. Extra personal protective equipment was used by 86% (95% CI 82.1 to 91.7) when engaging in sickness presenteeism. Sickness presenteeism is a common phenomenon among paediatric resident physicians. Our results should influence residents and supervising staff physicians to encourage appropriate self-care at home, rather than presenteeism.

Sickness Absence and Precarious Employment: A Comparative Cross-National Study of Denmark, Finland, Sweden, and Norway.

PubMed

Oke, A; Braithwaite, P; Antai, D

2016-07-01

Precarious employment is a major social determinant of health and health inequalities with effects beyond the health of workers. To investigate the association between precarious employment and sickness absence in 4 Nordic countries, Denmark, Finland, Norway, and Sweden. Logistic regression analyses were conducted separately for each country on data from 4186 respondents aged 15-65 years in Denmark, Finland, Norway, and Sweden derived from the 2010 European Working Conditions Survey. Sickness absence was based on self-reports and defined as absence of seven or more day per year. Precarious employment was operationalized as a multidimensional construct of indicators. Analyses were also conducted separately for men and women. The prevalence of sickness absence was lowest in Sweden (18%), and highest in Finland (28%). 3 precarious employment indicators were positively associated with sickness absence; the pattern being largely similar in the total sample. In the sex-disaggregated sample, 5 precarious employment indicators increased the likelihood of sickness absence; the pattern was heterogeneous, with women generally having significantly higher odds of sickness absence than men. "Low household income" and "sickness presenteeism" were strong predictors of sickness absence among both sexes in most of the 4 studied countries. Sickness absence varied between the Nordic countries in the sex-disaggregated analyses. Precarious employment indicators predicted sickness absence in the Nordic countries. Findings emphasize the need to prioritize informed and monitored collective bargaining for all workers, increase working time flexibility, and improving work conditions.

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.

The effect of mild motion sickness and sopite syndrome on multitasking cognitive performance.

PubMed

Matsangas, Panagiotis; McCauley, Michael E; Becker, William

2014-09-01

In this study, we investigated the effects of mild motion sickness and sopite syndrome on multitasking cognitive performance. Despite knowledge on general motion sickness, little is known about the effect of motion sickness and sopite syndrome on multitasking cognitive performance. Specifically, there is a gap in existing knowledge in the gray area of mild motion sickness. Fifty-one healthy individuals performed a multitasking battery. Three independent groups of participants were exposed to two experimental sessions. Two groups received motion only in the first or the second session, whereas the control group did not receive motion. Measurements of motion sickness, sopite syndrome, alertness, and performance were collected during the experiment Only during the second session, motion sickness and sopite syndrome had a significant negative association with cognitive performance. Significant performance differences between symptomatic and asymptomatic participants in the second session were identified in composite (9.43%), memory (31.7%), and arithmetic (14.7%) task scores. The results suggest that performance retention between sessions was not affected by mild motion sickness. Multitasking cognitive performance declined even when motion sickness and soporific symptoms were mild. The results also show an order effect. We postulate that the differential effect of session on the association between symptomatology and multitasking performance may be related to the attentional resources allocated to performing the multiple tasks. Results suggest an inverse relationship between motion sickness effects on performance and the cognitive effort focused on performing a task. Even mild motion sickness has potential implications for multitasking operational performance.

Relationship between motion sickness, migraine and menstruation in crew members of a "round the world" yacht race.

PubMed

Grunfeld, E; Gresty, M A

1998-11-15

The similarities between the symptoms reported by patients with migraine and those experienced by severely motion sick individuals raises the question of whether the two conditions involve common mechanisms. In women, attacks of migraine may follow the menstrual cycle, and anecdote suggests this may also be true of motion sickness. The aim of this study was to determine whether there was a cyclical pattern in the occurrence of migraine/headache and motion sickness among crew members of a "round the world" yacht race. The participants were asked to complete pre- and postrace questionnaires that related to their susceptibility to motion sickness and headache/migraine; additionally, the female subjects were asked for details about their menstrual cycle. During the race the subjects completed a logbook to record the occurrence of motion sickness (using a four-point scale), migraine/headache (including the type of headache), menstruation, medication consumption and duties aboard the yacht. Female sailors were found to be more prone to motion sickness than the males. Motion sickness was also found to be linked to time at sea, and subjects who suffered migraine during the race were also more susceptible to motion sickness. A distinct pattern was found in the occurrence of motion sickness and headache that related to the menstrual cycle, although motion sickness and headache did not generally occur together in most of the subjects. A cyclical pattern was not obvious for the male subjects.

[These vestibular problems in the absence of gravity...].

PubMed

Timsit, C

1986-01-01

For a few years, more and more astronauts complain to endure space motion sickness during the two or three first days of their mission. This is due to the repetition of shifting and sudden head movements, which becomes possible by the increasing of volume of the new space stations. To avoid that payload specialists onboard be obliged to renounce to conduct planned experiments, it has been necessary to find effective solutions to detect by ground based tests the candidates sensitive to space motion sickness and perfect therapeutic means able to avoid unexpected arrival of these symptoms, and even to treat them. The best results are undeniably obtained by the "Biofeedback" and the "tolerance" training, but we base wide hopes on ginger roots and on tolerance with sensorial deprivation lockers. However, we must not disregard the trigger action of emotional factors and anxiety in space motion sickness. The European mission SPACELAB-1 has been marked by the display of a caloric nystagmus during the vestibular experiments in weightlessness. If no explanation is given to this phenomenon, it will be necessary to call in question the role of the thermal convection described by Barany in the appearance of the caloric nystagmus.

Supporting the establishment and maintenance of lactation for mothers of sick infants.

PubMed

Harris, Elaine

2014-12-01

Breastfeeding is the healthiest way for a woman to feed her infant. The World Health Organization/United Nations International Children's Emergency Fund ( 1989 ) launched the Baby-Friendly Hospital Initiative to protect, promote and support breastfeeding in maternity services. However, this initiative focuses on healthy and full-term infants. While it remains the role of the nurse in children's hospitals and neonatal/children's units to promote, protect and support mothers to breastfeed sick and premature infants, this is performed in an environment that incorporates the unexpected nature of these infants' sickness/prematurity. In children's hospitals and neonatal/children's units, breastfeeding is challenged by infant's illness, prematurity, fasting or maternal/infant separation, resulting in mothers expressing their milk for their infants to consume either through alternative routes immediately or freezing it for a later date. Furthermore, once clinically stable, these mothers and infants should be afforded the opportunity to safely and effectively transition from expressed breast milk to direct breastfeeding. For the purpose of this article, the infant population of children's hospitals and neonatal/children's units is comprised of either an infant transferred from a maternity unit at birth due to illness/prematurity or an infant admitted up to the age of one year.

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.

Maternal susceptibility to nausea and vomiting of pregnancy: is the vestibular system involved?

NASA Technical Reports Server (NTRS)

Black, F. Owen

2002-01-01

Nausea and vomiting of pregnancy shares many characteristics with motion sickness, a vestibular dependent phenomenon. A number of physiologic changes that occur in normal pregnancy are also known to accompany nausea and vomiting in patients with motion sickness and certain vestibular disorders. This chapter summarizes some shared features of both phenomena. The unmasking of subclinical vestibular disorders may account for some cases of hyperemesis gravidarum. Hormonal effects on neurotransmitter function may also play a role in nausea and vomiting of pregnancy and in some vestibular disorders; however, the specific neural mechanisms of nausea and vomiting have not been identified. Until the neurochemical processes underlying these phenomena are understood, prevention and management will remain in the domain of astute, but so far limited, clinical observation.

Role of orientation reference selection in motion sickness

NASA Technical Reports Server (NTRS)

Peterka, Robert J.; Black, F. Owen

1990-01-01

Three areas related to human orientation control are investigated: (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. This process is referred as sensory selection. This proposal will attempt to quantify subject's sensory selection abilities and determine if this ability confers some immunity to the development of motion sickness symptoms.

Was the real Sherlock Holmes a pediatric surgeon?

PubMed

Raffensperger, John

2010-07-01

This article reviews the pioneering efforts of Joseph Bell, the model for Sherlock Holmes, in the surgical care of children during the antiseptic era. I reviewed biographies of Sir Arthur Conan Doyle; the biography of Joseph Bell; his surgical textbook, Edinburgh Medical Journals; and the history of the Royal Edinburgh Hospital for Sick Children. Dr Bell was a colleague of Joseph Lister and one of the first surgeons to apply antiseptic methods to operations involving children. He was the surgeon appointed to the first surgical ward of the Royal Edinburgh Hospital for Sick Children; in that role, he cared for many children with surgical diseases. Dr Joseph Bell, by his compassion for children and his surgical skill, was indeed a pioneer pediatric surgeon. Copyright 2010 Elsevier Inc. All rights reserved.

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.

A Bright Side to the Work-Family Interface: Husbands' Support as a Resource in Double-and-Triple-Duty Caregiving Wives' Work Lives.

PubMed

DePasquale, Nicole; Polenick, Courtney A; Davis, Kelly D; Berkman, Lisa F; Cabot, Thomas D

2017-06-16

This study examined how women who combine long-term care employment with unpaid, informal caregiving roles for children (double-duty-child caregivers), older adults (double-duty-elder caregivers), and both children and older adults (triple-duty caregivers) differed from their workplace-only caregiving counterparts on workplace factors related to job retention (i.e., job satisfaction and turnover intentions) and performance (i.e., perceived obligation to work while sick and emotional exhaustion). The moderating effects of perceived spouse support were also examined. Regression analyses were conducted on survey data from 546 married, heterosexual women employed in U.S.-based nursing homes. Compared to workplace-only caregivers, double-duty-elder and triple-duty caregivers reported more emotional exhaustion. Double-duty-child caregivers reported lower turnover intentions and both double-and-triple-duty caregivers felt less obligated to work while sick when perceiving greater support from husbands. Results indicate that double-and-triple-duty caregiving women's job retention and obligation to work while sick may depend on perceived spouse support, highlighting the important role husbands play in their wives' professional lives. Findings also lend support to the emerging literature on marriage-to-work positive spillover, and suggest that long-term care organizations should target marital relationships in family-friendly initiatives to retain and engage double-and-triple-duty caregiving employees. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Identification of the role of the sports pharmacist with a model for the prediction of athletes' actions to cope with sickness.

PubMed

Yamaguchi, Takumi; Horio, Ikuo; Aoki, Ryouta; Yamashita, Noboru; Tanaka, Mamoru; Izushi, Fumio; Miyauchi, Yoshirou; Araki, Hiroaki

2013-01-01

In 2009, the Japan Anti-Doping Agency (JADA) established Sports Pharmacist-a system for certified pharmacists. There are many over-the-counter drugs that contain prohibited substances in Japan, and they are easily available. In Japan, most doping violations are committed when athletes unintentionally take prohibited substances. Therefore, the Sports Pharmacist has a vital role in promoting the prevention of doping. In the present study, surveys involving a total of 350 athletes, (including 260 representatives of Ehime Prefecture in the National Athletic Meets and 90 college students who participated in the intercollegiate athletics Shikoku area meets), on awareness regarding doping and medical drugs were conducted. Using correspondence and logistic regression analyses, the results were examined to develop a model for the prediction of athletes' actions to cope with sickness based on changes in their awareness of anti-doping, and the relationship between them was also analyzed. The survey results suggested that attitudes towards doping were strongly influenced by gender, rather than the athletic ability and whether or not a doping test is scheduled. Their behavior and criteria for the selection of drugs to address sickness were strongly correlated with awareness of anti-doping. Therefore, athletes with an increased awareness of anti-doping are expected to consult a pharmacist prior to using medicine. The Sports Pharmacist should further promote environmental development, such as activities to improve awareness of doping among young athletes and the establishment of medical drug consultation services for athletes (female athletes in particular).

Frequent fliers, school phobias, and the sick student: school health personnel's perceptions of students who refuse school.

PubMed

Torrens Armstrong, Anna M; McCormack Brown, Kelli R; Brindley, Roger; Coreil, Jeannine; McDermott, Robert J

2011-09-01

This study explored school personnel's perceptions of school refusal, as it has been described as a "common educational and public health problem" that is less tolerated due to increasing awareness of the potential socioeconomic consequences of this phenomenon. In-depth interviews were conducted with school personnel at the middle school (N = 42), high school (N = 40), and district levels (N = 10). The findings focus on emergent themes from interviews with school health personnel (N = 12), particularly those themes related to their perceptions of and role in working with school-refusing students. Personnel, especially school health services staff, constructed a typification of the school-refusing student as "the sick student," which conceptualized student refusal due to reasons related to illness. Personnel further delineated sick students by whether they considered the illness legitimate. School health personnel referenced the infamous "frequent fliers" and "school phobics" within this categorization of students. Overarching dynamics of this typification included parental control, parental awareness, student locus of control, blame, and victim status. These typifications influenced how personnel reacted to students they encountered, particularly in deciding which students need "help" versus "discipline," thus presenting implications for students and screening of students. Overall, findings suggest school health personnel play a pivotal role in screening students who are refusing school as well as keeping students in school, underscoring policy that supports an increased presence of school health personnel. Recommendations for school health, prevention, and early intervention include the development of screening protocols and staff training. © 2011, American School Health Association.

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.

Diagnosis and duration of sickness absence as predictors for disability pension: results from a three-year, multi-register based* and prospective study.

PubMed

Gjesdal, Sturla; Bratberg, Espen

2003-01-01

A study was undertaken to identify predictors for the transition from long-term sickness absence into disability pension with special emphasis on routinely collected medical information (e.g. diagnoses on sickness certificates) and the duration of sickness-absence spells. The study used a 10% random sample of the Norwegian population of working age (the KIRUT database). Individuals below 60 years of age, with spells of long-term sickness absence starting in 1990-91, where the medical diagnoses on the sickness certificates were known, were identified. This group (4,432 men and 5,645 women) was followed up for three years after the end of sickness absence with regard to disability pension and working status. In logistic regression the following predictors significantly increased the risk of obtaining disability pension during the first three years after the long-term sickness spell: age, part-time employment, and duration of absence > 197 days. Higher education and having children < 11 years significantly decreased the risk. Having the medical diagnoses "mental problems" and diseases in the nervous system, respiratory system, and circulatory systems indicated high risk (compared with musculoskeletal disease). The diagnostic groups "pregnancy-related disease" and "injuries" implied low risk for disability pension. In separate regressions for both genders the "protective effect" of having small children remained only for women. High risk for sickness absence caused by "mental problems" reached significance only for men. Several risk factors for transition from long-term sickness absence into disability pension were identified. The finding that spells of sickness absence with duration up to seven months did not imply increased risk of disability during the first three years may have implications for interventions aimed at long-term sickness absentees.

Age, occupational class and sickness absence during pregnancy: a retrospective analysis study of the Norwegian population registry

PubMed Central

Ariansen, Anja M S

2014-01-01

Objective Western women increasingly delay having children to advance their career, and pregnancy is considered to be riskier among older women. In Norway, this development surprisingly coincides with increased sickness absence among young pregnant women, rather than their older counterparts. This paper tests the hypothesis that young pregnant women have a higher number of sick days because this age group includes a higher proportion of working class women, who are more prone to sickness absence. Design A zero-inflated Poisson regression was conducted on the Norwegian population registry. Participants All pregnant employees giving birth in 2004–2008 were included in the study. A total number of 216 541 pregnancies were observed among 180 483 women. Outcome measure Number of sick days. Results Although the association between age and number of sick days was U-shaped, pregnant women in their early 20s had a higher number of sick days than those in their mid-40s. This was particularly the case for pregnant women with previous births. In this group, 20-year-olds had 12.6 more sick days than 45-year-olds; this age difference was reduced to 6.3 after control for class. Among women undergoing their first pregnancy, 20-year-olds initially had 1.2 more sick days than 45-year-olds, but control for class altered this age difference. After control for class, 45-year-old first-time pregnant women had 2.9 more sick days than 20-year-olds with corresponding characteristics. Conclusions The negative association between age and sickness absence was partly due to younger age groups including more working class women, who were more prone to sickness absence. Young pregnant women's needs for job adjustments should not be underestimated. PMID:24793246

[Predictors of the duration of non-work-related sick leave due to anxiety disorders].

PubMed

Catalina-Romero, Carlos; Martínez-Muñoz, Paloma; Quevedo-Aguado, Luis; Ruiz-Moraga, Montserrat; Fernández-Labandera, Carlos; Calvo-Bonacho, Eva

2013-01-01

To analyze the duration of non-work-related sick leave due to anxiety disorders and to identify demographic, occupational and clinical variables that may contribute to its prediction. We performed a prospective cohort study of 1,161 workers with an episode of non-work-related sick leave due to an anxiety disorder, belonging to the insured population of a mutual insurance company. We assessed the duration of non-work-related sick leave episodes and the main potentially related demographic, occupational and clinical variables. All non-work-related sick leave processes were followed-up until discharge. Cox regression analyses were conducted to establish the predictors of non-work-related sick leave duration. The median duration of non-work-related sick leave due to anxiety disorders was 83 days. In a multivariate analysis, the following factors were identified as being significantly associated with increases in the duration of sick leave (p <0.05): age of over 35 years, lower educational level (primary school studies, secondary school studies or high-school diploma vs. university degree), and the existence of comorbidity and unemployment occurring during the sick leave. In contrast, being separated or divorced was associated with an earlier return to work (p <0.05). Anxiety disorders are associated with long periods of non-work-related sick leave compared with other disorders and standard time duration. Demographic, occupational and clinical variables collected at the initial assessment of the sick leave episode would help to identify groups with an increased risk of prolonged sick leave, requiring strategies to facilitate return to work. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

[Some occupational determinants of work disability].

PubMed

Szubert, Z; Sobala, W

1999-01-01

Occupational determinants play a significant role in the studies of the causes of work disability. The duration of employment is that particular variable, frequently analysed, which reflects indirectly the effect of work conditions on the worker's health state and also on his her disease-related work disability. Therefore, the aim of this work was to show the difference in sick absenteeism between various occupational groups, depending on the duration of employment. The empirical material embraced data on work disability, among workers employed in the automative industry plant during the years 1989-94. Out of 8,599 persons covered with the study, 77% left the job, including 7% of those who left the job because of health problems. An analysis of the impact of occupational determinants on the sick absenteeism was carried out on the basis of the absenteeism rate adjusted by age, sex and occupational activity in groups of the production, auxilliary and administrative workers, as well as in occupational groups exposed to possibly similar harmful factors. The duration of worker's employment in the plant showed a positive influence on sick absenteeism, since together with extended period of employment the decrease in the rate of general sick absenteeism was observed. However, in a number of disease categories an increase in absenteeism together with extended duration of employment, and a high level of absenteeism among workers involved directly in the production, were noted. This proves an adverse effect of work conditions on work disability among workers. The effect of harmful factors present at workposts is also confirmed by the increasing sick absenteeism together with the prolonged duration of employment in various occupational groups. In the group of welders the highest level of sick absenteeism was observed among persons with duration of employment ranging from 11 to 20 years (rate: 10.52), and it was related to diseases of the respiratory (3.10) and circulatory (2.09) systems. In this group the increase in absenteeism together with prolonged duration of employment was related to diseases of the genitourinary system (about fourfold), musculoskeletal system (about threefold) and nervous system and sense organs (about 20%). It may be concluded that in selected high risk occupational groups, the duration of employment may reflect the effect of work conditions on workers' sick absenteeism, and the analysis of work disability caused by individual diseases provides an image of health effects due to hazards to which those groups are exposed.

Motion sickness in cats - A symptom rating scale used in laboratory and flight tests

NASA Technical Reports Server (NTRS)

Suri, K. B.; Daunton, N. G.; Crampton, G. H.

1979-01-01

The cat is proposed as a model for the study of motion and space sickness. Development of a scale for rating the motion sickness severity in the cat is described. The scale is used to evaluate an antimotion sickness drug, d-amphetamine plus scopolamine, and to determine whether it is possible to predict sickness susceptibility during parabolic flight, including zero-G maneuvers, from scores obtained during ground based trials.

Musculoskeletal impairments in the Norwegian working population: the prognostic role of diagnoses and socioeconomic status: a prospective study of sickness absence and transition to disability pension.

PubMed

Gjesdal, Sturla; Bratberg, Espen; Maeland, John Gunnar

2009-06-15

Population-based, 5-year prospective cohort study. To assess the incidence of musculoskeletal disorders (MSDs) in sickness absence longer than 8 weeks in Norway, and to identify diagnostic and socioeconomic predictors of the transition to disability pension (DP). MSDs are prevalent and of major concern for sickness absence. Previous epidemiological studies are largely cross-sectional and based on self-reports, often with low response rates, selection, and reporting bias. Prospective studies with physician-verified diagnoses might be a better approach. Thirty-seven thousand nine hundred forty-two females and 26,307 males with an episode of sickness absence >8 weeks in 1997, certified with a MSD were followed up for 5 years. Diagnostic and sociodemographic data were obtained from a national database. Cases were divided into 9 diagnostic subgroups, based on the International Classification of Primary Health Care. Survival analysis was performed with granting of DP as the endpoint, in the full sample and for diagnostic subgroups. Over all 20% of cases obtained DP during follow-up. Among those aged 50 to 62 and among those with only basic education 46% obtained DP. DP rates were highest for osteoarthrosis (47%), rheumatoid arthritis (46%), and myalgia/fibromyalgia (38%). Fractures/injuries had the lowest rate. Controlled for age, education and income, relative risk of DP was 1.5 (95% CI: 1.4-1.6) for upper limb problems, 2.0 (95% CI: 1.8-2.1) for back problems, 2.8 (95% CI: 2.5-3.1) for osteoarthrosis, 3.3 (95% CI: 3.0-3.6) for myalgia/fibromyalgia, and 4.2 (95% CI: 3.9-4.7) for rheumatoid arthritis, compared to "fractures and injuries." Age, diagnoses, and socioeconomic variables were important predictors of an adverse outcome among workers with a sickness absence of 8 or more weeks. Further research is needed to determine whether differentiated follow-up strategies might prevent permanent disability.

Ascending caudal medullary catecholamine pathways drive sickness-induced deficits in exploratory behavior: brain substrates for fatigue?

PubMed

Gaykema, Ronald P A; Goehler, Lisa E

2011-03-01

Immune challenges can lead to marked behavioral changes, including fatigue, reduced social interest, anorexia, and somnolence, but the precise neuronal mechanisms that underlie sickness behavior remain elusive. Part of the neurocircuitry influencing behavior associated with illness likely includes viscerosensory nuclei located in the caudal brainstem, based on findings that inactivation of the dorsal vagal complex (DVC) can prevent social withdrawal. These brainstem nuclei contribute multiple neuronal projections that target different components of autonomic and stress-related neurocircuitry. In particular, catecholaminergic neurons in the ventrolateral medulla (VLM) and DVC target the hypothalamus and drive neuroendocrine responses to immune challenge, but their particular role in sickness behavior is not known. To test whether this catecholamine pathway also mediates sickness behavior, we compared effects of DVC inactivation with targeted lesion of the catecholamine pathway on exploratory behavior, which provides an index of motivation and fatigue, and associated patterns of brain activation assessed by immunohistochemical detection of c-Fos protein. LPS treatment dramatically reduced exploratory behavior, and produced a pattern of increased c-Fos expression in brain regions associated with stress and autonomic adjustments paraventricular hypothalamus (PVN), bed nucleus of the stria terminalis (BST), central amygdala (CEA), whereas activation was reduced in regions involved in exploratory behavior (hippocampus, dorsal striatum, ventral tuberomammillary nucleus, and ventral tegmental area). Both DVC inactivation and catecholamine lesion prevented reductions in exploratory behavior and completely blocked the inhibitory LPS effects on c-Fos expression in the behavior-associated regions. In contrast, LPS-induced activation in the CEA and BST was inhibited by DVC inactivation but not by catecholamine lesion. The findings support the idea that parallel pathways from immune-sensory caudal brainstem sources target distinct populations of forebrain neurons that likely mediate different aspects of sickness. The caudal medullary catecholaminergic projections to the hypothalamus may significantly contribute to brain mechanisms that induce behavioral "fatigue" in the context of physiological stressors. Copyright © 2010 Elsevier Inc. All rights reserved.

Ascending caudal medullary catecholamine pathways drive sickness-induced deficits in exploratory behavior: brain substrates for fatigue?

PubMed Central

Gaykema, Ronald P.A.; Goehler, Lisa E.

2010-01-01

Immune challenges can lead to marked behavioral changes, including fatigue, reduced social interest, anorexia, and somnolence, but the precise neuronal mechanisms that underlie sickness behavior remain elusive. Part of the neurocircuitry influencing behavior associated with illness likely includes viscerosensory nuclei located in the caudal brainstem, based on findings that inactivation of the dorsal vagal complex (DVC) can prevent social withdrawal. These brainstem nuclei contribute multiple neuronal projections that target different components of autonomic and stress-related neurocircuitry. In particular, catecholaminergic neurons in the ventrolateral medulla (VLM) and DVC target the hypothalamus and drive neuroendocrine responses to immune challenge, but their particular role in sickness behavior is not known. To test whether this catecholamine pathway also mediates sickness behavior, we compared effects of DVC inactivation with targeted lesion of the catecholamine pathway on exploratory behavior, which provides an index of motivation and fatigue, and associated patterns of brain activation assessed by immunohistochemical detection of c-Fos protein. LPS treatment dramatically reduced exploratory behavior, and produced a pattern of increased c-Fos expression in brain regions associated with stress and autonomic adjustments paraventricular hypothalamus (PVN), bed nucleus of the stria terminalis (BST), central amygdala (CEA), whereas activation was reduced in regions involved in exploratory behavior (hippocampus, dorsal striatum, ventral tuberomammillary nucleus, and ventral tegmental area). Both DVC inactivation and catecholamine lesion prevented reductions in exploratory behavior and completely blocked the inhibitory LPS effects on c-Fos expression in the behavior-associated regions. In contrast, LPS-induced activation in the CEA and BST was inhibited by DVC inactivation but not by catecholamine lesion. The findings support the idea that parallel pathways from immune-sensory caudal brainstem sources target distinct populations of forebrain neurons that likely mediate different aspects of sickness. The caudal medullary catecholaminergic projections to the hypothalamus may significantly contribute to brain mechanisms that induce behavioral “fatigue” in the context of physiological stressors. PMID:21075199

Investigating motion sickness using the conditioned taste aversion paradigm

NASA Technical Reports Server (NTRS)

Fox, Robert A.

1991-01-01

The avoidance of foods which are associated with uncomfortable or aversive internal states has long been recognized. Many people are aware, either directly or via anecdotal reports, of individuals who avoid foods which were eaten just before the onset of sickness. Awareness of this phenomenon can be traced to the writings of John Locke. The disruption of diet during cancer therapy is sometimes ascribed to the attribution of an unpleasant quality to foods eaten preceding the sickness induced by therapy itself. In addition, it has long been recognized by the manufacturers of rodent poisons that animals avoid the injection of food treated with nonlethal doses of poison. An important part of the laboratory study of this phenomenon was directed toward studying the role learning plays in this type of avoidance behavior. Following the lead of Garcia and his associates, this avoidance has come to be interpreted as arising from a form of classical conditioning. In typical laboratory studies of this bahavior, a novel food is ingested just prior to exposure to some stimulus, commonly poisoning or irradiation, which produces illness. Following the terminology of classical conditioning, it is common to describe this procedure as one of 'pairing' a conditioned stimulus (CS), the novel food, with an unconditioned stimulus (US), the illness induced by toxicosis or irradiation. Avoidance of the food in succeeding feeding opportunities is viewed as a learned response or a conditioned taste aversion (CTA). Garcia et al. asserted that motion sickness could produce 'gustatory' aversions, but passive motion was first reported as an US to establish CTA by Green and Rachlin. The purpose is to review the manner in which CTA has been used to study motion sickness. Numerous reviews concentrating on other aspects of CTA are available in the existing literature. Readers are encouraged to consult the various papers and edited books for extensive information on other aspects of this literature.

Sickness absence patterns and trends in the health care sector: 5-year monitoring of female municipal employees in the health and care sectors in Norway and Denmark

PubMed Central

2014-01-01

Background Sickness absence is a growing public health problem in Norway and Denmark, with the highest absence rates being registered in Norway. We compared time trends in sickness absence patterns of municipal employees in the health and care sectors in Norway and Denmark. Methods Data from 2004 to 2008 were extracted from the personnel registers of the municipalities of Kristiansand, Norway, and Aarhus, Denmark, for 3,181 and 8,545 female employees, respectively. Age-specific comparative statistics on sickness absence rates (number of calendar days of sickness absence/possible working days) and number of sick leave episodes were calculated for each year of the study period. Results There was an overall increasing trend in sickness absence rates in Denmark (P = 0.002), where rates were highest in the 20–29- (P = 0.01) and 50–59-year-old age groups (P = 0.03). Sickness absence rates in Norway were stable, except for an increase in the 20–29-year-old age group (P = 0.004). In both Norway and Denmark, the mean number of sick leave episodes increased (P <0.0001 and P <0.0001, respectively) in all age groups except for the 30–39- and 60–67-year-old age groups. The proportion of employees without sickness absence was higher in Norway than in Denmark. Both short-term and long-term absence increased in Denmark (P = 0.003 and P <0.0001, respectively), while in Norway, only short-term absence increased (P = 0.09). Conclusions We found an overall increase in sickness absence rates in Denmark, while the largest overall increase in sick leave episodes was found in Norway. In both countries, the largest increases were observed among young employees. The results indicate that the two countries are converging in regard to sickness absence measured as rates and episodes. PMID:25005027

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.

Swedish Council on Technology Assessment in Health Care (SBU). Chapter 6. Sickness absence due to back and neck disorders.

PubMed

Hansson, Tommy; Jensen, Irene

2004-01-01

The scientific evidence on the causes for sick leave attributed to back and neck disorders was reviewed. Categories were established for acute, recurring, and chronic problems based on the duration of the sick leave period. Forty-eight articles were found to be relevant, whereof two were of high quality and 26 were of medium or low quality. Quality was assessed exclusively in relation to the aim of this systematic review. The results reveal limited published research on causes for sick leave from back and neck disorders. The generalisability of the findings is also limited since most of the subjects were men and employees in manufacturing industries. Women, white-collar workers, employees in the public sector (care, social services, schools, etc) were underrepresented in the studies. Hence, these groups and areas should be studied further to verify conclusions and enhance knowledge about the causes for sick leave from back and neck disorders. The following factors were found to have consistent, but limited, support as regards their influence on the risk for sick leave due to back and neck disorders: (a) heavy physical workload, bent or twisted working position, and low work satisfaction increases the risk for short-term and long-term sick leave; (b) specific back diagnoses and previous sick leave due to back disorders increases the risk for short-term and long-term sick leave; (c) female gender, smoking, exposure to vibration, and deficient social support were not found to significantly increase the risk for short-term and long-term sick leave; (d) self-reported pain and functional impairments were associated with a high risk for long-term sick leave; (e) longer employment periods reduced the risk for short-term sick leave; (f) perceived demands at work did not influence short-term sick leave; (g) female gender and higher age increases the risk for disability pension.

Burnout as a predictor of self-reported sickness absence among human service workers: prospective findings from three year follow up of the PUMA study.

PubMed

Borritz, M; Rugulies, R; Christensen, K B; Villadsen, E; Kristensen, T S

2006-02-01

To investigate whether burnout predicts sickness absence days and sickness absence spells in human service workers. A total of 824 participants from an ongoing prospective study in different human service sector organisations were eligible for the three year follow up analysis. Burnout was measured with the work related burnout scale of the Copenhagen Burnout Inventory. Sickness absence was measured with self-reported number of days and spells during the last 12 months before the baseline and the follow up survey. A Poisson regression model with a scale parameter was used to account for over dispersion. A linear regression model was used for analysing changes in burnout and absence between baseline and follow up. Burnout was prospectively associated with both sickness absence days and sickness absence spells per year. Differences in sickness absence days varied from a mean of 5.4 days per year in the lowest quartile of the work related burnout scale to a mean of 13.6 in the highest quartile. An increase of one standard deviation on the work related burnout scale predicted an increase of 21% in sickness absence days per year (rate ratio 1.21, 95% CI 1.11 to 1.32) after adjusting for gender, age, organisation, socioeconomic status, lifestyle factors, family status, having children under 7 years of age, and prevalence of diseases. Regarding sickness absence spells, an increase of one standard deviation on the work related burnout scale predicted an increase of 9% per year (rate ratio 1.09, 95% CI 1.02 to 1.17). Changes in burnout level from baseline to follow up were positively associated with changes in sickness absence days (estimate 1.94 days/year, SE 0.63) and sickness absence spell (estimate 0.34 spells/year, SE 0.08). The findings indicate that burnout predicts sickness absence. Reducing burnout is likely to reduce sickness absence.

Microbe Phobia and Kitchen Microbiology.

ERIC Educational Resources Information Center

Williams, Robert P.; Gillen, Alan L.

1991-01-01

The authors present an exercise designed to help students overcome the misconception that most microbes make people sick. The activity helps students of all ages understand the important benefits of microbes such as in making bread, soy sauce, cheese, and wine. The role of microorganisms in processing cocoa and coffee and growing plants is also…

Child and Parent Attributions in Chronic Pediatric Conditions: Phenylketonuria (PKU) as an Exemplar

ERIC Educational Resources Information Center

Antshel, Kevin M.; Brewster, Scott; Waisbren, Susan E.

2004-01-01

Background: Attribution theory, self-regulation, self-handicapping and sick role theories all suggest that children with chronic disease may be held to different standards. This study assesses child and parent attributions in pediatric chronic health conditions and addresses how attributional style may be related to treatment adherence. Methods:…

The Critical Role of Teacher Incentives in the Northeast States.

ERIC Educational Resources Information Center

Title, David

This paper discusses a variety of incentives that can make a difference in attracting and retaining high quality teachers. These incentives include salaries, retirement benefits, working conditions, quality of life, tenure and seniority rights, and sick leave. The states in the Northeast vary considerably in their ability to attract quality…

When the patient is your mum.

PubMed

Trueland, Jennifer

Having a sick relative can be particularly stressful when you are a nurse, as the expectation that you will 'take charge' comes into conflict with the need to be reassured like any other relative. This article examines the tension between these roles, and provides advice for 'nurse family members' and the nursing teams who encounter them.

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.

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.

The impact of effort-reward imbalance and learning motivation on teachers' sickness absence.

PubMed

Derycke, Hanne; Vlerick, Peter; Van de Ven, Bart; Rots, Isabel; Clays, Els

2013-02-01

The aim of this study was to analyse the impact of the effort-reward imbalance and learning motivation on sickness absence duration and sickness absence frequency among beginning teachers in Flanders (Belgium). A total of 603 teachers, who recently graduated, participated in this study. Effort-reward imbalance and learning motivation were assessed by means of self-administered questionnaires. Prospective data of registered sickness absence during 12 months follow-up were collected. Multivariate logistic regression analyses were performed. An imbalance between high efforts and low rewards (extrinsic hypothesis) was associated with longer sickness absence duration and more frequent absences. A low level of learning motivation (intrinsic hypothesis) was not associated with longer sickness absence duration but was significantly positively associated with sickness absence frequency. No significant results were obtained for the interaction hypothesis between imbalance and learning motivation. Further research is needed to deepen our understanding of the impact of psychosocial work conditions and personal resources on both sickness absence duration and frequency. Specifically, attention could be given to optimizing or reducing efforts spent at work, increasing rewards and stimulating learning motivation to influence sickness absence. Copyright © 2012 John Wiley & Sons, Ltd.

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

Postural time-to-contact as a precursor of visually induced motion sickness.

PubMed

Li, Ruixuan; Walter, Hannah; Curry, Christopher; Rath, Ruth; Peterson, Nicolette; Stoffregen, Thomas A

2018-06-01

The postural instability theory of motion sickness predicts that subjective symptoms of motion sickness will be preceded by unstable control of posture. In previous studies, this prediction has been confirmed with measures of the spatial magnitude and the temporal dynamics of postural activity. In the present study, we examine whether precursors of visually induced motion sickness might exist in postural time-to-contact, a measure of postural activity that is related to the risk of falling. Standing participants were exposed to oscillating visual motion stimuli in a standard laboratory protocol. Both before and during exposure to visual motion stimuli, we monitored the kinematics of the body's center of pressure. We predicted that postural activity would differ between participants who reported motion sickness and those who did not, and that these differences would exist before participants experienced subjective symptoms of motion sickness. During exposure to visual motion stimuli, the multifractality of sway differed between the Well and Sick groups. Postural time-to-contact differed between the Well and Sick groups during exposure to visual motion stimuli, but also before exposure to any motion stimuli. The results provide a qualitatively new type of support for the postural instability theory of motion sickness.

Sickness absence in the private sector of Greece: comparing shipyard industry and national insurance data.

PubMed

Alexopoulos, Evangelos C; Merekoulias, Georgios; Tanagra, Dimitra; Konstantinou, Eleni C; Mikelatou, Efi; Jelastopulu, Eleni

2012-04-01

Approximately 3% of employees are absent from work due to illness daily in Europe, while in some countries sickness absence exceeds 20 days per year. Based on a limited body of reliable studies, Greek employees in the private sector seem to be absent far less frequently (<5 days/year) compared to most of the industrialized world. The aim of this study was to estimate the levels of sickness absence in the private sector in Greece, using shipyard and national insurance data. Detailed data on absenteeism of employees in a large shipyard company during the period 1999-2006 were utilized. National data on compensated days due to sickness absence concerning all employees (around 2 million) insured by the Social Insurance Institute (IKA, the largest insurance scheme in Greece) were retrieved from the Institute's annual statistical reports for the period 1987-2006. Sick-leave days per employee and sick-leave rate (%) were calculated, among other indicators. In the shipyard cohort, the employment time loss due to sick leave was 1%. The mean number of sick-leave days per employee in shipyards ranged between 4.6 and 8.7 and sick-leave rate (sickness absenteeism rate) varied among 2% and 3.7%. The corresponding indicators for IKA were estimated between 5 and 6.3 sick-leave days per insured employee (median 5.8), and 2.14-2.72% (median 2.49%), respectively. Short sick-leave spells (<4 days) may account at least for the 25% of the total number of sick-leave days, currently not recorded in national statistics. The level of sickness absence in the private sector in Greece was found to be higher than the suggested by previous reports and international comparative studies, but still remains one of the lowest in the industrialized world. In the 20-years national data, the results also showed a 7-year wave in sickness absence indexes (a decrease during the period 1991-1997 and an increase in 1998-2004) combined with a small yet significant decline as a general trend. These observations deserve detailed monitoring and could only partly be attributed to the compensation and unemployment rates in Greece so other possible reasons should be explored.

Sickness Absence in the Private Sector of Greece: Comparing Shipyard Industry and National Insurance Data

PubMed Central

Alexopoulos, Evangelos C.; Merekoulias, Georgios; Tanagra, Dimitra; Konstantinou, Eleni C.; Mikelatou, Efi; Jelastopulu, Eleni

2012-01-01

Approximately 3% of employees are absent from work due to illness daily in Europe, while in some countries sickness absence exceeds 20 days per year. Based on a limited body of reliable studies, Greek employees in the private sector seem to be absent far less frequently (<5 days/year) compared to most of the industrialized world. The aim of this study was to estimate the levels of sickness absence in the private sector in Greece, using shipyard and national insurance data. Detailed data on absenteeism of employees in a large shipyard company during the period 1999–2006 were utilized. National data on compensated days due to sickness absence concerning all employees (around 2 million) insured by the Social Insurance Institute (IKA, the largest insurance scheme in Greece) were retrieved from the Institute’s annual statistical reports for the period 1987–2006. Sick-leave days per employee and sick-leave rate (%) were calculated, among other indicators. In the shipyard cohort, the employment time loss due to sick leave was 1%. The mean number of sick-leave days per employee in shipyards ranged between 4.6 and 8.7 and sick-leave rate (sickness absenteeism rate) varied among 2% and 3.7%. The corresponding indicators for IKA were estimated between 5 and 6.3 sick-leave days per insured employee (median 5.8), and 2.14–2.72% (median 2.49%), respectively. Short sick-leave spells (<4 days) may account at least for the 25% of the total number of sick-leave days, currently not recorded in national statistics. The level of sickness absence in the private sector in Greece was found to be higher than the suggested by previous reports and international comparative studies, but still remains one of the lowest in the industrialized world. In the 20-years national data, the results also showed a 7-year wave in sickness absence indexes (a decrease during the period 1991–1997 and an increase in 1998–2004) combined with a small yet significant decline as a general trend. These observations deserve detailed monitoring and could only partly be attributed to the compensation and unemployment rates in Greece so other possible reasons should be explored. PMID:22690189

20 CFR 323.2 - Definition of nongovernmental plan for unemployment or sickness insurance.

Code of Federal Regulations, 2010 CFR

2010-04-01

... unemployment or sickness insurance. 323.2 Section 323.2 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.2 Definition of nongovernmental plan for unemployment or sickness insurance. A...

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 323.2 - Definition of nongovernmental plan for unemployment or sickness insurance.

Code of Federal Regulations, 2014 CFR

2014-04-01

... unemployment or sickness insurance. 323.2 Section 323.2 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.2 Definition of nongovernmental plan for unemployment or sickness insurance. A...

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 323.2 - Definition of nongovernmental plan for unemployment or sickness insurance.

Code of Federal Regulations, 2011 CFR

2011-04-01

... unemployment or sickness insurance. 323.2 Section 323.2 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.2 Definition of nongovernmental plan for unemployment or sickness insurance. A...

20 CFR 323.2 - Definition of nongovernmental plan for unemployment or sickness insurance.

Code of Federal Regulations, 2013 CFR

2013-04-01

... unemployment or sickness insurance. 323.2 Section 323.2 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.2 Definition of nongovernmental plan for unemployment or sickness insurance. A...

20 CFR 323.2 - Definition of nongovernmental plan for unemployment or sickness insurance.

Code of Federal Regulations, 2012 CFR

2012-04-01

... unemployment or sickness insurance. 323.2 Section 323.2 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.2 Definition of nongovernmental plan for unemployment or sickness insurance. A...

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...

What you thought you knew about motion sickness isn't necessarily so

NASA Technical Reports Server (NTRS)

Cowings, P. S.; Malmstrom, F. V.

1984-01-01

Motion sickness symptoms, stimuli, and drug therapy are discussed. Autogenic feedback training (AFT) methods of preventing motion sickness are explained. Research with AFT indicates that participants who had AFT could withstand longer periods of Coriolis acceleration, participants with high or low susceptibility to motion sickness could control their symptoms with AFT, AFT for Coriolis acceleration is transferable to other motion sickness stimuli, and most people can learn AFT, though with varying rates of learning.

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.

Sick leave before and after the age of 65 years among those in paid work in Sweden in 2000 or 2005: a register-based cohort study.

PubMed

Farrants, Kristin; Kjeldgård, Linnea; Marklund, Staffan; Head, Jenny; Alexanderson, Kristina

2018-02-01

Objective With pressure for older people to remain in work, research is needed on how people aged over 65 years fare in the labour market. However, few studies have focused on sick leave among older workers, especially those over the standard retirement age. This study investigated changes in sick-leave patterns among people aged over 65 years still in work. Methods All individuals in Sweden who turned 65 years old in 2000 or 2005 were followed from 1995 to 2010. The mean number of sick-leave days per year was measured for those who remained in paid work past the age of 65 years. Results Those over 65 years still working had fewer sick-leave days before the age of 65 years than those who retired. They also had fewer sick-leave days after 65 years than before. There were fewer socioeconomic differences after 65 years than before, but these differences were greater for workers over 65 years in the 2005 cohort. Conclusions Although there were more people over 65 years in paid work in 2005, sick-leave days and socioeconomic differences in sick leave were lower in this age group. Sick-leave days and socioeconomic differences in sick leave were greater in the 2005 cohort.

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.

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

[Greenhouse gardeners and sickness absence. A questionnaire study among greenhouse gardeners in Aarhus region].

PubMed

Pallesen, Ellen; Nielsen, Claus Vinther; Drews, Birgit Mammen

2007-02-26

The aim of the study was to examine sickness absence and risk factors for sickness absence in a population of greenhouse gardeners in the county of Arhus. The study was cross sectional and based on data from questionnaires sent to all employees and greenhouse gardens in the county. Greenhouse gardeners had an average of four days of sickness absence a year. Self-rated health was poorer than average of the Danish population in general. Female gender, age below 40 years, troublesome relationships to family and friends, "poor" physical working environment and job insecurity were all predictors for increased risk of sickness absence lasting more than two weeks a year. Sickness absence was low compared to the average of the Danish labour market. Considering poorer self-rated health and frequent occurrence of some of the above-mentioned predictors for increased risk of sickness absence--female gender, age below 40 years and for women, high exposure to "poor" physical working environment--an average sickness absence of only four days was a puzzle. The data from the study were not sufficient to explain this paradox. It might be due to compensating factors at work or at a personal level. It might be due to information bias, as sickness absence could be underestimated, but agreement between reported sickness absence from employees and greenhouse gardens diminished that probability. It might have been a consequence of selection bias, the "healthy workers'" effect. Employees with considerable sickness absence might have been dismissed for long-term absence or might have quit the job because they were not able to cope with it.

Long-term sick leave and its risk factors during pregnancy among Danish hospital employees.

PubMed

Kaerlev, Linda; Jacobsen, Lene B; Olsen, Jørn; Bonde, Jens Peter

2004-01-01

The authors sought to describe risk indicators of long-term sick leave during pregnancy among hospital employees. A register-based study was undertaken of 4,852 female hospital employees aged 20-45 years from the second largest hospital in Denmark during 1995-99 based on job titles, working time, sick leave, and births combined with a survey among a total of 773 women who had been pregnant during their employment (response rate 85%). Altogether 236 (31%) were on sick leave for at least 10% of their scheduled work time during their latest pregnancy and 169 (22%) had been absent at least 20% of the time. The pregnant women had an average sickness absence of 6.1 days per month, non-pregnant women 0.95 days per month. Sick leave was more frequent in late than in early gestation. Women employed as nursing aides or hospital orderlies, launderers, and nurses had more sick leave days than other hospital employees. Part-time work, previous sickness absence not related to pregnancy, and previous chronic back pain were risk factors for long-term sick leave as were much walking or standing, long working days, high work level, little practical support from supervisors and colleagues, low job control, much lifting and night or shift work. Sick leave was unrelated to family size, support from the family and number of working years. Long-term sick leave during pregnancy was frequent and to some extent predictable. Efforts should be made to organize work for pregnant women in a manner that optimizes their health and well-being.

Sickness presenteeism: The prevalence of coming to work while ill among paediatric resident physicians in Canada

PubMed Central

Vayalumkal, Joseph V.

2017-01-01

Abstract Background: Sickness presenteeism is defined as the act of attending one’s job despite ill-health. Recently, physicians and other health care workers have become the focus of sickness presenteeism research, because presenteeism in this population can put patients at risk of infection. There are currently no data on this topic among physicians in Canada. The aim of this study was to investigate sickness presenteeism in paediatric resident physicians in Canada. Methods: We conducted an anonymous, online, cross-sectional survey study in which all paediatric residents in Canada were eligible. Outcomes of interest included prevalences of sickness presenteeism, sickness during the study period and voluntary self-appointed personal protective equipment use when engaging in sickness presenteeism. Results: Response rate was 56.5% (N=323). During the previous 2 months, 61% (95% confidence interval [CI] 55.7 to 66.3) of respondents reported having experienced an illness and 59% (95% CI 53.7 to 64.5) of respondents had come to work sick. Of those who reported becoming ill during the study period, 97.0% (95% CI 94.6 to 99.4) reported coming to work while sick. There was no difference in prevalence when comparing across post-graduate year training levels. Extra personal protective equipment was used by 86% (95% CI 82.1 to 91.7) when engaging in sickness presenteeism. Conclusion: Sickness presenteeism is a common phenomenon among paediatric resident physicians. Our results should influence residents and supervising staff physicians to encourage appropriate self-care at home, rather than presenteeism. PMID:29479187

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.

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.

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.

Approaches for predicting long-term sickness absence. Re: Schouten et al. "Screening manual and office workers for risk of long-term sickness absence: cut-off points for the Work Ability Index".

PubMed

van Amelsvoort, Ludovic Gpm; Jansen, Nicole W H; Kant, I Jmert

2015-05-01

We read with much interest the article of Schouten et al (1) on identifying workers with a high risk for future long-term sickness absence using the Work Ability Index (WAI). The ability to identify high-risk workers might facilitate targeted interventions for such workers and, consequently, can reduce sickness absence levels and improve workers' health. Earlier studies by both Tamela et al (2), Kant et al (3), and Lexis et al (4) have demonstrated that such an approach, based on the identification of high-risk workers and a subsequent intervention, can be effectively applied in practice to reduce sickness absence significantly. The reason for our letter on Schouten et al's article is twofold. First, by including workers already on sick leave in a study predicting long-term sick leave will result in an overestimation of the predictive properties of the instrument and biased predictors, especially when also the outcome of interest is included as a factor in the prediction model. Second, we object to the use of the term "screening" when subjects with the condition screened for are included in the study. Reinforced by the inclusion of sickness absence in the prediction model, including workers already on sick leave will shift the focus of the study findings towards the prediction of (re)current sickness absence and workers with a below-average return-to-work rate, rather than the identification of workers at high risk for the onset of future long-term sickness absence. The possibilities for prevention will shift from pure secondary prevention to a mix of secondary and tertiary prevention. As a consequence, the predictors of the model presented in the Schouten et al article can be used as a basis for tailoring neither preventive measures nor interventions. Moreover, including the outcome (sickness absence) as a predictor in the model, especially in a mixed population including workers with and without the condition (on sick leave), will result in biased predictors and an overestimation of the predictive value. A methodological approach of related issues is provided in the works of Glymour et al (5) and Hamilton et al (6). This phenomenon is even more clearly illustrated by the predictive properties of the workability index, as described by Alavinia et al (7, page 328), which reported that "when adjusted for individual characteristics, lifestyle factors, and work characteristics, two dimensions of the WAI were significant predictors for both moderate and long durations of sickness absence: (i) the presence of sickness absence in the past 12 months prior to the medical examination and (ii) experienced limitations due to health problems." So, when applied to the study by Schouten et al (1), this means that most of the predictive value would be related to the factors "sickness absence in the past 12 months". In addition, we object to the use of the term "screening" in the Schouten et al study as it includes workers with the intended outcome (long-term sickness absence). One can identify three separate aims to study the longitudinal association between risk factors and subsequent long-term sickness absence: (i) to establish causal risk factors for long-term sickness absence, often to find clues for primary preventive strategies (beyond the scope here); (ii) to identify high-risk workers who are still at work and might benefit from an intervention before sickness absence occurs (secondary prevention); and (iii) to identify workers on sick leave who might suffer a below-average return-to-work rate or have a high risk for the recurrence of (long-term) sickness absence and might benefit from intensification or optimization of the return-to-work process (tertiary prevention). In this light, one needs to separate screening instruments from predictive instruments and reserve the term "screening" for the situation as defined by Wilson and Junger (8, page 7): "The object of screening for disease is to discover those among the apparently well who are in fact suffering from disease" (ie, situations of secondary prevention). This means that, when applying this definition on long-term sickness absence under the precondition that the individuals are still at work, screening enables the identification of high-risk individuals in the early "stages" of a "disease" that can progress into long-term sickness absence. In the case of the Schouten et al study, the population at risk, as derived from their predictive instrument, consists of workers with and without sickness absence, and as such excludes the use of the term "screening" in this case. To conclude, we have substantiated that, in addition to correct usage of the term "screening", careful selection of the study population, predictors and most importantly the aim of the predictive model are essential in the process of developing predictive instruments aimed at identifying workers at high risk of long-term sickness absence. Two fundamentally different approaches are possible. One approach aims at identifying workers on sick leave with either a below-average chance to return to work an/or a high risk for a successive episode of long-term sickness absence. From a methodological and practical point of view, such an instrument should be developed and validated among workers already on sick leave. A second approach aims at identifying workers who are still at work but at high risk for future long-term sickness absence. To develop and validate such an instrument, a study sample where workers already on sick leave are excluded is a prerequisite. Such instruments fit in a pro-active approach of preventing future sickness absence, where an early intervention can be offered to those workers with an increased risk for future sickness absence.

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...

The 'cultural inflation of morbidity' during the English mortality decline: a new look.

PubMed

Gorsky, Martin; Guntupalli, Aravinda; Harris, Bernard; Hinde, Andrew

2011-12-01

This article contributes to the debate about using insurance records to reconstruct historical experiences of sickness during the Western mortality transition. Critics regard these sources as problematic as they measure morbidity indirectly through absences from work; these might be determined not by timeless biological criteria but by more contingent factors, notably shifting norms surrounding the sick role and responses to economic incentives (for which we adopt the generic term 'cultural inflation of morbidity'). We review historical demographers' contributions to this literature and discuss the concepts of moral hazard and the principal/agent problem as developed by health economists. This leads us to frame three empirical tests for 'cultural inflation' which allow us to assess the validity of insurance records for deriving morbidity trends: was there an increasing frequency of claims for complaints of diminishing severity; were unduly prolonged claims noticeable, particularly by older people for whom sickness benefit may have compensated for income insecurity; and did the insurer satisfactorily manage the agency problem to ensure reliable physician gatekeeping? We analyse records of the Hampshire Friendly Society, an exceptionally well-documented fund operational in Southern England, 1825-1989. Findings are based on a dataset of individual sickness histories of a sample of 5552 men and on qualitative documentary analysis of administrative records. On each count our results fail to demonstrate a cultural inflation of morbidity, except perhaps for those aged over 65. However, occasional discussion in the administrative records of economic incentives encouraging unnecessary prolongation of claims means we cannot rule it out entirely. Copyright © 2011 Elsevier Ltd. All rights reserved.

Relationships of organizational social capital with the presence of "gossip and slander," "quarrels and conflicts," sick leave, and poor work ability in nursing homes.

PubMed

Kiss, Philippe; De Meester, Marc; Kristensen, Tage S; Braeckman, Lutgart

2014-11-01

This study aimed to explore the associations of organizational social capital (OSC) with the presence of "gossip and slander," the presence of "conflicts and quarrels," sick leave prevalence, and prevalence of poor work ability in frontline working personnel of nursing homes. A total of 239 subjects (81 % participation), working in 11 different nursing homes, took part in a cross-sectional questionnaire study. Following end points were considered, they are as follows: prevalence of "gossip and slander," "conflicts and quarrels," sick leave, and poor work ability. Associations with OSC were explored at individual level (binomial log-linear regression analysis) and on group level (Kendall's tau correlation coefficients). Significant associations were found between OSC and "gossip and slander," sick leave, and poor work ability, both in the individual- and group-level analyses. The associations showed a higher significance level in the group-level analyses, with the strongest association found between mean OSC of the workplace and the prevalence of poor work ability at the workplace (τ = -0.722; p = 0.002). This study demonstrated significant associations of OSC with three end points that are relevant within the framework of well-being at work in nursing homes. The results are suggestive that OSC should be treated as a characteristic of the entire workplace, rather than as an individually experienced characteristic. The strikingly strong association between OSC and prevalence of poor work ability is suggestive for an important role of OSC within the context of maintaining work ability.

Animal Husbandry Practices and Perceptions of Zoonotic Infectious Disease Risks among Livestock Keepers in a Rural Parish of Quito, Ecuador

PubMed Central

Lowenstein, Christopher; Waters, William F.; Roess, Amira; Leibler, Jessica H.; Graham, Jay P.

2016-01-01

Small-scale livestock production plays an essential role as a source of income and nutrition for households in low- and middle-income countries, yet these practices can also increase risk of zoonotic infectious diseases, especially among young children. To mitigate this risk, there is a need to better understand how livestock producers perceive and manage risks of disease transmission. Twenty semistructured, in-depth interviews were conducted with small-scale livestock producers in a semirural parish of Quito, Ecuador. Interviews explored livestock-raising practices, including animal health-care practices and use of antimicrobials, family members' interactions with livestock and other animals, and perceptions of health risk associated with these practices and activities. Interviews were analyzed for common themes. Awareness of zoonotic disease transmission was widespread, yet few study participants considered raising livestock a significant health risk for themselves or their families. Several study households reported handling and consuming meat or poultry from sick or dead animals and using animal waste as a fertilizer on their crops. Households typically diagnosed and treated their sick animals, occasionally seeking treatment advice from employees of local animal feed stores where medications, including antimicrobials, are available over the counter. Despite a basic understanding of zoonotic disease risk, this study identified several factors, such as the handling and consumption of sick and dead animals and purchasing medications for sick animals over the counter, that potentially increase the risk of zoonotic disease transmission as well as the development and spread of antimicrobial resistance. PMID:27928092

Atypical Protein Kinase C Activity in the Hypothalamus Is Required for Lipopolysaccharide-Mediated Sickness Responses

PubMed Central

Thaler, Joshua P.; Choi, Sun Ju; Sajan, Mini P.; Ogimoto, Kayoko; Nguyen, Hong T.; Matsen, Miles; Benoit, Stephen C.; Wisse, Brent E.; Farese, Robert V.; Schwartz, Michael W.

2009-01-01

By activating the Toll-like receptor 4-nuclear factor-κB signal transduction pathway, the bacterial endotoxin lipopolysaccharide (LPS) induces anorexia, weight loss, fever, and other components of the sickness response. By comparison, the hormones leptin and insulin cause anorexia without sickness via a central mechanism involving the phosphatidylinositol-3 kinase signaling pathway. In the current study, we investigated whether a common Toll-like receptor 4 and phosphatidylinositol-3 kinase signaling intermediate, atypical protein kinase Cζ/λ (aPKC), contributes to changes of energy balance induced by these stimuli. Immunohistochemistry analysis revealed that aPKC is expressed in the arcuate and paraventricular nuclei of the hypothalamus, key sites of leptin, insulin, and LPS action. Although administration of LPS, insulin, and leptin each acutely increased hypothalamic aPKC activity at doses that also reduce food intake, LPS treatment caused over 10-fold greater activation of hypothalamic a PKC signaling than that induced by leptin or insulin. Intracerebroventricular pretreatment with an aPKC inhibitor blocked anorexia induced by LPS but not insulin or leptin. Similarly, LPS-induced hypothalamic inflammation (as judged by induction of proinflammatory cytokine gene expression) and neuronal activation in the paraventricular nucleus (as judged by c-fos induction) were reduced by central aPKC inhibition. Although intracerebroventricular aPKC inhibitor administration also abolished LPS-induced fever, it had no effect on sickness-related hypoactivity or weight loss. We conclude that although hypothalamic aPKC signaling is not required for food intake inhibition by insulin or leptin, it plays a key role in inflammatory anorexia and fever induced by LPS. PMID:19819945

Animal Husbandry Practices and Perceptions of Zoonotic Infectious Disease Risks Among Livestock Keepers in a Rural Parish of Quito, Ecuador.

PubMed

Lowenstein, Christopher; Waters, William F; Roess, Amira; Leibler, Jessica H; Graham, Jay P

2016-12-07

Small-scale livestock production plays an essential role as a source of income and nutrition for households in low- and middle-income countries, yet these practices can also increase risk of zoonotic infectious diseases, especially among young children. To mitigate this risk, there is a need to better understand how livestock producers perceive and manage risks of disease transmission. Twenty semistructured, in-depth interviews were conducted with small-scale livestock producers in a semirural parish of Quito, Ecuador. Interviews explored livestock-raising practices, including animal health-care practices and use of antimicrobials, family members' interactions with livestock and other animals, and perceptions of health risk associated with these practices and activities. Interviews were analyzed for common themes. Awareness of zoonotic disease transmission was widespread, yet few study participants considered raising livestock a significant health risk for themselves or their families. Several study households reported handling and consuming meat or poultry from sick or dead animals and using animal waste as a fertilizer on their crops. Households typically diagnosed and treated their sick animals, occasionally seeking treatment advice from employees of local animal feed stores where medications, including antimicrobials, are available over the counter. Despite a basic understanding of zoonotic disease risk, this study identified several factors, such as the handling and consumption of sick and dead animals and purchasing medications for sick animals over the counter, that potentially increase the risk of zoonotic disease transmission as well as the development and spread of antimicrobial resistance. © The American Society of Tropical Medicine and Hygiene.

Limitations on work and attendance rates after employees with cancer returned to work at a single manufacturing company in Japan.

PubMed

Ohguri, Takayuki; Narai, Rie; Funahashi, Atsushi; Nishiura, Chihiro; Yamashita, Tsuyoshi; Yarita, Keiichiro; Korogi, Yukunori

2009-01-01

The purpose of this study was to evaluate the work limitations and attendance rates after employees diagnosed with cancer returned to work from sick leave, and to identify the related factors for the limitations and attendance rates at a single manufacturing company in Japan. This study retrospectively analyzed 129 men and 4 women, employed in a single manufacturing industry, who returned to work after sick leave due to newly diagnosis of cancer. Limitations on work after the return to work were enforced in the workplace based on an industrial physician's evaluation. All the employees who needed measures for work were examined by the industrial physicians every 1-6 months until the termination of such work limitations. Limitations on work after the return to work were enforced for 79 (59%) employees (36 employees with alteration of work, 31 with prohibition of shift work and 55 with prohibition of overtime work). A higher degree of work limitations was significantly correlated with work-related factors before sick leave (i.e. shift work, production line) as well as disease/treatment-related factors (i.e. chemotherapy, recurrence/metastasis), while the attendance rates after the return to work were not correlated with adverse work-related factors before sick leave. The enforcement of work limitations for employees with cancer was relatively common and was based on both disease/treatment- and work-related factors, and this phenomenon may play an important role in the return to work as well as the successful continuation of work after cancer survivors return to work.

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.

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.

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.

Leisure-time physical activity and direct cost of short-term sickness absence among Finnish municipal employees.

PubMed

Tolonen, Anu; Rahkonen, Ossi; Lahti, Jouni

2017-03-04

We aimed to examine the direct costs of short-term (1-14 days) sickness absence and the effect of employees' physical activity on the costs. The Finnish Helsinki Health Study survey (2007) was used in the analysis (n = 3,935). Physical activity was classified into inactive, moderately active, and vigorously active. Sickness absence (3 years follow-up) and salary data were derived from the employer's registers. On average, an employee was absent 6 days a year due to short-term sickness absence, with a production loss of 2,350 EUR during the 3 years. The vigorously active had less sickness absence than those less active. The direct cost of sickness absence of a vigorously active employee was 404 EUR less than that of an inactive employee. Promoting physical activity among employees may decrease direct cost of short-term sickness absence.

Psychosocial working conditions and sickness absence in a general population: a cohort study of 21,834 workers in Norway (The HUNT Study).

PubMed

Strømholm, Tonje; Pape, Kristine; Ose, Solveig Osborg; Krokstad, Steinar; Bjørngaard, Johan Håkon

2015-04-01

To examine the associations between psychosocial working conditions and sickness absence. Data for 21,834 employed adults from the Nord-Trøndelag Health Study (HUNT) were linked to the sickness benefit register and sickness absence during 1 year after survey participation was analyzed with logistic regression. A one unit change on a 0 to 3 self-reported job demand scale was associated with a fully adjusted 24% and 25% increased odds of sickness absence in men and women, respectively. A one unit change on a 0 to 3 scale for self-reported support at work was associated with a fully adjusted 13% and 17% reduced odds of sickness absence in men and women, respectively. The results of this study indicate that demands, and to some extent support, at work might influence sickness absence-also when adjusting for a detailed categorization of occupations.

Physical capacity and risk for long-term sickness absence: a prospective cohort study among 8664 female health care workers.

PubMed

Rasmussen, Charlotte Diana Nørregaard; Andersen, Lars Louis; Clausen, Thomas; Strøyer, Jesper; Jørgensen, Marie Birk; Holtermann, Andreas

2015-05-01

To assess the prospective associations between self-reported physical capacity and risk of long-term sickness absence among female health care workers. Female health care workers answered a questionnaire about physical capacity and were followed in a national register of sickness absence lasting for two or more consecutive weeks during 1-year follow-up. Using Cox regression hazard ratio analyses adjusted for age, smoking, body mass index, physical workload, job seniority, psychosocial work conditions, and previous sickness absence, we modeled risk estimates for sickness absence from low and medium physical capacity. Low and medium aerobic fitness, low muscle strength, low flexibility, and low overall physical capacity significantly increased the risk for sickness absence with 20% to 34% compared with health care workers with high capacity. Low physical capacity increases the risk of long-term sickness absence among female health care workers.

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…

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.

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...

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.

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.

Implementation of standardized time limits in sickness insurance and return-to-work: experiences of four actors.

PubMed

Ståhl, Christian; Müssener, Ulrika; Svensson, Tommy

2012-01-01

In 2008, time limits were introduced in Swedish sickness insurance, comprising a pre-defined schedule for return-to-work. The purpose of this study was to explore experienced consequences of these time limits. Sick-listed persons, physicians, insurance officials and employers were interviewed regarding the process of sick-listing, rehabilitation and return-to-work in relation to the reform. The study comprises qualitative interviews with 11 sick-listed persons, 4 insurance officials, 5 employers and 4 physicians (n = 24). Physicians, employers, and sick-listed persons described insurance officials as increasingly passive, and that responsibility for the process was placed on the sick-listed. Several ethical dilemmas were identified, where officials were forced to act against their ethical principles. Insurance officials' principle of care often clashed with the standardization of the process, that is based on principles of egalitarianism and equal treatment. The cases reported in this study suggest that a policy for activation and early return-to-work in some cases has had the opposite effect: central actors remain passive and the responsibility is placed on the sick-listed, who lacks the strength and knowledge to understand and navigate through the system. The standardized insurance system here promoted experiences of procedural injustice, for both officials and sick-listed persons.

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.

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.

Psychosocial and organizational risk factors for doctor-certified sick leave: a prospective study of female health and social workers in Norway.

PubMed

Aagestad, Cecilie; Tyssen, Reidar; Johannessen, Håkon A; Gravseth, Hans Magne; Tynes, Tore; Sterud, Tom

2014-09-29

Doctor-certified sick leave differs substantially across sectors, and among health and social workers, in particular, there is an increased risk. Previous studies have shown that work environmental factors contribute to sick leave. Hence, the identification of specific organizational and psychosocial risk factors for long- term sick leave, taking into account potential confounding related to mechanical risk factors such as lifting and awkward body postures, will be of importance in the work of prevention. A randomly drawn population sample of Norwegian residents was interviewed about working conditions in 2009 (n = 12,255; response rate 60.9%). Female health and social care workers (n = 925) were followed in a national registry for subsequent sickness absence during 2010. The outcome of interest was doctor-certified sick leave of 21 days or more (long-term sick leave). Eleven work-related psychosocial and organizational factors were evaluated. In total, 186 persons (20.1%) were classified with subsequent long-term sick leave. After thoroughly adjusting for competing explanatory variables, the most consistent predictors for long-term sick leave were violence and threats of violence (OR = 1.67; 95% CI 1.14-2.45). The estimated population attributable risk for violence and threats of violence was 13%. The present study among female health and social care workers revealed a substantial relationship between self-reported violence and threats of violence and subsequent long- term sick leave.

Labour market trajectories following sickness absence due to self-reported all cause morbidity--a longitudinal study.

PubMed

Pedersen, Pernille; Lund, Thomas; Lindholdt, Louise; Nohr, Ellen A; Jensen, Chris; Søgaard, Hans Jørgen; Labriola, Merete

2016-04-16

To investigate differences in return to work (RTW) and employment trajectories in individuals on sick leave for either mental health reasons or other health related reasons. This study was based on 2036 new sickness absence cases who completed a questionnaire on social characteristics, expectations for RTW and reasons for sickness absence. They were divided into two exposure groups according to their self-reported sickness absence reason: mental health reasons or other health reasons. The outcome was employment status during the following 51 weeks and was measured both as time-to-event analysis and with sequence analysis. Individuals with mental health reasons for sickness absence had a higher risk of not having returned to work (RR 0.87 (0.80;0.93)). Adjusting for gender, age, education and employment did not change the estimate, however, after adding RTW expectations to the model, the excess risk was no longer present (RR 1.01 (0.95;1.08)). In relation to the sequence analysis, individuals with mental health related absence had significantly higher odds of being in the sickness absence cluster and significantly lower odds for being in the fast RTW cluster, but when adjusting for RTW expectations, the odds were somewhat attenuated and no longer significant. Employees on sick leave due to self-reported mental health problems spent more weeks in sickness absence and temporary benefits and had a higher risk of not having returned to work within a year compared to employees on sick leave due to other health reasons. The difference could be explained by their lower RTW expectations at baseline. This emphasises the need to develop suitable and specific interventions to facilitate RTW for this group of sickness absentees.

Driving simulator sickness: Impact on driving performance, influence of blood alcohol concentration, and effect of repeated simulator exposures.

PubMed

Helland, Arne; Lydersen, Stian; Lervåg, Lone-Eirin; Jenssen, Gunnar D; Mørland, Jørg; Slørdal, Lars

2016-09-01

Simulator sickness is a major obstacle to the use of driving simulators for research, training and driver assessment purposes. The purpose of the present study was to investigate the possible influence of simulator sickness on driving performance measures such as standard deviation of lateral position (SDLP), and the effect of alcohol or repeated simulator exposure on the degree of simulator sickness. Twenty healthy male volunteers underwent three simulated driving trials of 1h's duration with a curvy rural road scenario, and rated their degree of simulator sickness after each trial. Subjects drove sober and with blood alcohol concentrations (BAC) of approx. 0.5g/L and 0.9g/L in a randomized order. Simulator sickness score (SSS) did not influence the primary outcome measure SDLP. Higher SSS significantly predicted lower average speed and frequency of steering wheel reversals. These effects seemed to be mitigated by alcohol. Higher BAC significantly predicted lower SSS, suggesting that alcohol inebriation alleviates simulator sickness. The negative relation between the number of previous exposures to the simulator and SSS was not statistically significant, but is consistent with habituation to the sickness-inducing effects, as shown in other studies. Overall, the results suggest no influence of simulator sickness on SDLP or several other driving performance measures. However, simulator sickness seems to cause test subjects to drive more carefully, with lower average speed and fewer steering wheel reversals, hampering the interpretation of these outcomes as measures of driving impairment and safety. BAC and repeated simulator exposures may act as confounding variables by influencing the degree of simulator sickness in experimental studies. Copyright © 2016 Elsevier Ltd. All rights reserved.

Determinants for return to work among sickness certified patients in general practice.

PubMed

von Celsing, Anna-Sophia; Svärdsudd, Kurt; Eriksson, Hans-G; Björkegren, Karin; Eriksson, Margaretha; Wallman, Thorne

2012-12-14

Long-term sickness absence is one of the main risk factors for permanent exit out of the labour market. Early identification of the condition is essential to facilitate return to work. The aim of this study was to analyse possible determinants of return to work and their relative impact. All 943 subjects aged 18 to 63 years, sickness certified at a Primary Health Care Centre in Sweden from 1 January until 31 August 2004, were followed up for three years. Baseline information on sex, age, sick leave diagnosis, employment status, extent of sick leave, and sickness absence during the year before baseline was obtained, as was information on all compensated days of sick leave, disability pension and death during follow-up. Slightly more than half the subjects were women, mean age was 39 years. Half of the study population returned to work within 14 days after baseline, and after three years only 15 subjects were still on sick leave. In multivariate proportional hazards regression analysis the extent of previous sick leave, age, being on part-time sick leave, and having a psychiatric, musculoskeletal, cardiovascular, nervous disease, digestive system, or injury or poisoning diagnosis decreased the return to work rate, while being employed increased it. Marital status, sex, being born in Sweden, citizenship, and annual salary had no influence. In logistic regression analyses across follow-up time these variables altogether explained 88-90% of return to work variation. Return to work was positively or negatively associated by a number of variables easily accessible in the GP's office. Track record data in the form of previous sick leave was the most influential variable.

Work-related psychosocial events as triggers of sick leave--results from a Swedish case-crossover study.

PubMed

Hultin, Hanna; Hallqvist, Johan; Alexanderson, Kristina; Johansson, Gun; Lindholm, Christina; Lundberg, Ingvar; Möller, Jette

2011-03-23

Although illness is an important cause of sick leave, it has also been suggested that non-medical risk factors may influence this association. If such factors impact on the period of decision making, they should be considered as triggers. Yet, there is no empirical support available.The aim was to investigate whether recent exposure to work-related psychosocial events can trigger the decision to report sick when ill. A case-crossover design was applied to 546 sick-leave spells, extracted from a Swedish cohort of 1430 employees with a 3-12 month follow-up of new sick-leave spells. Exposure in a case period corresponding to an induction period of one or two days was compared with exposure during control periods sampled from workdays during a two-week period prior to sick leave for the same individual. This was done according to the matched-pair interval and the usual frequency approaches. Results are presented as odds ratios (OR) with 95% confidence intervals (CI). Most sick-leave spells happened in relation to acute, minor illnesses that substantially reduced work ability. The risk of taking sick leave was increased when individuals had recently been exposed to problems in their relationship with a superior (OR 3.63; CI 1.44-9.14) or colleagues (OR 4.68; CI 1.43-15.29). Individuals were also more inclined to report sick on days when they expected a very stressful work situation than on a day when they were not under such stress (OR 2.27; CI 1.40-3.70). Exposure to problems in workplace relationships or a stressful work situation seems to be able to trigger reporting sick. Psychosocial work-environmental factors appear to have a short-term effect on individuals when deciding to report sick.

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.

Occupational stress and incidence of sick leave in the Belgian workforce: the Belstress study

PubMed Central

Moreau, M; Valente, F; Mak, R; Pelfrene, E; de Smet, P; De Backer, G; Kornitzer, M

2004-01-01

Context: Sick leave is a major problem in public health. The Karasek demands/control/social support/strain (JDCS) model has been largely used to predict a wide range of health outcomes and to a lesser extent sickness absence. Study objective: The aim of the study was to test the predictive power of the JDCS model in relation with one year incidence of sick leave in a large cohort of workers. Design and setting: Cohort study conducted between 1994 and 1998 in 25 companies across Belgium. Participants: A total of 20 463 workers aged 35 to 59 years were followed up for sick leave during one year after the baseline survey. Outcomes: The outcomes were a high sick leave incidence, short spells (⩾7 days), long spells (⩾28 days), and repetitive spells of sickness absence (⩾3 spells/year). Main results: Independently from baseline confounding variables, a significant association between high strained jobs with low social support and repetitive spells of sickness absence was observed in both sexes with odds ratios of 1.32 (99% CI, 1.04 to 1.68) in men and 1.61 (99% CI, 1.13 to 2.33) in women. In men, high strained jobs with low social support was also significantly associated with high sick leave incidence, and short spells of sick leave with odds ratios of 1.38 (99% CI, 1.16 to 1.64) and 1.22 (99% CI, 1.05 to 1.44) respectively. Conclusions: Perceived high strain at work especially combined with low social support is predictive of sick leave in both sexes of a large cohort of the Belgian workforce. PMID:15143121

Work outcomes of sickness absence related to mental disorders: a systematic literature review

PubMed Central

Dewa, Carolyn S; Loong, Desmond; Bonato, Sarah

2014-01-01

Objectives The purpose of this systematic literature review is to examine the current state of knowledge regarding the return-to-work outcomes of sickness absences related to mental disorders that increase costs borne by employers. We address two questions: (1) Based on the existing literature, from the employer's perspective, what are the relevant economic return-to-work outcomes for sickness absences related to mental disorders? and (2) From the employer's economic perspective, are there gaps in knowledge about the relevant return-to-work outcomes for sickness absences related to mental disorders? Setting The included studies used administrative data from either an employer, insurer or occupational healthcare provider. Participants Studies included working adults between 18 and 65 years old who had a sickness absence related to a mental disorder. Primary and secondary outcome measures The studies considered two general return-to-work outcome categories: (1) outcomes focusing on return-to-work and (2) outcomes focusing on sickness absence recurrence. Results A total of 3820 unique citations were identified. Of these, 10 studies were identified whose quality ranged from good to excellent. Half of the identified studies came from one country. The studies considered two characteristics of sickness absence: (1) whether and how long it took for a worker to return-to-work and (2) sickness absence recurrence. None of the studies examined return-to-work outcomes related to work reintegration. Conclusions The existing literature suggests that along with the incidence of sickness absence related to mental disorders, the length of sickness absence episodes and sickness absence recurrence (ie, number and time between) should be areas of concern. However, there also seems to be gaps in the literature regarding the work reintegration process and its associated costs. PMID:25023133

Adverse outcomes of sick leave due to mental disorders: A prospective study of discordant twin pairs.

PubMed

Mather, Lisa; Blom, Victoria; Bergström, Gunnar; Svedberg, Pia

2017-10-01

The aim of this study was to investigate whether sick leave due to different mental disorders increased the risk of reoccurring sick-leave, disability pension and unemployment, taking genetics and shared environment into account. This register-based cohort study contains 2202 discordant twin pairs 18-64 years old, where one twin had sick leave due to a mental disorder 2005-2006. The end of the sick-leave spell was the start of follow-up for both twins. The twins were followed up for reoccurring sick-leave, disability pension and unemployment (> 180 days in a year), until December 2012. Analyses were censored for disability pension, death, emigration and old-age pension. Cox proportional hazards models with time-varying covariates were used to calculate hazard ratios with 95% confidence intervals (CI). Those with sick leave due to mental disorders had a 3.64 (CI: 3.24-4.08) times higher risk of reoccurring sick-leave within the first two years; after that, hazard ratios were attenuated and explained by genetic factors. The first year, they had 12.24 (CI: 8.11-18.46) times the risk of disability pension. The risk was attenuated but remained at 2.75 (CI: 2.07-3.65) after one year. The risk of unemployment was 1.99 (CI: 1.72-2.31) during the whole follow-up period. The risk of unemployment and disability pension was lower for those with stress-related than other mental disorders, this was less clear for recurrent reoccuring sick-leave. Sick leave due to mental disorders increased the risk of reoccurring sick-leave within two years, disability pension and unemployment, independent of genetics and shared environment.

Leadership styles of nurse managers and registered sickness absence among their nursing staff.

PubMed

Schreuder, Jolanda A H; Roelen, Corné A M; van Zweeden, Nely F; Jongsma, Dianne; van der Klink, Jac J L; Groothoff, Johan W

2011-01-01

Sickness absence leads to understaffing and interferes with nursing efficiency and quality. It has been reported in literature that managerial leadership is associated with self-reported sickness absence in the working population. This study investigated the relationship between managerial leadership and sickness absence in health care by associating nurse managers' leadership styles with registered sickness absence among their nursing staff. The cross-sectional study included 699 nurses working in six wards (staff range = 91-140 employees) of a Dutch somatic hospital employing a total of 1,153 persons. The nurse managers heading the wards were asked to complete the Leadership Effectiveness and Adaptability Description questionnaire for situational leadership. The Leadership Effectiveness and Adaptability Description scores were linked to employer-registered nursing staff sickness absence. High relationship-high task behavior (odds ratio [OR] = 0.76, 95% confidence interval [CI] = 0.65-0.85) and high relationship-low task behavior (OR = 0.37, 95% CI = 0.14 -0.98) were inversely related to the number of short (one to seven consecutive days) episodes of sickness absence among the staff. Low relationship-high task styles (OR = 2.44, 95% CI = 1.14-5.22) as well as low relationship-low task styles (OR = 2.44, 95% CI = 1.26-4.71) were positively associated with the number of short episodes of sickness absence. However, the leadership styles only explained 10% of the variance in short episodes of sickness absence. Leadership styles are associated with registered sickness absence. The nursing staff of relationship-oriented nurse managers has fewer short episodes of sickness absence than the staff of task-oriented managers. Training nurse managers in relational leadership styles may reduce understaffing and improve nursing efficiency and quality.

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.

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.

Physical and mental health functioning after all-cause and diagnosis-specific sickness absence: a register-linkage follow-up study among ageing employees.

PubMed

Mänty, Minna; Lallukka, Tea; Lahti, Jouni; Pietiläinen, Olli; Laaksonen, Mikko; Lahelma, Eero; Rahkonen, Ossi

2017-01-25

Sickness absence has been shown to be a risk marker for severe future health outcomes, such as disability retirement and premature death. However, it is poorly understood how all-cause and diagnosis-specific sickness absence is reflected in subsequent physical and mental health functioning over time. The aim of this study was to examine the association of all-cause and diagnosis-specific sickness absence with subsequent changes in physical and mental health functioning among ageing municipal employees. Prospective survey and register data from the Finnish Helsinki Health Study and the Social Insurance Institution of Finland were used. Register based records for medically certified all-cause and diagnostic-specific sickness absence spells (>14 consecutive calendar days) in 2004-2007 were examined in relation to subsequent physical and mental health functioning measured by Short-Form 36 questionnaire in 2007 and 2012. In total, 3079 respondents who were continuously employed over the sickness absence follow-up were included in the analyses. Repeated-measures analysis was used to examine the associations. During the 3-year follow-up, 30% of the participants had at least one spell of medically certified sickness absence. All-cause sickness absence was associated with lower subsequent physical and mental health functioning in a stepwise manner: the more absence days, the poorer the subsequent physical and mental health functioning. These differences remained but narrowed slightly during the follow-up. Furthermore, the adverse association for physical health functioning was strongest among those with sickness absence due to diseases of musculoskeletal or respiratory systems, and on mental functioning among those with sickness absence due to mental disorders. Sickness absence showed a persistent adverse stepwise association with subsequent physical and mental health functioning. Evidence on health-related outcomes after long-term sickness absence may provide useful information for targeted interventions to promote health and workability.

Decisions on sick leave certifications for acute airways infections based on vignettes: A cross-sectional survey of GPs in Norway and Poland

PubMed Central

Halvorsen, Peder A.; Wennevold, Katrine; Fleten, Nils; Muras, Magdalena; Kowalczyk, Anna; Godycki-Cwirko, Maciek; Melbye, Hasse

2011-01-01

Objective To explore whether frequency and duration of sick-leave certification for acute airway infections differ between general practitioners (GPs) in Poland and Norway. Design Cross-sectional survey. Setting Educational courses for GPs. Intervention We used a questionnaire with four vignettes presenting patients with symptoms consistent with pneumonia, sinusitis, common cold, and exacerbation of chronic obstructive pulmonary disease (COPD), respectively. For each vignette GPs were asked whether they would offer a sick-leave note, and if so, for how many days. Subjects Convenience samples of GPs in Poland (n = 216) and Norway (n = 171). Main outcome measures Proportion of GPs offering a sick-leave certificate. Duration of sick-leave certification. Results In Poland 100%, 95%, 87%, and 94% of GPs would offer sick leave for pneumonia, sinusitis, common cold, and exacerbation of COPD, respectively. Corresponding figures in Norway were 97%, 83%, 60%, and 90%. Regression analysis adjusting for the GPs' sex, speciality, experience, and workload indicated that relative risks for offering sick leave (Poland versus Norway) were 1.16 (95% CI 1.07–1.26) for sinusitis and 1.50 (1.28–1.75) for common cold. Among GPs who offered sick leave for pneumonia, sinusitis, common cold, and exacerbation of COPD, mean duration was 8.9, 7.5, 5.1, and 6.9 days (Poland) versus 6.6, 4.3, 3.1, and 6.1 days (Norway), respectively. In regression analyses the differences between the Polish and Norwegian samples in duration of sick leave were statistically significant for all vignettes. A pattern of offering sick leave for three, five, seven, 10, or 14 days was observed in both countries. Conclusion In the Polish sample GPs were more likely to offer sick-leave notes for sinusitis and common cold. GPs in Poland offered sick leaves of longer duration for pneumonia, sinusitis, common colds, and exacerbation of COPD compared with GPs in the Norwegian sample. PMID:21323635

The Prognostic Value of the Work Ability Index for Sickness Absence among Office Workers.

PubMed

Reeuwijk, Kerstin G; Robroek, Suzan J W; Niessen, Maurice A J; Kraaijenhagen, Roderik A; Vergouwe, Yvonne; Burdorf, Alex

2015-01-01

The work ability index (WAI) is a frequently used tool in occupational health to identify workers at risk for a reduced work performance and for work-related disability. However, information about the prognostic value of the WAI to identify workers at risk for sickness absence is scarce. To investigate the prognostic value of the WAI for sickness absence, and whether the discriminative ability differs across demographic subgroups. At baseline, the WAI (score 7-49) was assessed among 1,331 office workers from a Dutch financial service company. Sickness absence was registered during 12-months follow-up and categorised as 0 days, 0

Partial sick leave associated with disability pension: propensity score approach in a register-based cohort study

PubMed Central

Kausto, Johanna; Solovieva, Svetlana; Virta, Lauri J; Viikari-Juntura, Eira

2012-01-01

Objectives To support sustainability of the welfare society enhanced work retention is needed among those with impaired work ability. Partial health-related benefits have been introduced for this target. The aim was to estimate the effects of partial sick leave on transition to disability pension applying propensity score methods. Design Register-based cohort study. Setting Sample from the national sickness insurance registers representative of the Finnish working population (full-time workers) with long-term sickness absence due to musculoskeletal disorders, mental disorders, traumas or tumours. Participants All recipients of partial or full sickness benefit whose sick leave period had ended between 1 May and 31 December 2007 were included. The sample was limited to four most prevalent diagnostic groups—mental and musculoskeletal disorders, traumas and tumours. The total sample consisted of 1047 subjects on partial sick leave (treatment group) and 28 380 subjects on full sick leave (control group). A subsample (1017 and 25 249 subjects, respectively) was formed to improve the comparability of the two groups. Outcome measures A three-category measure and a binary measure for the occurrence of disability pension on the last day of 2008 were computed. Results Partial sickness benefit reduced the risk (change in absolute risk) of full disability pension by 6% and increased the risk of partial disability pension by 8% compared with full sick leave. The effects did not differ markedly for the two main diagnostic groups of musculoskeletal and mental disorders. In men, the use of full disability pension was reduced by 10% with a 5% increase in the use of partial disability pension, while in women the effects were close to those of the total sample. Conclusions Our findings suggest that combining work with partial sick leave may provide one means to increase work retention at population level. The use of partial sick leave could be encouraged among men. PMID:23144260

[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 considering not only the probability of sick leave, but also its duration. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

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

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, which decreases sick leave. We recommend these issues to be further examined in a prospective longitudinal study since it may have important implications for sick leave frequency during pregnancy.

Assessing predictors of intention to prescribe sick leave among primary care physicians using the theory of planned behaviour.

PubMed

Swarna Nantha, Yogarabindranath; Wee, Lei Hum; Chan, Caryn Mei-Hsien

2018-01-16

Providing sickness certification is a decision that primary care physicians make on a daily basis. The majority of sickness certification studies in the literature involve a general assessment of physician or patient behaviour without the use of a robust psychological framework to guide research accuracy. To address this deficiency, this study utilized the Theory of Planned Behaviour (TPB) to specifically gauge the intention and other salient predictors related to sickness certification prescribing behaviour amongst primary care physicians. A cross-sectional study was conducted among N = 271 primary care physicians from 86 primary care practices throughout two states in Malaysia. Questionnaires used were specifically developed based on the TPB, consisting of both direct and indirect measures related to the provision of sickness leave. Questionnaire validity was established through factor analysis and the determination of internal consistency between theoretically related constructs. The temporal stability of the indirect measures was determined via the test-retest correlation analysis. Structural equation modelling was conducted to determine the strength of predictors related to intentions. The mean scores for intention to provide patients with sickness was low. The Cronbach α value for the direct measures was good: overall physician intent to provide sick leave (0.77), physician attitude towards prescribing sick leave for patients (0.77) and physician attitude in trusting the intention of patients seeking sick leave (0.83). The temporal stability of the indirect measures of the questionnaire was satisfactory with significant correlation between constructs separated by an interval of two weeks (p < 0.05). Attitudes and subjective norms were identified as important predictors in physician intention to provide sick leave to patients. An integrated behavioural model utilizing the TPB could help fully explain the complex act of providing sickness leave to patients. Findings from this study could assist relevant agencies to facilitate the creation of policies that may help regulate the provision of sickness leave and alleviate the work burden of sickness leave tasks faced by physicians in Malaysia.

Labour Market Segregation and Gender Differences in Sickness Absence: Trends in 2005-2013 in Finland.

PubMed

Leinonen, Taina; Viikari-Juntura, Eira; Husgafvel-Pursiainen, Kirsti; Virta, Lauri J; Laaksonen, Mikko; Autti-Rämö, Ilona; Solovieva, Svetlana

2018-04-18

Women have higher sickness absence rate than men, but less is known of changes in this difference over time. We examined gender differences in sickness absence trends focusing on gender segregation in the labour market. We used large nationwide register data on Finnish wage earners aged 25-59 and generalized estimation equations based on repeated logistic regression to estimate the annual risk of sickness absence lasting at least 2 weeks. Between 2005 and 2013, the age-adjusted proportion (%) of employees with all-cause sickness absence decreased from the initial levels of 10.6 among men and 15.1 among women by 16.7 and 13.6%, respectively. Among both genders, the largest decrease in sickness absence coincided with the peak of the economic recession in 2009. In sickness absence due to all causes and musculoskeletal diseases, also the excess decrease among men mainly occurred in 2009, and in sickness absence due to mental disorders 2 years later. In sickness absence due to all causes and musculoskeletal diseases, the increasing gender difference was mainly attributable to a larger decrease in sickness absence at the time of the recession in male-dominated groups, such as in manual and manufacturing work, than in other sectors and occupational classes. In mental disorders, the increasing gender difference was partly attributable to a later smaller decrease in sickness absence among female-dominated lower non-manual and lower income employment groups. The increasing gender differences did not result from differential distributional changes in employment or sociodemographic factors among the employed male and female populations. In fact, widening of the gender gap in sickness absence due to all causes and musculoskeletal diseases would have been even larger without faster increase among women in the educational level and in non-manual employment. Sickness absence decreased especially in male-dominated employment groups, resulting in a larger decrease in absences among men compared with women. More research is needed to ascertain whether these differential changes are attributable, for example, to reduced willingness to seek medical advice or increased presenteeism in male-dominated groups, or to increased work pressures in female-dominated groups. Selection mechanisms, i.e. men's increased ill-health-related exit from work through other routes than sickness absence, also cannot be ruled out.

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 already in 2008. The increased knowledge will assist in better decision making process regarding the management of disability related to MSDs. International Standard Randomised Controlled Trial Number Register, register number ISRCTN30911719.

[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 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.

[Missed lessons, missed opportunities: a role for public health services in medical absenteeism in young people].

PubMed

Vanneste, Y T M; van de Goor, L A M; Feron, F J M

2016-01-01

Young people who often miss school for health reasons are not only missing education, but also the daily routine of school, and social intercourse with their classmates. Medical absenteeism among students merits greater attention. For a number of years, in various regions in the Netherlands, students with extensive medical absenteeism have been invited to see a youth healthcare specialist. The MASS intervention (Medical Advice of Students reported Sick; in Dutch: Medische Advisering van de Ziekgemelde Leerling, abbreviated as M@ZL) has been developed by the West Brabant Regional Public Health Service together with secondary schools to address school absenteeism due to reporting sick. In this paper we discuss the MASS intervention and explain why attention should be paid by public health services to the problem of school absenteeism, especially absenteeism on health grounds.

Vestibular reflexes of otolith origin

NASA Technical Reports Server (NTRS)

Wilson, Victor J.

1988-01-01

The vestibular system and its role in the maintenance of posture and in motion sickness is investigated using cats as experimental subjects. The assumption is that better understanding of the physiology of vestibular pathways is not only of intrinsic value, but will help to explain and eventually alleviate the disturbances caused by vestibular malfunction, or by exposure to an unusual environment such as space. The first project deals with the influence on the spinal cord of stimulation of the vestibular labyrinth, particularly the otoliths. A second was concerned with the properties and neural basis of the tonic neck reflex. These two projects are related, because vestibulospinal and tonic neck reflexes interact in the maintenance of normal posture. The third project began with an interest in mechanisms of motion sickness, and eventually shifted to a study of central control of respiratory muscles involved in vomiting.

The Healthy School Handbook. Conquering the Sick Building Syndrome and Other Environmental Hazards In and Around Your School.

ERIC Educational Resources Information Center

Miller, Norma L., Ed.

This book compiles 22 articles concerning sick building syndrome in educational facilities in following three areas: determining whether a school is sick; assessing causes and initiating treatment; and developing interventions. Articles address such topics as managing the psycho-social aspects of sick building syndrome; how indoor air quality…

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.

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

Lightweight Helmet For Eye/Balance Studies

NASA Technical Reports Server (NTRS)

Mcstravick, M. Catherine; Proctor, David R.; Wood, Scott J.

1988-01-01

Lightweight helmet serves as mounting platform for stimulus and sensor modules in experiments on role of vestibulo-ocular reflex in motion sickness and space-adaptation syndrome. Fitted liner and five inflatable air bladders stabilize helmet with respect to subject's head. Personal bite board attached to chin-bar assembly makes hard palate in subject's mouth serve as final position reference for helmet.

The Role of Physical Contact and Association in Early Contamination Sensitivity.

ERIC Educational Resources Information Center

Springer, Ken; Belk, Amy

1994-01-01

Children were asked whether someone would get sick from drinking juice placed near a bug. Some preschoolers and most seven- and eight-year olds recognized the need for physical contact with the bug to make the juice noxious, whereas some believed the mere presence of a contaminant made it noxious. Thus, associational contamination sometimes plays…

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 ...

Frequency and nature of problems associated with sickness certification tasks: A cross-sectional questionnaire study of 5455 physicians

PubMed Central

Löfgren, Anna; Hagberg, Jan; Arrelöv, Britt; Ponzer, Sari; Alexanderson, Kristina

2007-01-01

Objective To study the frequency and nature of problems associated with physicians’ sickness certification practices. Design Cross-sectional questionnaire study. Setting Stockholm and Östergötland Counties in Sweden. Subjects Physicians aged ≤64 years, n =7665, response rate 71% (n =5455). Main outcome measures The frequency of consultations involving sickness certification, the frequency and nature of problems related to sickness certification. Results A total of 74% (n =4019) of the respondents had consultations including sickness certification at least a few times a year. About half of these physicians had sickness certification cases at least six times a week, and 1 out of 10 (9.4%) had this more than 20 times a week. The items that the highest percentage of physicians rated as very or fairly problematic included: handling conflicts with patients over certification, assessing work ability, estimating optimal length and degree of absence, and managing prolongation of sick leave initially certified by another physician. There were large differences in frequency and nature of problems between different types of clinics/practices. General practitioners had the highest frequency of problems concerning sickness certification while the lowest was found among specialists in internal medicine and surgery. Conclusion Sickness certification should be recognized as an important task also for physicians other than general practitioners. The physicians experienced problems with numerous tasks related to sickness certification and these varied considerably between types of clinics. The high rate of problems experienced may have consequences for the physicians’ work situation, for patients, and for society. PMID:17846937

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.

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.

Demonstrating the Potential for Dynamic Auditory Stimulation to Contribute to Motion Sickness

PubMed Central

Keshavarz, Behrang; Hettinger, Lawrence J.; Kennedy, Robert S.; Campos, Jennifer L.

2014-01-01

Auditory cues can create the illusion of self-motion (vection) in the absence of visual or physical stimulation. The present study aimed to determine whether auditory cues alone can also elicit motion sickness and how auditory cues contribute to motion sickness when added to visual motion stimuli. Twenty participants were seated in front of a curved projection display and were exposed to a virtual scene that constantly rotated around the participant's vertical axis. The virtual scene contained either visual-only, auditory-only, or a combination of corresponding visual and auditory cues. All participants performed all three conditions in a counterbalanced order. Participants tilted their heads alternately towards the right or left shoulder in all conditions during stimulus exposure in order to create pseudo-Coriolis effects and to maximize the likelihood for motion sickness. Measurements of motion sickness (onset, severity), vection (latency, strength, duration), and postural steadiness (center of pressure) were recorded. Results showed that adding auditory cues to the visual stimuli did not, on average, affect motion sickness and postural steadiness, but it did reduce vection onset times and increased vection strength compared to pure visual or pure auditory stimulation. Eighteen of the 20 participants reported at least slight motion sickness in the two conditions including visual stimuli. More interestingly, six participants also reported slight motion sickness during pure auditory stimulation and two of the six participants stopped the pure auditory test session due to motion sickness. The present study is the first to demonstrate that motion sickness may be caused by pure auditory stimulation, which we refer to as “auditorily induced motion sickness”. PMID:24983752

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

Suicidal ideation among surgeons in Italy and Sweden - a cross-sectional study.

PubMed

Wall, Maja; Schenck-Gustafsson, Karin; Minucci, Daria; Sendén, Marie Gustafsson; Løvseth, Lise Tevik; Fridner, Ann

2014-01-01

Suicidal ideation is more prevalent among physicians, compared to the population in general, but little is known about the factors behind surgeons' suicidal ideation. A surgeon's work environment can be competitive and characterised by degrading experiences, which could contribute to burnout, depression and even thoughts of suicide. Being a surgeon has been reported to be predictor for not seeking help when psychological distressed. The aim of the present study was to investigate to what extent surgeons in Italy and Sweden are affected by suicidal ideation, and how suicidal ideation can be associated with psychosocial work conditions. A cross-sectional study of surgeons was performed in Italy (N = 149) and Sweden (N = 272), where having suicidal ideation was the outcome variable. Work-related factors, such as harassment, depression and social support, were also measured. Suicidal ideation within the previous twelve months was affirmatively reported by 18% of the Italian surgeons, and by 12% of the Swedish surgeons in the present study. The strongest association with having recent suicidal ideation for both countries was being subjected to degrading experiences/harassment at work by a senior physician. Sickness presenteeism, exhaustion and disengagement were related to recent suicidal ideation among Italian surgeons, while role conflicts and sickness presenteeism were associated with recent suicidal ideation in the Swedish group. For both countries, regular meetings to discuss situations at work were found to be protective. A high percentage of surgeons at two university hospitals in Italy and Sweden reported suicidal ideation during the year before the investigation. This reflects a tough workload, including sickness presenteeism, harassment at work, exhaustion/disengagement and role conflicts. Regular meetings to discuss work situations might be protective.

Dropout during a driving simulator study: A survival analysis.

PubMed

Matas, Nicole A; Nettelbeck, Ted; Burns, Nicholas R

2015-12-01

Simulator sickness is the occurrence of motion-sickness like symptoms that can occur during use of simulators and virtual reality technologies. This study investigated individual factors that contributed to simulator sickness and dropout while using a desktop driving simulator. Eighty-eight older adult drivers (mean age 72.82±5.42years) attempted a practice drive and two test drives. Participants also completed a battery of cognitive and visual assessments, provided information on their health and driving habits, and reported their experience of simulator sickness symptoms throughout the study. Fifty-two participants dropped out before completing the driving tasks. A time-dependent Cox Proportional Hazards model showed that female gender (HR=2.02), prior motion sickness history (HR=2.22), and Mini-SSQ score (HR=1.55) were associated with dropout. There were no differences between dropouts and completers on any of the cognitive abilities tests. Older adults are a high-risk group for simulator sickness. Within this group, female gender and prior motion sickness history are related to simulator dropout. Higher reported experience of symptoms of simulator sickness increased rates of dropout. The results highlight the importance of screening and monitoring of participants in driving simulation studies. Older adults, females, and those with a prior history of motion sickness may be especially at risk. Copyright © 2015 Elsevier Ltd and National Safety Council. All rights reserved.

Effect of passengers' active head tilt and opening/closure of eyes on motion sickness in lateral acceleration environment of cars.

PubMed

Wada, Takahiro; Yoshida, Keigo

2016-08-01

This study examined the effect of passengers' active head-tilt and eyes-open/eyes-closed conditions on the severity of motion sickness in the lateral acceleration environment of cars. In the centrifugal head-tilt condition, participants intentionally tilted their heads towards the centrifugal force, whereas in the centripetal head-tilt condition, the participants tilted their heads against the centrifugal acceleration. The eyes-open and eyes-closed cases were investigated for each head-tilt condition. In the experimental runs, the sickness rating in the centripetal head-tilt condition was significantly lower than that in the centrifugal head-tilt condition. Moreover, the sickness rating in the eyes-open condition was significantly lower than that in the eyes-closed condition. The results suggest that an active head-tilt motion against the centrifugal acceleration reduces the severity of motion sickness both in the eyes-open and eyes-closed conditions. They also demonstrate that the eyes-open condition significantly reduces the motion sickness even when the head-tilt strategy is used. Practitioner Summary: Little is known about the effect of head-tilt strategies on motion sickness. This study investigated the effects of head-tilt direction and eyes-open/eyes-closed conditions on motion sickness during slalom automobile driving. Passengers' active head tilt towards the centripetal direction and the eyes-open condition greatly reduce the severity of motion sickness.

Benefits and Harms of Sick Leave: Lack of Randomized, Controlled Trials

ERIC Educational Resources Information Center

Axelsson, Inge; Marnetoft, Sven-Uno

2010-01-01

The aim of this study was to try to identify those randomized controlled trials that compare sick leave with no sick leave or a different duration or degree of sick leave. A comprehensive, systematic, electronic search of Clinical Evidence, the Cochrane Library and PubMed, and a manual search of the Campbell Library and a journal supplement was…

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

[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.

Sickness absence and disability pension following breast cancer - A population-based matched cohort study.

PubMed

Lundh, Marie Høyer; Lampic, Claudia; Nordin, Karin; Ahlgren, Johan; Bergkvist, Leif; Lambe, Mats; Berglund, Anders; Johansson, Birgitta

2014-12-01

To compare sickness absence and disability pension in a population-based cohort of women with breast cancer (n = 463) from 1 year pre-diagnosis until 3 years post-diagnosis with a matched control group (n = 2310), and to investigate predictors of sickness absence during the 2nd and 3rd year post-diagnosis. Following breast cancer, the proportion of disease-free women with sickness absence decreased post-diagnosis (1st-3rd year; 78%-31%-19%), but did not reach the pre-diagnostic level (14%; P < 0.05). Post-diagnosis, patients were more likely than controls to be sickness absent (1st-3rd year; P < 0.001). No between-group differences were observed for disability pension post-diagnosis (P > 0.05). Among patients, chemotherapy, baseline fatigue and pre-diagnosis sick days predicted sickness absence during the 2nd, 3rd, and 2nd and 3rd year post-diagnosis, respectively (P < 0.05). Breast cancer is associated with increased sickness absence 3 years post-diagnosis. In a clinical setting, prevention and treatment of side effects are important in reducing long-term consequences. Copyright © 2014 Elsevier Ltd. All rights reserved.

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.

Cabin location and the likelihood of motion sickness in cruise ship passengers.

PubMed

Gahlinger , P M

2000-01-01

The prevalence of motion sickness approaches 100% on rough seas. Some previous studies have reported a strong association between location on a ship and the risk of motion sickness, whereas other studies found no association. This study was undertaken to determine if there is a statistical association between the location of the passenger cabin on a ship and the risk of motion sickness in unadapted passengers. Data were collected on 260 passengers on an expedition ship traversing the Drake Passage between South America and Antarctica, during rough sea conditions. A standard scale was employed to record motion sickness severity. The risk of motion sickness was found to be statistically associated with age and sex. However, no association was found with the location of the passenger cabin. Previous research reporting a strong association of motion sickness and passenger location on a ship, studied passengers in the seated position. Passengers who are able to lie in a supine position are at considerably reduced risk of motion sickness. Expedition or cruise ships that provide ready access to berths, allow passengers to avoid the most nauseogenic positions. The location of the passenger cabin does not appear to be related to the likelihood of seasickness.

Organizational factors related to low levels of sickness absence in a representative set of Swedish companies.

PubMed

Stoetzer, Ulrich; Bergman, Peter; Aborg, Carl; Johansson, Gun; Ahlberg, Gunnel; Parmsund, Marianne; Svartengren, Magnus

2014-01-01

The aim of this qualitative study was to identify manageable organizational factors that could explain why some companies have low levels of sickness absence. There may be factors at company level that can be managed to influence levels of sickness absence, and promote health and a prosperous organization. 38 representative Swedish companies. The study included a total of 204 semi-structured interviews at 38 representative Swedish companies. Qualitative thematic analysis was applied to the interviews, primarily with managers, to indicate the organizational factors that characterize companies with low levels of sickness absence. The factors that were found to characterize companies with low levels of sickness absence concerned strategies and procedures for managing leadership, employee development, communication, employee participation and involvement, corporate values and visions, and employee health. The results may be useful in finding strategies and procedures to reduce levels of sickness absence and promote health. There is research at individual level on the reasons for sickness absence. This study tries to elevate the issue to an organizational level. The findings suggest that explicit strategies for managing certain organizational factors can reduce sickness absence and help companies to develop more health-promoting strategies.

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.

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.

The anatomy of absenteeism.

PubMed

Markussen, Simen; Røed, Knut; Røgeberg, Ole J; Gaure, Simen

2011-03-01

Based on comprehensive administrative register data from Norway, we examine the determinants of sickness absence behavior; in terms of employee characteristics, workplace characteristics, panel doctor characteristics, and economic conditions. The analysis is based on a novel concept of a worker's steady state sickness absence propensity, computed from a multivariate hazard rate model designed to predict the incidence and duration of sickness absence for all workers. Key conclusions are that (i) most of the cross-sectional variation in absenteeism is caused by genuine employee heterogeneity; (ii) the identity of a person's panel doctor has a significant impact on absence propensity; (iii) sickness absence insurance is frequently certified for reasons other than sickness; and (iv) the recovery rate rises enormously just prior to the exhaustion of sickness insurance benefits. Copyright © 2010 Elsevier B.V. All rights reserved.

CONNECTION BETWEEN THE INCREASED FIBRINOGEN CONCENTRATION IN DOGS WITH RADIATION SICKNESS AND THE FIBRINOGENASE ACTIVITY

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

Gordeeva, K.V.

1963-11-01

A study was made of the concentration of blood plasma fibrinogen in relation to the changes of fibrinogenase activity. Dogs with radiation sickness (severe, moderately severe, and mild) served as experimental animals. A rise of the blood plasma fibrinogen content was observed in dogs with severe and moderately severe radiation sickness. This phenomenon is especially pronounced at the height of radiation sickness. The activity of fibrinogenase in severe radiation sickness was considerably decreased at the initial period and at the height of the disease. The rise of fibrinogen content in severe and moderately severe radiation sickness should be regarded asmore » an adaptive reaction directed to control hemorrhages, not as the sequence of raduced fibrinogenase activity. (auth)« less

[Duration of sick-leave and the moment of recovery in the hotel industry].

PubMed

Folgerø, I S; Larsen, S

1991-09-10

The paper addresses the problem of sick leave in the hotel industry. It was hypothesized that there would be a tendency for granted sick leaves to include weekends, thus imposing an additional financial burden on the hotel in question. A total of 401 medical certificates from a large city hotel were reviewed. According to these certificates one third of the patients regained their health between Sunday and Monday. Of the patients with "short" sick leaves (less than a fortnight), 40% recovered between Sunday and Monday. The average duration of the sick leave for this group was 1.3 days longer than that of the patients whose sick leaves ended on other days of the week. The results are discussed in terms of the ambiguous position of the medical practitioner.

A two-year follow-up on a program theory of return to work intervention.

PubMed

Jensen, Anne Grete Claudi

2013-01-01

Validation of a salutogenic theory for return to work (RTW) and an associated program process theory. A longitudinal non-randomized one-year trial study design was used with a two-year follow-up and with comparison to a reference group. Changes in attitudes and active behaviour in the intervention group and at the workplace were supported by cognitive and behavioural approaches. The intervention group included 118 unskilled Danish public employees and privately employed house-cleaners on sick leave due to musculoskeletal and/or common mental illnesses. Significant improvements of work ability index and perceived health (SF36 subgroups) were reported. A significantly higher RTW and a shorter sick leave than in the reference group also emerged. Positive predictors of RTW were keeping the pre-sick-leave job and improving work ability index and physical impairment/role physical. Decline in self-efficacy was a negative predictor. Support for the theory and associated program process theory was found. The intervention seemed to influence RTW and the employees' attitudes, behaviour and health by affecting comprehensibility, meaningfulness and manageability. Sustainable RTW emerged from a synergism of support from the work place and improved personal resources, especially such as concern mental health. The approach is consistent with integrating health promotion in RTW.

Factors influencing improved attendance in the UK fire service

PubMed Central

Hinckley, P.

2016-01-01

Background Sickness absence rates in the UK continue to exceed those in much of the developed world, with an annual cost to employers of £29 billion. Rates of sickness absence in the public sector are higher than those in the private sector, with the exception of the fire service where they are consistently lower. Aims To understand the influences that increase attendance among operational firefighters. Methods A series of semi-structured interviews undertaken with operational staff to explore their attitudes to sickness absence. Results Review and analysis of participant responses identified a number of key themes, namely employee well-being, including physical fitness and mental health; employee engagement with the fire service as manifested by culture, experience, nature of the job and leadership; organizational factors including the staffing model and relationship with occupational health services and policy, which describes both refinements to and implementation of targeted policies. Conclusions Previously observed factors such as improved fitness and the distinct firefighter culture play a role, yet other factors emerged that could explain the differences. These include the greater work–life balance offered by their shift patterns, the terms and conditions of employment and perhaps most importantly the evolution of precisely targeted policies that understand the unique nature of the operational fire service. PMID:27810889

Recovery of the vomiting reflex following area postrema ablation in squirrel monkeys

NASA Technical Reports Server (NTRS)

Elfar, S.; Brizzee, Kenneth R.; Fox, Robert A.; Corcoran, Meryl Lee; Daunton, Nancy G.; Coleman, J.

1991-01-01

The role of the area postrema (AP) in motion-induced emesis was re-assessed recently in several different species. In a few of these studies, the role of the AP in motion-induced conditioned taste aversion (CTA) was also addressed. The purpose was to extend this comparative study to the squirrel monkey, to evaluate further the role of AP in vomiting, and to investigate the dynamics of the recovery process. The AP was ablated bilaterally in 7 motion-susceptible squirrel monkeys which previously had been characterized in terms of their responses to various motion sickness-inducing stimuli. After recovery from surgery all animals were tested at 30-day intervals for a period of 11 months to determine the effects of AP ablations on susceptibility to the same sickness-inducing conditions. In addition, the effectiveness of motion in preducing CTA was evaluated. All pre-ablation motion tests involved stimulation for 30 min., while post-lesion tests were 60 min., in duration. All animals showed significant increases in latencies to vomiting after AP ablations. However, the latencies tended to decrease with time after ablation. All but one animal vomited on at least one of the 10 motion tests occurring after ablation of AP. In addition, CTA was produced by motion used in the conditioning sessions. These results suggest that structures other than AP, and processes other that those mediated through AP, may play an important role in motion-induced emesis.

Care for Sick Children as a Proxy for Gender Equality in the Family

ERIC Educational Resources Information Center

Eriksson, Rickard; Nermo, Magnus

2010-01-01

Swedish parents are entitled to government paid benefits to take care of sick children. In this paper we show that the gender distribution of paid care for sick children is a good proxy for the gender division of household work. Using two examples we show that registry data on care for sick children is a useful data source for studies on gender…

Susceptibility of cat and squirrel monkey to motion sickness induced by visual stimulation: Correlation with susceptibility to vestibular stimulation

NASA Technical Reports Server (NTRS)

Daunton, N. G.; Fox, R. A.; Crampton, G. H.

1984-01-01

Experiments in which the susceptibility of both cats and squirrel monkeys to motion sickness induced by visual stimulation are documented. In addition, it is shown that in both species those individual subjects most highly susceptible to sickness induced by passive motion are also those most likely to become motion sick from visual (optokinetic) stimulation alone.

Locking-In Effects Due to Early Interventions? An Evaluation of a Multidisciplinary Screening Programs for Avoiding Long-Term Sickness

ERIC Educational Resources Information Center

Johansson, Per; Lindahl, Erica

2012-01-01

Objective: In this article, we estimate the effect of a multidisciplinary collaboration program on the length of sickness absence. The intention with the program was to avoid long-term sickness absence by providing an early and holistic evaluation of the sick-listed individuals' conditions. The target group was individuals who were at risk of…

Work and health, a blind spot in curative healthcare? A pilot study.

PubMed

Lötters, Freek J B; Foets, Marleen; Burdorf, Alex

2011-09-01

Most workers with musculoskeletal disorders on sick leave often consult with regular health care before entering a specific work rehabilitation program. However, it remains unclear to what extent regular healthcare contributes to the timely return to work (RTW). Moreover, several studies have indicated that it might postpone RTW. There is a need to establish the influence of regular healthcare on RTW as outcome; "Does visiting a regular healthcare provider influence the duration of sickness absence and recurrent sick leave due to musculoskeletal disorders?". A cohort of workers on sick leave for 2-6 weeks due to a-specific musculoskeletal disorders was followed for 12 months. The main outcomes for the present analysis were: duration of sickness absence till 100% return to work and recurrent sick leave after initial RTW. Cox regression analyses were conducted with visiting a general health practitioner, physical therapist, or medical specialist during the sick leave period as independent variables. Each regression model was adjusted for variables known to influence health care utilization like age, sex, diagnostic group, pain intensity, functional disability, general health perception, severity of complaints, job control, and physical load at work. Patients visiting a medical specialist reported higher pain intensity and more functional limitations and also had a worse health perception at start of the sick leave period compared with those not visiting a specialist. Visiting a medical specialist delayed return to work significantly (HR = 2.10; 95%CI 1.43-3.07). After approximately 8 weeks on sick leave workers visiting a physical therapist returned to work faster than other workers. A recurrent episode of sick leave during the follow up quick was initiated by higher pain intensity and more functional limitations at the moment of fully return to work. Visiting a primary healthcare provider during the sickness absence period did not influence the occurrence of a new sick leave period. Despite the adjustment for severity of the musculoskeletal disorder, visiting a medical specialist was associated with a delayed full return to work. More attention to the factor 'labor' in the regular healthcare is warranted, especially for those patients experiencing substantial functional limitations due to musculoskeletal disorders.

Sickness Absence and Disability Pension After Breast Cancer Diagnosis: A 5-Year Nationwide Cohort Study.

PubMed

Kvillemo, Pia; Mittendorfer-Rutz, Ellenor; Bränström, Richard; Nilsson, Kerstin; Alexanderson, Kristina

2017-06-20

Purpose To explore future diagnosis-specific sickness absence and disability pension among women with breast cancer compared with women without breast cancer. Also, to examine associations with disease-related and sociodemographic factors among those with breast cancer. Methods Longitudinal register data on 3,547 women living in Sweden (age 20 to 65 years) who were first diagnosed with breast cancer in 2005, and a matched comparison cohort (n = 14,188), were analyzed for the annual prevalence of diagnosis-specific sickness absence and disability pension over 5 years. Logistic regressions were used to explore associations of disease-related and sociodemographic factors with future sickness absence and disability pension among women with breast cancer. Results Immediately after being diagnosed with breast cancer, the proportion of women with sickness absence was high but decreased continuously from the 1st through 5th year after diagnosis (71%, 40%, 30%, 22%, and 19%, respectively). In comparison, the range for women without breast cancer was 17% to 11%, respectively. The higher prevalence of sickness absence after breast cancer was mainly a result of breast cancer diagnosis, not a mental diagnosis, or other somatic diagnoses. Advanced cancer at diagnosis, > 90 days sickness absence before diagnosis, low education, and being born outside Sweden were associated with higher odds ratios for sickness absence and disability pension (odds ratio range, 1.40 to 6.45). Conclusion The level of sickness absence increased substantially in women with breast cancer during the first year after diagnosis and approached the level of breast cancer-free women in the following years; however, even in the first year, most women were not on sickness absence for a substantial time, and even in high-risk groups, many were not on sickness absence or disability pension in the following years. Information about relatively low future sickness absence and disability pension levels can be used by patients when planning their work, by health care professionals, and by social insurance officers. Employers and Occupational Health Services need this information to adequately handle workplace adjustments.

Health monitoring of Japanese payload specialist: Autonomic nervous and cardiovascular responses under reduced gravity condition (L-0)

NASA Technical Reports Server (NTRS)

Sekiguchi, Chiharu

1993-01-01

In addition to health monitoring of the Japanese Payload Specialists (PS) during the flight, this investigation also focuses on the changes of cardiovascular hemodynamics during flight which will be conducted under the science collaboration with the Lower Body Negative Pressure (LBNP) Experiment of NASA. For the Japanese, this is an opportunity to examine firsthand the effects of microgravity of human physiology. We are particularly interested in the adaption process and how it relates to space motion sickness and cardiovascular deconditioning. By comparing data from our own experiment to data collected by others, we hope to understand the processes involved and find ways to avoid these problems for future Japanese astronauts onboard Space Station Freedom and other Japanese space ventures. The primary objective of this experiment is to monitor the health condition of Japanese Payload Specialists to maintain a good health status during and after space flight. The second purpose is to investigate the autonomic nervous system's response to space motion sickness. To achieve this, the function of the autonomic nervous system will be monitored using non-invasive techniques. Data obtained will be employed to evaluate the role of autonomic nervous system in space motion sickness and to predict susceptibility to space motion sickness. The third objective is evaluation of the adaption process of the cardiovascular system to microgravity. By observation of the hemodynamics using an echocardiogram we will gain insight on cardiovascular deconditioning. The last objective is to create a data base for use in the health care of Japanese astronauts by obtaining control data in experiment L-O in the SL-J mission.

"Dis-able bodied" or "dis-able minded": stakeholders' return-to-work experiences compared between physical and mental health conditions.

PubMed

Vossen, Emmie; Van Gestel, Nicolette; Van der Heijden, Beatrice I J M; Rouwette, Etiënne A J A

2017-05-01

This study aimed to explore if and why the return-to-work (RTW) experiences of various workplace stakeholders in the Netherlands and Denmark differ between physical and mental health conditions, and to understand the consequences of potentially different experiences for the RTW process in both health conditions. We studied 21 cases of long-term sickness absence, and held a total of 61 semi-structured interviews with the various actors involved in these cases. Physical cases were seen as "easy" and mental cases as "difficult" to manage, based on the visibility and predictability of health complaints. On this ground, assessing work ability and following required RTW actions were perceived as more urgent in mental than in physical cases. Despite these perceptions, in practice, the assessment of work ability seemed to impair the RTW process in mental cases (but not in physical ones), and the (non-)uptake of RTW actions appeared to have similar results in both mental and physical cases. With these outcomes, the effectiveness of a differential approach is questioned, and the relevance of a bidirectional dialog on work ability and a phased RTW plan is highlighted, regardless of the absence cause. Our study also demonstrates how policymakers need to strike a balance between obligatory and permissive legislation to better involve workplaces in RTW issues. Implications for rehabilitation Both physically and mentally sick-listed employees could benefit from a bidirectional dialog on work ability as well as from a phased RTW plan. A greater role for employers in the RTW process should be accompanied with a support for sick-listed employees, in both physical and mental sickness absence cases. Dutch and Danish RTW legislation could be improved by carefully balancing obligatory and permissive rules and regulations to involve workplaces in RTW matters.

Independent effect of physical workload and childhood socioeconomic status on low back pain among health care workers in Denmark.

PubMed

Jørgensen, Marie Birk; Nabe-Nielsen, Kirsten; Clausen, Thomas; Holtermann, Andreas

2013-03-15

Prospective cohort study. To investigate the independent effect of physical workload and childhood socioeconomic status (CSES) on low back pain (LBP) and LBP-related sickness absence among female health care workers. The role of physical workload on LBP independently from CSES is still subject to controversy. We used questionnaire data from 1661 female social and health care workers responding to a questionnaire in 2004, 2005, and 2006. We collected information on CSES (parental occupation), physical workload, and LBP-prevalence (no LBP, subchronic LBP, and frequent LBP), and LBP-related sickness absence. The participants were categorized into 5 groups according to CSES (I = highest, V = lowest). Data were analyzed using logistic regression analysis. Irrespective of CSES, high physical workload increased the odds ratio (OR) of future subchronic LBP (OR = 2.03; 95% confidence interval [CI], 1.61-2.57) and frequent LBP (OR = 2.20; 95% CI, 1.65-3.00), but not LBP-related sickness absence. The odds of subchronic LBP were lower in CSES groups II (OR = 0.62; 95% CI, 0.42-0.93) and III (OR = 0.58; 95% CI, 0.39-0.86) referencing CSES group I, irrespective of physical workload. The odds of short-term LBP-related sickness absence were higher in CSES groups III (OR = 2.78; 95% CI, 1.41-5.47) and IV (OR = 2.18; 95% CI, 1.11-4.27) referencing CSES group I, irrespective of physical workload. We found no interaction between physical workload and CSES. Physical workload and CSES are independently associated with future LBP within a group with similar occupational status. N/A.

Who needs a gatekeeper? Patients' views of the role of the primary care physician.

PubMed

Gross, R; Tabenkin, H; Brammli-Greenberg, S

2000-06-01

The primary care physician serving as a 'gatekeeper' can make judicious decisions about the appropriate use of medical services, and thereby contribute to containing costs while improving the quality of care. However, in Israel, sick funds competing for members have not adopted this model for fear of endangering their competitive stance. The purpose of this study was to examine, for the first time, the stated preferences and actual behaviour of a national sample of members of the four Israeli sick funds regarding self-referral to specialists, and to identify the characteristics of patients who prefer the gatekeeper model. Data were derived from a national telephone survey carried out in 1997. A random representative sample of 1084 of all adult sick fund members were interviewed, with a response rate of 81%. Bivariate analysis was conducted using over all chi-square tests, and multivariate analysis was performed using logistic regression models. A third of all respondents prefer self-referral to a specialist, 40% prefer their family physician to act as gatekeeper and 19% prefer the physician to co-ordinate care but to refer themselves to a specialist. Independent variables predicting preference for the gatekeeper model are: living in the periphery, sick fund membership, low level of education, being male, fair or poor health status, having a permanent family physician and being satisfied with the professional level of the family physician. A significant correlation was found between practising self-referral and preference for self-referral. CONCLUSIONS.: The findings indicate the importance of surveying patients' attitudes as an input in policy formulation. The study identified specific population groups which prefer the gatekeeper model, and explored the advantages of a flexible model of gatekeeping.

Effect of cleaning and disinfection of toys on infectious diseases and micro-organisms in daycare nurseries.

PubMed

Ibfelt, T; Engelund, E H; Schultz, A C; Andersen, L P

2015-02-01

The rising number of children in daycare nurseries increases opportunities for the transmission of infectious diseases. Pathogens may be transmitted directly from child to child via sneezing, coughing and touching, or indirectly via the environment. Toys are among the fomites with the highest pathogen load, but their role in disease transmission is unknown. To determine if washing and disinfection of toys can reduce sickness absence and microbial pathogen load in the nursery environment. Twelve nurseries (caring for 587 children) were randomized to intervention and control groups. The intervention consisted of washing and disinfection of toys and linen every two weeks for three months by a commercial cleaning company. The extent and causes of sickness absence among the children were recorded in both groups before and after introduction of the intervention. Ten sampling points in each nursery were examined for bacteria and respiratory viruses. The presence of respiratory virus DNA/RNA was widespread, but very few pathogenic bacteria were found in the environment. The intervention reduced the presence of adenovirus [odds ratio (OR) 2.4, 95% confidence interval (CI) 1.1-5.0], rhinovirus (OR 5.3, 95% CI 2.3-12.4) and respiratory syncytial virus (OR 4.1, 95% CI 1.5-11.2) compared with the control group, but the intervention had no effect on sickness absence or disease patterns in the nurseries. Although cleaning and disinfection of toys every two weeks can decrease the microbial load in nurseries, it does not appear to reduce sickness absence among nursery children. Copyright © 2014 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Cerebral Hypoperfusion Precedes Nausea During Centrifugation

NASA Technical Reports Server (NTRS)

Serrador, Jorge M.; Schlegel, Todd T.; Black, F. Owen; Wood, Scott J.

2004-01-01

Nausea and motion sickness are important operational concerns for aviators and astronauts. Understanding underlying mechanisms associated with motion sickness may lead to new treatments. The goal of this work was to determine if cerebral blood flow changes precede the development of nausea in motion sick susceptible subjects. Cerebral flow velocity in the middle cerebral artery (transcranial Doppler), blood pressure (Finapres) and end-tidal CO2 were measured while subjects were rotated on a centrifuge (250 degrees/sec). Following 5 min of rotation, subjects were translated 0.504 m off-center, creating a +lGx centripetal acceleration in the nasal-occipital plane. Ten subjects completed the protocol without symptoms while 5 developed nausea (4 while 6ff-center and 1 while rotating on-center). Prior to nausea, subjects had significant increases in blood pressure (+13plus or minus 3 mmHg, P less than 0.05) and cerebrovascular resistance (+46 plus or minus 17%, P less than 0.05) and decreases in cerebral flow velocity both in the second (-13 plus or minus 4%) and last minute (-22 plus or minus 5%) before symptoms (P less than 0.05). In comparison, controls demonstrated no change in blood pressure or cerebrovascular resistance in the last minute of off-center rotation and only a 7 plus or minus 2% decrease in cerebral flow velocity. All subjects had significant hypocapnia (-3.8 plus or minus 0.4 mmHg, P less than 0.05), however this hypocapnia could not fully explain the cerebral hypoperfusion associated with the development of nausea. These data indicate that reductions in cerebral blood flow precede the development of nausea. Further work is necessary to determine what role cerebral hypoperfusion plays in motion sickness and whether cerebral hypoperfusion can be used to predict the development of nausea in susceptible individuals.

Pioneers and laggards - is the effect of gender equality on health dependent on context?

PubMed

Backhans, Mona Christina; Burström, Bo; Lindholm, Lars; Månsdotter, Anna

2009-04-01

This study combines data at individual and area level to examine interactions between equality within couples and gender equality in the municipality in which individuals live. The research question is whether the context impacts on the association between gender equality and health. The material consists of data on 37,423 men and 37,616 women in 279 Swedish municipalities, who had their first child in 1978. The couples were classified according to indicators of their level of gender equality in 1980 in the public sphere (occupation and income) and private sphere (child care leave and parental leave) compared to that of their municipality. The health outcome is compensated days from sickness insurance during 1986-1999 with a cut-off at the 85% percentile. Data were analysed using logistic regression with the overall odds as reference. The results concerning gender equality in the private sphere show that among fathers, those who are equal in an equal municipality have lower levels of sick leave than the average while laggards (less equal than their municipality) and modest laggards have higher levels. In the public sphere, pioneers (more equal t han their municipality) fare better than the average while laggards fare worse. For mothers, those who are traditional in their roles in the public sphere are protected from high levels of sick leave, while the reverse is true for those who are equal. Traditional mothers in a traditional municipality have the lowest level of sick leave and pioneers the highest. These results show that there are distinct benefits as well as disadvantages to being a gender pioneer and/or a laggard in comparison to your municipality. The associations are markedly different for men and women.

The indirect association of job strain with long-term sickness absence through bullying: a mediation analysis using structural equation modeling.

PubMed

Janssens, Heidi; Braeckman, Lutgart; De Clercq, Bart; Casini, Annalisa; De Bacquer, Dirk; Kittel, France; Clays, Els

2016-08-22

In this longitudinal study the complex interplay between both job strain and bullying in relation to sickness absence was investigated. Following the "work environment hypothesis", which establishes several work characteristics as antecedents of bullying, we assumed that job strain, conceptualized by the Job-Demand-Control model, has an indirect relation with long-term sickness absence through bullying. The sample consisted of 2983 Belgian workers, aged 30 to 55 years, who participated in the Belstress III study. They completed a survey, including the Job Content Questionnaire and a bullying inventory, at baseline. Their sickness absence figures were registered during 1 year follow-up. Long-term sickness absence was defined as at least 15 consecutive days. A mediation analysis, using structural equation modeling, was performed to examine the indirect association of job strain through bullying with long-term sickness absence. The full structural model was adjusted for several possible confounders: age, gender, occupational group, educational level, company, smoking habits, alcohol use, body mass index, self-rated health, baseline long-term sickness absence and neuroticism. The results support the hypothesis: a significant indirect association of job strain with long-term sickness absence through bullying was observed, suggesting that bullying is an intermediate variable between job strain and long-term sickness absence. No evidence for the reversed pathway of an indirect association of bullying through job strain was found. Bullying was observed as a mediating variable in the relation between job strain and sickness absence. The results suggest that exposure to job strain may create circumstances in which a worker risks to become a target of bullying. Our findings are generally in line with the work environment hypothesis, which emphasizes the importance of organizational work factors in the origin of bullying. This study highlights that remodeling jobs to reduce job strain may be important in the prevention of bullying and subsequent sickness absence.

Differences in sickness absence between self-employed and employed doctors: a cross-sectional study on national sample of Norwegian doctors in 2010

PubMed Central

2014-01-01

Background Doctors have a low prevalence of sickness absence. Employment status is a determinant in the multifactorial background of sickness absence. The effect of doctors’ employment status on sickness absence is unexplored. The study compares the number of sickness absence days during the last 12 months and the impact of employment status, psychosocial work stress, self-rated health and demographics on sickness absence between self-employed practitioners and employed hospital doctors in Norway. Methods The study population consisted of a representative sample of 521 employed interns and consultants and 313 self-employed GPs and private practice specialists in Norway, who received postal questionnaires in 2010. The questionnaires contained items on sickness absence days during the last 12 months, employment status, demographics, self-rated health, professional autonomy and psychosocial work stress. Results 84% (95% CI 80 to 88%) of self-employed and 60% (95% CI 55 to 64%) of employed doctors reported no absence at all last year. In three multivariate logistic regression models with sickness absence as response variable, employment category was a highly significant predictor for absence vs. no absence, 1 to 3 days of absence vs. no absence and 4 to 99 days of absence vs. no absence), while in a model with 100 or more days of absence vs. no absence, there was no difference between employment categories, suggesting that serious chronic disease or injury is less dependent on employment category. Average or poor self-rated health and low professional autonomy, were also significant predictors of sickness absence, while psychosocial work stress, age and gender were not. Conclusion Self-employed GPs and private practice specialist reported lower sickness absence than employed hospital doctors. Differences in sickness compensation, and organisational and individual factors may to a certain extent explain this finding. PMID:24885230

Low back pain and widespread pain predict sickness absence among industrial workers

PubMed Central

Morken, Tone; Riise, Trond; Moen, Bente; Hauge, Signe HV; Holien, Solrun; Langedrag, Anne; Pedersen, Svein; Saue, Inger Lise L; Seljebø, Guri M; Thoppil, Varughese

2003-01-01

Background The prevalence of musculoskeletal disorders (MSD) in the aluminium industry is high, and there is a considerable work-related fraction. More knowledge about the predictors of sickness absence from MSD in this industry will be valuable in determining strategies for prevention. The aim of this study was to analyse the relative impact of body parts, psychosocial and individual factors as predictors for short- and long-term sickness absence from MSD among industrial workers. Methods A follow-up study was conducted among all the workers at eight aluminium plants in Norway. A questionnaire was completed by 5654 workers at baseline in 1998. A total of 3320 of these participated in the follow-up study in 2000. Cox regression analysis was applied to investigate the relative impact of MSD in various parts of the body and of psychosocial and individual factors reported in 1998 on short-term and long-term sickness absence from MSD reported in 2000. Results MSD accounted for 45% of all working days lost the year prior to follow-up in 2000. Blue-collar workers had significantly higher risk than white-collar workers for both short- and long-term sickness absence from MSD (long-term sickness absence: RR = 3.04, 95% CI 2.08–4.45). Widespread and low back pain in 1998 significantly predicted both short- and long-term sickness absence in 2000. In addition, shoulder pain predicted long-term sickness absence. Low social support predicted short-term sickness absence (RR = 1.28, 95% CI 1.11–1.49). Conclusions Reducing sickness absence from MSD among industrial workers requires focusing on the working conditions of blue-collar workers and risk factors for low back pain and widespread pain. Increasing social support in the work environment may have effects in reducing short-term sickness absence from MSD. PMID:12956891

Work-related psychosocial events as triggers of sick leave - results from a Swedish case-crossover study

PubMed Central

2011-01-01

Background Although illness is an important cause of sick leave, it has also been suggested that non-medical risk factors may influence this association. If such factors impact on the period of decision making, they should be considered as triggers. Yet, there is no empirical support available. The aim was to investigate whether recent exposure to work-related psychosocial events can trigger the decision to report sick when ill. Methods A case-crossover design was applied to 546 sick-leave spells, extracted from a Swedish cohort of 1 430 employees with a 3-12 month follow-up of new sick-leave spells. Exposure in a case period corresponding to an induction period of one or two days was compared with exposure during control periods sampled from workdays during a two-week period prior to sick leave for the same individual. This was done according to the matched-pair interval and the usual frequency approaches. Results are presented as odds ratios (OR) with 95% confidence intervals (CI). Results Most sick-leave spells happened in relation to acute, minor illnesses that substantially reduced work ability. The risk of taking sick leave was increased when individuals had recently been exposed to problems in their relationship with a superior (OR 3.63; CI 1.44-9.14) or colleagues (OR 4.68; CI 1.43-15.29). Individuals were also more inclined to report sick on days when they expected a very stressful work situation than on a day when they were not under such stress (OR 2.27; CI 1.40-3.70). Conclusions Exposure to problems in workplace relationships or a stressful work situation seems to be able to trigger reporting sick. Psychosocial work-environmental factors appear to have a short-term effect on individuals when deciding to report sick. PMID:21429193

Expectations and illness perceptions as predictors of benefit recipiency among workers with common mental disorders: secondary analysis from a randomised controlled trial

PubMed Central

Løvvik, Camilla; Shaw, William; Øverland, Simon; Reme, Silje Endresen

2014-01-01

Objective Common mental disorders (CMDs) are among the leading causes of sick leave, and more knowledge on factors related to work participation and return-to-work (RTW) in CMDs is needed. The aim of this study was to investigate RTW-expectations and illness perceptions as predictors of benefit recipiency in CMDs. Design Study participants were enrolled in a randomised controlled trial and reported CMDs as a main obstacle for work participation. Three prespecified subgroups were included: people at risk of going on sick leave, people on sick leave (>3 weeks) or people on long-term benefits. Baseline questionnaire data and registry data at baseline and 6 months were used to investigate predictors of benefit recipiency at 6-month follow-up. Benefit recipiency included sickness benefits, disability pension, work assessment allowance and unemployment benefits. Results In this study, uncertain and negative RTW-expectations were strong predictors of benefit recipiency at 6 months follow-up. Illness perceptions predicted benefit recipiency in the unadjusted model, but not in the fully adjusted model. In the subgroup on sick leave, uncertain and negative RTW-expectations predicted benefit recipiency, while in the subgroup of people at risk of going on sick leave, negative RTW-expectations predicted benefit recipiency. In the subgroup on long-term benefits, only female gender predicted benefit recipiency. Conclusions For people with CMDs, uncertain and negative RTW-expectations predict later benefit recipiency, and expectations seem particularly important for those at risk of or on sick leave. For those at risk of sick leave, benefit recipiency at follow-up denoted a transition onto sick leave or long-term benefit, while those on sick leave had remained so or were receiving long-term benefits. Addressing RTW-expectations in occupational healthcare services or vocational rehabilitation might be beneficial in early stages or even prior to a sick leave episode. Trial registration http://www.clinicaltrials.gov, NCT01146730. PMID:24589824

Four-year incidence of sick leave because of neck and shoulder pain and its association with work and lifestyle.

PubMed

Alipour, Akbar; Ghaffari, Mostafa; Shariati, Batoul; Jensen, Irene; Vingard, Eva

2009-02-15

Four-year prospective cohort study. To find the incidence of sick leave because of neck and shoulder pain (NSP) in industrial workers, and its association with work and lifestyle risk factors. Longitudinal studies to investigate NSP incidence and risk factors are rare, and even fewer have been conducted in middle- and low-income countries. After inviting all full-time employees of an Iranian car manufacturing company with 18,031 employees to participate in a baseline study, they were followed for 4 years. New episodes of sick leave because of NSP have been calculated based on sickness absence registration between the years 2003 and 2007. The incidence was compared for participants and nonparticipants. The association between sick leave, physical, and psychosocial risk factors at work, and previous self-reported NSP, was calculated for the remaining population of baseline participants (12,184 employees) during a 4-year follow-up. During a 4-year follow-up of study subjects for the remaining participants of the baseline study, the incidence of sick leave was 0.8% (98 sick leave cases in 12,184 employees). For nonparticipants this incidence was 4.2% (130 cases in 3127 employees). In the final regression model for sick leave cases, the remaining factors for potential physical risk factors were repetitive work and sitting positions at work; for psychosocial factors unattractive work was the only significant remaining factor. The incidence of NSP based on sick leave is definitely very low compared with previous studies in high-income countries. This incidence varies between participants and nonparticipants. Risk factors for sick leave differ from risk factors for self-reported pain. A young population, job security, the insurance system, different health behaviors, and healthy worker bias, are all factors that may affect the results, and sick-leave as an outcome must be interpreted with more caution in middle- and low-income countries.

Sick-leave track record and other potential predictors of a disability pension. A population based study of 8,218 men and women followed for 16 years

PubMed Central

Wallman, Thorne; Wedel, Hans; Palmer, Edward; Rosengren, Annika; Johansson, Saga; Eriksson, Henry; Svärdsudd, Kurt

2009-01-01

Background A number of previous studies have investigated various predictors for being granted a disability pension. The aim of this study was to test the efficacy of sick-leave track record as a predictor of being granted a disability pension in a large dataset based on subjects sampled from the general population and followed for a long time. Methods Data from five ongoing population-based Swedish studies was used, supplemented with data on all compensated sick leave periods, disability pensions granted, and vital status, obtained from official registers. The data set included 8,218 men and women followed for 16 years, generated 109,369 person years of observation and 97,160 sickness spells. Various measures of days of sick leave during follow up were used as independent variables and disability pension grant was used as outcome. Results There was a strong relationship between individual sickness spell duration and annual cumulative days of sick leave on the one hand and being granted a disability pension on the other, among both men and women, after adjustment for the effects of marital status, education, household size, smoking habits, geographical area and calendar time period, a proxy for position in the business cycle. The interval between sickness spells showed a corresponding inverse relationship. Of all the variables studied, the number of days of sick leave per year was the most powerful predictor of a disability pension. For both men and women 245 annual sick leave days were needed to reach a 50% probability of transition to disability. The independent variables, taken together, explained 96% of the variation in disability pension grantings. Conclusion The sick-leave track record was the most important predictor of the probability of being granted a disability pension in this study, even when the influences of other variables affecting the outcome were taken into account. PMID:19368715

Effectiveness of new legislation on partial sickness benefit on work participation: a quasi-experiment in Finland

PubMed Central

Kausto, Johanna; Viikari-Juntura, Eira; Virta, Lauri J; Gould, Raija; Koskinen, Aki; Solovieva, Svetlana

2014-01-01

Objectives To examine the effect of the new legislation on partial sickness benefit on subsequent work participation of Finns with long-term sickness absence. Additionally, we investigated whether the effect differed by sex, age or diagnostic category. Design A register-based quasi-experimental study compared the intervention (partial sick leave) group with the comparison (full sick leave) group regarding their pre-post differences in the outcome. The preintervention and postintervention period each consisted of 365 days. Setting Nationwide, individual-level data on the beneficiaries of partial or full sickness benefit in 2008 were obtained from national sickness insurance, pension and earnings registers. Participants 1738 persons in the intervention and 56 754 persons in the comparison group. Outcome Work participation, measured as the proportion (%) of time within 365 days when participants were gainfully employed and did not receive either partial or full ill-health-related or unemployment benefits. Results Although work participation declined in both groups, the decline was 5% (absolute difference-in-differences) smaller in the intervention than in the comparison group, with a minor sex difference. The beneficial effect of partial sick leave was seen especially among those aged 45–54 (5%) and 55–65 (6%) and in mental disorders (13%). When the groups were rendered more exchangeable (propensity score matching on age, sex, diagnostic category, income, occupation, insurance district, work participation, sickness absence, rehabilitation periods and unemployment, prior to intervention and their interaction terms), the effects on work participation were doubled and seen in all age groups and in other diagnostic categories than traumas. Conclusions The results suggest that the new legislation has potential to increase work participation of the population with long-term sickness absence in Finland. If applied in a larger scale, partial sick leave may turn out to be a useful tool in reducing withdrawal of workers from the labour market due to health reasons. PMID:25539780

Profile analysis of after-effects experienced during exposure to several virtual reality environments

NASA Technical Reports Server (NTRS)

Kennedy, Robert S.; Jones, Marshall B.; Lilienthal, Michael G.; Harm, Deborah L.

1994-01-01

Motion sickness symptoms are an unwanted by-product of exposure to virtual environments. This problem is not new and was reported in the early flight simulators and experiments on ego motions and vection. The cardinal symptom of motion sickness is, of course, vomiting, but this symptom is ordinarily preceded by a variety of other symptoms. In his classic studies of motion sickness conducted before and during World War II, G. R. Wendt introduced a three point scale to score motion sickness beyond a vomit/no vomit dichotomy. Later, Navy scientists developed a Motion Sickness Questionnaire (MSQ), originally for use in a slowly rotating room. In the last 20 years the MSQ has been used in a series of studies of air, sea, and space sickness. Only recently, however, has it been appreciated that symptom patterns in the MSQ are not uniform but vary with the way sickness is induced. In seasickness, for example, nausea is the most prominent symptom. In Navy simulators, however, the most common symptom is eye strain, especially when cathode ray tubes are employed in the simulation. The latter result was obtained in a survey of over 1,500 pilot exposures. Using this database, Essex scientists conducted a factor analysis of the MSQ. We found that signs and symptoms of motion sickness fell mainly into three clusters: 1) oculomotor disturbance, 2) nausea and related neurovegetative problems, and 3) disorientation, ataxia, and vertigo. We have since rescored the MSQ results obtained in Navy simulators in terms of these three components. We have also compared these and other profiles obtained from three different vitual reality systems to profiles obtained in sea sickness, space sickness, and alcohol intoxication. We will show examples of these various profiles and point out simularities and differences among them which indicate aspects of what might be called 'virtual-reality sickness'.

Age-, sex-, and diagnosis-specific incidence rate of medically certified long-term sick leave among private sector employees: The Japan Epidemiology Collaboration on Occupational Health (J-ECOH) study.

PubMed

Nishiura, Chihiro; Nanri, Akiko; Kashino, Ikuko; Hori, Ai; Kinugawa, Chihiro; Endo, Motoki; Kato, Noritada; Tomizawa, Aki; Uehara, Akihiko; Yamamoto, Makoto; Nakagawa, Tohru; Yamamoto, Shuichiro; Honda, Toru; Imai, Teppei; Okino, Akiko; Miyamoto, Toshiaki; Sasaki, Naoko; Tomita, Kentaro; Nagahama, Satsue; Kochi, Takeshi; Eguchi, Masafumi; Okazaki, Hiroko; Murakami, Taizo; Shimizu, Chii; Shimizu, Makiko; Kabe, Isamu; Mizoue, Tetsuya; Sone, Tomofumi; Dohi, Seitaro

2017-12-01

Long-term sick-leave is a major public health problem, but data on its incidence in Japan are scarce. We aimed to present reference data for long-term sick-leave among private sector employees in Japan. The study population comprised employees of 12 companies that participated in the Japan Epidemiology Collaboration on Occupational Health Study. Details on medically certified sick-leave lasting ≥30 days were collected from each company. Age- and sex-specific incidence rate of sick-leave was calculated for the period of April 2012 to March 2014. A total of 1422 spells in men and 289 in women occurred during 162,989 and 30,645 person-years of observation, respectively. The three leading causes of sick-leave (percentage of total spells) were mental disorders (52%), neoplasms (12%), and injury (8%) for men; and mental disorders (35%), neoplasms (20%), and pregnancy-related disease (14%) for women. Incidence rate of sick-leave due to mental disorders was relatively high among men in their 20s-40s but tended to decrease with age among women. Incidence rate of sick-leave due to neoplasms started to increase after age 50 in men and after age 40 in women, making neoplasms the leading cause of sick-leave after age 50 for women and after age 60 for men and the second leading cause after age 40 for women and after age 50 for men. Pregnancy-related disease was the second leading cause of sick-leave among women aged 20-39 years. These results suggest that mental disorder, neoplasms, and pregnancy-related disease are the major causes of long-term sick-leave among private sector employees in Japan. Copyright © 2017 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

Sickness absence as a predictor of disability retirement in different occupational classes: a register-based study of a working-age cohort in Finland in 2007-2014.

PubMed

Salonen, Laura; Blomgren, Jenni; Laaksonen, Mikko; Niemelä, Mikko

2018-05-09

The objective of the study was to examine diagnosis-specific sickness absences of different lengths as predictors of disability retirement in different occupational classes. Register-based prospective cohort study up to 8 years of follow-up. A 70% random sample of the non-retired Finnish population aged 25-62 at the end of 2006 was included (n=1 727 644) and linked to data on sickness absences in 2005 and data on disability retirement in 2007-2014. Cox proportional hazards regression was utilised to analyse the association of sickness absence with the risk of all-cause disability retirement during an 8-year follow-up. The risk of disability retirement increased with increasing lengths of sickness absence in all occupational classes. A long sickness absence was a particularly strong predictor of disability retirement in upper non-manual employees as among those with over 180 sickness absence days the HR was 9.19 (95% CI 7.40 to 11.40), but in manual employees the HR was 3.51 (95% CI 3.23 to 3.81) in men. Among women, the corresponding HRs were 7.26 (95% CI 6.16 to 8.57) and 3.94 (95% CI 3.60 to 4.30), respectively. Adjusting for the diagnosis of sickness absence partly attenuated the association between the length of sickness absence and the risk of disability retirement in all employed groups. A long sickness absence is a strong predictor of disability retirement in all occupational classes. Preventing the accumulation of sickness absence days and designing more efficient policies for different occupational classes may be crucial to reduce the number of transitions to early retirement due to disability. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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 ...

Sick leave among people in paid work after age 65: A Swedish population-based study covering 1995, 2000, 2005 and 2010.

PubMed

Farrants, K; Marklund, S; Kjeldgård, L; Head, J; Alexanderson, K

2018-05-01

Extending working life into older age groups is discussed in many countries. However, there is no knowledge about how this affects rates of sick leave. The aim of this work was to investigate rates of sick leave among people in paid work after retirement age and if such rates have changed over time. Swedish nationwide register data on people aged >65 years and living in Sweden in 1995, 2000, 2005 and 2010 were analysed. All people with a sufficiently high work income to be eligible for public sick leave benefits were included. The proportions in paid work and compensated rates of sick leave for people aged 66-70 and ≥71 were analysed by sex, educational level, country of birth, living area, and employment type and sector. The percentage of people in paid work at ages 66-70 years increased from <10% in 1995 to 24% in 2010 and among those aged ≥71 years from 2.7% in 1995 to 3.5% in 2010. The rates of sick leave among working people aged 66-70 years were 3.3% in 1995 and 2.4% in 2010 and for people aged ≥71 years the rates of sick leave were 2.2% in 1995 and 0.2% in 2010. Women had higher rates of sick leave than men in 2005 and 2010, but lower in 1995 and 2000. In 2010, the rates of sick leave were similar between employees and the self-employed, and higher among employees in the public sector than among employees in the private sector. Rates of sick leave among workers aged >65 years were lower in 2010 than in 1995, despite much higher rates of labour market participation in 2010.

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

Sick leave in Sweden before and after total joint replacement in hip and knee osteoarthritis patients.

PubMed

Stigmar, Kjerstin; Dahlberg, Leif E; Zhou, Caddie; Jacobson Lidgren, Helena; Petersson, Ingemar F; Englund, Martin

2017-04-01

Background and purpose - Little is know about patterns of sick leave in connection with total hip and knee joint replacement (THR and TKR) in patients with osteoarthritis (OA). Patients and methods - Using registers from southern Sweden, we identified hip and knee OA patients aged 40-59 years who had a THR or TKR in the period 2004-2012. Patients who died or started on disability pension were excluded. We included 1,307 patients with THR (46% women) and 996 patients with TKR (56% women). For the period 1 year before until 2 years after the surgery, we linked individual-level data on sick leave from the Swedish Social Insurance Agency. We created a matched reference cohort from the general population by age, birth year, and area of residence (THR: n = 4,604; TKR: n = 3,425). The mean number of days on sick leave and the proportion (%) on sick leave 12 and 24 months before and after surgery were calculated. Results - The month after surgery, about 90% of patients in both cohorts were on sick leave. At the two-year follow-up, sick leave was lower for both cohorts than 1 year before surgery, except for men with THR, but about 9% of the THR patients and 12-17% of the TKR patients were still sick-listed. In the matched reference cohorts, sick leave was constant at around 4-7% during the entire study period. Interpretation - A long period of sick leave is common after total joint replacement, especially after TKR. There is a need for better knowledge on how workplace adjustments and rehabilitation can facilitate the return to work and can postpone surgery.

Relation between sick leave and selected exposure variables among women semiconductor workers in Malaysia

PubMed Central

Chee, H; Rampal, K

2003-01-01

Aims: To determine the relation between sick leave and selected exposure variables among women semiconductor workers. Methods: This was a cross sectional survey of production workers from 18 semiconductor factories. Those selected had to be women, direct production operators up to the level of line leader, and Malaysian citizens. Sick leave and exposure to physical and chemical hazards were determined by self reporting. Three sick leave variables were used; number of sick leave days taken in the past year was the variable of interest in logistic regression models where the effects of age, marital status, work task, work schedule, work section, and duration of work in factory and work section were also explored. Results: Marital status was strongly linked to the taking of sick leave. Age, work schedule, and duration of work in the factory were significant confounders only in certain cases. After adjusting for these confounders, chemical and physical exposures, with the exception of poor ventilation and smelling chemicals, showed no significant relation to the taking of sick leave within the past year. Work section was a good predictor for taking sick leave, as wafer polishing workers faced higher odds of taking sick leave for each of the three cut off points of seven days, three days, and not at all, while parts assembly workers also faced significantly higher odds of taking sick leave. Conclusion: In Malaysia, the wafer fabrication factories only carry out a limited portion of the work processes, in particular, wafer polishing and the processes immediately prior to and following it. This study, in showing higher illness rates for workers in wafer polishing compared to semiconductor assembly, has implications for the governmental policy of encouraging the setting up of wafer fabrication plants with the full range of work processes. PMID:12660374

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

Return-to-Work Self-Efficacy and Actual Return to Work Among Long-Term Sick-Listed Employees.

PubMed

Volker, D; Zijlstra-Vlasveld, M C; Brouwers, E P M; van Lomwel, A G C; van der Feltz-Cornelis, C M

2015-06-01

Considering the costs incurred by sickness absence and the implications for the workers' quality of life, a fast return to work (RTW) is important. Self-efficacy (SE) seems to be an important predictor of RTW for employees with mental health problems. The predictive value of return-to-work self-efficacy (RTW-SE) has not been examined in employees on long-term sickness absence due to any cause. The aim of this study is to investigate whether RTW-SE is a predictor of time to RTW in long-term sick-listed employees with all-cause sickness absence. Furthermore, the relative contribution of RTW-SE in predicting RTW will be examined compared to health-related, job-related and personal factors. In a longitudinal study, sick-listed employees who were currently on sick leave for more than 4 weeks filled out a self-report questionnaire. Demographics, health-related, personal, and job-related factors, and RTW-SE were measured. Employees were followed for 2 years to determine the duration until full RTW. Cox proportional hazards regression analyses were used to identify factors associated with time to RTW. Data were collected from 493 sick-listed employees. RTW-SE was a significant predictor of RTW. In a multivariate model, low RTW-SE, the thought of not being able to work while having symptoms (illness behaviour) and having chronic medical conditions were predictors of a longer duration until RTW. When guiding long-term sick-listed employees, it is important to focus on factors such as SE and illness behaviour, instead of just focusing on the symptoms of the sick-listed employee.

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.

Short rest between shift intervals increases the risk of sick leave: a prospective registry study.

PubMed

Vedaa, Øystein; Pallesen, Ståle; Waage, Siri; Bjorvatn, Bjørn; Sivertsen, Børge; Erevik, Eilin; Svensen, Erling; Harris, Anette

2017-07-01

The purpose of this study was to use objective registry data to prospectively investigate the effects of quick returns (QR, <11 hours of rest between shifts) and night shifts on sick leave. A total of 1538 nurses (response rate =41.5%) answered questionnaires on demographics and personality and provided consent to link this information to registry data on shift work and sick leave from employers' records. A multilevel negative binomial model was used to investigate the predictive effect of exposure to night shifts and QR every month for 1 year, on sick leave the following month. Exposure to QR the previous month increased the risk for sick leave days (incidence rate ratio (IRR)=1.066, 95% CI 1.022 to 1.108, p<0.01) and sick leave spells (IRR=1.059, 95% CI 1.025 to 1.097, p<0.001) the following month, whereas night shifts did not. 83% per cent of the nurses experienced QR within a year, and on average they were exposed to 3.0 QR per month (SD=1.6). Personality characteristics associated with shift work tolerance (low on morningness, low on languidity and high on flexibility) were not associated with sick leave, and did not moderate the relationship between QR and sick leave. We found a positive linear relationship between QR and sick leave. Avoiding QR may help reduce workers' sick leave. The restricted recovery opportunity associated with QR may give little room for beneficial effects of individual characteristics usually associated with shift work tolerance. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Separate and combined associations of pain and emotional exhaustion with sickness absence.

PubMed

Saastamoinen, Peppiina; Leino-Arjas, Päivi; Rahkonen, Ossi; Lahelma, Eero

2016-01-01

Pain and emotional exhaustion are prevalent conditions with consequences for sickness absence. Although they often co-occur, their combined associations with sickness absence are poorly understood. This study aimed to examine the separate and combined associations of pain and emotional exhaustion with subsequent sickness absence. The data were derived from a cross-sectional questionnaire survey sent to 40 to 60-year-old employees of the City of Helsinki in 2000 to 2002 (n = 6457) linked with the City of Helsinki personnel register information on sickness absence (3 years on from the survey). Self-certified (1-3 days) and medically certified sickness absence spells (4-14 days, more than 14 days) were used as outcomes. Acute and chronic pain and emotional exhaustion were measured in a questionnaire survey. For the purposes of this study, sickness absence and pain variables were merged to form a new variable with 6 mutually exclusive categories. The main statistical method was negative binomial regression analysis. The synergy index was used to estimate the interaction. Among women, acute and chronic pain with and without emotional exhaustion predicted sickness absence, particularly absence lasting for more than 2 weeks, whereas emotional exhaustion alone did not. The associations persisted when further adjusted for socioeconomic and sociodemographic factors, health-related behaviors, and somatic and mental health. A synergistic interaction effect was found for co-occurring pain and emotional exhaustion on medically certified sickness absence. The results for men were mainly similar, but less stable. In order to tackle sickness absence, special attention should be paid to the prevention and treatment of employees with co-occurring pain and emotional exhaustion.

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.

Demographic trends of sick leave absenteeism among civil service employees at a federal agency from 2004 to 2012.

PubMed

Gajewski, Kim; Burris, Dara; Spears, D Ross; Sullivan, Kevin; Oyinloye, Oluremi; McNeil, Carrie; Meechan, Paul; Warnock, Eli; Trapp, Jonathan; Decker, K C; Chapman, Sandy

2015-03-01

To investigate the associations between demographic variables and sick leave use. We analyzed sick leave use among civil servants at a federal agency (FA) from 2004 to 2012 by demographic and FA-specific variables. We used a mixed methods approach and type III analysis to build a descriptive model of sick leave proportions and demographic variables. Sick absenteeism usage varied significantly (variation of greater than one sick day per year) by sex, Emergency Operations Center response tier, length of service at the FA, age, and general schedule pay grade level. Our final descriptive model contained age, sex, response tier and an interaction term between age and sex. Future studies should examine these associations on smaller time scales, perhaps breaking the data down by month or day of the week.

Comparison of sick leave patterns between Norway and Denmark in the health and care sector: a register study.

PubMed

Krane, Line; Fleten, Nils; Stapelfeldt, Christina M; Nielsen, Claus Vinther; Jensen, Chris; Johnsen, Roar; Braaten, Tonje

2013-11-01

Sickness absence is of considerable concern in both Norway and Denmark. Labour Force Surveys indicate that absence in Norway is about twice that in Denmark and twice that of the mean reported by the Organisation for Economic Co-operation and Development. This study compares absence patterns according to age, percentage of employment, and occupation between municipal employees in the health and care sectors in two municipalities in Norway and Denmark. Data recorded in the personnel registers of the municipalities of Kristiansand, Norway and Aarhus, Denmark were extracted for the years 2004 and 2008, revealing 3498 and 7751 employee-years, respectively. We calculated absence rates together with number of sick leave episodes, and their association with the above-mentioned covariates. Gender-specific comparative descriptive statistics and negative binomial regression analysis were performed. The sickness absence rate in women was 11.3% in Norway (95% confidence interval [CI] 11.2-11.4) and 7.0% in Denmark (95% CI 7.0-7.1) whereas mean number of sick leave episodes among women was 2.4 in Denmark, compared to 2.3 in Norway (p = 0.02). Young employees in Denmark had more sick leave episodes than in Norway. Proportion of absentees was higher in Denmark compared to Norway (p < 0.0001). The finding of that more employees in Denmark have more frequent, but shorter sick leave episodes compared to Norway, for whatever reasons, may indicate that more frequent sick leaves episodes prevent higher sick leaves rates.

Working parents: what factors are involved in their ability to take time off from work when their children are sick?

PubMed

Heymann, S J; Toomey, S; Furstenberg, F

1999-08-01

A series of studies has demonstrated that sick children fare better when their parents are present. To examine working conditions that determine whether parents can spend time with and become involved in the care of their children when they are sick. Survey with a multivariate analysis of factors influencing parental care of sick children. Mixed-income urban working parents aged 26 to 29 years participating in the Baltimore Parenthood Study. Only 42% of working parents in our sample cared for their young children when they became sick. A multivariate logistic regression analysis was conducted to predict which parents stayed at home when their children were sick. Those parents who had either paid sick or vacation leave were 5.2 times as likely to care for their children themselves when they were sick. Of parents with less than a high school education, 17% received paid leave, compared with 57% of parents with a general equivalency diploma, 76% of parents with a high school diploma, and 92% of parents with more than a high school education (P<.001). The finding that many parents were unable to care for their sick children themselves is important for pediatric care. While low-income children are more likely to face marked health problems and to be in need of parental care, they are more likely to live in households in which parents lack paid leave and cannot afford to take unpaid leave.

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

Improving the effectiveness of sickness benefit case management through a public-private partnership? A difference-in-difference analysis in eighteen Danish municipalities.

PubMed

Larsen, Malene Rode; Aust, Birgit; Høgelund, Jan

2017-04-18

The aim of this study was to investigate whether a multidimensional public-private partnership intervention, focussing on improving the quality and efficiency of sickness benefit case management, reduced the sickness benefit duration and the duration until self-support. We used a difference-in-difference (DID) design with six intervention municipalities and 12 matched control municipalities in Denmark. The study sample comprised 282,103 sickness benefit spells exceeding four weeks. The intervention group with 110,291 spells received the intervention, and the control group with 171,812 spells received ordinary sickness benefit case management. Using register data, we fitted Cox proportional hazard ratio models, estimating hazard ratios (HR) and confidence intervals (CI). We found no joint effect of the intervention on the sickness benefit duration (HR 1.02, CI 0.97-1.07) or the duration until self-support (HR 0.99, CI 0.96-1.02). The effect varied among the six municipalities, with sickness benefit HRs ranging from 0.96 (CI 0.93-1.00) to 1.13 (CI 1.08-1.18) and self-support HRs ranging from 0.91 (CI 0.82-1.00) to 1.11 (CI 1.06-1.17). Compared to receiving ordinary sickness benefit management the intervention had on average no effect on the sickness benefit duration or duration until self-support. However, the effect varied considerably among the six municipalities possibly due to differences in the implementation or the complexity of the intervention.

Pregnancy-related sickness absence among employed women in a Swedish county.

PubMed

Alexanderson, K; Hensing, G; Carstensen, J; Bjurulf, P

1995-06-01

The objective of this study was to analyze the variation of pregnancy-related sickness absence among employed women according to age, occupation, and degree of male-female domination within occupations. Data from a prospective study of all new sick-leave spells exceeding 7 d in 1985 and 1986 in the county of Ostergötland, Sweden, were related to the population at risk, through the Swedish Medical Birth Register. The subjects included in the analysis were all 7000 employed women that gave birth in 1985 and 1986, of which some 3000 were sick-listed at least once with pregnancy-related diagnoses. There was little difference in the pregnancy-related sickness absence between the age groups. The age-standardized rate for sick leaves involving pregnancy-related diagnoses differed substantially between occupations. Women in the metal industry had the highest rates; those employed in administration, banking, and insurance had the lowest. White-collar occupations generally had lower rates and blue-collar occupations higher rates, with some exceptions (eg, in saw mills, farming, and the chemical industry). Gender-integrated occupations had the lowest sick-leave rate, while extremely male-dominated jobs had the highest. The latter association remained after adjustment for occupational area. There were considerable differences between occupational groups in the rates of sick leaves involving pregnancy-related diagnoses. Some differences were related to physical load of the jobs being done, but not all. It seems important to consider also male-female domination within a job with respect to such sick leaves.

Sickness absence in relation to psychosocial work factors among daytime workers in an electric equipment manufacturing company.

PubMed

Otsuka, Yasumasa; Takahashi, Masaya; Nakata, Akinori; Haratani, Takashi; Kaida, Kosuke; Fukasawa, Kenji; Hanada, Takanobu; Ito, Akiko

2007-04-01

Associations between psychosocial work factors and sickness absence were investigated in a cross-sectional study of 833 daytime workers. Participants completed a questionnaire regarding psychosocial work factors using the US National Institute for Occupational Safety and Health Generic Job Stress Questionnaire (job control, quantitative workload, cognitive demands, variance in workload, intragroup conflict, intergroup conflict, supervisor support, coworker support, family support, job satisfaction and depressive symptoms) and the number of days of sickness absence within the previous year. Multivariate analyses of covariance with age and occupation as covariates (MANCOVA) were used to test the relationships between psychosocial work factors and sickness absence stratified by sex. In men, the age-adjusted MANCOVA showed that, quantitative workload was highest in the 0.5-4.5 d of sickness absence group (p<0.001). However, the levels of stress reactions (job satisfaction and depressive symptoms) in this group were almost identical to the levels recorded in the no sickness absence group. In contrast, low levels of job control (p<0.01), supervisor support (p<0.05), and job satisfaction (p<0.01) and higher symptoms of depression (p<0.001) were associated with 5 d or more sickness absence. In women, only high job satisfaction was associated with 5 d or more sickness absence (p<0.10). This study suggests that appropriate use of sickness absence at times of being exposed to high quantitative workload may help male workers to recover from stressful situations.

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.

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.

Prediction of space sickness in astronauts from preflight fluid, electrolyte, and cardiovascular variables and Weightless Environmental Training Facility (WETF) training

NASA Technical Reports Server (NTRS)

Simanonok, K.; Mosely, E.; Charles, J.

1992-01-01

Nine preflight variables related to fluid, electrolyte, and cardiovascular status from 64 first-time Shuttle crewmembers were differentially weighted by discrimination analysis to predict the incidence and severity of each crewmember's space sickness as rated by NASA flight surgeons. The nine variables are serum uric acid, red cell count, environmental temperature at the launch site, serum phosphate, urine osmolality, serum thyroxine, sitting systolic blood pressure, calculated blood volume, and serum chloride. Using two methods of cross-validation on the original samples (jackknife and a stratefied random subsample), these variables enable the prediction of space sickness incidence (NONE or SICK) with 80 percent sickness and space severity (NONE, MILD, MODERATE, of SEVERE) with 59 percent success by one method of cross-validation and 67 percent by another method. Addition of a tenth variable, hours spent in the Weightlessness Environment Training Facility (WETF) did not improve the prediction of space sickness incidences but did improve the prediction of space sickness severity to 66 percent success by the first method of cross-validation of original samples and to 71 percent by the second method. Results to date suggest the presence of predisposing physiologic factors to space sickness that implicate fluid shift etiology. The data also suggest that prior exposure to fluid shift during WETF training may produce some circulatory pre-adaption to fluid shifts in weightlessness that results in a reduction of space sickness severity.

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.

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.

The consequences of sickness presenteeism on health and wellbeing over time: A systematic review.

PubMed

Skagen, Kristian; Collins, Alison M

2016-07-01

The association between sickness presenteeism, defined as going to work despite illness, and different health outcomes is increasingly being recognized as a significant and relevant area of research. However, the long term effects on future employee health are less well understood, and to date there has been no review of the empirical evidence. The aim of this systematic review was to present a summary of the sickness presenteeism evidence so far in relation to health and wellbeing over time. Eight databases were searched for longitudinal studies that investigated the consequences of workplace sickness presenteeism, had a baseline and at least one follow-up point, and included at least one specific measure of sickness presenteeism. Of the 453 papers identified, 12 studies met the eligibility criteria and were included in the review. We adopted a thematic approach to the analysis because of the heterogeneous nature of the sickness presenteeism research. The majority of studies found that sickness presenteeism at baseline is a risk factor for future sickness absence and decreased self-rated health. However, our findings highlight that a consensus has not yet been reached in terms of physical and mental health. This is because the longitudinal studies included in this review adopt a wide variety of approaches including the definition of sickness presenteeism, recall periods, measures used and different statistical approaches which is problematic if this research area is to advance. Future research directions are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Sustainability and National Security

DTIC Science & Technology

2012-01-01

care for their sick and resolving and preventing conflict, while also healing its wounds. The NSS also places an emphasis on the develop- ment of...leader in helping other countries develop sustainable practices. This has both altruistic and self - serving attributes. Assisting other countries...integration, robotics ) (French 2005). En- vironmental sustainability offers yet another venue for the military to take a leadership role in American society

The Role of the Government in Work-Family Conflict

ERIC Educational Resources Information Center

Boushey, Heather

2011-01-01

The foundations of the major federal policies that govern today's workplace were put in place during the 1930s, when most families had a stay-at-home caregiver who could tend to the needs of children, the aged, and the sick. Seven decades later, many of the nation's workplace policies are in need of major updates to reflect the realities of the…

A Virtual Learning Environment for the Continuation of Education and Its Relationship with the Mental Well-Being of Chronically Ill Adolescents

ERIC Educational Resources Information Center

Zhu, Chang; Van Winkel, Lies

2016-01-01

Research has shown that the continuation of education by chronically ill adolescents is an important way to avoid social isolation, psychosocial problems and the accumulation of learning difficulties. In this light, virtual learning environments (VLEs), which connect sick adolescents to their schools, play an important role in ensuring that the…

Sickness Presence among Disabled Workers at the University Medical Centre Ljubljana

PubMed Central

ŠKERJANC, Alenka; DODIČ FIKFAK, Metoda

2014-01-01

Objectives The aim of the article is to investigate the differences in sickness present and non-sickness present in the group of disabled health care professionals. Methods Data were gathered from all disabled health care professionals suffering from invalidity of category II or III who were identified in the research among all health care professionals at the University Medical Centre Ljubljana and who were employed there in the period between 1 January 2010 and 31 December 2010. Each employee obtained a questionnaire composed of three standardized international questionnaires. Results There were 248 disabled workers of the II. and III. category of invalidity among the participants. Disabled sickness present reported to have more chronic diseases than disabled non-sickness present (OR = 57.0; 95% CI = 24.4–133.2), lower salary when on sick leave (OR = 13.1; 95% CI = 5.7–30.2) and poor self-rated health (OR = 5.8; 95% CI = 2.7–12.3). Conclusions The prerequisite for sickness presence among disabled workers is their chronic bad health. It is also formally recognized with the degree of disability. Economic factors are among the most important to direct disabled workers towards sickness presence. The results indicate that workplaces are not adapted to disabled workers in regard to their limitations. PMID:27669513

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.

Adjustment latitude and attendance requirements as determinants of sickness absence or attendance. Empirical tests of the illness flexibility model.

PubMed

Johansson, Gun; Lundberg, Ingvar

2004-05-01

This study investigates whether the two dimensions of illness flexibility at work, adjustment latitude and attendance requirements are associated to sickness absence and sickness attendance. Adjustment latitude describes the opportunities people have to reduce or in other ways change their work-effort when ill. Such opportunities can be to choose among work tasks or work at a slower pace. Attendance requirements describe negative consequences of being away from work that can affect either the subject, work mates or a third party. In a cross-sectional design data based on self-reports from a questionnaire from 4924 inhabitants in the county of Stockholm were analysed. The results showed that low adjustment latitude, as predicted, increased women's sickness absence. However, it did not show any relation to men's sickness absence and men's and women's sickness attendance. Attendance requirements were strongly associated to both men's and women's sickness absence and sickness attendance in the predicted way. Those more often required to attend were less likely to be absent and more likely to attend work at illness. As this is the first study of how illness flexibility at work affects behaviour at illness, it was concluded that more studies are needed.

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.

Effects of a weight-gain restriction programme for obese pregnant women on sickness absence and pregnancy benefits.

PubMed

Sydsjö, Gunilla; Monfils, Wiktor Gustafsson; de Keyser, Nicholas; Claesson, Ing-Marie; Sydsjö, Adam; Josefsson, Ann

2013-06-01

To evaluate the effect of a weight-gain restriction programme for obese pregnant women on sickness absence days and pregnancy benefit days during pregnancy and postpartum. A prospective, controlled intervention study. The Swedish Social Security Agency's records were utilized to compile sickness absence and pregnancy benefit information. Antenatal care clinics in the south-east of Sweden. One hundred fifty-five obese pregnant women who participated in a weight restriction program with weekly structured motivational and behavioural talks combined with aqua-aerobics during pregnancy. A total of 193 obese pregnant women with no intervention served as controls. Sickness absence benefits and pregnancy benefits expressed as a percentage. On average women in the intervention group had 76.68 total full days of sickness absence benefit compared with 53.09 days in the control group. Total full days of pregnancy benefits were 39.66% days and 41.41% for the intervention and control groups respectively. For the women who were on sick leave there were no differences between the groups in the amount of days taken. Given the complexity of factors that have an influence on sickness absence leave, it is possible that programmes that do not address the influence of social aspects and attitudes towards sickness absence have limited effect.

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.

From sick role to practices of health and illness.

PubMed

Frank, Arthur W

2013-01-01

Health care research generally, and medical education research specifically, make increasingly sophisticated use of social science methods, but these methods are often detached from the theories that are the substantive core of the social sciences. Enhanced understanding of theory is especially valuable for gaining a broader perspective on how issues in medical education reflect the social processes that contextualise them. This article reviews five social science theories, emphasising their relevance to medical education, beginning with the emergence of the sociology of health and illness in the 1950s, with Talcott Parsons' concept of the 'sick role'. Four turning points since Parsons are then discussed with reference to the theory developed by, respectively, Harold Garfinkel, Michel Foucault and Pierre Bourdieu, and what is called the 'narrative or dialogical turn'. In considering these, the author argues for a theory-grounded research that relates specific problems to what Max Weber called the 'fate of our times'. The conclusion considers how medical education research can critique the reproduction of a discourse of scarcity in health care, rather than participating in this discourse and legitimating the disciplinary techniques that it renders self-evident. © Blackwell Publishing Ltd 2013.

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.

Priorities for the elimination of sleeping sickness.

PubMed

Welburn, Susan C; Maudlin, Ian

2012-01-01

Sleeping sickness describes two diseases, both fatal if left untreated: (i) Gambian sleeping sickness caused by Trypanosoma brucei gambiense, a chronic disease with average infection lasting around 3 years, and (ii) Rhodesian sleeping sickness caused by T. b. rhodesiense, an acute disease with death occurring within weeks of infection. Control of Gambian sleeping sickness is based on case detection and treatment involving serological screening, followed by diagnostic confirmation and staging. In stage I, patients can remain asymptomatic as trypanosomes multiply in tissues and body fluids; in stage II, trypanosomes cross the blood-brain barrier, enter the central nervous system and, if left untreated, death follows. Staging is crucial as it defines the treatment that is prescribed; for both forms of disease, stage II involves the use of the highly toxic drug melarsoprol or, in the case of Gambian sleeping sickness, the use of complex and very expensive drug regimes. Case detection of T. b. gambiense sleeping sickness is known to be inefficient but could be improved by the identification of parasites using molecular tools that are, as yet, rarely used in the field. Diagnostics are not such a problem in relation to T. b. rhodesiense sleeping sickness, but the high level of under-reporting of this disease suggests that current strategies, reliant on self-reporting, are inefficient. Sleeping sickness is one of the 'neglected tropical diseases' that attracts little attention from donors or policymakers. Proper quantification of the burden of sleeping sickness matters, as the primary reason for its 'neglect' is that the true impact of the disease is unknown, largely as a result of under-reporting. Certainly, elimination will not be achieved without vast improvements in field diagnostics for both forms of sleeping sickness especially if there is a hidden reservoir of 'chronic carriers'. Mass screening would be a desirable aim for Gambian sleeping sickness and could be handled on a national scale in the endemic countries - perhaps by piggybacking on programmes committed to other diseases. As well as improved diagnostics, the search for non-toxic drugs for stage II treatment should remain a research priority. There is good evidence that thorough active case finding is sufficient to control T. b. gambiense sleeping sickness, as there is no significant animal reservoir. Trypanosoma brucei rhodesiense sleeping sickness is a zoonosis and control involves interrupting the fly-animal-human cycle, so some form of tsetse control and chemotherapy of the animal reservoir must be involved. The restricted application of insecticide to cattle is the most promising, affordable and sustainable technique to have emerged for tsetse control. Animal health providers can aid disease control by treating cattle and, when allied with innovative methods of funding (e.g. public-private partnerships) not reliant on the public purse, this approach may prove more sustainable. Sleeping sickness incidence for the 36 endemic countries has shown a steady decline in recent years and we should take advantage of the apparent lull in incidence and aim for elimination. This is feasible in some sleeping sickness foci but must be planned and paid for increasingly by the endemic countries themselves. The control and elimination of T. b. gambiense sleeping sickness may be seen as a public good, as appropriate strategies depend on local health services for surveillance and treatment, but public-private funding mechanisms should not be excluded. It is timely to take up the tools available and invest in new tools - including novel financial instruments - to eliminate this disease from Africa. Copyright © 2012 Elsevier Ltd. All rights reserved.

Long-term ill health and the social embeddedness of work: a study in a post-industrial, multi-ethnic locality in the UK.

PubMed

Qureshi, Kaveri; Salway, Sarah; Chowbey, Punita; Platt, Lucinda

2014-09-01

Against the background of an increasingly individualising welfare-to-work regime, sociological studies of incapacity and health-related worklessness have called for an appreciation of the role of history and context in patterning individual experience. This article responds to that call by exploring the work experiences of long-term sick people in East London, a post-industrial, multi-ethnic locality. It demonstrates how the individual experiences of long-term sickness and work are embedded in social relations of class, generation, ethnicity and gender, which shape people's formal and informal routes to work protection, work-seeking practices and responses to worklessness. We argue that this social embeddedness requires greater attention in welfare-to-work policy. © 2014 The Authors. Sociology of Health & Illness © 2014 Foundation for the Sociology of Health & Illness/John Wiley & sons Ltd.

[Characteristics of community-acquired pneumonia in servicemen during the military conflict on the Northern Caucasus in 1995-1996].

PubMed

Rakov, A L; Komarevtsev, V N; Kharitonov, M A; Kazantsev, V A

2005-07-01

The data of the examination and treatment of 1150 sick servicemen in different conditions of service in Republic of Chechnya in the military conflict in 1995-1996 are investigated. It was found out that the principal somatic pathology in the structure of sanitary losses of servicemen in the military conflict was respiratory organ diseases, mainly pneumonia, whose etiology as a rule does not depend on the character of the military-and-professional activities and places of troops' distribution. The chief role in the etiology of pneumonia was played by Streptococcus pneumoniae (43.4%). The peculiarities of the clinical picture of pneumoniaduring fighting are stipulated by chronic adaptation overstrain syndrome. Traditional schemes of treatment for such pneumonia do not ensure recovery of the sick within the usual period and do not prevent the development of various complications.

Caregiver mental health and HIV-infected child wellness: perspectives from Ugandan caregivers.

PubMed

Murray, S M; Familiar, I; Nakasujja, N; Winch, P J; Gallo, J J; Opoka, R; Caesar, J O; Boivin, M J; Bass, J K

2017-06-01

Prior studies indicate a substantial link between maternal depression and early child health but give limited consideration to the direction of this relationship or the context in which it occurs. We sought to create a contextually informed conceptual framework of this relationship through semi-structured interviews with women that had lived experience of caring for an HIV-infected child while coping with depression and anxiety symptoms. Caregivers explained their role in raising healthy children as complex and complicated by poverty, stigma, and isolation. Caregivers discussed the effects of their own mental health on child well-being as primarily emotional and behavioral, and explained how looking after a child could bring distress, particularly when unable to provide desired care for sick children. Our findings suggest the need for investigation of the reciprocal effects of child sickness on caregiver wellness and for integrated programs that holistically address the needs of HIV-affected families.

Caregiver mental health and HIV-infected child wellness: perspectives from Ugandan caregivers

PubMed Central

Murray, S.M.; Familiar, I.; Nakasujja, N.; Winch, P.; Gallo, J.; Opoka, R.; Caesar, J.O.; Boivin, M.J.; Bass, J.K.

2017-01-01

Prior studies indicate a substantial link between maternal depression and early child health but give limited consideration to the direction of this relationship or the context in which it occurs. We sought to create a contextually informed conceptual framework of this relationship through semi-structured interviews with women that had lived experience of caring for an HIV-infected child while coping with depression and anxiety symptoms. Caregivers explained their role in raising healthy children as complex and complicated by poverty, stigma, and isolation. Caregivers discussed the effects of their own mental health on child well-being as primarily emotional and behavioral, and explained how looking after a child could bring distress, particularly when unable to provide desired care for sick children. Our findings suggest the need for investigation of the reciprocal effects of child sickness on caregiver wellness and for integrated programs that holistically address the needs of HIV-affected families. PMID:27951734

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.

Exploring the role of co-worker social support on health care utilization and sickness absence

PubMed Central

Tamers, Sara L.; Beresford, Shirley A.A.; Thompson, Beti; Zheng, Yingye; Cheadle, Allen D.

2011-01-01

Objectives To explore the association of baseline co-worker social support with follow-up measures of health care use and sickness absence. Methods Data were obtained on 1,240 employees from 33 worksites, through Promoting Activity and Changes in Eating, a group randomized weight maintenance trial. Co-worker social support, health care utilization, and absenteeism were assessed via a self-reported questionnaire. Generalized Estimating Equations were employed using STATA version 10. Results Higher baseline co-worker social support was significantly associated with a greater number of doctors’ visits (p = 0.015). Co-worker social support was unrelated to number of hospitalizations, emergency room visits, or absenteeism. Conclusions The relationship between co-worker social support and health care utilization and absenteeism is complex and uncertain. Future studies should measure more specific outcomes, incorporate important mediating variables, and distill how social networks influence these outcomes. PMID:21685798

The Impact of Neonatal Illness on Nutritional Requirements—One Size Does Not Fit All

PubMed Central

Ramel, Sara E.; Brown, Laura D.

2015-01-01

Sick neonates are at high risk for growth failure and poorer neurodevelopment than their healthy counterparts. The etiology of postnatal growth failure in sick infants is likely multi-factorial and includes undernutrition due to the difficulty of feeding them during their illness and instability. Illness also itself induces fundamental changes in cellular metabolism that appear to significantly alter nutritional demand and nutrient handling. Inflammation and physiologic stress play a large role in inducing the catabolic state characteristic of the critically ill newborn infant. Inflammatory and stress responses are critical short-term adaptations to promote survival, but are not conducive to promoting long-term growth and development. Conditions such as sepsis, surgery, necrotizing enterocolitis, chronic lung disease and intrauterine growth restriction and their treatments are characterized by altered energy, protein and micronutrient metabolism that result in nutritional requirements that are different from those of the healthy, growing term or preterm infant. PMID:25722954

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.

Pathogen-Mediated Inhibition of Anorexia Promotes Host Survival and Transmission.

PubMed

Rao, Sheila; Schieber, Alexandria M Palaferri; O'Connor, Carolyn P; Leblanc, Mathias; Michel, Daniela; Ayres, Janelle S

2017-01-26

Sickness-induced anorexia is a conserved behavior induced during infections. Here, we report that an intestinal pathogen, Salmonella Typhimurium, inhibits anorexia by manipulating the gut-brain axis. Inhibition of inflammasome activation by the S. Typhimurium effector, SlrP, prevented anorexia caused by IL-1β-mediated signaling to the hypothalamus via the vagus nerve. Rather than compromising host defenses, pathogen-mediated inhibition of anorexia increased host survival. SlrP-mediated inhibition of anorexia prevented invasion and systemic infection by wild-type S. Typhimurium, reducing virulence while increasing transmission to new hosts, suggesting that there are trade-offs between transmission and virulence. These results clarify the complex and contextual role of anorexia in host-pathogen interactions and suggest that microbes have evolved mechanisms to modulate sickness-induced behaviors to promote health of their host and their transmission at the expense of virulence. Copyright © 2017 Elsevier Inc. All rights reserved.

The implications of medical ethics.

PubMed Central

Thompson, I. E.

1976-01-01

In this paper, Mr Thompson, one of the research fellows appointed to the Edinburgh Medical Group research project, seeks to define medical ethics in relation to traditional ethics in the philosophical sense of enquiring into right and wrong modes of thought and conduct, and to carry that study further into the field of moral decisions made by doctors and other professional people who care for the sick. Until very recently the Victorian definition of medical ethics - medical etiquette - served the doctor well but the complexity of modern medicine and the involvement of other professional workers in medical care appears to have swept away the old framework and left a vacuum. A new medical ethic must be evolved to fill that vacuum, taking account not only of technological advances but also of relationships between doctors and other professionals associated with them and of the role in caring for the sick. PMID:781252

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

Glucocorticoid exposure alters the pathogenesis of Theiler’s murine encephalomyelitis virus during acute infection

PubMed Central

Young, Erin E.; Prentice, Thomas W.; Satterlee, Danielle; McCullough, Heath; Sieve, Amy N.; Johnson, Robin R.; Welsh, Thomas H.; Welsh, C. Jane R.; Meagher, Mary W.

2008-01-01

Previous research has shown that chronic restraint stress exacerbates Theiler’s virus infection, a murine model for CNS inflammation and multiple sclerosis. The current set of experiments was designed to evaluate the potential role of glucocorticoids in the deleterious effects of restraint stress on acute CNS inflammatory disease. Exposure to chronic restraint stress resulted in elevated levels of corticosterone as well as increased clinical scores and weight loss (Experiment 1). In addition, corticosterone administration alone exacerbated behavioral signs of TMEV-induced sickness (i.e. decreased body weight, increased symptoms of encephalitis, and increased mortality) and reduced inflammation in the CNS (Experiment 2). Infected subjects receiving exogenous corticosterone showed exacerbation of acute phase measures of sickness and severe mortality as well as decreased viral clearance from CNS (Experiment 3). These findings indicate that corticosterone exposure alone is sufficient to exacerbate acute CNS inflammatory disease. PMID:18538803

The stability of individual patterns of autonomic responses to motion sickness stimulation

NASA Technical Reports Server (NTRS)

Cowings, Patricia S.; Toscano, William B.; Naifeh, Karen H.

1990-01-01

As part of a program to develop a treatment for motion sickness based on self-regulation of autonomic nervous system (ANS) activity, this study examined the stability of an individual's pattern of ANS responses to motion sickness stimulation on repeated occasions. Motion sickness symptoms were induced in 58 people during two rotating chair test. Physiological responses measured were heart rate, finger pulse volume, respiration rate, and skin conductance. Using standard scores, stability of responses of specific magnitudes across both tests is as examined. Correlational analyses, analysis of variance, and a components of variance analysis all revealed marked, but quite stable, individual differences in ANS responses to both mild and severe motion sickness. These findings confirm the prior observation that people are sufficiently unique in their ANS responses to motion sickness provocation to make it nesessary to individually tailor self-regulation training. Further, these data support the contention that individual ANS patterns are sufficiently consistent from test to test so as to serve as an objective indicator of individual motion sickness malaise levels.

Space sickness predictors suggest fluid shift involvement and possible countermeasures

NASA Technical Reports Server (NTRS)

Simanonok, K. E.; Moseley, E. C.; Charles, J. B.

1992-01-01

Preflight data from 64 first time Shuttle crew members were examined retrospectively to predict space sickness severity (NONE, MILD, MODERATE, or SEVERE) by discriminant analysis. From 9 input variables relating to fluid, electrolyte, and cardiovascular status, 8 variables were chosen by discriminant analysis that correctly predicted space sickness severity with 59 pct. success by one method of cross validation on the original sample and 67 pct. by another method. The 8 variables in order of their importance for predicting space sickness severity are sitting systolic blood pressure, serum uric acid, calculated blood volume, serum phosphate, urine osmolality, environmental temperature at the launch site, red cell count, and serum chloride. These results suggest the presence of predisposing physiologic factors to space sickness that implicate a fluid shift etiology. Addition of a 10th input variable, hours spent in the Weightless Environment Training Facility (WETF), improved the prediction of space sickness severity to 66 pct. success by the first method of cross validation on the original sample and to 71 pct. by the second method. The data suggest that WETF training may reduce space sickness severity.

Examination of the double burden hypothesis—a systematic review of work–family conflict and sickness absence

PubMed Central

Skipstein, Anni; Østby, Kristian A.; Mykletun, Arnstein

2017-01-01

Abstract Background: Women consistently have higher sickness absence than men. The double-burden hypothesis suggests this is due to higher work–family burden in women than men. The current study aimed to systematically review prospective studies of work–family conflict and subsequent sickness absence. Methods: A systematic search was conducted in the electronic databases Medline, PsycINFO, and Embase with subject heading terms and keywords with no language or time restrictions. Two reviewers independently screened abstracts and read full-texts with pre-defined inclusion and exclusion criteria. Results: Eight included studies (n = 40 856 respondents) measure perceived work–family conflict and subsequent sickness absence. We found moderate evidence for a positive relationship between work–family conflict and subsequent sickness absence, and that women experience higher levels of work–family conflict than men. Conclusion: Work–family conflict is associated with later sickness absence, and work–family conflict is more common for women than for men. This indicates that work–family conflict may contribute to the gender gap in sick leave. However, further studies are needed to confirm whether this relationship is causal. PMID:28486653

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.

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.

Effects of decades of physical driving on body movement and motion sickness during virtual driving

PubMed Central

Chang, Chih-Hui; Chen, Fu-Chen; Zeng, Wei-Jhong

2017-01-01

We investigated relations between experience driving physical automobiles and motion sickness during the driving of virtual automobiles. Middle-aged individuals drove a virtual automobile in a driving video game. Drivers were individuals who had possessed a driver’s license for approximately 30 years, and who drove regularly, while non-drivers were individuals who had never held a driver’s license, or who had not driven for more than 15 years. During virtual driving, we monitored movement of the head and torso. During virtual driving, drivers became motion sick more rapidly than non-drivers, but the incidence and severity of motion sickness did not differ as a function of driving experience. Patterns of movement during virtual driving differed as a function of driving experience. Separately, movement differed between participants who later became motion sick and those who did not. Most importantly, physical driving experience influenced patterns of postural activity that preceded motion sickness during virtual driving. The results are consistent with the postural instability theory of motion sickness, and help to illuminate relations between the control of physical and virtual vehicles. PMID:29121059

Partial sick leave--review of its use, effects and feasibility in the Nordic countries.

PubMed

Kausto, Johanna; Miranda, Helena; Martimo, Kari-Pekka; Viikari-Juntura, Eira

2008-08-01

Partial sick leave and partial sickness benefits are currently available in Sweden, Norway, Denmark, and Finland. The literature was reviewed to determine their use, describe their recipients, find evidence of their effects, and explore attitudes towards and experiences with their use. Eight databases were searched. National sickness absence statistics and other relevant sources were also reviewed. Of the sickness benefits, partial benefits accounted for approximately one-fifth in Norway, less than 10% in Denmark, and over a third in Sweden. In Finland, partial sick leave was seldom used during the first year (2007) of benefit availability. Few peer-reviewed studies on its effects were identified, and scientific evidence was scarce. Its acceptance was good in all four countries. Most of the recipients were women and over 45 years of age. Studies of its feasibility seem congruent in reporting hindrances due to inflexible work arrangements and poor collaboration between actors. More research and more rigorous study designs are needed to determine whether partial sick leave is feasible and beneficial in keeping those with reduced work ability in worklife.

Longitudinal Relationships Between Organizational Justice, Productivity Loss, and Sickness Absence Among Older Employees.

PubMed

Ybema, Jan F; van der Meer, Laudry; Leijten, Fenna R M

2016-10-01

The aim of this study was to assess whether organizational justice lowers productivity loss and sickness absence, and whether there are reverse effects of productivity loss and sickness absence on organizational justice. A longitudinal study with 2 years of follow-up was conducted among employed persons aged 45-64 years from the Study on Transitions in Employment, Ability and Motivation (STREAM). Participants (N = 7011) yearly filled out an online questionnaire. Structural equation modeling in LISREL was conducted to assess the longitudinal relationships between distributive justice of salary, distributive justice of appreciation, procedural justice, productivity loss, and sickness absence. Both distributive justice of appreciation and procedural justice contributed to lower productivity loss and lower sickness absence at 1-year follow-up. Productivity loss increased perceptions of distributive justice of appreciation at 1-year follow-up, whereas sickness absence lowered both perceptions of distributive justice of appreciation and procedural justice at follow-up. Improving organizational justice lowers the risk of productivity loss and sickness absence and may be a useful tool to improve the productivity of organizations.

Twenty Years of Research on Cytokine-Induced Sickness Behavior*

PubMed Central

Dantzer, Robert; Kelley, Keith W.

2007-01-01

Cytokine-induced sickness behavior was recognized within a few years of the cloning and expression of interferon-α, IL-1 and IL-2, which occurred around the time that the first issue of Brain, Behavior, and Immunity was published in 1987. Phase I clinical trials established that injection of recombinant cytokines into cancer patients led to a variety of psychological disturbances. It was subsequently shown that physiological concentrations of proinflammatory cytokines that occur after infection act in the brain to induce common symptoms of sickness, such as loss of appetite, sleepiness, withdrawal from normal social activities, fever, aching joints and fatigue. This syndrome was defined as sickness behavior and is now recognized to be part of a motivational system that reorganizes the organism's priorities to facilitate recovery from the infection. Cytokines convey to the brain that an infection has occurred in the periphery, and this action of cytokines can occur via the traditional endocrine route via the blood or by direct neural transmission via the afferent vagus nerve. The finding that sickness behavior occurs in all mammals and birds indicates that communication between the immune system and brain has been evolutionarily conserved and forms an important physiological adaptive response that favors survival of the organism during infections. The fact that cytokines act in the brain to induce physiological adaptations that promote survival has led to the hypothesis that inappropriate, prolonged activation of the innate immune system may be involved in a number of pathological disturbances in the brain, ranging from Alzheimers' disease to stroke. Conversely, the newly-defined role of cytokines in a wide variety of systemic co-morbid conditions, ranging from chronic heart failure to obesity, may begin to explain changes in the mental state of these subjects. Indeed, the newest findings of cytokine actions in the brain offer some of the first clues about the pathophysiology of certain mental health disorders, including depression. The time is ripe to begin to move these fundamental discoveries in mice to man, and some of the pharmacological tools are already available to antagonize the detrimental actions of cytokines. PMID:17088043

Nursing sickness in the mink--a metabolic mystery or a familiar foe?

PubMed

Rouvinen-Watt, Kirsti

2003-07-01

Nursing sickness, the largest single cause of mortality in adult female mink (Mustela vison), is an example of a metabolic disorder, which develops when the demands for lactation require extensive mobilization of body energy reserves. The condition is characterized by progressive weight loss, emaciation, and dehydration with high concentrations of glucose and insulin in the blood. Morbidity due to nursing sickness can be as high as 15% with mortality around 8%, but the incidence is known to vary from year to year. Stress has been shown to trigger the onset of the disease and old females and females with large litters are most often affected. Increasing demand for gluconeogenesis from amino acids due to heavy milk production may be a predisposing factor. Glucose metabolism is inextricably linked to that of protein and fats. In obesity (or lipodystrophy), the ability of adipose tissue to buffer the daily influx of nutrients is overwhelmed (or absent), interfering with insulin-mediated glucose disposal and leading to insulin resistance. Polyunsaturated fatty acids of the n-3 family play an important role in modulating insulin signalling and glucose uptake by peripheral tissue. The increasing demand on these fatty acids for milk fat synthesis towards late lactation may result in deficiency in the lactating female, thus impairing glucose disposal. It is suggested that the underlying cause of mink nursing sickness is the development of acquired insulin resistance with 3 contributing key elements: obesity (or lipodystrophy), n-3 fatty acid deficiency, and high protein oxidation rate. It is recommended that mink breeder females be kept in moderate body condition during fall and winter to avoid fattening or emaciation. A dietary n-3 fatty acid supplement during the lactation period may be beneficial for improved glycemic control. Lowering of dietary protein reduces (oxidative) stress and improves water balance in the nursing females and may, therefore, prevent the development and help in the management of nursing sickness. It is also surmised that other, thus far unexplained, metabolic disorders seen in male and female mink may be related to acquired insulin resistance.

Use of physical culture to increase resistance of sailors to motion sickness

NASA Technical Reports Server (NTRS)

Salanin, I. V.

1980-01-01

From 50% to 70% of sailors are exposed to motion sickness in storms. A program of physical exercises is described and tested for effectiveness in preventing this problem. In comparing the results of tests of susceptibility to motion sickness given to groups before and after a program of exercises and to a control group, it is found that physical education can strengthen the vestibulary apparatus and help prevent motion sickness.

Levodopa in Treatment of Decompression Sickness and of Air Embolism Induced Paraplegia in Rats.

DTIC Science & Technology

1981-08-28

nitrosoureas (BCNU, CCNU) made additional progress in the treatment of brain tumors. A lipid soluble agent , 1,3-bis (2-Chloroethyl)-l- Nitrosourea (BCNU...mechanisms of levodopa and some other agents in the prevention and in the recovery of rats from decompression sickness. For better clarity the...brain occurring in decompression sickness. B. Decompression Sickness Studies. We have shown that gelatin, an agent that protects platelets during freezing

Simulator Sickness During Emergency Procedures Training in a Helicopter Simulator: Age, Flight Experience, and Amount Learned

DTIC Science & Technology

2007-09-01

Aircrew Training Research Division, Human Resources Directorate. Smart, L. J ., Stoffregen, T. A ., & Bardy , B. G. (2002). Visually induced motion sickness...Aviation, Space, and Environmental Medicine, 60, 1043-1048. Benson, A . J . (1978). Motion sickness. In G. Dhenin & J . Ernsting (Eds.), Aviation Medicine...pp. 468-493). London: Tri-Med Books. Benson, A . J . (1988). Aetiological factors in simulator sickness. In AGARD, Motion cues in flight simulation and

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.

Autogenic-Feedback Training (AFT) as a preventive method for space motion sickness: Background and experimental design

NASA Technical Reports Server (NTRS)

Cowings, Patricia S.; Toscano, William B.

1993-01-01

Finding an effective treatment for the motion sickness-like symptoms that occur in space has become a high priority for NASA. The background research is reviewed and the experimental design of a formal life sciences shuttle flight experiment designed to prevent space motion sickness in shuttle crew members is presented. This experiment utilizes a behavioral medicine approach to solving this problem. This method, Autogenic-Feedback Training (AFT), involves training subjects to voluntarily control several of their own physiological responses to environmental stressors. AFT has been used reliably to increase tolerance to motion sickness during ground-based tests in over 200 men and women under a variety of conditions that induce motion sickness, and preliminary evidence from space suggests that AFT may be an effective treatment for space motion sickness as well. Proposed changes to this experiment for future manifests are included.

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.

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.

A preliminary study of MR sickness evaluation using visual motion aftereffect for advanced driver assistance systems.

PubMed

Nakajima, Sawako; Ino, Shuichi; Ifukube, Tohru

2007-01-01

Mixed Reality (MR) technologies have recently been explored in many areas of Human-Machine Interface (HMI) such as medicine, manufacturing, entertainment and education. However MR sickness, a kind of motion sickness is caused by sensory conflicts between the real world and virtual world. The purpose of this paper is to find out a new evaluation method of motion and MR sickness. This paper investigates a relationship between the whole-body vibration related to MR technologies and the motion aftereffect (MAE) phenomenon in the human visual system. This MR environment is modeled after advanced driver assistance systems in near-future vehicles. The seated subjects in the MR simulator were shaken in the pitch direction ranging from 0.1 to 2.0 Hz. Results show that MAE is useful for evaluation of MR sickness incidence. In addition, a method to reduce the MR sickness by auditory stimulation is proposed.

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

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.

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.

Occupational health physicians have better work conditions for handling sickness certification compared with general practitioners: results from a nationwide survey in Sweden.

PubMed

Ljungquist, Therese; Alexanderson, Kristina; Kjeldgård, Linnea; Arrelöv, Britt; Nilsson, Gunnar H

2015-02-01

To study whether occupational health physicians (OPs) have a better work situation regarding handling of sickness certification compared with other physicians, in particular general practitioners (GPs), and to analyze associations between OPs' experiences of assessing and providing a long-term prognosis of patients' work capacity and some potentially interrelated factors. Answers to a nationwide survey from physicians who had sickness certification consultations at least once monthly were analyzed. Differences among OPs (n=481), GPs (n=4257) and physicians working in other clinical settings (n=9452) were estimated by chi square tests. Associations between OPs' experiences as above and potentially interrelated factors were estimated using logistic regression analyses. Among OPs, a lower proportion experienced clinical work situations related to sickness certifications as 'very problematic', compared with the other physicians, and especially so compared with GPs. A higher proportion of OPs also had organizational support for handling sickness certifications. For OPs, experience of sickness certification consultations as problematic once a month or less often, not experiencing sickness certification tasks as a work environment problem, and having a well-established workplace policy regarding sickness certification matters were significantly positively associated with finding assessing and providing a long-term prognosis of work capacity as 'not at all/somewhat problematic'. OPs' work situation regarding sickness certifications was favorable compared with that of other physicians, and especially compared with that of GPS. Our results underline the importance of organizational support for ensuring physicians' experience of having professional competence in handling assessments of patients' work capacity. © 2014 the Nordic Societies of Public Health.

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

Emotional Dissonance and Sickness Absence Among Employees Working With Customers and Clients: A Moderated Mediation Model via Exhaustion and Human Resource Primacy.

PubMed

Indregard, Anne-Marthe R; Ulleberg, Pål; Knardahl, Stein; Nielsen, Morten B

2018-01-01

Emotional dissonance, i.e., a discrepancy between required and felt emotions, has been established as a predictor of sickness absence in studies, but little is known about mechanisms that can explain this association. In order to prevent and reduce the impact of emotional dissonance on sickness absence, there is a need for greater attention to variables explaining when and how emotional dissonance is related to sickness absence. The overarching aim of this study was to examine whether emotional dissonance has an indirect association with sickness absence through exhaustion. In addition, we examined whether human resource primacy (HRP), which is the employer's degree of concern for human resources, moderates this indirect effect. A sample of 7758 employees, all working with customers and clients, were recruited from 96 Norwegian organizations. Emotional dissonance, exhaustion, and HRP were measured through surveys and then linked to registry data on medically certified sickness absence for the year following the survey assessment. Results showed that exhaustion is a mediator for the relationship between emotional dissonance and sickness absence. Furthermore, higher levels of HRP were found to reduce the positive association between emotional dissonance and exhaustion, and the indirect effect of emotional dissonance on sickness absence through exhaustion is found to be weaker when HRP is high. By testing this moderated mediation model, the current study contributes to the literature on emotion work by clarifying mechanisms that are crucial for the development of targeted interventions that aim to reduce and prevent sickness absence in client-driven work environments.

Interactional justice at work is related to sickness absence: a study using repeated measures in the Swedish working population.

PubMed

Leineweber, Constanze; Bernhard-Oettel, Claudia; Peristera, Paraskevi; Eib, Constanze; Nyberg, Anna; Westerlund, Hugo

2017-12-08

Research has shown that perceived unfairness contributes to higher rates of sickness absence. While shorter, but more frequent periods of sickness absence might be a possibility for the individual to get relief from high strain, long-term sickness absence might be a sign of more serious health problems. The Uncertainty Management Model suggests that justice is particularly important in times of uncertainty, e.g. perceived job insecurity. The present study investigated the association between interpersonal and informational justice at work with long and frequent sickness absence respectively, under conditions of job insecurity. Data were derived from the 2010, 2012, and 2014 biennial waves of the Swedish Longitudinal Occupational Survey of Health (SLOSH). The final analytic sample consisted of 19,493 individuals. We applied repeated measures regression analyses through generalized estimating equations (GEE), a method for longitudinal data that simultaneously analyses variables at different time points. We calculated risk of long and frequent sickness absence, respectively in relation to interpersonal and informational justice taking perceptions of job insecurity into account. We found informational and interpersonal justice to be associated with risk of long and frequent sickness absence independently of job insecurity and demographic variables. Results from autoregressive GEE provided some support for a causal relationship between justice perceptions and sickness absence. Contrary to expectations, we found no interaction between justice and job insecurity. Our results underline the need for fair and just treatment of employees irrespective of perceived job insecurity in order to keep the workforce healthy and to minimize lost work days due to sickness absence.

What makes men and women with musculoskeletal complaints decide they are too sick to work?

PubMed

Hooftman, Wendela E; Westerman, Marjan J; van der Beek, Allard J; Bongers, Paulien M; van Mechelen, Willem

2008-04-01

The objective of this study was to determine what makes men and women with musculoskeletal complaints decide to call in sick for work. Qualitative, face-to-face interviews were used with employees (16 men and 14 women) who had called in sick due to a musculoskeletal complaint and who expected to be absent from work for at least 2 weeks on sick leave. The participants fell into the following two main groups: those who were off sick because of a diagnosed medical condition, such as a fracture, and those who were off sick because of an unidentifiable complaint, such as low-back pain. Employees in the former group called in sick because they were in the hospital or because they reckoned that their condition was too serious to warrant a continuation of work. Employees in the latter group felt hesitant and insecure and found it hard to judge whether absenteeism was justified. They decided either to "play it safe" and stay off work to prevent the complaints from worsening or to seek advice from medical professionals. Their advice did not include explicit instructions to stay at home, but were usually interpreted as such. Finally, women, but not men, were likely to call in sick if they felt that their home situation was being negatively affected by attempts to keep working while suffering physical complaints. The decision to call in sick is not taken lightly. Employees with nonspecific disorders base their decision on several factors, including advice from medical professionals. A factor found only among women was work-home interference.

Work-related physical and psychosocial risk factors for sick leave in patients with neck or upper extremity complaints.

PubMed

Bot, Sandra D M; Terwee, Caroline B; van der Windt, Daniëlle A W M; van der Beek, Allard J; Bouter, Lex M; Dekker, Joost

2007-08-01

To study work-related physical and psychosocial risk factors for sick leave among patients who have visited their general practitioner for neck or upper extremity complaints. Three hundred and forty two patients with neck or upper extremity complaints completed self-report questionnaires at baseline and after 3 months. Cox regression models were used to investigate the association between work-related risk factors and sick leave (i.e., lost days from work due to neck or upper extremity complaints in 3 months). Effect modification by sick leave at baseline, sex, worrying and musculoskeletal co-morbidity was evaluated by adding product terms to the regression models. In the subgroup of patients who scored high on the pain copying scale "worrying" the hazard ratio of sick leave was 1.32 (95% CI 1.07-1.62) per 10% increase in heavy physical work. The subgroup of patients who were sitting for long periods of time had a reduced risk of sick leave as compared to patients who did not spend a lot of time sitting, again only in patients who scored high on the pain coping scale "worrying" (adjusted HR=0.17, 95%-CI 0.04-0.72). Other work-related risk factors were not significantly related to sick leave. Heavy physical work increased the risk of sick leave and prolonged sitting reduced the risk of sick leave in a subgroup of patients who worried much about their pain. Additional large longitudinal studies of sufficiently large size among employees with neck or upper extremity complaints are needed to confirm our results.

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

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

Emotional Dissonance and Sickness Absence Among Employees Working With Customers and Clients: A Moderated Mediation Model via Exhaustion and Human Resource Primacy

PubMed Central

Indregard, Anne-Marthe R.; Ulleberg, Pål; Knardahl, Stein; Nielsen, Morten B.

2018-01-01

Emotional dissonance, i.e., a discrepancy between required and felt emotions, has been established as a predictor of sickness absence in studies, but little is known about mechanisms that can explain this association. In order to prevent and reduce the impact of emotional dissonance on sickness absence, there is a need for greater attention to variables explaining when and how emotional dissonance is related to sickness absence. The overarching aim of this study was to examine whether emotional dissonance has an indirect association with sickness absence through exhaustion. In addition, we examined whether human resource primacy (HRP), which is the employer’s degree of concern for human resources, moderates this indirect effect. A sample of 7758 employees, all working with customers and clients, were recruited from 96 Norwegian organizations. Emotional dissonance, exhaustion, and HRP were measured through surveys and then linked to registry data on medically certified sickness absence for the year following the survey assessment. Results showed that exhaustion is a mediator for the relationship between emotional dissonance and sickness absence. Furthermore, higher levels of HRP were found to reduce the positive association between emotional dissonance and exhaustion, and the indirect effect of emotional dissonance on sickness absence through exhaustion is found to be weaker when HRP is high. By testing this moderated mediation model, the current study contributes to the literature on emotion work by clarifying mechanisms that are crucial for the development of targeted interventions that aim to reduce and prevent sickness absence in client-driven work environments. PMID:29670556

Evaluation of adaptation to visually induced motion sickness based on the maximum cross-correlation between pulse transmission time and heart rate.

PubMed

Sugita, Norihiro; Yoshizawa, Makoto; Abe, Makoto; Tanaka, Akira; Watanabe, Takashi; Chiba, Shigeru; Yambe, Tomoyuki; Nitta, Shin-ichi

2007-09-28

Computer graphics and virtual reality techniques are useful to develop automatic and effective rehabilitation systems. However, a kind of virtual environment including unstable visual images presented to wide field screen or a head mounted display tends to induce motion sickness. The motion sickness induced in using a rehabilitation system not only inhibits effective training but also may harm patients' health. There are few studies that have objectively evaluated the effects of the repetitive exposures to these stimuli on humans. The purpose of this study is to investigate the adaptation to visually induced motion sickness by physiological data. An experiment was carried out in which the same video image was presented to human subjects three times. We evaluated changes of the intensity of motion sickness they suffered from by a subjective score and the physiological index rho(max), which is defined as the maximum cross-correlation coefficient between heart rate and pulse wave transmission time and is considered to reflect the autonomic nervous activity. The results showed adaptation to visually-induced motion sickness by the repetitive presentation of the same image both in the subjective and the objective indices. However, there were some subjects whose intensity of sickness increased. Thus, it was possible to know the part in the video image which related to motion sickness by analyzing changes in rho(max) with time. The physiological index, rho(max), will be a good index for assessing the adaptation process to visually induced motion sickness and may be useful in checking the safety of rehabilitation systems with new image technologies.

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

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.

Influence of change in psychosocial work characteristics on sickness absence: The Whitehall II Study.

PubMed

Head, Jenny; Kivimäki, Mika; Martikainen, Pekka; Vahtera, Jussi; Ferrie, Jane E; Marmot, Michael G

2006-01-01

To study the influence of change in self perceived psychosocial work characteristics on subsequent rates of sickness absence. Prospective cohort study of British civil service employees. Job control, job demands, and work social supports were measured in 1985/88 and in 1991/93. Analyses included 3817 British civil servants with sickness absence records at baseline (1985-89) and for two follow up periods, early (1994-95) and later follow up (1996-98). Change in work characteristics predicted subsequent incidence of long spells of sickness absence (>7 days) in the early follow up period after adjustment for covariates including baseline work characteristics, health status, and sickness absence. Adjusted rate ratios were 1.23 (95% CI 1.03 to 1.46) for decreased compared with stable decision latitude; 1.17 (95% CI 1.01 to 1.36) for increased compared with stable job demands and 0.79 (95% CI 0.67 to 0.93) for increased compared with stable work social support. These associations were also seen in a sub-sample who did not change employment grade. In the later follow up period, associations between work change and long spells of sickness absence were similar for decision latitude, less pronounced for job demands, and no longer apparent for social supports. Changes in work characteristics were not associated with subsequent short spells of sickness absence (

Quality in sickness certificates in a Swedish social security system perspective.

PubMed

Sturesson, Marine; Bylund, Sonya Hörnqvist; Edlund, Curt; Falkdal, Annie Hansen; Bernspång, Birgitta

2015-12-01

In Sweden, the information in the sickness certificate is crucially important for the sick-listed person as well as for the Swedish Social Insurance Agency and the sick-listed person's employer. The certificate is used as the basis for deciding whether a person is entitled to sickness benefits. Further, it communicates information significant for the return-to-work process. The aim of the study was to evaluate the quality of sickness certificates issued in primary health care and examine if the patients' or physicians' gender influences the information in the sickness certificate. An insurance specialist at the Swedish Social Insurance Agency assessed the quality of the stated information in a sample of 323 certificates issued by 146 different general practitioners at 29 different primary health care centres in northern Sweden. Thirty-four percent of the certificates did not contain sufficient information requested. The areas of the certificates in need of supplementary information were mainly the descriptions of impairment of body function and activity limitation. More certificates issued for women than certificates issued for men lacked the required information. Full-time sick leave was more often prescribed for male patients than for female. Significant differences between certificates issued for women and certificates issued for men appeared in the group of musculoskeletal diseases. No differences in quality aspects connected to physicians' gender were found. Our study indicates a need for increased knowledge about the descriptions of functioning for sick-listed persons; more cooperation between health professionals in primary health care and a better gender awareness in health care encounters. © 2015 the Nordic Societies of Public Health.

Work demands, job insecurity and sickness absence from work. how productive is the new, flexible labour force?

PubMed

D'Souza, Rennie M; Strazdins, Lyndall; Broom, Dorothy H; Rodgers, Bryan; Berry, Helen L

2006-06-01

We investigate one aspect of productivity--sickness absence--and ask whether job insecurity and high work demands are associated with increased sickness absence and, if so, whether mental or physical health mediates this association. We further investigate if having control at work modifies these associations. We used cross-sectional survey data from 2,248 employees aged 40-44 years living in two cities of south-eastern Australia. Logistic regressions were used to compare the associations between job insecurity and demands among those with short (1-3 days) or long-term (> 3 days) sickness absence with those who had no sickness absence in the last four weeks. The mediating effects of mental and physical health were assessed by evaluating changes in the magnitude of the association between these work conditions and sickness absence. High job insecurity (OR = 3.28; 95% CI 1.54-6.95) and high work demands (OR = 1.62; 95% CI 1.13-2.30) were significantly associated with long-term, but not with short-term, sickness absence. These associations were unaffected by job control. Depression and anxiety explained 61% of the association between high work demands and long-term sickness absence and 30% of the association between job insecurity and long-term sickness absence. Difficult working conditions may reduce productivity by contributing to longer absences from work. Reforms intended to improve economic performance should address any potential health costs of insecurity or intensification, which could inadvertently decrease productivity, possibly through their impact on mental health.

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.