Psychiatrists′ work with sickness certification: frequency, experiences and severity of the certification tasks in a national survey in Sweden

PubMed Central

2012-01-01

Background Many psychiatrists are involved in sickness certification of their patients; however, there is very limited knowledge about this aspect of their work. The objective of this study was to explore frequencies of problematic issues in the sickness certification tasks and experiences of severity regarding these problematic issues among psychiatrists. Methods A cross-sectional nationwide questionnaire study to all physicians in Sweden. The 579 specialists in psychiatry who answered the questionnaire, were under 65 years of age, worked mainly in psychiatric care, and had consultations involving sickness certification at least once a week were included. Results The frequency of problematic sickness certification consultations a few times per year or more often was considered by 87.3% of the psychiatrists; 11.7% handle such cases at least once a week. A majority (60.9%) reported ‘not having enough time with the patient’ at least once a week. The psychiatrists had access to several categories of professionals in their daily work. More than one third certified unnecessarily long sick-leave periods at least once a month due to waiting times for Social Insurance Office investigations or for treatments or investigations within health care. Conclusion The majority found it problematic to assess the level and duration of work incapacity, but also other types of problems like unnecessarily long sick-leave periods due to different types of waiting times. The findings have implications for different kinds of organisational and managerial support and training in sickness certification issues, like guidance to assess the level and duration of work incapacity. PMID:23075202

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.

New rules meet established sickness certification practice: a focus-group study on the introduction of functional assessments in Norwegian primary care.

PubMed

Krohne, Kariann; Brage, Søren

2007-09-01

To explore how general practitioners view and handle new standards for functional assessments in sickness certification practice. Qualitative study using focus group interviews. Data were analysed according to Giorgi's phenomenological approach and supported by theories on knowledge. General practitioners from three neighbouring counties in Norway. Four focus groups with a total of 23 participants were recruited through the Norwegian Medical Association and its Continuous Medical Education system. The participants reported difficulties and reluctance to act in accordance with new functional assessment demands on both a practical and a conceptual level. In established sickness certification practice functional assessment was described as an unspoken part of the medical examination. After the introduction of formal, written functional assessments they identified problems of terminology, communication, and trust. Strategies were developed to circumvent these problems. A gap was noticeable between the participants' established practice and the new standards' demand for a more theoretical and communicative functional assessment. The general lack of training, being confronted with new terminology, and increasingly high pressure to reduce sickness absences create an atmosphere of insecurity when assessing function.

Work-related sickness absence negotiations: GPs' qualitative perspectives

PubMed Central

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

2010-01-01

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

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

PubMed

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

2010-10-01

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

No physician gender difference in prescription of sick-leave certification: A retrospective study of the Skaraborg Primary Care Database

PubMed Central

Starzmann, Karin; Hjerpe, Per; Dalemo, Sofia; Björkelund, Cecilia; Boström, Kristina Bengtsson

2012-01-01

Objective The primary objective was to investigate how physicians’ gender and level of experience affects the rate and length of sick-leave certificate prescription. The secondary objective was to study the physicians’ gender and professional experience in relation to the diagnoses on the certificates. Design Retrospective, cross-sectional study of computerized medical records from 24 health care centres in 2005. Setting Primary care in Sweden. Subjects Primary care physicians (n = 589) and patients (n = 88 780) aged 18–64 years. Main outcome measures Rate and duration of sick leave certified by different categories of physicians and for different diagnoses and gender of patients. Results Sick leave was certified in 9.0% (musculoskeletal (3%) and psychiatric (2.3%) diagnoses were most common) of all contacts and the mean duration was 32.2 days. Overall there was no difference between male and female physicians in the sick-leave certification prescription rate (9.1% vs. 9.0%) or duration of sick leave (32.1 vs. 32.6 days). The duration of sick leave was associated with the physician's level of professional experience in general practice (GPs (Distriktläkare) 37, GP trainees (ST-läkare) 26, interns (AT-läkare) 20 and locum (vikarier) 19 days, p < 0.001). Conclusion Contrary to earlier studies we found no difference in sick-leave certification prescription rate and length between male and female physicians. PMID:22348513

Sickness certification of patients--a work environment problem among physicians?

PubMed

Ljungquist, T; Hinas, E; Arrelöv, B; Lindholm, C; Wilteus, A L; Nilsson, G H; Alexanderson, K

2013-01-01

According to several studies, physicians find sickness certification of patients to be problematic, and some smaller studies suggest that this is a psychosocial work environment problem (WEP). To explore to what extent physicians experience sickness certification as a WEP and the associations of this with the type of clinic and other workplace factors. Analyses of data from a questionnaire sent to all physicians who were living and working in Sweden. The study group consisted of physicians aged <65 years who performed sickness certification tasks (SCTs). Prevalence rates (PR) and 95% confidence intervals (CI) of finding SCTs as a WEP in relation to background factors were calculated. The response rate was 61%. The final study group consisted of 14 210 responders. Half of the physicians (50%) experienced SCTs as a WEP, and 11% found them as a WEP to a great extent. The proportion of physicians experiencing certification tasks as a WEP varied with the type of clinic and were highest in general practice (73%), orthopaedics (68%), rheumatology (67%), neurology (59%) and psychiatry (58%). Using internal medicine as a reference group, the PRs for finding SCTs as a WEP to a great extent were 4.05 (95% CI 3.23-5.09) in general practice, 2.67 (2.05-3.47) in psychiatry and 2.66 (2.04-3.47) in orthopaedics, after adjusting for educational level and frequency of sickness certification consultations. In ear, nose and throat clinics, the PR was 0.43 (0.21-0.88). The findings underline the importance of measures to improve the work situation for physicians regarding sickness certification practices.

New rules meet established sickness certification practice: A focus-group study on the introduction of functional assessments in Norwegian primary care

PubMed Central

Krohne, Kariann; Brage, Søren

2007-01-01

Objective To explore how general practitioners view and handle new standards for functional assessments in sickness certification practice. Design Qualitative study using focus group interviews. Data were analysed according to Giorgi's phenomenological approach and supported by theories on knowledge. Setting General practitioners from three neighbouring counties in Norway. Subjects Four focus groups with a total of 23 participants were recruited through the Norwegian Medical Association and its Continuous Medical Education system. Results The participants reported difficulties and reluctance to act in accordance with new functional assessment demands on both a practical and a conceptual level. In established sickness certification practice functional assessment was described as an unspoken part of the medical examination. After the introduction of formal, written functional assessments they identified problems of terminology, communication, and trust. Strategies were developed to circumvent these problems. Conclusions A gap was noticeable between the participants’ established practice and the new standards’ demand for a more theoretical and communicative functional assessment. The general lack of training, being confronted with new terminology, and increasingly high pressure to reduce sickness absences create an atmosphere of insecurity when assessing function. PMID:17846936

Diagnoses have the greatest impact on variation in sick-leave certification rate among primary-care patients in Sweden: A multilevel analysis including patient, physician and primary health-care centre levels.

PubMed

Starzmann, Karin; Hjerpe, Per; Dalemo, Sofia; Ohlsson, Henrik; Björkelund, Cecilia; Bengtsson Boström, Kristina

2015-11-01

The aims of this study were to determine and evaluate simultaneously the importance of factors known to influence sick-leave certification such as the sick leave-related diagnoses, the patients' socio-economic status, and characteristics of the physicians. Computerised medical records from 24 public primary health-care centres (PHCC) were used in a multilevel logistic regression analysis at three levels: patients (n=64,354; sex, age, socio-economic status, workplace factors and diagnoses), physicians (n=574; sex and level of experience) and PHCC (n=24). The variation of sick-leave certification at each level was the outcome. Most of the variation was attributed to the patient level and only 3.5% to the physician and 1.2% to the PHCC levels. Among the patient characteristics, psychiatric diagnoses (mostly acute stress) had the highest odds ratio (OR) for sick leave (OR=16.0; 95% confidence interval [CI] 15-17.2), followed by musculoskeletal diagnoses (OR=6.1; 95% CI 5.8-6.5). Other factors with increased OR were low education (OR=1.7; 95% CI 1.6-1.8), use of social allowance (OR=1.4; 95% CI 1.2-1.7) and certain workplaces (manufacture and health and social care). Being older was not associated with increased certified sick leave. The greatest variation in sick-leave certification rate was seen at the patient level, specifically psychiatric diagnoses. Socio-economic factors increasing the risk for sick-leave certification were education, social allowance and occupations in manufacture and caregiving. Understanding the impact of the different factors that influence certified sick leave is important both for targeted interventions in order to facilitate patients' return to work. © 2015 the Nordic Societies of Public Health.

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

[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.

Case-specific colleague guidance for general practitioners' management of sickness absence.

PubMed

Nordhagen, H P; Harvey, S B; Rosvold, E O; Bruusgaard, D; Blonk, R; Mykletun, A

2017-12-02

General practitioners (GPs) report sickness absence certification as challenging. They express need for support with functional assessment beyond guidelines and reforms. Case-specific collegial one-to-one guidance for other clinical topics has proved popular with GPs and may be an acceptable and effective way to improve GPs skills and competence in sickness absence certification. To present a new model of case-specific colleague guidance focusing on the management of long-term sickness absence and to describe its feasibility in terms of application and reception among GPs, and also GPs' self-reports of effects on their practice. Randomly selected GPs received case-specific collegial guidance over a 12-month period, in two Norwegian trials, delivered by former GPs employed by the social security administration. We measured reception and perceived effects by GPs' self-report and registered participation and withdrawal rates. The participation rate (n = 165) was 94%, and no GPs withdrew during training. Among the 116 GPs responding to the survey (70%), 112 (97%; 95% CI 92-99) stated they would recommend it to their colleagues. Considerable benefit from the guidance was reported by 68 (59%; 95% CI 50-68). The GPs self-reported other effects on their sickness absence certification, specifically an increased use of part-time sickness absence (Fit-Note equivalent). This model of case-specific colleague guidance to aid GPs' management of long-term sickness absence is feasible and was popular. This type of guidance was perceived by GPs to be somewhat beneficial and to alter their sickness absence certification behaviour, though the true impact requires further testing in controlled trials. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

[Sickness absence certification from the medical perspective].

PubMed

Echevarría-Zuno, Santiago; Mar-Obeso, Alvaro Julián; Borja-Aburto, Víctor Hugo; Méndez-Bueno, Francisco Javier; Aguilar-Sánchez, Leticia; Rascón-Pacheco, Ramón Alberto

2009-01-01

Sickness absence certification is a medical task with important clinical, social, occupational and ethical implications, in addition to economic consequences for the worker, the employers and social security institutions. In 2007, IMSS affiliated workers received certifications for 65,384,690 days of absence, with cash benefits for 8.1 billion pesos. The duration of return to work depends on the efficiency of health care team as well as factors associated to the worker and the occupational environment. The correct management of sickness absence certification requires adequate disease diagnosis, regulatory knowledge and adequate communication with the patient. The purpose of control and auditing is to make sure that the certification is adequate in the indication and the optimal length, in order to warrant a responsible and sustainable management of this resource of social protection. If expenditure reduction is not possible, the objective is to avoid inefficient or irrational management. Treating physicians, with proper information, can contribute to optimize the provision of this benefit to those who need it.

Physicians' messages in problematic sickness certification: a narrative analysis of case reports

PubMed Central

2011-01-01

Background Many physicians find sickness certification tasks problematic. There is some knowledge about situations that are experienced as problematic, whereas less is understood about how physicians respond to the problems they face. One way to acquire such knowledge is to consider "reflection-in-action", aspects of which are expressed in the physician's interpretation of the patient's story. The aim of this study was to gain knowledge about the meaning content of case reports about problematic sickness certification. Specifically, we looked for possible messages to the colleagues intended to read the reports. Methods A narrative approach was used to analyse reports about problematic sickness certification cases that had been written by GPs and occupational health service physicians as part of a sickness insurance course. The analysis included elements from both thematic and structural analysis. Nineteen case reports were used in the actual analysis and 25 in the validation of the results. Main narrative qualities and structural features of the written case reports were explored. Results Five types of messages were identified in the case reports, here classified as "a call for help", "a call for understanding", "hidden worries", "in my opinion", and "appearing neutral". In the reports, the physicians tried to achieve neutrality in their writing, and the patients' stories tended to be interpreted within a traditional biomedical framework. In some cases there was an open request for help, in others it was not obvious that the physician had any problems. Overall, the messages were about having problems as such, rather than the specific features of the problems. Conclusions The case reports clearly demonstrated different ways of writing about problems that arise during sickness certification, from being neutral and not mentioning the problems to being emotionally involved and asking for help. The general character of the messages suggests that they are also relevant for case reports in problematic areas other than sickness certification. If pertinent relationships can be found between reflection-in-practice and the narrative writing about practice, they will provide an approach to further research concerning consultations perceived as problematic and also to medical education. PMID:21481257

[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.

[The general practitioner and the unemployed].

PubMed

Ruud, J

1992-02-20

Unemployment has increased in Norway during the last years. In order to study the impact of unemployment on primary health care in Hedmark county, a questionnaire was sent to 132 general practitioners. 70% replied. Some of the questions dealt with the doctors' requests for social security benefits for patients whose problems were related to loss of job. During one week 30% of the doctors had written this kind of sickness certificate. Further, during one month, 35% had recommended rehabilitation or disability pension. During the last year, 26% of the doctors had received requests activity proposing sickness certification for some of their employees from companies that were forced to reduce activity. The author discusses these results, and outlines the possible consequences for patient, doctor and the social security system.

Determinants of sick-leave length: still limited to diagnosis elements.

PubMed

Lévy, Yvan; Denis, Angélique; Fassier, Jean-Baptiste; Kellou, Nadir; Schott, Anne-Marie; Letrilliart, Laurent

2017-12-01

Sickness certification implies that a health problem impairs ability to work. However, its assessment is seldom performed by physicians. Our objective was, therefore, to assess the specific influence of functional and environmental limitations on the length of sick-leave prescriptions. We conducted a cross-sectional study in French general teaching practices and recorded 353 initial sick-leave certifications. For each of them, the functional and environmental limitations were collected using the ATCIF questionnaire, derived from the International Classification of Functioning. Data analysis was based on a linear regression multivariate model. Among the functional limitations, "pain" was the main body function impairment (22% of impairments) and "mobility" the main activity limitation (48%). An environmental barrier was identified in 39% of sick-listed patients, mainly relating to "products and technology" (20%), which refers to workplace factors. The prescription was longer in cases of activity limitations relating to "mobility" and in cases of environmental barriers relating to "products and technology". The multivariate model explained 27% of the variability of sick-leave length through diagnosis elements and only 7% through functional and contextual elements. In sick-leave prescription, a functional and contextual approach, in addition to the traditional diagnosis-based approach, could better support patients' shared understanding and follow-up, and accountability towards health authorities. Implication for Rehabilitation Although sickness certification implies that a health problem impairs ability to work, decision on sick-leave length in general practice is primarily based on diagnosis. A more functional and contextual approach could better support patients' and other health professionals' shared understanding and follow-up, and accountability towards health authorities. Such evolution requires a change of paradigm in medical education, and the way of reasoning of healthcare professionals.

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.

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.

Sick-listed employees with severe medically unexplained physical symptoms: burden or routine for the occupational health physician? A cross sectional study

PubMed Central

2010-01-01

Background The two primary objectives of this study were to the assess consultation load of occupational health physicians (OHPs), and their difficulties and needs with regard to their sickness certification tasks in sick-listed employees with severe medical unexplained physical symptoms (MUPS). Third objective was to determine which disease-, patient-, doctor- and practice-related factors are associated with the difficulties and needs of the OHPs. Methods In this cross-sectional study, 43 participating OHPs from 5 group practices assessed 489 sick-listed employees with and without severe MUPS. The OHPs filled in a questionnaire about difficulties concerning sickness certification tasks, consultation time, their needs with regard to consultation with or referral to a psychiatrist or psychologist, and communication with GPs. The OHPs also completed a questionnaire about their personal characteristics. Results OHPs only experienced task difficulties in employees with severe MUPS in relation to their communication with the treating physician. This only occured in cases in which the OHP attributed the physical symptoms to somatoform causes. If they attributed the physical symptoms to mental causes, the OHPs reported a need to consultate a psychiatrist about the diagnosis and treatment. Conclusions OHPs experience few difficulties with their sickness certification tasks and consultation load concerning employees with severe MUPS. However, they encounter problems if the diagnostic uncertainties of the treating physician interfere with the return to work process. OHPs have a need for psychiatric expertise whenever they are uncertain about the psychiatric causes of a delayed return to work process. We recommend further training programs for OHPs. They should also have more opportunity for consultation and referral to a psychiatrist, and their communication with treating physicians should be improved. PMID:21059232

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.

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

[Costs and sick leave due to chikungunya in the Instituto Mexicano del Seguro Social in Guerrero, Mexico].

PubMed

Vázquez-Cruz, Irene; Juanico-Morales, Guillermina; Sánchez-Ramos, Apolinar; Morales-Sánchez, Ofelia de Jesúis

2018-01-01

Chikungunya fever (CHIK) generally causes temporary sick leave, affecting groups of productive age, which represents a significant economic impact from the labor point of view. The objective was to estimate costs of disability due to chikungunya in the Instituto Mexicano del Seguro Social (IMSS) in Guerrero, Mexico. Cost assessment of working population from IMSS in Guerrero who met the definition of case for CHIK and took sick leave, which was registered in the Original Disability Certificates (OCI, according to its initials in Spanish) processed from January to April, 2015. Paid sick days were multiplied by the current minimum wage of the municipality of Acapulco (geographical area A, general = $ 70.10: seventy pesos with 10 cents per day]). Of all the OCIs, 31.5% (38 271/12 062) met the criteria for CHIK with a total of 41 197 prescribed days and 14 941 paid sick days with an estimated cost of 2 397 393.40 pesos (two million, three hundred and ninety seven thousand, three hundred and ninety three dollars and forty cents). Sick leaves increase the costs in health systems. These costs increase as increases the number of days granted. The average number of days granted is consistent with the information published in different articles.

Unemployment, labor force composition and sickness absence: a panel data study.

PubMed

Askildsen, Jan Erik; Bratberg, Espen; Nilsen, Oivind Anti

2005-11-01

Sickness absence tends to be negatively correlated with unemployment rates. In addition to pure health effects, this may be due to moral hazard behavior by workers who are fully insured against income loss during sickness and to physicians who meet demand for medical certificates. Alternatively, it may reflect changes in the composition of the labor force, with more sickness-prone workers entering the labor force in upturns. A panel of Norwegian register data is used to analyze long-term sickness absences. The unemployment rate is shown to be negatively associated with the probability of absence, and with the number of days of sick leave. Restricting the sample to workers who are present in the whole sample period, the negative relationship between absence and unemployment becomes clearer. This indicates that procyclical variations in sickness absence are caused by established workers and not by the composition of the labor force.

The influence of prior training on GPs' attitudes to sickness absence certification post-fit note.

PubMed

Money, Annemarie; Hann, Mark; Turner, Susan; Hussey, Louise; Agius, Raymond

2015-09-01

Aim To investigate the attitudes to health and work of general practitioners (GPs) with training in occupational medicine (OM) compared with non-OM trained GPs, since the introduction of the fit note. Changes to the UK sickness certification system since 2010 and the introduction of the fit note required GPs to change their focus to what patients can do, rather than what they cannot do in relation to work. In an effort to reduce the UK sickness absence burden, GPs completion of the fit note should help to keep people in work, or assist patients to return to work as quickly as possible after a period of absence. Questionnaire data were collected via the 7th National General Practitioner Worklife Survey. Findings Results indicate that responses from GPs who had undertaken training in OM, and GPs having received some form of work and health training in the 12-month period before the study were associated with significantly more positive attitudes to patients' returning to work and to the fit note. This study reveals evidence of a difference between trained and non-trained GPs in their attitude to the fit note, and to work and health generally. Further work investigating the effect of specific training in OM on the management and recognition of ill-health by GPs is recommended.

Dizziness and Motion Sickness

MedlinePlus

... Humanitarian Efforts International Outreach Advocacy Board of Governors Industry Programs Professional Development Home AcademyU Home Study Course Maintenance of Certification Conferences & Events Practice Management Home Resources ...

Factors underlying the effect of organisational downsizing on health of employees: longitudinal cohort study

PubMed Central

Kivimäki, Mika; Vahtera, Jussi; Pentti, Jaana; Ferrie, Jane E

2000-01-01

Objective To explore the underlying mechanisms between organisational downsizing and deterioration of health of employees. Design Longitudinal cohort study. Data were assembled from before downsizing (time 1); during major downsizing affecting some job categories (time 2); and after downsizing (time 3). Contributions of changes in work, support, and health related behaviours between time 1 and time 2 to the relation between downsizing and sickness absence at time 3 were assessed by multilevel modelling. Mean length of follow up was 4.9 years. Setting Raisio, a town in Finland. Subjects 764 municipal employees who remained in employment after downsizing. Main outcome measures Records of absences from work from all causes with medical certificate. Results Downsizing was associated with negative changes in work, impaired support from spouse, and increased prevalence of smoking. Sickness absence rate from all causes was 2.17 (95% confidence interval 1.54 to 3.07) times higher after major downsizing than after minor downsizing. Adjustment for changes in work (for instance, physical demands, job control, and job insecurity) diminished the relation between downsizing and sickness absence by 49%. Adjustments for impaired social support or increased smoking did not alter the relation between downsizing and sickness absence. The findings were unaffected by sex and income. Conclusions The exploration of potential mediating factors provides new information about the possible causal pathways linking organisational downsizing and health. Downsizing results in changes in work, social relationships, and health related behaviours. The observed increase in certificated sickness absence was partially explained by concomitant increases in physical demands and job insecurity and a reduction in job control. A considerable proportion of the increase, however, remained unexplained by the factors measured. PMID:10753148

Factors influencing return to work after illness in France.

PubMed

Pélissier, C; Fontana, L; Chauvin, F

2014-01-01

Few studies have been published about the factors influencing return to work after sickness absence. To identify medical and occupational factors influencing the type of fitness certificate given by occupational physicians before employees return to work after sickness absence. A cross-sectional study was undertaken over 3 months in several health services in France. Workers undergoing a medical examination before returning to work after a period of sickness absence of at least 3 weeks were included. Medical and occupational factors were collected using a questionnaire. The relationship between different factors and certification of fitness was assessed by univariate and multivariate analyses. Among the 402 workers included, 64% were considered fit to return to work. Being older, strenuous work, prolonged sick leave and fear of returning to work appeared to be negative factors influencing the return to a previous job. In contrast, having an education level higher than secondary school, being satisfied at work, perception of very good health and benefitting from satisfactory professional relationships appeared to favour return to work. We developed a predictive score of not being fit to return to work after illness. Our study highlighted the relationship between medical and occupational factors with problems returning to work. The predictive score may be used by occupational physicians as a screening tool to identify those who are likely to have difficulties returning to work after illness, so that their working conditions can be modified to take this into consideration.

[Sick leave among workers employed in restructured enterprise].

PubMed

Szubert, Zuzanna; Sobala, Wojciech

2003-01-01

Ownership and restructuring transformations that are taking now place in Poland, as well as the situation on the labor market have their impact on the indicators, which illustrate the workers' health situation, including temporary work disability preceding the issue of the certification granting the disability pension. The aim of this analysis was to identify the changes in the extent and causes of sickness absence among workers after restructuring. The study was carried out in one of the largest transport industry enterprises during the years of its restructuring (1984-1994), covering 8588 workers, and after its restructuring (1997-1999), covering 2702 workers. Following the restructuring, the enterprise's staff was rejuvenated so that the number of workers aged over 50 years decreased by almost fifty percent. The analysis was based on the sickness absence rate calculated as the ratio between the number of days of work disability in a given period of time and the number of person-days in the same period. In 1997-1999, a 33% decrease in sickness absence among women and a 25% decrease among men were observed in the study enterprise as compared with the period of 1989-1994. However, the enhanced absence was also found due to the following diseases: mental disorders (a threefold increase in men); diseases of the musculoskeletal system (by 54% in men and by 43% in women); endocrine, nutritional and metabolic diseases and immunity disorders (a threefold increase in women). Following the restructuring, considerable changes in the sickness absence structure, by causes of diseases, were revealed. A substantial decrease in the share of male and female absence due to diseases of the respiratory and circulatory systems and almost threefold decrease in complications of pregnancy, childbirth and the puerperium in women were noted. In addition, over twofold increase in male and female sickness absence due to diseases of the musculoskeletal system, and lower but significant increase due to mental pathologies (from 3 to 12% in males and from 4 to 7% in women) were recorded. The changes observed in sickness absence result mainly from the changes in the magnitude and structure of employment in the restructured enterprise and related organizational modifications, which arise stressogenic situations among workers, more intensified at risk of unemployment.

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.

Workplace phobia--a first explorative study on its relation to established anxiety disorders, sick leave, and work-directed treatment.

PubMed

Muschalla, Beate; Linden, Michael

2009-10-01

Workplace phobia is defined as a phobic anxiety reaction with symptoms of panic occurring when thinking of or approaching the workplace. People suffering from workplace phobia regularly avoid confrontation with the workplace and are often on sick leave. The specific characteristics of workplace phobia are investigated empirically in comparison to established anxiety disorders. Two hundred thirty patients from an inpatient psychosomatic rehabilitation hospital were interviewed concerning workplace phobia and established anxiety disorders. Additionally, the patients filled in self-rating questionnaires on general and workplace phobic symptom load. Subjectively perceived degree of work load, sick leave, and therapy participation were assessed. Participants with workplace phobia reached significantly higher scores in workplace phobia self-rating than did participants with established anxiety disorders. A similar significant difference was not found concerning the general psychosomatic symptom load. Workplace phobics were more often on sick leave than patients with established anxiety disorders. Workplace phobia can occur as an alonestanding anxiety disorder. It has an own clinical value due to its specific consequences for work participation. Workplace phobia requires special therapeutic attention and treatment instead of purely 'sick leave' certification.

Sickness absence in Pertamina E.P. directorate

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

Harjono, P.T.; Arief, N.

Pertamina is the only one state oil enterprise in the country has a strategic position in the national development, mainly in terms of foreign exchange and domestic ID energy supply. Hence human factor in the company productivity is very important. Workday loss by sickness in the last 4 years was 2.00{per_thousand} up to 3.00{per_thousand} and 0.88 days up to 1.12 days loss per worker annually. Workday loss by sickness was 96.86 % up to 99.12 % of total workday loss and the rest by work injuries, These relative low sickness absence figures achieved by multidisiplinary efforts in the company mainlymore » by health department. All sickness absence certificate even for one day off should be signed by company medical doctor. Health department conduct comprehensive health care including occupational health programme. Health & safety issues solved by multidisiplinary approach. Beside health department also organize employee assistance programme (counseling) mainly for healthy life style and psychosocial problems. The low workday loss is one of the basic important factors to support discipline and human productivity mainly since mostly oil reserve discoveries located in the remote areas inland as well as offshore.« less

[Pregnancy-related and work-related sick leave of pregnant women].

PubMed

Tophøj, A; Mortensen, J T

1999-09-06

Pregnant women are allowed sick leave (SL) due to obstetrical or occupational risk factors. The aim was to describe reasons for SL during pregnancy. Pregnant women in a Danish county applying for SL were consecutively included in the study during 12 months in 1991-92. Data were obtained by questionnaires mailed to the women and their medical doctors. Of 1483 pregnant women on SL, 994 participated. Approximately 96% were on SL due to obstetrical risk factors. Occupational factors contributed to SL in at least 50% of the cases, mainly when working in a standing or walking position or when lifting. The women were rarely replaced in other jobs before leaving work. On average the women were absent for 83 days before official pregnancy leave started. Although SL during pregnancy is overwhelmingly due to obstetrical risk factors, occupational factors often contribute. Occupational Health and Safety Organizations are rarely involved at the workplace before issuing a sick leave certificate.

5 CFR 630.403 - Supporting evidence for the use of sick leave.

Code of Federal Regulations, 2010 CFR

2010-01-01

... calendar days after the date the agency requests such medical certification. If it is not practicable under... calendar days after the date requested by the agency despite the employee's diligent, good faith efforts... under the circumstances involved, but no later than 30 calendar days after the date the agency requests...

[Patients of immigrant origin in outpatient psychiatric facilities: a comparison between Turkish, eastern European and German patients].

PubMed

Schouler-Ocak, Meryam; Bretz, H Joachim; Hauth, Iris; Montesinos, Amanda Heredia; Koch, Eckhardt; Driessen, Martin; Heinz, Andreas

2010-11-01

Nationwide representative survey of the use of psychiatric outpatient services in Germany. Every fifth patient of several psychiatric outpatient services was surveyed on one index day (27 (th) of May 2008) with respect to sociodemographic characteristics, ICD-10 diagnoses, difficulties in communication, treatment duration, and number of sickness certificates. Patients with immigrant background comprised 32.5 % of all patients. Compared to German patients, patients with immigrant background received significantly more neurotic, stress-related and somatoform disorders (F4). Turkish patients received significantly more mood (affective) disorders diagnoses (F3), compared to German and Eastern Europe patients. Immigrants had shorter treatment duration and a higher number of sickness certificates. Eastern European patients had a significantly higher education, compared to patients with Turkish background. Patients with immigrant background were younger compared to German patients and had significantly more children. The utilization of outpatient psychiatric services by patients with a migratory background is high. This suggests that immigrants benefit from the multiprofessional team and the low-treshold service offered by outpatient units. © Georg Thieme Verlag KG Stuttgart · New York.

[Prescription of temporal disability certificates in workers attending to IMSS from the perspective of health economy].

PubMed

Constantino-Casas, Patricia; del Pilar Torres-Arreola, Laura; Posadas-García, Jorge Luis; Nevárez-Sida, Armando; García-Contreras, Fernando

2007-01-01

The repercussion of health-disease state on social life or individual includes his/her work performance. In many countries, social security is one of the options for diffusing and buffering the impact of the disease. This paper is focused on the analysis of the unjustified prescription of temporary sick leave certificates (CITT), which combines the social security medical components and economic benefits (subsidies). The objective is to analyze the mechanism of prescription of CITT from the perspective of health economics and health care services. The detailed flow of CITT at the Mexican Institute of Social Security is described, as are some concepts of the health economics perspective that contribute to explain the prescription of CITT. Statistical data of sick leaves due to work-related and non-work-related diseases are presented from the institutional perspective. Finally, it is emphasized that although CITT are a medical prescription, it is advisable to take into account the economic perspective and its concepts in order to achieve an efficient use of resources.

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.

[Sickness absence associated with major life events].

PubMed

Markussen, Simen; Røgeberg, Ole

2012-05-29

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

Work load, job control and risk of leaving work by sickness certification before delivery, Norway 1989.

PubMed

Strand, K; Wergeland, E; Bjerkedal, T

1997-09-01

Sickness absence in pregnancy has been shown to be associated with strenuous working conditions and parity. So far, few studies have made adjustments for possible interaction and confounding. Such adjustments are needed to more precisely identify targets for preventive measures. We have, therefore, in a representative population of pregnant employees in Norway 1989, computed adjusted odds ratios for leaving work by sickness absence more than three (LSC > 3) and eight (LSC > 8) weeks before delivery according to working conditions identified as risk factors in earlier studies; adjusted for job control, domestic conditions and sickness absence the year prior to pregnancy. The cumulative percentage of LSC > 8 and LSC > 3 was 26.4 and 51.1. Ergonomically strenuous postures and heavy lifting increased the risk of both outcomes. In addition, shift work and hectic work pace increased the risk of LSC > 3. Influence on breaks reduced risk. Only para experienced reduced risk of LSC when working part-time. Sicklisting the year prior to pregnancy had no confounding effect, which suggest that pregnancy represents a new incompatibility with work. Preventive measures should address work postures and heavy lifting, as well as conditions influencing the woman's control with her time.

Fit for purpose? Using the fit note with patients with chronic pain: a qualitative study

PubMed Central

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

2011-01-01

Background Staying in work may benefit patients with chronic pain, but can be difficult for GPs to negotiate with patients and their employers. The new fit note is designed to help this process, but little is known of how it is operating. Aim To explore GPs' views on the fit note, with particular reference to sickness certification for patients with chronic pain. Design and setting Qualitative study using semi-structured interviews in eight primary care trusts in south-west England. Method In-depth interviews with 13 GPs. Results GPs reported that the rationale behind the fit note is sound and that it may help patients with chronic pain to return to work earlier. However, GPs also reported barriers to successful fit note use, including the need to preserve doctor–patient relationships, inconsistent engagement from employers, GPs' lack of specialist occupational health knowledge, issues with fit note training, and whether a new form can achieve cultural shift. Conclusion While doctors agree that good work improves health outcomes, they do not think that fit notes will greatly alter sickness-certification rates without more concerted initiatives to manage the tripartite negotiation between doctor, patient, and employer. PMID:22137416

Modeling the cost of influenza: the impact of missing costs of unreported complications and sick leave

PubMed Central

2010-01-01

Background Estimating the economic impact of influenza is complicated because the disease may have non-specific symptoms, and many patients with influenza are registered with other diagnoses. Furthermore, in some countries like Norway, employees can be on paid sick leave for a specified number of days without a doctor's certificate ("self-reported sick leave") and these sick leaves are not registered. Both problems result in gaps in the existing literature: costs associated with influenza-related illness and self-reported sick leave are rarely included. The aim of this study was to improve estimates of total influenza-related health-care costs and productivity losses by estimating these missing costs. Methods Using Norwegian data, the weekly numbers of influenza-attributable hospital admissions and certified sick leaves registered with other diagnoses were estimated from influenza-like illness surveillance data using quasi-Poisson regression. The number of self-reported sick leaves was estimated using a Monte-Carlo simulation model of illness recovery curves based on the number of certified sick leaves. A probabilistic sensitivity analysis was conducted on the economic outcomes. Results During the 1998/99 through 2005/06 influenza seasons, the models estimated an annual average of 2700 excess influenza-associated hospitalizations in Norway, of which 16% were registered as influenza, 51% as pneumonia and 33% were registered with other diagnoses. The direct cost of seasonal influenza totaled US$22 million annually, including costs of pharmaceuticals and outpatient services. The annual average number of working days lost was predicted at 793 000, resulting in an estimated productivity loss of US$231 million. Self-reported sick leave accounted for approximately one-third of the total indirect cost. During a pandemic, the total cost could rise to over US$800 million. Conclusions Influenza places a considerable burden on patients and society with indirect costs greatly exceeding direct costs. The cost of influenza-attributable complications and the cost of self-reported sick leave represent a considerable part of the economic burden of influenza. PMID:21106057

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%.

Chronic Radiation Sickness Among Techa Riverside Residents

DTIC Science & Technology

1998-02-01

people with CRS. Consequently, data listed below are considered tentative; they can- 19 1 0.3 not be used to calculate death rates nor to analyze 20...age cohort 0-14 years Death rates for patients with diagnosed CRS were from the control group; the same age cohort is ab- studied by the cohort method...mortality contains age-specific archives of the civil registrars confirmed the deaths. death rates . Copies were made of the death certificates for de- ceased

[Evaluation of the management of nonwork-related sick leave lasting more than 15 days in Catalonia (Spain)].

PubMed

Benavides, Fernando G; Torá, Isabel; Miguel Martínez, José; Jardí, Josefina; Manzanera, Rafael; Alberti, Constança; Delclós, Jordi

2010-01-01

To compare the length of nonwork-related sick leave among cases managed by an insurance company versus those managed by the National Institute of Social Security (NISS). We performed a retrospective cohort study of 289,686 cases of sick leave lasting for more than 15 days that began in 2005 after certification by a primary care physician in Catalonia, were reported to the Catalonian Institute of Medical Evaluations, and were followed to term. Of the total, 156,676 cases were managed by the NISS. To account for repeat episodes (approximately 25% of the total), the Wang-Chang estimator was used to calculate the median duration and percentiles; comparisons were made using log-logistic regression with shared gamma frailty models, with calculation of time ratios (TR) and their corresponding 95% confidence intervals (95% CI). The median duration of sick leave was 43 days for cases managed by the NISS and 39 days for those managed by the insurance company. This difference was statistically significant both for men employed under contract (TR=0.87; 95% CI: 0.85-0.88) and for those who were self-employed (TR=0.78; 95% CI: 0.75-0.80) as well as for women under contract (TR=0.85; 95% CI: 0.84-0.87) and self-employed women (TR=0.84; 95% CI: 0.81-0.88). These differences persisted after adjustment was performed for age and health region. For sick leave lasting more than 15 days, these results confirm that cases managed by an insurance company ended earlier than for those managed by the NISS, both for contract and self-employed workers. Further research is needed to explore the reasons for these differences. Copyright 2009 SESPAS. Published by Elsevier Espana. All rights reserved.

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

PubMed

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

2007-10-01

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

Perceptions of health professionals towards the management of back pain in the context of work: a qualitative study

PubMed Central

2014-01-01

Background Musculoskeletal complaints have a significant impact on work in terms of reduced productivity, sickness absence and long term incapacity for work. This study sought to explore GPs’ and physiotherapists’ perceptions of sickness certification in patients with musculoskeletal problems. Methods Eleven (11) GPs were sampled from an existing general practice survey, and six (6) physiotherapists were selected randomly using ‘snowball’ sampling techniques, through established contacts in local physiotherapy departments. Semi-structured qualitative interviews were conducted with respondents lasting up to 30 minutes. The interviews were audio recorded and transcribed verbatim, following which they were coded using N-Vivo qualitative software and analysed thematically using the constant comparative methodology, where themes were identified and contrasted between and within both groups of respondents. Results Three themes were identified from the analysis: 1) Approaches to evaluating patients’ work problems 2) Perceived ability to manage ‘work and pain’, and 3) Policies and penalties in the work-place. First, physiotherapists routinely asked patients about their job and work difficulties using a structured (protocol-driven) approach, whilst GPs rarely used such structured measures and were less likely to enquire about patients’ work situation. Second, return to work assessments revealed a tension between GPs’ gatekeeper and patient advocacy roles, often resolved in favour of patients’ concerns and needs. Some physiotherapists perceived that GPs’ decisions could be influenced by patients’ demand for a sick certificate and their close relationship with patients made them vulnerable to manipulation. Third, the workplace was considered to be a specific source of strain for patients acting as a barrier to work resumption, and over which GPs and physiotherapists could exercise only limited control. Conclusion We conclude that healthcare professionals need to take account of patients’ work difficulties, their own perceived ability to offer effective guidance, and consider the ‘receptivity’ of employment contexts to patients’ work problems, in order to ensure a smooth transition back to work. PMID:24941952

Perceptions of health professionals towards the management of back pain in the context of work: a qualitative study.

PubMed

Wynne-Jones, Gwenllian; van der Windt, Danielle; Ong, Bie Nio; Bishop, Annette; Cowen, Jemma; Artus, Majid; Sanders, Tom

2014-06-18

Musculoskeletal complaints have a significant impact on work in terms of reduced productivity, sickness absence and long term incapacity for work. This study sought to explore GPs' and physiotherapists' perceptions of sickness certification in patients with musculoskeletal problems. Eleven (11) GPs were sampled from an existing general practice survey, and six (6) physiotherapists were selected randomly using 'snowball' sampling techniques, through established contacts in local physiotherapy departments. Semi-structured qualitative interviews were conducted with respondents lasting up to 30 minutes. The interviews were audio recorded and transcribed verbatim, following which they were coded using N-Vivo qualitative software and analysed thematically using the constant comparative methodology, where themes were identified and contrasted between and within both groups of respondents. Three themes were identified from the analysis: 1) Approaches to evaluating patients' work problems 2) Perceived ability to manage 'work and pain', and 3) Policies and penalties in the work-place. First, physiotherapists routinely asked patients about their job and work difficulties using a structured (protocol-driven) approach, whilst GPs rarely used such structured measures and were less likely to enquire about patients' work situation. Second, return to work assessments revealed a tension between GPs' gatekeeper and patient advocacy roles, often resolved in favour of patients' concerns and needs. Some physiotherapists perceived that GPs' decisions could be influenced by patients' demand for a sick certificate and their close relationship with patients made them vulnerable to manipulation. Third, the workplace was considered to be a specific source of strain for patients acting as a barrier to work resumption, and over which GPs and physiotherapists could exercise only limited control. We conclude that healthcare professionals need to take account of patients' work difficulties, their own perceived ability to offer effective guidance, and consider the 'receptivity' of employment contexts to patients' work problems, in order to ensure a smooth transition back to work.

Increase in sickness absence with psychiatric diagnosis in Norway: a general population-based epidemiologic study of age, gender and regional distribution

PubMed Central

Hensing, Gunnel; Andersson, Lena; Brage, Sören

2006-01-01

Background The aim of this study was to assess the incidence of sickness absence with psychiatric diagnoses from 1994–2000, and the distribution across gender, age groups, diagnostic groups and regions in a general population. Methods The population at risk was defined as all individuals aged 16–66 years who were entitled to sickness benefits in 1994, 1996, 1998 and 2000 (n = 2,282,761 in 2000). All individuals with a full-time disability pension were excluded. The study included approximately 77% of the Norwegian population aged 16–66 years. For each year, the study base started on 1 January and ended on 31 December. Individuals that were sick-listed for more than 14/16 consecutive days with a psychiatric diagnosis on their medical certificate were selected as cases. Included in this study were data for Norway, the capital city Oslo and five regions in the southeast of the country. Results Sickness absence with psychiatric diagnoses increased in all age groups, in women and men, and in all regions. At the national level, the cumulative incidence increased in women from 1.7% in 1994 to 4.6% in 2000, and in men from 0.8% in 1994 to 2.2% in 2000. The highest cumulative incidence was found in middle-aged women and men (30–59 years). Women had a higher incidence than men in all stratification groups. The cumulative incidences in 2000 varied between 4.6% to 5.6% in women in the different regions, and for men the corresponding figures were 2.1% to 3.2%. Throughout the four years studied, women in Oslo had more than twice as high incidence levels of sickness absence with alcohol and drug diagnoses as the country as a whole. There were some differences between regions in sickness absence with specific psychiatric diagnoses, but they were small and most comparisons were non-significant. Conclusion Sickness absence with psychiatric diagnoses increased between 1994 and 2000 in Norway. The increase was highest in the middle-aged, and in women. Few regional differences were found. That the increase pervaded all stratification groups supports general explanations of the increase, such as changes in attitudes to psychiatric disorders in both patients and doctors, and increased mental distress probably associated with societal changes at a more structural level. PMID:16923198

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.

Effectiveness of Integration and Re-Integration into Work Strategies for Persons with Chronic Conditions: A Systematic Review of European Strategies

PubMed Central

Ito, Elizabeth; Scaratti, Chiara; Vlachou, Anastasia; Stavroussi, Panayiota; Brecelj, Valentina; Kovačič, Dare S.

2018-01-01

Due to low employment rates associated to chronic conditions in Europe, it is essential to foster effective integration and re-integration into work strategies. The objective of this systematic review is to summarize the evidence on the effectiveness of strategies for integration and re-integration to work for persons with chronic diseases or with musculoskeletal disorders, implemented in Europe in the past five years. A systematic search was conducted in MedLine, PsycINFO, CDR-HTA, CDR-DARE and Cochrane Systematic Reviews. Overall, 32 relevant publications were identified. Of these, 21 were considered eligible after a methodological assessment and included. Positive changes in employment status, return to work and sick leave outcomes were achieved with graded sickness-absence certificates, part-time sick leave, early ergonomic interventions for back pain, disability evaluation followed by information and advice, and with multidisciplinary, coordinated and tailored return to work interventions. Additionally, a positive association between the co-existence of active labour market policies to promote employment and passive support measures (e.g., pensions or benefits) and the probability of finding a job was observed. Research on the evaluation of the effectiveness of strategies targeting integration and re-integration into work for persons with chronic health conditions needs, however, to be improved and strengthened. PMID:29562715

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.

Relationship between sickness presenteeism and awareness and presence or absence of systems for return to work among workers with mental health problems in Japan: an Internet-based cross-sectional study.

PubMed

Doki, Shotaro; Sasahara, Shinichiro; Suzuki, Shun; Hirai, Yasuhito; Oi, Yuichi; Usami, Kazuya; Matsuzaki, Ichiyo

2015-01-01

The objective of this study was to clarify the relationship between sickness presenteeism and the degree of awareness of company regulations regarding financial compensation for absenteeism. An Internet-based survey of 258 full-time workers who had more than 28 days of sickness absence due to mental health problems was conducted. Workers were categorized as having either low or high sickness presenteeism, and awareness and presence or absence of systems for return to work and duration of financial compensation were compared between groups. The following factors were significantly related to high sickness presenteeism based on logistic regression analyses: working for a private company (odds ratio [OR]=2.57; 95% confidence interval [CI]=1.10-5.99); recognition of a gradual resumption system (OR=3.89, 95% CI=1.02-14.81); and awareness regarding the duration of financial compensation (OR=1.04, 95% CI=1.01-1.07). No relationship was found between mental sickness presenteeism and presence or absence of systems for return to work in our multivariate analysis; however, a relationship was apparent between sickness presenteeism and characteristics of the workers' companies. These results are expected to contribute to research involving human resources and occupational health.

Waterborne outbreak of gastroenteritis: effects on sick leaves and cost of lost workdays.

PubMed

Halonen, Jaana I; Kivimäki, Mika; Oksanen, Tuula; Virtanen, Pekka; Virtanen, Mikko J; Pentti, Jaana; Vahtera, Jussi

2012-01-01

In 2007, part of a drinking water distribution system was accidentally contaminated with waste water effluent causing a gastroenteritis outbreak in a Finnish town. We examined the acute and cumulative effects of this incidence on sick leaves among public sector employees residing in the clean and contaminated areas, and the additional costs of lost workdays due to the incidence. Daily information on sick leaves of 1789 Finnish Public Sector Study participants was obtained from employers' registers. Global Positioning System-coordinates were used for linking participants to the clean and contaminated areas. Prevalence ratios (PR) for weekly sickness absences were calculated using binomial regression analysis. Calculations for the costs were based on prior studies. Among those living in the contaminated areas, the prevalence of participants on sick leave was 3.54 (95% confidence interval (CI) 2.97-4.22) times higher on the week following the incidence compared to the reference period. Those living and working in the clean area were basically not affected, the corresponding PR for sick leaves was 1.12, 95% CI 0.73-1.73. No cumulative effects on sick leaves were observed among the exposed. The estimated additional costs of lost workdays due to the incidence were 1.8-2.1 million euros. The prevalence of sickness absences among public sector employees residing in affected areas increased shortly after drinking water distribution system was contaminated, but no long-term effects were observed. The estimated costs of lost workdays were remarkable, thus, the cost-benefits of better monitoring systems for the water distribution systems should be evaluated.

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.

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.

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.

Development of a neural net paradigm that predicts simulator sickness

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

Allgood, G.O.

1993-03-01

A disease exists that affects pilots and aircrew members who use Navy Operational Flight Training Systems. This malady, commonly referred to as simulator sickness and whose symptomatology closely aligns with that of motion sickness, can compromise the use of these systems because of a reduced utilization factor, negative transfer of training, and reduction in combat readiness. A report is submitted that develops an artificial neural network (ANN) and behavioral model that predicts the onset and level of simulator sickness in the pilots and aircrews who sue these systems. It is proposed that the paradigm could be implemented in real timemore » as a biofeedback monitor to reduce the risk to users of these systems. The model captures the neurophysiological impact of use (human-machine interaction) by developing a structure that maps the associative and nonassociative behavioral patterns (learned expectations) and vestibular (otolith and semicircular canals of the inner ear) and tactile interaction, derived from system acceleration profiles, onto an abstract space that predicts simulator sickness for a given training flight.« less

Role of endogenous opioid peptides in the pathogenesis of motion sickness

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

Yasnetsov, V.V.; Il'ina, S.L.; Karsanova, S.K.

1986-01-01

This paper examines the pathogenesis of motion sickness and the role of the various neurochemical systems of the body in the genesis of the condition. It has been shown that the endogenous opioid system participates in the genesis of several pathological processes; this was the motivation for the study. The plasma beta-endorphin level was determined in samples from 19 clinically healthy males. Considering the positive prophylactic and therapeutic effect of naloxone against motion sickness it can be postulated that endogenous opioid peptides participate in the genesis of the vestibulo-autonomic disorders in motion sickness.

Morbidity and process of care in urban Malaysian general practice: the impact of payment system.

PubMed

Teng, C L; Aljunid, S M; Cheah, Molly; Leong, K C; Kwa, S K

2003-08-01

The majority of primary care consultations in Malaysia occur in the general practice clinics. To date, there is no comprehensive documentation of the morbidity and practice activities in this setting. We reported the reasons for encounter, diagnoses and process of care in urban general practice and the influence of payment system on the morbidity and practice activities. 115 clinics in Kuala Lumpur, Ipoh and Penang participated in this study. General practitioners in these clinics completed a 2-page questionnaire for each of the 30 consecutive patients. The questionnaire requested for the following information: demographic data, reasons for encounter, important physical findings, diagnoses, investigations ordered, outpatient procedures performed, medical certificate given, medication prescribed and referral made. The morbidity (reasons for encounter and diagnoses) was coded using ICPC-2 and the medication data was coded using MIMS Classification Index. During 3481 encounters, 5300 RFEs (152 RFEs per 100 encounters) and 3342 diagnoses (96 diagnoses per 100 encounters) were recorded. The majority of the RFEs and diagnoses are in the following ICPC Chapters: Respiratory, General and unspecified, Digestive, Neurological, Musculoskeletal and Skin. The frequencies of selected aspects of the process of care (rate per 100 encounters) were: laboratory investigations 14.7, outpatient procedures 2.4, sick certification 26.9, referral 2.4, and medication prescription 244. Consultation for chronic diseases and acute infections were influenced more by demographic variables (age, employment) rather than payment system. Cash-paying patients were more likely to receive laboratory investigations and injections. This study demonstrated the breadth of clinical care in the general practice. Relatively fewer patients consulted specifically for preventive care and treatment of chronic diseases. The frequencies of outpatient procedures and referrals appeared to be low. Payment system results in important differences in patient mix and influences some types of practice activities.

"Sick" or "not-sick": accuracy of System 1 diagnostic reasoning for the prediction of disposition and acuity in patients presenting to an academic ED.

PubMed

Wiswell, Jeffrey; Tsao, Kenyon; Bellolio, M Fernanda; Hess, Erik P; Cabrera, Daniel

2013-10-01

System 1 decision-making is fast, resource economic, and intuitive (eg, "your gut feeling") and System 2 is slow, resource intensive, and analytic (eg, "hypothetico-deductive"). We evaluated the performance of disposition and acuity prediction by emergency physicians (EPs) using a System 1 decision-making process. We conducted a prospective observational study of attending EPs and emergency medicine residents. Physicians were provided patient demographics, chief complaint, and vital sign data and made two assessments on initial presentation: (1) likely disposition (discharge vs admission) and (2) "sick" vs "not-sick". A patient was adjudicated as sick if he/she had a disease process that was potentially life or limb threatening based on pre-defined operational, financial, or educationally derived criteria. We obtained 266 observations in 178 different patients. Physicians predicted patient disposition with the following performance: sensitivity 87.7% (95% CI 81.4-92.1), specificity 65.0% (95% CI 56.1-72.9), LR+ 2.51 (95% CI 1.95-3.22), LR- 0.19 (95% CI 0.12-0.30). For the sick vs not-sick assessment, providers had the following performance: sensitivity 66.2% (95% CI 55.1-75.8), specificity 88.4% (95% CI 83.0-92.2), LR+ 5.69 (95% CI 3.72-8.69), LR- 0.38 (95% CI 0.28-0.53). EPs are able to accurately predict the disposition of ED patients using system 1 diagnostic reasoning based on minimal available information. However, the prognostic accuracy of acuity prediction was limited. © 2013.

Motion sickness and postural sway in console video games.

PubMed

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

2008-04-01

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

[The contribution of systems theory and "existential integrative psychotherapy" to the relationship of the concepts "endogenous", "exogenous", "psychogenic", and "sociogenic" in psychic disorders].

PubMed

Bühler, K E; Wyss, D

1980-01-01

Proof is given that the "atomistic" concepts of sickness lead to insolvable contradictions of methodic and logic origin. In this study these contradictions are exemplified and critically analysed, and historical aspects are included. We then propose the dimensions "Interior--Exterior" and "Psychogenous--Somatogeneous" as an heuristic model, dimensions on which any sickness is to be located according to its basic causes. The General System Theory had developed a new formal concept of sickness based on a relatively complete and integral vision of the human being. Nevertheless, the constructs of the General System Theory remain incomplete as they include only objects and their relations, never individual subjects. Wyss however has established explicitely an anthropology of the subject which he connects with his communication orientated concept of sickness. This concept does not judge sickness to be contradictory to health, but both, sickness and health together, form a functional whole on a higher level of abstraction. On this level the organism and its functions, the "interior", represent an inherent component of the "exterior". "Interior" and "exterior"--differentiated in various items--attempt to establish an equilibrium that is always in danger of being desquilibrized.

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

Predictive factors for work capacity in patients with musculoskeletal disorders.

PubMed

Lydell, Marie; Baigi, Amir; Marklund, Bertil; Månsson, Jörgen

2005-09-01

To identify predictive factors for work capacity in patients with musculoskeletal disorders. A descriptive, evaluative, quantitative study. The study was based on 385 patients who participated in a rehabilitation programme. Patients were divided into 2 groups depending on their ability to work. The groups were compared with each other with regard to sociodemographic factors, diagnoses, disability pension and number of sick days. The patient's level of exercise habits, ability to undertake activities, physical capacity, pain and quality of life were compared further using logistic regression analysis. Predictive factors for work capacity, such as ability to undertake activities, quality of life and fitness on exercise, were identified as important independent factors. Other well-known factors, i.e. gender, age, education, pain and earlier sickness certification periods, were also identified. Factors that were not significantly different between the groups were employment status, profession, diagnosis and levels of exercise habits. Identifying predictors for ability to return to work is an essential task for deciding on suitable individual rehabilitation. This study identified new predictive factors, such as ability to undertake activities, quality of life and fitness on exercise.

Physiology of motion sickness symptoms

NASA Technical Reports Server (NTRS)

Harm, Deborah L.

1990-01-01

Motion sickness research is reviewed with the emphasis placed on theories developed to explain its symptomatology. A general review of central nervous system, autonomic nervous system, and neuroendocrine system involvement in the syndrome. Particular attention is given to signs, symptoms, and physiological correlates, methodological issues, and directions for future research based on a dynamic interactive systems model.

A survey of support systems for return to work in Japanese companies: a cross-sectional study.

PubMed

Doki, Shotaro; Sasahara, Shinichiro; Oi, Yuichi; Matsuzaki, Ichiyo

2016-12-07

The present study aimed to survey systems in Japanese companies for supporting workers returning to work from sickness absence due to mental illness. A questionnaire survey was mailed to 3,545 companies. Support systems for return to work, sick leave, and multiple sick-listed (MSL) workers were examined. A total of 161 companies responded to the survey (response rate: 4.5%). About 80% of the companies expressed difficulty in dealing with workers with mental health problems. About half of all companies reported having reset period and financial compensation systems, as well as gradual resumption and trial attendance systems. Most large companies tended to have reset period and trial attendance systems. No association was found between company size and MSL rates. The most frequent diagnosis among workers was depression, and the mean number of sick leave days was 275.3. Although there might have been a selection bias due to the low response rate, the results of this study are expected to be useful for companies when formulating employment systems.

A survey of support systems for return to work in Japanese companies: a cross-sectional study

PubMed Central

DOKI, Shotaro; SASAHARA, Shinichiro; OI, Yuichi; MATSUZAKI, Ichiyo

2016-01-01

The present study aimed to survey systems in Japanese companies for supporting workers returning to work from sickness absence due to mental illness. A questionnaire survey was mailed to 3,545 companies. Support systems for return to work, sick leave, and multiple sick-listed (MSL) workers were examined. A total of 161 companies responded to the survey (response rate: 4.5%). About 80% of the companies expressed difficulty in dealing with workers with mental health problems. About half of all companies reported having reset period and financial compensation systems, as well as gradual resumption and trial attendance systems. Most large companies tended to have reset period and trial attendance systems. No association was found between company size and MSL rates. The most frequent diagnosis among workers was depression, and the mean number of sick leave days was 275.3. Although there might have been a selection bias due to the low response rate, the results of this study are expected to be useful for companies when formulating employment systems. PMID:27181916

The Combination of Scopolamine and Psychostimulants for the Prevention of Severe Motion Sickness.

PubMed

Zhang, Li-Li; Liu, Hong-Qi; Yu, Xu-Hong; Zhang, Ying; Tian, Jia-Sheng; Song, Xu-Rui; Han, Bing; Liu, Ai-Jun

2016-08-01

Severe motion sickness is a huge obstacle for people conducting precise aviation, marine or emergency service tasks. The combination of scopolamine and d-amphetamine is most effective in preventing severe motion sickness. However, this combination is not included in any present pharmacopoeia due to the abuse liability of d-amphetamine. We wanted to find a combination to replace it for the treatment of severe motion sickness. We compared the efficacy of scopolamine, diphenhydramine, and granisetron (representing three classes of drugs) with different doses, and found that scopolamine was the most effective one. We also found scopolamine inhibited central nervous system at therapeutic doses and caused anxiety. Then, we combined it with different doses of psychostimulants (d-amphetamine, modafinil, caffeine) to find the best combination for motion sickness. The efficacy of scopolamine with modafinil (1 + 10 mg/kg) was equivalent to that of scopolamine with d-amphetamine (1 + 1 mg/kg); This combination also excited central nervous system and abolished the anxiety caused by scopolamine. The optimal dose ratio of scopolamine and modafinil is 1:10. This combination is beneficial for motion sickness and can abolish the side effects of scopolamine. So, it might be a good replacement of scopolamine and d-amphetamine for severe motion sickness. © 2016 John Wiley & Sons Ltd.

A mechanism for sickness sleep: lessons from invertebrates.

PubMed

Davis, Kristen C; Raizen, David M

2017-08-15

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

Optimal Cutoff Values of WHO-HPQ Presenteeism Scores by ROC Analysis for Preventing Mental Sickness Absence in Japanese Prospective Cohort

PubMed Central

Suzuki, Tomoko; Miyaki, Koichi; Sasaki, Yasuharu; Song, Yixuan; Tsutsumi, Akizumi; Kawakami, Norito; Shimazu, Akihito; Takahashi, Masaya; Inoue, Akiomi; Kurioka, Sumiko; Shimbo, Takuro

2014-01-01

Objectives Sickness absence due to mental disease in the workplace has become a global public health problem. Previous studies report that sickness presenteeism is associated with sickness absence. We aimed to determine optimal cutoff scores for presenteeism in the screening of the future absences due to mental disease. Methods A prospective study of 2195 Japanese employees from all areas of Japan was conducted. Presenteeism and depression were measured by the validated Japanese version of the World Health Organization Health and Work Performance Questionnaire (WHO-HPQ) and K6 scale, respectively. Absence due to mental disease across a 2-year follow-up was surveyed using medical certificates obtained for work absence. Socioeconomic status was measured via a self-administered questionnaire. Receiver operating curve (ROC) analysis was used to determine optimal cutoff scores for absolute and relative presenteeism in relation to the area under the curve (AUC), sensitivity, and specificity. Results The AUC values for absolute and relative presenteeism were 0.708 (95% CI, 0.618–0.797) and 0.646 (95% CI, 0.546–0.746), respectively. Optimal cutoff scores of absolute and relative presenteeism were 40 and 0.8, respectively. With multivariate adjustment, cohort participants with our proposal cutoff scores for absolute and relative presenteeism were significantly more likely to be absent due to mental disease (OR = 4.85, 95% CI: 2.20–10.73 and OR = 5.37, 95% CI: 2.42–11.93, respectively). The inclusion or exclusion of depressive symptoms (K6≥13) at baseline in the multivariate adjustment did not influence the results. Conclusions Our proposed optimal cutoff scores of absolute and relative presenteeism are 40 and 0.8, respectively. Participants who scored worse than the cutoff scores for presenteeism were significantly more likely to be absent in future because of mental disease. Our findings suggest that the utility of presenteeism in the screening of sickness absence due to mental disease would help prevent such an absence. PMID:25340520

Female professional divers. Similarities and differences between male and female professional divers.

PubMed

Irgens, Ågot; Troland, Kari; Grønning, Marit

2017-01-01

The aim of the present study was to explore the potential differences between female and male professional divers with regards to demographics, diving certificates, areas of diving, diving activity and health effects. The Norwegian Labour Inspection Authority's Diving certificate register contains data on all professional inshore divers who have held a certificate at any time since 1980. Forty nine per cent of these divers responded to the "Norwegian diver 2011" questionnaire. Of these divers 64 female and 1327 male divers completed the questionnaire about their professional diving career, certificate, year of onset and the year they stopped diving professionally if they were not still active in the diving industry. The level of general education was higher among female divers. More males than females were fully certified in diving. The mean age was lower among female than male fully certified divers. Fully certified female divers reported a lower total number of dives, shallower dives and diving for a shorter period of time than the male divers. They also had a lower percentage of work within the quay/construction sector and more often worked as teachers/instructors. A lower percentage of fully certified females than males had experienced decompression sickness (16.7% vs. 26.9%). Life-threatening events and psychologically challenging events were less common among females, as were adverse health effects. No such gender differences were seen for divers with a restricted certificate. The fully certified, female professional divers in our study had a very short diving career, reported fewer and shallower dives, and chose less physically demanding jobs than their male counterparts. They also had a higher level of education, reported less health problems and a better quality of life. The health effects seem to be related to the type of work rather than to gender.

Proinflammatory cytokines, sickness behavior, and Alzheimer disease.

PubMed

Holmes, C; Cunningham, C; Zotova, E; Culliford, D; Perry, V H

2011-07-19

In Alzheimer disease (AD), systemic inflammation is known to give rise to a delirium. However, systemic inflammation also gives rise to other centrally mediated symptoms in the absence of a delirium, a concept known as sickness behavior. Systemic inflammation is characterized by the systemic production of the proinflammatory cytokines tumor necrosis factor-α (TNFα) and interleukin-6 (IL-6) that mediate immune to brain communication and the development of sickness behavior. To determine if raised serum TNFα or IL-6 are associated with the presence of sickness behavior symptoms, independent of the development of delirium, in a prospective cohort study of subjects with AD. A total of 300 subjects with mild to severe AD were cognitively assessed at baseline and a blood sample taken for inflammatory markers. Cognitive assessments, including assessments to detect the development of a delirium, and blood samples were repeated at 2, 4, and 6 months. The development of neuropsychiatric symptoms in the subject with AD over the 6-month follow-up period was assessed independently by carer interview at 2, 4, and 6 months. Raised serum TNFα and IL-6, but not CRP, were associated with an approximately 2-fold increased frequency of neuropsychiatric symptoms characteristic of sickness behavior. These relationships are independent of the development of delirium. Increased serum proinflammatory cytokines are associated with the presence of symptoms characteristic of sickness behavior, which are common neuropsychiatric features found in AD. This association was independent of the presence of delirium.

Proinflammatory cytokines, sickness behavior, and Alzheimer disease

PubMed Central

Cunningham, C.; Zotova, E.; Culliford, D.; Perry, V.H.

2011-01-01

Background: In Alzheimer disease (AD), systemic inflammation is known to give rise to a delirium. However, systemic inflammation also gives rise to other centrally mediated symptoms in the absence of a delirium, a concept known as sickness behavior. Systemic inflammation is characterized by the systemic production of the proinflammatory cytokines tumor necrosis factor–α (TNFα) and interleukin-6 (IL-6) that mediate immune to brain communication and the development of sickness behavior. Objective: To determine if raised serum TNFα or IL-6 are associated with the presence of sickness behavior symptoms, independent of the development of delirium, in a prospective cohort study of subjects with AD. Methods: A total of 300 subjects with mild to severe AD were cognitively assessed at baseline and a blood sample taken for inflammatory markers. Cognitive assessments, including assessments to detect the development of a delirium, and blood samples were repeated at 2, 4, and 6 months. The development of neuropsychiatric symptoms in the subject with AD over the 6-month follow-up period was assessed independently by carer interview at 2, 4, and 6 months. Results: Raised serum TNFα and IL-6, but not CRP, were associated with an approximately 2-fold increased frequency of neuropsychiatric symptoms characteristic of sickness behavior. These relationships are independent of the development of delirium. Conclusions: Increased serum proinflammatory cytokines are associated with the presence of symptoms characteristic of sickness behavior, which are common neuropsychiatric features found in AD. This association was independent of the presence of delirium. PMID:21753171

[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.

Dark focus of accommodation as dependent and independent variables in visual display technology

NASA Technical Reports Server (NTRS)

Jones, Sherrie; Kennedy, Robert; Harm, Deborah

1992-01-01

When independent stimuli are available for accommodation, as in the dark or under low contrast conditions, the lens seeks its resting position. Individual differences in resting positions are reliable, under autonomic control, and can change with visual task demands. We hypothesized that motion sickness in a flight simulator might result in dark focus changes. Method: Subjects received training flights in three different Navy flight simulators. Two were helicopter simulators entailed CRT presentation using infinity optics, one involved a dome presentation of a computer graphic visual projection system. Results: In all three experiments there were significant differences between dark focus activity before and after simulator exposure when comparisons were made between sick and not-sick pilot subjects. In two of these experiments, the average shift in dark focus for the sick subjects was toward increased myopia when each subject was compared to his own baseline. In the third experiment, the group showed an average shift outward of small amount and the subjects who were sick showed significantly less outward movement than those who were symptom free. Conclusions: Although the relationship is not a simple one, dark focus changes in simulator sickness imply parasympathetic activity. Because changes can occur in relation to endogenous and exogenous events, such measurement may have useful applications as dependent measures in studies of visually coupled systems, virtual reality systems, and space adaptation syndrome.

Neural circuitry engaged by prostaglandins during the sickness syndrome.

PubMed

Saper, Clifford B; Romanovsky, Andrej A; Scammell, Thomas E

2012-07-26

During illnesses caused by infectious disease or other sources of inflammation, a suite of brain-mediated responses called the sickness syndrome occurs, which includes fever, anorexia, sleepiness, hyperalgesia and elevated corticosteroid secretion. Much of the sickness syndrome is mediated by prostaglandins acting on the brain and can be prevented by nonsteroidal anti-inflammatory drugs, such as aspirin or ibuprofen, that block prostaglandin synthesis. By examining which prostaglandins are produced at which sites and how they interact with the nervous system, researchers have identified specific neural circuits that underlie the sickness syndrome.

Neural Circuitry Engaged by Prostaglandins during the Sickness Syndrome

PubMed Central

Saper, Clifford B.; Romanovsky, Andrej A.; Scammell, Thomas E.

2013-01-01

During illnesses caused by infectious disease or other sources of inflammation, a suite of brain-mediated responses called the “sickness syndrome” occurs, including fever, anorexia, sleepiness, hyperalgesia, and elevated corticosteroid secretion. Much of the sickness syndrome is mediated by prostaglandins acting on the brain, and can be prevented by non-steroidal anti-inflammatory drugs, such as aspirin or ibuprofen, that block prostaglandin synthesis. By examining which prostaglandins are produced at which sites and how they interact with the nervous system, researchers have identified specific neural circuits that underlie the sickness syndrome. PMID:22837039

Mental rotation - A key to mitigation of motion sickness in the virtual environments?

NASA Technical Reports Server (NTRS)

Parker, Donald E.; Harm, Deborah L.

1992-01-01

If mental rotation is important for the reduction of motion sickness and complement performance in virtual environments (VEs), the use of the Howard (1982) mental rotation test battery may identify individuals with lower susceptibility to VE-induced motion sickness and therefore a greater probability of success as VE operators. An apparatus and its associated procedures are currently under development for astronaut microgravity training aimed at reducing motion sickness; it is hypothesized that this system may be of significance to VE testing and training.

From inflammation to sickness and depression: when the immune system subjugates the brain.

PubMed

Dantzer, Robert; O'Connor, Jason C; Freund, Gregory G; Johnson, Rodney W; Kelley, Keith W

2008-01-01

In response to a peripheral infection, innate immune cells produce pro-inflammatory cytokines that act on the brain to cause sickness behaviour. When activation of the peripheral immune system continues unabated, such as during systemic infections, cancer or autoimmune diseases, the ensuing immune signalling to the brain can lead to an exacerbation of sickness and the development of symptoms of depression in vulnerable individuals. These phenomena might account for the increased prevalence of clinical depression in physically ill people. Inflammation is therefore an important biological event that might increase the risk of major depressive episodes, much like the more traditional psychosocial factors.

Relationship between the Onset of Depression and Stress Response Measured by the Brief Job Stress Questionnaire among Japanese Employees: A Cohort Study

PubMed Central

Wada, Keiko; Sairenchi, Toshimi; Haruyama, Yasuo; Taneichi, Hiromi; Ishikawa, Yumiko; Muto, Takashi

2013-01-01

Background The proportion of Japanese workers experiencing intense worry or stress during working life is in excess of 60%, and the incidence of psychiatric disorders and suicide due to psychological burden from work duties is increasing. To confirm whether the stress response measured by the Brief Job Stress Questionnaire (BJSQ) can identify risk for depression, a cohort study was conducted to evaluate whether the stress response measured by BJSQ was associated with the onset of depression. Methods A total of 1,810 participants aged 20–70 years in 2005 completed the stress response of the BJSQ and were followed-up until August, 2007 by examining sick pay records. Depression was defined by a description in sick pay records that included “depression” or “depressive symptoms” as a reason for sick leave according to a physician's medical certificate. The participants were divided into quartiles (Ql, Q2, Q3, and Q4) according to the total stress response score of BJSQ at baseline. Furthermore, the participants were divided into a higher score category (Q4) and a lower score category (Q1–Q3). Risk ratios of the stress response of the BJSQ for onset of depression were calculated using a multivariable Cox proportional hazard model. Results Among 1,810 participants, 14 developed depression during a mean of 1.8 years of follow-up. The risk ratio was 2.96 (95% confidence interval [CI], 1.04–8.42, p for trend = 0.002) when the higher stress response score category of BJSQ was compared with the low stress response score category for sick leave due to depression. After adjusting for gender, age, marital status, and having children, the risk ratios were similar to no adjustment. Conclusions These findings suggest that the stress response measured by the BJSQ can demonstrate risk for the onset of depression. PMID:23424656

Probiotics Improve Inflammation-Associated Sickness Behavior by Altering Communication between the Peripheral Immune System and the Brain.

PubMed

D'Mello, Charlotte; Ronaghan, Natalie; Zaheer, Raza; Dicay, Michael; Le, Tai; MacNaughton, Wallace K; Surrette, Michael G; Swain, Mark G

2015-07-29

Patients with systemic inflammatory diseases (e.g., rheumatoid arthritis, inflammatory bowel disease, chronic liver disease) commonly develop debilitating symptoms (i.e., sickness behaviors) that arise from changes in brain function. The microbiota-gut-brain axis alters brain function and probiotic ingestion can influence behavior. However, how probiotics do this remains unclear. We have previously described a novel periphery-to-brain communication pathway in the setting of peripheral organ inflammation whereby monocytes are recruited to the brain in response to systemic TNF-α signaling, leading to microglial activation and subsequently driving sickness behavior development. Therefore, we investigated whether probiotic ingestion (i.e., probiotic mixture VSL#3) alters this periphery-to-brain communication pathway, thereby reducing subsequent sickness behavior development. Using a well characterized mouse model of liver inflammation, we now show that probiotic (VSL#3) treatment attenuates sickness behavior development in mice with liver inflammation without affecting disease severity, gut microbiota composition, or gut permeability. Attenuation of sickness behavior development was associated with reductions in microglial activation and cerebral monocyte infiltration. These events were paralleled by changes in markers of systemic immune activation, including decreased circulating TNF-α levels. Our observations highlight a novel pathway through which probiotics mediate cerebral changes and alter behavior. These findings allow for the potential development of novel therapeutic interventions targeted at the gut microbiome to treat inflammation-associated sickness behaviors in patients with systemic inflammatory diseases. This research shows that probiotics, when eaten, can improve the abnormal behaviors (including social withdrawal and immobility) that are commonly associated with inflammation. Probiotics are able to cause this effect within the body by changing how the immune system signals the brain to alter brain function. These findings broaden our understanding of how probiotics may beneficially affect brain function in the context of inflammation occurring within the body and may open potential new therapeutic alternatives for the treatment of these alterations in behavior that can greatly affect patient quality of life. Copyright © 2015 the authors 0270-6474/15/3510822-10$15.00/0.

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.

[Social security and labor absenteeism in a regional health service].

PubMed

Soto Caro, Ariel; Herrera Cofré, Roberto; Fuentes Solís, Rodrigo

2015-08-01

Absenteism can generate important economic costs. To analyze the determinants of the time off work for sick leaves granted to workers of a regional health service. Information about 2033 individuals, working at a health service, that were granted at least one sick leave during 2012, was analyzed. Personal identification was censored. Special emphasis was given to the type of health insurance system of the workers (public or private). Workers ascribed to the Chilean public health insurance system (FONASA) had 11 days more off work than their counterparts ascribed to private health insurance systems. A higher amount of time off work was observed among older subjects and women. Age, gender and the type of health insurance system influence the number of day off work due to sick leaves.

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

PubMed

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

2017-01-01

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

Investigating motion sickness using the conditioned taste aversion paradigm

NASA Technical Reports Server (NTRS)

Fox, Robert A.

1990-01-01

The use of conditioned taste aversion (CTA) to study motion sickness is reviewed. The use of CTA to measure motion sickness is supported by studies showing that an intact vestibular system is essential for the production of CTA when motion is the unconditioned stimulus. The magnitude of CTA is assessed at a time removed from exposure to motion, and therefore is not affected by residual effects of motion. Since the magnitude of CTA is assessed as volume or weight of flood or fluid, the degree of sickness is reflected in a continuous measure rather than in the discrete, all-or-none fashion characteristic of vomiting.

General autonomic components of motion sickness

NASA Technical Reports Server (NTRS)

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

1986-01-01

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

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.

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.

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.

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.

An Analysis of Potential Predictive Parameters of Motion Sickness Using a Computerized Biophysical Data Acquisition System.

DTIC Science & Technology

1985-12-01

Despite the problems, drug therapy was seen as the easiest and most effective treatment. Some wartime research, primarily Canadian and Australian ...sickness was further supported by the Australians when they found that small head motions greatly contributed to the onset of motion sickness (46:20). It is...particularly noteworthy that one Australian , McIntyre, laid the groundwork for modern sensory conflict theory when he stated in 1941, "In most cases

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.

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

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.

[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.

Needs for further improvement: risk adjustment in the German health insurance system.

PubMed

Buchner, Florian; Wasem, Jürgen

2003-07-01

The German risk adjustment mechanism is used only within the public system. It was introduced in two steps, 1994 and 1995. Because of the income-related contribution, which the insured pay directly to their sickness fund, income of the insured is equalized by the mechanism and causes the biggest part of the payments among the sickness funds. On the expenditure side age, gender, disability and entitlement for sickness allowances are used as risk adjusters. The mechanism is retrospective, calculating average costs for each of the 670 risk cells defined by the risk adjusters and using these "standardized expenditures" as a base for the payment a single sickness fund gets because of its risk structure. There do still exist incentives for risk selection. The experience shows that mostly the young and healthy are willing to change sickness funds motivated by lower contribution rates. This can be used and is used for self-selection. Another cause of risk selection is regional differences. The central suggestion of an expertise on behalf of the German Ministry of Health on experiences and improvement proposals is the change to a direct modeling of morbidity.

How do general practitioners contribute to preventing long-term work disability of their patients suffering from depressive disorders? A qualitative study.

PubMed

Sylvain, Chantal; Durand, Marie-José; Maillette, Pascale; Lamothe, Lise

2016-06-07

Depression is a major cause of work absenteeism that general practitioners (GPs) face directly since they are responsible for sickness certification and for supervising the return to work (RTW). These activities give GPs a key role in preventing long-term work disability, yet their practices in this regard remain poorly documented. The objectives of this study were therefore to describe GPs' practices with people experiencing work disability due to depressive disorders and explore how GPs' work context may impact on their practices. We conducted semi-structured individual interviews with 13 GPs and six mental healthcare professionals in two sub-regions of Quebec. The sub-regions differed in terms of availability of specialized resources offering public mental health services. Data were anonymized and transcribed verbatim. Thematic analysis was performed to identify patterns in the GPs' practices and highlight impacting factors in their work context. Our results identified a set of practices common to all the GPs and other practices that differentiated them. Two profiles were defined on the basis of the various practices documented. The first is characterized by the integration of the RTW goal into the treatment goal right from sickness certification and by interventions that include the workplace, albeit indirectly. The second is characterized by a lack of early RTW-oriented action and by interventions that include little workplace involvement. Regardless of the practice profile, actions intended to improve collaboration with key stakeholders remain the exception. However, two characteristics of the work context appear to have an impact: the availability of a dedicated mental health nurse and the regular provision of clinical information by psychotherapists. These conditions are rarely present but tend to make a significant difference for the GPs. Our results highlight the significant role of GPs in the prevention of long-term work disability and their need for support through the organization of mental health services at the primary care level.

5 CFR 430.403 - System certification.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false System certification. 430.403 Section 430... MANAGEMENT Performance Appraisal Certification for Pay Purposes § 430.403 System certification. (a) The performance appraisal system(s) covering senior employees must be certified by OPM, with OMB concurrence, as...

5 CFR 430.403 - System certification.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false System certification. 430.403 Section 430... MANAGEMENT Performance Appraisal Certification for Pay Purposes § 430.403 System certification. (a) The performance appraisal system(s) covering senior employees must be certified by OPM, with OMB concurrence, as...

5 CFR 430.403 - System certification.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false System certification. 430.403 Section 430... MANAGEMENT Performance Appraisal Certification for Pay Purposes § 430.403 System certification. (a) The performance appraisal system(s) covering senior employees must be certified by OPM, with OMB concurrence, as...

Organisational justice and health of employees: prospective cohort study

PubMed Central

Kivimaki, M; Elovainio, M; Vahtera, J; Ferrie, J; Theorell, T

2003-01-01

Aims: To examine the association between components of organisational justice (that is, justice of decision making procedures and interpersonal treatment) and health of employees. Methods: The Poisson regression analyses of recorded all-cause sickness absences with medical certificate and the logistic regression analyses of minor psychiatric morbidity, as assessed by the General Health Questionnaire, and poor self rated health status were based on a cohort of 416 male and 3357 female employees working during 1998–2000 in 10 hospitals in Finland. Results: Low versus high justice of decision making procedures was associated with a 41% higher risk of sickness absence in men (rate ratio (RR) 1.4, 95% confidence interval (CI) 1.1 to 1.8), and a 12% higher risk in women (RR 1.1, 95% CI 1.0 to 1.2) after adjustment for baseline characteristics. The corresponding odds ratios (OR) for minor psychiatric morbidity were 1.6 (95% CI 1.0 to 2.6) in men and 1.4 (95% CI 1.2 to 1.7) in women, and for self rated health 1.4 in both sexes. In interpersonal treatment, low justice increased the risk of sickness absence (RR 1.3 (95% CI 1.0 to 1.6) and RR 1.2 (95% CI 1.2 to 1.3) in men and women respectively), and minor psychiatric morbidity (OR 1.2 in both sexes). These figures largely persisted after control for other risk factors (for example, job control, workload, social support, and hostility) and they were replicated in initially healthy subcohorts. No evidence was found to support the hypothesis that organisational justice would represent a consequence of health (reversed causality). Conclusions: This is the first longitudinal study to show that the extent to which people are treated with justice in workplaces independently predicts their health. PMID:12499453

Organisational justice and health of employees: prospective cohort study.

PubMed

Kivimäki, M; Elovainio, M; Vahtera, J; Ferrie, J E

2003-01-01

To examine the association between components of organisational justice (that is, justice of decision making procedures and interpersonal treatment) and health of employees. The Poisson regression analyses of recorded all-cause sickness absences with medical certificate and the logistic regression analyses of minor psychiatric morbidity, as assessed by the General Health Questionnaire, and poor self rated health status were based on a cohort of 416 male and 3357 female employees working during 1998-2000 in 10 hospitals in Finland. Low versus high justice of decision making procedures was associated with a 41% higher risk of sickness absence in men (rate ratio (RR) 1.4, 95% confidence interval (CI) 1.1 to 1.8), and a 12% higher risk in women (RR 1.1, 95% CI 1.0 to 1.2) after adjustment for baseline characteristics. The corresponding odds ratios (OR) for minor psychiatric morbidity were 1.6 (95% CI 1.0 to 2.6) in men and 1.4 (95% CI 1.2 to 1.7) in women, and for self rated health 1.4 in both sexes. In interpersonal treatment, low justice increased the risk of sickness absence (RR 1.3 (95% CI 1.0 to 1.6) and RR 1.2 (95% CI 1.2 to 1.3) in men and women respectively), and minor psychiatric morbidity (OR 1.2 in both sexes). These figures largely persisted after control for other risk factors (for example, job control, workload, social support, and hostility) and they were replicated in initially healthy subcohorts. No evidence was found to support the hypothesis that organisational justice would represent a consequence of health (reversed causality). This is the first longitudinal study to show that the extent to which people are treated with justice in workplaces independently predicts their health.

Belgium: risk adjustment and financial responsibility in a centralised system.

PubMed

Schokkaert, Erik; Van de Voorde, Carine

2003-07-01

Since 1995 Belgian sickness funds are partially financed through a risk adjustment system and are held partially financially responsible for the difference between their actual and their risk-adjusted expenditures. However, they did not get the necessary instruments for exerting a real influence on expenditures and the health insurance market has not been opened for new entrants. At the same time the sickness funds have powerful tools for risk selection, because they also dominate the market for supplementary health insurance. The present risk-adjustment system is based on the results of a regression analysis with aggregate data. The main proclaimed purpose of this system is to guarantee a fair treatment to all the sickness funds. Until now the danger of risk selection has not been taken seriously. Consumer mobility has remained rather low. However, since the degree of financial responsibility is programmed to increase in the near future, the potential profits from cream skimming will increase.

Changes in the dark focus of accommodation associated with simulator sickness

NASA Technical Reports Server (NTRS)

Fowlkes, Jennifer E.; Kennedy, Robert S.; Hettinger, Lawrence J.; Harm, Deborah L.

1993-01-01

The relationship between the dark focus of accommodation and simulator sickness, a form of motion sickness, was examined in three experiments. In Experiment 1, dark focus was measured in 18 college students in a laboratory setting before and after they viewed a projected motion scene depicting low altitude helicopter flight. In Experiments 2 and 3, dark focus was measured in pilots (N = 16 and 23, respectively) before and after they 'flew' in moving-base helicopter flight simulators with optical infinity CRT visual systems. The results showed that individuals who experienced simulator sickness had either an inward (myopic) change in dark focus (Experiments 1 and 3) or attenuated outward shifts in dark focus (Experiment 2) relative to participants who did not get sick. These results are consonant with the hypothesis that parasympathetic activity, which may be associated with simulator sickness, should result in changes in dark focus that are in a myopic direction. Night vision goggles, virtual environments, extended periods in microgravity, and heads-up displays all produce related visual symptomatology. Changes in dark focus may occur in these conditions, as well, and should be measured.

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

PubMed

Berrang Ford, Lea

2007-03-29

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

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

PubMed Central

Berrang Ford, Lea

2007-01-01

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

Sensory conflict in motion sickness: An observer theory approach

NASA Technical Reports Server (NTRS)

Oman, Charles M.

1989-01-01

Motion sickness is the general term describing a group of common nausea syndromes originally attributed to motion-induced cerebral ischemia, stimulation of abdominal organ afferent, or overstimulation of the vestibular organs of the inner ear. Sea-, car-, and airsicknesses are the most commonly experienced examples. However, the discovery of other variants such as Cinerama-, flight simulator-, spectacle-, and space sickness in which the physical motion of the head and body is normal or absent has led to a succession of sensory conflict theories which offer a more comprehensive etiologic perspective. Implicit in the conflict theory is the hypothesis that neutral and/or humoral signals originate in regions of the brain subversing spatial orientation, and that these signals somehow traverse to other centers mediating sickness symptoms. Unfortunately, the present understanding of the neurophysiological basis of motion sickness is far from complete. No sensory conflict neuron or process has yet been physiologically identified. To what extent can the existing theory be reconciled with current knowledge of the physiology and pharmacology of nausea and vomiting. The stimuli which causes sickness, synthesizes a contemporary Observer Theory view of the Sensory Conflict hypothesis are reviewed, and a revised model for the dynamic coupling between the putative conflict signals and nausea magnitude estimates is presented. The use of quantitative models for sensory conflict offers a possible new approach to improving the design of visual and motion systems for flight simulators and other virtual environment display systems.

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.

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'.

Motion sickness severity and physiological correlates during repeated exposures to a rotating optokinetic drum

NASA Technical Reports Server (NTRS)

Hu, Senqi; Grant, Wanda F.; Stern, Robert M.; Koch, Kenneth L.

1991-01-01

Fifty-two subjects were exposed to a rotating optokinetic drum. Ten of these subjects who became motion sick during the first session completed two additional sessions. Subjects' symptoms of motion sickness, perception of self-motion, electrogastrograms (EGGs), heart rate, mean successive differences of R-R intervals (RRI), and skin conductance were recorded for each session. The results from the first session indicated that the development of motion sickness was accompanied by increased EGG 4-9 cpm activity (gastric tachyarrhythmia), decreased mean succesive differences of RRI, increased skin conductance levels, and increased self-motion perception. The results from the subjects who had three repeated sessions showed that 4-9 cpm EGG activity, skin conductance levels, perception of self-motion, and symptoms of motion sickness all increased significantly during the drum rotation period of the first session, but increased significantly less during the following sessions. Mean successive differences of RRI decreased significantly during the drum rotation period for the first session, but decreased significantly less during the following sessions. Results show that the development of motion sickness is accompanied by an increase in gastric tachyarrhythmia, and an increase in sympathetic activity and a decrease in parasympathetic activity, and that adaptation to motion sickness is accompanied by the recovery of autonomic nervous system balance.

[Good practice in occupational health services: prophylactic care and occupational activation of people with disabilities due to respiratory diseases].

PubMed

Wiszniewska, Marta; Tymoszuk, Diana; Lipińska-Ojrzanowska, Agnieszka; Wagrowska-Koski, Ewa; Walusiak-Skorupa, Jolanta

2013-01-01

Respiratory diseases are a cause of long-term sickness absence, and even of partial or complete inability to work. This paper presents the first in Poland description of principles of good practice in occupational health service provided for people with respiratory diseases. The issues concerning the certification of the ability to work in this group of patients are discussed. The key-principles of preventive care of workers with obstructive and interstitial lung diseases with particular attention paid to the control of major risk factors are also presented. The importance of possible contraindications for job performance by workers affected by these diseases, as well as the responsibilities of occupational health physicians were highlighted. M

Passenger Acceptance of Alignments with Frequent Curves in Maglev or Other Very-High-Speed Ground Systems

DOT National Transportation Integrated Search

1999-03-31

This study explored comfort and motion-sickness effects of Maglev travel in corridors characterized by frequent curves. A procedure was developed for estimating the propensity of a given set of ride motions to induce motion sickness, generating a num...

[Musculoskeletal disorders in the offshore oil industry].

PubMed

Morken, Tone; Tveito, Torill H; Torp, Steffen; Bakke, Ashild

2004-10-21

Musculoskeletal disorders are important causes of sick leave and disability among Norwegian offshore petroleum workers. More knowledge and interventions are needed in order to prevent this. In this review we consider prevalence and risk factors among offshore petroleum workers and point to the need for more research. Literature searches on ISI Web of Science and PubMed were supplemented by reports from Norwegian offshore industry companies and the Norwegian Petroleum Directorate. Few studies were found on musculoskeletal disorders among offshore petroleum workers. The disorders are widespread, particularly among catering, construction and drilling personnel. It is not clear whether the prevalence is different from that among onshore workers. Risk factors are physical stressors and fast pace of work. Among catering personnel, these disorders are important causes of loss of the required health certificate but we could not identify any review of causes in the offshore industry generally. More scientific studies are needed on musculoskeletal disorders as comparisons of prevalence and risk factors for offshore and onshore workers may point to more effective interventions. Better knowledge of the causes of loss of the health certificate may contribute to preventing early retirement. Interventions to prevent these disorders should be evaluated by controlled intervention studies.

Vestibular factors influencing the biomedical support of humans in space

NASA Astrophysics Data System (ADS)

Lichtenberg, Byron K.

This paper will describe the biomedical support aspects of humans in space with respect to the vestibular system. The vestibular system is thought to be the primary sensory system involved in the short-term effects of space motion sickness although there is increasing evidence that many factors play a role in this complex set of symptoms. There is the possibility that an individual's inner sense of orientation may be strongly coupled with the susceptibility to space motion sickness. A variety of suggested countermeasures for space motion sickness will be described. Although there are no known ground-based tests that can predict space motion sickness, the search should go on. The long term effects of the vestibular system in weightlessness are still relatively unknown. Some preliminary data has shown that the otoconia are irregular in size and distribution following extended periods of weightlessness. The ramifications of this data are not yet known and because the data was obtained on lower order animals, definitive studies and results must wait until the space station era when higher primates can be studied for long durations. This leads us to artificial gravity, the last topic of this paper. The vestibular system is intimately tied to this question since it has been shown on Earth that exposure to a slow rotating room causes motion sickness for some period of time before adaptation occurs. If the artificial gravity is intermittent, will this mean that people will get sick every time they experience it? The data from many astronauts returning to Earth indicates that a variety of sensory illusions are present, especially immediately upon return to a 1- g environment. Oscillopsia or apparent motion of the visual surround upon head motion along with inappropriate eye motions for a given head motion, all indicate that there is much to be studied yet about the vestibular and CNS systems reaction to a sudden application of a steady state acceleration field like 1- g. From the above information it is obvious that the vestibular system does have unique requirements when it comes to the biomedical support of space flight. This is not to say that other areas such as cardiovascular, musculo-skeletal, immunological and hematological systems do not have their own unique requirements but that possible solutions to one system can provide continuing problems to another system. For example, artificial gravity might be helpful for long term stabilization of bone demineralization or cardiovascular deconditioning but might introduce a new set of problems in orientation, vestibular conflict and just plain body motion in a rotating space vehicle.

Vestibular factors influencing the biomedical support of humans in space

NASA Technical Reports Server (NTRS)

Lichtenberg, B. K.

1988-01-01

This paper will describe the biomedical support aspects of humans in space with respect to the vestibular system. The vestibular system is thought to be the primary sensory system involved in the short-term effects of space motion sickness although there is increasing evidence that many factors play a role in this complex set of symptoms. There is the possibility that an individual's inner sense of orientation may be strongly coupled with the susceptibility to space motion sickness. A variety of suggested countermeasures for space motion sickness will be described. Although there are no known ground-based tests that can predict space motion sickness, the search should go on. The long term effects of the vestibular system in weightlessness are still relatively unknown. Some preliminary data has shown that the otoconia are irregular in size and distribution following extended periods of weightlessness. The ramifications of this data are not yet known and because the data was obtained on lower order animals, definitive studies and results must wait until the space station era when higher primates can be studied for long durations. This leads us to artificial gravity, the last topic of this paper. The vestibular system is intimately tied to this question since it has been shown on Earth that exposure to a slow rotating room causes motion sickness for some period of time before adaptation occurs. If the artificial gravity is intermittent, will this mean that people will get sick every time they experience it? The data from many astronauts returning to Earth indicates that a variety of sensory illusions are present, especially immediately upon return to a 1-g environment. Oscillopsia or apparent motion of the visual surround upon head motion along with inappropriate eye motions for a given head motion, all indicate that there is much to be studied yet about the vestibular and CNS systems reaction to a sudden application of a steady state acceleration field like 1-g. From the above information it is obvious that the vestibular system does have unique requirements when it comes to the biomedical support of space flight. This is not to say that other areas such as cardiovascular, musculo-skeletal, immunological and hematological systems do not have their own unique requirements but that possible solutions to one system can provide continuing problems to another system. For example, artificial gravity might be helpful for long term stabilization of bone demineralization or cardiovascular deconditioning but might introduce a new set of problems in orientation, vestibular conflict and just plain body motion in a rotating space vehicle.

Vestibular factors influencing the biomedical support of humans in space.

PubMed

Lichtenberg, B K

1988-01-01

This paper will describe the biomedical support aspects of humans in space with respect to the vestibular system. The vestibular system is thought to be the primary sensory system involved in the short-term effects of space motion sickness although there is increasing evidence that many factors play a role in this complex set of symptoms. There is the possibility that an individual's inner sense of orientation may be strongly coupled with the susceptibility to space motion sickness. A variety of suggested countermeasures for space motion sickness will be described. Although there are no known ground-based tests that can predict space motion sickness, the search should go on. The long term effects of the vestibular system in weightlessness are still relatively unknown. Some preliminary data has shown that the otoconia are irregular in size and distribution following extended periods of weightlessness. The ramifications of this data are not yet known and because the data was obtained on lower order animals, definitive studies and results must wait until the space station era when higher primates can be studied for long durations. This leads us to artificial gravity, the last topic of this paper. The vestibular system is intimately tied to this question since it has been shown on Earth that exposure to a slow rotating room causes motion sickness for some period of time before adaptation occurs. If the artificial gravity is intermittent, will this mean that people will get sick every time they experience it? The data from many astronauts returning to Earth indicates that a variety of sensory illusions are present, especially immediately upon return to a 1-g environment. Oscillopsia or apparent motion of the visual surround upon head motion along with inappropriate eye motions for a given head motion, all indicate that there is much to be studied yet about the vestibular and CNS systems reaction to a sudden application of a steady state acceleration field like 1-g. From the above information it is obvious that the vestibular system does have unique requirements when it comes to the biomedical support of space flight. This is not to say that other areas such as cardiovascular, musculo-skeletal, immunological and hematological systems do not have their own unique requirements but that possible solutions to one system can provide continuing problems to another system. For example, artificial gravity might be helpful for long term stabilization of bone demineralization or cardiovascular deconditioning but might introduce a new set of problems in orientation, vestibular conflict and just plain body motion in a rotating space vehicle.

Controlled progressive innate immune stimulation regimen prevents the induction of sickness behavior in the open field test

PubMed Central

Chen, Qun; Tarr, Andrew J; Liu, Xiaoyu; Wang, Yufen; Reed, Nathaniel S; DeMarsh, Cameron P; Sheridan, John F; Quan, Ning

2013-01-01

Peripheral immune activation by bacterial mimics or live replicating pathogens is well known to induce central nervous system activation. Sickness behavior alterations are often associated with inflammation-induced increases in peripheral proinflammatory cytokines (eg, interleukin [IL]-1β and IL-6). However, most researchers have used acute high dose endotoxin/bacterial challenges to observe these outcomes. Using this methodology may pose inherent risks in the translational interpretation of the experimental data in these studies. Studies using Escherichia coli have yet to establish the full kinetics of repeated E. coli peripheral injections. Therefore, we sought to examine the effects of repeated low dose E. coli on sickness behavior and local peripheral inflammation in the open field test. Results from the current experiments showed a behavioral dose response, where increased amounts of E. coli resulted in correspondingly increased sickness behavior. Furthermore, animals that received a subthreshold dose (ie, one that did not cause sickness behavior) of E. coli 24 hours prior were able to withstand a larger dose of E. coli on the second day (a dose that would normally cause sickness behavior in mice without prior exposure) without inducing sickness behavior. In addition, animals that received escalating subthreshold doses of E. coli on days 1 and 2 behaviorally tolerated a dose of E. coli 25 times higher than what would normally cause sickness behavior if given acutely. Lastly, increased levels of E. coli caused increased IL-6 and IL-1β protein expression in the peritoneal cavity, and this increase was blocked by administering a subthreshold dose of E. coli 24 hours prior. These data show that progressive challenges with subthreshold levels of E. coli may obviate the induction of sickness behavior and proinflammatory cytokine expression. PMID:23950656

Controlled progressive innate immune stimulation regimen prevents the induction of sickness behavior in the open field test.

PubMed

Chen, Qun; Tarr, Andrew J; Liu, Xiaoyu; Wang, Yufen; Reed, Nathaniel S; Demarsh, Cameron P; Sheridan, John F; Quan, Ning

2013-01-01

Peripheral immune activation by bacterial mimics or live replicating pathogens is well known to induce central nervous system activation. Sickness behavior alterations are often associated with inflammation-induced increases in peripheral proinflammatory cytokines (eg, interleukin [IL]-1β and IL-6). However, most researchers have used acute high dose endotoxin/bacterial challenges to observe these outcomes. Using this methodology may pose inherent risks in the translational interpretation of the experimental data in these studies. Studies using Escherichia coli have yet to establish the full kinetics of repeated E. coli peripheral injections. Therefore, we sought to examine the effects of repeated low dose E. coli on sickness behavior and local peripheral inflammation in the open field test. Results from the current experiments showed a behavioral dose response, where increased amounts of E. coli resulted in correspondingly increased sickness behavior. Furthermore, animals that received a subthreshold dose (ie, one that did not cause sickness behavior) of E. coli 24 hours prior were able to withstand a larger dose of E. coli on the second day (a dose that would normally cause sickness behavior in mice without prior exposure) without inducing sickness behavior. In addition, animals that received escalating subthreshold doses of E. coli on days 1 and 2 behaviorally tolerated a dose of E. coli 25 times higher than what would normally cause sickness behavior if given acutely. Lastly, increased levels of E. coli caused increased IL-6 and IL-1β protein expression in the peritoneal cavity, and this increase was blocked by administering a subthreshold dose of E. coli 24 hours prior. These data show that progressive challenges with subthreshold levels of E. coli may obviate the induction of sickness behavior and proinflammatory cytokine expression.

The Alcohol Use Disorders Identification Test and carbohydrate-deficient transferrin in alcohol-related sickness absence.

PubMed

Hermansson, Ulric; Helander, Anders; Brandt, Lena; Huss, Anders; Rönnberg, Sten

2002-01-01

Previous studies have shown that elevated, risky levels of alcohol consumption may lead to higher rates of sickness absence. However, no studies have examined the Alcohol Use Disorders Identification Test (AUDIT) or serum carbohydrate-deficient transferrin (CDT) in relation to sickness absence in the workplace. The purpose of this study was to examine the relationship between sick-days, 12 months before screening, and the AUDIT and CDT (CDTect kit). Serum gamma-glutamyltransferase also was used for comparison. The study was carried out over 36 months in a large workplace and formed part of an ongoing controlled study. In conjunction with a routine health examination, employees were offered the opportunity to undergo an alcohol screening. Absence data were obtained from the company payroll system, and sickness absence was analyzed by using a three-ordinal level cumulative logistic model on the number of sick-days. Odds ratios (OR) and 95% confidence intervals (CI) are reported. Of the 989 subjects who participated in the study, 193 (19.5%) screened positive in relation to either the AUDIT (>or=8 points) or CDT (<20 units/liter for men, and <27 units/liter for women), or both. Employees who screened positive with the AUDIT had a significantly higher proportion of sick-days (p = 0.047) compared with those who screened negative (OR = 1.4, CI 1.0-1.9). Neither long, continuous periods of sickness absence nor absence on Mondays or Fridays gave a clear indication of individuals who screened positive on the AUDIT or CDT test. Our data indicate that individuals with moderately elevated or risky levels of alcohol consumption show an increase in sick-days. Accordingly, workplaces have a good reason for using a more systematic approach to alcohol screening in routine workplace health examinations.

Employer, insurance, and health system response to long-term sick leave in the public sector: policy implications.

PubMed

Heijbel, Bodil; Josephson, Malin; Jensen, Irene; Vingård, Eva

2005-06-01

This study has been conducted to describe the situation of long-term sick-listed persons employed in the public sector regarding the medical reasons of their sick leave, the duration of their problems, the duration of the actual sick leave, rehabilitation support, rehabilitation measures, and the persons expectations of the future. Response rate of a postal questionnaire, where 484 women and 51 men on long-term sick leave answered, was 69%. The study-group consisted of 90% women with a median age of 50 years. The most common reasons for sick listing were long-lasting musculoskeletal problems, especially neck/shoulder pain, low back pain and osteoarthritis or other joint problems and mental problems, especially depression and burn-out syndromes. Forty-seven procent of the men and 57% of the women had been on the sick list for more than a year. Only half of them had been subjected to the legally required rehabilitation investigation of the employer This half got access to rehabilitation programs and/or vocational rehabilitation to a greater extent than those who not had been subjected to rehabilitation investigation. Less than half had been in contact with the workplace-connected rehabilitation actors, the Occupational Health Service or the Trade Union. In spite of this the sick-listed persons had a positive view of their future return to work. For long-term sick-listed persons in the public sector, there is a great potential for improvements of the rehabilitation at the workplace arena, in the involvement and cooperation between the already existing rehabilitation actors, in order to promote return to work.

Reliability of psychophysiological responses across multiple motion sickness stimulation tests

NASA Technical Reports Server (NTRS)

Stout, C. S.; Toscano, W. B.; Cowings, P. S.

1995-01-01

Although there is general agreement that a high degree of variability exists between subjects in their autonomic nervous system responses to motion sickness stimulation, very little evidence exists that examines the reproducibility of autonomic responses within subjects during motion sickness stimulation. Our objectives were to examine the reliability of autonomic responses and symptom levels across five testing occasions using the (1) final minute of testing, (2) change in autonomic response and the change in symptom level, and (3) strength of the relationship between the change in symptom level and the change in autonomic responses across the entire motion sickness test. The results indicate that, based on the final minute of testing, the autonomic responses of heart rate, blood volume pulse, and respiration rate are moderately stable across multiple tests. Changes in heart rate, blood volume pulse, respiration rate, and symptoms throughout the test duration are less stable across the tests. Finally, autonomic responses and symptom levels are significantly related across the entire motion sickness test.

Preadapting to Weightlessness

NASA Technical Reports Server (NTRS)

Reschke, M. F.; Parker, D. E.; Arrott, A. P.

1986-01-01

Report discusses physiological and physical concepts of proposed training system to precondition astronauts to weightless environment. System prevents motion sickness, often experienced during early part of orbital flight. Also helps prevent seasickness and other forms of terrestrial motion sickness, often experienced during early part of orbital flight. Training affects subject's perception of inner-ear signals, visual signals, and kinesthetic motion perception. Changed perception resembles that of astronauts who spent many days in space and adapted to weightlessness.

Main sources of errors in diagnosis of chronic radiation sickness (in Russian)

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

Soldatova, V.A.

1973-11-01

With the aim of finding out the main sources of errors in the diagnosis of chronic radiation sickness, the author analyzed a total of 500 cases of this sickness in roenigenologists and radiologists sent to the clinic to be examined according to occupational indications. lt was shown that the main source of errors when interpreting the observed deviations as occupational was underestimation of etiological significance of functional and organic diseases of the nervous system, endocrinevascular dystonia and also such diseases as hypochromic anemia and chronic infection. The majority of diagnostic errors is explained by insufficient knowledge of the main regularitymore » of forming the picture of chronic radiation sickness and by the absence of the necessary differential diagnosis with general somatic diseases. (auth)« less

Feasibility of a walking virtual reality system for rehabilitation: objective and subjective parameters.

PubMed

Borrego, Adrián; Latorre, Jorge; Llorens, Roberto; Alcañiz, Mariano; Noé, Enrique

2016-08-09

Even though virtual reality (VR) is increasingly used in rehabilitation, the implementation of walking navigation in VR still poses a technological challenge for current motion tracking systems. Different metaphors simulate locomotion without involving real gait kinematics, which can affect presence, orientation, spatial memory and cognition, and even performance. All these factors can dissuade their use in rehabilitation. We hypothesize that a marker-based head tracking solution would allow walking in VR with high sense of presence and without causing sickness. The objectives of this study were to determine the accuracy, the jitter, and the lag of the tracking system and its elicited sickness and presence in comparison of a CAVE system. The accuracy and the jitter around the working area at three different heights and the lag of the head tracking system were analyzed. In addition, 47 healthy subjects completed a search task that involved navigation in the walking VR system and in the CAVE system. Navigation was enabled by natural locomotion in the walking VR system and through a specific device in the CAVE system. An HMD was used as display in the walking VR system. After interacting with each system, subjects rated their sickness in a seven-point scale and their presence in the Slater-Usoh-Steed Questionnaire and a modified version of the Presence Questionnaire. Better performance was registered at higher heights, where accuracy was less than 0.6 cm and the jitter was about 6 mm. The lag of the system was 120 ms. Participants reported that both systems caused similar low levels of sickness (about 2.4 over 7). However, ratings showed that the walking VR system elicited higher sense of presence than the CAVE system in both the Slater-Usoh-Steed Questionnaire (17.6 ± 0.3 vs 14.6 ± 0.6 over 21, respectively) and the modified Presence Questionnaire (107.4 ± 2.0 vs 93.5 ± 3.2 over 147, respectively). The marker-based solution provided accurate, robust, and fast head tracking to allow navigation in the VR system by walking without causing relevant sickness and promoting higher sense of presence than CAVE systems, thus enabling natural walking in full-scale environments, which can enhance the ecological validity of VR-based rehabilitation applications.

Cost-effectiveness of a workplace intervention for sick-listed employees with common mental disorders: design of a randomized controlled trial

PubMed Central

van Oostrom, Sandra H; Anema, Johannes R; Terluin, Berend; de Vet, Henrica CW; Knol, Dirk L; van Mechelen, Willem

2008-01-01

Background Considering the high costs of sick leave and the consequences of sick leave for employees, an early return-to-work of employees with mental disorders is very important. Therefore, a workplace intervention is developed based on a successful return-to-work intervention for employees with low back pain. The objective of this paper is to present the design of a randomized controlled trial evaluating the cost-effectiveness of the workplace intervention compared with usual care for sick-listed employees with common mental disorders. Methods The study is designed as a randomized controlled trial with a follow-up of one year. Employees eligible for this study are on sick leave for 2 to 8 weeks with common mental disorders. The workplace intervention will be compared with usual care. The workplace intervention is a stepwise approach that aims to reach consensus about a return-to-work plan by active participation and strong commitment of both the sick-listed employee and the supervisor. Outcomes will be assessed at baseline, 3, 6, 9 and 12 months. The primary outcome of this study is lasting return-to-work, which will be acquired from continuous registration systems of the companies after the follow-up. Secondary outcomes are total number of days of sick leave during the follow-up, severity of common mental disorders, coping style, job content, and attitude, social influence, and self-efficacy determinants. Cost-effectiveness will be evaluated from the societal perspective. A process evaluation will also be conducted. Discussion Return-to-work is difficult to discuss in the workplace for sick-listed employees with mental disorders and their supervisors. Therefore, this intervention offers a unique opportunity for the sick-listed employee and the supervisor to discuss barriers for return-to-work. Results of this study will possibly contribute to improvement of disability management for sick-listed employees with common mental disorders. Results will become available in 2009. Trial registration ISRCTN92307123 PMID:18194525

Reliability of Autonomic Responses and Malaise Across Multiple Motion Sickness Stimulation Tests

NASA Technical Reports Server (NTRS)

Stout, Cynthia S.; Toscano, William B.; Cowings, Patricia S.

1993-01-01

There is general agreement that a high degree of variability exists between subjects in their autonomic nervous system responses to motion sickness stimulation. Additionally, a paucity of data exists that examines the variability within an individual across repeated motion sickness tests. Investigators have also examined the relationship of autonomic responses to motion sickness development. These investigations have used analyses at discrete points in time to describe this relationship. This approach fails to address the time course of autonomic responses and malaise development throughout the motion sickness test. Our objectives were to examine the reliability of autonomic responses and malaise using the final minute of the motion sickness test across five testing occasions, to examine the reliability of the change in autonomic responses and the change in malaise across five testing occasions, and to examine the relationship between changes in autonomic responses and changes in malaise level across the entire motion sickness test. Our results indicate that, based on the final minute of testing, the autonomic responses of heart rate, blood volume pulse, and respiration rate are moderately stable across multiple tests. Changes in heart rate, blood volume pulse, respiration rate, and malaise throughout the test duration were less stable across the tests. We attribute this instability to variations in individual susceptibility and the error associated with estimating a measure of autonomic gain.

Swedish Council on Technology Assessment in Health Care (SBU). Chapter 5. Risk factors for sick leave - general studies.

PubMed

Allebeck, Peter; Mastekaasa, Arne

2004-01-01

Extensive information is available from official statistics and descriptive studies on the association between different socio-demographic background factors and sickness absence. This information addresses age, gender, place of residence, and socio-economic status. However, few studies have thoroughly analysed these background factors, and rigorous scientific evidence on the causal relationship between these factors and sick leave is lacking. Regarding the family, we found no scientific evidence that marital status or children living at home were associated with sickness absence. However, we found limited scientific evidence for an effect of divorce. Regarding work-related factors, we found limited scientific evidence for an effect of physically stressful work, and moderate scientific evidence for low psychological control over the work situation. We found limited scientific evidence for a correlation in time between unemployment and sickness absence, but insufficient scientific evidence for the causes of the association. There was moderate scientific evidence that the amount of sickness absence is influenced by the design of the social insurance system, but insufficient evidence on the magnitude of change required to influence the level of sickness absence. Essentially the same results apply to disability pension, although the number of studies is small. However, we found moderate scientific evidence for the effects of socio-economic status, which could be explained partly by childhood experiences.

5 CFR 1330.403 - System certification.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 3 2013-01-01 2013-01-01 false System certification. 1330.403 Section....403 System certification. (a) The performance appraisal system(s) covering senior employees must be... certify an agency's appraisal system(s) only when a review of that system's design, application, and...

5 CFR 1330.403 - System certification.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 3 2014-01-01 2014-01-01 false System certification. 1330.403 Section....403 System certification. (a) The performance appraisal system(s) covering senior employees must be... certify an agency's appraisal system(s) only when a review of that system's design, application, and...

75 FR 27182 - Energy Conservation Program: Web-Based Compliance and Certification Management System

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-14

... Conservation Program: Web-Based Compliance and Certification Management System AGENCY: Office of Energy... certification reports to the Department of Energy (DOE) through an electronic Web-based tool, the Compliance and... following means: 1. Compliance and Certification Management System (CCMS)--via the Web portal: http...

Politics and medicine: the case of Israeli National Health Insurance.

PubMed

Yishai, Y

1982-01-01

The paper focuses on the attempts to introduce a national health insurance system in Israel. So far all these attempts advanced through six public committees and various legislative initiatives have been futile. The major actors involved in the process of NHI formulation are (a) the sick funds, the largest of which (KH) nearly monopolizes the health services; (b) political parties which are affiliated with the sick funds; (c) the Israeli medical association. The labor oriented parties and sick funds aimed for the introduction of an NHI system which would strengthen KH and preserve its autonomy. The right wing parties and sick fund advocated nationalization of the NHI. The IMA took a mid-way position not identifying with either of the parties. By allying with a small coalition party it was effective in impeding the legislative process that was initiated by the Labor Party. The vigorous opposition of KH has hindered the adoption of the Likud's version of the NHI. Hence, the issue, torn between conflicting parties, reached a stalemate which is not likely to be resolved in the near future.

Industrial Energy Training and Certification

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

Glatt, Sandy; Cox, Daryl; Nimbalkar, Sachin U.

Compressed air systems, ammonia refrigeration systems, chilled water systems, steam systems, process heating systems, combined heat and power systems, pump systems and fan systems are major industrial energy systems commonly found in manufacturing facilities. Efficiency of these systems contributes significantly to whole facilities' energy performance. On the national, even international level, well-structured training and highly recognized certification programs help develop a highly-skilled and qualified workforce to maintain and improve facilities' energy performance, particularly as technologies within these systems become more advanced. The purpose of this paper is to review currently available training and certification programs focusing on these systems andmore » to identify the gap between market's needs and currently available programs. Three major conclusions are: first, most training programs focus on operations, maintenance, safety and design although some briefly touch the energy performance aspect; second, except CRES by RETA and PSA Certificate and PSAP Master Certification by HI, no other certifications had been found emphasizing on knowledge and skills for improving and maintaining these systems' energy performance; third, developing energy efficiency focused training and ANSI accredited certification programs on these energy systems will fill the gap between market's needs and currently available programs.« less

Industrial Energy Training and Certification

DOE PAGES

Glatt, Sandy; Cox, Daryl; Nimbalkar, Sachin U.; ...

2017-11-01

Compressed air systems, ammonia refrigeration systems, chilled water systems, steam systems, process heating systems, combined heat and power systems, pump systems and fan systems are major industrial energy systems commonly found in manufacturing facilities. Efficiency of these systems contributes significantly to whole facilities' energy performance. On the national, even international level, well-structured training and highly recognized certification programs help develop a highly-skilled and qualified workforce to maintain and improve facilities' energy performance, particularly as technologies within these systems become more advanced. The purpose of this paper is to review currently available training and certification programs focusing on these systems andmore » to identify the gap between market's needs and currently available programs. Three major conclusions are: first, most training programs focus on operations, maintenance, safety and design although some briefly touch the energy performance aspect; second, except CRES by RETA and PSA Certificate and PSAP Master Certification by HI, no other certifications had been found emphasizing on knowledge and skills for improving and maintaining these systems' energy performance; third, developing energy efficiency focused training and ANSI accredited certification programs on these energy systems will fill the gap between market's needs and currently available programs.« less

FUNCTIONAL CHANGES OF INTERNAL ORGANS AND SYSTEMS DURING SEVERE RADIATION SICKNESS FROM EXTERNAL RADIATION (in Russian)

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

Zedgenidze, G.A.

1957-01-01

Animals display different degrees of sensitivity to the action of ionizing radiation. At first increased intestinal motility of the alimentary tract is observed followed by a significant decrease in intestinal motility with radiation sickness of the third degree. Irradiation of the thoracic cage results in zonal atelectasis followed by emphysema. severe pneumonia resulting in death may develop. Contraction of the small bronchioles and expansion of the larger bronchioles is observed during radiation sickness. A decrease in muscle tone of the alimentary tract is accompanied by a decrease in muscle tone of the bronchial tubes. During moderate or severe radiation sicknessmore » it was noted that the flow of bile through the gall bladder was slowed down considerably. This disturbance in function of the liver and gall bladder could be frequently observed even during the latent period of radiation sickness. Damage to the kidneys during severe radiation sickness was noted by the fact that the sergosine clearance test took 300 min instead of the usual 40 to 80 min. A slowdown in kidney elimination was observed in all phases of radiation sickness, and hence, a determination of kidney function by urography is of value as a clinical test in the detection of mild radiation sickness. The subcutaneous injection of vitamins C, B/sub 1/, and B/sub 2/ moderated the course of the radiation sickness. It is concluded that the functional disturbances in internal organs such as the liver, kidneys, gall bladder, stomach, etc., are much more severe than the anatomical changes observed by histological examination. (TTT)« less

Gastrointestinal motility in space motion sickness

NASA Technical Reports Server (NTRS)

Thornton, William E.; Linder, Barry J.; Moore, Thomas P.; Pool, Sam L.

1987-01-01

Gastrointestinal symptoms in space motion sickness (SMS) are significantly different from those in ordinary motion sickness (MS). Recording and tabulation of sounds was the only technique that could be used as a measure of motility during spaceflight operations. There were 17 subjects, six unaffected by SMS, who made ambulatory recordings preflight and inflight. With one exception, all those affected had sharply reduced sounds, while those unaffected had increases or moderate reductions. The mechanism of vomiting in SMS appears to be secondary to this ileus, in contrast to vomiting in ordinary MS, where the emesis center is thought to be directly triggered by the vestibular system.

Workplace air-conditioning and health services attendance among French middle-aged women: a prospective cohort study.

PubMed

Preziosi, P; Czernichow, S; Gehanno, P; Hercberg, S

2004-10-01

To assess the relationship between type of ventilation in the workplace, health services attendance, and sickness absence among middle-aged women. In a national sample of 920 professionally active women aged 49-65 yr from the SU.VI.MAX cohort, recruited from the general population in France, health services attendance and sickness absence were assessed prospectively during 1999. Being exposed to heating, ventilation, and air-conditioning (HVAC) systems in the workplace proved to be a risk factor for attendance at global and several specialist medical services. The adjusted odds ratio for otorhinolaryngologist attendance was 2.33 (95% CI = 1.35-4.04) in the HVAC group compared with the natural ventilation group, and 1.70 (1.13-2.58) for sickness absence. Dermatologist and global medical services attendance rates may also be higher in this group (P = 0.06 in both cases). Exposure to HVAC systems was a strong and significant risk factor for otorhinolaryngologist attendance and sickness absence. HVAC systems are prevalent in recent office buildings and have been shown to be associated with several adverse health effects in terms of morbidity and mortality. From a public-health perspective, our results outline the need for a quantitative assessment of the health impact of ventilation systems, taking into account the possible loss of production that exists in addition to the direct costs of medical services use.

Preparation of ion-activated in situ gel systems of scopolamine hydrobromide and evaluation of its antimotion sickness efficacy.

PubMed

Cao, Shi-lei; Zhang, Qi-zhi; Jiang, Xin-guo

2007-04-01

To develop a novel, in situ gel system for nasal delivery of scopolamine hydrobromide (SCOP) and study its efficacy on motion sickness. SCOP in situ gels at 0.2%, 0.5%, and 1.0% gellan gum concentration (w/v) were prepared, respectively, and characterized in terms of viscosity, in vitro release, and nasal ciliotoxicity. Single photon emission computing tomography technique was used to evaluate the nasal residence time of gel containing (99m)Tc tracer. The antimotion sickness efficacy produced by the in situ gel formulation was investigated in rats and compared with those achieved after subcutaneous and oral administration. The viscosity of the gellan gum formulations either in solution or in gel increased with increasing concentrations of gellan gum. Its release in vitro was moderate in artificial nasal fluid. The micrographic results showed that in situ gels were safe, without nasal ciliotoxicity. In comparison with phosphate buffer saline, a prolonged radioactivity of (99m)Tc in the rabbit nasal cavity was observed after administration of the gellan gum formulation. Intranasal SCOP in situ gel at a dose of 100 microg/kg decreased symptoms of motion sickness significantly in comparison with subcutaneous and oral administration (P<0.01). SCOP nasal in situ gel is a safe and promising therapeutic alternative to existing medications for motion sickness.

Caffeic acid attenuates lipopolysaccharide-induced sickness behaviour and neuroinflammation in mice.

PubMed

Basu Mallik, Sanchari; Mudgal, Jayesh; Nampoothiri, Madhavan; Hall, Susan; Dukie, Shailendra Anoopkumar-; Grant, Gary; Rao, C Mallikarjuna; Arora, Devinder

2016-10-06

Accumulating data links inflammation, oxidative stress and immune system in the pathophysiology of major depressive disorders. Sickness behaviour is a set of behavioural changes that develop during infection, eventually leading to decrease in mobility and depressed behaviour. Lipopolysaccharide (LPS) induces a depression-like state in animals that mimics sickness behaviour. Caffeic acid, a naturally occurring polyphenol, possesses antioxidant and anti-inflammatory properties. The present study was designed to explore the potential of caffeic acid against LPS-induced sickness behaviour in mice. Caffeic acid (30mg/kg) and imipramine (15mg/kg) were administered orally one hour prior to LPS (1.5mg/kg) challenge. Behavioural assessment was carried out between 1 and 2h and blood samples were collected at 3h post-LPS injection. Additionally, cytokines (brain and serum) and brain oxidative stress markers were estimated. LPS increased the systemic and brain cytokine levels, altered the anti-oxidant defence and produced key signs of sickness behaviour in animals. Caffeic acid treatment significantly reduced the LPS-induced changes, including reduced expression of inflammatory markers in serum and whole brain. Caffeic acid also exerted an anti-oxidant effect, which was evident from the decreased levels of oxidative stress markers in whole brain. Our data suggests that caffeic acid can prevent the neuroinflammation-induced acute and probably the long term neurodegenerative changes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Work-related respiratory disease in employees leaving an electronics factory.

PubMed

Perks, W H; Burge, P S; Rehahn, M; Green, M

1979-02-01

Examination of the records of employees leaving an electronics factory over three-and-a-half years showed that a significantly greater proportion left the shop floor (where soldering took place) because of ill health than left the stores and office areas. This difference was largely due to work-related respiratory disease in those whose job was soldering. Shop floor workers leaving for health reasons also had increased sickness certification due to respiratory illness compared to stores and office workers. These findings suggest that work-related respiratory illness is a significant cause of morbidity and loss of employment in solderers working at the factory and that this has been a longstanding problem with its onset before the first recorded cases of occupational asthma caused by solder flux containing colophony.

Development and Effectiveness Analysis of a Personalized Ubiquitous Multi-Device Certification Tutoring System Based on Bloom's Taxonomy of Educational Objectives

ERIC Educational Resources Information Center

Hwang, Gwo-Haur; Chen, Beyin; Huang, Cin-Wei

2016-01-01

In recent years, with the gradual increase in the importance of professional certificates, improvement in certification tutoring systems has become more important. In this study, we have developed a personalized ubiquitous multi-device certification tutoring system (PUMDCTS) based on "Bloom's Taxonomy of Educational Objectives," and…

Professional Certification

EPA Pesticide Factsheets

WaterSense recognizes certification programs for irrigation professionals that meet the specification criteria. Certification programs cover three areas: irrigation system design, installation and maintenance, and system auditing.

Sickness behavior induced by endotoxin can be mitigated by the dietary soluble fiber, pectin, through up-regulation of IL-4 and Th2 polarization

PubMed Central

Sherry, Christina L.; Kim, Stephanie S.; Dilger, Ryan N.; Bauer, Laura L.; Moon, Morgan L.; Tapping, Richard I.; Fahey, George C.; Tappenden, Kelly A.; Freund, Gregory G.

2010-01-01

Peripheral activation of the immune system by infectious agents triggers the brain-cytokine system causing sickness behaviors which profoundly impact well-being. Dietary fiber is a beneficial foodstuff that, from a gastrointestinal tract perspective, exists in both insoluble and soluble forms. We show that a diet rich in soluble fiber protects mice from endotoxin-induced sickness behavior by polarizing mice Th2 when compared to a diet containing only insoluble fiber. Mice fed soluble fiber became less sick and recovered faster from endotoxin-induced sickness behaviors than mice fed insoluble fiber. In response to intraperitoneal endotoxin, mice fed soluble fiber had up-regulated IL-1RA and reduced IL-1βand TNF-αin the brain as compared to mice fed insoluble fiber. Importantly, mice fed soluble fiber had a basal increase in IL-4 in the ileum and spleen which was absent in MyD88 knockout mice. Con A stimulated splenocytes from mice fed soluble fiber showed increased IL-4 and IL-5 and decreased IL-2, IL-12 and IFN-γwhen compared to mice fed insoluble fiber. Likewise, endotoxin-stimulated macrophages from mice fed soluble fiber demonstrated decreased IL-1β, TNF-α, IFN-γ, IL-12 and nitrate and increased IL-1RA, arginase 1 and Ym1 when compared to mice fed insoluble fiber. Finally, the behavioral protection afforded by feeding mice soluble fiber was reduced in IL-4 knockout mice, as was the impact of soluble fiber on Con A stimulated splenocytes and endotoxin activated macrophages. These data show that a diet rich in soluble fiber protects against endotoxin-induced sickness behavior by polarizing mice Th2 and promoting alternative activation of macrophages. PMID:20138982

Impact of the "Symmetric Instability of the Computational Kind" at mesoscale- and submesoscale-permitting resolutions

NASA Astrophysics Data System (ADS)

Ducousso, Nicolas; Le Sommer, J.; Molines, J.-M.; Bell, M.

2017-12-01

The energy- and enstrophy-conserving momentum advection scheme (EEN) used over the last 10 years in NEMO is subject to a spurious numerical instability. This instability, referred to as the Symmetric Instability of the Computational Kind (SICK), arises from a discrete imbalance between the two components of the vector-invariant form of momentum advection. The properties and the method for removing this instability have been documented by Hollingsworth et al. (1983), but the extent to which the SICK may interfere with processes of interest at mesoscale- and submesoscale-permitting resolutions is still unkown. In this paper, the impact of the SICK in realistic ocean model simulations is assessed by comparing model integrations with different versions of the EEN momentum advection scheme. Investigations are undertaken with a global mesoscale-permitting resolution (1/4 °) configuration and with a regional North Atlantic Ocean submesoscale-permitting resolution (1/60 °) configuration. At both resolutions, the instability is found to alter primarily the most energetic current systems, such as equatorial jets, western boundary currents and coherent vortices. The impact of the SICK is found to increase with model resolution with a noticeable impact at mesoscale-permitting resolution and a dramatic impact at submesoscale-permitting resolution. The SICK is shown to distort the normal functioning of current systems, by redirecting the slow energy transfer between balanced motions to a spurious energy transfer to internal inertia-gravity waves and to dissipation. Our results indicate that the SICK is likely to have significantly corrupted NEMO solutions (when run with the EEN scheme) at mesocale-permitting and finer resolutions over the last 10 years.

Does the quality of encounters affect return to work? Lay people describe their experiences of meeting various professionals during their rehabilitation process.

PubMed

Müssener, Ulrika; Ståhl, Christian; Söderberg, Elsy

2015-01-01

Among the many aspects of the rehabilitation process that may be relevant for its outcome, the impact of encounters with various professionals has received little attention. The objective was to gain a deeper understanding of how individuals with experiences of being on sick leave perceive their encounters with professionals, and how such encounters affected their ability to return to work, as well as their attitudes towards the sickness insurance system. An inductive qualitative approach was used to analyze data from 20 interviews with men and women, aged 33-59, in Sweden who had experience of being on sick leave for at least 28 days. The study shows how interviewees encounters with professionals affected their self-confidence and perception of their ability to return to work. Professionals' treatment of people on sick leave seems to be affected by the structural prerequisites for offering support, where sickness insurance regulations are suggested to have a large impact. An encouraging and supportive attitude on the part of the professionals is essential for empowering people to handle obstacles during the rehabilitation process; whereas feeling rejected and belittled in the return to work process may lead to disempowerment, and/or delays in measures and longer periods on sick leave.

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.

76 FR 76896 - International Anti-Fouling System Certificate

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-09

...-fouling System (IAFS) Certificate to the list of certificates a recognized classification society may..., 2001. This final rule will enable recognized classification societies to apply to the Coast Guard for... the Coast Guard to authorize recognized classification societies to issue IAFS Certificates...

Moving in a Moving World: A Review on Vestibular Motion Sickness

PubMed Central

Bertolini, Giovanni; Straumann, Dominik

2016-01-01

Motion sickness is a common disturbance occurring in healthy people as a physiological response to exposure to motion stimuli that are unexpected on the basis of previous experience. The motion can be either real, and therefore perceived by the vestibular system, or illusory, as in the case of visual illusion. A multitude of studies has been performed in the last decades, substantiating different nauseogenic stimuli, studying their specific characteristics, proposing unifying theories, and testing possible countermeasures. Several reviews focused on one of these aspects; however, the link between specific nauseogenic stimuli and the unifying theories and models is often not clearly detailed. Readers unfamiliar with the topic, but studying a condition that may involve motion sickness, can therefore have difficulties to understand why a specific stimulus will induce motion sickness. So far, this general audience struggles to take advantage of the solid basis provided by existing theories and models. This review focuses on vestibular-only motion sickness, listing the relevant motion stimuli, clarifying the sensory signals involved, and framing them in the context of the current theories. PMID:26913019

Access control based on attribute certificates for medical intranet applications.

PubMed

Mavridis, I; Georgiadis, C; Pangalos, G; Khair, M

2001-01-01

Clinical information systems frequently use intranet and Internet technologies. However these technologies have emphasized sharing and not security, despite the sensitive and private nature of much health information. Digital certificates (electronic documents which recognize an entity or its attributes) can be used to control access in clinical intranet applications. To outline the need for access control in distributed clinical database systems, to describe the use of digital certificates and security policies, and to propose the architecture for a system using digital certificates, cryptography and security policy to control access to clinical intranet applications. We have previously developed a security policy, DIMEDAC (Distributed Medical Database Access Control), which is compatible with emerging public key and privilege management infrastructure. In our implementation approach we propose the use of digital certificates, to be used in conjunction with DIMEDAC. Our proposed access control system consists of two phases: the ways users gain their security credentials; and how these credentials are used to access medical data. Three types of digital certificates are used: identity certificates for authentication; attribute certificates for authorization; and access-rule certificates for propagation of access control policy. Once a user is identified and authenticated, subsequent access decisions are based on a combination of identity and attribute certificates, with access-rule certificates providing the policy framework. Access control in clinical intranet applications can be successfully and securely managed through the use of digital certificates and the DIMEDAC security policy.

Certify for success: A methodology for human-centered certification of advanced aviation systems

NASA Technical Reports Server (NTRS)

Small, Ronald L.; Rouse, William B.

1994-01-01

This position paper uses the methodology in Design for Success as a basis for a human factors certification program. The Design for Success (DFS) methodology espouses a multi-step process to designing and developing systems in a human-centered fashion. These steps are as follows: (1) naturalizing - understand stakeholders and their concerns; (2) marketing - understand market-oriented alternatives to meeting stakeholder concerns; (3) engineering - detailed design and development of the system considering tradeoffs between technology, cost, schedule, certification requirements, etc.; (4) system evaluation - determining if the system meets its goal(s); and (5) sales and service - delivering and maintaining the system. Because the main topic of this paper is certification, we will focus our attention on step 4, System Evaluation, since it is the natural precursor to certification. Evaluation involves testing the system and its parts for their correct behaviors. Certification focuses not only on ensuring that the system exhibits the correct behaviors, but ONLY the correct behaviors.

The effect of autogenic training and biofeedback on motion sickness tolerance.

PubMed

Jozsvai, E E; Pigeau, R A

1996-10-01

Motion sickness is characterized by symptoms of vomiting, drowsiness, fatigue and idiosyncratic changes in autonomic nervous system (ANS) responses such as heart rate (HR) and skin temperature (ST). Previous studies found that symptoms of motion sickness are controllable through self-regulation of ANS responses and the best method to teach such control is autogenic-feedback (biofeedback) training. Recent experiments indicated that biofeedback training is ineffective in reducing symptoms of motion sickness or in increasing tolerance to motion. If biofeedback facilitates learning of ANS self-regulation then autogenic training with true feedback (TFB) should lead to better control over ANS responses and better motion tolerance than autogenic training with false feedback (FFB). If there is a relationship between ANS self-regulation and coping with motion stress, a significant correlation should be found between amounts of control over ANS responses and measures of motion tolerance and/or symptoms of motion sickness. There were 3 groups of 6 subjects exposed for 6 weeks to weekly sessions of Coriolis stimulation to induce motion sickness. Between the first and second Coriolis sessions, subjects in the experimental groups received five episodes of autogenic training with either true (group TFB) or false (group FFB) feedback on their HR and ST. The control group (CTL) received no treatment. Subjects learned to control their HR and ST independent of whether they received true or false feedback. Learned control of ST and HR was not related to severity of motion sickness or subject's ability to withstand Coriolis stimulation following treatment. A lack of significant correlation between these variables suggested that subjects were not able to apply their skills of ANS self-regulation in the motion environment, and/ or such skills had little value in reducing symptoms of motion sickness or enhancing their ability to withstand rotations.

Inpatient care of small and sick newborns: a multi-country analysis of health system bottlenecks and potential solutions

PubMed Central

2015-01-01

Background Preterm birth is the leading cause of child death worldwide. Small and sick newborns require timely, high-quality inpatient care to survive. This includes provision of warmth, feeding support, safe oxygen therapy and effective phototherapy with prevention and treatment of infections. Inpatient care for newborns requires dedicated ward space, staffed by health workers with specialist training and skills. Many of the estimated 2.8 million newborns that die every year do not have access to such specialised care. Methods The bottleneck analysis tool was applied in 12 countries in Africa and Asia as part of the Every Newborn Action Plan process. Country workshops involved technical experts to complete the survey tool, which is designed to synthesise and grade health system "bottlenecks" (or factors that hinder the scale up) of maternal-newborn intervention packages. For this paper, we used quantitative and qualitative methods to analyse the bottleneck data, and combined these with literature review, to present priority bottlenecks and actions relevant to different health system building blocks for inpatient care of small and sick newborns. Results Inpatient care of small and sick newborns is an intervention package highlighted by all country workshop participants as having critical health system challenges. Health system building blocks with the highest graded (significant or major) bottlenecks were health workforce (10 out of 12 countries) and health financing (10 out of 12 countries), followed by community ownership and partnership (9 out of 12 countries). Priority actions based on solution themes for these bottlenecks are discussed. Conclusions Whilst major bottlenecks to the scale-up of quality inpatient newborn care are present, effective solutions exist. For all countries included, there is a critical need for a neonatal nursing cadre. Small and sick newborns require increased, sustained funding with specific insurance schemes to cover inpatient care and avoid catastrophic out-of-pocket payments. Core competencies, by level of care, should be defined for monitoring of newborn inpatient care, as with emergency obstetric care. Rather than fatalism that small and sick newborns will die, community interventions need to create demand for accessible, high-quality, family-centred inpatient care, including kangaroo mother care, so that every newborn can survive and thrive. PMID:26391335

45 CFR 1301.13 - Accounting system certification.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Accounting system certification. 1301.13 Section... START PROGRAM HEAD START GRANTS ADMINISTRATION General Requirements § 1301.13 Accounting system... shall submit an accounting system certification, prepared by an independent auditor, stating that the...

Certification Systems

EPA Pesticide Factsheets

The WaterSense Product Certification System outlines the process and procedures for the product certification to ensure that all WaterSense labeled products meet EPA's criteria for efficiency and performance.

On-track test of tilt control strategies for less motion sickness on tilting trains

NASA Astrophysics Data System (ADS)

Persson, Rickard; Kufver, Björn; Berg, Mats

2012-07-01

Carbody tilting is today a mature and inexpensive technology that permits higher train speeds in horizontal curves, thus shortening travel time. However, tilting trains run a greater risk of causing motion sickness than non-tilting ones. It is likely that the difference in motions between the two train types contributes to the observed difference in risk of motion sickness. Decreasing the risk of motion sickness has until now been equal to increasing the discomfort related to quasi-static lateral acceleration. But, there is a difference in time perception between discomfort caused by quasi-static quantities and motion sickness, which opens up for new solutions. One proposed strategy is to let the local track conditions influence the tilt and give each curve its own optimised tilt angle. This is made possible by new tilt algorithms, storing track data and using a positioning system to select the appropriate data. The present paper reports from on-track tests involving more than 100 test subjects onboard a tilting train. A technical approach is taken evaluating the effectiveness of the new tilt algorithms and the different requirements on quasi-static lateral acceleration and lateral jerk in relative terms. The evaluation verifies that the rms values important for motion sickness can be influenced without changing the requirements on quasi-static lateral acceleration and lateral jerk. The evaluation shows that reduced quantities of motions assumed to have a relation to motion sickness also lead to a reduction in experienced motion sickness. However, a limitation of applicability is found as the lowest risk of motion sickness was not recorded for the test case with motions closest to those of a non-tilting train. An optimal level of tilt, different from no tilt at all, is obtained. This non-linear relation has been observed by other researchers in laboratory tests.

Sickness absence due to musculoskeletal diagnoses and risk of diagnosis-specific disability pension: a nationwide Swedish prospective cohort study.

PubMed

Jansson, Catarina; Alexanderson, Kristina

2013-06-01

Musculoskeletal disorders constitute major public health problems. Few studies have, however, examined risk of disability pension among persons sickness absent due to musculoskeletal diagnoses. Thus, we constructed a prospective nationwide population-based cohort study based on Swedish registers, consisting of all 4,687,756 individuals living in Sweden December 31, 2004/2005, aged 20-64 years, who were not on disability or old-age pension. Those individuals who were sickness absent in 2005 due to musculoskeletal diagnoses were compared to those sickness absent due to non-musculoskeletal diagnoses and those with no sickness absence. Musculoskeletal diagnoses were categorized as follows: 1) artropathies/systemic connective tissue disorders, 2) dorsopathies, and 3) soft tissue disorders/osteopathies/chondropathies/other musculoskeletal disorders. All-cause and diagnosis-specific incident disability pension were followed from 2006 to 2009. Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were estimated by Cox proportional hazards regression. In models adjusted for socio-demographic factors and morbidity, sickness absence due to all categories of musculoskeletal diagnoses was associated with 12- to 18-fold increased risks of all-cause disability pension (adjusted model, category 2 diagnoses, IRR = 18.57, 95% CI = 18.18-18.97). Similar associations were observed among both women and men sickness absent due to all 3 musculoskeletal diagnostic categories. Moreover, increased risks of disability pension because of cancer, mental, circulatory and musculoskeletal diagnoses were observed among individuals sickness absent because of any musculoskeletal diagnostic category (disability pension due to musculoskeletal diagnoses, adjusted model, category 2 diagnoses, IRR = 50.66, 95% CI = 49.06-52.32). In conclusion, this nationwide cohort study reveals strongly increased risks of all-cause and diagnosis-specific disability pension among those sickness absent due to musculoskeletal diagnoses. Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. 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.

Scheduling Real-Time Mixed-Criticality Jobs

NASA Astrophysics Data System (ADS)

Baruah, Sanjoy K.; Bonifaci, Vincenzo; D'Angelo, Gianlorenzo; Li, Haohan; Marchetti-Spaccamela, Alberto; Megow, Nicole; Stougie, Leen

Many safety-critical embedded systems are subject to certification requirements; some systems may be required to meet multiple sets of certification requirements, from different certification authorities. Certification requirements in such "mixed-criticality" systems give rise to interesting scheduling problems, that cannot be satisfactorily addressed using techniques from conventional scheduling theory. In this paper, we study a formal model for representing such mixed-criticality workloads. We demonstrate first the intractability of determining whether a system specified in this model can be scheduled to meet all its certification requirements, even for systems subject to two sets of certification requirements. Then we quantify, via the metric of processor speedup factor, the effectiveness of two techniques, reservation-based scheduling and priority-based scheduling, that are widely used in scheduling such mixed-criticality systems, showing that the latter of the two is superior to the former. We also show that the speedup factors are tight for these two techniques.

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.

Efficacy of phosphatidylcholine in the modulation of motion sickness susceptibility

NASA Technical Reports Server (NTRS)

Kohl, R. L.; Ryan, P.; Homick, J. L.

1985-01-01

This study evaluated the efficacy of pharmacological doses of phosphatidylcholine (lecithin) in the modulation of motion sickness induced by exposure to coriolis stimulation in a rotating chair. Subjects received daily dietary supplements of 25 grams of lecithin (90 percent phosphatidylcholine) and were tested for their susceptibility to motion sickness after 4 h, 2 d, and 21 d. A small but statistically significant increase in susceptibility (+15 percent) was noted 4 h after supplemental phosphatidylcholine, with four of nine subjects demonstrating a marked increase in susceptibility. This finding was attributed to choline's stimulatory action on cholinergic systems, an action which opposes that of the classical antimotion sickness drug scopolamine. Chronic lecithin loading revealed a trend towards reduced susceptibility, possibly indicating the occurrence of adaptive mechanisms such as receptor down-regulation. Withdrawal from lecithin loading, perhaps coupled with anticholinergic treatment, might prove to be a potent prophylactic regimen and ought to be tested.

Inflammatory fatigue and sickness behaviour - lessons for the diagnosis and management of chronic fatigue syndrome.

PubMed

Arnett, S V; Clark, I A

2012-12-10

Persistent and severe fatigue is a common part of the presentation of a diverse range of disease processes. There is a growing body of evidence indicating a common inflammatory pathophysiology underlying many conditions where fatigue is a primary patient concern, including chronic fatigue syndrome. This review explores current models of how inflammatory mediators act on the central nervous system to produce fatigue and sickness behaviour, and the commonality of these processes in conditions as diverse as surgical trauma, infection, various cancers, inflammatory bowel disease, connective tissue diseases and autoimmune diseases. We also discuss evidence indicating chronic fatigue syndrome may have important pathophysiological similarities with cytokine mediated sickness behaviour, and what lessons can be applied from sickness behaviour to chronic fatigue syndrome with regards to the diagnosis and management. Copyright © 2012 Elsevier B.V. All rights reserved.

'Prion-like' propagation of the synucleinopathy of M83 transgenic mice depends on the mouse genotype and type of inoculum.

PubMed

Sargent, Dorian; Verchère, Jérémy; Lazizzera, Corinne; Gaillard, Damien; Lakhdar, Latifa; Streichenberger, Nathalie; Morignat, Eric; Bétemps, Dominique; Baron, Thierry

2017-10-01

The M83 transgenic mouse is a model of human synucleinopathies that develops severe motor impairment correlated with accumulation of the pathological Ser129-phosphorylated α-synuclein (α-syn P ) in the brain and spinal cord. M83 disease can be accelerated by intracerebral inoculation of brain extracts from sick M83 mice. This has also recently been described using peripheral routes, injecting recombinant preformed α-syn fibrils into the muscle or the peritoneum. Here, we inoculated homozygous and/or hemizygous M83 neonates via the intraperitoneal and/or intracerebral routes with two different brain extracts: one from sick M83 mice inoculated with brain extract from other sick M83 mice, and the other derived from a human multiple system atrophy source passaged in M83 mice. Detection of α-syn P using ELISA and western blot confirmed the disease in mice. The distribution of α-syn P in the central nervous system was similar, independently of the inoculum or inoculation route, consistent with previous studies describing M83 disease. ELISA tests revealed higher levels of α-syn P in homozygous than in hemizygous sick M83 mice, at least after IC inoculation. Interestingly, the immunoreactivity of α-syn P detected by ELISA was significantly lower in M83 mice inoculated with the multiple system atrophy inoculum than in M83 mice inoculated with the M83 inoculum, at the first two passages. 'Prion-like' propagation of the synucleinopathy up to the clinical disease was accelerated by both intracerebral and intraperitoneal inoculations of brain extracts from sick mice. This acceleration, however, depends on the levels of α-syn expression by the mouse and the type of inoculum. © 2017 International Society for Neurochemistry.

Space motion sickness preflight adaptation training: preliminary studies with prototype trainers

NASA Technical Reports Server (NTRS)

Parker, D. E.; Rock, J. C.; von Gierke, H. E.; Ouyang, L.; Reschke, M. F.; Arrott, A. P.

1987-01-01

Preflight training frequently has been proposed as a potential solution to the problem of space motion sickness. The paper considers successively the otolith reinterpretation, the concept for a preflight adaptation trainer and the research with the Miami University Seesaw, the Wright Patterson Air-Force Base Dynamic Environment Simulator and the Visually Coupled Airborne Systems Simulator prototype adaptation trainers.

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.

Immigrants’ use of emergency primary health care in Norway: a registry-based observational study

PubMed Central

2012-01-01

Background Emigrants are often a selected sample and in good health, but migration can have deleterious effects on health. Many immigrant groups report poor health and increased use of health services, and it is often claimed that they tend to use emergency primary health care (EPHC) services for non-urgent purposes. The aim of the present study was to analyse immigrants’ use of EPHC, and to analyse variations according to country of origin, reason for immigration, and length of stay in Norway. Methods We conducted a registry based study of all immigrants to Norway, and a subsample of immigrants from Poland, Germany, Iraq and Somalia, and compared them with native Norwegians. The material comprised all electronic compensation claims for EPHC in Norway during 2008. We calculated total contact rates, contact rates for selected diagnostic groups and for services given during consultations. Adjustments for a series of socio-demographic and socio-economic variables were done by multiple logistic regression analyses. Results Immigrants as a whole had a lower contact rate than native Norwegians (23.7% versus 27.4%). Total contact rates for Polish and German immigrants (mostly work immigrants) were 11.9% and 7.0%, but for Somalis and Iraqis (mostly asylum seekers) 31.8% and 33.6%. Half of all contacts for Somalis and Iraqis were for non-specific pain, and they had relatively more of their contacts during night than other groups. Immigrants’ rates of psychiatric diagnoses were low, but increased with length of stay in Norway. Work immigrants suffered less from respiratory and gastrointestinal infections, but had more injuries and higher need for sickness certification. All immigrant groups, except Germans, were more often given a sickness certificate than native Norwegians. Use of interpreter was reduced with increasing length of stay. All immigrant groups had an increased need for long consultations, while laboratory tests were most often used for Somalis and Iraqis. Conclusions Immigrants use EPHC services less than native Norwegians, but there are large variations among immigrant groups. Work immigrants from Germany and Poland use EPHC considerably less, while asylum seekers from Somalia and Iraq use these services more than native Norwegians. PMID:22958343

Effect of stratified care for low back pain in family practice (IMPaCT Back): a prospective population-based sequential comparison.

PubMed

Foster, Nadine E; Mullis, Ricky; Hill, Jonathan C; Lewis, Martyn; Whitehurst, David G T; Doyle, Carol; Konstantinou, Kika; Main, Chris; Somerville, Simon; Sowden, Gail; Wathall, Simon; Young, Julie; Hay, Elaine M

2014-01-01

We aimed to determine the effects of implementing risk-stratified care for low back pain in family practice on physician's clinical behavior, patient outcomes, and costs. The IMPaCT Back Study (IMplementation to improve Patient Care through Targeted treatment) prospectively compared separate patient cohorts in a preintervention phase (6 months of usual care) and a postintervention phase (12 months of stratified care) in family practice, involving 64 family physicians and linked physical therapy services. A total of 1,647 adults with low back pain were invited to participate. Stratified care entailed use of a risk stratification tool to classify patients into groups at low, medium, or high risk for persistent disability and provision of risk-matched treatment. The primary outcome was 6-month change in disability as assessed with the Roland-Morris Disability Questionnaire. Process outcomes captured physician behavior change in risk-appropriate referral to physical therapy, diagnostic tests, medication prescriptions, and sickness certifications. A cost-utility analysis estimated incremental quality-adjusted life-years and back-related health care costs. Analysis was by intention to treat. The 922 patients studied (368 in the preintervention phase and 554 in the postintervention phase) had comparable baseline characteristics. At 6 months follow-up, stratified care had a small but significant benefit relative to usual care as seen from a mean difference in Roland-Morris Disability Questionnaire scores of 0.7 (95% CI, 0.1-1.4), with a large, clinically important difference in the high risk group of 2.3 (95% CI, 0.8-3.9). Mean time off work was 50% shorter (4 vs 8 days, P = .03) and the proportion of patients given sickness certifications was 30% lower (9% vs 15%, P = .03) in the postintervention cohort. Health care cost savings were also observed. Stratified care for back pain implemented in family practice leads to significant improvements in patient disability outcomes and a halving in time off work, without increasing health care costs. Wider implementation is recommended.

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

Energy Systems Training Programs and Certifications Survey White Paper

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

Cox, Daryl; Nimbalkar, Sachin U.; Wenning, Thomas J.

2017-02-01

Compressed air system, industrial refrigeration system, chilled water system, pump system, fan system, steam system, process heating system, and combined heat and power system are the major industrial energy systems. By helping enhance knowledge and skills of workforce, training and certification programs on these systems are essential to improve energy efficiency of manufacturing facilities. A literature survey of currently available training and certification programs on these systems was conducted.

Access Control based on Attribute Certificates for Medical Intranet Applications

PubMed Central

Georgiadis, Christos; Pangalos, George; Khair, Marie

2001-01-01

Background Clinical information systems frequently use intranet and Internet technologies. However these technologies have emphasized sharing and not security, despite the sensitive and private nature of much health information. Digital certificates (electronic documents which recognize an entity or its attributes) can be used to control access in clinical intranet applications. Objectives To outline the need for access control in distributed clinical database systems, to describe the use of digital certificates and security policies, and to propose the architecture for a system using digital certificates, cryptography and security policy to control access to clinical intranet applications. Methods We have previously developed a security policy, DIMEDAC (Distributed Medical Database Access Control), which is compatible with emerging public key and privilege management infrastructure. In our implementation approach we propose the use of digital certificates, to be used in conjunction with DIMEDAC. Results Our proposed access control system consists of two phases: the ways users gain their security credentials; and how these credentials are used to access medical data. Three types of digital certificates are used: identity certificates for authentication; attribute certificates for authorization; and access-rule certificates for propagation of access control policy. Once a user is identified and authenticated, subsequent access decisions are based on a combination of identity and attribute certificates, with access-rule certificates providing the policy framework. Conclusions Access control in clinical intranet applications can be successfully and securely managed through the use of digital certificates and the DIMEDAC security policy. PMID:11720951

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.

48 CFR 246.504 - Certificate of conformance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Certificate of conformance. 246.504 Section 246.504 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE CONTRACT MANAGEMENT QUALITY ASSURANCE Acceptance 246.504 Certificate of conformance...

9 CFR 205.101 - Certification-request and processing.

Code of Federal Regulations, 2014 CFR

2014-01-01

... an introductory explanation of how the system will operate; (2) Identify the information which will... the system is created and operated, and the system operator is designated; (ii) All regulations, rules... certification of a system, a written request for certification must be filed together with such documents as...

9 CFR 205.101 - Certification-request and processing.

Code of Federal Regulations, 2013 CFR

2013-01-01

... an introductory explanation of how the system will operate; (2) Identify the information which will... the system is created and operated, and the system operator is designated; (ii) All regulations, rules... certification of a system, a written request for certification must be filed together with such documents as...

24 CFR 200.950 - Building product standards and certification program for solar water heating system.

Code of Federal Regulations, 2012 CFR

2012-04-01

... certification program for solar water heating system. 200.950 Section 200.950 Housing and Urban Development... solar water heating system. (a) Applicable standards. (1) All solar water heating systems shall be designed, manufactured, and tested in compliance with Solar Rating and Certification Corporation (SRCC...

24 CFR 200.950 - Building product standards and certification program for solar water heating system.

Code of Federal Regulations, 2013 CFR

2013-04-01

... certification program for solar water heating system. 200.950 Section 200.950 Housing and Urban Development... solar water heating system. (a) Applicable standards. (1) All solar water heating systems shall be designed, manufactured, and tested in compliance with Solar Rating and Certification Corporation (SRCC...

24 CFR 200.950 - Building product standards and certification program for solar water heating system.

Code of Federal Regulations, 2014 CFR

2014-04-01

... certification program for solar water heating system. 200.950 Section 200.950 Housing and Urban Development... solar water heating system. (a) Applicable standards. (1) All solar water heating systems shall be designed, manufactured, and tested in compliance with Solar Rating and Certification Corporation (SRCC...

Stroboscopic Goggles for Reduction of Motion Sickness

NASA Technical Reports Server (NTRS)

Reschke, M. F.; Somers, Jeffrey T.

2005-01-01

A device built around a pair of electronic shutters has been demonstrated to be effective as a prototype of stroboscopic goggles or eyeglasses for preventing or reducing motion sickness. The momentary opening of the shutters helps to suppress a phenomenon that is known in the art as retinal slip and is described more fully below. While a number of different environmental factors can induce motion sickness, a common factor associated with every known motion environment is sensory confusion or sensory mismatch. Motion sickness is a product of misinformation arriving at a central point in the nervous system from the senses from which one determines one s spatial orientation. When information from the eyes, ears, joints, and pressure receptors are all in agreement as to one s orientation, there is no motion sickness. When one or more sensory input(s) to the brain is not expected, or conflicts with what is anticipated, the end product is motion sickness. Normally, an observer s eye moves, compensating for the anticipated effect of motion, in such a manner that the image of an object moving relatively to an observer is held stationary on the retina. In almost every known environment that induces motion sickness, a change in the gain (in the signal-processing sense of gain ) of the vestibular system causes the motion of the eye to fail to hold images stationary on the retina, and the resulting motion of the images is termed retinal slip. The present concept of stroboscopic goggles or eyeglasses (see figure) is based on the proposition that prevention of retinal slip, and hence, the prevention of sensory mismatch, can be expected to reduce the tendency toward motion sickness. A device according to this concept helps to prevent retinal slip by providing snapshots of the visual environment through electronic shutters that are brief enough that each snapshot freezes the image on each retina. The exposure time for each snapshot is less than 5 ms. In the event that a higher rate of strobing is necessary for adequate viewing of the changing scene during rapid head movements, the rate of strobing (but not the exposure time) can be controlled in response to the readings of rate-of-rotation sensors attached to the device.

The Impact of Working in a Green Certified Building on Cognitive Function and Health.

PubMed

MacNaughton, Piers; Satish, Usha; Laurent, Jose Guillermo Cedeno; Flanigan, Skye; Vallarino, Jose; Coull, Brent; Spengler, John D; Allen, Joseph G

2017-03-01

Thirty years of public health research have demonstrated that improved indoor environmental quality is associated with better health outcomes. Recent research has demonstrated an impact of the indoor environment on cognitive function. We recruited 109 participants from 10 high-performing buildings (i.e. buildings surpassing the ASHRAE Standard 62.1-2010 ventilation requirement and with low total volatile organic compound concentrations) in five U.S. cities. In each city, buildings were matched by week of assessment, tenant, type of worker and work functions. A key distinction between the matched buildings was whether they had achieved green certification. Workers were administered a cognitive function test of higher order decision-making performance twice during the same week while indoor environmental quality parameters were monitored. Workers in green certified buildings scored 26.4% (95% CI: [12.8%, 39.7%]) higher on cognitive function tests, controlling for annual earnings, job category and level of schooling, and had 30% fewer sick building symptoms than those in non-certified buildings. These outcomes may be partially explained by IEQ factors, including thermal conditions and lighting, but the findings suggest that the benefits of green certification standards go beyond measureable IEQ factors. We describe a holistic "buildingomics" approach for examining the complexity of factors in a building that influence human health.

The Impact of Working in a Green Certified Building on Cognitive Function and Health

PubMed Central

MacNaughton, Piers; Satish, Usha; Laurent, Jose Guillermo Cedeno; Flanigan, Skye; Vallarino, Jose; Coull, Brent; Spengler, John D.; Allen, Joseph G.

2017-01-01

Thirty years of public health research have demonstrated that improved indoor environmental quality is associated with better health outcomes. Recent research has demonstrated an impact of the indoor environment on cognitive function. We recruited 109 participants from 10 high-performing buildings (i.e. buildings surpassing the ASHRAE Standard 62.1-2010 ventilation requirement and with low total volatile organic compound concentrations) in five U.S. cities. In each city, buildings were matched by week of assessment, tenant, type of worker and work functions. A key distinction between the matched buildings was whether they had achieved green certification. Workers were administered a cognitive function test of higher order decision-making performance twice during the same week while indoor environmental quality parameters were monitored. Workers in green certified buildings scored 26.4% (95% CI: [12.8%, 39.7%]) higher on cognitive function tests, controlling for annual earnings, job category and level of schooling, and had 30% fewer sick building symptoms than those in non-certified buildings. These outcomes may be partially explained by IEQ factors, including thermal conditions and lighting, but the findings suggest that the benefits of green certification standards go beyond measureable IEQ factors. We describe a holistic “buildingomics” approach for examining the complexity of factors in a building that influence human health. PMID:28785124

Using spacecraft trace contaminant control systems to cure sick building syndrome

NASA Technical Reports Server (NTRS)

Graf, John C.

1994-01-01

Many residential and commercial buildings with centralized, recirculating, heating ventilation and air conditioning systems suffer from 'Sick Building Syndrome.' Ventilation rates are reduced to save energy costs, synthetic building materials off-gas contaminants, and unsafe levels of volatile organic compounds (VOC's) accumulate. These unsafe levels of contaminants can cause irritation of eyes and throat, fatigue and dizziness to building occupants. Increased ventilation, the primary method of treating Sick Building Syndrome is expensive (due to increased energy costs) and recently, the effectiveness of increased ventilation has been questioned. On spacecraft venting is not allowed, so the primary methods of air quality control are; source control, active filtering, and destruction of VOC's. Four non-venting contaminant removal technologies; strict material selection to provide source control, ambient temperature catalytic oxidation, photocatalytic oxidation, and uptake by higher plants, may have potential application for indoor air quality control.

Modafinil as a potential motion sickness countermeasure.

PubMed

Hoyt, Robert E; Lawson, Benton D; McGee, Heather A; Strompolis, Melissa L; McClellan, Molly A

2009-08-01

Motion sickness adversely affects military air and sea operations. Medications help prevent motion sickness but are frequently associated with side effects. Better medications or combinations of medications are needed. Dextroamphetamine has documented anti-motion sickness effects but also has a potential for abuse. Modafinil is a relatively new central nervous system stimulant that has none of the drawbacks of dextroamphetamine, but has not been evaluated for the treatment of motion sickness. This double-blind, placebo-controlled study evaluated the anti-motion sickness efficacy of modafinil, alone or in combination with oral scopolamine. Moderate nausea was induced via a Coriolis cross-coupling stimulus. There were 60 participants who were assigned randomly to 1 of 3 conditions: 1) 2 placebo pills (DP); 2) modafinil plus placebo (MP); or 3) modafinil plus oral scopolamine (MS). The primary measure of drug efficacy was the number of head tilts tolerated upon reaching moderate nausea for 1 min without abatement. The combination of modafinil and scopolamine (MS) allowed subjects to tolerate significantly more head tilts than placebo, but modafinil alone (MP) failed to differ significantly from placebo (DP). No significant cognitive performance decrements were observed among the three experimental conditions. Modafinil was not found to be more effective than placebo. Further testing is recommended to determine whether the potentially promising combination of modafinil and scopolamine provides better efficacy or fewer side effects than scopolamine administered alone.

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.

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

PubMed Central

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

2012-01-01

Context: It is unknown whether or not measuring sleep disturbances repeatedly, rather than at only one point in time, improves prediction of work disability. Study Objective: o examine sleep disturbance patterns over time as a risk marker for diagnosis-specific work disability. Design: rospective cohort study linking repeatedly measured self-reported sleep disturbances with records of physician-certified work disability (sickness absence) from a national register. Participants responded to surveys in 2000–2002, and 2004, and were followed up for 12 mo. Setting: Public sector employees in Finland. Participants: 25,639 participants (mean age 45.6 yr, 82% female). Main Outcome Measure: Incident diagnosis-specific sickness absence of > 9 days. Results: During a mean follow-up of 323 days, 4,975 employees (19%) had a new episode of sickness absence. In multivariable-adjusted models corrected for multiple testing, stable severe sleep disturbances, in comparison with no sleep disturbances, were associated with an increased risk of sickness absence due to diseases of the musculoskeletal system (hazard ratio (HR) 1.68, 95% confidence interval (CI) 1.45–1.95), and injuries and poisonings (HR 1.64, 95% CI 1.23–2.18). Increases in sleep disturbances predicted subsequent sickness absence due to mental disorders (HR 1.59, 95% CI 1.32–1.91), and diseases of the musculoskeletal system (HR 1.44, 95% CI 1.27–1.64) According to net reclassification improvement analyses, measurement of sleep disturbance patterns rather than the level of sleep disturbances at one point in time improved prediction of all-cause sickness absence by 14%, and diagnosis-specific sickness absences up to 17% (P for improvement < 0.001). Conclusions: Increasing and severe chronic sleep disturbances mark an increased risk of diagnosis-specific work disability. Citation: Salo P; Vahtera J; Hall M; Rod NH; Virtanen M; Pentti J; Sjösten N; Oksanen T; Kivimäki M. Using repeated measures of sleep disturbances to predict future diagnosis-specific work disability: a cohort study. SLEEP 2012;35(4):559-569. PMID:22467994

78 FR 48642 - Privacy Act Systems of Records; Phytosanitary Certificate Issuance and Tracking System

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-09

... [Docket No. APHIS-2012-0104] Privacy Act Systems of Records; Phytosanitary Certificate Issuance and... records is the Phytosanitary Certificate Issuance and Tracking System, USDA-APHIS-13. This notice is... methods: Federal eRulemaking Portal: Go to http://www.regulations.gov/#!documentDetail ;D=APHIS-2012-0104...

78 FR 37775 - Privacy Act Systems of Records; Phytosanitary Certificate Issuance and Tracking System

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-24

... of Records; Phytosanitary Certificate Issuance and Tracking System AGENCY: Animal and Plant Health... to the Privacy Act of 1974, as amended. The system of records is the Phytosanitary Certificate...: You may submit comments by either of the following methods: Federal eRulemaking Portal: Go to http...

2015 IECRE: PV System Certification Workshop | Photovoltaic Research | NREL

Science.gov Websites

IECRE: PV System Certification Workshop 2015 IECRE: PV System Certification Workshop Thursday the guidelines for certifying PV systems. This workshop included an introduction of IECRE followed by discussions targeting the most critical or controversial items. This workshop gathered wide input from the PV

24 CFR 200.946 - Building product standards and certification program for exterior finish and insulation systems...

Code of Federal Regulations, 2011 CFR

2011-04-01

... Glass Fiber Reinforcing Mesh for Use in Exterior Insulation and Finish Systems (EIFS), Class PB. (xv... certification program for exterior finish and insulation systems, use of Materials Bulletin UM 101. 200.946... product standards and certification program for exterior finish and insulation systems, use of Materials...

24 CFR 200.946 - Building product standards and certification program for exterior finish and insulation systems...

Code of Federal Regulations, 2010 CFR

2010-04-01

... Glass Fiber Reinforcing Mesh for Use in Exterior Insulation and Finish Systems (EIFS), Class PB. (xv... certification program for exterior finish and insulation systems, use of Materials Bulletin UM 101. 200.946... product standards and certification program for exterior finish and insulation systems, use of Materials...

Histological analysis of the influence of certain extremal factors on the postradiational changes in the tissues of experimental animals

NASA Technical Reports Server (NTRS)

Sutulov, L. S.; Gaydamakin, N. A.; Sutulov, Y. L.

1975-01-01

Protons with energies of 120 MeV at a dose of 640 rads or gamma-neutron radiation at a dose of 300 rads produce radiation sickness of moderate severity in rats. The significance of toxemia and disturbances to the endocrine regulatory system in the development of metabolic processes in various stages of radiation sickness are discussed.

Framework for Design of Traceability System on Organic Rice Certification

NASA Astrophysics Data System (ADS)

Purwandoko, P. B.; Seminar, K. B.; Sutrisno; Sugiyanta

2018-05-01

Nowadays, the preferences of organic products such as organic rice have been increased. It because of the people awareness of the healthy and eco-friendly food product consumption has grown. Therefore, it is very important to ensure organic quality of the product that will be produced. Certification is a series of process that holds to ensure the quality of products meets all criteria of organic standards. Currently, there is a problem that traceability information system for organic rice certification has been not available. The current system still conducts manually caused the loss of information during storage process. This paper aimed at developing a traceability framework on organic rice certification process. First, the main discussed issues are organic certification process. Second, unified modeling language (UML) is used to build the model of user requirement in order to develop traceability system for all actors in the certification process. Furthermore, the information captured model along certification process will be explained in this paper. The model shows the information flow that has to be recorded for each actor. Finally, the challenges in the implementation system will be discussed in this paper.

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.

16 CFR 309.11 - Certification.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Manufacturers of Electric Vehicle Fuel Dispensing Systems § 309.11 Certification. (a) For non-liquid alternative... certification. (b) For electric vehicle fuel dispensing systems, in each transfer you make to anyone who is not a consumer, you must certify the fuel rating of the electric vehicle fuel dispensing system...

16 CFR 309.11 - Certification.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Manufacturers of Electric Vehicle Fuel Dispensing Systems § 309.11 Certification. (a) For non-liquid alternative... certification. (b) For electric vehicle fuel dispensing systems, in each transfer you make to anyone who is not a consumer, you must certify the fuel rating of the electric vehicle fuel dispensing system...

16 CFR 309.11 - Certification.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Manufacturers of Electric Vehicle Fuel Dispensing Systems § 309.11 Certification. (a) For non-liquid alternative... certification. (b) For electric vehicle fuel dispensing systems, in each transfer you make to anyone who is not a consumer, you must certify the fuel rating of the electric vehicle fuel dispensing system...

16 CFR 309.11 - Certification.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Manufacturers of Electric Vehicle Fuel Dispensing Systems § 309.11 Certification. (a) For non-liquid alternative... certification. (b) For electric vehicle fuel dispensing systems, in each transfer you make to anyone who is not a consumer, you must certify the fuel rating of the electric vehicle fuel dispensing system...

Certification, Re-certification and Continuing Education.

ERIC Educational Resources Information Center

Conchelos, Mary

1983-01-01

Discussion of certification for librarians notes definitions, certification program of Medical Library Association, continuing education as means of maintaining certification, and the voluntary recognition system, which encourages and supports those who participate in continuing education by setting standards for programs, objectively evaluating…

Internal medicine board certification and career pathways in Japan.

PubMed

Koike, Soichi; Matsumoto, Masatoshi; Ide, Hiroo; Kawaguchi, Hideaki; Shimpo, Masahisa; Yasunaga, Hideo

2017-05-08

Establishing and managing a board certification system is a common concern for many countries. In Japan, the board certification system is under revision. The purpose of this study was to describe present status of internal medicine specialist board certification, to identify factors associated with maintenance of board certification and to investigate changes in area of practice when physicians move from hospital to clinic practice. We analyzed 2010 and 2012 data from the Survey of Physicians, Dentists and Pharmacists. We conducted logistic regression analysis to identify factors associated with the maintenance of board certification between 2010 and 2012. We also analyzed data on career transition from hospitals to clinics for hospital physicians with board certification. It was common for physicians seeking board certification to do so in their early career. The odds of maintaining board certification were lower in women and those working in locations other than academic hospitals, and higher in physicians with subspecialty practice areas. Among hospital physicians with board certification who moved to clinics between 2010 and 2012, 95.8% remained in internal medicine or its subspecialty areas and 87.7% maintained board certification but changed their practice from a subspecialty area to more general internal medicine. Revisions of the internal medicine board certification system must consider different physician career pathways including mid-career moves while maintaining certification quality. This will help to secure an adequate number and distribution of specialists. To meet the increasing demand for generalist physicians, it is important to design programs to train specialists in general practice.

49 CFR Appendix I to Part 1201 - Certification of Branch Line Accounting System Records

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 9 2010-10-01 2010-10-01 false Certification of Branch Line Accounting System... RAILROAD COMPANIES Pt. 1201, App. I Appendix I to Part 1201—Certification of Branch Line Accounting System...__ the branch line accounting system data were collected and maintained for each line that met the...

78 FR 44895 - Energy Conservation Program for Consumer Products: First Co. Petition for Reconsideration

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-25

... lead times. Architects, engineers and builders often select HVAC systems for such projects up to 9-12... through the Compliance, Certification Management System (``CCMS'') as part of annual certification... System (``CCMS'') as part of annual certification reporting requirements; and (ii) publish the...

Occupational health impact of the 2009 H1N1 flu pandemic: surveillance of sickness absence.

PubMed

Torá-Rocamora, Isabel; Delclos, George L; Martínez, José Miguel; Jardí, Josefina; Alberti, Constança; Manzanera, Rafael; Yasui, Yutaka; Clèries, Ramón; Tobías, Aurelio; Benavides, Fernando G

2012-03-01

Workplace absences due to illness can disrupt usual operations and increase costs for businesses. This study of sickness absence due to influenza and influenza-related illness presents a unique opportunity to characterise and measure the impact of the 2009 (H1N1) pandemic, by comparing trends during the pandemic to those of previous years, and adding this information to that obtained by traditional epidemiological surveillance systems. We compared the numbers of cases of sickness absence due to illness caused by influenza and influenza-related illness in 2007-2009, and in the first 3 months of 2010 in Catalonia (n=811 940) using a time series approach. Trends were examined by economic activity, age and gender. The weekly endemic-epidemic index (EEI) was calculated and its 95% CI obtained with the delta method, with observed and expected cases considered as independent random variables. Influenza activity peaked earlier in 2009 and yielded more cases than in previous years. Week 46 (in November 2009) had the highest number of new cases resulting in sickness absence (EEI 20.99; 95% CI 9.44 to 46.69). Women and the 'education, health and other social activities' sector were the most affected. Results indicate that the new H1N1 pandemic had a significant impact on business, with shifts in the timing of peak incidence, a doubling in the number of cases, and changes in the distribution of cases by economic activity sector and gender. Traditional epidemiological surveillance systems could benefit from the addition of information based on sickness absence data.

Quality of nutrition services in primary health care facilities: Implications for integrating nutrition into the health system in Bangladesh

PubMed Central

Saha, Kuntal Kumar; Chowdhury, Ashfaqul Haq; Garnett, Sarah P.; Arifeen, Shams El; Menon, Purnima

2017-01-01

Background In 2011, the Bangladesh Government introduced the National Nutrition Services (NNS) by leveraging the existing health infrastructure to deliver nutrition services to pregnant woman and children. This study examined the quality of nutrition services provided during antenatal care (ANC) and management of sick children younger than five years. Methods Service delivery quality was assessed across three dimensions; structural readiness, process and outcome. Structural readiness was assessed by observing the presence of equipment, guidelines and register/reporting forms in ANC rooms and consulting areas for sick children at 37 primary healthcare facilities in 12 sub-districts. In addition, the training and knowledge relevant to nutrition service delivery of 95 healthcare providers was determined. The process of nutrition service delivery was assessed by observing 381 ANC visits and 826 sick children consultations. Satisfaction with the service was the outcome and was determined by interviewing 541 mothers/caregivers of sick children. Results Structural readiness to provide nutrition services was higher for ANC compared to management of sick children; 73% of ANC rooms had >5 of the 13 essential items while only 13% of the designated areas for management of sick children had >5 of the 13 essential items. One in five (19%) healthcare providers had received nutrition training through the NNS. Delivery of the nutrition services was poor: <30% of women received all four key antenatal nutrition services, 25% of sick children had their weight checked against a growth-chart and <1% had their height measured. Nevertheless, most mothers/caregivers rated their satisfaction of the service above average. Conclusions Strengthening the provision of equipment and increasing the coverage of training are imperative to improve nutrition services. Inherent barriers to implementing nutrition services in primary health care, especially high caseloads during the management of sick under-five children, should be considered to identify alternative and appropriate service delivery platforms before nationwide scale up. PMID:28542530

[Problems in Providing Care to Young Workers with Mental Health Disturbance - A Survey Using of the Cases of Workers Who Had Taken Sick Leave Due to Mental Health Disturbance].

PubMed

Ikegami, Kazunori; Eguchi, Masafumi; Osaki, Yohei; Nakao, Tomo; Nakamoto, Kengo; Hiro, Hisanori

2016-06-01

In this study we discuss the measures of providing care to young workers with mental health disturbance by analyzing the cases of workers who had taken sick leave due to mental health disturbance. We analyzed 36 cases, collected from 11 occupational physicians, of workers who had taken sick leave due to mental health disturbance, and discuss measures for providing care to such young workers. We organized and classified data containing the details of the care provided to the workers and analyzed the main aspects and problems in providing it. We compared two age groups of workers: a below age 30 group, and an age 30 and above group. We observed that occupational nurses were more frequently the primary persons who dealt with workplace consultations in the below age 30 group (before sick leave: 38.9%; during sick leave: 38.9%) compared to the age 30 and above group (before sick leave: 16.7%, during sick leave: 11.1%). Most of the case providers expressed the opinion that a support system is necessary to help the workers return to work and it is an important factor in providing care to workers who have taken sick leave due to mental health disturbance. Coordination with the families of the workers was also important in the below age 30 group. It might be difficult to assign young workers to suitable workplaces or duties because of their inadequate job skills, lack of sufficient experience, and influence of personal factors on mental health. Our results suggest that it is important to provide appropriate care for young workers with mental health disturbance, such as support by occupational nurses, and to strengthen the collaboration between their families and the workplace staff.

Cost-effectiveness of a participatory return-to-work intervention for temporary agency workers and unemployed workers sick-listed due to musculoskeletal disorders: design of a randomised controlled trial.

PubMed

Vermeulen, Sylvia J; Anema, Johannes R; Schellart, Antonius J M; van Mechelen, Willem; van der Beek, Allard J

2010-03-28

Within the working population there is a vulnerable group: workers without an employment contract and workers with a flexible labour market arrangement, e.g. temporary agency workers. In most cases, when sick-listed, these workers have no workplace/employer to return to. Also, for these workers access to occupational health care is limited or even absent in many countries. For this vulnerable working population there is a need for tailor-made occupational health care, including the presence of an actual return-to-work perspective. Therefore, a participatory return-to-work program has been developed based on a successful return-to-work intervention for workers, sick-listed due to low back pain.The objective of this paper is to describe the design of a randomised controlled trial to study the (cost-)effectiveness of this newly developed participatory return-to-work program adapted for temporary agency workers and unemployed workers, sick-listed due to musculoskeletal disorders, compared to usual care. The design of this study is a randomised controlled trial with one year of follow-up. The study population consists of temporary agency workers and unemployed workers sick-listed between 2 and 8 weeks due to musculoskeletal disorders. The new return-to-work program is a stepwise program aimed at making a consensus-based return-to-work implementation plan with the possibility of a (therapeutic) workplace to return-to-work. Outcomes are measured at baseline, 3, 6, 9 and 12 months. The primary outcome measure is duration of the sickness benefit period after the first day of reporting sick. Secondary outcome measures are: time until first return-to-work, total number of days of sickness benefit during follow-up; functional status; intensity of musculoskeletal pain; pain coping; and attitude, social influence and self-efficacy determinants. Cost-benefit is evaluated from an insurer's perspective. A process evaluation is part of this study. For sick-listed workers without an employment contract there can be gained a lot by improving occupational health care, including return-to-work guidance, and by minimising the 'labour market handicap' by creating a return-to-work perspective. In addition, reduction of sickness absence and work disability, i.e. a reduction of disability claims, may result in substantial benefits for the Dutch Social Security System. NTR1047.

Return to work of workers without a permanent employment contract, sick-listed due to a common mental disorder: design of a randomised controlled trial.

PubMed

Lammerts, Lieke; Vermeulen, Sylvia J; Schaafsma, Frederieke G; van Mechelen, Willem; Anema, Johannes R

2014-06-12

Workers without a permanent employment contract represent a vulnerable group within the working population. Mental disorders are a major cause of sickness absence within this group. Common mental disorders are stress-related, depressive and anxiety disorders. To date, little attention has been paid to effective return to work interventions for this type of sick-listed workers. Therefore, a participatory supportive return to work program has been developed. It combines elements of a participatory return to work program, integrated care and direct placement in a competitive job.The objective of this paper is to describe the design of a randomised controlled trial to evaluate the cost-effectiveness of this program compared to care as usual. The cost-effectiveness of the participatory supportive return to work program will be examined in a randomised controlled trial with a follow-up of twelve months.The program strongly involves the sick-listed worker in the identification of obstacles for return to work and possible solutions, resulting in a consensus based action plan. This plan will be used as a starting point for the search of suitable competitive employment with support of a rehabilitation agency. During this process the insurance physician of the sick-listed worker contacts other caregivers to promote integrated care.Workers eligible to participate in this study have no permanent employment contract, have applied for a sickness benefit at the Dutch Social Security Agency and are sick-listed between two and fourteen weeks due to mental health problems.The primary outcome measure is the duration until first sustainable return to work in a competitive job. Outcomes are measured at baseline and after three, six, nine and twelve months. If the participatory supportive return to work program proves to be cost-effective, the social security system, the sick-listed worker and society as a whole will benefit. A cost-effective return to work program will lead to a reduction of costs related to sickness absence. For the sick-listed worker a cost-effective program results in earlier sustainable return to work, which can be associated with both social and health benefits. The trial registration number and date is NTR3563, August 7, 2012.

Return to work of workers without a permanent employment contract, sick-listed due to a common mental disorder: design of a randomised controlled trial

PubMed Central

2014-01-01

Background Workers without a permanent employment contract represent a vulnerable group within the working population. Mental disorders are a major cause of sickness absence within this group. Common mental disorders are stress-related, depressive and anxiety disorders. To date, little attention has been paid to effective return to work interventions for this type of sick-listed workers. Therefore, a participatory supportive return to work program has been developed. It combines elements of a participatory return to work program, integrated care and direct placement in a competitive job. The objective of this paper is to describe the design of a randomised controlled trial to evaluate the cost-effectiveness of this program compared to care as usual. Methods/Design The cost-effectiveness of the participatory supportive return to work program will be examined in a randomised controlled trial with a follow-up of twelve months. The program strongly involves the sick-listed worker in the identification of obstacles for return to work and possible solutions, resulting in a consensus based action plan. This plan will be used as a starting point for the search of suitable competitive employment with support of a rehabilitation agency. During this process the insurance physician of the sick-listed worker contacts other caregivers to promote integrated care. Workers eligible to participate in this study have no permanent employment contract, have applied for a sickness benefit at the Dutch Social Security Agency and are sick-listed between two and fourteen weeks due to mental health problems. The primary outcome measure is the duration until first sustainable return to work in a competitive job. Outcomes are measured at baseline and after three, six, nine and twelve months. Discussion If the participatory supportive return to work program proves to be cost-effective, the social security system, the sick-listed worker and society as a whole will benefit. A cost-effective return to work program will lead to a reduction of costs related to sickness absence. For the sick-listed worker a cost-effective program results in earlier sustainable return to work, which can be associated with both social and health benefits. Trial registration The trial registration number and date is NTR3563, August 7, 2012. PMID:24919561

Quality assurance and risk management: Perspectives on Human Factors Certification of Advanced Aviation Systems

NASA Technical Reports Server (NTRS)

Taylor, Robert M.; Macleod, Iain S.

1994-01-01

This paper is based on the experience of engineering psychologists advising the U.K. Ministry of Defense (MoD) on the procurement of advanced aviation systems that conform to good human engineering (HE) practice. Traditional approaches to HE in systems procurement focus on the physical nature of the human-machine interface. Advanced aviation systems present increasingly complex design requirements for human functional integration, information processing, and cognitive task performance effectiveness. These developing requirements present new challenges for HE quality assurance (QA) and risk management, requiring focus on design processes as well as on design content or product. A new approach to the application of HE, recently adopted by NATO, provides more systematic ordering and control of HE processes and activities to meet the challenges of advanced aircrew systems design. This systematic approach to HE has been applied by MoD to the procurement of mission systems for the Royal Navy Merlin helicopter. In MoD procurement, certification is a judicial function, essentially independent of the service customer and industry contractor. Certification decisions are based on advice from MoD's appointed Acceptance Agency. Test and evaluation (T&E) conducted by the contractor and by the Acceptance Agency provide evidence for certification. Certification identifies limitations of systems upon release to the service. Evidence of compliance with HE standards traditionally forms the main basis of HE certification and significant non-compliance could restrict release. The systems HE approach shows concern for the quality of processes as well as for the content of the product. Human factors certification should be concerned with the quality of HE processes as well as products. Certification should require proof of process as well as proof of content and performance. QA criteria such as completeness, consistency, timeliness, and compatibility provide generic guidelines for progressive acceptance and certification of HE processes. Threats to the validity of certification arise from problems and assumptions in T&E methods. T&E should seek to reduce the risk of specification non-compliance and certification failure.

A Framework and Improvements of the Korea Cloud Services Certification System.

PubMed

Jeon, Hangoo; Seo, Kwang-Kyu

2015-01-01

Cloud computing service is an evolving paradigm that affects a large part of the ICT industry and provides new opportunities for ICT service providers such as the deployment of new business models and the realization of economies of scale by increasing efficiency of resource utilization. However, despite benefits of cloud services, there are some obstacles to adopt such as lack of assessing and comparing the service quality of cloud services regarding availability, security, and reliability. In order to adopt the successful cloud service and activate it, it is necessary to establish the cloud service certification system to ensure service quality and performance of cloud services. This paper proposes a framework and improvements of the Korea certification system of cloud service. In order to develop it, the critical issues related to service quality, performance, and certification of cloud service are identified and the systematic framework for the certification system of cloud services and service provider domains are developed. Improvements of the developed Korea certification system of cloud services are also proposed.

A Framework and Improvements of the Korea Cloud Services Certification System

PubMed Central

Jeon, Hangoo

2015-01-01

Cloud computing service is an evolving paradigm that affects a large part of the ICT industry and provides new opportunities for ICT service providers such as the deployment of new business models and the realization of economies of scale by increasing efficiency of resource utilization. However, despite benefits of cloud services, there are some obstacles to adopt such as lack of assessing and comparing the service quality of cloud services regarding availability, security, and reliability. In order to adopt the successful cloud service and activate it, it is necessary to establish the cloud service certification system to ensure service quality and performance of cloud services. This paper proposes a framework and improvements of the Korea certification system of cloud service. In order to develop it, the critical issues related to service quality, performance, and certification of cloud service are identified and the systematic framework for the certification system of cloud services and service provider domains are developed. Improvements of the developed Korea certification system of cloud services are also proposed. PMID:26125049

Are evolutionary hypotheses for motion sickness "just-so" stories?

PubMed

Oman, Charles M

2012-01-01

Vertebrates have evolved rapidly conditionable nausea and vomiting reflexes mediated by gut and brainstem receptors, clearly as a defense against neurotoxin ingestion. In 1977 Treisman proposed that sensory orientation linkages to emetic centers evolved for the same reason, and that motion sickness was an accidental byproduct. It was an "adaptationist" explanation for motion sickness, since it assumed that evolution has shaped all phenotypic traits for survival advantage. Treisman's "poison" theory is plausible, and frequently cited as the accepted scientific explanation for motion sickness. However, alternative explanations have been proposed. The creation of hypotheses is an essential part of science - provided they are testable. This paper reviews the evidence for the Poison theory and several other adaptationist explanations. These hypotheses are certainly not "just-so stories", but supporting evidence is equivocal, and contradictory evidence exists Parsimony suggests an alternative "pluralistic" view: The vertebrate reticular formation maintains oxygenated blood flow to the brain, discriminates unexpected sensory stimuli- including postural disturbances, and detects and expels ingested neurotoxins. The three systems share neuroarchitectural elements but normally function independently. Brainstem sensory conflict neurons normally discriminate brief postural disturbances, but can be abnormally stimulated during prolonged passive transport (e.g. by boat, beginning about 150-200 generations ago). Sensory conflict signals cross couple into the neurotoxin expulsion and avoidance system, producing an arguably maladaptive emetic phenotype.

Clinical findings and survival in 56 sick neonatal New World camelids.

PubMed

Bertin, F R; Squires, J M; Kritchevsky, J E; Taylor, S D

2015-01-01

Information pertaining to clinical presentation and outcome of neonatal New World camelids (NWC) is limited when compared to calves and foals. Values of variables at admission and subsequent treatment would predict survival in sick neonatal NWC. Fifty-six client-owned sick neonatal NWC presented over a 10-year period to the Purdue University Veterinary Teaching Hospital. A retrospective study was performed. Inclusion criteria were NWC less than 30 days of age with complete medical records that presented between 2000 and 2010. The median age at presentation was 1 day (range 1-20). The most common diagnoses were systemic inflammatory response syndrome (50%), congenital defects (41%), ophthalmic lesions (21%), sepsis (16%), and gastrointestinal diseases (16%). Sixty-six percent of NWC survived to discharge. Clinicopathologic findings on admission were variable and not specific for disorders. Factors associated with survival were absence of choanal atresia (P = .001, OR: 55.9 [2.5-1,232]), administration of llama plasma (P = .013, OR: 4.9 [1.4-17.7]), and antimicrobial treatment with trimethoprim-sulfamethoxazole (TMS) (P = .016, OR: 6.5 [1.3-32.2]). The use of antibiotics, particularly TMS, and llama plasma are recommended in sick neonatal NWC. Results from this study could contribute toward defining a NWC-specific sepsis scoring system. Copyright © 2014 by the American College of Veterinary Internal Medicine.

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.

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.

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 ...

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

PubMed

Sjöberg, Ola

2017-03-01

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

The efficacy of three objective systems for identifying beef cuts that can be guaranteed tender.

PubMed

Wheeler, T L; Vote, D; Leheska, J M; Shackelford, S D; Belk, K E; Wulf, D M; Gwartney, B L; Koohmaraie, M

2002-12-01

The objective of this study was to determine the accuracy of three objective systems (prototype BeefCam, colorimeter, and slice shear force) for identifying guaranteed tender beef. In Phase I, 308 carcasses (105 Top Choice, 101 Low Choice, and 102 Select) from two commercial plants were tested. In Phase II, 400 carcasses (200 rolled USDA Select and 200 rolled USDA Choice) from one commercial plant were tested. The three systems were evaluated based on progressive certification of the longissimus as "tender" in 10% increments (the best 10, 20, 30%, etc., certified as "tender" by each technology; 100% certification would mean no sorting for tenderness). In Phase I, the error (percentage of carcasses certified as tender that had Warner-Bratzler shear force of > or = 5 kg at 14 d postmortem) for 100% certification using all carcasses was 14.1%. All certification levels up to 80% (slice shear force) and up to 70% (colorimeter) had less error (P < 0.05) than 100% certification. Errors in all levels of certification by prototype BeefCam (13.8 to 9.7%) were not different (P > 0.05) from 100% certification. In Phase I, the error for 100% certification for USDA Select carcasses was 30.7%. For Select carcasses, all slice shear force certification levels up to 60% (0 to 14.8%) had less error (P < 0.05) than 100% certification. For Select carcasses, errors in all levels of certification by colorimeter (20.0 to 29.6%) and by BeefCam (27.5 to 31.4%) were not different (P > 0.05) from 100% certification. In Phase II, the error for 100% certification for all carcasses was 9.3%. For all levels of slice shear force certification less than 90% (for all carcasses) or less than 80% (Select carcasses), errors in tenderness certification were less than (P < 0.05) for 100% certification. In Phase II, for all carcasses or Select carcasses, colorimeter and prototype BeefCam certifications did not significantly reduce errors (P > 0.05) compared to 100% certification. Thus, the direct measure of tenderness provided by slice shear force results in more accurate identification of "tender" beef carcasses than either of the indirect technologies, prototype BeefCam, or colorimeter, particularly for USDA Select carcasses. As tested in this study, slice shear force, but not the prototype BeefCam or colorimeter systems, accurately identified "tender" beef.

Absenteeism due to mental health problems and systems for return to work: an internet-based unmatched case-control study.

PubMed

Doki, Shotaro; Sasahara, Shinichiro; Hirai, Yasuhito; Oi, Yuichi; Matsuzaki, Ichiyo

2016-11-01

The aim of this study was to investigate the risk factors for absenteeism due to mental health problems with regard to company characteristics and systems for return to work in Japan. This was an Internet-based unmatched case-control study. Two hundred and fifty-eight workers who experienced over 28 days of sick leave due to mental health problems (cases) and 258 workers who have not taken sick leave (controls) were recruited. Company characteristics and the awareness and presence of systems for return to work were analysed as indicators of absenteeism. A total of 501 workers were included in the analysis. Females were less likely to experience absenteeism when adjustments were made for both the awareness and presence of systems [odds ratio (OR) = 0.51 and 0.41, respectively]. Large companies showed an increased risk of having absentee workers than small companies. The awareness of a gradual resumption system and the presence of a sick pay system were related to absenteeism (OR = 2.75 and 2.40, respectively). The awareness and presence of systems for return to work are related to the long-term absenteeism. The predictors of sex and company size are also related to the experience of the long-term absenteeism. To understand the effect of systems for return to work on absenteeism due to mental problems, further studies are needed.

[Market Concentration in the Statutory Health Insurance of Germany since the Introduction of Free Choice of Sickness Funds].

PubMed

Götze, R

2016-11-01

Background: The expansion of trust law to the German statutory health insurance (SHI) and the declining numbers of sickness funds suggest a strong concentration process in the German SHI market. The paper examines the level and development of market concentration since the introduction of the free choice of sickness funds in 1996. Data: The study is based on a dataset containing information on membership, contribution rate, openness, area of activity and legal successor for all sickness funds in the period from 1996 to 2013. Methods: Market concentration is measured by the concentration rate (cumulative market share of the largest market participants) and the Herfindahl-Hirschman index (HHI). In addition, the change in the HHI is also disaggregated into 3 factors: opening, switching and fusion of sickness funds. Results: Concentration rate and HHI decreased significantly between 1996 and 2008 due to opening of former closed sickness funds and a switching behaviour from large to small funds. The SHI Competition Enhancement Act of 2007 led to a turnaround. The reform permitted cross-type mergers and introduced a completely new system of budget allocation with the central health fund. The latter put an end to the growing membership of small funds due to adverse selection processes. As a result, market concentration in the German SHI rises. Although recent mega-mergers were uncritical for nationwide competition, the study already indicates the risk of market dominance on the regional level. © Georg Thieme Verlag KG Stuttgart · New York.

Are There Side Effects to Watching 3D Movies? A Prospective Crossover Observational Study on Visually Induced Motion Sickness

PubMed Central

Solimini, Angelo G.

2013-01-01

Background The increasing popularity of commercial movies showing three dimensional (3D) images has raised concern about possible adverse side effects on viewers. Methods and Findings A prospective carryover observational study was designed to assess the effect of exposure (3D vs. 2D movie views) on self reported symptoms of visually induced motion sickness. The standardized Simulator Sickness Questionnaire (SSQ) was self administered on a convenience sample of 497 healthy adult volunteers before and after the vision of 2D and 3D movies. Viewers reporting some sickness (SSQ total score>15) were 54.8% of the total sample after the 3D movie compared to 14.1% of total sample after the 2D movie. Symptom intensity was 8.8 times higher than baseline after exposure to 3D movie (compared to the increase of 2 times the baseline after the 2D movie). Multivariate modeling of visually induced motion sickness as response variables pointed out the significant effects of exposure to 3D movie, history of car sickness and headache, after adjusting for gender, age, self reported anxiety level, attention to the movie and show time. Conclusions Seeing 3D movies can increase rating of symptoms of nausea, oculomotor and disorientation, especially in women with susceptible visual-vestibular system. Confirmatory studies which include examination of clinical signs on viewers are needed to pursue a conclusive evidence on the 3D vision effects on spectators. PMID:23418530

Are there side effects to watching 3D movies? A prospective crossover observational study on visually induced motion sickness.

PubMed

Solimini, Angelo G

2013-01-01

The increasing popularity of commercial movies showing three dimensional (3D) images has raised concern about possible adverse side effects on viewers. A prospective carryover observational study was designed to assess the effect of exposure (3D vs. 2D movie views) on self reported symptoms of visually induced motion sickness. The standardized Simulator Sickness Questionnaire (SSQ) was self administered on a convenience sample of 497 healthy adult volunteers before and after the vision of 2D and 3D movies. Viewers reporting some sickness (SSQ total score>15) were 54.8% of the total sample after the 3D movie compared to 14.1% of total sample after the 2D movie. Symptom intensity was 8.8 times higher than baseline after exposure to 3D movie (compared to the increase of 2 times the baseline after the 2D movie). Multivariate modeling of visually induced motion sickness as response variables pointed out the significant effects of exposure to 3D movie, history of car sickness and headache, after adjusting for gender, age, self reported anxiety level, attention to the movie and show time. Seeing 3D movies can increase rating of symptoms of nausea, oculomotor and disorientation, especially in women with susceptible visual-vestibular system. Confirmatory studies which include examination of clinical signs on viewers are needed to pursue a conclusive evidence on the 3D vision effects on spectators.

48 CFR 46.315 - Certificate of conformance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Certificate of conformance. 46.315 Section 46.315 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACT MANAGEMENT QUALITY ASSURANCE Contract Clauses 46.315 Certificate of conformance. The contracting officer...

48 CFR 307.7104 - Review and certification.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Review and certification. 307.7104 Section 307.7104 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES COMPETITION AND ACQUISITION PLANNING ACQUISITION PLANNING Acquisition Plan 307.7104 Review and certification...

7 CFR 1730.26 - Certification.

Code of Federal Regulations, 2010 CFR

2010-01-01

... ELECTRIC SYSTEM OPERATIONS AND MAINTENANCE Operations and Maintenance Requirements § 1730.26 Certification. (a) Engineer's certification. Where provided for in the borrower's loan documents, RUS may require the borrower to provide an “Engineer's Certification” as to the condition of the borrower's system...

7 CFR 1730.26 - Certification.

Code of Federal Regulations, 2011 CFR

2011-01-01

... ELECTRIC SYSTEM OPERATIONS AND MAINTENANCE Operations and Maintenance Requirements § 1730.26 Certification. (a) Engineer's certification. Where provided for in the borrower's loan documents, RUS may require the borrower to provide an “Engineer's Certification” as to the condition of the borrower's system...

7 CFR 1730.26 - Certification.

Code of Federal Regulations, 2012 CFR

2012-01-01

... ELECTRIC SYSTEM OPERATIONS AND MAINTENANCE Operations and Maintenance Requirements § 1730.26 Certification. (a) Engineer's certification. Where provided for in the borrower's loan documents, RUS may require the borrower to provide an “Engineer's Certification” as to the condition of the borrower's system...

7 CFR 1730.26 - Certification.

Code of Federal Regulations, 2014 CFR

2014-01-01

... ELECTRIC SYSTEM OPERATIONS AND MAINTENANCE Operations and Maintenance Requirements § 1730.26 Certification. (a) Engineer's certification. Where provided for in the borrower's loan documents, RUS may require the borrower to provide an “Engineer's Certification” as to the condition of the borrower's system...

7 CFR 1730.26 - Certification.

Code of Federal Regulations, 2013 CFR

2013-01-01

... ELECTRIC SYSTEM OPERATIONS AND MAINTENANCE Operations and Maintenance Requirements § 1730.26 Certification. (a) Engineer's certification. Where provided for in the borrower's loan documents, RUS may require the borrower to provide an “Engineer's Certification” as to the condition of the borrower's system...

48 CFR 307.7104 - Review and certification.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 4 2014-10-01 2014-10-01 false Review and certification. 307.7104 Section 307.7104 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES COMPETITION AND ACQUISITION PLANNING ACQUISITION PLANNING Acquisition Plan 307.7104 Review and certification...

48 CFR 307.7104 - Review and certification.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 4 2013-10-01 2013-10-01 false Review and certification. 307.7104 Section 307.7104 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES COMPETITION AND ACQUISITION PLANNING ACQUISITION PLANNING Acquisition Plan 307.7104 Review and certification...

48 CFR 307.7104 - Review and certification.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 4 2011-10-01 2011-10-01 false Review and certification. 307.7104 Section 307.7104 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES COMPETITION AND ACQUISITION PLANNING ACQUISITION PLANNING Acquisition Plan 307.7104 Review and certification...

48 CFR 307.7104 - Review and certification.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 4 2012-10-01 2012-10-01 false Review and certification. 307.7104 Section 307.7104 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES COMPETITION AND ACQUISITION PLANNING ACQUISITION PLANNING Acquisition Plan 307.7104 Review and certification...

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.

Coordination of International Standards with Implementation of the IECRE Conformity Assessment System to Provide Multiple Certification Offerings for PV Power Plants

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

Kelly, George; Haring, Adrian; Spooner, Ted

To help address the industry's needs for assuring the value and reducing the risk of investments in PV power plants; the International Electrotechnical Commission (IEC) has established a new conformity assessment system for renewable energy (IECRE). There are presently important efforts underway to define the requirements for various types of PV system certificates, and publication of the international standards upon which these certifications will be based. This paper presents a detailed analysis of the interrelationship of these activities and the timing for initiation of IECRE PV system certifications.

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.

48 CFR 301.607 - Certification of Program and Project Managers.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Certification of Program and Project Managers. 301.607 Section 301.607 Federal Acquisition Regulations System HEALTH AND HUMAN... Responsibilities 301.607 Certification of Program and Project Managers. ...

5 CFR 1330.403 - System certification.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false System certification. 1330.403 Section 1330.403 Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET JOINT REGULATIONS WITH THE OFFICE OF PERSONNEL MANAGEMENT HUMAN RESOURCES MANAGEMENT Performance Appraisal Certification for Pay Purposes § 1330...

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...

Autogenic-feedback training as a treatment for airsickness in high-performance military aircraft: Two case studies

NASA Technical Reports Server (NTRS)

Cowings, Patricia S.; Toscano, William B.; Miller, Neal E.; Reynoso, Samuel

1994-01-01

The purpose of this paper is to present a detailed description of the physiological and performance responses of two military pilots undergoing a treatment for motion sickness. The treatment used, Autogenic-Feedback Training (AFT), is an operant conditioning procedure where subjects are taught to control several of their autonomic responses and thereby suppress their motion sickness symptoms. Two male, active duty military pilots (U.S. Navy and U. S. Marine Corps), ages 30 and 35, were each given twelve 30-minute training sessions. The primary criterion for success of training was the subject's ability to tolerate rotating chair motion sickness tests for progressively longer periods of time and at higher rotational velocities. A standardized diagnostic scale was used during motion sickness to assess changes in the subject's perceived malaise. Physiological data were obtained from one pilot during tactical maneuvers in an F-18 aircraft after completion of his training. A significant increase in tolerance to laboratory-induced motion sickness tests and a reduction in autonomic nervous system (ANS) response variability was observed for both subjects after training. Both pilots were successful in applying AFT for controlling their airsickness during subsequent qualification tests on F-18 and T-38 aircraft and were returned to active duty flight status.

Kinetic characteristics of euflammation: the induction of controlled inflammation without overt sickness behavior.

PubMed

Tarr, Andrew J; Liu, Xiaoyu; Reed, Nathaniel S; Quan, Ning

2014-11-01

We found recently that controlled progressive challenge with subthreshold levels of E. coli can confer progressively stronger resistance to future reinfection-induced sickness behavior to the host. We have termed this type of inflammation "euflammation". In this study, we further characterized the kinetic changes in the behavior, immunological, and neuroendocrine aspects of euflammation. Results show euflammatory animals only display transient and subtle sickness behaviors of anorexia, adipsia, and anhedonia upon a later infectious challenge which would have caused much more severe and longer lasting sickness behavior if given without prior euflammatory challenges. Similarly, infectious challenge-induced corticosterone secretion was greatly ameliorated in euflammatory animals. At the site of E.coli priming injections, which we termed euflammation induction locus (EIL), innate immune cells displayed a partial endotoxin tolerant phenotype with reduced expression of innate activation markers and muted inflammatory cytokine expression upon ex vivo LPS stimulation, whereas innate immune cells outside EIL displayed largely opposite characteristics. Bacterial clearance function, however, was enhanced both inside and outside EIL. Finally, sickness induction by an infectious challenge placed outside the EIL was also abrogated. These results suggest euflammation could be used as an efficient method to "train" the innate immune system to resist the consequences of future infectious/inflammatory challenges. Copyright © 2014 Elsevier Inc. All rights reserved.

Bayesian Islamic medication expert system (B-IMES)

NASA Astrophysics Data System (ADS)

Daud, Hanita; Razali, Radzuan; Jung, Low Tan; Zaida, Shahnaz

2015-12-01

This paper discusses on the development of an expert system (ES) that applies Bayesian Probability concept for Islamic Medication practice that is made available on web platform. This ES allows user to choose sickness such as headache, stomachache, toothache and etc that he/she may have and list of symptoms related to the sickness will appear for the user to choose. Once symptom(s) is/are chosen the diagnosis is being carried out to suggest percentage of possible specific sickness such as classic migraine, common migraine, tension headache and etc if headache was chosen. This diagnosis is being carried out using Bayes' Theorem and the ES will suggest the treatments or therapy that he/she needs to perform in reference to Muslim Holy Quran and Hadith. This ES was developed to preserve Islamic medication and to create awareness among the young generation and make it accessible at anytime and anywhere and to save users time to meet Islamic Medication practitioners who are not easily available in Malaysia and other parts of the world.

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.

Analysis of nystagmus response to a pseudorandom velocity input

NASA Technical Reports Server (NTRS)

Lessard, C. S.

1986-01-01

Space motion sickness was not reported during the first Apollo missions; however, since Apollo 8 through the current Shuttle and Skylab missions, approximately 50% of the crewmembers have experienced instances of space motion sickness. Space motion sickness, renamed space adaptation syndrome, occurs primarily during the initial period of a mission until habilation takes place. One of NASA's efforts to resolve the space adaptation syndrome is to model the individual's vestibular response for basis knowledge and as a possible predictor of an individual's susceptibility to the disorder. This report describes a method to analyse the vestibular system when subjected to a pseudorandom angular velocity input. A sum of sinusoids (pseudorandom) input lends itself to analysis by linear frequency methods. Resultant horizontal ocular movements were digitized, filtered and transformed into the frequency domain. Programs were developed and evaluated to obtain the (1) auto spectra of input stimulus and resultant ocular resonse, (2) cross spectra, (3) the estimated vestibular-ocular system transfer function gain and phase, and (4) coherence function between stimulus and response functions.

[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.

Electronic Certification of Death in Slovenia - System Considerations and Development Opportunities.

PubMed

Stanimirovic, Dalibor

2016-01-01

Accurate and consistent death certification facilitates morbidity and mortality surveillance, and consequently supports evidence-informed health policies. The paper initially explores the current death certification practice in Slovenia, and identifies related deficiencies and system inconsistencies. Finally, the paper outlines a conceptualization of ICT-based model of death certification including renovation of business processes and organizational changes. The research is based on focus group methodology. Structured discussions were conducted with 29 experts from cross-sectional areas related to death certification. Research results imply that effective ICT-based transformation of the existing death certification model should involve a redefinition of functions and relationships between the main actors, as well as a reconfiguration of the technological, organizational, and regulatory elements in the field. The paper provides an insight into the complexities of the death certification and may provide the groundwork for ICT-based transformation of the death certification model in Slovenia.

48 CFR 1542.703-2 - Certificate of indirect costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Certificate of indirect costs. 1542.703-2 Section 1542.703-2 Federal Acquisition Regulations System ENVIRONMENTAL PROTECTION AGENCY CONTRACT MANAGEMENT CONTRACT ADMINISTRATION Indirect Cost Rates 1542.703-2 Certificate of indirect...

UAS noise certification and measurements status report : Tigershark UAS measurements, tracking system development, and certification metrics status

DOT National Transportation Integrated Search

2017-09-01

This report documents work done by Volpe staff to support the FAAs development of Unmanned Aerial Systems (UAS) noise certification and noise measurement criteria. The primary elements were the development of a small, lightweight Global Navigation...

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.

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

Air Force IT System Security Compliance with Law and Policy

DTIC Science & Technology

2016-04-01

production /1/saf_cio_a6/publication/afpd33-2/afpd33-2.pdf 21 AFI33-210, Air Force Certification and Accreditation Program (AFCAP), October 2014: http...cyber systems for support and operation. Today’s system certification and compliancy tracking methods are very costly, time intensive, unrealistic...and often lag behind operational and test requirements. However, with changes to policy and implementation requirements, the IT system certification

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.

KSC-02pd1410

NASA Image and Video Library

2002-09-30

KENNEDY SPACE CENTER, FLA. - Jack Wilcox (at the microphone) answers questions from the media during a reunion with his rescuers at the Hangar AF docks, Cape Canaveral Air Force Station. At right is his wife, Patty. Wilcox reunited with the men aboard KSC's Freedom Star SRB retrieval ship that was in the vicinity when Wilcox suffered decompression sickness on a diving expedition 20 miles off shore in the Atlantic Ocean. When the Freedom Star team heard the call for help, they asked the Coast Guard if they could assist. The ship was out on a crane certification exercise and coincidentally had a diver medical technician and other divers training on the crane. The ship's divers were trained for the hyperbaric chamber on board. Upon reaching the Army dock, KSC Occupational Health physician Skip Beeler entered the chamber and continued the process of helping to stabilize Wilcox. After several hours in the chamber, Wilcox, who lives in Orlando, was airlifted to Florida Hospital Orlando.

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.

Certification Archives

EPA Pesticide Factsheets

The requirements of this product certification system are applicable to EPA-approved accreditation bodies (approved accreditation bodies), licensed certifying bodies, and the manufacturers that are obtaining product certification.

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.

Cost-effectiveness of a participatory return-to-work intervention for temporary agency workers and unemployed workers sick-listed due to musculoskeletal disorders: design of a randomised controlled trial

PubMed Central

2010-01-01

Background Within the working population there is a vulnerable group: workers without an employment contract and workers with a flexible labour market arrangement, e.g. temporary agency workers. In most cases, when sick-listed, these workers have no workplace/employer to return to. Also, for these workers access to occupational health care is limited or even absent in many countries. For this vulnerable working population there is a need for tailor-made occupational health care, including the presence of an actual return-to-work perspective. Therefore, a participatory return-to-work program has been developed based on a successful return-to-work intervention for workers, sick-listed due to low back pain. The objective of this paper is to describe the design of a randomised controlled trial to study the (cost-)effectiveness of this newly developed participatory return-to-work program adapted for temporary agency workers and unemployed workers, sick-listed due to musculoskeletal disorders, compared to usual care. Methods/Design The design of this study is a randomised controlled trial with one year of follow-up. The study population consists of temporary agency workers and unemployed workers sick-listed between 2 and 8 weeks due to musculoskeletal disorders. The new return-to-work program is a stepwise program aimed at making a consensus-based return-to-work implementation plan with the possibility of a (therapeutic) workplace to return-to-work. Outcomes are measured at baseline, 3, 6, 9 and 12 months. The primary outcome measure is duration of the sickness benefit period after the first day of reporting sick. Secondary outcome measures are: time until first return-to-work, total number of days of sickness benefit during follow-up; functional status; intensity of musculoskeletal pain; pain coping; and attitude, social influence and self-efficacy determinants. Cost-benefit is evaluated from an insurer's perspective. A process evaluation is part of this study. Discussion For sick-listed workers without an employment contract there can be gained a lot by improving occupational health care, including return-to-work guidance, and by minimising the 'labour market handicap' by creating a return-to-work perspective. In addition, reduction of sickness absence and work disability, i.e. a reduction of disability claims, may result in substantial benefits for the Dutch Social Security System. Trial registration Trial registration number: NTR1047. PMID:20346183

Standards for Endovascular Neurosurgical Training and Certification of the Society of Korean Endovascular Neurosurgeons 2013

PubMed Central

Shin, Dong-Seong; Park, Sukh-Que; Kang, Hyun-Seung; Yoon, Seok-Mann; Cho, Jae-Hoon; Lim, Dong-Jun; Baik, Min-Woo; Kwon, O Ki

2014-01-01

The need for standard endovascular neurosurgical (ENS) training programs and certification in Korea cannot be overlooked due to the increasing number of ENS specialists and the expanding ENS field. The Society of Korean Endovascular Neurosurgeons (SKEN) Certification Committee has prepared training programs and certification since 2010, and the first certificates were issued in 2013. A task force team (TFT) was organized in August 2010 to develop training programs and certification. TFT members researched programs and systems in other countries to develop a program that best suited Korea. After 2 years, a rough draft of the ENS training and certification regulations were prepared, and the standard training program title was decided. The SKEN Certification Committee made an official announcement about the certification program in March 2013. The final certification regulations comprised three major parts: certified endovascular neurosurgeons (EN), certified ENS institutions, and certified ENS training institutions. Applications have been evaluated and the results were announced in June 2013 as follows: 126 members received EN certification and 55 hospitals became ENS-certified institutions. The SKEN has established standard ENS training programs together with a certification system, and it is expected that they will advance the field of ENS to enhance public health and safety in Korea. PMID:24851145

IMCS reflight certification requirements and design specifications

NASA Technical Reports Server (NTRS)

1984-01-01

The requirements for reflight certification are established. Software requirements encompass the software programs that are resident in the PCC, DEP, PDSS, EC, or any related GSE. A design approach for the reflight software packages is recommended. These designs will be of sufficient detail to permit the implementation of reflight software. The PDSS/IMC Reflight Certification system provides the tools and mechanisms for the user to perform the reflight certification test procedures, test data capture, test data display, and test data analysis. The system as defined will be structured to permit maximum automation of reflight certification procedures and test data analysis.

48 CFR 33.207 - Contractor certification.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Contractor certification... CONTRACTING REQUIREMENTS PROTESTS, DISPUTES, AND APPEALS Disputes and Appeals 33.207 Contractor certification. (a) Contractors shall provide the certification specified in paragraph (c) of this section when...

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.

Measurement and reduction of system latency in see-through helmet mounted display (HMD) systems

NASA Astrophysics Data System (ADS)

Vincenzi, Dennis A.; Deaton, John E.; Blickenderfer, Elizabeth L.; Pray, Rick; Williams, Barry; Buker, Timothy J.

2010-04-01

Future military aviation platforms such as the proposed Joint Strike Fighter F-35 will integrate helmet mounted displays (HMDs) with the avionics and weapon systems to the degree that the HMDs will become the aircraft's primary display system. In turn, training of pilot flight skills using HMDs will be essential in future training systems. In order to train these skills using simulation based training, improvements must be made in the integration of HMDs with out-thewindow (OTW) simulations. Currently, problems such as latency contribute to the onset of simulator sickness and provide distractions during training with HMD simulator systems that degrade the training experience. Previous research has used Kalman predictive filters as a means of mitigating the system latency present in these systems. While this approach has yielded some success, more work is needed to develop innovative and improved strategies that reduce system latency as well as to include data collected from the user perspective as a measured variable during test and evaluation of latency reduction strategies. The purpose of this paper is twofold. First, the paper describes a new method to measure and assess system latency from the user perspective. Second, the paper describes use of the testbed to examine the efficacy of an innovative strategy that combines a customized Kalman filter with a neural network approach to mitigate system latency. Results indicate that the combined approach reduced system latency significantly when compared to baseline data and the traditional Kalman filter. Reduced latency errors should mitigate the onset of simulator sickness and ease simulator sickness symptomology. Implications for training systems will be discussed.

[Cost comparison of temporary sickness absence in 2006 between Barcelona and Madrid provinces, Spain].

PubMed

Ballesteros Polo, Mónica; Serra Pujadas, Consol; Miguel Martínez, José; Plana Almuni, Manel; Delclos, George L; Benavides, Fernando G

2009-01-01

Sickness absence due to non work-related conditions is a major public health issue with important socio-economic implications, and is not homogenously distributed in Spain. The objective of this study is to compare cost differences of temporary sickness absence between Barcelona and Madrid. A study was carried out based on incident cases of temporary sickness absence of more than fifteen days of duration, followed to case closure, in a retrospective cohort of workers in 2006. The study population consisted of workers of companies covered by the general regime of the Social Security System, and managed by an insurance company based in the provinces of Barcelona and Madrid in the year 2006. We compared the incidence, median duration and daily income base between Barcelona and Madrid, adjusting by sex, age and economic sector, using statistical models that take into account recurrent events in the period. 24.527 cases of temporary sickness absence were identified, 62% of which originated in Barcelona. The mean cost was 33% higher in Barcelona with respect to Madrid (2.589 euros vs 1941 euros). The incidence was 22% higher in Barcelona than Madrid (1,22, IC95%: 1,10-1,36) and mean daily income base per episode was 7,80 euros higher (IC95% :7,20-8,40). In the duration the time ratio was: 1,03 ( IC95%: 1,01-1,05). The higher incidence and daily income base of temporary sickness absence in Barcelona with respect to Madrid may explain the higher costs observed in the former.

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.

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.

48 CFR 52.225-6 - Trade Agreements Certificate.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 2 2012-10-01 2012-10-01 false Trade Agreements Certificate. 52.225-6 Section 52.225-6 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION (CONTINUED) CLAUSES AND FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 52.225-6 Trade Agreements Certificate. As...

48 CFR 52.225-6 - Trade Agreements Certificate.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Trade Agreements Certificate. 52.225-6 Section 52.225-6 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION (CONTINUED) CLAUSES AND FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 52.225-6 Trade Agreements Certificate. As...

48 CFR 52.225-6 - Trade Agreements Certificate.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 2 2011-10-01 2011-10-01 false Trade Agreements Certificate. 52.225-6 Section 52.225-6 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION (CONTINUED) CLAUSES AND FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 52.225-6 Trade Agreements Certificate. As...

40 CFR 35.936-21 - Delegation to State agencies; certification of procurement systems.

Code of Federal Regulations, 2010 CFR

2010-07-01

...; certification of procurement systems. 35.936-21 Section 35.936-21 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works-Clean Water Act § 35.936-21 Delegation to State agencies; certification of procurement...

48 CFR 642.703-2 - Certificate of indirect costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Certificate of indirect costs. 642.703-2 Section 642.703-2 Federal Acquisition Regulations System DEPARTMENT OF STATE CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Indirect Cost Rates 642.703-2 Certificate of indirect...

A Toposcopic Investigation of Brain Electrical Activity Induced by Motion Sickness

DTIC Science & Technology

1992-12-01

This hypothesis explains motion sickness symptoms as the body’s natural response when the infcr- mation transmitted by the eyes, the vestibular system...consisting of the summed pixel values of their respective sets. Each of these images are then converted to a map of the mean values and a map of the variances ...Statistical mapping requires a sizable normative database of maps, a signif - icant investment of resources (11:25). Location-by-location comparisons be

Computerized Biophysical Data Acquisition System for Motion Sickness Studies.

DTIC Science & Technology

1984-12-01

biofeedback in Autogenic Feedback Training (AFT). Dr. Patricia Cowings of 1- 1 NASA-Ames Research Center has also successfully used AFT in her studies (7...analysis can be completed. Summary of Current Knowledge Researchers have approached the problem of motion sick- ness in several ways. One approach is to...that the technique is not "black magic" (17). Despite apparent successes by Dr. Levy and others, notably Dr. Patricia Cowings of the NASA-Ames Research

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.

The influence of trade associations and group certification programs on the hardwood certification movement

Treesearch

Iris B. Montague

2013-01-01

Forest certification has gained momentum around the world over the past two decades. Although there are advantages to being certified, many forest landowners and forest products manufacturers consider forest certification of U.S. forest and forest products unnecessary. Many believe that U.S. forests are already sustainably managed, the current certification systems are...

Coping with space motion sickness in Spacelab missions

NASA Astrophysics Data System (ADS)

Graybiel, Ashton

A substantial number of persons, around 75%, making their first transition into orbital flight will need to adapt to this unique environment. The two most powerful instruments in the prevention of space motion sickness reside in the selection process and in acquiring adaptation-prelaunch. Today, neither of these means is practical. One logical alternative is to administer preventative medication to all or none. One candidate drug is a high-potency transdermal therapeutic system (TTS)-scopolamine. This is marketed in the nature of a patch that is affixed to the skin behind the ear 12 hr before need and delivers scopolamine into the blood stream for three days. We are systematically evaluating all claims for its high potency and low side effects. We are also evaluating new antimotion sickness remedies and new combinations of homergic drugs.

Instability of the perceived world while watching 3D stereoscopic imagery: A likely source of motion sickness symptoms

PubMed Central

Hwang, Alex D.; Peli, Eli

2014-01-01

Watching 3D content using a stereoscopic display may cause various discomforting symptoms, including eye strain, blurred vision, double vision, and motion sickness. Numerous studies have reported motion-sickness-like symptoms during stereoscopic viewing, but no causal linkage between specific aspects of the presentation and the induced discomfort has been explicitly proposed. Here, we describe several causes, in which stereoscopic capture, display, and viewing differ from natural viewing resulting in static and, importantly, dynamic distortions that conflict with the expected stability and rigidity of the real world. This analysis provides a basis for suggested changes to display systems that may alleviate the symptoms, and suggestions for future studies to determine the relative contribution of the various effects to the unpleasant symptoms. PMID:26034562

PVDaCS - A prototype knowledge-based expert system for certification of spacecraft data

NASA Technical Reports Server (NTRS)

Wharton, Cathleen; Shiroma, Patricia J.; Simmons, Karen E.

1989-01-01

On-line data management techniques to certify spacecraft information are mandated by increasing telemetry rates. Knowledge-based expert systems offer the ability to certify data electronically without the need for time-consuming human interaction. Issues of automatic certification are explored by designing a knowledge-based expert system to certify data from a scientific instrument, the Orbiter Ultraviolet Spectrometer, on an operating NASA planetary spacecraft, Pioneer Venus. The resulting rule-based system, called PVDaCS (Pioneer Venus Data Certification System), is a functional prototype demonstrating the concepts of a larger system design. A key element of the system design is the representation of an expert's knowledge through the usage of well ordered sequences. PVDaCS produces a certification value derived from expert knowledge and an analysis of the instrument's operation. Results of system performance are presented.

Work-unit social capital and long-term sickness absence: a prospective cohort study of 32 053 hospital employees.

PubMed

Török, Eszter; Clark, Alice Jessie; Jensen, Johan Høy; Lange, Theis; Bonde, Jens Peter; Bjorner, Jakob Bue; Rugulies, Reiner; Hvidtfeldt, Ulla Arthur; Hansen, Åse Marie; Ersbøll, Annette Kjær; Rod, Naja Hulvej

2018-06-06

There is a lack of studies investigating social capital at the workplace level in small and relatively homogeneous work-units. The aim of the study was to investigate whether work-unit social capital predicts a lower risk of individual long-term sickness absence among Danish hospital employees followed prospectively for 1 year. This study is based on the Well-being in HospitAL Employees cohort. The study sample consisted of 32 053 individuals nested within 2182 work-units in the Capital Region of Denmark. Work-unit social capital was measured with an eight-item scale covering elements of trust, justice and collaboration between employees and leaders. Social capital at the work-unit level was computed as the aggregated mean of individual-level social capital within each work-unit. Data on long-term sickness absence were retrieved from the employers' payroll system and were operationalised as ≥29 consecutive days of sickness absence. We used a 12-point difference in social capital as the metric in our analyses and conducted two-level hierarchical logistic regression analysis. Adjustments were made for sex, age, seniority, occupational group and part-time work at the individual level, and work-unit size, the proportion of female employees and the proportion of part-time work at the work-unit level. The OR for long-term sickness absence associated with a 12-point higher work-unit social capital was 0.73 (95% CI 0.68 to 0.78). Further, we found an association between higher work-unit social capital and lower long-term sickness absence across quartiles of social capital: compared with the lowest quartile, the OR for long-term sickness absence in the highest quartile was 0.51 (95% CI 0.44 to 0.60). Our study provides support for work-unit social capital being a protective factor for individual long-term sickness absence among hospital employees in the Capital Region of Denmark. © 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.

[Disability leave and sick leave in Spain. 2016 legislative update].

PubMed

Vicente-Herrero, María Teófila; Terradillos-García, María Jesús; Capdevila-García, Luisa M; Ramírez-Íñiguez de la Torre, María Victoria; Aguilar-Jiménez, Encarna; Aguado-Benedí, María José; López-González, Angel Arturo; Torres-Alberich, José Ignacio

2018-01-01

In Spanish, the concepts of discapacidad (disability leave) and incapacidad (sick leave) jointly refer to the impairment of a person due to injuries, diseases or deficiencies that limit their activity in a social, personal or occupational field. However, this common link does not imply that both concepts are the same. Statistical data from INE (Instituto Nacional de Estadística: Statistic National Institute) show that Spain had in 2015 3.85 million persons with a disability (59.8% were women). Statistical data from 2015 from INSS (Instituto Nacional de Seguridad Social: Social Security National Institute) show high levels in the number of processes and in workers affected by temporary sick leave, with social costs to the social security system. Both concepts have been updated: about disability leave, Law 39/2006 adjusted terminology by avoiding the use of concepts with discriminating or pejorative connotation. Regarding sick leave, the Ley General de Seguridad Social (General Social Security Law)has been amended and came into effect in January, 2016. It is necessary to know and distinguish these aspects for a better administrative management, and a more oriented information to the affected patient.

Validation of "Signs of Inflammation in Children that Kill" (SICK) score for immediate non-invasive assessment of severity of illness.

PubMed

Gupta, Manoj A; Chakrabarty, Anjan; Halstead, Ruth; Sahni, Mohit; Rangasami, Jayanti; Puliyel, Ashish; Sreenivas, Vishnubhatla; Green, David A; Puliyel, Jacob M

2010-04-26

To validate the SICK scoring system's ability to differentiate between individuals with higher and lower probabilities of death We performed a one year two-centre prospective evaluation of all children aged between one month and 12 years referred to the Paediatric team at St Stephens Hospital in Delhi and admitted to the Paediatric Department at West Middlesex University Hospital in London. We calculated SICK scores at presentation and correlated them with subsequent in-hospital mortality. We used discrimination by areas under receiver operating characteristic (ROC) curves to measure performance. We prospectively evaluated 3895 children in Delhi and 1473 children in London. The areas under the ROC curves were 84.8% in Delhi, 81.0% in London and 84.1% (95% CI 77.4-90.8%) for combined data. Hosmer-Lemeshow goodness of fit for the combined data was good (Hosmer-Lemeshow Chi-square=2.13 (p=0.345). We propose the SICK score as a useful triage tool at initial presentation and highlight its particular suitability for resource poor settings.

Relative efficacy of the proposed Space Shuttle antimotion sickness medications

NASA Astrophysics Data System (ADS)

Hordinsky, J. R.; Schwartz, E.; Beier, J.; Martin, J.; Aust, G.

1982-07-01

Space motion sickness has been estimated as affecting between 1/3 and 1/2 of all space flight participants. NASA has at the moment proposed a combination of promethazine and ephedrine ( P/E) and one of scopolamine and dextroamphetamine ( S/D), both given orally, as well as a transdermally applied scopolamine (TAS), as preventive and ameliorative measures. The reported double-blind study tests the early phase actions and efficacy of the transdermal scopolamine (Transderm ™-V of ALZA Corporation) and compares these in detail to the oral medications. Motion sickness resistance was tested by standardized head movements while accelerating at 0.2°/sec 2 to a maximum rotation of 240°/sec, with an intermediate plateau of 10 min at 180°/sec. To permit weighting motion sickness protection against other system influences, cardiovascular, psychological (subjective and objective), and visual parameter changes were documented for the three therapeutic modes. The relative impact of the various modalities on operational and experimental components of space missions is discussed. A comparison to intramuscularly administered promethazine (a backup therapeutic mode suggested for Space Shuttle use) is also included.

Validation of "Signs of Inflammation in Children that Kill" (SICK) score for immediate non-invasive assessment of severity of illness

PubMed Central

2010-01-01

Objective To validate the SICK scoring system's ability to differentiate between individuals with higher and lower probabilities of death Method We performed a one year two-centre prospective evaluation of all children aged between one month and 12 years referred to the Paediatric team at St Stephens Hospital in Delhi and admitted to the Paediatric Department at West Middlesex University Hospital in London. We calculated SICK scores at presentation and correlated them with subsequent in-hospital mortality. We used discrimination by areas under receiver operating characteristic (ROC) curves to measure performance. Results We prospectively evaluated 3895 children in Delhi and 1473 children in London. The areas under the ROC curves were 84.8% in Delhi, 81.0% in London and 84.1% (95% CI 77.4 - 90.8%) for combined data. Hosmer-Lemeshow goodness of fit for the combined data was good (Hosmer-Lemeshow Chi-square = 2.13 (p = 0.345). Conclusions We propose the SICK score as a useful triage tool at initial presentation and highlight its particular suitability for resource poor settings. PMID:20420670

In vitro and in vivo evaluation of 28DAP010, a novel diamidine for treatment of second-stage African sleeping sickness.

PubMed

Wenzler, Tanja; Yang, Sihyung; Patrick, Donald A; Braissant, Olivier; Ismail, Mohamed A; Tidwell, Richard R; Boykin, David W; Wang, Michael Zhuo; Brun, Reto

2014-08-01

African sleeping sickness is a neglected tropical disease transmitted by tsetse flies. New and better drugs are still needed especially for its second stage, which is fatal if untreated. 28DAP010, a dipyridylbenzene analogue of DB829, is the second simple diamidine found to cure mice with central nervous system infections by a parenteral route of administration. 28DAP010 showed efficacy similar to that of DB829 in dose-response studies in mouse models of first- and second-stage African sleeping sickness. The in vitro time to kill, determined by microcalorimetry, and the parasite clearance time in mice were shorter for 28DAP010 than for DB829. No cross-resistance was observed between 28DAP010 and pentamidine on the tested Trypanosoma brucei gambiense isolates from melarsoprol-refractory patients. 28DAP010 is the second promising preclinical candidate among the diamidines for the treatment of second-stage African sleeping sickness. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

[Inability to work: analysis of sickness benefits granted in the State of Rondônia].

PubMed

Jakobi, Heinz Roland; Barbosa-Branco, Anadergh; Bueno, Luis Fernando; Ferreira, Ricardo de Godoi Mattos; Camargo, Luís Marcelo Aranha

2013-11-01

This is a descriptive epidemiological study aiming to o estimate the prevalence and duration of sickness benefits granted by the Brazilian Social Security Institute, as well as the clinical causes of inability to work among employees in Rondonia in 2008. The prevalence was submitted by 10,000 workers and stratified by sex, age, diagnosis, economic activity, and type and duration of benefits. Men had a higher prevalence and duration of benefits. Social security benefits were found to be 2,5 times more prevalent than accident benefits and both increased with age. Labor accidents were more prevalent in the age group ranging between 50-59 years, and Forestry, construction and manpower leasing: had the highest prevalence. The main diagnostic groups were injuries, musculoskeletal system disorders and digestive diseases. The duration of the sickness benefits was higher among men, =40 years and in the social security category. The economic activity is an important risk factor for Inability to work, and it needs to be further explored in order to improve sickness prevention and reduce the impact on workers' health arising from environmental conditions and working processes.

Who and where are the uncounted children? Inequalities in birth certificate coverage among children under five years in 94 countries using nationally representative household surveys.

PubMed

Bhatia, Amiya; Ferreira, Leonardo Zanini; Barros, Aluísio J D; Victora, Cesar Gomes

2017-08-18

Birth registration, and the possession of a birth certificate as proof of registration, has long been recognized as a fundamental human right. Data from a functioning civil registration and vital statistics (CRVS) system allows governments to benefit from accurate and universal data on birth and death rates. However, access to birth certificates remains challenging and unequal in many low and middle-income countries. This paper examines wealth, urban/rural and gender inequalities in birth certificate coverage. We analyzed nationally representative household surveys from 94 countries between 2000 and 2014 using Demographic Health Surveys and Multiple Indicator Cluster Surveys. Birth certificate coverage among children under five was examined at the national and regional level. Absolute measures of inequality were used to measure inequalities in birth certificate coverage by wealth quintile, urban/rural residence and sex of the child. Over four million children were included in the analysis. Birth certificate coverage was over 90% in 29 countries and below 50% in 36 countries, indicating that more than half the children under five surveyed in these countries did not have a birth certificate. Eastern & Southern Africa had the lowest average birth certificate coverage (26.9%) with important variability among countries. Significant wealth inequalities in birth certificate coverage were observed in 74 countries and in most UNICEF regions, and urban/rural inequalities were present in 60 countries. Differences in birth certificate coverage between girls and boys tended to be small. We show that wealth and urban/rural inequalities in birth certificate coverage persist in most low and middle income countries, including countries where national birth certificate coverage is between 60 and 80%. Weak CRVS systems, particularly in South Asia and Africa lead rural and poor children to be systematically excluded from the benefits tied to a birth certificate, and prevent these children from being counted in national health data. Greater funding and attention is needed to strengthen CRVS systems and equity analyses should inform such efforts, especially as data needs for the Sustainable Development Goals expand. Monitoring disaggregated data on birth certificate coverage is essential to reducing inequalities in who is counted and registered. Strengthening CRVS systems can enable a child's right to identity, improve health data and promote equity.

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.

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.

New security infrastructure model for distributed computing systems

NASA Astrophysics Data System (ADS)

Dubenskaya, J.; Kryukov, A.; Demichev, A.; Prikhodko, N.

2016-02-01

At the paper we propose a new approach to setting up a user-friendly and yet secure authentication and authorization procedure in a distributed computing system. The security concept of the most heterogeneous distributed computing systems is based on the public key infrastructure along with proxy certificates which are used for rights delegation. In practice a contradiction between the limited lifetime of the proxy certificates and the unpredictable time of the request processing is a big issue for the end users of the system. We propose to use unlimited in time hashes which are individual for each request instead of proxy certificate. Our approach allows to avoid using of the proxy certificates. Thus the security infrastructure of distributed computing system becomes easier for development, support and use.

[Occupational activity during pregnancy based on the Polish mother and child cohort study].

PubMed

Polańska, Kinga; Jurewicz, Joanna; Marcinkiewicz, Andrzej; Makowiec-Dabrowska, Teresa; Hanke, Wojciech

2014-01-01

In Poland conditions related to or aggravated by the pregnancy, childbirth or the puerperium are one of the common causes of sickness absence. The aim of the study was to analyze the occupational activity pattern during pregnancy and to evaluate the determinants of pregnancy-related temporary work disability confirmed by medical certificate. The presented analysis is based on data collected under the Polish Mother and Child Cohort Study. The study population consisted of 954 women who reported occupational activity during pregnancy. All women participating in the study were interviewed 3 times during pregnancy. Detail information on occupational activity during pregnancy and occupational stress, based on the Subjective Work Characteristics Questionnaire, was collected from all women. The pregnant women had been issued medical certificate of temporary work disability because of conditions related to or aggravated by the pregnancy, childbirth or by the puerperium at 16 week of gestation on average and did not continue their activities until the end of pregnancy. The statistically significant determinants of receiving such medical certificate in the first trimester of pregnancy (< or = 12 weeks of pregnancy) comprised poor health condition and complications during pregnancy (OR = 1.4; p = 0.01), lower education (OR = 2.4; p <0.001), socio-economic status (OR = 9.6; p = 0.03), use of public transport to commute to work (OR = 2.7; p <0.001), a longer work commute (OR = 1.4; p = 0.008) and a higher level of occupational stress (OR = 3.0; p < 0.01). Waitresses, nurses and saleswomen received medical certificate of temporary work disability in the first trimester of pregnancy more frequently than office workers (OR = 4.2; p = 0.005; OR = 3.3; p = 0.02; OR = 2.3; p < 0.001 respectively). It is crucial to develop the model of cooperation between occupational medicine physicians and gynecologists and a greater involvement of the former in the prophylactic care of occupationally active pregnant women. It is also important to increase the employers' awareness of potential risks and arduousness at work to assure working conditions safe for the pregnancy outcome and health of both women and their babies.

Certificate Revocation Using Fine Grained Certificate Space Partitioning

NASA Astrophysics Data System (ADS)

Goyal, Vipul

A new certificate revocation system is presented. The basic idea is to divide the certificate space into several partitions, the number of partitions being dependent on the PKI environment. Each partition contains the status of a set of certificates. A partition may either expire or be renewed at the end of a time slot. This is done efficiently using hash chains.

Certification of a weld produced by friction stir welding

DOEpatents

Obaditch, Chris; Grant, Glenn J

2013-10-01

Methods, devices, and systems for providing certification of friction stir welds are disclosed. A sensor is used to collect information related to a friction stir weld. Data from the sensor is compared to threshold values provided by an extrinsic standard setting organizations using a certification engine. The certification engine subsequently produces a report on the certification status of the weld.

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.

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.

Professional Certification

EPA Pesticide Factsheets

The WaterSense Professional Certification Program Labeling System specifies the requirements a professional certifying organization must meet to have the professional certification program labeled under one of the WaterSense program specifications.

Factors that Influence Information Systems Undergraduates to Pursue IT Certification

ERIC Educational Resources Information Center

Hunsinger, D. Scott; Smith, Michael A.

2008-01-01

We identify factors that influence the intent of undergraduate information systems majors to pursue IT certification. Previous research has revealed that IT/IS hiring managers may use certification as a job requirement or to differentiate between job candidates with similar levels of education and experience. As well, salary surveys have shown…

12 CFR 261b.10 - Certification of General Counsel.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Certification of General Counsel. 261b.10 Section 261b.10 Banks and Banking FEDERAL RESERVE SYSTEM (CONTINUED) BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM RULES REGARDING PUBLIC OBSERVATION OF MEETINGS § 261b.10 Certification of General Counsel...

A Parallel Universe--Certification in the Information Technology Guild.

ERIC Educational Resources Information Center

Adelman, Cliff

2000-01-01

States that the U.S. economy exhibits a voracious demand for information technology (IT) certification programs and, it is claimed, the U.S. system of education isn't producing them. Explains that most IT certification providers operate outside the formal postsecondary education system, do not participate in federal student aid and reporting…

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.

Effects of voluntary wheel running on LPS-induced sickness behavior in aged mice.

PubMed

Martin, Stephen A; Pence, Brandt D; Greene, Ryan M; Johnson, Stephanie J; Dantzer, Robert; Kelley, Keith W; Woods, Jeffrey A

2013-03-01

Peripheral stimulation of the innate immune system with LPS causes exaggerated neuroinflammation and prolonged sickness behavior in aged mice. Regular moderate intensity exercise has been shown to exert anti-inflammatory effects that may protect against inappropriate neuroinflammation and sickness in aged mice. The purpose of this study was to test the hypothesis that voluntary wheel running would attenuate LPS-induced sickness behavior and proinflammatory cytokine gene expression in ~22-month-old C57BL/6J mice. Mice were housed with a running wheel (VWR), locked-wheel (Locked), or no wheel (Standard) for 10 weeks, after which they were intraperitoneally injected with LPS across a range of doses (0.02, 0.08, 0.16, 0.33 mg/kg). VWR mice ran on average 3.5 km/day and lost significantly more body weight and body fat, and increased their forced exercise tolerance compared to Locked and Shoebox mice. VWR had no effect on LPS-induced anorexia, adipsia, weight-loss, or reductions in locomotor activity at any LPS dose when compared to Locked and Shoebox groups. LPS induced sickness behavior in a dose-dependent fashion (0.33>0.02 mg/kg). Twenty-four hours post-injection (0.33 mg/kg LPS or Saline) we found a LPS-induced upregulation of whole brain TNFα, IL-1β, and IL-10 mRNA, and increased IL-1β and IL-6 in the spleen and liver; these effects were not attenuated by VWR. We conclude that VWR does not reduce LPS-induced exaggerated or prolonged sickness behavior in aged animals, or 24h post-injection (0.33 mg/kg LPS or Saline) brain and peripheral proinflammatory cytokine gene expression. The necessity of the sickness response is critical for survival and may outweigh the subtle benefits of exercise training in aged animals. Copyright © 2012 Elsevier Inc. All rights reserved.

Process evaluation of a problem solving intervention to prevent recurrent sickness absence in workers with common mental disorders.

PubMed

Arends, Iris; Bültmann, Ute; Nielsen, Karina; van Rhenen, Willem; de Boer, Michiel R; van der Klink, Jac J L

2014-01-01

Common mental disorders (CMDs) are a major cause of sickness absence. Twenty to 30% of the workers who return to work after sickness absence due to CMDs experience recurrent sickness absence. We developed the Stimulating Healthy participation And Relapse Prevention (SHARP)-at work intervention, a problem solving intervention delivered by occupational physicians (OPs), to prevent recurrent sickness absence in this worker population in The Netherlands. A process evaluation was conducted alongside a cluster-randomised controlled trial to (1) evaluate whether the SHARP-at work intervention was implemented according to the protocol and differed from treatment in the control group, and (2) to investigate the relationship between the key elements of the intervention and the effect outcome (i.e. recurrent sickness absence). We collected process data for both the intervention and control group on recruitment, reach, dose delivered, dose received, fidelity, context and satisfaction. Data on recurrent sickness absence was collected through the registry system of the collaborating occupational health service. The study was performed in the Netherlands, and between 2010 and 2012, 154 OPs and 158 participants participated. Compared to the control group, participants in the intervention group more frequently had two or more consultations with the OP (odds ratio [OR] = 3.2, 95% confidence interval [CI] = 1.2-8.8) and completed more assignments (OR = 33.8, 95% CI = 10.4-109.5) as recommended in the intervention protocol. OPs and participants were satisfied with the intervention and rated it as applicable. Several individual intervention components were linked to the effect outcome. The process evaluation showed that the SHARP-at work intervention was conducted according to the protocol for the majority of the participants and well-received by OPs and participants. Furthermore, the intervention differed from treatment in the control group. Overall, the results provide support for implementing the intervention in practice. Copyright © 2013 Elsevier Ltd. All rights reserved.

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.

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

Implementing health care reform in Israel: organizational response to perceived incentives.

PubMed

Gross, Revital

2003-08-01

Devising new incentives was a main element of health care reform in Israel, which created a regulated market that embodies many principles of managed competition. This study examined sick fund directors' perceptions of the new incentives and their strategic responses to these incentives, enabling the testing of how managed competition works in practice. The methodology used was a multiple case study of Israel's four sick funds. Data were gathered through in-depth interviews with 160 senior officials, analysis of national health insurance legislation, and analysis of published and unpublished archival documents, newspaper articles, public statements of senior managers, and other published data on the sick funds' behavior. The study revealed discrepancies between planned and perceived incentives and highlighted the effect of the latter on strategy formulation. Analysis of sick fund strategies showed that their responses to managed competition incentives deviated from theoretical expectations, compromising some of the objectives of the reform. The study also shows that contextual features account for the specific model of managed competition that was implemented and for the specific strategies employed by the sick funds. The study concludes by highlighting the need to build a process that will enable policy makers to consider local contextual factors when planning and implementing reform, involving health care providers in designing incentives, continuously monitoring processes and outcomes in the reformed system, and allowing for flexibility in policy making.

Towards practical application of sensors for monitoring animal health: the effect of post-calving health problems on rumination duration, activity and milk yield.

PubMed

Steensels, Machteld; Maltz, Ephraim; Bahr, Claudia; Berckmans, Daniel; Antler, Aharon; Halachmi, Ilan

2017-05-01

Three sources of sensory data: cow's individual rumination duration, activity and milk yield were evaluated as possible indicators for clinical diagnosis, focusing on post-calving health problems such as ketosis and metritis. Data were collected from a computerised dairy-management system on a commercial dairy farm with Israeli Holstein cows. In the analysis, 300 healthy and 403 sick multiparous cows were studied during the first 3 weeks after calving. A mixed model with repeated measurements was used to compare healthy cows with sick cows. In the period from 5 d before diagnosis and treatment to 2 d after it, rumination duration and activity were lower in the sick cows compared to healthy cows. The milk yield of sick cows was lower than that of the healthy cows during a period lasting from 5 d before until 5 d after the day of diagnosis and treatment. Differences in the milk yield of sick cows compared with healthy cows became greater from 5 to 1 d before diagnosis and treatment. The greatest significant differences occurred 3 d before diagnosis for rumination duration and 1 d before diagnosis for activity and milk yield. These results indicate that a model can be developed to automatically detect post-calving health problems including ketosis and metritis, based on rumination duration, activity and milk yield.

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.

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.

Vestibular response to pseudorandom angular velocity input: progress report.

PubMed

Lessard, C S; Wong, W C

1987-09-01

Space motion sickness was not reported during the first Apollo missions; however, since Apollo 8 through the current Shuttle and Skylab missions, approximately 50% of the crewmembers have experienced instances of space motion sickness. One of NASA's efforts to resolve the space adaptation syndrome is to model the vestibular response for both basic knowledge and as a possible predictor of an individual's susceptibility to the disorder. This report describes a method to analyze the vestibular system when subjected to a pseudorandom angular velocity input.

The Effects of Asynchronous Visual Delays on Simulator Flight Performance and the Development of Simulator Sickness Symptomatology

DTIC Science & Technology

1986-12-26

NAVAL TRAINING SYSTEMS CENTER ORLANDO. FLORIDA IT FILE COPY THE EFFECTS OF ASYNCHRONOUS VISUAL DELAYS ON SIMULATOR FLIGHT PERFORMANCE AND THE...ASYNCHRONOUS VISUAL. DELAYS ON SI.WLATOR FLIGHT PERF OMANCE AND THE DEVELOPMENT OF SIMLATOR SICKNESS SYMPTOMATOLOGY K. C. Uliano, E. Y. Lambert, R. S. Kennedy...ACCESSION NO. N63733N SP-01 0785-7P6 I. 4780 11. TITLE (Include Security Classification) The Effects of Asynchronous Visual Delays on Simulator Flight

77 FR 53865 - Export Trade Certificate of Review

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-04

... process based on exports of poultry products (``the TRQ System'') to support the operation and... the Board of Directors of COLOM-PEQ. 3. Open Tender Process. COLOM-PEQ shall offer TRQ Certificates... through an open tender process with certificates awarded to the highest bidders (``TRQ Certificates...

A needs assessment of community pharmacists for pharmacist specialization in Canada.

PubMed

Jorgenson, Derek; Penm, Jonathan; MacKinnon, Neil; Smith, Jennifer

2017-04-01

Pharmacists are increasingly providing specialized services. However, no process exists for specialist certification in Canada. The aim of this study was to determine the extent to which Canadian community pharmacists support the development of a certification system for specialization. This study utilized a cross-sectional online survey of licensed Canadian pharmacists identified through the member databases of national and regional pharmacy associations. A questionnaire was developed (in French and English) and distributed via email, on behalf of the researchers, by multiple pharmacy organizations in January 2015. Multivariate logistic regressions were conducted to identify which sub-groups of respondents supported the creation of a certification system and which supported mandatory certification. A total of 770 responses were received. Many respondents were practising specialists (30.0%, 205/683) and the most commonly reported specialty areas were diabetes, smoking cessation and geriatrics. Almost 85% (n = 653/770) supported creation of a Canadian certification process and 68.5% (n = 447/653) felt certification should be mandatory. Respondents believed that the primary benefit of a certification system was greater public confidence in pharmacist specialist skills. They also felt that the most important factor in the development of the system is to create national definitions for specialty practice. The main barrier was the lack of reimbursement for specialty services in Canada. The majority of Canadian community pharmacist respondents support the creation of a certification process for pharmacist specialization. Future study is required to confirm this finding in a larger sample and to determine the optimal model and the financial feasibility of a national system in Canada. © 2016 Royal Pharmaceutical Society.

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.

The health system consequences of agency nursing and moonlighting in South Africa

PubMed Central

Rispel, Laetitia C.; Blaauw, Duane

2015-01-01

Background Worldwide, there is an increased reliance on casual staff in the health sector. Recent policy attention in South Africa has focused on the interrelated challenges of agency nursing and moonlighting in the health sector. Objective This paper examines the potential health system consequences of agency nursing and moonlighting among South African nurses. Methods During 2010, a cluster random sample of 80 hospitals was selected in four South African provinces. On the survey day, all nurses providing clinical care completed a self-administered questionnaire after giving informed consent. The questionnaire obtained information on socio-demographics, involvement in agency nursing and moonlighting, and self-reported indicators of potential health system consequences of agency nursing and moonlighting. A weighted analysis was done using STATA® 13. Results In the survey, 40.7% of nurses reported moonlighting or working for an agency in the preceding year. Of all participants, 51.5% reported feeling too tired to work, 11.5% paid less attention to nursing work on duty, and 10.9% took sick leave when not actually sick in the preceding year. Among the moonlighters, 11.9% had taken vacation leave to do agency work or moonlighting, and 9.8% reported conflicting schedules between their primary and secondary jobs. In the bivariate analysis, moonlighting nurses were significantly more likely than non-moonlighters to take sick leave when not sick (p=0.011) and to pay less attention to nursing work on duty (p=0.035). However, in a multiple logistic regression analysis, the differences between moonlighters and non-moonlighters did not remain statistically significant after adjusting for other socio-demographic variables. Conclusion Although moonlighting did not emerge as a statistically significant predictor, the reported health system consequences are serious. A combination of strong nursing leadership, effective management, and consultation with and buy-in from front-line nurses is needed to counteract the potential negative health system consequences of agency nursing and moonlighting. PMID:25971400

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.

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.

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

Danysz, A.; Proniewski, H.; Wisniewski, K.

< ; < > 8 ; 9 8 8 ; < ; 8 : to dogs (400 r), cats (400 r), gninea pigs (450 r), and mice (180-200 r). The course of radiation illness was estimated on the basis of leukocyte count. During radiation sickness the changes in pharmacologic action and toxicity of various drugs affecting the autonomic nervous system were investigated. By tests on the reactivity of mouse intestine in situ it was shown that at the peak of acute radiation sickness the toxicity of parasympathicotonics (pilocarpine, prostigmine), especially of acetylcholine, sympathicolytics (Priscol), and ganglioplegics (nicotine) decreased. The toxicitymore » of parasympathicolytic drugs (atropine) was higher. No changes of toxicity of sympathicotonics (adrenaline, iproniazid) were found, except for ephedrine, whose toxicity after irradiation significantly increased. Mouse intestinal motility tests showed a reduction 3--6 days postirradiation in the pharmacologic effects of parasympathicotonics (acetylcholine, prostigmine), especially of pilocarpine and ganglioplegics (nicotine, hexamethonium). At the same time the effects of sympathicotonic drugs (adrenaline, Sympatol) increased; on the contrary the monamine oxidase (MAO) inhibitor (iproniazid) showed a marked decrease in effect. With sympathicotonic drugs, pressor effects, changes of ECG, vasoconstrictive and mydriatic effects, and the contractive action on the nictitating membrane of cat were investigated. The pressor effects of adrenaline in dogs rose in the course of radiation sickness. No changes of pressor effects of noradrenaline and ephedrine were found, but the time of post-ephedrine hypertension was prolonged. In the acute stage of the illness, catecholamines evoked more significant changes in the ECG in dogs. During radiation sickness in cats, phasic changes in reactivity of the blood vessels in an isolated limb to catecholamines were observed: in the first phase, diminution; however, at the peak of the disease an increase in vasoconstrictory effects was seen. The action of iproniazid was insignificantly diminished. The mydriatic effect of catecholamines increased at the peak of radiation sickness. The reactivity of the nictitating membrane of cat did not change after smaller doses of adrenaline. In tests of parasympathicotonic drugs, the sensitivity of isolated guinea pig organs (intestine, uterus) to acetylcholine, pilocarpine, and prostigmine at the peak of radiation sickness was markedly diminished, but the sensitivity of intestinal smooth muscle to histamine remained unchanged. With parasympathicolnic drugs, an increase of mydriatic effect of atropine in irradiated mice was observed. Thus in most cases there were increased pharmacologic effects of directacting adrenergic drugs and decreased effects, but increased toxicity, of MAO inhibitors. The diminished pharmacologic effects and toxicity of parasympathicolytic drugs was also shown. The effects and toxicity of ganglioplegic drugs and toxicity of sympathicolytic drugs showed a marked decrease. The results indicrte increased susceptibility of adrenergic receptors and diminished susceptibility of cholinergic receptors on the peak of radiation sickness. It is suggested that these changes may arise from the characteristic disturbances in functional state of the vegetative nervous system, and particularly on the neurohormonal basis. To verify this, catecholamine level in the adrenals and cholinesterase activity was determined. Crtecholamine levels in the adrenals of irradiated mice varied phasically. In the first phase of radiation sickness (1--7 days) this level diminished to approximates 50% of the initial value. In the second phase it showed an increase of nearly 10 times. During radiation sickness a marked fall of acetylcholinesterase activity in the uterus, intestine, and brain of the gninea pigs was found. This supports the postulated parasympathicotonia at the peak of radiation sickness. The influence of increased acetylcholine level after prostigmine on the antiperistaltic action of adrenaline and on the toxicity« less

48 CFR 1252.237-71 - Certification of data.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Certification of data...: Certification of Data (APR 2005) Notice: The Secretary of Transportation has determined that this certification... represents and certifies that to the best of its knowledge and belief, the information and/or data (e.g...

48 CFR 1252.237-71 - Certification of data.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Certification of data...: Certification of Data (APR 2005) Notice: The Secretary of Transportation has determined that this certification... represents and certifies that to the best of its knowledge and belief, the information and/or data (e.g...

48 CFR 1252.237-71 - Certification of data.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 5 2012-10-01 2012-10-01 false Certification of data...: Certification of Data (APR 2005) Notice: The Secretary of Transportation has determined that this certification... represents and certifies that to the best of its knowledge and belief, the information and/or data (e.g...

48 CFR 1252.237-71 - Certification of data.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false Certification of data...: Certification of Data (APR 2005) Notice: The Secretary of Transportation has determined that this certification... represents and certifies that to the best of its knowledge and belief, the information and/or data (e.g...

48 CFR 19.602-2 - Issuing or denying a Certificate of Competency (COC).

Code of Federal Regulations, 2010 CFR

2010-10-01

... Certificate of Competency (COC). 19.602-2 Section 19.602-2 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Certificates of Competency and Determinations of Responsibility 19.602-2 Issuing or denying a Certificate of Competency (COC). Within 15...

Closing the Gap: The Effects of Alternative Certification Programs on Intern Self-Efficacy

ERIC Educational Resources Information Center

Mitchell, Marianne

2011-01-01

The shortage of teachers necessitates systems of certification that quickly provide teachers for the field, especially in hard to staff schools. Alternative certification programs have attempted to address the need by enlisting non-certified college graduates and offering these individuals shortcuts to certification, special assistance, or…

A Computer-Based Private Pilot (Airplane) Certification Exam: A First Step Toward Nation-Wide Computer-Administration of FAA Certification Exams.

ERIC Educational Resources Information Center

Anderson, Richard I.; Trollip, Stanley R.

1982-01-01

To assess the feasibility of computer-assisted Federal Aviation Administration certification examinations, a system for administering the Private Pilot Certification Examination was implemented using PLATO. Characteristics, reactions, and guidelines for use of the test are included. (Author/JJD)

Using ISO 25040 standard for evaluating electronic health record systems.

PubMed

Oliveira, Marília; Novaes, Magdala; Vasconcelos, Alexandre

2013-01-01

Quality of electronic health record systems (EHR-S) is one of the key points in the discussion about the safe use of this kind of system. It stimulates creation of technical standards and certifications in order to establish the minimum requirements expected for these systems. [1] In other side, EHR-S suppliers need to invest in evaluation of their products to provide systems according to these requirements. This work presents a proposal of use ISO 25040 standard, which focuses on the evaluation of software products, for define a model of evaluation of EHR-S in relation to Brazilian Certification for Electronic Health Record Systems - SBIS-CFM Certification. Proposal instantiates the process described in ISO 25040 standard using the set of requirements that is scope of the Brazilian certification. As first results, this research has produced an evaluation model and a scale for classify an EHR-S about its compliance level in relation to certification. This work in progress is part for the acquisition of the degree of master in Computer Science at the Federal University of Pernambuco.

Between Technocracy and Democracy: An Experimental Approach to Certification of Food Products by Japanese Consumer Cooperative Women

ERIC Educational Resources Information Center

Kimura, Aya Hirata

2010-01-01

Voluntary food certification systems have emerged as a prominent mechanism of food governance in recent years. However, critics have exposed certifications' inability to secure independence, quality, consumer trust, and costs. Recent criticism is even more pointed in that some theorists have critiqued "alternative" systems such as Fair…

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 ...

Compliance with referral of sick children: a survey in five districts of Afghanistan.

PubMed

Newbrander, William; Ickx, Paul; Werner, Robert; Mujadidi, Farooq

2012-04-27

Recognition and referral of sick children to a facility where they can obtain appropriate treatment is critical for helping reduce child mortality. A well-functioning referral system and compliance by caretakers with referrals are essential. This paper examines referral patterns for sick children, and factors that influence caretakers' compliance with referral of sick children to higher-level health facilities in Afghanistan. The study was conducted in 5 rural districts of 5 Afghan provinces using interviews with parents or caretakers in 492 randomly selected households with a child from 0 to 2 years old who had been sick within the previous 2 weeks with diarrhea, acute respiratory infection (ARI), or fever. Data collectors from local nongovernmental organizations used a questionnaire to assess compliance with a referral recommendation and identify barriers to compliance. The number of referrals, 99 out of 492 cases, was reasonable. We found a high number of referrals by community health workers (CHWs), especially for ARI. Caretakers were more likely to comply with referral recommendations from community members (relative, friend, CHW, traditional healer) than with recommendations from health workers (at public clinics and hospitals or private clinics and pharmacies). Distance and transportation costs did not create barriers for most families of referred sick children. Although the average cost of transportation in a subsample of 75 cases was relatively high (US$11.28), most families (63%) who went to the referral site walked and hence paid nothing. Most caretakers (75%) complied with referral advice. Use of referral slips by health care providers was higher for urgent referrals, and receiving a referral slip significantly increased caretakers' compliance with referral. Use of referral slips is important to increase compliance with referral recommendations in rural Afghanistan.

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.

Compliance with referral of sick children: a survey in five districts of Afghanistan

PubMed Central

2012-01-01

Background Recognition and referral of sick children to a facility where they can obtain appropriate treatment is critical for helping reduce child mortality. A well-functioning referral system and compliance by caretakers with referrals are essential. This paper examines referral patterns for sick children, and factors that influence caretakers’ compliance with referral of sick children to higher-level health facilities in Afghanistan. Methods The study was conducted in 5 rural districts of 5 Afghan provinces using interviews with parents or caretakers in 492 randomly selected households with a child from 0 to 2 years old who had been sick within the previous 2 weeks with diarrhea, acute respiratory infection (ARI), or fever. Data collectors from local nongovernmental organizations used a questionnaire to assess compliance with a referral recommendation and identify barriers to compliance. Results The number of referrals, 99 out of 492 cases, was reasonable. We found a high number of referrals by community health workers (CHWs), especially for ARI. Caretakers were more likely to comply with referral recommendations from community members (relative, friend, CHW, traditional healer) than with recommendations from health workers (at public clinics and hospitals or private clinics and pharmacies). Distance and transportation costs did not create barriers for most families of referred sick children. Although the average cost of transportation in a subsample of 75 cases was relatively high (US$11.28), most families (63%) who went to the referral site walked and hence paid nothing. Most caretakers (75%) complied with referral advice. Use of referral slips by health care providers was higher for urgent referrals, and receiving a referral slip significantly increased caretakers’ compliance with referral. Conclusions Use of referral slips is important to increase compliance with referral recommendations in rural Afghanistan. PMID:22540424

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

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.

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.

Availability of Data on Noncredit Education and Postsecondary Certifications: An Analysis of Selected State-Level Data Systems

ERIC Educational Resources Information Center

Sykes, Andrea R.; Szuplat, Mary A.; Decker, Cynthia G.

2014-01-01

Federal policymakers have interest in three specific areas of postsecondary career and technical education (CTE): associate degrees and certificates awarded in CTE, skills and training obtained through noncredit courses, and industry-recognized certifications. Research and data are readily available on students earning degrees and certificates in…

77 FR 3159 - Electronic Export Application and Certification Charge; Flexibility in the Requirements for...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-23

... Marks, Devices, and Certificates; Egg Products Export Certification AGENCY: Food Safety and Inspection... inspection marks, devices, and certificates. In addition, FSIS is proposing to amend the egg product export... possible under the current system. The Egg Products Inspection Act (EPIA) (21 U.S.C. 1031-1056) does not...

33 CFR 96.360 - Interim Safety Management Certificate: what is it and when can it be used?

Code of Federal Regulations, 2010 CFR

2010-07-01

... section, when— (1) The company's valid Document of Compliance certificate or Interim Document of Compliance certificate applies to that vessel type; (2) The company's safety management system for the vessel... to the responsible person or their company. (b) An Interim Safety Management Certificate is valid for...

Accident insurance, sickness, and science: New Zealand's no-fault system.

PubMed

Dew, Kevin

2002-01-01

This article explores the process of seeking compensation for occupational illness under a no-fault accident insurance scheme. The author uses two case studies--firefighters who attended a fire at a chemical storage depot and timbermill workers who worked with pentachlorophenol--to illustrate how science can be used to deny compensation to sick and dying workers. The results of the studies suggest that a no-fault accident compensation scheme, considered to be a victory for workers, offers no guarantee of just outcomes for working people. And science can be co-opted and used to support business and state interests against workers; this ideological support is increasingly hidden behind the development of "objective" systems of assessing compensation claims.

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.

48 CFR 53.301-1094A - SF 1094A, Tax Exemption Certificates Accountability Record.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false SF 1094A, Tax Exemption Certificates Accountability Record. 53.301-1094A Section 53.301-1094A Federal Acquisition Regulations System... 1094A, Tax Exemption Certificates Accountability Record. ER02JA97.013 ER02JA97.014 [62 FR 247, Jan. 2...

Implementation of a Computerized Maintenance Management System

NASA Technical Reports Server (NTRS)

Shen, Yong-Hong; Askari, Bruce

1994-01-01

A primer Computerized Maintenance Management System (CMMS) has been established for NASA Ames pressure component certification program. The CMMS takes full advantage of the latest computer technology and SQL relational database to perform periodic services for vital pressure components. The Ames certification program is briefly described and the aspects of the CMMS implementation are discussed as they are related to the certification objectives.

Skill Standards. Experience in Certification Systems Shows Industry Involvement To Be Key. Report to the Chairman, Joint Economic Committee, U.S. Congress.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC. Div. of Human Resources.

In an attempt to determine their role in improving the efficiency and effectiveness of skill training programs, existing standards and certification systems in 20 selected occupations were reviewed to identify the following: their common characteristics, barriers to their development and use, benefits of standards and certification to employers…

Certification and verification for Northrup Model NSC-01-0732 Fresnel lens concentrating solar collector

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

Not Available

1979-03-01

The certification and verification of the Northrup Model NSC-01-0732 Fresnel lens tracking solar collector are presented. A certification statement is included with signatures and a separate report on the structural analysis of the collector system. System verification against the Interim Performance Criteria are indicated by matrices with verification discussion, analysis, and enclosed test results.

76 FR 13436 - NIJ Request for Comments on Draft Vehicular Digital Multimedia Evidence Recording System...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-11

... Comments on Draft Vehicular Digital Multimedia Evidence Recording System Certification Program Requirements for Law Enforcement and Draft Law Enforcement Vehicular Digital Multimedia Evidence Recording System... two draft documents: ``Vehicular Digital Multimedia Evidence Recording System Certification Program...

46 CFR 126.470 - Marine-engineering systems.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Marine-engineering systems. 126.470 Section 126.470... CERTIFICATION Inspection for Certification § 126.470 Marine-engineering systems. The inspection procedures for marine-engineering systems contained in subchapter F of this chapter apply. ...

46 CFR 126.470 - Marine-engineering systems.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 4 2011-10-01 2011-10-01 false Marine-engineering systems. 126.470 Section 126.470... CERTIFICATION Inspection for Certification § 126.470 Marine-engineering systems. The inspection procedures for marine-engineering systems contained in subchapter F of this chapter apply. ...

46 CFR 126.470 - Marine-engineering systems.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 4 2014-10-01 2014-10-01 false Marine-engineering systems. 126.470 Section 126.470... CERTIFICATION Inspection for Certification § 126.470 Marine-engineering systems. The inspection procedures for marine-engineering systems contained in subchapter F of this chapter apply. ...

46 CFR 126.470 - Marine-engineering systems.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 4 2013-10-01 2013-10-01 false Marine-engineering systems. 126.470 Section 126.470... CERTIFICATION Inspection for Certification § 126.470 Marine-engineering systems. The inspection procedures for marine-engineering systems contained in subchapter F of this chapter apply. ...

46 CFR 126.470 - Marine-engineering systems.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 4 2012-10-01 2012-10-01 false Marine-engineering systems. 126.470 Section 126.470... CERTIFICATION Inspection for Certification § 126.470 Marine-engineering systems. The inspection procedures for marine-engineering systems contained in subchapter F of this chapter apply. ...

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.

RADIATION INJURY OF MYELOPOIESIS IN MONKEYS,

DTIC Science & Technology

RADIATION EFFECTS, *HEMATOPOIETIC SYSTEM, RADIATION INJURIES, GAMMA RAYS, LEUKOCYTES, BLOOD COUNTS, HEMOGLOBIN, MORTALITY RATE, BONE MARROW, LEUKEMIA, ANEMIAS , RADIATION SICKNESS, RADIATION DOSAGE, USSR.

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.

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.

Postlanding optimum designs for the assured crew return vehicle

NASA Technical Reports Server (NTRS)

Hosterman, Kenneth C.; Anderson, Loren A.

1990-01-01

The optimized preliminary engineering design concepts for postlanding operations of a water-landing Assured Crew Return Vehicle (ACRV) during a medical rescue mission are presented. Two ACRVs will be permanently docked to Space Station Freedom, fulfilling NASA's commitment to Assured Crew Return Capability in the event of an accident or illness. The optimized configuration of the ACRV is based on an Apollo command module (ACM) derivative. The scenario assumes landing a sick or injured crewmember on water with the possibility of a delayed rescue. Design emphasis is placed on four major areas. First is the design of a mechanism that provides a safe and time-critical means of removing the sick or injured crewmember from the ACRV. Support to the assisting rescue personnel is also provided. Second is the design of a system that orients and stabilizes the craft after landing so as to cause no further injury or discomfort to the already ill or injured crewmember. Third is the design of a system that provides full medical support to a sick or injured crewmember aboard the ACRV from the time of separation from the space station to rescue by recovery forces. Last is the design of a system that provides for the comfort and safety of the entire crew after splashdown up to the point of rescue. The four systems are conceptually integrated into the ACRV.

Postural Control Disturbances Produced By Exposure to HMD and Dome Vr Systems

NASA Technical Reports Server (NTRS)

Harm, D. L.; Taylor, L. C.

2005-01-01

Two critical and unresolved human factors issues in VR systems are: 1) potential "cybersickness", a form of motion sickness which is experienced in virtual worlds, and 2) maladaptive sensorimotor performance following exposure to VR systems. Interestingly, these aftereffects are often quite similar to adaptive sensorimotor responses observed in astronauts during and/or following space flight. Most astronauts and cosmonauts experience perceptual and sensorimotor disturbances during and following space flight. All astronauts exhibit decrements in postural control following space flight. It has been suggested that training in virtual reality (VR) may be an effective countermeasure for minimizing perceptual and/or sensorimotor disturbances. People adapt to consistent, sustained alterations of sensory input such as those produced by microgravity, and experimentally-produced stimulus rearrangements (e.g., reversing prisms, magnifying lenses, flight simulators, and VR systems). Adaptation is revealed by aftereffects including perceptual disturbances and sensorimotor control disturbances. The purpose of the current study was to compare disturbances in postural control produced by dome and head-mounted virtual environment displays. Individuals recovered from motion sickness and the detrimental effects of exposure to virtual reality on postural control within one hour. Sickness severity and initial decrements in postural equilibrium decreases over days, which suggests that subjects become dual-adapted over time. These findings provide some direction for developing training schedules for VR users that facilitate adaptation, and address safety concerns about aftereffects.

30 CFR 27.5 - Letter of certification.

Code of Federal Regulations, 2010 CFR

2010-07-01

... APPROVAL OF MINING PRODUCTS METHANE-MONITORING SYSTEMS General Provisions § 27.5 Letter of certification. (a) Upon completion of investigation of a methane-monitoring system, or component or subassembly...

30 CFR 27.5 - Letter of certification.

Code of Federal Regulations, 2011 CFR

2011-07-01

... APPROVAL OF MINING PRODUCTS METHANE-MONITORING SYSTEMS General Provisions § 27.5 Letter of certification. (a) Upon completion of investigation of a methane-monitoring system, or component or subassembly...

Policy brief on the current status of certification of electronic Health Records in the US and Europe.

PubMed

De Moor, Georges; O'Brien, John; Fridsma, Doug; Bean, Carol; Devlies, Jos; Cusack, Caitlin M; Bloomrosen, Meryl; Lorenzi, Nancy; Coorevits, Pascal

2011-01-01

If Electronic Health Record systems are to provide an effective contribution to healthcare, a set of benchmarks need to be set to ensure quality control and interoperability of systems. This paper outlines the prevailing status of EHR certification in the US and the EU, compares and contrasts established schemes and poses opportunities for convergence of activity in the domain designed to advance certification endeavours generally. Several EU Member States have in the past proceeded with EHR systems quality labeling and/or certification, but these differ in scope, in legal framework under which they operate, in policies (legislation and financial incentives), in organization, and perhaps most importantly in the quality criteria used for benchmarking. Harmonization, therefore, became a must. Now, through EuroRec (with approaches ranging from self-assessment to third party certification depending on the level of confidence needed) and its Seals, the possibility to achieve this for EHR systems has started in the whole of Europe. The US HITECH Act also attempts to create incentives for all hospitals and eligible providers to adopt and use electronic information. A centerpiece of the Act is to put in place strong financial incentives to adopt and meaningfully use EHRs. The HHS/EHR Certification Programme makes use of ISO/IEC 170XX standards for accreditation, testing and certification. The approved test method addresses the functional and the interoperability requirements defined in the Final Rule criteria and standards. To date six Authorized Testing and Certification Bodies (ATCBs) are testing and certifying products in the US.

The German Central Health Fund-recent developments in health care financing in Germany.

PubMed

Göpffarth, Dirk; Henke, Klaus-Dirk

2013-03-01

In 2009, Germany's Statutory Health Insurance System underwent a major financing reform. A uniform contribution rate set by government was introduced. Sickness funds retain only limited autonomy in charging additional premiums. A dynamic subsidy from general revenue was introduced. The aims of the reform were: (1) intensifying competition, (2) gearing competition towards quality and efficiency, and (3) increasing financial sustainability. This article describes the reform, presents the experiences made, and evaluates whether the policy aims have been met. Experiences have been mixed: on the one hand, the new arrangement showed a high level of flexibility in dealing with the severe recession in 2009. On the other hand, the new system of price differentiation has proven to be dysfunctional. Payments to sickness funds are based on predictions. But predictions have been of limited accuracy, and this has led to an accumulation of liquidity in the system. Price competition has been effectively eliminated. The intended surge in quality and product competition failed to appear, as sickness funds remain concerned mainly with their short term financial outlook. SHI finance has become more linked to the federal budget, leading to a higher level of political interventions. These arrangements will need a new reform - probably after the next general election in autumn 2013. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Behavioural defences in animals against pathogens and parasites: parallels with the pillars of medicine in humans

PubMed Central

Hart, Benjamin L.

2011-01-01

No other theme in animal biology seems to be more central than the concept of employing strategies to survive and successfully reproduce. In nature, controlling or avoiding pathogens and parasites is an essential fitness strategy because of the ever-present disease-causing organisms. The disease-control strategies discussed here are: physical avoidance and removal of pathogens and parasites; quarantine or peripheralization of conspecifics that could be carrying potential pathogens; herbal medicine, animal style, to prevent or treat an infection; potentiation of the immune system; and care of sick or injured group members. These strategies are seen as also encompassing the pillars of human medicine: (i) quarantine; (ii) immune-boosting vaccinations; (iii) use of medicinal products; and (iv) caring or nursing. In contrast to animals, in humans, the disease-control strategies have been consolidated into a consistent and extensive medical system. A hypothesis that explains some of this difference between animals and humans is that humans are sick more often than animals. This increase in sickness in humans leading to an extensive, cognitively driven medical system is attributed to an evolutionary dietary transition from mostly natural vegetation to a meat-based diet, with an increase in health-eroding free radicals and a dietary reduction of free-radical-scavenging antioxidants. PMID:22042917

Preventing Acute Kidney Injury: a qualitative study exploring 'sick day rules' implementation in primary care.

PubMed

Morris, Rebecca L; Ashcroft, Darren; Phipps, Denham; Bower, Peter; O'Donoghue, Donal; Roderick, Paul; Harding, Sarah; Lewington, Andrew; Blakeman, Thomas

2016-07-22

In response to growing demand for urgent care services there is a need to implement more effective strategies in primary care to support patients with complex care needs. Improving primary care management of kidney health through the implementation of 'sick day rules' (i.e. temporary cessation of medicines) to prevent Acute Kidney Injury (AKI) has the potential to address a major patient safety issue and reduce unplanned hospital admissions. The aim of this study is to examine processes that may enable or constrain the implementation of 'sick day rules' for AKI prevention into routine care delivery in primary care. Forty semi-structured interviews were conducted with patients with stage 3 chronic kidney disease and purposefully sampled, general practitioners, practice nurses and community pharmacists who either had, or had not, implemented a 'sick day rule'. Normalisation Process Theory was used as a framework for data collection and analysis. Participants tended to express initial enthusiasm for sick day rules to prevent AKI, which fitted with the delivery of comprehensive care. However, interest tended to diminish with consideration of factors influencing their implementation. These included engagement within and across services; consistency of clinical message; and resources available for implementation. Participants identified that supporting patients with multiple conditions, particularly with chronic heart failure, made tailoring initiatives complex. Implementation of AKI initiatives into routine practice requires appropriate resourcing as well as training support for both patients and clinicians tailored at a local level to support system redesign.

Working ability in relation to disease severity, everyday occupations and well-being in women with limited systemic sclerosis.

PubMed

Sandqvist, G; Scheja, A; Eklund, M

2008-11-01

To investigate how women with SSc and varying degrees of working ability differed regarding disease severity, everyday occupations and well-being. Working ability was operationalized according to the degree of sick leave. Forty-four women of working age with lcSSc were assessed regarding sociodemographic characteristics, disease severity including organ manifestation, perceived physical symptoms, hand function, and satisfaction with everyday occupations, self-rated health and well-being. The subjects formed three groups with regard to reduction in working capacity. Twenty-one women (48%) had no sick leave, 15 women (34%) were on partial sick leave and eight women (18%) were temporarily on full-time sick leave or had a full disability pension. There were no statistically significant differences concerning sociodemographics between the groups. Women without sick leave had less physically demanding jobs (P = 0.026), and the hypothesis that working ability reflects lower disease severity was confirmed regarding dexterity grip force and perceived fatigue and breathlessness (P < 0.05). Greater working ability was associated with better capacity to perform activities of daily life (P < 0.01), greater satisfaction with occupations (P < 0.01), better well-being (P < 0.001) and better health (P < 0.001). Fifty per cent of the women were restricted in their working ability; the lower the working ability, the lower their perceived well-being. This emphasizes the need for further research into the factors that promote working ability and the development of suitable methods to improve working ability.

Cybersickness Following Repeated Exposure to DOME and HMD Virtual Environments

NASA Technical Reports Server (NTRS)

Taylor, Laura C.; Harm, Deborah L.; Kennedy, Robert S.; Reschke, Millard F.; Loftin, R. Bowen

2011-01-01

Virtual environments (VE) offer unique training opportunities, including training astronauts to preadapt them to the novel sensory conditions of microgravity. However, one unresolved issue with VE use is the occurrence of cybersickness during and following exposure to VE systems. Most individuals adapt and become less ill with repeated interaction with VEs. The goal of this investigation was to compare motion sickness symptoms (MSS) produced by dome and head-mounted (HMD) displays and to examine the effects of repeated exposures on MSS. Sixty-one subjects participated in the study. Three experimental sessions were performed each separated by one day. The subjects performed a navigation and pick and place task in either a dome or HMD VE. MSS were measured using a Simulator Sickness Questionnaire before, immediately after, and at 1, 2, 4 and 6 hours following exposure to the VEs. MSS data were normalized by calculating the natural log of each score and an analysis of variance was performed. We observed significant main effects for day and time and a significant day by time interaction for total sickness and for each of the subscales, nausea, oculomotor and disorientation. However, there was no significant main effect for device. In conclusion, subjects reported a large increase in MSS immediately following exposure to both the HMD and dome, followed by a rapid recovery across time. Sickness severity also decreased over days, which suggests that subjects become dual-adapted over time making VE training a viable pre-flight countermeasure for space motion sickness.

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.

Emotional dissonance and sickness absence: a prospective study of employees working with clients.

PubMed

Indregard, Anne-Marthe Rustad; Knardahl, Stein; Nielsen, Morten Birkeland

2017-01-01

(1) Determine the relationship between emotional dissonance and medically certified sickness absence among employees working with clients and (2) compare the impact of emotional dissonance on medically certified sickness absence with the impact of other psychological and social work factors. A sample of 7758 employees was recruited from 96 Norwegian organizations in the period 2004 to 2014, all working with clients. The study design was prospective with emotional dissonance measured at baseline and then linked to official registry data of medically certified sickness absence for the year following the survey assessment. Quantitative demands, decision demands, role clarity, role conflict, control over work intensity, and decision control were included as additional work exposures. The impact of the study variables on the presence and duration of medically certified sickness absence was investigated with a negative binomial hurdle model. In the fully adjusted model, emotional dissonance and role conflict significantly predicted the presence of medically certified sickness absence. Control over work intensity and decision control were negatively related to presence of sickness absence. Only role conflict was a risk factor for the duration of sickness absence when all factors were analysed simultaneously. Emotional dissonance is a risk factor for the presence of medically certified sickness absence in client-driven work environments. Theoretical models of sickness absence, as well as interventions aiming to prevent sickness absence in such environments, should be aware of the effect emotional dissonance may have on employees.

Understanding chain-of-custody certification in the Appalachian hardwood region: Primary manufacturers' practices and perceptions

Treesearch

Iris B. Montague

2011-01-01

Many obstacles may deter hardwood manufacturers from obtaining chain-of-custody certification. Because the hardwood and softwood forest products industries have many differences between them, current certification systems may not fit the unique demographics of the hardwood industry. For this reason, it is important to understand chain-of-custody certification as it...

Forest certification in Bolivia: A status report and analysis of stakeholder perspectives

Treesearch

Omar Espinoza; Michael J. Dockry

2014-01-01

Forest certification systems are voluntary, market-based initiatives to promote the sustainable use of forests. The assumption is that consumers prefer sustainably sourced wood products. One of the major drivers for the creation of forest certification was to prevent deforestation in tropical forests. However, after 20 years of certification, only 10 percent of the...

From Government to Governance? Forest Certification and Crisis Displacement in Ontario, Canada

ERIC Educational Resources Information Center

Hackett, Ryan

2013-01-01

Discussions of forest certification have tended to characterize certification systems as a prime example of the hollowing out of the state and a shift from government to governance. The continued contention that certification is a product of a retreating state has implications for how we understand democratic participation and fails to pay…

The Whys and Hows of Certification. Public Librarian Certification Law.

ERIC Educational Resources Information Center

Wisconsin State Dept. of Public Instruction, Madison. Div. of Library Services.

Under Wisconsin state law (Administrative Code P1-6.03) any librarian employed in a public library system or any municipal public library, except in a city of the first class, supported in whole or in part by public funds, must hold state certification. Qualifications are delineated for three grades of certification: grade 1, for public libraries…

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.

30 CFR 27.7 - Certification plate or label.

Code of Federal Regulations, 2010 CFR

2010-07-01

... APPROVAL OF MINING PRODUCTS METHANE-MONITORING SYSTEMS General Provisions § 27.7 Certification plate or label. A certified methane-monitoring system or component thereof shall be identified with a...

30 CFR 27.7 - Certification plate or label.

Code of Federal Regulations, 2011 CFR

2011-07-01

... APPROVAL OF MINING PRODUCTS METHANE-MONITORING SYSTEMS General Provisions § 27.7 Certification plate or label. A certified methane-monitoring system or component thereof shall be identified with a...

Transdermal scopolamine in the prevention of motion sickness - Evaluation of the time course of efficacy

NASA Technical Reports Server (NTRS)

Homick, J. L.; Reschke, M. F.; Degioanni, J.; Cintron-Trevino, N. M.; Kohl, R. L.

1983-01-01

This study evaluated the time course of efficacy of transdermal scopolamine in the prevention of motion sickness induced by exposure to coriolis stimulation in a rotating chair. We measured levels of efficacy, quantified side effects and symptoms, and determined inter- and intra-subject variability following use of transdermal scopolamine. The response to transdermal scopolamine was highly variable, although overall we recorded a 40 percent improvement in test scores 16-72 h after application of the transdermal system. This variability could not be explained solely by the levels of scopolamine present in the blood. The improvement was not due to the artifactual repression by scopolamine of selected symptoms of motion sickness. An unexpectedly high incidence of side effects was reported. It was concluded that the therapeutic use of transdermal scopolamine be evaluated individually and that individuals be cautioned that subsequent usage may not always be effective.

The scent of disease: human body odor contains an early chemosensory cue of sickness.

PubMed

Olsson, Mats J; Lundström, Johan N; Kimball, Bruce A; Gordon, Amy R; Karshikoff, Bianka; Hosseini, Nishteman; Sorjonen, Kimmo; Olgart Höglund, Caroline; Solares, Carmen; Soop, Anne; Axelsson, John; Lekander, Mats

2014-03-01

Observational studies have suggested that with time, some diseases result in a characteristic odor emanating from different sources on the body of a sick individual. Evolutionarily, however, it would be more advantageous if the innate immune response were detectable by healthy individuals as a first line of defense against infection by various pathogens, to optimize avoidance of contagion. We activated the innate immune system in healthy individuals by injecting them with endotoxin (lipopolysaccharide). Within just a few hours, endotoxin-exposed individuals had a more aversive body odor relative to when they were exposed to a placebo. Moreover, this effect was statistically mediated by the individuals' level of immune activation. This chemosensory detection of the early innate immune response in humans represents the first experimental evidence that disease smells and supports the notion of a "behavioral immune response" that protects healthy individuals from sick ones by altering patterns of interpersonal contact.

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.

[Sick bodies textualized through images: what contemporary intensive care units can teach us].

PubMed

Vargas, Mara Ambrosina de Oliveira; Meyer, Dagmar Estermann

2003-01-01

This paper belongs to a dissertation in which, what we have call "nursing worker cyborgizing" in intensive therapy is discussed. In order to carry out this discussion we based our work on cultural theorizing, as well as on Donna Haraway understanding of cyborg. For the corpses analysis manuals and assistance protocols were used. The methodological approach used in this work is the cultural analysis, as it has been used in the Poststructuralist Cultural Studies, in order to describe and analyze the production of images of sick bodies and its decoding process through a complex monitoring system in which sick bodies, machines and nursing practitioners, connect in different ways and effects. We have concluded that it is useful and relevant to consider and discuss these instances of production and diffusion of meanings attributed to the body, life, and the Nursing care.

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.

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.

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

PubMed

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

2013-05-01

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

Some physiological effects of alternation between zero gravity and one gravity

NASA Technical Reports Server (NTRS)

Graybiel, A.

1977-01-01

The anatomy and physiology of the healthy vestibular system and the history of its study, maintenance of muskuloskeletal fitness under low-gravity conditions, tests of motion sickness, and data and techniques on testing subjects in a slow rotation room, are covered. Components of the inner ear labyrinth and their behavior in relation to equilibrium, gravity and inertial forces, motion sickness, and dizziness are discussed. Preventive medicine, the biologically effective force environment, weightlessness per se, activity in a weightless spacecraft, exercizing required to maintain musculoskeletal function, and ataxia problems are dealt with.

[The effect of vestibuloprotectors on the cyclic nucleotide system in experimental motion sickness].

PubMed

Leshchiniuk, I I; Konovalova, E O; Kvitchataia, A I; Shamraĭ, V G; Bobkov, Iu G

1989-01-01

Changes in the blood plasma cyclic nucleotide (cAMP and cGMP) level under the effect of vestibuloprotectors: bemytil and etoxibemytil were studied in rats with experimental motion sickness. It is established that rotation causes increase in the cAMP level and decrease in the cGMP level. The effect of the vestibuloprotectors is determined by the dose of the drug and is aimed first of all at maintaining a stable cAMP level in vestibular exertion. Under conditions of this experiment etoxibemytil was more effective than bemytil.

48 CFR 1609.471 - Contractor certification.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Contractor certification... EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION ACQUISITION PLANNING CONTRACTOR QUALIFICATIONS Debarment, Suspension, and Ineligibility 1609.471 Contractor certification. All FEHBP carriers and applicant carriers...

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.

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.

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.

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.

30 CFR 27.6 - Certification of components.

Code of Federal Regulations, 2010 CFR

2010-07-01

... APPROVAL OF MINING PRODUCTS METHANE-MONITORING SYSTEMS General Provisions § 27.6 Certification of... intended for use in a certified methane-monitoring system as evidence that further inspection and test of...

28 CFR 20.22 - Certification of compliance.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Local Criminal History Record Information Systems § 20.22 Certification of compliance. (a) Each State to... development of complete and accurate criminal history record information; (4) A description of existing system...

28 CFR 20.22 - Certification of compliance.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Local Criminal History Record Information Systems § 20.22 Certification of compliance. (a) Each State to... development of complete and accurate criminal history record information; (4) A description of existing system...

28 CFR 20.22 - Certification of compliance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Local Criminal History Record Information Systems § 20.22 Certification of compliance. (a) Each State to... development of complete and accurate criminal history record information; (4) A description of existing system...

28 CFR 20.22 - Certification of compliance.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Local Criminal History Record Information Systems § 20.22 Certification of compliance. (a) Each State to... development of complete and accurate criminal history record information; (4) A description of existing system...

28 CFR 20.22 - Certification of compliance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Local Criminal History Record Information Systems § 20.22 Certification of compliance. (a) Each State to... development of complete and accurate criminal history record information; (4) A description of existing system...

30 CFR 27.6 - Certification of components.

Code of Federal Regulations, 2011 CFR

2011-07-01

... APPROVAL OF MINING PRODUCTS METHANE-MONITORING SYSTEMS General Provisions § 27.6 Certification of... intended for use in a certified methane-monitoring system as evidence that further inspection and test of...

77 FR 11520 - Commission Information Collection Activities; Comment Request; Extension

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-27

..., Gas Pipeline Certificates: Annual Reports of System Flow Diagrams and System Capacity. DATES: Comments... Certificates: Annual Reports of System Flow Diagrams and System Capacity. OMB Control No.: 1902-0005. Type of... June 1 of each year, diagrams reflecting operating conditions on the pipeline's main transmission...

48 CFR 301.607-74 - Certification transfers.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Certification transfers. 301.607-74 Section 301.607-74 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES GENERAL HHS ACQUISITION REGULATION SYSTEM Career Development, Contracting Authority, and Responsibilities 301...

Comparing the Certification Criteria for CCHIT-Certified Ambulatory EHR with the SNUBH's EHR Functionalities

PubMed Central

Heo, Eun Young; Hwang, Hee; Kim, Eun Hye; Cho, Eun Young; Lee, Kee Hyuck; Kim, Tae Hun; Kim, Ki Dong; Baek, Rong Min

2012-01-01

Objectives This study aims to investigate the suitability of electronic health record (EHR) systems in Korea for global certification and to propose functions for future global systems by comparing and analyzing the certification criteria for Certification Commission for Health Information Technology (CCHIT) Certified Ambulatory EHR with BESTCare, which is the EHR system at Seoul National University Bundang hospital. Methods Domain expert groups were formed to analyze the inclusion of BESTCare functions and the types of differences for each of the CCHIT Certified 2011 Ambulatory EHR Certification Criteria. The types of differences were divided into differences in functions (F), differences in business processes (B), and differences in government policies (P). Results Generally, the criteria that showed differences in functions pertained to the connection between the diagnosis/problem list and order, the alert and warning functions for medication-diagnosis interactions, and the reminder/instruction/notification messages related to the patient's immunization status; these absent functions were enhanced clinical decision support system (CDSS) functions related to patient safety and healthcare quality. Differences in government policies were found in the pharmacy's electronic prescription functions, while differences in business processes were found in the functions constrained by the local workflow or internal policy, which require some customization. Conclusions Functions that differed between the CCHIT certification criteria and the BESTCare system in this study should be considered when developing a global EHR system. Such a system will need to be easily customizable to adapt to various government policies and local business processes. These functions should be considered when developing a global EHR system certified by CCHIT in the future. PMID:22509474

Towards Certification of a Space System Application of Fault Detection and Isolation

NASA Technical Reports Server (NTRS)

Feather, Martin S.; Markosian, Lawrence Z.

2008-01-01

Advanced fault detection, isolation and recovery (FDIR) software is being investigated at NASA as a means to the improve reliability and availability of its space systems. Certification is a critical step in the acceptance of such software. Its attainment hinges on performing the necessary verification and validation to show that the software will fulfill its requirements in the intended setting. Presented herein is our ongoing work to plan for the certification of a pilot application of advanced FDIR software in a NASA setting. We describe the application, and the key challenges and opportunities it offers for certification.

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.

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

Certification Strategies using Run-Time Safety Assurance for Part 23 Autopilot Systems

NASA Technical Reports Server (NTRS)

Hook, Loyd R.; Clark, Matthew; Sizoo, David; Skoog, Mark A.; Brady, James

2016-01-01

Part 23 aircraft operation, and in particular general aviation, is relatively unsafe when compared to other common forms of vehicle travel. Currently, there exists technologies that could increase safety statistics for these aircraft; however, the high burden and cost of performing the requisite safety critical certification processes for these systems limits their proliferation. For this reason, many entities, including the Federal Aviation Administration, NASA, and the US Air Force, are considering new options for certification for technologies that will improve aircraft safety. Of particular interest, are low cost autopilot systems for general aviation aircraft, as these systems have the potential to positively and significantly affect safety statistics. This paper proposes new systems and techniques, leveraging run-time verification, for the assurance of general aviation autopilot systems, which would be used to supplement the current certification process and provide a viable path for near-term low-cost implementation. In addition, discussions on preliminary experimentation and building the assurance case for a system, based on these principles, is provided.

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.

Effectiveness of guideline-based care by occupational physicians on the return-to-work of workers with common mental disorders: design of a cluster-randomised controlled trial.

PubMed

van Beurden, Karlijn M; Brouwers, Evelien P M; Joosen, Margot C W; Terluin, Berend; van der Klink, Jac J L; van Weeghel, Jaap

2013-03-06

Sickness absence due to common mental disorders (such as depression, anxiety disorder, adjustment disorder) is a problem in many Western countries. Long-term sickness absence leads to substantial societal and financial costs. In workers with common mental disorders, sickness absence costs are much higher than medical costs. In the Netherlands, a practice guideline was developed that promotes an activating approach of the occupational physician to establish faster return-to-work by enhancing the problem-solving capacity of workers, especially in relation to their work environment. Studies on this guideline indicate a promising association between guideline adherence and a shortened sick leave duration, but also minimal adherence to the guideline by occupational physicians. Therefore, this study evaluates the effect of guideline-based care on the full return-to-work of workers who are sick listed due to common mental disorders. This is a two-armed cluster-randomised controlled trial with randomisation at the occupational physician level. During one year, occupational physicians in the intervention group receive innovative training to improve their guideline-based care whereas occupational physicians in the control group provide care as usual. A total of 232 workers, sick listed due to common mental disorders and counselled by participating occupational physicians, will be included. Data are collected via the registration system of the occupational health service, and by questionnaires at baseline and at 3, 6 and 12 months. The primary outcome is time to full return-to-work. Secondary outcomes are partial return-to-work, total number of sick leave days, symptoms, and workability. Personal and work characteristics are the prognostic measures. Additional measures are coping, self-efficacy, remoralization, personal experiences, satisfaction with consultations with the occupational physician and with contact with the supervisor, experiences and behaviour of the supervisor, and the extent of guideline adherence. If the results show that guideline-based care in fact leads to faster and sustainable return-to-work, this study will contribute to lowering personal, societal and financial costs. ISRCTN86605310.

Effectiveness of guideline-based care by occupational physicians on the return-to-work of workers with common mental disorders: design of a cluster-randomised controlled trial

PubMed Central

2013-01-01

Background Sickness absence due to common mental disorders (such as depression, anxiety disorder, adjustment disorder) is a problem in many Western countries. Long-term sickness absence leads to substantial societal and financial costs. In workers with common mental disorders, sickness absence costs are much higher than medical costs. In the Netherlands, a practice guideline was developed that promotes an activating approach of the occupational physician to establish faster return-to-work by enhancing the problem-solving capacity of workers, especially in relation to their work environment. Studies on this guideline indicate a promising association between guideline adherence and a shortened sick leave duration, but also minimal adherence to the guideline by occupational physicians. Therefore, this study evaluates the effect of guideline-based care on the full return-to-work of workers who are sick listed due to common mental disorders. Methods/design This is a two-armed cluster-randomised controlled trial with randomisation at the occupational physician level. During one year, occupational physicians in the intervention group receive innovative training to improve their guideline-based care whereas occupational physicians in the control group provide care as usual. A total of 232 workers, sick listed due to common mental disorders and counselled by participating occupational physicians, will be included. Data are collected via the registration system of the occupational health service, and by questionnaires at baseline and at 3, 6 and 12 months. The primary outcome is time to full return-to-work. Secondary outcomes are partial return-to-work, total number of sick leave days, symptoms, and workability. Personal and work characteristics are the prognostic measures. Additional measures are coping, self-efficacy, remoralization, personal experiences, satisfaction with consultations with the occupational physician and with contact with the supervisor, experiences and behaviour of the supervisor, and the extent of guideline adherence. Discussion If the results show that guideline-based care in fact leads to faster and sustainable return-to-work, this study will contribute to lowering personal, societal and financial costs. Trial registration ISRCTN86605310 PMID:23496948

24 CFR 200.950 - Building product standards and certification program for solar water heating system.

Code of Federal Regulations, 2011 CFR

2011-04-01

... certification program for solar water heating system. 200.950 Section 200.950 Housing and Urban Development... solar water heating system. (a) Applicable standards. (1) All solar water heating systems shall be...) Document OG-300-93, Operating Guidelines and Minimum Standards for Certifying Solar Water Heating Systems...

24 CFR 200.950 - Building product standards and certification program for solar water heating system.

Code of Federal Regulations, 2010 CFR

2010-04-01

... certification program for solar water heating system. 200.950 Section 200.950 Housing and Urban Development... solar water heating system. (a) Applicable standards. (1) All solar water heating systems shall be...) Document OG-300-93, Operating Guidelines and Minimum Standards for Certifying Solar Water Heating Systems...

Certificate Structure Study: Do Stackable Certificates Really "Add" up to a Degree? Research Report 17-2

ERIC Educational Resources Information Center

Washington State Board for Community and Technical Colleges, 2017

2017-01-01

The purpose of this study is to answer key questions about the structure of certificates and their function in employability and degree attainment in the Washington State Community and Technical College (CTC) System. Specifically, this study addresses the following: (1) Do certificates play a role in helping students progress along career pathways…

[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

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.

Human factors certification in the development of future air traffic control systems

NASA Technical Reports Server (NTRS)

Evans, Alyson E.

1994-01-01

If human factors certification of aviation technologies aims to encompass the wide range of issues which need to be addressed for any new system, then human factors involvement must be present throughout the whole design process in a manner which relates to final certification. A certification process cannot simply be applied to the final product of design. Standards and guidelines will be required by designers at the outset of design for reference in preparing for certification. The most effective use of human factors principles, methods, and measures is made as part of an iterative design process, leading to a system which reflects these as far as possible. This particularly applies where the technology is complex and may be represented by a number of components or sub-systems. Some aspects of the system are best certified during early prototyping, when there is still scope to make changes to software or hardware. At this stage in design, financial and/or time pressures will not rule out the possibility of necessary changes, as may be the case later. Other aspects of the system will be best certified during the final phases of design when the system is in a more complete form and in a realistic environment.

46 CFR 176.814 - Steering systems.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 7 2014-10-01 2014-10-01 false Steering systems. 176.814 Section 176.814 Shipping COAST...) INSPECTION AND CERTIFICATION Material Inspections § 176.814 Steering systems. At each initial and subsequent inspection for certification the owner or managing operator shall be prepared to test the steering systems of...

46 CFR 176.814 - Steering systems.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 7 2013-10-01 2013-10-01 false Steering systems. 176.814 Section 176.814 Shipping COAST...) INSPECTION AND CERTIFICATION Material Inspections § 176.814 Steering systems. At each initial and subsequent inspection for certification the owner or managing operator shall be prepared to test the steering systems of...

14 CFR 145.211 - Quality control system.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Quality control system. 145.211 Section 145...) SCHOOLS AND OTHER CERTIFICATED AGENCIES REPAIR STATIONS Operating Rules § 145.211 Quality control system. (a) A certificated repair station must establish and maintain a quality control system acceptable to...

14 CFR 145.211 - Quality control system.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Quality control system. 145.211 Section 145...) SCHOOLS AND OTHER CERTIFICATED AGENCIES REPAIR STATIONS Operating Rules § 145.211 Quality control system. (a) A certificated repair station must establish and maintain a quality control system acceptable to...

46 CFR 176.814 - Steering systems.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Steering systems. 176.814 Section 176.814 Shipping COAST...) INSPECTION AND CERTIFICATION Material Inspections § 176.814 Steering systems. At each initial and subsequent inspection for certification the owner or managing operator shall be prepared to test the steering systems of...

15 CFR 2011.207 - Suspension of the certificate system.

Code of Federal Regulations, 2010 CFR

2010-01-01

... OFFICE OF THE UNITED STATES TRADE REPRESENTATIVE ALLOCATION OF TARIFF-RATE QUOTA ON IMPORTED SUGARS, SYRUPS AND MOLASSES Specialty Sugar § 2011.207 Suspension of the certificate system. (a) Suspension. The...

48 CFR 301.603-74 - Requirement for retention of FAC-C and HHS SAC certification.

Code of Federal Regulations, 2010 CFR

2010-10-01

... System HEALTH AND HUMAN SERVICES GENERAL HHS ACQUISITION REGULATION SYSTEM Career Development... result in a loss of warrant authority. (Note: The certification programs' continuous learning requirement...

15 CFR 2011.207 - Suspension of the certificate system.

Code of Federal Regulations, 2012 CFR

2012-01-01

... OFFICE OF THE UNITED STATES TRADE REPRESENTATIVE ALLOCATION OF TARIFF-RATE QUOTA ON IMPORTED SUGARS, SYRUPS AND MOLASSES Specialty Sugar § 2011.207 Suspension of the certificate system. (a) Suspension. The...

15 CFR 2011.207 - Suspension of the certificate system.

Code of Federal Regulations, 2014 CFR

2014-01-01

... OFFICE OF THE UNITED STATES TRADE REPRESENTATIVE ALLOCATION OF TARIFF-RATE QUOTA ON IMPORTED SUGARS, SYRUPS AND MOLASSES Specialty Sugar § 2011.207 Suspension of the certificate system. (a) Suspension. The...

15 CFR 2011.207 - Suspension of the certificate system.

Code of Federal Regulations, 2013 CFR

2013-01-01

... OFFICE OF THE UNITED STATES TRADE REPRESENTATIVE ALLOCATION OF TARIFF-RATE QUOTA ON IMPORTED SUGARS, SYRUPS AND MOLASSES Specialty Sugar § 2011.207 Suspension of the certificate system. (a) Suspension. The...

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...

Requirements for DGPS-based TSPI system used in aircraft noise certification tests

DOT National Transportation Integrated Search

1997-04-30

This letter report addresses that portion of a noise certification applicants Differential Global Positioning System (DGPS-based), Time Space Position Information (TSPI) system which is to be used as a position reference in place of a laser tracke...

Histaminergic response to Coriolis stimulation: implication for transdermal scopolamine therapy of motion sickness.

PubMed

Wang, E T; Zhou, D R; He, L H

1992-07-01

The blood levels of histamine and 5-hydroxytryptamine (5-HT) in 10 subjects, with or without administration of the transdermal therapeutic system of scopolamine (TTS-S), were measured following motion sickness (MS) induced by Coriolis stimulation. Histamine and 5-HT were assayed using the fluorometric method. The results demonstrated that the blood levels of histamine increased significantly following MS and were even higher in the subjects using TTS-S, but we found neither significant changes in the blood levels of 5-HT following MS nor any effect of TTS-S on it. The results suggest that histamine contributes to the development of MS, and scopolamine may exert its anti-MS action by affecting the histaminergic system as well as the acetylcholinergic system; there may not be a definite relation between 5-HT and the development of MS.

Post landing design and testing of an ACRV model. [Assured Crew Return Vehicles

NASA Technical Reports Server (NTRS)

Hosterman, Kenneth C.; Anderson, Loren A.

1991-01-01

Consideration is given to a 1990-1991 program concentrated on the design, building, and testing of a one-fifth scale model of the egress and stabilization systems for an Apollo Command Module (ACM)-based assured crew return vehicle (ACRV). The program is aimed at determining the feasibility of 1) stabilizing the ACRV out of the range of motions which cause space sickness and 2) the safe and rapid removaling of a sick or injured crewmember from the ACRV. Research have been conducted in the following areas: ACRV model construction, water test facility identification, and stabilization control systems. The fidelity of the model has been established from geometric and dynamic characteristic tests performed on the model.

Video training and certification program improves reliability of postischemic neurologic deficit measurement in the rat.

PubMed

Taninishi, Hideki; Pearlstein, Molly; Sheng, Huaxin; Izutsu, Miwa; Chaparro, Rafael E; Goldstein, Larry B; Warner, David S

2016-12-01

Scoring systems are used to measure behavioral deficits in stroke research. Video-assisted training is used to standardize stroke-related neurologic deficit scoring in humans. We hypothesized that a video-assisted training and certification program can improve inter-rater reliability in assessing neurologic function after middle cerebral artery occlusion in rats. Three expert raters scored neurologic deficits in post-middle cerebral artery occlusion rats using three published systems having different complexity levels (3, 18, or 48 points). The system having the highest point estimate for the correlation between neurologic score and infarct size was selected to create a video-assisted training and certification program. Eight trainee raters completed the video-assisted training and certification program. Inter-rater agreement ( Κ: score) and agreement with expert consensus scores were measured before and after video-assisted training and certification program completion. The 48-point system correlated best with infarct size. Video-assisted training and certification improved agreement with expert consensus scores (pretraining = 65 ± 10, posttraining = 87 ± 14, 112 possible scores, P < 0.0001), median number of trainee raters with scores within ±2 points of the expert consensus score (pretraining = 4, posttraining = 6.5, P < 0.01), categories with Κ:  > 0.4 (pretraining = 4, posttraining = 9), and number of categories with an improvement in the Κ: score from pretraining to posttraining (n = 6). Video-assisted training and certification improved trainee inter-rater reliability and agreement with expert consensus behavioral scores in rats after middle cerebral artery occlusion. Video-assisted training and certification may be useful in multilaboratory preclinical studies. © The Author(s) 2015.