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

PubMed

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

2017-10-01

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

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

PubMed Central

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

2014-01-01

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

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

PubMed

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

2014-02-01

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

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

PubMed

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

2018-03-01

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

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

PubMed

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

2012-11-01

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

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

PubMed

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

2010-12-01

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

Sleeping sickness in Uganda: revisiting current and historical distributions.

PubMed

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

2006-12-01

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

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

PubMed

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

2009-03-01

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

Sleep Duration in Rough Sea Conditions.

PubMed

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

2015-10-01

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

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

PubMed

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

2017-01-01

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

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

PubMed

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

2016-06-01

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

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

PubMed

Zare, Rezvan; Choobineh, Alireza; Keshavarzi, Sareh

2017-09-01

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

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.

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

PubMed

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

2015-01-15

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

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

PubMed Central

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

2014-01-01

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

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

PubMed

MacGregor, Paula; Matthews, Keith R

2010-09-01

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

Sleeping Sickness in the 'Omics Era.

PubMed

Tiberti, Natalia; Sanchez, Jean-Charles

2018-03-08

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

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

PubMed

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

2012-01-01

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

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

PubMed

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

2009-12-01

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

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

PubMed

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

2018-04-17

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

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

PubMed

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

2018-01-01

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

Diagnostic accuracy of PCR in gambiense sleeping sickness diagnosis, staging and post-treatment follow-up: a 2-year longitudinal study.

PubMed

Deborggraeve, Stijn; Lejon, Veerle; Ekangu, Rosine Ali; Mumba Ngoyi, Dieudonné; Pati Pyana, Patient; Ilunga, Médard; Mulunda, Jean Pierre; Büscher, Philippe

2011-02-22

The polymerase chain reaction (PCR) has been proposed for diagnosis, staging and post-treatment follow-up of sleeping sickness but no large-scale clinical evaluations of its diagnostic accuracy have taken place yet. An 18S ribosomal RNA gene targeting PCR was performed on blood and cerebrospinal fluid (CSF) of 360 T. brucei gambiense sleeping sickness patients and on blood of 129 endemic controls from the Democratic Republic of Congo. Sensitivity and specificity (with 95% confidence intervals) of PCR for diagnosis, disease staging and treatment failure over 2 years follow-up post-treatment were determined. Reference standard tests were trypanosome detection for diagnosis and trypanosome detection and/or increased white blood cell concentration in CSF for staging and detection of treatment failure. PCR on blood showed a sensitivity of 88.4% (84.4-92.5%) and a specificity of 99.2% (97.7-100%) for diagnosis, while for disease staging the sensitivity and specificity of PCR on cerebrospinal fluid were 88.4% (84.8-91.9%) and 82.9% (71.2-94.6%), respectively. During follow-up after treatment, PCR on blood had low sensitivity to detect treatment failure. In cerebrospinal fluid, PCR positivity vanished slowly and was observed until the end of the 2 year follow-up in around 20% of successfully treated patients. For T.b. gambiense sleeping sickness diagnosis and staging, PCR performed better than, or similar to, the current parasite detection techniques but it cannot be used for post-treatment follow-up. Continued PCR positivity in one out of five cured patients points to persistence of living or dead parasites or their DNA after successful treatment and may necessitate the revision of some paradigms about the pathophysiology of sleeping sickness.

Antisomnogenic cytokines, quality of life, and chronic rhinosinusitis: a pilot study.

PubMed

Alt, Jeremiah A; Sautter, Nathan B; Mace, Jess C; Detwiller, Kara Y; Smith, Timothy L

2014-04-01

Sleep disturbance, reduced quality of life (QOL), and other components of "sickness behavior" in patients with chronic rhinosinusitis (CRS) are poorly understood. These complex changes in central behavior are due to the effects of immune mediators acting in the brain. We hypothesized that immune mediators that have been associated with CRS are also associated with sickness behavior, somnifacient complaints, and CRS disease-specific QOL. Pilot study. Twenty patients with CRS were prospectively enrolled and completed the Pittsburgh Sleep Quality Index (PSQI), disease-specific QOL, and olfactory instruments. Ethmoid mucosa was obtained and reverse transcription-polymerase chain reaction was performed for the cytokines interleukin (IL)-4, -13, and transforming growth factor-β (TGF-β). Average change in crossover threshold was calculated, and differences in gene expression were correlated with sleep quality, CRS-specific QOL, and disease severity. Patients with CRS reported overall poor sleep quality and poor CRS-specific QOL with significant correlations between them. Increased expression of TGF-β (r = -0.443; P = .050) and IL-4 (r = -0.548; P = .012) correlated with sleep dysfunction, whereas IL-13 expression was linearly associated with worse sleep quality (PSQI scores r = -0.417; P = .075). IL-4 and TGF-β expression was not associated with CRS disease severity or QOL, whereas significantly higher levels of IL-13 expression correlated with worse CRS disease severity and QOL. Patients with CRS exhibited behavioral changes commonly referred to as sickness behavior, which include poor sleep quality and reduced QOL. The upregulation of IL-4 and TGF-β may contribute to inflammatory brain-mediated effects on sleep quality, whereas IL-13 may be a pleiotropic signaling molecule influencing sleep, QOL, and CRS disease severity. 2b. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

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

PubMed

Dobrodenkova, Silvia

2013-09-01

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

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

PubMed

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

2015-06-01

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

Fexinidazole: A New Drug for African Sleeping Sickness on the Horizon.

PubMed

Pollastri, Michael P

2018-03-01

Decades after the last new chemical entity was added to the pharmacopeia for human African trypanosomiasis (or sleeping sickness), orally dosed fexinidazole stands poised to replace the current treatment regimen for Trypanosoma brucei gambiense infections, following a positive Phase 2/3 clinical trial. Copyright © 2017 Elsevier Ltd. All rights reserved.

Does Group-Level Commitment Predict Employee Well-Being?: A Prospective Analysis.

PubMed

Clausen, Thomas; Christensen, Karl Bang; Nielsen, Karina

2015-11-01

To investigate the links between group-level affective organizational commitment (AOC) and individual-level psychological well-being, self-reported sickness absence, and sleep disturbances. A total of 5085 care workers from 301 workgroups in the Danish eldercare services participated in both waves of the study (T1 [2005] and T2 [2006]). The three outcomes were analyzed using linear multilevel regression analysis, multilevel Poisson regression analysis, and multilevel logistic regression analysis, respectively. Group-level AOC (T1) significantly predicted individual-level psychological well-being, self-reported sickness absence, and sleep disturbances (T2). The association between group-level AOC (T1) and psychological well-being (T2) was fully mediated by individual-level AOC (T1), and the associations between group-level AOC (T1) and self-reported sickness absence and sleep disturbances (T2) were partially mediated by individual-level AOC (T1). Group-level AOC is an important predictor of employee well-being in contemporary health care organizations.

A global sensitivity analysis for African sleeping sickness.

PubMed

Davis, Stephen; Aksoy, Serap; Galvani, Alison

2011-04-01

African sleeping sickness is a parasitic disease transmitted through the bites of tsetse flies of the genus Glossina. We constructed mechanistic models for the basic reproduction number, R0, of Trypanosoma brucei gambiense and Trypanosoma brucei rhodesiense, respectively the causative agents of West and East African human sleeping sickness. We present global sensitivity analyses of these models that rank the importance of the biological parameters that may explain variation in R0, using parameter ranges based on literature, field data and expertize out of Uganda. For West African sleeping sickness, our results indicate that the proportion of bloodmeals taken from humans by Glossina fuscipes fuscipes is the most important factor, suggesting that differences in the exposure of humans to tsetse are fundamental to the distribution of T. b. gambiense. The second ranked parameter for T. b. gambiense and the highest ranked for T. b. rhodesiense was the proportion of Glossina refractory to infection. This finding underlines the possible implications of recent work showing that nutritionally stressed tsetse are more susceptible to trypanosome infection, and provides broad support for control strategies in development that are aimed at increasing refractoriness in tsetse flies. We note though that for T. b. rhodesiense the population parameters for tsetse - species composition, survival and abundance - were ranked almost as highly as the proportion refractory, and that the model assumed regular treatment of livestock with trypanocides as an established practice in the areas of Uganda experiencing East African sleeping sickness.

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

PubMed

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

2015-03-01

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

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

PubMed

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

2018-05-09

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

Is there a suburban sleeping sickness in Libreville?

PubMed

Kohagne Tongué, L; Mavoungou, J F; Fako Hendji, G C; Pamba, R; Mbatchi, B

2013-06-01

The transmission of sleeping sickness occurs primarily in rural areas, and exposed populations are those living from rural activities such as agriculture, fishing, animal husbandry or hunting. However, urban and suburban foci are more and more reported in T. b. gambiense areas. In Libreville town, sleeping sickness cases are regularly diagnosed. In order to investigate about the establishment of a transmission cycle of that disease, we have carried out an entomological survey in two quarters in the vicinity of the town. Vavoua traps were set out in all suitable biotopes for tsetse flies during four days and examined twice a day. Flies were collected, identified and dissected. Two species of Glossina were caught: G. palpalis palpalis (90.58%) and G. caliginea (9.42%). A total infection rate of 9.37% was observed after dissection of all non-teneral flies captured. These results suggest the establishment of a trypanosomiasis transmission cycle in the area. No salivary gland was found infected. Given that infected persons are regularly detected, we can think about the existence of a suburban sleeping sickness focus in Libreville. More analysis is needed concerning the identification of human trypanosomes and the origin of Glossina blood meals that may confirm the existence of that focus.

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

PubMed

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

2013-01-01

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

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

PubMed Central

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

2013-01-01

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

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

PubMed

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

2013-01-01

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

[Control of human African trypanosomiasis: back to square one].

PubMed

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

2001-01-01

The natural history of sleeping sickness is cyclic. The first epidemic outbreak in the 19th century devastated the population and resolved spontaneously for lack of victims. Intensive development during the colonial period and the movement of population that it spawned led to another epidemic in the early 1920s that reached such severe proportions that drastic steps had to be taken. At that time, Jamot was given complete political, administrative, and financial freedom to combat the disease. This program led to the development of the mobile team concept and so-called vertically structured vector control strategy and was so successful that sleeping sickness ceased to be considered as a major public health problem at the beginning of the 1960s. In the ensuing years sleeping sickness was largely neglected. Monitoring the disease required specialized teams that were no longer considered as cost-effective. One by one the measures that had been implemented to control the disease disappeared, thus setting the scene for a new outbreak grew. In 1995, the incidence of sleeping sickness reached the same levels as in the 1920s. The current situation is a classic example of a neglected disease with a paucity of competent specialists, diagnostic tests, effective drugs, and operational facilities. It was not until 2001 that new hope appeared thanks to a combined public- and private-sector initiative allowing restructuring of treatment teams, renovation of facilities, free distribution of drugs, and research to develop new therapeutic agents. Also thanks to the PATTEC initiative, the governments of the African affected nations are showing new in interest in sleeping sickness. However the battle is far from won and much effort will be required. Time is running out and the stakes are high.

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

PubMed

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

2005-02-01

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

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

PubMed

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

2016-01-01

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

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

PubMed

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

2015-05-01

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

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

PubMed

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

2011-01-01

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

Three Drug Combinations for Late-Stage Trypanosoma brucei gambiense Sleeping Sickness: A Randomized Clinical Trial in Uganda

PubMed Central

Priotto, Gerardo; Fogg, Carole; Balasegaram, Manica; Erphas, Olema; Louga, Albino; Checchi, Francesco; Ghabri, Salah; Piola, Patrice

2006-01-01

Objectives: Our objective was to compare the efficacy and safety of three drug combinations for the treatment of late-stage human African trypanosomiasis caused by Trypanosoma brucei gambiense. Design: This trial was a randomized, open-label, active control, parallel clinical trial comparing three arms. Setting: The study took place at the Sleeping Sickness Treatment Center run by Médecins Sans Frontières at Omugo, Arua District, Uganda Participants: Stage 2 patients diagnosed in Northern Uganda were screened for inclusion and a total of 54 selected. Interventions: Three drug combinations were given to randomly assigned patients: melarsoprol-nifurtimox (M+N), melarsoprol-eflornithine (M+E), and nifurtimox-eflornithine (N+E). Dosages were uniform: intravenous (IV) melarsoprol 1.8 mg/kg/d, daily for 10 d; IV eflornithine 400 mg/kg/d, every 6 h for 7 d; oral nifurtimox 15 (adults) or 20 (children <15 y) mg/kg/d, every 8 h for 10 d. Patients were followed up for 24 mo. Outcome Measures: Outcomes were cure rates and adverse events attributable to treatment. Results: Randomization was performed on 54 patients before enrollment was suspended due to unacceptable toxicity in one of the three arms. Cure rates obtained with the intention to treat analysis were M+N 44.4%, M+E 78.9%, and N+E 94.1%, and were significantly higher with N+E (p = 0.003) and M+E (p = 0.045) than with M+N. Adverse events were less frequent and less severe with N+E, resulting in fewer treatment interruptions and no fatalities. Four patients died who were taking melarsoprol-nifurtimox and one who was taking melarsoprol-eflornithine. Conclusions: The N+E combination appears to be a promising first-line therapy that may improve treatment of sleeping sickness, although the results from this interrupted study do not permit conclusive interpretations. Larger studies are needed to continue the evaluation of this drug combination in the treatment of T. b. gambiense sleeping sickness. PMID:17160135

Getting Enough Sleep

MedlinePlus

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

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

PubMed

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

2001-01-01

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

Late stage infection in sleeping sickness.

PubMed

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

2012-01-01

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

Comparative analysis of cerebrospinal fluid from the meningo-encephalitic stage of T. b. gambiense and rhodesiense sleeping sickness patients using TMT quantitative proteomics.

PubMed

Tiberti, Natalia; Sanchez, Jean-Charles

2015-09-01

The quantitative proteomics data here reported are part of a research article entitled "Increased acute immune response during the meningo-encephalitic stage of Trypanosoma brucei rhodesiense sleeping sickness compared to Trypanosoma brucei gambiense", published by Tiberti et al., 2015. Transl. Proteomics 6, 1-9. Sleeping sickness (human African trypanosomiasis - HAT) is a deadly neglected tropical disease affecting mainly rural communities in sub-Saharan Africa. This parasitic disease is caused by the Trypanosoma brucei (T. b.) parasite, which is transmitted to the human host through the bite of the tse-tse fly. Two parasite sub-species, T. b. rhodesiense and T. b. gambiense, are responsible for two clinically different and geographically separated forms of sleeping sickness. The objective of the present study was to characterise and compare the cerebrospinal fluid (CSF) proteome of stage 2 (meningo-encephalitic stage) HAT patients suffering from T. b. gambiense or T. b. rhodesiense disease using high-throughput quantitative proteomics and the Tandem Mass Tag (TMT(®)) isobaric labelling. In order to evaluate the CSF proteome in the context of HAT pathophysiology, the protein dataset was then submitted to gene ontology and pathway analysis. Two significantly differentially expressed proteins (C-reactive protein and orosomucoid 1) were further verified on a larger population of patients (n=185) by ELISA, confirming the mass spectrometry results. By showing a predominant involvement of the acute immune response in rhodesiense HAT, the proteomics results obtained in this work will contribute to further understand the mechanisms of pathology occurring in HAT and to propose new biomarkers of potential clinical utility. The mass spectrometry raw data are available in the Pride Archive via ProteomeXchange through the identifier PXD001082.

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

PubMed

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

2010-02-01

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

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

PubMed

Åkerstedt, Torbjorn; Hallvig, David; Kecklund, Göran

2017-10-01

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

Recommendations for control of East african sleeping sickness in Uganda.

PubMed

Kotlyar, Simon

2010-01-01

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

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

PubMed Central

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

2013-01-01

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

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

PubMed

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

2013-01-01

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

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

PubMed

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

2008-02-01

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

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

PubMed

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

2014-06-01

Uganda has active foci of both chronic and acute HAT with the acute zoonotic form of disease classically considered to be restricted to southeast Uganda, while the focus of the chronic form of HAT was confined to the northwest of the country. Acute HAT has however been migrating from its traditional disease focus, spreading rapidly to new districts, a spread linked to movement of infected cattle following restocking. Cattle act as long-term reservoirs of human infective T. b. rhodesiense showing few signs of morbidity, yet posing a significant risk to human health. It is important to understand the relationship between infected cattle and infected individuals so that an appropriate response can be made to the risk posed to the community from animals infected with human pathogens in a village setting. This paper examines the relationship between human T. b. rhodesiense infection and human infective and non-human T. brucei s.l. circulating in cattle at village level in Kaberamaido and Dokolo Districts, Uganda. The study was undertaken in villages that had reported a case of sleeping sickness in the six months prior to sample collection and those villages that had never reported a case of sleeping sickness. The sleeping sickness status of the villages had a significant effect with higher odds of infection in cattle from case than from non-case villages for T. brucei s.l. (OR: 2.94, 95%CI: 1.38-6.24). Cattle age had a significant effect (p<0.001) on the likelihood of T. brucei s.l. infection within cattle: cattle between 18-36 months (OR: 3.51, 95%CI: 1.63-7.51) and cattle over 36 months (OR: 4.20, 95%CI: 2.08-8.67) had significantly higher odds of T. brucei s. l. infection than cattle under 18 months of age. Furthermore, village human sleeping sickness status had a significant effect (p<0.05) on the detection of T. b. rhodesiense in the village cattle herd, with significantly higher likelihood of T. b. rhodesiense in the village cattle of case villages (OR: 25, 95%CI: 1.2-520.71). Overall a higher than average T. brucei s.l. prevalence (>16.3%) in a village herd over was associated with significantly higher likelihood of T. b. rhodesiense being detected in a herd (OR: 25, 95%CI: 1.2-520.71).

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

PubMed

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

2015-05-01

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

How (and why) the immune system makes us sleep

PubMed Central

Imeri, Luca; Opp, Mark R.

2010-01-01

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

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

PubMed

Imeri, Luca; Opp, Mark R

2009-03-01

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

[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.

Sleeping sickness is a circadian disorder.

PubMed

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

2018-01-04

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

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

PubMed

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

2002-12-01

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

Work health determinants in employees without sickness absence.

PubMed

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

2013-01-01

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

Estimating and mapping the population at risk of sleeping sickness.

PubMed

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

2012-01-01

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

The effect of optokinetic stimulation on daytime sleepiness

NASA Technical Reports Server (NTRS)

Leslie, K. R.; Stickgold, R.; Dizio, P.; Lackner, J. R.; Hobson, J. A.

1997-01-01

This study examined the effect of optokinetic stimulation on objective sleepiness, as measured by the Multiple Sleep Latency Test (MSLT). The Nightcap, a portable sleep monitor, was used in a novel way to perform MSLTs, as well as record sleep in the home. Subjects wore the Nightcap for seven consecutive nights. On days 3 and 5 of the protocol, subjects came into the lab for an MSLT. On the experimental day, subjects underwent 10 minutes optokinetic stimulation (OKS), resulting in moderate motion sickness prior to each MSLT trial. Although subjects in the OKS condition reported significantly more drowsiness than controls, this did not result in significantly reduced sleep latencies.

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

PubMed

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

2009-10-01

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

High prevalence of Trypanosoma brucei gambiense group 1 in pigs from the Fontem sleeping sickness focus in Cameroon.

PubMed

Simo, G; Asonganyi, T; Nkinin, S W; Njiokou, F; Herder, S

2006-06-30

To understand the importance of domestic pigs in the epidemiology of human trypanosomiasis, PCR was used to identify trypanosome populations in 133 pigs from the Fontem sleeping sickness focus of Cameroon. The results from this study show that 73.7% (98/133) of pigs from the Fontem area carry at least one trypanosome species. Trypanosoma vivax, T. brucei s.l. and T. congolense forest were found in 34.6% (46/133), 40.0% (53/133) and 46.0% (61/133) of the pigs respectively. T. simiae and T. congolense savannah were not identified in these animals. The use of repeated DNA sequences detected T. b. gambiense group 1 in 14.8% (15/101) of the pigs. Such pigs can be possible reservoir hosts for T. b. gambiense group 1 and contribute to the maintenance of the disease in the area. Mixed infections were revealed in 35.3% (47/133) of the pigs. Furthermore, we observed that under natural conditions, 52.4% (11/21) of the pigs from the Fontem focus carry mixed infections with T. b. gambiense group 1. No significant difference was observed between the percentage of T. b. gambiense group 1 single and mixed infections, and between the prevalence of this trypanosome in pigs from villages with and without sleeping sickness patients.

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

PubMed

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

2015-01-01

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

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

PubMed

Gouteux, J P; Malonga, J R

1985-01-01

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

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

PubMed Central

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

2011-01-01

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

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

PubMed

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

2013-10-01

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

Recombinant antigens expressed in Pichia pastoris for the diagnosis of sleeping sickness caused by Trypanosoma brucei gambiense.

PubMed

Rogé, Stijn; Van Nieuwenhove, Liesbeth; Meul, Magali; Heykers, Annick; Brouwer de Koning, Annette; Bebronne, Nicolas; Guisez, Yves; Büscher, Philippe

2014-07-01

Screening tests for gambiense sleeping sickness, such as the CATT/T. b. gambiense and a recently developed lateral flow tests, are hitherto based on native variant surface glycoproteins (VSGs), namely LiTat 1.3 and LiTat 1.5, purified from highly virulent trypanosome strains grown in rodents. We have expressed SUMO (small ubiquitin-like modifier) fusion proteins of the immunogenic N-terminal part of these antigens in the yeast Pichia pastoris. The secreted recombinant proteins were affinity purified with yields up to 10 mg per liter cell culture. The diagnostic potential of each separate antigen and a mixture of both antigens was confirmed in ELISA on sera from 88 HAT patients and 74 endemic non-HAT controls. Replacement of native antigens in the screening tests for sleeping sickness by recombinant proteins will eliminate both the infection risk for the laboratory staff during antigen production and the need for laboratory animals. Upscaling production of recombinant antigens, e.g. in biofermentors, is straightforward thus leading to improved standardisation of antigen production and reduced production costs, which on their turn will increase the availability and affordability of the diagnostic tests needed for the elimination of gambiense HAT.

Molecular epidemiology of African sleeping sickness.

PubMed

Hide, G; Tait, A

2009-10-01

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

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

PubMed

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

2011-07-18

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

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

PubMed

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

2015-05-01

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

N-Myristoyltransferase inhibitors as new leads to treat sleeping sickness

PubMed Central

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

2010-01-01

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

Assessing Strategies Against Gambiense Sleeping Sickness Through Mathematical Modeling

PubMed Central

Rock, Kat S; Ndeffo-Mbah, Martial L; Castaño, Soledad; Palmer, Cody; Pandey, Abhishek; Atkins, Katherine E; Ndung’u, Joseph M; Hollingsworth, T Déirdre; Galvani, Alison; Bever, Caitlin; Chitnis, Nakul; Keeling, Matt J

2018-01-01

Abstract Background Control of gambiense sleeping sickness relies predominantly on passive and active screening of people, followed by treatment. Methods Mathematical modeling explores the potential of 3 complementary interventions in high- and low-transmission settings. Results Intervention strategies that included vector control are predicted to halt transmission most quickly. Targeted active screening, with better and more focused coverage, and enhanced passive surveillance, with improved access to diagnosis and treatment, are both estimated to avert many new infections but, when used alone, are unlikely to halt transmission before 2030 in high-risk settings. Conclusions There was general model consensus in the ranking of the 3 complementary interventions studied, although with discrepancies between the quantitative predictions due to differing epidemiological assumptions within the models. While these predictions provide generic insights into improving control, the most effective strategy in any situation depends on the specific epidemiology in the region and the associated costs. PMID:29860287

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

PubMed

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

2015-06-01

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

The 2018 Lake Louise Acute Mountain Sickness Score.

PubMed

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

2018-03-01

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

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.

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

NASA Astrophysics Data System (ADS)

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

2008-06-01

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

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

PubMed

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

2012-03-01

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

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

PubMed Central

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

2009-01-01

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

Hypobaric hypoxic cerebral insults: the neurological consequences of going higher.

PubMed

Maa, Edward H

2010-01-01

As increasing numbers of people live, work, and play at high altitudes, awareness of the neurological consequences of hypobaric hypoxic environments becomes paramount. Despite volumes of studies examining the pathophysiology of altitude sickness, the underlying mechanisms of the spectrum of altitude related illnesses is still elusive. High altitude headache, acute mountain sickness, high altitude cerebral edema and other neurological presentations including sleep disturbances and seizures at high altitude are reviewed. As our knowledge advances in the field of altitude physiology, the clinical and research techniques developed may help our understanding of hypoxic brain injury in general.

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

PubMed

Francoeur, Richard B

2015-01-01

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

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

PubMed

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

2016-08-01

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

N-myristoyltransferase inhibitors as new leads to treat sleeping sickness

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

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

2010-11-05

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

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

PubMed

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

2016-04-01

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

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

PubMed

Corbel, Vincent; Henry, Marie-Claire

2011-03-16

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

Sleeping sickness

MedlinePlus

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

African trypanosomiasis.

PubMed

Maudlin, I

2006-12-01

Trypanosomiasis remains one of the most serious constraints to economic development in sub-Saharan Africa and, as a consequence, related research has been subject to strong social and political as well as scientific influences. The epidemics of sleeping sickness that occurred at the turn of the 20th Century focussed research efforts on what became known as 'the colonial disease'. This focus is thought to have produced 'vertical' health services aimed at this one disease, while neglecting other important health issues. Given the scale of these epidemics, and the fact that the disease is fatal if left untreated, it is unsurprising that sleeping sickness dominated colonial medicine. Indeed, recent evidence indicates that, if anything, the colonial authorities greatly under-estimated the mortality attributable to sleeping sickness. Differences in approach to disease control between Francophone and Anglophone Africa, which in the past have been considered ideological, on examination prove to be logical, reflecting the underlying epidemiological divergence of East and West Africa. These epidemiological differences are ancient in origin, pre-dating the colonial period, and continue to the present day. Recent research has produced control solutions, for the African trypanosomiases of humans and livestock, that are effective, affordable and sustainable by small-holder farmers. Whether these simple solutions are allowed to fulfil their promise and become fully integrated into agricultural practice remains to be seen. After more than 100 years of effort, trypanosomiasis control remains a controversial topic, subject to the tides of fashion and politics.

Hypersomnia.

PubMed

Dauvilliers, Yves; Buguet, Alain

2005-01-01

Hypersomnia, a complaint of excessive daytime sleep or sleepiness, affects 4% to 6% of the population, with an impact on the everyday life of the patient Methodological tools to explore sleep and wakefulness (interview, questionnaires, sleep diary, polysomnography, Multiple Sleep Latency Test, Maintenance of Wakefulness Test) and psychomotor tests (for example, psychomotor vigilance task and Oxford Sleep Resistance or Osler Test) help distinguish between the causes of hypersomnia. In this article, the causes of hypersomnia are detailed following the conventional classification of hypersomnic syndromes: narcolepsy, idiopathic hypersomnia, recurrent hypersomnia, insufficient sleep syndrome, medication- and toxin-dependent sleepiness, hypersomnia associated with psychiatric disorders, hypersomnia associated with neurological disorders, posttraumatic hypersomnia, infection (with a special emphasis on the differences between bacterial and viral diseases compared with parasitic diseases, such as sleeping sickness) and hypersomnia, hypersomnia associated with metabolic or endocrine diseases, breathing-related sleep disorders and sleep apnea syndromes, and periodic limb movements in sleep.

Hypersomnia

PubMed Central

Dauvilliers, Yves; Buguet, Alain

2005-01-01

Hypersomnia, a complaint of excessive daytime sleep or sleepiness, affects 4% to 6% of the population, with an impact on the everyday life of the patient Methodological tools to explore sleep and wakefulness (interview, questionnaires, sleep diary, polysomnography Multiple Sleep Latency Test, Maintenance of Wakefulness Test) and psy-chomotor tests (for example, psychomotor vigilance task and Oxford Sleep Resistance or Osier Test) help distinguish between the causes of hypersomnia. In this article, the causes of hypersomnia are detailed following the conventional classification of hypersomnic syndromes: narcolepsy, idiopathic hypersomnia, recurrent hypersomnia, insufficient sleep syndrome, medication- and toxin-dependent sleepiness, hypersomnia associated with psychiatric disorders, hypersomnia associated with neurological disorders, posttraumatic hypersomnia, infection (with a special emphasis on the differences between bacterial and viral diseases compared with parasitic diseases, such as sleeping sickness) and hypersomnia, hypersomnia associated with metabolic or endocrine diseases, breathing-related sleep disorders and sleep apnea syndromes, and periodic limb movements in sleep. PMID:16416710

Development and evaluation of an intervention aiming to reduce fatigue in airline pilots: design of a randomised controlled trial

PubMed Central

2013-01-01

Background A considerable percentage of flight crew reports to be fatigued regularly. This is partly caused by irregular and long working hours and the crossing of time zones. It has been shown that persistent fatigue can lead to health problems, impaired performance during work, and a decreased work-private life balance. It is hypothesized that an intervention consisting of tailored advice regarding exposure to daylight, optimising sleep, physical activity, and nutrition will lead to a reduction of fatigue in airline pilots compared to a control group, which receives a minimal intervention with standard available information. Methods/design The study population will consist of pilots of a large airline company. All pilots who posses a smartphone or tablet, and who are not on sick leave for more than four weeks at the moment of recruitment, will be eligible for participation. In a two-armed randomised controlled trial, participants will be allocated to an intervention group that will receive the tailored advice to optimise exposure to daylight, sleep, physical activity and nutrition, and a control group that will receive standard available information. The intervention will be applied using a smartphone application and a website, and will be tailored on flight- and participant-specific characteristics. The primary outcome of the study is perceived fatigue. Secondary outcomes are need for recovery, duration and quality of sleep, dietary and physical activity behaviours, work-private life balance, general health, and sickness absence. A process evaluation will be conducted as well. Outcomes will be measured at baseline and at three and six months after baseline. Discussion This paper describes the development of an intervention for airline pilots, consisting of tailored advice (on exposure to daylight and sleep-, physical activity, and nutrition) applied into a smartphone application. Further, the paper describes the design of the randomised controlled trial evaluating the effect of the intervention on fatigue, health and sickness absence. If proven effective, the intervention can be applied as a new and practical tool in fatigue management. Results are expected at the end of 2013. Trial registration Netherlands Trial Register: NTR2722 PMID:23971514

Development and evaluation of an intervention aiming to reduce fatigue in airline pilots: design of a randomised controlled trial.

PubMed

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

2013-08-26

A considerable percentage of flight crew reports to be fatigued regularly. This is partly caused by irregular and long working hours and the crossing of time zones. It has been shown that persistent fatigue can lead to health problems, impaired performance during work, and a decreased work-private life balance. It is hypothesized that an intervention consisting of tailored advice regarding exposure to daylight, optimising sleep, physical activity, and nutrition will lead to a reduction of fatigue in airline pilots compared to a control group, which receives a minimal intervention with standard available information. The study population will consist of pilots of a large airline company. All pilots who posses a smartphone or tablet, and who are not on sick leave for more than four weeks at the moment of recruitment, will be eligible for participation.In a two-armed randomised controlled trial, participants will be allocated to an intervention group that will receive the tailored advice to optimise exposure to daylight, sleep, physical activity and nutrition, and a control group that will receive standard available information. The intervention will be applied using a smartphone application and a website, and will be tailored on flight- and participant-specific characteristics. The primary outcome of the study is perceived fatigue. Secondary outcomes are need for recovery, duration and quality of sleep, dietary and physical activity behaviours, work-private life balance, general health, and sickness absence. A process evaluation will be conducted as well. Outcomes will be measured at baseline and at three and six months after baseline. This paper describes the development of an intervention for airline pilots, consisting of tailored advice (on exposure to daylight and sleep-, physical activity, and nutrition) applied into a smartphone application. Further, the paper describes the design of the randomised controlled trial evaluating the effect of the intervention on fatigue, health and sickness absence. If proven effective, the intervention can be applied as a new and practical tool in fatigue management. Results are expected at the end of 2013. Netherlands Trial Register: NTR2722.

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

PubMed

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

2015-10-05

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

Factors associated with sleep quality among operating engineers.

PubMed

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

2013-06-01

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

Factors Associated With Sleep Quality Among Operating Engineers

PubMed Central

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

2016-01-01

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

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

PubMed

2013-10-01

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

Network Analysis Reveals Distinct Clinical Syndromes Underlying Acute Mountain Sickness

PubMed Central

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

2014-01-01

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

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

PubMed

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

2015-04-02

Human African trypanosomiasis or sleeping sickness is a severe, neglected tropical disease caused by the extracellular parasite Trypanosoma brucei. The disease, which leads to chronic neuroinflammation, is characterized by sleep and wake disturbances, documented also in rodent models. In rats and mice infected with Trypanosoma brucei brucei, we here tested the hypothesis that the disease could target neurons of the lateral hypothalamus (LH) containing orexin (OX)-A or melanin-concentrating hormone (MCH), implicated in sleep/wake regulation. In the cerebrospinal fluid of infected rats, the OX-A level was significantly decreased early after parasite neuroinvasion, and returned to the control level at an advanced disease stage. The number of immunohistochemically characterized OX-A and MCH neurons decreased significantly in infected rats during disease progression and in infected mice at an advanced disease stage. A marked reduction of the complexity of dendritic arborizations of OX-A neurons was documented in infected mice. The evaluation of NeuN-immunoreactive neurons did not reveal significant neuronal loss in the LH of infected mice, thus suggesting a potential selective vulnerability of OX-A and MCH neurons. Immunophenotyping and quantitative analysis showed in infected mice marked activation of microglial cells surrounding OX-A neurons. Day/night oscillation of c-Fos baseline expression was used as marker of OX-A neuron activity in mice. In control animals Fos was expressed in a higher proportion of OX-A neurons in the night (activity) phase than in the day (rest) phase. Interestingly, in infected mice the diurnal spontaneous Fos oscillation was reversed, with a proportion of OX-A/Fos neurons significantly higher at daytime than at nighttime. Altogether the findings reveal a progressive decrease of OX-A and MCH neurons and dysregulation of OX-A neuron diurnal activity in rodent models of sleeping sickness. The data point to the involvement of these peptidergic neurons in the pathogenesis of sleep/wake alterations in the disease and to their vulnerability to inflammatory signaling. Copyright © 2015 IBRO. Published by Elsevier Ltd. All rights reserved.

Reducing sound and light exposure to improve sleep on the adult intensive care unit: An inclusive narrative review.

PubMed

Bion, Victoria; Lowe, Alex Sw; Puthucheary, Zudin; Montgomery, Hugh

2018-05-01

Sleep disturbance is common in intensive care units. It is associated with detrimental psychological impacts and has potential to worsen outcome. Irregular exposure to sound and light may disrupt circadian rhythm and cause frequent arousals from sleep. We sought to review the efficacy of environmental interventions to reduce sound and light exposure with the aim of improving patient sleep on adult intensive care units. We searched both PubMed (1966-30 May 2017) and Embase (1974-30 May 2017) for all relevant human (adult) studies and meta-analyses published in English using search terms ((intensive care OR critical care), AND (sleep OR sleep disorders), AND (light OR noise OR sound)). Bibliographies were explored. Articles were included if reporting change in patient sleep in response to an intervention to reduce disruptive intensive care unit sound /light exposure. Fifteen studies were identified. Nine assessed mechanical interventions, four of which used polysomnography to assess sleep. Five studies looked at environmental measures to facilitate sleep and a further two (one already included as assessing a mechanical intervention) studied the use of sound to promote sleep. Most studies found a positive impact of the intervention on sleep. However, few studies used objective sleep assessments, sample sizes were small, methodologies sometimes imperfect and analysis limited. Data are substantially derived from specialist (neurosurgical, post-operative, cardiothoracic and cardiological) centres. Patients were often at the 'less sick' end of the spectrum in a variety of settings (open ward beds or side rooms). Simple measures to reduce intensive care unit patient sound/light exposure appear effective. However, larger and more inclusive high-quality studies are required in order to identify the measures most effective in different patient groups and any impacts on outcome.

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

PubMed

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

2014-08-16

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

Disease and Evolution.

ERIC Educational Resources Information Center

Wells, Calvin

1978-01-01

Discusses disease and genetic disorders as evolutionary mechanisms. Emphasizes the archeological evidence from past human populations and societies, mentioning albinism, scurvy, sleeping sickness, bone conditions, various host-parasite relationships, rickets, sickle-cell anemia, diabetes, and influenza. (CS)

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

PubMed

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

2014-01-01

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

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

PubMed

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

2014-09-01

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

The relationship between lifestyle, occupational health, and work-related factors with presenteeism amongst general practitioners.

PubMed

Pit, Sabrina Winona; Hansen, Vibeke

2016-01-01

There is evidence that general practitioners (GPs) are more likely to exhibit sickness presenteeism than other health professional groups or other high-income earners and less likely to take sick leave. This study aims to examine the relationship between lifestyle, occupational health, and work-related factors with presenteeism amongst GPs. A cross-sectional study was conducted amongst GPs in 2011. Logistic regression was used to determine crude and adjusted odds ratios between lifestyle, occupational health, and work-related factors with presenteeism. Whilst adjusting for age and gender, exercising 1 to 3 times a week (odds ratio [OR] = 4.88), not having a good work-life balance (OR = 4.2), work-related sleep problems (OR = 2.55), moderate psychological distress (OR = 3.94), and poor or fair health (OR = 6.22) were associated with presenteeism. Increased burnout and reduced job satisfaction and workability due to the physical demands of the job were also associated with presenteeism. In conclusion, presenteeism amongst GPs can be addressed by implementing interventions in relation to physical activity, stress reduction, and sleep hygiene and improving work-life balance and the physical demands of the job.

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

PubMed

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

2016-05-01

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

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

NASA Astrophysics Data System (ADS)

Strychacz, Christopher; Viirre, Erik; Wing, Shawn

2005-05-01

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

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.

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

PubMed

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

2015-06-01

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

Efficacy of Directional Cues from a Tactile System for Target Orientation in Helicopter Extractions over Moving Targets

DTIC Science & Technology

2013-01-01

incapacitating simulator sickness, current use of medications that alter sleep/ wake cycles, current acute illness, and significant sleep deprivation...tactile cueing using pager motors were not successful in the aviation environment due to ambient noise and vibration obscuring the tactile stimulus (see...continuous wakefulness ). Each day, each participant performed four, 10-minute stabilized hovering A B 6 maneuvers (at 70 feet above ground level

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

PubMed Central

Taylor, P. J.

1967-01-01

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

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

PubMed

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

2018-05-25

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

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

PubMed Central

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

2009-01-01

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

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

PubMed

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

2012-01-01

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

Agrochemicals against Malaria, Sleeping Sickness, Leishmaniasis and Chagas Disease

PubMed Central

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

2012-01-01

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

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

PubMed

Bardosh, Kevin Louis

2016-01-01

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

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

PubMed

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

2016-09-01

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

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

PubMed Central

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

2016-01-01

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

Xenomonitoring of sleeping sickness transmission in Campo (Cameroon).

PubMed

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

2016-04-12

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

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

PubMed

Bossard, Géraldine; Cuny, Gérard; Geiger, Anne

2013-01-01

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

Sleep patterns at an altitude of 3500 metres

NASA Astrophysics Data System (ADS)

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

1986-06-01

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

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

PubMed

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

2012-05-01

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

Melarsoprol sensitivity profile of Trypanosoma brucei gambiense isolates from cured and relapsed sleeping sickness patients from the Democratic Republic of the Congo.

PubMed

Pyana Pati, Patient; Van Reet, Nick; Mumba Ngoyi, Dieudonné; Ngay Lukusa, Ipos; Karhemere Bin Shamamba, Stomy; Büscher, Philippe

2014-10-01

Sleeping sickness caused by Trypanosoma brucei (T.b.) gambiense constitutes a serious health problem in sub-Sahara Africa. In some foci, alarmingly high relapse rates were observed in patients treated with melarsoprol, which used to be the first line treatment for patients in the neurological disease stage. Particularly problematic was the situation in Mbuji-Mayi, East Kasai Province in the Democratic Republic of the Congo with a 57% relapse rate compared to a 5% relapse rate in Masi-Manimba, Bandundu Province. The present study aimed at investigating the mechanisms underlying the high relapse rate in Mbuji-Mayi using an extended collection of recently isolated T.b. gambiense strains from Mbuji-Mayi and from Masi-Manimba. Forty five T.b. gambiense strains were used. Forty one were isolated from patients that were cured or relapsed after melarsoprol treatment in Mbuji-Mayi. In vivo drug sensitivity tests provide evidence of reduced melarsoprol sensitivity in these strains. This reduced melarsoprol sensitivity was not attributable to mutations in TbAT1. However, in all these strains, irrespective of the patient treatment outcome, the two aquaglyceroporin (AQP) 2 and 3 genes are replaced by chimeric AQP2/3 genes that may be associated with resistance to pentamidine and melarsoprol. The 4 T.b. gambiense strains isolated in Masi-Manimba contain both wild-type AQP2 and a different chimeric AQP2/3. These findings suggest that the reduced in vivo melarsoprol sensitivity of the Mbuji-Mayi strains and the high relapse rates in that sleeping sickness focus are caused by mutations in the AQP2/AQP3 locus and not by mutations in TbAT1. We conclude that mutations in the TbAQP2/3 locus of the local T.b. gambiense strains may explain the high melarsoprol relapse rates in the Mbuji-Mayi focus but other factors must also be involved in the treatment outcome of individual patients.

Motion Sickness Prevention by 8 Hz Stroboscopic Environment during Actual Air Transport

DTIC Science & Technology

2011-09-01

infancy, childhood and adolescence. London: John Libby. Blumenthal, M., Goldberg, A., & Brinkmann, J. 2000. Herbal Medicine: Expanded...Gough, E., Cardenas, R., & Miller, J. C. 2005. Sleep deprivation in humans, immunodepression and glutamine supplementation . University of

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

PubMed

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

2012-09-19

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

Therapeutic effectiveness of medications taken during spaceflight

NASA Technical Reports Server (NTRS)

Pool, Sam L.; Putcha, Lakshmi

1992-01-01

The therapeutic effectiveness of medications during spaceflight is considered in light of extensive anecdotal and experimental evidence. Attention is given to a range of medications for space motion sickness, sleeplessness, and physical discomfort. About 70 individual cases are reviewed in which crewmembers used such medications as: (1) scopolamine hydrobromide, dextroamphetamine sulfate, and promethazine hydrochloride for motion sickness; (2) metoclopramide hydrochloride and naloxone hydrochloride for bowel motility; and (3) aspirin and acetaminophen for headache and back pain. The effectiveness of orally ingested medications for space motion sickness is shown to be very low, while promethazine hydrochloride is effective when administered intramuscularly. The medications for pain are shown to be generally effective, and the use of sleep-inducing medications is limited by potentially detrimental performance effects.

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

NASA Technical Reports Server (NTRS)

Frost, J. D., Jr.

1976-01-01

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

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

PubMed

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

2016-07-01

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

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

PubMed Central

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

2016-01-01

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

Factors associated with self-reported need for treatment of sleeping difficulties: a survey of the general Swedish population.

PubMed

Sandlund, Christina; Westman, Jeanette; Hetta, Jerker

2016-06-01

This study aims to investigate factors associated with the self-reported need for treatment of sleeping difficulties in the general population. This study consisted of a cross-sectional telephone survey of 1550 people randomly selected from the total population of Sweden. The survey, conducted by the Swedish national statistics agency, Statistics Sweden, was completed by 1115 people aged 18-85 years. Participants were asked about sleep patterns, daytime symptoms, physical and mental health disorders, use of prescribed hypnotics, help-seeking behaviors, and sociodemographic characteristics. They were also asked whether they thought they needed treatment for sleeping difficulties. A total of 12.5% of the participants reported a need for treatment because of sleeping difficulties. Significantly more women than men reported such a need (OR 1.46, 95% CI 1.02-2.10). Additionally, in univariate analyses, older age (age 60-69), sick leave, retirement, and unemployment were associated with a self-reported need for treatment, as were several sleep complaints, daytime symptoms, and physical and mental health disorders. A logistic regression model showed that difficulty initiating sleep (OR 6.29, 95% CI 3.67-10.78) was the factor most strongly associated with a self-reported need for treatment for sleeping difficulties. Other important factors were nonrestorative sleep (OR 3.70, 95% CI 2.05-6.69), mental health disorders (OR 3.01, 95% CI 1.59-5.67), and fatigue (OR 2.95, 95% CI 1.53-5.68). There was considerable self-reported need for treatment for sleeping difficulties in the population. Difficulty initiating sleep was the factor most strongly associated with this need, followed by nonrestorative sleep, mental health disorders, and fatigue. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

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

PubMed

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

2009-12-01

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

Effect of Repeated Normobaric Hypoxia Exposures during Sleep on Acute Mountain Sickness, Exercise Performance, and Sleep during Exposure to Terrestrial Altitude

DTIC Science & Technology

2011-01-01

physiological adjustments that compensate for hypoxemia, with augmented ventilation being one of the most important and consistently reported (17, 18, 22, 28... physiological outcomes were affected favorably relative to no treatment utilized HH treatment prior to HH residence (2–4, 18) or NH treatment prior to NH...erythropoietin (EPO; Quantikine IVD ELISA, R & D Systems, Minneapolis, MN), epinephrine and norepinephine (HPLC; Bio-Rad), and cortisol and aldosterone

Occupational health of miners at altitude: adverse health effects, toxic exposures, pre-placement screening, acclimatization, and worker surveillance.

PubMed

Vearrier, David; Greenberg, Michael I

2011-08-01

Mining operations conducted at high altitudes provide health challenges for workers as well as for medical personnel. To review the literature regarding adverse health effects and toxic exposures that may be associated with mining operations conducted at altitude and to discuss pre-placement screening, acclimatization issues, and on-site surveillance strategies. We used the Ovid ( http://ovidsp.tx.ovid.com ) search engine to conduct a MEDLINE search for "coal mining" or "mining" and "altitude sickness" or "altitude" and a second MEDLINE search for "occupational diseases" and "altitude sickness" or "altitude." The search identified 97 articles of which 76 were relevant. In addition, the references of these 76 articles were manually reviewed for relevant articles. CARDIOVASCULAR EFFECTS: High altitude is associated with increased sympathetic tone that may result in elevated blood pressure, particularly in workers with pre-existing hypertension. Workers with a history of coronary artery disease experience ischemia at lower work rates at high altitude, while those with a history of congestive heart failure have decreased exercise tolerance at high altitude as compared to healthy controls and are at higher risk of suffering an exacerbation of their heart failure. PULMONARY EFFECTS: High altitude is associated with various adverse pulmonary effects, including high-altitude pulmonary edema, pulmonary hypertension, subacute mountain sickness, and chronic mountain sickness. Mining at altitude has been reported to accelerate silicosis and other pneumoconioses. Miners with pre-existing pneumoconioses may experience an exacerbation of their condition at altitude. Persons traveling to high altitude have a higher incidence of Cheyne-Stokes respiration while sleeping than do persons native to high altitude. Obesity increases the risk of pulmonary hypertension, acute mountain sickness, and sleep-disordered breathing. NEUROLOGICAL EFFECTS: The most common adverse neurological effect of high altitude is acute mountain sickness, while the most severe adverse neurological effect is high-altitude cerebral edema. Poor sleep quality and sleep-disordered breathing may contribute to daytime sleepiness and impaired cognitive performance that could potentially result in workplace injuries, particularly in miners who are already at increased risk of suffering unintentional workplace injuries. OPHTHALMOLOGICAL EFFECTS: Adverse ophthalmological effects include increased exposure to ultraviolet light and xerophthalmia, which may be further exacerbated by occupational dust exposure. RENAL EFFECTS: High altitude is associated with a protective effect in patients with renal disease, although it is unknown how this would affect miners with a history of chronic renal disease from exposure to silica and other renal toxicants. HEMATOLOGICAL EFFECTS: Advanced age increases the risk of erythrocytosis and chronic mountain sickness in miners. Thrombotic and thromboembolic events are also more common at high altitude. MUSCULOSKELETAL EFFECTS: Miners are at increased risk for low back pain due to occupational factors, and the easy fatigue at altitude has been reported to further predispose workers to this disorder. TOXIC EXPOSURES: Diesel emissions at altitude contain more carbon monoxide due to increased incomplete combustion of fuel. In addition, a given partial pressure of carbon monoxide at altitude will result in a larger percentage of carboxyhemoglobin at altitude. Miners with a diagnosis of chronic obstructive pulmonary disease may be at higher risk for morbidity from exposure to diesel exhaust at altitude. Both mining and work at altitude have independently been associated with a number of adverse health effects, although the combined effect of mining activities and high altitude has not been adequately studied. Careful selection of workers, appropriate acclimatization, and limited on-site surveillance can help control most health risks. Further research is necessary to more completely understand the risks of mining at altitude and delineate what characteristics of potential employees put them at risk for altitude-related morbidity or mortality.

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

PubMed

Rashmi, Mayank; Swati, D

2015-12-01

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

Health correlates of workplace bullying: a 3-wave prospective follow-up study.

PubMed

Bonde, Jens Peter; Gullander, Maria; Hansen, Åse Marie; Grynderup, Matias; Persson, Roger; Hogh, Annie; Willert, Morten Vejs; Kaerlev, Linda; Rugulies, Reiner; Kolstad, Henrik A

2016-01-01

This study aimed to examine the course of workplace bullying and health correlates among Danish employees across a four-year period. In total, 7502 public service and private sector employees participated in a 3-wave study from 2006 through 2011. Workplace bullying over the past 6-12 months and data on health characteristics were obtained by self-reports. We identified major depression using Schedules for Clinical Assessment in Neuropsychiatry interviews and the Major Depression Inventory. We performed cross-sectional and longitudinal analyses of outcomes according to self-labelled bullying at baseline using logistic regression. Reports of bullying were persistent across four years in 22.2% (57/257) of employees who initially reported bullying. Baseline associations between self-labelled bullying and sick-listing, poor self-rated health, poor sleep, and depressive symptoms were significant with adjusted odds ratios (OR) ranging from 1.8 [95% confidence interval (95% CI) 1.5-2.4] for poor sleep quality among those bullied "now and then" to 6.9 (95% CI 3.9-12.3) for depression among those reporting being bullied on a daily to monthly basis. In longitudinal analyses adjusting for bullying during follow-up, all health correlates except poor sleep quality persisted up to four years. Self-reported health correlates of workplace bullying including sick-listing, poor self-rated health, depressive symptoms, and a diagnosis of depression tend to persist for several years regardless of whether bullying is discontinued or not. Independent measures of bullying and outcomes are needed to learn whether these findings reflect long lasting health consequences of workplace bullying or whether self-labelled workplace bullying and health complaints are correlated because of common underlying factors.

75 FR 81625 - Government-Owned Inventions; Availability for Licensing

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-28

... the Treatment of Chagas Disease and African Trypanosomiasis Description of Technology: Parasitic... Trypanosoma brucei rhodesiensi. If left untreated, African sleeping sickness results in death. Chagas disease... America. Untreated, Chagas disease causes decreased life expectancy and can also result in death. The...

Taking the Bite Out of Vector-Borne Diseases

MedlinePlus

... the 'Bite' Out of Vector-Borne Diseases Inside Life Science View All Articles | Inside Life Science Home Page Taking the 'Bite' Out of Vector- ... Science Solving the Sleeping Sickness 'Mystery' This Inside Life Science article also appears on LiveScience . Learn about related ...

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

PubMed

Ashley, Noah T; Walton, James C; Haim, Achikam; Zhang, Ning; Prince, Laura A; Fruchey, Allison M; Lieberman, Rebecca A; Weil, Zachary M; Magalang, Ulysses J; Nelson, Randy J

2013-07-15

Sleep is restorative, whereas reduced sleep leads to negative health outcomes, such as increased susceptibility to disease. Sleep deprivation tends to attenuate inflammatory responses triggered by infection or exposure to endotoxin, such as bacterial lipopolysaccharide (LPS). Previous studies have demonstrated that Siberian hamsters (Phodopus sungorus), photoperiodic rodents, attenuate LPS-induced fever, sickness behavior and upstream pro-inflammatory gene expression when adapted to short day lengths. Here, we tested whether manipulation of photoperiod alters the suppressive effects of sleep deprivation upon cytokine gene expression after LPS challenge. Male Siberian hamsters were adapted to long (16 h:8 h light:dark) or short (8 h:16 h light:dark) photoperiods for >10 weeks, and were deprived of sleep for 24 h using the multiple platform method or remained in their home cage. Hamsters received an intraperitoneal injection of LPS or saline (control) 18 h after starting the protocol, and were killed 6 h later. LPS increased liver and hypothalamic interleukin-1 (IL-1) and tumor necrosis factor-alpha (TNF) gene expression compared with vehicle. Among LPS-challenged hamsters, sleep deprivation reduced IL-1 mRNA levels in liver and hypothalamus, but not TNF. IL-1 attenuation was independent of circulating baseline cortisol, which did not increase after sleep deprivation. Conversely, photoperiod altered baseline cortisol, but not pro-inflammatory gene expression in sleep-deprived hamsters. These results suggest that neither photoperiod nor glucocorticoids influence the suppressive effect of sleep deprivation upon LPS-induced inflammation.

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

PubMed

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

2016-01-01

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

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

PubMed Central

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

2013-01-01

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

High-Altitude Illnesses: Physiology, Risk Factors, Prevention, and Treatment

PubMed Central

Taylor, Andrew T.

2011-01-01

High-altitude illnesses encompass the pulmonary and cerebral syndromes that occur in non-acclimatized individuals after rapid ascent to high altitude. The most common syndrome is acute mountain sickness (AMS) which usually begins within a few hours of ascent and typically consists of headache variably accompanied by loss of appetite, nausea, vomiting, disturbed sleep, fatigue, and dizziness. With millions of travelers journeying to high altitudes every year and sleeping above 2,500 m, acute mountain sickness is a wide-spread clinical condition. Risk factors include home elevation, maximum altitude, sleeping altitude, rate of ascent, latitude, age, gender, physical condition, intensity of exercise, pre-acclimatization, genetic make-up, and pre-existing diseases. At higher altitudes, sleep disturbances may become more profound, mental performance is impaired, and weight loss may occur. If ascent is rapid, acetazolamide can reduce the risk of developing AMS, although a number of high-altitude travelers taking acetazolamide will still develop symptoms. Ibuprofen can be effective for headache. Symptoms can be rapidly relieved by descent, and descent is mandatory, if at all possible, for the management of the potentially fatal syndromes of high-altitude pulmonary and cerebral edema. The purpose of this review is to combine a discussion of specific risk factors, prevention, and treatment options with a summary of the basic physiologic responses to the hypoxia of altitude to provide a context for managing high-altitude illnesses and advising the non-acclimatized high-altitude traveler. PMID:23908794

Trypanosoma brucei parasites occupy and functionally adapt to the adipose tissue in mice

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

Trindade, Sandra; Rijo-Ferreira, Filipa; Carvalho, Tania

Trypanosoma brucei is an extracellular parasite that causes sleeping sickness. In mammalian hosts, trypanosomes are thought to exist in two major niches: early in infection, they populate the blood; later, they breach the blood-brain barrier. Working with a well-established mouse model, we discovered that adipose tissue constitutes a third major reservoir for T. brucei. Parasites from adipose tissue, here termed adipose tissue forms (ATFs), can replicate and were capable of infecting a naive animal. ATFs were transcriptionally distinct from bloodstream forms, and the genes upregulated included putative fatty acid β-oxidation enzymes. Consistent with this, ATFs were able to utilize exogenousmore » myristate and form β-oxidation intermediates, suggesting that ATF parasites can use fatty acids as an external carbon source. Lastly, these findings identify the adipose tissue as a niche for T. brucei during its mammalian life cycle and could potentially explain the weight loss associated with sleeping sickness.« less

New optical, acoustic, and electrical diagnostics for the developing world

NASA Astrophysics Data System (ADS)

Neale, S. L.; Witte, C.; Bourquin, Y.; Kremer, C.; Menachery, A.; Zhang, Y.; Wilson, R.; Reboud, J.; Cooper, J. M.

2012-03-01

Infectious diseases cause 10 million deaths each year worldwide, accounting for ~60% of all deaths of children aged 5- 14. Although these deaths arise primarily through pneumonia, TB, malaria and HIV, there are also the so called "neglected diseases" such as sleeping sickness and bilharzia, which have a devastating impact on rural communities, in sub-Sahara Africa. There, the demands for a successful Developing World diagnostic are particularly rigorous, requiring low cost instrumentation with low power consumption (there is often no fixed power infrastructure). In many cases, the levels of infection within individuals are also sufficiently low that instruments must show extraordinary sensitivity, with measurements being made in blood or saliva. In this talk, a description of these demands will be given, together with a review of some of the solutions that have been developed, which include using acoustics, optics and electrotechnologies, and their combinations to manipulate the fluid samples. In one example, we show how to find a single trypanosome, as the causative agent of sleeping sickness.

Trypanosoma brucei parasites occupy and functionally adapt to the adipose tissue in mice

DOE PAGES

Trindade, Sandra; Rijo-Ferreira, Filipa; Carvalho, Tania; ...

2016-05-26

Trypanosoma brucei is an extracellular parasite that causes sleeping sickness. In mammalian hosts, trypanosomes are thought to exist in two major niches: early in infection, they populate the blood; later, they breach the blood-brain barrier. Working with a well-established mouse model, we discovered that adipose tissue constitutes a third major reservoir for T. brucei. Parasites from adipose tissue, here termed adipose tissue forms (ATFs), can replicate and were capable of infecting a naive animal. ATFs were transcriptionally distinct from bloodstream forms, and the genes upregulated included putative fatty acid β-oxidation enzymes. Consistent with this, ATFs were able to utilize exogenousmore » myristate and form β-oxidation intermediates, suggesting that ATF parasites can use fatty acids as an external carbon source. Lastly, these findings identify the adipose tissue as a niche for T. brucei during its mammalian life cycle and could potentially explain the weight loss associated with sleeping sickness.« less

The Oral Antimalarial Drug Tafenoquine Shows Activity against Trypanosoma brucei

PubMed Central

Carvalho, Luis; Martínez-García, Marta; Pérez-Victoria, Ignacio; Manzano, José Ignacio; Yardley, Vanessa

2015-01-01

The protozoan parasite Trypanosoma brucei causes human African trypanosomiasis, or sleeping sickness, a neglected tropical disease that requires new, safer, and more effective treatments. Repurposing oral drugs could reduce both the time and cost involved in sleeping sickness drug discovery. Tafenoquine (TFQ) is an oral antimalarial drug belonging to the 8-aminoquinoline family which is currently in clinical phase III. We show here that TFQ efficiently kills different T. brucei spp. in the submicromolar concentration range. Our results suggest that TFQ accumulates into acidic compartments and induces a necrotic process involving cell membrane disintegration and loss of cytoplasmic content, leading to parasite death. Cell lysis is preceded by a wide and multitarget drug action, affecting the lysosome, mitochondria, and acidocalcisomes and inducing a depolarization of the mitochondrial membrane potential, elevation of intracellular Ca2+, and production of reactive oxygen species. This is the first report of an 8-aminoquinoline demonstrating significant in vitro activity against T. brucei. PMID:26195527

[The Prince Léopold Institute for Tropical Medicine in Antwerp: an overview].

PubMed

Baetens, Roland

2009-01-01

The struggle against the sleeping sickness in Congo was the major reason for the opening of a School of Tropical Medicine (1906). The edition of new statutes in 1931 at the moment of the transfer to Antwerp conformed the autonomous and neutral character of the Institute. On the other hand, as the person responsible to the community represented by the Ministery of Colonies and--later--the Ministery of Education, she had to publish an annual report on their activities and finances.After the independence of the colony (1960) the teaching and research policy accentuated development aid, and in particular the fight against tropical disease (malaria, sleeping sickness, leishmaniasis...) and HIV (AIDS and Tuberculosis). The Institute delivers postgraduate and master's degrees. Each year, two hundred doctors and nurses attend its classes, and around a hundred students from over the world prepare for their medical degree. The Institute of Tropical Medicine in Antwerp is a'center of excellence' and an important component in an international network that aims for 'Health for all'.

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

PubMed

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

2010-01-14

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

Clinical features, diagnosis, and treatment of human African trypanosomiasis (sleeping sickness).

PubMed

Kennedy, Peter Ge

2013-02-01

Human African trypanosomiasis, or sleeping sickness, is caused by infection with parasites of the genus Trypanosoma, transmitted by the tsetse fly. The disease has two forms, Trypanosoma brucei (T b) rhodesiense and T b gambiense; and is almost always fatal if untreated. Despite a recent reduction in the number of reported cases, patients with African trypanosomiasis continue to present major challenges to clinicians. Because treatment for CNS-stage disease can be very toxic, diagnostic staging to distinguish early-stage from late-stage disease when the CNS in invaded is crucial but remains problematic. Melarsoprol is the only available treatment for late-stage T b rhodesiense infection, but can be lethal to 5% of patients owing to post-treatment reactive encephalopathy. Eflornithine combined with nifurtimox is the first-line treatment for late-stage T b gambiense. New drugs are in the pipeline for treatment of CNS human African trypanosomiasis, giving rise to cautious optimism. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

PubMed

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

2016-09-08

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

The Oral Antimalarial Drug Tafenoquine Shows Activity against Trypanosoma brucei.

PubMed

Carvalho, Luis; Martínez-García, Marta; Pérez-Victoria, Ignacio; Manzano, José Ignacio; Yardley, Vanessa; Gamarro, Francisco; Pérez-Victoria, José M

2015-10-01

The protozoan parasite Trypanosoma brucei causes human African trypanosomiasis, or sleeping sickness, a neglected tropical disease that requires new, safer, and more effective treatments. Repurposing oral drugs could reduce both the time and cost involved in sleeping sickness drug discovery. Tafenoquine (TFQ) is an oral antimalarial drug belonging to the 8-aminoquinoline family which is currently in clinical phase III. We show here that TFQ efficiently kills different T. brucei spp. in the submicromolar concentration range. Our results suggest that TFQ accumulates into acidic compartments and induces a necrotic process involving cell membrane disintegration and loss of cytoplasmic content, leading to parasite death. Cell lysis is preceded by a wide and multitarget drug action, affecting the lysosome, mitochondria, and acidocalcisomes and inducing a depolarization of the mitochondrial membrane potential, elevation of intracellular Ca(2+), and production of reactive oxygen species. This is the first report of an 8-aminoquinoline demonstrating significant in vitro activity against T. brucei. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

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

PubMed

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

2014-04-01

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

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

PubMed

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

2011-02-01

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

The Impact of Cultural Behaviours, Local Beliefs, and Practices on Emerging Parasitic Diseases in Tropical Africa

ERIC Educational Resources Information Center

Onwuliri, Celestine O. E.; Anosike, Jude C.; Oguoma, Chibuzor; Onwuliri, Viola A.; Nwoke, Betram E. B.; Dozie, Ikechukwu, N. S.; Iwuala, Moses O. E.

2005-01-01

The scourge of emerging parasitic diseases (e.g., urinary schistosomiasis, ascariasis, malaria, chagas disease, leishmaniasis, trachoma, trichiuriasis, taeniasis, dracunculiasis, sleeping sickness, filariasis) causes tremendous pain, suffering, and eventually death in tropical African communities. Patterns of transmission of these emerging…

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

PubMed

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

2016-01-01

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

The MMPI-2 Symptom Validity Scale (FBS) not influenced by medical impairment: a large sleep center investigation.

PubMed

Greiffenstein, Manfred F

2010-06-01

The Symptom Validity Scale (Minnesota Multiphasic Personality Inventory-2-FBS [MMPI-2-FBS]) is a standard MMPI-2 validity scale measuring overstatement of somatic distress and subjective disability. Some critics assert the MMPI-2-FBS misclassifies too many medically impaired persons as malingering symptoms. This study tests the assertion of malingering misclassification with a large sample of 345 medical inpatients undergoing sleep studies that standardly included MMPI-2 testing. The variables included standard MMPI-2 validity scales (Lie Scale [L], Infrequency Scale [F], K-Correction [K]; FBS), objective medical data (e.g., body mass index, pulse oximetry), and polysomnographic scores (e.g., apnea/hypopnea index). The results showed the FBS had no substantial or unique association with medical/sleep variables, produced false positive rates <20% (median = 9, range = 4-11), and male inpatients showed marginally higher failure rates than females. The MMPI-2-FBS appears to have acceptable specificity, because it did not misclassify as biased responders those medical patients with sleep problems, male or female, with primary gain only (reducing sickness). Medical impairment does not appear to be a major influence on deviant MMPI-2-FBS scores.

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

PubMed Central

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

2005-01-01

Background Trypanosomosis is a major impediment to livestock farming in sub-Saharan Africa and limits the full potential of agricultural development in the 36 countries where it is endemic. In man, sleeping sickness is fatal if untreated and causes severe morbidity. This study was undertaken in western Kenya, an area that is endemic for both human and livestock trypanosomosis. While trypanosomosis in livestock is present at high levels of endemicity, sleeping sickness occurs at low levels over long periods, interspersed with epidemics, underscoring the complexity of the disease epidemiology. In this study, we sought to investigate the prevalence of trypanosomes in small ruminants and pigs, and the potential of these livestock as reservoirs of potentially human-infective trypanosomes. The study was undertaken in 5 villages, to address two key questions: i) are small ruminants and pigs important in the transmission dynamics of trypanosomosis? and ii), do they harbour potentially human infective trypanosomes? Answers to these questions are important in developing strategies for the control of both livestock and human trypanosomosis. Results Eighty-six animals, representing 21.3% of the 402 sampled in the 5 villages, were detected as positive by PCR using a panel of primers that identify trypanosomes to the level of the species and sub-species. These were categorised as 23 (5.7%) infections of T. vivax, 22 (5.5%) of T. simiae, 21 (5.2%) of the T. congolense clade and 20 (5.0%) of T. brucei ssp. The sheep was more susceptible to trypanosome infection as compared to goats and pigs. The 20 T. brucei positive samples were evaluated by PCR for the presence of the Serum Resistance Associated (SRA) gene, which has been linked to human infectivity in T. b. rhodesiense. Three samples (one pig, one sheep and one goat) were found to have the SRA gene. These results suggest that sheep, goats and pigs, which are kept alongside cattle, may harbour human-infective trypanosomes. Conclusion We conclude that all livestock kept in this T. b. rhodesiense endemic area acquire natural infections of trypanosomes, and are therefore important in the transmission cycle. Sheep, goats and pigs harbour trypanosomes that are potentially infective to man. Hence, the control of trypanosomosis in these livestock is essential to the success of any strategy to control the disease in man and livestock. PMID:16018802

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

PubMed

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

2009-12-15

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

Performance of parasitological and molecular techniques for the diagnosis and surveillance of gambiense sleeping sickness.

PubMed

Mumba Ngoyi, Dieudonné; Ali Ekangu, Rosine; Mumvemba Kodi, Marie France; Pyana, Patient Pati; Balharbi, Fatima; Decq, Mélanie; Kande Betu, Victor; Van der Veken, Wim; Sese, Claude; Menten, Joris; Büscher, Philippe; Lejon, Veerle

2014-06-01

Recently, improvements have been made to diagnostics for gambiense sleeping sickness control but their performance remains poorly documented and may depend on specimen processing prior to examination. In a prospective study in the Democratic Republic of the Congo, we compared the diagnostic performance of several parasite detection techniques, immune trypanolysis and of m18S PCR on whole blood stored in a stabilisation buffer or dried on filter paper. Individuals with CATT whole blood (WB) titer ≥1∶4 or with clinical signs indicative for sleeping sickness were examined for presence of trypanosomes in lymph node aspirate (LNA) and/or in blood. Blood was examined with Capillary Centrifugation Technique (CTC), mini-Anion Exchange Centrifugation Technique (mAECT) and mAECT on buffy coat (BC). PCR was performed on whole blood (i) stored in guanidine hydrochloride EDTA (GE) stabilisation buffer and (ii) dried on filter paper, and repeatability and reproducibility were assessed. Immune trypanolysis (TL) was performed on plasma. A total of 237 persons were included. Among 143 parasitologically confirmed cases, 85.3% had a CATT-WB titre of ≥1/8, 39.2% were positive in LNA, 47.5% in CTC, 80.4% in mAECT-WB, 90.9% in mAECT-BC, 95.1% in TL and up to 89.5% in PCR on GE-stabilised blood. PCR on GE-stabilised blood showed highest repeatability (87.8%) and inter-laboratory reproducibility (86.9%). Of the 94 non-confirmed suspects, respectively 39.4% and 23.4% were TL or PCR positive. Suboptimal specificity of PCR and TL was also suggested by latent class analysis. The combination of LNA examination with mAECT-BC offered excellent diagnostic sensitivity. For PCR, storage of blood in stabilisation buffer is to be preferred over filter paper. TL as well as PCR are useful for remote diagnosis but are not more sensitive than mAECT-BC. For TL and PCR, the specificity, and thus usefulness for management of non-confirmed suspects remain to be determined.

Performance of Parasitological and Molecular Techniques for the Diagnosis and Surveillance of Gambiense Sleeping Sickness

PubMed Central

Mumba Ngoyi, Dieudonné; Ali Ekangu, Rosine; Mumvemba Kodi, Marie France; Pyana, Patient Pati; Balharbi, Fatima; Decq, Mélanie; Kande Betu, Victor; Van der Veken, Wim; Sese, Claude; Menten, Joris; Büscher, Philippe; Lejon, Veerle

2014-01-01

Objectives Recently, improvements have been made to diagnostics for gambiense sleeping sickness control but their performance remains poorly documented and may depend on specimen processing prior to examination. In a prospective study in the Democratic Republic of the Congo, we compared the diagnostic performance of several parasite detection techniques, immune trypanolysis and of m18S PCR on whole blood stored in a stabilisation buffer or dried on filter paper. Methods Individuals with CATT whole blood (WB) titer ≥1∶4 or with clinical signs indicative for sleeping sickness were examined for presence of trypanosomes in lymph node aspirate (LNA) and/or in blood. Blood was examined with Capillary Centrifugation Technique (CTC), mini-Anion Exchange Centrifugation Technique (mAECT) and mAECT on buffy coat (BC). PCR was performed on whole blood (i) stored in guanidine hydrochloride EDTA (GE) stabilisation buffer and (ii) dried on filter paper, and repeatability and reproducibility were assessed. Immune trypanolysis (TL) was performed on plasma. Results A total of 237 persons were included. Among 143 parasitologically confirmed cases, 85.3% had a CATT-WB titre of ≥1/8, 39.2% were positive in LNA, 47.5% in CTC, 80.4% in mAECT-WB, 90.9% in mAECT-BC, 95.1% in TL and up to 89.5% in PCR on GE-stabilised blood. PCR on GE-stabilised blood showed highest repeatability (87.8%) and inter-laboratory reproducibility (86.9%). Of the 94 non-confirmed suspects, respectively 39.4% and 23.4% were TL or PCR positive. Suboptimal specificity of PCR and TL was also suggested by latent class analysis. Conclusion The combination of LNA examination with mAECT-BC offered excellent diagnostic sensitivity. For PCR, storage of blood in stabilisation buffer is to be preferred over filter paper. TL as well as PCR are useful for remote diagnosis but are not more sensitive than mAECT-BC. For TL and PCR, the specificity, and thus usefulness for management of non-confirmed suspects remain to be determined. PMID:24921941

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

PubMed

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

2013-07-10

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

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

PubMed

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

2017-01-17

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

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

PubMed Central

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

2016-01-01

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

[History of the public health policy in Chad 1900-1995].

PubMed

Massenet, D

1996-01-01

Public health policy in Chad began after colonization in 1899 and remained under the control of French Army Medical Corps for a long time. Military doctors shared their time between treating service personnel and indigenous people entitled Medical Assistance and making rounds in their sector. Since independence public health in the country has been based on a two-pronged association including fixed facilities (hospitals and dispensaries) and mobile services such as the Endemic Disease Unit whose most notable success was control of sleeping sickness in the southern part of the country. Over the years Chad has built up a national medical staff comprising 150 physicians. A medical school was opened in N'Djamena in 1990 and paramedical personnel are now trained at the National School for Public Health. War and lack of funds interrupted mobile services and there is presently a recrudescence of sleeping sickness. Since 1990 the World Health Organization has imposed its views and primary care is now available for all. However, it is now too early to judge the efficacity of this program in Chad.

Paratransgenesis applied for control of tsetse transmitted sleeping sickness.

PubMed

Aksoy, Serap; Weiss, Brian; Attardo, Geoffrey

2008-01-01

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

Exciting discoveries on the health effects of family violence: where we are, where we need to go.

PubMed

Kendall-Tackett, Kathleen

2005-02-01

In the 20 years since the founding of the Journal of Interpersonal Violence, there have been exciting new discoveries on the long-term physical health effects of family violence. As exciting as these discoveries have been, we still know little about why the experience of family violence makes people sick. Some of the most promising areas of study on this topic will be in neuroscience, sleep studies, and cognitive variables such as hostility. Once we understand mechanisms, we can design interventions that can ameliorate these effects.

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

PubMed

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

2009-08-01

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

[Effect of 2000 m descent simulated in a hyperbaric chamber on arterial blood oxygen saturation and sleep quality in workers of a gold mine situated at an altitude of 3800-4200 m above sea level].

PubMed

Przybyłowski, Tadeusz; Ashirbaev, Aibek; Le Roux, Johannes; Zieliński, Jan

2003-01-01

Acute mountain sickness can become life threatening to people traveling at high altitude. Simulated descent with a hyperbaric chamber is a widely accepted way to treat this condition. The aim of this study was to analyze the influence of simulated descent to 2000 m on arterial oxygen saturation (SaO2), periodic breathing and sleep quality in a group of workers of a gold mine situated at 3800 m. Sleep studies were performed twice in stationary hyperbaric chamber with a portable system--MESAM IV in 20 workers. During the first study the chamber was not pressurized and on the second night the barometric pressure was set to mimic descent to 2000 m. During second study, a significant decrease in ODI (Oxygen Desaturation Index), from 9.7 +/- 6/h to 1.8 +/- 3.4/h (p < 0.0001), was noticed; mean SaO2 increased from 84.3 +/- 3.2% do 92.7 +/- 2.8% (p < 0.0001), significant changes in percentage of study time in individual SaO2 ranges were also noticed. The number (12.7 +/- 8.4 vs. 7.5 +/- 5; p < 0.05) and index of changes in body position were decreased (2.0 +/- 1.5 vs. 1.2 +/- 0.9/h; p < 0.05) as well. Simulated descent to 2000 m causes a decrease in number of desaturations, improvement in mean SaO2 during sleep, decrease in heart rate and these data suggest a decrease in periodic breathing during sleep. A decrease in number and index of body position changes suggests improved sleep quality.

Clinical outcomes among febrile children aged 2 to 59 months with negative malaria rapid diagnostic test results in Mchinji District, Malawi.

PubMed

Mwandama, Dyson; Mwale, Chawanangwa; Bauleni, Andrew; Phiri, Themba; Chisaka, Joseph; Nsona, Humphreys; Mathanga, Don P

2016-12-01

Malawi malaria treatment guidelines recommend a definitive diagnosis, using a malaria rapid diagnostic test (mRDT), for all patients with fever or history of fever. Improving the management and outcomes of febrile children with negative mRDT results should be a priority. Through a prospective cohort study designed to investigate clinical outcomes of children treated at the community level, we followed, for 7 days, children aged 2 to 59 months, who had negative mRDT results and were treated with antipyretic medication. Clinical outcomes were assessed on days 3 and 7 post-recruitment. The median age of recruited children was 19 months. Of the 285 children enrolled, 139 (48.8%) were females. Of the children for whom data were available for analysis, 95/236 (40.3%) had fever (temperature ≥ 37.5°C) at enrolment, and almost half of the sick children (125/268; 46.6%) had symptoms of upper respiratory tract infection. Most sick children (89.6%; 95% confidence interval, CI = 84.2 to 93.3) recovered, while 10.4% (95% CI: 6.7 to 15.8) were still sick by day 7 of follow-up. There were no deaths reported during the 7 days of follow-up. Being afebrile at enrolment (odds ratio, OR = 2.5; 95% CI = 1.1 to 6.0; P = 0.027) and sleeping under an insecticide-treated net (ITN) (OR = 2.7; 95% CI = 1.2 to 6.2; P = 0.011) were associated with recovery by day 7. In multivariable analysis, sleeping under an ITN the previous night was the only factor associated with recovery by day 7. Microscopy did not detect any malaria parasites in the blood of recruited children, at recruitment or on day 7. In this community-level study, the majority of febrile children with negative mRDT results recovered within 7 days of health worker consultation for a febrile illness, having only taken antipyretics.

Inhaled budesonide and oral dexamethasone prevent acute mountain sickness.

PubMed

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

2014-10-01

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

Perceived stress, disturbed sleep, and cognitive impairments in patients with work-related stress complaints: a longitudinal study.

PubMed

Eskildsen, Anita; Fentz, Hanne Nørr; Andersen, Lars Peter; Pedersen, Anders Degn; Kristensen, Simon Bang; Andersen, Johan Hviid

2017-07-01

Patients on sick leave due to work-related stress often present with cognitive impairments as well as sleep disturbances. The aim of this longitudinal study was to examine the role of perceived stress and sleep disturbances in the longitudinal development in cognitive impairments in a group of patients with prolonged work-related stress (N = 60) during a period of 12 months following initial professional care-seeking. Objective cognitive impairments (neuropsychological tests) were measured on two occasions - at initial professional care-seeking and at 12-month follow-up. Questionnaires on perceived stress, sleep disturbances, and cognitive complaints were completed seven times during the 12 months which facilitated multilevel analysis with segregation of within-person (change) and between-person (baseline level) components of the time-varying predictors (perceived stress and sleep disturbances). Change in perceived stress was associated with concurrent and subsequent change in self-reported cognitive complaints over the period of 12 months and to a lesser extent the change in performance on neuropsychological tests of processing speed from baseline to 12-month follow-up. Change in sleep disturbances was also associated with concurrent and subsequent change in self-reported cognitive complaints over the 12 months but not with change on neuropsychological test performance. Although the mechanism behind the improvement in cognitive impairments in patients with work-related stress should be further explored in future studies, the results could suggest that improvement in cognitive impairments is partly mediated by decreasing levels of perceived stress and, to a lesser extent, decreasing levels of sleep disturbances. Lay summary This study examines the role of perceived stress and sleep disturbances in respect to the development of cognitive impairments (e.g. memory and concentration) in a group of patients with work-related stress. We found that change in cognitive impairments seems to be partly explained by change in perceived stress and, to a lesser extent, sleep disturbances over time. This could suggest that cognitive impairments can be reduced by stress management interventions which aim to reduce perceived stress and sleep disturbances but future studies are needed to confirm this interpretation.

Systematic review: Factors associated with return to work in burnout.

PubMed

Kärkkäinen, R; Saaranen, T; Hiltunen, S; Ryynänen, O P; Räsänen, K

2017-08-01

Professional burnout predicts sick leave and even permanent withdrawal from the labour force. However, knowledge of the barriers to and facilitators of return to work (RTW) in such burnout is limited. To identify factors associated with RTW of burned-out individuals to inform occupational health care (OHC) RTW policy. A systematic search of peer-reviewed quantitative and mixed-method studies published from January 2005 to July 2016 in English and Finnish in ARTO, CINAHL (EBSCO), Medic, PsycINFO (ProQuest), PubMed, Scopus and Web of Science databases, followed by a manual search. We included studies that identify burnout with valid burnout measures and measure the degree of RTW or sick leave as outcomes. We excluded studies with heterogeneous samples without subgroup analyses of RTW in burnout cases. We included 10 studies (three experimental and seven observational) of the initial 1345 identified. The studies reported work-related factors; enhanced communication (positive association) and low control at work (negative association) and individual-related factors; male gender (positive association), covert coping (negative association), high over-commitment to work (positive association) and burnout-related factors; unimpaired sleep (positive association), duration of sick leave over 6 months (negative association) and part-time sick leave (positive association) associated with RTW in burnout. Associations between burnout rehabilitation and RTW, and the level of symptoms and cognitive impairment and RTW remained unclear. Few quantitative studies, of varied methodological quality, explore factors associated with RTW in burnout. Further research is needed to build an evidence base and develop guidelines for supportive OHC actions. © 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

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

PubMed Central

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

2012-01-01

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

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

PubMed

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

2016-12-01

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

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

PubMed Central

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

2016-01-01

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

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

PubMed

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

2013-01-01

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

Human African Trypanosomiasis Transmission, Kinshasa, Democratic Republic of Congo

PubMed Central

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

2006-01-01

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

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

PubMed Central

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

2012-01-01

Study objectives: Susceptible subjects ascending rapidly to high altitude develop pulmonary edema (HAPE). We evaluated whether HAPE leads to sleep and breathing disturbances that are alleviated by dexamethasone. Design: Double-blind, randomized, placebo-controlled trial with open-label extension. Setting: One night in sleep laboratory at 490 m, 2 nights in mountain hut at 4,559 m. Participants: 21 HAPE susceptibles. Intervention: Dexamethasone 2 × 8 mg/d, either 24 h prior to ascent and at 4,559 m (dex-early), or started on day 2 at 4,559 m only (dex-late). Measurements: Polysomnography, questionnaires on sleep and acute mountain sickness. Results: Polysomnographies at 490 m were normal. In dex-late (n = 12) at 4,559 m, night 1 and 3, median oxygen saturation was 71% and 80%, apnea/hypopnea index 91.3/h and 9.6/h. In dex-early (n = 9), corresponding values were 78% and 79%, and 85.3/h and 52.3/h (P < 0.05 vs. 490 m, all instances). In dex-late, ascending from 490 m to 4,559 m (night 1), sleep efficiency decreased from 91% to 65%, slow wave sleep from 20% to 8% (P < 0.05, both instances). In dex-early, corresponding sleep efficiencies were 96% and 95%, slow wave sleep 18% and 9% (P < 0.05). From night 1 to 3, sleep efficiency remained unchanged in both groups while slow wave sleep increased to 20% in dex-late (P < 0.01). Compared to dex-early, initial AMS scores in dex-late were higher but improved during stay at altitude. Conclusions: HAPE susceptibles ascending rapidly to high altitude experience pronounced nocturnal hypoxemia, and reduced sleep efficiency and deep sleep. Dexamethasone taken before ascent prevents severe hypoxemia and sleep disturbances, while dexamethasone taken 24 h after arrival at 4,559 m increases oxygenation and deep sleep. Citation: Nussbaumer-Ochsner Y; Schuepfer N; Ursprung J; Siebenmann C; Maggiorini M; Bloch KE. Sleep and breathing in high altitude pulmonary edema susceptible subjects at 4,559 meters. SLEEP 2012;35(10):1413-1421. PMID:23024440

A probabilistic analysis of the crystal oscillator behavior at low drive levels

NASA Astrophysics Data System (ADS)

Shmaliy, Yuriy S.; Brendel, Rémi

2008-03-01

The paper discusses a probabilistic model of a crystal oscillator at low drive levels where the noise intensity is comparable with the oscillation amplitude. The stationary probability density of the oscillations envelope is derived and investigated for the nonlinear resonator loses. A stochastic explanation is given for the well-known phenomenon termed sleeping sickness associated with losing a facility of self-excitation by a crystal oscillator after a long storage without a power supply. It is shown that, with low drive levels leading to an insufficient feedback, a crystal oscillator generates the noise-induced oscillations rather than it absolutely "falls in sleep".

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

PubMed Central

2013-01-01

Background The northwards spread of acute T. b. rhodesiense sleeping sickness in Uganda has been linked to cattle movements associated with restocking following the end to military conflict in 2006. This study examined the number of cattle traded from T. b. rhodesiense endemic districts, the prevalence of the parasite in cattle being traded and the level of trypanocidal treatment at livestock markets. Methods Between 2008 and 2009 interviews were carried out with government veterinarians from 20 districts in Uganda, 18 restocking organisations and numerous livestock traders and veterinarians. Direct observations, a review of movement permit records (2006 to 2008) and blood sampling of cattle (n = 1758) for detection of parasites were also conducted at 10 livestock markets in T. b. rhodesiense endemic districts. Results Records available from 8 out of 47 identified markets showed that 39.5% (5,238/13,267) of the inter-district cattle trade between mid-2006 and mid-2008 involved movement from endemic areas to pathogen-free districts. PCR analysis showed a prevalence of 17.5% T. brucei s.l. (n = 307/1758 [95% CI: 15.7-19.2]) and 1.5% T. b. rhodesiense (n = 26/1758 [95% CI: 0.9-2.0]) from these same markets. In a two-year period, between late-2006 to late-2008, an estimated 72,321 to 86,785 cattle (57, 857 by 18 restocking organisations and 10,214 to 24,679 by private traders) were imported into seven pathogen-free northern districts, including districts that were endemic for T. b. gambiense. Between 281 and 1,302 of these cattle were likely to have carried T. b. rhodesiense. While governmental organisations predominantly adhered to trypanocidal treatment, most Non-Governmental Organisations (NGOs) and private traders did not. Inadequate market infrastructure, poor awareness, the need for payment for drug treatments, and the difficulty in enforcing a policy of treatment at point of sale contributed to non-compliance. Conclusion With increasing private trade, preventing the spread of Rhodesian sleeping sickness in Uganda requires government support to ensure mandatory trypanocidal treatment at livestock markets, investment in market infrastructure and possible drug subsidy. Mapping the northern reaches of T. b. rhodesiense in livestock and preparation of risk assessments for cattle trading could mitigate future outbreaks. PMID:24289452

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

PubMed

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

2013-09-27

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

Mössbauer effect study of iron(III) inidazolidine nitroxyl-free radical ligand complex

NASA Astrophysics Data System (ADS)

Mulaba, A.; Kiremire, E.; Pollak, H.; Boeyens, J.

1999-09-01

A new complex, [Fe(acac)L2], bearing inidazolidine nitroxyl-free radical ligand (L-) was recently synthesised for biological studies. It proved to be biologically active against African sleeping sickness, plasmodium falciparum (malaria), leishmaniasis and chaga disease causative agents. Three ESR well resolved peaks indicated the presence of a free (unpaired) and chemically active electron in the complex. The structural complex ferric iron was found at the centre of two electric gradient whose the biggest is suggested to be initiated by the unpaired charge. No distinction between different cis isomers could be made.

[Sleep disorders among physicians on shift work].

PubMed

Schlafer, O; Wenzel, V; Högl, B

2014-11-01

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

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

PubMed Central

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

2017-01-01

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

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

PubMed

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

2010-01-01

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

African Trypanosomiasis

DTIC Science & Technology

2011-06-01

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

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

PubMed Central

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

2018-01-01

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

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

PubMed

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

2018-02-01

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

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

PubMed

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

2016-06-10

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

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

PubMed

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

2012-03-01

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

Coping with Work-Related Stress through Guided Imagery and Music (GIM): Randomized Controlled Trial.

PubMed

Beck, Bolette Daniels; Hansen, Åse Marie; Gold, Christian

2015-01-01

Long-term stress-related sick leave constitutes a serious health threat and an economic burden on both the single worker and the society. Effective interventions for the rehabilitation and facilitation of return to work are needed. The aim of the study was to examine the effects of Guided Imagery and Music (GIM), a psychotherapy intervention including relaxation, music listening, and imagery, on biopsychosocial measures of work-related stress. Twenty Danish workers on sick leave were randomized to music therapy versus wait-list control. Data collection was carried out at an occupational health ward in the period 2008-2010. Changes in salivary cortisol, testosterone, and melatonin were explored, and self-reported data on psychological stress symptoms (perceived stress, mood disturbance, sleep quality, physical distress symptoms, work readiness, well-being, anxiety, depression, immediate stress) were collected. Data regarding sick leave situation and job return were collected from participants throughout the study. Significant beneficial effects of GIM compared to wait-list after nine weeks with large effect sizes were found in well-being, mood disturbance, and physical distress, and in cortisol concentrations with a medium effect size. A comparison between early and late intervention as related to the onset of sick leave showed faster job return and significantly improved perceived stress, well-being, mood disturbance, depression, anxiety, and physical distress symptoms in favor of early intervention. In the whole sample, 83% of the participants had returned to work at nine weeks' follow-up. The results indicate that GIM is a promising treatment for work-related chronic stress, and further studies are recommended. © the American Music Therapy Association 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

PubMed

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

2012-10-01

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

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

PubMed

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

2017-07-01

Gambian sleeping sickness or HAT (human African trypanosomiasis) is a neglected tropical disease caused by Trypanosoma brucei gambiense transmitted by riverine species of tsetse. A global programme aims to eliminate the disease as a public health problem by 2020 and stop transmission by 2030. In the South of Chad, the Mandoul area is a persistent focus of Gambian sleeping sickness where around 100 HAT cases were still diagnosed and treated annually until 2013. Pre-2014, control of HAT relied solely on case detection and treatment, which lead to a gradual decrease in the number of cases of HAT due to annual screening of the population. Because of the persistence of transmission and detection of new cases, we assessed whether the addition of vector control to case detection and treatment could further reduce transmission and consequently, reduce annual incidence of HAT in Mandoul. In particular, we investigated the impact of deploying 'tiny targets' which attract and kill tsetse. Before tsetse control commenced, a census of the human population was conducted and their settlements mapped. A pre-intervention survey of tsetse distribution and abundance was implemented in November 2013 and 2600 targets were deployed in the riverine habitats of tsetse in early 2014, 2015 and 2016. Impact on tsetse and on the incidence of sleeping sickness was assessed through nine tsetse monitoring surveys and four medical surveys of the human population in 2014 and 2015. Mathematical modelling was used to assess the relative impact of tsetse control on incidence compared to active and passive screening. The census indicated that a population of 38674 inhabitants lived in the vicinity of the Mandoul focus. Within this focus in November 2013, the vector is Glossina fuscipes fuscipes and the mean catch of tsetse from traps was 0.7 flies/trap/day (range, 0-26). The catch of tsetse from 44 sentinel biconical traps declined after target deployment with only five tsetse being caught in nine surveys giving a mean catch of 0.005 tsetse/trap/day. Modelling indicates that 70.4% (95% CI: 51-95%) of the reduction in reported cases between 2013 and 2015 can be attributed to vector control with the rest due to medical intervention. Similarly tiny targets are estimated to have reduced new infections dramatically with 62.8% (95% CI: 59-66%) of the reduction due to tsetse control, and 8.5% (95% 8-9%) to enhanced passive detection. Model predictions anticipate that elimination as a public health problem could be achieved by 2018 in this focus if vector control and screening continue at the present level and, furthermore, there may have been virtually no transmission since 2015. This work shows that tiny targets reduced the numbers of tsetse in this focus in Chad, which may have interrupted transmission and the combination of tsetse control to medical detection and treatment has played a major role in reducing in HAT incidence in 2014 and 2015.

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

PubMed

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

2012-03-01

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

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

PubMed Central

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

2012-01-01

Background Human African trypanosomiasis (HAT) or sleeping sickness leads to a complex neuropsychiatric syndrome with characteristic sleep alterations. Current division into a first, hemolymphatic stage and second, meningoencephalitic stage is primarily based on the detection of white blood cells and/or trypanosomes in the cerebrospinal fluid. The validity of this criterion is, however, debated, and novel laboratory biomarkers are under study. Objective clinical HAT evaluation and monitoring is therefore needed. Polysomnography has effectively documented sleep-wake disturbances during HAT, but could be difficult to apply as routine technology in field work. The non-invasive, cost-effective technique of actigraphy has been widely validated as a tool for the ambulatory evaluation of sleep disturbances. In this pilot study, actigraphy was applied to the clinical assessment of HAT patients. Methods/Principal Findings Actigraphy was recorded in patients infected by Trypanosoma brucei gambiense, and age- and sex-matched control subjects. Simultaneous nocturnal polysomnography was also performed in the patients. Nine patients, including one child, were analyzed at admission and two of them also during specific treatment. Parameters, analyzed with user-friendly software, included sleep time evaluated from rest-activity signals, rest-activity rhythm waveform and characteristics. The findings showed sleep-wake alterations of various degrees of severity, which in some patients did not parallel white blood cell counts in the cerebrospinal fluid. Actigraphic recording also showed improvement of the analyzed parameters after treatment initiation. Nocturnal polysomnography showed alterations of sleep time closely corresponding to those derived from actigraphy. Conclusions/Significance The data indicate that actigraphy can be an interesting tool for HAT evaluation, providing valuable clinical information through simple technology, well suited also for long-term follow-up. Actigraphy could therefore objectively contribute to the clinical assessment of HAT patients. This method could be incorporated into a clinical scoring system adapted to HAT to be used in the evaluation of novel treatments and laboratory biomarkers. PMID:22348168

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

PubMed

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

2011-11-11

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

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

PubMed

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

2015-01-01

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

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

PubMed

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

2011-12-01

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

Neck pain and disability: a cross-sectional survey of the demographic and clinical characteristics of neck pain seen in a rheumatology clinic.

PubMed

Frank, A O; De Souza, L H; Frank, C A

2005-02-01

This hospital-based cross-sectional cohort study examines the clinical and demographic features of neck pain, disability (using the Northwick Park neck pain questionnaire) and relationships to handicap in employment. Of 173 consecutive referrals to a rheumatology clinic with neck pain, 70% had neck/arm pain without neurological involvement, 13% other conditions, 11% nerve involvement and 5% other spinal pain. 141 patients (mean age 50 years) had mechanical or degenerative neck pain, of which 13% was probably work-related and 13% was trauma-related. 44 had taken sickness absence for an average of 30 weeks. Comorbidities were frequent (lumbar pain 51%). Those in work were significantly less disabled than those not working (p = 0.001) and those off sick (p < 0.01). Those reporting sleep disturbance, tearfulness and crying were significantly more disabled (p = 0.0001) than those who did not. Neck pain in secondary care is complicated by physical and emotional comorbidities. Comprehensive management requires a biopsychosocial model of care.

Intellectual Property Rights and Access to Medicines: International Trade Issues

DTIC Science & Technology

2009-05-28

for pharmaceutical companies to invest in R&D. • Type III diseases, such as dengue fever and African sleeping sickness, are those that have...As such, the United States has pursued strong IPR regimes through multilateral, regional , and bilateral free trade agreement (FTA) negotiations and...standards for IPR protection and enforcement. Countries have advanced IPR protection and enforcement efforts through multilateral, regional , and

The Long War Concept - Determining the Right Health Service Support Capabilities for the Special Purpose MAGTF (SP MAGTF) - (Security Cooperation) Operating in Africa

DTIC Science & Technology

2011-03-29

bases across the continent. This was false when the rumors arose at the time of AFRICOM’s creation and remains false today." Admiral Moeller also went...diseases such as river blindness, sleeping sickness, ’ ’ diarrhea, cholera , typhoid, and other water based ~iseases like guinea worm and Bilharzias. 6

The Atlas of human African trypanosomiasis: a contribution to global mapping of neglected tropical diseases

PubMed Central

2010-01-01

Background Following World Health Assembly resolutions 50.36 in 1997 and 56.7 in 2003, the World Health Organization (WHO) committed itself to supporting human African trypanosomiasis (HAT)-endemic countries in their efforts to remove the disease as a public health problem. Mapping the distribution of HAT in time and space has a pivotal role to play if this objective is to be met. For this reason WHO launched the HAT Atlas initiative, jointly implemented with the Food and Agriculture Organization of the United Nations, in the framework of the Programme Against African Trypanosomosis. Results The distribution of HAT is presented for 23 out of 25 sub-Saharan countries having reported on the status of sleeping sickness in the period 2000 - 2009. For the two remaining countries, i.e. Angola and the Democratic Republic of the Congo, data processing is ongoing. Reports by National Sleeping Sickness Control Programmes (NSSCPs), Non-Governmental Organizations (NGOs) and Research Institutes were collated and the relevant epidemiological data were entered in a database, thus incorporating (i) the results of active screening of over 2.2 million people, and (ii) cases detected in health care facilities engaged in passive surveillance. A total of over 42 000 cases of HAT and 6 000 different localities were included in the database. Various sources of geographic coordinates were used to locate the villages of epidemiological interest. The resulting average mapping accuracy is estimated at 900 m. Conclusions Full involvement of NSSCPs, NGOs and Research Institutes in building the Atlas of HAT contributes to the efficiency of the mapping process and it assures both the quality of the collated information and the accuracy of the outputs. Although efforts are still needed to reduce the number of undetected and unreported cases, the comprehensive, village-level mapping of HAT control activities over a ten-year period ensures a detailed and reliable representation of the known geographic distribution of the disease. Not only does the Atlas serve research and advocacy, but, more importantly, it provides crucial evidence and a valuable tool for making informed decisions to plan and monitor the control of sleeping sickness. PMID:21040555

Health-related quality of life in patients with Burnout on sick leave: descriptive and comparative results from a clinical study.

PubMed

Grensman, Astrid; Acharya, Bikash Dev; Wändell, Per; Nilsson, Gunnar; Werner, Sigbritt

2016-02-01

To explore the health-related quality of life (HRQoL), the cause of being ill, and the pharmacological treatment in patients on sick leave because of Burnout. The HRQoL among these patients was also compared with that of individuals who were working full time. HRQoL was measured using the SWED-QUAL questionnaire, comprising 67 items grouped into 13 subscales, scored from 0 (worst) to 100 (best) points, and covering aspects of physical and emotional well-being, cognitive function, sleep, general health, social, and sexual functioning. The Burnout group (n = 94), mean age 43 years, were on 50% sick leave or more. The comparison group consisted of healthy persons (n = 88) of similar age and educational level who were working full time. The Burnout group had markedly low scores in general. The cause of illness was mainly work-related. Psychotropic medication was prescribed for 55%. Significantly lower scores were found in the Burnout group than in the comparison group in all subscales, p < 0.001. The median differences in scores ranged from 10 to 56 points. Differences rated by effect size were large, 0.85-2.01. Patients on sick leave because of Burnout rated their HRQoL as very low in general, their cause of being ill was mainly work-related, and psychotropic medication was prescribed for a majority. Their scores were markedly lower in all subscales in comparison with healthy individuals working full time. The study adds to our understanding of the situation of patients with Burnout. The results can be useful in clinical work and future research.

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

PubMed

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

2005-01-01

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

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

PubMed

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

1999-02-01

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

Expression of interferon-inducible chemokines and sleep/wake changes during early encephalitis in experimental African trypanosomiasis.

PubMed

Laperchia, Claudia; Tesoriero, Chiara; Seke-Etet, Paul F; La Verde, Valentina; Colavito, Valeria; Grassi-Zucconi, Gigliola; Rodgers, Jean; Montague, Paul; Kennedy, Peter G E; Bentivoglio, Marina

2017-08-01

Human African trypanosomiasis or sleeping sickness, caused by the parasite Trypanosoma brucei, leads to neuroinflammation and characteristic sleep/wake alterations. The relationship between the onset of these alterations and the development of neuroinflammation is of high translational relevance, but remains unclear. This study investigates the expression of interferon (IFN)-γ and IFN-inducible chemokine genes in the brain, and the levels of CXCL10 in the serum and cerebrospinal fluid prior to and during the encephalitic stage of trypanosome infection, and correlates these with sleep/wake changes in a rat model of the disease. The expression of genes encoding IFN-γ, CXCL9, CXCL10, and CXCL11 was assessed in the brain of rats infected with Trypanosoma brucei brucei and matched controls using semi-quantitative end-point RT-PCR. Levels of CXCL10 in the serum and cerebrospinal fluid were determined using ELISA. Sleep/wake states were monitored by telemetric recording. Using immunohistochemistry, parasites were found in the brain parenchyma at 14 days post-infection (dpi), but not at 6 dpi. Ifn-γ, Cxcl9, Cxcl10 and Cxcl11 mRNA levels showed moderate upregulation by 14 dpi followed by further increase between 14 and 21 dpi. CXCL10 concentration in the cerebrospinal fluid increased between 14 and 21 dpi, preceded by a rise in the serum CXCL10 level between 6 and 14 dpi. Sleep/wake pattern fragmentation was evident at 14 dpi, especially in the phase of wake predominance, with intrusion of sleep episodes into wakefulness. The results show a modest increase in Cxcl9 and Cxcl11 transcripts in the brain and the emergence of sleep/wake cycle fragmentation in the initial encephalitic stage, followed by increases in Ifn-γ and IFN-dependent chemokine transcripts in the brain and of CXCL10 in the cerebrospinal fluid. The latter parameter and sleep/wake alterations could provide combined humoral and functional biomarkers of the early encephalitic stage in African trypanosomiasis.

Salivary Pharmacodynamics and Bioavailability of Promethazine in Human Subjects

NASA Technical Reports Server (NTRS)

Putcha, Lakshmi; Harm, Deborah L.; Nimmagudda, Ram; Berens, Kurt L.; Bourne, David W. A.

1999-01-01

The acute effects of exposure to microgravity include the development of space motion sickness which usually requires therapeutic intervention. The current drug of choice, promethazine (PMZ), has side effects which include nausea, drowsiness, dizziness, sedation and impaired psychomotor performance. In a ground-based study with commercial airline pilots and shuttle simulator trainers, we measured sleep and psychomotor performance variables, and physiological variables such as blood pressure and heart rate, as a function of circulating drug concentrations in the body. We evaluated a non-invasive sampling method (saliva) as a means of assessing pharmacodynamics following a single intramuscular (IM) dose of PMZ.

Dressed for success: the surface coats of insect-borne protozoan parasites.

PubMed

Roditi, Isabel; Liniger, Matthias

2002-03-01

Three major human diseases, malaria, sleeping sickness and leishmaniasis, are caused by protozoan parasites that are transmitted by blood-sucking insects. These insects are not mere 'flying syringes' that mechanically transfer parasites from one mammal to the next. Instead, they provide a specific environment--albeit not a particularly hospitable one--in which the parasites differentiate, proliferate and migrate to the correct tissues to ensure transmission to the next mammalian host. Recent studies on the role of parasite surface molecules in insect vectors have delivered some surprises and could provide insights on ways to interrupt transmission.

Precipitating pharmakologies and capital entrapments: narcolepsy and the strange cases of Provigil and Xyrem.

PubMed

Wolf-Meyer, Matthew

2009-01-01

Since the mid-1990s, Americans have been made more aware of chronic sleep deprivation and sleep disorders exacerbated by dominant temporal regimes of work, school, and family life, primarily through increased medical and media attention. Concomitantly, Americans have turned to medical treatments and pharmaceutical cocktails to achieve normalcy rather than attending to the social and cultural causes of sleep sickness. This turn toward pharmaceuticalization is aided in part by the proliferation of medical disorders and the pharmaceuticals marketed to treat them (e.g., "excessive daytime sleepiness" requires treatment once reserved for narcoleptics). These cocktails have explicit and implicit components: the former consist of pharmaceuticals, the latter of capital dependencies, including ties to medical insurance companies, stable employment, and familial networks. In this article, I examine the proliferation of pharmaceutical cocktails through the concept of the pharmakon-something simultaneously remedy and cause-to illuminate the causes and effects of such pharmaceutical regimens in contemporary American society, specifically those relating to sleepiness. Specific cases of this struggle between chemical dependence and normalcy are offered from my ethnographic work with patients who suffer from sleep disorders.

Analysis of a model of gambiense sleeping sickness in humans and cattle.

PubMed

Ndondo, A M; Munganga, J M W; Mwambakana, J N; Saad-Roy, C M; van den Driessche, P; Walo, R O

2016-01-01

Human African Trypanosomiasis (HAT) and Nagana in cattle, commonly called sleeping sickness, is caused by trypanosome protozoa transmitted by bites of infected tsetse flies. We present a deterministic model for the transmission of HAT caused by Trypanosoma brucei gambiense between human hosts, cattle hosts and tsetse flies. The model takes into account the growth of the tsetse fly, from its larval stage to the adult stage. Disease in the tsetse fly population is modeled by three compartments, and both the human and cattle populations are modeled by four compartments incorporating the two stages of HAT. We provide a rigorous derivation of the basic reproduction number R0. For R0 < 1, the disease free equilibrium is globally asymptotically stable, thus HAT dies out; whereas (assuming no return to susceptibility) for R0 >1, HAT persists. Elasticity indices for R0 with respect to different parameters are calculated with baseline parameter values appropriate for HAT in West Africa; indicating parameters that are important for control strategies to bring R0 below 1. Numerical simulations with R0 > 1 show values for the infected populations at the endemic equilibrium, and indicate that with certain parameter values, HAT could not persist in the human population in the absence of cattle.

The sopite syndrome revisited: Drowsiness and mood changes during real or apparent motion

NASA Astrophysics Data System (ADS)

Lawson, B. D.; Mead, A. M.

The sopite syndrome is a poorly understood response to motion. Drowsiness and mood changes are the primary characteristics of the syndrome. The sopite syndrome can exist in isolation from more apparent symptoms such as nausea, can last long; after nausea has subsided, and can debilitate some individuals. It is most likely a distinct syndrome from "regular" motion sickness or common fatigue, and is of potential concern in a variety of situations. The syndrome may be particularly hazardous in transportation settings where other performance challenges (e.g., sleep deprivation) are already present. It is also a potential concern in cases where illnesses such as sleep disorders or depression may interact with the syndrome and confuse diagnosis.

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

PubMed Central

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

2017-01-01

Background Gambian sleeping sickness or HAT (human African trypanosomiasis) is a neglected tropical disease caused by Trypanosoma brucei gambiense transmitted by riverine species of tsetse. A global programme aims to eliminate the disease as a public health problem by 2020 and stop transmission by 2030. In the South of Chad, the Mandoul area is a persistent focus of Gambian sleeping sickness where around 100 HAT cases were still diagnosed and treated annually until 2013. Pre-2014, control of HAT relied solely on case detection and treatment, which lead to a gradual decrease in the number of cases of HAT due to annual screening of the population. Methods Because of the persistence of transmission and detection of new cases, we assessed whether the addition of vector control to case detection and treatment could further reduce transmission and consequently, reduce annual incidence of HAT in Mandoul. In particular, we investigated the impact of deploying ‘tiny targets’ which attract and kill tsetse. Before tsetse control commenced, a census of the human population was conducted and their settlements mapped. A pre-intervention survey of tsetse distribution and abundance was implemented in November 2013 and 2600 targets were deployed in the riverine habitats of tsetse in early 2014, 2015 and 2016. Impact on tsetse and on the incidence of sleeping sickness was assessed through nine tsetse monitoring surveys and four medical surveys of the human population in 2014 and 2015. Mathematical modelling was used to assess the relative impact of tsetse control on incidence compared to active and passive screening. Findings The census indicated that a population of 38674 inhabitants lived in the vicinity of the Mandoul focus. Within this focus in November 2013, the vector is Glossina fuscipes fuscipes and the mean catch of tsetse from traps was 0.7 flies/trap/day (range, 0–26). The catch of tsetse from 44 sentinel biconical traps declined after target deployment with only five tsetse being caught in nine surveys giving a mean catch of 0.005 tsetse/trap/day. Modelling indicates that 70.4% (95% CI: 51–95%) of the reduction in reported cases between 2013 and 2015 can be attributed to vector control with the rest due to medical intervention. Similarly tiny targets are estimated to have reduced new infections dramatically with 62.8% (95% CI: 59–66%) of the reduction due to tsetse control, and 8.5% (95% 8–9%) to enhanced passive detection. Model predictions anticipate that elimination as a public health problem could be achieved by 2018 in this focus if vector control and screening continue at the present level and, furthermore, there may have been virtually no transmission since 2015. Conclusion This work shows that tiny targets reduced the numbers of tsetse in this focus in Chad, which may have interrupted transmission and the combination of tsetse control to medical detection and treatment has played a major role in reducing in HAT incidence in 2014 and 2015. PMID:28750007

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

PubMed Central

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

2008-01-01

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

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

PubMed

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

2016-01-01

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

Management of vibration sickness in coal mines by hyperbaric oxygenation

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

Soboleva, N.P.

1985-02-01

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

Contemplating cognitive enhancement in medical students and residents.

PubMed

Webb, Jadon R; Thomas, John W; Valasek, Mark A

2010-01-01

Medical school and residency can be stressful times, involving years of intensive academic study and pressure to earn high grades. Students and residents must learn to care for the sick, a task requiring long work hours and sleep deprivation. In such an environment, it is important to monitor the mental health of trainees and the factors that influence it. This essay examines a relatively unexplored facet of physician mental health: the use of pharmacological stimulants by students and residents to study better, earn higher grades, stay awake longer, and take better care of patients. Practical and ethical considerations of stimulant use in the medical profession, along with future directions for medical student mental health, are discussed.

Relationship between transitions in self-rated health and health indicators in Japanese workers.

PubMed

Tsurugano, Shinobu; Takahashi, Eiko; Negami, Masako; Otsuka, Hiroki; Moriyama, Kengo

2012-12-20

Self-rated health (SRH) reflects lifestyle habits, chronic disease, and psychosocial conditions. The aim of this study was to examine the relationship between transitions in SRH and health indicators among Japanese white-collar workers. Three-year medical examination data from an occupational field was used. The distribution of data related to SRH, lifestyle habits, treatment of chronic disease, laboratory data abnormalities, job stress, and sickness absences were compared using ridit analysis, and the odds ratios and 95% confidence intervals were calculated using the first year of observation as a reference. During the observation period, the proportion of workers with poor SRH, self-rated lifestyle habits, sleep, dietary habits, and body mass index increased. Particularly, high job stress (heavy job burden and low job control) and few sickness absences were strongly related to poor SRH. Unfavorable lifestyles and work-related conditions worsened as SRH declined among workers. The results suggest that health indicators related to SRH are different according to the population. Tracking changes in SRH using indices related to SRH is useful for evaluating the health status in a target group.

Potent antiprotozoal activity of a novel semi-synthetic berberine derivative.

PubMed

Bahar, Mark; Deng, Ye; Zhu, Xiaohua; He, Shanshan; Pandharkar, Trupti; Drew, Mark E; Navarro-Vázquez, Armando; Anklin, Clemens; Gil, Roberto R; Doskotch, Raymond W; Werbovetz, Karl A; Kinghorn, A Douglas

2011-05-01

Treatment of diseases such as African sleeping sickness and leishmaniasis often depends on relatively expensive or toxic drugs, and resistance to current chemotherapeutics is an issue in treating these diseases and malaria. In this study, a new semi-synthetic berberine analogue, 5,6-didehydro-8,8-diethyl-13-oxodihydroberberine chloride (1), showed nanomolar level potency against in vitro models of leishmaniasis, malaria, and trypanosomiasis as well as activity in an in vivo visceral leishmaniasis model. Since the synthetic starting material, berberine hemisulfate, is inexpensive, 8,8-dialkyl-substituted analogues of berberine may lead to a new class of affordable antiprotozoal compounds. Copyright © 2011. Published by Elsevier Ltd.

Occupational health of patients with obstructive sleep apnea syndrome: a systematic review.

PubMed

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

2015-03-01

The aim of this systematic literature review was to assess the impact of obstructive sleep apnea syndrome (OSAS) on patients' occupational health. We selected 19 studies that dealt with issues related to job performance and productivity, absenteeism, and psychosocial health of patients with OSAS and assessed the risk of bias in their conclusions. Although methodologically rigorous studies are needed to confirm these findings, the results obtained suggest the existence of multiple relationships between OSAS and work limitations of patients (i.e., difficulties maintaining attention, learning new tasks, or performing monotonous tasks). The studies reviewed reached more scientifically consistent conclusions about such patients' risk of taking more days of sick leave or having work disability, particularly if they reported excessive daytime sleepiness. Very few studies have explored the relationship between OSAS and psychosocial occupational health of patients. Thus, there is a need for research to clarify these aspects of occupational medicine. OSAS has numerous effects on patients' occupational health, yet, in general, results should be confirmed by studies with sufficiently large samples in which OSAS is diagnosed with reliable methods and occupational variables are assessed with standardized and validated questionnaires.

Expression of interferon-inducible chemokines and sleep/wake changes during early encephalitis in experimental African trypanosomiasis

PubMed Central

Seke-Etet, Paul F.; La Verde, Valentina; Colavito, Valeria; Grassi-Zucconi, Gigliola; Rodgers, Jean; Montague, Paul; Bentivoglio, Marina

2017-01-01

Background Human African trypanosomiasis or sleeping sickness, caused by the parasite Trypanosoma brucei, leads to neuroinflammation and characteristic sleep/wake alterations. The relationship between the onset of these alterations and the development of neuroinflammation is of high translational relevance, but remains unclear. This study investigates the expression of interferon (IFN)-γ and IFN-inducible chemokine genes in the brain, and the levels of CXCL10 in the serum and cerebrospinal fluid prior to and during the encephalitic stage of trypanosome infection, and correlates these with sleep/wake changes in a rat model of the disease. Methodology/Principal findings The expression of genes encoding IFN-γ, CXCL9, CXCL10, and CXCL11 was assessed in the brain of rats infected with Trypanosoma brucei brucei and matched controls using semi-quantitative end-point RT-PCR. Levels of CXCL10 in the serum and cerebrospinal fluid were determined using ELISA. Sleep/wake states were monitored by telemetric recording. Using immunohistochemistry, parasites were found in the brain parenchyma at 14 days post-infection (dpi), but not at 6 dpi. Ifn-γ, Cxcl9, Cxcl10 and Cxcl11 mRNA levels showed moderate upregulation by 14 dpi followed by further increase between 14 and 21 dpi. CXCL10 concentration in the cerebrospinal fluid increased between 14 and 21 dpi, preceded by a rise in the serum CXCL10 level between 6 and 14 dpi. Sleep/wake pattern fragmentation was evident at 14 dpi, especially in the phase of wake predominance, with intrusion of sleep episodes into wakefulness. Conclusions/Significance The results show a modest increase in Cxcl9 and Cxcl11 transcripts in the brain and the emergence of sleep/wake cycle fragmentation in the initial encephalitic stage, followed by increases in Ifn-γ and IFN-dependent chemokine transcripts in the brain and of CXCL10 in the cerebrospinal fluid. The latter parameter and sleep/wake alterations could provide combined humoral and functional biomarkers of the early encephalitic stage in African trypanosomiasis. PMID:28821016

Determination of Altitude Sickness Risk (DASR) User’s Guide for Apple Mobile Devices

DTIC Science & Technology

2015-06-01

Android Smartphone Relevance to Military Weather Applications”.2 2.  DASR Inputs  To launch DASR, simply tap the DASR icon on the device start screen...risk due to sleep deprivation). TB MED 505 should be consulted for additional details if necessary. 5 Fig. 4 Individual Factors view The risk...armypubs.army.mil/med/index.html]. 2. Sauter, D. Android smartphone relevance to military weather applications. White Sands Missile Range (NM); Army Research

Effects of rotation on the sleep state-dependent midlatency auditory evoked P50 potential in the human

NASA Technical Reports Server (NTRS)

Dornhoffer, John L.; Mamiya, N.; Bray, P.; Skinner, Robert D.; Garcia-Rill, Edgar

2002-01-01

Sopite syndrome, characterized by loss of initiative, sensitivity to normally innocuous sensory stimuli, and impaired concentration amounting to a sensory gating deficit, is commonly associated with Space Motion Sickness (SMS). The amplitude of the P50 potential is a measure of level of arousal, and a paired-stimulus paradigm can be used to measure sensory gating. We used the rotary chair to elicit the sensory mismatch that occurs with SMS by overstimulating the vestibular apparatus. The effects of rotation on the manifestation of the P50 midlatency auditory evoked response were then assessed as a measure of arousal and distractibility. Results showed that rotation-induced motion sickness produced no change in the level of arousal but did produce a significant deficit in sensory gating, indicating that some of the attentional and cognitive deficits observed with SMS may be due to distractibility induced by decreased habituation to repetitive stimuli.

Poor sleep quality predicts decreased cognitive function independently of chronic mountain sickness score in young soldiers with polycythemia stationed in Tibet.

PubMed

Kong, Fan-Yi; Li, Qiang; Liu, Shi-Xiang

2011-01-01

Little is known about the association between poor sleep and cognitive function in people with polycythemia at high altitude. The aim of this study was to survey the sleep quality of individuals with polycythemia at high altitude and determine its association with cognitive abilities. We surveyed 230 soldiers stationed in Tibet (all men; mean age 21-52±4.30 yr) at altitudes ranging from 3658 to 3996 m. All participants were given a blood tests for hemoglobin level and a questionnaire survey of cognitive function. Polycythemia was defined as excessive erythrocytosis (Hb≥21 g/dL in men or ≥19 g/dL in women). Poor sleepers were defined as having a global Pittsburgh Sleep Quality Index score (PSQI)>5. Cognitive abilities were determined by the Chinese revision of the Wechsler Adult Intelligence Scale and the Benton Visual Retention Test. Multiple linear regression analysis was used to determine the association between the PSQI and cognitive function. Logistic regression analysis was performed to determine the independent effect of sleep quality on cognitive function. The global PSQI score of enrolled participants was 8.14±3.79. Seventy-five (32.6%) soldiers were diagnosed with polycythemia. The proportion of poor sleepers was 1.45 times greater in those with polycythemia compared with those without polycythemia [95% (confidence interval) CI 1.82-2.56], and they had a statistically significant lower score for cognitive function. Multiple linear regression analysis showed that the global PSQI score was negatively associated with IQ (β=0.11, 95% CI -0.16 to -0.05) and digit symbol scores (β=0.66, 95% CI -0.86 to -0.44). Poor sleep quality was determined to be an independent predictor of impaired IQ [odds ratio (OR) 1.59, 95% CI 1.30-1.95] and digit symbol score (OR 1.18, 95% CI 1.07-1.31) in logistic regression analysis. The present study showed that for young soldiers with polycythemia at high altitude impaired subjective sleep quality was an independent predictor of decreased cognitive function, especially IQ and verbal short-term memory.

The societal costs of insomnia

PubMed Central

Wade, Alan G

2011-01-01

Objective Insomnia can be broadly defined as difficulty initiating or maintaining sleep, or sleep that is not refreshing or of poor quality with negative effect on daytime function. Insomnia can be a primary condition or comorbid to an underlying disorder. Subjective measures of insomnia used in population studies, usually based on complaints of unsatisfactory sleep, put the prevalence at about 10%. Insomnia is more common in the elderly and in women, and is often associated with medical and psychiatric disorders. This review examines the measures used to assess quality of sleep (QOS) and daytime functioning and the impact of insomnia on society using these measures. Methods Literature searches were performed to identify all studies of insomnia (primary and comorbid) in adults (aged 18–64 years) and the elderly (aged ≥ 65 years) with baseline and/or outcomes relating to QOS or daytime functioning. The impact of poor QOS on quality of life (QOL), psychomotor and cognitive skills, health care resource utilization, and other societal effects was examined. Results Although definitions and measurement scales used to assess sleep quality vary widely, it is clear that the societal consequences of insomnia are substantial and include impaired QOL and increased health care utilization. The impact of poor QOS and impaired daytime functioning common in insomnia can lead to indirect effects such as lower work productivity, increased sick leave, and a higher rate of motor vehicle crashes. Conclusions Insomnia is associated with substantial direct and indirect costs to society. It is almost impossible to separate the costs associated with primary and comorbid insomnia. More studies are required which control for the severity of any primary disorder to accurately evaluate the costs of comorbid insomnia. Development of standardized diagnostic and assessment scales will enable more accurate quantification of the true societal burden of insomnia and will contribute to greater understanding of this disorder. PMID:21326650

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

PubMed

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

2012-09-01

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

Sickness behaviour after lipopolysaccharide treatment in ghrelin deficient mice.

PubMed

Szentirmai, Éva; Krueger, James M

2014-02-01

Ghrelin is an orexigenic hormone produced mainly by the gastrointestinal system and the brain. Much evidence also indicates a role for ghrelin in sleep and thermoregulation. Further, ghrelin was recently implicated in immune system modulation. Administration of bacterial lipopolysaccharide (LPS) induces fever, anorexia, and increased non-rapid-eye movement sleep (NREMS) and these actions are mediated primarily by proinflammatory cytokines. Ghrelin reduces LPS-induced fever, suppresses circulating levels of proinflammatory cytokines and reduces the severity and mortality of various models of experimental endotoxemia. In the present study, we determined the role of intact ghrelin signaling in LPS-induced sleep, feeding, and thermoregulatory responses in mice. Sleep-wake activity was determined after intraperitoneal, dark onset administration of 0.4, 2 and 10 μg LPS in preproghrelin knockout (KO) and wild-type (WT) mice. In addition, body temperature, motor activity and changes in 24-h food intake and body weight were measured. LPS induced dose-dependent increases in NREMS, and suppressed rapid-eye movement sleep, electroencephalographic slow-wave activity, motor activity, food intake and body weight in both Ppg KO and WT mice. Body temperature changes showed a biphasic pattern with a decrease during the dark period followed by an increase in the light phase. The effects of the low and middle doses of LPS were indistinguishable between the two genotypes. Administration of 10 μg LPS, however, induced significantly larger changes in NREMS and wakefulness amounts, body temperature, food intake and body weight in the Ppg KO mice. These findings support a role for ghrelin as an endogenous modulator of inflammatory responses and a central component of arousal and feeding circuits. Copyright © 2013 Elsevier Inc. All rights reserved.

The Proceedings of the Hypobaric Decompression Sickness Workshop Held in Armstrong Laboratory, Brooks AFB, Texas on 16-18 October 1990.

DTIC Science & Technology

1992-06-01

exhibited by humans, ostium secundum (15) and, like humans with PFO, are generally a3ymptomatic. Yucatan Miniature Swine exhibited an incidence of 8...W. Corin; A. Fazel; W.W.R. Biederman; F.G. Spinale and P.C. Gillette. Heritable Ventricular Septal Defect In Yucatan Miniature Swine. Laboratory...of sleep, poor nutrition , and recent illness; exercising prior to flight (two separate cases of bends); dehydration. 448 Immediately following are 7

Trypanosomiasis control in relation to other public health services.

PubMed

FENDALL, N R; SOUTHGATE, B A; BERRIE, J R

1963-01-01

The authors describe the aims and principles of trypanosomiasis control and discuss the individual techniques of control and the ways in which these can be channelled through a general rural health service. They argue that, given the circumstances at present prevailing in rural Africa, a broad-based general public health service should be established before specific campaigns for control or eradication of sleeping-sickness, or indeed any other specific diseases, are instituted. They emphasize the necessity of international co-operation for effective trypanomiasis control.

Trypanosomiasis control in relation to other public health services*

PubMed Central

Fendall, N. R. E.; Southgate, B. A.; Berrie, J. R. H.

1963-01-01

The authors describe the aims and principles of trypanosomiasis control and discuss the individual techniques of control and the ways in which these can be channelled through a general rural health service. They argue that, given the circumstances at present prevailing in rural Africa, a broad-based general public health service should be established before specific campaigns for control or eradication of sleeping-sickness, or indeed any other specific diseases, are instituted. They emphasize the necessity of international co-operation for effective trypanomiasis control. PMID:13962907

Effect of traditional yoga, mindfulness-based cognitive therapy, and cognitive behavioral therapy, on health related quality of life: a randomized controlled trial on patients on sick leave because of burnout.

PubMed

Grensman, Astrid; Acharya, Bikash Dev; Wändell, Per; Nilsson, Gunnar H; Falkenberg, Torkel; Sundin, Örjan; Werner, Sigbritt

2018-03-06

To explore if health related quality of life(HRQoL) increased after traditional yoga(TY), mindfulness based cognitive therapy(MBCT), or cognitive behavioral therapy(CBT), in patients on sick leave because of burnout. Randomized controlled trial, blinded, in ninety-four primary health care patients, block randomized to TY, MBCT or CBT (active control) between September 2007 and November 2009. Patients were living in the Stockholm metropolitan area, Sweden, were aged 18-65 years and were on 50%-100% sick leave. A group treatment for 20 weeks, three hours per week, with homework four hours per week. HRQoL was measured by the SWED-QUAL questionnaire, comprising 67 items grouped into 13 subscales, each with a separate index, and scores from 0 (worse) to 100 (best). SWED-QUAL covers aspects of physical and emotional well-being, cognitive function, sleep, general health and social and sexual functioning. Statistics: Wilcoxon's rank sum and Wilcoxon's sign rank tests, Bonett-Price for medians and confidence intervals, and Cohen's D. Twenty-six patients in the TY (21 women), and 27 patients in both the MBCT (24 women) and in the CBT (25 women), were analyzed. Ten subscales in TY and seven subscales in MBCT and CBT showed improvements, p < 0.05, in several of the main domains affected in burnout, e.g. emotional well-being, physical well-being, cognitive function and sleep. The median improvement ranged from 0 to 27 points in TY, from 4 to 25 points in CBT and from 0 to 25 points in MBCT. The effect size was mainly medium or large. Comparison of treatments showed no statistical differences, but better effect (small) of both TY and MBCT compared to CBT. When comparing the effect of TY and MBCT, both showed a better effect (small) in two subscales each. A 20 week group treatment with TY, CBT or MBCT had equal effects on HRQoL, and particularly on main domains affected in burnout. This indicates that TY, MBCT and CBT can be used as both treatment and prevention, to improve HRQoL in patients on sick leave because of burnout, reducing the risk of future morbidity. July 22, 2012, retrospectively registered. ClinicalTrails.gov NCT01168661 . Stockholm County Council, grant 2003-5.

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

PubMed Central

2013-01-01

Background Caused by trypanosomes and transmitted by tsetse flies, Human African Trypanosomiasis and bovine trypanosomiasis remain endemic across much of rural Uganda where the major reservoir of acute human infection is cattle. Following elimination of trypanosomes by mass trypanocidal treatment, it is crucial that farmers regularly apply pyrethroid-based insecticides to cattle to sustain parasite reductions, which also protect against tick-borne diseases. The private veterinary market is divided between products only effective against ticks (amidines) and those effective against both ticks and tsetse (pyrethroids). This study explored insecticide sales, demand and use in four districts of Uganda where mass cattle treatments have been undertaken by the ‘Stamp Out Sleeping Sickness’ programme. Methods A mixed-methods study was undertaken in Dokolo, Kaberamaido, Serere and Soroti districts of Uganda between September 2011 and February 2012. This included: focus groups in 40 villages, a livestock keeper survey (n = 495), a veterinary drug shop questionnaire (n = 74), participatory methods in six villages and numerous semi-structured interviews. Results Although 70.5% of livestock keepers reportedly used insecticide each month during the rainy season, due to a variety of perceptions and practices nearly half used products only effective against ticks and not tsetse. Between 640 and 740 litres of insecticide were being sold monthly, covering an average of 53.7 cattle/km2. Sales were roughly divided between seven pyrethroid-based products and five products only effective against ticks. In the high-risk HAT district of Kaberamaido, almost double the volume of non-tsetse effective insecticide was being sold. Factors influencing insecticide choice included: disease knowledge, brand recognition, product price, half-life and mode of product action, product availability, and dissemination of information. Stakeholders considered market restriction of non-tsetse effective products the most effective way to increase pyrethroid use. Conclusions Conflicts of interest between veterinary business and vector control were found to constrain sleeping sickness control. While a variety of strategies could increase pyrethroid use, regulation of the insecticide market could effectively double the number of treated cattle with little cost to government, donors or farmers. Such regulation is entirely consistent with the role of the state in a privatised veterinary system and should include a mitigation strategy against the potential development of tick resistance. PMID:23841963

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

NASA Technical Reports Server (NTRS)

Dinges, David F.

1999-01-01

This project is concerned with identifying ways to prevent neurobehavioral and physical deterioration due to inadequate sleep in astronauts during long-duration manned space flight. The performance capability of astronauts during extended-duration space flight depends heavily on achieving recovery through adequate sleep. Even with appropriate circadian alignment, sleep loss can erode fundamental elements of human performance capability including vigilance, cognitive speed and accuracy, working memory, reaction time, and physiological alertness. Adequate sleep is essential during manned space flight not only to ensure high levels of safe and effective human performance, but also as a basic regulatory biology critical to healthy human functioning. There is now extensive objective evidence that astronaut sleep is frequently restricted in space flight to averages between 4 hr and 6.5 hr/day. Chronic sleep restriction during manned space flight can occur in response to endogenous disturbances of sleep (motion sickness, stress, circadian rhythms), environmental disruptions of sleep (noise, temperature, light), and curtailment of sleep due to the work demands and other activities that accompany extended space flight operations. The mechanism through which this risk emerges is the development of cumulative homeostatic pressure for sleep across consecutive days of inadequate sleep. Research has shown that the physiological sleepiness and performance deficits engendered by sleep debt can progressively worsen (i.e., accumulate) over consecutive days of sleep restriction, and that sleep limited to levels commonly experienced by astronauts (i.e., 4 - 6 hr per night) for as little as 1 week, can result in increased lapses of attention, degradation of response times, deficits in complex problem solving, reduced learning, mood disturbance, disruption of essential neuroendocrine, metabolic, and neuroimmune responses, and in some vulnerable persons, the emergence of uncontrolled sleep attacks. The prevention of cumulative performance deficits and neuroendocrine disruption from sleep restriction during extended duration space flight involves finding the most effective ways to obtain sleep in order to maintain the high-level cognitive and physical performance functions required for manned space flight. There is currently a critical deficiency in knowledge of the effects of how variations in sleep duration and timing relate to the most efficient return of performance per unit time invested in sleep during long-duration missions, and how the nature of sleep physiology (i.e., sleep stages, sleep electroencephalographic [EEG] power spectral analyses) change as a function of sleep restriction and performance degradation. The primary aim of this project is to meet these critical deficiencies through utilization of a response surface experimental paradigm, testing in a dose-response manner, varying combinations of sleep duration and timing, for the purpose of establishing how to most effectively limit the cumulative adverse effects on human performance and physiology of chronic sleep restriction in space operations.

Efficacy, Safety, and Dose of Pafuramidine, a New Oral Drug for Treatment of First Stage Sleeping Sickness, in a Phase 2a Clinical Study and Phase 2b Randomized Clinical Studies

PubMed Central

Burri, Christian; Yeramian, Patrick D.; Merolle, Ada; Serge, Kazadi Kyanza; Mpanya, Alain; Lutumba, Pascal; Mesu, Victor Kande Betu Ku; Lubaki, Jean-Pierre Fina; Mpoto, Alfred Mpoo; Thompson, Mark; Munungu, Blaise Fungula; Josenando, Théophilo; Bernhard, Sonja C.; Olson, Carol A.; Blum, Johannes; Tidwell, Richard R.; Pohlig, Gabriele

2016-01-01

Background Sleeping sickness (human African trypanosomiasis [HAT]) is caused by protozoan parasites and characterized by a chronic progressive course, which may last up to several years before death. We conducted two Phase 2 studies to determine the efficacy and safety of oral pafuramidine in African patients with first stage HAT. Methods The Phase 2a study was an open-label, non-controlled, proof-of-concept study where 32 patients were treated with 100 mg of pafuramidine orally twice a day (BID) for 5 days at two trypanosomiasis reference centers (Angola and the Democratic Republic of the Congo [DRC]) between August 2001 and November 2004. The Phase 2b study compared pafuramidine in 41 patients versus standard pentamidine therapy in 40 patients. The Phase 2b study was open-label, parallel-group, controlled, randomized, and conducted at two sites in the DRC between April 2003 and February 2007. The Phase 2b study was then amended to add an open-label sequence (Phase 2b-2), where 30 patients received pafuramidine for 10 days. The primary efficacy endpoint was parasitologic cure at 24 hours (Phase 2a) or 3 months (Phase 2b) after treatment completion. The primary safety outcome was the rate of occurrence of World Health Organization Toxicity Scale Grade 3 or higher adverse events. All subjects provided written informed consent. Findings/Conclusion Pafuramidine for the treatment of first stage HAT was comparable in efficacy to pentamidine after 10 days of dosing. The cure rates 3 months post-treatment were 79% in the 5-day pafuramidine, 100% in the 7-day pentamidine, and 93% in the 10-day pafuramidine groups. In Phase 2b, the percentage of patients with at least 1 treatment-emergent adverse event was notably higher after pentamidine treatment (93%) than pafuramidine treatment for 5 days (25%) and 10 days (57%). These results support continuation of the development program for pafuramidine into Phase 3. PMID:26881924

Efficacy, Safety, and Dose of Pafuramidine, a New Oral Drug for Treatment of First Stage Sleeping Sickness, in a Phase 2a Clinical Study and Phase 2b Randomized Clinical Studies.

PubMed

Burri, Christian; Yeramian, Patrick D; Allen, James L; Merolle, Ada; Serge, Kazadi Kyanza; Mpanya, Alain; Lutumba, Pascal; Mesu, Victor Kande Betu Ku; Bilenge, Constantin Miaka Mia; Lubaki, Jean-Pierre Fina; Mpoto, Alfred Mpoo; Thompson, Mark; Munungu, Blaise Fungula; Manuel, Francisco; Josenando, Théophilo; Bernhard, Sonja C; Olson, Carol A; Blum, Johannes; Tidwell, Richard R; Pohlig, Gabriele

2016-02-01

Sleeping sickness (human African trypanosomiasis [HAT]) is caused by protozoan parasites and characterized by a chronic progressive course, which may last up to several years before death. We conducted two Phase 2 studies to determine the efficacy and safety of oral pafuramidine in African patients with first stage HAT. The Phase 2a study was an open-label, non-controlled, proof-of-concept study where 32 patients were treated with 100 mg of pafuramidine orally twice a day (BID) for 5 days at two trypanosomiasis reference centers (Angola and the Democratic Republic of the Congo [DRC]) between August 2001 and November 2004. The Phase 2b study compared pafuramidine in 41 patients versus standard pentamidine therapy in 40 patients. The Phase 2b study was open-label, parallel-group, controlled, randomized, and conducted at two sites in the DRC between April 2003 and February 2007. The Phase 2b study was then amended to add an open-label sequence (Phase 2b-2), where 30 patients received pafuramidine for 10 days. The primary efficacy endpoint was parasitologic cure at 24 hours (Phase 2a) or 3 months (Phase 2b) after treatment completion. The primary safety outcome was the rate of occurrence of World Health Organization Toxicity Scale Grade 3 or higher adverse events. All subjects provided written informed consent. Pafuramidine for the treatment of first stage HAT was comparable in efficacy to pentamidine after 10 days of dosing. The cure rates 3 months post-treatment were 79% in the 5-day pafuramidine, 100% in the 7-day pentamidine, and 93% in the 10-day pafuramidine groups. In Phase 2b, the percentage of patients with at least 1 treatment-emergent adverse event was notably higher after pentamidine treatment (93%) than pafuramidine treatment for 5 days (25%) and 10 days (57%). These results support continuation of the development program for pafuramidine into Phase 3.

African trypanosome infections of the nervous system: parasite entry and effects on sleep and synaptic functions.

PubMed

Kristensson, Krister; Nygård, Mikael; Bertini, Giuseppe; Bentivoglio, Marina

2010-06-01

The extracellular parasite Trypanosoma brucei causes human African trypanosomiasis (HAT), also known as sleeping sickness. Trypanosomes are transmitted by tsetse flies and HAT occurs in foci in sub-Saharan Africa. The disease, which is invariably lethal if untreated, evolves in a first hemo-lymphatic stage, progressing to a second meningo-encephalitic stage when the parasites cross the blood-brain barrier. At first, trypanosomes are restricted to circumventricular organs and choroid plexus in the brain outside the blood-brain barrier, and to dorsal root ganglia. Later, parasites cross the blood-brain barrier at post-capillary venules, through a multi-step process similar to that of lymphocytes. Accumulation of parasites in the brain is regulated by cytokines and chemokines. Trypanosomes can alter neuronal function and the most prominent manifestation is represented by sleep alterations. These are characterized, in HAT and experimental rodent infections, by disruption of the sleep-wake 24h cycle and internal sleep structure. Trypanosome infections alter also some, but not all, other endogenous biological rhythms. A number of neural pathways and molecules may be involved in such effects. Trypanosomes secrete prostaglandins including the somnogenic PGD2, and they interact with the host's immune system to cause release of pro-inflammatory cytokines. From the sites of early localization of parasites in the brain and meninges, such molecules could affect adjacent brain areas implicated in sleep-wakefulness regulation, including the suprachiasmatic nucleus and its downstream targets, to cause the changes characteristic of the disease. This raises challenging issues on the effects of cytokines on synaptic functions potentially involved in sleep-wakefulness alterations. (c) 2009 Elsevier Ltd. All rights reserved.

The Population Structure of Glossina palpalis gambiensis from Island and Continental Locations in Coastal Guinea

PubMed Central

Solano, Philippe; Ravel, Sophie; Bouyer, Jeremy; Camara, Mamadou; Kagbadouno, Moise S.; Dyer, Naomi; Gardes, Laetitia; Herault, Damien; Donnelly, Martin J.; De Meeûs, Thierry

2009-01-01

Background We undertook a population genetics analysis of the tsetse fly Glossina palpalis gambiensis, a major vector of sleeping sickness in West Africa, using microsatellite and mitochondrial DNA markers. Our aims were to estimate effective population size and the degree of isolation between coastal sites on the mainland of Guinea and Loos Islands. The sampling locations encompassed Dubréka, the area with the highest Human African Trypanosomosis (HAT) prevalence in West Africa, mangrove and savannah sites on the mainland, and two islands, Fotoba and Kassa, within the Loos archipelago. These data are discussed with respect to the feasibility and sustainability of control strategies in those sites currently experiencing, or at risk of, sleeping sickness. Principal Findings We found very low migration rates between sites except between those sampled around the Dubréka area that seems to contain a widely dispersed and panmictic population. In the Kassa island samples, various effective population size estimates all converged on surprisingly small values (10

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

PubMed

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

2017-05-01

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

The prevalence of vestibular symptoms in migraine or tension-type headache.

PubMed

Akdal, Gülden; Ozge, Aynur; Ergör, Gül

2013-01-01

We assessed frequency of vestibular symptoms in Headache Clinic patients over 10 years. A descriptive study of 5111 consecutive patients with tension-type headache or migraine, analyzed for dizziness/ vertigo accompanying headache and for a lifetime history of motion-sickness, cyclic vomiting, recurrent abdominal pain or atopy. Migraine patients were re-grouped as those with vestibular symptoms (dizziness/vertigo or motion sickness) and those without and their data then re-analyzed. There were 1880 migraine patients and 3231 tension-type headache patients. Significantly more migraine patients than tension-type headache patients experienced vestibular symptoms (p< 0.0001). The migraine with vestibular symptoms group was significantly younger (p< 0.05) had more aura, more phonophobia with migraine attacks (p< 0.0001). Menstruation and reported sleep problems impacted on headaches. While past history of cyclical vomiting, recurrent abdominal pain or atopy was about twice as common in migraine with aura and it was also more common in migraine with vestibular symptoms than migraine without vestibular symptoms. Vestibular symptoms are common in migraine patients. Migraine with vestibular symptoms might constitute a special group, one more likely to have had cyclic vomiting, recurrent abdominal pain or atopy.

Where, When and Why Do Tsetse Contact Humans? Answers from Studies in a National Park of Zimbabwe

PubMed Central

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

2012-01-01

Background Sleeping sickness, also called human African trypanosomiasis, is transmitted by the tsetse, a blood-sucking fly confined to sub-Saharan Africa. The form of the disease in West and Central Africa is carried mainly by species of tsetse that inhabit riverine woodland and feed avidly on humans. In contrast, the vectors for the East and Southern African form of the disease are usually savannah species that feed mostly on wild and domestic animals and bite humans infrequently, mainly because the odours produced by humans can be repellent. Hence, it takes a long time to catch many savannah tsetse from people, which in turn means that studies of the nature of contact between savannah tsetse and humans, and the ways of minimizing it, have been largely neglected. Methodology/Principal Findings The savannah tsetse, Glossina morsitans morsitans and G. pallidipes, were caught from men in the Mana Pools National park of Zimbabwe. Mostly the catch consisted of young G. m. morsitans, with little food reserve. Catches were increased by 4–8 times if the men were walking, not stationary, and increased about ten times more if they rode on a truck at 10 km/h. Catches were unaffected if the men used deodorant or were baited with artificial ox odour, but declined by about 95% if the men were with an ox. Surprisingly, men pursuing their normal daily activities were bitten about as much when in or near buildings as when in woodland. Catches from oxen and a standard ox-like trap were poor indices of the number and physiological state of tsetse attacking men. Conclusion/Significance The search for new strategies to minimize the contact between humans and savannah tsetse should focus on that occurring in buildings and vehicles. There is a need to design a man-like trap to help to provide an index of sleeping sickness risk. PMID:22953013

Where, when and why do tsetse contact humans? Answers from studies in a national park of Zimbabwe.

PubMed

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

2012-01-01

Sleeping sickness, also called human African trypanosomiasis, is transmitted by the tsetse, a blood-sucking fly confined to sub-Saharan Africa. The form of the disease in West and Central Africa is carried mainly by species of tsetse that inhabit riverine woodland and feed avidly on humans. In contrast, the vectors for the East and Southern African form of the disease are usually savannah species that feed mostly on wild and domestic animals and bite humans infrequently, mainly because the odours produced by humans can be repellent. Hence, it takes a long time to catch many savannah tsetse from people, which in turn means that studies of the nature of contact between savannah tsetse and humans, and the ways of minimizing it, have been largely neglected. The savannah tsetse, Glossina morsitans morsitans and G. pallidipes, were caught from men in the Mana Pools National park of Zimbabwe. Mostly the catch consisted of young G. m. morsitans, with little food reserve. Catches were increased by 4-8 times if the men were walking, not stationary, and increased about ten times more if they rode on a truck at 10 km/h. Catches were unaffected if the men used deodorant or were baited with artificial ox odour, but declined by about 95% if the men were with an ox. Surprisingly, men pursuing their normal daily activities were bitten about as much when in or near buildings as when in woodland. Catches from oxen and a standard ox-like trap were poor indices of the number and physiological state of tsetse attacking men. The search for new strategies to minimize the contact between humans and savannah tsetse should focus on that occurring in buildings and vehicles. There is a need to design a man-like trap to help to provide an index of sleeping sickness risk.

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

PubMed

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

2009-07-01

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

A Countermeasure for Space Motion Sickness

NASA Technical Reports Server (NTRS)

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

2006-01-01

Overall, the results obtained in both the U.S. and the Russian space programs indicate that most space crews will experience some symptoms of motion sickness (MS) causing significant impact on the operational objectives that must be accomplished to assure mission success. At this time the primary countermeasure for MS requires the administration of Promethazine. Promethazine is not a benign drug, and is most frequently administered just prior to the sleep cycle to prevent its side effects from further compromising mission objectives. Clearly other countermeasures for SMS must be developed. Currently the primary focus is on two different technologies: (1) developing new and different pharmacological compounds with less significant side effects, (2) preflight training. The primary problem with all of these methods for controlling MS is time. New drugs that may be beneficial are years from testing and development, and preflight training requires a significant investment of crew time during an already intensive pre-launch schedule. Granted, motion sickness symptoms can be minimized with either of the two methods detailed above, however, it may be possible to develop a countermeasure that does not require either extensive adaptation time or exposure to motion sickness. Approximately 25 years ago Professor Geoffrey Melvill Jones presented his work on adaptation of the vestibuloocular reflex (VOR) using optically reversed vision (left-right prisms) during head rotations in the horizontal plane. It was of no surprise that most subjects experienced motion sickness while wearing the optically reversing prisms. However, a serendipitous finding emerged during this research showing that the same subjects did not experience motion sickness symptoms when wearing the reversing prisms under stroboscopic illumination. The mechanism, by which this side-effect was believed to have occurred, is not clearly understood. However, the fact that no motion sickness was ever noted, suggests the possibility of producing functionally useful adaptation during space flight without the penalty of disabling motion sickness by controlling the rate of the adaptive process by means of an appropriate stroboscopically presented environment. After several recent meetings with Professor Melvill Jones, we were encouraged to repeat the motion sickness portions of his and Mandl's 1981 stroboscopic experiment. In conducting this experiment we used a randomized cross-over design where subjects were randomly assigned to either a stroboscopic flash or no strobe for their first exposure in the experimental design. Twenty subjects (19 subjects completed the study) read a short passage from Treasure Island mounted on the wall approximately 1 m from their eyes while wearing left-right reversing prisms. The strobe on time of 3 microseconds and flash frequency of 4 Hz was set to equal that used in the original study. Motion sickness was scored using a modified Miller and Graybiel scale that we constructed to include symptoms that may be elicited under conditions where reversing prisms are worn. On this scale a score of 5 represented Malaise IIa (mild motion sickness) and a score of 8 or above is approaching frank sickness. Symptoms were tracked and recorded every 5 min during the task. Testing was limited to 30 min unless the subject had reached the MIIa score, at which time the test was terminated. Performance under stroboscopic illumination was significantly better than when the subjects read under normal room illumination while wearing the left-right reversing prisms. Based on these results we developed a goggle system using LCD material that can be strobed. To evaluate the effectiveness of stroboscopic goggles we tested an additional 9 subjects in addition to retesting 10 used in the stroboscopic pilot study described above. These 19 subjects wore a pair of strobing LCD goggles that could be cycled at 4 Hz. These subjects wore the goggles while also wearing left-right reversg prisms. Results while wearing the goggles showed that none of the 19 subjects scored at the MIIa level on the motion sickness rating scale. When the goggles did not flash (no strobe), 11 of the 19 developed symptoms above the MIIa criteria. As a countermeasure the goggles seem to be effective, even with an on time of 10 msec (time the goggles are clear). We have also collected anecdotal data, from our personnel in the Neuroscience Laboratory at the Johnson Space Center, suggesting that the goggles may effective in preventing carsickness.

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

NASA Technical Reports Server (NTRS)

Dijk, Derk-Jan

1999-01-01

Shuttle astronauts typically sleep only 6 to 6.5 hours per day while in orbit. This sleep loss is related to recurrent sleep cycle shifting--due to mission-dependent orbital mechanics and mission duration requirements-- and associated circadian displacement of sleep, the operational demands of space flight, noise and space motion sickness. Such sleep schedules are known to produce poor subjective sleep quality, daytime sleepiness, reduced attention, negative mood, slower reaction times, and impaired daytime alertness. Countermeasures to allow crew members to obtain an adequate amount of sleep and maintain adequate levels of neurobehavioral performance are being developed and investigated. However, it is necessary to develop methods that allow effective and attainable in-flight monitoring of vigilance to evaluate the effectiveness of these countermeasures and to detect and predict online critical decrements in alertness/performance. There is growing evidence to indicate that sleep loss and associated decrements in neurobehavioral function are reflected in the spectral composition of the electroencephalogram (EEG) during wakefulness as well as in the incidence of slow eye movements recorded by the electro-oculogram (EOG). Further-more, our preliminary data indicated that these changes in the EEG during wakefulness are more pronounced when subjects are in a supine posture, which mimics some of the physiologic effects of microgravity. Therefore, we evaluate the following hypotheses: (1) that during a 40-hour period of wakefulness (i.e., one night of total sleep deprivation) neurobehavioral function deteriorates, the incidence of slow eye-movements and EEG power density in the theta frequencies increases especially in frontal areas of the brain; (2) that the sleep deprivation induced deterioration of neurobehavioral function and changes in the incidence of slow eye movements and the spectral composition of the EEG are more pronounced when subjects are in a supine position; and (3) that based on assessment of slow-eye movements and quantitative on-line topographical analyses of EEG during wakefulness an EEG and or EOG parameter can be derived/constructed which accurately predicts changes in neurobehavioral function.

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

PubMed

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

2010-12-21

Human African trypanosomiasis (HAT), also known as sleeping sickness, is a fatal parasitic disease caused by trypanosomes. Current treatment options for HAT are scarce, toxic, no longer effective, or very difficult to administer, in particular for the advanced, fatal stage of the disease (stage 2, chronic HAT). New safe, effective and easy-to-use treatments are urgently needed. Here it is shown that fexinidazole, a 2-substituted 5-nitroimidazole rediscovered by the Drugs for Neglected Diseases initiative (DNDi) after extensive compound mining efforts of more than 700 new and existing nitroheterocycles, could be a short-course, safe and effective oral treatment curing both acute and chronic HAT and that could be implemented at the primary health care level. To complete the preclinical development and meet the regulatory requirements before initiating human trials, the anti-parasitic properties and the pharmacokinetic, metabolic and toxicological profile of fexinidazole have been assessed. Standard in vitro and in vivo anti-parasitic activity assays were conducted to assess drug efficacy in experimental models for HAT. In parallel, a full range of preclinical pharmacology and safety studies, as required by international regulatory guidelines before initiating human studies, have been conducted. Fexinidazole is moderately active in vitro against African trypanosomes (IC₅₀ against laboratory strains and recent clinical isolates ranged between 0.16 and 0.93 µg/mL) and oral administration of fexinidazole at doses of 100 mg/kg/day for 4 days or 200 mg/kg/day for 5 days cured mice with acute and chronic infection respectively, the latter being a model for the advanced and fatal stage of the disease when parasites have disseminated into the brain. In laboratory animals, fexinidazole is well absorbed after oral administration and readily distributes throughout the body, including the brain. The absolute bioavailability of oral fexinidazole was 41% in mice, 30% in rats, and 10% in dogs. Furthermore, fexinidazole is rapidly metabolised in vivo to at least two biologically active metabolites (a sulfoxide and a sulfone derivative) that likely account for a significant portion of the therapeutic effect. Key pharmacokinetic parameter after oral absorption in mice for fexinidazole and its sulfoxide and sulfone metabolites are a C(max) of 500, 14171 and 13651 ng/mL respectively, and an AUC₀₋₂₄ of 424, 45031 and 96286 h.ng/mL respectively. Essentially similar PK profiles were observed in rats and dogs. Toxicology studies (including safety pharmacology and 4-weeks repeated-dose toxicokinetics in rat and dog) have shown that fexinidazole is well tolerated. The No Observed Adverse Event Levels in the 4-weeks repeated dose toxicity studies in rats and dogs was 200 mg/kg/day in both species, with no issues of concern identified for doses up to 800 mg/kg/day. While fexinidazole, like many nitroheterocycles, is mutagenic in the Ames test due to bacterial specific metabolism, it is not genotoxic to mammalian cells in vitro or in vivo as assessed in an in vitro micronucleus test on human lymphocytes, an in vivo mouse bone marrow micronucleus test, and an ex vivo unscheduled DNA synthesis test in rats. The results of the preclinical pharmacological and safety studies indicate that fexinidazole is a safe and effective oral drug candidate with no untoward effects that would preclude evaluation in man. The drug has entered first-in-human phase I studies in September 2009. Fexinidazole is the first new clinical drug candidate with the potential for treating advanced-stage sleeping sickness in thirty years.

Need for recovery from work related fatigue and its role in the development and prediction of subjective health complaints

PubMed Central

Sluiter, J; de Croon, E M; Meijman, T; Frings-Dresen, M

2003-01-01

Aims: To present the available empirical evidence for the assumed position of the concept of work related fatigue as: (1) short term effect of the working day; and (2) an intermediate variable between work demands and the development of subjective health complaints and sickness absence. Methods: Results from six single occupation studies, conducted between 1996 and 2002, are presented. Work demands (working hours, decision latitude, break control/autonomy, and mental, emotional, and physical demands) were assessed through validated scales. Work related fatigue was represented and assessed by means of the need for recovery after working time scale in all studies. Subjective health complaints and duration of sickness absence were quantified with the same instruments in most studies as well. Both cross sectional studies (four) as well as prospective studies (two; up to two years follow up) were performed. Cross sectional data of 3820 workers, in total, were available. Prospective data were accessible for 1200 workers in industry and health care. Models were tested with stepwise multiple regression analyses. Results: Strong associations between work demands and need for necovery were found in different occupations. The variance explained in need for recovery by work demands, age, and (baseline) need for recovery ranged between 14% and 48% in both types of studies. The amount of explained variance by work demands, age, and (baseline) need for recovery in subjective health complaints ranged between 24% and 58% in the different occupations. The prospective data showed the prognostic value of need for recovery in relation to subjective health complaints (in terms of psychosomatic complaints, emotional exhaustion, or sleep problems) and duration of future sickness absence. Conclusions: The hypothesised role for work related fatigue as a link in the causal string of events, that is assumed to exist between repeated adverse work demands and the development of work related stress reactions, (psychological) overload and, eventually, health problems, was confirmed. PMID:12782749

Shape-Dependent Optoelectronic Cell Lysis**

PubMed Central

Kremer, Clemens; Witte, Christian; Neale, Steven L; Reboud, Julien; Barrett, Michael P; Cooper, Jonathan M

2014-01-01

We show an electrical method to break open living cells amongst a population of different cell types, where cell selection is based upon their shape. We implement the technique on an optoelectronic platform, where light, focused onto a semiconductor surface from a video projector creates a reconfigurable pattern of electrodes. One can choose the area of cells to be lysed in real-time, from single cells to large areas, simply by redrawing the projected pattern. We show that the method, based on the “electrical shadow” that the cell casts, allows the detection of rare cell types in blood (including sleeping sickness parasites), and has the potential to enable single cell studies for advanced molecular diagnostics, as well as wider applications in analytical chemistry. PMID:24402800

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

PubMed

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

2016-02-01

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

Automatic classification of background EEG activity in healthy and sick neonates

NASA Astrophysics Data System (ADS)

Löfhede, Johan; Thordstein, Magnus; Löfgren, Nils; Flisberg, Anders; Rosa-Zurera, Manuel; Kjellmer, Ingemar; Lindecrantz, Kaj

2010-02-01

The overall aim of our research is to develop methods for a monitoring system to be used at neonatal intensive care units. When monitoring a baby, a range of different types of background activity needs to be considered. In this work, we have developed a scheme for automatic classification of background EEG activity in newborn babies. EEG from six full-term babies who were displaying a burst suppression pattern while suffering from the after-effects of asphyxia during birth was included along with EEG from 20 full-term healthy newborn babies. The signals from the healthy babies were divided into four behavioural states: active awake, quiet awake, active sleep and quiet sleep. By using a number of features extracted from the EEG together with Fisher's linear discriminant classifier we have managed to achieve 100% correct classification when separating burst suppression EEG from all four healthy EEG types and 93% true positive classification when separating quiet sleep from the other types. The other three sleep stages could not be classified. When the pathological burst suppression pattern was detected, the analysis was taken one step further and the signal was segmented into burst and suppression, allowing clinically relevant parameters such as suppression length and burst suppression ratio to be calculated. The segmentation of the burst suppression EEG works well, with a probability of error around 4%.

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

PubMed

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

2016-09-01

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

PubMed Central

Laveissière, C.; Meda, A. H.; Doua, F.; Sane, B.

1998-01-01

The solution to the problem of human African trypanosomiasis (HAT) first of all requires improved case detection. Effective tests have been available for a number of years but the results of medical surveys are still mediocre, mainly because the populations are poorly mobilized. Those few mobile teams still visiting villages obtain very low presentation rates. In spite of major information campaigns among villagers, in Côte d'Ivoire the Institut Pierre Richet (IPR) and Trypanosomiasis Clinical Research Project (PRCT) teams examined only 42% (9311) of the 22,300 inhabitants of a disease focus during a conventional ten-day survey. In the same focus, community health workers specially trained in sleeping sickness and in the collection of blood samples on filter-paper examined 73% of the population (15,000 individuals) in less than two months. Implementation of a sleeping sickness control strategy is restricted to two types of intervention: either conventional mobile teams which are on hand, competent and rapidly operational but which fail to carry out exhaustive case detection, or integration of case detection into primary health care by entrusting surveillance to the community health workers. This approach requires a minimum of training but ensures that sentinels are permanently present in the village communities. By using the community health workers rather than mobile teams it should be possible to achieve comprehensive monitoring. In operational terms, the cost of surveillance per person is US$ 0.55 for the mobile teams as against US$ 0.10 for the community health workers. Integration of HAT case detection into primary health care is therefore an effective and economical solution, provided the community health workers are properly supervised and above all motivated. PMID:10191551

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

PubMed

Kennedy, Peter G E

2008-08-01

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

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.

The trucker strain monitor: an occupation-specific questionnaire measuring psychological job strain.

PubMed

De Croon, E M; Blonk, R W; Van der Beek, J; Frings-Dresen, M H

2001-08-01

To develop and validate a short and user-friendly questionnaire measuring psychological job strain in truck drivers. In cooperation with an occupational physician in the Dutch road transport industry we developed items on the basis of face validity and information of existing questionnaires on the subject. These items were pilot-tested, by means of interviews, in 15 truck drivers. Study I examined the factorial structure of the initial 30-item trucker strain monitor (TSM) in a sample of 153 truck drivers. Subsequently, number of items per factor was reduced on the basis of reliability analyses (Cronbach's alpha). Study II examined construct and criterion validity of the TSM in a randomly selected group of 2,000 truck drivers, of whom 1,111 participated (adjusted response = 63%). Additionally, sensitivity and specificity were assessed by examining the ability of the TSM to identify truck drivers with or without self-reported sickness absence in the past 12 months because of psychological complaints. Factor analyses of the initial 30-item TSM revealed a two-factor solution. Item reduction resulted in a six-item work-related fatigue scale and four-item sleeping problems scale with high internal consistency. Results of study II confirmed the internal consistency of the TSM scales and provided support for construct and criterion validity. The composite, work-related fatigue, and sleeping problems scale had a sensitivity of 83%, 80% and 71% respectively, in identifying truck drivers with prior sickness absence because of psychological complaints. Specificity rates were 72%, 73% and 72% respectively. Despite methodological limitations, the results suggest that the TSM is a reliable and valid indicator of psychological job strain in truck drivers. In particular, the composite and work-related fatigue scale identified drivers with prior absenteeism because of psychological complaints, quite accurately. Future longitudinal research in specific sub-groups of truck drivers including both self-reported and objective psychological health measures should evidence whether (1) the distinction between two indicators of psychological job strain is useful, and whether (2) the TSM can be used in screening out truck drivers at risk of developing psychological health problems.

Individual characteristics in occupational accidents due to imbalance: a case-control study of the employees of a railway company.

PubMed

Gauchard, G C; Chau, N; Touron, C; Benamghar, L; Dehaene, D; Perrin, PhP; Mur, J-M

2003-05-01

Falls are frequent occupational accidents, and are responsible for a significant amount of lost working time and, more importantly, for a high mortality. The factors involved in falling mechanisms can be of external or individual origin, the latter being less well identified. To assess the relations between certain individual characteristics and occupational accidents due to imbalance. A total of 427 male employees, who had been victims of at least one occupational accident with sick leave due to imbalance (cases) and 427 controls were recruited among the employees of a large French railway company. A standardised questionnaire on life conditions and professional factors, and a description of the accidents was filled in by an occupational physician for each subject. Some job categories were more affected by a specific release mechanism of work related falls. Certain individual characteristics such as smoking, alcohol consumption, inactivity, sleep disorders, and request for a job change were correlated with the occurrence of occupational accidents. Sick leaves of eight days or over were more frequent in older and overweight injured workers. Some lesions were linked with the specific fall released mechanisms. Individual characteristics can increase the risk of occupational accidents, especially falling. This study identified subjects most at risk on whom prevention related to working conditions and falls could be focused.

PubMed Central

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

1993-01-01

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

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

PubMed

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

2016-11-01

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

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

PubMed Central

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

2012-01-01

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

A polymorphism in the haptoglobin, haptoglobin related protein locus is associated with risk of human sleeping sickness within Cameroonian populations.

PubMed

Ofon, Elvis; Noyes, Harry; Mulindwa, Julius; Ilboudo, Hamidou; Simuunza, Martin; Ebo'o, Vincent; Njiokou, Flobert; Koffi, Mathurin; Bucheton, Bruno; Fogue, Pythagore; Hertz-Fowler, Christiane; MacLeod, Annette; Simo, Gustave

2017-10-01

Human African Trypanosomiasis (HAT) is a neglected disease targeted for elimination as a public health problem by 2020. Elimination requires a better understanding of the epidemiology and clinical evolution of HAT. In addition to the classical clinical evolution of HAT, asymptomatic carriers and spontaneous cure have been reported in West Africa. A genetic component to human susceptibility to HAT has been suggested to explain these newly observed responses to infection. In order to test for genetic associations with infection response, genetic polymorphism in 17 genes were tested (APOL1, IL1B, IL4, IL4R, IL6, IL8, IL12B, IL12RB1, IL10, TNFA, INFG, MIF, HLA-G, HLA-A, HP, HPR and CFH). A case-control study was performed on 180 blood samples collected from 56 cases and 124 controls from Cameroon. DNA was extracted from blood samples. After quality control, 25 samples (24 controls and 1 case) were eliminated. The genotyping undertaken on 155 individuals including 55 cases and 100 controls were investigated at 96 loci (88 SNPs and 8 indels) located on 17 genes. Associations between these loci and HAT were estimated via a case-control association test. Analyses of 64 SNPs and 4 indels out of 96 identified in the selected genes reveal that the minor allele (T) of rs8062041 in haptoglobin (HP) appeared to be protective against HAT (p = 0.0002395, OR 0.359 (CI95 [0.204-0.6319])); indicating higher frequency in cases compared to controls. This minor allele with adjusted p value of 0.0163 is associated with a lower risk (protective effect) of developing sleeping sickness. The haptoglobin related protein HPR and HP are tightly linked and both are duplicated in some people and may lead to higher activity. This increased production could be responsible of the protection associated with rs8062041 even though this SNP is within HP.

A polymorphism in the haptoglobin, haptoglobin related protein locus is associated with risk of human sleeping sickness within Cameroonian populations

PubMed Central

Ofon, Elvis; Noyes, Harry; Mulindwa, Julius; Ilboudo, Hamidou; Simuunza, Martin; Ebo’o, Vincent; Njiokou, Flobert; Koffi, Mathurin; Bucheton, Bruno; Fogue, Pythagore; Hertz-Fowler, Christiane; MacLeod, Annette

2017-01-01

Background Human African Trypanosomiasis (HAT) is a neglected disease targeted for elimination as a public health problem by 2020. Elimination requires a better understanding of the epidemiology and clinical evolution of HAT. In addition to the classical clinical evolution of HAT, asymptomatic carriers and spontaneous cure have been reported in West Africa. A genetic component to human susceptibility to HAT has been suggested to explain these newly observed responses to infection. In order to test for genetic associations with infection response, genetic polymorphism in 17 genes were tested (APOL1, IL1B, IL4, IL4R, IL6, IL8, IL12B, IL12RB1, IL10, TNFA, INFG, MIF, HLA-G, HLA-A, HP, HPR and CFH). Methodology A case-control study was performed on 180 blood samples collected from 56 cases and 124 controls from Cameroon. DNA was extracted from blood samples. After quality control, 25 samples (24 controls and 1 case) were eliminated. The genotyping undertaken on 155 individuals including 55 cases and 100 controls were investigated at 96 loci (88 SNPs and 8 indels) located on 17 genes. Associations between these loci and HAT were estimated via a case-control association test. Results Analyses of 64 SNPs and 4 indels out of 96 identified in the selected genes reveal that the minor allele (T) of rs8062041 in haptoglobin (HP) appeared to be protective against HAT (p = 0.0002395, OR 0.359 (CI95 [0.204–0.6319])); indicating higher frequency in cases compared to controls. This minor allele with adjusted p value of 0.0163 is associated with a lower risk (protective effect) of developing sleeping sickness. Conclusion The haptoglobin related protein HPR and HP are tightly linked and both are duplicated in some people and may lead to higher activity. This increased production could be responsible of the protection associated with rs8062041 even though this SNP is within HP. PMID:29077717

Factors Associated with Acquisition of Human Infective and Animal Infective Trypanosome Infections in Domestic Livestock in Western Kenya

PubMed Central

von Wissmann, Beatrix; Machila, Noreen; Picozzi, Kim; Fèvre, Eric M.; deC. Bronsvoort, Barend M.; Handel, Ian G.; Welburn, Susan C.

2011-01-01

Background Trypanosomiasis is regarded as a constraint on livestock production in Western Kenya where the responsibility for tsetse and trypanosomiasis control has increasingly shifted from the state to the individual livestock owner. To assess the sustainability of these localised control efforts, this study investigates biological and management risk factors associated with trypanosome infections detected by polymerase chain reaction (PCR), in a range of domestic livestock at the local scale in Busia, Kenya. Busia District also remains endemic for human sleeping sickness with sporadic cases of sleeping sickness reported. Results In total, trypanosome infections were detected in 11.9% (329) out of the 2773 livestock sampled in Busia District. Multivariable logistic regression revealed that host species and cattle age affected overall trypanosome infection, with significantly increased odds of infection for cattle older than 18 months, and significantly lower odds of infection in pigs and small ruminants. Different grazing and watering management practices did not affect the odds of trypanosome infection, adjusted by host species. Neither anaemia nor condition score significantly affected the odds of trypanosome infection in cattle. Human infective Trypanosoma brucei rhodesiense were detected in 21.5% of animals infected with T. brucei s.l. (29/135) amounting to 1% (29/2773) of all sampled livestock, with significantly higher odds of T. brucei rhodesiense infections in T. brucei s.l. infected pigs (OR = 4.3, 95%CI 1.5-12.0) than in T. brucei s.l. infected cattle or small ruminants. Conclusions Although cattle are the dominant reservoir of trypanosome infection it is unlikely that targeted treatment of only visibly diseased cattle will achieve sustainable interruption of transmission for either animal infective or zoonotic human infective trypanosomiasis, since most infections were detected in cattle that did not exhibit classical clinical signs of trypanosomiasis. Pigs were also found to be reservoirs of infection for T. b. rhodesiense and present a risk to local communities. PMID:21311575

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.

Optoelectronic tweezers for medical diagnostics

NASA Astrophysics Data System (ADS)

Kremer, Clemens; Neale, Steven; Menachery, Anoop; Barrett, Mike; Cooper, Jonathan M.

2012-01-01

Optoelectronic tweezers (OET) allows the spatial patterning of electric fields through selected illumination of a photoconductive surface. This enables the manipulation of micro particles and cells by creating non-uniform electrical fields that then produce dielectrophoretic (DEP) forces. The DEP responses of cells differ and can produce negative or positive (repelled or attracted to areas of high electric field) forces. Therefore OET can be used to manipulate individual cells and separate different cell types from each other. Thus OET has many applications for medical diagnostics, demonstrated here with work towards diagnosing Human African Trypanosomiasis, also known as sleeping sickness.

Tsetse-Wolbachia symbiosis: Comes of age and has great potential for pest and disease control

PubMed Central

Doudoumis, Vangelis; Alam, Uzma; Aksoy, Emre; Abd-Alla, Adly M.M.; Tsiamis, George; Brelsfoard, Corey; Aksoy, Serap; Bourtzis, Kostas

2013-01-01

Tsetse flies (Diptera: Glossinidae) are the sole vectors of African trypanosomes, the causative agent of sleeping sickness in human and nagana in animals. Like most eukaryotic organisms, Glossina species have established symbiotic associations with bacteria. Three main symbiotic bacteria have been found in tsetse flies: Wigglesworthia glossinidia, an obligate symbiotic bacterium, the secondary endosymbiont Sodalis glossinidius and the reproductive symbiont Wolbachia pipientis. In the present review, we discuss recent studies on the detection and characterization of Wolbachia infections in Glossina species, the horizontal transfer of Wolbachia genes to tsetse chromosomes, the ability of this symbiont to induce cytoplasmic incompatibility in Glossina morsitans morsitans and also how new environment-friendly tools for disease control could be developed by harnessing Wolbachia symbiosis. PMID:22835476

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.

Correlates of occupational injuries for various jobs in railway workers: a case-control study.

PubMed

Chau, Nearkasen; Mur, Jean-Marie; Touron, Christian; Benamghar, Lahoucine; Dehaene, Dominique

2004-07-01

Few studies have simultaneously addressed the role of occupational factors, individual characteristics and living conditions in occupational injuries, and to the best of our knowledge none on railway workers. This survey assessed the roles of these factors in various types of injuries and for various jobs in French railway workers. This case-control study was conducted on 1,305 male workers with an occupational injury during a one-year period and 1,305 male controls. A standardized questionnaire was administrated by an occupational physician. Data were analyzed by the logistic regression method. The significant factors found for all the injuries combined were: young age (<30 yr) (adjusted odds ratio 1.47, 95% CI 1.01-2.14), 5 yr or less in present job (1.43, 1.15-1.78), sleep disorders (1.30, 1.08-1.57), current smoker (1.27, 1.08-1.50), and no do-it-yourself or gardening activity (1.23, 1.02-1.48). Young age, sleep disorders, and smoking were common for several types of injuries. The role of these factors differed between various job categories. Among injured workers sick leaves of eight days or over were more frequent in current smokers and overweight subjects. In conclusion, young age, lack of experience, job dissatisfaction, sleep disorders, smoking, and lack of physical activity increase the risk of occupational injuries. The risks induced were related with jobs. Preventive measures concerning work conditions and these factors could be conducted in railway workers generally, and especially in workers most at risk. The occupational physician could make workers more sensitive to these risks and help them to improve their living conditions during medical examinations.

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

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

PubMed

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

2016-04-01

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

Assessment of Evidence Base from Medical Debriefs Data on Space Motion Sickness Incidence and Treatment

NASA Technical Reports Server (NTRS)

Younker, D.R.; Daniels, V.R.; Boyd, J.L.; Putcha, L.

2008-01-01

An objective of this data compilation and analysis project is to examine incidence and treatment efficacy of common patho-physiological disturbances during spaceflight. Analysis of medical debriefs data indicated that astronauts used medications to alleviate symptoms of four major ailments for which astronauts received treatment for sleep disturbances, space motion sickness (SMS), pain (headache, back pain) and sinus congestion. In the present data compilation and analysis project on SMS treatment during space missions, subject demographics (gender, age, first-time or repeat flyer), incidence and severity of SMS symptoms and subjective treatment efficacy from 317 crewmember debrief records were examined from STS-1 through STS-89. Preliminary analysis of data revealed that 50% of crew members reported SMS symptoms on at least one flight and 22% never experienced it. In addition, there were 387 medication dosing episodes reported, and promethazine was the most commonly used medication. Results of analysis of symptom check lists, medication use/efficacy and gender and flight record differences in incidence and treatment efficacy will be presented. Evidence gaps for treatment efficacy along with medication use trend analysis will be identified.

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.

Monitors Track Vital Signs for Fitness and Safety

NASA Technical Reports Server (NTRS)

2012-01-01

Have you ever felt nauseous reading a book in the back seat of a car? Or woken from a deep sleep feeling disoriented, unsure which way is up? Momentary mixups like these happen when the sensory systems that track the body's orientation in space become confused. (In the case of the backseat bookworm, the conflict arises when the reader s inner ear, part of the body s vestibular system, senses the car s motion while her eyes are fixed on the stationary pages of the book.) Conditions like motion sickness are common on Earth, but they also present a significant challenge to astronauts in space. Human sensory systems use the pull of gravity to help determine orientation. In the microgravity environment onboard the International Space Station, for example, the body experiences a period of confusion before it adapts to the new circumstances. (In space, even the body s proprioceptive system, which tells the brain where the arms and legs are oriented without the need for visual confirmation, goes haywire, meaning astronauts sometimes lose track of where their limbs are when they are not moving them.) This Space Adaptation Syndrome affects a majority of astronauts, even experienced ones, causing everything from mild disorientation to nausea to severe vomiting. "It can be quite debilitating," says William Toscano, a research scientist in NASA s Ames Research Center Psychophysiology Laboratory, part of the Center s Human Systems Integration Division. "When this happens, as you can imagine, work proficiency declines considerably." Since astronauts cannot afford to be distracted or incapacitated during critical missions, NASA has explored various means for preventing and countering motion sickness in space, including a range of drug treatments. Many effective motion sickness drugs, however, cause undesirable side effects, such as drowsiness. Toscano and his NASA colleague, Patricia Cowings, have developed a different approach: Utilizing biofeedback training methods, the pair can teach astronauts, military pilots, and others susceptible to motion sickness to self-regulate their own physiological responses and suppress the unpleasant symptoms. This NASA-patented method invented by Cowings is called the Autogenic Feedback Training Exercise (ATFE), and several studies have demonstrated its promise

[Human African trypanosomiasis in Côte d'Ivoire and Burkina Faso: optimization of epidemiologic surveillance strategies].

PubMed

Kambiré, R; Lingué, K; Courtin, F; Sidibé, I; Kiendrébéogo, D; N'gouan, K E; Blé, L; Kaba, D; Koffi, M; Solano, P; Bucheton, B; Jamonneau, V

2012-11-01

The objective of this paper was to describe recent data from Burkina Faso and Côte d'Ivoire on Human African Trypanosomosis medical monitoring in order to (i) update the disease situation in these two countries that have been sharing important migratory, economic and epidemiological links for more than a century and (ii) to define the future strategic plans to achieve the goal of a sustainable control/elimination process. Results of active and passive surveillance indicate that all sleeping sickness patients diagnosed these last years in Burkina Faso were imported cases from Côte d'Ivoire. Nevertheless the re-introduction of the parasite is effective and the risk of a resumption of transmission exists. In Côte d'Ivoire, few cases are still diagnosed in several historical foci and the fear exists that the disease could reemerge in these foci or spread to other areas. In order to achieve a sustainable elimination of sleeping sickness in these two countries, control entities have to adapt their strategy to the different epidemiological contexts. At the exception of specific cases, the current disease prevalence no longer justifies the use of expensive medical surveys by exhaustive screening of the population. New disease control strategies, based on the exchange of epidemiological information between the two countries and integrated to the regular national health systems are required to target priority intervention areas. Follow-up in time of both treated patients and serological suspects that are potential asymptomatic carriers of parasite is also important. In parallel, researchers need to better characterize the respective roles of the human and animal reservoir in the maintenance of transmission and evaluate the different control strategies taken by National Control Programs in term of cost/effectiveness to help optimize them.

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

PubMed

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

2014-11-01

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

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

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.

[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.

Family practice residents' maternity leave experiences and benefits.

PubMed

Gjerdingen, D K; Chaloner, K M; Vanderscoff, J A

1995-09-01

A growing number of residents are having babies during residency training. While many businesses are working to improve maternity conditions and benefits for their employees, residency programs are often not prepared to accommodate pregnant residents. This study was conducted to examine the maternity leave experiences of women who delivered infants during their family practice residency training. Program directors from each of the 394 family practice residency programs listed in the 1993 Directory of Family Practice Residency Programs were asked to distribute surveys to female residents who gave birth during their residency training and had returned to work by the time of the study. Of 199 known eligible residents, 171 (86%) completed surveys; these women represented 127 programs located in 36 states and Puerto Rico. Only 56.8% of women were aware of their program having a written maternity leave policy. The average length of maternity leave was 8 weeks; 76% had leaves of 10 weeks or less. For many, the maternity leave was derived from more than one source, including vacation, sick time, or a mother-child elective. Nearly all (88.3%) the women breast-fed, and the mean duration of breast-feeding was more than 19 weeks. In general, participants believed that having a baby during residency was somewhat difficult. Problems frequently encountered by women after their return to work included sleep deprivation and tiredness, difficulty arranging for child care, guilt about child care, and breast-feeding. Factors that detracted most from the childbirth experience were too little sleep, problems arranging for child care, and lack of support from the partner, residency faculty, and other residents. Having a baby during residency is somewhat difficult for the average female resident. Factors that may ease this difficulty include getting adequate sleep and receiving support from one's partner, faculty, and other residents.

The Silicon Trypanosome: a test case of iterative model extension in systems biology

PubMed Central

Achcar, Fiona; Fadda, Abeer; Haanstra, Jurgen R.; Kerkhoven, Eduard J.; Kim, Dong-Hyun; Leroux, Alejandro E.; Papamarkou, Theodore; Rojas, Federico; Bakker, Barbara M.; Barrett, Michael P.; Clayton, Christine; Girolami, Mark; Luise Krauth-Siegel, R.; Matthews, Keith R.; Breitling, Rainer

2016-01-01

The African trypanosome, Trypanosoma brucei, is a unicellular parasite causing African Trypanosomiasis (sleeping sickness in humans and nagana in animals). Due to some of its unique properties, it has emerged as a popular model organism in systems biology. A predictive quantitative model of glycolysis in the bloodstream form of the parasite has been constructed and updated several times. The Silicon Trypanosome (SilicoTryp) is a project that brings together modellers and experimentalists to improve and extend this core model with new pathways and additional levels of regulation. These new extensions and analyses use computational methods that explicitly take different levels of uncertainty into account. During this project, numerous tools and techniques have been developed for this purpose, which can now be used for a wide range of different studies in systems biology. PMID:24797926

Tsetse-Wolbachia symbiosis: comes of age and has great potential for pest and disease control.

PubMed

Doudoumis, Vangelis; Alam, Uzma; Aksoy, Emre; Abd-Alla, Adly M M; Tsiamis, George; Brelsfoard, Corey; Aksoy, Serap; Bourtzis, Kostas

2013-03-01

Tsetse flies (Diptera: Glossinidae) are the sole vectors of African trypanosomes, the causative agent of sleeping sickness in human and nagana in animals. Like most eukaryotic organisms, Glossina species have established symbiotic associations with bacteria. Three main symbiotic bacteria have been found in tsetse flies: Wigglesworthia glossinidia, an obligate symbiotic bacterium, the secondary endosymbiont Sodalis glossinidius and the reproductive symbiont Wolbachia pipientis. In the present review, we discuss recent studies on the detection and characterization of Wolbachia infections in Glossina species, the horizontal transfer of Wolbachia genes to tsetse chromosomes, the ability of this symbiont to induce cytoplasmic incompatibility in Glossina morsitans morsitans and also how new environment-friendly tools for disease control could be developed by harnessing Wolbachia symbiosis. Copyright © 2012 International Atomic Energy Agency. Published by Elsevier Inc. All rights reserved.

Parasite-specific immune response in adult Drosophila melanogaster: a genomic study

PubMed Central

Roxström-Lindquist, Katarina; Terenius, Olle; Faye, Ingrid

2004-01-01

Insects of the order Diptera are vectors for parasitic diseases such as malaria, sleeping sickness and leishmania. In the search for genes encoding proteins involved in the antiparasitic response, we have used the protozoan parasite Octosporea muscaedomesticae for oral infections of adult Drosophila melanogaster. To identify parasite-specific response molecules, other flies were exposed to virus, bacteria or fungi in parallel. Analysis of gene expression patterns after 24 h of microbial challenge, using Affymetrix oligonucleotide microarrays, revealed a high degree of microbe specificity. Many serine proteases, key intermediates in the induction of insect immune responses, were uniquely expressed following infection of the different organisms. Several lysozyme genes were induced in response to Octosporea infection, while in other treatments they were not induced or downregulated. This suggests that lysozymes are important in antiparasitic defence. PMID:14749722

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

PubMed

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

2004-03-01

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

Population mobility and trypanosomiasis in Africa*

PubMed Central

Prothero, R. Mansell

1963-01-01

Population mobility has long been established as a feature of life in Africa south of the Sahara. Even though it appears to be a factor in the spread of sleeping-sickness there do not seem to have been serious epidemics until the latter part of the nineteenth century and the early decades of the twentieth century. Various types of population movement of the present day and their possible relevance to trypanosomiasis are discussed. Density of population and settlement patterns are also important. Some of the changes in these which are relevant to trypanosomiasis are outlined and the need for more detailed information on these and on population mobility is emphasized. PMID:13986384

Preacclimatization in hypoxic chambers for high altitude sojourns.

PubMed

Küpper, Thomas E A H; Schöffl, Volker

2010-09-01

Since hypoxic chambers are more and more available, they are used for preacclimatization to prepare for sojourns at high altitude. Since there are different protocols and the data differ, there is no general consensus about the standard how to perform preacclimatization by simulated altitude. The paper reviews the different types of exposure and focuses on the target groups which may benefit from preacclimatization. Since data about intermittent hypoxia for some hours per day to reduce the incidence of acute mountain sickness differ, it is suggested to perform preacclimatization by sleeping some nights at a simulated altitude which follows the altitude profile of the "gold standard" for high altitude acclimatization.

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.

Improvement in altitude performance test after further acclimatization in pre-acclimatized soldiers.

PubMed

Tannheimer, Markus; Buzzelli, Mark D; Albertini, Nadine; Lechner, Raimund; Ulmer, Hans-V; Engelhardt, Michael

2013-05-01

The Altitude Performance Test is a measure designed to assess an individual's degree of acclimatization to reduce the risk of acute mountain sickness during high-altitude activities. The aim of this study was to investigate the hypothesis that test results will improve in pre-acclimatized soldiers after several days of further acclimatization. The Altitude Performance Test consists of an uphill run at high altitude. The event is timed and performed with continuous oxygen saturation (SpO2) monitoring. The individual's time and lowest SpO2 measurement are recorded. This test was performed on the first day of arriving at 11,060 ft, and after 9 days at the same location. The 37 male soldiers were all pre-acclimatized before arrival. The sleeping altitude remained constant at 11,060 ft, and the daytime altitudes increased up to a maximum of 15,775 ft. Test results improved significantly after a further 9 days of acclimatization (time, -11 s; SpO2, +5%-points; p ≤ 0.001). This is remarkable because all soldiers were pre-acclimatized and showed only minor acute mountain sickness symptoms during the entire stay. This indicates that the acclimatization process is not finished after amelioration of altitude symptoms. The demonstrated improvement in physical performance could prove very important, particularly during military missions performed at high altitude. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

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.

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.

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.

What paramedics think about when they think about fatigue: contributing factors.

PubMed

Paterson, Jessica L; Sofianopoulos, Sarah; Williams, Brett

2014-04-01

Paramedic fatigue is associated with burnout, attrition, sick leave, work disability, physical and mental health complaints and impaired performance. However, no studies have addressed how fatigue is understood by paramedics. The present study addresses this shortcoming by exploring factors paramedics recognise as contributors to fatigue. Forty-nine (12F; 38 years ± 9.7 years) Australian paramedics completed a survey on perceived causes of performance impairing fatigue. A total of 107 responses were systematically coded following principles common to qualitative data analysis: data immersion, coding, categorisation and theme generation. Six themes emerged: working time, sleep, workload, health and well-being, work-life balance and environment. Consistent with a scientific understanding of fatigue, prior sleep and wake, time of day and task-related factors were often identified as contributing to fatigue. In other cases, paramedics' attributions deviated from a scientific understanding of direct causes of fatigue. These findings demonstrate that paramedics have a broad understanding of fatigue. It is critical to take this into account when discussing fatigue with paramedics, particularly in the case of fatigue education or wellness programmes. These data highlight areas for intervention and education to minimise the experience of paramedic fatigue and the negative health and safety outcomes for paramedics and patients as a result. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

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.

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

PubMed Central

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

2014-01-01

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

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

PubMed

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

2015-04-01

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

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.

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.

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.

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.

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

PubMed

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

2013-07-01

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

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

Self Motion Perception and Motion Sickness

NASA Technical Reports Server (NTRS)

Fox, Robert A. (Principal Investigator)

1991-01-01

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

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

PubMed

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

2015-01-01

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

Towards understanding the presence/absence of Human African Trypanosomosis in a focus of Côte d'Ivoire: a spatial analysis of the pathogenic system

PubMed Central

Courtin, Fabrice; Jamonneau, Vincent; Oké, Emmanuel; Coulibaly, Bamoro; Oswald, Yohan; Dupont, Sophie; Cuny, Gérard; Doumenge, Jean-Pierre; Solano, Philippe

2005-01-01

Background This study aimed at identifying factors influencing the development of Human African Trypanosomosis (HAT, or sleeping sickness) in the focus of Bonon, located in the mesophile forest of Côte d'Ivoire. A previous study mapping the main daytime activity sites of 96 patients revealed an important disparity between the area south of the town- where all the patients lived- and the area north of the town, apparently free of disease. In order to explain this disparity, we carried out a spatial analysis of the key components of the pathogenic system, i.e. the human host, the tsetse vector and the trypanosomes in their environment using a geographic information system (GIS). Results This approach at the scale of a HAT focus enabled us to identify spatial patterns which linked to the transmission and the dissemination of this disease. The history of human settlement (with the rural northern area exploited much earlier than the southern one) appears to be a major factor which determines the land use pattern, which itself may account for differences found in vector densities (tsetse were found six times more abundant in the southern rural area than in the northern). Vector density, according to the human and environmental context in which it is found (here an intense mobility between the town of Bonon and the rural areas), may explain the observed spatial differences in HAT prevalence. Conclusion This work demonstrates the role of GIS analyses of key components of the pathogenic system in providing a better understanding of transmission and dissemination of HAT. Moreover, following the identification of the most active transmission areas, and of an area unfavourable to HAT transmission, this study more precisely delineates the boundaries of the Bonon focus. As a follow-up, targeted tsetse control activities starting north of Bonon (with few chances of reinvasion due to very low densities) going south, and additional medical surveys in the south will be proposed to the Ivoirian HAT control program to enhance the control of the disease in this focus. This work also shows the evolution of HAT regarding time and environment, and the methodology used may be able to predict possible sleeping sickness development/extinction in areas with similar history and space organization. PMID:16269078

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.

Brief intervention, physical exercise and cognitive behavioural group therapy for patients with chronic low back pain (The CINS trial).

PubMed

Harris, A; Moe, T F; Eriksen, H R; Tangen, T; Lie, S A; Tveito, T H; Reme, S E

2017-09-01

Cognitive-behavioural treatments (CBT) and physical group exercise (PE) have both shown promising effects in reducing disability and increasing work participation among chronic low back pain (CLBP) patients. A brief cognitive intervention (BI) has previously been demonstrated to reduce work disability in CLBP. The aim of this study was to test if the effect of BI could be further increased by adding either group CBT or group PE. A total of 214 patients, all sick listed 2-10 months due to CLBP, were randomized to BI (n = 99), BI + group CBT (n = 55) or BI + group PE (n = 60). Primary outcome was increased work participation at 12 months, whereas secondary outcomes included pain-related disability, subjective health complaints, anxiety, depression, coping and fear avoidance. There were no significant differences between the groups in work participation at 12 months follow-up (χ 2  = 1.15, p = 0.56). No significant differences were found on the secondary outcomes either, except for a statistically significant reduction (time by group) in pseudoneurology one domain of subjective health complaints (sleep problems, tiredness, dizziness, anxiety, depression, palpitation, heat flushes) (F 2,136  = 3.109, p = 0.048) and anxiety (F 2,143  = 4.899, p = 0.009) for the groups BI + group CBT and BI + group PE, compared to BI alone. However, these differences were not significant in post hoc analyses (Scheffé adjusted). There was no support for an effect of the added group CBT or group PE treatments to a brief cognitive intervention in this study of patients on sick leave due to low back pain. Our study demonstrates that treatments that previously were found to be effective and are included in most treatment guidelines, such as group cognitive-behavior therapy and exercise, were not effective in this given context compared to a brief, cognitive intervention. This implies that an optimized brief intervention is difficult to outperform in patients on sick leave due to low back pain. © 2017 European Pain Federation - EFIC®.

Advances in Pharmacotherapeutics of Space Motion Sickness

NASA Technical Reports Server (NTRS)

Putcha, Lakshmi

2006-01-01

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

[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.

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

The insomnia plague: a Gabriel García Márquez story.

PubMed

Sghirlanzoni, A; Carella, F

2000-08-01

"All the great writers have good eyes" is a sentence by V. Nabokov that is very suitable for G.G. Márquez and his One Hundred Years of Solitude. The novel, published in 1967, introduces among many others, the character of little Rebeca, whose frailness and greenish skin revealed hunger "that was older than she was". The girl, because of a pica syndrome, only liked to eat earth and the cake of whitewash. But her fate appears to be determined by the lethal insomnia plague, whose most fearsome part was not the impossibility of sleeping but its inexorable evolution toward a loss of memory in which the sick person "sinks into a kind of idiocy that had no past". Rebeca's lethal insomnia looks quite similar to the "peculiar, fatal disorder of sleep" originally described by Lugaresi et al. in 1986. One Hundred Years (of Solitude shows that G.G. Márquez was gifted not only with good eyes, but has the seductive power of changing reality into fantasy, while transforming his visions into reality.

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.

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.

TNF-alpha suppresses the expression of clock genes by interfering with E-box-mediated transcription.

PubMed

Cavadini, Gionata; Petrzilka, Saskia; Kohler, Philipp; Jud, Corinne; Tobler, Irene; Birchler, Thomas; Fontana, Adriano

2007-07-31

Production of TNF-alpha and IL-1 in infectious and autoimmune diseases is associated with fever, fatigue, and sleep disturbances, which are collectively referred to as sickness behavior syndrome. In mice TNF-alpha and IL-1 increase nonrapid eye movement sleep. Because clock genes regulate the circadian rhythm and thereby locomotor activity and may alter sleep architecture we assessed the influence of TNF-alpha on the circadian timing system. TNF-alpha is shown here to suppress the expression of the PAR bZip clock-controlled genes Dbp, Tef, and Hlf and of the period genes Per1, Per2, and Per3 in fibroblasts in vitro and in vivo in the liver of mice infused with the cytokine. The effect of TNF-alpha on clock genes is shared by IL-1beta, but not by IFN-alpha, and IL-6. Furthermore, TNF-alpha interferes with the expression of Dbp in the suprachiasmatic nucleus and causes prolonged rest periods in the dark when mice show spontaneous locomotor activity. Using clock reporter genes TNF-alpha is found here to inhibit CLOCK-BMAL1-induced activation of E-box regulatory elements-dependent clock gene promoters. We suggest that the increase of TNF-alpha and IL-1beta, as seen in infectious and autoimmune diseases, impairs clock gene functions and causes fatigue.

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.

Work-focused cognitive behavioral intervention for psychological complaints in patients on sick leave due to work-related stress: Results from a randomized controlled trial.

PubMed

Dalgaard, Vita Ligaya; Andersen, Lars Peter Sønderbo; Andersen, Johan Hviid; Willert, Morten Vejs; Carstensen, Ole; Glasscock, David John

2017-08-22

Work-related stress is a global problem with negative implications for individuals and society. The purpose of the current study was to evaluate a stress management intervention for patients on sick leave due to work-related stress complaints using a three-armed randomized controlled design. Participants were patients referred from three municipalities to the regional Department of Occupational Medicine. Inclusion criteria were: 1) sick leave due to work-related stress complaints, 2) a diagnosis of adjustment disorder or reactions to severe stress (ICD 10 code: F43,2 - F 43,9 not PTSD) or mild depressive episode (F 32.0). Through a double randomization procedure patients (n = 163) were randomized to either an intervention group (n = 58), a 'control group A' receiving a clinical examination (n = 56), or 'control group B' (n = 49) receiving no offers at the department. The intervention comprised six sessions of individual cognitive behavioral therapy and the offer of a small workplace intervention. Questionnaire data were analyzed with multivariate repeated measurements analysis. Primary outcomes assessed were perceived stress and general mental health. Secondary outcomes were sleep quality and cognitive failures. Follow-up was at four and 10 months after baseline. Complaints were significantly reduced in all groups over time. No group effects were observed between the intervention group and control group A that was clinically assessed. Significant group effects were found for perceived stress and memory when comparing the intervention group to group B, but most likely not due to an intervention effect. Psychological complaints improved substantially over time in all groups, but there was no significant treatment effect on any outcomes when the intervention group was compared to control group A that received a clinical assessment. ISRCTN ISRCTN91404229. Registered 03 August 2012 (retrospectively registered).

French research program on the physiological problems caused by weightlessness. Use of the primate model

NASA Astrophysics Data System (ADS)

Pesquies, P. C.; Milhaud, C.; Nogues, C.; Klein, M.; Cailler, B.; Bost, R.

The need to acquire a better knowledge of the main biological problems induced by microgravity implies—in addition to human experimentation—the use of animal models, and primates seem to be particularly well adapted to this type of research. The major areas of investigation to be considered are the phospho-calcium metabolism and the metabolism of supporting tissues, the hydroelectrolytic metabolism, the cardiovascular function, awakeness, sleep-awakeness cycles, the physiology of equilibrium and the pathophysiology of space sickness. Considering this program, the Centre d'Etudes et de Recherches de Medecine Aerospatiale, under the sponsorship of the Centre National d'Etudes Spatiales, developed both a program of research on restrained primates for the French-U.S. space cooperation (Spacelab program) and for the French-Soviet space cooperation (Bio-cosmos program), and simulation of the effects of microgravity by head-down bedrest. Its major characteristics are discussed in the study.

Asperentin B, a New Inhibitor of the Protein Tyrosine Phosphatase 1B.

PubMed

Wiese, Jutta; Aldemir, Hülya; Schmaljohann, Rolf; Gulder, Tobias A M; Imhoff, Johannes F

2017-06-21

In the frame of studies on secondary metabolites produced by fungi from deep-sea environments we have investigated inhibitors of enzymes playing key roles in signaling cascades of biochemical pathways relevant for the treatment of diseases. Here we report on a new inhibitor of the human protein tyrosine phosphatase 1B (PTP1B), a target in the signaling pathway of insulin. A new asperentin analog is produced by an Aspergillus sydowii strain isolated from the sediment of the deep Mediterranean Sea. Asperentin B ( 1 ) contains an additional phenolic hydroxy function at C-6 and exhibits an IC 50 value against PTP1B of 2 μM in vitro, which is six times stronger than the positive control, suramin. Interestingly, asperentin ( 2 ) did not show any inhibition of this enzymatic activity. Asperentin B ( 1 ) is discussed as possible therapeutic agents for type 2 diabetes and sleeping sickness.

Asperentin B, a New Inhibitor of the Protein Tyrosine Phosphatase 1B

PubMed Central

Wiese, Jutta; Aldemir, Hülya; Schmaljohann, Rolf; Gulder, Tobias A. M.; Imhoff, Johannes F.

2017-01-01

In the frame of studies on secondary metabolites produced by fungi from deep-sea environments we have investigated inhibitors of enzymes playing key roles in signaling cascades of biochemical pathways relevant for the treatment of diseases. Here we report on a new inhibitor of the human protein tyrosine phosphatase 1B (PTP1B), a target in the signaling pathway of insulin. A new asperentin analog is produced by an Aspergillus sydowii strain isolated from the sediment of the deep Mediterranean Sea. Asperentin B (1) contains an additional phenolic hydroxy function at C-6 and exhibits an IC50 value against PTP1B of 2 μM in vitro, which is six times stronger than the positive control, suramin. Interestingly, asperentin (2) did not show any inhibition of this enzymatic activity. Asperentin B (1) is discussed as possible therapeutic agents for type 2 diabetes and sleeping sickness. PMID:28635658

Psychosocial consequences for children experiencing parental loss due to HIV/AIDS in central China.

PubMed

Zhao, Guoxiang; Li, Xiaoming; Kaljee, Linda; Zhang, Liying; Fang, Xiaoyi; Zhao, Junfeng; Lin, Danhua; Lin, Xiuyun; Stanton, Bonita

2009-06-01

Individual in-depth interviews were conducted with 47 children (ages 8-17 years) experiencing the loss of one or both parents due to HIV/AIDS in two rural counties of central China. Findings in this study reveal that the families of the children orphaned by AIDS had experienced financial burdens because of treatment costs for sick parents and loss of labor in the household. The majority of the participants reported some level of stigmatization because of their parents' HIV status. The participants described feelings of sadness, fear, anxiety, anger, loneliness, low self-esteem, social withdrawal, and sleep problems. Implications for intervention programs include the need for psychological support and special counseling services, more public education with accurate knowledge about HIV/AIDS to decrease stigma and discrimination, and financial programs to decrease economic and caregiving burdens for these children.

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

PubMed Central

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

2004-01-01

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

Structural Genomics of Protein Phosphatases

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

Almo,S.; Bonanno, J.; Sauder, J.

The New York SGX Research Center for Structural Genomics (NYSGXRC) of the NIGMS Protein Structure Initiative (PSI) has applied its high-throughput X-ray crystallographic structure determination platform to systematic studies of all human protein phosphatases and protein phosphatases from biomedically-relevant pathogens. To date, the NYSGXRC has determined structures of 21 distinct protein phosphatases: 14 from human, 2 from mouse, 2 from the pathogen Toxoplasma gondii, 1 from Trypanosoma brucei, the parasite responsible for African sleeping sickness, and 2 from the principal mosquito vector of malaria in Africa, Anopheles gambiae. These structures provide insights into both normal and pathophysiologic processes, including transcriptionalmore » regulation, regulation of major signaling pathways, neural development, and type 1 diabetes. In conjunction with the contributions of other international structural genomics consortia, these efforts promise to provide an unprecedented database and materials repository for structure-guided experimental and computational discovery of inhibitors for all classes of protein phosphatases.« less

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.

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

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.

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

PubMed Central

2012-01-01

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

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

PubMed

Gahlinger , P M

2000-01-01

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

Automated electroencephalography system and electroencephalographic correlates of space motion sickness, part 3

NASA Technical Reports Server (NTRS)

Frost, J. D., Jr.

1977-01-01

Computer quantification methods were used to analyze the Skylab electroencephalographic data obtained during the course of the M133 series of experiments. This undertaking was prompted by initial observations made during visual analysis of the tape-recorded sleep records where there appeared to be an increase of the alpha-rhythm frequency during some inflight recording sessions, as compared to preflight baseline observations. A number of potential etiological factors are identified and their various possible influences discussed. The presence of the zero-g state is thought to be an important factor, possibly influencing EEG through alteration of vestibular function and/or by producing fluid shifts secondary to loss of hydrostatic pressure.

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.

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.

Barometric pressure change and heart rate response during sleeping at 3000 m altitude

NASA Astrophysics Data System (ADS)

Horiuchi, Masahiro; Endo, Junko; Handa, Yoko; Nose, Hiroshi

2018-05-01

We investigated effects of change in barometric pressure ( P B) with climate change on heart rate (HR) during sleep at 3000 m altitude. Nineteen healthy adults (15 males and four females; mean age 32 years) participated in this study. We measured P B (barometry) and HR (electrocardiography) every minute during their overnight stay in a mountain lodge at 3000 m. We also measured resting arterial oxygen saturation (SpO2) and evaluated symptoms of acute mountain sickness (AMS) by using the Lake Louise Questionnaire at 2305 and 3000 m, respectively. P B gradually decreased during the night at the speed of approximately - 0.5 hPa/h. We found that HR during sleep decreased linearly as P B decreased in all subjects, with significance ( r = 0.492-0.893; all, P < 0.001). Moreover, cross correlation analysis revealed that HR started to decrease after 15 min following the decrease in P B, on average. SpO2 was 93.8 ± 1.7% at 2305 m before climbing, then decreased significantly to 90.2 ± 2.2% at the lodge before going to bed, and further decreased to 87.5 ± 2.7% after waking (all, P < 0.05). Four of the 19 subjects showed a symptom of AMS after waking (21%). Further, the decrease in HR in response to a given decrease in P B (ΔHR/ΔPB) was negatively related with a decrease in SpO2 from before going to bed to after waking at 3000 m ( r = - 0.579, P = 0.009) and with total AMS scores after waking ( r = 0.489, P = 0.033).

Barometric pressure change and heart rate response during sleeping at 3000 m altitude

NASA Astrophysics Data System (ADS)

Horiuchi, Masahiro; Endo, Junko; Handa, Yoko; Nose, Hiroshi

2017-12-01

We investigated effects of change in barometric pressure (P B) with climate change on heart rate (HR) during sleep at 3000 m altitude. Nineteen healthy adults (15 males and four females; mean age 32 years) participated in this study. We measured P B (barometry) and HR (electrocardiography) every minute during their overnight stay in a mountain lodge at 3000 m. We also measured resting arterial oxygen saturation (SpO2) and evaluated symptoms of acute mountain sickness (AMS) by using the Lake Louise Questionnaire at 2305 and 3000 m, respectively. P B gradually decreased during the night at the speed of approximately - 0.5 hPa/h. We found that HR during sleep decreased linearly as P B decreased in all subjects, with significance (r = 0.492-0.893; all, P < 0.001). Moreover, cross correlation analysis revealed that HR started to decrease after 15 min following the decrease in P B, on average. SpO2 was 93.8 ± 1.7% at 2305 m before climbing, then decreased significantly to 90.2 ± 2.2% at the lodge before going to bed, and further decreased to 87.5 ± 2.7% after waking (all, P < 0.05). Four of the 19 subjects showed a symptom of AMS after waking (21%). Further, the decrease in HR in response to a given decrease in P B (ΔHR/ΔPB) was negatively related with a decrease in SpO2 from before going to bed to after waking at 3000 m (r = - 0.579, P = 0.009) and with total AMS scores after waking (r = 0.489, P = 0.033).

Preventing recurrence of severe morning sickness.

PubMed

Koren, Gideon; Maltepe, Caroline

2006-12-01

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

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

PubMed Central

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

2004-01-01

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

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.

[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.

Sickness behavior in feverish children is independent of the severity of fever. An observational, multicenter study.

PubMed

Corrard, François; Copin, Christian; Wollner, Alain; Elbez, Annie; Derkx, Véronique; Bechet, Stéphane; Levy, Corinne; Boucherat, Michel; Cohen, Robert

2017-01-01

Behavioral changes in a febrile child are usually considered to stem from the fever. We studied sickness behavior (SB) in terms of its clinical components and its relation to fever. This observational, multicenter study included children aged 6 months to 3 years who were either febrile (fever ≥12 hours, ≥ 39°C and ≥38°C at inclusion) or non-febrile and well. The child had to have been awake for the 2 hours preceding the consultation and cared for by the parent who brought him/her to the doctor. SB was evaluated according to 6 parameters over this 2-hour period: time spent playing, distance covered, time spent seeking comfort, time spent whining or crying, time spent in a state of irritation or of anger, most distorted facial expression. Two parameters were assessed for the 24-hour period preceding the consultation: time spent sleeping and appetite. The parent reported the degree of change in these parameters compared with the usual situation, using rating scales. 200 febrile children (most with nonspecific upper respiratory infections) and 200 non-febrile children were included. The mean values of the 8 parameters differed significantly (p<0.001) between the 2 groups and were independent of the height of fever at inclusion in the febrile children. In the study conditions, paracetamol failed to improve SB when the child was still feverish. The 8 parameters suggested that SB and fever are two independent manifestations that are activated simultaneously during an infection. This independence is in harmony with recommendations to treat the discomfort of SB and not the fever.

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 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.

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

PubMed

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

2009-02-15

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

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

PubMed Central

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

2009-01-01

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

Dropout during a driving simulator study: A survival analysis.

PubMed

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

2015-12-01

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

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.

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.

The work ability index and single-item question: associations with sick leave, symptoms, and health--a prospective study of women on long-term sick leave.

PubMed

Ahlstrom, Linda; Grimby-Ekman, Anna; Hagberg, Mats; Dellve, Lotta

2010-09-01

This study investigated the association between the work ability index (WAI) and the single-item question on work ability among women working in human service organizations (HSO) currently on long-term sick leave. It also examined the association between the WAI and the single-item question in relation to sick leave, symptoms, and health. Predictive values of the WAI, the changed WAI, the single-item question and the changed single-item question were investigated for degree of sick leave, symptoms, and health. This cohort study comprised 324 HSO female workers on long-term (>60 days) sick leave, with follow-ups at 6 and 12 months. Participants responded to questionnaires. Data on work ability, sick leave, health, and symptoms were analyzed with regard to associations and predictability. Spearman correlation and mixed-model analysis were performed for repeated measurements over time. The study showed a very strong association between the WAI and the single-item question among all participants. Both the WAI and the single-item question showed similar patterns of associations with sick leave, health, and symptoms. The predictive value for the degree of sick leave and health-related quality of life (HRQoL) was strong for both the WAI and the single-item question, and slightly less strong for vitality, neck pain, both self-rated general and mental health, and behavioral and current stress. This study suggests that the single-item question on work ability could be used as a simple indicator for assessing the status and progress of work ability among women on long-term sick leave.

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.

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.

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

PubMed Central

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

2017-01-01

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

Target organ damage in African American hypertension: role of APOL1.

PubMed

Freedman, Barry I; Murea, Mariana

2012-02-01

Apolipoprotein L1 (APOL1) gene association studies and results of the African American Study of Kidney Disease and Hypertension are disproving the longstanding concept that mild to moderate essential hypertension contributes substantially to end-stage renal disease susceptibility in African Americans. APOL1 coding variants underlie a spectrum of kidney diseases, including that attributed to hypertension (labeled arteriolar or hypertensive nephrosclerosis), focal segmental glomerulosclerosis, and HIV-associated nephropathy. APOL1 nephropathy risk variants persist because of protection afforded from the parasite that causes African sleeping sickness. This breakthrough will lead to novel treatments for hypertensive African Americans with low-level proteinuria, for whom effective therapies are lacking. Furthermore, APOL1 nephropathy risk variants contribute to racially variable allograft survival rates after kidney transplantation and assist in detecting nondiabetic forms of nephropathy in African Americans with diabetes. Discovery of APOL1-associated nephropathy was a major success of the genetics revolution, demonstrating that secondary hypertension is typically present in nondiabetic African Americans with nephropathy.

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

PubMed

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

2014-09-29

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

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.

Preventing recurrence of severe morning sickness

PubMed Central

Koren, Gideon; Maltepe, Caroline

2006-01-01

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

[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.

[Workplace bullying and sickness absenteeism].

PubMed

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

2013-01-01

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

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

PubMed

Murphy, I J

2014-09-01

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

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

PubMed

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

2014-01-01

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

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.

Commuting--a further stress factor for working people: evidence from the European Community. II. An empirical study.

PubMed

Costa, G; Pickup, L; Di Martino, V

1988-01-01

This report summarizes the main results of research promoted by the European Foundation for the Improvement of Living and Working Conditions, concerning the impact of commuting on the health and safety of workers. An empirical study, carried out among 1167 industrial Italian workers, shows that "commuters" (workers whose journey from home to work usually does not take less than 45 min in each direction) experienced a more stressed life-style than did "non commuters" (whose journey does not take more than 20 min). Commuting appears for many workers to be a necessity which is imposed by external factors, such as the housing market and job opportunities. Commuting is shown to interfere with patterns of everyday life by restricting free-time and reducing sleeping time. A majority of commuters use public transport mainly because of cost. Public transport commuters have problems due to more changes between modes, idle waiting times and delays leading to late arrival at work. Inside transport modes, commuters suffered discomfort as a result of overcrowding, microclimatic conditions, noise and vibrations. Commuters also reported higher psychological stress scores, more health complaints, essentially of psychosomatic nature, and greater absenteeism from work due to sickness. Commuting, in addition to shiftwork, further increases sleep problems, psychosomatic complaints and difficulties with family and social life. Women commuters were at a greater disadvantage than men, having more family difficulties, more travelling complaints and higher absenteeism.

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.

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.

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

PubMed

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

2015-04-15

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

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

PubMed

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

2015-01-01

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

Tsetse Control and Gambian Sleeping Sickness; Implications for Control Strategy

PubMed Central

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

2015-01-01

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

Cloning and expression of the hypoxanthine-guanine phosphoribosyltransferase gene from Trypanosoma brucei.

PubMed Central

Allen, T E; Ullman, B

1993-01-01

The hypoxanthine-guanine phosphoribosyltransferase (HGPRT) enzyme of Trypanosoma brucei and related parasites provides a rational target for the treatment of African sleeping sickness and several other parasitic diseases. To characterize the T. brucei HGPRT enzyme in detail, the T. brucei hgprt was isolated within a 4.2 kb SalI-KpnI genomic insert and sequenced. Nucleotide sequence analysis revealed an open reading frame of 630 bp that encoded a protein of 210 amino acids with a M(r) = 23.4 kd. After gap alignment, the T. brucei HGPRT exhibited 21-23% amino acid sequence identity, mostly in three clustered regions, with the HGPRTs from human, S. mansoni, and P falciparum, indicating that the trypanosome enzyme was the most divergent of the group. Surprisingly, the T. brucei HGPRT was more homologous to the hypoxanthine phosphoribosyltransferase (HPRT) from the prokaryote V. harveyi than to the eukaryotic HGPRTs. Northern blot analysis revealed two trypanosome transcripts of 1.4 and 1.9 kb, each expressed to equivalent degrees in insect vector and mammalian forms of the parasite. The T. brucei hgprt was inserted into an expression plasmid and transformed into S phi 606 E. coli that are deficient in both HPRT and xanthine-guanine phosphoribosyltransferase activities. Soluble, enzymatically active recombinant T. brucei HGPRT was expressed to high levels and purified to homogeneity by GTP-agarose affinity chromatography. The purified recombinant enzyme recognized hypoxanthine, guanine, and allopurinol, but not xanthine or adenine, as substrates and was inhibited by a variety of nucleotide effectors. The availability of a molecular clone encoding the T. brucei hgprt and large quantities of homogeneous recombinant HGPRT enzyme provides an experimentally manipulable molecular and biochemical system for the rational design of novel therapeutic agents for the treatment of African sleeping sickness and other diseases of parasitic origin. Images PMID:8265360

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.

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

PubMed

Skagen, Kristian; Collins, Alison M

2016-07-01

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

Predictors of sickness absence in college and university educated self-employed: a historic register study

PubMed Central

2014-01-01

Background Despite a large proportion of the workforce being self-employed, few studies have been conducted on risk factors for sickness absence in this population. The aim of this study is to identify risk factors for future sickness absence in a population of college and university educated self-employed. Methods In a historic register study based on insurance company files risk factors were identified by means of logistic regression analysis. Data collected at application for private disability insurance from 634 applicants were related to subsequent sickness absence periods of 30 days or more during a follow-up period of 7.95 years. Variables studied were self-reported lifestyle variables, variables concerning medical history and present health conditions and variables derived from the general medical examination including blood tests and urinary analysis. Results Results from analysis of data from 634 applicants for private disability insurance show that previous periods of sickness absence (OR 2.07), female gender (OR 2.04), health complaints listed in the health declaration (OR 1.88), elevated erythrocyte sedimentation rate (ESR) (OR 4.05) and the nature of the profession were related to a higher risk of sickness absence. Conclusions Sickness absence was found to be related to demographic variables (gender, profession), medical variables (health complaints and erythrocyte sedimentation rate) and to variables with both a medical and a behavioural component (previous sickness absence). PMID:24886527

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

PubMed

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

2016-09-01

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

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.

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

PubMed

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

2017-10-01

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

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 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.

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

PubMed

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

2013-11-01

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

Methods of Reducing Sick Leave Abuse. An ERS Information Aid.

ERIC Educational Resources Information Center

Stemnock, Suzanne K.

A perennial concern to educational administrators is the abuse of sick leave by school employees. Numerous suggestions have been offered for reducing the abuse of sick leave both within education and industry. This publication reviews 12 research studies that evaluate plans for reducing sick leave abuse among various categories of employees. Also…

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

Hearing difficulties, ear-related diagnoses and sickness absence or disability pension--a systematic literature review.

PubMed

Friberg, Emilie; Gustafsson, Klas; Alexanderson, Kristina

2012-09-12

Hearing difficulties is a large public health problem, prognosticated to be the ninth leading burden of disease in 2030, and may also involve large consequences for work capacity. However, research regarding sickness absence and disability pension in relation to hearing difficulties is scarce. The aim was to gain knowledge about hearing difficulties or other ear-related diagnoses and sickness absence and disability pension through conducting a systematic literature review of published studies. Studies presenting empirical data on hearing difficulties or ear-related diagnoses and sick leave or disability pension, published in scientific peer-reviewed journals, were included. Studies were sought for in three ways: in literature databases (Pub-Med, Embase, PsycInfo, SSCI, and Cochrane) through March 2011, through scrutinising lists of references, and through contacts. Identified publications were assessed for relevance and data was extracted from the studies deemed relevant. A total of 18 studies were assessed as relevant and included in this review, regardless of scientific quality. Fourteen studies presented empirical data on hearing difficulties/ear diagnoses and sick leave and six on these conditions and disability pension. Only two studies presented rate ratios or odds ratios regarding associations between hearing difficulties and sick leave, and only two on hearing difficulties and risk of disability pension. Both measures of hearing difficulties and of sick leave varied considerable between the studies. Remarkably few studies on hearing difficulties in relation to sickness absence or disability pension were identified. The results presented in them cannot provide evidence for direction or magnitude of potential associations.

Hearing difficulties, ear-related diagnoses and sickness absence or disability pension - a systematic literature review

PubMed Central

2012-01-01

Background Hearing difficulties is a large public health problem, prognosticated to be the ninth leading burden of disease in 2030, and may also involve large consequences for work capacity. However, research regarding sickness absence and disability pension in relation to hearing difficulties is scarce. The aim was to gain knowledge about hearing difficulties or other ear-related diagnoses and sickness absence and disability pension through conducting a systematic literature review of published studies. Methods Studies presenting empirical data on hearing difficulties or ear-related diagnoses and sick leave or disability pension, published in scientific peer-reviewed journals, were included. Studies were sought for in three ways: in literature databases (Pub-Med, Embase, PsycInfo, SSCI, and Cochrane) through March 2011, through scrutinising lists of references, and through contacts. Identified publications were assessed for relevance and data was extracted from the studies deemed relevant. Results A total of 18 studies were assessed as relevant and included in this review, regardless of scientific quality. Fourteen studies presented empirical data on hearing difficulties/ear diagnoses and sick leave and six on these conditions and disability pension. Only two studies presented rate ratios or odds ratios regarding associations between hearing difficulties and sick leave, and only two on hearing difficulties and risk of disability pension. Both measures of hearing difficulties and of sick leave varied considerable between the studies. Conclusions Remarkably few studies on hearing difficulties in relation to sickness absence or disability pension were identified. The results presented in them cannot provide evidence for direction or magnitude of potential associations. PMID:22966953

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.

Measuring Adaptive Coping of Hospitalized Patients With a Severe Medical Condition: The Sickness Insight in Coping Questionnaire.

PubMed

Boezeman, Edwin J; Hofhuis, José G M; Hovingh, Aly; Cox, Christopher E; de Vries, Reinout E; Spronk, Peter E

2016-09-01

Adaptive coping strategies are associated with less psychological distress. However, there is no brief, specific, and validated instrument for assessing adaptive coping among seriously ill patients. Our objective was to examine the validity and patient-proxy agreement of a novel instrument, the Sickness Insight in Coping Questionnaire. A cross-sectional design which included two related studies. A single university-affiliated Dutch hospital. Hospitalized patients (study 1) and ICU-patients and proxies (study 2). None. Study 1 (n = 103 hospitalized patients) addressed the Sickness Insight in Coping Questionnaire's performance relative to questionnaires addressing similar content areas. Coping subscales of the BRIEF COPE, Illness Cognition Questionnaire, and Utrecht Coping List were used as comparator measures in testing the construct validity of the Sickness Insight in Coping Questionnaire-subscales (fighting spirit, toughness, redefinition, positivism, and non-acceptance). The Sickness Insight in Coping Questionnaire had good internal consistency (0.64 ≤ α ≤ 0.79), a clear initial factor structure, and fair convergent (0.24 ≤ r ≤ 0.50) and divergent (r, ≤ 0.12) construct validity. Study 2 examined the performance of the Sickness Insight in Coping Questionnaire among 100 ICU patients and their close family members. This study showed that the Sickness Insight in Coping Questionnaire has good structural validity (confirmatory factor analyses with Comparative Fit Index > 0.90 and Root Mean Square Error of Approximation < 0.08) and moderate (r, 0.37; non-acceptance) to strong (r, > 0.50; fighting spirit, toughness, redefinition, and positivism) patient-close proxy agreement. Overall, the Sickness Insight in Coping Questionnaire has good psychometric properties. ICU clinicians can use the Sickness Insight in Coping Questionnaire to gain insight in adaptive coping style of patients through ratings of patients or their close family members.

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.

Liver-brain interactions in inflammatory liver diseases: implications for fatigue and mood disorders.

PubMed

D'Mello, Charlotte; Swain, Mark G

2014-01-01

Chronic inflammatory liver diseases are often accompanied by behavior alterations including fatigue, mood disorders, cognitive dysfunction and sleep disturbances. These altered behaviors can adversely affect patient quality of life. The communication pathways between the inflamed liver and the brain that mediate changes in central neural activity leading to behavior alterations during liver inflammation are poorly understood. Neural and humoral communication pathways have been most commonly implicated as driving peripheral inflammation to brain signaling. Classically, the cytokines TNFα, IL-1β and IL-6 have received the greatest scientific attention as potential mediators of this communication pathway. In mice with liver inflammation we have identified a novel immune-mediated liver-to-brain communication pathway whereby CCR2(+) monocytes found within the peripheral circulation transmigrate into the brain parenchyma in response to MCP-1/CCL2 expressing activated microglia. Inhibition of cerebral monocyte infiltration in these mice significantly improved liver inflammation associated sickness behaviors. Importantly, in recent work we have found that at an earlier time point, when cerebral monocyte infiltration is not evident in mice with liver inflammation, increased monocyte:cerebral endothelial cell adhesive interactions are observed using intravital microscopy of the brain. These monocyte:cerebral endothelial cell adhesive interactions are P-selectin mediated, and inhibition of these interactions attenuated microglial activation and sickness behavior development. Delineating the pathways that the periphery uses to communicate with the brain during inflammatory liver diseases, and the central neurotransmitter systems that are altered through these communication pathways (e.g., serotonin, corticotrophin releasing hormone) to give rise to liver inflammation-associated sickness behaviors, will allow for the identification of novel therapeutic targets to decrease the burden of debilitating symptoms in these patients. Copyright © 2013 Elsevier Inc. All rights reserved.

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

PubMed Central

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

2007-01-01

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

Low back pain predict sickness absence among power plant workers

PubMed Central

Murtezani, Ardiana; Hundozi, Hajrije; Orovcanec, Nikola; Berisha, Merita; Meka, Vjollca

2010-01-01

Background: Low back pain (LBP) remains the predominant occupational health problem in most industrialized countries and low-income countries. Both work characteristics and individual factors have been identified as risk factors. More knowledge about the predictors of sickness absence from LBP in the industry will be valuable in determining strategies for prevention. Objectives: The aim of this longitudinal study was to investigate whether individual, work-related physical risk factors were involved in the occurrence of LBP sickness absence. Methods: A follow-up study was conducted among 489 workers, aged 18–65 years, at Kosovo Energetic Corporation in Kosovo. This cross-sectional study used a self-administered questionnaire to collect data on individual and work-related risk factors and the occurrence of LBP sickness absence. Logistic regression models were used to determine associations between risk factors and the occurrence of sickness absence due to LBP. Results: Individual factors did not influence sickness absence, whereas work-related physical factors showed strong associations with sickness absence. The main risk factors for sickness absence due to LBP among production workers were extreme trunk flexion (OR = 1.71, 95% CI = 1.05–2.78) as well as very extreme trunk flexion (OR = 6.04, 95% CI = 1.12–32.49) and exposure to whole-body vibration (OR = 1.75, 95% CI = 1.04–2.95). Conclusion: Reducing sickness absence from LBP among power plant workers requires focusing on the working conditions of blue-collar workers and risk factors for LBP. Increasing social support in the work environment may have effects in reducing sickness absence from LBP. PMID:21120081

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

PubMed

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

2008-08-01

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

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

PubMed

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

2016-10-01

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

Sickness absenteeism and associated factors among horticulture employees in lume district, southeast Ethiopia.

PubMed

Tadesse, Sebsibe; Ebrahim, Kamil; Gizaw, Zemichael

2015-01-01

Sickness absenteeism is the major occupational health problem in developing countries where the majority of working population are engaged in hazardous sectors, such as agriculture. However, there is a dearth of studies clarifying the situation in most of Subsaharan African countries, like Ethiopia. The present study determined the magnitude of sickness absenteeism and associated factors among horticulture employees in Lume District, southeast Ethiopia. An institutional-based cross-sectional study was conducted among horticulture employees in Lume District, southeast Ethiopia from March to May 2014. Stratified sampling followed by simple random sampling techniques was used to select the study participants. A pre-tested and structured questionnaire was used to collect data. Multivariable analyses were employed to see the effect of explanatory variables on dependent variable. The magnitude of sickness absenteeism was 58.8 % [95 % CI: (54.9, 62.5)] in the past three months. Absence of periodic medical checkup, working for more than 48 h per week, working overtime, job dissatisfaction, and job stress were factors significantly associated with sickness absenteeism. In this study a relatively higher rate of sickness absenteeism was reported compared to other studies. Interventions to reduce sickness absenteeism should focus on areas, such as periodic medical checkup, monitoring work schedules, improving employees' job satisfaction, and managing job stress.

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.

Associations between sickness absence and harassment, threats, violence, or discrimination: a cross-sectional study of the Swedish Police.

PubMed

Svedberg, Pia; Alexanderson, Kristina

2012-01-01

To study if sick leave among employees in the Swedish Police was associated with experiences of discrimination, harassment, or (threats of) violence. All employees in the Swedish Police in 2005. Analyses of data from a questionnaire to all employees; 74% (n=16,725) responded. Odds ratios (OR) with 95% confidence intervals (CI) between sick leave and the studied factors were assessed. The rate of sickness absence was higher for women (12%) than for men (8%) (p< 0.001). More women than men had experienced discrimination, while more men reported harassment from the public and experiences of threats or violence. ORs were significant between sick-leave and discrimination, sexual harassment, and violence, and higher for the men. Associations between harassment from the public, threats of violence or violence, and sickness absence were statistically significant for men only. The study identifies the importance of investigating discrimination, harassment, and violence in relation to health outcomes for both male and female Police employees.

Chinese hyper-susceptibility to vection-induced motion sickness

NASA Technical Reports Server (NTRS)

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

1993-01-01

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

Examination of the double burden hypothesis-a systematic review of work-family conflict and sickness absence.

PubMed

Nilsen, Wendy; Skipstein, Anni; Østby, Kristian A; Mykletun, Arnstein

2017-06-01

Women consistently have higher sickness absence than men. The double-burden hypothesis suggests this is due to higher work-family burden in women than men. The current study aimed to systematically review prospective studies of work-family conflict and subsequent sickness absence. A systematic search was conducted in the electronic databases Medline, PsycINFO, and Embase with subject heading terms and keywords with no language or time restrictions. Two reviewers independently screened abstracts and read full-texts with pre-defined inclusion and exclusion criteria. Eight included studies ( n = 40 856 respondents) measure perceived work-family conflict and subsequent sickness absence. We found moderate evidence for a positive relationship between work-family conflict and subsequent sickness absence, and that women experience higher levels of work-family conflict than men. Work-family conflict is associated with later sickness absence, and work-family conflict is more common for women than for men. This indicates that work-family conflict may contribute to the gender gap in sick leave. However, further studies are needed to confirm whether this relationship is causal. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association.

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

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

PubMed

Johansson, Gun; Lundberg, Ingvar

2004-05-01

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

Converging Indicators for Assessing Individual Differences in Adaptation to Extreme Environments: Preliminary Report

NASA Technical Reports Server (NTRS)

Cowings, Patricia S.; Toscano, William B.; DeRoshia, Charles W.; Taylor, Bruce; Hines, Seleimah; Bright, Andrew; Dodds, Anika

2006-01-01

This paper describes the development and validation of a new methodology for assessing the deleterious effects of spaceflight on crew health and performance. It is well known that microgravity results in various physiological alterations, e.g., headward fluid shifts which can impede physiological adaptation. Other factors that may affect crew operational efficiency include disruption of sleep-wake cycles, high workload, isolation, confinement, stress and fatigue. From an operational perspective, it is difficult to predict which individuals will be most or least affected in this unique environment given that most astronauts are first-time flyers. During future lunar and Mars missions space crews will include both men and women of multi-national origins, different professional backgrounds, and various states of physical condition. Therefore, new methods or technologies are needed to monitor and predict astronaut performance and health, and to evaluate the effects of various countermeasures on crew during long duration missions. This paper reviews several studies conducted in both laboratory and operational environments with men and women ranging in age between 18 to 50 years. The studies included the following: soldiers performing command and control functions during mobile operations in enclosed armored vehicles; subjects participating in laboratory tests of an anti-motion sickness medication; subjects exposed to chronic hypergravity aboard a centrifuge, and subject responses to 36-hours of sleep deprivation. Physiological measurements, performance metrics, and subjective self-reports were collected in each study. The results demonstrate that multivariate converging indicators provide a significantly more reliable method for assessing environmental effects on performance and health than any single indicator.

How physicians have learned to handle sickness-certification cases.

PubMed

Löfgren, Anna; Silén, Charlotte; Alexanderson, Kristina

2011-05-01

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

Sick leave and the impact of job-to-job mobility on the likelihood of remaining on the labour market--a longitudinal Swedish register study.

PubMed

Nordström, Karin; Ekberg, Kerstin; Hemmingsson, Tomas; Johansson, Gun

2014-04-03

Change of job could be a strategy in vocational rehabilitation when return to the original job is not possible, but research is very limited concerning the effects of job mobility on the future vocational situation. The aim of the study was to investigate whether job-to-job mobility affects the likelihood of remaining on the labour market over time among persons who are employed and have experienced long-term sick leave. In a longitudinal register study, cohorts from three base years (1994, 1999 and 2004) were created, based on the Swedish population who were 20-60 years old, had sickness allowance insurance, and were employed in the base year and the following year (n>3,000,000). The likelihood that individuals on long-term sick leave were employed later depending on whether or not they changed workplace during the present or next year of long-term sick leave was analyzed using logistic regression analysis. Age, sector, industry, children, marital status, education, income, rate of sick leave and earlier sick leave and earlier mobility were taken into consideration. Women with more than 180 days' sick leave who changed workplaces were more likely to have a job later compared with those who did not change jobs. For men, the association was statistically significant with 1994 and 2004 as base years, but not in the cohort from 1999. The present study indicates that for those on long-term sick leave that changed workplaces, the opportunities to stay on the labour market might increase. However, the study has methodological limitations and the results for men are ambiguous. We do not therefore have enough evidence for recommending job change as a strategy for vocational rehabilitation.

[Profile of tropical diseases in Portugal].

PubMed

Ventura, F A

1996-01-01

The increased incidence of Imported Tropical Diseases in Portugal is correlated to a recent higher standard of living, influence of media and a consequent expansion of tourism, and above all to the close relationship existing between Portugal and Africa. The number and pathology (parasitic diarrhoeas, protozoal and helminthic infections) of in-patients with Tropical Diseases at the Unidade de Doenças Infecciosas, Parasitárias e de Medicina Tropical (UDIP-MT) were described, with special emphasis on Malaria (155 in-patients during the period from 1989 to 1993) and on Sleeping Sickness, where Eflornitin (DFMO) was for the first time used in Portugal. Finally, the impact of HIV epidemic on incidence and different clinical presentations of parasitic and other tropical pathology was also evaluated.

Activation and inhibition of CTP synthase from Trypanosoma brucei, the causative agent of African sleeping sickness.

PubMed

Steeves, Craig H; Bearne, Stephen L

2011-09-15

CTP Synthase from Trypanosoma brucei (TbCTPS) catalyzes the conversion of UTP to CTP and is a recognized target for the development of antiprotozoal agents. GTP activates glutamine-dependent CTP formation catalyzed by TbCTPS at concentrations below 0.2 mM, but inhibits this activity at concentrations above 0.2 mM. TbCTPS catalyzes ammonia-dependent CTP formation, which is inhibited by purine derivatives such as GTP, guanosine, caffeine, and uric acid with IC(50) values of 460, 380, 480, and 100 μM, respectively. These observations suggest that the purine ring may serve as a useful scaffold for the development of inhibitors of trypanosomal CTP synthase. Copyright © 2011 Elsevier Ltd. All rights reserved.

African trypanosomiasis with special reference to Egyptian Trypanosoma evansi: is it a neglected zoonosis?

PubMed

El-Bahnasawy, Mamdouh M M; Khater, Mai Kh A; Morsy, Tosson A

2014-12-01

Trypanosomes (including humans) are blood and sometimes tissue parasites of the order Kinetoplastida, family Trypanosomatidae, genus Trypanosoma, principally transmitted by biting insects where most of them undergo a biological cycle. They are divided into Stercoraria with the posterior station inoculation, including T. cruzi, both an extra- and intracellular parasite that causes Chagas disease, a major human disease affecting 15 million people and threatening 100 million people in Latin America, and the Salivaria with the anterior station inoculation, mainly African livestock pathogenic trypanosomes, including the agents of sleeping sickness, a major human disease affecting around half a million people and threatening 60 million people in Africa. Now, T. evansi was reported in man is it required to investigate its zoonotic potential?

Focus Group Study Exploring Factors Related to Frequent Sickness Absence.

PubMed

Notenbomer, Annette; Roelen, Corné A M; van Rhenen, Willem; Groothoff, Johan W

2016-01-01

Research investigating frequent sickness absence (3 or more episodes per year) is scarce and qualitative research from the perspective of frequent absentees themselves is lacking. The aim of the current study is to explore awareness, determinants of and solutions to frequent sickness absence from the perspective of frequent absentees themselves. We performed a qualitative study of 3 focus group discussions involving a total of 15 frequent absentees. Focus group discussions were audiotaped and transcribed verbatim. Results were analyzed with the Graneheim method using the Job Demands Resources (JD-R) model as theoretical framework. Many participants were not aware of their frequent sickness absence and the risk of future long-term sickness absence. As determinants, participants mentioned job demands, job resources, home demands, poor health, chronic illness, unhealthy lifestyles, and diminished feeling of responsibility to attend work in cases of low job resources. Managing these factors and improving communication (skills) were regarded as solutions to reduce frequent sickness absence. The JD-R model provided a framework for determinants of and solutions to frequent sickness absence. Additional determinants were poor health, chronic illness, unhealthy lifestyles, and diminished feeling of responsibility to attend work in cases of low job resources. Frequent sickness absence should be regarded as a signal that something is wrong. Managers, supervisors, and occupational health care providers should advise and support frequent absentees to accommodate job demands, increase both job and personal resources, and improve health rather than express disapproval of frequent sickness absence and apply pressure regarding work attendance.

The popularity of injections in the Third World: origins and consequences for poliomyelitis.

PubMed

Wyatt, H V

1984-01-01

Paralysis from poliomyelitis may follow injections yet injections are extremely popular in the Third World. Some injections are given by hospital doctors and nurses but the majority are given by traditional healers, pharmacists and paramedical workers who have acquired syringes. Many injections may be given to a sick child. I suggest that the early use of vaccines did not persuade people of the mystic of injections and that the mystic predated the use of penicillin. The earliest mystical result would have been the injection of quinine for malaria and antrypal for sleeping sickness. The words brilliant, spectacular and dramatic were first used to describe the mass campaigns against yaws and kala-azar in the 1920s and 1930s. A single injection healed the ugly lesions in a week: cause and effect were visible. In the 1950s penicillin was used in mass eradication campaigns. The countries where injections are so popular correspond roughly with the areas of mass eradication programmes. Many or perhaps most of the injections are not sterile and present a great risk of attendant paralysis. Proof that injections are causal may be impossible. Meanwhile we need to know why injections are so popular and how they can be less so.

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

PubMed

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

2008-02-25

The importance of staying active instead of bed rest has been acknowledged in the management of musculoskeletal disorders (MSDs). This emphasizes the potential benefits of adjusting work to fit the employee's remaining work ability. Despite part-time sick leave being an official option in many countries, its effectiveness has not been studied yet. We have designed a randomized controlled study to assess the health effects of early part-time sick leave compared to conventional full-day sick leave. Our hypothesis is that if work time is temporarily reduced and work load adjusted at the early stages of disability, employees with MSDs will have less disability days and faster return to regular work duties than employees on a conventional sick leave. The study population will consist of 600 employees, who seek medical advice from an occupational physician due to musculoskeletal pain. The inclusion requires that they have not been on a sick leave for longer than 14 days prior to the visit. Based on the physician's judgement, the severity of the symptoms must indicate a need for conventional sick leave, but the employee is considered to be able to work part-time without any additional risk. Half of the employees are randomly allocated to part-time sick leave group and their work time is reduced by 40-60%, whereas in the control group work load is totally eliminated with conventional sick leave. The main outcomes are the number of days from the initial visit to return to regular work activities, and the total number of sick leave days during 12 and 24 months of follow-up. The costs and benefits as well as the feasibility of early part-time sick leave will also be evaluated. This is the first randomised trial to our knowledge on the effectiveness of early part-time sick leave compared to conventional full-time sick leave in the management of MSDs. The data collection continues until 2011, but preliminary results on the feasibility of part-time sick leave will be available already in 2008. The increased knowledge will assist in better decision making process regarding the management of disability related to MSDs. International Standard Randomised Controlled Trial Number Register, register number ISRCTN30911719.

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

PubMed Central

2013-01-01

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

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.

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.

Disability associated with low back pain in Mulago Hospital, Kampala Uganda.

PubMed

Galukande, M; Muwazi, S; Mugisa, B D

2006-09-01

Low back pain is sufficiently disabling and a common cause of disability particularly during the productive middle years of adult life. Disability implies interference with daily activities. To assess and document the disability associated with low back pain in terms of sick leave days, interference with daily activities and some pain characteristics. This study was carried out in the Orthopaedic out patient clinic of Mulago Hospital, a tertiary national referral hospital in Kampala, Uganda. It was a descriptive cross sectional study over a period of seven months. 204 patients with mechanical back pain were enrolled in the study, after screening all consecutive new adult patients referred with low back pain as the major complaint. A validated modified Oswestry instrument was used to collect data. Nine daily activities: sleep, sex, lifting, traveling, social and recreational activities, dressing, sitting, walking and running activities were investigated. Data was analyzed using SPSS for windows version 10. Mean and Standard deviations were used to summarize continuous variables. P value was considered statistically significant if it was equal or less than 0.05. 87% of the respondents reported a mean of 14 days off work during the 4 weeks prior to the interview because of back problems. The mean duration of a current low back pain episode was 5 months. All activities were interfered with; with lifting as the most affected with a mean score of 4.5, walking and running was 3.6, standing was 3.3, sex life was 2.9, traveling was 2.9, sitting was 2.7, social and recreational activities was 2.7, getting dressed was 2.1 and sleeping was 1.8. Our results confirm that low back pain is a significant cause of disability affecting the productive middle years of adult life and causes significant disruption of daily activities including sleep and sex. The cost of lost work time, compensation and treatment for our setting is a knowledge gap that should be filled by further study. There is need for a community-based study to ascertain extent of the problem in at a wider population level.

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.

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

ERIC Educational Resources Information Center

Axelsson, Inge; Marnetoft, Sven-Uno

2010-01-01

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

Sick at work: prevalence and determinants among healthcare workers, western Ethiopia: an institution based cross-sectional study.

PubMed

Mekonnen, Tesfaye Hambisa; Tefera, Mekuriaw Alemayewu; Melsew, Yayehirad Alemu

2018-01-01

Going to work despite feeling sick also known as sickness presenteeism is one of the emerging global occupational health challenges. Sickness presenteeism negatively affects both health of work forces and productivity of organizations in general. However, there is insufficient research exploring this situation in majority of the Sub-Saharan African countries, including Ethiopia. Thus this study intended to investigate the prevalence and determinant factors of sickness presenteeism among health care workers, Western Ethiopia. This study used an institution based cross-sectional quantitative study design. The study period was from February to March, 2017. We employed simple random sampling method to select 360 study samples. Data collection was performed by pre-tested structured and self- administered questionnaire. We used SPSS version 20 to carry out binary logistic regression analysis. Odds ratio with 95% confidence intervals was calculated and significance of associations was determined at p -value < 0.05. A total of 344 respondents fully completed the survey questionnaire. Mean age with standard deviation was 30.28 ± 6.181. Prevalence of sickness Presenteeism was 52.6% [95%CI: (47.4, 57.8)] in the past 12 months. Educational status [AOR:2.1, 95%CI: (1.17,3.90)], financial problem [AOR:1.9,95%CI:(1.07,3.46)], sickness absenteeism [AOR:2.7,95% CI:(1.50,5.02)], lack of staff replacement [AOR:2.7,95%CI:(1.50,5.02)], absence of occupational health services [AOR:3.0,95%CI:(1.34,6.70)], and pressure from supervisor [AOR:1.8,95% CI:(1.01,3.31)] were significant predictors of the dependent variable. Relatively higher proportions of workers indicated sickness presenteeism as compared to other studies. Risk factors like educational status, personal financial problem, sickness absenteeism, lack of staff replacement, absence of occupational health services, and pressure from supervisors considerably increased the likely occurrence of employees' sick attendance. It is advisable for health care managers to hire adequate health care staffs, to implement basic occupational health services and to design strategies which reduce pressure from supervisors.

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

PubMed

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

2016-08-22

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

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

PubMed Central

2014-01-01

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

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

PubMed Central

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

2003-01-01

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

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

PubMed Central

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

2014-01-01

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

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

PubMed

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

2017-12-01

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

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

PubMed

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

2018-05-09

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

School neighborhood disadvantage as a predictor of long-term sick leave among teachers: prospective cohort study.

PubMed

Virtanen, Marianna; Kivimäki, Mika; Pentti, Jaana; Oksanen, Tuula; Ahola, Kirsi; Linna, Anne; Kouvonen, Anne; Salo, Paula; Vahtera, Jussi

2010-04-01

This ongoing prospective study examined characteristics of school neighborhood and neighborhood of residence as predictors of sick leave among school teachers. School neighborhood income data for 226 lower-level comprehensive schools in 10 towns in Finland were derived from Statistics Finland and were linked to register-based data on 3,063 teachers with no long-term sick leave at study entry. Outcome was medically certified (>9 days) sick leave spells during a mean follow-up of 4.3 years from data collection in 2000-2001. A multilevel, cross-classified Poisson regression model, adjusted for age, type of teaching job, length and type of job contract, school size, baseline health status, and income level of the teacher's residential area, showed a rate ratio of 1.30 (95% confidence interval: 1.03, 1.63) for sick leave among female teachers working in schools located in low-income neighborhoods compared with those working in high-income neighborhoods. A low income level of the teacher's residential area was also independently associated with sick leave among female teachers (rate ratio = 1.50, 95% confidence interval: 1.18, 1.91). Exposure to both low-income school neighborhoods and low-income residential neighborhoods was associated with the greatest risk of sick leave (rate ratio = 1.71, 95% confidence interval: 1.27, 2.30). This study indicates that working and living in a socioeconomically disadvantaged neighborhood is associated with increased risk of sick leave among female teachers.

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

Stroboscopic Vision as a Treatment for Space Motion Sickness

NASA Technical Reports Server (NTRS)

Reschke, Millard F.; Somers, Jeffrey T.; Ford, George; Krnavek, Jody M.

2007-01-01

Results obtained from space flight indicate that most space crews will experience some symptoms of motion sickness causing significant impact on the operational objectives that must be accomplished to assure mission success. Based on the initial work of Melvill Jones we have evaluated stroboscopic vision as a method of preventing motion sickness. Given that the data presented by professor Melvill Jones were primarily post hoc results following a study not designed to investigate motion sickness, it is unclear how motion sickness results were actually determined. Building on these original results, we undertook a three part study that was designed to investigate the effect of stroboscopic vision (either with a strobe light or LCD shutter glasses) on motion sickness using: (1) visual field reversal, (2) Reading while riding in a car (with or without external vision present), and (3) making large pitch head movements during parabolic flight.

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

PubMed Central

Tomba, Gianpaolo Scalia; de Blasio, Birgitte Freiesleben

2016-01-01

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

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

PubMed

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

2016-06-01

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

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

PubMed

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

2016-04-16

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

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.

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

PubMed

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

2011-01-01

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

Strong support for relocation to other work tasks: A cross-sectional study of attitudes to sickness insurance regulations in Sweden.

PubMed

Hensing, G; Holmgren, K; Rohdén, H

2015-01-01

Profound changes are taking place in the Swedish welfare state. The general population's attitudes are important insofar changes will be perceived as fair and effective to become implemented. The aim was to study attitudes to the strictness of the sick-leave rules, relocation to other work tasks after 3 months of sick leave and applications for new jobs after 6 months of sick leave. Eligible for this questionnaire study were 1,140 individuals aged 19 to 64 years. Their attitudes were analyzed in relation to age, gender, political ideology and health status. Health status was measured as sick-leave experiences, self-reported health and level of symptoms. Showed that 42% considered the sick-leave rules to be too strict, 60% found relocation to other work tasks to be good while 35% found that applications for new work were good. In logistic regression analyses, high sick-leave experience was associated with increased odds of finding the sick-leave rules too strict and disagreement with relocation to other work tasks or application for new jobs. In conclusion, strong support was found for relocation to other work tasks with the present employer. Earlier research on returning to work has found workplace interventions to be efficient. From a policy perspective it seems relevant to promote such interventions given the strong public opinion in their favor.

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

PubMed

Wada, Takahiro; Yoshida, Keigo

2016-08-01

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

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

Registry-based analysis of participator representativeness: a source of concern for sickness absence research?

PubMed

Knapstad, Marit; Löve, Jesper; Holmgren, Kristina; Hensing, Gunnel; Øverland, Simon

2016-10-21

Selective participation can bias results in epidemiological surveys. The importance of health status is often suggested as a possible explanation for non-participation but few empirical studies exist. In a population-based study, explicitly focused on sickness absence, health and work, we examined whether a history of high levels of sickness absence was associated with non-participation. The study is based on data from official sickness absence registers from participants, non-participants and the total target population of the baseline survey of the Health Assets Project (HAP). HAP is a population-based cohort study in the Västra Götaland region in South Western Sweden. HAP included a random population cohort (n=7984) and 2 cohorts with recent sickness absence (employees (n=6140) and non-employees (n=990)), extracted from the same overall general working-age population. We examined differences in participation rates between cohorts (2008), and differences in previous sickness absence (2001-2008) between participants (individual-level data) and non-participants or the target population (group-level data) within cohorts. Participants had statistically significant less registered sickness absence in the past than non-participants and the target population for some, but not all, of the years analysed. Yet these differences were not of substantial size. Other factors than sickness absence were more important in explaining differences in participation, whereby participants were more likely to be women, older, born in Nordic countries, married and have higher incomes than non-participants. Although specifically addressing sickness absence, having such experience did not add any substantial layer to selective participation in the present survey. Detailed measures are needed to gain a better understanding for health selection in health-related surveys such as those addressing sickness absence, for instance in order to discriminate between selection due to ability or motivation for participation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

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

ERIC Educational Resources Information Center

Eriksson, Rickard; Nermo, Magnus

2010-01-01

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

Per capita alcohol consumption and sickness absence in Norway.

PubMed

Norström, Thor; Moan, Inger Synnøve

2009-08-01

There is only one previous study addressing the relationship between population drinking and sickness absence. That study, based on Swedish time-series data, showed a statistically significant relationship between per capita alcohol consumption and the male sickness absence rate. Estimates suggested that a 1-l increase in consumption was associated with a 13% increase in sickness absence among men. In the present study, we aim at replicating and expanding the Swedish study on the basis of data for Norway. The outcome measure comprised annual data for Norway on registered sickness absence for manual employees covering the period 1957-2001. The unemployment rate was included as a control, as this factor may be correlated with alcohol as well as sickness absence. Alcohol consumption was gauged by sales of alcohol (total and beverage specific by beer, spirits and wine) per inhabitant 15 years and above. The data were analysed using the Box-Jenkins method for time-series analysis. The results suggested that a 1-l increase in total consumption was associated with a 13% increase in sickness absence among men (P < 0.05). This corresponds to an elasticity coefficient equal to 0.62. The alcohol effect was not significant for women. Unemployment was negatively associated with the outcome for men as well as for women (P < 0.05). In the beverage-specific analyses, spirits were statistically significant for men (P < 0.05), but not beer and wine. The present findings strengthen the conclusion from the Swedish study, that sickness absence may be added to the list of indicators of alcohol-related harm.

Can work ability explain the social gradient in sickness absence: a study of a general population in Sweden.

PubMed

Löve, Jesper; Holmgren, Kristina; Torén, Kjell; Hensing, Gunnel

2012-03-07

Understanding the reasons for the social gradient in sickness absence might provide an opportunity to reduce the general rates of sickness absence. The complete explanation for this social gradient still remains unclear and there is a need for studies using randomized working population samples. The main aim of the present study was to investigate if self-reported work ability could explain the association between low socioeconomic position and belonging to a sample of new cases of sick-listed employees. The two study samples consisted of a randomized working population (n = 2,763) and a sample of new cases of sick-listed employees (n = 3,044), 19-64 years old. Both samples were drawn from the same randomized general population. Socioeconomic status was measured with occupational position and physical and mental work ability was measured with two items extracted from the work ability index. There was an association between lower socioeconomic status and belonging to the sick-listed sample among both women and men. In men the crude Odds ratios increased for each downwards step in socioeconomic status, OR 1.32 (95% CI 0.98-1.78), OR 1.53 (1.05-2.24), OR 2.80 (2.11-3.72), and OR 2.98 (2.27-3.90). Among women this gradient was not as pronounced. Physical work ability constituted the strongest explanatory factor explaining the total association between socioeconomic status and being sick-listed in women. However, among men, the association between skilled non-manual, OR 2.07 (1.54-2.78), and non-skilled manual, OR 2.03 (1.53-2.71) positions in relation to being sick-listed remained. The explanatory effect of mental work ability was small. Surprisingly, even in the sick-listed sample most respondents had high mental and physical work ability. These results suggest that physical work ability may be an important key in explaining the social gradient in sickness absence, particularly in women. Hence, it is possible that the factors associated with the social gradient in sickness absence may differ, to some extent, between women and men.

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.

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

PubMed

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

2018-01-01

Emotional dissonance, i.e., a discrepancy between required and felt emotions, has been established as a predictor of sickness absence in studies, but little is known about mechanisms that can explain this association. In order to prevent and reduce the impact of emotional dissonance on sickness absence, there is a need for greater attention to variables explaining when and how emotional dissonance is related to sickness absence. The overarching aim of this study was to examine whether emotional dissonance has an indirect association with sickness absence through exhaustion. In addition, we examined whether human resource primacy (HRP), which is the employer's degree of concern for human resources, moderates this indirect effect. A sample of 7758 employees, all working with customers and clients, were recruited from 96 Norwegian organizations. Emotional dissonance, exhaustion, and HRP were measured through surveys and then linked to registry data on medically certified sickness absence for the year following the survey assessment. Results showed that exhaustion is a mediator for the relationship between emotional dissonance and sickness absence. Furthermore, higher levels of HRP were found to reduce the positive association between emotional dissonance and exhaustion, and the indirect effect of emotional dissonance on sickness absence through exhaustion is found to be weaker when HRP is high. By testing this moderated mediation model, the current study contributes to the literature on emotion work by clarifying mechanisms that are crucial for the development of targeted interventions that aim to reduce and prevent sickness absence in client-driven work environments.

Emotional Dissonance, Mental Health Complaints, and Sickness Absence Among Health- and Social Workers. The Moderating Role of Self-Efficacy

PubMed Central

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

2018-01-01

Health- and social workers are frequently exposed to emotionally demanding work situations that require emotion regulation. Studies have demonstrated a direct relationship between emotion regulation and health complaints and sickness absence. In order to prevent health complaints and to reduce sickness absence among health- and social workers, there is need for greater attention to mechanisms explaining when and how emotionally demanding work situations are related to employee health and sickness absence. The overarching aim of this study was therefore to examine the moderating role of generalized self-efficacy on the association between emotional dissonance, employee health (mental distress and exhaustion), and registry based sickness absence. The sample consisted of 937 health- and social workers. Data on emotional dissonance, generalized self-efficacy, exhaustion, and mental distress was collected through questionnaires, whereas official registry data were used to assess sickness absence. A two-step hierarchical regression analysis showed that emotional dissonance was significantly associated with exhaustion, mental distress, and sickness absence, after adjusting for sex, age, and occupation. Interaction analyses with simple slope tests found that self-efficacy moderated the association between emotional dissonance and both exhaustion and mental distress, but not the association with sickness absence. This study shows that health- and social workers who frequently experience emotional dissonance report higher levels of exhaustion and mental distress, and have a higher risk of medically certified sickness absence. Further, health- and social workers with lower self-efficacy beliefs are apparently more sensitive to the degree of emotional dissonance and experienced higher levels of exhaustion and mental distress. PMID:29740375

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

PubMed

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

2016-01-01

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

Focus Group Study Exploring Factors Related to Frequent Sickness Absence

PubMed Central

van Rhenen, Willem

2016-01-01

Introduction Research investigating frequent sickness absence (3 or more episodes per year) is scarce and qualitative research from the perspective of frequent absentees themselves is lacking. The aim of the current study is to explore awareness, determinants of and solutions to frequent sickness absence from the perspective of frequent absentees themselves. Methods We performed a qualitative study of 3 focus group discussions involving a total of 15 frequent absentees. Focus group discussions were audiotaped and transcribed verbatim. Results were analyzed with the Graneheim method using the Job Demands Resources (JD–R) model as theoretical framework. Results Many participants were not aware of their frequent sickness absence and the risk of future long-term sickness absence. As determinants, participants mentioned job demands, job resources, home demands, poor health, chronic illness, unhealthy lifestyles, and diminished feeling of responsibility to attend work in cases of low job resources. Managing these factors and improving communication (skills) were regarded as solutions to reduce frequent sickness absence. Conclusions The JD–R model provided a framework for determinants of and solutions to frequent sickness absence. Additional determinants were poor health, chronic illness, unhealthy lifestyles, and diminished feeling of responsibility to attend work in cases of low job resources. Frequent sickness absence should be regarded as a signal that something is wrong. Managers, supervisors, and occupational health care providers should advise and support frequent absentees to accommodate job demands, increase both job and personal resources, and improve health rather than express disapproval of frequent sickness absence and apply pressure regarding work attendance. PMID:26872050

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

PubMed Central

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

2018-01-01

Emotional dissonance, i.e., a discrepancy between required and felt emotions, has been established as a predictor of sickness absence in studies, but little is known about mechanisms that can explain this association. In order to prevent and reduce the impact of emotional dissonance on sickness absence, there is a need for greater attention to variables explaining when and how emotional dissonance is related to sickness absence. The overarching aim of this study was to examine whether emotional dissonance has an indirect association with sickness absence through exhaustion. In addition, we examined whether human resource primacy (HRP), which is the employer’s degree of concern for human resources, moderates this indirect effect. A sample of 7758 employees, all working with customers and clients, were recruited from 96 Norwegian organizations. Emotional dissonance, exhaustion, and HRP were measured through surveys and then linked to registry data on medically certified sickness absence for the year following the survey assessment. Results showed that exhaustion is a mediator for the relationship between emotional dissonance and sickness absence. Furthermore, higher levels of HRP were found to reduce the positive association between emotional dissonance and exhaustion, and the indirect effect of emotional dissonance on sickness absence through exhaustion is found to be weaker when HRP is high. By testing this moderated mediation model, the current study contributes to the literature on emotion work by clarifying mechanisms that are crucial for the development of targeted interventions that aim to reduce and prevent sickness absence in client-driven work environments. PMID:29670556

Emotional Dissonance, Mental Health Complaints, and Sickness Absence Among Health- and Social Workers. The Moderating Role of Self-Efficacy.

PubMed

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

2018-01-01

Health- and social workers are frequently exposed to emotionally demanding work situations that require emotion regulation. Studies have demonstrated a direct relationship between emotion regulation and health complaints and sickness absence. In order to prevent health complaints and to reduce sickness absence among health- and social workers, there is need for greater attention to mechanisms explaining when and how emotionally demanding work situations are related to employee health and sickness absence. The overarching aim of this study was therefore to examine the moderating role of generalized self-efficacy on the association between emotional dissonance, employee health (mental distress and exhaustion), and registry based sickness absence. The sample consisted of 937 health- and social workers. Data on emotional dissonance, generalized self-efficacy, exhaustion, and mental distress was collected through questionnaires, whereas official registry data were used to assess sickness absence. A two-step hierarchical regression analysis showed that emotional dissonance was significantly associated with exhaustion, mental distress, and sickness absence, after adjusting for sex, age, and occupation. Interaction analyses with simple slope tests found that self-efficacy moderated the association between emotional dissonance and both exhaustion and mental distress, but not the association with sickness absence. This study shows that health- and social workers who frequently experience emotional dissonance report higher levels of exhaustion and mental distress, and have a higher risk of medically certified sickness absence. Further, health- and social workers with lower self-efficacy beliefs are apparently more sensitive to the degree of emotional dissonance and experienced higher levels of exhaustion and mental distress.

Influence of change in psychosocial work characteristics on sickness absence: The Whitehall II Study.

PubMed

Head, Jenny; Kivimäki, Mika; Martikainen, Pekka; Vahtera, Jussi; Ferrie, Jane E; Marmot, Michael G

2006-01-01

To study the influence of change in self perceived psychosocial work characteristics on subsequent rates of sickness absence. Prospective cohort study of British civil service employees. Job control, job demands, and work social supports were measured in 1985/88 and in 1991/93. Analyses included 3817 British civil servants with sickness absence records at baseline (1985-89) and for two follow up periods, early (1994-95) and later follow up (1996-98). Change in work characteristics predicted subsequent incidence of long spells of sickness absence (>7 days) in the early follow up period after adjustment for covariates including baseline work characteristics, health status, and sickness absence. Adjusted rate ratios were 1.23 (95% CI 1.03 to 1.46) for decreased compared with stable decision latitude; 1.17 (95% CI 1.01 to 1.36) for increased compared with stable job demands and 0.79 (95% CI 0.67 to 0.93) for increased compared with stable work social support. These associations were also seen in a sub-sample who did not change employment grade. In the later follow up period, associations between work change and long spells of sickness absence were similar for decision latitude, less pronounced for job demands, and no longer apparent for social supports. Changes in work characteristics were not associated with subsequent short spells of sickness absence (

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

The influence of lifestyle and gender on sickness absence in Brazilian workers

PubMed Central

2014-01-01

Background Despite an increasing body of knowledge concerning gender and lifestyle factors as determinants of sickness absence in well-developed countries, the relationship between these variables has not been elucidated in emerging economic power countries, where the burden of non-communicable diseases is particularly high. This study aimed to analyze the relationships among lifestyle-related factors and sick leave and to examine whether gender differences in sickness absence can be explained by differences in socio-demographic, work and lifestyle-related factors among Brazilian workers. Methods In this longitudinal study with a one year follow-up among 2.150 employees of a Brazilian airline company, sick leave was the primary outcome of interest. Independent variables collected by interview at enrolment in the study were gender, age, educational level, type of work, stress, and lifestyle-related factors (body mass index, physical activity and smoking). In addition, the risk for coronary heart disease was determined based on measurement of blood pressure, total cholesterol and glucose levels. The total number of days on sick leave during 12 months follow-up was available from the company register. Logistic regression analysis was used to determine the influence of socio-demographic, type of work and lifestyle-related factors on sick leave. Results Younger employees, those with lower educational level, those who worked as air crew members and those with higher levels of stress were more likely to have sick leave. Body mass index and level of physical activity were not associated with sick leave. After adjustment by socio-demographic variables, increased odds for 10 or more days of sick leave were found in smokers (OR = 1.51, CI = 1.05-2.17), and ex-smokers (OR = 1.45, CI = 1.01-2.10). Women were more likely to have 10 or more days of sick leave. Gender differences were reduced mainly when adjusted for type of work (15%) and educational level (7%). Conclusions The higher occurrence of sick leave among women than among men was partly explained by type of work and educational level. Our results suggest that type of work, a stressful life, and smoking are important targets for health promotion in this study population. PMID:24708760

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

PubMed Central

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

2012-01-01

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

Coping and sickness absence

PubMed Central

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

2007-01-01

Objectives The aim of this study is to examine the role of coping styles in sickness absence. In line with findings that contrast the reactive–passive focused strategies, problem-solving strategies are generally associated with positive results in terms of well-being and overall health outcomes; our hypothesis is that such strategies are positively related to a low frequency of sickness absence and with short lengths (total number of days absent) and durations (mean duration per spell). Methods Using a prospective design, employees’ (N = 3,628) responses on a self-report coping inventory are used to predict future registered sickness absence (i.e. frequency, length, duration, and median time before the onset of a new sick leave period). Results and conclusions In accordance with our hypothesis, and after adjustment for potential confounders, employees with an active problem-solving coping strategy are less likely to drop out because of sickness absence in terms of frequency, length (longer than 14 days), and duration (more than 7 days) of sickness absence. This positive effect is observed in the case of seeking social support only for the duration of sickness absence and in the case of palliative reaction only for the length and frequency of absence. In contrast, an avoidant coping style, representing a reactive–passive strategy, increases the likelihood of frequent absences significantly, as well as the length and duration of sickness absence. Expression of emotions, representing another reactive–passive strategy, has no effect on future sickness absenteeism. The median time before the onset of a new episode of absenteeism is significantly extended for active problem-solving and reduced for avoidance and for a palliative response. The results of the present study support the notion that problem-solving coping and reactive–passive strategies are inextricably connected to frequency, duration, length and onset of sickness absence. Especially, active problem-solving decreases the chance of future sickness absence. PMID:17701200

Coping and sickness absence.

PubMed

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

2008-02-01

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

[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.

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

PubMed Central

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

2014-01-01

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

Measuring multimorbidity in a working population: the effect on incident sickness absence.

PubMed

Ubalde-Lopez, Monica; Delclos, George L; Benavides, Fernando G; Calvo-Bonacho, Eva; Gimeno, David

2016-05-01

Multimorbidity research typically focuses on chronic and common diseases in patient and/or older populations. We propose a multidimensional multimorbidity score (MDMS) which incorporates chronic conditions, symptoms, and health behaviors for use in younger, presumably healthier, working populations. Cross-sectional study of 372,370 Spanish workers who underwent a standardized medical evaluation in 2006. We computed a MDMS (range 0-100) based on the sex-specific results of a multicorrespondence analysis (MCA). We then used Cox regression models to assess the predictive validity of this MDMS on incident sickness absence (SA) episodes. Two dimensions in the MCA explained about 80% of the variability in both sexes: (1) chronic cardiovascular conditions and health behaviors, and (2) pain symptoms, in addition to sleep disturbances in women. More men than women had at least one condition (40 vs 15%) and two or more (i.e., multimorbidity) (12 vs 2%). The MDMS among those with multimorbidity ranged from 16.8 (SD 2.4) to 51.7 (SD 9.9) in men and 18.5 (SD 5.8) to 43.8 (SD 7.8) in women. We found that the greater the number of health conditions, the higher the risk of SA. A higher MDMS was also a risk factor for incident SA, even after adjusting for prior SA and other covariates. In women, this trend was less evident. A score incorporating chronic health conditions, behaviors, and symptoms provides a more holistic approach to multimorbidity and may be useful for defining health status in working populations and for predicting key occupational outcomes.

Associations between work stress, alcohol consumption and sickness absence.

PubMed

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

1998-02-01

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

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

PubMed Central

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

2008-01-01

Background Zoonotic sleeping sickness, or HAT (Human African Trypanosomiasis), caused by infection with Trypanosoma brucei rhodesiense, is an under-reported and neglected tropical disease. Previous assessments of the disease burden expressed as Disability-Adjusted Life Years (DALYs) for this infection have not distinguished T.b. rhodesiense from infection with the related, but clinically distinct Trypanosoma brucei gambiense form. T.b. rhodesiense occurs focally, and it is important to assess the burden at the scale at which resource-allocation decisions are made. Methods The burden of T.b. rhodesiense was estimated during an outbreak of HAT in Serere, Uganda. We identified the unique characteristics affecting the burden of rhodesiense HAT such as age, severity, level of under-reporting and duration of hospitalisation, and use field data and empirical estimates of these to model the burden imposed by this and other important diseases in this study population. While we modelled DALYs using standard methods, we also modelled uncertainty of our parameter estimates through a simulation approach. We distinguish between early and late stage HAT morbidity, and used disability weightings appropriate for the T.b. rhodesiense form of HAT. We also use a model of under-reporting of HAT to estimate the contribution of un-reported mortality to the overall disease burden in this community, and estimate the cost-effectiveness of hospital-based HAT control. Results Under-reporting accounts for 93% of the DALY estimate of rhodesiense HAT. The ratio of reported malaria cases to reported HAT cases in the same health unit was 133:1, however, the ratio of DALYs was 3:1. The age productive function curve had a close correspondence with the HAT case distribution, and HAT cases occupied more patient admission time in Serere during 1999 than all other infectious diseases other than malaria. The DALY estimate for HAT in Serere shows that the burden is much greater than might be expected from its relative incidence. Hospital based control in this setting appears to be highly cost-effective, highlighting the value of increasing coverage of therapy and reducing under-reporting. Conclusion We show the utility of calculating DALYs for neglected diseases at the local decision making level, and emphasise the importance of improved reporting systems for acquiring a better understanding of the burden of neglected zoonotic diseases. PMID:18366755

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

PubMed

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

2015-10-12

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

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 Bullying: A Tale of Adverse Consequences

PubMed Central

Sansone, Lori A.

2015-01-01

Workplace bullying is defined as the repetitive and systematic engagement of interpersonally abusive behaviors that negatively affect both the targeted individual and the work organization. According to the findings of 12 studies, being bullied in the workplace affects approximately 11 percent of workers. Victims are frequently blue-collar and unskilled workers. However, there also appear to be gender and milieu/management factors. Emotional/psychological consequences of workplace bullying may include increased mental distress, sleep disturbances, fatigue in women and lack of vigor in men, depression and anxiety, adjustment disorders, and even work-related suicide. Medical consequences of workplace bullying may include an increase in health complaints such as neck pain, musculoskeletal complaints, acute pain, fibromyalgia, and cardiovascular symptoms. Finally, socioeconomic consequences of workplace bullying may include absenteeism due to sick days and unemployment. Clinicians in both mental health and primary care settings need to be alert to the associations between bullying in the workplace and these potential negative consequences, as patients may not disclose workplace maltreatment due to embarrassment or fears of retribution. PMID:25852978

Workplace bullying: a tale of adverse consequences.

PubMed

Sansone, Randy A; Sansone, Lori A

2015-01-01

Workplace bullying is defined as the repetitive and systematic engagement of interpersonally abusive behaviors that negatively affect both the targeted individual and the work organization. According to the findings of 12 studies, being bullied in the workplace affects approximately 11 percent of workers. Victims are frequently blue-collar and unskilled workers. However, there also appear to be gender and milieu/management factors. Emotional/psychological consequences of workplace bullying may include increased mental distress, sleep disturbances, fatigue in women and lack of vigor in men, depression and anxiety, adjustment disorders, and even work-related suicide. Medical consequences of workplace bullying may include an increase in health complaints such as neck pain, musculoskeletal complaints, acute pain, fibromyalgia, and cardiovascular symptoms. Finally, socioeconomic consequences of workplace bullying may include absenteeism due to sick days and unemployment. Clinicians in both mental health and primary care settings need to be alert to the associations between bullying in the workplace and these potential negative consequences, as patients may not disclose workplace maltreatment due to embarrassment or fears of retribution.

Bioluminescent Imaging of Trypanosoma brucei Shows Preferential Testis Dissemination Which May Hamper Drug Efficacy in Sleeping Sickness

PubMed Central

Claes, Filip; Vodnala, Suman K.; van Reet, Nick; Boucher, Nathalie; Lunden-Miguel, Hilda; Baltz, Theo; Goddeeris, Bruno Maria; Büscher, Philippe; Rottenberg, Martin E.

2009-01-01

Monitoring Trypanosoma spread using real-time imaging in vivo provides a fast method to evaluate parasite distribution especially in immunoprivileged locations. Here, we generated monomorphic and pleomorphic recombinant Trypanosoma brucei expressing the Renilla luciferase. In vitro luciferase activity measurements confirmed the uptake of the coelenterazine substrate by live parasites and light emission. We further validated the use of Renilla luciferase-tagged trypanosomes for real-time bioluminescent in vivo analysis. Interestingly, a preferential testis tropism was observed with both the monomorphic and pleomorphic recombinants. This is of importance when considering trypanocidal drug development, since parasites might be protected from many drugs by the blood-testis barrier. This hypothesis was supported by our final study of the efficacy of treatment with trypanocidal drugs in T. brucei-infected mice. We showed that parasites located in the testis, as compared to those located in the abdominal cavity, were not readily cleared by the drugs. PMID:19621071

Divalent Cation Control of Flagellar Motility in African Trypanosomes

NASA Astrophysics Data System (ADS)

Westergard, Anna M.; Hutchings, Nathan R.

2005-03-01

Changes in calcium concentration have been shown to dynamically affect flagellar motility in several eukaryotic systems. The African trypanosome is a monoflagellated protozoan parasite and the etiological agent of sleeping sickness. Although cell motility has been implicated in disease progression, very little is currently known about biochemical control of the trypanosome flagellum. In this study, we assess the effects of extracellular changes in calcium and nickel concentration on trypanosome flagellar movement. Using a flow through chamber, we determine the relative changes in motility in individual trypanosomes in response to various concentrations of calcium and nickel, respectively. Extracellular concentrations of calcium and nickel (as low as 100 micromolar) significantly inhibit trypanosome cell motility. The effects are reversible, as indicated by the recovery of motion after removal of the calcium or nickel from the chamber. We are currently investigating the specific changes in flagellar oscillation and coordination that result from calcium and nickel, respectively. These results verify the presence of a calcium-responsive signaling mechanism(s) that regulates flagellar beat in trypanosomes.

Establishment of a structure-activity relationship of 1H-imidazo[4,5-c]quinoline-based kinase inhibitor NVP-BEZ235 as a lead for African sleeping sickness.

PubMed

Seixas, João D; Luengo-Arratta, Sandra A; Diaz, Rosario; Saldivia, Manuel; Rojas-Barros, Domingo I; Manzano, Pilar; Gonzalez, Silvia; Berlanga, Manuela; Smith, Terry K; Navarro, Miguel; Pollastri, Michael P

2014-06-12

Compound NVP-BEZ235 (1) is a potent inhibitor of human phospoinositide-3-kinases and mammalian target of rapamycin (mTOR) that also showed high inhibitory potency against Trypanosoma brucei cultures. With an eye toward using 1 as a starting point for anti-trypanosomal drug discovery, we report efforts to reduce host cell toxicity, to improve the physicochemical properties, and to improve the selectivity profile over human kinases. In this work, we have developed structure-activity relationships for analogues of 1 and have prepared analogues of 1 with improved solubility properties and good predicted central nervous system exposure. In this way, we have identified 4e, 9, 16e, and 16g as the most promising leads to date. We also report cell phenotype and phospholipidomic studies that suggest that these compounds exert their anti-trypanosomal effects, at least in part, by inhibition of lipid kinases.

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

PubMed Central

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

2016-01-01

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

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.

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

PubMed Central

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

2014-01-01

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

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

PubMed

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

2005-11-01

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

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

PubMed

Tolonen, Anu; Rahkonen, Ossi; Lahti, Jouni

2017-03-04

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

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

PubMed

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

2015-05-01

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

Early identification in primary health care of people at risk for sick leave due to work-related stress - study protocol of a randomized controlled trial (RCT).

PubMed

Holmgren, Kristina; Sandheimer, Christine; Mårdby, Ann-Charlotte; Larsson, Maria E H; Bültmann, Ute; Hange, Dominique; Hensing, Gunnel

2016-11-25

Early identification of persons at risk of sickness absence due to work-related stress is a crucial problem for society in general, and primary health care in particular. Tho date, no established method to do this exists. This project's aim is to evaluate whether systematic early identification of work-related stress can prevent sickness absence. This paper presents the study design, procedure and outcome measurements, as well as allocation and baseline characteristics of the study population. The study is a two-armed randomized controlled trial with follow-up at 3, 6 and 12 months. Non-sick-listed employed women and men, aged 18 to 64 years, who had mental and physical health complaints and sought care at primary health care centers (PHCC) were eligible to participate. At baseline work-related stress was measured by the Work Stress Questionnaire (WSQ), combined with feedback at consultation, at PHCC. The preventive intervention included early identification of work-related stress by the WSQ, GP training in the use of WSQ, GP feedback at consultation and finding suitable preventive measures. A process evaluation was used to explore how to facilitate future implementation and structural use of the WSQ at the PHCC. The primary outcome to compare the preventive sick leave intervention by the general practitioner (GP) versus treatment as usual is sick leave data obtained from the Swedish Social Insurance Agency register. Early screening for sick leave due to work-related stress makes it possible not only to identify those at risk for sick leave, but also to put focus on the patient's specific work-related stress problems, which can be helpful in finding suitable preventive measures. This study investigates if use of the WSQ by GPs at PHCCs, combined with feedback at consultation, prevents future sickness absence. ClinicalTrials.gov. Identifier: NCT02480855 . Registered 20 May 2015.

Sick leave and the impact of job-to-job mobility on the likelihood of remaining on the labour market - a longitudinal Swedish register study

PubMed Central

2014-01-01

Background Change of job could be a strategy in vocational rehabilitation when return to the original job is not possible, but research is very limited concerning the effects of job mobility on the future vocational situation. The aim of the study was to investigate whether job-to-job mobility affects the likelihood of remaining on the labour market over time among persons who are employed and have experienced long-term sick leave. Methods In a longitudinal register study, cohorts from three base years (1994, 1999 and 2004) were created, based on the Swedish population who were 20–60 years old, had sickness allowance insurance, and were employed in the base year and the following year (n > 3,000,000). The likelihood that individuals on long-term sick leave were employed later depending on whether or not they changed workplace during the present or next year of long-term sick leave was analyzed using logistic regression analysis. Age, sector, industry, children, marital status, education, income, rate of sick leave and earlier sick leave and earlier mobility were taken into consideration. Results Women with more than 180 days’ sick leave who changed workplaces were more likely to have a job later compared with those who did not change jobs. For men, the association was statistically significant with 1994 and 2004 as base years, but not in the cohort from 1999. Conclusions The present study indicates that for those on long-term sick leave that changed workplaces, the opportunities to stay on the labour market might increase. However, the study has methodological limitations and the results for men are ambiguous. We do not therefore have enough evidence for recommending job change as a strategy for vocational rehabilitation. PMID:24694029

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.

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

PubMed

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

2013-11-01

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

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

PubMed

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

1999-08-01

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

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

PubMed

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

2017-04-18

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

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

PubMed

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

1995-06-01

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

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

PubMed

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

2007-04-01

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

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

PubMed

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

2008-11-01

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

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

Prediction of sickness absence: development of a screening instrument

PubMed Central

Duijts, S F A; Kant, IJ; Landeweerd, J A; Swaen, G M H

2006-01-01

Objectives To develop a concise screening instrument for early identification of employees at risk for sickness absence due to psychosocial health complaints. Methods Data from the Maastricht Cohort Study on “Fatigue at Work” were used to identify items to be associated with an increased risk of sickness absence. The analytical procedures univariate logistic regression, backward stepwise linear regression, and multiple logistic regression were successively applied. For both men and women, sum scores were calculated, and sensitivity and specificity rates of different cut‐off points on the screening instrument were defined. Results In women, results suggested that feeling depressed, having a burnout, being tired, being less interested in work, experiencing obligatory change in working days, and living alone, were strong predictors of sickness absence due to psychosocial health complaints. In men, statistically significant predictors were having a history of sickness absence, compulsive thinking, being mentally fatigued, finding it hard to relax, lack of supervisor support, and having no hobbies. A potential cut‐off point of 10 on the screening instrument resulted in a sensitivity score of 41.7% for women and 38.9% for men, and a specificity score of 91.3% for women and 90.6% for men. Conclusions This study shows that it is possible to identify predictive factors for sickness absence and to develop an instrument for early identification of employees at risk for sickness absence. The results of this study increase the possibility for both employers and policymakers to implement interventions directed at the prevention of sickness absence. PMID:16698807

Predictive factors for disability pension--an 11-year follow up of young persons on sick leave due to neck, shoulder, or back diagnoses.

PubMed

Borg, K; Hensing, G; Alexanderson, K

2001-06-01

Although back diagnoses are recurrent and the main diagnoses behind sickness absence and disability pension surprisingly few longitudinal studies have been performed. This study identifies predictive factors for disability pension among young persons initially sick-listed with back diagnoses. An 11-year prospective cohort study was conducted, including all individuals in a Swedish city who, in 1985, were aged 25-34 and sick-listed > or =28 days owing to neck, shoulder, or back diagnoses (n = 213). The following data was obtained: disability pension, emigration, and death for 1985-96, sickness absence for 1982-84, and demographics in 1985 regarding sex, income, occupation, marital status, diagnosis, socioeconomic group, and citizenship. Cox regression and life tables were used in the analyses. In 1996, i.e. within 11 years, 22% of the individuals (27% of the women and 14% of the men) had been granted disability pension. The relative risk for disability pension was higher for women (2.4; p = 0.010), persons with foreign citizenship (3.6; p=0.009), and those who had had >14 sick-leave days per spell during the three years before inclusion, compared to those with <7 days/spell (3.1; p=0.003). This cohort of young persons proved to be a high-risk group for disability pension. Some of the factors known to predict long-time sickness absence also predict disability pension in a cohort of already sick-listed persons.

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.

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.

Can sickness absence be reduced by stress reduction programs: on the effectiveness of two approaches.

PubMed

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

2007-05-01

The aim of the study was to evaluate the effectiveness of two brief preventive stress reduction programs--a cognitive focused program and a combined intervention of physical exercise and relaxation--on sickness absence in stressed and non-stressed employees working in various jobs in a telecom company. The study was designed as an a priori randomized trial and the follow-up period for sickness absence was 1 year. Sickness absence data of 242 employees were analyzed with respect to spells of sickness (frequency, incidence rate), days (length, duration) and time between intervention and first subsequent absent spell. For stressed employees this study suggests that the illness burden represented by absenteeism is not affected by the interventions. There is no substantial difference in effectiveness between the cognitive and physical interventions. However, in comparison with the physical intervention the cognitive intervention decreases the period between the intervention and the first recurrence of a sick leave period with 144 days (marginal significant). The illness burden represented by absenteeism is effected in detail but not substantially by the interventions.

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

DTIC Science & Technology

1981-08-28

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

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.

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.

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

PubMed

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

2013-01-08

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

Increased Risk of Long-Term Sickness Absence, Lower Rate of Return to Work, and Higher Risk of Unemployment and Disability Pensioning for Thyroid Patients: A Danish Register-Based Cohort Study

PubMed Central

Watt, T.; Pedersen, J.; Bonnema, S. J.; Hegedüs, L.; Rasmussen, A. K.; Feldt-Rasmussen, U.; Bjorner, J. B.

2014-01-01

Context: Little is known about how thyroid diseases affect work ability. Objective: The objective of this study was to evaluate the risk of work disability for patients with thyroid disease compared with the general population. Design, Setting, and Participants: In a longitudinal register study, outpatients (n = 862) with nontoxic goiter, hyperthyroidism, Graves' orbitopathy (GO), autoimmune hypothyroidism, or other thyroid diseases and their matched controls (n = 7043) were observed in the years 1994–2011 in Danish national registers of social benefits, health, and work characteristics. Cox regression analyses estimated adjusted hazard ratios (HRs) for the first year after diagnosis and subsequent years. Main Outcome Measures: Transitions between work, long-term sickness absence, unemployment, and disability pension were measured. Results: Patients differed significantly from the general population with regard to sickness absence, disability pension, return from sickness absence, and unemployment. In the first year after diagnosis, higher risks of sickness absence was seen for GO (HR 6.94) and other hyperthyroid patients (HR 2.08), who also had lower probability of returning from sickness absence (HR 0.62) and higher risk of disability pension (HR 4.15). Patients with autoimmune hypothyroidism showed a lower probability of returning from sickness absence (HR 0.62). In subsequent years, GO patients had significantly higher risk of sickness absence (HR 2.08), lower probability of return from sickness absence (HR 0.51), and unemployment (HR 0.52) and a higher risk of disability pension (HR 4.40). Hyperthyroid patients also had difficulties returning from sickness absence (HR 0.71). Conclusions: Thyroid patients' risk of work disability is most pronounced in the first year after diagnosis and attenuates in subsequent years. GO patients have the highest risk of work disability. PMID:24937367