Lower Sickness Research Articles

Associations Between Gut Microbial Features and Sickness Symptoms in Kidney Transplant Recipients.

The study investigated the relationship of gut microbiome features and sickness symptoms in kidney transplant recipients. Employing a prospective, longitudinal design, we collected data from 19 participants who had undergone living-donor kidney transplant at three timepoints (pre-transplant and 1week and 3months post-transplant). Sickness symptom data and fecal specimens were collected at each timepoint. Participants were grouped either as high or low sickness symptom severity at baseline. Shotgun metagenomics sequencing characterized gut microbial structure and functional gene content. Fecal microbial features, including alpha (evenness and richness within samples) and beta (dissimilarities between samples) diversity and relative abundances, were analyzed using R statistical packages. Cross-sectional and longitudinal analyses examined relationships between gut microbial features and sickness symptoms. Although our exploratory findings revealed no significant differences in alpha and beta diversity between groups, the high-severity group showed lower microbial richness and evenness than the low-severity group. The high-severity group had enriched relative abundance of bacteria from the genera Citrobacter and Enterobacter and reduced relative abundance of bacteria from the genus Akkermansia across timepoints. No functional genes differed significantly between groups or timepoints. Kidney transplant recipients with high symptom burden displayed increased putative proinflammatory bacteria and decreased beneficial bacteria. This study provides an effect size that future large cohort studies can employ to confirm associations between gut microbial features and sickness symptom experiences in the kidney transplant population. The study findings also have implications for future interventional studies aiming to alleviate the sickness symptom burden in this population.

Associations between perceived quantitative work demands at different organisational levels and pain and sickness absence in eldercare workers: a multi-level longitudinal analysis

PurposeEldercare work is characterised by high quantitative work demands and high occurrence of musculoskeletal pain and sickness absence. Our aim was to investigate the association between quantitative demands aggregated at the different organizational levels of eldercare and low back pain (LBP) and sickness absence due to pain among workers.MethodsThis study was conducted in 527 eldercare workers from 105 wards across 20 nursing homes in Denmark. We collected workers’ perceived quantitative demands at baseline and workers’ LBP and sickness absence repeatedly over the following year. We aggregated worker-level quantitative demands to the ward and nursing home-levels, and used mixed-effects regression models to investigate the associations between quantitative demands at different organizational levels and LBP and sickness absence over 1 year.ResultsAcross all models, increased quantitative demands (0–100 scale) at the worker-level was associated with an increased likelihood (OR 1.02) and intensity of LBP (β = 0.01). We did not identify any associations between quantitative demands at the ward-level and either of our outcomes. Across all models, increased quantitative demands at the nursing home-level was associated with increased days with sickness absence due to pain (β = 0.03 to 0.06).ConclusionIn eldercare, workers’ perceived quantitative demands are associated with the presence and intensity of LBP. Further, quantitative demands across the overall nursing home-level are associated with sickness absence due to pain among eldercare workers. These results are of relevance to developing organisational interventions targeting quantitative demands to reduce sickness absence in eldercare.

Blockchain‐Based Contact Tracing and Information Sharing Model for COVID‐19 Pandemic

COVID‐19 is the worst contagious disaster in the history of humankind, triggering a worldwide sickness pandemic. In lacking specialized treatments or immunizations, finding and eliminating the infection source is the best option to decrease disease transmission and lower sickness and degree of fatality among the general public. Generally, few significant barriers are present in the existing system of monitoring the contamination. One of the obstacles is regarding health‐related data storage. The user’s e‐health data is kept in a traditional method that might have been compromised if shared with third parties. Secondly, the current disease tracking technologies fail to monitor diseases numerous ways. The tracing system is either personal or location‐based. Apart from these, gathering individual consent and sharing their health data with unknown associations is a real‐time problem. We propose a blockchain‐based data system that maintains confidentiality with transparency. Users can acquire unlimited and nontampered vital routes as the suggested blockchain solution leverages to link the user/patient and approved solvers. Also, automatically executed smart contracts are constructed to desensitize the user ID and reallocation. The anonymous feature delivered by private blockchain with wireless technologies defends the customer’s identity secrecy. We develop a matching approach using machine learning technology. Users may take safeguards in advance by employing our suggested analytical technique for predicting the risk due to infectious source presence.

Predictors of Sickness Absence in a Clinical Population With Chronic Pain

Chronic pain-related sickness absence is an enormous socioeconomic burden globally. Optimized interventions are reliant on a lucid understanding of the distribution of social insurance benefits and their predictors. This register-based observational study analyzed data for a 7-year period from a population-representative sample of 44,241 chronic pain patients eligible for interdisciplinary treatment (IDT) at specialist clinics. Sequence analysis was used to describe the sickness absence over the complete period and to separate the patients into subgroups based on their social insurance benefits over the final 2 years. The predictive performance of features from various domains was then explored with machine learning-based modeling in a nested cross-validation procedure. Our results showed that patients on sickness absence increased from 17% 5 years before to 48% at the time of the IDT assessment, and then decreased to 38% at the end of follow-up. Patients were divided into 3 classes characterized by low sickness absence, sick leave, and disability pension, with eight predictors of class membership being identified. Sickness absence history was the strongest predictor of future sickness absence, while other predictors included a 2008 policy, age, confidence in recovery, and geographical location. Information on these features could guide personalized intervention in the specialized healthcare. PerspectiveThis study describes sickness absence in patients who visited a Swedish pain specialist interdisciplinary treatment clinic during the period 2005 to 2016. Predictors of future sickness absence are also identified that should be considered when adapting IDT programs to the patient's needs.

Individual differences in the temporal progression of motion sickness and anxiety: the role of passengers’ trait anxiety and motion sickness history

The objective of the study is to show that trait anxiety and motion sickness history are responsible for different temporal progressions of sickness in passengers. The level of inflight anxiety and inflight sickness severity was monitored for 124 passengers in a full-motion cabin simulator during a short-haul flight with four different flight segments. Four groups with different characteristics in trait anxiety and motion sickness susceptibility showed different profiles of inflight sickness development. High trait anxiety was responsible for high inflight anxiety and a constantly high level of motion sickness, while passengers with just a motion sickness history showed an increase in motion sickness severity over time. We suggest that trait anxiety and motion sickness susceptibility interact and have an impact on the temporal progression of inflight sickness severity. The analysis of temporal developments of anxiety and sickness are fruitful for understanding the origins of motion sickness, research and individual treatments. Practitioner summary: In a full-motion cabin simulator study with 124 passengers the level of inflight anxiety and inflight sickness severity was monitored. Trait anxiety and motion sickness history were found to have different impacts on the temporal progression of individual sickness severity. Abbreviations: ANOVA: analysis of variance; AVES: air vehicle simulator; hiA/hiM: group with high anxiety and high motion sickness susceptibility; hiA/loM: group with high anxiety and low motion sickness susceptibility;MSSQ: motion sickness susceptibility scale; loA/hiM: group with low anxiety and high motion sickness susceptibility; loA/loM: group with low anxiety and low motion sickness susceptibility; SPSS: statistical package for the social sciences; SSQ-TS: total score from the simulator sickness questionaire; STAI: state trait anxiety inventory

Enhancing the care of children with chronic diseases through the narratives of patient, physician, nurse and carer.

We tested the hypothesis that a narrative approach may enhance a bio-psycho-social model (BPS) in caring for chronically ill children. Forty-eight narratives were collected from 12 children with six different medical conditions, their mothers, physicians, and nurses. By a textual analysis, narratives were classified on their predominant focus as disease (biological focus), illness (psychologic focus), or sickness (social focus). Sixty-one percent of narrative' text were classified as illness, 28% as disease and 11% as sickness. All narratives had a degree of illness focus. Narratives by patients and physicians on the one hand, and nurses' and mothers' on the other were disease focused. Narratives were also evaluated with respect to the type of medical condition: Illness was largely prevalent in all but Crohn's disease and HIV infection, the latter having a predominance of sickness most probably related to stigma. Narrative exploration proved a valuable tool for understanding and addressing the needs of children with complex conditions. Narrative approaches allow identification of the major needs of different patients according to health conditions and story tellers. In the narratives, we found a greater illness and disease focus and surprisingly a low sickness focus, except with HIV stories. Narrative medicine provides a tool to strengthen the BPS model in health care.

Association between physiological responses after exercise at low altitude and acute mountain sickness upon ascent is sex-dependent

BackgroundAcute mountain sickness (AMS) is the mildest form of acute altitude illnesses, and consists of non-specific symptoms when unacclimatized persons ascend to elevation of ≥2500 m. Risk factors of AMS include: the altitude, individual susceptibility, ascending rate and degree of pre-acclimatization. In the current study, we examined whether physiological response at low altitude could predict the development of AMS.MethodsA total of 111 healthy adult healthy volunteers participated in this trial; and 99 (67 men and 32 women) completed the entire study protocol. Subjects were asked to complete a 9-min exercise program using a mechanically braked bicycle ergometer at low altitude (500 m). Heart rate, blood pressure (BP) and pulse oxygen saturation (SpO2) were recorded prior to and during the last minute of exercise. The ascent from 500 m to 4100 m was completed in 2 days. AMS was defined as ≥3 points in a 4-item Lake Louise Score, with at least one point from headache wat 6–8 h after the ascent.ResultsAmong the 99 assessable subjects, 47 (23 men and 24 women) developed AMS at 4100 m. In comparison to the subjects without AMS, those who developed AMS had lower proportion of men (48.9% vs. 84.6%, P < 0.001), height (168.4 ± 5.9 vs. 171.3 ± 6.1 cm, P = 0.019), weight (62.0 ± 10.0 vs. 66.7 ± 8.6 kg, P = 0.014) and proportion of smokers (23.4% vs. 51.9%, P = 0.004). Multivariate regression analysis revealed the following independent risks for AMS: female sex (odds ratio (OR) =6.32, P < 0.001), SpO2 change upon exercise at low altitude (OR = 0.63, P = 0.002) and systolic BP change after the ascent (OR = 0.96, P = 0.029). Women had larger reduction in SpO2 after the ascent, higher AMS percentage and absolute AMS score. Larger reduction of SpO2 after exercise was associated with both AMS incidence (P = 0.001) and AMS score (P < 0.001) in men but not in women.ConclusionsLarger SpO2 reduction after exercise at low altitude was an independent risk for AMS upon ascent. Such an association was more robust in men than in women.Trial registrationChinese Clinical Trial Registration, ChiCTR1900025728. Registered 6 September 2019.

Important work demands for reducing sickness absence among workers with neck or upper back pain: a prospective cohort study

BackgroundThe aim of this study was to investigate what exposure to work demands, physical and psychosocial, is associated with lower levels of sickness absence among workers with neck or upper back pain in different groups, by age, gender, duration of sickness absence and work ability score.MethodsThis study was a prospective study of 4567 workers with neck or upper back pain. Data on neck or upper back pain, work demand and work ability were obtained from the Swedish Work Environment survey over a 3–year period (2009–2013). Register data on sickness absence, 1 year after each survey was conducted, were obtained from the Swedish health insurance database. Analyses were performed to estimate the association between self-reported work demands and registered sick days > 14 days. The analyses were stratified for gender, age group and work ability score.ResultsLower numbers of sick days were found for workers reporting low exposure to lifting ≥15 kg and twisted or forward-leaning work postures. Lower numbers of sick days were found for workers reporting high work control and seated work. The associations were generally stronger in the older age groups for the physical work demands.ConclusionsThe findings in this study suggest that certain physical work demands and having high control over one’s work can result in lower sickness absence, especially among middle-aged and older workers with neck or upper back pain.

Musculoskeletal disorders and disability among forest industry workers in lower and higher sickness absence groups: a case-control study

Background: Musculoskeletal wellbeing and disorders and explanatory factors were investigated among forest industry employees.Methods: A new positive approach to maintenance of working ability focuses on being present at work. 140 individuals with low sickness absence (≤1.5% in hours during the past 6.5 years) and 140 controls with higher sickness absence (>1.5%), randomly selected from the source population (n = 636) in workplace clusters (n = 5), were studied. Questionnaire data on functioning, musculoskeletal disorders (MSD) and disability, work ability and wellbeing were collected (response rate 65%) during December 2012–January 2013. 183 employees (mean age 48.5; females 32%) participated. Differences between cases and controls were studied with t- and Mann–Whitney tests and between age groups with Kruskal–Wallis tests. Associations between dependent and independent variables were studied using linear and logistic regression.Results: The sickness absence groups showed no statistically significant difference in MSD prevalence, although the lower sickness absence group reported less musculoskeletal disability than controls (p<.001). Across all participants, a low prevalence of MSD was explained by good work ability (p<.001) and high maximal oxygen consumption (p = .045). Lower musculoskeletal disability in the lower sickness absence group was explained by high psychological resources (OR =0.58) and in controls by good work ability (OR =0.03) and sedentary work (OR =0.08)Conclusion: Employee heterogeneity is important issue when seeking to minimise prevalence of musculoskeletal disability or sickness absence or their interaction.

Oral Midazolam Vs Promethazine as Pre Sedation Medication in Pediatric Dentistry

Objectives Pre- and post-sedation effect of oral Midazolam to promethazine in2-6 yrs old fearful children for dental treatmentMethods This randomized clinical trial was carried out on a group of 26 children aged 2-6 years referred to the dental school due to their fear and multiple dental needs. Patients were selected from ASA I or II classification and scored 1 in Frankl Behavior scale. Each patient was scheduled for two subsequent visits to receive one of the two pre medications before IV sedation. Each patient served as self-control and randomly assigned to either group A: receiving Midazolam oral as premed in 1st visit or group B: receiving Promethazine oral as the premed in 1st visit. Six hour NPO was instructed prior to sedation visit. Monitoring vital signs were conducted at every 15 minutes starting with base line before any drug administration. Sedation score was recorded using Houpt Sedation scale. Post sedation problems were recorded by operator. Data were analyzed using Student t test and Kruskal Wallis.Results No significant difference was noted between the patient perceptions at the two different visits. Children did not show a significant difference on symptoms such as Crying, Movement, Sleep and overall behavior in two visits at the first 15 minutes of sedative injection. Post-operative complications were having no significant difference. Lower sickness and vomiting were reported following promethazine intake.Conclusion Promethazine seems to be as effective and as acceptable premedication as Midazolam in pediatric dentistry.

A motivated workforce means lower sickness rates and sizeable agency fee savings, report shows

A motivated workforce means lower sickness rates and sizeable agency fee savings, report shows

Distributed leadership in public service organizations

During the past two decades there has been increased interest in collective or distributed forms of leadership within generic leadership theory and organizational psychology. “Distributed leadership” describes the sharing of leadership tasks between employees and managers with the aim to influence decision making, resource availability, and goal setting within an organization. This article introduces the concept of distributed leadership to the public administration literature and empirically examines the relevance of this leadership constellation for different public organization performance measures. Using survey and archival data collected at one of Denmark’s largest public hospitals, the analysis shows that hospital wards with high levels of distributed leadership also have employees who are more satisfied and innovative and who report higher levels of performance. Moreover, distributed leadership seems to be positively related with lower sickness absence among hospital employees. This indicates that distributed leadership is a relevant leadership constellation in public service producing organizations.

Change of the quality management culture through health-promotion activities?

There is great demand for workplace health-promotion programmes that improve co-worker health and provide a return on investment, which is due to the continuous escalation of care costs and the prioritisation of co-worker health by businesses. Early research found that organisations that have achieved good co-worker health with low sickness absence through their conscious and well-structured work were also working according to Quality Management. Health-promotion interventions are possible in every organisation, but before starting a health-promotion programme it is necessary to analyse the organisation and especially its culture. The purpose of this paper is to measure in what way health-promoting activities influence the Quality Management culture, particularly the health-related values ‘Leadership commitment’ and ‘Participation of everybody’. A comparison between the Quality Management culture before starting a health-promotion project and the results a year later is presented. The results show that health-promotion activities do not affect the Quality Management culture, at least not from a year perspective. On the other hand, the results show that health-promotion activities can affect co-workers’ perception of their health.

Dependent Children and Women's Sickness Absence in the EU Countries and Norway

ABSTRACTPrevious research has yielded quite varying results with regard to the relationship between children and women's sickness absence from work. This study examines the issue using data from the EU Labour Surveys. Cross-sectional data from 2005 covering 23 EU countries plus Norway are used. The data are analysed by means of logistic regression with control for country, age, working hours and socio-economic status. For married/cohabiting women, there is a quite consistent tendency for dependent children to be associated with lower sickness absence. A single young child is, however, related to higher sickness absence in some analyses, suggesting that the transition to parenthood may be stressful. Single mothers do not in general have higher sickness absence than their married/cohabiting counterparts. The tendency toward lower sickness absence in most groups of married/cohabiting mothers is likely to be due to selection to some extent, but also to favourable role accumulation effects.

Doctors still have lowest sickness rate of all NHS staff

The sickness rate among doctors in England has shown a small rise over the past three years but remains the lowest of all NHS staff groups, figures from the Health and Social Care Information Centre indicate. On average, hospital doctors took 2.8 working days off sick in 2012-13, up slightly from 2.7 days in 2011-12 and 2009-10.1 On an average …

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

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

Self-rated coping styles and registered sickness absence among nurses working in hospital care: A prospective 1-year cohort study

Background Sickness absence is an important problem in healthcare that affects the quality of care. Sickness absence has been related to coping strategies. Problem-focused coping was shown to be associated with low sickness absence and emotion-focused coping with high sickness absence among postal workers. Objectives This study investigated the relationship between coping styles and sickness absence in healthcare. Design Prospective study linking self-rated coping styles at baseline with the number of episodes of sickness absence during one year of follow-up. Setting Somatic hospital employing 1153 persons. Participants Convenience sample of 566 female nurses working in the hospital's clinical wards and outpatient clinic. Of these, 386 (68%) nurses had complete data for analysis. Methods The nurses completed a questionnaire at baseline with items on health, work, and coping styles. Three styles of coping were defined: problem-solving coping (i.e., looking for opportunities to solve a problem), social coping (i.e., seeking social support in solving a problem), and palliative avoidant coping (i.e., seeking distraction and avoiding problems). Sickness absence data were retrieved from the hospital's register in the following year. The association between the coping styles and the number of both short (1–7 days) and long (>7 days) episodes of sickness absence was assessed by Poisson regression analyses with age, work hours per week, general health, mental health, and effort–reward [ER] ratio as covariates. Results Problem-solving coping was negatively associated with the number of long episodes of sickness absence (rate ratio [RR] = 0.78, 95% confidence interval [CI] = 0.64–0.95). Social coping was negatively associated with the number of both short episodes (RR = 0.88, 95% CI = 0.79–0.97) and long episodes (RR = 0.79, 95% CI = 0.64–0.97) of sickness absence. After adjustment for the ER-ratio, the associations of coping with short episodes of sickness absence strengthened and associations with long episodes weakened, however, significance was lost for both types of sickness absence. Palliative avoidant coping was not associated with sickness absence among female hospital nurses. Conclusion Problem-solving coping and social coping styles were associated with less sickness absence among female nurses working in hospital care. Nurse managers may use this knowledge and reduce sickness absence and understaffing by stimulating problem-solving strategies and social support within nursing teams.

The impact of ART scale upon health workers: evidence from two South African districts

This study explores the effects of antiretroviral treatment (ART) programmes on health-care human resources in South Africa. The study included two parts, a questionnaire-based survey of 269 health workers published earlier and a qualitative study of 21 purposively selected health practitioners involved in ART scale up. Contrary to what has been presented in literature, our survey showed that health workers in ART programmes experienced higher levels of morale, lower stress, lower sickness absenteeism and higher levels of job satisfaction. This paper uses qualitative data to provide insights into the working environment of ART workers and examines some possible explanations for our survey findings. The key factors that contribute to the different perception of working environment by ART workers identified in this study include bringing hope to patients, delaying deaths, acquiring training and the ability to better manage and monitor the disease.

Work conditions for workers with good long‐term health

PurposeThe aim of this paper is to investigate which work‐ and private life factors are associated with long‐term health, operationalized as low sickness absence and low sickness presence.Design/methodology/approachA representative sample of 2,297 individuals responded to a questionnaire on two occasions at an interval of one year. In total, 28 percent were classified as having good long‐term health.FindingsUnivariate and multivariate analyses showed that some quality‐related work environment factors were rather strongly associated with long‐term health. For some variables women showed a clear dose‐response pattern on the three‐level scale alternatives in relation to health, while men had a more asymmetric response pattern. The results are discussed in relation to the symmetry in the work environment factors, i.e. if there are different factors that explain health and illness.Practical implicationsIssues concerning health and health‐enhancing factors are of considerable interest to practitioners concerned with management issues, organizational structure, and rehabilitation.Originality/valueThe paper shows the importance of including a positive health variable within the health research paradigm to supplement the dominance of variables focusing on illness and disease.

“Inclusive Working Life” in Norway – Experience from “Models of Good Practice” Enterprises

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