Pain among employees : risk factors and consequences

The overall objective of this study was to gain epidemiological knowledge about pain among employee populations. More specifically, the aims were to assess the prevalence of pain, to identify socio-economic risk groups and work-related psychosocial risk factors, and to assess the consequences in terms of health-related functioning and sickness absence. The study was carried out among the municipal employees of the City of Helsinki. Data comprised questionnaire survey conducted in years 2000-2002 and register data on sickness absence. Altogether 8960 40-60 year old employees participated to the survey (response rate 67%). Pain is common among ageing employees. Approximately 29 per cent of employees reported chronic pain and 15 per cent acute pain, and about seven per cent reported moderately or severely limiting disabling chronic pain. Pain was more common among those with lower level of education or in a low occupational class. -- Psychosocial work environment was associated with pain reports. Job strain, bullying at workplace, and problems in combining work and home duties were associated with pain among women. Among men combining work and home duties was not associated with pain, whereas organizational injustice showed associations. Pain affects functional capacity and predicts sickness absence. Those with pain reported lower level of both mental and physical functioning than those with no pain, physical functioning being more strongly affected than mental. Bodily location of pain or whether pain was acute or chronic had only minor impact on the variation in functioning, whereas the simple count of painful locations was associated with widest variation. Pain accounted for eight per cent of short term (1-3 day) sickness absence spells among men and 13 per cent among women. Of absence spells lasting between four and 14 days pain accounted for 23 per cent among women and 25 per cent among men, corresponding figures for over 14 day absence spells being 37 and 30 per cent. The association between pain and sickness absence was relatively independent of physical and psychosocial work factors, especially among women. The results of this study provide a picture of the epidemiology of pain among employees. Pain is a significant problem that seriously affects work ability. Information on risk groups can be utilized to make prevention measures more effective among those at high risk, and to decrease pain rates and thereby narrow the differences between socio-economic groups. Furthermore, the work-related psychosocial risk factors identified in this study are potentially modifiable, and it should be possible to target interventions on decreasing pain rates among employees.

Associations among working conditions and behavioral risk factors : The Helsinki Health Study with International Comparisons

Adverse health behaviors as well as obesity are key risk factors for chronic diseases. Working conditions also contribute to health outcomes. It is possible that the effects of psychosocially strenuous working conditions and other work-related factors on health are, to some extent, explained by adverse behaviors. Previous studies about the associations between several working conditions and behavioral outcomes are, however, inconclusive. Moreover, the results are derived mostly from male populations, one national setting only, and with limited information about working conditions and behavioral risk factors. Thus, with an interest in employee health, this study was set to focus on behavioral risk factors among middle-aged employees. More specifically, the main aim was to shed light on the associations of various working conditions with health behaviors, weight gain, obesity, and symptoms of angina pectoris. In addition to national focus, international comparisons were included to test the associations across countries thereby aiming to produce a more comprehensive picture. Furthermore, a special emphasis was on gaining new evidence in these areas among women. The data derived from the Helsinki Health Study, and from collaborative partners at the Whitehall II Study, University College London, UK, and the Toyama University, Japan. In Helsinki, the postal questionnaires were mailed in 2000-2002 to employees of the City of Helsinki, aged 40 60 years (n=8960). The questionnaire data covered e.g., socio-economic indicators and working conditions such as Karasek s job demands and job control, work fatigue, working overtime, work-home interface, and social support. The outcome measures consisted of smoking, drinking, physical activity, food habits, weight gain, obesity, and symptoms of angina pectoris. The international cohorts included comparable data. Logistic regression analysis was used. The models were adjusted for potential confounders such as age, education, occupational class, and marital status subject to specific aims. The results showed that working conditions were mostly unassociated with health behaviors, albeit some associations were found. Low job strain was associated with healthy food habits and non-smoking among women in Helsinki. Work fatigue, in turn, was related to drinking among men and physical inactivity among women. Work fatigue and working overtime were associated with weight gain in Helsinki among both women and men. Finally, work fatigue, low job control, working overtime, and physically strenuous work were associated with symptoms of angina pectoris among women in Helsinki. Cross-country comparisons confirmed mostly non-existent associations. High job strain was associated with physical inactivity and smoking, and passive work with physical inactivity and less drinking. Working overtime, in turn, related to non-smoking and obesity. All these associations were, however, inconsistent between cohorts and genders. In conclusion, the associations of the studied working conditions with the behavioral risk factors lacked general patters, and were, overall, weak considering the prevalence of psychosocially strenuous work and overtime hours. Thus, based on this study, the health effects of working conditions are likely to be mediated by adverse behaviors only to a minor extent. The associations of work fatigue and working overtime with weight gain and symptoms of angina pectoris are, however, of potential importance to the subsequent health and work ability of employees.

Epidemiological data of seasonal variation in mood and behaviour

The aim of this study was to measure seasonal variation in mood and behaviour. The dual vulnerability and latitude effect hypothesis, the risk of increased appetite, weight and other seasonal symptoms to develop metabolic syndrome, and perception of low illumination in quality of life and mental well-being were assessed. These variations are prevalent in persons who live in high latitudes and need balancing of metabolic processes to adapt to environmental changes due to seasons. A randomized sample of 8028 adults aged 30 and over (55% women) participated in an epidemiological health examination study, The Health 2000, applying the probability proportional to population size method for a range of socio-demographic characteristics. They were present in a face-to-face interview at home and health status examination. The questionnaires included the modified versions of the Seasonal Pattern Assessment Questionnaire (SPAQ) and Beck Depression Inventory (BDI), the Health Related Quality of Life (HRQoL) instrument 15D, and the General Health Questionnaire (GHQ). The structured and computerized Munich Composite International Diagnostic Interview (M-CIDI) as part of the interview was used to assess diagnoses of mental disorders, and, the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII) criteria were assessed using all the available information to detect metabolic syndrome. A key finding was that 85% of this nationwide representative sample had seasonal variation in mood and behaviour. Approximately 9% of the study population presented combined seasonal and depressive symptoms with a significant association between their scores, and 2.6% had symptoms that corresponded to Seasonal Affective Disorder (SAD) in severity. Seasonal variations in weight and appetite are two important components that increase the risk of metabolic syndrome. Other factors such as waist circumference and major depressive disorder contributed to the metabolic syndrome as well. Persons reported of having seasonal symptoms were associated with a poorer quality of life and compromised mental well-being, especially if indoors illumination at home and/or at work was experienced as being low. Seasonal and circadian misalignments are suggested to associate with metabolic disorders, and could be remarked if individuals perceive low illumination levels at home and/or at work that affect the health-related quality of life and mental well-being. Keywords: depression, health-related quality of life, illumination, latitude, mental well-being, metabolic syndrome, seasonal variation, winter.

Psychiatric disturbances in children with intellectual disability : Prevalence, risk factors and assessment

Children with intellectual disability are at increased risk for emotional and behavioural problems, but many of these disturbances fail to be diagnosed. Structured checklists have been used to supplement the psychiatric assessment of children without intellectual disability, but for children with intellectual disability, only a few checklists are available. The aim of the study was to investigate psychiatric disturbances among children with intellectual disability: the prevalence, types and risk factors of psychiatric disturbances as well as the applicability of the Finnish translations of the Developmental Behaviour Checklist (DBC-P) and the Child Behavior Checklist (CBCL) in the assessment of psychopathology. The subjects comprised 155 children with intellectual disability, and data were obtained from case records and five questionnaires completed by the parents or other carers of the child. According to case records, a psychiatric disorder had previously been diagnosed in 11% of the children. Upon careful re-examination of case records, the total proportion of children with a psychiatric disorder increased to 33%. According to checklists, the frequency of probable psychiatric disorder was 34% by the DBC-P, and 43% by the CBCL. The most common diagnoses were pervasive developmental disorders and hyperkinetic disorders. The results support previous findings that compared with children without intellectual disability, the risk of psychiatric disturbances is 2-3-fold in children with intellectual disability. The risk of psychopathology was most significantly increased by moderate intellectual disability and low socio-economic status, and decreased by adaptive behaviour, language development, and socialisation as well as living with both biological parents. The results of the study suggest that both the DBC-P and the CBCL can be used to discriminate between children with intellectual disability with and without emotional or psychiatric disturbance. The DBC-P is suitable for children with any degree of intellectual disability, and the CBCL is suitable at least for children with mild intellectual disability. Because the problems of children with intellectual disability differ somewhat from those of children without intellectual disability, checklists designed specifically for children with intellectual disability are needed.

Socio-cultural influences on sanitation, fish handling and artisanal fish processing within the fishing communities

The fishery sector in Uganda has seen important changes in the last two decades. Among the changes registered, is the expansion of fish markets locally, regionally and internationally. Upon which, remarkable benefits have been realized at local and national levels, for instance, it is estimated that an average of 40m$ is being earned annually as foreign exchange. Besides, presently fish accounts for over 50% of total animal protein in take. However, it is argued that sustaining these gains has become an up hill task due to failure to maintain fish quality as a result of the rudimentary and inappropriate sanitary, fish handling and artisanal fish processing practices that both directly and indirectly affect the quality of fish and fish products. Therefore, against this background, a study of 507 respondents was undertaken among the Lake Victoria Communities specifically in Wakiso, Mayuge and Mukono districts. The study examined the perceptions of fishers on the social cultural practices of sanitation, fish handling and artisanal fish processing and consequently identified factors that influenced these practices.

Sanitation, fish handling and artisanal fish processing within fishing communities: socio-cultural influences

postive transformation of the fisheries sector in Uganda has of recent been scatted by failure to mountain fish quality and safety,akey prerequiste for retaining and gaining fish markets. The social cultural study established the extent to which social cutural practices had affected the levels and the use of sanitation facilities,fish handling facilities and artisanal fish processing techniques and the factors that influenced these practices in the fishing communities of lake victoria. This information is of significance for the purpose of advocacy and mobilization of fishers in order to improve sanitation, fish handling and artisanal fishing processing situation in the fishing communities.

The role of social,economic and cultural factors in the management of satellite lake fisheries in Uganda

The fisheries of small lakes are important for producing fish for local populations not clear the larger lakes.The satelite support important fisheries and other economic activities like fishing water for domestic purpose and tourism besides socio-cultural functions.

Impact of dead and sunken water hyacinth on biotic communities, the aquatic environment and socio-economic activities

The mobile water hyacinth, which was produced in growth zones, especially Murchison Bay, was mainly exported to three sheltered storage bays (Thruston, Hannington and Waiya). Between 1996 and May 1998, the mobile form of water hyacinth occupied about 800 ha in Thruston Bay, 750 ha in Hannington Bay and 140 ha in Waiya Bay). Biological control weevils and other factors, including localised nutrient depletion, weakened the weed that was confined to the bays and it sunk around October 1998. The settling to the bottom of such huge quantities of organic matter its subsequent decomposition and the debris from this mass was likely to have environmental impacts on biotic communities (e.g. fish and invertebrate), physico-chemical conditions (water quality), and on socio-economic activities (e.g. at fish landings, water abstraction, and hydro-power generation points). Sunken water. hyacinth debris could also affect nutrient levels in the water column and lead to reduction in the content of dissolved oxygen. The changes in nutrient dynamics and oxygen levels could affect algal productivity, invertebrate composition and fish communities. Socio-economic impacts of dead sunken weed were expected from debris deposited along the shoreline especially at fish landings, water abstraction and hydropower generation points. Therefore, environmental impact assessment studies were carried out between 1998 and 2002 in selected representative zones of Lake Victoria to identify the effects of the sunken water hyacinth biomass

Socio-economic and marketing aspects of Laila and Bottom Long Line fisheries in the Kalpitiya peninsula of Sri Lanka

Surrounding Net Fishery (laila) and Bottom Long Line Fishery which operate in the coastal waters of Kalpitiya Peninsula, compete for the same fish resources, resulting in a fishery dispute between the respective fishermen. Both fisheries target demersal as well as mid pelagic fishes, such as travellys (parava), mullets (galmalu) and barracudas (ulava). As the dispute had an adverse impact on the social harmony in the fishing community of the area, a socio-economic survey was conducted to study the underlying factors and to suggest policy measures to resolve the issue. The laila fishermen were resident fishermen in the Kalpitiya Peninsula while bottom long line fishermen were migratory fishermen from Negombo and Chilaw areas in the west coast of Sri Lanka. The Kalpitiya peninsula is located in the North West coast, some 50 km away from the west coast. Although the educational level and literacy rate of the laila community was below that of the bottom long line community, the laila community was economically better off. The net economic returns from laila fishery were superior to that from bottom long line fishery. The boat owner's and crew's share per operation of laila fishery were Rs.3,736 and Rs.947 respectively. The same figures for bottom long line fishery were Rs.588 and Rs.327 respectively. The resource rent from laila fishery was Rs.5,860, however, and much higher than that for bottom long line fishery (Rs.275), showing that the laila fishery exploits the targeted fish resource at a much higher rate compared to bottom long line fishery. This situation badly affects the equitable distribution of resources between the two fishing communities and results in unequal economic gains. Based on the findings of this study, certain input/output controls are proposed to address this problem, among which is the need to increase license fee for laila fishery units to offset the higher exploitation rate of fish resources.

Socio-economics of fishing communities on Uganda water bodies

Control and management of Uganda fishery resources has been hindered by among other factors the multispecies nature of the resource and the characteristic behaviour of the fishing communities. Fishermen have both genuine and uncompromising attitudes as to why they carry out certain fishing technologies.All fishing activities aim at maximizing the catches or profits while others may fish on a small scale for subsistence. Sensitizing the fisherfolk on the appropriate fishing technologies, importance of a well regulated fishery exploitation and their participation in control and management of the resource would enhance or lead to increased and sustainable fish production. Socio-economics of fishing technologies were therefore examined using prepared questionnaires and reasons why the fishing communities behave the way they do established

Dynamics of learner affective development in early FLL

Affective learner factors were first considered as a cause of success in language learning. This was followed by a change in approach and recently authors (e.g., Edelenbos, Johnstone, & Kubanek, 2006) have considered them an important outcome, especially in early foreign language learning (FLL). Current research into affective learner factors in early FLL tries to catch the developmental aspects too, and studies are emerging that take a contextual view as well. This paper describes a study on affective characteristics of young FL learners that combines the developmental and contextual perspectives. Using the case study methodology the author analyses the affective profiles of three young learners of English as a foreign language who were followed for 4 years. The analyses are done taking into account their immediate language learning environment, home support, out-of-school exposure to English and language achievement. The findings suggest that affective learner factors contribute to the dynamic complexity of early FLL.

Women's help seeking behaviour and the associated influencing factors on self discovery of a breast symptom

To investigate women’s help seeking behavior (HSB) following self discovery of a breast symptom and determine the associated influencing factors. A descriptive correlation design was used to ascertain the help seeking behavior (HSB) and the associated influencing factors of a sample of women (n = 449) with self discovered breast symptoms. The study was guided by the ‘Help Seeking Behaviour and Influencing Factors” conceptual framework (Facione et al., 2002; Meechan et al., 2003, 2002; Leventhal, Brissette and Leventhal, 2003 and O’Mahony and Hegarty, 2009b). Data was collected using a researcher developed multi-scale questionnaire package to ascertain women’s help seeking behavior on self discovery of a breast symptom and determine the factors most associated with HSB. Factors examined include: socio-demographics, knowledge and beliefs (regarding breast symptom; breast changes associated with breast cancer; use of alternative help seeking behaviours and presence or absence of a family history of breast cancer),emotional responses, social factors, health seeking habits and health service system utilization and help seeking behavior. A convenience sample (n = 449 was obtained by the researcher from amongst women attending the breast clinics of two large urban hospitals within the Republic of Ireland. All participants had self-discovered breast symptoms and no previous history of breast cancer. The study identified that while the majority of women (69.9%; n=314) sought help within one month, 30.1% (n=135) delayed help seeking for more than one month following self discovery of their breast symptom. The factors most significantly associated with HSB were the presenting symptom of ‘nipple indrawn/changes’ (p = 0.005), ‘ignoring the symptom and hoping it would go away’ (p < 0.001), the emotional response of being ‘afraid@ on symptom discovery (p = 0.005) and the perception/belief in longer symptom duration (p = 0.023). It was found that women who presented with an indrawn/changed nipple were more likely to delay (OR = 4.81) as were women who ‘ignored the symptoms and hoped it would go away’ (OR = 10.717). Additionally, the longer women perceived that their symptom would last, they more likely they were to delay (OR = 1.18). Conversely, being afraid following symptom discovery was associated with less delay (OR = 0.37; p=0.005). This study provides further insight into the HSB of women who self discovered breast symptoms. It highlights the complexity of the help seeking process, indicating that is not a linear event but is influenced by multiple factors which can have a significant impact on the outcomes in terms of whether women delay or seek help promptly. The study further demonstrates that delayed HSB persists amongst women with self discovered breast symptoms. This has important implications for continued emphasis on the promotion of breast awareness, prompt help seeking for self discovered breast symptoms and early detection and treatment of breast cancer, amongst women of all ages.

Victimisation of street children in Addis Ababa: factors of resilience and susceptibility

Cross-cultural variations in conceptions of childhood are discussed, particularly with regard to child abuse and child labour. Regardless of cultural background, a universal minimum standard of child rearing is required. The street child literature is reviewed, culminating in an analysis of Ethiopian street children. Theoretically this work is informed by victimology. Concepts shared by victimology and rational choice perspective are discussed, after Fattah (1993a). Victim surveys are described, highlighting their accuracy of crime estimates. Juvenile prostitution, runaways and rape are examined, particularly with regard to their relevance in Addis Ababa. Fifty five male and 135 female street children were interviewed. Interviews with boys focused on delinquency. An age-related pattern emerged, with younger boys less likely to drink, chew khat, steal or be sexually active. Interviews with street girls focused on the differences between girls living on the streets (girls of the street), girls working on the streets (girls on the street) and a sample of homebased girls. Girls of the street come to the street come to the streets for many reasons. Conflicts with a parent or guardian account for almost 50%. They are highly vulnerable to sexual assaults, particularly those 43% who have worked as prostitutes. Girls on the street experience considerably less victimisation. Urban poor girls live in socio-economic circumstances akin to girls on the street but enjoy almost universal protection from victimisation because they do not spend time on the streets. Unprotected by the stability which a family provides, girls of the street experience high victimisation levels. Such victimisation is often the result of reliance on types of work, such as prostitution, which brings the girls into contact with exploitative adults. Resistance to such victimisation is provided by a secure place to sleep, companions, and relatively safe types of work. Such protective factors are more readily available to family based children as compared to those living independently.

Socio-economic status and malaria-related outcomes in Mvomero District, Tanzania.

While policies often target malaria prevention and treatment - proximal causes of malaria and related health outcomes - too little attention has been given to the role of household- and individual-level socio-economic status (SES) as a fundamental cause of disease risk in developing countries. This paper presents a conceptual model outlining ways in which SES may influence malaria-related outcomes. Building on this conceptual model, we use household data from rural Mvomero, Tanzania, to examine empirical relationships among multiple measures of household and individual SES and demographics, on the one hand, and malaria prevention, illness, and diagnosis and treatment behaviours, on the other. We find that access to prevention and treatment is significantly associated with indicators of households' wealth; education-based disparities do not emerge in this context. Meanwhile, reported malaria illness shows a stronger association with demographic variables than with SES (controlling for prevention). Greater understanding of the mechanisms through which SES and malaria policies interact to influence disease risk can help to reduce health disparities and reduce the malaria burden in an equitable manner.

Affective and Experiential Influences on English Skills of Heritage Spanish Speakers

Gemstone Team GABS (Grammar Acquisition in Bilingual Students)