Teachers' sick leave due to mental and behavioral disorders and return to work

This manuscript presents a review of the literature about medical leaves due to mental and behavioral disorders and return to work of teachers. There are scarce published manuscripts. Most articles relate with prevalence of mental disorders and factors associated with the work organization, and did not mention intervention proposals and or changes in the work organization and teaching work. Proposed actions are discussed.

A daily perspective on work interruptions

Diese Dissertation basiert auf einem theoretischen Artikel und zwei empirischen Studien.rnrnDer theoretische Artikel: Es wird ein theoretisches Rahmenmodell postuliert, welches die Kumulierung von Arbeitsunterbrechung und deren Effekte untersucht. Die meisten bisherigen Studien haben Unterbrechungen als isoliertes Phänomen betrachtet und dabei unberücksichtigt gelassen, dass während eines typischen Arbeitstages mehrere Unterbrechungen gleichzeitig (oder aufeinanderfolgend) auftreten. In der vorliegenden Dissertation wird diese Lücke gefüllt, indem der Prozess der kumulierenden Unterbrechungen untersucht wird. Es wird beschrieben,rninwieweit die Kumulation von Unterbrechungen zu einer neuen Qualität vonrn(negativen) Effekten führt. Das Zusammenspiel und die gegenseitige Verstärkung einzelner Effekte werden dargestellt und moderierende und mediierende Faktoren aufgezeigt. Auf diese Weise ist es möglich, eine Verbindung zwischen kurzfristigen Effekten einzelner Unterbrechungen und Gesundheitsbeeinträchtigungen durch die Arbeitsbedingung ‚Unterbrechungen‘rnherzustellen.rnrnStudie 1: In dieser Studie wurde untersucht, inwieweit Unterbrechungen Leistung und Wohlbefinden einer Person innerhalb eines Arbeitstages beeinflussen. Es wurde postuliert, dass das Auftreten von Unterbrechungen die Zufriedenheit mit der eigenen Leistung vermindert und das Vergessen von Intentionen und das Irritationserleben verstärkt. Geistige Anforderung und Zeitdruck galten hierbei als Mediatoren. Um dies zu testen, wurden 133 Pflegekräften über 5 Tage hinweg mittels Smartphones befragt. Mehrebenenanalysen konnten die Haupteffekte bestätigen. Die vermuteten Mediationseffekte wurden für Irritation und (teilweise) für Zufriedenheit mit der Leistung bestätigt, nicht jedoch für Vergessen von Intentionen. Unterbrechungen führen demzufolge (u.a.) zu negativen Effekten, da sie kognitiv anspruchsvoll sind und Zeit beanspruchen.rnrnStudie 2: In dieser Studie wurden Zusammenhänge zwischen kognitiven Stressorenrn(Arbeitsunterbrechungen und Multitasking) und Beanspruchungsfolgen (Stimmung und Irritation) innerhalb eines Arbeitstages gemessen. Es wurde angenommen, dass diese Zusammenhänge durch chronologisches Alter und Indikatoren funktionalen Alters (Arbeitsgedächtniskapazität und Aufmerksamkeit) moderiert wird. Ältere mit schlechteren Aufmerksamkeitsund Arbeitsgedächtnisleistungen sollten am stärksten durch die untersuchten Stressoren beeinträchtigt werden. Es wurde eine Tagebuchstudie (siehe Studie 1) und computergestützternkognitive Leistungstests durchgeführt. Mehrebenenanalysen konnten die Haupteffekte für die abhängigen Variablen Stimmung (Valenz und Wachheit) und Irritation bestätigen, nicht jedoch für Erregung (Stimmung). Dreifachinteraktionen wurden nicht in der postulierten Richtung gefunden. Jüngere, nicht Ältere profitierten von einem hohen basalen kognitivenrnLeistungsvermögen. Ältere scheinen Copingstrategien zu besitzen, die mögliche kognitive Verluste ausgleichen. rnrnIm Allgemeinen konnten die (getesteten) Annahmen des theoretischen Rahmenmodellsrnbestätigt werden. Prinzipiell scheint es möglich, Ergebnisse der Laborforschung auf die Feldforschung zu übertragen, jedoch ist es notwendig die Besonderheiten des Feldes zu berücksichtigen. Die postulieren Mediationseffekte (Studie 1) wurden (teilweise) bestätigt. Die Ergebnisse weisen jedoch darauf hin, dass der volle Arbeitstag untersucht werden muss und dass sehr spezifische abhängige Variablen auch spezifischere Mediatoren benötigen. Des Weiteren konnte in Studie 2 bestätigt werden, dass die kognitive Kapazität eine bedeutsamernRessource im Umgang mit Unterbrechungen ist, im Arbeitskontext jedoch auch andere Ressourcen wirken.

Work-related behavior and experience patterns and predictors of mental health in German physicians in medical practice

Background and Objectives: Work-related stress and burnout among physicians are of increasing relevance. The aim of this study was to investigate work-related behavior and experience patterns and predictors of mental health of physicians working in medical practice in Germany. Methods: We surveyed a stratified, random sample of 900 physicians from different specialties. The questionnaire included the standardized instruments Work-related Behavior and Experience Pattern (AVEM) and the Short Form-12 Health Survey (SF-12). Results: Only one third of physicians reported high or very high general satisfaction with their job, but 64% would choose to study medicine again. Only 18% of physicians presented a healthy behavior and experience pattern. Almost 40% presented a pattern of reduced motivation to work, 21% were at risk of overexertion, and 22% at risk for burnout. Willingness to study medicine again, fulfilled job expectations, professional years, marital status, and behavior patterns were significant predictors of mental health and accounted for 35.6% of the variance in mental health scores. Job-related perceptions also had a significant effect on burnout. Conclusions: The strong influence of work-related perceptions suggests a need for realistic expectation management in medical education, as well as support in stress management and coping strategies during medical training.

An Analysis of Capacities, Moral Hierarchies, and the Moral Status of Non-Human Animals in Contemporary Animal Rights Work

The primary objective of this thesis is to demonstrate the pernicious impact that moral hierarchies have on our perception and subsequent treatment of non-human animals. Moral hierarchies in general are characterized by a dynamic in which one group is considered to be fundamentally superior to a lesser group. This thesis focuses specifically on the moral hierarchies that arise when humans are assumed to be superior to non-human animals in virtue of their advanced mental capabilities. The operative hypothesis of this thesis is essentially that moral hierarchies thwart the provision of justice to non-human animals in that they function as a justification for otherwise impermissible actions. When humans are assumed to be fundamentally superior to non-human animals then it becomes morally permissible for humans to kill non-human animals and utilize them as mere instrumentalities. This thesis is driven primarily by an in-depth analysis of the approaches to animal rights that are provided by Peter Singer, Tom Regan, and Gary Francione. Each of these thinkers claim that they overcome anthropocentrism and provide approaches that preclude the establishment of a moral hierarchy. One of the major findings of this thesis, however, is that Singer and Regan offer approaches that remain highly anthropocentric despite the fact that each thinker claims that they have overcome anthropocentrism. The anthropocentrism persists in these respective approaches in that each thinkers gives humans Regan and Singer have different conceptions of the criteria that are required to afford a being moral worth, but they both give preference to beings that have the cognitive ability to form desires regarding the future.. As a result, a moral hierarchy emerges in which humans are regarded to be fundamentally superior. Francione, however, provides an approach that does not foster a moral hierarchy. Francione creates such an approach by applying the principle of equal consideration of interests in a consistent manner. Moreover, Francione argues that mere sentience is both a necessary and sufficient condition for being eligible and subsequently receiving moral consideration. The upshot of this thesis is essentially that the moral treatment of animals is not compatible with the presence of a moral hierarchy. As a result, this thesis demonstrates that future approaches to animal rights must avoid the establishment of moral hierarchies. The research and analysis within this thesis demonstrates that this is not a possibility, however, unless all theories of justice that are to accommodate animals abandon the notion that cognition matters morally.

Evidence for mental ability related individual differences in the attentional blink obtained by an analysis of the P300 component

Attentional blink (AB) refers to impaired identification of a target (T2) when this target follows a preceding target (T1) after about 150-450 ms within a stream of rapidly presented stimuli. Previous research on a possible relation between AB and mental ability (MA) turned out to be highly ambiguous. The present study investigated MA-related individual differences in consolidation of T2 in working memory during the AB as indicated by the P300 component of the event-related potential. Thirty high (HA) and 30 low MA (LA) female participants performed an AB task while their brain activity was recorded. The AB did not differ between the two groups. HA individuals exhibited a larger P300 amplitude and longer P300 latencies during the AB suggesting higher mental effort. This higher mental effort, however, did not result in better performance presumably because of more competition between target and distractor stimuli in HA than LA individuals.

Driving ability, mental illness and psychotropic medication in the elderly

Fitness to drive in elderly drivers is most commonly discussed with a focus on cognitive impairment. Therefore, this article is focussing on mental illness and the use of psychotropic drugs in elderly drivers, which can both interfere with fitness to drive. Based on a detailed literature review and on clinical judgement, we propose signposts and "red flags" to judge the individual risks. Health professionals dealing with elderly patients should in particular be aware of the dangers related to cumulative risks and need to inform the patients appropriately. For medico-legal reasons the information provided to patients must be written down in the medical record. Individual counselling is important as fitness to drive is a complex topic.

Ability to Work and Employment Rates in Human Immunodeficiency Virus (HIV)-1-Infected Individuals Receiving Combination Antiretroviral Therapy: The Swiss HIV Cohort Study

Background.  Limited data exist on human immunodeficiency virus (HIV)-infected individuals' ability to work after receiving combination antiretroviral therapy (cART). We aimed to investigate predictors of regaining full ability to work at 1 year after starting cART. Methods.  Antiretroviral-naive HIV-infected individuals <60 years who started cART from January 1998 through December 2012 within the framework of the Swiss HIV Cohort Study were analyzed. Inability to work was defined as a medical judgment of the patient's ability to work as 0%. Results.  Of 5800 subjects, 4382 (75.6%) were fully able to work, 471 (8.1%) able to work part time, and 947 (16.3%) were unable to work at baseline. Of the 947 patients unable to work, 439 (46.3%) were able to work either full time or part time at 1 year of treatment. Predictors of recovering full ability to work were non-white ethnicity (odds ratio [OR], 2.06; 95% confidence interval [CI], 1.20-3.54), higher education (OR, 4.03; 95% CI, 2.47-7.48), and achieving HIV-ribonucleic acid <50 copies/mL (OR, 1.83; 95% CI, 1.20-2.80). Older age (OR, 0.55; 95% CI, .42-.72, per 10 years older) and psychiatric disorders (OR, 0.24; 95% CI, .13-.47) were associated with lower odds of ability to work. Recovering full ability to work at 1 year increased from 24.0% in 1998-2001 to 41.2% in 2009-2012, but the employment rates did not increase. Conclusions.  Regaining full ability to work depends primarily on achieving viral suppression, absence of psychiatric comorbidity, and favorable psychosocial factors. The discrepancy between patients' ability to work and employment rates indicates barriers to reintegration of persons infected with HIV.