Working While the World Sleeps: A Consideration of Sleep and Shift Work Design

The evolution of society and economic pressure has provided the impetus for operating on a 24-hr basis in many industries. This has occurred with relatively little attention toward sleep deprivation and related problems facing shift workers and the organizations employing them. This paper first documents the move toward shift work and some sleep problems associated with it. We then describe sleep disorders that impact job performance. Next, we describe alternative schedules and give suggestions for shift work implementation. Finally, we offer some normative advice regarding the treatment of shift employees.     

人格障碍研究与童年期经历相关研究综述

人格障碍是近年来心理学界的研究热点,人格障碍与童年期经历的关系是主要的研究取向之一,通过概括人格障碍的定义和分类方法,总结了主要测量工具,综述了人格障碍与父母教养方式、依恋、虐待的相关研究等文献资料,在此基础上对人格障碍与童年期经历相关研究进行总结和展望。     

Economic evaluation of linaclotide for the treatment of adult patients with irritable bowel syndrome with constipation in the United States

Abstract

Objectives:

To use techniques of decision-analytic modeling to evaluate the effectiveness and costs of linaclotide vs lubiprostone in the treatment of adult patients with irritable bowel syndrome with constipation (IBS-C).

Methods:

Using model inputs derived from published literature, linaclotide Phase III trial data and a physician survey, a decision-tree model was constructed. Response to therapy was defined as (1) a ≥14-point increase from baseline in IBS-Quality-of-Life (IBS-QoL) questionnaire overall score at week 12 or (2) one of the top two responses (moderately/significantly relieved) on a 7-point IBS symptom relief question in ≥2 of 3 months. Patients who do not respond to therapy are assumed to fail therapy and accrue costs associated with a treatment failure. Model time horizon is aligned with clinical trial duration of 12 weeks. Model outputs include number of responders, quality-adjusted life-years (QALYs), and total costs (including direct and indirect). Both one-way and probabilistic sensitivity analyses were conducted.

Results:

Treatment for IBS-C with linaclotide produced more responders than lubiprostone for both response definitions (19.3% vs 13.0% and 61.8% vs 57.2% for IBS-QoL and symptom relief, respectively), lower per-patient costs ($803 vs $911 and $977 vs $1056), and higher QALYs (0.1921 vs 0.1917 and 0.1909 vs 0.1894) over the 12-week time horizon. Results were similar for most one-way sensitivity analyses. In probabilistic sensitivity analyses, the majority of simulations resulted in linaclotide having higher treatment response rates and lower per-patient costs.

Limitations:

There are no available head-to-head trials that compare linaclotide with lubiprostone; therefore, placebo-adjusted estimates of relative efficacy were derived for model inputs. The time horizon for this model is relatively short, as it was limited to the duration of available clinical trial data.

Conclusions:

Linaclotide was found to be a less costly option vs lubiprostone for the treatment of adult patients with IBS-C.     

The management of acid-related disorders: the burden of disease and the need for effective treatment

Summary

A large and increasing number of people suffer from acid-related disorders such as dyspepsia, gastro-oesophageal reflux disease (GORD), and peptic ulcer disease. In 1994 alone, about 2 million patients consulted their family doctor for an acid-related disorder. Treatment of these patients represents a high cost to the NHS in terms of medications, consultations, referrals and treatment of complications. UK government statistics also indicate that there is a huge economic burden associated with acid-related disorders in terms of lost productivity.

Effective management of acid-related disorders is required to ensure that the available resources are used efficiently and to the benefit of the NHS, society and the patient.

Proton pump inhibitors are the most effective and predictable therapy available for acid-related disorders and many clinical studies have demonstrated their superior efficacy over H2-receptor antagonists in the management of these conditions. These therapeutic advantages translate into economic gains. Several economic studies have shown that it is more cost-effective to treat GORD and peptic ulcer disease with the proton pump inhibitor omeprazole than with H2-receptor antagonists.     

2021年河北省滦南县生活饮用水水碘含量调查

目的：调查滦南县生活饮用水中水碘含量,了解生活饮用水中水碘分布情况,为采取针对性防治措施和科学调整干预策略提供依据。方法：按照《河北省生活饮用水水碘含量调查方案》中的调查方法和实验方法,由相应的调查人员和合格的实验室及实验人员完成此次调查取样及实验监测任务。结果：2021年全县采集17个乡(镇)及街道办事处总计701份水样,水碘含量为0.2～23.9μg·L^-1,水碘中位数是6.5μg·L^-1;集中式供水水样水碘含量低于分散式供水水样水碘含量,全县分散式供水水碘含量与井深呈弱负相关性,滨海平原咸水区水碘含量与井深呈明显负相关性。结论：滦南县为外环境缺碘地区,生活饮用水水碘含量均<40μg·L^-1,结合其他碘营养监测结果,建议今后继续加大碘缺乏病宣传力度,长期坚持食用加碘盐,并积极开展碘营养监测工作,为综合评估重点人群碘营养状态,及时调整碘缺乏病防控措施,科学补碘提供依据。     

The impact of recent mental health changes on employment: new evidence from longitudinal data

This study uses longitudinal data and four different measures of mental health to tease out the impact of psychiatric disorder onsets and recoveries on employment outcomes. Results suggest that developing a mental health problem leads to a significant increase in the probability of transitioning to non-employment, while a recovery increases the probability of return to work among the not employed with a mental health problem. No consistent effect was found on hours worked and earnings. Research and policy attention is needed with respect to early interventions such as job retention programmes to help workers with mental health problems remain employed as well as interventions that may lead to recovery and return to work. More research is needed especially with data and models that can differentiate between the effects of mental health onsets and recoveries on employment exit and return to work transitions.     

Associations between workers' health,and non-standard hours and insecurity: the case of home care workers in Ontario,Canada

This article examines associations between home care workers' health, and non-standard hours and insecurity. Health refers to symptoms of stress and musculoskeletal disorders (MSDs), non-standard hours refer to part-time and casual hours, and insecurity refers to job and employability insecurity. Data come from our 2002 survey of 532 home care workers (nurses, therapists and personal support workers) in a medium-sized city in Ontario, Canada. Path analysis regression results for the conceptual model show that (1) part-time and casual hours and job insecurity are positively and significantly associated with symptoms of stress, (2) the associations between part-time and casual hours and MSDs are mediated by symptoms of stress, and (3) job and employability insecurity are directly associated with MSDs. Results provide evidence that non-standard hours and insecurity must be addressed in order to improve home care workers' health. We show the detrimental effects of non-standard hours and insecurity on workers' health, and the results have implications for employers, human resource managers, trade unionists and government policy-makers.     

Attention Deficit/Hyperactivity Disorder in Adults: Will This Be the Greatest Challenge for Employment Discrimination Law?

This article examines the issues surrounding the treatment of attention deficit/hyperactivity disorder (ADHD) under the Americans with Disabilities Act (ADA). Recently, medical research has shown that ADHD, which had formerly been thought to be a childhood impairment, in many cases persists into adulthood. Because of the projected prevalence and severity of the disorder, ADHD has the potential to be a critical employment issue as well. This article begins with an examination of the current state of knowledge regarding ADHD. Then, attention is turned to the intersection of ADHD and the ADA. Three central questions are then addressed. These include whether ADHD is a covered condition under the ADA and how ADHD might enter into the employment selection process, and finally, the question of how employers can and should provide reasonable accommodation to ADHD-affected employees. A concluding discussion addresses how the convergence of ADHD and the ADA could become the health issue of the 1990s and beyond for both individual employers and employment law in general.     

The Political Economy of Bulimia Nervosa

Bulimia Nervosa constitutes a major social problem. There have, however, been few, if any, attempts to understand the distinctive features of this disorder from within the social sciences. Rather, the increasing prevalence of all forms of eating disorders are understood as a product of how the concepts of ‘femininity’ and the ‘controlled body’ are constructed within contemporary society. Bulimia and anorexia are ultimately seen to have their roots in the same social phenomena. While recognising the insights that the existing literature offers, we argue that in order to fully understand the rise of bulimia we must focus on the food system. More precisely, we must examine how the commercialisation of food preparation has led to a partial breakdown in meal structures and the rise of ‘everyday’ bingeing. The rise of extreme forms of disordered consumption associated with bulimia can be related to broader changes in the eating regime.     

The economic burden of kidney disorders in Korea

Aims: To estimate the economic burden of kidney disorders in Korea.

Materials and methods: The economic burden of kidney disorders was estimated using a prevalence-based approach. Related kidney diseases in patients with kidney disorders (RPWKD) were defined using codes from the tenth International Classification of Disease (E70–E90, F30–F48, F60–F69, F90–F99, K65–K67, N00–N08, N17–N19, and N30–N39). All diseases in patients with kidney disorders (APWKD) were defined as kidney disorders that involved all disease codes. Economic costs were divided into direct costs (medical costs and non-medical costs) and indirect costs (productivity loss because of morbidity and premature mortality).

Results: The prevalence of kidney disorders increased from 0.08% (2008) to 0.11% (2011). The total economic burden of RPWKD also substantially increased from $898.9 million (2008) to $1.43 billion (2011). This ～59.4% increase in the economic burden was equal to 0.12% of the Korean gross domestic product. The economic burden of APWKD also increased during the study period: $1.06 billion (2008), $1.23 billion (2009), $1.44 billion (2010), and $1.46 billion (2011).

Conclusions: The present study provides the first data regarding the economic burden of kidney disorders in Korea. The findings support the need for early intervention services and prevention programs to prevent, identify, and manage kidney disorders.