bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peroneus longus stretch reflex amplitude increases after ankle brace application
Authors: Cordova M L , Ingersoll C D 
Published: June 2003

Background:The use of external ankle support is widespread throughout sports medicine. However, the application of ankle bracing to a healthy ankle over a long period has been scrutinised because of possible neuromuscular adaptations resulting in diminished dynamic support offered by the peroneus longus.Objective:To investigate the immediate and chronic effects of ankle brace application on the amplitude of peroneus longus stretch reflex.Methods:Twenty physically active college students (mean (SD) age 23.6 (1.7) years, height 168.7 (8.4) cm, and mass 69.9 (12.0) kg) who had been free from lower extremity pathology for the 12 months preceding the study served as subjects. None had been involved in a strength training or conditioning programme in the six months preceding the study. A 3 × 3 × 2 (test condition × treatment condition × time) design with repeated measures on the first and third factor was used. The peroneus longus stretch reflex (% of maximum amplitude) during sudden foot inversion was evaluated under three ankle brace conditions (control, lace up, and semi-rigid) before and after eight weeks of ankle brace use.Results:A 3 × 3 × 2 repeated measures analysis of variance showed that peroneus longus stretch reflex amplitude increased immediately after application of a lace up brace (67.1 (4.4)) compared with the semi-rigid (57.9 (4.3)) and control (59.0 (5.2)) conditions (p<0.05). Peroneus longus stretch reflex also increased after eight weeks of use of the semi-rigid brace compared with the lace up and control conditions (p<0.05).Conclusions:Initial application of a lace up style ankle brace and chronic use of a semi-rigid brace facilitates the amplitude of the peroneus longus stretch reflex. It appears that initial and long term ankle brace use does not diminish the magnitude of this stretch reflex in the healthy ankle.
Assessment of fatigue among working people: a comparison of six questionnaires
Authors: De Vries J , Michielsen H J , Van Heck G L 
Published: June 2003

Aims:To compare the psychometric qualities of six fatigue questionnaires in a sample of working persons.Methods:Internal consistency and test-retest reliability, content validity, convergent validity, and the dimensionality of the fatigue instruments were explored.Results:All scales had a satisfactory internal consistency. Furthermore, based on factor analyses and Mokken scale analyses, all scales were unidimensional and appeared to measure an identical construct. The Fatigue Assessment Scale (FAS) had the highest factor loading on the one factor solution obtained in a factor analysis of the total scores of all scales.Conclusions:All the questionnaires were unidimensional and had good reliability and validity. The FAS was the most promising fatigue measure.
Quality of rehabilitation among workers with adjustment disorders according to practice guidelines; a retrospective cohort study
Authors: Nieuwenhuijsen K , Verbeek J H A M , Siemerink J C M J , Tummers-Nijsen D 
Published: June 2003

Aims:To assess the quality of occupational rehabilitation for patients with adjustment disorders and to determine whether high quality of care is related to a shorter period of sickness absence.Methods:A retrospective cohort study was conducted by means of an audit of 100 files of patients with adjustment disorders who visited their occupational physicians. Quality of rehabilitation was assessed by means of 10 performance indicators, derived from the guidelines for the treatment of employees with mental health disorders. Performance was dichotomised into optimal and deviant care according to explicit criteria. The performance rates were related to time until work resumption during a one year follow up period. Kaplan-Meier survival analyses and Cox proportional hazards analysis were used to study this relation.Results:Four of 10 performance rates were below 50%: continuity of care (34%), interventions aimed at providers of care in the curative sector (39%), assessment of impediments in the return to work process (41%), and assessment of symptoms (45%). The highest performance rate concerned assessment of work related causes (94%). Overall optimal care was found in 10% of the cases. Median time to complete recovery was 195 days (IQR 97 to 365), and 73% of all patients recovered completely after one year. Optimal continuity of care was significantly related to a shorter time to both partial and complete work resumption (hazard ratio (HR) 0.3; CI 0.2 to 0.6) independently of other performance indicators. Performance regarding interventions aimed at the organisation was also related to a shorter time until first return to work (HR 0.5; CI 0.3 to 0.9).Conclusions:This study shows that the rehabilitation process of employees with adjustment disorders leaves significant room for improvement, especially with regard to continuity of care. Quality of care was partly related to a better outcome. More rigorous study designs are needed to corroborate these findings.
Acute and chronic job stressors among ambulance personnel: predictors of health symptoms
Authors: van der Ploeg E , Kleber R J 
Published: June 2003

Objectives:To predict symptomatology (post-traumatic distress, fatigue, and burnout) due to acute and chronic work related stressors among ambulance personnel.Methods:Data were gathered from 123 ambulance workers in The Netherlands in a longitudinal design. At two measurements they completed standardised questionnaires to assess health symptoms, such as the Impact of Event Scale, the Maslach Burnout Inventory, and the Checklist Individual Strength. Acute stressors were assessed with specific questions, and chronic work related stressors were measured with the Questionnaire on the Experience and Assessment of Work.Results:Most of the ambulance workers had been confronted with acute stressors in their work. They also reported more chronic work related stressors than a reference group. Of the participants, more than a tenth suffered from a clinical level of post-traumatic distress, a tenth reported a fatigue level that put them at high risk for sick leave and work disability and nearly a tenth of the personnel suffered from burnout. Best predictors of symptomatology at time 2 were lack of social support at work and poor communication, such as not being informed about important decisions within the organisation.Conclusions:Ambulance personnel are at risk to develop health symptoms due to work related stressors. Although, acute stressors are related to health symptoms, such as fatigue, burnout, and post-traumatic symptoms, it was not found to predict health symptoms in the long term. Main risk factors have to do with social aspects of the work environment, in particular lack of support from the supervisor as well as colleagues and poor communication. When implementing workplace interventions these social aspects need to be taken into account.
Work schedules and fatigue: a prospective cohort study
Authors: Jansen N W H , van Amelsvoort L G P M , Kristensen T S , van den Brandt P A , Kant IJ 
Published: June 2003

Aims:(1) To describe the prevalence of fatigue among employees in different work schedules (day work, three-shift, five-shift, and irregular shift work); (2) to investigate whether different work schedules are related to increasing fatigue over time, while taking into account job title and job characteristics; and (3) to study fatigue among shift workers changing to day work.Methods:Data from nine consecutive four-monthly self administered questionnaires from the Maastricht Cohort Study on Fatigue at work (n = 12 095) were used with 32 months of follow up. Day and shift workers were matched on job title.Results:The prevalence of fatigue was 18.1% in day workers, 28.6% in three-shift, 23.7% in five-shift, and 19.1% in irregular shift workers. For three-shift and five-shift workers substantial higher fatigue levels were observed compared to day workers at baseline measurement. In the course of fatigue over the 32 months of follow up there were only small and insignificant differences between employees in different work schedules. However, among employees fatigued at baseline, fatigue levels decreased faster over time among five-shift workers compared to fatigued day workers. Shift workers changing to day work reported substantially higher fatigue levels prior to change, compared to those remaining in shift work.Conclusions:Substantial differences in fatigue existed between day and shift workers. However, as no considerable differences in the course of fatigue were found, these differences have probably developed within a limited time span after starting in a shift work job. Further, evidence was found that fatigue could be an important reason for quitting shift work and moving to day work. Finally, in the relation between work schedules and fatigue, perceived job characteristics might play an important role.
Physiological differences between burnout patients and healthy controls: blood pressure, heart rate, and cortisol responses
Authors: De Vente W , Olff M , Van Amsterdam J G C , Kamphuis J H , Emmelkamp P M G 
Published: June 2003

Objectives:To investigate differences between burnout patients and healthy controls regarding basal physiological values and physiological stress responses. Measures of the sympathetic-adrenergic-medullary (SAM) axis and the hypothalamic-pituitary-adrenal (HPA) axis were examined.Methods:SAM axis and HPA axis activity was compared between 22 burnout patients and 23 healthy controls. SAM axis activity was measured by means of heart rate (HR) and blood pressure (BP). HPA axis activity was investigated by means of salivary cortisol levels. Resting levels of HR, BP, and cortisol were determined as well as reactivity and recovery of these measures during a laboratory session involving mental arithmetic and speech tasks. In addition, morning levels of cortisol were determined.Results:Burnout patients showed higher resting HR than healthy controls. BP resting values did not differ between burnout patients and healthy controls, nor did cardiovascular reactivity and recovery measurements during the laboratory session. Basal cortisol levels and cortisol reactivity and recovery measures were similar for burnout patients and healthy controls. However, burnout patients showed elevated cortisol levels during the first hour after awakening in comparison to healthy controls.Conclusions:The findings provided limited proof that SAM axis and HPA axis are disturbed among burnout patients. Elevated HR and elevated early morning cortisol levels may be indicative of sustained activation.
Need for recovery from work related fatigue and its role in the development and prediction of subjective health complaints
Authors: Sluiter J K , de Croon E M , Meijman T F , Frings-Dresen M H W 
Published: June 2003

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.
The Depression Anxiety Stress Scales (DASS): detecting anxiety disorder and depression in employees absent from work because of mental health problems
Authors: Nieuwenhuijsen K , de Boer A G E M , Verbeek J H A M , Blonk R W B , van Dijk F J H 
Published: June 2003

Aims:To (1) evaluate the psychometric properties and (2) examine the ability to detect cases with anxiety disorder and depression in a population of employees absent from work because of mental health problems.Methods:Internal consistency, construct validity, and criterion validity of the Depression Anxiety Stress Scales (DASS) were assessed. Furthermore, the ability to identify anxiety disorders or depression was evaluated by calculating posterior probabilities of these disorders following positive and negative test results for different cut off scores of the DASS-Depression and DASS-Anxiety subscales.Results:Internal consistency of the DASS subscales was high, with Cronbach’s alphas of 0.94, 0.88, and 0.93 for depression, anxiety, and stress respectively. Factor analysis revealed a three factor solution, which corresponded well with the three subscales of the DASS. Construct validity was further supported by moderately high correlations of the DASS with indices of convergent validity (0.65 and 0.75), and lower correlations of the DASS with indices of divergent validity (range −0.22 to 0.07). Support for criterion validity was provided by a statistically significant difference in DASS scores between two diagnostic groups. A cut off score of 5 for anxiety and 12 for depression is recommended. The DASS showed probabilities of anxiety and depression after a negative test result of 0.05 and 0.06 respectively. Probabilities of 0.29 for anxiety disorder and 0.33 for depression after a positive test result reflect relatively low specificity of the DASS.Conclusion:The psychometric properties of the DASS are suitable for use in an occupational health care setting. The DASS can be helpful in ruling out anxiety disorder and depression in employees with mental health problems.
Need for recovery after work and the subsequent risk of cardiovascular disease in a working population
Authors: van Amelsvoort L G P M , Kant IJ , Bültmann U , Swaen G M H 
Published: June 2003

Background:A high need for recovery after work can be regarded as a short term adverse effect of working day stressors and the person’s inability to cope and recover. Consequently, it might be an intermediate factor between job stressors and cardiovascular disease (CVD).Aim:To investigate, in a longitudinal study, the relation between need for recovery and subsequent CVD.Methods:Data from the Maastricht Cohort Study of 12 140 workers were used, with 42 incident self reported CVD cases during 32 months of follow up. Cox proportional hazards analysis was used to calculate age, gender, smoking status, and educational level adjusted relative risks.Results:The adjusted relative CVD risk for the second compared to the first tertile of the need for recovery score was 1.22 (95% CI: 0.49 to 3.04), and for the third compared to the first tertile was 3.16 (95% CI: 1.34 to 7.48). When need for recovery was entered as continuous score, an adjusted relative risk per SD increase of 1.54 (95% CI: 1.15 to 2.03) was found. Additional adjustment for several work related factors as job demands, did not notably change the observed relation between need for recovery and CVD. Moreover, the increased risk for subjects reporting high job demands (1.38 per SD increase; 95% CI: 1.02 to 3.92) decreased substantially after adjustment for need for recovery.Conclusion:The results show that need for recovery is a strong predictor of subsequent cardiovascular disease and might be an intermediate factor between job stressors and cardiovascular disease.
Fatigue as a risk factor for being injured in an occupational accident: results from the Maastricht Cohort Study
Authors: Swaen G M H , van Amelsvoort L G P M , Bültmann U , Kant IJ 
Published: June 2003

Aims:To determine whether fatigue and need for recovery are risk factors for being injured in an occupational accident.Methods:These associations were investigated within the Maastricht Cohort Study of “Fatigue at Work”, a prospective cohort study of employees from a wide range of companies and organisations. For 7051 employees information was available on fatigue as measured with the Checklist Individual Strength (CIS), need for recovery as measured with the VBBA, and possible confounding factors such as age, smoking, alcohol consumption, educational level, shift work, and work environment. Information on the risk factors was collected in May 1999 and January 2000, before the occurrence of the occupational accidents. The incidence of being injured in an occupational accident was inventoried over the year 2000. A total of 108 employees reported having been injured in an occupational accident in 2000.Results:For the highest CIS fatigue score tertile a for age, gender, educational level, smoking, shift work, and work environment, adjusted relative risk for being injured in an occupational accident of 1.29 (95% CI: 1.03 to 2.78) was found compared to the lowest tertile, and for the highest tertile of need for recovery a relative risk of 2.28 (95% CI: 1.41 to 3.66) was found.Conclusions:Fatigue and need for recovery were found to be independent risk factors for being injured in an occupational accident. This means that in the push back of occupational accidents, fatigue, and even more importantly need for recovery, need special attention.
Fatigue in employees with diabetes: its relation with work characteristics and diabetes related burden
Authors: Weijman I , Ros W J G , Rutten G E H M , Schaufeli W B , Schabracq M J , Winnubst J A M 
Published: June 2003

Aims:To examine the relations between work characteristics as defined by the Job Demand-Control-Support model (JDCS) (that is, job demands, decision latitude, and social support), diabetes related burden (symptoms, seriousness of disease, self care activities, and disease duration), and fatigue in employees with diabetes mellitus.Methods:Employees (n = 292) aged 30–60 years, with insulin treated diabetes, filled in self administered questionnaires that assess the above mentioned components of the JDCS model and diabetes related burdens.Results:Both work and diabetes related factors are related to fatigue in employees with diabetes. Regression analyses revealed that work characteristics explain 19.1% of the variance in fatigue; lack of support, and the interaction of job demands and job control contribute significantly. Diabetes related factors explain another 29.0% of the variance, with the focus on diabetes related symptoms and the burden of adjusting insulin dosage to circumstances. Fatigue is more severe in case of lack of social support at work, high job demands in combination with a lack of decision latitude, more burden of adjusting insulin dosage to circumstances, and more diabetic symptoms. Furthermore, regression analysis revealed that diabetic symptoms and the burden of adjusting the insulin dosage to circumstances are especially relevant in combination with high job demands.Conclusions:Both diabetes and work should be taken into consideration—by (occupational) physicians as well as supervisors—in the communication with people with diabetes.
Associations between fatigue attributions and fatigue, health, and psychosocial work characteristics: a study among employees visiting a physician with fatigue
Authors: Andrea H , Kant IJ , Beurskens A J H M , Metsemakers J F M , van Schayck C P 
Published: June 2003

Aims:To study associations between characteristics of employees active at work and making a fatigue related visit to the general practitioner (GP) or occupational physician (OP) in terms of fatigue, physical health problems, mental health problems, psychosocial work characteristics, and attributions of their fatigue complaints.Methods:Self report questionnaires from the Maastricht Cohort Study Fatigue at Work were used to measure fatigue (Checklist Individual Strength, Maslach Burnout Inventory–General Survey), physical health problems (chronic illness), mental health problems (Hospital Anxiety and Depression Scale), psychosocial work characteristics (Job Content Questionnaire), and fatigue attributions (somatic, psychological, none) in employees who made a fatigue related visit to the GP or OP over a six month period.Results:In employees visiting only the GP, fatigue was an important reason to visit in one of seven (13.9%) employees. These fatigue related visits were in particular associated with high fatigue levels and mental health problems. A psychological fatigue attribution was reported by 41.8%, a somatic fatigue attribution by 44.0%. On a multivariate level, mental health problems showed the strongest association with psychological fatigue attributions, over and beyond fatigue itself. No associations were found between fatigue attributions and psychosocial work characteristics. Attributional patterns appeared to be different between visitors of the GP and the OP.Conclusions:Fatigue is a common reason among employees to consult a GP. Asking employees for their own fatigue attributions in terms of somatic or psychological causes may be useful for the GP—and possibly also the OP—to gather information about underlying health problems in employees active at work and making a fatigue related visit.
Occupation and gastric cancer
Authors: Raj A , Mayberry J F , Podas T 
Published: June 2003

Abstract
Gastric cancer is a cause of significant morbidity and mortality. There are several risk factors, with occupation emerging as one of these. There is considerable evidence that occupations in coal and tin mining, metal processing, particularly steel and iron, and rubber manufacturing industries lead to an increased risk of gastric cancer. Other “dusty” occupations—for example, wood processing, or work in high temperature environments have also been implicated but the evidence is not strong. The mechanism of pathogenesis of gastric cancer is unclear and the identification of causative agents can be difficult. Dust is thought to be a contributor to the pathological process, but well known carcinogens such as N-nitroso compounds have been detected in some environments. Further research on responsible agents is necessary and screening for detection of precursor gastric cancer lesions at the workplace merits consideration.
Management of asthma in adults: current therapy and future directions
Authors: Green R H , Brightling C E , Pavord I D , Wardlaw A J 
Published: June 2003

Abstract
Asthma is increasing in prevalence worldwide and results in significant use of healthcare resources. Although most patients with asthma can be adequately treated with inhaled corticosteroids, an important number of patients require additional therapy and an increasing number of options are available. A further minority of patients develop severe persistent asthma which remains difficult to manage despite current pharmacological therapies. This review discusses the various treatment options currently available for each stage of asthma severity, highlights some of the limitations of current management, and outlines directions which may improve the management of asthma in the future.