Tuberculosis, Brucellosis and Leucosis in Cattle: A Cost Description of Eradication Programmes in the Region of Lazio, Italy.

The eradication of tuberculosis, brucellosis and leucosis in cattle has not yet been achieved in the entire Italian territory. The region of Lazio, Central Italy, represents an interesting case study to evaluate the evolution of costs for these eradication programmes, as in some provinces the eradication has been officially achieved, in some others the prevalence has been close to zero for years, and in still others disease outbreaks have been continuously reported. The objectives of this study were i) to describe the costs for the eradication programmes for tuberculosis, brucellosis and leucosis in cattle carried out in Lazio between 2007 and 2011, ii) to calculate the ratio between the financial contribution of the European Union (EU) for the eradication programmes and the estimated total costs and iii) to estimate the potential savings that can be made when a province gains the certification of freedom from disease. For the i) and ii) objectives, data were collected from official sources and a costing procedure was applied from the perspective of the Regional Health Service. For the iii) objective, a Bayesian AR(1) regression was used to evaluate the average percentage reduction in costs for a province that gained the certification. The total cost for the eradication programmes adjusted for inflation to 1 January 2016 was estimated at 18 919 797 euro (5th and 95th percentiles of the distribution: 18 325 050-19 552 080 euro). When a province gained the certification of freedom from disease, costs decreased on average by (median of the posterior distribution) 47.5%, 54.5% and 54.9% for the eradication programmes of tuberculosis, brucellosis and leucosis, respectively. Information on possible savings from the reduction of control costs can help policy makers operating under budget constraints to justify the use of additional resources for the final phase of eradication.

Perceived fatigue after mental work: an experimental evaluation of a fatigue inventory.

The aim of this study was to investigate the perceived fatigue after mental work and to test the Swedish Occupational Fatigue Inventory (SOFI). Twenty male and 20 female participants worked with proof reading (2 x 90 min) and a vigilance task (2 x 60 min). After each task session, perceived fatigue was rated with the SOFI and Borg's CR10O-scale. In addition, physiological reactions were registered; blood pressure, heart rate, heart rate variability and muscle activity in corrugator supercilii, as well as measures of performance: reaction time, number of pages read and number of proof errors found, number of detected signals. As expected, the highest ratings were obtained on Lack of energy, Lack of motivation and Sleepiness, particularly after the vigilance task. High ratings after both work tasks were also found on the CR10-scale. Men and women did not differ significantly with respect to their ratings. No clear-cut physiological reactions were found to correlate with ratings of fatigue. The results indicate the validity of the mental dimension of the SOFI.

SPES: a psychological test system to diagnose environmental hazards. Swedish Performance Evaluation System.

The effects of unfavorable work environmental conditions can be studied using psychological performance measures and subjective ratings of mood and symptoms. In the present article the rationale for such investigations is discussed, and the computerized performance evaluation system developed at the Swedish National Institute of Occupational Health is presented. The background and the research experience leading to the system's development are described, and references to the numerous empirical studies demonstrating its applicability to different research objectives are given. Also included is information regarding the technical requirements for running the SPES tests.

Work motivation among high school students before and during the economic recession in the Swedish labour market.

In 1990, 2349 high school pupils from 21 high schools in the Stockholm, Uppsala and Södertälje regions answered a questionnaire concerning how important different characteristics of work were in their future job. The questionnaire also included an open question, "How would you describe an ideal job?" In 1993 the same questionnaire was answered by 1171 high school students. The two measurement occasions were separated by economic changes leading, from a condition of economic security and full employment, to a condition characterised by economic insecurity and high unemployment especially among young people. Results showed that the economic insecurity of 1993 lowered the students' ratings of the importance of all characteristics of work with the exception of the security of work. A strong gender factor influenced the ratings. Thus, the female students rated the importance of the characteristics of work higher than the male students did. The only exception concerned "good pay", which was rated higher by the male. In 1993 these effects were less pronounced, although still evident. The motivational structure seemed to be unaffected by the economic insecurity. The same four motivational factors, i.e. (1) the expressive work goals, (2) the working conditions, (3) the benefits of work and (4) the social aspects of work, appeared in the analyses of both measurement occasions.

The role of the psychologist in multidisciplinary treatments for chronic neck and shoulder pain: a controlled cost-effectiveness study.

This study was designed to determine a cost-effective use of psychologist resources in multimodal cognitive-behavioural treatments (MMCBT) for chronic neck/shoulder pain. A randomised controlled trial was conducted with 66 patients divided in two groups. The first group (A) was treated following the approach of MMCBT with the clinical psychologist only functioning as a "coach" to the other health professionals. In this group, the psychologist had on average 5 hours of input per patients. The second group (B) was treated with the same inpatient MMCBT but with the behavioural component administered by the clinical psychologist directly to the patients. In this second group the psychologist had on average 17 hours of input per patient in the entire intervention. The outcome variables included physical, emotional and social factors, and sick-leave. Both groups showed significant improvements over time. The improvements were evident only in sub-groups, specifically in women. The only significant difference between the groups was in "perceived helplessness" favouring the "psychologist contact" setting. It is concluded that in terms of input of clinical psychology, the treatment setting with the "coaching" technique proved to be the most cost-effective use of the psychologist in the two treatment settings investigated.

Coping with long-term musculoskeletal pain and its consequences: is gender a factor?

We did a descriptive study of 121 patients (71 women and 50 men) to explore the role of gender in coping with long-term intractable pain of the neck, shoulder and back and to determine the consequences of pain. Questionnaires used to assess the dependent variables were the Coping Strategy Questionnaire (CSQ) and the Multidimensional Pain Inventory (MPI). Distinctions were found between men and women. In particular, the coping strategies used by women were those which in previous research had been found to be associated with dysfunction and poor outcome in terms of rehabilitation. Moreover, considering the consequences of pain on daily living, a more complex pattern of related factors was found in women rather than men. Given the high proportion of working women in Sweden with long-term musculoskeletal pain and considering recent observations in controlled studies showing that the benefits of cognitive behaviourally based treatments are confined to women, our findings suggest the need to tailor rehabilitative strategies differently for men and women and point to a research agenda which pays more attention to the distinctive challenges of women in the workplace when they are affected by chronic ailments.

A three-year follow-up of 195 reported occupational over-exertion injuries.

Three years after reporting occupational over-exertion injuries, 181 persons took part in a follow-up study by questionnaire. The objective was to study these persons with respect to their current status of health, well-being and functional capacity and when possible compare collected data to reference data from the "normal population". The studied group reported more physical and psychological symptoms than the reference groups. More than 50% reported difficulties in activities of daily living. Long sick-leaves in the year following the reported injury were associated with remaining pain and low rate of employment. Three years after the injury, 109 persons were in employment. Almost one third of these had changed occupations and now had more varied tasks than at the time of the report. Those whose work loads had been reduced after the injury, did not report less musculoskeletal disorders than others. However, access to social support was positively related with health and psychological well-being.

The use of behavioral and psychophysiological methods in the monitoring of health at the worksite.

The paper discusses the possibility of identifying and preventing certain occupational health hazards by assessing and evaluating a number of behavioral and psychophysiological responses induced by exposure to unfavorable environmental conditions at work. The main aspects of the research strategies and measurement methods used in this field of research are described to provide a background for the establishment of a policy of health promotion based on the monitoring of early behavioral and psychophysiological indices of functional CNS changes at the worksite.

Human behavioral toxicology. Central nervous effects of low-dose exposure to neurotoxic substances in the work environment.

The central nervous effects of low-dose exposure to the neurotoxic substances found in the work environment can manifest themselves both as adverse subjective reactions and as performance impairments and physiological changes. The acute manifestations of these effects can be studied under highly controlled conditions in laboratory experiments on volunteers or in quasi-experimental field studies on occupationally exposed workers. The effects of long-term occupational exposure are commonly studied with the use of epidemiologic techniques in cross-sectional investigations or cohort studies. In addition studies using data from clinical cases have been conducted to describe the chronic effects of exposure. Although these types of investigations can provide valuable information on the health hazards due to the neurotoxicity of different substances, their accomplishment encounters theoretical and practical problems, some of which are described and discussed in the present paper.

Behavioral and psychophysiological effects of the physical work environment. Research strategies and measurement methods.

An international course on the behavioral and psychophysiological effects of the physical work environment was held in Stockholm, Sweden, in April 1988 by the Nordic Institute of Advanced Training in Occupational Health and the Swedish National Institute of Occupational Health. It dealt primarily with the behavioral and psychophysiological responses to aspects of the physical work environment and was devoted to neural and behavioral functions. The increasing interest in these functions is mainly motivated by the involvement of the central nervous system in the adverse effects induced by unfavorable environmental conditions of the workplace and by the need for more sensitive indicators than those based solely on recognized occupational disease and pathology. By describing the main aspects of the research strategies and the measurement methods used in this field of research, this paper provides a background for the assessment and evaluation of the early behavioral and psychophysiological indices of potential occupational hazards.

Physiological and psychological effects of exposure to extremely low-frequency electric and magnetic fields on humans.

Research into the hypothetical adverse effects on health that might result from living or working in the proximity of high-voltage power lines has been intense over the last decade. The present paper provides a brief review of the human studies concerned with the physiological and psychological effects of exposure to extremely low-frequency electric and magnetic fields. It was concluded that, on the basis of available experience, electric and magnetic fields associated with transmission lines do not cause physiological or psychological effects to be considered as health hazards.

Perception of effort in manual materials handling.

Measurement of subjective work load has emerged as a central topic of interest in the study of physical work and effort. From the practical point of view, subjective estimates of physical effort can contribute greatly to the assessment of work loads in physical activities and to the design of manual handling tasks. The rationale of this approach is that subjective estimates reflect the individual perception of the amount of physical and motivational resources that the subjects invest to meet the demand imposed by the physical task. The present paper provides an illustration of some of the techniques used in measuring the perception of physical effort and reviews and discusses the main results obtained with these techniques in the assessment of manual materials handling.

Critical issues in the study of the acute effects of solvent exposure.

The acute effects of exposure to solvent vapour can be studied under highly controlled conditions in laboratory experiments on volunteers or in quasi-experimental field studies on occupationally exposed workers. Although these two types of investigations can provide valuable information on the neurotoxicity of solvents, their accomplishment encounters theoretical and practical difficulties. In the present paper the independent, the extraneous and the dependent variables of these studies are described, and both the research strategy and the methodology of these types of investigations are presented and discussed.

Acute effects of ELF electromagnetic fields: a field study of linesmen working with 400 kV power lines.

The aim of the study was to investigate the possible acute effects of exposure to electric and magnetic fields. Twenty six experienced linesmen, aged 25 to 52, were studied during two working days while performing a simulated routine inspection of insulators on steel poles of a 400 kV power line. During one of the working days the inspection was performed on a power line in operation and on the other day the same procedure was performed on an identical power line, which was not in operation. The two days were found to be comparable with regard to the physical workload which, on the basis of heart rate measurements, was estimated to be high. Exposure to the electric and magnetic fields was measured using a device designed for on-worker sampling on each linesman. The mean exposure for the working day was estimated to be 2.8 kV/m (SD = 0.35) and 23.3 microT (SD = 4.2). The possible effects of exposure were studied using a battery of four automated performance tests, EEG, a mood scale, and a questionnaire to assess subjective symptoms. All workers were examined immediately before and after each workday. Furthermore, blood samples were collected for each subject on three different occasions during each workday. The battery of behavioural tests comprised a test of simple reaction time, a vigilance test, a test of short term memory (digit span), and a perceptual test (symbol digit). The four EEG recordings for each worker were judged blindly and sorted with regard to amount and stability of alpha activity. The blood samples were used for an analysis of possible changes during the workday with regard to the following hormones: thyroid stimulated hormone, luteinising hormone, follicle stimulating hormone, prolactin, cortisol, testosterone, and neopterin. Detailed analyses of the results using both parametric and nonparametric tests showed no statistically significant difference between the two conditions which could be attributed to exposure to electric and magnetic fields.

An experimental evaluation of psychophysical criteria for repetitive lifting work.

Two experiments were performed to test the reliability and validity of psychophysically determined maximum acceptable workloads for setting lifting standards. The perceived workload in a repetitive diagonal lifting task was found to be a positively accelerated function of the weight lifted and of the work pace respectively. A twofold increase in objective workload resulted in a four- to fivefold increase in perceived workload. This relation was independent of previous occupational experience of lifting work. The psychophysically assessed maximum acceptable workloads for this type of lifting task appeared to be satisfactorily reproducible when subjects had to adjust work pace or when they were left free to adjust both the weight and the work pace. However, the results raised several questions concerning the applicability of the psychophysical assessment of maximum acceptable lifting work. Slight changes in the instructions given to the subjects had a definite effect on the selection of workloads. Furthermore, the workloads selected by subjects with previous occupational experience of lifting work - i e, warehouse workers - were systematically lower than those selected by subjects without such previous experience - i e, office employees. At the same time, the warehouse workers rated perceived exertion higher than the office employees, indicating that previous occupational experience of lifting work enhanced the subjective assessment of physical effort. There were no consistent relations between the workloads found acceptable by the subjects and their physical characteristics and performance capacity.

Experimental exposure to toluene in combination with ethanol intake. Psychophysiological functions.

Effects of experimental exposure to toluene (3.2 mmol/m3, ie, 300 mg/m3) for 4.5 h and ethanol ingestion (15 mmol/kg) on the results of four performance tests, symptoms, mood, and physiological indices of wakefulness were studied in 12 male volunteers. Toluene exposure produced symptoms like headache and local irritation, as well as a weak depression of heart rate during rest, but did not reduce performance capability. Ethanol ingestion impaired performance on two of the tests and also increased heart rate. Mood was likewise altered by ethanol, but no increase in subjective symptoms due to ethanol ingestion could be demonstrated. Physiological indices of wakefulness were not affected by toluene exposure or by ethanol intake. No interaction effects were found.

Coexposure to toluene and p-xylene in man: central nervous functions.

Sixteen men were studied in an exposure chamber to assess the effect of four hours' exposure to toluene (3.25 mmol/m3), xylene (2.84 mmol/m3), a mixture of toluene and xylene (2.20 + 0.94 mmol/m3), and a control condition. With the aid of microcomputers, subjects performed tests of simple reaction time, short term memory, and choice reaction time immediately after entering the chamber, after two, and after four hours' exposure. The results indicate that the performance on the tests was unaffected by exposure. In the light of this result the risk of an acute effect on central nervous functions after exposure for four hours at concentrations that do not exceed the Swedish threshold limit values was considered to be minimal.