COVID-19 vaccination - Does it affect sick leave in military personnel?

OBJECTIVE

Sick leave is a major negative economic effect of the COVID-19 pandemic. In April 2021, the Integrated Benefits Institute reported that employers spent a total of US $50.5 billion for workers absent due to the COVID-19 pandemic. While vaccination programs lowered the number of severe illness and hospitalizations worldwide, the number of side effects following vaccination against COVID-19 were high. The present study aimed to evaluate the effect of vaccination on the probability of taking sick leave in the week following vaccination.

SUBJECTS AND METHODS

The study population was comprised of all personnel serving in the Israel Defense Forces (IDF) between October 7, 2020, and October 3, 2021, (a total of 52 weeks) who were vaccinated with at least one dose of the BNT162b2 vaccine. Data on Israel Defense Forces (IDF) personnel sick leaves were retrieved and the probability of a "post-vaccination week sick leave" and a "regular (not post-vaccination week) sick leave" were analyzed. An additional analysis was performed to determine whether winter-related diseases or the sex of the personnel affected the probability of taking sick leave.

RESULTS

The probability of taking sick leave in a post-vaccination week was significantly higher than the probability of taking sick leave in a regular week (8.45% vs. 4.3%, respectively, p < 0.01). The increased probability remained unchanged after analysis of sex-related and winter disease-related variables.

CONCLUSIONS

Given the major effect of vaccination against COVID-19 by BNT162b2 vaccine on the probability of taking sick leave, when medically feasible, the timing of the vaccination should be considered by medical, military, and industrial authorities with the intent to minimize the effect on overall national economy and safety.

Implicit bias instruction across disciplines related to the social determinants of health: a scoping review

One criticism of published curricula addressing implicit bias is that few achieve skill development in implicit bias recognition and management (IBRM). To inform the development of skills-based curricula addressing IBRM, we conducted a scoping review of the literature inquiring, "What interventions exist focused on IBRM in professions related to social determinants of health: education, law, social work, and the health professions inclusive of nursing, allied health professions, and medicine?"Authors searched eight databases for articles published from 2000 to 2020. Included studies: (1) described interventions related to implicit bias; and (2) addressed knowledge, attitude and/or skills as outcomes. Excluded were interventions solely focused on reducing/neutralizing implicit bias. Article review for inclusion and data charting occurred independently and in duplicate. Investigators compared characteristics across studies; data charting focused on educational and assessment strategies. Fifty-one full-text articles for data charting and synthesis, with more than 6568 learners, were selected. Educational strategies included provocative/engagement triggers, the Implicit Association Test, reflection and discussion, and various active learning strategies. Most assessments were self-report, with fewer objective measures. Eighteen funded studies utilized federal, foundation, institutional, and private sources. This review adds to the literature by providing tangible examples of curricula to complement existing frameworks, and identifying opportunities for further research in innovative skills-based instruction, learner assessment, and development and validation of outcome metrics. Continued research addressing IBRM would enable learners to develop and practice skills to recognize and manage their implicit biases during clinical encounters, thereby advancing the goal of improved, equitable patient outcomes.

It Can Be Done! A Skills-Based Elective in Implicit Bias Recognition and Management for Preclinical Medical Students

PURPOSE

Students perceive bias in learning environments. Curricula targeting implicit bias recognition and management increase student awareness and achieve strategy identification, but fall short of actual skill development to address bias. In light of this gap, the authors developed and evaluated a skills-based elective to recognize and manage implicit bias in the learning environment.

METHOD

Nine 1.5-hour sessions were delivered to 15 first-year medical students from 2017 to 2019. An evidence-based conceptual framework and transformative learning theory informed the instructional design; it incorporated active learning exercises. Skills assessment occurred through direct observation of student performances in role-play exercises. Using thematic analysis, the authors conducted a program evaluation based on focus groups with students and data from notes taken by the investigative team.

RESULTS

Students engaged with all aspects of instruction, including role-plays. Authors identified 3 themes from the program evaluation: (1) Student engagement can be enhanced, (2) Instruction is empowering, and (3) It (addressing bias in one's own and witnessed encounters) can be done! Analysis additionally highlighted opportunities for improvement and lessons learned.

CONCLUSIONS

This innovative course achieved skill development and practice for medical students in implicit bias recognition and management as it pertains to 3 facets of clinical care present at every stage of a health professional's career. These include interpersonal encounters, advocating for patients when bias is perceived in witnessed encounters with peers and supervisors, and addressing comments made by others within the learning environment. Outcomes could inform novel, skills-based curricula across the spectrum of health professions training and practice.

Molecular Structure of the Bony Tissue after Experimental Trauma to the Mandibular Region followed by Laser Therapy

OBJECTIVE

We investigated the therapeutic efficiency of laser irradiation and Bio-Oss, both and separately, on the post-traumatic regeneration of bone tissue in rats using infrared spectroscopy as an informative and accurate measuring method.

BACKGROUND DATA

The therapeutic effect of low-power laser irradiation on bone tissue regeneration processes in animal models has been studied using morphogenic, biochemical, roentgenographic and electron microscopic measurements. Natural bone minerals, such as Bio-Oss collagen, were recommended for the reconstruction of bone defects in the alveolar process.

MATERIALS AND METHODS

29 male Wistar rats, divided into four random groups in a blinded manner were operated on the right alveolar process. A bone defect was made by penetrating the right alveolar process of the mandible bone using a 3-mm drill. The rats were divided into four groups as follows: Group I, left side served as intact bone and right injured side as the control; Group II, right injured side was treated by organic bovine bone (Bio-Oss); Group III, right side bone defect was treated by HeNe laser (632.8 nm, 35 mW) applied transcutaneously for 20 min to the injured area daily for the following 14 consecutive days; and Group IV, Bio-Oss was placed loosely in the right side defect followed by laser treatment. After 2 weeks, the intact bone and bone replicas of the trauma area were removed and analyzed by infra-red spectroscopy technique. The composition and the structure of the bone tissue mineral substances were determined and compared among the four groups. For quantitative analysis of the regenerative bone process, the Mineralization index was used. An increase in this index indicates regenerative bone processes.

RESULTS

The normal state analysis of the IR spectra of the normal alveolar bone tissue within the intervals of 400 to 4000 cm(-1) revealed characteristic absorption bands for the inorganic bone component in spectrum regions 450-1480 cm(-1), and the organic component at 1540-3340 cm(-1). In the case of trauma, the intensity of absorption of the inorganic component was decreased by 54%, and the absorption band became narrow, which can be interpreted as quantitative changes of the bone tissue mineral content. The wavelength characteristics of the inorganic component remained unchanged; that is, the induced trauma under these experimental conditions did not provoke alterations in the structure of the phosphate framework. The organic component showed decreased absorption by 10-15%, compared to the normal bone, and slight displacement of the wavelength, which can be interpreted as changes occurring in the quality of the organic content of the bone tissue. In the Bio-Oss-treated group, the intensity of absorption of the inorganic component increased by 43%, compared to the control injured area; however, there was a decrease of 22.6% in the normal bone. The wavelength characteristics of the inorganic component remained unchanged. The organic component showed similar absorption results in the injured non-treated group and absorption was 10-15% less than in the normal bone. Mineralization Index in the Bio-Oss-treated group was 0.93, compared to 0.63 in the control group and 2.04 in the normal bone. In the laser-treated group, the intensity of absorption of the inorganic component increased by 62, compared to the control injured area, and decreased only 11.4% in the normal bone. The wavelength characteristics of the organic component remained unchanged; that is, the organic component was similar to that of normal bone. Mineralization Index in the laser-treated group increased significantly to 1.86, compared to 0.63 in the control group and 2.04 in the normal bone. In the combined laser and Bio-Oss-treated groups, the intensity of absorption of the inorganic component and organic component was similar to that of normal bone. Mineralization Index in this group increased significantly to 1.98, compared to 0.63 in the control group and 2.04 in the normal bone.

CONCLUSION

The results suggest that low-power laser irradiatults suggest that low-power laser irradiation alone and in combination with Bio-Oss enhances bone healing and increases bone repair.

Neuroactive steroids protect against pilocarpine- and kainic acid-induced limbic seizures and status epilepticus in mice

Several structurally related metabolites of progesterone (3 alpha-hydroxy pregnane-20-ones) and deoxycorticosterone (3 alpha-hydroxy pregnane-21-diol-20-ones) and their 3 beta-epimers were evaluated for protective activity against pilocarpine-, kainic acid- and N-methyl-D-aspartate (NMDA)-induced seizures in mice. Steroids with the 3-hydroxy group in the alpha-position and 5-H in the alpha- or beta-configurations were highly effective in protecting against pilocarpine (416 mg/kg, s.c.)-induced limbic motor seizures and status epilepticus (ED50 values, 7.0-18.7 mg/kg, i.p.). The corresponding epimers with the 3-hydroxy group in the beta-position were also effective but less potent (ED50 values, 33.8-63.5, i.p.). Although the neuroactive steroids were considerably less potent than the benzodiazepine clonazepam in protecting against pilocarpine seizures, steroids with the 5 alpha,3 alpha-configuration had comparable or higher protective index values (TD50 for motor impairment divided by ED50 for seizure protection) than clonazepam, indicating that some neuroactive steroids may have lower relative toxicity. Steroids with the 5 alpha,3 alpha- or 5 beta,3 alpha-configurations also produced a dose-dependent delay in the onset of limbic seizures induced by kainic acid (32 mg/kg, s.c.), but did not completely protect against the seizures. However, when a second dose of the steroid was administered 1 hr after the first dose, complete protection from the kainic acid-induced limbic seizures and status epilepticus was obtained. The steroids also caused a dose-dependent delay in NMDA (257 mg/kg, s.c.)-induced lethality, but did not completely protect against NMDA seizures or lethality. We conclude that neuroactive steroids are highly effective in protecting against pilocarpine- and kainic acid-induced seizures and status epilepticus in mice, and may be of utility in the treatment of some forms of status epilepticus in humans.

Norepinephrine stimulation of pentose cycle in rat brain prisms

Using the C1/C6 14CO2 ratio as a relative measure of pentose shunt metabolism, rat brain prisms were incubated with (1-14C) or (6-14C) glucose and respired 14CO2 collected. Shunt metabolism was stimulated with 10-4M but not 10-5M norepinephrine. MAO inhibitors and reserpine blocked norepinephrine stimulation but uptake inhibition did not. These data demonstrate that, under the tested conditions, MAO mediated norepinephrine metabolism does stimulate shunt activity but not at physiological concentrations.

Hemispheric differences in simple reaction time to auditory stimuli of different frequencies

To determine whether reaction time varies as a function of tone frequency and/or ear stimulated 27 adult subjects were presented with two two-tone series (1,000 Hz vs 2,500 Hz and 1,500 Hz vs 4,000 Hz) in a simple reaction-time paradigm. The analyses clearly indicated that the higher tone in each series and stimulation to the right ear resulted in significantly shorter reaction times. These results were interpreted as indicating that cerebral asymmetries are apparent in tasks and with stimuli that do not seem to require higher-order inferences regrading the functional organization of the cerebral hemispheres.

Hemispheric differences in reaction time to verbal and non-verbal stimuli

It has been argued that the brain hemispheres are functionally asymmetrical in their ability to process verbal and non-verbal materials. The correctness of this generalization was tested by studying reaction times to the monaural presentation of verbal and non-verbal stimuli in young normal adults. Systematic differences in reaction times were obtained for the two ears, but these differences did not depend upon the verbal or non-verbal character of the stimuli. Rather, speed of response appeared to be related to stimulus properties within the verbal and non-verbal categories and not to the classification of the stimuli as verbal or non-verbal.