5. ACON. Post Exposure Prophylaxis. PEP Hotline. http:// www.acon.org.au/hiv/pep (12 May 2014, date last accessed). 6. University of Cape Town. Medicines Information Centre. HIV & TB Hotline. http://www.mic.uct.ac.za/MIC/Hotline (13 May 2014, date last accessed). 7. Kotwal A, Taneja DK. Health care workers and universal precautions: perceptions and determinants of non-compliance. Indian J Community Med 2010;35:526–528. 8. Tebeje B, Hailu C. Assessment of HIV post-exposure prophylaxis use among health workers of governmental health institutions in Jimma Zone, Oromiya Region, Southwest Ethiopia. Ethiop J Health Sci 2010;20:55–64. 9. Tesfaye G, Gebeyehu H, Likisa J. Knowledge, attitude and practice towards HIV post-exposure prophylaxis of health professionals of Gimbi town in Ethiopia: a cross-sectional study. Int J Res Med Sci 2014;2:468–4 71. doi:10.1093/occmed/kqv033

Fifty years ago: ‘Malaises and Discontents’ working days were lost in 1962 for every insured person, a total of nearly 300 million working days. Sickness benefit payments cost the State £160 million, about one-sixth of the total expenditure on the National Health Service. 9 ¼ million new claims were made for sickness benefit in 1963, an increase of over 2 million over the 1950 figure. These are some of the many facts given in a recent publication by the Office of Health Economics. The increase both in days lost and in spells commencing is partly accounted for by an increase in the total number of insured persons. The male working population increased by 0.8 per cent per year from 1953–4; the female decreased by 1.2 per cent per year, but the preponderance of men in the insured population meant a slight increase in the total each year. Even when allowance is made for this, and for the effect of ageing, however, the number both of working days lost and of spells commencing was substantially higher than in 1953, for both sexes. There has been a change in the pattern of causes of incapacity: absences from respiratory tuberculosis, skin diseases, rheumatism and peptic ulcer have shown a striking decline, and those due to injuries and accidents, ‘debility’, vascular lesions, psychoneurosis, psychosis and bronchitis an increase. Bronchitis remains the principal cause of lost time in men. Some of the facts set out, and trends shown, may not be particularly significant, but others at least suggest the kind of questions we should be asking about our society. For instance, we know the cost of ill health to the Exchequer, but what does it cost industry in addition—not only in payments under sick pay schemes, when these exist, but in idle machinery and


lost orders, or alternatively in bigger labour forces than should be required to maintain production? The plain fact is that most industrial managements do not know, and those who are least informed tend also to regard expenditure on occupational health services as a luxury they cannot afford. Measures of compulsion are not incompatible with a ‘free society’, as the whole history of our factory legislation shows, in spite of the screams of the die-hards who swear each social advance will mean their ruin. The issue is basically an economic one, and will ultimately have to be faced without sentimentality or deference to sectional interests. Why do people go sick? The answer ‘because they are ill’ is tautological unless ‘illness’ is given a much wider connotation than it has in everyday speech. It is common knowledge that a host of extraneous factors determine whether a person who does not feel very well takes the day off work. A correspondent recently sent us a note on a small personal study suggesting that the state of the weather and the incidence of pay-day were among these. Undoubtedly feelings of worth, responsibility and job satisfaction are others, and when these are lacking, absence attributed to frankly psychological causes, and to ‘debility’ as well as to some somatic causes will tend to rise. From: Malaises and Discontents. Available at: Occup Med (Lond) 1965;15:81–82. doi:10.1093/ occmed/15.1.81. This article and the entire Occupational Medicine archive can be accessed online at http://occmed. oxfordjournals.org

Downloaded from http://occmed.oxfordjournals.org/ at University of Wisconsin-Oshkosh on November 15, 2015

perception amongst nurses, doctors and other healthcare workers in rural India. Ind J Med Res 2005;122:258–264. 2. Yadav SS, Yadav S, Mishra P. Knowledge and risk perception regarding HIV among healthcare workers in a medical college hospital. Int J Med Sci Public Health 2014;3:73–75. 3. National AIDS Control Organization, Ministry of Health & Family Welfare, Government of India. Antiretroviral Therapy Guidelines for HIV Infected Adults and Adoles­ cents Including Post-Exposure Prophylaxis, 2007. http:// naco.gov.in/upload/Policies%20&%20Guidelines/1.%20 Antiretroviral%20Therapy%20Guidelines%20for%20 HIV-Infected%20Adults%20and%20Adolescents%20 Including%20Post-exposure.pdf (10 May 2014, date last accessed). 4. University of California, San Francisco. Clinician Consultation Center. Post-Exposure Prophylaxis (PEP). http://nccc.ucsf.edu/clinician-consultation/post-exposureprophylaxis-pep/ (12 May 2014, date last accessed).

Fifty years ago: 'Malaises and Discontents'. 1965.

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