Assessing inclusiveness for indigenous communities in mineral rights allocation in Ghana.

Ghana is blessed with an abundance of mineral resources. These mineral resources are situated in indigenous communities, but the ownership is vested in the government. Indigenous communities where these resources are located are mostly marginalized. Significant legal reforms have been implemented to ensure the inclusivity of these indigenous communities in allocating mineral rights, yet the problem persists. This research investigates the legal framework that governs the allocation of mineral rights in Ghana and the impact thereof on the empowerment of indigenous communities, bringing attention to the difficulties that indigenous communities must overcome to have access to and benefit from mineral resources. To this end, one hundred and eight (108) documents, including legislations and reports on mineral rights allocation in Ghana, were analyzed using thematic analysis. The study found that the current legal framework is deficient in providing sufficient protection for the rights of indigenous communities. Specifically, the absence of a workable scheme for mineral rights allocation from various stakeholders to these indigenous communities is an identifiable lapse in the current legal framework. The findings of this research are relevant to policymakers, legal practitioners, and other stakeholders to improve the rights and well-being of indigenous communities following the analysis of the legal complexities and implications associated with the allocation of mining rights distribution of ensuing royalties inter alia expounded in this paper.

Conceptualised psycho-medical footprint for health status outcomes and the potential impacts for early detection and prevention of chronic diseases in the context of 3P medicine.

Background: The Suboptimal Health Status Questionnaire-25 (SHSQ-25) is a distinctive medical psychometric diagnostic tool designed for the early detection of chronic diseases. However, the synaptic connections between the 25 symptomatic items and their relevance in supporting the monitoring of suboptimal health outcomes, which are precursors for chronic diseases, have not been thoroughly evaluated within the framework of predictive, preventive, and personalised medicine (PPPM/3PM). This baseline study explores the internal structure of the SHSQ-25 and demonstrates its discriminatory power to predict optimal and suboptimal health status (SHS) and develop photogenic representations of their distinct relationship patterns. Methods: The cross-sectional study involved healthy Ghanaian participants (n = 217; aged 30-80 years; ~ 61% female), who responded to the SHSQ-25. The median SHS score was used to categorise the population into optimal and SHS. Graphical LASSO model and multi-dimensional scaling configuration methods were employed to describe the network structures for the two populations. Results: We observed differences in the structural, node placement and node distance of the synaptic networks for the optimal and suboptimal populations. A statistically significant variance in connectivity levels was noted between the optimal (58 non-zero edges) and suboptimal (43 non-zero edges) networks (p = 0.024). Fatigue emerged as a prominently central subclinical condition within the suboptimal population, whilst the cardiovascular system domain had the greatest relevance for the optimal population. The contrast in connectivity levels and the divergent prominence of specific subclinical conditions across domain networks shed light on potential health distinctions. Conclusions: We have demonstrated the feasibility of creating dynamic visualizers of the evolutionary trends in the relationships between the domains of SHSQ-25 relative to health status outcomes. This will provide in-depth comprehension of the conceptual model to inform personalised strategies to circumvent SHS. Additionally, the findings have implications for both health care and disease prevention because at-risk individuals can be predicted and prioritised for monitoring, and targeted intervention can begin before their symptoms reach an irreversible stage. Supplementary information: The online version contains supplementary material available at 10.1007/s13167-023-00344-2.

A review contribution to emission trading schemes and low carbon growth.

In this study, the researchers focus on policy instruments that employ a market-based strategy to promote emission reduction, find the key spots and recent changing aspects in the field of Eemission Trading Systems (ETS) and Low Carbon Growth, and make suggestions for future studies. Making use of the bibliometric analysis, the researchers examine a sample of 1,390 research from the ISI Web of Science database to find research activity on ETS and low carbon growth between 2005 and 2022. Also, the researchers visualized the knowledge domains in this field using software like CiteSpace and R-Biblioshiny. The research unravels the most influential published articles and authors on their citations and publications and their location and significance within the network. The researchers further examined the recent themes, identified the barriers to developing literature in this field, and made recommendations for future research. Research on ETS and low carbon growth globally lack cross-border collaborations between emerging and developed economies. The researchers concluded the study by recommending three future research directions.

A bibliometric analysis of the impact of COVID-19 social lockdowns on air quality: research trends and future directions.

Social lockdowns improved air quality during the COVID-19 pandemic. Governments had previously spent a lot of money addressing air pollution without success. This bibliometric study measured the influence of COVID-19 social lockdowns on air pollution, identified emerging issues, and discussed future perspectives. The researchers examined the contributions of countries, authors, and most productive journals to COVID-19 and air pollution research from January 1, 2020, to September 12, 2022, from the Web of Sciences Core Collection (WoS). The results showed that (a) publications on the COVID-19 pandemic and air pollution were 504 (research articles) with 7495 citations, (b) China ranked first in the number of publications (n = 151; 29.96% of the global output) and was the main country in international cooperation network, followed by India (n = 101; 20.04% of the total articles) and the USA (n = 41; 8.13% of the global output). Air pollution plagues China, India, and the USA, calling for many studies. After a high spike in 2020, research published in 2021 declined in 2022. The author's keywords have focused on "COVID-19," "air pollution," "lockdown," and "PM25." These keywords suggest that research in this area is focused on understanding the health impacts of air pollution, developing policies to address air pollution, and improving air quality monitoring. The COVID-19 social lockdown served as a specified procedure to reduce air pollution in these countries. However, this paper provides practical recommendations for future research and a model for environmental and health scientists to examine the likely impact of COVID-19 social lockdowns on urban air pollution.

Development of an Interactive Software Tool for Designing Solvent Recovery Processes.

Solvents are used in chemical and pharmaceutical industries as a reaction medium, selective dissolution and extraction media, and dilution agents. Thus, a sizable amount of solvent waste is generated due to process inefficiencies. Most common ways of handling solvent waste are on-site, off-site disposal, and incineration, which have a considerable negative environmental impact. Solvent recovery is typically not used because of potential difficulties in achieving required purity guidelines, as well as additional infrastructure and investments that are needed. To this end, this problem must be studied carefully by involving aspects from capital needs, environmental benefits, and comparison with traditional disposal methods, while achieving the required purity. Thus, we have developed a user-friendly software tool that allows engineers to easily access solvent recovery options and predict an economical and environmentally favorable strategy, given a solvent-containing waste stream. This consists of a maximal process flow diagram that encompasses multiple stages of separations and technologies within those stages. This process flow diagram develops the superstructure that provides multiple technology pathway options for any solvent waste stream. Separation technologies are placed in different stages; depending on the component, they can separate in terms of their physical and chemical properties. A comprehensive chemical database is created to store all relevant chemical and physical properties. The pathway prediction is modeled as an economic optimization problem in General Algebraic Modeling Systems (GAMS). With GAMS code as the backend, a Graphical User Interface (GUI) is created in Matlab App Designer to provide a user-friendly tool to the chemical industry. This tool can act as a guidance system to assist professional engineers and provide an easy comparative estimate in the early stages of process design.

Cost-effectiveness of specialised manual therapy versus orthopaedic care for musculoskeletal disorders: long-term follow-up and health economic model.

Background: Physiotherapy is usually the first line of treatment for musculoskeletal disorders. If pain persists, an appointment with an orthopaedic surgeon is indicated, but many disorders for which patients are placed on orthopaedic waiting lists cannot be treated in an orthopaedic clinic. Specialised manual therapy, although not mainstream, can be an effective alternative to orthopaedic care, although its cost-effectiveness beyond 12 months is unknown. Objectives: To perform an 8-year follow-up of the quality of life and costs of specialised manual therapy versus standard orthopaedic care for working-age patients with common nonsurgical musculoskeletal disorders referred to orthopaedic surgeons and to develop a health economic model. Design: Cost-effectiveness study using Markov modelling. Methods: The index group of a previously published pragmatic randomised controlled trial received a maximum of five treatment sessions of specialised manual therapy, while the control group received orthopaedic 'care as usual'. At 3, 6, 12 and 96 months, Health-Related Quality of Life and costs were measured with Short Form Health Survey 36, Short Form Health Survey 6D and Diagnostic Related Groups. An incremental cost-effectiveness ratio was calculated, a Markov model was developed and a sensitivity analysis was performed. Results: Overall, 95% (n = 75) of the participants completed the 8-year follow-up. Recovery rates during the first 3 months ('per protocol') in the index and control group were 69% and 58%, respectively. The index group had 0.159 more gains in quality-adjusted life years and cost 40,270 SEK (€4027) less per patient over 8 years. The sensitivity analysis results were consistent with the main results. Conclusion: Specialised manual therapy dominated standard care after 8 years. The results of this small but very first study are promising; therefore, further exploration within other health care professions, clinics and/or countries is required. Our study raises questions about the triaging of orthopaedic outpatients, cost-effectiveness and resource allocation. Registration: Not applicable per the information provided by ClinicalTrials.gov. Plain Language Summary: Specialised manual therapy is more cost-effective than 'care as usual' for working-age patients referred to an orthopaedist. This study provides an 8-year follow-up of the cost effects and quality of life of a previously published trial. Why was this study conducted? The standard care for musculoskeletal pain consists of exercises with a physiotherapist in primary care. If the pain persists, a referral to an orthopaedic clinic is often made. Many of these referrals are inappropriate because they concern pain from muscles and joints that do not benefit from surgery or the resources available in an orthopaedic clinic. There is a gap in competence and treatment between primary and specialised care that is costly, time- and resource-consuming and causes prolonged patient suffering. Although specialised manual therapy (MT) is effective, its use is not mainstream. Costs and effects after more than 12 months of treatment that may shorten waiting lists have never been evaluated. What did the researchers do? Quality of life and costs were compared in 75 patients with nonsurgical disorders referred to orthopaedic surgeons at 8 years after treatment with specialised MT or standard orthopaedic care. A health economics model for the probability of recovery was also developed and tested. What did the researchers find? Compared with the control group, the study participants treated with specialised MT had a better quality of life, required fewer health care interventions, underwent less surgery, incurred significantly lower costs and demonstrated an increased probability of recovery. What do these findings mean? It seems probable that using specialised MT for an old, well-known structural problem may yield better treatment effects at a significantly lower cost. Our study findings suggest that policy recommendations should focus on costs and effects rather than resource utilisation alone. The study is small and requires expansion using its economic health model.

Comments and recommendations on Sponge City - China's solutions to prevent flooding risks.

Background: /Objective: Flooding risk is a global issue, and various approaches have been established to prevent flooding risk around the world. China is one of the heavily flood-affected countries and has been implementing the Sponge City program since 2015 to defend against flooding. Unfortunately, flooding has been common in China in recent years, causing severe health risks to citizens. This research mainly focuses on (a) evaluating the implementation of China's Sponge City program and the associated impacts on human health and (b) exploring the future improvement of the Sponge City program in China. Methods: The Interpretive Document Approach was used to explore an inclusive review of the Sponge City program and its implications on human health. Results: /Findings: The Sponge City program in China is still insufficient to prevent flooding risks effectively. In the past eight years, 24/34 provinces have recorded flooding, which caused a total of 4701 deaths and over 525.5 billion RMB (around 72.9 billion US$) in economic loss. Till now, only 64/654 cities have promulgated local legislation to manage sponge city construction, although the Sponge City was implemented in 2015. Besides, the completed Sponge City program constructions cannot fully prevent flooding risks, the flood prevention capacity is limited. The Sponge City program is not granted priority, lacking national legislation hinders Sponge City program implementation in China. Conclusions: China needs to make national legislation on the Sponge City program and update the Sponge City program technology guidelines. Local governments should implement Sponge City construction according to local geographic environments.

Manual therapy versus advice to stay active for nonspecific back and/or neck pain: a cost-effectiveness analysis.

BACKGROUND: Low back and neck pain are the most common musculoskeletal disorders worldwide, and imply suffering and substantial societal costs, hence effective interventions are crucial. The aim of this study was to evaluate the cost-effectiveness of manual therapy compared with advice to stay active for working age persons with nonspecific back and/or neck pain. METHODS: The two interventions were: a maximum of 6 manual therapy sessions within 6 weeks, including spinal manipulation/mobilization, massage and stretching, performed by a naprapath (index group), respectively information from a physician on the importance to stay active and on how to cope with pain, according to evidence-based advice, at 2 occasions within 3 weeks (control group). A cost-effectiveness analysis with a societal perspective was performed alongside a randomized controlled trial including 409 persons followed for one year, in 2005. The outcomes were health-related Quality of Life (QoL) encoded from the SF-36 and pain intensity. Direct and indirect costs were calculated based on intervention and medication costs and sickness absence data. An incremental cost per health related QoL was calculated, and sensitivity analyses were performed. RESULTS: The difference in QoL gains was 0.007 (95% CI - 0.010 to 0.023) and the mean improvement in pain intensity was 0.6 (95% CI 0.068-1.065) in favor of manual therapy after one year. Concerning the QoL outcome, the differences in mean cost per person was estimated at - 437 EUR (95% CI - 1302 to 371) and for the pain outcome the difference was - 635 EUR (95% CI - 1587 to 246) in favor of manual therapy. The results indicate that manual therapy achieves better outcomes at lower costs compared with advice to stay active. The sensitivity analyses were consistent with the main results. CONCLUSIONS: Our results indicate that manual therapy for nonspecific back and/or neck pain is slightly less costly and more beneficial than advice to stay active for this sample of working age persons. Since manual therapy treatment is at least as cost-effective as evidence-based advice from a physician, it may be recommended for neck and low back pain. Further health economic studies that may confirm those findings are warranted. Trial registration Current Controlled Trials ISRCTN56954776. Retrospectively registered 12 September 2006, http://www.isrctn.com/ISRCTN56954776 .

Investigating evolutionary trends and characteristics of renewable energy research in Africa: a bibliometric analysis from 1999 to 2021.

Several countries across the African continent have been challenged with energy crises for decades. A growing number of studies have identified renewable energy as a sustainable way for Africa to address its persisting energy situation while combating climate change, as the continent has in abundance some of the common renewable energy resources. Little has been reported in the body of literature to quantitatively and qualitatively map the knowledge domain of this growing research field. In the current study, we conduct a bibliometric analysis on research documents extracted from the Web of Science Core Collection to identify trends and characteristics of the knowledge domain related to renewable energy in Africa from 1999 to 2021. Using two different software (VOSviewer and ITgInsight), we report the contribution of journals, countries, institutions, and authors and their collaboration patterns. We also perform co-citation and keyword analysis to identify the intellectual base and central themes of this research field. The results from the study revealed a growing interest in Africa's renewable energy, with about 90% of the total publication from within the last decade. Renewable & Sustainable Energy Reviews was identified as the most productive as well as the most influential journal in this field. The most contributing countries in this field were South Africa, USA, and Algeria. Centre de Developpement Des Energies Renouvelables, a research institute in Algeria, emerged as the most productive and influential institution. The analysis of research hotspots under different categories revealed that "solar energy," "CO2 emissions," and "rural electrification" are the topics that have gained maximum attention over the years. Keyword evolution analysis also identified "economic growth" and "green hydrogen production" as emerging topics that will play a major role in future studies. We conclude our work by providing specific suggestions and strategies to help bridge the gap which exists in the quantity and quality of renewable energy research between Africa and the rest of the world.

The Cost-Effectiveness Analysis of the Productivity Measurement and Enhancement System Intervention to Reduce Employee Work-Related Stress and Enhance Work Performance.

BACKGROUND: The study evaluates the cost-effectiveness of the Productivity Measurement and Enhancement System (ProMes) intervention to reduce employee work-related stress and enhance work performance. METHODS: A prospective cohort study was used to undertake the evaluation from a business perspective. Objective workload data and stress were gathered repeatedly over a 17-month period (i.e., before and after intervention). Independent t-test and an interrupted time series (ITS) analysis were used in the analysis. The average cost-effectiveness ratio (ACER) was calculated as a ratio of the average cost of the intervention and the effect sizes of the different outcomes to reflect the average cost per clinician for each unit change in outcome. RESULTS: Based on the results of the ITS analysis, an expenditure of EUR 41,487 was linked with no change in stress levels, according to the ACER for stress. In addition, the expenditures associated with each unit change were EUR 3319 for overall tasks per hour worked, EUR 2761 for visits per hour worked, EUR 2880 for administrative tasks, but EUR 9123 for answering phone calls. CONCLUSIONS: ProMes is not cost-effective in terms of work-related stress levels, but the intervention seemed to have increased efficiency in some objective work performance measures, albeit at a relatively high extra cost.

A systematic review of the research on telework and organizational economic performance indicators.

Introduction: A systematic review is conducted in the study to investigate the relationship between telework and organizational economic performance indicators such as self-reported employee performance, organizational performance, actual employee turnover rates, or intentions. Methods: The databases Scopus, Business Source Premier, and Web of Science were used to conduct a literature search. Original articles published from 2000 and up to May 2021 were selected. Studies were screened for inclusion independently by review pairs and data were extracted. The Mixed Methods Appraisal Tool (MMAT) was used to evaluate the quality of the studies included. Results: Forty-three studies were included with some addressing multiple outcomes. Self-reported performance was higher for teleworking employees compared to those working in the ordinary workplace. The extent of the change in performance was dependent on individual characteristics and the extent of the teleworking practice in the organization. Telework was also associated with increased organizational performance, particularly in homogenous samples with unique work tasks. When telework is voluntary, it appears that both actual employee turnover rates and intentions to leave the organization are lower. Discussion: Further research with high-quality prospective designs is necessary to properly understand the contribution of telework to organizational economic performance indicators.

Systems level roadmap for solvent recovery and reuse in industries.

Recovering waste solvent for reuse presents an excellent alternative to improving the greenness of industrial processes. Implementing solvent recovery practices in the chemical industry is necessary, given the increasing focus on sustainability to promote a circular economy. However, the systematic design of recovery processes is a daunting task due to the complexities associated with waste stream composition, techno-economic analysis, and environmental assessment. Furthermore, the challenges to satisfy the desired product specifications, particularly in pharmaceuticals and specialty chemical industries, may also deter solvent recovery and reuse practices. To this end, this review presents a systems-level approach including various methodologies that can be implemented to design and evaluate efficient solvent recovery pathways.

Construct validity of the Suboptimal Health Status Questionnaire-25 in a Ghanaian population.

BACKGROUND: The Suboptimal Health Status Questionnaire-25 (SHS-Q-25) developed to measure Suboptimal Health Status has been used worldwide, but its construct validity has only been tested in the Chinese population. Applying Structural Equation Modelling, we investigate aspects of the construct validity of the SHS-Q-25 to determine the interactions between SHS subscales in a Ghanaian population. METHODS: The study involved healthy Ghanaian participants (n = 263; aged 20-80 years; 63% female), who responded to the SHSQ-25. In an exploratory factor and parallel analysis, the study extracted a new domain structure and compared to the established five-domain structure of SHSQ-25. A confirmatory factor analysis (CFA) was conducted and the fit of the model further discussed. Invariance analysis was carried out to establish the consistency of the instrument across multi-groups. RESULTS: The extracted domains were reliable with Cronbach's [Formula: see text] of 0.846, 0.820 and 0.864 respectively, for fatigue, immune-cardiovascular and cognitive. The CFA revealed that the model fit indices were excellent [Formula: see text]. The fit indices for the three-domain model were statistically superior to the five-domain model. There were, however, issues of insufficient discriminant validity as some average variance extracts were smaller than the corresponding maximum shared variance. The three-domain model was invariant for all constrained aspects of the structural model across age, which is an important risk factor for most chronic diseases. CONCLUSION: The validity tests suggest that the SHS-Q25 can measure SHS in a Ghanaian population. It can be recommended as a screening tool to early detect chronic diseases especially in developing countries where access to facilities is diminished.

Industrial hemp as an agricultural crop in Ghana.

BACKGROUND: Cannabis is one of humanity's oldest crops with several uses, from food to clothing and medicine. It remains one of the most controversial crops whose production, possession, and usage are regulated differently across jurisdictions. Academic research and advocacy have resulted in the redefinition of the legal status of cannabis in several countries. Ghana recently reviewed its laws on cannabis, allowing for the cultivation of industrial hemp. The legislation paves the way for Ghana to benefit from industrial hemp and include it in the agricultural cash crop list. This paper looks at the economic prospects of industrial hemp in the wake of the new law. METHODS: A systematic electronic research was conducted to identify journal articles, reports, news, blogs, and other relevant materials on cannabis, marijuana, and industrial hemp. The electronic search was done primarily on Google, Google Scholar, Bing, and "Baidu Xueshi" to identify cannabis-related publications. The search was expanded beyond Ghana to find other perspectives on cannabis. The search began in January 2020 on Google using search terms like "cannabis in Ghana" and "which countries have legal cannabis." Materials on history, financial prospects, industrial uses, and legislations on cannabis and industrial hemp were reviewed. RESULTS: Existing research on cannabis in Ghana has focused on the psychotic effects of cannabis other than its industrial aspects, which has potentials for the economy. Industrial hemp has CBD with no psychotic effects and is very useful in making medicine, paper, and textiles. Ghana has both the land and workforce to produce hemp to feed local industries and the international market. CONCLUSION: The new legislation can put Ghana in a position to benefit from the current cannabis industry. Therefore, policymakers should implement a registration regime that would favor local investors and farmers to reduce illegal production. The regulatory framework should establish a well-equipped agency that will supervise production and research into hemp development.

H-WORK Project: Multilevel Interventions to Promote Mental Health in SMEs and Public Workplaces.

The paper describes the study design, research questions and methods of a large, international intervention project aimed at improving employee mental health and well-being in SMEs and public organisations. The study is innovative in multiple ways. First, it goes beyond the current debate on whether individual- or organisational-level interventions are most effective in improving employee health and well-being and tests the cumulative effects of multilevel interventions, that is, interventions addressing individual, group, leader and organisational levels. Second, it tailors its interventions to address the aftermaths of the Covid-19 pandemic and develop suitable multilevel interventions for dealing with new ways of working. Third, it uses realist evaluation to explore and identify the working ingredients of and the conditions required for each level of intervention, and their outcomes. Finally, an economic evaluation will assess both the cost-effectiveness analysis and the affordability of the interventions from the employer perspective. The study integrates the training transfer and the organisational process evaluation literature to develop toolkits helping end-users to promote mental health and well-being in the workplace.

A Resourceful Work Environment Moderates the Relationship between Presenteeism and Health. A Study Using Repeated Measures in the Swedish Working Population.

The objective of this study was to investigate if the psychosocial work environment moderates the proposed negative impact of presenteeism on future general health. We expect that the negative impact of presenteeism on general health is weaker if the psychosocial work environment is resourceful, and more pronounced if the environment is stressful. Data were derived from the 2008-2018 biennial waves of the Swedish Longitudinal Occupational Survey of Health (SLOSH). The final analytic sample consisted of n = 15,779 individuals. We applied repeated measures regression analyses through generalized estimating equations (GEE). Results from the autoregressive GEE models showed statistically significant interaction terms between presenteeism and all four investigated moderators, i.e., job demands, job control, job support and job strain. The results indicate that the psychosocial work environment moderates the negative association between presenteeism and general health and illustrates a buffering effect of the psychosocial work environment. A possible explanation for these results may be that psychosocially resourceful work environments give room for adjustments in the work situation and facilitate recovery. The results also indicate that by investing the psychosocial work environment employers may be able to promote worker health as well as prevent reduced job performance due to presenteeism.

Presenteeism, Psychosocial Working Conditions and Work Ability among Care Workers-A Cross-Sectional Swedish Population-Based Study.

Presenteeism, attending work while ill, has been examined in different contexts in the last few decades. The aim was to examine whether poor psychosocial working conditions and perceived work ability are associated with increased odds ratios for presenteeism, focusing on nursing professionals and care assistants. A cross-sectional population-based study was conducted. The selected individuals were extracted from representative samples of employees, aged 16-64, who participated in the Swedish Work Environment Surveys between 2001 and 2013 (n = 45,098). Three dimensions of psychosocial working conditions were measured: job demands, job control, and job support. Presenteeism and perceived work ability was measured. Using multiple logistic regression analyses, odds ratios for presenteeism with 95% confidence intervals (CI) were estimated. While nurses (n = 1716) showed the same presenteeism level as all the other occupation groups (n = 37,125), it was more common among care assistants (n = 6257). The odds ratio for presenteeism among those with high job demands (OR = 2.37, 95% CI 2.21-2.53), were higher among women than among men. For nursing professionals and care assistants, the odds ratios for presenteeism were highest among those with the lowest work ability level. The problems of presenteeism and low work ability among many health and care workers may be lessened by a reduction in psychosocial demands.

What is Number of Days in Number of Times? Associations Between, and Responsiveness of, Two Sickness Presenteeism Measures.

OBJECTIVE: To examine the associations between sickness presenteeism (SP) reported as number of days with SP reported as number of times and to evaluate their responsiveness. METHODS: The study population (n = 454) consisted of employed individuals, at risk of long-term sickness absence. Correlation analyses were performed to examine associations between the two SP measures and external constructs such as work performance, general health, and registered sick leave. Both SP constructs were measured several times to examine responsiveness. RESULTS: The SP measures are moderately correlated. They moderately correlated with work performance and health status measures. SP reported as number of times seems to be more sensitive than number of days in detecting changes after rehabilitation. CONCLUSIONS: Numerical or categorical constructs are valid sources of data on SP. However, categorized SP seems to be more responsive.