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PubMed2004

Cardiac mortality is higher around Christmas and New Year's than at any other time: the holidays as a risk factor for death.

BACKGROUND: Research published in Circulation has shown that cardiac mortality is highest during December and January. We investigated whether some of this spike could be ascribed to the Christmas/New Year's holidays rather than to climatic factors. METHODS AND RESULTS: We fitted a locally weighted polynomial regression line to daily mortality to estimate the number of deaths expected during the holiday period, using the null hypothesis that natural-cause mortality is unaffected by the Christmas/New Year's holidays. We then compared the number of deaths expected during the holiday period, given the null hypothesis, with the number of deaths observed. For cardiac and noncardiac diseases, a spike in daily mortality occurs during the Christmas/New Year's holiday period. This spike persists after adjusting for trends and seasons and is particularly large for individuals who are dead on arrival at a hospital, die in the emergency department, or die as outpatients. For this group during the holiday period, 4.65% (+/-0.30%; 95% CI, 4.06% to 5.24%) more cardiac and 4.99% (+/-0.42%; 95% CI, 4.17% to 5.81%) more noncardiac deaths occur than would be expected if the holidays did not affect mortality. Cardiac mortality for individuals who are dead on arrival, die in the emergency department, or die as outpatients peaks at Christmas and again at New Year's. These twin holiday spikes also are conspicuous for noncardiac mortality. The excess in holiday mortality is growing proportionately larger over time, both for cardiac and noncardiac mortality. CONCLUSIONS: Our findings suggest that the Christmas/New Year's holidays are a risk factor for cardiac and noncardiac mortality. There are multiple explanations for this association, including the possibility that holiday-induced delays in seeking treatment play a role in producing the twin holiday spikes.

Air Pollution↗

PubMed2001

Solar UVR exposures of indoor workers in a Working and a Holiday Period assessed by personal dosimeters and sun exposure diaries.

BACKGROUND/AIM: The aim of this study was to quantify ultraviolet radiation (UVR) exposure of fully employed indoor workers during a Working Period and a Holiday Period in the summer months. A further aim was to investigate the correlation between individual personal UVR dosimeter reading and self-reported data in a diary about sun exposure habits and to investigate whether skin type, age and gender influence sun exposure. METHODS: The solar UVR, in standard erythema doses (SED) measured by UV sensitive spore-film filter type personal dosimeters (VioSpor), and sun exposure diaries were compared. The study included 44 healthy Danish adult indoor workers during a Working Period of a mean of 13 days and a Holiday Period of a mean of 17 days from June to September. RESULTS: The individual total UVR exposure correlated significantly (P<0.001) in both the Holiday and Working Periods with individual total hours spent outdoors from 07:00 to 19:00 and with skin area exposure hours. There was no significant correlation between sun exposure dose and gender, age or skin type I-IV, or between the individual solar exposure dose in the Working and the Holiday Period. However, subjects with UVR exposures in the upper quartile spent their Holiday Period in Southern Europe, and/or had been more than the mean time outdoors at the beach/sea and/or between 12:00 and 15:00. Subjects with UVR exposure in the lower quartiles spent their holidays in Denmark or Northern Europe and did not stay at the beach at all. They received an average solar UVR dose which was 22% of ambient in Denmark in the same period while subjects having their holidays in Southern Europe received as much as 90% of the ambient dose in Denmark. CONCLUSIONS: Despite information campaigns to avoid the midday sun, on average 35% of the recorded hours outdoors were spent between 12:00 and 15:00 in the Holiday Period. Total hours outdoors give the best estimate of the total sun exposure dose. Registration in a diary of total hours outdoors and whether the Holiday Period was in Northern or Southern Europe can be used to predict the solar exposure dose in a Holiday Period of a few weeks.

Adult↗

PubMed2006

Introduction and evaluation of a newly established holiday work system in the pharmacy ward at Municipal Ikeda Hospital.

At the Municipal Ikeda Hospital, a system in which pharmacists stationed in one ward pharmacy dispense drugs to be administered by injection and injectable preparations delivered to patients' bedsides was introduced in April 2000. This system was aimed at minimizing risks related to injections. Initially, however, on holidays, nurses played the roles of pharmacists in terms of the injections, and there were concerns over a possible rise in the incidence of errors (adverse events/near-misses) related to injections on these days compared with weekdays. Later, when planning to introduce a new holiday work system in the ward pharmacy, we took into account such factors as the number of pharmacists needed on holidays, their duties on holidays and the influence on weekday pharmacy activity of compensatory days-off taken by such pharmacists. In May 2004, the new holiday work system was introduced in the ward pharmacy. Under the new system, 5 pharmacists work at the ward pharmacy on holidays. After this system was put into operation, the number of injections dispensed at the ward pharmacy averaged 230 per day, and 177 per holiday. To evaluate the validity of this system, we recently conducted a questionnaire survey of nurses at our hospital. The survey involved 139 nurses. Of these nurses, 69.1% responded that the number of incidents (adverse events/near-misses) related to dispensing injections on holidays had decreased. Furthermore, 65.4% of the nurses reported a decrease in incidents related to the delivery and administration of injectable preparations. More than half of the nurses answered that the new system had made it easier for them to collect information on medicines and helped them provide better nursing services. When the nurses were asked to make a general assessment of the new system, 90% rated the system as "good." The results of this survey indicate that keeping the ward pharmacy open on holidays contributes to the promotion of the proper use of medicines, reduction of risks related to injections and improvement in the quality of medical care.

Humans↗

PubMed2006

The role of conjugated linoleic acid in reducing body fat and preventing holiday weight gain.

OBJECTIVE: The incidence of obesity and overweight in the US has increased considerably during the past two decades and currently affects 65% of the adult population. Research has indicated that small, yet irreversible, gains during the holiday season contribute to increases in weight during adulthood. Conjugated linoleic acid (CLA), a naturally occurring dietary fatty acid, has been found to reduce weight gain and dramatically decrease fat mass in animals. Although research in humans has shown inconsistent results, most studies have been of insufficient duration or have utilized body composition methods that are less accurate than the currently accepted criterion. DESIGN: Randomized, double-blind, placebo-controlled study of 3.2 g/day CLA for 6 months. SUBJECTS: Forty healthy, overweight subjects (age: 18-44 years; body mass index: 25-30 kg/m(2)). MEASUREMENTS: Body composition by the four-compartment model, resting metabolic rate (RMR) by indirect calorimetry, self-reported physical activity and dietary intake, and blood chemistries were determined at baseline and after 6 months. Body weight was measured monthly during the pre-holiday season (August-October), holiday season (November-December) and post-holiday season (January-March). Adverse events were assessed monthly. RESULTS: Compared to CLA, the placebo group showed a greater rate of weight gain during the holiday season (P=0.01). Within the placebo group, holiday weight change was significantly greater compared to the pre-holiday period (August-October) (P=0.03). Six-month change in body composition was improved with CLA compared to placebo (P=0.02), and body fat was significantly reduced within the CLA group (-1.0+/-2.2 kg, P=0.05). CLA had no effect on RMR, physical activity or dietary intake. The rate of reported negative emotions decreased significantly with CLA, although there was no difference in any other category of adverse event. In comparison to the placebo, CLA did not affect insulin resistance, blood lipids and markers of liver function or markers of inflammation, with the exception of a significant decrease in a biomarker of endothelial dysfunction. CONCLUSION: CLA supplementation among overweight adults significantly reduced body fat over 6 months and prevented weight gain during the holiday season. Although no adverse effects were seen, additional studies should evaluate the effect of prolonged use of CLA.

Adipose Tissue↗

PubMed1987

A drop in suicides around major national holidays.

To study the fluctuation of suicides around the holidays, we examined 188,047 U.S. suicides from 1973 to 1979. Correcting for the effects of extraneous variables, such as seasons and days of the week, we found that suicides dropped by an annual average of -102.5 in the period surrounding the holidays. One set of holidays (Memorial Day, Thanksgiving, and Christmas) was associated with an unusually low risk of suicide before, during, and after the holiday. Another set of holidays (New Year's Day, July 4th, and Labor Day) was associated with a low risk of suicide before the holiday and a high risk just afterwards. Almost all demographic groups experienced a low risk of suicide around the holidays: whites, blacks, males, females, retired persons, and persons of working age. Only white teenagers deviated from this pattern. Thus, the evidence does not support the widespread popular assumption that holidays are a risk factor in suicide.

Adult↗

PubMed2006

Holiday and weekend operating room on-call staffing requirements.

BACKGROUND: Every facility that performs cases on holidays has in some way decided on its operating room (OR) and anesthesia staffing for holidays. Previous studies have not examined how best to calculate appropriate holiday staffing. METHODS: We analyzed weekend and holiday data from a university hospital. RESULTS: There were high rank correlations between the number of cases starting during each 12-h period of a holiday, the total hours of OR time used, and the patients and surgeons waiting for cases to start. Weekend and holiday 12-h periods were divided into 8 categories (e.g., Saturday 7:00 am to 7:00 pm). There was perfect rank correlation between the mean number of cases starting during each 12-h period and appropriate staffing during the 12-h period, whether quantified by total hours of cases or by the under-utilized and over-utilized OR time resulting from staffing decisions. CONCLUSIONS: The number of cases starting during each period of a holiday is a statistically valid end point for OR managers to use to evaluate how busy holidays are relative to weekend days. To be useful, the statistic must be combined with mathematically valid assessments of appropriate weekend staffing on-call, whether in-house, or from home.

Holidays↗

PubMedDate not supplied

Firm but fair policies for staff vacations and holidays.

Paid holiday and vacations are a wonderful employee benefit for your staff. However, without some firm policies in place that anticipate and avoid problems, holidays and vacations can backfire in a medical practice and become a source of problems both for the practice and for the staff. This article provides concrete tips for reducing vacation and holiday conflicts and particularly for structuring a firm-but-fair vacation policy for new employees. It provides guidance for solo practitioners' vacation scheduling and offers a list of the most common paid holidays in professional practices today. In addition, this article offers answers to common holiday and vacation scheduling questions such as how to handle holidays that fall during a vacation and weekend holidays. Finally, this article offers specific advice for making the December holiday season a pleasant and trouble-free one for your staff.

Holidays↗

PubMed1995

A longitudinal study of the effects of an L-dopa drug holiday on the course of Parkinson's disease.

Drug holidays as treatment in Parkinson's disease (PD) to ameliorate the effects of chronic L-dopa use are a controversial method. They are used in an attempt to resensitize dopamine receptors in the striatum so that L-dopa therapy can be reinstated at lower doses with fewer of the side effects that normally accompany long-term use of the drug. In the present study, 15 patients with PD were submitted to a 7-day L-dopa drug holiday and then followed for 3 years. The effect of the holiday on parkinsonian symptoms and grade of severity of PD was determined using the Webster and the Hoehn and Yahr scales, administered at intervals over the 3-year period. We found that within the first 6 months post-drug-holiday, there was a dramatic improvement in the rating of the symptoms of PD that was statistically significant (p < 0.005). At 12 months, Webster scale scores had risen, but they remained significantly improved (p < 0.05) in comparison with the first postholiday score. This level of improvement was maintained at 24 and 36 months. The grade of severity of the disease stabilized since Hoehn and Yahr scale scores improved for all patients, except one, for the length of the study. One patient left the study after 6 months for unknown reasons. Of the 14 patients that remained, three were given additional drug holidays: two patients at 12 months and one patient at 12, 24, and 36 months. All patients were able to be maintained on a reduced L-dopa dose regimen of 50-70% of their pre-drug-holiday level for the entire 3-year period. In the patients in whom the drug holiday was least beneficial overall, there was a notable reduction in rigidity and in the "on-off" phenomenon. We conclude that an L-dopa drug holiday is a valuable option in the treatment of PD.

Aged↗

PubMed1999

Factors associated with gay men's sexual behaviours and risk on holiday.

Findings are presented from a questionnaire survey of 562 gay men resident in southern England on their sexual behaviour in the context of holidays. Data were gathered during summer 1996 by means of a self-completion questionnaire; 395 men reported at least one holiday undertaken in 1996 and the analysis focuses on the first or only holiday described. Of 391 men giving details of sexual activity, 187 reported sex with a new partner, 113 men reported penetrative sex and 17 reported penetration without consistent use of condoms. Sexual activity on holiday was predicted by: being on holiday alone or with friends, taking condoms, being motivated by 'gay social life and sex' in planning a holiday, higher expectations of sexual activity/risk and a higher number of new partners at home. Penetrative sex was predicted by: more sexual partners on holiday, taking condoms and higher expectations of sexual activity/risk. Unprotected sex was predicted by: not taking condoms, higher expectations of sexual activity/risk and positive HIV status. Survey findings are discussed in relation to previous research, and implications for travel-related HIV prevention initiatives targeting gay men are explored.

Acquired Immunodeficiency Syndrome↗

PubMed1999

Attempted suicide and major public holidays in Europe: findings from the WHO/EURO Multicentre Study on Parasuicide.

OBJECTIVE: The aim of the study was to examine the relationship between suicide attempts and major public holidays in Europe. METHOD: The analysis was based on data on 24 388 suicide attempts by persons aged 15 years or older in the period 1989-1996. Data from 13 centres (representing 11 countries) participating in the WHO/EURO Multicentre Study on Parasuicide were analysed. The analysis of the fluctuation of suicide attempts around public holidays was based on the daily number of suicide attempts for each centre. For each day in the period under examination a mean number of suicide attempts (mu) was calculated. The analysis was based on the assumption that the data followed a Poisson distribution. The observed number of daily suicide attempts was compared with the expected number of attempts. A multiplicative model for the expected number in each centre was developed. RESULTS: Before Christmas there were fewer suicide attempts than expected, and after Christmas there were approximately 40% more attempts than expected. In addition, more attempts than expected were registered on New Year's Day. In countries where people have the day off work on Whit Monday there were significantly fewer attempts during the 3 days before, but where Whit Monday is a normal working day significantly fewer attempts occurred on the Monday to Wednesday after Whit Sunday. CONCLUSION: There appears to be a transposition of a significant number of suicide attempts from before (and during) a major public holiday until after it. The division of holidays into non-working and working days showed that a 'holiday effect' could only be found around major public holidays, particularly Christmas, Easter and Whitsun. These findings support the theory of the 'broken-promise effect' for major public holidays.

Adolescent↗

PubMed1991

Holidays and atopic eczema.

Information was collected by telephone about 300 holidays taken over a three year period by 126 children with severe atopic eczema. During the holidays, improvement in eczema occurred more frequently (112/300, 37%) than deterioration (63/300, 21%). There was a significant correlation between improvement and a more southerly holiday location: improvement was common in holidays taken in the Mediterranean or further south (63/92, 69%), but holidays in northern Britain were more likely to be associated with deterioration (27/100, 27%) than improvement (13/100, 13%). Changes in eczema were correlated with changes in asthma in 231 holidays taken by children with both conditions, but improvement was not significantly associated with pet ownership. All patients returned to their preholiday state, usually within two weeks of return home. The causes of changes in eczema while on holiday have not been identified.

Adolescent↗

PubMed2006

The effect of the Thanksgiving holiday on weight gain.

BACKGROUND: More people than ever are considered obese and the resulting health problems are evident. These facts highlight the need for identification of critical time periods for weight gain. Therefore the purpose was to assess potential changes that occur in body weight during the Thanksgiving holiday break in college students. METHODS: 94 college students (23.0 +/- 4.6 yrs, 72.1 +/- 14.0 kg, 172.6 +/- 9.3 cm, 24.0 +/- 3.9 kg/m2) reported to the human body composition laboratory at the University of Oklahoma following a 6-hour fast with testing occurring prior to, and immediately following the Thanksgiving holiday break (13 +/- 3 days). Body weight (BW) was assessed using a balance beam scale while participants were dressed in minimal clothing. Paired t-tests were used to assess changes in BW pre and post Thanksgiving holiday with additional analysis by gender, body mass index (BMI), and class standing (i.e. undergraduate vs. graduate). RESULTS: Overall, a significant (P < 0.05) increase in BW was found between pre (72.1 kg) and post (72.6 kg) Thanksgiving holiday. When stratified by gender and class standing a significant (P < 0.05) increase in body weight was observed between the pre and post Thanksgiving holiday in males (0.6 kg), females (0.4 kg) and graduate students (0.8 kg). When participants were classified by BMI as normal or as overweight/obese, a significant 1.0 kg BW gain was found (P < 0.05) in the overweight/obese (>/=25 kg/m2) group compared to a non significant 0.2 kg gain in the normal group (<25 kg/m2). CONCLUSION: These data indicate that participants in our study gained a significant amount of BW (0.5 kg) during the Thanksgiving holiday. While an increase in BW of half a kilogram may not be cause for alarm, the increase could have potential long-term health consequences if participants retained this weight gain throughout the college year. Additionally, because the overweight/obese participants gained the greatest amount of BW, this group may be at increased risk for weight gain and further obesity development during the holiday season.

Adolescent↗

PubMed2000

Relationship between suicide and holidays.

Employing the vital statistics from January 1, 1979 to December 31, 1994 in Hokkaido Prefecture, Japan, we investigated the relationship between suicide (ICD 9 code, El15) and days of the week. In one day 1.97 males and 0.98 females committed suicide on average. On Saturdays the number of suicides per day was the smallest. On Mondays it was the highest. When the days were classified into (1) a holiday, (2) the day before a holiday, (3) the day after a holiday (4) the day both before and after a holiday and (5) others, the rate of suicide was the lowest in the days before a holiday. In the days after a holiday, however, the rate was the highest. The same tendency was also noted when the subjects were classified into several subgroups from the viewpoint of ages, seasons or calendar years. The time relation of holidays seemed to have something to do with the intention to commit suicide.

Chi-Square Distribution↗

PubMed1999

Postponed suicide death? Suicides around birthdays and major public holidays.

The relationship between suicide and birthdays, and suicide and public holidays has been studied from data on 32,291 Danish suicides by persons ages 15 years and older in the 25-year period 1970-1994. Evidence was found to support the theory of the "broken-promise effect" for major public holidays in that there appears to be a postponement of a significant number of suicides from before a holiday until after. The division of holidays into nonworking and (half-time) working days showed that a "holiday effect" could only be found around major public holidays, particularly Christmas, Easter, and Whitsun. The postponing or transpositioning effect is relevant to prevention, especially because of the availability and accessibility of help at the end of and after major public (nonworking) holidays.

Adolescent↗

PubMed1992

Trend analysis of solar ultraviolet exposure of the Austrian population caused by holiday patterns since 1969.

Over the last few decades, a steady increase in the incidence of skin cancer has been observed. Solar ultraviolet (UV) exposure is undoubtedly one of the primary causes, and of these, holiday patterns are an intrinsic component. To assess solar UV exposure for this trend analysis, changes in holiday patterns were investigated. For Austrians, a preponderance of holidays are spent at the Mediterranean Sea. These holidays represent not only a potentially high UV exposure because of location but also because sun-intensive activities are preferred. The analysis shows an increase in solar UV exposure from all holidays of 1.6% per year. About 22% of the population spends holidays at the Mediterranean Sea, and UV exposure of the total population from these holidays has increased annually by about 3.3%. Because of the latency period, it is not possible to draw conclusions from the increase in UV exposure and the temporal trends in skin cancer. A longer time series would be necessary to do this. A direct comparison of data from other countries reporting increases in skin cancer does not seem appropriate, as levels of UV exposure vary greatly and such factors as genetic susceptibility are involved.

Austria↗

PubMed1994

Holiday travel and morbidity reported to general practitioners.

AIM: This study set out to explore the influence that holiday travel might have on the rate at which new episodes of illness are reported to general practitioners. METHOD: The study was carried out in a semi-rural practice of five doctors in Wiltshire in 1989. Details of patients' holiday travel were determined by postal questionnaire. Sociodemographic and clinical data were obtained from the patients' medical records. RESULTS: The response rate to the questionnaire was 85%. The study subjects were divided into those who had taken their holiday abroad (n = 643), those who had taken their holiday in the United Kingdom (n = 973), and those who had taken no holiday (n = 668) during the study year. Interim assessment of clinical results revealed no changes in morbidity indices in relation to holiday intervals in any of the groups except for an apparent rise in the number of new episodes of illness presented in the month before departure by those about to go abroad. Further analysis showed that this was due to a significant 112% increase in the number of episodes of illness presented by this study group in the week before they left home. CONCLUSION: This study suggests that the present focus on the supposed excess morbidity of patients returning from foreign holidays is misplaced.

Adolescent↗

PubMed1989

Effects of repeated drug holidays on serum haloperidol concentrations, psychiatric symptoms, and movement disorders in schizophrenic patients.

In a crossover experiment the authors investigated the effects of repeated weekly, 2-day, haloperidol drug holidays on serum haloperidol concentrations, mental status, and neuroleptic-induced movement disorders in seven chronic schizophrenic patients. Haloperidol concentrations decreased about 64% during the initial 36 hours of drug holiday and subsequently increased slightly during the next 24 hours of drug holiday. Two-day weekly drug holidays for 6 weeks resulted in an average reduction of 25% in serum haloperidol concentrations at all drug holiday points. Mental status and movement disorders scores, rated by observers blind to the drug-holiday condition, were not significantly affected by drug holidays.

Drug Administration Schedule↗

PubMed2006

Incidence of acute myocardial infarction during Islamic holiday seasons.

Some weather and holiday seasons are associated with increased incidence of acute myocardial infarction (AMI). We studied the influence of one such season, Islamic holiday season of "Eid Al-Fitr", on the incidence of AMI in a Muslim country. This was carried out by examining the admissions to the coronary care unit of a large hospital over six consecutive years (from 1997 to 2003), encompassing six consecutive holiday seasons in Kuwait. We compared the admission rates during three time intervals in each of those 6 years; the Eid holiday season, the 2 months before and the 2 months after. A total of 964 AMI admissions occurred, with a mean age of 55 years. When the admission rates were compared, the Islamic holiday seasons were associated with a significant increase in AMI admission rate (45 cases vs. 31 cases, p < 0.01). This increase occurred mainly on the second day of the 4-day holiday season. This finding was confirmed using Locally Weighted Smooth Regression (LOESS) regression models with different smoothing levels. Our finding might have potential implications for preventive health campaigns in Muslim countries.

Adult↗