Some studies confirmed the association between resilience and positive emotion (e.g., Ong, Bergeman, Bisconti, & Wallace, 2006; Tugade et al., 2004) . Examining the role positive emotion plays in resilience, Ong et al. (2006) found that widows with high levels of resilience experience more positive (e.g., peaceful) and negative (e.g., anxious) emotions than those with low levels. The former group shows high emotional complexity which is the capacity to maintain the differentiation of positive and negative emotional states while underlying stress. Ong et al. (2006) further suggest that the adaptive consequence of resilience is a function of an increase in emotional complexity while stress is present. Moreover, high resilient widows showed the likelihood of controlling their positive emotional experiences to recover and bounce back from daily stress. Indeed, positive emotions were found to disrupt the experience of stress and help high resilient individuals to recover efficiently from daily stress (Fredrickson et al., 2003) . In this case, some studies argue (e.g., Fredrickson et al., 2003; Tugade et al., 2004) that positive emotion helps resilient people to construct psychological resources that are necessary for coping successfully with significant catastrophe, such as the September 11th attacks. As a result, positive emotion experienced by resilient people functions as a protective factor to moderate the magnitude of adversity to individuals and assists them to cope well in the future (Tugade et al., 2004).

In addition to the above findings, a study (Fredrickson et al., 2003) further suggests that positive emotions are active elements within resilience. By examining people’s emotional responses to the September 11th, Fredrickson et al. (2003) suggests that positive emotions are critical elements in resilience and as a mediator that buffer people from depression after the crises. Moreover, high resilient people were more likely to notice positive meanings within the problems they faced (e.g., felt grateful to be alive), endured fewer depressive symptoms, and experienced more positive emotions than low resilient people after terrorism attacks (Fredrickson et al., 2003). Similar results were obtained in another study regarding the effects of 911 attacks on resilient individuals’ healthy adjustment (Bonanno et al., 2007) . People with high levels of resilience are likely to show low levels of depression, and less likely to smoke cigarettes or use marijuana (Bonanno et al., 2007). Moreover, low resilient people exhibit the difficulties of regulating negative emotions and demonstrate sensitive reaction to daily stressful life events (e.g., the loss of loved one) (Ong et al., 2006). They are likely to believe that there is no end for the unpleasant experience of daily stressors and may have higher levels of stress. In general, resilient people are believed to possess positive emotions, and such emotions in turn influence their responses to adversity.

Adapted from the Wikipedia article Psychological resilience, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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The first enforceable hours’ law in the United States was in 1874 when Massachusetts enacted a law which limited the amount of time that women and children could work each week.[http://eh.net/encyclopedia/article/whaples.work.hours.us] This limit was set at sixty hours per week. Similar laws were later adopted by about half of the country’s states. Only men in exceptionally hazardous jobs were covered in early legislation and most had no limit to the number of hours their employers could have them work.

Ten-hour workdays were accepted in the agriculture industry during certain seasons and six-day workweeks were not unheard of. Bakers did not win the right to work less than ten hours per day until 1905 with the court case of Lochner vs. New York.

The general presumption during this period was that the courts would allow regulation of labor concerning women and children, who were thought to be incapable of bargaining on an equal footing with employers and in special need of protection. Men were allowed freedom of contract unless it could be proven that regulating their hours served a higher good for the population at large.[http://eh.net/encyclopedia/article/whaples.work.hours.us]

During the turn of the twentieth century, the push for an eight-hour workday was geared primarily toward raising the hourly wage. The idea was that by maintaining the current weekly pay while lowering working hours, a fairer rate of pay would result. The slogan, “Whether you work by the piece or work by the day, decreasing the hours increases the pay,” seemed to carry the mood of the day. [http://eh.net/encyclopedia/article/whaples.work.hours.us]

The early twentieth century laid the groundwork for the idea of work-life balance. Advancements in social sciences would move the focus towards the impact of long hours on the physical and mental health of the employee.

At this time, however, the new information was used to enhance productivity for the company. The shorter hours movement began to focus on the fact that an overworked employee is more prone to injury or mistake and becomes less productive. Josephine Goldmark wrote a book in 1912 detailing this fact and the Federal Public Works Act was passed the same year.

This new act required a forty-hour workweek for employees of government contracted firms. Over the next ten years, the government passed legislation requiring a forty-hour work week for individual industries nearly every time the issue arose in court.[http://eh.net/encyclopedia/article/whaples.work.hours.us]

When the employees of the steel industry failed to obtain a reduction from their eighty-four-hour work week in 1919, the industry soon allowed their employees an eight-hour workday, a four hour per day reduction—a move brought about by much “arm-twisting” on the part of President Harding. [http://eh.net/encyclopedia/article/whaples.work.hours.us]

By the 1920s, the average work week was fifty hours and was considered a great stride and well-earned award for America’s working man. (Whaples) The push for fewer hours had come to a close, but they had one more hurdle to overcome. The new concentration was on the ability to work half a day on Saturdays or have the day off completely. The ability to have two days of rest was unprecedented, but was considered vital to finalize an ethical work schedule. Pressure was put on businesses to make the change, especially in industries and cities with a large number of Jewish workers (since the Jewish Sabbath is on Saturday), and they finally achieved this goal by the end of the decade. Where only thirty-two firms had a five-day workweek in 1920, nearly half had adopted the practice by 1927. [http://eh.net/encyclopedia/article/whaples.work.hours.us]

Their success was short lived. In the 1920s, the workers were coaxed into believing that they wanted to work longer hours and that they would be harmed by measures that limited how many hours they were allowed to work. Social scientists would later name this force the “gospel of consumption.” Beginning in the 1920s, advertisers persuaded Americans that happiness would not come from leisure time, but from purchasing commodities, and he concluded that this made it easier for managers to “allow” workers to make more money by working longer hours. [http://eh.net/encyclopedia/article/whaples.work.hours.us]

Social scientists would conclude that a new work ethic began as Americans left the psychology of scarcity and adopted one of abundance. Some argue that this mentality of consumption or “consumerism” persists to this day. [http://eh.net/encyclopedia/article/whaples.work.hours.us]

During the twentieth century, the average workweek has changed drastically. In 1900, the average workweek in manufacturing was approximately fifty-three hours. However, the workweek is responsive to business conditions. During the Great Depression, the average number of hours for production workers in manufacturing dropped to 34.6 each week. During World War II, hours worked rose to forty-five each week.

The normal range of hours worked during the four decades after World War II was thirty-nine to forty-one hours; (Whaples) however, starting in the 1990s, factory workweek hours began to exceed forty-one hours. As previously mentioned, Americans work approximately 47.1 hours each week; some employees work up to seventy hours. Therefore, it is safe to state that the average number of hours Americans presently work each week is the highest it has been in nearly seventy-five years.

In 1900, only nineteen percent of women of working age were in the labor force. In 1999 sixty percent of women worked outside the home. Even if the hours worked were slightly higher at the turn of the century, most households were supported by one paycheck. “In 1900, eighty percent of American children had a working father and a stay-at-home mother; however, by 1999, that figure was only twenty-four percent.” [http://www.bls.gov/opub/cwc/]

During the Great Depression, working hours were reduced. By 1932, approximately fifty percent of Americans were working a shortened work week. Instead of reducing wages, employers decided to lay off many workers and attempted to protect the employees that remained by encouraging them to job share.

President Hoover’s Commission for Work Sharing pushed voluntary hours reductions, and it is estimated that nearly three to five million jobs had been saved. (Whaples) Companies such as Sears, General Motors, and Standard Oil reduced the number of days worked each week, and Akron began a six-hour workday. The AFL began to call for a federally-mandated thirty-hour workweek. [http://eh.net/encyclopedia/article/whaples.work.hours.us]

By 1933, some experts were predicting that the “thirty-hour workweek was within a month of becoming federal law.” [http://eh.net/encyclopedia/article/whaples.work.hours.us] Congress began hearings on mandating the thirty-hour workweek, and the Senate even passed the bill (which was written by Hugo Black and sponsored in the House by William Connery) fifty-three to thirty.

Newly-elected President, Franklin Roosevelt initially supported the bill, but had second thoughts when he realized that the bill had a provision to forbid importation of goods produced by workers who worked longer than thirty hours a week. Instead, Roosevelt began to support the National Industrial Recovery Act. Labor leaders were encouraged to support the NIRA instead of the Black-Connery Thirty-Hour Bill with a guarantee of union organization and collective bargaining. With the threat of a mandated thirty-hour work week, businesses “fell into line.” [http://eh.net/encyclopedia/article/whaples.work.hours.us] When specifics codes for the NIRA were drawn up, shorter hours were no longer a genuine concern.[http://eh.net/encyclopedia/article/whaples.work.hours.us]

After the Great Depression ended, the average weekly hours worked began to rise. (According to the Bureau of Labor Statistics, in 1934 the average hours worked each week was approximately thirty-four hours). During World War II, hours increased by approximately ten hours a week but, in the aftermath of the war, weekly work hours averaged forty hours. [http://eh.net/encyclopedia/article/whaples.work.hours.us]

With automation of the workplace in “full swing” by the 1970s, large numbers of women began entering the work force and an “awareness of stress rose to the forefront” [http://library.cqpress.com/cqresearcher/cqresrre1995080400.] In the publication ”Type A Behavior and Your Heart”, cardiologists Meyer Friedman and Ray H. Rosenman wrote about the “hurry sickness” common to “workaholics”—people who had no friends and who “never relaxed or went to museums” [http://library.cqpress.com/cqresearcher/cqresrre1995080400.]

In the late 1970s, Professor Robert Karasek of the University of Lowell (now known as University of Massachusetts Lowell) developed a method for analyzing stress-producing factors in the workplace. It has been widely employed to examine workplace pressures and their relationship with research data on coronary heart disease, musculoskeletal illnesses, psychological strain and absenteeism. Karasek explains, “In situations where an individual has high demands on him and low control, the undesirable stress of work and other situations becomes problematic.” [http://library.cqpress.com/cqresearcher/cqresrre1995080400.]

The 1980s brought new complaints of work-life balance related stress. This time period was given such names as “the ME generation,” “the age of narcissism” and “the pursuit of loneliness.”[http://library.cqpress.com/cqresearcher/cqresrre1995080400.] The number of cases of emotional depression in the United States was believed to have doubled between 1970 and 1990.

“What you do is what you are” was the common and unhealthy assumption. According to ‘The Workaholic Syndrome’, written by Judith K. Sprankle and Henry Ebel, “By their sheer numbers and the consequently narrowing opportunities at every upward run of the organizational ladder, the baby-boomers have been compelled to do more, to move faster, to compete harder. They, in turn, have set the pace for other age groups. The signs of increased stress are legion and have been intensified by an economic climate that mandates that if we marry at all, we marry a working spouse.” [http://library.cqpress.com/cqresearcher/cqresrre1995080400.]

In the late 1980s, the “computer revolution” was not only responsible for corporate downsizing, but also increased the demand of employee output. Social critic Jeremy Rifkin states, “Back in the agriculture-based society, people were more attuned to generatively [http://library.cqpress.com/cqresearcher/cqresrre1995080400.], and middle-stress disorders and diseases of affluence were not part of life. They weren’t triggered until the Industrial Age, and now the Information Age has worsened them. Nowadays, instead of seconds, it’s nanoseconds. We have moved from designing a schedule that real people can execute in whatever time it takes them, to a program which people can monitor but can’t affect.” [http://library.cqpress.com/cqresearcher/cqresrre1995080400.]

In the 1980s, the number of workers’ compensation claims for “gradual mental stress” began to rise. Claims rose from 1,844 cases in 1981 to 15,688 in 1999 in the state of California alone. Because of the large number of cases as well as evidence of numerous cases of fraud, efforts were made in the early 1990s to reform the workers compensation program. Led by Republican Governor of California Pete Wilson and Democratic Party State assembly Speaker Willie Brown, the new law stated that claimants had to prove that stress was at least 51 percent of the reason for their illness. [http://library.cqpress.com/cqresearcher/cqresrre1995080400.]

Unfortunately, because of these reforms some feel that it is now extremely difficult to be approved for workers compensation. John Burton, dean of the school of management and labor relations at Rutgers University feels that part of the reason for the decline is that “a number of states made it difficult to get stress into the system.

So even if the stress is out there, it’s not showing up (in the compensation statistics). Some of it shows up in the rising violence, which is a crude proxy for the stress out there.” [http://library.cqpress.com/cqresearcher/cqresrre1995080400.]

Adapted from the Wikipedia article Work–life balance (United States), under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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Physical exercise is important for maintaining physical fitness and can contribute positively to maintaining a healthy weight, building and maintaining healthy bone density, muscle strength, and joint mobility, promoting physiological well-being, reducing surgical risks, and strengthening the immune system.

Exercise also reduces levels of cortisol. Cortisol is a stress hormone that builds fat in the abdominal region, making weight loss difficult. Cortisol causes many health problems, both physical and mental.

Frequent and regular aerobic exercise has been shown to help prevent or treat serious and life-threatening chronic conditions such as high blood pressure, obesity, heart disease, Type 2 diabetes, insomnia, and depression. Endurance exercise before meals lowers blood glucose more than the same exercise after meals. According to the World Health Organization, lack of physical activity contributes to approximately 17% of heart disease and diabetes, 12% of falls in the elderly, and 10% of breast cancer and colon cancer.

There is some evidence that vigorous exercise (90–95% of VO2 Max) is more beneficial than moderate exercise (40 to 70% of VO2 Max).

Some studies have shown that vigorous exercise executed by healthy individuals can increase opioid peptides (a.k.a. endorphins, naturally occurring opioids that in conjunction with other neurotransmitters are responsible for exercise-induced euphoria and have been shown to be addictive), increase testosterone and growth hormone, effects that are not as fully realized with moderate exercise. More recent research indicates that anandamide may play a greater role than endorphins in “runner’s high”.

Both aerobic and anaerobic exercise also work to increase the mechanical efficiency of the heart by increasing cardiac volume (aerobic exercise), or myocardial thickness (strength training). Such changes are generally beneficial and healthy if they occur in response to exercise.

Not everyone benefits equally from exercise. There is tremendous variation in individual response to training: where most people will see a moderate increase in endurance from aerobic exercise, some individuals will as much as double their oxygen uptake, while others can never augment endurance. Similarly, only a minority of people will show significant muscle growth after prolonged weight training, while a larger fraction experience improvements in strength. This genetic variation in improvement from training is one of the key physiological differences between elite athletes and the larger population. Studies have shown that exercising in middle age leads to better physical ability later in life.

Effect on the cardiovascular system

The effect of exercise on the cardiovascular system is well documented.

There is a direct relation between physical inactivity and cardiovascular mortality, and physical inactivity is an independent risk factor for the development of coronary artery disease. There is a dose-response relation between the amount of exercise performed from approximately 700 to 2000 kcal of energy expenditure per week and all-cause mortality and cardiovascular disease mortality in middle-aged and elderly populations. The greatest potential for reduced mortality is in the sedentary who become moderately active. Most beneficial effects of physical activity on cardiovascular disease mortality can be attained through moderate-intensity activity (40% to 60% of maximal oxygen uptake, depending on age). … persons who modify their behavior after myocardial infarction to include regular exercise have improved rates of survival. … Persons who remain sedentary have the highest risk for all-cause and cardiovascular disease mortality. [http://circ.ahajournals.org/cgi/content/full/94/4/857]

Effect on the immune system

Although there have been hundreds of studies on exercise and the immune system, there is little direct evidence on its connection to illness. Epidemiological evidence suggests that moderate exercise has a beneficial effect on the human immune system while extreme exercise impairs it, an effect which is modeled in a J curve. Moderate exercise has been associated with a 29% decreased incidence of upper respiratory tract infections (URTI), but studies of marathon runners found that their prolonged high-intensity exercise was associated with an increased risk of an infection, although another study did not find the effect. Immune cell functions are impaired following acute sessions of prolonged, high-intensity exercise, and some studies have found that athletes are at a higher risk for infections. The immune systems of athletes and nonathletes are generally similar. Athletes may have slightly elevated natural killer cell count and cytolytic action, but these are unlikely to be clinically significant.

Vitamin C supplementation has been associated with lower URTIs in marathon runners.

Biomarkers of inflammation such as C-reactive protein, which are associated with chronic diseases, are reduced in active individuals relative to sedentary individuals, and the positive effects of exercise may be due to its anti-inflammatory effects. The depression in the immune system following acute bouts of exercise may be one of the mechanisms for this anti-inflammatory effect.

Effects on brain function

A 2008 review of cognitive enrichment therapies (strategies to slow or reverse cognitive decline) concluded that “physical activity, and aerobic exercise in particular, enhances older adults’ cognitive function”.

In mice, exercise improves cognitive functioning via improvement of hippocampus-dependent spatial learning, and enhancement of synaptic plasticity and neurogenesis. In addition, physical activity has been shown to be neuroprotective in many neurodegenerative and neuromuscular diseases. For instance, it reduces the risk of developing dementia. Furthermore, anecdotal evidence suggests that frequent exercise may reverse alcohol-induced brain damage.

There are several possibilities for why exercise is good for the brain:

* increasing the blood and oxygen flow to the brain

* increasing growth factors that help create new nerve cells and promote synaptic plasticity

* increasing chemicals in the brain that help cognition, such as dopamine, glutamate, norepinephrine, and serotonin

Physical activity is thought to have other beneficial effects related to cognition as it increases levels of nerve growth factors, which support the survival and growth of a number of neuronal cells.

Effects on depression

A number of factors may contribute to depression including being overweight, low self-esteem, stress and anxiety.

Endorphins act as a natural pain reliever and antidepressant in the body. Endorphins have long been regarded as responsible for what is known as “runner’s high”, a euphoric feeling a person receives from intense physical exertion. However, recent research indicates that anandamide may possibly play a greater role than endorphins in “runner’s high”. When a person exercises, levels of both circulating serotonin and endorphins are increased. These levels are known to stay elevated even several days after exercise is discontinued, possibly contributing to improvement in mood, increased self-esteem, and weight management. Exercise alone is a potential prevention method and/or treatment for mild forms of depression.

Exercise also affects the sleep that a person will receive at night. When the body is physically exhausted it will slip into Rapid Eye Movement (REM) sleep easier and for a longer period.

Adapted from the Wikipedia article Physical exercise, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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Some studies confirmed the association between resilience and positive emotion (e.g., Ong, Bergeman, Bisconti, & Wallace, 2006; Tugade et al., 2004) . Examining the role positive emotion plays in resilience, Ong et al. (2006) found that widows with high levels of resilience experience more positive (e.g., peaceful) and negative (e.g., anxious) emotions than those with low levels. The former group shows high emotional complexity which is the capacity to maintain the differentiation of positive and negative emotional states while underlying stress. Ong et al. (2006) further suggest that the adaptive consequence of resilience is a function of an increase in emotional complexity while stress is present. Moreover, high resilient widows showed the likelihood of controlling their positive emotional experiences to recover and bounce back from daily stress. Indeed, positive emotions were found to disrupt the experience of stress and help high resilient individuals to recover efficiently from daily stress (Fredrickson et al., 2003) . In this case, some studies argue (e.g., Fredrickson et al., 2003; Tugade et al., 2004) that positive emotion helps resilient people to construct psychological resources that are necessary for coping successfully with significant catastrophe, such as the September 11th attacks. As a result, positive emotion experienced by resilient people functions as a protective factor to moderate the magnitude of adversity to individuals and assists them to cope well in the future (Tugade et al., 2004).

In addition to the above findings, a study (Fredrickson et al., 2003) further suggests that positive emotions are active elements within resilience. By examining people’s emotional responses to the September 11th, Fredrickson et al. (2003) suggests that positive emotions are critical elements in resilience and as a mediator that buffer people from depression after the crises. Moreover, high resilient people were more likely to notice positive meanings within the problems they faced (e.g., felt grateful to be alive), endured fewer depressive symptoms, and experienced more positive emotions than low resilient people after terrorism attacks (Fredrickson et al., 2003). Similar results were obtained in another study regarding the effects of 911 attacks on resilient individuals’ healthy adjustment (Bonanno et al., 2007) . People with high levels of resilience are likely to show low levels of depression, and less likely to smoke cigarettes or use marijuana (Bonanno et al., 2007). Moreover, low resilient people exhibit the difficulties of regulating negative emotions and demonstrate sensitive reaction to daily stressful life events (e.g., the loss of loved one) (Ong et al., 2006). They are likely to believe that there is no end for the unpleasant experience of daily stressors and may have higher levels of stress. In general, resilient people are believed to possess positive emotions, and such emotions in turn influence their responses to adversity.

Adapted from the Wikipedia article Psychological resilience, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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The non-contagious disease manifests as clusters of chronic abscesses, epidermoid cyst, sebaceous cysts, pilonidal cyst or multilocalised infections, which can be as large as baseballs or as small as a pea, that are extremely painful to the touch and may persist for years with occasional to frequent periods of inflammation, culminating in incision and drainage of pus, often leaving open wounds that will not heal. The simple procedure of incision and drainage provides some relief from severe, often debilitating, pressure pain. Flare-ups may be triggered by severe stress, perspiration, hormonal changes (such as monthly cycles in women), humidity and heat, and clothing friction. Persistent lesions may lead to scarring and the formation of sinus tracts, or tunnels connecting the abscesses or infections under the skin. At this stage, complete healing is usually not possible, and progression varies from person to person, with some experiencing remission anywhere from months to years at a time, while others may worsen and require multiple surgeries in order to live comfortably. Wound dehiscence, a premature “bursting” open of a wound often complicates the healing process. Occurrences of bacterial infections and cellulitis (deep tissue inflammation) may occur at these sites. HS pain and depression can be difficult to manage.

HS often goes undiagnosed for years because patients are too ashamed to speak with anyone. When they do see a doctor or medical practitioner, the disease is frequently misdiagnosed or prescribed treatments are ineffective, temporary and sometimes even harmful. There is no known cure nor any consistently effective treatment. Carbon dioxide laser surgery is currently considered the last resort for those who have advanced to its highest stage, where the affected areas are excised, and the skin is grafted. Surgery doesn’t always alleviate the condition, however, and can be very expensive.

Several articles and clinics consider this disease as widely misdiagnosed, due to the misunderstanding of the causes and progression of the disease. HS is neither the biblical stigmata, leprosy nor caused by poor hygiene. HS is often called an ‘orphan illness’, due to little research being conducted on the disease at this time. Because HS is considered a rare disease, its incidence rate is not well known, but has been estimated as being between 1:24 (4.1%) and 1:600 (0.2%).

Areas of Involvement in Men and Women with Hidradenitis Suppurativa

* Note that for the study involved in the Table above was a personal series of 164 patients. Of the 164 patients with HS, 76% were in Hurley’s Stage I, 20% were in Hurley’s Stage II, and 4% were in the final phase of the disease, Hurley’s Stage III.

;Other names for HS

Hidradenitis suppurativa has been referred to by multiple names in the literature, as well as in various cultures. Some of these are also used to describe different diseases, or specific instances of this disease.

*Acne conglobata – not really a synonym – this is a similar process but in classic acne areas of chest and back

*Acne Inversa (AI) – a proposed new term which has not gained widespread favour.

*Apocrine Acne – a misnomer, out-dated, based on the disproven concept that apocrine glands are primarily involved. Though many do suffer with apocrine gland infection, so thought should be given to using HS with subtext re: glands involved.

*Apocrinitis – another misnomer, out-dated, based on the disproven concept that apocrine glands are primarily involved

*Fox-den disease – a catchy term not used in medical literature, based on the deep fox den / burrow – like sinuses

*Hidradenitis Supportiva – a misspelling

*Pyodermia fistulans sinifica – an older term, considered archaic now

*Velpeau’s disease – commemorating the French surgeon who first described the disease in 1833

*Verneuil’s disease – recognizing the French surgeon whose name is most often associated with the disorder as a result of his 1854-1865 studies

Adapted from the Wikipedia article Hidradenitis suppurativa, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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