It gives ambitious people a ladder to fight over, increases the conflict and reduces effectiveness.
The indirect costs are those associated with absence from work and reduced effectiveness while at work.
Main outcome measures for headache related disability were workdays lost and reduced effectiveness at work and home due to headaches.
But by far the greater part of the financial cost of headache is the indirect cost of absenteeism and reduced effectiveness at work [9, 130].
By far the greater part of the financial cost of headache is the indirect cost of absenteeism and reduced effectiveness at work [16, 26] (HARDSHIP questions 58 and 59).
If disability measures use absenteeism and reduced effectiveness at work as proxies (see above), reasonable estimates of this cost can be made with knowledge of average wage-rates (age- and gender-corrected) for the population in question.
Nevertheless, as a contributor to this element of burden, these costs are dwarfed by the indirect cost to national economies of absenteeism and reduced effectiveness at work [6, 9].
As discussed above, switching can result in poorer adherence and persistence, increased adverse-event reporting and reduced effectiveness.
Maslach and colleagues originally defined burnout as a psychological syndrome of emotional exhaustion, depersonalisation (later replaced with the construct cynicism) and reduced effectiveness or personal accomplishment, which makes this scale a multidimensional construct [ 2, 3].
The initial stages of the evolution of eusociality can thus be characterized by lower Ne, high linkage disequilibrium, higher genetic loads and reduced effectiveness of natural selection due to interference between linked mutations.
The effects of fluid expansion related to endurance training as an intervention to improve orthostatic tolerance appear to be paradoxically offset by cardiac remodelling and reduced effectiveness of baroreceptor control mechanisms.
