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1.
J Headache Pain ; 22(1): 19, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33794761

RESUMEN

BACKGROUND: With headache experienced by up to 75% of adults worldwide in the last year, primary headache disorders constitute a major public health problem, yet they remain under-diagnosed and under-treated. Headache prevalence and burden is changing as society evolves, with headache now occurring earlier in life. Contributing factors, mostly associated with changing life style, such as stress, bad posture, physical inactivity, sleep disturbance, poor diet and excess use of digital technology may be associated with the phenomenon that could be labelled as '21st century headache'. This is especially notable in workplace and learning environments where headache impacts mental clarity and therefore cognitive performance. The headache-related impact on productivity and absenteeism negatively influences an individual's behaviour and quality of life, and is also associated with a high economic cost. Since the majority of sufferers opt to self-treat rather than seek medical advice, substantial knowledge on headache prevalence, causation and burden is unknown globally. Mapping the entire population of headache sufferers can close this knowledge gap, leading to better headache management. The broad use of digital technology to gather real world data on headache triggers, burden and management strategies, in self-treated population will allow these sufferers to access appropriate support and medication, and therefore improve quality of life. CONCLUSION: These data can yield important insights into a substantial global healthcare issue and form the basis for improved patient awareness, professional education, clinical study design and drug development.


Asunto(s)
Cefalea , Calidad de Vida , Absentismo , Adulto , Eficiencia , Cefalea/diagnóstico , Cefalea/epidemiología , Humanos , Lugar de Trabajo
2.
Artículo en Inglés | MEDLINE | ID: mdl-33572766

RESUMEN

Sickness absence is one of the most important working population health indicators. It is a complex phenomenon that is investigated by health care and occupational health specialists, economists, and work psychologists. Sickness absence is used as a predictor for morbidity and mortality, but besides the health status of an individual, sickness absence is influenced by demographic, socio-economic factors, and work environment factors. Conflicts at work are a common psychosocial risk factor that can affect sickness absence. The aim of the study was to investigate the association between different types of workplace conflict and self-reported medically certified sickness absence using cross-sectional survey data pooled from four periodic national surveys-Work conditions and risks in Latvia (2006-2018). The sample is representative of the working population of Latvia, as respondents were randomly drawn from different regions and industries. In total, the study sample (n = 8557) consisted of employees between 16 and 80 years old (average 42.8 +/- 12.6) of which 46.2% were males and 53.8% were females. Researchers used the computer-assisted personal interviewing (CAPI) method for collecting data. The association between workplace conflicts and sickness absence was analysed by using binomial logistic regression and calculated as odds ratios (OR) with 95% confidence intervals (CI), with adjustment for gender, age, education and survey year. The risk of sickness absence was higher among women (OR = 1.24, CI 1.13-1.35), employees aged 25-44 years old and employees with higher income. Controlling for socio-demographic factors and survey year, the odds of sickness absence increased significantly for all types of workplace conflict analysed. The strongest association with sickness absence was related to conflicts between managers and employees (OR = 1.51, CI 1.37-1.66) and conflicts between groups of employees (OR = 1.45, CI 1.31-1.61). Conflicts between employees and with customers also increased the odds of sickness absence (OR = 1.39, CI 1.27-1.52 and OR = 1.11, CI 1.01-1.23, respectively). Our findings suggest that tailored interventions at a company level for reducing workplace conflicts as risk factors of sickness absence are required. Those should focus on the improvement of managers' leadership and human resource management skills.


Asunto(s)
Absentismo , Lugar de Trabajo , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Letonia , Masculino , Persona de Mediana Edad , Autoinforme , Ausencia por Enfermedad , Encuestas y Cuestionarios , Adulto Joven
3.
BMC Health Serv Res ; 21(1): 132, 2021 Feb 11.
Artículo en Inglés | MEDLINE | ID: mdl-33573650

RESUMEN

This study aimed to estimate both direct medical and indirect costs of treating the Coronavirus disease 2019 (COVID-19) from a societal perspective in the patients at a referral hospital in Fars province as well as the economic burden of COVID-19 in Iran in 2020. METHODS: This study is a partial economic evaluation and a cross-sectional cost-description study conducted based on the data of the COVID-19 patients referred to a referral university hospital in Fars province between March and July 2020. The data were collected by examining the patients' records and accounting information systems. The subjects included all the inpatients with COVID-19 (477 individuals) who admitted to the medical centre during the 4 months. Bottom-up costing (also called micro-costing approach), incidence-based and income-based human capital approaches were used as the main methodological features of this study. RESULTS: The direct medical costs were estimated to be 28,240,025,968 Rials ($ 1,791,172) in total with mean cost of 59,203,409 Rials ($ 3755) per person (SD = 4684 $/ 73,855,161 Rials) in which significant part (41%) was that of intensive and general care beds (11,596,217,487 Rials equal to $ 735,510 (M = 24,310,728 Rials or $ 1542, SD = 34,184,949 Rials or $ 2168(. The second to which were the costs of medicines and medical consumables (28%). The mean indirect costs, including income loss due to premature death, economic production loss due to hospitalization and job absenteeism during recovery course were estimated to be 129,870,974 Rials ($ 11,634) per person. Furthermore, the economic burden of the disease in the country for inpatient cases with the definitive diagnosis was 22,688,925,933,095 Rials equal to $ 1,439,083,784. CONCLUSION: The results of this study showed that the severe status of the disease would bring about the extremely high cost of illness in this case. It is estimated that the high prevalence rate of COVID-19 has been imposing a heavy economic burden on the country and health system directly that may result in rationing or painful cost-control approaches.


Asunto(s)
/economía , Costo de Enfermedad , Absentismo , Adolescente , Adulto , Anciano , Estudios Transversales , Femenino , Costos de la Atención en Salud/estadística & datos numéricos , Hospitalización/economía , Hospitales Universitarios/economía , Humanos , Incidencia , Renta/estadística & datos numéricos , Irán/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Derivación y Consulta , Adulto Joven
4.
Clin Med (Lond) ; 21(2): e150-e154, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33547066

RESUMEN

INTRODUCTION: COVID-19 presents a risk to healthcare workers, incurring harm to staff physical and mental wellbeing and difficulties in provision of care and service planning. METHODOLOGY: Doctors' anonymised demographic and staff sickness data were collected between 16 March and 26 April 2020, corresponding with the single centre's greatest COVID-19 caseload. FINDINGS: 128 (39%) of doctors experienced at least one sickness episode. Episodes totalled 1,240 days, equating to a sickness absence rate of 9.1%. Rates varied between departments and grades. High levels of sickness were seen in medicine and both adult and paediatric emergency departments with the lowest levels seen in intensive care. DISCUSSION: COVID-19 caused a burden of sickness on the medical workforce which must be accounted for in future workforce planning. The disparity in sickness rates across departments is likely to be multi-factorial. Further study is needed to investigate these factors to protect healthcare staff and their patients.


Asunto(s)
Absentismo , Personal de Salud , Adulto , Prestación de Atención de Salud , Servicio de Urgencia en Hospital , Humanos , Cuerpo Médico
5.
Artículo en Inglés | MEDLINE | ID: mdl-33445682

RESUMEN

Schooling of children between 0 and 3 years old involves a process of adaptation and increases their exposure to infectious diseases, which leads to school absenteeism. Breastfeeding facilitates the development of secure attachment and protects the infant against infections. This study aimed to determine whether breastfeeding facilitates the adaptation of infants between 0 and 3 years old to early childhood center and decreases school absenteeism. A cross-sectional study was carried out by collecting data through a questionnaire, which was filled out by the parents and the childcare professionals. 160 infants participated. 40% of the infants who received infant formula from birth showed dependency behaviors (inconsolable crying or do not leave the caregiver for a long time) at the time of pick-up from the center, compared with 10%, 2.7%, and 2.6% of children breastfed between 0 and 6 months, and more than 6 and 12 months, respectively (p = 0.001). The interquartile range of absenteeism days per episode was 2-3 days for infants fed infant formula versus 1-2 days for those who were breastfed for more than 12 months (p = 0.041). Breastfeeding seems to be associated with fewer dependency behaviors at the time of collection and with fewer days of absence.


Asunto(s)
Absentismo , Lactancia Materna , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Lactante , Fórmulas Infantiles , Recién Nacido
7.
BMC Infect Dis ; 21(1): 52, 2021 Jan 11.
Artículo en Inglés | MEDLINE | ID: mdl-33430793

RESUMEN

BACKGROUND: Workplace absenteeism increases significantly during influenza epidemics. Sick leave records may facilitate more timely detection of influenza outbreaks, as trends in increased sick leave may precede alerts issued by sentinel surveillance systems by days or weeks. Sick leave data have not been comprehensively evaluated in comparison to traditional surveillance methods. The aim of this paper is to study the performance and the feasibility of using a detection system based on sick leave data to detect influenza outbreaks. METHODS: Sick leave records were extracted from private French health insurance data, covering on average 209,932 companies per year across a wide range of sizes and sectors. We used linear regression to estimate the weekly number of new sick leave spells between 2016 and 2017 in 12 French regions, adjusting for trend, seasonality and worker leaves on historical data from 2010 to 2015. Outbreaks were detected using a 95%-prediction interval. This method was compared to results from the French Sentinelles network, a gold-standard primary care surveillance system currently in place. RESULTS: Using sick leave data, we detected 92% of reported influenza outbreaks between 2016 and 2017, on average 5.88 weeks prior to outbreak peaks. Compared to the existing Sentinelles model, our method had high sensitivity (89%) and positive predictive value (86%), and detected outbreaks on average 2.5 weeks earlier. CONCLUSION: Sick leave surveillance could be a sensitive, specific and timely tool for detection of influenza outbreaks.


Asunto(s)
Absentismo , Epidemias , Gripe Humana/epidemiología , Vigilancia en Salud Pública/métodos , Vigilancia de Guardia , Ausencia por Enfermedad , Francia/epidemiología , Humanos , Incidencia , Gripe Humana/virología , Seguro de Salud , Persona de Mediana Edad , Modelos Estadísticos , Estudios Retrospectivos , Sensibilidad y Especificidad , Lugar de Trabajo
8.
Artículo en Inglés | MEDLINE | ID: mdl-33419033

RESUMEN

The main purpose of the paper is to identify the outcomes for employers and employees indicated in research related to workplace health promotion interventions (WHPIs). We investigated what methods are used and what types of organization this type of research is most often carried out in. In addition, the authors attempted to assess to what extent the methods used in the previous research prove the effectiveness of the implemented WHPIs. A systematic review of English-language papers (2000-2020) focused on types of health-promoting interventions in the workplace, and outcomes for employers and employees were conducted using the SCOPUS database (n = 260). As a result, 29 texts qualified for a final qualitative synthesis of the results. The analyses were most frequently conducted in small and medium-sized enterprises (SMEs) based on both quantitative and qualitative methods. In order to draw conclusions, analyses were made by classifying the research presented in the texts according to the type of intervention implemented, classifying the outcomes identified, and indicating the type of evaluation made by the researcher. The analysis showed that most of the outcomes presented refer to changes in the strategy and organizational culture, as well as the behavior of employees. In 18 studies, the indication of outcomes resulted directly from the evaluation outcomes. In other cases, the outcomes were identified by an evaluation of the process or structure of WHPI. The conducted analysis showed significant diversity in terms of the outcomes measured and the research methods used. The quasi-experimental methods, randomly controlled cluster trials, or cross-sectorial studies used in the study to confirm the effectiveness of WHPI were used only in every third study. In these studies, measurements were usually performed twice: at baseline and after intervention. The majority of studies confirmed that WHPIs led to a positive change in the healthy behavior of employees and effected an organizational change, and more rarely led to savings or a reduction in costs resulting from sickness absenteeism, presentism, turnover, etc., and return on investment (ROI). The article shows the need to conduct further research towards the development of guidelines for the evaluation of the effectiveness of implemented programs.


Asunto(s)
Promoción de la Salud , Lugar de Trabajo , Absentismo , Investigación Empírica , Cultura Organizacional
9.
Esc. Anna Nery Rev. Enferm ; 25(2): e20200223, 2021. tab
Artículo en Portugués | LILACS, BDENF - Enfermería | ID: biblio-1142955

RESUMEN

RESUMO Objetivo analisar se o ambiente de trabalho e as características sociodemográficas e laborais influenciam o absenteísmo de técnicos de enfermagem. Método estudo transversal e correlacional, em unidade de urgência e emergência com técnicos de enfermagem. Aplicado instrumento com dados sociodemográficos e laborais, absenteísmo referido e versão brasileira validada para técnicos de enfermagem do Nursing Work Index Revised (B-NWI-R). Resultados participaram 62 técnicos de enfermagem, predominância do sexo feminino, jovens, trabalho de 36 a 40 horas semanais e turno diurno. Absenteísmo foi referido por 33,87% dos participantes e o ambiente de trabalho foi considerado favorável à prática, com média 2,47. A cada ponto na escala B-NWI-R a chance de absenteísmo aumenta em 2,63 vezes, ou seja, quanto mais desfavorável à prática profissional é o ambiente de trabalho maior é a chance de absenteísmo. Conclusão um ambiente de trabalho desfavorável à prática profissional aumenta a chance de absenteísmo entre os técnicos de enfermagem. Implicações para a prática uma análise do absenteísmo associada ao ambiente de trabalho dos técnicos de enfermagem contribui para que os gerentes de enfermagem criem estratégias para melhorar o ambiente de trabalho.


RESUMEN Objetivo analizar si el entorno laboral y las características sociodemográficas y laborales influyen en el absentismo de los técnicos de enfermería. Método estudio transversal y correlacional, en una unidad de urgencias y emergencias con técnicos de enfermería. Instrumento aplicado con datos sociodemográficos y laborales, ausentismo referido y versión brasileña validada para técnicos de enfermería del Nursing Work Index Revised (B-NWI-R). Resultados participaron 62 técnicos de enfermería, predominantemente mujeres, jóvenes, trabajando de 36 a 40 horas a la semana y turno de día. El ausentismo fue reportado por el 33,87% de los participantes y el ambiente de trabajo se consideró favorable a la práctica, con un promedio de 2,47. En cada punto de la escala B- NWI-R, la posibilidad de absentismo aumenta en 2,63 veces, es decir, cuanto más desfavorable sea la práctica profesional en el entorno laboral, mayores serán las posibilidades de absentismo. Conclusión un ambiente de trabajo desfavorable para la práctica profesional aumenta las posibilidades de absentismo entre los técnicos de enfermería. Implicaciones para la práctica un análisis del absentismo asociado con el ambiente de trabajo de los técnicos de enfermería ayuda a los gerentes de enfermería a crear estrategias para mejorar el ambiente de trabajo.


ABSTRACT Objective to analyze whether the work environment and socio-demographic and work characteristics influence the absenteeism of nursing technicians. Method a cross-sectional and correlational study, conducted in an urgency and emergency unit with nursing technicians. Instrument applied with sociodemographic and work data, referred absenteeism and validated Brazilian version for nursing technicians of the Nursing Work Index Revised (B-NWI-R). Results a total of 62 nursing technicians participated, predominantly female, young, working from 36 to 40 hours a week and day shift. Absenteeism was reported by 33.87% of the participants and the work environment was considered favorable to the practice, with a mean of 2.47. At each point on the B-NWI-R scale, the chance of absenteeism increases by 2.63 times, that is, the more unfavorable the professional practice is to the work environment, the greater the chance of absenteeism. Conclusion a work environment unfavorable for the professional practice increases the chance of absenteeism among nursing technicians. Implications for the practice an analysis of absenteeism associated with the work environment of nursing technicians helps nursing managers to create strategies to improve the work environment.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Ambiente de Trabajo , Absentismo , Enfermeros no Diplomados/estadística & datos numéricos , Factores Socioeconómicos , Estudios Transversales , Servicio de Urgencia en Hospital
10.
Allergol. immunopatol ; 48(6): 545-552, nov.-dic. 2020. tab
Artículo en Inglés | IBECS | ID: ibc-199241

RESUMEN

INTRODUCTION AND OBJECTIVES: Asthma may have a detrimental effect on school attendance and achievement. Friend relations, attendance to school activities, quality of life (QOL) of asthmatic children may be negatively affected. The aim of this study was to evaluate factors influencing school functioning for asthmatic school-age children. MATERIALS AND METHODS: From January to May 2019, parents and school-age children who were followed by a diagnosis of asthma for more than one year, from seven pediatric allergy centers, were given a standard questionnaire including questions about child's disease, school performance, absenteeism, home-family-school conditions. A pediatric QOL questionnaire was filled out by children. For evaluating control in the previous year, children who had more than two exacerbations and/or had any exacerbations needing systemic corticosteroids in the previous year were defined as inadequate control. School absence over nine days was taken into account as this has been shown to bring a risk for successful school life. RESULTS: 507 patients were included. Asthma control status was found to be effective on school absence (p < 0.001), on school success (especially math scores) (p < 0.001), on friend relations (p = 0.033), QOL (p < 0.001), attendance to school activities (p < 0.001). Regular follow-up (p < 0.001), regular use of asthma medication (p = 0.014), tobacco smoke exposure (p < 0.001), heating with stove at home (p = 0.01) affected asthma control. School conditions such as crowdedness (p = 0.044), humidity of the class (p = 0.025), knowledge of teacher about child's asthma (p = 0.012) were effective on asthma control independent of home conditions and asthma treatment parameters. CONCLUSION: School interventions are important to improve asthma management


No disponible


Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Asma/prevención & control , Absentismo , Rendimiento Académico/estadística & datos numéricos , Calidad de Vida , Estudiantes/estadística & datos numéricos , Asma/fisiopatología , Encuestas y Cuestionarios , Modelos Logísticos , Factores Socioeconómicos , Análisis Multivariante , Factores de Riesgo
11.
Rev Fac Cien Med Univ Nac Cordoba ; 77(4): 318-321, 2020 12 01.
Artículo en Español | MEDLINE | ID: mdl-33351398

RESUMEN

Introduction: Asthma as a chronic inflammatory disease of the airways that is characterized by wheezing, respiratory distress, chest tightness and cough, which occurs mainly at night or in the early hours of the morning. In spite of the diagnostic and therapeutic advances, the prevalence of this pathology worldwide continues to increase, affecting mainly the child and adolescent population, in which it generates limitations in daily physical activity, interference in sleep, absence from school days and low academic performance. The objective of this study was to determine the frequency of school absenteeism in asthmatic students of an educational institution in the city of Cali. Methodology: A total of 385 students from 5 to 14 years were included in the study, to which they were supplied with the ISAAC questionnaire, which were completed by the caregivers. From the data obtained, the statistical analysis was performed in the SPSS package version 20 Results: The prevalence of asthma found was 27%, in relation to the absenteeism in this group of students it was evidenced that in total 776 days of classes had been lost during the year, with an average of 7.5 days (DE +/- 7) per student. 45% missed 1-5 times and 6% more than 20 times Conclusions: Based on the findings, it is concluded that asthma is a disease that can have clear repercussions at school level.


Asunto(s)
Absentismo , Asma , Adolescente , Asma/epidemiología , Niño , Preescolar , Humanos , Instituciones Académicas , Estudiantes , Universidades
13.
Rev. SPAGESP ; 21(2): 7-22, jul.-dez. 2020. ilus, tab
Artículo en Inglés | LILACS, Index Psicología - Revistas técnico-científicas | ID: biblio-1125728

RESUMEN

We carried out an evaluation of the evidence of internal structure and scores reliability of the Social Skills Inventory for the Elderly (SSI-E) in a sample of 616 Brazilian elderly, between the ages of 60 and 94, from diverse Social-economic stratum. We used EFA, CFA, and reliability measures (Composite Reliability). SSI-E is a 20-item instrument (χ2/gl = 1.406, CFI = 0.912, RMSEA = 0.037, SRMR = 0.0563) with four factors: Emotional expressiveness; Assertiveness; Conversation and social resourcefulness; Affective-sexual approach. The composite reliability of the factors ranged between 0.70 and 0.80, suggesting good precision. The SSI-E allows a very parsimonious application. We discuss the implications of these findings for research, assessment, and intervention on mental health among the elderly.


Considerando a ausência de um instrumento de habilidades sociais específico para idosos, os objetivos deste estudo foram obter e validar uma estrutura própria de itens e fatores para o Inventário de Habilidades Sociais para idosos (IHSI-Del-Prette). Os participantes foram 616 pessoas entre 60 e 94 anos, de diversos níveis socioeconômicos. Foram realizadas Análise Fatorial Exploratória, Análise Fatorial Confirmatória e avaliação da confiabilidade composta. O IHSI-Del-Prette é composto por 20 itens (χ2/gl = 1.406, CFI = 0.912, RMSEA = 0.037, SRMR = 0.0563) organizados em quatro fatores: Assertividade; Conversação e desenvoltura social; Abordagem afetivo-sexual, com confiabilidade composta entre 0.70 e 0.80. O IHSI-Del-Prette possibilita uma avaliação precisa, com contribuições para pesquisa, avaliação e intervenção relacionadas à saúde mental em idosos.


Considerando la ausencia de un instrumento específico de habilidades sociales para los ancianos, los objetivos de este estudio fueron obtener y validar una estructura específica de ítems y factores para el Inventario de Habilidades Sociales para los ancianos (IHSI-Del-Prette). Los participantes fueron 616 personas entre 60 y 94 años, de diferentes niveles socioeconómicos. Se realizaron análisis factoriales exploratorios, análisis factoriales confirmatorios y evaluación de confiabilidad compuesta. El IHSI-Del-Prette consta de 20 ítems (χ2 / gl = 1,406, CFI = 0.912, RMSEA = 0.037, SRMR = 0.0563) distribuidos en cuatro factores: Asertividad; Conversación e ingenio social; Aproximación afectivo-sexual, con fiabilidad entre 0,70 y 0,80. El IHSI-Del-Prette permite una evaluación precisa, con contribuciones a la investigación, evaluación e intervención relacionadas con la salud mental en los ancianos.


Asunto(s)
Humanos , Masculino , Femenino , Anciano , Asertividad , Ingenio y Humor como Asunto , Brasil , Absentismo , Habilidades Sociales , Ajuste Emocional
14.
Biomedica ; 40(Supl. 2): 159-165, 2020 10 30.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33152199

RESUMEN

INTRODUCTION: Healthcare personnel plays an important role in the prevention of acute respiratory infections in hospital settings. OBJECTIVE: Our aim was to establish the level of knowledge about respiratory virus infections and the attitudes and practices among healthcare workers, leaders of infection control committees in hospitals of Bogotá, Colombia. MATERIALS AND METHODS: We used a self-administered questionnaire of 28 items during the monthly meeting sponsored by the local health authority. "Yes or no" and "true or false" questions were applied to measure knowledge. Attitudes and practices were measured with a Likert-type scale according to the agreement degree. RESULTS: We surveyed 70 healthcare workers. Respondents demonstrated a good level of knowledge as 80% of them answered correctly more than five questions. A total of 54.4% showed a low degree of agreement when asked if their institutions have the policy to stay home when they are sick with respiratory symptoms and 67.1% never or rarely remain at home under such conditions. CONCLUSION: Healthcare worker leaders of infection control committees in Bogotá's ospitals have adequate knowledge about the prevention of seasonal respiratory viruses. There is a need for implementing urgent sick leave policies as a measure to prevent the spread of potential coronavirus infections in hospitals.


Asunto(s)
Planificación en Desastres , Conocimientos, Actitudes y Práctica en Salud , Personal de Salud/psicología , Pandemias/prevención & control , Infecciones del Sistema Respiratorio/prevención & control , Absentismo , Adulto , Colombia/epidemiología , Estudios Transversales , Femenino , Humanos , Control de Infecciones/organización & administración , Masculino , Persona de Mediana Edad , Política Organizacional , Ausencia por Enfermedad , Encuestas y Cuestionarios
15.
Emergencias ; 32(5): 320-331, 2020 09.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33006832

RESUMEN

OBJECTIVES: To estimate the impact of the coronavirus disease 2019 (COVID-19) pandemic on the organization of Spanish hospital emergency departments (EDs). To explore differences between Spanish autonomous communities or according to hospital size and disease incidence in the area. MATERIAL AND METHODS: Survey of the heads of 283 EDs in hospitals belonging to or affiliated with Spain's public health service. Respondents evaluated the pandemic's impact on organization, resources, and staff absence from work in March and April 2020. Assessments were for 15-day periods. Results were analyzed overall and by autonomous community, hospital size, and local population incidence rates. RESULTS: A total of 246 (87%) responses were received. The majority of the EDs organized a triage system, first aid, and observation wards; areas specifically for patients suspected of having COVID-19 were newly set apart. The nursing staff was increased in 83% of the EDs (with no subgroup differences), and 59% increased the number of physicians (especially in large hospitals and locations where the COVID-19 incidence was high). Diagnostic tests for the severe acute respiratory syndrome coronavirus 2 were the resource the EDs missed most: 55% reported that tests were scarce often or very often. Other resources reported to be scarce were FPP2 and FPP3 masks (38% of the EDs), waterproof protective gowns (34%), and space (32%). More than 5% of the physicians, nurses, or other emergency staff were on sick leave 20%, 19%, and 16% of the time. These deficiencies were greatest during the last half of March, except for tests, which were most scarce in the first 15 days. Large hospital EDs less often reported that diagnostic tests were unavailable. In areas where the COVID-19 incidence was higher, the EDs reported higher rates of staff on sick leave. Resource scarcity differed markedly by autonomous community and was not always associated with the incidence of COVID-19 in the population. CONCLUSION: The COVID-19 pandemic led to organizational changes in EDs. Certain resources became scarce, and marked differences between autonomous communities were detected.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Servicio de Urgencia en Hospital/estadística & datos numéricos , Encuestas de Atención de la Salud , Pandemias , Neumonía Viral/epidemiología , Absentismo , Adulto , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Brotes de Enfermedades , Servicio de Urgencia en Hospital/organización & administración , Recursos en Salud/provisión & distribución , Necesidades y Demandas de Servicios de Salud , Fuerza Laboral en Salud/estadística & datos numéricos , Capacidad de Camas en Hospitales , Hospitales Públicos/organización & administración , Hospitales Públicos/estadística & datos numéricos , Humanos , Incidencia , Personal de Hospital/estadística & datos numéricos , Neumonía Viral/diagnóstico , Asignación de Recursos , /etiología , España/epidemiología , Triaje/organización & administración
16.
Cochrane Database Syst Rev ; 10: CD006237, 2020 10 13.
Artículo en Inglés | MEDLINE | ID: mdl-33052607

RESUMEN

BACKGROUND: Work disability such as sickness absence is common in people with depression. OBJECTIVES: To evaluate the effectiveness of interventions aimed at reducing work disability in employees with depressive disorders. SEARCH METHODS: We searched CENTRAL (The Cochrane Library), MEDLINE, Embase, CINAHL, and PsycINFO until April 4th 2020. SELECTION CRITERIA: We included randomised controlled trials (RCTs) and cluster-RCTs of work-directed and clinical interventions for depressed people that included days of sickness absence or being off work as an outcome. We also analysed the effects on depression and work functioning. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted the data and rated the certainty of the evidence using GRADE. We used standardised mean differences (SMDs) or risk ratios (RR) with 95% confidence intervals (CI) to pool study results in studies we judged to be sufficiently similar.  MAIN RESULTS: In this update, we added 23 new studies. In total, we included 45 studies with 88 study arms, involving 12,109 participants with either a major depressive disorder or a high level of depressive symptoms. Risk of bias The most common types of bias risk were detection bias (27 studies) and attrition bias (22 studies), both for the outcome of sickness absence. Work-directed interventions Work-directed interventions combined with clinical interventions A combination of a work-directed intervention and a clinical intervention probably reduces days of sickness absence within the first year of follow-up (SMD -0.25, 95% CI -0.38 to -0.12; 9 studies; moderate-certainty evidence). This translates back to 0.5 fewer (95% CI -0.7 to -0.2) sick leave days in the past two weeks or 25 fewer days during one year (95% CI -37.5 to -11.8). The intervention does not lead to fewer persons being off work beyond one year follow-up (RR 0.96, 95% CI 0.85 to 1.09; 2 studies, high-certainty evidence). The intervention may reduce depressive symptoms (SMD -0.25, 95% CI -0.49 to -0.01; 8 studies, low-certainty evidence) and probably has a small effect on work functioning (SMD -0.19, 95% CI -0.42 to 0.06; 5 studies, moderate-certainty evidence) within the first year of follow-up.  Stand alone work-directed interventions A specific work-directed intervention alone may increase the number of sickness absence days compared with work-directed care as usual (SMD 0.39, 95% CI 0.04 to 0.74; 2 studies, low-certainty evidence) but probably does not lead to more people being off work within the first year of follow-up (RR 0.93, 95% CI 0.77 to 1.11; 1 study, moderate-certainty evidence) or beyond (RR 1.00, 95% CI 0.82 to 1.22; 2 studies, moderate-certainty evidence). There is probably no effect on depressive symptoms (SMD -0.10, 95% -0.30 CI to 0.10; 4 studies, moderate-certainty evidence) within the first year of follow-up and there may be no effect on depressive symptoms beyond that time (SMD 0.18, 95% CI -0.13 to 0.49; 1 study, low-certainty evidence). The intervention may also not lead to better work functioning (SMD -0.32, 95% CI -0.90 to 0.26; 1 study, low-certainty evidence) within the first year of follow-up.   Psychological interventions A psychological intervention, either face-to-face, or an E-mental health intervention, with or without professional guidance, may reduce the number of sickness absence days, compared with care as usual (SMD -0.15, 95% CI -0.28 to -0.03; 9 studies, low-certainty evidence). It may also reduce depressive symptoms (SMD -0.30, 95% CI -0.45 to -0.15, 8 studies, low-certainty evidence). We are uncertain whether these psychological interventions improve work ability (SMD -0.15 95% CI -0.46 to 0.57; 1 study; very low-certainty evidence). Psychological intervention combined with antidepressant medication Two studies compared the effect of a psychological intervention combined with antidepressants to antidepressants alone. One study combined psychodynamic therapy with tricyclic antidepressant (TCA) medication and another combined telephone-administered cognitive behavioural therapy (CBT) with a selective serotonin reuptake inhibitor (SSRI). We are uncertain if this intervention reduces the number of sickness absence days (SMD -0.38, 95% CI -0.99 to 0.24; 2 studies, very low-certainty evidence) but found that there may be no effect on depressive symptoms (SMD -0.19, 95% CI -0.50 to 0.12; 2 studies, low-certainty evidence). Antidepressant medication only Three studies compared the effectiveness of SSRI to selective norepinephrine reuptake inhibitor (SNRI) medication on reducing sickness absence and yielded highly inconsistent results. Improved care Overall, interventions to improve care did not lead to fewer days of sickness absence, compared to care as usual (SMD -0.05, 95% CI -0.16 to 0.06; 7 studies, moderate-certainty evidence). However, in studies with a low risk of bias, the intervention probably leads to fewer days of sickness absence in the first year of follow-up (SMD -0.20, 95% CI -0.35 to -0.05; 2 studies; moderate-certainty evidence). Improved care probably leads to fewer depressive symptoms (SMD -0.21, 95% CI -0.35 to -0.07; 7 studies, moderate-certainty evidence) but may possibly lead to a decrease in work-functioning (SMD 0.5, 95% CI 0.34 to 0.66; 1 study; moderate-certainty evidence). Exercise Supervised strength exercise may reduce sickness absence, compared to relaxation (SMD -1.11; 95% CI -1.68 to -0.54; one study, low-certainty evidence). However, aerobic exercise probably is not more effective than relaxation or stretching (SMD -0.06; 95% CI -0.36 to 0.24; 2 studies, moderate-certainty evidence). Both studies found no differences between the two conditions in depressive symptoms. AUTHORS' CONCLUSIONS: A combination of a work-directed intervention and a clinical intervention probably reduces the number of sickness absence days, but at the end of one year or longer follow-up, this does not lead to more people in the intervention group being at work. The intervention may also reduce depressive symptoms and probably increases work functioning more than care as usual. Specific work-directed interventions may not be more effective than usual work-directed care alone. Psychological interventions may reduce the number of sickness absence days, compared with care as usual. Interventions to improve clinical care probably lead to lower sickness absence and lower levels of depression, compared with care as usual. There was no evidence of a difference in effect on sickness absence of one antidepressant medication compared to another. Further research is needed to assess which combination of work-directed and clinical interventions works best.


Asunto(s)
Absentismo , Depresión/terapia , Trastorno Depresivo Mayor/terapia , Salud Laboral , Reinserción al Trabajo/psicología , Adulto , Antidepresivos/uso terapéutico , Sesgo , Terapia Cognitivo-Conductual , Humanos , Ejercicios de Estiramiento Muscular , Ensayos Clínicos Controlados Aleatorios como Asunto , Ausencia por Enfermedad , Rendimiento Laboral
17.
N Engl J Med ; 383(20): 1907-1919, 2020 11 12.
Artículo en Inglés | MEDLINE | ID: mdl-33017106

RESUMEN

BACKGROUND: Antibiotic therapy has been proposed as an alternative to surgery for the treatment of appendicitis. METHODS: We conducted a pragmatic, nonblinded, noninferiority, randomized trial comparing antibiotic therapy (10-day course) with appendectomy in patients with appendicitis at 25 U.S. centers. The primary outcome was 30-day health status, as assessed with the European Quality of Life-5 Dimensions (EQ-5D) questionnaire (scores range from 0 to 1, with higher scores indicating better health status; noninferiority margin, 0.05 points). Secondary outcomes included appendectomy in the antibiotics group and complications through 90 days; analyses were prespecified in subgroups defined according to the presence or absence of an appendicolith. RESULTS: In total, 1552 adults (414 with an appendicolith) underwent randomization; 776 were assigned to receive antibiotics (47% of whom were not hospitalized for the index treatment) and 776 to undergo appendectomy (96% of whom underwent a laparoscopic procedure). Antibiotics were noninferior to appendectomy on the basis of 30-day EQ-5D scores (mean difference, 0.01 points; 95% confidence interval [CI], -0.001 to 0.03). In the antibiotics group, 29% had undergone appendectomy by 90 days, including 41% of those with an appendicolith and 25% of those without an appendicolith. Complications were more common in the antibiotics group than in the appendectomy group (8.1 vs. 3.5 per 100 participants; rate ratio, 2.28; 95% CI, 1.30 to 3.98); the higher rate in the antibiotics group could be attributed to those with an appendicolith (20.2 vs. 3.6 per 100 participants; rate ratio, 5.69; 95% CI, 2.11 to 15.38) and not to those without an appendicolith (3.7 vs. 3.5 per 100 participants; rate ratio, 1.05; 95% CI, 0.45 to 2.43). The rate of serious adverse events was 4.0 per 100 participants in the antibiotics group and 3.0 per 100 participants in the appendectomy group (rate ratio, 1.29; 95% CI, 0.67 to 2.50). CONCLUSIONS: For the treatment of appendicitis, antibiotics were noninferior to appendectomy on the basis of results of a standard health-status measure. In the antibiotics group, nearly 3 in 10 participants had undergone appendectomy by 90 days. Participants with an appendicolith were at a higher risk for appendectomy and for complications than those without an appendicolith. (Funded by the Patient-Centered Outcomes Research Institute; CODA ClinicalTrials.gov number, NCT02800785.).


Asunto(s)
Antibacterianos/uso terapéutico , Apendicectomía , Apendicitis/tratamiento farmacológico , Apendicitis/cirugía , Apéndice/cirugía , Absentismo , Administración Intravenosa , Adulto , Antibacterianos/efectos adversos , Apendicectomía/estadística & datos numéricos , Apendicitis/complicaciones , Apéndice/patología , Impactación Fecal , Femenino , Estado de Salud , Hospitalización/estadística & datos numéricos , Humanos , Laparoscopía , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología , Calidad de Vida , Encuestas y Cuestionarios , Resultado del Tratamiento
18.
PLoS One ; 15(10): e0241030, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33108381

RESUMEN

BACKGROUND/OBJECTIVES: To analyze mortality, costs, residents and personnel characteristics, in six long-term care facilities (LTCF) during the outbreak of COVID-19 in Spain. DESIGN: Epidemiological study. SETTING: Six open LTCFs in Albacete (Spain). PARTICIPANTS: 198 residents and 190 workers from LTCF A were included, between 2020 March 6 and April 5. Epidemiological data were also collected from six LTCFs of Albacete for the same period of time, including 1,084 residents. MEASUREMENTS: Baseline demographic, clinical, functional, cognitive and nutritional variables were collected. 1-month and 3-month mortality was determined, excess mortality was calculated, and costs associated with the pandemics were analyzed. RESULTS: The pooled mortality rate for the first month and first three months of the outbreak were 15.3% and 28.0%, and the pooled excess mortality for these periods were 564% and 315% respectively. In facility A, the percentage of probable COVID-19 infected residents were 33.6%. Probable infected patients were older, frail, and with a worse functional situation than those without COVID-19. The most common symptoms were fever, cough and dyspnea. 25 residents were transferred to the emergency department, 21 were hospitalized, and 54 were moved to the facility medical unit. Mortality was higher upon male older residents, with worse functionality, and higher comorbidity. During the first month of the outbreak, 65 (24.6%) workers leaved, mainly with COVID-19 symptoms, and 69 new workers were contracted. The mean number of days of leave was 19.2. Costs associated with the COVID-19 in facility A were estimated at € 276,281/month, mostly caused by resident hospitalizations, leaves of workers, staff replacement, and interventions of healthcare professionals. CONCLUSION: The COVID-19 pandemic posed residents at high mortality risk, mainly in those older, frail and with worse functional status. Personal and economic costs were high.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Instituciones de Salud/estadística & datos numéricos , Cuidados a Largo Plazo , Pandemias , Neumonía Viral/epidemiología , Absentismo , Anciano , Anciano de 80 o más Años , Comorbilidad , Infecciones por Coronavirus/economía , Costo de Enfermedad , Infección Hospitalaria/economía , Infección Hospitalaria/epidemiología , Anciano Frágil , Instituciones de Salud/economía , Personal de Salud/estadística & datos numéricos , Mortalidad Hospitalaria , Hospitalización/economía , Humanos , Cuidados a Largo Plazo/economía , Masculino , Mortalidad , Enfermedades Profesionales/epidemiología , Pandemias/economía , Neumonía Viral/economía , España/epidemiología
19.
Emergencias (Sant Vicenç dels Horts) ; 32(5): 320-331, oct. 2020. mapas, graf, tab
Artículo en Español | IBECS | ID: ibc-197083

RESUMEN

OBJETIVO: Estimar el impacto del brote pandémico de COVID-19 en diversos aspectos organizativos de los servicios de urgencias hospitalarios (SUH) españoles e investigar si difirió en función de la comunidad autónoma, tamaño del hospital e incidencia local de la pandemia. MÉTODO: Encuesta a los responsables de los 283 SUH españoles de uso público, quienes valoraron el impacto de la pandemia en aspectos organizativos, disponibilidad de recursos, y bajas del personal durante marzo-abril de 2020, diferenciando dicho impacto por quincenas. Los resultados se analizaron en conjunto, por comunidad autónoma, según tamaño del hospital y según incidencia local de la pandemia. RESULTADOS: Se recibieron 246 encuestas (87% de los SUH españoles). La mayoría de SUH reorganizaron el triaje, primera asistencia y observación y habilitó nuevos espacios específicos para pacientes con sospecha de COVID-19. Un 83% aumentó dotación enfermera (sin diferencias entre grupos) y un 59% la dotación de médicos (más frecuente en hospitales grandes y zonas de alta incidencia). El recurso que más escaseó fue el test diagnóstico de SARS-CoV-2 (55% del tiempo insuficiente con cierta o mucha frecuencia), seguido de mascarillas FPP2-FPP3 (38%), batas impermeables (34%) y espacio asistencial (32%). Hubo más del 5% de médicos/enfermería/otro personal de baja el 20%/19%/16% del tiempo. Estos déficits fueron máximos la segunda quincena de marzo, excepto para los test diagnósticos (primera quincena de marzo). Los SUH de grandes centros tuvieron menos escasez de tests diagnósticos, y los de zonas de alta incidencia pandémica más profesionales de baja. Existieron marcadas diferencias en todas estos déficits entre comunidades autónomas, no siempre concordantes con el grado de afectación pandémica en cada comunidad. CONCLUSIONES: La pandemia COVID-19 generó cambios estructurales en los SUH, que sufrieron una escasez considerable en ciertos recursos, con diferencias marcadas entre comunidades autónomas


OBJECTIVE: To estimate the impact of the coronavirus disease 2019 (COVID-19) pandemic on the organization of Spanish hospital emergency departments (EDs). To explore differences between Spanish autonomous communities or according to hospital size and disease incidence in the area. METHODS: Survey of the heads of 283 EDs in hospitals belonging to or affiliated with Spain's public health service. Respondents evaluated the pandemic's impact on organization, resources, and staff absence from work in March and April 2020. Assessments were for 15-day periods. Results were analyzed overall and by autonomous community, hospital size, and local population incidence rates. RESULTS: A total of 246 (87%) responses were received. The majority of the EDs organized a triage system, first aid, and observation wards; areas specifically for patients suspected of having COVID-19 were newly set apart. The nursing staff was increased in 83% of the EDs (with no subgroup differences), and 59% increased the number of physicians (especially in large hospitals and locations where the COVID-19 incidence was high). Diagnostic tests for the severe acute respiratory syndrome coronavirus 2 were the resource the EDs missed most: 55% reported that tests were scarce often or very often. Other resources reported to be scarce were FPP2 and FPP3 masks (38% of the EDs), waterproof protective gowns (34%), and space (32%). More than 5% of the physicians, nurses, or other emergency staff were on sick leave 20%, 19%, and 16% of the time. These deficiencies were greatest during the last half of March, except for tests, which were most scarce in the first 15 days. Large hospital EDs less often reported that diagnostic tests were unavailable. In areas where the COVID-19 incidence was higher, the EDs reported higher rates of staff on sick leave. Resource scarcity differed markedly by autonomous community and was not always associated with the incidence of COVID-19 in the population. CONCLUSIONS: The COVID-19 pandemic led to organizational changes in EDs. Certain resources became scarce, and marked differences between autonomous communities were detected


Asunto(s)
Humanos , Adulto , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Servicios Médicos de Urgencia/estadística & datos numéricos , Encuestas de Atención de la Salud , Pandemias , Absentismo , Infecciones por Coronavirus/diagnóstico , Neumonía Viral/diagnóstico , Servicios Médicos de Urgencia/organización & administración , Brotes de Enfermedades , Necesidades y Demandas de Servicios de Salud , Personal de Hospital , España/epidemiología , Triaje/organización & administración , Fuerza Laboral en Salud
20.
An. psicol ; 36(3): 503-511, oct. 2020. tab, graf
Artículo en Español | IBECS | ID: ibc-195667

RESUMEN

El propósito de esta investigación es analizar las relaciones entre las condiciones de contratación y el absentismo laboral en una muestra de 5524 trabajadores, con el fin de identificar qué segmentos (por tipo de contrato y jornada, tiempo contratado, antigüedad en la empresa y bajas por enfermedad común ocurridas en los tres últimos años) están más relacionados con la posibilidad de sufrir un proceso de incapacidad temporal en el año 2017. Se realizaron análisis descriptivos, la prueba chi-cuadrado Para tablas de contingencia con dos muestras independientes y los árboles de decisión, basados en el algoritmo CHAID (Chi-squared Automatic Interaction Detection), para detectar las variables más importantes en la identificación de perfiles con una mayor probabilidad de sufrir una incapacidad temporal derivada de contingencias comunes. Los resultados ponen de manifiesto la existencia de diferencias entre las variables estudiadas. Se considera la modalidad de contratación un factor de riesgo importante del absentismo laboral


The purpose of this research is to analyze the relationship between hiring conditions and work absenteeism in a sample of 5.524 workers in order to identify which segments (by type of contract and workday, time hired, seniority in the company and sick leaves occurred in the last three years) are more related to the possibility of suffering a disease process in 2017. Descriptive analyzes, the chi-square test for contingency tables with two independent samples, and the decision trees based on the CHAID algorithm (Chi-squared Automatic Interaction Detection) were carried out to detect the most important variables in the identification of profiles with a greater probability of suffering a temporary disability. The results show the existence of differences between the variables studied. The hiring modality is considered an important risk factor for work absenteeism


Asunto(s)
Humanos , Masculino , Femenino , Absentismo , Condiciones de Trabajo , Contratos , Carga de Trabajo/psicología , Factores de Tiempo , Curva ROC , Factores de Riesgo , Distribución de Chi-Cuadrado , Enfermedades Profesionales , Ausencia por Enfermedad/estadística & datos numéricos , Árboles de Decisión
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