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1.
Rio de Janeiro; s.n; 20200100. 60 p. ilus, tab, graf.
Monografía en Portugués | Coleciona SUS | ID: biblio-1049879

RESUMEN

A Ergonomia busca o ajuste mútuo entre o homem e seu ambiente de trabalho de forma confortável, produtiva e segura. Em relação à saúde do trabalhador, a desatenção com a Ergonomia, implica em maior afastamento por licença médica gerando custos por parte das Empresas e Instituições. Dito isto, durante a visita técnica ao setor de internação do Instituto Nacional de Câncer- Unidade III foi observada situações de trabalho causadoras de desconforto e fadiga relacionadas à organização do trabalho, ao ritmo e a produtividade. O estudo do absenteísmo revelou que os profissionais de enfermagem (enfermeiros e técnicos de enfermagem) eram os mais acometidos por doenças osteomusculares e distúrbios psicossociais. Diante desta constatação, houve a necessidade de realizar a Análise Ergonômica do Trabalho e a aplicação de questionário estruturado e distribuído à equipe de enfermagem para que externassem suas percepções quanto ao ambiente de trabalho. Em seguida, foram entrevistados os mesmos profissionais, tendo sido convidados de forma aleatória dois trabalhadores por função. Posteriormente, foi utilizado o método REBA (Rapid Entire Body Assessment) para analisar o conjunto das posições adotadas pelos membros superiores, tronco, coluna cervical e pernas. Por se tratar de uma Instituição de tratamento de pacientes oncológicos, os fatores organizacionais e psicossociais/cognitivos foram os mais prevalentes. Além disso, ficou evidente que, a alta demanda de trabalho com a exigência de concentração e atenção, associada à constante necessidade de tomada de decisão, impõe um ritmo acelerado e estressante para os trabalhadores. A complexidade do conteúdo das tarefas e a incorporação de novos tratamentos e tecnologias, também exigem aperfeiçoamento e treinamento constantes. Os fatores relacionados à Ergonomia Física e Ambiental, embora tenham sido menos valorizados, foram estudados através do método REBA, que avalia os riscos relacionados ao sistema musculoesquelético. Esse método apontou a necessidade de intervenção no ambiente de trabalho ao receber a pontuação cinco, o que significa risco médio de adoecimento por doenças osteomusculares. Assim sendo, será elaborado um plano de ação com propostas de melhorias a serem implantadas a curto, médio e longo prazo que contemple orientações sobre a necessidade de mudança de normas, métodos e processos de trabalho.(AU)


Ergonomics pursues the mutual matching between man and his work environment in a comfortable, productive and safe manner. In terms of labor health, disregarding ergonomics implies a greater absence due to sick leave, generating costs on the part of companies and institutions. That said, during a technical visit to the hospitalization sector of the National Institute of Cancer - Unit III, workplace situations causing discomfort and fatigue related to work organization, rhythm and productivity were observed. The absenteeism study revealed that nursing professionals (nurses and nursing technicians) were the professionals the most affected by musculoskeletal and psychosocial disorders. Given this finding, it was necessary to perform the Ergonomic Work Analysis and the application of a structured questionnaire to the nursing team to allow them to express their perceptions about the work environment. Subsequently, the professionals were interviewed by randomly inviting two workers per function. Afterward, the REBA (Rapid Entire Body Assessment), was used to analyze the set of positions performed by the upper limbs, trunk, cervical spine and legs. Since it is an institution for cancer treatment, the organizational and psychosocial/cognitive factors were the most prevalent. Moreover, the high work demand, with concentration and attention requirements, associated with the constant need for decision making impose a fast imposes a fast and stressful pace for workers. The tasks complexity and the incorporation of new treatments and technologies also require continuous professional improvement and training. Factors related to Physical and Environmental Ergonomics, although less valued, were studied through the REBA method, which assesses the risks related to the musculoskeletal system. This method pointed to the need for intervention in the workplace after receiving a score of five, translating an average risk of getting sick with musculoskeletal diseases. Therefore, an action plan will be prepared with improvement proposals to be implemented in short, medium and long terms, and that will provide guidance on the need of modifying norms, methods and work processes.


Asunto(s)
Humanos , Masculino , Femenino , Ergonomía , Riesgos Laborales , Salud Laboral , Absentismo , Enfermeras Practicantes
2.
MMWR Morb Mortal Wkly Rep ; 68(53): 1201-1205, 2020 Jan 17.
Artículo en Inglés | MEDLINE | ID: mdl-31945036

RESUMEN

Control of communicable diseases in children, including respiratory and diarrheal illnesses that affect U.S. school-aged children, might require public health preventive efforts both in the home and at school, a primary setting for transmission. National Health Interview Survey (NHIS) data on school absenteeism and gastrointestinal and respiratory illnesses in the United States during 2010-2016 were analyzed to examine their associations with income. Prevalence of gastrointestinal and respiratory illnesses (queried for the 2 weeks preceding the survey) increased as income decreased. The likelihood of missing any school days during the past year decreased with reduced income. However, among children who missed school, those from low-income households missed more days of school than did children from higher income households. Although the reason for absenteeism cannot be ascertained from this analysis, these data underscore the importance of preventive measures (e.g. hand hygiene promotion and education) and the opportunity for both homes and schools to serve as important points for implementation of public health preventive measures, including improved hand hygiene practices.


Asunto(s)
Absentismo , Enfermedades Gastrointestinales/epidemiología , Renta/estadística & datos numéricos , Infecciones del Sistema Respiratorio/epidemiología , Instituciones Académicas , Adolescente , Niño , Preescolar , Femenino , Humanos , Masculino , Estados Unidos/epidemiología
3.
BMC Public Health ; 19(1): 1418, 2019 Oct 30.
Artículo en Inglés | MEDLINE | ID: mdl-31666045

RESUMEN

BACKGROUND: Early exit from paid employment is a notable public health and societal challenge. Previous research has largely focused on the relationships among variables instead of the relationships among individuals with different work participation history. Person-oriented methods enable to identify latent groups of individuals who are likely to follow similar development in their work participation over time. We thus aimed to identify work participation trajectories during early and midlife careers and their social determinants using large nationally representative data comprising over 1 million initially employed individuals and a 10-year follow-up for their work participation. A further aim was to determine the cumulative incidence of sickness absence due to key diagnostic groups, mental disorders and musculoskeletal diseases within the trajectories. METHODS: Young (25-38 years at baseline, n = 495,663) and midlife (39-52 years at baseline, n = 603,085) Finnish people, all working in 2004, were followed up through 2013, with registers of the Social Insurance Institution, and the Statistics Finland. The registers provided data for work participation and its determinants, as well as for computing the cumulative incidence of sickness absence. Latent class growth analysis was used to identify trajectories. RESULTS: Three distinctive trajectories were identified: temporary exit, permanent exit, and continuously employed people. As compared to the other trajectories, those belonging to the permanent exit trajectory were more likely men, manual workers and had a lower income. The cumulative incidence of sickness absence due to mental disorders was highest in the permanent exit trajectory group. For musculoskeletal diseases, the cumulative incidence of sickness absence increased in the permanent exit trajectory mainly in the older age groups. CONCLUSION: Distinct group-based trajectories of early work exit can be identified in a representative cohort of initially employed people. Focusing on the determinants of premature exit and early intervention to tackle increasing sickness absence may promote work participation particularly in the most vulnerable groups.


Asunto(s)
Absentismo , Empleo , Renta , Trastornos Mentales/epidemiología , Enfermedades Musculoesqueléticas/epidemiología , Ocupaciones , Ausencia por Enfermedad , Factores de Edad , Anciano , Estudios de Cohortes , Empleo/estadística & datos numéricos , Femenino , Finlandia/epidemiología , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Ocupaciones/estadística & datos numéricos , Factores Sexuales , Ausencia por Enfermedad/estadística & datos numéricos , Desempleo
4.
BMC Neurol ; 19(1): 258, 2019 Oct 28.
Artículo en Inglés | MEDLINE | ID: mdl-31660897

RESUMEN

BACKGROUND: Multiple sclerosis (MS) is prevalent among working age individuals (20-60 years), leading to high burden on work productivity. Few data are available about the absenteeism and presenteeism in employed individuals with MS in comparison to non-MS personnel. This study aimed to quantify the burden of illness of employed US adults with relapsing-remitting multiple sclerosis (RRMS) and examine burden by levels of work impairment. METHODS: A retrospective cross-sectional analysis was conducted using patient-reported responses from the US National Health and Wellness Survey (NHWS). Data from NHWS 2015-2016 were analyzed from 196 employed RRMS respondents who were matched 1:4 to employed respondents without MS based on demographic and general health characteristics. Demographic and general health characteristics for employed RRMS individuals were analyzed by levels of work impairment (none, 1-30%; 31-68%; 69-100%). Work productivity (absenteeism, presenteeism, and work impairment), decrements in health-related quality of life (HRQoL) (short form-36, EQ-5D), and healthcare resource utilization (HCRU) were compared to determine the burden of RRMS. RESULTS: After propensity score matching, the levels of absenteeism and presenteeism were 2 and 1.8 times higher in the employed RRMS population than the employed non-MS population, respectively (P < 0.001 for both). HRQoL was significantly lower in employed respondents with RRMS than those without MS (P < 0.001 for all). Employed respondents with RRMS had significantly more HCRU over 6 months compared to those without MS (P < 0.001). Furthermore, among employed RRMS respondents, greater levels of impairment were associated with increasing disease severity, greater healthcare resource use, fatigue, and cognitive impairment and inversely associated with mental and physical HRQoL (P < 0.0001 for all). CONCLUSIONS: Among employed individuals, respondents with RRMS had lower, work productivity, HRQoL, and higher HCRU as compared with those without MS. Given the large impact RRMS has on work impairment, a need exists to manage individuals on therapies that improve HRQoL, reduce symptoms, and improve their ability to perform in the workforce.


Asunto(s)
Absentismo , Costo de Enfermedad , Esclerosis Múltiple Recurrente-Remitente , Aceptación de la Atención de Salud/estadística & datos numéricos , Adulto , Estudios Transversales , Empleo/estadística & datos numéricos , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Esclerosis Múltiple Recurrente-Remitente/complicaciones , Calidad de Vida/psicología , Estudios Retrospectivos , Estados Unidos
5.
Artículo en Inglés | MEDLINE | ID: mdl-31505862

RESUMEN

This study examines the association between school absenteeism, health-related quality of life (HRQOL) and happiness among young adults aged 16-26 years attending vocational education. Cross-sectional data from a survey among 676 young adults were analyzed. School absenteeism was measured by the self-reported number of sick days in the past eight weeks and hours of truancy in the past four weeks. HRQOL was measured by the 12-item Short Form Health Survey; physical and mental component summary scores were calculated. General happiness was assessed on a scale of 0-10, higher scores indicating greater happiness. Linear regression analyses were performed. The study population had a mean age of 18.5 years (SD 2.2); 26.1% were boys. Young adults with ≥5 sick days or ≥6 h of truancy reported lower mental HRQOL compared to young adults without sickness absence or truancy (p < 0.05). Young adults with 1-4 and ≥5 sick days reported lower physical HRQOL compared to young adults who had not reported to be sick (p < 0.05). Young adults with 1-5 h and ≥6 h of truancy reported higher physical HRQOL compared to young adults who were not truant (p < 0.05). No associations were observed between school absence and happiness. Lower self-reported mental HRQOL was observed among young adults with more school absenteeism due to sickness or truancy. Sickness absence was additionally associated with lower physical HRQOL.


Asunto(s)
Absentismo , Felicidad , Calidad de Vida , Instituciones Académicas/estadística & datos numéricos , Adolescente , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Países Bajos , Autoinforme , Adulto Joven
6.
Cochrane Database Syst Rev ; 9: CD010905, 2019 09 25.
Artículo en Inglés | MEDLINE | ID: mdl-31560414

RESUMEN

BACKGROUND: Many workers suffer from work-related stress and are at increased risk of work-related cardiovascular, musculoskeletal, or mental disorders. In the European Union the prevalence of work-related stress was estimated at about 22%. There is consensus that stress, absenteeism, and well-being of employees can be influenced by leadership behaviour. Existing reviews predominantly included cross-sectional and non-experimental studies, which have limited informative value in deducing causal relationships between leadership interventions and health outcomes. OBJECTIVES: To assess the effect of four types of human resource management (HRM) training for supervisors on employees' psychomental stress, absenteeism, and well-being. We included training aimed at improving supervisor-employee interaction, either off-the-job or on-the-job training, and training aimed at improving supervisors' capability of designing the work environment, either off-the-job or on-the-job training. SEARCH METHODS: In May 2019 we searched CENTRAL, MEDLINE, four other databases, and most relevant trials registers (ICTRP, TroPHI, ClinicalTrials.gov). We did not impose any language restrictions on the searches. SELECTION CRITERIA: We included randomised controlled trials (RCT), cluster-randomised controlled trials (cRCT), and controlled before-after studies (CBA) with at least two intervention and control sites, which examined the effects of supervisor training on psychomental stress, absenteeism, and well-being of employees within natural settings of organisations by means of validated measures. DATA COLLECTION AND ANALYSIS: At least two authors independently screened abstracts and full texts, extracted data and assessed the risk of bias of included studies. We analysed study data from intervention and control groups with respect to different comparisons, outcomes, follow-up time, study designs, and intervention types. We pooled study results by use of standardised mean differences (SMD) with 95% confidence intervals when possible. We assessed the quality of evidence for each outcome using the GRADE approach. MAIN RESULTS: We included 25 studies of which 4 are awaiting assessment. The 21 studies that could be analysed were 1 RCT, 14 cRCTs and 6 CBAs with a total of at least 3479 employees in intervention and control groups. We judged 12 studies to have an unclear risk of bias and the remaining nine studies to have a high risk of bias. Sixteen studies focused on improving supervisor-employee interaction, whereas five studies aimed at improving the design of working environments by means of supervisor training.Training versus no interventionWe found very low-quality evidence that supervisor training does not reduce employees' stress levels (6 studies) or absenteeism (1 study) when compared to no intervention, regardless of intervention type or follow-up. We found inconsistent, very low-quality evidence that supervisor training aimed at employee interaction may (2 studies) or may not (7 studies) improve employees' well-being when compared to no intervention. Effects from two studies were not estimable due to missing data.Training versus placeboWe found moderate-quality evidence (2 studies) that supervisor training off the job aimed at employee interaction does not reduce employees' stress levels more than a placebo training at mid-term follow-up. We found low-quality evidence in one study that supervisor training on the job aimed at employee interaction does not reduce employees' absenteeism more than placebo training at long-term follow-up. Effects from one study were not estimable due to insufficient data.Training versus other trainingOne study compared the effects of supervisor training off the job aimed at employee interaction on employees' stress levels to training off the job aimed at working conditions at long-term follow-up but due to insufficient data, effects were not estimable. AUTHORS' CONCLUSIONS: Based on a small and heterogeneous sample of controlled intervention studies and in contrast to prevailing consensus that supervisor behaviour influences employees' health and well-being, we found inconsistent evidence that supervisor training may or may not improve employees' well-being when compared to no intervention. For all other types of interventions and outcomes, there was no evidence of a considerable effect. However, due to the very low- to moderate-quality of the evidence base, clear conclusions are currently unwarranted. Well-designed studies are needed to clarify effects of supervisor training on employees' stress, absenteeism, and well-being.


Asunto(s)
Agotamiento Profesional , Liderazgo , Salud Laboral , Administración de Personal , Estrés Psicológico , Absentismo , Promoción de la Salud/métodos , Humanos , Trastornos Mentales , Ensayos Clínicos Controlados Aleatorios como Asunto , Recursos Humanos , Lugar de Trabajo
7.
BMC Health Serv Res ; 19(1): 660, 2019 09 11.
Artículo en Inglés | MEDLINE | ID: mdl-31511004

RESUMEN

BACKGROUND: Healthcare worker absenteeism is common in resource limited settings and contributes to poor quality of care in maternal and child health service delivery. There is a dearth of qualitative information on the scope, contributing factors, and impact of absenteeism in Kenyan healthcare facilities. METHODS: In-depth semi-structured interviews were conducted between July 2015 and June 2016 with 20 healthcare providers in public and private healthcare facilities in Central and Western Kenya. Interviews were audio-recorded, transcribed, coded, and analyzed using an iterative thematic approach. RESULTS: Half of providers reported that absenteeism occurs in both private and public health facilities. Absenteeism was most commonly characterized by providers arriving late or leaving early during scheduled work hours. The practice was attributed to institutional issues including: infrequent supervision, lack of professional consequences, limited accountability, and low wages. In some cases, healthcare workers were frequently absent because they held multiple positions at different health facilities. Provider absences result in increased patient wait times and may deter patients from seeking healthcare in the future. CONCLUSION: There is a significant need for policies and programs to reduce provider absenteeism in Kenya. Intervention approaches must be cognizant of the contributors to absenteeism which occur at the institutional level.


Asunto(s)
Absentismo , Instituciones de Salud/estadística & datos numéricos , Personal de Salud/organización & administración , Accesibilidad a los Servicios de Salud/organización & administración , Humanos , Kenia/epidemiología , Admisión y Programación de Personal , Investigación Cualitativa , Salarios y Beneficios
8.
BMC Public Health ; 19(1): 1232, 2019 Sep 05.
Artículo en Inglés | MEDLINE | ID: mdl-31488092

RESUMEN

BACKGROUND: School absenteeism data have been collected daily by the public health unit in Wellington-Dufferin-Guelph, Ontario since 2008. To date, a threshold-based approach has been implemented to raise alerts for community-wide and within-school illness outbreaks. We investigate several statistical modelling approaches to using school absenteeism for influenza surveillance at the regional level, and compare their performances using two metrics. METHODS: Daily absenteeism percentages from elementary and secondary schools, and report dates for influenza cases, were obtained from Wellington-Dufferin-Guelph Public Health. Several absenteeism data aggregations were explored, including using the average across all schools or only using schools of one type. A 10% absence threshold, exponentially weighted moving average model, logistic regression with and without seasonality terms, day of week indicators, and random intercepts for school year, and generalized estimating equations were used as epidemic detection methods for seasonal influenza. In the regression models, absenteeism data with various lags were used as predictor variables, and missing values in the datasets used for parameter estimation were handled either by deletion or linear interpolation. The epidemic detection methods were compared using a false alarm rate (FAR) as well as a metric for alarm timeliness. RESULTS: All model-based epidemic detection methods were found to decrease the FAR when compared to the 10% absence threshold. Regression models outperformed the exponentially weighted moving average model and including seasonality terms and a random intercept for school year generally resulted in fewer false alarms. The best-performing model, a seasonal logistic regression model with random intercept for school year and a day of week indicator where parameters were estimated using absenteeism data that had missing values linearly interpolated, produced a FAR of 0.299, compared to the pre-existing threshold method which at best gave a FAR of 0.827. CONCLUSIONS: School absenteeism can be a useful tool for alerting public health to upcoming influenza epidemics in Wellington-Dufferin-Guelph. Logistic regression with seasonality terms and a random intercept for school year was effective at maximizing true alarms while minimizing false alarms on historical data from this region.


Asunto(s)
Absentismo , Epidemias , Gripe Humana/epidemiología , Vigilancia de la Población/métodos , Instituciones Académicas , Adolescente , Niño , Humanos , Ontario/epidemiología , Estaciones del Año
9.
Pediatrics ; 144(4)2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31501238

RESUMEN

BACKGROUND AND OBJECTIVES: Fifteen percent of US children live in households with inadequate food. Children who are food insecure often experience worse physical, emotional, and developmental health outcomes. Authors of previous studies have not examined the quality and cost implications of food insecurity in children. METHODS: This is a retrospective study of 7959 nationally representative US children (aged 1-17 years) in the 2016 Medical Expenditure Panel Survey. Households with food insecurity were identified by ≥3 positive responses to the 30-day, 10-item US Food Security Survey. Main outcomes were annual health expenditures and quality of care indicators: emergency department (ED) and inpatient use, primary care and specialist visits, routine medical and dental care, patient experience measures, and school absenteeism. Logistic and 2-part regression models were constructed to estimate outcomes conditional on sociodemographic and medical covariates. RESULTS: Children in households with food insecurity were more often publicly insured and had special needs compared with all other children. In multivariable logistic regression, household food insecurity was associated with significantly higher adjusted odds of an ED (adjusted odds ratio [aOR] = 1.37) or primary care treatment visit (aOR = 1.24) during the year. Household food insecurity was associated with significantly higher school absenteeism (aOR = 1.74) and lower access to care for routine (aOR = 0.55) or illness (aOR = 0.57) care. There were no differences in annual health expenditures, hospitalizations, or receipt of routine medical or dental care. CONCLUSIONS: Household food insecurity is associated with higher ED use and school absenteeism and lower access to care; however, it was not associated with higher annual health expenditures in children.


Asunto(s)
Abastecimiento de Alimentos/estadística & datos numéricos , Necesidades y Demandas de Servicios de Salud/estadística & datos numéricos , Atención Primaria de Salud/estadística & datos numéricos , Absentismo , Adolescente , Niño , Preescolar , Atención Dental para Niños/estadística & datos numéricos , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Abastecimiento de Alimentos/economía , Gastos en Salud , Necesidades y Demandas de Servicios de Salud/economía , Hospitalización/estadística & datos numéricos , Humanos , Lactante , Modelos Logísticos , Masculino , Oportunidad Relativa , Atención Primaria de Salud/economía , Indicadores de Calidad de la Atención de Salud , Estudios Retrospectivos , Instituciones Académicas/estadística & datos numéricos , Estados Unidos
10.
PLoS Med ; 16(8): e1002898, 2019 08.
Artículo en Inglés | MEDLINE | ID: mdl-31419219

RESUMEN

BACKGROUND: Occupational medicine seeks to reduce sick leave; however, evidence for an add-on effect to usual care is sparse. The objective of the GOBACK trial was to test whether people with low back pain (LBP) in physically demanding jobs and at risk of sick leave gain additional benefit from a 3-month complex intervention that involves occupational medicine consultations, a work-related evaluation and workplace intervention plan, an optional workplace visit, and a physical activity program, over a single hospital consultation and an MRI. METHODS AND FINDINGS: We enrolled people from the capital region of Denmark to an open-label, parallel-group randomized controlled trial with a superiority design from March 2014 through December 2015. In a hospital setting 305 participants (99 women) with LBP and in physically demanding jobs were randomized to occupational intervention (n = 153) or no additional intervention (control group; n = 152) added to a single hospital consultation giving a thorough explanation of the pain (i.e., clinical examination and MRI) and instructions to stay active and continue working. Primary outcome was accumulated sick leave days due to LBP during 6 months. Secondary outcomes were changes in neuropathic pain (painDETECT questionnaire [PDQ]), pain 0-10 numerical rating scale (NRS), Fear-Avoidance Beliefs Questionnaire (FABQ), Roland-Morris Disability Questionnaire (RMDQ), Short Form Health Survey (SF-36) for physical and mental health-related quality of life (HRQoL), and self-assessed ability to continue working (range 0-10). An intention-to-treat analysis of sick leave at 6 months showed no significant difference between groups (mean difference in days suggestively in favor of no additional intervention: 3.50 [95% CI -5.08 to 12.07], P = 0.42). Both groups showed significant improvements in average pain score (NRS), disability (RMDQ), fear-avoidance beliefs about physical activities and work (FABQ), and physical HRQoL (SF-36 physical component summary); there were no significant differences between the groups in any secondary outcome. There was no statistically significant improvement in neuropathic pain (PDQ score), mental HRQoL (SF-36 mental component summary), and self-assessed ability to stay in job. Four participants could not complete the MRI or the intervention due to a claustrophobic attack or accentuated back pain. Workplace visits may be an important element in the occupational intervention, although not always needed. A per-protocol analysis that included the 40 participants in the intervention arm who received a workplace visit as part of the additional occupational intervention did not show an add-on benefit in terms of sick leave (available cases after 6 months, mean difference: -0.43 days [95% CI -12.8 to 11.94], P = 0.945). The main limitations were the small number of sick leave days taken and that the comprehensive use of MRI may limit generalization of the findings to other settings, for example, general practice. CONCLUSIONS: When given a single hospital consultation and MRI, people in physically demanding jobs at risk of sick leave due to LBP did not benefit from a complex additional occupational intervention. Occupational interventions aimed at limiting biopsychological obstacles (e.g., fear-avoidance beliefs and behaviors), barriers in the workplace, and system barriers seem essential to reduce sick leave in patients with LBP. This study indicates that these obstacles and barriers may be addressed by thorough usual care. TRIAL REGISTRATION: Clinical Trials.gov: NCT02015572.


Asunto(s)
Dolor de la Región Lumbar/prevención & control , Enfermedades Profesionales/prevención & control , Absentismo , Femenino , Humanos , Dolor de la Región Lumbar/diagnóstico por imagen , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Medicina del Trabajo/métodos
11.
Artículo en Inglés | MEDLINE | ID: mdl-31426543

RESUMEN

The economic burden of rheumatoid arthritis (RA) on society is high. Disease-modifying antirheumatic drugs (DMARDs) are the cornerstone of therapy. Biological DMARDs are reported to prevent disability and improve quality of life, thus reducing indirect RA costs. We systematically reviewed studies on the relationship between RA and indirect costs comparing biological treatment with standard care. Studies, economic analyses, and systematic reviews published until October 2018 through a MEDLINE search were included. A total of 153 non-duplicate citations were identified, 92 (60%) were excluded as they did not meet pre-defined inclusion criteria. Sixty-one articles were included, 17 of them (28%) were reviews. After full-text review, 28 articles were included, 11 of them were reviews. Costs associated with productivity loss are substantial; in several cases, they may represent over 50% of the total. The most common method of estimation is the Human Capital method. However, certain heterogeneity is observed in the method of estimating, as well as in the resultant figures. Data from included trials indicate that biological therapy is associated with improved labor force participation despite an illness, in which the natural course of disease is defined by progressive work impairment. Use of biological DMARDs may lead to significant indirect cost benefits to society.


Asunto(s)
Antirreumáticos/economía , Antirreumáticos/uso terapéutico , Artritis Reumatoide/tratamiento farmacológico , Artritis Reumatoide/economía , Costo de Enfermedad , Absentismo , Humanos , Estudios Observacionales como Asunto , Presentismo , Ensayos Clínicos Controlados Aleatorios como Asunto
12.
J Pak Med Assoc ; 69(Suppl 2)(6): S57-S63, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31369535

RESUMEN

Objective: Eczema, a chronic dermatologic disease, has been recognized as an economic burden in publications all over the word but only minimally as such in Vietnam. The aim of this prospective study was to quantify the financial hardships and impairments suffered by eczema patients. Methods: This cross-sectional prevalence-based study involved 136 patients, whose conditions were classified into three severity levels on the basis of the medications that they were prescribed. Prescription therapy was administered for a month, after which there was patient-oriented assessment of effectiveness. The work productivity and activity impairment (WPAI) questionnaire was used to evaluate productivity loss, which was expressed in percentage form. Bootstrapping was conducted to determine continuous variables and demographybased differences in cost values among the patient groups. Results: For the month-long treatment, each eczema patient needed an average of US$68.1 (range: US$56.2- US$81.5) with the highest proportion being spent on cosmetic treatments. There is noticeable difference between groups among which patients' symptoms demonstrated in distinct levels. The estimates indicated that eczema resulted in 27.8% and 23.1% impairments in work and daily activities, respectively. Conclusions: The aggravation of disease symptoms can increase the direct costs borne by eczema patients. A decrease in productivity, which is one of the most serious consequences of the condition, should be paid adequate attention to minimize burdens to society.


Asunto(s)
Dermatitis Atópica/economía , Eficiencia , Rendimiento Laboral/economía , Absentismo , Corticoesteroides/economía , Corticoesteroides/uso terapéutico , Adulto , Anciano , Inhibidores de la Calcineurina/economía , Inhibidores de la Calcineurina/uso terapéutico , Cosméticos/economía , Cosméticos/uso terapéutico , Estudios Transversales , Dermatitis Atópica/terapia , Fármacos Dermatológicos/economía , Fármacos Dermatológicos/uso terapéutico , Suplementos Dietéticos/economía , Costos de los Medicamentos , Emolientes/economía , Emolientes/uso terapéutico , Femenino , Estudios de Seguimiento , Costos de la Atención en Salud , Antagonistas de los Receptores Histamínicos/economía , Antagonistas de los Receptores Histamínicos/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Cuidados de la Piel , Vietnam
13.
Int J Clin Pract ; 73(11): e13384, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31389146

RESUMEN

AIM: To evaluate the association of erectile dysfunction (ED) with work productivity loss, activity impairment and health-related quality of life (HRQoL) across Brazil, China, France, Germany, Italy, Spain, the UK and the US. METHODS: This cross-sectional observational study used data from adult men (40-70 years old; N = 52 697) from the 2015 and 2016 National Health and Wellness Surveys. ED assessment was based on self-reported difficulty in achieving or maintaining an erection in the past 6 months. Impairment to work and non-work activities and HRQoL were assessed for each country and compared against the US. Multivariable models tested interactions between ED status and country for each outcome. RESULTS: Overall ED prevalence was reported as 49.7%, with Italy reporting the highest rate (54.7%). Men with ED reported significantly higher absenteeism (7.1% vs 3.2%), presenteeism (22.5% vs 10.1%), overall work productivity impairment (24.8% vs 11.2%), activity impairment (28.6% vs 14.5%) and significantly lower Mental Component Summary scores (MCS; 46.7 vs 51.2), Physical Component Summary scores (PCS; 48.3 vs 53.0), and health state utilities (SF-6D: 0.693 vs 0.778; all, P < 0.001) than men with no ED. After adjusting for covariates, compared with the US, the association of ED status with overall work productivity impairment was greatest in the UK (26% higher; P < 0.05), and with MCS, PCS and SF-6D scores was greatest in China (-2.67, -1.58, and -0.043 points, respectively; all, P < 0.001). Greater ED severity was significantly associated with higher impairment to work and non-work activities and lower HRQoL, with China reporting the highest burden, compared with the US (most P < 0.05). CONCLUSION: ED poses a significant burden with respect to work productivity and HRQoL, with greater severity associated with worse outcomes. Better management and earlier detection may help reduce this burden, especially in countries reporting a strong association between ED and poor economic and health outcomes.


Asunto(s)
Absentismo , Disfunción Eréctil/epidemiología , Calidad de Vida/psicología , Adulto , Anciano , Brasil/epidemiología , China/epidemiología , Estudios Transversales , Femenino , Francia/epidemiología , Alemania/epidemiología , Encuestas Epidemiológicas , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Presentismo , Autoinforme , España/epidemiología
14.
Rev Lat Am Enfermagem ; 27: e3156, 2019 Jul 18.
Artículo en Portugués, Inglés, Español | MEDLINE | ID: mdl-31340344

RESUMEN

OBJECTIVE: to represent the dynamics of stress generation, accumulation and reduction in the nursing team at an oncology therapy center. METHOD: a mathematical simulation model of system dynamics was developed based on data collection in loco. The model served to test the impact of three policies aimed at reducing stress in the team, namely i) increase in the service load; ii) increase in the size of shift teams and iii) reduction of service hours per bed. RESULTS: the model showed that the policy of increasing the size of the team obtained the best results, with the absenteeism index stabilizing at 8%; staff at leave also stabilizing at 4-5 people per month, as well as accumulated stress reduced to baseline levels. CONCLUSION: measures to monitor physical and emotional demands, hiring staff, better technical training for so-called stressful activities, and a better distribution of tasks can be effective in reducing absenteeism rates and improving the quality of life of these workers.


Asunto(s)
Personal de Enfermería en Hospital/organización & administración , Personal de Enfermería en Hospital/psicología , Grupo de Enfermería/organización & administración , Grupo de Enfermería/estadística & datos numéricos , Estrés Laboral/psicología , Absentismo , Instituciones Oncológicas , Humanos , Modelos Teóricos , Estrés Laboral/prevención & control , Estrés Laboral/rehabilitación , Calidad de Vida
15.
Folia Med (Plovdiv) ; 61(2): 163-171, 2019 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-31301669

RESUMEN

INTRODUCTION: Pharmacoeconomics (PE) treats the problems of pharmacotherapy policy, drug marketing and reimbursement and clinical trials. It guides policy makers for effective health resources utilization and determines the profitability of the new drugs on the basis of their price, efficacy and benefits for society. Types of health costs and pharmacoeconomic analyses: In the current review the main types of health costs are discussed. The main PE analyses with their advantages and disadvantages are presented. Pharmacoeconomic of bronchial asthma: The main aspects of PE of bronchial asthma are available in the current review. The costs of health services (direct and indirect), the educational programs and asthma medications in different countries are discussed. Recently published data showed correlation between asthma cost and disease severity, control, social status and therapy adherence. CONCLUSION: PE analyses provide the benefit of making cost consistent decisions in the field of asthma care. This review adds more data on the cost of current asthma treatment worldwide and in Bulgaria.


Asunto(s)
Asma/economía , Costos de la Atención en Salud , Absentismo , Antiasmáticos/economía , Asma/terapia , Bulgaria , Costos Directos de Servicios , Costos de los Medicamentos , Economía Farmacéutica , Servicios de Salud/economía , Humanos , Educación del Paciente como Asunto/economía
16.
J Youth Adolesc ; 48(9): 1637-1667, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31312979

RESUMEN

School absenteeism and dropout are associated with many different life-course problems. To reduce the risk for these problems it is important to gain insight into risk factors for both school absenteeism and permanent school dropout. Until now, no quantitative overview of these risk factors and their effects was available. Therefore, this study was aimed at synthesizing the available evidence on risk factors for school absenteeism and dropout. In total, 75 studies were included that reported on 781 potential risk factors for school absenteeism and 635 potential risk factors for dropout. The risk factors were classified into 44 risk domains for school absenteeism and 42 risk domains for dropout. The results of a series of three-level meta-analyses yielded a significant mean effect for 28 school absenteeism risk domains and 23 dropout risk domains. For school absenteeism, 12 risk domains were found with large effects, including having a negative attitude towards school, substance abuse, externalizing and internalizing problems of the juvenile, and a low parent-school involvement. For dropout, the risk domains having a history of grade retention, having a low IQ or experiencing learning difficulties, and a low academic achievement showed large effects. The findings of the current study contribute to the fundamental knowledge of the etiology of school absenteeism and dropout which in turn contributes to a better understanding of the problematic development of adolescents. Further, more insight into the strength of effects of risk factors on school absenteeism and dropout is important for the development and improvement of both assessment, prevention and intervention strategies.


Asunto(s)
Absentismo , Conducta del Adolescente/psicología , Abandono Escolar/psicología , Estudiantes/psicología , Adolescente , Femenino , Humanos , Masculino , Factores de Riesgo , Abandono Escolar/estadística & datos numéricos , Estudiantes/estadística & datos numéricos , Trastornos Relacionados con Sustancias/psicología
17.
J Water Health ; 17(4): 633-646, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31314000

RESUMEN

Clean water provision remains a serious problem in low- and middle-income countries. In 2017, about 30% of the world population relied on unimproved water sources located outside of the dwellings. Often women and children are occupied in fetching water. This situation increases the prevalence of water-related diseases such as diarrhoea and reduces children's study time. School attendance may decrease due to the combined effects of diarrhoea and time spent on fetching water. We investigate the effects on school absenteeism and primary school enrolment in Indonesia, using a panel data set for 295 districts over the period 1994-2014. Districts with higher diarrhoea prevalence are found to have lower school enrolment (B: -0.202, sig p < 0.01) and higher school absenteeism (B: 2.334, sig p < 0.001). Districts where more households have access to private water facilities have higher school enrolment (B: 0.025, sig p < 0.01) and lower school absenteeism (B: -0.027, sig p < 0.01). More use of piped and bottled water in a district is associated with a lower diarrhoea prevalence (B: -0.004, sig p < 0.05). Policy-makers should take the benefits of improved water supply into account when making cost-benefit analyses regarding investments in water infrastructure.


Asunto(s)
Absentismo , Agua Potable/microbiología , Niño , Femenino , Humanos , Indonesia , Instituciones Académicas , Abastecimiento de Agua
18.
Pediatr Rheumatol Online J ; 17(1): 44, 2019 Jul 15.
Artículo en Inglés | MEDLINE | ID: mdl-31307487

RESUMEN

BACKGROUND: The aim of the study was to describe school attendance and participation in physical education in school among children with juvenile idiopathic arthritis (JIA). METHODS: Consecutive cases of JIA from defined geographical areas of Finland, Sweden and Norway with disease onset in 1997 to 2000 were followed for 8 years in a multi-center cohort study, aimed to be as close to population-based as possible. Clinical characteristics and information on school attendance and participation in physical education (PE) were registered. RESULTS: Participation in school and in PE was lowest initially and increased during the disease course. Eight years after disease onset 228/274 (83.2%) of the children reported no school absence due to JIA, while 16.8% reported absence during the last 2 months due to JIA. Full participation in PE was reported by 194/242 (80.2%), partly by 16.9%, and none by 2.9%. Lowest participation in PE was found among children with ERA and the undifferentiated categories. Absence in school and PE was associated with higher disease activity measures at the 8-year visit. School absence > 1 day at baseline predicted use of disease-modifying anti-rheumatic drugs, including biologics (DMARDs) (OR 1.2 (1.1-1.5)), and non-remission off medication (OR 1.4 (1.1-1.7) 8 years after disease onset. CONCLUSION: School absence at baseline predicted adverse long-term outcome. In children and adolescents with JIA participation in school activities is mostly high after 8 years of disease. For the minority with low participation, special attention is warranted to promote their full potential of social interaction and improve long-term outcome.


Asunto(s)
Absentismo , Artritis Juvenil/fisiopatología , Educación y Entrenamiento Físico , Instituciones Académicas , Adolescente , Antirreumáticos/uso terapéutico , Artritis Juvenil/tratamiento farmacológico , Niño , Estudios de Cohortes , Femenino , Finlandia , Humanos , Estudios Longitudinales , Masculino , Noruega , Suecia
19.
MMWR Morb Mortal Wkly Rep ; 68(26): 577-582, 2019 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-31269013

RESUMEN

During an influenza pandemic and during seasonal epidemics, more persons have symptomatic illness without seeking medical care than seek treatment at doctor's offices, clinics, and hospitals (1). Consequently, surveillance based on mortality, health care encounters, and laboratory data does not reflect the full extent of influenza morbidity. CDC uses a mathematical model to estimate the total number of influenza illnesses in the United States (1). In addition, syndromic methods for monitoring illness outside health care settings, such as tracking absenteeism trends in schools and workplaces, are important adjuncts to conventional disease reporting (2). Every month, CDC's National Institute for Occupational Safety and Health (NIOSH) monitors the prevalence of health-related workplace absenteeism among full-time workers in the United States using data from the Current Population Survey (CPS) (3). This report describes the results of workplace absenteeism surveillance analyses conducted during the high-severity 2017-18 influenza season (October 2017-September 2018) (4). Absenteeism increased sharply in November, peaked in January and, at its peak, was significantly higher than the average during the previous five seasons. Persons especially affected included male workers, workers aged 45-64 years, workers living in U.S. Department of Health and Human Services (HHS) Region 6* and Region 9,† and those working in management, business, and financial; installation, maintenance, and repair; and production and related occupations. Public health authorities and employers might consider results from relevant absenteeism surveillance analyses when developing prevention messages and in pandemic preparedness planning. The most effective ways to prevent influenza transmission in the workplace include vaccination and nonpharmaceutical interventions, such as staying home when sick, covering coughs and sneezes, washing hands frequently, and routinely cleaning frequently touched surfaces (5).


Asunto(s)
Absentismo , Empleo/estadística & datos numéricos , Epidemias , Gripe Humana/epidemiología , Pandemias , Vigilancia de la Población/métodos , Lugar de Trabajo , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Modelos Teóricos , Prevalencia , Estaciones del Año , Estados Unidos/epidemiología , Adulto Joven
20.
J Glob Health ; 9(2): 020402, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31360445

RESUMEN

Background: Water, sanitation, and hygiene (WASH) in schools is promoted by development agencies as a modality to improve school attendance by reducing illness. Despite biological plausibility, the few rigorous studies that have assessed the effect of WASH in schools (WinS) interventions on pupil health and school attendance have reported mixed impacts. We evaluated the impact of the Laos Basic Education, Water, Sanitation and Hygiene Programme - a comprehensive WinS project implemented by UNICEF Lao People's Democratic Republic (Lao PDR) in 492 primary schools nationwide between 2013 and 2017 - on pupil education and health. Methods: From 2014-2017, we conducted a cluster-randomized trial among 100 randomly selected primary schools lacking functional WASH facilities in Saravane Province, Lao PDR. Schools were randomly assigned to either the intervention (n = 50) or comparison (n = 50) arm. Intervention schools received a school water supply, sanitation facilities, handwashing facilities, drinking water filters, and behavior change education and promotion. Comparison schools received the intervention after research activities ended. At unannounced visits every six to eight weeks, enumerators recorded pupils' roll-call absence, enrollment, attrition, progression to the next grade, and reported illness (diarrhea, respiratory infection, conjunctivitis), and conducted structured observations to measure intervention fidelity and adherence. Stool samples were collected annually prior to de-worming and analyzed for soil-transmitted helminth (STH) infection. In addition to our primary intention-to-treat analysis, we conducted secondary analyses to quantify the role of intervention fidelity and adherence on project impacts. Results: We found no impact of the WinS intervention on any primary (pupil absence) or secondary (enrollment, dropout, grade progression, diarrhea, respiratory infection, conjunctivitis, STH infection) impacts. Even among schools with the highest levels of fidelity and adherence, impact of the intervention on absence and health was minimal. Conclusions: While WinS may create an important enabling environment, WinS interventions alone and as currently delivered may not be sufficient to independently impact pupil education and health. Our results are consistent with other recent evaluations of WinS projects showing limited or mixed effects of WinS.


Asunto(s)
Absentismo , Diarrea/prevención & control , Helmintiasis/prevención & control , Infecciones del Sistema Respiratorio/prevención & control , Servicios de Salud Escolar , Animales , Niño , Diarrea/epidemiología , Heces/parasitología , Femenino , Helmintiasis/epidemiología , Helmintiasis/transmisión , Helmintos/aislamiento & purificación , Humanos , Higiene/educación , Higiene/normas , Laos/epidemiología , Masculino , Evaluación de Programas y Proyectos de Salud , Infecciones del Sistema Respiratorio/epidemiología , Saneamiento/normas , Suelo/parasitología , Abastecimiento de Agua/normas
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