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1.
MMWR Morb Mortal Wkly Rep ; 68(26): 577-582, 2019 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-31269013

RESUMO

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).


Assuntos
Absenteísmo , Emprego/estatística & dados numéricos , Epidemias , Influenza Humana/epidemiologia , Pandemias , Vigilância da População/métodos , Local de Trabalho , Adolescente , Adulto , Idoso , Centers for Disease Control and Prevention (U.S.) , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , Prevalência , Estações do Ano , Estados Unidos/epidemiologia , Adulto Jovem
2.
J Glob Health ; 9(2): 020402, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31360445

RESUMO

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.


Assuntos
Absenteísmo , Diarreia/prevenção & controle , Helmintíase/prevenção & controle , Infecções Respiratórias/prevenção & controle , Serviços de Saúde Escolar , Animais , Criança , Diarreia/epidemiologia , Fezes/parasitologia , Feminino , Helmintíase/epidemiologia , Helmintíase/transmissão , Helmintos/isolamento & purificação , Humanos , Higiene/educação , Higiene/normas , Laos/epidemiologia , Masculino , Avaliação de Programas e Projetos de Saúde , Infecções Respiratórias/epidemiologia , Saneamento/normas , Solo/parasitologia , Abastecimento de Água/normas
3.
J Water Health ; 17(4): 633-646, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31314000

RESUMO

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.


Assuntos
Absenteísmo , Água Potável/microbiologia , Criança , Feminino , Humanos , Indonésia , Instituições Acadêmicas , Abastecimento de Água
4.
Rev Lat Am Enfermagem ; 27: e3156, 2019 Jul 18.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31340344

RESUMO

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.


Assuntos
Recursos Humanos de Enfermagem no Hospital/organização & administração , Recursos Humanos de Enfermagem no Hospital/psicologia , Equipe de Enfermagem/organização & administração , Equipe de Enfermagem/estatística & dados numéricos , Estresse Ocupacional/psicologia , Absenteísmo , Institutos de Câncer , Humanos , Modelos Teóricos , Estresse Ocupacional/prevenção & controle , Estresse Ocupacional/reabilitação , Qualidade de Vida
5.
Rev Med Suisse ; 15(653): 1127-1130, 2019 May 29.
Artigo em Francês | MEDLINE | ID: mdl-31148424

RESUMO

Diabetes mellitus (DM) affects an increasing proportion of workers, a trend that will compound with the ageing of the workforce. It is therefore important to consider DM in the workplace context. There is an interrelationship between DM and work. Indeed dysglycemia is associated with a greater risk of work accidents and long-term DM complications. On the other side work conditions can affect DM's stability. The consequences are absenteeism, presenteeism, early retirement or even disability with significant socio-economic costs. To keep patients with DM into the workforce, the evaluation of their working conditions is mandatory and ideally in collaboration with the general practitioner, diabetologist and occupational physician (OP). This article outlines some practical guidelines for the evaluation of diabetic's worker.


Assuntos
Absenteísmo , Diabetes Mellitus , Pessoas com Deficiência , Aposentadoria , Complicações do Diabetes , Humanos , Local de Trabalho
6.
Niger J Clin Pract ; 22(6): 855-861, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31187773

RESUMO

Background: Understanding the impact of asthma is the key to optimal care. Objective: To determine the physical, economic, and social impact of asthma from the perspectives of individual patients in Nigeria. Methods: This was a multicenter study of 172 adult asthma patients attending tertiary hospitals. We assessed the different impact of asthma in the preceding 12 months using a questionnaire. Physical impact (such as daily activity/chores, sport/exercise, and sleep quality), social impact (such as job loss, mental anguish, employer, and peers discrimination) and economic impact (like savings, indebtedness, mortgage/asset, and school or work absence). Results: The physical, social and economic impacts were perceived by 59.3%, 47.7%, and 51.2% of patients, respectively. The physical impacts were poor sleep (44.2%), limitation of daily activity/chores (38.4%), and sporting/exercise (39.5%). The economic impacts were reduced savings (38.4%) and indebtedness (17.4%). Absence from school and work were respectively reported by 75% of students and 38.3% of workers. Socially, 34.9% reported mental torture, 10.5% changed job, 4.7% experienced discrimination and 3.5% lost their jobs due to asthma. Asthma-related emergency department visit was 42% and hospitalization was 32.6%. The physical impact was associated with non-adherence to ICS and persistent asthma symptoms. Economic impact was associated with asthma hospitalization, work absenteeism, comorbidity, and National Health Insurance (NHIS) coverage. Male sex and lack of post-secondary education were associated with social impact. Conclusion: Asthma causes broad and substantial physical and socioeconomic impacts in our sample of patients. Exploring these impacts and engaging the patient is imperative for holistic management and good health outcomes.


Assuntos
Atividades Cotidianas , Asma/economia , Cobertura do Seguro , Programas Nacionais de Saúde , Absenteísmo , Adulto , Asma/tratamento farmacológico , Asma/psicologia , Status Econômico , Escolaridade , Serviço Hospitalar de Emergência/estatística & dados numéricos , Emprego , Exercício , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Adesão à Medicação , Pessoa de Meia-Idade , Nigéria , Exame Físico , Preconceito , Fatores Sexuais , Sono , Inquéritos e Questionários , Centros de Atenção Terciária , Adulto Jovem
7.
Environ Monit Assess ; 191(Suppl 2): 332, 2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-31254081

RESUMO

In this study, we found that machine learning was able to effectively estimate student learning outcomes geo-spatially across all the campuses in a large, urban, independent school district. The machine learning showed that key factors in estimating the student learning outcomes included the number of days students were absent from school. In turn, one of the most important factors in estimating the number of days a student was absent was whether or not the student had asthma. This highlights the importance of environmental public health for student learning outcomes.


Assuntos
Absenteísmo , Asma/epidemiologia , Saúde Ambiental/métodos , Aprendizado de Máquina , Sucesso Acadêmico , Adolescente , Criança , Saúde Ambiental/estatística & dados numéricos , Feminino , Humanos , Masculino , Instituições Acadêmicas , Estudantes , Texas/epidemiologia
8.
BMC Public Health ; 19(Suppl 4): 608, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31196025

RESUMO

BACKGROUND: 1Little is known of the extent of workplace bullying in Malaysia, despite its growing recognition worldwide as a serious public health issue in the workplace. Workplace bullying is linked to stress-related health issues, as well as socioeconomic consequences which may include absenteeism due to sick days and unemployment. We sought to examine the prevalence of workplace bullying and its association with socioeconomic factors and psychological distress in a large observational study of Malaysian employees. METHODS: This study employed cross-sectional, self-reported survey methodology. We used the 6-item Kessler screening scale (K6) to assess psychological distress (cutoff score ≥ 13, range 0-24, with higher scores indicating greater psychological distress). Participants self-reported their perceptions of whether they had been bullied at work and how frequently this occurred. A multivariate logistic regression was conducted with ever bullying and never bullying as dichotomous categories. RESULTS: There were a total of 5235 participants (62.3% female). Participant ages ranged from 18 to 85, mean ± standard deviation (M ± SD): 33.88 ± 8.83. A total of 2045 (39.1%) participants reported ever being bullied. Of these, 731 (14.0%) reported being subject to at least occasional bullying, while another 194 (3.7%) reported it as a common occurrence. Across all income strata, mean scores for psychological distress were significantly higher for ever bullied employees (M ± SD: 8.69 ± 4.83) compared to those never bullied (M ± SD: 5.75 ± 4.49). Regression analysis indicated significant associations (p < 0.001) between workplace bullying with being female (Adjusted OR (aOR) = 1.27, 95% CI 1.12-1.44), higher individual income levels of between RM4,000 to RM7,999 (aOR =1.24, 95% CI 1.06-1.45) and RM8,000 and above (aOR = 1.31, 95% CI 1.10-1.56), and psychological distress (aOR = 1.15, 95% CI 1.13-1.16). CONCLUSIONS: More than one in three employees reported having experienced workplace bullying, which was found to be specifically associated with being female, drawing a higher income, and greater psychological distress. In general, low individual income was associated with greater psychological distress. However, higher income employees were far more likely to report experiencing workplace bullying. Findings from this study offer relevant insight into the associations between socioeconomic status and psychological distress in workplace bullying.


Assuntos
Bullying/estatística & dados numéricos , Doenças Profissionais/epidemiologia , Classe Social , Estresse Psicológico/epidemiologia , Absenteísmo , Adulto , Bullying/psicologia , Estudos Transversais , Emprego/psicologia , Emprego/estatística & dados numéricos , Feminino , Humanos , Modelos Logísticos , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/psicologia , Prevalência , Autorrelato , Estresse Psicológico/psicologia , Local de Trabalho/psicologia , Adulto Jovem
9.
BMC Public Health ; 19(Suppl 4): 540, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31196096

RESUMO

BACKGROUND: Organization productivity is strongly linked to employees' socioeconomic characteristics and health which is marked by absenteeism and presenteeism. This study aims to identify anteceding factors predicting employees' absenteeism and presenteeism by income, physical and mental health. METHODS: An online health survey was conducted between May to July 2017 among employees from 47 private companies located in urban Malaysia. A total of 5235 respondents completed the 20-min online employee health survey on a voluntary basis. Chi-Square or Fisher's exact tests were used to determine association between income with demographic and categorical factors of absenteeism and presenteeism. Multivariate linear regression was used to identify factors predicting absenteeism and presenteeism. RESULTS: More than one third of respondents' monthly income were less than RM4,000 (35.4%), 29.6% between RM4,000-RM7,999 and 35.0% earned RM8,000 and above. The mean age was 33.8 years (sd ± 8.8) and 49.1% were married. A majority were degree holders (74.4%) and 43.6% were very concerned about their financial status. Mean years of working was 6.2 years (sd ± 6.9) with 68.9% satisfied with their job. More than half reported good general physical health (54.5%) (p = 0.065) and mental health (53.5%) (p = 0.019). The mean hours of sleep were 6.4 h (sd ± 1.1) with 63.2% reporting being unwell due to stress for the past 12 months. Mean work time missed due to ill-health (absenteeism) was 3.1% (sd ± 9.1), 2.8% (sd ± 9.1) and 1.8% (sd ± 6.5) among employees whose monthly income was less than RM4,000, RM4,000-RM7,999 and over RM8,000 respectively (p = 0.0066). Mean impairment while working due to ill-health (presenteeism) was 28.2% (sd ± 25.3), 24.9% (sd ± 25.5) and 20.3% (sd ± 22.9) among employees whose monthly income was less than RM4,000, RM4,000-RM7,999 and over RM8,000 respectively (p < 0.0001). Factors that predict both absenteeism and presenteeism were income, general physical health, sleep length and being unwell due to stress. CONCLUSIONS: A combination of socioeconomic, physical and mental health factors predicted absenteeism and presenteeism with different strengths. Having insufficient income may lead to second jobs or working more hours which may affect their sleep, subjecting them to stressful condition and poor physical health. These findings demand holistic interventions from organizations and the government.


Assuntos
Absenteísmo , Saúde do Trabalhador/estatística & dados numéricos , Presenteísmo/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adulto , Feminino , Inquéritos Epidemiológicos , Humanos , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores Socioeconômicos
10.
J Headache Pain ; 20(1): 65, 2019 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-31151382

RESUMO

BACKGROUND: Migraine is a disabling, chronic neurological disease leading to severe headache episodes affecting 13.2% of the Swedish population. Migraine leads to an extensive socio-economic burden in terms of healthcare costs, reduced workforce and quality of life (QoL) but studies of the health-economic consequences in a Swedish context are lacking. The objective of this study is to map the health-economic consequences of migraine in a defined patient population in terms of healthcare consumption, production loss and QoL in Sweden. METHODS: The study is based on data from a web-based survey to members in the Swedish patients' association suffering from migraine. The survey was conducted in May 2018 and included people with migraine aged 18 years or older. The survey included questions on health resource consumption, lost production resulting from migraine-related absenteeism and presenteeism, and QoL as measured by the EuroQol 5 dimensions questionnaire (EQ-5D-5 L) and the Headache Impact Test (HIT-6). The results are presented in yearly costs per patient and losses in quality adjusted life years (QALYs). RESULTS: The results are based on answers from 630 individuals with migraine and are presented by number of migraine days per month. The total cost per patient and year increased with the number of migraine days per month (p < 0.001) and varied between approximately €5000 for those with less than 3 migraine days per month and €24,000 per year for those with 21-28 migraine days per month. Production loss represented the main part of the costs, approximately 80%. The average loss in QALYs per year also increased with the monthly number of migraine days (p = 0.023). CONCLUSIONS: Migraine leads to significant societal costs and loss of quality of life. There appears to be an unmet need and a potential for both cost savings and QoL benefits connected with a reduction in the number of migraine days.


Assuntos
Efeitos Psicossociais da Doença , Transtornos de Enxaqueca/epidemiologia , Transtornos de Enxaqueca/psicologia , Qualidade de Vida/psicologia , Inquéritos e Questionários , Absenteísmo , Adulto , Idoso , Doença Crônica , Feminino , Custos de Cuidados de Saúde/tendências , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos de Enxaqueca/diagnóstico , Suécia/epidemiologia
11.
Managua; s.n; mayo 2019. 71 p. tab, ilus, graf.
Tese em Espanhol | LILACS | ID: biblio-1015387

RESUMO

OBJETIVO: Caracterizar el ausentismo laboral de causa médica en el personal del Centro de Salud Sócrates Flores de la ciudad de Managua ­ Nicaragua en el año 2018 METODOLOGÍA: Estudio de tipo descriptivo, de corte transversal, con un universo de 115 trabajadores, estableciendo una muestra de 58 recursos que se ausentaron de sus labores por causa médica. Se establecieron criterios de selección y exclusión. La recolección de la información se realizó a través de una ficha. RESULTADOS: El ausentismo laboral por causa médica predominó en las mujeres (46%), en las edades entre 50 y 59 años (36%), en médicos generales (21%), con un perfil asistencial (59%), con más de 15 años de laborar (52%), en el área de la consulta externa (24%). El tiempo de ausencia predominante fue de 1 a 3 días (60%), por enfermedad común (67%), la mayoría presentó de 1 a 3 afectaciones en el año (36%), por problemas de tipo musculoesquelético (50%), con mayor frecuencia en los meses de agosto (13%) y octubre (12%). Tasa de Frecuencia de 1.43 episodios de ausencia por año en relación al número de trabajadores. Tasa de Incapacidad anual de 10.98 días de ausencia por trabajador y una Tasa de Severidad anual de 8 días de duración promedio por ausencia. CONCLUSIONES: El ausentismo laboral por causa médica predominó en las mujeres, en trabajadores entre 50 y 59 años, médicos generales, con un perfil de trabajo asistencial, con más de 15 años de laborar, en el área de la consulta externa. El tiempo de ausencia predominante fue de 1 a 3 días, por enfermedad común, la mayoría presentó de 1 a 3 ausencias, por problemas de tipo musculoesquelético, con mayor frecuencia en los meses de agosto y octubre. La tasa de frecuencia anual se encuentra por encima de lo encontrado en otros estudios internacionales


Assuntos
Humanos , Trabalhadores , Absenteísmo , Serviços de Saúde do Trabalhador , Epidemiologia Descritiva , Estudos Transversais
12.
BMC Public Health ; 19(1): 598, 2019 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-31101035

RESUMO

BACKGROUND: There is a growing interest in the costs of informal care; however, the results of previous studies mostly rely on self-reported data, which is subject to numerous biases. The aim of this study is to contribute to the topic by estimating the indirect costs of short-term absenteeism associated with informal caregiving in Poland with the use of social insurance data on care absence incidence. METHODS: The human capital method was used to estimate the indirect costs of caregiving from a societal perspective. The incidence of caregiving was identified based on the Social Insurance Institution's data on absence days attributable to care provided to children and other family members. Gross domestic product (GDP) per worker was used as a proxy of labour productivity. Deterministic one-way sensitivity analysis was performed. RESULTS: The indirect costs of short-term caregivers' absenteeism in Poland was €306.2 million (0.116% of GDP) in 2006 and increased to €824.0 million in 2016 (0.180% of GDP). The number of care absence days grew from 5.9 million (0.45 days per worker) in 2006 to 10.6 million (0.70 days per worker) in 2016. Approximately 85% of the total costs were attributable to child care. The results of the sensitivity analysis show that the indirect costs varied from the base scenario by - 30.8 to + 15.8%. CONCLUSION: Informal short-term caregiving leads to substantial productivity losses in the Polish economy, and the dynamic upward trend of care absence incidence suggests that the costs of caregiving are expected to rise in the future.


Assuntos
Absenteísmo , Cuidadores/economia , Cuidado da Criança/economia , Efeitos Psicossociais da Doença , Gastos em Saúde/estatística & dados numéricos , Adulto , Criança , Eficiência , Feminino , Produto Interno Bruto , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Previdência Social/economia , Fatores de Tempo
13.
BMC Public Health ; 19(1): 595, 2019 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-31101093

RESUMO

BACKGROUND: Childhood epilepsy can adversely affect education and employment in addition to health. Previous studies are small or highly selective producing conflicting results. This retrospective cohort study aims to compare educational and health outcomes of children receiving antiepileptic medication versus peers. METHODS: Record linkage of Scotland-wide databases covering dispensed prescriptions, acute and psychiatric hospitalisations, maternity records, deaths, annual pupil census, school absences/exclusions, special educational needs, school examinations, and (un)employment provided data on 766,244 children attending Scottish schools between 2009 and 2013. Outcomes were adjusted for sociodemographic and maternity confounders and comorbid conditions. RESULTS: Compared with peers, children on antiepileptic medication were more likely to experience school absence (Incidence Rate Ratio [IRR] 1.43, 95% CI: 1.38, 1.48), special educational needs (Odds ratio [OR] 9.60, 95% CI: 9.02, 10.23), achieve the lowest level of attainment (OR 3.43, 95% CI: 2.74, 4.29) be unemployed (OR 1.82, 95% CI: 1.60, 2.07), be admitted to hospital (Hazard Ratio [HR] 3.56, 95% CI: 3.42, 3.70), and die (HR 22.02, 95% CI: 17.00, 28.53). Absenteeism partly explained poorer attainment and higher unemployment. Girls and younger children on antiepileptic medication had higher risk of poor outcomes. CONCLUSIONS: Children on antiepileptic medication fare worse than peers across educational and health outcomes. In order to reduce school absenteeism and mitigate its effects, children with epilepsy should receive integrated care from a multidisciplinary team that spans education and healthcare.


Assuntos
Anticonvulsivantes/uso terapêutico , Epilepsia/epidemiologia , Hospitalização/estatística & dados numéricos , Instituições Acadêmicas/estatística & dados numéricos , Desemprego/estatística & dados numéricos , Absenteísmo , Adolescente , Adulto , Criança , Bases de Dados Factuais , Prescrições de Medicamentos/estatística & dados numéricos , Escolaridade , Epilepsia/tratamento farmacológico , Feminino , Humanos , Masculino , Registro Médico Coordenado , Razão de Chances , Gravidez , Estudos Retrospectivos , Escócia/epidemiologia , Adulto Jovem
14.
BMC Public Health ; 19(1): 609, 2019 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-31109317

RESUMO

BACKGROUND: In multiple sclerosis (MS), half of affected people are unemployed within 10 years of diagnosis. The aim of this study was to assess the economic impact of MS in adult subjects with relapsing-remitting MS (RRMS) and primary progressive MS (PPMS). METHODS: A multicenter, non-interventional, cross-sectional study was conducted. The Expanded Disability Status Scale (EDSS) and the 23-item Multiple Sclerosis Work Difficulties Questionnaire (MSWDQ-23) were used to assess disability and work performance, respectively. Only indirect costs were considered using the human capital method, including work costs. Professional support costs and informal caregivers' costs were also estimated. RESULTS: A total of 199 subjects were studied (mean age: 43.9 ± 10.5 years, 60.8% female, 86.4% with RRMS). Median EDSS score was 2.0 (interquartile range: 1.0-3.5) and median MSWDQ-23 total score was 31.5 (15.2, 50.0). The number of employed subjects decreased after MS diagnosis from 70.6 to 47.2%, and the number of retired people increased (23.6%). Mean age of retirement was 43.6 ± 10.5 years. Ten percent of the population had sick leaves (absenteeism was seen in 90.9% of the student population and 30.9% of the employed population). Professional support in their daily life activities was needed in 28.1% of subjects. Costs for sick leave, work absenteeism, premature retirement and premature work disability/pensioner were €416.6 ± 2030.2, €763.4 ± 3161.8, €5810.1 ± 13,159.0 and €1816.8 ± 9630.7, respectively. Costs for professional support and informal caregiving activities were €1026.93 ± 4622.0 and €1328.72, respectively. CONCLUSIONS: MS is responsible for a substantial economic burden due to indirect and informal care costs, even in a population with low physical disability.


Assuntos
Efeitos Psicossociais da Doença , Pessoas com Deficiência/estatística & dados numéricos , Esclerose Múltipla/economia , Absenteísmo , Adulto , Estudos Transversais , Emprego/economia , Emprego/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pensões/estatística & dados numéricos , Aposentadoria/economia , Aposentadoria/estatística & dados numéricos , Licença Médica/economia , Licença Médica/estatística & dados numéricos , Espanha , Inquéritos e Questionários
15.
Cochrane Database Syst Rev ; 5: CD013098, 2019 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-31087323

RESUMO

BACKGROUND: From the societal and employers' perspectives, sickness absence has a large economic impact. Internationally, there is variation in sickness certification practices. However, in most countries a physician's certificate of illness or reduced work ability is needed at some point of sickness absence. In many countries, there is a time period of varying length called the 'self-certification period' at the beginning of sickness absence. During that time a worker is not obliged to provide his or her employer a medical certificate and it is usually enough that the employee notifies his or her supervisor when taken ill. Self-certification can be introduced at organisational, regional, or national level. OBJECTIVES: To evaluate the effects of introducing, abolishing, or changing the period of self-certification of sickness absence on: the total or average duration (number of sickness absence days) of short-term sickness absence periods; the frequency of short-term sickness absence periods; the associated costs (of sickness absence and (occupational) health care); and social climate, supervisor involvement, and workload or presenteeism (see Figure 1). SEARCH METHODS: We conducted a systematic literature search to identify all potentially eligible published and unpublished studies. We adapted the search strategy developed for MEDLINE for use in the other electronic databases. We also searched for unpublished trials on ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP). We used Google Scholar for exploratory searches. SELECTION CRITERIA: We considered randomised controlled trials (RCTs), controlled before-after (CBA) studies, and interrupted time-series (ITS) studies for inclusion. We included studies carried out with individual employees or insured workers. We also included studies in which participants were addressed at the aggregate level of organisations, companies, municipalities, healthcare settings, or general populations. We included studies evaluating the effects of introducing, abolishing, or changing the period of self-certification of sickness absence. DATA COLLECTION AND ANALYSIS: We conducted a systematic literature search up to 14 June 2018. We calculated missing data from other data reported by the authors. We intended to perform a random-effects meta-analysis, but the studies were too different to enable meta-analysis. MAIN RESULTS: We screened 6091 records for inclusion. Five studies fulfilled our inclusion criteria: one is an RCT and four are CBA studies. One study from Sweden changed the period of self-certification in 1985 in two districts for all insured inhabitants. Three studies from Norway conducted between 2001 and 2014 changed the period of self-certification in municipalities for all or part of the workers. One study from 1969 introduced self-certification for all manual workers of an oil refinery in the UK.Longer compared to shorter self-certificationfor reducing sickness absence in workersOutcome: average duration of sickness absence periodsExtending the period of self-certification from one week to two weeks produced a higher mean duration of sickness absence periods: mean difference in change values between the intervention and control group (MDchange) was 0.67 days/period up to 29 days (95% confidence interval (95% CI) 0.55 to 0.79; 1 RCT; low-certainty evidence).The introduction of self-certification for a maximum of three days produced a lower mean duration of sickness absence up to three days (MDchange -0.32 days/period, 95% CI -0.39 to -0.25; 1 CBA study; very low-certainty evidence). The authors of a different study reported that prolonging self-certification from ≤ 3 days to ≤ 365 days did not lead to a change, but they did not provide numerical data (very low-certainty evidence). OUTCOME: number of sickness absence periods per workerExtending the period of self-certification from one week to two weeks resulted in no difference in the number of sickness absence periods in one RCT, but the authors did not report numerical data (low-certainty evidence).The introduction of self-certification for a maximum of three days produced a higher mean number of sickness absence periods lasting up to three days (MDchange 0.48 periods, 95% CI 0.33 to 0.63) in one CBA study (very low-certainty evidence).Extending the period of self-certification from three days to up to a year decreased the number of periods in one CBA study, but the authors did not report data (very low-certainty evidence). OUTCOME: average lost work time per 100 person-yearsExtending the period of self-certification from one week to two weeks resulted in an inferred increase in lost work time in one RCT (very low-certainty evidence).Extending the period of self-certification (introduction of self-certification for a maximum of three days (from zero to three days) and from three days to five days, respectively) resulted in more work time lost due to sickness absence periods lasting up to three days in two CBA studies that could not be pooled (MDchange 0.54 days/person-year, 95% CI 0.47 to 0.61; and MDchange 1.38 days/person-year, 95% CI 1.16 to 1.60; very low-certainty evidence).Extending the period of self-certification from three days up to 50 days led to 0.65 days less lost work time in one CBA study, based on absence periods lasting between four and 16 days. Extending the period of self-certification from three days up to 365 days resulted in less work time lost due to sickness absence periods longer than 16 days (MDchange -2.84 days, 95% CI -3.35 to -2.33; 1 CBA study; very low-certainty evidence). OUTCOME: costs of sickness absence and physician certificationOne RCT reported that the higher costs of sickness absence benefits incurred by extending the period of self-certification far outweighed the possible reduction in costs of fewer physician appointments by almost six to one (low-certainty evidence).In summary, we found very low-certainty evidence that introducing self-certification of sickness absence or prolonging the self-certification period has inconsistent effects on the mean number of sickness absence days, the number of sickness absence periods, and on lost work time due to sickness absence periods. AUTHORS' CONCLUSIONS: There is low- to very low-certainty evidence of inconsistent effects of changing the period of self-certification on the duration or frequency of short-term sickness absence periods or the amount of work time lost due to sickness absence. Because the evidence is of low or very low certainty, more and better studies are needed.


Assuntos
Absenteísmo , Emprego , Exame Físico , Licença Médica , Certificação , Humanos , Médicos , Ensaios Clínicos Controlados Aleatórios como Assunto , Licença Médica/estatística & dados numéricos , Fatores de Tempo
16.
Einstein (Sao Paulo) ; 17(2): eAO4526, 2019 May 02.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31066792

RESUMO

OBJECTIVE: To compare the use of the radiofrequency thermoablation of the saphenous vein with the ligation technique, and complete removal of the saphenous vein, from the saphenofemoral junction to the ankle. METHODS: A total of 49 patients with chronic venous disease in the Comprehensive Classification System for Chronic Venous Disorders (CEAP) classes 2 to 4 for clinical signs, etiology, anatomic distribution and pathophysiology, were assessed at baseline, after 4 weeks, and after 1 year. The parameters assessed were complications, period of absence from activities, Venous Clinical Severity Score (VCSS) and quality of life scores according to Aberdeen Varicose Veins Questionnaire (AVVQ). They were re-examined 1 and 3 years after treatment to evaluate recurrence rates. RESULTS: The success rate per limb (p=0.540), VCSS (p=0.636), AVVQ (p=0.163), and clinical complications were similar in the two treatment groups. Nevertheless, the radiofrequency thermoablation group had significant shorter length of hospital stay (0.69±0.47) and absence from activities (8.62±4.53), p<000.1. CONCLUSION: Patients submitted to radiofrequency thermoablation had an occlusion rate, clinical recurrence and improvement in quality of life comparable to removal of the saphenous vein. However, these patients spent less time hospitalized and away from their daily activities during recovering.


Assuntos
Ablação por Radiofrequência/métodos , Veia Safena/cirurgia , Doenças Vasculares/cirurgia , Absenteísmo , Adulto , Idoso , Doença Crônica , Feminino , Seguimentos , Humanos , Tempo de Internação , Ligadura/métodos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Estudos Prospectivos , Qualidade de Vida , Recidiva , Veia Safena/diagnóstico por imagem , Índice de Gravidade de Doença , Fatores de Tempo , Resultado do Tratamento , Ultrassonografia Doppler em Cores , Doenças Vasculares/diagnóstico por imagem , Adulto Jovem
17.
BMC Public Health ; 19(1): 506, 2019 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-31053064

RESUMO

BACKGROUND: Due to the progress in screening and cancer treatments, survivor's prognosis has improved enabling a more likely return to work. However, return to work after a cancer diagnosis may be complex because of an unbalanced health status and work demands relationship that may push them out of the labor market. The aim of this study is to assess the risk of dropping out of the labor market due to unemployment, partial retirement, and permanent disability during the year following an episode due to a malignant neoplasm compared to other non-malignant pathologies. METHODS: Cohort study of 9699 workers affiliated with the Social Security System in Catalonia, who had a sickness absence episode between 2012 and 2013 due to malignant neoplasm, mental, musculoskeletal disorders, cardiovascular diseases and injuries. Competing risk regression models were applied to assess the risk of dropping out of the labor market, by calculating subhazard ratios (SHR) in both sexes. Models were adjusted for age, occupational category, type of contract, economic activity, annual median salary and duration of the SA episode as potential confounders. RESULTS: Sickness absence due to malignant neoplasia represented 1.7% out of the 9699 episodes included between 2012 and 2013. Although, 80% of individuals continued working in the year following an episode due to malignant neoplasm, women showed a trend towards exiting the labor market because of partial retirement [SHR = 8.4(1.5-45.5)] and permanent disability [SHR = 5.8(1.5-22.9)] compared to non-malignant pathologies. There were no significant differences for unemployment either in women [SHR = 0.4(0.2-0.9)] and in men [SHR = 0.2(0.1-0.6)]. CONCLUSIONS: Although return to work is a common pathway among cancer survivors, partial retirement and permanent disability seem to be potential pathways to exit the labor market among women.


Assuntos
Absenteísmo , Hispano-Americanos/estatística & dados numéricos , Neoplasias/epidemiologia , Licença Médica/estatística & dados numéricos , Adulto , Doenças Cardiovasculares/epidemiologia , Estudos de Coortes , Pessoas com Deficiência , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Musculoesqueléticas/epidemiologia , Desemprego/estatística & dados numéricos
18.
BMC Public Health ; 19(1): 500, 2019 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-31053139

RESUMO

BACKGROUND: It is well documented that tobacco, alcohol and drug use can be detrimental to health. However, little is known about the relative impact of these factors on sickness absence, and whether the association between use of these substances and sickness absence is different for women and men. The aim of this study was to examine the association between tobacco-, alcohol- and drug use, as well as polydrug use, and sickness absence among Norwegian employees. METHODS: During 2011-2014, 1911 employees in Norway completed a questionnaire about their tobacco, alcohol and drug use habits, their total number of sickness absences during the last 12 months, and the length (no. of days) of their last sick leave. Samples of oral fluid were analysed for illegal and medicinal drugs. RESULTS: Daily smoking and current use of medical drugs were significantly associated with sickness absence. Employees who were daily smokers also had an increased likelihood of having long and frequent sickness absence. Use of snus (Swedish moist snuff), binge drinking, current use of illegal drugs and polydrug use were not significantly associated with sickness absence. Women and young participants were more likely to report having had sickness absence the past 12 months. However, the associations between daily smoking and medical drug use and sickness absence, respectively, were only statistically significant for men. CONCLUSION: According to this study, daily smoking and use of medical drugs are the substance use habits most closely associated with sickness absence. Implications for future research are discussed.


Assuntos
Absenteísmo , Consumo de Bebidas Alcoólicas/epidemiologia , Licença Médica/estatística & dados numéricos , Fumar/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Inquéritos e Questionários , Suécia
19.
Univ. salud ; 21(1): 100-112, ene.-abr. 2019. tab
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-986199

RESUMO

Resumen Introducción: El ausentismo laboral ha sido entendido como la no asistencia al trabajo por un periodo de uno o más días laborales, considerado como una problemática de salud con un creciente interés por su impacto en la calidad de vida, salud mental del trabajador, economía y competitividad organizacional. Objetivo: Identificar factores atribuidos al ausentismo laboral en Países de América Latina en los últimos 20 años. Materiales y métodos: Se empleó la metodología de revisión sistemática, siguiendo las etapas de: construcción de la pregunta problema y objetivo; especificación de criterios de inclusión; formulación del plan de búsqueda; exploración de artículos; evaluación de calidad; sistematización de información; interpretación y presentación de resultados. Resultados: Se identificó que los factores atribuibles al ausentismo laboral se pueden agrupan en tres grupos: factores individuales, relacionados con las condiciones propias del trabajador, factores sociodemográficos y por último los intralaborales, que están conexos con el contexto laboral. Conclusión: La presencia del ausentismo laboral se debe a la confluencia de factores individuales, sociodemográficos, intralaborales y extralaborales, que se relacionan entre sí, corroborándose con la literatura que la presencia de este fenómeno se debe a una etiología multifactorial con efectos negativos a nivel individual y organizacional.


Abstract Introduction: Absenteeism has been understood as non-attendance at work for a period of one or more working days, which is considered as a health problem with a growing interest in its impact on the quality of life, mental health of the worker, economy and organizational competitiveness. Objective: To identify factors attributed to absenteeism in Latin American countries in the last 20 years. Materials and methods: The systematic review methodology was used following the stages of: construction of the problem question and objective; specification of inclusion criteria; formulation of the search plan; item browsing; quality assessment; systematization of information; interpretation and presentation of results. Results: The factors attributable to absenteeism can be grouped into three groups: individual factors related to the conditions of the worker, demographic factors and finally the intralabor ones, which are related to the labor context. Conclusion: The presence of labor absenteeism is due to the confluence of individual, demographic, intralabor and extralabor factors, which relate to each other. According to literature, the presence of this phenomenon is due to a multifactorial etiology with negative effects at the individual and organizational level.


Assuntos
Humanos , Absenteísmo , Trabalho
20.
San Salvador; s.n; abr. 2019. 44 p. tab, graf.
Tese em Espanhol | LILACS | ID: biblio-1007213

RESUMO

OBJETIVO. Determinar los recursos destinados para el ausentismo laboral por enfermedad en los trabajadores del nivel central del Ministerio de Salud de El Salvador durante el año 2018. DISEÑO: Estudio descriptivo, de corte transversal, El universo y muestra 172 trabajadores del nivel central que presentaron ausentismo laboral por enfermedad durante el año 2018, teniendo como unidad de análisis la base de datos pertenecientes al departamento de Recursos Humanos, se establecieron como variables del estudio las características socio laborales, el tipo de enfermedades que causan ausentismo laboral y los costos anuales generados por el ausentismo. RESULTADOS: De los 172 trabajadores estudiados, 94 (54.7%) fueron mujeres y el resto 78 (45.3%) fueron hombres. El grupo de edad que predominó en el estudio fue el de 50 o más años, con 80 trabajadores, que representa el 46.5% del total. El área de trabajo que presentó la mayor cantidad de incapacidades fue el Viceministerio de Servicios de Salud, con 65 trabajadores (37.8%) del total de la muestra. La causa médica certificada que predominó en el estudio fue la Cirugía con 61 trabajadores (35.5%). El costo anual del ausentismo a causa de enfermedad fue de $163,723.65. CONCLUSIONES: La mayoría de los trabajadores del nivel central del Ministerio de Salud que presentaron ausentismo laboral por enfermedad fueron mujeres, con edades de 50 o mas años y pertenecían al Viceministerio de servicios de salud. La causa principal de ausentismo por enfermedad fue la cirugía. El costo anual que genera el ausentismo laboral por enfermedad es de $163,723.65


Assuntos
Humanos , Doença , Saúde do Trabalhador , Custos e Análise de Custo , Absenteísmo , Economia da Saúde , Epidemiologia Descritiva , Estudos Transversais
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