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1.
MMWR Morb Mortal Wkly Rep ; 68(53): 1201-1205, 2020 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-31945036

RESUMO

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.


Assuntos
Absenteísmo , Gastroenteropatias/epidemiologia , Renda/estatística & dados numéricos , Infecções Respiratórias/epidemiologia , Instituições Acadêmicas , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Estados Unidos/epidemiologia
2.
Cochrane Database Syst Rev ; 9: CD010905, 2019 09 25.
Artigo em Inglês | MEDLINE | ID: mdl-31560414

RESUMO

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.


Assuntos
Esgotamento Profissional , Liderança , Saúde do Trabalhador , Administração de Recursos Humanos , Estresse Psicológico , Absenteísmo , Promoção da Saúde/métodos , Humanos , Transtornos Mentais , Ensaios Clínicos Controlados Aleatórios como Assunto , Recursos Humanos , Local de Trabalho
3.
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
4.
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 , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , Prevalência , Estações do Ano , Estados Unidos/epidemiologia , Adulto Jovem
5.
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
6.
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
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.
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
9.
Int J Occup Med Environ Health ; 32(3): 281-290, 2019 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-31180070

RESUMO

It is estimated that every third person living in Europe suffers from allergic diseases. Allergies are a growing health problem in Poland where 40% of the population have allergy symptoms, including 12% afflicted with asthma. The actual cost of allergic diseases is difficult to estimate due to the lack or incompleteness of the relevant data. The aim of this review is to present estimates of the indirect costs of allergic diseases in Poland and globally, using asthma, allergic rhinitis and atopic dermatitis as examples. The analysis also includes the impact of allergic diseases on the costs to the social welfare system and employers. The literature review of the indirect costs of allergic diseases shows that the indirect costs of a disease, which substantially exceed the direct costs, increase with the disease activity and severity. Interestingly, some studies have found that the indirect costs of lost productivity due to hours missed from work to take care of a sick child could be threefold higher than those of absence due to a worker's own illness. The indirect costs of a disease can be significantly reduced by early diagnosis and appropriate treatment. Int J Occup Med Environ Health. 2019;32(3):281-90.


Assuntos
Asma/economia , Efeitos Psicossociais da Doença , Dermatite Atópica/economia , Rinite Alérgica/economia , Absenteísmo , Asma/epidemiologia , Criança , Cuidado da Criança/economia , Dermatite Atópica/epidemiologia , Humanos , Presenteísmo , Qualidade de Vida , Rinite Alérgica/epidemiologia
10.
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
11.
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
12.
J Dermatol ; 46(8): 662-671, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31166620

RESUMO

Atopic dermatitis negatively impacts work productivity. This study investigated the impact of nemolizumab on work productivity and activity impairment in adults with moderate to severe atopic dermatitis inadequately controlled by topical treatments in a two-part, phase II, randomized control trial. The Work Productivity and Activity Impairment - Atopic Dermatitis questionnaire was an exploratory end-point. Part A was a 12-week, placebo-controlled study in which patients received s.c. nemolizumab 0.1, 0.5 or 2.0 mg/kg every 4 weeks or 2.0 mg/kg every 8 weeks. Part B was a 52-week extension in which all patients received active treatment. A total of 138 patients had Work Productivity and Activity Impairment - Atopic Dermatitis data; 104 were employed at baseline. At week 12, patients receiving nemolizumab every 4 weeks showed greater mean (standard error) Work Productivity and Activity Impairment - Atopic Dermatitis improvement (score reduction) from baseline versus placebo: Percent Work Time Missed (0.1, 0.5 or 2.0 mg/kg vs placebo): -4.0% (3.9%), -1.7% (4.2%) and -1.6% (4.2%) versus 4.9% (4.5%); Percent Impairment While Working, -15.8% (6.0%), -24.1% (6.5%) and -34.3% (6.4%) versus -16.5% (7.1%); Percent Overall Work Impairment, -16.3% (6.0%), -23.1% (6.5%) and -34.5% (6.3%) versus -16.6% (7.1%); and Percent Activity Impairment, -13.4% (5.3%), -23.5% (5.3%) and -41.9% (5.5%) versus -10.9% (5.7%). Improvements were sustained through week 64. Nemolizumab-treated patients with moderate to severe atopic dermatitis reported improvements in Work Productivity and Activity Impairment through week 64.


Assuntos
Anticorpos Monoclonais Humanizados/administração & dosagem , Dermatite Atópica/tratamento farmacológico , Eficiência/efeitos dos fármacos , Trabalho/estatística & dados numéricos , Absenteísmo , Adulto , Dermatite Atópica/complicações , Dermatite Atópica/diagnóstico , Relação Dose-Resposta a Droga , Método Duplo-Cego , Esquema de Medicação , Feminino , Humanos , Injeções Subcutâneas , Masculino , Pessoa de Meia-Idade , Placebos/administração & dosagem , Presenteísmo , Índice de Gravidade de Doença , Inquéritos e Questionários/estatística & dados numéricos , Resultado do Tratamento , Adulto Jovem
13.
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
14.
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
15.
Rev. Hosp. Ital. B. Aires (2004) ; 39(2): 43-50, jun. 2019. tab., graf.
Artigo em Espanhol | LILACS | ID: biblio-1047853

RESUMO

Introducción: la vacunación antigripal es la forma más eficaz para prevenir la enfermedad por virus Influenza y sus complicaciones. La cobertura en los profesionales sanitarios es un indicador de calidad hospitalaria. Material y métodos: estudio descriptivo de corte transversal. A partir de registros vacunales, se calculó la cobertura para las campañas 2013 a 2018. Se compararon las coberturas por trienios. Se describieron características generales de las campañas de 2016 a 2018. Resultados: en 2016 se alcanzó la mayor tasa del período (59,79%, IC 95%:58,75-60,81); en 2017, la menor (34,46%, IC 95%:33,48-35,46). La campaña 2018 obtuvo una cobertura de 54,90% (IC 95%: 53,88-55,92) y se inició más tempranamente que otras. Al comparar las tasas trienales del período se observó una diferencia de proporción de -1,3% (IC 95%: -2.84-0.24). Durante los tres últimos años, el personal vacunado correspondió mayormente al sexo femenino, a la Sede Central y tenía relación contractual directa. Las mayores coberturas específicas correspondieron a la sede de San Justo y a los profesionales de enfermería. El puesto ambulante fue el que aplicó más vacunas. Conclusión: si bien hubo variaciones en las coberturas alcanzadas a lo largo de los años, siendo la del año 2016 la más elevada y la del año 2017 la más baja, no se observaron diferencias estadísticamente significativas en las coberturas alcanzadas al comparar trienios. Resulta necesario continuar realizando intervenciones adaptadas al contexto local que permitan alcanzar los objetivos de cobertura esperados. Discusión: se reconocieron varios obstáculos para alcanzar las coberturas esperadas. La educación al personal de salud, la evaluación sistematizada de los ESAVI (Eventos supuestamente atribuibles a vacunación e inmunización) y la descripción de los elementos que facilitaron las coberturas específicas elevadas de algunas subpoblaciones podrían contribuir para mejorar los resultados. (AU)


Introduction: influenza vaccination is the most effective way to prevent influenza virus disease and its complications. Coverage in health professionals measurement is an indicator of hospital quality. Material and methods: descriptive cross-sectional study. From vaccination records, the coverage was calculated for the 2013 to 2018 campaigns. The coverage for three years was compared. General characteristics of the campaigns from 2016 to 2018 were described. Results: in 2016, the highest was achieved during the period (59.79%, IC 95%: 58.75 -60.81). In 2017, the lowest (34.46%, IC 95%: 33.48-35,46). The 2018 campaign achieved a coverage of 54.90% (IC 95%: 53.88-55.92) and started earlier than others. When comparing the triennial rates of the period, a difference of proportion of -1.3% was observed (IC 95%: -2.84-0.24). During the last three years, the vaccinated staff corresponded mostly to the female sex, to the headquarters and had a direct contractual relationship. The largest specific coverage corresponded to the San Justo headquarters and to nursing professionals. The ambulatory position was the post that applied the most vaccines. Conclusion: although there were variations in the coverage achieved over the years, with 2016 being the highest and 2017 being the lowest, there were no statistically significant differences in the coverage achieved when comparing trienniums. It is necessary to continue carrying out interventions adapted to the local context to achieve the expected coverage objectives. Discussion: several obstacles were recognized to reach the expected coverage. The education of health personnel, the systematic evaluation of the ESAVIs and the description of the elements that facilitated the high specific coverage of some subpopulations could contribute to improve the results. (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Vacinas contra Influenza/administração & dosagem , Infecções por Orthomyxoviridae/prevenção & controle , Cobertura Vacinal/estatística & dados numéricos , Qualidade da Assistência à Saúde/estatística & dados numéricos , Vacinas contra Influenza/efeitos adversos , Vacinas contra Influenza/provisão & distribução , Fatores Sexuais , Epidemiologia Descritiva , Fatores Etários , Pessoal de Saúde/educação , Pessoal de Saúde/estatística & dados numéricos , Programas de Imunização/provisão & distribução , Programas de Imunização/estatística & dados numéricos , Infecções por Orthomyxoviridae/complicações , Absenteísmo , Cobertura Vacinal/organização & administração
16.
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
17.
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
18.
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
19.
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
20.
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
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