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1.
Bone Joint J ; 102-B(11): 1446-1456, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33135433

RESUMO

AIMS: Gender bias and sexual discrimination (GBSD) have been widely recognized across a range of fields and are now part of the wider social consciousness. Such conduct can occur in the medical workplace, with detrimental effects on recipients. The aim of this review was to identify the prevalence and impact of GBSD in orthopaedic surgery, and to investigate interventions countering such behaviours. METHODS: A systematic review was conducted by searching Medline, EMCARE, CINAHL, PsycINFO, and the Cochrane Library Database in April 2020, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to which we adhered. Original research papers pertaining to the prevalence and impact of GBSD, or mitigating strategies, within orthopaedics were included for review. RESULTS: Of 570 papers, 27 were eligible for inclusion. These were published between 1998 and 2020. A narrative review was performed in light of the significant heterogeneity displayed by the eligible studies. A total of 13 papers discussed the prevalence of GBSD, while 13 related to the impact of these behaviours, and six discussed mitigating strategies. GBSD was found to be common in the orthopaedic workplace, with all sources showing women to be the subjects. The impact of this includes poor workforce representation, lower salaries, and less career success, including in academia, for women in orthopaedics. Mitigating strategies in the literature are focused on providing female role models, mentors, and educational interventions. CONCLUSION: GBSD is common in orthopaedic surgery, with a substantial impact on sufferers. A small number of mitigating strategies have been tested but these are limited in their scope. As such, the orthopaedic community is obliged to participate in more thoughtful and proactive strategies that mitigate against GBSD, by improving female recruitment and retention within the specialty. Cite this article: Bone Joint J 2020;102-B(11):1446-1456.


Assuntos
Ortopedia/estatística & dados numéricos , Sexismo/prevenção & controle , Sexismo/estatística & dados numéricos , Sucesso Acadêmico , Emprego/economia , Emprego/normas , Emprego/estatística & dados numéricos , Feminino , Mão de Obra em Saúde/economia , Mão de Obra em Saúde/estatística & dados numéricos , Humanos , Masculino , Mentores , Ortopedia/economia , Ortopedia/educação , Ortopedia/normas , Papel do Médico , Prevalência , Sexismo/economia , Mudança Social , Fatores Socioeconômicos
2.
J Med Internet Res ; 22(10): e22835, 2020 10 30.
Artigo em Inglês | MEDLINE | ID: mdl-33038075

RESUMO

BACKGROUND: Essential workers have been shown to present a higher prevalence of positive screenings for anxiety and depression during the COVID-19 pandemic. Individuals from countries with socioeconomic inequalities may be at increased risk for mental health disorders. OBJECTIVE: We aimed to assess the prevalence and predictors of depression, anxiety, and their comorbidity among essential workers in Brazil and Spain during the COVID-19 pandemic. METHODS: A web survey was conducted between April and May 2020 in both countries. The main outcome was a positive screening for depression only, anxiety only, or both. Lifestyle was measured using a lifestyle multidimensional scale adapted for the COVID-19 pandemic (Short Multidimensional Inventory Lifestyle Evaluation-Confinement). A multinomial logistic regression model was performed to evaluate the factors associated with depression, anxiety, and the presence of both conditions. RESULTS: From the 22,786 individuals included in the web survey, 3745 self-reported to be essential workers. Overall, 8.3% (n=311), 11.6% (n=434), and 27.4% (n=1027) presented positive screenings for depression, anxiety, and both, respectively. After adjusting for confounding factors, the multinomial model showed that an unhealthy lifestyle increased the likelihood of depression (adjusted odds ratio [AOR] 4.00, 95% CI 2.72-5.87), anxiety (AOR 2.39, 95% CI 1.80-3.20), and both anxiety and depression (AOR 8.30, 95% CI 5.90-11.7). Living in Brazil was associated with increased odds of depression (AOR 2.89, 95% CI 2.07-4.06), anxiety (AOR 2.81, 95%CI 2.11-3.74), and both conditions (AOR 5.99, 95% CI 4.53-7.91). CONCLUSIONS: Interventions addressing lifestyle may be useful in dealing with symptoms of common mental disorders during the strain imposed among essential workers by the COVID-19 pandemic. Essential workers who live in middle-income countries with higher rates of inequality may face additional challenges. Ensuring equitable treatment and support may be an important challenge ahead, considering the possible syndemic effect of the social determinants of health.


Assuntos
Ansiedade/epidemiologia , Infecções por Coronavirus/epidemiologia , Depressão/epidemiologia , Emprego/economia , Emprego/estatística & dados numéricos , Inquéritos Epidemiológicos , Estilo de Vida , Saúde Mental/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Adulto , Brasil/epidemiologia , Infecções por Coronavirus/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Pandemias , Pneumonia Viral/psicologia , Prevalência , Autorrelato , Fatores Socioeconômicos , Espanha/epidemiologia
3.
Prev Chronic Dis ; 17: E119, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33006541

RESUMO

INTRODUCTION: Little is known about the social needs of low-income households with children during the coronavirus-2019 (COVID-19) pandemic. Our objective was to conduct a cross-sectional quantitative and qualitative descriptive analysis of a rapid-response survey among low-income households with children on social needs, COVID-19-related concerns, and diet-related behaviors. METHODS: We distributed an electronic survey in April 2020 to 16,435 families in 4 geographic areas, and 1,048 responded. The survey asked families enrolled in a coordinated school-based nutrition program about their social needs, COVID-19-related concerns, food insecurity, and diet-related behaviors during the pandemic. An open-ended question asked about their greatest concern. We calculated descriptive statistics stratified by location and race/ethnicity. We used thematic analysis and an inductive approach to examine the open-ended comments. RESULTS: More than 80% of survey respondents were familiar with COVID-19 and were concerned about infection. Overall, 76.3% reported concerns about financial stability, 42.5% about employment, 69.4% about food availability, 31.0% about housing stability, and 35.9% about health care access. Overall, 93.5% of respondents reported being food insecure, a 22-percentage-point increase since fall 2019. Also, 41.4% reported a decrease in fruit and vegetable intake because of COVID-19. Frequency of grocery shopping decreased and food pantry usage increased. Qualitative assessment identified 4 main themes: 1) fear of contracting COVID-19, 2) disruption of employment status, 3) financial hardship, and 4) exacerbated food insecurity. CONCLUSION: Our study highlights the compounding effect of the COVID-19 pandemic on households with children across the spectrum of social needs.


Assuntos
Economia/estatística & dados numéricos , Abastecimento de Alimentos , Determinação de Necessidades de Cuidados de Saúde , Pobreza , Determinantes Sociais da Saúde , Betacoronavirus , Criança , Infecções por Coronavirus/economia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Inquéritos sobre Dietas , Emprego/estatística & dados numéricos , Características da Família , Feminino , Abastecimento de Alimentos/métodos , Abastecimento de Alimentos/normas , Humanos , Masculino , Pandemias/economia , Pandemias/prevenção & controle , Pneumonia Viral/economia , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pobreza/economia , Pobreza/estatística & dados numéricos , Serviços de Saúde Escolar/estatística & dados numéricos , Estados Unidos/epidemiologia
4.
PLoS One ; 15(9): e0239383, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32941536

RESUMO

INTRODUCTION: Rapidly increasing population old age dependency ratios create a growing economic imperative for people to work to older ages. However, rates of older worker employment are only increasing slowly. Amongst a cohort of contemporary older workers, we investigated risk factors for health-related job loss (HRJL) over 2 years of follow-up. METHODS: HEAF is a population based cohort study of adults in England (aged 50-64 years at baseline) who provided information about socio-demographic characteristics, lifestyle, and work at baseline and annual follow-ups. Exits from paid work were mapped and risk factors for HRJL explored in a multiple-record survival dataset by Cox proportional hazards models. RESULTS: 2475 (75%) men and 2668 (66%) women were employed; 115 (4.6%) men and 182 (6.8%) women reported HRJL. Employment as road transport drivers/in vehicle trades (men), or as teaching/education/nursing/midwifery professionals or in caring personal services (women), was more frequent among people exiting work for health-related versus non-health-related reasons. Principal socio-demographic and lifestyle risk factors for HRJL were: struggling financially (men and women); low physical activity (men); being overweight or obese, and current smoking (women). Mutually adjusted work-related risk factors for HRJL were job dissatisfaction, and not coping with the physical (hazard ratio [95% confidence interval]: men 5.34[3.40,8.39]; women 3.73[2.48,5.60]) or mental demands (women only, 2.02[1.38,2.96]) of work. CONCLUSIONS: Employment characteristics of contemporary older workers differ by sex. Job satisfaction and perceived ability to cope with the physical and mental demands of work are key determinants of HRJL which employers could potentially influence to enable work to older ages.


Assuntos
Emprego/estatística & dados numéricos , Saúde , Local de Trabalho/estatística & dados numéricos , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Inquéritos e Questionários
6.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(8): 1242-1249, 2020 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-32867430

RESUMO

Objective: To understand the sleep status and related influencing factors among 18-59 years old employed floating population and to provide evidence for policy development. Methods: Data were gathered from the Chinese Floating Population Chronic Disease Surveillance (2012) program. Floating population were selected through multistage clustering sampling method and stratified by industries from China. Information on demographics, behavior-related risk factors, sleep duration and social pressure etc., were collected through face-to-face interview on questionnaires. After complex weighting of data, multivariable logistic regression method was used to explore the sleep status and related influencing factors among these employed floating people. Results: A total of 43 521 subjects were included in the study. The average sleep duration per day was 7.77 h, with females (7.87 h) higher than males (7.69 h). The prevalence of insufficient sleep was 12.3% (95%CI: 11.8%-12.7%), with 45-59 years old group (21.2%) higher than that of the 18-year olds (11.2%). Results from the multivariable logistic regression analysis showed that factors as gender, age, marital status, education, occupation, inflowing area, behavior-related risk factors, BMI, social pressure, self-rated health status and self-reported chronic diseases were the main factors that affecting the rates of sleep deficiency in this population. The prevalence rate of insufficient sleep was 1.18 times higher (95%CI: 1.07-1.31) in males than that in females, and 1.22 (95%CI: 1.11-1.33) times higher in smokers than that in the non-smokers, 1.31(95%CI: 1.16-1.49) times higher in excessive drinkers than that of the normal population, 1.46 (95%CI: 1.29-1.65) times and 1.33 (95%CI: 1.18-1.50) times in those with heavier workload and stress than those without. Conclusion: The prevalence of insufficient sleep among the employed floating population was affected by multiple factors that called for more attention by different departments of the government.


Assuntos
Emprego/estatística & dados numéricos , Privação do Sono/epidemiologia , Sono , Adolescente , Adulto , China/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Adulto Jovem
7.
S Afr Med J ; 110(9): 910-915, 2020 08 31.
Artigo em Inglês | MEDLINE | ID: mdl-32880277

RESUMO

BACKGROUND: With COVID-19 having spread across the globe, it has become standard to implement infection control strategies (colloquially known as lockdown) with the intention of reducing the magnitude and delaying the peak of the epidemiological curve. Personal infection mitigation strategies coupled with lockdown have caused a change in healthcare-seeking behaviour, with individuals not attending to their ill health as they previously did. OBJECTIVES: To determine whether admissions for urgent and emergency surgical pathologies have declined during the COVID-19 lockdown period, and the magnitude of the decline. METHODS: A retrospective analysis was conducted, comparing pre-lockdown (3 February - 26 March 2020) and lockdown (27 March - 30 April 2020) admission incidences for surgical pathologies at a tertiary healthcare complex in North West Province, South Africa. Poisson regression models were created to determine admission incidence rate ratios (IRRs). RESULTS: Of 769 surgical admissions included in the analysis, 49.7% were male and 67.2% were unemployed. There was a 44% reduction in the incidence of non-trauma admissions during lockdown (IRR 0.56; 95% confidence interval (CI) 0.47 - 0.68; p<0.001) and a 53% reduction in the incidence of trauma-related admissions (IRR 0.47; 95% CI 0.34 - 0.66; p<0.001). CONCLUSIONS: Even when the prevalence of SARS-CoV-2 infection was minimal, COVID-19 lockdown in North West was associated with a significant reduction in surgical admissions. In order to ensure an overall benefit to public health, a balance between maintaining the integrity of COVID-19 control mechanisms and access to healthcare services is essential.


Assuntos
Apendicite/epidemiologia , Infecções por Coronavirus/epidemiologia , Hospitalização/estatística & dados numéricos , Neoplasias/epidemiologia , Pneumonia Viral/epidemiologia , Infecções dos Tecidos Moles/epidemiologia , Centro Cirúrgico Hospitalar , Ferimentos e Lesões/epidemiologia , Adulto , Idoso , Betacoronavirus , Emergências , Emprego/estatística & dados numéricos , Feminino , Hemorragia Gastrointestinal/epidemiologia , Humanos , Obstrução Intestinal/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Retrospectivos , África do Sul/epidemiologia , Centros de Atenção Terciária , Adulto Jovem
8.
Ann Glob Health ; 86(1): 112, 2020 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-32944509

RESUMO

Background: Although "social isolation" protects the life and health of Vietnamese citizens from the adverse effects of the COVID-19 pandemic, it also triggers massive reductions in the economic activities of the country. Objective: our study aimed to identify negative impacts of COVID-19 on occupations of Vietnamese people during the first national lockdown, including the quality and quantity of jobs as well as adverse problems at work due to COVID-19. Methods: A cross-sectional study using web-based platforms was conducted during the first time of social isolation in Vietnam at the beginning of April 2020. We utilized a respondent-driven sampling technique to select 1423 respondents from 63 cities and provinces over Vietnam. Exploratory factor analysis (EFA) was used to define sub-domains of perceived impacts of COVID-19 on occupations. Findings: Approximately two-thirds of respondents reported decreases in their income (61.6%), and 28.2% reported that their income deficit was 40% and above. The percentage of female individuals having decreased revenue due to COVID-19 was higher than that of male respondents (65.2% and 54.7%, respectively). "Worry that colleagues exposed to COVID-19 patients" and "Being alienated because employment-related to COVID-19" accounted for the highest score in each factor. Compared to healthcare workers, being self-employed/unemployed/retired were less likely to suffer from "Increased workload and conflicts due to COVID-19" and "Disclosure and discrimination related to COVID-19 work exposure." Conclusion: Our study revealed a drastic reduction in both the quality and quantity of working, as well as the increased fear and stigmatization of exposure to COVID-19 at workplaces. Health protection and economic support are immediate targets that should be focused on when implementing policies and regulations.


Assuntos
Controle de Doenças Transmissíveis , Infecções por Coronavirus , Recessão Econômica/estatística & dados numéricos , Emprego/estatística & dados numéricos , Pandemias , Pneumonia Viral , Adulto , Betacoronavirus , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/economia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Estudos Transversais , Feminino , Humanos , Renda/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde , Pandemias/economia , Pandemias/prevenção & controle , Pneumonia Viral/economia , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Controle Social Formal/métodos , Vietnã/epidemiologia , Desempenho Profissional , Carga de Trabalho/estatística & dados numéricos
9.
Psychiatr Danub ; 32(Suppl 2): 262-268, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32970645

RESUMO

BACKGROUND: Approximately 20% of the European labour force is involved in some type of shift work, with nurses being on the forefront. In Bosnia and Herzegovina, a specific work scheme is pervasive in the health care arena, where all nurses involved in shift work are committed to eight night shifts per month - unlike other European countries that restrict the number of night shifts. Accordingly, we aimed to investigate whether such shift work significantly affects psychosocial functioning and the quality of life of hospital nursing personnel in this country. SUBJECTS AND METHODS: A comparative cross-sectional study design was applied on a total of 157 hospital nursing professionals at the University Clinical Hospital Mostar during 2019. Subjects were divided into two groups: a total of 51% study subjects worked in specific shifts (12-hour day shift / 24 hours off / 12-hour night shift / 48 hours off), while 49% subjects worked in accordance with the regular 7-hour daily schedule. Standard Shiftwork Index (SSI) questionnaire was used, alongside comprehensive socio-demographic and quality of life appraisal. Descriptive and inferential statistical methods were applied, and statistical significance was set at p<0.05. RESULTS: This study demonstrated increased amounts of stress, reduced coping abilities and reduced levels of life enjoyment in shift work nurses in comparison to day work nurses. Furthermore, increased anxiety, stress, psychoorganic symptoms and sleep disturbances were significantly more common in shift work hospital nursing staff. In our study, nurses that worked in shifts have experienced negative externalities such as decreased social functioning, as well as reduced family and leisure time. Conversely, significantly higher satisfaction rates with shift work were only shown in regards to compensation. CONCLUSIONS: Our results reveal many detrimental effects of shift work and contribute to the field of research that is still laden with gaps in understanding its exact impact on the overall health of nursing personnel. Going forward, prospective (and even interventional) studies will be needed to disentangle the exact interplay between work-related factors in various health care systems and subsequent psychosocial disorders in health personnel.


Assuntos
Enfermeiras e Enfermeiros/psicologia , Recursos Humanos de Enfermagem no Hospital/psicologia , Qualidade de Vida , Jornada de Trabalho em Turnos/psicologia , Tolerância ao Trabalho Programado/fisiologia , Tolerância ao Trabalho Programado/psicologia , Adulto , Bósnia e Herzegóvina/epidemiologia , Estudos Transversais , Emprego/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Transtornos do Sono-Vigília/epidemiologia , Inquéritos e Questionários , Adulto Jovem
10.
PLoS One ; 15(9): e0238401, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32970671

RESUMO

BACKGROUND: Social epidemiologic research in relation to the health impacts of precarious employment has grown markedly during the past decade. While the multidimensional nature of precarious employment has long been acknowledged theoretically, empirical studies have mostly focused on one-dimensional approach only (based either on employment temporariness or perceived job insecurity). This study compares the use of a multidimensional employment precariousness scale (EPRES) with traditional one-dimensional approaches in relation to distinct health outcomes and across various socio-demographic characteristics. METHODS: We used a subsample of formal salaried workers (n = 3521) from the first Chilean employment and working conditions survey (2009-2010). Multilevel modified Poisson regressions with fixed effects (individuals nested within regions) and survey weights were conducted to estimate the association between general health, mental health and occupational injuries and distinct precarious employment exposures (temporary employment, perceived job insecurity, and the multidimensional EPRES scale). We assessed the presence of effect measure modification according to sex, age, educational level, and occupational class (manual/non-manual). RESULTS: Compared to one-dimensional approaches to precarious employment, the multidimensional EPRES scale captured a larger picture of potential health effects and differences across subgroups of workers. Patterns of effect measure that modification were consistent with the expectations that groups in greater disadvantage (women, older individuals, less educated and manual workers) were more vulnerable to poor employment conditions. CONCLUSIONS: Multidimensional measures of precarious employment better capture its association with a breath of health outcomes, being necessary tools for research in order to strengthen the evidence base for policy making in the protection of workers' health.


Assuntos
Emprego , Nível de Saúde , Adolescente , Adulto , Idoso , Chile , Emprego/estatística & dados numéricos , Feminino , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Saúde do Trabalhador , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
11.
J Med Internet Res ; 22(9): e22457, 2020 09 29.
Artigo em Inglês | MEDLINE | ID: mdl-32924947

RESUMO

BACKGROUND: Maintaining compliance with personal preventive measures is important to achieve a balance of COVID-19 pandemic control and work resumption. OBJECTIVE: The aim of this study was to investigate self-reported compliance with four personal measures to prevent COVID-19 among a sample of factory workers in Shenzhen, China, at the beginning of work resumption in China following the COVID-19 outbreak. These preventive measures included consistent wearing of face masks in public spaces (the workplace and other public settings); sanitizing hands using soap, liquid soap, or alcohol-based hand sanitizer after returning from public spaces or touching public installations and equipment; avoiding social and meal gatherings; and avoiding crowded places. METHODS: The participants were adult factory workers who had resumed work in Shenzhen, China. A stratified two-stage cluster sampling design was used. We randomly selected 14 factories that had resumed work. All full-time employees aged ≥18 years who had resumed work in these factories were invited to complete a web-based survey. Out of 4158 workers who had resumed work in these factories, 3035 (73.0%) completed the web-based survey from March 1 to 14, 2020. Multilevel logistic regression models were fitted. RESULTS: Among the 3035 participants, 2938 (96.8%) and 2996 (98.7%) reported always wearing a face mask in the workplace and in other public settings, respectively, in the past month. However, frequencies of self-reported sanitizing hands (2152/3035, 70.9%), avoiding social and meal gatherings (2225/3035, 73.3%), and avoiding crowded places (1997/3035, 65.8%) were relatively low. At the individual level, knowledge about COVID-19 (adjusted odds ratios [AORs] from 1.16, CI 1.10-1.24, to 1.29, CI 1.21-1.37), perceived risk (AORs from 0.58, CI 0.50-0.68, to 0.85, CI 0.72-0.99) and severity (AOR 1.05, CI 1.01-1.09, and AOR 1.07, CI 1.03-1.11) of COVID-19, perceived effectiveness of preventive measures by the individual (AORs from 1.05, CI 1.00-1.10, to 1.09, CI 1.04-1.13), organization (AOR 1.30, CI 1.20-1.41), and government (AORs from 1.14, CI 1.04-1.25, to 1.21, CI 1.02-1.42), perceived preparedness for a potential outbreak after work resumption (AORs from 1.10, CI 1.00-1.21, to 1.50, CI 1.36-1.64), and depressive symptoms (AORs from 0.93, CI 0.91-0.94, to 0.96, CI 0.92-0.99) were associated with self-reported compliance with at least one personal preventive measure. At the interpersonal level, exposure to COVID-19-specific information through official media channels (AOR 1.08, CI 1.04-1.11) and face-to-face communication (AOR 0.90, CI 0.83-0.98) were associated with self-reported sanitizing of hands. The number of preventive measures implemented in the workplace was positively associated with self-reported compliance with all four preventive measures (AORs from 1.30, CI 1.08-1.57, to 1.63, CI 1.45-1.84). CONCLUSIONS: Measures are needed to strengthen hand hygiene and physical distancing among factory workers to reduce transmission following work resumption. Future programs in workplaces should address these factors at multiple levels.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Emprego/estatística & dados numéricos , Inquéritos Epidemiológicos , Controle de Infecções/estatística & dados numéricos , Saúde do Trabalhador/estatística & dados numéricos , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Autorrelato , Local de Trabalho , Adulto , Betacoronavirus , China/epidemiologia , Infecções por Coronavirus/transmissão , Estudos Transversais , Surtos de Doenças , Feminino , Humanos , Controle de Infecções/métodos , Masculino , Saúde do Trabalhador/normas , Razão de Chances , Pneumonia Viral/transmissão , Adulto Jovem
12.
PLoS One ; 15(9): e0239113, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32946463

RESUMO

Social distancing interventions can be effective against epidemics but are potentially detrimental for the economy. Businesses that rely heavily on face-to-face communication or close physical proximity when producing a product or providing a service are particularly vulnerable. There is, however, no systematic evidence about the role of human interactions across different lines of business and about which will be the most limited by social distancing. Here we provide theory-based measures of the reliance of U.S. businesses on human interaction, detailed by industry and geographic location. We find that, before the pandemic hit, 43 million workers worked in occupations that rely heavily on face-to-face communication or require close physical proximity to other workers. Many of these workers lost their jobs since. Consistently with our model, employment losses have been largest in sectors that rely heavily on customer contact and where these contacts dropped the most: retail, hotels and restaurants, arts and entertainment and schools. Our results can help quantify the economic costs of social distancing.


Assuntos
Comércio/tendências , Infecções por Coronavirus/prevenção & controle , Emprego/tendências , Controle de Infecções/economia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Betacoronavirus/patogenicidade , Comércio/normas , Comércio/estatística & dados numéricos , Infecções por Coronavirus/economia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Conjuntos de Dados como Assunto , Emprego/economia , Emprego/estatística & dados numéricos , Humanos , Controle de Infecções/métodos , Controle de Infecções/normas , Pandemias/economia , Pneumonia Viral/economia , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Estados Unidos
13.
Bull Cancer ; 107(9): 867-880, 2020 Sep.
Artigo em Francês | MEDLINE | ID: mdl-32919610

RESUMO

INTRODUCTION: Few studies have explored the long-term occupational situation after cancer. The aim of our study were to study the employment status among long-term cancer survivors and to compare it to cancer-free controls from the general population at 5, 10 or 15 years after cancer diagnosis. METHODS: From data of a registry-based study, long-term survivors from breast,cervical and colorectal cancer, randomly selected from three tumor registries in France, were compared to cancer-free controls randomly selected from electoral lists. We selected active cancer survivors and cancer-free controls aged less than 60 at the time of the survey. We have studied the employment status of cases vs. controls and the factors associated with employment status. RESULTS: At 5, 10 or 15 years after diagnosis, we did not observe any significant difference in employment status between cases and controls. Among cases, 17% had lost their jobs. Older age, lower incomes, lower education, a short-term employment contract, the presence of co-morbidities, fatigue and a worse quality of life were associated with job loss. DISCUSSION: Although the employment status of the cases was comparable to that of the controls, efforts should be intensified to make it easier for patients diagnosed with cancer to return to work.


Assuntos
Sobreviventes de Câncer , Emprego/estatística & dados numéricos , Adulto , Neoplasias da Mama/terapia , Neoplasias Colorretais/terapia , Estudos Transversais , Feminino , França , Humanos , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Fatores de Tempo , Neoplasias do Colo do Útero/terapia , Adulto Jovem
14.
Health Aff (Millwood) ; 39(10): 1822-1831, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32757955

RESUMO

The recent coronavirus disease 2019 (COVID-19) global pandemic has resulted in unprecedented job losses in the United States, disrupting health insurance coverage for millions of people. Several models have predicted large increases in Medicaid enrollment among those who have lost jobs, yet the number of Americans who have gained coverage since the pandemic began is unknown. We compiled Medicaid enrollment reports covering the period from March 1 through June 1, 2020, for twenty-six states. We found that in these twenty-six states, Medicaid covered more than 1.7 million additional Americans in roughly a three-month period. Relative changes in Medicaid enrollment differed significantly across states, although enrollment growth was not systemically related to job losses. Our results point to the important effects of state policy differences in the response to COVID-19.


Assuntos
Infecções por Coronavirus/epidemiologia , Definição da Elegibilidade/estatística & dados numéricos , Emprego/estatística & dados numéricos , Cobertura do Seguro/estatística & dados numéricos , Medicaid/estatística & dados numéricos , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Estudos de Coortes , Infecções por Coronavirus/prevenção & controle , Bases de Dados Factuais , Definição da Elegibilidade/métodos , Emprego/economia , Feminino , Humanos , Incidência , Seguro Saúde/organização & administração , Masculino , Pessoas sem Cobertura de Seguro de Saúde/estatística & dados numéricos , Determinação de Necessidades de Cuidados de Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Estudos Retrospectivos , Medição de Risco , Fatores de Tempo , Estados Unidos
16.
PLoS One ; 15(8): e0234900, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804945

RESUMO

BACKGROUND: Keeping older workers in employment is critical for societies facing the challenge of an ageing population. This study examined the association between types of health conditions and differentials in the probability of employment by level of education among men and women between 60-69 years of age in Canada, Denmark, Sweden and England. METHODS: Data were drawn from the Canadian Community Health Survey, Survey of Health, Ageing and Retirement in Europe and English Longitudinal Study of Ageing. We combined country data, applied logistic regression, adjusted for educational level, and stratified the analysis by sex to calculate the odds ratio (OR) of employment (>15 hours work per week) for persons with physical health conditions, mental health conditions (depression) and physical-mental health comorbidity. RESULTS: The odds of employment among men and women with physical-mental health comorbidity were lower compared to those with no/other conditions (men: OR 0.32, 95% CI: 0.25-0.42, women: OR 0.38 95% CI: 0.30-0.48). Women with low education had lower odds of employment compared to their counterparts with high education (OR 0.66, 95% CI: 0.57-0.76). The odds of employment at older ages was lower in Canada, Denmark and England compared with Sweden (e.g. English men: OR 0.48 95% CI 0.40-0.58; English women OR 0.33 95% CI 0.27-0.41). CONCLUSIONS: The odds of employment beyond age 60 is lower for groups with low education, particularly women, and those with physical-mental health co-morbidities. As such, policies to extend working lives should not be 'one size fits all' but instead consider subgroups, in particular, these groups that we have shown to be most vulnerable on the labour market.


Assuntos
Emprego , Aposentadoria , Idoso , Envelhecimento , Canadá , Estudos Transversais , Dinamarca , Escolaridade , Emprego/estatística & dados numéricos , Inglaterra , Feminino , Nível de Saúde , Humanos , Modelos Logísticos , Estudos Longitudinais , Masculino , Saúde Mental , Pessoa de Meia-Idade , Ocupações/estatística & dados numéricos , Razão de Chances , Aposentadoria/estatística & dados numéricos , Fatores Socioeconômicos , Inquéritos e Questionários , Suécia
17.
Cochrane Database Syst Rev ; 8: CD008016, 2020 08 11.
Artigo em Inglês | MEDLINE | ID: mdl-32840872

RESUMO

BACKGROUND: The symptoms and signs of schizophrenia have been linked to high levels of dopamine in specific areas of the brain (limbic system). Antipsychotic drugs block the transmission of dopamine in the brain and reduce the acute symptoms of the disorder. An original version of the current review, published in 2012, examined whether antipsychotic drugs are also effective for relapse prevention. This is the updated version of the aforesaid review. OBJECTIVES: To review the effects of maintaining antipsychotic drugs for people with schizophrenia compared to withdrawing these agents. SEARCH METHODS: We searched the Cochrane Schizophrenia Group's Study-Based Register of Trials including the registries of clinical trials (12 November 2008, 10 October 2017, 3 July 2018, 11 September 2019). SELECTION CRITERIA: We included all randomised trials comparing maintenance treatment with antipsychotic drugs and placebo for people with schizophrenia or schizophrenia-like psychoses. DATA COLLECTION AND ANALYSIS: We extracted data independently. For dichotomous data we calculated risk ratios (RR) and their 95% confidence intervals (CIs) on an intention-to-treat basis based on a random-effects model. For continuous data, we calculated mean differences (MD) or standardised mean differences (SMD), again based on a random-effects model. MAIN RESULTS: The review currently includes 75 randomised controlled trials (RCTs) involving 9145 participants comparing antipsychotic medication with placebo. The trials were published from 1959 to 2017 and their size ranged between 14 and 420 participants. In many studies the methods of randomisation, allocation and blinding were poorly reported. However, restricting the analysis to studies at low risk of bias gave similar results. Although this and other potential sources of bias limited the overall quality, the efficacy of antipsychotic drugs for maintenance treatment in schizophrenia was clear. Antipsychotic drugs were more effective than placebo in preventing relapse at seven to 12 months (primary outcome; drug 24% versus placebo 61%, 30 RCTs, n = 4249, RR 0.38, 95% CI 0.32 to 0.45, number needed to treat for an additional beneficial outcome (NNTB) 3, 95% CI 2 to 3; high-certainty evidence). Hospitalisation was also reduced, however, the baseline risk was lower (drug 7% versus placebo 18%, 21 RCTs, n = 3558, RR 0.43, 95% CI 0.32 to 0.57, NNTB 8, 95% CI 6 to 14; high-certainty evidence). More participants in the placebo group than in the antipsychotic drug group left the studies early due to any reason (at seven to 12 months: drug 36% versus placebo 62%, 24 RCTs, n = 3951, RR 0.56, 95% CI 0.48 to 0.65, NNTB 4, 95% CI 3 to 5; high-certainty evidence) and due to inefficacy of treatment (at seven to 12 months: drug 18% versus placebo 46%, 24 RCTs, n = 3951, RR 0.37, 95% CI 0.31 to 0.44, NNTB 3, 95% CI 3 to 4). Quality of life might be better in drug-treated participants (7 RCTs, n = 1573 SMD -0.32, 95% CI to -0.57 to -0.07; low-certainty evidence); probably the same for social functioning (15 RCTs, n = 3588, SMD -0.43, 95% CI -0.53 to -0.34; moderate-certainty evidence). Underpowered data revealed no evidence of a difference between groups for the outcome 'Death due to suicide' (drug 0.04% versus placebo 0.1%, 19 RCTs, n = 4634, RR 0.60, 95% CI 0.12 to 2.97,low-certainty evidence) and for the number of participants in employment (at 9 to 15 months, drug 39% versus placebo 34%, 3 RCTs, n = 593, RR 1.08, 95% CI 0.82 to 1.41, low certainty evidence). Antipsychotic drugs (as a group and irrespective of duration) were associated with more participants experiencing movement disorders (e.g. at least one movement disorder: drug 14% versus placebo 8%, 29 RCTs, n = 5276, RR 1.52, 95% CI 1.25 to 1.85, number needed to treat for an additional harmful outcome (NNTH) 20, 95% CI 14 to 50), sedation (drug 8% versus placebo 5%, 18 RCTs, n = 4078, RR 1.52, 95% CI 1.24 to 1.86, NNTH 50, 95% CI not significant), and weight gain (drug 9% versus placebo 6%, 19 RCTs, n = 4767, RR 1.69, 95% CI 1.21 to 2.35, NNTH 25, 95% CI 20 to 50). AUTHORS' CONCLUSIONS: For people with schizophrenia, the evidence suggests that maintenance on antipsychotic drugs prevents relapse to a much greater extent than placebo for approximately up to two years of follow-up. This effect must be weighed against the adverse effects of antipsychotic drugs. Future studies should better clarify the long-term morbidity and mortality associated with these drugs.


Assuntos
Antipsicóticos/uso terapêutico , Quimioterapia de Manutenção/métodos , Esquizofrenia/prevenção & controle , Antipsicóticos/efeitos adversos , Viés , Antagonistas de Dopamina/efeitos adversos , Antagonistas de Dopamina/uso terapêutico , Emprego/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Humanos , Pacientes Desistentes do Tratamento/estatística & dados numéricos , Placebos/uso terapêutico , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Recidiva , Esquizofrenia/tratamento farmacológico , Prevenção Secundária
18.
Am J Geriatr Psychiatry ; 28(10): 1030-1039, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32753338

RESUMO

OBJECTIVE: To examine the psychological distress and the associated predictor factors of the 2019 corona-virus disease (COVID-19) on survivors in the early convalescence in Shenzhen. METHOD: A survey questionnaire consisting of post-traumatic stress disorder self-rating scale (PTSD-SS), self-rating depression scale (SDS), and self-rating anxiety scale (SAS) was presented to COVID-19 survivors still in quarantine. Scores of each scale and subscale were dependent variables in the Mann-Whitney test and stepwise regression analysis. RESULTS: A total of 126 subjects were included in the study, the mean scores of PTSD-SS, SDS, and SAS were 45.5 ± 18.9, 47.3 ± 13.1, and 43.2 ± 10.2, respectively, meanwhile, 9 (31.0%), 28 (22.2%), and 48 (38.1%) of the survivors met the cut-score for clinical significant symptoms of stress response, anxiety, and depression, respectively. Infected family members, and postinfection physical discomforts were significantly associated with scores on all three scales. Social support, retirement, and being female had significant associations with the PTSD-SS score. The survivors aged 60 or above experienced less severe stress response symptoms, fewer emotional symptoms of depression, and fewer anxiety symptoms than younger survivors. CONCLUSION: The occurrence rate of psychological distress among the COVID-19 survivors in early convalescence was high, highlighting the need for all COVID-19 survivors to be screened for psychological distress regularly for timely intervention. The predictors indicated by the current study may help to identify those at high-risk. Besides, the results indicated the older survivors suffered less emotional reactivity and fewer stress response symptoms from infectious diseases than the younger ones.


Assuntos
Ansiedade/epidemiologia , Infecções por Coronavirus/psicologia , Depressão/epidemiologia , Pneumonia Viral/psicologia , Aposentadoria/estatística & dados numéricos , Apoio Social , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Estresse Psicológico/epidemiologia , Sobreviventes/estatística & dados numéricos , Adulto , Fatores Etários , Idoso , Ansiedade/psicologia , Betacoronavirus , China/epidemiologia , Convalescença , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Depressão/psicologia , Emprego/estatística & dados numéricos , Família , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia , Fatores de Proteção , Angústia Psicológica , Fatores de Risco , Índice de Gravidade de Doença , Fatores Sexuais , Transtornos de Estresse Pós-Traumáticos/psicologia , Estresse Psicológico/psicologia , Sobreviventes/psicologia
19.
PLoS One ; 15(8): e0236996, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32750066

RESUMO

Using novel registry data on persons receiving asylum welfare benefits in Germany for the period from 2010 to 2016, and quasi-experimental variation induced by German allocation policies, we identify the role that the size and composition of local co-national networks of asylum seekers play for formal labor market access within the same group. While the individual employment probability is not linked to network size, it increases with the number of employed local co-national asylum seekers and decreases with the number of non-employed network members, thereby underlining the central importance of network quality. JEL Classification: F22, J61, R23.


Assuntos
Emprego/estatística & dados numéricos , Refugiados , Adulto , Idoso , Emprego/tendências , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Adulto Jovem
20.
Isr Med Assoc J ; 7(22): 380-384, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32692501

RESUMO

BACKGROUND: Fibromyalgia is a common pain syndrome treated by physicians of many disciplines and presents with many co-morbidities. We reviewed the complexities in assessing disabilities in fibromyalgia patients and the complex interrelationships between patients, their working places, and the medical community regarding preserving productivity. Flexibility is essential to keep the patients functional and productive. Job loss is costly to both society and patients and joint measures are needed to prevent unemployment.


Assuntos
Pessoas com Deficiência , Eficiência/fisiologia , Fibromialgia/fisiopatologia , Avaliação da Deficiência , Emprego/estatística & dados numéricos , Humanos
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