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1.
Sci Rep ; 11(1): 5160, 2021 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-33664279

RESUMO

The extent that antibodies to SARS-CoV-2 may protect against future virus-associated disease is unknown. We invited all employees (n = 15,300) at work at the Karolinska University Hospital, Stockholm, Sweden to participate in a study examining SARS-Cov-2 antibodies in relation to registered sick leave. For consenting 12,928 healthy hospital employees antibodies to SARS-CoV-2 could be determined and compared to participant sick leave records. Subjects with viral serum antibodies were not at excess risk for future sick leave (adjusted odds ratio (OR) controlling for age and sex: 0.85 [95% confidence interval (CI) (0.85 (0.43-1.68)]. By contrast, subjects with antibodies had an excess risk for sick leave in the weeks prior to testing [adjusted OR in multivariate analysis: 3.34 (2.98-3.74)]. Thus, presence of viral antibodies marks past disease and protection against excess risk of future disease. Knowledge of whether exposed subjects have had disease in the past or are at risk for future disease is essential for planning of control measures.Trial registration: First registered on 02/06/20, ClinicalTrials.gov NCT04411576.


Assuntos
Anticorpos Antivirais/sangue , /imunologia , Licença Médica/estatística & dados numéricos , Adulto , Anticorpos Antivirais/imunologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Suécia/epidemiologia
2.
J Ment Health Policy Econ ; 24(1): 31-41, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33739934

RESUMO

BACKGROUND: Unemployment is associated with a high risk of experiencing mental illness. This can lead to stigmatisation, reduced quality of life, and long-term costs like increased healthcare expenditure and productivity losses for society as a whole. Previous research indicates evidence for an association between unemployment and higher mental health service costs, but there is insufficient information available for the German healthcare system. AIM OF THE STUDY: This study aims to identify costs and cost drivers for health and social service use among unemployed people with mental health problems in Germany. METHODS: A sample of 270 persons participated at baseline and six-month-follow-up. Healthcare and social service use was assessed using the Client Socio-Demographic and Service Receipt Inventory. Descriptive cost analysis was performed. Associations between costs and potential cost drivers were tested using structural equation modelling. RESULTS: Direct mean costs for 12 months range from EUR 1265.13 (somatic costs) to EUR 2206.38 (psychiatric costs) to EUR 3020.70 (total costs) per person. Path coefficients indicate direct positive effects from the latent variable mental health burden (MHB) on stigma stress, somatic symptoms, and sick leave. DISCUSSION: The hypothesis that unemployed people with mental health problems seek help for somatic symptoms rather than psychiatric symptoms was not supported. Associations between MHB and costs strongly mediated by sick leave indicate a central function of healthcare provision as being confirmation of the inability to work. IMPLICATIONS FOR HEALTH POLICIES: Targeted interventions to ensure early help-seeking and reduce stigma remain of key importance in reducing long-term societal costs. IMPLICATIONS FOR FURTHER RESEARCH: Future research should explore attitudes regarding effective treatment for the target group.


Assuntos
Custos de Cuidados de Saúde/estatística & dados numéricos , Transtornos Mentais/economia , Transtornos Mentais/terapia , Serviços de Saúde Mental/economia , Licença Médica/economia , Desemprego/estatística & dados numéricos , Adulto , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Transtornos Mentais/epidemiologia , Saúde Mental , Serviços de Saúde Mental/estatística & dados numéricos , Pessoa de Meia-Idade , Qualidade de Vida , Estigma Social , Desemprego/psicologia , Adulto Jovem
3.
JAMA Netw Open ; 4(3): e210684, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33704475

RESUMO

Importance: Latinx individuals, particularly immigrants, are at higher risk than non-Latinx White individuals of contracting and dying from coronavirus disease 2019 (COVID-19). Little is known about Latinx experiences with COVID-19 infection and treatment. Objective: To describe the experiences of Latinx individuals who were hospitalized with and survived COVID-19. Design, Setting, and Participants: The qualitative study used semistructured phone interviews of 60 Latinx adults who survived a COVID-19 hospitalization in public hospitals in San Francisco, California, and Denver, Colorado, from March 2020 to July 2020. Transcripts were analyzed using qualitative thematic analysis. Data analysis was conducted from May 2020 to September 2020. Main Outcomes and Measures: Themes and subthemes that reflected patient experiences. Results: Sixty people (24 women and 36 men; mean [SD] age, 48 [12] years) participated. All lived in low-income areas, 47 participants (78%) had more than 4 people in the home, and most (44 participants [73%]) were essential workers. Four participants (9%) could work from home, 12 (20%) had paid sick leave, and 21 (35%) lost their job because of COVID-19. We identified 5 themes (and subthemes) with public health and clinical care implications: COVID-19 was a distant and secondary threat (invincibility, misinformation and disbelief, ingrained social norms); COVID-19 was a compounder of disadvantage (fear of unemployment and eviction, lack of safeguards for undocumented immigrants, inability to protect self from COVID-19, and high-density housing); reluctance to seek medical care (worry about health care costs, concerned about ability to access care if uninsured or undocumented, undocumented immigrants fear deportation); health care system interactions (social isolation and change in hospital procedures, appreciation for clinicians and language access, and discharge with insufficient resources or clinical information); and faith and community resiliency (spirituality, Latinx COVID-19 advocates). Conclusions and Relevance: In interviews, Latinx patients with COVID-19 who survived hospitalization described initial disease misinformation and economic and immigration fears as having driven exposure and delays in presentation. To confront COVID-19 as a compounder of social disadvantage, public health authorities should mitigate COVID-19-related misinformation, immigration fears, and challenges to health care access, as well as create policies that provide work protection and address economic disadvantages.


Assuntos
/etnologia , Emigração e Imigração , Emprego , Medo , Comportamento de Busca de Ajuda , Hispano-Americanos , Hospitalização , Saúde Pública , Adulto , California , Colorado , Comunicação , Status Econômico , Feminino , Gastos em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Áreas de Pobreza , Pesquisa Qualitativa , Licença Médica , Classe Social , Normas Sociais , Imigrantes Indocumentados
4.
BJS Open ; 5(2)2021 03 05.
Artigo em Inglês | MEDLINE | ID: mdl-33688956

RESUMO

BACKGROUND: During the initial COVID-19 outbreak up to 28.4 million elective operations were cancelled worldwide, in part owing to concerns that it would be unsustainable to maintain elective surgery capacity because of COVID-19-related surgeon absence. Although many hospitals are now recovering, surgical teams need strategies to prepare for future outbreaks. This study aimed to develop a framework to predict elective surgery capacity during future COVID-19 outbreaks. METHODS: An international cross-sectional study determined real-world COVID-19-related absence rates among surgeons. COVID-19-related absences included sickness, self-isolation, shielding, and caring for family. To estimate elective surgical capacity during future outbreaks, an expert elicitation study was undertaken with senior surgeons to determine the minimum surgical staff required to provide surgical services while maintaining a range of elective surgery volumes (0, 25, 50 or 75 per cent). RESULTS: Based on data from 364 hospitals across 65 countries, the COVID-19-related absence rate during the initial 6 weeks of the outbreak ranged from 20.5 to 24.7 per cent (mean average fortnightly). In weeks 7-12, this decreased to 9.2-13.8 per cent. At all times during the COVID-19 outbreak there was predicted to be sufficient surgical staff available to maintain at least 75 per cent of regular elective surgical volume. Overall, there was predicted capacity for surgeon redeployment to support the wider hospital response to COVID-19. CONCLUSION: This framework will inform elective surgical service planning during future COVID-19 outbreaks. In most settings, surgeon absence is unlikely to be the factor limiting elective surgery capacity.


Assuntos
Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Licença para Cuidar de Pessoa da Família/estatística & dados numéricos , Mão de Obra em Saúde , Quarentena/estatística & dados numéricos , Licença Médica/estatística & dados numéricos , Cirurgiões/provisão & distribução , Centro Cirúrgico Hospitalar , Estudos Transversais , Humanos , Internacionalidade
5.
Artigo em Inglês | MEDLINE | ID: mdl-33572766

RESUMO

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


Assuntos
Absenteísmo , Local de Trabalho , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Letônia , Masculino , Pessoa de Meia-Idade , Autorrelato , Licença Médica , Inquéritos e Questionários , Adulto Jovem
6.
Rev Med Liege ; 76(1): 36-43, 2021 Jan.
Artigo em Francês | MEDLINE | ID: mdl-33443327

RESUMO

Since the introduction of laparoscopy and mini-invasive techniques, gynaecological surgery has largely evolved. However, post-operative recommendations still remain very restrictive with poor evidence from literature. The survey, performed by the GGOLFB surgical working group, shows that the post-operative advices to the patients are very heterogeneous for the sick leave period as for more specific advices like the period of disallowance of sexual intercourse, bathing and weightlifting. It is nevertheless fundamental to prescribe clear and precise advices to patients, from the first pre-operative consultation on, which will substantially improve the perception of their recovery and promote a return to their normal activity under good conditions. It is not necessary to be too restrictive concerning certain activities in the post-operative period, neither to give too long periods of work incapacity because it may have a negative impact on their quality of life. This survey and the data from literature helped our surgical taskforce group to propose and develop harmonised recommendations on recovery and work incapacity after gynaecological surgery, taking into account the actual surgical practice in 2020.


Assuntos
Procedimentos Cirúrgicos em Ginecologia , Qualidade de Vida , Bélgica , Feminino , Humanos , Licença Médica , Inquéritos e Questionários
7.
J Occup Health ; 63(1): e12195, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33464695

RESUMO

INTRODUCTION: Emergency physicians frequently provide care for patients who are experiencing viral illnesses and may be asked to provide verification of the patient's illness (a sick note) for time missed from work. Exclusion from work can be a powerful public health measure during epidemics; both legislation and physician advice contribute to patients' decisions to recover at home. METHODS: We surveyed Canadian Association of Emergency Physicians members to determine what impacts sick notes have on patients and the system, the duration of time off work that physicians recommend, and what training and policies are in place to help providers. Descriptive statistics from the survey are reported. RESULTS: A total of 182 of 1524 physicians responded to the survey; 51.1% practice in Ontario. 76.4% of physicians write at least one sick note per day, with 4.2% writing 5 or more sick notes per day. Thirteen percentage of physicians charge for a sick note (mean cost $22.50). Patients advised to stay home for a median of 4 days with influenza and 2 days with gastroenteritis and upper respiratory tract infections. 82.8% of physicians believe that most of the time, patients can determine when to return to work. Advice varied widely between respondents. 61% of respondents were unfamiliar with sick leave legislation in their province and only 2% had received formal training about illness verification. CONCLUSIONS: Providing sick notes is a common practice of Canadian Emergency Physicians; return-to-work guidance is variable. Improved physician education about public health recommendations and provincial legislation may strengthen physician advice to patients.


Assuntos
Atitude do Pessoal de Saúde , Medicina de Emergência , Relações Médico-Paciente , Médicos/psicologia , Padrões de Prática Médica/estatística & dados numéricos , Retorno ao Trabalho , Licença Médica , Adulto , Canadá , Tomada de Decisões , Feminino , Mau Uso de Serviços de Saúde , Humanos , Masculino , Inquéritos e Questionários
8.
J Stroke Cerebrovasc Dis ; 30(4): 105628, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33508728

RESUMO

OBJECTIVES: To explore factors from the acute phase, and after three and 12 months, associated with level of self-reported physical activity 12 months after a minor ischemic stroke with National Institutes of Health Stroke Scale (NIHSS) score ≤ 3 in persons 70 years or younger. MATERIALS AND METHOD: In this longitudinal cohort study patients were recruited consecutively from two stroke units. Activity level were measured with three sets of questions addressing the average number of frequency (times exercising each week), the average intensity, and duration (the average time), and a sum score was constructed. The association between physical activity 12 months after stroke and sociodemographic factors, NIHSS, body mass index, balance, and neuropsychiatric symptoms were explored using multiple linear regression. RESULTS: This study included 101 patients, with mean age (SD) 55.5 (11.4) years, NIHSS median (Q1, Q3) 0.0 (0.0, 1.0), and 20 % were female. Multiple linear regression analyses showed sick leave status at stroke onset, balance at three and 12 months, and anxiety, depression, apathy, and fatigue at 12 months to be factors associated with physical activity at 12 months after stroke. CONCLUSION: We found that pre-stroke sick leave, post-stroke balance, and neuropsychiatric symptoms were associated with the level of physical activity one year after minor stroke. This might be of importance when giving information about physical activity and deciding about post-stroke follow-up.


Assuntos
Tolerância ao Exercício , Exercício Físico , Saúde Mental , Adulto , Idoso , Avaliação da Deficiência , Feminino , Humanos , /psicologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Equilíbrio Postural , Prognóstico , Recuperação de Função Fisiológica , Fatores de Risco , Licença Médica , Inquéritos e Questionários , Fatores de Tempo
9.
Artigo em Inglês | MEDLINE | ID: mdl-33435424

RESUMO

Socioeconomic differences in sickness absence are well known, but previous studies have tended to focus on wage earners only. This study examined incidence and length of sickness absence comparing the employee groups of upper and lower non-manual employees and manual workers, but also entrepreneurs, the unemployed and other non-wage-earners. The study utilized register data on a nationally representative 70% sample of Finns aged 25-62 at the end of year 2012 (N = 1,615,352). Sickness absence spells compensated by sickness allowance and initiated during 2013 were retrieved from the register of the Social Insurance Institution of Finland (SIIF) and followed until the end of each episode and linked to socio-demographic covariates collected from the registers of the SIIF and of Statistics Finland. Zero-inflated negative binomial regression was used in multivariate models. After adjusting for age, marital status, region and income, there were clear differences in the occurrence and length of sickness absence across socioeconomic groups. Compared to upper non-manual employees, lower non-manual employees and especially manual workers had higher cumulative annual incidence of sickness absence among both men and women, but the entrepreneurs, the unemployed and other non-wage-earners had a clearly higher expected number of sickness absence days. Results varied by diagnostic group. The results highlight the importance of different types of preventive measures for reducing the occurrence of sickness absence and for preventing prolongations of sickness absence spells in different socioeconomic groups.


Assuntos
Ocupações , Licença Médica , Adulto , Feminino , Finlândia/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Desemprego
10.
BMJ Open ; 11(1): e040941, 2021 01 25.
Artigo em Inglês | MEDLINE | ID: mdl-33495252

RESUMO

OBJECTIVES: The aim was to describe the course of sickness absence (SA), disability pension (DP) and work-related economic situation defined as earnings (EA) and disposable income (DI), after spontaneous subarachnoid haemorrhage (SAH). Associations of SA, DP, EA and DI with demographic factors were also studied. DESIGN: A longitudinal cohort study of all 1932 people in Sweden who in January 2005 to December 2010 had a first time SAH when aged 17 to 64 years and survived during the 3-year follow-up. Microdata from four nationwide administrative registers were used. MAIN OUTCOME MEASURES: Primary outcome was the presence of SA and DP and how this changed during the study period of 5 years (the year before, the year of SAH and the following 3 years). The secondary outcome was the development of the income variables EA and DI. Demographic factors analysed were sex, age, source of bleeding, country of birth, family situation, educational level and type of living area. RESULTS: The year before the SAH, 7.9% of women and 4.6% of men had some SA registered (p<0.004). A model consisting of female sex, higher education and living single predicted having SA that year. At the end of the follow-up, 39.2% of women and 28.3% of men had SA and/or DP (p<0.0001). A model consisting of female sex, living in a village/ rural area and having a defined bleeding source for the SAH was predicting having SA and/or DP at end of follow-up. The levels of EA decreased, while DI increased during follow-up and were at the end of follow-up associated with age, sex, type of living area, country of birth, educational level and family situation. The women's EA was lower than the men's during all years. CONCLUSIONS: SAH influenced future SA, DP, as well as EA. Both SA, DP and the economic variables studied were predicted by models including sex.


Assuntos
Pessoas com Deficiência/estatística & dados numéricos , Pensões/estatística & dados numéricos , Licença Médica/estatística & dados numéricos , Hemorragia Subaracnóidea/psicologia , Adulto , Estudos de Coortes , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Gravidez , Fatores de Risco , Licença Médica/economia , Hemorragia Subaracnóidea/epidemiologia , Suécia/epidemiologia
11.
BMC Infect Dis ; 21(1): 52, 2021 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-33430793

RESUMO

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


Assuntos
Absenteísmo , Epidemias , Influenza Humana/epidemiologia , Vigilância em Saúde Pública/métodos , Vigilância de Evento Sentinela , Licença Médica , França/epidemiologia , Humanos , Incidência , Influenza Humana/virologia , Seguro Saúde , Pessoa de Meia-Idade , Modelos Estatísticos , Estudos Retrospectivos , Sensibilidade e Especificidade , Local de Trabalho
12.
Bull Cancer ; 108(3): 272-283, 2021 Mar.
Artigo em Francês | MEDLINE | ID: mdl-33455735

RESUMO

BACKGROUND: Return-to-work after cancer depends on several factors related to the disease but also other socio-professional factors. The primary aim of this study was to identify socio-demographic, disease related and professional factors influencing the return-to-work process. METHODS: It was a prospective and descriptive study reporting the return-to-work process in 89 cancer patients, in a professional activity age, who had cancer treatment and a follow up in the Oncology department in Tahar Maamouri Teaching Hospital of Nabeul, between September 2015 to December 2019. RESULTS: Our study included 89 patients. Mean age was 45 years±8. The population was predominantly feminine (59 %). They were employees in 45 % of cases. Private professional sectors included 60 % of all patients. An open-ended contract was performed in 87 % of cases. Most frequent primary tumors were breast tumors (45 %) and colon tumors (20 %). Thirty-four patients went back to work after recovery. Seventy-nine percent of them were female patients and 70 % had breast cancer. Predictive factors identified in univariate statistical analysis and correlated to return-to-work were gender (P=0.002), occupation (P<10-3), initial duration off sick (P=0.015), fitting out measures at work (P=0.01), primary tumor origin (P=0.01), disease stage (P=0.037), treatment (P=0.014) and disease outcome after treatment (P=0.024). CONCLUSION: Our study underlined a need to create a pluridisciplinary platform unifying collaborators among oncologists and occupational health professionals in order to enhance professional reintegration process and to hold patient's professional equilibrium after cancer recovery.


Assuntos
Emprego/estatística & dados numéricos , Neoplasias/terapia , Retorno ao Trabalho/estatística & dados numéricos , Adulto , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/patologia , Neoplasias da Mama/terapia , Neoplasias do Colo/epidemiologia , Neoplasias do Colo/patologia , Neoplasias do Colo/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Neoplasias/patologia , Ocupações , Fatores Sexuais , Licença Médica/estatística & dados numéricos , Tunísia/epidemiologia
13.
Am J Ind Med ; 64(2): 73-77, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33355943

RESUMO

Globally, migrant and immigrant workers have borne the brunt of the COVID-19 pandemic as essential workers. They might be a Bulgarian worker at a meat processing plant in Germany, a Central American farmworker in the fields of California, or a Filipino worker at an aged-care facility in Australia. What they have in common is they are all essential workers who have worked throughout the coronavirus pandemic and have been infected with coronavirus at work. COVID-19 has highlighted the inequitable working conditions of these workers. In many instances, they are employed precariously, and so are ineligible for sick leave or social security, or COVID-19 special payments. If these are essential workers, they should get at least the same health and safety benefits of all nonessential workers. Improving the working and living conditions of migrant workers can and should be a positive outcome of the coronavirus pandemic.


Assuntos
/epidemiologia , Doenças Profissionais/epidemiologia , Migrantes/estatística & dados numéricos , /transmissão , Estudos Transversais , Saúde Global/estatística & dados numéricos , Mão de Obra em Saúde/estatística & dados numéricos , Humanos , Benefícios do Seguro/estatística & dados numéricos , Saúde do Trabalhador/estatística & dados numéricos , Serviços de Saúde do Trabalhador/provisão & distribução , Fatores de Risco , Licença Médica/estatística & dados numéricos , Previdência Social/estatística & dados numéricos , Valores Sociais , Fatores Socioeconômicos
14.
Biomedica ; 40(Supl. 2): 159-165, 2020 10 30.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33152199

RESUMO

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


Assuntos
Planejamento em Desastres , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/psicologia , Pandemias/prevenção & controle , Infecções Respiratórias/prevenção & controle , Absenteísmo , Adulto , Colômbia/epidemiologia , Estudos Transversais , Feminino , Humanos , Controle de Infecções/organização & administração , Masculino , Pessoa de Meia-Idade , Política Organizacional , Licença Médica , Inquéritos e Questionários
16.
J Appl Behav Anal ; 53(4): 1935-1954, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-33063854

RESUMO

The coronavirus pandemic highlighted that workplaces may serve as a hub of disease transmission if proper precautions are not enacted. The Centers for Disease Control recommends several strategies for decreasing the spread of illnesses in the workplace, including a) promoting proper hand hygiene, b) cleaning and sanitizing the work area, c) encouraging sick employees to stay home, d) personal protective equipment, and, e) social distancing. Research suggests that instructions are often not sufficient to change work behaviors, and behavioral interventions may be needed. Thus, the present paper reviews existing research that informs the implementation of behavioral strategies to reduce the spread of disease in the workplace, and makes recommendations for organizations to protect employees, clients, and customers. Intervention components such as training, prompts, the reduction of response effort, clear workplace policies, feedback, and consequences are discussed, and practical recommendations and suggestions for future research are provided.


Assuntos
Infecções por Coronavirus/prevenção & controle , Controle de Infecções/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Local de Trabalho , Infecções por Coronavirus/transmissão , Desinfecção/métodos , Higiene das Mãos , Humanos , Saúde do Trabalhador , Equipamento de Proteção Individual , Pneumonia Viral/transmissão , Licença Médica , Local de Trabalho/organização & administração
17.
Cochrane Database Syst Rev ; 10: CD006237, 2020 10 13.
Artigo em Inglês | MEDLINE | ID: mdl-33052607

RESUMO

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


Assuntos
Absenteísmo , Depressão/terapia , Transtorno Depressivo Maior/terapia , Saúde do Trabalhador , Retorno ao Trabalho/psicologia , Adulto , Antidepressivos/uso terapêutico , Viés , Terapia Cognitivo-Comportamental , Humanos , Exercícios de Alongamento Muscular , Ensaios Clínicos Controlados Aleatórios como Assunto , Licença Médica , Desempenho Profissional
18.
An. psicol ; 36(3): 503-511, oct. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-195667

RESUMO

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


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


Assuntos
Humanos , Masculino , Feminino , Absenteísmo , Condições de Trabalho , Contratos , Carga de Trabalho/psicologia , Fatores de Tempo , Curva ROC , Fatores de Risco , Distribuição de Qui-Quadrado , Doenças Profissionais , Licença Médica/estatística & dados numéricos , Árvores de Decisões
19.
Lancet Psychiatry ; 7(10): 893-910, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32949521

RESUMO

Mental illness and substance use disorders in the workplace have been increasingly recognised as a problem in most countries; however, evidence is scarce on which solutions provide the highest return on investment. We searched academic and grey literature databases and additional sources for studies that included a workplace intervention for mental health or substance abuse, or both, and that did an economic analysis. We analysed the papers we found to identify the highest yielding and most cost-effective interventions by disorder. On the basis of 56 studies, we found moderate strength of evidence that cognitive behavioural therapy is cost-saving (and in some cases cost-effective) to address depression. We observed strong evidence that regular and active involvement of occupational health professionals is cost-saving and cost-effective in reducing sick leave related to mental health and in encouraging return to work. We identified moderate evidence that coverage for pharmacotherapy and brief counselling for smoking cessation are both cost-saving and cost-effective. Addressing mental health and substance misuse in the workplace improves workers' wellbeing and productivity, and benefits employers' bottom line (ie, profit). Future economic analyses would benefit from the consideration of subgroup analyses, examination of longer follow-ups, inclusion of statistical and sensitivity analyses and discussion around uncertainty, and consideration of potential for bias.


Assuntos
Serviços de Saúde do Trabalhador/economia , Serviços de Saúde do Trabalhador/métodos , Terapia Ocupacional/economia , Terapia Ocupacional/métodos , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Terapia Cognitivo-Comportamental/economia , Terapia Cognitivo-Comportamental/métodos , Análise Custo-Benefício , Economia Médica , Humanos , Saúde Mental , Ensaios Clínicos Controlados Aleatórios como Assunto , Licença Médica/estatística & dados numéricos , Local de Trabalho
20.
Syst Rev ; 9(1): 218, 2020 09 25.
Artigo em Inglês | MEDLINE | ID: mdl-32977848

RESUMO

BACKGROUND: The objective of this review was to examine the current guidelines for infection prevention and control (IPAC) of coronavirus disease-19 (COVID-19) or other coronaviruses in adults 60 years or older living in long-term care facilities (LTCF). METHODS: EMBASE, MEDLINE, Cochrane library, pre-print servers, clinical trial registries, and relevant grey literature sources were searched until July 31, 2020, using database searching and an automated method called Continuous Active Learning® (CAL®). All search results were processed using CAL® to identify the most likely relevant citations that were then screened by a single human reviewer. Full-text screening, data abstraction, and quality appraisal were completed by a single reviewer and verified by a second. RESULTS: Nine clinical practice guidelines (CPGs) were included. The most common recommendation in the CPGs was establishing surveillance and monitoring systems followed by mandating the use of PPE; physically distancing or cohorting residents; environmental cleaning and disinfection; promoting hand and respiratory hygiene among residents, staff, and visitors; and providing sick leave compensation for staff. CONCLUSIONS: Current evidence suggests robust surveillance and monitoring along with support for IPAC initiatives are key to preventing the spread of COVID-19 in LTCF. However, there are significant gaps in the current recommendations especially with regard to the movement of staff between LTCF and their role as possible transmission vectors. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020181993.


Assuntos
Moradias Assistidas , Infecções por Coronavirus/prevenção & controle , Controle de Infecções/métodos , Casas de Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Idoso , Betacoronavirus , Infecções por Coronavirus/transmissão , Desinfecção , Higiene das Mãos , Humanos , Assistência de Longa Duração , Pessoa de Meia-Idade , Equipamento de Proteção Individual , Pneumonia Viral/transmissão , Guias de Prática Clínica como Assunto , Síndrome Respiratória Aguda Grave/prevenção & controle , Síndrome Respiratória Aguda Grave/transmissão , Licença Médica , Instituições de Cuidados Especializados de Enfermagem
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