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3.
Praxis (Bern 1994) ; 109(13): 1050-1054, 2020.
Artigo em Alemão | MEDLINE | ID: mdl-33050816

RESUMO

Working After Lung Transplantation Abstract. Whether patients return to work after a successful lung transplant depends on various factors. The best predictive factor for employment after transplantation is the employment status before transplantation. Currently, there is no internationally standardized procedure regarding the questions of when and according to what criteria patients should be reintegrated into the working environment after lung transplantation. The risk of infection at the workplace/during the work activity should definitely be assessed before resuming work: a detailed work history is mandatory, an additional workplace inspection a further option. Advice should be based on the medical literature and general recommendations, and psychosocial factors must also be taken into account. In case of ambiguities, an interdisciplinary discussion is recommended.


Assuntos
Transplante de Pulmão , Retorno ao Trabalho , Emprego , Humanos
4.
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
8.
Vestn Otorinolaringol ; 85(4): 58-64, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32885639

RESUMO

Fitness for work in persons with middle ear disease who are exposed to harmful work environment and their possible return to work was analyzed. Fitness for work expertise procedure in the Russian Federation is disclosed in detail. A list of medical contraindications to work in harmful and/or dangerous work environment according to hearing condition is given. Clinical aspects of middle ear diseases in the industry workers are presented and modern ideas about middle ear surgical treatment, it's functional results, documenting technique and outcome calculation are described in detail. Possibility of returning the employee to work is discussed based on all the analyzed materials.


Assuntos
Orelha Média , Retorno ao Trabalho , Humanos , Federação Russa
11.
Work ; 66(4): 713-716, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32925132

RESUMO

BACKGROUND: The primary response to the coronavirus (COVID-19) pandemic has been to minimize social contact through lockdown measures. The closure of non-essential businesses to tackle the spread of the coronavirus has had negative consequences for the global economy, production, and employment. OBJECTIVE: To outline how known occupational health principles can be used for preventative management of the coronavirus in workplaces to support resumption of work. METHODS: A discussion of current knowledge of COVID-19, the cost of the lockdown strategy, and preventative biological cycle management. RESULTS: The evidence-based literature indicates that biological cycle management can control the risk of coronavirus infection, provide a suitable and sufficient exit strategy from lockdown, and support getting employees back to work. Adherence to personal protective equipment standards has been insufficient, indicating a need for workplace investment and education. CONCLUSION: Imposed restrictions on workplace operations can be lifted without compromising worker health and safety when a workplace commits to practicing the three principles of biological cycle management.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/prevenção & controle , Saúde do Trabalhador , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Quarentena/normas , Retorno ao Trabalho , Local de Trabalho/organização & administração , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Guias como Assunto , Higiene das Mãos/normas , Humanos , Equipamento de Proteção Individual/normas , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Quarentena/organização & administração , Fatores de Tempo
12.
J Bras Nefrol ; 42(2 suppl 1): 4-8, 2020 Aug 26.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32877490

RESUMO

The Covid-19 pandemic brought several challenges to the healthcare system: diagnosis, treatment and measures to prevent the spread of the disease. With the greater availability and variety of diagnostic tests, it is essential to properly interpret them. This paper intends to help dialysis units concerning the use of clinical criteria and diagnostic tests for decision making regarding the discontinuation of isolation of patients with suspected or confirmed Covid-19, as well as the return to work activities for employees with suspected or confirmed Covid-19.


Assuntos
Betacoronavirus , Técnicas de Laboratório Clínico/normas , Infecções por Coronavirus/diagnóstico , Nefrologia/normas , Pneumonia Viral/diagnóstico , Diálise Renal , Retorno ao Trabalho , Algoritmos , Brasil , Lista de Checagem , Tomada de Decisão Clínica , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/epidemiologia , Humanos , Doenças Profissionais/diagnóstico , Pandemias , Isolamento de Pacientes , Pneumonia Viral/epidemiologia , Reação em Cadeia da Polimerase em Tempo Real/métodos , Reação em Cadeia da Polimerase em Tempo Real/normas , Sociedades Médicas/normas , Unidade Hospitalar de Urologia/normas
13.
J Occup Environ Med ; 62(9): 771-779, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32890217

RESUMO

: Businesses are struggling to re-open as the world continues to deal with the coronavirus 2019 (COVID-19) pandemic. The reopening of businesses will require employers to implement safe return-to-work strategies through evaluation, testing, work modifications, and development of appropriate workplace policies. There will be unique challenges along the way as no one approach will be ideal for all workplaces and industries. This document is intended to provide return-to-work guidance for both employers and the occupational and environmental medicine physicians who will be supporting businesses in implementing safe return-to-work strategies.


Assuntos
Betacoronavirus , Comércio/organização & administração , Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Retorno ao Trabalho , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Humanos , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Estados Unidos
16.
Diving Hyperb Med ; 50(3): 278-287, 2020 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-32957131

RESUMO

Scuba diving is a critical activity for commercial industry, military activities, research, and public safety, as well as a passion for many recreational divers. Physicians are expected to provide return-to-diving recommendations after SARS-CoV-2 (COVID-19) infection based upon the best available evidence, often drawn from experience with other, similar diseases. Scuba diving presents unique physiologic challenges to the body secondary to immersion, increased pressure and increased work of breathing. The long-term sequelae of COVID-19 are still unknown, but if they are proven to be similar to other coronaviruses (such as Middle East respiratory syndrome or SARS-CoV-1) they may result in long-term pulmonary and cardiac sequelae that impact divers' ability to safely return to scuba diving. This review considers available literature and the pathophysiology of COVID-19 as it relates to diving fitness, including current recommendations for similar illnesses, and proposes guidelines for evaluation of divers after COVID-19. The guidelines are based upon best available evidence about COVID-19, as well as past experience with determination of diving fitness. It is likely that all divers who have contracted COVID-19 will require a medical evaluation prior to return to diving with emphasis upon pulmonary and cardiac function as well as exercise capacity.


Assuntos
Infecções por Coronavirus/complicações , Mergulho , Guias como Assunto , Pneumonia Viral/complicações , Retorno ao Trabalho , Betacoronavirus , Humanos , Pandemias
17.
Work ; 67(1): 67-79, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32955475

RESUMO

BACKGROUND: The COVID-19 epidemic not only cast a shadow on China's economic development but also caused phased panic and anxiety among the Chinese population. At the stage when the spread of the epidemic is not completely controlled, the business activities will surely cause employees to worry and produce a work stress reaction. OBJECTIVE: This study explores the impact of psychosocial stress caused by the COVID-19 epidemic on the work stress of returned workers. Furthermore, we explore the boundary conditions for reducing work stress from the perspectives of perceived organizational support, perceived social support and epidemic awareness. METHODS: Data were collected within two weeks after the Chinese government announced the work resumption of industrial enterprises. During this period, 526 returned workers participated in the study. RESULTS: The results showed that the psychosocial stress caused by the epidemic had a positive impact on work stress. Both perceived organizational support and perceived that social support can alleviate the impact of psychosocial stress on work stress. The moderating effect of epidemic awareness was only established in non-severe epidemic areas. CONCLUSIONS: In the current period of the spread of the COVID-19 epidemic, the conclusions of this study have a certain theoretical significance and practical value.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Estresse Ocupacional , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Retorno ao Trabalho/psicologia , Ansiedade , Betacoronavirus , China/epidemiologia , Pesquisa Empírica , Conhecimentos, Atitudes e Prática em Saúde , Inquéritos Epidemiológicos , Humanos , Cultura Organizacional , Apoio Social
18.
Arch. prev. riesgos labor. (Ed. impr.) ; 23(3): 315-329, jul.-sept. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-194118

RESUMO

INTRODUCCIÓN: los avances en el diagnóstico y tratamiento del cáncer de mama han mejorado el pronóstico para estas pacientes, por lo tanto, se espera que un mayor número de supervivientes se enfrenten con el proceso de retornar al trabajo. El objetivo del presente estudio es analizar la frecuencia, la mediana del tiempo, así como los factores relacionados con el retorno al trabajo de pacientes con cáncer de mama, posterior al diagnóstico en un centro de referencia oncológico de la ciudad de Medellín, Colombia. MÉTODOS: estudio de cohorte retrospectiva realizado con los registros de pacientes con cáncer de mama (n = 141) atendidas un centro oncológico de referencia. Se midieron variables sociodemográficas, laborales, relacionadas con el tratamiento y de retorno al trabajo. RESULTADOS: la edad promedio al diagnóstico fue de 45.8 ± 9 años, La mayoría de las mujeres estaban en la premenopausia, el 45% realizaban trabajo manual. Los indicadores de mayor severidad de la enfermedad, así como el trabajo manual, la presencia de linfedema y un mayor número y días de incapacidad se relacionaron negativamente con el retorno al trabajo de estas pacientes. El 93% de las pacientes retornaron al trabajo. CONCLUSIONES: el retorno al trabajo después de un cáncer de mama difiere según la severidad de la enfermedad, factores relacionados con el tratamiento y tipo de trabajo


INTRODUCTION: Advances in the diagnosis and treatment of breast cancer have improved the prognosis for these patients. Consequently, a greater number of survivors are facing the process of returning to work. The objective of the present study was to analyze the frequency, median time and factors related to the return to work of patients with breast cancer, after diagnosis and completion of treatment at a cancer referral center in the city of Medellín, Colombia. METHODS: a retrospective cohort study was carried out with registries of patients with breast cancer (n = 141) from a reference cancer center. Sociodemographic, occupational, treatment variables and prevalence of return to work were measured. RESULTS: The average age at diagnosis was 45.8 ± 9 years, Most of the women were premenopausal, and 45% performed manual labour. Advanced disease stage, manual labour, the presence of lymphedema and a greater number of episodes and days of disability were negatively related to return to work. A total of 93% of patients returned to work. CONCLUSIONS: This study shows that return to work differs according to disease stage, treatment-related factors and type of work


Assuntos
Humanos , Feminino , Adulto , Retorno ao Trabalho/estatística & dados numéricos , Neoplasias da Mama/complicações , Avaliação da Capacidade de Trabalho , Fatores Socioeconômicos , Estudos Retrospectivos , Menopausa , Neoplasias da Mama/terapia , Colômbia
19.
Epidemiol Infect ; 148: e214, 2020 09 18.
Artigo em Inglês | MEDLINE | ID: mdl-32943130

RESUMO

In March 2020, China had periodically controlled the coronavirus disease-19 (COVID-19) epidemic. We reported the results of health screening for COVID-19 among returned staff of a hospital and conducted a summary analysis to provide valuable experience for curbing the COVID-19 epidemic and rebound. In total, 4729 returned staff from Zhongnan Hospital of Wuhan University, Wuhan, China were examined for COVID-19, and the basic information, radiology and laboratory test results were obtained and systematically analysed. Among the 4729 employees, medical staff (62.93%) and rear-service personnel (30.73%) were the majority. The results of the first physical examination showed that 4557 (96.36%) were normal, 172 (3.64%) had abnormal radiological or laboratory test results. After reexamination and evaluation, four were at high risk (asymptomatic infections) and were scheduled to transfer to a designated hospital, and three were at low risk (infectivity could not be determined) and were scheduled for home isolation observation. Close contacts were tracked and managed by the Center for Disease Control and Prevention (CDC) in China. Asymptomatic infections are a major risk factor for returning to work. Extensive health screening combined with multiple detection methods helps to identify asymptomatic infections early, which is an important guarantee in the process of returning to work.


Assuntos
Infecções Assintomáticas/epidemiologia , Infecções por Coronavirus/diagnóstico , Recursos Humanos em Hospital/estatística & dados numéricos , Pneumonia Viral/diagnóstico , Retorno ao Trabalho , Adolescente , Adulto , Anticorpos Antivirais/sangue , Betacoronavirus , China/epidemiologia , Técnicas de Laboratório Clínico , Feminino , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Fatores de Risco , Adulto Jovem
20.
Medicine (Baltimore) ; 99(38): e21237, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32957304

RESUMO

Arthroscopic techniques are considered the gold standard for treatment of displaced avulsion fractures of the anterior cruciate ligament. However, most arthroscopic surgical techniques and fixation methods are technically demanding and require removal of hard implant. This report describes a new, easy, safe, and all-arthroscopic method for reduction and fixation of displaced tibial intercondylar eminence fractures by using 1 anchor and 1 Pushlock.From January 2015 to June 2017, 8 adult patients with type II and III displaced tibial intercondylar eminence fractures were operated using this technique. Clinical assessment included patient demographics, cause of injury, delay before surgery, operation time, time to return to work and sport, International Knee Documentation Committee scores, and Lysholm knee scores.The average operation time was 48 minutes. The average follow-up period was 12.5 months. At the 6-month follow-up, all patients had acquired fracture union and complete functional recovery and were able to return to work. International Knee Documentation Committee objective scores and Lysholm knee scores were 92.4 (range 88-94) and 93.6 (range 90-96), respectively. At the last follow-up, anterior drawer, Lachman's test, and pivot shift tests were negative, and all patients had returned to their preinjury activity levels.Arthroscopic fixation by use of 1 anchor and 1 Pushlock is an easy, safe, and minimally invasive technique for treatment of displaced tibial intercondylar eminence fractures and does not require further surgery to remove fixation devices.Level of Evidence: Level IV, therapeutic case series.


Assuntos
Ligamento Cruzado Anterior/cirurgia , Artroscopia/métodos , Tíbia/cirurgia , Adulto , Feminino , Fixação Interna de Fraturas , Humanos , Masculino , Duração da Cirurgia , Amplitude de Movimento Articular , Retorno ao Trabalho , Fatores Socioeconômicos , Técnicas de Sutura , Tempo para o Tratamento
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