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Okawara M, Ishimaru T, Tateishi S, Hino A, Tsuji M, Ogami A, Nagata T, Matsuda S, Fujino Y. Treatment interruption is a risk factor for sickness presenteeism: A large-scale cross-sectional study during the COVID-19 pandemic. J Occup Health 2022; 64:e12313. [PMID: 35043519 PMCID: PMC8766292 DOI: 10.1002/1348-9585.12313] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 12/27/2021] [Accepted: 12/31/2021] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES This study examined the relationship between interruption to routine medical care during the coronavirus disease 2019 pandemic and sickness presenteeism among workers in Japan. METHODS A cross-sectional study using data obtained from an internet monitor questionnaire was conducted. Interruption to medical care was defined based on the response "I have not been able to go to the hospital or receive treatment as scheduled." The fraction of sickness presenteeism days in the past 30 days was employed as the primary outcome. A fractional logit model was used for analysis to treat bounded data. RESULTS Of the 27 036 participants, 17 526 (65%) were workers who did not require routine medical care, 8451 (31%) were using medical care as scheduled, and 1059 (4%) experienced interrupted medical care. The adjusted odds ratio (aOR) of sickness presenteeism was significantly higher among workers who experienced interrupted medical care (3.44; 95% confidence interval [CI]: 3.04-3.89) than those who did not require routine medical care. In terms of symptoms, the highest aOR was observed among workers with mental health symptoms (aOR: 5.59, 95% CI: 5.04-6.20). CONCLUSIONS This study suggests the importance of continuing necessary treatment during a pandemic to prevent presenteeism.
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Affiliation(s)
- Makoto Okawara
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Tomohiro Ishimaru
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Seiichiro Tateishi
- Disaster Occupational Health Center, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Ayako Hino
- Department of Mental Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Mayumi Tsuji
- Department of Environmental Health, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Akira Ogami
- Department of Work Systems and Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Tomohisa Nagata
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Shinya Matsuda
- Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Yoshihisa Fujino
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
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Jordakieva G, Kundi M, Lemell P, Zieglmayer R, Zieglmayer P, Jensen-Jarolim E, Crevenna R. Cetirizine inhibits gender-specific blood cell dynamics upon allergen contact in allergic rhinitis. Clin Immunol 2020; 215:108422. [PMID: 32304734 DOI: 10.1016/j.clim.2020.108422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 04/08/2020] [Accepted: 04/14/2020] [Indexed: 12/15/2022]
Abstract
IgE-mediated inflammatory responses upon allergen contact in allergic rhinitis (AR) are associated with rapid alterations of circulating blood cell numbers detectable in a complete blood count (CBC). Aim of this study was to evaluate whether intake of antihistamines may modulate allergen-induced CBC dynamics in male and female patients. A total of N = 112 specific allergen challenges were performed in otherwise healthy AR subjects. Seventy-two (n = 72) subjects received placebo and forty (n = 40) received cetirizine (H1-receptor antagonist) per os prior to allergen exposure in a randomized, double-blind trial at the Vienna Challenge Chamber (VCC); a subgroup of twenty-five (n = 25) subjects received cetirizine and placebo on different study days (parallel group). Blood samples and symptom scores were taken at baseline and immediately after 6 h of airway challenge simulating ambient allergen contact. Female sex was associated with a pronounced circulating monocyte increase (p < .01) and male sex with an eosinophil decrease (p < .05) in the placebo group, but not in cetirizine treated subjects. The significant increase in segmented neutrophils (p < .001) and decrease in circulating erythrocytes (p < .01) upon allergen challenge was less prominent after cetirizine intake in both sexes. A more prominent thrombocyte increase in female subjects (p < .05) was noted upon allergen exposure, regardless of prior cetirizine intake. Cetirizine inhibited the mobilization of neutrophils, lymphocytes and decline in erythrocyte numbers, but did not affect thrombocyte increase upon allergen challenge. It further diminished gender-specific blood cell dynamics. Overall, as reflected in a simple CBC, cetirizine critically diminished immediate and late innate immune responses subsequent to allergen exposure.
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Affiliation(s)
- G Jordakieva
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Austria.
| | - M Kundi
- Center for Public Health, Department of Environmental Health, Medical University of Vienna, Austria
| | - P Lemell
- Power Project GmbH, Dept. Vienna Challenge Chamber (VCC), Austria
| | - R Zieglmayer
- Power Project GmbH, Dept. Vienna Challenge Chamber (VCC), Austria
| | - P Zieglmayer
- Power Project GmbH, Dept. Vienna Challenge Chamber (VCC), Austria
| | - E Jensen-Jarolim
- Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Austria; The Interuniversity Messerli Research Institute, Medical University Vienna, University of Veterinary Medicine Vienna, University of Vienna, Austria
| | - R Crevenna
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Austria
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Arueira Chaves L, de Souza Serio Dos Santos DM, Rodrigues Campos M, Luiza VL. Use of health outcome and health service utilization indicators as an outcome of access to medicines in Brazil: perspectives from a literature review. Public Health Rev 2019; 40:5. [PMID: 31867131 PMCID: PMC6902426 DOI: 10.1186/s40985-019-0115-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 08/21/2019] [Indexed: 11/24/2022] Open
Abstract
Background To guarantee the right to health, the health system must also ensure access to medicines. Several financial arrangements to provide these technologies are implemented and range from the direct (either total or partial) to indirect payment by the patient, being necessary to evaluate its effect on access to medicines. However, to ensure access to medicines is not just about ensuring its availability, as this only materializes in its use. Thus, evaluation studies of interventions in access to medicines have been using indicators related to the health results and use of health services as its outcomes. Furthermore, as this relationship is not direct, it is important to critically assess the adequacy of these tools to measure this phenomenon and, additionally, the ability to use it in the Brazilian scenario. Therefore, this study sought to identify, describe, and analyze the use of these indicators as medicine access outcomes, through a review of the scientific literature. Methods An extensive literature review was done using a bibliographic database for a systematic review. The references were selected based on inclusion and exclusion criteria, and the indicators from the papers retained were analyzed using the parameters of validity, measurability, reliability, and relevance. Results We have analyzed over 12,000 references of which 30 references were included, describing the use of 49 health outcomes and health service use indicators. The majority reported the use of health service utilization measures. In our evaluation, the best indicators for assessing the effects of co-payment intervention on access are the ones aimed at specific populations or symptomatic health conditions in which the response to the therapeutic treatment is known and occurs in a short period of time. It was evident the lack of information on the indicators analyzed as well as the limitation of the Brazilian secondary databases for its calculation. Conclusions This research showed the variety and heterogeneity of the indicators used in scientific studies. The best indicators for access to medicines are sought to measure the use of health services for symptomatic health conditions that are quickly responsive to pharmacological treatment, while the indicators related to worker productivity loss was the most suitable for health outcomes. Electronic supplementary material The online version of this article (10.1186/s40985-019-0115-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Luisa Arueira Chaves
- 1Federal University of Rio de Janeiro, Macaé, Brazil.,2National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Monica Rodrigues Campos
- 4Department of Social Sciences, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Vera Lucia Luiza
- 5Department of Medicines and Pharmaceutical Policies, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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ABDURACHMAN, PRADANA KA, HAMZAH, HENDARTO H. Acupuncture at Tàichōng (太冲 LR 3) for dysmenorrhea. WORLD JOURNAL OF ACUPUNCTURE-MOXIBUSTION 2018. [DOI: 10.1016/j.wjam.2018.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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DUPLICATE: Clinical effectiveness of acupuncture at Liv3 as complementary therapy for relieving pain at dysmenorrhea. WORLD JOURNAL OF ACUPUNCTURE-MOXIBUSTION 2018. [DOI: 10.1016/j.wjam.2018.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Abstract
: The role of the corporate medical director (CMD) has evolved over the last 300 years since Ramazzini first identified diseases of Italian workers in the early 1700s. Since then, there has been a gradual blurring of the boundaries between private and workplace health concerns. Today's CMD must have intimate knowledge of their corporation's industry and the businesses that they support, particularly the occupational and environmental programs that comply with all local, state, and/or national standards and regulations. Leading companies not only measure compliance with such standards but also may hold programs to their own internal corporate global standards even if these go beyond local government requirements. This document will explore in greater depth the strength and importance that the CMD brings to the business operations to support a healthy, engaged, and high performing workforce. Part 1 describes the role and value of the CMD, while Part 2 provides collective wisdom for the new CMD from current and past highly experienced CMDs.
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Zhao DH, Cheung JMY, Smith L, Saini B. Exploring asthma in the workplace: A triangulation of perspectives from management, employees and people with asthma. J Asthma 2017; 55:859-867. [PMID: 28858530 DOI: 10.1080/02770903.2017.1369991] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE People with asthma spend a significant amount of time in the workplace but little is known about the current state of disease management in such contexts. The aim of the current study is to explore the experiences, attitudes and perceptions of asthma across different stakeholders in the workplace to help inform potential recommendations for workplace asthma policies. METHOD Using purposive and convenience sampling methods, in-depth semi-structured interviews were conducted in Australia with 5 human resource personnel, 10 employees with asthma and 10 employees without asthma. Interviews were guided by a schedule of questions focusing on attitudes and experiences of people with asthma in the workplace, which were audio recorded, transcribed verbatim and thematically analysed. RESULTS Analysis of the qualitative dataset revealed three key themes: Beliefs and Attitudes about Asthma, Asthma Solutions in the Workplace and Workplace Obstacles. Findings suggest that employees with asthma experience problems managing their asthma at work and there is a lack of workplace support in relation to asthma emergency management. CONCLUSION Key recommendations for workplace asthma policies have been made to provide better support for employees with asthma. However, further investigation into the experience of managing asthma is required in a wider variety of occupations and work experiences to inform the development of a workplace asthma policy.
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Affiliation(s)
- Denise H Zhao
- a Faculty of Pharmacy , The University of Sydney , Sydney , NSW , Australia
| | - Janet M Y Cheung
- a Faculty of Pharmacy , The University of Sydney , Sydney , NSW , Australia.,b CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research , University of Sydney , NSW , Australia
| | - Lorraine Smith
- a Faculty of Pharmacy , The University of Sydney , Sydney , NSW , Australia
| | - Bandana Saini
- a Faculty of Pharmacy , The University of Sydney , Sydney , NSW , Australia.,b CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research , University of Sydney , NSW , Australia
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Vandenplas O, Vinnikov D, Blanc PD, Agache I, Bachert C, Bewick M, Cardell LO, Cullinan P, Demoly P, Descatha A, Fonseca J, Haahtela T, Hellings PW, Jamart J, Jantunen J, Kalayci Ö, Price D, Samolinski B, Sastre J, Tian L, Valero AL, Zhang X, Bousquet J. Impact of Rhinitis on Work Productivity: A Systematic Review. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2017; 6:1274-1286.e9. [PMID: 29017832 DOI: 10.1016/j.jaip.2017.09.002] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 08/02/2017] [Accepted: 09/06/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND Allergic rhinitis (AR) is increasingly acknowledged as having a substantial socioeconomic impact associated with impaired work productivity, although available information remains fragmented. OBJECTIVE This systematic review summarizes recently available information to provide a quantitative estimate of the burden of AR on work productivity including lost work time (ie, absenteeism) and reduced performance while working (ie, presenteeism). METHODS A Medline search retrieved original studies from 2005 to 2015 pertaining to the impact of AR on work productivity. A pooled analysis of results was carried out with studies reporting data collected through the validated Work Productivity and Activity Impairment (WPAI) questionnaire. RESULTS The search identified 19 observational surveys and 9 interventional studies. Six studies reported economic evaluations. Pooled analysis of WPAI-based studies found an estimated 3.6% (95% confidence interval [CI], 2.4; 4.8%) missed work time and 35.9% (95% CI, 29.7; 42.1%) had impairment in at-work performance due to AR. Economic evaluations indicated that indirect costs associated with lost work productivity are the principal contributor to the total AR costs and result mainly from impaired presenteeism. The severity of AR symptoms was the most consistent disease-related factor associated with a greater impact of AR on work productivity, although ocular symptoms and sleep disturbances may independently affect work productivity. Overall, the pharmacologic treatment of AR showed a beneficial effect on work productivity. CONCLUSIONS This systematic review provides summary estimates of the magnitude of work productivity impairment due to AR and identifies its main determinant factors. This information may help guide both clinicians and health policy makers.
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Affiliation(s)
- Olivier Vandenplas
- Department of Chest Medicine, Centre Hospitalier Universitaire UCL Namur, Université Catholique de Louvain, Yvoir, Belgium.
| | - Denis Vinnikov
- Department of Biostatistics and Evidence-Based Medicine, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Paul D Blanc
- Division of Occupational and Environmental Medicine, Department of Medicine, University of California San Francisco, San Francisco, Calif
| | - Ioana Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | - Claus Bachert
- Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium
| | | | - Lars-Olaf Cardell
- Department of Ear, Nose and Throat Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Paul Cullinan
- Department of Occupational and Environmental Medicine, Royal Brompton Hospital and Imperial College (NHLI), London, UK
| | - Pascal Demoly
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - Alexis Descatha
- AP-HP, Occupational Health Department, Unité de pathologie professionnelle, University Hospital of West Suburb of Paris, Poincaré, Garches, and Versailles St-Quentin University, INSERM, Villejuif, France
| | - Joao Fonseca
- Center for Health Technology and Services Research-CINTESIS, Faculdade de Medicina, Universidade do Porto; and Allergy Unit, CUF Porto Instituto & Hospital, Porto, Portugal
| | - Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - Peter W Hellings
- Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Jacques Jamart
- Scientific Support Unit, Centre Hospitalier Universitaire UCL Namur, Université Catholique de Louvain, Yvoir, Belgium
| | - Juha Jantunen
- South Karelia Allergy and Environment Institute, Imatra, Finland
| | - Ömer Kalayci
- Pediatric Allergy and Asthma Unit, Hacettepe University School of Medicine, Ankara, Turkey
| | - David Price
- Observational and Pragmatic Research Institute, Singapore, Singapore; Optimum Patient Care, Cambridge, UK; Academic Centre of Primary Care, University of Aberdeen, Aberdeen, UK
| | - Boleslaw Samolinski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - Joaquin Sastre
- Allergy Department, Fundacion Jimenez Diaz, Universidad Autonoma de Madrid, CIBER de Enfermedades Respiratorias (CIBERES), Institute Carlos III, Madrid, Spain
| | - Longxiu Tian
- Ross School of Business, University of Michigan, Ann Arbor, Mich
| | - Antonio L Valero
- Pneumology and Allergy Department Hospital Clínic, Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain
| | | | - Jean Bousquet
- MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France; INSERM, VIMA: Ageing and chronic diseases Epidemiological and public health approaches, U1168, Paris, France; UVSQ, UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, Versailles, France
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Jakubczyk M, Koń B. The impact of firms' adjustments on the indirect cost of illness. INTERNATIONAL JOURNAL OF HEALTH ECONOMICS AND MANAGEMENT 2017; 17:10.1007/s10754-017-9212-1. [PMID: 28154961 DOI: 10.1007/s10754-017-9212-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Accepted: 01/23/2017] [Indexed: 06/06/2023]
Abstract
Illness-related absenteeism reduces firms' output, an effect referred to as indirect cost (IC) and often included in cost-of-illness or cost-effectiveness (of health technologies) studies. The companies may foresee this effect and modify hiring or contracting policies. We present a model allowing the estimation of IC with such adjustments. We show that the risk of illness does not change the general shape and properties of the (expected) marginal productivity function. We apply our model to several illustrative examples and show that firm's adjustments impact IC in an ambiguous way, depending on detailed company/market characteristics: in some cases the company reduces the employment (further increasing IC), in another-the opposite happens. Contrary to previous findings, teamwork and shortfall penalties may reduce IC in some settings. Our analysis highlights that IC should be split into the result of companies preparing for and actually experiencing sick leaves.
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Affiliation(s)
- Michał Jakubczyk
- Decision Analysis and Support Unit, SGH Warsaw School of Economics, Al. Niepodległości 162, 02-554, Warsaw, Poland.
| | - Beata Koń
- Decision Analysis and Support Unit, SGH Warsaw School of Economics, Al. Niepodległości 162, 02-554, Warsaw, Poland
- Department of Analysis and Strategy, Ministry of Health, ul. Miodowa 15, 00-952, Warsaw, Poland
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Sun L, Liu L, Zong S, Wang Z, Zhou J, Xu Z, Ding G, Xiao W, Kou J. Traditional Chinese medicine Guizhi Fuling capsule used for therapy of dysmenorrhea via attenuating uterus contraction. JOURNAL OF ETHNOPHARMACOLOGY 2016; 191:273-279. [PMID: 27340106 DOI: 10.1016/j.jep.2016.06.042] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 06/10/2016] [Accepted: 06/16/2016] [Indexed: 06/06/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Guizhi Fuling formula, a well-known Chinese herbal formula recorded in the Eastern Han Dynasty, is composed of Cinnamomum cassia (L.) J.Presl (Cassia bark), Poria cocos (Schw.) Wolf (Poria), Paeonia suffruticosa andrews (Moutan Cortex), Paeonia lactiflora Pall (Herbaceous peony), and Amygdalus persica L.(Persicae Semen). It has clinical efficacy of activating blood circulation to dissipate blood stasis and is commonly used for the treatment of primary dysmenorrhea. However, its therapeutic mechanism has not been clearly elucidated. The aim of this study is to reveal molecular mechanisms of action using in vivo and in vitro experimental models. MATERIAL AND METHODS The ICR mouse uterine contraction was induced by oxytocin exposure following estradiol benzoate pretreatment. Mice were given GZFLC (0.54, 1.08g/kg) by gavage. The levels of NO, PGF2α and Ca(2+) in uterine tissue were determined according to instructions. Cyclooxygenase-2 (COX-2) and oxytocin receptor (OTR) proteins in uterine tissue were assessed by Western Blot. Mouse isolated uterus strips were mounted in tissue organ baths containing Locke's solution. The contractile responses were recorded with Power Lab recording system. The effect of GZFLC on spontaneous uterine contraction, and uterine contraction induced by oxytocin, PGF2α was observed. Myometrial cells were exposed to oxytocin (5U/L) to induce calcium release, and the effect of GZFLC and its components (PL, PGG, CA) on intracellular Ca(2+) was analyzed with fluorometry imaging. RESULTS In vivo study demonstrated that GZFLC significantly reduced oxytocin-induced writhing responses with a maximal inhibition of 55%. It also decreased the levels of NO, PGF2α and Ca(2+) in oxytocin-induced mice uterine tissue. Moreover, Western blot analysis showed that COX-2 and OTR expressions in uterine tissue of dysmenorrhea mice were significantly reduced. GZFLC inhibited spontaneous uterus contractions in a dose-dependent manner, and the IC50 value was 0.99mg/ml. The IC50 values of GZFLC on PGF2α, oxytocin-induced contractions were 1.45mg/ml, 3.53mg/ml, respectively. Further in vitro studies indicated that GZFLC and its components (PL, PGG, CA) could restrain intracellular calcium levels in favour of uteri relaxation. CONCLUSIONS Both in vivo and in vitro results indicated that GZFLC possessed a significant spasmolytic effect on uterine tetanic contraction. The present study provides in vivo and in vitro experimental evidence to support the use of GZFLC for the clinical treatment of primary dysmenorrheal (PD).
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Affiliation(s)
- Lan Sun
- Jiangsu Provincial Key Laboratory for TCM Evaluation and Translational Research, China Pharmaceutical University, Nanjing, Jiangsu 211198, PR China; State Key Laboratory of New-tech For Chinese Medicine Pharmaceutic Process, Jiangsu Kanion Pharmaceutical Co., Ltd., Lianyungang, Jiangsu 222001, PR China.
| | - Lina Liu
- State Key Laboratory of New-tech For Chinese Medicine Pharmaceutic Process, Jiangsu Kanion Pharmaceutical Co., Ltd., Lianyungang, Jiangsu 222001, PR China
| | - Shaobo Zong
- State Key Laboratory of New-tech For Chinese Medicine Pharmaceutic Process, Jiangsu Kanion Pharmaceutical Co., Ltd., Lianyungang, Jiangsu 222001, PR China
| | - Zhengzhong Wang
- State Key Laboratory of New-tech For Chinese Medicine Pharmaceutic Process, Jiangsu Kanion Pharmaceutical Co., Ltd., Lianyungang, Jiangsu 222001, PR China
| | - Jun Zhou
- State Key Laboratory of New-tech For Chinese Medicine Pharmaceutic Process, Jiangsu Kanion Pharmaceutical Co., Ltd., Lianyungang, Jiangsu 222001, PR China
| | - Zhiliang Xu
- State Key Laboratory of New-tech For Chinese Medicine Pharmaceutic Process, Jiangsu Kanion Pharmaceutical Co., Ltd., Lianyungang, Jiangsu 222001, PR China
| | - Gang Ding
- State Key Laboratory of New-tech For Chinese Medicine Pharmaceutic Process, Jiangsu Kanion Pharmaceutical Co., Ltd., Lianyungang, Jiangsu 222001, PR China
| | - Wei Xiao
- State Key Laboratory of New-tech For Chinese Medicine Pharmaceutic Process, Jiangsu Kanion Pharmaceutical Co., Ltd., Lianyungang, Jiangsu 222001, PR China.
| | - Junping Kou
- Jiangsu Provincial Key Laboratory for TCM Evaluation and Translational Research, China Pharmaceutical University, Nanjing, Jiangsu 211198, PR China.
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Yang T, Shen YM, Zhu M, Liu Y, Deng J, Chen Q, See LC. Effects of Co-Worker and Supervisor Support on Job Stress and Presenteeism in an Aging Workforce: A Structural Equation Modelling Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 13:ijerph13010072. [PMID: 26703705 PMCID: PMC4730463 DOI: 10.3390/ijerph13010072] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Revised: 12/11/2015] [Accepted: 12/18/2015] [Indexed: 11/16/2022]
Abstract
We examined the effects of co-worker and supervisor support on job stress and presenteeism in an aging workforce. Structural equation modelling was used to evaluate data from the 2010 wave of the Health and Retirement Survey in the United States (n = 1649). The level of presenteeism was low and the level of job stress was moderate among aging US workers. SEM revealed that co-worker support and supervisor support were strongly correlated (β = 0.67; p < 0.001). Job stress had a significant direct positive effect on presenteeism (β = 0.30; p < 0.001). Co-worker support had a significant direct negative effect on job stress (β = -0.10; p < 0.001) and presenteeism (β = -0.11; p < 0.001). Supervisor support had a significant direct negative effect on job stress (β = -0.40; p < 0.001) but not presenteeism. The findings suggest that presenteeism is reduced by increased respect and concern for employee stress at the workplace, by necessary support at work from colleagues and employers, and by the presence of comfortable interpersonal relationships among colleagues and between employers and employees.
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Affiliation(s)
- Tianan Yang
- Department of Organization and Human Resource Management, School of Management and Economics, Beijing Institute of Technology, Beijing 100081, China.
| | - Yu-Ming Shen
- Institute of Medical Informatics, Biometry and Epidemiology (IBE), Pettenkofer School of Public Health, Faculty of Medicine Ludwig-Maximilians University Munich, Munich 81377, Germany.
| | - Mingjing Zhu
- Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China.
| | - Yuanling Liu
- Human Resources Department, Guangdong Women and Children Hospital, Guangzhou 511442, China.
| | - Jianwei Deng
- Department of Public Administration, School of Management and Economics, Beijing Institute of Technology, Beijing 100081, China.
| | - Qian Chen
- Medical Affair Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100032, China.
| | - Lai-Chu See
- Department of Public Health, Medical College, Chang Gung University, Taoyuan 33302, Taiwan.
- Biostatistics Core Laboratory, Molecular Medicine Research Center, Chang Gung University, Taoyuan 33302, Taiwan.
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Fujino Y, Uehara M, Izumi H, Nagata T, Muramatsu K, Kubo T, Oyama I, Matsuda S. Development and validity of a work functioning impairment scale based on the Rasch model among Japanese workers. J Occup Health 2015; 57:521-31. [PMID: 26345178 DOI: 10.1539/joh.15-0135-oa] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES The purpose of this study was to develop a new work functioning impairment scale (WFun) and examine its validity. METHODS The WFun was developed based on the Rasch model, which consists of seven items. We conducted a pilot study (n=1,000) using an Internet investigation and a field study (n=1,294) in a manufacturing industry, and we additionally collected data from six workplaces from other industries. This series of studies was examined with a Rasch model analyses including item fit statistics as well as hypothesis testing. Convergent validity was used to examined the association of the WFun with the Stanford Presenteeism Scale, SF-8, Work Ability Index, and several types of job disruptions. We also examined differential test functioning. RESULTS All the items showed adequate fit (infit mean-square statistics <1.5). The item reliability was 0.98, and the item separation index was 6.37. The person reliability was 0.86, and the person separation index was 2.32. All tests for convergent validity showed significant differences. All p values derived from ANOVA were highly significant (p<0.001). No differential test function was observed between groups by age, sex, or job type or between various samples from different workplaces. The intraclass correlation of the estimated Rasch measurements from these groups was 0.99 (95% CI: 0.976-0.992). CONCLUSIONS The WFun was confirmed to show good fit to a Rasch model and construct validity. Given that its good fit indicates specific objectivity, this tool will be useful in assessing the ability of individuals to function at work and in evaluating group levels for benchmarking.
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Affiliation(s)
- Yoshihisa Fujino
- Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health
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Effectiveness of a health promotion program among employees in a western United States school district. J Occup Environ Med 2015; 56:639-44. [PMID: 24854257 DOI: 10.1097/jom.0000000000000153] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate the effectiveness of a worksite wellness program in decreasing health risk. METHODS Analyses were based on 2411 employees from a school district in the western United States that participated in the WellSteps wellness program for 12 months. RESULTS The numbers of high-risk employees at baseline were 683 for body mass index, 360 for systolic blood pressure, 242 for diastolic blood pressure, 72 for blood glucose, and 216 for total cholesterol. Among participants, 46.0% lowered body mass index, 34.7% lowered systolic blood pressure, 56.3% lowered diastolic blood pressure, 65.6% lowered blood glucose, and 38.6% lowered total cholesterol. The percentages moving out of the high-risk categories after 1 year were 11.6%, 39.4%, 70.7%, 38.9%, and 40.7%, respectively. CONCLUSIONS The worksite wellness program effectively lowered risk measures among those identified in high-risk categories at baseline.
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Measuring production loss due to health and work environment problems: construct validity and implications. J Occup Environ Med 2014; 55:1475-83. [PMID: 24270303 DOI: 10.1097/jom.0000000000000005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The aim was to validate two measures of production loss, health-related and work environment-related production loss, concerning their associations with health status and work environment factors. METHODS Validity was assessed by evaluating the construct validity. Health problems related and work environment-related problems (or factors) were included in separate analyses and evaluated regarding the significant difference in proportion of explained variation (R) of production loss. RESULT health problems production loss was not found to fulfill the criteria for convergent validity in this study; however, the measure of work environment-related production loss did fulfill the criteria that were set up. CONCLUSION The measure of work environment-related production loss can be used to screen for production loss due to work environment problems as well as an outcome measure when evaluating the effect of organizational interventions.
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M. Merrill R, Grant Merrill J. An evaluation of a comprehensive, incentivized worksite health promotion program with a health coaching component. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2014. [DOI: 10.1108/ijwhm-10-2012-0027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– The use of lifestyle coaches in a worksite setting to improve weight, nutrition, physical activity, and smoking behavior among at risk individuals is a relatively new area of research in the field of health promotion. The purpose of this paper is to assess the effectiveness of an accountability-based worksite telephonic health coaching program that incorporates financial incentives, a personal wellness profile (PWP) assessment tool, and biometric testing.
Design/methodology/approach
– A retrospective cohort study was conducted based on data from four midsize companies in Utah (USA), 2007-2010. Individuals with high-risk biometric scores were required to work with a health coach.
Findings
– Participants had fewer healthcare claims and lower costs than nonparticipants, which became more pronounced over the study period. Health risks and PWP results significantly improved, more so in those in poorer health at baseline that worked with a health coach. Mean difference between health age and potential achievable age significantly decreased, more so for men than women and among those with the greatest need for improvement.
Originality/value
– Health coaching effectively improved biometric scores among high-risk individuals and narrowed the difference between current health age and achievable age, more so among those with the greatest health risks at baseline who worked with a health coach.
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Johnson JL, Prochaska JO, Paiva AL, Fernandez AC, DeWees SL, Prochaska JM. Advancing Bodies of Evidence for Population-Based Health Promotion Programs: Randomized Controlled Trials and Case Studies. Popul Health Manag 2013; 16:373-80. [DOI: 10.1089/pop.2012.0094] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Janet L. Johnson
- Pro-Change Behavior Systems, Inc., South Kingstown, Rhode Island
| | - James O. Prochaska
- Cancer Prevention Research Center, University of Rhode Island, Kingston, Rhode Island
| | - Andrea L. Paiva
- Cancer Prevention Research Center, University of Rhode Island, Kingston, Rhode Island
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Lensberg BR, Drummond MF, Danchenko N, Despiégel N, François C. Challenges in measuring and valuing productivity costs, and their relevance in mood disorders. CLINICOECONOMICS AND OUTCOMES RESEARCH 2013; 5:565-73. [PMID: 24273412 PMCID: PMC3836685 DOI: 10.2147/ceor.s44866] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Lost productivity is often excluded from economic evaluations, which may lead to an underestimation of the societal benefits of treatment. However, there are multiple challenges in reliably estimating and reporting productivity losses. This article explores the main challenges, ie, selecting an appropriate valuation method (ie, human capital, friction cost, or multiplier), avoiding double counting, and accounting for equity. It also discusses the use of presenteeism instruments and their application in clinical trials, with a specific focus on their relevance in individuals with mood disorders. Further research and discussion is required on the development of reliable techniques for measuring and valuing productivity changes due to presenteeism.
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Landy SH, Cady RK, Nelsen A, White J, Runken MC. Consistency of return to normal function, productivity, and satisfaction following migraine attacks treated with sumatriptan/naproxen sodium combination. Headache 2013; 54:640-54. [PMID: 24102322 DOI: 10.1111/head.12214] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To assess the consistency of improved functioning, productivity, and medication satisfaction in migraines treated with a single tablet of sumatriptan 85 mg/naproxen sodium 500 mg (S/NS) using an early intervention approach. METHODS Two randomized, double-blind, placebo-controlled, 4-period crossover, multi-attack, multi-center, outpatient studies of moderate to severe adult migraineurs were conducted to compare S/NS with placebo. Participants recorded outcome assessments in a diary during the 24 hours following study medication. Analyses were conducted on the intent-to-treat population who treated at least 1 attack. Statistical significance between treatment groups used analysis of variance repeated measures models and the intent-to-treat population. There were no corrections for multiplicity. RESULTS Almost half (48.5%) of migraineurs treated with S/NS returned to normal functioning at 2 hours and 73.3% at 4 hours postdose, compared with 28.7% (2 hours) and 43.3% (4 hours) of placebo-treated attacks. Total productivity loss over the 24 hours postdose was significantly reduced following S/NS treatment (2.5 hours on average) compared with placebo (4.0 hours). Sumatriptan/naproxen treatment resulted in significantly higher medication satisfaction scores on the efficacy, functionality, and total efficacy subscales compared with placebo in all attacks in both studies. Sumatriptan/naproxen treatment also provided significantly greater ease of use in 7 of the 8 attacks. Although tolerability was high in both treatment groups (over 90%), the placebo group was significantly less bothered by side effects in 6 of 8 attacks. CONCLUSION Results from these 2 randomized, double-blind, placebo-controlled, multi-attack, crossover studies demonstrated the rapid and consistent restoration of patients' functioning, the consistent reduction in productivity loss, and high satisfaction ratings from patients treating multiple migraine attacks with S/NS using an early intervention approach.
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Tang K, Beaton DE, Amick BC, Hogg-Johnson S, Côté P, Loisel P. Confirmatory factor analysis of the Work Limitations Questionnaire (WLQ-25) in Workers' Compensation Claimants with chronic upper-limb disorders. JOURNAL OF OCCUPATIONAL REHABILITATION 2013; 23:228-38. [PMID: 23117847 DOI: 10.1007/s10926-012-9397-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
PURPOSE To examine the factorial validity of the Work Limitations Questionnaire (WLQ-25) among workers' compensation claimants with chronic upper-limb disorders. METHODS Attendees of the WSIB Shoulder and Elbow Specialty clinic in Toronto, Ontario, Canada, completed a survey that includes the WLQ-25 [4 subscales: time-management (TM), physical demands (PD), mental-interpersonal (MI), and output demands (OD)]. Confirmatory factor analyses (n = 2262) were conducted to evaluate and compare alternative 4- and 5-factor WLQ-25 structures [MI subscale intact vs. separated into mental demands (MD) and interpersonal demands (IP) subscales]. Model fit indices, saliency of factor loadings, and convergent/divergent validity of latent factors (r = 0.4 - 0.85 expected) were concurrently assessed. RESULTS The 4-factor WLQ-25 showed acceptable model fit after allowing the residuals of a pair of PD items to correlate (CFI = 0.924, TLI = 0.915, RMSEA = 0.057, SRMR = 0.054); however, significantly lower-than-expected correlations between the PD factor and all other factors (r = -0.11 - -0.03) were also observed. Model fit for the 5-factor WLQ-25 was even more optimal (CFI = 0.934, TLI = 0.925, RMSEA = 0.053, SRMR = 0.051), with MD and IP factors correlating at r = 0.83. CONCLUSIONS Evidence of factorial validity was demonstrated by the WLQ-25; however, users should be attentive of an instrumentation issue that could be directly related to the psychometric performance of its PD subscale.
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Affiliation(s)
- Kenneth Tang
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
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Kim JI. Effect of Heated Red Bean Pillow Application for College Women with Dysmenorrhea. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2013; 19:67-74. [PMID: 37684753 DOI: 10.4069/kjwhn.2013.19.2.67] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023] Open
Abstract
PURPOSE Dysmenorrhea is a menstrual condition characterized by severe and frequent cramps and pain. Effective treatment methods for dysmenorrhea are not yet fully understood. This research compares the effects of pain killers and heated red bean pillows. METHODS Data were got on demographic data, menstrual cycle status, and activities of daily living (ADLs) limitations, dysmenorrhea severity and menstrual pain scores. Following a 10% drop-out rate, 44 young women satisfied the inclusion criteria. To prevent any bias, the experimental and control groups were selected from different campuses. We used two sizes of red bean pillows: 15x18 cm, weighing 400g; and 13x11.5 cm, weighing 220g. For analysis, we used IBM SPSS statistics 19.0. RESULTS Ninety-nine point seven percentage of total subjects reported moderate to severe dysmenorrhea and 63.6% reported as moderate to severe daily activities limitations. The mean pain score with visual analogue scale was 80.2+/-9.42 of 100 and 86.4% used pain killers to alleviate menstrual discomfort in all the subjects. In both groups, all three variables showed significant improvement and the Moos's Menstrual Distress Questionnaire (MDQ) scores changed significantly between menstrual and post-menstrual time point at within groups and not significantly different at premenstrual and menstrual time point at between groups. However, the MDQ score was significantly higher in experimental group than control group at post-menstruation time point and the degree of satisfaction was higher in the control group. CONCLUSION This research shows that red-bean pillows on the abdomen are effective in assisting the ADL and diminishing pain severity. With regard to its safety the study indicates it can be a convenient and safe option for female students with menstrual discomfort in schoolas a non-pharmacological self-help.
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Affiliation(s)
- Jeung Im Kim
- School of Nursing, SoonChunHyang University, Chonan, Korea
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Impact of medication adherence on absenteeism and short-term disability for five chronic diseases. J Occup Environ Med 2012; 54:792-805. [PMID: 22796923 DOI: 10.1097/jom.0b013e31825463e9] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To estimate the impact of medication adherence on absenteeism and short-term disability among employees with chronic disease. METHODS Cross-sectional analysis of administrative health care claims, absenteeism, and short-term disability data using multivariate regression and instrumental variable models for five cohorts of employees: diabetes, hypertension, congestive heart failure, dyslipidemia, and asthma/chronic obstructive pulmonary disease. Adherence was defined as possessing medication on at least 80% of days during follow-up. RESULTS Adherent employees with diabetes, hypertension, dyslipidemia, and asthma/chronic obstructive pulmonary disease realized between 1.7 and 7.1 fewer days absent from work and between 1.1 and 5.0 fewer days on short-term disability. Absenteeism and short-term disability days by adherent employees with congestive heart failure were not significantly different from nonadherent employees with the condition in most specifications. CONCLUSIONS Appropriate management of chronic conditions can help employers minimize losses due to missed work.
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Quantifying the value of worksite clinic nonoccupational health care services: a critical analysis and review of the literature. J Occup Environ Med 2012; 54:394-403. [PMID: 22418274 DOI: 10.1097/jom.0b013e31824b2157] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Confusion exists regarding the approach to quantifying employer value of worksite nonoccupational care. A literature review and analysis was performed to characterize and critically evaluate existing methods to quantify the value of these services. METHODS PubMed was searched for publications describing measurement of value of nonoccupational worksite clinic services in US locations. Nineteen studies and two methodologic reviews met criteria for further analysis. RESULTS Return-on-investment calculations were commonly based on the comparative cost-effectiveness of worksite clinic services relative to community health care. Only one study evaluated the impact of worksite clinics on health care cost trend among clinic users, and none assessed the impact on total health and productivity costs. CONCLUSIONS Significant variability exists among current methods for calculating return on investment of nonoccupational worksite health care services; methodologic approaches are poorly aligned with employer health care cost containment objectives.
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Merrill RM, Aldana SG, Pope JE, Anderson DR, Coberley CR, Whitmer RW. Presenteeism according to healthy behaviors, physical health, and work environment. Popul Health Manag 2012; 15:293-301. [PMID: 22856386 DOI: 10.1089/pop.2012.0003] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The objective of this study is to identify the contribution that selected demographic characteristics, health behaviors, physical health outcomes, and workplace environmental factors have on presenteeism (on-the-job productivity loss attributed to poor health and other personal issues). Analyses are based on a cross-sectional survey administered to 3 geographically diverse US companies in 2010. Work-related factors had the greatest influence on presenteeism (eg, too much to do but not enough time to do it, insufficient technological support/resources). Personal problems and financial stress/concerns also contributed substantially to presenteeism. Factors with less contribution to presenteeism included physical limitations, depression or anxiety, inadequate job training, and problems with supervisors and coworkers. Presenteeism was greatest for those ages 30-49, women, separated/divorced/widowed employees, and those with a high school degree or some college. Clerical/office workers and service workers had higher presenteeism. Managers and professionals had the highest level of presenteeism related to having too much to do but too little time to do it, and transportation workers had the greatest presenteeism because of physical health limitations. Lowering presenteeism will require that employers have realistic expectations of workers, help workers prioritize, and provide sufficient technological support. Financial stress and concerns may warrant financial planning services. Health promotion interventions aimed at improving nutrition and physical and mental health also may contribute to reducing presenteeism.
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Affiliation(s)
- Ray M Merrill
- Department of Health Science, College of Life Sciences, Brigham Young University, Provo, UT 84602, USA.
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Skin adhesive low-level light therapy for dysmenorrhoea: a randomized, double-blind, placebo-controlled, pilot trial. Arch Gynecol Obstet 2012; 286:947-52. [PMID: 22648444 DOI: 10.1007/s00404-012-2380-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2011] [Accepted: 05/08/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE The cause of dysmenorrhoea is an abnormal function of smooth muscles in the uterus due to long-term deficient blood supply into smooth muscle tissue. The purpose of this study was to evaluate the effectiveness of skin adhesive low-level light therapy (LLLT) in participants with dysmenorrhoea. METHODS Thirty-one women were included in this randomized, double-blind, placebo-controlled, pilot trial. Twenty-one women were treated with active LLLT and ten women were treated with placebo one. The therapy was performed in a laboratory room for 20 min a day over a period of 5 days prior to the expected onset of menstruation. The outcome was measured using a visual analog scale (VAS) for each participant's dysmenorrhoeal pain severity. VAS of each subject was measured every month for 6 months. RESULTS In the active LLLT group, 16 women reported successful results during their first menstrual cycle just after active LLLT and 5 women had successful results from the second menstrual cycle after active LLLT. The pain reduction rate was 83 % in the active LLLT group, whereas there was only a slight and temporary reduction in pain in the placebo LLLT group. Changes of VAS within 6 months of LLLT showed statistical significance (p = 0.001) over placebo control. CONCLUSIONS Our study suggests that skin adhesive LLLT on acupuncture points might be an effective, simple and safe non-pharmacological treatment for dysmenorrhoea.
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Kim E, Cho JH, Jung WS, Lee S, Pak SC. Effect of acupuncture on heart rate variability in primary dysmenorrheic women. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2011; 39:243-9. [PMID: 21476202 DOI: 10.1142/s0192415x11008786] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Primary dysmenorrhea is a common gynecological complaint among young women that is related to an autonomic nervous system (ANS) disturbance. Acupuncture is one of several therapeutic approaches for primary dysmenorrhea, since it can modulate ANS function. The heart rate variability (HRV) parameters such as high frequency (HF), low frequency (LF) and LF/HF ratio are generally accepted tools to assess ANS activity. The purpose of this study was to investigate the effects of acupuncture applied at Hegu (LI4) and Sanyinjiao (SP6) points on HRV of women with primary dysmenorrhea during the late luteal phase. The experimental design was a crossover and patient-blinded procedure. All subjects participated in Sham (SA) and Real Acupuncture (RA) procedure, separated by one month, in a crossover sequence. The participants included 38 women (mean age 22.3 years; weight 53.8 kg; height 162.6 cm). HRV measurement was 15 min before and 15 min after an acupuncture procedure. The RA procedure was performed at two bilateral acupoints, but needles were inserted subcutaneously to the acupuncture points for the SA procedure. The RA induced a significant decrease in LF/HF ratio and a significant increase in the HF power, while SA treatment caused a significant increase only in the HF power. Manual acupuncture at bilateral acupoints of LI4 and SP6 may play a role in dysmenorrhea treatment with autonomic nervous system involvement.
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Affiliation(s)
- Eunsook Kim
- Department of Gynecology, College of Oriental Medicine, Kyung Hee University, Seoul, South Korea
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Employee Self-rated Productivity and Objective Organizational Production Levels. J Occup Environ Med 2011; 53:838-44. [DOI: 10.1097/jom.0b013e31822589c2] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Rakhshaee Z. Effect of three yoga poses (cobra, cat and fish poses) in women with primary dysmenorrhea: a randomized clinical trial. J Pediatr Adolesc Gynecol 2011; 24:192-6. [PMID: 21514190 DOI: 10.1016/j.jpag.2011.01.059] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2010] [Revised: 01/25/2011] [Accepted: 01/28/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVE We have evaluated the clinical efficacy of yoga for primary dysmenorrhea. Primary dysmenorrhea occurs in 50% of female adolescents and is a common problem in women of reproductive age. We have assessed whether three yoga poses (Cobra, Cat, and Fish Poses) are able to reduce severity and duration of primary dysmenorrhea. METHODS To determine the effectiveness of yoga in adolescents with primary dysmenorrhea, 92 girl students,18-22 years old, were randomly assigned to an experimental group (n = 50) and a control group (n = 42). The Visual Analog Scale for Pain was used to assess intensity of pain and the pain duration was calculated in terms of hours. Each group was evaluated for three menstrual cycles. At first cycle no method was presented; the participants only were asked to complete the questionnaire of menstrual characteristics during their menstrual. Then the participants were asked by the experimental group to do yoga poses at luteal phase, and also to complete the menstrual characteristics questionnaire in during of menstruation. The control group did not receive any intervention except to complete menstrual characteristics questionnaire in during of menstruation. RESULTS There was a significant difference in the pain intensity and pain duration in the post-tests compared with the pretest in yoga group (P < 0.05). The results showed that compared with the Control group, there was a significant difference in the pain intensity and pain duration in the experimental group (P < 0.05). CONCLUSION Yoga reduced the severity and duration of primary dysmenorrhea. The findings suggest that yoga poses are safe and simple treatment for primary dysmenorrhea.
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Affiliation(s)
- Zahra Rakhshaee
- Department of Midwifery, Islamic Azad University, Rasht Branch, Rasht, Iran.
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Mirbagher-Ajorpaz N, Adib-Hajbaghery M, Mosaebi F. The effects of acupressure on primary dysmenorrhea: A randomized controlled trial. Complement Ther Clin Pract 2011; 17:33-6. [DOI: 10.1016/j.ctcp.2010.06.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Mérelle SYM, Couturier EGM, van Bokhorst J, Busschbach JJV, Passchier J. Large-Scale Screening and Subsequent Effects of Migraine Treatment on the Work Floor in the Netherlands. Cephalalgia 2009; 29:606-15. [DOI: 10.1111/j.1468-2982.2008.01769.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In a large retail business group the ID Migraine Screening Test was sent to employees with three or more absences from work in the past year ( n = 2893). Employees with positive results were invited for a neurological consultation and migraine patients were randomly assigned to: first attack ‘treated as usual’ and the second attack treated with 40 mg eletriptan, or reversed order. Of the 2893 employees, 799 responded (28%), 260 were positively screened for migraine (33%), 84 patients were diagnosed by a neurologist and 41 of the 75 included patients completed the protocol. Eletriptan induced pain-free response in 33.3% of the patients at 4 h compared with 0% after ‘non-specific’ treatment ( P = 0.03). Eletriptan also significantly improved quality of life, but differences in absence from work and productivity loss could not be detected. In conclusion, in-company screening can be beneficial for undertreated employees, but implementation obstacles can reduce the effectiveness of screening.
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Affiliation(s)
- SYM Mérelle
- Department of Medical Psychology and Psychotherapy, Erasmus University Medical Centre, Rotterdam
| | - EGM Couturier
- Department of Medical Psychology and Psychotherapy, Erasmus University Medical Centre, Rotterdam
- Medical Centre Boerhaave, Amsterdam, the Netherlands
| | - J van Bokhorst
- Department of Medical Psychology and Psychotherapy, Erasmus University Medical Centre, Rotterdam
| | - JJV Busschbach
- Department of Medical Psychology and Psychotherapy, Erasmus University Medical Centre, Rotterdam
| | - J Passchier
- Department of Medical Psychology and Psychotherapy, Erasmus University Medical Centre, Rotterdam
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The Direct and Indirect Costs of Employee Depression, Anxiety, and Emotional Disorders—An Employer Case Study. J Occup Environ Med 2009; 51:564-77. [DOI: 10.1097/jom.0b013e3181a1f5c8] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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The association between a tiered pharmacy benefit plan and medication usage, health status, and disability absence days--one employer's experience. J Occup Environ Med 2009; 50:1176-84. [PMID: 18849763 DOI: 10.1097/jom.0b013e31817e7bc1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine the association of a three-tier pharmacy benefit plan with prescription drug spending and utilization, employee health status, and short-term disability (STD) absences in a large financial services corporation. METHODS Retrospective observational study of approximately 17,000 employees enrolled in the company's pharmacy benefit plan in anyone year from 2000 to 2004. Pharmacy claims compared before and after the plan implementation at the start of 2003. STD absences also compared each year. A self-report health status measure was compared before and after the plan change for a subset of employees who participated in a health risk appraisal. RESULTS After the benefit plan change, a reduction in the number of filed pharmacy claims was observed in five drug categories for acute conditions whereas medications for cardiovascular, antihyperlipidemic, asthma, and diabetes remained unchanged. There was no significant increase in the percentage of employees filing an STD claim or the average duration per STD event. Self-reported health status did not change significantly from 2002 to 2004. CONCLUSIONS Although the degree of employee cost-sharing for prescription medications increased from 2000 to 2004 and the utilization of some medication categories decreased, there was no observed association with overall employee health status or STD absenteeism during the 5-year study period.
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Schultz AB, Chen CY, Edington DW. The cost and impact of health conditions on presenteeism to employers: a review of the literature. PHARMACOECONOMICS 2009; 27:365-378. [PMID: 19586075 DOI: 10.2165/00019053-200927050-00002] [Citation(s) in RCA: 170] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Employers are becoming concerned with the costs of presenteeism in addition to the healthcare and absenteeism costs that have traditionally been explored. But what is the true impact of health conditions in terms of on-the-job productivity? This article examines the literature to assess the magnitude of presenteeism costs relative to total costs of a variety of health conditions. Searches of MEDLINE, CINAHL and PubMed were conducted in July 2008, with no starting date limitation, using 'presenteeism' or 'work limitations' as keywords. Publications on a variety of health conditions were located and included if they assessed the total healthcare and productivity cost of one or more health conditions. Literature on presenteeism has investigated its link with a large number of health conditions ranging from allergies to irritable bowel syndrome. The cost of presenteeism relative to the total cost varies by condition. In some cases (such as allergies or migraine headaches), the cost of presenteeism is much larger than the direct healthcare cost, while in other cases (such as hypertension or cancer), healthcare is the larger component. Many more studies have examined the impact of pharmaceutical treatment on certain medical conditions and the resulting improvement in on-the-job productivity. Based on the research reviewed here, health conditions are associated with on-the-job productivity losses and presenteeism is a major component of the total employer cost of those conditions, although the exact dollar amount cannot be determined at this time. Interventions, including the appropriate use of pharmaceutical agents, may be helpful in improving the productivity of employees with certain conditions.
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Affiliation(s)
- Alyssa B Schultz
- University of Michigan Health Management Research Center, Ann Arbor, Michigan 48104-1689, USA
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Witt CM, Reinhold T, Brinkhaus B, Roll S, Jena S, Willich SN. Acupuncture in patients with dysmenorrhea: a randomized study on clinical effectiveness and cost-effectiveness in usual care. Am J Obstet Gynecol 2008; 198:166.e1-8. [PMID: 18226614 DOI: 10.1016/j.ajog.2007.07.041] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2007] [Revised: 05/04/2007] [Accepted: 07/24/2007] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To investigate the clinical effectiveness and cost-effectiveness of acupuncture in patients with dysmenorrhea. STUDY DESIGN In a randomized controlled trial plus non-randomized cohort, patients with dysmenorrhea were randomized to acupuncture (15 sessions over three months) or to a control group (no acupuncture). Patients who declined randomization received acupuncture treatment. All subjects were allowed to receive usual medical care. RESULTS Of 649 women (mean age 36.1 +/- 7.1 years), 201 were randomized. After three months, the average pain intensity (NRS 0-10) was lower in the acupuncture compared to the control group: 3.1 (95% CI 2.7; 3.6) vs. 5.4 (4.9; 5.9), difference -2.3 (-2.9; -1.6); P<.001. The acupuncture group had better quality of life and higher costs. (overall ICER 3,011 euros per QALY). CONCLUSION Additional acupuncture in patients with dysmenorrhea was associated with improvements in pain and quality of life as compared to treatment with usual care alone and was cost-effective within usual thresholds.
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Affiliation(s)
- Claudia M Witt
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité University Medical Center, Berlin, Germany.
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Schultz AB, Edington DW. Employee health and presenteeism: a systematic review. JOURNAL OF OCCUPATIONAL REHABILITATION 2007; 17:547-79. [PMID: 17653835 DOI: 10.1007/s10926-007-9096-x] [Citation(s) in RCA: 287] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2007] [Accepted: 06/27/2007] [Indexed: 05/14/2023]
Abstract
INTRODUCTION Many employers focus on their large and easily measured cost of health care, yet until recently they have ignored the impact of health on productivity. Studies of some chronic conditions and some health risk factors suggest that costs of lost productivity exceed costs of medical care. This review will examine the literature to explore the link between employee health and on-the-job productivity, also known as presenteeism. METHODS Searches of Medline, CINAHL and PubMed were conducted in October 2006, with no starting date limitation with "presenteeism" or "work limitations" as keywords. A total of 113 studies were found using this method. Each study was evaluated based on the strength of the study design, statistical analyses, outcome measurement, and controlling of confounding variables. RESULTS Literature on presenteeism has investigated its link with a large number of health risks and health conditions ranging from exercise and weight to allergies and irritable bowel syndrome. As expected, the research on some topic areas is stronger than others. CONCLUSIONS Based on the research reviewed here, it can be said with confidence that health conditions such as allergies and arthritis are associated with presenteeism. Moreover, health risks traditionally measured by a health risk appraisal (HRA), especially physical activity and body weight, also show an association with presenteeism. The next step for researchers is to tease out the impact of individual health risks or combinations of risks and health conditions on this important outcome measure.
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Affiliation(s)
- Alyssa B Schultz
- Health Management Research Center, University of Michigan, 1015 E. Huron St., Ann Arbor, MI 48104-1688, USA.
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Wahlqvist P, Guyatt GH, Armstrong D, Degl'innocenti A, Heels-Ansdell D, El-Dika S, Wiklund I, Fallone CA, Tanser L, Veldhuyzen van Zanten S, Austin P, Barkun AN, Chiba N, Schünemann HJ. The Work Productivity and Activity Impairment Questionnaire for Patients with Gastroesophageal Reflux Disease (WPAI-GERD): responsiveness to change and English language validation. PHARMACOECONOMICS 2007; 25:385-96. [PMID: 17488137 DOI: 10.2165/00019053-200725050-00003] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
BACKGROUND A validated productivity questionnaire, the Work Productivity and Activity Impairment questionnaire for Gastroesophageal Reflux Disease (WPAI-GERD), exists for Swedish patients with GERD. OBJECTIVE To assess responsiveness to change of the WPAI-GERD and construct validity of the English language version. METHODS We used the WPAI-GERD in a before-after treatment clinical study of Canadian GERD patients with moderate or severe symptoms treated with esomeprazole 40 mg once daily for 4 weeks. We measured productivity variables including GERD-specific absence from work, reduced productivity while at work and reduced productivity while carrying out regular daily activities other than work during the preceding week. RESULTS The analysis included 217 patients, of whom 71% (n = 153) were employed. Before treatment, employed patients reported an average 0.9 hours of absence from work due to GERD and 14.0% reduced work productivity (5.8 hours equivalent) in the previous week, as well as 21.0% reduced productivity in daily activities (all patients). After treatment, the corresponding figures decreased to 0.3 hours, 3.0% (1.1 hours equivalent) and 4.9%, respectively. Thus, the improvement (difference from start of treatment) in productivity was 0.6 hours (p = 0.011) for absence from work and 11.0% units (p < 0.001) for reduced work productivity (4.7 hours equivalent, p < 0.001). This translated into an avoided loss of work productivity of 5.3 hours in total on a weekly basis per employed patient. In addition, a 16.1% unit (p < 0.001) improvement for reduced productivity in activities was observed. Cross-sectional correlation coefficients of WPAI variables with symptoms (range 0.04-0.63) and health-related quality of life (HR-QOL; range 0.02-0.65) supported cross-sectional construct validity. Corresponding change score correlations between WPAI variables and HR-QOL (range 0.05-0.56) supported longitudinal construct validity of the WPAI-GERD while low change score correlations between productivity variables and relevant symptoms (range 0.06-0.34) did not. CONCLUSION The English version of the WPAI-GERD showed good cross-sectional construct validity, and results indicated that the WPAI-GERD is responsive to change. Although the results also indicated that longitudinal construct validity may be poor, the overall findings suggest that further study of the instrument remains warranted.
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Wahlqvist P, Reilly MC, Barkun A. Systematic review: the impact of gastro-oesophageal reflux disease on work productivity. Aliment Pharmacol Ther 2006; 24:259-72. [PMID: 16842452 DOI: 10.1111/j.1365-2036.2006.02996.x] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Gastro-oesophageal reflux disease has wide-ranging effects on patients' lives. AIM To review systematically the effects of gastro-oesophageal reflux disease on work productivity. METHODS Studies of gastro-oesophageal reflux disease and work productivity were identified in a systematic literature search and their results were valued in US dollars using the human capital method. Work productivity loss was defined as absence from work (absenteeism) plus reduced effectiveness while working (presenteeism). RESULTS Eight eligible studies were included. Reported work productivity loss among individuals with gastro-oesophageal reflux disease ranged from 6% to 42% and was primarily because of presenteeism (6-40%) rather than absenteeism (<1% to 7%). Reported losses were greatest in patients experiencing sleep disturbance because of gastro-oesophageal reflux disease, and lowest in individuals from the general population taking appropriate prescription medication. Work productivity impairment correlated with symptom severity and responded to acid-suppressive therapy. Assuming a 40-h working week and average wages in the US, the weekly mean productivity loss per employee with gastro-oesophageal reflux disease can be estimated between 2.4 (62 dollars) and 16.6 h (430 dollars), depending on the population studied. CONCLUSIONS Gastro-oesophageal reflux disease has a substantial impact on employee productivity, primarily by impairing productivity while working. Further studies are needed to confirm that this impact can be decreased by acid-suppressive therapy.
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Lyngberg AC, Rasmussen BK, Jørgensen T, Jensen R. Secular changes in health care utilization and work absence for migraine and tension-type headache: a population based study. Eur J Epidemiol 2006; 20:1007-14. [PMID: 16331432 DOI: 10.1007/s10654-005-3778-5] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To assess changes in consultation rates, medication use and work absences due to migraine and tension-type headache (TTH) in Denmark over a 12-year period. METHODS Surveys of the general population in 1989 and 2001. Medical doctors conducted all headache diagnostic interviews based on ICDH-I and II. The participation rate was 76% (740) in 1989 and 74% (711) in 2001. Headache status was categorized as pure migraine, pure frequent TTH (frequent episodic or chronic TTH), coexisting migraine and frequent TTH, and healthy subjects (no primary headache or only infrequent TTH). RESULTS Headache-related consultation rates (OR = 1.6 (1.1-2.2)), especially specialist consultations (OR = 3.6 (2.3-5.6)), increased for all headache groups. Use of prescription medication because of headache increased moderately (OR = 2.1 (1.1-3.9)) while the use of prophylactic medication was stable (OR = 1.1 (0.3-4.0)). Both headache-related (OR = 1.1 (0.7-1.7)) and overall (OR = 0.9 (0.7-1.2)) absence rates were largely unchanged. Headache-related absence rates were higher for subjects with both headache types (OR = 7.5 (4.3-13.1)) or with pure migraine (OR = 3.6 (2.0-6.6)) than for subjects with frequent TTH alone. Triptans users had higher migraine headache frequency and tended to have higher absence rates than non-users. Overall absence rates were higher for subjects with both headache types (OR = 2.3 (1.3-4.0)) or with frequent TTH (OR = 1.9 (1.4-2.7)) than for healthy subjects. Pure migraine was not associated with higher overall absence rates (OR = 1.0 (0.6-1.6)). CONCLUSION Despite an increase in headache consultation rates and in use of prescription medication and triptans, no improvement in work absence rates was observed. Consultations, medication use, and absence rates were highest for individuals with both migraine and frequent TTH.
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Affiliation(s)
- A C Lyngberg
- Research Centre for Prevention and Health, Copenhagen University Hospital, Copenhagen County, Glostrup, Denmark.
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Abstract
Lee and Biggerstaff discuss two new studies on the cost effectiveness of different strategies for screening blood for West Nile virus.
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Affiliation(s)
- Bruce Y Lee
- Section of Decision Sciences and Clinical Systems Modeling, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
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Pace F, Molteni P, Wiklund I. Outcome research in gastroenterology: the case of gastroesophageal reflux disease (GERD). Drug Dev Res 2006. [DOI: 10.1002/ddr.20083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Abstract
OBJECTIVE The objective of this work was the investigation of the extent to which the introduction of new drugs has increased society's ability to produce goods and services by increasing the number of hours worked per member of the working-age population. METHODS Econometric models of ability-to-work measures from data on approximately 200,000 individuals with 47 major chronic conditions observed throughout a 15-year period (1982-1996) were estimated. RESULTS Under very conservative assumptions, the estimates indicate that the value of the increase in ability to work attributable to new drugs is 2.5 times as great as expenditure on new drugs. CONCLUSIONS The potential of drugs to increase employee productivity should be considered in the design of drug-reimbursement policies. Conversely, policies that broadly reduce the development and utilization of new drugs may ultimately reduce our ability to produce other goods and services.
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Abstract
Substantial epidemiologic and clinical evidence indicates that agents inhaled at work can induce asthma. In industrialized countries, occupational factors have been implicated in 9 to 15% of all cases of adult asthma. Work-related asthma includes (1) immunologic occupational asthma (OA), characterized by a latency period before the onset of symptoms; (2) nonimmunologic OA, which occurs after single or multiple exposures to high concentrations of irritant materials; (3) work-aggravated asthma, which is preexisting or concurrent asthma exacerbated by workplace exposures; and (4) variant syndromes. Assessment of the work environment has improved, making it possible to measure concentrations of several high- and low-molecular-weight agents in the workplace. The identification of host factors, polymorphisms, and candidate genes associated with OA is in progress and may improve our understanding of mechanisms involved in OA. A reliable diagnosis of OA should be confirmed by objective testing early after its onset. Removal of the worker from exposure to the causal agent and treatment with inhaled glucocorticoids lead to a better outcome. Finally, strategies for preventing OA should be implemented and their cost-effectiveness examined.
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Affiliation(s)
- Cristina E Mapp
- Section of Hygiene and Occupational Medicine, Department of Clinical and Experimental Medicine, University of Ferrara, Italy.
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Pransky GS, Berndt E, Finkelstein SN, Verma S, Agrawal A. Performance Decrements Resulting From Illness in the Workplace: The Effect of Headaches. J Occup Environ Med 2005; 47:34-40. [PMID: 15643157 DOI: 10.1097/01.jom.0000150208.20117.34] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Studies on the impact of illness on work productivity are important to rationally allocate healthcare resources and to design programs to mitigate these effects. This investigation was conducted to develop and apply daily measures of illness episodes, and to collect subjective and objective data on work performance impacts. Medical bill reviewers completed daily responses to a questionnaire about headache manifestations, severity, and speed of work using interactive voice response (IVR). Of 134 eligible enrolled subjects, 117 (86%) provided at least 30 daily reports over 3 months. Their responses were matched to difficulty-adjusted objective measures: daily output, time on the system, and productivity. Respondents were clinically classified as migraineurs (n = 56), other headache disorders (n = 47), or having no headache disorder (n = 14). Each headache episode was classified as a migraine or nonmigraine headache based on reported manifestations. RESULTS The three groups were similar in a variety of demographic factors, and mean subject-specific measures of speed, output, and productivity. In a multivariate model using general estimating equations, only episode severity (not type of headache or person-specific diagnosis) was found to be associated with a significant decrement in speed or productivity. The self-reported decrement in speed (approximately 20%) was much greater than the actual measured effect on productivity (approximately 8%). Intensive daily diary collection by IVR on symptoms and work performance is feasible. However, analysis of detailed daily objective productivity data can be complex, with significant unmeasured sources of variance. Severity may be a more important determinant of headache effect on work performance than specific diagnosis. Future studies on illness episodes and work performance should measure informal accommodations that may enable employees to compensate for episodic illnesses.
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Affiliation(s)
- G S Pransky
- Liberty Mutual Research Institute, Hopkinton, Massachusetts and Harvard School of Public Health, Boston, Massachusetts 01748, USA.
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Lynch WD, Riedel JE, Hymel PA, Loeppke RR, Nelson RW, Ashenfelter JW. Factors Affecting the Frequency of Value-Focused Health Activities and Policies by Employers. J Occup Environ Med 2004; 46:1103-14. [PMID: 15534497 DOI: 10.1097/01.jom.0000147156.30071.c0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE We sought to gather employer perspectives about value-focused activities (VFAs), intentions to make decisions based on value, and other factors affecting decisions. METHODS Health decision-makers (n = 174), both American College of Occupational and Environmental Medicine members and corporate HR/benefits directors, responded to an Internet-based questionnaire. RESULTS Of a total of 32 listed VFAs, companies reported, on average, performing 5.2 activities currently and considering 2.6. Twenty-five percent of companies reported doing eight or more. The most common VFAs were providing access to flu shots, centers of excellence, and wellness programs. Greater access to detailed outcome data was associated with doing more VFAs, as was greater accountability for absence, disability, and productivity outcomes. CONCLUSIONS Employers vary widely in the number of VFAs in which they participate. Decision-makers with more information about, and accountability for, value outcomes reported doing more VFAs.
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Abstract
Gastroesophageal reflux disease (GERD) is associated with a range of symptoms (typically heartburn, acid regurgitation and dysphagia), which may or may not be accompanied by endoscopically evident esophagitis. A number of studies have demonstrated that health-related quality of life (HRQoL) in reflux disease patients is significantly impaired in comparison to the general population, regardless of the endoscopic findings. Furthermore, this impairment is comparable to or greater than that observed in other chronic conditions, such as diabetes, arthritis or congestive heart failure. Impaired HRQoL in GERD patients is a result of features such as disturbed sleep, reduced vitality, generalized body pain, an impaired sex life and anxiety about the underlying cause of the symptoms. Nocturnal symptoms of reflux disease appear to have a particularly marked impact on HRQoL. The burden of illness imposed by reflux disease on HRQoL also has an impact on productivity, both at and outside work. The impact of reflux disease on productivity is significant and comparable to that caused by headache or back pain. Effective treatment is available for reflux disease, and there is evidence that this can quickly restore HRQoL to levels observed in the general population. However, poor communication between physicians and patients is contributing to unacceptable levels of patient dissatisfaction. Understanding patients' experience of GERD and its treatment through the study of HRQoL is one way to address this problem.
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