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BMC Public Health Dec 2023Randomized trials have shown that vitamin C shortens the duration of common colds. Some trials reported greater effects on severe cold symptoms compared with mild... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Randomized trials have shown that vitamin C shortens the duration of common colds. Some trials reported greater effects on severe cold symptoms compared with mild symptoms. This review systematically compares the effects of vitamin C on severe and mild common cold symptoms.
METHODS
We included all placebo-controlled trials of orally administered vitamin C in doses of at least 1 g/day for the common cold for people in good health at baseline. The analysis was restricted to trials which reported both the total duration of the common cold, and the severity of the common cold measured using severity scales, the duration of more severe stages of the cold, or proxies for severe colds such as days indoors. Findings were pooled using the inverse variance, fixed effect options of the metacont function of the R package meta to calculate the ratio of means estimate.
RESULTS
Fifteen comparisons from 10 trials which reported both mild and severe symptoms were identified. All trials were randomized and double-blind. Compared to placebo, vitamin C significantly decreased the severity of the common cold by 15% (95% CI 9-21%). The direct comparison of the effect of vitamin C on mild and severe symptoms was limited to five comparisons which found that vitamin C had a significant benefit on the duration of severe symptoms. In this subset, there was a significant difference in the size of the effect of vitamin C on the overall duration of colds versus the duration of severe colds (P = 0.002), and vitamin C had no significant effect on the duration of mild symptoms.
CONCLUSIONS
The common cold is the leading cause of acute morbidity and a major cause of absenteeism from work and school. However, absenteeism is dependent on the severity of symptoms. The finding that vitamin C may have a greater effect on more severe measures of the common cold is therefore important. Further research on the therapeutic effects of vitamin C on the common cold should measure outcomes of differing levels of severity.
Topics: Humans; Common Cold; Ascorbic Acid; Vitamins; Double-Blind Method; Absenteeism; Randomized Controlled Trials as Topic
PubMed: 38082300
DOI: 10.1186/s12889-023-17229-8 -
Gastroenterology Sep 2023Belching, bloating, and abdominal distention are all highly prevalent gastrointestinal symptoms and account for some of the most common reasons for patient visits to... (Review)
Review
DESCRIPTION
Belching, bloating, and abdominal distention are all highly prevalent gastrointestinal symptoms and account for some of the most common reasons for patient visits to outpatient gastroenterology practices. These symptoms are often debilitating, affecting patients' quality of life, and contributing to work absenteeism. Belching and bloating differ in their pathophysiology, diagnosis, and management, and there is limited evidence available for their various treatments. Therefore, the purpose of this American Gastroenterological Association (AGA) Clinical Practice Update is to provide best practice advice based on both controlled trials and observational data for clinicians covering clinical features, diagnostics, and management considerations that include dietary, gut-directed behavioral, and drug therapies.
METHODS
This Expert Review was commissioned and approved by the AGA Institute Clinical Practice Updates Committee and the AGA Governing Board to provide timely guidance on a topic of high clinical importance to the AGA membership, and underwent internal peer review by the Clinical Practice Updates Committee and external peer review through standard procedures of Gastroenterology. These best practice advice statements were drawn from a review of the published literature based on clinical trials, the more robust observational studies, and from expert opinion. Because systematic reviews were not performed, these best practice advice statements do not carry formal ratings regarding the quality of evidence or strength of the presented considerations. Best Practice Advice Statements BEST PRACTICE ADVICE 1: Clinical history and physical examination findings and impedance pH monitoring can help to differentiate between gastric and supragastric belching. BEST PRACTICE ADVICE 2: Treatment options for supragastric belching may include brain-gut behavioral therapies, either separately or in combination, such as cognitive behavioral therapy, diaphragmatic breathing, speech therapy, and central neuromodulators. BEST PRACTICE ADVICE 3: Rome IV criteria should be used to diagnose primary abdominal bloating and distention. BEST PRACTICE ADVICE 4: Carbohydrate enzyme deficiencies may be ruled out with dietary restriction and/or breath testing. In a small subset of at-risk patients, small bowel aspiration and glucose- or lactulose-based hydrogen breath testing may be used to evaluate for small intestinal bacterial overgrowth. BEST PRACTICE ADVICE 5: Serologic testing may rule out celiac disease in patients with bloating and, if serologies are positive, a small bowel biopsy should be done to confirm the diagnosis. A gastroenterology dietitian should be part of the multidisciplinary approach to care for patients with celiac disease and nonceliac gluten sensitivity. BEST PRACTICE ADVICE 6: Abdominal imaging and upper endoscopy should be ordered in patients with alarm features, recent worsening symptoms, or an abnormal physical examination only. BEST PRACTICE ADVICE 7: Gastric emptying studies should not be ordered routinely for bloating and distention, but may be considered if nausea and vomiting are present. Whole gut motility and radiopaque transit studies should not be ordered unless other additional and treatment-refractory lower gastrointestinal symptoms exist to warrant testing for neuromyopathic disorders. BEST PRACTICE ADVICE 8: In patients with abdominal bloating and distention thought to be related to constipation or difficult evacuation, anorectal physiology testing is suggested to rule out a pelvic floor disorder. BEST PRACTICE ADVICE 9: When dietary modifications are needed (eg, low-fermentable oligosaccharides, disaccharides, monosaccharides and polyols diet), a gastroenterology dietitian should preferably monitor treatment. BEST PRACTICE ADVICE 10: Probiotics should not be used to treat abdominal bloating and distention. BEST PRACTICE ADVICE 11: Biofeedback therapy may be effective for bloating and distention when a pelvic floor disorder is identified. BEST PRACTICE ADVICE 12: Central neuromodulators (eg, antidepressants) are used to treat bloating and abdominal distention by reducing visceral hypersensitivity, raising sensation threshold, and improving psychological comorbidities. BEST PRACTICE ADVICE 13: Medications used to treat constipation should be considered for treating bloating if constipation symptoms are present. BEST PRACTICE ADVICE 14: Psychological therapies, such as hypnotherapy, cognitive behavioral therapy, and other brain-gut behavior therapies may be used to treat patients with bloating and distention. BEST PRACTICE 15: Diaphragmatic breathing and central neuromodulators are used to treat abdominophrenic dyssynergia.
Topics: Female; Humans; United States; Eructation; Celiac Disease; Pelvic Floor Disorders; Quality of Life; Constipation; Flatulence; Dilatation, Pathologic
PubMed: 37452811
DOI: 10.1053/j.gastro.2023.04.039 -
La Tunisie Medicale Jun 2023To assess the impact of non-insulin-requiring Type 2 diabetes (T2D) on professional activity in terms of absenteeism, presenteeism, reduced productivity and daily...
AIM
To assess the impact of non-insulin-requiring Type 2 diabetes (T2D) on professional activity in terms of absenteeism, presenteeism, reduced productivity and daily activities.
METHODS
We conducted a comparative cross-sectional survey of two groups of employees in the Cap Bon textile sector: 75 diabetic and 75 workers free from any endocrinological pathology, seen in the occupational medicine group of Nabeul. The study was spread over 10 months from March 2020.A questionnaire was administered containing the Arabic version of WPAI-GH « Work Productivity and Activity Impairment Questionnaire-General Health » to assess absenteeism, presenteeism, decreased productivity and daily activity.
RESULTS
A total of 150 workers participated in our study. Diabetes was responsible for absenteeism of 5.1 ± 8.9%, presenteeism of 4.8 ± 6,4%, a decrease in productivity of 7.3 ± 7.8% and a decrease in the daily activity of 14,6 ± 10%. The rate of presenteeism, decrease in productivity and daily activity were significantly higher in T2D (p = 0.015). Absenteeism was associated with degenerative complications (p< 0,001). Presenteeism was associated with the duration of the course of diabetes (p < 0,001).
CONCLUSION
Diabetes has a negative impact in productivity and general activity. Early and multidisciplinary management of these patients improves their professional performance.
Topics: Humans; Diabetes Mellitus, Type 2; Cross-Sectional Studies; Efficiency; Surveys and Questionnaires; Absenteeism
PubMed: 38372549
DOI: No ID Found -
Cureus Nov 2023The burgeoning field of organizational psychological medicine identifies presenteeism, the practice of attending work while medically or psychologically unwell, as a...
The burgeoning field of organizational psychological medicine identifies presenteeism, the practice of attending work while medically or psychologically unwell, as a complex factor influencing workplace health and overall organizational performance. This article examines presenteeism's many facets, focusing on how it affects the Indian labor force and how it increased during the COVID-19 epidemic, particularly in the field of healthcare. Utilizing data from the Ministry of Statistics and Programme Implementation and global surveys, the paper elucidates that an alarming percentage of the workforce abstains from utilizing entitled vacations, often leading to presenteeism. The article also probes the paradoxical aspect of presenteeism through the lens of "workaholism," arguing that while presenteeism may offer short-term psychological benefits such as boosting self-esteem or serving as a distraction from personal ailments, it is detrimental in the long term, impacting both individual health and organizational productivity. Recent surveys from the United Kingdom cited within the article indicate that presenteeism has tripled over the last decade, exacerbating health outcomes and compromising economic viability. Contributing factors are delineated, distinguishing between organizational imperatives such as financial penalties for absenteeism and individual motivations like job insecurity. The article ends by putting forward a multifaceted plan to mitigate the adverse consequences of presenteeism. The implementation of compassionate leadership, the adoption of flexible work practices, and the introduction of comprehensive employee well-being initiatives are among the key suggestions. Supervisors should also be trained in the identification and management of presenteeism. The article concludes by emphasizing the critical importance of strategic investment in human resources as a sustainable solution for curbing the detrimental impact of presenteeism on organizations.
PubMed: 38084200
DOI: 10.7759/cureus.48620 -
Revista Brasileira de Medicina Do... 2023Teachers, especially those in primary education, face unfavorable working conditions, which lead to job dissatisfaction and affect their physical and mental health, thus...
INTRODUCTION
Teachers, especially those in primary education, face unfavorable working conditions, which lead to job dissatisfaction and affect their physical and mental health, thus contributing to absenteeism.
OBJECTIVES
To verify the association between lower job satisfaction and absenteeism due to short and long term health problems in elementary and hight school teachers.
METHODS
This observational, analytical, individual, cross-sectional, retrospective cohort study included 899 elementary and high school teachers. Absenteeism was determined by self-reported absences in the last 12 months for health reasons, categorized as short term (1-7 days) or long term (≥8 days). Job satisfaction was measured by the Occupational Stress Indicator scale, categorized as lower satisfaction (≤25th percentile) or higher satisfaction (>25th percentile). Multinomial logistic regression was used, and the odds ratio was calculated as a measure of association.
RESULTS
The majority of the teachers were women (68.3%) and were permanently employed (69.1%); the mean age was 42 (SD, 10) years. Women, younger teachers, permanent employees, those reporting chronic pain or illness, and those reporting a moderate/poor level of physical or mental work capacity had a higher risk of absenteeism. Lower job dissatisfaction was associated with short-term and long-term absenteeism. Job satisfaction was only related to short-term absenteeism after the adjustments made.
CONCLUSIONS
There was an association between absenteeism and lower job satisfaction, which indicates that measures to improve job satisfaction are necessary.
PubMed: 38313775
DOI: 10.47626/1679-4435-2023-1054 -
La Clinica Terapeutica 2023Work-related stress represents a major health problem within most work environments and its rates of incidence are increasing as time goes by. Work-related stress is... (Review)
Review
BACKGROUND
Work-related stress represents a major health problem within most work environments and its rates of incidence are increasing as time goes by. Work-related stress is both detrimental for workers' psychophysical health and costly to societies. Besides the direct medical costs that represent only a fraction of the total cost, data is either lacking or unreliable to properly estimate the economic impact of occupational stress.
METHODS
This paper reviews international studies and organisational reports in order to highlight occupational stress economic impact on an international level.
RESULTS
The study shows that work-related stress imposes an undeniable financial burden on worldwide societies. Findings show estimations that vary from € 54 million up to € 280 billion depending on the country. Results suggest that productivity loss due to absenteeism and presenteeism has a greater economic impact compared to the medical expenses.
DISCUSSION
Generally speaking, the costs of work-related stress, also according to Europe, impact both on employers and welfare sy-stems, and from the point of view of prevention we should work hard to improve stress-management strategies.
CONCLUSIONS
The discussion around this matter should be emphasized in order to properly address occupational stress and make implications for job redesign under the perspective that promoting and protecting workers' mental well-being will benefit the individual and allow cost containment benefitting the collective as well.
Topics: Humans; Europe; Working Conditions; Absenteeism; Occupational Stress
PubMed: 37674456
DOI: 10.7417/CT.2023.2464