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PloS One 2020The lack of established measurement tools in the study of menstrual health and hygiene has been a significant limitation of quantitative studies to date. However, there...
BACKGROUND
The lack of established measurement tools in the study of menstrual health and hygiene has been a significant limitation of quantitative studies to date. However, there has been limited exploration of existing measurement to identify avenues for improvement.
METHODS
We undertook two linked systematic reviews of (1) trials of menstrual health interventions and their nested studies in low- and middle-income countries, (2) studies developing or validating measures of menstrual experiences from any location. Systematic searching was undertaken in 12 databases, together with handsearching. We iteratively grouped and audited concepts measured across included studies and extracted and compared measures of each concept.
RESULTS
A total of 23 trials, 9 nested studies and 22 measure development studies were included. Trials measured a range of outcomes including menstrual knowledge, attitudes, and practices, school absenteeism, and health. Most measure validation studies focused on assessing attitudes towards menstruation, while a group of five studies assessed the accuracy of women's recall of their menstrual characteristics such as timing and cycle length. Measures of menstrual knowledge, attitudes, beliefs and restrictions were inconsistent and frequently overlapped. No two studies measured the same menstrual or hygiene practices, with 44 different practices assessed. This audit provides a summary of current measures and extant efforts to pilot or test their performance.
CONCLUSIONS
Inconsistencies in both the definition and operationalisation of concepts measured in menstrual health and hygiene research should be addressed. To improve measurement, authors should clearly define the constructs they aim to measure and outline how these were operationalised for measurement. Results of this audit indicate the need for the development and validation of new measures, and the evaluation of the performance of existing measures across contexts. In particular, the definition and measurement of menstrual practices, knowledge, attitudes, norms and restrictions should be addressed.
REVIEW PROTOCOL REGISTRATION
CRD42018089884.
Topics: Adolescent; Adult; Attitude to Health; Baths; Clinical Trials as Topic; Culture; Dysmenorrhea; Female; Health Education; Health Knowledge, Attitudes, Practice; Humans; Hygiene; Menstrual Cycle; Menstrual Hygiene Products; Middle Aged; Social Behavior; Young Adult
PubMed: 32497117
DOI: 10.1371/journal.pone.0232935 -
Frontiers in Public Health 2022Employee alcohol and other drug use can negatively impact the workplace, resulting in absenteeism, reduced productivity, high turnover, and worksite safety issues. As...
UNLABELLED
Employee alcohol and other drug use can negatively impact the workplace, resulting in absenteeism, reduced productivity, high turnover, and worksite safety issues. As the workplace can influence employee substance use through environmental and cultural factors, it also presents a key opportunity to deliver interventions, particularly to employees who may not otherwise seek help. This is a systematic review of workplace-based interventions for the prevention and treatment of problematic substance use. Five databases were searched for efficacy, effectiveness and/or cost-effectiveness studies and reviews published since 2010 that measured use of psychoactive substances (i.e., alcohol, cannabis, hallucinogens, inhalants, opioids, sedatives, hypnotics, anxiolytics, and stimulants) as a primary or secondary outcome, in employees aged over 18. Thirty-nine articles were identified, 28 describing primary research and 11 reviews, most of which focused solely on alcohol use. Heterogeneity between studies with respect to intervention and evaluation design limited the degree to which findings could be synthesized, however, there is some promising evidence for workplace-based universal health promotion interventions, targeted brief interventions, and universal substance use screening. The few studies that examined implementation in the workplace revealed specific barriers including lack of engagement with e-health interventions, heavy use and reluctance to seek help amongst male employees, and confidentiality concerns. Tailoring interventions to each workplace, and ease of implementation and employee engagement emerged as facilitators. Further high-quality research is needed to examine the effectiveness of workplace substance use testing, Employee Assistance Programs, and strategies targeting the use of substances other than alcohol in the workplace.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=227598, PROSPERO [CRD42021227598].
Topics: Male; Humans; Adolescent; Adult; Workplace; Cost-Benefit Analysis; Substance-Related Disorders; Work Engagement; Cannabis; Ethanol
PubMed: 36419993
DOI: 10.3389/fpubh.2022.1051119 -
Injury Jun 2021Open tibia fractures are a common injury following road traffic collisions and place a large economic burden on patients and healthcare systems. Summarising their... (Review)
Review
BACKGROUND
Open tibia fractures are a common injury following road traffic collisions and place a large economic burden on patients and healthcare systems. Summarising their economic burden is key to inform policy and help prioritise treatment.
METHODS
All studies were identified from a systematic search of Medline, Embase and the Cochrane Central Register of Controlled Trials. We included any human with a diagnosed open tibia fracture, following any intervention. The primary outcome was any costs reported or patient return to work status. Secondary outcomes included average length of stay, wage loss, absenteeism and complications such as infection, amputation and nonunion. Data was extracted and we performed a descriptive narrative summary.
RESULTS
We reviewed 1,204 studies from our searches. A total of 34 studies were included from 14 different countries. The average age was 37.7 years old and 76% of the patients were male. 6.5% were Gustilo I, 12% Gustilo II and 82% Gustilo III. Initial direct hospitalisation costs were reported to be between £356 to £126,479 with an average length of stay of 56 days (3.1-244). 89% of participants were working pre-injury, 60% fully returned to work, 17% returned to work part time or changed profession and 22% did not return to work at one-year. The most common complications reported were 22% infection, 11% nonunion and 16% amputation. Mean follow-up duration for the studies was 25 months.
CONCLUSION
The economic burden of open tibia fractures varies greatly, but it is costly for both hospitals and patients. The current evidence is predominantly from high-income countries (HICs), especially the USA. Further research is required to investigate the costs of open tibia fractures using validated costing tools, especially in low-income countries (LICs), to help inform and direct policy.
Topics: Accidents, Traffic; Adult; Amputation, Surgical; Cost of Illness; Female; Fractures, Open; Humans; Male; Tibia; Tibial Fractures
PubMed: 33691946
DOI: 10.1016/j.injury.2021.02.022 -
Reproductive Health Jun 2022Menstrual health and hygiene are a major public health and social issues in Nepal. Due to inadequate infrastructure to provide education, healthcare, and communication... (Review)
Review
Menstrual health and hygiene are a major public health and social issues in Nepal. Due to inadequate infrastructure to provide education, healthcare, and communication as well as religious teachings, women and girls are excluded from participation in many activities of daily living and community activities during menstruation. Evidence based research addressing menstrual health and hygiene in Nepal is scares. The objective of this paper is to review the current state of knowledge on menstrual health and hygiene in Nepal through a socio-ecological perspective. This systematic review identifies knowledge gaps and targets for future research and interventions. Studies from Nepal that examined factors contributing to menstrual health and hygiene were identified through searches across six databases (Medline, CINAHL, Web of Science, PsychInfo, Nepal Journals Online and Kathmandu University Medical Journal) in January 2019. The SEM is a public health framework that describes how health is impacted at multiple levels including the individual, interpersonal, community, organizational and policy levels. Key themes were identified, and factors contributing to menstrual health and hygiene were categorized as per the level of socio-ecological model (SEM). After a comprehensive literature review, twenty peer-reviewed publications, published between 2003 and January 2019 were included in this review. Eighteen studies were descriptive and two were interventional. The main outcomes reported were reproductive health concerns and menstrual hygiene practices. Nine studies focused on knowledge, attitude, and practices regarding menstruation, seven studies highlighted reproductive health issues, three studies focused on prevalence of culturally restrictive practices, and one on school absenteeism and intimate partner violence. Lack of awareness regarding menstrual health and hygiene, inadequate WASH facilities, no sex education and culturally restrictive practices makes menstruation a challenge for Nepali women. These challenges have negative implications on women and girls' reproductive as well as mental health and school attendance among adolescent girls. There are gaps in the evidence for high quality interventions to improve menstrual health and hygiene in Nepal. Future research and interventions should address needs identified at all levels of the SEM.
Topics: Activities of Daily Living; Adolescent; Female; Health Knowledge, Attitudes, Practice; Humans; Hygiene; Menstruation; Nepal; Schools
PubMed: 35773696
DOI: 10.1186/s12978-022-01456-0 -
Advances in Therapy Dec 2022In light of the lack of an agreed international standard for how to conduct cost-effectiveness analyses (CEAs), including cost-utility analyses (CUAs) from a societal... (Review)
Review
INTRODUCTION
In light of the lack of an agreed international standard for how to conduct cost-effectiveness analyses (CEAs), including cost-utility analyses (CUAs) from a societal perspective, there is uncertainty regarding to what extent the inclusion of productivity losses/gains in economic evaluations can affect cost-effectiveness results and subsequently decisions on whether to recommend new health technologies. To investigate this, we conducted a systematic review of CEAs and CUAs of drug-based therapies for a set of chronic immune-mediated disorders to understand how cost elements and calculation methods related to productivity losses/gains are used, examine the impact on the incremental cost-effectiveness ratio (ICER) of including productivity costs, and explore factors that affect the inclusion of productivity loss.
METHODS
Databases (MEDLINE In-process, MEDLINE, Embase and Cochrane Library) were searched from January 2010 to October 2020 by two independent reviewers for all CEAs and CUAs in adults with any of the following conditions: ankylosing spondylitis, chronic idiopathic urticaria, Crohn's disease, fibromyalgia, juvenile idiopathic arthritis, psoriasis, rheumatoid arthritis, systemic lupus erythematosus and ulcerative colitis. Relevant study data were extracted and evidence was synthesized for both qualitative and quantitative analysis. Productivity cost elements including absenteeism, presenteeism, unemployment/early retirement, premature mortality and informal care were extracted, along with the method used to determine them. A multivariate analysis was performed to identify factors associated with the inclusion of productivity loss.
RESULTS
Our searches identified 5016 records, culminating in 198 unique studies from 234 publications following screening. Most of the studies investigated rheumatoid arthritis (37.0%) or psoriasis (32.0%). The majority were CUAs, with some including both a CEA and a CUA (73.0%). Most studies used a payer perspective only (28.5%) or a societal perspective only (21.0%). Of the 49 studies incorporating productivity losses/gains, 42 reported the type of cost element used; all of these used patient absenteeism, either alone or in addition with other elements. Only 16 studies reported the method used to value productivity changes, of which eight used a human capital approach, four used a friction cost approach and four used both approaches. Twenty-eight of the 49 studies (57.1%) reported inclusion of productivity losses/gains as contributing to more favourable cost-effectiveness outcomes and ICERs, while 12 (24.5%) reported no substantial impact. On the basis of a multivariate analysis, rheumatoid arthritis as the target disease had a statistically significant association with the inclusion of productivity loss compared with psoriasis and inflammatory bowel disease.
CONCLUSIONS
The results of our review suggest that incorporating productivity cost elements may positively affect cost-effectiveness outcomes in evaluations of therapeutics for immune-mediated disorders. Our work highlights the continued need for clarity when reporting how CEAs and CUAs in this disease area are conducted, in order to better inform healthcare decision-making.
Topics: Adult; Humans; Cost-Benefit Analysis; Efficiency; Arthritis, Rheumatoid; Absenteeism; Psoriasis
PubMed: 36205907
DOI: 10.1007/s12325-022-02321-z -
International Journal of Environmental... Jan 2021The main purpose of the paper is to identify the outcomes for employers and employees indicated in research related to workplace health promotion interventions (WHPIs).... (Review)
Review
The main purpose of the paper is to identify the outcomes for employers and employees indicated in research related to workplace health promotion interventions (WHPIs). We investigated what methods are used and what types of organization this type of research is most often carried out in. In addition, the authors attempted to assess to what extent the methods used in the previous research prove the effectiveness of the implemented WHPIs. A systematic review of English-language papers (2000-2020) focused on types of health-promoting interventions in the workplace, and outcomes for employers and employees were conducted using the SCOPUS database ( 260). As a result, 29 texts qualified for a final qualitative synthesis of the results. The analyses were most frequently conducted in small and medium-sized enterprises (SMEs) based on both quantitative and qualitative methods. In order to draw conclusions, analyses were made by classifying the research presented in the texts according to the type of intervention implemented, classifying the outcomes identified, and indicating the type of evaluation made by the researcher. The analysis showed that most of the outcomes presented refer to changes in the strategy and organizational culture, as well as the behavior of employees. In 18 studies, the indication of outcomes resulted directly from the evaluation outcomes. In other cases, the outcomes were identified by an evaluation of the process or structure of WHPI. The conducted analysis showed significant diversity in terms of the outcomes measured and the research methods used. The quasi-experimental methods, randomly controlled cluster trials, or cross-sectorial studies used in the study to confirm the effectiveness of WHPI were used only in every third study. In these studies, measurements were usually performed twice: at baseline and after intervention. The majority of studies confirmed that WHPIs led to a positive change in the healthy behavior of employees and effected an organizational change, and more rarely led to savings or a reduction in costs resulting from sickness absenteeism, presentism, turnover, etc., and return on investment (ROI). The article shows the need to conduct further research towards the development of guidelines for the evaluation of the effectiveness of implemented programs.
Topics: Absenteeism; Empirical Research; Health Promotion; Organizational Culture; Workplace
PubMed: 33419033
DOI: 10.3390/ijerph18020383 -
Journal of Clinical Epidemiology Feb 2022To investigate how work participation outcomes in randomized controlled trials are measured internationally and across disciplines. (Review)
Review
OBJECTIVE
To investigate how work participation outcomes in randomized controlled trials are measured internationally and across disciplines.
STUDY DESIGN AND SETTING
We identified trials that reported on work participation in Medline, Embase, PsycINFO and Cochrane Central published between 2014 and 2019. Screening, selection, and data extraction were done by two authors independently. We grouped outcomes into four categories ("employment status", "absence from work", "at-work productivity loss," and "employability") and created subcategories according to how the outcome was measured.
RESULTS
From 10,022 database hits we selected 269 trials reporting on 435 work participation outcomes. Authors used inconsistent outcome terminology to describe the measured constructs. Grouped in four main categories we identified 70 outcomes that reported on "employment status", 196 on "absence from work" and return-to-work, 132 on "at-work productivity loss," and 37 on "employability" outcomes. Variability in measurement methods existed across all categories. Employment status and absenteeism measures consisted mostly of clinimetrically unvalidated tools. "At-work productivity loss" and "employability" were measured by at least 41 different questionnaires.
CONCLUSION
Extensive variability exists among trials in the measurement of outcomes, measurement methods and measurement instruments that focus on work participation. This study is a first step towards the development of a Core Outcome Set for work participation.
Topics: Efficiency; Employment; Humans; Randomized Controlled Trials as Topic; Surveys and Questionnaires; Work Performance
PubMed: 34715311
DOI: 10.1016/j.jclinepi.2021.10.013 -
Health Economics Review Sep 2023Chronic migraine (CM) is a significant neurological condition affecting a substantial portion of the global population. The economic burden of CM includes both direct... (Review)
Review
BACKGROUND
Chronic migraine (CM) is a significant neurological condition affecting a substantial portion of the global population. The economic burden of CM includes both direct healthcare costs and indirect costs resulting from productivity losses and intangible impacts on patients' quality of life. However, there is limited research that comprehensively evaluates all cost components associated with CM, highlighting the need for a systematic review.
METHODS
We conducted a systematic literature search in databases including MEDLINE, Embase, and CINAHL to identify studies estimating the cost of illness of chronic migraines. The search was restricted to English language articles published from inception to October 2021, and only findings from Organisation for Economic Co-operation and Development (OECD) countries were included. Methodology features and key findings were extracted from the studies, and reported costs were converted to GBP for cross-country comparisons.
RESULTS
Thirteen cost-of-illness studies on CM from various OECD countries were included in this review. The studies demonstrated substantial variations in monetary estimates, but consistently highlighted the considerable economic burden of CM. Direct costs, particularly hospitalisation and medication expenses, were identified as the highest contributors. However, indirect costs, such as productivity losses due to absenteeism and presenteeism, were often underexplored in the reviewed studies. Additionally, intangible costs related to emotional and social impacts on patients were largely overlooked.
CONCLUSION
Chronic migraine imposes a significant economic burden on individuals, healthcare systems, and society. Policymakers and healthcare stakeholders should consider both direct and indirect cost components, as well as intangible costs, in developing targeted strategies for effective CM management and resource allocation. Further research focusing on comprehensive cost assessments and sensitivity analyses is needed to enhance the understanding of CM's economic implications and inform evidence-based healthcare policy decisions. Addressing these research gaps can alleviate the economic burden of CM and improve patient outcomes.
PubMed: 37656228
DOI: 10.1186/s13561-023-00459-2 -
Brazilian Oral Research 2023This study aimed to assess the potential association between perception malocclusion and school performance in children and adolescents. An electronic search was...
This study aimed to assess the potential association between perception malocclusion and school performance in children and adolescents. An electronic search was performed in ten databases. Based on the PECO acronym (Population, Exposition, Comparator, and Outcome), the eligibility criteria included observational studies that compared the school performance of children and adolescents with and without the perception of malocclusion. There were no restrictions on the language or year of publication. Two reviewers selected the studies, extracted the data, and assessed the risk of bias by using the Joanna Briggs Institute tool for cross-sectional studies. School performance was measured by analyzing student grades; levels of absenteeism; and child or adolescent self-perception and/or the perception of parents, guardians, close friends, and teachers regarding the impact of malocclusion on school performance. The data were described narratively/descriptively. The search resulted in 3,581 registers, of which eight were included in the qualitative synthesis. These studies were published between 2007 and 2021. Two studies concluded that there was no significant association between school performance and perception of malocclusion, five studies found that only some of the children with malocclusion had their school performance affected, and one study concluded that there was a significant association between perception of malocclusion and low school performance. Considering all variables and the very low certainty of evidence, the perception of malocclusion seems to negatively impact school performance when associated with external and subjective factors. Further studies using additional measurement standards are required.
Topics: Child; Humans; Adolescent; Cross-Sectional Studies; Malocclusion; Students; Parents; Perception
PubMed: 37132722
DOI: 10.1590/1807-3107bor-2023.vol37.0033 -
European Review For Medical and... Jan 2021Inflammatory bowel diseases (IBD), including Crohn's disease (CD) and Ulcerative Colitis (UC), are chronic, relapsing intestinal disorders that may severely compromise...
OBJECTIVE
Inflammatory bowel diseases (IBD), including Crohn's disease (CD) and Ulcerative Colitis (UC), are chronic, relapsing intestinal disorders that may severely compromise patients' labour force participation. In this context, the present review aims to provide an overview on possible IBD pathological, socio-demographic, and treatment-related factors predictive for work disability with the purpose to provide guidance for a successful clinical and occupational management.
MATERIALS AND METHODS
A systematic review of PubMed, Scopus, and ISI Web of Science databases was performed to retrieve all the studies addressing IBD-related predictors for work disability.
RESULTS
Several factors have been suggested to predict work disability in the 15 revised investigations, although with not homogeneous results. Having CD was reported as a significantly better predictor for permanent work disability compared to UC, maybe in relation to the generally more serious disease course. Activity and severity of IBD, also indicated by the need for surgical treatment and comorbidities, was related to a significantly greater risk for work disability, although the exact role of other variables, i.e., specific symptoms, disease pattern and inflammatory parameters are still unclear. Among demographic factors, a significant predictive role has been suggested for female gender.
CONCLUSIONS
Further research seems necessary to confirm the role of IBD related factors on work disability, and on other parameters of work impairment, i.e., absenteeism, presenteeism, activity and productivity loss. Additionally, work disability should be evaluated in relation to specific occupational risk factors. Overall, this may require a multidisciplinary approach aimed to achieve an adequate IBD clinical evaluation and management, an improvement of patients' psychosocial and professional well-being, while appropriately assessing and managing risks in the workplace.
Topics: Disabled Persons; Humans; Inflammatory Bowel Diseases; Risk Factors
PubMed: 33506905
DOI: 10.26355/eurrev_202101_24382