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Healthcare (Basel, Switzerland) May 2023The workplace is a vital setting to support positive mental health. Mental health conditions in the workforce contribute to decreased work engagement and participation.... (Review)
Review
The workplace is a vital setting to support positive mental health. Mental health conditions in the workforce contribute to decreased work engagement and participation. There is existing literature on return-to-work (RTW) interventions for individuals with work-related mental health conditions, however, there lacks consensus on their effectiveness. Therefore, the primary aim of this systematic review was to synthesize the literature and evaluate the effectiveness of return-to-work interventions on return-to-work rates, quality of life, and psychological wellbeing for individuals with work-related mental health conditions. Selected articles were organized and identified using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and the Population/Intervention/Comparison/Outcome (PICO) framework. Quality assessment of the included studies was completed using the Critical Appraisal Skills Programme randomized controlled trials checklist and the Joanna Briggs Institute quasi-experimental studies checklist. A random effects meta-analysis model was performed using DerSimonian-Laird weighting to calculate standard mean difference and risk ratios to assess the impact of RTW interventions on return-to-work rates, absenteeism, stress symptoms, depression symptoms, and quality of life. A total of 28 out of 26,153 articles met the inclusion criteria. Diagnoses for participants in the studies ranged from work-related stress to work-related PTSD following exposure to a psychologically traumatizing event in the workplace. No significant differences were found for the meta-analyses examining return-to-work rates, absenteeism, depression, stress, and quality of life. The most effective interventions were found to be a multi-domain intervention (67% of participants RTW full time) and a health-focused intervention (85% RTW rate). Future research may consider establishing effective interventions to develop programs or policies supporting the RTW of employees and promote mental well-being among employees experiencing work-related mental health conditions.
PubMed: 37239689
DOI: 10.3390/healthcare11101403 -
Journal of Occupational Health 2023Prolonged and constant stress from work often leads to numerous adverse health effects. In recent years, interest in probiotics, living microorganisms that can benefit... (Review)
Review
BACKGROUND
Prolonged and constant stress from work often leads to numerous adverse health effects. In recent years, interest in probiotics, living microorganisms that can benefit their host when consumed in adequate amounts, to aid health and well-being has increased. This scoping review is to systematically evaluate the current state of science on the effects of probiotic supplements on health, stress, and stress-related symptoms among working adults in occupational settings.
METHODS
We performed a systematic scoping review following the Arksey and O'Malley Framework. Studies that examined the effects of probiotics on workers' health and stress-related indicators/outcomes in occupational settings were included. A comprehensive search was performed from November 2021 to January 2022 using MEDLINE/PubMed, Cochrane Library, CINAHL, PsychInfo, Scopus, and Embase.
RESULTS
A total of 14 papers met the inclusion and exclusion criteria. Probiotics consisted primarily of Lactobacillus and/or Bifidobacterium strains in various forms and doses. Three out of eight studies reported statistical differences in inflammatory markers or stress hormone levels between probiotic and placebo groups. Three of six reported reduced respiratory tract infection incidents in the probiotic groups and three out of four studies reported no differences in anxiety and depression between groups. Lastly, three studies found that absenteeism and presentism were lower in probiotic groups compared with placebo groups.
CONCLUSION
The potential benefits of probiotics exist; however, the measurements of outcomes, the types of probiotics used, and the characteristics of the intervention varied across studies. Further research is needed focusing on probiotics' direct and indirect mechanisms of action on the stress response and the standardization of strains and dosing.
Topics: Adult; Humans; Occupational Health; Probiotics; Lactobacillus; Absenteeism; Anxiety
PubMed: 37218068
DOI: 10.1002/1348-9585.12404 -
BMJ Open Apr 2023Low back pain (LBP) is the leading cause of disability and work absenteeism globally, and it poses significant clinical and economic burden to individuals, health...
OBJECTIVES
Low back pain (LBP) is the leading cause of disability and work absenteeism globally, and it poses significant clinical and economic burden to individuals, health systems and the society. This study aimed to synthesise the clinical and economic burden of LBP in low-income and middle-income countries (LMICs).
METHODS
A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed. PubMed, Medline, CINAHL, PsycINFO, AMED, Embase and Scopus databases were systematically searched for studies that examined the clinical and economic burden of LBP in LMICs, published from inception to 10 December 2021. Only studies with clearly stated methodologies and published in English were eligible for review.
RESULTS
Nine studies met the inclusion criteria and were reviewed. Of these, three of them were clinical burden studies. The mean Newcastle-Ottawa Quality Assessment Scale (NOS) score of the included studies was 4, with an average from 3 to 6. The included studies were conducted in Argentina, Brazil, China, Ethiopia, Nigeria and Republic of Serbia. The rates of hospitalisation due to LBP ranged between 13.4% and 18.7%. Due to variation of methodological approaches, the reported cost estimates were inconsistent across the studies. A total cost of US$2.2 billion per population and US$1226.25 per patient were reported annually due to LBP.
CONCLUSION
This systematic literature review suggests that LBP is associated with significantly high rates of hospitalisation and costs. As LBP is an important threat to the population, health professionals and policymakers are to put in place appropriate programmes to reduce the clinical and economic burden associated with LBP and improve the health outcomes of individuals with this condition in LMICs.
PROSPERO REGISTRATION NUMBER
CRD42020196335.
Topics: Humans; Low Back Pain; Developing Countries; Financial Stress; Argentina; Brazil
PubMed: 37185180
DOI: 10.1136/bmjopen-2022-064119 -
Musculoskeletal Science & Practice Jun 2023Lifestyle factors are expected to contribute to the persistence and burden of low-back pain (LBP). However, there are no systematic reviews on the (cost-)effectiveness... (Review)
Review
INTRODUCTION
Lifestyle factors are expected to contribute to the persistence and burden of low-back pain (LBP). However, there are no systematic reviews on the (cost-)effectiveness of combined lifestyle interventions for overweight or obese people with LBP.
AIM
To assess whether combined lifestyle interventions are (cost-)effective for people with persistent LBP who are overweight or obese, based on a systematic review.
DESIGN
Systematic review METHOD: PubMed, Cochrane, Embase, CINAHL, PsycINFO and the Wiley/Cochrane Library were searched from database inception till January 6 2023. Two independent reviewers performed study selection, data-extraction and risk of bias scoring using the Cochrane RoB tool 2 and/or the Consensus Health Economic Criteria list. GRADE was used to assess the level of certainty of the evidence.
RESULTS
In total 2510 records were screened, and 4 studies on 3 original RCTs with 216 participants were included. Low certainty evidence (1 study) showed that combined lifestyle interventions were not superior to usual care for physical functioning, pain and lifestyle outcomes. Compared to usual care, moderate certainty evidence showed that healthcare (-$292, 95%CI: 872; -33), medication (-$30, 95% CI -65; -4) and absenteeism costs (-$1000, 95%CI: 3573; -210) were lower for the combined lifestyle interventions.
CONCLUSION
There is low certainty evidence from 3 studies with predominantly small sample sizes, short follow-up and low intervention adherence that combined lifestyle interventions are not superior to physical functioning, pain and lifestyle outcomes compared to usual care, but are likely to be cost-effective.
Topics: Healthy Lifestyle; Low Back Pain; Obesity; Overweight; Cost-Effectiveness Analysis; Cost-Benefit Analysis; Physical Therapy Modalities
PubMed: 37167807
DOI: 10.1016/j.msksp.2023.102770 -
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 -
BJPsych Open Apr 2023Screening for asymptomatic health conditions is perceived as mostly beneficial, with possible harms receiving little attention. (Review)
Review
BACKGROUND
Screening for asymptomatic health conditions is perceived as mostly beneficial, with possible harms receiving little attention.
AIMS
To quantify proximal and longer-term consequences for individuals receiving a diagnostic label following screening for an asymptomatic, non-cancer health condition.
METHOD
Five electronic databases were searched (inception to November 2022) for studies that recruited asymptomatic screened individuals who received or did not receive a diagnostic label. Eligible studies reported psychological, psychosocial and/or behavioural outcomes before and after screening results. Independent reviewers screened titles and abstracts, extracted data from included studies, and assessed risk of bias (Risk of Bias in Non-Randomised Studies of Interventions). Results were meta-analysed or descriptively reported.
RESULTS
Sixteen studies were included. Twelve studies addressed psychological outcomes, four studies examined behavioural outcomes and none reported psychosocial outcomes. Risk of bias was judged as low ( = 8), moderate ( = 5) or serious ( = 3). Immediately after receiving results, anxiety was significantly higher for individuals receiving versus not receiving a diagnostic label (mean difference -7.28, 95% CI -12.85 to -1.71). On average, anxiety increased from the non-clinical to clinical range, but returned to the non-clinical range in the longer term. No significant immediate or longer-term differences were found for depression or general mental health. Absenteeism did not significantly differ from the year before to the year after screening.
CONCLUSIONS
The impacts of screening asymptomatic, non-cancer health conditions are not universally positive. Limited research exists regarding longer-term impacts. Well-designed, high-quality studies further investigating these impacts are required to assist development of protocols that minimise psychological distress following diagnosis.
PubMed: 37073644
DOI: 10.1192/bjo.2023.49 -
Advances in Therapy May 2023The clinical benefits of advanced therapies (i.e., biologics and small-molecule drugs) in the treatment of moderate-to-severe ulcerative colitis (UC) have been... (Review)
Review
INTRODUCTION
The clinical benefits of advanced therapies (i.e., biologics and small-molecule drugs) in the treatment of moderate-to-severe ulcerative colitis (UC) have been demonstrated; however, there is less clarity regarding the economic and health-related quality of life (HRQoL) impact of these treatments. We conducted a systematic literature review to synthesize data on cost, healthcare resource utilization (HCRU), and HRQoL for patients who received approved advanced therapies for moderate-to-severe UC in the United States and Europe.
METHODS
Databases including MEDLINE, Embase, the Database of Abstracts of Reviews of Effects (DARE), the National Health Service Economic Evaluation Database (NHS EED), and EconLit were searched systematically to identify observational studies published between January 1, 2010 and October 14, 2021 that assessed the impact of advanced therapies on cost, HCRU, and/or HRQoL in adults with moderate-to-severe UC. Supplementary gray literature searches of conference proceedings from the past 4 years (January 2018 to October 2021) were also performed.
RESULTS
47 publications of 40 unique cost/HCRU studies and 13 publications of nine unique HRQoL studies were included. Findings demonstrated that biologics have a positive impact on indirect costs (i.e., productivity, presenteeism, and absenteeism) and HRQoL. High costs of biologics were not always fully offset by reductions in cost and HCRU associated with disease management. For many patients, treatment switching and dose escalations were required, thus increasing drug costs, particularly when switching across treatment classes.
CONCLUSION
These findings highlight a high unmet need for therapies for moderate-to-severe UC that can reduce the healthcare burden and impact on society. Further research is warranted, as the reported evidence was limited by the small sample sizes of some treatment groups within a study.
Topics: Adult; Humans; Colitis, Ulcerative; Quality of Life; State Medicine; Biological Products; Cost-Benefit Analysis
PubMed: 37000363
DOI: 10.1007/s12325-023-02488-z -
Environmental Health : a Global Access... Mar 2023The adverse effects of air pollution on human health include many diseases and health conditions associated with mortality, morbidity and disability. One example of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The adverse effects of air pollution on human health include many diseases and health conditions associated with mortality, morbidity and disability. One example of these outcomes that can be translated into economic costs is the number of days of restricted activity. The aim of this study was to assess the effect of outdoor exposure to particulate matter with an aerodynamic diameter less than or equal to 10 and 2.5 μm (PM, PM), nitrogen dioxide (NO), and ozone (O), on restricted activity days.
METHODS
Observational epidemiological studies with different study designs were included, and pooled relative risks (RR) with 95% confidence intervals (95%CI) were calculated for an increase of 10 μg/m of the pollutant of interest. Random-effects models were chosen because of the environmental differences between the studies. Heterogeneity was estimated using prediction intervals (PI) and I-Squared (I2) values, while risk of bias was assessed using a tool developed by the World Health Organization specifically designed for air pollution studies, and based on different domains. Subgroup and sensitivity analyses were performed where possible. The protocol for this review was registered with PROSPERO (CRD42022339607).
RESULTS
We included 18 articles in the quantitative analysis. Associations between pollutants and restricted activity days in time-series studies of short-term exposures, measured as work-loss days, school-loss days, or both were significant for PM (RR: 1.0191; 95%CI: 1.0058-1.0326; 80%PI: 0.9979-1.0408; I2: 71%) and PM (RR: 1.0166; 95%CI: 1.0050-1.0283; 80%PI: 0.9944-1.0397; I2: 99%), but not for NO or O. Some degree of heterogeneity between studies was observed, but sensitivity analysis showed no differences in the direction of the pooled relative risks when studies with a high risk of bias were excluded. Cross-sectional studies also showed significant associations for PM and restricted activity days. We could not perform the analysis for long-term exposures because only two studies analysed this type of association.
CONCLUSION
Restricted activity days and related outcomes were associated with some of the pollutants under evaluation, as shown in studies with different designs. In some cases, we were able to calculate pooled relative risks that can be used for quantitative modelling.
Topics: Humans; Air Pollutants; Nitrogen Dioxide; Cross-Sectional Studies; Air Pollution; Particulate Matter; Ozone; Environmental Pollutants; Environmental Exposure; Observational Studies as Topic
PubMed: 36991377
DOI: 10.1186/s12940-023-00979-8 -
International Journal of Environmental... Mar 2023Adolescents spend most of their daily time in school and performing school-related activities. Different aspects of their school experiences, such as school performance,... (Review)
Review
Adolescents spend most of their daily time in school and performing school-related activities. Different aspects of their school experiences, such as school performance, psychological factors related to school, and structural factors, consistently impact adolescents' health and are likely to be intertwined with their sleep (i.e., quantity and quality, sleep disturbances). This systematic review aimed to comprehensively summarize the reciprocal and longitudinal associations between adolescents' sleep and multiple aspects of their school experience. Using multiple search strategies and applying a two-step selection process, 25 journal articles matched the eligibility criteria and were thus included in the review. The results highlighted the contribution of poor sleep quality and sleep disturbances in predicting longitudinal school experiences-related outcomes (i.e., decreasing school engagement and performance, and increasing school-related burnout, absenteeism, and bullying). At the same time, the results showed how experiences related to the school's psychological factors (e.g., high levels of school burnout and stressful environment) and structural characteristics (e.g., early school entrance time) affect youth sleep over time (i.e., decreasing sleep quality and quantity). These main findings provided novel insights into the bidirectional relationship between school experience and sleep health, highlighting the importance of more longitudinal research investigating all aspects of healthy sleep, including the size and direction of the association.
Topics: Humans; Adolescent; Schools; Sleep; Sleep Quality; Sleep Initiation and Maintenance Disorders; Longitudinal Studies
PubMed: 36981738
DOI: 10.3390/ijerph20064829 -
PharmacoEconomics Jul 2023Insufficient and disturbed sleep are associated with significant morbidity among working-age adults. Poor sleep results in negative health outcomes and increases...
OBJECTIVE
Insufficient and disturbed sleep are associated with significant morbidity among working-age adults. Poor sleep results in negative health outcomes and increases economic costs to employers. The current systematic review surveyed the peer-reviewed scientific literature and aggregated scientific evidence of sleep-related economic burdens borne by employers.
METHODS
A systematic review was performed to identify peer-reviewed, English language studies evaluating the economic impact of insufficient and disturbed sleep among adult employee populations. An exhaustive literature search was performed using keywords related to sleep, economics, and the workplace. Included were scientific studies (randomized controlled trials, cohort and case control studies, cross-sectional and longitudinal studies) examining specific employee populations with relevant sleep and economic outcomes. Each included study was evaluated for risk of bias and relevant data was extracted and summarized.
RESULTS
Sleep problems among employee populations are associated with worsened workplace outcomes, such as presenteeism, absenteeism, and accidents. Sleep problems also increased costs to employers, ranging from US$322 to US$1967 per employee. Interventions to improve sleep, such as the use of blue-light filtering glasses, strategic shift scheduling, and targeted interventions to treat insomnia, may improve workplace outcomes and reduce costs.
CONCLUSIONS
This review synthesizes the existing data regarding the negative impacts of insufficient and disturbed sleep on the workplace, suggesting that employers have an economic stake in their employees' sleep.
TRIAL REGISTRATION
PROSPERO: CRD42021224212.
Topics: Adult; Humans; Cross-Sectional Studies; Workplace; Surveys and Questionnaires; Sleep; Sleep Wake Disorders; Absenteeism
PubMed: 36933184
DOI: 10.1007/s40273-023-01249-8