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Tidsskrift For Den Norske Laegeforening... Jan 2011Sick leave is a topical subject, particularly following the revision of the Agreement on a More Inclusive Working Life (the IA agreement). However, there has been little... (Review)
Review
BACKGROUND
Sick leave is a topical subject, particularly following the revision of the Agreement on a More Inclusive Working Life (the IA agreement). However, there has been little discussion about the extent to which sick leave may be related to work.
MATERIAL AND METHODS
The paper is based on a non-systematic literature search using PubMed combined with personal research and experience.
RESULTS
Various studies indicate that a significant proportion of all sick leaves may be due to illness caused by working conditions. Heavy physical work, awkward work postures and low job control are particularly important factors. People who suffer from work-related illnesses have a greater need for absence from work than people with similar illnesses caused by factors other than their work. Workplace interventions designed to prevent work-related illness may also prevent sick leave. Sick leaves which are due to an imbalance between an individual's resources and his/her job demands, may often be prevented or shortened by workplace interventions, irrespective of what causes the imbalance.
INTERPRETATION
It is my view that more importance should be attached to primary preventive measures to reduce work-related illness, combined with workplace interventions to accommodate people who carry a higher risk of sick leave. However, this is not given sufficient attention in the current IA agreement.
Topics: Humans; Musculoskeletal Diseases; Occupational Diseases; Occupational Health; Self Report; Sick Leave; Workplace
PubMed: 21267027
DOI: 10.4045/tidsskr.10.0665 -
Current Opinion in Infectious Diseases Aug 2007To review recent evidence supporting the guidelines for preventing catheter-related and catheter-associated infections. (Review)
Review
PURPOSE OF REVIEW
To review recent evidence supporting the guidelines for preventing catheter-related and catheter-associated infections.
RECENT FINDINGS
A series of studies has confirmed, over the past few years, that education-based preventive programmes can reduce these infections by one half to two thirds. The evidence supporting some specific measures has increased for the optimal timing for set replacement, for catheter-site dressing with chlorhexidine-impregnated devices, and for the use of some coated or impregnated intravascular devices.
SUMMARY
Catheter-related and associated infections are largely preventable and should not be viewed as an unaffordable tribute to technical medicine. Improvements in existing techniques and new technologies should all be integrated into a structured process of continuous improvement in the quality of care.
Topics: Anti-Infective Agents, Local; Bacterial Infections; Catheterization, Central Venous; Catheterization, Peripheral; Catheters, Indwelling; Cross Infection; Equipment Contamination; Humans; Infection Control; Infectious Disease Transmission, Professional-to-Patient; Practice Guidelines as Topic
PubMed: 17609594
DOI: 10.1097/QCO.0b013e32818be72e -
Public Health Reports (Washington, D.C.... 1989Evidence from a variety of sources indicates that exercise can increase the mineral content of bone, raising the expectation that exercise programs may be effective... (Review)
Review
Evidence from a variety of sources indicates that exercise can increase the mineral content of bone, raising the expectation that exercise programs may be effective therapy for the treatment of osteoporosis, and the prevention of hip and spinal fractures. Indeed, prospective studies demonstrate that primarily weight-bearing exercise prevents the age-related decline in axial skeletal mass and, in some instances, increases bone mineral content. Optimal changes in the skeleton in response to exercise are seen in those women with adequate intake of dietary calcium. Neither hormonal status nor age appears to preclude the skeletal benefits of exercise. The design of an exercise program must consider the physical condition of the participants, their current levels of activity, their compliance, and the objectives of the program. Generic programs that are not designed for individuals' needs and limitations, and that are not adequately supervised, will result in a high rate of musculoskeletal complications and noncompliance. Unfortunately, additional studies are necessary before we can construct an optimum exercise prescription for bone health which addresses duration, frequency, intensity, and type of exercise. Of concern is the fact that gains in bone mass achieved with exercise are lost following their discontinuation in postmenopausal women, underscoring the concept that the level of physical activity is a major and dynamic determinant of skeletal integrity. Thus, it will be necessary to develop strategies to preserve the gains in skeletal mass achieved through exercise. Finally, before exercise can be promoted for bone health, it will be necessary to demonstrate that such programs can indeed prevent osteoporotic fractures.
Topics: Adult; Aged; Animals; Exercise; Female; Humans; Middle Aged; Osteoporosis, Postmenopausal
PubMed: 2517702
DOI: No ID Found -
Patient Education and Counseling Jun 2023We examined changes in people's trust in information sources in Japan during the COVID-19 pandemic over the course of 1 year and investigated longitudinal associations...
OBJECTIVE
We examined changes in people's trust in information sources in Japan during the COVID-19 pandemic over the course of 1 year and investigated longitudinal associations between trust in such sources and engaging in infection prevention behaviors.
METHODS
We conducted a longitudinal survey of Japanese populations under a declared state of emergency at two time points, August 2020 and August 2021. We surveyed sociodemographic data, seven Trust in COVID-19 information sources and six COVID-19 preventive behaviors.
RESULTS
In all, 784 participants completed the two surveys. Physicians were the most consistently trusted information source over the 1-year period. We identified three preventive behaviors that were positively associated with trust in physicians as an information source (social distancing, wearing masks, and washing hands with soap), four preventive behaviors that were positively associated with trusting infected patients (social distancing, using ventilation, wearing masks, and using hand sanitizer), and one preventative behavior that was negatively associated with trust in government (avoiding closed spaces).
CONCLUSION
In the ongoing pandemic, information from physicians and patients may encourage people to engage in long-term preventive behaviors.
PRACTICE IMPLICATIONS
Physicians and patients should be promoted as trusted and behavior influencing sources of information during the pandemic.
Topics: Humans; COVID-19; SARS-CoV-2; Pandemics; Trust; Information Sources; Japan; Longitudinal Studies; Surveys and Questionnaires
PubMed: 36857804
DOI: 10.1016/j.pec.2023.107686 -
Sexual and Reproductive Health Matters Dec 2019Papua New Guinea (PNG) is the most populous country in the Pacific with more than 9 million people. Difficult terrain, poor roads and limited infrastructure mean... (Review)
Review
Papua New Guinea (PNG) is the most populous country in the Pacific with more than 9 million people. Difficult terrain, poor roads and limited infrastructure mean providing effective health care - especially in rural areas, where most people live - is challenging. Women and newborns in PNG experience high rates of preventable morbidity and mortality; however, reliable data are often limited or unavailable. The aim of this paper is to provide an overview of research on key maternal and neonatal health (MNH) indicators conducted approximately over the past 11 years in PNG comparing research findings to global MNH estimates of the indicators. There was considerable variation in mortality indicators (maternal mortality ratio, neonatal mortality rate and stillbirth) reported across studies in PNG. Mortality was generally higher in rural areas. Rates of sexually transmitted infections (STIs) in pregnancy were consistently high, while anaemia in pregnancy, preterm birth and low birth weight varied widely between studies and settings. Breastfeeding seems to have been under-researched. There was a lack of data available on other indicators such as the adolescent birth rate, postnatal care provided to women and newborns, intermittent preventative treatment to prevent malaria in pregnancy and treatment to prevent mother-to-child transmission of HIV. Studies demonstrate the high burden of preventable maternal and newborn morbidity and mortality across PNG. Efforts to improve MNH outcomes need to be escalated.
Topics: Adult; Female; Humans; Infant; Infant Health; Infant Mortality; Infant, Newborn; Infectious Disease Transmission, Vertical; Malaria; Male; Maternal Health; Maternal Mortality; Papua New Guinea; Pregnancy; Sexually Transmitted Diseases; Young Adult
PubMed: 31790637
DOI: 10.1080/26410397.2019.1686199 -
American Journal of Obstetrics and... Jun 2024Women can develop posttraumatic stress disorder in response to experienced or perceived traumatic, often medically complicated, childbirth; the prevalence of these... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Women can develop posttraumatic stress disorder in response to experienced or perceived traumatic, often medically complicated, childbirth; the prevalence of these events remains high in the United States. Currently, no recommended treatment exists in routine care to prevent or mitigate maternal childbirth-related posttraumatic stress disorder. We conducted a systematic review and meta-analysis of clinical trials that evaluated any therapy to prevent or treat childbirth-related posttraumatic stress disorder.
DATA SOURCES
PsycInfo, PsycArticles, PubMed (MEDLINE), ClinicalTrials.gov, CINAHL, ProQuest, Sociological Abstracts, Google Scholar, Embase, Web of Science, ScienceDirect, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched for eligible trials published through September 2023.
STUDY ELIGIBILITY CRITERIA
Trials were included if they were interventional, if they evaluated any therapy for childbirth-related posttraumatic stress disorder for the indication of symptoms or before posttraumatic stress disorder onset, and if they were written in English.
METHODS
Independent coders extracted the sample characteristics and intervention information of the eligible studies and evaluated the trials using the Downs and Black's quality checklist and Cochrane's method for risk of bias evaluation. Meta-analysis was conducted to evaluate pooled effect sizes of secondary and tertiary prevention trials.
RESULTS
A total of 41 studies (32 randomized controlled trials, 9 nonrandomized trials) were reviewed. They evaluated brief psychological therapies including debriefing, trauma-focused therapies (including cognitive behavioral therapy and expressive writing), memory consolidation and reconsolidation blockage, mother-infant-focused therapies, and educational interventions. The trials targeted secondary preventions aimed at buffering childbirth-related posttraumatic stress disorder usually after traumatic childbirth (n=24), tertiary preventions among women with probable childbirth-related posttraumatic stress disorder (n=14), and primary prevention during pregnancy (n=3). A meta-analysis of the combined randomized secondary preventions showed moderate effects in reducing childbirth-related posttraumatic stress disorder symptoms when compared with usual treatment (standardized mean difference, -0.67; 95% confidence interval, -0.92 to -0.42). Single-session therapy within 96 hours of birth was helpful (standardized mean difference, -0.55). Brief, structured, trauma-focused therapies and semi-structured, midwife-led, dialogue-based psychological counseling showed the largest effects (standardized mean difference, -0.95 and -0.91, respectively). Other treatment approaches (eg, the Tetris game, mindfulness, mother-infant-focused treatment) warrant more research. Tertiary preventions produced smaller effects than secondary prevention but are potentially clinically meaningful (standardized mean difference, -0.37; -0.60 to -0.14). Antepartum educational approaches may help, but insufficient empirical evidence exists.
CONCLUSION
Brief trauma-focused and non-trauma-focused psychological therapies delivered early in the period following traumatic childbirth offer a critical and feasible opportunity to buffer the symptoms of childbirth-related posttraumatic stress disorder. Future research that integrates diagnostic and biological measures can inform treatment use and the mechanisms at work.
Topics: Humans; Stress Disorders, Post-Traumatic; Female; Pregnancy; Parturition; Cognitive Behavioral Therapy
PubMed: 38122842
DOI: 10.1016/j.ajog.2023.12.013 -
BMJ (Clinical Research Ed.) Sep 2009To review systematically the evidence of effectiveness of physical interventions to interrupt or reduce the spread of respiratory viruses. (Review)
Review
OBJECTIVE
To review systematically the evidence of effectiveness of physical interventions to interrupt or reduce the spread of respiratory viruses.
DATA SOURCES
Cochrane Library, Medline, OldMedline, Embase, and CINAHL, without restrictions on language or publication. Data selection Studies of any intervention to prevent the transmission of respiratory viruses (isolation, quarantine, social distancing, barriers, personal protection, and hygiene). A search of study designs included randomised trials, cohort, case-control, crossover, before and after, and time series studies. After scanning of the titles, abstracts and full text articles as a first filter, a standardised form was used to assess the eligibility of the remainder. Risk of bias of randomised studies was assessed for generation of the allocation sequence, allocation concealment, blinding, and follow-up. Non-randomised studies were assessed for the presence of potential confounders and classified as being at low, medium, or high risk of bias.
DATA SYNTHESIS
58 papers of 59 studies were included. The quality of the studies was poor for all four randomised controlled trials and most cluster randomised controlled trials; the observational studies were of mixed quality. Meta-analysis of six case-control studies suggested that physical measures are highly effective in preventing the spread of severe acute respiratory syndrome: handwashing more than 10 times daily (odds ratio 0.45, 95% confidence interval 0.36 to 0.57; number needed to treat=4, 95% confidence interval 3.65 to 5.52), wearing masks (0.32, 0.25 to 0.40; NNT=6, 4.54 to 8.03), wearing N95 masks (0.09, 0.03 to 0.30; NNT=3, 2.37 to 4.06), wearing gloves (0.43, 0.29 to 0.65; NNT=5, 4.15 to 15.41), wearing gowns (0.23, 0.14 to 0.37; NNT=5, 3.37 to 7.12), and handwashing, masks, gloves, and gowns combined (0.09, 0.02 to 0.35; NNT=3, 2.66 to 4.97). The combination was also effective in interrupting the spread of influenza within households. The highest quality cluster randomised trials suggested that spread of respiratory viruses can be prevented by hygienic measures in younger children and within households. Evidence that the more uncomfortable and expensive N95 masks were superior to simple surgical masks was limited, but they caused skin irritation. The incremental effect of adding virucidals or antiseptics to normal handwashing to reduce respiratory disease remains uncertain. Global measures, such as screening at entry ports, were not properly evaluated. Evidence was limited for social distancing being effective, especially if related to risk of exposure-that is, the higher the risk the longer the distancing period.
CONCLUSION
Routine long term implementation of some of the measures to interrupt or reduce the spread of respiratory viruses might be difficult. However, many simple and low cost interventions reduce the transmission of epidemic respiratory viruses. More resources should be invested into studying which physical interventions are the most effective, flexible, and cost effective means of minimising the impact of acute respiratory tract infections.
Topics: Acute Disease; Communicable Disease Control; Epidemiologic Methods; Humans; Randomized Controlled Trials as Topic; Respiratory Tract Infections; Virus Diseases
PubMed: 19773323
DOI: 10.1136/bmj.b3675 -
Polski Przeglad Chirurgiczny Apr 2018Pancreatic fistula is one of the most severe complications after pancreatic surgeries. The risk of pancreatic fistula after distal pancreatectomy is up to 60%. Effective... (Review)
Review
Pancreatic fistula is one of the most severe complications after pancreatic surgeries. The risk of pancreatic fistula after distal pancreatectomy is up to 60%. Effective methods to prevent pancreatic fistula are still sought. A unified definition of pancreatic fistula, which was introduced in 2005 by the International Study Group of Pancreatic Surgery (ISGPS), has allowed for an easier diagnosis and determination of fistula severity, as well as for a reliable inter-center comparison of data. Furthermore, a number of publications point out the risk factors of pancreatic fistula, which may be classified into patient-related risk factors, such as MBI, gender, smoking tobacco or pancreatic structure; and surgery-related risk factors, such as blood loss, prolonged surgery and non-underpinning of the major pancreatic duct. The analysis of risk factors and the use of different methods for the prevention of pancreatic fistula, including novel surgical techniques, may reduce both, the formation and severity of fistula. This will, in turn, lead to reduced secondary complications and mortality, as well as a shorter hospital stay. We present a literature review on different strategies used to prevent pancreatic fistula. It seems, however, that multicenter, prospective, randomized studies in two large groups of patients after pancreatectomy are necessary to establish clear recommendations for the preventive management.
Topics: Adult; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Pancreas; Pancreatectomy; Pancreatic Fistula; Postoperative Complications; Prospective Studies; Risk Factors
PubMed: 29773760
DOI: 10.5604/01.3001.0011.7491 -
The Lancet. Global Health Mar 202370% of children with obesity and overweight live in low-income and middle-income countries. Several interventions have been done to reduce the prevalence of childhood... (Meta-Analysis)
Meta-Analysis
BACKGROUND
70% of children with obesity and overweight live in low-income and middle-income countries. Several interventions have been done to reduce the prevalence of childhood obesity and prevent incident cases. Hence, we did a systematic review and meta-analysis to determine the effectiveness of these interventions in reducing and preventing childhood obesity.
METHODS
We conducted a search for randomised controlled trials and quantitative non-randomised studies published on MEDLINE, Embase, Web of Science, and PsycINFO databases between Jan 1, 2010, and Nov 1, 2022. We included interventional studies on the prevention and control of obesity in children up to age 12 years in low-income and middle-income countries. Quality appraisal was performed using Cochrane's risk-of-bias tools. We did three-level random-effects meta-analyses and explored the heterogeneity of studies included. We excluded critical risk-of-bias studies from primary analyses. We assessed the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation.
FINDINGS
The search generated 12 104 studies, of which eight studies were included involving 5734 children. Six studies were based on obesity prevention, most of which targeted behavioural changes with a focus on counselling and diet, and a significant reduction in BMI was observed (standardised mean difference 2·04 [95% CI 1·01-3·08]; p<0·001). In contrast, only two studies focused on the control of childhood obesity; the overall effect of the interventions in these studies was not significant (p=0·38). The combined studies of prevention and control had a significant overall effect, with study-specific estimates ranging between 0·23 and 3·10, albeit with a high statistical heterogeneity (I>75%).
INTERPRETATION
Preventive interventions, such as behavioural change and diet modification, are more effective than control interventions in reducing and preventing childhood obesity.
FUNDING
None.
Topics: Child; Humans; Pediatric Obesity; Developing Countries; Poverty; Databases, Factual; Overweight
PubMed: 36866473
DOI: 10.1016/S2214-109X(23)00099-2 -
Drug Safety Mar 2022Medication-related problems often lead to patient harm. This paper aims to review the Australian literature to determine the overall incidence, severity and... (Review)
Review
INTRODUCTION
Medication-related problems often lead to patient harm. This paper aims to review the Australian literature to determine the overall incidence, severity and preventability of medication-related hospital admissions, as well as providing a national estimate on their extent and cost.
METHODS
The first part of the paper includes a literature search to identify studies that provided estimates of medication-related problems that caused hospital admissions. Incidence of medication-related hospital admissions, type of medication-related problem contributing to admission (e.g. adverse medicine reaction) and method used to estimate incidence (e.g. chart review) were extracted. Data on severity and preventability of the admissions were extracted where available. The second part of the paper involves use of methodological triangulation to estimate the extent and cost of medication-related hospital admission. Median estimates used to assess medication-related hospital admissions and the 2019-2020 national hospital admissions data were used to calculate the national estimate on the extent of medication-related hospital admission. Costs were also estimated.
RESULTS
Seventeen studies provided estimates on the extent of medication-related hospital admissions as assessed using medication chart review. The median incidence of 2.5% (interquartile range [IQR] 0.6%) as a proportion of all hospital admissions suggests 275,000 hospital admissions annually in Australia are medication related. The median incidence of 9% (IQR 3.9%) of emergency admissions suggests that 270,000 admissions annually are medication related. Eight studies provided estimates of the extent of medication-related hospital admissions identified from administrative health data; the median incidence of 1.7% with an under-reporting rate of 82% suggests 280,000 hospital admissions annually are medication related. Triangulation of results suggests that at least 250,000 hospital admissions annually in Australia are medication related, with an estimated cost of 1.4 billion Australian dollars (AUD$). Five studies assessed severity, and nine studies assessed preventability. Preventability estimates suggest two-thirds of medication-related hospital admissions are potentially preventable.
CONCLUSIONS
We estimated that 250,000 hospital admissions in Australia are medication related, with an annual cost of AUD$1.4 billion to the healthcare system. Two-thirds of medication-related hospital admissions are potentially preventable.
Topics: Australia; Drug-Related Side Effects and Adverse Reactions; Hospitalization; Hospitals; Humans; Incidence
PubMed: 35089582
DOI: 10.1007/s40264-021-01144-1