Decreased Work Productivity Research Articles

ASSOCIATION BETWEEN PSYCHOLOGICAL UPSET AND IRRITABLE BOWEL SYNDROME AMONG NURSING STUDENTS AT KSA

Irritable bowel syndrome (IBS) is a fairly common disorder that occurs in the general population. IBS is a functional bowel disorder associated with decreased work productivity. The aim of this study is to investigate the relationship between psychological upset and irritable bowel syndrome among nursing students at the Hafr Albatin University king Saudi Arabia. A descriptive cross-sectional research design on 223 student nurses from Hafr Al Batin university. One tool is divided into three main parts; demographic data, student's psychological upset, and irritable bowel syndrome manifestations sheet. According to the results of the study there is a statistically significant correlation between students' psychological stiffness and manifestations of irritable bowel syndrome (p

The Relationship between Work Shifts and Work Environment with Nurse Fatigue in the Emergency Department

Introduction: Work fatigue is one of the common health problems faced by nurses. Work shifts and work environment are factors that cause work fatigue for nurses. Nurse fatigue can cause work accidents and decreased work productivity. It was reported that 47% of employees experienced decreased productivity, and 32% of employees experienced injuries and near misses due to work fatigue. This research aimed to figure out whether and to what extent work shifts and work environment were correlated with nurse fatigue at the emergency department of Surabaya Haji General Hospital. Method: This analytic observational study employed a cross-sectional approach with work fatigue as the dependent variable and work shifts and work environment as independent variables. This research used the Spearman’s correlation test with 30 emergency department nurses at Surabaya Haji General Hospital as the samples. The instruments used in this research were work environment questionnaires and work fatigue questionnaires from IFRC. Results: The results showed that work shift had a very weak relationship with work fatigue. At the same time, there was a moderate relationship between work environment and work fatigue. Conclusion: The work fatigue among emergency department nurses at the Surabaya Haji General Hospital observed had a very weak relationship with work shifts and a moderate relationship with their work environment.

An Ergonomic Intervention to Redesign Fish Smoking Device of Home Industry

Smoke and heat become the contributors for increasing temperature and humidity in the production room, and workload of workers, and decreasing work productivity of a smoked fish home industry in Hative Kecil Village, Ambon City, Indonesia. This paper was aimed to redesign a fish smoking device with ergonomic consideration for solving the problem. An ergonomic intervention method applied to redesign the device. Redesign process describe result of ergonomic assessment in to the stages of rational method in order to produce new design. Despite the environmental variable (temperature and humidity), 10 male workers (age 40-50 year) were assessed their characteristics consisting of personal, anthropometric, workload and work productivity data. Final results presented a decreasing temperature (15.03%), humidity (8.06%), and workload of workers (75.89%) while work productivity increased 88.92%. It concluded that the device redesign can improve temperature, humidity, workload of workers and work productivity in the smoked fish home industry.

Analysis of the Quality of the Work Environment and Nutritional Status on the Fatigue of Educators

<p class="normal"><em>Work fatigue is a criterion that concerns physical and psychological fatigue only, but has more to do with a decrease in physical performance, a feeling of fatigue, a decrease in motivation, and a decrease in work productivity. The purpose of this study was to measure the quality of the work environment (noise, lighting) and nutritional status of educators at the Maluku Husada High School of Health Sciences (STIkes). This research is a type of quantitative research with analytical and descriptive methods. The population in this study were 33 respondents and the sampling technique used was total sampling and cluster sampling. Data analysis was performed using correlation tests: Spearman Correlations and Mann-Whitney tests. The results of statistical tests using Spearman Correlations the effect of nutritional status on work fatigue obtained a p-value of 0.426 indicating that there is no effect between nutritional status and work fatigue. The conclusion is that there is an influence between the level of lighting on work fatigue. There is no effect between noise level and body mass index on work fatigue.</em></p><p class="normal"><em> </em></p><p class="normal"><em>Keywords ; Quality of Work Environment, Nutritional Status, Work Fatigue</em></p>

MO214: Health-Related Quality of Life Among Patients With Anca Vasculitis

BACKGROUND AND AIMSAnti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) is a debilitating disease that can have a significant impact on a patient's quality of life. The aim of this study was to assess the longitudinal quality of life amongst those diagnosed with AAV using the EQ-5D instrument, which allows for calculation of quality-adjusted life years (QALYs.)METHODA total of 343 patients with AAV participated in this study, of which 191 (55.7%) were male, resulting in 2746 episodes. The EQ-5D-5L standardised instrument was used to evaluate health-related quality of life in the domains of mobility, self-care, usual activities, pain/discomfort, anxiety/depression and to generate a summary index score. Overall health was also rated using a visual analogue scale (0–100). EQ-5D questionnaires were completed during routine nephrology clinic attendances and through a vasculitis patient support smartphone app. We used a random effects model to control for multiple entries relating to individual patients.RESULTSA lower quality of life was seen amongst those with AAV (median index value 0.80, overall population average 0.856). The mean visual analogue scale score was 75.6 ± 17.3 (overall population average 82.8, Fig. 1). Patients’ pain and discomfort level (mean 1.95) was most affected while self-care (mean 1.33) was least affected (Fig. 1). An increase in BVAS tightly correlated with a reduction in quality of life. Using the random effects model, the index score was seen to decrease with increasing age with a 2.7% reduction in index score per decade. A 7% reduction in index score was seen during periods of disease activity compared with periods of remission. Patients with end-stage kidney disease requiring dialysis had an 8% reduction in index score. A reduced quality of life was seen following COVID-19 lockdown with a 5% reduction in index score seen. Using a median survival rate of 6.16 years for patients with small vessel vasculitis, we calculated the QALYs for this population as 4.9 years.FIGURE 1:(A) Domain-specific EQ5D levels and (B) visual analogue score. Both graphs reflect mean and 95% confidence interval.CONCLUSIONWe have defined for the first time the EQ-5D index value over the full disease course in patients with AAV. Notably, we have identified a reduction in quality of life during periods of disease activity. Other studies have demonstrated a reduction in quality of life during active disease using the AAV–PRO questionnaire and the Medical Outcomes Study Short Form-36. A decrease in work productivity has also been noted. Previously reported mean index values of 0.72 and 0.76 were lower than our observed values, although both are significantly reduced compared with population norms. In conclusion, this research highlights the negative impact of AAV on patients’ lives.

Penerapan Sanksi Pidana Dalam Penegakan Upah Minimum Selama Masa Pandemi Covid 19

The increase in the minimum wage that occurs every year becomes a separate issue for employers because they have to prepare additional costs, because the minimum wage must be adhered to avoid criminal labor sanctions. The application of criminal sanctions violations of the minimum wage provisions into two sharp blades for employers, on the one hand meet the minimum wage provisions are considered burdensome amid tight business competition and decreased work productivity due to restriction policies from the government in order to cope with the covid-19 outbreak. Sociological position of employers higher and stronger than workers it is necessary to force power to protect it. Violation minimum wage provisions are absolute complaints. Enforcement of criminal sanctions against companies that pay workers wages below the minimum wage during the covid-19 period, it is necessary to protect workers by prioritizing the return of wages until in accordance with the provisions and settlement of the parties (restorative justice) and criminal sanctions are a last resort (ultimum remidium).

Moral distress: Does this impact on intent to stay among adult critical care nurses?

Moral distress is recognized as an international problem that contributes to decreased work productivity, job dissatisfaction and intent to leave for adult Critical Care nurses. To explore Critical Care nurses moral distress levels using the Moral Distress Scale Revised (MDS-R) and its relationship with intention to stay. The study reported in this paper was part of a larger study that also investigated Critical Care nurses' work environment in Canada and the Midlands region of the UK. During January to August 2017 a cross-sectional survey was distributed to adult Critical Care nurses in the Midlands region of the UK. Surveys were distributed to adult Critical Care Registered Nurses in the Midlands region of the UK examining moral distress levels and intention to stay in Critical Care, the organization (NHS Trust) and in the nursing profession. Two hundred sixty-six number of a potential sample of 1066 Critical Care nurses completed the survey (25% response rate). Age and moral distress were significantly positively correlated with intention to stay on their current unit (r=0.16, P=.05), indicating older nurses were more likely to stay in the critical care unit. Moral distress was negatively correlated with intent to stay scores, showing critical care nurses with higher levels of moral distress were less likely to stay on their unit (r=-0.20, P=.02). Moral distress was also significantly negatively correlated with intention to stay with their current employer (r=-0.28, P < .001). Nurses that stated they had high rates of moral distress were more likely to consider leaving their current employer. Moral distress appears to be an issue among adult Critical Care nurses requiring further exploration and development of effective strategies to reduce this phenomenon and stabilize the workforce by reducing turnover. By identifying the top causes of moral distress, tools and strategies can be developed to allow the Critical Care nurse to work within an ethically safe clinical environment and reduce the turnover of experienced adult Critical Care nurses.

THE RELATIONSHIP BETWEEN WORK FATIGUE AND JOB SATISFACTION WITH THE WORK PRODUCTIVITY OF NURSES IN EFARINA HOSPITAL INPATIENT WARDS, 2016

Fatigue is a problem that needs attention. All types of work, both formal and informal, cause work fatigue. Work fatigue will reduce performance and increase work errors. Decreasing performance means decreasing work productivity. Job satisfaction is also an important target in human resource management because it directly or indirectly affects the work productivity of employees in an organization or company. analytic with a cross-sectional design to analyze the relationship between work fatigue and type of research. Tengku Mansyur Tanjungbalai Measurement of work fatigue, job satisfaction and work productivity respectively using a questionnaire. Work fatigue uses KAUPK2, job satisfaction uses a job satisfaction questionnaire while measuring work productivity uses a work productivity questionnaire. The results showed that there were 28 nurses who were tired (56.6%), the work productivity of nurses who were not suitable were 24 people (51.1%) and there were 4 people who were suitable (7.7%). There were 19 nurses (40.4%) who were not tired, 8 nurses (17.0%) who were not fit for work, and 11 nurses (23.4%) who were fit. There were 25 nurses (53.2%) who were dissatisfied, 25 nurses (53.2%) who were suitable for work productivity and none (0%) did not have suitable nurse productivity. There are 22 nurses who are satisfied (46.8%), the work productivity of nurses who are not suitable there are 7 people (14, 9%) and the work productivity of nurses who did not fit there were 15 people (31.9%). The relationship between work fatigue and job satisfaction with work productivity shows significant results (p &lt;0.05). It is hoped that further research will be carried out on the factors that affect work productivity other than fatigue and satisfaction factors.

P261 Burden of bowel urgency across specific treatment groups among Ulcerative Colitis patients – real world global study analyses

Abstract Background Bowel urgency, the sudden and immediate need to have a bowel movement, is a common symptom in ulcerative colitis (UC) and is associated with higher disease activity, decreased work productivity and markedly reduced quality of life1. This study explored differences in disease burden among UC patients with bowel urgency based on their treatment pathway. Methods Data were extracted from the Adelphi Disease Specific Programme for UC, a point-in-time survey of gastroenterologists (GIs) and patients from Jan 2020-Mar 2021 in Germany, France, Spain, Italy, UK and US. GIs provided patient demographics, clinical characteristics and treatment history. The same patients were invited to complete the Short Inflammatory Bowel Disease Questionnaire (SIBDQ), EQ-5D and Work Productivity and Activity Impairment (WPAI) questionnaire. Three patient subgroups were identified: never received targeted therapy (biologics and JAK inhibitors) (TT-naïve), receiving first TT currently (1L TT) and receiving TT with prior TT use (TT-exp). Within these groups, patients currently experiencing day- or nighttime bowel urgency, reported by physicians, with current treatment duration &amp;gt;3 months, were included. ANOVA, chi-squared and Kruskal-Wallis tests were used to compare the groups. Results Of the UC patients in the TT-naïve (n=595), 1L TT (n=851) and TT-exp (n=321) groups, 23%, 17% and 26% experienced bowel urgency, respectively. Of those with bowel urgency, TT-naïve patients were younger with lower BMI and the lowest proportion of never smokers vs. the 1L TT and TT-exp groups (Table 1). 70–80% of patients across the three groups remained in non-remission based on the derived Mayo score, while 19% of the TT-naïve group were flaring vs. 18% 1L TT and 32% TT-exp patients (p=0.0324). Steroid use was highest in the TT-naïve group (43%) vs. 10% 1L TT and 17% TT-exp (p&amp;lt;0.0001). 1L TT had the highest number of visits to healthcare professionals in the last 12 months. The patient reported outcome measures indicated substantial and similar quality of life impairment across all patients with bowel urgency (Table 2). The only significant difference was across impairment while working (31% TT-naïve, 17% 1L TT, 28% TT-exp; p=0.0232). Conclusion This study confirmed that a substantial proportion of patients across all three groups still experience bowel urgency despite receiving treatment. Since bowel urgency is known to negatively impact patients’ quality of life, there is a therapeutic need to address this symptom. Reference 1. Ha, C, et al. Rectal Urgency Among Ulcerative Colitis and Crohn’s Disease Patients: Analyses from a Global Survey. Poster presented at: Digestive Disease Week; 2021 May 21–23; Online event.

Conservative Treatment of Low Back Pain with Incidental Finding of Diffuse Idiopathic Skeletal Hyperostosis: A Case Report

Low back pain affects 630 million people worldwide and may result in a physical, social, or psychological liability to those people [1]. Patients with lower back pain commonly will have a higher incidence of functional disability, psychosocial issues, and decreased work productivity [1]. The clinician muscle must provide the correct course of treatment for the patient, clinician [2]. Diffuse idiopathic skeletal hyperostosis (DISH) is a noninflammatory condition resulting from a pathologic calcification and ossification of areas of the spine and possibly other joints [3]. Several risk factors in developing DISH are advanced age, hypertension, diabetes, obesity, and genetics [4,5]. Individuals with DISH are typically asymptomatic; however, a study of two hundred individuals diagnosed with DISH demonstrated that 72% were experiencing back pain and 84% reported overall spinal stiffness [3,4]. Diffuse idiopathic skeletal hyperostosis is an incidental finding in imaging in which the pathogenesis is currently not known [3,4]. To diagnose DISH in the spine it is required to observe at least three bony bridges at the anterolateral spine [4]. The bony bridges are viewed as osteophytes on the anterior portion of the spine [3]. DISH in the cervical spine may lead to symptoms such as dysphagia or upper airway obstruction [3]. Additionally, in the spine DISH has been linked to compression of neural structures resulting in myeloradiculopathy [3]. Structurally, this can lead to spinal stenosis, and spinal cord or nerve root compression [3].Currently, there is one published article describing chiropractic treatment of DISH with flexion distraction technique [6]. Al-Herz et al. [7] discussed exercise therapy for patients with DISH. Additionally, Le et al. [3] discussed, briefly, several strategies for the management of DISH. Current literature does not combine instrument-assisted manipulation, soft tissue therapy, and exercise therapy for the management of DISH. Therefore the purpose of this article is to demonstrate the effectiveness of exercise and manual therapy for the treatment of DISH related pain and dysfunction.

Occupational Heat Stress in the Floriculture Industry of Ethiopia: Health Risks and Productivity Losses

Background: The Ethiopian flower industry is growing fast with successful diversification of export products under greenhouse structures. Higher temperatures in the greenhouses pose a serious threat to the health of workers and add to the risk of occupational heat stress. Excessive heat in workplace settings also reduces work capacity and labour productivity. This study aims to investigate the level of heat exposure, and workers’ and managers’ perceptions and behavioural responses towards extreme heat exposure in a warming climate. Methods: We used the Wet Bulb Globe Temperature (WBGT) measured in representative greenhouses to capture the heat exposure during hotter and cooler seasons following ISO 7243 (generally risk of heat stress occurs when WBGT exceeds 26°C). A comparative cross-sectional study design with a stratified sampling method was used to assess occupational heat stress and workers’ perceptions of the impact of heat on their health and productivity in six different floriculture greenhouses in Ethiopia representing three different agro-ecologies and products. A questionnaire survey was conducted (30 managers/supervisors and 305 workers; 76.1% female) to capture perceptions on heat exposures, symptoms of potential health impacts, productivity losses and coping mechanisms. Results: Heat exposure varied across different agroecologies, product types and greenhouse materials with a median WBGT Index of 25.5°C and a range from 18.1°C to 31.5°C. The impact of heat stress also varied across different employment sectors and geographical regions. Overall, workers in cut-flower greenhouses are exposed to higher than recommended WBGT Index (26°C) for 3 - 6 working hours daily. 65% of the managers reported that heat stress has a significant impact on the workers’ labour productivity, but do not have guidance about working in hot conditions. Workers reported more heat-related health issues and reduced productivity, especially in the mid-altitude greenhouses. About 50% of the workers reported that heat exposure decreased work productivity during hot hours. Sweating, exhaustion, heat-rashes, dehydration, crumps, nausea and headache were self-reported health issues. Labour productivity losses ranged from no loss to 19.5% in the mid- and low-altitudes. Conclusions and Recommendations: Excessive workplace heat in the greenhouses is both an occupational health hazard and detrimental to productivity in the floriculture industry. However, the level of understanding and actions on the ground regarding occupational heat stress are low. The code of conduct in place now does not consider the occupational heat stress issues. Multiple actions (engineering, management, training and policy-related recommendations) have to be implemented by Ethiopian Horticultural Producers and Exporters Association (EHPEA) and farm owners to mitigate heat stress and loss of productivity. Designing and implementing these heat prevention strategies and incorporating them into the code of conduct is in the interests of both employers and employees.

A cross-sectional research on female workers examining the loss of productivity caused by mild, moderate and severe fibromyalgia.

To assess (a) the impacts of fibromyalgia (FM) symptoms on patients' ability to work and (b) the relationship between FM severity states and lost productivity from the perspective of patients. FM female patients were retrospectively evaluated for this cross-sectional study. FM severity was determined using the revised Fibromyalgia Impact Questionnaire (FIQR). Work Productivity and Activity Impairment-Fibromyalgia (WPAI-FM) was used to evaluate patients' employment status. Differences across FM severity states were evaluated using the one-way analysis of variance (ANOVA) and chi-square or Fisher's exact test. The Pearson's r test was performed for the correlation analysis. The study included 209 subjects, 64 (30.6%) had mild, 64 (30.6%) had moderate, and 81 (38.8%) had severe FM; 57.9% were working full-time, and 42.1% were working part-time. According to WPAI-FM the work productivity and activity impairment resulted: absenteeism 7.03%; presenteeism 44.35%; activity impairment 47.24%; overall work productivity loss 58.23%. Disease severity was associated with decreased work productivity. Presenteeism, overall work productivity loss, and activity impairment demonstrated significant correlations with FIQR and PainDETECT Questionnaire. FM severity is associated to a reduced job productivity. Early identification and treatment of FM may provide a window of opportunity for job preservation.

Long-term clinical and cost-effectiveness of collaborative care in people with uncontrolled type 2 diabetes mellitus and polypharmacy: A multicenter randomized controlled trial

AimsThis study examined the effectiveness of a collaborative care model on clinical and humanistic outcomes, medical cost, productivity loss, and its cost-effectiveness in managing uncontrolled Type 2 Diabetes Mellitus (T2DM). MethodsA randomized controlled study was conducted in two outpatient health institutions in Singapore. Patients aged above 21 years with HbA1c > 7% and polypharmacy were included. Eligible patients were randomized into the intervention (collaborative care) and control (usual care) arms. ResultsA total of 255 patients were included in the analysis. Compared to the control arm, the intervention arm achieved significantly greater glycated hemoglobin (HbA1c) reduction (mean difference: 0.25, 95%CI: [0.001, 0.50], p = 0.049) and quality-adjusted life year (QALY) (+0.011, 95%CI: [0.003, 0.019], p = 0.011) at 12 months. The costs per additional HbA1c and QALY improvements over one year were $40.52 and $920.91 respectively. Activity impairment was lower in the intervention group both at 6 months (12.7% vs 19.0%; p = 0.022) and at 12 months (6.7% vs 14.0%; p = 0.008). ConclusionsThe collaborative care model achieved earlier HbA1c reduction and reduced patients’ activity impairment without decreasing work productivity or increasing medical costs. This intervention is cost-effective for improving glycemic control and quality of life in patients with T2DM.

Work productivity and activity impairment in patients with primary Sjögren's syndrome.

In this observational, analytical, cross-sectional study we aimed to describe the impact of primary Sjögren's syndrome (pSS) on work productivity and activities of daily living (ADL) to assess the association between ADL impairment and clinical manifestations and to compare ADL impairment according to patients' socioeconomic condition. Patients diagnosed with pSS attending 11 centres from Argentina were included. To evaluate work productivity and ADL impairment, a work productivity and activity impairment questionnaire (WPAI) was used. A multiple linear regression model was performed, considering deterioration on ADL due to health as a dependent variable, adjusted for potential confounders. 252 patients were included, 98.4% were women, with a mean age of 52.6 years (±14.8). The average percentage of time lost due to health was 15.7 hours (±30.1 95% CI: 9.6-21.9); the decrease in work productivity was 27.2 (±30.2 95% CI: 21.3-33.1), the total disability was 33.7 (±35.8 95% CI: 26.4-4) and ADL deterioration was 34.2 (±30.9. 95% CI: 30.4-38). In the multivariate analysis, xerostomia, arthritis and depression showed significant and independent association. The mean of ADL impairment was 38.2 (±30.7) in patients attending public centres versus 28 (± 30.6) in private centres, which was a statistically significant difference. We found a compromise in all WPAI domains. Arthritis, xerostomia and depression were associated significantly and independently with ADL impairment. Deterioration in ADL was greater in patients treated in public centres. Considering these aspects will allow a better understanding of patients who suffer from this disease.

P016 Impact of Non-Remission on Health-Related Quality of Life and Patient Reported Outcomes in Patients With Crohn's Disease: Targeted Literature Review.

Crohn's disease (CD) leads to chronic inflammation of the gastrointestinal tract that significantly impacts patients over an entire lifetime. The decrease in health-related quality of life (HRQoL) may have an impact on patient's level of functioning, work productivity, and other activities. The goal of treatment for CD is clinical remission based on clinical, endoscopic, and biological parameters. There has been introduction of new treatments in recent years. A review was conducted to assess the impact of non-remission on HRQoL and patient reported outcomes (PROs) in patients with CD. Literature search of English language publications from 2015-2021 was conducted in Embase® and MEDLINE®. Real world studies meeting predefined criteria (adult CD patients in non-remission presenting data for HRQoL or PROs) were included in the review. Data on study characteristics, disease characteristics, HRQoL and PROs were extracted from the included studies. The review retrieved 1384 records from which only 10 studies presented data for HRQoL and/or PROs. The definition of remission varied across the included studies. In most studies (90%), remission was defined using Harvey-Bradshaw Index and/or Crohn's disease activity index. Different tools were used to assess HRQoL and sleep quality. In a study, no normalization of long-term HRQoL was observed in patients who did not achieve clinical remission. A negative correlation was found between utility indexes & disease activity in a study (ρ = -0.586, p < 0.001). A significant correlation was also observed in a study between HRQoL and disease activity where HRQoL in patients with active disease was poor compared to patients in remission. The HRQoL domains of anxiety, depression and pain were impacted in non-remitters. The mean IBDQ score was 189 ± 16.1 in remitters and 145 ± 15.9 in non-remitters (p < 0.001). A strong negative correlation between IBDQ and disease activity was reported by a study. In a study, work productivity was moderately but significantly correlated with disease activity indicating reduction in work productivity of patients with active disease (mild, moderate, and severe) compared to remitters. In another study, severe disease activity was significantly associated with an increased amount of fragmented sleep. Patients with moderate to severe disease had a significantly longer time awake after falling asleep compared to patients in remission or with mild disease activity (65.8 minutes, 44.3 minutes, 49.1 minutes, respectively). Patients with active disease also reported poor sleep quality and suffered from excessive daytime sleepiness. There was a significant difference in the median sleep efficiency for patients with moderate to severe disease compared to patients with remission. This targeted review found in general that not being able to achieve/maintain remission had an impact on the HRQoL of patients with CD. Patients not achieving remission were associated with decreased work productivity, poor sleep quality, lower sleep efficiency, daytime sleepiness and poor HRQoL. However, studies assessing HRQoL and PROs in the real-world are scarce, with discrepancies based on remission status. Further research is warranted, and health care providers and payers should consider the impact of therapies on the improvement in HRQoL of patients with CD.

Prevalence of Erectile Dysfunction and Associated Factors among Hypertensive Patients Attending Governmental Health Institutions in Gondar City, Northwest Ethiopia: A Cross-Sectional Study

Introduction Erectile dysfunction is a common sexual problem affecting men with hypertension. It may result in withdrawal from sexual engagement, decreased work productivity, psychosocial problems including poor self-esteem and depression, and reduction in quality of life for both the affected men and their female partners. Objective This study was aimed to determine the prevalence of erectile dysfunction and associated factors among hypertensive patients attending governmental health institutions in Gondar city, Northwest Ethiopia. Materials and Methods An institutional-based cross-sectional study was conducted on 423 hypertensive men randomly selected using a systematic random sampling technique. Erectile dysfunction was assessed using the International Index of Erectile Function-5 tool. Sociodemographic, clinical, and behavioral factors were also collected using pretested interviewer-administered questionnaires. Data were entered into EpiData version 4.6 and analyzed using Stata-14. Binary logistic regression was performed to identify factors associated with erectile dysfunction. The level of significance was computed at a p value ≤ 0.05. Results The mean age of the study participants was 58.84 ± 13.52 years. The prevalence of erectile dysfunction among hypertensive men was 46.34% (95% CI: 41.61, 51.12). About 28% of them had a mild form of erectile dysfunction while nearly 6% had severe forms. Age above 60 years (AOR = 3.8, 95% CI: 1.62, 6.55), stage II hypertension (AOR = 3.5, 95% CI: 1.63, 5.74), hypertension duration >10 years (AOR = 2.5, 95% CI:1.12, 4.19), comorbidity (AOR = 1.7, 95% CI: 1.04, 3.15), depression (AOR = 2.35, 95% CI: 1.31, 4.21), and being physically active (AOR = 0.48, 95% CI: 0.28, 0.83) were factors significantly associated with erectile dysfunction. Conclusion Nearly half of the study participants had some form of erectile dysfunction, indicating the presence of a high burden of the problem. Assessment of hypertensive men for erectile dysfunction should be part of routine medical care.

The 2021 report of the MJA-Lancet Countdown on health and climate change: Australia increasingly out on a limb.

The MJA-Lancet Countdown on health and climate change in Australia was established in 2017, and produced its first national assessment in 2018, its first annual update in 2019, and its second annual update in 2020. It examines indicators across five broad domains: climate change impacts, exposures and vulnerability; adaptation, planning and resilience for health; mitigation actions and health co-benefits; economics and finance; and public and political engagement. Our special report in 2020 focused on the unprecedented and catastrophic 2019-20 Australian bushfire season, highlighting indicators that explore the relationships between health, climate change and bushfires. For 2021, we return to reporting on the full suite of indicators across each of the five domains and have added some new indicators. We find that Australians are increasingly exposed to and vulnerable to excess heat and that this is already limiting our way of life, increasing the risk of heat stress during outdoor sports, and decreasing work productivity across a range of sectors. Other weather extremes are also on the rise, resulting in escalating social, economic and health impacts. Climate change disproportionately threatens Indigenous Australians' wellbeing in multiple and complex ways. In response to these threats, we find positive action at the individual, local, state and territory levels, with growing uptake of rooftop solar and electric vehicles, and the beginnings of appropriate adaptation planning. However, this is severely undermined by national policies and actions that are contrary and increasingly place Australia out on a limb. Australia has responded well to the COVID-19 public health crisis (while still emerging from the bushfire crisis that preceded it) and it now needs to respond to and prepare for the health crises resulting from climate change.

How do systemic sclerosis manifestations influence patients’ lives? Results from a survey on patients and caregivers

Objective: To investigate the patient- and caregiver-reported impact of systemic sclerosis (SSc) manifestations (hand/feet/joint involvement and pulmonary complications) on diagnostic and therapeutic journey, working productivity and social life. Methods: Two questionnaires (one for the patients, n = 260 and one for the caregivers, n = 47) were designed in collaboration with the patients’ association Gruppo Italiano per la Lotta alla Sclerodermia (GILS). Validated questionnaires were combined with specific questions relevant for the Italian scenario. Results: Pulmonary fibrosis and hand/feet/joint involvement have a major impact on patient’s working status: (85.3% of patients with pulmonary fibrosis and 72.6% with hand/feet/joint involvement report loss of job/job change due to SSc. Productivity was affected as well: 60.6% of the patients (75% of those with fibrosis) reported that working productivity in the previous 4 weeks was restricted by physical limitations. The disease has a significant impact on patients’ life, limiting the ability to conduct common activities, especially those related to movement, such as object manipulation (61.1%), doing small manual jobs (44.0%), writing (38.9%), and an increased impact in case of pulmonary fibrosis and hands/feet/joints involvement. Half of the patients also present some difficulties in eating-related activities a Patients also experience poorer social life, personal relationships and sexual life. Caregivers are also deeply influenced by the manifestations of SSc. Pulmonary fibrosis and hand/feet/joint involvement represent an additional challenge. Conclusion: Pulmonary fibrosis and hand/feet/joint involvement are extremely burdensome complications for both SSc patients and caregivers, decreasing work productivity, limiting relationship and social life and impacting psychological status and everyday activities.

The Effect of Career Development on Employee Performance at PT Angkasa Pura Solusi

This research is motivated by a decrease in work productivity in Indonesia, which impacts employee performance. One of the company’s efforts to increase employee productivity and performance is employee career development through training activities. Through employee career development, employee knowledge, abilities, and skills will increase and impact employee productivity and performance. This study aims to determine the effect of career development on employee performance. The population is the total number of objects of a study. The population in this study were employees of PT Angkasa Pura Solusi Soekarno-Hatta International Airport Terminal 3 Domestic, 4th Floor Office Building, Tangerang, amounting to 99 people. At the same time, the sample in this study was 80 people—data analysis technique using simple linear regression analysis. The results showed a positive influence between career development and employee performance when viewed from the t-test with a value of tcount &gt; table (7.185 &gt; 1.988) with a significant level of 0.05. Based on the analysis of the coefficient of determination, it can be seen that the R Square value of 0.398 or 39.8% of employee performance variables can be explained by career development variables. In comparison, the remaining 60.2% is influenced by other variables not explained by the author in this study. The results showed a positive influence between career development and employee performance when viewed from the t-test with a value of t-count &gt; t-table (7.185 &gt; 1.988) with a significant level of 0.05. Based on the analysis of the coefficient of determination, it can be seen that the R Square value of 0.398 or 39.8% of employee performance variables can be explained by career development variables. In comparison, the remaining 60.2% is influenced by other variables not explained by the author in this study. The results showed a positive influence between career development and employee performance when viewed from the t-test with a value of t-count &gt; t-table (7.185 &gt; 1.988) with a significant level of 0.05. Based on the analysis of the coefficient of determination, it can be seen that the R Square value of 0.398 or 39.8% of employee performance variables can be explained by career development variables. In comparison, the remaining 60.2% is influenced by other variables not explained by the author in this study.

Indonesian mothers' perception about the children nutritional status and its related factors

Background: Nutrition problems are the main public health issues in developing countries, including Indonesia. Malnutrition will lead to failure of physical growth and development of intelligence, decreased work productivity, and reduced endurance resulting in increased rates of pain and death. Therefore, mothers have an essential role in the prevention of nutritional disorders in children.Objective: To compare the nutritional status of primary school children based on maternal assessment and anthropometry measurements and analyze factors that influence the mother's misperceptions about the nutritional status of the children.Methods: A cross-sectional research design was used. A total of 96 mothers of elementary school students were included. Quota sampling was used in selecting samples based on population characteristics. Children's nutritional status was classified according to WHO anthropometry standards 2006 for children aged 5-18 years based on age and gender. The mother's perception of the child's nutritional status was measured using an online validated questionnaire (Google Form). Descriptive and bivariate statistics were used for data analysis.Results: 56.2% of mothers gave an appropriate assessment of the nutritional status of the children. Education and work significantly influenced the accuracy of the mother's perception of their children’s nutritional status. A total of 38.4% of mothers with high school education levels misjudged their child's nutritional status compared to those who did not finish high school (p = 0.058). Also, 56.3% of non-working mothers were wrong in assessing their child's nutritional status compared to working mothers (p=0.014).Conclusion: The results of this study can be used to improve the knowledge and skills of mothers in assessing the nutritional status of children as one of the strategies to reduce the incidence of malnutrition in children.