Work Absenteeism Research Articles

Patient Experience Survey of Anti-Vascular Endothelial Growth Factor Treatment for Neovascular Age-Related Macular Degeneration and Diabetic Macular Edema.

Understanding patient perspectives of treatment may improve adherence and outcomes. This study explored real-world patient experiences with anti-vascular endothelial growth factor (anti-VEGF) treatment for diabetic macular edema (DME) and neovascular age-related macular degeneration (nAMD). This multinational, non-interventional, quantitative, cross-sectional, observational survey assessed treatment barriers/burden, patient-reported visual functioning, and treatment satisfaction in DME and nAMD patients in the USA, the UK, Canada, France, Italy, and Spain. Treatment patterns and visual outcomes were extracted from medical charts. Regression models evaluated relationships between adherence, total missed visits, number of anti-VEGF injections, and clinical and patient-reported outcomes for visual functioning. Association between treatment satisfaction and aspects of burden were assessed. The survey was completed by 183 DME and 391 nAMD patients. Patients had moderately high vision-related functioning (25-item National Eye Institute Visual Functioning Questionnaire score: mean = 74.8) and were satisfied with their current treatment (mean total score: Macular Disease Treatment Satisfaction Questionnaire = 59.2; Retinopathy Treatment Satisfaction Questionnaire = 61.3). Treatment satisfaction scores were worse with higher time-related impacts of treatment (nAMD/DME), higher impacts on finances and daily life (nAMD), negative impacts on employment and lower expectations for treatment effectiveness (DME). Most patients reported ≥1 barrier (66.1% DME, 49.2% nAMD patients) related to treatment (35.0%), clinic (32.6%), and COVID-19 (21.1%). Moreover, 44.9% of patients reported some impairment in activities of daily living. Work absenteeism was observed among >60% of working patients. Nearly one-quarter (24.2%) of patients needed ≥1 day to recover from intravitreal injections; most reported ≥30 min of travel time (73.7%) and clinic wait time (54.2%). In unadjusted univariable analyses, treatment adherence (vs. nonadherence) was related to higher most recent visual acuity (β = 8.98 letters; CI, 1.34-16.62) and lower odds of visual acuity below driving vision (≤69 letters) (OR = 0.50; CI, 0.25-1.00). More durable treatments with reduced frequency of injections/visits may reduce treatment burden and improve patient satisfaction, which may enhance adherence and visual outcomes.

A Comprehensive Workplace Exercise Intervention to Reduce Musculoskeletal Pain and Improve Functional Capacity in Office Workers: A Randomized Controlled Study.

The high levels of musculoskeletal pain, in conjunction with the low levels of functional capacity, may negatively affect workers' health, efficiency, and productivity. This randomized controlled study investigated the efficacy of a 6-month comprehensive workplace exercise program on musculoskeletal pain and functional capacity in office workers. Seventy male and female office workers with musculoskeletal pain in any body area were randomly assigned to either an intervention (IG; n = 35) or a control group (CG; n = 35). The IG participated every working day (during working hours) in a 6-month supervised combined (flexibility, strength, and balance) exercise program (120 training sessions; five times/week) for the total body. The CG did not participate in any intervention. Musculoskeletal pains in nine body areas and functional capacity (flexibility, balance, and strength) of the lower and upper body were measured before and following the intervention. The IG significantly reduced duration and intensity of pain (43.1-70%; p = 0.000) as well as days of work absenteeism (84.6%; p = 0.000), while improving work capacity (87.1%; p = 0.000). Furthermore, the IG significantly increased cervical, handgrip, back, and leg maximal strength (10.3-27.1%; p = 0.000) and flexibility and balance (12.3-73.7%; p = 0.000). In CG, all musculoskeletal pain and functional capacity indices remained unchanged. In conclusion, this program may be effectively used to reduce musculoskeletal pain and improve functional capacity.

Economic burden assessment for the management of asthma patients at Mexico's National Institute for Respiratory Diseases

Determinar la carga económica anual del asma, desde una perspectiva institucional y con base en la clasificación recomendada por GINA, en una cohorte retrospectiva de adultos atendidos en el Instituto Nacional de Enfermedades Respiratorias (INER) de México. Estudio observacional, longitudinal y retrospectivo, llevado a cabo a partir de la información recabada de 247 pacientes femeninas con asma. Se estimaron los costos directos anuales: visitas, pruebas de laboratorio, tratamiento farmacológico y de las crisis o exacerbaciones, para determinar la carga anual de la enfermedad desde una perspectiva institucional, y según la clasificación de la Iniciativa Global para el Asma. El costo promedio anual fue de $43,813,92, que aumentó en relación con la necesidad de aumento de dosis de corticoides inhalados y beta-agonistas de acción prolongada. El costo promedio de la consulta médica fue de $2004.57, $982.82 por gestión de crisis y $2645.95 por pruebas de laboratorio. El tratamiento farmacológico representó la principal carga económica, con un costo promedio anual de $38,180.58. Los resultados resaltan una carga económica del asma estimada en un costo anual por paciente de $43,813.92 MXN (DE=93,348.85), en el contexto del tercer nivel de atención en el sistema de salud público mexicano. La gravedad del asma, los tratamientos y los biológicos fueron los principales factores que aumentaron los costos directos de la atención.

Professional identity and local realities: social work education in Ethiopia

ABSTRACT The three historical eras of social work education in Ethiopia are examined in this article, with particular attention devoted to how each era began, was contextualized, and was integrated with service delivery. Interviews with 28 social work graduates and faculty members were conducted as part of the qualitative research study. Additionally, unpublished documents from ministerial offices and universities were examined. The data are arranged and presented chronologically to offer the experiences in the three periods. The analysis found that various contextualizing strategies for social work education were used through curriculum development, fieldwork, community engagement, and obtaining research outputs. Making social work education more responsive to the national context has been challenging due to a lack of country-specific reading materials and policy frameworks that define professional social work and standards of practice. Further, the absence of social work for 30 years has erased the profession’s identity from public memory. The continued development of social work education and practice in Ethiopia will benefit from the creation of local educational resources and policy frameworks.

Imaginary work: media representations of work and gender in Italy from the economic miracle to the present day

AbstractThe article explores media depictions of industrial labour in Italy, with a special focus on visual, film and television portrayals, spanning from the 1960s to the first two decades of the twenty-first century. Rather than delving into an analysis of labour processes, the primary objective of the article is to scrutinise the gendered representations of work and whether and how the representation of work, including all professions, has played a pivotal role in shaping narratives about Italian society and its inherent contradictions. In this context, the article also emphasises the significance of what remains unrepresented, highlighting the absence of work as equally consequential as its presence. Of particular importance within this exploration is the examination of women's work, a realm less frequently depicted than that of men. The article dedicates specific attention to unravelling the nuances of women's role in the workforce, recognising their portrayal as a key element in understanding broader narratives about Italian society and its complexities.

Childhood Maltreatment and Adult Work Absenteeism: Work Meaningfulness as a Double-Edged Sword.

The adverse impacts of childhood maltreatment (CM) on an individual's health and economic welfare are widely recognized, yet its occupational and organizational effects remain less explored. Employee absenteeism, known as absenteeism, is often a sign of workplace maladjustment and may be linked to a history of CM. Some individuals in the helping professions, who exhibit a strong sense of purpose in their employment and pursue it in demanding environments, are CM survivors. This study investigates whether a heightened sense of meaningfulness in their work is associated with increased absenteeism among this subgroup. We recruited 320 helping professionals from a variety of social and mental health settings, one third of whom reported experiencing CM. As hypothesized, CM was positively correlated with work absenteeism. Furthermore, the relationship between work meaningfulness and absenteeism was moderated by their CM history: among those with CM experiences, greater work meaningfulness was associated with higher absenteeism rates. Our findings highlight the possibility that work meaningfulness may operate as a double-edged sword, and the importance of better understanding the challenges that high-functioning survivors of CM face within organizational contexts.

Quality of Life Assessment in Patients with Knee Osteoarthritis

IntroductionOsteoarthritis is one of the most common diseases and a leading cause of functional limitation and dependence, significantly impacting the quality of life (QOL).ObjectivesThe aim of this study was to evaluate the impact of knee osteoarthritis on QOL and identify associated factors.Methods This prospective cross-sectional descriptive study was conducted in the Physical Medicine and Functional Rehabilitation Department over a 4-month period, involving patients with symptomatic bilateral knee osteoarthritis (according to the American College of Rheumatology (ACR) criteria). Sociodemographic data, comorbidities, and characteristics of knee osteoarthritis were collected. The assessment of QOL and the functional impact of knee osteoarthritis were based on the KOOS (Knee Injury and Osteoarthritis Outcome Score) self-questionnaire, Lequesne Index, and modified WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) Score. The KOOS questionnaire included 5 subscales: pain (KOOS-Pain), symptoms other than pain (KOOS-Symptoms), activities of daily living (KOOS-ADL), sports and recreational function (KOOS-Sport), and QOL (KOOS-QOL).Results We included 30 patients with an average age of 59.27±6.3; the male-to-female ratio was 0.15. Sixty percent of patients lived in urban areas, with varying levels of education: primary (n=10), secondary (n=4), and university (n=4), while the majority were illiterate (40%). Most of our patients were employed, with 64.28% engaging in significant physical activity, resulting in an average of 6±2 days of work absenteeism every 3 months due to knee pain. The mean duration of knee osteoarthritis was 7.97 years±3.14. The average pain visual analog scale (VAS) score was 5.2±0.4. Knee osteoarthritis was classified as stage 2 in 40% and stage 3 in 60% of cases. Regarding functional impact, the mean WOMAC global index was 16.6±4.68, and the mean Lequesne Index was 11.05±3.45; moderate disability was observed in 16.7%, significant disability in 50%, and severe disability in 16.7% of patients. Furthermore, the KOOS questionnaire revealed decreased KOOS-Sport and KOOS-QOL scores, with mean values of 35±10.2 and 37±8.9, respectively. Our study identified factors associated with a poor quality of life: age > 65 years (p<0.05), disease duration (p=0.02), and VAS pain > 5 (p=0.02).ConclusionsImproving the quality of life is an essential therapeutic goal in managing knee osteoarthritis. Our study demonstrates that advanced age, longer disease duration, and high pain intensity can negatively impact quality of life.Disclosure of InterestNone Declared

Mohammad Ebrahim Jafari: Aesthetics of Painting in Poetry

The article is devoted to the creative heritage of the outstanding figure of Iranian culture — poet and artist Mohammad Ebrahim Jafari (1940–2018). The novelty of the presented research is determined by the almost complete absence of scientific works devoted to this issue: basic biographical facts, analysis of artistic language and the specific imagery of M. E. Jafari are poorly represented even in the Persian language. The purpose of the work is to identify the features of the national-cultural horizon of the synthetic genre combining painting and poetry developed by Jafari. To achieve this goal, it was necessary, firstly, to trace the poet’s biography; secondly, to clarify the nature of the artistic images created by him at different stages of his life and to analyze the original method of the author’s initiative as a way of artistic enrichment of the new synthetic genre. The multifaceted nature of the research subject determined the need for an interdisciplinary approach and the use of a complex of methods such as biographical, hermeneutic, and comparative typological. The author of the article has studied all the video materials and interviews of the poet published to date, his paintings, as well as a collection of selected poems. The author of the article also translated, for the first time, from Persian all the poetic material presented in the text. The study showed that M. E. Jafari, who does not differentiate the forms of creativity, easily transfers the stylistic techniques of his paintings to poems, which fills his lyrics with different shades of colors and smells. Poetic rhythm can be seen in his paintings, at the same time, abstract pictorial images embody the most significance for the poet in terms of acuity of perception, creating images of space and time as a unique experience, extremely concrete in its strength and depth. The masterly combination of abstract expressiveness and specificity of the sensual image makes it possible to attribute the deeply personal artistic creativity of M. E. Jafari to the cultural wave of new poetry, which meets the basic principles of the philosophy of Iranian modernism.

National Estimates of Incremental Work Absenteeism Costs Associated With Adult Children of Parents With Alzheimer's Disease and Related Dementias

ObjectiveMore than half of primary caregivers for ADRD patients are adult children, yet there is little empirical evidence on how caring for parents with ADRD affects their employment. Using a nationally representative dataset, this study aimed to estimate incremental work absenteeism costs for adult children of parents with ADRD. Design, Setting, and ParticipantsThe study used the data from the 2015–2021 Medical Expenditure Panel Survey (MEPS). Multivariate regressions and two-part models were employed to estimate the incremental work absenteeism costs among adult children aged 40 to 64 who had at least one parent diagnosed with ADRD, compared with those who did not have ADRD parents. MeasurementsThe incremental work absenteeism costs due to caregiving for adult children with ADRD parents was a cumulated estimation of labor productivity cost at three stages: (1) the likelihood of not working due to unemployment, (2) the likelihood of missing any workdays for caregiving, and (3) the number of workdays missed due to caregiving. ResultsAdult children with ADRD parents were more likely to be unemployed (OR = 1.80, p = 0.024) and 2.95 times more likely to miss work for caregiving (p = 0.002) than those with non-ADRD parents. The difference in the number of workdays missed for caregiving between children with and without ADRD parents was not significant. The incremental effects of having ADRD parents were estimated to be $4,510.29 ($1,702.09–$6,723.69) per person per year. ConclusionsHaving ADRD parents significantly increases the chances of unemployment and missing any workdays for caregiving, leading to higher lost labor productivity costs for adult children with ADRD parents.

Machine learning in small sample neuroimaging studies: Novel measures for schizophrenia analysis.

Novel features derived from imaging and artificial intelligence systems are commonly coupled to construct computer-aided diagnosis (CAD) systems that are intended as clinical support tools or for investigation of complex biological patterns. This study used sulcal patterns from structural images of the brain as the basis for classifying patients with schizophrenia from unaffected controls. Statistical, machine learning and deep learning techniques were sequentially applied as a demonstration of how a CAD system might be comprehensively evaluated in the absence of prior empirical work or extant literature to guide development, and the availability of only small sample datasets. Sulcal features of the entire cerebral cortex were derived from 58 schizophrenia patients and 56 healthy controls. No similar CAD systems has been reported that uses sulcal features from the entire cortex. We considered all the stages in a CAD system workflow: preprocessing, feature selection and extraction, and classification. The explainable AI techniques Local Interpretable Model-agnostic Explanations and SHapley Additive exPlanations were applied to detect the relevance of features to classification. At each stage, alternatives were compared in terms of their performance in the context of a small sample. Differentiating sulcal patterns were located in temporal and precentral areas, as well as the collateral fissure. We also verified the benefits of applying dimensionality reduction techniques and validation methods, such as resubstitution with upper bound correction, to optimize performance.

Leontiev and Napoleon III: Two Conservatism Tendencies of the Same Century

The subject of the study is the dispute between the Russian philosopher, K. Leontiev, and the French emperor, Napoleon III, regarding the meaning and orientation of historical events. The topicality of the study is determined by the importance of the problem of progress in the modern world and the need to take into account the entire range of previous approaches to it. The novelty is defined by the absence of works in which a comparison of the two analyzed approaches would be presented. The article uses the following methods: hermeneutic, phenomenological, and comparative historical. The policy of Napoleon III is characterized in the artistic works of Leontiev as well as in the works in philosophical and publicistic genres. In the novel Odysseus Polychroniades, the Second French Empire appears as a mechanical structure devoid of a spiritual core. In the autobiographical work Egyptian pigeon, the emperor appears as a usurper. In his philosophical and political writings, Leontiev focuses on the theory of cultural types. Napoleon III's France in this context serves as an illustration of the period of secondary mixing and simplification in the lives of civilizations. But its history is also important to Leontiev as a kind of reference point in the historical coordinate system, which allows us to compare the Western path with the fate of Russia. The Russian thinker strongly emphasized the connection between the history of his country and Byzantine principles. He saw its future in their preservation and support. Leontiev considered France, which rushed along the path of liberal egalitarianism, a decaying state characterized by decomposition and loss of originality and religiosity, as well as by the transition from complexity to a more primitive organization. Napoleon III, on the contrary, considered France the vanguard of civilization, and the principle of nationalities proclaimed by him was seen as the only reliable basis for international politics. Although Leontiev and Napoleon III do not have the same interpretations of progress, in their understanding of the general meaning of history and the laws of civilizational development both considered it necessary to introduce conservative elements into public life. The forecasts of the Russian philosopher regarding the future give more reason to name him (rather than the emperor) a prophet.

Job Flexibility, Job Security, and Mental Health Among US Working Adults

Understanding the association between job characteristics and mental health can inform policies and practices to promote employee well-being. To investigate associations between job characteristics and mental health, work absenteeism, and mental health care use among US adults. This cross-sectional study analyzed data from the 2021 National Health Interview Survey and included adults aged 18 years or older who reported employment during the past 12 months. Data were analyzed from May 2023 to January 2024. Job flexibility was assessed as a summative variable to 3 questions: perceived ease of changing one's work schedule to do things important to oneself or their family, regularity of work schedule changes, and advance notice of work hours. Job security was measured as perceived likelihood of losing one's job. Mental health outcomes included self-reported serious psychological distress and frequency of anxiety. Work absenteeism was assessed using the number of missed workdays due to illness. Mental health care use was examined for both current and past year use. Multivariable logistic and binomial regression analyses were used to examine associations of interest. The analytic sample consisted of 18 144 adults (52.3% [95% CI, 51.5%-53.2%] male; mean age, 42.2 [95% CI, 41.9-42.6] years). Greater job flexibility was associated with decreased odds of serious psychological distress (odds ratio [OR], 0.74 [95% CI, 0.63-0.86]; P < .001) and lower odds of weekly anxiety (OR, 0.89 [95% CI, 0.81-0.97]; P = .008) or daily anxiety (OR, 0.87 [95% CI, 0.79-0.96]; P = .005). Greater job security was associated with decreased odds of serious psychological distress (OR, 0.75 [95% CI, 0.65-0.87]; P < .001) and lower odds of anxiety weekly (OR, 0.79 [95% CI, 0.71-0.88]; P < .001) or daily (OR, 0.73 [95% CI, 0.66-0.81]; P < .001). Greater job flexibility (incidence rate ratio [IRR], 0.84 [95% CI, 0.74-0.96]; P = .008) and job security (IRR, 0.75 [95% CI, 0.65-0.87]; P < .001) were each associated with decreased number of days worked despite feeling ill over the past 3 months. Greater job security was associated with decreased absenteeism in the past year (IRR, 0.89 [95% CI, 0.82-0.98]; P < .014). Organizational policies that enhance job flexibility and security may facilitate a healthier work environment, mitigate work-related stress, and ultimately promote better mental health.

РАЗВИТИЕ ЦИФРОВИЗАЦИИ В СЕЛЬСКИХ ТЕРРИТОРИЯХ В ПОСТКОВИДНЫЙ ПЕРИОД И ЕГО ВЛИЯНИЕ НА ЭКОНОМИКУ СЕЛЬСКОГО ХОЗЯЙСТВА

The coronavirus pandemic continues to pose serious challenges to agricultural production since 2020. Restrictions on trade in agricultural products affect marketing opportunities and the availability of operational resources. Seasonal labor is becoming scarce, and new consumption patterns and hygiene requirements pose new challenges for the industry. Restrictions imposed due to the coronavirus pandemic have led to an unprecedented market situation. In this work, to study the digital divide between rural and urban areas, the profile indicators of rural residents of the Russian Federation who did not have access to the Internet in 2019-2021 were analyzed. The research substantiated the service components of the digital potential of rural areas, which together will allow the development of information and communication technologies in rural areas and agricultural organizations, the skills of people who are participants in the digital transformation of processes in all spheres of rural life. Such service components include: 1) information and communication technologies and infrastructure; 2) digital management of business processes in an agricultural organization; 3) electronic digital business; 4) digital competence and literacy of rural residents and employees of agricultural organizations to assess the possibility of digital interaction with each other. A detailed analysis of trends in the digital gap in the use of the Internet through the construction of logit models made it possible to confirm the results obtained that in the absence of completed secondary education and work, the risk of a rural resident becoming one of those who do not use the Internet, that is, being in “digital isolation”, increases, and more significantly compared to other characteristics considered.

Mixed method evaluation of a learning from excellence programme for community health workers in Neno, Malawi

BackgroundCommunity Health Workers (CHWs) play an essential role in linking communities to facility-based healthcare. However, CHW programmes have often been hampered by low levels of staff motivation, and new tools aimed at improving staff motivation and work environment are needed. One such intervention is the “Learning from Excellence” (LfE) programme. We aimed to assess feasibility, outputs, and impact of a co-designed LfE programme on CHW motivation, in Neno District.MethodsWe conducted a convergent mixed-method evaluation of the LfE programme. Co-design of the programme and forms took place between October 2019 and January 2020. LfE forms submitted between September and November 2020 were analysed using descriptive statistics and memos summarising answers to the open-ended question. To investigate experiences with LfE we conducted in-depth semi-structured interviews with key stakeholders, CHWs, and site supervisors, which were analysed thematically. A pre-post intervention questionnaire was developed to assess the impact of the co-designed LfE intervention on CHW motivation and perceived supervision. Outcomes were triangulated into a logic model.ResultsIn total 555 LfE forms were submitted, with 34.4% of CHWs in Neno District submitting at least one LfE report. Four themes were identified in the interviews: LfE implementation processes, experience, consequences, and recommendations. A total of 50 CHWs participated in the questionnaire in January 2020 and 46 of them completed the questionnaire in December 2020. No statistically significant differences were identified between pre-and post-LfE measurements for both motivation (Site F: p = 0.86; Site G: p = 0.31) and perceived supervision (Site F: p = 0.95; Site G: p = 0.45). A logic model, explaining how the LfE programme could impact CHWs was developed.ConclusionsMany CHWs participated in the LfE intervention between September 2020 and November 2020. LfE was welcomed by CHWs and stakeholders as it allowed them to appreciate excellent work in absence of other opportunities to do so. However, no statistically significant differences in CHW motivation and perceived supervision were identified. While the intervention was feasible in Neno District, we identified several barriers and facilitators for implementation. We developed a logic model to explain contextual factors, and mechanisms that could lead to LfE outcomes for CHWs in Neno District. The developed logic model can be used by those designing and implementing interventions like LfE for health workers.

Working with a chronic health condition: The implications of proactive vitality management for occupational health and performance

Employees with a chronic disease are confronted with health problems, pain, and a limited energy reserve, which may hinder their day-to-day functioning at work. In the current study, we use proactive motivation and job demands-resources (JD-R) theories to hypothesize that chronically ill individuals may optimize their own well-being and work performance by using proactive vitality management (PVM). In Study 1, we tested our hypotheses through multigroup comparative analyses among a mixed sample of both healthy and chronically ill employees who participated in a weekly, three-wave study (T1 N = 399, M age = 45.18 (SD = 13.13), 48 % female). In Study 2, employees with a chronic liver disease were followed over the course of 2,5 years and filled out surveys at three points in time (T1 N = 192, M age = 48.73 (SD = 10.75), 72 % female). Findings from both studies were in line with our hypotheses. More specifically, consistent with JD-R theory's health impairment hypothesis, results showed that exhaustion mediated the relation between PVM and (a) functional limitations and (b) absenteeism. Consistent with JD-R's motivational hypothesis, work engagement mediated the relation between PVM and (a) creative work performance and (b) absenteeism. In addition, results of moderated mediation analyses indicated that these indirect effects were stronger for chronically ill employees with more (vs. less) self-insight – i.e., a developed understanding of one's own thoughts, feelings, and behaviors. These findings contribute to JD-R and proactive motivation theories and suggest that PVM is an important behavioral strategy that may protect chronically ill employees' occupational health and promote their performance, especially when combined with self-insight.

Stress as a mediator between abusive supervision and clinical nurses' work outcomes.

This study aimed to test whether stress could mediate the association between abusive supervision and nurses' work engagement, absenteeism, and turnover intention. Abusive supervision has been attributed to suboptimal work performance and reduced productivity among employees in different sectors. While existing nursing literature links abusive supervision to a wide range of work-related outcomes in the nursing workforce, little is known regarding the mechanism underlying this relationship. Data for this descriptive study were collected from 770 direct-care nurses from seven acute care hospitals in the Philippines, utilizing five standardized scales. Abusive supervision had direct positive effects on absenteeism (β=.189, p<.001) and intent to leave (β=.138, p<.001) and a direct negative effect on job engagement (β=-.131, p<.001). The relationships between abusive supervision and absenteeism (β=.175, p<.001), intent to leave (β=.131, p<.001), and work engagement (β=-.122, p<.001) were partially mediated by stress. Stress mediated the relationship between abusive supervision and nurses' work outcomes, including turnover intention, absenteeism, and work disengagement. The evident connection between abusive supervision, stress, and work-related outcomes underscores the importance of focusing on enhancing managerial supervisory styles as a potential organizational strategy to enhance staff retention and well-being.

Evaluation of the Efficacy and Safety of Dienogest in the Treatment of Primary Dysmenorrhea: A Study in a District-Level Hospital in Bangladesh

Background: Dysmenorrhea is a common symptom secondary to various gynecological disorders, but it is also represented in most women as a primary form of disease. Pain associated with dysmenorrhea is caused by hypersecretion of prostaglandins and an increased uterine contractility. The primary dysmenorrhea is quite frequent in young women and remains with a good prognosis, even though it is associated with low quality of life. Objectives: The aim of this study is to evaluate of the efficacy and safety of dienogest in the treatment of primary dysmenorrhea: a study in a district-level hospital in Bangladesh. Methods: The cross-sectional observational study was conducted in the Department of Gynae and Obs, Naogaon Sadar Hospital from July 2022 to June 2023. A total of 100 subjects who received DNG (1 mg/day, orally) were included in the study. Data were collected by face-to-face interview and analyzed by appropriate computer based programmed software Statistical Package for the Social Sciences (SPSS), version 24. Results: In this study, most of the patients 43% lies between 21 years to 25 years and body weight of 24% patients were between 51 to 55 kg. In this study, most of the patients 41% body mass index were 18.5 – 24.9 kg/m2. Most of the patients’ clinical symptoms were cramping pain in the lower abdomen (89%), low back pain (86%), pain spreading down to the leg (73%), fatigue (64%). About (56%) adverse effects were body weight gain and irregular uterine bleeding occurred in 35 of 100 cases (35%). Conclusion: Primary dysmenorrhea is one of the most common illnesses in women of childbearing age. When severe, it may interfere with the activities of daily living and may lead to school and work absenteeism. Primary dysmenorrhea is also one of the most underdiagnosed diseases, so clinicians should suspect the diagnosis in a timely manner and provide appropriate treatment.

The Genre and Trends of Crime Fiction in Nigeria

The field of crime fiction in Nigeria remains under-explored in scholarly discourse. This lacuna is particularly notable given the absence of comprehensive academic works dedicated to this genre. Crime fiction, which delineates narratives surrounding criminals, their crimes, detection and investigation processes, and underlying motivations, has been a prolific subject in Nigerian creative literature. Despite the substantial body of Nigerian literary works delving into themes of crime, punishment, and motivation, it is intriguing that the genre has not garnered significant critical analysis. This study adopts a diachronic approach to trace the historical evolution of crime fiction in Nigeria. It further investigates various sub-genres within this literary category and examines how a multitude of socio-political dynamics have influenced the thematic focus of Nigerian crime fiction. The study posits that crime fiction is gaining relevance in contemporary Nigerian society. It reveals that a significant corpus of these narratives grapple with issues such as colonialism, militarism, corruption, government apathy towards human and national development, and other opaque political and economic elements that perpetuate Nigeria’s precarious journey towards democratic stability.

COVID-19-Related Work Absenteeism and Associated Lost Productivity Cost in Germany: A Population-Based Study.

The aim of the study is to estimate COVID-19 absenteeism and indirect costs, by care setting. A population-based retrospective cohort study using data from the German Statutory Health Insurance (SHI) database to define outpatient (April 2020-December 2021) and hospitalized (April 2020-October 2022) cohorts of employed working-aged individuals. In the outpatient cohort ( N = 369,220), median absenteeism duration and associated cost was 10.0 (Q1, Q3: 5.0, 15.0) days and €1061 (530, 1591), respectively. In the hospitalized cohort ( n = 20,687), median absenteeism and associated cost was 15.0 (7.0, 32.0) days and €1591 (743, 3394), respectively. Stratified analyses showed greater absenteeism in older workers, those at risk, and those with severe disease. The hospitalized cohort had longer absenteeism resulting in higher productivity loss. Being older, at risk of severe COVID-19 and higher disease severity during hospitalization were important drivers of higher absenteeism duration.

Access and cost of services for autistic children and adults in Italy: a carers' perspective.

Limited information exists on autistic service access and costs in Italy. This study aims to investigate access to educational, healthcare, social, and related services for autistic individuals in Italy as part of the Autism Spectrum Disorder in the European Union (ASDEU) project. Italian carers of autistic individuals completed an online survey regarding services and costs in the 6 months before completion. Three hundred and three carers of autistic people participated in the survey. The majority of those receiving care were children, males, and lived at home with their parents. Autistic adults were often students (17%) or unemployed but willing to work (17%). Employed carers (49%) worked on average 32.23 ± 9.27 hours per week. A significant portion (82%) took work or school absences to care for autistic individuals, averaging 15.56 ± 14.70 days. On average, carers spent 58.84 ± 48.36 hours per week on caregiving duties. Fifty-five of the autistic individuals received some form of support, 5% utilized residential care, and 6% were hospitalized. Thirty-four percent received outpatient hospital care, and 20% underwent some form of autism-related psychopharmacological therapy. School support was primarily provided by support teachers (18.16 ± 7.02 hours/week). Educational psychologists (80.73%), psychomotor therapists/physiotherapists (53.85%), and speech therapists (50.91%) were frequently paid by carers who paid more per hour. Autistic children received support from educators (73.96 hours/week), group therapy (32.36 hours/week), and speech therapists (31.19 hours/week). Psychologists (76.00%) and counseling/individual therapists (89.13%) were often paid by carers. Carers reported high costs for psychiatrists and psychologists, with frequent use of psychiatric services (8 ± 8 times in 6 months). Carers' perspectives on the access and costs of services for autistic individuals in Italy can provide insights into areas for improvement in the delivery of autism services.