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Background The broader cost consequences of diseases may be of interest for a wide range of stakeholders. We aimed to estimate all relevant societal costs of cancer and to provide insight into the relative magnitude of the different cost categories. Method We used data from eight different health and work-related registries in Norway. Direct, indirect, and intangible costs (value of lost life years) were estimated over a period of one year with a combination of a top-down and a bottom-up costing approach. Results The indirect costs (EUR 1,997 million per year) are almost as high as direct costs (EUR 2,154 million), and the value of lost life years and quality of life represents the greatest cost related to cancer (EUR 18,200 million). In addition, cancer is associated with other costs which are commonly omitted from cost-of-illness analyses, including informal nursing (EUR 306 million), patient time costs (EUR 85 million), and excess costs of using public funds (EUR 439 million). Breast and cervical cancer had relatively high work absenteeism costs, while pancreatic and lung cancer had relatively high production costs due to premature deaths. Discussion Direct health care costs represent small proportions of the total societal costs of cancer. Costs commonly omitted in cost-of-illness analyses represent a significant cost and should be measured and valued in these analyses.

Recent case studies show that the SARS-CoV-2 infectious disease, COVID-19, is associated with accelerated decline of mental health, in particular, cognition in elderly individuals, but also with neurological and neuropsychiatric illness in young people. Recent studies also show a bidirectional link between COVID-19 and mental health in that people with previous history of psychiatric illness have a higher risk for contracting COVID-19 and that COVID-19 patients display a variety of psychiatric illnesses. Risk factors and the response of the central nervous system to the virus show large overlaps with pathophysiological processes associated with Alzheimer’s disease, delirium, post-operative cognitive dysfunction and acute disseminated encephalomyelitis, all characterized by cognitive impairment. These similarities lead to the hypothesis that the neurological symptoms could arise from neuroinflammation and immune cell dysfunction both in the periphery as well as in the central nervous system and the assumption that long-term consequences of COVID-19 may lead to cognitive impairment in the well-being of the patient and thus in today’s workforce, resulting in large loss of productivity. Therefore, particular attention should be paid to neurological protection during treatment and recovery of COVID-19, while cognitive consequences may require monitoring.

Highlights • The effect of endometritis disease on the milk yield among zero-grazed dairy cows on smallholder farms in rwanda were quantified. • The daily milk yield of endometritis positive cows was 15.3% lower compared to endometritis negative cows. • The estimated mean MY discarded was 51.4 ± 2.2 litres/cow with a median of 51.5 litres/cow. • The percent of total MY loss was much higher (41.6%) among CLE positive cows that received treatment compared to the untreated cows (14.1%). • The mean MY loss (litres/cow/day) was 3.2 ± 0.3 for cows having both CLE and SCLE, 2.9 ± 0.2 for CLE only and 1.4 ± 0.7 for cows that had SCLE only., Endometritis being a post-partum uterine infection in dairy cows is likely with substantial production loss through reduction in milk yield (MY), discarded milk during treatment and withdrawal period, and increased cost of veterinary treatment. This study quantified the influence of endometritis on MY of zero-grazed dairy cows managed on smallholder farms in Rwanda. The study enrolled a total of 461 cows within their 21 to 60 days in milk to examine for clinical endometritis (CLE) and subclinical endometritis (SCLE). A cow was considered having endometritis if it was positive for at least one test (CLE or SCLE), otherwise was negative. The MY data were collected prospectively from endometritis positive and negative cows for 30-day post-endometritis diagnosis. Compared to cows negative for endometritis, the positive endometritis cows were 2.4 times more (29.7 vs. 70.3%) with daily MY 15.3% lower (7.5 ± 0.2 vs. 8.9 ± 0.3 litres; p

Background The aim was to investigate the prevalence of health problems and work environment problems and how these are associated with subjective production loss among women and men at an academic workplace. An additional aim was to investigate whether there were differences between women and men according to age group, years at current workplace, academic rank or managerial position. Methods A questionnaire was sent in 2011 to all employees at a Swedish university (n = 5144). Only researchers and teachers were included in the study (n = 3207). Spearman correlations were performed to investigate differences in health and work environment problems. Employees who reported having experienced work environment or health problems in the previous seven days (n = 1475) were included in the analyses in order to investigate differences in subjective production loss. This was done using Student’s t-test, One-way Anova and generalized linear models. Results The response rate was 63% (n = 2022). A total of 819 academic staff (40% of the population) reported experiencing either health problems, work environment problems or both during the previous seven days. The prevalence of health problems only or a combination of work environment and health problems was higher among women than men (p-value ˂0.05). This was especially the case for younger women, those in lower academic positions and those who had worked for fewer years at their current workplace. No difference was found for work environment problems. The majority of the employees who reported problems said that these problems affected their ability to perform at work (84–99%). The average production loss varied between 31 and 42% depending on the type of problem. Production loss due to health-related and work-environment related problems was highest among junior researchers and managers. No significant difference between men and women was found in the level of production loss. Conclusion Subjective production loss in academia can be associated with health and work- environment problems. These losses appear similar for women and men even though younger female academics, women in lower academic ranks and those with fewer years of employment in their current workplace report a higher prevalence of health problems and combined work-environment and health problems than men.

Enormous production losses have ascended in diverse operational and technical issues due to deposition of heavy crude oil (HCO) in various production components like tubing, near well bore (skin formation), surface storage tank, pipeline blockage, etc. Existing methods employed for the dissolution of HCO are either cumbersome or use organic solvents, which are hazardous to the environment. This study presents findings on the enhanced dissolution of HCO using low waxy crude oil (LWC) in the presence of ionic liquid (IL). The use of ILs is found to be compatible with the polar moieties in heavy crude oil, such as resins, aromatics, and asphaltenes, enhancing its dissolution. Twelve ionic liquids were tested for the dissolution of HCO using LWC. The dissolution of HCO was performed and confirmed using gravimetric analyses, ultraviolet-visible (UV-vis) spectrophotometry, Fourier transform-infrared spectroscopy (FT-IR), 13C-nuclear magnetic resonance (13C NMR), and the interfacial tension (IFT) measurements. The total percentage of dissolution of HCO in LWC (2:3 wt/wt) with 100 ppm of ionic liquid is found to be increased by a magnitude of 30% (71% from 41%) of the standard HCO+LWC alone. The increase in solubility (%) of HCO+ LWC with organic solvent (used for dilution in UV-vis) in the presence of ILs is observed to be a maximum of 38%. The results are further confirmed qualitatively through the use of FT-IR and 13C NMR spectroscopy. These findings are further supported by the determination of IFT substantiating the fact that the ILs possess the tendency to dissolve and recover residual oil from production systems and reservoirs. In all of the above experiments, the efficiency of the ILs with a longer alkyl chain and a larger ring size is very convincing as compared with the rest of the studied ILs. � 2015 American Chemical Society.

Brainstorming is a series of procedures designed to maximize the productivity of groups. This study examines two main factors, production loss and ownership of the topic that influence the performance in group brainstorming. 115 groups from 6 different universities have participated in this experiment study. The data is analyzed at group-level. Results reveal that production blocking is negatively related to the group brainstorming performance whereas evaluation apprehension is positively related to the performance of group brainstorming. Ownership of the topic is related to the performance too. The results are of potential interest to industrial design context, educators, and researchers.

Background To determine whether healthcare resources are allocated fairly, it is helpful to have information on the quality of life (QoL) of patients with Unexplained Physical Symptoms (UPS) and on the costs associated with them, and on how these relate to corresponding data in other patient groups. As studies to date have been limited to specific patient populations with UPS, the objective of this study was to assess QoL and costs in a general sample of patients with UPS using generic measures. Methods In a cross-sectional study, 162 patients with UPS reported on their QoL, use of healthcare resources and lost productivity in paid and unpaid work. To assess QoL, the generic SF-36 questionnaire was used, from which multidimensional quality-of-life scores and a one-dimensional score (utility) using the SF-6D scorings algorithm were derived. To assess costs, the TiC-P questionnaire was used. Results Patients with UPS reported a poor QoL. Their QoL was mostly decreased by limitations in functioning due to physical health, and the least by limitations in functioning due to emotional problems. The median of utilities was 0.57, and the mean was 0.58 (SD = .09). The cost for the use of healthcare services was estimated to be €3,123 (SD = €2,952) per patient per year. This cost was enlarged by work-related costs: absence from work (absenteeism), lower on-the-job productivity (presenteeism), and paid substitution of domestic tasks. The resulting mean total cost was estimated to be €6,815 per patient per year. Conclusions These findings suggest that patients with UPS have a high burden of disease and use a considerable amount of healthcare resources. In comparison with other patient groups, the QoL values of patients with UPS were among the poorest and their costs were among the highest of all patient groups. The burden for both patients and society helps to justify the allocation of sufficient resources to effective treatment for patients with UPS. Trial registration Nederlands Trial Register, NTR1609

Rikke Søgaard1, Jan Sørensen1, Louise Linde2, Merete L Hetland2,31CAST – Centre for Applied Health Services Research and Technology Assessment, University of Southern Denmark, Denmark; 2Department of Rheumatology, Hvidovre and Glostrup Hospitals, Denmark; 3The DANBIO registry, Hvidovre and Glostrup Hospitals, DenmarkAbstract: Lost production can be due to individuals’ time lost to work (absenteeism), as well as their time at work with reduced productivity because of ill health (presenteeism). A sound methodological framework for the assessment of presenteeism remains to be established but given its significance, ignoring it would lead to severe underestimations, eg, in cost-of-illness studies. The objective of this study was to assess the empirical significance of absenteeism and presenteeism in terms of production loss using the case of rheumatoid arthritis (RA). Selected modules from the Health and Labor Questionnaire were applied in a cross-sectional study of 3,704 patients with RA. The costs of absenteeism and presenteeism were estimated using the Human Capital approach, and the impact of including multipliers adjusting for the productivity effect of a workers’ absence or impaired presenteeism on societal productivity was demonstrated. RA-related absenteeism over the last 14 days was 22.31 hours (standard deviation [SD], 26.51) with a resulting cost of €473 (SD, 575) and €762 (SD, 926) depending on whether a multiplier was included. Presenteeism was found to affect 7.98 (SD, 3.24) working days over the last 14 days with a resulting cost of €168 (SD, 203) and €203 (SD, 245), again depending on whether a multiplier was included. Overall, this article demonstrates that the value of lost production due to RA could be subject to an almost factor 2 increase if productivity effects of presenteeism and general multipliers are included.Keywords: work limitations, Health and Labor Questionnaire, productivity, production loss

Background The aim of this study is to evaluate the construct validity and responsiveness of a Swedish measure of health-related production loss as well as to investigate if there is a difference in the level of production loss within a population suffering from persistent back/neck pain and CMDs. Methods The sample was drawn from a study that assessed employees’ health and working capacity in 74 health care units before and after intervention. The study included 692 patients who reported working the previous six months at baseline measurement, and who were also asked to answer questions related to health-related production loss. Health-related measures were general health derived from Short Form-12, health-related quality of life derived from EQ-5D, and work ability derived from the Work Ability Index (WAI). Convergent validity and external responsiveness were assessed using Spearman’s Rank Correlation Coefficient and a linear regression model, respectively. Results The different measures of health showed a moderate-to-strong correlation with the measure of health-related production loss and fulfilled the criteria for construct validity. Changes in health and work ability led to significant changes in health-related production loss, which demonstrates external responsiveness. This result is valid for both the total population and for the two different subgroups that were evaluated. Conclusions The present study shows that this measure of health-related production loss is a valid measure for capturing production loss due to illness, and that work ability is more strongly correlated with health-related production loss than people’s general health is. The result shows an average of about 50 % reduced production due to illness, with back pain being the most costly.