bluuebunny/crossref_metadata_2025 huggingface dataset:
Healthier breath for all and everywhere – Urban air quality monitoring experience
Authors: Gajic J , Dimovski D , Vukajlovic B , Jevtic M
Published: November 2019

Issue/problem

Increasing attention is being paid to air pollution as one of the greatest threats to public and urban health. The WHO’s Urban Health Initiative points out the importance of collecting data and mapping the present state of air quality in urban areas. For citizens, such engagement is enabled by the appearance of personal air quality measurement devices that use crowd-sourcing to make measurement results publicly accessible in real time.

Description of the problem

As a way of contributing to air pollution monitoring in their town, three PhD Public health students conducted over 40 measurements between the start of June and end of August 2018 on various locations in the city of Novi Sad, Serbia. Measurements were performed using AirBeam personal air quality monitoring devices and their results presented as μg/m3 of Particulate Matter 2.5 (PM2.5) and automatically uploaded to the internet using the Air-casting app.

Results

Measurements conducted in public transportation vehicles returned the rather high average value of 40 μg/m3, where coffee shops and restaurants scored an even higher value of 48,67 μg/m3. The lowest average air pollution levels were registered near the Danube river bank (5.67) and in the parks (6), while the sites near crossroads or in the street showed average air pollution of 8.33 μg/m3.

Residential areas where smoking is present during the day reported 2.5 times higher PM2.5 values than those without smokers (33.8 and 12.78 μg/m3).

Lessons

Bearing in mind that the air quality is considered as a serious health risk in urban areas, results of this pilot investigation suggest potential health risk for citizens living in urban areas.

The negative effects of combustion and smoking on air quality are strongly highlighted, as well as the positive impact of green areas and parks near residential areas.

Key messages

Air pollution exposure as a serious health risk in urban areas. Crowdsourcing as a way of air quality monitoring has great potential for contributing to public health.
Integrated veterinary-medical activity on characterization of shigatoxin producing Escherichia coli
Authors: Bertasi B , Finazzi G , Colombo R , Vignati C , Dodaro A , Spelta C , Romanò A , Tel F , Ardissino G L , Luini M V
Published: November 2019

Background

Shiga toxin-producing Escherichia coli (STEC) are an important public health concern as they cause severe conditions (bloody diarrhea and hemolytic uremic syndrome - HUS) and have epidemic potential. Cattle are the main reservoir for the highly virulent STEC O157 strain, and other HUS-associated non-O157 strains. This study aimed to characterize strains from animals and humans and to compare their molecular profiles. Animal isolates were tested for the presence of virulence factors correlated to their pathogenic potential.

Methods

74 STEC human isolates from 43 clinical cases (sporadic or epidemic) and 270 animal isolates from feces from 62 cattle farms were collected. Epidemiological investigation to collect environmental and suspected food samples was carried out for 22 cases. All isolates were typed with PFGE and their serotype was defined by Real-Time PCR. Animal isolates were also tested for the presence of subAB, saa, tia, cfk, adfO, hlyA, efaI1-lifA5’3’, and toxB virulence genes.

Results

O157 was detected in 44% of human cases, other relevant serogroups O26, O111, O103, O145 in 21, 9, 5 and 5% of cases, respectively. The source of infection was identified in one case (cheese contaminated by a O157 strain). Among animal isolates 2, 0.7, 0.7 and 0.3% were identified as O157, O11, O113, and O145, respectively. PFGE highlighted a high heterogeneicity among animal strains, however no pulsotype common to cattle and clinical isolates was found. adfO, cfk, efaI1-lifA5’3’ and toxB were found significantly correlated to eae (intimin).

Conclusions

Human and cattle strains were not correlated, however STEC diversity in cattle was very high and included some strains potentially pathogenic to humans. For this reason, upholding an integrated surveillance is very important.

Key messages

Serotypes relevant to human health were found in cattle in a small but not negligible frequence. No direct correlation was found between animal and clinical isolates.
Customer satisfaction survey in Friuli Venezia Giulia university canteens
Authors: Perri G , Righini M , Tullio A , Del Pin M , Maifreni M , Marino M , Fedele M C , Parpinel M
Published: November 2019

Background

Customer satisfaction represents an innovative approach to measure strengths and weaknesses of an organization and is useful for a customer-focused management and culture development. Our survey’s aim was to investigate perceived quality and needs of customers in the university canteen sector.

Methods

Between April and June 2018, an anonymous online questionnaire was distributed by “agenzia regionale per il diritto agli studi superiori” (ARDISS) among university students in Friuli Venezia Giulia, Italy. The questions covered 3 thematic areas: attendance of the service, quality of services and opinions on new initiatives. Furthermore, there was an open question to collect students’ suggestions or proposals to improve the service. Satisfaction about the service was evaluated through five topics: environments, hygiene, staff, meals, global satisfaction. Collected data were analyzed with descriptive, univariate and multivariate analyses. Statistical analyses were performed using 9.4 SAS software.

Results

Response rate was 20.5% (1933/9404). Multiple logistic regression analyses showed a difference in meal choice (entire vs reduced) between institutional canteen and partner cafeterias users (p < 0.0001) and that male (p < 0.0001) and foreign students (p 0.0003) prefer entire meal instead of reduced. Percentage of students who prefer entire meal is reduced (p < 0.0001) if price range increases. Univariate and multivariate analyses showed that high quality perception is associated with lower price range and no suggestions about food and environments (p < 0.0001); multivariate analyses also showed an association between high quality perception and high canteen attendance (p < 0.05).

Conclusions

The survey showed an association between meal choice and students’ profile and between perceived quality and customer’s features. These data and further analyses may help to select areas where an intervention could improve service quality and, therefore, customer satisfaction.

Key messages

Customer satisfaction is an important tool to measure and improve university canteen service quality. These results helped us to identify services’ strengths and weaknesses according to students’ opinions; this could be useful to select improvement areas.
Risk assessment of Portuguese population to multiple mycotoxins: the human biomonitoring approach
Authors: Martins C , Vidal A , De Saeger S , Nunes C , Torres D , Goios A , Lopes C , Assunção R , Alvito P , De Boevre M
Published: November 2019

Mycotoxins constitute a relevant group of food contaminants with several associated health outcomes such as estrogenic, immunotoxic, nephrotoxic and teratogenic effects. Although scarce data are available in Portugal, human biomonitoring studies have been globally developed to assess the exposure to mycotoxins at individual level.

The present study concerned the analysis of mycotoxins in 24h urine and first-morning urine paired samples from 94 participants enrolled within the scope of the National Food, Nutrition, and Physical Activity Survey of the Portuguese General Population (2015-2016). Following a salt-assisted matrix extraction, urine samples were analyzed by liquid chromatography-mass spectrometry for the simultaneous determination of 37 urinary mycotoxins’ biomarkers and data obtained used to estimate the probable daily intake as well as the risk characterization applying the Hazard Quotient approach.

Results revealed the exposure of Portuguese population to zearalenone, deoxynivalenol, ochratoxin A, alternariol, citrinin and fumonisin B1 through the quantification in 24h urine and first-morning urine paired samples. Risk characterization data revealed a potential concern to some reported mycotoxins since the reference intake values were exceeded by some of the considered participants. Alternariol was identified for the first time in urine samples from a European country; however, risk characterization was not performed due to lack of reference intake value.

The present study contributed with reliable and evidence-based results, and confirmed that mycotoxins represent a burden and are part of the human exposome of the Portuguese population. Further studies are needed to shed a light on the determinants of exposure in order to contribute for the promotion of public health measures to reduce the mycotoxins’ exposure in Portugal.

Key messages

Portuguese population is exposed to mycotoxins, chemical food contaminants that may be harmful (carcinogenic, immunotoxic, mutagenic, teratogenic, hepatotoxic) for human health. Human biomonitoring studies provide realistic data on internal exposure at individual level, allowing a more accurate knowledge of the determinants of exposure to these contaminants.
Estimating the burden of disease of exposure to chemical contaminants in food in Denmark
Authors: Jakobsen L S , Thomsen S T , Pires S M
Published: November 2019

Background

Recent global estimates have shown that dietary exposure to chemical contaminants cause over 56,000 deaths and 9 million healthy life years lost each year. However, the contribution of causative agents varies greatly between world regions and countries due to local food consumption and contamination. To prioritize public health interventions to reduce disease burden, national-level risk ranking evidence is needed. The overall aims of this project are to estimate the burden of disease (BoD) of selected chemical hazards in foods consumed in Denmark, and to identify the relative contribution of foods.

Methods

We identified chemicals on the basis of their presumed public health impact. The final list of chemicals was defined in agreement with the Danish Veterinary and Food Administration, and included: methylmercury, inorganic arsenic, cadmium, acrylamide, dioxin/dioxin-like PCBs and lead. We estimated BoD in terms of disability adjusted life years (DALY) in a model combining exposure assessment with dose response models to derive probabilities of health effects, taking an incidence-based approach. Data were collected from the Danish National Survey of Diet and Physical Activity, food monitoring, literature, and national statistics.

Results

We estimated that methylmercury, inorganic arsenic, cadmium and acrylamide lead to a BoD of 514 DALY (95% uncertainty interval: 185, 990) in 2016 (preliminary results). Estimates for lead and dioxin/dioxin-like PCBs are pending. Methylmercury exposure from fish was the greatest contributor to overall burden (478 DALY), and acrylamide from potato products the second (30 DALY). The health outcomes leading to highest burden were intellectual disability and cancer.

Conclusions

Our estimates will assist public health managers identifying the chemical contaminants in foods with the highest impact on public health in Denmark. Future research should focus on estimating the effect of mitigation strategies on the disease burden.

Key messages

We provide national quantitative evidence of the health impact of chemical exposures from foods. Information on the relative contribution of foods and population groups affected may focus mitigation.
Evaluation of the effects of health impact assessment (hia) practice in monteregie
Authors: Nour K
Published: November 2019

This study explores the effects of the collaborative model of health impact assessment (HIA), as deployed in Monteregie (Quebec), on the development, adoption and implementation of municipal projects that include health considerations.

Nine HIA processes were studied in nine territories and 35 individuals were interviewed. Data collection was based on the six steps of contribution analysis, and included document analysis, semi-structured interviews, and on-site observations.

The study results showed that the HIAs had varying results. First, the actors involved acquired new knowledge. However, the HIAs had little impact in terms of increasing the municipal actors’ awareness of health issues. Rather, it helped them acquire arguments for raising awareness among and convincing their municipal council members of the merits of certain actions and their potential positive impacts on citizens’ health. In fact, the HIAs were generally undertaken by municipal actors already aware of the importance of promoting citizen health. Second, in a few of the HIAs, some recommendations were integrated into planning documents, but usually the HIA report constituted an additional planning document and was not merged with the original planning documents. Lastly, following the HIAs, most of the municipal actors continued to include health considerations in their subsequent planning of public policies and projects.

Prerequisites for effective HIA include the presence of municipal actors who are aware of the importance of their role in their local population’s health, municipal policies that include health considerations, and the municipality’s active participation in the HIA process.

This study sheds light on the complexity of the factors that ensure HIA impact on municipal decision making and decisions.

Key messages

HIA have a significant impact to change municipality practice. The HIA process is crucial in order to have an impact on municipal projects that include health considerations.
Nursing community 2.0: a method to promote online collaborative learning
Authors: Arnone R , Cascio M I , Parenti I , Catino A , Zoda M L , Botta V C
Published: November 2019

This article describes a project seeking to establish an online community of practice involving nurses in Sicily, known as Nursing Community 2.0. The Community has initially involved 585 Sicilian nurses who took part in the residential activities. They had been selected thorough a questionnaire addressed to measure the initial technological competencies. All students - registered on open source LMS (Moodle) - attended DL courses promoted by CEFPAS (Centre for training and Research in Public Health located in Sicily). To promote collaborative Learning, Learning Community provided 4 areas: Forum, to confront and to debate about professional interests moderated by a renowned nurse; Camera Cafè, a virtual “agora” to change opinion without a moderator; The corner of the joke; a Tweetboard; Project work Area, where the Topic has been developed to be presented during the last examination. Indeed, the project was designed to provide nurses with a space for building collaborative relationships, exchanging professional knowledge and practices, developing competencies, shaping organizational policy and reporting Adverse Drug Reactions. The quality of solutions will depend on the professional and on the nature of the competencies to be developed. The impact of a training initiative addressed to an adult public through the technological tool, depends both on the interest for the topic and on the ability of the user to manage own training, to acquire familiarity with network services and technologies and, when it occurs, to be able to autonomously cope with training using technologies useful to get information and knowledge to be used to solve a specific professional problem in time. Qualitative and quantitative analysis of online interactions have been carried out. Results indicate that, thanks to the deployment of suitable technology and expert tutor support, Nursing Community 2.0 has successfully established itself as an environment for generating and exchanging knowledge.

Key messages

Collaborative learning depends on the interest for the topic and on the ability of the user to manage learning through technological tools. Nursing Community gives results when learning environment generates debates and interactions.
Breast Cancer Screening (BCS) by Mammography Tomosynthesis
Authors: Correia M , Aleixo F , Lagoa A , Ferrinho D , Pereira R , Vale L , Cardoso C , Faria M
Published: November 2019

Issue

Breast cancer is the 2nd cause of death for women in Portugal and 6000 new cases are detected annually. The prognosis is better for women whose cancers are detected earlier.

Description

Algarve BCS begin in 2005 using a digital mammography with 2 incidences/breast with double reading and consensus by a 3rd radiologist. Each 2 years women age 50 to 69, are invited to a Mobile Unit to do the mammography, a partnership with Algarve Oncologic Association. In 2017, direct digital mammography with Tomosynthesis(DDMT)was implemented. This technique increase cancer detection, reduction of false positives, false negatives and radiation dose. Diagnostic accuracy is better and also improves accessibility to the most vulnerable population groups to this technology.

Results

BCS covers 100% of the region and the mobile unit is user friendly for women with mobility impairment. Adhesion rate is > 62%. Is the 1st screening using Tomosynthesis in Portugal.Preliminary results show that the confirmation rate increased (10 %), the detection rate per 1.000 women also increased and the positive predictive value >95%.

Costs associated with the program decrease and less number of women called for false positives is observed. The number of positive mammograms increased, due to diagnostic acuity, with better visualization of the breast, namely in the patterns of greater mammary density; which leads to an improvement in further assessment rates.

Lessons

The technique increases the adhesion rate, with the same human resources. The decrease of the false positives improves the number of women send to further assessment and Senology Center. Earlier diagnoses, less aggressive treatments, and a higher survival rate are also expected.

Messages- Using this technology is expected that cancer diagnosis will be earlier, more reliable and wiht higher survival rate for this disease. The possibility of a population based screening with DDMT is an opportunity to reduce inequalities in the region.

Key messages

Mammography Tomosynthesis is expected that cancer diagnosis will be earlier, more reliable and wiht higher survival rate for this disease. The possibility of a population based screening with Mammography Tomosynthesis is an opportunity to reduce inequalities in the region.
Effects of sickness absence on disability pension risk: Finnish register study of two native groups
Authors: Reini K , Klein J , Saarela J
Published: November 2019

Background

Sickness absence and disability pension have a close connection and both describe the health of working-aged populations. The aim of this paper was to study if Swedish and Finnish speakers differ in the risk of disability pension after first-time sickness absence. This may reveal new aspects how to support health and work ability promotion activities.

Methods

The longitudinal register data used come from Statistics Finland. They consist of random samples of 5 % of all Finnish speakers and 20 % of all Swedish speakers, observed throughout the period 1989-2010. The analyses concerned non-retired individuals aged 16-60 years who were under risk of first-time sickness absence that extended 10 days. Discrete-time hazard models were estimated to both language groups to evaluate how first-time sickness absence, time since absence, length of absence, and various socio-economic control variables affected the disability pension risk.

Results

The disability pension risk was extremely high immediately after the sickness absence receipt and remained elevated thereafter approximately 20 times higher as compared to non-recipients. A strong interrelation between first-time sickness absence and the risk of subsequent disability pension was found for both language groups and the risk was persistent in the very long term. The risk pattern looked similar to both Swedish and Finnish speakers and we did not observe any differences between women and men.

Conclusions

Paid sickness absence is illustrative of strong health selection and a notable risk for reduced work ability even in the more distant future. The currently implemented policies in Finland, which require statements about rehabilitation plans soon after individuals have entered a sickness spell, can be considered beneficial for both the individual and society. Comparison of the language groups shows that the disability pension process after sickness absence is operating similarly to both groups.

Key messages

Sickness absence requiring medical certificate is an indicator of possible long-term work disability. Timing of rehabilitation process during the sickness absence is critical.
Manager perspectives on workers’ return to work after cancer treatment
Authors: Torp S , Valle-Olsen Å , Brusletto B
Published: November 2019

Background

Due to improved cancer treatment, the survival rate of cancer is increasing Unfortunately, many cancer survivors suffer from serious late effects because of this treatment. Therefore, more and more cancer survivors with reduced work ability are, and will in the future be, in work. To include this group of workers in working life is a challenge for the society in general and for the enterprises in particular. The aim of this study was to investigate managers’ experiences regarding cancer survivors’ return to work (RTW).

Methods

We performed qualitative individual in-depth interviews with nine managers who had experience with workers who needed adaptations at work after cancer treatment. The interviews were transcribed in verbatim and thematically analyzed in accordance with guidelines for stepwise deductive-inductive analysis (Tjora, 2016).

Results

All managers emphasized the importance of taking good care of workers with serious diseases and to adapt work according to their work ability. The managers tried to follow the Work Environment Act and guidelines given by the Norwegian Labor and Welfare Administration but they experienced that the guidelines did not fit well with the needs of the cancer survivor and/or the enterprise. A good RTW process was dependent on an open dialog that was initiated early in the RTW trajectory to establish a sense of safe situation for both the cancer survivor and the company. A good RTW process could only be established if the colleagues of the survivor gave their support to both the survivor and the manager. In addition, it was of great importance that the needs of the cancer survivor had to be balanced by the production needs of the enterprise.

Conclusions

Managers need support from health personnel and social security agencies to support cancer survivors to retain work.

Key messages

Cancer survivors need adaptations at work. Managers are crucial in securing a successful vocational rehabilitation of cancer survivors.
Topic modeling to mind illegal compensation for occupational injuries
Authors: Song S H , Min J Y , Kim H J , Min K B
Published: November 2019

Background

Accurate reports of occupational injuries are important to monitor workplace safety and health initiatives. In South Korea, media reports, experts, and workers have been constantly raising the issue of underreporting. Supposedly it is because employers have strong market “incentives” by underreporting their employees’ injuries. A critical way to underreport or cover-up is illegal compensation (in Korean called “gong-sang”). Unfortunately, “gong-sang” is not counted as official occupational injury statistics. The aim of this study was to analyze the social media data using topic modeling and to explore issues surrounding “gong-sang”.

Methods

We used web scraping technology and collected 2,210 social media data from Web search engines. Data was processed to transform unstructured textual documents into structured data using the Python and applied Latent Dirichlet allocation (LDA) in the Python library, Gensim, for topic modeling.

Results

Based on the LDA method from “gong-sang”- related documentation, 10 topics were identified. Topic 1 was the greatest concern (60.5%), with keywords implying the choice between illegal compensation (“gong-sang”) and legal insurance claims. The next concern was Topic 2 including keywords associated with claims for industrial accident insurance benefits. The rest topics (topic 3-10) showed the monetary issue, precarious employment, and vulnerable body parts to “gong-sang”.

Conclusions

We explored web-based data and identified the salient issues surrounding “gong-sang”. LDA topics may be helpful to ensure efficient occupational health and safety scheme to protect vulnerable employees from “gong-sang” practices.

Key messages

The topics formulated by LDA included queries about legal insurance claims. Legal insurance claims including private or social insurance, monetary compensation, injured body parts, and the type of jobs vulnerable to “gong-sang”.
Work capacity assessments – reviewing the what and how of physicians’ clinical practice
Authors: Nordling P
Published: November 2019

Background

Although a main task in the sickness certification process, physicians’ clinical practice when assessing work capacity has not been thoroughly described. Increased knowledge on the matter is needed to support a better and more reliable certification process. In this review, we aimed to synthesise existing evidence to provide a clearer description of the work capacity assessment as practiced by physicians.

Methods

Seven electronic databases were searched systematically for qualitative studies examining what and how physicians do when they assess work capacity. Data was analysed and synthesised using qualitative manifest content analysis.

Results

Twelve articles were included in the review. Results show that physicians seek to form a knowledge base including understanding the condition, the patient and the patient’s workplace. They consider both medical and non-medical aspects to affect work capacity. Accordingly, to acquire and process the information they use both medical and non-medical skills, methods and resources. Medical competence is an important basis, but not enough. Time, trust, intuition and reasoning are also used to assess the patient’s claims and to translate the findings into a final decision. The depth and focus of the information seeking and processing vary depending on several factors.

Conclusions

The work capacity assessment is a complex task where physicians rely on their non-medical skills to a higher degree than in ordinary clinical work. These skills are highly relevant but need to be complemented with methods to better understand the patient’s work place, as well as theoretical knowledge regarding the intricate associations between health, work and social security. This would further enhance physicians’ competence and confidence, and promote better experiences and practices of the work capacity assessment.

Key messages

In the complex task of assessing work capacity physicians rely on their non-medical skills to a higher degree than in ordinary clinical work. A better understanding of the patient’s work situation and the intricate associations between health, work and social security would enhance physicians’ competence and promote better assessments.
The effects of skill-based team learning curriculum in workplace violence prevention for nurses
Authors: Chen F-L , Chen P , Kuo T-Y , Chiou S-Y
Published: November 2019

Background

Workplace violence, faced by health care workers, is a severe occupational safety and health hazard, and has received global attentions in research and in practice. The aim of this study was to design, implement, and evaluate a skill-based team learning curriculum of violence prevention for clinical nurses.

Methods

78 clinical nurses were purposively selected including 41 nurses of treatment group, and 37 nurses of control group. Each treatment group received the training curriculum which included three sessions: (1) 50-minutes workplace violence lecture and video to illustrate the various workplace violence situations, (2) 50-minute team group discussion to design effective violence prevention skills for a hospital violence situation, (3) 60-minute interactive skills training curriculum focusing on role play, rehearsal and feedback. The control group only received a self-learning violence prevention manual. Generalized Estimating Equation (GEE) model was used to examine the program effects.

Results

The results for the GEE statistics indicated a significant time effect. The pretest-posttest and after the posttest results that treatment group showed significant improvement in preventive skills (β = 1.828, β=1.330; p<0.001) and self-efficacy(β = 4.123, β=5.363; p<0.001) compared to the control group. Besides, the experimental group significantly decreased incidents of verbal violence (β=-1.140, p < 0.05) compared to the control group.

Conclusions

The study showed integration of skill-based teamwork learning in clinical nursing training provides an additional venue to prevent and reduce workplace violence. This shall be a feasible module and significant reference in junior or pre-service health care workers training in the future.

Key messages

The study demonstrates the feasibility of implementing the team learning curriculum for clinical nurses. The present study provides empirical evidence of the skill-based team learning training curriculum in workplace violence program for clinical nurses.
Lung cancer screening by low-dose CT among asbestos-exposed workers: first results of a pilot program
Authors: Heidrich J , Wolff C , Centmayer A , Wiethege T , Duell M , Taeger D , Harth V
Published: November 2019

Background

Occupational asbestos exposure (OAE) is a risk factor for lung cancer (LC) and can cause malignant diseases decades after exposure. Lung cancer screening with low-dose computed tomography (LCS) in heavy smokers has shown LC-mortality reductions in two large trials. Recent guidelines advocate LCS in high-risk populations with OAE and additional smoking history.

Methods

A structured pilot program on LCS in three German regions has been implemented from 2014 to 2018. Eligibility criteria are: OAE ≥10 years starting before 1985 or diagnosis of OAE-related lung disease other than cancer, age ≥55 years and smoking history ≥30 pack years. Eligible persons are centrally invited for LCS on a voluntary basis in 12 months intervals. All persons willing to participate receive obligatory physician counselling before LCS. CT scans are performed according to a standardized protocol. The program provides technical quality assurance as well as independent double reading of all suspicious findings and of a random sample of all CT scans.

Results

Of 2715 and 1534 persons invited to first and second LCS, 1571 (57.9%) and 715 (46.6%) agreed to participate, respectively. Main reason for disagreement was principal refusal of LCS (15.5% in first and 22.2% in second LCS), whereas 8.5% and 6.9%, respectively, refused after counselling. Additionally, 12.9% and 5.7% did not respond at all. Effectively, 68.8% and 70.6% of those who initially agreed, received first and second LCS, respectively. Variations between regions were observed (range 61.0% to 79.8%). First preliminary outcome assessment shows detection rates of 0.019 and 0.011 in first and second LCS, respectively.

Conclusions

A substantial group of eligible persons with OAE participated in LCS after physician counselling. Participation remained stable over two screening rounds. First results show detection of LC in the expected range. The effectiveness of early detection of LC in OAE needs to be evaluated further.

Key messages

Participation over the first two screening rounds in structured lung cancer screening remained stable among eligible persons with OAE and smoking history who were counselled by physicians. Detection of lung cancer in a structured pilot screening program in three German regions seems to be within the range to be expected from previous research.
The barriers of workplace safety and health management: from the supervisor’s perspective
Authors: Tsai M , Chen F , Hsu P , Chen C
Published: November 2019

Background

Previous researches demonstrated that workplace safety and health (WSH) management plays a major role in promoting worker’s health and well-being. However, organizational factors hinder promoting WSH management program. The main aim of this study is to explore the probable existence of barrier from WSH supervisor’s perspective.

Methods

This study employed a qualitative design to gain an in-depth and holistic understanding of WSH from the supervisor’s perspective. Eight focus groups were conducted in Taiwan. A total of 81 supervisors (employer, human resource section, environmental safety section) from the manufacturing industry, construction industry, and service industry participated in this study. All interview contents were transcribed and coded. Matrices were constructed to identify themes and evolving concepts.

Results

Three main barriers were identified1. Lacking of top management commitment and support (e.g., top management focused more on employees’ work performance than their safety and health, top management commitment was just a declaration but with no action, and top management only conducted the traditional occupational hazards control to fit the minimum standards of national policy, and ignored employees’ mental health and well-being); 2.Lacking of employee’s safety awareness (e.g., employee lacked the motivation to attend training program; 3.Organizational resources were not enough to implement occupational safety and health management (e.g., the supervisor lacked professional skills in promoting WSH program).

Conclusions

The study findings provide an integrated basis for practical application and further research. The workplace supervisor should be trained the professional skills in workplace safety and health management. Then, the workplace psychosocial safety climate can be built while top management and employee have higher workplace safety and health awareness.

Key messages

This study contributes to occupational health research from the supervisor’s perspective. This study also hints at the potential role of top management promoting employee’s health and well-being.
Two step cluster analysis of burnout among preschool teachers
Authors: Piperac P , Terzic-Supic Z , Todorovic J , Maksimovic A , Karic S , Soldatovic I
Published: November 2019

Background

The burnout is influenced by a variety of personal, work-related and client-related factors, which are included in different domains of Copenhagen burnout inventory (CBI). The aim of this study was to examine if there are different groups of preschool teachers which differ in scores on different domains of CBI.

Methods

This was the analysis of the data from the survey on burnout on a National representative sample of 456 preschool teachers in Serbia. The study was conducted between October of 2018 and January 2019. The study instrument contained questions on socio-demographic characteristics, workplace environment characteristics, and Copenhagen burnout inventory. We used two-step cluster analysis in SPSS to segment the participants based on age and average scores on personal, work-related and client related domains of CBI.

Results

Our participants clustered in three distinguished groups: participants aged 35.31 years, who worked in shifts, with personal burnout average of 29.46, work-related burnout average of 24.06 and client related burnout average of 19.46; participants aged 44.09 years, who worked in shifts, personal domain scores of 55.24, work-related burnout scores of 51.72, and client-related burnout scores of 51.13; and participants aged 43.01 years, who did not work in shifts, with personal burnout scores of 36.47, work-related burnout scores of 31.95, and client-related burnout scores of 32.08.

Conclusions

Participants clustered in three different groups, and the group with the highest average age and with the shift work had higher scores on all three domains compared to other groups.

Key messages

Preschool teachers clustered in three groups with different scores on domains on burnout. The group with the highest average age had the highest scores on all three domains of burnout.
A taxonomy of mechanisms underpinning the impact of welfare rights advice on health
Authors: Forster N , Lhussier M , Woodhead C , Barnes A , Carr S M , Haighton K
Published: November 2019

Background

Welfare rights advice has potential to help address the social determinants of health and reduce inequalities. Existing logic models identify the sequence of proximal to distal outcomes following welfare advice, but attribution remains challenging. This paper reports on the contextual influences and key mechanisms leading to health outcomes.

Methods

We undertook comprehensive searches of the literature addressing the links between welfare advice and health. Titles and abstracts were screened first, then full text, using inclusion and exclusion criteria. Employing a realist logic of analysis, data extraction and synthesis focused on disentangling evidence of how and why advice improves (or not) health related outcomes, depending on the context. These insights were then paired with existing theory (either explicitly referenced or inferred by authors), in order to produce a robust explanatory model of when and how advice leads to improved health.

Results

59 articles were included in the analysis. Preliminary findings point to the significance of target group in influencing the types of outcomes achieved. Fineman’s (2013) typology of embodied, situational and structural vulnerability helped explain the differential impact of advice. Where people experience embodied vulnerabilities, such as life-limiting illness or disabling physical or mental health conditions, advice may increase quality of life, but is less likely to improve existing health status. Likewise, advice interventions alone are unlikely to alter health outcomes stemming from entrenched structural disadvantages such as poverty or discrimination, and appear to be most effective in addressing situational vulnerabilities generated more temporarily by difficult circumstances.

Conclusions

The review provides a more nuanced understanding of how and why welfare advice may impact on health. These insights will help to more appropriately target, tailor and monitor the health impact of welfare advice.

Key messages

Welfare advice has differential impact, depending on specific client vulnerabilities. This highlights the importance of appropriate targeting, and selecting suitable measures of success.
Setting the agenda for further research on health and welfare
Authors: Lhussier M , Forster N , Haighton K , Egan M , Woodhead C , Webb C , Poole L , Carr S M , Dalkin S , Brown H
Published: November 2019

Background

Given the recognised relationship between poverty, welfare provision and health, welfare rights advice has emerged as a potentially key intervention in improving health and reducing inequalities. The generation of evidence in this area has proven difficult however, creating a need to take stock of existing research and develop an agenda for future work.

Methods

A series of four workshops was convened involving researchers from four UK universities who had previously undertaken work examining the relationship between welfare advice and health, from a range of methodological perspectives. Run concurrently to a scoping of the literature, these workshops aimed to synthesise lessons from prior research; formulate outstanding research questions; and outline potential methodological approaches for addressing these. A survey was undertaken with professionals (from welfare or legal advice sectors, the health sector, commissioning, local government, and housing services, n = 50) to test out, refine and add to these research questions.

Results

Key research questions developed from these workshops were: Are there inequalities in the impact and reach of advice services across social groups? How/ does advice delivery mode matter?What are the individual and system level impacts of the de-implementation of advice services?What are the impacts of changes to welfare provision on children, inter-generationally and throughout the life course?How do experiences of social welfare vary by social group, geographically and across generations? How do different identities combine to influence how social welfare is understood?

Conclusions

While the collaborative process brought challenges in balancing research and practitioner expertise, this model of working has been successful in setting an agenda for further research with maximum utility to practice. Direct outputs from the projects have been the collaborative submission of a journal article and a research bid.

Key messages

The collaboration, which was supported by the NIHR School of Public Health Research, led to the establishment of a concise research agenda. Through extensive stakeholder consultation, this will have maximal utility for practice.
Trajectories of musculoskeletal pain among midlife employees
Authors: Neupane S , Lallukka T , Pietiläinen O , Rahkonen O , Leino-Arjas P
Published: November 2019

Background

We examined the developmental trajectories of multisite musculoskeletal pain to acquire the developmental patterns of musculoskeletal pain among midlife municipal employees and whether pain trajectories associate with common mental disorders or behaviors.

Methods

Middle-aged (44 to 67 years) municipal employees from the city of Helsinki were studied. The baseline survey was conducted in 2000-02 (N = 8960) and two follow-up surveys in 2007 (N = 7332) and 2012 (N = 6809). Repeated measurement of musculoskeletal pain in four anatomical sites was obtained. Trajectories of number of pain sites (0-4) were modeled using latent class growth analysis (n = 6527). Common mental disorders were measured using the General Health Questionnaire 12-item version (GHQ-12). Information on behavior factors, morbidity, and the socioeconomic position was obtained from the questionnaire survey. Associations of baseline factors with pain trajectories were assessed by multinomial logistic regression.

Results

We found four distinct trajectories of the number of pain sites: high (15%), increasing (24%), decreasing (20%) and low (41%). In multivariable multinomial regression model high, increasing and decreasing trajectories were strongly associated with higher odds with both medium and high common mental disorders. However, the magnitude of the association was much higher for high vs. low trajectory group due to medium (OR 3.70, 95% CI 2.81-4.89) and high (OR 5.37, 95% 4.36-6.61) common mental disorders. Mean score of common mental disorders was also highest for high trajectory group. High, increasing and decreasing trajectory group were also associated with poor behavior, having one or more musculoskeletal comorbidities and low socioeconomic position.

Conclusions

Multisite musculoskeletal pain remain persistent among midlife employees and those high trajectories of musculoskeletal pain are associated with common mental disorders, behavior, and musculoskeletal comorbidities.

Key messages

Four distinct trajectories of number of pain sites was identified among midlife municipal employees. High common mental disorders and poor behavior, as well as low socioeconomic position and musculoskeletal comorbidities were strongly associated with pain trajectories.
Mapping, guiding, and assessing social prescription services in the UK
Authors: Husk K
Published: November 2019

Background

The use of non-health service referral, or ’social prescribing’ interventions have been proposed as a cost-effective alternative to help those with long-term conditions manage their illness and improve health and well-being. We are generating theory through review and primary data collection relating to the social prescribing system, how to maximise the benefits of this system and how it might be implemented.

Methods

A realist synthesis and evaluation. Working with three UK case-sites who are all at various stages in the process of setting up social prescription services, we are conducting patient pathway analyses, focus groups, and interviews. An important component of this work is iterative, targeted reviews of the literature relating to these pathways and identified mechanisms to assess effectiveness and reach.

Results

The study is ongoing; however, we are testing prototype theory generated in a previous realist review (presented last year) and elaborating on which mechanisms within each pathway relate to suitable population types and aspects of wellbeing.

Conclusions

We aim to draw together service delivery practitioners, users, researchers and clinicians to create specified theory for setting up social prescription services. This guidance will be context sensitive and make recommendations for increasing acceptability and spread of complex system service delivery and interventions.

Key messages

We are building highly specified, context sensitive system specification and ‘lessons learned’ implementation guidance for social prescribing programmes in the UK. We are producing these outputs through collaborative partnerships with services delivering programmes as they develop, using realist evaluation and qualitative comparative methods.
Societal Expenditure on Prevention
Authors: Van Gils P , Suijkerbuijk A W M , de Wit G A , Polder J J , Koopmanschap M A
Published: November 2019

Introduction

In 2015, Dutch healthcare expenditure exceeded 85 billion euros. But what about prevention? In this study we estimated national expenditure on prevention. A distinction was made between health protection, health promotion and disease prevention. In the estimation of prevention expenditures, this study is limited to universal, selective and indicated prevention, as healthcare-related prevention can hardly be distinguished from curative care. This study analyzed expenditure on preventive activities in the Netherlands in 2015 and took a societal perspective.

Methods

We used various sources to investigate spending on prevention in 2015. Insofar as costs were part of healthcare expenditure, estimates were based on the Care Accounts of Statistics Netherlands. For the remainder, we estimated expenditure using annual reports and annual accounts of governments and other organizations. We included preventive activities by consumers, industry, NGOs, insurance companies, and government.

Results

In 2015, an estimated € 12.4 billion (1.8% of the GDP) was spent on prevention: € 2.4 billion on disease prevention (19%), € 0.6 billion on health promotion (5%) and € 9.4 billion on health protection (76%). This is a decrease of 17% compared to 2007, the last year that a similar estimate was made. Within health promotion, the largest expenditure was for working conditions and safety: € 160 million. € 67 million was spent on mental disorders. The largest expenditure item within disease prevention was dental care: € 675 million. Within health protection, this was the sewer by more than € 3 billion.

Conclusions

Spending on prevention is relatively low compared to total spending on healthcare. The largest part is targeted at health protection. In the coming years there may be an increase in expenditure, due to more governmental prevention policies such as the National Prevention Agreement.

Key messages

Spending on prevention is relatively low compared to total spending on healthcare. Relatively little money for health protection.