bluuebunny/crossref_metadata_2025 huggingface dataset:
Social and environmental stressors and cardiometabolic risk
Authors: Bartoskova Polcrova A , Dalecka A , Szabo D , Gonzalez Rivas J P , Bobak M , Pikhart H
Published: October 2023

Background

Cardiometabolic health is influenced by many social and environmental factors, as demonstrated by the ubiquitous health inequalities. Exposures to social and environmental stressors produce individual biological and behavioural responses and thus may lead to impaired health both directly and indirectly. This study investigated several social and environmental stressors and describe the paths of their effect on cardiometabolic health.

Methods

We analysed a cross-sectional population sample of 2154 Czech subjects (aged 25-64 years, 55% women). The composite score (range 0-5) of metabolic disorders was calculated using 5 biomarkers: waist circumference, blood pressure, fasting blood glucose, HDL-cholesterol, and triglycerides. The higher score represents the higher cardiometabolic risk (CMR). The effects of social stressors (education, income), environmental stressors (air pollution, greenspace, noise) and behavioural factors (unhealthy diet, smoking, alcohol intake, sedentary behaviours) on CMR were assessed using a structural pathway model.

Results

We observed a significant direct effect of higher education on CMR (β=-0.101; 95% CI [-0.146, -0.056], as well as an indirect effect mediated via an unhealthy diet (β=-0.013; 95% CI [-0.022, -0.006]), smoking (β=-0.015; 95% CI [-0.028, -0.003]), and sedentary behaviours (β = 0.013; 95% CI [0.007, 0.022]). We also observed a significant indirect effect of higher income via sedentary behaviours (β = 0.012; 95% CI [0.006, 0.019]). The only environmental stressor significantly predicting CMR was noise (β = 0.054; 95% CI [0.006, 0.019]), which was also mediating the effect of higher education (β=-0.003; 95% CI [-0.008, -0.001]).

Conclusions

The effect of social stressors on the development of CMR had a higher magnitude than the effect of the assessed environmental factors. Social stressors lead to an individual's unhealthy behaviour and predispose individuals to higher levels of environmental stressors exposures.

Key messages

• Social stressors exhibited a greater magnitude of effect on cardiometabolic risk compared to environmental stressors.

• Social stressors lead to unhealthy behaviours and predispose individuals to higher environmental stressors exposure.
Covid-19 pandemic and mental health in italy: a multicenter, longitudinal national project
Authors: Petrelli A , Leone S , Ciampichini R , Fano V , Pacifici M , Di Napoli A , Aragona M , Rosini C , Silvestri C , Ventura M
Published: October 2023

Background

The impact of the COVID-19 pandemic on mental health has been widely documented. In Italy, however, no robust evidence has yet been produced. The objective of this abstract is to describe the profile of the Covid-19 and Mental Health (CoMeH) study cohort and preliminary describe the impact of the pandemic on population mental health.

Methods

Multicenter project promoted and coordinated by National Institute for Health, Migration and Poverty (INMP), involving an open cohort study of incident subjects with mental health disorders, enrolled from 01/01/2018 to 30/06/2022, in 3 centers (ATS Bergamo, Tuscany Region, ASL Roma 2). Subjects aged ≥14 years, residing at least in the previous 2 years, with at least 3 outpatient mental health services, 1 admission to a residential mental health service, 1 hospitalization or emergency room access with psychiatric diagnosis, prescription of at least 2 drugs for mental disorders and exemption for psychiatric disease were included. We estimated the immediate impact of the Covid-19 pandemic, as well as pre- and post-Covid-19 trend by fitting a Poisson segmented regression model in the context of the interrupted time series analysis.

Results

As of January 2023, the cohort consisted of 242,442 cases (13% in ATS Bergamo, 73% in Tuscany Region and 14% in ASL Roma 2), and mainly had access to prescription drugs (45%, 60%, 62% respectively). Regression model preliminary conducted on ATS Bergamo and ASL Roma 2 showed a decrease in the number of incident cases in the first month of Covid-19 (IRR: 0.793; 95%CI: 0.733-0.857 compared to counterfactual). In the post-Covid-9 period an increasing monthly trend was observed (IRR: 1.013; 95%CI: 1.008-1.019). Findings were similar between women and men.

Conclusions

Our findings suggest evidence of a negative effect of the pandemic on mental health, with an increasing trend in the post-Covid-19 period. Future analysis will be focalized in evaluating socioeconomic inequalities.

Key messages

• The study aims to evaluate the impact of the COVID-19 pandemic on mental health in Italy.

• A large longitudinal open cohort will be used to investigate the role of socioeconomic and migrant status.
Socioeconomic inequalities in COVID-19 - An analysis of health insurance data
Authors: Wachtler B , Beese F , Wahrendorf M , Hoebel J
Published: October 2023

Background

Evidence on socioeconomic inequalities in COVID-19 outcomes largely rests on ecological studies. Only few studies investigated inequalities in different COVID-19 outcomes prospectively on an individual level. We therefore conducted an analysis of German health insurance data to assess socioeconomic inequalities in COVID-19 incidence and hospitalizations within a cohort of insured individuals.

Methods

We used data of 3.17 million working-aged individuals (18 to 67 years) from various statutory health insurances in Germany. Educational level and occupational position were used as measures of socioeconomic position (SEP). We calculated directly age-standardized incidence rates per 1000 person-weeks (IR) and incidence rate ratios (IRR) among the sample population for COVID-19 incidence and COVID-19 hospitalizations for each exposure during the first four pandemic waves (01.01.2020-31.12.2021).

Results

Age-standardized IR and IRR of COVID-19 incidence and hospitalizations showed social gradients with higher rates in socioeconomically more disadvantaged groups. Incidence risk was higher among those in a low occupational position (IRR low vs. high: 1.29, 95% CI 1.27-1.31) and with a low level of education (IRR low vs. high: 1.36, 95% CI 1.34-1.38). Inequalities in COVID-19 hospitalizations were more pronounced with an IRR for low vs. high occupational position of 2.29 (95% CI 2.10-2.50) and an IRR for low vs. high level of education of 1.86 (95% CI 1.72-2.03).

Conclusions

We found socioeconomic inequalities in COVID-19 by education and occupational position, with inequalities in hospitalizations being more pronounced than those in incidence risk. These results show a high potential of prevention to improve population health and health equity in pandemics with novel respiratory pathogens. Further research on the underlying mechanisms of these inequalities in COVID-19 is needed.

Key messages

• Socioeconomically more disadvantaged individuals have a higher risk of COVID-19 and a severe disease progression.

• These inequalities should be addressed in future pandemic preparedness planning in order to minimize the unequal health impacts of pandemics with new emerging diseases.
Differences by immigration status on Covid-19 acute outcomes in the Emilia-Romagna ORCHESTRA cohort
Authors: Corsaro A , Banchelli F , Buttazzi R , Gagliotti C , Ricchizzi E , Moro M L , Berti E , Caranci N
Published: October 2023

Covid-19 pandemic increased health inequalities, affecting vulnerable populations as ethnic minorities and migrants. This retrospective observational population-based cohort study, as a part of the Horizon 2020 ORCHESTRA Project (funded under Grant Agreement n.101016167), assessed differences in risks of hospitalization, disease severity and mortality during the first 30 days after Covid-19 infection, comparing immigrants from high migratory pressure countries (HMPCs) to Italians and other residents from low migratory pressure countries (LMPCs) in the Emilia-Romagna (E-R) Region in Italy. All adult positive cases from February ’20 to February ’22 and residing for at least 1 year in E-R were included. Poisson regression with robust estimation of standard error was used to obtain risk ratios for main outcomes, stratifying by sex, epidemic period and adjusting for age, citizenship, deprivation index, care complexity index and vaccination status. Data came from the regional administrative healthcare databases. Sensitivity analyses were performed with people <75 years old and disaggregating into 7 main citizenship. Among the 859,754 tested positive for SARS-CoV-2, 9.6% were immigrants from HMPCs. Hospitalization risk among them was higher than for Italians and other LMPCs in both sexes (p < 0.01), in all periods and with an increasing trend over time; similarly, migrants had higher risk of severity (p < 0.05), with higher point estimates in women. Even if with lower level of evidence as compared to other outcomes, an indication of higher mortality among immigrant was evident in the first 7 months and confirmed by sensitivity analysis including population <75 years old. Sensitivity analyses showed higher risk of severe outcomes in Asians and Sub-Saharan Africans, particularly in women. Immigrants, in particular vulnerable subgroups such as women or migrants from Asia and Sub-Saharan Africa, showed higher risk of acute severe disease during the first 2 years of pandemic in E-R.

Key messages

• Numerous barriers to primary care access led migrants from HMPCs to show higher risk of disease severity, especially among most marginalized groups.

• Implementing equity-oriented and gender-based interventions is essential to overcome barriers to primary care and improve awareness and inclusion of migrants from HMPCs.
Sentinel Surveillance of Severe Acute Respiratory Infections in Serbia in 2022-2023 Season
Authors: Dimitrijevic D , Jovanovic V , Milinkovic M , Tomasevic T , Protic J , Grego E , Maris S , Cosic J
Published: October 2023

Introduction

Sentinel surveillance of severe acute respiratory infections (SARI) was implemented in Serbia in November 2009. Nine sentinel hospitals in 3 cities participated in the integrated SARI surveillance system. Four of them are children's hospitals. The aim of this study is to provide a review of integrated sentinel surveillance of SARI in Serbia in 2022-2023 influenza season, from October 2022 to April 2023.

Methods

Integrated Sentinel Surveillance of SARI has been done in accordance with professional guidance for epidemiological surveillance of influenza. Both epidemiological and virological data were collected on a weekly basis. All specimens were tested for influenza, SARS-CoV-2 and Respiratory syncytial virus (RSV). Intensive care units (ICUs), pediatric and respiratory disease wards were all represented. For laboratory confirmation, Real time polymerase chain reaction (RT-PCR) was used.

Results

Start of influenza season was registered in week 44/2022. A total of 3027 SARI cases were reported with 100% recorded age. Of these, 14% were 0-4 years old, 9% were 5-14, 7% were 15-29, 38% were 30-64 and 32% were ≥65. Among these cases, 607(20%) respiratory specimens were collected during the surveillance period. The number of positive samples for influenza was 208(34%), for SARS-CoV-2 was 37(6%) and for RSV 12(2%). The highest proportion of laboratory-confirmed influenza cases was 58% in week 51/2022. then, above 50% in week 7/2023 and 8/2023. All three influenza viruses were confirmed: A(H1)pdm09, A(H3) and type B. B viruses predominated, accounting for 38% of all sentinel SARI detections. There no were death associated to influenza, SARS-CoV-2 and RSV.

Conclusions

Integration epidemiological with laboratory surveillance as well as integrated sentinel SARI surveillance for influenza, SARS -CoV-2 and RSV highlights the importance of maintaining and improving national influenza surveillance capacity especially in the frame of International Health Regulations.

Key messages

• Quality, representativeness and sustainability are the guiding principles for integrated, SARS-CoV-2, RSV and influenza sentinel SARI surveillance.

• The threat of influenza remains, and it is essential for countries to be vigilant for the emergence of non seasonal influenza viruses of pandemic potential and prepare for the next influenza season.
Operationalization, characterization and validation of a healthy lifestyle index in 35 LMICs
Authors: Schindlmayr R , Theilmann M , Davies J , Danquah I
Published: October 2023

Background

For low- and middle-income countries (LMICs), there is no comprehensive and valid index reflecting overall lifestyle. This study aimed to operationalize, characterize, and validate a healthy lifestyle index (HLI), based on the World Health Organization (WHO) recommendations.

Methods

We used cross-sectional, complete-case data from individual-level, nationally representative surveys among non-pregnant adults in 35 LMICs, applying the WHO STEPwise approach to NCD risk factor surveillance (2009-2019; N = 125,607). The HLI was constructed based on WHO recommendations for fruit and vegetable intake, physical activity, smoking, and alcohol intake (unhealthiest = 0 points; healthiest = 16 points). We calculated the distributions of the HLI and its subcomponents across socio-demographic and geographic strata, accounting for the survey design and each country's World Bank population estimate. Partial Spearman correlations were calculated for the HLI with its subcomponents and cardio-metabolic risk markers.

Results

In this study (females: 51%, median age: 35.4 years), median HLI-score was 10.3 (interquartile range: 8.2-12.3), being highest in females (versus males) and low-income countries (versus middle-income countries). Twenty-two percent had at least five servings of fruits and vegetables per day (males: 20%, females: 24%); 82% exercised at least 600 MET-min/week (males: 87%, females: 78%); 69% never smoked (males: 40%, females: 97%); 64% were alcohol abstainers (males: 50%, females: 78%). Correlations of the HLI with its subcomponents were moderate and positive, ranging between r = 0.35 and r = 0.64; correlations with cardio-metabolic risk markers were weak, ranging between r = |0.02| and r =|0.12|.

Conclusions

The majority of adults in LMICs appear to live a healthy lifestyle, particularly women and individuals in low-income countries. Low fruit and vegetable intakes are a major concern. The HLI shows good content but poor construct validity.

Key messages

• There is an urgent need for interventions to promote fruit and vegetable consumption in LMICs.

• The HLI is suitable to monitor lifestyles in LMICs on individual-, country- and WHO region-level.
A descriptive study assessing the infodemic medical students faced during COVID-19 pandemic
Authors: Ataoğlu B , Hıdıroğlu S , Çetin H , Gümüş E G , Kılınç M , Köksal C , Karavuş M
Published: October 2023

With COVID-19, a new pandemic on worldwide basis emerged. An infodemic is a rapid and far-reaching spread of both accurate and inaccurate information about certain issues. Misinformation and disinformation can spread like a virus from person to person and affect people like a disease. The aim of this descriptive study was to assess the infodemic the medical students faced during COVID-19 pandemic. Second (n = 266) and third (n = 242) graders from a medical school in Istanbul, Türkiye were the study population. The study was completed with a total of 181 participants, 98 students from second grade and 83 from third grade who accepted to be included in the study in February 2022 while the COVID-19 pandemic was still continuing. A 5 point scale lickert type questionnaire was prepared and applied by the researchers to measure how much and particularly on which aspects the participants faced infodemic. Nearly half of the participants (47.5%) believed that they ‘almost always thought there was a COVID-19 infodemic'. As the most important causes of this infodemic the participants stated were ‘It is a new virus ‘ (31.5%) and ‘It affects daily routine life’ (31.5%). Around 40.9 % of the participants believed that the COVID-19 infodemic ‘adversely affected their health,’ 23.2% reporting low-mood and 15.5% anxiety. Around 52.5% of the participants stated that the COVID-19 infodemic had a negative impact on their general learning process at school. Additionally, 69.9% of the participants declared that they may not have shared anything that might have been the cause of any infodemic during the pandemic. Health authorities and educators should be aware that infodemic exists freely, adversely affecting health and education.

Key messages

• Majority of the medical students believed that there was a COVID-19 infodemic.

• The COVID-19 infodemic adversely affected their health and education.
Prehabilitation prior to elective surgery for frail elderly – protocol for a scale-up analysis
Authors: Felgner S , Eckhardt H , Quentin W , Rombey T
Published: October 2023

Background

Elderly patients frequently develop a frailty syndrome. Frailty is characterized by reduced physical reserves which increases the risk of perioperative complications and, thus, of patients needing long-term care. Prehabilitation before elective surgery can reduce risk factors and is currently evaluated as a new and sustainable care pathway for frail elderly in a randomized trial (NCT04418271). If found to be effective (the primary outcome being the level of care dependency 12 months after surgery), the pathway will be recommended for national scale-up. This protocol outlines the analyses intended to prepare for scale-up.

Methods

We will perform a scale-up analysis to assess whether and how prehabilitation can be implemented into routine care in Germany, including: (i) a Strengths-Weaknesses-Opportunities-Threats (SWOT) analysis of facilitating factors and barriers from the perspective of health care providers and patients (via semi-structured interviews, and a realist review); (ii) a scalability analysis using the Intervention Scalability Assessment Tool (ISAT) in an expert advisory board; (iii) a subgroup analysis to identify patients in the PRAEP-GO trial for whom prehabilitation was particularly effective; and (iv) a budget impact analysis based on routine data to estimate the total cost of implementing prehabilitation from a payer's perspective. The scale-up analysis will identify challenges and opportunities for the implementation of prehabilitation. It will contribute to the development of an implementation strategy, including specific proposals on how to finance the intervention. The budget impact analysis will provide an estimate of the financial impact of routine implementation of prehabilitation on the health budget.

Conclusions

If prehabilitation for the frail elderly is evaluated positively, its implementation should be prepared based on our study results, which includes establishing required infrastructures and defining financing concepts.

Key messages

• The proposed scale-up analysis will examine scalability of the implementation of prehabilitation for frail elderly into routine care in Germany.

• The implementation of a new care pathway having a positive effect on patients’ level of care dependency can be considered sustainable.
HTA challenges for personalized medicine: the case of liquid biopsy for lung cancer
Authors: Aguilera-Cobos L , García-Sanz P , Rosario-Lozano M P , Blasco-Amaro J A
Published: October 2023

Background

Personalized medicine and related health technologies are growing rapidly. In this context, health technology assessment methodologies must be prepared and adapted. Evaluating liquid biopsy (LB) for the diagnosis, treatment indication and prognosis of lung cancer is an example of the challenges in the personalized medicine assessment.

Methods

A systematic review and metanalysis based on EUnetHTA CoreModel. Review question: What is the effectiveness of LB for the diagnosis, therapeutic adequacy and prognosis of lung cancer versus tissue biopsy? The Covidence software was used for the systematic review and MetaDiSC software for the meta-analysis. The quality of the included systematic reviews was assessed with AMSTAR-2 and the quality of the clinical studies with QUADAS-II.

Results

69 systematic reviews corresponding to different therapeutic purposes: 12 for treatment adequacy, 47 for diagnosis and 13 for prognosis. Also 24 clinical trials were included. The omics alterations analysed were: punctual mutations in EGFR, BRAF, KRAS and ALK, methylation patterns, lncRNA expression, detection of circulating tumour cells, quantification of circulating DNA, NGS analysis of point mutations, miRNA expression and analysis of exosome content.

Conclusions

Use of LB tests at different disease stages and need of individual validation for the biomolecules and mutations analysed, are the main challenges. An evaluation framework that includes the specificities of these technologies is necessary for their proper assessment.

Key messages

• Liquid biopsy may be an alternative to tissue biopsy. The evaluation of the biomolecules analysed should be disaggregated.

• The particularities of personalised medicine technologies require assessment methodologies adapted to them.
Mathematical model for the prediction of high blood pressure through digital dermatoglyphics
Authors: Castro-Jimenez L , Rodriguez-Florian R , Rocha-Gonzalez J
Published: October 2023

Background

Hypertension is considered not only a disease belonging to the large group of cardiovascular conditions, but also a risk factor that impacts at an economic, social, environmental, and cultural level, among others. Worldwide, it is recognized that arterial hypertension is increasing, with projections that estimate a 30% increase in prevalence by the year 2025. Objective. To develop a mathematical model for the prediction of high blood pressure in young people through digital dermatoglyphics.

Methods

This study was carried out in a sequence of three activities, which included in the first instance the collection and analysis of all the fingerprints of the upper limbs of each study participant with an image recognition device, to later carry out a characterization. in terms of number and type of footprint on each of the participants’ fingers. Subsequently, a multiple linear regression model was carried out for the right and left hand, which includes information on the type of footprint, number of relevant characteristics and other physical characteristics of everyone with which it is possible to determine an expected value of the pressure. diastolic and systolic arterial pressure, a model that was validated through the estimation of different types of error, the correlation coefficient, and the tracking signal, in a contrast between predicted and observed blood pressure in a second control sample with different participants. those used in the formulation of the mathematical model.

Results

The model had a significant R-square, allowing to establish a relationship of similarity and explanation of the blood pressure values, from the quantification of the characteristics of the fingerprints of the right and left hand with a significance level of 95%.

Conclusions

An important advance is presented for the prediction of high blood pressure through genetic markers with a non-invasive and low-cost method.

Key messages

• This type of research allows progress in the establishment of relationships between the subject's genetic conditions and the potential risk for the development of diseases.

• Biotechnology is currently presented as a tool that contributes to the challenges that are generated in different areas such as the health sector.
The employment consequences of hearing loss among teachers: a 7-year follow-up study
Authors: Schriemer A G , Bültmann U , Roelen CAM
Published: October 2023

Background

Hearing loss is the third leading cause of years lived with disability. As the retirement age is rising, age-related hearing loss (HL) is an increasing occupational health (OH) problem. This study aimed to examine long-term changes in employment and work outcomes in teachers with HL and to identify barriers to and facilitators for their work participation.

Methods

In this prospective cohort study with 7-year follow-up, teachers completed an internet survey and an online hearing test. Teachers were classified as normal hearing (NH) and teachers with HL. For those who had stopped working during follow-up, we compared retirement age and proportions receiving disability pension in both groups. For those still working, differences between NH and teachers with HL in work outcome changes, i.e. work ability (Work Ability Scale), work performance (Health & Work Performance Questionnaire), and sustainable employability (Capability Set for Work Questionnaire) were investigated with ANOVA. Furthermore, teachers with HL answered questions on work participation barriers and facilitators for a thematic analysis.

Results

Of the invited N = 325 teachers, n = 211 (65%) responded and n = 89 were teachers with HL. Among those who had stopped working (n = 89), the mean retirement age was 64.6 years for both NH and teachers with HL. At follow-up, n = 10 received disability pension of which n = 9 had HL (p < 0.01). No differences were found over time for changes in work outcomes. Barriers for work participation were attending meetings, teaching, and poor classroom acoustics. Facilitators were job satisfaction, cooperation of the work environment, task adjustment, good acoustics, and technical equipment.

Conclusions

Teachers with HL retired at the same age as NH teachers, but more often received disability pension. No differences were found in work outcomes over time. Our study identified barriers and facilitators relevant for OH professionals when advising teachers with HL about work participation.

Key messages

• Although work outcomes over time were not different for teachers with and without hearing loss, teachers with hearing loss more often stopped working because of disability pensioning.

• The identified barriers to and facilitators can be used to advise teachers with hearing loss and their employers about workplace accommodations.
Work-related stress, reason for consultation and sick leave diagnosis in primary health care patients
Authors: Hultén A-M , Holmgren K , Bjerkeli P
Published: October 2023

Background

Work-related stress is common and stress-related ill health is often managed in primary health care. The reason for consultation is important for diagnosis and treatment. This study aimed to improve the understanding of the association between reason for consultation, work-related stress and sick leave diagnosis in primary health care patients.

Methods

In all, 232 patients who sought care for mental and physical health complaints at primary health care centres in Sweden participated. At inclusion, the patients were employed and non-sick listed. Pearson chi-squared test and relative risk were used to assess the associations.

Results

Patients reporting high work-related stress, compared with low work-related stress, were more prone to seek care for mental symptoms (59% versus 18%), sleep disturbance (36% versus 17%) and fatigue (40% versus 26%). Among the high-stress patients, the risk for sick leave with a mental diagnosis was three times as high as in low-stress patients within a year of baseline (RR 2.97, 95% CI 1.59;5.55). However, no risk increase was seen in sick leave with a musculoskeletal diagnosis (RR 0.55, 95% CI 0.22;1.37). Stating mental symptoms, sleep disturbance or fatigue as reason for consultation were associated with future mental sick leave diagnosis (p-values < 0.001). Stating musculoskeletal symptoms as reason for consultation was also associated with future musculoskeletal sick leave diagnosis (p-value 0.009), but not in patients reporting high work-related stress.

Conclusions

High-stress patients, compared with low-stress patients, more often sought care for mental symptoms, sleep disturbance and fatigue leading to a mental sick leave diagnosis. No such associations were found between stress, care seeking due to musculoskeletal symptoms and future musculoskeletal sick leave diagnosis. It can therefore be assumed that patients as well as general practitioners saw work-related stress as a mental issue.

Key messages

• Incorporating the reason for consultation increased the understanding of the association between work-related stress and sick leave.

• Work-related stress was characterized as a mental issue, which could affect care seeking behaviors and measures taken.
Organisational aspects and determinants on intention to seek psychotherapeutic consultation at work
Authors: Kohl F , Angerer P , Weber J
Published: October 2023

Background

Worldwide, a minority of people suffering from mental illness receives adequate treatment. Psychotherapeutic consultation at work (PT-A) offers low-threshold and short-term access to psychotherapeutic care for employees with mental burden. However, utilisation has been low so far. Therefore, this study aimed to identify employees’ preferences on organisational aspects and determinants on intention to seek PT-A.

Methods

In total, 755 employees answered online questions on organisational aspects of PT-A (type, time, location, scope and purpose) and on determinants (sociodemographic variables, psychological well-being, stigma-related barriers and psychosocial safety climate) of intention to seek PT-A. To identify organisational preferences, various repeated measures analyses of variances were conducted. Multiple linear regressions were used to identify determinants of intention to seek PT-A.

Results

Results showed that employees prefer in-person consultations that take place outside of working hours and outside company premises, with treatment sessions included in addition to diagnostics. Intention to seek PT-A for occupational reasons was higher than for private reasons. The study also found that male gender, higher psychological well-being and higher perceived stigma-related barriers were associated with a lower intention to seek PT-A. However, these associations were found to depend on whether participants currently showed symptoms of depression.

Conclusions

These results provide practical indications under which conditions employees would make use of PT-A. Furthermore, recommendations that might increase utilisation can be derived from these results (e.g. anti-stigma campaigns). Nevertheless, longitudinal studies are necessary to confirm whether these factors determine actual utilisation.

Key messages

• Results suggest that employees prefer PT-A as in-person consultation during working hours and off company premises.

• Interventions like anti-stigma campaigns or target group specific advertising might address the determinants on intention to seek PT-A found in this study.
The use of employment and social services and rehabilitation after the onset of unemployment
Authors: Rinne H , Perhoniemi R
Published: October 2023

Background

Even though employment and social services and rehabilitation are available to the unemployed, there is little information about their service paths after the onset of unemployment. The aim was to follow different service spells using sequence analysis among those who became unemployed.

Methods

The register-based data included all 18-59-year-old individuals living in the City of Oulu, Finland, who became unemployed in 2017 (N = 8,935). For the 12 months after the onset of unemployment, eight states were constructed: rehabilitative work activities, mental health and substance abuse services, social work, rehabilitation, work trial, labour market training (LMT), several services, and no services. We used sequence analysis and clustering to identify groups with different service paths. Sociodemographic and health-related factors and later employment were examined using multinomial regression analysis.

Results

We identified eight clusters: 1) no services (57%), 2) short LMT (11%), 3) several and simultaneous services (6%), 4) mental health or substance abuse services (2%), 5) work trial (10%), 6) rapid LMT (6%), 7) intermediate LMT (5%), and 8) long LMT (4%). Persons in cluster 1 had a more advantaged background. Compared to them, clusters 3 and 5 were associated with being female and cluster 7 was associated with being male. All service clusters were associated with being under 50 years old. Clusters 3-8 were associated with primary education and clusters 3, 5, and 8 also with secondary education. All service clusters were associated with no employment days before the onset of unemployment. Clusters 3-5 were associated with chronic diseases. Later employment was highest among clusters 1, 6, and 8.

Conclusions

The unemployed can have very different service paths. Lower SES predicts the use of employment and social services and rehabilitation, but the paths also differ by sex and health. Duration and timing of LMT vary by sociodemographic characteristics.

Key messages

• Most of the unemployed do not use any employment or social services or rehabilitation. Those who do can have very different service paths.

• Lower education predicts more frequent use of services. Paths vary by sex, age, and health.
The unemployed on sickness allowance: segmenting 3-year labour market pathways with sequence analysis
Authors: Blomgren J , Laaksonen M
Published: October 2023

Background

Understanding how the combination of unemployment and work disability affects future labour market pathways is important. We followed labour market pathways among those who were unemployed at the start of a sickness allowance spell.

Methods

Register data covered disability pensions (DP), rehabilitation spells, sickness allowance spells, unemployment spells and employment spells, retrieved for unemployed Finnish 18-58 years old persons who had a new sickness allowance spell in 2016. Sequence analysis and clustering were used to identify latent homogenous subgroups. Using multinomial regressions, demographic, socioeconomic, and disability-related covariates were examined.

Results

Preliminary analyses revealed six clusters with unique pathways and identities. 1) Unemployment; 2) Employment; 3) Rehabilitation spells, recurring disability and unemployment; 4) Unknown sources of income; 5) Permanent disability pension; and 6) Temporary disability pensions. Compared to the cluster with emphasis on return-to-work, other clusters were associated with less pre-LTSA employment days, having a pre-LTSA chronic illness, and a mental disorder.

Conclusions

Unemployed persons starting an LTSA have very different labour market pathways. For many, there are low chances for employment or regained work ability in the following years. Persons with poor health, long history outside employment, older age, low educational level and a mental disorder could benefit from targeted support.

Key messages

• Despite heterogeneous pathways found, for most of the unemployed, sickness allowance spells are followed by recurring unemployment, recurring sickness allowance, or disability retirement.

• Since the unemployed with work disability rarely regain work ability in the following years, supporting their work ability is crucial in preventing permanent exclusion from working life.
The effect of COVID-pandemic on retirement timing and interest to work alongside pension in Finland
Authors: Tenhunen S
Published: October 2023

Background

The health risks of COVID-pandemic may have made retirement more desirable for those close to the retirement age. At the same time, wide lockdowns may also have emphasized the importance of maintaining social contacts at work. This study examines if the COVID-pandemic reflected to retirement timing and to the interest to work after that in Finland.

Methods

We use register-supplemented survey data (3,350 observations, response rate 68%) of Finnish pensioners who retired from work to old-age pension in years 2019-2021. We use descriptive analysis and logistic regression models to describe the prevalence of the pandemic's impact and to find out if the effects on retirement and interest to work after retirement vary by population groups.

Results

According to preliminary results, for majority (85 %) the pandemic had no effect on their re-tirement decision. However, seven per cent of respondents told the pandemic made them retire earlier, while two per cent postponed retirement. Advancing retirement was more common among high-educated, upper-level employees and those who had retired after statutory retirement age. Three quarters of recently retired Finns told COVID-pandemic had no effect on interest to work after retirement. Ten per cent told the pandemic decreased and four per cent that the pandemic increased their interest to work. Women, upper-level employees and high-educated reported more often their interest to work had decreased because of the pandemic.

Conclusions

From both a societal and individual point of view, it is important to notice how widely the pandemic affected the retirement timing and the interest to participate in working life at the end of the working career. Our results suggest that while for a great majority the pandemic did not have any impact on their retirement decisions or interest to work after retirement, there were small groups of retirees whose retirement timing and working interest were affected.

Key messages

• For the great majority of Finns retiring from work in 2019–2021, the COVID pandemic did not affect retirement timing or their interest to work alongside old-age pension.

• For some, the pandemic affected their retirement timing and interest to work, more often by inducing earlier retirement and decreasing interest to work.
The effects of an interdisciplinary employment program among persons with severe mental disorders
Authors: Hijdra R W , Robroek SJW , Sadigh Y , Burdorf A , Schuring M
Published: October 2023

Purpose

This study evaluates the effects of the interdisciplinary employment program ‘Work As Best Care (WABC)’ on employment participation and mental health of persons with severe mental disorders.

Methods

WABC is a ‘work first’ employment program for unemployed persons with severe mental disorders in which employment professionals work closely together with mental health professionals. In a longitudinal non-randomized controlled study, participants of WABC (n = 35) are compared with participants of the control group (n = 37), who received regular employment support. Participants were followed for one year and filled out questionnaires on individual characteristics and health at baseline, after 6 and 12 months. This information was enriched with monthly register data on employment status from 2015 until 2020. Difference-in-differences analyses were performed to investigate changes in employment participation among participants of WABC and the control group. A generalized linear mixed effects model was used to compare changes in mental health (measured on 0-100 scale) between the two groups.

Results

Before WABC, employment participation was 22.0 %points lower among participants of WABC compared to the control group. After starting WABC, employment participation increased with 15.3 %points per year among participants of WABC, compared to 5.6 %points in the control group. Among participants of WABC, no change in mental health was found (β 1.0, 95%CI -3.4;5.5).

Conclusions

To enhance employment participation of persons with severe mental disorders, an interdisciplinary ‘work-first’ approach in which professionals of employment services and mental health services work in close collaboration, is of paramount importance.

Key messages

• An interdisciplinary work-first approach where employment- and mental health services work in close collaboration, is of paramount importance for re-employment of persons with severe mental disorders.

• Having a severe mental disorder should not be an exclusion criterion for receiving support towards paid employment.
Age-friendly practices during the COVID-19 pandemic: Findings from a scoping review
Authors: Guzman V , Kinsella E , Pertl M , Foley R , Doyle F
Published: October 2023

Background

The COVID-19 pandemic called for innovation and leverage of existing age-friendly practices to promote older people's functional ability and enable them to contribute to their communities and enjoy life. Our aim was to explore the evidence available concerning the development, adaptation, and evaluation of age-friendly practices during the COVID-19 pandemic.

Methods

A review was conducted in line with the Joanna Briggs Institute scoping review methodology. We considered publications of practices across the 8 domains of the World Health Organization (WHO) age-friendly framework. Our search strategy comprised databases (PubMed, Web of Science, Scopus) and grey literature sources.

Results

Preliminary findings identified 37 practices by member organizations of the WHO network. The most targeted domains were community support and healthcare services; communication and information; and social participation; while the least targeted were transportation; housing; and outdoor spaces and buildings. Adaptive strategies often relied on remote delivery of information and services through digital or phone contact. Most practices were led by local authorities in collaboration with community organizations, universities, and healthcare practitioners. Opportunities for older people to contribute to the design and implementation of practices varied widely across settings. Enablers for adaptation or development included pre-existing collaborations between stakeholders, availability of contact details of older people in the community, and availability of human and material resources to implement changes. Challenges included limited literacy and access to digital technologies, and participants’ distrust of remote activities.

Conclusions

Findings emerging from the scoping review provide insights regarding age-friendly practices during COVID-19 and may inform the development of appropriate multi-stakeholder and participatory interventions during future public health crises.

Key messages

• Age-friendly practices may significantly contribute to meet older people’s material, social and affective needs during public health crises.

• Opportunities to leverage age-friendly practices increase with the inclusion of older people’s voices, intergenerational solidarity, multi-stakeholder involvement and strong political will.
Provisions regarding organizational and social work environment and future sickness absence in Sweden
Authors: Nyman C , Alexanderson K , Svedberg P , Friberg E
Published: October 2023

Background

Sickness absence is high among healthcare employees in many European countries, including Sweden. In addition to physical workload, the importance of psychosocial work factors for this is emphasized. To promote a good psychosocial work environment, provisions on organisational and social work environment, mandatory to all work sectors, was launched in 2016 in Sweden. We compared sickness absence (SA) due to mental diagnoses two years before and two years after these provisions were introduced, among healthcare employees, employed by the municipality, the region, or private organisations.

Methods

Register microdata were used for analyses of all employees in the healthcare sector in Sweden in 2014 (N = 260,709) and in 2018 (N = 277,901). The odds ratios (OR) with 95% confidence intervals (CI) of new SA (in SA spells >14 days) and of long-term SA (>90 days) with a mental diagnosis in 2018 compared to 2014 were calculated, using logistic regression.

Results

The ORs of new SA and long-term SA with mental diagnoses among healthcare employees were somewhat higher in 2018 than in 2014 (OR = 1.14; 95% CI 1.11-1.17), (OR = 1.12; 1.07-1.17). The OR for the private sector for a new SA spell was 1.11; 1.02-1.19, and for the regional sector, OR 1.05; 1.01-1.08. The highest probability of long-term SA with mental diagnoses in 2018 compared to 2014 was found among employees in the municipal sector, OR 1.33, CI; 1.11-1.61, and in the private sector, OR 1.15, CI; 1.03-1.29.

Discussion

The mandatory provisions aim to promote good work environment and prevent risks of ill health due to organisational and social conditions at work. We observed a somewhat higher probability of SA with mental diagnoses two years after the provisions were introduced. SA due to mental diagnoses is influenced by many factors of which psychosocial work environment is only one part and maybe longer follow-ups are needed.

Key messages

• Sickness absence due to mental diagnoses among healthcare employees was somewhat higher two years after the introduction of an organisational and social work environment provision.

• Many factors influence sickness absence with mental diagnoses; other factors and longer follow-ups are needed to gain knowledge on possible effects of the work environment provision.
Disability-related policies and practices and sustained employment: A survey and register data study
Authors: Van Ooijen R , Koning PWC , Boot CRL , Brouwer S
Published: October 2023

Background

Many OECD countries implemented reforms to promote sustained employment of employees on long-term sick leave. Still, sustained employment remains low, which is worrying as it may affect the health and well-being of this vulnerable group of workers. This study aimed to examine the extent to which a firm's disability policies and practices increase the likelihood of sustained employment of long-term sick-listed employees with remaining work capacity.

Methods

Survey data on firms’ disability policies and practices was obtained from the Dutch Employee Insurance Agency (UWV) and linked to register data covering the employment outcomes of all employees that applied for disability benefits between 2006 and 2010 (N = 6103 employees from N = 366 employers). The dependent variable was sustained employment one year after the disability assessment. Implemented disability policies and practices were measured across seven domains: sick leave prevention, absenteeism management, reintegration management, occupational health and safety services (OHS), reintegration activities with the current/another employer, and positive workplace culture. Multilevel multiple logistic regression analyses were performed.

Results

Sick leave prevention policies (OR = 2.3, 95% CI 1.3-4.0), absenteeism management policies (OR = 1.8, 95% CI 1.0-3.3) and OHS (OR = 1.8, 95 CI 1.1-3.2) were positively associated with sustained employed one year after the disability assessment. No significant results were found for the other domains.

Conclusions

Employees with remaining work capacity in firms with the most comprehensive absence management policies, prevention policies, and OHS are about twice as likely to continue working one year after the disability assessment than firms with the least comprehensive policies. Legislation that encourages firms to invest more in absence management and prevention policies may result in better employment opportunities for this vulnerable group of employees.

Key messages

• Firm's prevention and absence management policies could be highly effective in fostering sustained employment of employees on long-term sick leave.

• Legislation that encourages firms to invest more in disability policies and practices may result in better employment opportunities, health, and well-being of people with partial work disabilities.