bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emotional demands at work and risk of long-term sickness absence among 1.5 million Danish employees
Authors: Framke E , Sørensen J K , Madsen I E H , Rugulies R 
Published: November 2019

Abstract

Background
Emotional demands concern aspects of work requiring an emotional effort of employees and have been associated with risk of depression and long-term sickness absence (LTSA) in previous studies. Associations may, however, partly be affected by reporting bias. Further, previous studies have primarily been conducted using smaller samples in selected job groups or sectors. We, therefore, examined the association between emotional demands and LTSA using a job exposure matrix (JEM) in a nationwide cohort.

Methods
We included all employed individuals in Denmark who were 30 to 59 years old in 2000. We assessed emotional demands at work with a JEM. JEM values were categorized into quartiles based on the distribution within each year and updated annually from 2000 to 2009. LTSA was register-based, defined as ≥ 6 weeks and assessed until 2015. Individuals with LTSA from 1998 to 2000 were excluded, yielding a sample of 1,521,352 individuals. Exposure in year t was related to outcome in year t + 1 until 2009. We estimated hazard ratios (HR) and 95% confidence intervals (95%CI) using Cox regression adjusted for age, sex, income and ergonomic job demands.

Results
During 15,453,980 person-years, we identified 594,858 LTSA cases. In the fully adjusted model, individuals in the highest emotional demands quartile had a HR of 1.30 (95%CI: 1.29-1.31) compared to individuals the lowest quartile Repeating the analysis separately for women and men showed similar results.

Conclusions
Emotional demands at work were prospectively associated with an increased LTSA risk in this JEM based nationwide cohort study.

Key messages
This study found that emotional demands at work predict risk of long-term sickness absence. Future studies should focus on factors that may buffer the association between emotional demands at work and long-term sickness absence.
Work-pressure, job-satisfaction and turnover intentions among health managers in Serbia
Authors: Šantrić Milićević M , Gačević M , Milić N , Filipović J , Todorovic J , Terzic-Supic Z 
Published: November 2019

Abstract

Background
Rationalization, freezing of salaries and additional taxation of salaries above a certain amount have marked the reform of the public health sector in Serbia in 2014/15. Health managers bear responsibility for success in reform activities, and improvement of subordinates’ job satisfaction and health care quality with constrained resources. This study explored factors associated with work-pressure, turnover intentions and job satisfaction among health managers in 323 public health institutions in Serbia.

Methods
Data of the 2015 job satisfaction survey of the Ministry of Health and the Serbian Public Health Institute were used to carry out a secondary analysis. Logistic regression was applied, including factors such as age, gender, occupation (doctors, nurses, other health workers, healthcare associates and non-medical managers), workplace, work-conditions’ satisfaction, general job satisfaction, and turnover intention in relation to work-pressure of 7818 health managers (response rate was 91.5%).

Results
Almost 39.5% of the health managers experienced high/very high work-pressure (p &lt; 0.001), 51.2% were dissatisfied (p &lt; 0.001), and 23.7% had turnover intention outside the health sector/country (p &lt; 0.001). High/very high work-pressure positively correlated with health managers of secondary (Odds Ratio-OR =1.37, p &lt; 0.001) and tertiary care institution (OR = 1.72, p &lt; 0.001), female sex (OR = 1.19, p = 0.004), younger than 55 years of age (OR = 1.26, p &lt; 0.001), and nurses (OR = 1.13, p = 0.024). Other factors showing positive correlations include job dissatisfaction in general (p &lt; 0.001) and with all workplace conditions (p &lt; 0.001), as well as turnover intentions (p &lt; 0.001).

Conclusions
Work pressure of health managers seems to be perceived highest in the group of younger female nurse executives in hospital care. Their dissatisfaction with the job in general and with the working conditions, as well as turnover intentions positively correlate with the increase of work pressure.

Key messages
Improving working conditions and job satisfaction is key to reduce work pressure of health managers. Young female nurse managers perceive highest levels of work pressure, and need reinforcement at work.
Economic hardship over twenty-two consecutive years of adult life and markers of early ageing
Authors: Foverskov E , Petersen G L , Pedersen J L M , Rod N H , Mortensen E L , Bruunsgaard H , Lund R 
Published: November 2019

Abstract

Background
The authors examined the associations between annual measures of economic hardship (EH) across 22 years of adulthood and objective measures of early ageing in a Danish late-middle aged population.

Methods
A linkage of longitudinal register data from Statistics Denmark covering the period 1987-2008 and cross-sectional survey data from the Copenhagen Ageing and Midlife Biobank collected in 2009-11 (N = 5,575). EH was defined as &lt; 60% of the National median equivalized household disposable income and two exposures were calculated: 1) a categorical measure of total number if years in EH, and 2) trajectories of the probability of EH being low, declining, rising or high. Early ageing outcomes included four measures of physical capability, three inflammatory markers and one cognitive test. Associations were analyzed using linear regression models adjusted for sex, age, cohort, education, baseline income and long-term parental unemployment/financial problems.

Results
Four or more years in EH (reference=null years in EH) was related to poorer physical capability (chair rise: -1.49 counts/30 seconds [95% confidence interval (CI) -2.36, -0.61], hand grip strength: -1.22 kg [95% CI -2.38, -0.07], jump height: -1.67 cm [95% CI -2.44, -0.91] and balance: 18% [95% CI 9, 28]), poorer cognitive function (Intelligenz-Struktur-Test: -1.50 points [95% CI -2.89, -0.12]) and higher inflammatory levels (C-reactive protein: 22% [95% CI 4, 44], and Interleukin-6: 23% [95% CI 10, 39]). Comparing the four EH trajectories, people with a high vs. low probability of EH over time had poorer physical capability (chair rise: -1.70 counts/30 seconds [95% CI -3.38, -0.01], grip: -4.33 kg [95% CI -6.50, -2.16], jump: -1.68 cm [95% CI -3.12, -0.25], and balance: 31% [95% CI 12, 52]). No associations were observed with Tumor necrosis factor α.

Conclusions
This study suggests that sustained EH across adulthood may lead to early ageing.

Key messages
Sustained economic hardship in adulthood may lead to early ageing. Being in economic hardship for a few years is not associated with early ageing.
Implementing integrated care for multi-morbidity: analysis of experiences in 17 European programmes
Authors: Struckmann V , Looman W , van Ginneken E , Bal R , Busse R , Rutten-van Mölken M 
Published: November 2019

Abstract

Background
Many countries are experimenting with new models of care provision and numerous integrated care programmes have been established internationally. However, little information is available on how to implement integrated care. The aim is to provide more in-depth insights in the implementation of integrated care for developers and managers of integrated care programmes, policy makers, health insurers, and researchers.

Methods
17 integrated care programmes addressing multi-morbidity were selected and studied in 8 European countries as part of the Horizon 2020-funded project SELFIE (Sustainable intEgrated care modeLs for multi-morbidity: delivery, FInancing and performancE). An overarching analysis with data extraction forms of the Thick Descriptions completed for all 17 programmes in combination with previous insights from the literature was applied. Information about the implementation of integrated care was extracted and coded according to the six components of the SELFIE framework: service delivery, leadership & governance, workforce, financing, technologies & medical products, and, information & research and sub-elements of each component at the micro, meso and macro level.

Results
The results show the interrelatedness of the six SELFIE framework components and that alignment work between them, different elements and levels is important. The meso-level seems to be the driving force of implementation and that a stepwise approach to change by building upon what is already there (e.g. existing collaborative networks) and gradually expand and broaden the scope of the integrated care programmes was supportive.

Conclusions
Implementation activities should simultaneously focus at the micro, meso and macro-levels at which integration occurs as they strongly influence each other. Alignment of the integrated care programme and the active influence of the macro-level context by creating an enabling environment facilitates successful implementation.

Key messages
Integrated care should be implemented with an incremental growth model rather than from a disruptive innovation approach. Integrated care should involve bottom-up and top-down implementation at different levels of the programme.
Monitoring of non-communicable diseases in Belgium
Authors: Devleesschauwer B , Abboud L A , Bogaert P , Cornez A , Raes L , Scohy A , Van der Heyden J , Renard F 
Published: November 2019

Abstract

Non-communicable diseases (NCDs) account for the highest share of deaths and burden of disease in Belgium. Nevertheless, there is currently no national plan to prevent and monitor the health impact of NCDs. Recently, two initiatives have been launched by Sciensano, the Belgian institute for health, providing new opportunities for monitoring NCDs in an integrated and comparable way - i.e., the Belgian Health Status Report (HSR) and the Belgian National Burden of Disease Study (BeBOD).
The HSR, launched in February 2019, integrates health status information in a continuously updated website: www.healthybelgium.be. Key indicators, identified through literature and stakeholder consultations, highlight specific needs and warning signals. Currently, the HSR integrates self-reported information on NCD prevalence from the Belgian Health Interview Surveys, with objective information on cancer and diabetes from the Belgian Cancer Registry and health insurance data, respectively. Future versions will include a broadened scope with national best estimates for other NCD groups.
The BeBOD study was launched in 2016, aiming to provide a first set of internally consistent burden estimates by 2020. BeBOD will complement the HSR by integrating information on morbidity and mortality of NCDs into a single measure of burden of disease - the Disability-Adjusted Life Year (DALY). DALYs quantify the number of healthy life years lost due to disease, and allow comparing the burden of fatal and non-fatal conditions. Annual updates of the BeBOD study will further provide unprecedented opportunities to monitor the impact of NCDs over time.
In addition to the new opportunities provided by the HSR and BeBOD study, NCD monitoring requires continued investment in active data collection and integration of available data sources. In term, these NCD monitoring systems will provide a solid basis for evaluating the impact of NCD control policies.

Key messages
There is currently no national plan to prevent and monitor the health impact of non-communicable diseases in Belgium. The Belgian Health Status Report and the Belgian National Burden of Disease Study provide new opportunities for monitoring non-communicable diseases in an integrated and comparable way.
Best practices for core capacities at ports
Authors: Hadjichristodoulou C , Mouchtouri B 
Published: November 2019

Abstract

Introduction
A survey was conducted in the frame of the EU HEALTHY GATEWAYS joint action with the purpose to identify best practices implemented at designated points of entry-ports of EU Member States for: core capacities implementation; detection, surveillance and management of public health events; vector surveillance and control practices at ports; contingency planning; risk communication; and inspection of ships for vectors.

Methodology
A questionnaire was disseminated to the EU Member States designated partners of the joint action. “Best practices” were considered those which fulfilled the following four criteria: a) practices are implemented according to the International Health Regulations (2005) requirements for core capacities; b) practices are documented and legislated/formalised; c) staff have been trained in implementing the documented practices; d) practices have been tested with exercises or have been applied in real life events.

Results
Data were collected from 15 ports of 13 countries including eight designated ports and one that that designation has not been completed. Best practices were described for medical services including diagnostic facilities, training programmes, exercise for testing contingency plans, staff competency frameworks, equipment and health measures implementation. Standard Operating Procedures and national legal frameworks were collected.

Conclusions
Despite the progress that has been made in the IHR core capacities implementation, it seems that best practices exist based on the countries priorities and needs. There are not many examples of PoE implementing best practices in all areas of the survey. Achievement of core capacities is a continuing effort and exchange of best practices among EU MS can be beneficial.
The contribution of eHealth to improve fall and balance disorder care in the elderly
Authors: Gaspar Andréa , Velez-Lapão Luís 
Published: November 2019

Abstract

Background
The global ageing and consequent vulnerability for chronic multimorbidity, balance disturbances and falls represent a significant public health challenge that needs to be addressed. The use of Information Systems and Technologies to support eHealth services responding to balance disorders represents an opportunity to optimize health outcomes and insure autonomy support for older people.

Methods
A systematic review was performed in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement (PRISMA) to describe the contribution of eHealth to balance disorders care of older adults. The search was limited to English language journals and to reports that were published in the last 5 years related to use of eHealth in the context of balance and fall, restricted to the population older than 60 years of age without functional limitation by neurological disease.

Results
From a total of 1005 unduplicated articles, only 12 articles complied with the eligibility criteria. It was found a growing interest on the research but it was not possible to effectively compare the results of the studies. This can be explained due to diversity of older population engaged on the studies, differences in follow-up times, lack of homogeneity of study methodology and use of different remote technologies, yet to reach maturity. It was observed a gap between investigation and actual clinical use that should be addressed.

Conclusions
The use of eHealth in the context of older people with fall risk due balance disorders represents an opportunity to be explored, reaching the fragile and growing elderly population. The patient, caregiver and health human resources engagement and the homogeneity on research are necessary keys to allow clinical applicability and alignment with health policies.

Key messages
The use of eHealth in the context of older people with fall risk due balance disorders represents an opportunity to be explored, reaching the fragile and growing elderly population. Homogeneity on research is necessary to allow clinical applicability and alignment with health policies.
A National Digital Diabetes Prevention Programme: Feasible, acceptable and effective?
Authors: Murray E , Valabhji J , Lavida A , Henley W , Daff K , Irwin J , Brownlee L , McGough B 
Published: November 2019

Abstract

Background
Type 2 Diabetes (T2DM) is a global public health priority affecting 425 million adults with 352 million more at risk of developing T2DM. Intensive group programmes focusing on weight loss and physical activity can prevent or postpone the development of T2DM, but certain groups (e.g working age) find it difficult to attend sessions. Digital options offer a flexible alternative with the potential to widen access and increase uptake. The National Health Service of England (NHSE) has initiated a pilot of a national digital Diabetes Prevention Programme (DPP) to determine its feasibility, acceptability and impact. This is the first national digital DPP in the world, and lessons learnt will be of interest internationally.

Methods
Single arm, pre-post design located in 9 geographic areas with a total population of 5.6 million adults. Adults identified in primary care as being at risk of T2DM were referred to a digital diabetes prevention intervention (DDPI). Baseline data included demographic details (age, gender, ethnicity, highest level of education achieved) and clinical data (weight (kg), Body Mass Index (BMI) and glycated haemoglobin (HbA1c mmol/mol)). Clinical data were collected at baseline, 6 and 12 months, with the primary outcome change in HbA1c at 12 months.

Results
The programme was effectively implemented in all 9 areas with a total of 5,053 referrals. 3,228 (64%) of those referred registered with a DDPI. Mean baseline values for registered patients was BMI 31.1, Weight 87.7 kg and HbA1c 43.4 mmol/mol. To date, 2,687 patients have reached the 6 month point, of whom 867 dropped out. Mean (95% CI) HbA1c change was -1.6 (-1.8 to -1.4) mmol/mol (n = 1,264) and mean (95% CI) weight change was -4 (-4.3 to -3.7) kg (n = 1,184).

Conclusions
A national digital DPP is feasible, acceptable to patients and healthcare providers, and appears to be associated with beneficial impacts on HbA1c and weight in those who participate.

Key messages
A digital DPP is feasible, acceptable and associated with reductions in weight and HbA1c amongst participants. A digital DPP could be a useful part of a public health strategy to combat T2DM.
Compared to whom? Reference groups in socio-economic comparisons and self-reported health
Authors: Gugushvili A , Jarosz E , McKee M 
Published: November 2019

Abstract

Background
The association between socio-economic position and health is believed to be mediated, in part, by psycho-social comparison of one’s situation to that of others. But with who? Possibilities include family, friends, elites, or even those in other countries or in previous times. So far, there has been almost no research on whether the reference point matters.

Methods
We take advantage of a comparative data set that, uniquely, allows us to ask this question. The Life in Transition Survey was conducted in four Southern European and 30 Central and Eastern European and Eurasian countries. We sought differences in the probability of good self-reported health among those using different reference groups, including own family, friends and neighbours, domestic elites, people living in other countries and, those living prior to the major politico-economic transition. We used multivariable and multilevel mixed-effects Poisson regressions and estimated treatment effects via the regression adjustment of Poisson models.

Results
In most cases the choice of reference group did not matter but in some it did. Among men in Eastern European and Eurasian societies, those who compared themselves to their parents and their own families before the start of transition were less likely to report good health compared to those who did not compare their own economic situation with any specific reference group.

Conclusions
For some individuals, the choice of who to compare one’s situation with does seem to matter, pointing to an area for future investigation in research on psycho-social determinants of health.

Key messages
We found no difference in self-reported health between those who compare their situation with friends and neighbours, domestic elites, and people living in other countries. In post-communist countries, those who compared their situation to that of their parents and their own situation before the politico-economic transition were less likely to report good health.
Do poor health behaviors have an impact on the transition from sick leave to disability pension?
Authors: Svedberg P , Helgadóttir B , Mather L , Narusyte J , Ropponen A , Blom V 
Published: November 2019

Abstract

Background
High age, being a woman, and having low socioeconomic status are among the important risk factors for transitioning from sickness absence (SA) to disability pension (DP). But, little is known about the effect of poor health behaviors, although there are indications that poor health behaviors increase the risk of both SA and DP. The aims were to study the associations between three poor health behaviors (current smoking, high alcohol consumption and low physical activity levels) and DP among individuals who recently been sickness absent, and to explore whether having multiple poor health behaviors increased the risk of transitioning from SA to DP.

Methods
This prospective cohort study included 1991 twin individuals aged 20-46 who participated in a survey in 2005 and who had been on long-term SA in the two years preceding baseline (date of answering the survey) data collection of health behaviors (smoking, alcohol and physical activity) and relevant covariates. The participants were followed up for incident all-cause DP until the 31st of December 2012 (mean follow-up 5.2 years). National register data of SA and DP were used, and the association between each health behavior and DP was estimated using Cox proportional hazards regression analyses. The results are presented as Hazard Ratios (HR) with 95% Confidence Intervals (CI).

Results
Results showed that compared to never smoking, current smoking was associated with a higher risk of transitioning from SA to DP (HR 1.76, 95%CI 1.08-2.84). Alcohol use, lack of physical activity or having several poor health behaviors showed no significant associations.

Conclusions
Being a current smoker influences the risk of transitioning from SA to DP. Poor health behaviors are well established risk factors for poor physical and mental health. Hence, from a public health perspective it is important to emphasize the value of improving health behaviors in general but also among people with a history of SA.

Key messages
Many factors including health behaviors influence the risk of transitioning from sickness absence to permanent work incapacity in terms of disability pension. Supporting people on sickness absence to improve their health behaviors, e.g. smoking cessation, could be a promising approach to prevent exit from the labor market through disability pension.