bluuebunny/crossref_metadata_2025_split huggingface dataset:
Job demands & control among employees in Sweden aged 55-64 and labour market status 11 years later
Authors: Farrants K , Alexanderson K 
Published: November 2019

Abstract

Background
As discussions about extending working lives are ongoing, more knowledge is warranted on how psychosocial working conditions are associated with labour market status in older age.

Aim
Among employees aged 55-64 years, explore associations between job demands/control with their labour market status 11 years later, using a job exposure matrix (JEM).

Methods
A population-based prospective cohort study using nationwide register data. All 616,818 individuals in Sweden who in 2001 were in paid work and aged 55-64, were categorized using JEM into 9 groups, based on tertiles. They were followed up in 2012 regarding their labour market status (main income from: paid work, old-age pension, marginalised (no income/social assistance), sickness absence &gt;183 net days, emigrated, dead) using multinomial logistic regression for odds ratios (OR) and 95% confidence intervals (CI), controlling for labour market status and sociodemographics in 2001. Analyses were stratified by sex.

Results
The majority (women: 84.9%, men: 80.3%) had main income from old-age pension at the 11-year follow-up; 4.7% from paid work (women: 3.9%, men: 5.6%). Those initially in jobs with high demands were less likely to be marginalised at follow-up (OR women high demands/medium control 0.51, CI 0.38-0.68, high demands/high control 0.68, CI 0.50-0.92; OR men high demands/medium control 0.55, CI 0.31-0.96, high demands/high control 0.47, CI 0.30-0.73). Those in occupations with low demands were less likely to be in paid work (OR women low demands/low control 0.56, CI 0.51-0.62, low demands/medium control 0.63, CI 0.58-0.69; OR men low demands/low control 0.56, CI 0.51-0.63, low demands/medium control 0.63, CI 0.58-0.69).

Conclusions
High job demands with high job control among people aged 55-64 in 2001 were associated with higher rate and OR of having main income from paid work in 2012, and high job demands regardless of level of job control were associated with less marginalisation.

Key messages
Levels of job demands when aged 55-64 were associated with labour market status 11 years later for women and men, while levels of job control were less so. High job demands were associated with a higher likelihood of being in paid work and lower likelihood of being marginalised at the end of follow-up.
Health inequality and self-employment in South Korea
Authors: Kim HyeJin , Min Jin-Young , Min Kyoung-Bok 
Published: November 2019

Abstract

Background
Self-employed persons work for themselves as owners of a business rather than for an employer. Although self-employed persons have autonomy and flexibility, they are vulnerable to workplace health and safety hazards. However, there has been little interest in the health of self-employed persons, especially in small business owners. This study investigated the health status of small self-employed business owners compared to standard workers.

Methods
The third Korean Working Conditions Survey for a total of 32,630 workers aged 20-59 were analyzed. A small business was defined as self-employment with 0-4 workers. Standard employment included full-time employment with a permanent or one-year contract. Health outcomes included the presence of depressive symptom and 8 types of physical health; hearing problems, skin problems, backache, muscular pains (upper limbs), muscular pains (lower limbs), headaches/eye strain, injuries, and overall fatigue.

Results
Among 32,630 workers, 10,652 (32.64%) were small business self-employed. Compared with standard employed workers, small business self-employed had a 1.2-fold [adjusted OR (Odds Ratio) =1.20, 95%CI (Confidence Interval) 1.09-1.32] increased likelihood for depression after adjustment for potential covariates. Small business self-employed was at higher risk of work-related physical health problems: backache (OR = 1.16, 95%CI 1.06-1.26), muscular pains in upper limbs (OR = 1.19, 95%CI 1.12-1.27), and muscular pains in lower limbs (OR = 1.14, 95%CI 1.07-1.22).

Conclusions
Our study found health inequality of small business self-employed, showing higher odds for mental and physical health problems in small business self-employed than in standardly employed workers.

Key messages
The current study showed vulnerability of self-employed in small business to health problems. Our study would be helpful to build up better working environment for small business owners and improve occupational health inequalities in South Korea.
Prenatal care: missed opportunity for HBV prevention in women of childbearing age in rural Senegal
Authors: Djaogol T , Coste M , Marcellin F , Diallo A , Carrieri P , Boyer S ,   and the ANRS 12356 AmBASS Study Group
Published: November 2019

Abstract

Background
Perinatal transmission of hepatitis B virus (HBV) constitutes an important risk in highly endemic countries including Senegal. Although the prevalence of chronic HBV infection is estimated at 11% in this country, specific data on women of childbearing age are sorely lacking. We described in this study the prevalence of the HBV antigen (HbsAg) in women of childbearing age in rural Senegal, as well as general knowledge on HBV and hepatitis B status awareness.

Methods
A cross-sectional study including HBV screening was conducted at home in the rural Niakhar area. Chronic HBV infection was determined through HBsAg detection using dried blood spots. Socio-demographic and behavioral data were collected through standardized face-to-face questionnaires. The analyzes included 368 women aged 15-49 (67% married; 65% with at least 1 child) enrolled from October 2018 to March 2019.

Results
Preliminary results show that 49 women (13%) had positive HBsAg. Only 68 women (18%) have already heard about HBV. Among them, 53% knew that there exists an HBV vaccine and 78%, 75% and 67% correctly answered that HBV can be transmitted through blood contact, childbirth and sexual intercourse, respectively.
Among the 233 (63%) women who had already given birth, 76% had attended at least 4 antenatal care sessions and 74% had given birth in a healthcare facility for their last pregnancy. However, only 1% reported to have already been screened for HBV. Main reasons reported for not having been screened were having never heard about this test (80%) and not having been offered screening during antenatal care sessions (10%).

Conclusions
General knowledge and awareness of HBV status are particularly low in women of childbearing age living in rural Senegal, despite high antenatal care sessions attendance. Given the high prevalence of chronic HBV infection found in this population, it is urgent to ensure systematic HVB screening and to provide adequate information to women during pregnancy.

Key messages
The prevalence of chronic HBV is high in women of childbearing age in Senegal. National recommendations for women attending antenatal care sessions should include HBV screening and counselling.
Does the over-medicalisation of pregnancy help to improve neonatal outcomes?
Authors: Kundisova L , Nante N , Cuccaro C , Mariottini E , Alaimo L 
Published: November 2019

Abstract

Introduction
The over-medicalization of pregnancy is frequent, especially in high-income countries and comports unnecessary costs for health systems. In Italy the national health service guarantees access to health care services, but still a lot of pregnant women search for private health care. This study aimed to analyse if the over-medicalization of pregnancy had an impact on neonatal outcomes.

Methods
The cross-sectional study was conducted in Siena (Italy), data were extracted from medical records. All women that gave birth between January 2016-May 2018 and were classified as “low/moderate risk” pregnancy were included. Examined variables were: age, number of obstetrics and ultrasound (US) visits (≤9/≥10), timing of the first visit (&lt;12weeks/&gt;12weeks of pregnancy), health facility (public/private), previous spontaneous abortions (SA) or voluntary interruptions of pregnancy (VIP). The outcome variables were preterm birth (PB) and admission in neonatal intensive therapy unit (NITU). Analysis was performed with Stata 12.

Results
A total of 2392 women were included; 22% with≥10 obstetrics visits; 19% with≥10 US visits; 87% had the first visit before 12 weeks of pregnancy and 57% were followed by a private healthcare facility. Six percent of babies were born preterm and 11% were admitted in NITU. The PB condition appeared associated with SA (OR:2.4, 95%CI 1.6-3.6 p &lt; 0.001) and VIP (OR:1.8, 95%CI 1.2-2.8 p &lt; 0.005).
Admission in NITU was associated with previous VIP (OR:1.4, 95%CI 1.01-2.03 p &lt; 0.05) and PB (OR:2.16 95%CI 1.37-3.41 p = 0.001). Multiple logistic regression identified only PB as associated with this outcome.

Conclusions
Neonatal outcomes do not show association with number of obstetric/US visits and the type of health facility. It seems that controlled pregnancy does not help to reduce the risk of adverse events as premature birth or admission in intensive therapy.

Key messages
The over-medicalization of pregnancy is frequent, especially in high-income countries and it has an important impact on health-related costs. More controlled pregnancy does not help to reduce the risk of adverse events as preterm birth and necessity of recovery in neonatal intensive therapy unit.
Individual and process factors influencing user’s satisfaction with Housing First services
Authors: Loubiere S , Tinland A , Boucekine M , Girard V , Auquier P 
Published: November 2019

Abstract

Objectives
Housing First models aim to give homeless with severe drugs and mental health problems a permanent home and assertive care team support. Concern persists that user satisfaction and retention rate are key values in the evaluation of such inclusive-care programs, to secure good outcomes. The aims of this study were 1) to explore user’s satisfaction with Housing First services, and 2) to determine individual or contextual factors influencing user’s satisfaction.

Methods
Based on the French Un Chez Soi d’Abord sample, we analysed data from homeless people with severe mental problems assigned to the Housing First and followed during 3 years. Measures included team tracking frequency, service users’ needs, and a Client Satisfaction Questionnaire (CSQ-8). Generalized estimating equations were used with a random effect for site to identify relevant baseline confounders for the CSQ score.

Results
At 36-month follow-up, 131 HF participants completed the services user’s needs and CSQ-8 questionnaires. 94% were still housed. Respondents reported needs from the HF team for managing housing (74%), administrative assistance (63%) and mental illness (43%). The mean total CSQ-8 score was 25.6 (SD = 5.2) out of 32. Four predictors of a higher CSQ score were: higher frequency of visits (regression coefficients 8.2), lower user’s education (-2.2), ever been a tenant (1.4), and suffering of schizophrenia disorder (0.9) (p&lt;.001).

Conclusions
The users’ perception of the quality of HF services appears to be high. Our results underscore the interaction of individual and process factors influencing user satisfaction. These findings suggested that HF intervention in France is a promising strategy for high quality of services to homeless people with mental illness.

Key messages
He users’ perception of the quality of Housing First services appears to be high. Housing First intervention in France is a promising strategy for high quality of services to homeless people with mental illness.
The Public Health Implications of Brexit: A Health Impact Assessment Approach
Authors: Green L 
Published: November 2019

Abstract

On March 29th 2019, the United Kingdom (UK) was due to exit the EU in a process known informally as ’Brexit’. This exit and entry into a 2-year transition is a period of unprecedented political and social upheaval - with many unknowns and much uncertainty attached to the outcomes and future impact.
In preparation for Brexit, Public Health Wales commissioned the Wales HIA Support Unit to carry out a health impact assessment of Brexit in Wales to support and inform its and other public bodies planning and future work.
This paper examines the unique HIA carried out between July and December 2018 on the impact of the UK withdrawal from the EU in Wales. It discusses the robust, participatory process undertaken, the stakeholders involved and the benefits reaped from this. It highlights the evidence gathered and analysed including the collection methods, the complex nature of the work and disseminates the main findings from the HIA including the potential determinants of health and population groups identified.
Finally, it describes the challenges faced, how these were overcome, and the huge benefits, impact and influence it has had to date across a wide range of UK and Welsh organisations and public bodies. This work demonstrates continued leadership in the field of impact assessment and spearheads the requirement for public bodies to carry out HIAs as part of the forthcoming statutory requirements of the Public Health (Wales) Act 2017 an can inform practice at a global level.

Key messages
HIA can inform and influence action in response to important strategic decisions. The Brexit HIA is a unique example which can inform international HIA practice.
Determinants of frequent use of primary care in the German healthcare system
Authors: Rommel A 
Published: November 2019

Abstract

Background
In Germany, patients are consulting general practitioners increasingly frequently, resulting in a high burden on the healthcare system. This study aimed to identify factors associated with frequent primary care attendance in the German healthcare system.

Methods
The German Health Interview and Examination Survey for Adults (DEGS) is part of Germany’s national health monitoring, and includes a large representative sample of the German population aged 18-79 years. We defined the 10% of participants with the highest number of physician contacts in the preceding 12 months as frequent attenders. Binary logistic regression models with average marginal effects were used to identify determinants for the frequent use of primary care services.

Results
The sample comprised 7,956 participants. Significant effects on frequent use of primary care were observed for low socioeconomic status, stressful life events, and factors related to objective need for medical care and subjective health status. In the full model, the number of non-communicable diseases and subjective health status had the strongest effect on frequent primary care use. We found an interaction effect between subjective health status and number of non-communicable diseases, indicating the association of disease with frequent use was highly moderated by subjective perception of health.

Conclusions
We observed strong associations between frequent primary care attendance and objective and subjective health-related factors. These findings suggest that better coordination of care may be a preferred method to manage health services utilization behaviour and avoid redundant examinations and uncoordinated clinical pathways. Further research is needed to clarify moderating and mediating factors contributing to high utilization of primary care services.

Key messages
The number of NCDs diseases and subjective health had the strongest effect on frequent primary care use. The findings suggest that better coordination of care may be the preferred method to manage health services utilization.
Healthcare Workers’ attitudes towards mandatory influenza vaccination: a systematic review
Authors: Corezzi M , Gualano M R , Voglino G , Olivero E , Rossello P , Bert F , Siliquini R 
Published: November 2019

Abstract

Background
Influenza affects approximately between 5 to 10% of general population every year, leading to 3 to 5 million cases of severe illness, and about 290 000 to 650 000 respiratory deaths. Healthcare Workers (HCWs) play a crucial role in spreading the infection to patients. Although the strong recommendations provided, influenza vaccination coverage rates among HCWs are globally well below the coverage target set by WHO. The aim of this study is to assess attitudes towards mandatory influenza vaccination programs among HCWs, in order to make a quantitative synthesis of the phenomenon.

Methods
The present study systematically reviewed published cross-sectional studies investigating attitudes towards compulsory influenza vaccination in Healthcare Workers. PubMed and Scopus scientific databases were searched and 4,198 results were returned. Of these, 23 met the inclusion criteria for the review and 13 were eligible for the meta-analyses. PRISMA statements were followed.

Results
Thirteen studies were conducted in North America, 4 were conducted in Europe, 3 in Asia, 2 were performed in Australia and one study collected data both from Europe and Asia. According to the assessed studies, the percentage of agreement ranged from 44% to 95% for different compulsory vaccination programs. A combined prevalence of 59.8% (95%CI 50.1-68.8) was found in the meta-analysis. Having been vaccinated against influenza in the previous year increases the likelihood (OR 4.1; 95%CI 2.8-6.1) of being in favour of mandatory vaccination policies.

Conclusions
Compulsory influenza vaccination programs are generally accepted by the majority of health professionals, especially by those who have already been vaccinated previously. These results could be important to improve European vaccination strategies, in order to increase influenza vaccination rates among Healthcare Workers.

Key messages
Mandatory influenza vaccination programs are accepted by the majority of Healthcare Workers. Having been previously vaccinated against influenza increases the likelihood of being in favor of a mandatory vaccination policy.
Frailty as predictor for all-cause and cause-specific mortality: 11-year follow-up cohort study
Authors: Dorner T E , Grabovac I , Mogg C , Oberndorfer M , Haider S 
Published: November 2019

Abstract

Background
Frailty is a geriatric syndrome characterised by sarcopenia, malnutrition, and chronic inflammation that leads to adverse health outcomes including dependency, low quality of life, and higher risk for morbidity and mortality. It was the aim of this study to examine the relationship between frailty status and risk of all-cause and cause-specific mortality.

Methods
The study is based on data from the Survey on Health, Aging and Retirement in Europe (SHARE) including 11 European countries with an 11-year follow up. 24,634 participants with a mean age of 64.2 (9.8) 53.6% female, were analysed. Frailty status was calculated using the SHARE- Frailty Instrument, categorizing the participants as robust, pre-frail, and frail. Cox Proportional Hazard models were used to estimate the risk of all-cause and cause-specific (stroke, heart attack, other cardiovascular disease, cancer, respiratory illness, infectious, digestive and other) mortality in frail and pre-frail subjects compared to robust persons.

Results
14.7% and 6.9% were found to be pre-frail or frail at the baseline. During the follow-up, we observed both pre-frailty and frailty being associated with a higher risk of all-cause and cause-specific mortality in the unadjusted model. After adjusting for sex, age, education level, body mass index, smoking, alcohol consumption and a number of comorbidities, frailty was associated with a higher risk of all-cause mortality [HR 1.56 (95% CI 1.37-1.78)], and mortality due to other cardiovascular diseases [HR 1.88 (95% CI 1.27-2.76)], cancer [HR 1.47 (95% CI 1.14-1.90)], and respiratory disease HR [1.82 (95% CI 1.10-3.01)]. Furthermore, pre-frailty was associated with a higher risk of all-cause mortality [HR 1.27 (95% CI 1.14-1.42)] and other cardiovascular disease mortality [HR 1.70 (95% CI 1.22-2.35)].

Conclusions
Our study showed that baseline pre-frailty and frailty are associated with increased all-cause and cause-specific mortality over an 11-year follow up.

Key messages
Frailty but also pre-frailty leads to a higher mortality, even when adjusted for morbidity, lifestyle factors, and socio-demographic factors. More effort is needed to prevent, detect, and treat frailty and pre-frailty, both, on individual and on community level.
Final clinical practicum of nursing education and transition experience of new nurses
Authors: Kaihlanen A-M , Elovainio M , Salminen L , Haavisto E , Sinervo T 
Published: November 2019

Abstract

Background
Challenges in transitioning from a student to a registered nurse may contribute to new nurses high turnover rates. Final clinical practicum (FCP) before graduation is known for its importance in preparing students for the transition but little is known about the specific elements of FCPs essential for successful transition. We examined the associations between multiple FCP elements and transition experiences in new nurses and whether work characteristics modified these associations.

Methods
The data were collected in 2018 with electronic survey. The sample comprised 712 Finnish nurses graduated within the last two years. Linear regression analyses was used to examine the association of five FCP elements (Preparing for demands; Being part of team; Systematicness of FCP; Teacher involvement; Quality of supervision) with the transition experience that was measured with four scales demonstrating its emotional, physical, socio-developmental and intellectual domains. Work characteristics were defined based on demand-control -model and multiple potential confounders were considered.

Results
Several associations were found between the FCP elements and the four transition indicators (psychological distress, sleep problems, role conflict/ambiguity and perception of transition/educational preparation). Systematicness of FCP was, however, the only element associated with all the transition indicators, whereas quality of supervision was not associated with any. Multiple interactions were also detected between the FCP elements and job demands.

Conclusions
Our results suggest that FCP experiences reflect to new nurses’ first years of employment. Especially systematic planning and implementation of FCP, collegial work atmosphere and an opportunity for students to become an active member of the work community should be ensured for promoting a smoother transition from student to nurse. This could increase the chances to retain new nurses in the health care workforce.

Key messages
Well planned and implemented final clinical practicums with an opportunity to become an active member of professional team could help nursing students to obtain a smoother transition into nurses. The benefits of having a good final clinical practicum experience may be squandered if considerably high level of job demands (e.g. timepressure) is experienced in the first years of employment.