bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quantitative Health Impact Assessment Methodology for Societal Initiatives: A Scoping Review
Authors: Reumers L M , Bekker M P M , Jansen M W J , Hilderink H B M , Ruwaard D 
Published: November 2019

Abstract

Background
Promoting health rather than treating disease is gaining popularity and promotion initiatives are increasingly situated in the societal domain. In this scoping review, the literature on quantitative health impact assessment (HIA) practice and methodology is explored in order to provide an overview of methods that have been used or proposed for estimating societal initiatives’ health outcomes.

Methods
Systematic searches were done in PubMed and Web of Science in order to identify relevant literature. A set of selection criteria ensured that studies held useful quantitative HIA methodology and a societal approach. Reference lists of all selected studies were then examined for other studies. After literature selection, quantifiable features of interest were recorded and general observations on the composition of the current literature were made.

Results
The literature selection process yielded 54 included studies, most of which focus on lifestyle-related determinants. Of different health outcome measurements, deaths (averted) was most frequently used, followed by life years and quality- and disability-adjusted life years. Equity is frequently mentioned, but not often estimated. Most studies made estimates based on simulation models, notably with Monte Carlo, Markov and system dynamics models (simulation period mean 46 years; median 50 years). Inputs for the models such as relative risks, transition probabilities and price elasticities were taken from census and register data, survey data, evidence from previous (scientific) studies and outcomes from stakeholder sessions.

Conclusions
HIA holds a wide range of practices with some overlap. Different methods’ strengths and weaknesses partly depend on the phenomenon of interest. Some policy types have standard approaches, but there is no one universal optimal method and therefore having a grasp of multiple methods is useful. Furthermore, estimating health effect distributions could make an important addition to HIA.

Key messages
Quantitative HIA can be conducted using various methodological bases and most studies use some form of simulation modelling. Different simulation methods are distinct, but do show some overlap. Quantitative HIA topics often relate to individual behaviour (micro-level proximal determinants). There is room for HIA method development for determinants with indirect connections to the individual.
Hospital contextual factors affecting the use of health technologies: a systematic review
Authors: Grossi A , Hoxhaj I , Gabutti I , Carini E , Pezzullo A M , Cacciatore P , Specchia M L , Cicchetti A , Boccia S , de Waure C 
Published: November 2019

Abstract

Background
Healthcare systems are facing great challenges due to increased share of aging population, growing health needs and economic restraints. To keep a high quality of assistance it is important to invest in health technologies (HTs) that have the potential of improving health outcomes. Even though a lot of guidance does exist on how HTs should be introduced, used and dismissed, there is a surprising gap in literature concerning the awareness of hospitals in the actual utilization of HTs, namely utilization in daily practice after formal adoption.

Methods
We performed a systematic literature review of qualitative and quantitative studies aimed at investigating hospital contextual factors that influence the actual utilization of HTs at hospital level. PubMed, Scopus, Web of Science, Econlit and Ovid were searched to retrieve studies published in English from 1st January 2010 to 31st May 2018.

Results
A total of 33 studies were included mostly addressing information and communication technologies (ICTs). Findings suggest that contextual factors that impact on actual utilization of HTs at hospital level are ascribable to four main families: financial factors, leadership styles, human resource management and hospital infrastructure. It emerges also that involving professionals at all levels and planning people’s work and competencies are major determinants of HTs actual utilization.

Conclusions
The evidence suggests that several contextual factors play a major role in HTs actual utilization at hospital level even though data are mostly referred to ICTs being the other HTs unexplored. Indeed, findings from this study suggest that numerous items should be evaluated when considering to use a new HTs at hospital level. Nevertheless, evidence regarding actual utilization of medical and surgical HTs is still lacking and future research is needed.

Key messages
Financial factors, leadership styles, human resource management, hospital infrastructure are relevant determinants of actual utilization of new HTs at hospital level. The evidence on contextual factors that influence actual utilization of HTs is mostly referred to ICTs and further research is indeed deserved.
Usefulness of the results of a surveillance program for uncompensated work-related diseases in France
Authors: Robert M , Fouquet A , Rivière S , Delezire P , Homère J , Garras L , Chatelot J 
Published: November 2019

Abstract

Background
French employees receive compensations for diseases officially recognized as professionnal disease. Reimbursment data are thus used to produce statistics. Such data do not integrate uncompensated work-related diseases (UUWRD) defined as likely to be of occupational origin but not recognized as well. In 2003, the National Public Health Agency implemented a surveillance program on UWRD. This program is a complement to the compensation system for occupational diseases.
This communication presents results UWRD program can provide.

Methods
Twice a year, a network of volunteer occupational physicians (OP) reports ill health and associated work exposures of employees. Employee sociodemographics are notified. In 2018, half of French regions are integrated in the program.
Prevalence rates are calculated for UWRD. Chi-squared tests are used to compare prevalence rates between groups. Multivariate logistic regressions are conducted to evaluate:1- risks to report UWRD between groups, 2- prevalence rates trends. Underreporting rates of UWRD are approximated using an indicator capturing differences between figures produced by UWRD program and the compensation system.

Results
Over the 2009-2014 period, women working in mass food retail were observed at higher risk to present musuculoskeletical disorders than women of other sectors (ORa = 2.0). Same results were noted for men (ORa = 1.3). In mass food retail, decreases in musculoskeletal disorder prevalence rates were reported. Estimated average annual change rates were of 7.0 % for women and 11.0% for men. In 2011, UWRD data highlighted that between half and three-quarter of work-related musculoskeletal disorders were unreported by the compensation system.

Conclusions
UWRD data are used to identify vulnerable groups, analyse temporal trends and evaluate underreporting of professionnal disease.

Key messages
URWD program is a complement to the compensation system and let to better monitor health status of communities. Such informations are of interest to guide prevention policies.
Longitudinal analysis of work-family conflict and self-rated health among working parents in Germany
Authors: Borgmann L S , Rattay P , Lampert T 
Published: November 2019

Abstract

In the wake of a rising labor market participation of women and changing and family arrangements, parents are increasingly faced with the challenge of reconciling work and family life, which can lead to work-family conflicts (WFC). The present study examined the longitudinal effect of WFC on self-rated health among working parents in Germany.
The data was drawn from wave 6 (2013) and wave 8 (2015) of the pairfam family and relationship panel. It included working persons living together with at least one child (662 mothers and 529 fathers). Pairfam is a random sample of about 12,000 persons drawn from German habitants in private households. Data was collected via computer-assisted personal interviews with yearly follow-ups. The drop-out rate of the panel from wave 1 to wave 8 is 62%. Self-rated health was measured as a single item with five response options. Using logistic regressions, we estimated the longitudinal effects of the effect of WFC in wave 8 on self-rated health. Moderating effects of education and household income were considered. The analyses were adjusted for self-rated health in wave 6.
The odds ratio for poor self-rated health for mothers who developed WFC in wave 8 compared to mothers who did not report a conflict in both waves was 2.6 (95% CI: 1.47-2.41). For fathers with newly emerged WFC in wave 8, the odds ratio was 2.1 (95% CI: 1.08-3.80). Interaction of WFC with education and household income showed a weak non-significant effect on the self-rated health of mothers and fathers. The health of parents who reported a conflict in wave 6 but not in wave 8 was on a similar level as the health of parents with no conflict in both waves.
The results point out that WFC can lead to a decline of self-rated health. Further investigations should be carried out to determine groups who are particularly affected by health-related outcomes of WFC. It also remains to be discussed how self-rated health can be improved e.g. through reconciliation policies.

Key messages
Work-family conflict leads to a poorer self-rated health of working parents in Germany. The health of working parents with lower education and income is affected more severely by work-family conflict compared to parents with higher education and income.
Individual- and company level determinants of vocational rehabilitation: a multilevel study
Authors: Laaksonen M , Rantala J , Liukko J , Polvinen A , Varis J , Kesälä M , Kuivalainen S 
Published: November 2019

Abstract

Backround
Vocational rehabilitation (VR) is considered an important means to combat work ability problems and enable people to continue working despite health problems. We examined the magnitude of company level variation in VR and determined which individual- and company level characteristics are associated with access to VR due to mental disorders, musculoskeletal diseases, and other somatic diseases.

Methods
A 30% random sample of all Finnish private sector companies with more than 10 employees aged 25-62 years at the end of 2010 (5.567 companies with 300.601 employees) was followed up for incident VR for six years. Company size and industry, as well as gender, age, education, social class and sickness absence measured both at the individual- and company level, were used as explanatory variables in multilevel logit models.

Results
After controlling for the individual level covariates, companies accounted for 12% of the variance in VR. The proportion was largest in VR due to musculoskeletal diseases. VR was more common among women, older employees (except the very oldest age group), those with low education (particularly due to musculoskeletal diseases), low social class, and previous sickness absence. VR was more common in larger companies, and in construction and in health and social work, and less common in professional activities. VR was more common in companies with low proportion of highly educated employees and with higher sickness absence rates.

Conclusions
Company level variation in VR was substantial after controlling for individual level characteristics of the employees. The employer may have an important role in the prevention of work disability through vocational rehabilitation.

Key messages
Company level variation in vocational rehabilitation was substantial after controlling for individual level characteristics of the employees. The employer may have an important in the prevention of work disability through vocational rehabilitation.
Physicians’ use of information from sickness certification guidelines: A nationwide Swedish survey
Authors: Svärd V , Alexanderson K 
Published: November 2019

Abstract

Background
Sickness certification guidelines, introduced in Sweden 2007, are to support physician’s work with sickness certification of patients. Our aim was to explore the clinical importance of the guidelines, by studying what kind of information from guidelines the physicians use, and if this differ between type of clinics.

Methods
Data from a questionnaire sent to all 34 718 physicians in Sweden in 2017 were used (54% response rate). The study is based on answers from the 13 750 physicians who had sick-leave consultations.

Results
Half of the respondents used the guidelines at least once a month, and this was most common in primary healthcare (72%), occupational health services (64%) and psychiatry (61%). The type of information used differed; 53% used recommendations about suggested sick-leave duration and 29% about degree (full- or part-time) of sickness absence. Using information about function respectively work capacity was more common within psychiatry (42 and 42%), primary healthcare (37 and 38%) and occupational health services (35 and 41%) and less common among physicians in surgery and orthopaedic clinics (12 and 12%) who more often used information about duration (48 and 53%). In total, 74% reported that the guidelines to some extent were problematic to apply while 29% reported that they improved the quality of how they handled sickness certification tasks. Half (47%) experienced that the guidelines facilitated their contacts with patients.

Conclusions
The use of sickness certification guidelines varied between type of clinic and a majority experienced to some extent that the guidelines were problematic to apply. Further studies are needed to assess what information physicians in different settings need and what developments of the guidelines that are warranted.

Key messages
Half of the physicians used the sickness certification guidelines every month, but the type of information used varied with type of clinical setting. As many as half of the physicians stated that the sickness certification guidelines facilitated their contacts with patients, but a majority found them somewhat problematic to apply.
Determinants of managerial preventive actions in relation to common mental disorders at work
Authors: van de Voort I W H , De Rijk A , Hensing G , Bertilsson M 
Published: November 2019

Abstract

Background
Managers may prevent Common Mental Disorders (CMDs) among their subordinates due to their authority to influence the work environment. Yet, their perspective has received only limited attention in research. This study aims to increase managers’ capacity to contribute to the prevention of CMDs by exploring the determinants of two managerial preventive actions: ’reviewing assignments and the work situation’ (MPA-review) and ’taking initiative to talk about depression and anxiety at work’ (MPA-talk).

Methods
An online survey was sent to 4,737 Swedish managers, aged 20-65 years (71% participated, n = 3,358) in 2017, of which 2,921 were included as they answered the MPA-items. Ten possible determinants of MPAs, comprising person-, work-, and competence-related characteristics of managers were related to performing MPAs (yes or no). Bivariate and multivariate binary logistic regression was performed to test associations (OR with 95% CI) between each determinant and MPAs. We have adjusted for experience-related characteristics of managers and company size.

Results
50% of managers initiated MPA-review and 57% MPA-talk. Managers had a higher odds to initiate respectively MPA-review and MPA-talk when being female (OR 1.42, 95% CI 1.17-1.73; OR 1.33, 95% CI 1.08-1.64), working in organizations offering lectures on CMDs (OR 1.36, 95% CI 1.01-1.83; OR 1.84, 95% CI 1.30-2.60) or stress counselling (OR 1.79, 95% 1.46-2.20; OR 1.53, 95% CI 1.22-1.91), having responsibility for the work environment (OR 1.42, 95% CI 1.15-1.74; OR 1.44, 95% CI 1.16-1.79), or having had received training on CMDs (OR 1.56, 95% CI 1.27-1.93; OR 1.61, 95% CI 1.28-2.03).

Conclusions
Managers report taking more actions to prevent CMDs in their workforce when they are female, have received training on CMDs or work in organisations where CMD preventive measures have been implemented.

Key messages
Organizations could invest in company-wide preventive measures and training to enable MPAs. Managerial education should include information on CMDs in order to improve managers’ preventive capacity.
Occupational diseases in self-employed workers in France
Authors: Latil F , Neme B 
Published: November 2019

Abstract

Background
In France, self- employed workers receive disability benefits, but are outside of the specific legislation protecting employees from occupational accident and diseases. Physicians are generally not aware of this shortcoming and ask for occupational diseases benefits, as they do for salaried employees. The health fund of independent workers (HFIW ), dismiss the application, which is uphold by law, but can be a threat to the patient, if it shutters hope for other available benefits. Our aim was to see if the request for occupational diseases was related to significant disability in self-employed workers, and if such a disability could be handled by available benefits from HFIW. This survey could be instructive for countries without occupational diseases frame for self-employed workers.

Methods
A prospective study was conducted on self-employed claimants applying for occupational disease, from June 2015 to September 2017, with an 18 month period follow-up, in the Ile- de- France region. A questionnaire was sent to the claimant and the data were completed through a phone call or appointment. The main outcome was the number of claimants qualifying for disability benefit available at the HFIW.

Results
148 claimants were identified and 141 (95%) matched with the occupational diseases legal setting. The causative agents were close to those observed in employed workers: musculoskeletal, asbestosis. Disability allowance, complete or partial, could be provided by the HFIW because his criteria were met in 38 claimants(27%);benefits for asbestosis exposure were possible through a specialized body in 16 claimants(11%).

Conclusions
The occupational disease request from self-employed workers matched with medical conditions granted by the HFIW, or external social bodies. This screening should be routinely implemented by nurses or any insurance officer.

Key messages
Self-employed workers are outside of the specific legislation protecting employees from occupational accident and diseases but 27% of them may apply for other disability benefits. The occupational disease request from self-employed workers dismiss an application but match with available disability benefits from the Independent health fund and should be routinely screened.
Predicting occupational exposure to trace metals from welding by non-air monitoring based models
Authors: Omrane F , Gargouri I , Khadhraoui M , Elleuch B , Zmirou-Navier D 
Published: November 2019

Abstract

Mathematical models for estimating occupational exposure to chemicals were developed as a promising alternative to air monitoring that is pricey and sometimes unavailable. Still, models parameters are derived from former air monitoring. Contrarily, our study aims to calculate all parameters independently of monitoring data. We implemented this approach to assess exposure in welding plants. Then, prediction abilities are evaluated by comparison with air measurements.
The Near Field-Far Field (NF-FF) model seeks to give accurate exposure estimation near an emission source. One workplace includes Shielded Metal Arc Welding (SMAW) worker T1 who is in the NF. The other contains induction welding (IW) T2 and packaging workers T3 who are in NF and FF, respectively. The emitted metals are identified from materials compositions. Ventilation rates are calculated by the anemometer technique. Emission rates are calculated using the emission factor method for SMAW and mass balance method for IW, solely based on literature, materials quantities and their compositions. To evaluate the match between measured (6 replicates) and predicted levels, we checked their correlations and tested the mean differences of paired values.
T1 is exposed to Al, Cu, Ni, Cr and Pb, while T2 and T3 are exposed to Al, Cu, Ni, Cr and Zn. A strong correlation was found (r = 0.78, p = 0.008) for NF predictions and air measurements. The T-test was significant, confirming that NF predictions and measured levels are quite close.
In contrast, our approach did not succeed to predict the FF exposure (insignificant correlation), which is probably due to the mobility of T3.
Non-air monitoring based models showed good effectiveness to predict the exposure levels close to emission sources for SMAW and IW processes. Thus, to assess health risks or to evaluate compliance with workplace air standards, our modeling approach that is time and cost saving, can be adopted as a support tool or even an alternative to air monitoring.

Key messages
With a view to assess occupational exposure, non-air monitoring based models, that are time and cost saving tools, showed good prediction abilities for trace metal levels near welding emission sources. The use of non-air monitoring based models would help to control the working environment of occupationally exposed populations to welding fumes, which is useful to comply with air quality standards.
Direct access physiotherapy for patients with musculoskeletal disorders: a systematic review
Authors: Demont A , Bourmaud A , Kechichian A , Desmeules F 
Published: November 2019

Abstract

Background
Although the benefits of physiotherapy is well supported in the literature, the impact of having direct access to physiotherapy is not well established. Update of the current available evidence is warranted. The aim of this systematic review was to update the current evidence regarding the impact of direct access physiotherapy compared to usual care for patients with musculoskeletal disorders.

Methods
Systematic searches were conducted in 5 bibliographic databases up until May 2018. Two independent raters reviewed studies and used the Quality Assessment Tool for Quantitative Studies to conduct the methodological quality assessment and a data extraction regarding patient outcomes, adverse events, health care utilization and processes, patient satisfaction and health care costs.

Results
Sixteen studies of weak to moderate quality were included. Five studies found no significant differences in pain reduction between usual family physician led care and direct access physiotherapy. However, three studies reported better clinical outcomes in patients with direct access in terms of function and quality of life. Five studies did not observe any adverse events with direct access physiotherapy. Three studies showed shorter waiting time and four studies reported fewer number of physiotherapy visits with direct access. Three studies showed that patients with direct access were less likely to have medication and imaging tests prescribed compared to usual care. Five studies reported higher levels of satisfaction for direct access. In terms of health care costs, four studies demonstrated that costs were lower with direct access and one study reported similar costs between both types of care.

Conclusions
Emerging evidence, although of weak to moderate quality, suggest that direct access physiotherapy provides equal or better outcomes than family physician led care models for musculoskeletal disorders patients. More methodologically strong studies are needed.

Key messages
This review supports the efficacy, safety and cost-effectiveness of direct access PT, while increasing access to care with a more efficient use of resources. There is a need for more methodologically strong studies to evaluate the efficiency of direct access models of care of physiotherapy for patients with MSKD.