bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lung cancer screening by low-dose CT among asbestos-exposed workers: first results of a pilot program
Authors: Heidrich J , Wolff C , Centmayer A , Wiethege T , Duell M , Taeger D , Harth V 
Published: November 2019

Abstract

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

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

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

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

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

Abstract

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

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

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

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

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

Abstract

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

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

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

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

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

Abstract

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

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

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

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

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

Abstract

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

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

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

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

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

Abstract

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

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

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

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

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

Abstract

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

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

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

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

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

Abstract

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

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

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

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

Key messages
Spending on prevention is relatively low compared to total spending on healthcare. Relatively little money for health protection.
Evaluation designs of outpatient health centres focusing on vulnerable patient groups
Authors: Winkler R , Reinsperger I 
Published: November 2019

Abstract

Background
Homeless and non-insured persons experience worse physical and mental health than comparable populations. Outpatient (public) health institutions, which are easily accessible, contribute considerably to the medical treatment of vulnerable patient groups. Sound evaluation methods, indicators and instruments are necessitated to target patients’ needs and to enable strategic health and social policy planning.

Methods
We conducted a systematic literature search in several databases (PubMed, EMBASE, PsycINFO etc.) for studies from 2000 to 2019 reporting on evaluations in outpatient health institutions for homeless and/ or non-insured patients. In addition, we contacted 5 Austrian public health/ research institutions dealing with complex interventions for relevant publications.

Results
12 evaluation studies and 7 evaluation reports met our inclusion criteria. Evaluation designs mostly considered various target groups and nearly all assessments pursued a ’mixed-method’ approach. 13 publications assessed socio-demographic data, 11 the use of health and social services and 7 patients’ health status. Further indicators related to ’satisfaction issues’ such as patients’ satisfaction with the provided range of health and social services (n = 7). 6 publications reported on health economic indicators. In total, 7 out of 19 studies reported on evaluation instruments; most instruments (n = 6) were on patients’ mental health status.

Conclusions
Patients represented the major target group in the included evaluations. There is little research on evaluation indicators directing on health professionals. Evaluations focusing on the intersectional levels (e.g. the impact of health programmes for vulnerable groups on various institutions) are lacking.

Key messages
Evaluation designs involving ‘hardly to reach populations’ shall consider a ‘participatory assessment approach’ to avoid drop-outs and to create a trustworthy evaluation situation. Hence, evaluation indicators shall be commonly selected and adequately reflect patients’ realities.
The experience of patients and family caregivers during Hospital-at-Home in France
Authors: Rossinot H , Marquestaut O , De Stampa M 
Published: November 2019

Abstract

Background
Public health policies tend to generalize the use of Hospital-At-Home (HAH) to answer the growing will of patients to be treated or to die at home. HAH is a model of care that provides acute-level services in the patient’s home with the interventions of variety of health care professionals. Relatives participate also in the interventions by helping for sick patients at home, but we lack data on the care of patients and caregivers in HAH. The aim of this study was to make an inventory of the experiences of patients and family caregivers in HAH.

Methods
The research was qualitative using nineteen semi-directed interviews from nine patients and ten caregivers of one care unit of Greater Paris University Hospitals’ HAH, and the grounded theory was used to analyze the transcripts. Caregivers were also asked, after the interview, to fill in the Zarit Burden Inventory.

Results
HAH remained mostly unknown for patients and caregivers before the admission proposition and the outlook of being admitted in HAH was perceived as positive, for both of them. Caregivers had a versatile role throughout HAH, leading to situations of suffering, but also had sources of support. The return home was considered satisfactory by both caregivers and patients, related to the quality of care and increased morale despite HAH’s organizational constraints. We noted an impact of HAH on the relationship between the patient and the caregiver(s), but caused by multiple factors: the fact that the care takes places at home, its consequences but also the disease itself.

Conclusions
HAH strongly involved the patient’s caregiver(s) all along the process. HAH’s development necessitates to associate both patients and caregivers and to take into account their needs at every step. This study highlights the need to better assess the ability of the caregiver to cope with his or her relative in HAH with acute and subacute care at home.

Key messages
Health care services need to take into account family caregivers. Hospital at home services should be developped worldwide.