bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interrupted time series analyses on the effect on integrated care among the older population
Authors: Agerholm J 
Published: November 2019

Abstract

Background
Current health and social care systems in most European countries, are highly fragmented into specialist services, and poorly designed to provide health and social care for patients with multiple health problems and social needs. As some groups of patients might have greater difficulties navigating in a fragmented and divided system than others, current system also risks increasing inequalities in access and use of health and social care services. The aim of this study is to investigate if a comprehensive integrated care system perform better than ‘standard care’ in regards to emergency department visits, hospitalization for ambulatory care sensitive conditions (ACSC), costs and re-admissions as well as increase equity in health care among older people.

Methods
This study is an intervention study based on a comparative interrupted time series design comparing data from Norrtälje, where an integrated care system was implemented in 2006, with other areas of Stockholm county with a standard care system. The time series consists of register data from 2000-2015, obtained from the Stockholm County Council’s administrative database of healthcare utilization and population data on socio-demographic characteristics from national registers.
Preliminary results
The preliminary results based on data from 2000-2011 suggest that the introduction of an integrated care system in Norrtälje did not affect the rate of hospitalization for ACSC, costs or rates of emergency department visits. When stratifying on income group we saw that the lowest income group did improve in some of the outcomes.

Conclusions
The integrated care system in Norrtälje seems to have no significant effect on the outcome measures included. Whether socioeconomic inequity was affected is still to be investigated further.

Key messages
In this study we used interrupted time series to investigate organisational changes in the health care sector. Introducing integrated care in Norrtälje seems to have little effect on register based outcome measures.
In-home monitoring evaluation by home-dwelling older adults, caregivers and healthcare providers
Authors: Pais B , Buluschek P , Nef T , Schütz N , Saner H , Gatica D , Santschi V 
Published: November 2019

Abstract

Background
In Europe, population ageing is increasing the healthcare needs and costs. Both frailty and chronic diseases affecting older people reduce their ability to live independently. However, most older people prefer to age in their own homes. New development of in-home monitoring can play a role in staying independent, active and healthy. Our objective was to evaluate a new in-home monitoring system among home-dwelling older adults (OA), their family caregivers (FC), and their healthcare providers (HCP) for the support of home care.

Methods
The system continuously monitored OA’s daily activities (e.g., mobility, sleep habits, fridge visits, door events) at home by ambient sensor system (DomoCare®) and health-related events by wearable sensors (Fitbit®, ECG). In case of deviations in daily activities (e.g., changes in mobility), alerts were transmitted to HCP via email. Using specific questionnaires, the opinion of 13 OA, 13 FC, and 20 HCP were collected at the end of 12-month of follow-up focusing on their user experience and the impact of in-home monitoring on home care services.

Results
These preliminary results underlined that the majority of OA, FC, and HCP consider that in-home sensors can help staying at home, improving home care, reducing family stress, and preventing domestic accidents. The opinion tended to be more favourable toward ambient sensors (80%) than toward Fitbit® (67%) and ECG (64%). On average, OA (80%) and FC (73%) tended to be more enthusiast than HCP (63%). Some barriers reported by HCP were a fear of weakening of the relationship with OA and an excessive surveillance.

Conclusions
Overall, the opinion of OA, FC and HCP were positive related to in-home sensors, with HCP being more mixed about their use in clinical practice.

Key messages
In-home monitoring technologies seem to be generally well accepted. In-home monitoring technologies could be help facilitating home care of older people.
Impact of a community respiratory service on emergency hospital admissions
Authors: Levin K , Anderson D , Milligan M , Crighton E 
Published: November 2019

Abstract

Background
A community respiratory service was implemented in the North West of Glasgow in January 2013, comprising a team of physiotherapists, occupational therapists and support workers, to provide education, self-management advice, and, where appropriate, treatment at home, for COPD patients, to reduce the risk of hospital admission. This study measures the impact of the service on emergency admission to hospital.

Methods
COPD EAs were defined as emergency admissions to hospital with a primary diagnosis of COPD. Rate of COPD EAs per 1000 population aged 65 years+ in Glasgow City was compared before and after onset of the service, using segmented linear regression with 21-month pre- and 17-month post-intervention periods. COPD EAs for residents of South and North East Glasgow (S+NE) - areas with no such service in place - were used as a comparison group. The model adjusted for the rate of all-cause emergency admissions. Autoregressive terms were included in the model, as well as a fourier term to adjust for seasonality. Models were similarly run for outcome emergency admissions with COPD in any of the other five fields of diagnosis.

Results
Adjusting for all cause EAs and changes in S+NE, thus factoring out the impact of other initiatives that may have affected emergency admission to hospital, the impact of the service was found to be a level change of -0.33 (-0.51, -0.16) and a trend change of -0.03 (-0.05, -0.02) COPD EAs per 1000 per month. This is equivalent to a predicted reduction due to the service of -0.88 COPD EAs per 1000 popn per month, in March 2015, and a relative reduction of 35.8%. Rate of COPD EAs per month reduced over time after the introduction of the service (from the point of full staffing). Rate of EAs with COPD in a field of diagnosis other than primary saw no significant change in level or trend associated with the service.

Conclusions
The community respiratory service was associated with a significant reduction in the rate of COPD EAs.

Key messages
The Community Respiratory service was associated with reductions in emergency hospital admissions with COPD as a primary diagnosis. There was no significant change in emergency admissions with COPD as a secondary diagnosis, suggesting hospital attendance for patients with COPD overall reduced following the intervention.
Energy drink consumption pattern among university students in North East England
Authors: Visram S , Ananthakkarasu V 
Published: November 2019

Abstract

Background
Energy drinks (EDs) are popular beverages with young people, particularly in the UK. There is an emerging evidence base on the negative health impacts in children and adolescents, largely relating to the high caffeine and sugar contents of these drinks. However, no studies have been conducted to date focusing on university students in the UK. The purpose of this study was to investigate factors underpinning ED consumption, as well as health effects reported by students.

Methods
An online survey was conducted with a non-representative sample of 900 students from the five universities in the North East of England. This included questions on ED consumption, perceived stress (10-item PSS), general health status, personal wellbeing (ONS4), lifestyle and use of other substances such as alcohol. Responses were analysed using SPSS.

Results
84% of respondents (n = 756) had consumed EDs at least once, mainly while partying or during revision. Of these ED consumers, 542 (71.7%) reported experiencing symptoms following intake, with the most common being elevation of heart rate and palpitations. No associations were found between ED consumption and perceived stress or wellbeing, but an inverse U-shaped association was observed with self-reported health (i.e. lowest consumption among those who rated their health as either “very good” or “bad”). Consumers were more likely to be male, White, from the UK, less affluent backgrounds, and report having no religion. Co-consumption with alcohol was common in the cohort (46.2%). Those who used substances such as cigarettes, e-cigarettes and cannabis were also more likely to be ED consumers.

Conclusions
ED consumption is highly prevalent in the student population, linked to socioeconomic and cultural factors rather than perceived stress or wellbeing. Prevention campaigns targeting students should aim to raise awareness of the consequences of chronic and acute ED consumption, particularly in conjunction with other substances.

Key messages
ED consumption is highly prevalent in the student population, often in conjunction with alcohol. Consumption is linked to socioeconomic and cultural factors rather than perceived stress or personal wellbeing.
Community infrastructure to boost social relations: a systematic review
Authors: Bagnall A , South J , Southby K , Di Martino S , Pilkington G , Mitchell B , Pennington A , Corcoran R 
Published: November 2019

Abstract

Background
‘Boosting social relations’ in communities has been identified as a priority UK policy-related topic. An earlier scoping review identified evidence gaps in social relations & community infrastructure. We undertook a mixed method systematic review on this topic, which has potential for immediate practical impact.

Methods
A comprehensive search included 11 databases (1997-2017), grey literature and citation checking. Studies of interventions to improve or make alternative use of community or neighbourhood places, reporting outcomes of social relations, community wellbeing & related concepts were included. Established validity checklists. Qualitative data was synthesised thematically and a narrative synthesis was produced. GRADE and CERQual approaches were used to rate the overall strength of evidence for each outcome.

Results
51 included studies, mostly of poor to moderate quality, and mostly qualitative, provided moderate evidence that: Community hubs may promote social cohesion, increase social capital and build trust, widen social networks, increase interaction, and increase knowledge or skills;Changes to neighbourhood design may positively affect sense of belonging and pride in a community;Green and blue space interventions that provide the opportunity to participate in activities or meetings may improve social interactions, increase social networks, bonding and bridging social capital, physical activity and healthy eating, and improve people’s skills and knowledge.
There were also common themes relating to facilitators and barriers to successful interventions.

Conclusions
There is moderate evidence that a range of intervention approaches to community infrastructure can boost social relations and community wellbeing. Future research should prioritise high quality evaluations using repeated measures and validated tools, and robust and credible qualitative evidence.

Key messages
There is moderate evidence that a range of intervention approaches to community infrastructure can boost social relations and community wellbeing. Community hubs may promote social cohesion, increase social capital and build trust, widen social networks, increase interaction, and increase knowledge or skills.
School environment and obesity in primary schools. An analysis of the WHO European COSI in Austria
Authors: Aufschnaiter A , Schindler K , Fuchs-Neuhold B , Maruszczak K , Pail E , Sulz I , Weghuber D 
Published: November 2019

Abstract

Background
Overweight and obesity in childhood and the associated secondary diseases are constantly on the increase. Studies show that the school environment can have an influence on the weight of children. The Childhood Obesity Surveillance Initiative (COSI) of the WHO is a Europe-wide epidemiological monitoring of anthropometric sizes of school children aged six to nine, with Austria participating in COSI for the first time in 2016.

Methods
A retrospective secondary data analysis based on two standardized questionnaires was performed. On the one hand, data on determinants specific to the school field were collected, on the other hand anthropometric data of children in third grade were measured. Across Austria, data from 97 schools and 2530 children were collected and evaluated using descriptive and inductive statistical methods.

Results
In 43,3 % of the schools, an existing playground can be used outside school opening hours. 73,2 % of the schools integrate nutrition education into their school curriculum either as a separate subject or in combination with another subject. Milk and dairy products are available in 60,8 % of schools, fresh fruit in 63,9 % and vegetables in 51,5 %.
28,3 % of the examined, 8 to 9-year-old children are overweight or obese (n = 658), while boys have a significant higher BMI than girls (p &lt; 0,001). Also, in urban areas children have a significant higher BMI on average than in rural areas (p = 0,025). No significant relationship could be identified between the duration of physical education lessons per week and the BMI. However, a significant difference in childreńs BMI became visible when school playgrounds were also accessible outside opening hours (p = 0,018).

Conclusions
The alarming number of overweight children in Austria should be diminished through policies and further interventions. Schools can make a substantial contribution to this. The course of the development could be closely observed through possible further surveys by COSI.

Key messages
73,2% of the schools include nutrition education in their curricula. Yet, about every third Austrian child aged between 8 and 9 is overweight, with boys being significantly more overweight than girls. If school playgrounds are accessible outside opening hours, the childreńs BMI is significantly lower. In urban areas, children have a significantly higher BMI than in rural areas.
Use of voice messaging via mobile phone to communicate female adolescents in Bangladeshi urban slum
Authors: Shah M , Rahman K , khondker H 
Published: November 2019

Abstract

Problem
Utilization of available maternal health services is comparatively low among adolescent population in Dhaka urban slum areas and lack of adequate knowledge is one major contributor to low service utilization among slum dwelling adolescent mothers.

Description of problem
Dhaka urban slum dwelling female adolescents are difficult to reach adequately with health messages through traditional home visit by community health workers for counseling, because many of these adolescents in Dhaka urban slums have a job outside home. We designed and implemented an innovative health communication intervention “Health Boost” - an approach to provide reproductive, maternal and newborn health information for married female adolescents using the voice message system on mobile phone.

Methods
We delivered ‘Health Boost’ (HB) voice messages to enrolled married adolescent girls, twice a week, with re-listening option. Pregnant and non-pregnant participants received separate sets of messages. Enrollment was started after baseline survey (September 2016) and continued during October 2016 - April 2017. Pregnant participants received messages at least for 6 months before delivery. For evaluation, we followed pre-post observation study design and had the endline survey in November 2017.

Results
Comparing HB non-receivers at baseline (n = 321) and HB receivers at endline (n = 45), statistically significant improvement was revealed for knowledge on danger signs - (a) during pregnancy (55.5% vs. 93.3%; p &lt; 0.001), (b) during child delivery (54.2% vs. 82.2%; p &lt; 0.001), (c) for newborn (56.7% vs. 75.6%; p &lt; 0.02). We also found significantly higher utilization of service among HB receivers: Utilization of antenatal care increased from 70.4% to 87.5% (p &lt; 0.02); and use of postnatal care increased from 31.6% to 73.7% (p &lt; 0.03).

Lessons
‘Health Boost’ messages were instrumental and effective to increase knowledge and service utilization among married adolescent girls in Dhaka urban slum areas.

Key messages
Voice message is an innovative way to reach hard-to-reach population by using mobile phone technology. Voice messages were instrumental and effective to increase knowledge and service utilization among urban female adolescent population, for reproductive, maternal and newborn health.
Work stress, migration background and risk of long-term sickness absence in Denmark
Authors: Rugulies R , Sørensen J K , Madsen I E H , Nordentoft M , Sørensen K , Framke E 
Published: November 2019

Abstract

Background
Work stress may increase risk of long-term sickness absence, but little is known if this association differs by migration background. In this study, we examined the prospective association between effort-reward imbalance at work and risk of long-term sickness absence in individuals with and without migration background in the Danish workforce.

Methods
We included 59,468 respondents from a nationwide survey on work and health, 3,226 with a migration background (immigrants or first generation descendants of immigrants) and 56,242 without a migration background. Effort-reward imbalance was assessed by self-report. Migration background and long-term sickness absence (spells ≥6 weeks) were assessed by national register data. Using Cox regression, we estimated the association between effort-reward imbalance and onset of long-term sickness absence during 12 months follow-up separately for participants with and without a migration background, adjusted for age, sex, education and previous long-term sickness absence.

Results
The effort-reward imbalance score at baseline was similar for respondents with and without a migration background. The hazard ratio for long-term sickness absence during follow-up per 1 standard deviation increment in effort-reward imbalance at baseline was 1.26 (95% CI: 1.16-1.37) and 1.16 (95% CI: 1.13-1.20) for respondents with and without a migration background, respectively.

Conclusions
Work stress, measured by effort-reward imbalance, is associated with an increased risk of long-term sickness absence in workers with and without a migration background in Denmark. Although the estimate was higher in workers with a migration background, confidence intervals overlapped indicating that associations were similar in both groups. The results suggest that prevention activities on effort-reward imbalance and long-term sickness absence should not be prioritized by migration background but should be offered to the whole workforce.

Key messages
Work stress, measured by effort-reward imbalance, is associated with an increased risk of long-term sickness absence in workers with and without a migration background in Denmark. The results suggest that prevention activities on effort-reward imbalance and long-term sickness absence activities should be offered to the whole workforce.
Socioeconomic differences in paid sickness allowances in Finland
Authors: Blomgren J , Jäppinen S , Pekkala J , Rahkonen O 
Published: November 2019

Abstract

Background
Receipt of sickness allowance (SA), which in the Finnish benefit system functions as compensation for loss of income due to over 10-days-long sickness absence, is more prevalent in lower socioeconomic groups. As SA is an earnings-related benefit and higher occupational classes have on average higher previous income, their share of SA expenditure must be higher than their share of SA days would suggest. However, the allocation of SA costs to different socioeconomic groups is not known. The aim of this study was to compare occupational classes in terms of their shares of total paid SA days and SA benefit costs.

Methods
We used register data covering the total working-age (16-64) employed population of Finland at the end of 2016 (N = 2.2 million), with linked data on paid sickness allowances during 2017. Yearly accumulated sickness allowance days and allowance costs, paid by the Social Insurance Institution of Finland, were calculated for upper and lower non-manual employees, manual workers and self-employed persons.

Results
Of the total yearly SA days of the employed population, 13% were paid to upper non-manual employees, 40% to lower non-manual employees, 37% to manual workers and 10% to the self-employed (the respective shares of these occupational classes of the employed population were 23%, 36%, 30% and 11 %). The average gross allowance was 77€ per day among upper non-manuals and between 54€ and 60€ in the other groups. Accordingly, upper non-manuals accounted for a larger share of the SA costs compared to their share of SA days: the proportions of costs were 16%, 39%, 36% and 9% in each occupational class, respectively.

Conclusions
The results show that as the average amount of daily sickness allowance is distributed in an opposite manner compared to the prevalence and length of sickness allowance spells, socioeconomic differences in sickness allowance costs are smaller than differences in the prevalence of sickness allowance.

Key messages
Upper non-manual employees have a lower prevalence of sickness absence and shorter spells than other occupational groups. Because of higher earnings-related sickness allowance among upper non-manual employees, their share of sickness allowance costs is higher than their share of sickness allowance days.
Organizational climate and work commitment as predictor of 10-year registered sickness absence
Authors: Knapstad M , Lissner L , Bjorkelund C , Holmgren K 
Published: November 2019

Abstract

Background
Early identification of persons at risk for sickness absence offers an opportunity to put in place preventive measures in the future. The Work Stress Questionnaire (WSQ) is specifically designed to identify people at risk for sickness absence due to work-related stress. In this study we examine prospective associations between work-related stress as measured by the WSQ and registered sickness absence up till 10 years later among employed and self-employed women in the general population in Gothenburg.

Methods
This is a survey-linkage study based on the 2004-05 wave of the Swedish “Population Study of Women in Gothenburg (PSWG)” and 10-year follow-up in the MiDAS sickness absence register. Participants registered as employed or self-employed were included (n = 396). Outcomes were number of sickness absence episodes during follow-up and sickness absence during each two-year time band of follow-up.

Results
High perceived stress due to poor organizational climate, compared to low stress, gave an adjusted Incidence Risk Rate (IRR) of 1.99 [95% CI 1.19-3.34] for sickness absence episodes. Combining high perceived stress due to poor organizational climate with high perceived stress due to work commitment gave an IRR of 2.32 [95% CI 1.26-4.26]. Examining separate time periods, similar associations were found during years 5-6 and 7-8. Perceived low influence at work also gave increased odds for sickness absence, at both in the shorter term (1st-2nd year) and longer term (7th-8th year).

Conclusions
The findings align with previous studies that WSQ may successfully identify women with elevated risk for future sickness absence, and adds that this is even true in a general population context and using a very long follow-up period. Nevertheless, the findings should preferably be confirmed using a larger sample to improve precision of the observed associations.

Key messages
The present study contribute with knowledge about screening instruments that may identify women in the general working population with elevated risk for sickness absence. The findings suggest that high perceived stress due to organizational climate, alone and in combination with high work commitment, as well as low influence at work, increase risk of sickness absence.