bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combined Lifestyle Intervention to reduce overweight at the workplace: opinions of stakeholders
Authors: Beurskens P , Houkes I , Norder G , de Rijk A 
Published: October 2023

Abstract

Background
Overweight is a risk factor for employee health and sustainable employability. Multifactorial interventions, addressing both the employee's individual lifestyle and the work environment, are expected to be most effective in overweight reduction. In the Netherlands, primary care patients with overweight are referred to Combined Lifestyle Interventions (CLI), but this is not yet common in occupational health. This study explores the attitudes, intentions and perceived facilitators and barriers of three groups of stakeholders (employees, employers and occupational physicians (OP's)).

Methods
A cross-sectional survey focusing on attitudes, barriers and facilitators was conducted among a convenience sample of, varying in age and gender, Dutch OPs (n = 267), employers (n = 401) and employees (n = 1,023) in 2021/2022.

Results
Preliminary results indicate that 32% of the employers would offer CLIs if accessible and 25% of the overweight employees intend to participate in a CLI. For employers, the main reasons to offer a CLI were reduction of sick leave (42%) and good employment practice (37%), barriers were the conviction that employees would not be interested (33%), lack of finance (21%) and lack of time (21%). Employee's main reason for attending was boost for good lifestyle (27%), facilitators were alignment with working hours (24%) and employer's payment for the CLI (25%). Barriers were ‘I already do enough for my health’ (22%). The main barriers for OPs to refer to a CLI were lack of knowledge (66%) and a preference for known professionals (40%), while a facilitator was having more time during their consultations.

Conclusions
Although not yet common in the Netherlands, a relative large portion of participating employers is willing to invest in lifestyle interventions to reduce overweight. The shared barrier of lack of time needs to be tackled in combination with strengthening of attitudes and facilitators to achieve a successful CLI implementation.

Key messages
• Employers are willing to invest in a combined lifestyle intervention to reduce or prevent employee’s overweight.
• Implementation requires sufficient time for referral and participation, employers to pay and OPs to be informed about the combined lifestyle intervention.
The role of multidimensional health patterns over time in older workers' labor force participation
Authors: Gut V , Baumann I , Gabriel R , Fredriksson D , Fritzell J 
Published: October 2023

Abstract

Background
A non-negligible share of workers is affected by adverse health at the end of their careers. While many of them drop out of the labor force, others remain, prompting the question of how various health indicators interact to influence these different pathways. Therefore, we investigate the effect of multidimensional health patterns on labor force participation among older workers.

Methods
We used six-year-longitudinal data from 5007 older workers (Mean age: 55.8 years; 55.9 % female) from the Survey of Health, Ageing and Retirement in Europe. First, we conducted a latent transition analysis with four indicators (chronic diseases, limitations with activities, perceived health, and depression) to identify multidimensional health patterns. Second, we examined individual change in these patterns over time and their association with workers’ job situations and changes in work hours four years later using Wald-tests.

Results
We identified four multidimensional health patterns with high structural stability over time (ranging from &lt;.005 to .25): (1) Overall healthy workers, (2) workers with moderate activity limitations and low perceived health, (3) overall unhealthy workers, and (4) physically healthy workers with low perceived health and depressive symptoms. Furthermore, individuals predominantly remain in the same pattern over time, except for pattern (4), where 56% of the individuals transition to pattern (1). Moreover, we found differences between the patterns in job situation (p &lt; .001) and changes in work hours (p &lt; .001) four years later with patterns (2) and (4) showing the greatest reduction in working hours.

Conclusions
The high rate of transitions from the pattern (4) to the more favorable pattern (1) may be explained by the relatively high potential for recovery from depression. Our findings suggest that interventions among older workers with depressive symptoms and moderate activity limitations may improve their chances to remain in the labor force.

Key messages
• We identified four largely stable multidimensional health patterns over time.
• Older workers with moderate activity limitations and low perceived health reduced their work hours most strongly.
The prevalence of Sudden Cardiac Death among workers: a systematic review and meta-analysis
Authors: Corona V F , Amantea C , Pilia E , Gualano M R , Moscato U , Ricciardi W 
Published: October 2023

Abstract

Background
Sudden cardiac death (SCD) is one of the main causes of death worldwide, and it continues to be a significant public health concern. In Europe, the prevalence of sudden cardiac death differs between countries and populations; it is estimated to account for approximately 20% of all deaths. However, there are few data regarding the prevalence of SCD among employees. This systematic review and meta-analysis aim to investigate the prevalence of this phenomenon in workers and recommend potential interventions and preventive measures that could be implemented in the workplace to reduce the risk of SCD in employees.

Methods
A systematic review and meta-analysis was performed on three databases: PubMed, Scopus, and Web of Science, according to the PRISMA statement. There were no time restrictions placed on the evaluation of English-language source documents. Using the Egger regression model, publication bias was evaluated. A forest plot was used to demonstrate the pooled prevalence of Sudden Cardiac Death in workers. STATA Software/MP, version 14.1 was used for the statistical analyses.

Results
The initial search resulted 1,408 relevant articles across all three databases; after removing duplicates and filtering the abstracts, the full texts of 23 articles were reviewed, and 17 were excluded due to a wrong outcome. Six articles were subsequently included in the systematic review and meta-analysis. A proportional meta-analysis was carried out on the 6 included studies and the pooled prevalence of Sudden Cardiac Death in employees was 17.48% (95% CI: 6.70-31.91%).

Conclusions
SCD is a severe and potentially preventable illness that can affect employees and cause fallout from European and global health policies. We can reduce the incidence of SCD and enhance the cardiovascular health and well-being of workers by identifying and addressing work-related risk factors, providing appropriate screening and interventions, and promoting healthy lifestyle behaviors.

Key messages
• Promote a healthy lifestyle in the workplace, such as regular physical activity, healthy eating and stress reduction techniques, at European and global level.
• Implement, in European countries and worldwide, screening strategies during health surveillance visit, such as performing ECGs or specialist cardiology consultations, for the work population at risk.
Shielding healthcare workers: the impact of workplace discrimination on workforce health
Authors: Martin A , Jamieson S 
Published: October 2023

Abstract

Aims
To understand the impacts of shielding on junior doctors (JDs) in Scotland during the COVID-19 pandemic.

Methods
11 JDs and 2 consultants took part in qualitative individual semi-structured interviews (September-November 2022). Reflexive thematic analysis was used to analyse the data. The local Research Ethics Committee confirmed ethical approval was not required (‘not research’ letter given).

Results
‘Negativity and stigmatisation’ were discussed by 82% of JDs, with one JD being told that providing reasonable adjustments would set a ‘bad precedent'. Several were threatened with punitive action including dismissal. Other themes included ‘overlooked and undervalued’ as 73% described their contribution as being dismissed or unrecognised and had to ‘pester’ their supervisors for work. All JDs reported inadequate support at workplace and Occupational Health levels. Mental health impacts included guilt, anxiety, and isolation. Consultant interviews were consistent with these themes and provided insight into supervisory challenges including not receiving guidance or resources, and ongoing issues supporting disabled and pregnant JDs.

Discussion
These findings offer novel insight into the experiences of shielding from a JD and supervisor perspective. This ‘natural experiment’ revealed that the support infrastructure available to JDs in Scotland with disabilities and during maternity didn't withstand the pressures upon it or was absent entirely. These findings are in line with existing literature in this area and reflect a concerning paucity of support for these JDs, and a wider culture of stigmatisation and workplace maternity and disability discrimination impacting workforce health. Particularly in the current climate of widespread burnout and a recruitment and retention crisis in healthcare, the medical community stand to lose a lot if they don't recognise the reality of a diverse workforce, where all healthcare workers are given the support they need to thrive.

Key messages
• The infrastructure for supporting junior doctors with disabilities, health issues, and during maternity in Scotland is insufficient.
• These findings indicate concerning workplace maternity and disability discrimination impacting part of the healthcare workforce in Scotland.
Hospital mortality after acute myocardial infarction- really an indicator of quality of acute care?
Authors: Stolpe S , Kowall B , Werdan K , Zeymer U , Bestehorn K , Weber M A , Schneider S , Stang A 
Published: October 2023

Abstract

Introduction
‘AMI 30-day-mortality using unlinked data’ is reported by OECD as indicator for quality of acute care. It relates to hospital mortality after acute myocardial infarction (AMI, ICD-10: I21-I22). AMI hospital mortality in Germany is among the highest in Europe - indicating major problems in quality of acute care. In contrast, Germany ranks high on health expenditure and availability of cardiologists and PCI facilities. We explain these contradictory findings.

Methods
Literature and public health reports on AMI patient characteristics, acute care, patient registration and healthcare organisation were reviewed. OECD indicators ‘AMI 30-day-mortality using unlinked data’ and ‘average length of stay after AMI’ for European countries were downloaded for 2000-2019. The trend in AMI hospital mortality was described graphically. The influence of average length of stay (LOS) on AMI mortality was assessed by linear regression.

Results
Since 2000, AMI hospital mortality fell strongly. In 2019, it was 2.9% in the Netherlands, 3.2% in Norway, but 8.5% in Germany. Different patient characteristics or therapies do not account for the differences in mortality, but health care organization: 1. Day cases are not always included in OECD source data; 2. Average LOS is associated with AMI hospital mortality (R2=0.58) and is itself influenced by patient transfer frequency and reimbursement policy; 3. In centralised health systems, AMI patient transfers are more frequent. These factors reduce the registered AMI deaths or increase the number of cases, all resulting in lower hospital mortality.

Discussion
AMI hospital mortality is highly influenced by factors that are not related to acute patient care, but to health care organization and patient registration rules. AMI registries reporting hospital mortality include selected AMI patient populations, which hampers valid comparisons. European sentinel registries are needed to validly describe quality of acute care and outcomes in AMI.

Key messages
• OECD indicator ‘AMI hospital mortality’ does not allow valid conclusions on quality of acute care.
• AMI hospital mortality is strongly influenced by patient registration rules and healthcare organization, namely frequency of patient transfers and length of stay in hospital after AMI.
Long-term sickness absence among adults with ADHD: the role of psychosocial working conditions
Authors: Ontiveros N , Nevriana A , Almroth M , Falkstedt D , Pan K-Y 
Published: October 2023

Abstract

Background
Symptoms of Attention-deficit/hyperactivity disorder (ADHD) do not only occur during childhood but often persist into adulthood and affect individuals’ ability to work. Adults with ADHD compared to those without ADHD are at a higher risk of negative labour market outcomes, such as long-term sickness absence (LTSA). Identifying modifiable factors in the workplace such as psychosocial working conditions may be a plausible strategy to lower this risk. This study aimed to investigate the effect modification of job control and job demands on the risk of LTSA among adults with ADHD.

Methods
The study population consisted of around 3.7 million individuals aged 20-60 years in Sweden in 2009. Of them, 0.3% had a diagnosis of ADHD extracted from the national patient registers. LTSA was defined as having one sick-leave spell of 90 days or more between 2010-2020. Job control and job demands were measured using job exposure matrices. Multivariable Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of LTSA among adults with ADHD compared to those without. Stratified analysis was conducted to test the effect modification by job demand-control status.

Results
During the follow-up, 812,971 (22%) adults had LTSA. Both men and women with a diagnosis of ADHD were at a higher risk of LTSA (HR 1.75, 95% CI 1.68-1.82 and HR 1.61, 95% CI 1.55-1.68, respectively) compared to those without ADHD, after adjusting for demographics, previous LTSA, and other mental and somatic disorders. The increased risk of LTSA among adults with ADHD was present regardless of the levels of job control, job demands and job demand-control categories (HRs ranged from 1.55 to 2.10).

Conclusions
Adults with a diagnosis of ADHD have a higher risk of LTSA and job demand-control status does not seem to substantially modify this risk. Future studies identifying factors in the workplace that may potentially help prevent LTSA among adults with ADHD are highly warranted.

Key messages
• Adults with ADHD have a higher risk of LTSA regardless of the job demand-control status.
• There is an urgent need to identify factors that may help improve the work ability of this population.
The association between patient experiences in outpatient care and their characteristics in Slovenia
Authors: Murko E , Kralj M , Poldrugovac M , Ropret N , Zaletel M 
Published: October 2023

Abstract

Background
The aim of the cross-sectional study was to measure adult patients’ experiences in the outpatient specialist medical settings in the fields of neurology and neurosurgery, cardiology, ophthalmology, gynaecology and obstetrics, orthopaedics and oncology with radiotherapy, and explore the association between the general score of the healthcare service given by patients and their socio-demographic characteristics and health status.

Methods
The survey used mixed mode design (i.e. paper questionnaire and online survey), took into account various aspects of healthcare such as waiting period to the visit, admission, waiting time in the waiting room, physician work, nurse work, privacy, patient rights information, and familiarity with continuation of treatment. As part of the study, patients evaluated overall care at a specialist outpatient clinic on a scale of 0 to 10. The questionnaire used has been recently developed, based on a review of the literature and focus groups with patients. The questionnaire was also cognitively tested and piloted before national rollout. Multi-level regression analysis was used as the main method of statistical analysis.

Results
The national survey was conducted in autumn 2022. A total of 10,533 valid completed questionnaires from 210 specialist outpatient clinics were received. 82.4% of the surveyed patients rated the medical treatment with a score of 9 or 10 with the average rating 9.34. Preliminary statistical analysis indicates the presence of association between socio-demographic/health status variables on one hand and overall assessment of treatment on the other.

Conclusions
A possible association between socio-demographic and health status factors with overall score on specialist outpatient clinic rating calls for caution when comparing outpatient clinics that care for patients with different socio-demographic characteristics and health status.

Key messages
• There is an association between sociodemographic factors and health status of patients with overall score of healthcare experiences in specialist outpatient clinics.
• The association calls for caution when comparing outpatient clinics.
Trends in acute hospital smoking prevalence and support of campus ban in Dublin, Ireland (1997-2018)
Authors: Mattson A , Lyons A , Doherty K , Douglass A , Stynes S , Kerley M , Fitzpatrick P , Kelleher C 
Published: October 2023

Abstract

Background
St Vincent's University Hospital (SVUH), a major hospital in Dublin, Ireland pioneered a hospital smoke-free campus policy in 2009; pre/post this intervention it conducted periodic surveys of patients, staff & visitors for smoking prevalence and policy attitudes. As rates of smoking decline nationally in Ireland, it is important to monitor trends for at-risk groups, including lower socioeconomic status (SES).

Methods
Repeat questionnaires were administered by census surveys of inpatients, quota or random sub-sample surveys of staff, and quota surveys with outpatients and visitors between 1997 and 2018. As a proxy for social deprivation, the rate of inpatients eligible by income for the state-funded General Medical Services (GMS) card was assessed. Chi square test for trend and SPSS v.27 were used for analysis.

Results
Support for and awareness of the campus smoking ban increased steadily; post ban agreement varied by smoking status (64.7% smokers, 89.7% ex-smokers; 92.5% non-smokers, p = 0.002). Smoking rates declined in all groups but significantly in outpatients (19.5% vs. 10%; p &lt; 0.01), visitors (27.4% vs 9.5%; p &lt; 0.0001) and staff (30.0% vs 10.8%; p &lt; 0.0001). Rates of inpatient GMS entitlement was high at 54.2% average, compared with national rates of approximately 30% in 2021. Rates of smoking were non-significantly higher in GMS entitled inpatients (33.2% vs 26.8%; p = 0.09) across all survey periods.

Conclusions
While hospital smoking prevalence has decreased and campus ban support persists, the campus is not immune to challenges in keeping it smoke-free. There are many socioeconomically deprived patients who smoke; this in part may reflect a private hospital on the same campus where affluent smokers are more likely to attend. Recent national initiatives for free nicotine replacement therapy and targeted smoking cessation courses in deprived areas work to address inequalities. We are not aware of similar studies in a hospital population over 25 years.

Key messages
• Periodic hospital smoking surveys show trends in prevalence which mirror the falling national trends in Ireland.
• Socioeconomic differences persist in smoking rates among hospital patients.
Clustering users of healthcare, social and employment services: a register study from Finland
Authors: Blomgren J , Jäppinen S , Perhoniemi R 
Published: October 2023

Abstract

Background
Understanding the population's overall use of healthcare, social and employment services is important for comprehending service needs and improving the coordination of services. The aim of this exploratory study was to find separate groups in a working-age population based on individuals’ use of various healthcare, social and employment services during one year and to investigate sociodemographic and health-related predictors of user groups.

Methods
Administrative register data on the use of 22 distinct healthcare, social and employment services and on socio-demographic and health-related covariates from year 2018 were linked for all working-age residents of the municipality of Oulu, Finland (N = 119,740). K-means cluster analysis was used to group the study subjects into clusters, based on their yearly frequency of using each service. Multinomial logistic regression was used to assess the associations of sociodemographic and health-related covariates with cluster assignment.

Results
Five distinct clusters were identified, labelled ‘low to moderate users of healthcare’ (82%), ‘regular employment services users with moderate use of healthcare’ (10%), ‘supported employment services users’ (3%), ‘frequent users of healthcare, social and employment services’ (3%) and ‘disability and specialized services users’ (3%). Each cluster showed different patterns of service use and was also uniquely associated with sociodemographic and health-related covariates, reflecting distinct service user types.

Conclusions
The study identified five distinct groups of healthcare, social and employment services users in a working-age population. Knowledge of different user profiles and their determinants can help predict future need and use of services, coordinate and integrate services, and plan early interventions and prevention measures. This is important in order to save costs and improve the overall quality and effectiveness of services for groups with different care needs.

Key messages
• In terms of their use of healthcare, social and employment services, the working-age population can be classified into distinct groups, uniquely associated with various determinants.
• Understanding the population’s use of different services can help predict future needs and improve coordination, integration and effectiveness of services in groups with different needs.