bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sick at work and future sickness absence - a prospective study of two measures of sickness presence
Authors: Hansen C D , Dalgaard L , Winding T N , Andersen J H 
Published: October 2023

Abstract

Background
Sickness presence (SP), or going to work despite being ill, is a common way of practicing sickness absence (SA). However, its consequences for long-term SA are poorly understood, and there is no consensus on how to measure SP. This study aims to examine the consequences of SP on long-term sickness absence (&gt;14 days) using two different measures.

Methods
Data from a Danish public human service organization were analyzed, with approximately 2400 employees answering questionnaires in November 2019, yielding a response rate of 50%. Information on SA, work environment, self-reported health, SP episodes, and sociodemographic information were included in negative binomial regression models. The outcome variable was prospective episodes of SA (&gt;14 days) taken from the SA register of the organization. Two different ways of measuring SP were used: a traditional measure of overall SP frequency and a measure of going to work with specific symptoms (fever, cold, headache, musculoskeletal pain).

Results
Participants who reported SP frequency of more than 10 times during the last 6 months had a two-fold risk of long-term SA (IRR: 2.19 (95%CI 1.09-4.58)) in the follow-up period. This risk remained significant even after adjusting for work environment factors, sociodemographic factors, self-rated health, and spells of sickness absence in the previous year. Going to work with fever (IR: 1.43) or cold (IR: 1.48) was also associated with long-term SA in the follow-up period.

Conclusions
SP may negatively impact employees’ health status and increase long-term sickness absence. Health professionals should be aware of the negative consequences of focusing solely on reducing short-term sickness absence especially if they inadvertently encourage employees to substitute sickness presence for sickness absence.

Key messages
• Going to work despite having ill health is common but may have adverse health consequences and lead to long-term sickness absence.
• Focusing narrowly on reducing short-term sickness absence might be a bad idea for public health. Employees might feel encouraged to go ill to work which could increase future sick leave.
Introducing outdoor office work to reduce stress among office workers in Sweden
Authors: Javan Abraham F , Andreasson P , King A , Bälter K , Toivanen S 
Published: October 2023

Abstract

Background
Office workplace stress is concerning as it leads to adverse and chronic health outcomes. Outdoor office work (OOW), an innovative practice may address these challenges as being outdoors has potential benefits. This study aims to assess stress among office workers that are working in their normal indoor office compared to practicing OOW and identifying facilitators and barriers for doing OOW.

Methods
In a feasibility study, 9 office workers were asked to work indoors the 1st week and OOW for at least 30 minutes per day during the 2nd week. They wore a heart rate variability (HRV) monitor (FirstBeat BG3) for 2 weeks while at work to assess objective stress. Subjective stress was assessed via daily surveys using a scale of 1 to 10 from “not stressed at all” to “very stressed”. They were instructed to use the app “Our Voice Discovery Tool” to take photos of facilitators or barriers to practicing OOW.
Subjective stress data was analysed using paired sample t-test in SPSS 28. Photos were categorised into themes. Analysis of HRV time and frequency parameters is underway.

Results
Preliminary findings show statistically significant decrease in stress scores between week 1 (M = 4.42, SD = 1.43) and week 2 (M = 3.74, SD = 1.31) t(7)=1.91, p=.049 (one-tailed), mean decrease in self-rated stress was .68 with a 95% confidence interval ranging from -.12 to 1.43. The Cohen's d (.67) indicated a medium effect size. Picture analysis revealed themes related to “convenience/comfort”, equipment/facilities”, and “weather” as barriers. Out of 76 pictures, most themed “nature”, both indoor and outdoor, were marked as positive experiences.

Conclusions
Reduction in subjective stress from week 1 to week 2 suggests OOW's potential as useful method to reduce work-related stress. Picture analysis suggests, to ensure a healthier milieu for office workers, conditions conducive to OOW such as outdoor work facilities and green spaces in offices’ vicinity may need to be facilitated by employers.

Key messages
• Outdoor office work (OOW) may reduce workplace stress, potentially improving employee health, well-being, and productivity.
• Employers should facilitate outdoor workspaces and green areas to promote healthier office environments.
Identification and evaluation of cases of polypharmacy and irrational pharmacotherapy in Georgia
Authors: Gabunia L , Ratiani L , Gorgaslidze N , Sanikidze T , Gvishiani M , Gumbaridze L , Rukhadze L , Rtveladze T , Iosebidze T , Varazi G 
Published: October 2023

Abstract

Background
Medical practice sometimes involves the prescription of multiple medications (5 or more) at once, known as polypharmacy. Most frequently it occurs when a patient receives care from multiple doctors as a result of poly morbidity. The study aimed to identify polypharmacy cases (prescribing 5 or more than 5 medications) and irrational pharmacotherapy.

Methods
Polypharmacy and irrational pharmacotherapy cases in Georgia from 1 July to 30 September 2021 were evaluated using an electronic prescription system. The total number of polypharmacy was 7665, where 5 or more medications were prescribed. Out of 7665 cases, 612 (8%) were irrational pharmacotherapy that was assessed according to Beers criteria (American Geriatrics Association, 2015) and STOP/START criteria (recommendations of the Great Britain National Health Organization, NHS, 2014).

Results
Out of 612 cases 95 (15.6%) indicated irrational prescription (2 or more drugs) containing the same active ingredient under different trade names, which represented 1.2% of the total number of prescriptions; out of 612 cases 72% (440) and 5.9% out of a total number of cases the simultaneous appointment of drugs of the same and/or similar pharmacological group was detected. In 9.4% of cases (57) non-rational pharmacotherapy (an incompatibility of drugs) was revealed that was 0.8% of the total cases; out of 612 cases 20, or 3%, and 0.3% of the total cases showed that the prescription contained more than 2 antibiotics.

Conclusions
Medical polypharmacy is widespread in Georgia, especially in co-morbid elderly patients, which further increases their morbidity and mortality rates. The obtained results could be used to increase the efficiency of treatment, improve the population's health and reduce treatment costs.

Key messages
• The selection drug or combination of drugs is a complex process and requires justification of the appropriateness of the prescription for a particular patient.
• A major goal of the best clinical practice is to optimize the use of medical preparations, improve quality of life and reduce expenses on drugs.
Knowledge and use of ICT-based coordination mechanisms in three regions of Spain
Authors: Campaz D , Vargas I , Pomar J , Sanclemente C , Bulilete O , Ortuño R , Ogueta M , Cots F , Plaja P , Vázquez M L 
Published: October 2023

Abstract

Background
Although there is a consensus on the potential benefits of information and communications technology (ICT) based mechanisms to improve cross-level clinical coordination, their introduction varies greatly among regions and services. The aim is to analyse the knowledge and use of digital coordination mechanisms and the factors related to the use in the health services of three autonomous communities (ACs) of the Spanish national health system.

Methods
Cross-sectional study based on an on-line survey by means of self-administration of the COORDENA-TICs questionnaire to primary and secondary care doctors of the health services in Catalonia (CAT) (n = 2277), Balearic Islands (BI) (n = 441), Basque Country (BC) (n = 572). Outcome variables: Knowledge and use of digital coordination mechanisms and difficulties of use. Explanatory variables: sociodemographic, labour-related, contextual, organizational, and interactional factors. Descriptive and multivariate analysis were performed to compare the ACs.

Results
There were some differences between the ACs: the access to and use of ICT-based coordination mechanisms in BI was limited, with the electronic health record (EHR) being the most available but infrequently used, whereas in BC and CAT there was wide access to and use of the EHR and virtual consultations between levels. In all three ACs common difficulties in EHR use emerged such as, technical problems, disorganized and/or insufficient information. Different contextual, organizational, and interactional factors were associated to their use in all three ACs.

Conclusions
There were differences in the type and level of implementation of ICT-based coordination mechanisms between the ACs that can be related to organizational and contextual factors, that should be further analysed. Addressing the relevant factors in each context should contribute to design effective strategies based on ICT-based coordination mechanisms to improve cross-level clinical coordination.

Key messages
• Implementation and use of ICT-based coordination mechanisms differed across the three ACs and could be related to differences in contextual and organizational factors in each context.
• It is necessary to explore factors and difficulties related to the use of these mechanisms to develop more effective strategies to improve their use and hence impact on clinical coordination.
Gender and citizenship disparities in the COVID-19 vaccination campaign in Italy
Authors: Marconi D , Arniani S , Magi S , Cotoloni C , Moscatelli C , Nisticò F , Golinelli D , Nante N 
Published: October 2023

Abstract

Background
The literature identifies several cultural, religious, and gender-related factors associated with vaccine hesitancy. To guide a fair and more effective vaccination campaign, we investigated the association between these factors and adherence to COVID-19 vaccination in the 815,000 population assisted by the Local Health Authority (LHA) of Tuscany South-East, Italy.

Methods
Anonymized data on the vaccination status of patients (≥5 years) assisted by the LHA from December 2020 to January 2022 were extracted from the Health Information System of Collective Prevention. We evaluated vaccination coverage (≥2 doses, also considering any previous or subsequent infections) by age, gender and nationality. We performed logistic regression with STATA/MP13, setting the significance level at p &lt; 0.05.

Results
Adherence to vaccination was significantly lower among foreign patients (68.1% vs 86.6% p &lt; 0.01); after adjusting for age and nationality, a significantly lower propensity to vaccination was observed among women (adjOR 0.90 CI95% 0.89-0.91), also of Italian nationality (aOR 0.94 0.93-0.95). The gender difference was more marked among non-Italian citizens (aOR 0.82 0.79-0.84) and is accentuated in specific ethnic groups: Macedonian (aOR 0.61 0.52-0.71), Kosovar (aOR 0.53 0.45-0.61), Pakistani (aOR 0.63 0.52-0.75), Nigerian (aOR 0.49 0.38-0.64).

Conclusions
Lower vaccination coverage in women, particularly of foreign nationality, can be due to lower participation in social and working life, as it was decisive by law to access jobs with regular contracts. Public health has the task of removing these barriers and protecting the health of all citizens equally. According to our findings, we implemented equity-oriented measures, such as vaccination sessions without an appointment and with the presence of a cultural mediator, specific awareness campaigns aimed at personal assistants, dissemination of information material translated into several languages.

Key messages
• Women, especially of foreign nationality, have lower vaccination coverage.
• Gender is a determinant of health: Public health has the task of removing these barriers and protecting the health of all citizens equally.
Gender and regional differences of avoidable mortality in Italy: a 14-year time-trend analysis
Authors: Sanna A , Golinelli D , Guarducci G , Viti F , Lenzi J , Sanmarchi F , Nante N 
Published: October 2023

Abstract

Background
Similar to other European countries, Italy's healthcare system is undergoing significant changes. Variations in ‘avoidable’ mortality (AM) may reflect such changes on management and quality of care. The aim of this study was to investigate the regional and gender-related trends of AM, and to provide evidence for addressing policy and reducing health disparities in Italy.

Methods
We conducted a 14-year time-trend analysis (2006-2019). Mortality and population data were obtained from the Italian Institute of Statistics. Bi-yearly age-standardized AM was calculated by gender and region, using the joint OECD/Eurostat list that includes both preventable and treatable causes of death.

Results
Overall, AM showed a significant reduction from 2006/7 to 2018/9 (221.0 vs. 166.4 per 100,000 pop, p &lt; 0.05). A heterogeneous decrease in AM was registered between regions, ranging from −39% of Trento to − 17% of Molise. The analysis showed significant gender differences in AM, with females showing lower rates in both 2006/7 (144.5 vs. 306.3, p &lt; 0.05) and 2018/9 (117.1 vs. 219.9, p &lt; 0.05). Gender differences were also registered across regions, both overall and in terms of yearly % reduction.

Conclusions
While gender disparities in AM have reduced between 2006 and 2019 in Italy, the study shows that inequalities between regions have increased, thus underlying a worsening in the capacity of the Italian healthcare system to equally provide quality care to its population. We advocate the urgent need to reduce health disparities through a balanced regional development strategy.

Key messages
• Avoidable mortality is a key indicator for assessing quality and equity of healthcare. We have recorded significant gender and regional differences in this indicator between 2006 and 2019 in Italy.
• Targeted interventions are needed to reduce gender and geographic disparities and to achieve the global goals of universalism and accessibility of health services, also in Italy.
The challenge of community care: evidence from the Family and Community Nurse model in Tuscany
Authors: Taddeucci L , Barchielli C , Vainieri M 
Published: October 2023

Abstract

Background
The strengthening of primary care is one of the solutions proposed to increase the resilience of healthcare systems in Italy. Tuscany was the first region in Italy to use this model based on the results of a Regional Agency for Regional Health Services study. The aims is to describe the FCN model implementation across the three Local Health Authorities (LHAs) through the four C's framework of primary care. The regional resolution on FCN relabeled these milestones based on the FCN's role: transversality, proximity, continuity, customization.

Methods
A mixed method study was conducted with in-depth interviews of regional managers and surveys administered to middle nurse managers of the three LHAs.

Results
The interviews revealed a different state of progress of the FNC organisational model implementation, with one LHA pioneering, another LHA dealing with the implementation stage, and the third with a more recent, non-gradual implementation. The first two LHAs interpret the transversality as a strategic and the proximity as a vicinity feature. The other LHA sees the FNC as a tool for patient empowerment and proximity as service availability. The quantitative analysis shows a continuous take in charge in the pioneer LHA 54.8% (IC95% 46.8%-62.9%) with a lower temporary taking charge, 25.9% (IC95% 19.8%-31.9%), compared to the others, respectively 34.3% (IC95% 21.7%-47.0%) and 36.39% (IC95% 26.9%-45.8%). Places where the FCN provides care: the pioneering LHA as most of the home care and a 12% (IC95% 1.4%-22.5%) of intermediate care facilities use, the implementing LHA is totally home-based: 99% (IC95% 97.6%-100.3%) and with a continuous take in charge 48.6% (IC95% 34.5%-62.8), the recently implemented LHA a 6.8% (IC95% 2.2%-11.3%) of others.

Conclusions
Even in the same regional context, ruled by the same features’ model defining resolution, there have been different implementations and interpretations related to the different LHAs’ organizational histories.

Key messages
• In spite of the model’s implementations, the assistance provided doesn’t focus on single diseases but on people in the broader context of their family and community.
• The FCN model is designed to strengthen the timely care of patients at home by coordinating activities and care interventions through a multidisciplinary team.
Comorbidities in women with polycystic ovary syndrome: a sibling study
Authors: Boldis V , Grünberger I , Cederström A , Björk J , Nilsson A , Helgertz J 
Published: October 2023

Abstract

Background
Polycystic ovary syndrome (PCOS) has previously been associated with several comorbidities that may have shared genetic, epigenetic, developmental or environmental origins. We analyzed the association between PCOS and several relevant comorbidities while adjusting for early-life biological and socioeconomic conditions, also investigating the extent to which the association is affected by familial risk factors.

Methods
This total-population register-based cohort study included 857,757 singleton females (333,999 with at least one full sister) born between 1962 and 1980. PCOS and comorbidity diagnoses were measured at age 17-45 years through national hospital register data from 1997 to 2011, and complemented with information on the study subjectś early-life and social characteristics. In the main analysis, sibling fixed effects (FE) models were used to control for all factors that are shared and time-invariant among sisters, thereby testing whether PCOS and examined comorbidities are determined by unobserved familial; environmental, social or genetic factors.

Results
9,321 women were diagnosed with PCOS, of whom 15% had obesity, 9% had depression, 8% had anxiety and 4% suffered from sleeping, sexual and eating disorders (SSE). Having PCOS was associated with the odds of obesity increasing nearly 6-fold (adjusted OR (aOR): 5.8 [95%CI:5.5-6.2]). This association was attenuated considerably when accounting for characteristics shared between full sisters (Sister FE: aOR: 4.5 [95% CI: 3.6-5.6]). Among the psychiatric comorbidities, depression (Sister FE: aOR: 1.4 [95% CI: 1.2-1.8]) and anxiety (Sister FE: aOR: 1.5 [95% CI: 1.2-1.8), there was a small decrease in the aORs when also controlling for factors shared between sisters.

Conclusions
Having been diagnosed with PCOS is associated with an increased risk of obesity and psychiatric comorbidities and a substantial part of this risk can be attributed to factors shared between sisters.

Key messages
• PCOS is associated with an increased risk of obesity, depression and anxiety.
• Among women with PCOS, 16% of the increased risk for obesity, 20% for depression and 29% for anxiety can be attributed to shared family factors between sisters.
Cross-cultural comparisons of limited cancer health literacy rates
Authors: Dumenci L , Wing-Lok C , Pun J 
Published: October 2023

Abstract

Purpose
This study aims to compare the limited cancer health literacy (LCHL) rates among White (U.S.), Black (U.S.) and Chinese (H.K.) cancer patients using the Cancer Health Literacy Test - 6 (CHLT-6) and its recent adaptation in Chinese.

Rationale
Arbitrary nature of determining LCHL using the cut-score method is a major obstacle to scientifically investigate racial/ethnic differences in LCHL rates. To overcome, we used the multi-group latent class analysis (LCA) to test invariant measurement properties of the CHLT-6, a necessary condition to claim that the differences in LCHL rates reflect true group differences.

Results
Data included 1,899 cancer patients: White (N = 806) and Black (N = 491) and Chinese (N = 602). Measurement invariance test between the unconstrained and conditional probability constrained multi-group LCA favored the latter using the Bayesian Information Criterion (BIC: 10,388 vs.10,334) indicating that the LCHL label has the same meaning between three groups. The CHLT-6 determines cancer patients with LCHL with high accuracy (&gt;90%) in all three groups. The model-based estimates of LCHL rates varied across groups: White (4%), Black (50%), and Chinese (25%).

Conclusions
This study provides a strong construct validity evidence for the CHLT-6 by showing that it has invariant measurement properties between racial/ethnic groups and that it assigns cancer patients into LCHL group with high accuracy. Causal mechanisms underlying a wide range of LCHL rates need further explorations.

Key messages
• A substantial difference in limited cancer health literacy rates among White (U.S), Black (U.S.), and Chinese (Hong Kong) cancer patients.
• The CHLT-6 accurately captures the limited cancer health literacy in diverse racial/ethnic groups.
Mental health promotion in the elderly in Slovenian local communities
Authors: Stanojević Jerković O , Brlek A , Tkalec S 
Published: October 2023

Abstract

Issue/problem
Key issues in the elderly's mental health are: growing trends in mental disorders (dementia, depression), social exclusion with consequent lack of information, awareness and poorer access to prevention and assistance programs, discrimination, and high risk of poverty after retirement (especially in women). The public health challenge is to cope with these issues, as the share of the elderly population rapidly increases, also across European countries.

Description of the problem
According to the Resolution of the National Mental Health Program 2018-2028, and Action Plan 2021-2023, an interdisciplinary working group for mental health promotion among the elderly was established. Basic goals were prepared through regular meetings: adequately providing necessary information for the target population and enabling better networking of key actors in the field of mental health, including cooperation with existing networks. Specific activities ( &gt;&gt;Open hours for elderly &lt;&lt; and &gt;&gt;Longevity society fairs &lt;&lt;) were implemented in the local communities.

Results
Twenty-one events, broadly promoted in the local communities, were realized. Different stakeholders were supported with developed materials (brochures, leaflets). A national conference on decreasing loneliness and social exclusion in the elderly was organized.

Lessons
Supportive environment for the empowerment of key actors and their continuous cooperation, could improve information flow, competencies, and inclusion of the target population in the local community and consequently decrease stigma. Despite pandemic measures, activities were realized, as recognized to be necessary. Regular financial support of less developed communities is a precondition for preventing inequities between communities.

Key messages
• A sensitized, empowered, connected, proactive and supported local community is a key for improving elderly's quality of life.
• A connected and empowered local community is a precondition to prevent further stigmatization of the elderly.