bluuebunny/crossref_metadata_2025_split huggingface dataset:
Function, coping and health as predictors of sick leave after rehabilitation
Authors: Berget AM , Moen VP , Hustoft M , Assmus J , Strand LI , Skouen JS , Hetlevik Ø 
Published: October 2022

Abstract

Background
Function, coping and health are central factors in rehabilitation after injury or sickness. To investigate how these factors are associated with sick leave during 12 months after rehabilitation is the aim of this study.

Methods
A sample of 412 rehabilitation patients ≤ 67years were included. They were all employed, and referred to inter-professional rehabilitation in western Norway. Rehabilitation consisted of physical activity/exercise, cognitive approaches and pain management. In two surveys patients reported mental (MCS) and physical (PCS) function (SF-36), self-perceived health (EQ-VAS) and coping (SOC-13). Register data on sick leave during 12 months in the calendar year after rehabilitation was retrieved from Statistics Norway and categorised to; non, (n = 168), ≤ 364 days (n = 152) and 365 days (n = 92). Ordinal regression was used to analyse association between sick leave and MCS, PCS, EQ-VAS and SOC-13, adjusted for age, sex and diagnoses.

Results
The levels of MCS and PCS (SF-36) were found to be associated with sick leave; OR 0.96, 95% CI 0.92-0.99, p = 0.004 and OR 0.93, 95% CI 0.90-0.97, p &lt; 0.001, respectively (Pseudo R2 = 0.1133). EQ-VAS and SOC-13 were significant predictors of sick leave in crude analysis (EQ-VAS: OR 0.97, 95% CI 0.96-0.98, p &lt; 0.001. SOC-13: OR 0.98, 95% CI 0.95-0.98, p &lt; 0.001), but not in the fully adjusted model (EQ-VAS: OR 0.98, 95% CI 0.96-1.01, p = 0.178. SOC-13: OR 0.99, 95% CI 0.99-1.03, p = 0.479).

Conclusions
Patientś self-reported mental and physical function were associated with sick leave 12 months after inter-professional rehabilitation. Higher level of function was associated with no sick leave. In our study, patient’s self-reported health and coping were not associated with sick leave. This suggest that interventions for functional improvement are beneficial in health care strategies to help patients return to work after injury or sickness.

Key messages
• Achieved higher physical and mental function after rehabilitation seems to contribute to reduced sick leave after injury or sickness.
• Improving function should remain a central factor in rehabilitation.
The effect of vocational rehabilitation on the use of health care services in Finland
Authors: Rinne H 
Published: October 2022

Abstract

Background
Because vocational rehabilitation is a separate service from other health services, there may be interruptions at their interface. We examined whether the use of health services changes before and after rehabilitation.

Methods
Longitudinal individual-level register-based data was utilized on all individuals aged 15-60 living in the city of Oulu, Finland and starting vocational rehabilitation in 2014-2015 (N = 792). We compared their use of outpatient health care services in 3-month periods from 1.5 years before to 1.5 after the rehabilitation period to the total population of the same age and to the propensity score matched controls. Several socio-demographic factors and sickness and employment histories were used for matching.

Results
According to the preliminary results, rehabilitees had on average 1.5 visits to outpatient health care services in the 6th quarter before the start of rehabilitation, twice that of the total population. In the 4th quarter before the start of rehabilitation, the number increased to 1.8. After the rehabilitation period, the quarterly number of visits were at the same level as in the beginning of the follow-up. The biggest changes took place in the use of occupational health services. Changes were modest in public health care services. In other services changes were minimal. Compared to the propensity score matched controls, vocational rehabilitation did not appear to have an effect on the use of health care services.

Conclusions
The use of health care services is more common before vocational rehabilitation than after it. The effect of rehabilitation on the use of health care needs further analysis.

Key messages
• The pattern of the use of health care services changes in the course of vocational rehabilitation. The changes are mainly due to visits in occupational health care services.
• The use of health care services is most common before rehabilitation. However, vocational rehabilitation does not appear to have an effect on the use of outpatient and inpatient health care services.
Patient-Reported Outcome Measures for care quality assessment of a breast cancer Care Pathway
Authors: Angioletti C , de Mattia E , Perilli A , de Belvis AG 
Published: October 2022

Abstract

Background
Breast Cancer (BC) is the most common type of cancer among women in Europe, accounting for around 28% of newly diagnosed female cancers. A clinical Pathway (CP) is an effective tool able to deliver high quality care especially if linked to a Monitoring System. Still, it is essential to integrate them with the patient’s perspective according to Value-Based Care. This paper aims to define and test a tool for care quality assessment in patients with breast cancer, in a value-based perspective.

Methods
A scoping search of the main databases (PubMed, Scopus, Web of Science) and official websites of institutions and organizations (AIOM, CIPOMO, EORTC, ICHOM, Istat) was carried out. A Delphi survey was conducted to assess the tool, according to four criteria (general relevance, evidence-based, measurability, actionability). We only included indicators that achieved strong agreement. Time-points for data collection were defined and validated in relation to the different steps of the CP.

Results
The final tool consists of 21 questions coming from the following sources: BREAST-Q and EORT QLQ-BR23 questionnaire. BREAST-Q’s questions, have to be administered at T0 (first medical contact) and T12 (follow-up), while the EORT QLQ-BR23’s questions have to be administered at T0 (first medical contact) T Surgery, T6 (follow-up) and T12 (follow-up). The survey will be administered to a sample of 152 BC patients (MOE 5%; CL 95%) undergoing surgery in the period June-September 2021.

Conclusions
The present tool will give a quick view of Value provided by the CP to these patients. In light of the high volume of patients treated at our center (1008 breast cancer surgery hospitalisations in 2020), this study acquires further public health relevance. Additionally, this approach can be extended for further evaluation of other CPs.

Key messages
• We assess care quality for Breast Cancer patients in a large hospital in Italy through Patient-Reported Outcome Measures, based on an evidence-based, Value-based, Delphi-validated tool.
• Assessing Value brought to patients with Breast Cancer gives a unique perspective on care quality assessment and paves the way for further quality improvements and extension to other health issues.
Use of healthcare services and hospitalisation among elderly people in Latvia
Authors: Dātava S , Reine I 
Published: October 2022

Abstract

Background
Demographic changes have occurred worldwide during the recent decades, with an increasing proportion of the elderly in the society, leading to higher average age of the population. Older people are more likely to suffer from different chronic diseases, and higher consumption of healthcare services and, thus, posing additional burden and challenges to the healthcare system.

Methods
The descriptive analysis relied on the longitudinal study of Health, Ageing and Retirement (SHARE). The target population included people aged 50 years or older, a total of 782 residents living in Latvia. We used the data from wave 8, collected from 2019-2020.

Results
The mean age in the study population was 69 years, and 62.5 % of the respondents were women. Results show that 14.7 % of all respondents were hospitalised in the last 12 months. The average length of stay at hospital was 10.9 days (range 1 - 71, SD 10.5). In 36.7 % of the cases hospitalisation was planned, but in 42.9 % it was due to an emergency. More than a half had visited hospital only once, but 19.1 % four times or more. The most common diseases among the hospitalised patients were high blood pressure/hypertension (60 %), heart attack (27.8 %), high cholesterol (26.1 %), osteoarthritis (21.7 %), stroke (18.3 %), diabetes (12.2 %) and different fractures (11.3 %).

Conclusions
We found that the main ailments for hospitalised patients were both chronic diseases like cardiovascular diseases, rheumatism, diabetes and acute conditions like fractures. The average hospital stay was 11 days.

Key messages
• Understanding how causes of hospitalisation among elderly interact with the use of healthcare services might help to reduce risk factors associated with hospitalisation and improve the health systems.
• Further studies on hospital admissions among older persons with particular characteristics health conditions could help to reduce the burden of disease and improve the well - being of the elderly.
Use of diabetic healthcare according to the accessibility of diabetology services
Authors: Maláková K , Šídlo L 
Published: October 2022

Abstract

Background
Diabetologists, as other specialists, are more likely concentrated in towns and cities rather than in the countryside so the people who live in these municipalities have a wider supply of health services. Our aim is to determine whether there are significant differences in the use of diabetology services between patients who live in the municipality with these services or not in Czechia.

Methods
The sorted anonymized data obtained from the General Health Insurance Company of the Czech Republic (GHIC CR) were used. The studied patients were people with a diagnosis of type 2 diabetes mellitus (E11) who were insured by GHIC CR and used health services in 2019 in Czechia.

Results
The distribution of providers of diabetology services (PDS) is relatively even throughout the country, and PDS are mainly concentrated in the municipality with a large population. In total, 52% of patients have the diabetologist in their municipality of residence. Patients living in the municipality with PDS have greater odds of using their services (OR 1.63, Cl 1.61-1.65). Specifically, 67% of the patients who have the diabetologist in their municipality of residence use diabetology services compared to 55% of the patients living in the municipality without PDS commute for diabetology services to the other municipality.

Conclusions
The results show that diabetology services are concentrated mainly in towns and cities and patients living in the municipality with the diabetologist use more diabetology services compared to patients living in the municipality without them. At the same time, it seems that more than half of the patients in the municipality where is not PDS are willing and able to commute for diabetology services.

Key messages
• Although patients living in the municipality without the diabetologist use diabetology services less often than with them, due to the commuting for healthcare, the differences are blurred.
Development of cancer policies between Europe Against Cancer Programme and Europe’s Beating Cancer
Authors: Albreht T , Jelenc M 
Published: October 2022

Abstract

Issue/problem
European Union has legally certain limitations in developing joint policies for services, activities and interventions that belong to the national competencies. Cancer control and cancer policy occupy a special place as they have received special attention throughout the last 40 years.

Description of the problem
European Union launched its first important disease policy with the start of the Europe Against Cancer Programme in 1984/85. It was a step, supported by a few interventions and activities, which facilitated the development of several important policy tools. After its closure in 2003, there was some unease, especially in view of the forthcoming biggest enlargement of the EU in 2004. Several activities revived the EU cancer policy and these processes culminated in the adoption of the Europe’s Beating Cancer Plan. There were some doubts whether the latter would be feasible but a careful development process at different levels resulted in success.

Results
A policy analysis will be presented that will introduce key steps and documents that mark the period between the two milestones - Europe Against Cancer Programme (EACP) and Europe’s Beating Cancer Plan (EBCP). We will present the development of various tools as well as the important outcomes of the different policies and interventions triggered by the two documents. The period between 2003 and 2019 will be elaborated in view of the adoption of EBCP. Three Joint Actions and their various outputs with a strong impact on the cancer policy development, contributing also to the development of flagships and actions of EBCP will be presented as well.

Lessons
EU top level decisions and policies can be developed harmoniously and to the benefit of both - the EU and the Member States - when launched in a joint process and with the involvement of all the relevant stakeholders.

Key messages
• EU policy documents are important drivers for the development of health policy tools at both the EU level as well as at the Member State level.
• A combination of top-level documents with carefully developed policy tools enables the development of cancer policies acting at both EU and Member State level.
Health promotion among unemployed people – meta-analytic evidence
Authors: Hollederer A , Paul K 
Published: October 2022

Abstract

Background
It is well known that unemployment impairs health. However, less is known about health promotion among unemployed people and healthy coping strategies to deal with unemployment.

Methods
A random-effect meta-analysis was applied to statistically integrate quantitative controlled intervention studies among unemployed people.

Results
The meta-analysis included 34 eligible primary studies with 36 independent intervention samples. For mental health, the average meta-analytic effect sizes for the comparison of intervention group and comparison group was significant and of small size after the intervention d = 0.25; 95% CI [0.10, 0.39], and at follow-up, d = 0.13; 95% CI [0.04, 0.22]. For health behavior (measured as physical activity), the effects were also significant after the intervention, d = 0.30; 95% CI [0.12, 0.47] (no data available at follow-up). Effects on self-assessed physical health status were very small and not significant. However, when health improvement was the only goal of the respective intervention (in contrast to studies with multiple goals, e.g., health improvement plus re-employment), the effect on physical health was significant, too, d = 0.15; 95% CI [0.04, 0.25]. Moderator tests showed that intervention effects on mental health were significantly stronger when cognitive-behavioral methods were used (p &lt; .05), while the use other kinds of stress-management techniques (p &lt; .05), of methods to increase social support (p &lt; .05), or of relaxation techniques (p &lt; .07) did not improve the effectiveness of the intervention.

Conclusions
The present meta-analyses provided evidence that, on average, interventions aiming at improving unemployed people’s health do indeed improve participants’ health.

Key messages
• The present meta-analysis confirms that it is possible to promote unemployed people’ health. The moderator effects for type of intervention that were found here might be helpful for health promotion.
• The inclusion of cognitive-behavioral methods, appears to be a successful approach for health-oriented interventions with unemployed people.
Changes in university student health behaviors since the beginning of the COVID-19 pandemic
Authors: Patin A , Ladner J , Tavolacci MP 
Published: October 2022

Abstract

Background
The COVID-19 pandemic lead many upheavals in the life habit whith lockdowns and curfews since March 2020 and possibly in the health behaviours of university students could be impacted. The objective of the study was to assess the evolution of the health behaviors of university students between before the COVID-19 period and May 2021.

Methods
Two retrospectives online studies of a university students in France were in May 2020 and May 2021 were conducted. Socio demographics and academics environment data, tobacco smoking, binge drinking, cannabis use, and vigorous physical activity were collected in a declarative way.

Results
In 2020, 3483 (72.5% of women, mean age 20.9 (SD = 2.46)) and in 2021, 3504 (74.4 of women, mean age 20.73 (SD = 2.32)) university students were included. After logistic regression, in 2020 compared to the pre-COVID19 period, the regular vigorous physical activity didn't change significantly while there appears to be a study period effect with a decrease of the regular binge drinking (AOR=0.24 IC95% [0.20,0.29]). In 2021 compared to the pre-COVID19 period, the regular vigorous physical activity and the regular binge drinking decreased respectively, (AOR=0.53; IC95% [0.48,0.59]) and (AOR=0.60 IC95% [0.52,0.70]). Regular tobacco smoking and cannabis use didn't change significantly in 2020 and 2021 compared to the pre-COVID period.
Discussion: The decrease of binge drinking and physical activity between preCOVID-19 and 2021 could be attribute by the restricting mobility and social interactions. We did not observe an increase in risky health behaviors as smoking and cannabis use. These behaviors remain to be monitored in the future to assess the long-term effects of the pandemic COVID-19 on student health behaviors

Key messages
• Health-promotion strategies directed at adopting or maintaining positive mental health should be developed for university students to better manage future lockdown periods.
• Recommendations to maintain health during the ongoing COVID-19 pandemic specifically target university student populations are needed.
Digital Health Literacy in the Training of Informal Caregivers – Community Intervention
Authors: Águas D , Paço M , Henriques A , Arriaga M , Costa A 
Published: October 2022

Abstract

Background
Health Literacy allows optimizing healthy lifestyles and preventive and health protective behaviors (DGS, 2019). Low literacy can lead to a greater number of hospitalizations, a more frequent use of emergency services and a lower prevalence of preventive attitudes in the field of health. Internet-based interventions could have a positive impact on informal caregivers, reducing the geographical barrier, promoting self-efficacy in managing their own emotions, reducing burden.

Aim
Contribute to the training of informal caregivers of a primary health care unit in Lisbon, through the promotion of digital health literacy.

Methods
The Community Intervention project was carried out in the context of a home visit, focusing on 11 informal caregivers, through the presentation of an interactive digital manual. It was based on the methodology of health planning, through the elaboration of a diagnosis of the situation, definition of priorities, setting of objectives, selection of strategies, operational preparation and evaluation (Imperatori & Giraldes, 1993).

Results
It was found that not all informal caregivers have access to the internet or digital technologies, and it was necessary to deliver the printed manual. Caregivers who accessed the interactive digital manual rated its content as very important, having accessed the suggested links without difficulty. The possibility of forwarding the digital manual to other caregivers was valid for all.

Conclusions
Digital technologies promote communication in terms of health promotion, contributing to universal access and digital training in health, giving individuals the opportunity to increase care for their own health. The creation of digital health tools must be directed to the characteristics of the population. For individuals with low digital literacy, simple technologies must be created and for those who cannot or do not want to use digital tools, adequate alternatives must be created.

Key messages
• Primary care health professionals may use digital technologies to promote health literacy.
• Vulnerable groups with low digital health literacy need support to increase access to digital technology that can promote health literacy.
Addressing health literacy to reduce inequalities among migrants: which profiles need our attention?
Authors: Marques MJ , Gama A , Cheng C , Osborne R , Dias S 
Published: October 2022

Abstract

Health literacy, the ability to access, understand, appraise, remember and use health information and services, has great potential to reduce inequalities in access to and outcomes of care. People may have different patterns of health literacy needs and strengths. Yet, the design of interventions is frequently not responsive to the specificities of different segments of the population, including migrant groups. We aimed to identify profiles of migrants to inform the co-design of interventions targeting people at risk of poor outcomes. A cross-sectional survey was conducted with 1126 adult migrants living in Portugal. Data were collected using the 9-dimension HLQ (Health Literacy Questionnaire), and a sociodemographic questionnaire. A cluster analysis of data was performed. Semi-structured interviews were conducted with 15 migrants, stratified by the clusters. The optimal cluster solution yielded 16 profiles revealing diversity in combinations of strengths and needs across the HLQ domains. While 29.8% of migrants scored moderate to high on all 9 domains (profiles 2, 6, 8, 16), 63.4% of participants struggled with 1 or several aspects of health literacy, namely ‘Feeling understood and supported by healthcare providers'. Notably, 36.8% (6 profiles) exhibited difficulty across most of health literacy domains. The interviews provided a tangible description of the health literacy needs and resources with five main themes (access, understand, appraise, retrieve and use). Regarding ‘access', migrants expressed different preferred learning styles and needed to access different sorts of information at distinct times. The ‘use’ of information was rarely a one-time decision but a decision that people needed to make repeatedly. Health literacy is a highly diverse concept where subgroups exhibited diverse patterns. The cluster analysis can be used to inform the co-design, prioritisation and implementation of locally designed, fit-for-purpose solutions to improve health literacy.

Key messages
• Health literacy profiles can inform interventions to mitigate health inequalities among vulnerable migrant groups.
• The identification of distinct profiles can contribute to minimise the disconnect between what people/communities need and what is developed to improve health and equity.