| 111. |
- Goethals, L, et al.
(författare)
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Social Marketing Intervention to Engage Older Adults in Balance Workshops for Fall Prevention: A Multicenter Quasi-Experimental Protocol Study
- 2021
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Ingår i: Frontiers in public health. - : Frontiers Media SA. - 2296-2565. ; 9, s. 614119-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Falls affects one of three people after 65 years old, and it can lead to serious consequences. Scientific evidence point out that physical exercise is the most efficient way to prevent falls among older adults.Objective: The main objective of this study is to determine if a social marketing program can increase the attendance rate of people aged 60 and over at group balance workshops.Methods: This quasi-experimental multicenter study is being conducted in three French Regions (Loire, Haute-Loire and Rhône) over a period of 18 months. The Social Marketing Campaign will be done in three ways. Firstly, a Communication Campaign will take place in the two Test Areas but not in the Control Area. Secondly, flyers have been designed to be distributed by local partners. Finally, conferences for older people will be organized in the areas of intervention in order to reach the target audience for the program. The study will include people aged 60 and older who want to participate in the Balance Program.Results: The Crédit Agricole Loire/Haute-Loire Foundation funded the study and the Jean Monnet University of Saint-Etienne reviewed it. The Ethics Committee of the University Teaching Hospital of Saint-Etienne approved and peer-reviewed it on September 6, 2019, under Reference Number IRBN622019/CHUSTE.Conclusion: The results of this first study will demonstrate whether or not social marketing for promoting group balance workshops in the elderly will increase their attendanceship in adapted physical activity sessions, especially those that prevent falls.Clinical Trial Registration:https://clinicaltrials.gov/ct2/show/NCT04136938, identifier NCT04136938.
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| 112. |
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| 113. |
- Graells, Tiscar, et al.
(författare)
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Exploring the factors that contribute to the successful implementation of antimicrobial resistance interventions : a comparison of high-income and low-middle-income countries
- 2023
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Ingår i: Frontiers in Public Health. - 2296-2565. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionAntimicrobial resistance (AMR) is a challenge to modern medicine. Interventions have been applied worldwide to tackle AMR, but these actions are often not reported to peers or published, leading to important knowledge gaps about what actions are being taken. Understanding factors that influence the implementation of AMR interventions and what factors are relevant in low-middle-income countries (LMICs) and high-income countries (HICs) were the key objectives of this exploratory study, with the aim to identifying which priorities these contexts need.MethodsA questionnaire was used to explore context, characteristics, and success factors or obstacles to intervention success based on participant input. The context was analyzed using the AMR-Intervene framework, and success factors and obstacles to intervention success were identified using thematic analysis.ResultsOf the 77 interventions, 57 were implemented in HICs and 17 in LMICs. Interventions took place in the animal sector, followed by the human sector. Public organizations were mainly responsible for implementation and funding. Nine themes and 32 sub-themes emerged as important for intervention success. The themes most frequently reported were 'behavior', 'capacity and resources', 'planning', and 'information'. Five sub-themes were key in all contexts ('collaboration and coordination', 'implementation', 'assessment', 'governance', and 'awareness'), two were key in LMICs ('funding and finances' and 'surveillance, antimicrobial susceptibility testing and preventive screening'), and five were key in HICs ('mandatory', 'multiple profiles', 'personnel', 'management', and 'design').ConclusionLMIC sub-themes showed that funding and surveillance were still key issues for interventions, while important HIC sub-themes were more specific and detailed, including mandatory enforcement, multiple profiles, and personnel needed for good management and good design. While behavior is often underrated when implementing AMR interventions, capacity and resources are usually considered, and LMICs can benefit from sub-themes captured in HICs if tailored to their contexts. The factors identified can improve the design, planning, implementation, and evaluation of interventions.
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| 114. |
- Grima, Simon, et al.
(författare)
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High Out-of-Pocket Health Spending in Countries With a Mediterranean Connection
- 2018
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Ingår i: Frontiers in Public Health. - : Frontiers Media SA. - 2296-2565. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- In this study, we analyzed healthcare provision and health expenditure across six Mediterranean countries that adopt the National Health System (Beveridge model) and that form part of the European Union (EU) with the main aim being that of analyzing and comparing out-of-pocket health spending in countries with a European Mediterranean connection. To this end, we considered various economic indicators and statistics to derive commonalities and differences across these countries and also compared trends in these indicators to those observed across the rest of the EU. We then analyzed these findings in light of other data related to the quality of healthcare delivery and the infrastructure of the health system and discussed recent developments in healthcare within each country and the main challenges faced by the respective health systems. The results show that on average, Mediterranean countries spend less on total healthcare expenditure (THE) than the EU average, both as a proportion of GDP, as well as in per capita terms. This is primarily driven by lower-than-EU-average public funding of healthcare. The 2008/2009 macro-economic and financial crisis had a significant impact on the countries under review, and explains the persistent reductions in public health spending as part of the austerity measures put in force across sectors. On the flipside, Mediterranean countries have a higher presence of private health providers in total funding, thereby explaining the higher Out-of-Pocket (OOPs) health expenditures in these countries relative to the EU-average. With regard to the overall health infrastructure in these countries, we observed that although the supply of physicians is largely in line with the rest of the EU, there is under-supply when it comes to hospital beds. This may be symptomatic of lower government funding. Nonetheless, all countries score highly in the evaluation of the quality of health services, as recorded by international rankings like the WHO's 2000 metric, whereas health system performance indicators, namely mortality rates and life expectancy reveal favorable health outcomes in the Mediterranean EU countries. The findings in this paper may be seen in light of the Mediterranean region's lifestyle in terms of diet, health behavior, health beliefs and shared culture. In particular, the higher out-of-pocket expenditure may reflect the tendency for one-to-one relationships with private clinicians and the pursuit of person-centered care (1). Additionally, the Mediterranean people may not be as disciplined as their European counterparts in accessing and using the public health sector. The lower THE also reflects the fact that the Mediterranean countries are less wealthy than the more economically-advanced European countries.
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| 115. |
- Gunnarsdóttir, Hrafnhildur, et al.
(författare)
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To live and not only survive – an ongoing endeavor : Resilience experiences among adult women abused as children
- 2021
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Ingår i: Frontiers in Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Background: A significant proportion of individuals exposed to maltreatment in childhood adapt positively in adulthood despite the adversities, i.e., show resilience. Little is known about resources and processes related to adulthood that promote resilience. Since women are overrepresented as victims of intrafamilial violence, understanding resilience among adult women is important.Objective: To explore experiences of resilience among adult women who perceive well-being and well-functioning although being exposed to maltreatment during childhood.Participants and Setting: This study included 22 women with experiences of childhood maltreatment, mean age of 48 years, living in Sweden.Methods: Individual interviews were conducted and analyzed according to constructivist grounded theory.Results: The process of resilience was experienced as an ongoing endeavor to live, not only survive, an internal process that interacted with external processes involving social relations and conditions. This endeavor was built on four interrelated resources: establishing and maintaining command of life; employing personal resources; surrounding oneself with valuable people; and reaching acceptance. These worked together, not in a linear or chronological order, but in up and down ways, turns and straight lines (now and then), through the process from maltreatment to well-being.Conclusion: Resilience was found to rest on intrapersonal and interpersonal resources. Individual's inherent capabilities can be, depending on life circumstances and available resources, realized in a way that promote well-being and well-functioning despite severe adversities. Therefore, public health initiatives, social services, and policies should provide conditions that help women maltreated in childhood to live fully rather than merely to survive.
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| 116. |
- Gunnarsdottir, Hrafnhildur, 1973-, et al.
(författare)
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To Live, Not Only Survive - An Ongoing Endeavor : Resilience of Adult Swedish Women Abused as Children.
- 2021
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Ingår i: Frontiers in Public Health. - : Frontiers Media SA. - 2296-2565. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Background: A significant proportion of individuals exposed to maltreatment in childhood adapt positively in adulthood despite the adversities, i.e., show resilience. Little is known about resources and processes related to adulthood that promote resilience. Since women are overrepresented as victims of intrafamilial violence, understanding resilience among adult women is important. Objective: To explore experiences of resilience among adult women who perceive well-being and well-functioning although being exposed to maltreatment during childhood. Participants and Setting: This study included 22 women with experiences of childhood maltreatment, mean age of 48 years, living in Sweden. Methods: Individual interviews were conducted and analyzed according to constructivist grounded theory. Results: The process of resilience was experienced as an ongoing endeavor to live, not only survive, an internal process that interacted with external processes involving social relations and conditions. This endeavor was built on four interrelated resources: establishing and maintaining command of life; employing personal resources; surrounding oneself with valuable people; and reaching acceptance. These worked together, not in a linear or chronological order, but in up and down ways, turns and straight lines (now and then), through the process from maltreatment to well-being. Conclusion: Resilience was found to rest on intrapersonal and interpersonal resources. Individual's inherent capabilities can be, depending on life circumstances and available resources, realized in a way that promote well-being and well-functioning despite severe adversities. Therefore, public health initiatives, social services, and policies should provide conditions that help women maltreated in childhood to live fully rather than merely to survive.
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| 117. |
- Halling Ullberg, Oskar, et al.
(författare)
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Workplace health promotion to facilitate physical activity among office workers in Sweden
- 2023
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Ingår i: Frontiers in Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Office workers spend most of their working time being sedentary, contributing to a sedentary lifestyle that increases the risk of developing disease and disability. A gradual decline in cardiorespiratory fitness among adults, along with increased rate of non-communicable diseases across developed countries, makes the workplace an important opportunity for promoting healthy behaviors. This study aimed to investigate: how office companies in Sweden organize and provide workplace health promotion services related to physical activity; the companies' vision for providing workplace health promotion; and potential facilitators and barriers. Nine informants from eight companies participated in the study, and both qualitative and quantitative data were collected by semi-structured interviews. Informants were selected through purposive sampling in collaboration with eight companies in the office market, including companies that own and develop office buildings, shared workspaces, interior design, sustainable solutions, or consult on issues related to the office sector. The framework method was used to analyze the data in a flexible and systematic way. The results showed that workplace health promotion is implemented to maintain employee health, productivity, and employee branding. Also, a significant number of financial resources, organizational support and office space are devoted to workplace health promotion. Convenience and easy access to storage and fitness facilities are key facilitators. In conclusion, this study highlights the importance of employees' engagement in developing and improving workplace health promotion and addressing work-life balance constraints that hinder a healthy lifestyle. Removing barriers on an organizational level may improve the usage of workplace health promotion related to physical activity among office employees.
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| 118. |
- Hansen, Karin, et al.
(författare)
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Exploring the microbial landscape uncovering the pathogens associated with community-acquired pneumonia in hospitalized patients
- 2023
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Ingår i: Frontiers in Public Health. - 2296-2565. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: This study aimed to investigate the etiology, clinical features, and outcomes of community-acquired pneumonia (CAP) in adults. Understanding the causative pathogens is essential for effective treatment and prevention.DESIGN: Between 2016-2018, 518 hospitalized adults with CAP and 241 controls without symptoms were prospectively enrolled. Urine samples were collected for pneumococcal urinary antigen tests and nasopharyngeal swabs for viral and bacterial analysis, combined with routine diagnostic care.RESULTS: Among the included CAP patients, Streptococcus pneumoniae was the most common pathogen, detected in 28% of patients, followed by Haemophilus influenzae in 16%. Viruses were identified in 28%, and concurrent viruses and bacteria were detected in 15%. There was no difference in mortality, length of stay, or symptoms at hospitalization when comparing patients with bacterial, viral, or mixed etiologies. Among the control subjects without respiratory symptoms, S. pneumoniae, H. influenzae, or Moraxella catarrhalis were detected in 5-7%, and viruses in 7%. CONCLUSION: Streptococcus pneumoniae emerged as the predominant cause of CAP, followed closely by viruses and H. influenzae. Intriguingly, symptoms and outcome were similar regardless of etiology. These findings highlight the complexity of this respiratory infection and emphasize the importance of comprehensive diagnostic and treatment strategies. Clinical Trial Registration: ClinicalTrials.gov, identifier [NCT03606135].
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| 119. |
- Hansen, Karin, et al.
(författare)
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Radiographically confirmed community-acquired pneumonia in hospitalized adults due to pneumococcal vaccine serotypes in Sweden, 2016–2018—The ECAPS study
- 2023
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Ingår i: Frontiers in Public Health. - : Frontiers Media SA. - 2296-2565. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: In Sweden, pneumococcal serotype distribution in adults with community-acquired pneumonia (CAP) and potential coverage of currently licensed pneumococcal conjugate vaccines (PCVs) is unknown. Methods: During 2016–2018, patients aged ≥18 years hospitalized with radiologically confirmed (RAD+) CAP were enrolled at Skåne University Hospital in a study on the etiology of CAP in Sweden (ECAPS). Urine samples and blood cultures were collected per-protocol. Streptococcus pneumoniae (Spn) culture isolates were serotyped and urine samples tested for the pan-pneumococcal urinary antigen (PUAT) and multiplex urine antigen detection (UAD) assay, detecting 24 serotypes. Results: Analyses included 518 participants with RAD+CAP; 67.4% were ≥65 years of age, 73.4% were either immunocompromised or had an underlying chronic medical condition. The proportion of CAP due to Spn identified by any method was 24.3% of which 9.3% was detected by UAD alone. The most frequently identified serotypes were 3 (26 cases, 5.0% of all CAP), and 8, 11A and 19A (10 cases each, 1.9%). In individuals aged 18–64 and ≥65 years, respectively, PCV20 serotypes contributed to 35 of 169 (20.7%) and 53 of 349 cases of all CAP (15.2%), and PCV13 serotypes caused 21 of 169 (12.4%) and 35 of 349 (10.0%) cases. PCV15 coverage was 23 of 169 (13.6%) and 42 of 349 (12.0%) in individuals aged 18–64 and ≥65 years, respectively. Overall, PCV20 increases the coverage of all CAP from 10.8% (PCV13) to 17.0%. Conclusion: Compared to earlier pneumococcal vaccines, PCV20 expands the coverage of all-cause CAP. Routine diagnostic tests underestimate the proportion of CAP caused by Spn.
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| 120. |
- Hedna, Khedidja, 1978, et al.
(författare)
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Antidepressant Use and Suicide Rates in Adults Aged 75 and Above: A Swedish Nationwide Cohort Study
- 2021
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Ingår i: Frontiers in Public Health. - : Frontiers Media SA. - 2296-2565. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Background: The treatment of depression is a main strategy for suicide prevention in older adults. We aimed to calculate suicide rates by antidepressant prescription patterns in persons aged >= 75 years. A further aim was to estimate the contribution of antidepressants to the change in suicide rates over time. Methods: Swedish residents aged >= 75 years (N = 1,401,349) were followed between 2007 and 2014 in a national register-based retrospective cohort study. Biannual suicide rates were calculated for those with selective serotonin reuptake inhibitor (SSRI) single use, mirtazapine single use, single use of other antidepressants and use of >= 2 antidepressants. The contribution of antidepressants to the change in biannual suicide rates was analyzed by decomposition analysis. Results: There were 1,277 suicides. About one third of these were on an antidepressant during their last 3 months of life. In the total cohort, the average biannual suicide rate in non-users of antidepressants was 13 per 100,000 person-years. The corresponding figure in users of antidepressants was 34 per 100,000 person-years. These rates were 25, 42 and 65 per 100,000 person-years in users of SSRI, mirtazapine and >= 2 antidepressants, respectively. In the total cohort, antidepressant users contributed by 26% to the estimated increase of 7 per 100,000 in biannual suicide rates. In men, biannual suicide rates increased by 11 suicides per 100,000 over the study period; antidepressant users contributed by 25% of the change. In women, those on antidepressant therapy accounted for 29% of the estimated increase of 4.4 per 100,000. Conclusion: Only one third of the oldest Swedish population who died by suicide filled an antidepressant prescription in their last 3 months of life. Higher suicide rates were observed in mirtazapine users compared to those on SSRIs. Users of antidepressants accounted for only one quarter of the increase in the suicide rate. The identification and treatment of suicidal older adults remains an area for prevention efforts.
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