| 1. |
- Baumbach, Linda, et al.
(author)
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Association between received treatment elements and satisfaction with care for patients with knee osteoarthritis seen in general practice in Denmark
- 2021
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In: Scandinavian Journal of Primary Health Care. - : Taylor & Francis. - 0281-3432 .- 1502-7724. ; 39:2, s. 257-264
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Journal article (peer-reviewed)abstract
- Objective: While education, exercise, and weight reduction when indicated, are recommended first-line treatments for knee osteoarthritis patients, they remain poorly implemented in favour of pain killer treatment, imaging and referral to surgery. A reason could be that patients are more satisfied with receiving these adjunctive treatment elements. This study aimed to investigate the associations between the received elements of care and the patient's satisfaction with the care for knee osteoarthritis in general practice.Design: Cross-sectional study.Setting: A Danish general practice.Subjects: All consecutive patients >= 30 years of age who consulted the general practitioner (GP) with chronic knee complaints during 18 months and who replied to a mailed questionnaire (n = 136).Main outcome measures: The questionnaire addressed patient's knee-related quality of life, and overall satisfaction with care, as well as reception of seven types of information, which are known quality indicators. Information on reception of adjunctive treatment elements was obtained from electronic medical records.Results: Patient satisfaction (versus neutrality/dissatisfaction) was positively associated with reception of information on: physical activity and exercise (relative risks [RR] 1.38, 95% bootstrap percentile interval [BPI] 1.02-4.33), and the relationship between weight and osteoarthritis (1.38, 1.01-4.41). No significant associations were found for the five remaining types of information and all the adjunctive treatment elements.Conclusion: Providing information as education to patients with knee osteoarthritis as part of the treatment is positively associated with satisfaction with care.
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| 2. |
- Baumbach, Linda, et al.
(author)
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Changes in received quality of care for knee osteoarthritis after a multicomponent intervention in a general practice in Denmark
- 2021
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In: Health Science Reports. - : John Wiley & Sons. - 2398-8835. ; 4:4
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Journal article (peer-reviewed)abstract
- Objective: First-line treatment for patients with knee osteoarthritis should ideally prescribe patient education, exercise, and if needed, weight loss. In practice, however, adjunctive treatments, including painkillers and referrals to specialists, are typically introduced before these measures. This study evaluated interventions to sustainably improve general practitioner delivered care for patients with knee osteoarthritis.Design: Comparison of impacts of knee osteoarthritis care during four half-year periods: before, 6, 12, and 18 months after primary intervention based on electronic medical records (EMR) and patient questionnaires.Setting: Danish general practitioners (GPs) treating 6240 patients.Participants: Four GPs, two GP trainees, and six staff members.Interventions: Six pre-planned primary interventions: patient leaflet, GP and staff educational session, knee osteoarthritis consultation, two functional tests monitoring patient function, EMR phrase aiding consultation, and waiting room advertisement and three supportive follow-up interventions.Main outcome measures: Usage of first-line and adjunctive treatment elements, the functional tests, and the EMR phrase.Results: Approximately 50 knee osteoarthritis cases participated in each of the four half-year periods. Primary interventions had only transient effects lasting <12 months on the knee osteoarthritis care. Functional tests and EMR phrases were used predominantly during the first 6 months, where a transient drop in the referral rate to orthopedics was observed. Use of educational elements was moderate and without significant change during follow-up.Conclusion: More routine use of the primary or inclusion of novel increased-adherence interventions is needed to sustainably improve care for knee osteoarthritis patients in Danish general practice.
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| 3. |
- Cao, Ling, et al.
(author)
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Vulnerability of blue foods to human-induced environmental change
- 2023
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In: Nature Sustainability. - 2398-9629. ; 6, s. 1186-1198
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Journal article (peer-reviewed)abstract
- Global aquatic foods are a key source of nutrition, but how their production is influenced by anthropogenic environmental changes is not well known. The vulnerability of global blue food systems to main environmental stressors and the related spatial impacts across blue food nations are now quantified. Global aquatic or 'blue' foods, essential to over 3.2 billion people, face challenges of maintaining supply in a changing environment while adhering to safety and sustainability standards. Despite the growing concerns over their environmental impacts, limited attention has been paid to how blue food production is influenced by anthropogenic environmental changes. Here we assess the vulnerability of global blue food systems to predominant environmental disturbances and predict the spatial impacts. Over 90% of global blue food production faces substantial risks from environmental change, with the major producers in Asia and the United States facing the greatest threats. Capture fisheries generally demonstrate higher vulnerability than aquaculture in marine environments, while the opposite is true in freshwater environments. While threats to production quantity are widespread across marine and inland systems, food safety risks are concentrated within a few countries. Identifying and supporting mitigation and adaptation measures in response to environmental stressors is particularly important in developing countries in Asia, Latin America and Africa where risks are high and national response capacities are low. These findings lay groundwork for future work to map environmental threats and opportunities, aiding strategic planning and policy development for resilient and sustainable blue food production under changing conditions.
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| 4. |
- Cottrell, Richard, et al.
(author)
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Food production shocks across land and sea
- 2019
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In: Nature Sustainability. - : Springer Science and Business Media LLC. - 2398-9629. ; 2, s. 130-137
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Journal article (peer-reviewed)abstract
- Sudden losses to food production (that is, shocks) and their consequences across land and sea pose cumulative threats to global sustainability. We conducted an integrated assessment of global production data from crop, livestock, aquaculture and fisheries sectors over 53 years to understand how shocks occurring in one food sector can create diverse and linked challenges among others. We show that some regions are shock hotspots, exposed frequently to shocks across multiple sectors. Critically, shock frequency has increased through time on land and sea at a global scale. Geopolitical and extreme-weather events were the main shock drivers identified, but with considerable differences across sectors. We illustrate how social and ecological drivers, influenced by the dynamics of the food system, can spill over multiple food sectors and create synchronous challenges or trade-offs among terrestrial and aquatic systems. In a more shock-prone and interconnected world, bold food policy and social protection mechanisms that help people anticipate, cope with and recover from losses will be central to sustainability. © 2019, The Author(s), under exclusive licence to Springer Nature Limited.
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| 5. |
- Love, David C., et al.
(author)
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Emerging COVID-19 impacts, responses, and lessons for building resilience in the seafood system
- 2021
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In: Global food security. - : Elsevier BV. - 2211-9124. ; 28
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Journal article (peer-reviewed)abstract
- The COVID-19 pandemic and subsequent lockdowns are creating health and economic crises that threaten food and nutrition security. The seafood sector provides important sources of nutrition and employment, especially in low-income countries, and is highly globalized allowing shocks to propagate. We studied COVID-19-related disruptions, impacts, and responses to the seafood sector from January through May 2020, using a food system resilience ‘action cycle’ framework as a guide. We find that some supply chains, market segments, companies, small-scale actors and civil society have shown initial signs of greater resilience than others. COVID-19 has also highlighted the vulnerability of certain groups working in- or dependent on the seafood sector. We discuss early coping and adaptive responses combined with lessons from past shocks that could be considered when building resilience in the sector. We end with strategic research needs to support learning from COVID-19 impacts and responses.
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