European Journal of Public Health最新文献

Impact of specialist palliative care on utilization of healthcare and social services at the end-of-life: a nationwide register-based cohort study. 专科姑息治疗对临终医疗保健和社会服务利用的影响：一项全国性的基于登记的队列研究。

IF 3.7 3区医学

European Journal of Public Health Pub Date : 2025-05-28 DOI: 10.1093/eurpub/ckaf044

Satu E Ahtiluoto, Timo P Carpén, Pirita T Forsius, Mikko S J Nuutinen, Nelli-Sofia A Nåhls, Pauliina M Kitti, Teija H Hammar, Harriet U Finne-Soveri, Tiina H Saarto

{"title":"Impact of specialist palliative care on utilization of healthcare and social services at the end-of-life: a nationwide register-based cohort study.","authors":"Satu E Ahtiluoto, Timo P Carpén, Pirita T Forsius, Mikko S J Nuutinen, Nelli-Sofia A Nåhls, Pauliina M Kitti, Teija H Hammar, Harriet U Finne-Soveri, Tiina H Saarto","doi":"10.1093/eurpub/ckaf044","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf044","url":null,"abstract":"Non-malignant diseases cause 60% of non-communicable diseases requiring palliative care, yet specialist palliative care services primarily focus on cancer. We investigated end-of-life healthcare and social services utilization among cancer and non-malignant patients, and, secondarily, access to specialist palliative care and its effect on services utilization. This retrospective, nationwide register-based study included all adults (n = 38 540) who died from non-communicable life-limiting diseases in Finland in 2019, categorized into neurodegenerative (31%), other non-malignant (36%), and cancer (33%) groups. Hospital was the most common place of death (61%). Healthcare utilization substantially increased during the final weeks of life in all groups but remained highest in cancer patients. Social services utilization was highest in neurodegenerative diseases. Specialist palliative care contact was significantly (P < .001) higher in cancer (30.1%) compared to neurodegenerative (10.9%) and other non-malignant (7%) diseases. Early (>30 days before death) compared to late/no specialist palliative care contact significantly reduced emergency care contacts (47.8% vs. 52.2%) and hospitalizations in secondary hospitals (24.7% vs. 33.7%), and increased specialist palliative care ward (15.5% vs. 1.5%) and hospital-at-home (36.8% vs. 3.4%) utilization during the final month (P < .001). Healthcare utilization was high in all disease groups, highest among cancer patients. Hospital was the most common place of death. Specialist palliative care contact was rare in non-malignant diseases. Early contact with specialist palliative care associated with lower emergency care utilization and secondary hospital inpatient care during the last month of life. These results highlight the necessity for timely equitable specialist palliative care services for all.","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

IF 3.7 3区医学

European Journal of Public Health Pub Date : 2025-05-28 DOI: 10.1093/eurpub/ckaf080

Kuan-Yu Pan, Melody Almroth, Alicia Nevriana, Tomas Hemmingsson, Katarina Kjellberg, Daniel Falkstedt

{"title":"Person-related work and the risk of cardiovascular disease: a Swedish register-based cohort study.","authors":"Kuan-Yu Pan, Melody Almroth, Alicia Nevriana, Tomas Hemmingsson, Katarina Kjellberg, Daniel Falkstedt","doi":"10.1093/eurpub/ckaf080","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf080","url":null,"abstract":"Person-related work requires interaction with individuals not employed at the workplace, such as clients and patients, and can result in emotional labour, emotional demands, and confrontation. These stressors may increase workers' risk of cardiovascular disease (CVD), including coronary heart disease (CHD) and stroke, whereas colleagues' support may help buffer their impact. We aimed to examine the association between person-related work and the risk of CVD, and effect modification of social support at work. The study included around two million CVD-free workers aged 40-60 years in Sweden in 2006. Three dimensions of person-related work, including general contact with people, emotional demands, and confrontation, and job control and social support were respectively assessed using job exposure matrices. CVDs in 2007-20 were recorded in patient and death registers. Multivariable Cox regression models were used. A total of 114 404 individuals developed CVD (65 857 CHD and 48 547 stroke). High exposures to the three dimensions were associated with 4%-12% increased risks of CVD (7%-20% for CHD and 2%-7% for stroke) in women and 2%-8% (2%-7% for CHD and 3%-10% for stroke) in men. Adjusting for job control attenuated the associations for general contact with people in women. The increased risks related to emotional demands and confrontation in women and general contact with people and confrontation in men were not present in those more likely to receive high social support. In conclusion, person-related work is associated with an increased risk of CVD, and social support at work seems to modify the magnitude of this association.","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Health status of a migrant population: a survey within an Extraordinary Reception Centre in Parma, Northern Italy. 移民人口的健康状况：意大利北部帕尔马一个特别接待中心的调查。

IF 3.7 3区医学

European Journal of Public Health Pub Date : 2025-05-17 DOI: 10.1093/eurpub/ckaf076

Riccardo Mazzoli, Anna Laura Santunione, Francesca Marezza, Alessandra Sannella, Francesca Berghenti, Tommaso Filippini, Marco Vinceti, Rossana Cecchi

{"title":"Health status of a migrant population: a survey within an Extraordinary Reception Centre in Parma, Northern Italy.","authors":"Riccardo Mazzoli, Anna Laura Santunione, Francesca Marezza, Alessandra Sannella, Francesca Berghenti, Tommaso Filippini, Marco Vinceti, Rossana Cecchi","doi":"10.1093/eurpub/ckaf076","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf076","url":null,"abstract":"The steady flow of migrants is an ongoing challenge that requires health systems to adapt to unique health needs and to address inequalities. For this reason, comprehensive screening, early intervention, and culturally sensitive care are vital to improve migrants' health outcomes. We assessed migration history and health status in 536 migrants housed at \"Svoltare ONLUS\", an Extraordinary Reception Centre in Parma (Northern Italy), from 2015 to 2018. The focus was on migration journey characteristics and motivations, and testing for infectious diseases such as hepatitis B (HBV) and C (HCV), HIV, tuberculosis (TB), syphilis, and parasitosis. Migrants were overwhelmingly male (95.9%), with a mean (range) age of 26 (18-50) years. The majority originated from Sub-Saharan Africa (83.2%), with Nigeria as the predominant country. Most migrants entered via Libya (87.1%), disembarking primarily in Southern Italy, particularly Sicily (75.4%). High prevalence rates were found for HBV (48.8%), TB (27.8%), and parasitosis (23.1%), particularly among those from Western Africa. In contrast, HCV (2.61%), chronic hepatitis (5.41%), syphilis (2.99%), and HIV (1.31%) were less common. These trends are consistent with disease epidemiology in migrants' countries of origin as well those visited during the journey. Given the higher prevalence of infectious diseases among migrants compared to the general population in Italy, it is essential to enhance public health measures. This includes implementing timely screening services, targeted surveillance, and prompt treatment upon arrival at reception centers to protect both migrant and community health.","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Long-term trends in mortality by living arrangements and the role of socioeconomic factors, Finland 1991-2020. 1991-2020年芬兰按生活安排分列的死亡率长期趋势和社会经济因素的作用。

IF 3.7 3区医学

European Journal of Public Health Pub Date : 2025-05-09 DOI: 10.1093/eurpub/ckaf068

Ulla K Suulamo, Hanna M Remes, Lasse H Tarkiainen, Pekka T Martikainen

{"title":"Long-term trends in mortality by living arrangements and the role of socioeconomic factors, Finland 1991-2020.","authors":"Ulla K Suulamo, Hanna M Remes, Lasse H Tarkiainen, Pekka T Martikainen","doi":"10.1093/eurpub/ckaf068","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf068","url":null,"abstract":"Recent decades have witnessed major changes in living arrangements, potentially impacting their well-established associations with mortality. However, research considering long-term trends in these differentials is scarce. We used individual-level register data on the total Finnish population aged 30 years and over from 1991 to 2020 to examine trends in the association between living arrangements and all-cause, as well as external and alcohol-related mortality. We calculated age-standardized mortality rates, quantified group differentials in absolute and relative terms, and assessed the contribution of socioeconomic factors with Poisson-models. Analyses were conducted separately for men and women in age groups 30-49, 50-69, and 70+. All-cause mortality was consistently lowest among men and women living with a partner. Highest rates were observed in the growing group of individuals living alone or with persons other than a partner or child, who experienced up to a five-fold excess mortality compared to those living with a partner and children. Mortality declined across all living arrangement groups over time. While absolute rate differences mostly narrowed, relative differences widened across all ages. Adjustments for socioeconomic factors somewhat attenuated mortality differentials, with their contribution increasing modestly by the end of the study period. In conclusion, over the past 30 years, relative mortality differences by living arrangement have increased at all ages for both men and women. These widening differentials pose a growing public health burden, particularly for the growing group of individuals living alone. Our results suggest that factors beyond socioeconomic differentiation are contributing to these trends.","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The economic costs of alcohol consumption in Lithuania, 2015-20. 2015- 2020年立陶宛酒精消费的经济成本。

IF 3.7 3区医学

European Journal of Public Health Pub Date : 2025-05-09 DOI: 10.1093/eurpub/ckaf069

Vaida Liutkutė-Gumarov, Claire de Oliveira, Auksė Domeikienė, Lukas Galkus, Ahmed S Hassan, Shannon Lange, Laura Miščikienė, Birutė Peištarė, Janina Petkevičienė, Ričardas Radišauskas, Jürgen Rehm, Pol Rovira, Ilona Tamutienė, Mark James Thompson, Mindaugas Štelemėkas

{"title":"The economic costs of alcohol consumption in Lithuania, 2015-20.","authors":"Vaida Liutkutė-Gumarov, Claire de Oliveira, Auksė Domeikienė, Lukas Galkus, Ahmed S Hassan, Shannon Lange, Laura Miščikienė, Birutė Peištarė, Janina Petkevičienė, Ričardas Radišauskas, Jürgen Rehm, Pol Rovira, Ilona Tamutienė, Mark James Thompson, Mindaugas Štelemėkas","doi":"10.1093/eurpub/ckaf069","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf069","url":null,"abstract":"Alcohol per capita consumption in Lithuania among the population 15 years of age and older has been among the highest globally in recent decades. Long-term alcohol consumption trends and drinking patterns signal a significant public health problem, as well as social and economic losses. This study aimed to estimate the economic burden associated with alcohol consumption in Lithuania from 2015 to 2020. We used a cost-of-illness methodology with the human capital approach to estimate the economic burden and applied a prevalence-based approach. Using multiyear data, we estimated both, direct and indirect costs. Direct costs included healthcare and childcare, law enforcement, and justice system costs. Indirect costs included costs of productivity loss due to premature mortality. The total economic cost of alcohol consumption in Lithuania between 2015 and 2020 was estimated at an annual average of €542.958 million (in 2020 Euros) or about 1.18% of the Lithuanian total Gross Domestic Product. The highest proportion (65%) of the estimated costs was associated with productivity losses due to premature mortality. Alcohol use places a considerable burden on Lithuanian society in terms of illness, injury, death, and economic costs. Alcohol control policies, in particular excise taxation increases and availability restrictions have been shown to decrease this burden.","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Quality of clinical practice guidelines on the COVID-19 management in pregnancy during the pandemic: a systematic review. 大流行期间妊娠期COVID-19管理临床实践指南质量：系统评价

IF 3.7 3区医学

European Journal of Public Health Pub Date : 2025-05-07 DOI: 10.1093/eurpub/ckaf046

Luz García-Valdés, Bassel H Al Wattar, Mar García-Valdés, Carmen Amezcua-Prieto

{"title":"Quality of clinical practice guidelines on the COVID-19 management in pregnancy during the pandemic: a systematic review.","authors":"Luz García-Valdés, Bassel H Al Wattar, Mar García-Valdés, Carmen Amezcua-Prieto","doi":"10.1093/eurpub/ckaf046","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf046","url":null,"abstract":"The Coronavirus Disease 2019 (COVID-19) pandemic disrupted maternity care, highlighting the need for rapid, high-quality clinical practice guidelines (CPGs) to ensure safe care for pregnant women. We assessed the quality and recommendations of CPGs related to COVID-19 in pregnancy. Following prospective registration (PROSPERO number: CRD42022346031) we searched Medline, Web of Science, and UpToDate from inception until July 2024. The methodological quality was appraised using the Appraisal of Guidelines for Research and Evaluation II (AGREE II). A total of 27 CPGs were included. High scores were achieved in scope and purpose (21/27, 78%) and clarity (17/27, 63%). The most poorly addressed domains were rigour of development and applicability to clinical practice (18/27, 67% and 19/27, 70% scored low quality, respectively). Overall, only four (15%) guidelines were recommended. Most CPGs (25/27, 93%) addressed COVID-19 screening and transmission prevention, but few covered psychological care (3/27, 11%) or maternal delivery preferences (4/21, 19%). Consensus was found on timing and mode of delivery (16/17, 94%), but there was disagreement on delayed cord clamping and virus transmission interventions. Evidence-based practice requires health care providers, patients and stakeholders to be aware of variations in both the quality and recommendations of CPGs, especially during times of uncertainty.","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Correction to: All-cause and cause-specific mortality among older migrant and non-migrant adults in Finland: a register study on all deaths, 2002-2020. 更正：芬兰老年移民和非移民成年人的全因死亡率和特定原因死亡率：2002-2020年所有死亡的登记研究。

IF 3.7 3区医学

European Journal of Public Health Pub Date : 2025-05-07 DOI: 10.1093/eurpub/ckaf041

引用次数: 0

Implementation of genetic tests for disease prevention: challenges in evidence synthesis across clinical utility domains. 实施预防疾病的基因检测：跨临床应用领域证据合成的挑战。

IF 3.7 3区医学

European Journal of Public Health Pub Date : 2025-04-28 DOI: 10.1093/eurpub/ckaf047

Angelica Valz Gris, Astrid M Vicente, Stefania Boccia

引用次数: 0

Behavioural and metabolic mediators of socioeconomic inequalities in type 2 diabetes: comparing counterfactual and traditional mediation analysis. 2型糖尿病社会经济不平等的行为和代谢中介：比较反事实和传统中介分析。

IF 3.7 3区医学

European Journal of Public Health Pub Date : 2025-04-28 DOI: 10.1093/eurpub/ckaf056

Diego Yacaman Mendez, Ylva Trolle Lagerros, Antonio Ponce de Leon, Per Tynelius, Stefan Fors, Anton Lager

{"title":"Behavioural and metabolic mediators of socioeconomic inequalities in type 2 diabetes: comparing counterfactual and traditional mediation analysis.","authors":"Diego Yacaman Mendez, Ylva Trolle Lagerros, Antonio Ponce de Leon, Per Tynelius, Stefan Fors, Anton Lager","doi":"10.1093/eurpub/ckaf056","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf056","url":null,"abstract":"There is a well-established social gradient in the occurrence of type 2 diabetes, but the extent to which behavioural or metabolic risk factors explain these inequalities remains unclear. Leveraging data from 7123 adults and over 20 years of follow-up, we used counterfactual mediation analysis to estimate the direct effect of low socioeconomic status (measured as educational attainment and occupational class) on the risk of type 2 diabetes, and the indirect effect through behavioural and metabolic risk factors. Mediators included were smoking, high alcohol consumption, low physical activity, diet low in vegetables or fruits, high body mass index (BMI), high fasting glucose, and hypertension. We compared the results to mediation analysis using the difference and the product of coefficients methods. We found an association between low educational attainment 1.31 (95% CI 1.16, 1.45) and low occupational class 1.24 (95% CI 1.09, 1.38) with future risk of type 2 diabetes. In the counterfactual mediation analysis, behavioural and metabolic risk factors explained 60% (95% CI 41%, 75%) of the effect of low educational attainment and 42% (95% CI 19%, 65%) of the effect of occupational class on the risk of type 2 diabetes. The difference and product of coefficients methods yielded similar results. Well-established behavioural and metabolic mediators explained roughly half of the health inequalities in the incidence of type 2 diabetes. Public health interventions should consider alternative mechanisms to reduce disparities in the incidence of type 2 diabetes.","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clustering of non-medical risk factors and the association with duration of social care in pregnant women in highly vulnerable circumstances. 非医疗风险因素的聚类及其与高度脆弱环境中孕妇社会护理时间的关系。

IF 3.7 3区医学

European Journal of Public Health Pub Date : 2025-04-27 DOI: 10.1093/eurpub/ckaf062

Kajal S C Mohabier, Lizbeth Burgos-Ochoa, Johanna P de Graaf, Eric A P Steegers, Loes C M Bertens

{"title":"Clustering of non-medical risk factors and the association with duration of social care in pregnant women in highly vulnerable circumstances.","authors":"Kajal S C Mohabier, Lizbeth Burgos-Ochoa, Johanna P de Graaf, Eric A P Steegers, Loes C M Bertens","doi":"10.1093/eurpub/ckaf062","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf062","url":null,"abstract":"Pregnancy can be considered a window of opportunity to help pregnant women optimize the circumstances they live in. Within the Mothers of Rotterdam study, pregnant women in highly vulnerable circumstances received standard social care or targeted social care to improve their circumstances. Women in this study had many combinations of non-medical risk factors contributing to their vulnerable circumstances. Here, the aim is to study the association between different combinations of non-medical risk factors and duration of care. Existing non-medical risk factors, assessed with a vulnerability checklist, were clustered using Latent Class Analysis (LCA). Linear regression was used to examine the relationship with duration of social care. The model was adjusted for maternal age, deprived neighbourhood, and type of social care. Four vulnerability classes were identified among 840 women and were labelled complex (9%), educational (24%), social network (12%), and financial vulnerability (55%). In the unadjusted model, all three classes showed a significant longer duration of social care compared to the financial vulnerability class. After adjustment, only the longer duration of care of the social network vulnerability class remained statistically significant. The four identified vulnerability classes illustrate that even within a group of women in highly vulnerable circumstances, subgroups of vulnerability exist. The vulnerability classes were identifiable through different combinations of non-medical risk factors and are all, associated with different durations of social care. These findings help to understand, and plan for, the requirements of social care for women in highly vulnerable circumstances.","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0