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Titze S, Strain T, Wagner P, Schuster A, Karner J, Dorner TE. The Impact of Removing the 10-Minute Bout Requirement and of Different Survey Administration Methods on National Physical Activity Estimates in Austria. J Phys Act Health 2024; 21:491-499. [PMID: 38460506 DOI: 10.1123/jpah.2023-0459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 01/03/2024] [Accepted: 01/30/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND Monitoring survey methods, as well as movement recommendations, evolves over time. These changes can make trend observations over time difficult. The aim of this study was to examine the differences between 2 computer-assisted survey administration methods and the effect of the omission of the 10-minute minimum bout requirement in physical activity (PA) questions on PA outcomes. METHODS We used data from the second Austrian PA Surveillance System for 2998 adults (18-64 y), applying computer-assisted personal interviewing and computer-assisted web interviewing. Within the computer-assisted web interviewing sample only, we added PA questions without the 10-minute requirement. Quantile and logistic regressions were applied. RESULTS Between computer-assisted web interviewing and computer-assisted personal interviewing, within the computer-assisted personal interviewing sample, we found lower PA estimates in the leisure domain and work and household domain, but not in the travel domain, and no significant difference in the proportion of people meeting the PA recommendations. In all 3 PA domains, the median minutes did not differ when assessed with or without the 10-minute requirement. However, the percentage participation in the travel domain and work and household domain performing >0 minutes per week PA was higher when there was no 10-minute requirement. The proportion of people meeting the Austrian aerobic recommendation for adults when computed with or without the 10-minute requirement did not differ. CONCLUSION Our findings suggest that the omission of the 10-minute requirement does not seem to result in marked differences in PA estimates or the proportion of adults meeting the recommendations.
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Affiliation(s)
- Sylvia Titze
- Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
| | - Tessa Strain
- Physical Activity for Health Research Center, University of Edinburgh, Edinburgh, Scotland
| | | | | | | | - Thomas E Dorner
- Academy for Aging Research, Haus der Barmherzigkeit, Vienna, Austria
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Stein KV, Dorner TE. From Health-in-All-Policies to Climate-in-All-Policies: Using the Synergies between Health Promotion and Climate Protection to Take Action. Int J Environ Res Public Health 2024; 21:110. [PMID: 38248572 PMCID: PMC10815089 DOI: 10.3390/ijerph21010110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/12/2024] [Accepted: 01/14/2024] [Indexed: 01/23/2024]
Abstract
The climate crisis is developing into a life-changing event on a global level. Health promotion with the aim to increase the health status of individuals, independent of the present health status, has been developed on a scientific basis at least for the last eight decades. There are some basic principles which are prerequisites for both health promotion and climate protection. Those principles include (1) sustainability, (2) orientation on determinants, and (3) requirement of individual as well as community approaches. People are generally aiming to protect their lifestyle habits (e.g., traveling and consumer habits) and personal property (e.g., car and house) with easy solutions and as little effort as possible, and this can affect both health and climate. To reduce the emission of greenhouse gases and to protect our environment, changes towards a sustainable lifestyle have to be embedded into everybody's mind. Examples for domains that need to be addressed in health promotion as well as in climate protection include (health and climate) literacy, physical activity and active mobility, and nutrition and dietary habits. If health promotion fails to tackle those domains, this will continue to drive the climate crisis. And climate change, in turn, will affect health. On the other hand, developing and promoting health resources in the domains mentioned could help to mitigate the health-damaging effects of climate change. Success in the joint efforts to promote health and protect the climate would improve the One Health approach, the health of people and the environment.
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Affiliation(s)
- K. Viktoria Stein
- Karl-Landsteiner Institute for Health Promotion Research, 3062 Kirchstetten, Austria;
- Department for Public Health and Primary Care, Leiden University Medical Centre, 2333 The Hague, The Netherlands
| | - Thomas E. Dorner
- Karl-Landsteiner Institute for Health Promotion Research, 3062 Kirchstetten, Austria;
- Academy for Ageing Research, Haus der Barmherzigkeit, 1060 Vienna, Austria
- Centre for Public Health, Department for Social and Preventive Medicine, Medical University Vienna, 1090 Vienna, Austria
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Oberndorfer M, Leyland AH, Pearce J, Grabovac I, Hannah MK, Dorner TE. Unequally Unequal? Contextual-level status inequality and social cohesion moderating the association between individual-level socioeconomic position and systemic chronic inflammation. Soc Sci Med 2023; 333:116185. [PMID: 37598618 DOI: 10.1016/j.socscimed.2023.116185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 06/07/2023] [Accepted: 08/17/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND Status inequality is hypothesised to increase socioeconomic inequalities in health by creating an environment in which social cohesion erodes and social comparisons intensify. Such an environment may cause systemic chronic inflammation. Although these are often-used explanations in social epidemiology, empirical tests remain rare. METHODS We analysed data from the West of Scotland Twenty-07 Study. Our sample consisted of 1977 participants in 499 small residential areas. Systemic chronic inflammation was measured by high-sensitivity C-reactive protein (hs-CRP; <10 mg/L). An area-level measurement of status inequality was created using census data and contextual-level social cohesion was measured applying ecometrics. We estimated linear multilevel models with cross-level interactions between socioeconomic position (SEP), status inequality, and social cohesion adjusted for age and gender. Our main analysis on postcode sector-level was re-estimated on three smaller spatial levels. RESULTS The difference in hs-CRP between disadvantaged and advantaged SEPs (0.806 mg/L; p = 0.063; [95%CI: -0.044; 1.656]) was highest among participants living in areas where most residents were in advantaged SEPs. In these status distributions, high social cohesion was associated with a shallower socioeconomic gradient in hs-CRP and low social cohesion was associated with a steeper gradient. In areas with an equal mix of SEPs or most residents in disadvantaged SEPs, the estimated difference in hs-CRP between disadvantaged and advantaged SEPs was -0.039 mg/L (p = 0.898; [95%CI: 0.644; 0.566]) and -0.257 mg/L (p = 0.568; [95%CI: 1.139; 0.625]) respectively. In these status distributions, the gradient in hs-CRP appeared steeper when social cohesion was high and potentially reversed when social cohesion was low. Results were broadly consistent when using area-levels smaller than postcode sectors. CONCLUSIONS Inequalities in hs-CRP were greatest among participants living in areas wherein a majority of residents were in advantaged SEPs and social cohesion was low. In other combinations of these contextual characteristics, inequalities in systemic chronic inflammation were not detectable or potentially even reversed.
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Affiliation(s)
- Moritz Oberndorfer
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria; MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, Scotland.
| | - Alastair H Leyland
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, Scotland
| | - Jamie Pearce
- Centre for Research on Environment, Society, And Health, School of GeoSciences, University of Edinburgh, Edinburgh, Scotland
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Mary K Hannah
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, Scotland
| | - Thomas E Dorner
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria; Academy for Ageing Research, Haus der Barmherzigkeit, Vienna, Austria
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Dorner TE, Zeegers Paget D. The European Public Health Community is mourning Richard Horst Noack. Eur J Public Health 2023; 33:ckad099. [PMID: 37381075 PMCID: PMC10395760 DOI: 10.1093/eurpub/ckad099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023] Open
Affiliation(s)
- Thomas E Dorner
- Austrian Public Health Association, Vienna, Austria
- European Public Health Association, Utrecht, The Netherlands
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Woldemariam S, Dorner TE, Wiesinger T, Stein KV. Multi-omics approaches for precision obesity management : Potentials and limitations of omics in precision prevention, treatment and risk reduction of obesity. Wien Klin Wochenschr 2023; 135:113-124. [PMID: 36717394 PMCID: PMC10020295 DOI: 10.1007/s00508-022-02146-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 12/12/2022] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Obesity is a multifactorial chronic disease that cannot be addressed by simply promoting better diets and more physical activity. To date, not a single country has successfully been able to curb the accumulating burden of obesity. One explanation for the lack of progress is that lifestyle intervention programs are traditionally implemented without a comprehensive evaluation of an individual's diagnostic biomarkers. Evidence from genome-wide association studies highlight the importance of genetic and epigenetic factors in the development of obesity and how they in turn affect the transcriptome, metabolites, microbiomes, and proteomes. OBJECTIVE The purpose of this review is to provide an overview of the different types of omics data: genomics, epigenomics, transcriptomics, proteomics, metabolomics and illustrate how a multi-omics approach can be fundamental for the implementation of precision obesity management. RESULTS The different types of omics designs are grouped into two categories, the genotype approach and the phenotype approach. When applied to obesity prevention and management, each omics type could potentially help to detect specific biomarkers in people with risk profiles and guide healthcare professionals and decision makers in developing individualized treatment plans according to the needs of the individual before the onset of obesity. CONCLUSION Integrating multi-omics approaches will enable a paradigm shift from the one size fits all approach towards precision obesity management, i.e. (1) precision prevention of the onset of obesity, (2) precision medicine and tailored treatment of obesity, and (3) precision risk reduction and prevention of secondary diseases related to obesity.
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Affiliation(s)
- Selam Woldemariam
- Karl Landsteiner Institute for Health Promotion Research, 3062, Kirchstetten, Austria
| | - Thomas E Dorner
- Karl Landsteiner Institute for Health Promotion Research, 3062, Kirchstetten, Austria
- Academy for Ageing Research, House of Mercy, 1160, Vienna, Austria
| | - Thomas Wiesinger
- Karl Landsteiner Institute for Health Promotion Research, 3062, Kirchstetten, Austria
| | - Katharina Viktoria Stein
- Karl Landsteiner Institute for Health Promotion Research, 3062, Kirchstetten, Austria.
- Department of Public Health and Primary Care, Leiden University Medical Centre, 2511 DP, The Hague, The Netherlands.
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Beichler H, Grabovac I, Dorner TE. Integrated Care as a Model for Interprofessional Disease Management and the Benefits for People Living with HIV/AIDS. Int J Environ Res Public Health 2023; 20:3374. [PMID: 36834069 PMCID: PMC9965658 DOI: 10.3390/ijerph20043374] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Today, antiretroviral therapy (ART) is effectively used as a lifelong therapy to treat people living with HIV (PLWH) to suppress viral replication. Moreover, PLWH need an adequate care strategy in an interprofessional, networked setting of health care professionals from different disciplines. HIV/AIDS poses challenges to both patients and health care professionals within the framework of care due to frequent visits to physicians, avoidable hospitalizations, comorbidities, complications, and the resulting polypharmacy. The concepts of integrated care (IC) represent sustainable approaches to solving the complex care situation of PLWH. AIMS This study aimed to describe the national and international models of integrated care and their benefits regarding PLWH as complex, chronically ill patients in the health care system. METHODS We conducted a narrative review of the current national and international innovative models and approaches to integrated care for people with HIV/AIDS. The literature search covered the period between March and November 2022 and was conducted in the databases Cinahl, Cochrane, and Pubmed. Quantitative and qualitative studies, meta-analyses, and reviews were included. RESULTS The main findings are the benefits of integrated care (IC) as an interconnected, guideline- and pathway-based multiprofessional, multidisciplinary, patient-centered treatment for PLWH with complex chronic HIV/AIDS. This includes the evidence-based continuity of care with decreased hospitalization, reductions in costly and burdensome duplicate testing, and the saving of overall health care costs. Furthermore, it includes motivation for adherence, the prevention of HIV transmission through unrestricted access to ART, the reduction and timely treatment of comorbidities, the reduction of multimorbidity and polypharmacy, palliative care, and the treatment of chronic pain. IC is initiated, implemented, and financed by health policy in the form of integrated health care, managed care, case and care management, primary care, and general practitioner-centered concepts for the care of PLWH. Integrated care was originally founded in the United States of America. The complexity of HIV/AIDS intensifies as the disease progresses. CONCLUSIONS Integrated care focuses on the holistic view of PLWH, considering medical, nursing, psychosocial, and psychiatric needs, as well as the various interactions among them. A comprehensive expansion of integrated care in primary health care settings will not only relieve the burden on hospitals but also significantly improve the patient situation and the outcome of treatment.
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Affiliation(s)
- Helmut Beichler
- Nursing School, Vienna General Hospital, Medical University of Vienna, 1090 Vienna, Austria
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Thomas E. Dorner
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, 1090 Vienna, Austria
- Academy for Ageing Research, Haus der Barmherzigkeit, 1090 Vienna, Austria
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Beichler H, Kutalek R, Dorner TE. People Living with HIV and AIDS: Experiences towards Antiretroviral Therapy, Paradigm Changes, Coping, Stigma, and Discrimination-A Grounded Theory Study. Int J Environ Res Public Health 2023; 20:3000. [PMID: 36833695 PMCID: PMC9962544 DOI: 10.3390/ijerph20043000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/06/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The experiences in coping with HIV/AIDS from people living with HIV (PLWH) in Austria, Munich, and Berlin regarding adherence, antiretroviral therapy (ART), stigmatization, and discrimination were the main focus of this study. Therapy adherence is the cornerstone for PLWH to reduce disease progression and increase life expectancy combined with a high quality of life. The experience of stigmatization and discrimination in different life situations and settings is still experienced today. AIMS We aimed to examine the subjective perspective of PLWH concerning living with, coping with, and managing HIV/AIDS in daily life. METHODS Grounded Theory Methodology (GTM) was used. Data collection was conducted with semi-structured face-to-face interviews with 25 participants. Data analysis was performed in three steps, open, axial, and selective coding. RESULTS Five categories emerged, which included the following: (1) fast coping with diagnosis, (2) psychosocial burden due to HIV, (3) ART as a necessity, (4) building trust in HIV disclosure, (5) stigmatization and discrimination are still existing. CONCLUSION In conclusion, it can be said that it is not the disease itself that causes the greatest stress, but the process of coping with the diagnosis. Therapy, as well as lifelong adherence, is hardly worth mentioning today. Much more significant is currently still the burden of discrimination and stigmatization.
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Affiliation(s)
- Helmut Beichler
- Nursing School, General Hospital, Medical University Vienna, 1090 Vienna, Austria
| | - Ruth Kutalek
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Thomas E. Dorner
- Academy for Ageing Research, Haus der Barmherzigkeit, 1160 Vienna, Austria
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1, 1090 Vienna, Austria
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Wieczorek M, Verstappen SM, Putrik P, Gwinnutt JM, Balanescu A, Bischoff-Ferrari HA, Boonen A, Cavalli G, de Souza S, de Thurah A, Dorner TE, Moe RH, Rodríguez-Carrio J, Silva-Fernández L, Stamm T, Walker-Bone K, Welling J, Zlatković-Švenda M, Guillemin F. Association of vocational interventions and work-related factors with disease and work outcomes in people with RMDs: A systematic review. Semin Arthritis Rheum 2023; 58:152135. [PMID: 36434893 DOI: 10.1016/j.semarthrit.2022.152135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 10/20/2022] [Accepted: 11/11/2022] [Indexed: 11/14/2022]
Abstract
OBJECTIVE A EULAR taskforce was convened to develop recommendations for lifestyle behaviours amongst people with rheumatic and musculoskeletal diseases (RMDs). This paper reviews the literature on work-related factors and disease-specific outcomes for people with osteoarthritis, rheumatoid arthritis (RA), systemic lupus erythematosus, axial spondyloarthritis (axSpA), psoriatic arthritis, systemic sclerosis (SSc) and gout. METHODS Two separate systematic literature reviews (SLRs) were conducted. The first identified SLRs, published between 01/2013 and 09/2018. The second identified original observational and intervention studies published before 05/2019. Manuscripts were included if they assessed the effects of vocational interventions on disease-specific outcomes (i.e. clinical outcomes, patient-reported outcomes, and work outcomes) or if they assessed the association between work-related factors and these outcomes. Medline, Embase, Cochrane Library of systematic reviews and CENTRAL databases were searched. RESULTS Two SLRs were identified including individuals with SSc and inflammatory arthritis. Subsequently, 23 original manuscripts were identified, with most of them (43.5%) including people with RA and no manuscripts on gout. Most observational studies evaluated the association between work-related factors and work outcomes while limited information was available on the impact of work on clinical outcomes. A few studies suggested that physically demanding jobs have a small detrimental effect on radiographic progression in axSpA and PsA. Intervention studies showed beneficial effects of vocational interventions for disease-specific outcomes, but with small effect sizes. CONCLUSION Many studies indicated that work participation is not likely to be detrimental and, in some cases, may be beneficial for RMD-specific outcomes and should therefore receive attention within healthcare consultations.
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Affiliation(s)
- Maud Wieczorek
- Université de Lorraine, EA 4360 Apemac, Nancy, France; Centre on Aging and Mobility, University Hospital Zurich, City Hospital Zurich, Waid and University of Zurich, Zurich, Switzerland
| | - Suzanne Mm Verstappen
- Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine and Health, The University of Manchester, UK; MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, UK; NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, UK.
| | - Polina Putrik
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, The Netherlands; Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - James M Gwinnutt
- Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine and Health, The University of Manchester, UK
| | - Andra Balanescu
- Department of Internal Medicine and Rheumatology Department, "Sf Maria Hospital", "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Heike A Bischoff-Ferrari
- Centre on Aging and Mobility, University Hospital Zurich, City Hospital Zurich, Waid and University of Zurich, Zurich, Switzerland; Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland; University Clinic for Aging Medicine, City Hospital - Waid, Zurich, Switzerland
| | - Annelies Boonen
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, The Netherlands; Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Giulio Cavalli
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, Italy
| | - Savia de Souza
- Centre for Rheumatic Diseases, King's College London, United Kingdom
| | - Annette de Thurah
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
| | - Thomas E Dorner
- Centre for Public Health, Department of Social and Preventive Medicine, Medical University of Vienna, Vienna, Austria; Social Insurance Fund for Public Service, Railway and Mining Industries, Sitzenberg-Reidling, Austria; Karl-Landsteiner Institute for Health Promotion Research, Sitzenberg-Reidling, Austria
| | - Rikke Helene Moe
- National Advisory Unit for Rehabilitation in Rheumatology, Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Javier Rodríguez-Carrio
- Area of Immunology, Department of Functional Biology, Universidad de Oviedo, Spain; Department of Metabolism, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Asturias, Spain
| | - Lucía Silva-Fernández
- Rheumatology Department. Hospital Universitari Son Espases. Palma de Mallorca, Spain
| | - Tanja Stamm
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
| | - Karen Walker-Bone
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, UK
| | - Joep Welling
- NVLE Dutch Patient Organization for Systemic Autoimmune Diseases, Utrecht, The Netherlands
| | - Mirjana Zlatković-Švenda
- Institute of Rheumatology, University of Belgrade School of Medicine, Belgrade, Serbia; Department of Internal Medicine University of East Sarajevo Medical Faculty Foča, Republika Srpska, Bosnia and Herzegovina
| | - Francis Guillemin
- Université de Lorraine, EA 4360 Apemac, Nancy, France; Inserm, CHRU Nancy, Université de Lorraine, CIC-1433 Epidémiologie Clinique, Nancy, France
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Gwinnutt JM, Wieczorek M, Balanescu A, Bischoff-Ferrari HA, Boonen A, Cavalli G, de Souza S, de Thurah A, Dorner TE, Moe RH, Putrik P, Rodríguez-Carrio J, Silva-Fernández L, Stamm T, Walker-Bone K, Welling J, Zlatković-Švenda MI, Guillemin F, Verstappen SMM. 2021 EULAR recommendations regarding lifestyle behaviours and work participation to prevent progression of rheumatic and musculoskeletal diseases. Ann Rheum Dis 2023; 82:48-56. [PMID: 35260387 DOI: 10.1136/annrheumdis-2021-222020] [Citation(s) in RCA: 50] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/04/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVES A European League Against Rheumatism taskforce was convened to review the literature and develop recommendations on lifestyle behaviours for rheumatic and musculoskeletal diseases (RMDs). METHODS Six lifestyle exposures (exercise, diet, weight, alcohol, smoking, work participation) and seven RMDs (osteoarthritis, rheumatoid arthritis, axial spondyloarthritis, psoriatic arthritis, systemic lupus erythematosus, systemic sclerosis, gout) were considered. The taskforce included health professionals in rheumatology, geriatricians, epidemiologists, public health experts, people with RMDs and exposure domain experts. Systematic reviews were conducted to gather available evidence, from which recommendations were developed. RESULTS Five overarching principles and 18 specific recommendations were defined based on available evidence. The overarching principles define the importance of a healthy lifestyle, how lifestyle modifications should be implemented, and their role in relation to medical treatments. Exercise recommendations highlight the safety and benefits of exercise on pain and disability, particularly among people with osteoarthritis and axial spondyloarthritis. The diet recommendations emphasise the importance of a healthy, balanced diet for people with RMDs. People with RMDs and health professionals should work together to achieve and maintain a healthy weight. Small amounts of alcohol are unlikely to negatively affect the outcomes of people with RMDs, although people with rheumatoid arthritis and gout may be at risk of flares after moderate alcohol consumption. Smokers should be supported to quit. Work participation may have benefits on RMD outcomes and should be discussed in consultations. CONCLUSIONS These recommendations cover a range of lifestyle behaviours and can guide shared decision making between people with RMDs and health professionals when developing and monitoring treatment plans.
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Affiliation(s)
- James M Gwinnutt
- Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | | | - Andra Balanescu
- Department of Internal Medicine and Rheumatology, "Sf. Maria" Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Heike A Bischoff-Ferrari
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland.,Center on Aging and Mobility, University of Zurich, Zurich, Switzerland.,University Clinic for Aging Medicine, City Hospital Zurich - Waid, Zurich, Switzerland
| | - Annelies Boonen
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Giulio Cavalli
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, Italy
| | - Savia de Souza
- Centre for Rheumatic Diseases, King's College London, London, UK
| | - Annette de Thurah
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
| | - Thomas E Dorner
- Centre for Public Health, Department of Social and Preventive Medicine, Medical University of Vienna, Vienna, Austria.,Social Insurance Fund for Public Service, Railway and Mining Industries, Sitzenberg-Reidling, Austria.,Karl-Landsteiner Institute for Health Promotion Research, Sitzenberg-Reidling, Austria
| | - Rikke Helene Moe
- National Advisory Unit for Rehabilitation in Rheumatology, Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Polina Putrik
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Javier Rodríguez-Carrio
- Area of Immunology, Department of Functional Biology, Universidad de Oviedo, Oviedo, Spain.,Department of Metabolism, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Lucía Silva-Fernández
- Rheumatology Department, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Tanja Stamm
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria.,Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
| | - Karen Walker-Bone
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
| | - Joep Welling
- NVLE Dutch Patient Organization for Systemic Autoimmune Diseases, Utrecht, The Netherlands
| | - Mirjana I Zlatković-Švenda
- Institute of Rheumatology, University of Belgrade School of Medicine, Belgrade, Serbia.,Department of Internal Medicine, University of East Sarajevo Faculty of Medicine Foča, Republika Srpska, Bosnia and Herzegovina
| | - Francis Guillemin
- EA 4360 Apemac, Université de Lorraine, Nancy, France.,Inserm, CHRU Nancy, CIC-1433 Epidémiologie Clinique, Université de Lorraine, Nancy, France
| | - Suzanne M M Verstappen
- Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK .,MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK.,NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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Janka C, Stamm T, Heinze G, Dorner TE. A Training Programme for Developing Social and Personal Resources and Its Effects on the Perceived Stress Level in Adults in Daily Life-Study Protocol for a Prospective Cohort Study. Int J Environ Res Public Health 2022; 20:523. [PMID: 36612844 PMCID: PMC9819783 DOI: 10.3390/ijerph20010523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
Abstract
Persistent stress and insufficient coping strategies have negative consequences for physical and mental health. Teaching adults the skills needed to sustainably improve stress-buffering aspects of their character could contribute to the prevention of stress-related diseases. In this non-randomised, observational, prospective cohort study, participants of a training programme for developing social and personal skills, to which they previously self-assigned, are assessed. The 12-month training programme focuses on improving perceived stress level (primary outcome), health behaviour, presence of common somatic symptoms, satisfaction with life, quality of social relationships, and wellbeing by addressing life goals, meaning in life, sense of coherence, social and personal resources, and transcendence. Study participants are recruited from the training groups via the training organiser. Companions, persons with whom they share a close relationship, are recruited to assess the interpersonal diffusion effects of the training. Matched individuals not participating in the training are the control group. Parameter assessment follows a pre-, post-, and follow-up (6 months) design. Designed to improve health-related outcomes in adults by addressing personality characteristics and using Lozanov's superlearning principles to improve learning efficiency, this training programme is, to the study team's knowledge, the first of its kind. From a research perspective, the outcomes of this study can provide new insights into primary prevention of stress-related diseases and how the effects of these measures are passed on through common personal interaction. The trial has been pre-registered (registration number: NCT04165473).
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Affiliation(s)
- Christoph Janka
- Center for Public Health, Institute of Social and Preventive Medicine, Medical University of Vienna, Kinderspitalgasse 15/1, 1090 Vienna, Austria
| | - Tanja Stamm
- Center for Medical Data Science, Institute of Outcomes Research, Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, 1090 Vienna, Austria
| | - Georg Heinze
- Center for Medical Data Science, Institute of Clinical Biometrics, Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria
| | - Thomas E. Dorner
- Center for Public Health, Institute of Social and Preventive Medicine, Medical University of Vienna, Kinderspitalgasse 15/1, 1090 Vienna, Austria
- Karl-Landsteiner Institute for Health Promotion Research, Haus der Barmherzigkeit—Clementinum, Paltram 12, 3062 Kirchstetten, Austria
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11
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Oberndorfer M, Stolz E, Dorner TE. Evidence for changes in population-level subjective well-being during the COVID-19 pandemic from 30 waves of representative panel data collected in Austria between March 2020 and March 2022. Public Health 2022; 212:84-88. [PMID: 36265427 PMCID: PMC9472574 DOI: 10.1016/j.puhe.2022.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/23/2022] [Accepted: 09/08/2022] [Indexed: 11/25/2022]
Abstract
Objectives This study was conducted to describe how population-level subjective well-being (SWB) evolved throughout the pandemic. Study design Thirty waves of panel data representative of the Austrian population aged ≥14 years were collected between March 2020 and March 2022. Participants were quota sampled from a pre-existing online panel based on key demographics closely mirroring the Austrian resident population. Methods We present wave-specific means of SWB throughout 2 years of the COVID-19 pandemic next to the evolution of the pandemic (cases and deaths) and stringency of lockdown measures in Austria as well as estimate their bivariate correlations. Results The analysed sample consisted of 3,293 participants contributing to a total of 46,168 observations. All components of SWB – negative affect, positive affect and life satisfaction – showed population-level fluctuation between March 2020 and March 2022. The magnitude of these changes was small. Population-level SWB correlated with the incidence rate of COVID-19 deaths (negative affect: r = 0.69, positive affect: r = −0.70, life satisfaction: r = −0.47), the Stringency Index (negative affect = 0.50, positive affect = −0.47, life satisfaction = −0.47) and less so with the incidence of COVID-19 cases (negative affect = 0.43, positive affect = −0.31, life satisfaction = −0.38). Conclusions Population-level SWB fluctuated in accordance with rises and falls in COVID-19 cases and deaths as well as with the stringency of lockdown measures. This connection suggests that incidence of COVID-19 cases and deaths, as well as public health measures to contain the pandemic affect population-level SWB and could thereby impact population health and productivity.
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12
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Oberndorfer M, Dorner TE, Brunnmayr M, Berger K, Dugandzic B, Bach M. Health-related and socio-economic burden of the COVID-19 pandemic in Vienna. Health Soc Care Community 2022; 30:1550-1561. [PMID: 34219320 PMCID: PMC8444637 DOI: 10.1111/hsc.13485] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 05/17/2021] [Accepted: 06/07/2021] [Indexed: 05/07/2023]
Abstract
Previous pandemics have rarely affected everyone equally and, so far, the COVID-19 pandemic is no exception. Emerging evidence has shown that incidence rate, hospitalisation rate, and mortality due to COVID-19 are higher among people in lower socio-economic position (SEP). In addition, first investigations indicate that not everyone is equally affected by this pandemic's collateral public health damage. Using a stratified random sample of 1,004 participants living in Vienna, a Central European city with approximately 1.9 million inhabitants, this study analysed the distribution of 10 adverse health-related and socio-economic outcomes attributable to the COVID-19 pandemic across socio-economic strata. To this end, we estimated differences in the incidence rate of these outcomes by SEP and each of its indicators using zero-inflated Poisson and logistic regression models, adjusted for age and gender. Data were collected during first lockdown measures between 27 April and 17 May 2020. Differences in the incidence rate between the two lowest and two highest SEP groups were clearly visible. Participants in the lowest SEP category had a 32.96% higher incidence rate (IRR = 1.333 [95% CI: 1.079-1.639]), and participants in the second lowest SEP category had a 44.69% higher incidence rate (IRR = 1.447 [95% CI: 1.190-1.760]) compared with participants in the highest SEP category. In sum, 6 out of 10 adverse COVID-19-related outcomes were, to a greater or lesser extent, disproportionately experienced by Viennese residents in lower SEP. Inequalities were most visible between income groups and for the outcomes job loss, worsening of the financial situation, and worse mental health. These results strengthen and extend the current evidence on the unequally distributed burden of the COVID-19 pandemic. In light of effect heterogeneity across SEP indicators, we encourage future investigators to pay increased attention to their operationalisation of SEP. Such awareness will help to correctly identify those in most urgent need of supportive polices.
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Affiliation(s)
- Moritz Oberndorfer
- Department of Social and Preventive MedicineCentre for Public HealthMedical University of ViennaViennaAustria
| | - Thomas E. Dorner
- Department of Social and Preventive MedicineCentre for Public HealthMedical University of ViennaViennaAustria
- Social Insurance Fund for Public Service, Railway and Mining IndustriesGesundheitseinrichtung Sitzenberg‐ReidlingSitzenberg‐ReidlingAustria
| | - Martina Brunnmayr
- Social Insurance Fund for Public Service, Railway and Mining IndustriesTherapiezentrum JustusparkBad HallAustria
| | - Katharina Berger
- Social Insurance Fund for Public Service, Railway and Mining IndustriesTherapiezentrum JustusparkBad HallAustria
| | - Belma Dugandzic
- Social Insurance Fund for Public Service, Railway and Mining IndustriesTherapiezentrum JustusparkBad HallAustria
| | - Michael Bach
- Social Insurance Fund for Public Service, Railway and Mining IndustriesTherapiezentrum JustusparkBad HallAustria
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13
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Gwinnutt JM, Wieczorek M, Rodríguez-Carrio J, Balanescu A, Bischoff-Ferrari HA, Boonen A, Cavalli G, de Souza S, de Thurah A, Dorner TE, Moe RH, Putrik P, Silva-Fernández L, Stamm T, Walker-Bone K, Welling J, Zlatković-Švenda M, Guillemin F, Verstappen SMM. Effects of diet on the outcomes of rheumatic and musculoskeletal diseases (RMDs): systematic review and meta-analyses informing the 2021 EULAR recommendations for lifestyle improvements in people with RMDs. RMD Open 2022; 8:rmdopen-2021-002167. [PMID: 35654458 PMCID: PMC9096533 DOI: 10.1136/rmdopen-2021-002167] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 04/01/2022] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND A EULAR taskforce was convened to develop recommendations for lifestyle behaviours in rheumatic and musculoskeletal diseases (RMDs). In this paper, the literature on the effect of diet on the progression of RMDs is reviewed. METHODS Systematic reviews and meta-analyses were performed of studies related to diet and disease outcomes in seven RMDs: osteoarthritis (OA), rheumatoid arthritis (RA), systemic lupus erythematosus, axial spondyloarthritis, psoriatic arthritis, systemic sclerosis and gout. In the first phase, existing relevant systematic reviews and meta-analyses, published from 2013 to 2018, were identified. In the second phase, the review was expanded to include published original studies on diet in RMDs, with no restriction on publication date. Systematic reviews or original studies were included if they assessed a dietary exposure in one of the above RMDs, and reported results regarding progression of disease (eg, pain, function, joint damage). RESULTS In total, 24 systematic reviews and 150 original articles were included. Many dietary exposures have been studied (n=83), although the majority of studies addressed people with OA and RA. Most dietary exposures were assessed by relatively few studies. Exposures that have been assessed by multiple, well conducted studies (eg, OA: vitamin D, chondroitin, glucosamine; RA: omega-3) were classified as moderate evidence of small effects on disease progression. CONCLUSION The current literature suggests that there is moderate evidence for a small benefit for certain dietary components. High-level evidence of clinically meaningful effect sizes from individual dietary exposures on outcomes in RMDs is missing.
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Affiliation(s)
- James M Gwinnutt
- Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Maud Wieczorek
- EA 4360 Apemac, Université de Lorraine, Nancy, France,Center on Aging and Mobility, University of Zurich, Zurich, Switzerland
| | - Javier Rodríguez-Carrio
- Area of Immunology, Department of Functional Biology, Universidad de Oviedo, Oviedo, Spain,Department of Metabolism, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Andra Balanescu
- Department of Internal Medicine and Rheumatology, ‘Sf Maria’ Hospital, ‘Carol Davila’ University of Medicine and Pharmacy, Bucharest, Romania
| | - Heike A Bischoff-Ferrari
- Center on Aging and Mobility, University of Zurich, Zurich, Switzerland,Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland,University Clinic for Aging Medicine, City Hospital Zurich - Waid, Zurich, Switzerland
| | - Annelies Boonen
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Giulio Cavalli
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, Italy
| | - Savia de Souza
- Centre for Rheumatic Diseases, King's College London, London, UK
| | - Annette de Thurah
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark,Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
| | - Thomas E Dorner
- Centre for Public Health, Department of Social and Preventive Medicine, Medical University of Vienna, Vienna, Austria,Social Insurance Fund for Public Service, Railway and Mining Industries, Sitzenberg-Reidling, Austria,Karl-Landsteiner Institute for Health Promotion Research, Sitzenberg-Reidling, Austria
| | - Rikke Helene Moe
- National Advisory Unit for Rehabilitation in Rheumatology, Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Polina Putrik
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Lucía Silva-Fernández
- Rheumatology Department, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Tanja Stamm
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria,Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
| | - Karen Walker-Bone
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
| | - Joep Welling
- NVLE Dutch Patient Organization for Systemic Autoimmune Diseases, Utrecht, The Netherlands
| | - Mirjana Zlatković-Švenda
- Institute of Rheumatology, University of Belgrade School of Medicine, Belgrade, Serbia,Department of Internal Medicine, University of East Sarajevo Faculty of Medicine Foča, Republika Srpska, Bosnia and Herzegovina
| | - Francis Guillemin
- EA 4360 Apemac, Université de Lorraine, Nancy, France,Inserm, CHRU Nancy, CIC-1433 Epidémiologie Clinique, Université de Lorraine, Nancy, France
| | - Suzanne M M Verstappen
- Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK .,MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK.,NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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14
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Gwinnutt JM, Wieczorek M, Cavalli G, Balanescu A, Bischoff-Ferrari HA, Boonen A, de Souza S, de Thurah A, Dorner TE, Moe RH, Putrik P, Rodríguez-Carrio J, Silva-Fernández L, Stamm T, Walker-Bone K, Welling J, Zlatković-Švenda MI, Guillemin F, Verstappen SMM. Effects of physical exercise and body weight on disease-specific outcomes of people with rheumatic and musculoskeletal diseases (RMDs): systematic reviews and meta-analyses informing the 2021 EULAR recommendations for lifestyle improvements in people with RMDs. RMD Open 2022; 8:rmdopen-2021-002168. [PMID: 35361692 PMCID: PMC8971792 DOI: 10.1136/rmdopen-2021-002168] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/23/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND A European League Against Rheumatism (EULAR) taskforce was convened to develop recommendations for lifestyle behaviours in rheumatic and musculoskeletal diseases (RMDs). This paper reviews the literature on the effects of physical exercise and body weight on disease-specific outcomes of people with RMDs. METHODS Three systematic reviews were conducted to summarise evidence related to exercise and weight in seven RMDs: osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus, axial spondyloarthritis (axSpA), psoriatic arthritis, systemic sclerosis and gout. Systematic reviews and original studies were included if they assessed exercise or weight in one of the above RMDs, and reported results regarding disease-specific outcomes (eg, pain, function, joint damage). Systematic reviews were only included if published between 2013-2018. Search strategies were implemented in the Medline, Embase, Cochrane Library of systematic reviews and CENTRAL databases. RESULTS 236 articles on exercise and 181 articles on weight were included. Exercise interventions resulted in improvements in outcomes such as pain and function across all the RMDs, although the size of the effect varied by RMD and intervention. Disease activity was not influenced by exercise, other than in axSpA. Increased body weight was associated with worse outcomes for the majority of RMDs and outcomes assessed. In general, study quality was moderate for the literature on exercise and body weight in RMDs, although there was large heterogeneity between studies. CONCLUSION The current literature supports recommending exercise and the maintenance of a healthy body weight for people with RMDs.
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Affiliation(s)
- James M Gwinnutt
- Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Maud Wieczorek
- EA 4360 Apemac, Université de Lorraine, Nancy, France,Center on Aging and Mobility, University of Zurich, Zurich, Switzerland
| | - Giulio Cavalli
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, Italy
| | - Andra Balanescu
- Department of Internal Medicine and Rheumatology, “Sf. Maria” Hospital, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Heike A Bischoff-Ferrari
- Center on Aging and Mobility, University of Zurich, Zurich, Switzerland,Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland,University Clinic for Aging Medicine, City Hospital Zurich - Waid, Zurich, Switzerland
| | - Annelies Boonen
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Savia de Souza
- Centre for Rheumatic Diseases, King's College London, London, UK
| | - Annette de Thurah
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark,Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
| | - Thomas E Dorner
- Centre for Public Health, Department of Social and Preventive Medicine, Medical University of Vienna, Vienna, Austria,Social Insurance Fund for Public Service, Railway and Mining Industries, Sitzenberg-Reidling, Austria,Karl-Landsteiner Institute for Health Promotion Research, Sitzenberg-Reidling, Austria
| | - Rikke Helene Moe
- National Advisory Unit for Rehabilitation in Rheumatology, Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Polina Putrik
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Javier Rodríguez-Carrio
- Area of Immunology, Department of Functional Biology, Universidad de Oviedo, Oviedo, Spain,Department of Metabolism, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Lucía Silva-Fernández
- Rheumatology Department, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Tanja Stamm
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria,Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
| | - Karen Walker-Bone
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
| | - Joep Welling
- NVLE Dutch Patient Organization for Systemic Autoimmune Diseases, Utrecht, The Netherlands
| | - Mirjana I Zlatković-Švenda
- Institute of Rheumatology, University of Belgrade School of Medicine, Belgrade, Serbia,Department of Internal Medicine, University of East Sarajevo Faculty of Medicine Foča, Republika Srpska, Bosnia and Herzegovina
| | - Francis Guillemin
- EA 4360 Apemac, Université de Lorraine, Nancy, France,Inserm, CHRU Nancy, CIC-1433 Epidémiologie Clinique, Université de Lorraine, Nancy, France
| | - Suzanne M M Verstappen
- Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK .,MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK.,NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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15
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Geirsdottir G, Mittendorfer-Rutz E, Björkenstam E, Chen L, Dorner TE, Amin R. Differences in labour market marginalisation between refugees, non-refugee immigrants and Swedish-born youth: Role of age at arrival and residency duration. Scand J Public Health 2022:14034948221079060. [PMID: 35343330 DOI: 10.1177/14034948221079060] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIMS We investigated if the risk of long-term unemployment (LTU) and disability pension (DP) differs between young refugees and non-refuge immigrants compared to the Swedish-born. The role of age at arrival, duration of residency and morbidity in this association was also investigated. METHODS All 19- to 25-year-olds residing in Sweden on 31 December 2004 (1691 refugees who were unaccompanied by a parent at arrival, 24,697 accompanied refugees, 18,762 non-refugee immigrants and 621,455 Swedish-born individuals) were followed from 2005 to 2016 regarding LTU (>180 days annually) and DP using nationwide register data. Cox regression models were used to estimate crude and multivariate-adjusted (adjusted for several socio-demographic, labour market and health-related covariates) hazard ratios (aHRs) with 95% confidence intervals. RESULTS Compared to the Swedish-born, all migrant groups had around a 1.8-fold higher risk of LTU (range aHR=1.71-1.83) and around a 30% lower risk of DP (range aHR=0.66-0.76). Older age at arrival was associated with a higher risk of LTU only for non-refugee immigrants. Both older age at arrival and a shorter duration of residency were associated with a lower risk of DP for all migrant groups. Psychiatric morbidity had the strongest effect on subsequent DP, with no significant differences between migrant groups and the Swedish-born (range aHR=5.1-6.1). CONCLUSIONS Young immigrants had a higher risk of LTU and a lower risk of DP than their Swedish-born peers. No differences between the different immigrant groups were found. Age at arrival, psychiatric morbidity and duration of residency are strong determinants of being granted DP.
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Affiliation(s)
- Gerdur Geirsdottir
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | | | - Emma Björkenstam
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Lingjing Chen
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Thomas E Dorner
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Sweden.,Karl-Landsteiner Institute for Health Promotion Research, Austria
| | - Ridwanul Amin
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
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Oberndorfer M, Dorner TE, Leyland AH, Grabovac I, Schober T, Šramek L, Bilger M. The challenges of measuring social cohesion in public health research: A systematic review and ecometric meta-analysis. SSM Popul Health 2022; 17:101028. [PMID: 35111897 PMCID: PMC8790679 DOI: 10.1016/j.ssmph.2022.101028] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/13/2022] [Accepted: 01/13/2022] [Indexed: 01/15/2023] Open
Abstract
The relationship between social cohesion and health has been studied for decades. Yet, due to the contextual nature of this concept, measuring social cohesion remains challenging. Using a meta-analytical framework, this review's goal was to study the ecometric measurement properties of social cohesion in order to describe dissimilarities in its measurement as well as bring a new perspective on the empirical usefulness of the concept itself. To this end, we analysed if, and to what extent, contextual-level reliability and intersubjective agreement of 78 social cohesion measurements varied under different measurement conditions like measurement instrument, spatial unit, ecometric model specification, or region. We found consistent evidence for the contextual nature of social cohesion, however, most variation existed between individuals, not contexts. While contextual dependence in response behaviour was fairly insensitive to item choices, population size within chosen spatial units of social cohesion measurements mattered. Somewhat counterintuitively, using spatial units with, on average, fewer residents did not yield systematically superior ecometric properties. Instead, our results underline that precise theory about the relevant contextual units of causal relationships between social cohesion and health is vital and cannot be replaced by empirical analysis. Although adjustment for respondent's characteristics had only small effects on ecometric properties, potential pitfalls of this analytic strategy are discussed in this paper. Finally, acknowledging the sensitivity of measuring social cohesion, we derived recommendations for future studies investigating the effects of contextual-level social characteristics on health. Social cohesion aims to describe aspects of the social environment we live in but its measurement remains challenging. We meta-analysed the ecometric properties of 78 social cohesion measurements. There is modest but consistent evidence for the contextual nature of social cohesion. Contextual dependence in individual response behaviour is sensitive to the chosen spatial unit. Meta-ecometrics studies the empirical usefulness of theoretical concepts aiming to describe social environments.
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Affiliation(s)
- Moritz Oberndorfer
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
- Corresponding author. Department of Social and Preventive Medicine Centre for Public Health Medical University of Vienna Kinderspitalgasse 15/1, 1090, Vienna, Austria.
| | - Thomas E. Dorner
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria
- Karl-Landsteiner Institute for Health Promotion Research, BVAEB-Health Promotion Facility Resilienzpark Sitzenberg, Sitzenberg-Reidling, Austria
| | - Alastair H. Leyland
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria
| | - Thomas Schober
- School of Government and Public Policy, Department of Politics, University of Strathclyde, Glasgow, UK
| | - Lukas Šramek
- Department of Infectious Disease Epidemiology & Surveillance, Austrian Agency for Health and Food Safety, AGES, Vienna, Austria
| | - Marcel Bilger
- Health Economics and Policy, Vienna University of Economics and Business, Vienna, Austria
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17
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Oberndorfer M, Dorner TE. Inequalities in COVID-19’s collateral public health damage in Vienna. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Although lockdown measures are effective in containing the spread of COVID-19, such societal shutdowns may be accompanied by collateral public health damage. We aimed to assess potential inequalities in the distribution of adverse health-related and socioeconomic outcomes related to this pandemic for an urban Central European context.
Methods
Using a stratified random sample of 1004 participants living in Vienna, the capital of Austria with approximately 2 million inhabitants, this study analysed the distribution of 10 adverse health-related and socioeconomic outcomes attributable to the COVID-19 pandemic across socioeconomic strata. Data were collected between April, 27th and May, 17th 2020. Outcomes comprised a worsened economic situation, worsened self-reported mental and physical health, and a suspected or diagnosed infection with COVID-19 of the participant or someone close. Socioeconomic position (SEP) was indicated by income, education, and household overcrowding. We estimated differences in the incidence rates of our 10 outcomes by SEP using zero-inflated Poisson and logistic regression models adjusted for age and gender.
Results
Analysing the total number of experienced adverse outcomes, participants in the lowest and second lowest SEP category experienced a higher incidence rate (IRR=1.333[95%CI: 1.079 - 1.639] and IRR=1.447[95%CI: 1.190 - 1.760] respectively) compared to participants in the highest SEP category. Inequalities were highest for the outcomes job loss, worsened financial situation, and worse mental health. Different measurements of SEP yielded similar results, however, inequalities were most visible across income groups.
Conclusions
These results add to the rapidly accumulating evidence on the unequally distributed burden of the COVID-19 pandemic. Increased awareness about effect heterogeneity across SEP indicators will help to identify those in most urgent need of supportive policies.
Key messages
During the early phase of the COVID-19 pandemic in Vienna, its health-related and socioeconomic burden has been disproportionately carried by people in low socioeconomic positions. Inequalities in the incidence rate of adverse COVID-19-related outcomes were highest across income groups and for the outcomes job loss, worse financial situation, and worse mental health.
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Affiliation(s)
- M Oberndorfer
- Department of Social and Preventive Medicine, Medical University of Vienna, Vienna, Austria
| | - TE Dorner
- Department of Social and Preventive Medicine, Medical University of Vienna, Vienna, Austria
- Gesundheitszentrum Resilienzpark Sitzenberg-Reidling, Social Insurance Fund for Public Service, Railway and Mining Industries, Sitzenberg-Reidling, Austria
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Amin R, Rahman S, Dorner TE, Björkenstam E, Helgesson M, Norredam ML, Sijbrandij M, Sever CA, Mittendorfer-Rutz E. Country of birth, time period of resettlement and subsequent treated common mental disorders in young refugees in Sweden. Eur J Public Health 2021; 30:1169-1175. [PMID: 32840306 PMCID: PMC7733052 DOI: 10.1093/eurpub/ckaa140] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Little is known regarding treatment for common mental disorders (CMDs) in young refugees. We aimed to identify (i) if the risk of treatment for CMDs in young refugees varies by their country of birth, compared with the Swedish-born population and (ii) if time period of resettlement influences these possible associations. METHODS All Swedish-born individuals and people who were granted refugee status, aged 16-25 years, living in Sweden on 31 December 1999, 2004 or 2009 (around 1 million people with 3-4% refugees in each cohort), were followed for 4 years for treated CMDs by linking register data. To facilitate stratified analyses by refugees' country of birth, the 2009 cohort was followed for 7 years with regard to specialized healthcare and antidepressant prescription due to CMDs. Hazard ratios with 95% confidence intervals were computed in crude and adjusted models. RESULTS Refugees in the 2009 cohort with 7-year follow-up had a 25% lower risk for treated CMDs, compared with the Swedish-born. Stratified analysis by country of birth showed a similarly lower risk regarding treated CMDs among refugees from all countries but Iran [hazard ratios (95% confidence intervals): 1.15 (1.05-1.26)] than their Swedish-born peers. No substantial effect of time period of resettlement was observed in the risk for treated CMDs in refugees. CONCLUSIONS Treatment for CMDs is lower in young refugees than in the majority population in Sweden, is stable across time, but varies with country of birth. Strategies to improve access to mental healthcare for young refugees are warranted.
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Affiliation(s)
- Ridwanul Amin
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-17177, Stockholm, Sweden
| | - Syed Rahman
- Department of Global Public Health, Karolinska Institutet, SE-17177 Stockholm, Sweden
| | - Thomas E Dorner
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, A-1090 Vienna, Austria
| | - Emma Björkenstam
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-17177, Stockholm, Sweden
| | - Magnus Helgesson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-17177, Stockholm, Sweden
| | - Marie L Norredam
- Danish Research Centre for Migration, Ethnicity and Health, Section of Health Services Research, University of Copenhagen, 1014 Copenhagen, Denmark
| | - Marit Sijbrandij
- Faculty of Behavioural and Movement Sciences, Department of Clinical, Neuro- and Developmental Psychology, World Health Organization WHO Collaborating Centre for Research, and Dissemination of Psychological Interventions, Vrije Universiteit, 1081 H Amsterdam, The Netherlands
| | - Cansu Alozkan Sever
- Faculty of Behavioural and Movement Sciences, Department of Clinical, Neuro- and Developmental Psychology, World Health Organization WHO Collaborating Centre for Research, and Dissemination of Psychological Interventions, Vrije Universiteit, 1081 H Amsterdam, The Netherlands
| | - Ellenor Mittendorfer-Rutz
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-17177, Stockholm, Sweden
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Markovic L, Schönherr D, Zandonella M, Gil-Salmeron A, Smith L, McDermott D, Yang L, Dorner TE, Mües H, Grabovac I. Associations between workplace characteristics and 'outness' in LGBTI workers in Austria. Occup Environ Med 2021; 79:10-16. [PMID: 34039754 DOI: 10.1136/oemed-2020-107345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 05/01/2021] [Accepted: 05/07/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Lesbian, gay, bisexual, transgender and intersex (LGBTI) individuals are often subjected to negative attitudes in the workplace, which may lead to non-disclosure of their sexual orientation and/or gender identities. We aimed to determine the prevalence of workplace disclosure of sexual or gender identity (ie, 'outness'; being 'out') and to examine its associations with workplace characteristics in LGBTI workers in Austria. METHODS This cross-sectional study analysed sociodemographic, work-related and well-being-related data from self-identifying gender and/or sexual minority participants elicited by an online questionnaire between February and June 2017. From the initial 1268 respondents, 1177 (93%) provided complete data and were included in the subsequent analyses. RESULTS The largest proportion of the sample were 26-35 years old (39.1%), cisgender gay men (40.0%) in full-time employment (63.9%). Overall, 51.7% of the sample were 'out' at the workplace. Being bisexual (OR=0.46, 95% CI 0.27 to 0.81), the provision of antidiscrimination guidelines in the workplace (OR=0.53, 95% CI 0.32 to 0.90), living alone (OR=0.50, 95% CI 0.32 to 0.79) and in shared households (OR=0.49, 95% CI 0.25 to 0.96) were associated with a decreased likelihood of being 'out' at work.Factors associated with being 'out' at work were being middle aged (36-45 years old; OR=1.74, 95% CI 1.07 to 2.85), having been in employment for >10 years (OR=2.03, 95% CI 1.08 to 3.81), an LGBTI-friendly work environment (OR 1.61, 95% CI 1.36 to 1.91), labour-management antidiscrimination contract (OR=2.02, 95% CI 1.23 to 3.32) and work council protections (OR=1.56, 95% CI 1.04 to 2.36). CONCLUSIONS Instating antidiscrimination protections might facilitate 'outness' of LGBTI workers and lead to a better promotion of diversity in the workplace.
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Affiliation(s)
- Lovro Markovic
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna, Austria .,Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria
| | - Daniel Schönherr
- SORA Institute for Social Research and Consulting, Ogris & Hofinger GmbH, Vienna, Austria
| | - Martina Zandonella
- SORA Institute for Social Research and Consulting, Ogris & Hofinger GmbH, Vienna, Austria
| | | | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Daragh McDermott
- Department of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UK
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada.,Departments of Oncology & Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Thomas E Dorner
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria.,Health Promotion Facility Sitzenberg-Reidling, Social Insurance Fund for Public Service, Railway and Mining Industries, Sitzenberg-Reidling, Austria
| | - Hanna Mües
- Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria
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Lackinger C, Grabovac I, Haider S, Kapan A, Winzer E, Stein KV, Dorner TE. Adherence Is More Than Just Being Present: Example of a Lay-Led Home-Based Programme with Physical Exercise, Nutritional Improvement and Social Support, in Prefrail and Frail Community-Dwelling Older Adults. Int J Environ Res Public Health 2021; 18:4192. [PMID: 33920981 PMCID: PMC8071284 DOI: 10.3390/ijerph18084192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/07/2021] [Accepted: 04/10/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND Little is known about the implementation of lifestyle interventions in frail, community-dwelling people. This study highlights different domains of adherence to explain an effectively delivered home-based intervention. METHODS Eighty prefrail and frail persons (≥65 years) participated in a physical training, nutritional, and social support intervention over 24 weeks. A detailed log book was kept for comprehensive documentation in order to assess adherence and further organizational, exercise, and nutritional parameters. RESULTS Participants reached an adherence rate (performed home visits/number of planned visits) of 84.0/80.5% from week 1-12/13-24. Out of those, 59% carried out ≥75% of the offered visits. Older age was associated with a higher adherence rate. A mean of 1.5 (0.6) visits/week (2 were planned) were realized lasting for a mean of 1.5 (0.9) hours (154% of the planned duration). Per visit, 1.2 (0.6) circuits of strength training were performed (60.5% of the planned value) and 0.5 (0.3) nutritional interventions (47%). After twelve months, 4.2% still carried out the home visits regularly and 25.0% occasionally. CONCLUSION Adherence is much more than "being there". Adherence rate and category are limited parameters to describe the implementation of a complex lifestyle intervention, therefore a comprehensive documentation is needed.
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Affiliation(s)
- Christian Lackinger
- Karl-Landsteiner Institute for Health Promotion Research, 3454 Sitzenberg-Reidling, Austria; (K.V.S.); (T.E.D.)
- Social Insurance Fund for Public Service, Railway and Mining Industries, Gesundheitseinrichtung Sitzenberg-Reidling, 3454 Sitzenberg-Reidling, Austria
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, 1080 Vienna, Austria; (I.G.); (S.H.); (A.K.); (E.W.)
| | - Sandra Haider
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, 1080 Vienna, Austria; (I.G.); (S.H.); (A.K.); (E.W.)
| | - Ali Kapan
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, 1080 Vienna, Austria; (I.G.); (S.H.); (A.K.); (E.W.)
| | - Eva Winzer
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, 1080 Vienna, Austria; (I.G.); (S.H.); (A.K.); (E.W.)
| | - K. Viktoria Stein
- Karl-Landsteiner Institute for Health Promotion Research, 3454 Sitzenberg-Reidling, Austria; (K.V.S.); (T.E.D.)
- Social Insurance Fund for Public Service, Railway and Mining Industries, Gesundheitseinrichtung Sitzenberg-Reidling, 3454 Sitzenberg-Reidling, Austria
| | - Thomas E. Dorner
- Karl-Landsteiner Institute for Health Promotion Research, 3454 Sitzenberg-Reidling, Austria; (K.V.S.); (T.E.D.)
- Social Insurance Fund for Public Service, Railway and Mining Industries, Gesundheitseinrichtung Sitzenberg-Reidling, 3454 Sitzenberg-Reidling, Austria
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, 1080 Vienna, Austria; (I.G.); (S.H.); (A.K.); (E.W.)
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21
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Seiler-Ramadas R, Grabovac I, Niederkrotenthaler T, Dorner TE. Adolescents' Perspective on Their Sexual Knowledge and the Role of School in Addressing Emotions in Sex Education: An Exploratory Analysis of Two School Types in Austria. J Sex Res 2020; 57:1180-1188. [PMID: 32808815 DOI: 10.1080/00224499.2020.1802644] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Sex education for adolescents should include building knowledge on the emotional, social and physical aspects of sexuality. This study aimed to find out how adolescents from two different school types perceived their own knowledge on sexual matters, the importance they placed on sex education in school, and how well they felt that emotional, social and physical issues were raised within the frame of sex education. A cross-sectional 74-item questionnaire survey was conducted among adolescents (n = 198, age 13-16 years) from two secondary schools and one polytechnic school in Austria. From the linear regression analyses, secondary school students felt more knowledgeable on sexual matters than polytechnic students (beta = -0.288, p = .005). Secondary school students had more knowledge on the biology of sexuality but were less informed of the emotional aspects and other topics masturbation [mean score (SD)] [2.42(1.24) vs 3.42(1.44); p < .001], forms of sexual contact [2.81(1.08) vs 3.54(1.22), p = .006] and dealing with love and sexual feelings in relationships [2.68(1.19) vs 3.33(2.60); p = .030] than polytechnic students. While teachers were considered important providers of sex education, a more varied and practical means of learning was desired. Sex education should allow for the interplay between fact and emotion using varied teaching and learning strategies.
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Affiliation(s)
- R Seiler-Ramadas
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna
| | - I Grabovac
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna
| | - T Niederkrotenthaler
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna
| | - T E Dorner
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna
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22
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Haider S, Schwarzinger A, Stefanac S, Soysal P, Smith L, Veronese N, Dorner TE, Grabovac I. Nutritional supplements for neuropsychiatric symptoms in people with dementia: A systematic review and meta-analysis. Int J Geriatr Psychiatry 2020; 35:1285-1291. [PMID: 32805754 PMCID: PMC7692950 DOI: 10.1002/gps.5407] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 08/11/2020] [Accepted: 08/14/2020] [Indexed: 12/24/2022]
Abstract
UNLABELLED The aim of the present study was to assess the effects of nutritional supplementation on neuropsychiatric symptoms among people with dementia. METHODS/DESIGN Randomized controlled trials (RCTs) were searched in the Databases PubMed, EMBASE, SCOPUS, Cochrane Central Register of Controlled Trials and Clinicaltrials.gov from inception until January 31, 2020. Studies of RCTs carried out on people with any type of dementia who were taking nutritional supplements and had neuropsychiatric symptoms were included in this systematic review and meta-analysis. Neuropsychiatric symptoms were assessed with the validated Neuropsychiatric Inventory (NPI). Effect sizes were calculated with standardized mean differences (SMD) and 95% confidence intervals (95%CI), applying a random effect model. RESULTS The search yielded 1034 studies with four studies being included in the meta-analysis with a total of 377 people with dementia (mean age 69.3 [SD: 7.7] years). The diagnoses comprised mild to late Alzheimer's disease and frontotemporal dementia. Two studies included a multicomponent supplementation, one an omega-3, and one a special supplement tailored for cognitive impairment. The median follow-up was 18 weeks, with a range from 12 to 24 weeks. Pooled data showed that nutritional supplementation did not improve NPI (SMD = -0.33; [95%CI: -0.74 to 0.08]; P = 0.11; I2 = 45%). CONCLUSIONS The findings of this meta-analysis demonstrated no significant impact on NPI through nutritional supplementation. However, the generalization of the results is limited, as different supplements were used in different stages of dementia with a short follow-up time.
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Affiliation(s)
- Sandra Haider
- Department of Social and Preventive Medicine, Center for Public HealthMedical University of ViennaViennaAustria
| | | | - Sinisa Stefanac
- Department of Social and Preventive Medicine, Center for Public HealthMedical University of ViennaViennaAustria,Institute of Outcome ResearchCenter for Medical Statistics, Informatics and Intelligent Systems, Medical University of ViennaViennaAustria
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of MedicineBezmialem Vakif UniversityIstanbulTurkey
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise SciencesAnglia Ruskin UniversityCambridgeUK
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and GeriatricsUniversity of PalermoPalermoItaly
| | - Thomas E. Dorner
- Department of Social and Preventive Medicine, Center for Public HealthMedical University of ViennaViennaAustria,Sozialversicherung öffentlich Bediensteter, Eisenbahnen und BergbauViennaAustria
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Center for Public HealthMedical University of ViennaViennaAustria
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23
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Oberndorfer M, Grabovac I, Haider S, Dorner TE. Effectiveness of e-cigarettes in smoking cessation: a systematic review and meta-analysis. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1226] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Reports of the effectiveness of e-cigarettes (ECs) for smoking cessation vary across different studies making implementation recommendations hard to attain. We performed a systematic review and meta-analysis to synthesise the current evidence regarding the effectiveness of ECs for smoking cessation.
Methods
PubMed, PsycInfo and Embase databases were searched for randomized controlled trials comparing nicotine ECs with non-nicotine ECs or with established smoking cessation interventions (nicotine replacement therapy (NRT) and or counselling) published between 01/01/2014 and 01/05/2019. Data from eligible studies were extracted and used for random-effects meta-analyses.
Results
Our literature review yielded 13190 publications with 10 studies being identified as eligible for systematic review, covering 8362 participants, and 8 for meta-analyses (n = 30 - 6006). Using the last follow-up of eligible studies, the proportion of smokers achieving abstinence was 1.67 [95CI:0.99 - 2.81] times higher in nicotine EC users compared to non-nicotine EC users. The proportion of abstinent smokers was 1.69 [95CI:1.25 - 2.27] times higher in EC users compared to participants receiving NRT. EC users showed a 2.70 [95CI:1.15 - 6.30] times higher proportion of abstinent smokers in comparison to participants solely receiving counselling.
Conclusions
Our analysis showed modest effects of nicotine-ECs compared to non-nicotine ECs. When compared to NRT or counselling, results suggest that nicotine EC may be more effective for smoking cessation. As ECs also help maintaining routinized behaviour and social aspects of smoking, we hypothesise that this may explain their advantage as a tool for smoking cessation. However, given the small number of included studies, different populations, heterogeneous designs, and the overall moderate to low quality of evidence, it is not possible to offer clear recommendations. More comparable data is needed to strengthen confidence in the quality of evidence.
Key messages
The number of previous studies assessing the effectiveness of ECs for smoking cessation is limited. Further, comparability of these studies is restricted, weakening the quality of evidence. Although current evidence on the effectiveness of ECs for smoking cessation is inconclusive, our meta-analyses suggest that ECs could be a promising alternative tool in attempts to achieve abstinence.
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Affiliation(s)
- M Oberndorfer
- Department of Social and Preventive Medicine, Medical University of Vienna, Vienna, Austria
| | - I Grabovac
- Department of Social and Preventive Medicine, Medical University of Vienna, Vienna, Austria
| | - S Haider
- Department of Social and Preventive Medicine, Medical University of Vienna, Vienna, Austria
| | - T E Dorner
- Department of Social and Preventive Medicine, Medical University of Vienna, Vienna, Austria
- Sozialversicherung öffentlicher Bediensteter, Eisenbahnen und Bergbau, Vienna, Austria
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24
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Dorner TE, Haider S, Grabovac I, Rieder A. Depression and lack of physical activity as factors leading to higher health care utilisation. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Depressive symptoms and lack of physical activity (PA) often occur simultaneously, since depression, associated with listlessness can lead to lack of PA, and lack of PA, associated with poor quality of life and health satisfaction can lead to depressive symptoms. Both factors are independent risk factors for a higher health care utilisation. We aimed to assess the effects of the combination of depressive symptoms and lack of aerobic PA on the probability of using in- and outpatient health care services.
Methods
Data from 15.770 people from the nationally representative Austrian Health Interview Survey from 2014 were used for the analysis.
Results
In analysis, adjusted for socio-demographic, health related, and lifestyle-related factors, the combination of depressive symptoms and lack of PA were associated with higher odds of outpatient health care utilisation (OR: 1.43; 95%CI: 0.99-2.07) in men and (OR: 2.02; 95%CI: 1.50-2.73) in women, and with higher odds of inpatient health care utilisation (OR: 1.52; 95%CI: 1.02-2.26) in men and (OR: 1.75; 95%CI: 1.28-2.40) in women. Being affected by depressive symptoms alone showed slightly lower, and being affected by lack of PA alone showed clearly lower OR for health care utilisation compared to the combination of the two factors
Conclusions
Our results show that the combination of depressive symptoms and lack of PA are associated with a higher health care utilisation. Both factors are often neglected health hazards in the health care system and the attendance of affected people could be regarded as opportunity to address those factors properly.
Key messages
The combination of depressive symtoms and lack of physical activity lead to higher health care utilisation. Addressing those factors in the health care system properly would be a good opportunity to address those important health hazards.
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Affiliation(s)
- T E Dorner
- Medical University Vienna, Centre for Public Health, Department for Social and Preventive Medicine, Vienna, Austria
- BVAEB, Sozialversicherung öffentlich Bediensteter, Eisenbahnen und Bergbau, Vienna, Austria
| | - S Haider
- Medical University Vienna, Centre for Public Health, Department for Social and Preventive Medicine, Vienna, Austria
| | - I Grabovac
- Medical University Vienna, Centre for Public Health, Department for Social and Preventive Medicine, Vienna, Austria
| | - A Rieder
- Medical University Vienna, Centre for Public Health, Department for Social and Preventive Medicine, Vienna, Austria
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Grabovac I, Stefanac S, Smith L, Haider S, Cao C, Jackson SE, Dorner TE, Waldhoer T, Rieder A, Yang L. Association of depression symptoms with receipt of healthcare provider advice on physical activity among US adults. J Affect Disord 2020; 262:304-309. [PMID: 31733918 DOI: 10.1016/j.jad.2019.11.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 09/10/2019] [Accepted: 11/08/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Given the high burden and prevalence of depression, various guidelines underscore the role of healthcare providers in supplying advice on physical activity (PA) as a potential modifying factor influencing the incidence and severity of depressive symptoms in adults. We aimed to investigate the extent to which healthcare providers provide PA advice to adults with depressive symptoms in the US. METHODS Data on adults aged 20-64 years (n = 4971) in the National Health and Nutrition Examination Study between 2011 and 2016 were analysed. Depressive symptoms were assessed using the Patient Health Questionnaire and response options were categorised as "none or minimal", "mild", "moderate-severe". Receipt of PA advice from a healthcare provider was self-reported. We restricted our study sample to adults free from chronic diseases. RESULTS Higher odds of receiving advice to exercise were reported among adults with mild (OR = 1.7, 95% CI: 1.3-2.3) and moderate-severe depressive symptoms (OR = 1.7, 95% CI: 1.0-2.8). Furthermore, exercise advice was more commonly reported among adults who were overweight, obese, Hispanic, Asian, being insured with private insurance, with education higher than high school, and had access to a routine place for health care. LIMITATIONS Social and culutral aspects of overweight/obesity may prohibit generalizations. Cross sectional design does not allow for causal realtionships. CONCLUSIONS In the US, fewer than one in three adults experiencing symptoms of depression report having received exercise advice from a healthcare provider. Providing such advice may be a sustainable clinical strategy in reducing the incidence and severity of depression symptoms.
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Affiliation(s)
- I Grabovac
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Austria
| | - S Stefanac
- Institute of Outcome Research, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Austria.
| | - L Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - S Haider
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Austria
| | - C Cao
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, MO, USA; Program in Physical Therapy, Washington University School of Medicine, St Louis, MO, USA
| | - S E Jackson
- Department of Behavioural Science and Health, University College London, London, UK
| | - T E Dorner
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Austria
| | - T Waldhoer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Austria
| | - A Rieder
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Austria
| | - L Yang
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Alberta, Canada; Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Hoffmann K, George A, Jirovsky E, Dorner TE. Re-examining access points to the different levels of health care: a cross-sectional series in Austria. Eur J Public Health 2019; 29:1005-1010. [PMID: 30938408 PMCID: PMC6896971 DOI: 10.1093/eurpub/ckz050] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND There is high variation in service utilization behaviour, health equity and outcomes among countries based upon the organization of access to primary and secondary care levels. Austria is a country with universal health coverage and access without clear delineation between access to primary and secondary care. The aim of this study was to investigate development of access points to the Austrian system over time and subsequent utilization. METHODS The databases used were the Austrian Health Interview Surveys 2006/2007 and 2014, including 15 747 and 15 771 persons, respectively. Descriptive analysis of health services utilization behaviour and demographic factors were conducted. Logistic regression models were applied. Furthermore, differences between the two periods are shown. RESULT Utilization of all services assessed was high in 2014 when compared to 2006/2007. Between these periods, a 6-7% increase in use of secondary care services was found. There was a 10.8% increase in access to specialist care services and 4.1% increase in hospital outpatient visits, each without prior General Practitioner (GP) visits. The largest increases were found in those groups that had previously demonstrated the lowest utilization behaviour of accessing specialist consultations and consultations without a prior GP visit. CONCLUSION Despite the lack of change to the health care system or access to care, there was an increase in utilization of secondary care services, with a lower percentage of patients seeking direct GP consultation. This is concerning for systems development, cost containment and quality of care, as it demonstrates a possible trend shifting away from primary care as initial access point.
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Affiliation(s)
- Kathryn Hoffmann
- Kathryn Hoffmann, MD, MPH, Department of General Practice and Family Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15/I, 1090 Vienna, Austria
| | - Aaron George
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA USA
| | - Elena Jirovsky
- Elena Jirovsky, PhD, Department of General Practice and Family Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15/I, 1090 Vienna, Austria
| | - Thomas E Dorner
- Thomas E. Dorner, MD, MPH, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15/I, 1090 Vienna, Austria
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Bokenberger K, Rahman S, Wang M, Vaez M, Dorner TE, Helgesson M, Ivert T, Mittendorfer-Rutz E. Work disability patterns before and after incident acute myocardial infarction and subsequent risk of common mental disorders: A Swedish cohort study. Sci Rep 2019; 9:16086. [PMID: 31695106 PMCID: PMC6834568 DOI: 10.1038/s41598-019-52487-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 10/17/2019] [Indexed: 11/09/2022] Open
Abstract
This study investigated the extent to which work disability patterns including sickness absence and disability pension (SA/DP) before and after acute myocardial infarction (AMI) were associated with subsequent common mental disorders (CMDs) such as depression and anxiety in AMI patients without previous CMD. Total 11,493 patients 26–64 years with incident AMI during 2008–10 were followed up for CMD (measured as antidepressant prescription) through 2013. Four SA/DP trajectory groups during the 3-years pre-AMI and 1-year post-AMI were identified. Hazard ratios (HRs) with 95% confidence intervals for subsequent CMD were estimated in Cox models. Higher pre-AMI SA/DP annual levels (>1–12 months/year) were associated with 40–60% increased CMD rate than the majority (78%) with low increasing levels (increasing up to 1 month/year). Regarding post-AMI findings, constant high (~25–30 days/month) SA/DP levels within the first 3 months was associated with a 76% higher CMD rate, compared to constant low (0 days/month). A gradually decreasing post-AMI SA/DP pattern over a 12-month period suggested protective influences for CMD (HR = 0.80). This is the first study to demonstrate that pre- and post-AMI work disability patterns are associated with subsequent CMD risk in AMI patients. Work disability patterns should be considered as an indicator of AMI prognosis in terms of CMD risk.
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Affiliation(s)
- K Bokenberger
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - S Rahman
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - M Wang
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - M Vaez
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - T E Dorner
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria
| | - M Helgesson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - T Ivert
- Department of Molecular Medicine and Surgery, Karolinska Institutet and Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden
| | - E Mittendorfer-Rutz
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Dorner TE, Grabovac I, Mogg C, Oberndorfer M, Haider S. Frailty as predictor for all-cause and cause-specific mortality: 11-year follow-up cohort study. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz187.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Frailty is a geriatric syndrome characterised by sarcopenia, malnutrition, and chronic inflammation that leads to adverse health outcomes including dependency, low quality of life, and higher risk for morbidity and mortality. It was the aim of this study to examine the relationship between frailty status and risk of all-cause and cause-specific mortality.
Methods
The study is based on data from the Survey on Health, Aging and Retirement in Europe (SHARE) including 11 European countries with an 11-year follow up. 24,634 participants with a mean age of 64.2 (9.8) 53.6% female, were analysed. Frailty status was calculated using the SHARE- Frailty Instrument, categorizing the participants as robust, pre-frail, and frail. Cox Proportional Hazard models were used to estimate the risk of all-cause and cause-specific (stroke, heart attack, other cardiovascular disease, cancer, respiratory illness, infectious, digestive and other) mortality in frail and pre-frail subjects compared to robust persons.
Results
14.7% and 6.9% were found to be pre-frail or frail at the baseline. During the follow-up, we observed both pre-frailty and frailty being associated with a higher risk of all-cause and cause-specific mortality in the unadjusted model. After adjusting for sex, age, education level, body mass index, smoking, alcohol consumption and a number of comorbidities, frailty was associated with a higher risk of all-cause mortality [HR 1.56 (95% CI 1.37-1.78)], and mortality due to other cardiovascular diseases [HR 1.88 (95% CI 1.27-2.76)], cancer [HR 1.47 (95% CI 1.14-1.90)], and respiratory disease HR [1.82 (95% CI 1.10-3.01)]. Furthermore, pre-frailty was associated with a higher risk of all-cause mortality [HR 1.27 (95% CI 1.14-1.42)] and other cardiovascular disease mortality [HR 1.70 (95% CI 1.22-2.35)].
Conclusions
Our study showed that baseline pre-frailty and frailty are associated with increased all-cause and cause-specific mortality over an 11-year follow up.
Key messages
Frailty but also pre-frailty leads to a higher mortality, even when adjusted for morbidity, lifestyle factors, and socio-demographic factors. More effort is needed to prevent, detect, and treat frailty and pre-frailty, both, on individual and on community level.
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Affiliation(s)
- T E Dorner
- Department for Social and Preventive Medicine, Centre for Public Health, Medical University Vienna, Vienna, Austria
| | - I Grabovac
- Department for Social and Preventive Medicine, Centre for Public Health, Medical University Vienna, Vienna, Austria
| | - C Mogg
- Department of Sport Science, University Vienna, Vienna, Austria
| | - M Oberndorfer
- Department for Social and Preventive Medicine, Centre for Public Health, Medical University Vienna, Vienna, Austria
| | - S Haider
- Department for Social and Preventive Medicine, Centre for Public Health, Medical University Vienna, Vienna, Austria
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Haider S, Dorner TE, Grabovac I. Influence of Physical Activity, Protein Intake and Social Network on the Frailty development. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Frailty, a geriatric syndrome, is associated with many adverse health outcomes. Risk factors include physical inactivity, low protein intake and an inadequate social network. In this analysis we aimed to assess the influence of these factors and their combination in an 11-year-follow-up study on a Europe-wide level.
Methods
The analysed dataset included 22,226 community-dwelling robust and prefrail persons aged ≥50 years (11 countries) from the Study on Health, Ageing and Retirement in Europe (SHARE). Frailty was measured with the “Frailty Instrument for Primary care of the Survey of Health, Ageing and Retirement in Europe”. Additionally, self-reported level of vigorous physical activity (PA), protein intake and satisfaction with social network were assessed. The impact of these parameters on the development of frailty was calculated using Cox regressions, adjusted for age, education, smoking, alcohol BMI, depression, long-term illness and each other.
Results
People who do not engage in PA, had a higher HRs for frailty development compared to people performing PA regularly [women: 1.62 (95%CI: 1.22-2.13); men: 1.83 (95%CI: 1.44-2.33)]. People with low protein intake did not have significant higher HR [women: 1.05 (95%CI: 0.80-1.37); men: 1.16 (95%CI: 0.93-1.46)]. Women with poor social network showed HRs of 1.34 (95%CI: 1.24-2.15)], men with poor social network had a HR of 0.88 (95%CI: 0.70-1.10). In general, we found that persons with a combination of two risk factors had a higher risk for frailty compared to those with no or only one. However, no significant synergy index could be found.
Conclusions
Regular PA, but also adequate social networks seem to be important factors in frailty prevention.
Key messages
Sufficient PA and satisfaction with social network were shown as modifiable factors to prevent frailty in an 11-year-follow-up study. A combination of two risk factors was associated with a higher risk for frailty compared to one, however, with no significant synergy index.
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Affiliation(s)
- S Haider
- Institute of Social Medicine, Centre for Public Health, Medical University of Vienna, Wien, Austria
| | - T E Dorner
- Institute of Social Medicine, Centre for Public Health, Medical University of Vienna, Wien, Austria
| | - I Grabovac
- Institute of Social Medicine, Centre for Public Health, Medical University of Vienna, Wien, Austria
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Bokenberger K, Rahman S, Wang M, Vaez M, Dorner TE, Helgesson M, Ivert T, Mittendorfer-Rutz E. Work disability before and after incident myocardial infarction and subsequent common mental disorder. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz187.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
This study investigated the extent to which work-disability patterns including sickness absence and disability pension (SA/DP) before and after acute myocardial infarction (AMI) were associated with subsequent common mental disorders (CMDs) such as depression and anxiety in AMI patients without previous CMD.
Methods
A cohort of 11,493 patients aged 26-64 years without previous CMD with incident AMI during 2008-2010 were followed up for CMD measured as antidepressant prescription through 2013. Four SA/DP trajectory groups during the 3 years pre-AMI and 1 year post-AMI were identified. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated in Cox models.
Results
Higher pre-AMI SA/DP levels (>1-12 months/year), compared to the majority of patients (78%) following low increasing annual levels (increasing up to 1 month/year) of pre-AMI SA/DP, were associated with a 40-60% increased CMD rate. Regarding post-AMI findings, constant high (∼25-30 days/month) and steeply decreasing SA/DP levels within the first 3 months were associated with a 76% and 35% higher CMD rate, respectively, compared to constant low (<1 days/month) levels. Conversely, a gradually decreasing pattern of post-AMI SA/DP over a 12-month period suggested protective influences for CMD (HR = 0.80), even after adjusting for sociodemographic and medical factors.
Conclusions
This is the first study to demonstrate that pre- and post-AMI work disability patterns are associated with subsequent CMD risk in AMI patients. Work disability patterns should be considered in clinical practice as an indicator of AMI prognosis in terms of CMD risk.
Key messages
Increasing and high persistent levels of pre-AMI work disability are associated with higher risk of subsequent CMD, while gradually decreasing post-AMI work disability has a favourable CMD prognosis. Pre- and post-AMI patterns of work disability (sickness absence and disability pension) can be a useful marker in terms of CMD prognosis.
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Affiliation(s)
- K Bokenberger
- Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - S Rahman
- Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - M Wang
- Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - M Vaez
- Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - T E Dorner
- Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Medizinische Universitat Wien, Institute of Social Medicine, Centre for Public Health, Viena, Austria
| | - M Helgesson
- Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - T Ivert
- Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Cardiothoracic Surgery and Anesthesiology, Karolinska Institutet, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - E Mittendorfer-Rutz
- Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Haider S, Grabovac I, Smith L, Stefanac S, Jackson SE, Li Y, Cao C, Waldhoer T, Zhang Y, Dorner TE, Yang L. Health Care Providers' Advice on Lifestyle Modification for Older Adults. J Am Med Dir Assoc 2019; 21:361-366.e1. [PMID: 31537481 DOI: 10.1016/j.jamda.2019.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 07/16/2019] [Accepted: 07/20/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To describe the pattern of health care providers' advice on lifestyle modification to older adults, and identify correlates of receiving such advice. DESIGN Cross-sectional survey. SETTING AND PARTICIPANTS Data from the National Health and Nutrition Examination Survey study from 2007-2016 on adults ≥65 years (n = 3758) were analyzed. METHODS We estimated the weighted prevalence and correlates of receiving advice on the following lifestyle modifications: (1) increase physical activity, (2) reduce fat/calories, (3) control/lose weight, and (4) a combination of control/lose weight and physical activity. Data were analyzed according to level of comorbidity (number of chronic conditions including high blood pressure, high blood cholesterol, type 2 diabetes mellitus, coronary heart disease, and arthritis) and body mass index (BMI). RESULTS Physical activity was the most widely prescribed lifestyle modification, reported by 15.7% of older adults free of chronic conditions and 28.9%, 35.4%, and 52.6% of older adults with 1, 2, and ≥3 comorbidities. Advice on reducing fat/calories was reported by 9.2%, 18.5%, 26.3%, and 40.9% of older adults with 0, 1, 2, and ≥3 comorbidities, respectively, and advice on weight loss/control was reported by 6.5%, 19.1%, 20.8%, and 37.5%, respectively. The combination of advice on weight loss/control and physical activity was least commonly reported: 5.1%, 13.5%, 16.6%, and 32.0%, respectively. Overall, lifestyle modifications were more frequently advised to older adults who were overweight, obese, or Hispanic. CONCLUSIONS AND IMPLICATIONS In the United States, lifestyle modifications are not routinely recommended to older adults, particularly those free of chronic conditions, presenting a missed opportunity for chronic disease prevention and management. Among those advised to lose or manage weight, concurrent advice to increase physical activity is not consistently provided.
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Affiliation(s)
- Sandra Haider
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria.
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Sinisa Stefanac
- Institute of Outcomes Research, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Sarah E Jackson
- Department of Behavioral Science and Health, University College London, London, United Kingdom
| | - Ying Li
- Department of Health Management, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Chao Cao
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, MO; Program in Physical Therapy, Washington University School of Medicine, St Louis, MO
| | - Thomas Waldhoer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Yin Zhang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Thomas E Dorner
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Lin Yang
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria; Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Canada; Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
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Grabovac I, Haider S, Mogg C, Majewska B, Drgac D, Oberndorfer M, Dorner TE. Frailty Status Predicts All-Cause and Cause-Specific Mortality in Community Dwelling Older Adults. J Am Med Dir Assoc 2019; 20:1230-1235.e2. [PMID: 31351859 DOI: 10.1016/j.jamda.2019.06.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 05/15/2019] [Accepted: 06/05/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVES To examine the relationship between frailty status and risk of all-cause and cause-specific mortality. DESIGN Longitudinal cohort study with an 11-year follow up. SETTING AND PARTICIPANTS Data from the Survey on Health, Aging and Retirement in Europe (SHARE) were used. In the analysis, we included data from 11 European countries. We included men and women older than 50 years residing in Europe. Overall, 24,634 participants were analyzed with a mean age of 64.2 (9.8), 53.6% female, where 14.7% and 6.9% were found to be prefrail or frail, respectively, at the baseline. METHODS Frailty status was calculated using the SHARE-Frailty Instrument, categorizing the participants as robust, prefrail, and frail. Multivariate Cox regression models were used to estimate the risk of all-cause and cause-specific (stroke, heart attack, other cardiovascular disease, cancer, respiratory illness, infectious, and digestive and other) mortality. RESULTS During the follow-up, and after adjusting for sex, age, education, body mass index, smoking, alcohol consumption, and number of comorbidities, frailty was associated with a higher risk of all-cause (HR 2.17, 95% CI 1.90-2.48) and mortality due to stroke (HR 2.06, 95% CI 1.37-3.10), heart attack (HR 1.67, 95% CI 1.19-2.34), other cardiovascular disease (HR 2.77, 95% CI 1.87-4.12), cancer (HR 2.11, 95% CI 1.63-2.73), respiratory disease (HR 2.76, 95% CI 1.66-4.60), infectious diseases (HR 1.79, 95% CI 1.03-3.11), and digestive and other causes (HR 2.02, 95% CI 1.51-2.71). Prefrailty was associated with a higher risk of all-cause (HR 1.47, 95% CI 1.31-1.63), heart attack (HR 1.31, 95% CI 1.01-1.72), other cardiovascular disease (HR 2.03, 95% CI 1.46-2.81), respiratory disease (HR 1.70, 95% CI 1.09-2.65), and digestive and other causes (HR 1.50, 95% CI 1.18-1.91) mortality. CONCLUSIONS AND IMPLICATIONS Baseline prefrailty and frailty are associated with increased all-cause and cause-specific mortality over an 11-year follow up. Public health policy should include preventive programs aimed at older adults to prevent frailty and reduce mortality.
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Affiliation(s)
- Igor Grabovac
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Sandra Haider
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria.
| | - Christina Mogg
- Department of Sport Science, University of Vienna, Vienna, Austria
| | - Barbara Majewska
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Deborah Drgac
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Moritz Oberndorfer
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Thomas E Dorner
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
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Haider S, Grabovac I, Berner C, Lamprecht T, Fenzl KH, Erlacher L, Quittan M, Dorner TE. Frailty in seropositive rheumatoid arthritis patients of working age: a cross-sectional study. Clin Exp Rheumatol 2019; 37:585-592. [PMID: 30557129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 09/03/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES The prevalence of frailty has been widely researched in the elderly population. However, data about people of working age are scarce. The aim of this paper was to assess the prevalence of prefrailty and frailty in rheumatoid arthritis (RA) patients of working age, and to assess factors associated with prefrailty/frailty. METHODS In this monocentric cross-sectional study, 100 RA patients aged 18-65 years were included. Frailty was measured with the Frailty Instrument for Primary Care of the Survey of Health, Ageing and Retirement in Europe (SHARE-FI) and disease activity with the Clinical Disease Activity Index (CDAI). In addition, disease duration (years), pain intensity (visual analogue scale) and employment status were also assessed. RESULTS Fifty-five percent were robust, 30% prefrail and 15% were frail. Eighty-nine of the prefrail/frail individuals suffered from exhaustion. Compared to robust individuals, the prefrail/frail individuals had significantly higher median scores in disease activity [4.0 (Q25-Q75: 0-10) vs. 11 (Q25-Q75: 6-18)] and pain intensity [3.0 (Q25-Q75: 2.0-4.0) vs. 4.0 (Q25-Q75: 2.8-6.3)] and a higher rate of unemployment [31% vs. 53%]. In the multivariable analysis, higher disease activity (ß=0.444; p<0.001), unemployment (ß=0.243; p=0.005), higher pain intensity (ß=0.186; p=0.060) and longer disease duration (ß=0.181; p=0.020) were associated with a higher frailty score. CONCLUSIONS Frailty is common in RA patients, even those of working age. As the prevalence of frailty increases with age, it is important to take this syndrome into account in younger persons and to take action to counteract frailty.
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Affiliation(s)
- Sandra Haider
- Department of Social and Preventive Medicine, Centre of Public Health, Medical University of Vienna, Austria
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Centre of Public Health, Medical University of Vienna, Austria.
| | - Carolin Berner
- Department of Rheumatology and Osteology, Kaiser Franz Josef Hospital, SMZ Süd, Vienna, Austria
| | - Thomas Lamprecht
- Karl Landsteiner Institute for Autoimmune Diseases and Rheumatology, Vienna, Austria
| | - Karl-Heinrich Fenzl
- Karl Landsteiner Institute for Autoimmune Diseases and Rheumatology, Vienna, Austria
| | - Ludwig Erlacher
- Department of Rheumatology and Osteology, Kaiser Franz Josef Hospital, SMZ Süd, Vienna; and Karl Landsteiner Institute for Autoimmune Diseases and Rheumatology, Vienna, Austria
| | - Michael Quittan
- Karl Landsteiner Institute for Physical Medicine and Rehabilitation, and Department of Physical Medicine and Rehabilitation, Kaiser Franz Josef-Hospital, SMZ Süd, Vienna, Austria
| | - Thomas E Dorner
- Department of Social and Preventive Medicine, Centre of Public Health, Medical University of Vienna, Austria
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Sommer I, Titscher V, Teufer B, Klerings I, Nußbaumer-Streit B, Szelag M, Affengruber L, Wagner G, Glechner A, Kien C, Ebenberger A, Schiller-Frühwirth I, Dorner TE, Siebenhofer A, Haditsch B, Bachler H, Siebert U, Gartlehner G. [Evidence-based recommendations for the revision of the Austrian periodic health examination]. Wien Med Wochenschr 2019; 169:339-349. [PMID: 31187373 DOI: 10.1007/s10354-019-0699-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 05/15/2019] [Indexed: 12/27/2022]
Abstract
The Austrian periodic health examination (PHE) was introduced in 1974 as a health insurance benefit and was redesigned for the last time in 2005. Therefore, the aim of this work was to revise the scientific basis of the PHE using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. We updated the scientific evidence of examinations and consultations that are currently part of the PHE and searched and integrated new examinations. We assessed the expectations of the population towards the PHE in three focus groups. A panel of experts developed evidence-based recommendations for the revised PHE. They formulated 26 recommendations on 20 target diseases or risk factors. In comparison to the previous PHE, the panel added screening for abdominal aortic aneurysm, osteoporotic fracture risk, and chronic kidney disease to the recommendations, while screening for asymptomatic bacteriuria, screening for iron deficiency/pernicious anaemia, and risk identification of glaucoma should no longer be included.
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Affiliation(s)
- Isolde Sommer
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich.
| | - Viktoria Titscher
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich
| | - Birgit Teufer
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich
| | - Irma Klerings
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich
| | - Barbara Nußbaumer-Streit
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich
| | - Monika Szelag
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich
| | - Lisa Affengruber
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich
| | - Gernot Wagner
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich
| | - Anna Glechner
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich
| | - Christina Kien
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich
| | - Agnes Ebenberger
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich
| | | | - Thomas E Dorner
- Zentrum für Public Health, Abteilung für Sozial- und Präventivmedizin, Medizinische Universität Wien, Wien, Österreich
| | - Andrea Siebenhofer
- Institut für Allgemeinmedizin und evidenzbasierte Versorgungsforschung, Medizinische Universität Graz, Graz, Österreich.,Institut für Allgemeinmedizin, Goethe-Universität, Frankfurt am Main, Deutschland
| | | | | | - Uwe Siebert
- Institut für Public Health, Medical Decision Making und Health Technology Assessment, UMIT - Universität für Gesundheitswissenschaften, Medizinische Informatik und Technik, Hall i.T., Österreich.,Center for Health Decision Science, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Gerald Gartlehner
- Department für Evidenzbasierte Medizin und Klinische Epidemiologie, Universität für Weiterbildung, Krems, Österreich.,Research Triangle Institute International, Raleigh, NC, USA
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Rahman S, Mittendorfer-Rutz E, Dorner TE, Pazarlis K, Ropponen A, Svedberg P, Wang M, Helgesson M. Work-disability in low back pain patients with or without surgery, and the role of social insurance regulation changes in Sweden. Eur J Public Health 2019; 29:524-530. [PMID: 30445623 DOI: 10.1093/eurpub/cky243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The aims were to study the differences in work-disability in patients with low back pain (LBP) in relation to (i) treatment provided (non-surgical or lumber spine surgery (decompression or fusion), and (ii) two time points, i.e. before and after the social insurance regulation changes in the in 2008. METHODS All non-pensioned individuals, aged 19-60 years, living in Sweden, diagnosed with LBP in 2004-06 or 2008-10 were included (n = 153739). Hazard ratios (HRs) with 95% confidence intervals for long-term sickness absence (>90 days, LTSA) and disability pension (DP) for LBP-patients (non-surgical, decompression, fusion, both surgeries) were estimated by Cox regression compared with the matched references from the general population without LBP (n = 566008). RESULTS LBP-patients had a higher risk of subsequent work-disability compared with the references before and after insurance regulation changes. LBP-patients receiving decompression surgery had similar risk for later work-disability as those treated non-surgically. However, following regulation changes, LBP-patients undergoing fusion surgery had higher risk estimates of both LTSA (HR: 3.3) and DP (HR: 4.8) than patients treated non-surgically (HR: LTSA 2.1; DP 2.5) or with decompression (HR: LTSA 2.6; DP 2.1). In the adjusted models, risk estimates mainly attenuated after controlling for previous sickness absence. CONCLUSION Risk for subsequent work-disability among LBP-patients was higher compared with people without LBP and lumbar spine surgery. Discrepancies in risk were explained by the treatment provided previous sickness absence and changes in the social insurance regulations, specifically LBP-patients treated with fusion surgery had an increased risk of subsequent work-disability after changes in regulations.
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Affiliation(s)
- Syed Rahman
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Ellenor Mittendorfer-Rutz
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Thomas E Dorner
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Wien, Austria
| | - Konstantinos Pazarlis
- Division of Orthopaedics, Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden
| | - Annina Ropponen
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Finnish Institute of Occupational Health, Työterveyslaitos, Finland
| | - Pia Svedberg
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Mo Wang
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Magnus Helgesson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Crevenna R, Dorner TE. Association between fulfilling the recommendations for health-enhancing physical activity with (instrumental) activities of daily living in older Austrians. Wien Klin Wochenschr 2019; 131:265-272. [PMID: 31119390 PMCID: PMC6570675 DOI: 10.1007/s00508-019-1511-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 04/30/2019] [Indexed: 01/03/2023]
Abstract
Aim The aim of the study was to describe the association between fulfilling the recommendation for health-enhancing physical activity (PA), and deficits in activities of daily living (ADL) and instrumental activities of daily living (IADL) in 3308 subjects aged 65+ years from the Austrian Health Interview Survey 2014. Methods The proportion of subjects who fulfilled the minimal recommendations for health-enhancing PA was assessed with the Physical Activity Questionnaire of the European Health Interview Survey (EHIS-PAQ). The ADLs were assessed based on the Barthel index, and IADLs by the IADL scale of Lawton and Brody. Additionally, various sociodemographic and health-related factors were assessed. Results Of the participants 54.7% did not fulfil the minimal requirements for aerobic PA, and 67.1% not for muscle strengthening PA, 16.4% reported ADL deficits, and 47.1% IADL deficits. Adjusted for sociodemographic and health-related parameters, not fulfilling the recommendations for aerobe PA was associated with a higher chance for ADL deficits (odds ratio, OR 1.73, 95%-confidence interval 1.36–2.21), and IADL deficits (1.57; 1.34–1.84). Not fulfilling the recommendations for muscle strengthening PA also increased the chance for ADL and IADLs deficits (1.34; 1.04–1.72, and 1.29; 1.09–1.53, respectively). Conclusion The number of participants who did not fulfil the minimal requirements for aerobic or strengthening PA was very high, and these participants showed significantly more problems in ADLs and IADLs. Therefore, all future efforts should focus on increasing participation and adherence in exercise programs for older people with the intention to improve their performance status and functions in daily life.
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Affiliation(s)
- Richard Crevenna
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna, Austria
| | - Thomas E Dorner
- Unit Lifestyle & Prevention, Department for Social- und Preventive Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/I, 1090, Vienna, Austria.
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37
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Dorner TE, Wilfinger J, Hoffman K, Lackinger C. Association between physical activity and the utilization of general practitioners in different age groups. Wien Klin Wochenschr 2019; 131:278-287. [PMID: 31076889 PMCID: PMC6570780 DOI: 10.1007/s00508-019-1503-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 04/24/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Physical activity (PA) is an important tool in health promotion, prevention, curation, and rehabilitation and should be part of general practitioners (GP) consultations. For tailoring GP's service it is important to know the PA habits of the clients. METHODS Data from the Austrian Health Interview Survey 2014 with 15,770 subjects were analyzed. The association between PA, measured with the Physical Activity Questionnaire of the European Health Intervies Survey (EHIS-PAQ) and having visited a GP within the last 4 weeks was examined in different age groups (15-29, 30-64, and 65+ years). In multivariate analyses we adjusted for sociodemographic and health-related variables (body mass index, 17 chronic diseases, and the use of medication). RESULTS In subjects aged 15-29 years and 30-64 years fulfilling aerobic PA recommendations was significantly associated with a lower chance of having consulted the GP with unadjusted OR (95% CI) 0.82 (0.70-0.96) and 0.90 (0.82-0.99), respectively, whereas work-related PA was associated with a higher chance, with OR 1.21 (1.03-1.42) and 1.10 (1.00-1.20), respectively. Adjusting for sociodemographic and health-related factors led to loss of significance. In subjects aged 30-64 years, muscle strengthening PA was associated with a higher chance for GP consultation with OR 1.12 (1.00-1.24) in the fully adjusted model. In subjects aged 65+ years, PA was associated with a lower chance of having visited the GP with OR 0.74 (0.64-0.86) and 0.83 (0.71-0.97) for work related PA and total PA, respectively, in the fully adjusted model. CONCLUSION The association of PA and GP consultation is dependent on age and type of PA, and partly mediated by sociodemographic and health-related factors.
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Affiliation(s)
- Thomas E Dorner
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1, 1090, Vienna, Austria.
| | - Julia Wilfinger
- Department for Health Promotion and Prevention, SPORTUNION Austria, Falkestraße 1, 1010, Vienna, Austria
| | - Kathryn Hoffman
- Department of General Practice and Family Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/I, 1090, Vienna, Austria
| | - Christian Lackinger
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1, 1090, Vienna, Austria.,Department for Health Promotion and Prevention, SPORTUNION Austria, Falkestraße 1, 1010, Vienna, Austria
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38
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Haider S, Grabovac I, Dorner TE. Effects of physical activity interventions in frail and prefrail community-dwelling people on frailty status, muscle strength, physical performance and muscle mass-a narrative review. Wien Klin Wochenschr 2019; 131:244-254. [PMID: 30941525 PMCID: PMC6570667 DOI: 10.1007/s00508-019-1484-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 03/16/2019] [Indexed: 01/10/2023]
Abstract
Background Frailty is a geriatric syndrome, which is highly prevalent in community-dwelling older adults and is associated with a variety of unwanted health outcomes, including dependency and institutionalization. Physical activity (PA) interventions may be of great importance in frail people to improve the frailty status, muscle strength, physical performance and muscle mass. Methods A narrative review of randomized-controlled trails was performed, including frail and prefrail community-dwelling older adults. Included were studies with different PA interventions, such as aerobic activity, strength and balance training, stretching, and a combination of these methods. Results Overall, 14 studies were included. The PA interventions led to a significant reduction in the frailty status (3/5 studies), to an increase in muscle strength (4/8 studies), to improved physical performance (7/11 studies), and to an increase in muscle mass (1/4 studies), when compared to the control group. The studies analyzed differed in various aspects of study protocols (training protocol, intensity, frequency, follow-up time, measuring tools) and delivery method of intervention (health professionals, lay volunteers, at home in health care institutions). Conclusions Although it was not consistently reported in the studies that PA interventions are successful in increasing muscle mass in frail and prefrail older people, the results support the effectiveness of PA interventions on the reduction of frailty, and the increase in muscle strength and physical performance.
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Affiliation(s)
- Sandra Haider
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, 1090, Vienna, Austria
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, 1090, Vienna, Austria.
| | - Thomas E Dorner
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, 1090, Vienna, Austria
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Mayer S, Spickschen J, Stein KV, Crevenna R, Dorner TE, Simon J. The societal costs of chronic pain and its determinants: The case of Austria. PLoS One 2019; 14:e0213889. [PMID: 30893370 PMCID: PMC6426226 DOI: 10.1371/journal.pone.0213889] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 03/04/2019] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Chronic pain is among the most burdensome conditions. Its prevalence ranges between 12% and 30% in Europe, with an estimated 21% among Austrian adults. The economic impact of chronic pain from a societal perspective, however, has not been sufficiently researched. This study aims to provide an estimate of the societal costs for working-age adults with chronic pain in Austria. It explores the impact of sex, number of pain sites, self-reported pain severity, health literacy and private health insurance on costs associated with chronic pain. METHODS A bottom-up cost-of-illness study was conducted based on data collected from 54 adult patients with chronic pain at three Viennese hospital outpatient departments. Information on healthcare costs including out-of-pocket expenses and productivity losses due to absenteeism and informal care were collected over 12 months. Resource use estimates were combined with unit costs and mean costs per patient were calculated in € for year 2016. RESULTS Mean annual societal costs were estimated at EUR 10191. Direct medical costs were EUR 5725 including EUR 1799 out-of-pocket expenses (mainly pain relieving activities and private therapy). Productivity losses including informal care amounted to EUR 4466. Total costs for women and patients with three or more pain sites were significantly higher. No association with health literacy was found but there was a tendency towards higher out-of-pocket expenses for patients with complementary private health insurance. CONCLUSION This study is the first to provide a comprehensive assessment of the individual and societal burden of chronic pain in Austria. It highlights that chronic pain is associated with substantial direct medical costs and productivity losses. Patient costs may show systematic differences by health insurance status, implying a need for future research in this area.
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Affiliation(s)
- Susanne Mayer
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Jonah Spickschen
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - K. Viktoria Stein
- International Foundation for Integrated Care, Wolfson College, Oxford, United Kingdom
| | - Richard Crevenna
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna, Austria
| | - Thomas E. Dorner
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Judit Simon
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute Applied Diagnostics, Vienna, Austria
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Grabovac I, Hochfellner L, Rieger M, Jewell J, Snell A, Weber A, Stüger HP, Schindler KE, Mikkelsen B, Dorner TE. Impact of Austria's 2009 trans fatty acids regulation on all-cause, cardiovascular and coronary heart disease mortality. Eur J Public Health 2019; 28:4-9. [PMID: 30371837 PMCID: PMC6204548 DOI: 10.1093/eurpub/cky147] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Unhealthy diet, especially consumption of trans fatty acids (TFAs), is a known risk factor for cardiovascular disease (CVD), a leading cause of death in Austria. In 2009, Austria introduced a law regulating the content of TFAs in foods. The aim of this study was to assess the impact of the TFA regulation on CVD-related outcomes. Methods The study evaluated the TFA regulation as an intervention in a natural experiment. Two study periods were assessed: pre-intervention (1995-2009) and post-intervention (2010-14). The study compared the age-standardized death rates per 100 000 population for CVD outcomes with those of a 'synthetic' international comparator population, created from data of OECD countries where TFA regulation has not been implemented, but where the population is otherwise comparable. Results There was a continuous decrease in CVD-related mortality throughout the study period in both the synthetic international comparator population, as well as in the adult Austrian population, with no significant change in this trend observed as an effect of TFA regulation. Conclusions Whilst the results are counterintuitive, given the established link between TFA consumption and an increased risk of CVD, there are many possible explanations: high prevalence of tobacco smoking, changes in TFA content in foods due to international guidance as opposed to formal regulation and a beneficial impact of TFA regulation on sub-groups of the population that might not be detected with nationally aggregated data. However, reduction in TFAs should still be considered an important part of risk factor reduction for CVD and other non-communicable diseases.
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Affiliation(s)
- Igor Grabovac
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria
| | - Lisa Hochfellner
- Department of Statistics and Analytical Epidemiology, Austrian Agency for Health and Food Safety, Graz, Austria
| | - Matthias Rieger
- International Institute of Social Studies of Erasmus University Rotterdam, The Hague, The Netherlands
| | - Jo Jewell
- World Health Organisation Regional Office for Europe, Copenhagen, Denmark
| | - Andrew Snell
- World Health Organisation Regional Office for Europe, Copenhagen, Denmark
| | - Adelheid Weber
- Department of Maternal, Child and Gender Health and Nutrition, Federal Ministry of Labour, Social Affairs, Health and Consumer Protection, Vienna, Austria
| | - Hans-Peter Stüger
- Department of Statistics and Analytical Epidemiology, Austrian Agency for Health and Food Safety, Graz, Austria
| | - Karin E Schindler
- Department of Maternal, Child and Gender Health and Nutrition, Federal Ministry of Labour, Social Affairs, Health and Consumer Protection, Vienna, Austria
| | - Bente Mikkelsen
- World Health Organisation Regional Office for Europe, Copenhagen, Denmark
| | - Thomas E Dorner
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria
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41
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Winzer E, Dorner TE, Grabovac I, Haider S, Kapan A, Lackinger C, Schindler K. Behavior changes by a buddy-style intervention including physical training, and nutritional and social support. Geriatr Gerontol Int 2019; 19:323-329. [PMID: 30724012 PMCID: PMC6849832 DOI: 10.1111/ggi.13616] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 12/14/2018] [Accepted: 01/06/2019] [Indexed: 11/30/2022]
Abstract
Aim Previous research suggests that multicomponent interventions including physical training, and nutritional and social support are required to improve a person's behavior. As a pre‐specified secondary outcome, this analysis aimed to ascertain whether a “buddy‐style” intervention could produce physical activity and nutritional behavior changes in older adults. Methods A 12‐week, home‐based, randomized controlled trial was carried out with 80 older persons, who were randomly assigned to an intervention group (n = 39), including physical training and nutritional support, and a control group (n = 41). Trained non‐professional volunteers visited the participants at home twice a week. Physical activity and nutritional behavior were assessed through validated questionnaires. Results In total, 36 participants in the intervention group and 26 participants in the control group completed the final questionnaire. The intervention group showed significant improvements in physical activity behavior, such as light sport activity (β = 9.13, 95% CI 0.90–17.37 min/day; P = 0.030), muscle strength exercise (β = 68.18, 95% CI 46.45–89.91 min/week; P < 0.001) and overall activities (β = 0.69, 95% CI 0.21–1.18 h/day; P = 0.006), compared with the control group. Nutritional behavior improvements for the intervention group were observed in the consumption of legumes/nuts (β = 0.18, 95% CI 0.00–0.35 portions/day; P = 0.047) and fluids (β = 0.48, 95% CI 0.01–0.98 portions/day; P = 0.050), relative to controls. Conclusions A “buddy‐style” program in older adults living at home can produce effective physical activity changes and, to a lesser extent, changes in dietary behavior, and has the potential to be efficient and feasible. Geriatr Gerontol Int 2019; 19: 323–329.
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Affiliation(s)
- Eva Winzer
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria.,Special Institute for Preventive Cardiology and Nutrition - SIPCAN, Salzburg, Austria
| | - Thomas E Dorner
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Sandra Haider
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Ali Kapan
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Christian Lackinger
- Department for Health Promotion and Prevention, SPORTUNION Austria, Vienna, Austria
| | - Karin Schindler
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.,Section 8-Nutrition, Mother, Child and Gender Health, Federal Ministry of Health and Women's Affairs, Vienna, Austria
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42
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Haider S, Grabovac I, Dorner TE. Fulfillment of physical activity guidelines in the general population and frailty status in the elderly population : A correlation study of data from 11 European countries. Wien Klin Wochenschr 2018; 131:288-293. [PMID: 30421283 PMCID: PMC6570679 DOI: 10.1007/s00508-018-1408-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 10/24/2018] [Indexed: 02/07/2023]
Abstract
Background We report on the correlation between the proportion of people who fulfil the recommended amount of aerobic physical activity in the general population and the prevalence of frailty or prefrailty in the population ≥65 years in 11 European countries (Austria, Czech Republic, Denmark, Estonia, France, Germany, Italy, Luxembourg, Slovenia, Spain and Sweden). In a subgroup analysis, it was assessed if people who do aerobic physical activity also do strength training. Methods Aggregated physical activity data were taken from the European Health Interview Survey with the minimum effective sample size of 90,036 participants. Data on frailty status were taken from the Survey of Health Ageing and Retirement in Europe (SHARE) study (N = 24,590). For the subgroup analysis, data of the Austrian Health Interview Survey (ATHIS) (N = 15,770) were included. Results The results indicate a significant negative correlation between the proportion of people fulfilling the minimal aerobic physical activity recommendations (≥150 min/week) and the proportion of prefrail or frail people (R = −0.745; p = 0.008). The correlation between the optimal aerobic physical activity recommendations (≥300 min/week) and the proportion of prefrail or frail individuals was R = −0.691 (p = 0.019). In both data sets a north-south gradient was seen. Austrian data showed that 52.0% of the participants fulfilled the minimal aerobic physical activity recommendations and conducted strength training, whereas 18.4% did not fulfil the aerobic recommendations but performed strength training (p < 0.001). Conclusions By taking into account that the number of people ≥65 years will increase in the future these results may be relevant in planning public health interventions for the whole population with the goal of reducing frailty in the elderly.
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Affiliation(s)
- Sandra Haider
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1, 1090, Vienna, Austria
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1, 1090, Vienna, Austria.
| | - Thomas E Dorner
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1, 1090, Vienna, Austria
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Dorner TE, Haider S, Berner C, Grabovac I, Lamprecht T, Fenzl KH, Quittan M, Erlacher L. Sexual health in seropositive rheumatoid arthritis patients and its association with physical fitness. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky218.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- TE Dorner
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Austria
| | - S Haider
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Austria
| | - C Berner
- Karl Landsteiner Institute for Autoimmune Diseases and Rheumatology, Vienna, Austria
- Department of Rheumatology and Osteology, Kaiser Franz Josef Hospital, Sozialmedizinisches Zentrum-Süd, Vienna, Austria
| | - I Grabovac
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Austria
| | - T Lamprecht
- Karl Landsteiner Institute for Autoimmune Diseases and Rheumatology, Vienna, Austria
| | - KH Fenzl
- Karl Landsteiner Institute for Autoimmune Diseases and Rheumatology, Vienna, Austria
| | - M Quittan
- Karl Landsteiner Institute for Physical Medicine and Rehabilitation, Vienna, Austria
| | - L Erlacher
- Karl Landsteiner Institute for Autoimmune Diseases and Rheumatology, Vienna, Austria
- Department of Rheumatology and Osteology, Kaiser Franz Josef Hospital, Sozialmedizinisches Zentrum-Süd, Vienna, Austria
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Grabovac I, Meillinger M, Schalk H, Leichsenring B, Dorner TE. Prevalence and Determinants of Illicit Drug and Polydrug Use in People Living with HIV in Austria. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky213.252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- I Grabovac
- Medical University of Vienna, Vienna, Austria
| | | | - H Schalk
- ”Schalk-Pichler” Group Practice, Vienna, Austria
| | | | - TE Dorner
- Medical University of Vienna, Vienna, Austria
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Wang M, Mittendorfer-Rutz E, Dorner TE, Pazarlis KA, Ropponen A, Svedberg P, Helgesson M. Determinants of work disability following lumbar spine decompression surgery. Scand J Public Health 2018; 47:281-292. [PMID: 29974820 DOI: 10.1177/1403494818785055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIMS Scientific knowledge about risk factors for work disability in terms of long-term sickness absence and disability pension following lumbar spine decompression surgery remains insufficient. This study aimed to investigate the associations between socio-demographic, work-related, and medical characteristics with subsequent long-term sickness absence (>90 days) and disability pension for individuals who underwent lumbar spine decompression surgery. METHODS A prospective cohort study of all individuals aged 19-60 years with diagnosed dorsopathies, who underwent lumbar spine decompression surgery 2008-10 in Sweden ( n=7373) was performed. Univariate and multivariate hazard ratios with 95% confidence intervals regarding long-term sickness absence and disability pension with a 3-year follow-up period were estimated by Cox proportional regression. RESULTS Low educational level, being a non-European immigrant and preoperative sickness absence were risk factors for both long-term sickness absence and disability pension (hazard ratios: 1.2-3.8). Female sex was a risk factor for long-term sickness absence (hazard ratios: 1.3) whereas age >44 years and being a Nordic immigrant were risk factors for disability pension (hazard ratios: 1.9-2.6). Medical factors as common mental disorders, other mental disorders, prescribed psychiatric medication and somatic comorbidity were risk factors for both long-term sickness absence and disability pension (hazard ratios: 1.2-3.4). A simultaneous lumbar fusion surgery and high preoperative pain severity were risk factors for long-term sickness absence (hazard ratios 1.2-1.8). CONCLUSIONS To prevent long-term work disability after lumbar spine decompression surgery, specific focus is required on older and female patients, those with mental or somatic comorbidities, high levels of preoperative pain or sickness absence, with a simultaneous lumbar fusion surgery, a low educational level or a non-European immigrant background.
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Affiliation(s)
- Mo Wang
- 1 Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | | | - Thomas E Dorner
- 2 Department of Social and Preventive Medicine, Medical University of Vienna, Austria
| | | | - Annina Ropponen
- 1 Department of Clinical Neuroscience, Karolinska Institutet, Sweden.,4 Finnish Institute of Occupational Health, Finland
| | - Pia Svedberg
- 1 Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Magnus Helgesson
- 1 Department of Clinical Neuroscience, Karolinska Institutet, Sweden
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Titze S, Lackinger C, Grossschaedl L, Strehn A, Dorner TE, Niebauer J, Schebesch-Ruf W. How Does Counselling in a Stationary Health Care Setting Affect the Attendance in a Standardised Sports Club Programme? Process Evaluation of a Quasi-Experimental Study. Int J Environ Res Public Health 2018; 15:ijerph15010134. [PMID: 29342896 PMCID: PMC5800233 DOI: 10.3390/ijerph15010134] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 12/22/2017] [Accepted: 01/11/2018] [Indexed: 11/21/2022]
Abstract
Actions in partnership across sectors is one principle for the promotion of health behaviours. The objective of this study was to describe the participation in a sports club-based exercise programme—named JACKPOT—following an intervention in a health care setting. Focus was given to the recruitment into JACKPOT, the attendance level, and whether the different programme elements were implemented as intented. The practicability of the project was also retrospectively rated. Participants were 238 inactive people (50% women) between 30 and 65 years of age who attended a health resort. Of these, 77% were assigned to the intervention group (IG). The recruitment into the 12 JACKPOT sessions and the attendance levels were recorded via attendance lists. The implementation of the intervention standards was assessed with structured interviews and participatory observation. The Pragmatic Explanatory Continuum Indicator Summary (PRECIS)-2 tool served to rate the practicability of the project. Almost 50% of the IG subjects attended JACKPOT sessions at least once and 54% of the attenders visited ≥75% of the 12 sessions. Some of the programme elements were not delivered fully. The process evaluation results showed that the project worked in a real-world setting, and also uncovered potential reasons such as incomplete information delivery for the moderate recruitment and attendance level.
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Affiliation(s)
- Sylvia Titze
- Institute of Sport Science, University of Graz, Mozartgasse 14, 8010 Graz, Austria.
| | - Christian Lackinger
- Department of Health Promotion and Prevention, SPORTUNION Österreich, Falkestrasse 1, 1010 Vienna, Austria.
| | - Lena Grossschaedl
- Social Insurance Authority for Business, Regional Office Styria, Körblergasse 115, 8010 Graz, Austria.
| | - Albert Strehn
- Competence Center Health Promotion, Social Insurance Authority for Business, Osterwiese 2, 7000 Eisenstadt, Austria.
| | - Thomas E Dorner
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1, 1090 Vienna, Austria.
| | - Josef Niebauer
- Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports and Rehabilitation Medicine, Paracelsus Medical University Salzburg, Lindhofstrasse 20, 5020 Salzburg, Austria.
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Dorner TE. Pain and chronic pain epidemiology : Implications for clinical and public health fields. Wien Klin Wochenschr 2017; 130:1-3. [PMID: 29270720 DOI: 10.1007/s00508-017-1301-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 12/08/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Thomas E Dorner
- Center for Public Health, Department of Social and Preventive Medicine, Unit Lifestyle and Prevention, Medical University of Vienna, Kinderspitalgasse 15/1, 1090, Wien, Austria.
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Ivert T, Vaez M, Dorner TE, Rutz EM. Ichemic heart disease and common mental disorders and the risk of disability pension. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- T Ivert
- Karolinska Institutet, Stockholm, Sweden
| | - M Vaez
- Karolinska Institutet, Stockholm, Sweden
| | - TE Dorner
- Medical University Vienna, Vienna, Austria
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Grabovac I, Haider S, Dorner TE. Correlation of aerobic physical activity and frailty prevalence in elderly in 8 European countries. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx186.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- I Grabovac
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - S Haider
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - TE Dorner
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
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Kapan A, Winzer E, Haider S, Titze S, Schindler K, Lackinger C, Dorner TE. Impact of a lay-led home-based intervention programme on quality of life in community-dwelling pre-frail and frail older adults: a randomized controlled trial. BMC Geriatr 2017; 17:154. [PMID: 28724351 PMCID: PMC5517808 DOI: 10.1186/s12877-017-0548-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Accepted: 07/13/2017] [Indexed: 12/05/2022] Open
Abstract
Background Due to the demographic ageing process and the increasing number of pre-frail and frail individuals, new lifestyle interventions to enhance the quality of life (QoL) in community-dwelling older adults are necessary. Therefore, we performed a randomised controlled trial (RCT) to compare effects of a lay-led home-based physical and nutritional intervention programme with social support alone on different QoL domains in community-dwelling pre-frail and frail older adults. Methods In this analysis within a RCT (12 weeks), lay volunteers visited one-on-one pre-frail or frail older adults at home twice a week. Participants in the physical training and nutritional intervention (PTN) group performed six strength exercises and discussed main nutritional issues during each visit. The social support (SOSU) group received home visits twice a week for social exchanges. The QoL was assessed with the WHOQOL-BREF and the WHOQOL-OLD instruments. Analyses of covariance (ANCOVA) were used to examine differences between groups with baseline values as the covariate. Changes within groups were assessed with paired t-tests. Results Eighty participants (n = 39 in the PTN group and n = 41 in the SOSU group) were included. No significant differences were found between the two groups except in past, present and future activities domain [β = 3.66 (95% confidence interval 0.13 to 7.18)] in favour of the PTN group. However, there was some evidence of greater within group improvements in the PTN group particularly in overall QoL, social relations and social participation. In the SOSU group, no significant effect was observed in any QoL domain. Conclusion A combination of a home-based physical and nutritional intervention was not more effective compared to social support alone, on QoL in community-dwelling pre-frail and frail older adults. However, the small but significant improvement within the PTN group suggests that a home-based physical and nutritional intervention delivered by volunteers may influence the QoL in a positive way. Trial registration The study protocol was registered on 6 November 2013 at ClinicalTrials.gov (identifier: NCT01991639).
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Affiliation(s)
- A Kapan
- Centre for Public Health, Department of Social and Preventive Medicine, Medical University of Vienna, Kinderspitalgasse 15/1, 1090, Vienna, Austria.
| | - E Winzer
- Centre for Public Health, Department of Social and Preventive Medicine, Medical University of Vienna, Kinderspitalgasse 15/1, 1090, Vienna, Austria
| | - S Haider
- Centre for Public Health, Department of Social and Preventive Medicine, Medical University of Vienna, Kinderspitalgasse 15/1, 1090, Vienna, Austria
| | - S Titze
- Institute of Sport Science, University of Graz, Graz, Austria
| | - K Schindler
- Division of Endocrinology and Metabolism, Department of Medicine, Medical University of Vienna, Vienna, Austria
| | - C Lackinger
- Department of Health Promotion and Prevention, Sportunion Austria, Vienna, Austria
| | - T E Dorner
- Centre for Public Health, Department of Social and Preventive Medicine, Medical University of Vienna, Kinderspitalgasse 15/1, 1090, Vienna, Austria
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