European journal of public health
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Eur J Public Health · Apr 2015
The development of a mental health screening tool and referral pathway for police custody.
Time spent in police custody should present an opportunity for the early identification of mental ill health. However, this stage of the criminal justice system (CJS) is currently the least developed in terms of its links with health and social services. In England, police custody sergeants administer a standardized risk assessment tool to determine a detainee's need for health-care and/or risk reduction measures while detained. Specialized mental health services are often reliant on this process to generate referrals; however, previous research has shown this to be ineffective. The aim of this study was to develop an improved mental health screening tool and referral pathway to better identify individuals with mental ill health in police custody. ⋯ The study resulted in a screening tool, referral pathway and training package. PolQuest is expected to facilitate the mental health screening of all adult detainees; improve the early identification of mental ill health; aid timely access to services; provide clear indicators for referral; and reduce ambiguity in the roles and responsibilities of staff across a range of criminal justice and health-care services.
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Eur J Public Health · Apr 2015
Unemployment, public-sector health-care spending and breast cancer mortality in the European Union: 1990-2009.
The global economic crisis has been associated with increased unemployment, reduced health-care spending and adverse health outcomes. Insights into the impact of economic variations on cancer mortality, however, remain limited. ⋯ Rises in unemployment are associated with significant short- and long-term increases in breast cancer mortality, while increases in PSEH are associated with reductions in breast cancer mortality. Initiatives that bolster employment and maintain total health-care expenditure may help minimize increases in breast cancer mortality during economic crises.
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Eur J Public Health · Feb 2015
Comparative StudyComparing the performance of the Charlson/Deyo and Elixhauser comorbidity measures across five European countries and three conditions.
The Charlson and Elixhauser comorbidity measures are commonly used methods to account for patient comorbidities in hospital-level comparisons of clinical quality using administrative data. Both have been validated in North America, but there is less evidence of their performance in Europe and in pooled cross-country data, which are features of the European Collaboration for Healthcare Optimization (ECHO) project. This study compares the performance of the Charlson/Deyo and Elixhauser comorbidity measures in predicting in-hospital mortality using data from five European countries in three inpatient groups. ⋯ The Elixhauser list contains more comorbidities, which may enable it to achieve better discrimination than the Charlson measure. Both measures achieve similar calibration, so for the purpose of ECHO we judged the Elixhauser measure to be preferable.
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Eur J Public Health · Dec 2014
Sleep problems, exercise and obesity and risk of chronic musculoskeletal pain: the Norwegian HUNT study.
The objective was to investigate the association between self-reported sleep problems and risk of chronic pain in the low back and neck/shoulders, and whether physical exercise and body mass index (BMI) alter this association. ⋯ Sleep problems are associated with an increased risk of chronic pain in the low back and neck/shoulders. Regular exercise and maintenance of normal body weight may reduce the adverse effect of mild sleep problems on risk of chronic pain.