Search

ZusammenfassungIm folgenden Beitrag werden die Veränderungen der Arbeitswelt durch die New Work-Bewegung aus einer gruppendynamischen Perspektive untersucht. Dazu werden auf den Dimensionen Hierarchie, Zugehörigkeit und Intimität, Vorteile und Folgen der Veränderungen durch New Work sowohl aus der Personensicht als auch aus der Perspektive der Organisation aufgezeigt und anhand von Fallbeispielen illustriert.

Background Digital health interventions are effective for hypertension self-management, but a comparison of the effectiveness and implementation of the different modes of interventions is not currently available. This study aimed to compare the effectiveness of SMS, smartphone application, and website interventions on improving blood pressure in adults with hypertension, and to report on their reach, uptake, and feasibility. Methods In this systematic review and meta-analysis we searched CINAHL Complete, Cochrane Central Register of Controlled Trials, Ovid Embase, Ovid MEDLINE, and APA PsycInfo on May 25, 2022, for randomised controlled trials (RCTs) published in English from Jan 1, 2009, that examined the effectiveness of digital health interventions on reducing blood pressure in adults with hypertension. Screening was carried out using Covidence, and data were extracted following Cochrane's guidelines. The primary endpoint was change in the mean of systolic blood pressure. Risk of bias was assessed with Cochrane Risk of Bias 2. Data on systolic and diastolic blood pressure reduction were synthesised in a meta-analysis, and data on reach, uptake and feasibility were summarised narratively. Grading of Recommendations, Assessment, Development, and Evaluation criteria were used to evaluate the level of evidence. The study was registered with PROSPERO CRD42021247845. Findings Of the 3235 records identified, 29 RCTs from 13 regions (n=7592 participants) were included in the systematic review, and 28 of these RCTs (n=7092 participants) were included in the meta-analysis. 11 studies used SMS as the primary mode of delivery of the digital health intervention, 13 used smartphone applications, and five used websites. Overall, digital health intervention group participants had a –3·62 mm Hg (95% CI –5·22 to –2·02) greater reduction in systolic blood pressure, and a –2·45 mm Hg (–3·83 to –1·07) greater reduction in diastolic blood pressure, compared with control group participants. No statistically significant differences between the three different modes of delivery were observed for both the systolic (p=0·73) and the diastolic blood pressure (p=0·80) outcomes. Smartphone application interventions had a statistically significant reduction in diastolic blood pressure (–2·45 mm Hg [–4·15 to –0·74]); however, there were no statistically significant reductions for SMS interventions (–1·80 mm Hg [–4·60 to 1·00]) or website interventions (–3·43 mm Hg [–7·24 to 0·38]). Due to the considerable heterogeneity between included studies and the high risk of bias in some, the level of evidence was assigned a low overall score. Interventions were more effective among people with greater severity of hypertension at baseline. SMS interventions reported higher reach and smartphone application studies reported higher uptake, but differences were not statistically significant. Interpretation SMS, smartphone application, and website interventions were associated with statistically and clinically significant systolic and diastolic blood pressure reductions, compared with usual care, regardless of the mode of delivery of the intervention. This conclusion is tempered by the considerable heterogeneity of included studies and the high risk of bias in most. Future studies need to describe in detail the mediators and moderators of the effectiveness and implementation of these interventions, to both further improve their effectiveness as well as increase their reach, uptake, and feasibility.

Ensuring utilization of antenatal care (ANC) services by adolescent mothers (ages 10-19) is an enormous challenge in low-and middle-income countries (LMICs). This study provides the first comprehensive analysis of ANC visits among adolescent and adult mothers.Using all available Demographic and Health Survey and Multiple Indicator Cluster Surveys between 2000 and 2019 in 54 LMICs, we estimated proportion of ANC visits among women. Bayesian hierarchical regression models were used to estimate trend, projection, and determinants of single and four ANC visits (ANC1 and ANC4) independently. Equity analysis were performed to assess the magnitude of wealth-based and urban-rural inequalities in access to ANC visits.Compared to women aged 36-49 years, coverage of ANC1 and ANC4 are expected to increase significantly for adolescent mothers and women aged 20-35 years. This increase was observed at the national level, as well as both urban and rural areas in most countries between 2000 and 2030. By 2030, the coverage of ANC1 is predicted to reach 80% or more in all countries except Angola, Central African Republic and Togo, whereas only 16 countries are predicted to reach 80% or more for ANC4. According to wealth quintile, the lowest inequalities with highest coverage of 80% or more ANC4 will be observed in Armenia, Cambodia, Dominican Republic, Ghana, Maldives, Indonesia, and Sao Tome and Principe in 2030. Determinant analysis found increased odds of receiving ANC visits during pregnancy for adolescent mothers with higher educational levels, frequency of listening/watching mass media, and various household socio-economic status factors.This study calls for advanced, innovative and cost-effective approaches to increase ANC coverage among adolescent mothers, particularly in rural areas and/or in low socioeconomic groups.

Complete (100%) protection against catastrophic health expenditure (CHE) and impoverishment is the main target of universal health coverage (UHC). Evidence-based estimates must be at the heart of policy development for UHC, further research using updated data is essential to monitor, track, and compare country progress up to 2030. We estimate global, regional, and country-level CHE and impoverishment during 2000-2030.We aggregated 636 data points from 140 countries that were conducted between 2000 and 2021. We used Bayesian hierarchical model for trend and projection analysis. Furthermore, we constructed scenario-based projections of CHE and impoverishment based on 5% GDP spending on health and per capita health expenditure (PCHE) of $86.Most countries fail to achieve financial protection targets by 2030, with the global incidence of CHE predicted to persist around 7% at 10% threshold. CHE is predicted to increase in most of Asia (Southern: 8.1% in 2000 to 13.4% in 2030; Central: 3.6%-23.2%; Eastern: 8.3%-14.4%; and Western: 7.3%-20.2%), Northern Africa (12.4%-27.2%), Eastern (7.1%-14.9%) and Northern Europe (6.6%-13.2%). In contrast, a decrease is predicted in Oceania, Latin America and the Caribbean, and Northern America. By 2030, incidence of impoverishment is predicted to be 0% worldwide at $3.10 poverty line, however in several African and Soth Asian countries is predicted to be high impoverishment. The scenario-based analysis indicated that CHE and impoverishment is expected to decrease in 41 and 42 countries for GDP increase and 43 and 62 for PCHE increase respectively compared to current spending on health.To accelerate progress towards reducing financial protection, governments should carefully assess the country context to determine how health can be prioritised through government spending to reduce out-of-pocket payments.

Background: Technology-based interventions (TBIs) are widely being tested to integrate into the existing health system to increase preventative healthcare utilizations. Despite an uptake of TBIs, evidence remains inconclusive regarding its effectiveness due to a lack of comprehensive and concrete evaluations. This study aims to evaluate the impact and effectiveness of TBIs in improving antenatal visits, postnatal visits, and delivery care services in LMICs using Bayesian network meta-analysis. Methods: To identify the relevant studies, we will perform a comprehensive search of electronic databases and grey literatures with no language or publication date restriction. We will include experimental studies if they assess effectiveness of TBIs on improving perinatal care utilization among pregnant women. The primary outcomes are antenatal visits, postnatal visits, and delivery care. Two reviewers will independently identify eligible study and perform data extraction and quality assessment. We will use Bayesian meta-analysis to summarize the effect size of individual interventions for each outcome separately. In addition, Bayesian network meta-analyses will be used to pool the direct and indirect effects of all possible comparisons and to provide a hierarchy of all interventions for our primary outcomes. Furthermore, we will assess publication bias and certainty of evidence by GRADE approach for NMA.Discussion: The findings of this review will fill the gaps in evidence by synthesizing the impact of TBIs on a comprehensive range of reported outcomes in antenatal, postnatal, and delivery care. Furthermore, our meta-analyses will further guide policymakers or stakeholders on the potential use of TBIs in given contexts. Systematic review registration: PROSPERO Protocol ID CRD42019137331

Objective:To obtain projections of the prevalence of childhood malnutrition indicators up to 2030 and to analyse the changes of wealth-based inequality in malnutrition indicators and the degree of contribution of socio-economic determinants to the inequities in malnutrition indicators in Bangladesh. Additionally, to identify the risk factors of childhood malnutrition.Design:Cross-sectional study. A Bayesian linear regression model was used to estimate trends and projections of malnutrition. For equity analysis, slope index, relative index and decomposition in concentration index were used. Multilevel logistic models were used to identify risk factors of malnutrition.Setting:Household surveys in Bangladesh from 1996 to 2014.Participants:Children under the age of 5 years.Results:A decreasing trend was observed for all malnutrition indices. In 1990, predicted prevalence of stunting, wasting and underweight was 55·0, 15·9 and 61·8 %, respectively. By 2030, prevalence is projected to reduce to 28·8 % for stunting, 12·3 % for wasting and 17·4 % for underweight. Prevalence of stunting, wasting and underweight were 34·3, 6·9 and 32·8 percentage points lower in the richest households than the poorest households. Contribution of the wealth index to child malnutrition increased over time and the largest contribution of pro-poor inequity was explained by wealth index. Being an underweight mother, parents with a lower level of education and poorer households were the key risk factors for stunting and underweight.Conclusions:Our findings show an evidence-based need for targeted interventions to improve education and household income-generating activities among poor households to reduce inequalities and reduce the burden of child malnutrition in Bangladesh.

Maternal anemia affects approximately 56 million women worldwide and increases the risk of adverse pregnancy outcomes. Our study aimed to summarize the evidence for the association between maternal hemoglobin (Hb) concentrations and maternal or infant outcomes, evaluating it in a continuous manner. In this systematic review and meta-analysis, we conducted an electronic search on PubMed, Embase, CINAHL, and Web of Science from inception to April 19, 2017, and further updated to November 21, 2018, applying subject heading terms related to pregnant women with anemia. We included 117 studies with 4,127,430 pregnancies. Maternal anemia increased the risk of low birth weight (odds ratio (OR), 1.65; 95% confidence interval (CI): 1.45-1.87), preterm birth (PTB) (OR, 2.11; 95% CI: 1.76-2.53), perinatal mortality (PNM) (OR, 3.01; 95% CI: 1.92-4.73), stillbirth (OR, 1.95; 95% CI: 1.15-3.31), and maternal mortality (OR, 3.20; 95% CI: 1.16-8.85). A nonlinear relationship was found between maternal Hb and adverse maternal and infant outcomes. The OR of outcomes such as PTB, small-for-gestational age, PNM, preeclampsia, gestational hypertension, and postpartum hemorrhage was increased by two to three times. Assessing Hb as a continuous variable is important to determine the associated risk of adverse outcomes with decreasing or increasing levels.

Background: In South Asian region particularly in Bangladesh, adolescent pregnancy is still a major public concern. Therefore, identification of potential risk factors of adolescent pregnancy and childbearing may help to formulate policy to prevent premature delivery, death and disability.Objectives: The main objective of this study was to identity the determinants factors of adolescent pregnancy in Bangladesh.Study design: Retrospective two-stage stratified sample design.Methods: Data were extracted from nationally representative Bangladesh Demographic and Health Survey conducted in 2011. In this study, age of childbearing was considered as dependent variable and classified as adolescent (≤19 years) and adult (>19 years). Several individual, household and community level factors were considered as the independent variables. Multilevel logistic regression model with household and community random intercept was used to identify the association between dependent and independent variable.Results: The study found that about 28% adolescent had given birth in Bangladesh. Higher educated women (OR=0.65, 95% CI, 0.49-0.96), husband with higher education (OR=0.69, 95% CI, 0.56-0.84) and age at first marriage after age 15 years (OR=0.50, 95% CI, 0.45-0.55) were found to be protective for adolescent pregnancy. Secondary educated women (OR, 1.21; 95% CI, 1.03-1.39) showing the higher adolescent pregnancy than women with no education. The risk is high among women in Rangpur (OR=1.19; 95% CI, 1.12 1.25), followed by Khulna (OR=1.16; 95% CI, 1.09 1.23), Rajshahi (OR=1.16; 95% CI, 1.09 1.23) division showing among in Barisal division.Conclusion: Around one fourth of the total pregnancy occurred adolescent age in Bangladesh which is caused by various individual, household and community-level factors. Proper education and increase awareness about the adverse effect of adolescent pregnancy are necessary to reduce occurrence of adolescent pregnancy in Bangladesh.

Trachoma is one of the major causes of preventable blindness worldwide. In Australia it is solely a disease of Aboriginal people. Trachoma in non-indigenous Australians has been eradicated earlier this century, however, is still prevalent among Aboriginal communities. Poor living condition, lack of access to water supply and sanitation, living in a crowded and unhealthy environment are the main causes of trachoma in Indigenous Australians. The World Health Organization (WHO) has initiated Global Alliance for the Elimination of Trachoma by the year 2020 (GET2020). The alliance has adopted the "SAFE" (Surgery, Antibiotic distribution, Facial cleanliness and Environmental improvements) strategy to eliminate trachoma in endemic countries. In Australia, the National Trachoma Surveillance and Reporting Unit (NTSRU) was established in 2006 and ever since has been providing high quality surveillance data on national trachoma burden. In 2009, the Australian Government made a commitment investment of $16 million over a 4-year period to eliminate trachoma from Australia. Today, promising success has been achieved in surveillance and management of trachoma using the SAFE strategy. But the ultimate elimination of the disease would require a long-term political commitment founded, inter alia, on multi-sectoral collaboration, targeted research, and community engagement.

Background Bangladesh is one of the highest tobacco consuming countries in the world, with reported 21.2% of the population as daily smokers, 24.3% as smokeless tobacco users, and 36.3% as adult passive smoker. Given the high prevalence and established harmful effects of passive tobacco smoking, this study aimed to estimate of pattern of smoking policies in residential and work place, and to identify the associated socio-economic and demographic correlates in Bangladesh. Data and methods Secondary data of sample size 9629 collected by the Global Adult Tobacco Survey (GATS) 2010 has been used. Along with descriptive analysis, binary logistic regression model has been used to analyze the socio-demographic and economic correlates to tobacco smoking policy. Results The prevalence of male and female passive tobacco smokers was 74.3% and 25.8% respectively. Among the passive tobacco smokers, 22.2% reported that smoking was allowed at their home and 29.8% reported that there was no such smoking policy at their home. Alternatively, 26.0% passive tobacco smokers reported that smoking was allowed and 27.5% reported that there was no such smoking policy at their work place. Logistic regression analysis indicated that for tobacco smokers group, the odds of allowing smoking at home was 4.85 times higher than the non-smoker respondent (OR = 4.85, 95% CI = 4.13, 5.71), 1.18 times more likely to be allowed at home in rural areas than urban areas (OR = 1.18, 95% CI = 1.06,1.32) and less for college/university completed and (or) higher educated respondent than no formal schooling (OR = 0.35, 95% CI = 0.24, 0.52). On the other hand, smoking was 1.70 times more likely to be allowed at work place for tobacco smokers than their counter part respondent (OR = 1.70, 95% CI = 1.36, 2.14) and was less likely to be allowed for college/university completed and (or) higher educated respondent (OR = 0.26, 95% CI = 0.14, 0.45) than respondent with no formal schooling. Conclusion To reduce the passive smoking, lower educated people and people in urban areas should advocate more about the adverse effect of active and passive tobacco smoking. Also, smoking policy should reform introducing smoking zone at work places and residential buildings.

Background Rapid increasing of high body mass index (BMI) is a global health concern. Population with high BMI predicts an increased risk of diabetes and hypertension. The objective of the present study is to estimate the trend and prediction of diabetes and hypertension in Bangladesh, to examine the association of BMI with risk of diabetes and hypertension, and to ascertain an appropriate BMI cut-off point for screening diabetes. Methods We searched PubMed from inception to August 2016 and identified studies reporting diabetes and hypertension prevalence in Bangladesh. Bangladesh Demographic and Health Survey 2011 data was also included in this study. Bayesian model was used to estimate trend and projection in diabetes and hypertension prevalence by sex and residence. Receiver operating characteristic curves was used to determine the optimal BMI cut-off point for screening diabetes. Findings Of 535 articles reviewed, 35 studies reported prevalence of diabetes and hypertension. Prevalence of diabetes (95% credible interval) increased between 1992 and 2015 from 3.2% (2.2–4.3) to 12.1% (9.1–15.4) in men, and from 2.5% (1.8–3.5) to 13.4% (9.7–17.6) in women. Diabetes prevalence in 2030 is expected to reach 23.6% (13.6–36.3) for men and 33.5% (19.9–50.9) for women. Hypertension prevalence increased between 1992 and 2015 from 11.0% (8.6–13.7) to 20.4% (18.4–22.4%) in 2015 in men, and from 14.0% (10.3–19.0) to 21.3% (19.0–23.6) in women. Annual average rate of change for diabetes prevalence was higher among women and in rural areas, while for hypertension prevalence it was higher in men and urban areas. Adults with BMI of 22.5 kg/m2 or above had a higher risk of diabetes and hypertension in this study. The optimal BMI cut-off point for screening diabetes was 23 kg/m2 for overall population, 22 kg/m2 for men, and 23 kg/m2 for women. Interpretation Diabetes is more prevalent among women and rural population groups, while hypertension is more prevalent among men and urban population groups in Bangladesh. A BMI of 22.5 kg/m2 or more is risk factors for developing diabetes and hypertension. Screening for diabetes may be considered for all Bangladeshi adults with a BMI of ⩾23 kg/m2.

Aim The long-term outcomes of childhood infective encephalitis are variable and not well quantified. We aimed to systematically review the literature and undertake meta-analyses on predetermined outcomes to address this knowledge gap and identify areas for future research. Method We searched electronic databases, performed complementary reviews of references of fully extracted articles, and made contact with experts on infective encephalitis. Articles published up until April 2016 were selected for screening. Results We evaluated sequelae of 1018 survivors of childhood infective encephalitis (934 with complete follow-up) from 16 studies. Mean age during acute encephalitis episodes was 5 years 3.6 months (range 1.2mo–17y), 57.6% were male (500/868), and mean follow-up period was 4 years 1.2 months (range 1–12y). Incomplete recovery was reported in 312 children (42.0%; 95% confidence interval [CI] 31.6–53.1% in pooled estimate). Among the other sequelae, developmental delay, abnormal behaviour, motor impairment, and seizures were reported among 35.0% (95% CI 10.0–65.0%), 18.0% (95% CI 8.0–31.0%), 17.0% (95% CI 10.0–26.0%), and 10.0% (95% CI 6.0–14.0%) respectively. Interpretation Almost half of childhood infective encephalitis survivors report incomplete recovery in the long-term; most commonly developmental delay, behavioural abnormality, and neurological impairments (i.e. seizure). Well designed, large-scale prospective studies are needed to better quantify neurodevelopmental sequelae among childhood encephalitis survivors.

There is a lack of data on the prevalence and causes of blindness in Bangladesh, which is important to plan effective eye health programs and advocate support services to achieve the goals of Vision 2020.We conducted a rapid assessment of avoidable blindness (RAAB) in 8 districts of Bangladesh (January 2010 - December 2012) to establish the prevalence and causes of blindness. People aged ≥50 years were selected, and eligible participants had visual acuity (VA) measured. Ocular examinations were performed in those with VA6/18. Additional information was collected for those who had or had not undergone cataract surgery to understand service barriers and quality of service.In total, 21,596 people were examined, of which 471 (2.2%, 95% confidence interval, CI, 2.0-2.4%) were blind. The primary cause of blindness was cataract (75.8%). The majority of blindness (86.2%) was avoidable. Cataract and refractive error were the primary causes of severe visual impairment (73.6%) and moderate visual impairment (63.6%), respectively. Cataract surgical coverage for blind persons was 69.3% (males 76.6%, females 64.3%, P0.001). The magnitude of blindness among people aged ≥50 years was estimated to be 563,200 people (95% CI 512,000-614,400), of whom 426,342 had un-operated cataract.In Bangladesh, the majority of blindness (86.2%) among people aged ≥50 years was avoidable, and cataract was the most important cause of avoidable blindness. Improving cataract surgical services and refraction services would be the most important step towards the elimination of avoidable blindness in Bangladesh.

Background The causes and pathogenesis of cerebral palsy (CP) are all poorly understood, particularly in low- and middle-income countries (LMIC). There are gaps in knowledge about CP in Bangladesh, especially in the spheres of epidemiological research, intervention and service utilization. In high-income countries CP registers have made substantial contributions to our understanding of CP. In this paper, we describe a pilot study protocol to develop, implement, and evaluate a CP population register in Bangladesh (i.e., Bangladesh Cerebral Palsy Register - BCPR) to facilitate studies on prevalence, severity, aetiology, associated impairments and risk factors for CP. Methods/Design The BCPR will utilise a modified version of the Australian Cerebral Palsy Register (ACPR) on a secured web-based platform hosted by the Cerebral Palsy Alliance Research Institute, Australia. A standard BCPR record form (i.e., data collection form) has been developed in consultation with local and international experts. Using this form, the BPCR will capture information about maternal health, birth history and the nature of disability in all children with CP aged

This study investigates the effects of ownership structures and corporate governance on firms' performance in the Chinese capital market, which is in the early developmental stage of a socialist market economy. First, we examined companies that issued "A" stock listed on Shanghai and Shenzhen Stock Exchanges from 2004-2007 to analyze the effects of various facets of ownership structures and corporate governance on firms' values. Second, we examined the firms' performances under varying proportions of state ownership to examine the impact on ownership structures and corporate governance. Factors of ownership governing structures, such as state ownerships, largest shareholder ownership, and managerial ownership were found to negatively affect the firms' values. We also examined the effect of interactions between firms' performances and corporate governance structures on board independence and the existence of audit committees on the valuation of firms with high performance values.