Disease burden and risk factors of children aged 0-14 years in China: a retrospective study on data from the Global Burden of Disease Study 2019

Objectives
This study aimed to analyse the current status, trends and risk factors of disease burden from 1990 to 2019 among Chinese children.

Design and participants
It was a retrospective study on data from the Global Burden of Disease Study 2019 (GBD 2019). Data of disease burden and risk factors were extracted from the GBD 2019. Children were divided into two groups of

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Maggio 2024

Tranquilisers and sedatives misuse and associated factors among adolescents in Estonia: findings from cross-sectional ESPAD surveys, 2003-2019

Objectives
This study aimed to (1) to describe trends of tranquilliser and sedative (TS) misuse in Estonia during 2003–2019 and (2) to analyse the associations between TS misuse and explanatory factors (perceived access to TS, medical use of TS, family-related, friends-related, school-related factors, risk behaviour and leisure time physical activity).

Design
A cross-sectional study.

Setting
Data were collected from the European School Survey Project on Alcohol and Other Drugs (ESPAD) from 2003 to 2019 in Estonia.

Participants
Estonian schoolchildren aged 15–16 years old (n=11 328), 48.6% were boys.

Outcome measures
Prevalence, crude and adjusted ORs with 95% CIs for TS misuse.

Results
The prevalence of lifetime TS misuse significantly increased from 2003 (5.0% of boys and 12.6% of girls) to 2019 (11.3% and 17.5%, respectively) (p

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Maggio 2024

Characteristics of first-time users of the nursing small-scale multifunctional home care service: a pooled cross-sectional study using Japanese long-term care insurance claims data from 2012 to 2019

Objectives
In April 2012, the Japanese government launched a new nursing service called the nursing small-scale multifunctional home care (NSMHC) to meet the nursing care demands of individuals with moderate-to-severe activities of daily living (ADLs) dysfunction and who require medical care, thereby allowing them to continue living in the community. We aimed to preliminarily analyse the characteristics of first-time users of NSMHC service.

Design
This pooled cross-sectional study used the Japanese long-term care insurance (LTCI) claims data from the users’ first use of NSMHC (from April 2012 to December 2019).

Setting
NSMHC includes nursing home visits, home care, daycare, overnight stays and medical treatment.

Participants
The study population included LTCI beneficiaries who received their first long-term care requirement certification in Japan from April 2012 onwards, died between April 2012 and December 2019, and used any LTCI service at least once.

Results
Among the 836 563 individuals who used any LTCI service at least once, 3957 (0.47%) used NSMHC. We analysed 3634 individuals without any missing data regarding long-term care requirement certification. Most individuals were aged 80 years or older, with 64.3% requiring care level 3 or above, indicating complete assistance with ADLs. Regarding ADLs in individuals with dementia, 70.6% were at level 2 or below, indicating they can live almost independently even with dementia. A large proportion of NSMHC users availed the service approximately 6 months before death, with no prior use of any LTCI services; they continued using the service for around 4 months, although some people continued to use NSMHC until their month of death.

Conclusions
Using individual data on nationwide LTCI, we described the characteristics of first-time users of NSMHC among those who died within 7.5 years from the first certification of care needs. Further studies are needed to investigate the effect of NSMHC use on user outcomes.

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Maggio 2024

Risk-adjusted trend in national inpatient fall rates observed from 2011 to 2019 in acute care hospitals in Switzerland: a repeated multicentre cross-sectional study

Objectives
This study aimed to investigate whether a significant trend regarding inpatient falls in Swiss acute care hospitals between 2011 and 2019 could be confirmed on a national level, and whether the trend persists after risk adjustment for patient-related fall risk factors.

Design
A secondary data analysis was conducted based on annual multicentre cross-sectional studies carried out between 2011 and 2019.

Setting
All Swiss acute care hospitals were obliged to participate in the surveys. Except for emergency departments, outpatient wards and recovery rooms, all wards were included.

Participants
All inpatients aged 18 or older who had given their informed consent and whose data were complete and available were included.

Outcome measure
Whether a patient had fallen in the hospital was retrospectively determined on the survey day by asking patients the following question: Have you fallen in this institution in the last 30 days?

Results
Based on data from 110 892 patients from 222 Swiss hospitals, a national inpatient fall rate of 3.7% was determined over the 9 survey years. A significant linear decreasing trend (p=0.004) was observed using the Cochran-Armitage trend test. After adjusting for patient-related fall risk factors in a two-level random intercept logistic regression model, a significant non-linear decreasing trend was found at the national level.

Conclusions
A significant decrease in fall rates in Swiss hospitals, indicating an improvement in the quality of care provided, could be confirmed both descriptively and after risk adjustment. However, the non-linear trend, that is, an initial decrease in inpatient falls that flattens out over time, also indicates a possible future increase in fall rates. Monitoring of falls in hospitals should be maintained at the national level. Risk adjustment accounts for the observed increase in patient-related fall risk factors in hospitals, thus promoting a fairer comparison of the quality of care provided over time.

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Maggio 2024