Use In Austria Research Articles

Translation and cross-cultural adaptation of the young children participation and environment measure for its use in Austria, Germany, and Switzerland.

Concepts such as participation and environment may differ across cultures. Consequently, cultural equivalence must be assured when using a measure like the Young Children Participation and Environment Measure (YC-PEM) in other settings than the original English-speaking contexts. This study aimed to cross-culturally translate and adapt the YC-PEM into German as it is used in Germany, Austria, and Switzerland. Following international guidelines, two translations were compared, and the research and expert team made the first adaptations. Twelve caregivers of children with and without disabilities from three German-speaking countries participated in two rounds of think-aloud interviews. Data were analyzed by content analysis to look for item, semantic, operational, conceptual, and measurement equivalence to reach a cultural equivalence version in German. Adaptations were needed in all fields but prominently in item, operational, and conceptual equivalence. Operational equivalence resulted in graphical adaptations in the instructions and questions to make the German version of YC-PEM, YC-PEM (G), more user-friendly. This study presents a cross-cultural translation and adaptation process to develop a German version of the YC-PEM suitable for Germany, Austria, and Switzerland. A culturally adapted YC-PEM (G) is now available for research, practice, and further validation.

Youth Participation and Social Media

This work-in-progress-paper presents the multi-layered research design of the Austrian team in the U-YouPa project. First, we give a brief overview of Social Media use in Austria. After a short description of our research design at a glance, we focus on our methodological considerations for four case studies. Our research approach can be used to explore youth in its diversity and to prevent limited perspectives.

The energy austerity pitfall: Linking hidden energy poverty with self-restriction in household use in Austria

This paper investigates whether energy poor households may be overlooked because they self-restrict their residential heating to underconsumption. Energy poverty definitions predominantly focus on energy expenses relative to household income or theoretically estimated energy needs. Deprived households may accept colder room temperatures to avoid excessive energy bills, but this austerity reaction may backfire if they are no longer classified as energy poor. We thus propose a complementary perspective, highlighting hidden energy poverty emerging from residents’ reactions to their impaired situation. Drawing on survey data of predominantly low-income residents in energy inefficient housing in the cities of Vienna (N = 220) and Graz (N = 433), Austria, latent class analysis identifies two distinct classes of self-restricting and non-restricting households. Cross-tabulating these classes with current poverty definitions indicates a blind spot: about a third of those not considered income poor or energy poor cope by self-imposed restriction in energy use. This blind spot applies across a range of common income poverty and energy poverty definitions, and is replicated in both the Vienna and Graz samples reflecting different housing contexts. Self-restriction blurs the lines of current classifications, as some deprived households may not be recognized in poverty statistics or eligibility criteria of welfare and housing policies. Thus, we propose to consider self-restriction in energy use complementary to the energy poverty triad of high energy expenditures, low income and poor housing conditions in order to avoid misidentification.

Drivers and Barriers Influencing the Willingness to Adopt Technologies for Variable Rate Application of Fertiliser in Lower Austria

Even though a broad range of technologies for variable rate application of nitrogen fertiliser is available, there are hardly any documented cases of their use in Austria. In this study, the drivers and barriers of adoption have been investigated. A survey of 242 farmers in Lower Austria was conducted. The survey covered the farmers’ economic situation, concerns, and expectations regarding the future of their farms and their interest in precision farming technologies. A choice experiment was included in the survey to elicit farmers’ preferences for different features of variable rate application technologies. A series of multinomial logit, mixed logit and latent class logit models were run to analyze the choice experiment. Most farmers were interested in variable rate application, whereas technology costs, yield and environmental improvements were found to be important drivers of adoption. Also, farm size, farming system, technological level and network activities seem to play an important role in the uptake of variable rate application technologies.

Sex-specific trends in smoking prevalence over seven years in different Austrian populations: results of a time-series cross-sectional analysis.

ObjectivesAim of this study was to examine trends over time in smoking status in men and women, and in subgroups, in Austria, a country with poor smoking regulation policies.Design and participantsTwo cross-sectional surveys (Austrian Health Interview Surveys for 2007 and 2014), each with more than 15 000 participants from the general population, aged ≥15 years.Outcome measuresPrevalence of self-reported daily smoking. ORs for daily smoking in subgroups, presented as results of logistic regression models, adjusted for sociodemographic variables and presence of chronic diseases.ResultsPrevalence of daily cigarette smoking was 26.0% for men in both years, and increased from 19.1% to 22.0% (p<0.001) in women from 2007 to 2014. Smoking prevalence increased especially in female patients with diabetes mellitus (from 9.9% to 16.4%, p=0.005), obesity (from 17.1% to 21.6%, p=0.010) and hypertension (from 11.2% to 14.2%, p=0.010). Smoking prevalence increased significantly in unemployed men (from 43.6% to 57.1%, p<0.001). In women, smoking prevalence increased in those aged 30–64 years (from 21.9% to 26.3%, p<0.001) and 65+ (from 3.9% to 6.2%, p=0.002), with primary (from 17.2% to 24.4%, p<0.001) and secondary education (from 21.4% to 23.4%, p=0.021), and with a European (from 16.6% to 26.1%, p<0.001) and non-European migration background (from 25.0% to 32.8%, p=0.003). In the adjusted analysis for women in 2014, there was a higher likelihood of smoking (OR 1.22, 95% CI 1.12 to 1.32, p<0.001) compared with 2007, and for those affected by a chronic disease (OR 1.15, 95% CI 1.06 to 1.25, p=0.002).ConclusionsThere has been a remarkable increase in smoking prevalence over the 7-year period in women in Austria, especially for those with chronic diseases, higher age, lower education and a migration background. Better political and clinical efforts are needed to reduce the high tobacco use in Austria.

Configuring the Older Non-User: Between Research, Policy and Practice of Digital Exclusion

Older adults face significant barriers when accessing the Internet. What can be done to address these barriers? This article analyses existing strategies to tackle the age-related digital divide on three different levels: research, policy and practice. It analyses (1) scientific conceptualisations that are used when studying Internet use and non-use in later life, (2) policies that address older adults’ Internet (non-)use in Austria and (3) characteristics of older Austrian non-users of the Internet based on the Survey of Health, Ageing and Retirement in Europe (SHARE, wave 6). Analysis shows that Austrian policy tends to emphasise the individual responsibility to learn digital technologies, while placing a lower priority on structural issues, such as investments in infrastructure. However, SHARE data shows that only a small percentage of older non-users of the Internet is in fact reached with such interventions. Thus, this article suggests that policy needs to base its strategies on more refined understandings of Internet use and non-use in later life as well as a more nuanced image of the older non-user. A perspective of critical-cultural gerontology, as laid out in this article, highlights that technology adoption is a domestication process that takes place in the everyday lives of older adults, and it is these processes that interventions that tackle the age-related digital divide should take as a starting point.

Influenza vaccination in Austria: Persistent resistance and ignorance to influenza prevention and control.

In the Austrian population approximately 350,000-400,000 cases and 1,000-1,200 deaths are observed during an average epidemic, which puts influenza-related deaths on top of the list of vaccine-preventable cases of death. In face of extensive vaccination recommendations, the current vaccination rate of the general population of about 6% is one of the lowest worldwide. The objective of this study was to provide an update regarding the use of influenza vaccination in Austria over the period 1982-2015. This paper presents data on influenza vaccine use in Austria displayed by the number of distributed doses per 1,000 population over a period of 33 years. Further data was collected from representative population-based telephone surveys. Austria has always been among the countries with a low number of distributed doses of influenza vaccine. The highest number ever was reached in 2006 with 142 doses/1,000. From 2007 onwards, a steady decrease happened to 62 doses/1,000 in the 2015/16 season, which corresponds to the level of the mid-nineties. Despite the fact that Austria is a country with comprehensive recommendations for influenza vaccination, this vaccination continues to be misjudged by the Austrian population and many areas of the medical system. From a public health point of view, this situation is not acceptable. Efforts must be increased to attain a much higher vaccination rate, e.g. the importance of the healthcare workers' influence must be recognized, the options of social marketing have to be utilized and studies on the main barriers in Austria are urgently needed.

Tri-country translation, cultural adaptation, and validity confirmation of the Scored Patient-Generated Subjective Global Assessment.

The Scored Patient-Generated Subjective Global Assessment (PG-SGA) is the only malnutrition (risk) assessment tool that combines patient-generated measures with professional-generated (medical) factors. We aimed to apply international standards to produce a high quality, validated, translation and cultural adaptation of the original PG-SGA for the Austrian, German, and Swiss setting. Analogue to methodology used for the Dutch, Portuguese, and Thai versions of PG-SGA, the ten steps of the International Society for Pharmacoeconomics and Outcomes Research's principles of good practice for translation and cultural adaptation were followed. Comprehensibility and difficulty of the translation were assessed in 103 patients and 104 healthcare professionals recruited from all three German-speaking countries. Content validity of the translation was assessed among healthcare professionals (HCP). Item and scale indices were calculated for content validity (I-CVI; S-CVI), comprehensibility (I-CI; S-CI), and difficulty (I-DI; S-DI). Patients' perceived comprehensibility and difficulty of the PG-SGA fell within the range considered to be excellent (S-CI = 0.90, S-DI = 0.90), HCP-perceived content validity (S-CVI = 0.90) was also excellent, while HCP-perceived comprehensibility fell within the high range of acceptable (S-CI = 0.87). The professional component of the PG-SGA was perceived as below acceptable (S-DI = 0.72) with the physical exam being rated the most difficult (I-DI=0.29-0.75). The systematic approach resulted in a high-quality validation of the German language version of the PG-SGA, that is internationally comparable, comprehensible, easy to complete, and considered relevant for use in Austria, Germany and Switzerland.

Prescription of antibiotics for systemic use in Austria, 2006 – 2014

Prescription of antibiotics for systemic use in Austria, 2006 – 2014

Statistical entropy analysis to evaluate resource efficiency: Phosphorus use in Austria

In a resource efficient economy, entropy generation must be kept low and high-entropy wastes should be transformed into low-entropy recycled products, thus saving natural resources. Based on this idea, statistical entropy analysis (SEA) was put forward as a method to evaluate material flow systems with respect to their ability to concentrate or dilute a substance throughout its life cycle using a single metric, relative statistical entropy (RSE). Whereas its application has so far been restricted to highly aggregated material flow systems or to assessments at plant or process level, in the present study the SEA method was adapted to assess the efficiency of resource use in material flow systems which consist of numerous resource flows and include multiple recycling loops. Phosphorus (P) use in Austria served as a case study to illustrate SEA-based resource efficiency assessment for different scenarios and over time. The evaluation enabled exploiting the outcomes of existing P flow studies in a straightforward way and produced additional insights related to the characteristics of resource use within the system. Changes in P management over time had a significant effect on the resource efficiency of P use. The RSE increased by 40% due to P use in Austria in the year 2000 compared to an increase of 30% in 2010. The generally favorable trend of statistical entropy (lower dissipation) in 2010 could be attributed mainly to lower dissipative emissions, more efficient bio-industry, and increasing P removal rates in waste water treatment, which overcompensated the negative impact of the ban of recycling of meat and bone meal (in 2001) on P use efficiency. Further, the SEA-based assessment applied to a scenario of optimized P management reflected the positive effects of measures to reduce emissions, enhance recycling, and reduce consumption of P on resource efficiency (50% lower RSE increase in the target system compared to the original state). In synthesis, this study shows that the SEA method is able to integrate various dimensions of resource use into a single indicator, which can serve as a basis to assess and improve the resource efficiency of macro-scale material flow systems.

Quality Indicators of Primary Health Care Facilities in Austria

The strengthening of primary health care is one major goal of the current national health reform in Austria. In this context, a new interdisciplinary concept was developed in 2014 that defines structures and requirements for future primary health care facilities. The aim of this project was the development of quality indicators for the evaluation of the scheduled primary health care facilities in Austria, which are in accordance with the new Austrian concept. We used the RAND/NPCRDC method for the development and selection of the quality indicators. We conducted systematic literature searches for existing measures in international databases for quality indicators as well as in bibliographic databases. All retrieved measures were evaluated and rated by an expert panel in a 2-step process regarding relevance and feasibility. Overall, the literature searches yielded 281 potentially relevant quality indicators, which were summarized to 65 different quality measures for primary health care. Out of these, the panel rated and accepted 30 measures as relevant and feasible for use in Austria. Five of these indicators were structure measures, 14 were process measures and the remaining 11 were outcome measures. Based on the Austrian primary health care concept, the final set of quality indicators was grouped in the 5 following domains: Access to primary health care (5), quality of care (15), continuity of care (5), coordination of care (4), and safety (1). This set of quality measures largely covers the four defined functions of primary health care. It enables standardized evaluation of primary health care facilities in Austria regarding the implementation of the Austrian primary health care concept as well as improvement in healthcare of the population.

PIN81 - Seasonal Variations of Outpatient Antibiotic use in Austria

Large seasonal variations concerning the prescription of antibiotics for systemic use (ATC group J01) in the outpatient sector may be a sign of overuse regarding virus infections. The aim of this study is to analyse those seasonal variations in Austria. The data comprise all filled prescriptions at the expense of the 19 statutory health insurance funds in Austria, covering more than 97% of the national population. Observation period lasts from 2013 to 2015, on a quarterly basis. The main measure of antibiotic use is the number of persons to whom at least one antibiotic drug has been prescribed. Additionally, analyses were conducted regarding patient age as well as antibiotic subgroups. The highest number of patients was observed in the first quarter of every year, followed by the fourth and the second quarter. Thus, 10.0% of the population received an antibiotic in 2013/Q3, while in 2013/Q1 the share amounted to 15.3% - this represents a fluctuation of 53%. In 2014 and 2015 the respective fluctuations were 34% and 63%. Variations were especially high among the youngest cohorts (age 0 to 9 years) – with up to 99%. Looking at the number of prescribed medication packages of the subgroups, fluctuations were highest for macrolides, lincosamides and streptogramins (J01F), with 58% more packages being prescribed in winter 2014/15 (2014/Q4, 2015/Q1) than in the previous summer (2014/Q2, 2014/Q3). The respective increase for cephalosporins (J01DB/DC/DD/DE) was 34%, and for penicillins (J01C) 32%. Compared to other European countries, Austria has a relatively low overall antibiotic use. Nonetheless, the seasonal variations are high. This might be an indicator for suboptimal use of antibiotics. As this is a growing public health concern, the use of antibiotics in the Austrian health system should be considered carefully by doctors as well as patients.

A national point prevalence study on healthcare-associated infections and antimicrobial use in Austria.

The first point prevalence survey performed in Austria had the aim to assess the magnitude of healthcare-associated infections and antimicrobials use in the country. A multicentre study was carried out from May until June 2012 in nine acute care hospitals with a mean bed number of 620. Data from 4321 patients' clinical charts were reviewed. The overall healthcare-associated infections prevalence was 6.2% (268/4321) with the highest rate in intensive care departments (20.9%; 49/234). In medical and surgical departments the healthcare-associated infections prevalence was 5.4% (95/1745) and 6.6% (105/1586), respectively. The most frequent healthcare-associated infections were: urinary tract infections (21.3%; 61/287), pneumonia (20.6%; 59/287) and surgical site infections (17.4%; 50/287). The most common isolated microorganisms were: Escherichia coli (14.8%; 26/176), Enterococcus species (13.1%; 23/176) and Pseudomonas aeruginosa (11.4%; 20/176). Thirty-three per cent (1425/4321) of the patients received antimicrobials because of community-acquired infections treatment (14.2%; 615/4321), healthcare-associated infections treatment (6.4%; 278/4321), and surgical (8.2%; 354/4321) and medical prophylaxis (3.2%; 138/4321). Surgical prophylaxis was the indication for 22.0% (394/1792) of the overall prescriptions and was prolonged for more than 1 day in 77.2% (304/394) of the cases. The national Austrian survey proved the feasibility of a nation-wide network of surveillance of both healthcare-associated infections and antimicrobial use that will be repeated in the future. Healthcare-associated infections and antimicrobial use have been confirmed to be a grave health problem. The excessive prolongation of perioperative prophylaxis in Austria needs to be limited.

Fragile ecosystems and scarce resources meet growing food demand: Is “business as usual” land use an appropriate long-term solution for the Alpine countries?

The Alpine region is exposed to two major challenges in terms of sustainable agriculture: 1) topographical conditions constrain the area, which can be used for agricultural production and 2) the Alps have suffered a dramatic loss of biodiversity in the last few decades. This loss is to great extent caused by a) intensified use of agricultural land in high-yielding areas (e. g. excessive nitrogen depositions) and b) abandonment of agricultural areas with low productivity. In the near future, these challenges are expected to amplify, as the Alpine region will have to contribute to a growing global food demand. In order to find anchor points which help to tackle these challenges a qualitative system analysis was conducted to identify and analyse the variables which influence agricultural land use in Austria, Liechtenstein and Switzerland. Results suggest that our Alpine land use system exerts an enormous pressure on the level of certain variables. If current trends of land use continue to maintain, the level of the variables “ecological quality of agricultural areas” and “attractiveness of landscapes” will most likely decline. Contrarily, the level of “land use intensity on arable land and grassland” will increase further. This shows an imminent need to substantially change land use especially if we seek for long-term food security and conservation of natural resources. Keywords: land use, food production, ecosystem services, Alpine region, qualitative system analysis

Analyzing consumer-related nitrogen flows: A case study on food and material use in Austria

Nitrogen budgets cover pools and flows of nitrogen (N) contained in human-made goods and compounds, which may potentially affect the global nitrogen cycle and in consequence the human environment. Acknowledging the importance of food and other agricultural products, this paper additionally investigates frequently neglected flows of N related to consumers and estimates their magnitude, using Austria in 2010 as an example. Specifically, N in non-food industrial products (synthetic & natural polymers, wood & paper products, waste), and N related to pets, gardens, and energy use is considered. Over the last five decades, both food and material consumption have increased distinctly. While food supply accounts for 52% of total directly consumer-related nitrogen inflows covered in this study (66,000tNa−1), also material products account for a considerable share of 28% (36,000tNa−1). N application in gardens (12%) and N in pet food (7%) do also play a role. Quantified outflows are human excretion (54%), food waste (13%), garden waste (16%), material waste (7%) and waste from pets (10%). The detected balance surplus of 34,000tNa−1, corresponding to 27% of total inflows, points to some accumulation of N in the form of durable consumer goods and to potentially missing flows. The analysis focusses on the apparent knowledge gaps. Especially flows involving material products are poorly understood and would require better understanding of nitrogen contents of products and of waste. This indicates that improvements may be possible by providing more complete nitrogen budgets in the future that cover all environmental pools.

Possible implications of dietary changes on nutrient fluxes, environment and land use in Austria

Health recommendations clearly show that in Austria and other highly developed countries less animal and more plant based food should be consumed. A meat based diet is held responsible for a number of environmental problems. We explore the impacts on nutrient fluxes (nitrogen and phosphorus) and land use as the result of a change from a meat based diet to a healthier balanced diet consisting of less animal based products and more plant based food in Austria. We use a detailed material flow analysis and the nutrient emissions model MONERIS in combination with scenarios. The scenarios address differing farming methods, varying trade options and different use of potentially available agricultural area. Our findings show that overall, a shift to a healthy balanced diet leads to less land being used for agricultural production (−30%), less resource consumption (20% to 25% less phosphorus) and lower transfer of nutrients from agriculture into the environment compared to the reference situation. Total emissions of nitrogen and phosphorus into water decrease (between 15% and 11% for nitrogen and by 5% to 6% for phosphorus) and nitrogen concentrations in groundwater change substantially depending on the intensity of farming assumed by different scenarios.

Influenza vaccination in Austria from 1982 to 2011: A country resistant to influenza prevention and control

BackgroundAustria's position on influenza vaccination is unique. Generally it is recommended for everyone, and specifically for those over the age of 50 years and all children between 6 months and 5 years. However, the vaccination rate among the general public is one of the lowest in the world (<10%). Our objective was to provide baseline information to allow a better understanding of the low vaccination rate. MethodsThis paper presents data on influenza vaccine use in Austria during a period of almost 30 years, from 1982 to 2011. Data presented in this study were obtained from three sources. ResultsBetween 1982 and 1992, Austria showed little change in its low proportion of vaccinations (from 20 to 23 doses/1000); from 1992 to 1995, the proportion increased to 52 doses/1000, retaining its status as one of the low-use countries. By 2003, the proportion had increased to 127 doses/1000, but Austria remained one of the three lowest-use Western European countries. Between 2007 and 2011/2012, a steady decrease to 81 doses/1000 was observed. ConclusionThe Austrian population, and parts of the medical system, have shown distinct ignorance regarding the prevention and control of influenza over past decades. Possible reasons for this development are discussed.

Austrian height and body proportion references for children aged 4 to under 19 years

Background: Previous studies have demonstrated differences between national and the WHO reference curves in children older than 5 years. Moreover, reference curves for body proportions (sitting height, subischial leg length and their ratio) based on state-of-the-art statistics are not available.Aim: To develop reference curves for height and body proportions for use in Austria and compare the curves with WHO reference curves. To estimate and statistically investigate extreme percentiles.Subjects and methods: A sample of ∼14 500 children between 4–19 years of age was drawn via schooling institutions, stratified by provinces according to age- and sex-specific population proportions. GAMLSS models were used for a flexible estimation of percentile curves.Results and conclusions: After the age of 5 years national reference curves are more suitable than the WHO reference curves for clinical use in Austria. These height curves are very similar to the German reference curves published recently. Therefore, these reference curves for criteria of body proportions are recommended for use in other populations. Further validation studies are needed to establish whether the recently recommended −2.5 and −3.0 SD for height are a sensitive and specific cut-off in the diagnostic work-up for children with a suspected growth disorder using this new Austrian height chart.

Economic crises: Impacts on the forest-based sector and wood-based energy use in Austria

In light of the recent economic crisis, the authors have assessed the effects of different types of economic crises' scenarios on the Austrian forest-based sector using a simulation model (FOHOW) written in the System-Dynamics (SD) language. The model addresses the interactions between the general economy and the forest sector, including forestry, forestry-based industries and energy. The simulation period for all of the scenarios ranged from 2006 to 2025. As compared to the past, the development of the sector substantially changes, even in the base scenario. These changes are primarily caused by increased demand for wooden biomass for energy due to the assumed execution of the National Action Plan for Renewable Energy. All crises' scenarios resulted in declining production and lower prices compared to the base scenario, differing only in magnitude. Forestry, sawmill and paper industries perform better in an export crisis than in a local crisis, because decreased exports can, to a certain extent, be compensated for by increasing domestic demand, while the domestic shortfalls are difficult to compensate by raising exports. By contrast, the export-oriented panel industry does better in a local crisis simulation. In general, economic crises only moderately change the assortment composition of timber supply within the forestry industry. The results also show that the sawmill industry plays a vital role in the allocation of wooden biomass in all of the scenarios. When developing policies for forest-based industries, specifically the procurement of wooden raw material, the key role of the sawmill industry must be considered in each case.

A holistic water balance of Austria – how does the quantitative proportion of urban water requirements relate to other users?

Traditional water use statistics only include the blue water withdrawal/consumption of municipalities, industry and irrigated agriculture. When, however, green water use of the agricultural sector is included as well as the virtual water use/water footprint (WF), water use quantity statistics become very different. In common water use statistics, Austria withdraws in total about 2.5 km(3) per year, only 3% of available resources (total discharge 81.4 km(3) = surface and ground water). The total water consumption (0.5 km(3)) is less than 1% of available resources. Urban (municipal) water requirements account for 27% of total withdrawal or 33% of consumption. When agricultural green water use (cropland) is included in statistics, the fraction of municipal water requirements diminishes to 7.6% of total withdrawal and 2.5% of total consumption. If the evapotranspiration of grassland and alpine meadows is also included in agricultural green water use, this fraction decreases to 3.2% and 0.9% respectively. When the WF is assessed as base value for water use in Austria, the municipal water use represents 5.8% of this value. In this globalized world, these traditional water use statistics are no longer recommendable. Only a holistic water balance approach really represents water use statistics.