Luule Sakkeus | Tallinn University (original) (raw)

Papers by Luule Sakkeus

STEPP: socialinė teorija, empirija, politika ir praktika, Feb 1, 2024

Europe, notably in countries like Lithuania, is facing substantial demographic shifts due to agin... more Europe, notably in countries like Lithuania, is facing substantial demographic shifts due to aging, impacting various systems, including the labor market. In this context understanding retirement intentions is crucial. Quality of work is a key determinant of retirement intentions, yet other factors such as financial situation, health, or family pressures also play a role, and a comprehensive understanding of their interactions remains a research gap. Therefore, the aim of this study was to conduct a systematic literature review of research on the relationship between retirement intentions and quality of work, with a specific focus on potential control factors, moderators and mediators of this relationship. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA). Articles were electronically retrieved from Scopus, Web of Science, ScienceDirect, and EBSCO databases. Studies selected were full-text, peer-reviewed articles in English from 2003 to 2023, which used quantitative methodologies and focused on the relationship between retirement intentions and quality of work for workers aged 50+. The quality of the selected publications was assessed using the Appraisal Tool for Cross-Sectional Studies-AXIS tool. Of the initial 776 sources, after removing duplicates and irrelevant articles, 91 were fully screened, and 17 met the criteria for inclusion in the systematic review. This systematic literature review provided further insights into the relationship between retirement intentions and quality of work, highlighting the roles of moderators, mediators, and control factors in this relationship.

The Lancet

Background: International comparisons of stillbirth allow assessment of variations in clinical pr... more Background: International comparisons of stillbirth allow assessment of variations in clinical practice to reduce mortality. Currently such comparisons only include stillbirths from 28 or more completed weeks of gestational age which underestimates the true burden of stillbirth. With increased registration of early stillbirths in high income countries we assessed the reliability of including stillbirths before 28 completed weeks. Methods: We used national cohort data from 19 European countries participating in the Euro-PERISTAT project on live births and stillbirths from 22 completed weeks of gestation in 2004, 2010 and 2015. Pooled stillbirth rates were calculated using a random-effects model and changes in rates between 2004 and 2015 were calculated using risk ratios (RR) by gestational age and country. Results: Stillbirths at 22 +0-27 +6 weeks of gestation accounted for 32% of all stillbirths in 2015. The pooled stillbirth rate at 24 +0-27 +6 weeks declined from 0.97 to 0.71 per 1000 births from 2004 to 2015, a reduction of 24% (RR=0.77, 95% CI 0.68 to 0.88). The pooled stillbirth rate at 22 +0-23 +6 weeks of gestation in 2015 was 0.53 per 1000 births and had not significantly changed over time (RR 0.97, 95% CI 0.80 to 1.16) although changes varied widely between countries (RRs 0.62 to 2.09). Wide variation in the percentage of all births occurring at 22 +0-23 +6 weeks of gestation suggest international differences in the ascertainment. Conclusions: Current definitions used for international comparisons exclude a third of stillbirths. International consistency of reporting stillbirths at 24 +0-27 +6 weeks suggests these deaths should be included in routinely reported comparisons. This would have a major impact, acknowledging the burden of perinatal death to families, and making international assessments more informative for clinical practice and policy. Ascertainment of fetal deaths at 22 +0-23 +6 weeks should be stabilised so that all stillbirths from 22 completed weeks of gestation onwards can be reliably compared.

The Lancet Regional Health - Europe

Общественные науки и современность

Revue d’études comparatives Est-Ouest

PLoS ONE, 2011

Background: The first European Perinatal Health Report showed wide variability between European c... more Background: The first European Perinatal Health Report showed wide variability between European countries in fetal (2.6-9.1%) and neonatal (1.6-5.7%) mortality rates in 2004. We investigated gestational age patterns of fetal and neonatal mortality to improve our understanding of the differences between countries with low and high mortality. Methodology/Principal Findings: Data on 29 countries/regions participating in the Euro-Peristat project were analyzed. Most European countries had no limits for the registration of live births, but substantial variations in limits for registration of stillbirths before 28 weeks of gestation existed. Country rankings changed markedly after excluding deaths most likely to be affected by registration differences (22-23 weeks for neonatal mortality and 22-27 weeks for fetal mortality). Countries with high fetal mortality 28weekshadonaveragehigherproportionsoffetaldeathsatandnearterm(28 weeks had on average higher proportions of fetal deaths at and near term (28weekshadonaveragehigherproportionsoffetaldeathsatandnearterm(37 weeks), while proportions of fetal deaths at earlier gestational ages (28-31 and 32-36 weeks) were higher in low fetal mortality countries. Countries with high neonatal mortality rates $24 weeks, all new member states of the European Union, had high gestational age-specific neonatal mortality rates for all gestational-age subgroups; they also had high fetal mortality, as well as high early and late neonatal mortality. In contrast, other countries with similar levels of neonatal mortality had varying levels of fetal mortality, and among these countries early and late neonatal mortality were negatively correlated. Conclusions: For valid European comparisons, all countries should register births and deaths from at least 22 weeks of gestation and should be able to distinguish late terminations of pregnancy from stillbirths. After excluding deaths most likely to be influenced by existing registration differences, important variations in both levels and patterns of fetal and neonatal mortality rates were found. These disparities raise questions for future research about the effectiveness of medical policies and care in European countries.

PLoS ONE, 2013

Background: Fetal and neonatal mortality rates are essential indicators of population health, but... more Background: Fetal and neonatal mortality rates are essential indicators of population health, but variations in recording of births and deaths at the limits of viability compromises international comparisons. The World Health Organization recommends comparing rates after exclusion of births with a birth weight less than 1000 grams, but many analyses of perinatal outcomes are based on gestational age. We compared the effects of using a 1000-gram birth weight or a 28-week gestational age threshold on reported rates of fetal and neonatal mortality in Europe. Methods: Aggregated data from 2004 on births and deaths tabulated by birth weight and gestational age from 29 European countries/regions participating in the Euro-Peristat project were used to compute fetal and neonatal mortality rates using cutoffs of 1000-grams and 28-weeks (2.8 million total births). We measured differences in rates between and within countries using the Wilcoxon signed rank test and 95% confidence intervals, respectively.

Paediatric and Perinatal Epidemiology, 2009

Perinatal mortality rates differ markedly between countries in Europe. If population characterist... more Perinatal mortality rates differ markedly between countries in Europe. If population characteristics, such as maternal age, parity or multiple births, contribute to these differences, standardised rates may be useful for international comparisons of health status and especially quality of care. This analysis used aggregated population-based data on fetal and neonatal mortality stratified by maternal age, parity and multiple birth from 12 countries participating in the EURO-PERISTAT project to explore this question. Adjusted odds ratios were computed for fetal and neonatal mortality and tested for inter-country heterogeneity; standardised mortality rates were calculated using a direct standardisation method. There were wide variations in fetal and neonatal mortality rates, from 3.3 to 7.1 and 2.0 to 6.0 per 1000 total and livebirths, respectively, and in the prevalence of mothers over 35 (7-22%), primiparae (41-50%) and multiple births (2-4%). These population characteristics had a significant association with mortality, although results were less consistent for primiparity. Odds ratios for older mothers and primiparae showed significant inter-country heterogeneity. The association between maternal age and fetal mortality declined as the prevalence of older mothers in the population increased. Standardised rates did not substantially change inter-country rankings and demographic characteristics did not explain the higher mortality observed in some countries. Our results do not support the use of mortality rates standardised for age, parity and multiple births for international comparisons of quality of care. Further research should explore why the negative effects of older maternal age decrease as delayed childbearing becomes more common and, in particular, whether this is due to changes in the social characteristics of older mothers or in health care provision.