bluuebunny/crossref_metadata_2025_split huggingface dataset:
Human centered AI design for clinical monitoring and data management
Authors: Adnan H S , Matthews S , Hackl M , Das P P , Manaswini M , Gadamsetti S , Filali M , Owoyele B , Santuber J , Edelman J 
Published: October 2020

Abstract

Background
In clinical settings, significant resources are spent on data collection and monitoring patients' health parameters to improve decision-making and provide better care. With increased digitization, the healthcare sector is shifting towards implementing digital technologies for data management and in administration. New technologies offer better treatment opportunities and streamline clinical workflow, but the complexity can cause ineffectiveness, frustration, and errors. To address this, we believe digital solutions alone are not sufficient. Therefore, we take a human-centred design approach for AI development, and apply systems engineering methods to identify system leverage points. We demonstrate how automation enables monitoring clinical parameters, using existing non-intrusive sensor technology, resulting in more resources toward patient care. Furthermore, we provide a framework on digitization of clinical data for integration with data management.

Methods
Activities of Daily Living (ADLs) are essential parameters, necessary for evaluating patients in mental health wards. Ideally logging the parameters should take place at hourly intervals; however, time constraints and lack of resources restrict the nursing staff to consolidating the overall impression during the day, relying on what they recall. Using design methods, sensors (e.g. infrared, proximity, pressure) are used to automate the acquisition of data for machine learning that correspond to the ADLs, considering privacy and other medical requirements.

Results
We present a concept of a room with sensors that can be deployed in clinical settings. Sensor data log ADLs, and provide machine learning data. A theoretical framework demonstrates how collected data can be used in electronic/medical health records.

Conclusions
Data acquisition of the ADLs with automation enable variable specificity and sensitivity on-demand. It further facilitates interoperability and provides data for machine learning.

Key messages
Our research demonstrates automated data acquisition techniques for clinical monitoring. Human centered AI design approach enables on-demand analysis of ADLs for mental health treatment.
Information system in the context of the use of electronic patient record in Burundi
Authors: Munezero F , Sossa C , Bazira L 
Published: October 2020

Abstract

Objective
The Information System is an essential catalyst for the performance of a hospital. In order to strengthen the hospital information system, the patient record computerization project has been initiated since 2014. Our objective was to assess the hospital information system in the context of using the electronic patient record to highlight the factors to be strengthened.

Methods
This is a cross-sectional survey using the Health Metrics Network assessment tool. Eleven hospitals were included in the study, including 4 computerized in 2015 and 7 computerized in 2017. We carried out an evaluation of the hospital information system as a whole and an evaluation of the level of filling of patient files. In each hospital, the director of care, the chief nursing officer and the data manager were surveyed. Data collection was done in October 2019.

Results
This evaluation showed that 4 components (resources, indicators, information product and the use of information) were satisfactory with a score varying from 55% to 67% while 2 components (data source and data management) were present but not satisfactory. The score was 61% for resources, 60% for indicators, 41% for data sources, 43% for data management, 55% for information product and 67% for dissemination and use of information. The proportion of files with the main diagnosis at discharge was 61% before computerization, while it was 81% when using EPR (p &lt; 10-4). It was also noted that the electronic patient record had 2.73 [1.83 - 4.07; p &lt; 10-4] times more likely to report the main diagnosis on exit than the paper file.

Conclusions
the source components of the data and data management have shortcomings. Corrective strategies should be considered to support the ongoing hospital information system strengthening reforms

Key messages
The health metric network tool for evaluating the health information system adapted to the national level can also be used to assess the hospital information system. The computerization of the patient record is not enough to make the hospital information system efficient.
Economic arguments for population interventions to reduce alcohol consumption in Russian population
Authors: Myrzamatova A , Kontsevaya A , Mukaneeva D , Balanova Y u , Khudyakov M , Drapkina O 
Published: October 2020

Abstract

Aim
To get economic arguments for population-based interventions to reducing the consumption of alcohol in the Russian Federation.

Material and Methods
Studies of international practice on the implementation of population-based preventive measures to reducing alcohol consumption was carried out in order to identify interventions with proven effectiveness. We used the official statistics data collected by Ministry of health on the number of patients, health care resources utilization. Directs nonmedical costs included disability payments. Indirect costs included decreased productivity due to premature mortality and disability.

Results
Russian Federation has on the moment rather strong legislation in the area of alcohol regulation, but still there is a potential for further improvement. Increase in the price for alcoholic beverages by 10% in the Russian Federation can potentially prevent 7 477 potential years of life lost, the prognosed economic effect due to premature deaths reduction will be 42 002 523€ for 5 years. Increase in the minimum age for alcohol sales from 18years to 21years can save 48 920 potential years of life lost in Russian population, and the economic effect will be 279 912 075€ for 3 years. Reducing the permissible limit of blood alcohol concentration in vehicle drivers to 0.03mg/ml will allow to gain 8 834 673€ of economic effect for 3years.The deprivation of driving license for longer period after drinking and driving will give economic 916 809€ for 1 year due to prevent 217fatal accidents in alcohol intoxicated condition. And the effect of a complete ban on advertising alcoholic beverages in all media will give potential impact of 678 437 773€ for 10years

Conclusions
There are still potential for improvement the legislation in the area of alcohol control in Russian Federation. Described interventions demonstrate substantial potential economic effect. These data can be used as an argument for policy makers to justify the investments in these interventions

Key messages
The main results obtained in the simulation demonstrated the possibility of improving the prognosis of mortality and morbidity from NCDs associated with alcohol consumption. These data can be used as an argument for policy makers to justify the investments in these interventions.
Are Danish adolescents’ internalizing and externalizing symptoms associated with their substance use?
Authors: Vallentin-Holbech L , Thomsen K R , Stock C 
Published: October 2020

Abstract

Background
Several studies have found that externalizing symptoms are associated with harmful substance use. Also, findings suggest that girls are more likely to report internalizing symptoms compared to boys. This study assessed the association between internalizing and externalizing symptoms (independent variables) and substance use and alcohol-related harms (dependent variables). Furthermore, it was investigated whether associations differentiate among boys and girls.

Methods
Data from Danish students aged 13-17 years (N = 2601) were collected using online self-administrated questionnaires measuring demographics, substance use (drunkenness, binge drinking, smoking, cannabis use and other illicit drug use) and alcohol-related harms. Externalizing and internalizing symptoms were measured using the Strength and Difficulties Questionnaire. To test associations multilevel logistic regressions were applied for each dependent variable including both internalizing and externalizing symptoms. Gender differences were tested separately.

Results
The study population comprised of 1235 boys (47%) and 1366 girls (53%) from 42 schools in the region of Southern Denmark. Strong positive associations between externalizing symptoms and substance use were found for both boys and girls. When internalizing symptoms were present, boys demonstrated a negative association with binge drinking (OR: 0.90, p &lt; 0.001), drunkenness (OR: 0.91, p = 0.001) and alcohol-related harms (OR: 0.91, p = 0.006). Among girls, a negative association was only found for binge drinking (OR: 0.94, p = 0.009).

Conclusions
This study demonstrated strong positive associations between externalizing symptoms and substance use both among boys and girls and showed that internalizing problems protect particularly boys from harmful alcohol use. The findings suggest that Danish girls should be considered equally to Danish boys regarding externalizing symptoms and substance use.

Key messages
Boys with internalizing problems are more protected against harmful alcohol use compared to girls. Targeting gender-specific risk factors should be considered when developing prevention programmes.
Moving towards or away from universal health coverage in the EU-8 countries
Authors: Tambor M , Klich J , Domagała A 
Published: October 2020

Abstract

Background
The transformation of health care systems in Central and Eastern European (CEE) countries after the fall of communism resulted in increased household out-of-pocket payments for health and a deterioration of equity in health care. Since then, CEE countries have been struggling to ensure sufficient public resources for health and improve universal health coverage.

Methods
We evaluated the progress in achieving universal health care coverage made over the last two decades in eight European Union countries (EU-8): Czechia, Estonia, Hungary, Latvia, Lithuania, Poland, Slovakia, and Slovenia. A desk research method was applied (2019) to collect and analyze quantitative data on health care expenditure and qualitative data on health care coverage (population coverage, service coverage, patient cost-sharing, and quality of care).

Results
The results show an increased priority on the part of governments to fund health care in the EU-8 countries. Nevertheless, public resources have not been sufficient to significantly reduce the role of out-of-pocket expenditure. Out-of-pocket payments in the analyzed countries result from the explicit decision to shift costs to households (patient cost-sharing for medicines, excluding dental care) or implicit rationing (long waiting times for specialist services). Despite some common features, there is a great diversity across the EU-8 with some countries (Latvia) marked with significant gaps in health care coverage, and others (Czechia, Slovenia) providing universal health care with relatively low out-of-pocket payments.

Conclusions
There is room for reducing out-of-pocket payments in the EU-8 through further budget prioritization. A systematic and evidence-based approach to establish a benefit basket and patient cost-sharing obligations might help to improve universal health coverage in these countries.

Key messages
In the last two decades, the EU-8 countries have made moderate progress in achieving universal health coverage. Despite governments’ increased priority for health, significant gaps in service and cost coverage, as well as quality of care, persist in some EU-8 countries.
Vaccination on the move for asylum seekers and refugees: evidence, policies and practicalities
Authors: Campos-Matos I 
Published: October 2020

Abstract
Public Health England works alongside the International Organization for Migration to provide migration health assessments and a travel service to refugees entering the UK through the Gateway Resettlement Programme. As part of this programme, catch-up vaccination is offered to align these migrants with the UK schedule. IC-M will describe current UK approaches to improving vaccination coverage in migrants both to and within the country, and highlight lessons learned for European health systems.
Key developments and results from the Australian Burden of Disease Study
Authors: Gourley M , Juckes R , Moon L 
Published: October 2020

Abstract
Australia has been at the forefront of national burden of disease study development for more than 20 years. Australia's 1996 national burden of disease study was one of the first in the world and updates have continued over the following two decades with the fifth study now underway. The studies adapt the global framework most recently implemented by the Global Burden of Disease Study to suit Australia's specific needs, producing estimates of fatal and non-fatal burden via the Disability-Adjusted-Life-Year metric, as well as attribution of the burden to many risk factors.
Detailed Australian data are used from a range of sources (e.g. death registrations, population surveys, disease registers, hospitalisations and linked health data) with minimal reliance on modelling to fill data gaps. Comprehensive burden of disease estimates are produced, including for the Indigenous population, for each of the eight states and territories, the five remoteness areas and five socioeconomic quintiles.
A number of method developments have been made as part of these studies, including redistribution of deaths data and a detailed quality framework for describing the robustness of the underlying data and methods. Data and methods continue to be refined as part of the studies, and developments in global studies and other national studies are incorporated where appropriate.
This presentation will describe the history of burden of disease work in Australia, including some of the key method developments made, challenges faced over the years and lessons learned. It will also present some key results from the latest Australian Burden of Disease Study (2015) and how these estimates are being used for population health monitoring, health policy and research in Australia.
Substance use, mental health, and life satisfaction in Czech straight and sexual-minority population
Authors: Pitonak M , Chomynová P , Mravčík V 
Published: October 2020

Abstract

Background
Evidence shows that sexual minorities are more vulnerable to substance use and psychological distress as a result of minority stress compared with heterosexuals. So far, research conducted outside North America or Western Europe has been underrepresented. This research compares for the first time the substance use, quality of mental health and life satisfaction between the sexual minority people and heterosexuals using a nationally representative probability sample in the Czech population.

Methods
Sample of the general population aged 15+ years surveyed within the National Survey on Substance Use in 2016 in randomly selected households (N = 3,601, F2F interviews). Prevalence of licit and illicit substance use, psychological distress (MHI-5 scale) and life satisfaction (SWLS scale) were analyzed by respondents' self-reported sexual identity and behaviors. Logistic regressions were applied to evaluate the differences between groups. Adjustment for basic sociodemographic characteristics was performed.

Results
2.8% of adults identified as sexual minorities, including 0.5% lesbians or gays and 2.3% bisexuals. Sexual minorities were more likely to experiment with (illicit) substance use in the last 12 months (OR = 1.74, 95% CI: 1.03-2.94), more often experience psychological distress (OR = 2.56, 95% CI: 1.50-4.38), and were slightly less often satisfied with their lives (OR = 0.79, 95% CI: 0.46-1.37) compared to heterosexuals. Sexual minority status was not found as a significant predictor for daily tobacco smoking nor for frequent excessive/binge alcohol consumption.

Conclusions
In accordance with international evidence, sexual minorities represent a vulnerable group from the perspective of substance use and psychological distress. Factors influencing life satisfaction of sexual minority people living in geographically underrepresented regions need to be further investigated using measures more sensitive to local cultural circumstances.
Clean air policy challenges in Europe: achieving air standards that prevent disease
Authors: Stauffer A , Perroud S 
Published: October 2020

Abstract
Despite a large regulatory framework on clean air, air pollution in the European Union continues to be the top environmental threat to health, leading to approx. 400,000 early deaths annually and high health costs. Over 20 of the 27 EU countries fail to keep air quality standards, which for key pollutants are already less strict than what the World Health Organization (WHO) recommends.
In the EU Green Deal Communication, the European Commission has pledged to align current standards more closely with WHO. At the same time, the latest science underlines that there is no safe level of air pollution, and WHO is reviewing current guidelines. In EU neighbouring countries, the need to act on clean air standards is even more pressing. During the COVID-19 lockdown, many countries have witness a drop in air pollution, especially in cities. As transport and economic activities kick in again, pollution is on the rebound, making the need for long-term clean air even more apparent.
The presentation/paper will showcase ongoing policy opportunities at EU and national level, and discuss how the health sector can become engaged to prevent chronic disease from poor air quality, especially as part of a healthy, green and just recovery.
Multidrug-resistant organism infections and mortality: estimates from a large Italian hospital
Authors: Moro M , Vigezzi G P , Callari E , Biancardi A , Nizzero P , Cichero P , Signorelli C , Odone A 
Published: October 2020

Abstract

Background
Multidrug-resistant organisms (MDRO) are one of the most critical public health concerns, particularly in hospital settings. Nearly 8% of hospitalized patients develop healthcare-associated infections (HAI), 20% of which is caused by MDRO.
Aim of the study was to estimate nosocomial infection-associated in-hospital mortality, by different MDRO, in a large Italian teaching hospital.

Methods
We conducted a retrospective cohort study on patients hospitalized at San Raffaele Hospital, Milan, from 2016 to 2018. Two existing datasets were merged: hospital discharge records and MDRO surveillance data. Exposure was defined as any HAI caused by MDRO, and main outcome variable was in-hospital mortality from all causes.

Results
A total of 78,795 patients were studied (mean age 59.3 y, age range 18-105 y). 1,345 patients with at least one MDRO had mean age of 68 y, mean length of stay (LOS) of 32.8 days and mean DRG weight of 3.8. 77,450 patients without MDRO isolation had mean age of 59 y, mean LOS of 7.2 days and mean DRG weight of 1.6. Risk of in-hospital mortality is 3.4 times higher in patients with at least one MDRO isolation (OR 3.4; 95% CI 2.8-4.2). Enterococci (OR 2.6; 95% CI 1.1-6.3), A. baumannii (OR 3.5; 95% CI 1.4-8.6), P. aeruginosa (OR 1.8; 95% CI 0.8-4.2), MRSA (OR 3.4; 95% CI 2.1-5.4), ESBL-producing (OR 1.9; 95% CI 1.4-2.7) and carbapenem-resistant bacteria (OR 3.8; 95% CI 2.5-5.7), and carbapenem-resistant K. pneumoniae (OR 5.5; 95% CI 3.2-9.2) isolations were risk factors for nosocomial mortality.

Conclusions
Patients with MDRO isolations were older, more complex and had 5 times longer LOS than ones without MDRO. Deceased patients were 18% among MDRO cohort against only 2% among others.
Bacteria included in WHO list of priority pathogens with antibiotic resistance were associated with a significantly higher risk of death. These results prove the urgency of controlling MDROs' spread that threatens global public health and available treatments of infections.

Key messages
Nosocomial MDRO isolation is a significant risk factor for in-hospital mortality from all causes. Infection prevention and control measures, and antibiotic stewardship are key strategies in order to prevent MDRO transmission and HAI, AR spreading and their burden of related deaths.
Italy on gaining official parliamentary recognition that obesity is a chronic disease
Authors: Serra F , Lenzi A , Pella R , Spinato C , Fatati G , Carruba M , Caretto A , Sbraccia P , Busetto L , Zani I 
Published: October 2020

Abstract
Obesity places a significant burden on people affected, increasing their risk of unintended health consequences and reducing their life expectancy. Rising obesity levels have also had an adverse effect on society and economic prosperity, causing a decrease in economic activity through loss of productive life years, and by placing increasing demands on healthcare systems.
Despite the scientific community recognising obesity as a multifactorial chronic disease which requires long-term management, it is often considered to be the responsibility of the individual by governments, healthcare systems and even people with obesity. Obesity is not recognition as disease in Italy, but it has a relevant impact on heath policy, clinical, social and economic.
On November 13th 2019, the Chamber of Deputies of the Italian Parliament voted unanimously to approve a motion that recognises obesity as a chronic disease and asks the Government to implement specific actions to promote and improve obesity prevention and management. Among the various commitments there is also a national plan that harmonises the activities in the field of prevention and the fight against obesity; full access to the diagnostic procedures for comorbidities, to dietary-food treatments in the most serious cases, access to second-level centres to evaluate psychological, pharmacological and surgical approaches; guidelines concerning the “first 1,000 days of life” of the child and programs for the prevention of childhood obesity.
Obesity now recognised as a chronic disease in Italy. The collaborative, multi-stakeholder effort was long in the making and includes a Charter of Human Rights for People Living with Obesity. The document enumerates actions necessary for the protection of health for obesity prevention and treatment of people living with obesity. The process implemented as a typical policy domino game.

Key messages
Obesity now recognised as a chronic disease. Policy domino game.