bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk assessment of Portuguese population to multiple mycotoxins: the human biomonitoring approach
Authors: Martins C , Vidal A , De Saeger S , Nunes C , Torres D , Goios A , Lopes C , Assunção R , Alvito P , De Boevre M 
Published: November 2019

Abstract

Mycotoxins constitute a relevant group of food contaminants with several associated health outcomes such as estrogenic, immunotoxic, nephrotoxic and teratogenic effects. Although scarce data are available in Portugal, human biomonitoring studies have been globally developed to assess the exposure to mycotoxins at individual level.
The present study concerned the analysis of mycotoxins in 24h urine and first-morning urine paired samples from 94 participants enrolled within the scope of the National Food, Nutrition, and Physical Activity Survey of the Portuguese General Population (2015-2016). Following a salt-assisted matrix extraction, urine samples were analyzed by liquid chromatography-mass spectrometry for the simultaneous determination of 37 urinary mycotoxins’ biomarkers and data obtained used to estimate the probable daily intake as well as the risk characterization applying the Hazard Quotient approach.
Results revealed the exposure of Portuguese population to zearalenone, deoxynivalenol, ochratoxin A, alternariol, citrinin and fumonisin B1 through the quantification in 24h urine and first-morning urine paired samples. Risk characterization data revealed a potential concern to some reported mycotoxins since the reference intake values were exceeded by some of the considered participants. Alternariol was identified for the first time in urine samples from a European country; however, risk characterization was not performed due to lack of reference intake value.
The present study contributed with reliable and evidence-based results, and confirmed that mycotoxins represent a burden and are part of the human exposome of the Portuguese population. Further studies are needed to shed a light on the determinants of exposure in order to contribute for the promotion of public health measures to reduce the mycotoxins’ exposure in Portugal.

Key messages
Portuguese population is exposed to mycotoxins, chemical food contaminants that may be harmful (carcinogenic, immunotoxic, mutagenic, teratogenic, hepatotoxic) for human health. Human biomonitoring studies provide realistic data on internal exposure at individual level, allowing a more accurate knowledge of the determinants of exposure to these contaminants.
Estimating the burden of disease of exposure to chemical contaminants in food in Denmark
Authors: Jakobsen L S , Thomsen S T , Pires S M 
Published: November 2019

Abstract

Background
Recent global estimates have shown that dietary exposure to chemical contaminants cause over 56,000 deaths and 9 million healthy life years lost each year. However, the contribution of causative agents varies greatly between world regions and countries due to local food consumption and contamination. To prioritize public health interventions to reduce disease burden, national-level risk ranking evidence is needed. The overall aims of this project are to estimate the burden of disease (BoD) of selected chemical hazards in foods consumed in Denmark, and to identify the relative contribution of foods.

Methods
We identified chemicals on the basis of their presumed public health impact. The final list of chemicals was defined in agreement with the Danish Veterinary and Food Administration, and included: methylmercury, inorganic arsenic, cadmium, acrylamide, dioxin/dioxin-like PCBs and lead. We estimated BoD in terms of disability adjusted life years (DALY) in a model combining exposure assessment with dose response models to derive probabilities of health effects, taking an incidence-based approach. Data were collected from the Danish National Survey of Diet and Physical Activity, food monitoring, literature, and national statistics.

Results
We estimated that methylmercury, inorganic arsenic, cadmium and acrylamide lead to a BoD of 514 DALY (95% uncertainty interval: 185, 990) in 2016 (preliminary results). Estimates for lead and dioxin/dioxin-like PCBs are pending. Methylmercury exposure from fish was the greatest contributor to overall burden (478 DALY), and acrylamide from potato products the second (30 DALY). The health outcomes leading to highest burden were intellectual disability and cancer.

Conclusions
Our estimates will assist public health managers identifying the chemical contaminants in foods with the highest impact on public health in Denmark. Future research should focus on estimating the effect of mitigation strategies on the disease burden.

Key messages
We provide national quantitative evidence of the health impact of chemical exposures from foods. Information on the relative contribution of foods and population groups affected may focus mitigation.
Evaluation of the effects of health impact assessment (hia) practice in monteregie
Authors: Nour K 
Published: November 2019

Abstract

This study explores the effects of the collaborative model of health impact assessment (HIA), as deployed in Monteregie (Quebec), on the development, adoption and implementation of municipal projects that include health considerations.
Nine HIA processes were studied in nine territories and 35 individuals were interviewed. Data collection was based on the six steps of contribution analysis, and included document analysis, semi-structured interviews, and on-site observations.
The study results showed that the HIAs had varying results. First, the actors involved acquired new knowledge. However, the HIAs had little impact in terms of increasing the municipal actors’ awareness of health issues. Rather, it helped them acquire arguments for raising awareness among and convincing their municipal council members of the merits of certain actions and their potential positive impacts on citizens’ health. In fact, the HIAs were generally undertaken by municipal actors already aware of the importance of promoting citizen health. Second, in a few of the HIAs, some recommendations were integrated into planning documents, but usually the HIA report constituted an additional planning document and was not merged with the original planning documents. Lastly, following the HIAs, most of the municipal actors continued to include health considerations in their subsequent planning of public policies and projects.
Prerequisites for effective HIA include the presence of municipal actors who are aware of the importance of their role in their local population’s health, municipal policies that include health considerations, and the municipality’s active participation in the HIA process.
This study sheds light on the complexity of the factors that ensure HIA impact on municipal decision making and decisions.

Key messages
HIA have a significant impact to change municipality practice. The HIA process is crucial in order to have an impact on municipal projects that include health considerations.
Nursing community 2.0: a method to promote online collaborative learning
Authors: Arnone R , Cascio M I , Parenti I , Catino A , Zoda M L , Botta V C 
Published: November 2019

Abstract

This article describes a project seeking to establish an online community of practice involving nurses in Sicily, known as Nursing Community 2.0. The Community has initially involved 585 Sicilian nurses who took part in the residential activities. They had been selected thorough a questionnaire addressed to measure the initial technological competencies. All students - registered on open source LMS (Moodle) - attended DL courses promoted by CEFPAS (Centre for training and Research in Public Health located in Sicily). To promote collaborative Learning, Learning Community provided 4 areas: Forum, to confront and to debate about professional interests moderated by a renowned nurse; Camera Cafè, a virtual “agora” to change opinion without a moderator; The corner of the joke; a Tweetboard; Project work Area, where the Topic has been developed to be presented during the last examination. Indeed, the project was designed to provide nurses with a space for building collaborative relationships, exchanging professional knowledge and practices, developing competencies, shaping organizational policy and reporting Adverse Drug Reactions. The quality of solutions will depend on the professional and on the nature of the competencies to be developed. The impact of a training initiative addressed to an adult public through the technological tool, depends both on the interest for the topic and on the ability of the user to manage own training, to acquire familiarity with network services and technologies and, when it occurs, to be able to autonomously cope with training using technologies useful to get information and knowledge to be used to solve a specific professional problem in time. Qualitative and quantitative analysis of online interactions have been carried out. Results indicate that, thanks to the deployment of suitable technology and expert tutor support, Nursing Community 2.0 has successfully established itself as an environment for generating and exchanging knowledge.

Key messages
Collaborative learning depends on the interest for the topic and on the ability of the user to manage learning through technological tools. Nursing Community gives results when learning environment generates debates and interactions.
Breast Cancer Screening (BCS) by Mammography Tomosynthesis
Authors: Correia M , Aleixo F , Lagoa A , Ferrinho D , Pereira R , Vale L , Cardoso C , Faria M 
Published: November 2019

Abstract

Issue
Breast cancer is the 2nd cause of death for women in Portugal and 6000 new cases are detected annually. The prognosis is better for women whose cancers are detected earlier.

Description
Algarve BCS begin in 2005 using a digital mammography with 2 incidences/breast with double reading and consensus by a 3rd radiologist. Each 2 years women age 50 to 69, are invited to a Mobile Unit to do the mammography, a partnership with Algarve Oncologic Association. In 2017, direct digital mammography with Tomosynthesis(DDMT)was implemented. This technique increase cancer detection, reduction of false positives, false negatives and radiation dose. Diagnostic accuracy is better and also improves accessibility to the most vulnerable population groups to this technology.

Results
BCS covers 100% of the region and the mobile unit is user friendly for women with mobility impairment. Adhesion rate is &gt; 62%. Is the 1st screening using Tomosynthesis in Portugal.Preliminary results show that the confirmation rate increased (10 %), the detection rate per 1.000 women also increased and the positive predictive value &gt;95%.
Costs associated with the program decrease and less number of women called for false positives is observed. The number of positive mammograms increased, due to diagnostic acuity, with better visualization of the breast, namely in the patterns of greater mammary density; which leads to an improvement in further assessment rates.

Lessons
The technique increases the adhesion rate, with the same human resources. The decrease of the false positives improves the number of women send to further assessment and Senology Center. Earlier diagnoses, less aggressive treatments, and a higher survival rate are also expected.
Messages- Using this technology is expected that cancer diagnosis will be earlier, more reliable and wiht higher survival rate for this disease. The possibility of a population based screening with DDMT is an opportunity to reduce inequalities in the region.

Key messages
Mammography Tomosynthesis is expected that cancer diagnosis will be earlier, more reliable and wiht higher survival rate for this disease. The possibility of a population based screening with Mammography Tomosynthesis is an opportunity to reduce inequalities in the region.
Effects of sickness absence on disability pension risk: Finnish register study of two native groups
Authors: Reini K , Klein J , Saarela J 
Published: November 2019

Abstract

Background
Sickness absence and disability pension have a close connection and both describe the health of working-aged populations. The aim of this paper was to study if Swedish and Finnish speakers differ in the risk of disability pension after first-time sickness absence. This may reveal new aspects how to support health and work ability promotion activities.

Methods
The longitudinal register data used come from Statistics Finland. They consist of random samples of 5 % of all Finnish speakers and 20 % of all Swedish speakers, observed throughout the period 1989-2010. The analyses concerned non-retired individuals aged 16-60 years who were under risk of first-time sickness absence that extended 10 days. Discrete-time hazard models were estimated to both language groups to evaluate how first-time sickness absence, time since absence, length of absence, and various socio-economic control variables affected the disability pension risk.

Results
The disability pension risk was extremely high immediately after the sickness absence receipt and remained elevated thereafter approximately 20 times higher as compared to non-recipients. A strong interrelation between first-time sickness absence and the risk of subsequent disability pension was found for both language groups and the risk was persistent in the very long term. The risk pattern looked similar to both Swedish and Finnish speakers and we did not observe any differences between women and men.

Conclusions
Paid sickness absence is illustrative of strong health selection and a notable risk for reduced work ability even in the more distant future. The currently implemented policies in Finland, which require statements about rehabilitation plans soon after individuals have entered a sickness spell, can be considered beneficial for both the individual and society. Comparison of the language groups shows that the disability pension process after sickness absence is operating similarly to both groups.

Key messages
Sickness absence requiring medical certificate is an indicator of possible long-term work disability. Timing of rehabilitation process during the sickness absence is critical.
Manager perspectives on workers’ return to work after cancer treatment
Authors: Torp S , Valle-Olsen Å , Brusletto B 
Published: November 2019

Abstract

Background
Due to improved cancer treatment, the survival rate of cancer is increasing Unfortunately, many cancer survivors suffer from serious late effects because of this treatment. Therefore, more and more cancer survivors with reduced work ability are, and will in the future be, in work. To include this group of workers in working life is a challenge for the society in general and for the enterprises in particular. The aim of this study was to investigate managers’ experiences regarding cancer survivors’ return to work (RTW).

Methods
We performed qualitative individual in-depth interviews with nine managers who had experience with workers who needed adaptations at work after cancer treatment. The interviews were transcribed in verbatim and thematically analyzed in accordance with guidelines for stepwise deductive-inductive analysis (Tjora, 2016).

Results
All managers emphasized the importance of taking good care of workers with serious diseases and to adapt work according to their work ability. The managers tried to follow the Work Environment Act and guidelines given by the Norwegian Labor and Welfare Administration but they experienced that the guidelines did not fit well with the needs of the cancer survivor and/or the enterprise. A good RTW process was dependent on an open dialog that was initiated early in the RTW trajectory to establish a sense of safe situation for both the cancer survivor and the company. A good RTW process could only be established if the colleagues of the survivor gave their support to both the survivor and the manager. In addition, it was of great importance that the needs of the cancer survivor had to be balanced by the production needs of the enterprise.

Conclusions
Managers need support from health personnel and social security agencies to support cancer survivors to retain work.

Key messages
Cancer survivors need adaptations at work. Managers are crucial in securing a successful vocational rehabilitation of cancer survivors.
Topic modeling to mind illegal compensation for occupational injuries
Authors: Song S H , Min J Y , Kim H J , Min K B 
Published: November 2019

Abstract

Background
Accurate reports of occupational injuries are important to monitor workplace safety and health initiatives. In South Korea, media reports, experts, and workers have been constantly raising the issue of underreporting. Supposedly it is because employers have strong market “incentives” by underreporting their employees’ injuries. A critical way to underreport or cover-up is illegal compensation (in Korean called “gong-sang”). Unfortunately, “gong-sang” is not counted as official occupational injury statistics. The aim of this study was to analyze the social media data using topic modeling and to explore issues surrounding “gong-sang”.

Methods
We used web scraping technology and collected 2,210 social media data from Web search engines. Data was processed to transform unstructured textual documents into structured data using the Python and applied Latent Dirichlet allocation (LDA) in the Python library, Gensim, for topic modeling.

Results
Based on the LDA method from “gong-sang”- related documentation, 10 topics were identified. Topic 1 was the greatest concern (60.5%), with keywords implying the choice between illegal compensation (“gong-sang”) and legal insurance claims. The next concern was Topic 2 including keywords associated with claims for industrial accident insurance benefits. The rest topics (topic 3-10) showed the monetary issue, precarious employment, and vulnerable body parts to “gong-sang”.

Conclusions
We explored web-based data and identified the salient issues surrounding “gong-sang”. LDA topics may be helpful to ensure efficient occupational health and safety scheme to protect vulnerable employees from “gong-sang” practices.

Key messages
The topics formulated by LDA included queries about legal insurance claims. Legal insurance claims including private or social insurance, monetary compensation, injured body parts, and the type of jobs vulnerable to “gong-sang”.
Work capacity assessments – reviewing the what and how of physicians’ clinical practice
Authors: Nordling P 
Published: November 2019

Abstract

Background
Although a main task in the sickness certification process, physicians’ clinical practice when assessing work capacity has not been thoroughly described. Increased knowledge on the matter is needed to support a better and more reliable certification process. In this review, we aimed to synthesise existing evidence to provide a clearer description of the work capacity assessment as practiced by physicians.

Methods
Seven electronic databases were searched systematically for qualitative studies examining what and how physicians do when they assess work capacity. Data was analysed and synthesised using qualitative manifest content analysis.

Results
Twelve articles were included in the review. Results show that physicians seek to form a knowledge base including understanding the condition, the patient and the patient’s workplace. They consider both medical and non-medical aspects to affect work capacity. Accordingly, to acquire and process the information they use both medical and non-medical skills, methods and resources. Medical competence is an important basis, but not enough. Time, trust, intuition and reasoning are also used to assess the patient’s claims and to translate the findings into a final decision. The depth and focus of the information seeking and processing vary depending on several factors.

Conclusions
The work capacity assessment is a complex task where physicians rely on their non-medical skills to a higher degree than in ordinary clinical work. These skills are highly relevant but need to be complemented with methods to better understand the patient’s work place, as well as theoretical knowledge regarding the intricate associations between health, work and social security. This would further enhance physicians’ competence and confidence, and promote better experiences and practices of the work capacity assessment.

Key messages
In the complex task of assessing work capacity physicians rely on their non-medical skills to a higher degree than in ordinary clinical work. A better understanding of the patient’s work situation and the intricate associations between health, work and social security would enhance physicians’ competence and promote better assessments.
The effects of skill-based team learning curriculum in workplace violence prevention for nurses
Authors: Chen F-L , Chen P , Kuo T-Y , Chiou S-Y 
Published: November 2019

Abstract

Background
Workplace violence, faced by health care workers, is a severe occupational safety and health hazard, and has received global attentions in research and in practice. The aim of this study was to design, implement, and evaluate a skill-based team learning curriculum of violence prevention for clinical nurses.

Methods
78 clinical nurses were purposively selected including 41 nurses of treatment group, and 37 nurses of control group. Each treatment group received the training curriculum which included three sessions: (1) 50-minutes workplace violence lecture and video to illustrate the various workplace violence situations, (2) 50-minute team group discussion to design effective violence prevention skills for a hospital violence situation, (3) 60-minute interactive skills training curriculum focusing on role play, rehearsal and feedback. The control group only received a self-learning violence prevention manual. Generalized Estimating Equation (GEE) model was used to examine the program effects.

Results
The results for the GEE statistics indicated a significant time effect. The pretest-posttest and after the posttest results that treatment group showed significant improvement in preventive skills (β = 1.828, β=1.330; p&lt;0.001) and self-efficacy(β = 4.123, β=5.363; p&lt;0.001) compared to the control group. Besides, the experimental group significantly decreased incidents of verbal violence (β=-1.140, p &lt; 0.05) compared to the control group.

Conclusions
The study showed integration of skill-based teamwork learning in clinical nursing training provides an additional venue to prevent and reduce workplace violence. This shall be a feasible module and significant reference in junior or pre-service health care workers training in the future.

Key messages
The study demonstrates the feasibility of implementing the team learning curriculum for clinical nurses. The present study provides empirical evidence of the skill-based team learning training curriculum in workplace violence program for clinical nurses.