bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exposure to particulate matter and risk of dementia in subjects with mild cognitive impairment
Authors: Vinceti M , Filippini T , Malagoli C , Cherubini A , Maffeis G , Chiari A 
Published: October 2020

Abstract

Background
Exposure to air pollutants increases the risk of several chronic diseases, possibly including neurodegenerative disease such as Alzheimer's dementia. In this study, we aimed to evaluate the effect of long-term exposure to as major outdoor air pollutant, particulate matter ≤10μm (PM10), on the risk of dementia in a cohort of subjects with mild cognitive impairment.

Methods
We recruited a cohort of 53 subjects newly diagnosed with mild cognitive impairment residing in Modena and Reggio Emilia provinces. We geocoded their residence address, and we estimated their exposure to PM10 from motorized traffic using a validated air dispersion model. We investigated the relation of baseline exposure to subsequent conversion to dementia using a Cox proportional hazards model. We computed hazard ratio (HR) and 95% confidence interval (CI) of dementia according to increasing PM10 exposure, adjusting for sex, age, and education.

Results
During a median follow-up of 42 months, 24 participants developed dementia, 19 of Alzheimer's type. Baseline average PM10 exposure concentrations were 9.6µg/m3. Using PM10 levels below 5µg/m3 as reference, we found a dose-response increase in any dementia risk, with a HR of 1.04 (95% CI 0.41-2.66) 5-10µg/m3, 1.32 (95% CI 0.36-4.92) at 10-20µg/m3, and 1.38 (95% CI 0.14-13.13) above 20µg/m3.

Conclusions
Using a cohort study design, we found that exposure to outdoor PM10 was associated with increased risk of conversion from mild cognitive impairment to dementia. However, the limited study size suggests caution in the interpretation of this finding.

Key messages
Air pollution may be a risk factor for dementia. Dementia risk may be linked to modifiable environmental risk factors.
Analysis of the impact of sub-acute care activities on consumption of hospital resources in Milan
Authors: Perri M G , Zanardi S , Mosconi C , Mosillo M , Nicolosi D 
Published: October 2020

Abstract

Background
In 2011, a new health service called 'sub-acute care activities' (SA) has been provided by Lombardy. It is a protected hospitalization of patients, especially elderlies, suffering for clinical issues following an acute disease or for non-complex clinical failures due to a chronic pathology. This is a hospitalization area between the hospital and home, created to reduce the number of post-acute hospitalized patients who can't be discharged. The goal of this study is the analysis of the hospitalizations in the SA setting within medical structures located in the Metropolitan area of Milan.

Methods
The data extracted from the hospital discharge card database, is focused on hospitalizations in SA that occurred from 2016 to 2019. The analysis describes yearly production, the characteristics of hospitalizations and patients, finally some trends.

Results
16,395 hospitalizations in SA were analyzed (0.7% of the total). Some data are constant in time: hospitalizations (1%), age (average 79), days of hospitalization (average 26). Patients coming from public hospitals (from 28% to 22%) are decreasing while those coming from other in-patient admission typologies within the same organization (from 44% to 54%) are increasing. The major diagnostic categories are related to cardiovascular and respiratory diseases. Over the 85% of hospitalizations are paid with the highest daily rate among those allowed by law. Talking about discharge typologies, 57% of patients return home, 20% are re-transferred to the acute ward, 16% are sent to rehabilitation/long-term care while 7% have died.

Conclusions
The use of the highest daily tariff and the high number of patients who need to be re-transferred to the acute ward place, gives many doubts on how appropriate is allocation of resources and about the accuracy of admissions in the SA unit during the patient care path. We're planning to return to these issues with further targeted studies.

Key messages
The analysis showed constant characteristics of SA activities during the four years. Data showed that there may be management issues in the appropriate use of resources in SA assistence.
Patient Reported Outcome Measures (PROMs) for quality of care assessment: a pilot study protocol
Authors: Fauci A J , Acampora A , Cadeddu C , Angioletti C , De Belvis A G , Iannone P 
Published: October 2020

Abstract

Background
There is emerging interest in integrating Patient Reported Outcome Measures (PROMs) into the assessment of care quality. This study protocol aims at testing the collection and use of PROMs for evaluating and comparing health outcomes by patients with colorectal cancer. This is part of a project of the Istituto Superiore di Sanità and Gruppo Italiano di Reti Oncologiche (GIRO) aimed at promoting Value-Based Healthcare (VBHC) for performance evaluation of oncological healthcare providers.

Methods
A multicentric prospective observational study will be conducted at the seven GIRO oncological hospitals. For each hospital, 40 colorectal cancer patients undergoing either surgery or surgery plus neoadjuvant therapy, will be recruited (20 colon; 20 rectum) over 12 months. The data will be collected twice (before and after surgery) or three times for patients undergoing neoadjuvant therapy, by using EORTC-C30, a generic module for cancer patients and EORTC-CR29, a specific module for colorectal cancer patients. Collected data will be analyzed descriptively and the scores of each hospital will be compared to the overall scores of all the centers. Additional medical information will be used to adjust for the center casemix. Feedback from health professionals and patients will be collected through structured questionnaires and focus groups.

Results
The results will be interpreted to assess and compare the health outcomes reported by the patients among the GIRO hospitals. Feedback from health professionals and patients will help identify barriers and facilitators of implementation of PROs collection.

Conclusions
PROMs have the potential to systematically incorporate the patient perspective into the health outcome measurements for performance evaluation and benchmarking, which is essential to delivering high-value patient-centered care. The PROMs collected in this study will be integrated in a set of process and outcome indicators previously defined within same project.

Key messages
Patient-Reported Outcome Measures (PROMs) have the potential to systematically incorporate the patient perspective, which is essential to delivering high-value patient-centered care. It is critical to integrate PROMs in performance evaluation and comparison among oncological healthcare providers for improving the quality of care in a Value-Based Healthcare perspective.
The MAastricht Instrument for Sustainable Employability – Italian version: a validation study
Authors: Picco E , Houkes I , De Rijk A E , Miglioretti M 
Published: October 2020

Abstract

Background
Health promotion and age management at work are top priorities for governments and employers. To promote sustainable employability (SE) in ageing societies is more necessary than ever. In the Netherlands, an instrument for tapping the employee perspective on SE (MAISE-NL), has recently been developed. This study aims to validate the Italian version of MAISE (MAISE-IT).

Methods
The MAISE-IT (a translated and adapted version of the MAISE for the Italian population), the Work-Health Balance questionnaire and demographics (age, gender, education, and occupational activity) were answered online by a total of 455 respondents (328 public administration workers and 127 respondents recruited on social networks). Construct and criterion validity were tested by CFA, reliability and correlational analyses and subgroup analyses through ANOVAs.

Results
The CFA analysis provided evidence of the MAISE-IT to consist of 12 scales divided over five areas: (1) Meaning of SE; (2) Level of SE; (3) Factors affecting SE; (4) Overall responsibility for SE; and (5) Responsibility for factors affecting SE. Construct validity, reliability and criterion validity were good. Italian employees reported a moderately high level of SE. They considered employers as being somewhat more responsible for SE than employees.

Conclusions
This study showed the validity of the MAISE-IT in the Italian context. The MAISE-IT is valuable to assess employees' needs in order to develop SE interventions that align with the employee perspective. Specific policy regulations and campaigns should be developed to make employees more aware of opportunities to increase their SE.

Key messages
The MAISE-IT can be used to measure the meaning and level of SE, factors affecting SE and responsibility for SE, in order to develop group level SE interventions. As employees in different contexts might have different ideas on SE, an instrument that measures perspectives on different SE dimensions separately is innovative.
Psychosocial interventions at the workplace, a systematic literature review
Authors: Friberg E , Lytsy P 
Published: October 2020

Abstract
The psychosocial work environment has been shown to be of importance for the health and wellbeing of individuals as well as for the productivity, sickness absence levels, and wellbeing of an organization. The aim was to map the existing knowledge, as presented in relevant and well performed systematic reviews, that have investigated the effects of work-related interventions, aiming to affect the psychosocial work environment and health related outcomes in workers/employees and in organizations.
A systematic literature review of published systematic literature reviews was performed to map the knowledge on psychosocial interventions at the workplace. The search was performed in three electronic databases: PubMed, PsycINFO, and Cinahl.
A total of 44 systematic literature reviews, of moderate or good quality, about studies on effects of workplace-related psychosocial interventions on health-related outcomes of the employees or the organization, were included. The types of interventions that were carried out mainly concerned different forms of stress-reducing or stress-management programs, or different forms of health-promotion either aimed specifically for mental ill-health or more general. Interventions aimed at bullying, social support, work efficiency and psychosocial climate in the workplace were also identified. The vast majority of outcomes were related to mental or general health. The majority of the systematic literature reviews reported several different outcome measures. A large proportion of the systematic literature reviews included interventions aimed at a general group of 'workers', or healthcare personnel.
A substantial amount of research regarding effects of psychosocial workplace interventions, have been published to date. Much of the existing knowledge indicates that the psychosocial work environment affects the individual and that active workplace interventions may promote health for the individual as well as the organization.

Key messages
A substantial amount of research regarding effects of psychosocial workplace interventions, have been published to date. Active psychosocial workplace interventions can have beneficial effects for the levels of sickness absence both for individuals and organizations.
An action research to improve social health insurance coverage of Philippines’ informal sector
Authors: Salvador D , Sales R K , Reyes G K , Lechuga J , Llevado J A L , Ting T 
Published: October 2020

Abstract

Background
PhilHealth, the social health insurance (SHI) agency of the Philippines, still does not sufficiently cover the informal sector workers (ISWs) - or the “missing middle”. Previous approaches had limited success. The impetus for finding solutions to protect the missing middle still remains.

Methods
A multi-component action research was done to address the complex social problem. Literature review and interviews were conducted to understand the nature of ISWs. National survey data was analyzed for factors affecting the ISWs' membership and retention in SHI. Findings were triangulated to construct evidence-based and context-rich marketing personas to understand PhilHealth's target clients. Using Human-Centered Design Thinking (HCDT), solutions that aim to address the low retention of ISWs in health insurance (HI) were proposed.

Results
The exact nature of ISWs is still unknown. Costly insurance premiums, poor knowledge of SHI, low perceived value of SHI, and inconvenient payment mechanisms contribute to low participation in SHI. Every additional 1000 PHP (∼20 USD) income increases odds of being an active member by 4%. Those who access private facilities are 2.8 times more likely to be active members. Those who perceive themselves to be sickly were 52% more likely to drop-out of the insurance. The results were fed into the HCDT process producing four prototypes: 1) solutions that explore partnership of PhilHealth with other organizations, 2) use of mobile application platforms for payment and member status updates, 3) automated algorithm to identify and calculate fair premiums, and 4) integration of money-saving strategies.

Conclusions
The government needs to step-up current efforts to extend health financial risk protection for the ISWs. PhilHealth can take advantage of the research results by testing the prototypes produced, and by adopting the HCDT process to improve their service and coverage for the informal sector.

Key messages
This government-funded project integrated principles of public health, epidemiology, health financing, participatory governance, and implementation research to address a complex social problem. The results provide a better understanding of the informal sector workers’ nature and needs with regards health insurance and can help PhilHealth improve coverage of informal sector workers.
Mental health outcomes in road traffic accident survivors: prospective cohort study
Authors: Kovacevic J , Miskulin M , Degmecic D , Vcev A , Palenkic H , Miskulin I 
Published: October 2020

Abstract

Background
Mental health outcomes of road traffic accidents (RTAs) are always investigated amongst the injured. The aim of this study was to investigate psychological consequences and associated factors in all RTA survivors irrelevant of their injury status.

Methods
A cohort of 200 Croatian RTA survivors was assessed one month after experiencing a RTA using the posttraumatic stress disorder (PTSD) Checklist for civilians, the Beck Depression Inventory and the Beck Anxiety Inventory. The New Injury Severity Scale was used for the injury severity assessment.

Results
RTA survivors reported substantial rates of PTSD (35.5%) and depression (20.0%) symptoms, and low rates of anxiety (4.5%). Symptoms of depression were associated with under-average self-perceived economic status (SES) (P = 0.001), irreligiousness (P = 0.001), medication use (P &lt; 0.001), injury severity (P &lt; 0.001), self-perceived threat to life (P &lt; 0.022), hospitalization (P = 0.003), hospitalization duration (P = 0.004), surgical treatment of the injury (P &lt; 0.001), unconsciousness in the RTA (P = 0.033) and post-RTA amnesia (0.039). PTSD symptoms were associated with unemployment (P = 0.034), under average SES (P = 0.004), lack of previous RTA experience (P = 0.025), previous psychiatric illness (P = 0.001), medication use (P = 0.001), psychiatric medication use (P &lt; 0.001), injury affliction (P = 0.001), injury severity (P &lt; 0.001), self-perceived threat to life (P &lt; 0.001), pain after RTA (P = 0.009), hospitalization duration (P = 0.017) and claiming compensation (P = 0.008). Anxiety symptoms were associated with previous chronic (P = 0.037) or psychiatric illness (P = 0.010), previous permanent pain (P &lt; 0.001), psychiatric medication use (P = 0.013) and rehabilitation after injury (P = 0.032).

Conclusions
A RTA is a traumatic event that can result in physical injuries, but also with psychological consequences depending on pre-RTA survivor's characteristics. Psychological support to those at risk may prevent psychological disorders after a RTA.

Key messages
Along with evaluation and treatment of road traffic accidents injuries, health care providers should evaluate pre-accident health status of all road traffic accidents victims. Understanding factors that present risk for poor mental health outcomes after the road traffic accidents is the key step in planning and organizing recovery of accidents survivors.
The impact of tendonitis and RSI/WMSD on HRQoL according to gender: a population based study
Authors: Souza D B O , Barbosa L P , Santini P A , Barros M B A , Lima M G 
Published: October 2020

Abstract

Background
Repetitive Strain Injury (RSI)/Work-related Musculoskeletal Disorders (WMSD) and tendonitis are considered a serious problem in the area of Occupational Health. The present study aims to estimate the prevalence of these disorders on the adult population of a metropolis in the state of São Paulo and to analyze their impact on Health-Related Quality of Life (HRQoL), according to gender.

Methods
A population-based cross-sectional study was conducted using data from the “Campinas City Health Survey (ISACamp 2014/15)”. The sample consisted of 2,166 individuals aged 18 years or older and the SF-36 instrument was used for HRQoL analysis. The association between the variables was verified by the chi-square test and the Poisson simple and multiple regression models were used to estimate the prevalence ratios (PR). In HRQoL estimates, the average SF-36 scores were calculated according to the independent variables.

Results
The prevalence of tendonitis and RSI/WMSD was 8.5%, with 6.7% tendonitis and 2.7% RSI/WMSD. The prevalence was higher among women (11%; 1.34-2.56), on individuals aged between 40-59 years (PR = 3.63; 2.28-5.80), who were on occupational activity (PR = 2.04; 1.12-3.68) or on work leave (PR = 7.07; 2.77-18.03) and on the most educated (PR = 2.45; 1.28-4.70). Subjects with these morbidities decreased in 6 of the 8 HRQoL domains and on stratification by gender, we observed that women had greater decreases in mental component scores in the presence of RSI/WMSD and men in physical component (p &lt; 0.05).

Conclusions
The diseases analyzed can affect men and women differently, and it is essential to consider the peculiarity of the impact between the sexes in the elaboration of interventions and preventive measures aimed at improving the quality of life.

Key messages
No population-based studies were found that assess the impact of RSI/WMSD on HRQoL, according to gender differences, showing the relevance of this study. It is very important to understand how these diseases affect men and women differently so that specific and more effective preventive and rehabilitative measures can be carried out.
The evaluation of low back pain and perceived stress among prehospital emergency care workers
Authors: Kılınç A , Çalışkan Pala S , Arslantaş D , Ünsal A 
Published: October 2020

Abstract

Background
Low back pain (LBP) is one of the most common musculoskeletal system complaints in Prehospital Emergency Care workers consisting of paramedics, emergency medical technicians and doctors. Since their high stress job also includes physical work, such as lifting and bending, it's important to address the LBP. The aim of the study was to evaluate the low back pain and perceived stress in prehospital emergency care workers.

Methods
This is a cross-sectional study conducted on Eskişehir prehospital emergency care workers in 2020. The study group consisted of 372 (77.5%) personnels out of 480. The questionnaire form included sociodemographics, factors related to low back pain, Back Pain Functional Scale (BPFS) and Perceived Stress Scale (PSS). Scoring high on BPFS implies function loss due to LBP while it means high stress for PSS. Mann Whitney U, Kruskal Wallis and Spearman correlation analyses were used to determine the relationship between the variables.

Results
Females made up 55.1% of the 372 participants. The mean age was 32.15±7.5 and it ranged from 18 to 60. In the study group, 280 (75.3%) reported to have low back pain. Among those with LBP, 133 (47.5%) stated that they have had LBP for less than 5 years, 194 (69.2%) workers reported lifting is the most common reason for their LBP and 158 (56.4%) expressed that they've seen a doctor to deal with the LBP. The prehospital emergency care workers scored between 5 and 60 from BPFS, the median score was 49.0 while the mean was 45.74±12.09. There was a weak negative correlation between perceived stress and BPFS (R=-0.187, p &lt; 0.001).

Conclusions
LBP was a common complaint among prehospital emergency care workers. Those who are older than 30, have chronical disease(s), had a family history of LBP, had an injury/trauma, had LBP for more than 5 years and those who worked 24 hour shifts scored less on the FBPS implying a funcionality loss due to LBP.

Key messages
Prehospital emergency care workers are overworked and it takes a toll on both mental and body health. Educating the workers to create a better understanding on lifting and bending may help them with low back pain.
Relationship between falls and Fall Risk Increasing Drugs. A retrospective case control study
Authors: Tiwana N , Pietronigro A , Mosillo M , Principi N , Carnevali D , Avanzi G M , Corna S , Colombo R , Castaldi S 
Published: October 2020

Abstract

Background
Falls and fall-related injuries are a major public health issue which needs global attention due to its clinical and socioeconomic impact. Inpatient falls are the most common adverse event in hospital. Important risk factors for falls are polypharmacy and the assumption of so-called Fall Risk Increasing Drugs (FRIDs). Aims of our study were to investigate the associations between falls and the use of medications among inpatients by conducting a retrospective case-control study in a rehabilitation hospital in Northern Italy in 2018.

Methods
Three unique control for each faller, matched by age, sex and hospitalization ward, were selected. A Conditional Logistic Regression was performed to analyze the impact that 13 types of FRIDs individually and the number of administrated FRIDs had on the risk of falling. A second regression model was obtained adjusting the case-control matching for CIRS, Morse and Barthel scores.

Results
We identified 148 cases and 444 controls. 3 types of FRIDs were significantly correlated (p &lt; 0,05) with an increased risk of falling: Antipsychotics [OR:1,98;CI 95%:1,01-3,89], Antidepressants [OR:2,18;CI 95%:1,32-3,59], Diuretics [OR:1,71;CI 95%:1,09-2,68]. Antidepressants were the only type of FRID significantly correlated (p = 0,008) even in the model adjusted for CIRS, Morse and Barthel scores [OR:2,00;CI 95%:1,20-3,34]. The unadjusted model showed that the addition of one type of FRID to therapy was significantly associated with the fall event (p &lt; 0.05) [OR:1.21;CI 95%: 1.05 - 1.40].

Conclusions
Assumption of drugs and polypharmacy could play a role in hospital falling. Recently developed fall risk assessment tools suffer from low specificity and sensitivity and do not assess these risk factors. A holistic approach with a multidimensional evaluation of the patient through screening tools, functional assessment tools and a full medical evaluation should be improved.

Key messages
Drugs may represent an important variable in determining the risk of falls in hospitalized patients, but they should not be considered alone. Screening tools for fall risk should take into account polypharmacy such as other intrinsic and extrinsic risk factors within an holistic approach.