bluuebunny/crossref_metadata_2025_split huggingface dataset:
Alcohol intake and patterns of multi-site musculoskeletal pain in the British Whitehall II study
Authors: Zhao Z , Lallukka T , Chandola T , Britton A 
Published: October 2024

Abstract

Background
Patterns of multi-site musculoskeletal (MSK) pain and its relationship with alcohol drinking among white-collar employees and retirees remain unclear compared to blue-collar workers. This study aimed to examine the relationship between alcohol drinking and MSK pain through latent class analysis (LCA) in current and retired white-collar employees.

Methods
We used the data from the 7th phase (2000-2002, n = 6,967, response rate 71.6%) of the British Whitehall II study, chosen for its availability of MSK items and approximately 1:1 ratio of employees to retirees, allowing for an evaluation of the relationship between alcohol drinking and MSK pain by employment status. LCA was used to distinguish patterns of multi-site MSK pain. A multinomial logistic regression model was used to examine the association between alcohol drinking and the identified pain patterns, with analyses conducted separately for employees and retirees.

Results
We identified five latent classes for pain (back/cervical: 7.1%, cervical: 28.9%, upper limb: 29.4%, combined LBP/upper limb/cervical: 13.2%, and LBP alone: 21.5%). Increased alcohol intake might be associated with elevated odds of upper limb pain in current drinkers, but this could not be statistically confirmed (OR: 1.04, 95% CI: 0.99-1.09). Employment status may modify the association with a significant interaction found between alcohol intake and retirement (p-value: 0.043). Every 7-unit increase in alcohol intake is associated with 18% and 12% higher odds of pain in LBP/UBP/cervical and upper limbs, respectively (95% CI: 1.02-1.37; 1.02-1.23).

Conclusions
Increased alcohol intake was associated with pain patterns only among retired white-collar employees but not the current ones. Interventions on alcohol consumption could help confirm if, reducing alcohol intake or avoiding hazardous drinking, for white-collar retirees prevents not only upper limb pain but also more complex pain patterns.

Key messages
• Musculoskeletal pain in white-collar employees and retirees contributes to the cervical and upper extremities, differing from low back/neck pain studies among general or blue-collar workers.
• The association between alcohol drinking and pain patterns may differ across employment status. Reducing alcohol intake might be advised to retired drinkers for preventing multi-site pain.
The relationship between mental health and employment: a systematic review of cohort studies
Authors: Bruggeman H , Héroufosse J , Van der Heyden J , Smith P 
Published: October 2024

Abstract

Background
Knowledge on the bi-directional association between employment status and mental health is important, as it affects multiple dimensions of our daily lives, both at the individual and societal level. Given that the mental health status and employment situation of individuals are likely to change over time, there is an important need for longitudinal data to better understand causality patterns in this association and the underlying mechanisms.

Methods
A systematic review was carried out based on the PRISMA guidelines in 3 electronic databases: PubMed, Embase, and PsycInfo. Studies eligible for inclusion were cohort studies, involving the general population, and assessing the relationship between employment status and mental health longitudinally.

Results
In total, 3,733 studies were identified and 36 met the inclusion criteria. The eleven studies focusing on the social causation hypothesis highlighted the negative long-term impact of unemployment and unstable employment on mental health. Four studies observed mental health improvements upon re-entering employment, although limited and in more specific contexts. The fourteen studies focusing on the health selection hypothesis found a lower probability for individuals with mental health problems in finding and maintaining employment. Finally, the eleven studies assessing the two hypothesis simultaneously found that mental health problems were both a consequence of and risk factor for poor employment status, although some important moderating factors, such as gender differences, influence the direction and strength of the association.

Conclusions
This review underscores the bi-directional association between the employment status and mental health of individuals, highlighting the need to develop targeted prevention (e.g. mental health support in the workplace) and interventions strategies (e.g. supported employment programs) in both the mental health and labor market systems.

Key messages
• The bidirectional link between employment and mental health highlights the need for concurrent responses to break the vicious cycle between poor mental health and social exclusion.
• To reduce the clinical and social burden of mental health problems, gender differences must be taken into account in mental health and employment support practices and policies.
Deployment of in-body wearable devices in healthcare and at work: closing the EU regulatory gap
Authors: Marassi S , Foldes M E 
Published: October 2024

Abstract

Background
In-body wearable devices can protect workers’ health and safety. Moreover, they might provide data that could be capitalized on in the context of the European Health Data Space (EHDS), which aims at fostering a single market for medical devices and high-risk AI systems. Yet, neither EU legislation nor national law regulates the use of in-body wearables at the workplace and the related data protection and safety issues. This regulatory gap impacts on workers’ rights.

Methods
The study explores whether the EU regulatory framework used in the healthcare sector for medical devices could fit the in-body wearables’ application in employment. The legal and policy analysis takes the perspective of workers’ rights and discusses the application of a key GDPR principle: lawfulness. The research discusses the potential transformations in the EU health data protection framework that could close the regulatory gap.

Results
The EU regulatory framework for medical devices (focused on product safety, performance, and quality) is not equipped to address the data protection challenges linked to the use of in-body wearables for occupational health and safety purposes. The GDPR’s principle of lawfulness and the related guidance by EU and national data protection authorities lack clarity on employers’ possibilities to apply in-body wearables for occupational health purposes. Filling the regulatory gap is conducive to appropriate qualification and risk-based classification of in-body wearables, which affect pre- and post-market requirements and impact on data protection.

Conclusions
a. The EU legislator could use its social policy competence to regulate the use of in-body wearables to protect workers’ health while safeguarding their data. b. EU authorities should clarify whether and how the data collected by in-body wearables at the workplace could be shared and (re)used within the EHDS. c. Further input by data protection authorities is needed to close the regulatory gap.

Key messages
• The EU should regulate the use of in-body wearables to protect workers’ health and safety.
• Health data gathered through the application of in-body wearables at the workplace may be an asset for the EHDS.
Predicting hospital readmission in multimorbid patients with the use of AI: A systematic review
Authors: Zain Y , Hassan N , Marley K , Slight R D , Bates D W , Slight S P 
Published: October 2024

Abstract

Background
Multimorbid patients are at higher risk of hospital readmission due to the complex nature of their conditions. Identifying those who may be at particularly high risk would allow us to intervene early and potentially delay or prevent such readmissions occurring, thus reducing healthcare costs. We conducted a systematic review investigating the use of machine learning models in predicting 30-days unplanned hospital readmission of multimorbid patients.

Methods
This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines, and was registered with PROSPERO (CRD42022373937). We searched MEDLINE, Embase, Web of Science and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Included studies developed an AI model for prediction of 30-days hospital readmission for adult patients with two or more health conditions. The CHARM and PROBAST checklists for data extraction and bias assessment were used. The quality of included studies was assessed with the CASP checklist.

Results
Eighteen papers were eligible for inclusion. A total of 669 predictors were reported with an average of 37 used per model. Predictors were classified as modifiable and non-modifiable with the most common modifiable predictors being hospital length of stay, hypertension, anaemia and obesity. Average sensitivity and specificity of the models was reported to be 72% in 13 studies and 79.2 in 11 studies, respectively. Area under the curve (AUC) was reported in 13 studies, five of which were considered to have good discrimination power (AUC&gt;0.8).

Conclusions
Machine learning models are capable of accurately predicting 30-days hospital readmission of multimorbid patients. Identifying modifiable predictors with highest weight allows for better planning and resource allocation to potentially reduce the risk of 30-days readmissions. An important area for future work would be the implementation of these high performance models in practice.

Key messages
• Hospital readmissions are preventable and identifying those at higher risk allows us to intervene early.
• Machine learning models are capable of predicting 30-days readmission of multimorbid patients.
Evolution of online health-related information seeking in France from 2010 to 2023
Authors: Quiviger A , Ducrot P , Richard J B 
Published: October 2024

Abstract

Background
Given the rapid ongoing progression of the internet and increase in health information available online since 2010, it is important to understand how these changes impact online health information-seeking behaviour of the population and the way of managing one’s health. This study aims to describe the evolution of the use of internet to seek health-related information as well as the characteristics of online health information seekers.

Methods
We used data from the French nationally representative surveys Health Barometers. It is a cross-sectional repeated survey of random representative samples of the French population conducted by the French national public health agency since 1992 using computer-assisted telephone interviewing. It serves to measure the evolution of key indicators regarding health-related behaviors, attitudes, and opinions in the general population and includes individuals aged 18-75 years old selected through randomly generated phone numbers. In the 2010, 2014, 2017 and 2023 editions, the same question was asked about the internet use as a source of health information. Evolutions over time were assessed using chi-square tests. Associations with sociodemographic characteristics and health status were evaluated using logistic regression models.

Results
Although internet access increased steadily during this period, from 72.8% in 2010 to 95.2% in 2023, the use of the internet as a source of health information rose between 2010 and 2014 (from 37.3% to 67.9%), decreased significantly in 2017 (60.3%) and rose again in 2023 at 65.3 %. The study describes the characteristics of the online health information-seekers trough time.

Conclusions
The past decade was marked by a breakthrough of the use of internet in the general population and the use of internet to seek health information. The analysis of the digital health information-seekers serves the public health authorities in their mission to provide accessible information on public health.

Key messages
• This study aims to describe the evolution of Online Health-Related Information Seeking in France from 2010 to 2023 and the characteristics of digital health information-seekers.
• The analysis of the digital health information-seekers serves the public health authorities in their mission to provide accessible information on public health.
Prediction of mental health risk in adolescents via a smartphone app: a feasibility pilot study
Authors: Bellido Bel T , Kadirvelu B , Freccero A , Di Simplicio M , Faisal A A , Nicholls D 
Published: October 2024

Abstract

Background
The prevalence of mental health problems in adolescents is a global public health concern. Machine learning (ML) can analyse multidimensional data collected by phone sensors (passive tracking) and symptom self-reporting (active tracking) to model and predict mental health states. However, research in adolescents is lacking. This study investigated the feasibility of using ML to predict mental health in a non-clinical population of adolescents from active and passive data collected through the Mindcraft mobile app.

Methods
We recruited 103 secondary students (aged 14-18) who first completed the Strengths and Difficulties Questionnaire (SDQ) and then used the Mindcraft app for two weeks. The app integrates sensor data (location, steps, noise, light, battery, app usage) and self-reports. We extracted 85 sensor-based features and 19 from questionnaires to develop a gradient-boosted ensemble ML model. This model identifies students with abnormal SDQ scores and was evaluated using leave-one-out cross-validation.

Results
All students completed the active questionnaires; 67 also provided passive sensor data. 31 had abnormal SDQ scores. Using passive data, the ML model reached a balanced accuracy of 0.64 and an AUC score of 0.57. Incorporating both data types improved accuracy to 0.67 and AUC to 0.70. Feature importance scores showed step count and questionnaire on racing thoughts and hopefulness as most significant.

Conclusions
Our findings affirm the potential of integrating passive and active data collection to monitor mental health in real-world settings. Our ML model demonstrated moderate accuracy in predicting adolescents’ mental health risk measured with a behavioural screening questionnaire. This study will guide the development of a ML-driven, personalised mobile intervention for early symptom detection and mental health self-management, which might constitute an innovative and scalable tool for mental health prevention and intervention in adolescents.

Key messages
• This study shows the feasibility of using active and passive data to predict mental health risk in adolescents.
• This study informs the development of a personalised machine learning-driven mobile intervention.
Land of Shadow: Perceived maternal self-efficacy
Authors: Capitani E , Prosperi G , Alaimo L , Nante N 
Published: October 2024

Abstract

Background
In our society, often women arrive at the motherhood without community and family models, and without an effective support network from the services. The aim of the study is to investigate mothers’ perceived maternal competence (self -efficacy) and its possible correlations with pregnancy, birth and breastfeeding outcomes.

Methods
A retrospective observational study was conducted on a sample of mothers from all over Italy, using an online survey conducted from August to October2023.The questionnaire consisted of 26 questions including the Brief Parental Self-Efficacy Scale.The instrument used a score from 5 to 25; we used a score of 15 as cut-off for perceived low or high self-efficacy.Statistical analysis was performed with the chi-square test and subsequently, the Odds Ratio was calculated to define how statistically strong the association is between the BPSE score obtained and specific variables studied.

Results
The sample consisted of 4553 mothers.56.6% were women between the ages of 31 and 40 and 28.7% were women over 40 years old.20% of the women in our sample suffered from postpartum depression. The women in our sample report having received help in caring for their first child in 42% of the cases from their partner and in 30% of the cases from other family members.The mean BPSE score was 19.45.Women who obtained a BPSE Score &gt;15 were more likely to have received support from their partner(O.R:1.4;C.I:1.1-2.0). Women who scored a BPSE Score&lt;15 were less likely to have had support from partners/family members (OR:1.5;C.I:1.1-2.0).Women with a BPSE Score&lt;15 were more likely to have experienced postpartum depression (OR:1.4;C.I:1.1-1.8).

Conclusions
Our study shows that the woman in particular who becomes a mother, cannot be left alone; she needs emotional and environmental support so that she can rediscover within herself the value, competence and power of motherhood.

Key messages
• Action must be taken so that, along with improved health care, the network of social interventions for new mothers and couples is strengthened.
• The woman, in particular who becomes a mother, cannot be left alone.
Using the innovative tool to prepare a quality national cancer control programme
Authors: Jelenc M , Albreht T 
Published: October 2024

Abstract

Issue
National cancer control programmes (NCCPs) are key documents in European Member States (MSs) used for the management of cancer policy. While some countries still have not prepared their NCCPs, there are several others, whose NCCP is not of high quality or not implemented.

Description of the problem
There is frequently a lack of knowledge in countries on how to prepare a quality NCCP or how to improve the existing one. Our objectives were: 1. To provide help in the preparation of an NCCPs and in cancer control to EU MSs 2. To enhance the availability of all the documents needed and provide best practices from other MSs. The development of an innovative tool was therefore the main objective of iPAAC Joint Action (JA). Streamlining of all NCCP-related documents prepared by the three JAs in cancer policy (EPAAC, CanCon, iPAAC) was central to the deliverables.

Results
The solution lied in the preparation of the interactive innovative tool called Roadmap on the Implementation and Sustainability of Cancer Control Actions (Roadmap). It was developed in a joint effort and collaboration between EU MSs and the European Commission. It is available online and can be used by all countries, including countries that are not part of EU, and who aim at preparing a high quality NCCP. The extensive content of the tool covers primary prevention, health promotion, screening, diagnosis, treatment, and health care, as well as a number of sub-areas with important contents, and over a hundred one-pagers, which include national and regional experiences. Among the latter, the European Guide for Quality NCCPs with instructions how to prepare a quality NCCP is presented as one pager.

Lessons
As the result of over 10 years of joint work in cancer control at EU level MSs have now both, the opportunity to learn from each other and the opportunity to access all key information they need for controlling cancer, including the instructions on the preparation of the key document, their NCCP.

Key messages
• Using the Roadmap countries have access to instructions and guidance for the preparation of a quality NCCP.
• The Roadmap enables the access to all key documents for the management of cancer control in one place to all countries.
Introducing innovative policy instrument to reduce antibiotics use. Relevant evidence from Bulgaria
Authors: Vankova D , Veleva N , Mihaylova S , Boncheva P , Vladimirova M , Vankov P , Radkova Z H , Radkov R , Micheva I , Kerekovska A 
Published: October 2024

Abstract

Background of the public health challenge
Excessive individual consumption of antibiotics (ABs) increases global antimicrobial resistance (AMR). Therefore, shaping consumers’ behaviors towards responsible ABs use is an essential strategy in the battle with the silent pandemic of AMR. The EU One Health (OH) Action Plan against AMR targets making Europe a best-practice region. Overall consumption of ABs in the EU decreased significantly, especially during the COVID-19 pandemic. Bulgaria is the only EU country that has reported an annual increase in ABs use during this period (ECDC data). A growing part of Bulgarians, believe that ‘ABs kill viruses’ and is unaware that ‘unnecessary use of ABs makes them ineffective’ (Eurobarometer 2022). This limited understanding of adequate ABs use resulted in counterproductive behaviors that demand change. Introducing innovative policy instrument as a tool for behavioral change: Undeniably, drug prescription monitoring has the potential to change consumers’ behaviors. In October 2023 mandatory electronic prescribing (e-Rx) for ABs was introduced in Bulgaria at a primary healthcare level. Consequently, there was an observed decline exceeding 30% in ABs sales (IQVIA Bulgaria data), evidencing a reduction in ABs consumption. However, there were negative reactions by the stakeholders, due to time-consuming procedures, nonoptimal IT infrastructure, etc., and that led to e-Rx-moratorium. Finally, in April 2024, the e-Rx is sustainably introduced.

Conclusions
Legislative measures, like e-Rx, can hinder the chaotic use of ABs. Moreover, Bulgarians need to reflect on their behaviors and values of solidarity which OH offers. Herewith, a multidisciplinary team of academic educators unite their OH efforts in raising awareness related to AMR and the rational use of ABs. Years of national endeavors toward healthcare digitalisation led to the introduction of e-Rx for ABs in Bulgaria. Research will prove its relevance for the rest of Europe.

Key messages
• To the European community: The introduction of the innovative policy tool (e-Rx for antibiotics) in Bulgaria is a significant national effort in making Europe a best-practice region regarding AMR.
• To the Bulgarian society: Antibiotics are not bonbons! Responsible ABs use of every one of us can contribute to the EU efforts to manage AMR. In the context of AMR, every person is a stakeholder.