bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incentivization of Sexually Transmitted Infection Testing at a Large Public University
Authors: Farah R , Ferrara R , Hayden M , Holstege C 
Published: October 2024

Abstract

Background
According to the United States (U.S.) Centers for Disease Control and Prevention, more than 2.5 million cases of syphilis, gonorrhea, and chlamydia were reported in 2022, with notable increases in gonorrhea and chlamydia. The highest rates of chlamydia, gonorrhea, and syphilis were found in men and women of college age. This study compared free STI testing events to usual care with regard to patient socio-economic factors and testing positivity rates.

Methods
The Department of Student Health & Wellness at a large, public university offers routine testing at a low cost, flat rate, including chlamydia, gonorrhea, hepatitis C Ab, syphilis and HIV testing. Two weeks of free testing were held during calendar year 2023. Utilization and positivity rates between free testing and regular testing weeks were compared using Pearson’s chi squared and Fisher Exact tests.

Results
A total of 8705 tests were performed during routine testing weeks with associated cost averaging 174 tests per week as compared to 1177 tests for the free testing weeks averaging 589 tests per week. Testing uptake during free testing weeks was higher among females (65.6% (n = 772) vs. 55.1% (n = 4797); p &lt; 0.001) and minorities such as, Black or African American [11.3% (n = 133) vs. 9.4% (n = 813); p = 0.02], Hispanic [11.4% (n = 134) vs. 9.2% (n = 798); p = 0.02] and Asian [13.1% (n = 154) vs. 8.8% (n = 763); p &lt; 0.001] when compared to testing during regular weeks. Chlamydial infection positivity rate was lower during the free testing weeks [1.8% (n = 7)] vs. [3.9% (n = 123); p = 0.04]. Gonorrhea, hepatitis C, HIV, and Syphilis positivity rates did not differ between the two testing periods.

Conclusions
Free STI testing in the context of a large, public university Student Health Department shows increased utilization. The establishment of free testing weeks was associated with an increase in female students and minorities use of testing services at a large public university.

Key messages
• Incentivization can improve STI testing utilization among university students.
• The establishment of STI free testing periods can increase the use of testing services among minority students and females.
Developing a nationwide dataset of UK veterans seeking help from sector charities
Authors: Serra G , Tomietto M , McGill A , Kiernan M 
Published: October 2024

Abstract

Background
The assistance to military veterans and their families in the UK is provided by both the NHS and over 1800 military charities. These charities count services using different definitions and reporting systems, so to date a national registry of service usage does not exist. The aim of the MONARCH study is to build a standardised registry of service usage data for the military charity sector, in order to identify patterns of use, gain insight on possible risk factors, and guide the allocation of resources.

Methods
Data is anonymised and a unique identifier is generated by adopting a Secure Hashing Algorithm, allowing both privacy protection and avoiding double counts. Data is standardised, and linked with an automated process to create an aggregated dataset. The dataset describes the population, using both a-priori and machine learning approaches (K-means clustering) to unveil different usage patterns. In addition, it will be linked to an online interactive dashboard.

Results
To date 5 national charities have shared data, for a total of 42,509 veterans with 128,423 needs. The mean age of beneficiaries was 60.1 years (SD 20.5), and 90% were male. 65% were receiving some other form of statutory benefit, 5% was homeless and 1% was imprisoned. 65% of the needs recorded concerned social wellbeing. 40% of veterans were helped at least in two different years. The k-means clustering approach based on the number of accesses, number of needs and repetition of need returned 4 subgroups of use that were identical to those created using a priori knowledge.

Conclusions
The dataset is the most comprehensive source of charity usage data in the UK to date. Service usage is generally homogenous among subgroups, but some differences were highlighted indicating that younger, non-officer veterans may be more at risk of presenting with more complex needs. These first useful insights can help allocate resources to build an effective preventive strategy for more complex cases.

Key messages
• The MONARCH dataset is the first comprehensive nationwide registry in the UK of military charity data.
• The understanding of usage patterns can lead to the design of targeted preventive strategies.
Inter-regional Hospital Patients’ mobility: Is co-operation better than competition?
Authors: Guarducci G , Moirano F , Nante N 
Published: October 2024

Abstract

Background
According to Italian law, citizens are free to choose their preferred place of care across the national territory. This study aims to analyze the associations between patients’ mobility between Tuscany (Italy) and other Italian regions and the complexity of Diagnosis Related Groups (DRGs) provided for these hospitalizations.

Methods
A retrospective study was conducted using 2019 Hospital Discharge Cards data of Tuscany provided by the Italian Ministry of Health. The surgical DRGs of each Major Diagnostic Categories (MDCs) were considered according to high specialty (HS) and non-high specialty (N-HS). For each MDCs, patients’ attractions, and escapes to bordering and non-bordering regions with Tuscany were associated with HS and N-HS surgical discharge DRGs by using the Odds Ratio. The analysis was performed using STATA software, and the significance level was set at 95%.

Results
For Digestive Diseases, patients from non-border regions were more likely to be attracted to Tuscan hospitals for HS DRGs (OR: 1.37 95%CI: 1.08-1.74; p &lt; 0,05), while for Musculoskeletal Diseases those from non-border regions were less likely to be attracted for HS DRGs (OR: 0.51 95%CI: 0.47-0.56; p &lt; 0,05). For Nervous Diseases (OR: 3.08 95%CI: 2.18-4.37; p &lt; 0,05), for Ear, Nose, Mouth And Throat Diseases (OR: 2.41 95%CI: 1.52-5.03; p &lt; 0,05) and for Hepatobiliary And Pancreas Diseases (OR: 4.55 95%CI: 2.71-7.68; p &lt; 0,05), Tuscan patients were more likely to escape to non-border regions for HS DRGs, while for Musculoskeletal Diseases (OR: 0.76 95%CI: 0.68-0.84; p &lt; 0,05) they were less likely to be admitted to non-border regions for HS DRGs.

Conclusions
The results suggest the necessity of establishing mobility agreements between regions, particularly for high-specialty DRGs. In fact, the provision of mobility care economically benefits the receiving (creditor) region, which provides the medical service, but is not advantageous to the patient’s region of residence (debtor).

Key messages
• Monitoring mobility flows is critical to improve identify possible lack of supply of resources.
• There is a need to develop interregional mobility agreements to ensure better cooperation between different regional health systems.
Characteristics of sick-listed employees diagnosed with a mental disorder in Germany
Authors: Starke F , Houkes I , Sikora A , Wegewitz U , de Rijk A 
Published: October 2024

Abstract

Purpose
Employees with mental disorders (MDs) are more likely to exit the labour market prematurely. In Western European countries, characteristics of employees diagnosed with a MD have not been reported comprehensively, hampering targeting the risk group and developing preventive interventions. The aim was to describe the socio-demographic, health, treatment, organisation, job and labour market characteristics of employees diagnosed with a MD in Germany and their gender differences.

Methods
This cross-sectional study uses baseline data from sick-listed (≥6 weeks) employees diagnosed with a MD, aged 20-60 years, who were patients in the German mental health care, and recruited in the context of a return to work (RTW) intervention evaluation trial (RTW-PIA study). Descriptive T-tests/Chi-2 tests were applied.

Results
484 individuals (58.5% female; 31% highly educated, average age 42.6) were included, of which 88.4% had affective disorders. Most were salaried employees working full-time, employed in large companies and having permanent contracts. 65.5% reported moderate depressions and the average work ability was 3.9 on a 0-10 scale. 74.2% had a positive RTW prognosis; 15.3% scored high levels of RTW self-efficacy. Gradual RTW (GRTW) was perceived the most important requirement for RTW (76.9%). More than 60% had discussed various work-related topics during therapy; further RTW-measures were prepared among 47.7%. Almost 60% received a recommendation for GRTW. Significant gender differences were found among the socio-demographic, health, job and labour market characteristics.

Conclusions
This study gives insights into a hardly investigated group. Almost two thirds had moderate depressions, 84.7% had low RTW self-efficacy and a very low average work ability. This highlights the vulnerability of persons with MDs in the labour market and suggest an urgent need for more work-related (health-)care. Gender differences need to be better addressed in mental health research.

Key messages
• Comprehensive knowledge of the characteristics of sick-listed employees diagnosed with MDs is crucial for targeting interventions to promote RTW.
• Moderate depression scores, low RTW self-efficacy and very low work ability highlight the vulnerability of persons with MDs in the labour market, suggesting an urgent need for more work-related care.
How do working conditions change for in-person versus digital work? The case of schoolteachers
Authors: MacEachen E , Hopwood P , Whitson J , Aurini J , Premji S , Miller M , AlMomani Y , Sultana I 
Published: October 2024

Abstract

Background
Telework has significantly increased in Europe and internationally in the aftermath of COVID-19 lockdowns, with estimates of 22% of Europeans now doing some form of telework. However, it is unclear how working conditions for the same job differ when work is conducted in-person versus digitally, and if occupational health risks can be considered as equal across formats. Our study addressed the profession of school teaching to examine online working conditions versus those for in-person teaching.

Methods
To allow for close consideration of employment contexts, a qualitative study was conducted. Focus groups and interviews took place in 2023-24 with 45 teachers and tutors who teach from kindergarten to secondary grades across Canada.

Results
We found that online teaching added to emotional labour of teaching work and involved new occupational exposures. These included challenges with engaging students via cameras and microphones, digital surveillance of teachers by parents and students, unwanted exposure to students’ intimate home lives, and technostress.

Conclusions
The work of being an online teacher was very different than teaching in-person, yet there has been slow recognition of working condition differences for understanding of OHS exposures and for collective agreements.

Key messages
• In the context of a significant expansion of telework, assumptions cannot be made that the job conditions and exposures are the same job when performed in-person or at-home.
• These differences will need to be recognized in job agreements and occupational risk assessments.
Heavy Work Investment (HWI) and Its Effect on Employees’ Physical and Mental Health
Authors: Inchi L 
Published: October 2024

Abstract

Background
Economic reality and centrality of work have led to employees investing much time and effort in work. However, The number of hours spent at work may not be the only explanation, and other characteristics, such as type of work, employees’ personality, economic status, motivations, etc., need to be considered. The Heavy Work Investment model (Snir & Harpaz, 2012) considers these variables and classifies employees into four types of investors. This study examines the physical and mental health consequences of each HWI group.

Methods
Participants (N = 962) were workers who came to a medical center for annual medical screenings. About 70% were males, and the average age was 50.13 years (SD = 9.53). They divided into 5 groups: Typical full-time workers (N = 208, 29.2%), ‘Needy’ (N = 111, 15.6%), ‘Employer directed’ (N = 111, 15.6%), ‘Workaholic’ (N = 192, 26.9%) and ‘Work devoted’ (N = 91, 12.7%). The personal data was cross-referenced with the respondents’ health data. Differences for categorical variables were examined with Chi-square analyses.

Results
‘Employer-directed’ employees, more than ‘work-devoted’ employees, perceived their health status as preventing them from performing mild activities. ‘Employer-directed’ and ‘needy’ employees, more than ‘work-devoted’ employees, perceived their health status as interfering with their social activities and their pain as interfering with their regular activities. ‘Workaholic’ employees suffered from more diseases than ‘work-devoted’ employees, and they were found to be 3.70 times more likely to be at a high risk of cardiovascular disease than typical full-time workers.

Conclusions
It is possible to anticipate types of health damage according to occupation type and develop occupation-adjusted health promotion programs. It is necessary to base labor laws on protecting employees’ health, particularly regarding time and workload’ outside of work’ in both hours (additional or flexible) and location (hybrid work).

Key messages
• Inspire organizations to be aware of potential injuries caused by HWI and promote the creation of intervention programs, potentially significantly improving employees’ health and well-being.
• Evidence for the necessary laws that protect employees’ health, particularly regarding time and workload ‘outside of work’ in both hours (additional or flexible) and location (hybrid work).
Association of Workplace Toilet Access with Urinary Tract Symptoms and Productivity Loss among Female
Authors: Lee Y M , Kang M-Y 
Published: October 2024

Abstract

Purpose
Lower urinary tract symptoms (LUTS) are prevalent among women, affecting not only their physical well-being but also their quality of working life. We investigate workplace toilet access related to LUTS among women in the Korean workforce.

Materials and methods
An online survey was conducted to determine the demographic characteristics, occupational risk factors, and urinary tract symptoms among employed Korean women. Occupational risk factors included three survey questions on access to toilets at work: A) enduring urinary symptoms at work; B) capability to use the toilet at will during work, and C) needing to use the toilet during work but were unable to. The LUTS were assessed using the overactive bladder symptom score (OABSS) and international consultation on incontinence questionnaire-urinary incontinence short form (ICIQ-SF). Health-related productivity losses (HRPL) were estimated using the work productivity and activity impairment (WPAI) questionnaire for urinary symptoms. Multiple logistic regression was used to determined the association between workplace toilet access and LUTS. In addition, generalised linear regression analysis was performed to assess HRPL according to workplace toilet access.

Results
Of the 1057 participants, 260 (24.6%) and 294 (27.81%) had overactive bladder and urinary incontinence, respectively. More than 50% reported poor access to toilet. Multiple logistic regression analysis showed that the lower the access to toilets in the workplace, the higher the incidence of LUTS and the higher HRPL.

Conclusions
Restricted access to toilets at work are associated with poor urinary health and loss of productivity. The results highlight the need for interventions to improve the workplace environment.

Key messages
• Restricted access to toilets at work are associated with poor urinary health and loss of productivity.
• The results highlight the need for interventions to improve the workplace environment.
Return to work after hip and knee arthroplasty: qualitative outcome from the Netherlands
Authors: Wouters N T , Wijnands KAP , Geilen I , van Tuijn I , Boonen B , Gielen C , Schotanus MGM 
Published: October 2024

Abstract

Background
Total Hip Arthroplasty (THA) and Total Knee Arthroplasty (TKA) are performed daily worldwide. More younger working-age patients are receiving a THA and/or TKA. Outcomes, including Quality-of-Life (QOL), patient satisfaction and Return-to-Work (RTW) are becoming more important and have implications for healthcare budget and health workforce. Clinical recovery pathways should improve patient outcomes and cost-effective care. Insight in patient experiences and expectations regarding RTW remains behind. This study aims to gain insight into influenceable factors in the recovery pathway after THA or TKA that could lead to improved care and enhanced patient participation.

Methods
In this single-center qualitative study, performed at Zuyderland Medical Center (Sittard-Geleen, the Netherlands), 12 patients (n = 6 THA; n = 6 TKA) aged under 65 years were approached to participate. During interviews 6-weeks after arthroplasty, this research explored their RTW experiences in both pre-, and postoperative, in- and outpatient settings.

Results
In total, 12 employed patients who received a THA (n = 6, mean age 56 ± 7.4 years; female: n = 4, 66%) or a TKA (n = 6, mean age 61 ± 2.6 years; female n = 3, 50%) participated. Own control regarding RTW and a minimal recovery time after the operation was necessary for all patients. During this time, focus on physical therapy and strengthening was most important. RTW was not expected to be the primary goal during the clinical recovery pathway. The RTW topic was said to belong to the occupational physician (OP) and employer. Patients however knowledge that the type of work should gain importance in the consultation room. Patients missed accessible communication between the orthopedic surgeon and OP.

Conclusions
Overall, patients are satisfied with the current clinical recovery pathway. Intercollegiate communication should be made more accessible. Own control and strengthening self-management in the RTW remain important for all patients.

Key messages
• Own control and strengthening self-management should have importance in the guidance of working-age patients after THA or TKA.
• Intercollegiate communication should be made more accessible.
Preparing a dataset for new life: cleaning a longitudinal study for new analyses and linkages
Authors: Morse A , Higgins K 
Published: October 2024

Abstract

Issue
The Belfast Youth Development Study (BYDS) was conducted from 2000-2010, comprising 7 waves of collection. The data contain valuable insights into the health and social lives of adolescents but were stored using inconsistent management practices and lacked a metadata crosswalk describing all variables and their content. Primary challenges to new analysts included shared questions entered using varying notations across waves of collection (“mother” and “yes” in a “mother lives at home” variable), single question responses stored wide across multiple variables, and a need for comprehensive metadata.

Description
Individual questions were un-joined from the linked dataset, cleaned using the tidyverse suite of packages in R, and then left-joined to the primary dataset. Where responses were recorded differently across years, scales were standardised across waves of collection. Questions were arranged in their original order to maintain dataset integrity.
Simultaneously, a crosswalk was created of each question, its old and new variable names, and its response scales. Rows for old variable names and response scales were collapsed into comma-separated values and deduplicated by the new variable names using the dplyr package.

Results
Following this work, the BYDS dataset is ready for new researchers to analyse and describe findings. A large grant has recently been awarded to conduct a new wave of data collection, the analysis of which will be enhanced by the cleaned dataset and its associated metadata.

Lessons
It is feasible and desirable to maintain older datasets through semi-automated practices facilitated through the tidyverse suite of packages in R. Improvements in data management since the initial digitisation of large datasets more than 20 years ago provide a framework for conducting this work.

Key messages
• The tidyverse suite of packages allow for low-burden cleaning and maintenance of important historical datasets to facilitate their ongoing use and preservation.
• There is value in supporting staff training on simple data management skills in R to support lower burden in data management practices.
Trade as a commerical determinant of health: The health impact of a free trade agreement on Wales
Authors: Green L , Silva L , Petchey L , Douglas M , Mcnamara C , Fletcher M , Clemens T 
Published: October 2024

Abstract

As a result of the UK’s withdrawal from the European Union (‘Brexit’), the UK can negotiate its own trade agreements for the first time in over 40 years. This includes the Comprehensive and Progressive Trans-Pacific Partnership Agreement (CPTPP). Public Health Wales undertook a mixed-method Health Impact Assessment (HIA) to assess the potential impact of the CPTPP on health, well-being and inequalities in Wales. It is only the second ever HIA carried out on a free trade agreement (FTA) globally. A literature review on the potential impact of the CPTPP on health was conducted. Qualitative interviews with cross-sectoral representation, such as the environment, were undertaken alongside the development of a community health and demographic profile. The HIA identified significant potential impacts across health determinants, e.g., employment, agricultural production and health care, as well as impacts on population groups, e.g., those on low incomes. The Investor State Dispute Settlement (ISDS) mechanism, economic uncertainty and loss of regulatory alignment were identified as potential pathways for health impacts to affect the population. The HIA highlighted trade as a key commercial determinant of health. The findings have been beneficial in informing policy and decision-makers to prepare for the implementation of the CPTPP and take action to maximise opportunities and prevent potential negative impacts. Communicating HIA evidence that links trade to health has also led to valuable cross-sector and cross-UK engagement and sparked a “rethinking” of trade through a well-being economy lens where health, well-being and sustainability are primary objectives. This work has demonstrated the value of a HIA approach to FTAs by mobilising a range of evidence through a transparent process, resulting in transferrable learning for others as well providing an entry point for public health to have direct engagement with trade negotiators and those participating in trade discussions.

Key messages
• Trade agreements are a key commercial determinant of health across health behaviour, policy and economy.
• Multiple population groups are affected by trade agreements both positively and negatively.