bluuebunny/crossref_metadata_2025_split huggingface dataset:
Machine learning algorithms for prediction of double burden of malnutrition among Tunisian adults
Authors: Zribi M , Zaier F , Zoghlami N , Elati J , Traissac P , Aounallah-Skhiri H 
Published: October 2023

Abstract

Background
Malnutrition, referring to both nutritional deficits and excess adiposity (EA), currently affects one third of the world population. In Tunisia, nutritional deficits are still major challenges in a context of epidemiological and nutritional transition. The objectives of our study were to identify the potential risk factors of DBM and propose a better machine learning (ML) based model for predicting DBM among Tunisian adults.

Methods
About 7963 respondents aged 20 years and over were taken from Tunisian Health Examination Survey (THES), a cross-sectional national household survey undertaken in 2016. DBM was defined as the association of EA and anemia. EA was defined as a waist-to-height ratio ≥0.6 and /or overweight: BMI ≥25kg/m2. Anemia was defined as hemoglobin (Hb)&lt;13g/L in men and Hb &lt; 12g/L in women. The potential risk factors for malnutrition were extracted using logistic regression (LR). Five ML algorithms including Naïve Bayes, support vector machine (SVM), artificial neural network (ANN), AdaBoost and random forest (RF) were employed for predicting DBM and their performance was evaluated using accuracy, precision, recall, and area under the curve (AUC).

Results
LR illustrated that age, sex, region, wealth index, educational level and marital status were identified as potential risk factors for DBM. AdaBoost had the highest accuracy (89.8%), followed by SVM (89.6%). Naïve Bayes had the highest Recall (98.1%) and the most performant AUC (91.4%), while RF had the highest Precision (70.8%). The ANN had an accuracy of 89%, a precision of 70.4%, a recall of 78.7% and an AUC of 0.851.

Conclusions
The study demonstrated the efficacy of ML algorithms in predicting DBM in Tunisian adults. AdaBoost and SVM showed the highest accuracy, and could be utilized as an early detection tool to manage DBM and alleviate the burden on the healthcare system. However, larger and more diverse datasets are needed for further validation.

Key messages
• Double burden of malnutrition, defined as the coexistence of undernutrition and overnutrition, is a significant issue globally and a major challenge in Tunisia.
• Machine learning algorithms, particularly AdaBoost and SVM, can be effective tools for predicting and managing double burden of malnutrition in Tunisian adults.
HIA as a standard tool for effective decision-making on NCD policies
Authors: Pekarcikova J 
Published: October 2023

Abstract

Background
Increasing rates of NCD are observed within EU countries. This paper aims to highlight the potential of Health Impact Assessment (HIA) in informing projects, plans, and programs related to health improvement, thus enhancing its role in the decision-making process.

Methods
The preliminary analysis focuses on HIA's involvement in the decision-making process regarding NCD in the EU, particularly in CEE countries over the past decade. The study examines various aspects of the identified HIAs, including their general information, the time frame of the HIA, proposed preventive measures, methods used, the description of the determinants of health affected by the decision, the type of document assessed, the affected population, the impact of the HIA on subsequent decisions, the source and cost of funding, the limitations of the study, HIA as a part of EIA or not, the use of artificial intelligence algorithms in the possibility of HIA implementation, etc. The impact of each HIA on subsequent decisions was categorized using an adaptation of a classification system developed by Wismar et al. for use in evaluating European HIAs (Wismar et al. 2007).

Results
The findings suggest that HIA is crucial in addressing the public and providing transparent information to entities with decision-making authority. It is recommended that the HIA process be a standard tool used to clarify information on health risk factors, implement new health policies, and monitor their effectiveness. The study also indicates that a completely digital approach to HIA is an open question that requires further research. AI algorithms can potentially aid in improving HIA's efficiency and processing complex information and data.

Conclusions
HIA has excellent potential to improve the decision-making process related to non-communicable diseases, and its incorporation as a standard tool is essential. The use of AI algorithms in HIA implementation is a promising area for future research.

Key messages
• HIA is a crucial tool in addressing the public and providing transparent information to entities with decision-making authority.
• The use of AI algorithms in HIA implementation is a promising area for future research.
Time from sickness absence due to cancer until return to work by locations and sex, Catalonia, Spain
Authors: Ayala A , Benavides F G , Serra L 
Published: October 2023

Abstract

Background
Number of people diagnosed with cancer in the workplace are expected to increase steadily. Sickness absence is a tool of social protection system through which workers with a health problem can get absence from work, while receive economic and medical support until they are able to return to their workplace.

Methods
Cohort study of 426 affiliates to Social Security (57.5% women), residents in Catalonia who suffered an sickness absence due to a cancer between 2012-2015. Individuals were followed up from the beginning of the sickness absence episode until return to work. Kaplan Meier survival estimates were applied, stratified by sex, to compare time until return to work distinguishing between different cancer locations.

Results
Median age among workers who returned to work after an sickness absence was 49.3 years (sd 9.2). Among men, most frequent locations were male genital organs (28.7%), digestive (23.2%) and urinary organs (22.7%), and among women, breast and female genital organs (61.2%) and skin neoplasm (21.6%). Maximum time until return to work was 11.2 months. The median time until return to work was 1 month in both sexes. In men, we found the longest median time in male genital organs with 38 days and the lowest in skin cancer with 10 days. In women, we found the longest median time in digestive and the lowest in skin neoplasms with 14 days. Kaplan Meier curves showed bigger differences in time to return to work between locations among women than among men. Differences between both sexes were found statistically significant (p &lt; 0.0001).

Conclusions
Most of the people who survive a cancer go back to employment. Time until return to work vary between cancer locations and sexes. Studying return to work of people who suffer a cancer allows us to determine how the disease affects survivors and society to better understand specific needs of survivors and detecting vulnerable groups.

Key messages
• Time from sickness absence due to cancer until return to work vary between cancer locations and sexes.
• Research on sickness absence in important to better understand specific needs of survivors and detecting vulnerable groups.
The association of depressive symptoms with perceived occupational noise exposure in young adults
Authors: Heinonen-Guzejev M , Whipp A M , Wang Z , Anu Ranjit A , Palviainen T , van Kamp I , Kaprio J 
Published: October 2023

Abstract

Background
Previous studies show that occupational noise annoyance is associated with depressive symptoms. This study aimed to investigate the association of perceived occupational noise exposure and depressive symptoms in young adulthood and to evaluate whether noise sensitivity mediates or moderates this association. This study was part of Equal-Life program, grant No 874724.

Methods
The study was based on FinnTwin12, an ongoing longitudinal twin study. We included those participants who were working daily (n = 521) or weekly (n = 245) during the past 12 months. Mean age was 22.4, SD 0.7, 53% were female. The main analysis was to examine the association between perceived occupational noise exposure and depressive symptoms in young adulthood, at age 22. We studied depressive symptoms using the General Behavior Inventory (GBI). We also studied whether depressive symptoms assessed at age 17 were associated with perceived noise exposure at work at age 22. Linear regression analyses were used. Noise sensitivity and other covariates were included in linear regression models.

Results
Perceived daily occupational noise exposure was associated with depressive symptoms at age 22 (beta 1.19; 95% CI 0.09, 2.29) in all participants, and separately in females (beta 2.22; 95% CI 0.34, 4.09) but not males (beta 0.22; 95% CI -1.08, 1.52). Noise sensitivity was independently associated with depressive symptoms in all (beta 1.35; 95% CI 0.54, 2.17), and separately in males (beta 1.96; 95% CI 0.68, 3.24) but not females (beta 1.05; 95 % CI -0.04, 2.13). Pre-existing depressive symptoms at age 17 were predictive of perceived occupational noise exposure at age 22. Noise sensitivity was independent of perceived occupational noise exposure.

Conclusions
Perceived occupational noise exposure was associated with depressive symptoms in young adults, females in particular. Noise sensitivity was independently associated with depressive symptoms in all, males in particular.

Key messages
• In young adults and females in particular, perceived daily noise exposure at work was associated with depressive symptoms.
• Noise sensitivity was independently associated with depressive symptoms among all participants, males in particular.
Association between bed supply and pneumonia hospitalization according to hospital types in Korea
Authors: Kweon S S , Yang J H , Lee E Y , Kim J H , Kim H Y , Shin M H , Jang Y L 
Published: October 2023

Abstract

Background
An ecological study was conducted to determine the causes of regional differences in hospitalized pneumonia incidence in Korea. We evaluated the association between regional bed capacity and pneumonia hospitalization rates, and the interaction of hospital type.

Methods
Variables of hospitalized pneumonia patients (n = 2,226,243) aged 19 years from 2015 to 2020, prior to the COVID-19 pandemic, were extracted from the Korean National Insurance database. Age-standardized pneumonia hospitalization rates per 10,000 population by region and year were calculated. Multilevel linear regression was conducted to assess the association between the regional number of beds by hospital type and pneumonia hospitalization rates. The multilevel analysis was stratified by length of stay (LOS) and whether recommended clinical practices for pneumonia treatment were performed during hospitalization.

Results
Pneumonia hospitalization rates were highest in the Gwangju metropolitan city. The excessive pneumonia hospitalization rate in Gwangju occurred mainly in primary care (PC) and nursing care (NC) hospitals. A significant positive association between regional number of bed supply and pneumonia hospitalization rates (p-value=0.0157) was found. Interaction effect of hospital type and regional bed number supply was statistically significant (p-value&lt;0.001). Positive association between regional bed supply and hospitalization rates was prominent in low grade hospitals, such as PC or NC hospital, and with the poor adequacy of pneumonia care, including long LOS and without recommended clinical practices.

Conclusions
The results suggest that while public health benefits can be expected from increased regional bed availability, there may be unexpected harms associated with supplier-induced demand for hospitalization, mostly in inferior hospitals. Therefore, hospital type and quality of medical care also should be considered in the process of expanding bed capacity in a region.

Key messages
• Regional difference of pneumonia hospitalization rates was associated with hospital bed capacity.
• Supplier induced hospitalization of pneumonia occurred mainly in inferior type of hospital.
Evaluation of family physicians’ attitude towards primary healthcare consultations
Authors: Jasiukaitiene V , Venckute I 
Published: October 2023

Abstract

Background
The quality of services in the health care system is very important for both patients’ health and health care providers. In the past decade, good service ratings from the patient's perspective have become crucial in evaluating the work of medical professionals and health care institutions. However, it is also important to consider the opinions of health care specialists, especially when it comes to medical consultation, which is one of the most important components of primary health care (PHC) chain.

Aim
To evaluate the attitude of family physicians (FP) towards consultations provided in PHC.

Methods
The study was conducted in 2022. December - 2023 in February. The research contingent is FP of Lithuania. Research method - quantitative momentary research, anonymous questionnaire survey, 206 subjects were interviewed. Calculated chi-square (χ2) and z-criterion.

Results
The majority of FP indicated that they involve the patient in the decision-making process (68.0%), those working in private institutions said so more often than those working in public institutions (p &lt; 0.05). 89.3% of the subjects stated that the consultation time with the patient is not enough, and 70.4% respondents receive many unregistered patient visits per day. E-health makes it difficult for 81.1%, 86.4% of the respondents indicated that there is too much of a workload and this was mostly said by respondents working in public institutions (p &lt; 0.05). Remote consultations facilitate the workflow (76.2%). The older age of the respondents and greater work experience lead to lower self-confidence during remote consultation, longer consultation time and less belief in the benefits of remote consultation (p &lt; 0.05).

Conclusions
Most FP positively evaluate the consultation they provide, but they also said that the consultation time is insufficient, they must consult a number of unregistered patients, e-health complicates the work. Remote consultations facilitate the workflow.

Key messages
• The consultation time is insufficient.
• Remote consultations facilitate the workflow.
Prejudices towards the Romas in Hungarian healthcare: taboos and areas to tackle inequalities
Authors: Marek E , Katz Z , Szilard I , Orsos Z , Nemeth T 
Published: October 2023

Abstract

Background
The Roma or Gipsy population is the largest ethnic minority both in Europe and Hungary with 10-15 years lower life expectancy and worse health indicators than majority populations. The aim of our study was to investigate a sensitive and controversial issue: the perspectives of Hungarian health professionals about the presence and impacts of prejudice towards Roma patients.

Methods
Semi-structured interviews were conducted between June 2017 and May 2018 involving 19 healthcare professionals. Qualitative methods were applied to analyse the transcripts.

Results
The presence and occasional manifestation of prejudices against the Romas were confirmed by the interviewees, most commonly in the form of longer waiting time, comments or other meta-communicative tools. Prejudicial attitudes and discriminatory behaviour are less common in wards where the prevalence of disadvantaged patients (HIV-positive, homeless) is higher (e.g. infectology). Prejudice is not specifically directed at the Roma ethnic minority, but also extends to populations living in poor socio-economic conditions, or with underlying self-destructive behaviour (alcoholism, drug use). In the opinion of our interviewees, occasional prejudicial behaviour does not lead directly to sub-standard care and poorer health, but it cannot be ruled out that it may indirectly contribute to it, in case the patient does not seek medical attention due to a former negative experience within healthcare. In terms of prevention, the education of both parties and the prevention of burnout of health providers are essential tasks for the future as this latter may also enhance the manifestation of prejudices.

Conclusions
Our study includes the investigation of a highly sensitive and understudied area of research. Our findings may provide a better understanding of Hungarian health professionals’ views on the effects of prejudice towards the Roma patients in healthcare, as well as about the need and strategies of prevention.

Key messages
• Direct relationship between healthcare providers’ prejudices and the lower quality of healthcare services or the worse health status of Roma patients may be excluded.
• Indirect negative effects of prejudices may occur in cases where a patient refrains from seeking care due to previous perceived or experienced discrimination.
Determinants of implementing the ID ROLL OUT study's interventions: qualitative results
Authors: Wimmesberger N , Allen R , Först G , Fink G , Giesen R , Kern W V , Rieg S , Farin-Glattacker E 
Published: October 2023

Abstract

Issue
Antimicrobial stewardship programmes (ASP) and infectious disease (ID) specialists aim to ensure the rational use of antimicrobials and to improve patient outcomes. Whilst ASPs are established to varying degrees, ID specialists are rarely available in secondary and tertiary care hospitals in Germany.

Description of the problem
With the ID ROLL OUT study, we implemented and evaluated an intervention, which comprises ASP with and without ID specialists’ consultation in ten hospitals (excl. university hospitals) in south-west Germany. Little has been reported on the medical and pharmaceutical staff's perspectives on the implementations. This study describes barriers, facilitators, and suggestions for improvement to successfully establish a large-scale multicentre intervention. The participants responsible for implementing the intervention were interviewed using semi-structured, guided interviews at two time-points (t1: n = 17; t2: n = 18). The recorded interviews were analysed for content, following Kuckartz.

Results
A high level of acceptance and a positive attitude towards the intervention are conducive to the intervention's successful implementation. The teams find extra time for the study and a close staff collaboration at a local team level to be helpful. The main barriers identified are a high workload, lack of acceptance by colleagues in key roles, and the Covid-19 pandemic. Lack of digitalisation and entrenched internal structures were identified as major barriers. To further improve implementation, more infectious disease training should be provided, along with support from superiors and extension of the intervention phase. Moreover, government-mandated ASP guidelines and quality management by the German Medical Association are desired and expected to contribute in the future.

Lessons
The identified determinants provide much-needed key information, which is important for the efficient, targeted and successful implementation of future similar interventions.

Key messages
• Acceptance, positive attitude and staff collaboration help to implement the intervention.
• Heavy workloads and lack of support from key colleagues hinder the intervention’s implementation.
Hospital management of an epidemic in intensive care: a predictive tool for saturation
Authors: Capitanio L , Josseran L , Dumas L , Gautier S 
Published: October 2023

Abstract

The COVID-19 epidemic has highlighted the importance of hospital resource management in exceptional health contexts. The hospital capacity of intensive care units has emerged as a determining factor in overall hospital management. The objective of this study is to create a tool for predicting the saturation status of an intensive care unit. The predictive model was developed based on a SIR compartmental model. The model was trained using hospitalization data (admissions, discharges, and capacity) from the Raymond Poincaré Hospital, AP-HP. The model parameters (transmission and recovery rates) were estimated using the least squares method. A web application, OHASiS® (Outil Hospitalier d'Analyse de Situations de Saturations), was developed using Shiny and embeds the model. The model provides a reliable prediction over 7 days of the evolution of the number of admissions and discharges in COVID-19 intensive care units. Information on capacity makes it possible to predict a possible saturation of the service. A sensitivity analysis of the model revealed no significant difference between predicted and observed attendance data. The OHASiS® tool allows for the visualization of epidemiological data and helps with medical decision-making as the epidemic evolves. It would be desirable to integrate this application into future hospital management plans. This tool could also be used during simulation exercises. Validation of the predictive model in the context of seasonal epidemics still needs to be conducted.

Key messages
• A SIR compartmental model was used to develop a tool for predicting the saturation status of ICU.
• The web application OHASiS® can help with medical decision-making and should be integrated into future hospital management plans, though further validation is needed for use during seasonal epidemics.
Organisational and Structural Drivers of Childhood Immunisation in the European Region
Authors: Valdecantos R L , Palladino R , Lo Vecchio A , Montella E , Triassi M , Nardone A 
Published: October 2023

Abstract

Background
Evaluating the immunisation program is vital to identify the inherent factors that impact the achievement of the intended countrywide vaccine coverage rates (VCRs). However, despite the implementation of widespread vaccination programs, the European Health Systems continue to experience care challenges attributable to organizational and structural issues. This study aimed to review the available data on aspects within the organizational and structural domains that might impact vaccination coverage.

Results
This systematic review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched a comprehensive range of databases from 1 January 2007 to 6 July 2021 for studies that reported quantitative or qualitative research on interventions to raise childhood vaccine coverage. Outcome assessments comprised organizational and structural factors that contribute to vaccine concerns among pediatric parents, as well as data reported influencing the willingness to vaccinate. To analyze the risk of bias, the Ottawa, JBI's (Joanna Briggs Institute) critical appraisal tool, and Amstar quality assessment were used accordingly. The inclusion criteria were met by 205 studies across 21 articles. The majority of the studies were conducted in the United Kingdom (6), the European Union (3), and Italy (3).

Conclusions
A range of interventions studied in primary health care settings have been revealed to improve vaccination coverage rates including parental engagement and personalization, mandatory vaccination policies, vaccine program redesign, vaccine supply chain design, administering multiple/combination vaccines, improved vaccination timing and intervals, parental education and reminders, surveillance tool and Supplemental Immunisation Activity (SIA), and child health information model.

Key messages
• Maintaining high vaccine uptake rates is critical to the success of any vaccination program and the improvement of children’s health.
• Parents and the general public must be actively engaged by health planners and specialists, and process mechanisms must be implemented to guarantee that children receive primary prevention.