bluuebunny/crossref_metadata_2025_split huggingface dataset:
A systematic review of case-series studies on the effectiveness of interventions to reduce polypharmacy and its adverse consequences in the elderly
Authors: Michelazzo Maria Benedetta , Milovanovic Sonja , Boccia Stefania 
Published: April 2023

Background. Aging is frequently accompanied by chronic diseases; as a consequence, older people are often exposed to polypharmacy that has been associated with negative health-consequences. The aim of this study is to conduct a systematic review of the literature reporting on the effectiveness of different approaches to reduce polypharmacy in the elderly.
Methods. We conducted a comprehensive literature search of MEDLINE, Scopus and ISI Web of Knowledge databases. Eligible studies were case-series reporting outcomes of interventions aimed at reducing polypharmacy and its consequences in the elderly. A quality appraisal of the studies included was performed.
Results. Nineteen studies were included, of which six conducted in community setting, seven in hospital setting, and six in nursing homes. Seventeen of them were judged as moderate quality, and two of them as poor quality. The majority of the interventions were carried out by pharmacists, alone (35%) or with other professionals (40%). Interventions consisted in pharmacotherapy reviews based on various tools and software; in some cases educational interventions were performed for review-performers and patients. Studies conducted in community-setting provided also a feedback to primary care physician. The outcomes included five categories: therapy’s characteristics (e.g. number of drugs, appropriate prescriptions), quality of life, health-related outcomes, costs, healthcare services’ utilization. Therapy-related outcomes were those more affected by all types of interventions.
Conclusion. Interventions aimed at reviewing patients’ therapy are effective in optimizing the use of drugs, and could be considered also in improving quality of life, healthcare costs, services’ utilization, and health-related outcomes.
Pubertal maturation and health risk behaviors in adolescents: a systematic review
Authors: Morais de Azevedo Kesley Pablo , Dos Santos Isis Kelly , Silva Dantas Paulo Moreira , Knackfuss Maria Irany , Bento Teresa , De Leitão José Carlos , De Medeiros Humberto Jefferson 
Published: April 2023

Objective: The objective of this academic work is to demonstrate evidences available in literature about the association among the pubertal maturation and health risk behavior in adolescents.
Methods: It was used the database from MEDLINE/Pubmed, Scopus, Lilacs and Web of Science. The terms used in the research, with its variations, were “puberty”, “maturation”, “maturity”, “risk behaviors”, “risk factors”, “adolescent” and “student”.
Results: Out of 838 manuscripts found in the databases, after the sorting and applied the eligibility criteria, remained in this systematic review 13 articles. Early maturation was associated significantly with the use of alcohol, cigarettes and illegal drugs, early sexual initiation, sedentary behaviors and involvement in fights, where girls showed higher prevalence.
Conclusions: Henceforth, the results from the current study indicates that the early maturation is associated with health risk behaviors in adolescents, especially with the use of alcohol and cigarettes.
Cut-off point estimation of Neck circumference to determine Overweight and Obesity among Asian Indian adults
Authors: Mondal Nitish , Timungpi Ruplin , Kathar Moniram , Hanse Sarlongki , Teronpi Siko , Timung Ajitsingh , Bose Kaushik , Sen Jaydip 
Published: April 2023

Background: Neck circumference (NC) is a relatively new anthropometric measure of differentiating body fat distribution and considered as a marker of upper subcutaneous adiposity.
Aims and Objectives: The present study was undertaken to assess the suitability and cut-offs estimation of NC to determine overweight and obesity in Asian Indian adults.
Materials and Methods: The present cross-sectional study was carried out among 1830 adults (914 males; 916 females) aged 20-49 years of Karbi-Anglong, Northeast-India, using multistage-stratified sampling method. Height, weight, waist circumference (WC) and neck circumference (NC) were recorded using standard procedures. The body mass index (BMI kg m−2) was calculated and overweight and obesity were assessed using standard cut-offs. Results: Linear and binary logistic regression analyses showed that NC had a better predictive value of BMI (p<0.001). The ROC-AUC results showed that NC seems to have relatively better predictive value in greater adiposity (BMI≥30.00 kg m−2) among both males (AUC 0.83, 95% CI: 0.81-0.86) and females (AUC 0.88, 95%CI: 0.85-0.89) (p<0.01). The cut-offs of NC were observed to be 36.0 cm and 38.0 cm (in males) and 30.9 cm and 33.0 cm (in females) for BMI ≥25.00 kg m−2 and BMI 30 kg m−2, respectively.
Conclusion: Further studies should be undertaken to determine and validate the existing and/or newly proposed cut-offs among larger samples for pan-Indian cut-offs for the assessment of overweight and obesity and related risks of non-communicable diseases and metabolic disorders.
Health promotion actions in mass-media for seniors in selected European countries
Authors: Rogala Maciej Bartłomiej 
Published: April 2023

Background
The paper consists results of research aimed at health promotion for older people (HP4OP) in mass-media in 10 selected European countries involved in project ProHealth 65+. Identification, describing and analysis of contemporary good practices sector in media allowed for review selected interventions, programmes and actions directed to seniors corresponding to health promotion. Research indicated main relationships that determine presence of media activities in health promotions focused on seniors.
Methods
The content of report has been focused on target group of elderly and prepared on ground of the literature review on public health and health promotion, analysis and evaluations of EU programmes and official reports, research studies focused on impact of mass-media for health, indications of experts and partners in project ProHealth 65+, documents describing realisations of mass-media initiatives, good practices in HP4OP and searches using PubMed, Web of Science, Google Scholar, Google and base CRODIS.
Results
The results of the research conducted that mass-media as sector can be one of a tool enabling promotion of health for older people through activities directed to HP4OP. Results of the studies showed that mass-media engaged in health communication process apply all kind of health promotion functions. Research confirm significant role of media influencing knowledge, attitudes and behaviours about health related topics.
Conclusion
In the report was presented significance and important functions of media in societies not as a tool of information but additionally a source of education and raising awareness in context of healthy and active ageing strategy in Europe. However potential of mass-media seems to be not completely appreciated and used in HP4OP process in 10 analysed countries. The conclusion can be substantial issue to further discussions and finding solutions how to strengthen engagement of mass-media in HP4OP.
Central and territorial governmental institutions involved in health promotion for older people in European Union countries
Authors: Domagala Alicja 
Published: April 2023

Defining, planning and achieving health goals including health promotion and health promotion for older people (HP4OP) are always the responsibility of the public authority. In European countries the public health and health promotion strategic framework, including HP4OP is provided by the ministry of health or others national public health organisations, which are responsible for defining of legal regulations on the different aspects of health promotion.
The goal of this article is the analysis of the central and territorial government (CTG) sector’s involvement in the issue of HP4OP, their functions, activities and responsibilities in this area. The analysis is focused on the main differences and similarities between CTG’s institutions.
The authors triangulated data collected using varied methods: literature review, questionnaire research (conducted in European Pro-Health 65+ project’s countries) and in-depth interviews with national experts from selected countries.
In the majority of analysed countries, the central government and municipalities are the main stakeholders responsible for providing funding for these programs. The operational level for the implementation of majority HP4OP is the local level. Research countries have been identified as strongly varying in institutional, legal and political specificity. The analysis shows the increasing position of HP4OP in public health policy. Many of the identified problems come from the implementation of a fragmented approach, the duplication of efforts undertaken by different stakeholders and the lack of a co-ordinated strategy and dedicated legal regulations at both the national and regional/local levels.
Workplace health promotion programs in different areas of Europe
Authors: Magnavita Nicola , Capitanelli Ilaria , Falvo Roberto , La Milia Daniele I. , Borghini Alice , Moscato Umberto , Poscia Andrea , Ricciardi Walter 
Published: April 2023

Background
Aging of the workforce challenges European countries. Keeping aged workers healthy and productive, through health promotion, is a key goal of European labour policy. The aim of the present study was to collect experiences of workplace health promotion for older workers (WHPOW) conducted in 10 representative countries of Central Europe, Eastern Europe and the Mediterranean.
Methods
A literature review of activities of WHPOW was conducted through a comprehensive search of major scientific databases and on the website of the major European Agencies on worker health promotion. The search was restricted to papers published in English from 2000 to 2015. Companies were asked for additional documentation about WHPOW programmes in a survey conducted with SurveyMonkey.
Results
A total of 756 initiatives regarding WHPOW were identified. 134 of these were guidelines, regulations, or review studies. The remaining 622 activities were intervention studies performed or promoted in the workplace and targeted at older workers or at the aging of the workforce. Most of the programs were carried out in Central Europe (295, 47.4%), less in East Europe (193, 31.0%) and in Mediterranean countries (134, 21.6%).
Conclusion
Our study shows that there are only a limited number of WHPOW actions throughout the 10 selected European Countries. While in Central Europe widespread interest in issues of aging workforce has resulted in national policies to encourage WHPO, not all the countries of Eastern Europe are equally well equipped. Lastly, in Southern Europe health promotion activities are largely inadequate compared to needs.
Health promotion for the oldest seniors in the social sector. Examples of policies and programmes from Poland and the Czech Republic
Authors: Sowa-Kofta Agnieszka , Szetela Anna , Golinowska Stanisława 
Published: April 2023

The article identifies health promotion activities for the oldest people, who often become users of social services due to loss of capabilities, solitude and raising care needs related to worsening health status. The analysis is based on the literature overview, experts’ consultations and interviews on the role of the social sector institutions in health promotion in selected countries. Examples of best practices in health promotion for older people in the social sector are presented. These include programmes of health information and campaigns on health risks avoidance, stimulation of physical activity, healthy eating for the oldest seniors, promotion of mental health and support of cognitive abilities, primary prevention activities and stimulation of social and cultural participation. The article concludes that health promotion activities for the oldest population, although on the side of main activities of the social sector, are an important element of activities of public and non-public institutions in providing care to dependent populations. Good practices identified typically involve numerous health promotion activities and require cooperation at the national – policy setting – level and within community.

The article identifies health promotion activities for the oldest people, who often become users of social services due to loss of capabilities, solitude and raising care needs related to worsening health status. The analysis is based on the literature overview, experts’ consultations and interviews on the role of the social sector institutions in health promotion in selected countries. Examples of best practices in health promotion for older people in the social sector are presented. These include programmes of health information and campaigns on health risks avoidance, stimulation of physical activity, healthy eating for the oldest seniors, promotion of mental health and support of cognitive abilities, primary prevention activities and stimulation of social and cultural participation. The article concludes that health promotion activities for the oldest population, although on the side of main activities of the social sector, are an important element of activities of public and non-public institutions in providing care to dependent populations. Good practices identified typically involve numerous health promotion activities and require cooperation at the national – policy setting – level and within community.
Poisson mixture distribution analysis for North Carolina SIDS counts using information criteria
Authors: Massaro Tyler 
Published: April 2023

Mixture distribution analysis provides us with a tool for identifying unlabeled clusters that naturally arise in a data set. In this paper, we demonstrate how to use the information criteria AIC and BIC to choose the optimal number of clusters for a given set of univariate Poisson data. We give an empirical comparison between minimum Hellinger distance (MHD) estimation and EM estimation for finding parameters in a mixture of Poisson distributions with artificial data. In addition, we discuss Bayes error in the context of classification problems with mixture of 2, 3, 4, and 5 Poisson models. Finally, we provide an example with real data, taken from a study that looked at sudden infant death syndrome (SIDS) count data from 100 North Carolina counties (Symons et al., 1983). This gives us an opportunity to demonstrate the advantages of the proposed model framework in comparison with the original analysis.
Childhood vaccinations. Validation of a tool for measuring knowledge, attitudes and vaccine hesitancy in pregnant women
Authors: Massimi Azzurra , Rosso Annalisa , Marzuillo Carolina , Prencipe Grazia Pia , De Soccio Pasquale , Adamo Giovanna , Sturabotti Giulia , De Vito Corrado , Villari Paolo 
Published: April 2023

Background. The objective of this pilot study was to test a questionnaire aimed at assessing knowledge of and attitudes towards vaccination, as well as intention to vaccinate, among pregnant women.
Methods. The questionnaire was self-administered by 49 pregnant women attending antenatal classes at three Family Centers in Rome.
Results. Poor knowledge of vaccinations, inadequate attention from healthcare professionals, recurrent consultation of unreliable sources of information, and misconceptions about the side effects of vaccines, all contribute to vaccine hesitancy. Where appropriate, questionnaire sections were shown to be internally consistent.
Conclusion. The questionnaire proved reliable and is suitable for further studies.
A comparison of two approaches to implementing propensity score methods following multiple imputation
Authors: Penning de Vries Bas BL , Groenwold Rolf HH 
Published: April 2023

Background. In observational research on causal effects, missing data and confounding are very common problems. Multiple imputation and propensity score methods have gained increasing interest as methods to deal with these, but despite their popularity methodologists have mainly focused on how they perform in isolation.

Methods. We studied two approaches to implementing propensity score methods following multiple imputation, both of which have been used in applied research, and compared their performance by way of Monte Carlo simulation for a continuous outcome and partially unobserved covariate, treatment or outcome data. In the first, so-called Within, approach, propensity score analysis is performed within each of m imputed datasets, and the resulting m effect estimates are averaged. In the Across approach, for each subject the m estimated propensity scores are averaged first, after which the propensity score method is implemented based on each subject’s average propensity score. Because of its common use, complete case analysis was also implemented. Five propensity score estimators were studied, including regression, matching, and inverse probability weighting.

Results. The Within approach was found to be superior to the Across approach in terms of bias as well as variance in settings with missing covariate data, when missing data were missing at random as well as when they were missing completely at random. In settings with incomplete treatment or outcome values only, the Within and Across approaches yielded similar results. Complete case analysis was generally least efficient and unbiased only in scenarios where missing data were missing completely at random.

Conclusion. We advise researchers not to use the Across approach as the default method, because even when data are missing completely at random, this may yield biased effect estimates. Instead, the Within is the preferred approach when implementing propensity score methods following multiple imputation.
A Bayesian approach to correct for unmeasured or semi-unmeasured confounding in survival data using multiple validation data sets
Authors: Chen Wencong , Zhang Xiang , Faries Douglas E. , Shen Wei , Seaman, Jr. John W. , Stamey James D. 
Published: April 2023

Purpose: The existence of unmeasured confounding can clearly undermine the validity of an observational study. Methods of conducting sensitivity analyses to evaluate the impact of unmeasured confounding are well established. However, application of such methods to survival data (“time-to-event” outcomes) have received little attention in the literature. The purpose of this study is to propose a novel Bayesian method to account for unmeasured confounding for survival data.

Methods: The Bayesian method is proposed under an assumption that the supplementary information on unmeasured confounding in the form of internal validation data, external validation data or expert elicited prior distributions is available. The method for incorporating such information to Cox proportional hazard model is described. Simulation studies are performed based on the recently published instrumental variable method to assess the impact of unmeasured confounding and to illustrate the improvement of the proposed method over the naïve model which ignores unmeasured confounding.

Results: Simulation studies illustrate the impact of ignoring the unmeasured confounding and the effectiveness of our Bayesian approach. The corrected model had significantly less bias and coverage of 95% intervals much closer to nominal.

Conclusion: The proposed Bayesian method provides a useful and flexible tool in incorporating different types of supplemental information on unmeasured confounding to adjust the treatment estimates when the outcome is survival data. It out-performed the naïve model in simulation studies based on a real world study.
Application of random survival forest for competing risks in prediction of cumulative incidence function for progression to AIDS
Authors: Hamid Omid , Tapak Mahtab , Poorolajal Jalal , Amini Payam , Tapak Leili 
Published: April 2023

Objective: There has remained a need to better understanding of prognostic factors that affect the survival or risk in patients with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), particularly in developing countries. The aim of the present study aimed to identify the prognostic factors influencing AIDS progression in HIV positive patients in Hamadan province of Iran, using random survival forest in the presence of competing risks (death from causes not related to AIDS). This method considers all interactions between variables and their nonlinear effects.
Method(s): A data set of 585 HIV-infected patients extracted from 1997 to 2011 was utilized. The effect of several prognostic factors on cumulative incidence function (probability) of AIDS progression and death were investigated.
Result: The used model indicated that using antiretroviral therapy tuberculosis co-infection are two top most important variables in predicting cumulative incidence function for AIDS progression in the presence of competing risks, respectively. The patients with tuberculosis had much higher predicted cumulative incidence probability. Predicted cumulative incidence probability of AIDS progression was also higher for mother to child mode of HIV transmission. Moreover, transmission type and gender were two top most important variables for the competing event. Men and those patients with IDUS transmission mode had higher predicted risk compared to others.
Conclusion: Considering nonlinear effects and interaction between variables, confection with tuberculosis was the most important variable in prediction of cumulative incidence probability of AIDS progression.
Factor associated with health-related quality of life among population in Northern Jordan
Authors: Matalqah Laila Mahmoud , Radaideh Khaldoon M. Radaideh , Khatatbeh Moawia M , Omari Omar Al 
Published: April 2023

Objective: This study aimed to assess health-related quality of life among Jordanians.
Design: A cross-sectional design study was conducted at three shopping centers in Northern Jordan. Measures: Respondents were invited to fill a questionnaire assessed quality of life (QoL) using the SF-36 health survey.
Results: Data was obtained from 915 Jordanian adults from the public with a mean age of 33.8 years (SD= 28.2). The total SF-36 score for the whole population was 71.2. Significantly, females reported lower SF-36 scores in both physical and emotional health domains (P= <0.001). Furthermore, elderly reported the lowest mean score in physical health scores (P=0.05). Physical health was dramatically affected by having health problems such as rheumatoid arthritis, obesity, back pain and asthma (P=0.05). On the other hand, emotional health domain was adversely affected only by monthly income (P<0.001).
Conclusions: Quality of life among Jordanian populations is considered fine. Young adults need more concern about their emotional health, which is highly affected by their economic level.