bluuebunny/crossref_metadata_2025_split huggingface dataset:
Leading causes of death in Tunisia, 2020
Authors: Rejaibi S , Zoghalami N , Silini A , Ben Slama I , Skhiri A , Mariem I , Mensi I , Bennour MA , Taibi S , Aounallah-Skhiri H 
Published: October 2022

Abstract

Background
Mortality data represent a primary source of information for monitoring a population health status over years. In Tunisia, the national Information System on Causes of Death (ISCD) lacks completeness (average coverage rate of 40%); however, in order to examine covid-19’s effect on mortality data, the ISCD was reinforced. We aimed to give an overview of leading causes of death in Tunisia for 2020.

Methods
Data were obtained from Medical Certificates of Cause Of Death (MCCOD) sent by municipalities to the National Institute of Health in accordance with the legislative framework. Causes of Death (CoD) coding process was performed based on the International Classification of Diseases, Tenth Revision (ICD-10). The underlying cause of death was identified based on IRIS software, and mortality statistics were presented based on the world health organization cause-of-death lists for tabulating mortality statistics. Data analysis was performed using SPSS software.

Results
A total of 46.420 MCCOD among 75.365 deaths officially declared by the National Institute of Statistics, were analyzed (coverage rate of 61.2%). The 10 leading causes of death for both sexes, in rank order were: diabetes mellitus, cerebrovascular diseases, covid-19, ischemic heart diseases, external causes of death, digestive and pulmonary malignant neoplasms, conditions of neonatal period, hypertensive diseases, and influenza and pneumonia. Leading causes of infant deaths were: certain conditions originating in perinatal period, congenital malformations, deformations and chromosomal abnormalities, diseases of respiratory system, certain infectious and parasitic diseases, and diseases of nervous system.

Conclusions
The COVID-19 pandemic was an opportunity to improve the Tunisian ISCD’s coverage rate. However, efforts should be maintained to optimize system completeness, and decision makers should be more sensitized regarding the urgent need for system digitalization.

Key messages
• Mortality statistics have shown that covid-19 ranks third among leading causes of death in Tunisia for 2020; and non communicable disease accounted for 6 out of 10 leading causes of deaths.
• The ISCD coverage rate was improved in 2020 reaching 61.2%; however the system digitalization is an essential and sustainable solution to optimize completeness.
Ethical perspectives of the involvement of vulnerable populations in health research
Authors: Lampa E , Warner G , Sarkadi A , Perez Aronsson A , Thell M , Kihlbom U 
Published: October 2022

Abstract

Background
Public involvement in research has potential to transform public health research processes and outcomes, as well as contribute to sustainable collaborations between academia and the civil society. However, this all relies on public involvement being conducted in an ethical and inclusive way, especially when involving representatives from vulnerable populations.

Methods
In this empirically informed theoretical reflection, ethical perspectives on involvement of vulnerable populations in health research were explored using data collected within a public involvement evaluation project. By analysing observational and longitudinal qualitative data from research projects involving public representatives from vulnerable groups, ethical aspects were identified.

Results
Responsibility and decision-making appeared as important ethical aspects, where laws and regulations conflicted with involvement ideals. Similarly, reimbursement and recognition for public contributors became an ethical issue when facing legislation and bureaucracy, especially when involving children or refugees. Another ethical aspect concerned researchers’ concerns in balancing involvement and protection of vulnerable groups, especially when involving contributors living under unstable circumstances. Finally, effectively communicating around research and involvement in an accessible way, for contributors to be involved but not burdened, was a challenge for researchers.

Conclusions
Public involvement of vulnerable populations led to ethical challenges related to conflicting ideals and practical realities, including balancing involvement and protection of contributors. This highlighted a need for ethical guidance to support ethical decision-making and practice. The findings are used to guide the development of an ethical framework for decision-making in public involvement.

Key messages
• Researchers involving public contributors from vulnerable groups face ethical challenges which causes barriers to involvement.
• There is need for guidance on ethical decision-making for researchers involving representatives from vulnerable groups in research.
Who is following me? Public attitude towards government tracing apps in the covid Era in Israel
Authors: Golan O , Bord S , Satran C 
Published: October 2022

Abstract

Background
In the battle to decrease coronavirus infection and mortality, Israel has employed emergency tools, e.g., tracking civilians’ locations via their cellphones or activating the HaMagen app that identifies when a person is near someone who has been diagnosed with the virus. While the aim of these tools is to ensure the public’s health, they could harm human rights.

Objective
To examine the Israeli public’s attitudes towards enhancing public health during the pandemic while preserving privacy, by examining the relationship between trust in the healthcare system, threat perceptions, cellphone tracking, and HaMagen App.

Methods
Surveys (distributed by iPanel) was completed by 741 adults, aged ≥18.

Results
About half the respondents (47.1%) perceived cellphone tracking as harmful to privacy, yet one-quarter (24.4%) reported that this increases their sense of security. About half (48.4%) agreed/greatly agreed with the item whereby the government uses the gathered data for non-coronavirus purposes. Jewish respondents had more positive attitudes towards government tracking than Arab ones, yet the latter reported higher downloading of HaMagen. The findings indicate that threat perceptions and positive attitudes towards cellphone tracking were related to greater chances of downloading the app. Moreover, attitudes towards such tracking were mediated by the relationship between trust levels/threat perceptions and downloading the app, whereby the former was association with more positive attitudes towards cellphone tracking, which in turn was related to greater app downloading.

Conclusions and Recommendations
Trust plays a central role in people’s willingness to forgo their privacy for the good of public health. To enhance trust, messages must be suited to a range of communities, presented in a suitable language by local professionals.

Key messages
• Trust plays a central role in people’s willingness to forgo their privacy for the good of public health.
• Concern for public health must include ethical considerations.
Prevalence and factors associated with food insecurity in southern Mozambique
Authors: Militao E , Uthman O , Salvador E , Vinberg S , Macassa G 
Published: October 2022

Abstract

Background
Food insecurity (FI) is one of the major causes of malnutrition in low- and middle-income countries. In Mozambique, the burden of FI and how it’s related to negative health outcomes is unknown. This study aimed to investigate the prevalence of FI as well as the factors associated with FI in southern Mozambique.

Methods
Preliminary data from 301 household heads residing in suburb and peri-urban districts of Maputo were analysed in a cross-sectional design. Accordingly, FI was assessed using the 8-items of the United States Department of Agriculture Household Food Security Survey Module, and its association with various factors was determined through multiple regression models.

Results
The prevalence of FI was 62.8% (23.6% of households had mild FI, 16.6% had moderate FI, 22.6% had severe FI). Based on multiple regression models, 10 variables (out of 11) were relevant drivers of FI and reached statistical significance (p-value&lt;0.05) with focus on food diversity, climate change, illnesses, household income, number of meals, type of work, household size.

Conclusions
These preliminary findings suggest the need for decent work and job creation. In addition, food diversity, climate change and some relevant diseases should be taken into account in the development of public health policies designed to alleviate household food insecurity in Mozambique.

Key messages
• Food insecurity in Mozambique calls for joint efforts from government, private sector, international institutions and communities.
• The basic food basket for the most vulnerable groups is encouraged as a short-term solution.
A dietary intervention study to reduce Metabolic Syndrome risks in heart-transplanted patients
Authors: Valdi G , Ferrara V , Marinoni M , Nalli C , Di Nora C , Sponga S , Benedetti G , Parpinel M , Livi U , Moretti V 
Published: October 2022

Abstract

Background
Since heart transplantation (HTx) has become the gold standard therapy in end-staged heart failure, many factors, including metabolic syndrome (MS), represent a burden in HTx patients. Considering key role of immunosuppressive therapy and its side effects on the appearance of MS, we focused on modifiable factors including adherence to Mediterranean Diet (MD) and improvement of dietary habits.

Methods
21 heart-transplanted patients were enrolled and randomized in a control group (CG; N 10) and an intervention group (IG; N 11). During two meetings (baseline, 6-month follow-up) were administered a validated Food Frequency Questionnaire (FFQ), to assess adherence to MD, and collected clinical and anthropometric parameters, IG were additionally requested to fill a food diary. IG received personalized advices, CG received standard recommendations. Comparison between IG and CG were analyzed, differences into the IG were also assessed.

Results
The prevalence of MS at baseline was 46% in IG and 20% in CG. During 6-month follow-up, significant lower blood pressure values were observed (median, 25th-75th: systolic 130, 120-130 IG vs 145, 130-147 CG; p = 0.004). Seven patients of IG underwent a 12-month meeting. In this group MD scores increased significantly (7 + 1.3 vs 4 + 1.5, p = 0.001). Furthermore, significant decrease of fat mass percentage (%) (23.3 + 6.3 vs 14.8 + 10.1, p = 0.014), increase of fat free mass % (76 + 6.3 vs 85.2 + 10.1, p = 0.014) and increase of body cell mass % (50.9 + 3.8 vs 53.4 + 3.4, p = 0.031) were observed. Dietary data in IG showed significant decrease of energy from saturated fatty acids % (13.0±2.1 vs 9.6±1.5, p = 0.001), sodium (mg) (2138±359 vs 1822±417, p = 0.045), and decreasing trend for cholesterol (mg) (219±82 vs 171±59, p = 0.082).

Conclusions
Dietary intervention based on MD perhaps can improve MS risks in heart-transplanted patients. Further investigations may be needed to assess the fundamental role of a structured nutritional follow-up in these patients.

Key messages
• Personalized nutritional advices based on the MD, compared to general recommendation, can significantly improve health and quality of life in heart-transplanted patients.
• A structured nutritional follow-up for heart-transplanted patients may be desirable to prevent risks of Metabolic Syndrome as a public health instrument in selected categories as these patients.
Air purifiers, comparison between real and declared surface for use: fake it or make it?
Authors: Gullotto C , Dragoni L , Amodeo D , Cevenini G , Nante N , Messina G 
Published: October 2022

Abstract

Introduction
Air pollution has been recognized as one of the major risk factors for the global burden of disease. In modern society, most exposure occurs indoors, and air quality may be improved with air purifiers utilizing various cleaning techniques. This analysis aims to evaluate whether recommended room surface in which to use these devices as declared by producers is actually in line with their real effective area of activity.

Methods
A review of devices for the purification of the air was carried out between January-April 2022. Four different types of air purifiers were considered based on the adopted technologies: I) HEPA filters and UV lamps; II) only with HEPA filters; III) only UV lamps and IV) those using other technologies. For each group, based on the CADR (Clean Air Delivery Rate) provided by the producers, the optimal real surface area of the room to use the device was calculated, referring to the standard EN779:2012. This value was compared with the recommended area of the room declared by the producers. Descriptive statistics and Wilcoxon matched pair test used for comparisons. The significance level was set at p &lt; 0.05.

Results
The analysis was carried out on 252 devices; I) 52 had HEPA filters + UV lamps, with a recommended mean room area of 40 m2 (IQR 49.75), II) 142 devices had only HEPA filters with 52.5 m2 (IQR 46.75), III) 27 devices only UV lamps, 40 m2 (IQR 105), IV) 31 devices with other technologies, 54 m2 (IQR 84.2). As required by EN779:2012, the effective area of activity was calculated using CADR x 0.075: the medians of the 4 groups were I) 12 m2 (IQR 16.5), II) 15.83 m2 (IQR 26.4), III) 4.5 m2 (IQR 22.5), IV) 7.5 m2 (IQR 21.53), respectively. Comparing declared and calculated CADR values, all the groups showed significant differences (p &lt; 0.05).

Conclusions
Results show that recommended surfaces derived from CADR declared by producers largely overestimate the real volume of the room that devices can purify, whatever the technology used.

Key messages
• There’s no correspondence between recommended area of room to be sanitized indicated by producers of air purifiers and area that they are actually able to sanitize, which is significantly lower.
• It is necessary to be aware of the difference between data indicated by producers and real data, in order to purchase a device that actually corresponds to dimensional needs of the environment itself.
Which one to choose? A cost-effectiveness analysis between different technologies of air purifiers
Authors: Gullotto C , Sparacino M , Amodeo A , Cevenini G , Nante N , Messina G 
Published: October 2022

Abstract

Introduction
CoViD19 pandemic highlighted the importance of air purifiers and, in commercialization, their performance and price influence the choice. Since primary focus concerns only performance in terms of CADR (Clean Air Delivery Rate), this study aims to compare: I) levels of declared air purifications according to different types of air purification technologies; II) price of them to evaluate if, with similar group-mean CADR (within +/- 1 SD), there are significant differences in selling prices.

Methods
A review of several devices was carried out, collecting data in January-April 2022. Four different types of air purifiers were considered, divided into as many groups: those equipped with HEPA filters + UV lamps, only with HEPA filters, only with UV lamps and those using other technologies. We applied Kruskal-Wallis test to evaluate statistical differences among prices normalized by CADR, at significant level of 0.05.

Results
Analysis was carried out on 186 devices: I) 37 had HEPA filters + UV lamps, II) 117 only HEPA filters, III) 11 only UV lamps and IV) 21 other technologies. Eight system had HEPA H11 (95% reduction of particle matter 0.5 μm), 8 had HEPA H12 (99.5%), 70 had HEPA H13 (99.95%), 11 had HEPA H14 (99.995%). The mean normalized costs of each group devices, in Euros/CADR were I) 1.22 (SD 2), II) 1.49 (SD 1.4), III) 7.63 (SD 7.38), IV) 1.22 (SD 0.99), respectively. Statistical comparison of four-group selling prices show significant differences (p &lt; 0.05) due to the devices equipped with only UV lamps.

Conclusions
Comparison between technologies analyzed by mean price normalized to CADR showed significant differences between those that used only UV lamps compared to all the others. This is reasonably due to the fact that the use of only UV lamps requires radiant powers considerably greater than all the others, therefore also higher costs (about 5-6 times). In all cases, the level of disinfection reached, as declared, was always &gt; 95%.

Key messages
• With the same mean price normalized to CADR, the selling price is significanly different only for devices equipped with UV lamps compared to all the others.
• Choice of devices with a certain level of declared air purifications can be directed towards those with HEPA+UV/HEPA/other without the mean price normalized to CADR undergoing significant differences.
Health and morbidity among those in paid work after age 64: a systematic review
Authors: Farrants K , Alexanderson K , Dervish J , Marklund S 
Published: October 2022

Abstract

Background
Despite the increase of labour market participation at older ages, very little is known about health and morbidity among those who remain in a paid work after age 64. The aim was to systematically review the scientific knowledge on health and morbidity among people aged above 64 years who are in paid work.

Methods
A systematic literature review of studies published in English in scientific journals in 2014-2020. We identified 18,972 unique publications, of which 66 were deemed relevant by at least two independent researchers. Quality judgements and data extraction were done by at least two independent researchers according to pre-specified templates.

Results
There was a great heterogeneity in the included studies regarding study design, included populations (both size and type), exposures, outcomes, covariates, measures, and analytical methods. Few were assessed as having high quality. Most studies (95%) were from OECD countries and results were about men to a greater extent than women. 42 of the 66 studies had results indicating that being in paid work after age 64 was associated with good health and less morbidity. Six studies presented at least one result showing the opposite; those in paid work had worse health than those not, while 21 studies presented at least one result showing that there were no health/morbidity differences between those in paid work and who were not. Only one study presented results regarding mortality. Many aspects had not been studied at all, or only in one or two studies.

Conclusions
Many studies had results indicating that those who were in paid work &gt;64 had better health/less morbidity than those who were not, however, there was a great variety in the results. There are surprisingly few studies about health/morbidity among people in paid work after age 64, and those published are heterogeneous: it is thus not possible to draw conclusions regarding scientific evidence based on the currently existing studies.

Key messages
• Both study designs and results were very heterogenous in the 66 studies that presented results on health or morbidity among people in paid work after age 64.
• More and better studies are needed as well as greater clarity regarding study designs, populations, measures, analytical methods and definitions of central concepts such as work, health and morbidity.
Managers’ prevention and self-confidence in supporting employees with common mental disorders
Authors: Hultqvist J , Zhang P , Staland-Nyman C , Bertilsson M 
Published: October 2022

Abstract

Background
Despite managers’ responsibility for work environment and employee health few studies have investigated managers’ actions to prevent common mental disorders (CMD). Concerning prevention of CMD, qualitative studies report managers feeling unconfident. We investigated managers’ self-confidence in supporting employees with CMD and two managerial preventive actions (MPA): ‘reviewing assignments and the work situation’ (MPA-review) and ‘taking initiative to talk about depression and anxiety at the workplace’ (MPA-talk). We hypothesized that managers’ self-confidence in supporting employees with CMD would be positively associated with both MPAs.

Methods
An on-line survey was sent in 2017 to 4737 managers, answer rate 71% (n = 3358), of which 2 899 were included in this study. Both independent and dependent variables were measured through single questions. Self-confidence in supporting employees with CMD was analyzed in relation to MPA-review and MPA-talk using binary logistic regression analysis adjusted for sex, education, managerial experience and training, lived experiences of CMD, work organizational context and general preventive actions in the organization towards CMD.

Results
The proportion of managers with higher self-confidence in supporting employees with CMD was 48.9%, performing MPA-review and MPA-talk was 50% and 57% respectively. Adjusted for all co-variates, managers with higher self-confidence in supporting employees with CMDs were more likely to do both MPA-review (OR 1.57; 95% CI, 1.31-1.87) and MPA-talk (OR 2.06; 95% CI, 1.71-2.25).

Conclusions
The study hypotheses were confirmed. Managers with more self-confidence in supporting employees with CMD were more likely to take actions to prevent CMD, particularly regarding initiating talks about CMD with subordinates. The study suggests it is important to strengthen managers self-confidence in supporting employees with CMD to increase their preventive actions towards CMD.

Key messages
• Managers’ self-confidence in supporting employees with CMD is vital for workplace prevention.
• To strengthen managers’ self-confidence in supporting employees with CMD is essential.
Violence against healthcare workers during COVID-19 vaccination campaign
Authors: Lo Presti T , Scarpis E , Arnoldo L , Fiorillo F , Zuliani P , Farneti F , Croci E , Pellizzari B , Cocconi R , Brunelli L 
Published: October 2022

Abstract

Background
Violence against healthcare workers (HCWs) has gained increasing attention in recent years, both because it is on the rise and because there is growing concern about these incidents, which are classified as sentinel events by the Italian Ministry of Health. Since little is known about the actual burden of this phenomenon, especially during the stressful COVID-19 vaccination campaign, we decided to explore the problem in our region.

Methods
Between January and March 2022, in the 1.2 million-inhabitant Friuli Venezia Giulia region (Italy), we conducted an anonymous online survey to collected data on episodes of violence and their consequences for HCWs. Data from validated tools assessing characteristics of violent episodes and post-trauma impact were analyzed in conjunction with socio-demographic data of respondents.

Results
200 HCWs participated in the survey, most of whom were women (72%), worked as nurses (107) or doctors (71), and had a mean age of 47 years. More than half of them (59%) reported at least one episode of violence, mainly in the form of a verbal assault (64%); there were no differences between victims. In 72 cases, these incidents affected the HCW’s private life, mainly disturbing sleep or concentration (68%). Most HCWs stated that inadequate communication was a trigger for the violence (97%). Although 80% of HCWs would readily report any violent incident, to improve the situation they called for certainty of action against the perpetrator (87%), more organizational support (85%), standard procedures (75%) and self-defense courses (75%).

Conclusions
Violence in COVID-19 vaccination campaign appears to be common and to affect both the personal and professional lives of HCWs. Improvements at the institutional and personal level could help to address this problem that affects the health workforce.

Key messages
• Given the growing public debate, violence in healthcare settings is an important issue that needs to be addressed in the coming years.
• Assessing workplace violence and its associated risk factors will help focus on the strategies that can be usefully employed to prevent it in the future.