bluuebunny/crossref_metadata_2025_split huggingface dataset:
Healthcare-associated infections in a neonatal ICU before and during COVID-19: preliminary results
Authors: Ceparano M , Sciurti A , Isonne C , De Blasiis MR , Imeshtari V , Cammalleri V , Romano A , Bellomo RK , Marzuillo C , Villari P 
Published: October 2022

Abstract

Background
Healthcare-associated infections (HAIs) are a frequent complication in neonatal intensive care units (NICUs). Hospital policies caused by COVID-19 pandemic may have played a role in HAIs development. The aim of this study was to describe and characterize over time the occurrence of HAIs in a NICU at the Policlinico Umberto I in Rome both before and during the COVID-19 pandemic.

Methods
All infants of all birth weight (BW) classes with &gt;2 days in the NICU, admitted from January 2018 to December 2021, were included. To assess the effect of the pandemic, we compared surveillance data from 2018-2019 with those from 2020-2021. Infections were defined using standard Centers for Disease Control and Prevention definitions.

Results
We included 513 infants, 274 admitted in 2018-2019 and 239 between 2020-2021. NICU stay in days was similar in the two periods (14.4 and 15.3 respectively) but the number of patients who died in 2018-2019 (N = 13) was almost double that of 2020-2021 (N = 7). A total of 27 infections were recorded in the post-pandemic period compared to 9 recorded in the previous period, mainly central line-associated bloodstream infections (CLABSI) (7% vs 3.0%, p = 0.043), followed by ventilator-associated pneumonias (VAP) (3.0% vs 0.4%, p = 0.019). The incidence density of device-associated infections was higher in patients with lower BW class in both periods analyzed. Different microorganisms were isolated: in 2018-2019 K. pneumoniae (33.3%) and Serratia marcescens (33.3%) were the most found, while S. aureus (29.0%) and Staphylococci coagulase negative (51.6%) were predominant in the following years.

Conclusions
Results indicate that patient management may have influenced the occurrence of HAIs during the pandemic. This reinforces the importance of the HAI surveillance protocol in the NICU, which monitors microbiologic isolates and medical device use for all classes of infants with BW.

Key messages
• The Covid-19 pandemic has resulted in an increase in healthcare-associated infections occurrence in our neonatal intensive care unit.
• Monitoring device-associated infections in all BW classes of infants is critical to prevent nosocomial infections.
GIS analysis of the relationship between PM2.5 and acute CVD and respiratory hospitalizations
Authors: Slachtova H , Tomaskova H , Polaufova P , Michalik J , Tomasek I , Splichalova A 
Published: October 2022

Abstract

Background and aims
The PM air pollution is a serious concern in northern Moravia in the Czech Republic. The aim is to evaluate the risk of acute hospital admissions for cardiovascular and respiratory causes with the use of the Geographic information system (GIS).

Methods
The data on acute hospital admissions for cardiovascular (I00-99 according to ICD-10) and respiratory (J00-99) causes was assigned based on the information on residence to 77 geographical units (601,299 inhabitants). The annual concentrations of PM2.5 in the period 2013-2019 were assigned to this units according to the respective concentration iso-shapes (step 2 μg.m-3, concentrations ≤29 to ≥ 38 μg.m-3). The Incidence Rate Ratio (IRR) and 95% confidence interval (CI) was calculated for each concentration category. The incidence in the first category with the lowest PM2.5 concentrations (≤29 μg.m-3) was chosen the reference category. The statistical analyses were performed using the SW STATA v.15.

Results
About a half of population (56%) in the year 2013 belonged into the PM2.5 category 34-35 μg.m-3, 26 thousand of inhabitants (4%) live in the PM2.5 concentrations ≥38 μg.m-3. During the analysed period the average concentration values decreased from 30.8 to 21.4 μg.m-3. A statistically significant risk of the acute hospitalization for cardiovascular causes was identified in the categories ≤36 μg.m-3, in the highest interval of PM2.5 the IRR values were 2-3-fold higher comparing with the reference category. As for respiratory causes, the trend is similar, but the statistically significant risk was found already from the interval 34-35 μg.m-3.

Conclusions
With increasing concentrations, the risk of both acute cardiovascular, and respiratory hospitalizations increased.
This presentation was supported by the project TH03030195 of the Technology Agency of the Czech Republic and the project Healthy Aging in the Industrial Environment CZ.02.1.01/0.0/0.0/16_019/0000798 (HAIE).

Key messages
• A statistically significant increase of the IRR for acute cardiovascular and respiratory hospitalizations was found at PM2.5 concentrations ≤34 μg.m-3 compared to the reference category ≤29 μg.m-3.
• Average annual PM2.5 concentration decreased from 30.8 to 21.4 μg.m-3 during the followed period and also the risk of acute hospitalization from cardiovascular and respiratory causes decreased.
Federated learning for describing COVID-19 patients and hospital outcomes: An unCoVer analysis
Authors: Peñalvo JL , Mertens E , Cottam J , Berrozpe-Maldonado V , Fernández-Lobón D , Solarte-Pabón O , Menasalvas E 
Published: October 2022

Abstract

Background
Since the onset of the pandemic, the unCoVer network has been identifying real-world data from EMR of hospitalised patients with COVID-19 across countries. These heterogeneous data are integrated into a multi-user data repository operated through Opal/DataSHIELD, an interoperable open-source server application, providing privacy-preserving access to individual-level information for federated data analyses.

Methods
unCoVer’s federated data platform provided access to EMR collected between 02/2020 - 04/2022 from 6 hospitals in Bosnia and Herzegovina (1), Romania (2), Spain (2), and Turkey (1) for a total of 14,236 patients. Demographics, and co-morbidities at admission, length of hospital stay and intensive care (ICU) needs, are presented according to the patients’ status at discharge.

Results
A total of 11,248 (79.0%) of all patients reviewed recovered from COVID-19 after an average 11.5 (SD 10.8) days hospitalised, with only 4.09% of patients needing ICU. A smaller proportion of patients were transferred (5.93%), and 2143 (15.1%) were considered in-hospital deaths after an average 11.6 (SD 10.5) days in the hospital where most (81.2%) needed ICU. Recovered patients had a mean age of 57.7 (SD 16.3) years old, and gender neutral (51.2% men), in contrast to deceased patients that were 74.2 (SD 12.4) years old (59.7% men). Current smoking was infrequent for both recovered or deceased patients (3.27%, and 2.83%, respectively). Cardiometabolic conditions were less commonly reported among later recovered patients in comparison with deceased patients: obesity (10.7% vs 12.1%), diabetes (15.9% vs 27.4%), hypertension (23.2% vs 42.7%), and CVD (9.33% vs 44.9%). Chronic pulmonary disease was also more frequent among deceased patients (10.3% vs 18.1%).

Conclusions
Characteristics of hospitalised COVID-19 patients differ according to outcomes at discharge with more in-hospital death reported among older, chronic patients across 6 hospitals in 4 countries.

Key messages
• Federated analyses provide unique opportunities for robust results by privacy-preserving accessing individual-level data from heterogeneous data sources.
• The unCoVer network aims to demonstrate the usability of the infrastructure to address research questions related to the COVID-19 while extending the concept to other clinical areas.
The effect of employment services on employment and health among unemployed persons: an IV approach
Authors: Schuring M , Knoef MG , Burdorf A 
Published: October 2022

Abstract

Background
In a large city in the Netherlands, professionals of one department of the municipality focus on rapid return to work, even if that work is not directly in line with education, experience or preference of the client. The first aim was to investigate the effects of this work-first strategy of the municipality on entering paid employment and on health among unemployed persons. The second aim was to determine whether these effects differed between persons, depending on age, sex, education, health, and employment history.

Methods
To identify the effectiveness of employment services of the municipality, a judge leniency instrumental variable (IV) design was used, based on referral behaviour of case workers. In total, 3272 persons who applied for welfare in a large city in the Netherlands in the year 2015, were included in the study. Information on employment services was derived from the municipality. Information on individual characteristics and employment status was derived from register data from Statistics Netherlands. Information on diseases was derived from a medication register. IV regression models and ordinary least squares (OLS) regression models were performed.

Results
The work-first strategy increased the likelihood of entering paid employment by 27% points (b = 0.26, se = 0.07) and had a positive influence on health by 4% points (b = 0.06, se 0.03) of welfare recipients compared to other employment services. Although standard errors were larger for subgroups, the positive effect of the work-first strategy on employment was driven by relatively young (18-30 yrs) and old (45-65 yrs) welfare recipients, with low and intermediate education level.

Conclusions
The instrumental variable approach is a valuable approach to investigate the effect of employment services on entering paid employment and health. To improve health of unemployed persons, it is important to promote entering paid employment.

Key messages
• Active labour market policies, such as the work-first approach, are beneficial for individuals, by increasing employment participation and health, and society, by increasing the employment rate.
• The IV approach is a promising approach to study causal relations in a quasi-experimental study. By using large datasets, differential effects across different groups of participants can be studied.
Sexual harassment, other types of harassment and derogatory treatment in the academy
Authors: Pilgaard F , Agardh A , Östergren P-O , Priebe G 
Published: October 2022

Abstract

Background
Sexual harassment (SH) continues to be a significant public health problem, especially among women. SH and other types of harassment and derogatory treatment/bullying exist at many academic workplaces. The aim of this study is to explore how SH relates to other forms of harassment among staff at a large Swedish university, separated by gender.

Methods
Using data from a web-based survey sent out to all staff in November 2019 (response rate 33%), a multiple logistic regression analysis was performed. Exposure to SH was defined as having experienced at least one of ten defined SH behaviours related to work. Exposure to harassment (other than sexual) was defined as having experienced violation of onés dignity associated with one of the Swedish seven legal grounds for discrimination: sex, transgender identity or expression, ethnicity, religion or other belief, disability, sexual orientation or age. Exposure to derogatory treatment was defined as having experienced undesirable negative behaviours, such as withholding information, derogatory comments or exclusion. All SH, harassment and derogatory treatment took place during the last 12 months.

Results
Preliminary results show a sixfold increased risk among women subjected to SH to also experience harassment, a three times higher risk to experience derogatory treatment and a seven times higher risk to experience multiple forms of harassment (two or more forms of harassment or derogatory treatment) compared to women unexposed to SH. The elevated risk remained after adjusting for relevant background variables. The pattern was similar among men but with lower prevalence of SH, harassment and derogatory treatment.

Conclusions
The results indicate that individuals subjected to SH at work have an increased risk of experiencing other types of harassment or derogatory treatment. This new information is relevant to consider in prevention of SH and harassment in academia.

Key messages
• The results indicate that individuals subjected to sexual harassment at work have an increased risk of experiencing other types of harassment or derogatory treatment.
• Findings indicating a relationship between sexual harassment and other types of harassment or derogatory treatment may be valuable for counteracting the problem.
Predictors of job satisfaction among German teachers during the SARS-CoV-2 pandemic
Authors: Dicks T , Eggert V , Köstner C , Beutel T , Kalo K , Zähme C , Letzel S , Dietz P 
Published: October 2022

Abstract

Background
To contribute the containment of the infections during the SARS-COV-2 pandemic, changes in working conditions occurred worldwide. In the school context, teaching was changed several times to distance learning and teachers were forced to work from home. This increasing spatial separation between work and private life increased the potential for conflicts. Based on the theoretical assumption that stressors worsen job satisfaction and resources increase satisfaction, the aim of our study was to identify the predictors of teachers’ job satisfaction during the pandemic. The focus on job satisfaction is interesting because the concept is often related to health-related aspects from a public health perspective.

Methods
A nationwide cross-sectional survey was conducted among German teachers in March 2021. After data cleaning, 31,089 participants were included in the analyses. The survey consisted of established instruments (e.g., COPSOQ) and self-developed items if necessary. A multiple linear regression was performed to predict teachers’ job satisfaction by stepwise inclusion of sociodemographic, work-related and covid-specific variables.

Results
Overall, the regression revealed that especially work-related variables were strong predictors of job satisfaction. The analyses showed that higher levels of meaning of work, autonomy and predictability of work increased job satisfaction. In contrast, increased emotional stress, feelings of unfair treatment, and work-privacy conflicts deteriorated job satisfaction.

Conclusions
The present study identified important predictors of job satisfaction which may be used to derive specific recommendations for improving teachers’ job satisfaction during the SARS-CoV-2 pandemic. The relevance of job satisfaction for the scientific and public discourse becomes apparent because it was closely related to teachers’ somatic and mental health.

Key messages
• Teachers’ job satisfaction during the pandemic can be further improved by making appropriate adjustments, particularly in work-specific requirements.
• Improving job satisfaction significantly contributes to promoting teachers’ health.
Working re-organisation due to the pandemic may negatively affect workers’ quality of life
Authors: Ghelli F , Bellisario V , Squillacioti G , Panizzolo M , Bono R 
Published: October 2022

Abstract

Background
From the beginning of 2020, the COVID-19 pandemic imposed many changes in the organization of our personal and professional life, allowing a shift to teleworking and hybrid working arrangements worldwide. The persistence of this condition determined the integration of these changes in the daily routine, and our aim was to investigate how these changes could affect workers’ Quality of Life (QOL) in the long run.

Methods
An online questionnaire was administered to 650 workers employed in an Italian company in July 2021. The domains considered were socio-demographic characteristics, QOL (WHOQOL-bref and Healthy Days), lifestyle, health status, physical activity, and work-related factors. Comparisons were performed with non-parametric tests.

Results
Among the 332 respondents (response rate = 51.1%), 79.2% were white-collar workers. The concern for the pandemic affected workers’ QOL, especially in the physical health and the environmental domains (p &lt; 0.001 and p = 0.001, respectively), with lower values in subjects reporting the highest values of concern. A similar effect was found also for healthy days concerning physical and psychological health, and the ability to perform usual activities (p = 0.003, p = 0.003, and p = 0.029, respectively). As well, changes in working arrangements significantly affected the environmental and physical domains (p = 0.023 and p = 0.015, respectively) and the ability to do usual activities (p = 0.011), with lower values in those who interrupted the working activity. Workers whose activity required a shift to teleworking reported higher scores in the physical health domain (p = 0.041) and a higher number of days with good physical health (p = 0.002), while a lower number of days with good psychological health (p = 0.006).

Conclusions
These preliminary data revealed that organizational strategies adopted in working scenarios to contain the spread of COVID-19 may have an impact on workers’ QOL, as well as the concern for the pandemic.

Key messages
• Changes in the working arrangements due to pandemic may negatively affect the workers’ Quality of Life, especially for those who had to interrupt their working activity.
• The shift to telework, even if appearing to be beneficial for physical health perception, seems to negatively affect workers’ psychological health.
Patient experiences of hospital care during the COVID-19 pandemic in Ireland
Authors: Rohde D , Foley C , Murphy R , Kelly M , Drummond L 
Published: October 2022

Abstract

Introduction
The COVID-19 pandemic has greatly impacted healthcare service delivery. This study explored patient experiences of hospital care during the COVID-19 pandemic in Ireland, using National Inpatient Experience Survey (NIES) 2021 data.

Methods
NIES is a repeat cross-sectional survey of inpatient experiences in all public acute hospitals in Ireland. Patients who spent 24+ hours in hospital and were discharged in September 2021 were eligible to participate. 7 questions addressed experiences specific to the pandemic. Comparisons between 2019 and 2021 were conducted using t-tests. Effect sizes (d) are reported. Qualitative data were thematically analysed.

Results
10,743 patients participated (42% response rate). While 68% did not feel at risk of catching COVID-19, 9% felt at risk. 35% reported that staff always helped them to keep in touch with family. There were small, statistically significant differences between 2019 and 2021 ratings, with questions on opportunity for family to talk to a doctor (d=-.328), provision of information to family (d=-.136), and being able to find staff to talk to about worries and fears (d=-.167) recording the biggest decreases. Scores for cleanliness of wards (d = 0.063) and bathrooms (d=.075), and privacy during examination or treatment in the ED (d = 0.085) improved significantly. Patients commented on their appreciation of staff, but missed having visitors, with restrictions posing challenges for those with sensory or physical impairments.

Conclusions
Given the unique challenges experienced by acute healthcare services during the COVID-19 pandemic, comparisons with pre-pandemic patient experiences should be interpreted with caution. Continuing to gather patient feedback during a pandemic presents a unique opportunity to understand the resilience of healthcare systems as they continue to operate under unprecedented pressure, with the potential to inform responses and delivery of care during future pandemics or other emergencies.

Key messages
• Visiting restrictions posed many challenges for patients and affected communication both between patients and their family members, as well as between healthcare staff and patients’ family.
• Gathering patient feedback during a pandemic presents a unique opportunity to inform responses and delivery of care during future pandemics or other emergencies.
The value of uterine oncological surgery in a University Hospital. Results of a break-even analysis
Authors: Specchia ML , Arcuri G , Di Pilla A , La Gatta E , Osti T , Limongelli P , Scambia G , Bellantone RDA 
Published: October 2022

Abstract

Background
Robotic surgery has many clinical advantages but high costs, raising the issue of healthcare sustainability. This study aims to a comparative analysis of the value, in terms of costs and outcomes, of robotic, laparoscopic, and laparotomy surgery for uterine cancer in a University Hospital.

Methods
An observational retrospective study was carried out on hospitalizations between 1 Jan 2019 and 31 Oct 2021 for uterine cancer surgery. DRG amount, costs, economic margins and 30-days readmissions percentage (mean values and 95% CIs) were calculated for robotic, laparoscopic and laparotomy surgery. Student’s t and Chi-square tests were used to assess differences and the break-even point was calculated.

Results
1336 hospitalizations were analyzed, 366 with robotic, 591 with laparoscopic, and 379 with laparotomy surgery. Robotic surgery compared to laparoscopic and laparotomy ones showed a significant difference (p &lt; 0,001) for economic margin, which was largely negative (-1069.18 €; 95%CI: -1240.44 - -897.92 €) mainly due to devices cost (3549.37 €; 95%CI: 3459.32 € - 3639.43 €), and a lower 30-days readmissions percentage (1.4%; 95%CI: 0.2% - 2.6%) with a significant difference only versus laparotomy (p = 0.029). Laparoscopic compared to laparotomy surgery showed a significantly (p &lt; 0,001) more profitable economic margin (1692.21 €; 95%CI: 1531.75 € - 1852.66 €) without a significant difference for 30-days readmissions. The break-even analysis showed that, on average, for every uterine cancer laparoscopic elective surgery, 1.58 elective robotic surgeries are sustainable for the hospital (95% CI: 1.23 - 2.06).

Conclusions
The systematic application of the break-even analysis will allow defining over time the right distribution of robotic, laparoscopic and laparotomy surgeries’ volumes to perform in order to ensure both quality and economic-financial balance and therefore value of uterine oncological surgery in the University Hospital.

Key messages
• The value-based healthcare approach, defined as the measured improvement in a patient’s health outcomes in relation to its cost, finds effective application in uterine cancer surgery.
• The use of the break-even approach allows to promote the value-based view by identifying a useful criterion for the planning and governance of interventions for uterine malignancies.