UNASSIGNED: The objectives of this study were to explore the rate and types of inappropriate referrals to the wellness services and to assess the impact of multi-level interventions on the rate of inappropriate referrals at Rawdat Al-Khail health center in Qatar.
UNASSIGNED: This study employed a retrospective analysis of all referrals data to Rawdat Al-Khail wellness services extracted from the Electronic Health Records (EHRs) between July 2022 and August 2023. The monthly rates and types of inappropriate referrals were calculated. In this study, pre-post analyses were performed to evaluate the impact of two sets of interventions on reducing inappropriate referral rates. The first set involved the development and distribution of e-referral pathways training manual in September 2022. The second set, implemented in April 2023, included close monitoring the rate and types of referrals, and the initiation of feedback communication between wellness services supervisors and referring physicians for advice and corrective actions.
UNASSIGNED: A total of 966 referrals were received during the study period, with 1:5 male-to-female ratio. Of all referrals, 34.9 % were classified as inappropriate, exhibiting considerable variations among different referring health centers. The most common reason for inappropriate referrals was due to the lack of \"exercise wellness gym assessment form\" (23.8 %). While interventions aimed at enhancing the referral process, they did not result in a significant overall reduction in inappropriate referral rates. However, there was a noteworthy reduction in the inappropriate referrals caused by the lack of \"exercise wellness gym assessment form\" observed from March to August 2023 (41 %-18 %).
UNASSIGNED: This study sheds light on the complexities of wellness services referrals, revealing a high rate of inappropriate referrals that require closer scrutiny. Despite interventions not significantly reducing the rate of these referrals, it emphasizes the need for ongoing improvement strategies. Structured, periodic interventions at higher levels are recommended to enhance referral appropriateness.

Pressure ulcers carry a significant risk in clinical practice. This paper proposes a practical and interpretable approach to estimate the risk levels of pressure ulcers using decision tree models. In order to address the common problem of imbalanced learning in nursing classification datasets, various oversampling configurations are analyzed to improve the data quality prior to modeling. The decision trees built are based on three easily identifiable and clinically relevant pressure ulcer risk indicators: mobility, activity, and skin moisture. Additionally, this research introduces a novel tabular visualization method to enhance the usability of the decision trees in clinical practice. Thus, the primary aim of this approach is to provide nursing professionals with valuable insights for assessing the potential risk levels of pressure ulcers, which could support their decision-making and allow, for example, the application of suitable preventive measures tailored to each patient\'s requirements. The interpretability of the models proposed and their performance, evaluated through stratified cross-validation, make them a helpful tool for nursing care in estimating the pressure ulcer risk level.

Change in lifestyle leads to change in disease patterns from infectious diseases and malnutrition to degenerative diseases, such as coronary heart disease (CHD). The increasing prevalence of cardiovascular diseases among Indonesian workers and the general public will not only burden medical care expenses but also reduce work productivity, leading to more work-related injuries and work-related losses. The aim of this study was to determine the risk factors for CHD (age, sex, blood pressure, smoking, diabetes mellitus, body mass index, and weekly physical activity) and the CHD risk level among university workers. A cross-sectional study was conducted at workers at School of Medicine, Universitas Malikussaleh, Lhokseumawe, Indonesia. The risk level of CHD was calculated using Jakarta Cardiovascular Score and predicting model analyzed with multiple logistic regression model. Our data found that 58.2%, 25.5% and 16.3% of the university workers had low-, medium- and high-risk to have CHD. The final model indicted that the risk of heart disease was determined by gender, age, and the presence of hypertension and diabetes mellitus. Being male had odds ratio (OR) 30.84, aged >41 years old had OR 11.52, having hypertension had OR 4.87 and having diabetes mellitus had OR 13.99 for having high risk of CHD compared to female, those younger than 41 years old, having no hypertension and having no diabetes mellitus, respectively. In conclusion, our data suggests that more than 15% the respondents (university employees) have high risk of CHD and being male and older, and having hypertension and diabetes mellitus are associated with risk of CHD. Implantation of the preventive measures is therefore important to be implemented at the universities.

To quickly isolate suspected cases to control the epidemics, this study proposes a body temperature monitoring system with a thermography based on the Internet of Things (IoT) architecture. The collected data are transmitted to a back-end platform via wireless communication. Using the analyzed data, the platform provides services, such as instant alerts for any anomalies, infectious disease outbreak prediction, and risk level assessment for a given area, and it will be a great help to epidemic prevention. The mean absolute percentage error and root mean square error of the proposed monitoring system under an extensive series of experiments are 0.04% and 0.0204°C, respectively. It shows that the body temperature measured by the thermal imaging sensor in the system can accurately represent the actual body temperature after specific calibrations that take the environmental temperature into account. It can also be expanded to a decision supporting system to help schools or government agencies to make proper decisions to stop the spread of infectious diseases.

Background: COVID-19 affects not only patients\' physical health but also their mental health. For the general public, although their physical health may not be directly affected, their mental health may be affected by stress, anxiety, and social panic caused by COVID-19. Controlling the pandemic should focus on not only physical health but also mental health. For the general public, mental health is even more important, as good mental health at the individual level can form a positive social mentality conducive to pandemic prevention and control. Therefore, it is important to assess mental health during the pandemic, and analyze risk and protective factors. Methods: A self-compiled COVID-19 Social Mentality Questionnaire was used to conduct an online survey. A total of 16,616 participants responded, with 13,511 valid questionnaires. Results: Results showed that 10.7% of participants rated their mental health as \"worse than usual\" during the pandemic, and there were gender, age, and educational differences. Social support was positively correlated with pandemic-related knowledge and self-efficacy, and could indirectly predict mental health. Pandemic-related knowledge was positively correlated with self-efficacy and mental health, and risk level was negatively correlated with mental health. Hierarchical regression analysis showed that pandemic-related knowledge played a partial mediating role in the relationship between social support and self-efficacy, while self-efficacy played a complete mediating role in the relationship between social support and mental health. Logistic regression analysis showed that risk level moderated the relationship between self-efficacy and mental health. Conclusions: Social support can increase pandemic-related knowledge, thus improving self-efficacy and maintaining/promoting mental health. High risk levels can undermine the role of self-efficacy in promoting mental health. Therefore, in the fight against the COVID-19, people need to support and cooperate with each other, to improve self-efficacy and reduce risk, thus maintaining and promoting mental health.

The potential health risk of trace elements in nut foods has been widely concerned. The accumulations of trace elements by plants in the environment are disturbed by multiple factors. The objective of this work was to investigate the risk levels of trace elements in walnuts and their influence factors (planting area and cultivar). A total of 228 walnut samples were collected from four major walnut producing areas of China. The contents of essential elements for Fe, Cu, Zn, Mo and Se were 35.8, 21.9, 14.8, 0.3 and 0.04 mg/kg, respectively. The contribution of Cu for dietary reference intake was as high as 82.22%. The risk levels of potential toxicological elements and toxic elements within the acceptable limits. Significantly, the hazard quotients (HQs) of Ba and Co were up to 26.14% and 25.31%, respectively. The effect of planting area on trace elements was determined from the aspects of regional distribution and urbanization. Significant differences of essential elements were found between northeast and northwest areas. The urbanization directly influenced toxic elements, which could cause variation up to 85.0% (Pb) and 42.9% (As). Finally, cultivar effect was confirmed that all walnut cultivars were divided into four categories with different trace element characteristics.

BACKGROUND: Small and medium-sized enterprises (SMEs) face greatest difficulty in managing occupational risks compared to large enterprises. Limited resources, little knowledge about risk management process and deficiencies in organizational processes are often pointed in the literature as important obstacles to occupational safety and health (OSH) performance in SMEs. However, external factors can also be of paramount importance, such as the economic crisis. Because under specific scenarios OSH conditions may deteriorate in SMEs, is important to establish effective indicators.
OBJECTIVE: This study aims to identify OSH performance indicators within the context of SMEs.
METHODS: To identify the indicators, a literature review was carried out on different studies published in scientific journals in the OSH field between 2008 and October 2018 using the Scopus, ScienceDirect, Web of Science and PubMed databases.
RESULTS: As a result, 14 management and organization OSH indicators applied to SMEs were identified, along with 5 at individual OSH indicators.
CONCLUSIONS: The indicators were discussed in relation to its applicability to assess OSH performance, as well as their reliability. Future research should be done to assess the identified indicators in SMEs.

Existing heat-health warning systems focus on warning vulnerable groups in order to reduce mortality. However, human health and performance are affected at much lower environmental heat strain levels than those directly associated with higher mortality. Moreover, workers are at elevated health risks when exposed to prolonged heat. This study describes the multilingual \"HEAT-SHIELD occupational warning system\" platform (https://heatshield.zonalab.it/) operating for Europe and developed within the framework of the HEAT-SHIELD project. This system is based on probabilistic medium-range forecasts calibrated on approximately 1800 meteorological stations in Europe and provides the ensemble forecast of the daily maximum heat stress. The platform provides a non-customized output represented by a map showing the weekly maximum probability of exceeding a specific heat stress condition, for each of the four upcoming weeks. Customized output allows the forecast of the personalized local heat-stress-risk based on workers\' physical, clothing and behavioral characteristics and the work environment (outdoors in the sun or shade), also taking into account heat acclimatization. Personal daily heat stress risk levels and behavioral suggestions (hydration and work breaks recommended) to be taken into consideration in the short term (5 days) are provided together with long-term heat risk forecasts (up to 46 days), all which are useful for planning work activities. The HEAT-SHIELD platform provides adaptation strategies for \"managing\" the impact of global warming.

OBJECTIVE: This research has been conducted for the purpose of determining the cancer risk levels of women living in a small village of in Saraycık village of Ankara and their knowledge and application of breast cancer early diagnose-scan methods.
METHODS: 317 women were taken as examples for the study. Data were collected by giving survey forms to women and conducting face-to-face interviews. In determining breast cancer risk, \"the form to determine the breast cancer risk\" has been used. For breast cancer informational questions, one point has been given for each correct answer. In evaluating the data, number, percentage calculations, average and standard deviation, Mann-Whitney U (MU), Kruskal-Wallis (KW), One-way analysis of variance (F) independent sample T (t) tests have been used.
RESULTS: It has been found that breast cancer risk is low, the knowledge level about cancer early recognition methods are medium among the women. It has been determined that 74.4% women didn\'t perform breast self-examination. 89.6% of women don\'t have mammography taken and 88.6% don\'t have their breast examined by health personnel.
CONCLUSIONS: In our study, it has been found that the risk levels of women are low, their knowledge about early diagnosis and cure are at a medium level and their use of these methods are inadequate. For this reason, we suggest that responsibility of healthcare professionals have to be increased in determining breast cancer risk among women and education and advisory services for this subject to be offered.

UNASSIGNED: Diwali is a Hindu holiday observed each autumn in India, where it is known as the \'celebration of lights\'. Burning of fireworks on this day leads to air and noise pollution, causing adverse effects to human health.
UNASSIGNED: To monitor and analyze air quality and noise levels in a residential college campus in northeast India over Diwali 2015.
UNASSIGNED: Components of PM10, including metals (cadmium (Cd), cobalt (Co), iron (Fe), zinc (Zn) and nickel (Ni)), ions (calcium (Ca2+), ammonium (NH4 +), sodium (Na+), potassium (K+), chloride (Cl-), nitrate (NO3-) and sulfate (SO4 2-)) and bacterial counts were studied for a period of ten days in November 2015. In addition, a health-based survey of patients attending the institute\'s hospital during those days was conducted to evaluate the risk level due to fireworks burning.
UNASSIGNED: The mean PM10 concentration during Diwali, 311 μg/m3, was 81% higher than other days and 3.1-times higher the Indian National Ambient Air Quality Standards. While noise levels were increased by 65%, the concentration of bacteria in PM10 was reduced by 39% during Diwali compared to other days. The concentrations of metals, cations and anions were increased by 51%, 72% and 77%, respectively. A health study conducted during the analysis period revealed an increase in hospital admissions in the campus due to respiratory symptoms. The higher concentrations of metals during the Diwali period resulted in a 0.5% increase in the hazard index.
UNASSIGNED: The present study suggests that reducing fireworks during Diwali could reduce pollutant concentrations and result in potential health benefits.
UNASSIGNED: Obtained.
UNASSIGNED: The study and survey design were approved by the Institutional Bioethics Committee of the Indian Institute of Technology, Guwahati.
UNASSIGNED: The authors declare no competing financial interests.