Laura C. Rosella's research while affiliated with City of Toronto and other places
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Publications (467)
Objective
To compare how different imputation methods affect the estimates and performance of a prediction model for premature mortality.
Study Design and Setting
Sex-specific Weibull accelerated failure time survival models were run on four separate datasets using complete case, mode, single and multiple imputation to impute missing values. Six p...
Introduction and Objective: It is unclear whether DKD incidence varies by world region of birth. We examined whether the incidence of DKD (defined as the Kidney Disease Improving Global Outcomes (KDIGO) categories 2-4) differs between immigrants and long-term residents (LTRs) with T2D in Ontario, Canada.
Methods: This retrospective cohort study use...
Objective
Estimate the impact of 20% flat-rate and tiered sugary drink tax structures on the consumption of sugary drinks, sugar-sweetened beverages, and 100% juice by age, sex, and socioeconomic position.
Design
We modelled the impact of price changes –for each tax structure– on the demand for sugary drinks by applying own- and cross-price elasti...
Urban environmental factors such as air quality, heat islands, and access to greenspaces and community amenities impact public health. Some vulnerable populations such as low-income groups, children, older adults, new immigrants, and visible minorities live in areas with fewer beneficial conditions, and therefore, face greater health risks. Plannin...
Mental health is a complex, multidimensional concept that goes beyond clinical diagnoses, including psychological distress, life stress, and well-being. In this study, we aimed to use unsupervised clustering approaches to identify multidimensional mental health profiles that exist in the population, and their associated service-use patterns. The da...
Background:
Small area estimation refers to statistical modelling procedures that leverage information or "borrow strength" from other sources or variables. This is done to enhance the reliability of estimates of characteristics or outcomes for areas that do not contain sufficient sample sizes to provide disaggregated estimates of adequate precisi...
Introduction
Characterizing diabetes risk in the population is important for population health assessment and diabetes prevention planning. We aimed to externally validate an existing 10-year population risk model for type 2 diabetes in the USA and model the population benefit of diabetes prevention approaches using population survey data.
Researc...
Some patients with back pain contribute disproportionately to high healthcare costs; however, characteristics of high-cost users with back pain are not well defined. We described high-cost healthcare users based on total costs among a population-based cohort of adults with back pain within the Ontario government's single-payer health system across...
Background Mitochondrial disease has been linked to mental health disorder in clinical cohorts and post-mortem studies. However, a lack of population-level studies examining the relationship between mitochondrial disease and mental health has resulted in an evidence gap and creates a challenge for identifying and addressing care needs for the mitoc...
Background
There is growing interest in understanding the care needs of lonely people but studies are limited and examine healthcare settings separately. We estimated and compared healthcare trajectories in lonely and not lonely older female and male respondents to a national health survey.
Methods
We conducted a retrospective cohort study of comm...
Background
Predicting chronic disease incidence at a population level can help inform overall future chronic disease burden and opportunities for prevention. This study aimed to estimate the future burden of chronic disease in Ontario, Canada, using a population-level risk prediction algorithm and model interventions for equity-deserving groups who...
Introduction
Avoidable hospitalizations are considered preventable given effective and timely primary care management and are an important indicator of health system performance. The ability to predict avoidable hospitalizations at the population level represents a significant advantage for health system decision-makers that could facilitate proact...
Background
Premature deaths are a strong population health indicator. There is a persistent and widening pattern of income inequities for premature mortality. We sought to understand the combined effect of health behaviours and income on premature mortality in a large population-based cohort.
Methods
We analyzed a cohort of 121,197 adults in the 2...
Background
Waning immunity from seasonal influenza vaccination can cause suboptimal protection during peak influenza activity. However, vaccine effectiveness studies assessing waning immunity using vaccinated and unvaccinated individuals are subject to biases.
Aim
We examined the association between time since vaccination and laboratory-confirmed...
Background
People who are unhoused, use substances (drugs and/or alcohol), and who have mental health conditions experience barriers to care access and are frequently confronted with discrimination and stigma in health care settings. The role of Peer Workers in addressing these gaps in a hospital-based context is not well characterized. The aim of...
Background
Community belonging, an important constituent of subjective well-being, is an important target for improving population health. Ageing involves transitioning across different social conditions thus, community belonging on health may vary across the life course. Using a nationally representative cohort, this study estimates the life stage...
Background: While many standardized surveys exist to measure patient experience, they are not designed to assess unique features of integrated care (IC) programs including transitions from hospital to community, satisfaction with homecare, or resources and supports provided post-discharge. The aim was to have patients lead efforts to develop a set...
Urban environmental factors such as air quality, heat islands, and access to greenspaces and community amenities impact public health. Some vulnerable populations such as low income groups, children, older adults, new immigrants, and visible minorities live in areas with fewer beneficial conditions and therefore face greater health risks. Planning...
Objective
To control virus spread while keeping the economy open, identifying individuals at increased risk of COVID-19 transmission in the workplace is paramount.
Methods
Among adult participants in a large Canadian rapid antigen screening program (January 2021-March 2022), we examined screening, personal, and workplace characteristics and conduc...
Background
Understanding what promotes or hinders a community’s capacity to serve the priorities of its residents is essential for the alignment of citizen needs and governance. Participatory approaches that engage community residents on the topic of community wellbeing are useful methods for defining outcomes that reflect a community’s goals and p...
Background
Adults with multiple chronic conditions (MCC) are a heterogeneous population with elevated risk of future adverse health outcomes. Yet, despite the increasing prevalence of MCC globally, data about MCC in pregnancy are scarce.
Objectives
To estimate the population prevalence of MCC in pregnancy and determine whether certain types of chr...
The clinical trajectory of survivors of critical illness following hospital discharge can be complex and highly unpredictable. Assessing long-term outcomes after critical illness can be challenging due to possible competing events such as all-cause death during follow-up (which preclude the occurrence of an event of particular interest). In this pe...
Background
Surgical site infections (SSIs) occur frequently and impact patients and health care systems. Remote surveillance of surgical wounds is currently limited by the need for manual assessment by clinicians. Machine learning (ML)–based methods have recently been used to address various aspects of the postoperative wound healing process and ma...
BACKGROUND
Surgical site infections (SSIs) occur frequently and impact patients and healthcare systems. Re-mote surveillance of surgical wounds is currently limited by the need for manual assessment by clinicians. Machine learning (ML)-based methods have recently been used to address various aspects of the postoperative wound healing process and ma...
Background
Social determinants of health are non-medical factors that influence health outcomes (SDOH). There is a wealth of SDOH information available in electronic health records, clinical reports, and social media data, usually in free text format. Extracting key information from free text poses a significant challenge and necessitates the use o...
Obesity is a known risk factor for major chronic diseases. Prevention of chronic disease is a top global priority. The study aimed to model scenarios of population-level and targeted weight loss interventions on 10-year projected risk of chronic disease in Canada using a population-level risk prediction algorithm. The validated Chronic Disease Popu...
Health inequities are differences in health that are 'unjust'. Yet, despite competing ethical views about what counts as an 'unjust difference in health', theoretical insights from ethics have not been systematically integrated into epidemiological research. Using diabetes as an example, we explore the impact of adopting different ethical standards...
The labor market is undergoing a rapid artificial intelligence (AI) revolution. There is currently limited empirical scholarship that focuses on how AI adoption affects employment opportunities and work environments in ways that shape worker health, safety, well-being and equity. In this article, we present an agenda to guide research examining the...
Objectives
Mortality-based indicators are commonly used as measures of population health but less frequently applied to measuring health system performance. This systematic review aimed to identify and describe mortality indicators relevant to the measurement of population health and health system performance in high-income countries.
Methods
We s...
Scarce evidence is available on the impact of real-world smoking cessation treatment on subsequent health outcomes, such as incidence of chronic disease. This study compared two cohorts of people that smoke-those that enrolled in a smoking cessation program, and a matched control that had not accessed the program-to assess the incidence of cancer,...
Background
Adults with back pain commonly consult chiropractors, but the impact of chiropractic use on medical utilization and costs within the Canadian health system is unclear. We assessed the association between chiropractic utilization and subsequent medical healthcare utilization and costs in a population-based cohort of Ontario adults with ba...
Abstract Introduction Studying high resource users (HRUs) across jurisdictions is a challenge due to variation in data availability and health services coverage. In Canada, coverage for pharmaceuticals varies across provinces under a mix of public and private plans, which has implications for ascertaining HRUs. We examined sociodemographic and beha...
Objectives:
Several Canadian provinces and territories have reformed their health systems by centralizing power, resources, and responsibilities. Our study explored motivating factors and perceived impacts of centralization reforms on public health systems and essential operations.
Methods:
A multiple case study design was used to examine three...
Importance:
People who survive hospitalization for COVID-19 are at risk for developing new cardiovascular, neurological, mental health, and inflammatory autoimmune conditions. It is unclear how posthospitalization risks for COVID-19 compare with those for other serious infectious illnesses.
Objective:
To compare risks of incident cardiovascular,...
Background:
Few large-scale studies have examined the health impacts of overcrowded housing in European countries. The aim of this study was to assess whether household crowding during adolescence increases the risk of all-cause and cause-specific mortality in Switzerland.
Methods:
Study participants were 556,191 adolescents aged 10-19 years at...
This study examined the association between physiotherapy utilization and subsequent medical healthcare utilization and costs in a population-based sample of adults with back pain in Ontario. We conducted a population-based cohort study of Ontario respondents with back pain (≥18 years) of the Canadian Community Health Survey 2003 to 2010 cycles, li...
Objective:
Individuals with Type 2 Diabetes are likely to experience multimorbidity and accumulate multiple chronic conditions over their life. We aimed to identify causes of death and chronic conditions at the time of death in a population-based cohort, and to analyze variations in the presence of diabetes at the time of death overall and across...
Background:
Health care delivery is often poorly coordinated and fragmented. Integrated care (IC) programs represent one solution to improving continuity of care. The aim of this study was to understand experiences and reported outcomes of patients and caregivers in an IC Program that coordinates hospital and home care for thoracic surgery.
Metho...
Aims:
To examine the influence of immigration status and region of origin on the risk of type 2 diabetes in women with prior gestational diabetes (GDM).
Methods:
This retrospective population-based cohort study included women with gestational diabetes (GDM) aged 16 to 50 years in Ontario, Canada who gave birth between 2006-2014. We compared the...
Introduction
Patients with diabetes have a higher risk of mortality compared with the general population. Large population-based studies that quantify variations in mortality risk for patients with diabetes among subgroups in the population are lacking. This study aimed to examine the sociodemographic differences in the risk of all-cause mortality,...
Background:
Among people who inject drugs, frequent injecting and experiencing withdrawal are associated with facilitating others' first injections. As these factors may reflect an underlying substance use disorder, we investigated whether first-line oral opioid agonist treatment (OAT; methadone or buprenorphine/naloxone) reduces the likelihood th...
Background:
Current methods used to estimate surgical wait times in Ontario may be subject to inconsistencies and inaccuracies. In this population-level study, we aimed to estimate cataract surgery wait times in Ontario using a novel, objective and data-driven method.
Methods:
We identified adults who underwent cataract surgery between 2005 and...
COVID-19 health impacts and risks have been disproportionate across social, economic, and racial gradients (Chen et al., 2021; Thompson et al., 2021; Mamuji et al., 2021; COVID-19 and Ethnicity, 2020). By examining the first five waves of the pandemic in Ontario, we identify if Forward Sortation Area (FSAs)based measures of sociodemographic status...
Background:
Older adults are recommended to receive influenza vaccination annually and many use statins. Statins have immunomodulatory properties that might modify influenza vaccine effectiveness (VE) and alter influenza infection risk.
Methods:
Using the test-negative design and linked laboratory and health administrative databases in Ontario,...
As the frequency of international travel increases, more individuals are at risk of travel-acquired infections (TAIs). In this ecological study of over 170,000 unique tests from Public Health Ontario’s laboratory, we reviewed all laboratory-reported cases of malaria, dengue, chikungunya, and enteric fever in Ontario, Canada between 2008–2020 to ide...
Objectives:
To describe risk factors for major cardiovascular events in adults following hospital discharge after sepsis.
Design:
Population-based cohort study.
Setting:
Ontario, Canada (2008-2017).
Patients:
Adult patients (age 18 yr or older) who survived a first sepsis hospitalization without preexisting cardiovascular disease.
Intervent...
Objectives
To investigate whether trazodone is being initiated in lieu of antipsychotics following antipsychotic reduction efforts, this study described changes in medication initiation over time.
Methods
We conducted a retrospective cohort study of new admissions to nursing homes in Ontario, Canada between April 2010 and December 2019 using healt...
Background: Potentially inappropriate antipsychotic use has declined in nursing homes over the past decade; however, increases in the documentation of relevant clinical indications (eg, delusions) and the use of other psychotropic medications have raised concerns about diagnosis upcoding and medication substitution. Few studies have examined how th...
Cross-sector partnerships are vital for maintaining resilient health systems; however, few studies have sought to empirically assess the barriers and enablers of effective and responsible partnerships during public health emergencies. Through a qualitative, multiple case study, we analyzed 210 documents and conducted 26 interviews with stakeholders...
Background
There have been longstanding calls for public health systems transformations in many countries, including Canada. Core to these calls has been strengthening performance measurement. While advancements have been made in performance measurement for certain sectors of the health care system (primarily focused on acute and primary health car...
Background:
Evidence on the effects of in utero exposure to maternal diabetes on cerebral palsy (CP) in offspring is limited. We aimed to examine the effects of pregestational (PGDM) and gestational diabetes (GDM) separately on CP risk and the mediating role of increased fetal size.
Methods:
In a population-based study, we included all live birt...
Importance:
There is an urgent need for evidence to inform preoperative risk assessment for the millions of people who have had SARS-CoV-2 infection and are awaiting elective surgery, which is critical to surgical care planning and informed consent.
Objective:
To assess the association of prior SARS-CoV-2 infection with death, major adverse card...
Importance
Although maternal unintentional injury during pregnancy has shown negative impacts on the mother and fetus, the evidence on its long-term associations with children’s neurodevelopment is limited.
Objective
To examine the association between maternal unintentional injury and cerebral palsy (CP) in offspring.
Design, Setting, and Partici...
Artificial intelligence (AI) has the potential to improve public health’s ability to promote the health of all people in all communities. To successfully realize this potential and use AI for public health functions it is important for public health organizations to thoughtfully develop strategies for AI implementation. Six key priorities for succe...
The extent to which power, resources, and responsibilities for public health are centralized or decentralized within a jurisdiction and how public health functions are integrated or coordinated with health care services may shape pandemic responses. However, little is known about the impacts of centralization and integration on public health system...
Background and aims:
Although opioid-related harms have reached new heights across North America, the size of the gap in opioid agonist therapy (OAT) delivery for opioid-related health problems is unknown in most jurisdictions. This study sought to characterize the gap in OAT treatment using a cascade of care framework, and determine factors assoc...
Background
People experiencing homelessness have diverse patterns of healthcare use. This study examined the distribution and determinants of healthcare encounters among adults with a history of homelessness.
Methods
Administrative healthcare records were linked with survey data for a general cohort of adults with a history of homelessness and a c...
Rationale:
Adult sepsis survivors have an increased risk of experiencing long-term cardiovascular events.
Objective:
To determine whether the cardiovascular risk following sepsis is mitigated by renin-angiotensin system inhibitors (RASi).
Methods:
Population-based cohort study of adult sepsis survivors designed to emulate a target randomized t...
Global increases in thyroid cancer incidence (≥90% differentiated thyroid cancers; DTC) are hypothesized to be related to increased use of pre-diagnostic imaging. These procedures can detect DTC during imaging for conditions unrelated to the thyroid (incidental detection). The objectives were to evaluate incidental detection of DTC associated with...
Aims:
As an indicator of maternal cardio-metabolic health, newborn birthweight may be an important predictor of maternal type 2 diabetes mellitus (diabetes). We evaluated the relation between offspring birthweight and onset of maternal diabetes after pregnancy.
Methods:
This retrospective cohort study used linked population-based health database...
Objective
The objective of this study is to simultaneously assess the associations between suboptimal oral health (SOH) and cardiovascular disease (CVD) and competing death (CD).Methods
Ontario residents aged 40 years and over who participated in the Canadian Community Health Survey 2003 and 2007–2008 were followed until December 31, 2016 for the i...
Introduction
Nations thorughout the world are imposing mandatory quarantine on those entering the country. While such measures may be effective in reducing the importation of COVID-19, the mental health implications remain unclear.
Objectives
This study sought to assess mental well-being and factors associated with changes in mental health in indi...
Context:
The COVID-19 pandemic has impacted health systems worldwide. Studies to date have largely focused on the health care system with less attention to the impact on public health systems and practice.
Objective:
To describe the early impacts of COVID-19 on public health systems and practice in 3 Canadian provinces from the perspective of pu...
There has been considerable growth in the development of machine learning models for clinical applications; however, less attention has been paid to applications at the health systems level. Here, we survey recent models developed using provincial administrative health data holdings in Ontario, Canada to synthesize key learnings across use cases. W...
Objectives
Local neighbourhoods have great potential to foster community belonging which can improve health and well-being. In partnership with the City of Toronto, we prioritize and assess the importance of physical and social environmental attributes to community belonging. Using new data linkages, we contribute to Toronto’s community safety and...
BACKGROUND
Public health professionals regularly engage in complex tasks involving data and models on large population segments, and use various tools to help support their data-driven decision-making. Human factors methods can be employed in the design of such tools to better support public health professionals in decision-making tasks.
OBJECTIVE...
The COVID-19 pandemic has heightened the food insecurity crisis in Canada, and existing supports have been largely insufficient to meet the food needs of communities. In response to increasing reports of food insecurity among Toronto residents during the pandemic, the Food RX program was developed as a collaborative initiative between FoodShare Tor...
Introduction
There has been little investigation of whether the clinical effectiveness of smoking cessation treatments translates into differences in healthcare costs, using real-world cost data, to determine if anticipated benefits of smoking cessation treatment are being realized. We sought to determine the association between smoking cessation t...
Background
Autism spectrum disorder (ASD) incidence has increased in past decades. ASD etiology remains inconclusive, but research suggests genetic, epigenetic, and environmental contributing factors and likely prenatal origins. Few studies have examined modifiable environmental risk factors for ASD, and far fewer have examined protective exposures...
Background
Limited access to mental health and addiction (MHA) services in rural areas may increase the risk of recurrent alcohol-related harm among rural, relative to urban, residents. This study evaluated (1) rural-urban differences in clinical trajectories following alcohol-related hospitalizations and (2) whether limited access to MHA services...
Purpose:
Rates of alcohol-related harm are higher in rural versus urban Canada. This study characterized the spatial distribution and regional determinants of alcohol-related emergency department (ED) visits and hospitalizations in Ontario to better understand this rural-urban disparity.
Methods:
This was a cross-sectional spatial analysis of ra...
Aim
To examine the prevalence and temporal trends of cerebral palsy (CP) overall and by population characteristics.
Method
We identified 2 110 177 live births born in the province of Ontario, Canada, between 2002 and 2017 using administrative health data and estimated CP prevalence in children aged 0 to 16 years overall and by specific population...
Background
Causal inference using area-level socioeconomic measures is challenging due to risks of residual confounding and imprecise specification of the neighbourhood-level social exposure. By using multi-linked longitudinal data to address these common limitations, our study aimed to identify protective effects of neighbourhood socioeconomic imp...
Background
Due to the growing amount of COVID-19 research literature, medical experts, clinical scientists, and researchers frequently struggle to stay up to date on the most recent findings. There is a pressing need to assist researchers and practitioners in mining and responding to COVID-19-related questions on time.
Methods
This paper introduce...
In December 2020, Ontario, Canada, entered a provincewide shutdown to mitigate COVID-19 transmission. A regionalized approach was taken to reopen schools throughout early 2021 without any other opening of the economy, offering a unique natural experiment to estimate the impact of school reopening on community transmission. Estimated increases of 0....
Pediatric intensivists are bombarded with more patient data than ever before. Integration and interpretation of data from patient monitors and the electronic health record (EHR) can be cognitively expensive in a manner that results in delayed or suboptimal medical decision making and patient harm. Machine learning (ML) can be used to facilitate ins...
People experiencing homelessness are often considered frequent healthcare users. Although their service use is not uniform, it can be difficult to identify the highest-cost users without access to comprehensive cost data. This study validated a set of algorithms that apply healthcare encounter data to identify high-cost users among adults with a hi...
Objective:
To investigate the prospective association between life satisfaction and future mental health service use in: (1) hospital/emergency department, and (2) outpatient settings.
Design and setting:
Population-based cohort study of adults from Ontario, Canada. Baseline data were captured through pooled cycles of the Canadian Community Heal...
There has been considerable growth in the development of machine learning algorithms for clinical applications. The authors survey recent machine learning models developed with the use of large health administrative databases at ICES and highlight three areas of ongoing development that are particularly important for health system applications.
Background
Mitochondrial disease prevalence has been estimated at 1 in 4000 in the United States, and 1 in 5000 worldwide. Prevalence in Canada has not been established, though multi-linked health administrative data resources present a unique opportunity to establish robust population-based estimates in a single-payer health system. This study use...
Prediction models have been a cornerstone of cardiovascular epidemiology for decades. Various types of methods have been tested for improvements in model performance, including machine learning models. In this issue of the International Journal of Epidemiology, Barbieri et al.¹ combine survival methods with deep learning models to predict the 5-yea...
Objective
To predict older adults’ risk of avoidable hospitalisation related to ambulatory care sensitive conditions (ACSC) using machine learning applied to administrative health data of Ontario, Canada.
Design, setting and participants
A retrospective cohort study was conducted on a large cohort of all residents covered under a single-payer syst...
Introduction
Public health professionals engage in complex cognitive tasks, often using evidence-based decision support tools to bolster their decision-making. Human factors methods take a user-centred approach to improve the design of systems, processes, and interfaces to better support planning and decision-making. While human factors methods hav...
Objective
To determine if expansion of multi-use physical activity trails in an urban centre is associated with reduced rates of cardiovascular disease (CVD).
Methods
This was a natural experiment with a difference in differences analysis using administrative health records and trail-based cycling data in Winnipeg, Canada. Prior to the interventio...
Background
Modern health surveillance and planning requires an understanding of how preventable risk factors impact population health, and how these effects vary between populations. In this study, we compare how smoking, alcohol consumption, diet and physical activity are associated with all-cause mortality in Canada and the United States using co...
Background
The linkage of records across administrative databases has become a powerful tool to increase information available to undertake research and analytics in a privacy protective manner. Objective
The objective of this paper was to describe the data integration strategy used to link the Ontario Ministry of Children, Community and Social Ser...
Artificial intelligence (AI) has the potential to improve public health surveillance, health promotion, and population health management through improved targeting of interventions and policy to populations that are most in need, known as precision public health. To successfully realize this potential and use AI for public health functions it is im...
Background:
The linkage of records across administrative databases has become a powerful tool to increase information available to undertake research and analytics in a privacy protective manner.
Objective:
The objective of this paper was to describe the data integration strategy used to link the Ontario Ministry of Children, Community and Socia...
Background:
Myocardial infarction mortality has declined since the 1970s, but contemporary drivers of this trend remain unexplained. The aim of this study was to compare the contribution of trends in event rates and case fatality to declines in myocardial infarction mortality in four high-income jurisdictions from 2002-15.
Methods:
Linked hospit...
The transmission of coronavirus disease 2019 (COVID-19) in workplaces has been a persistent issue throughout the pandemic. In response, a not-for-profit initiative emerged to mitigate COVID-19 workplace transmission in Canada. We report the process for establishing a workplace frequent rapid antigen test (RAT) program. The screening program identif...
Purpose: To determine whether surviving a first sepsis hospitalization is associated with long-term cardiovascular events.
Methods: Population-based matched cohort study conducted in Ontario, Canada (2008-2017). Adult survivors (older than 18 years) of a first sepsis hospitalization were matched to adult survivors of a non-sepsis hospitalization u...
Citations
... We see an opportunity for the ECE framework to be paired with a learning health systems (LHSs) approach to support implementation, evaluation and adaptation (Greene et al. 2012;Lee-Foon et al. 2023a, 2023bReid 2016;Reid and Greene 2023;Reid et al. 2024 ). In an LHS, communities, researchers and health system operators come together to define, understand and tackle complex healthcare problems (Reid et al. 2024). ...
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... However, this approach may be subject to the so-called 'depletion-of-susceptibles' bias, which arose from differential depletion of susceptible individuals between vaccinated and unvaccinated groups and may lead to the apparent VE waning [21]. To reduce the effects of this bias, the second approach considers only vaccinees and evaluates the risk of influenza at different time points since vaccination [22,23]. This vaccineonly approach may instead underestimate risk of influenza in the early vaccinees and consequently underestimate VE waning [22]. ...
... En plus d'être plus bénéfiques pour la patientèle, les straté gies non punitives réduisent le nombre et les coûts des hospitali sations 5 Accès aux soins de santé ayant vécu une forme de marginalisation, comme l'itinérance, un problème de santé mentale ou la consommation de substances psychoactives, d'aider la patientèle ayant des expériences com parables à établir un lien de confiance avec l'équipe clinique, à explorer le soutien social offert dans la communauté et à éviter l'hospitalisation. La littérature récente portant sur les personnes en pairaidance en milieu hospitalier montre qu'elles offrent un appui essentiel aux patientes et patients qui ont accès au soutien social et aux services de réduction des méfaits 6 . ...
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... However, these survival analysis methods were originally developed to describe all-cause mortality in the presence of loss to follow-up independent of the study outcome [24,29]. Therefore, when KM and Cox proportional hazards models are used to describe outcomes other than all-cause mortality in the presence of a significant and related competing risk, such as death, it is likely that biased results may result [30,31]. ...
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... In recent years, dramatic improvements in the performance of language models and increased availability of open source state-of-the-art transformer-based models such as BERT [5], Longformer [6], and Llama-2 [7] have accelerated the development and application of ML and NLP tools to augment health service delivery alongside human experts [8][9][10][11]. In the context of mental health, NLP tools have been successfully developed to identify signs of depression in social media posts, and also to support triaging and reduce wait times in message-based suicide support platforms [12,13]. These real-world applications demonstrate the ability of NLP to be harnessed to help those facing mental health challenges through both non-clinical and clinical channels. ...
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... Örneğin, eğer bir eşitlik standardı benimsenecekse tüm eşitsizlikler azaltılmalıdır. 'Yeterli sağlık düzeyinin' üzerindeki eşitsizliklerin ele alınmasına gerek kalmayacaktır (Brendan, 2023). ...
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... Tursunbayeva and Renkema (2022) investigate the impact of AI applications in the healthcare sector on the job design of healthcare professionals. Jetha (2023) highlights the implications of AI adoption for employment opportunities, work environments, and worker health, safety, well-being, and equity. Jaiswal et al. (2021) discuss the upskilling of employees for AI adoption in multinational corporations. ...
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... Adding a measure of crowdedness introduce a possibility to evaluate if the space is too small for the number of persons living in the home. The most common method to calculate crowdedness is persons per room excluding kitchens and bathrooms (63,64), why this method was applied to this study. It did not seem appropriate to use number of persons and bedrooms as the measured IAQ was conducted in the living room. ...
... It remains unclear whether the post-acute sequelae of SARS-CoV-2 are distinct from those that follow infections with other viruses. While some studies suggest that the post-acute sequelae of SARS-CoV-2 tend to be more severe compared to those of other viral infections such as influenza [13,20,[24][25][26][27], other studies have reported otherwise, claiming that the post-acute sequelae of SARS-CoV-2 are comparable to those of other viral infections like influenza [28,29]. Our results, which show that the relative risk of symptoms in SARS-CoV-2 patients at 90 days after diagnosis is not significantly different from that of influenza controls, are consistent with the latter. ...
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... For example, some studies reported that mortality in patients hospitalized with influenza was significantly lower in statins users than it was in statins non-users [21]. However, other studies showed that statins use was associated with an increased risk of laboratory-confirmed influenza [22] and reduced influenza vaccine efficacy against medically attended acute respiratory illness (MAARI) [23]. In addition, some studies found that there was no statistically significant difference in the risk of hospitalization for pneumonia or influenza between statins users and non-users [24,25]. ...
