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Poor indoor air quality (IAQ) in schools is associated with pupils’ health and their learning performance. This study aims to provide an overview of the outdoor factors that affect the IAQ in educational settings in order to develop public health measures. We conducted a systematic literature review to investigate the outdoor factors that affect IAQ in educational settings. The selection of articles included 17,082 search string hits from the ScienceDirect database published between 2010 and 2023, with 92 relevant studies selected based on the inclusion and exclusion criteria. Based on a systematic review of the literature, we identified the following outdoor factors: proximity to busy roads, commercial and industrial establishments, meteorological conditions, compounds from the natural environment, emissions from heating buildings, atmospheric reactions and secondary pollutants, unpaved school playgrounds, and smoking. This study provides key information on the mentioned outdoor factors and gives recommendations on measures to reduce classroom pollutant concentrations while highlighting educational settings that require special attention. Our study shows that classroom IAQ is affected by many outdoor pollutant sources, the prevalence of which depends on the educational setting’s micro location. Therefore, it is essential to develop an appropriate classroom ventilation strategy for each educational setting.

Air quality is becoming an important asset of modern society. Europe is adopting regulations that will enable better air quality for residents and encourage detailed study of emissions sources. Transport is recognized as a flourishing sector with the yearly growth of vehicle numbers. Even if the transport emissions trend slightly decreases, there is a concern that the increase in vehicle numbers on the road will slow down the process. Data from the bottom-up approach, estimating emissions from transit vehicles and tourism activities, was identified as a critical knowledge gap. Our study identifies and evaluates the issue of vehicle congestion on the roads during the summer, primarily driven by transit demands and tourism activities. The methodology to capture an understanding of traffic-related emissions from the summer vehicle peak was developed. Summer traffic peak was estimated by comparing the summer vehicle numbers with those of other parts of the year. Vehicle numbers were recognized by vehicle counters located on a Slovenian highway junction in the year 2021. Moreover, the study also revealed the emissions from the summer traffic peak, calculated by the COPERT emission model. We observed that, on an average summer day, there are up to 11,520 additional vehicles on Slovenian roads. It was estimated that the peak in summer passenger cars contributes up to 41,875 kg, 9542 kg, and 3057 kg of NOx, NMVOCs, and PM2.5 emissions. The maximum emissions of NOx and PM2.5 from light duty vehicles are 17,108 kg and 867 kg. There are non-negligible emissions of NMVOCs from motorcycles and these represent up to 3042 kg.

This study assessed discrepancies between self-reported and administrative data sources in identifying mental health issues in Slovenia, and investigated associated socio-demographic factors. Data were linked from the 2019 Slovenian European Health Interview Survey (EHIS; n=9,900) and national health administrative databases capturing inpatient hospitalisations, outpatient prescription drugs and mental health-related sick leave. Mental health issues were identified in EHIS by self-report and in administrative databases using diagnostic codes and medication claims. Socio-demographic factors were obtained from EHIS. Discrepancies were assessed and multinomial logistic regression was used to analyse the association between these factors and the source of case identification. Of the 9,900 EHIS respondents, 1,336 (13.5%) self-reported mental health issues, while 1,675 (16.9%) were identified in administrative databases. Only 613 individuals (4.6% of the total sample) were identified in both sources. Older age was associated with being identified in both data sources and administrative data only compared to not being identified. Females and unemployed persons were more likely than males and employed persons to be identified as having mental health issues, regardless of the data source. Compared to those with primary education or lower, individuals with higher education were less likely to be identified in administrative data only or in both data sources. discrepancies exist between self-reported and administrative data sources in identifying mental health issues. Discrepancies are associated with socio-demographic factors and may lead to different interpretations of population mental health. This study underscores the importance of cautiously interpreting self-reported and administrative health data in public health.

IntroductionSystemic allergic reaction (SAR) to a Hymenoptera venom is a potentially life-threatening disorder. The rate of SAR between beekeepers in comparison with a healthy individual is different. The risk for an SAR is particularly high in beekeepers due to their persistent or seasonal exposure to the stinging Hymenoptera. We aim to provide a critical appraisal and a synthesis of evidence-based data from epidemiological observational studies, focusing on SARs to a Hymenoptera venom and the associated risk factors for SARs in beekeepers worldwide.Methods and analysisSearching will include seven electronic databases for published studies without language restrictions, from inception up to 3 August 2021, and it will be rerun for all electronic databases prior publication. Only epidemiological observational studies in beekeepers will be included. The risk of bias in the included studies will be appraised by using the Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies and the Newcastle-Ottawa Scale, adapted for cross-sectional studies. For the certainty of evidence, the Grading of Recommendations Assessment, Development and Evaluation approach will be used. Qualitative synthesis will be presented in a tabulated format with the selected characteristics across primary studies and the main outcome of interest. A meta-analysis is planned to be performed if there will be a sufficient number of homogeneous studies with complete data. The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015 statement will guide the reporting of this systematic literature review.Ethics and disseminationNo ethics approval is needed to conduct the systematic literature review since it will be solely based on the published literature. Findings will be disseminated through the relevant conferences, peer-review and open-access journals.PROSPERO registration numberCRD42021260922.

Background Emergency departments (ED) are struggling with an increased influx of patients. One of the methods to help departments prepare for surges of admittance is time series forecasting (TSF). The aim of this study was to create an overview of current literature to help guide future research. Firstly, we aimed to identify external variables used. Secondly, we tried to identify TSF methods used and their performance. Methods We included model development or validation studies that were forecasting patient arrivals to the ED and used external variables. We included studies on any forecast horizon and any forecasting methodology. Literature search was done through PubMed, Scopus, Web of Science, CINAHL and Embase databases. We extracted data on methods and variables used. The study is reported according to TRIPOD-SRMA guidelines. The risk of bias was assessed using PROBAST and authors’ own dimensions. Results We included 30 studies. Our analysis has identified 10 different groups of variables used in models. Weather and calendar variables were commonly used. We found 3 different families of TSF methods. However, none of the studies followed reporting guidelines and model code was seldom published. Conclusions Our results identify the need for better reported results of model development and validation to better understand the role of external variables used in created models, as well as for more uniform reporting of results between different research groups and external validation of created models. Based on our findings, we also suggest a future research agenda for this field. Clinical trial number Not applicable.

Beekeepers represent a high-allergic risk population group due to their unavoidable seasonal or persistent exposure to the elicitors of venom allergy, bees in particular. A systematic literature review and meta-analysis aimed to estimate the prevalence of self-reported systemic allergic reaction to venom among beekeepers worldwide. We rigorously reviewed and conducted meta-analysis on observational studies retrieved from seven electronic databases (MEDLINE via PubMed, Web of Science Core Collection, Scopus, Academic Search Complete, ScienceDirect, Cumulative Index to Nursing and Allied Health Literature, Zoological Record), spanning data from inception to August 1, 2023. The Joanna Briggs Institute Prevalence Critical Appraisal Tool was employed to assess the risk of bias. A meta-analysis was conducted to synthesize evidence. Out of 468 studies, eight original articles met the inclusion criteria. The estimated overall lifetime and one-year prevalence of self-reported systemic allergic reaction to bee venom were 23.7% (95% CI: 7.7-53.4) and 7.3% (95% CI: 5.8-9.2), respectively. The estimated lifetime prevalence of self-reported systemic allergic reaction to bee venom for grades III-IV (severe systemic allergic reaction) was 6.0% (95% CI: 3.0-11.7). In general, substantial heterogeneity and a high risk of bias were observed across the majority of studies. The impact of geographical location and climate differences on the estimated lifetime prevalence is suggestive for severe systemic allergic reaction. Future observational cross-sectional studies should employ rigorous study designs, using validated questionnaires, and thoroughly report the observed health outcomes, verified by physicians.

Background Out-of-hospital cardiac arrest (OHCA) is a major contributor to overall morbidity and mortality. Survival depends on several factors, including rhythm shockability and timely defibrillation; for the latter, the availability of Public Access Defibrillators (PADs) is crucial. Across countries, PADs can be a limited resource, necessitating strategic placement to ensure optimal accessibility and effective utilization. The objective of this scoping review was to analyse existing experience with PAD positioning and to identify potential for the geospatial optimisation of PAD positioning. Methods An electronic search of PubMed and Scopus databases was performed to identify studies on PAD positioning. We included peer-reviewed articles as well as graduate and undergraduate theses, and excluded conference abstracts, books, and book chapters. Only English-language publications were considered. A Risk of Bias analysis was conducted and reported using Mixed Method Appraisal Tool. We adhered to PRISMA-ScR guidelines. Using the PCC framework, the Population was the general public, the Concept was PAD optimization, and the Context ranged from buildings to nations. Data charting was done manually. We quantitatively synthesized findings from included studies based on extracted data and Synthesis Without Meta-Analysis guidelines. Results We included 43 works, mostly from North America. We found substantial diversity in study methodologies, outcome measures and results reporting. Within buildings, PADs are recommended to be positioned centrally or in elevators. Outside, places with high-footfall were preferred. Optimisation models most often employed the Maximal Covering Location Problem. Most studies based their models on the locations of existing and candidate PADs, alongside historical or simulated OHCA occurrences, and tried to minimise that distance. Conclusions In this scoping review of studies optimising PAD network deployment, we found that PAD network optimisation is feasible and improves coverage of historical OHCA locations. Data-driven positioning strategies should incorporate historical OHCA locations, population health indicators, and socioeconomic variables to identify high-risk zones effectively and inform appropriate PAD density. Future studies should adopt prospective and real-world design, while adhering to guidelines for reporting results. Graphical Abstract

Background: Allergic reactions to Hymenoptera stings can have varying levels of severity, according to the Müller grading system. Methods: By an epidemiological concept, this is a retrospective cohort study. The observed cohort was represented by patients referred to the University Clinic Golnik due to Hymenoptera allergic reaction in the period from 1997 to 2015. From the immunological database of the University Clinic Golnik, we obtained laboratory data (sIgE, skin tests and basophil activation test). The clinical characteristics of patients were obtained from BIRPIS. With the help of a questionnaire, which was sent to each patient in the period from May 2019 to April 2021, we obtained epidemiological data. For the assessment of the association between the severity of allergic reaction for the observed outcome, the severity of the first allergic reaction after Hymenoptera sting was used. Other variables were grouped according to risk factors. Discussion: We will identify the risk factors that could play an important role in a severe systemic reaction: the aetiology of the Hymenoptera sting, sex, age, history and severity of previous systemic reactions, being re-stung in an interval of two months, the frequency of re-stings, atopy, genetic predisposition, preventive medication use, other medication use, beekeeping or living next to beehives and why immunotherapy was not taken. Laboratory data will also be analysed to determine if there is any association with laboratory tests and the severity of the allergic reactions after Hymenoptera stings. Conclusions: Several new approaches are introduced in the study design. The most important is that the protocol covers epidemiological data gained from the questionnaire, as well as clinical data gained from the Immunological database and BIRPIS database. We expect to obtain significant results that will explain the risk factors for the natural history of Hymenoptera sting allergic reactions and will help allergologists, as well as general doctors, when facing those patients allergic to Hymenoptera venom without immunotherapy.

Among physiotherapists, work-related musculoskeletal disorders (WMSDs) are the most common health problem. This study aimed to provide evidence for planning evidence-based health promotion programmes for ensuring and maintaining adequate physical fitness (PF) to decrease WMSDs among physiotherapists which would have started already during the study.A cross-sectional study involved the participation of a total of 100 physiotherapy students and 62 physiotherapists. Observed variables were prevalence of WMSDs in the last 12 months, lasting >3 days during physiotherapeutic activities and five PF components: body composition, cardiorespiratory and muscle endurance, muscle strength, and flexibility. A chi-square test and binary logistic regression were used as the main analytical methods.Prevalence of WMSDs in physiotherapists was 63.9% (the most common locations: lower back, shoulders, neck), while in physiotherapy students it was 46.5% (the most common locations: lower back, neck, upper back) (p=0.031). Among the PF components, the results showed statistically significantly worse flexibility among students compared to physiotherapists (about two thirds of students had poor or very poor results of flexibility testing) (p=0.002) in comparison to physiotherapists. A statistically significant positive association between WMSDs and PF was observed only between knee pain and poor cardiorespiratory endurance (OR=4.03 with 95% CI 1.12-14.58; p=0.033).The study showed poor flexibility among students indicating that it is necessary to direct them to perform activities that will increase the extensibility of muscles. The awareness of this problem should be increased. A specific role should be played by staff involved in clinical practice.

To estimate the lifetime prevalence of first and recurrent systemic allergic reaction to bee venom among Slovenian beekeepers. Additionally, we aimed to elucidate the risk factors predisposing beekeepers to developing systemic allergic reaction to bee venom. A nationwide cross-sectional study was conducted among 1,080 beekeepers who are members of the Slovenian beekeeper's association, between 1 November 2021 and 31 May 2023. Epidemiological data were collected using a validated questionnaire, with the clinician-confirmed observed health outcome. The estimated overall lifetime prevalence of self-reported first systemic allergic reaction to bee venom was 9.4% (102/1,080), with 40.7% (24/59) of the clinician-confirmed cases being severe (grade III-IV according to the Mueller classification). The estimated overall lifetime prevalence of reported recurrent systemic allergic reaction to bee venom was lower at 3.7% (40/1,080), with 60.0% (9/15) of the clinician-confirmed cases being severe (grade III-IV according to the Mueller classification). Risk factors associated with the first systemic allergic reaction to bee venom included age, male sex, number of bee stings per season, a history of large local reaction and experiencing nasal symptoms while working at hives. Younger male beekeepers, with a low number of bee stings per season, a history of large local reaction and nasal symptoms while working at hives, are at a high risk of having systemic allergic reaction to bee venom. High lifetime prevalence of clinician-confirmed severe first and recurrent systemic allergic reaction to bee venom underscored the importance of targeted public health strategies and clinical interventions to protect this high-risk population.