bluuebunny/crossref_metadata_2025_split huggingface dataset:
Smoking habits among 5th and 6th degree medical students
Authors: Erden Cengiz C , Ay P , Aigbovbiosa M , Yıldırım K , Guder S 
Published: November 2019

Abstract

Smoking is the most common cause of preventable mortality and morbidity worldwide. In the fight against tobacco physicians take active role. The objective of this study is to determine the rate and patterns of tobacco use among students of Marmara University School of Medicine (MUSM). This is a cross sectional study carried out in MUSM. The study population were all students studying in the 5th and 6th grades. Data were collected through questionnaires. The questionnaire form included sociodemographics, tobacco usepatterns, quitting attitudes and experiences. Among 410 students, 328 participated. Among all 56.1% were 5th year and 43.9% were 6th year students. The median age was 24 and 55.8% were female. 22.6% of the participants were current smoker. 33.8% of males and 13.7% of females are smoking (p:0,001). Common reasons for starting to smoke were the influence of close friends (11.3%), curosity (8.2%), stress (4.6%). Of the participants, 8.5% had smoked waterpipe. 28.4% of the current smokers still smoke waterpipe, 46.2% had tried to quit more than once and 13.5% wished to quit but had never tried to quit. 40.2% of the participants whose close friend smokes and %44.4 whose partner smokes are current smokers (p:0.001). %70 of current smokers tried at least one time electronic cigarette (p:0.001).
Approximately one fourt of the students are current smokers, higher in men. Those who smoked cigarettes had high affinity for waterpipe, electronic cigarettes. Electronic cigarette is fast rising trend daily. Starting smoking and quitting is influenced by close friends and partners.

Key messages
The primary goal should be to stop the smokers and prevent the start of the smokers. Information should be made on the harms of electronic cigarettes and the community should be informed.
Reliability and Validity of Disability Literacy Scale for Medical School Students
Authors: Aydoğan S , Atay E , Metintaş S , Demirtaş Z , Öcal E E , Pala S Çalışkan , Oktar D , Mutlu A , Önsüz M F 
Published: November 2019

Abstract

Background
Disability literacy is the ability to perceive definition of disabled person, their characteristics, difficulties in daily life and solution suggestions, their rights and false thoughts and orientations about them. The aim of the study was to develop the Disability Literacy Scale (DLS) to determine the disability literacy of medical school students with a high probability of encountering disabled people.

Methods
This study was conducted in 1110 medical school students in 2018-2019 academic year. By using literature 97 questions were collected. DLS was created with 22 questions by taking expert opinions. Correct answer was scored as 1, while wrong or ’do not know’ answer as 0. In order to evaluate the reliability of the scale, item total score correlation and internal consistency (Cronbach’s alpha) analyzes and exploratory and confirmatory factor analysis were used for construct validity.

Results
Of the 51.1% students were female and their age ranged from 17-40, the mean was 21.1±2.2. After the scale development study, the scale consisted of 14 items and 3 sub-dimensions. Scale items explain 43.21% of total variance and factor loadings ranged from 0.37-0.80. The Cronbach’s alpha coefficient was 0.61, 0.64, 0.51 for communication, health problems and social life sub-dimensions, and 0.68 for the whole scale. The fit of scale and the fit index were found to be acceptable after confirmatory factor analysis. In the last form of the scale, the score that can be taken from scale range 0-14. It was accepted that by increasing of the score, disability literacy level was increased. The mean score of students was 9.79±2.57 and the median was 10.0. The scores obtained from DLS were found to be lower in the first 3 grades (p &lt; 0.001), low level mother and father education (p &lt; 0.001/p=0.012) and who have not yet taken lesson about disability (p = 0.021).

Conclusions
DLS is a valid-reliable tool for assessing disability literacy levels of medical school students.

Key messages
It is essential to place disability related lessons from the earliest grades of medical school curriculum. In the literature, DLS seems the first scale about disability literacy and needs to be tested in large communities.
Validating a model & self-assessment tool to measure organizational health literacy in hospitals
Authors: Pelikan J , Nowak P 
Published: November 2019

Abstract

Background
The European Health Literacy Survey (HLS-EU) demonstrated that in many European countries a considerable proportion of the population has limited health literacy (HL), that there is a social gradient for HL and that HL is associated with use of health services. Furthermore research mostly from the US also showed that HL of patients has detrimental effects not only on use but also on outcomes of health care. Therefore in the US the concept of the Health Literate Health Care Organization (HLHCO) has been developed by IOM to make health services more sensitive to the needs of patients with limited HL.

Methods
Based on the IOM concept, a more comprehensive model of a Health Literate Health Care Organization fulfilling criteria of WH&Oacute;s health promoting setting approach has been developed. A set of standards and indicators according to quality management criteria (ISQUA) to measure the organizational HL of a hospital has been constructed, tested and validated in 9 different kinds of hospitals by a team in Vienna. This model and measurement tool has been translated to English and other languages and been used and validated also in other countries (Belgium, Italy, Taiwan). By an international working group of the international Health Promoting Hospitals and Health Services network an international version of the model and tool has been developed and will be tested in different countries.

Results
The model and self-assessment tool has been demonstrated to be acceptable, feasibly, valid and useful to start self-assessment and improvement of organizational HL in different types of hospitals and health care systems.

Conclusions
Organizational HL of health services matters for use and quality of health care of patients. Measuring organizational HL of hospitals by a validated instrument can support development of a more health literate health care organization and by that improve quality of care and tackle the health gap.

Key messages
Health literacy matter for health care and can be measured and improved on a personal and on an organizations or systems level to improve quality of care and tackle the health gap. A model and self-assessment instrument to measure organizational health literacy of hospitals has been developed and validated to support hospitals to improve their organizational health literacy.
Interventions for gestational diabetes prevention: An umbrella review of meta-analyses of RCTs
Authors: Giannakou K , Constantinou E , Lamnisos D 
Published: November 2019

Abstract

Background
Gestational diabetes mellitus (GDM) is a common pregnancy complication, defined as glucose intolerance with onset or first recognition during pregnancy, in women without diabetes history during pregnancy. It is a major cause for adverse maternal and fetal outcomes and affects around 15% of all pregnancies. GDM is considered to be a risk factor for future metabolic conditions and cardiovascular disease.

Methods
An umbrella review was performed to identify systematic reviews and meta-analyses of randomized controlled trials for GDM prevention in order to summarize evidence and evaluate the validity of the interventions. We searched PubMed, the Cochrane library and ISI Web of Science from inception to March 2019. For each meta-analysis we estimated the summary effect size by random-effects and fixed-effects models, the 95% confidence interval, the 95% prediction interval, the between-study heterogeneity expressed by I2, evidence of small-study effects and evidence of excess significance bias.

Results
Six-teen eligible papers were identified providing data on 39 associations. Eighteen (46%) associations had nominally statistically significant findings at P &lt; 0.05, while only one (3%) remain significant at P &lt; 10-6 under the random-effects model. Eight (21%) associations had large or very large heterogeneity. Evidence for small-study effects and excess significance bias was found in 5 (13%) and 2 (5%) associations, respectively. Only one intervention presented robust evidence for a convincing association: prenatal exercise compared with no exercise (RR 0.62, 95% CI: 0.52-0.75). It was supported by &gt; 500 cases, 95% prediction intervals excluding the null, no large heterogeneity, small-study effects, or excess of significance.

Conclusions
Prenatal exercise shows the strongest consistent evidence. The findings from our study highlight the importance of patient education about lifestyle modifications to reduce risk of GDM.

Key messages
Prenatal exercise could lower the risk of GDM based on solid epidemiologic evidence. Obesity, pregnancy hypertension and other metabolic conditions could be prevented as well.
Impact of an excise tax on the consumption of sugar-sweetened beverages in Catalonia, Spain
Authors: Bordonada MA Royo , Escobar C Fernández , Simón L , Barbero B Sanz , Padilla J 
Published: November 2019

Abstract

Background
Sugar-sweetened beverage consumption is contributing to the obesity epidemic. On 28 March 2017, Catalonia enacted a law levying an excise tax on sugar-sweetened beverages for public health reasons. The purpose of this study is to assess the impact of the tax on the consumption of sugar-sweetened beverages in Catalonia (Spain).

Methods
Before-and-after study to assess changes in the prevalence of consumption of sugar-sweetened beverages among 1929 persons aged 12 to 40 years residing in low-income neighbourhoods of Barcelona (intervention) and Madrid (control). Beverage consumption frequency was ascertained via a validated questionnaire administered during the month prior to the tax’s introduction (May 2017) and again at one year after it had come into force. The effect of the tax was obtained using Poisson regression models with robust variance.

Results
While the prevalence of regular consumers of taxed beverages fell by 41% in Barcelona as compared to Madrid, the prevalence of consumers of untaxed beverages remained stable. The main reason cited by more than two-thirds of those surveyed for reducing their consumption of sugar-sweetened beverages was the increase in price, followed by a heightened awareness of their health effects.

Conclusions
The introduction of the Catalonian excise tax on sugar-sweetened beverages was followed by a reduction in the prevalence of regular consumers of taxed beverages.

Key messages
This is the first study to show the efficacy of the Catalonian excise tax to reduce the prevalence of regular consumers of sugar sweetened beverages by residents of low-income neighbourhoods in Spain. Our results, along with the remaining scientific evidence on the subject, would justify the extension of the measure to the rest of Spain for public health reasons.
How the French Nutri-Score can impact sales of processed-foods? A complex system perspective
Authors: Breton E , Ode O , Oikonomidi T ,   the EHESP MPH working group on Nutri-Score
Published: November 2019

Abstract

Background
Nutri-Score (NS) is France Front-of-Pack Food Labelling System to provide at-a-glance information about the nutritional quality of pre-packaged food products. Based on the Food Standards Agency nutrient profiling system, its algorithm generates a score by taking into account the presence of both the harmful and beneficial contents in food. In this presentation, we report on our analysis of the logic model of NS and on its potential impact on the production and marketing of processed foods.

Methods
We reviewed the scientific and grey literature on NS to identify its potential mechanisms and loci of change. We also appraised the policy against Meadow’s leverage points for system change.

Results
The official adoption of the NS algorithm is instrumental in modifying both consumer food-related behaviours and food industry corporate practices. The algorithm takes 3 forms: 1) the front-of-pack logo indicating an integrated colour/letter score for the product, 2) mobile device applications which help consumers assess the nutritional value of food products even without an affixed logo, 3) nutritional parameters which influence food manufacturing decision-making in the industry. NS can trigger different drivers of corporate practice. From the current uptake trends, small and medium size food manufacturers appear more likely to welcome the NS Logo as a means to stand out against the multinational corporations presently dominating the market. As for the capacity of NS to transform the existing systems of producing and marketing processed foods, we find that it is mostly by changing the flow of information. NS presents new information, previously inaccessible to consumers, to support the population in making healthier food choices by providing a means for nuanced nutritional comparisons between food products of the same category.

Conclusions
We conclude on the potential evolution of Nutri-Score and how its uptake by food corporations may be fostered.

Key messages
Nutri-Score’s impact is through: the front-of-pack logo; nutrition apps; and as a parameter of food industry decision-making. Nutri-Score impacts the flow of information of the processed-food system.
The Trends of Underweight in South Korean between 1998 and 2015
Authors: Lee Kyung Jin , Lim Juwon 
Published: November 2019

Abstract

Background
Underweight is associated with increased mortality, relative to the normal weight category. The importance of managing underweight patients has not yet been recognized seriously in South Korea, and little information is available on the prevalence of underweight and its associated risk factors. This study aims to investigate changes in the prevalence of underweight by gender and age and analyze its trend.

Methods
Data were obtained from individuals aged &gt;20 years, from the Korean National Health and Nutrition Examination Survey between 1998 and 2015. The subjects of this study included 134,613 adults (male, 61,152; female, 73,461). The prevalence of underweight was determined as defined by the Asia-Pacific Perspective, and socioeconomic factors associated with a predisposition to underweight were analyzed using the chi-squared test and multiple logistic regression analysis.

Results
Among Korean adults, the age-adjusted prevalence of underweight (body mass index &lt;18.5 kg/m2) was 3.1% in men and 6.3% in women. Overall, a U-shaped relationship was established between the prevalence of underweight by gender and age. There was no significant difference in socioeconomic factors related to the prevalence of underweight in men and women in their twenties. The prevalence of underweight in women aged 20-59 years showed an increasing trend (P for trends &lt;0.05).

Conclusions
In individuals aged 20-29 years, the prevalence of being underweight was higher in women than in men. Recently, there has been an increasing trend in the prevalence of underweight young women of reproductive age. This requires national public health attention.

Key messages
Underweight in old age and young age requires nation wide public health attention. Especially thinness in young women in reproductive age must be considered as global health issue.
Evaluation of Malnutrition and Depression in Elderly People: An Epidemiological Study in Turkey
Authors: Aydoğan S , Ünsal A , Arslantaş D 
Published: November 2019

Abstract

Background
Malnutrition is an important cause of morbidity and mortality. Malnutrition increases the number of hospitalizations and prolongs the length of hospitalization by disrupting organ functions, increasing the number and severity of infections and delaying wound healing. The aim of this study was to determine the frequency of suspected malnutrition in the elderly, to examine some related variables and to evaluate the depression.

Methods
The study is a cross-sectional study conducted between March-April 2019 in individuals aged 60 years and older living in Sivrihisar. Sample size was calculated as 579. Cluster sampling method used. Data was collected by door to door in 4 neighborhoods determined by randomly. Mini Nutritional Assessment Test-Short Form (for malnutrition), Katz Daily Living Activities Scale (for dependency) and Geriatric Depression Scale-Short Form (for depression) were used. Chi-square test, Mann Whitney U test and logistic regression analysis were used for the analyzes.

Results
The study group consisted of 220 (38%) women and 359 (62%) men. The mean age was 68.9±6.4 (ranged 60-93). Frequency of suspected malnutrition was 25% (n = 145). Being 80 years of age or older (OR:3.24, CI:1.53-6.85), having a primary and lower education level (OR:2.54, CI:1.32-4.90), history of chronic illness (OR:2.34, CI:1.33-4.03), using dentures (OR:1.62, CI:1.03-2.55) and suspected depression (OR:4.97, CI:3.17-7.78) are important risk factors for malnutrition. Those with suspicion of malnutrition had lower scores on DLA (z = 8.982;p=0.001).

Conclusions
Malnutrition was found to be an important health problem for the elderly. The frequency of suspected malnutrition is higher in individuals with depression. Those with suspected malnutrition have higher level of dependency. In order to reduce the frequency of malnutrition, it may be beneficial to increase the awareness of the elderly and caregivers and to give importance to the elderly nutrition of primary health care providers.

Key messages
Depression is an important risk factor for malnutrition. Malnutrition increases the dependence of the individual on daily activities.
Socioeconomic disparities in diabetes prevalence and quality of care among Israeli children
Authors: Weisband Y Loewenberg , Calderon-Margalit R , Wolff-Sagy Y , Krieger M , Abu-Ahmed W , Ben-Yehuda A , Horwitz E , Manor O 
Published: November 2019

Abstract

Background
Despite Israel’s universal health coverage, disparities in health services provision may still exist. We aimed to assess socioeconomic disparities in diabetes prevalence and quality of care among Israeli children, and to assess trends in these over time.

Methods
Repeated cross-sectional analyses in the setting of the National Program for Quality Indicators in Community Healthcare that receives data based on electronic medical records from Israel’s four health maintenance organizations. The study population included all Israeli children aged 2-19 years in 2011-2017 (for 2017: N = 2,364,374, including 2,914 with diabetes). Socio-economic position (SEP) was measured using Central Bureau of Statistics data further updated by a private company (Points Business Mapping Ltd), and grouped into 4 categories, ranging from 1 (lowest) to 4 (highest). Using logistic regression, we assessed the association of SEP with diabetes prevalence, diabetes clinic visits, hemoglobin A1C (HbA1C) testing, and poor glycemic control (HbA1C&gt; 9%), and assessed whether these changed over time. Models were adjusted for age, and sex.

Results
Diabetes prevalence increased with age and SEP. SEP was positively associated with visiting a specialized diabetes clinic (OR SEP 4 vs. 1 2.53, 95% CI 1.72 - 3.70). Odds of HbA1C testing and odds of poor glycemic control were negatively associated with SEP (OR SEP 4 vs. 1: 0.54, 95% CI 0.40 - 0.72 and OR SEP 4 vs. 1: 0.25, 95% CI 0.18 - 0.34 respectively). Disparities were especially apparent among children aged 2-9 (4.6% poor glycemic control in SEP 4 vs. 40.8% in SEP 1). Poor glycemic control decreased over time, from 44.0% in 2011 to 34.8% in 2017.

Conclusions
While poor glycemic control rates among children have improved, significant socioeconomic gaps remain. It is eminent to study the causes of these disparities and develop policies to improve care provided to children in the lower SEP levels, to promote health equity.

Key messages
Major socioeconomic inequalities in the control of diabetes among children in Israel remain despite universal health care coverage. The rate of uncontrolled diabetes among Israeli children has improved over time.
Mood disorders with onset in early adulthood and socio-economic outcomes over the long run
Authors: Hakulinen C , Musliner K L , Agerbo E 
Published: November 2019

Abstract

Background
Mood disorders have been associated with poor socioeconomic outcomes, but there is a lack of large-scale population-based studies on the topic. We examined associations between bipolar disorder and depression with an onset between ages 15 and 25, and subsequent socio-economic outcomes (employment, income and educational attainment) using Danish registry data.

Methods
All individuals (n = 2 390 127; 49% women) born in Denmark between 1955 and 1990, who were alive at their 25th birthday were included. Employment status, wage or self-employment earnings, and educational attainment were assessed annually from the age of 25 to 58 (years 1980 to 2015). Mood disorder diagnosis was obtained from the Danish Psychiatric Central Register. The associations were examined using logistic regression analyses.

Results
At the age of 30, 46% of individuals with bipolar disorder and 35% of individuals with depression were not employed, and 52% of individuals diagnosed with bipolar disorder and 42% of individuals with depression did not have any secondary or post-secondary education. Bipolar disorder and depression were associated with increased and increasing risk (at age 30: bipolar disorder, OR 7.21, 95% CI 6.54 to 7.96; depression, OR 4.07, 95% CI 3.93 to 4.22) of not being employed over the follow-up. Similarly, both bipolar disorder and depression were associated with increased risk of not completing secondary or post-secondary education (at the age of 30, bipolar disorder: OR 3.21, 95% CI 2.92 to 3.54; depression: OR 2.81, 95% CI 2.71 to 2.91), but this difference become smaller over the follow-up. An individual with bipolar disorder or depression earned around 36% and 51%, respectively, of the earnings earned by an individual without mood disorders.

Conclusions
Mood disorders diagnosed in early adulthood are associated with lasting poor socioeconomic outcomes over the long run.

Key messages
Early onset mood disorders are associated with consistently, and in some cases increasingly, poorer socioeconomic outcomes over time. An individual with early onset bipolar disorder or depression earned around third and half, respectively, of the earnings earned by an individual without early onset mood disorders.