bluuebunny/crossref_metadata_2025_split huggingface dataset:
Suicide among Brazilian adolescents - a growing reality
Authors: Saldanha R C O , Abe G M , Abe A H M , Mariano M E O , Pierson I D S , Santana B F , Lima P H R O 
Published: October 2020

Abstract

Introduction
In Brazil, suicide is an alarming and growing health problem among adolescents. The Sustainable Development Goals aims to promote mental health.

Methods
Descriptive epidemiological study regarding the proportion of deaths by suicide according to ICD-10 classification, gender, Brazilian region, place of occurrence, race and year in adolescents from 10 to 19 years old in the period of 2008 to 2017 in Brazil, through the national system of health data, DATASUS.

Results
From 2008 to 2017, there were 175,543 deaths in adolescents due to external causes in Brazil; voluntarily self-inflicted injuries were the second main cause with 8,028 (4.6%) deaths - Among them, 728 occurred in 2008, 672 in 2009, 706 in 2010, 733 in 2011, 792 in 2012, 786 in 2013, 814 in 2014, 854 in 2015, 897 in 2016, and 1047 in 2017. Cases of strangulation/hanging/suffocation were 5,429 (67.2%); self-poisoning by pesticides were 512 (6.5%); intentional self-harm caused by the firing of another firearm and an unspecified firearm were 456 (5.7%). The most affected gender was male, with 5,536 (69%) deaths; female was 2,492 (31%). Among regions, the Southeast Region had 2,238 (27.9%) death records, followed by the Northeast, with 2,128 (26.5%). The most reported place of occurrence was home, with 4,570 (56.9%) deaths, followed by hospital, with 1,627 (20.3%). Among races, brown people were 3,803 (47.4%) deaths, and whites were 3,023 (37.7%).

Conclusions
Suicide of adolescents is a growing tragedy, with an increase of 55% in the analyzed period. Expanding studies on the theme will favor better conduct and management by health professionals. The timely identification of adolescents with a suicidal tendency and its specialized follow-up may be tools to reduce this sad reality.

Key messages
The study of child and youth suicide is important to assess the aspects that promote it, propose effective interventions and evaluate, by monitoring, the problems caused at home. It elucidates a important topic to Brazilian public health: suicide among young people. Due to its prevalence, discussing it corroborates to develop new guidelines and conducts for managing patients.
Factors associated with dating violence in young university students of Veracruz - Boca del Río
Authors: Valencia Almeida S I , Villegas Domínguez J E , Villegas Vázquez E A , Leyva Chipol J C , Márquez Celedonio F G 
Published: October 2020

Abstract

Introduction
In the Mexican - American population, violence occurs between 10 and 40% of initial affective relationships. Veracruz is one of the main Mexican states that suffers violence and is the one with the largest number of femicides (3.44 per 100,000 women). Research question: what are the associated factors in the victimization in the courtship of young university students from the Veracruz - Boca del Río conurbation zone?

Methods
A cross-sectional, prospective, observational and analytical study was conducted from August to November 2019. University students enrolled in a higher education educational program in public and private universities of Veracruz-Boca del Río, who have had the minus a dating relationship and those who did not agree to participate were excluded. Violence in dating was quantified with the “Questionnaire on Violence in Dating (CUVINO)” (Alfa Cronbach 0.91). The spss v22 software was used to analyze the data.

Results
680 participants were included, distributed in private schools (56.47%) and public schools (43.52%), with 444 (65.2%) women and 236 (34.7%) men. The prevalence of dating violence was 74.9%, however, only 21.6% of the participants considered having had such a relationship. The factors associated with dating violence were studying in a private school (OR = 0.62 IC95% 0.4-0.9), witnessing some act of violence in your family (OR = 1.47 IC95% 1.02-2.12), meeting a friend with a relationship violent (OR = 2.0 95% CI 1.4-2.9), believe that abuse exists in courtship (OR = 4.7 95% CI 2.9-7.4) and suspect that you may be in a violent relationship (OR = 4.67 95% CI 2.22- 9.83), while not witnessing any act of violence in your family (OR = 0.61 95% CI 0.4-0.8) is a protective factor to avoid violence in dating, all these values with p &lt; 0.05. It was not associated with violence.

Conclusions
Violence in dating is associated with behaviors of family members and friends of the violent.

Key messages
The social situation close to a person influences the violence allowed in their courtship. Young people normalize violence in a relationship, since many of them do not identify it when living it.
Medicinal cannabis, a medicine. Characterization of the reality in Portugal
Authors: Garrido J , Martins T , Pedro A R , Santos I , Miranda R , Silva D 
Published: October 2020

Abstract
Cannabis has been used over the centuries for medicinal purposes. The first evidence dates from the third millennium BC in India and Chinese Empire, due to its analgesic, antiemetic and anticonvulsant properties. Nevertheless, its use is also associated to manufacture industry - hemp - translating a widespread function. However, through time, it is its recreational, additive and illegal purposes are the ones that we most quickly associate with it. This stigmatized its use in society and neglected the benefits. Its only in the XX century with the discover of the of the endocannabinoid system that allowed a new vision on the theme, challenging and revolutionizing the, until then, ingrained classic vision. In fact, its benefits in several pathologies or clinical symptons are well documented today. In light of the current debate on the use of cannabis for medicinal purposes worldwide and recently in Portugal with new legislation, a review of the available literature is required to explain the national reality and its context in the international reality. Due to the clinical and social relevance of the theme, the authors aimed to study, collect and systematize information in order to uptodate the state of art in: innovation, potential indications for its therapeutic use; understand the existing legal framework in Portugal, for cannabinoids and for the previous phases, such as cultivation and production; understand and compare the international reality and that existing in Portugal, namely in Portuguese hospitals; and, understand what are the future perspectives for cannabis as a therapeutic line.

Key messages
Clinical and social relevance of the theme and its legal framework. What are the future perspectives for cannabis as a therapeutic line nd the stigma of using it.
Characteristics of people with mental disorders differ between currently smoking and ceased smoking
Authors: Dahal R , Bharrarai A , Adhikari K 
Published: October 2020

Abstract

Introduction
Although the prevalence of smoking is higher among people with mental disorders compared to those without mental disorders, people with mental disorders are less successful for smoking cessation. This study examined the variation in characteristics of people with mental disorders across those who are current smokers and former smokers.

Methodology
This study used the Public Used Microdata File of the Canadian Community Health Survey 2012. (n = 25,113). People with any mental health disorder in the last 12 months were identified using the World Health Organization Composite International Diagnostic Interview instrument. Smoking status was classified based on self-report responses as: current, former, and never smoking. Multivariable logistic regression analysis was used to examine the association between the characteristics of people with mental disorders and smoking cessation (vs continuation).

Results
Overall, the prevalence of current smoking, former smoking, and nonsmoker were 37.5%, 33.6%, and 28.8% respectively. Immigrants compared to Canadian-born (OR = 0.6, 95% CI = 0.3, 0.8) and those who were single (either widowed or divorced or separated or single) compared to married or living with a partner (OR = 0.4, 95% CI = 0.1, 0.6) were less likely to quit smoking. Similarly, less educated and young people were also less likely to quit smoking.

Conclusions
Young people, living alone, less educated, and immigrants are less successful to quit smoking. Findings indicate the social disparity in smoking cessation among people with mental disorders. This may have been related to the barriers in accessing smoking cessation support among this group.

Key messages
Findings underscore the disparity in smoking cessation among people with mental disorder. Implementation of tailored, personalized smoking cessation support may be helpful to address the challenges.
Use of alcohol associated with mental disorders in adult men
Authors: Bulgareli J , Souza C , Pereira A , Meneghim M , Guerra L , Cavalcanti D , Gondinho B , Checchi M , Mendes K 
Published: October 2020

Abstract

Background
This study aimed to identify the use of alcohol in adult men and to verify the association with socioeconomic, demographic and mental disorders.

Methods
A cross-sectional analytical study was carried out on adults aged 20 to 59 years old in the city of Piracicaba registered in the Family Health Units (FHU) in 2018. The pattern of alcohol use was investigated in the population through the application of the AUDIT (The Alcohol Use Disorders Identification Test) instrument. Through the modified socioeconomic questionnaire by Meneghim et al, socioeconomic and demographic factors were investigated. The brief investigation of the main mental disorders: major depressive episode and generalized anxiety disorder, was carried out with the Mini International Neuropsychiatric Interview (MINI). The sample was selected “post-hoc” considering the sample, with a significance level of 5% and test power above 80% (β = 0.20) (effect size = 0, 33). After contacting the FHU and selecting participants, the interviews were conducted over the phone in one step. The eligible sample had 227 participants. After descriptive analyzes, variables with p-value &lt;0.20 in simple analyzes were studied in multiple negative binomial regression models (95% confidence intervals).

Results
There was a high prevalence of alcohol consumption, 26.9%. The AUDIT score increased with age (RM: 1.02; 95% CI: 0.99-1.03). Protestants and evangelicals had an average AUDIT score lower than other religions (RM: 1.78; 95% CI: 1.14-2.79). People with mental disorders have an average AUDIT score higher than those without disorders (RM: 2.30; 95% CI: 1.28-4.11).

Conclusions
It is concluded that alcohol in the adult male population was prevalent, increases with age, and religion has a protective effect. We highlight the importance of the USF in the development of strategies that investigate the conditions of its population, as well as the discussion and approach of interventions

Key messages
The adult male population is more vulnerable to alcohol use and its consequences. Thus, early detection and the search for associated factors is necessary to avoid possible damage to men's health. The application of the Mini International Neuropsychiatric Interview instrument, can act preventively and with early interventions in mental disorders and in association with alcohol use.
Cervical screening for HIV-positive women in the transition to primary HPV testing in Ireland
Authors: Kelly C , Mason-Mohan C , Doherty L 
Published: October 2020

Abstract

Background
CervicalCheck, Ireland's national cervical cancer screening programme, will transition to primary HPV testing in March 2020. CervicalCheck sought an evidence review to inform the screening pathway for HIV-positive women in this context, with regard to age of initiation and frequency of screening. Currently, HIV-positive women commence cervical screening at age 20 in Ireland with annual screening thereafter.

Methods
An electronic literature search was conducted to identify relevant peer-reviewed publications using the database Pubmed. A hand search of reference lists of suitable articles and international cervical screening guidelines was conducted to check for additional material. Publications pertaining to international cervical screening guidance and practice were sourced via internet searches using Google. The relevant grey literature was also explored.

Results
The prevalence of multiple and more persistent high-risk HPV types is higher among HIV-positive women compared to HIV-negative women. HIV-positive women are also at an increased risk of progression and post-treatment recurrence of HPV-associated cervical lesions. The degree of immunosuppression is a key factor in the relationship between HPV and HIV. There is significant heterogeneity internationally as regards cervical screening pathways for HIV-positive women. Many programmes commence screening at the time of diagnosis with HIV. Most developed countries screen HIV-positive women more frequently than HIV-negative women, although the screening interval varies.

Conclusions
HIV-positive women warrant special attention within an organised population-based cervical screening programme. The evidence synthesised in this review was used to inform change to the screening pathway for HIV-positive women as part of the planned transition to primary HPV testing. Cervical screening for these women using primary HPV testing will now commence at the time of diagnosis with HIV, with annual screening thereafter.

Key messages
HIV-positive women warrant special attention within an organised population-based cervical screening programme. The evidence synthesised in this review was used to inform change to the screening pathway for HIV-positive women as part of the planned transition to primary HPV testing in Ireland.
Palliative care and complex chronic conditions since the perspective of healthcare professionals
Authors: Doñate-Martínez A , Llop L , Garcés J 
Published: October 2020

Abstract

Background
According to the WHO, palliative care (PC) is applicable early in the course of illness together with other curative therapies. Early PC has demonstrated beneficial effects on quality of life and symptom intensity among cancer patients. However, PC is not as early integrated on the care pathway of complex chronic conditions (CCC). This abstract presents barriers and needs identified to effectively implement early PC on CCC performed under the EU-funded InAdvance project (ref.: 825750).

Methods
Semi-structured interviews were performed with 16 healthcare professionals (HPs) from primary care and hospital settings working with older patients with CCC in Valencia (Spain).

Results
Interviews reported that main needs identified to provide early PC are: (a) coordinated strategies between multi-setting HPs to an early identification of CCC patients in need of PC; (b) adequate resources to attend patients' PC needs from a holistic view, i.e. psychosocial and spiritual needs; and (c) early integration of basic PC at primary care teams. The main barriers identified were: (a) stereotypes associated to the traditional PC approach; (b) poor knowledge from HPs of the PC holistic approach; and (c) lack of specific protocols or pathways for CCC in need of PC.

Conclusions
Specific skills and resources are the most relevant needs to effectively provide early PC among patients with CCC. First, it is urgent to demystify the negative culture-related vision of PC that is commonly associated to sedation and last days of a person's life. Also, multidisciplinary HPs require specific training to identify and provide early PC tailored to CCC. And, it is required a strategic and multi-setting organizational approach with fluent information flow and coordinated roles.

Key messages
Healthcare expenditure would be considerably reduced, especially at hospital and emergency units, with an early identification of patients with CCC in need of PC. Empowering primary HPs in PC would improve the quality of care of patients with CCC.
The impact of Multidisciplinary Tumor Boards on breast cancer care: results of a systematic review
Authors: Castrini F , Specchia M L , Spina F , Carini E , Di Pilla A , Grieco A , Frisicale E , Ricciardi W , Damiani G 
Published: October 2020

Abstract
A Multidisciplinary Tumor Board (MTB) is a group of professionals from different clinical areas that meets to examine oncological patients to face multiple aspects of the pathology. MTBs represent an effective way for clinical decision making and management of complex diseases like cancer that needs an integrated approach. They have the potential to implement patient's care optimizing both evaluation and treatment. The aim of this study was to evaluate the clinical and organizational impact and benefits of MTBs on breast cancer cases.
The databases investigated to carry out the research were Pubmed and Web of Science. Only Italian and English articles focused on breast cancer patients evaluated through MTB approach were included. No time restriction was adopted. Articles about other types of cancer were not included; systematic reviews and non-peer reviewed papers such as editorial and commentaries were excluded from the study.
The research found 5163 publications; duplicated records were omitted. 5086 articles were excluded through the analysis of title and abstract; after full text reading 52 studies were excluded. Only 25 publications fulfilled the inclusion and exclusion criteria. Two articles considered the impact of MTB on overall survival; 1 publication studied the effect of diagnostic changes; 7 articles examined the impact of MTBs on cancer treatment; 2 studies analysed the effects on clinical performance. Other publications examined secondary outcomes and indicators.
MTB has been described to have a positive impact on breast cancer. It improves overall survival (substantial results for over 65), diagnostic accuracy (up to 65%) and treatment scheme making it more adherent to guidelines (28%-93,1%). Furthermore, MTB makes patient's management more functional and avoids inappropriate interventions.
Further studies are needed to deepen on some topics such as the economic aspects and the importance of the participation of general practitioners to MTBs.

Key messages
MTB could improve patient’s care and clinical management of cancer. It is necessary to study if greater accuracy in patient’s management could have economic impact as it avoids inappropriate procedures.
Long-term outcome after off-pump coronary artery bypass grafting: implication for public health
Authors: Rosato S , Barili F , D'Errigo P , Biancari F , Forti M , Cerza F , Cicala S D , Badoni G , Seccareccia F 
Published: October 2020

Abstract

Background
The debate on the benefits and limitations of off-pump (OPCAB) coronary artery bypass grafting (CABG) on long-term outcomes is not yet settled. This study aimed to compare the impact of OPCAB vs on-pump CABG on long-term outcomes and to evaluate possible public health implications linked to their use.

Methods
The PRIORITY project was planned to evaluate the long-term outcomes of two prospective multicenter studies on CABG conducted between 2002-2004 and 2007-2008. Data on isolated CABG were linked to administrative data in order to retrieve patients' late outcome. Time-to-event distributions were analyzed accordingly to primary event-type (death, major adverse cardiac events (MACEs)) using the Kaplan-Meier and the Cox proportional hazards methods.

Results
The study population consisted of 11 021 patients who underwent isolated CABG (27.2% OPCAB). The median follow-up time was 8.0 years (interquartile range 7.6-10.0 years). OPCAB had comparable late all-cause mortality to on-pump CABG (HR 0.94, 95%CI 0.85-1.03, p = 0.19), but it was associated to an increased risk of MACE (adjusted HR 1.14, 95%CI 1.06-1.23, p = 0.001). In particular, OPCAB had an increased risk of repeated revascularization with percutaneous cardiac intervention (PCI) (adjusted HR 1.33, 95%CI 1.16-1.53, p &lt; 0.001) compared to on-pump CABG.

Conclusions
OPCAB does not affect long-term mortality, but it significantly increases the risk of MACEs. In particular, OPCAB had an increased risk of repeated revascularization with PCI. These findings may have important implications towards health resources allocation.

Key messages
Off-pump coronary artery bypass grafting strategy is associated with an increased long-term risk of MACE and repeated PCI. Off-pump strategy is mainly based on operator preferences and can have important implications in terms of healthcare costs.
Healthcare services use and costs for a cohort of high needs elderly diabetic patients
Authors: Caberlotto R , Buja A , Pinato C , Mafrici S , Bolzonella U , Baldovin T , Corti M C , Avossa F , Schievano E , Baldo V 
Published: October 2020

Abstract

Background
The worldwide prevalence of diabetes mellitus is increasing, which especially involves people aged &gt;65 years. A recent study also found that almost 75% of adults with diabetes have two or more comorbid conditions. The aim of the study was to investigate the impact of comorbidities on health care service use and health care costs of an elderly diabetes cohort with high health care needs (HHCN), based on real-world data.

Methods
For the purposes of the present study, people with a diagnosis of diabetes, residing in the area served by the ex-ULSS4-Veneto LHU, and characterized as having HHCN, corresponding to ACG-RUBs 4 and 5 were considered. The comorbidities was assessed using clinical diagnoses that the ACG System assigns to single patients by combining different information flows. The presence of correlation between comorbidity classes and total annual health care costs and use was tested with Spearman Test. Moreover, the association between above mentioned variables was tested with a appropriate regression, adjusting for age and sex.

Results
Mean overall cost and drug cost ranged respectively from 6284 euro, 525 euro in a patient with only 1 comorbidity to 10752 euro and 1764 euro for a patient with more than 8 comorbidities. The study shows that all measures of health care services use (as emergency care accesses; number of outpatients visits; number of inpatients admissions) have a statistically significant correlation with comorbidities class. However, multivariate analyses revealed that no different use in hospitalization was associated with comorbidity class. A significant correlation was also detected among costs variables (total annual costs and pharmacy costs) and comorbidity classes.

Conclusions
The increase in total healthcare services use and costs due to the increased number of comorbidities was seen mainly for primary care services, highlighting the need of primary care to be strengthen in an ageing and multi-morbid population.

Key messages
Overall cost and drug cost for patients with more than 8 comorbidities are respectively almost doubled and more than threefold greater than those with only one comorbidities. The study revealed an increase in primary care services, suggesting an implementation of these services giving the aging population and the increase prevalence of comorbid diabetic patients worldwide.