bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increase in cocaine-related deaths in Slovenia
Authors: Jandl M , Rostohar K , Krek M 
Published: October 2020

Abstract

Background
In 2016, sudden increase in cocaine related deaths was reported in Slovenia. Study aims to provide data for understanding this new trend and results will serve to create responds to prevent those deaths in the future.

Methods
We used a trendspotter study methodology. Data from General Mortality Register with forensic autopsies and toxicological analysis were overviewed. For further analysis we linked mortality data with the treatment database for the history of treatment. Data from Early Warning System and national Police service were used.

Results
All 18 cocaine deaths in 2016 were men with average age 38.9 years. The highest number of deaths occurred in the 30-34 age group. Deaths in time periods can not be linked with seizures of cocaine with certainty. An autopsy was performed in 17 people. Cocaine with benzodiazepines was found in 7 deaths or with opiates in five deaths. Followed are combinations with amphetamines, alcohol and cannabis. 33% were included in the treatment programs.

Conclusions
No detailed data on cocaine related deaths was available in Slovenia until now. With analysis we got an important inside on this problem and the basis for setting trends regarding cocaine deaths in Slovenia.

Key messages
Sudden increase in cocaine related deaths was reported in Slovenia. Study aims to provide data for understanding new trend in cocaine related deaths.
School staff’s views on poor mental health among Swedish students in a rural setting
Authors: Svensson Å , Warne M 
Published: October 2020

Abstract

Background
School staffs' views on poor mental health in students is of interest when planning and evaluating mental health promotion in school. The aim of the present study was to explore school staff's views on poor mental health in students.

Methods
The study was carried out in a rural municipality in the northern part of Sweden in 2019-2020. The baseline data presented here was collected prior to a mental health promotion intervention (Youth Aware of Mental Health). Three focus group interviews were conducted with teachers/teacher assistants in grade 7-9 at three different schools, and one with the central student health team. One individual interview was carried out with a psychologist from the student health team. Thematic content analysis was used.

Results
Preliminary analysis resulted in three themes. In To discover and interpret poor mental health, the school staff discussed distribution, signs, and difficulties for school staff and students to detect and handle poor mental health. In The surrounding community, school staff reflected on the impact of students' contexts, including school, home, leisure activities, and social media, in the rural setting. Lastly, in What the school and students can do, school staff elaborated on conditions and possibilities to prevent and manage poor mental health in the local context.

Conclusions
School staff expressed that they and the students had difficulties interpreting and managing students' poor mental health. Students are surrounded by norms, and demands for responsibility, engagement and performance in different contexts. Inadequacies in the school organization put greater responsibility on the individual teacher.

Key messages
There are shortcomings in school staffs' as well as students’ knowledge of and management of poor mental health. In order to promote mental health among students, the rural school needs to create an organization that takes into account the conditions of sparsely populated areas.
Anticholinergic burden and cognitive functions in schizophrenia: a systematic literature review
Authors: Giannakou K , Georgiou R , Lamnisos D 
Published: October 2020

Abstract

Background
Cognitive dysfunction in schizophrenia forms the key cause of the disease's disability, leading in serious functional implications at the individual level and socioeconomic effects at global level. Dopaminergic-cholinergic balance is considered essential to cognitive function in schizophrenia while patients are often treated with many drugs with anticholinergic activity. This study aims to examine the association between high anticholinergic burden medication and cognitive function in schizophrenia patients.

Methods
A systematic review was performed on English language research studies published on PubMed from inception to December 2019 focusing on the effect of anticholinergic loads on cognitive domains in schizophrenia. No restrictions on study designs, age or geographical distribution were applied. Two researchers performed independently the screening and shortlisting of the eligible articles. A narrative synthesis of the main characteristics and the findings of included studies was reported.

Results
In total, fourteen articles of varying methodological design met the inclusion criteria. Three of them found significant improvement in cognition after anticholinergic discontinuation without adverse effects. Eleven studies found a significant association between high anticholinergic burden and cognitive impairment (e.g. verbal memory, information processing speed and working memory). However, the magnitude of the association in the largest study is statistically significant but of dubious clinical significance.

Conclusions
Medication with increased anticholinergic load has been found in most of the studies to affect the cognitive functions of people with schizophrenia. However, the lack of clinical and methodological homogeneity of selected studies, limit our interpretation and conclusions.

Key messages
There is some evidence indicating a negative effect of anticholinergic drug treatment on cognitive function of schizophrenia patients. Well-designed large prospective studies and randomized clinical trials are required to examine the effect of anticholinergic drug treatment in the cognition of schizophrenia patients.
Minor mental disorders among undergraduate students: Prevalence and associated factors
Authors: Ferreira Júnior V , de Sousa Gomes E , Pereira Lima M , Maura Mascarini L 
Published: October 2020

Abstract
Although it is recognized that mental disorders are more likely to occur in adulthood, especially in university period, and result in damage to health and incapacity for work, researches with university population are scarce in Brazil. We aimed to evaluate the prevalence of Minor Mental Disorders (MMD) among undergraduate students of a public university of São Paulo state, and investigate its association with social and economic conditions, sexuality and gender. This is a cross-sectional study conducted in 2018 with 376 undergraduate students who were halfway through the course. Data were collected from an anonymously and self-administered questionnaire, and MMD was evaluated from Self Report Questionnaire (SRQ-20). Associations were estimated through logistic regression, and odds ration calculated. We found prevalence of 53.9% of MMD among the students, and associated with gender (OR, 3.66; 95% CI, 2.37-5.67), being LGBT + (e.g Bisexuals OR, 2.92; 95% CI, 1.56-5.50), not receiving necessary family support (OR, 5.6; 95% CI, 2.00 - 15.68), not being satisfied with the course (OR, 23.69 95% CI, 2.95 - 190,03) and not practicing physical activities regularly (OR, 2.05; 95% IC, 1.33 - 3.17). Minor mental disorders prevalence found was high, reaching more than 70% in some courses (e.g 77.8% among Biomedicine students), mainly associated with gender, sexual orientation and emotional support. Our study draws attention to the urgency of monitoring the mental health status of undergraduate students, and implementing mental health centers at universities, as well as facilitating access and improve existing centers.

Key messages
The high prevalence of minor mental disorders found among undergraduate students indicates the urgent need for interventions in this populations. Women and LGBT+ students are groups at higher risk for the development of minor mental disorders at university. Strategies must be created to reduce the higher prevalence in this populations.
Psychiatric morbidity among patients attending a rural non-communicable disease clinic
Authors: Sangwan G , Mehra A , Grover S , Avasthi A 
Published: October 2020

Abstract

Background
The presence of psychiatric illness among patients with physical illnesses leads to poor treatment adherence, poor lifestyle, increased cost of treatment, poor quality of life, worsening of physical illness, work absenteeism, increased hospital visits, poor self-care and higher mortality. The study evaluated the prevalence of cognitive impairment and psychiatric morbidity in non-communicable disease patients. The study highlights that NCD patients should be provided information about the development of cognitive impairment in order to prevent it.

Methods
It was a cross-sectional study conducted among the patients attending the non-communicable disease clinic of a rural community health centre run in collaboration with the Postgraduate Institute Medical Education and Research (PGIMER), Chandigarh. We registered 124 patients after obtaining written informed consent. Instruments: Hindi Mental Status Examination (HMSE), Patient Health Questionnaire-9, Generalized anxiety disorder-7 (GAD-7) scale. Analysis of covariance was applied to see the relationship between the domain of the HMSE and NCDs.

Results
The mean age of the participants was 55.5 years (SD-11.9, Range-26-90). A little more than one third (N = 48, 38.7%) were diagnosed with hypertension only, one-sixth (N = 22; 17.7%) were diagnosed with diabetes mellitus only, and 54 (43.5%) patients were diagnosed with both hypertension and diabetes mellitus. A slightly more than one-third of the study participants were diagnosed with depressive disorder (N = 44, 35.5%), and 29% (N = 36) of the participants were diagnosed with an anxiety disorder. About one-fourth of patients with NCD have cognitive impairment and 39.51% have psychiatric morbidity.

Conclusions
The prevalence of cognitive impairment is higher among patients of NCD with psychiatric morbidity. Patients with NCDs should be routinely screened for cognitive functioning and provided information about the development of cognitive impairment.

Key messages
Because of high prevalence of cognitive impairment and psychiatric morbidity in NCD patients, patients should be provided information to prevent it. There is a need to screen NCD patients routinely for cognitive functioning, and provide them information to prevent cognitive impairment.
Loneliness, social isolation, and chronic disease outcomes
Authors: Christiansen J , Lund R , Qualter P , Andersen C M , Pedersen S S , Lasgaard M 
Published: October 2020

Abstract

Background
Research suggests that loneliness and social isolation are serious public health concerns. However, our knowledge of the associations of loneliness and social isolation with specific chronic diseases is limited. The present prospective cohort study investigated (a) the longitudinal associations of loneliness and social isolation with four chronic diseases (cardiovascular disease [CVD], chronic obstructive pulmonary disease [COPD], diabetes mellitus Type 2 [T2D], and cancer), (b) the synergistic association of loneliness and social isolation with chronic disease, and (c) baseline psychological and behavioral explanatory factors.

Methods
Self-reported data from the 2013 Danish “How are you?” survey (N = 24,607) were combined with individual-level data from the National Danish Patient Registry on diagnoses in a 5 year follow-up period (2013-2018).

Results
Cox proportional hazard regression analyses showed that loneliness and social isolation were independently associated with CVD (loneliness: adjusted hazard ratio (AHR) = 1.20, 95% confidence interval [CI; 1.03, 1.40]; SI: AHR = 1.23, 95% CI [1.04, 146]) and T2D (loneliness: AHR =1.90, 95% CI [1.42, 2.55]; SI: AHR = 1.59, 95% CI [1.15, 2.21]). No significant associations were found between loneliness or social isolation and COPD and cancer, respectively. Likewise, loneliness and social isolation did not demonstrate a synergistic effect on chronic disease. Multiple mediation analysis indicated that loneliness and social isolation had an indirect effect on CVD and T2D through both baseline psychological and behavioral factors.

Conclusions
Loneliness and social isolation were independently associated with a diagnosis of CVD and T2D within a 5 year follow-up period. The associations of loneliness and social isolation with CVD and T2D were fully explained by baseline psychological and behavioral factors.

Key messages
Individuals exposed to loneliness and social isolation constitute vulnerable groups in risk of chronic disease. Psychological and behavioural factors explain the associations with chronic disease.
Does seeing a psychologist reduce sickness absence due to mental disorders? A quasi-experiment
Authors: Lahti J , Harkko J , Sumanen H , Piha K , Pietiläinen O , Mänty M , Rahkonen O , Lallukka T , Kouvonen A 
Published: October 2020

Abstract

Background
Mental ill-health in young adults is a major public health and work-life problem. We examined in a quasi-experimental design whether occupational psychologist appointment can reduce subsequent sickness absence due to mental disorders among young Finnish employees.

Methods
The present study was conducted among 18-39-year-old employees of the City of Helsinki using register data from the City of Helsinki and the Social lnsurance Institution of Finland. We used Wald test to compare the differences in sickness absence days due to mental disorders (ICD-10, F-diagnosed) between those treated (occupational psychologist appointment for work ability support) and the non-treated (no psychologist appointment) during a one year follow-up. The full sample (n = 2156, 84% women) consisted of employees with mental disorder diagnosed sickness absence during 2009-2014. To account for the systematic differences between the treated and non-treated, the participants were matched according to their characteristics (age, sex, occupational class, education, previous sickness absence and psychotropic medication). The matched sample included 886 participants. We excluded those with treatment before the treatment screening time (± 3 months to the end of sickness absence period), non-treated with treatment during the follow-up and those that could not be matched (lack of common support).

Results
In the full sample, the mean of sickness absence days due to mental disorders was 17.7 (95% CI, 11.4, 24.1) days for those treated (n = 240) and 23.2 (95% CI, 20.5, 25.9) days for non-treated (n = 1916), difference being non-significant. The corresponding figures in the matched sample were (16.8, 95% CI, 9.5-24.1) for those treated (n = 195) and (27.8, 95% CI, 22.6-32.9) for non-treated (n = 691), difference being statistically significant (p = 0.02).

Conclusions
This quasi-experiment suggests that seeing an occupational psychologist to support work ability may be reduce mental health related sickness absence.

Key messages
We showed that supporting work ability at an early stage may prevent sickness absence due to mental disorders. More efforts to provide early stage support for maintaining work ability may prove useful in reducing sickness absence rates in younger employees.
Disparities in prevalence of metabolic syndrome: A cross-sectional analysis of Indian adults
Authors: Joshi C , Thanikachalam M , OI Bermudez  , Chui K K H 
Published: October 2020

Abstract

Background
Metabolic syndrome (MS) is a cluster of risk factors: central obesity, a low level of high-density lipoprotein cholesterol, high levels of triglyceride, fasting glucose, and blood pressure. Individuals with MS have an increased risk for cardiovascular disease and diabetes. South Asians, including Indians, generally have higher rates, earlier onset, and severe forms of cardiovascular diseases and the associated risk factors compared to other ethnic groups. This study assessed the prevalence of MS in an adult South Indian population, and further examined socioeconomic, gender and rurality disparities.

Methods
We analyzed data from 7,697 adults aged between 20 and 76 years participating in the baseline PURSE-HIS study, a community-based cross-sectional study conducted in India in 2012. Socioeconomic status was derived from summary scores of three variables: family income, education and occupation. Univariate and multivariate logistic regressions were conducted to find the association between behavioral risk factors and metabolic syndrome, after adjusting for age, sex, rurality and socioeconomic status.

Results
The overall prevalence of metabolic syndrome was 36.3%, with significant gender difference (38.3% for women vs. 33.8% for men, P &lt; 0.01). Women in semi-urban areas were twice as likely to have metabolic syndrome compared to men in urban areas (OR = 2.0, 95%CI:1.2 to 3.1, p &lt; 0.01). Women in higher socioeconomic group were more than four times likely to have metabolic syndrome compared to men in lower socioeconomic group (OR = 4.2, 95%CI:2.3 to 7.6, p &lt; 0.01).

Conclusions
The study emphasizes the need of preventative and curative interventions focused on low-socioeconomic populations, particularly women who reside in non-urban areas. The findings have important implications for the USA because there are 2.4 million foreign-born population from India, making it the second-largest immigrant group in the USA after Mexicans.

Key messages
Low socioeconmic population and women residing in non-urban areas are at higher risk for metabolic syndrome. Preventative and curative interventions focused on low-socioeconomic populations should be prioritized.
Illustrated Prescription – History of evolution at the School of Patients DF
Authors: Cubas-Rolim E , Yung F R , Marques L A , Souza B V , Gripp M R , Ribeiro L , Oliveira C L A , Gasperi C , Fagundes M C , Mendonça D L 
Published: October 2020

Abstract

Issue
There are challenges in PHC associated with low functional literacy in health. The Illustrated Prescription was developed aiming to reduce drug error and increase access to self-care, allowing better understanding and adherence to treatment; facilitate the safe use of medications; strengthen the support network.

Description of the Problem
In April 2016, systematization and preparation of pictorial prescriptions began in the service of origin, one of the researches with the highest participation of multiprofessional residents of pharmacy and medical interns. Optimization and complement of recipe was performed. Several models were systematized in the orientation of users in face-to-face care of prescription reviews. The proposed model has (1) written component, schedule of medicines and strategy organizing medicines according to time of administration and (2) strategy for organizing primary packaging of medicinal products using coloured elastic bands.

Results
The evolution of Illustrated Prescription components resulted in the progressive organization and understanding in the indication of schedules and drugs. There was development, improvement and validation of it as a self-care tool, especially for patients with CNDs. There was a social impact with media dissemination (6 TV stations and 2 radio stations) and national and international congresses; totaling 5 show-forums and 4 congress with participation of the service. Cash prizes were invested in the infrastructure of the FHS workplaces.

Lessons
The evolution of Illustrated Prescription allowed progressive gain of organization and clarity for patients with difficulty reading, which directed efforts to avoid drug errors, especially prescription.

Key messages
Illustrated Prescription allowed us to invest more time guiding the patient in accessible and understandable language. Illustrated Prescription is useful for empowering and training it in self-care, promoting, mainly, autonomy and citizenship.
Perfluoroalkyl substances and lipid profile in exposed pregnant women in the Veneto Region, Italy
Authors: Dalla Zuanna T , Barbieri G , Pitter G , Zare Jeddi M , Daprà F , Savitz D , Fabricio A , Russo F , Fletcher T , Canova C 
Published: October 2020

Abstract

Background
Perfluoroalkyl substances (PFASs) are persistent and widespread environmental pollutants. Residents of a large area of the Veneto Region (North-Eastern Italy) were exposed to high concentrations of PFASs through drinking water from the late-1970s to 2013. PFASs have been consistently associated with raised serum lipids, but only few studies have been conducted among pregnant women, and none has stratified analyses by trimesters of gestation. Our main objective was to evaluate the association between perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) levels and lipid profiles in high-exposed pregnant women.

Methods
A cross-sectional analysis was conducted in 319 pregnant women (age 14-48 years) recruited in the Regional health surveillance program. Serum PFASs were measured by HPLC-MS/MS. Non-fasting serum total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C) were measured by enzymatic assays in automated analysers, and low-density lipoprotein cholesterol (LDL-C) was calculated. The associations between ln-transformed PFASs (and categorized into quartiles) and lipids were assessed using generalized additive models. Analyses were adjusted for potential confounders and stratified according to pregnancy trimester.

Results
In the first trimester, plasma concentrations of both PFOA and PFOS were positively associated with TC. However in the third trimester PFOA levels were instead inversely significantly associated with TC and LDL-C levels. Overall, both PFOA and PFOS were positively associated with HDL-C, and PFOA negatively with LDL-C.

Conclusions
In a small highly exposed population of pregnant women, the associations between PFASs concentrations and lipid profile were modified by trimester of gestation. Patterns late in pregnancy were different to the positive associations with LDL-C generally found. Differential transfer and bioaccumulation of lipids and PFAS in the placenta across gestation might explain our findings.

Key messages
This study provides evidence of different patterns of PFAS associations with lipids in pregnant women across the trimesters of gestation. The different patterns of association from general population studies sheds light on the role of fetal nutrition during pregnancy affecting both lipids and PFAS in serum.