bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health literacy and mortality in individuals with NCDs: A 6-year Danish follow-up study (N = 29.473)
Authors: Friis K , Aaby A , Lasgaard M , Pedersen M H , Osborne R H , Maindal H T 
Published: October 2020

Abstract

Background
Non-communicable diseases impact to the globally unequal distribution of health. From a public health perspective, health literacy (HL) may be a promising modifiable social determinant, suggested to be associated with adverse health outcomes. Few studies have explored how HL is related to mortality in the general population and in subgroups. This study examines HL as a predictor for mortality in the general population and among individuals with cardiovascular disease (CVD), chronic obstructive pulmonary disease (COPD), diabetes, and mental illness.

Methods
Design: Data from a large Danish health survey (n = 29,473) from 2013 were linked with national mortality registry data to permit a 6-year survival analysis using Cox regression analyses. Participants: The study included people in the general population people reporting different long-term conditions: CVD (n = 2,389), COPD (n = 1,214), diabetes (n = 1,685) and mental illness (n = 1,577). Outcome Measures: Two subscales from the Health Literacy Questionnaire (HLQ) were included: 1) Ability to understand information about health well enough to know what to do, and 2) Ability to actively engage with healthcare providers.

Results
After adjusting for sociodemographic factors, multimorbidity and health behaviour, individuals reporting difficulties in understanding information about health, had higher risk of dying during follow-up (hazard rate (HR) 1.38 [95% CI 1.11-1.73]). Higher risk was also observed among people reporting CVD (HR 1.47 [95% CI 1.01-2.14]), diabetes (HR 1.91 [95% CI 1.13-3.22]) and mental illness (HR 2.18 [95% CI 1.25-3.81]), but not for individuals with COPD. Difficulties in actively engaging with healthcare providers was not associated with mortality.

Conclusions
Aspects of HL predict higher risk of dying during a 6 years follow-up period. Our study serves as a reminder to public health organizations to consider the HL responsiveness of their services in relation to diverse HL challenges and needs.

Key messages
Aspects of health literacy predict higher risk of dying during a 6 years follow-up period in individuals with CVD, diabetes and mental illness. Our study serves as a reminder to public health organizations to consider the health literacy responsiveness of their services in relation to diverse health literacy challenges and needs.
The social engagement framework for addressing the chronic-disease-challenge
Authors: Alhambra-Borrás T , Tan S S , Macchione S , Vasiljev V , Zanutto O , Garcés-Ferrer J , Juraga D , Korenhof S , Rentoumis T , Raat H 
Published: October 2020

Abstract

Background
The Social Engagement Framework for Addressing the Chronic-disease-challenge (SEFAC) intends to empower citizens to self-manage chronic conditions by combining mindfulness, social engagement and ICT support. This study evaluates effects in terms of perceived effectiveness, utility, efficiency, sustainability and satisfaction with SEFAC intervention.

Methods
A prospective cohort study with 6-month pre-post design was conducted in Croatia, Italy and the Netherlands. A total of 270 citizens ≥50 and at risk of or with a chronic condition were recruited. Self-reported effects of SEFAC intervention were assessed post-intervention using 5-point Likert scale [Strongly disagree -Strongly agree] and overall satisfaction on a scale from 1-10.

Results
Post-intervention analyses of a preliminary sample of 98 participants showed the SEFAC intervention was effective. In particular, perceived effectiveness for stimulating the work towards a healthy lifestyle was found for: mindfulness training (63.3%; n = 62), social engagement (48%; n = 47) and ICT support (40.8%; n = 40). After the intervention, 57.1% participants (n = 56) reported having become more aware of moment-to-moment sensations, thoughts and emotions and being able to better accept them without getting lost in them. Most participants (73.5%; n = 72) found the intervention was beneficial (perceived utility). A total of 78.6% (n = 77) participants found it was worth the investment in time and effort (perceived efficiency) and 61% participants (n = 60) agreed the intervention led to sustainable changes/benefits that will last. Finally, satisfaction with the intervention was high overall (8.5 out of 10).

Conclusions
This is the first study to develop an intervention combining the concepts of mindfulness, social engagement and ICT support. By this combination, self-reported effects were satisfactory. We expect this intervention to be feasible and cost-effective to promote self-management and self-care of chronic conditions.

Key messages
This study provides an innovative intervention to promote self-management and self-care of citizens with chronic conditions. This is the first study to develop an intervention combining the concepts of mindfulness, social engagement and ICT support.
Internet gaming disorder symptoms among Slovenian gamers
Authors: Selak Š , Vinko M , Rehberger M , Lavtar D , Korošec A 
Published: October 2020

Abstract

Background
Problematic use of digital technologies has been attracting extensive amount of attention worldwide, especially (internet) gaming disorder (IGD). Prevalence of IGD varies across studies, depending mostly on the methodology, assessment tool and participant group. Despite numerous research on the topic a strong need to better understand technology's impact on population remains in order to better tackle this public health challenge.

Methods
National Survey on the Use of Tobacco, Alcohol and Other Drugs was conducted in 2018 on a national representative sample (n = 16,000; age: 15-64 years; 62.4% response rate), using mixed-mode (CAWI and CAPI). The final sample consisted of 9,161 respondents, of those 24.2 % (n = 2,212) reported having played a videogame in the last 12 months (gamers-only sample). Prevalence of IGD symptoms was assessed with 9-item Internet Gaming Disorder Scale-Short-Form using 5-point scale (total score: 9-45 points). Disordered and non-disordered gamers were dichotomized with a cut-off point at 36 points with higher scores indicating higher degree of IGD.

Results
Data shows 0.4% [95% CI:0.2-0.8] of the Slovenian gamers reported to have symptoms of IGD, whereas higher rates were observed within younger population. Namely, 1.0% [95% CI: 0.2-3.9] within 20-24 year olds and 0.7% [95% CI:0.2-2.2] within 15-19 year old. Men (0.5% [95% CI:0.2-1.2]) reported more IGD symptoms than women (0.1% [95% CI:0.0-0.8]). The share of IGD symptoms was also higher among unemployed and those who live without partner.

Conclusions
Results obtained in present study are consistent with results of comparable studies conducted in other countries. A relatively low share of IGD symptoms in the sample might be due to a high cut-off point. However, obtained data allows for tailored public health interventions in Slovenia, such as awareness raising and prevention and treatment programmes, as well calls for further analyses on IGD epidemiology and research methodology.

Key messages
0.4% of the Slovenian residents, who played videogames in the last 12 months reported to have symptoms of internet gaming disorder, with higher rates observed within younger population. The share of population experiencing symptoms of internet gaming disorder in Slovenia is similar to that of other countries where comparable studies were done.
Substance use disorder and the baby boomers: Does German outpatient addiction care face a change?
Authors: Specht S , Braun-Michl B , Schwarzkopf L , Piontek D , Seitz N , Wildner M , Kraus L 
Published: October 2020

Abstract

Background
The aging of baby boomers is expected to confront addiction care with new challenges. This study aims to investigate if German addiction care is confronted with a sustained change in its clientele that was initiated by the baby boomers.

Methods
Using data from Berlin outpatient addiction care facilities, we contrasted type of primary substance use disorder and number of comorbid substance use disorders in baby boomers with an older (n = 6524) as well as a younger cohort (n = 15677). To isolate cohort effects, two-level random-intercept regression models were applied in the overlapping age groups of the baby boomer cohort with each other cohort.

Results
Compared to the older cohort, alcohol use disorder lost importance while illicit substances use disorder gained importance in the baby boomers. Baby boomers presented a higher number of comorbid substance use disorders than the older cohort. Comparing baby boomers with the younger cohort, these relationships pointed in the opposite direction.

Conclusions
Outpatient addiction care faces a sustained change to more illicit and comorbid substance use disorders. The addiction care system ought to adapt its services to address the changing needs of its clientele.

Key messages
Baby boomers differed in comparison to the older cohort regarding type of substance use disorder and comorbid substance use disorders. The changes set off by the baby boomers continued in the younger cohort.
Job demands/control among people in paid work age 55-64 and their labour market status 11 years later
Authors: Farrants K , Head J , Framke E , Rugulies R , Alexanderson K 
Published: October 2020

Abstract

Background
As discussions about extending working lives are ongoing, more knowledge is warranted on working conditions that are associated with labour market status in older age.

Aim
Among employees aged 55-64 years, associations between job demands/job control with their labour market status 11 years later were explored.

Methods
A population-based prospective cohort study using a job exposure matrix (JEM) and nationwide register data. All 616,818 individuals in Sweden who in 2001 were in paid work and aged 55-64, were assigned JEM values for job demands/control that were categorized into tertiles resulting in nine combinations of job demands/control (reference=medium control/medium demands). Follow-up was in 2012 regarding labour market status (paid work, old-age pension, low/no income, sickness absence emigrated, dead). Odds ratios (OR) and 95% confidence intervals (CI) were calculated using multinomial logistic regression (reference category=old-age pension) with adjustment for educational level, age, birth country, family situation and type of living area.

Results
Women in occupations with high control (OR low demands/high control 1.21, CI 1.06-1.39, medium demands/high control 1.32, CI 1.20-1.46, high demands/high control 1.29, CI 1.20-1.37); and men in occupations with high demands/high control (OR 1.11, CI 1.02-1.21) were more likely to be in paid work. Those in occupations with high demands at baseline were less likely to have low/no income at follow-up (OR women high demands/medium control 0.51, CI 0.37-0.68, high demands/high control 0.68, CI 0.50-0.92; men high demands/medium control 0.55, CI 0.31-0.96, high demands/high control 0.47, CI 0.32-0.74.

Conclusions
High job control combined with any level of demands for women and high demands for men aged 55-64 in 2001 were associated with higher OR of having main income from paid work in 2012, and high job demands combined with any level of job control were associated with lower OR of low/no income.

Key messages
Combinations of job demands and job control among workers aged 55-64 years in 2001 were associated with labour market situations in 2012. Using a job exposure matrix divided into tertiles allows for greater detail in measuring high, medium, and low demands and control than methods used in previous studies.
Social engagement technologies and their use among grandparents and adult grandchildren
Authors: Mueller J , Foran H 
Published: October 2020

Abstract
The quality of close family relationships can affect the health and well-being of older adults. Further, research suggests that relationships between grandparents and adult grandchildren can have a positive impact on the lives of each generation, particularly regarding social and emotional support. Social engagement technologies may provide new opportunities for older adults to foster and maintain family relationships, including those between grandparents and adult grandchildren. The current cross-sectional study examined associations between the use of social engagement technologies and health and well-being outcomes in 177 younger adults (M = 26.67, SD = 7.83; 81.4% female) and 202 older adults (M = 71.09, SD = 8.17; 77.8% female). Social technology use was assessed through ﬁve mediums that are used to enhance social connectivity (e.g., e-mail, social network sites, online video or phone calls, instant messaging, and smartphones). Higher use of social engagement technologies was associated with better self-rated health, subjective well-being, and social support among younger and older adults. Interestingly, social technology use was associated with less depressive symptoms only for older adults (r=-.26, p&lt;.05). There was, however, no correlation between social technology use and loneliness at the bivariate level. Of all five media, only smartphone use was correlated with more positive evaluations of the grandparent-grandchild relationship. After controlling for age, both grandparent-grandchild relationship quality and social technology use were associated with better self-rated health, subjective well-being, and social support for grandparents and adult grandchildren.

Key messages
Taken together, these findings indicate the need for a nuanced perspective on the benefits of social engagement technologies. More research is needed to explore the use case for social engagement technologies among older adults and their family members.
Meal delivery and public health nutrition: a comparison study in three international cities
Authors: Poelman M P , Thornton L , Zenk S 
Published: October 2020

Abstract

Background
The food environment has been recognized as a dominant driver of public health nutrition. Although planning mechanisms are increasingly being triggered to help control the proliferation of fast food outlets, the recent upsurge in meal delivery options has reshaped the food environment. Currently, we lack insight in the breath of meal delivery options. Therefore, this study sought to examine between-city differences and within-city socio-economic differences in the number of online meal delivery options and meal types.

Methods
A cross-sectional study was conducted in three international cities. Across 10 sampled addresses in Chicago (USA), Amsterdam (The Netherlands) and Melbourne (Australia), meal delivery options provided by a major international meal delivery company were sampled. Bonferroni adjusted Chi2-tests were conducted to assess between-city - and within-city socio-economic differences.

Results
Across the 10 sampled addresses in each city, there were 1668 delivery options in Chicago, 1496 in Amsterdam and 1159 in Melbourne. In total, 10220 keywords (representing 148 different meal types) were recorded across all delivery options. In Amsterdam and Melbourne, a greater number of options was available for the addresses in the least disadvantaged neighborhoods. Among all cities, sandwiches (14.6%), burgers (14.4%), and pizza (13.4%) were most commonly advertised. In contrast, salads (7.8%) and 'healthy' options (5.5.%) were less frequent offered for delivery.

Conclusions
Meals available for delivery did not favor a healthy diet, and healthy options were less often advertised then unhealthier ones. Currently, meal delivery platforms appear to operate in a largely unregulated environment continued growth is likely in the near future. It is vital that public health professionals and policy makers become aware of this online component of the food environment and its potential consequences for public health nutrition.

Key messages
Most commonly advertised meals for delivery do not favor a healthy diet, and healthy options were less often advertised then unhealthier ones. It is vital that public health professionals and policy makers become aware of the online component of the food environment and its potential consequences for public health nutrition.
Dietary patterns and their association with cardio-metabolic outcomes in US firefighters
Authors: Christodoulou A , Sotos-Prieto M , Kales S N , Christophi C A 
Published: October 2020

Abstract

Background
Cardiovascular disease is prevalent among US firefighters. Obesity is known to be associated with an increased risk of CVD and it can be prevented by following a more Mediterranean style diet. The aim of this study was to identify the dietary patterns of US firefighters and assess how these patterns are associated with cardio-metabolic outcomes in the specific population.

Methods
Individuals were recruited from within a FEMA sponsored study from the Indiana Fire Department. IFD members with permanent station assigned were included. All participants underwent the Public Safety Medical examination, which includes occupational and medical history; a physical examination; routine laboratory tests; resting electrocardiograms; and maximal treadmill exercise testing. Participants self-reported their dietary habits.

Results
The mean BMI of the participants was 30.0 ± 4.5 kg/m2 and the percentage of body fat was 28.1 ± 6.1%. Using principal component analysis, two dietary patterns were identified, namely a Mediterranean style diet and an American Standard style diet. The Mediterranean style diet is positively associated with HDL cholesterol (β = 2.08, p = 0.001) even after adjusting for gender, BMI, VO2 max, max METS, age, and body fat percent. Triglycerides (β=-3.195, p = 0.585) and glucose (β=-0.079, p = 0.219) decreased with the Mediterranean style diet. The Standard American diet was also significantly associated with HDL cholesterol (β=-4.82, p = 0.002) and LDL cholesterol (β = 0.455, p = 0.014). In addition, body fat percentage increases significantly in the Standard American style diet (β = 1.778, p = 0.029), even after the adjustments.

Discussion
Two dietary patterns were identified in US firefighters - a Mediterranean style diet and an American Standard diet. Mediterranean diet was protective whereas the American Standard diet had the opposite effect. This could help provide suitable recommendations that could improve the lives of US firefighters.

Key messages
Two diet patterns have been identified in US firefighters. The Mediterranean style diet seems to have a protective effect. The American Standard diet has a negative impact on cardio-metabolic outcomes as expected.
The impact of informal payment on Caesarean delivery rates in obstetric care in Hungary
Authors: Veroszta Z , Boros J 
Published: October 2020

Abstract

Background
Our objective is to investigate factors increasing the likelihood of Caesarean sections in Hungary, in particular whether planned Caesarean deliveries might be a consequence of the widespread informal payment practice in obstetric care.

Methods
We use data from the “Cohort '18 - Growing Up in Hungary” birth cohort study. In the 1st wave a nationwide representative sample (N = 8,287) of pregnant women was surveyed in 2018/2019. The 2nd wave was conducted 6 months after childbirth. Data was analyzed by a multinomial logistic regression model. The output variable was the type of childbirth: natural (ref.)/Caesarean/planned Caesarean. The explanatory variables were informal payment at birth, private/public prenatal care, maternal health, SES.

Results
Based on the explanatory model (Pseudo-R2=0.278) the increased likelihood of planned Caesarean section is associated with out of pocket payment at birth (Exp(B)=3.749). This health system related factor absorbs the effect of social background for the possibility of planned Caesarean section, since its inclusion in the model reduces the independent influence of SES. However, the likelihood of planned Caesarean delivery compared to natural births is also determined by the mother' age and physical condition.

Conclusions
The high Caesarean delivery rates (over 40%) in Hungary are largely due to features of health system finance, particularly for planned Caesarean deliveries (22% of births). Although deliveries basically take place in public hospitals, the presence of an out of pocket paid private doctor at birth is a frequent and socially selective factor. Whereas planned Caesarean sections are strongly determined by SES, at the system level it is channeled into the various private or informal forms of financing.

Key messages
Informal payment within the general public care system strengthens the social selection in prenatal and delivery care in Hungary. This effect is reflected in the proportion of planned Caesarean sections.
Assessing Contact, Coverage, and Quality of continuum of care in Uttar Pradesh, India
Authors: Gupta S , S K , Yonzon K , Kumar P , Choudhry V 
Published: October 2020

Abstract

Background
Given the high neonatal mortality in LMIC, strategies suggest a continuum of care (COC) as an effective framework to ensure timely and appropriate service provision throughout the MNCH continuum. However, the measurement approaches traditionally focus on assessing continuum of care from the lenses of time-based coverage and missing out on the quality of coverage and service delivery. This paper aims to assess the continuum of care based on these three parameters and the factors affecting its achievement.

Methods
Multistage sampling design identified live births and stillbirths in the last calendar year (March 2018-February 2019) across the 50 districts of Uttar Pradesh(n = 16646).COC was assessed on three measurements 1) Contact: Any contact with the health system across the continuum, 2)Coverage: Adequate contacts of the health system through outreach services and clinical care, and 3)Quality: receiving adequate services along with these contacts. Further, a multilevel regression model was used to estimate the factors associated with the continuum of care.

Results
64% (60.04-67.65) of the women and child received health system contact across the continuum while only 2.1% (1.57-2.78) and 2.8% (2.33-3.44) women and children achieved coverage and quality based COC, respectively. Achievement of COC coverage and COC quality is highly affected by the service delivery platform, with women at outreach platform being more likely to achieve adequate coverage while women at facilities are more likely to achieve quality services across ANC, delivery, and PNC.

Conclusions
Achievement of both coverage and quality based COC remains low in Uttar Pradesh, India. Even those who achieve contact(s) failed to receive quality services along with these contacts with health systems. Efforts should be focused on building quality service at the outreach and non-outreach platforms across the continuum of care for reducing the risk of neonatal mortality.

Key messages
Owing to the lack of an integrated approach for service delivery across outreach, clinical care and community care, continuum of care remains broken for most of the mothers and children. For targeting coverage and quality of COC, focus should be on improving the quality of service provision across the outreach platforms which are already in reach of the women.