bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of health on social capital. A longitudinal observation study of the UK
Authors: Downward Paul , Rasciute Simona , Kumar Harish 
Published: March 2020

Abstract
Background: UK health policy increasingly focusses on health as an asset. This represents a shift of focus away from specific risk factors towards the more holistic capacity by which integrated care assets in the community support improvements in both health and the wider flourishing of individuals. Though the social determinants of health are well known, relatively little research has focussed on the impact of an individual’s health on their social outcomes. This research investigates how improved health can deliver a social return through the development of social capital. Methods: An observational study is undertaken on 25 years of longitudinal data, from 1991, drawn from the harmonised British Household Panel Survey (BHPS) and Understanding Society Survey (USS). Fixed effects instrumental variable panel data regression analysis is undertaken on individuals. The number of memberships of social organisations, as a measure of structural social capital, is regressed on subjectively measured general health and GHQ12 (Likert) scores. Distinction is drawn between males and females. Results: Improved general health increases social capital though differences exist between males and females. Interaction effects, that identify the impacts of health for different age groups, reveal that a general effect of increased health on social capital for males is enhanced as they age. However, in the case of females increases in general health increase social capital only in connection with their age group. In contrast mental illness generally reduces social capital for males and females, and these effects are reduced through aging. Conclusions: Investing in health as an asset can improve the social outcomes of individuals. Increasing the outcomes requires tailoring integrated care systems to ensure that opportunities for social engagement are available to individuals and reflect age groups. Targeting improvements in mental health is required, particularly for younger age groups, to promote social capital. The results suggest the importance of ensuring that opportunity for engagement in social and civic organisation be linked to general and mental health care support.
The evaluation of Suchana, a large-scale development program to prevent chronic undernutrition in north-eastern Bangladesh: A large scale nutrition program design
Authors: Choudhury Nuzhat , Raihan Mohammad Jyoti , Ahmed S M Tanvir , Islam Kazi Eliza , Self Vanessa , Rahman Shahed , Schofield Lilly , Hall Andrew , Ahmed Tahmeed 
Published: March 2020

Abstract
Background Evidence of the impact of community-based nutrition programs is uncommon for two main reasons: the lack of untreated controls, and implementation does not account for the evaluation design. Suchana is a large-scale program to prevent malnutrition in children in Sylhet Division, Bangladesh by improving the livelihoods and nutrition knowledge of very poor households.Methods Suchana is being implemented in 157 unions, the smallest administrative unit of government, in two districts of Sylhet. Suchana will deliver a package of interventions to poor people in about 40 randomly selected new unions annually over four years, until all are covered. All beneficiaries will receive the normal government nutrition services. For evaluation purposes the last 40 unions will act as a control for the first 40 intervention unions. The remaining unions will receive the program but will not take part in the evaluation. A baseline survey was conducted in both intervention and control unions; it will be repeated after three years to estimate the impact on the prevalence of stunted children and other indicators.Results This stepped wedge design has several advantages for both implementation and evaluation, as well as some disadvantages. The units of delivery are randomized, which controls for other influences on outcomes; the program supports government service delivery systems, so it is replicable and scalable; and the program can be improved over time as lessons are learned. The main disadvantages are the difficulty of estimating the impact of each component of the program, and the geographical distribution of unions, which increases program delivery costs. Stepped implementation allows a cluster randomized trial to be achieved within a large-scale poverty alleviation program.Conclusions A stepped wedge design for implementation was used which is particularly suited to evaluations of service delivery. The design allows the intervention to be phased-in and scaled-up over a period of time. The phased or ‘stepped’ process of implementation enables a cluster randomized controlled trial to be achieved without having a permanently untreated control group. However, the design does not allow to assess the impact of each individual component of intervention.
Community Dialogue Approach for addressing the drivers of antibiotic resistance in Bangladesh: a mixed methods study on developing a sustainable and scalable approach to community engagement
Authors: King Rebecca , Hicks Joseph , Rassi Christian , Shafique Muhammad , Barua Deepa , Bhowmik Prashanta , Das Mahua , Elsey Helen , Questa Kate , Fieroze Fariza , Hamade Prudence , Huque Sameena , Newell James , Huque Rumana 
Published: March 2020

Abstract
Background Community engagement approaches that have impacted on health outcomes are often time intensive, small-scale and require high levels of financial and human resources. They can be difficult to sustain and scale-up in low resource settings. Given the reach of health services into communities in low income countries, the health system provides a valuable and potentially sustainable entry point that would allow for scale-up of community engagement interventions. This study explores the process of developing an embedded approach to community engagement taking the global challenge of antibiotic resistance as an example. Methods The intervention was developed using a sequential mixed methods study design. This consisted of: exploring the evidence base through an umbrella review, and identifying key international standards on the appropriate use of antibiotics; undertaking detailed exploratory research through a) a qualitative study to explore the most appropriate mechanisms through which to embed the intervention within the existing health system and community infrastructure, and to understand patterns of knowledge, attitudes and practice regarding antibiotics and antibiotic resistance; and b) a household survey – which drew on the qualitative findings - to quantify knowledge, and reported attitudes and practice regarding antibiotics and antibiotic resistance within the target population; and c) drawing on appropriate theories regarding change mechanisms and experience of implementing community engagement interventions to co-produce the intervention processes and materials with key stakeholders at policy, health system and community level. Results A community engagement intervention was co-produced and was explicitly designed to link into existing health system and community structures and be appropriate for the cultural context, and therefore have the potential to be implemented at scale. We anticipate that taking this approach increases local ownership, as well as the likelihood that the intervention will be sustainable and scalable. Conclusions This study demonstrates the value of ensuring that a range of stakeholders co-produce the intervention, and ensuring that the intervention is designed to be appropriate for the health system, community and cultural context.
The association between metabolic syndrome and elevated serum alanine transaminase levels in an indigenous population in Northern Taiwan: a community-based study
Authors: Chen Yi-Fang , Lin Yen-An , Yeh Wei-Chung , Tsao Yu-Chung , Li Wen-Cheng , Chen I-Ju , Chen Jau-Yuan 
Published: March 2020

Abstract
Background: Metabolic syndrome (MetS), a prevalent health condition in Taiwan, places individuals at higher risk of cardiovascular disease, diabetes, and stroke. Therefore, the identification of risk factors associated with MetS is crucial. Nevertheless, only limited studies about MetS have been conducted among indigenous peoples in Taiwan; these studies identified a high prevalence of MetS among an indigenous population, which encouraged us to investigate further. Thus, our study aims to determine the prevalence of MetS among the indigenous Taiwanese population and to explore the relationship between MetS and associated risk factors, especially serum alanine transaminase (ALT). Methods: This is an observational, population-based, cross-sectional study that was conducted in remote villages of an indigenous community in northern Taiwan between 2010 and 2015. A total of 454 participants, 47.36% male and 52.64% female, were eligible for analysis. The participants underwent anthropometric assessment and measurements of blood pressure, serum triglyceride levels, fasting plasma glucose levels, serum HDL-C levels and serum ALT levels. MetS was defined based on the revised NCEP/ATPIII criteria from Taiwan Health Promotion Administration. Results: A total of 454 participants were included in the analysis. There were 277 people with MetS and 177 people without. The prevalence of MetS was 61.01%. The average age was 49.50 years old. People with MetS had a significantly higher ALT level (average 31.21±25.00 U/L vs. 23.29±15.98 U/L, p<0.001) than those without MetS. In addition, the chi-square comparison showed that participants with abnormal ALT levels (>36 U/L) had a tendency towards a higher prevalence of MetS (76.7% vs. 57.3%, p=0.001) than those with normal ALT levels (≤36 U/L). The adjusted odds ratio (OR) of abnormal ALT levels for MetS was 2.58 (95% CI=1.23-5.44, p=0.01). The area under the ROC curve (AUC) of the ALT level was 0.63 (95% CI=0.58-0.68, p<0.001), which showed that the ALT level was positively associated with MetS. Conclusions: The overall prevalence of MetS was 61.01% in the highland indigenous population in Taiwan, which suggests an unignorable health problem that should actively be addressed. Furthermore, these findings indicated that higher serum ALT levels (>36 U/L) were associated with an increased risk of MetS.
Housing First, Connection Second: The Impact of Professional Helping Relationships on the Developmental Trajectories of Housing Stability for People Facing Severe and Multiple Disadvantage
Authors: Sandu Rebeca Denisa , Anyan Frederick , Stergiopoulos Vicky 
Published: March 2020

Abstract
Background . This study sought to establish the impact of professional helping relationships on the developmental trajectories over 24 months of housing stability for 2,141 people facing severe and multiple disadvantage using data from the Housing First controlled trial in Canada. Method: The study used a mixed method design. Latent growth curve and growth mixture models assessed the impact of working alliance across the sample as a whole and within subgroups with different patterns of housing stability. Thematic analysis explored the factors that may affect the quality of working alliances within different subgroups. Results: Three distinct trajectories of housing stability emerged (i.e., Class 1: “sharp, sustained, gradual decline”; Class 2: “hardly any time housed”; Class 3: “high, sustained, and gradual decline”) with professional helping relationships having different effects in each. The analysis revealed structural and individual circumstances that may explain differences among the classes. Conclusions: The findings underscore the role of the relationships, as distinct from services, in major interventions for highly disadvantaged populations, and draws new attention to the temporal patterns of responses to both the quality of relationship and targeted interventions. Keywords: relationships, Housing First, sub-groups, housing stability, severe and multiple disadvantage
Supplementing Substance Use Prevention with Sexual Health Education A Partner-Informed Approach to Intervention Development
Authors: Powell Terrinieka W , Jo Meghan , Smith Anne D. , Marshall Beth D. , Thigpen Santha , Offiong Asari , Geffen Sophia R. 
Published: March 2020

Abstract
Background Threats to adolescent health have been shown to co-occur and influence one another. Supplementing substance use prevention with sexual health education would allow educators to address the risk and protective factors that influence both health issues. This streamlined approach may minimize the inefficiencies of multi-session, single-purpose interventions. Methods LifeSkills Training (LST) for middle school is a skills-based cognitive behavioral prevention program delivered over three years during grades 6-8, with a focus on substance use and violence prevention. This paper describes the development of a supplemental sexual and reproductive health (SRH) unit for the middle school LST curriculum, in partnership with content experts and school personnel. This partner-informed approach took place across three key phases: 1) formative insights, 2) unit development, and 3) pilot implementation. Result The final supplemental SRH unit is ten 45-minute sessions offered to 7 th and 8 th grade students and includes a set of learning objectives that are aligned with individual sessions. The supplemental SRH unit also mirrors existing LST modules in length, flow, layout, facilitator instructions, focus on prevention, and utilization of a student workbook. Conclusions Our findings suggest that there is great potential in partnering with content experts and school personnel to develop supplemental materials for existing interventions. This collaborative approach resulted in a set of sessions that are medically accurate and developmentally appropriate. This partnership approach may serve as a model for future researchers and practitioners aiming to extend the reach of existing evidence-based programs.
Non-Communicable Disease and the Need to Strengthen Prehospital Care: Experience from Kigali, Rwanda
Authors: Rosenberg Ashley , Mukagasasira Jacqueline , Turikumana Verene , Dworkin Myles , Nsengimana Vizir , Bailey Pamela , Kankindi Eugenie , Niyonsaba Mediatrice , Nkeshimana Menelas , Uwitonze Jean Marie , Kabagema Igance , Dushime Theophile , Jayaraman Sudha 
Published: March 2020

Abstract
Background Non-communicable diseases (NCDs) are increasing in incidence in low-and middle-income countries (LMICs). Many NCDs present as emergencies which require emergency response. We aimed to review NCDs transported by Service d’Aide Medicale Urgente (SAMU), the public ambulance service in Rwanda.Methods Descriptive analysis of a REDCap database was performed for medical cases between December 2012 to May 2016 and compared to non-medical cases. Student’s t-test, ANOVA, and chi square test were run with p < 0.05 considered significant.Results A total of 832 patients were seen. 51% were female, and the average age was 57 years old + 22. Cardiac indications were most common (52%) followed by diabetic complications (22%), cancer (16%) and stroke (10%). Patients with NCDs were more likely to be tachycardic, HR>100 bpm (OR 2.61 [P<0.001]), hypoxic with SPO2 <90% (OR 3.28 [P<0.0001]), hypotensive with blood pressure <100 mmHg (OR 2.65 [P<0.0001]), and tachypneic with respiratory rate >20 breaths per minute (OR 2.06 [P<0.0001]).Conclusions Access to emergency services is essential for NCD management. Compared to other emergencies treated by SAMU in Kigali, Rwanda, the NCD cohort had a higher acuity despite being a smaller proportion. As NCDs increase, investment in robust prehospital care will have substantial value in LMICs.
Factors associated with cyber-victimization among immigrants and non-immigrants in Canada: A cross-sectional nationally-representative study.
Authors: Kenny Kathleen , Merry Lisa , Douglas Brownbridge A. , Urquia ML 
Published: March 2020

Abstract
Objectives There is a paucity of research on patterns of cyber-victimization in minority groups, including immigrants. This study aimed at identifying individual, interpersonal and contextual characteristics associated with cyber-victimization among immigrants and non-immigrants.Methods We drew on nationally representative data from adolescents and adults in the Canadian General Social Survey on victimization (2014). Multivariable logistic regression was employed to identify potential factors associated with cyber-victimization in the last 12 months, stratified by immigrant status and sex.Results Among 27,425 survey respondents, the weighted prevalence of cyber-victimization in the last 12 months was 2.1% among immigrants and 2.3% among non-immigrants. Cyber-victimization rates differed significantly by sex among immigrants (2.8% for males vs. 1.4% for females), but not among non-immigrants (2.1% for males vs. 2.4% for females). While most other factors associated with cyber-victimization were similar for immigrants and non-immigrants, we found pronounced associations of past child maltreatment (adjusted prevalence odds ratio [aPOR] 4.85, 95% confidence interval [CI] 2.76, 8.52) and residence in an unwelcoming neighbourhood (aPOR 5.08, 95% CI 2.44, 10.55) with cyber-victimization among immigrants that were diminished or absent among non-immigrants. Additionally, sex-stratified analyses among immigrants showed cyber-victimization to be strongly associated with having a mental health condition (aPOR 3.50, 95% CI 1.36, 8.97) among immigrant males only, and with perceived discrimination (aPOR 4.08, 95% CI 1.65, 10.08), as well as being under 24 years old (aPOR 3.24, 95% CI 1.09, 9.60) among immigrant females.Conclusions Immigration status and sex were differentially associated with cyber-victimization. Findings support the salience of a social-ecological perspective and gender-stratified analyses to better elucidate complex pathways linking cyber-victimization to potential gender-based health inequities among immigrants.
Prevalence and determinants of undernutrition among under-five children residing in urban slums and rural area, Maharashtra, India: a community based cross sectional study
Authors: Murarkar Sujata Kapil , Gothankar Jayashree Sachin , Doke Prakash , Pore Prasad , Lalwani Sanjay , Dhumale Girish , Quraishi Sanjay , Patil Reshma Sudhir , Waghachavare Vivek , Dhobale Randhir , Rasote Kirti , Palkar Sonali , Malshe Nandini 
Published: March 2020

Abstract
Background Undernutrition among under five children in India is a major public health problem. In India almost 60 million children are underweight. Despite India’s growth in economy, child mortality rate due to undernutrition is still high in both urban and rural area. Studies that focuses on undernutrition in urban slums are scarce. Hence present study was carried out to measure all forms of undernutrition like underweight, stunting and wasting. Methods A community based cross sectional study was conducted in 16 randomly selected clusters in two districts of Maharashtra state,India. All 2,929 mothers of under five children from these clusters were included in the study. Data was collected by house to house survey by interviewing mothers of underfive children.Odds ratio was calculated to determine association between the variables. Results Total 3,671 under five children were covered. Mean age of the children was 2.38 years (± SD 1.365).Stunting (45.9%) was found to be the commonest form of undernutrition among under five children, followed by underweight (35.4%), and wasting (17.1%). Sex of the child (urban slum; OR=1.32, rural area OR=1.63) birth order (rural area; OR= 0.47), immunization status (urban slum; OR=0.23) exclusive breast feeding (urban slum; OR=0.51), childhood infections like diarrhea(rural area OR= 1.69) acute respiratory tract infection (ARI) (rural area OR= 0.82), economic status of the family, (urban slum OR= 1.32), maternal age (P = 0.001)and maternal education(P <0.001) had either positive or negative influence on nutritional status of the children from urban slums and rural area. Conclusion Undernutrition in the form of underweight and stunting is more prevalent than wasting in the urban slum and rural area. It was related to sex of the child, economic status of the family, partial immunization of the child, ARI (Past 1 month) and maternal education. Improvement of immunization of under five children and maternal education will improve the nutritional status of the child. Trial registration-This article is part of baseline data of the project, hence not related to trial registration. After baseline data principal investigator had done trial registration retrospectively.
Are social media use disorders associated with higher addictions (alcohol, smoking and waterpipe) among Lebanese adults?
Authors: Awad Emmanuelle , Hallit Rabih , Haddad Chadia , Akel Marwan , Obeid Sahar , Hallit Souheil 
Published: March 2020

Abstract
Background: Since cigarette and waterpipe smoking and alcohol use are on the rise in Lebanon, with no studies on their association with social media use, it was deemed interesting to conduct such a research in the country. The purpose of this study was to evaluate the correlation between social media use disorder, alcohol use disorder and smoking addiction through both cigarettes and waterpipe among a sample of Lebanese adults.Methods: This cross-sectional study was carried out between January and April 2019. It enrolled 461 residents of the community randomly selected from Lebanon's Mohafazat in a proportionate rate.Results: The results showed that 107 (23.7%) participants were classified as having social media use disorder. The results of a stepwise linear regression showed that higher social media use disorder score (Beta=0.17), higher alcohol addiction (Beta=0.20), higher cigarette smoking addiction (Beta=0.31) and higher insomnia (Beta=0.05) were significantly associated with more waterpipe addiction. The social media use disorder was not significantly associated with the cigarette dependence and alcohol use disorder.Conclusion: Our results revealed a significant association between social media use disorder and waterpipe smoking dependence. This study findings might serve as a starting point towards the development and implementation of anti-smoking waterpipe awareness campaigns, similar to those negatively representing cigarette smoking.