bluuebunny/crossref_metadata_2025_split huggingface dataset:
Suicide epidemiology in Italy: a population-based study in Piedmont Region
Authors: Mamo C , Coggiola N , Dalmasso M , Pitidis A , Costa G 
Published: November 2019

Abstract

Background
Among the largest Italian Regions, Piedmont (Northern Italy) is the one with the highest rate of suicide. Aim of the study was to describe intentional self-harm related deaths in Piedmont analyzing trends by gender, age, area of residence, socio-economic level.

Methods
Observational mortality study of the resident population in Piedmont from 2003 to 2014. Age-standardized rates of suicide (ICD-10: X60-X84) were estimated, by gender, health district of residence, mountain/level ground, and educational level. Suicide methods and places of occurrence by gender and age were inquired.

Results
In a context of declining injury related mortality, especially for traffic accidents, the regional trend of suicides shows only a slight decrease, becoming the main cause of injury deaths since 2009, equal to 21% of all injury deaths in the studied period. There are no significant trend variations related to the period of economic crisis. The occurrence is higher among men in general and particularly in older people, persons with low educational level and those living in deprived areas. The main suicide method used by women is “jumping from a high place” (36.7%) while the main one for men is “hanging, strangulation and suffocation” (50%). This is globally the most frequent method for all ages. “Self-poisoning” gains importance between 30 and 49 years old. Suicides occur for over half of cases in home.

Conclusions
Suicides are a public health and social concern. Yet despite its extent, this problem is still not adequately considered in public health prevention programs. Social and geographical gradients highlitght the importance to improve mental health service provision in deprived areas and to enhance public social welfare measures. Further contributions to a deeper understanding of the determinants of self-harm behaviour and suicidal risk can be obtained from health information systems, in particular data from Emergency Departments and multiple causes of deaths records.

Key messages
In Italy, suicides are the main cause of injury deaths, without trend variations. Occurrence is higher among men, older people, persons with low educational level and those living in deprived areas.
Mental health service use among university students with adverse childhood experiences
Authors: Jakovljevic M , Matejic B , Medarevic A , Mladenovic Jankovic S , Neskovic A , Tripkovic K , Belamaric G 
Published: November 2019

Abstract

Background
Adverse childhood experiences (ACE) are a risk factor for mental health disorders and serious somatic illnesses. There is a need for preventing ACE and using mental health care by youth who experienced them. Aims of this study were to examine which ACE are related to mental health service use and to identify a scope of unrecognized needs for these services among students who had experienced abuse/neglect in childhood.

Methods
Descriptive cross-sectional study was performed on a sample of 2.381 first-year students from six universities in Serbia in 2014. The survey instrument was a questionnaire developed by WHO and CDC. Thirteen ACE (covering household dysfunctionalities, abuse, neglect, peer and collective violence) and using of mental health services at least once during lifetime were assessed. Data were analyzed by univariate and multivariate logistic regression.

Results
Compared to respondents without particular ACE, odds (±95% CI) of mental health service use were higher only in those with next adversities: parental divorce, OR = 2,26 (1,53-3,33); suicidal/mentally ill family member, OR = 2,21 (1,42-3,44); witnessing partner violence, OR = 1,51 (1,04-2,18); peer violence, OR = 2,14 (1,51-3,03); collective violence OR = 1,48 (1,05- 2,10).
Among respondents who had experienced emotional neglect, 81% have never used professional help. For physical neglect, physical and psychological abuse this percentage was 83%.

Conclusions
The study highlights ACE associated with mental health service use and shows a significant presence of unrecognized needs for these services. There is need for: determining barriers in this area and formulation of effective health promotion strategies; more consistent application of legislation; conducting screening on child abuse/neglect in families with a higher risk for them.

Key messages
High share of youth with childhood adversities remains without help of mental health specialists.It opens the issue of barriers on the side of youth as well as on the side of health system and society Considering consequences of adverse childhood experiences, there is need for comprehensive public health interventions in order to increase mental health service use among young people with ACE.
The impact of participation in support groups on mental health of parents having children with autism
Authors: Alibekova R , Kadyrzhanuly K , Chan C K , An S , Gusmanov A , Yerubayev Z , Yessimkulova F , Bekisheva A , Ospanova Z , Rakhimova M 
Published: November 2019

Abstract

Introduction
Whilst there is accumulated evidence about the high prevalence of stress and mood disorders in parents of children with autism, few studies have shown that participating in parental support groups was associated with less mental health problems. This study was aimed to explore the association of participation in support groups with stress and mood disorders in parents of children with autism in Kazakhstan.

Methods
Participants (n = 146) were recruited to this cross-sectional survey from autism non-governmental organizations and Republican Children’s Rehabilitation Center in Nur-Sultan city during April-December 2018. A 59 item survey consisted of questions on parental socio-demographics, needs, participation in support groups, depression, anxiety and stress (DASS), and Multidimensional Scale of Perceived Social Support (MSPSS). Descriptive, bivariate and multivariate logistic regression analyses were performed in STATA 15.

Results
44.4% of parents reported experiencing stress, and almost half of the sample had elevated depressive (53.7%) and anxiety symptoms (47.4%). 45.3% of participants were members of parental organizations; there were no significant differences in the prevalence of stress and mood disorders among members and non-members of parental support groups. Results of the multivariate logistic regression showed that parents with older autistic children (OR 1.37, p-value 0.001), less family support (OR 0.894, p-value 0.044) and higher income (OR 3.01, p-value 0.025) were more likely to be members of support groups.

Conclusions
These findings indicate the need to increase support groups to under-served populations of Kazakhstan’s families with autistic children. Additional efforts are needed to strengthen the role of support groups in meeting the emotional needs of the parents.

Key messages
Parents of children with autism spectrum disorder experience elevated level of stress and mood disorders; however participation in support groups was not beneficial for relieving parental distress. Further research is warranted to explore the benefits of participation in support groups, and interventions are needed to strengthen the role of support groups in meeting the needs of parents.
The neighborhood age structure and mental health
Authors: Verspoor E , Beenackers M A , Ouder Groeniger J , Noordzij J M , Van Lenthe F J 
Published: November 2019

Abstract

Background
Against the background of urbanization and aging and the aim to design age-friendly cities, it is crucially important to understand whether and why older adults’ health may benefit from being surrounded by older peers mainly, or by residents from all ages. We assessed the association between neighborhood age structure and mental health and the mediating role of social neighborhood perceptions.

Methods
Survey data were obtained from 1255 older adults aged 65 years and over, participating in the Dutch GLOBE study. The neighborhood age structure, measured in 2011, was defined as the Herfindahl-Hirschman index to assess homogeneity in the age composition (range from 0-100, a higher score indicating more homogeneity) and percentages of different age groups in a neighborhood. Mental health was measured in 2014 by the Mental Health Inventory-5 score, ranging from 0 to 100, where a higher score indicates better mental health. Perceptions of neighborhood social cohesion, feeling at home in a neighborhood, and social participation was assessed in 2011. Linear regression models were used to assess the association of neighborhood age composition with mental health. Causal mediation analysis was used to assess the potential mediating role of social neighborhood perceptions.

Results
A more homogeneous neighborhood age structure was associated with better mental health status. Feeling at home in a neighborhood partly mediated the association, whereas social cohesion and social participation did not mediate the association. While a higher percentage of children in the neighborhood was associated with better mental health, a higher percentage of elderly in the neighborhood was associated with lower mental health status.

Conclusions
The neighborhood age composition is a promising, but currently insufficiently understood, entry point for policies addressing the challenge of growing urban and aging European cities.

Key messages
The neighborhood age composition is a promising, but currently insufficiently understood, entry point for policies addressing the challenge of growing urban and aging European cities. Feeling at home in a neighborhood partly mediated the association between neighborhood age structure and mental health; social cohesion and social participation did not mediate the association.
The impact of the economic crisis on the mental health of Portuguese primary-school children
Authors: Costa D , Cunha M , Ferreira C , Gama A , Rodrigues A M N , Rosado-Marques V , Nogueira H , Silva M R G , Padez C 
Published: November 2019

Abstract

Objective
To measure the impact of the economic crisis on the mental health correlates of Portuguese children attending primary school during 2016.

Methods
Cross-sectional analysis of primary school-aged children and their parents (n = 1157), conducted in public and private schools of three Portuguese districts. Parent reports of children mental health symptoms (Strengths and Difficulties Questionnaire - SDQ) and children self-reports of health-related quality of life (KIDSCREEN-27) and depressive, anxiety and stress symptoms (Depression, Anxiety and Stress Scales, Children version - DASS-C), were compared according to a set of yes/no questions on how the economic crisis changed the normal aspects of routine life (e.g. During the financial crisis did you had to use savings? Started buying cheaper food?). Linear regression models were fitted for the SDQ, the KIDSCREEN-27 and the DASS-C as dependent variables adjusted for children sex, socioeconomic status and district of residence.

Results
Affirmative answers to the crisis impact questions were associated with more frequent psychosocial functioning problems in children, with poorer self-reported health-related quality of life and with more frequent symptoms of depression, anxiety and stress.

Conclusions
Portuguese children mental health correlates show significant worse scores for those whose parents declared having to change daily routine habits as a result of the recent macroeconomic financial crisis, compared to those who did not change habits. Public Health programs should be developed to mitigate the potential negative impact of the financial crisis to the mental health of children.

Key messages
A negative impact on children mental health was observed as a result of the economic crisis. Public health programs designed to mitigate the impact of the economic crisis should include primary-school aged children.
Effectiveness of the Children of Divorce Intervention Program in the Netherlands
Authors: Klein Velderman M , van Dommelen P , Pannebakker F D , Reijneveld S A 
Published: November 2019

Abstract

Background
Many children experience parental separation and divorce. This experience is likely to negatively affect their wellbeing, conduct, psychological adjustment and social relations. Prevention of these problems thus has major priority but effective intervention programmes are still rare. This study therefore aimed to assess the effects of a 12-session preventive group intervention “Dappere Dinos™” for 6 to 8 year old children.

Methods
We performed a quasi-experimental study (registered as NTR 6788) on 105 children participating in the intervention group, 37 children with separated parents not participating (’divorce controls’) and 138 children from intact families (’intact controls’). Outcomes regarded children’s positive functioning (Parent Evaluation Form; Pedro-Carroll & Cowen, 1989), emotional and behavioral problems (Strengths and Difficulties Questionnaire; Goodman, 1997), and wellbeing (Cantril ladder, Cantril, 1965).

Results
Analyses showed that children’s positive functioning after participating in Dappere Dino’s increased according to mothers (M&Delta;pre-post(SD) = 0.26 (0.32); p &lt; .001). Also, children’s overall emotional and behavioral problems decreased after participation (M&Delta;pre-post_mother(SD) = -2.02 (4.55); p &lt; .01; M&Delta;pre-post_trainer(SD) = -1.07 (4.34); p &lt; .05; M&Delta;pre-post_teacher(SD) = -1.64 (3.54); p &lt; .01). Children’s wellbeing increased after participation (M&Delta;pre-post_mother(SD) = 0.77 (1.02); p &lt; .001; M&Delta;pre-post_trainer(SD) = 0.69 (0.94); p &lt; .001), or stayed the same (M&Delta;pre-post_teacher(SD) = 0.19 (1.03); p = n.s.). No such changes were found in the two comparison groups.

Conclusions
After parental divorce, a 12-session preventive group intervention Dappere Dino’s™ for 6- to 8-year-olds can be efficacious in promoting children’s emotional well-being and positive functioning, and reducing their emotional and behavioral problems.

Key messages
Given the high prevalence of divorce and the potential risk for child well-being and functioning, prevention of problems for these children and helping them adapt to the divorce are major priorities. After parental divorce, preventive group support can be efficacious in promoting children’s emotional well-being and positive functioning, and reducing their emotional and behavioral problems.
Mental wellbeing among the oldest old, living in nursing home or at home
Authors: Ådnanes M , Melby L , Kaasbøll J , Kalseth J 
Published: November 2019

Abstract

Background
People 80 plus are the fastest growing age-group in Europe. While research is focusing on health deficiencies and losses and need for medical care and follow up, life conditions and mental health of older people are fields with insufficient knowledge. The promotion, maintenance, and improvement of well-being in this group is a great public health concern. This study aimed to explore differences in perspectives of what contributes to mental wellbeing (MWB) within three groups of persons 80 plus: 1) living at home, 2) living at home and attending day center some weekdays, 3) living in nursing home.

Methods
A qualitative approach was followed, with six focus groups - two in each of the three categories. 35 persons were recruited from senior community centers, adult day care centers, and nursing homes. Data was assessed using qualitative content analysis.

Results
The preliminary results from our study show significant variations between the three groups of participants in their perspectives on what contributes to MWB for them. In group 1 and partly group 2, engagement in fruitful or inspiring activities and insightful experiences with friends strongly associated with MWB. While the relevance of these factors also was mentioned by participants in group 3, they at the same time pointed at the limitations of living in a nursing home. Staying healthy and maintaining independence positively contributed to MWB in all three groups, however highly relatively, based on the person’s actual health situation. Having close relationships with family and friends were considered important in all three groups.

Conclusions
Perspectives on what contributes to MWB among persons 80 plus varies a lot as they control for what is possible based on own health and functionality, but also on what is accessible depending on institutional limitations. While such conditions are partly accepted, there is a potential for better MWB, simply based on more and/or better initiatives.

Key messages
Perspectives on what contributes to mental wellbeing among the oldest old varies a lot based on health and functionality, and on what is possible and accessible within institutions for elderly. There is a potential for better mental wellbeing based on more and/or better initiatives.
Elderly drivers with dementia – how do experts and relatives assess their safety risk?
Authors: Reime B , Pilgram N , Bertsche T 
Published: November 2019

Abstract

Background
Demographic change increases the proportion of car drivers over the age of 70. With increasing age, the likelihood of developing a form of dementia increases. In Germany, about 1.6 million people suffer from dementia. Surveys among dementia patients showed that about two-thirds said they held a valid driving licence and just under half reported still actively driving. We explored whether and to what extent motorists with dementia are putting road safety at risk and how relatives deal with the driving behaviour of their elders.

Methods
Semi-structured qualitative interviews were conducted with seven experts from the fields of police, gerontology and geriatrics as well as with 16 relatives of patients with different stages of dementia. All interviews were then transcribed. The analyses based on the qualitative content analysis (Mayring 2015) with MAXQDA.

Results
The experts regarded elderly drivers with dementia as a public health relevant safety risk. Among those elders who are affected by dementia the awareness of the problem often is limited and not rarely they are characterized by an unsafe driving style. Experts from Austria and Switzerland supported the concept of a mandatory dementia assessment for elderly drivers while experts from Germany did not. Relatives reported very similar descriptions of their elderly’s driving characteristics. Furthermore, the cognitive and motor limitations associated with dementia often are not noticed by both patients themselves and their relatives.

Conclusions
Representative studies are needed to test which measures, such as a mandatory dementia check from retirement age, are likely to improve the safety of older drivers with dementia. Family doctors and GPs should address and educate dementia patients in relation to their risk of accidents. Relatives should receive information material on how to communicate with their elderlys on this topic to maximize safety while avoiding conflict.

Key messages
The prevalence of elderly drivers with dementia is unknown. Representative studies are needed to test best practice appoaches for harm reduction in drivers with dementia.
Risk factors of addictive behavior in adolescents in Tunisia
Authors: Ghali H , Ben Cheikh A , Khefacha Aissa S , Tourki Dhidah M , Bhiri S , Kaabi Y , Ben Othman W , Ben Rejeb M , Said Latiri H 
Published: November 2019

Abstract

Background
Adolescence is a period of physical, psychological and sociocultural transformation, but also of curiosity and experimentation. In Tunisia, the levels of use of some psychoactive substances, especially alcohol, tobacco and cannabis, remain high among adolescents, despite progress in regulatory efforts to limit access to these products by minors, and regular prevention campaigns. We aimed to determine the prevalence of addictive behavior among students in the region of Sousse and to specify the risk factors.

Materials/Methods
We conducted a cross-sectional epidemiological study in two public schools in the governorate of Sousse during the 2017/2018 school year. All students in each class were included when they agreed to participate in the study. The data was collected by anonymous self-questionnaire, then processed and analyzed using the SPSS version 20 software.

Results
In total, 294 students participated in this study with a mean age of 17.03 ± 1.51 years. A female predominance was noted (56.1%). The prevalence of addictive behavior was 52% (95% CI = [45.9% - 57.8%]). In univariate analysis, male gender, advanced age, and repeating the study year were significantly associated with addictive behavior (p = 0.014, p &lt; 10-3, p = 0.004 respectively). However, multivariate analysis showed that the probability of addictive behavior decreased in students who read books frequently (OR = 0.6, 95% CI = [0.37 - 0.96], p = 0.03). The only independent risk factor associated with addictive behavior was age (OR = 1.34, 95% CI = [1.14 - 1.59], p &lt; 10-3).

Conclusions
The findings have implications for identifying protection factors and risk factors for addictive behaviors, and the development of primary prevention strategies derived from such factors.

Key messages
Our results highlight the need to better understand behaviors at risk in Tunisia and the perceptions of prevention policies among students. Knowledge of related factors is important for prevention program planning.
Could Euroqol 5 Dimension questionnaire predict the characteristics of a hospitalization?
Authors: Cuccaro C , Kundisova L , Nante N 
Published: November 2019

Abstract

Background
Health related quality of life (HRQL) reflects how a particular state of health could influence individual wellbeing. Pathologies have a significant impact on the life, but the same conditions can be perceived differently so subjective evaluation by patient can be a valuable help to the doctors.
The aim of the study is to describe how the HRQL may correlate with some clinical conditions.

Methods
A cross-sectional study was conducted in January-March 2019 in a private clinic. The Euroqol-5 Dimension (EQ-5D) questionnaire is a measure of quality of life to capture physical, mental and social functioning of patients and it was submitted at the time of admission. Examined variables were: age, sex, hospitalization period, EQ-5D index, EQ-5D dimensions (mobility, self-care, activity, pain, depression) and mini-mental state examination (MMSE). The sample was divided into subgroups for age (S1:&lt;75 years, S2:&gt;75) and for presence of problems (with or without). Statistical analysis was conducted using Stata 12.

Results
A total of 59 patients were admitted, but only 33 (69.7% females) received the EQ-5D questionnaire. Average age was 80.2±12.3, higher for females (p = 0.02). The average length of stay was 12.7±9.4 days. The mean of EQ-5D index for the patients was 0.36±0.27 (S1:0.38±0.26; S2:0.27±0.3) and it did not seem to be significantly correlated with variables. The frequency of the EQ-5D dimensions problem stratified by age group was: mobility 96.97%(S1 21.21%, S2 75.76%), self-care 90.91%(S1 21.21%, S2 69.7%), usual activity 93.94%(S1 21.21%, S2 72.73%), pain 87.88%(S1 18.18%, S2 69.7%), depression 66.66%(S1 15.15%, S2 51.51%). The length of stay showed a significant correlation with pain(Spearman r=-0.45, p = 0.018) and depression(r = 0.46, p = 0.015).

Conclusions
The majority of patients showed low level of EQ-5D index which is reflected in a low level of perceived HRQL. Pain and depression are the two dimensions that have shown a possible correlation.

Key messages
The EQ-5D index does not appear correlated to variables such as sex, age and length of stay. Depression and pain could be two important factors influencing a patient’s admission and its length.