bluuebunny/crossref_metadata_2025_split huggingface dataset:
Conduct disorder and somatic health in children: a nationwide genetically sensitive study
Authors: Kerekes Nóra , Zouini Btissame , Karlsson Emma , Cederholm Emma , Lichtenstein Paul , Anckarsäter Henrik , Råstam Maria 
Published: December 2020

Abstract
Background
Conduct disorder (CD), a serious behavioral and emotional disorder in childhood and adolescence, characterized by disruptive behavior and breaking societal rules. Studies have explored the overlap of CD with neurodevelopmental problems (NDP). The somatic health of children with NDP has been investigated; however, the prevalence of these problems in children with CD has not been sufficiently studied. Holistic assessment of children with CD is required for establishing effective treatment strategies.
Aims: (1) Define the prevalence of selected neurological problems (migraine and epilepsy) and gastrointestinal problems (celiac disease, lactose intolerance, diarrhea, and constipation) in a population of twins aged 9 or 12; (2) Compare the prevalence of somatic problems in three subpopulations: (a) children without CD or NDP, (b) children with CD, and (c) children with both CD and NDP; (3) Select twin pairs where at least one child screened positive for CD but not NDP (proband) and map both children’s neurological and gastrointestinal problems.

Method
Telephone interviews with parents of 20,302 twins in a cross-sectional, nationwide, ongoing study. According to their scores on the Autism-Tics, AD/HD, and Comorbidities inventory, screen-positive children were selected and divided into two groups: (1) children with CD Only, (2) children with CD and at least one NDP.

Results
Children with CD had an increased prevalence of each neurological and gastrointestinal problem (except celiac disease), and the prevalence of somatic problems was further increased among children with comorbid CD and NDP. The presence of CD (without NDP) increased the odds of constipation for girls and the odds of epilepsy for boys. Girls with CD generally had more coexisting gastrointestinal problems than boys with CD. Female co-twins of probands with CD were strongly affected by gastrointestinal problems. Concordance analyses suggested genetic background factors in neurological and gastrointestinal problems, but no common etiology with CD could be concluded.

Conclusion
Co-occurring NDP could explain most of the increased prevalence of somatic problems in CD. Our results raise a new perspective on CD in children and adolescents; their CD seems to be linked to a number of other health problems, ranging from neurodevelopmental and psychiatric disorders to somatic complaints.
Sudden death in the young adult: a Tunisian autopsy-based series
Authors: Saadi Said , Ben Jomaa Sami , Bel Hadj Mariem , Oualha Dorra , Haj Salem Nidhal 
Published: December 2020

Abstract
Background
We aim to study the profile, and pathological characteristics of sudden death in young in purpose of recommendations for prevention.

Methods
We performed a retrospective cohort study using autopsy data from the Department of Forensic Medicine of Monastir (Tunisia). A review of all autopsies performed for 28 years was done (August 1990 to December 2018). In each case, clinical information, and circumstances of death were obtained. A complete forensic autopsy and histological, and toxicological investigations were performed. We have included all sudden death in persons aged between 18 and 35 years.

Results
We collected 137 cases of sudden death during the studied period. The mean age of the studied population was 26.47 years. Almost 72% deaths were classified as cardiac death, and was due to ischemic heart disease in 32.32%. Sudden death was attributed to a pleuropulmonary cause in 7.4%, an abdominal cause in 6%, and from a neurological origin in 4.5%. The cause of sudden death in this group was not established by 9.5%.

Conclusion
In this series, sudden death in young adults occurs mainly in a smoking male, aged between 18 and 24 years old, occurring at rest, in the morning, and early in the week. It is more common, especially in summer. Sudden death is most often the first manifestation of pathologies, especially unsuspected heart diseases. The predominance of cardiovascular causes is the common denominator of almost all studies reported in the literature. Our findings suggest that prevention of sudden death among young adults under the age of 35 years should also focus on evaluation for causes not associated with structural heart disease.
Barriers to accessing healthcare among women in Ghana: a multilevel modelling
Authors: Seidu Abdul-Aziz , Darteh Eugene Kofuor Maafo , Agbaglo Ebenezer , Dadzie Louis Kobina , Ahinkorah Bright Opoku , Ameyaw Edward Kwabena , Tetteh Justice Kanor , Baatiema Linus , Yaya Sanni 
Published: December 2020

Abstract
Background
Women’s health remains a global public health concern, as enshrined in the Sustainable Development Goals. This study, therefore, sought to assess the individual and contextual factors associated with barriers to accessing healthcare among women in Ghana.

Methods
The study was conducted among 9370 women aged 15–49, using data from the 2014 Ghana Demographic and Health Survey. Barrier to healthcare, derived from four questions— whether a woman faced problems in getting money, distance, companionship, and permission to see a doctor—was the outcome variable. Descriptive and multilevel logistic regression analyses were carried out. The fixed effect results of the multilevel logistic regression analyses were reported using adjusted odds ratios at a 95% confidence interval.

Results
More than half (51%) of the women reported to have at least one form of barrier to accessing healthcare. Women aged 45–49 (AOR = 0.65, CI: 0.49–0.86), married women (AOR = 0.71, CI:0.58–0.87), those with a higher level of education (AOR = 0.51, CI: 0.37–0.69), those engaged in clerical or sales occupation (AOR = 0.855, CI: 0.74–0.99), and those who were covered by health insurance (AOR = 0.59, CI: 0.53–0.66) had lower odds of facing barriers in accessing healthcare. Similarly, those who listened to radio at least once in a week (AOR =0.77, CI: 0.66–0.90), those who watched television at least once a week (AOR = 0.75, CI: 0.64–0.87), and women in the richest wealth quintile (AOR = 0.47, CI: 0.35–0.63) had lower odds of facing barriers in accessing healthcare. However, women who were widowed (AOR = 1.47, CI: 1.03–2.10), those in the Volta Region (AOR 2.20, CI: I.38–3.53), and those in the Upper West Region (AOR =2.22, CI: 1.32–3.74) had the highest odds of facing barriers to healthcare accessibility.

Conclusion
This study shows that individual and contextual factors are significant in predicting barriers in healthcare access in Ghana. The factors identified include age, marital status, employment, health insurance coverage, frequency of listening to radio, frequency of watching television, wealth status, and region of residence. These findings highlight the need to pay critical attention to these factors in order to achieve the Sustainable Development Goals 3.1, 3.7, and 3.8. It is equally important to strengthen existing strategies to mitigate barriers to accessing healthcare among women in Ghana.
A multicenter randomized controlled trial protocol to evaluate the effectiveness of an educational intervention on fertility knowledge, intention and behavior among Iranian new couples
Authors: Gharacheh Maryam , Khalajabadi Farahani Farideh , Mirghafourvand Mojgan , Janani Leila , Ranjbar Fahimeh 
Published: December 2020

Abstract
Background
Recent evidence shows that men and women have inadequate fertility knowledge which may negatively affect their childbearing decisions in future. Given the fact that decision making for fertility needs accurate information, targeted educational interventions especially through media are needed to improve knowledge regarding the best age of fertility, factors affecting fertility potential and fertility options available for sub-fertile couples. Aim of the study is to evaluate whether a fertility educational program can be effective in increasing fertility knowledge, childbearing intention and the planned pregnancy rate among couples referring to premarital counselling centers.

Methods
This study is a parallel randomised clinical trial with pre-test/post-test design. We will recruit 1240 marrying couples referring for compulsory premarital counselling in public health centers through stratified sampling in five metropolitan cities of Iran. The intervention group will receive both the typical premarital counselling training and a fertility knowledge package containing verbal and virtual educational package at five time episodes (one verbal session and four virtual sessions) within 4 weeks. The primary outcomes are fertility knowledge, childbearing intention and the first planned pregnancy rate (positive pregnancy test) and the secondary outcomes include contraception method use, miscarriage and unplanned pregnancy. Participants will respond to a self-administered demographic/reproductive characteristics questionnaire, the Cardiff Fertility Knowledge Scale (CFKS) and the childbearing intention questionnaire.
Data will be collected through online questionnaires at baseline and 3, 12 and 18 months after the intervention. Data will be analyzed using Chi-square or Fisher-exact test for categorical variables, Independent sample t-test for normally distributed quantitative variables and Mann–Whitney U test for non-normally distributed quantitative variables. To compare the outcomes between the two groups over the time, repeated measures ANOVA will be used. We hypothesize that the positive impact of increasing the fertility knowledge is the reduced involuntarily childlessness.

Discussion
The findings are proposed to inform government policies and public education strategies aiming at supporting childbearing among young couples who postpone their first pregnancy while they might not have any important social and economic obstacles.

Trial registration
This study was approved by Iranian Registry of Clinical Trials (IRCT), Number: IRCT20201005048925N1, Date of registration: 2020-10-12.
Do work- and home-related demands and resources differ between women and men during return-to-work? A focus group study among employees with common mental disorders
Authors: Nybergh Lotta , Bergström Gunnar , Hellman Therese 
Published: December 2020

Abstract
Background
Common mental disorders present the main reason for registered sick leave in Sweden today, and women are at a higher risk of such sick leave than men. The aim of our study was to explore how the experiences of work- and home-related demands as well as resources influence return-to-work among employees sick-listed for common mental disorders in Sweden. Specifically, we aimed to explore similarities and differences in patterns of experiences among women and men.

Methods
A qualitative design with semi-structured focus group interviews was applied. One pilot interview and six additional focus groups, with a total of 28 participants, were conducted. The focus group discussions were audiotaped and transcribed verbatim. Data was analyzed with conventional content analysis.

Results
The analysis resulted in four main categories and eight sub-categories. While the study aim was to explore aspects of work and home, additional considerations related to internal demands and involved actors were also found. The main and sub-categories were “Home-related demands and resources” (sub-categories: “Not on sick leave for home-related demands”, “Feeling responsible for relationships and the well-being of others”, “An affected economy” and “Finding energizing activities and creating routines”), “Work-related demands and resources” (sub-categories: “Encountering tough emotions and an over-bearing feeling of responsibility at work”, “Continued work-related demands create un-certainty about the future”, “Loss of boundaries” and “(Desired) support from managers and colleagues”), “Internal demands and resources” and “Demands and resources linked to involved actors”. The experiences described among women and men were similar in some categories while patterns of experiences differed in others.

Conclusions
Home-related demands and resources influence return-to-work among women and men sick-listed for common mental disorders in Sweden, also when work-related demands are experienced as the main reason for the sick leave period. Furthermore, several of these aspects were described differently among women and men, which highlights the need to consider possible gender differences in relation to return-to-work, while maintaining attention to individual variations.
Associations of self-reported atopic dermatitis with comorbid conditions in adults: a population-based cross-sectional study
Authors: Smirnova Jevgenija , Montgomery Scott , Lindberg Magnus , Svensson Åke , von Kobyletzki Laura 
Published: December 2020

Abstract
Background
The objective of this study was to investigate the relationships between atopic dermatitis (AD) and other common chronic health conditions in adults.

Methods
A cross-sectional survey was sent to a randomly selected population sample of 78,004 adults in Sweden. The questionnaires included measures of self-reported physical and mental health. Binary and multinomial logistic regression were used to examine the associations of AD with common chronic health conditions and psychological wellbeing.

Results
AD was self-reported by 4,175 respondents, representing almost 14% of the study population of 34,313 adults. Our results showed positive associations between AD and chronic health disorders, including conditions of the oral cavity: chronic obstructive pulmonary disease (adjusted odds ratio [aOR] = 1.58, 95% confidence interval [CI]: 1.30 to 1.92), asthma (aOR = 2.13, 95% CI: 1.91 to 2.38), mild recurrent gastrointestinal symptoms (adjusted relative risk ratio [aRRR] = 1.78, 95% CI: 1.64 to 1.92), high blood pressure (aOR = 1.16, 95% CI: 1.06 to 1.26), obesity (aOR = 1.34, 95% CI: 1.23 to 1.47), mild joint pain (aRRR = 1.47, 95% CI: 1.35 to 1.61), mild headache or migraine (aRRR = 1.50, 95% CI: 1.38 to 1.64), caries (aOR = 1.25, 95% CI: 1.04 to 1.49), bleeding gums (aOR = 1.69, 95% CI: 1.38 to 2.08), periodontitis (aOR = 1.42, 95% CI: 1.13 to 1.77), sensitive teeth (aOR = 1.57, 95% CI: 1.35 to 1.82), and dry mouth (aOR = 1.52, 95% CI: 1.33 to 1.74). Adjustment for asthma and depression attenuated the magnitude of the associations between AD and the study outcomes. AD was also associated with poorer general psychological wellbeing.

Conclusions
Adults reporting AD may be at increased risk of chronic disorders and decreased psychological wellbeing. Physicians should recognize that individuals with severe AD and those with comorbid asthma or depression may be especially vulnerable.
Effects of habitat edges on vegetation structure and the vulnerable golden-brown mouse lemur (Microcebus ravelobensis) in northwestern Madagascar
Authors: Andriatsitohaina Bertrand , Romero-Mujalli Daniel , Ramsay Malcolm S. , Kiene Frederik , Rasoloharijaona Solofonirina , Rakotondravony Romule , Lehman Shawn M. , Radespiel Ute 
Published: December 2020

AbstractBackgroundEdge effects can influence species composition and community structure as a result of changes in microenvironment and edaphic variables. We investigated effects of habitat edges on vegetation structure, abundance and body mass of one vulnerableMicrocebusspecies in northwestern Madagascar. We trapped mouse lemurs along four 1000-m transects (total of 2424 trap nights) that ran perpendicular to the forest edge. We installed 16 pairs of 20 m2vegetation plots along each transect and measured nine vegetation parameters. To determine the responses of the vegetation and animals to an increasing distance to the edge, we tested the fit of four alternative mathematical functions (linear, power, logistic and unimodal) to the data and derived the depth of edge influence (DEI) for all parameters.ResultsLogistic and unimodal functions best explained edge responses of vegetation parameters, and the logistic function performed best for abundance and body mass ofM.ravelobensis. The DEI varied between 50 m (no. of seedlings, no. of liana, dbh of large trees [dbh ≥ 10 cm]) and 460 m (tree height of large trees) for the vegetation parameters, whereas it was 340 m forM. ravelobensisabundance and 390 m for body mass, corresponding best to the DEI of small tree [dbh < 10 cm] density (360 m). Small trees were significantly taller and the density of seedlings was higher in the interior than in the edge habitat. However, there was no significant difference inM. ravelobensisabundance and body mass between interior and edge habitats, suggesting thatM. ravelobensisdid not show a strong edge response in the study region. Finally, regression analyses revealed three negative (species abundance and three vegetation parameters) and two positive relationships (body mass and two vegetation parameters), suggesting an impact of vegetation structure onM. ravelobensiswhich may be partly independent of edge effects.ConclusionsA comparison of our results with previous findings reveals that edge effects are variable in space in a small nocturnal primate from Madagascar. Such an ecological plasticity could be extremely relevant for mitigating species responses to habitat loss and anthropogenic disturbances.
Hydrology influences breeding time in the white-throated dipper
Authors: Nilsson Anna L. K. , Skaugen Thomas , Reitan Trond , L’Abée-Lund Jan Henning , Gamelon Marlène , Jerstad Kurt , Røstad Ole Wiggo , Slagsvold Tore , Stenseth Nils C. , Vøllestad L. Asbjørn , Walseng Bjørn 
Published: December 2020

Abstract
Background
Earlier breeding is one of the strongest responses to global change in birds and is a key factor determining reproductive success. In most studies of climate effects, the focus has been on large-scale environmental indices or temperature averaged over large geographical areas, neglecting that animals are affected by the local conditions in their home ranges. In riverine ecosystems, climate change is altering the flow regime, in addition to changes resulting from the increasing demand for renewable and clean hydropower. Together with increasing temperatures, this can lead to shifts in the time window available for successful breeding of birds associated with the riverine habitat. Here, we investigated specifically how the environmental conditions at the territory level influence timing of breeding in a passerine bird with an aquatic lifestyle, the white-throated dipper Cinclus cinclus. We relate daily river discharge and other important hydrological parameters, to a long-term dataset of breeding phenology (1978–2015) in a natural river system.

Results
Dippers bred earlier when winter river discharge and groundwater levels in the weeks prior to breeding were high, and when there was little snow in the catchment area. Breeding was also earlier at lower altitudes, although the effect dramatically declined over the period. This suggests that territories at higher altitudes had more open water in winter later in the study period, which permitted early breeding also here. Unexpectedly, the largest effect inducing earlier breeding time was territory river discharge during the winter months and not immediately prior to breeding. The territory river discharge also increased during the study period.

Conclusions
The observed earlier breeding can thus be interpreted as a response to climate change. Measuring environmental variation at the scale of the territory thus provides detailed information about the interactions between organisms and the abiotic environment.
Important aspects of conducting an interdisciplinary public preventive oral health project for children in areas with low socioeconomic status: staff perspective
Authors: Blomma C. , Krevers B. 
Published: December 2020

Abstract
Background
To achieve good and equal oral health in children, interdisciplinary preventive oral health actions, directed toward disadvantaged areas, can be an important means. Staff play a crucial role in the implementation of these actions. The aim of the present study was to analyze circumstances of importance for conducting an interdisciplinary public preventive oral health project for children, directed toward parents in areas with low socioeconomic status from the interdisciplinary perspective of the involved staff.

Method
The present study consisted of a qualitative content analysis with an inductive approach, based on interviews with interdisciplinary staff who had participated in a public preventive oral health project directed toward parents in areas with low socioeconomic status. The interviews were analyzed using text-driven analysis.

Results
The main category concerned the staff members’ prerequisites and understanding necessary to perform their tasks in interdisciplinary public preventive oral health project. To have the right prerequisites and understanding regarding the oral health project enabled staff to be committed, able and willing to perform in it. Important aspects of this are to have knowledge, motivation and to experience a supportive professional context, to have good leadership and for certain resources to fulfilled. A crucial aspect was to reach the targeted mothers.

Conclusions
For interdisciplinary cooperation in preventive oral health care to be achieved, it is essential for the involved disciplines and professions to embrace a common view on the project’s aim, their duties, and oral health, from the leadership to the individual level. Staff require competent leadership but also allocated time and adapted method support to be successful in this context. When allocating preventive health actions directed at low SES areas, it is important to acknowledge the risk of stigmatization and for staff to understand that families might be facing social challenges that prevent them from taking part in health-promoting actions. An important conclusion is that to be able to reach people, it is important for both those who design preventive programs for oral health and the staff who administer them to have sufficient knowledge about the target group.