bluuebunny/crossref_metadata_2025_split huggingface dataset:
Temporal trend in adolescent mortality from aggression in Brazil, 2000 to 2017
Authors: Pereira V O M , Aquino E C , Corassa R B , Mascarenhas M D M , Ramalho W M , Mello N F , Fagg C W 
Published: October 2020

Abstract

Background
Mortality from aggression in adolescents reflects one of the symptoms of the Brazilian social situation, which makes this population group vulnerable, exposing them to situations that determine their death in an early and violent way. This work contributes to the analysis of the temporal trend of adolescent mortality due to aggression throughout Brazil from 2000 to 2017.

Methods
A ecological design time series was carried out on the mortality rate of adolescents due to aggression in Brazil, from 2000 to 2017. Data from the Mortality Information System (SIM) of the Ministry of Health of Brazil was used. Mortality rates were analyzed according to sex and age groups (10-14 and 15-19 years). The joinpoint regression method was used to calculate the annual trend in mortality rates.

Results
The mortality rate among female adolescents aged 10 to 14 years decreased from 1.81 to 1.74 deaths/100 thousand inhab., and in the group aged 15 to 19, increased from 6.64 to 7.87 deaths/100.000 inhab., from 2000 to 2017. The Average Annual Percentage Change (AAPC) of the rates showed a steady trend of mortality in the groups from 10 to 14 years (AAPC = -0.4; 95% CI -1.4-0.7) and 15 to 19 years (AAPC = 0.7; 95% CI -2.3-3.9). In males, the rate for the 10 to 14-year-old group increased from 4.56 to 6.64 deaths/100.000 inhab., and in the 15 to 19 year old group, increased from 73.06 to 122.78 deaths/100.000 inhab., from 2000 to 2017. The AAPC showed an upward trend in the groups between 10 and 14 years old (AAPC = 2.3; 95% CI % 0.2-4.4) and 15 to 19 years (AAPC = 2.8; 95% CI 2.1-3.5). In the 15 to 19-year-old group, the upward trend of the period between 2009 and 2017 stood out [Annual Percentage Change (APC) = 5.1; 95% CI 4.0-6.3)].

Conclusions
This analysis can contribute with subsidies for the improvement of public policies and intersectoral actions that act on the vulnerabilities to which adolescents are exposed and that reduce the mortality rates due to aggressions.

Key messages
Mortality from aggression in adolescents aged 15-19 showed, in the female sex, an increase from 6.64 to 7.87 deaths/100.000 inhab., and in males, an increase from 73.06 to 122.78 deaths/100.000 inhab. The upward trend in the mortality rate in male adolescents aged 15 to 19 was highlighted in the period from 2009 to 2017 [Annual Percentage Variation (APC) = 5.1; 95% CI 4.0–6.3).
Combining jobs and motherhood: is it worse when growing children alone?
Authors: Roxo L , Porto G , Perelman J 
Published: October 2020

Abstract

Background
Women combining paid job and motherhood may experience a poorer health status than those childless. This risk is expectedly higher among lone mothers due to their greater emotional, social, and economic vulnerability. This study aims to assess the impact of employment characteristics on the health of working mothers and to understand differences between lone and coupled mothers.

Methods
We used data from the 5th Portuguese National Health Survey from employed women (N = 1,649) aged 25-55 living with a child (&lt;16). We modelled depression (assessed by the Personal Health Questionnaire-8) and less-than-good self-reported health as a function of employment variables (part-time job; self-employment; instable job situation; skill level and sector of activity) using logistic regressions, adjusting for age, family variables, socioeconomic status, and social support. Interaction terms assessed differences between lone and coupled mothers.

Results
Women in part-time (OR = 3.04, 95%CI=2.97-3.11), high-skilled jobs (OR = 3.57, 95%CI=1.30-1.38), and self-employed (OR = 1.34, 95%CI=1.30-1.38) had higher odds for depression, compared to those working in low-skilled, full time and not self-employed jobs. Less-than-good health was also more likely among those working part-time (OR = 1.34, 95%CI=1.31-1.36) and self-employed (OR = 1.34, 95%CI=1.31-1.37). Mothers' mental health disadvantage was amplified when alone regarding self-employment and part-time jobs.

Conclusions
Employed mothers' physical and mental health may be harmed by part-time jobs, self-employment, and working in more differentiated jobs. Employed lone mothers may experience greater risks than coupled mothers.

Key messages
Part-time, high-differentiated jobs or self-employment may harm the physical and mental health of working mothers. Lone mothers are disproportionately impacted by these employment characteristics.
Periconceptional folic acid intake in Northwest Russia: a birth registry study
Authors: Postoev V A , Menshikova L I , Usynina A A , Grjibovski A M , Odland J O 
Published: October 2020

Abstract

Introduction
Periconceptional use of folic acid supplementation is an evidence-based measure of birth defects prevention. The study was aimed to assess effect of periconceptual use of folic acid on birth defect prevalence in Arkhangelsk county and to investigate socio-demographic factors, which are associated with adherence to this preventive measure.

Methods
A registry-based study was conducted with data from the Arkhangelsk County Birth Registry for 2012-2015. The study population included 57084 pregnancies to calculate the proportion of women taking folic acid and 53340 pregnancy outcomes without missing data to analyze related socio-demographic characteristics.

Results
The proportion of women followed a folic acid supplementation before pregnancy was 1.3% (95% CI: 1.2-1.4), during pregnancy - 55.8% (95%CI: 54.6-56.4). Such women had less risk to deliver a newborn with any birth defects (OR = 0,84, 95%CI: 0,75 - 0,95). Considering birth defects prevalence of 38,6 per 1000 newborns in Arkhangelsk county, number needed to prevent one case of birth defect was 142,9. Based on multivariate analysis, nulliparous married women with higher education, aged 30 or more, had a higher chance to use folic acid before and during pregnancy. The history of spontaneous abortion in the mother's medical history and the first pregnancy were negatively associated with the probability of folic acid intake both before and during pregnancy.

Conclusions
The compliance to periconceptional intake of folic acid among women in the region was low. A level of compliance was associated with such socio-demographic factors as age, education, marital status, gravidity and parity. The findings have direct applications in improving prenatal care in Arkhangelsk county and establishing targets for prenatal counseling.

Key messages
A level of compliance to primary prevention of birth defects is associated with such socio-demographic factors as age, education, marital status, gravidity and parity. Prenatal counseling in terms of birth defects prevention should be based on socio-demographic characteristics of pregnant women.
Refining insights in SES and other determinants on perceived health; a Positive Health Perspective
Authors: Dierx J A J , Kasper H D P 
Published: October 2020

Abstract

Background
Many studies use dichotomous distinction between high and low SES and overall 'general total health' as outcome variable in studying Socio-Economic Status (SES) as determinant of health. In light of recent views on health and society, this study challenges this approach by proposing a more multidimensional view on both SES as well as health by analyzing four groups of SES and including six dimensions of positive health (PG) next to total general health. This study therefore addresses the impact of SES on the perception of total general health and the six domains distinguishing four instead two SES groups.

Methods
An online questionnaire on health perceptions was performed amongst 1000 respondents age 18 years and older in the Netherlands. Spearman correlations and regression analysis have been performed determining relationships and relative contributions of effects to the main outcome of perceived total general health using IBM SPSS Statistics 24.

Results
It appears that on average total general health is higher with increasing SES scores. Furthermore, distinguishing between four levels of SES instead of two revealed that low and mid low SES group evaluated total general health and all six health domains equal. However, mid low SES group evaluate their general health and 5 out of 6 domains lower than mid high SES group and mid high SES group scored lower on general health and all 6 domains than very high SES group. Variance in people's evaluation of their perceived health was explained for 10% of the impact of SES on total general health using simple regression analysis which remarkably disappeared using multiple regression including other socioeconomic and demographic variables.

Discussion
Results show that a more refined SES score and using the six health domains of positive health seems to give more insight into peoples' perceptions of their health. These findings suggest that health promoting interventions should be tailored to different SES-groups.

Key messages
Using more SES-groups and positive health domains gives more insight in peoples' perception on experienced health. Tailoring health promoting interventions to peoples' perspectives on health and SES might decrease health disparities.
Integrating child’s health promotion in schools – local mechanisms and strategies
Authors: Kerschbaumer L , Gell S , Nesimovic A , Röthlingshofer E , Heiss R , Zoller C 
Published: October 2020

Abstract

Background
Evidence shows the importance of promoting awareness towards healthy nutrition; sports and health literacy in childhood, as early-incorporated behaviour often shape life-long behaviour patterns. Despite the legally formulated mission by the Austrian government to promote children's health, the available support for this purpose is still disproportionate and does not meet the expectations and demands of health care experts, insurances, and teaching staff regarding the pace and consistency of implementing necessary measures. Thus, local and regional stakeholders (e.g., insurances or education departments) are indispensable to accelerate implementation in the federal province of Tyrol. One measure is the “Quality Label Healthy School Program” which contains a strict set of requirements (e.g. healthy snacks/drinks; psychosocial health, sports and so forth) to promote the overall health of children.

Methods
We conducted 11 focus groups with five Participants on average to explore enabling and restricting factors, which may determine the successful implementation of the healthy school program. We recruited schools who joined the quality label and invited directly involved teachers as a source to provide insights into the practices, restricting and enabling factors for various health promotion measures. For processing the data, we used partially content analytical tools and the documentary method.

Results
Influencing factors include: a) lack of resource provision b) creativity in devising strategies for health promotion c) decision-making sovereignty d) support from local authorities & parents e) collaboration & networks f) school-specific needs & circumstances g) Workload & capacity and h) professional ethics.

Conclusions
Despite the lack of national support for required efforts, local authorities, health insurances and education departments developed own mechanisms and creative strategies to implement child health promotion.

Key messages
Local authorities, health insurances and education departments developed own mechanisms to promote child’s health and the teaching staff established creative strategies for its implementation. Despite the existing legally formulated mission to promote children's health in Austria, the national support made available for this purpose is still disproportionate to the required efforts.
Characteristics of patients visiting naturopathic practitioners for maternal and reproductive health
Authors: Steel A , Foley H , Schloss J , Redmond R 
Published: October 2020

Abstract

Background
Naturopathy, recognised by the World Health Organisation as a European traditional medicine system, is practiced in every world region. Patients in countries where naturopathy is practiced visit a naturopathic practitioner for a range of health concerns including maternal and reproductive health; recognised as a global health priority area. This study aims to examine the characteristics of patients visiting naturopathic practitioners for their maternal and reproductive health concerns, and the clinical care provided by naturopathic practitioners to those patients.

Methods
An international cross-sectional survey of typical naturopathic practices and their associated patients, conducted in naturopathic clinics in 14 countries and 4 world regions. Naturopathic practitioners(n = 54) were invited to prospectively complete an online survey for up to 20 consecutive cases within the study period. Univariate relationships were examined through chi-square tests. Backwards stepwise logistic regression was employed to explore the characteristics most likely to be associated with individuals visiting a naturopath for maternal and reproductive health.

Results
Naturopathic practitioners provided data for 852 patients, with 43 (5.0%) visiting a naturopath for maternal and reproductive health concerns such as fertility (54.8%), pregnancy (26.2%), preconception health (11.9%), and lactation, breastfeeding or other postnatal care (7.1%). The regression analysis indicates the practitioners are more likely to prescribe acupuncture (OR 2.71, p&lt;.001) and more likely to identify gynecological (OR 4.31, p&lt;.001) or endocrine (OR 3.30, p=.01) systems as important in the management of the health of these patients.

Conclusions
Individuals are accessing naturopathic practitioners for maternal and reproductive health. An examination of the motivations influencing this population to access naturopathic care and the outcomes of this care is urgently needed.

Key messages
Naturopathic practitioners throughout the world are being visited for assistance with maternal and reproductive health issues including fertility, pregnancy, preconception and postnatal care. Naturopathic practitioners are prescribing acupuncture, as well as a wide range of other treatments, for maternal and reproductive health issues.
When universal health care isn’t truly universal: Beyond filling gaps in access to medicines
Authors: James L , Menezes S , Lawrence S , Aranago M 
Published: October 2020

Abstract

Issue
The Canadian healthcare system is defined by universality, but unfortunately that does not extend to drugs outside of hospitals. Access to medication remains an area of inequity, fragmentation and system failure, with millions struggling with cost related non-adherence. This has created major implications for public health, limiting the health status of populations. Canada's inequitable system and the recent pursuit to fix it, provides an opportunity to examine ways of balancing public health goals and health systems reform in a country with established public and private care services.

Background
The government mandated the creation of a plan to improve access to medications. Stakeholder consultations ran from June -September 2018 and the Heart & Stroke Foundation (H&S) aimed to create policy recommendations that would improve population health outcomes and inequities. Research review and analysis determined the scope of the problem and viable solutions. Questions arose around whether a solution could improve equity and lower health care costs without dismantling the existing private system.

Results
Visionary principles led to the recommendation of a universal pharmacare program, designed to improve access to cost-effective medicines for all people in Canada regardless of geography, age, or ability to pay. A hybrid -program would include a robust common formulary for which the public payer is the first payer creating cost efficiencies. Top-up private insurance would result in less strain on the public system and maintain the presence of the existing private industry.

Lessons
Health charities have a unique role to play in creating innovative policy solutions that also serve patient interests. In order to advance public health, health charities need to maintain focus on equity and avoid policy development that is biased with conflict of interest.

Key messages
Canada is primed to implement a unique universal pharmacare program that addresses healthy inequities. Varied stakeholder interests can block public health goals.
Challenges Facing the Health System in Somalia and Implications for Achieving the SDGs
Authors: Gele A 
Published: October 2020

Abstract
While Somalia's health system has been slightly progressing over the last 6 years, there has been significant challenges in both the provision of health services and enabling access to the services. The existing health system is essentially privatized, and it is confined to major towns, leaving the poor majority, in the rural areas, out of affordable health care. Moreover, the national health system is fragmented, and the absence of unified health system governance has affected the capacity of national authorities to regulate the private sector and to partner NGO's to deliver services to remote areas. Consequently, less than 30% of the Somali population have access to health services. The neonatal mortality rate is 40 deaths per 1000 live births and the under-5 mortality rate is 137 deaths per 1000 live births. The maternal mortality rate is estimated at 732 per 100 000 live births. The use of family planning remains low, resulting in high fertility rates. The progress, and also the setbacks, of the health sector has been obscured by lack of reliable data at regional and national level. The absence of research institutions and human resources in research are among the obstacles to implementing evidence-based health interventions and the subsequent quality of health policy and practices. Investing health research is prerequisite for evidence-based health interventions that not only save lives, but also are crucial investment in the wider economy and development of the country. Therefore, to achieve the health-related SDGs, Somalia should invest in research by revitalizing essential public health research institutions.
Disability and social participation in Europe 2002-2016
Authors: Hadfield-Spoor M 
Published: October 2020

Abstract

Background
Social participation is an important aspect of social inclusion and affects health, wellbeing, equality and citizenship. Informal participation is particularly important for the inclusion and wellbeing of disabled people who are a growing demographic across Europe and the world (GBD, 2017). Despite some disability rights progress such as the UNCPRD, increasing foodbank use may reflect rising prevalence of social exclusion and inequality for some disabled people.

Methods
Analysis of data from all countries that participated in the European Social Survey Rounds 1-8, using Stata16, assessed the extent of a relationship between informal social participation and disability (defined as being hampered by disability or ill-health in daily activities), and over time. Logistic regression was used including possible confounding variables e.g. country variation.

Preliminary Findings
In most years, the data showed a significant negative association between disability severity and social participation, after accounting for potential confounders. For example, in 2016 people who reported 'no' disability (OR 1.678, CI 1.102948 - 2.551828) were more likely to socialise and to have higher levels of participation than people disabled 'a lot' (OR 1.253, CI 1.097011 - 1.431516). The association fluctuated slightly over time but no clear trend was yet identifiable.

Conclusions
It is likely that the relationship observed reflects real inequality in social participation among disabled people, suggesting persisting significant barriers to inclusion for disabled people, which can negatively impact on people's wellbeing and broader health systems. Analysis accounted for some personal and socioeconomic barriers but not cultural or environmental barriers. Inclusion and accessibility issues become an even more acute concern (and opportunity) for policy and practice relating to equality and wellbeing when facing climate chaos: more barriers to inclusion and increased disability prevalence.

Key messages
Inequality indicated by lower levels of social participation of people with disabilities remains a significant concern considering personal and social costs of social isolation. Successful social inclusion improves lives of people and communities here and now and can assist in developing resilience to climate change.
Patterns of beverage purchases amongst British households: a latent class analysis
Authors: Berger N , Cummins S , Smith R D , Cornelsen L 
Published: October 2020

Abstract

Background
Policies to tackle obesity have increasingly targeted drinks, in particular sugar-sweetened beverages (SSBs), as a major source of excess sugar and energy. However, precision targeting of policies is difficult as information on what types of consumers they might affect, and to what degree, is missing. To fill this gap, we categorised consumers on the basis of drink purchase behaviour and explored whether they are patterned by socio-demographic characteristics, total food purchasing and weight status.

Methods
We used latent class (LC) analysis to characterise patterns of drink purchases using the 2016 UK Kantar FMCG household purchase panel. We restricted analyses to frequent purchasers of drinks (n = 8,675) and used 6 drink categories: SSB; diet drink; fruit-/milk-based drinks; beer & cider; wine; and water. We used multinomial logistic and linear models to relate household characteristics, BMI and food purchase behaviours to LC membership.

Results
We identified 7 LCs. Disadvantaged households were more frequent in LCs with high volumes of SSBs ('SSB') and diet drinks ('Diet'). Higher BMI was more likely in LCs 'Diet' and 'SSB'. LC 'SSB' obtained higher total energy, relatively less energy from fruits and vegetables, and more energy from less healthy products, compared to others. LCs 'Diet' and 'SSB' obtained relatively more energy from sweet snacks.

Conclusions
Households who mainly purchased high volumes of SSBs or diet drinks were at greater risk of obesity and tended to purchase less healthy foods, including a high proportion of energy from sweet snacks. These households might additionally benefit from policies targeting unhealthy foods, such as sweet snacks, as a way of reducing excess energy intake.

Key messages
The effects of fiscal policies on SSB consumption is likely to vary across types of beverage consumers. Fiscal policies should be extended to sweet snacks as a major source of excess energy.