bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investigation of vitamin utilization in primary care in Istanbul
Authors: Ataç A , Aydin  , Kiraci  , Akici  
Published: October 2020

Abstract

Background
Vitamins which are necessary for maintaining health and preventing some medical conditions can be used upon physician recommendation or as self-medication for supplemental purposes. In this study, we aimed to examine the usage of vitamins in primary care prescriptions.

Methods
Prescriptions of 1431 family physicians in 2016 selected by systematic sampling in Istanbul were examined in this cross-sectional study (n = 5,936,852). Among these vitamins, the ones containing ATC code of A11 were determined, where the usage of these drugs and drug groups were analyzed in terms of age, sex, diagnosis, and concurrent usage with other medicines.

Results
We identified vitamins in 8.3% of all prescriptions. In vitamin-containing prescriptions, 71.4% of them were written for women and 32.3% of them were written for people aged between 45-65 (mean age: 47.0 ± 1.38 years). Vitamins comprised 34.9% of all drugs in those prescriptions. The most common vitamins are vitamin D and analogues (41.3%), vitamin B1, plain and in combination with Vitamin B6 and B12 (37.4%), and multivitamin (20.9%). The most common drugs co-prescribed with vitamins were alimentary tract and metabolism (20.9%) and blood and blood forming organs (13.3%) drugs. Among the prescriptions with single diagnosis (n = 131,194), we mostly encountered vitamin D deficiency (23.1%) as the indication. Vitamin D analogues were found to be significantly likely to be prescribed for women (44.4%) than men (32.7%, p &lt; 0.001) and vitamin B and its combinations were more likely to be written for men compared to that in women (43.3% vs. 35.2%, respectively; p &lt; 0.001).

Conclusions
The majority of vitamins prescribed in primary care seem to contain D and B vitamins, which are more likely to be prescribed for women and middle-aged population. This research is expected to shed light on future studies which aim to understand overall consumption of vitamins in different settings.

Key messages
The vitamins appear to be mostly prescribed for women and middle-aged people. The majority of vitamins prescribed in primary care seem to constitute D and B vitamins.
Examining social determinants by locale to inform community linkages
Authors: Davis J 
Published: October 2020

Abstract
Achieving a long-lasting impact on health outcomes requires focus not just on patient care, but also on community approaches aimed at improving population health through addressing gaps in Social Determinants of Health (SDOH). SDOH have been found to disproportionately affect those in low-income brackets and the disabled to varying degrees based on locale. The purpose of this exploratory research was to determine 1) which SDOH have the greatest negative impact on disabled and elderly populations within four targeted states (Iowa, Ohio, Minnesota, Wisconsin) and 2) if there is a difference in negative SDOH impact between metro and non-metro locales. Individual-level data were obtained from disabled persons aged 65 years or older who responded to the Centers for Disease Control and Prevention's 2017 Behavioral Risk Factor Surveillance System (BRFSS) survey. Utilizing these data, frequency distributions were obtained using SPSS. Rank order variation in SDOH was observed among four Midwestern states and between metro vs. non-metro geographic regions. Frequency distributions assisted in identifying the greatest negative impacting SDOH on elderly disabled populations. An examination of the rank order tables allowed the investigator to accurately assess the rank of negative impacts.
There were variabilities in responses to questions with moving two or more times within 12 months having the lowest negative impact. When regrouped based upon SDOH negative impacts, were you able to pay your bills was the most frequent SDOH across all states. Feeling unsafe or extremely unsafe in your neighborhood was the highest negatively impacted SDOH within states. Cited determinants in three categories were highest in Ohio. Ohio also had the highest proportion of negatively impacted SDOH across all states. No money for balanced meals was a close second SDOH across states.

Key messages
Social Determinants Impacting Elderly Disabled. Impact of Social Determinants by Geography.
'There is actually no one who is supporting me' - social networks and their relevance for health
Authors: Mairhofer S 
Published: October 2020

Abstract
The presented research project deals with current issues of family and services working with families (social affairs, health, education) in South Tyrol (Northern Italy). The qualitative data were collected in an extensive survey through 120 interviews with parents from different family types and service staff. The qualitative part of the project is based on the Grounded-Theory-Methodology. Therefore the differentiated subject areas were developed in the research process itself. In parallel, a quantitative data collection was implemented. For this purpose, about 1300 parents were interviewed by a written questionnaire.
Among the most significant results of the study are the often hardly existing or missing social networks of families (results of the qualitative part with ego-centred network maps and quantitative questionnaires coherent), the frequent description of pressure and stress on all levels, lack of comprehensible information (especially in the area of financing support, services and health topics) and dissatisfaction with social and health services. Based on these results, the relationships between these variables will now be investigated and first evaluations will show that there is a direct correlation between social networks and described well-being, stress or pressure perception, but also in the use of and satisfaction with social and health services. There existsis also a correlation between children's health status and parents' social networks. It is not only about the quantity of networks (number of network partners), but also about qualitative aspects, for example who these network partners are and how positive or conflictual relationships have been described.
The results illustrate the relevance of working with social networks as a public health issue and why further research is needed.

Key messages
Social networks are an important determinant of health. There is a need for more research about the connection between social networks and health.
System-mapping the child health system at a local level to reduce health inequalities
Authors: Jessiman P , Fairbrother H , Williams P , Powell K , Crowder M , Williams J , Kipping R 
Published: October 2020

Abstract

Background
Systems thinking has emerged as a promising approach to addressing complex public health issues. For children, the focus of the approach has been on single outcomes e.g. obesity, rather than addressing the broad range of inequalities in health outcomes. We report on an approach to developing a system-oriented perspective on the determinants of inequalities in child health and wellbeing in English local authorities.

Methods
Qualitative group concept mapping workshops (a 'soft' system science approach) were held in two contrasting English local authorities with a range of stakeholders: professionals (N = 35); children and young people (N = 33) and carers (N = 5). Initial area maps were refined using data from qualitative interviews with professionals (N = 16) and resulting maps reviewed and validated by expert stakeholders in each area (N = 9; N = 35). Commonalities between two area-specific system maps (and removal of locality-specific factors) were used to develop a map that could be applied in any English local area. Two rounds of online consultation (N = 21; N = 8) and qualitative interviews (N = 12) with experts in public health, local governance and systems science refined the final system map displaying the determinants of child health inequalities, and give insight into its potential utilisation.

Results
The process created a map of over 150 factors influencing inequalities in health outcomes for children aged 0-25 years at the local area level. The system map has six domains; physical environment, governance, economic, social, service, and personal.

Conclusions
To our knowledge this is the first study taking a systems approach to addressing inequalities across all aspects of child health. Group concept mapping can support systems thinking at the local level. The resulting system map illustrates the complexity of factors influencing child health inequalities and is a useful tool for strategy development, action prioritisation and systems evaluation planning.

Key messages
Group concept mapping can be successfully applied to facilitate a systems approach to child health inequalities at the local area level. Mapping the local child health system highlights complex relationships between physical, social, personal, service, governance and economic factors which influence inequalities and health outcomes.
Does long-term disease in adolescence predict educational career?
Authors: Rimpela A , Koivusilta L , Myöhänen A , Lindfors P , Kaltiala-Heino R-K 
Published: October 2020

Abstract

Background
Serious long-term diseases like asthma, diabetes or epilepsy in adolescence means extra efforts to cope everyday life in school, hobbies or at home. These also set extra challenges on adolescents to go through the developmental tasks of that age. We study here, if adolescents with a long-term disease have lower chances for an academic education compared to those without a long-term disease.

Methods
In 2011, all 7th graders in the Helsinki Metropolitan area, Finland were invited to the MetLoFin survey (8946 students from 128 schools answered). In 2014, all 9th graders, representing the same cohort were invited in the end of the lower secondary school (7629; 127). The data were linked with the national Joint Application Registry for the upper secondary schools. Serious diseases were asthma, diabetes, epilepsy and some other individual diseases (6%).

Results
At the 7th grade, the OR for continuing in vocational track or not having got a study place instead of academic track was 1.2 for those with the long-term disease. The difference stayed after adjusting for parents' education and sex but disappeared after adjusting for GPA. At 9th grade, results were similar, but the association disappeared after adjusting for parents' education and sex.

Conclusions
Even in a country like Finland, with high quality health services for children, a long-term disease can compromise educational career, even if the effect is small. The effect mediates mainly through GPA, which is the main selection criteria for upper secondary school.

Key messages
A long-term disease in adolescence can lower chances for academic educational career, even though the effect is small. The effect is mainly mediating through poorer GPA.
Socioeconomic inequalities in self-reported dental and general health in a Norwegian county study
Authors: Lyshol H , Sen A , Natland Fagerhaug T , Jullumstrø Feuerhern A , Jakhelln G , Grøtvedt L 
Published: October 2020

Abstract

Background
Studies have shown socioeconomic gradients in both dental health and general health, with poorer health in lower-socioeconomic status (SES) groups than in their higher-SES counterparts. We wanted to see if these gradients were present in our study population according to educational differences, and whether age or gender would have effect.

Methods
In 2015-16 a cross-sectional interview survey was carried out in three of Norway's then 19 counties. Questions about dental and general health were included. The respondents' educational level was available from linkages to the national education registry. 4551 men and 5141 women responded; a response rate of 42.7%. We included respondents aged 25-79. We compared the percentages reporting good/very good dental and general health by degree of education according to ISCED classification (0-2, 3-4 and 5-6) across the age groups 25-44, 45-66 and 67-79; by gender and county, in a regression with general linear models in STATA 15

Results
Clear educational gradients were found for both general and dental health. Stratifying by gender and county, we found more consistent age gradients for general health than for dental health, and consistent educational gradients for both. Both general and dental health were expected to deteriorate with age, and age was weakly associated with dental health. In regression analyses, general health was (negatively) associated with age (RR 1.04, CI 1.02-1.07) and (positively) associated with education (RR 0.92, CI 0.89-0.94), but not with gender. Dental health was not associated with age, but with education (RR 0.93, CI 0.91-0.96).

Conclusions
Self-reported dental health varied more by education than by age, and showed clear gradients only by education. There were county variations, but the oldest people with the highest education reported better health, both dental and general, than the youngest people with the lowest education. This may be connected to other socio-economic differences.

Key messages
There is often a gradient for age within each educational group regarding general health, but more rarely so regarding dental health. Education has a stronger influence on both dental health and general health than age.
Intersectorial educational incentive and youth leadership program: promoting opportunities
Authors: Vieira A M M , Secundino R C C B , Ortiz M S P , Castro V D S , Amaral M I B , Santos A C C 
Published: October 2020

Abstract
The Poupança Escola Program, created by municipal law and part of the Prevention Axis of the Niterói Pact Against Violence, aims to encourage young people from low-income communities and members of Bolsa Família Program, to study and complete high school. To receive the financial incentive in addition to the annual approval, the student must participate in mandatory extracurricular activities offered by the Municipality, such as courses and workshops on financial education, health education, entrepreneurship, among others. Its implementation results from a collective construction, wich had the participation of Niterói Pact Against Violence's secretariats and the Program Supervision Commission, in order to stimulate the agreement and shared management. In 2019, of 281 eligible students, 231 pre-registered on the program's website and of this total, 72.29% students opened their savings account in a public bank. After analyzing the 2019's monitoring informations of Niterói's public schools, students who met all requirements were identified and the first financial incentives was paid, totaling R$ 41.400,00 (about $ 10,000). For that, it was necessary an intense work of intra-municipal articulation and partnerships: the Government of Rio de Janeiro and federal schools, strengthening the reduction of school dropout. In 2020, the challenge will be to expand the availability of extracurricular activities, through public partnerships and non-governmental institutions, with the aim of improving the professional and citizen training of young people, encouraging their autonomy and protagonism over their future and contributing to the reduction of inequities. It is important to highlight the potential for replicability of the experience in other units of the federation and also for other countries.

Key messages
As a public policy, Poupança Escola encourages low-income youth to develop professional and citizen training, contributing to the reduction of risk factors that influence youth violence rates. Extracurricular activities expand opportunities for generating skills and abilities, contributing to the reduction of inequalities in access for low-income youth.
Social determinants of self-rated health in women
Authors: Mijatovic Jovanovic V , Milijasevic D , Cankovic S , Susnjevic S , Harhaji S , Tomasevic T 
Published: October 2020

Abstract

Background
Social determinants of health determine the extent to which a person possesses the physical, social and personal resources to stay healthy and achieve personal aspirations, satisfy needs, and cope with the environment.

Methods
Data from a cross-sectional study - The 2013 National Health Survey in Serbia was used. The study involved 1840 women aged 20 years and over in the Province of Vojvodina. The research instrument was a specially designed questionnaire. Multivariate logistic regression was implemented to assess the association between self-rated health as a dependent variable and social-demographic characteristics of women as independent variables (age, type of settlement, marital status, material status - DHS Wealth Index (WI), level of education, employment status, social support (Oslo-3 Social Support Scale), smoking and alcohol consumption.

Results
Out of a total 38.8% of women had a low level of education, according to WI 49.3% were poor, 21.9% were unemployed and 11.5% had poor social support. Every third woman was a smoker (31.9%) and 21.3% self-rated their health as poor. The number of women with poor health increased significantly with the decrease in social support, level of education and WI (from 14.3% among women with strong social support to 36.0% with poor social support, from 8.5% among highly educated to 31,4% among the low educated, from 11.1% among the rich to 24.4% among the poor). Multivariate logistic regression indicated that poor social support (OR = 3.96; 95%CI=2.34-6.70), low level of education (OR = 2.87; 95%CI=1.47-5.58), WI category of poor (OR = 1.77; 95%CI=1.10-2.84), ex smoking (OR = 2.49; 95%CI=1.51-4.08) and smoking (OR = 2.16; 95%CI=1.42-3.29) were significantly associated with poor self-rated health.

Conclusions
The research shows that there is a strong association between social determinants and self-rated health, which demands multi-disciplinary strategies to improve health and reduce health inequalities.

Key messages
Protecting the health of women is not only a basic human right, it is also crucial for health and economic development. Social determinants of health are leading causes of the health inequalities and demand an adequate health policy development at local, as well as at the national level.
Self-reported prevalence and risk factors for NCD in a Roma community in Romania
Authors: Mangaloiu D , Bratu E C , Mardare I , Brinduse L A , Minca D G 
Published: October 2020

Abstract

Background
Most of Romanian Roma communities are considered a vulnerable group, but there are limited data regarding the exposure and the prevalence of NCD specific for these communities. The research aims to assess the self-reported NCD prevalence and NCD risk factors among members of a rural Roma community.

Methods
A cross-sectional survey was carried out among a sample of 116 adults aged 18-85 years (52 male and 64 female), from a rural community with 800 Roma members. The study tools included questions to record NCD risk factors (WHO STEPwise approach) and self-reported data about the presence of chronic conditions. Descriptive statistics methods were used to analyse the data.

Results
Unhealthy diets (25% -95%CI, 17,7: 37,4), tobacco use (35,3% -95%CI, 27,0: 44,3), obesity and physical inactivity have been identified as the top NCD risk factors, with higher prevalence than ones reported for Romanian general population. Overall, the self-reported prevalence of chronic diseases in the sample was 56,8%, (95%CI, 47.8:95.9), no significant difference between men and women. 62% (95%CI, 50.4:73,8) of respondents with self-reported disease have declared co-morbidities. The most prevalent disease reported was hypertension (37.0% - CI95%, 28.2: 45.8), followed by dyslipidaemia (23,2% -CI95%,15,5:30.9), diabetes type 2, gastritis and ischemic heart disease (IHD). One quarter of respondents with HTA are daily smokers and more than half have obesity and dyslipidaemia.

Conclusions
This analysis provides information that NCD risk factors and self-reported NCD prevalence in a typical rural Roma community are higher than in the majority population of Romania. Both prevalences should be known in order to increase access to prevention, diagnostic and treatment programs.

Key messages
The health system should monitor NCDs and risk factors and implement equitable public health policies to address health inequities and meet the needs of Roma population groups. The high prevalence of risk factors for NCD in this rural Roma community indicates the likelihood of a high future burden of illness.
Equitable Access of Naloxone Programs in Durham Region, Ontario, Canada
Authors: Martignetti L , Sun W 
Published: October 2020

Abstract

Background
In 2019 there were over 1500 opioid-related deaths in the province of Ontario, Canada. While the opioid crisis is affecting many socioeconomic groups and communities across Canada not all are being affected equally despite the presence of naloxone distribution programs in Ontario. This qualitative exploratory study seeks to understand facilitators and barriers that influence equitable access of naloxone programs in Durham Region, Ontario, Canada.

Methods
An environmental scan will be conducted to examine the availability and distribution of naloxone across community pharmacies and organizations in Durham Region. A qualitative descriptive phenomenology will be the methodological approach where key informant interviews will explore experiences of users and providers of naloxone programs. Key informants will include service providers and clients of both Ontario Naloxone Program and Ontario Naloxone Program for Pharmacies in Durham Region. The harm reduction framework will be used to guide data analysis where thematic analysis will be conducted to generate overarching themes about the phenomenon.

Results
The environmental scan will result in the creation of a map outlining availability and distribution of naloxone programs to examine possible gaps that exist in Durham Region. It is expected that key informant interview findings will help understand where inequity exists in accessing Ontario's naloxone programs in Durham Region by highlighting its barriers and facilitators.

Conclusions
Findings generated will be used for larger scale studies in the future examining equitable access of naloxone distribution programs in Canada. This study will have implications to provide recommendations to policymakers for developing new policies to facilitate timely access of naloxone to mitigate risk of opioid-related harms.

Key messages
This research will help to better understand the inequities that exist in Ontario's naloxone distribution programs. This research will help to inform recommendations to improve policies surrounding Ontario's naloxone distribution programs.