bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of underweight, overweight and obesity among Palestinian school-age children and the associated risk factors: a cross sectional study
Authors: Al-Lahham Saad , Jaradat Nidal , Altamimi Mohammad , Anabtawi Ola , Irshid Alma , AlQub Malik , Dwikat Majdi , Nafaa Fouad , Badran Lama , Mohareb Rawan , Haji Reema , Aqqad Tareq , Jayyab Sadeq , Ghosh Budour Abu , Taher Rina , Al Zabadi Hamzeh 
Published: December 2019

Abstract
Background
Childhood obesity is rising in developed and developing countries, while childhood underweight is rising mainly in developing countries. Childhood underweight has been shown to increase a child’s risk of rapid weight gain. Overweight and obese children are more likely to become obese adults, which increases the risk of type-II diabetes and cardiovascular diseases. Studies concerning obesity among Palestinian children are scarce. The prevalence of obesity among Palestinian children has increased from 3 to 6% within 5 years in comparison to the worldwide rise from 1 to 7%, within 41 years. We aim to determine the current prevalence of underweight, overweight and obesity among Palestinian school-age children and to assess the role of dietary and sociodemographic factors.

Methodology
A cross sectional study was conducted in Palestine in 2017. A total of 1320 school-age children and their 2640 corresponding parents were recruited. A written questionnaire was filled out by the parents. Anthropometric indices were measured and categorized according to the Center for Disease Control and prevention (CDC).

Results
The mean ± SD age of the children was 9.5 ± 1.5 years and 48.8% were females. The prevalence of underweight, overweight and obesity among the children was approximately 7.3% (95% CI = 5.9–8.8%), 14.5% (95% CI = 12.7–16.6%) and 15.7% (95% CI = 13.8–17.8%) respectively. Multinomial logistic regression analysis demonstrated a significant correlation of waist circumference, age, gender and living place with the body mass indexes of the students.

Conclusion
Our findings highlighted the accelerated increase in the prevalence of underweight, overweight and obesity (37.5%) among Palestinian children within a very short time in comparison to the globe. Therefore, Interventions aiming to prevent obesity and underweight at an early stage might be vital to avoid obesity later in life and its health-related co-morbidities, e.g. type-II diabetes and cardiovascular diseases.
Drinking beer, wine or spirits – does it matter for inequalities in alcohol-related hospital admission? A record-linked longitudinal study in Wales
Authors: Gartner Andrea , Trefan Laszlo , Moore Simon , Akbari Ashley , Paranjothy Shantini , Farewell Daniel 
Published: December 2019

Abstract
Background
Alcohol-related harm has been found to be higher in disadvantaged groups, despite similar alcohol consumption to advantaged groups. This is known as the alcohol harm paradox. Beverage type is reportedly socioeconomically patterned but has not been included in longitudinal studies investigating record-linked alcohol consumption and harm. We aimed to investigate whether and to what extent consumption by beverage type, BMI, smoking and other factors explain inequalities in alcohol-related harm.

Methods
11,038 respondents to the Welsh Health Survey answered questions on their health and lifestyle. Responses were record-linked to wholly attributable alcohol-related hospital admissions (ARHA) eight years before the survey month and until the end of 2016 within the Secure Anonymised Information Linkage (SAIL) Databank. We used survival analysis, specifically multi-level and multi-failure Cox mixed effects models, to calculate the hazard ratios of ARHA. In adjusted models we included the number of units consumed by beverage type and other factors, censoring for death or moving out of Wales.

Results
People living in more deprived areas had a higher risk of admission (HR 1.75; 95% CI 1.23–2.48) compared to less deprived. Adjustment for the number of units by type of alcohol consumed only reduced the risk of ARHA for more deprived areas by 4% (HR 1.72; 95% CI 1.21–2.44), whilst adding smoking and BMI reduced these inequalities by 35.7% (HR 1.48; 95% CI 1.01–2.17). These social patterns were similar for individual-level social class, employment, housing tenure and highest qualification. Inequalities were further reduced by including either health status (16.6%) or mental health condition (5%). Unit increases of spirits drunk were positively associated with increasing risk of ARHA (HR 1.06; 95% CI 1.01–1.12), higher than for other drink types.

Conclusions
Although consumption by beverage type was socioeconomically patterned, it did not help explain inequalities in alcohol-related harm. Smoking and BMI explained around a third of inequalities, but lower socioeconomic groups had a persistently higher risk of (multiple) ARHA. Comorbidities also explained a further proportion of inequalities and need further investigation, including the contribution of specific conditions. The increased harms from consumption of stronger alcoholic beverages may inform public health policy.
Association of bone mineral density with lung function in a Chinese general population: the Xinxiang rural cohort study
Authors: Zeng Xiang , Liu Dongling , Zhao Xiangmei , Chao Ling , Li Yuchun , Li Huijun , Li Wen , Gui Lihui , Wu Weidong 
Published: December 2019

Abstract
Background
Bone mineral density (BMD) has been positively associated with lung function in patients diagnosed with respiratory diseases such as chronic obstructive pulmonary disease (COPD) and cystic fibrosis. However, the relationship between BMD and lung function is inconsistent in the general population.

Methods
To investigate the association between BMD and lung function in a Chinese general population, a total of 1024 adults aged 40–70 years old from Qiliying (an industrial polluted exposure area) and Langgongmiao (the reference area with non-industrial pollution) were recruited and underwent BMD and spirometry tests.

Results
Both BMD and lung function levels were lower in the exposed area compared to the reference area. In addition, BMD and lung function levels were also lower in females compared to males. Both Spearman and partial correlation analyses showed that BMD was positively correlated with FVC and FEV1. After adjusting linear regression analyses for potential confounding factors, every 0.1 g/cm2 drop in BMD was associated with 53.0 mL decrease in FVC and 33.5 mL decrease in FEV1.

Conclusions
A reduction of BMD is associated with lower lung function in a general population from China.
Spontaneous breathing in patients with severe acute respiratory distress syndrome receiving prolonged extracorporeal membrane oxygenation
Authors: Xia Jingen , Gu Sichao , Li Min , Liu Donglin , Huang Xu , Yi Li , Wu Lijuan , Fan Guohui , Zhan Qingyuan 
Published: December 2019

Abstract
Background
The use of extracorporeal membrane oxygenation (ECMO) in awake, spontaneously breathing and non-intubated patients (awake ECMO) may be a novel therapeutic strategy for severe acute respiratory distress syndrome (ARDS) patients. The purpose of this study is to assess the feasibility and safety of awake ECMO in severe ARDS patients receiving prolonged ECMO (> 14 days).

Methods
We describe our experience with 12 consecutive severe ARDS patients (age, 39.1 ± 16.4 years) supported with awake ECMO to wait for native lung recovery during prolonged ECMO treatment from July 2013 to January 2018. Outcomes are reported including the hospital mortality, ECMO-related complications and physiological data on weaning from invasive ventilation.

Results
The patients received median 26.0 (15.5, 64.8) days of total ECMO duration in the cohort. The longest ECMO support duration was 121 days. Awake ECMO and extubation was implemented after median 10.2(5.0, 42.9) days of ECMO. Awake ECMO was not associated with increased morbidity. The total invasive ventilation duration, lengths of stay in the ICU and hospital in the cohort were 14.0(12.0, 37.3) days, 33.0(22.3, 56.5) days and 46.5(27.3, 84.8) days, respectively. The hospital mortality rate was 33.3% (4/12) in the cohort. Survivors had more stable respiratory rate and heart rate after extubation when compared to the non-survivors.

Conclusions
With carefully selected patients, awake ECMO is a feasible and safe strategy for severe pulmonary ARDS patients receiving prolonged ECMO support to wait for native lung recovery.
Chronic widespread pain and its associations with quality of life and function at a 20- year follow-up of individuals with chronic knee pain at inclusion
Authors: Bergman Stefan , Thorstensson Carina , Andersson Maria L. E. 
Published: December 2019

Abstract
Objective
To study the prevalence of chronic widespread pain (CWP) and chronic regional pain (CRP), and their association to quality of life, pain, physical function at a 20-year follow-up in a population based cohort with chronic knee pain at inclusion.

Methods
121 individuals (45% women, mean age 64 years, range 54–73) with chronic knee pain from a population-based cohort study, answered a questionnaire and had radiographic knee examination at a 20-year follow-up. The responders were divided into three groups according to reported pain; individuals having no chronic pain (NCP), chronic widespread pain (CWP) and chronic regional pain (CRP). Pain and physical function were assessed using Knee injury and Osteoarthritis Outcome Score (KOOS). Health related quality of life (HRQL) was assessed with Euroqol-5D-3 L (EQ5D) and Short form 36 (SF36). The associations between pain groups and KOOS, EQ5D, and SF36 were analysed by multiple logistic regression, controlled for age, gender and radiographic changes indicating knee osteoarthritis (OA).

Results
The prevalence of CWP was 30%, and CWP was associated to worse scores in all KOOS subscales, controlled for age, gender and radiographic changes. CWP was also associated to worse scores in EQ-5D and in seven of the SF-36 subgroups, controlled for age, gender and radiographic changes.

Conclusion
One third of individuals with chronic knee pain met the criteria for CWP. CWP was associated with patient reported pain, function and HRQL. This suggest that it is important to assess CWP in the evaluation of patients with chronic knee pain, with and without radiographic knee OA.
Association between tooth loss and hypertension among older Chinese adults: a community-based study
Authors:   and the Shanghai Aging Study, Da Dongxin , Wang Fei , Zhang Hao , Zeng Xiaoli , Jiang Yiwei , Zhao Qianhua , Luo Jianfeng , Ding Ding , Zhang Ying , Wu Bei 
Published: December 2019

AbstractBackgroundThe purpose of the study is to examine the association between tooth loss and hypertension among older community residents in urban China.MethodsThis study included 3677 participants aged ≥50 years from the Shanghai Aging Study. We determined the number of teeth missing from questionnaires. Hypertension was defined as the mean of two measurements of systolic blood pressure (SBP) (140 mmHg or higher), diastolic blood pressure (DBP) (90 mmHg or higher) or physician-diagnosed hypertension confirmed from medical records. A multivariable logistic regression model was used to investigate the association between tooth loss and hypertension.ResultsThe average number of missing teeth among study participants was 9.67. Among them, participants with hypertension had lost an average of 10.88 teeth, significantly higher than those without hypertension (8.95) (p < 0.0001). After adjusting for covariates (socio-demographic characteristics, health behaviors and other chronic conditions), teeth lost (15 or more) was significantly associated with grade III hypertension, with OR = 1.55(95% CI 1.09–2.20).ConclusionsSignificant tooth loss maybe associated with severe hypertension among older Chinese adults. Prevention of tooth loss is important to the overall health of this population.
“Guarding their practice”: a descriptive study of Canadian nursing policies and education related to medical cannabis
Authors: Balneaves Lynda G. , Alraja Abeer A. 
Published: December 2019

Abstract
Background
In Canada, federal regulations allow Nurse Practitioners (NPs) to authorize medical cannabis. Nursing regulatory bodies, however, have been hesitant to include medical cannabis within NPs’ scope of practice. As the interest in cannabis increases, NPs have the potential to play a pivotal role in promoting the safe and appropriate use of cannabis. This study aimed to: summarize nursing policies in Canada related to medical cannabis; explore the perspective of nursing regulatory bodies regarding practice and policy issues related to medical cannabis; and examine the inclusion of medical cannabis content within Canadian NP curricula.

Methods
A descriptive study was conducted that comprised three phases. The first phase reviewed nursing regulatory bodies’ existing policies related to medical cannabis. In the second phase, practice consultants from nursing regulatory bodies were interviewed regarding policies and practices issues related to medical cannabis. The interviews were analyzed using thematic analysis. The third phase was a national survey of NP program coordinators regarding inclusion of cannabis in curricula. Descriptive statistics summarized survey responses.

Results
Of the 12 nursing regulatory bodies in Canada, only 7 had policies or statements related to cannabis, with only Ontario allowing NPs to authorize medical cannabis. There was confusion among practice consultants regarding the role of nurses in the administration of medical cannabis and several barriers were identified regarding nursing engagement in care related to medical cannabis, including lack of knowledge and clinical guidelines. 60% of NP programs included cannabis in their curricula, however, less than half addressed the risks and benefits of medical cannabis and dosing and administration protocols. Limited faculty expertise was a barrier to including cannabis content in NP curricula.

Conclusion
Nursing regulatory bodies must be proactive in developing policies and educational resources that will support nurses in providing safe and informed care related to cannabis. To ensure patients using medical cannabis receive consistent and safe care from nurses, harmonized regulations and policies are needed across all jurisdictions. Education programs must also provide updated knowledge and training for both registered nurses and NPs that will support them in providing non-judgemental and evidence-based care to the growing number of individuals using cannabis.
The effectiveness of interventions to involve men living with HIV positive pregnant women in low-income countries: a systematic review of the literature
Authors: Triulzi Isotta , Palla Ilaria , Ciccacci Fausto , Orlando Stefano , Palombi Leonardo , Turchetti Giuseppe 
Published: December 2019

Abstract
Background
Male involvement (MI) along the continuum of HIV healthcare services has been promoted as a critical intervention in low-income countries and represents one of the reasons for dropout and low retention of women along the cascade of care. The present review aims to identify interventions adopted to improve MI across Antenatal Clinics (ANCs).

Methods
For this systematic review, we searched electronic databases, including Scopus, PubMed, Web of Science (from 2008 to 2018) in English language. We included all interventions explicitly aimed at involving partners in pregnant women’s HIV continuum of care and we excluded studies performed in developed countries, not involving pregnant women. We followed the PRISMA checklist.

Results
We identified a total of 1694 records and excluded 1651 after duplicates were removed and abstract eligibility assessments were performed. Forty-three full-text articles were screened, but only 12 studies were included. Recurrent intermediate outcomes were antenatal partner attendance rate and male HIV testing. We subdivided articles according to the type of intervention: single intervention (7) and multiple interventions (5). Among single interventions, two studies evaluated the use of an invitation letter sent via women to encourage male attendance to the ANC. Four Randomized Controlled Trials (RCTs) compared the invitation card (standard of care, SC) to word of mouth, information letter, home visit and invitation card plus partner tracing. The partner attendance rate was lower in SC than in the intervention arm in three RCTs: information letter (14.2% vs 16.2%), home-visit (39% vs 87%) and invitation card plus partner tracing (52% vs 74%). Home visit strategies seemed the most effective. One study evaluated words of encouragement adopted to trigger women to invite their partners.
Among multiple interventions, the most effective strategies in terms of male attendance included health promotion through education and healthcare worker development. These interventions were more likely to be effective in promoting MI than single interventions.

Conclusions
From the review emerges the importance of male involvement in HIV cascade for pregnant women in countries with a significant HIV incidence and the need to define more precise indicators for measuring MI.
Service provision for depressed children and youth: a survey of the scope and nature of services in Ontario
Authors: Watson Priya , Mehra Kamna , Hawke Lisa D. , Henderson Joanna 
Published: December 2019

AbstractBackgroundThe worldwide prevalence of depressive disorders among children and youth has been reported in ranges from just under 3% to over 10%. In Canada, 7% of youth report past year depression, which is higher than any other age demographic. Yet, many of these youth do not receive evidence based interventions, increasing their risk for serious lifetime consequences. To better understand low service use, it is crucial to map and evaluate current services. This study aimed to determine the scope and nature of services available to depressed children and youth, and compare services to best evidence treatment guidelines.MethodsSeveral government and non-government resources were utilized to develop a new multi-sectoral database of depression services for children and youth across Ontario. An online survey was sent to program managers serving children/youth with depression, examining agency characteristics, populations served, services provided, patterns of service use, evaluation activities, and research priorities.Results413 agencies with 869 program managers participated, representing mental health, addictions and other sectors. Age groups served included children up to 12 years of age (31%), adolescents aged 13–17 (70%) and transition aged youth (18–25 years) (81%). Over half of respondents worked in the mental health (43.4%) or mental health and addiction (24.4%) sectors. The most frequently provided services were assessment, psychotherapy, case management, and psychoeducation; the most common types of psychotherapy provided included cognitive behavioral therapy, social skills training, and solution-focused therapy. Psychotherapies are offered in widely varying formats, frequencies and durations. Discontinuation rates varied, with higher discontinuation among transition aged youth as compared to children. Respondents identified effective treatment, improving access, and reducing service gaps as top future research priorities.ConclusionsThis study provides important new data on service provision and uptake for depressed children and youth. Comparing these results with best-evidence practice guidelines raises significant concerns about the services most commonly offered and their delivery formats. In addition, high early discontinuation rates raise questions about the service experiences of children, youth and their families. Other factors which may contribute to ongoing treatment engagement challenges include access barriers, service or client characteristics, and unintentional treatment impacts.
Outpatient mental healthcare service use among women with migrant background in Norway: a national register study
Authors: Straiton Melanie , Corbett Karina , Hollander Anna-Clara , Hauge Lars Johan 
Published: December 2019

AbstractBackgroundStudies show that migrant women are at greater risk of common mental disorders than the majority population, yet underrepresented in healthcare services. This study investigates the use of outpatient mental healthcare services over a five-year period among migrant and descendant women compared to majority women in Norway.MethodsUsing linked national registry data, we selected all women resident in Norway between 2009 and 2013 (N = 1,834,822). We conducted generalised estimated equations with logistic regression to assess if the odds of using outpatient mental healthcare services differed for migrant and descendant women compared to majority women. We also conducted generalised estimated equations with negative binomial regression to calculate consultation incidence rate ratios for migrant and descendant women relative to majority women among those with a common mental disorder.ResultsBoth migrant and descendant women had lower odds (OR = 0.47 and OR = 0.60 respectively) of using outpatient mental healthcare services than majority women. Odds of using services increased with length of residency. We also found significant variation by country of origin. Among women with common mental disorders who had used services, migrants, but not descendants, had a lower consultation rate ratio than majority women. Analyses by region of origin revealed that this did not apply to women from EU European countries, North America and Australia and New Zealand.ConclusionWomen with migrant background are, overall, underrepresented in OPMH services. Findings indicate that migrant women may not only experience barriers to seeking and accessing care but also in maintaining access to care. This may especially be the case for newly arrived migrant women and women from non-Western countries. Treatment may not be culturally adapted for these groups. Closer investigation of the barriers migrant women experience after using OPMH services is required.
Serum bilirubin level is associated with exercise capacity and quality of life in chronic obstructive pulmonary disease
Authors: Leem Ah Young , Kim Young Sam , Lee Ji-Hyun , Kim Tae-Hyung , Kim Ha Yan , Oh Yeon Mok , Lee Sang Do , Jung Ji Ye 
Published: December 2019

Abstract
Background
Bilirubin has antioxidant properties against chronic respiratory diseases. However, previous studies are limited by acquisition of serum bilirubin level at one time point and its analysis with clinical parameters. We evaluated the association of serum bilirubin levels with various clinical outcomes of chronic obstructive pulmonary disease (COPD) in Korean Obstructive Lung Disease (KOLD) cohort.

Methods
We included 535 patients with COPD from the KOLD cohort. Serum bilirubin levels and various clinical parameters, such as lung function, 6-min walking (6 MW) distance, quality of life (QoL), and exacerbation, were evaluated annually; their association was analyzed using generalized estimating equations and the linear mixed model.

Results
Among 535 patients, 345 (64.5%) and 190 (35.5%) were categorized into Global Initiative for Chronic Obstructive Lung Disease (GOLD) I-II and GOLD III-IV groups, respectively. 6 MW distance was positively associated with serum bilirubin levels, especially in the GOLD I-II group (estimated mean = 41.5). Among QoL indexes, the COPD assessment test score was negatively associated with serum bilirubin levels only in the GOLD I-II group (estimated mean = − 2.8). Higher serum bilirubin levels were independently associated with a higher number of acute exacerbation in the GOLD III-IV group (estimated mean = 0.45, P = 0.001). Multivariate analysis revealed that lung function and mortality were not associated with serum bilirubin levels.

Conclusions
Higher serum bilirubin levels were associated with a longer 6 MW distance and better QoL, especially in the GOLD I-II group, whereas they were related to a higher risk of acute exacerbation, especially in the GOLD III-IV group. Bilirubin levels may represent various conditions in COPD.