bluuebunny/crossref_metadata_2025_split huggingface dataset:
Burden of neurological and neurocognitive impairment in pediatric sickle cell anemia in Uganda (BRAIN SAFE): a cross-sectional study
Authors: Green Nancy S. , Munube Deogratias , Bangirana Paul , Buluma Linda Rosset , Kebirungi Bridget , Opoka Robert , Mupere Ezekiel , Kasirye Philip , Kiguli Sarah , Birabwa Annet , Kawooya Michael S. , Lubowa Samson K. , Sekibira Rogers , Kayongo Edwards , Hume Heather , Elkind Mitchell , Peng Weixin , Li Gen , Rosano Caterina , LaRussa Philip , Minja Frank J. , Boehme Amelia , Idro Richard 
Published: October 2019

AbstractBackgroundChildren with sickle cell anemia (SCA) are highly susceptible to stroke and other manifestations of pediatric cerebral vasculopathy. Detailed evaluations in sub-Saharan Africa are limited.MethodsWe aimed to establish the frequency and types of pediatric brain injury in a cross-sectional study at a large SCA clinic in Kampala, Uganda in a randomly selected sample of 265 patients with HbSS ages 1–12 years. Brain injury was defined as one or more abnormality on standardized testing: neurocognitive impairment using an age-appropriate test battery, prior stroke by examination or transcranial Doppler (TCD) velocities associated with stroke risk in children with SCA (cerebral arterial time averaged mean maximum velocity ≥ 170 cm/second).ResultsMean age was 5.5 ± 2.9 years; 52.3% were male. Mean hemoglobin was 7.3 ± 1.01 g/dl; 76.4% had hemoglobin < 8.0 g/dl. Using established international standards, 14.7% were malnourished, and was more common in children ages 5–12. Overall, 57 (21.5%) subjects had one to three abnormal primary testing. Neurocognitive dysfunction was found in 27, while prior stroke was detected in 15 (5.7%). The most frequent abnormality was elevated TCD velocity 43 (18.1%), of which five (2.1%) were in the highest velocity range of abnormal. Only impaired neurocognitive dysfunction increased with age (OR 1.44, 95%CI 1.23–1.68),p < 0.001). In univariate models, malnutrition defined as wasting (weight-for-height ≤ −2SD), but not sex or hemoglobin, was modestly related to elevated TCD (OR 1.37, 95%CI 1.01–1.86,p = 0.04). In adjusted models, neurocognitive dysfunction was strongly related to prior stroke (OR 6.88, 95%CI 1.95–24.3,p = .003) and to abnormal TCD (OR 4.37, 95%CI 1.30,p = 0.02). In a subset of 81 subjects who were enriched for other abnormal results, magnetic resonance imaging and angiography (MRI/MRA) detected infarcts and/or arterial stenosis in 52%. Thirteen subjects (25%) with abnormal imaging had no other abnormalities detected.ConclusionsThe high frequency of neurocognitive impairment or other abnormal results describes a large burden of pediatric SCA brain disease in Uganda. Evaluation by any single modality would have underestimated the impact of SCA. Testing the impact of hydroxyurea or other available disease-modifying interventions for reducing or preventing SCA brain effects is warranted.
Motor and cognitive functioning in children treated for idiopathic clubfoot at the age of 3 years
Authors: Dillmann Julia , Schwarzer Gudrun , Peterlein Christian-Dominik 
Published: October 2019

Abstract

Background
Several studies have investigated motor and cognitive skills in infants as well as gross motor abilities in schoolchildren treated for congenital idiopathic clubfoot, mostly indicating specific impairments in those children. However, until now, little is known about the motor and cognitive abilities of preschool children treated for idiopathic clubfoot. Thus, it was the aim of this study to examine gross motor, fine motor and cognitive skills of 3-year-old-children treated for idiopathic clubfoot.

Method
We tested gross motor, fine motor and cognitive functioning of 10 children treated for idiopathic clubfoot and 10 typically developing children at the age of 40 months (SD = 1) with the Bayley Scales of Infant and Toddler Development.

Results
The children treated for idiopathic clubfoot showed a slight delay in gross motor development. In particular, they demonstrated difficulties in tiptoeing, walking upstairs and walking downstairs. Moreover, we found some slight deficits in cognitive development, particularly in visual-spatial memory.

Discussion
Children treated for idiopathic clubfoot appear to have an increased risk of gross motor and spatial cognitive deficits. Orthopedic pediatrics should incorporate measures of gross motor functioning, for example tiptoeing, in their orthopedic setting. Moreover, future studies are needed to clarify whether the observed deficits persist through childhood. If so, some kind of a motor training for children with idiopathic clubfoot might be required.
Association between benzodiazepines and suicide risk: a matched case-control study
Authors: Cato Ville , Holländare Fredrik , Nordenskjöld Axel , Sellin Tabita 
Published: October 2019

Abstract

Background
It is unclear whether benzodiazepines increase the risk of suicide. The aim of this study was to test the hypothesis that benzodiazepines are associated with an increased risk of suicide, by comparing psychopharmacological interventions between psychiatric patients who committed suicide and a group of matched controls.

Methods
The case group comprised 154 psychiatric patients (101 men, 53 women; age range: 13–96 years) who had committed suicide in Örebro County, Sweden. Control psychiatric patients matched by age, sex, and main psychiatric diagnosis were selected for each case. Binary logistic regression was used to calculate odds ratios in unadjusted and adjusted models.

Results
Benzodiazepine prescriptions were more common among cases than controls (65/154 [42.2%] versus 43/154 [27.9%], p = 0.009, odds ratio: 1.89 [95% CI: 1.17–3.03]). This association remained significant in a model adjusted for previous suicide attempts and somatic hospitalizations (odds ratio: 1.83 [95% CI: 1.06–3.14]). No statistically significant differences were seen between the groups in the use of any other subtype of psychopharmaceutical agent.

Conclusions
These data indicate that benzodiazepine use may increase the risk of suicide. However, this study is limited by the potential for indication bias.
Comparative analysis of trends and determinants of anaemia between adult and teenage pregnant women in two rural districts of Ghana
Authors: Ampiah Millicenta K. M. , Kovey Jerry J. , Apprey Charles , Annan Reginald A. 
Published: October 2019

Abstract

Background
The prevalence of iron deficiency anaemia remains high in pregnant women and the situation may be worse for pregnant adolescents. This study aimed to comparatively analyse the trends and determinants of anaemia between adult and teenage pregnant women in rural Ghana.

Methods
A retrospective study design was employed. Data including primarily pregnancy history, haemoglobin levels and anaemia status were collected from the manual medical records of 1002 women stored in the repositories of two rural district hospitals in the Ashanti Region of Ghana over the years 2011–2015. Data was analysed using chi-square analysis, t-test, two-way ANOVA and binary logistic regression. Bivariate and multivariate analyses were also done to establish associations and predictors of anaemia.

Results
An overall drop in mean haemoglobin from 11.1 g/dl in 2011 to 10.6 g/dl in 2015 was observed for adults, while an overall increase from 9.4 g/dl to 10.2 g/dl occurred in teenagers. Further, anaemia prevalence declined at the 36th week of pregnancy, and from 2011 to 2015, for both teenagers and adults. Among factors tested for association with haemoglobin levels using bivariate and multivariate analyses, gestational age alone was significant (P = 0.028). Between-subject effects determined using 2-way ANOVA indicated year of pregnancy alone, as well as in combination with age group (F = 3.1, P = 0.019) significantly affected haemoglobin levels. From binary regression analysis, BMI (OR 0.967, 95% CI:0.936–0.999, P = 0.042), gestational age (OR 1.058, 95% CI:1.013–1.106, P = 0.011) and pregnancy year (OR-2012(0.402); 2013(0.53); 2014(0.569); 2015(0.817), 95% CI: 2012(0.256–0.631); 2013(0.338–0.829); 2014(0.366–0.886); 2015(0.501–1.333), P = 0.001) were found to be significant predictors of anaemia at first antenatal visit. Also, the trimester of reporting for antenatal care, specifically the second trimester (OR-0.261, 95% CI: 0.072–0.951, P = 0.042) and the pregnancy year (OR-2012(0.235); 2013(0.206); 2014(0.530); 2015(0.222), 95% CI: 2012(0.101–0.545); 2013(0.081–0.522); 2014(0.197–1.428); 2015(0.049–1.018), P = 0.003) were more significant at the 36th pregnancy week.

Conclusions
Although the trends observed were decreasing in both adults and teenagers in the years reported, anaemia levels remained high for each year in either group. Anaemia, therefore remains a major health problem, especially in the areas studied, and antenatal interventions need a second look to know what might make them more effective.
Spatial association between outdoor air pollution and lung cancer incidence in China
Authors: Xing D. F. , Xu C. D. , Liao X. Y. , Xing T. Y. , Cheng S. P. , Hu M. G. , Wang J. X. 
Published: October 2019

Abstract

Background
Lung cancer is the most common cancer in China. Previous studies have indicated that lung cancer incidence exhibits remarkable spatial heterogeneity, and lung cancer is related to outdoor air pollution. However, the non-linear spatial association between outdoor air pollution and lung cancer incidence in China remains unclear.

Methods
In this study, the relationships between the lung cancer incidence of males and females from 207 counties in China in 2013 with annual concentrations of PM2.5, PM10, SO2, NO2, CO and O3 were analysed. GeoDetector q statistic was used for examining the non-linear spatial association between outdoor air pollution and incidence of lung cancer.

Results
An apparent spatial and population gender heterogeneity was found in the spatial association between outdoor air pollution and lung cancer incidence. Among the six selected pollutants, SO2 has the greatest influence on lung cancer (q = 0.154 in females) in north China. In the south, each selected pollutant has a significant impact on males or females, and the mean q value in the south is 0.181, which is bigger than that in the north (q = 0.154). In addition, the pollutants have evident non-linear interaction effects on lung cancer. In north China, the interaction between SO2 and PM2.5 is the dominant interaction, with q values of 0.207 in males and 0.334 in females. In the south, the dominant interactive factors are between SO2 and O3 in males and between SO2 and CO in females, with q values of 0.45, 0.232 respectively. Smoking is a substantial contributor to lung cancer among men, either in South or North China, with q value of 0.143 and 0.129 respectively, and the interaction between smoking and air pollutants increases this risk.

Conclusions
This study implies that the influence of SO2 and PM2.5 on lung cancer should be focused on in north China, and in the south, the impact of O3 and CO as well as their interaction with SO2 need to be paid more attention. Smoking, particularly in men, remains a significant risk factor for lung cancer in both North and South China.
UPRIGHT, a resilience-based intervention to promote mental well-being in schools: study rationale and methodology for a European randomized controlled trial
Authors:   on behalf of the UPRIGHT consortium, Las Hayas Carlota , Izco-Basurko Irantzu , Fullaondo Ane , Gabrielli Silvia , Zwiefka Antoni , Hjemdal Odin , Gudmundsdottir Dora G. , Knoop Hans Henrik , Olafsdottir Anna S. , Donisi Valeria , Carbone Sara , Rizzi Silvia , Mazur Iwona , Krolicka-Deregowska Anna , Morote Roxanna , Anyan Frederick , Ledertoug Mette Marie , Tange Nina , Kaldalons Ingibjorg , Jonsdottir Bryndis Jona , González-Pinto Ana , Vergara Itziar , González Nerea , Mar Medina Javier , de Manuel Keenoy Esteban 
Published: October 2019

Abstract

Background
Adolescence is crucial period for laying the foundations for healthy development and mental well-being. The increasing prevalence of mental disorders amongst adolescents makes promotion of mental well-being and prevention interventions at schools important. UPRIGHT (Universal Preventive Resilience Intervention Globally implemented in schools to improve and promote mental Health for Teenagers) is designed as a whole school approach (school community, students and families) to promote a culture of mental well-being and prevent mental disorders by enhancing resilience capacities. The present article aims at describing the rationale, conceptual framework, as well as methodology of implementation and evaluation of the UPRIGHT intervention.

Methods
UPRIGHT project is a research and innovation project funded by the European Union’s Horizon 2020 Research and Innovation programme under grant agreement No. 754919 (Duration: 48 months). The theoretical framework has been developed by an innovative and multidisciplinary approach using a co-creation process inside the UPRIGHT Consortium (involving seven institutions from Spain, Italy, Poland, Norway, Denmark, and Iceland). Resulted is the UPRIGHT programme with 18 skills related to 4 components: Mindfulness, Coping, Efficacy and Social and Emotional Learning.
Among the five Pan-European regions, 34 schools have been currently involved (17 control; 17 intervention) and around 6000 adolescents and their families are foreseen to participate along a 3-year period of evaluation. Effectiveness of the intervention will be evaluated as a randomized controlled trial including quantitative and qualitative analysis in the five Pan-European regions representative of the cultural and socioeconomic diversity. The cost-effectiveness assessment will be performed by simulation modelling methods.

Discussion
We expect a short- to medium-term improvement of mental well-being in adolescents by enhancing resilience capacities. The study may provide robust evidence on intrapersonal, familiar and social environmental resilience factors promoting positive mental well-being.

Trial registration
ClinicalTrials.gov Identifier: NCT03951376. Registered 15 May 2019.
Standardised snus packaging reduces brand differentiation: a web-based between-subject experiment
Authors: Halkjelsvik Torleif , Scheffels Janne 
Published: October 2019

Abstract

Background
Perceptions of tobacco packaging may be consequential for consumption and initiation. We explored the potential effect of standardised packaging on young adults’ ratings of the appeal of brands of snus (Swedish moist snuff) and on their perceptions of typical users of these brands. We were interested in both the effects on average levels of ratings and on the within-subject variability of the ratings. The latter was used as a measure of the extent to which individuals can differentiate between brands.

Methods
A sample of 625 Norwegians aged 16–30 were randomly allocated to one of three between-subject conditions: Branded Packaging, Standardised Packaging, or Standardised Packaging with Health Warnings. The participants rated 10 snus brands on measures of general appeal and on their perceptions of the typical brand user (e.g., “… is sporty and active”).

Results
The standardised packages (without health warnings) were not rated more negatively than the branded packages, while the standardised packages with health warnings were rated slightly more negatively than the branded packages. However, in terms of within-subject standard deviations, the variability of the brand ratings across the packages was substantially lower for standardised packaging types in comparison to branded packages.

Conclusions
Even in cases where standardised tobacco packaging appears to have little overall effect on the valence of the average ratings, it can have a strong effect on the variability of the ratings. This suggests that standardised packaging can reduce the potential for brand differentiation.
Alcohol consumption’s attributable disease burden and cost-effectiveness of targeted public health interventions: a systematic review of mathematical models
Authors: Bardach Ariel Esteban , Alcaraz Andrea Olga , Ciapponi Agustín , Garay Osvaldo Ulises , Riviere Andrés Pichón , Palacios Alfredo , Cremonte Mariana , Augustovski Federico 
Published: October 2019

AbstractBackgroundAround 6% of total deaths are related to alcohol consumption worldwide. Mathematical models are important tools to estimate disease burden and to assess the cost-effectiveness of interventions to address this burden.MethodsWe carried out a systematic review on models, searching main health literature databases up to July 2017. Pairs of reviewers independently selected, extracted data and assessed the quality of the included studies. Discrepancies were resolved by consensus. We selected those models exploring: a) disease burden (main metrics being attributable deaths, disability-adjusted life years, quality-adjusted life years) or b) economic evaluations of health interventions or policies, based on models including the aforementioned outcomes. We grouped models into broad families according to their common central methodological approach.ResultsOut of 4295 reports identified, 63 met our inclusion criteria and were categorized in three main model families that were described in detail: 1) State transition -i.e Markov- models, 2) Life Table-based models and 3) Attributable fraction-based models. Most studies pertained to the latter one (n = 29, 48.3%). A few miscellaneous models could not be framed into these families.ConclusionsOur findings can be useful for future researchers and decision makers planning to undertake alcohol-related disease burden or cost-effectiveness studies. We found several different families of models. Countries interested in adopting relevant public health measures may choose or adapt the one deemed most convenient, based on the availability of existing data at the local level, burden of work, and public health and economic outcomes of interest.
In everybody’s interest but no one’s assigned responsibility: midwives’ thoughts and experiences of preventive work for men’s sexual and reproductive health and rights within primary care
Authors: Grandahl Maria , Bodin Maja , Stern Jenny 
Published: October 2019

AbstractBackgroundSexual and reproductive health and rights (SRHR) have historically been regarded as a woman’s issue. It is likely that these gender norms also hinder health care providers from perceiving boys and men as health care recipients, especially within the area of SRHR. The aim of this study was to explore midwives’ thoughts and experiences regarding preventive work for men’s sexual and reproductive health and rights in the primary care setting.MethodsAn exploratory qualitative study. Five focus group interviews, including 4–5 participants in each group, were conducted with 22 midwives aged 31–64, who worked with reproductive, perinatal and sexual health within primary care. Data were analysed by latent content analysis.ResultsOne overall theme emerged, in everybody’s interest, but no one’s assigned responsibility, and three sub-themes: (i) organisational aspects create obstacles, (ii) mixed views on the midwife’s role and responsibility, and (iii) beliefs about men and women: same, but different.ConclusionsMidwives believed that preventive work for men’s sexual and reproductive health and rights was in everybody’s interest, but no one’s assigned responsibility. To improve men’s access to sexual and reproductive health care, actions are needed from the state, the health care system and health care providers.
Implementation strategy and cost of Mozambique’s HPV vaccine demonstration project
Authors: Soi Caroline , Babigumira Joseph B. , Chilundo Baltazar , Muchanga Vasco , Matsinhe Luisa , Gimbel Sarah , Augusto Orvalho , Sherr Kenneth 
Published: October 2019

Abstract

Background
Cost is an important determinant of health program implementation. In this study, we conducted a comprehensive evaluation of the implementation strategy of Mozambique’s school-based HPV vaccine demonstration project. We sought to estimate the total costs for the program, cost per fully immunized girl (FIG), and compute projections for the total cost of implementing a similar national level vaccination program.

Methods
We collected primary data through document review, participatory observation, and key informant interviews at all levels of the national health system and Ministry of Education. We used a combination of micro-costing methods—identification and measurement of resource quantities and valuation by application of unit costs, and gross costing—for consideration of resource bundles as they apply to the number of vaccinated girls. We extrapolated the cost per FIG to the HPV-vaccine-eligible population of Mozambique, to demonstrate the projected total annual cost for two scenarios of a similarly executed HPV vaccine program.

Results
The total cost of the Mozambique HPV vaccine demonstration project was $523,602. The mean cost per FIG was $72 (Credibility Intervals (CI): $62 - $83) in year one, $38 (CI: $37 - $40) in year two, and $54 CI: $49 - $61) for years one and two. The mean cost per FIG with the third HPV vaccine dose excluded from consideration was $60 (CI: $50 - $72) in year one, $38 (CI: $31 - $46) in year two, and $48 (CI: $42 - $55) for years one and two. The mean cost per FIG when only one HPV vaccine dose is considered was $30 (CI: $27 - $33)) in year one, $19 (CI: $15–$23) in year two, and $24 (CI: $22–$27) for both years. The projected annual cost of a two-and one-dose vaccine program targeting all 10-year-old girls in the country was $18.2 m (CI: $15.9 m - $20.7 m) and $9 m (CI: $8 m - $10 m) respectively.

Conclusion
National adaptation and scale-up of Mozambique’s school-based HPV vaccine strategy may result in substantial costs depending on dosing. For sustainability, stakeholders will need to negotiate vaccine price and achieve higher efficiency in startup activities and demand creation.