bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of an educational manual to promote infant feeding practices in primary health care
Authors: Relvas G R B , Buccini G S , Potvin L , Venancio S I 
Published: October 2020

Abstract

Background
Breastfeeding and adequate complementary feeding in the first years of life provide short- and long-term benefits for child health. However, breastfeeding and adequate complementary feeding prevalence's are low. In Brazil, the Estratégia Amamenta e Alimenta Brasil (EAAB) aims to improve the quality of the assistance provided by primary healthcare teams to ultimately improving infant feeding practices in the Brazilian population. In primary healthcare units, continuing education in breastfeeding and complementary feeding is facilitated by EAAB tutors. A Manual to Support EAAB Tutor (the Manual) was developed following a problem-based learning methodology. This study aimed to evaluate the effectiveness of using the Manual by analyzing exclusive breastfeeding and complementary feeding indicators.

Methods
A before and after study was conducted at primary healthcare units in Embu das Artes, Brazil. The intervention consisted in the use of the Manual by EAAB tutors who performed some comprehensive training activities with healthcare teams, in a period of 8 months. Subjects consisted of mothers of infants under one year of age attended at primary healthcare units. 561 mothers before and 598 mothers after intervention were interviewed about breastfeeding and complementary feeding practices. Multivariate analysis was performed using Poisson multilevel regression to test the hypothesis.

Results
Lack of minimum food diversity (before 62.9%; after 50.3%) and lack of food adequacy (before 77.5%; after 63.3%) decreased significantly. Regression analysis confirmed that infants after the intervention had lower prevalence of inadequacy of complementary feeding. While the intervention did not show significant association with exclusive breastfeeding, it showed association with the improvement of complementary feeding practices.

Conclusions
The Manual is a continuing educational strategy that improved complementary feeding practices in primary health care.

Key messages
The use of a continuing education strategy grounded on a problem-based learning methodology was effective to produce improvements in complementary feeding practices in primary health care. The 'Manual to Support EAAB Tutor' consists of a tool that has the potential to be adapted for different contexts and easy to disclose to all EAAB tutors in the country.
Is depression a cause of metabolic abnormality? A European Small State experience
Authors: Cuschieri S 
Published: October 2020

Abstract

Background
A relationship between depression and metabolic syndrome has been reported. Considering the diabesity rates effecting the small state of Malta it was considered appropriate to explore for links between these diseases, their metabolic determinants with depression.

Methods
A national health examination survey was conducted. A validated questionnaire note down (1) self-reported depression (2) anti-depressive medication (3) PHQ-9 depression symptoms score (&gt;5 positive for depression). Participants with the presence of one or more of these variables were labelled as having depression. Body mass index (BMI), waist circumference (WC) and blood pressure (BP) were measured. Blood testing for fasting blood glucose (FBG) and lipid profile were performed. The biochemical (FBG, Lipid profiles) and anthropometric profiles (BMI, WC, BP) of the depression population were compared to those without this disease. Univariant and multivariant binary logistic regression models were performed.

Results
The depression population (17.2% of the total population) had significantly higher median LDL, triglyceride (TG) and total cholesterol (TC) levels when compared to those without the disease (p = &lt;0.01). On univariant modelling each variable (LDL OR:1.15 p = 0.01; TG OR:1.16 p = 0.01; TC OR:1.64 p = &lt;0.01) showed a positive association with having depression even after adjusting for confounding factors (sex, age, education, smoking, alcohol habits). On multivariant modelling only an increase in TC was associated with increased risk of having depression (OR: 1.36 CI95%: 1.05-1.76 p = 0.02) after adjusting for confounders.

Conclusions
The various components of the metabolic syndrome appeared not to be associated with a diagnosis of depression. Only high cholesterol level exhibited a metabolic link with depression. Although further research is merited, it is suggested that physicians incorporate a depression screening tool as part of their consultation when examining high-risk patients.

Key messages
A metabolic syndrome profile is not linked with depression. A high cholesterol level is linked with depression, making these individuals susceptible to potential cardiovascular disease.
Mental health status among male and female methamphetamine-dependent inmates in Japan
Authors: Ohnishi M , Kawasaki R , Nakane H 
Published: October 2020

Abstract

Background
Although the prevalence of drug addiction in Japan is lower than that of in European and/or American countries, the number of methamphetamine-related arrests in this decade has exceeded 10,000 every year, with 66.2% of the arrests made in 2017 being of re-offenders. This study was performed to assess the mental health status among prison inmates whose sentences were related to methamphetamine use.

Methods
Face-to-face individual interviews using a questionnaire including self-rated health questions (answered on a 4-point Likert scale) and the Kessler 6-item psychological distress scale (K6, range: 0-24) was established by the authors and conducted with 30 methamphetamine-dependent inmates (15 male and 15 female inmates) in Japan.

Results
The age of inmates ranged from the 20s to the 70s. The median time served in adulthood was 5 (range: 2 - 12) among male inmates, and 4.5 (range: 2 - 12) among female inmates (Mann-Whitney U test, P = 0.202). The median K6 scores were 4 (0-8) for the male inmates and 6 (1-17) for the female inmates (Mann-Whitney U test, P = 0.074). The cut-off point for K6 exhibited variation, and the authors considered a participant psychologically distressed if K6 was 10 or higher. Six (40.0%) female inmates were found to be psychologically distressed, which was a higher proportion than among the male inmates (0.0%) (Fisher's exact test, P = 0.017). Regarding self-rated health, 13 (86.7%) of both male and female inmates reported being in “very good/good health” (Cochran-Armitage Test, P ¬= 1.000). There was no statistical correlation between the K6 scores and the self-rated health scores among the male inmates (ρ = 0.148, P = 0.599) or the female inmates (ρ = -0.499, P = 0.058).

Conclusions
Although the interviewees were not representative samples, the male inmates demonstrated better mental health status than the female inmates did; however, there was no difference in self-rated health between the two genders.

Key messages
The male inmates demonstrated better mental health status than the female inmates did; however, there was no difference in self-rated health between the two genders. Gender differences in mental health status among inmates, should be considered when a drug addiction recovery program is implemented to ensure the successful prevention of relapse.
Characteristics of supported living – a perspective of professionals and potential residents
Authors: Overmars-Marx T , Wessel R 
Published: October 2020

Abstract

Background
Policies are increasingly decentralized, and people with a demand for support often live in familiar environments and regular neighborhoods instead of institutions. To meet the demand for support, the local government aims to offer supported living facilities in Staphorst, Netherlands. Accordingly, this study aimed to provide insight into the characteristics of supported living from the perspective of professionals and potential residents.

Methods
Semi-structured interviews were conducted with professionals and potential residents to obtain insight about their perspectives regarding supported living. First, ten interviews were conducted with professionals (i.e. local government, care, welfare, and housing corporation), followed by six interviews with potential residents and/or their parents. The interviews were transcribed, coded and analyzed by two researchers.

Results
A small amount of the residents in Staphorst would benefit from supported living. This concerns mainly (young) adults with a mild intellectual disability and/or a mental illness who need practical, social and emotional support in order to live on their own. Composing the support, it is important to acknowledge the religious identity of the potential residents and their families. Furthermore, the interviews with professionals and potential residents revealed that the following options should be considered: time-out, short- and long-term support, daycare and open house facilities, various types of support (i.e. volunteer and professional) and combining target groups (i.e. adolescents and adults).

Conclusions
This study reveals several options to consider when composing supported living in Staphorst. Accordingly, most participants emphasized the need for short-term support focusing on skills related to independent living. Furthermore, it is important to involve professionals and potential residents and/or their parents in order to offer sustainable supported living for the residents in Staphorst.

Key messages
Most participants emphasized the need for short-term support focusing on skills related to independent living. Both professionals and potential residents should be involved when composing supported living facilities.
Intersectoral actions for mental health care in areas of high vulnerability in São Paulo/ Brazil
Authors: Bezerra P 
Published: October 2020

Abstract

Background
The objective of this research was to analyze the results achieved after intersectoral actions carried out by primary health care teams working in areas of high socio-environmental vulnerability in the city of São Paulo / Brazil. The establishment of intersectoral partnerships to tackle social inequalities and inequalities can be a reality in vulnerable health territories and a way to give sustainability to expanded health care (De Andrade et al, 2015).

Methods
Primary data were obtained from August to October 2018 in four focus groups formed by a total of 24 health professionals, selected after quantitative analysis. The data were transcribed in full and the qualitative analysis was according to Van Den Hoonaard (2018): a) open coding of the transcriptions; b) identification of recurrent themes and respective subthemes and c) connection of themes and concepts interpreted in the light of social processes. The research was approved by the Research Ethics Committee of the Centro Universitário Saúde ABC.

Results
The themes found were: a) Search for partnerships for mental health assistance: in a personalized way, the teams entered into partnerships with the sectors of education, social assistance, leisure and justice for assistance; b) Effectiveness of treatment by intersectoral basis: the teams helped to insert people into public policy actions, they realized the reduction in the need to use psychotropics and specialized services in mental health.

Conclusions
Intersectoral collaboration was established and maintained to resume mental health care for people with psychological distress who were waiting in line for specialized treatment.

Key messages
Primary health care teams when looking for partners to assist patients in mental health have an expanded look at the citizen who should be embraced by public policies. There is a need to add community-based care for people with mental suffering to care based on intersectoral actions in health territories.
Risk and resource factors for the development of depression during adolescence and young adulthood
Authors: Wüstner A , Otto C , Klasen F , Westenhöfer J , Reiss F , Hölling H , Ravens-Sieberer U 
Published: October 2020

Abstract

Background
Depression is one of the most common mental disorders in adolescents and young adults worldwide, and causes severe impairments in psychological health, social functioning and employment. The identification of risk and resource factors for depression is an important research aim. The present study aims to investigate which individual, familial and social risk and resource factors in childhood and adolescence are associated with depressive symptoms five years later in a population-based cohort in Germany.

Methods
Analyses were performed using data from the longitudinal BELLA study. Data on risk and resource factors were collected among N = 632 children and adolescents aged 11 to 17 years. Depressive symptoms were measured five years later. The effects of risk and resource factors on depression were investigated using multivariate linear regression analyses. In subsequent models, we explored potential moderator effects of resource factors on the relationship between risk factors and depressive symptoms.

Results
A negative mother-child relationship was associated with stronger depressive symptoms in girls, while school stress was identified as a risk factor in boys. Peer competence was associated with fewer depressive symptoms in girls, and family cohesion served as a resource factor in boys. Moreover, self-efficacy moderated the association between negative mother-child relationship and depressive symptoms. Family cohesion acted as a moderator between peer problems and depressive symptoms.

Conclusions
Our findings provide evidence of gender-specific risk and resource factors for depressive symptoms. Individuals who are exposed to one of the identified risk factors must be monitored during the transition from childhood to adolescence and young adulthood. Gender-sensitive health promotion and early prevention programs are needed.

Key messages
Information concerning risk and resource factors for the development of depressive symptoms during adolescence and emerging adulthood are of high interest for public health, research and practice. The findings of the present study are of great relevance for the development of gender-sensitive health promotion and early prevention programs.
Ozone effect on inflammatory and proteomic profile of human macrophages and airway epithelial cells
Authors: Falcone L , Aruffo E , Di Carlo P , Del Boccio P , Cufaro M C , Pesce M , Patruno A , Ballerini P 
Published: October 2020

Abstract

Background
Reactive oxygen species (ROS) and oxidative stress in the respiratory system are involved in lung inflammation and tumorigenesis. Ozone (O3) is one of the main components of air pollution in urban areas able to act as strong pro-oxidant agent, however its effects on human health is still poorly investigated. In this study the effect of O3 has been evaluated in THP-1 monocytes differentiated into macrophages with PMA and in HBEpC (primary human bronchial epithelial) cells, two model systems for in vitro studies and translational research.

Methods
Cell viability, ROS and pro-inflammatory cytokines like interleukin-8(IL-8) and tumor necrosis factor(TNF-α) have been tested in the above-mentioned cell lines not exposed to any kind of pollution (basal condition-b.c.) or exposed to O3 at a concentration of 120 ppb. In HBEpC a labelfree shotgun proteomics analysis has been also performed in the same conditions.

Results
Ozone significantly increased the production of IL-8 and TNF-α in THP-1 whereas no changes were shown in HBEpC. In both cell lines lipopolysaccharide(LPS) caused an increase of IL-8 and TNF-α production in b.c. and O3 treatment potentiated this effect. Ozone exposure increased ROS formation in a time dependent manner in both cell lines and in THP-1 cells a decrease in catalase activity was also shown. Finally, according to these data, functional proteomics analysis revealed that in HBEpC exposure to O3 many differential proteins are related to oxidative stress and inflammation.

Conclusions
Our results indicate that O3, at levels that can be reached in urban areas, causes an increase of pro-inflammatory agents either per se or potentiating the effect of immune response stimulators in cell models of human macrophages and human airway epithelial cells. Interestingly, the proteomic analysis showed that besides the dysregulated proteins, O3 induced the expression of AKR1D1 and AKR1B10, proteins recognized to play a significant role in cancer development.

Key messages
This study adds new pieces of information on the association between O3 exposure and detrimental effects on respiratory system. This study suggests the need for further research on the mechanisms involved and for a continued monitoring/re-evaluation of air pollution standards aimed at safeguarding human health.
The importance of peer support in the recovery process of persons with mental disorders
Authors: Stimac Grbic D , Pavic Simetin I , Istvanovic A 
Published: October 2020

Abstract

Issue
Care for people with severe mental disorders requires approach that is focused on a person's strengths, not his weaknesses, and is a shift from a deficit model that is often associated with mental illness. Care users and their family members play an important role in this approach.

Description of the Problem
Mental disorders are the leading group of diseases in Croatia, according to the number of days of hospital treatment. The number of hospitalizations is high, and the rate of hospitalization for depression has tripled in the last twenty years. Such indicators highlight the need for reorientation of mental health care, from hospital-based to community-based, by organizing mobile community intervention teams.

Results
In Croatia, psychosocial peer teams were established by the NGO Ludruga, financed by local government, to provide peer support to persons with mental disorders. The main activities are: development of a personal recovery plan, home visits and providing psychological support to persons with mental disorders, organizing support groups and education of peer workers. The teams consist of a peer worker, social worker, psychologist, and operate under the supervision of a psychiatrist. The teams have been operating for five years, have had over a hundred users so far and are a significant help to the healthcare system in preventing rehospitalizations.

Lessons
The goal of therapeutic interventions in mental health care should be recovery. Recovery involves empowering a person to take responsibility for themselves and their health. Peer workers play an important role in the recovery process, providing hope for recovery. Their role must also be recognized by the health system.

Key messages
People with mental disorders and their families should be co-creators of care and recovery-oriented interventions. Only by comprehensive interventions, tackling all determinants of health, therapeutic goal can be achieved.
Psychosocial health of farmers
Authors: Wessel R , Kuijk J , Kunst A E , Olsen I G 
Published: October 2020

Abstract

Background
Studies from several countries have shown increased suicide mortality rates among farmers as compared to non-farmer citizens. Research has shown that farmers often face psychosocial problems resulting from business operations and financial problems. However, there are hardly European studies on these potential problems. Therefore, the study aimed to assess the psychosocial health and health services use among farmers in The Netherlands.

Methods
A qualitative study including 16 semi-structured interviews with farmers in eastern Netherlands. The interview guide was based on the health care use process model of Levesque. Interviews were verbatim transcribed and thematically analyzed in MAXQDA.

Results
This study identified several risk conditions for psychosocial health problems related to the social and occupational position of farmers, including: financial problems, persistently high work pressure, negative public views towards farming, uncertainties due to continuously changing regulations, traditional attitudes emphasizing stoicism and hard work, and lack of support from nearby farmers. Farmers are often not seeking help for psychosocial problems, due to underestimation of their own health needs, lack of knowledge and confidence in professional support, and difficult in using and finding support tailored to their needs.

Conclusions
This study for eastern Netherlands revealed several themes contributing to a high risk of farmers to develop psychosocial problems, and low use of appropriate mental health and social services.

Key messages
Farmers are at increased risk of psychosocial problems, due to social and work-related conditions. Nonetheless, these farmers were less likely to find and use health and social services. This implies an urgent need for the development of services that provide appropriate psychological support to farmers in the Netherlands.
Gender differences in perceived stress level among undergraduate students in Armenia
Authors: Harutyunyan A , Musheghyan L , Hayrumyan V 
Published: October 2020

Abstract

Background
Stress is an important issue in academic institutions and can have a negative impact on overall academic performance. This study was conducted as a research assignment during the Basics of Healthy Lifestyle course and aimed to investigate the stress level among undergraduate students at the American University of Armenia (AUA).

Methods
A cross-sectional survey was conducted among undergraduate students recruited by non-random convenience sampling. The study utilized a structured questionnaire to conduct face to face interviews. The questionnaire contained 40 close-ended questions on students' perceived stress level, the Student Stress Scale (SSS) (sum of scores of 31 questions) to measure actual stress, and socio-demographic characteristics. Data entry, descriptive and comparative statistics were performed using SPSS software. Secondary data analysis was conducted to explore gender differences in stress level.

Results
Overall, 111 AUA students participated and slightly over half of participants (59.5%) were female. The SSS revealed that 46.0% of students experience medium stress levels (self-perceived mean stress score =-5.8). Only 21.6% perceived themselves as having high stress levels; however, SSS showed that about one third had high stress. Female participants' perception of being highly stressed and having high stress level based on SSS were similar (28.8% and 27.3%, respectively). In contrast, less males perceived being highly stressed (13.3%), though, SSS showed that 40.0% of males experienced high stress levels.

Conclusions
The majority of AUA undergraduate students experienced medium or low stress levels. Male students experience higher stress levels, but their perceived stress level was much lower than in among females. Research is needed to explore the gender differences in stress levels and coping mechanisms among students. These findings may be useful for university administration for developing stress-reduction and stress-management strategies.

Key messages
There are disparities in perceived stress and actual stress levels between male and female students that warrant further exploration. Gender differences in stress level of the students should be considered for stress-reduction and stress-management strategies.