bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of living with multiple long-term conditions (multimorbidity) on everyday life – a qualitative evidence synthesis
Authors: Holland Emilia , Matthews Kate , Macdonald Sara , Ashworth Mark , Laidlaw Lynn , Cheung Kelly Sum Yuet , Stannard Sebastian , Francis Nick A. , Mair Frances S. , Gooding Charlotte , Alwan Nisreen A. , Fraser Simon D. S. 
Published: December 2024

Abstract
Background
Multiple long-term conditions (MLTCs), living with two or more long-term conditions (LTCs), often termed multimorbidity, has a high and increasing prevalence globally with earlier age of onset in people living in deprived communities. A holistic understanding of the patient’s perspective of the work associated with living with MLTCs is needed. This study aimed to synthesise qualitative evidence describing the experiences of people living with MLTCs (multimorbidity) and to develop a greater understanding of the effect on people’s lives and ways in which living with MLTCs is 'burdensome' for people.

Methods
Three concepts (multimorbidity, burden and lived experience) were used to develop search terms. A broad qualitative filter was applied. MEDLINE (Ovid), EMBASE (Ovid), PsycINFO (EBSCO), CINAHL (EBSCO) and the Cochrane Library were searched from January 2000-January 2023. We included studies where at least 50% of study participants were living with three or more LTCs and the lived experience of MLTCs was expressed from the patient perspective. Screening and quality assessment (CASP checklist) was undertaken by two independent researchers. Data was synthesised using an inductive approach. PPI (Patient and Public Involvement) input was included throughout.

Results
Of 30,803 references identified, 46 met the inclusion criteria. 31 studies (67%) did not mention ethnicity or race of participants and socioeconomic factors were inconsistently described. Only two studies involved low- and middle-income countries (LMICs). Eight themes of work were generated: learning and adapting; accumulation and complexity; symptoms; emotions; investigation and monitoring; health service and administration; medication; and finance. The quality of studies was generally high. 41 papers had no PPI involvement reported and none had PPI contributor co-authors.

Conclusions
The impact of living with MLTCs was experienced as a multifaceted and complex workload involving multiple types of work, many of which are reciprocally linked. Much of this work, and the associated impact on people, may not be apparent to healthcare staff, and current health systems and policies are poorly equipped to meet the needs of this growing population. There was a paucity of data from LMICs and insufficient information on how patient characteristics might influence experiences. Future research should involve patients as partners and focus on these evidence gaps.
Association of air purifier usage during pregnancy with adverse birth outcomes: the Japan Environment and Children’s Study
Authors: Inadera Hidekuni , Matsumura Kenta , Kasamatsu Haruka , Shimada Kanako , Kitase Akiko , Tsuchida Akiko ,   the Japan Environment and Children’s Study Group, Kamijima Michihiro , Yamazaki Shin , Ohya Yukihiro , Kishi Reiko , Yaegashi Nobuo , Hashimoto Koichi , Ito Shuichi , Yamagata Zentaro , Nakayama Takeo , Sobue Tomotaka , Shima Masayuki , Kageyama Seiji , Suganuma Narufumi , Ohga Shoichi , Katoh Takahiko 
Published: December 2024

Abstract
Objective
Previous studies have reported that ambient air pollutants such as PM2.5 can increase the risk of adverse birth outcomes. The objective of this study was to ascertain whether air purifier usage during pregnancy is associated with a lower risk of adverse birth outcomes in a large Japanese birth cohort.

Methods
We conducted a prospective cohort analysis using data from the Japan Environment and Children’s Study. Use of air purifiers during pregnancy was assessed using a self-administered questionnaire. Primary outcomes were the prevalence of preterm birth (PTB), small for gestational age (SGA), and low birth weight (LBW). Logistic regression analysis was performed to estimate odds ratios (ORs) and 95% confidence intervals (CIs).

Results
The prevalence of outcomes was 4.5% for PTB, 7.4% for SGA, and 8.1% for LBW. The crude model analysis revealed that PTB, SGA, and LBW showed lower ORs in the group that used an air purifier, although the association disappeared in the adjusted model except for SGA (OR: 0.94; 95% CI: 0.89, 1.00, p = 0.048) and LBW (OR: 0.93; 95% CI: 0.88, 0.98, p = 0.003). Subgroup analysis stratified by infant sex revealed that the lower OR for LBW was observed only in male infants.

Conclusions
Our results suggest that avoiding maternal air pollution exposure during pregnancy may be useful in preventing adverse birth outcomes. These findings provide evidence supporting the development of protective measures against air pollutants in the gestational period by relevant health agencies.
Education of household head and maternal healthcare utilization: the case of Bangladesh
Authors: Rahman Md Mahabubur , Amin Md Tazvir , Ferdous Zannatul , Patwary Hridoy , Haider M. Moinuddin 
Published: December 2024

Abstract
Background
The high maternal mortality ratio in South Asian countries could be attributed to poor maternal healthcare (MHC) utilization. Here household heads (HHs) are the main decision-makers of the households and thus can be key stakeholders in women’s MHC uptake. We aim to investigate the role of HHs’ education in MHC utilization and explore the educational status of male adolescents who will eventually replace today’s HHs in the future.

Method
We investigated antenatal care (ANC), and institutional delivery as two MHC during pregnancy and childbirth using the Bangladesh Multiple Indicator Cluster Survey 2019. Due to the stratified cluster sampling nature of the BMICS 2019, we estimated odds ratios from mixed-effect multiple logistic regression considering women nested within clusters and estimated marginal effects to conclude. Using the Bangladesh Adolescent Health and Wellbeing Survey 2019–20, we estimated region-specific school dropout rates and identified the reasons for and timing of dropout among male adolescents.

Results
The odds of ANC uptake and institutional delivery decreased by lower levels of HHs’ education. Marginal effects of HHs’ education on institutional delivery across comparable levels of ANC uptake show that less educated HHs diminish the full potential of ANC uptake in facilitating institutional delivery. The heaviest burden (~ 70%) of less educated (up to primary level) HHs was in the northeastern region. The highest rate of school dropout (40%) was also in the northeastern region. Around 60% of dropouts left school before or just after completing primary level. The primary reasons for dropout were lack of interest and financial constraints.

Conclusion
Integrating HHs into MHC programs can be the immediate call for action while averting male adolescents’ school dropouts can be the long-term strategy.
Factors associated with parental intentions to vaccinate 0-4-year-old children against COVID-19 in Canada: a cross-sectional study using the Childhood COVID-19 Immunization Coverage Survey (CCICS)
Authors: Zareef Israa , Frescura Anna-Maria , Dave Sailly , Uhlik Caren , Guan David , Samhat Hussein , Ebrahim Marwa , Laroche Julie 
Published: December 2024

Abstract
Background
The objective of this study was to determine the factors associated with low or no parental intention to vaccinate children of 0-4-years in Canada with a COVID-19 vaccine through the 2022 Childhood COVID-19 Immunization Coverage Survey (CCICS). The CCICS was conducted prior to the introduction of a COVID-19 vaccine and a vaccine recommendation for this age group.

Methods
Simple and multiple logistic regression models were used to determine associations between sociodemographic factors as well as knowledge, attitudes and beliefs and low/no intentions to vaccinate against COVID-19 among parents of children 0–4 years.

Results
Factors associated with low intentions to vaccinate children against COVID-19 included being male (aOR: 2.0; 95% CI: 2.0‒2.1) compared to female; being 30–39 (aOR 1.1; 95% CI: 1.1‒1.2) compared to 40+; being Black (aOR: 2.3, 95% CI: 2.2‒2.5), East/Southeast Asian (aOR: 3.6, 95% CI: 3.3‒3.8), or having multiple ethnicities (aOR: 1.3, 95% CI: 1.1‒1.6) compared to White European ethnicity; living in a rural (aOR: 2.0, 95% CI: 1.9‒2.1) compared to urban community; having a total 2021 household income of $60,000‒$79,999 CAD (aOR: 1.4, 95% CI: 1.3‒1.5) compared to $150,000 CAD and above; and trusting government bodies (aOR: 2.4; 95% CI: 1.1‒1.2), international bodies (aOR: 2.4; 95% CI: 2.2‒2.5), or media (aOR: 2.0, 95% CI: 1.9‒2.2) for information about COVID-19 vaccines compared to health care providers.

Conclusions
The findings of this study demonstrate that several sociodemographic factors and parental beliefs impact the decision to vaccinate children 0–4 years of age against COVID-19. Future research should focus on sociodemographic barriers to vaccination and how to most appropriately tailor the delivery of vaccination programs to specific groups, in an effort to narrow the gap between intentions and uptake of COVID-19 vaccination in younger children. As well, messaging should specifically be targeted to parents who have lower confidence in the COVID-19 vaccine and the government to provide correct information and build trust.
The relationship between non-communicable disease risk and mental wellbeing in adolescence: a cross-sectional study utilising objective measures in Indonesia
Authors: Cini Karly I. , Dumuid Dorothea , Francis Kate L. , Wulan Nisaa R. , Sawyer Susan M. , Handy Agung Fransisca , Pham Minh D. , Kennedy Elissa C. , Fisher Jane , Tran Thach , Medise Bernie E. , Devaera Yoga , Riyanti Aida , Wiweko Budi , Kaligis Fransiska , Wiguna Tjhin , Ansariadi Ansariadi , Azzopardi Peter S. 
Published: December 2024

Abstract
Background
Risk factors for non-communicable diseases (NCDs, cardiovascular diseases, cancers, chronic respiratory diseases, diabetes, and mental disorders) arise in adolescence but are mostly framed as relevant to health in adulthood; little is known about the relationship between co-occurring NCD risks and mental wellbeing in young people. This study aims to describe the prevalence and co-occurrence of distinct NCD risk factors, and how they relate to current mental wellbeing amongst adolescents in Indonesia, a young and populous country where NCD burden is increasing rapidly.

Methods
We assessed NCD risk and mental wellbeing amongst 1,331 school-based 16–18-year-olds in Jakarta (N = 609) and South Sulawesi (N = 722). Five domains of NCD risk (adiposity, substance use, physical inactivity, excess sedentary time, and diet) were either measured or self-reported. In Jakarta, we also measured blood glucose, triglycerides, cholesterol, and blood pressure. Wellbeing was assessed using three indicators: general quality of life (QoL), physical function QoL, and psychological distress. We used linear regression to estimate the associations between co-occurring risks and wellbeing, adjusted for covariates of wellbeing: province, sex, socioeconomic status, and religion.

Results
NCD risk clustering was common, and more than half of adolescents had co-occurring risks in 3 or more of the 5 domains (58.9% (95%CI 53.7—63.9)). Adolescents with any NCD risk were more likely to report psychological distress, with this relationship most pronounced in those with excess sedentary time spent on video gaming and computer use. A higher number of NCD risk factors was associated with poorer psychological wellbeing and decreased general and physical function QoL. In the Jakarta subsample, reduced HDL and raised blood glucose was associated with psychological distress; and a higher number of risk biomarkers was associated with lower physical function QoL.

Conclusions
Our analysis also shows that these NCD risks (both individual risks and co-occurring risk count) are related to poorer profiles of mental wellbeing in adolescents, after adjusting for likely confounders.
Key informant perspectives of suicide prevention in Australia
Authors: Bassilios Bridget , Dunt David , Krysinska Karolina , Machlin Anna , Newton Danielle , Currier Dianne 
Published: December 2024

Abstract
Background
Suicide prevention policy in Australia is in a period of reform. The National Suicide Prevention Office is leading the development of a new National Suicide Prevention Strategy (Strategy). Stakeholder input is a critical element in the development of the new Strategy. This article describes key informant views about government-led suicide prevention efforts in Australia obtained as part of an environmental scan conducted as one input to inform the Strategy development process.

Methods
We interviewed 24 key informants in November and December 2022. Key informants were purposively recruited to ensure representation from cross-jurisdiction government departments/agencies, peak bodies and leaders in the suicide prevention sector, people with lived experience of suicide, and suicide prevention researchers. We enquired about successes, challenges, and opportunities. NVivo was used to conduct thematic analysis.

Results
Key themes identified as successes in Australia’s suicide prevention efforts included: leadership and funding for programs, services, and research; valuing the collective lived experience voice; moving towards a whole-of-government/system approach; and high community and political suicide (prevention) awareness. Key themes emerging as challenges in the sector were: defining the suicide prevention sector, limitations in the service system, workforce issues, and building the evidence base. Key themes mentioned as opportunities for improving suicide prevention efforts were: leveraging the current unprecedented awareness and desire for collaboration among multiple stakeholder groups; adopting wellness rather than crisis-driven models of care; including lived experience and co-design in all stages and aspects of policy planning, service development, and evaluation; and investing in data, research, and evaluation.

Conclusions
Key informants from across the suicide prevention sector in Australia identified a range of issues for consideration in the development of Australia’s new National Suicide Prevention Strategy which are also relevant for suicide prevention policy and program development in other high-income countries. Key issues include the need for concerted efforts to define and build the capacity of the suicide prevention sector, implement and monitor a whole-of-government approach that includes wellness models of care and lived experience, and bolster the evidence base. These efforts require effective leadership and resourcing.
Measuring associations between the food environment and dietary habits: comparing the proportion and density of food outlets
Authors: Bernsdorf Kamille Almer , Bøggild Henrik , Aadahl Mette , Toft Ulla 
Published: December 2024

Abstract
Background
The food environment plays a crucial role in shaping our dietary choices and overall health. Spatial measures provide distinct perspectives on the physical food environment and its impact on diet. While proportion measures are theoretically considered to provide a more accurate representation of the overall physical food environment than density measures, it is important to recognize that the association between food environments and diet can vary depending on the context. Therefore, relying solely on one measure may not be appropriate.

Methods
We systematically assessed the density and proportion of multiple food outlet types (fast-food outlets, convenience stores, supermarkets, and restaurants) around individuals homes using a large cross-sectional Danish study (N = 71,840). Densities were modeled in separate multilevel linear regression models, incorporating random intercepts from linear splines for each of the four food outlet types. Proportions were modeled without splines. Through the association with a dietary quality score (DQS), we examined the impact of quantifying the foodscape from density versus proportion measures. Associations were compared using parameter estimates, p-values, Akaike Information Criterion (AIC) values, and Akaike weights.

Results
AIC values and Akaike weights were in favor of models including density measures. Across all outlet types, density measures were consistently negatively associated with the DQS until reaching densities of 3–5 (count/km2), at which point the direction of association became positive, indicating a shift towards a healthier DQS. After correcting for multiple comparisons, the most significant effect was observed for the sole significant proportion measure. A 10% increase in the proportion of fast-food outlets among "eating out options" was associated with a 7% decrease in the DQS, towards poorer dietary quality.

Conclusions
The associations highlight that choosing food outlet density versus proportions to quantify the foodscape impact findings of substantial importance when considering the significance level and direction of association. Findings suggests a threshold effect when using density measures indicating abundance of many food outlets, at which the association with dietary quality alters significantly towards healthier diet quality.
The association between socioeconomic position and depression or suicidal ideation in low- and middle-income countries in Southeast Asia: a systematic review and meta-analysis
Authors: Barrass Lucy , Joshi Elisha , Dawe Joshua , Rubbo Bruna , Redaniel Maria Theresa , Riglin Lucy , Lee Nanette R. , Howe Laura D. , Knipe Duleeka 
Published: December 2024

Abstract
Background
Mental illnesses contribute to a significant burden of disease in low- and middle- income countries (LMICs). Understanding risk factors for poor mental health is essential to reducing the burden, and for preventative measures to be implemented. The role of socioeconomic position (SEP) in poorer mental health is well established in high income countries, but less is known in LMICs. This study aimed to identify and synthesise epidemiological evidence for the associations between SEP and depression and suicidal ideation in LMICs in Southeast Asia, and to describe the strength and direction of any associations identified.

Methods
This systematic review identified evidence by searching four databases in February 2023 (Medline, Embase, PsycInfo and Web of Science), grey literature and reference searching of included papers. Papers were included if they were based in a Southeast Asian LMIC general or hospital populations (= 16 years of age) and explored at least one measure of SEP in association with depression or suicidal ideation. Study quality was assessed using the Joanna Briggs Institute tool. A meta-analysis and narrative synthesis were performed.

Results
Fifty-nine papers from six out of nine Southeast Asian LMICs were identified, with education the most commonly examined measure of SEP. Several papers explored more than one measure of SEP. Around half of the papers were rated as higher quality. Meta-analyses of education (OR: 1.87, 95% CI: 1.49-2.35) and working status (OR: 1.30, 95% CI: 0.99-1.71) provided evidence of lower levels of education and not being employed being associated with higher odds of depression. Consistent associations between lower SEP and higher odds of depression were also found for financial difficulty and subjective economic status. Three papers used suicidal ideation as their outcome, and there was some evidence of an association with lower SEP and higher ideation.

Conclusions
Evidence indicates that lower SEP is associated with higher likelihood of depression, whereas for suicidal ideation, the evidence available is insufficient to reach a conclusion. The lack of longitudinal studies prevents the temporal nature of these associations being established.

Systematic review registration
PROSPERO: CRD42023410444.
The generic version of China Health Related Outcomes Measures (CHROME-G): psychometric testing and comparative performance with the EQ-5D-5L and SF-6Dv2 among the Chinese general population
Authors: Xie Shitong , Wu Jing , Chen Pinan , He Xiaoning , Zhao Kun , Xie Feng ,   for the CHROME Study Group
Published: December 2024

Abstract
Objectives
The CHROME-G is the first generic preference-based measure developed in China. This study aimed to validate and compare the psychometric properties of the CHROME-G with the EQ-5D-5L and SF-6Dv2 among the Chinese general population.

Methods
A representative sample of the Chinese general population in terms of age, gender, education, and urban/rural residence was recruited for an online survey. During the survey, respondents completed three instruments (first the CHROME-G, then the EQ-5D-5L and SF-6Dv2 in random order), demographic and health-related questions. The retest survey was carried out after two weeks. Ceiling/floor effects were first assessed. Convergent and divergent validity was examined using Spearman’s rank correlation. Known-group validity was examined using the non-parametric Kruskal–Wallis H test and effect size. Test–retest reliability was assessed using the intraclass correlation coefficient and weighted Kappa statistics.

Results
One thousand respondents (51.1% male, mean age 44.7 years) completed the first survey, with 378 also completing the retest survey. The mean ± SD completion time was 2.03 ± 0.58 min for the CHROME-G, and 1.37 ± 0.54 and 1.13 ± 0.38 min for the EQ-5D-5L and SF-6Dv2. Only the EQ-5D-5L had a ceiling effect of 35.1%. The range of Spearman rank’s correlations was 0.45–0.62 for convergent validity and 0.14–0.46 for divergent validity. Among different health subgroups, the effect size for the CHROME-G, EQ-5D-5L and SF-6Dv2 was 1.348–3.416, 1.362–3.325 and 1.097–2.228, respectively. The ICC for test–retest was 0.791 for the CHROME-G, compared with 0.994 and 0.971 for the EQ-5D-5L and SF-6Dv2.

Conclusions
The CHROME-G showed good and comparable psychometric properties with the EQ-5D-5L and SF-6Dv2.