bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors influencing (health-promoting) telework during COVID-19: A company sample in Austria
Authors: Lang G , Hofer-Fischanger K 
Published: October 2021

Abstract

Background
Many companies had to switch to teleworking (TW) due to COVID-19 pandemic in spring 2020. However, TW conditions (home office) are not always health promoting. The question was: To what extent companies enabled TW before, during and after the first lockdown (time points t1-t3) and what is the role of workplace health promotion (WHP) in the establishment of health-promoting TW?

Methods
Using TAM, hypotheses were operationalised using a standardised questionnaire. At the beginning of 2020, a selection of 1858 Austrian companies were asked to participate in an online survey. The n = 192 responses from company representatives cover a broad mix of different sectors, industries, company sizes and regions in Austria. The analysis was carried out using structural equation models.

Results
Both the extent of TW implemented (means: mt1=3.7, mt2=18.4, mt3=8.6 days per month/employee) and the proportion of the workforce that could make use of TW (mt1=17.3%, mt2=58.6%, mt3=40.1%) increased significantly during the 1st lockdown and did not return to the pre-lockdown level afterwards. The degree of TW depended on how well the companies were prepared for it (β = 0.271). The (a) experience with TW and the (b) willingness to continue offering TW depended on the preparation (a: 0.243; b: 0.453) and on the actual degree of implementation of TW (a: 0.228; b: 0.193). For the intention to implement health-promoting TW in the company, the general willingness for TW (0.415) but also the existing WHP structures are central requirements (0.446; all p &lt; 0.050).

Conclusions
Far more than before COVID-19, TW is of central interest for public health and WHP. In terms of a holistic health understanding of TW, companies have to adapt to the changing conditions (eg technical, communication) and to establish comprehensive WHP structures and processes. Support for companies can come from training or further education to raise awareness and develop an appropriate health-promoting company culture.

Key messages
Health promoting telework conditions need to be assessed and developed further. Companies need to be supported when implementing health-promoting telework, eg with guidelines, further education.
Government effectiveness and early childhood development in 33 countries
Authors: Cortes J 
Published: October 2021

Abstract

Background
The sustainable development goals call for favoring all the resources and strategies to stimulate early childhood development. Government effectiveness is the central axis of developing such actions, policies, and procedures in all countries, especially in low and middle-income countries.

Methods
We used the early child development module and index from national health surveys (MICS) of 33 countries to calculate the children on track. We also use the World Bank Governance Index, specifically the effective governance score. In addition, we carry out geospatial analyzes with the ArcGIS and GeoDa software to evaluate geographic correlations between the variables studied and identify geographic patterns of child development levels and effective governance. Pearson and Spearman correlation tests were performed in Stata software.

Results
We studied children from 33 low and middle-income countries; from 7 world regions. Thailand (91.1%) and Turkmenistan (90.7%) have the highest percentages of child development and the lowest in Burundi (39.6%). On the GE estimate, the lowest value is in Burundi (-1.3) and the highest in the Democratic Republic of Korea (1). In the GE Rank, the highest values are in Korea with 82.1% and the lowest in Haiti (0.9%). The grade of correlation between ECDI and GE Estimate was moderate positive (0.522, P-0.001, Correlation Spearman test), similarly to (0.518, P-0001, Pearson correlation test).

Conclusions
To date, this study presents the most practical spatial correlation analysis of child development and Government effectiveness using an instrument specially developed for national health surveys. The multifactorial aspect of early childhood development and the significant gaps we found only adds to the challenge of not leaving any children behind.

Key messages
To date, this study presents the most comprehensive spatial correlation analysis of child development and Government effectiveness. The multifactorial aspect of early child development and the large gaps we found only add to the challenge of not leaving any children behind.
Estimating cost of illness for kindergarten children with contagious diseases in Germany
Authors: Graichen J 
Published: October 2021

Abstract

Child mortality in Europe steadily declined in the last decades. Children, especially in the kindergarten age, however, still suffer from multiple contagious diseases (CD). This is a burden for children and families and causes high costs for society. While studies examine epidemiology and costs for certain diseases, there is no cost estimation including various CD. Thus, the aim of the study is to estimate costs for kindergarten children with common CD in Germany from a societal perspective. Aggregated results should help design and implement preventive measures. Costs are estimated bottom-up. Direct medical costs are derived from resource costs in the healthcare sector as provided by the German Federal Statistical Office (GFSO), census data and epidemiological data as provided by KIGGS (a representative child health study by the German government). Direct non-medical costs are neglected because they are minor, even though substantial for some families. Indirect costs are calculated using the human capital approach. Work absenteeism days of caregivers are based on statutory health insurance data and weighted with gross income figures from the GFSO. Direct costs are estimated to be 1556 (main driver being hospitalization) and indirect costs 125 Euro per child per year. This sums up to 3817 Mio Euro that are spent yearly due to children in the kindergarten age, infected with common CD. The estimation is conservative not only due to used data but also due to other societal factors that are not translated into monetary terms like costs for parents not joining the workforce because their sick child might need a caregiver, or systematic adverse employment decisions due to more frequent absenteeism from work (especially among care-giving women). The presented estimation shows the magnitude of costs caused by CD among children. Further research is needed to detail the estimation, to quantify factors not yet valued in monetary terms and to estimate costs for other countries.

Key messages
Contagious diseases of kindergarten children not only endanger the wellbeing of children and their families but are also a major cost burden for society. Over 1600 Euro of direct and indirect costs occur yearly per child in the kindergarten age due to common contagious diseases, that could possibly be prevented through adequate measures.
Psychosocial protective factors in promoting healthy lifestyles in children and adolescents
Authors: Ouadine G 
Published: October 2021

Abstract

Introduction
Children and adolescents from socially vulnerable families experience social as well as health-related disadvantages at a very early age. Resilience research increasingly focuses on general psychosocial protective factors and their positive role as an effective health resource. In this research, the influence of some selected protective factors on a healthy lifestyle in the target group of secondary school students is shown.

Methods
Using a method of a cluster analysis, a theory-led lifestyle typology was developed based on the variables ‘physical-sport activity' and ‘media consumption patterns'. Four lifestyle clusters were identified: sports-active frequent media users, sports-active low media users, sports-inactive frequent media users und sports-inactive low media users. The study examined how the resilience factor ‘physical fitness' (measured by the 6 min run) as well as personal, family and social protective factors were manifested in the respective clusters.

Results
In the sporty-active clusters, the proportion of children with good physical fitness was high (47%). In the sporty-inactive clusters, however, this proportion was only about 23%. Approximately 71.5% of the children in sporty-active clusters reported good health and health-promoting behavior, while in sporty-inactive clusters this percentage was 49.2%. Trusting and appreciative parent-child relationship and positive sibling ties were mentioned more frequently in sporty-active clusters than in sporty-inactive clusters.

Discussion
Regular exercise and moderate use of media have a positive effect on protective resilience factors. These can be considered as ‘health-enhancing' lifestyle characteristics in health-related behavior. Personal, family and social protective factors interact with physical activity and are effective health resources: physically active children are more resilient to stressful environmental situations.

Key messages
Regular exercise and moderate use of media have a positive effect on protective resilience factors. Protective resilience factors are ‘health-enhancing' lifestyle characteristics in health-related behavior.
Mental disorders, multimorbidity and labor market marginalization among refugee youths in Sweden
Authors: Chen J , Mittendorfer-Rutz E , Klimek P 
Published: October 2021

Abstract

Background
Little is known about how disease co-occurrences with common mental disorders (CMD) associate with social integration in young refugees. We identify diagnostic groups associated with labor market marginalization (LMM) in refugees and Swedish-born with CMD and determine whether multimorbidity is associated with LMM in young refugees and Swedish-born with CMD.

Methods
This longitudinal registry-based study included adults aged 20-25 years followed from 2011-2016 in Sweden. LMM was defined as &gt; 180 days unemployment or being granted disability pension. A multimorbidity score was derived from a network of disease co-occurrences observed in 2009-2011. Relative risks for LMM in refugees with CMD compared to Swedish-born with CMD in 114 diagnostic groups were calculated. Multivariate logistic regression was applied to estimate the odds of LMM by CMD.

Results
Among 249,245 young adults, 2,841 (1.1%) were granted disability pension and 16,323 (6.5%) individuals experienced unemployment, 20,679 (8.3%) suffered from CMD. Most comorbid diagnostic groups were positively associated with unemployment in young refugees with CMD. Inflammatory bowel disease and acute upper respiratory disease showed the highest relative risks of unemployment for young refugees with CMD, compared to Swedish-born with CMD: RRs 6.4[3.2, 12.8], 4.0[2.6, 6.1], respectively. The multimorbidity score was associated with elevated odds for unemployment and granted disability pension in refugees with/without CMD and Swedish-born with/without CMD (OR range: 1.1-1.8; highest for young refugees without CMD).

Conclusions
Specific diagnostic group had differential risks for unemployment for refugees and Swedish-born. Early culturally sensitive public health measures are warranted to target the detrimental consequences of multimorbidity on LMM in young adults.

Key messages
The importance of diagnostic groups for LMM differs for young refugees and Swedish-born with CMD. Multimorbidity increases the risk for LMM, particularly disability pension.
Discrimination between migrants and non-migrants in depression’s management by General Practitioners
Authors: Duveau C , Wets C , Delaruelle K , Lepièce B , Dauvrin M , Ceuterick M , Demaesschalk S , Bracke P , Lorant V 
Published: October 2021

Abstract

Background
In Europe, migrants have a higher prevalence of depression compared to the native population and, more often, they face unmet medical needs, including less frequent referral to mental health services. According to social psychology, general practitioners (GPs) may undertreat migrants due to unconscious stereotypical bias that could lead to and sustain discrimination in primary health care. The central question in this research is whether patients' migration background influences GPs' attitudes and decisions regarding treatment and referral in mental health.

Methods
In 2021, an experimental design was delivered to GPs with two video vignettes staging a depressed native and a Belgo-Moroccan patient, respectively. The randomly assigned vignette was followed by an online questionnaire regarding treatment and referral decisions. We recruited a national sample of Belgian GPs' (n = 700). T-tests and chi-square were used for analyses.

Results
The preliminary results are based on the first 224 respondents. Overall, there was no significant difference in the management of depression between a Belgian patient and a Belgo-Moroccan patient. Nevertheless, severity of symptoms was rated lower in the Belgo-Moroccan as compared to the Belgo-Moroccan (t = 2.37, p = .019).

Conclusions
In summary, these results indicate that general practitioners seem to treat migrants fairly in comparison with non-migrants. However, underestimation of the severity of the symptoms could lead to a different medical decision. This hypothesis will be investigated in the coming months.

Key messages
These findings may help us to further understand the role of general practitioner behaviour in mental health care discrimination. This research shed light on current management of migrants’ mental health by the primary health care providers in Belgium.
Gender medicine: a cross-sectional survey on knowledge and curriculum among Italian medical students
Authors: Cremona A , Bert F , Pompili E , Boietti E , Rousset S , Franzini Tibaldeo E , Tatti R , Siliquini R 
Published: October 2021

Abstract

Introduction
Gender and sex are important predictors of many attitudes and behaviours that have an impact on health and disease. Gender medicine is then a fundamental approach for better quality of care in Europe. Few information is available on Italian medical students and their knowledge about gender medicine. Our study aimed to investigate knowledge about gender medicine in a sample of Italian medical students in order to identify specific knowledge gaps and improve Medicine degree curricula.

Methods
In 2020, an online cross-sectional survey was conducted on 430 medical students of the University of Turin, Italy. Participants filled out a questionnaire consisting of 29 items concerning the areas of knowledge and attitudes regarding gender medicine. Multivariable logistic regression model was performed to explore potential predictors of knowledge among students.

Results
More than 60% of the students knew the correct definition of gender medicine and around 90% of them knew the difference between sex and gender. In total, 58.16% of female students had a good level of knowledge, significantly more than male students (37,5%; p &lt; 0.001); female students also showed a higher mean score compared to male students (respectively 17.96±2.75 vs 16.59±3.20, p &lt; 0.001). Using a multivariate linear regression model, with level of knowledge about gender medicine used as a continuous variable, we found that being female was the only potential predictor of high consideration of gender medicine in patient management.

Conclusions
The results indicate that students have a good knowledge and high regard for gender medicine. Female students seem more aware of the importance of gender medicine and areas of improvement can be identified. Future European physicians must consider gender medicine in order to encourage a patient-tailored approach and to reduce gender gap still existent in current practice.

Key messages
Gender medicine is a fundamental approach to improve quality of care and to reduce gender gap among European patients. Medical students should be more aware and trained about gender and sex differences during clinical practice in order to encourage a patient-tailored medicine.
Primary Health Care during the COVID-19 pandemic: an analysis based on the HSRM
Authors: Kumpunen S , Webb E , Permanand G , Zheleznyakov E , Edwards N , van Ginneken E , Jakob M 
Published: October 2021

Abstract
The COVID-19 pandemic has had a dramatic impact on workload and responsibilities for those working at primary health care (PHC) level in the European region - much of which has gone unnoticed relative to the focus on hospitals. Based on the PHC-relevant data extracted from the HSRM, we describe PHC models of care and the political and system levers that supported them. Three key themes emerged: (1) varied forms of PHC multidisciplinary collaboration were developed to manage the emergency response - supported by the movement of staff to areas requiring support; (2) vulnerable patients were identified and prioritized for medical outreach within PHC, and were supported through financial incentives and complementary action from centralized and local governments that used much broader definitions of vulnerability; and (3) digital solutions for remote triage, medical advice and treatment enhanced the effectiveness of the PHC response and were facilitated through centralized investment in digital technologies. Based on our analysis, we raise opportunities for the future of PHC, namely that multidisciplinary approaches to PHC service delivery are essential to future infectious and non-infectious outbreaks, and the agility and rapid pace of change that took place among PHC providers should continue. PHC providers lacked visibility during the pandemic and should work together to develop a strong voice in all health systems.
Pathways through rehabilitation for traumatic brain injury: preliminary results from an Irish study
Authors: O'Donnell K , Healy A , Staines A , Corrigan C , Burke T , McGettrick G , Waldron B 
Published: October 2021

Abstract

Background
Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. In Ireland, little data exists on the number of TBI survivors or the availability of brain injury rehabilitation services. To address this, we examined nationally representative data to estimate the number of moderate to severe TBI survivors and to learn of their rehabilitation experiences.

Methods
A two-year mixed-methods, observational, cohort study was used to investigate the rehabilitation pathways of moderate to severe TBI survivors (N = 120). Participants were surveyed on two occasions six months apart using a range of standardised instruments (EQ-5D-3L, WHOQOL BREF and EBIQ). Preliminary findings from first surveys are reported.

Results
Fifty percent of participants reported having received some rehabilitation during their initial hospitalization. Following discharge, inpatient rehabilitation was recommended in 55.8% of cases (N = 67); 62.5% (N = 75) in an outpatient setting and 52.1% (N = 62) in a specialised brain injury community-based setting. Rehabilitation was not recommended in 9.2% (N = 11) of cases. Univariant analyses showed statistically significant differences between the experiences of males (N = 87) and females (N = 33) in three main elements; Isolation: males (M), mean 1.88, SD .488, females (F) mean 1.64, SD .476, (p = .015); Communication: M mean 1.85, SD .565, F mean 1.57, SD .469 (p = .012); Cognitive difficulties: M mean 1.81, SD .456, F mean 1.59, SD .426 (p = .020).

Discussion
Referrals to rehabilitation services varied substantially in this cohort of TBI survivors with evidence to suggest that, overall, males experience greater impacts on quality of life than do females. These findings support the need to, a) increase political priority and resource allocation for rehabilitation services for TBI survivors in Ireland and b) further study gender differences in TBI survivor outcome.

Key messages
Survivors of moderate to severe brain injury in Ireland have very divergent, and often inadequate experiences of rehabilitation. There is some evidence that male survivors of moderate to severe traumatic brain injury face more challenges than do female survivors.
Association between obesity and life courses in young adulthood. Results from the KiGGS cohort study
Authors: Rattay P , Schienkiewitz A , Vogelgesang F 
Published: October 2021

Abstract

In the last decades, young adulthood has established as an independent phase of life with important biographical transitions impacting further life course and health. In turn, health in adolescence can also affect the transitions into young adulthood. So far, for Germany there are no analyses on the association between family-related and employment-related biographies and obesity in young adults. The analysis is based on data from the KiGGS cohort study on 3,100 participants aged 23-31 at second follow-up (t2). Using BMI measurements at t0 (2003-2006) and at t2 (2014-2017), obesity groups were formed (no obesity, incidence, remission, persistence). Sequence analysis was used to retrospectively determine family-related and education/employment-related individual trajectories. Differences in life courses between obesity groups were calculated using discrepancy tests. Young adults with incident obesity were more likely to have children or to be a single parent than young adults without obesity at t2. Young adults with obesity at t0 lived longer in the parental home than those without obesity. Young adults with incident or persistent obesity were less likely to attend university and had experienced longer periods of unemployment than those without obesity at t0 and t2. The employment sequences of those without obesity at t2 were not statistically different. Both family and employment biographies were associated with obesity trajectories in young people. However, based on the analysis, it cannot be clarified whether early parenthood led to obesity or early transitions into parenthood led to interruptions in education or employment and subsequently to obesity. The finding that young adults with obesity were less likely to attend university and more likely to be unemployed could be related to disadvantages or discrimination in school, education or work. Obesity in adolescence that did not persist into young adulthood had less adverse effects on education and employment.

Key messages
Young people’s obesity trajectories were linked to different family/employment biographies. The life courses of young adults with obesity were more often marked by early parenthood and unemployment.