bluuebunny/crossref_metadata_2025_split huggingface dataset:
Single-parenthood and health conditions among children receiving public assistance in Japan: a cohort study
Authors: Nishioka Daisuke , Saito Junko , Ueno Keiko , Kondo Naoki 
Published: May 2021

Abstract
Background
Children’s healthy development is important. While governmental public assistance benefits financially troubled families, it cannot compensate for a lack of social support. Single-parenthood is a health risk factor for children owing to low-income-associated food insecurity and stress. No study has investigated the association between single-parenthood and health status in children from families receiving public assistance. This study aimed to examine the association between single-parent households and children’s health among public assistance recipients in Japan by using linkage data of two municipal public assistance databases and administrative medical assistance data.

Methods
We performed a retrospective cohort study. Public assistance for households below the poverty line ensures income security and medical care. The study population included all children aged 15 or younger availing public assistance in January 2016. We extracted recipients’ sociodemographic factors from January 2016 and identified the incidence of childhood diseases’ diagnosis until December 2016 as the outcome, including 1) acute upper respiratory infections; 2) influenza and pneumonia; 3) injuries, including fractures; 4) intestinal infectious diseases; 5) conjunctivitis; 6) asthma; 7) allergic rhinitis; 8) dermatitis and eczema, including atopic dermatitis; and 9) diseases of the oral cavities, salivary glands, and jaws, such as tooth decay or dental caries.

Results
Among the 573 children, 383 (66.8%) lived in single-parent households. A multivariable Poisson regression, with a robust standard error estimator, showed that single-parenthood is associated with a higher prevalence of asthma (incidence ratio [IR] = 1.62; 95% confidence interval [CI], 1.16–2.26), allergic rhinitis (IR = 1.41; 95% CI, 1.07–1.86), dermatitis and eczema (IR = 1.81; 95% CI, 1.21–2.70), and dental diseases (IR = 1.79; 95% CI, 1.33–2.42) compared to non-single parent households, whereas little association was found between single-parenthood and children’s acute health conditions.

Conclusions
Among public assistance recipients, living in single-parent households may be a risk factor for children’s chronic diseases. The Japanese public assistance system should provide additional social care for single-parent households. Further investigations are necessary using more detailed longitudinal data, including environmental factors, the severity of children’s health conditions, contents of medical treatments, and broader socioeconomic factors.
Work-related medical rehabilitation in patients with mental disorders: the protocol of a randomized controlled trial (WMR-P, DRKS00023175)
Authors: Markus Miriam , Gabriel Nina , Bassler Markus , Bethge Matthias 
Published: May 2021

Abstract
Background
Various rehabilitation services and return-to-work programs have been developed in order to reduce sickness absence and increase sustainable return-to-work. To ensure that people with a high risk of not returning to work can participate in working life, the model of work-related medical rehabilitation was developed in Germany. The efficacy of these programs in patients with mental disorders has been tested in only a few trials with very specific intervention approaches. To date, there is no clear evidence of the effectiveness of work-related medical rehabilitation implemented in real-care practice.

Methods/design
Our randomized controlled trial will be conducted in six rehabilitation centers across Germany. Within 15 months, 1800 patients with mental disorders (300 per rehabilitation center) will be recruited and assigned one-to-one either to a work-related medical rehabilitation program or to a conventional psychosomatic rehabilitation program. Participants will be aged 18–60 years. The control group will receive a conventional psychosomatic rehabilitation program without additional work-related components. The intervention group will receive a work-related medical rehabilitation program that contains at least 11 h of work-related treatment modules. Follow-up data will be assessed at the end of the rehabilitation and 3 and 12 months after completing the rehabilitation program. The primary outcome is a stable return to work. Secondary outcomes cover several dimensions of health, functioning and coping strategies. Focus groups and individual interviews supplement our study with qualitative data.

Discussion
This study will determine the relative effectiveness of a complex and newly implemented work-related rehabilitation strategy for patients with mental disorders.

Trial registration
German Clinical Trials Register (DRKS00023175, September 29 2020).
A national evaluation of the Irish public health counselling in primary care service– examination of initial effectiveness data
Authors: Brand Charles , Ward Fiona , MacDonagh Niamh , Cunningham Sharon , Timulak Ladislav 
Published: May 2021

Abstract
Background
The Counselling in Primary Care service (CIPC) is the first and only nationally available public counselling service in the Republic of Ireland. This study provides initial data for the effectiveness of short-term psychotherapy delivered in a primary care setting in Ireland for the first time.

Method
A practice-based observational research approach was employed to examine outcome data from 2806 clients receiving therapy from 130 therapists spread over 150 primary care locations throughout Ireland. Pre-post outcomes were assessed using the CORE-OM and reliable and clinically significant change proportions. Binary logistic regression examined the effect of pre therapy symptom severity on the log odds of recovering. Six and 12 month follow up data from a subsample of 276 clients were also analysed using growth curve analysis.

Results
Of 14,156 referred clients, 5356 presented for assessment and 52.3% (N = 2806) consented to participate. Between assessment and post-therapy a large reduction in severity of symptoms was observed- Cohen’s d = 0.98. Furthermore, 47% of clients achieved recovery,a further 15.5% reliably improved, 2.7% reliably deteriorated and34.7% showed no reliable improvement. Higher initial severity was associated with less chance of recovering at post-therapy. Significant gains were maintained between assessment and12 months after therapy- Cohen’s d = 0.50.

Conclusions
Outcomes for clients in the CIPC service compared favourably with large scale counselling and psychotherapy services in jurisdictions in the U.K., the U.S.A., Norway and Sweden. This study expands the international primary care psychotherapy research base to include the entire Republic of Ireland jurisdiction.
Patterns and predictors of private and public health care utilization among residents of an informal settlement in Nairobi, Kenya: a cross-sectional study
Authors: Wambiya Elvis O. A. , Otieno Peter O. , Mutua Martin Kavao , Donfouet Hermann Pythagore Pierre , Mohamed Shukri F. 
Published: May 2021

Abstract
Background
Knowledge of health care utilization is important in low-and middle-income countries where inequalities in the burden of diseases and access to primary health care exist. Limited evidence exists on health seeking and utilization in the informal settlements in Kenya. This study assessed the patterns and predictors of private and public health care utilization in an urban informal settlement in Kenya.

Methods
This study used data from the Lown scholars study conducted between June and July 2018. A total of 300 households were randomly selected and data collected from 364 household members who reported having sought care for an illness in the 12 months preceding the study. Data were collected on health-seeking behaviour and explanatory variables (predisposing, enabling, and need factors). Health care utilization patterns were described using proportions. Predictors of private or public health care use were identified using multinomial logistic regression with the reference group being other providers.

Results
Majority of the participants used private (47%) and public facilities (33%) with 20% using other providers including local pharmacies/drug shops and traditional healers. In the model comparing public facilities vs other facilities, members who were satisfied with the quality of health care (vs not satisfied) were less likely to use public facilities (adjusted relative risk ratio (aRRR) 0.29; CI 0.11–0.76) while members who reported an acute infection (vs no acute infection) were more likely to use public facilities (aRRR 2.31; 95% CI 1.13–4.99) compared to other facilities. In the second model comparing private facilities to other facilities, having health insurance coverage (aRRR 2.95; 95% CI 1.53–5.69), satisfaction with cost of care (aRRR 2.08; CI 1.00–4.36), and having an acute infection (aRRR 2.97; 95% CI 1.50–5.86) were significantly associated with private facility use compared to other facilities.

Conclusions
The majority of urban informal settlement dwellers seek care from private health facilities. As Kenya commits to achieving universal health coverage, interventions that improve health care access in informal and low-resource settlements are needed and should be modelled around enabling and need factors, particularly health care financing and quality of health care.
Time trends in HPV vaccination according to country background: a nationwide register-based study among girls in Norway
Authors: Bjerke Randi Dalene , Laake Ida , Feiring Berit , Aamodt Geir , Trogstad Lill 
Published: May 2021

Abstract
Background
Since the human papillomavirus (HPV) vaccine was introduced in Norway in 2009, the vaccine uptake has increased. Whether this increase is similar regardless of the girls’ country background is unknown. We examined changes in HPV vaccine uptake from 2009 to 2014 and studied the impact of parental education and income on HPV vaccine uptake according to country background.

Methods
Girls in the first six birth cohorts (1997–2002) eligible for HPV vaccination were identified through the National Registry. Information on HPV vaccination, country background and socioeconomic factors was extracted from the Norwegian Immunisation Registry and Statistics Norway. Risk differences (RDs) and confidence intervals (CIs) were estimated with linear binomial regression. A total of 177,387 girls were included in the study.

Results
The HPV vaccine uptake increased from 72.5% in 2009 to 87.3% in 2014. The uptake increased for girls in all country background categories. Highest vaccine uptake was observed in girls with East−/South-East Asian background, 88.9% versus 82.5% in the total population. Vaccine uptake decreased slightly with increasing parental education, RD = − 1.6% (95% CI: − 2.3% to − 0.8%) for highest compared with lowest education level. In contrast, the uptake increased with increasing household income, RD = 4.9% (95% CI, 4.3 to 5.5%) for highest compared with lowest quintile. Parental education had largest impact in girls with Asian background, RD = − 8.1% (95% CI − 10.5% to − 5.6%) for higher vs lower education. The largest impact of household income was observed in girls with background from Middle East/Africa, RD for a 200,000 NOK increase in income was 2.1% (95% CI 1.2 to 3.0%).

Conclusions
The HPV vaccine uptake differed with country background but increased over time in all country background categories. Moreover, the impact of education and income on vaccine uptake differed with country background.
Explaining the reasons for not maintaining the health guidelines to prevent COVID-19 in high-risk jobs: a qualitative study in Iran
Authors: SoleimanvandiAzar Neda , Irandoost Seyed Fahim , Ahmadi Sina , Xosravi Tareq , Ranjbar Hadi , Mansourian Morteza , Yoosefi Lebni Javad 
Published: May 2021

AbstractBackgroundAlthough the workers in many occupations are at the greatest risk of catching and spreading COVID-19 due to assembling and contacting people, the owners of these occupations do not follow COVID-19 health instructions. The purpose of this study is to explain the reasons for not maintaining health guidelines to prevent COVID-19 in high-risk jobs in Iran.MethodsThe present study was conducted with a qualitative approach among people with high-risk jobs in Tehran during March and April of 2020. Data were collected through semi-structured interviews with 31 people with high-risk occupations selected by purposeful sampling and snowballing. The data were analyzed using the conventional qualitative content analysis method and MAXQDA-18 software. Guba and Lincoln’s criteria were also used to evaluate the quality of the research results.Results4 main categories and 13 sub-categories were obtained, including individual factors (personality traits, lack of self-efficacy, little knowledge of the disease and how to observe health norms related to it, misconceptions about health), structural factors (difficulty of access to health supplies, lack of supportive environment, weak laws and supervision, the poor performance of officials and national media), economic factors (economic costs of living, lack of government economic support), Socio-cultural factors (learning, cultural beliefs, social customs, and rituals).ConclusionCOVID-19 prevention requires intervention at different levels. At the individual level: increasing people’s awareness and understanding about how to prevent COVID-19 and strengthening self-efficacy in observing health norms, at the social level: highlighting positive patterns of observing health issues and training people about the consequences of social interactions during the outbreak of the virus, and at the macro level: strengthening regulatory rules and increasing people’s access to hygienic products and support for the vulnerable must be taken into account.
Functional health and symptoms in Spain before and during the COVID-19 pandemic
Authors: Lehmann Jens , Holzner Bernhard , Giesinger Johannes M. , Bottomley Andrew , Ansari Shaad , von Butler Ludwig , Kemmler Georg 
Published: May 2021

Abstract
Background
The impact of the coronavirus disease (COVID-19) pandemic on wellbeing and health has so far been studied using mostly cross-sectional designs. To place recent findings into context, we compared symptoms and functional health status in two independent samples assessed before and during the COVID-19 pandemic.

Methods
Participants were recruited via an online panel using quota sampling. We assessed symptoms, functional health, and global quality of life with the EORTC QLQ-C30 in two general population samples in Spain (collected in July 2019 and April 2020). We also assessed several COVID-19 related variables, such as adherence to social distancing.

Results
Data from N = 1010 participants before the pandemic (mean age 47.1 years, 50.5% female) were compared with data from N = 504 participants during the pandemic (mean age 47.1 years, 50.8% female). Participants during the pandemic (vs. before the pandemic) reported lower role functioning and emotional functioning, as well as less symptom burden. A lower degree of social distancing was associated with better functional health and lower symptom burden.

Conclusion
Our findings indicate an impact of the COVID-19 pandemic on functional health and symptom burden in the Spanish general population. The comparison of before and during the pandemic can be used to benchmark results raised only during the pandemic.
Dynamic monitor of CT scan within short interval in invasive pulmonary aspergillosis for nonneutropenic patients: a retrospective analysis in two centers
Authors: Chen Fei , Zhong Yonghong , Li Na , Wang Huijie , Tan Yanbin , Zhang Hao , Hua Wen , Mao Yanxiong , Huang Huaqiong 
Published: May 2021

AbstractBackgroundIn nonneutropenic patients with underlying respiratory diseases (URD), invasive pulmonary aspergillosis (IPA) is a life-threatening disease. Yet establishing early diagnosis in those patients remains quite a challenge.MethodsA retrospective series of nonneutropenic patients with probable or proven IPA were reviewed from January 2014 to May 2018 in Department of Respiratory Medicine of two Chinese hospitals. Those patients were suspected of IPA and underwent lung computed tomography (CT) scans twice within 5–21 days. The items required for IPA diagnosis were assessed by their host factors, mycological findings and CT scans according to the European Organization for Research and Treatment of Cancer (EORTC) and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (MSG) criteria (EORTC/MSG criteria).ResultsTogether with the risk factors, mycological findings and nonspecific radiological signs on first CT, ten patients were suspected of IPA. With the appearance of cavities on second CT scan in the following days, all patients met the criteria of probable or possible IPA. Except one patient who refused antifungal treatment, nine patients received timely antifungal treatment and recovered well. One of the nine treated IPA cases was further confirmed by pathology, one was confirmed by biopsy.ConclusionsDynamic monitor of CT scan provided specific image evidences for IPA diagnosis. This novel finding might provide a noninvasive and efficient strategy in IPA diagnosis with URD.
Total parathyroidectomy with forearm autotransplantation in secondary hyperparathyroidism patients: analysis of muscle, subcutaneous and muscle + subcutaneous method
Authors: Zhou Bin , Zhu Lei , Xiang Cheng , Cheng Feng , Zhu Xi , Zhou Yi , Wang Yong 
Published: May 2021

Abstract
Background
Forearm autotransplantation after parathyroidectomy has turned into the standard method for secondary hyperparathyroidism (SHPT) treatment in chronic kidney disease patients. Our study aimed to explore the effects of three methods including muscle, subcutaneous and muscle + subcutaneous transplant methods on SHPT.

Methods
Seventy five SHPT patients were enrolled and assigned into the muscle + subcutaneous (M + S) (n = 26), muscle (M) (n = 35), and subcutaneous (S) (n = 14) groups. The operation efficacy evaluation included preoperative and postoperative biological characteristics such as parathyroid hormone (PTH), serum phosphorus, serum calcium and alkaline phosphatase (ALP). The data were recorded from pre-operation time point to 1, 2, 3, 6, 12, 18, 24 month (mo) postoperation periods. After operation, short-form health survey (SF-36) scores was made for life quality identification at 1, 2, 3, 6, 12, 24 time points. Symptoms about SHPT including bone pain, fracture, pruritus, and coronary artery calcification were followed-up based on the scale.

Results
Compared with the preoperative record, all the M + S, M, and S groups showed postoperative decreased levels of PTH, serum phosphorus, serum calcium, calcium-phosphorus. In M + S group, the PTH and serum calcium level kept more steady compared with the M and S groups during a 24 mo duration observation. After this, a SF-36 score scale which represents the life quality show M + S group got more scores at 3, 6, 12, 18 and 24 mo points. At last, the incidence of SHPT associated symptoms including Bone pain, Fracture, Pruritus, and Coronary artery calcification in M + S group were decreased compared with M and S groups at 1, 3, 6, 12 and 24 mo post-operation time points.

Conclusion
M + S seems to be an efficient method for medical treatment of SHPT patients in the control of PTH and serum calcium. This mixed transplant strategy improves the biochemical characterizes compared with M and S groups in SHPT patients. Furthermore, the M + S method make beneficial on clinical outcomes and life quality of patients.
Keyhole versus Sugarbaker techniques in parastomal hernia repair following ileal conduit urinary diversion: a retrospective nationwide cohort study
Authors: Mäkäräinen-Uhlbäck Elisa , Vironen Jaana , Vaarala Markku , Nordström Pia , Välikoski Anu , Kössi Jyrki , Falenius Ville , Kechagias Aristotelis , Mattila Anne , Ohtonen Pasi , Scheinin Tom , Rautio Tero 
Published: May 2021

Abstract
Background
Previous research on parastomal hernia repair following ileal conduit urinary diversion is limited. This nationwide cohort study aims to present the results of keyhole and Sugarbaker techniques in parastomal hernia repair in the setting of ileal conduit urinary diversion.

Method
All patients in this cohort underwent primary elective parastomal hernia repair following ileal conduit urinary diversion in four university hospitals and one central hospital in Finland in 2007–2017. Retrospective clinical data were collected from patient registries to compare keyhole and Sugarbaker parastomal hernia repair techniques. The primary outcome was parastomal hernia recurrence during the follow-up from primary surgery to the last confirmed follow-up date of the patient. The secondary outcomes were reoperations during the follow-up and complication rate at 30 days’ follow-up.

Results
The results of 28 hernioplasties were evaluated. The overall parastomal hernia recurrence rate was 18%, the re-operation rate was 14%, and the complication rate was 14% during the median follow-up time of 30 (21–64) months. Recurrence rates were 22% (4/18) after keyhole repair and 10% (1/10) after Sugarbaker repair. Re-operation rates referred to keyhole repair were 22% and Sugarbaker repair 0% during follow-up. The majority of reoperations were indicated by recurrence. Complication rates were 17% after keyhole and 10% after Sugarbaker repair during the 30 days’ follow-up.

Conclusion
The results of parastomal hernia repair in the setting of ileal conduits are below optimal in this nationwide cohort comparing keyhole to Sugarbaker repair in elective parastomal hernia repair. Nonetheless, the Sugarbaker technique should be further studied to confirm the encouraging results of this cohort in terms of recurrence.
Association of Cardiovascular Risk Factors and Metabolic Syndrome with non-alcoholic and alcoholic fatty liver disease: a retrospective analysis
Authors: Han A. L. 
Published: May 2021

Abstract
Background
Although many studies on non-alcoholic fatty liver disease (NAFLD) are underway worldwide, and several existing studies have investigated the association between NAFLD and cardiovascular risk factors, studies comparing NAFLD and alcoholic fatty liver disease (AFLD) are scarce. This study aimed to evaluate differences between the incidence of cardiovascular risk factors and metabolic syndrome in NAFLD and AFLD.

Methods
A retrospective analysis of 913 patients who underwent abdominal computed tomography (CT) was performed to compare the incidence of cardiovascular risk factors and metabolic syndrome between NAFLD and AFLD. Subjects were divided into three groups based on criteria: healthy (n = 572), NAFLD (n = 295), and AFLD (n = 46). The healthy group had no liver disease. NAFLD was defined as fatty liver diagnosed on CT and drinking less than 140 g/week for men or 70 g/week for women. AFLD was defined as fatty liver diagnosed on CT and drinking more than 140 g/week for men or 70 g/week for women. We compared the incidence of cardiovascular risk factors and metabolic syndrome between the three groups. The relationship between each group and the metabolic syndrome risk was analyzed through multivariate logistic regression analysis.

Results
No significant differences in several cardiovascular risk factors were observed between the NAFLD and AFLD groups. Upon analyzing the metabolic syndrome status in each group after making appropriate adjustments, the odds ratios (ORs) in the NAFLD (OR = 2.397, P = 0.002) and AFLD groups (OR = 4.445, P = 0.001) were found to be significantly higher than that in the healthy group; the incidence rate of metabolic syndrome was similar in the NAFLD and AFLD groups.

Conclusions
Both the NAFLD and AFLD groups had more cardiovascular risk factors and higher metabolic syndrome risk than the healthy group. Thus, the prevention of fatty liver disease, regardless of the specific type, should involve the identification of cardiovascular and metabolic syndrome risk factors. If abdominal CT reveals a fatty liver, whether NAFLD or AFLD, the risk of cardiovascular disease and metabolic syndrome should be assessed.