bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mental health of Finnish cis- and transgender youth before, during and after the COVID-19 pandemic
Authors: Kiviruusu O , Sares-Jäske L , Therman S , Lehtonen J , Suvisaari J 
Published: October 2024

Abstract

Background
Transgender youth report more mental health problems than their cisgender peers, but little is known about their mental health during and after the COVID-19 pandemic. We studied symptoms of anxiety and depression among cis- and transgender youth before, during, and after the pandemic using large nationwide samples.

Methods
Data from the Finnish School Health Promotion survey from years 2019, 2021 and 2023 (461,249 students in total; mean age 15.7, SD 1.3) were used. Self-reports covered official gender, gender identity, symptoms of anxiety (Generalized Anxiety Disorder Scale-7 ≥10) and depression (Patient Health Questionnaire-2 ≥3). Categories of cisgender boy (officially boy; gender identity boy; N = 214,423), transfeminine youth (officially boy; gender identity girl, both, neither, or it varies; N = 5,069), cisgender girl (officially girl; gender identity girl; N = 224,753), and transmasculine youth (officially girl; gender identity boy, both, neither, or it varies; N = 14,508) were formed.

Results
In all timepoints, proportion of those with anxiety or depression was higher among transfeminine youth compared with cisgender boys and among transmasculine youth compared with cisgender girls. In all groups anxiety and depression increased significantly from 2019 to 2021 (ORs 1.4-1.8, p &lt; 0.0001), with no significant differences in these changes between cis- and transgender groups. From 2021 to 2023, anxiety (OR 0.91, p = 0.015) and depression (OR 0.77, p &lt; 0.0001) decreased among transmasculine youth but increased among cisgender girls (ORs 1.11 [p &lt; 0.0001] and 1.07 [p &lt; 0.0001], interactions p &lt; 0.0001). Among transfeminine youth, generalized anxiety symptoms decreased from 2021 to 2023, whereas they remained at the level observed in 2021 among cisgender boys (interaction p = 0.0025).

Conclusions
In Spring 2023, we found still increasing mental health problems among cisgender girls, while among transgender youth the post-pandemic developments were more positive.

Key messages
• Post-pandemic, we found further increases in mental health symptoms in cisgender youth, while among transgender youth the development seemed more promising.
• Transgender youth experience more anxiety and depression than their cisgender peers, thus gender diversity deserves still more attention in educational, social, and health care services.
How can healthcare providers reduce the adverse effects of endometriosis on women’s life course?
Authors: Zarecki C , Satran C , Kaldawy A , Klaitman V , Tesler R , Bord S 
Published: October 2024

Abstract

Background
Endometriosis is a chronic gynecological disease that affects about 10% of women of reproductive age. Its symptoms vary in severity and manifestation. Diagnosis is often delayed by an average of 10 years, which may significantly affect women’s lives. This study explores how endometriosis morbidity affects women’s relationships, intimacy, and employment over their lifetime.

Methods
An online survey was conducted in February 2024 among Jewish Israeli women aged 18 to 50. Out of the 573 women, 270 were diagnosed with endometriosis. The survey collected information on the women’s diagnostic status, pain severity, social support, negative interactions, life-course impact, and distance from the doctor’s clinic.

Results
Women with endometriosis experience a negative impact on their life course compared to women without the disease, particularly in relationships and intimacy (39.41 vs. 18.44, p&lt;.001) and employment (19.39 vs. 19.11, p&lt;.001). A multivariate regression model was used to predict the effect of endometriosis on the women’s life course and revealed that a negative impact on relationships and intimacy (R2=.385, n = 505) might be predicted by longer travel distance to the doctor’s clinic, higher reported pain level, less reported social support level, and higher reported negative interactions. Furthermore, a negative effect on employment (R2 = .270, n = 513) was predicted by a longer distance to the clinic, a higher reported pain level, less reported social support level, and higher reported negative interactions.

Conclusions
Enencing supportive environments and increasing accessibility to health services is vital to improving the negative impact of endometriosis on women’s lives.

Key messages
• Endometriosis treatment requires a multi-faceted approach, including supportive frameworks, reducing negative interactions, and addressing gaps in health service accessibility.
• Awareness must be raised among employers regarding endometriosis, creating a supportive environment and making necessary adjustments for employees to openly communicate their needs and struggles.
Mixed-methods systematic review of shared decision-making tools for cancer screening
Authors: Herrera D J , van de Veerdonk W , Berhe N M , Talboom S , van Loo M , Ruiz-Alejos A , Ferrari A , Van Hal G 
Published: October 2024

Abstract

Shared decision-making (SDM) tools hold promise for guiding informed choices in cancer screening. However, their effectiveness among underserved people, as well as the specific characteristics of these tools preferred by this group and clinicians, remains unclear. This review aimed to synthesize evidence on the effectiveness of SDM tools for cancer screening and explored the preferences of underserved people and clinicians regarding the specific characteristics of the SDM tools. A mixed-method convergent segregated approach was employed, which involved an independent synthesis of quantitative and qualitative data. Articles were systematically selected and screened, resulting in the inclusion and critical appraisal of 55 studies. Results from the meta-analyses showed that SDM tools for cancer screening are effective in reducing decisional conflict for both the general population and the underserved, and in increasing cancer screening knowledge and intention for underserved people only. Subgroup analyses showed minimal heterogeneity for decisional conflict outcomes, measured over a six-month period. Insights from the qualitative findings revealed that underserved people highly preferred SDM tools with relevant information about cancer risk, culturally tailored content, and high accessibility, both during clinical encounters and beyond. Meanwhile, clinicians highly preferred tools that can be easily integrated into medical systems, and can effectively guide SDM, while considering their patients’ values and the limited time for consultation. There is strong evidence on the effectiveness of SDM tools in facilitating informed choice in cancer screening, especially among underserved people. However, evidence on long-term outcomes remains insufficient. Additionally, considering the difference in preferences of key stakeholders in terms of tool characteristics, fostering collaboration with them during the creation of an SDM tool for cancer screening is essential.

Key messages
• Shared decision-making tools are effective in increasing screening knowledge and intention among underserved people.
• Considering the difference in preferences of key stakeholders in terms of tool characteristics, fostering collaboration with them during the creation of an SDM tool for cancer screening is essential.
Human-forest proximity and the risk infectious diseases in a changing world
Authors: Fanelli A , Cescatti A , Riccetti N , Debois G , Robuchon M , Szewczy W , Ibarreta D , Ciscar J C 
Published: October 2024

Abstract

Background
Emerging Infectious Diseases (EIDs) pose a significant threat to global human health; they can lead to epidemics and pandemics with severe repercussions on human life, economic performance, and societal well-being. Despite the recognized negative impact of the EIDs, current research lacks a comprehensive global framework to assess the significance and interaction of various environmental and anthropogenic factors driving emergence of these diseases.

Methods
In this study, we examine both environmental and anthropogenic factors and their relation to the emergence of EIDs, focusing on historical trends from 1975 to 2020. We focus on 10 diseases with pandemic and epidemic potential. Spatial data on outbreaks in humans and animals from 1975 to 2020 were retrieved from the GIDEON database. Using Bayesian statistical models, we pinpoint regions at increased risk, and we focus on a new indicator based on the human-forest proximity.

Conclusions
Our results show that human-forest proximity together with biodiversity loss, and high population density increase the likelihood of diseases being transmitted from animals to humans, influencing where outbreaks occur among human populations. Lastly, we introduce a country vulnerability index that combines our risk assessment with the IHRC3 indicator from the WHO, which gauges a country’s capability to handle zoonotic diseases. These combined indices help us to assess each country’s ability to respond to an outbreak. The study also addresses data limitations and proposes directions for future research, emphasizing the importance of our findings in shaping public health policies and decision-making.

Key messages
• Anthropogenic drivers shape the distribution of outbreaks in human populations.
• Human-forest proximity exacerbates the likelihood of Emerging Infectious Disease.
Level of tobacco dependence and beliefs towards heated tobacco products
Authors: Gradowicz-Prajsnar B , Kozela M , Sytnik-Czetwertyński J , Polak M 
Published: October 2024

Abstract

Nicotine dependence affects not only behaviors related directly to smoking, quit attempts or looking for alternative products but also beliefs about smoking. We sought to assess whether the level of tobacco dependence is associated with beliefs and feelings towards heated tobacco products (HTP) and to assess the relationship between tobacco dependence and the motivators to quit HTP use. Random population sample of Polish citizens aged 18+ years, former smokers, current HTP users was recruited. Tobacco dependence was assessed using 5 question; participants were classified into two groups of tobacco dependence (low or high) using a two-stage cluster analysis. An extensive questionnaire on beliefs on HTP use was administered. The χ2 test and logistic regression were used. There were 2,500 participants (62.6% women) of median age=36 years (Q1=29, Q3=45). The median number of years of smoking was 10 (Q1=5, Q3=15) and median number of years of HTP use was 2 (Q1=1, Q3=3). High tobacco dependence was found in 958 (38,3%) participants. Compared to low dependence, high tobacco dependence was related with feeling of strong need for HTP use (69.7% vs. 47.6%, p &lt; 0,001). High level of tobacco dependence was positively related to perceived social pressure against smoking (72.9% vs. 44.9%, p &lt; 0,001), but it did not differentiate perceived social pressure against HTP use. Compared to low tobacco dependence, participants with high tobacco dependence more often indicated fear of illness OR = 1,73 95%CI=1,46-2,07, own resolution OR = 1,32 95%CI =1,12-1,55 and price OR = 1,34 95%CI=1,13-1,59 as possible motivators to quit HTP use. Level of tobacco dependence in former smokers shaped beliefs and feelings towards HTP use. High tobacco dependence contributed to strong need to use HTP and also increased perception of social pressure against smoking, but not against using HTP. It also increased the importance of fear of illness, price and one’s own resolution as motivators to quit HTP use.

Key messages
• High level of tobacco dependence in former smokers results in stronger perceived social pressure against smoking but not against HTP use.
• High tobacco dependence in former smokers is related with stronger need to use HTP.
CKD incidence, predictors & progression: African migrants vs. Non-Migrants (RODAM cohort study)
Authors: Mungamba M M , Chilunga F P , van der Linden E L , Beune E , Hayfron-Benjamin C F , Meeks KAC , Vogt L , van den Born B J , Nkeh-Chungag B N , Agyemang C O 
Published: October 2024

Abstract

Background
Limited longitudinal data exist on chronic kidney disease (CKD) in African populations undergoing epidemiological transitions. We investigated incidence, long-term predictors, and progression of CKD among Ghanaians residing in rural- and urban-Ghana, and Ghanaian migrants in the Netherlands (Amsterdam).

Methods
We analysed data from 2183 participants in the transcontinental population-based prospective RODAM-cohort, followed for approximately seven years. CKD incidence and its progression to end-stage renal disease (ESRD) were defined using KDIGO criteria. CKD incidence was calculated using age-and sex-standardization for those without CKD at baseline. Long-term predictors of CKD incidence were identified using one-step robust Poisson regression. CKD progression to ESRD from baseline was also assessed using robust Poisson regressions.

Results
Overall age-and-sex standardized CKD incidence was 11.0% (95%CI; 9.3%-12.3%). Rural and urban-Ghanaians had higher CKD incidence (12.5%;8.5%-15.5%; 12.3%;8.2%-15.8%; respectively) than Amsterdam-Ghanaians (7.6%; 5.4%-10.6%). Residence in Amsterdam was associated with lower CKD incidence compared to rural Ghana after adjustments (Incidence Rate Ratio=0.34; 0.13-0.89), but not with urban-Ghana (IRR=1.07; 0.69-1.67). CKD incidence predictors were advanced age, female sex, alcohol consumption, uric acid levels, and hypertension. CKD progression to ESRD was 2.5% (1.4%-3.6%) in rural- Ghana, 2.3% (1.3%-3.2%) in urban-Ghana and 0.0% in Amsterdam.

Conclusions
One-tenth of Ghanaians developed CKD over seven-years, with higher incidence in Ghana compared to Europe. Age, female sex, alcohol use, uric acid levels, and hypertension were predictive factors. CKD progression to ESRD was minimal. High CKD incidence among Ghanaians, especially among non-migrants, calls for in-depth assessment of contributing factors and targeted interventions.

Key messages
• We observed higher CKD Rates in Rural/Urban Ghana vs. Amsterdam:Indicating geographic Disparities.
• CKD Predictors: Age, Sex, Alcohol, Uric Acid, Hypertension (Minimal ESRD Progression). Interventions target: Non-Migrant Ghanaians.
Persistent organic pollutants and developmental trajectories of ADHD symptoms: The Rhea cohort study
Authors: Mouatsou C , Margetaki K , Kampouri M , Psoma S , Roumeliotaki T , Vafeiadi M , Chatzi L , Kogevinas M , Koutra K 
Published: October 2024

Abstract

Background
Prenatal exposure to persistent organic pollutants (POPs) has been linked to elevated symptoms related to attention deficit hyperactivity disorder (ADHD) in a few studies, but findings remain inconclusive. We aimed to explore how prenatal exposure to POPs affects the developmental course of ADHD symptoms from early childhood to adolescence in the Rhea cohort in Crete, Greece.

Methods
We determined concentrations of HCB, DDE, and PCBs in first-trimester maternal serum. Child ADHD symptoms were reported by mothers using the ADHD Test at 4 years and the Conners’ Parent Rating Scale at 6, 11 and 15 years. Group-Based Trajectory Modeling was used to classify 551 participants into 4 distinct groups: Stable low (60.1%), Stable high (9.6%), Low-increasing (14.6%), and High-decreasing (15.7%) symptoms. Adjusted multinomial regression models were applied to assess the risk of being grouped into an adverse developmental trajectory as compared to the reference group (stable low), in relation to prenatal POP exposure in 465 children. The analyses were performed in sex-specific manner.

Results
Prenatal HCB exposure was associated with elevated risk of being grouped in the stable high ADHD symptoms trajectory only in girls (RRR [95%CI]: 2.0 [1.04, 3.82]). Overall, exposure to DDE and sum of PCBs was linked to decreased risk of membership in an adverse ADHD symptoms trajectory. More specifically, in utero exposure to DDE and sum of PCBs was associated with lower risk of being grouped in the low-increasing trajectory for boys (RRR [95%CI]: 0.7 [0.54, 0.95] and 0.5 [0.32, 0.88], respectively) and in the high-decreasing symptoms group for girls (RRR [95%CI]: 0.6 [0.44, 0.84] and 0.5 [0.30, 0.93], respectively).

Conclusions
The findings suggest that prenatal exposure to HCB is linked to increased risk of stable high ADHD symptoms from preschool age and up to adolescence. The association was pronounced only in girls, a group for which less is understood in relation to ADHD.

Key messages
• Prenatal exposure to HCB increases the risk of persistently high ADHD symptoms from preschool age to adolescence.
• The impact of prenatal HCB exposure on ADHD symptoms is evident in girls.
An intergenerational study of mental health among parents and adolescents
Authors: Labriola M , Lund T , Lindholdt L 
Published: October 2024

Abstract

Background
The aim of this study was to examine the association between parents’ mental disorders and adolescents’ self-rated health, using both subjective and objective assessment of parents’ mental health status.

Methods
This cohort study was based on the Danish Future Occupation of Children and Adolescents cohort. Study population 25,891parents (biological parents or registered guardians) linked to 13,067 adolescents. Survey data were merged with register data on parent mental health, and logistic regression was used to analyse association between the register- and self-report data on parents mental health, and self-rated global health among their offspring.

Results
Adolescents’ self-rated health was associated with their parents’ mental disorders, showing an unadjusted OR of 1.5 (95% CI 1.4-1.6) when assessing parental mental disorders using ICD-10 diagnoses and an unadjusted OR of 2.0 (95% CI 1.8-2.2) when using the adolescents’ self-reported measure on the parental mental disorder. Adjustment for adolescents’ sex, adolescents’ mental disorders during childhood, parental education, and parental labour market attachment led to a decreased association between parents’ mental disorders and adolescents’ self-rated health in both analyses with an adjusted OR of 1.2 (95% CI 1.1-1.4) when assessing parents’ mental disorders using ICD-10 diagnoses and an adjusted OR of 1.8 (95% CI 1.6-2.0) when using the adolescents’ self-reported measure on parental mental disorder.

Conclusions
This study documents a clear pattern in mental disorders across generations and that parental labour market attachment as well as mental disorders in earlier life phases are risk factors for developing mental disorders in adolescence. The results point to the importance of public health interventions aimed at the more vulnerable group of adolescents, where mental health problems are observed over two generations.

Key messages
• There is a clear pattern in mental disorders across generations.
• Parental labour market attachment are risk factors for developing mental disorders among their offspring.
Demographic, socioeconomic and lifecourse risk-factors for internalized weight stigma
Authors: Hughes A , Flint S W , Clare K , Kousoulis A A , Rothwell E R , Bould H , Howe L D 
Published: October 2024

Abstract

Background
Obesity is highly stigmatized, with negative obesity-related stereotypes widespread across society. Internalized weight stigma (IWS) is linked to negative outcomes including poor mental health and disordered eating. Previous evidence examining population groups at higher risk of experiencing IWS comes from small, nonrepresentative samples. Here, we re-assess previously reported associations of IWS with social factors in a large general population birth cohort study for the first time.

Methods
In the Avon Longitudinal Study of Parents and Children (ALSPAC), we explored differences in IWS at age 31 years by sex, ethnicity, socioeconomic factors, and sexual orientation using multivariable regression. Using data collected over a 32-year period, we explore the impact of family, peer, and wider social influences in adolescence, and bullying from mid-childhood to adulthood, whilst minimising risk of recall bias.

Results
In models adjusted for potential confounders and BMI in childhood, adolescence, and adulthood (N = 4060), IWS was higher for females (0.56 S.D. higher, CI:0.50-0.61), sexual minorities (0.17 S.D. higher, CI:0.09-0.24), and less socioeconomically advantaged individuals (0.16 S.D. higher (CI:0.08-0.24) for those whose mothers had minimum or no qualifications, compared to a university degree). The social environment during adolescence and young adulthood was important: IWS was higher for people who at age 13 years felt pressure to lose weight from family (0.13 S.D., CI:0.03-0.23), and the media (S.D. 0.17, CI:0.10-0.25), or had experienced bullying (0.25 S.D., CI:0.17-0.33 for bullying at age 23 years).

Conclusions
Internalized weight stigma differs substantially between demographic groups, and this is not explained by differences in BMI. The family environment during adolescence, bullying, and pressure to lose weight from the media may have long-lasting impacts on adult IWS. These may be fruitful avenues for intervention to reduce IWS and its consequences.

Key messages
• Females, sexual minorities, and socioeconomically disadvantaged adults are at greater risk of IWS irrespective of BMI.
• To reduce IWS, interventions should improve the family and social environment.
Workplace health promotion in the German Federal Armed Forces-Economic analysis and health benefits
Authors: Ludwig S , Seeland U , Arnold L , Roehle R , Dickob C , Hauck M , Ucar J , Willich S N , Reinhold T , Roy R 
Published: October 2024

Abstract

Background
In the German Federal Armed Forces (GFAF) workplace health promotion measures (WHPM) are implemented since 2015 to promote the health of military and civilian employees and thus improve the ability to defend state interests. Here the aim is to evaluate the social and health benefits associated with WHPM in relation to expenditures for WHPM.

Methods
Calculations are based on data from departmental reporting (full survey) on WHPM, the number of participants and days of incapacity for work (DIW). Mean indirect costs for the WHPM participation and DIW were calculated as 249.33 Euro per DIW. To assess the costs for the use of health care services and social and health benefits a longitudinal observational study (T0: 06-09/2022; T1: 06-09/2023) was conducted online and paper based. The survey invitation was addressed to 223.967 employees of the GFAF. Statistical analyses were performed using R software.

Results
In departments offering WHPM the chance of DIW is lower (-19%) compared to departments without WHPM offers and in case of DIW, the duration is shorter (-10%). In T0 23.568 (10.5%) and in T1 14.059 (6%) employees participated. 63.9% (T1: 3.070/4.805) reported positive effects of WHPM on their working ability and general health status (T1: 63.0% (3.013/4.782)). Of those participating in WHPM 81% (T0: 5.442/6.716) would recommend the GFAF as an employer. A number of 4.540 employees participated in both surveys, of which 2.249 participated in WHPM. The average costs per employee participating in WHPM compared to employees not participating are 0,4% higher (T0; T1: 3,5%) and thus almost equal.

Conclusions
Although WHPM need expenditures, the total costs per employee participating and not participating in WHPM are comparable. WHPM participants report better self-rated health status, higher working ability and commitment to the employer than non-participants. The chance of DIW is reduced in departments offering WHPM to its employees.
*shared authorship

Key messages
• Although WHPM need expenditures, the total costs per employee participating and not participating in WHPM are comparable.
• Employees participating in workplace health promotion measures report higher working ability and commitment to the employer.