bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of childhood mental health and cardiovascular risk in adolescence and young adulthood
Authors: Büschges J , Beyer A-K , Schmidt-Trucksäss A , Berger K , Neuhauser H 
Published: October 2024

Abstract

Introduction
Mental health (MH), and in particular depression, is linked bi-directionally to cardiovascular disease through biological as well as behavioral pathways. Low MH has been associated with behaviors associated closely with cardiovascular risk (CVR) factors, such as reduced physical activity and sleep disturbances. It is not clear at what age the relation between MH and CVR begins to manifest and if MH in the young is also associated with vascular remodeling, operationalized as carotid-intima media thickness (CIMT).

Methods
We investigated the longitudinal association between childhood MH problems (age 3 to 17) and CVR factors as well as CIMT from carotid sonography in 4,361 14 to 28-year-olds of the KiGGS cohort. Using linear regression analyses adjusted for socioeconomic status, we analyzed the association of the Strength and Difficulties Questionnaire (SDQ) score with systolic blood pressure (SBP), body mass index (BMI), total cholesterol (TC), and CIMT in z-scores by sex and age. Additional cross-sectional analyses included scores of the Mental Health Inventory (MHI-5) and Patient Health Questionnaire (PHQ-9) in young adulthood.

Results
Childhood SDQ scores were significantly associated with SBP, BMI and TC one decade later (-0.03 ≤ ß ≥ 0.02). Cross-sectionally, no association of MHI-5 scores in young adults with CVR factors was found. PHQ-9 scores in young adults were associated significantly with SBP and BMI (-0.26≤ ß≥ 0.01). The investigated MH problems from childhood to young adulthood were not linked to CIMT.

Conclusions
Our results confirm an early association of MH with the examined CVR factors. However, we could not find evidence for an association between MH and vascular remodeling in this population-based sample of adolescents and young adults. Our results emphasize the importance of prevention strategies focusing on both, physical and MH of the young, in order to prevent vascular damage later in life.

Key messages
• Our results show an early association of childhood mental health with the examined cardiovascular risk factors systolic blood pressure, body mass index and total cholesterol one decade later.
• Our results confirm the importance of prevention strategies focusing on both, physical and mental health of the young.
Professional support for children or adolescents whose mental well-being is at risk
Authors: Putkuri T , Latva-Korpela I , Häkkinen M 
Published: October 2024

Abstract

Background
Children and adolescents’ mental health issues are globally among the most significant concerns. Research on the topic often focuses on already manifested mental health problems, and research concerning mental well-being and the preferences of service users regarding early-stage support is scarce. This study aimed to define what professional support experts-by-experience hope for a child or adolescent in situations where mental well-being is threatened.

Methods
The qualitative study with focus group interviews was conducted in Finland during the autumn of 2022. Participants (n = 26) were experts-by-experience who had experienced threats to mental well-being either during their own childhood (before the age of eighteen years) (n = 19) or through the perspective of being a parent (n = 3), or both (n = 4). The data was analyzed using inductive content analysis.

Results
In situations where the mental well-being of children or adolescents is at risk, professionals working with families were expected to 1) demonstrate an appreciative and compassionate attitude, 2) provide a daycare environment or school environment that supports mental well-being, 3) support the participation of children and adolescents, 4) involve and support family, 5) organize peer support, and 6) provide services that are seamless and need-adapted.

Conclusions
The results help to develop services supporting mental well-being, considering the perspective and preferences of service users. During the study, one model identified to meet the participants’ desires was the Open Dialogue Approach originally developed in Finland.

Key messages
• In services supporting mental well-being, ensuring the child’s or adolescent’s participation and involving parents is important.
• In addition to the support provided by professionals, the significance of peer support was highlighted. Professionals should actively refer service users to peer support.
Longitudinal analyses (2018-2022) of the COVID-19 impact on Swiss pediatric healthcare utilization
Authors: Dey M , von Rhein M , Volken T , Chaouch A , Laasner U , Seiler M , Dratva J 
Published: October 2024

Abstract

Background
The impact of COVID-19 on healthcare utilization in the early pandemic is well documented. However, studies on changes in both primary and tertiary pediatric healthcare utilization that considered data beyond the first pandemic year is lacking.

Methods
National health insurance data (primary care) and pediatric emergency department data (tertiary care) from Jan. 2018 - June 2022 and on 0-18-year-olds were analyzed with interrupted time series. The first lockdown was used to differentiate between pre-pandemic and pandemic periods.

Results
Several healthcare services yielded significantly lower average utilization rates during the pandemic vs. the pre-pandemic period, particularly in the youngest age groups. In primary care, the relative utilization, compared to the pre-pandemic mean, dropped in regards to regular (0-5y: 0.760 [0.644-0.896]; 6-10y: 0.850 [0.742-0.974]), well-child (0-5y: 0.871 [0.765-0.992]), and urgent visits (0-5y: 0.638 [0.500-0.813]; 6-10y: 0.810 [0.665-0.985]), and for the vaccination against measles/mumps/rubella (MMR; 0-5y: 0.841 [0.729-0.971]). Similarly, in tertiary care, this pattern emerged for non-urgent (Zurich: 0.55 [0.482-0.627]; Geneva: 0.526 [0.435-0.636]; Ticino: 0.502 [0.436-0.578]) and urgent visits (Zurich: 0.573 [0.498-0.659]; Geneva: 0.487 [0.375-0.632]; Ticino: 0.676 [0.57-0.802]). The utilization rates of most services dropped markedly after the lockdown and recovered to some extent over the pandemic phase. However, no recovery was found for the MMR-vaccination. In primary care, higher average utilization rates during the pandemic were identified for telephone consultations (0-5y: 1.394 [1.218-1.594]; 6-10y: 1.547 [1.387-1.726]; 11-15y: 1.578 [1.430-1.741]; 16-18y: 1.831 [1.614-2.076]).

Conclusions
The pandemic’s effect on utilization seemed to have occurred temporarily, but it cannot be ruled out that some children have not fully caught up on preventative measures (well-child visits and MMR-vaccinations).

Key messages
• Pediatric healthcare utilization dropped considerably immediately after the lockdown, with the most pronounced decrease observed in the youngest children.
• The heterogenous recovery over the pandemic period points to the necessity to continue to monitor utilization rates, catch-up visits, and vaccination statistics.
Long-term care facilities: what do we know about multidrug-resistant organisms in this setting?
Authors: Hidad-Nuh S , de Greeff S C , Haenen A , de Haan F , Leusink G L , Timen A 
Published: October 2024

Abstract

Background
People with intellectual disabilities (ID) are an often overlooked high-risk group for health-related issues. In the Netherlands, people with ID may reside at home, in small communities, or within long-term care facilities. This diverse living arrangement challenges the healthcare system, with responsibilities spread among multiple formal and informal caregivers. During an outbreak with multidrug-resistant organisms (MDROs), coordinated efforts should be made to prevent further spread throughout all healthcare settings. Therefore, adequate infection prevention and control (IPC) practices, are required to improve or maintain individual health outcomes. To understand the complexity of MDROs in long-term care for people with ID, it is important to gain insight into knowledge, attitudes and perceptions of involved healthcare professionals and, investigate innovative strategies that could play a role in surveillance or monitoring an outbreak within this setting.

Methods
We conduct several studies in long-term care for people with ID, using a wide scale of methodologies including a cross-sectional survey study and innovative quantitative methods, such as wastewater surveillance.

Results
We have identified several challenges in long-term care for people with ID related to IPC and MDROs. First, while IPC and MDRO guidelines exist, they lack specific context and applicability to the long-term care setting. Second, proper use of hand gloves among healthcare professionals demands increased attention as knowledge about this preventive measure seems to be insufficient. Finally, given the challenges in sample collection for MDRO screening, non-invasive strategies are needed to offer insight during outbreaks, serving surveillance or outbreak management purposes.

Conclusions
Insights from these studies could inform future strategies to prevent or respond early in case of an MDRO outbreak within long-term care for people with ID.
Long-term effects of unintended pregnancies carried to term on mothers and children
Authors: Beumer W Y , Koot M H , Vrijkotte T , Roseboom T J , van Ditzhuijzen J 
Published: October 2024

Abstract

Background
Research on psychological effects of unintended pregnancies that are carried to term presents mixed results, and evidence on long-term associations is scarce. The aim of the current study was to examine effects of unintended pregnancies carried to term on both mothers and children, up to 16 years postpartum.

Methods
This study is based on the Dutch population-based birth cohort study ‘Amsterdam Born Children and their Development’ (ABCD-study), which included pregnant people in 2003 (n = 7784) and is still following these mothers and their children. Structural Equation Models were analyzed per time-point, examining associations between unintended pregnancy and maternal psychosocial distress, and children’s internalizing- and externalizing problems, while controlling for co-occurring risks. Further, mediating effects via maternal mental health and bonding on children were assessed.

Results
Around 5 years postpartum, pregnancy mistiming was positively associated to maternal psychological distress. Antenatal psychological distress was a much stronger predictor of maternal psychological distress than unintended pregnancy. Pregnancy mistiming was a significant predictor of internalizing and externalizing problems and unwanted pregnancy of internalizing problems in the children from these pregnancies, around 5 years postpartum. These associations were mostly mediated by maternal mental health and poorer maternal bonding. All associations were no longer present at 12 and 16 years postpartum.

Conclusions
Unintended pregnancies often coincide with maternal mental health problems, and results showed that associations between unintended pregnancy and both mother’s and children’s psychosocial problems are strongly influenced by maternal mental health. Therefore it is important to improve maternal mental health for the benefit of both mother and child, rather than on the isolated effect of unintended pregnancy.

Key messages
• Carrying an unintended pregnancy to term impacts psychological health in both mothers and their children up to 5 years but no longer at 12 or 16 years postpartum.
• The effects of unintended pregnancy on psychological health in mothers and children are mostly explained by maternal mental health and bonding, so the focus should be on improving these.
Impact of Adverse Childhood Experiences on Child Development in South America: A Systematic Review
Authors: Cooklin Urbano S , Hurt L , Copeland L 
Published: October 2024

Abstract

Background
Adverse Childhood Experiences (ACEs) have garnered attention globally for their detrimental effects on children’s development, such as lower communication, gross and fine motor, and personal-social domains. While extensively studied in high-income countries, there remains a gap in understanding their prevalence and impact in low- and middle-income countries (LMICs). This review aimed to identify, evaluate, and summarize the findings of an association between ACEs and children’s developmental and mental health outcomes in South America

Methods
A systematic review was conducted to investigate the association between ACEs and childhood development in South America. Databases MEDLINE, PsycINFO, Web of Science, Applied Social Sciences Index and Abstracts, Literatura Latino Americana em Ciências da Saúde, IBECS and CINAHL were searched. Selection criteria encompassed studies from Brazil, Colombia, Argentina, Peru, Venezuela, Chile, Ecuador, Bolivia, Paraguay, Uruguay, Guyana and Suriname examining the effects of ACEs on developmental outcomes and mental health disorders in children under 18 years old. Quality assessment aligned with World Health Organization standards was employed.

Results
Twenty-four studies met the inclusion criteria, with most categorized as low or very low quality. While the majority demonstrated a significant association between ACEs and developmental or mental health outcomes, a few studies reported null findings. Challenges in study quality, such as small sample sizes and selection bias, were identified.

Conclusions
Despite limitations in study quality, findings underscore the impact of ACEs on child development and mental health in South America. Because of the low quality of the existent studies the next steps should be to grasp a greater understanding of the issue. This review also highlights the urgency for further research and targeted interventions to mitigate the long-term consequences of ACEs in this region.

Key messages
• ACEs profoundly affect child development and mental health in South America, necessitating urgent attention and intervention.
• Addressing the impact of ACEs in South America is critical for fostering healthier developmental trajectories and enhancing public health outcomes.
Influence of socio-economic factors on obstetric morbidity in Eastern India: A study based on NFHS 5
Authors: Gupta N , Raj P 
Published: October 2024

Abstract

Background
Obstetric morbidity encompasses health issues related to pregnancy or childbirth, excluding accidental causes. The whole process of childbearing is not just a biological phenomenon, rather it is governed by personal, social, cultural, and institutional factors. The entire eastern region of India including the four provinces of Bihar, Jharkhand, Odisha, and West Bengal is susceptible to high maternal mortality and morbidity. It presents a strong background to further envisage the factors responsible for such situation. Thus, the study aims to explore regional variations and socio-economic factors associated with obstetric morbidity among women in eastern India.

Methods
This study uses data from the 2019-2021 National Family and Health Survey (NFHS 5). The explanatory variable, obstetric morbidity, includes issues during pregnancy and delivery- vision difficulties, bleeding, swelling, convulsions, fever, breech presentation, and prolonged labor. Predictor variables include age, age at marriage and first birth, wealth index, residence, toilet facility, caste, working status, media exposure, religion, birth order, and education level. Bivariate and binary logistic regression analyses have been used as a methodological tool.

Results
In the eastern region, 53.76% women experience obstetric issues. Women belonging to 15-24 years with higher educational attainment increases the prevalence of obstetric morbidity. The probable reason is, with education, awareness about reproductive morbidity increases and in turn the reporting for morbidity increases. Therefore, the findings showed age, educational attainment, wealth quintile, media exposure, residence, work status, birth order and toilet facilities are highly associated with obstetric morbidity among women.

Conclusions
Implementing of targeted interventions, and awareness campaigns are crucial to reducing obstetric complications and maternal mortality in the eastern region of India

Key messages
• Socioeconomic correlates impact obstetric morbidity in eastern India in manifolds especially education, age, and wealth quintile of women in eastern India.
• Obstetric morbidity is a growing concern in eastern India, thus implementing targeted interventions and awareness campaigns are much needed.
Preparedness for and collaboration during regional outbreaks with multidrug-resistant organisms
Authors: Beishuizen B , Stein M L , Tostmann A , Rovers C P , Timen A 
Published: October 2024

Abstract

Background
Outbreaks with multidrug-resistant organisms (MDROs) are a significant burden on the healthcare system and the wellbeing of affected patients and carriers. Cross-institutional MDRO outbreaks require a concerted multidisciplinary effort for effective outbreak management. This presents challenges regarding cooperation, coordination and communication between stakeholders. In this study, we investigate collaborative structures and coordination roles in Dutch outbreak response networks and how Dutch healthcare professionals engage in preparedness activities relating to MDRO outbreaks. These findings form the basis for the development of a stress test exercise for improving professional and organizational collaboration and coordination during MDRO outbreaks.

Methods
Using a mixed-methods design, an online survey and qualitative interviews are conducted among healthcare professionals in two healthcare regions in the Netherlands. Social network analysis is used to gain insight in collaborative structures and brokerage roles. To investigate preparedness activities, the survey is combined with qualitative interviews to explore respondents’ experiences, preferences and needs regarding preparedness activities for MDRO outbreak management.

Results
During the workshop we will show the cross-organizational network structures, the strengths and weakness of the mutual connections and provide insight in positions in networks, roles and responsibilities. Also, we provide insight in how the use of and experience with training and exercise activities, such as stress tests, contribute to preparedness for MDRO outbreaks in vulnerable patient populations.

Conclusions
This study shows how healthcare professionals from different organizations collaborate during MDRO outbreaks, and how they engage with preparedness activities. This provides valuable input for development of a stress test specific to MDRO outbreak management, and other interventions to improve outbreak preparedness.
Correlation between vaccine hesitancy, vaccine reliability and perceptions of infectious diseases
Authors: Bal M , Yücel E , Salış E , Dinleyici M , Arslantaş D , Ünsal A 
Published: October 2024

Abstract

Background
Vaccine hesitancy is a delay in vaccine acceptance or refusal despite the availability of vaccination services. In recent years, the rise in vaccine hesitancy has attracted attention. This study aimed to evaluate the perception of vaccine hesitancy, vaccine safety, and infectious diseases among parents.

Methods
This cross-sectional study was conducted with 503 parents who applied to the pediatrics outpatient clinic of a university hospital. The questionnaire used in the study included questions on sociodemographic characteristics, factors related to vaccine hesitancy, The Vaccine Hesitancy Scale (VAS), the Vaccine Safety Scale (VSS), and the Perception Scale for Infectious Diseases (PPSID). Multivariate Linear Regression Analysis was used to find the variables associated with vaccine hesitancy.

Results
The mean age of the parents was 37.6±7.6 years. Parents’ scores on the ATS ranged from 17-85, with a mean score of 20.1±6.6 points. A moderate negative correlation was found between parents’ VAS and VSS scores, and between VAS and PPSID scores (r=-0.412, p &lt; 0.001; r=-0.409, p &lt; 0.001, respectively). According to the multivariate linear regression analysis the variables found to be associated with vaccine hesitancy, income status, maternal education level, child’s age group, having information about childhood vaccination schedule, child’s immunization status, the necessity of childhood vaccines, having sufficient information about the safety of vaccines, vaccine safety level, and infectious disease perception level were found to be significant predictors of vaccine hesitancy (F: 12,844, p ≤ 0.001, R2: 0.334).

Conclusions
This study determined that vaccine hesitancy was higher in families with lower income, who have not completed the schedule nor been vaccinated, doubt the necessity of vaccines to prevent infectious diseases, lack of knowledge about the reliability of vaccines, and whose children are still in primary school.

Key messages
• Health professionals have a critical role in reducing vaccine hesitancy.
• It would be appropriate to plan face-to-face or online programs with parents.
Implementation as the acid test: International lessons from Universal Health Coverage reforms around the world
Authors: Farsaci L 
Published: October 2024

Abstract

Introduction
Health systems around the world are moving towards Universal Health Coverage, which is included in the Sustainable Development Goals. However, the journey towards UHC began decades ago, with countries in Europe introducing national health services following World War II. This was mirrored in Canada and, more recently, countries in Latin America introduced health reforms as part of broader social movements. Since the millennium, reforms have also taken place in Low and Middle Income Countries as well as High Incomes Countries. However, because the introduction of UHC often necessitates far-reaching reforms, countries face significant challenges along the path of policy implementation.

Methods
A realist review explored international experiences of introducing and implementing UHC. Embase, Medline and Web of Science were searched. Descriptive, inductive and deductive realist analysis aided the development of Context, Mechanism, Outcome Configurations, alongside stakeholder engagement.

Findings
How countries go about establishing UHC depends on their social, political, cultural and economic contexts. For reforms to be facilitated, there must be cohesion and commitment across all systems, as well as the functions of financing, governance and service delivery. This includes political support, often underpinned by legislation framing healthcare as a human right, as well as communication between stakeholders and the development of a strong primary care sector. Conversely, fragmentation across these systems and functions pose significant barriers to reform.

Conclusions
Examining international experiences of UHC reforms supports learning around the factors that facilitate or challenge implementation. These learnings empower policy makers and health system leaders by providing roadmaps for reform implementation. Finally, this research provides insights into health inequities that are rebalanced through the implementation of UHC reforms.