bluuebunny/crossref_metadata_2025_split huggingface dataset:
Operationalizing Macro-Level Structural Sexual Minority Stigma: A Scoping Review of the Literature
Authors: van der Star A , Garetti O 
Published: October 2024

Abstract

Background
Structural stigma, including discriminatory laws, inequitable policies, and negative attitudes, has been conceptualized as the general societal climate and institutional conditions that shape sexual minorities’ lives, mental, and physical health. While multidimensional indices have been used globally, U.S.-based studies have largely relied on single indicators (e.g., a law or policy; presence of resources). This scoping review aimed to identify structural sexual minority stigma indicators relevant to the U.S. context, to inform comprehensive, multidimensional future operationalizations.

Methods
Systematic database searches in PubMed, PsycINFO, and JSTOR, and snowball techniques resulted in 70 articles. After duplicate deletion and abstract review, 25 unique indices were long-listed relevant to structural sexual minority stigma at country or state level (i.e., macro level). School (district) and county (i.e., exo level) indicators were excluded.

Results
From the long-listed indices, a total of 112 legal and policy indicators were narrowed down to relevant 33 macro-level indicators and grouped across seven domains: criminal justice, hate crime protections, non-discrimination, religious refusal, relationship recognition, parenting, and youth laws and policies. Two different quantifications of population attitudes were identified that aggregated social and policy opinions across states regarding sexual minority adoption, hate crimes, health benefits, labor and housing, public speaking or teaching, marriage, sodomy, and civil unions.

Discussion
While a large variety of legal and attitudinal indicators was identified, few U.S.-based studies used multidimensional operationalizations (e.g., law, policy, opinion) needed to reduce risk of confounding bias through population-attitudes-to-law/policy backdoor pathways. To further advance the science on structural sexual minority stigma and health globally, future studies may benefit from multidimensional approaches.

Key messages
• With many legal and attitudinal indicators identified, few studies used multidimensional operationalizations (e.g., law, policy, opinion) needed to reduce risk of confounding bias.
• To further advance the science on structural sexual minority stigma and health globally, future studies may benefit from multidimensional approaches.
Gender-specific impact of COVID-19 in the UAE: Analyzing gender disparities in health and well-being
Authors: Saddik B , Shukla A , Zeidan R 
Published: October 2024

Abstract

Background
Understanding gender disparities in health impacts during pandemics is crucial. While early observations of the COVID-19 pandemic suggested higher severity and mortality rates among males, subsequent studies hinted at a disproportionate impact on females’ health and well-being. This study aimed to explore gender-specific differences related to COVID-19 in the United Arab Emirates (UAE).

Methods
Data from four independent surveys were analyzed to assess gender differences in knowledge about available vaccines, vaccine hesitancy, COVID-19 severity, admission to the Intensive Care Unit (ICU), anxiety among healthcare workers (HCWs), and psychological health of healthcare workers and the general population. Gender gaps were calculated as the absolute difference between males and females. Chi-square tests and logistic regression were performed to test the association between gender, age, and selected outcome variables.

Results
Males had a significantly higher risk of moderate to severe COVID-19 symptoms (71%) compared to females (63%). The gender gap in symptom severity was smallest among those aged 55+ and highest among adults aged 35-54. Post-discharge, 22% more females reported multiple conditions than males. Among HCWs, females showed lower knowledge (19% gap) and higher vaccine hesitancy (20% gap), with larger gaps among older age groups. Females also experienced more anxiety and psychological stress, especially in the 35-54 age group. Logistic regression confirmed higher odds for females in reporting vaccine hesitancy, long COVID-19 symptoms, and anxiety, even after adjusting for demographic factors.

Conclusions
This study highlights unequal health outcomes and burdens experienced by women and men during the COVID-19 pandemic in the UAE. The distinct challenges faced by women, including higher mental health burdens and persistent post-recovery symptoms, suggest systemic gender disparities that require targeted attention in healthcare policies and practices.

Key messages
• Gender disparities in COVID-19 were evident in the UAE with males experiencing severe COVID-19 symptoms, while females experienced post-recovery symptons, vaccine hesitancy, and stress.
• Urgent action is required to address gender disparities in COVID-19 impacts, emphasizing mental health support and post-recovery care in policy formulation.
Intention to use HIV pre-exposure prophylaxis (PrEP) in health sciences students
Authors: Vicente Molina F , Ramos Tenorio M P , Sosa Gonzalez Y R , Hernandez Rico M , Villegas-Dominguez J E , Hernandez Rico M , Sosa Gonzalez Y R 
Published: October 2024

Abstract

Introduction
HIV is a public health issue, and as such, there are currently programs for the use of pre-exposure prophylaxis for HIV (PrEP) in various public institutions, with family physicians being one of the pillars to provide information and raise awareness among individuals at risk for HIV who wish to use these strategies.

Objectives
To determine the factors associated with the intention to use PrEP among university students in the healthcare field in the Veracruz-Boca del Río region.

Methods
A cross-sectional, prospective, and analytical study was conducted from August 2023 to March 2024, including students from healthcare-related majors at universities in the Veracruz region. An instrument was used to assess the level of knowledge about PrEP (Cronbach’s alpha of 0.8), with scores ranging from 0 to 10. Students were invited to participate in this research at different faculties of health sciences.

Results
508 subjects participated, with 299 (58.9%) females and 386 (76.0%) heterosexual; 65.9% had never heard the term ‘PrEP,’ and 12% learned it from social media. The intention to use PrEP was positive in 81.5% of subjects in case of becoming a high-risk person for acquiring HIV. The level of knowledge about PrEP showed a score of 2.2 (SD ± 2.6), with 3.7% having high knowledge, 10.2% having a passing grade, and 55.9% scoring above the median (1.4) of the group’s scores. No association was identified between gender identity, sexual orientation, academic characteristics, and sources of information with the intention to use PrEP (p &gt; 0.05). Knowledge level above the median of 6 points showed an odds ratio of 2.95 (95% CI 1.03-8.3) for the intention to use PrEP (p &lt; 0.05).

Conclusions
The level of knowledge increases the probability of the intention to use PrEP in young people, making it essential for the primary care physician to carry out this training and awareness activity within their daily interactions with young patients.

Key messages
• It is essential to generate education programs on Prep for the population, as this will favor informed decision making on the use of these medicines in case they are required.
• It is necessary to provide people with general information about Prep, since despite the existence of active programs for its distribution, most people have never heard anything about this drug scheme.
Injury risk in foreign workers: a proposal for a prevention plan in South Tuscany
Authors: Guerreschi E M , Francini C , Giomarelli A , Nante N 
Published: October 2024

Abstract

Background
There are nearly 2.3 million foreign workers in Italy, many of whom hold low-skilled and heavy jobs that expose them to greater safety risks. The aim of the study is to analyze data on the accident phenomenon by using information flows from the national work accident insurance institute, in order to ensure a safe and inclusive work environment.

Methods
The total number of foreign workers’ accidents in the South Tuscany during the five-year period 2017-2021 was quantified. General injury trend was assessed, breaking down the events by province (Siena, Arezzo, Grosseto), year of occurrence and severity. We analyzed the events by nationality of the injured ones and by severity of compartment.

Results
A total of 38,254 occupational accidents were recorded, of which 6,172 (16.13%) occurred to foreign workers. Compared to the incidence of foreigners residing in the reference territory, the accident figure is 16.13% out of the 10.5% resident population. The majority involve people from Eastern Europe (60.8%). The most representative nationalities are: Romania (1,477 events), Albania (1,022), Morocco (404), Macedonia (341), Kosovo (264), Tunisia (190) and India (170). Romanian workers are the population most affected by occupational injuries in Southeast Tuscany with 1,477 events. Agriculture is the predominant sector with 17.7% of total injuries.

Conclusions
Information flows on foreign workers’ accidents is the starting point for specific design of prevention plans (supervision, assistance, research, information and training, awareness raising) aimed at reducing specific accident risk factors. Language and cultural differences represent an element of possible conditioning of risk perception, which must be considered in an effective design of safety training courses for foreigners.

Key messages
• The study of accident information flows of foreign workers provides the basis for specific design of prevention plans in order to reduce accident risk factors.
• Language and cultural differences must be considered in an effective design of safety training courses for foreigners.
School-based outdoor education and teacher well-being: the LärMiljö (Learning Environment) - study
Authors: Simonsen N , Wackström N , Ray J 
Published: October 2024

Abstract

Background
School-based outdoor education (OE) is a teaching method aiming to promote pupils’ learning and wellbeing. OE with its action-oriented and cooperative learning approach can inspire teachers to develop their teaching and may also have a positive impact on their work wellbeing. According to self-determination theory, satisfaction or frustration of employees’ basic psychological needs - need for autonomy, competence and relatedness - are important facilitators or impediments of work wellbeing. We explored possible associations between OE use and teachers’ 1) satisfaction/frustration of basic needs at work and b) work engagement.

Methods
The study, part of the LärMiljö-study, used data collected in 2022 through electronic surveys among teachers in Swedish-language primary schools in Finland; N = 134 teachers from 44 schools. Main measures were the 24-item Basic Psychological Need Satisfaction and Need Frustration at Work Scale and 9-item Utrecht Work Engagement Scale. Data was analysed with Mann-Whitney U-tests and Spearman correlation.

Results
The vast majority was female, classroom teachers and had a master’s degree. Preliminary findings show that 69% practiced OE (sporadically or regularly) and 31% did not; both groups were similar in terms of teaching experience, age and gender. Teachers using OE had higher autonomy and competence need satisfaction, and lower relatedness need frustration than teachers not using OE (p &lt; 0.05). There was no difference in overall work engagement (p = 0.07), but OE teachers had higher dedication to work (p &lt; 0.05). Satisfaction of basic needs at work was positively, and frustration of needs negatively, associated with work engagement (p &lt; 0.001).

Conclusions
Practicing OE appears to have positive associations with teachers’ dedication to work and satisfaction of need for autonomy and competence, and a negative association with relatedness frustration. More research is needed to confirm and examine the direction of these associations.

Key messages
• Outdoor education (OE) may besides pupils’ learning and wellbeing also promote teachers’ work wellbeing. Work wellbeing among teachers was studied within the framework of self-determination theory.
• Practicing OE seems to be positively associated with teachers’ dedication to work, a sub-dimension of work engagement, and satisfaction of the basic needs for autonomy and competence at work.
Phenotypes of Italian workers with disability: a cluster analysis on workers with multiple sclerosis
Authors: Ponzio M , Grange E , Di Antonio F , Persechino B , Manacorda T , Inglese M , Durando P , Battaglia M A , Brichetto G , Podda J 
Published: October 2024

Abstract

Background
While job maintaining/reintegrating are clearly complex issues in multiple sclerosis (MS), where many aspects (physical, psychological, relational and personal resources) can play a key role, they offer scope for potential interventions. This study aimed to identify and describe phenotypes of workers with MS considering specific work-related domains such as work-related difficulties, anxiety and depressive symptoms, and coping strategies.

Methods
A cross-sectional online survey on MS workers was conducted in Italy. Hierarchical cluster analysis was performed by the Ward method followed by k-means cluster analysis.

Results
A total of 209 workers with MS were included in the analysis. We identified four phenotypes: phenotype 1 had low work difficulties, low depressive symptoms and mild anxiety, with a moderate tendency to use problem focus and positive attitude and a mild one to use social support as coping strategies (n = 82, 39.2%); phenotype 2 had low-to-mild work difficulties, mild anxiety and low depressive symptoms, with a high tendency to use positive attitude and religion, moderate problem focus and social support, and mild denial (n = 38, 18.7%); phenotype 3 had low-to-mild work difficulties, moderate anxiety and depressive symptoms, with a mild tendency to use problem focus, positive attitude, religion, social support, denial as coping strategies (n = 50, 23.9%); phenotype 4 had mild-to-moderate work difficulties, moderate anxiety and depressive symptoms, with a moderate tendency to use problem focus, positive attitude, and mild social support and denial as coping strategies (n = 39, 18.7%)

Conclusions
This explorative analysis aimed to find distinct workers with MS profiles in a working-age population based on work-related domains such as work-related difficulties, coping strategies, and psychological aspects. This could lead to a better tailoring of the vocational rehabilitation interventions for workers with MS.

Key messages
• This approach, in which different domains related to work are considered, could help to identify a taxonomy that recognizes distinct and predominant MS worker phenotypes.
• Identification of subgroup MS workers, could result in better tailoring of the vocational rehabilitative interventions for people with MS.
Unveiling social disparities in later life: Income’s Impact on mortality among the elderly in Italy
Authors: Frova L , Coppola L , Grande E , Pappagallo M , Siciliani I 
Published: October 2024

Abstract

Background
Income is an important predictor of adult mortality, as a proxy of living conditions, capability and access to health services. Previous studies show that mortality decreases by increasing income. In Italy, studies at a national level are missing. This study aims to investigate inequalities in mortality by income in Italy.

Methods
The analysis is based on the integration of the National Population Register (comprising the resident population as of Dec 31, 2018, and deaths in 2019) and the Income Statistical Register (representing perceived income during 2018). This integration enabled the availability of information on age, sex, residence, education, income, and vital status at the individual level for 13 million people aged 65 or above. Individuals were categorized according to their individual disposable income quintiles both before and after disability benefits. Inequalities by income are assessed by mortality rate ratios (MRR) estimated using negative binomial regression models controlling for demographic and socioeconomic features. The study is carried out within the Next Gen EU-funded project “Age-It Ageing well in an ageing society” (PE0000015), NRRF, M4.C2, Intervention 1.3.

Results
Considering income net of disability benefits, lower income levels are associated with higher mortality rates compared to the highest income level, for both sexes. Inequalities are more marked for men. The highest excess was observed for individuals with the lowest income (male MRR=1.65, 95%CI: 1.6-1.71; female MRR=1.43, 95%CI: 1.38-1.48). The excess decreases with increasing income.

Conclusions
The observed relationships between income and mortality are crucial for targeting policies to reduce health inequalities and promote the well-being of the elderly, the goal of which should be to improve access to social and health care and develop supportive policies for the most disadvantaged people. Further research will be devoted to the use of household income for individuals.

Key messages
• For the elderly, lower income levels are associated with higher mortality, with wider disparities in men.
• The choice of definition of income is essential for an accurate assessment of the association between income and mortality.
Understanding smoking cessation process in Tunisia from 2020 to 2023: description of quit attempts
Authors: Bebses K , Ayedi Y , Fitouri S , Skhiri A , Ben Aissa M , Fourati A , Nsiri Z , Hamdi R , Harizi C , Fakhfakh R 
Published: October 2024

Abstract

Background
Many smokers attempt multiple cessation methods before seeking specialist intervention. This study aims to describe these prior cessation attempts and identify relapse factors to enhance support for these individuals.

Methods
Data from 440 patients consulting the Department of Epidemiology Statistics at Abderrahman Mami Hospital from 2020 to 2023 were analyzed. It included information on previous quit attempts, methods used, longest duration of abstinence, number of attempts, reaction to cessation, and reasons for relapse. Statistical description was conducted using IBM SPSS 25.

Results
Among participants, More than half of the smokers had previously attempted to quit smoking 63,4%, with an average of 2 attempts ± 1,7 (0-10 attempts) per patient. The majority of patients (86.8%) quit smoking without using substitution methods. Among those who resorted to substitution, nicotine replacement therapy was the most frequently used method (n = 30; 6.8%). The longest duration of abstinence averaged 8 years. The main reaction to smoking cessation among patients was an improvement in their health (9,1%). The most common reasons for relapse were psychosocial problems (5.5%), followed by relapses during social events (4.3%), and withdrawal symptoms (3%).

Conclusions
This study emphasizes the importance of considering each patient’s journey during their smoking cessation process. Analyzing these factors will enable better management of the cessation program with the patient, as well as a deeper understanding of their feedback regarding our program, ensuring long-term cessation success.

Key messages
• Failed spontaneous quit attempts prior to NRT initiation are prevalent among smoking patients.
• Understanding failed spontaneous cessation attempts can guide the development of more effective strategies.
InfoQ: Certifying credible providers of digital health information
Authors: Schmidt-Kähler S , Münch I , de Gani S M , Flaschberger E , Nitsch M , Schaefer C 
Published: October 2024

Abstract

Background
Access to accurate health information is crucial. Despite the abundance of information online, sorting through it can be overwhelming, especially with the spread of misinformation. This poses a threat to public health and challenges health literacy. Efforts to combat misinformation are struggling due to the rapid growth of available information. We need complementary strategies, such as promoting trustworthy information sources. An initiative by Bertelsmann Stiftung, aims to counter misinformation by promoting health information from credible sources.

Methods
In 2021, the U.S. National Academy of Medicine outlined principles for identifying credible health information sources, endorsed globally by the WHO and embraced by the social media industry. However, these principles lack operationalization, leaving indicators for credibility undefined. To address this gap, Bertelsmann Stiftung, in collaboration with German experts, conducted workshops in 2023 to draft evaluation criteria. Their ongoing work, alongside initiatives by the Careum Foundation and Gesundheit Österreich GmbH will be presented.

Results
The criteria focus on structure (e.g., the expertise of providers) and process (e.g., methods for identifying relevant evidence) rather than outcome (i.e., the quality of each piece of information), and are based on the domains science-basis, transparency and legitimacy. Mandatory and complementary criteria allow a two-step approach to identify health information providers of good quality (meeting all mandatory criteria) and excellent quality (meeting all criteria).

Conclusions
These criteria build the basis of the establishment of an international certification system and represent a crucial measure to combat misinformation and promote population health literacy. Various international partners and social platforms have already reached a strong consensus on the relevance of the project goals and expressed their willingness to deepen their efforts in this regard.
Factors Influencing Depression in People with Disabilities:Individual and Interpersonal Levels
Authors: Cho J H , Choi E H , Yeob K E , Kim S Y , Lee Y S , Park J H 
Published: October 2024

Abstract

Depression is an increasingly important social problem, and this also applies to the disabled, a health-vulnerable group. Although the distribution and influencing factors of depression may be different among the disabled population (young adults vs. the elderly, older adults with disabilities vs. disabilities due to old age), only the high prevalence of depression among the disabled is generally reported. This study seeks to determine the distribution and influencing factors of depression in disabled people according to sociodemographic standards. This study employed data from the 2021 Panel Survey on People with Disabilities (National Unit Survey) to investigate the influence of individual-level factors (health behaviors, health level, environment) and interpersonal-level factors (social network) on depression. Multivariate logistic regression analysis was performed while controlling for demographic sociological factors and disability characteristic factors. The experience of depression was among elderly disabled individuals (age 50+: 40.9%) than younger ones (age 19-49: 36.1%), and in disability with aging (49.3%) versus aging with disabilities (39.2%) (P &lt; 0.05). Chronic diseases, daily living assistance, living environment, and emotional support from family and neighbors affected both young and elderly disabled individuals. Specifically, among the elderly disabled, exercise frequency (aOR=0.78; [CI]0.63-0.97), social network size (aOR=0.87; [CI]0.82-0.93), and social interaction frequency (aOR=0.68; [CI]0.51-0.91) were significant. Disability with aging was influenced by exercise frequency (aOR=0.29; [CI]0.09-0.95) and emotional support (aOR=0.37; [CI]0.17-0.77) from peers. older adults with disabilities were affected by not only individual-level factors (exercise frequency) but also both functional (emotional support) and structural (size of social network, frequency of meetings) aspects of their interpersonal social networks.

Key messages
• Depression experiences among older adults with disabilities are influenced by both functional and structural social networks.
• Developing depression prevention strategies for people with disabilities requires a customized approach that takes into account age-specific characteristics.