bluuebunny/crossref_metadata_2025_split huggingface dataset:
Socioeconomic inequalities in type 2 diabetes and job demands/control/support - The Maastricht Study
Authors: Sezer B , Koster A , Albers J , Meisters R , Schram M , Eussen S , Dukers N , de Rijk A , Stehouwer CDA , Bosma H 
Published: October 2023

Abstract

Background
Low socioeconomic position (SEP) is an important determinant of Type 2 Diabetes Mellitus (T2DM). Adverse environments in the exposome might be involved; however, the environmental factors are under-studied compared to lifestyle. We explored low job control, high job demands, and low job support as pathways between SEP and T2DM.

Methods
Cross-sectional and longitudinal data from 8,090 participants of The Maastricht Study were used. Prevalent T2DM was measured by an oral glucose tolerance test and incident T2DM was self-reported in annual follow-up questionnaires. SEP was operationalized by baseline measures of education, occupation, and income. The work stressors were measured by questionnaires at baseline. For Cox regression, the survival time was computed by midpoint imputation. The associations of SEP, job demands, control, and support with T2DM were examined as well as the mediating role of the work stressors by using a counterfactual framework.

Results
2.8% (N = 172) of the participants without T2DM at baseline reported incident T2DM. People with lower SEP were more likely to report T2DM during the follow-up course (e.g.; education HR = 2.21, 95%CI: 1.53-3.20) and more often had prevalent T2DM. Low job control was associated with prevalent T2DM (OR = 1.44 95%CI: 1.25-1.67), but not with incident T2DM. Job control explained 7.23% of the relationship between income and prevalent T2DM. Job demand suppressed the relationship of education (3.65%) and occupation (3.72%) with prevalent T2DM.

Conclusions
Our findings provide modest evidence for environmental injustice in T2DM exposome. The substantial higher risks of diabetes in low SEP is to a small extent explained by lower control at work. Furthermore, by having lower psychosocial job demands, they are protected against T2DM.

Key messages
• Job demands and control play a role in SEP and prevalent T2DM relationship.
• Work stressors might not be a major target for tackling socioeconomic inequalities in type 2 diabetes.
Time trends in the prevalence of depressive disorder symptoms in the Danish workforce, 2012 to 2018
Authors: Dalsager L , Sørensen K , Sørensen J K , Madsen IEH , Rugulies R 
Published: October 2023

Abstract

Background
Over the last decade, and well-before the COVID-19 pandemic, the prevalence of mental health problems has increased in many European countries, particularly in youth, raising public health concerns. Yet, there has been little focus on the mental health status of the working population, and it is unknown if the proportion of workers with impaired mental health is growing as well. In this paper, we report change in the prevalence of depressive disorder in a large nationwide sample of the Danish workforce (N = 76,802) from 2012 to 2018.

Methods
We used data from the Work Environment and Health in Denmark study, a bi-annual nationwide survey on working conditions and health. We measured depressive symptoms using the Major Depression Inventory and defined prevalence of depressive disorder by a score ≥21, in accordance with previous clinical validation studies. Using a log-binomial regression model, we estimated change in prevalence of depressive disorders from 2012 to 2018 with 95% confidence intervals (95% CI).

Results
From 2012 to 2018, the prevalence of depressive disorder increased from 7.0% (95% CI: 6.7-7.4) to 9.4% (9.0-9.9) corresponding to an adjusted increase of 36.1% (27.4-45.4) over the 6-year period. We observed a statistically significant increase in the prevalence in every wave, from 2012 to 2014 (adjusted change in prevalence: 10.8%, 3.2-18.9), from 2014 to 2016 (8.6%, 1.3-16.4)), and from 2016 to 2018 (13.1%, 6.0-20.7)). The increase occurred in both sexes, all age groups and for all types of occupational status, but was more pronounced among women, younger workers and workers of low occupational status.

Conclusions
In a large nationwide sample of the Danish workforce, we observed an increasing prevalence of depressive disorder from 2012 to 2018. The results indicate that the general trend towards increased levels of mental health problems also encompasses the workforce and underlines the need for public health action.

Key messages
• The prevalence of depressive disorder in the Danish workforce increased considerably from 2012 to 2018.
• The increase in prevalence of depressive disorder was observed in all groups, but was particularly pronounced for women, younger workers and basic-skilled workers.
Breastfeeding initation after Postpartum Haemorrhage: Associated factors and potential implications
Authors: Gilroy J , Wall P 
Published: October 2023

Abstract

Background
Breastfeeding has been recognised as a significant driver of neonatal and infant outcomes, particularly in LMIC settings. Postpartum haemorrhage (PPH) is an increasingly common complication of childbirth, with multiple effects on mothers and their babies. This study aimed to explore the association between aspects of PPH care and outcomes and the rates of breastfeeding among this cohort of women.

Methods
This was a secondary analysis of data from the WOMAN trial, an international, randomised, double-blind, placebo-controlled trial, investigating the effect of tranexamic acid in women who have experienced PPH. A binary logistic regression model was developed to examine the associations between the rates of any breastfeeding during the study period and the occurrence of specific factors within the peripartum period.

Results
16,285 mothers of healthy singleton babies were included in the current study. Factors that may result in maternal-infant separation in the immediate postpartum period were significantly associated with lower rates of breastfeeding. These included: the mother requiring transfer between hospitals following PPH (Odds Ratio 0.47 [95%CI 0.41-0.54]) and the mother being admitted to ICU postpartum (OR 0.65 [95%CI 0.54-0.78]). Transfusion of any blood product was associated with a lower rate of breastfeeding (OR 0.82 [95%CI 0.73-0.93]), as was the use of Ergometrine (OR 0.69 [95%CI 0.62-0.77]). Maternal pain (OR 0.65 [95%CI 0.58-0.75]) and maternal anxiety or depression (OR 0.63 [95% CI 0.53-0.75]) were also associated with lower rates of breastfeeding.

Conclusions
Identifying women at higher risk of experiencing difficulties in initiating or sustaining breastfeeding following a PPH may allow for targeted information and support to be provided to those women. Specific prospective research should be carried out to ascertain the true implications of the identified associations.

Key messages
• Identifying women at higher risk of experiencing difficulties in initiating or sustaining breastfeeding following a PPH may allow for targeted information and support to be provided to those women.
• Certain environments, interventions and aspects associated with PPH care are associated with lower rates of breastfeeding initiation prior to hospital discharge.
Population health approach for health systems: public health organization, workforce and governance
Authors: Magalhães J P , Silvia I M , Sousa C R , Lourenço Silva R 
Published: October 2023

Abstract

Background
The health systems have been evolving based on solely individual care of diseases, which is no longer sustainable. A combination of a public health and individual approach is needed, although how to deliver those population health services remains a challenge. This study explores how population health outcomes are determined by the organizational model and workforce capacity of public health services at local level.

Methods
Using publicly available data on organizational, geodemographic and population health characteristics of the total 55 public health units (PHU) in mainland Portugal, a fixed effects panel regression of three models was performed. The analysis considered synergies between public health workforce (medical doctors and nurses), organizational (considering a Local Health Unit (LHU) group, that includes both primary and secondary care, and non-LHU) and infrastructure characteristics, and population health outcomes (premature standardized mortality rate and life expectancy at birth (LE)). Confidence intervals (CI) at 95% and odds ratio (OR) were calculated.

Results
A lower premature standardized mortality rate and a higher life expectancy at birth were observed when there is one public health doctor per between 22 319.4 and 24 616.7 habitants and 25 382.5 and 27 680.0 habitants, respectively. The regression models that were run showed that PHU under a LHU model or disaggregated services are associated with an increase in the premature standardized mortality rate (OR = 1.23 [CI 95% 0.21-15.24]) and a decrease in the LE (OR = 0.50 [CI 95% 0.17-1.41]).

Conclusions
Health systems must promote public health services capable of delivering the essential public health functions, particularly at local level, where they must be concentrated and integrated at the same level of governance as individual levels of care, and equipped with a public health workforce adapted to the size of the population on which they must intervene.

Key messages
• Strengthening health systems resilience require a combination of public health and individual approaches to improve population health and tackle inequalities.
• Essential public health functions require concentrated and integrated governance models and a public health workforce adapted to the size of the population.
A Qualitative Exploration of the Impact of Mutual Aid on the COVID-19 (Coronavirus) Pandemic Response
Authors: Ibrahiim K , Oghenenyerovwome Iki V , Jackson V 
Published: October 2023

Abstract

Background
During the COVID-19 (coronavirus) pandemic, responses of mutual aid took place at both the national and community levels. A study was conducted in the United Kingdom to investigate how grassroots community action helps people during pandemics and other types of emergency circumstances to meet their immediate health, care and social needs. In addition, the necessity for community self-organization, its success, and any challenges that developed are also evaluated.

Methods
An interpretative approach was utilised in order to gain an understanding of the points of view held by (N = 15) organisers, volunteers, and people who received support from mutual aid, who were a part of the first mutual aid group that was founded by a community in response to the COVID-19 pandemic. A purposive sampling technique was used with semi-structured interviews conducted virtually. The results of the interviews were transcribed verbatim and analyzed using thematic content analysis.

Results
The results of the interviews yielded the following themes: 1) lack of trust in government during the COVID-19 pandemic, 2) people feeling forgotten by the national government and their local council, and 3) the need to support vulnerable populations and members of the community, including those who belong to marginalized groups. It has been demonstrated how grassroots community organizing may build community cohesiveness and attempts to reinforce local and national government activities, particularly in times of emergency, that can bring communities together to assist one another.

Conclusions
This approach could be used to co-produce sustainable public health services in collaboration with communities and government, building trust and meeting population health needs by co-creating equitable services while also developing community cohesiveness.

Key messages
• This study is innovative. The community identified their needs and developed a support system.
• Working with a local council to develop a sustainable community service to meet the population health needs of the community.
Evidence on community-based intervention for tackling childhood pneumonia Project in Bangladesh
Authors: Shah M , Rana S , Mothabbir G , Islam J , Rahman L 
Published: October 2023

Abstract

In Bangladesh, pneumonia is a major cause of child mortality, killed 26,766 under 5 children, accounting for 24% of all under 5 child deaths in 2022. To address this issue, we implemented a community-based project in Barishal from June 2021 to December 2022. Project activities aimed to strengthen the health system for improved access and utilization of quality child health care and child immunization services, encouraged community practice and behavior for care-seeking and exclusive breastfeeding. During the project period, 22 medical doctors, 30 paramedics and 168 MoHFW employed service providers including community clinics, community-based health facility for six thousand population, received case management training, 38 health centers were equipped with necessary logistics and supplies for improved case management of sick children. We also conducted special vaccination campaigns in 13 hard-to-reach areas, deployed 11 vaccination aids for improving child vaccination coverage in remote areas and raised awareness of recommended health practices at the community level. A comparison of baseline and endline survey data showed significant improvements in children among 12-23 months of age who received all recommended basic vaccines by 12 months [77% in baseline (n = 239) vs. 92% in endline (n = 235); p &lt; 0.01]; care-seeking from health facilities or trained health service providers for sick children with pneumonia [40% in baseline (n = 127) vs. 52% in endline (n = 225); p &lt; 0.005]; and exclusive breastfeeding for children below 6 months [52% in baseline (n = 122) vs. 62% in endline (n = 120); p &lt; 0.01]. These results revealed the project's success with simple but contextualized efforts to enhance the health system by developing the capacity and skills of service providers to provide high-quality child health care for sick children, improving access to equitable child immunization, and raising social awareness through partnerships with the MoHFW and community engagement initiatives.

Key messages
• Community-based intervention with minimum resources have potential to scale up with improving accessibility and utilization of health services, specially in hard to reach areas in Bangladesh.
• Contextualized and simple intervention through collaboration with local government and community engagement is critical for success of community based health system strengthening project.
Factors related to oral health behavior among primary schoolchildren in rural Armenia
Authors: Muradyan D , Atanyan A , Demirchyan A 
Published: October 2023

Abstract

Background
Oral health (OH) of children is very important for their physical and mental health and wellbeing. OH is known to be tightly linked to OH behavior. There is lack of studies on children's OH behavior in rural Armenia. This study aimed to measure OH behavior among primary schoolchildren in two villages of Armenia and identify factors associated with their desired OH behavior.

Methods
A cross-sectional study among schoolchildren and their primary caregivers (parents) was carried out in 2022 in Sardarapat and Mrgashat communities of Armavir province, Armenia. Overall, OH status of 400 schoolchildren was assessed by a dentist, and their parents participated in a telephone interview. The survey questionnaire included items on parent's OH knowledge, child's OH behavior and nutrition practices, and family's socio-demographic characteristics. Multiple linear regression model was fitted to identify factors associated with child's OH behavior score.

Results
The mean age of children was 8.3 years, and the mean age of their caregivers was 33.6 years. Children's mean OH behavior score was 1.8 of the maximum of 5 (i.e. 36% score); nutrition practice score was 6.0 of 14, and parental OH knowledge score was 6.9 of 9. Factors positively associated with child's OH behavior in the adjusted analysis included child's nutrition practice score (B = 0.07; p = 0.026), parent's OH knowledge score (B = 0.12; p = 0.002), higher than secondary education of parent (B = 0.22; p = 0.042), and family's higher than average living standards (B = 0.48; p = 0.051).

Conclusions
The study identified that OH behavior of primary schoolchildren in rural Armenia was poor. It could be improved through increasing the knowledge of parents on child's desired OH behavior and nutrition practices. An unexpected finding was the lack of association between children's OH behavior and objective measures of their OH - plaque index and DMFT (number of decayed, missing due to caries and filled permanent and primary teeth).

Key messages
• Rural children’s OH behavior in Armenia was mainly poor. To address this issue, parents should be educated on correct child care practices including child’s oral health and nutrition behavior.
• Further research is needed to explain the reason of the lack of association between objective measures of child’s oral health (plaque index and DMFT) and child’s OH behavior score.
Patient and public involvement in co-designing a smoking cessation pathway for people with cancer
Authors: Frazer K , Bhardwaj N , Fox P , Niranjan V , Lyons A , Mc Cann A , Quinn E , Quinn S , Johnson M , Fitzpatrick P 
Published: October 2023

Abstract

Background
Developing an intervention to support people who smoke and have cancer is a complex public health issue. Inclusive research development is fundamental, with public health funding agencies and research guidance emphasising the inclusion of patient and public involvement (PPI). PPI means involving ‘experts by experience’ (EBE) as partners rather than research participants. Limited evidence of PPI engagement exists in published literature. This study aimed to embed PPI across co-design phases in developing a smoking cessation (SC) pathway for people who smoke and have a cancer diagnosis.

Methods
A five-stage approach was completed [Feb 2020 - Apr 2022]. Stage 1: Dragons’ Den: PPI knowledge sought to refine the research question at a Patient Voice in Cancer Research (PVCR) and National Cancer Research Institute UK (NCRI) event. Stage 2: Study Advisory Committee (SAC) formed with membership from EBE (three former smoker cancer patients), cancer specialists and national tobacco control experts. Stage 3: Documentation review by SAC, including interview topic guides and questionnaires. Stage 4: Systematic review outputs reviewed by EBE. Stage 5: PVCR workshop held to examine systematic review evidence, survey and qualitative interview data supporting the co-design of a SC pathway.

Results
PPI was embedded across the study through research questions shaping, choice of wording and terminology used, including (i) phrasing of questions associated with treatment and quitting, (ii) piloting and sequencing of questions in surveys and interviews, including emotive questions on the nature of smoking. Members of the SAC provided unique expertise, resulting in co-authorship on published papers and abstracts. The PVCR virtual workshop facilitated collaborative discussions to inform the development of a SC pathway for cancer patients.

Conclusions
PPI partnership provided real-time confirmation of decision-making and was a key strength in co-designing a SC pathway.

Key messages
• Developing a smoking cessation pathway, including co-design methods, ensures that research questions are important for patients and use appropriate methods.
• Patient and Public Involvement in research design and development is an essential partnership.
Impact of digital health for adolescents with type 1 diabetes mellitus on health literacy
Authors: Naef A 
Published: October 2023

Abstract

Background
Adolescents with type 1 diabetes (T1DM) require high health literacy (HL) to prevent complications. However, little is known about the association between distal technologies (DT) use and HL, and the role of healthcare institutions in supporting DT remains unclear.

Methods
We conducted a systematic review (SR) following PRISMA guidelines to investigate the impact of DT on HL in adolescents with T1DM. Relevant studies published from 2011 to 2021 were identified through literature searches. We also conducted an exploratory study with medical doctors (n = 12) and adolescents with T1DM (n = 20) in Germany based on the SR. Interview data was analyzed using coding techniques to identify differences and similarities.

Results
Out of 981 studies, 22 were included. Findings suggest that social media interactions between healthcare providers and patients can improve HL, aligning with the ‘communication and interactions’ dimension of health literacy. In the exploratory study, medical doctors and adolescents with T1DM reported underutilization of DT due to resource and legal constraints, and a lack of structural conditions for the transition to adult healthcare. Peer support and trustworthy interactions with healthcare professionals were identified as factors that enhanced HL and patient empowerment.

Conclusions
Further investigation is needed to determine the most effective social media platform for enhancing HL among adolescents, considering communication, interaction, and peer relationships as important factors. Promoting the use of DT and improving HL may require capacity building through patient-centered and participatory approaches. The findings of this study provide valuable insights for informing practice, research, and policy recommendations.

Key messages
• Distal technologies, have the potential to improve HL among adolescents with T1DM, but further investigation is needed to identify effective platforms for enhancing HL.
• This study's findings highlight underutilization of distal technologies among adolescents with T1DM due to resource and legal constraints.