bluuebunny/crossref_metadata_2025_split huggingface dataset:
European training program for competence enhancement in management of health regions
Authors: Behrens Y , Amort F M , Kollányi Z , Romaniuk P , Horváth G , Ferrandiz Roberto R , Todorovska N , Cassens M 
Published: October 2023

Abstract

Background
Health regions aim to increase equal opportunities in health care through the networking of regional actors. In the Erasmus+ founded project Com.HeNet, a European training for the management of health regions was developed. The contents were defined through interviews with European health experts (n = 33). The Com.HeNet training was developed in international interdisciplinary teams with a great transfer potential to other sectors.

Objectives
The objective of the Com.HeNet training is to impart European competences in the development, management, and evaluation of health regions. The training is designed for 5 ECTS (EQF level 6) and consists of 6 teaching modules (Blended Learning). The question arises: Do EU blended learning modules for the management of health regions offer the potential for competence enhancement for successful management in the health sector?

Results
Through an Erasmus+ grant, a total of 23 students and health care practitioners from seven EU countries were able to evaluate the Com.HeNet Training. In a qualitative survey, the training was evaluated for quality, quantity, and professional relevance. 19 (n = 23) respondents stated a high to very high increase in their knowledge regarding the online course on theoretical introduction. 21 (n = 22) respondents perceive, inter alia, the teaching of ‘Health and society - theoretical background’ as helpful to very helpful for their professional future.

Conclusions
The blended learning format of the Com.HeNet training has the potential to useful enhance competences in European health management. The modules have been successfully piloted and will now be transferred into practice.

Key messages
• A European establishment of health regions and the associated training requires cooperation between the national level and the European Union.
• Interdisciplinary competencies can be taught in European blended learning trainings.
A Pilot Study on the Prevalence of Peripheral Arterial Disease in Kigali, Rwanda
Authors: Denison Martin K , Dockery D , Harelimana J , Ahishakiye E , Licht A , Nuenzweig S , Allu S , Cunningham R , Ingabire E , Izere J 
Published: October 2023

Abstract

Background
Peripheral arterial disease (PAD) has significant morbidity including limb loss. The prevalence of PAD in low- and middle-income countries ranges from 3-25% though the global burden is accepted to be near 6%. The objective of this pilot study was to estimate the prevalence of PAD and associated risk factors in Kigali, Rwanda.

Methods
This is a multicenter, mixed-methods, cross-sectional study conducted at three health facilities in Kigali, Rwanda. Patients older than 40 years old presenting for non-emergent reasons at the clinics were eligible for participation in the study. An ankle-brachial index (ABI) was measured using the Unetixs Revo 1100/8 MHz probe for PAD screening. An ABI &lt;/=0.9 was the value diagnostic for PAD, and &gt;1.3 was used for an inconclusive ABI. A self-reported survey was collected to determine demographics and medical history, including smoking status and medication use.

Results
A total of 861 participants were included in this study with an overall PAD positivity rate of 3.14%. Additionally, 166 patients (19.3%) had inconclusive ABIs. Patients who screened positive for PAD were significantly more likely to be older (63 vs 56, p = 0.009), of lower wealth indexes (p = 0.016), and were more likely to be current or former smokers (13 (48.1%) vs 217 (32.5%), p = 0.041) (Table 1). Patients with inconclusive ABIs were significantly more likely to be male (70 (42%) vs 140 (21%), p = &lt;0.001), more likely to have chronic kidney disease (4 (2.4%) vs 2 (0.3%), p = 0.016), and more likely to be positive for human immunodeficiency virus (HIV) (44 (27%) vs 127 (19%), p = 0.041). There were also lower rates of DM and HTN in the inconclusive group but no differences in the diagnostic group.

Conclusions
Our results revealed that the prevalence of PAD in Kigali, Rwanda, was similar to ranges quoted in the literature at 3.14%. Results hint that traditional risk factors such as DM and HTN may be less common amongst people with PAD in Rwanda.

Key messages
• The prevalence of peripheral artery disease (PAD) in Rwanda is similar to estimates in other LMICs.
• Traditional risk factors such as diabetes and hypertension may play smaller roles in the etiology of peripheral artery disease (PAD) in Rwanda.
Environmental determinants of body mass index trajectories: results from a longitudinal Swedish study
Authors: Rebouillat P , Gefenaite G , Mattisson K , Östergren P-O , Nilsson P M , Björk J 
Published: October 2023

Abstract

Exposure to natural environments is thought to benefit mental and physical health. A better understanding of the interplay between the individual and the environment in relation to public health is imperative in light of the joint biodiversity, climate, and health crises. This study aimed to 1) identify Body Mass Index (BMI) trajectories in the Scania Public Health Cohort (SPHC), 2) characterise trajectories in terms of sociodemographics, lifestyle, health and living environments and 3) study the associations between BMI trajectories and green qualities of the environment. The SPHC was established in southern Sweden (Scania) in 2000. Participants (n = 13581 at baseline, 18-80 years old) responded to 4 surveys (2000-2016) including questions on sociodemographics, lifestyle and health. Residential coordinates were linked to the Scania Outdoor Environment Database (ScOut) comprising perceived sensory dimensions. “Diverse”, “serene” and “natural” dimensions were summed up to obtain the Scania Green Score. Sex-specific BMI trajectories, identified using group-based trajectory modeling, were compared using multinomial regression, adjusted for main confounders. Five trajectories were identified with similar shapes in men and women. Stable-normal (1) and stable-overweight (2) trajectories exhibited slow linear BMI increase. Fluctuating-overweight (3) and fluctuating-obesity (4) trajectories showed BMI increase followed by decrease, starting from overweight or obesity. The increasing-obesity (5) trajectory showed a persistent increase towards obesity. Trajectories were associated with socioeconomic and lifestyle factors. The highest proportions of university education and lowest proportions of sedentary lifestyle were found in the stable trajectories (1-2). Economic strain was highest in (5). Preliminary analyses showed no clear associations between Scania Green Score at baseline and trajectory membership. BMI trajectories were associated with socioeconomic and lifestyle factors.

Key messages
• BMI trajectories were associated with socioeconomic and lifestyle factors.
• Identifying environmental risk factors is of importance for both public health and urban planning.
Correlates of HIV infection among HIV-exposed infants in low-income settlements Nairobi, Kenya
Authors: Kiilu E M , Kikuvi G M , Karanja S M , Wanzala P 
Published: October 2023

Abstract

Background
Prevention-of-mother-to-child-transmission of HIV services provide timely catchpoints for universal test-and-treat strategies, improving health outcomes among HIV-exposed infants. We explored factors influencing vertical transmission of HIV among HIV-exposed infants in Nairobi County, Kenya.

Methods
A longitudinal study design was adopted and cohort of 166 mother-infant pairs were followed-up over 12 months. The study was conducted in three public healthcare facilities. Simple random sampling was used to select participants. Fisher's exact test was used to test for associations while Poisson regression analyzed data at the multivariable level. The study was powered at 0.08 (P &lt; 0.05 at 95% CI). Correlates were assessed at 6 weeks, 6 and 12 months. All ethical approvals were obtained. The outcome measure was infant HIV status over a 12-month follow-up period.

Results
Infant HIV incidence rate over 12-months was 9 cases per 100 person-years (CI:5.465, 16.290). Maternal non-disclosure of HIV status to partner(s) presented a higher risk of infant HIV positivity relative to mothers who had disclosed their status i.e., at 6 months (relative risk 5.22 CI:1.40, 19.45) and 12 months (relative risk 4.54 CI: 1.62, 12.73). Mothers unaware of their partners’ HIV status had a higher risk of infant HIV positivity relative to mothers who knew their partners’ HIV status i.e., 6 weeks (relative risk 5.3 CI:1.10, 27.98), 6 months (relative risk 4.51 CI:1.13, 17.96) and 12 months (relative risk 5.14 CI:1.66, 16.07). Underweight mothers had a higher risk of infant HIV positivity relative to mothers with a normal body mass index i.e., relative risk 5.82 CI:2.0, 16.89 at 12 months/endpoint.

Conclusions
Maternal non-disclosure of HIV status and unawareness of their partners’ HIV status increased the risk of infant HIV vertical transmission. Recommendation: Healthcare provider assisted disclosure should be enforced to remove barriers brought about by HIV status non-disclosure.

Key messages
• Strategies to improve healthcare provider assisted disclosure of HIV status should be enforced to increase partner support, consequently reducing barriers associated with HIV status non-disclosure.
• Nutritional support should be offered to all mothers living with HIV during the pregnancy and the breastfeeding period, to reduce the risk of vertical transmission of HIV to their infants.
Cluster analysis of maternal socioeconomic and non-modifiable factors with birth & placental outcomes
Authors: Teo S , Murrin C , Mehegan J , Douglass A , Segurado R , Kelleher C , Phillips C , Hébert J 
Published: October 2023

Abstract

Background
Maternal social disadvantage adversely affects both maternal and offspring health outcomes. This study aimed to explore clustering of socioeconomic and non-modifiable factors in mothers and their association with birth and placental outcomes, which are under-researched in this context.

Methods
This analysis of the Lifeways Cross-Generational Cohort includes 250 mother-child pairs. Self-completed general health and food frequency questionnaires in early pregnancy provided information on diet, lifestyle, socioeconomic status (SES) and non-modifiable factors. Parity, untrimmed placental weight (PW) and birthweight (BW) were abstracted from hospital records, and the BW:PW ratio was generated. TwoStep cluster analysis clustered mothers based on age, parity, marital status, net household income, private healthcare insurance, homeowner status, and tertiary education. Differences between clusters were assessed using one-way ANOVA and chi-square tests.

Results
A three-cluster solution was found to be optimal with a modest average silhouette coefficient of 0.3. Clusters were classified as “Married Homeowners” (n = 140, 37.1%), “Highest Income” (n = 58, 23.2%) and “Renters” (n = 52, 20.8%) based on predictor importance. Renters were younger, more likely to smoke, have a medical card (an indicator of social disadvantage) and have poorer dietary quality and dietary inflammatory status (as indicated by lower Healthy Eating Index (HEI-2015) and higher energy-adjusted Dietary Inflammatory Index (E-DII) scores) compared to other clusters (all p &lt; 0.01). Offspring of Renters were more likely to have lower BW (-259.26g, p &lt; 0.01) and shorter birth length (-1.31cm, p &lt; 0.01) and head circumference (-0.59cm, p = 0.02) compared to offspring of Married Homeowners.

Conclusions
Results suggest associations of SES (particularly housing status) with birth, but not placental, outcomes and less favourable lifestyle factors, which may have multi-behavioural and multi-sectoral policy implications.

Key messages
• Associations between low SES, adverse lifestyle behaviours and birth outcomes highlight the importance of a multi-sectoral public health strategy.
• Placental outcomes should be examined in further studies.
Selected outcomes from the study The Youth and Parents Risk Factor Behavior Survey in Bratislava
Authors: Babjakova J , Vondrova D , Wimmerova S , Mayer-Vargova K , Weitzman M , Argalasova L 
Published: October 2023

Abstract

Background
The cross-sectional study of behavioural risk factors in adolescents and adults in Slovakia comes from a bilateral American-Slovak project aimed to evaluate the impact of selected behavioural, psychological, and socioeconomic factors on the health of adolescents/young adults and their parents/caregivers.

Methods
The questionnaires for students and parents were developed according to the studies designed by CDC and adapted to national specificities. A total of 2,384 questionnaires were distributed to a sample of students aged 15-19 years from eight secondary schools and to their caregivers (798 + 1,586). The survey was anonymous and voluntary, approved by the Ethical Committee of the Faculty of Medicine Comenius University and University Hospital in Bratislava.

Results
The study found a high prevalence of behavioural risk factors among adolescents, including smoking (19.9 %), alcohol consumption (39.7 %), substance abuse (27.3%), and suicidal thoughts (41%), particularly at a younger age. The excessive use of IT was also found, mainly over the weekend. The study revealed a significantly lower age of first alcohol consumption and first sexual intercourse among adolescents than among their parents. Additionally, the study confirmed a significant relationship between maternal and child smoking (p = 0.043; OR = 1.84 95% CI 1.02-3.34), while the proportion of children who drank at least once in the last month increased significantly with the intensity of the father's drinking (p = 0.013). Similarly, statistically significant relationship was found between children's and mothers’ drug use (p = 0.008; OR = 2.77 95% CI 1.28-5.99).

Conclusions
The study identified various forms of risky behaviour among adolescents and highlighted the significant influence of parents’ risky behaviour on their children. Parents/caregivers serve as primary role models for their children, and their behaviour significantly impacts adolescent development. Supported by KEGA 015UK-4/2022

Key messages
• The study assessed behavioural risk factors in adolescents, revealing high prevalence of smoking, substance abuse, suicidal thoughts.
• Parental/caregiver behaviour was found to significantly impact adolescent development.
Neonatal jaundice detection in low-income Mexican settings: is there scope for mHealth innovation?
Authors: Jiménez-Díaz G , Keitsch M , Marcuzzi A , Gierman L , Elizarrarás-Rivas J , Aune A , Infanti J J 
Published: October 2023

Abstract

Introduction
Neonatal jaundice (NNJ) is a common and usually harmless condition, but undetected severe cases can cause brain damage and disabilities in thousands of babies each year. Low- and middle-income countries often lack accurate methods for detection and rely primarily on visual assessment (VA), resulting in a higher incidence of consequences. Norwegian researchers developed an easy-to-use and affordable smartphone app (Picterus) to detect NNJ that has shown higher accuracy than VA in Norwegian and Mexican neonates. We evaluated the feasibility of implementing Picterus in low-income settings in Mexico to improve outcomes for affected newborns.

Methods
Qualitative methods, including 1 focus group, 15 semi structured interviews, and 4 observations, were used in urban and rural health facilities in Oaxaca, Mexico, with medical doctors, nurses, and health authorities as participants.

Results
Four themes were identified through thematic analysis guided by the Consolidated Framework for Implementation Research: (1) the current process to detect NNJ, (2) participants’ needs to improve it, (3) feasibility of implementing Picterus in the health system, and (4) users’ expectations from the app. The findings indicate deficiencies in the current process of NNJ detection and a desire among participants for a more accurate tool. Picterus was perceived as an easy-to-use and useful tool compatible with the work routine; however, barriers to adoption were identified, primarily related to internet deficiencies and costs.

Conclusions
Picterus has the potential to improve NNJ detection but contextual barriers must be addressed for a successful implementation in the setting. Additionally, there is scope to optimize VA to strengthen NNJ detection.

Key messages
• Prevalence of severe consequences of NNJ is higher in LMIC compared to high-income ones reflecting an unjust but preventable health inequity with significant health, social and economic costs.
• Picterus offers a reliable and accessible tool to bridge the gap in NNJ detection, potentially improving outcomes for affected newborns in all settings.
The role of labor market inequalities in the gender gap in depression risk among older US adults
Authors: Gueltzow M , Bijlsma M J , van Lenthe F J , Myrskylä M 
Published: October 2023

Abstract

Background
We aim to investigate to what extent gender inequality at the labor market explains higher depression risk for women than men among older US adults.

Methods
We analyze data for 35,699 US adults aged 50-70 years that participated in the Health and Retirement Study. We calculate the gender gap as the difference in the prevalence of elevated depression symptoms ( &gt; = 3, 8-item Center for Epidemiological Studies Depression Scale) between women and men. We employ a dynamic causal decomposition and simulate the life course of a synthetic cohort from ages 50 to 80 with the longitudinal g-formula. We introduce four nested interventions and assign women the same probabilities of being in a labor force category, occupation class, current income, and prior income as men conditional on women's health and family status until age 70.

Findings
The gender gap in depression risk is 2.9 percentage points at age 50 which increases to 7.6 per 100 at age 70. Giving women the same employment, occupation, and income opportunities as men decreases the gap on average over ages 50-71 by 1.2%-points (95%CI: -3 to 0.5), 1.2%-points (95%CI: -3 to 0.5), and 1.3%-points (95%CI: -3.2 to 0.3), respectively and 1.6%-points (95%CI: -3.5 to 0), or approximately one third, if we additionally intervene on prior income. The impact of the simulated intervention is particularly large for Hispanics and low-educated groups.

Interpretation
Policies that equalize labor market opportunities may reduce depression risk in older women and contribute up to one-third to the gender gap in depression risk.

Key messages
• We disentangle the complex relationship between gender, labor market and mental health in older US adults in an innovative life course approach with the help of hypothetical interventions.
• Equalizing opportunities at the labor market reduces the gender depression gap most in groups with the largest gender depression gap, i.e. Hispanics and low educated groups.
Social support and emotional wellbeing among women living with bacterial vaginosis in new york city
Authors: Sun Y , Landers S , Ashmore M , Pathela P , Crawley A , Davis A 
Published: October 2023

Abstract

Background
Bacterial Vaginosis (BV) is a common pathological vaginal condition in women and is disproportionately higher among Black (33%) and Hispanic women (31%) than among non-Hispanic White (23%) or Asian women (11%). BV can have highly distressing impacts on women, yet the role of social support has received limited attention. This paper aimed to explore women's experiences of social support for BV.

Methods
We conducted semi-structured interviews with women (n = 41) aged 18 years or older and who had a BV diagnosis in the past year. Interviews examined women's infection history and symptoms, BV management approaches, the impact of BV on women's lives, and BV clinical care experiences. Qualitative data were analyzed with an a priori coding framework based on key domains, followed by open-coding to uncover emergent themes.

Results
The majority of participants were Non-Hispanic Black/African American (63.4%). Nearly a quarter (22.0%) of participants identified as lesbian or bisexual or reported having sex with a woman in the past year. Most women with BV expressed feelings of shame. Many women noted a lack of social support, particularly from sexual partners, which might lead to relationship mistrust and blame for the infection. Sexual partners’ inadequate knowledge of BV resulted in women's reluctance to discuss their diagnosis and avoidance of sexual activities. Supportive partners or friends helped women recognize BV infection and seek treatment earlier, provided emotional support and reduced feelings of isolation. In addition, women reported receiving greater support and care from sexual health clinics than from other healthcare settings.

Conclusions
The study highlights the importance of social support in women's experiences of BV. Findings imply that enhancing sexual partners’ understanding of BV, fostering open-dialogues among women, and promoting empathetic healthcare systems can potentially improve women's emotional well-being and overall BV experiences.

Key messages
• The study highlights the importance of social support in women’s experiences of BV.
• Enhancing sexual partners’ understanding of BV, fostering open-dialogues among women, and promoting empathetic healthcare systems can potentially improve women’s overall BV experiences.
Associations between problematic use of ICTs, depression, psychosocial, and behavioral factors
Authors: Méndez-López F , Dominguez-Gárcía M , León-Herrera S , Mártinez-Pecharroman M , Samper-Pardo M , Aguilar-Latorre A 
Published: October 2023

Abstract

Background
Depression is a significant and growing health problem that has a significant impact on psychosocial functioning and quality of life. The onset and the severity of mental health problems have been related to various biological, psychosocial, and behavioral variables.

Purpose
The purpose of this study is to explore the association among the severity of depression, problematic information and communications technology (ICT) use, and some related personal factors with health behavior among adults. It also analyzes the moderating role of personal factors in the relationship between the problematic use of ICT and depression.

Patients and methods
Descriptive, bivariate, multivariate, and moderation analyzes of data from 391 participants of 35-74 years old in primary healthcare centers located in Aragón, in northern Spain were performed between July 2021 and July 2022. The primary outcome was the severity of depressive symptoms as continuous variable (PHQ-9).

Results
Low sense of coherence (β = - 0.058; p = 0.043), low self-esteem (β = −0.171; p=0.002), and low self-efficacy (β = −0.122; p= 0.001), are predictors of having more severe depressive symptoms. The negative relationship between problematic ICT use and higher depression was stronger in participants with lower self-efficacy (b = 0.1805, p = 0.080).

Conclusions
The problematic use of ICT and personal factors are related to depressive symptomatology. The interrelationship between problematic ICT use, personal factors, and depression needs to be further explored. The development of prevention and communication strategies by the authorities, which consider the psychosocial factors of adults and promote knowledge of the disease, will increase the adoption of protective health behavior.

Key messages
• The abusive use of information and communication technologies occurs at all ages and in very different cultural contexts, being a growing health problem.
• Knowing the psychosocial risk factors that predispose to this problematic use of ICTs should be key to preventive identification and early care measures among people at risk and their families.