bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exposure to sunlight and allergic morbidity in children (Pollution and Asthma Risk: an Infant Study)
Authors: Lefebvre L , Rancière F , Amazouz H , Roda C , Momas I 
Published: October 2023

Abstract

Background
Sunlight relationship with allergies is poorly studied in children. Thus, we examined how early exposure to solar radiation is associated with allergic morbidity in the PARIS birth cohort.

Methods
This study dealt with children who attended at least one of the two health check-ups: 18 months (n = 2012) and 8/9 years (n = 1080). Early exposure (prenatal and during the first year of life) to solar radiation was assessed using meteorological data (solar radiation, temperature, relative humidity). Children with similar exposure trajectories were grouped by longitudinal and multidimensional cluster analysis. Association of solar radiation exposure with allergic morbidity (i.e. allergic sensitisation at 18 months and 8/9 y., current asthma, rhinitis, and eczema at 8/9 y.) was quantified by multivariable logistic regression models adjusted for potential confounders. The effect modification of maternal vitamin D (VitD) supplementation during pregnancy was also tested.

Results
Four exposure trajectories were found. The trajectory with the highest exposure to early solar radiation had a reduced risk of sensitisation at 8/9 y. compared to the trajectory with the lowest exposure (p = 0.06). This association was statistically significant in the VitD supplemented subgroup. Solar radiation during pre- and post-natal period was significantly associated with a lower risk of sensitisation at 8/9 y. (for ↗IQR, aOR: 0.47; 95%CI: 0.25-0.87 and 0.84;0.70-1.00, respectively). Increased prenatal exposure to solar radiation was significantly associated with a lower asthma risk at 8/9 y. (for ↗IQR, 0.32; 0.10-0.96).

Conclusions
Early sunlight exposure may reduce the risk of sensitisation and asthma in school-aged children, especially in those prenatally exposed to VitD intake. These findings highlight the importance of VitD in preventing allergic diseases in children, either through supplementation or sunlight exposure.

Key messages
• Pre-natal and early postnatal exposure to sunlight could reduce the risk of sensitisation and asthma among school-aged children.
• The association may be explained by vitamin D immunomodulatory effect, highlighting its importance in preventing allergic diseases in children through supplementation or sunlight exposure.
Waste incineration and cancer mortality: a longitudinal controlled population-based study
Authors: Capitão C , Feteira-Santos R , Fialho M , Virgolino A , Santos O 
Published: October 2023

Abstract

Background
Waste incinerator emissions have been associated with the possibility of increased risk for some cancers. Indeed, emissions are usually composed of heavy metals, dioxins, and furans, including carcinogens. Although emissions levels of incineration activity are considered safe, evidence about the impact of long-term human exposure to low dosages is lacking. We performed a longitudinal population-based study to compare cancer mortality rates between a geographical area exposed to pollutant emissions due to waste incineration and combined local industry activity, a non-exposed control area, and a reference (larger) area.

Methods
Exposed area was defined according to pollutants dispersion models, considering predominant wind intensity and direction. The control area was defined as near-to-the-exposed parishes unaffected by the pollutants emitted at the location where the incinerator is situated. Another larger area (“Large Lisbon”) was also considered as the reference area. Data about cancer mortality was provided by the Portuguese National Statistics Institute. Relative risks (RR) compared standardized (age and sex) specific mortality rates due to malignant neoplasms (ICD-9 and ICD-10) between the exposed area and (a) control are and (b) reference area.

Results
In the first five years of the waste incinerator activity (2000-2004), the RR for each cancer-related mortality was not statistically significant (considering either control or reference areas). Considering the average mortality rates between 2015 and 2019 for exposed versus control area, we found increased RR for hepatic and biliary tract (RR = 1.50; 95%CI:1.15-1.85), pancreatic (RR = 1.37; 95%CI:1.06-1.67), and respiratory tract cancer (RR = 1.24; 95%CI:1.07-1.41). No significant RR was found when comparing the exposed with the reference area.

Conclusions
Strengthening public health surveillance systems is pivotal to assess air pollution's impact on health.

Key messages
• Exposure to emissions from an industrial region including a waste incinerator plant was found to have increased risk for hepatic and biliary tract, pancreatic, and respiratory tract cancer mortality.
• Surveillance systems are needed to continuously monitor how long-term exposure to low concentrations of carcinogenic substances from waste incinerator emissions impacts on population’s health.
Motheŕs own milk (MOM) feeding in preterm infants in Germany – A status quo of personal attitudes
Authors: Schwab I , Ohnhaeuser T , Scholten N 
Published: October 2023

Abstract

Background
The best nutrition for all new-borns and especially vulnerable groups like preterm infants is motheŕs own milk (MOM). Nevertheless, recent research showed that many preterm infants receive formula in neonatal intensive care units (NICU) in Germany. In order to achieve MOM feeding in preterm infants, a MOM-friendly clinical environment is crucial. In Germany, no data is yet available on the attitudes towards MOM of physicians and nurses in NICUs and mothers.

Methods
Written surveys were conducted to assess attitudes and the current status of MOM-feeding from different perspectives (medical and nursing staff and mothers of preterm infants). Questions included personal attitudes towards MOM and perceived lactation support in NICUs. Descriptive statistics and bivariate tests (Spearman's rho, Pearson chi2) were examined.

Results
Data of 158 leading physicians (response rate: 76%), 143 nurses (response rate: 68%) and 533 mothers (response rate: 32%) was included. The personal importance of MOM feeding is slightly higher in both physicians and nurses than their attitude towards the effects of feeding with MOM on the medical outcome of preterm infants (M: 9.5/9.5 vs. 8.3/8.9; [1-10]). Mothers predominantly perceived the NICU staff as MOM promotive (M:4.7,4.9; [1-6]) and reported an overall positive attitude towards feeding preterm infants with MOM (M:5.6; [1-6]). Their attitude showed no significant differences between educational levels (p = 0.635), age (p = 0.079) or ethnicity (p = 0.184), whereas the MOM promotive NICU staff was significantly correlated to the motherś attitude (p = 0.001, p = 0.001).

Conclusions
The status quo of attitudes towards MOM in Germany is rather positive in both health care professionals and mothers, independently of sociodemographic characteristics. Presumably, the challenge in achieving MOM feeding seems to occur in transferring positive attitudes to actual interventions.

Key messages
• To enhance MOM feeding in preterm infants, future interventions should focus on the transmission of positive attitudes to actual strategies.
• NICU staff that is MOM promotive is eminent for the maternal attitudes towards MOM.
Group Antenatal Care (gANC) for Somali-speaking women in Sweden – a process evaluation
Authors: Ahrne M , Byrskog U , Essén B , Andersson E , Small R , Schytt E 
Published: October 2023

Abstract

Background
Language supported group antenatal care (gANC) for Somali-born women was implemented in a Swedish public antenatal care clinic. Seven 60-minute sessions were offered, facilitated by midwives and starting with a presentation of a selected topic, with an additional 15-minute individual appointment before or after. The aim was to assess the feasibility for participants and midwives of implementing language supported gANC, including implementation, mechanisms of impact and contextual factors.

Methods
The Medical Research Council guidelines for evaluating complex interventions was used as a framework. Both qualitative and quantitative data sources including observations, in-depth and key-informant interviews (women n = 6, midwives n = 4, interpreters and research assistants n = 3) and questionnaire data (women n = 44; midwives n = 8) were used.

Results
gANC provided more comprehensive ANC and addressed knowledge gaps related to pregnancy, birth and the Swedish health care system. The majority of women thought listening to other pregnant women was valuable (91%), felt comfortable in the group (98%) and supported by the other women (79%), and they said that gANC suited them (79%). The intervention seemed to enhance cultural understanding among midwives, thus contributing to more women-centred care, but was not successful in involving partners.

Conclusions
Language-supported gANC was acceptable to participants and midwives, but did not lead to greater partner inclusion. Main mechanisms of impact were more comprehensive ANC and enhanced mutual cultural understanding. The position of women was strengthened, and the way in which the midwives expanded their understanding of the participants and their narratives was promising. To be feasible at a large scale, gANC might require further adaptations and the “othering” of women in risk groups should be avoided.

Key messages
• Group antenatal care seemed to enhance knowledge and cultural understanding among midwives, thus contributing to more women-centred care.
• The “othering” of women in risk groups should be avoided.
The use of digital health services and its predicting factors among health maintenance organizations
Authors: Gur A , Mashiach-Eizenberg M , Lavy I , Obid S 
Published: October 2023

Abstract

Background
In line with insights whereby digital health services (DHS) can increase the accessibility and availability of health services, health maintenance organizations (HMO) have developed various DHS, with the aim of improving services and reducing disparities in health. Specifically, the COVID-19 crisis forced HMO to accelerate the use of DHS, to allow for remote health services. Yet, the implementation of technology-based services in healthcare is complex, due to a range of obstacles related to technological, ethical, and human aspects. This study aimed at identifying and comparing the predicting factors of DHS use, including digital health literacy and attitudes towards DHS, to understand its implementation among the four HMO in Israel.

Methods
The study included a correlative cross-sectional design. Data was gathered via a closed-end questionnaire, distributed through an online panel to 609 Israeli respondents, aged ≥20, regarding demographics and attitudes towards DHS, digital health literacy, and the extent of DHS use. Hierarchical regression was performed to examine whether the research variables predict DHS use. One-way ANOVA was conducted to compare between HMO.

Results
Higher use of DHS was found to be predicted by ethnicity (Jews), income (average and above), belonging to a certain HMO (Maccabi and Leumit Health Services), positive attitudes towards DHS, and higher digital health literacy (R2=.26). In addition, significant differences were seen between HMO in the degree of use (moderate effect) and attitudes towards DHS (weak effect): members of Maccabi and Leumit Health Services held more positive attitudes towards DHS, and made greater use of them, compared to members of Clalit and Meuhedet Health Services.

Conclusions
As use of DHS differs across HMO, the latter should act to adapt DHS to meet the characteristics and needs of certain target groups among their members, as a means for increasing the use of digital services.

Key messages
• HMO should adapt their DHS to meet members’ demographic characteristics and needs.
• Adjusting DHS may improve members’ attitudes towards such services and increase their involvement in using them.
The implementation of an electronic medical record (EMR) and its impact on quality of documentation
Authors: Wurster F , Cecon-Stabel N , Hansen T , Jaschke J , Köberlein-Neu J , Okumu M R , Rusniok C , Pfaff H , Karbach U 
Published: October 2023

Abstract

Background
The German healthcare system is still poorly digitized. With the Hospital Future Act, the government now mandates hospitals to implement an institutional electronic medical record (EMR). While multiple benefits are described for its adoption, knowledge on its impact on actual documentation is lacking. However, a documentation that is of good quality is, additionally to its patient safety aspect, required to enable benefits such as big data analyzability. The completeness of documentation is a dimension of quality most often researched in this context. The purpose of the present study is therefore to analyze a change in completeness of documentation after the implementation of an EMR.

Methods
Data were collected on an orthopaedical ward of a German academic teaching hospital before and after the implementation of the EMR. Paper-based and electronic medical records were compared, each representing all treated patients of a three-week period. Our analysis focused on ten items that were commonly documented in both record types (e.g. documentation of pain). T-tests, χ2-tests and Odds Ratios were calculated to compare the average completeness per record type and the percentage of completeness per item.

Results
A total of N = 180 records were analyzed. Average completeness rose from 6.25 out of 10 (SD = 2.15) in the paper-based record type to 7.13 (SD = 2.01) in the electronic record type (p=.014). Of the ten analyzed items, three showed higher rates of completeness and another three lower rates of completeness in the EMR. Four items retained a constant rate of completeness in both record types.

Conclusions
The implementation of an EMR can influence the quality of documentation with both, positive and negative impacts. Further research is needed on what determines the direction of the impact. Doing so could make it feasible to increase quality of documentation and simultaneously reduce staff's burden caused by documentational tasks.

Key messages
• The present study strengthens evidence, that implementing an institutional electronic medical record can have an impact on the quality of clinical documentation in the inpatient setting.
• Understanding the mechanisms influencing documentation could help increase the quality of documentation and reduce the burden caused by documentational tasks at the same time.
Use of technology among older adults in Baltic states during the Covid-19 pandemic
Authors: Pasupathy R , Sazevari R , Queen C 
Published: October 2023

Abstract

Background
The population in the Baltic nations of Estonia, Latvia, and Lithuania is ageing rapidly. Technology is a potential resource in enhancing the health and wellbeing of the elderly. The use of technology reduces social isolation through the facilitation of communication and facilitates access to healthcare resources. This study is based on the theory of reasoned action that aims to explains the relationship between attitudes and behavior of individuals.

Study Aim
Determine nature of the use of technology by older adults in the Baltic states across countries, genders, age, and employment status.

Methods
Data from Wave 9, COVID-19 Survey 2 (Summer 2021) of the of the cross-national panel dataset of the Survey of Health, Ageing and Retirement in Europe (SHARE) were examined using a sample of 6303 adults over 50 years old from Latvia, Lithuania and Estonia.

Analysis
Nonparametric one-way ANOVA (Kruskal-Wallis test) was performed to test the null hypothesis that the rate of use of technology is equal across gender, age, and country in Baltic states.

Findings
There was a statistically significant difference in the use of technology reported by country [= 15.7, df = 2; p&lt; .001], and age [= 1471.64, df = 6; p&lt; .001.

Conclusions
These finding suggest that country and age are significant predictors of use of technology.
Implications for Policy and Practice: Initiatives for the care of older adults should not only aim to increase the use of technology by older adults but also increase the utility of information and ease of navigation of websites targeted towards this population.

Key messages
• Country and age are significant predictors of use of technology among the elderly in Baltic states.
• Policy initiatives that aim to alleviate social isolation among the elderly through use of technology, need to increase the ease of navigation of websites targeted towards this population.
Negative social media experiences and lower self-efficacy are associated with depressive symptoms
Authors: Bonsaksen T , Steigen A M , Stea T H , Kleppang A L , Lien L , Leonhardt M 
Published: October 2023

Abstract

Background
Social media are an integral part of adolescents’ daily lives, and reviews have suggested an overall small association between more social media use and mental health problems. However, researchers have commonly investigated social media use solely in a time use perspective, rendering nuances in adolescents’ social media experience less well explored. This study examined depressive symptoms in adolescents in relationship to time spent on social media, negative social media-related experiences, and general self-efficacy.

Methods
Cross-sectional data collected in a national survey of adolescents aged 13-19 years in Norway, Ungdata 2021 (n = 139841), was used. Depressive symptoms were measured with a six-item scale based on the Depressive Mood Inventory. Associations with depressive symptoms were analyzed with multivariate linear regression analyses.

Results
Time spent on social media was associated with depressive symptoms (β = 0.09, p &lt; 0.001). However, negative social media-related experiences were more strongly associated with depressive symptoms (β ranging 0.09-0.22, all p &lt; 0.001), and their inclusion weakened the initial association between time on social media and depressive symptoms. General self-efficacy was directly associated with lower symptom levels (β=-0.29, p &lt; 0.001) but did not change the associations between social media use and depressive symptoms.

Conclusions
The findings imply that not only time spent on social media, but in particular negative social media-related experiences, are related to depressive symptoms in Norwegian adolescents. General self-efficacy is an important resource for adolescents’ mental health. Public health initiatives should include efforts to monitor and prevent negative events related to adolescents’ social media use, as well as efforts to increase adolescents’ general self-efficacy.

Key messages
• Negative social media-related experiences are related to depressive symptoms in Norwegian adolescents.
• Public health initiatives may focus on monitoring and preventing negative social media-related experiences among adolescents.
Are internet users with high risk for internet addiction prone to substance use?
Authors: Selak Š , Žmavc M , Makivić I 
Published: October 2023

Abstract

Background
Similar to psychoactive substances, certain internet activities can produce highly rewarding sensations, leading to addictive use. Previous research reported associations between internet addiction (IA) and substance use. Our aim is to identify key differences between internet users with low and high IA risk in terms of which substances they consume (alcohol, tobacco, illicit drugs) and in terms of internet activities they engage in.

Methods
The National survey on the use of tobacco, alcohol and other drugs was conducted in 2018 in Slovenia on a nationally representative sample (age range: 15-64 years; 62.4% response rate). Among people who used internet at least once per week (N = 7,413), we distinguished between internet users with low IA risk (n = 6,929; 93.6%) and high IA risk (n = 484; 6.4%), based on latent profile analysis of responses on the Internet disorder scale (IDS-15).

Results
Higher IA scores were associated with lower age (r = - .310), but not with gender. Significantly more users in the high risk group were using internet to access social media (%L = 54.4; %H = 73.1), pornography (%L = 7.8; %H = 18.2), video content (%L = 42.7; %H = 61.0), and videogames (%L = 13.1; %H = 25.8), compared to the low risk group. Higher IA scores were associated with frequency (r = .040) and volume (r = .179) of drinking alcohol, while no associations were found with tobacco smoking measures. Lastly, smoking marihuana (%L = 6.3; %H = 12.7) and using any other illicit drugs (%L=2.2; %H = 5.6) in the past 12 months was significantly more common in the high risk group.

Conclusions
The present study underlines the addictive potential of four internet content categories (social media, pornography, video content and videogames). People who are sensitive to the rewarding potential of internet content may also be more prone to seeking rewarding sensations associated with consuming psychoactive substances, in particular alcohol, marijuana and illicit drugs, but not tobacco.

Key messages
• Using internet to access social media, videogames, video content and pornography is significantly more common among individuals with high risk for internet addiction.
• High risk for internet addiction is associated with consuming alcohol, marijuana and illicit drugs, but not with tobacco use.
Factors of the changes in depressive symptoms among retirees: a 3-year follow-up study in Taiwan
Authors: Huang N C , Hung Y T , Hu S C 
Published: October 2023

Abstract

Background
Depression is a critical mental problem for middle-aged and older adults. In addition, retirement and its adjustment may further affect their physical and psychological health. Hence, this study aims to explore the risk and protective factors associated with the changes in depressive symptoms among retirees.

Methods
A 3-year follow-up study was designed to examine the factors affecting the changes in depressive symptoms in retired people. A total of 2,379 participants aged 50 to 74 years were recruited from the Taiwan Health and Retirement Study during 2015-2019 (two waves). Three types of study variables were included: (i) sociodemographic factors: 9 items, (ii) health-related variables: 7 items, and (iii) psychosocial factors: 6 items. The changes in the 10-item CESD score after three years were measured as the outcome variable. The score change was divided into three groups: maintenance, deterioration, and improvement. Multinomial logistic regressions were used to analyze risk and protective factors related to changes in depressive symptoms in retirees.

Results
After adjusting for all covariates, this study found that retirement time ≥ 10 years, unskilled occupation before retirement, and having stressful life events after retirement may worsen depression scores three years later. Instead, getting a good night's sleep prevented worsening depression scores after three years. For the improvement group, the results showed that being a volunteer could improve the depression score; however, living alone and having poor health may hinder improving depression scores after three years. Furthermore, we found that factors associated with changes in depressive symptoms showed gender differences.

Conclusions
Future interventions to prevent depression should consider the diverse needs of different risk and protective factors and gender differences.

Key messages
• Retirees over ten years, with unskilled occupations and recent stressful events, were at high risk for depression. However, good sleep quality can help prevent depression.
• For male retirees, regular physical activity was an enabling factor for improving depression, whereas women benefited from social connections.