bluuebunny/crossref_metadata_2025_split huggingface dataset:
Working mothers during COVID-19: a cross-sectional study on mental health status and associations with the receipt of employment benefits
Authors: Kirwin Melissa A. , Ettinger Anna K. 
Published: March 2022

Abstract
Background
Beyond the sweeping physiological effects of COVID-19 infections in 2020 and 2021, the psychosocial impacts of lockdowns, social distancing, and the associated disruptions to daily life have brought on a simultaneous mental health crisis, particularly among many working mothers who are disproportionately balancing childcare, virtual schooling, and employment vulnerability. The aim of this study was to measure the mental health status of working mothers in the United States and associations with the provision of family-friendly employment benefits one year into the pandemic.

Methods
Cross-sectional data were collected from a sample of working mothers in the U.S. using an online survey of mental health status and the receipt of employer-provided family-friendly benefits. Mental health was measured with the Kessler 6 (K-6) and the Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS). Perceived helpfulness of benefits was assessed through self-reported Likert-scale scores of 0 (not at all helpful) to 4 (extremely helpful) to determine mean helpfulness scores for benefit types. Multivariable logistic regression analyses were conducted to determine associations between receipt of employment benefits and serious mental illness (SMI).

Results
A total of 728 participants met the study criteria, 83.7% were non-Hispanic/Latino white and 61.1% were 35–44 years of age. Among study participants, 54.3% (n = 395) and 21.8% (n = 159) reported psychological distress levels associated with moderate mental illness (MMI) and serious mental illness (SMI), respectively. Not receiving benefits was associated with a 50% increase in odds of SMI (aOR = 1.50, 95% CI [1.03–2.20], p = 0.036). Benefits perceived to be the most helpful for participants were flexible hours/schedule (3.5; SD ± 0.9), flexible work location (3.3; SD ± 1.1), and supplemental paid time off (3.1; SD ± 1.1), with mean scores above very helpful.

Conclusion
Results suggest employment benefits may help support the mental health of working mothers and provide a call to action to employers and policy stakeholders to develop solutions addressing gaps in workplace benefits and mental health support for working parents, with sustainable reform in mind to mitigate employment benefit inequities exposed by the pandemic.
Location, location, location: a discrete choice experiment to inform COVID-19 vaccination programme delivery in the UK
Authors: McPhedran Robert , Gold Natalie , Bemand Charlotte , Weston Dale , Rosen Rachel , Scott Robert , Chadborn Tim , Amlôt Richard , Mawby Max , Toombs Ben 
Published: March 2022

Abstract
Background
Large-scale vaccination is fundamental to combatting COVID-19. In March 2021, the UK’s vaccination programme had delivered vaccines to large proportions of older and more vulnerable population groups; however, there was concern that uptake would be lower among young people. This research was designed to elicit the preferences of 18–29-year-olds regarding key delivery characteristics and assess the influence of these on intentions to get vaccinated, to inform planning for this cohort.

Methods
From 25 March to 2 April 2021, an online sample of 2012 UK adults aged 18–29 years participated in a Discrete Choice Experiment. Participants made six choices, each involving two SMS invitations to book a vaccination appointment and an opt-out. Invitations had four attributes (1 × 5 levels, 3 × 3 levels): delivery mode, appointment timing, proximity, and sender. These were systematically varied according to a d-optimal design. Responses were analysed using a mixed logit model.

Results
The main effects logit model revealed a large alternative-specific constant (β = 1.385, SE = 0.067, p < 0.001), indicating a strong preference for ‘opting in’ to appointment invitations. Pharmacies were dispreferred to the local vaccination centre (β = − 0.256, SE = 0.072, p < 0.001), appointments in locations that were 30–45 min travel time from one’s premises were dispreferred to locations that were less than 15 min away (β = − 0.408, SE = 0.054, p < 0.001), and, compared to invitations from the NHS, SMSs forwarded by ‘a friend’ were dispreferred (β = − 0.615, SE = 0.056, p < 0.001) but invitations from the General Practitioner were preferred (β = 0.105, SE = 0.048, p = 0.028).

Conclusions
The results indicated that the existing configuration of the UK’s vaccination programme was well-placed to deliver vaccines to 18–29-year-olds; however, some adjustments might enhance acceptance. Local pharmacies were not preferred; long travel times were a disincentive but close proximity (0–15 min from one’s premises) was not necessary; and either the ‘NHS’ or ‘Your GP’ would serve as adequate invitation sources. This research informed COVID-19 policy in the UK, and contributes to a wider body of Discrete Choice Experiment evidence on citizens’ preferences, requirements and predicted behaviours regarding COVID-19.
The inequalities and determinants of Households’ Distress Financing on Out-off-Pocket Health expenditure in Malaysia
Authors: Mohd Hassan Nor Zam Azihan , Mohd Nor Sham Kunusagaran Mohd Shaiful Jefri , Zaimi Nur Amalina , Aminuddin Farhana , Ab Rahim Fathullah Iqbal , Jawahir Suhana , Abdul Karim Zulkefly 
Published: March 2022

Abstract
Background
Out-of-pocket (OOP) payments for healthcare services potentially have severe consequences on households, especially among the poor. Under certain circumstances, healthcare payments are financed through selling household assets, or borrowings. This certainly could influence households’ decision, which likely resorts to forgoing healthcare services. Thus, the focal point of this study is aimed to identify the inequalities and determinants of distress financing among households in Malaysia.

Methods
This study used secondary data from the National Health and Morbidity Survey (NHMS) 2019, a national cross-sectional household survey that used a two-stage stratified random sampling design involving 5,146 households. The concentration curve and concentration index were used to determine the economic inequalities in distress financing. Whereas, the determinants of distress financing were identified using the modified Poisson regression model.

Results
The prevalence of borrowing without interest was the highest (13.86%), followed by borrowing with interest (1.03%) while selling off assets was the lowest (0.87%). Borrowing without interest was highest among rural (16.21%) and poor economic status (23.34%). The distribution of distress financing was higher among the poor, with a concentration index of -0.245. The modified Poisson regression analysis revealed that the poor, middle, rich, and richest had 0.57, 0.58, 0.40 and 0.36 times the risk to develop distress financing than the poorest socio-economic group. Whereas, the presence of one and two or more elderly were associated with a 1.94 and 1.59 times risk of experiencing distress financing than households with no elderly members. The risk of developing distress financing was also 1.28 and 1.58 times higher among households with one and two members receiving inpatient care in the past 12 months compared to none.

Conclusions
The findings implied that the improvement of health coverage should be emphasized to curtail the prevalence of distress financing, especially among those caring for the elderly, requiring admission to hospitals, and poor socio-economic groups. This study could be of interest to policymakers to help achieve and sustain health coverage for all.
The effect of barberry (Berberis integerrima) on lipid profile and systemic inflammation in subjects with cardiovascular risk factors: a randomized controlled trial
Authors: Emamat Hadi , Zahedmehr Ali , Asadian Sanaz , Nasrollahzadeh Javad 
Published: March 2022

Abstract
Background
Despite significant advances in the management of cardiovascular disease (CVDs), there is still a large burden of CVD in the world. The inclusion of functional foods in the diet may provide beneficial effects on CVD. Purple-black barberry due to its richness in anthocyanins and berberine has shown beneficial effects on cardiometabolic factors. We investigated the effects of barberry on plasma lipids as well as inflammatory biomarkers in subjects with cardiovascular risk factors.

Methods
This was an 8-weeks, single-blinded, randomized controlled clinical trial that the participants were randomly assigned to a barberry (10 g/day dried barberry) or placebo group. At baseline and end of the study, plasma lipid profiles including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), small-dense LDL-C (sd-LDL-C), non-HDL-C, and TC/HDL-C, as well as inflammatory biomarkers including C-reactive protein (CRP) and interleukin-6 (IL-6), were determined. An intention-to-treat analysis was performed.

Results
Eighty-four participants were randomly assigned to study groups. The mean (± SD) participants' age was 54.06 ± 10.19 years. Body weight, body mass index (BMI), physical activity, and dietary intake were not different between the two groups at baseline and the end of the study. After adjusting for baseline values, we observed a significant decrease in plasma levels of TG, TC, LDL-C, sd-LDL-C, non-HDL-C, and TC/HDL-C (p < 0.001, p = 0.011, p = 0.015, p = 0.019, p = 0.004, and p = 0.039 respectively) as well as CRP (p = 0.020) in the barberry group compared to the placebo group.

Conclusions
Our results indicate that purple-black barberry consumption decreases plasma levels of CRP and improves lipid profile in subjects with cardiovascular risk factors.

Trial registration
This clinical trial was registered at ClinicalTrials.gov (NCT number: NCT04084847).
“We could be good partners if we work together”: the perspectives of health and social service providers on the barriers to forming collaborative partnerships with social housing providers for older adults
Authors: Sheppard Christine L. , Gould Sarah , Guilcher Sara J. T. , Liu Barbara , Linkewich Elizabeth , Austen Andrea , Hitzig Sander L. 
Published: March 2022

Abstract

Background
Many older adults are aging-at-home in social housing. However, the lack of integration between housing and health services makes it difficult for older tenants to access needed supports. We examined barriers and facilitators health and social service providers face providing on-site services to older tenants.

Methods
We conducted semi-structured qualitative interviews and focus groups with health and social service professionals (n = 58) in Toronto, Canada who provide community programs in support of older tenants who live in non-profit, rent-geared-to-income social housing. Interviews examined the barriers they faced in providing on-site services to older tenants.

Findings
Service providers strongly believed that collaboration with on-site housing staff led to better health and housing outcomes for older tenants. Despite the recognized benefits of partnering with housing staff, service providers felt that their ability to work effectively in the building was dependent on the staff (particularly the superintendent) assigned to that building. They also identified other barriers that made it difficult to work collaboratively with the housing provider, including staffing challenges such as high staff turnover and confusion about staff roles, a lack of understanding among housing staff about the link between housing and health, challenges sharing confidential information across sectors, and complex and inefficient partnership processes.

Conclusion
Older adult tenants are increasingly vulnerable and in need of supports but the housing provider has a long history of ineffective partnerships with service providers driven by complex and inefficient staffing models, and an organizational culture that questions the role of and need for partnerships. Findings highlight the need for more effective integration of housing and health services. Simplified processes for establishing partnerships with service agencies and more opportunities for communication and collaboration with housing staff would ensure that services are reaching the most vulnerable tenants.
Health insurance coverage and antenatal care services utilization in West Africa
Authors: Dadjo Joshua , Ahinkorah Bright Opoku , Yaya Sanni 
Published: March 2022

Abstract
Background
In recent decades, there has been a significant focus towards the improvement of maternal mortality indicators in low-and middle-income countries. Though progress has been made around the world, West Africa has maintained an elevated burden of diseases. One proposed solution to increasing access to primary care services is health insurance coverage. As limited evidence exists, we sought to understand the relationship between health insurance coverage and at least four antenatal care (ANC) visits in West Africa.

Methods
Demographic and Health Survey data from 10 West African countries were weighted, cleaned, and analysed. The total sample was 79,794 women aged 15 to 49 years old were considered for the analysis. Health insurance coverage was the explanatory variable, and the outcome variable was number of ANC visits. The data were analysed using binary logistic regression. The results were presented using crude and adjusted odds ratio (aOR) at 95% confidence interval.

Results
Approximately 86.73% of women who were covered by health insurance had four or more ANC visits, compared to 55.15% for women without insurance. In total, 56.91% of the total sample attended a minimum of four ANC visits. Women with health insurance coverage were more likely to make the minimum recommended number of ANC visits than their non-insured-peers (aOR [95% CI] =1.55 [1.37–1.73]).

Conclusion
Health insurance is a significant determinant in accessing primary care services for pregnant women. Yet, very few in the region are covered by an insurance scheme. In the wake of the COVID-19 pandemic, policy makers should prioritize rapid solutions to provide primary care while setting the infrastructure for long-term and sustainable options such as publicly run health insurance schemes.
Talking together in rural palliative care: a qualitative study of interprofessional collaboration in Norway
Authors: Johansen May-Lill , Ervik Bente 
Published: March 2022

Abstract
Background
Caring for people with palliative care needs in their homes requires close collaboration within and between primary and hospital care. However, such close collaboration is often lacking. Transitions of care are potentially unsafe and distressing points in a patient trajectory. Few studies have explored the experiences of healthcare professionals in the community who receive patients from hospital care and provide them with palliative care at home.

Objective
To explore how rural health professionals experience local and regional collaboration on patients in need of palliative care.

Methods
This was a qualitative focus group and interview study in rural Northern Norway involving 52 primary care health professionals including district nurses, general practitioners, oncology nurses, physiotherapists, and occupational therapists. Five uni-professional focus group discussions were followed by five interprofessional discussions and six individual interviews. Transcripts were analysed thematically.

Results
“Talking together” was perceived as the optimal form of collaboration, both within primary care and with specialists. Nurses and GPs had similar perceptions of their worst-case scenario in primary palliative care: the sudden arrival after working hours of a sick patient about whom they lacked information. These situations could be the result of a short notice transfer from secondary care or an emergency presentation after a crisis in patient management locally, the latter often resulting in a hospital admission. Participants missed timely and detailed discharge letters and in complex cases a telephone call or conference. Locally, co-location was perceived as advantageous for crucial communication, mutual support, and knowledge about each other’s competencies and work schedule. Because local health professionals belonged to different units within the primary health care organisation, in some places they had limited knowledge about each other’s roles and skill sets.

Conclusions
Lack of communication, both locally and between specialist and primary care, was a key factor in the worst-case patient scenarios for GPs and nurses working in primary palliative care in rural Northern Norway. Co-location of primary care professionals promoted local collaboration and should be encouraged. Hospital discharge planning should involve the receiving primary care professionals.
Molecular prevalence and subtyping of Cryptosporidium spp. in fecal samples collected from stray cats in İzmir, Turkey
Authors: Köseoğlu Ahmet Efe , Can Hüseyin , Karakavuk Muhammet , Güvendi Mervenur , Değirmenci Döşkaya Aysu , Manyatsi Pumla Bhekiwe , Döşkaya Mert , Gürüz Adnan Yüksel , Ün Cemal 
Published: March 2022

Abstract
Background
Cryptosporidium spp. are obligate intracellular apicomplexan parasites transmitted to humans and other animals by contaminated water, food, or direct contact. They mainly cause gastrointestinal symptoms, although subclinical infections are also common. Cats are primarily infected by host-adapted Cryptosporidium felis while C. parvum and C. muris have also been detected in some cases. In this study, the molecular prevalence of Cryptosporidium spp. was investigated by screening 399 fecal samples collected from stray cats using nested PCR targeting the 18S rRNA gene for the first time in Turkey. Additionally, Cryptosporidium PCR-positive samples were genotyped by nested PCR- restriction fragment length polymorphism (RFLP), and subsequently, amplicons of 18S SSU rRNA were sequenced. They were further subtyped by amplification and sequencing of the gp60 gene.

Results
Among fecal samples screened, 12 of them (3%) were found to be Cryptosporidium-positive, and according to RFLP and sequencing of 18S rRNA gene, all positive samples were identified as C. felis. Subtyping analyses at the gp60 gene showed that C. felis isolates belonged to the XIXa subtype family, which are closely related to human subtypes of the parasite.

Conclusions
The results of this study are important in terms of indicating the potential role of stray cats for transmission of Cryptosporidium spp. to humans or other animals. Also, the presence of XIXa, which is the dominant subtype family of C. felis in cats and humans was shown for the first time in stray cats of İzmir, Turkey.
Association of body mass index and COPD exacerbation among patients with chronic bronchitis
Authors: Shin Sun Hye , Kwon Sung Ok , Kim Victor , Silverman Edwin Kepner , Kim Tae-Hyung , Kim Deog Kyeom , Hwang Yong Il , Yoo Kwang Ha , Kim Woo Jin , Park Hye Yun 
Published: March 2022

Abstract
Background and objective
Chronic obstructive pulmonary disease (COPD) patients with a body mass index (BMI) < 25 kg/m2 are prone to develop adverse event of pharmacological treatment for frequent exacerbation. As chronic bronchitis (CB) is one of the strong risk factors of exacerbation, we investigated the associations between BMI and COPD exacerbations in patients with CB.

Methods
Patients with COPD were included from the Korean COPD Subgroup Study (KOCOSS), a multicenter observational cohort study. CB was defined using the St. George’s Respiratory Questionnaire and the participants were categorized according to BMI cut-off of 25 kg/m2. Exacerbations during a 1-year follow-up were compared among four groups: non-CB with BMI ≥ 25 kg/m2, non-CB with BMI < 25 kg/m2, CB with BMI ≥ 25 kg/m2, and CB with BMI < 25 kg/m2.

Results
Among the 1264 patients with COPD, 451 (35.7%) had CB and 353 (27.9%) had both CB and BMI < 25 kg/m2. The COPD exacerbation risk increased across the non-CB with BMI < 25 kg/m2, CB with BMI ≥ 25 kg/m2, and CB with BMI < 25 kg/m2 groups (adjusted incidence rate ratio [95% confidence interval] 1.21 [0.89–1.62], 1.20 [0.77–1.88], and 1.41 [1.02–1.91], respectively, compared to the non-CB with BMI ≥ 25 kg/m2 group).

Conclusions
COPD patients having both CB and a BMI < 25 kg/m2 are at higher risk of exacerbations. Considering that a BMI < 25 kg/m2 often limits treatment options preventing exacerbations, modified guidelines might be needed for non-obese CB patients in Asia.
Using routine programmatic data to measure HIV incidence among pregnant women in Botswana
Authors: Ortblad Katrina F. , Mawandia Shreshth , Bakae Odirile , Tau Lenna , Grande Matias , Mogomotsi Goabaone Pankie , Mmatli Esther , Ngombo Modise , Seckel Laura , Heffron Renee , Pintye Jillian , Ledikwe Jenny 
Published: March 2022

Abstract
Introduction
Pregnant women in sub-Saharan Africa have high risk of HIV acquisition, yet approaches for measuring maternal HIV incidence using routine surveillance systems are undefined. We used programmatic data from routine antenatal care (ANC) HIV testing in Botswana to measure real-world HIV incidence during pregnancy.

Methods
From January 2018 to September 2019, the Botswana Ministry of Health and Wellness implemented an HIV testing program at 139 ANC clinics. The program captured information on testers’ age, testing date and result, and antiretroviral treatment (ART) initiation. In our analysis, we excluded individuals who previously tested HIV-positive prior to their first ANC visit. We defined incident HIV infection as testing HIV-positive at an ANC visit after a prior HIV-negative result within ANC.

Results
Overall, 29,570 pregnant women (median age 26 years, IQR 22–31) tested for HIV at ANC clinics: 3% (836) tested HIV-positive at their first recorded ANC visit and 97% tested HIV-negative (28,734). Of those who tested HIV-negative, 28% (7940/28,734) had a repeat HIV test recorded at ANC. The median time to HIV re-testing was 92 days (IQR 70–112). In total, 17 previously undiagnosed HIV infections were detected (HIV incidence 8 per 1000 person-years, 95% CI 0.5–1.3). ART initiation among women newly diagnosed with HIV at ANC (853) was 88% (671/762).

Conclusions
In Botswana, real-world HIV incidence among pregnant women at ANC remains above levels of HIV epidemic control (≤ 1 per 1000 person-years). This study shows how HIV programmatic data can answer timely population-level epidemiological questions and inform ongoing implementation of HIV prevention and treatment programs.