bluuebunny/crossref_metadata_2025_split huggingface dataset:
Country-level determinants of gender differences in major depression and alcohol use disorder
Authors: Hagen D , Goldmann E , Ompad DC , Bambra C 
Published: October 2022

Abstract

Background
Major depressive disorder (MDD) and alcohol use disorder (AUD) are leading causes of disease burden in Europe, with MDD disproportionately affecting women and AUD being more prevalent among men. However, it is unclear how country-level political and socio-cultural characteristics contribute to gender differences in these conditions.

Methods
Data for 30,416 participants from 16 countries were obtained from the 2014 European Social Survey. Depressive symptoms were ascertained using the 8-item CES-D scale, and alcohol use was assessed with items on past-year alcohol use frequency and quantity, as well as frequency of heavy episodic drinking. Country-level data for attitudes to gender equality, needs-adjusted public social expenditure, and other covariates came from the 2012 International Social Survey Programme and the OECD. Modified Poisson and linear regression with log link examined additive and multiplicative interactions of country-level characteristics with gender for MDD, AUD, and their specific symptoms/dimensions.

Results
Public social expenditure was not associated with gender differences in MDD (CES-D&gt;10), but with greater differences in the prevalence of the loneliness and sadness symptoms; support for gender equality was associated with smaller differences in loneliness (p &lt; 0.05). For AUD, there was evidence of increased alcohol use frequency and quantity among women, and decreased frequency and quantity among men associated with support for gender equality, resulting in lower gender differences in predicted probabilities (from 23% to 5% across exposure levels; p &lt; 0.001). Heavy episodic drinking was strongly positively associated with support for gender equality among women (p &lt; 0.001), but not among men.

Conclusions
Country-level characteristics appear to exert differential impact on the prevalence of AUD and certain psychological symptoms of MDD among men and women in Europe. Pending replication, future research should examine underlying mechanisms.

Key messages
The association of loneliness and social isolation with healthcare utilization in Denmark
Authors: Christensen J , Pedersen SS , Andersen CM , Qualter P , Lund R , Lasgaard M 
Published: October 2022

Abstract

Objectives
The present prospective cohort study investigated the association of loneliness and social isolation (SI) with healthcare utilization (HCU) in the general population over time.

Methods
Data from the 2013 Danish “How are you?’ survey (n = 29,472) were combined with individual-level register data from the National Danish Patient Registry and the Danish National Health Service Registry over a 6-year follow-up period (2013-2018). Negative binomial regression analyses were performed while adjusting for baseline demographics and chronic disease.

Results
Loneliness measured at baseline was significantly associated with more GP contacts (incident-rate ratio (IRR) = 1.03, 95% confidence interval (CI) [1.02, 1.04]), more emergency treatments (IRR = 1.06, 95% CI [1.03, 1.10]), more emergency admissions (IRR = 1.06, 95% CI [1.03, 1.06]), and hospital admission days (IRR=1.05, 95% CI [1.00, 1.11]) across the 6-year follow-up period. No significant associations were found between social isolation and HCU with one minor exception, in which SI was associated with fewer planned outpatient treatments (IRR = .97, 95% CI [.94, .99]).

Conclusions
Our findings suggest that loneliness is a risk factor for certain types of HCU, independent of social isolation, baseline demographics, and chronic disease.

Key messages
Burden of alcohol use disorder in Balkan countries
Authors: Todorovic J , Santric- Milicevic M , Terzic-Supic Z , Stevanovic A , Stamenkovic Z , Terzic N , Scepanovic L , Albreht T , Stoisavljevic S 
Published: October 2022

Abstract

Background
Alcohol use is recognized as an important risk factor for more than 200 different diseases and injuries. In the Diagnostic statistic Manual- 5 (DSM-5) it is defined as ‘impaired control over alcohol consumption with chronic, heavy and often escalating pattern of alcohol use despite significant detrimental consequences to their overall health, the lives of their family members and friends and society in general’. The aim of this study was to describe the disability adjusted life years (DALY) associated with the alcohol use disorder in the Balkan countries in the period between 1990 and 2019.

Methods
The study included the data on age-standardized DALY rate per 100,000 for alcohol use disorder in the period between 1990 and 2019 for ten Balkan countries (Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Greece, Montenegro, North Macedonia, Romania, Serbia and Slovenia) from the Institute of Health Metrics and Evaluation. We acknowledge the support from the COST Action 18218 - European Burden of Disease Network.

Results
The highest age-standardized DALY rate in 1990 was in Romania 484.03 per 100,000 (95% CI: 394.68-594.99), while the highest age-standardized DALY rate per 100,000 in 2019 was in Slovenia 427.75 (95% CI: 332.28-543.83). Along with Slovenia, only country that recorded the increase in the age-standardized DALY rates in the period between 1990 and 2019 was Albania, but the increase was only marginal (DALY per 100,000 increased from 174.24, 95% CI: 115.07-244.76 to 187.92, 95% CI: 127.26-262.41). The lowest burden measured in age-standardized DALY rates per 100,000 in 1990 was in Albania, and in 2019 was in Greece- 174.68, 95% CI: 113.66-251.34.

Conclusions
In the majority of the Balkan countries the age-standardized DALY rates per 100,000 for alcohol use disorder decreased in the observed period. The increase is observed for Slovenia and Albania, with the more apparent increase in Slovenia.

Key messages
Sexual and Contraceptive Behaviour of Adolescents and Young Adults in Germany
Authors: Scharmanski S , Hessling AH 
Published: October 2022

Abstract

Background
For 40 years the Federal Centre for Health Education in Germany has been analysing the contraception behaviour of young people. The current Survey is the ninth iteration, carried out in 2019. This continuous monitoring generates insights on the sexual and reproductive health of young people in Germany. The survey provides an important basis for the development of sexuality education and family planning measures.

Methods
A total of N = 6032 adolescents and young adults participated in the survey. Date collection was conducted by computer-assisted personal interviewing (CAPI). The current sexual and contraceptive behaviour of adolescents and young adults will be summarized using descriptive results. In addition, the association between contraception non-use and sociodemographic factors, characteristics of sexuality education and situated factors of first sexual intercourse is analysed by multivariate logistic regressions.

Results
A key finding of this iteration is that with regards to the age of the first sexual intercourse, the proportion of adolescents younger than 17 years has been declining for several years. For contraception, adolescents most frequently used condoms, and use of the pill has decreased. 9% of the participants reported non-contraception use at first sexual intercourse. This is significantly associated (p &lt; .01) with unexpected and only unilaterally desired sexual intercourse and the absence of sexuality education in School. In addition, the younger the adolescence were at first sexual intercourse the greater the risk for contraception non-use.

Conclusions
The data from the current iteration indicate safe and responsible contraceptive behaviour among young people in Germany. It is important to maintain the commitment in the field of sexual health promotion and expand prevention measures for young people. This is the only way to ensure the sexual and reproductive health also in the next generation.

Key messages
Social inequalities in multimorbidity patterns in southern Spain: findings from the DEMMOCAD survey
Authors: Carretero-Bravo J , Ortega-Martín ME , Ramos-Fiol B , Suárez-Lledó V , Álvarez-Gálvez J 
Published: October 2022

Abstract

Background
Multimorbidity (MM) is associated with lower quality of life, greater disability, and higher use of health services. It is a complex problem that is difficult to capture due to the broad spectrum of concurrent chronic diseases involved. There is a need to identify and characterize patterns of chronic conditions in the local context of specific population groups. The DEMMOCAD project aims to respond to this knowledge gap by detecting patterns of MM and their inequalities in the province of Cadiz (Spain).

Methods
A cross-sectional study was carried out by means of telephone interviews with people over 50 years of age. The final sample was 1592 individuals with MM. A latent class analysis was carried out to identify patterns of MM from 31 chronic conditions. First, the appropriate number of classes was established, considering model fit indices, class size, and clinical interpretability. Subsequently, covariates were introduced into the model using the three-step approach, a technique that minimizes biases in the multinomial regression model.

Results
Preliminary analyses of the goodness-of-fit indices of the model derived five MM patterns (entropy = 0.727): (C1) mild MM; (C2) cardiovascular; (C3) musculoskeletal; (C4) musculoskeletal plus mental; and (C5) complex MM. Compared with class C1, persons in class C5 were significantly older and less educated, class C4 had a lower income, class C3 was smokers and disabled, and class C2 was characteristic among older males. All four classes also showed lower scores on mental and physical dimensions of the SF12 scale compared to class C1.

Conclusions
In addition to providing an adjusted characterization of the population of the area analyzed, these initial findings highlight the existence of social inequalities in multimorbidity at the local level that should be addressed by implementing policies targeting the most vulnerable groups in Cadiz (low socioeconomic status groups, people with disabilities, and the elderly).

Key messages
An analysis of RMNCH data quality on technological applications and methods to improve it
Authors: Harhini H , Sidh P Nath 
Published: October 2022

Abstract

Background
Health information management systems (HIMS) are used by most countries to record data on the coverage of reproductive, maternal, newborn and child health services (RMNCH). The HIMS in India manually collects data from primary health care facilities. Low and middle income countries (LMIC) are shifting to technological applications (apps) to improve reporting and real time tracking of RMNCH services. This study found high disparity of data between different sources. Yet governments and other stakeholders continue to use poorly reported data for daily monitoring, review and decision making. This study shares insight on the high degree of data variation, and proposes process and policy changes to improve it.

Methods
To quantify the extent of data variation, critical RMNCH indicators from apps and HIMS are compared for a given geography and time period. Workshops with the primary health workers and their supervisors were conducted to understand the challenges in reporting, based on which solutions to improve the efficiency of apps are proposed.

Results
Preliminary analysis in the state of Madhya Pradesh shows, in the year 2020-2021 live births, neonatal deaths and Infant deaths were 93%, 91% and 71% less respectively on apps as compared to HIMS. Major challenges of reporting on technological applications by primary health workers

Conclusions
Online data quality must be governed by policies that focus on implementing mechanisms to analyze and validate data from different sources and remove blockages to quality reporting. Online public health reports need to be demystified by building capacities of primary health workers and their supervisors to use data to reflect on their performance and plan for improvement.

Key messages
Trends in working years lost due to different types of work disability and unemployment
Authors: Leinonen T , Viikari-Juntura E , Solovieva S 
Published: October 2022

Abstract

Background
Little is known about working years lost (WYL) due to work disability and unemployment by industrial sector. This information would help in directing interventions promoting healthy working careers, knowing that the sectors have been differently affected by economic fluctuations and other changes in the labour market. We examined trends in WYL in the general Finnish population and by industrial sector in the period after the 2008 financial crisis with a particular focus on different types of work disability.

Methods
Utilising register data on the Finnish working-age population and the Sullivan method, we calculated expected WYL due to sickness absence, other temporary work disability, partial disability retirement, full disability retirement, unemployment and other reasons in years 2010, 2013 and 2016 for the general male and female populations and by industrial sector.

Results
In 2010, a 30-year-old person was expected to have around two-and-a-half to three WYL due to full disability retirement and unemployment until reaching age 65, depending on gender and the reason. By 2016, WYL due to full disability retirement decreased to less than two years and that due to unemployment increased to around four years among both genders. WYL due to sickness absence, other temporary work disability, partial disability retirement and other reasons remained relatively stable. The total WYL increased between 2010 and 2016 particularly among women. The differences by industrial sector in WYL were attributable more to unemployment than to the different work disability statuses.

Conclusions
After the financial crisis unemployment appears to have replaced disability retirement as the most important reason for WYL. Furthermore, as individuals with a defined industrial sector are initially employed, sectoral differences in WYL are not largely attributable to disability retirement, disability pensioners typically having been outside the labour market for a long time.

Key messages
Job resources do not mitigate the impact of job demands for workers with depression
Authors: Ots P , Keller AC , Altrock E , van Zon SKR , Brouwer S 
Published: October 2022

Abstract

Introduction
Jobs characterized by low to moderate job demands and high job resources are associated with better work outcomes among healthy workers, yet it remains unclear whether this is the case for workers with depression. This study examined whether depression moderates the relationship between job demands, job resources, and maintaining employment.

Methods
Data from the longitudinal population-based Lifelines cohort study were matched with register data on employment status from Statistics Netherlands (n = 55,950). The two-way interaction between job demands and depression and the three-way interaction between job demands, job resources and depression were examined in a zero-inflated Poisson regression model with path 1 including a binary employment outcome and path 2 a count variable including months out of employment.

Results
The interaction effect of job demands and depression on being employed was significant (b=-0.22, 95% CI: -0.44; 0.01), showing that workers without depression were more likely to be employed whereas workers with depression were less likely to be employed if they had high job demands. The three-way interaction between job demands, job resources, and depression was significant for months out of employment (b = 0.15, 95% CI: 0.01; 0.29), indicating that workers with depression had more months out of employment when reporting high job demands and high job resources compared to workers without depression.

Discussion
Although increasing resources to prevent negative work outcomes may be beneficial for workers without depression, this approach might be limited for the vulnerable subgroup of workers with depression.

Key messages
Determinants influencing municipal decision-makers in Germany regarding community health promotion
Authors: Paulsen L , Benz L , Müller C , Wallmann-Sperlich B , Bucksch J 
Published: October 2022

Abstract

Background
Community health promotion should be based on theoretical behavioural and environmental approaches. Especially changes in the physical environment require administrative and political decisions. This study aims to identify determinants that influence decision-makers from local politics and administrations on decisions so that health promotion can be placed on the agenda of communities as a prerequisite of intervention implementation.

Methods
We used the methods of qualitative guided interviews and a quantitative survey. First, decision-makers from local politics and administrations in both urban and rural areas in Germany were interviewed in the period from July to November 2020. The interviews were analysed using qualitative content analysis according to Kuckartz and MAXQDA. Second, a nationwide online survey was conducted using Limesurvey. We used descriptive analyses. In both surveys, decision-makers reported the determinants for decision-making processes and their decision-making behaviour.

Results
22 interviews were conducted (women n = 7), and 415 participants (women n = 118) responded to the online survey. The decision-making behaviour of local decision-makers can be differentiated on different levels, following socio-ecological models: individual, socio-cultural, institutional, municipal and political. Each of these levels comprises a multitude of determinants that are essential for successful persuasion toward community health promotion. At the individual level, we identified determinants like attitudes, outcome expectations or emotions towards a topic.

Conclusions
The identification and understanding of determinants for local decision-making are essential for a tailored and theory-based intervention approach to place health promotion on the agenda of communities and to implement interventions. Further research is needed to replicate the importance of potential determinants and to develop effective intervention methods and techniques.

Key messages
Hand hygiene and HAI transmission in Piedmont, Italy: an observational study, 2017-2019
Authors: Russotto A , Vicentini C , Zotti CM 
Published: October 2022

Abstract

Background
Hand hygiene (HH) is one of the most important measures to prevent healthcare-associated infections (HAIs). Several indicators have been proposed to measure HH practices, including alcohol-based handrub consumption (AHC). The objective of this study was to evaluate whether AHC is associated with HAI transmission.

Methods
All 25 public hospitals/trusts of Piedmont, in Northern Italy, are required to provide data each year concerning HAIs and infection prevention and control (IPC) activities, as part of a mandatory regional indicator system. Data on AHC and HAIs were extracted from reports provided concerning the years 2017-2019. The mean annual AHC for each facility was expressed as liters per patient-day. The rate of hospital-wide Methicillin-resistant Staphylococcus aureus (MRSA) and carbapenem-resistant Enterobacteriaceae (CRE) infections was calculated per 1000 patient-days (pd). Mean ventilation-associated infections (VAP) for 1000 days of ventilation (vd) and mean catheter-related bloodstream infections (CR-BSI) for 1000 days of catheterization (cd) were calculated for intensive care units (ICUs). Spearman's correlational analysis was conducted between AHC and HAIs: hospital-level, ICU-level.

Results
Hospital-level: mean AHC was 15.4 liters/pd; mean HAI rate was 39.6/1000 pd (MRSA) and 18.5/1000 pd (CRE). No significant correlation was found. ICU-level: mean AHC was 39.6 liters/pd; mean HAI rate was 1.7/1000 cd (CR-BSI) and 8.2/1000 vd (VAP). A moderate correlation was found between AHC and CR-BSI rate (Spearman's ρ -0.55, p 0.022). Concerning AHC and VAP, higher AHC was reported from facilities with lower VAP rates, however no significant correlation was found (Spearman's ρ -0.203, p 0.451).

Conclusions
Results of this study support the validity of AHC as an indicator of IPC practices in ICUs. The hospital-level analysis could have been affected by important differences in AHC among ward types.

Key messages
Impact of lockdown on football players’ injuries
Authors: Falcone V , Romani D , Nante N , Cocchi F , Messina G 
Published: October 2022

Abstract

Background
The global outbreak of COVID-19 has resulted in the closure of stadiums and the interruption of Serie A for three months. Many studies have evaluated the effects of COVID on population health, but few have evaluated the effects of containment measures on the health of football players. With this study, we evaluated the impact of this break on Serie A football players.

Methods
This cross-sectional study was conducted considering a timespan of three Serie A seasons (2018-19; 2019-20; 2020-21). The information was obtained from the German website Transfermarkt. All the players who had played at least one match during each of the Serie A season were identified. For each of the players, data concerning the number of days lost due to injury, both before and after the stop in the championship due to Covid, were collected. Statistical analysis was performed using Stata 17 Software.

Results
According to the selection criteria, 264 players were selected. This group was subsequently skimmed to 256 players after eliminating all players who did not suffer physical injuries over the timespan considered (non-purely orthopedic surgery; COVID; Intestinal problems; Infections). 256 players were analysed, 228 had skipped at least one day for pre-lockdown due to physical injury (median=37,5), while 227 missed a day for post-lockdown (median=27). Wilcoxon signed-rank test between days lost due to injuries before and after lockdown highlighted significant differences (p &lt; 0.05).

Conclusions
Comparing pre-lockdown and post-lockdown periods, we noticed that there were fewer days skipped due to physical injury post lockdown. Statistical evidence suggests that the same players were more susceptible to suffer physical injuries in the pre-lockdown period. This is probably because some players have worked with home coaching by spending more time in the gym and less time on the field. Also tapis roulant and cyclettes were often delivered to football players’ homes.

Key messages