1,721,119 research outputs found
Socioeconomic inequality in non-communicable diseases in Europe between 2004 and 2015: evidence from the SHARE survey
Full text linkBackground
The scope of this work was to investigate socioeconomic inequalities among European adults aged 50 or older in chronic diseases and behavioural risk factors for these diseases, namely, smoking habits, obesity and physical inactivity, between 2004 and 2015.
Methods
Data for this study were drawn from the Survey of Health, Ageing and Retirement (SHARE) in Europe, which is a panel database of microdata on health, socioeconomic status and social and family networks of people aged 50 years or older, covering most of the European Union. The predicted number of non-communicable diseases (NCDs) was used to estimate the concentration index and to find the contributions of determinants to socioeconomic inequalities in chronic diseases.
Results
The inequality disfavoured the poor in both years, but the effect was stable from 2004 (C = −0.071) to 2015 (C = −0.081). Inequality was shown to be attributed mostly to physical inactivity and obesity and this contribution increased during the study period. Among socioeconomic status (SES) determinants, education and marital status were the most concentrated in both years, while physical inactivity and obesity were the most concentrated behavioural risk factors in both years.
Conclusions
To prevent chronic diseases, health policy should aim not only to improve individual health behaviours in the population, but also to reduce socioeconomic inequality. Our study suggests promoting a healthy lifestyle in the most disadvantaged socioeconomic classes as a strategy to improve the health conditions of the whole population
Non-communicable diseases, socio-economic status, lifestyle and well-being in Italy: An additive Bayesian network model
No full textThe aim of the paper is to investigate the statistical association, on a sample
of Italian subjects, extracted by Survey of Health, Ageing and Retirement in Europe
(SHARE) dataset, between chronic diseases (occurrence or number of chronic
diseases) and socio-economic and behavioural determinants (lifestyle indicators,
QoL indicators, cognitive functioning variables). To this aim, additive Bayesian
network (ABN) analysis was used. The resulting ABN model shows that better educated
individuals have better health outcomes, age is direct and gender is an
indirect determinant of the number of chronic diseases. Furthermore, self-perceived
health is associated with lower number of chronic diseases, lower physical limitations
and higher quality of life and these indicators can be considered within a
unitary vision to represent well-being of elderly people, as they share a similar distribution
by gender and age
Evaluating the reform of the healthcare system in sicily: Variations of efficiency and appropriateness between 2008 and 2010
Full text linkBackground: Sicilian government has developed a very ambitious Reform through Regional Law n. 5 (14th April 2009). Hospitals were requested to ensure the quality of care through monitoring of appropriateness and quality of service. The aim of this study was to assess variations of efficiency and organizational appropriateness of healthcare delivery before and after this Reform, and to show patterns associated to different types of healthcare delivery organizations. Methods: This study was based on repeated cross-sectional data for 118 (out of 129) short-term, acute-care, non teaching-and-research Sicilian hospitals, in 2008 and 2010. Congestion and slacks analysis was used, with four inputs, two desirable outputs and two undesirable outputs of healthcare delivery. Results: The loss of desirable output increased between 2008 (23%) and 2010 (31%). Most of the variation between the two years in the measured inefficiency could be attributed to congestion due to inappropriate care (p=0.009) and scale inefficiency (p=0.028). Hospitals that have undergone an organizational transformation did not show congestion in the study period. Conversely, hospitals with no variations in their organization were congested in association to the shortfall in the ODs (p=0.019) and in DHs (p=0.018). Conclusion: This study has shown the general worsening of efficiency of acute-care Sicilian hospitals from 2008 to 2010 and, in particular, has suggested that the reduction of efficiency was due to hospitals that have not undergone an organizational transformation. They are medium-low sized and low-complexity public hospitals and for-profits, while larger and high-complexity organizations were shown to be the least congested
Assessing congestion in emergency obstetric care in public hospitals in Tamil Nadu
No full textPurpose – The purpose of this paper is to assess congestion as the simultaneous occurrence of desirable
health output (e.g. maternal admissions) along with undesirable output (e.g. still births (SB)), in emergency
obstetric care settings of public hospitals in Tamil Nadu.
Design/methodology/approach – The study is based on a cross-sectional data set of 97 public hospitals
collected by the statistical cell of Tamil Nadu Health Systems Project for the year 2013–2014. The study uses
three inputs – beds, doctors and nurses; three desirable outputs – maternal admissions, neonatal admission
and live births; and four undesirable outputs – SB, intra-uterine deaths, neonatal deaths and maternal deaths.
Congestion analysis, a variant of the data envelopment analysis (DEA) method and slack analysis, has been
applied to detect an excessive use of some inputs or a shortfall in some outputs across these hospitals.
Furthermore, the association between congestion and some contextual factors has been examined.
Findings – On an average, the hospitals in our sample can increase the total amount of outputs by
62.8 percent by improving overall efficiency, and about 34.2 percent of this inefficiency can be attributed
to congestion. Analysis of sub-samples showed that government hospitals at the taluk level have higher
congestion than district headquarter hospitals. Congestion seems to decrease with greater hospital volume
up to a limit; beyond that, it increases in obstetric care settings.
Originality/value – Hospital-based efficiency studies in the Indian context, so far, have estimated relative
efficiency among hospitals using the classical DEA method, but ignoring adverse health outcomes.
Congestion analysis, an advance in the DEA method, considers how much the desirable outputs can be
increased as also how much undesirable outputs affect efficiency
Social networks and social activities promote cognitive functioning in both concurrent and prospective time: evidence from the SHARE survey
No full textThe study aimed to investigate the role of social activities, social networks as well as socioeconomic status (SES) in influ-encing some aspects of cognitive functioning (immediate and delayed verbal recall tests and semantic verbal fluency) in elderly people over time. This analysis was conducted on a sample of 31,954 healthy elderly people (58% female, mean age 65.54 ± 9.74) interviewed in both the fourth and sixth waves of the Survey on Health, Aging and Retirement in Europe (SHARE), in 2011 and 2015. A structural equation model with measurement component was used to assess the relation-ship between cognitive function, social life and SES over time. Multilevel ordinal logistic regression was applied to explain satisfaction with social network in relation to different types of social network across countries. Being equipped with good cognitive skills did not seem to be predictive of their maintenance over time (latent coefficient = 0.24, p value = 0.34). On the contrary, the subject’s social and participatory life, understood as satisfying one’s social network and engaging in diversi-fied non-professional social activities, seemed to play a crucial role in the maintenance of cognitive functions in the elderly (latent coefficient = 3.5, p value = 0.03). This research suggests that a socially active and participatory lifestyle mitigates the effects of the physiological process of brain aging
Gingival displacement using diode laser or retraction cords: A comparative clinical study
No full textPURPOSE:
To compare two systems used for conditioning the gingival sulcus and exposing the finish line before the final impression for a fixed denture: retraction cords and diode laser. METHODS:
All subjects participating in the study had healthy gingival and periodontal status before intervention for fixed prosthesis. 74 abutments for complete crown restoration were randomly divided into two groups for displacing the gingival sulcus before the final impression: gingival retraction cords (RC) and diode laser (DL). The height of the clinical crowns was measured by a blinded examiner in three points of the buccal surface (mesial, midline and distal) at four different times: after tooth preparation (T0), 15 days after tooth preparation, before exposing the finish line with RC or with DL (T1), 10 minutes after exposing the finish line (T2), and 15 days after the final impression was taken (T3). The amount of gingival retraction produced (ΔT2-T1) and restoration to baseline (ΔT3-T1) were calculated. Ease of technique and patient comfort were evaluated through the Visual Analog Scale. The time required to carry out the technique and bleeding during and after the conditioning procedure were also evaluated.
RESULTS:
There was no difference between the two techniques with regard to the height differences: ΔT2-T1 was 0.65±0.33 for RC and 0.66±0.43 for the DL (P= 0.966), while ΔT3-T1 was 0.03±0.27 for RC and 0.02±0.46 for DL (P= 0.286). DL required less time, was easier for the operator and more comfortable than RC for the patient (all P<0.001).
CLINICAL SIGNIFICANCE:
The amount of gingival retraction and restoration to baseline resulting from use of gingival retraction cords or diode laser technique is similar, but diode laser required less time, was simpler for the operator and was more comfortable to the patient than retraction cords
Sedentariness and weight status related to SES and family characteristics in Italian adults: exploring geographic variability through multilevel models
No full textAim: In this study, our aim was to assess the prevalence of sedentariness and overweight/obesity, two modifiable risk factors for non-communicable diseases (NCDs), and to investigate the geographic variability in their association with socio-economic status (SES) and family characteristics in Italian adults. Methods: The Multipurpose Survey on Health Conditions and the Recourse to Health Services (MSHC), 2012/2013 edition, conducted by the National Institute of Statistics was used as data source. The sample for this study included 99,479 interviewed people aged 18 and over, which are representative of about 50 million persons. For the scope of this analysis, data were considered as individuals nested within families within regions and analysed through multilevel models. Results: It was estimated that 39.8% of Italian adults are sedentary, 38.1% are partially active and 22.1% are physically active; 11.3% of Italian adults are obese and the 34.5% are overweight. There was evidence of inverse socio-economic gradient for both sedentariness and body mass index (BMI). There was higher risk of sedentariness for one-parent (odds ratio (OR) = 1.10; 95% confidence interval (CI) = (1.02; 1.20)) and other family types (OR = 1.34; 95% CI = (1.20; 1.48 )) compared with couples with children. Also, the relative variation of BMI was statistically significant for one-parent, one-person and other families (p < 0.05). An increasing northâsouth gradient was suggested for BMI, but not for sedentariness. Conclusions: Policy interventions could be addressed to reduce BMI levels in the southern area and to encourage physical activity in regions with high sedentariness. The Italian family is the key driver to promote virtuous healthy behaviours
Knowledge and attitudes towards smoking cessation counselling: an Italian cross-sectional survey on tertiary care nursing staff
Full text linkBackground: One of the most effective smoking cessation strategies involves care
and advice from nurses due to their role in the front line of treatment. Lack of
education on smoking cessation counselling may be detrimental, and adequate
smoking cessation training during healthcare studies is needed.
Objectives: The study aimed to examine nurses’ attitudes, belief, and knowledge of
smoking cessation counselling; knowledge of the health risks associated with
smoking was also assessed.
Design: A cross-sectional survey on 77 nurses from the nursing staff of Cardiology,
Cardiac Intensive Care and Surgical Oncology Units of two tertiary hospitals.
Methods: Cronbach’s alpha was calculated to assess the questionnaire’s internal
consistency, and three composite indicators were computed to assess the three
dimensions of the questionnaire (knowledge, attitude, belief). Furthermore, a
stepwise linear regression model was used to predict the attitude to be engaged in
smoking cessation counselling, related to demographic and behavioural variables,
as well as knowledge and belief indicators. The analysis was stratified by Unit.
Results: Nurses from three Units had a significantly different attitude score (2.55 ±
0.93 for Cardiology, 2.49 ± 0.72 for Cardiac Intensive Care and 2.09 ± 0.59 for
Surgical Oncology Unit) (P-value = 0.0493). Analogously, knowledge of smoking
cessation counselling was reported to be higher for Cardiac Intensive Care
Unit nurses (3.19 ± 0.70) compared to Surgical Oncology nurses (2.73 ± 0.74)
(P-value = 0.021). At the multivariable analysis, attitude towards smoking cessation
counselling was significantly related to the nurse’s belief about counselling, for
Cardiology staff (coeff = 0.74, 95% CI [0.32–1.16], P-value = 0.002) and for Surgical
Oncology staff (coeff = 0.37, 95% CI [0.01–0.72], P-value = 0.042).
Conclusions: Incorporation of smoking cessation interventions in nurses’ and
nursing managers’ education could improve the nursing staff’s attitude, belief, and
knowledge regarding smoking cessation counselling, which would lead to the
inclusion of tobacco prevention and cessation as an integral part of patient care
Caries Severity, Decayed First Permanent Molars and Associated Factors in 6-7 Years Old Schoolchildren Living in Palermo (Southern Italy).
Full text linkTo date, there are very few epidemiologic studies on caries disease in 6-7 year old children living in Sicily (Southern Italy). The first permanent molar (FPM) is the most commonly affected tooth in this target population, and a one-unit increase in the number of decayed FPMs is predictive of caries in other teeth and in adulthood. The primary aim of this research is to estimate the prevalence of caries in 6-7 year old schoolchildren living in Palermo and, as a secondary aim, to estimate the prevalence of affected FPMs. It was designed as a cluster cross-sectional survey on 995 children from 16 schools, selected based on their geographical location, in one of the eight city districts. Caries data were recorded using the International Caries Detection and Assessment System for each tooth surface. The relation between socio-economic status, behavioural determinants, and clinical information and the number of teeth with initial caries (IC), moderate caries (MC), or extensive caries (SC) was analysed through the ordinal logistic regression. Among the 995 schoolchildren, 662 (66.5%) had at least one lesion and 742 (74.6%) had FPMs. Of the latter, 238 (32.0%) were affected by IC, 86 (11.6%) were affected by MC, and only 3 (0.4%) were affected by SC. During multivariable analysis, there was evidence of an increased risk of MC and SC related to the deprivation of the district in which the children lived and went to school, as well as to the protective role of parental education and employment. The same significant determinants were found for IC and MC FPMs. The study showed the important role of socio-economic determinants, unhealthy behaviours, and social deprivation related to the increased risk of moderate and extensive caries in 6-7 year old schoolchildren. Investigating this target population is very important, as early development of caries in FPMs may have serious consequences in the prognostics of oral health in an adult
The Impact of a Change in Employment on Three Work-Related Diseases: A Retrospective Longitudinal Study of 10,530 Belgian Employees
Full text linkBACKGROUND: The literature that has investigated to what extent a change in employment contributes to good health is contradictory or shows inconsistent results. The aim of this study was to investigate whether an association exists between a change in employment and cardiovascular, musculoskeletal and neuropsychological diseases in a sample of 10,530 Belgian workers in a seven-year follow-up study period. METHODS: The following factors were analysed: Demographic variables, a change in employment and the work-related risks. Individuals being on medication for cardiovascular, musculoskeletal, and neuropsychological diseases were used as proxies for the three health issues. Logistic regression models for autocorrelated data with repeated measures were used to examine each medication type. RESULTS: A change in employment and psychosocial load can have an important effect on the health of cardiovascular employees. Demographic variables, such as BMI and age, are risk factors for all three medications. Repetitive, manual tasks, handling static, exposure to noise levels of 87 dB, mechanical and/or manual handling with loads, and shift work were found to be positively associated with medications taken for musculoskeletal diseases. Exposure to noise 80 dB(A), managing physical loads and night work were found to be associated with being on medication for neuropsychological diseases. Physical activity and skill levels were considered to be protective factors for being on medication for neuropsychological diseases. CONCLUSIONS: Change in employment and psychosocial load were found as two important risk factors for being on medication for cardiovascular (CVD). Dealing with loads, doing shift work and being daily exposed to the noise of 87 dB correlated with being on medication for musculoskeletal (MSD). Dealing with physical loads, doing night work and being exposed to the noise of 80 dB were risk factors for being on medication for neuropsychological (NPD). While doing physical activity and reporting higher skill levels were found to be protective factors for NPD.status: Publishe
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