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Ecdc, in Europa i contagi di morbillo decuplicati in un anno
Nel 2024 35mila casi e 23 morti, Italia seconda con 1.057 casi
Asma nei bimbi, da sport ad allergie i 10 falsi miti da sfatare
Giornata mondiale il 6 maggio, controlli in 56 centri in Italia
Trends and demographic differences in interpersonal violence against children in sub-Saharan Africa: findings from the 1990-2019 Global Burden of Disease Study
Objectives
To analyse the past 30-year trends in mortality and morbidity of interpersonal violence against children, its demographic distribution and correlation with specific risk factors.
Design
Ecological study at the country and regional level.
Setting
46 countries and 4 subregions of sub-Saharan Africa (SSA): Central, Eastern, Southern and Western.
Participants
Children aged 0–19 years old.
Primary and secondary outcome measures
Trends in mortality rates and disability-adjusted life-years (DALYs) attributed to interpersonal violence injuries in children; correlation between socio-demographic index (SDI)/alcohol consumption per capita and child interpersonal violence.
Results
Deaths and DALYs per 100 000 population from child violence-related injuries in SSA declined from 4.0 (95% uncertainty interval (UI): 3.3–4.9) to 3.1 (95% UI: 2.3 to 3.9) and 334.9 (95% UI: 276.4 to 407.7) to 260.3 (95% UI: 197.9 to 321.9) respectively from 1990 to 2019 (reductions of 22.5% and 22.3%). Southern SSA had the highest deaths/DALYs rates for each type of physical violence (sharp object/firearm/other) and Central SSA for sexual violence. Alcohol consumption correlated significantly with deaths and DALYs, but SDI showed a non-significant correlation.
Conclusions
Rates of child interpersonal violence deaths and DALYs decreased from 2009 to 2019 in SSA, driven by remarkable decreases in the Southern subregion. Understanding the determinants of these downward trends and implementation of policies targeting known risk factors like alcohol consumption may pave the way for enhanced child safety protection. Further curbing the disparities between countries and subregions necessitates long-term commitment to evidence-based action plans.
Hiv, farmaci a lunga azione strategici per prevenzione e terapia
Con 1 sola iniezione bimestrale,ma in Italia uso ancora limitato
Amianto: 7mila vittime in Italia scorso anno,”bando è un'utopia”
Osservatorio nazionale,200mila decessi nel mondo ma sottostimati
Longitudinal trajectories of healthcare costs among high-need high-cost patients: a population-based retrospective cohort study in British Columbia, Canada
Objectives
We sought to identify groups of high-need high-cost (HNHC) patients with distinct cost trajectories and describe the sociodemographic and clinical characteristics associated with group membership.
Design
A population-based retrospective cohort study, using administrative health data.
Setting
British Columbia, Canada.
Participants
People who were HNHC in 2017, defined as incurring health system costs in the top 5% of the population, and were continuously registered in the Medical Service Plan from January 2015 to December 2019 and alive at the end of the study period.
Outcome measures
The primary objective was to identify longitudinal patterns of healthcare costs using group-based trajectory modelling. Adopting a health sector perspective, we conducted person-level costing for hospital episodes, day surgeries, physician services, prescription medications, and home and community care services. The secondary objective was to explore sociodemographic and clinical characteristics associated with group membership using adjusted ORs and 95% CIs from a multinomial logit model.
Results
Our final sample comprised 5.4 million British Columbians. In 2017, 224 285 people met our definition of an HNHC and were included in our analysis (threshold: $C7968). We selected a model with five groups. These groups included those with persistently very high costs (44%, mean 5-year total: $C124 622); persistent high costs (32%, mean 5 year total: $C38 997); rising costs (7%, mean 5-year total: $C43 140); declining costs (10%, mean 5-year total: $C30 545); and those with a cost spike (7%, mean 5-year total: $C19 601). Being older, being in the lowest income quintile and having a greater number of comorbid health conditions were associated with increased odds of being in the persistently very-high-cost trajectory group relative to each other group. There was heterogeneity in the association between individual comorbidities and trajectory group membership. Several comorbidities were associated with a statistically significant increase in the odds of being in the persistently very-high-cost group compared with all other groups (eg, diabetes, renal failure), while others were associated with decreased odds (eg, metastatic cancer, alcohol abuse).
Conclusion
This study unveils the complex and diverse cost trajectories of HNHC patients in British Columbia, highlighting the necessity for tailored healthcare strategies that address individual patient needs and circumstances. Notably, a high proportion of HNHC patients exhibit persistently high costs over a 5-year period, and available sociodemographic and clinical data are not predictive of group membership. Future research is needed to develop methods for predicting future HNHC patients and to identify evidence-based interventions that can improve patient outcomes and mitigate unnecessary healthcare utilisation and costs.
Iss, nel 2023 in Italia 798 casi di malaria tutti importati
L’80% dei casi in stranieri di ritorno dal Paese di origine
Aviaria, 'in Italia situazione sotto controllo'
In 6 mesi 156 focolai tra uccelli selvatici, pollame e mammiferi
Le statine possono migliorare la sopravvivenza nei pazienti con alcuni tumori del sangue
L’uso di statine, farmaci ampiamente utilizzati per abbassare il colesterolo, […]
Identificata una nuova immunoterapia mirata per il cancro ovarico
I ricercatori della Mayo Clinic hanno scoperto che un nuovo bersaglio dell’immunoterapia, […]
Nuove cellule nel tessuto connettivo aprono una strategia contro il cancro al pancreas
I ricercatori dell’Università di Umeå in Svezia, hanno scoperto un tipo […]
Intracerebral Hemorrhage in Patients With CADASIL: Additive Impact of the NOTCH3 R544C Variant and Hypertension?
Stroke, Ahead of Print. BACKGROUND:Intracerebral hemorrhage (ICH) is increasingly recognized in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, especially in Asian patients with theNOTCH3R544C variant. The associations between ICH,NOTCH3variants, and hypertension remain unclear.METHODS:We enrolled patients from 2 independent cohorts with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy in France (recruited since 2003) and Taiwan (recruited since 2019) and performed a cross-sectional retrospective analysis. Clinical history and evaluation were collected using standardized questionnaires and scales, while neuroimaging features were assessed with the CADA-MRIT inventory tool. Patients with and without a history of ICH were compared. Logistic regression and mediation analyses were conducted to identify factors associated with ICH.RESULTS:Of 552 patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (440 from France and 112 from Taiwan), 34 (6.2%) had a history of ICH. Patients with ICH were older (62.9±11.4 versus 53.4±12.3 years), had a higher proportion of theNOTCH3R544C variant (79.4% versus 15.3%), and had hypertension (85.3% versus 24.9%). Analysis of magnetic resonance imaging data showed that they had more cerebral microbleeds, worse cerebral atrophy, and higher number of dilated perivascular spaces in basal ganglia. Hypertension (odds ratio, 7.90 [95% CI, 2.83–22.08]) andNOTCH3R544C variant (odds ratio, 9.91 [95% CI, 3.84–25.57]) were each independently associated with ICH, while no multiplicative interaction was detected between these 2 factors (Pinteraction=0.81). Having bothNOTCH3R544C variant and hypertension carried an additive effect on the risk of ICH (36.9% if both present, 8.8% if havingNOTCH3R544C variant without hypertension, 5.4% if having hypertension withoutNOTCH3R544C variant, and 0.6% if both absent;Ptrend
Provision of medical same day emergency care services within the UK: analysis from the Society for Acute Medicine Benchmarking Audit
Aim
To evaluate the current provision of medical same day emergency care (SDEC) services within the UK, and the current utilisation of these pathways in the assessment of unplanned medical attendances.
Design
Survey data was used from the Society for Acute Medicine Benchmarking Audit (SAMBA), including anonymised patient-level data collected annually using a day of care survey.
Setting
Hospitals accepting unplanned medical attendances within the UK, 2019–2023.
Participants
34 948 unplanned and 4342 planned attendances across 188 hospital sites.
Results
29.8% of unplanned medical attendances received their initial medical assessment within SDEC services (2403 patients in SAMBA23), with the proportion increasing over time. 82.4% of patients assessed in SDEC services were discharged without overnight admission. Assessment in SDEC services was less likely in male patients, patients with frailty and older adults (all p
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