Risultati per: Report aggiornato sulla qualità dell’aria in Europa (2015)

Tra emergenze anche sovraffollamento e alti tassi suicidio

Rapporto Cergas Bocconi-Essity, troppa eterogeneità tra Regioni

Objectives
To identify the factors associated with transcatheter aortic valve implantation (TAVI) use of TAVI in inpatients with aortic stenosis (AS) in Portugal and its geographical distribution.

Methods
A quantitative, observational and retrospective study using the Portuguese National Health Service inpatient discharge database from 2015 to 2017. Surgical aortic valve replacement (SAVR) and TAVI procedures were selected using the International Classification of Diseases. First, we mapped the yearly age-standardised rate for each procedure using QGIS. Then, we performed 2 tests, independent t-tests and logistic regressions to study the factors associated with TAVI use.

Results
From 2015 to 2017, 8398 hospitalisations were selected, 88.5% SAVR and 11.5% TAVI. From 2015 to 2017, SAVR use increased in the Northern region and decreased in the Lisbon region, while the opposite was observed for TAVI. TAVI was performed among the most complex (p

Objectives
Self-monitoring of physical activity (PA) has the potential to contribute to successful behaviour change in PA interventions in different populations, including people with inflammatory joint diseases (IJDs). The objectives of this study were to describe the use and knowledge of self-report-based and device-based PA measures in people with IJDs in four European countries, and to explore if the use of such devices, sociodemographic or disease-related variables were associated with adherence to the recommendations of at least 150 min of moderate to vigorous PA per week.

Setting
Cross-sectional survey, performed in 2015–2016.

Participants
People with IJDs in Belgium, Denmark, Ireland and Sweden.

Primary and secondary outcome measures
Use of self-report and device-based PA measures, receipt of instructions how to use PA measures, confidence in using them, adherence to PA recommendations and associated factors for adherence to PA recommendations.

Results
Of the 1305 respondents answering questions on PA measures, 600 (46%) reported use of any kind of self-report or device-based measures to self-monitor PA. Between country differences of 34%–58% was observed. Six per cent and four per cent received instructions from health professionals on how to use simple and complex devices, respectively. Independent associated factors of fulfilment of recommendations of PA were living in Ireland (OR=84.89, p

Contagi in lieve aumento nel mondo, specie nelle Americhe

Stroke, Volume 54, Issue Suppl_1, Page AWMP41-AWMP41, February 1, 2023. Introduction:Although stroke death rates declined since 1950s, age-adjusted rates remained higher among non-Hispanic Black (NHB) than among non-Hispanic White (NHW) persons. No study has examined changes in disparities of stroke mortality among NHB and NHW before and during the COVID-19 pandemic.Methods:We calculated age-adjusted (US 2000 population) stroke death rates per 100,000 people among NHB and NHW ages ≥35 years from 2015-2021 using CDC WONDER. We compared NHB and NHW stroke death rates from 2015-2019 (before pandemic) to 2020-2021 (during pandemic) with respect to changes in rates, rate ratios (RR) and difference-in-difference in rates.Results:Trends and disparities of overall stroke death rates before the pandemic remained consistent between NHB (100.9 to 101.6 per 100,000 people) and NHW (69.1 to 70.6 per 100,000 people), with an average difference in rates of 31.3/100,000 and RR of 1.45. During the pandemic, stroke death rates increased but with different magnitudes among NHB (110.0 and 113.4 per 100,000) and NHW (72.0 and 73.1 per 100,000). Between pre-pandemic and pandemic periods, the absolute difference in rates increased 25% from 31.3 (95% confidence interval 30.8-31.7) to 39.1 (38.3-39.8) per 100,000 and the relative difference measured by RR increased from 1.45 (1.44-1.46) to 1.54 (1.53-1.55) (p

Stroke, Volume 54, Issue Suppl_1, Page ATMP106-ATMP106, February 1, 2023. Background:Monitoring changes in ischemic stroke severity at the population level is important as changes in risk factors and clinical treatments could influence stroke severity. We describe trends in the distribution of NIHSS across 3 time periods in a population-based epidemiologic stroke study.Methods:In 2005, 2010, and 2015 all adult acute ischemic strokes occurring within the Greater Cincinnati area presenting to 15 hospitals were ascertained using discharge codes (ICD-9 433-436; IDC-10 I63-I68, G45-46). Following physician verification, confirmed ischemic stroke cases underwent chart abstraction including estimation of a retrospective (rNIHSS) score at presentation. Descriptive statistics (rNIHSS median, IQR) were generated by survey year, demographics, and medical history. Using a binary definition of stroke severity (median rNIHSS score &gt 4 versus &lt 4), multivariable logistic regression was used to estimate changes in stroke severity over time, adjusting for potential confounders. Random effects were used to account for multiple admissions occurring in the same subject.Results:The number of ischemic stroke admissions in the 2005, 2010, and 2015 surveys was 1778, 1903, and 1933, respectively (Table). The median (IQR) rNIHSS scores were 3 (2-7), 3 (1-6), and 2 (1-6) across the 3 surveys, respectively; the proportion of admissions with rNIHSS &gt 4 was 48%, 39% and 37%, respectively. After adjusting for demographics, medical history and pre-stroke function, compared to 2005, the odds ratio for more severe stroke was 0.69 (95% CI= 0.60-0.79, p=0.001) in 2010 and 0.63 (95% CI= 0.55-0.73, p=0.001) in 2015.Conclusions:In this population- based study there was a statistically significant change in the severity of ischemic stroke hospitalizations with increases in the proportion of milder strokes over time. Potential reasons for this change need to be explored but could include changes in risk factors, clinical treatments or diagnostic approach.

Stroke, Volume 54, Issue Suppl_1, Page A47-A47, February 1, 2023. Background:Endovascular thrombectomy (EVT) demonstrated superiority to medical management in the 2015 trials. We sought to compare outcomes in acute ischemic stroke (AIS) treated with EVT before and after 2015.Methods:A query of the 2000-2019 National Inpatient Sample was performed for patients admitted with AIS (ICD9 433, 43401, 43411, 43491, ICD-10 I63). Demographics, comorbidities, and outcomes were identified. Univariate analysis with t-tests or chi-square performed as appropriate. A 1:1 nearest neighbor propensity score matched cohort was generated. Variables with standardized mean differences >0.1 used in multivariate regression to generate adjusted odds ratios (AOR)/β-coefficients for EVT on outcomes. Significance set at an alpha level of

Stroke, Volume 54, Issue Suppl_1, Page AWMP98-AWMP98, February 1, 2023. Objective:There are known associations between long-term air pollution exposure and greater stroke incidence, morbidity, and mortality; however, there is little research on the association of pollutant exposure with poststroke hospital readmission.Methods:We assessed associations of average annual CO, NO2, O3, PM2.5, and SO2exposure with 30-day all-cause hospital readmission in US fee-for-service Medicare beneficiaries age ≥65 years hospitalized for ischemic stroke in 2014-2015. We fit Cox models to assess 30-day readmission as a function of these pollutants, adjusted for patient and hospital factors and temperature. We repeated the models stratified by performance of the treating hospital on the Centers for Medicare & Medicaid Services (CMS) risk-standardized 30-day all-cause readmission for stroke measure to determine if the results were independent of performance: Low (CMS rate for hospital 75thpercentile), and Middle (all others).Results:There were 448148 patients discharged with stroke in 2014-2015 of whom 12.5% were readmitted. Average 2-year CO, O3, PM2.5, and SO2values during the study were below national standards. In adjusted analyses, each 1 standard deviation increase in average annual NO2and SO2exposure was associated with a 3.6% (95% CI 2.9%-4.4%) and a 2.0% (95% CI 1.1%-3.0%) increased readmission risk within 30-days, respectively (Table). Associations between long-term air pollution exposure and increased readmissions persisted across performance categories.Conclusion:Long-term air pollution exposure was associated with increased 30-day readmissions after stroke at pollutant levels below national standards across hospital performance categories. Additional research is needed to determine whether improvements in air quality lead to reductions in poststroke hospital readmissions.

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Circulation, Ahead of Print. BACKGROUND:The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs).METHODS:The American Heart Association, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2023 Statistical Update is the product of a full year’s worth of effort in 2022 by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. The American Heart Association strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year’s edition includes additional COVID-19 (coronavirus disease 2019) publications, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains.RESULTS:Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics.CONCLUSIONS:The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

Introduction
Digital technologies present tremendous opportunities for enabling long-term measurement of mental health in the general population. Emerging studies have established preliminary efficacy of collecting self-report data digitally. However, a key challenge when developing a new self-report instrument is navigating the abundance of existing instruments to select relevant constructs for measurements. This review is a precursor to developing a novel future integrated digital instrument for repeated measurements. We interrogate the literature as the first step towards optimal measurement of the multifaceted mental health concept, in the context of digital repeated measurement. This review aims to identify (1) digital self-report instruments administered repeatedly to measure the mental health of the general adult population; (2) their structure and format; (3) their psychometric properties; (4) their usage in empirical studies; and (5) the constructs these instruments were designed to measure (as characterised in the original publication), and the constructs the instruments have been used to measure in the identified empirical studies.

Methods and analysis
Five major electronic databases will be searched. Studies administering mental health instruments (in English) repeatedly to community dwellers in the general adult population are eligible. A reviewer will preliminarily screen for eligible studies. Then, two reviewers will independently screen the full text of the eligible articles and extract data. Both reviewers will resolve any disagreement through discussion or with a third reviewer. After the data extraction, a reviewer will manually search for the structure, format, psychometric properties and the original constructs these instruments were developed to measure. This review will synthesise the results in a narrative approach. The reporting in this review will be guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist.

Ethics and dissemination
Ethical approval is not required as no data will be collected. Findings of the systematic review will be disseminated through peer-reviewed publications and conference presentations.

PROSPERO registration number
CRD42022306547

Annals of Internal Medicine, Ahead of Print.

Cholera cases and cholera-associated deaths jumped globally in 2022 following years of decline, marking a resurgence of the ongoing seventh cholera pandemic, which began in 1961, according to a World Health Organization (WHO) report.

Kluge: ‘ Nessuna minaccia imminente, varianti circolanti già viste in Ue e altrove, casi Kraken in numero piccolo ma crescente’

Varianti sono già presenti in Ue e popolazione ha alta immunità