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

Objective
Given the paucity of evidence-based research investigating different suicidal ideation profiles and trajectories, this project sought to investigate health and socio-economic factors associated with the presence of suicidal ideation and changes in ideation over time.

Design
Longitudinal cohort design, using logistic regression analysis.

Setting
A public health survey was administered at two timepoints in a community setting across the North West of England. In the 2015/2016 survey, participants were recruited from high (n=20) and low (n=8) deprivation neighbourhoods. In the 2018 survey, only the 20 high-deprivation neighbourhoods were included.

Participants
4287 people were recruited in 2015/2016 and 3361 were recruited in 2018. The 2018 sample was subdivided into those who responded only in 2018 (n=2494: replication sample) and those who responded at both timepoints (n=867: longitudinal sample).

Primary outcome measures
Suicide ideation was the dependent variable which was assessed using item 9 of the Patient Health Questionnaire instrument.

Results
The prevalence of suicidal ideation was 11% (n=454/4319) at 2015/2016 and 16% (n=546/3361) at 2018.
Replication study results highlighted: persistent debilitation from physical ill health and/or medication side effects; demographic factors (ie, middle-aged, single or never married); and personal coping strategies (ie, smoking) as risk factors for suicidal ideation. A static/improved financial position and high levels of empathy were protective factors.
Longitudinal study results confirmed three suicidal ideation trajectories: ‘onset’, ‘remission’ and ‘persistence’. Similar findings to the replication study were evidenced for the onset and persistence trajectories. Persistent suicidal ideation was synonymous with higher levels of practical support which may correspond to the higher levels of debilitation and functional disability reported within this group. Remission was characterised by fewer debilitating factors and higher levels of self-agency.

Conclusion
A greater appreciation of the heterogeneity of suicidal trajectories should lead to the implementation of broad clinical assessments and targeted interventions.

Objectives
To examine the prevalence of institutional delivery and postnatal care after home delivery and to identify their determinants in Myanmar mothers who received at least four antenatal care visits.

Design
The study used the Myanmar Demographic and Health Survey data (2015–2016), a nationally representative cross-sectional study.

Participants
The study included women aged 15–49 years who had at least one birth within the 5 years preceding the survey and completed four or more antenatal visits.

Outcome measures
Institutional delivery and postnatal care after home delivery were used as outcomes. We used two separate samples, that is, 2099 women for institutional delivery and 380 mothers whose most recent birth was within 2 years before the survey and delivered at home for postnatal care utilisation. We used multivariable binary logistic regression analyses.

Setting
Fourteen states/regions and Nay Pyi Taw Union Territory in Myanmar.

Results
The prevalence of institutional delivery was 54.7% (95% CI: 51.2%, 58.2%) and postnatal care utilisation was 76% (95% CI: 70.2%, 80.9%). Women who lived in urban areas, women who had higher education, women who had higher wealth status, women who had educated husbands and women having their first childbirth were more likely to have institutional delivery than their counterparts. The institutional delivery was lower among women who live in rural areas, poor women and women with husbands who worked in agriculture than their counterparts. Postnatal care utilisation was significantly higher among women living in central plains and coastal regions, women who received all seven components of antenatal care and women who had skilled assistance at birth than their counterparts.

Conclusions
Policymakers should address the identified determinants to improve the service continuum and reduce maternal mortality in Myanmar.

Objective
This study aims to explore the relationship between slack resources and cost consumption index in tertiary and secondary hospitals and to provide targeted healthcare resource utilisation recommendations for tertiary and secondary hospital managers.

Design
This is a panel data study of 51 public hospitals in Beijing from 2015 to 2019.

Setting
Tertiary and secondary public hospitals in Beijing. Data envelope analysis was used to calculate the slack resources. Regression models were used to explore the relationship between slack resources and healthcare costs.

Participants
A total of 255 observations were collected from 33 tertiary hospitals and 18 secondary hospitals.

Outcome measures
Slack resources and healthcare costs in tertiary and secondary public hospitals in Beijing from 2015 to 2019. Linear or curve relationship between slack resources and healthcare costs in tertiary and secondary hospitals.

Results
The cost of healthcare in tertiary hospitals has always been higher than in secondary hospitals, and the slack resources in secondary hospitals have always been worse than in tertiary hospitals. For tertiary hospitals, the cubic coefficient of slack resources is significant (β=–12.914, p

Circulation, Volume 147, Issue 14, Page e674-e674, April 4, 2023.

Per oncologi Usa e Ue è tra parametri valutazione valore farmaci

Crohn’s Disease (CD) is a chronic granulomatous inflammatory disease involving any section of the gastrointestinal (GI) tract. Metastatic Crohn’s Disease (MCD) is a rare extraintestinal manifestation of CD defined as cutaneous granulomatous lesions non-adjacent to the GI tract. We present a case of suppurative lymphadenitis as a presentation of MCD. This has not yet been reported in the literature.

Inflammatory Bowel Disease (IBD) can have numerous complications involving all systems of the body. There are limited data investigating the effect of renal disease on outcomes in patients with IBD . The aim of our study was to examine the impact of End-Stage Renal Disease (ESRD) on the outcomes of patients with IBD.

Inflammatory Bowel Disease results in numerous complications due to inflammatory damage to the intestinal mucosa. One complication of IBD is perforation of the intestines. The aim of our study was to study the impact of IBD on clinical outcomes in patients with intestinal perforation.

As the number of people with mental health disorders climbed, racial and ethnic disparities continued to underlie who received care for their conditions and where, according to a report by the US Centers for Disease Control and Prevention’s National Center for Health Statistics.

Objectives
To evaluate the association between periodontitis severity and hypertension based on Chinese epidemiological data.

Design
This cross-sectional survey enrolled adults from the Fourth National Oral Health Survey of China (2015–2016).

Setting
The data were obtained from the Fourth National Oral Health Survey of China (2015–2016).

Participants
The study included individuals aged 35–44 years (n=4409), 55–64 years (n=4568) and 65–74 years (n=4218).

Primary and secondary outcome measures
Periodontal status, defined on the basis of the 2017 classification scheme, and periodontal parameters (eg, bleeding on probing (BOP)) were compared between individuals with hypertension and individuals with normotension. Smoothed scatterplots were constructed to demonstrate the associations of periodontal parameters and periodontal status with hypertension.

Results
Severe periodontitis (stages III and IV) was present in 41.4% of individuals with hypertension and 28.0% of individuals with normotension, respectively (p

Circulation, Ahead of Print. BACKGROUND:Treatment options for high-risk Brugada syndrome (BrS) with recurrent ventricular fibrillation (VF) are limited. Catheter ablation is increasingly performed but a large study with long-term outcome data is lacking. We report the results of the multicenter, international BRAVO (Brugada Ablation of VF Substrate Ongoing Registry) for treatment of high-risk symptomatic BrS.METHODS:We enrolled 159 patients (median age 42 years; 156 male) with BrS and spontaneous VF in BRAVO; 43 (27%) of them had BrS and early repolarization pattern. All but 5 had an implantable cardioverter-defibrillator for cardiac arrest (n=125) or syncope (n=34). A total of 140 (88%) had experienced numerous implantable cardioverter-defibrillator shocks for spontaneous VF before ablation. All patients underwent a percutaneous epicardial substrate ablation with electroanatomical mapping except for 8 who underwent open-thoracotomy ablation.RESULTS:In all patients, VF/BrS substrates were recorded in the epicardial surface of the right ventricular outflow tract; 45 (29%) patients also had an arrhythmic substrate in the inferior right ventricular epicardium and 3 in the posterior left ventricular epicardium. After a single ablation procedure, 128 of 159 (81%) patients remained free of VF recurrence; this number increased to 153 (96%) after a repeated procedure (mean 1.2±0.5 procedures; median=1), with a mean follow-up period of 48±29 months from the last ablation. VF burden and frequency of shocks decreased significantly from 1.1±2.1 per month before ablation to 0.003±0.14 per month after the last ablation (P

Objectives
The structure and composition of the household has important influences on child mortality. However, little is known about these factors in HIV-endemic areas and how associations may change with the introduction and widespread availability of antiretroviral treatment (ART). We use comparative, longitudinal data from two demographic surveillance sites in rural South Africa (2000–2015) on mortality of children younger than 5 years (n=101 105).

Design
We use multilevel discrete time event history analysis to estimate children’s probability of dying by their matrilineal residential arrangements. We also test if associations have changed over time with ART availability.

Setting
Rural South Africa.

Participants
Children younger than 5 years (n=101 105).

Results
3603 children died between 2000 and 2015. Mortality risks differed by co-residence patterns along with different types of kin present in the household. Children in nuclear households with both parents had the lowest risk of dying compared with all other household types. Associations with kin and child mortality were moderated by parental status. Having older siblings lowered the probability of dying only for children in a household with both parents (relative risk ratio (RRR)=0.736, 95% CI (0.633 to 0.855)). Only in the later ART period was there evidence that older adult kin lowered the probability of dying for children in single parent households (RRR=0.753, 95% CI (0.664 to 0.853)).

Conclusions
Our findings provide comparative evidence of how differential household profiles may place children at higher mortality risk. Formative research is needed to understand the role of other household kin in promoting child well-being, particularly in one-parent households that are increasingly prevalent.

Adolescent mental health continued to worsen through 2021, based on survey responses from 17 232 high school students. According to the report from the US Centers for Disease Control and Prevention, teen girls scored worse than boys on almost all measures collected, with nearly twice the number of girls—57% in total—experiencing persistent sadness or hopelessness during the past year. In addition, 30% of teen girls seriously considered suicide and 18% experienced sexual violence.

Russia’s invasion of Ukraine has led to the displacement of about 12.3 million Ukrainians—more than 25% of the country’s population. About half of those displaced left for other countries; the remainder moved within Ukraine.

Un’indagine su oltre 30.000 persone tra i 18 e i 74 anni in 16 diversi paesi mostra che è lo stress il disturbo mentale più diffuso a livello globale: da noi è avvertito dal 56% del campione, ma cresce la propensione a prendersene cura

Un’indagine su oltre 30.000 persone tra i 18 e i 74 anni in 16 diversi paesi mostra che è lo stress il disturbo mentale più diffuso a livello globale: da noi è avvertito dal 56% del campione, ma cresce la propensione a prendersene cura