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Pérez-Rubio A, Mestre-Ferrandiz J, López-Belmonte JL, Diaz-Aguiló A, Lorenzo-Herrero S, Crespo C. Impact of twelve immunization-preventable infectious diseases on population health using disability-adjusted life years (DALYs) in Spain. BMC Infect Dis 2024; 24:779. [PMID: 39103777 DOI: 10.1186/s12879-024-09637-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 07/22/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND The objective of this study is to estimate the burden of selected immunization-preventable infectious diseases in Spain using the Burden of Communicable Diseases in Europe (BCoDE) methodology, as well as focusing on the national immunization programme and potential new inclusions. METHODS The BCoDE methodology relies on an incidence and pathogen-based approach to calculate disease burden via disability-adjusted life year (DALY) estimates. It considers short and long-term sequelae associated to an infection via outcome trees. The BCoDE toolkit was used to populate those trees with Spanish-specific incidence estimates, and de novo outcome trees were developed for four infections (herpes zoster, rotavirus, respiratory syncytial virus [RSV], and varicella) not covered by the toolkit. Age/sex specific incidences were estimated based on data from the Spanish Network of Epidemiological Surveillance; hospitalisation and mortality rates were collected from the Minimum Basic Data Set. A literature review was performed to design the de novo models and obtain the rest of the parameters. The methodology, assumptions, data inputs and results were validated by a group of experts in epidemiology and disease modelling, immunization and public health policy. RESULTS The total burden of disease amounted to 163.54 annual DALYs/100,000 population. Among the selected twelve diseases, respiratory infections represented around 90% of the total burden. Influenza exhibited the highest burden, with 110.00 DALYs/100,000 population, followed by invasive pneumococcal disease and RSV, with 25.20 and 10.57 DALYs/100,000 population, respectively. Herpes zoster, invasive meningococcal disease, invasive Haemophilus influenza infection and hepatitis B virus infection ranked lower with fewer than 10 DALYs/100,000 population each, while the rest of the infections had a limited burden (< 1 DALY/100,000 population). A higher burden of disease was observed in the elderly (≥ 60 years) and children < 5 years, with influenza being the main cause. In infants < 1 year, RSV represented the greatest burden. CONCLUSIONS Aligned with the BCoDE study, the results of this analysis show a persisting high burden of immunization-preventable respiratory infections in Spain and, for the first time, highlight a high number of DALYs due to RSV. These estimates provide a basis to guide prevention strategies and make public health decisions to prioritise interventions and allocate healthcare resources in Spain.
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Affiliation(s)
| | | | | | | | | | - Carlos Crespo
- Axentiva Solutions, Barcelona, Spain.
- University of Barcelona, Barcelona, Spain.
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Torres-Collado L, Rychter A, González-Palacios S, Compañ-Gabucio LM, Oncina-Cánovas A, García de la Hera M, Vioque J. A high consumption of ultra-processed foods is associated with higher total mortality in an adult Mediterranean population. Clin Nutr 2024; 43:739-746. [PMID: 38320465 DOI: 10.1016/j.clnu.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 01/11/2024] [Accepted: 01/15/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND & AIMS The consumption of ultra-processed foods (UPF) has been associated with higher all-cause and cardiovascular disease (CVD) mortality, although this association has not been sufficiently investigated in Mediterranean populations. We aimed to evaluate the association between UPF consumption and all-cause, CVD and cancer mortality in an adult population in Spain. METHODS We analysed data from 1,538 participants aged 20 years and above in the Valencia Nutrition Survey in 1995. Diet was assessed at baseline using a validated food frequency questionnaire and the consumption of UPF was calculated using the NOVA system. Information on socio-demographic characteristics, lifestyles, and presence of diseases was also collected at baseline. Cause of death was ascertained during an 18-year follow-up period. We used Cox regression and competing risk models as proposed by Fine and Gray's to estimate adjusted hazard ratios (HR) and 95 % confidence intervals (95 %CI). RESULTS After 18 years of follow-up, we documented 312 deaths (36.5 % of CVD and 25.6 % of cancer). Compared with participants in the lowest tertile of UPF consumption, those in the highest tertile showed 40 % higher risk of all-cause mortality, HR 1.40 (95 %CI: 1.04-1.90), and evidence of a higher CVD mortality, HR 1.39 (95 %CI: 0.80-2.41) and of cancer mortality, HR 1.53 (95 %CI: 0.83-2.82). CONCLUSIONS This study suggests that a high UPF consumption is associated with a higher all-cause mortality in a Mediterranean population after a long follow-up period. Considering the increase in UPF consumption and their detrimental health effects on mortality, these results should be confirmed by other studies in other populations.
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Affiliation(s)
- Laura Torres-Collado
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-UMH), Alicante, Spain; Unidad de Epidemiología de la Nutrición, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), Alicante, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Anna Rychter
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland; Doctoral School, Poznan University of Medical Sciences, Poznan, Poland
| | - Sandra González-Palacios
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-UMH), Alicante, Spain; Unidad de Epidemiología de la Nutrición, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), Alicante, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
| | - Laura María Compañ-Gabucio
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-UMH), Alicante, Spain; Unidad de Epidemiología de la Nutrición, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), Alicante, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Alejandro Oncina-Cánovas
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-UMH), Alicante, Spain; Unidad de Epidemiología de la Nutrición, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), Alicante, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Manoli García de la Hera
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-UMH), Alicante, Spain; Unidad de Epidemiología de la Nutrición, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), Alicante, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Jesús Vioque
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-UMH), Alicante, Spain; Unidad de Epidemiología de la Nutrición, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), Alicante, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
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Heng X, Liu X, Li N, Lin J, Zhou X. Spatial disparity and factors associated with dementia mortality: A cross-sectional study in Zhejiang Province, China. Front Public Health 2023; 11:1100960. [PMID: 37033083 PMCID: PMC10080143 DOI: 10.3389/fpubh.2023.1100960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 03/07/2023] [Indexed: 04/11/2023] Open
Abstract
Objective Evidence of spatial disparity in dementia mortality in China has been found to have higher dementia mortality in eastern and rural China. Regional factors of physical and social features may be influencing this spatial disparity. However, the extent of spatial difference in dementia mortality across small regional localities is unclear. This study aims to investigate the geographic variations in mortality and risk of all dementia subtypes and identify the effect of the associated environmental risk factors. Methods We used surveillance data on death reports from Alzheimer's disease and other forms of dementia in Zhejiang province from 2015 to 2019. We estimated the relative risk of dementia mortality using a Bayesian spatial model. We mapped predicted relative risk to visualize the risk of death from different types of dementia and to identify risk factors associated with dementia. Results Thirty thousand three hundred and ninety-eight deaths attributable to dementia as the underlying or related cause (multiple causes) were reported during 2015-2019. Counties and districts in the southeast and west of Zhejiang province had significantly higher standardized mortality ratios than others. Counties and districts with a smaller proportion of residents aged 60 years or older, poorer economic status, insufficient health resources, and worse pollution had a higher risk of deaths due to dementia. Conclusion Higher risks of dementia mortality were found in counties and districts with poorer economic status, insufficient health resources, and worse pollution in Zhejiang. Our study adds new evidence on the association between socioeconomic and environmental factors and the mortality risk due to dementia.
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Affiliation(s)
- Xiaotian Heng
- School of Public Health, Zhejiang University, Hangzhou, China
| | - Xiaoting Liu
- School of Public Affairs, Zhejiang University, Hangzhou, China
| | - Na Li
- Department of Chronic Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
- *Correspondence: Na Li,
| | - Jie Lin
- School of Public Affairs, Zhejiang University, Hangzhou, China
- Jie Lin,
| | - Xiaoyan Zhou
- Department of Chronic Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
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Rehman S, Jianglin Z. Micronutrient deficiencies and cardiac health. Front Nutr 2022; 9:1010737. [PMID: 36313070 PMCID: PMC9614333 DOI: 10.3389/fnut.2022.1010737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 09/26/2022] [Indexed: 11/13/2022] Open
Abstract
Inadequate diet and nutritional quality are potentially correlated with an escalated risk of cardiac-related morbidity and mortality. A plethora of knowledge is available regarding the influence of heart-healthy dietary patterns in response to disability-adjusted life years (DALYs), yet little is known regarding the best approaches to adopt. In response, the present investigation aims to bridge this knowledge gap by implementing mathematical machine learning grey methodology to assess the degree of influence and the potential contributing factors in DALYs due to ischemic heart disease and stroke, in conjunction with the Hurwicz (Min-Max) criterion. The outcomes highlighted that a diet low in fruits is a potential contributor to IHD-related DALYS, whereas a diet low in vegetables is a more grounded contributor to stroke-related DALYs in Spain, among others. Moreover, the Hurwicz approach highlighted IHD to be more impacted due to dietary and nutritional factors than stroke. In conclusion, our investigation strongly supports a balanced diet and precision nutrition guidelines as a strategy for reducing cardiac-related diseases in the Spanish population. It is a public health primary consideration to build an ambiance that encourages, rather than hinders, compliance with cardioprotective dietary practices among all people.
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Affiliation(s)
- Shazia Rehman
- Department of Biomedical Sciences, Pak-Austria Fachhochschule, Institute of Applied Sciences and Technology, Haripur, Pakistan
| | - Zhang Jianglin
- Department of Dermatology, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, China,Candidate Branch of National Clinical Research Center for Skin Diseases, Shenzhen, China,*Correspondence: Zhang Jianglin
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Nigri A, Levantesi S, Piscopo G. Causes-of-Death Specific Estimates from Synthetic Health Measure: A Methodological Framework. SOCIAL INDICATORS RESEARCH 2022; 162:887-908. [PMID: 35039708 PMCID: PMC8756417 DOI: 10.1007/s11205-021-02870-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/17/2021] [Indexed: 06/14/2023]
Abstract
Life expectancy at birth has attracted interest in various fields, as a health indicator that measures the quality of life. Its appeal relies on the ability to enclose and summarize all the factors affecting longevity. However, more granular information, provided by social indicators such as cause-of-death mortality rates, plays a crucial role in defining appropriate policies for governments to achieve well-being and sustainability goals. Unfortunately, their availability is not always guaranteed. Exploiting the relationship between life expectancy at birth and cause-of-death mortality rates, in this paper we propose an indirect model to produce estimates of death rates due to specific causes using the summary indicator of life expectancy at birth, thus the general levels of the observed mortality. By leveraging on a constrained optimization procedure, we ensure a robust framework where the cause-specific mortality rates are coherent to the aggregate mortality. The main advantage is that indirect estimations allow us to overcome the data availability problem: very often the cause-specific mortality data are incomplete, whereas data on the aggregate mortality are not. Using data from the Human Cause-of-Death Database, we show a numerical application of our model to two different countries, Russia and Spain, which have experienced a different evolution of life expectancy and different leading causes of death. In Spain, we detected the impact of several public health policies on the lowered levels of cancer deaths and related life expectancy increases. As regards the Russia, our results catch the effects of the anti-alcohol campaign of 1985-1988 on longevity changes.
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Affiliation(s)
- Andrea Nigri
- Department of Social and Political Sciences, Bocconi University, Milan, Italy
| | | | - Gabriella Piscopo
- Department of Economics and Statistical Science, University of Naples Federico II, Napoli, Italy
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Scheffer MC, Pastor-Valero M, Cassenote AJF, Compañ Rosique AF. How many and which physicians? A comparative study of the evolution of the supply of physicians and specialist training in Brazil and Spain. HUMAN RESOURCES FOR HEALTH 2020; 18:30. [PMID: 32316989 PMCID: PMC7171868 DOI: 10.1186/s12960-020-00472-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 04/04/2020] [Indexed: 05/13/2023]
Abstract
BACKGROUND In the face of the medical workforce shortage, several countries have promoted the opening of medical schools and the expansion of undergraduate and specialization education in medicine. Few studies have compared the characteristics and effects of expanding the supply of general practitioners and specialist physicians between countries. Brazil and Spain, two countries with distinct historical processes and socioeconomic scenarios, yet both with universal public health systems and common aspects in training and medical work, have registered a significant increase in the number of physicians and can be used to understand the challenges of strategic planning for the medical workforce. METHODS This study provides a descriptive approach using longitudinal data from official databases in Brazil and Spain from 1998 to 2017. Among the comparable indicators, the absolute numbers of physicians, the population size, and the physician's ratio by inhabitants were used. The number of medical schools and undergraduate places in public and private institutions, the supply of residency training posts, and the number of medical specialists and medical residents per 100 000 inhabitants were also used to compare both countries. Seventeen medical specialties with the highest number of specialists and comparability between the two countries were selected for further comparison. RESULTS Due to the opening of medical schools, the density of physicians per 1 000 inhabitants grew by 28% in Spain and 51% in Brazil between 1998 and 2017. In that period, Spain and Brazil increased the supply of annual undergraduate places by 60% and 137%, respectively. There is a predominance of private institutions providing available undergraduate places, and the supply of medical residency posts is smaller than the contingent of medical graduates/general practitioners each year. CONCLUSION Both countries have similar specialist densities in cardiology, dermatology, and neurosurgery specialties. However, family medicine and community in Spain has 91.27 specialists per 100 000 inhabitants, while in Brazil, the density is only 2.64. The comparative study indicated the complexity of the countries' decisions on increasing the medical supply of general practitioners and specialist physicians. Research and planning policies on the medical workforce must be aligned with the actual health needs of populations and health systems.
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Affiliation(s)
- Mário César Scheffer
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
| | - Maria Pastor-Valero
- Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández, Alicante, Spain
- Centro de Investigación Biomédica en Red Epidemiología y Salud Publica (CIBERESP), Madrid, Spain
| | - Alex Jones Flores Cassenote
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Departamento de Gastroenterologia, Faculdade de Medicina, Universidade de São Pauloa, São Paulo, Brazil
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Mieziene B, Emeljanovas A, Cesnaitiene VJ, Vizbaraite D, Zumbakyte-Sermuksniene R. Health Behaviors and Psychological Distress Among Conscripts of the Lithuanian Military Service: A Nationally Representative Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E783. [PMID: 32012683 PMCID: PMC7037156 DOI: 10.3390/ijerph17030783] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 01/22/2020] [Accepted: 01/23/2020] [Indexed: 12/26/2022]
Abstract
The decline in healthy behavior in young people is a concern for public health in general and for country's defense. The aim of this study is to identify and compare health behaviors and psychological distress between male conscripts enlisted and rejected for military service. This cross-sectional study included 1243 men aged 19-26 years (mean age 22.50 ± 2.43 years). We assessed health behaviors (physical activity, adherence to healthy eating patterns, cigarette smoking, and alcohol consumption) and psychological distress. Among all conscripts, 44.7% were physically inactive, 50.2% had low adherence to healthy nutrition, 9.6% were heavy drinkers, 62.3% were current smokers, and 9.1% had high psychological distress level. Compared with physically inactive conscripts, physically active conscripts were more likely to be enlisted (adjusted odds ratio (OR) = 1.42; 95% confidence interval (CI) 1.11-2.03). Compared with current nonsmokers, current smokers were less likely to be enlisted (OR = 0.58; CI 0.39-0.86). Compared with conscripts with a high distress level, those with a low distress level were almost four times more likely to be enlisted (OR = 0.26; 95% CI 0.12-0.55). Adherence to guidelines for healthy eating and alcohol consumption was not significantly related to enlistment. These findings suggest that health behaviors in male conscripts are unsatisfactory. That is, about half are physically inactive, have a poor diet, and smoke, and nearly one in 10 is a heavy drinker and has a high psychological distress level. The enlisted conscripts were more likely to be sufficiently physically active and less likely to be a current smoker or have a high distress level. Early intervention programs to provide a heathier population of young men for conscription should focus on mental well-being and target health-related behaviors such as physical activity and not smoking. Preferably, these should be implemented as health education programs in schools to help prevent the development of adverse health behaviors among young men. Governmental policies and strategies are required to enable intersectional collaboration and shared responsibility among the education, military and health sectors.
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Affiliation(s)
- Brigita Mieziene
- Lithuanian Sports University, 44221 Kaunas, Lithuania; (A.E.); (V.J.C.); (D.V.)
| | - Arunas Emeljanovas
- Lithuanian Sports University, 44221 Kaunas, Lithuania; (A.E.); (V.J.C.); (D.V.)
| | | | - Daiva Vizbaraite
- Lithuanian Sports University, 44221 Kaunas, Lithuania; (A.E.); (V.J.C.); (D.V.)
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Consequences of VGluT3 deficiency on learning and memory in mice. Physiol Behav 2019; 212:112688. [PMID: 31622610 DOI: 10.1016/j.physbeh.2019.112688] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/22/2019] [Accepted: 09/22/2019] [Indexed: 01/06/2023]
Abstract
The aim of the present study was to test the hypothesis that vesicular glutamate transporter 3 (VGluT3) deficiency is associated with cognitive impairments. Male VGluT3 knockout (KO) and wild type (WT) mice were exposed to a behavioral test battery covering paradigms based on spontaneous exploratory behavior and reinforcement-based learning tests. Reversal learning was examined to test the cognitive flexibility. The VGluT3 KO mice clearly exhibited the ability to learn. The social recognition memory of KO mice was intact. The y-maze test revealed weaker working memory of VGluT3 KO mice. No significant learning impairments were noticed in operant conditioning or holeboard discrimination paradigm. In avoidance-based learning tests (Morris water maze and active avoidance), KO mice exhibited slightly slower learning process compared to WT mice, but not a complete learning impairment. In tests based on simple associations (operant conditioning, avoidance learning) an attenuation of cognitive flexibility was observed in KO mice. In conclusion, knocking out VGluT3 results in mild disturbances in working memory and learning flexibility. Apparently, this glutamate transporter is not a major player in learning and memory formation in general. Based on previous characteristics of VGluT3 KO mice we would have expected a stronger deficit. The observed hypolocomotion did not contribute to the mild cognitive disturbances herein reported, either.
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