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Inotai A, Kaló Z, Petykó Z, Gyöngyösi K, O'Keeffe DT, Czech M, Ágh T. Facilitators and Barriers of Incremental Innovation by Fixed Dose Combinations in Cardiovascular Diseases. J Cardiovasc Dev Dis 2024; 11:186. [PMID: 39057609 DOI: 10.3390/jcdd11070186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 06/18/2024] [Accepted: 06/19/2024] [Indexed: 07/28/2024] Open
Abstract
Despite the availability of affordable pharmaceuticals treating cardiovascular diseases (CVDs), many of the risk factors remain poorly controlled. Fixed-dose combinations (FDCs), a form of incremental innovation, have already demonstrated improvements over combinations of single medicines in adherence and hard clinical endpoints. Nevertheless, there are many barriers related to the wider use of FDCs in CVDs. Our aim was to identify these barriers and explore system-level facilitators from a multi-stakeholder perspective. Identified barriers include (i) hurdles in evidence generation for manufacturers, (ii) limited acceptance of adherence as an endpoint by clinical guideline developers and policymakers, (iii) limited options for a price premium for incremental innovation for healthcare payers, (iv) limited availability of real-world evidence, and (v) methodological issues to measure improved adherence. Initiatives to standardize and link healthcare databases in European countries, movements towards improved patient centricity in healthcare, and extended value assessment provide opportunities to capture the benefits of FDCs. Still, there is an emerging need to facilitate the generalizability of sporadic clinical evidence across different FDCs and to improve adherence measures. Finally, healthcare payers need to be convinced to pay a fair premium price for the added value of FDCs to incentivize incremental innovation in CVD treatment.
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Affiliation(s)
- András Inotai
- Center for Health Technology Assessment, Semmelweis University, 1091 Budapest, Hungary
- Syreon Research Institute, 1142 Budapest, Hungary
| | - Zoltán Kaló
- Center for Health Technology Assessment, Semmelweis University, 1091 Budapest, Hungary
- Syreon Research Institute, 1142 Budapest, Hungary
| | - Zsuzsanna Petykó
- Center for Health Technology Assessment, Semmelweis University, 1091 Budapest, Hungary
- Syreon Research Institute, 1142 Budapest, Hungary
| | - Kristóf Gyöngyösi
- Center for Health Technology Assessment, Semmelweis University, 1091 Budapest, Hungary
- Syreon Research Institute, 1142 Budapest, Hungary
| | - Derek T O'Keeffe
- School of Medicine, University of Galway, H91TK33 Galway, Ireland
| | - Marcin Czech
- Department of Pharmacoeconomics, Institute of Mother and Child, 01-211 Warsaw, Poland
| | - Tamás Ágh
- Syreon Research Institute, 1142 Budapest, Hungary
- Medication Adherence Research Group, Center for Health Technology Assessment and Pharmacoeconomic Research, University of Pécs, 7623 Pécs, Hungary
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Mubarik S, Luo L, Naeem S, Mubarak R, Iqbal M, Hak E, Yu C. Epidemiology and demographic patterns of cardiovascular diseases and neoplasms deaths in Western Europe: a 1990-2019 analysis. Public Health 2024; 231:187-197. [PMID: 38703493 DOI: 10.1016/j.puhe.2024.04.003] [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: 01/23/2024] [Revised: 03/25/2024] [Accepted: 04/03/2024] [Indexed: 05/06/2024]
Abstract
OBJECTIVES Cardiovascular diseases (CVDs) and neoplasms have been considered as public health concerns worldwide. This study aimed to estimate the epidemiological patterns of death burden on CVDs and neoplasms and its attributable risk factors in Western Europe from 1990 to 2019 to discuss the potential causes of the disparities. STUDY DESIGN AND METHODS We collected data on CVDs and neoplasms deaths in 24 Western European countries from the Global Burden of Disease Study. We analyzed patterns by age, sex, country, and associated risk factors. The results include percentages of total deaths, age-standardized death rates per 100,000 population, and uncertainty intervals (UIs). Time trends were assessed using annual percent change. RESULTS In 2019, CVDs and neoplasms accounted for 33.54% and 30.15% of Western Europe's total deaths, with age-standardized death rates of 128.05 (95% UI: 135.37, 113.02) and 137.51 (95% UI: 142.54, 128.01) per 100,000. Over 1990-2019, CVDs rates decreased by 54.97%, and neoplasms rates decreased by 19.54%. Top CVDs subtypes were ischemic heart disease and stroke; top cancers for neoplasms were lung and colorectal. Highest CVD death burdens were in Finland, Greece, Austria; neoplasm burdens in Monaco, San Marino, Andorra. The major risk factors were metabolic (CVDs) and behavioral (neoplasms). Gender differences revealed higher CVDs death burden in males, while neoplasms burden varied by risk factors and age groups. CONCLUSION In 2019, CVDs and neoplasms posed significant health risks in Western Europe, with variations in death burdens and risk factors across genders, age groups, and countries. Future interventions should target vulnerable groups to lessen the impact of CVDs and neoplasms in the region.
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Affiliation(s)
- S Mubarik
- PharmacoTherapy, -Epidemiology and -Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, the Netherlands; Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan 430071 China.
| | - L Luo
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
| | - S Naeem
- Department of Preventive Medicine, School of Public Health, Wuhan University, Wuhan, China.
| | - R Mubarak
- Department of Economics, PMAS, Arid Agriculture University, Rawalpindi, Pakistan.
| | - M Iqbal
- Department of Psychology, School of Philosophy, Wuhan University, Wuhan, China.
| | - E Hak
- PharmacoTherapy, -Epidemiology and -Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, the Netherlands.
| | - C Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan 430071 China.
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Santos JV, Padron-Monedero A, Bikbov B, Grad DA, Plass D, Mechili EA, Gazzelloni F, Fischer F, Sulo G, Ngwa CH, Noguer-Zambrano I, Peñalvo JL, Haagsma JA, Kissimova-Skarbek K, Monasta L, Ghith N, Sarmiento-Suarez R, Hrzic R, Haneef R, O'Caoimh R, Cuschieri S, Mondello S, Kabir Z, Freitas A, Devleesschauwer B. The state of health in the European Union (EU-27) in 2019: a systematic analysis for the Global Burden of Disease study 2019. BMC Public Health 2024; 24:1374. [PMID: 38778362 PMCID: PMC11110444 DOI: 10.1186/s12889-024-18529-3] [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: 05/31/2023] [Accepted: 04/05/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND The European Union (EU) faces many health-related challenges. Burden of diseases information and the resulting trends over time are essential for health planning. This paper reports estimates of disease burden in the EU and individual 27 EU countries in 2019, and compares them with those in 2010. METHODS We used the Global Burden of Disease 2019 study estimates and 95% uncertainty intervals for the whole EU and each country to evaluate age-standardised death, years of life lost (YLLs), years lived with disability (YLDs) and disability-adjusted life years (DALYs) rates for Level 2 causes, as well as life expectancy and healthy life expectancy (HALE). RESULTS In 2019, the age-standardised death and DALY rates in the EU were 465.8 deaths and 20,251.0 DALYs per 100,000 inhabitants, respectively. Between 2010 and 2019, there were significant decreases in age-standardised death and YLL rates across EU countries. However, YLD rates remained mainly unchanged. The largest decreases in age-standardised DALY rates were observed for "HIV/AIDS and sexually transmitted diseases" and "transport injuries" (each -19%). "Diabetes and kidney diseases" showed a significant increase for age-standardised DALY rates across the EU (3.5%). In addition, "mental disorders" showed an increasing age-standardised YLL rate (14.5%). CONCLUSIONS There was a clear trend towards improvement in the overall health status of the EU but with differences between countries. EU health policymakers need to address the burden of diseases, paying specific attention to causes such as mental disorders. There are many opportunities for mutual learning among otherwise similar countries with different patterns of disease.
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Affiliation(s)
- João Vasco Santos
- MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
- CINTESIS@RISE, Faculty of Medicine of the University of Porto, 4200-450, Porto, Portugal.
- Public Health Unit, ULS Santo António, Porto, Portugal.
| | | | | | - Diana Alecsandra Grad
- Department of Public Health, Babeş-Bolyai University, Cluj-Napoca-Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca-Napoca, Romania
| | - Dietrich Plass
- Department for Exposure Assessment and Environmental Health Indicators, Germany Environment Agency, Berlin, Germany
| | - Enkeleint A Mechili
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Crete, Greece
- Department of Healthcare, Faculty of Public Health, University of Vlora, Vlora, Albania
| | | | - Florian Fischer
- Institute of Gerontological Health Services and Nursing Research, Ravensburg-Weingarten University of Applied Sciences, Weingarten, Germany
| | - Gerhard Sulo
- Centre for Disease Burden, Norwegian Institute of Public Health, Oslo, Norway
| | - Che Henry Ngwa
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | | | - José L Peñalvo
- National Center for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Katarzyna Kissimova-Skarbek
- Department of Health Economics and Social Security, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Lorenzo Monasta
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Nermin Ghith
- Research group for Childhood Cancer, Danish Cancer Institute, Danish Cancer Society, Copenhagen, Denmark
| | - Rodrigo Sarmiento-Suarez
- National School of Public Health. Instituto de Salud Carlos III, Madrid, Spain
- Medicine School, University of Applied and Environmental Sciences, Bogota, Colombia
| | - Rok Hrzic
- Department of International Health, Maastricht University, Care and Public Health Research Institute - CAPHRI, Maastricht, The Netherlands
| | - Romana Haneef
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, Saint-Maurice, France
| | - Rónán O'Caoimh
- Department of Medicine, University College Cork, College Road, Cork City, Ireland
- Department of Geriatric Medicine, Mercy University Hospital, Grenville Place, Cork City, Ireland
| | - Sarah Cuschieri
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Stefania Mondello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Zubair Kabir
- School of Public Health, University College Cork, Cork, Ireland
| | - Alberto Freitas
- MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE, Faculty of Medicine of the University of Porto, 4200-450, Porto, Portugal
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Ghent, Belgium
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Niu HJ, Huang KS, Huang PY, Ju HF. Leisure-Time Physical Activity as a Pathway to Sustainable Living: Insights on Health, Environment, and Green Consumerism. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:618. [PMID: 38791832 PMCID: PMC11121333 DOI: 10.3390/ijerph21050618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/19/2024] [Accepted: 04/25/2024] [Indexed: 05/26/2024]
Abstract
In the aftermath of the COVID-19 pandemic, the intricate relationship between health and the environment has emerged with unparalleled significance. This investigation examines the effect of leisure-time physical activity (LTPA) on health and environmental consciousness and its influence on attitudes towards green/sustainable products among 533 individuals. Utilizing linear structural modeling and regression analysis, the findings reveal that participation in sports and leisure activities significantly mediates the connection between individual well-being and eco-responsible consumer behaviors. Highlighting LTPA's crucial role in enhancing environmental awareness, this study offers invaluable perspectives for the green product sector. It advocates for the development of strategies that align with consumers' environmental values, underscoring the essential function of sports and leisure in fostering sustainable consumer practices. Crucially, this underscores the intertwined nature of environmental sustainability and individual health, highlighting their mutual dependence.
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Affiliation(s)
- Han-Jen Niu
- Department of Management Sciences, Tamkang University, New Taipei City 251301, Taiwan
| | - Kuei-Shu Huang
- Office of Physical Education, Tamkang University, New Taipei City 251301, Taiwan;
| | - Pao-Yuan Huang
- Department of Hospitality Management, Hsing Wu University, New Taipei City 244012, Taiwan;
| | - Huey-Fang Ju
- Center for Teacher Education, Tamkang University, New Taipei City 251301, Taiwan
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Pires L, González-Paramás AM, Heleno SA, Calhelha RC. The Role of Gut Microbiota in the Etiopathogenesis of Multiple Chronic Diseases. Antibiotics (Basel) 2024; 13:392. [PMID: 38786121 PMCID: PMC11117238 DOI: 10.3390/antibiotics13050392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 04/23/2024] [Accepted: 04/25/2024] [Indexed: 05/25/2024] Open
Abstract
Chronic diseases (CD) may result from a combination of genetic factors, lifestyle and social behaviours, healthcare system influences, community factors, and environmental determinants of health. These risk factors frequently coexist and interact with one another. Ongoing research and a focus on personalized interventions are pivotal strategies for preventing and managing chronic disease outcomes. A wealth of literature suggests the potential involvement of gut microbiota in influencing host metabolism, thereby impacting various risk factors associated with chronic diseases. Dysbiosis, the perturbation of the composition and activity of the gut microbiota, is crucial in the etiopathogenesis of multiple CD. Recent studies indicate that specific microorganism-derived metabolites, including trimethylamine N-oxide, lipopolysaccharide and uremic toxins, contribute to subclinical inflammatory processes implicated in CD. Various factors, including diet, lifestyle, and medications, can alter the taxonomic species or abundance of gut microbiota. Researchers are currently dedicating efforts to understanding how the natural progression of microbiome development in humans affects health outcomes. Simultaneously, there is a focus on enhancing the understanding of microbiome-host molecular interactions. These endeavours ultimately aim to devise practical approaches for rehabilitating dysregulated human microbial ecosystems, intending to restore health and prevent diseases. This review investigates how the gut microbiome contributes to CD and explains ways to modulate it for managing or preventing chronic conditions.
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Affiliation(s)
- Lara Pires
- Centro de Investigação de Montanha (CIMO), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal; (L.P.); (S.A.H.)
- Grupo de Investigación en Polifenoles en Alimentos, Implicaciones en la Calidad y en Salud Humana, Facultad de Farmacia, Universidad de Salamanca, Campus Miguel de Unamuno s/n, 37007 Salamanca, Spain;
| | - Ana M. González-Paramás
- Grupo de Investigación en Polifenoles en Alimentos, Implicaciones en la Calidad y en Salud Humana, Facultad de Farmacia, Universidad de Salamanca, Campus Miguel de Unamuno s/n, 37007 Salamanca, Spain;
| | - Sandrina A. Heleno
- Centro de Investigação de Montanha (CIMO), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal; (L.P.); (S.A.H.)
- Laboratório Associado para Sustentabilidade e Tecnologia em Regiões de Montanha (SusTEC), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
| | - Ricardo C. Calhelha
- Centro de Investigação de Montanha (CIMO), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal; (L.P.); (S.A.H.)
- Laboratório Associado para Sustentabilidade e Tecnologia em Regiões de Montanha (SusTEC), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
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Fang J, Wu J, Hong G, Zheng L, Yu L, Liu X, Lin P, Yu Z, Chen D, Lin Q, Jing C, Zhang Q, Wang C, Zhao J, Yuan X, Wu C, Zhang Z, Guo M, Zhang J, Zheng J, Lei A, Zhang T, Lan Q, Kong L, Wang X, Wang Z, Ma Q. Cancer screening in hospitalized ischemic stroke patients: a multicenter study focused on multiparametric analysis to improve management of occult cancers. EPMA J 2024; 15:53-66. [PMID: 38463627 PMCID: PMC10923752 DOI: 10.1007/s13167-024-00354-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/02/2024] [Indexed: 03/12/2024]
Abstract
Background/aims The reciprocal promotion of cancer and stroke occurs due to changes in shared risk factors, such as metabolic pathways and molecular targets, creating a "vicious cycle." Cancer plays a direct or indirect role in the pathogenesis of ischemic stroke (IS), along with the reactive medical approach used in the treatment and clinical management of IS patients, resulting in clinical challenges associated with occult cancer in these patients. The lack of reliable and simple tools hinders the effectiveness of the predictive, preventive, and personalized medicine (PPPM/3PM) approach. Therefore, we conducted a multicenter study that focused on multiparametric analysis to facilitate early diagnosis of occult cancer and personalized treatment for stroke associated with cancer. Methods Admission routine clinical examination indicators of IS patients were retrospectively collated from the electronic medical records. The training dataset comprised 136 IS patients with concurrent cancer, matched at a 1:1 ratio with a control group. The risk of occult cancer in IS patients was assessed through logistic regression and five alternative machine-learning models. Subsequently, select the model with the highest predictive efficacy to create a nomogram, which is a quantitative tool for predicting diagnosis in clinical practice. Internal validation employed a ten-fold cross-validation, while external validation involved 239 IS patients from six centers. Validation encompassed receiver operating characteristic (ROC) curves, calibration curves, decision curve analysis (DCA), and comparison with models from prior research. Results The ultimate prediction model was based on logistic regression and incorporated the following variables: regions of ischemic lesions, multiple vascular territories, hypertension, D-dimer, fibrinogen (FIB), and hemoglobin (Hb). The area under the ROC curve (AUC) for the nomogram was 0.871 in the training dataset and 0.834 in the external test dataset. Both calibration curves and DCA underscored the nomogram's strong performance. Conclusions The nomogram enables early occult cancer diagnosis in hospitalized IS patients and helps to accurately identify the cause of IS, while the promotion of IS stratification makes personalized treatment feasible. The online nomogram based on routine clinical examination indicators of IS patients offered a cost-effective platform for secondary care in the framework of PPPM. Supplementary Information The online version contains supplementary material available at 10.1007/s13167-024-00354-8.
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Affiliation(s)
- Jie Fang
- Department of Neurology and Department of Neuroscience, School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen University, 55 Zhenhai Road, Xiamen, 361003 China
- Fujian Key Laboratory of Brain Tumors Diagnosis and Precision Treatment, Xiamen, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
- Xiamen Medical Quality Control Center for Neurology, Xiamen, China
- Fujian Provincial Clinical Research Center for Brain Diseases, Xiamen, China
- Xiamen Clinical Research Center for Neurological Diseases, Xiamen, China
- School of Medicine, Xiamen University, Xiamen, China
| | - Jielong Wu
- Department of Neurology and Department of Neuroscience, School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen University, 55 Zhenhai Road, Xiamen, 361003 China
- School of Medicine, Xiamen University, Xiamen, China
- National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, China
| | - Ganji Hong
- Cerebrovascular Interventional Department, Zhangzhou Hospital of Fujian Province, Zhangzhou, China
| | - Liangcheng Zheng
- Department of Neurology and Department of Neuroscience, School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen University, 55 Zhenhai Road, Xiamen, 361003 China
- Fujian Key Laboratory of Brain Tumors Diagnosis and Precision Treatment, Xiamen, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
- Xiamen Medical Quality Control Center for Neurology, Xiamen, China
- Fujian Provincial Clinical Research Center for Brain Diseases, Xiamen, China
- Xiamen Clinical Research Center for Neurological Diseases, Xiamen, China
| | - Lu Yu
- Department of Neurology, Changxing People’s Hospital, Huzhou, China
| | - Xiuping Liu
- Department of Neurology, The Jilin Center Hospital, Jilin, China
| | - Pan Lin
- Department of Neurology, The Second Hospital of Longyan City, Longyan, China
| | - Zhenzhen Yu
- Department of Neurology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, China
| | - Dan Chen
- Department of Neurology, Xiamen Haicang Hospital, Xiamen, China
| | - Qing Lin
- Department of Neurology and Department of Neuroscience, School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen University, 55 Zhenhai Road, Xiamen, 361003 China
- Fujian Key Laboratory of Brain Tumors Diagnosis and Precision Treatment, Xiamen, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
- Xiamen Medical Quality Control Center for Neurology, Xiamen, China
- Fujian Provincial Clinical Research Center for Brain Diseases, Xiamen, China
- Xiamen Clinical Research Center for Neurological Diseases, Xiamen, China
| | - Chuya Jing
- Department of Neurology and Department of Neuroscience, School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen University, 55 Zhenhai Road, Xiamen, 361003 China
- Fujian Key Laboratory of Brain Tumors Diagnosis and Precision Treatment, Xiamen, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
- Xiamen Medical Quality Control Center for Neurology, Xiamen, China
- Fujian Provincial Clinical Research Center for Brain Diseases, Xiamen, China
- Xiamen Clinical Research Center for Neurological Diseases, Xiamen, China
| | - Qiuhong Zhang
- Department of Neurology and Department of Neuroscience, School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen University, 55 Zhenhai Road, Xiamen, 361003 China
- Fujian Key Laboratory of Brain Tumors Diagnosis and Precision Treatment, Xiamen, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
- Xiamen Medical Quality Control Center for Neurology, Xiamen, China
- Fujian Provincial Clinical Research Center for Brain Diseases, Xiamen, China
- Xiamen Clinical Research Center for Neurological Diseases, Xiamen, China
| | - Chen Wang
- Department of Neurology and Department of Neuroscience, School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen University, 55 Zhenhai Road, Xiamen, 361003 China
- Fujian Key Laboratory of Brain Tumors Diagnosis and Precision Treatment, Xiamen, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
- Xiamen Medical Quality Control Center for Neurology, Xiamen, China
- Fujian Provincial Clinical Research Center for Brain Diseases, Xiamen, China
- Xiamen Clinical Research Center for Neurological Diseases, Xiamen, China
| | - Jiedong Zhao
- School of Clinical Medicine, Fujian Medical University, Fuzhou, China
| | - Xiaodong Yuan
- Department of Gynecology of Xiamen Maternal and Child Health Care Hospital, Xiamen, China
| | - Chunfang Wu
- Department of Neurology, Huaihe Hospital, Henan University, Huaihe, China
| | - Zhaojie Zhang
- Department of Neurology, Kaifeng Hospital of Traditional Chinese Medicine, Kaifeng, China
| | - Mingwei Guo
- Department of Neurology, First Affiliated Hospital of Gannan Medical University, Gannan, China
| | - Junde Zhang
- Department of Neurology, First Affiliated Hospital of Gannan Medical University, Gannan, China
| | - Jingjing Zheng
- Department of Neurology, Ningde Municipal Hospital of Ningde Normal University, Ningde, China
| | - Aidi Lei
- Department of Neurology, The Fifth Hospital of Xiamen, Xiamen, China
| | - Tengkun Zhang
- Department of Neurology, The Fifth Hospital of Xiamen, Xiamen, China
| | - Quan Lan
- Department of Neurology and Department of Neuroscience, School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen University, 55 Zhenhai Road, Xiamen, 361003 China
- Fujian Key Laboratory of Brain Tumors Diagnosis and Precision Treatment, Xiamen, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
- Xiamen Medical Quality Control Center for Neurology, Xiamen, China
- Fujian Provincial Clinical Research Center for Brain Diseases, Xiamen, China
- Xiamen Clinical Research Center for Neurological Diseases, Xiamen, China
| | | | - Xinrui Wang
- NHC Key Laboratory of Technical Evaluation of Fertility Regulation for Non-Human Primate (Fujian Maternity and Child Health Hospital), No. 19 Jinjishan Road, Jin’an District, Fuzhou, 350013 China
- Medical Research Center, College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Maternityand Child Health Hospital, Fujian Medical University, Fuzhou, China
| | - Zhanxiang Wang
- Fujian Key Laboratory of Brain Tumors Diagnosis and Precision Treatment, Xiamen, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
- Xiamen Medical Quality Control Center for Neurology, Xiamen, China
- Fujian Provincial Clinical Research Center for Brain Diseases, Xiamen, China
- Xiamen Clinical Research Center for Neurological Diseases, Xiamen, China
- School of Medicine, Xiamen University, Xiamen, China
- National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, China
- Department of Neurosurgery and Department of Neuroscience, School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen University, 55 Zhenhai Road, Xiamen, 361003 China
| | - Qilin Ma
- Department of Neurology and Department of Neuroscience, School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen University, 55 Zhenhai Road, Xiamen, 361003 China
- Fujian Key Laboratory of Brain Tumors Diagnosis and Precision Treatment, Xiamen, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
- Xiamen Medical Quality Control Center for Neurology, Xiamen, China
- Fujian Provincial Clinical Research Center for Brain Diseases, Xiamen, China
- Xiamen Clinical Research Center for Neurological Diseases, Xiamen, China
- School of Medicine, Xiamen University, Xiamen, China
- National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, China
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Aparicio-Rodríguez YD, Alonso-Morillejo E, García-Torrecillas JM. Epidemiological Situation of High-Prevalence Non-Communicable Diseases in Spain: A Systematic Review. J Clin Med 2023; 12:7109. [PMID: 38002721 PMCID: PMC10672730 DOI: 10.3390/jcm12227109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/07/2023] [Accepted: 11/12/2023] [Indexed: 11/26/2023] Open
Abstract
High-prevalence non-communicable diseases (HNCDs) are an ongoing global public health problem, posing a risk to the continuity of the 2030 Agenda for Sustainable Development. The aim of this study is to describe the current situation in Spain regarding certain HNCDs, namely, ischaemic heart disease, type 2 diabetes mellitus and colorectal cancer, including their prevalence and incidence in recent years. A systematic review was conducted between October 2022 and February 2023 using the MEDLINE, ProQuest and Scopus databases. After an exhaustive search, a total of thirty-four articles were included, comprising fourteen articles on colorectal cancer, seven on ischaemic heart disease and thirteen on diabetes mellitus type 2. The main topics included risk factors, lifestyles, mortality and incidence, the importance of screening and patient empowerment. On analysing each disease, it can be gleaned that risk factors and lifestyle impact the incidence, prevalence and mortality of the diseases studied. In addition, responsible human behaviour, associated with lifestyle factors, is related to the occurrence of these three diseases.
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Affiliation(s)
| | | | - Juan Manuel García-Torrecillas
- Emergency and Research Unit, Torrecardenas University Hospital, 04009 Almería, Spain;
- CIBER de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Instituto de Investigación Biosanitaria Ibs, 18012 Granada, Spain
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8
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Latuapon E, Hochstenbach L, Mahr D, Scheenstra B, Kietselaer B, Spreeuwenberg M. Cocreation to Facilitate Communication and Collaboration Between Multidisciplinary Stakeholders in eHealth Research and Development: Case Study of the CARRIER (Coronary Artery Disease: Risk Estimations and Interventions for Prevention and Early Detection) Consortium. JMIR Hum Factors 2023; 10:e45006. [PMID: 37874629 PMCID: PMC10630860 DOI: 10.2196/45006] [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: 12/13/2022] [Revised: 06/15/2023] [Accepted: 08/20/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Collaboration with diverse stakeholders in eHealth research is fundamental yet complex. Stakeholders from various disciplines do not "speak the same language" and have different levels of power and interest, resulting in contrasting objectives, priorities, and expectations. An approach to constructive communication and collaboration is necessary to overcome this complex dynamic. Cocreation, known in the field of eHealth most often to involve end users, may also be suitable for facilitating stakeholder engagement and alignment. OBJECTIVE This paper provides insights into the application of cocreation, specifically in the early phases of research that focus on involving and aligning relevant stakeholders from different academic and professional backgrounds. METHODS The case for this study was a group discussion with members of a multidisciplinary consortium that works on developing a personalized eHealth intervention for atherosclerotic cardiovascular disease. Using stakeholder mapping, health and medicine experts, big data scientists, software developers, and an innovation manager (N=8) were invited to participate. The discussion was based on a user scenario and structured according to the Six Thinking Hats of de Bono, representing 6 different types of thinking. The discussion was recorded, transcribed verbatim, and analyzed thematically with the use of ATLAS.ti software. RESULTS First, informative and intuitive thinking served the preparatory purpose of familiarization with the project details and other participants. Second, positive and critical thinking constituted the body of the discussion and resulted in an in-depth conversation. Third, creative and organizational thinking were action oriented and focused on solutions and planning to safeguard future progress. The participants repeatedly reflected on various intervention-related themes, ranging from intervention content to technical functionalities and from legal requirements to implementation in practice. Moreover, project-related matters were discussed, including stakeholder management and time and budget constraints. CONCLUSIONS This paper demonstrates how cocreation can be of value for multidisciplinary stakeholder engagement and alignment. Based on stakeholder mapping (with whom to discuss), a dream user scenario (what to discuss), and the Six Thinking Hats of de Bono (how to discuss), the participants shared information, discussed differences, searched for solutions, and moved toward a collective approach regarding intervention development. The lessons learned may further improve the understanding of how cocreation can contribute to multidisciplinary collaboration.
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Affiliation(s)
- Elizabeth Latuapon
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Laura Hochstenbach
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Dominik Mahr
- Department of Marketing & Supply Chain Management, School of Business and Economics, Maastricht University, Maastricht, Netherlands
| | - Bart Scheenstra
- Department of Cardiothoracic Surgery, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Bas Kietselaer
- Department of Cardiovascular Disease, Mayo Clinic, Rochester, MN, United States
- Department of Cardiology, Zuyderland Medical Centre, Heerlen, Netherlands
| | - Marieke Spreeuwenberg
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
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Fras Z, Jakše B, Kreft S, Malek Ž, Kamin T, Tavčar N, Fidler Mis N. The Activities of the Slovenian Strategic Council for Nutrition 2023/24 to Improve the Health of the Slovenian Population and the Sustainability of Food: A Narrative Review. Nutrients 2023; 15:4390. [PMID: 37892467 PMCID: PMC10610012 DOI: 10.3390/nu15204390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/10/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
The health status of individuals in Slovenia across age groups is a matter of concern, as current unsustainable lifestyle choices are already leading to various chronic noncommunicable diseases (NCDs). Outdated national dietary guidelines, their inconsistent implementation, and a lack of structural changes represent obstacles to promoting healthy and sustainable nutrition. Limited access to and rising prices of healthy, sustainable foods, in addition to the high availability of low-priced, highly processed foods, increase the risk of NCDs. The lack of systematic health monitoring and early disease detection poses a challenge. Global and local environmental issues, resistance, and/or the inability to adopt healthier diets hinder individuals from changing their nutritional behaviours. In this narrative review, we provide an overview of the current situation in Slovenia as well as planned activities initiated by the Slovenian government and the Prime Minister's Strategic Council for Nutrition, aiming to make progress in supporting healthy and sustainable nutrition, limiting food waste, and increasing the availability of healthier foods for all. Improving the sustainability of the Slovenian food system can contribute to several Sustainable Development Goals (SDGs), ensuring Slovenia's commitment to internationally agreed-upon targets. This could lead Slovenia to take a role as a pilot country in testing and implementing the necessary systemic changes, which could be further applied in other countries.
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Affiliation(s)
- Zlatko Fras
- Division of Medicine, Centre for Preventive Cardiology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia;
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | | | - Samo Kreft
- Faculty of Pharmacy, University of Ljubljana, 1000 Ljubljana, Slovenia;
| | - Žiga Malek
- Institute for Environmental Studies (IVM), Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands;
| | - Tanja Kamin
- Faculty of Social Sciences, University of Ljubljana, 1000 Ljubljana, Slovenia;
| | - Nika Tavčar
- Umanotera, The Slovenian Foundation for Sustainable Development, 1000 Ljubljana, Slovenia;
| | - Nataša Fidler Mis
- Ministry of Health, 1000 Ljubljana, Slovenia
- Division of Paediatrics, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
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10
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Soares Andrade CA, Shahin B, Dede O, Akpeji AO, Ajene CL, Albano Israel FE, Varga O. The burden of type 2 diabetes mellitus in states of the European Union and United Kingdom at the national and subnational levels: A systematic review. Obes Rev 2023; 24:e13593. [PMID: 37401729 DOI: 10.1111/obr.13593] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 03/31/2023] [Accepted: 05/21/2023] [Indexed: 07/05/2023]
Abstract
Type 2 diabetes mellitus (T2D) is a highly prevalent disease worldwide, with an equally increased expenditure associated with it. We aimed to longitudinally evaluate the epidemiologic and economic burden of T2D in the current member states of the European Union and the United Kingdom (EU-28). The present systematic review is registered on PROSPERO (CRD42020219894), and it followed the PRISMA guidelines. Eligibility criteria comprised original observational studies in English reporting economic and epidemiological data for T2D in member states of the EU-28. Methodological assessment was performed with the Joanna Briggs Institute (JBI) Critical Appraisal Tools. The search retrieved 2253 titles and abstracts. After study selection, 41 studies were included in the epidemiologic analysis and 25 in the economic analysis. Economic and epidemiologic studies covered only 15 member states with reported data between 1970 and 2017, resulting in an incomplete picture. For children in particular, limited information is available. The prevalence, incidence, mortality, and expenditure of the T2D population have increased across the decades in member states. Therefore, policies should aim to prevent or reduce the burden of T2D in the EU and consequently mitigate the expenditure on T2D.
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Affiliation(s)
| | - Balqees Shahin
- Faculty of Medicine, Department of Public Health and Epidemiology, University of Debrecen, Debrecen, Hungary
| | - Onisoyonivosekume Dede
- Faculty of Medicine, Department of Public Health and Epidemiology, University of Debrecen, Debrecen, Hungary
| | - Anne Omagu Akpeji
- Faculty of Medicine, Department of Public Health and Epidemiology, University of Debrecen, Debrecen, Hungary
| | - Comfort-Lucia Ajene
- Faculty of Medicine, Department of Public Health and Epidemiology, University of Debrecen, Debrecen, Hungary
| | | | - Orsolya Varga
- Faculty of Medicine, Department of Public Health and Epidemiology, University of Debrecen, Debrecen, Hungary
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11
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Binyaruka P, Mtenga S. Catastrophic health care spending in managing type 2 diabetes before and during the COVID-19 pandemic in Tanzania. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002180. [PMID: 37607181 PMCID: PMC10443863 DOI: 10.1371/journal.pgph.0002180] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 07/20/2023] [Indexed: 08/24/2023]
Abstract
COVID-19 disrupted health care provision and access and reduced household income. Households with chronically ill patients are more vulnerable to these effects as they access routine health care. Yet, a few studies have analysed the effect of COVID-19 on household income, health care access costs, and financial catastrophe due to health care among patients with type 2 diabetes (T2D), especially in developing countries. This study fills that knowledge gap. We used data from a cross-sectional survey of 500 people with T2D, who were adults diagnosed with T2D before COVID-19 in Tanzania (March 2020). Data were collected in February 2022, reflecting the experience before and during COVID-19. During COVID-19, household income decreased on average by 16.6%, while health care costs decreased by 0.8% and transport costs increased by 10.6%. The overall financing burden for health care and transport relative to household income increased by 32.1% and 45%, respectively. The incidences of catastrophic spending above 10% of household income increased by 10% (due to health care costs) and by 55% (due to transport costs). The incidences of catastrophic spending due to health care costs were higher than transport costs, but the relative increase was higher for transport than health care costs (10% vs. 55% change from pre-COVID-19). The likelihood of incurring catastrophic health spending was lower among better educated patients, with health insurance, and from better-off households. COVID-19 was associated with reduced household income, increased transport costs, increased financing burden and financial catastrophe among patients with T2D in Tanzania. Policymakers need to ensure financial risk protection by expanding health insurance coverage and removing user fees, particularly for people with chronic illnesses. Efforts are also needed to reduce transport costs by investing more in primary health facilities to offer quality services closer to the population and engaging multiple sectors, including infrastructure and transportation.
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Affiliation(s)
- Peter Binyaruka
- Department of Health System, Impact Evaluation, and Policy, Ifakara Health Institute, Dar es Salaam, Tanzania
| | - Sally Mtenga
- Department of Health System, Impact Evaluation, and Policy, Ifakara Health Institute, Dar es Salaam, Tanzania
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Buchholz M, Weber N, Borel S, Sayah S, Xie F, Schulz JB, Reetz K, Boesch S, Klopstock T, Karin I, Schöls L, Grobe-Einsler M, Klockgether T, Davies EH, Schmeder M, Nadke A, Michalowsky B. Patient-reported, health economic and psychosocial outcomes in patients with Friedreich ataxia (PROFA): protocol of an observational study using momentary data assessments via mobile health app. BMJ Open 2023; 13:e075736. [PMID: 37527887 PMCID: PMC10394552 DOI: 10.1136/bmjopen-2023-075736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/03/2023] Open
Abstract
INTRODUCTION Friedreich ataxia (FA) is the most common hereditary ataxia in Europe, characterised by progressively worsening movement and speech impairments with a typical onset before the age of 25 years. The symptoms affect the patients' health-related quality of life (HRQoL) and psychosocial health. FA leads to an increasing need for care, associated with an economic burden. Little is known about the impact of FA on daily lives and HRQoL. To fill that gap, we will assess patient-reported, psychosocial and economic outcomes using momentary data assessment via a mobile health application (app). METHODS AND ANALYSIS The PROFA Study is a prospective observational study. Patients with FA (n=200) will be recruited at six European study centres (Germany, France and Austria). We will interview patients at baseline in the study centre and subsequently assess the patients' health at home via mobile health app. Patients will self-report ataxia severity, HRQoL, speech and hearing disabilities, coping strategies and well-being, health services usage, adverse health events and productivity losses due to informal care on a daily to monthly basis on the app for 6 months. Our study aims to (1) validate measurements of HRQoL and psychosocial health, (2) assess the usability of the mobile health app, and (3) use descriptive and multivariate statistics to analyse patient-reported and economic outcomes and the interaction effects between these outcomes. Insights into the app's usability could be used for future studies using momentary data assessments to measure outcomes of patients with FA. ETHICS AND DISSEMINATION Ethical approval has been obtained from the Ethics Committee of the University Medicine of Greifswald, (BB096/22a, 26 October 2022) and from all local ethics committees of the participating study sites. Findings of the study will be published in peer-reviewed journals, presented at relevant international/national congresses and disseminated to German and French Patient Advocacy Organizations. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Registry (NCT05943002); Pre-results.
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Affiliation(s)
- Maresa Buchholz
- Translational Health Care Research, German Center for Neurodegenerative Diseases, Site Rostock/Greifswald, Greifswald, Germany
| | - Niklas Weber
- Translational Health Care Research, German Center for Neurodegenerative Diseases, Site Rostock/Greifswald, Greifswald, Germany
| | - Stephanie Borel
- Paris Brain Institute (ICM - Institut du Cerveau), INSERM, CNRS, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne University, Paris, France
| | - Sabrina Sayah
- Paris Brain Institute (ICM - Institut du Cerveau), INSERM, CNRS, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne University, Paris, France
| | - Feng Xie
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Jörg B Schulz
- Department of Neurology, RWTH Aachen University, Aachen, Germany
| | - Kathrin Reetz
- Department of Neurology, RWTH Aachen University, Aachen, Germany
| | - Sylvia Boesch
- Clinical Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Thomas Klopstock
- Friedrich-Baur-Institut, Department of Neurology, Ludwig Maximilians University of Munich, Munich, Germany
| | - Ivan Karin
- Friedrich-Baur-Institut, Department of Neurology, Ludwig Maximilians University of Munich, Munich, Germany
| | - Ludger Schöls
- Hertie Institute for Clinical Brain Research and Center of Neurology, University Hospital Tübingen, Tubingen, Germany
| | - Marcus Grobe-Einsler
- German Center for Neurodegenerative Diseases, Bonn, Germany
- Department of Neurology, University Hospital Bonn, Bonn, Germany
| | - Thomas Klockgether
- German Center for Neurodegenerative Diseases, Bonn, Germany
- Department of Neurology, University Hospital Bonn, Bonn, Germany
| | | | | | - Andreas Nadke
- Deutsche Heredo-Ataxie-Gesellschaft, Stuttgart, Germany
| | - Bernhard Michalowsky
- Translational Health Care Research, German Center for Neurodegenerative Diseases, Site Rostock/Greifswald, Greifswald, Germany
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13
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Racoviță M, Tate J, Wait S, Adams E. Overcoming the nursing workforce crisis in Europe to improve care for people with non-communicable diseases. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2023; 32:698. [PMID: 37495410 DOI: 10.12968/bjon.2023.32.14.698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Affiliation(s)
| | | | - Suzanne Wait
- Managing Director, The Health Policy Partnership
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14
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Hajna S, Nafilyan V, Cummins S. Associations between residential greenspace exposure and mortality in 4 645 581 adults living in London, UK: a longitudinal study. Lancet Planet Health 2023; 7:e459-e468. [PMID: 37286243 DOI: 10.1016/s2542-5196(23)00057-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 03/17/2023] [Accepted: 03/17/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND Urban greenspaces could reduce non-communicable disease (NCD) risk. The links between greenspaces and NCD-related mortality remain unclear. We aimed to estimate associations between residential greenspace quantity and access and all-cause mortality, cardiovascular disease mortality, cancer mortality, respiratory mortality, and type 2 diabetes mortality. METHODS We linked 2011 UK Census data of London-dwelling adults (aged ≥18 years) to data from the UK death registry and the Greenspace Information for Greater London resource. We calculated percentage greenspace area, access point density (access points per km2), and distance in metres to the nearest access point for each respondent's residential neighbourhood (defined as 1000 m street network buffers) for greenspaces overall and by park type using a geographic information system. We estimated associations using Cox proportional hazards models, adjusted for a range of confounders. FINDINGS Data were available for 4 645 581 individuals between March 27, 2011, and Dec 31, 2019. Respondents were followed up for a mean of 8·4 years (SD 1·4). All-cause mortality did not differ with overall greenspace coverage (hazard ratio [HR] 1·0004, 95% CI 0·9996-1·0012), increased with increasing access point density (1·0076, 1·0031-1·0120), and decreased slightly with increasing distance to the nearest access point (HR 0·9993, 0·9987-0·9998). A 1 percentage point (pp) increase in pocket park (areas for rest and recreation under 0·4 hectares) coverage was associated with a decrease in all-cause mortality risk (0·9441, 0·9213-0·9675), and an increase of ten pocket park access points per km2 was associated with a decreased respiratory mortality risk (0·9164, 0·8457-0·9931). Other associations were observed, but the estimated effects were small (eg, all-cause mortality risk for increases of 1 pp in regional park area were 0·9913, 0·9861-0·9966 and increases of ten small open space access points per km2 were 1·0247, 1·0151-1·0344). INTERPRETATION Increasing the quantity of, and access to, pocket parks might help mitigate mortality risk. More research is needed to elucidate the mechanisms that could explain these associations. FUNDING Health Data Research UK (HDRUK).
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Affiliation(s)
- Samantha Hajna
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, St Catharines, ON, Canada; Child Health Informatics Group, Great Ormond Street Institue of Child Health, University College London, London, UK; Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK
| | | | - Steven Cummins
- Population Health Innovation Lab, Department of Public Health, Environments, & Society, London School of Hygiene & Tropical Medicine, London, UK.
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Faghy MA, Ashton RE, Skipper L, Kane B. Long COVID - integrated approaches to chronic disease management? Am J Med 2023:S0002-9343(23)00332-7. [PMID: 37230401 DOI: 10.1016/j.amjmed.2023.04.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/17/2023] [Accepted: 04/27/2023] [Indexed: 05/27/2023]
Affiliation(s)
- Mark A Faghy
- Biomedical Research Theme, School of Human Sciences, University of Debry, Derby, United Kingdom.
| | - Ruth Em Ashton
- Biomedical Research Theme, School of Human Sciences, University of Debry, Derby, United Kingdom
| | - Lindsay Skipper
- Patient and Public Involvement and Engagement Representative
| | - Binita Kane
- Manchester University Foundation Trust and School of Biological Sciences, University of Manchester, Manchester, UK
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16
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Ortega-Paz L, Giordano S, Capodanno D, Mehran R, Gibson CM, Angiolillo DJ. Clinical Pharmacokinetics and Pharmacodynamics of CSL112. Clin Pharmacokinet 2023; 62:541-558. [PMID: 36928983 PMCID: PMC10019422 DOI: 10.1007/s40262-023-01224-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2023] [Indexed: 03/18/2023]
Abstract
Cardiovascular diseases are the leading cause of death worldwide. Although there have been substantial advances over the last decades, recurrent adverse cardiovascular events after myocardial infarction are still frequent, particularly during the first year of the index event. For decades, high-density lipoprotein (HDL) has been among the therapeutic targets for long-term prevention after an ischemic event. However, early trials focusing on increasing HDL circulating levels showed no improvement in clinical outcomes. Recently, the paradigm has shifted to increasing the functionality of HDL rather than its circulating plasma levels. For this purpose, apolipoprotein-AI-based infusion therapies have been developed, including reconstituted HDL, such as CSL112. During the last decade, CSL112 has been extensively studied in Phase 1 and 2 trials and has shown promising results. In particular, CSL112 has been studied in the Phase 2b AEGIS trial exhibiting good safety and tolerability profiles, which has led to the ongoing large-scale Phase 3 AEGIS-II trial. This systematic overview will provide a comprehensive summary of the CSL112 drug development program focusing on its pharmacodynamic, pharmacokinetic, and safety profiles.
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Affiliation(s)
- Luis Ortega-Paz
- Division of Cardiology, University of Florida College of Medicine, 655 West 8th Street, Jacksonville, FL, 32209, USA
| | - Salvatore Giordano
- Division of Cardiology, University of Florida College of Medicine, 655 West 8th Street, Jacksonville, FL, 32209, USA
- Division of Cardiology, Department of Medical and Surgical Sciences, "Magna Graecia" University, Catanzaro, Italy
| | - Davide Capodanno
- Division of Cardiology, A.O.U. "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
| | - Roxana Mehran
- Icahn School of Medicine at Mount Sinai, Zena and Michael A. Wiener Cardiovascular Institute, New York, USA
| | - C Michael Gibson
- Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| | - Dominick J Angiolillo
- Division of Cardiology, University of Florida College of Medicine, 655 West 8th Street, Jacksonville, FL, 32209, USA.
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Why and How Should We Assess the Cardiovascular Risk in Patients with Juvenile Idiopathic Arthritis? A Single-Centre Experience with Carotid Intima-Media Measurements. CHILDREN 2023; 10:children10030422. [PMID: 36979980 PMCID: PMC10047782 DOI: 10.3390/children10030422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/16/2023] [Accepted: 02/21/2023] [Indexed: 02/24/2023]
Abstract
Background: Children diagnosed with juvenile idiopathic arthritis (JIA) are thought to be more likely to develop cardiovascular disease in adulthood. The factors modulating the cardiovascular risk, involving exposure to secondhand smoking, sedentary lifestyle and abnormal body mass index, might have had a stronger impact during the COVID-19 pandemic. The lack of reliable prognostic markers for a higher probability of cardiovascular events might be solved by carotid intima-media thickness (cIMT) measurement. The paramount goal of the study was to assess its usefulness in JIA patients. Materials and Methods: The results of cIMT measured by a single physician in 45 children diagnosed with JIA were compared to 37 age- and sex-matched healthy counterparts. The analysis also involved anthropometric parameters, laboratory tests, and a survey regarding lifestyle-related factors. Results: Four JIA patients appeared to have cIMT above the 94th percentile. A positive correlation between erythrocytes sedimentation rate (ESR) and right carotid artery percentiles was found. Passive smoking increased the cardiovascular risk regardless of JIA. Doubling the daily screen time during the pandemic led to a significant reduction in children’s physical activity. However, the number of enrolled subjects was not enough to make significant recommendations. Conclusions: cIMT measurements remain an interesting perspective for future cardiovascular screening of children with JIA. It has yet to be determined whether it should be considered in all JIA patients on a reliable basis.
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Wieczorek M, Meier C, Vilpert S, Reinecke R, Borrat-Besson C, Maurer J, Kliegel M. Association between multiple chronic conditions and insufficient health literacy: cross-sectional evidence from a population-based sample of older adults living in Switzerland. BMC Public Health 2023; 23:253. [PMID: 36747134 PMCID: PMC9901105 DOI: 10.1186/s12889-023-15136-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 01/24/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Health literacy is the ability to find, understand, assess, and apply health information. Individuals suffering from multiple chronic conditions have complex healthcare needs that may challenge their health literacy skills. This study aimed to investigate the relationship between multimorbidity, the number of chronic conditions, and health literacy levels in a sample of adults aged 58+ in Switzerland. METHODS We used data from 1,615 respondents to a paper-and-pencil questionnaire administered as part of wave 8 (2019/2020) of the Survey of Health, Ageing and Retirement in Europe (SHARE) in Switzerland. Health literacy was measured using the short version of the European Health Literacy Survey questionnaire. The final score ranged from 0 to 16 and was categorised into three health literacy levels: inadequate (0-8), problematic (9-12), and sufficient (13-16). The number of chronic conditions was self-reported based on a pre-defined list. Associations were examined using multivariable ordinary least squares and ordered probit regression models, controlling for key socio-demographic characteristics. RESULTS Overall, 63.5% of respondents reported having at least one chronic condition. Respondents who reported one, two, and three or more chronic conditions were more likely to have lower health literacy scores compared to respondents who did not report any chronic condition (p<0.05, p<0.01, and p<0.001, respectively). Suffering from two and three or more chronic conditions (vs. no chronic condition) was significantly associated with a higher likelihood of having inadequate or problematic health literacy levels (both p-values <0.01). CONCLUSIONS Our findings suggest a need to improve health literacy in older adults suffering from chronic conditions. Improved health literacy could constitute a promising lever to empower individuals to better self-manage their health to ultimately reduce the double burden of chronic diseases and insufficient health literacy in this vulnerable population.
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Affiliation(s)
- Maud Wieczorek
- Swiss National Centre of Competence in Research LIVES - Overcoming vulnerability: Life course perspectives, University of Lausanne, Building Géopolis, CH-1015, Lausanne and Geneva, Switzerland.
| | - Clément Meier
- grid.9851.50000 0001 2165 4204Faculty of Biology and Medicine (FBM), University of Lausanne, Lausanne, Switzerland ,grid.9851.50000 0001 2165 4204Faculty of Business and Economics (HEC), University of Lausanne, Lausanne, Switzerland ,grid.9851.50000 0001 2165 4204Swiss Centre of Expertise in the Social Sciences (FORS), University of Lausanne, Lausanne, Switzerland
| | - Sarah Vilpert
- grid.9851.50000 0001 2165 4204Faculty of Business and Economics (HEC), University of Lausanne, Lausanne, Switzerland ,grid.9851.50000 0001 2165 4204Swiss Centre of Expertise in the Social Sciences (FORS), University of Lausanne, Lausanne, Switzerland
| | - Robert Reinecke
- grid.9851.50000 0001 2165 4204Swiss Centre of Expertise in the Social Sciences (FORS), University of Lausanne, Lausanne, Switzerland
| | - Carmen Borrat-Besson
- grid.9851.50000 0001 2165 4204Swiss Centre of Expertise in the Social Sciences (FORS), University of Lausanne, Lausanne, Switzerland
| | - Jürgen Maurer
- grid.9851.50000 0001 2165 4204Swiss National Centre of Competence in Research LIVES - Overcoming vulnerability: Life course perspectives, University of Lausanne, Building Géopolis, CH-1015, Lausanne and Geneva, Switzerland ,grid.9851.50000 0001 2165 4204Faculty of Business and Economics (HEC), University of Lausanne, Lausanne, Switzerland
| | - Matthias Kliegel
- grid.9851.50000 0001 2165 4204Swiss National Centre of Competence in Research LIVES - Overcoming vulnerability: Life course perspectives, University of Lausanne, Building Géopolis, CH-1015, Lausanne and Geneva, Switzerland ,grid.8591.50000 0001 2322 4988Centre for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland
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Cheng H, Yu X, Li YT, Jia Z, Wang JJ, Xie YJ, Hernandez J, Wang HHX, Wu HF. Association between METS-IR and Prediabetes or Type 2 Diabetes Mellitus among Elderly Subjects in China: A Large-Scale Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1053. [PMID: 36673809 PMCID: PMC9859146 DOI: 10.3390/ijerph20021053] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
The metabolic score for insulin resistance (METS-IR) was recently proposed as a non-insulin-based, novel index for assessing insulin resistance (IR) in the Western population. However, evidence for the link between METS-IR and prediabetes or type 2 diabetes mellitus (T2DM) among the elderly Chinese population was still limited. We aimed to investigate the associations between METS-IR and prediabetes or T2DM based on large-scale, cross-sectional, routine physical examination data. In a total of 18,112 primary care service users, an increased METS-IR was independently associated with a higher prevalence of prediabetes (adjusted odds ratio [aOR] = 1.457, 95% confidence interval [CI]: 1.343 to 1.581, p < 0.001) and T2DM (aOR = 1.804, 95%CI: 1.720 to 1.891, p < 0.001), respectively. The aOR for prediabetes in subjects with the highest quartile of METS-IR was 3.060-fold higher than that in those with the lowest quartile of METS-IR. The aOR for T2DM in subjects with the highest quartile of METS-IR was 6.226-fold higher than that in those with the lowest quartile of METS-IR. Consistent results were obtained in subgroup analyses. Our results suggested that METS-IR was significantly associated with both prediabetes and T2DM. The monitoring of METS-IR may add value to early identification of individuals at risk for glucose metabolism disorders in primary care.
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Affiliation(s)
- Hui Cheng
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Xiao Yu
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yu-Ting Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Zhihui Jia
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Jia-Ji Wang
- Centre for General Practice, The Seventh Affiliated Hospital, Southern Medical University, Foshan 528244, China
- School of Public Health, Guangzhou Medical University, Guangzhou 510182, China
| | - Yao-Jie Xie
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon 852, Hong Kong, China
| | - Jose Hernandez
- Medicine and Health, EDU Institute of Higher Education, 1320 Kalkara, Malta
- Green Templeton College, University of Oxford, Oxford OX2 6HG, UK
| | - Harry H. X. Wang
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Hua-Feng Wu
- Shishan Community Health Centre of Nanhai, Foshan 528234, China
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20
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Liu Y, Zhang Z, Han D, Zhao Y, Yan X, Cui S. Association between environmental chemicals co-exposure and peripheral blood immune-inflammatory indicators. Front Public Health 2022; 10:980987. [PMID: 36483254 PMCID: PMC9725172 DOI: 10.3389/fpubh.2022.980987] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/07/2022] [Indexed: 11/23/2022] Open
Abstract
Chronic inflammation is closely related to chronic inflammatory diseases, autoimmune diseases and cancer. Few studies have evaluated the effects of exposure to multiple chemical combinations on immunoinflammatory related indicators and their possible molecular mechanisms. This study explored the effect of exposure to various chemicals on immune-inflammatory biomarkers and its molecular mechanism. Using data from 1,723 participants in the National Health and Nutrition Examination Survey (NHANES, 2011-2012), the aim was to determine the association between chemical mixtures and immunoinflammatory biomarkers [including White blood cell (Wbc), neutrophil (Neu), lymphocytes (Lym), and Neutrophil-to-lymphocyte ratio (NLR)] using linear regression model, weighted quantile sum regression (WQSR) model, and bayesian nuclear machine regression (BKMR) model. Meanwhile, functional enrichment analysis and protein-protein interaction network establishment were performed to explore the molecular mechanism of inflammation induced by high-weight chemicals. In the linear regression model established for each single chemical, the four immunoinflammatory biomarkers were positively correlated with polycyclic aromatic hydrocarbons (PAHs), negatively correlated with perfluoroalkyl substances (PFASs), and positively or negatively correlated with metallic and non-metallic elements. WQSR model showed that cadmium (Cd), perfluorooctane sulfonic acid (PFOS) and perfluorodecanoic acid (PFDE) had the highest weights. In BKMR analysis, the overall effect of chemical mixtures was significantly associated with Lym and showed an increasing trend. The hub genes in high-weight chemicals inflammation-related genes were interleukin-6 (IL6), tumor necrosis factor (TNF), and interleukin-1B (IL1B), etc. They were mainly enriched in inflammatory response, Cytokine-cytokine receptor interaction, Th17 cell differentiation and IL-17 signaling pathway. The above results show that exposure to environmental chemical cocktails primarily promotes an increase in Lym across the immune-inflammatory spectrum. The mechanism leading to the inflammatory response may be related to the activation of IL-6 amplifier by the co-exposure of environmental chemicals.
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Affiliation(s)
- Yong Liu
- Department of Dermatology, Shaanxi Provincial Hospital of Traditional Chinese Medicine, Xi'an, China,School of Life Science, Beijing University of Chinese Medicine, Beijing, China
| | - Zhihui Zhang
- Department of Plastic Surgery, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang Medical University, Ürümqi, China
| | - Dongran Han
- School of Life Science, Beijing University of Chinese Medicine, Beijing, China
| | - Yiding Zhao
- Department of Dermatology, Shaanxi Provincial Hospital of Traditional Chinese Medicine, Xi'an, China
| | - Xiaoning Yan
- Department of Dermatology, Shaanxi Provincial Hospital of Traditional Chinese Medicine, Xi'an, China,Xiaoning Yan
| | - Shengnan Cui
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Graduate School, China Academy of Chinese Medical Sciences, Beijing, China,*Correspondence: Shengnan Cui
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21
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Zhou L, Hu W, Liu S, Qiao Y, He D, Xiong S, Peng L, Cao L, Wu Y, Sun N, Han Q, Chu J, Chen X, Li T, Feng Z, He Q, Ke C, Shen Y. Cohort profile: the Liyang cohort study on chronic diseases and risk factors monitoring in China (Liyang Study). BMJ Open 2022; 12:e060978. [PMID: 35851009 PMCID: PMC9297217 DOI: 10.1136/bmjopen-2022-060978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE The Liyang cohort study on chronic diseases and risk factors monitoring in China (Liyang Study) is a prospective population-based study which aims to investigate and identify the determinants of the most prevalent chronic non-communicable diseases (NCDs) and to evaluate the impact of demographic characteristics, lifestyle, dietary habits, cognition, disability and NCDs on the health-related quality of life. PARTICIPANTS Between March 2019 and June 2020, 10 056 individuals aged ≥18 years were administered a baseline survey through a multistage cluster random sampling in Liyang City, southern Jiangsu Province, China. FINDINGS TO DATE The Liyang Study included detailed sociodemographic, anthropometric and health-related behaviour, common NCDs and blood sample information. Moreover, the study gathered a series of data on specific scales including the activities of daily living, instrumental activities of daily living, abbreviated mental test, Food Frequency Questionnaire and EuroQol 5-Dimensions 5-Levels Scale. Of the 10 056 participants, 52.92% (n=5322) were female and 92.26% (n=9278) came from rural areas. The mean age was 49.9±16.2 years. Men were more likely to have a higher level of education, annual income and a paid job than women (p<0.05). The top three overall most prevalent NCDs in the study were hypertension (18.06%, n=1815), digestive diseases (7.88%, n=791), and arthritis or rheumatism (5.28%, n=530). Women had a significantly higher prevalence of diabetes (5.46%, n=290 vs 4.42%, n=209, p=0.016) and arthritis (6.04%, n=321 vs 4.42%, n=209, p<0.001) than men, while the opposite was true for chronic lung diseases such as chronic obstructive pulmonary disease (1.37%, n=65 vs 0.92%, n=49, p=0.032) and chronic hepatic diseases (0.80%, n=38 vs 0.47%, n=25, p=0.035). FUTURE PLANS The current study will give valuable insights into the association between sociodemographic factors, health-related behaviour, diet, cognition, disability and genetic factors and the most prevalent NCDs among local community residents. Starting from 2022, a follow-up survey will be conducted every 3 years to further explore the causal relationship between the above factors and NCDs.
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Affiliation(s)
- Liang Zhou
- Liyang Center for Disease Control and Prevention, Liyang Health Bureau, Liyang, China
| | - Wei Hu
- Department of Epidemiology and Biostatistics, Soochow University Medical College, Suzhou, China
| | - Siyuan Liu
- Department of Epidemiology and Biostatistics, Soochow University Medical College, Suzhou, China
| | - Yanan Qiao
- Department of Epidemiology and Biostatistics, Soochow University Medical College, Suzhou, China
| | - Dingliu He
- Department of Epidemiology and Biostatistics, Soochow University Medical College, Suzhou, China
| | - Shuting Xiong
- Department of Epidemiology and Biostatistics, Soochow University Medical College, Suzhou, China
| | - Liuming Peng
- Liyang Center for Disease Control and Prevention, Liyang Health Bureau, Liyang, China
| | - Lei Cao
- Liyang Center for Disease Control and Prevention, Liyang Health Bureau, Liyang, China
| | - Ying Wu
- Liyang Center for Disease Control and Prevention, Liyang Health Bureau, Liyang, China
| | - Na Sun
- Department of Epidemiology and Biostatistics, Soochow University Medical College, Suzhou, China
| | - Qiang Han
- Department of Epidemiology and Biostatistics, Soochow University Medical College, Suzhou, China
| | - Jiadong Chu
- Department of Epidemiology and Biostatistics, Soochow University Medical College, Suzhou, China
| | - Xuanli Chen
- Department of Epidemiology and Biostatistics, Soochow University Medical College, Suzhou, China
| | - Tongxing Li
- Department of Epidemiology and Biostatistics, Soochow University Medical College, Suzhou, China
| | - Zhaolong Feng
- Department of Epidemiology and Biostatistics, Soochow University Medical College, Suzhou, China
| | - Qida He
- Department of Epidemiology and Biostatistics, Soochow University Medical College, Suzhou, China
| | - Chaofu Ke
- Department of Epidemiology and Biostatistics, Soochow University Medical College, Suzhou, China
| | - Yueping Shen
- Department of Epidemiology and Biostatistics, Soochow University Medical College, Suzhou, China
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22
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Blaschke K, Hellmich M, Samel C, Listl S, Schubert I. Association between Periodontal Treatment and Healthcare Costs in Patients with Coronary Heart Disease: A Cohort Study Based on German Claims Data. Dent J (Basel) 2022; 10:dj10070133. [PMID: 35877407 PMCID: PMC9320253 DOI: 10.3390/dj10070133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/09/2022] [Accepted: 07/11/2022] [Indexed: 02/01/2023] Open
Abstract
There is empirical evidence of an association between periodontitis and coronary heart disease (CHD). However, it is uncertain whether periodontal treatment in CHD patients might lead to reduced healthcare costs. This study aims to assess the association between periodontal treatment and healthcare costs in newly diagnosed CHD patients. Data from 21,263 adults who were continuously insured between 2011 and 2016 and who were newly diagnosed with CHD in 2013 were selected from a German claims database. The study population was differentiated by the utilization of periodontal treatment. The average treatment effect (ATE) of periodontal treatment on healthcare costs (total, inpatient, outpatient, drugs) was investigated using weighted Poisson regression models conditional on covariates and is shown as a ratio (of geometric means). Periodontal treatment was documented for 4.7% of the persons in the study population. Newly diagnosed CHD patients showed an ATE of 0.98 for total healthcare cost (95% CI 0.90–1.06), 0.79 for inpatient costs (95% CI 0.61–1.04), and 0.95 for drug costs (95% CI 0.87–1.04). A statistically significant 7% increase in outpatient costs was shown (95% CI 1.01–1.13). Despite a lack of statistical significance in most cases, the study provides evidence of a meaningful decrease in inpatient costs after periodontal treatment. Further studies are needed.
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Affiliation(s)
- Katja Blaschke
- PMV Research Group, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany;
- Correspondence:
| | - Martin Hellmich
- Institute of Medical Statistics and Computational Biology (IMSB), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany; (M.H.); (C.S.)
| | - Christina Samel
- Institute of Medical Statistics and Computational Biology (IMSB), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany; (M.H.); (C.S.)
| | - Stefan Listl
- Department of Dentistry—Quality and Safety of Oral Healthcare, Radboud University—Radboudumc (RIHS), 6525 EX Nijmegen, The Netherlands;
| | - Ingrid Schubert
- PMV Research Group, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany;
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23
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Understanding Household Catastrophic Health Expenditures and Fairness of Financing for Cancer Treatment: A Cross-Sectional Case Study in West of Iran. HEALTH SCOPE 2022. [DOI: 10.5812/jhealthscope-119827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background: Direct out-of-pocket (OOP) and indirect healthcare payments can limit the household budget and cause several financial problems for the household. Objectives: This study aimed to measure the financial protection and determinants of catastrophic health expenditures (CHEs) for cancer treatment in Shahid Rahimi Hospital, Khorramabad, located in western Iran. Methods: This study was conducted on 220 households of cancer patients in Lorestan Province, Iran. The framework of data collection was based on the World Health Organization (WHO) Global Health Survey. Interviews were conducted with individuals who met the inclusion criteria of this study; they were selected using a simple random sampling method. Data were analyzed using Chi-square test in STATA. Results: The present results showed that the incidence of CHEs and the fair financial contribution index (FFCI) were 70% and 86%, respectively. There was a significant relationship between the household CHEs and variables, such as supplementary insurance coverage, household income status, educational level of the household head, household size, age of the household head, type of cancer, and type of cancer treatment. Conclusions: More financial protection should be provided for the families of cancer patients due to the high incidence of CHEs and unfair financing of cancer care services. Moreover, healthcare systems should consider supportive policies for cancer patients and their household members by increasing the insurance coverage and expanding service packages to reduce cancer treatment expenditures.
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24
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Vandenberghe D. Simulating lifestyle and medical interventions to prevent type-2 diabetes: an economic evaluation for Belgium. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2022; 23:237-248. [PMID: 34390431 DOI: 10.1007/s10198-021-01362-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 07/29/2021] [Indexed: 06/13/2023]
Abstract
By 2040, over half a billion people globally are expected to have diabetes. This disease implies a loss in life quality and comes with a significant financial impact. To avoid prevalence increases in the main category of diabetes-type-2 diabetes (T-2D)-, preventive action among high-risk groups is necessary. Lifestyle and medical interventions with metformin among prediabetic individuals show strong potential to decrease or delay T-2D. The aim of this paper is to evaluate the cost-effectiveness and budget impact of a nation-wide implementation of these interventions, between 2020 and 2040, in Belgium. This is done through a dynamic, non-homogeneous, semi-Markov model which simulates prevalence and costs of a type of prediabetes (impaired glucose tolerance or IGT) and T-2D in Belgium. High-risk individuals are first screened; individuals with IGT then enroll in a lifestyle or metformin program. Compared to no intervention, both programs are very cost effective from the perspective of the health care system and cost-saving from a broader societal perspective. Both interventions require an initial, affordable government investment and later yield government savings. The lifestyle program is a cost-effective alternative to the metformin intervention and may yield additional benefits through, for example, improvements in mental health.
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Affiliation(s)
- Désirée Vandenberghe
- Department of Economics, Faculty of Economics and Business Administration, Ghent University, Tweekerkenstraat 2, 9000, Ghent, Belgium.
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25
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Hospitalization Expenses and Influencing Factors for Inpatients with Ischemic Heart Disease in Iran: A Retrospective Study. HEALTH SCOPE 2022. [DOI: 10.5812/jhealthscope.117711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Ischemic heart disease (IHD) is the leading cause of death and disability worldwide and in Iran, which imposes a heavy financial burden both on patient’s family and society. Objectives: This study aimed to analyze the direct medical costs of inpatients with IHD and its influencing factors in Iran in 2020. Methods: The sample of this cross-sectional study included 41,357 patients with IHD selected from the hospital information system (HIS) of the Iran Health Insurance Organization from August 23, 2019, to June 20, 2020. The study used the claims data of these patients, which included their demographics, length of stay (LOS), intensive care unit (ICU) admission, hospital accreditation grade, hospital ownership type, and patient discharge status. The multiple linear regression model was employed to evaluate the relationship between hospitalization costs and the associated factors. All statistical tests were conducted at the significance level of P < 0.05 using the R 3.6.3 software. Results: The mean age of patients was 63.95 ± 12.63 years old, and most of them were male (54.4%). The mean hospitalization cost per patient and per day was 586.42 ± 472.51 USD and 103.64 ± 100.29 USD, respectively. Moreover, the mean LOS was 4.92 days. Drugs and consumable medical supplies, as well as nursing and hoteling services, had the highest shares of hospitalization costs (29.54% and 29.4%, respectively). The hospitalization costs of patients with IHD were higher among men (β = 1.24), age 61 - 70 years (β = 1.38), LOS ≥ 5 (β = 2.92), ICU admission (β = 1.62), Iranian health fund (β = 1.21), and private hospitals (β = 1.91). Top-grade and first-grade hospitals had higher costs compared to grade 2 (β = 0.67), grade 3 (β = 0.35), and grade 4 (β = 0.72) hospitals. Deceased patients had also higher costs than patients with complete recovery (β = 0.63), relative recovery (β = 0.59), follow-up (β = 0.51), transfer to other medical centers (β = 0.44), and discharge against medical advice (DAMA) (β = 0.62). Conclusions: According to the results, shortening the LOS and controlling the high costs of drugs and consumable medical supplies are among the main strategies to reduce high hospitalization costs.
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26
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The Problems Experienced by Employees with Chronic Disease during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19010578. [PMID: 35010836 PMCID: PMC8744943 DOI: 10.3390/ijerph19010578] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/31/2021] [Accepted: 01/01/2022] [Indexed: 11/16/2022]
Abstract
Chronic diseases served as a silent global epidemic before the pandemic, and individuals living with chronic disease now form one of the groups most affected by COVID-19. This study aims to determine the problems that employees with chronic disease face during the COVID-19 pandemic. As part of the study, data were collected from 952 individuals who live with chronic disease in Turkey. Of these, 76.6% of respondents worked for the public sector, a large majority of whom (67.7%) have worked full time during the COVID-19 pandemic. It was found that the COVID-19 fear level of employees living with chronic disease was higher than moderate (21.061 ± 7.607). When the variables affecting the COVID-19 fear level are listed in order of relative significance, eating problems, residing in the Mediterranean region, having asthma, and working as a female employee made the greatest impact, respectively. Necessary conditions of work should be provided to those living with chronic disease who could adapt themselves to working flexibly or working from home, so that they would not feel isolated from business life. This group should be provided with essential protective equipment, their working conditions must be reviewed and vaccination priority could be given to them.
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27
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Why Do We Harm the Environment or Our Personal Health despite Better Knowledge? The Knowledge Action Gap in Healthy and Climate-Friendly Behavior. SUSTAINABILITY 2021. [DOI: 10.3390/su132313361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Non-communicable diseases, such as hypertension, diabetes, or depression, result from an interplay of physiological, genetic, behavioral, and environmental aspects. Together with climate change, they are arguably among the most significant challenges mankind faces in the 21st century. Additionally, the bidirectional influences of climate change and health on each other are undisputed. Behavioral changes could curb both climate change and the spread of non-communicable diseases. Much effort has been put into information campaigns in both fields, but success has been limited. In the following, the knowledge action gap is compared and analyzed in healthy and climate-friendly behavior from a practical point of view and the supporting theoretical models are highlighted. The analysis shows that self-efficacy plays an essential role in both areas of research for effecting behavioral changes. The models of ‘Planned Behavior’ and ‘Stages of Change’ seems helpful and can be applied and adapted to explain behavioral changes in health and climate changes settings. We compared two previously unrelated research fields to uncover new avenues for further study and stimulate fruitful transdisciplinary discussion. Future directions on how behavioral medicine and climate change research can learn from each other are discussed.
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28
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Orhan R, Paric M, Czabanowska K. Lessons Learnt from the EU Response to NCDs: A Content Analysis on Building Resilient Post-COVID Health Systems. Healthcare (Basel) 2021; 9:1659. [PMID: 34946385 PMCID: PMC8701320 DOI: 10.3390/healthcare9121659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/17/2021] [Accepted: 11/27/2021] [Indexed: 11/21/2022] Open
Abstract
Non-communicable diseases (NCDs) impose a heavy burden on the healthcare system of countries in the European Union (EU). An estimated 91.3% of all deaths and 86.6% of DALYs in the EU-28 were attributable to NCDs. It is imperative that the EU act on mitigating this challenging health issue and help create trajectories for building resilient health systems. Using qualitative analysis, this study examines the question of how the European Commission 2019-2024 is planning to mitigate the impact of NCDs on health systems, while taking into account the COVID-19 pandemic. A content analysis of 44 documents communicating the European Commission's position on the issue was done. In vivo coding was performed using the software package ATLAS.ti 9. Unique codes were simplified and grouped into main themes. Five main themes were identified: 'health plan', 'COVID-19', 'future direction', 'collaboration and solidarity', and 'persuasion'. This study shows that the European Commission is emphasising the impact of the pandemic and the relevance of policies tackling NCDs. By calling for more cross- and multi-sectoral collaboration, the Commission hopes to create the right climate for a European framework for cooperation, which can help develop EU-wide resilient health systems.
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Affiliation(s)
- Rana Orhan
- Department of International Health, Care and Public Health Research Institute CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6229 GT Maastricht, The Netherlands; (M.P.); (K.C.)
- The Association of Schools of Public Health in the European Region, 1150 Brussels, Belgium
| | - Martina Paric
- Department of International Health, Care and Public Health Research Institute CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6229 GT Maastricht, The Netherlands; (M.P.); (K.C.)
| | - Katarzyna Czabanowska
- Department of International Health, Care and Public Health Research Institute CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6229 GT Maastricht, The Netherlands; (M.P.); (K.C.)
- Department of Health Policy Management, Institute of Public Health, Faculty of Health Sciences, Jagiellionian University, 31-066 Krakow, Poland
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29
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Martin-Delgado J, Guilabert M, Mira-Solves J. Patient-Reported Experience and Outcome Measures in People Living with Diabetes: A Scoping Review of Instruments. THE PATIENT 2021; 14:759-773. [PMID: 34043215 PMCID: PMC8563512 DOI: 10.1007/s40271-021-00526-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/16/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Diabetes mellitus is a global public health concern, with over 463 million people living with this chronic disease. Pathology complexity, management difficulty, and limited participation in care has resulted in healthcare systems seeking new strategies to engage people living with diabetes. Patient-reported experience measures (PREMs) and patient-reported outcome measures (PROMs) were developed to address the gap between the healthcare system expectation and patient preference. OBJECTIVE This study aimed to review the existing literature on PREMs and PROMs specific to type 1 and 2 diabetes, and report the dimensions report the dimensions they have measured. METHODS A scoping review was conducted from January 1985 to March 2020 of six databases, MEDLINE, EMBASE, PsycINFO, CINHAL, Scopus, and BiblioPro, to identify PREM and PROM instruments specific for type 1 and 2 diabetes. RESULTS Overall, 34 instruments were identified, 32 PROMs and two PREMs. The most common instrument included outcomes related to quality of life at 44% (n = 15), followed by satisfaction (whether with treatment, device, and healthy habits) at 26% (n = 9). Furthermore, instruments regarding personal well-being accounted for 15% (n = 5). For instruments that measure experiences of persons with diabetes, there were two scales of symptoms, and one related to the attitude patients have toward the disease. CONCLUSIONS Diabetes-specific validated instruments mainly focus on quality of life, education, and treatment, and sometimes overlap each other, in their subscales and assessment dimensions. Constructs such as cultural and religious beliefs, leisure, and work life may need more attention. There appears to be a gap in instruments to measure experiences of individuals who "live with diabetes" and seek to lead a "normal life."
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Affiliation(s)
- Jimmy Martin-Delgado
- Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research, Health District Alicante-Sant Joan, Carretera Nacional 332, Av. de Benidorm, Sant Joan d´Alacant, 03550, Alicante, Spain.
- Health Services and Policy Research Group, University of Exeter Medical School, Exeter, UK.
- Department of Public Health, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador.
| | - Mercedes Guilabert
- Department of Health Psychology, Miguel Hernández University, Elche, Spain
| | - José Mira-Solves
- Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research, Health District Alicante-Sant Joan, Carretera Nacional 332, Av. de Benidorm, Sant Joan d´Alacant, 03550, Alicante, Spain
- Department of Health Psychology, Miguel Hernández University, Elche, Spain
- Research Network on Health Services in Chronic Diseases (REDISSEC), Alicante, Spain
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30
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Cuschieri S, Grech S. Insight into the Occurrence of Common Non-communicable Diseases at a Population Level and the Potential Impact During the Coronavirus Pandemic - a Need for a Syndemic Healthcare Approach? SN COMPREHENSIVE CLINICAL MEDICINE 2021; 3:2393-2400. [PMID: 34568765 PMCID: PMC8455231 DOI: 10.1007/s42399-021-01064-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/13/2021] [Indexed: 12/27/2022]
Abstract
People suffering from non-communicable diseases (NCDs) are at an increased risk for severe Covid-19. The aim was to determine the burden of common NCDs at a population level, assess Covid-19 impact while exploring whether a syndemic approach is merited to deal with NCDs and Covid-19. Baseline data from a Malta national representative survey. Individuals with type 2 diabetes (T2DM), hypertension, cardiovascular disease, dyslipidaemia and overweight-obese status were considered. Prevalence for single disease and multimorbidity were used to estimate population burden. Covid-19 impact at a population level was estimated through local Covid-19 infectivity rates. Years of life lost (YLL) and mortality rate were calculated using Covid-19 data and compared to corresponding NCDs data reported by global burden of disease (GBD) study. Half the study population (n = 3947) had a single NCD while a third had multimorbidity. Of these, 6.55% were estimated to be at risk of Covid-19 and require admission. Covid-19 YLL over 12 months was 5228.54 years, which is higher than the estimated YLL for hypertension and T2DM by GBD study for Malta. Health systems and policies should be re-focused to accommodate both Covid-19 and NCDs simultaneously through a targeted syndemic approach with primary healthcare playing a central role. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s42399-021-01064-2.
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Affiliation(s)
- Sarah Cuschieri
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
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Choi M, Raeside R, Hyun K, Partridge SR, Thiagalingam A, Redfern J. Understanding Preferences for Lifestyle-Focused Visual Text Messages in Patients With Cardiovascular and Chronic Respiratory Disease: Discrete Choice Experiment. J Med Internet Res 2021; 23:e26224. [PMID: 34542413 PMCID: PMC8491117 DOI: 10.2196/26224] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/15/2021] [Accepted: 07/21/2021] [Indexed: 12/04/2022] Open
Abstract
Background Supporting healthy lifestyle changes is a key aim of cardiovascular and pulmonary rehabilitation programs. SMS text messaging programs have demonstrated effectiveness in cardiovascular disease risk reduction, weight loss, increasing physical activity, and smoking cessation. The optimization of SMS text messaging programs may deliver greater population benefits as mobile phone use becomes ubiquitous. Visual messaging (ie, image-based messages) has the potential to communicate health messages via digital technology and result in enhanced engagement. Objective This study aims to determine and understand patient preferences for lifestyle-focused visual text messages that support cardiovascular and pulmonary rehabilitation. Methods A discrete choice experiment was conducted in a 4-stage iterative process to elicit patient preferences for visual message features. Attribute and level development yielded 3 attributes (purpose, image type, and web address), and 16 choice sets were subsequently constructed according to a full factorial design. Patients participating in cardiovascular and pulmonary rehabilitation were surveyed (on the web) for their preferences regarding the visual message choice sets. Respondents were asked to choose among 16 pairs of visual messages regarding key lifestyle behaviors, namely, physical activity and nutrition. The data were analyzed using a conditional logit model. Results There was a total of 1728 observations from 54 unique respondents. Two factors that were associated with patient preference were gain-framed purpose compared with no purpose (odds ratio [OR] 1.93, 95% CI 1.40-2.65) and real images compared with cartoon images (OR 1.26, 95% CI 1.04-1.54). A loss-framed purpose was less preferred than no purpose (OR 0.55, 95% CI 0.42-0.74). Overall, patients preferred positive images that were colorful and engaged with text that supported the image and had a preference for images of real people rather than cartoons. Conclusions A discrete choice experiment is a scientific method for eliciting patient preferences for a visual messaging intervention that is designed to support changes in lifestyle behaviors. SMS text messaging programs that use visual aids may result in greater patient satisfaction by using a gain frame, using real images, and avoiding a loss frame. Further research is needed to explore the feasibility of implementation and the health and behavioral outcomes associated with such visual messaging programs.
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Affiliation(s)
- Michael Choi
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Rebecca Raeside
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Consumer Engagement and Codesign Research Hub, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Karice Hyun
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Consumer Engagement and Codesign Research Hub, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Department of Cardiology, Concord Repatriation General Hospital, Sydney, Australia
| | - Stephanie R Partridge
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Consumer Engagement and Codesign Research Hub, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Prevention Research Collaboration, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Aravinda Thiagalingam
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Department of Cardiology, Westmead Hospital, Sydney, Australia.,George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Julie Redfern
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Consumer Engagement and Codesign Research Hub, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,George Institute for Global Health, University of New South Wales, Sydney, Australia.,Research Education Network, Western Sydney Local Health District, Sydney, Australia
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Assessing the Physiological Effects of Traditional Regional Diets Targeting the Prevention of Cardiovascular Disease: A Systematic Review of Randomized Controlled Trials Implementing Mediterranean, New Nordic, Japanese, Atlantic, Persian and Mexican Dietary Interventions. Nutrients 2021; 13:nu13093034. [PMID: 34578911 PMCID: PMC8466163 DOI: 10.3390/nu13093034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 08/23/2021] [Accepted: 08/27/2021] [Indexed: 12/20/2022] Open
Abstract
Traditional regional diets are considered as sustainable dietary patterns, while many have been examined with regard to their health benefits. The aim of the present systematic review was to aggerate all evidence on the physiological effects of regional diets among adults at high risk for cardiovascular disease (CVD). Three databases were searched for randomized controlled trials (RCTs) implementing any regional diet (Mediterranean (MedD), Persian, Southern European Atlantic, Japanese, Chinese, new Nordic, or other) while examining cardiovascular risk factors among adults at increased risk. Primary outcomes included anthropometric indices and secondary outcomes involved blood lipid concentrations, glucose metabolism, inflammation and other markers of CVD progression. Twenty RCTs fulfilled the study’s criteria and were included in the qualitative synthesis, with the majority implementing a MedD. Adherence to most of the regional diets induced a reduction in the BW and anthropometric indices of the participants. The majority of RCTs with blood pressure endpoints failed to note a significant reduction in the intervention compared to the comparator arm, with the exception of some new Nordic and MedD ones. Despite the interventions, inflammation markers remained unchanged except for CRP, which was reduced in the intervention groups of one new Nordic, the older Japanese, and the Atlantic diet RCTs. With regard to blood lipids, regional diet interventions either failed to induce significant differences or improved selective blood lipid markers of the participants adhering to the experimental regional diet arms. Finally, in the majority of RCTs glucose metabolism failed to improve. The body of evidence examining the effect of regional dietary patterns on CVD risk among high-risk populations, while employing an RCT design, appears to be limited, with the exception of the MedD. More research is required to advocate for the efficacy of most regional diets with regard to CVD.
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Moz-Christofoletti MA, Wollgast J. Sugars, Salt, Saturated Fat and Fibre Purchased through Packaged Food and Soft Drinks in Europe 2015-2018: Are We Making Progress? Nutrients 2021; 13:nu13072416. [PMID: 34371927 PMCID: PMC8308506 DOI: 10.3390/nu13072416] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 11/16/2022] Open
Abstract
The availability, purchase and consumption of foods high in fat, sugars and salt and low in fibre are linked to the high health and economic burden of noncommunicable diseases, including cancer, in Europe. Therefore, assessing the quality of the food offer is key as feedback to decision makers, as well as to identify good practices and areas of the food supply still requiring urgent action. We combined detailed market share and sales data with nutrition composition data to evaluate the nutritional quality of 14 packaged food and soft drinks categories sold across 22 European countries over the 2015–2018 period. Our analysis shows great variability of the nutritional composition within and among packaged food and soft drinks categories across European countries. Our estimates of the market-share weighted mean, a measure that integrates possible changes in nutrient content with the amount of a product sold to consumers, as well as daily per capita nutrient sale estimates, suggest a small but statistically significant progress in certain food categories only. Overall, the amounts of sugars, saturated fat, salt and fibre being sold to European citizens through these products is not improving to an extent to meet public health objectives.
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Kazibwe J, Tran PB, Annerstedt KS. The household financial burden of non-communicable diseases in low- and middle-income countries: a systematic review. Health Res Policy Syst 2021; 19:96. [PMID: 34154609 PMCID: PMC8215836 DOI: 10.1186/s12961-021-00732-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 04/30/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The chronic nature of noncommunicable diseases (NCD) and costs associated with long-term care can result in catastrophic health expenditure for the patient and their household pushing them deeper into poverty and entrenching inequality in society. As the full financial burden of NCDs is not known, the objective of this study was to explore existing evidence on the financial burden of NCDs in low- and middle-income countries (LMICs), specifically estimating the cost incurred by patients with NCDs and their households to inform the development of strategies to protect such households from catastrophic expenditure. METHODS This systematic review followed the PRISMA guidelines, PROSPERO: CRD42019141088. Eligible studies published between 1st January 2000 to 7th May 2020 were systematically searched for in three databases: Medline, Embase and Web of Science. A two-step process, comprising of qualitative synthesis proceeded by quantitative (cost) synthesis, was followed. The mean costs are presented in 2018 USD. FINDINGS 51 articles were included, out of which 41 were selected for the quantitative cost synthesis. Most of the studies were cross-sectional cost-of-illness studies, of which almost half focused on diabetes and/or conducted in South-East Asia. The average total costs per year to a patient/household in LMICs of COPD, CVD, cancers and diabetes were $7386.71, $6055.99, $3303.81, $1017.05, respectively. CONCLUSION This review highlighted major data and methodological gaps when collecting data on costs of NCDs to households along the cascade of care in LMICs. More empirical data on cost of specific NCDs are needed to identify the diseases and contexts where social protection interventions are needed most. More rigorous and standardised methods of data collection and costing for NCDs should be developed to enable comprehensive and comparable evidence of the economic and financial burden of NCDs to patients and households in LMICs. The available evidence on costs reveals a large financial burden imposed on patients and households in seeking and receiving NCD care and emphasizes the need for adequate and reliable social protection interventions to be implemented alongside Universal Health Coverage.
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Affiliation(s)
- Joseph Kazibwe
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
- The Health and Social Protection Action Research and Knowledge Sharing Network (SPARKS), Solna, Sweden
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
| | - Phuong Bich Tran
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
- The Health and Social Protection Action Research and Knowledge Sharing Network (SPARKS), Solna, Sweden
- Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Kristi Sidney Annerstedt
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden.
- The Health and Social Protection Action Research and Knowledge Sharing Network (SPARKS), Solna, Sweden.
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Gomes L, Liébana-Presa C, Araújo B, Marques F, Fernández-Martínez E. Heart Disease, Now What? Improving Quality of Life through Education. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063077. [PMID: 33802701 PMCID: PMC8002524 DOI: 10.3390/ijerph18063077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/11/2021] [Accepted: 03/15/2021] [Indexed: 11/24/2022]
Abstract
Introduction: The management of chronic illness assumes a level of demand for permanent care and reaches a priority dimension in the health context. Given the importance of nursing care to post-acute coronary syndrome patients, the objective of this study is to evaluate the impact of an educational intervention program on quality of life in patients after acute coronary syndrome. Method: Quasi-experimental study with two groups: an experimental group exposed to the educational intervention program and the control group without exposure to the educational intervention program. Results: The results showed statistically significant differences between both groups (p < 0.001). Although only valid for the specific group of subjects studied, the educational intervention program enabled significant gains in quality of life. Conclusions: According to the findings of the study, a systematized and structured educational program, integrated into the care organization and based on transition processes, is effective in developing self-care skills and improves the quality of life in patients after acute coronary syndrome.
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Affiliation(s)
- Lisa Gomes
- Nursing School, Minho University, 4710-057 Braga, Portugal;
| | - Cristina Liébana-Presa
- SALBIS Research Group, Faculty of Health Sciences, Campus of Ponferrada, Universidad de León, 24401 Ponferrada, Spain
- Correspondence:
| | - Beatriz Araújo
- Institute of Health Sciences, Universidade Católica Portuguesa, 4169-005 Porto, Portugal;
| | - Fátima Marques
- Intensive Care Coronary Unit, Centro Hospitalar De Trás-Os-Montes E Alto Douro, E.P.E., 5000-508 Vila Real, Portugal;
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Ilan Y. Improving Global Healthcare and Reducing Costs Using Second-Generation Artificial Intelligence-Based Digital Pills: A Market Disruptor. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:811. [PMID: 33477865 PMCID: PMC7832873 DOI: 10.3390/ijerph18020811] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/16/2021] [Accepted: 01/17/2021] [Indexed: 12/12/2022]
Abstract
Background and Aims: Improving global health requires making current and future drugs more effective and affordable. While healthcare systems around the world are faced with increasing costs, branded and generic drug companies are facing the challenge of creating market differentiators. Two of the problems associated with the partial or complete loss of response to chronic medications are a lack of adherence and compensatory responses to chronic drug administration, which leads to tolerance and loss of effectiveness. Approach and Results: First-generation artificial intelligence (AI) systems do not address these needs and suffer from a low adoption rate by patients and clinicians. Second-generation AI systems are focused on a single subject and on improving patients' clinical outcomes. The digital pill, which combines a personalized second-generation AI system with a branded or generic drug, improves the patient response to drugs by increasing adherence and overcoming the loss of response to chronic medications. By improving the effectiveness of drugs, the digital pill reduces healthcare costs and increases end-user adoption. The digital pill also provides a market differentiator for branded and generic drug companies. Conclusions: Implementing the use of a digital pill is expected to reduce healthcare costs, providing advantages for all the players in the healthcare system including patients, clinicians, healthcare authorities, insurance companies, and drug manufacturers. The described business model for the digital pill is based on distributing the savings across all stakeholders, thereby enabling improved global health.
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Affiliation(s)
- Yaron Ilan
- Department of Medicine, The Hebrew University of Jerusalem-Hadassah Medical Center, Jerusalem 12000, Israel
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Cheraghian B, Hashemi SJ, Hosseini SA, Poustchi H, Rahimi Z, Sarvandian S, Saki Malehi A, Alipour M, Eghtesad S, Fatahiasl J, Bayat A, Raji H, Saki N. Cohort profile: The Hoveyzeh Cohort Study (HCS): A prospective population-based study on non-communicable diseases in an Arab community of Southwest Iran. Med J Islam Repub Iran 2020; 34:141. [PMID: 33437737 PMCID: PMC7787022 DOI: 10.34171/mjiri.34.141] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Indexed: 11/05/2022] Open
Abstract
Background: The Hoveyzeh cohort study (HCS) is a population-based cohort study that conducted in Hoveyzeh County (South-west Iran). HCS focus on common chronic diseases, disorders and risk factors of NCDs in the Arab ethnicity.
Methods: A total number of 10009 participants (35-70 years old) were recruited in this prospective cohort study from May 2016 to August 2018. The HCS data were gathered by trained interviewer through interviewer-administered questionnaires. Also anthropometric measurements, physical examinations, clinical assessments, ophthalmology evaluation, auditory examinations, respiratory and cardiovascular assessments was conducted by means of standard instruments. Biological samples including blood, urine, hair, and nail collected and stored in the biobank.
Results: The overall participation rate was 82.7%. The prevalence of obesity was 27.4% in males and 47% in females. Cigarette smoking prevalence was 20.9% (40.6 % in men and 7.6 % in women). Prevalence of major non communicable diseases such as diabetes, hypertension, metabolic syndrome, cardiac ischemic, myocardial infarction and stroke was 22.2%, 26.4% 31.9 %, 13.6%, 1.85% and 1.6% respectively.
Conclusion: Considering the high prevalence of obesity and smoking in the population of Hoveyzeh and since the important role of these risk factors in development of common non communicable diseases, this issue should be taken into consideration and the necessary interventions in this context must be considered to modify lifestyle. The HCS is the only comprehensive cohort in the region, enabling it to provide valuable evidence about NCDs for a wide geographical area covering millions of people in both Iran and Iraq.
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Affiliation(s)
- Bahman Cheraghian
- Alimentary Tract Research Center, Department of Biostatistics & Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Jalal Hashemi
- Alimentary Tract Research Center, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Ahmad Hosseini
- Nutrition and Metabolic Diseases Research Center, Department of Nutrition, School of Allied Medical Sciences , Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Rahimi
- Department of Biostatistics & Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sara Sarvandian
- Department of Biostatistics & Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Amal Saki Malehi
- Department of Biostatistics & Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Meysam Alipour
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sareh Eghtesad
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Jafar Fatahiasl
- Department of Radiology Technology, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Arash Bayat
- Hearing Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hanieh Raji
- Department of Internal Medicine, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nader Saki
- Department of Otolaryngology, Head and Neck Surgery, Hearing Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Lenasi H, Drenjancevic I, Klonizakis M. Editorial: Exploration of the Physiological Effects of Exercise in Cardiovascular Diseases. Front Physiol 2020; 11:1097. [PMID: 33013467 PMCID: PMC7508210 DOI: 10.3389/fphys.2020.01097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 08/07/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Helena Lenasi
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Ines Drenjancevic
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia.,Scientific Centre of Excellence for Personalized Health Care University Josip Juraj Strossmayer Osijek, Osijek, Croatia
| | - Markos Klonizakis
- Lifestyle Exercise and Nutrition Improvement (LENI) Research Group, Sheffield Hallam University, Sheffield, United Kingdom
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Santos JV, Vandenberghe D, Lobo M, Freitas A. Cost of cardiovascular disease prevention: towards economic evaluations in prevention programs. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:512. [PMID: 32395556 PMCID: PMC7210201 DOI: 10.21037/atm.2020.01.20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Affiliation(s)
- João Vasco Santos
- Public Health Unit, ACES Grande Porto VIII - Espinho/Gaia, ARS Norte, Portugal.,MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Portugal.,CINTESIS - Centre for Health Technology and Services Research, Portugal
| | - Désirée Vandenberghe
- Department of Economics, Faculty of Economics and Business Administration, Ghent University, Belgium
| | - Mariana Lobo
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Portugal.,CINTESIS - Centre for Health Technology and Services Research, Portugal
| | - Alberto Freitas
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Portugal.,CINTESIS - Centre for Health Technology and Services Research, Portugal
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European Union state of health from 1990 to 2017: time trends and its enlargements' effects. Int J Public Health 2020; 65:175-186. [PMID: 32067062 DOI: 10.1007/s00038-020-01335-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 01/21/2020] [Accepted: 01/23/2020] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES We aimed to study health status' time trends in the European Union (EU) during 1990-2017 and its enlargements' impact. METHODS Using estimates from the Global Burden of Disease 2017 study and calculating age-sex-standardized rates, we have described time trends and analysed the differences between EU groups regarding the state of health. Interrupted time-series analyses were also performed in order to assess the enlargement impact in the EU state of health. RESULTS All age-sex-standardized rates (mortality, years of life lost, years lived with disability and disability-adjusted life years) declined (annualized rates of change of - 1.7%, - 1.52%, - 0.06% and - 1.01%, respectively) between 1990 and 2017 (except between 2014 and 2015). For EU-28, life expectancy and healthy life expectancy increased 5.9 and 4.6 years, respectively. With the EU-25 and EU-27 enlargements, all age-sex-standardized rates and life expectancies worsened (with statistical significance). The EU-28 enlargement revealed the same tendency, contrasting with the EU-15 one. CONCLUSIONS Overall, the EU health status is improving, despite changes in its composition over the years. However, the average EU state of health declined with the 2004, 2007 and 2013 EU enlargements.
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Bousquet J, Farrell J, Illario M. Aligning the Good Practice MASK With the Objectives of the European Innovation Partnership on Active and Healthy Ageing. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2020; 12:238-258. [PMID: 32009320 PMCID: PMC6997284 DOI: 10.4168/aair.2020.12.2.238] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 11/08/2019] [Accepted: 11/10/2019] [Indexed: 12/16/2022]
Abstract
The reference sites of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) were renewed in 2019. The DG Santé good practice Mobile Airways Sentinel networK was reviewed to meet the objectives of the EIP on AHA. It included 1) Management of care process, 2) Blueprint of digital transformation, 3) EIP on AHA, innovation to market, 4) Community for monitoring and assessment framework, 5) Political, organizational, technological and financial readiness, 6) Contributing to European co-operation and transferability, 7) Delivering evidence of impact against the triple win approach, 8) Contribution to the European Digital Transformation of Health and Care and 9) scale of demonstration and deployment of innovation.
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Affiliation(s)
- J Bousquet
- CHU Arnaud de Villeneuve, Montpellier, France.,MACVIA-France, Montpellier, France.,INSERM U 1168, VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Villejuif, France.,UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, Montigny le Bretonneux, France.,Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.
| | - J Farrell
- LANUA International Healthcare Consultancy, Belfast, Northern Ireland, UK
| | - M Illario
- Division for Health Innovation, Campania Region.,Federico II University Hospital Naples (R&D and DISMET) Naples, Italy
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