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Pizzo G, Matranga D, Maniscalco L, Buttacavoli F, Campus G, Giuliana G. Caries Severity, Decayed First Permanent Molars and Associated Factors in 6-7 Years Old Schoolchildren Living in Palermo (Southern Italy). J Clin Med 2023; 12:4343. [PMID: 37445380 DOI: 10.3390/jcm12134343] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/12/2023] [Accepted: 06/25/2023] [Indexed: 07/15/2023] Open
Abstract
To date, there are very few epidemiologic studies on caries disease in 6-7 year old children living in Sicily (Southern Italy). The first permanent molar (FPM) is the most commonly affected tooth in this target population, and a one-unit increase in the number of decayed FPMs is predictive of caries in other teeth and in adulthood. The primary aim of this research is to estimate the prevalence of caries in 6-7 year old schoolchildren living in Palermo and, as a secondary aim, to estimate the prevalence of affected FPMs. It was designed as a cluster cross-sectional survey on 995 children from 16 schools, selected based on their geographical location, in one of the eight city districts. Caries data were recorded using the International Caries Detection and Assessment System for each tooth surface. The relation between socio-economic status, behavioural determinants, and clinical information and the number of teeth with initial caries (IC), moderate caries (MC), or extensive caries (SC) was analysed through the ordinal logistic regression. Among the 995 schoolchildren, 662 (66.5%) had at least one lesion and 742 (74.6%) had FPMs. Of the latter, 238 (32.0%) were affected by IC, 86 (11.6%) were affected by MC, and only 3 (0.4%) were affected by SC. During multivariable analysis, there was evidence of an increased risk of MC and SC related to the deprivation of the district in which the children lived and went to school, as well as to the protective role of parental education and employment. The same significant determinants were found for IC and MC FPMs. The study showed the important role of socio-economic determinants, unhealthy behaviours, and social deprivation related to the increased risk of moderate and extensive caries in 6-7 year old schoolchildren. Investigating this target population is very important, as early development of caries in FPMs may have serious consequences in the prognostics of oral health in an adult.
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Affiliation(s)
- Giuseppe Pizzo
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127 Palermo, Italy
| | - Domenica Matranga
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy
| | - Laura Maniscalco
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy
| | - Fortunato Buttacavoli
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127 Palermo, Italy
| | - Guglielmo Campus
- Department of Restorative, Preventive and Paediatric Dentistry, University of Bern, 3012 Bern, Switzerland
- Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, 07100 Sassari, Italy
| | - Giovanna Giuliana
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127 Palermo, Italy
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Maniscalco L, Schouteden M, Boon J, Vandenbroeck S, Mehlum IS, Godderis L, Matranga D. The long-term effect of job mobility on workers' mental health: a propensity score analysis. BMC Public Health 2022; 22:1145. [PMID: 35676646 PMCID: PMC9175471 DOI: 10.1186/s12889-022-13558-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 05/25/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES The main purpose of this longitudinal study was to elucidate the impact of external job mobility, due to a change of employer, on mental health. METHODS A cohort of Belgian employees from the IDEWE occupational medicine registry was followed-up for twenty-seven years, from 1993 to 2019. The use of drugs for neuropsychological diseases was considered as an objective indicator of mental health. The covariates were related to demographic, physical, behavioural characteristics, occupational and work-related risks. Propensity scores were calculated with a Cox regression model with time-varying covariates. The PS matching was used to eliminate the systematic differences in subjects' characteristics and to balance the covariates' distribution at every time point. RESULTS The unmatched sample included 11,246 subjects, with 368 (3.3%) that changed their job during the baseline year and 922 (8.2%) workers that left their employer during the follow-up. More than half of the matched sample were males, were aged less than 38 years old, did not smoke, were physically active, and normal weighted, were not exposed to shift-work, noise, job strain or physical load. A strong association between job mobility and neuropsychological treatment was found in the matched analysis (HR = 2.065, 95%CI = 1.397-3.052, P-value < 0.001) and confirmed in the sensitivity analysis (HR of 2.012, 95%CI = 1.359-2.979, P-value < 0.001). Furthermore, it was found a protective role of physical activity and a harmful role of job strain on neuropsychological treatment. CONCLUSIONS Our study found that workers with external job mobility have a doubled risk of treatment with neuropsychological medication, compared to workers without job mobility.
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Affiliation(s)
- Laura Maniscalco
- Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Via del Vespro, 129 90127, Palermo, Italy.
| | - Martijn Schouteden
- IDEWE, External Service for Prevention and Protection at Work, Interleuvenlaan 58, 3001, Heverlee, Belgium
| | - Jan Boon
- IDEWE, External Service for Prevention and Protection at Work, Interleuvenlaan 58, 3001, Heverlee, Belgium
| | - Sofie Vandenbroeck
- IDEWE, External Service for Prevention and Protection at Work, Interleuvenlaan 58, 3001, Heverlee, Belgium
- Katholieke Universiteit Leuven, Centre for Environment and Health, 3000, Louvain, Belgium
| | - Ingrid Sivesind Mehlum
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health (STAMI), Oslo, Norway
- Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Lode Godderis
- IDEWE, External Service for Prevention and Protection at Work, Interleuvenlaan 58, 3001, Heverlee, Belgium
- Katholieke Universiteit Leuven, Centre for Environment and Health, 3000, Louvain, Belgium
| | - Domenica Matranga
- Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Via del Vespro, 133, 90127, Palermo, Italy
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Matranga D, Maniscalco L. Inequality in Healthcare Utilization in Italy: How Important Are Barriers to Access? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1697. [PMID: 35162720 PMCID: PMC8835011 DOI: 10.3390/ijerph19031697] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 02/01/2023]
Abstract
With the ageing population, equitable access to medical care has proven to be paramount for the effective and efficient management of all diseases. Healthcare access can be hindered by cost barriers for drugs or exams, long waiting lists or difficult access to the place where the needed healthcare service is provided. The aim of this paper is to investigate whether the probability of facing one of these barriers varies among individuals with different socio-economic status and care needs, controlling for geographical variability. METHODS The sample for this study included 9629 interviews with Italian individuals, aged 15 and over, from the second wave (2015) of the European Health Interview Survey, which was conducted in all EU Member States. To model barriers to healthcare, two-level variance components of logistic regression models with a nested structure given by the four Italian macro-areas were considered. RESULTS Of the barriers considered in this study, only two were found to be significantly associated with healthcare utilization. Specifically, they are long waiting lists for specialist service accessibility (adjOR = 1.20, 95% CI (1.07; 1.35)) and very expensive exams for dental visit accessibility (adjOR = 0.84, 95% CI (0.73; 0.96)). Another important result was the evidence of an increasing north-south gradient for all of the considered barriers. CONCLUSION In Italy, healthcare access is generally guaranteed for all of the services, except for specialist and dental visits that face a waiting time and financial barriers. However, barriers to healthcare were differentiated by income and sex. The north-south gradient for healthcare utilization could be explained through the existing differences in organizational characteristics of the several regional healthcare services throughout Italy.
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Affiliation(s)
- Domenica Matranga
- Department of Health Promotion, Mother and Child Care, Internal and Medical Specialties “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy
| | - Laura Maniscalco
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy;
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Matranga D, Restivo V, Maniscalco L, Bono F, Pizzo G, Lanza G, Gaglio V, Mazzucco W, Miceli S. Lifestyle Medicine and Psychological Well-Being toward Health Promotion: A Cross-Sectional Study on Palermo (Southern Italy) Undergraduates. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5444. [PMID: 32731643 PMCID: PMC7432036 DOI: 10.3390/ijerph17155444] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 07/21/2020] [Accepted: 07/23/2020] [Indexed: 11/17/2022]
Abstract
(1) Aim: To assess the attitude toward Lifestyle Medicine and healthy behaviours among students in the healthcare area and to demonstrate its association to psychological well-being; (2) Methods: A cross-sectional study is conducted among 508 undergraduates of the University of Palermo (140 (27.6%) in the healthcare area and 368 (72.4%) in the non-healthcare area), during the academic year 2018-2019. Psychological well-being is measured through two dimensions of eudaimonia and hedonia, using the 10-item Hedonic and Eudaimonic Motives for Activities-Revised (HEMA-R) scale, with answers coded on a 7-point scale. The association between demographic and modifiable behavioural risk factors for chronic diseases is assessed through crude and adjusted Odds ratios with 95% confidence intervals; (3) Results: Orientation to both hedonia and eudaimonia is significantly associated to the Mediterranean diet (ORAdj = 2.28; 95% CI = (1.42-3.70)) and drinking spirits less than once a week (ORAdj = 1.89; 95% CI = (1.10-3.27)) and once a week or more (ORAdj = 6.02; 95% CI = (1.05-34.52)), while these conditions occur together less frequently for current smokers (ORAdj = 0.38; 95% CI = (0.18-0.81)). Students inclined to well-being consider healthcare professionals as models for their patients and all people in general (OR = 1.96, 95% CI = (1.28-3.00)); (4) Conclusions: The positive relation found between a virtuous lifestyle and psychological well-being suggests the construction, development and cultivation of individual skills are a means to succeed in counteracting at risk behaviours for health.
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Affiliation(s)
- Domenica Matranga
- Department of Health Promotion, Mother and Infant Care, Internal and Specialized Medicine “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (D.M.); (V.R.); (G.L.); (V.G.); (W.M.)
| | - Vincenzo Restivo
- Department of Health Promotion, Mother and Infant Care, Internal and Specialized Medicine “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (D.M.); (V.R.); (G.L.); (V.G.); (W.M.)
| | - Laura Maniscalco
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy
| | - Filippa Bono
- Department of Economics, Business and Statistics, University of Palermo, 90128 Palermo, Italy;
| | - Giuseppe Pizzo
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127 Palermo, Italy;
| | - Giuseppe Lanza
- Department of Health Promotion, Mother and Infant Care, Internal and Specialized Medicine “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (D.M.); (V.R.); (G.L.); (V.G.); (W.M.)
| | - Valerio Gaglio
- Department of Health Promotion, Mother and Infant Care, Internal and Specialized Medicine “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (D.M.); (V.R.); (G.L.); (V.G.); (W.M.)
| | - Walter Mazzucco
- Department of Health Promotion, Mother and Infant Care, Internal and Specialized Medicine “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (D.M.); (V.R.); (G.L.); (V.G.); (W.M.)
| | - Silvana Miceli
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90128 Palermo, Italy;
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Self-Perceived Health, Objective Health, and Quality of Life among People Aged 50 and Over: Interrelationship among Health Indicators in Italy, Spain, and Greece. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072414. [PMID: 32252321 PMCID: PMC7178192 DOI: 10.3390/ijerph17072414] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/23/2020] [Accepted: 03/30/2020] [Indexed: 11/17/2022]
Abstract
It is well known that self-perceived health (SPH), even if it is a subjective health indicator, is significantly associated with objective health and quality of life (QoL) in the general population. Whether it can be considered an indicator of cognitive functioning and quality of life in the elderly is still an open issue. This study used a data-driven approach to investigate the interrelationship among SPH, non-communicable diseases (NCDs), QoL, and cognitive functioning to answer this question. The study sample included information about 12,831 people living in Italy, Spain, and Greece, extracted from the Survey on Health, Aging, and Retirement in Europe, in the year 2015. The additive Bayesian networks methodology was used to identify the best directed acyclic graphs (DAG) for SPH, QoL, and NCDs. Results were given as posterior estimates of generalized linear models (GLM) coefficients, with 95% credibility intervals. Good SPH was associated with a decreasing number of chronic diseases in Italy (coeff = −0.52, 95%CI: [−0.59, −0.44]), Spain (coeff = −0.53, 95%CI: [−0.60, −0.46]) and Greece (coeff = −0.57, 95%CI: [−0.64, −0.50]). Age and Body Mass Index were determinants of NCDs in all countries. QoL of elderly was associated with SPH in Italy (coeff = 0.12, 95%CI: [0.10, 0.14]), Spain (coeff = 0.16, 95%CI: [0.15, 0.18]), and Greece (coeff = 0.18, 95%CI: [0.16, 0.20]). The number of NCDs was higher for people who were not employed in Spain (coeff = 0.45, 95%CI: [0.37, 0.53]) and was decreasing for a unitary increase in years of education in Greece (coeff = −0.12, 95%CI: [−0.14, −0.09]). As a general rule, the framework of the interrelationship among NCDs, SPH, and QoL was similar for Italy, Spain, and Greece. The connections found among indicators could be proposed to identify strategies for health promotion and healthy aging among people aged 50 and above, which are viable in general and at a country level. Reinforcing strategies targeted at some health indicators could have relevant effects on other related indicators.
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Bono F, Matranga D. Socioeconomic inequality in non-communicable diseases in Europe between 2004 and 2015: evidence from the SHARE survey. Eur J Public Health 2019; 29:105-110. [PMID: 30169634 DOI: 10.1093/eurpub/cky165] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background The scope of this work was to investigate socioeconomic inequalities among European adults aged 50 or older in chronic diseases and behavioural risk factors for these diseases, namely, smoking habits, obesity and physical inactivity, between 2004 and 2015. Methods Data for this study were drawn from the Survey of Health, Ageing and Retirement (SHARE) in Europe, which is a panel database of microdata on health, socioeconomic status and social and family networks of people aged 50 years or older, covering most of the European Union. The predicted number of non-communicable diseases (NCDs) was used to estimate the concentration index and to find the contributions of determinants to socioeconomic inequalities in chronic diseases. Results The inequality disfavoured the poor in both years, but the effect was stable from 2004 (C = -0.071) to 2015 (C = -0.081). Inequality was shown to be attributed mostly to physical inactivity and obesity and this contribution increased during the study period. Among socioeconomic status (SES) determinants, education and marital status were the most concentrated in both years, while physical inactivity and obesity were the most concentrated behavioural risk factors in both years. Conclusions To prevent chronic diseases, health policy should aim not only to improve individual health behaviours in the population, but also to reduce socioeconomic inequality. Our study suggests promoting a healthy lifestyle in the most disadvantaged socioeconomic classes as a strategy to improve the health conditions of the whole population.
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Affiliation(s)
- Filippa Bono
- Department of Economics, Business and Statistics (SEAS), University of Palermo, Palermo, Italy
| | - Domenica Matranga
- Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro", University of Palermo, Palermo, Italy
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Miceli S, Maniscalco L, Matranga D. Social networks and social activities promote cognitive functioning in both concurrent and prospective time: evidence from the SHARE survey. Eur J Ageing 2019; 16:145-154. [PMID: 31139029 PMCID: PMC6509309 DOI: 10.1007/s10433-018-0486-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The study aimed to investigate the role of social activities, social networks as well as socioeconomic status (SES) in influencing some aspects of cognitive functioning (immediate and delayed verbal recall tests and semantic verbal fluency) in elderly people over time. This analysis was conducted on a sample of 31,954 healthy elderly people (58% female, mean age 65.54 ± 9.74) interviewed in both the fourth and sixth waves of the Survey on Health, Aging and Retirement in Europe (SHARE), in 2011 and 2015. A structural equation model with measurement component was used to assess the relationship between cognitive function, social life and SES over time. Multilevel ordinal logistic regression was applied to explain satisfaction with social network in relation to different types of social network across countries. Being equipped with good cognitive skills did not seem to be predictive of their maintenance over time (latent coefficient = 0.24, p value = 0.34). On the contrary, the subject's social and participatory life, understood as satisfying one's social network and engaging in diversified non-professional social activities, seemed to play a crucial role in the maintenance of cognitive functions in the elderly (latent coefficient = 3.5, p value = 0.03). This research suggests that a socially active and participatory lifestyle mitigates the effects of the physiological process of brain aging.
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Affiliation(s)
- Silvana Miceli
- Department of Psychological, Pedagogical, and Educational Sciences, University of Palermo, Palermo, Italy
| | - Laura Maniscalco
- Department of Biomedical, Surgical, and Dental Sciences, University of Palermo, Palermo, Italy
| | - Domenica Matranga
- Department of Sciences for Health Promotion and Mother and Child Care “G. D’Alessandro”, University of Palermo, Palermo, Italy
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