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Milanovic SM, Buoncristiano M, Križan H, Rathmes G, Williams J, Hyska J, Duleva V, Zamrazilová H, Hejgaard T, Jørgensen MB, Salanave B, Shengelia L, Kelleher CC, Spinelli A, Nardone P, Abdrakhmanova S, Usupova Z, Pudule I, Petrauskiene A, Sant'Angelo VF, Kujundžic E, Fijałkowska A, Rito AI, Cucu A, Brinduse LA, Peterkova V, Gualtieri A, García-Solano M, Gutiérrez-González E, Boymatova K, Yardim MS, Tanrygulyyeva M, Melkumova M, Weghuber D, Nurk E, Mäki P, Bergh IH, Ostojic SM, Jonsson KR, Spiroski I, Rutter H, Ahrens W, Rakovac I, Whiting S, Breda J. S02-2 Socioeconomic determinants of physical activity, sleep and screen time among children aged 6-9 years of age in Europe. Eur J Public Health 2022. [PMCID: PMC9434802 DOI: 10.1093/eurpub/ckac093.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Physical activity is key for preventing obesity and development of noncommunicable diseases later in life. Previous research suggests that socioeconomic factors, such as parental education or income, may influence a child’s risk of obesity. However, previous research on this has provided heterogeneity in results. Our aim was to investigate the socioeconomic disparities between physical activity, sedentary behaviour and sleep patterns in school-aged children aged 6 to 9 years in 24 European countries, using a large nationally-representative sample of children from 24 countries (Albania, Bulgaria, Croatia, Czechia, Denmark, France, Georgia, Ireland, Italy, Kazakhstan, Kyrgyzstan, Lithuania, Latvia, Malta, Montenegro, Poland, Portugal, Romania, Russian Federation – only Moscow, San Marino Republic, Spain, Tajikistan, Türkiye and Turkmenistan).
Methods
COSI collected information on physical activity patterns of children, sedentary behaviour and sleep duration through a questionnaire filled by parents. Among these, the paper focused on the following behaviours: Transportation to and from schools, Time spent on practising sports, Time spent on actively/vigorously playing, Time spent watching TV or using electronic devices and Hours of sleep per night. For the paper purpose, countries were grouped in 4 macro-regions according to United Nations “Standard Country or Area Codes for Statistical Use”.
Results
Findings indicated that a high prevalence of motorized school transport among children of employed parents in Southern Europe. The highest prevalence of insufficient sports and active play was among families from West-Central Asia who meet the end of the month with troubles, the highest prevalence of excessive screen time is among families from Eastern Europe, where both parents have a low level of education and the highest prevalence of insufficient sleep is among families from West-Central Asia where both parents have a high level of education.
Conclusions
There are important differences in the socioeconomic determinants of PA, sleep and screen related behaviours both between countries and sub-regions across the WHO European Region. This analysis of results from the COSI survey provides important insights that can help guide policy makers to take action to address the childhood obesity epidemic.
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Affiliation(s)
- Sanja Music Milanovic
- Croatian Institute of Public Health , Zagreb, Croatia
- School of Medicine, University of Zagreb , Zagreb, Croatia
| | - Marta Buoncristiano
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
| | - Helena Križan
- Croatian Institute of Public Health , Zagreb, Croatia
| | - Giulia Rathmes
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
| | - Julianne Williams
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
| | - Jolanda Hyska
- Nutrition and Food Safety Sector, Institute of Public Health , Tirana, Albania
| | - Vesselka Duleva
- Department Food and Nutrition, National Centre of Public Health and Analyses , Sofia, Bulgaria
| | - Hana Zamrazilová
- Obesity Management Centre, Institute of Endocrinology , Prague, Czech Republic
| | - Tatjana Hejgaard
- Health Promotion and Inequality, Danish Health Authority , Copenhagen, Denmark
| | | | - Benoît Salanave
- Department of Non-Communicable Diseases and Traumatisms, Santé Publique France, the French Public Health Agency , Saint-Maurice, France
- Nutritional Surveillance and Epidemiology Team (ESEN), University Sorbonne Paris Nord , Bobigny, France
| | - Lela Shengelia
- Maternal, Child and Reproductive Health, National Center for Disease Control and Public Health , Tbilisi, Georgia
| | - Cecily C Kelleher
- College of Health and Agricultural Sciences, University College Dublin , Dublin, Ireland
| | - Angela Spinelli
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità) , Rome, Italy
| | - Paola Nardone
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità) , Rome, Italy
| | - Shynar Abdrakhmanova
- Department of Science and Professional Development, National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan , Almaty, Kazakhstan
- Kazakhstan School of Public Health, Kazakhstan's Medical University , Almaty, Kazakhstan
| | - Zhamilya Usupova
- Republican Center for Health Promotion and Mass Communication, Ministry of Health of the Kyrgyz Republic , Bishkek, Kyrgyzstan
| | - Iveta Pudule
- Department of Research and Health Statistics, Centre for Disease and Prevention Control , Riga, Latvia
| | - Ausra Petrauskiene
- Department of Preventive Medicine, Lithuanian University of Health Sciences , Kaunas, Lithuania
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ivo Rakovac
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
| | - Stephen Whiting
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
| | - João Breda
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
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Whiting S, Buoncristiano M, Gelius P, Abu-Omar K, Pattison M, Hyska J, Duleva V, Milanović SM, Zamrazilová H, Hejgaard T, Rasmussen M, Nurk E, Shengelia L, Kelleher CC, Heinen MM, Spinelli A, Nardone P, Abildina A, Abdrakhmanova S, Aitmurzaeva G, Usuopva Z, Pudule I, Petrauskiene A, Angelo VFS, Kujundzic E, Popovic S, Fismen AS, Bergh IH, Fijalkowska A, Rito AI, Cucu A, Brinduse LA, Peterkova V, Gualtieri A, García-Solano M, Gutiérrez-González E, Abdurrahmonova Z, Boymatova K, Yardim N, Tanrygulyyeva M, Weghuber D, Schindler K, Stojisavljević D, Hadžiomeragić AF, Ionnaidu EM, Ahrens W, Hassapidou M, Kovacs VA, Ostojic SM, Ticha L, Starc G, Jonsson KR, Spiroski I, Rutter H, Mendes R, Williams J, Rakovac I, Breda J. S02-1 Physical activity and sedentary behaviour of children aged 6-9 in Europe: an analysis within the Childhood Obesity Surveillance Initiative (COSI). Eur J Public Health 2022. [PMCID: PMC9421738 DOI: 10.1093/eurpub/ckac093.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Children are becoming less physically active for a variety of interrelated reasons. The availability of opportunities for safe active playgrounds, recreational activities and active transport has decreased, while time spend on sedentary screen-based activities has increased. This study aimed to evaluate physical activity (PA), sedentary and sleep behaviours of children aged 6-9 years in Europe using data from the WHO Childhood Obesity Surveillance Initiative (COSI).
Methods
The fourth COSI data collection round was conducted in 36 countries from 2015-2018 using a standardized protocol including a family form completed by parents with specific questions about diet and physical activity-related behaviours.
Results
Nationally representative data from the 24 countries, who filled in the non-mandatory family record form, were included. Information on PA, screen-time and sleep behaviours of 137,807 children were analysed. Pooled analysis showed that: one in two children walked or cycled to school every day; one in two children were members of a sport or dancing club; around 40 % of children spent at least two hours per day watching TV or using electronic devices; around four in five children were actively or vigorously playing each day; around 88 % of children slept for at least nine hours per night. Country specific analyses showed pronounced differences in prevalence estimates between countries.
Conclusions
While the severity of the problem varies between countries, physical inactivity and sedentary behaviours are common across the European Region. Policy makers across the Region must do more in order to increase opportunities for young people to participate in daily activities. Furthermore, they should explore solutions to reduce the amount of time spend on sedentary activities, in order to halt the rise in overweight and obesity.
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Affiliation(s)
- Stephen Whiting
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto , Porto, Portugal
| | - Marta Buoncristiano
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
| | - Peter Gelius
- Department of Sport Science and Sport, FAU , Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, FAU , Erlangen, Germany
| | - Mary Pattison
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
| | - Jolanda Hyska
- Nutrition and Food Safety Sector, Institute of Public Health , Tirana, Albania
| | - Vesselka Duleva
- National Center of Public Health and Analyses , Sofia, Bulgaria
| | - Sanja Musić Milanović
- School of Medicine, University of Zagreb, Croatian Institute of Public Health , Zagreb, Croatia
| | - Hana Zamrazilová
- Institute of Endocrinology, Obesity Management Centre , Prague, Czechia
| | | | - Mette Rasmussen
- National Institute of Public Health, University of Southern Denmark , Copenhagen, Denmark
| | - Eha Nurk
- National Institute for Health Development , Tallinn, Estonia
| | - Lela Shengelia
- National Center for Disease Control and Public Health , Tbilisi, Georgia
| | - Cecily C Kelleher
- National Nutrition Surveillance Centre, University College Dublin , Dublin, Ireland
| | - Mirjam M Heinen
- National Nutrition Surveillance Centre, University College Dublin , Dublin, Ireland
| | | | | | - Akbota Abildina
- National Centre of Public Health of the Ministry of Health of the Republic of Kazakhstan , Nur-Sultan, Kazakhstan
| | - Shynar Abdrakhmanova
- National Centre of Public Health of the Ministry of Health of the Republic of Kazakhstan , Nur-Sultan, Kazakhstan
| | | | | | - Iveta Pudule
- Ministry of Health, Centre for Disease Prevention and Control , Riga, Latvia
| | - Aušra Petrauskiene
- Lithuanian University of Health Sciences, Health Research Institute and Department of Preventive Medicine , Kaunas, Lithuania
| | | | - Enisa Kujundzic
- Institute of Public Health of Montenegro , Podgorica, Montenegro
| | - Stevo Popovic
- Faculty for Sport and Physical Education, University of Montenegro , Niksic, Montenegro
| | - Anne-Siri Fismen
- Department of Health Promotion, Norwegian Institute of Public Health , Bergen, Norway
| | - Ingunn Holden Bergh
- Department of Health and Inequality, Division of Mental and Physical Health, Norwegian Institute of Public Health , Bergen, Norway
| | - Anna Fijalkowska
- Department of Cardiology, Institute of Mother and Child , Warsaw, Poland
| | - Ana Isabel Rito
- National Institute of Health Dr Ricardo Jorge I.P ., Lisbon, Portugal
| | - Alexandra Cucu
- National Institute of Public Health , Bucharest, Romania
| | | | | | - Andrea Gualtieri
- Health Authority San Marino , San Marino
- Republic of San Marino , San Marino
| | - Marta García-Solano
- Spanish Agency for Food Safety and Nutrition, Ministry of Health , Madrid, Spain
| | | | - Zulfinissio Abdurrahmonova
- Republican Centre for Nutrition, Ministry of Health and Social Protection of Population , Duschanbe, Tajikistan
| | | | - Nazan Yardim
- Diabetes and Metabolic Disorders Department, Ministry of Health, Public Health Institution , Ankara, Turkey
| | - Maya Tanrygulyyeva
- Scientific Research Institute of Maternal and Child Health , Ashgabat, Turkmenistan
| | - Daniel Weghuber
- Department of Pediatrics, Paracelsus Medical University , Salzburg, Austria
| | | | - Dragana Stojisavljević
- Public Health Institute of Republic of Srpska, the University of Banja Luka, Faculty of Medicine , Banja Luka
- Bosnia and Herzegovina , Banja Luka
| | - Aida Filipović Hadžiomeragić
- Institute of Public Health of Federation of Bosnia and Herzegovina , Banja Luka
- Bosnia and Herzegovina , Banja Luka
| | | | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Institute of Statistics, University of Bremen , Bremen, Germany
| | | | | | - Sergej M Ostojic
- Faculty of Sport and PE, University of Novi Sad , Novi Sad, Serbia
| | - Lubica Ticha
- National Institute of Children Diseases, Medical Faculty of Comenius University , Bratislava, Slovakia
| | - Gregor Starc
- Faculty of Sport, University of Ljubljana , Ljubljana, Slovenia
| | - Kenisha Russell Jonsson
- Department of Living Conditions and Lifestyle, Public Health Agency of Sweden , Solna, Sweden
| | - Igor Spiroski
- Department of Physiology and Monitoring of Nutrition, Institute of Public Health , Skopje, Republic of Macedonia
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath , Bath, UK
| | - Romeu Mendes
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto , Porto, Portugal
| | - Julianne Williams
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
| | - Ivo Rakovac
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
| | - João Breda
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
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Ramos Salas X, Buoncristiano M, Williams J, Kebbe M, Spinelli A, Nardone P, Rito A, Duleva V, Musić Milanović S, Kunesova M, Braunerová RT, Hejgaard T, Rasmussen M, Shengelia L, Abdrakhmanova S, Abildina A, Usuopva Z, Hyska J, Burazeri G, Petrauskiene A, Pudule I, Sant'Angelo VF, Kujundzic E, Fijałkowska A, Cucu A, Brinduse LA, Peterkova V, Bogova E, Gualtieri A, Solano MG, Gutiérrez-González E, Rakhmatullaeva S, Tanrygulyyeva M, Yardim N, Weghuber D, Mäki P, Russell Jonsson K, Starc G, Juliusson PB, Heinen MM, Kelleher C, Ostojic S, Popovic S, Kovacs VA, Akhmedova D, Farpour-Lambert NJ, Rutter H, Li B, Boymatova K, Rakovac I, Wickramasinghe K, Breda J. Parental Perceptions of Children's Weight Status in 22 Countries: The WHO European Childhood Obesity Surveillance Initiative: COSI 2015/2017. Obes Facts 2021; 14:658-674. [PMID: 34818257 PMCID: PMC8739931 DOI: 10.1159/000517586] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 05/28/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Parents can act as important agents of change and support for healthy childhood growth and development. Studies have found that parents may not be able to accurately perceive their child's weight status. The purpose of this study was to measure parental perceptions of their child's weight status and to identify predictors of potential parental misperceptions. METHODS We used data from the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative and 22 countries. Parents were asked to identify their perceptions of their children's weight status as "underweight," "normal weight," "a little overweight," or "extremely overweight." We categorized children's (6-9 years; n = 124,296) body mass index (BMI) as BMI-for-age Z-scores based on the 2007 WHO-recommended growth references. For each country included in the analysis and pooled estimates (country level), we calculated the distribution of children according to the WHO weight status classification, distribution by parental perception of child's weight status, percentages of accurate, overestimating, or underestimating perceptions, misclassification levels, and predictors of parental misperceptions using a multilevel logistic regression analysis that included only children with overweight (including obesity). Statistical analyses were performed using Stata version 15 1. RESULTS Overall, 64.1% of parents categorized their child's weight status accurately relative to the WHO growth charts. However, parents were more likely to underestimate their child's weight if the child had overweight (82.3%) or obesity (93.8%). Parents were more likely to underestimate their child's weight if the child was male (adjusted OR [adjOR]: 1.41; 95% confidence intervals [CI]: 1.28-1.55); the parent had a lower educational level (adjOR: 1.41; 95% CI: 1.26-1.57); the father was asked rather than the mother (adjOR: 1.14; 95% CI: 0.98-1.33); and the family lived in a rural area (adjOR: 1.10; 95% CI: 0.99-1.24). Overall, parents' BMI was not strongly associated with the underestimation of children's weight status, but there was a stronger association in some countries. DISCUSSION/CONCLUSION Our study supplements the current literature on factors that influence parental perceptions of their child's weight status. Public health interventions aimed at promoting healthy childhood growth and development should consider parents' knowledge and perceptions, as well as the sociocultural contexts in which children and families live.
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Affiliation(s)
- Ximena Ramos Salas
- WHO European Office for Prevention and Control of NCDs, Country Health Programmes, WHO Regional Office for Europe, Copenhagen, Denmark
- European Association for the Study of Obesity, Teddington, United Kingdom
| | | | - Julianne Williams
- European Association for the Study of Obesity, Teddington, United Kingdom
| | - Maryam Kebbe
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | | | | | - Ana Rito
- National Institute of Health Dr. Ricardo Jorge I.P., Lisbon, Portugal
| | - Vesselka Duleva
- National Center of Public Health and Analyses, Ministry of Health, Sofia, Bulgaria
| | - Sanja Musić Milanović
- University of Zagreb, School of Medicine/Croatian Institute of Public Health, Zagreb, Croatia
| | - Marie Kunesova
- Obesity Management Centre, Institute of Endocrinology, Prague, Czechia
| | | | | | - Mette Rasmussen
- National Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Lela Shengelia
- National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | - Shynar Abdrakhmanova
- National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan, Nur-Sultan, Kazakhstan
| | - Akbota Abildina
- National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan, Nur-Sultan, Kazakhstan
| | | | | | | | - Aušra Petrauskiene
- Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Iveta Pudule
- Centre for Disease Prevention and Control, Riga, Latvia
| | | | | | - Anna Fijałkowska
- Department of Cardiology, Institute of Mother and Child, Warsaw, Poland
| | - Alexandra Cucu
- Department of Public Health and Management, University of Medicine and Pharmacy Carol Davila Romania, Bucharest, Romania
| | - Lacramioara Aurelia Brinduse
- Department of Public Health and Management, University of Medicine and Pharmacy Carol Davila Romania, Bucharest, Romania
| | - Valentina Peterkova
- Institute of Pediatric Endocrinology, Endocrine Research Centre, Moscow, Russian Federation
| | - Elena Bogova
- Institute of Pediatric Endocrinology, Endocrine Research Centre, Moscow, Russian Federation
| | | | - Marta García Solano
- Observatory of Nutrition and Study of Obesity, Spanish Agency for Food Safety & Nutrition, Ministry of Health, Madrid, Spain
| | - Enrique Gutiérrez-González
- Observatory of Nutrition and Study of Obesity, Spanish Agency for Food Safety & Nutrition, Ministry of Health, Madrid, Spain
| | - Sanavbar Rakhmatullaeva
- Department for Organization of Health Services to Children, Mothers, Adolescents and Family Planning, Ministry of Health and Social Protection of the Population, Dushanbe, Tajikistan
| | - Maya Tanrygulyyeva
- Internal Diseases Department of the Scientific Clinical Centre of Mother and Child Health, Ashgabat, Turkmenistan
| | - Nazan Yardim
- Ministry of Health, Public Health General Directorate, Ankara, Turkey
| | - Daniel Weghuber
- WHO European Office for Prevention and Control of NCDs, Country Health Programmes, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Päivi Mäki
- European Association for the Study of Obesity, Teddington, United Kingdom
| | | | | | | | - Mirjam M. Heinen
- National Center of Public Health and Analyses, Ministry of Health, Sofia, Bulgaria
| | - Cecily Kelleher
- National Center of Public Health and Analyses, Ministry of Health, Sofia, Bulgaria
| | - Sergej Ostojic
- University of Zagreb, School of Medicine/Croatian Institute of Public Health, Zagreb, Croatia
| | - Stevo Popovic
- Obesity Management Centre, Institute of Endocrinology, Prague, Czechia
| | | | - Dilorom Akhmedova
- National Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | | | - Harry Rutter
- National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan, Nur-Sultan, Kazakhstan
| | - Bai Li
- Centre for Health Promotion, Bishkek, Kyrgyzstan
| | | | - Ivo Rakovac
- European Association for the Study of Obesity, Teddington, United Kingdom
| | - Kremlin Wickramasinghe
- Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Joao Breda
- European Association for the Study of Obesity, Teddington, United Kingdom
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4
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Breda J, McColl K, Buoncristiano M, Williams J, Abdrakhmanova S, Abdurrahmonova Z, Ahrens W, Akhmedova D, Bakacs M, Boer JMA, Boymatova K, Brinduse LA, Cucu A, Duleva V, Endevelt R, Sant'Angelo VF, Fijałkowska A, Hadžiomeragić AF, García-Solano M, Grøholt EK, Gualtieri A, Hassapidou M, Hejgaard T, Hyska J, Kelleher CC, Kujundžić E, Mäki P, Markidou Ioannidou E, Melkumova M, Moyersoen I, Milanović SM, Nurk E, Ostojic SM, Peterkova V, Petrauskienė A, Pudule I, Rito AI, Russell Jonsson K, Rutter H, Salanave B, Seyidov N, Shengelia L, Silitrari N, Spinelli A, Spiroski I, Starc G, Stojisavljević D, Tanrygulyyeva M, Tichá Ľ, Usupova Z, Weghuber D, Yardim N, Zamrazilová H, Zbanatskyi V, Branca F, Weber M, Rakovac I. Methodology and implementation of the WHO European Childhood Obesity Surveillance Initiative (COSI). Obes Rev 2021; 22 Suppl 6:e13215. [PMID: 34738283 DOI: 10.1111/obr.13215] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/18/2021] [Accepted: 01/18/2021] [Indexed: 11/30/2022]
Abstract
Establishment of the WHO European Childhood Obesity Surveillance Initiative (COSI) has resulted in a surveillance system which provides regular, reliable, timely, and accurate data on children's weight status-through standardized measurement of bodyweight and height-in the WHO European Region. Additional data on dietary intake, physical activity, sedentary behavior, family background, and school environments are collected in several countries. In total, 45 countries in the European Region have participated in COSI. The first five data collection rounds, between 2007 and 2021, yielded measured anthropometric data on over 1.3 million children. In COSI, data are collected according to a common protocol, using standardized instruments and procedures. The systematic collection and analysis of these data enables intercountry comparisons and reveals differences in the prevalence of childhood thinness, overweight, normal weight, and obesity between and within populations. Furthermore, it facilitates investigation of the relationship between overweight, obesity, and potential risk or protective factors and improves the understanding of the development of overweight and obesity in European primary-school children in order to support appropriate and effective policy responses.
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Affiliation(s)
- João Breda
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Karen McColl
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Marta Buoncristiano
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Julianne Williams
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Shynar Abdrakhmanova
- Department of Science and Professional Development, National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan, Almaty, Kazakhstan.,Kazakhstan School of Public Health, Kazakhstan's Medical University, Almaty, Kazakhstan
| | - Zulfiya Abdurrahmonova
- Republican Centre for Nutrition, Ministry of Health and Social Protection of Population, Dushanbe, Tajikistan
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.,Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Dilorom Akhmedova
- Republic Specialized Scientific Practical Medical Centre for Pediatrics, Tashkent, Uzbekistan
| | - Márta Bakacs
- Department of Nutrition and Epidemiology, National Institute of Pharmacy and Nutrition, Budapest, Hungary
| | - Jolanda M A Boer
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Khadichamo Boymatova
- Division of Noncommunicable Diseases and Promoting Health through the Life-course, WHO Country Office, Dushanbe, Tajikistan
| | - Lacramioara Aurelia Brinduse
- National Centre of Health Promotion and Health Evaluation, National Institute of Public Health, Bucharest, Romania.,Faculty of Medicine, Department of Public Health and Management, University of Medicine and Pharmacy Carol Davila Bucharest, Bucharest, Romania
| | - Alexandra Cucu
- National Centre of Health Promotion and Health Evaluation, National Institute of Public Health, Bucharest, Romania.,Faculty of Midwifery and Nursing, Discipline of Public health and Health management, University of Medicine and Pharmacy Carol Davila Bucharest, Bucharest, Romania
| | - Vesselka Duleva
- Department Food and Nutrition, National Centre of Public Health and Analyses, Sofia, Bulgaria
| | - Ronit Endevelt
- University of Haifa School of Public Health, Israel.,Ministry of Health, Israel
| | | | - Anna Fijałkowska
- Department of Cardiology, Institute of Mother and Child, Warsaw, Poland
| | - Aida Filipović Hadžiomeragić
- Department of Hygiene, Health Ecology Service, Institute of Public Health of Federation of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
| | - Marta García-Solano
- Spanish Agency for Food Safety and Nutrition, Ministry of Consumer Affairs, Madrid, Spain
| | - Else Karin Grøholt
- Department of Health and Inequality, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Maria Hassapidou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Tatjana Hejgaard
- Health Promotion and Inequality, Danish Health Authority, Copenhagen, Denmark
| | - Jolanda Hyska
- Nutrition and Food Safety Sector, Institute of Public Health, Tirana, Albania
| | - Cecily C Kelleher
- College of Health and Agricultural Sciences, University College Dublin, Dublin, Ireland
| | - Enisa Kujundžić
- Center for Health Ecology, Institute of Public Health of Montenegro, Podgorica, Montenegro
| | - Päivi Mäki
- Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Marina Melkumova
- Institute of Child and Adolescent Health, Arabkir Medical Centre, Yerevan, Armenia
| | - Isabelle Moyersoen
- Department of Epidemiology and Public Health Sciensano, Brussels, Belgium
| | - Sanja Musić Milanović
- Croatian Institute of Public Health, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Eha Nurk
- Department of Nutrition Research, National Institute for Health Development, Tallinn, Estonia
| | - Sergej M Ostojic
- Biomedical Sciences Department, Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Valentina Peterkova
- Institute of Paediatric Endocrinology, National Medical Research Centre for Endocrinology of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Aušra Petrauskienė
- Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Iveta Pudule
- Department of Research and Health Statistics, Centre for Disease and Prevention Control, Riga, Latvia
| | - Ana Isabel Rito
- WHO/Europe Collaborating Center for Nutrition and Childhood Obesity - Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Kenisha Russell Jonsson
- Department of Living Conditions and Lifestyle, Public Health Agency of Sweden, Solna, Sweden
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Benoît Salanave
- Department of Non-Communicable Diseases and Traumatisms, Santé publique France, the French Public Health Agency, Saint Maurice, France.,Nutritional Surveillance and Epidemiology Team (ESEN), University Sorbonne Paris Nord, Bobigny, France
| | - Nabil Seyidov
- Department of Healthy Policy and Planning, Public Health and Reforms Center of Ministry of Health, Baku, Azerbaijan
| | - Lela Shengelia
- Maternal, Child and Reproductive Health, National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | | | - Angela Spinelli
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Igor Spiroski
- Institute of Public Health, Skopje, North Macedonia.,Faculty of Medicine, SS. Cyril and Methodius University, Skopje, North Macedonia
| | - Gregor Starc
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Dragana Stojisavljević
- Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina.,Public Health Institute of Republic of Srpska, Banja Luka, Bosnia and Herzegovina
| | - Maya Tanrygulyyeva
- Internal Diseases Department, Scientific Clinical Centre of Mother and Child Health, Ashgabat, Turkmenistan
| | - Ľubica Tichá
- Children's Hospital National Institute of Children's Diseases, Medical Faculty, Comenius University, Bratislava, Slovakia
| | - Zhamilya Usupova
- Republican Center for Health Promotion and Mass Communication, Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan
| | - Daniel Weghuber
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | - Nazan Yardim
- Public Health General Directorate, Ministry of Health of Turkey, Ankara, Turkey
| | - Hana Zamrazilová
- Obesity Management Centre, Institute of Endocrinology, Prague, Czechia
| | | | - Francesco Branca
- Department of Nutrition and Food Safety, World Health Organization, Geneva, Switzerland
| | - Martin Weber
- World Health Organization (WHO) Child and Adolescent Health and Development, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Ivo Rakovac
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
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5
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Musić Milanović S, Buoncristiano M, Križan H, Rathmes G, Williams J, Hyska J, Duleva V, Zamrazilová H, Hejgaard T, Jørgensen MB, Salanave B, Shengelia L, Kelleher CC, Spinelli A, Nardone P, Abdrakhmanova S, Usupova Z, Pudule I, Petrauskiene A, Farrugia Sant'Angelo V, Kujundžić E, Fijałkowska A, Rito AI, Cucu A, Brinduse LA, Peterkova V, Gualtieri A, García-Solano M, Gutiérrez-González E, Boymatova K, Yardim MS, Tanrygulyyeva M, Melkumova M, Weghuber D, Nurk E, Mäki P, Bergh IH, Ostojic SM, Russell Jonsson K, Spiroski I, Rutter H, Ahrens W, Rakovac I, Whiting S, Breda J. Socioeconomic disparities in physical activity, sedentary behavior and sleep patterns among 6- to 9-year-old children from 24 countries in the WHO European region. Obes Rev 2021; 22 Suppl 6:e13209. [PMID: 34235843 DOI: 10.1111/obr.13209] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 12/30/2020] [Indexed: 12/22/2022]
Abstract
Physical activity, sedentary behavior, and sleep are important predictors of children's health. This paper aimed to investigate socioeconomic disparities in physical activity, sedentary behavior, and sleep across the WHO European region. This cross-sectional study used data on 124,700 children aged 6 to 9 years from 24 countries participating in the WHO European Childhood Obesity Surveillance Initiative between 2015 and 2017. Socioeconomic status (SES) was measured through parental education, parental employment status, and family perceived wealth. Overall, results showed different patterns in socioeconomic disparities in children's movement behaviors across countries. In general, high SES children were more likely to use motorized transportation. Low SES children were less likely to participate in sports clubs and more likely to have more than 2 h/day of screen time. Children with low parental education had a 2.24 [95% CI 1.94-2.58] times higher risk of practising sports for less than 2 h/week. In the pooled analysis, SES was not significantly related to active play. The relationship between SES and sleep varied by the SES indicator used. Importantly, results showed that low SES is not always associated with a higher prevalence of "less healthy" behaviors. There is a great diversity in SES patterns across countries which supports the need for country-specific, targeted public health interventions.
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Affiliation(s)
- Sanja Musić Milanović
- Croatian Institute of Public Health, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Marta Buoncristiano
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Helena Križan
- Croatian Institute of Public Health, Zagreb, Croatia
| | - Giulia Rathmes
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Julianne Williams
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Jolanda Hyska
- Nutrition and Food Safety Sector, Institute of Public Health, Tirana, Albania
| | - Vesselka Duleva
- Department Food and Nutrition, National Centre of Public Health and Analyses, Sofia, Bulgaria
| | - Hana Zamrazilová
- Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic
| | - Tatjana Hejgaard
- Health Promotion and Inequality, Danish Health Authority, Copenhagen, Denmark
| | | | - Benoît Salanave
- Department of Non-Communicable Diseases and Traumatisms, Santé publique France, the French Public Health Agency, Saint-Maurice, France.,Nutritional Surveillance and Epidemiology Team (ESEN), University Sorbonne Paris Nord, Bobigny, France
| | - Lela Shengelia
- Maternal, Child and Reproductive Health, National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Cecily C Kelleher
- College of Health and Agricultural Sciences, University College Dublin, Dublin, Ireland
| | - Angela Spinelli
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Paola Nardone
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Shynar Abdrakhmanova
- Department of Science and Professional Development, National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan, Almaty, Kazakhstan.,Kazakhstan School of Public Health, Kazakhstan's Medical University, Almaty, Kazakhstan
| | - Zhamilya Usupova
- Republican Center for Health Promotion and Mass Communication, Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan
| | - Iveta Pudule
- Department of Research and Health Statistics, Centre for Disease and Prevention Control, Riga, Latvia
| | - Ausra Petrauskiene
- Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | - Enisa Kujundžić
- Center for Health Ecology, Institute of Public Health, Podgorica, Montenegro
| | - Anna Fijałkowska
- Department of Cardiology, Institute of Mother and Child, Warsaw, Poland
| | - Ana Isabel Rito
- WHO/Europe Collaborating Center for Nutrition and Childhood Obesity - Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Alexandra Cucu
- Faculty of Midwifery and Nursing, Discipline of Public Health and Health Management, University of Medicine and Pharmacy Carol Davila Bucharest, Bucharest, Romania.,National Centre of Health Promotion and Health Evaluation, National Institute of Public Health, Bucharest, Romania
| | - Lacramioara Aurelia Brinduse
- National Centre of Health Promotion and Health Evaluation, National Institute of Public Health, Bucharest, Romania.,Faculty of Medicine, Department of Public Health and Management, University of Medicine and Pharmacy Carol Davila Bucharest, Bucharest, Romania
| | - Valentina Peterkova
- Institute of Paediatric Endocrinology, National Medical Research Centre for Endocrinology of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | | | - Marta García-Solano
- Spanish Agency for Food Safety and Nutrition, Ministry of Consumer Affairs, Madrid, Spain
| | | | - Khadichamo Boymatova
- Division of Noncommunicable Diseases and Promoting Health through the Life-Course, WHO Country Office for Tajikistan, Dushanbe, Tajikistan
| | | | - Maya Tanrygulyyeva
- Scientific Research Institute of Maternal and Child Health, Ashgabat, Turkmenistan
| | - Marina Melkumova
- Institute of Child and Adolescent Health, Arabkir Medical Centre-Institute of Child and Adolescent Health, Yerevan, Armenia
| | - Daniel Weghuber
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | - Eha Nurk
- Department of Nutrition Research, National Institute for Health Development, Tallinn, Estonia
| | - Päivi Mäki
- Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Ingunn Holden Bergh
- Department of Health and Inequality, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Sergej M Ostojic
- Biomedical Sciences Department, Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Kenisha Russell Jonsson
- Department of Living Conditions and Lifestyle, Public Health Agency of Sweden, Solna, Sweden
| | - Igor Spiroski
- Institute of Public Health, Skopje, North Macedonia.,Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, North Macedonia
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany.,Institute of Statistics, Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Ivo Rakovac
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Stephen Whiting
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - João Breda
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
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6
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Spinelli A, Buoncristiano M, Nardone P, Starc G, Hejgaard T, Júlíusson PB, Fismen AS, Weghuber D, Musić Milanović S, García-Solano M, Rutter H, Rakovac I, Cucu A, Brinduse LA, Rito AI, Kovacs VA, Heinen MM, Nurk E, Mäki P, Abdrakhmanova S, Rakhmatulleoeva S, Duleva V, Farrugia Sant'Angelo V, Fijałkowska A, Gualtieri A, Sacchini E, Hassapidou M, Hyska J, Kelleher CC, Kujundžić E, Kunešová M, Markidou Ioannidou E, Ostojic SM, Peterkova V, Petrauskienė A, Popović S, Pudule I, Russell Jonsson K, Dal-Re Saavedra MÁ, Salanave B, Shengelia L, Spiroski I, Tanrygulyyeva M, Tichá Ľ, Usupova Z, Ozcebe LH, Abildina A, Schindler K, Weber MW, Filipović Hadžiomeragić A, Melkumova M, Stojisavljević D, Boymatova K, Williams J, Breda J. Thinness, overweight, and obesity in 6- to 9-year-old children from 36 countries: The World Health Organization European Childhood Obesity Surveillance Initiative-COSI 2015-2017. Obes Rev 2021; 22 Suppl 6:e13214. [PMID: 34235850 DOI: 10.1111/obr.13214] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 01/04/2021] [Indexed: 01/07/2023]
Abstract
In 2015-2017, the fourth round of the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) was conducted in 36 countries. National representative samples of children aged 6-9 (203,323) were measured by trained staff, with similar equipment and using a standardized protocol. This paper assesses the children's body weight status and compares the burden of childhood overweight, obesity, and thinness in Northern, Eastern, and Southern Europe and Central Asia. The results show great geographic variability in height, weight, and body mass index. On average, the children of Northern Europe were the tallest, those of Southern Europe the heaviest, and the children living in Central Asia the lightest and the shortest. Overall, 28.7% of boys and 26.5% of girls were overweight (including obesity) and 2.5% and 1.9%, respectively, were thin according to the WHO definitions. The prevalence of obesity varied from 1.8% of boys and 1.1% of girls in Tajikistan to 21.5% and 19.2%, respectively, in Cyprus, and tended to be higher for boys than for girls. Levels of thinness, stunting, and underweight were relatively low, except in Eastern Europe (for thinness) and in Central Asia. Despite the efforts to halt it, unhealthy weight status is still an important problem in the WHO European Region.
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Affiliation(s)
- Angela Spinelli
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Marta Buoncristiano
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Paola Nardone
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Gregor Starc
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Tatjana Hejgaard
- Health Promotion and Inequality, Danish Health Authority, Copenhagen, Denmark
| | - Petur Benedikt Júlíusson
- Department of Health Registry Research and Development, Norwegian Institute of Public Health, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Anne-Siri Fismen
- Department of Health Promotion and Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Bergen, Norway
| | - Daniel Weghuber
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | - Sanja Musić Milanović
- Croatian Institute of Public Health, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Marta García-Solano
- Spanish Agency for Food Safety and Nutrition, Ministry of Consumer Affairs, Madrid, Spain
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Ivo Rakovac
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Alexandra Cucu
- Faculty of Midwifery and Nursing, Discipline of Public health and Health Management, University of Medicine and Pharmacy Carol Davila Bucharest, Bucharest, Romania.,National Centre of Health Promotion and Health Evaluation, National Institute of Public Health, Bucharest, Romania
| | - Lacramioara Aurelia Brinduse
- National Centre of Health Promotion and Health Evaluation, National Institute of Public Health, Bucharest, Romania.,Faculty of Medicine, Department of Public Health and Management, University of Medicine and Pharmacy Carol Davila Bucharest, Bucharest, Romania
| | - Ana Isabel Rito
- WHO/Europe Collaborating Center for Nutrition and Childhood Obesity - Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | | | - Mirjam M Heinen
- National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Eha Nurk
- Department of Nutrition Research, National Institute for Health Development, Tallinn, Estonia
| | - Päivi Mäki
- Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Shynar Abdrakhmanova
- Department of Science and Professional Development, National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan, Almaty, Kazakhstan.,Kazakhstan School of Public Health, Kazakhstan's Medical University, Almaty, Kazakhstan
| | - Sanavbar Rakhmatulleoeva
- Department of the Organization of Medical Services for Mothers, Children and Family Planning Ministry of Health and Social Protection, Dushanbe, Tajikistan
| | - Vesselka Duleva
- Department Food and Nutrition, National Center of Public Health and Analyses, Sofia, Bulgaria
| | | | - Anna Fijałkowska
- Department of Cardiology, Institute of Mother and Child, Warsaw, Poland
| | | | - Elena Sacchini
- Health Authority, Ministry of Health, San Marino, San Marino
| | - Maria Hassapidou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Jolanda Hyska
- Nutrition and Food Safety Sector, Institute of Public Health, Tirana, Albania
| | - Cecily C Kelleher
- National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Enisa Kujundžić
- Center for Health Ecology, Institute of Public Health, Podgorica, Montenegro
| | - Marie Kunešová
- Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic
| | | | - Sergej M Ostojic
- Biomedical Sciences Department, Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Valentina Peterkova
- Institute of Paediatric Endocrinology, National Medical Research Centre for Endocrinology of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Aušra Petrauskienė
- Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Stevo Popović
- Faculty for Sport and Physical Education, University of Montenegro, Niksic, Montenegro.,Montenegrin Sports Academy, Podgorica, Montenegro
| | - Iveta Pudule
- Department of Research and Health Statistics, Centre for Disease and Prevention Control, Riga, Latvia
| | - Kenisha Russell Jonsson
- Department of Living Conditions and Lifestyle, Public Health Agency of Sweden, Solna, Sweden
| | | | - Benoît Salanave
- Departement of Non-Communicable Diseases and Traumatisms, Santé publique France, the French Public Health Agency, Saint Maurice, France.,Nutritional Surveillance and Epidemiology Team (ESEN), University Sorbonne Paris Nord, Bobigny, France
| | - Lela Shengelia
- Maternal, Child and Reproductive Health, National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | - Igor Spiroski
- Institute of Public Health, Skopje, North Macedonia.,Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, North Macedonia
| | - Maya Tanrygulyyeva
- Scientific Research Institute of Maternal and Child Health, Ashgabat, Turkmenistan
| | - Ľubica Tichá
- Children's Hospital National Institute of Children's Diseases, Medical Faculty, Comenius University, Bratislava, Slovakia
| | - Zhamilya Usupova
- Republican Center for Health Promotion and Mass Communication, Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan
| | - Lütfiye Hilal Ozcebe
- Medical Faculty, Department of Public Health, Hacettepe University, Ankara, Turkey
| | - Akbota Abildina
- National Center of Public Health, Ministry of Health of the Republic of Kazakhstan/WHO Collaborating Center for Promoting Healthy Lifestyle, Nur-Sultan, Kazakhstan
| | - Karin Schindler
- Federal Ministry Social Affairs, Health Care and Consumer Protection, Division of Mother, Child, Gender Health and Nutrition, Vienna, Austria
| | - Martin W Weber
- World Health Organization (WHO) Child and Adolescent Health and Development, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Aida Filipović Hadžiomeragić
- Department of Hygiene, Health Ecology Service, Institute of Public Health of Federation of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
| | - Marina Melkumova
- Institute of Child and Adolescent Health, Arabkir Medical Centre- Institute of Child and Adolescent Health, Yerevan, Armenia
| | - Dragana Stojisavljević
- Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina.,Public Health Institute of Republic of Srpska, Banja Luka, Bosnia and Herzegovina
| | - Khadichamo Boymatova
- Division of Noncommunicable Diseases and Promoting Health through the Life-course, WHO Tajikistan Country Office, Dushanbe, Tajikistan
| | - Julianne Williams
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - João Breda
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
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7
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Heinen MM, Bel-Serrat S, Kelleher CC, Buoncristiano M, Spinelli A, Nardone P, Milanović SM, Rito AI, Bosi ATB, Gutiérrrez-González E, Pudule I, Abdrakhmanova S, Abdurrahmonova Z, Brinduse LA, Cucu A, Duleva V, Fijałkowska A, Gualtieri A, Hejgaard T, Hyska J, Kujundžić E, Petrauskiene A, Sacchini E, Shengelia L, Tanrygulyyeva M, Usupova Z, Bergh IH, Weghuber D, Taxová Braunerová R, Kunešová M, Sant'Angelo VF, Nurk E, Ostojic SM, Spiroski I, Tichá Ľ, Rutter H, Williams J, Boymatova K, Rakovac I, Weber MW, Breda J. Urban and rural differences in frequency of fruit, vegetable, and soft drink consumption among 6-9-year-old children from 19 countries from the WHO European region. Obes Rev 2021; 22 Suppl 6:e13207. [PMID: 34235832 DOI: 10.1111/obr.13207] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 12/30/2020] [Indexed: 11/28/2022]
Abstract
In order to address the paucity of evidence on the association between childhood eating habits and urbanization, this cross-sectional study describes urban-rural differences in frequency of fruit, vegetable, and soft drink consumption in 123,100 children aged 6-9 years from 19 countries participating in the fourth round (2015-2017) of the WHO European Childhood Obesity Surveillance Initiative (COSI). Children's parents/caregivers completed food-frequency questionnaires. A multivariate multilevel logistic regression analysis was performed and revealed wide variability among countries and within macroregions for all indicators. The percentage of children attending rural schools ranged from 3% in Turkey to 70% in Turkmenistan. The prevalence of less healthy eating habits was high, with between 30-80% and 30-90% children not eating fruit or vegetables daily, respectively, and up to 45% consuming soft drinks on >3 days a week. For less than one third of the countries, children attending rural schools had higher odds (OR-range: 1.1-2.1) for not eating fruit or vegetables daily or consuming soft drinks >3 days a week compared to children attending urban schools. For the remainder of the countries no significant associations were observed. Both population-based interventions and policy strategies are necessary to improve access to healthy foods and increase healthy eating behaviors among children.
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Affiliation(s)
- Mirjam M Heinen
- National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Silvia Bel-Serrat
- National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Cecily C Kelleher
- College of Health and Agricultural Sciences, University College Dublin, Dublin, Ireland
| | - Marta Buoncristiano
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Angela Spinelli
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Paola Nardone
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Sanja Musić Milanović
- Croatian Institute of Public Health, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Ana Isabel Rito
- WHO/Europe Collaborating Center for Nutrition and Childhood Obesity - Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - A Tülay Bağci Bosi
- Medical Faculty, Department of Public Health, Hacettepe University, Ankara, Turkey
| | | | - Iveta Pudule
- Department of Research and Health Statistics, Centre for Disease and Prevention Control, Riga, Latvia
| | - Shynar Abdrakhmanova
- Department of Science and Professional Development, National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan, Almaty, Kazakhstan.,Kazakhstan School of Public Health, Kazakhstan's Medical University, Almaty, Kazakhstan
| | - Zulfiya Abdurrahmonova
- Republican Centre for Nutrition, Ministry of Health and Social Protection of Population, Duschanbe, Tajikistan
| | - Lacramioara Aurelia Brinduse
- Faculty of Medicine, Department of Public Health and Management, University of Medicine and Pharmacy Carol Davila Bucharest, Bucharest, Romania.,National Centre of Health Promotion and Health Evaluation, National Institute of Public Health, Bucharest, Romania
| | - Alexandra Cucu
- National Centre of Health Promotion and Health Evaluation, National Institute of Public Health, Bucharest, Romania.,Faculty of Midwifery and Nursing, Discipline of Public Health and Health Management, University of Medicine and Pharmacy Carol Davila Bucharest, Bucharest, Romania
| | - Vesselka Duleva
- Department Food and Nutrition, National Centre of Public Health and Analyses, Sofia, Bulgaria
| | - Anna Fijałkowska
- Department of Cardiology, Institute of Mother and Child, Warsaw, Poland
| | | | - Tatjana Hejgaard
- Health Promotion and Inequality, Danish Health Authority, Copenhagen, Denmark
| | - Jolanda Hyska
- Nutrition and Food Safety Sector, Institute of Public Health, Tirana, Albania
| | - Enisa Kujundžić
- Center for Health Ecology, Institute of Public Health, Podgorica, Montenegro
| | - Ausra Petrauskiene
- Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Elena Sacchini
- Health Authority, Ministry of Health, San Marino, San Marino
| | - Lela Shengelia
- Maternal, Child and Reproductive Health, National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | - Maya Tanrygulyyeva
- Scientific Research Institute of Maternal and Child Health, Ashgabat, Turkmenistan
| | - Zhamilya Usupova
- Republican Center for Health Promotion and Mass Communication, Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan
| | - Ingunn Holden Bergh
- Department of Health and Inequality, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Daniel Weghuber
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | | | - Marie Kunešová
- Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic
| | | | - Eha Nurk
- Department of Nutrition Research, National Institute for Health Development, Tallinn, Estonia
| | - Sergej M Ostojic
- Biomedical Sciences Department, Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Igor Spiroski
- Institute of Public Health, Skopje, North Macedonia.,Faculty of Medicine, SS. Cyril and Methodius University, Skopje, North Macedonia
| | - Ľubica Tichá
- Children's Hospital National Institute of Children's Diseases, Medical Faculty, Comenius University, Bratislava, Slovakia
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Julianne Williams
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Khadichamo Boymatova
- Division of Noncommunicable Diseases and Promoting Health Through the Life-Course, WHO Country Office for Tajikistan, Dushanbe, Tajikistan
| | - Ivo Rakovac
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Martin W Weber
- World Health Organization (WHO) Child and Adolescent Health and Development, WHO Regional Office for Europe, Copenhagen, Denmark
| | - João Breda
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
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8
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Whiting S, Buoncristiano M, Gelius P, Abu-Omar K, Pattison M, Hyska J, Duleva V, Musić Milanović S, Zamrazilová H, Hejgaard T, Rasmussen M, Nurk E, Shengelia L, Kelleher CC, Heinen MM, Spinelli A, Nardone P, Abildina A, Abdrakhmanova S, Aitmurzaeva G, Usuopva Z, Pudule I, Petrauskiene A, Sant'Angelo VF, Kujundzic E, Popovic S, Fismen AS, Bergh IH, Fijalkowska A, Rito AI, Cucu A, Brinduse LA, Peterkova V, Gualtieri A, García-Solano M, Gutiérrez-González E, Abdurrahmonova Z, Boymatova K, Yardim N, Tanrygulyyeva M, Weghuber D, Schindler K, Stojisavljević D, Filipović Hadžiomeragić A, Markidou Ionnaidu E, Ahrens W, Hassapidou M, Kovacs VA, Ostojic SM, Ticha L, Starc G, Russell Jonsson K, Spiroski I, Rutter H, Mendes R, Williams J, Rakovac I, Breda J. Physical Activity, Screen Time, and Sleep Duration of Children Aged 6-9 Years in 25 Countries: An Analysis within the WHO European Childhood Obesity Surveillance Initiative (COSI) 2015-2017. Obes Facts 2021; 14:32-44. [PMID: 33352575 PMCID: PMC7983588 DOI: 10.1159/000511263] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 08/24/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Children are becoming less physically active as opportunities for safe active play, recreational activities, and active transport decrease. At the same time, sedentary screen-based activities both during school and leisure time are increasing. OBJECTIVES This study aimed to evaluate physical activity (PA), screen time, and sleep duration of girls and boys aged 6-9 years in Europe using data from the WHO European Childhood Obesity Surveillance Initiative (COSI). METHOD The fourth COSI data collection round was conducted in 2015-2017, using a standardized protocol that included a family form completed by parents with specific questions about their children's PA, screen time, and sleep duration. RESULTS Nationally representative data from 25 countries was included and information on the PA behaviour, screen time, and sleep duration of 150,651 children was analysed. Pooled analysis showed that: 79.4% were actively playing for >1 h each day, 53.9% were not members of a sport or dancing club, 50.0% walked or cycled to school each day, 60.2% engaged in screen time for <2 h/day, and 84.9% slept for 9-11 h/night. Country-specific analyses of these behaviours showed pronounced differences, with national prevalences in the range of 61.7-98.3% actively playing for >1 h/day, 8.2-85.6% were not members of a sport or dancing club, 17.7-94.0% walked or cycled to school each day, 32.3-80.0% engaged in screen time for <2 h/day, and 50.0-95.8% slept for 9-11 h/night. CONCLUSIONS The prevalence of engagement in PA and the achievement of healthy screen time and sleep duration are heterogenous across the region. Policymakers and other stakeholders, including school administrators and parents, should increase opportunities for young people to participate in daily PA as well as explore solutions to address excessive screen time and short sleep duration to improve the overall physical and mental health and well-being of children.
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Affiliation(s)
- Stephen Whiting
- WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation,
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal,
| | - Marta Buoncristiano
- WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation
| | - Peter Gelius
- Department of Sport Science and Sport, FAU, Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, FAU, Erlangen, Germany
| | - Mary Pattison
- WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation
| | - Jolanda Hyska
- Nutrition and Food Safety Sector, Institute of Public Health, Tirana, Albania
| | - Vesselka Duleva
- National Center of Public Health and Analyses, Sofia, Bulgaria
| | - Sanja Musić Milanović
- School of Medicine, University of Zagreb, Croatian Institute of Public Health, Zagreb, Croatia
| | - Hana Zamrazilová
- Institute of Endocrinology, Obesity Management Centre, Prague, Czechia
| | | | - Mette Rasmussen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Eha Nurk
- National Institute for Health Development, Tallinn, Estonia
| | - Lela Shengelia
- National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Cecily C Kelleher
- National Nutrition Surveillance Centre, University College Dublin, Dublin, Ireland
| | - Mirjam M Heinen
- National Nutrition Surveillance Centre, University College Dublin, Dublin, Ireland
| | | | | | - Akbota Abildina
- National Centre of Public Health of the Ministry of Health of the Republic of Kazakhstan, Nur-Sultan, Kazakhstan
| | - Shynar Abdrakhmanova
- National Centre of Public Health of the Ministry of Health of the Republic of Kazakhstan, Nur-Sultan, Kazakhstan
| | | | | | - Iveta Pudule
- Ministry of Health, Centre for Disease Prevention and Control, Riga, Latvia
| | - Aušra Petrauskiene
- Lithuanian University of Health Sciences, Health Research Institute and Department of Preventive Medicine, Kaunas, Lithuania
| | | | - Enisa Kujundzic
- Institute of Public Health of Montenegro, Podgorica, Montenegro
| | - Stevo Popovic
- Faculty for Sport and Physical Education, University of Montenegro, Niksic, Montenegro
| | - Anne-Siri Fismen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
| | - Ingunn Holden Bergh
- Department of Health and Inequality, Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway
| | - Anna Fijalkowska
- Department of Cardiology, Institute of Mother and Child, Warsaw, Poland
| | - Ana Isabel Rito
- National Institute of Health Dr Ricardo Jorge I.P., Lisbon, Portugal
| | | | | | | | | | - Marta García-Solano
- Spanish Agency for Food Safety and Nutrition, Ministry of Health, Madrid, Spain
| | | | - Zulfinissio Abdurrahmonova
- Republican Centre for Nutrition, Ministry of Health and Social Protection of Population, Duschanbe, Tajikistan
| | | | - Nazan Yardim
- Diabetes and Metabolic Disorders Department, Ministry of Health, Public Health Institution, Ankara, Turkey
| | - Maya Tanrygulyyeva
- Scientific Research Institute of Maternal and Child Health, Ashgabat, Turkmenistan
| | - Daniel Weghuber
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | | | - Dragana Stojisavljević
- Public Health Institute of Republic of Srpska, the University of Banja Luka, Faculty of Medicine, Banja Luka, Bosnia and Herzegovina
| | | | | | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Institute of Statistics, University of Bremen, Bremen, Germany
| | | | | | - Sergej M Ostojic
- Faculty of Sport and PE, University of Novi Sad, Novi Sad, Serbia
| | - Lubica Ticha
- National Institute of Children Diseases, Medical Faculty of Comenius University, Bratislava, Slovakia
| | - Gregor Starc
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Kenisha Russell Jonsson
- Department of Living Conditions and Lifestyle, Public Health Agency of Sweden, Solna, Sweden
| | - Igor Spiroski
- Department of Physiology and Monitoring of Nutrition, Institute of Public Health, Skopje, North Macedonia
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, United Kingdom
| | - Romeu Mendes
- WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Julianne Williams
- WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation
| | - Ivo Rakovac
- WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation
| | - João Breda
- WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation
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9
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Williams J, Buoncristiano M, Nardone P, Rito AI, Spinelli A, Hejgaard T, Kierkegaard L, Nurk E, Kunešová M, Musić Milanović S, García-Solano M, Gutiérrez-González E, Brinduse LA, Cucu A, Fijałkowska A, Farrugia Sant’Angelo V, Abdrakhmanova S, Pudule I, Duleva V, Yardim N, Gualtieri A, Heinen M, Bel-Serrat S, Usupova Z, Peterkova V, Shengelia L, Hyska J, Tanrygulyyeva M, Petrauskiene A, Rakhmatullaeva S, Kujundzic E, Ostojic SM, Weghuber D, Melkumova M, Spiroski I, Starc G, Rutter H, Rathmes G, Bunge AC, Rakovac I, Boymatova K, Weber M, Breda J. A Snapshot of European Children's Eating Habits: Results from the Fourth Round of the WHO European Childhood Obesity Surveillance Initiative (COSI). Nutrients 2020; 12:E2481. [PMID: 32824588 PMCID: PMC7468747 DOI: 10.3390/nu12082481] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 07/23/2020] [Accepted: 08/04/2020] [Indexed: 12/16/2022] Open
Abstract
Consuming a healthy diet in childhood helps to protect against malnutrition and noncommunicable diseases (NCDs). This cross-sectional study described the diets of 132,489 children aged six to nine years from 23 countries participating in round four (2015-2017) of the WHO European Childhood Obesity Surveillance Initiative (COSI). Children's parents or caregivers were asked to complete a questionnaire that contained indicators of energy-balance-related behaviors (including diet). For each country, we calculated the percentage of children who consumed breakfast, fruit, vegetables, sweet snacks or soft drinks "every day", "most days (four to six days per week)", "some days (one to three days per week)", or "never or less than once a week". We reported these results stratified by country, sex, and region. On a daily basis, most children (78.5%) consumed breakfast, fewer than half (42.5%) consumed fruit, fewer than a quarter (22.6%) consumed fresh vegetables, and around one in ten consumed sweet snacks or soft drinks (10.3% and 9.4%, respectively); however, there were large between-country differences. This paper highlights an urgent need to create healthier food and drink environments, reinforce health systems to promote healthy diets, and continue to support child nutrition and obesity surveillance.
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Affiliation(s)
- Julianne Williams
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, 125009 Moscow, Russian Federation; (M.B.); (G.R.); (A.C.B.); (I.R.); (J.B.)
| | - Marta Buoncristiano
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, 125009 Moscow, Russian Federation; (M.B.); (G.R.); (A.C.B.); (I.R.); (J.B.)
| | - Paola Nardone
- Italian National Institute of Health (Istituto Superiore Di Sanità), 00161 Rome, Italy; (P.N.); (A.S.)
| | - Ana Isabel Rito
- National Institute of Health Dr. Ricardo Jorge, 1600 560 Lisbon, Portugal;
| | - Angela Spinelli
- Italian National Institute of Health (Istituto Superiore Di Sanità), 00161 Rome, Italy; (P.N.); (A.S.)
| | | | - Lene Kierkegaard
- National Institute of Public Health, University of Southern Denmark, 1455 Copenhagen K, Denmark;
| | - Eha Nurk
- Department of Nutrition Research, National Institute for Health Development, 11619 Tallinn, Estonia;
| | - Marie Kunešová
- Institute of Endocrinology, Obesity Unit, 116 94 Prague, Czechia;
| | - Sanja Musić Milanović
- Croatian Institute of Public Health, University of Zagreb, School of Medicine, 10000 Zagreb, Croatia;
| | - Marta García-Solano
- Spanish Agency for Food Safety and Nutrition, 28014 Madrid, Spain; (M.G.-S.); (E.G.-G.)
| | | | - Lacramioara Aurelia Brinduse
- Department of Public Health and Management, University of Medicine and Pharmacy Carol Davila, 030167 Bucharest, Romania; (L.A.B.); (A.C.)
| | - Alexandra Cucu
- Department of Public Health and Management, University of Medicine and Pharmacy Carol Davila, 030167 Bucharest, Romania; (L.A.B.); (A.C.)
| | - Anna Fijałkowska
- Department of Cardiology, Institute of Mother and Child, 01-211 Warsaw, Poland;
| | | | - Shynar Abdrakhmanova
- National Center of Public health, Ministry of Health of the Republic of Kazakhstan, 010000 Nur-Sultan City, Kazakhstan;
| | - Iveta Pudule
- Centre for Disease Prevention and Control, LV-1005 Latvia, Riga;
| | - Vesselka Duleva
- National Center of Public Health and Analyses, 1431 Sofia, Bulgaria;
| | - Nazan Yardim
- Turkish Ministry of Health, Public Health General Directorate, 34400 Istanbul, Turkey;
| | - Andrea Gualtieri
- Health Authority, Department of Health and Social Security, 47893 San Marino, San Marino;
| | - Mirjam Heinen
- National Nutrition Surveillance Centre, University College Dublin, Dublin, Ireland; (M.H.); (S.B.-S.)
| | - Silvia Bel-Serrat
- National Nutrition Surveillance Centre, University College Dublin, Dublin, Ireland; (M.H.); (S.B.-S.)
| | - Zhamyla Usupova
- Republican Center for Health Promotion and Mass Communication, 720040 Bishkek, Kyrgyzstan;
| | - Valentina Peterkova
- Institute of Paediatric Endocrinology, National Medical Research Centre for Endocrinology of the Ministry of Health of the Russian Federation, 117036 Moscow, Russian Federation;
| | - Lela Shengelia
- National Center for Disease Control and Public Health of Georgia, 0198 Tbilisi, Georgia;
| | | | - Maya Tanrygulyyeva
- Internal Diseases Department of the Scientific Clinical Centre of Mother and Child Health, 744036 Ashgabat, Turkmenistan;
| | - Ausra Petrauskiene
- Department of Preventive Medicine, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania;
| | - Sanavbar Rakhmatullaeva
- Department for Organization of Health Services to Children, Mothers, Adolescents and Family Planning, Ministry of Health and Social Protection of Population, 734025 Dushanbe, Tajikistan;
| | - Enisa Kujundzic
- Institute of Public Health of Montenegro, 81 000 Podgorica, Montenegro;
| | - Sergej M. Ostojic
- Applied Bioenergetics Lab, University of Novi Sad, 21000 Novi Sad, Serbia;
| | - Daniel Weghuber
- Department of Pediatrics, Paracelsus Medical University, 5020 Salzburg, Austria;
| | - Marina Melkumova
- Arabkir Medical Centre-Institute of Child and Adolescent Health, 0014 Yerevan, Armenia;
| | - Igor Spiroski
- Institute of Public Health, Faculty of Medicine, Ss. Cyril and Methodius University, 1000 Skopje, North Macedonia;
| | - Gregor Starc
- Faculty of Sport, University of Ljubljana, 1000 Ljubljana, Slovenia;
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath BA2 7AY, UK;
| | - Giulia Rathmes
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, 125009 Moscow, Russian Federation; (M.B.); (G.R.); (A.C.B.); (I.R.); (J.B.)
| | - Anne Charlotte Bunge
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, 125009 Moscow, Russian Federation; (M.B.); (G.R.); (A.C.B.); (I.R.); (J.B.)
| | - Ivo Rakovac
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, 125009 Moscow, Russian Federation; (M.B.); (G.R.); (A.C.B.); (I.R.); (J.B.)
| | | | - Martin Weber
- WHO Child and Adolescent Health and Development, WHO Regional Office for Europe, 2100 Copenhagen, Denmark;
| | - João Breda
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, 125009 Moscow, Russian Federation; (M.B.); (G.R.); (A.C.B.); (I.R.); (J.B.)
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Chang AY, Cowling K, Micah AE, Chapin A, Chen CS, Ikilezi G, Sadat N, Tsakalos G, Wu J, Younker T, Zhao Y, Zlavog BS, Abbafati C, Ahmed AE, Alam K, Alipour V, Aljunid SM, Almalki MJ, Alvis-Guzman N, Ammar W, Andrei CL, Anjomshoa M, Antonio CAT, Arabloo J, Aremu O, Ausloos M, Avila-Burgos L, Awasthi A, Ayanore MA, Azari S, Azzopardi-Muscat N, Bagherzadeh M, Bärnighausen TW, Baune BT, Bayati M, Belay YB, Belay YA, Belete H, Berbada DA, Berman AE, Beuran M, Bijani A, Busse R, Cahuana-Hurtado L, Cámera LA, Catalá-López F, Chauhan BG, Constantin MM, Crowe CS, Cucu A, Dalal K, De Neve JW, Deiparine S, Demeke FM, Do HP, Dubey M, El Tantawi M, Eskandarieh S, Esmaeili R, Fakhar M, Fazaeli AA, Fischer F, Foigt NA, Fukumoto T, Fullman N, Galan A, Gamkrelidze A, Gezae KE, Ghajar A, Ghashghaee A, Goginashvili K, Haakenstad A, Haghparast Bidgoli H, Hamidi S, Harb HL, Hasanpoor E, Hassen HY, Hay SI, Hendrie D, Henok A, Heredia-Pi I, Herteliu C, Hoang CL, Hole MK, Homaie Rad E, Hossain N, Hosseinzadeh M, Hostiuc S, Ilesanmi OS, Irvani SSN, Jakovljevic M, Jalali A, James SL, Jonas JB, Jürisson M, Kadel R, Karami Matin B, Kasaeian A, Kasaye HK, Kassaw MW, Kazemi Karyani A, Khabiri R, Khan J, Khan MN, Khang YH, Kisa A, Kissimova-Skarbek K, Kohler S, Koyanagi A, Krohn KJ, Leung R, Lim LL, Lorkowski S, Majeed A, Malekzadeh R, Mansourian M, Mantovani LG, Massenburg BB, McKee M, Mehta V, Meretoja A, Meretoja TJ, Milevska Kostova N, Miller TR, Mirrakhimov EM, Mohajer B, Mohammad Darwesh A, Mohammed S, Mohebi F, Mokdad AH, Morrison SD, Mousavi SM, Muthupandian S, Nagarajan AJ, Nangia V, Negoi I, Nguyen CT, Nguyen HLT, Nguyen SH, Nosratnejad S, Oladimeji O, Olgiati S, Olusanya JO, Onwujekwe OE, Otstavnov SS, Pana A, Pereira DM, Piroozi B, Prada SI, Qorbani M, Rabiee M, Rabiee N, Rafiei A, Rahim F, Rahimi-Movaghar V, Ram U, Ranabhat CL, Ranta A, Rawaf DL, Rawaf S, Rezaei S, Roro EM, Rostami A, Rubino S, Salahshoor M, Samy AM, Sanabria J, Santos JV, Santric Milicevic MM, Sao Jose BP, Savic M, Schwendicke F, Sepanlou SG, Sepehrimanesh M, Sheikh A, Shrime MG, Sisay S, Soltani S, Soofi M, Soofi M, Srinivasan V, Tabarés-Seisdedos R, Torre A, Tovani-Palone MR, Tran BX, Tran KB, Undurraga EA, Valdez PR, van Boven JFM, Vargas V, Veisani Y, Violante FS, Vladimirov SK, Vlassov V, Vollmer S, Vu GT, Wolfe CDA, Yonemoto N, Younis MZ, Yousefifard M, Zaman SB, Zangeneh A, Zegeye EA, Ziapour A, Chew A, Murray CJL, Dieleman JL. Past, present, and future of global health financing: a review of development assistance, government, out-of-pocket, and other private spending on health for 195 countries, 1995-2050. Lancet 2019; 393:2233-2260. [PMID: 31030984 PMCID: PMC6548764 DOI: 10.1016/s0140-6736(19)30841-4] [Citation(s) in RCA: 213] [Impact Index Per Article: 42.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 03/22/2019] [Accepted: 03/27/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Comprehensive and comparable estimates of health spending in each country are a key input for health policy and planning, and are necessary to support the achievement of national and international health goals. Previous studies have tracked past and projected future health spending until 2040 and shown that, with economic development, countries tend to spend more on health per capita, with a decreasing share of spending from development assistance and out-of-pocket sources. We aimed to characterise the past, present, and predicted future of global health spending, with an emphasis on equity in spending across countries. METHODS We estimated domestic health spending for 195 countries and territories from 1995 to 2016, split into three categories-government, out-of-pocket, and prepaid private health spending-and estimated development assistance for health (DAH) from 1990 to 2018. We estimated future scenarios of health spending using an ensemble of linear mixed-effects models with time series specifications to project domestic health spending from 2017 through 2050 and DAH from 2019 through 2050. Data were extracted from a broad set of sources tracking health spending and revenue, and were standardised and converted to inflation-adjusted 2018 US dollars. Incomplete or low-quality data were modelled and uncertainty was estimated, leading to a complete data series of total, government, prepaid private, and out-of-pocket health spending, and DAH. Estimates are reported in 2018 US dollars, 2018 purchasing-power parity-adjusted dollars, and as a percentage of gross domestic product. We used demographic decomposition methods to assess a set of factors associated with changes in government health spending between 1995 and 2016 and to examine evidence to support the theory of the health financing transition. We projected two alternative future scenarios based on higher government health spending to assess the potential ability of governments to generate more resources for health. FINDINGS Between 1995 and 2016, health spending grew at a rate of 4·00% (95% uncertainty interval 3·89-4·12) annually, although it grew slower in per capita terms (2·72% [2·61-2·84]) and increased by less than $1 per capita over this period in 22 of 195 countries. The highest annual growth rates in per capita health spending were observed in upper-middle-income countries (5·55% [5·18-5·95]), mainly due to growth in government health spending, and in lower-middle-income countries (3·71% [3·10-4·34]), mainly from DAH. Health spending globally reached $8·0 trillion (7·8-8·1) in 2016 (comprising 8·6% [8·4-8·7] of the global economy and $10·3 trillion [10·1-10·6] in purchasing-power parity-adjusted dollars), with a per capita spending of US$5252 (5184-5319) in high-income countries, $491 (461-524) in upper-middle-income countries, $81 (74-89) in lower-middle-income countries, and $40 (38-43) in low-income countries. In 2016, 0·4% (0·3-0·4) of health spending globally was in low-income countries, despite these countries comprising 10·0% of the global population. In 2018, the largest proportion of DAH targeted HIV/AIDS ($9·5 billion, 24·3% of total DAH), although spending on other infectious diseases (excluding tuberculosis and malaria) grew fastest from 2010 to 2018 (6·27% per year). The leading sources of DAH were the USA and private philanthropy (excluding corporate donations and the Bill & Melinda Gates Foundation). For the first time, we included estimates of China's contribution to DAH ($644·7 million in 2018). Globally, health spending is projected to increase to $15·0 trillion (14·0-16·0) by 2050 (reaching 9·4% [7·6-11·3] of the global economy and $21·3 trillion [19·8-23·1] in purchasing-power parity-adjusted dollars), but at a lower growth rate of 1·84% (1·68-2·02) annually, and with continuing disparities in spending between countries. In 2050, we estimate that 0·6% (0·6-0·7) of health spending will occur in currently low-income countries, despite these countries comprising an estimated 15·7% of the global population by 2050. The ratio between per capita health spending in high-income and low-income countries was 130·2 (122·9-136·9) in 2016 and is projected to remain at similar levels in 2050 (125·9 [113·7-138·1]). The decomposition analysis identified governments' increased prioritisation of the health sector and economic development as the strongest factors associated with increases in government health spending globally. Future government health spending scenarios suggest that, with greater prioritisation of the health sector and increased government spending, health spending per capita could more than double, with greater impacts in countries that currently have the lowest levels of government health spending. INTERPRETATION Financing for global health has increased steadily over the past two decades and is projected to continue increasing in the future, although at a slower pace of growth and with persistent disparities in per-capita health spending between countries. Out-of-pocket spending is projected to remain substantial outside of high-income countries. Many low-income countries are expected to remain dependent on development assistance, although with greater government spending, larger investments in health are feasible. In the absence of sustained new investments in health, increasing efficiency in health spending is essential to meet global health targets. FUNDING Bill & Melinda Gates Foundation.
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11
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Spinelli A, Buoncristiano M, Kovacs VA, Yngve A, Spiroski I, Obreja G, Starc G, Pérez N, Rito AI, Kunešová M, Sant'Angelo VF, Meisfjord J, Bergh IH, Kelleher C, Yardim N, Pudule I, Petrauskiene A, Duleva V, Sjöberg A, Gualtieri A, Hassapidou M, Hyska J, Burazeri G, Petrescu CH, Heinen M, Takacs H, Zamrazilová H, Bosi TB, Sacchini E, Pagkalos I, Cucu A, Nardone P, Gately P, Williams J, Breda J. Prevalence of Severe Obesity among Primary School Children in 21 European Countries. Obes Facts 2019; 12:244-258. [PMID: 31030201 PMCID: PMC6547273 DOI: 10.1159/000500436] [Citation(s) in RCA: 146] [Impact Index Per Article: 29.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 04/17/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) was established more than 10 years ago to estimate prevalence and monitor changes in overweight and obesity in children aged 6-9 years. Since then, there have been five rounds of data collection in more than 40 countries involving more than half a million children. To date, no comparative studies with data on severe childhood obesity from European countries have been published. OBJECTIVES The aim of this work was to present the prevalence of severe obesity in school-aged children from 21 countries participating in COSI. METHOD The data are from cross-sectional studies in 21 European WHO member states that took part in the first three COSI rounds of data collection (2007/2008, 2009/2010, 2012/2013). School-aged children were measured using standardized instruments and methodology. Children were classified as severely obese using the definitions provided by WHO and the International Obesity Task Force (IOTF). Analyses overtime, by child's age and mother's educational level, were performed in a select group of countries. RESULTS A total of 636,933 children were included in the analysis (323,648 boys and 313,285 girls). The prevalence of severe obesity varied greatly among countries, with higher values in Southern Europe. According to the WHO definition, severe obesity ranged from 1.0% in Swedish and Moldovan children (95% CI 0.7-1.3 and 0.7-1.5, respectively) to 5.5% (95% CI 4.9-6.1) in Maltese children. The prevalence was generally higher among boys compared to girls. The IOTF cut-offs lead to lower estimates, but confirm the differences among countries, and were more similar for both boys and girls. In many countries 1 in 4 obese children were severely obese. Applying the estimates of prevalence based on the WHO definition to the whole population of children aged 6-9 years in each country, around 398,000 children would be expected to be severely obese in the 21 European countries. The trend between 2007 and 2013 and the analysis by child's age did not show a clear pattern. Severe obesity was more common among children whose mother's educational level was lower. CONCLUSIONS Severe obesity is a serious public health issue which affects a large number of children in Europe. Because of the impact on educational, health, social care, and economic systems, obesity needs to be addressed via a range of approaches from early prevention of overweight and obesity to treatment of those who need it.
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Affiliation(s)
- Angela Spinelli
- Istituto Superiore di Sanità (National Institute of Health), National Centre for Disease Prevention and Health Promotion, Rome, Italy,
| | - Marta Buoncristiano
- WHO European Office for the Prevention and Control of the NCDs, Moscow, Russian Federation
| | - Viktoria Anna Kovacs
- National Institute of Pharmacy and Nutrition, DG of Food and Nutrition Science, Budapest, Hungary
| | - Agneta Yngve
- Department of food studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - Igor Spiroski
- Institute of Public Health of the Republic of Macedonia, Skopje, North Macedonia
| | - Galina Obreja
- State University of Medicine and Pharmacy, Chișinău, Moldova
| | - Gregor Starc
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Napoleón Pérez
- Spanish Observatory of Nutrition and Study of Obesity, Madrid, Spain
| | - Ana Isabel Rito
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Marie Kunešová
- Obesity Management Centre, Institute of Endocrinology, Prague, Czechia
| | | | - Jørgen Meisfjord
- Department of Health and Inequality, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Ingunn Holden Bergh
- Department of Child Health and Development, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | | | | | - Iveta Pudule
- Centre for Disease Prevention and Control, Riga, Latvia
| | - Ausra Petrauskiene
- Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Vesselka Duleva
- National Center of Public Health and Analyses, Sofia, Bulgaria
| | - Agneta Sjöberg
- Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | | | - Maria Hassapidou
- Department of Nutrition and Dietetics, Alexander Technological Educational Institute of Thessaloniki, Thessaloniki, Greece
| | | | | | | | | | - Hajnalka Takacs
- Semmelweis University, Karoly Racz School of PhD Studies, Budapest, Hungary
| | - Hana Zamrazilová
- Obesity Management Centre, Institute of Endocrinology, Prague, Czechia
| | | | | | - Ioannis Pagkalos
- Department of Nutrition and Dietetics, Alexander Technological Educational Institute of Thessaloniki, Thessaloniki, Greece
| | | | - Paola Nardone
- Istituto Superiore di Sanità (National Institute of Health), National Centre for Disease Prevention and Health Promotion, Rome, Italy
| | - Paul Gately
- Centre for Applied Obesity Research, Leeds Beckett University, Leeds, United Kingdom
| | - Julianne Williams
- WHO European Office for the Prevention and Control of the NCDs, Moscow, Russian Federation
| | - João Breda
- WHO European Office for the Prevention and Control of the NCDs, Moscow, Russian Federation
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Global, regional, and national age-sex-specific mortality and life expectancy, 1950-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392:1684-1735. [PMID: 30496102 PMCID: PMC6227504 DOI: 10.1016/s0140-6736(18)31891-9] [Citation(s) in RCA: 575] [Impact Index Per Article: 95.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 07/14/2018] [Accepted: 08/08/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Assessments of age-specific mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Affairs (UNPOP), the United States Census Bureau, WHO, and as part of previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Previous iterations of the GBD used population estimates from UNPOP, which were not derived in a way that was internally consistent with the estimates of the numbers of deaths in the GBD. The present iteration of the GBD, GBD 2017, improves on previous assessments and provides timely estimates of the mortality experience of populations globally. METHODS The GBD uses all available data to produce estimates of mortality rates between 1950 and 2017 for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries. Data used include vital registration systems, sample registration systems, household surveys (complete birth histories, summary birth histories, sibling histories), censuses (summary birth histories, household deaths), and Demographic Surveillance Sites. In total, this analysis used 8259 data sources. Estimates of the probability of death between birth and the age of 5 years and between ages 15 and 60 years are generated and then input into a model life table system to produce complete life tables for all locations and years. Fatal discontinuities and mortality due to HIV/AIDS are analysed separately and then incorporated into the estimation. We analyse the relationship between age-specific mortality and development status using the Socio-demographic Index, a composite measure based on fertility under the age of 25 years, education, and income. There are four main methodological improvements in GBD 2017 compared with GBD 2016: 622 additional data sources have been incorporated; new estimates of population, generated by the GBD study, are used; statistical methods used in different components of the analysis have been further standardised and improved; and the analysis has been extended backwards in time by two decades to start in 1950. FINDINGS Globally, 18·7% (95% uncertainty interval 18·4-19·0) of deaths were registered in 1950 and that proportion has been steadily increasing since, with 58·8% (58·2-59·3) of all deaths being registered in 2015. At the global level, between 1950 and 2017, life expectancy increased from 48·1 years (46·5-49·6) to 70·5 years (70·1-70·8) for men and from 52·9 years (51·7-54·0) to 75·6 years (75·3-75·9) for women. Despite this overall progress, there remains substantial variation in life expectancy at birth in 2017, which ranges from 49·1 years (46·5-51·7) for men in the Central African Republic to 87·6 years (86·9-88·1) among women in Singapore. The greatest progress across age groups was for children younger than 5 years; under-5 mortality dropped from 216·0 deaths (196·3-238·1) per 1000 livebirths in 1950 to 38·9 deaths (35·6-42·83) per 1000 livebirths in 2017, with huge reductions across countries. Nevertheless, there were still 5·4 million (5·2-5·6) deaths among children younger than 5 years in the world in 2017. Progress has been less pronounced and more variable for adults, especially for adult males, who had stagnant or increasing mortality rates in several countries. The gap between male and female life expectancy between 1950 and 2017, while relatively stable at the global level, shows distinctive patterns across super-regions and has consistently been the largest in central Europe, eastern Europe, and central Asia, and smallest in south Asia. Performance was also variable across countries and time in observed mortality rates compared with those expected on the basis of development. INTERPRETATION This analysis of age-sex-specific mortality shows that there are remarkably complex patterns in population mortality across countries. The findings of this study highlight global successes, such as the large decline in under-5 mortality, which reflects significant local, national, and global commitment and investment over several decades. However, they also bring attention to mortality patterns that are a cause for concern, particularly among adult men and, to a lesser extent, women, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasing. FUNDING Bill & Melinda Gates Foundation.
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Ciobanu M, Iosif I, Calomfirescu C, Brinduse L, Stuckler D, Reeves A, Snell A, Mauer-Stender K, Mikkelsen B, Cucu A. Variation across Romania in the health impact of increasing tobacco taxation. Eur J Public Health 2018; 28:10-13. [PMID: 30371834 PMCID: PMC6204550 DOI: 10.1093/eurpub/cky180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background Tobacco is the leading preventable cause of death globally and tobacco taxation is a cost-effective method of reducing tobacco use in countries and increasing revenue. However, without adequate enforcement some argue the risk of increasing illicit trade in cheap tobacco makes taxation ineffective. We explore this by testing sub-national variations in the impact of tobacco tax increases from 2009 to 2011, on seven smoking-related diseases in adults in Romania, to see if regions that are prone to cigarette smuggling due to bordering other countries see less benefit. Method We use a pragmatic natural experiment study approach to analyse the study period 2009-15. Findings from hospital episodes data relating to smoking-attributable diseases are analysed for six regional subgroups which are compared according to border characteristics with other countries. Results At a national level smoking-attributable diseases reduced over the study period especially around the tax increase years, with asthma showing the most significant decline. Sub-nationally there was no statistically significant correlation in variations between central regions and those bordering other countries. Conclusion There is a reassuring decline in hospitalizations for smoking-related diseases associated with the tax increases, and no sub-national association with smuggling risk measured by variation in the size of this effect and regions that border other countries. More comprehensive and progressive tobacco control in Romania should be implemented in line with the WHO Framework Convention for Tobacco Control.
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Affiliation(s)
- Magdalena Ciobanu
- Institutul National de Pneumoftiziologie “Marius Nasta” Bucuresti, Romania
| | - Ionel Iosif
- Institutul National de Sanatate Publica, Bucuresti, Romania
| | | | | | - David Stuckler
- Department of Social and Political Sciences, Università Bocconi, Milan, Italy
| | - Aaron Reeves
- Department of Social Policy and Intervention, University of Oxford, Oxford, England
| | - Andrew Snell
- World Health Organisation Regional Office for Europe, Copenhagen, Denmark
| | | | - Bente Mikkelsen
- World Health Organisation Regional Office for Europe, Copenhagen, Denmark
| | - Alexandra Cucu
- Institutul National de Sanatate Publica, Bucuresti, Romania
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Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet 2017; 390:2627-2642. [PMID: 29029897 PMCID: PMC5735219 DOI: 10.1016/s0140-6736(17)32129-3] [Citation(s) in RCA: 3623] [Impact Index Per Article: 517.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 07/12/2017] [Accepted: 07/19/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults. METHODS We pooled 2416 population-based studies with measurements of height and weight on 128·9 million participants aged 5 years and older, including 31·5 million aged 5-19 years. We used a Bayesian hierarchical model to estimate trends from 1975 to 2016 in 200 countries for mean BMI and for prevalence of BMI in the following categories for children and adolescents aged 5-19 years: more than 2 SD below the median of the WHO growth reference for children and adolescents (referred to as moderate and severe underweight hereafter), 2 SD to more than 1 SD below the median (mild underweight), 1 SD below the median to 1 SD above the median (healthy weight), more than 1 SD to 2 SD above the median (overweight but not obese), and more than 2 SD above the median (obesity). FINDINGS Regional change in age-standardised mean BMI in girls from 1975 to 2016 ranged from virtually no change (-0·01 kg/m2 per decade; 95% credible interval -0·42 to 0·39, posterior probability [PP] of the observed decrease being a true decrease=0·5098) in eastern Europe to an increase of 1·00 kg/m2 per decade (0·69-1·35, PP>0·9999) in central Latin America and an increase of 0·95 kg/m2 per decade (0·64-1·25, PP>0·9999) in Polynesia and Micronesia. The range for boys was from a non-significant increase of 0·09 kg/m2 per decade (-0·33 to 0·49, PP=0·6926) in eastern Europe to an increase of 0·77 kg/m2 per decade (0·50-1·06, PP>0·9999) in Polynesia and Micronesia. Trends in mean BMI have recently flattened in northwestern Europe and the high-income English-speaking and Asia-Pacific regions for both sexes, southwestern Europe for boys, and central and Andean Latin America for girls. By contrast, the rise in BMI has accelerated in east and south Asia for both sexes, and southeast Asia for boys. Global age-standardised prevalence of obesity increased from 0·7% (0·4-1·2) in 1975 to 5·6% (4·8-6·5) in 2016 in girls, and from 0·9% (0·5-1·3) in 1975 to 7·8% (6·7-9·1) in 2016 in boys; the prevalence of moderate and severe underweight decreased from 9·2% (6·0-12·9) in 1975 to 8·4% (6·8-10·1) in 2016 in girls and from 14·8% (10·4-19·5) in 1975 to 12·4% (10·3-14·5) in 2016 in boys. Prevalence of moderate and severe underweight was highest in India, at 22·7% (16·7-29·6) among girls and 30·7% (23·5-38·0) among boys. Prevalence of obesity was more than 30% in girls in Nauru, the Cook Islands, and Palau; and boys in the Cook Islands, Nauru, Palau, Niue, and American Samoa in 2016. Prevalence of obesity was about 20% or more in several countries in Polynesia and Micronesia, the Middle East and north Africa, the Caribbean, and the USA. In 2016, 75 (44-117) million girls and 117 (70-178) million boys worldwide were moderately or severely underweight. In the same year, 50 (24-89) million girls and 74 (39-125) million boys worldwide were obese. INTERPRETATION The rising trends in children's and adolescents' BMI have plateaued in many high-income countries, albeit at high levels, but have accelerated in parts of Asia, with trends no longer correlated with those of adults. FUNDING Wellcome Trust, AstraZeneca Young Health Programme.
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Croitoru C, Turliuc D, Danciu F, Cucu A, Costea C. The miracle of St. Alfege’s Hospital and the history of the treatment of myasthenia gravis. Romanian Neurosurgery 2017. [DOI: 10.1515/romneu-2017-0011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Having a recent history, the neurological condition called myasthenia gravis has raised dilemmas and questions among doctors since it was first discovered in the 16th century and it has not ceased to be a challenge. Nowadays, neuroscience researchers from around the world have been striving to perfect a modern treatment of this condition. Our paper is an incursion into the past, more precisely into the history of the treatment of this disease, from its origin to date, when immunological therapy has progressed.
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Turliuc D, Cucu A, Sandu R, Dumitrescu G, Costea C. Spinal schwannomatosis of the cauda equina in the absence of neurofibromatosis: case report and treatment strategies. Romanian Neurosurgery 2017. [DOI: 10.1515/romneu-2017-0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AbstractSchwannomatosis is a rare tumor syndrome characterized by the presence of multiple benign non-vestibular, non-intradermal schwannomas and by the absence of neurofibromatosis type 1 or 2 syndromes. Multiple schwannomas are clinically and genetically distinct from neurofibromatosis, and the main treatment in case of symptomatic lesions is represented by surgical resection. In case of asymptomatic lesions, the indicated treatment is neuroimaging follow-up (MRI). We are presenting the case of a patient with three schwannomas of the cauda equina, as well as the treatment strategy in the case of this rare pathology.
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Oestreicher U, Samaga D, Ainsbury E, Antunes AC, Baeyens A, Barrios L, Beinke C, Beukes P, Blakely WF, Cucu A, De Amicis A, Depuydt J, De Sanctis S, Di Giorgio M, Dobos K, Dominguez I, Duy PN, Espinoza ME, Flegal FN, Figel M, Garcia O, Monteiro Gil O, Gregoire E, Guerrero-Carbajal C, Güçlü İ, Hadjidekova V, Hande P, Kulka U, Lemon J, Lindholm C, Lista F, Lumniczky K, Martinez-Lopez W, Maznyk N, Meschini R, M’kacher R, Montoro A, Moquet J, Moreno M, Noditi M, Pajic J, Radl A, Ricoul M, Romm H, Roy L, Sabatier L, Sebastià N, Slabbert J, Sommer S, Stuck Oliveira M, Subramanian U, Suto Y, Que T, Testa A, Terzoudi G, Vral A, Wilkins R, Yanti L, Zafiropoulos D, Wojcik A. RENEB intercomparisons applying the conventional Dicentric Chromosome Assay (DCA). Int J Radiat Biol 2016; 93:20-29. [DOI: 10.1080/09553002.2016.1233370] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Ursula Oestreicher
- Bundesamt fuer Strahlenschutz, Department Radiation Protection and Health, Oberschleissheim, Germany
| | - Daniel Samaga
- Bundesamt fuer Strahlenschutz, Department Radiation Protection and Health, Oberschleissheim, Germany
| | - Elizabeth Ainsbury
- Public Health England, Centre for Radiation Chemical and Environmental Hazards, Chilton, Oxfordshire, UK
| | - Ana Catarina Antunes
- Centro de Ciências e Tecnologias Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Bobadela-LRS, Lisbon, Portugal
| | | | | | - Christina Beinke
- Bundeswehr Institute of Radiobiology affiliated to the University of Ulm, Munich, Germany
| | | | - William F. Blakely
- Armed Forces Radiobiology Research Institute, Uniformed Service University of the Health Sciences, Bethesda, USA
| | | | | | - Julie Depuydt
- Faculty of Medicine and Health Sciences, Universiteit Gent, Gent, Belgium
| | | | | | - Katalin Dobos
- National Research Institute for Radiobiology & Radiohygiene, Budapest, Hungary
| | | | - Pham Ngoc Duy
- Center of Biotechnology, Nuclear Research Institute, Dalat, Vietnam
| | | | - Farrah N. Flegal
- Canadian Nuclear Laboratories, Radiobiology & Health, Chalk River, Ontario, Canada
| | - Markus Figel
- Helmholtz Zentrum München, Auswertungsstelle für Strahlendosimeter
| | - Omar Garcia
- Centro de Protección e Higiene de las Radiaciones (CPHR), La Havana. Cuba
| | - Octávia Monteiro Gil
- Centro de Ciências e Tecnologias Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Bobadela-LRS, Lisbon, Portugal
| | - Eric Gregoire
- Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | | | - İnci Güçlü
- Turkish Atomic Energy Authority, Cekmece Nuclear Research and Traning Center Radiobiology Unit Yarımburgaz, Istanbul, Turkey
| | | | - Prakash Hande
- Department of Physiology, Yong Loo Lin School of Medicine: National University of Singapore, Singapore
| | - Ulrike Kulka
- Bundesamt fuer Strahlenschutz, Department Radiation Protection and Health, Oberschleissheim, Germany
| | | | | | - Florigio Lista
- Army Medical and Veterinary Research Center, Rome, Italy
| | - Katalin Lumniczky
- National Research Institute for Radiobiology & Radiohygiene, Budapest, Hungary
| | | | - Nataliya Maznyk
- Institute for Medical Radiology of National Academy of Medical Science of Ukraine, Kharkiv, Ukraine
| | | | - Radia M’kacher
- PROCyTOX, Commissariat à l’Energie Atomique et aux Energies Alternatives, Fontenay-aux-Roses, France and Université Paris-Saclay, France
| | - Alegria Montoro
- Fundacion para la Investigation del Hospital Universitario la Fe de la Comunidad Valenciana, Valencia, Spain
| | - Jayne Moquet
- Public Health England, Centre for Radiation Chemical and Environmental Hazards, Chilton, Oxfordshire, UK
| | - Mercedes Moreno
- Servicio Madrileño de Salud – Hospital General Universitario Gregorio Marañón, Spain
| | | | - Jelena Pajic
- Serbian Institute of Occupational Health, Radiation Protection Center, Belgrade, Serbia
| | - Analía Radl
- Autoridad Regulatoria Nuclear (ARN), Buenos Aires, Argentina
| | - Michelle Ricoul
- PROCyTOX, Commissariat à l’Energie Atomique et aux Energies Alternatives, Fontenay-aux-Roses, France and Université Paris-Saclay, France
| | - Horst Romm
- Bundesamt fuer Strahlenschutz, Department Radiation Protection and Health, Oberschleissheim, Germany
| | - Laurence Roy
- Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | - Laure Sabatier
- PROCyTOX, Commissariat à l’Energie Atomique et aux Energies Alternatives, Fontenay-aux-Roses, France and Université Paris-Saclay, France
| | - Natividad Sebastià
- Fundacion para la Investigation del Hospital Universitario la Fe de la Comunidad Valenciana, Valencia, Spain
| | | | | | | | - Uma Subramanian
- Armed Forces Radiobiology Research Institute, Uniformed Service University of the Health Sciences, Bethesda, USA
| | - Yumiko Suto
- National Institute of Radiological Sciences, Chiba, Japan
| | - Tran Que
- Center of Biotechnology, Nuclear Research Institute, Dalat, Vietnam
| | - Antonella Testa
- Agenzia Nazionale per le Nuove Tecnologie, ĹEnergia e lo Sviluppo Economico Sostenibile, Rome, Italy
| | - Georgia Terzoudi
- National Center for Scientific Research “Demokritos”, NCSR”D”, Greece
| | - Anne Vral
- Faculty of Medicine and Health Sciences, Universiteit Gent, Gent, Belgium
| | | | - LusiYanti Yanti
- Center for Technology of Radiation Safety and Metrology, National Nuclear Energy Agency, Batan, Indonesia
| | | | - Andrzej Wojcik
- Stockholm University, Institute Molecular Biosciences, Stockholm, Sweden
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Kulka U, Abend M, Ainsbury E, Badie C, Barquinero JF, Barrios L, Beinke C, Bortolin E, Cucu A, De Amicis A, Domínguez I, Fattibene P, Frøvig, AM, Gregoire E, Guogyte K, Hadjidekova V, Jaworska A, Kriehuber R, Lindholm C, Lloyd D, Lumniczky K, Lyng F, Meschini R, Mörtl S, Della Monaca S, Monteiro Gil O, Montoro A, Moquet J, Moreno M, Oestreicher U, Palitti F, Pantelias G, Patrono C, Piqueret-Stephan L, Port M, Prieto MJ, Quintens R, Ricoul M, Romm H, Roy L, Sáfrány G, Sabatier L, Sebastià N, Sommer S, Terzoudi G, Testa A, Thierens H, Turai I, Trompier F, Valente M, Vaz P, Voisin P, Vral A, Woda C, Zafiropoulos D, Wojcik A. RENEB – Running the European Network of biological dosimetry and physical retrospective dosimetry. Int J Radiat Biol 2016; 93:2-14. [DOI: 10.1080/09553002.2016.1230239] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Ulrike Kulka
- Bundesamt für Strahlenschutz, Department Radiation Protection and Health, Oberschleissheim, Germany
| | - Michael Abend
- Bundeswehr Institute of Radiobiology affiliated to the University of Ulm, Munich, Germany
| | | | | | | | | | - Christina Beinke
- Bundeswehr Institute of Radiobiology affiliated to the University of Ulm, Munich, Germany
| | | | | | | | | | | | | | - Eric Gregoire
- Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | | | | | | | | | | | - David Lloyd
- affiliated to Public Health England, CRCE, Chilton, Didcot, Oxon, UK
| | - Katalin Lumniczky
- National Public Health Centre – National Research Directorate for Radiobiology and Radiohygiene, Budapest, Hungary
| | - Fiona Lyng
- Dublin Institute of Technology, Dublin, Ireland
| | | | - Simone Mörtl
- HelmholtzZentrum München, Oberschleissheim, Germany
| | | | - Octávia Monteiro Gil
- Centro de Ciências e Tecnologias Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Bobadela-LRS, Portugal
| | - Alegria Montoro
- Hospital Universitario y Politécnico la Fe de la Comunidad Valenciana, Valencia, Spain
| | - Jayne Moquet
- Public Health England, CRCE, Chilton, Didcot, Oxon, UK
| | - Mercedes Moreno
- Servicio Madrileño de Salud – Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Ursula Oestreicher
- Bundesamt für Strahlenschutz, Department Radiation Protection and Health, Oberschleissheim, Germany
| | | | | | - Clarice Patrono
- Agenzia Nazionale per le Nuove Tecnologie, ĹEnergia e lo Sviluppo Economico Sostenibile, Rome, Italy
| | - Laure Piqueret-Stephan
- PROCyTOX, Commissariat à l’Energie Atomique et aux Energies Alternatives, Fontenay-aux-Roses, and Université Paris-Saclay, Paris, France
| | - Matthias Port
- Bundeswehr Institute of Radiobiology affiliated to the University of Ulm, Munich, Germany
| | - María Jesus Prieto
- Servicio Madrileño de Salud – Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Michelle Ricoul
- PROCyTOX, Commissariat à l’Energie Atomique et aux Energies Alternatives, Fontenay-aux-Roses, and Université Paris-Saclay, Paris, France
| | - Horst Romm
- Bundesamt für Strahlenschutz, Department Radiation Protection and Health, Oberschleissheim, Germany
| | - Laurence Roy
- Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | - Géza Sáfrány
- National Public Health Centre – National Research Directorate for Radiobiology and Radiohygiene, Budapest, Hungary
| | - Laure Sabatier
- PROCyTOX, Commissariat à l’Energie Atomique et aux Energies Alternatives, Fontenay-aux-Roses, and Université Paris-Saclay, Paris, France
| | - Natividad Sebastià
- Hospital Universitario y Politécnico la Fe de la Comunidad Valenciana, Valencia, Spain
| | | | - Georgia Terzoudi
- National Centre for Scientific Research Demokritos, Athens, Greece
| | - Antonella Testa
- Agenzia Nazionale per le Nuove Tecnologie, ĹEnergia e lo Sviluppo Economico Sostenibile, Rome, Italy
| | - Hubert Thierens
- Universiteit Gent, Faculty of Medicine and Health Sciences, Gent, Belgium
| | - Istvan Turai
- affiliated to National Public Health Centre – National Research Directorate for Radiobiology and Radiohygiene, Budapest, Hungary
| | - François Trompier
- Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | | | - Pedro Vaz
- Centro de Ciências e Tecnologias Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Bobadela-LRS, Portugal
| | - Philippe Voisin
- affiliated to Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | - Anne Vral
- Universiteit Gent, Faculty of Medicine and Health Sciences, Gent, Belgium
| | - Clemens Woda
- HelmholtzZentrum München, Oberschleissheim, Germany
| | | | - Andrzej Wojcik
- Stockholm University, Centre for Radiation Protection Research, Stockholm, Sweden
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Monteiro Gil O, Vaz P, Romm H, De Angelis C, Antunes AC, Barquinero JF, Beinke C, Bortolin E, Burbidge CI, Cucu A, Della Monaca S, Domene MM, Fattibene P, Gregoire E, Hadjidekova V, Kulka U, Lindholm C, Meschini R, M’Kacher R, Moquet J, Oestreicher U, Palitti F, Pantelias G, Montoro Pastor A, Popescu IA, Quattrini MC, Ricoul M, Rothkamm K, Sabatier L, Sebastià N, Sommer S, Terzoudi G, Testa A, Trompier F, Vral A. Capabilities of the RENEB network for research and large scale radiological and nuclear emergency situations. Int J Radiat Biol 2016; 93:136-141. [DOI: 10.1080/09553002.2016.1227107] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Octávia Monteiro Gil
- Centro de Ciências e Tecnologias Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Bobadela-LRS, Portugal
| | - Pedro Vaz
- Centro de Ciências e Tecnologias Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Bobadela-LRS, Portugal
| | - Horst Romm
- Bundesamt für Strahlenschutz, Department Radiation Protection and Health, Oberschleissheim, Germany
| | | | - Ana Catarina Antunes
- Centro de Ciências e Tecnologias Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Bobadela-LRS, Portugal
| | | | - Christina Beinke
- Institute of Radiobiology affiliated to the University of Ulm, Munich, Germany
| | | | - Christopher Ian Burbidge
- Centro de Ciências e Tecnologias Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Bobadela-LRS, Portugal
| | - Alexandra Cucu
- Institutul National de Sanatate Publica, Bucharest, Romania
| | | | | | | | - Eric Gregoire
- Institut de Radioprotection et de Sureté Nucléaire, Fontenay aux Roses, France
| | - Valeria Hadjidekova
- National Centre of Radiobiology and Radiation Protection (NCRRP), Sofia, Bulgaria
| | - Ulrike Kulka
- Bundesamt für Strahlenschutz, Department Radiation Protection and Health, Oberschleissheim, Germany
| | | | - Roberta Meschini
- Department of Ecological & Biological Sciences, University of Tuscia, Viterbo, Italy
| | - Radhia M’Kacher
- Commissariat à l’Énergie Atomique, PROCyTOX, Fontenay aux Roses, France
| | - Jayne Moquet
- Public Health England, Centre for Radiation Chemicals and Environmental Hazards, Chilton, Oxfordshire, UK
| | - Ursula Oestreicher
- Bundesamt für Strahlenschutz, Department Radiation Protection and Health, Oberschleissheim, Germany
| | - Fabrizio Palitti
- Department of Ecological & Biological Sciences, University of Tuscia, Viterbo, Italy
| | - Gabriel Pantelias
- National Centre for Scientific Research “Demokritos”, Athens, Greece
| | | | | | | | - Michelle Ricoul
- Commissariat à l’Énergie Atomique, PROCyTOX, Fontenay aux Roses, France
| | - Kai Rothkamm
- Public Health England, Centre for Radiation Chemicals and Environmental Hazards, Chilton, Oxfordshire, UK
- University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Laure Sabatier
- Commissariat à l’Énergie Atomique, PROCyTOX, Fontenay aux Roses, France
| | | | | | - Georgia Terzoudi
- National Centre for Scientific Research “Demokritos”, Athens, Greece
| | - Antonella Testa
- Agenzia Nazionale per le Nuove Tecnologie, l’Energia e lo Sviluppo Sostenibile, Rome, Italy
| | - François Trompier
- Institut de Radioprotection et de Sureté Nucléaire, Fontenay aux Roses, France
| | - Anne Vral
- Ghent University, Department of Basic Medical Sciences, Ghent, Belgium
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Romm H, Ainsbury EA, Barquinero JF, Barrios L, Beinke C, Cucu A, Domene MM, Filippi S, Monteiro Gil O, Gregoire E, Hadjidekova V, Hatzi V, Lindholm C, M´ kacher R, Montoro A, Moquet J, Noditi M, Oestreicher U, Palitti F, Pantelias G, Prieto MJ, Popescu I, Rothkamm K, Sebastià N, Sommer S, Terzoudi G, Testa A, Wojcik A. Web based scoring is useful for validation and harmonisation of scoring criteria within RENEB. Int J Radiat Biol 2016; 93:110-117. [DOI: 10.1080/09553002.2016.1206228] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Horst Romm
- Bundesamt fuer Strahlenschutz, Neuherberg, Germany
| | | | | | | | - Christina Beinke
- Bundeswehr Institute of Radiobiology affiliated to the University of Ulm, Munich, Germany
| | - Alexandra Cucu
- Institutul National de Sanatate Publica, Bucharest, Romania
| | - Mercedes Moreno Domene
- Servicio Madrileño de Salud – Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Silvia Filippi
- Department of Ecological and Biological Sciences, University of Tuscia, Viterbo, Italy
| | - Octávia Monteiro Gil
- Centro de Ciêincias e Tecnologias Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
| | - Eric Gregoire
- Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | | | - Vasia Hatzi
- National Centre for Scientific Research ‘Demokritos’, Athens, Greece
| | | | - Radhia M´ kacher
- Commissariat à l´ Énergie Atomique, Paris, France
- Cell Environment, Paris, France
| | | | - Jayne Moquet
- Public Health England, CRCE, Chilton, Didcot, UK
| | - Mihaela Noditi
- Institutul National de Sanatate Publica, Bucharest, Romania
| | | | - Fabrizio Palitti
- Department of Ecological and Biological Sciences, University of Tuscia, Viterbo, Italy
| | - Gabriel Pantelias
- National Centre for Scientific Research ‘Demokritos’, Athens, Greece
| | - María Jesús Prieto
- Servicio Madrileño de Salud – Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Irina Popescu
- Institutul National de Sanatate Publica, Bucharest, Romania
| | - Kai Rothkamm
- University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | | | | | - Georgia Terzoudi
- National Centre for Scientific Research ‘Demokritos’, Athens, Greece
| | - Antonella Testa
- Agenzia Nazionale per le Nuove Tecnologie, l'Energia e lo Sviluppo Economico Sostenibile, Rome, Italy
| | - Andrzej Wojcik
- Stockholm University, Department of Molecular Biosciences, Stockholm, Sweden and Jan Kochanowski University, Kielce, Poland
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Shreder K, Cucu A, Deloch L, Frey B, Gaipl US, Durante M, Fournier C. A7.20 Low-dose ionising radiation inhibits adipokine induced inflammation in rheumatoid arthritis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-209124.151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ignatoiu-Sora E, Radulescu G, Bratu EC, Radulescu D, Sandu M, Cucu A, Galan A. The importance of team work for improving the health situation of Roma communities. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv175.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Girjoaba O, Cucu A. Romanian medical exposure to ionising radiation in 2012. Radiat Prot Dosimetry 2015; 165:137-140. [PMID: 25848102 DOI: 10.1093/rpd/ncv105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Medical exposure, the main source of artificial exposure, shows an increasing trend in the last years, manifested both by increasing the number of examinations with ionising radiation and by increasing the patient dose level. Annual results obtained for medical exposure to ionising radiation based on the data collected from Romanian hospitals are useful for the update of the national database and optimisation of diagnostic procedures in radiology and nuclear medicine. Medical exposure level is expressed in terms of annual collective dose and is evaluated from annual frequencies and the average effective dose per procedure for different types of radiological and nuclear medicine procedures. The Romanian hospitals reported during 2012 a number of 5,505,792 radiological examinations and 17,088 diagnostic procedures of nuclear medicine. Based on the data reported, the average effective doses and their contributions to the collective dose were evaluated. The main contributions to the collective dose of the radiological procedures are registered for CT abdomen and pelvis region, followed by thorax CT and head CT examinations. The next positions are fluoroscopic examination of the thorax and gastrointestinal disease and radiographic examination of the lumbar spine and thorax, which in spite of their low effective dose have an important contribution to the collective dose due to the large number of examinations. For nuclear medicine procedures, major contributions to collective dose are given by bone scintigraphy, followed by PET-CT and thyroid scintigraphy.
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Affiliation(s)
- O Girjoaba
- National Institute of Public Health, 1-3 Dr. A. Leonte Street, Bucharest 050463, Romania
| | - A Cucu
- National Institute of Public Health, 1-3 Dr. A. Leonte Street, Bucharest 050463, Romania
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25
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Kulka U, Ainsbury L, Atkinson M, Barnard S, Smith R, Barquinero JF, Barrios L, Bassinet C, Beinke C, Cucu A, Darroudi F, Fattibene P, Bortolin E, Monaca SD, Gil O, Gregoire E, Hadjidekova V, Haghdoost S, Hatzi V, Hempel W, Herranz R, Jaworska A, Lindholm C, Lumniczky K, M'kacher R, Mörtl S, Montoro A, Moquet J, Moreno M, Noditi M, Ogbazghi A, Oestreicher U, Palitti F, Pantelias G, Popescu I, Prieto MJ, Roch-Lefevre S, Roessler U, Romm H, Rothkamm K, Sabatier L, Sebastià N, Sommer S, Terzoudi G, Testa A, Thierens H, Trompier F, Turai I, Vandevoorde C, Vaz P, Voisin P, Vral A, Ugletveit F, Wieser A, Woda C, Wojcik A. Realising the European network of biodosimetry: RENEB-status quo. Radiat Prot Dosimetry 2015; 164:42-5. [PMID: 25205835 PMCID: PMC4401036 DOI: 10.1093/rpd/ncu266] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Creating a sustainable network in biological and retrospective dosimetry that involves a large number of experienced laboratories throughout the European Union (EU) will significantly improve the accident and emergency response capabilities in case of a large-scale radiological emergency. A well-organised cooperative action involving EU laboratories will offer the best chance for fast and trustworthy dose assessments that are urgently needed in an emergency situation. To this end, the EC supports the establishment of a European network in biological dosimetry (RENEB). The RENEB project started in January 2012 involving cooperation of 23 organisations from 16 European countries. The purpose of RENEB is to increase the biodosimetry capacities in case of large-scale radiological emergency scenarios. The progress of the project since its inception is presented, comprising the consolidation process of the network with its operational platform, intercomparison exercises, training activities, proceedings in quality assurance and horizon scanning for new methods and partners. Additionally, the benefit of the network for the radiation research community as a whole is addressed.
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Affiliation(s)
- U Kulka
- Bundesamt für Strahlenschutz, Salzgitter, Germany
| | | | - M Atkinson
- Helmholtz Centre Munich, Neuherberg, Germany
| | | | - R Smith
- Public Health England, Chilton, UK
| | - J F Barquinero
- Universitat Autonoma de Barcelona, Cerdanyola del Valles, Spain
| | - L Barrios
- Universitat Autonoma de Barcelona, Cerdanyola del Valles, Spain
| | - C Bassinet
- Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | - C Beinke
- Bundeswehr Institut für Radiobiologie/Universität Ulm, Ulm, Germany
| | - A Cucu
- National Institute of Public Health Romania, Bucharest, Romania
| | - F Darroudi
- Leiden University Medical Center, Leiden, The Netherlands
| | | | - E Bortolin
- Istituto Superiore di Sanità, Rome, Italy
| | | | - O Gil
- Instituto Superior Técnico, Universidade de Lisboa, Bobadela LRS, Portugal
| | - E Gregoire
- Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | - V Hadjidekova
- National Centre of Radiobiology and Radiation Protection, Sofia, Bulgaria
| | | | - V Hatzi
- National Centre for Scientific Research Demokritos, Athens, Greece
| | - W Hempel
- Commissariat à l'Énergie Atomique, Fontenay-aux-Roses, France
| | - R Herranz
- Servicio Madrileño de Salud, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - A Jaworska
- Norwegian Radiation Protection Authority, Osteraas, Norway
| | - C Lindholm
- Radiation and Nuclear Safety Authority, Research and Environmental Surveillance, Helsinki, Finland
| | - K Lumniczky
- National Research Institute for Radiobiology and Radiohygiene, Budapest, Hungary
| | - R M'kacher
- Commissariat à l'Énergie Atomique, Fontenay-aux-Roses, France
| | - S Mörtl
- Helmholtz Centre Munich, Neuherberg, Germany
| | - A Montoro
- Fundación para la Investigation del Hospital Universitario la Fe de la Comunidad Valenciana, Valencia, Spain
| | - J Moquet
- Public Health England, Chilton, UK
| | - M Moreno
- Servicio Madrileño de Salud, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - M Noditi
- National Institute of Public Health Romania, Bucharest, Romania
| | - A Ogbazghi
- Commissariat à l'Énergie Atomique, Fontenay-aux-Roses, France
| | | | - F Palitti
- University of Tuscia, Viterbo, Italy
| | - G Pantelias
- National Centre for Scientific Research Demokritos, Athens, Greece
| | - I Popescu
- National Institute of Public Health Romania, Bucharest, Romania
| | - M J Prieto
- Servicio Madrileño de Salud, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - S Roch-Lefevre
- Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | - U Roessler
- Bundesamt für Strahlenschutz, Salzgitter, Germany
| | - H Romm
- Bundesamt für Strahlenschutz, Salzgitter, Germany
| | | | - L Sabatier
- Commissariat à l'Énergie Atomique, Fontenay-aux-Roses, France
| | - N Sebastià
- Fundación para la Investigation del Hospital Universitario la Fe de la Comunidad Valenciana, Valencia, Spain
| | - S Sommer
- Instytut Chemii i Techniki Jadrowej, Warsaw, Poland
| | - G Terzoudi
- National Centre for Scientific Research Demokritos, Athens, Greece
| | - A Testa
- Agenzia Nazionale per le Nuove Tecnologie, L'Energia e lo Sviluppo Economico Sostenibile, Rome, Italy
| | - H Thierens
- Faculty of Medicine and Health Sciences, Universiteit Gent, Gent, Belgium
| | - F Trompier
- Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | - I Turai
- National Research Institute for Radiobiology and Radiohygiene, Budapest, Hungary
| | - C Vandevoorde
- Faculty of Medicine and Health Sciences, Universiteit Gent, Gent, Belgium
| | - P Vaz
- Instituto Superior Técnico, Universidade de Lisboa, Bobadela LRS, Portugal
| | - P Voisin
- Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | - A Vral
- Faculty of Medicine and Health Sciences, Universiteit Gent, Gent, Belgium
| | - F Ugletveit
- Norwegian Radiation Protection Authority, Osteraas, Norway
| | - A Wieser
- Helmholtz Centre Munich, Neuherberg, Germany
| | - C Woda
- Helmholtz Centre Munich, Neuherberg, Germany
| | - A Wojcik
- Stockholm University, Stockholm, Sweden
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26
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Girjoaba O, Cucu A. The patient dose estimation from medical exposure for 2010-2012 years. Phys Med 2014. [DOI: 10.1016/j.ejmp.2014.07.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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27
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Ion D, Stoian RV, Bolocan A, Cucu A, Serban MB, Paduraru DN. Is prosthetic repair of the abdominal wall in clean-contaminated surgical interventions possible? Chirurgia (Bucur) 2013; 108:855-858. [PMID: 24331326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2013] [Indexed: 06/03/2023]
Abstract
The present study tries to provide an expressive, customized answer to the question in the title. The study relies on a ten-year experience (2000-2009), evaluated retrospectively on a group of 488 prosthetic repairs of incisional herniae, out of which 432 were performed in a clean environment and 56 cases in a clean-contaminated one. The two groups are superimposable based on the Apache score. The visceral surgical procedures associated to the surgery of the parietal defect were varied (cholecystectomy, appendectomy, enterectomy enterorrhaphy,colectomy colotomy-colorrhaphy, hysterectomy with adnexectomy). The assessment of postoperative suppurative complications showed no significant differences between the two groups (p 0.001). These results lead us to the idea of defining the indication for parietal prosthetic repair in a contaminated environment. The major factors of this decision are: the nature, the source and the amount of the septicinoculum, the duration of exposure, the intensity of the host inflammatory response (more difficult to quantify), and finally the surgical judgment. The last mentioned factor will evaluate the above-mentioned data and will take into account that not all bacterial contaminations are necessarily followed by an established infection. Thus, additional exaggerations - which would mean taking useless, ineffective precautions- as well as negative exaggerations - which would mean hazardous boldness- will be avoided.
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28
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Kulka U, Ainsbury L, Atkinson M, Barquinero JF, Barrios L, Beinke C, Bognar G, Cucu A, Darroudi F, Fattibene P, Gil O, Gregoire E, Hadjidekova V, Haghdoost S, Herranz R, Jaworska A, Lindholm C, Mkacher R, Mörtl S, Montoro A, Moquet J, Moreno M, Ogbazghi A, Oestreicher U, Palitti F, Pantelias G, Popescu I, Prieto MJ, Romm H, Rothkamm K, Sabatier L, Sommer S, Terzoudi G, Testa A, Thierens H, Trompier F, Turai I, Vandersickel V, Vaz P, Voisin P, Vral A, Ugletveit F, Woda C, Wojcik A. Realising the European Network of Biodosimetry (RENEB). Radiat Prot Dosimetry 2012; 151:621-625. [PMID: 22923244 DOI: 10.1093/rpd/ncs157] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
In Europe, a network for biological dosimetry has been created to strengthen the emergency preparedness and response capabilities in case of a large-scale nuclear accident or radiological emergency. Through the RENEB (Realising the European Network of Biodosimetry) project, 23 experienced laboratories from 16 European countries will establish a sustainable network for rapid, comprehensive and standardised biodosimetry provision that would be urgently required in an emergency situation on European ground. The foundation of the network is formed by five main pillars: (1) the ad hoc operational basis, (2) a basis of future developments, (3) an effective quality-management system, (4) arrangements to guarantee long-term sustainability and (5) awareness of the existence of RENEB. RENEB will thus provide a mechanism for quick, efficient and reliable support within the European radiation emergency management. The scientific basis of RENEB will concurrently contribute to increased safety in the field of radiation protection.
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Affiliation(s)
- U Kulka
- Bundesamt für Strahlenschutz, Salzgitter, Germany.
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29
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Pond K, Kim R, Carroquino MJ, Pirard P, Gore F, Cucu A, Nemer L, MacKay M, Smedje G, Georgellis A, Dalbokova D, Krzyzanowski M. Workgroup report: developing environmental health indicators for European children: World Health Organization Working Group. Environ Health Perspect 2007; 115:1376-82. [PMID: 17805431 PMCID: PMC1964892 DOI: 10.1289/ehp.9958] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2006] [Accepted: 05/10/2007] [Indexed: 05/10/2023]
Abstract
A working group coordinated by the World Health Organization developed a set of indicators to protect children's health from environmental risks and to support current and future European policy needs. On the basis of identified policy needs, the group developed a core set of 29 indicators for implementation plus an extended set of eight additional indicators for future development, focusing on exposure, health effects, and action. As far as possible, the indicators were designed to use existing information and are flexible enough to be developed further to meet the needs of policy makers and changing health priorities. These indicators cover most of the priority topic areas specified in the Children's Environment and Health Action Plan for Europe (CEHAPE) as adopted in the Fourth Ministerial Conference on Health and Environment in 2004, and will be used to monitor the implementation of CEHAPE. This effort can be viewed as an integral part of the Global Initiative on Children's Environmental Health Indicators, launched at the World Summit on Sustainable Development in 2002.
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Affiliation(s)
- Kathy Pond
- Robens Centre for Public and Environmental Health, University of Surrey, Guildford, United Kingdom
| | - Rokho Kim
- WHO European Centre for Environment and Health, Bonn, WHO Regional Office for Europe
- Address correspondence to R. Kim, WHO European Centre for Environment and Health, Hermann-Ehlers-Strasse 10, D-53113 Bonn, Germany. Telephone: +49 228 815 0414. Fax: +49 228 815 0440. E-mail:
| | | | | | | | | | - Leda Nemer
- WHO European Centre for Environment and Health, Rome, WHO Regional Office for Europe
| | - Morag MacKay
- European Child Safety Alliance, Amsterdam, The Netherlands
| | - Greta Smedje
- Department of Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden
| | - Antonis Georgellis
- Occupational and Environmental Health Department, Stockholm County Council, Stockholm, Sweden
| | - Dafina Dalbokova
- WHO European Centre for Environment and Health, Bonn, WHO Regional Office for Europe
| | - Michal Krzyzanowski
- WHO European Centre for Environment and Health, Bonn, WHO Regional Office for Europe
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30
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Toma C, Cucu A, Constantinescu T, Mitrache M, Dumitrache-Rujinski S, Tudose C, Bumbacea D, Bogdan M. 263 L’analyse de l’efficacité du traitement du cancer bronchopulmonaire dans un service de pneumologie en Roumanie. Rev Mal Respir 2007. [DOI: 10.1016/s0761-8425(07)72639-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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31
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Cucu A, Sculeanu R, Durach L, Martoma F, Cornilă R. [Alloplastic or autoplastic in incisional hernia]. Chirurgia (Bucur) 2003; 98:531-4. [PMID: 15143610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
The study is retrospective and includes 194 patients with incisional hernia (IH). Local and general factors involved in IH pathogeny were tried to be identified, namely tactical and technical solutions for surgically solving the abdominal parietal deficiencies. Main risk factors, for the lot having been studied, are general: obesity, diabetes, cancer and local: wound suppuration, repeated surgical operations, emergency surgery, multiparity and physical effort. Simple suture and aloplastic procedures prevailed being adapted to the type of lesion, intraoperatory identified. For patients with multiple orifices different techniques were used during the same surgical operation.
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Affiliation(s)
- A Cucu
- Clinica Chirurgie III, Spitalul Judeţean Braşov
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32
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Cucu A, Cornila R, Cristian A, Durach L, Sculeanu R. [Pancreatic pseudo-cyst]. Chirurgia (Bucur) 2003; 98:337-40. [PMID: 14999959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Pancreatic pseudo-cyst (PKP) represents a late complication of acute and chronic pancreatitis and of pancreatic trauma. Male sex is predominant (22/27). Average age is 43.9. PKP was most frequently associated with chronic ethylism (16), chronic pancreatitis (14) and acute pancreatitis (9), cancer (1). Ultrasonography (US) is the method used for surgical indication (parietal maturation, content) and lesion follow up. Internal drainage was used for 15 patients: 13 Jurasz cystogastroanastomy and 2 transduodenal cysto duodenostomy. External drainage was used with 9 patients. Topography was: cephalic (4), corporeal (6) corporeo caudal (13); with 4 patients topography could not be set (PKP over 15 cm). Postoperative complications occurred with 7 patients: upper digestive bleeding (4), pancreatic abscess (2), hemi-peritoneum (1). Surgical abstention (3 patients) was determined by: lack of cyst parietal maturation, progressively reduced dimensions and an acute pancreatitis episode. One patient deceased due to haemorrhagic recurrence in tryptic erosion of the portal vein. Surgical decision is supported by US. Surgical tactics shall be adapted to the topography and lesion. Inner derivation represents election indication in mature PKP. In some circumstances, external drainage is however necessary.
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Affiliation(s)
- A Cucu
- Clinica Chirurgie III, Spitalul Judeţean Braşov
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33
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Ionescu G, Pereni O, Cucu A, Ionescu C. [The technical modalities of duodenojejunoplasty in large parietal defects of the duodenum]. Rev Chir Oncol Radiol O R L Oftalmol Stomatol Chir 1989; 38:107-12. [PMID: 2528177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The authors present two technical modalities for solving extensive defects of the duodenal wall which occurred during surgery for large duodenal ulcers, which in one case involved the entire anterior part of D1-D2. In another case the duodenal wall defect was due to tumoral invasion by cancer of the hepatic angle of the colon. The solution consisted in duodenoplasty with excluded intestinal loop in "Y", in the first case, and duodenoplasty on an omega loop associated with GEP in the second case.
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34
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Ionescu NG, Cucu A, Szabó I, Mircea P, Cotul S, Bojan A. [Autografting of the traumatized spleen]. Rev Chir Oncol Radiol O R L Oftalmol Stomatol Chir 1988; 37:363-70. [PMID: 2976961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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35
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Ionescu NG, Cucu A, Szabó I, Trelea E, Gomboşiu C, Oancea A. [Laparostomy in the treatment of acute pancreatitis]. Rev Chir Oncol Radiol O R L Oftalmol Stomatol Chir 1988; 37:283-8. [PMID: 2974605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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36
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Ionescu G, Neumann E, Domokos M, Andercou A, Cardan E, Cucu A. Experimental preparation of deantigenized vascular heterografts and study of tolerance after transplantation. Acta Chir Belg 1977; 76:393-9. [PMID: 562571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
A new technique in preparing a heterograft is presented. Deantigenized calf carotid arteries are obtained by papain digestion and formol tanning. The biochemical determinations show a pronounced reduction in total protein content after papain digestion. The formol tanning gives a good rigidity and elasticity in adapting to different blood volumes without aneurysmal dilatation. Eight dogs were grafted : two died after surgery, two were killed after 35 days and two others 60 days after transplantation, one died after 8 months and one is alive 30 months after transplantation. The good in vivo tolerability has been appreciated. There have been no haemodynamic troubles and no cell changes of rejection. An insignificant quantity of immunoglobulins G has been found in the sera of the animals with heterografts. These data draw attention on the possibility of the use, in clinical practice, of the deantigenized calf arteries.
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37
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Gavrilă I, Soloviev M, Cîrstina D, Cucu A, Procopan V. [Current aspects of infectious mononucleosis]. Rev Ig Bacteriol Virusol Parazitol Epidemiol Pneumoftiziol Bacteriol Virusol Parazitol Epidemiol 1976; 21:207-12. [PMID: 138923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The authors discuss present aspects in infectious mononucleosis, with reference to the cases admitted to the Clinic of communicable Diseases of Cluj-Napoca, i.e. 115 cases during the 1954--1973 period (3 to 13 cases a year). In most cases the clinical symptomatology was mild and the laboratory tests typical not giving rise to any diagnostic difficulties. However, 28 cases (25%) presented jaundice, with positive hepatic tests, so that a differential diagnosis was established with viral hepatitis. In 9 cases nervous manifestations were reported: 4 encephalitis, 1 neuritis of the hypoglossal nerve, 2 facial paralysis, 2 benign serous meningitis cases, all of which fully recovered. The Paul Bunnel-Hăngănuţiu test was positive in titers of 1 : 40 -- 1 : 1280, in all the cases. Corticotherapy was applied with good results in 24 cases. All the cases ran a favourable course. On admission, 45% of the patients came with a diagnosis of infectious mononucleosis; the others were admitted with a diagnosis of : diphteric angina, viral hepatitis, influenza, German measles, mups, typhoid fever, prolonged febrile syndrome.
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38
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Gavrilă I, Ardeleanu R, Belu M, Cucu A, Runcan C, Soloviev M, Serban I. [Staphylococcal infections in the Cluj-Napoca Clinic of Infectious Diseases during the years 1967-1972]. Rev Ig Bacteriol Virusol Parazitol Epidemiol Pneumoftiziol Bacteriol Virusol Parazitol Epidemiol 1976; 21:73-8. [PMID: 134444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Over a six year period, in the Clinic of Communicable Diseases of Cluj Napoca, 2301 patients with staphylococcal infections were admitted to the Clinic, representing 8% of the total number of patients admitted, and 3513 staphylococcal strains were isolated. A number of 43 of the 2301 patients died (1.8%), but staphylococcal infection was actually the cause of death in only 35 cases (1.5%) (septicemia, staphylococcal meningitis and pulmonary infections). Eight of the patients died from the basic disease (hepatitis, tetanus, paratyphoid C fever etc.). A number of 2246 Staphylococcus hemolyticus aureus, 80 non-hemolytic Staphylococcus aureus and 162 Staphylococcus albus strains were isolated; most of the strains were resistant to antibiotics in different proportions.
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39
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Gavrilă I, Josan R, Pîrvu C, Serban I, Cucu A, Marina M, Iepureanu A. [Clinical and therapeutic aspects of measles in the past 15 years]. Microbiol Parazitol Epidemiol (Bucur) 1973; 18:339-44. [PMID: 4135398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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40
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Gavrilă I, Procopan V, Cucu A, Soloviev M, Igna M. [Disorders of glycoregulation during cortisone therapy]. Med Interna (Bucur) 1969; 21:947-53. [PMID: 5345700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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41
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Gavrilă I, Cucu A, Cîrstina D. [Influence of chloramphenicol and corticoid therapy on the evolution of typhoid fever]. Med Interna (Bucur) 1967; 19:403-8. [PMID: 6052152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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