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Cheng Y, Chen ZL, Wei Y, Gu N, Tang SL. Examining dynamic developmental trends: the interrelationship between age-friendly environments and healthy aging in the Chinese population-evidence from China Health and Retirement Longitudinal Study, 2011-2018. BMC Geriatr 2024; 24:429. [PMID: 38750429 PMCID: PMC11094897 DOI: 10.1186/s12877-024-05053-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 05/07/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND The objective of this research is to investigate the dynamic developmental trends between Age-Friendly Environments (AFE) and healthy aging in the Chinese population. METHODS This study focused on a sample of 11,770 participants from the CHARLS and utilized the ATHLOS Healthy Aging Index to assess the level of healthy aging among the Chinese population. Linear mixed model (LMM) was used to explore the relationship between AFE and healthy aging. Furthermore, a cross-lagged panel model (CLPM) and a random-intercept cross-lagged panel model (RI-CLPM) were used to examine the dynamic developmental trends of healthy aging, taking into account both Between-Person effects and Within-Person effects. RESULTS The results from LMM showed a positive correlation between AFE and healthy aging (β = 0.087, p < 0.001). There was a positive interaction between the geographic distribution and AFE (central region * AFE: β = 0.031, p = 0.038; eastern region * AFE: β = 0.048, p = 0.003). In CLPM and RI-CLPM, the positive effect of healthy aging on AFE is a type of Between-Person effects (β ranges from 0.147 to 0.159, p < 0.001), while the positive effect of AFE on healthy aging is Within-Person effects (β ranges from 0.021 to 0.024, p = 0.004). CONCLUSION Firstly, individuals with high levels of healthy aging are more inclined to actively participate in the development of appropriate AFE compared to those with low levels of healthy aging. Furthermore, by encouraging and guiding individuals to engage in activities that contribute to building appropriate AFE, can elevate their AFE levels beyond the previous average level, thereby improving their future healthy aging levels. Lastly, addressing vulnerable groups by reducing disparities and meeting their health needs effectively is crucial for fostering healthy aging in these populations.
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Affiliation(s)
- Yan Cheng
- Nanjing Hospital of Chinese Medicine, Affiliated to Nanjing University of Chinese Medicine, Nanjing, 210000, People's Republic of China
| | - Zhi-Liang Chen
- Nanjing Hospital of Chinese Medicine, Affiliated to Nanjing University of Chinese Medicine, Nanjing, 210000, People's Republic of China
| | - Yue Wei
- Nanjing University of Chinese Medicine, Nanjing, 210023, People's Republic of China
| | - Ning Gu
- Nanjing Hospital of Chinese Medicine, Affiliated to Nanjing University of Chinese Medicine, Nanjing, 210000, People's Republic of China
| | - Shao-Liang Tang
- Nanjing University of Chinese Medicine, Nanjing, 210023, People's Republic of China.
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Sierra A, Mercader C, Pagés R, Seguí E, Musquera M, Ribal MJ. Gender trends at the annual Spanish Urologic Association (AEU) meeting: A review of AEU programmes over a 10-year period (2012-2022). Actas Urol Esp 2024:S2173-5786(24)00065-9. [PMID: 38735434 DOI: 10.1016/j.acuroe.2024.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 02/27/2024] [Indexed: 05/14/2024]
Abstract
INTRODUCTION Gender equity in urological meetings is pivotal for fostering diversity and inclusivity in the field. This study aims to evaluate the representation of Spanish urologist and regional disparities, and to assess its alignment with the demographic composition of the urological community. MATERIALS AND METHODS All urology meetings organized by the AEU between January 2012 and December 2022 were reviewed, including meeting information and details of the faculty. Additionally, we analysed geographic distribution of speakers across 17 different regions. Gender demographics were obtained disaggregating data by sex and year from the Organización Médica Colegial de España (OMC) and from those urologists affiliated to the AEU. RESULTS Analysing 52 AEU congresses held from 2012 to 2022, encompassing 3,407 speakers, the study found that 95.25% of speakers were from Spain and 89.6% were male speakers. Over the years, there was a positive trend in female speaker representation, increasing by 1.1% annually, slightly lagging the 1.8% annual rise in the number of female urologists in Spain. In specific subfields like functional, transplantation, and oncology sessions, the study revealed a higher representation of women, indicating focused efforts in these areas. Geographically, Madrid, Catalonia and Andalusia exhibited the highest representation. CONCLUSIONS Although there was a positive trend towards an increased participation of female urologists in Spanish urological meetings, it fails to accurately reflect the proportional increase in the number of women entering the urology profession in recent years. This study underscores the importance of ongoing efforts to ensure diverse and balanced representation in urological forum.
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Affiliation(s)
- A Sierra
- Servicio de Urología, Universitat de Barcelona, Hospital Clínic de Barcelona, Barcelona, Spain.
| | - C Mercader
- Servicio de Urología, Universitat de Barcelona, Hospital Clínic de Barcelona, Barcelona, Spain
| | - R Pagés
- Servicio de Urología, Universitat de Barcelona, Hospital Clínic de Barcelona, Barcelona, Spain
| | - E Seguí
- Servicio de Neuro-Urología, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, United Kingdom
| | - M Musquera
- Servicio de Urología, Universitat de Barcelona, Hospital Clínic de Barcelona, Barcelona, Spain
| | - M J Ribal
- Servicio de Urología, Universitat de Barcelona, Hospital Clínic de Barcelona, Barcelona, Spain
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Li T, Zhang S, Li H. Research on social and economic factors influencing regional mortality patterns in China. Sci Rep 2024; 14:10614. [PMID: 38719922 PMCID: PMC11078968 DOI: 10.1038/s41598-024-61262-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 05/03/2024] [Indexed: 05/12/2024] Open
Abstract
Regional population mortality correlates with regional socioeconomic development. This study aimed to identify the key socioeconomic factors influencing mortality patterns in Chinese provinces. Using data from the Seventh Population Census, we analyzed mortality patterns by gender and urban‒rural division in 31 provinces. Using a functional regression model, we assessed the influence of fourteen indicators on mortality patterns. Main findings: (1) China shows notable gender and urban‒rural mortality variations across age groups. Males generally have higher mortality than females, and rural areas experience elevated mortality rates compared to urban areas. Mortality in individuals younger than 40 years is influenced mainly by urban‒rural factors, with gender becoming more noticeable in the 40-84 age group. (2) The substantial marginal impact of socioeconomic factors on mortality patterns generally becomes evident after the age of 45, with less pronounced differences in their impact on early-life mortality patterns. (3) Various factors have age-specific impacts on mortality. Education has a negative effect on mortality in individuals aged 0-29, extending to those aged 30-59 and diminishing in older age groups. Urbanization positively influences the probability of death in individuals aged 45-54 years, while the impact of traffic accidents increases with age. Among elderly people, the effect of socioeconomic variables is smaller, highlighting the intricate and heterogeneous nature of these influences and acknowledging certain limitations.
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Affiliation(s)
- Tiantian Li
- School of Systems Science, Beijing Normal University, Beijing, China
| | - Shuyin Zhang
- School of Systems Science, Beijing Normal University, Beijing, China
| | - Handong Li
- School of Systems Science, Beijing Normal University, Beijing, China.
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Huang Y, Li Z. Assessing pesticides in the atmosphere: A global study on pollution, human health effects, monitoring network and regulatory performance. Environ Int 2024; 187:108653. [PMID: 38669719 DOI: 10.1016/j.envint.2024.108653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 01/18/2024] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024]
Abstract
Pesticides are widely used in agriculture, but their impact on the environment and human health is a major concern. While much attention has been given to their presence in soil, water, and food, there have been few studies on airborne pesticide pollution on a global scale. This study aimed to assess the extent of atmospheric pesticide pollution in countries worldwide and identify regional differences using a scoring approach. In addition to analyzing the health risks associated with pesticide pollution, we also examined agricultural practices and current air quality standards for pesticides in these countries. The pollution scores varied significantly among the countries, particularly in Europe. Asian and Oceanic countries generally had higher scores compared to those in the Americas, suggesting a relatively higher level of air pollution caused by pesticides in these regions. It is worth noting that the current pollution levels, as assessed theoretically, pose minimal health risks to humans. However, studies in the literature have shown that excessive exposure to pesticides present in the atmosphere has been associated with various health problems, such as cancer, neuropsychiatric disorders, and other chronic diseases. Interestingly, European countries had the highest overall pesticide application intensities, but this did not necessarily correspond to higher atmospheric pesticide pollution scores. Only a few countries have established air quality standards specifically for pesticides. Furthermore, pollution scores across states in the USA were investigated and the global sampling sites were mapped. The findings revealed that the scores varied widely in the USA and the current sampling sites were limited or unevenly distributed in some countries, particularly the Nordic countries. These findings can help global relevant environmental agencies to set up comprehensive monitoring networks. Overall, the present research highlights the need to create a pesticide monitoring system and increase efforts to enhance pesticide regulation, ensure consistency in standards, and promote international cooperation.
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Affiliation(s)
- Yabi Huang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong 518107, China
| | - Zijian Li
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong 518107, China.
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Nilssen Y, Brustugun OT, Fjellbirkeland L, Grønberg BH, Haram PM, Helbekkmo N, Helland Å, Wahl SGF, Aanerud M, Solberg S. Small Cell Lung Cancer in Norway: Patterns of Care by Health Region and Survival Trends. Clin Lung Cancer 2024:S1525-7304(24)00046-9. [PMID: 38692990 DOI: 10.1016/j.cllc.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/19/2024] [Accepted: 04/04/2024] [Indexed: 05/03/2024]
Abstract
INTRODUCTION/BACKGROUND There has been a marked survival improvement for patients with non-small-cell lung cancer. We describe the national trends in characteristics and survival, and geographical differences in diagnostic workup, treatment, and survival for patients with small-cell lung cancer (SCLC). MATERIALS AND METHODS Patients registered with SCLC at the Cancer Registry of Norway in 2002 to 2022 were included. Trends in overall survival were estimated for all SCLC patients, patients with limited stage SCLC, patients undergoing surgery, and by health region. Adjusting for case-mix, a multivariable Cox regression was performed examining the association between health region and death. RESULTS The study included 8374 patients. The stage distribution remained unchanged during the study period. The 5-year overall survival increased from 7.7% to 22.8% for patients with limited stage. The use of multidisciplinary team meetings varied from 62.5% to 85.7%, and the use of positron emission tomography-computer tomography varied from 70.4% to 86.2% between the health regions. Treatment patterns differed markedly between the health regions, with the proportion dying without any registered treatment ranging from 1.2% to 10.9%. For limited stage patients in 2018 to 2022, the median overall survival ranged from 16.5 to 25.5 months across health regions, and the 5-year overall survival ranged from 18.7% to 28.7% (P = .019). CONCLUSION The survival for patients with SCLC remains poor. The use of diagnostic procedures, treatment modalities, and survival differed between regions, warranting investigations to further explore the reasons.
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Affiliation(s)
- Yngvar Nilssen
- Department of Registration, Cancer Registry of Norway, Oslo, Norway
| | - Odd Terje Brustugun
- Section of Oncology, Vestre Viken Hospital Trust, Drammen, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lars Fjellbirkeland
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Respiratory Medicine, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| | - Bjørn Henning Grønberg
- Department of Oncology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Clinical and Molecular Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Per Magnus Haram
- Department of Cardiothoracic Surgery, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Nina Helbekkmo
- Department of Pulmonology, University Hospital of North Norway, Tromsø, Norway
| | - Åslaug Helland
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Sissel Gyrid Freim Wahl
- Department of Pathology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Marianne Aanerud
- Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Steinar Solberg
- Department of Registration, Cancer Registry of Norway, Oslo, Norway; Department of Cardiothoracic Surgery, Rikshospitalet, Oslo University Hospital, Oslo, Norway.
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Raja A, Khan O, Sagar RS, Kumar R, Bhimani PD, Bhimani RK, Danial M, Raja S, Deepak F, Shafique MA, Mustafa MS. Insights into Covid-19 mortality: A comprehensive study of cardiovascular sensitivity, gender, race, and geography trends in the United States (2020-2023). Curr Probl Cardiol 2024; 49:102435. [PMID: 38301913 DOI: 10.1016/j.cpcardiol.2024.102435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 01/29/2024] [Indexed: 02/03/2024]
Abstract
This investigation meticulously explores the evolving landscape of Covid-19-related mortality in the United States from 2020 to 2023. Leveraging the comprehensive CDC WONDER database, the study conducts a detailed analysis of age-adjusted mortality rates (AAMRs), considering various demographic and regional parameters. The identified pattern illustrates an initial surge in AAMRs from 2020 to 2021, followed by a subsequent decline until 2023. Notably, there is a discernible reduction in AAMRs for both the elderly (85 years and older) and infants (below one year). Within specific demographic segments, heightened AAMRs are observed among NH American Indian or Alaska Native individuals, men, and residents in particular states and regions. Emphasizing the significant impact of Covid-19 on cardiovascular health, the study underscores increased mortality rates associated with the cardiovascular and respiratory systems. AAMR rates were standardized per 100,000 population, providing a comparative metric. Noteworthy states with elevated AAMRs include Mississippi, Oklahoma, Kentucky, New Mexico, and Alabama, with the Southern region exhibiting the highest AAMR. The research sheds light on demographic and regional disparities in Covid-19-related mortality, calling for intensified efforts in prevention and treatment strategies. These findings, offering nuanced insights, serve as a guide for strategic public health initiatives to mitigate the multifaceted repercussions of the pandemic, especially among vulnerable populations.
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Affiliation(s)
- Adarsh Raja
- Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi, Pakistan.
| | - Owais Khan
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | | | - Rohet Kumar
- Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi, Pakistan
| | | | | | - Muhammad Danial
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Sandesh Raja
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Fnu Deepak
- Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi, Pakistan
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Li S, Mohamed Nor N, Kaliappan SR. Social determinants of child malnutrition outcomes: Evidence from CHNS in China. Heliyon 2024; 10:e23887. [PMID: 38187311 PMCID: PMC10767191 DOI: 10.1016/j.heliyon.2023.e23887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 01/09/2024] Open
Abstract
China is committed to reduce child malnutrition outcomes (CMO) rates to less than 5 % by 2030 in order to meet the Sustainable Development Goal (SDG). Yet, this is still an enormous challenge for China, particularly in disadvantaged areas, due to regional and urban-rural disparities. Using China Health and Nutrition Survey (CHNS) data from 1991 to 2015 and fixed-effect models, this study investigates the social determinants of stunting (n = 4012) measured by height-for-age z score (HAZ) and wasting (n = 4229) measured by weight-for-height z score (WHZ) in children under the age of five. According to the empirical findings, the significant social determinants of child stunting encompassed whether the child is insured (p < 0.01), maternal education level (primary school (p < 0.01) low middle school (p < 0.01); vocational school (p < 0.01)), maternal employment status (p < 0.05), mother's average working days (p < 0.05), average household per capita income (p < 0.01), household asset index (p < 0.01), urbanization index living in a community (medium (p < 0.05); higher (p < 0.01); highest (p < 0.01)) and living regions (west (p < 0.01); northeast (p < 0.05)). Children's maternal employment status (p < 0.05), mother's average working days (p < 0.05), living areas (p < 0.05) and living regions (central (p < 0.01); west (p < 0.01); north-east (p < 0.05)) are the significant factors impacting child wasting. Furthermore, the interaction impact between maternal employment and have one additional working day per week is positive. To attain SDGs, the Chinese government should priorities lowering stunting and wasting among 5-year-olds in the western region, particularly in impoverished regions. Also, it is possible to develop tailored policies for the growth and development of children under the age of five by addressing pertinent socio-economic factors.
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Affiliation(s)
- Sa Li
- School of Business and Economics, Universiti Putra Malaysia, 43400, UPM, Serdang, Selangor, Malaysia
- School of Business, Zhengzhou College of Finance and Economics, Zhengzhou, 450000, China
| | - Norashidah Mohamed Nor
- School of Business and Economics, Universiti Putra Malaysia, 43400, UPM, Serdang, Selangor, Malaysia
| | - Shivee Ranjanee Kaliappan
- School of Business and Economics, Universiti Putra Malaysia, 43400, UPM, Serdang, Selangor, Malaysia
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Chen S, Si Y, Hanewald K, Li B, Wu C, Xu X, Bateman H. Association between multimorbidity and informal long-term care use in China: a nationwide cohort study. BMC Geriatr 2023; 23:700. [PMID: 37904087 PMCID: PMC10617137 DOI: 10.1186/s12877-023-04371-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 10/03/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND The impact of multimorbidity on long-term care (LTC) use is understudied, despite its well-documented negative effects on functional disabilities. The current study aims to assess the association between multimorbidity and informal LTC use in China. We also explored the socioeconomic and regional disparities. METHODS The study included 10,831 community-dwelling respondents aged 45 years and older from the China Health and Retirement Longitudinal Study in 2011, 2015, and 2018 for analysis. We used a two-part model with random effects to estimate the association between multimorbidity and informal LTC use. Heterogeneity of the association by socioeconomic position (education and income) and region was explored via a subgroup analysis. We further converted the change of informal LTC hours associated with multimorbidity into monetary value and calculated the 95% uncertainty interval (UI). RESULTS The reported prevalence of multimorbidity was 60·0% (95% CI: 58·9%, 61·2%) in 2018. We found multimorbidity was associated with an increased likelihood of receiving informal LTC (OR = 2·13; 95% CI: 1·97, 2·30) and more hours of informal LTC received (IRR = 1·20; 95% CI: 1·06, 1·37), ceteris paribus. Participants in the highest income quintile received more hours of informal LTC care (IRR = 1·62; 95% CI: 1·31, 1·99). The estimated monetary value of increased informal LTC hours among participants with multimorbidity was equivalent to 3·7% (95% UI: 2·2%, 5·4%) of China's GDP in 2018. CONCLUSION Our findings substantiate the threat of multimorbidity to LTC burden. It is imperative to strengthen LTC services provision, especially among older adults with multimorbidity and ensure equal access among those with lower income.
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Affiliation(s)
- Shu Chen
- Australian Research Council Centre of Excellence in Population Ageing Research (CEPAR), University of New South Wales, Sydney, NSW, 2052, Australia.
- School of Risk & Actuarial Studies, University of New South Wales, Sydney, Australia.
| | - Yafei Si
- Australian Research Council Centre of Excellence in Population Ageing Research (CEPAR), University of New South Wales, Sydney, NSW, 2052, Australia
- School of Risk & Actuarial Studies, University of New South Wales, Sydney, Australia
| | - Katja Hanewald
- Australian Research Council Centre of Excellence in Population Ageing Research (CEPAR), University of New South Wales, Sydney, NSW, 2052, Australia
- School of Risk & Actuarial Studies, University of New South Wales, Sydney, Australia
| | - Bingqin Li
- Social Policy Research Centre, University of New South Wales, Sydney, Australia
| | - Chenkai Wu
- Global Health Research Centre, Duke Kunshan University, Kunshan, China
| | - Xiaolin Xu
- Department of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou, China.
- Centre of Clinical Big Data and Analytics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China.
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia.
| | - Hazel Bateman
- Australian Research Council Centre of Excellence in Population Ageing Research (CEPAR), University of New South Wales, Sydney, NSW, 2052, Australia
- School of Risk & Actuarial Studies, University of New South Wales, Sydney, Australia
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Kim SA, Choi SK. Regional disparities in food security and depression among single-person households in the Republic of Korea. BMC Public Health 2023; 23:2047. [PMID: 37858062 PMCID: PMC10588069 DOI: 10.1186/s12889-023-16874-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 10/02/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Single-person households constitute over 40% of all households in the Republic of Korea and are more vulnerable to food insecurity and depression than multi-person households. There is a lack of research on examining whether regional characteristics are associated with the degree of food insecurity and depression among single-person households. This study aimed to examine the regional disparities in food security and depression among single-person households in the Republic of Korea. METHODS A total of 227,873 adults from the 2019 Korean Community Health Survey was included in the analysis. According to population density and poverty rate, the residence of the participants was classified into four regions: metropolitan areas with high population density were classified into areas with low poverty rates (Region 1) and high poverty rates (Region 2), and provinces with low population density were classified into areas with low poverty rates (Region 3) and high poverty rates (Region 4). Using a single item of household food security, those who had experienced a lack of food due to financial difficulties over the past year were classified as food insecure. Depression was measured using the Patient Health Questionnaire-9. Odds ratios and 95% confidence intervals (CI) for the risk of food insecurity and depression according to regional characteristics were calculated after adjusting for potential confounding variables. RESULTS After adjusting for confounding variables, single-person households in regions with high population density, Regions 1 and 2, had 1.16 times (95% CI = 1.04-1.30) and 1.43 times (95% CI = 1.27-1.61) higher odds of food insecurity, respectively, compared to those in Region 4. Single-person households in regions with low poverty rates, Regions 1 and 3, had 1.54 times (95% CI = 1.34-1.77) and 1.21 times (95% CI = 1.01-1.46) higher odds of depression, respectively, than those in Region 4. Among those who lived alone, the middle-aged, having low income, receiving livelihood benefits, or having a low educational attainment had higher odds of experiencing both food insecurity and depression than their counterparts. CONCLUSIONS As the risk of food insecurity and depression in single-person households differs according to regional characteristics, local governments need to implement policies for single-person households in consideration of these distinct characteristics.
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Affiliation(s)
- Seong-Ah Kim
- Department of Urban Society, The Seoul Institute, Seoul, 06756, Republic of Korea
| | - Seul Ki Choi
- Graduate School of Urban Public Health, University of Seoul, Seoul, 02504, Republic of Korea.
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Isoyama K, Matsuura M, Hayasaka M, Nagao S, Nishimura Y, Yoshioka T, Imai Y, Miyagi E, Suzuki Y, Saito T. Nationwide trends in and regional factors associated with minimally invasive hysterectomy for benign indications in Japan. Eur J Obstet Gynecol Reprod Biol 2023; 289:129-135. [PMID: 37660507 DOI: 10.1016/j.ejogrb.2023.08.388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/18/2023] [Accepted: 08/28/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVE To examine the prevalence trends of minimally invasive hysterectomy for benign indications in Japan and investigate regional disparities. STUDY DESIGN A retrospective cohort and ecological study using "The National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) Open Data". SETTING Nationwide Japan. PATIENTS Individuals who underwent hysterectomy for benign indications from 2014 to 2020. INTERVENTIONS Trend analysis of minimally invasive surgery (MIS) rates through laparoscopic hysterectomies (LH) and robotic-assisted laparoscopic hysterectomies (RA-LH) at the national and prefecture levels. Examination of regional factors contributing to the disparity in MIS implementation rates by second medical service area (SMSA). RESULTS The number of LH has increased from 16,016 in 2014 to 27,755 in 2020. The nationwide MIS hysterectomy rate increased from 29% in 2014 to 55% in 2020 (p less than 0.001). More than 50% of hysterectomies have been performed as MIS since 2019. There was an increasing trend in MIS rates in all age groups. All prefectures except one showed a significant upward trend (p less than 0.05) in the MIS rates, but MIS rates varied widely (23-84%). In a multivariable model, the MIS was more likely to be performed in the SMSAs in western Japan (p = 0.011), in the SMSAs where the number of laparoscopy-qualified gynecologists is 5-10 (p = 0.013), and 11 or higher (p less than 0.001). CONCLUSIONS This study reveals a shift towards minimally invasive surgery (MIS) in total hysterectomy procedures in Japan. However, significant disparities in the prevalence of MIS hysterectomy exist, potentially influenced by the number of laparoscopy-qualified gynecologists.
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Affiliation(s)
- Kyoko Isoyama
- Department of Gynecology, Sapporo Medical University, 291, West 16, South 1, Chuo-Ku, Sapporo, Hokkaido 060-8543, Japan
| | - Motoki Matsuura
- Department of Gynecology, Sapporo Medical University, 291, West 16, South 1, Chuo-Ku, Sapporo, Hokkaido 060-8543, Japan.
| | - Misa Hayasaka
- Department of Obstetrics and Gynecology, Asahikawa Medical University, Midorigaokahigashi 2-1-1-1, Asahikawa, Hokkaido 078-8510, Japan
| | - Sachiko Nagao
- Department of Gynecology, Sapporo Medical University, 291, West 16, South 1, Chuo-Ku, Sapporo, Hokkaido 060-8543, Japan
| | - Yoko Nishimura
- Department of Gynecology, Sapporo Medical University, 291, West 16, South 1, Chuo-Ku, Sapporo, Hokkaido 060-8543, Japan
| | - Toshiki Yoshioka
- Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama 236-0004, Kanagawa, Japan
| | - Yuichi Imai
- Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama 236-0004, Kanagawa, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama 236-0004, Kanagawa, Japan
| | - Yukio Suzuki
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
| | - Tsuyoshi Saito
- Department of Gynecology, Sapporo Medical University, 291, West 16, South 1, Chuo-Ku, Sapporo, Hokkaido 060-8543, Japan
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11
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Abstract
Breast cancer is the second most diagnosed malignancy in American women with a lifetime occurrence of 1 in 8 women in the United States. There has been a dearth of research focusing on regional differences in breast cancer mortality with respect to race in the US. It is crucial to identify regions that are lagging to uplift the outreach of breast cancer care to certain races. Data for this study were obtained from the 2016-2018 Nationwide Inpatient Sample. In-hospital mortality, race and hospital regions for the patients with the primary diagnosis of Malignant Neoplasms of Breast were studied. Baseline characteristics of participants were summarized using descriptive statistics. The patient population was stratified as per race, hospital region, gender, therapy received and family history. Logistic regression was performed to derive the odds ratio while adjusting for different variables. 99, 543 patients with metastatic breast cancer were identified. African Americans (AAs) were found to have the highest reported deaths at 5.54%, followed by Asians and Pacific Islanders at 4.80% and Caucasians 4.09% (p < 0.0001). The odds of dying were significantly higher in the AA population when compared to Caucasian population (OR 1.391 (1.286-1.504)), and the odds were consistently higher across all regions of the US. In terms of regional disparities with respect to race, AA's had highest mortality in the south whereas all other races had the highest mortality in the west. It was seen that races identifying as "others" had significantly higher odds of dying in the Northeast. It is crucial to identify racial differences in the various regions across the US in order to implement appropriate outreach strategies to tackle these disparities.
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Affiliation(s)
- Akshita Khosla
- Department of Internal Medicine, Crozer-Chester Medical Center, 1 Medical Center Blvd, Upland, PA, USA.
| | - Devashish Desai
- Department of Palliative Care, Einstein Medical Center, Philadelphia, PA, USA
| | - Sachi Singhal
- Department of Internal Medicine, Crozer-Chester Medical Center, 1 Medical Center Blvd, Upland, PA, USA
| | - Aanchal Sawhney
- Department of Internal Medicine, Crozer-Chester Medical Center, 1 Medical Center Blvd, Upland, PA, USA
| | - Rashmika Potdar
- Department of Hematology-Oncology, Crozer-Chester Medical Center, Upland, PA, USA
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12
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Pechanec V, Prokopová M, Salvati L, Cudlín O, Včeláková R, Pohanková T, Štěrbová L, Purkyt J, Plch R, Jačková K, Cudlín P. Toward spatially polarized human pressure? A dynamic factor analysis of ecological stability and the role of territorial gradients in Czech Republic. Environ Monit Assess 2023; 195:819. [PMID: 37286820 DOI: 10.1007/s10661-023-11391-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 05/12/2023] [Indexed: 06/09/2023]
Abstract
In light of global change, research on ecosystem dynamics and the related environmental policies are increasingly required to face with the inherent polarization in areas with low and high human pressure. Differential levels of human pressure are hypothesized to reflect development paths toward ecological stability of local systems vis à vis socioeconomic resilience. To delineate the latent nexus between socioeconomic development paths and ecological stability of local systems, we proposed a multidimensional, diachronic analysis of 28 indicators of territorial disparities, and ecological stability in 206 homogeneous administrative units of Czech Republic over almost 30 years (1990-2018). Mixing time-invariant factors with time-varying socio-environmental attributes, a dynamic factor analysis investigated the latent relationship between ecosystem functions, environmental pressures, and the background socioeconomic characteristics of the selected spatial units. We identified four geographical gradients in Czech Republic (namely elevation, economic agglomeration, demographic structure, and soil imperviousness) at the base of territorial divides associated with the increased polarization in areas with low and high human pressure. The role of urbanization, agriculture, and loss of natural habitats reflective of rising human pressure was illustrated along the selected gradients. Finally, policy implications of the (changing) geography of ecological disturbances and local development paths in Czech Republic were briefly discussed.
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Affiliation(s)
- Vilém Pechanec
- Department of Geoinformatics, Faculty of Science, Palacký University Olomouc, 17. Listopadu 50, 771 46, Olomouc, Czech Republic
| | - Marcela Prokopová
- Global Change Research Institute of the Czech Academy of Sciences, Lipová 9, 370 05, České Budějovice, Czech Republic
| | - Luca Salvati
- Department of Methods and Models for Economics, Territory and Finance, Sapienza University of Rome, Via del Castro Laurenziano 9, I-00161, Rome, Italy.
| | - Ondřej Cudlín
- Global Change Research Institute of the Czech Academy of Sciences, Lipová 9, 370 05, České Budějovice, Czech Republic
| | - Renata Včeláková
- Global Change Research Institute of the Czech Academy of Sciences, Lipová 9, 370 05, České Budějovice, Czech Republic
| | - Tereza Pohanková
- Department of Geoinformatics, Faculty of Science, Palacký University Olomouc, 17. Listopadu 50, 771 46, Olomouc, Czech Republic
| | - Lenka Štěrbová
- Global Change Research Institute of the Czech Academy of Sciences, Lipová 9, 370 05, České Budějovice, Czech Republic
| | - Jan Purkyt
- Global Change Research Institute of the Czech Academy of Sciences, Lipová 9, 370 05, České Budějovice, Czech Republic
| | - Radek Plch
- Global Change Research Institute of the Czech Academy of Sciences, Lipová 9, 370 05, České Budějovice, Czech Republic
| | - Kateřina Jačková
- Global Change Research Institute of the Czech Academy of Sciences, Lipová 9, 370 05, České Budějovice, Czech Republic
| | - Pavel Cudlín
- Global Change Research Institute of the Czech Academy of Sciences, Lipová 9, 370 05, České Budějovice, Czech Republic
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Boumahdi I, Zaoujal N. Regional Well-Being Disparities in Morocco and its OECD Partners. Soc Indic Res 2023; 167:183-211. [PMID: 37304458 PMCID: PMC10078024 DOI: 10.1007/s11205-023-03097-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/12/2023] [Indexed: 06/13/2023]
Abstract
This article proposes a multidimensional analysis grid to assess regional disparities, transcending monetary considerations. This grid agrees overall with the common framework that prevails in the literature review that we have carried out. It is built around four dimensions of well-being: economy (development, labor market, human capital and innovation), social (health, living conditions and gender), environment and governance. Our analysis of regional disparities was based on the synthesis of fifteen indicators by constructing a Synthetic Index of Well-being (SIWB) by combining its four dimensions using an aggregative-compensative approach. This analysis covers Morocco, 35 of the OECD member countries and their 389 regions between 2000 and 2019. We have assessed the dynamics of Moroccan regions compared to those of the benchmark. Thus, we have highlighted the gaps to be made up in relation to the different areas of well-being as well as their thematic variations.
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Affiliation(s)
- Ilyes Boumahdi
- Laboratory in Gender, Economics, Actuarial, Statistics, Demography and Sustainable Development (GEAS3D Lab), National Institute of Statistics and Applied Economics, Rabat-Instituts, B.P.:6217, Rabat, Morocco
| | - Nouzha Zaoujal
- Laboratory in Gender, Economics, Actuarial, Statistics, Demography and Sustainable Development (GEAS3D Lab), National Institute of Statistics and Applied Economics, Rabat-Instituts, B.P.:6217, Rabat, Morocco
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14
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Reiner C, Musil R. The regional variation of a housing boom. Disparities of land prices in Austria, 2000-2018. Jahrb Reg Wiss 2023; 43:125-146. [PMID: 37520680 PMCID: PMC9870203 DOI: 10.1007/s10037-022-00176-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/06/2022] [Indexed: 08/01/2023]
Abstract
Debates accompanying the global housing boom have primarily focussed on the economic and social implications for urban housing markets. Against this background, this paper analyses the repercussions for regional land prices of a national housing boom in and beyond agglomerations. Convergence and divergence dynamics, regional price drivers, and spatial diffusion are investigated by examining average building-land prices of 95 Austrian regions between 2000 and 2018. The results indicate a clear increase in regional disparities in land prices, with the main rise taking place during a high price-growth period. Regions with high land prices are the main drivers of divergence, while a substantial number of peripheral regions with converging land prices were hardly affected by the national price boom. Land-price growth rates are positively affected by the number of households but negatively impacted by income growth, which points to a problematic decoupling of household income and land prices. Finally, the diffusion of the land-price boom occurs along the urban hierarchy as well as via neighbouring regions, confirming the ripple-effect hypothesis.
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Affiliation(s)
| | - Robert Musil
- Institute for Urban and Regional Research, Austrian Academy of Sciences, Bäckerstraße 13, 1010 Vienna, Austria
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15
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Yuan L, Cao J, Wang D, Yu D, Liu G, Qian Z. Regional disparities and influencing factors of high quality medical resources distribution in China. Int J Equity Health 2023; 22:8. [PMID: 36627636 PMCID: PMC9832614 DOI: 10.1186/s12939-023-01825-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/02/2023] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND With the gradual increase of residents' income and the continuous improvement of medical security system, people's demand for pursuing higher quality and better medical and health services has been released. However, so far little research has been published on China's high quality medical resources (HQMR). This study aims to understand the spatiotemporal variation trend of HQMR from 2006 to 2020, analyze regional disparity of HQMR in 2020, and further explore the main factors influencing the distribution of HQMR in China. METHODS The study selected Class III level A hospitals (the highest level medical institutions in China) to represent HQMR. Descriptive statistical methods were used to address the changes in the distribution of HQMR from 2006 to 2020. Lorentz curve, Gini coefficient (G), Theil index (T) and High-quality health resource density index (HHRDI) were used to calculate the degree of inequity. The geographical detector method was used to reveal the key factors influencing the distribution of HQMR. RESULTS The total amount of HQMR in China had increased year by year, from 647 Class III level A hospitals in 2006 to 1580 in 2020. In 2020, G for HQMR by population was 0.166, while by geographic area was 0.614. T was consistent with the results for G, and intra-regional contribution rates were higher than inter-regional contribution rates. HHRDI showed that Beijing, Shanghai, and Tianjin had the highest allocated amounts of HQMR. The results of the geographical detector showed that total health costs, government health expenditure, size of resident populations, GDP, number of medical colleges had a significant impact on the spatial distribution of HQMR and the q values were 0.813, 0.781, 0.719, 0.661, 0.492 respectively. There was an interaction between the influencing factors. CONCLUSIONS China's total HQMR is growing rapidly but is relatively inadequate. The distribution of HQMR by population is better than by geography, and the distribution by geography is less equitable. Population size and geographical area both need to be taken into account when formulating policies, rather than simply increasing the number of HQMR.
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Affiliation(s)
- Lei Yuan
- grid.452223.00000 0004 1757 7615Xiangya Hospital, Central South University, Changsha, Hunan China ,grid.452223.00000 0004 1757 7615National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan China
| | - Jing Cao
- grid.431010.7Department of Cardiovascular Medicine, Third Xiangya Hospital, Central South University, Changsha, Hunan China
| | - Dong Wang
- grid.452223.00000 0004 1757 7615Xiangya Hospital, Central South University, Changsha, Hunan China
| | - Dan Yu
- grid.452223.00000 0004 1757 7615Xiangya Hospital, Central South University, Changsha, Hunan China ,grid.452223.00000 0004 1757 7615National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan China
| | - Ge Liu
- grid.452223.00000 0004 1757 7615Xiangya Hospital, Central South University, Changsha, Hunan China
| | - Zhaoxin Qian
- grid.452223.00000 0004 1757 7615Xiangya Hospital, Central South University, Changsha, Hunan China ,grid.452223.00000 0004 1757 7615National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan China
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16
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Rontos K, Ermini B, Salvati L. Enlarging the divide? Per-Capita Income as a measure of social inequalities in a southern European City. Qual Quant 2023; 57:345-361. [PMID: 35313505 PMCID: PMC8929262 DOI: 10.1007/s11135-022-01360-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 01/29/2022] [Accepted: 02/20/2022] [Indexed: 02/03/2023]
Abstract
Earlier studies relating form and functions of cities address an intriguing and complex research issue, especially for specific urban typologies. Although with inherent differences on a local scale, Mediterranean cities represent diversified settlement morphologies and multifaceted socioeconomic contexts. The present study investigates the socioeconomic structure at the base of rapid development of a large Mediterranean agglomeration (Athens, Greece). Results of a multivariate analysis of the spatial distribution of average (per-capita) declared income and non-parametric correlations of contextual indicators suggest that the characteristic socio-spatial structure of the 1970s and the 1980s in Athens had slightly changed in recent times. A remarkable segregation in wealthy and disadvantaged communities - well beyond the urban-rural divide usually observed in Mediterranean regions - consolidated in recent decades. Despite economic transformations shaping urban design and infrastructural networks, persistent disparities between affluent and economically depressed neighborhoods still characterize the socio-spatial structure of contemporary Athens.
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Affiliation(s)
- Kostas Rontos
- Department of Sociology, University of the Aegean, University Hill, EL-81100 Mytilene, Greece
| | - Barbara Ermini
- Department of Economics and Social Science, Polytechnic University of Marche, Piazzale Martelli, 8, I-60121 Ancona, Italy
| | - Luca Salvati
- Department of Economics and Law, University of Macerata, Via Armaroli 43, I-62100 Macerata, Italy
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17
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Kim S. Effect of primary care-level chronic disease management policy on self-management of patients with hypertension and diabetes in Korea. Prim Care Diabetes 2022; 16:677-683. [PMID: 35985963 DOI: 10.1016/j.pcd.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 09/15/2021] [Revised: 07/04/2022] [Accepted: 08/02/2022] [Indexed: 11/17/2022]
Abstract
AIMS This study aimed to evaluate the effect of introducing a regional chronic disease management project on the self-management of patients with hypertension and diabetes. METHODS This study included 174,546 patients. The relationship between introducing chronic disease management in a region and the self-awareness of disease status was analyzed using a generalized estimating equation model. Poisson regression analysis was used to evaluate the effect of policy adoption on medication adherence and risk-reduction behavior in patients with hypertension and diabetes. Finally, we used a difference-in-differences model to assess the net effectiveness of policies. RESULTS Overall, regions with policies implemented showed more condition awareness and drug adherence than those without; however, this was only significant in regions where patients and physicians were incentivized. Risk-reduction behavior for patients with diabetes was higher in regions with policies implemented than in those without. The policy had a net effect of significantly and non-significantly increasing disease awareness and medication adherence, respectively. CONCLUSION Chronic disease management policies at the primary care level that incentivized both patients and physicians improved patient self-management. However, the effects on patients with diabetes and hypertension differed. Future studies should account for additional patient outcomes, including long-term impact assessments and clinical outcomes.
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Affiliation(s)
- Seungju Kim
- Department of Nursing, College of Nursing, The Catholic University of Korea, Seoul, Republic of Korea.
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18
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Sun DQ, Yang F, Li H, Cao MM, Yan XX, He SY, Zhang SL, Xia CF, Chen WQ. [ Regional disparities in trends of global gastric cancer incidence and mortality from 1990 to 2019]. Zhonghua Zhong Liu Za Zhi 2022; 44:950-954. [PMID: 36164696 DOI: 10.3760/cma.j.cn112152-20220120-00049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To depict gastric cancer burden trends globally and analyze geographical and socioeconomic disparities among different countries and territories. Methods: We extracted the data from Global Burden of Disease 2019 Database. We conducted the Joinpoint regression and calculated the average annual percent change (AAPC) and corresponding 95% confidence interval (CI) for age-standardized gastric cancer incidence and mortality from 1990 to 2019. Linear regression was performed to measure the association of sociodemographic index (SDI) with each country's gastric cancer incidence and mortality AAPC. We applied the age-period-cohort analysis to assess the cohort effect on gastric cancer incidence and mortality. Results: The AAPCs for gastric cancer age-standardized incidence and mortality rates from 1990 to 2019 were -1.27% (95% CI: -1.43%, -1.11%) and -1.87% (95% CI: -2.01%, -1.72%), respectively. SDI levels were negatively associated with AAPCs, which means that countries with higher SDI had higher AAPC (P<0.001). The decrease of gastric cancer burden in countries with low or medium SDI levels was slower than that globally. The age-period-cohort analysis indicated that countries with higher SDI levels had more apparent decline in birth cohort effects from 1900 to 1999. Conclusions: Countries with different socioeconomic levels have various decreasing rates for gastric cancer incidence and deaths. Countries with higher SDI levels have higher declining rates for gastric cancer burden.
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Affiliation(s)
- D Q Sun
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College/Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Beijing 100021, China
| | - F Yang
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College/Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Beijing 100021, China
| | - H Li
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College/Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Beijing 100021, China
| | - M M Cao
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College/Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Beijing 100021, China
| | - X X Yan
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College/Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Beijing 100021, China
| | - S Y He
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College/Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Beijing 100021, China
| | - S L Zhang
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College/Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Beijing 100021, China
| | - C F Xia
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College/Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Beijing 100021, China
| | - W Q Chen
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College/Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Beijing 100021, China
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19
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Jeong SH, Lee HJ, Yun C, Yun I, Jung YH, Kim SY, Lee HS, Jang SI. Healthcare vulnerability disparities in pancreatic cancer treatment and mortality using the Korean National Sample Cohort: a retrospective cohort study. BMC Cancer 2022; 22:925. [PMID: 36030217 PMCID: PMC9419365 DOI: 10.1186/s12885-022-10027-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/19/2022] [Indexed: 12/24/2022] Open
Abstract
Background The gap in treatment and health outcomes after diagnosis of pancreatic cancer is a major public health concern. We aimed to investigate the differences in the health outcomes and treatment of pancreatic cancer patients in healthcare vulnerable and non-vulnerable areas. Methods This retrospective cohort study evaluated data from the Korea National Health Insurance Corporation-National Sample Cohort from 2002 to 2019. The position value for relative comparison index was used to define healthcare vulnerable areas. Cox proportional hazard regression was used to estimate the risk of mortality in pancreatic cancer patients according to healthcare vulnerable areas, and multiple logistic regression was used to estimate the difference in treatment. Results Among 1,975 patients, 279 (14.1%) and 1,696 (85.9%) lived in the healthcare vulnerable and non-vulnerable areas, respectively. Compared with the non-vulnerable area, pancreatic cancer patients in the vulnerable area had a higher risk of death at 3 months (hazard ratio [HR]: 1.33, 95% confidence interval [CI] = 1.06–1.67) and 6 months (HR: 1.23, 95% CI = 1.03–1.48). In addition, patients with pancreatic cancer in the vulnerable area were less likely to receive treatment than patients in the non-vulnerable area (odds ratio [OR]: 0.70, 95% CI = 0.52–0.94). This trend was further emphasized for chemotherapy (OR: 0.68, 95% CI = 0.48–0.95). Conclusion Patients with pancreatic cancer belonging to medically disadvantaged areas receive less treatment and have a higher risk of death. This may be a result of the late diagnosis of pancreatic cancer among these patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-10027-2.
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Affiliation(s)
- Sung Hoon Jeong
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Republic of Korea
| | - Hyeon Ji Lee
- Institute of Health Services Research, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Republic of Korea
| | - Choa Yun
- Department of Biostatistics & Computing, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Il Yun
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Republic of Korea
| | - Yun Hwa Jung
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Republic of Korea
| | - Soo Young Kim
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Republic of Korea
| | - Hee Seung Lee
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sung-In Jang
- Institute of Health Services Research, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Republic of Korea. .,Department of Preventive Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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20
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Uddin J, Zhu S, Malla G, Levitan EB, Rolka DB, Long DL, Carson AP. Trends in diagnosed hypertension prevalence by geographic region for older adults with and without diagnosed diabetes, 2005-2017. J Diabetes Complications 2022; 36:108208. [PMID: 35597703 PMCID: PMC10142383 DOI: 10.1016/j.jdiacomp.2022.108208] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 01/29/2022] [Revised: 05/02/2022] [Accepted: 05/03/2022] [Indexed: 11/16/2022]
Abstract
Given that the prevalence of hypertension increases with age and is more common among adults with diabetes than those without diabetes, the objective of this study was to examine trends in hypertension prevalence by geographic region among older adults with and without diabetes. Among older adults with diabetes, hypertension prevalence generally increased from 2005 to 2017 across all regions, although the annual percent change was lower from 2011 to 2017 than 2005-2011 for all regions.
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Affiliation(s)
- Jalal Uddin
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, USA.
| | - Sha Zhu
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, USA.
| | - Gargya Malla
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, USA.
| | - Emily B Levitan
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, USA.
| | - Deborah B Rolka
- Division of Diabetes Translation, Centers for Disease Control and Prevention, USA.
| | - D Leann Long
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, USA.
| | - April P Carson
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.
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21
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Vaňková I, Vrabková I. Productivity analysis of regional-level hospital care in the Czech republic and Slovak Republic. BMC Health Serv Res 2022; 22:180. [PMID: 35148770 PMCID: PMC8840586 DOI: 10.1186/s12913-022-07471-y] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 01/05/2022] [Indexed: 11/10/2022] Open
Abstract
Background Providing hospital care is an essential objective of national health policies. The countries that share common history, when they emerged from the same health system and similar conditions in the early 1990s, after the division of Czechoslovakia, became the objects of evaluation of the development of technical efficiency of hospital care. The subsequent development of their health care system also was very similar, but no longer entirely identical. The article aims to identify the trends and disparities in the productivity of the capacities of hospital care on the regional level (NUTS III.) in the Czech Republic and the Slovak Republic in 2009–2018 before the COVID-19 pandemic using the multi-criteria decision methods. Methods The window analysis as a dynamic DEA method based on moving averages and also the Malmquist Index, that allows the evaluation of changes in relative efficiency and of changes in the production possibilities frontier have become the key methods for evaluating the over time efficiency evolution. To model technical efficiency, an output-oriented method assuming constant returns to scale was chosen. Aggregated input and output parameters for each region were the object of study. Results The results showed that differences in the efficiency trends in terms of the examined parameters among the individual regions are slightly greater in the Czech Republic than in the Slovak Republic. The least efficient regions are those where capital cities are located. Furthermore, the analysis showed that in 2018 all of the Slovak Republic regions improved its productivity compared to 2009 and that technological conditions had a significant impact on this improvement. The results of the Czech Republic regions show productivity improvement in 57% of the regions that, on the contrary, was due to changes in technical efficiency. Conclusions It should be recommended to the state- and regional-level governments to refrain from unilaterally preferring the orientation of public policies on the efficiency of the provision of hospital care, and rather focus on increasing the quality and availability of hospital care, especially in smaller, rural, and border regions, in the interest of population safety during pandemics and other emergencies. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07471-y.
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Affiliation(s)
- Ivana Vaňková
- Department of Public Economics, Faculty of Economics, VSB - Technical University of Ostrava, Sokolská třída 33, 702 00, Ostrava 1, Czech Republic.
| | - Iveta Vrabková
- Department of Public Economics, Faculty of Economics, VSB - Technical University of Ostrava, Sokolská třída 33, 702 00, Ostrava 1, Czech Republic
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Liu X, Zhang L, Hao Y, Yin X, Shi Z. Increasing disparities in the embedded carbon emissions of provincial urban households in China. J Environ Manage 2022; 302:113974. [PMID: 34710764 DOI: 10.1016/j.jenvman.2021.113974] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 03/14/2021] [Revised: 09/28/2021] [Accepted: 10/17/2021] [Indexed: 06/13/2023]
Abstract
In the context of carbon neutrality and the National Economic Circle Strategy, understanding regional disparities in carbon emissions from household consumption is conducive to regional coordination as well as high-quality and low-carbon development in China. In this study, a multiregional input-output (MRIO) model and structural decomposition analysis (SDA) are adopted to investigate the regional disparity change trends of embedded carbon emissions (ECEs) from urban households and the underlying drivers during the rapid economic development period from 2002 to 2012 in China. The results indicate that the eastern regions tended to have larger increments in total urban household ECEs, while the western regions tended to have faster growth rates. An increasing disparity and evident outsourcing pattern can be observed during the study period. The consumption level had a strong positive effect on urban household ECEs in all of the provinces, while the carbon efficiency, consumption pattern, production structure, and population size had differentiated offsetting effects on urban household ECEs in various provinces. The results obtained in this study are conducive to promoting joint efforts for carbon emission reduction and narrowing regional disparities.
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Affiliation(s)
- Xiaoyu Liu
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Beijing Normal University, Beijing, 100875, China; Advanced Institute of Natural Sciences, Beijing Normal University at Zhuhai, Zhuhai, 519087, China
| | - Lixiao Zhang
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Beijing Normal University, Beijing, 100875, China.
| | - Yan Hao
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Beijing Normal University, Beijing, 100875, China
| | - Xuemei Yin
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Beijing Normal University, Beijing, 100875, China
| | - Zhimin Shi
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Beijing Normal University, Beijing, 100875, China
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23
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Jeong SH, Joo JH, Park M, Yun C, Kang SH, Park EC, Han YD, Jang SI. Difference in medical service use among Korean gastric cancer survivors according to regional healthcare vulnerabilities: a cohort study. Support Care Cancer 2022; 30:9233-41. [PMID: 36056274 DOI: 10.1007/s00520-022-07346-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 08/24/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE This study investigated the relationship between medical service use and healthcare vulnerability, pre- and post-gastric cancer diagnosis. Differences between healthcare-vulnerable and healthcare-nonvulnerable regions identified inequities that require intervention. METHODS This cohort study was done using the National Health Insurance claims data of patients diagnosed with gastric cancer between 2004 and 2013. The Position Value for Relative Comparison Index was used to determine whether the patients lived in a healthcare-vulnerable region. Medical service use was classified into annual outpatient treatment, hospitalization days, and emergency treatment. We used a generalized linear model to which the Poisson distribution was applied and compared regional differences in medical service use. RESULTS A total of 1797 gastric cancer patients who had survived 5 years post-diagnosis were included in the study, of which 14.2% lived in healthcare-vulnerable regions. The patients in vulnerable regions surviving 5-7 years post-diagnosis had a higher number of outpatient visits than those in nonvulnerable regions. Furthermore, hospitalization days were lesser for patients in vulnerable regions who survived 6 years post-diagnosis than those in nonvulnerable regions; however, this number increased in the seventh year. CONCLUSIONS Our results suggest that gastric cancer survivors living in healthcare-vulnerable regions have a higher probability of increased medical service use 5 years post-diagnosis compared with patients in nonvulnerable regions, which may significantly increase healthcare disparities over time. Therefore, in the future, additional research is needed to elucidate the causes of the disparities in healthcare use and the results of the differences in health outcomes.
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24
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Fleischmann-Struzek C, Rose N, Reinhart K. [Sepsis-associated deaths in Germany: characteristics and regional variation]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 65:388-395. [PMID: 34750647 PMCID: PMC8575348 DOI: 10.1007/s00103-021-03427-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 09/02/2021] [Indexed: 11/04/2022]
Abstract
Hintergrund Sepsis ist weltweit jährlich für geschätzt 11 Mio. Todesfälle verantwortlich. Die Epidemiologie sepsisassoziierter Todesfälle ist in Deutschland unzureichend verstanden, da Sepsis bisher nicht über die deutsche unikausale Todesursachenstatistik erfasst werden kann. Ziel der Arbeit Epidemiologie und Charakteristika sepsisassoziierter Krankenhaustodesfälle sollen analysiert sowie regionale Unterschiede beschrieben werden. Material und Methoden Retrospektive Beobachtungsstudie basierend auf der deutschlandweiten fallpauschalenbezogenen Krankenhausstatistik (DRG-Statistik) 2016. Sepsisassoziierte Krankenhaustodesfälle wurden über explizite und implizite Sepsis-ICD-10-GM(Internationale statistische Klassifikation der Krankheiten und verwandter Gesundheitsprobleme, 10. Revision, German Modification)-Codierungen identifiziert. Verstorbene wurden anhand der klinischen Merkmale und ihres Wohnortes entsprechend Amtlichem Gemeindeschlüssel (AGS-5-Steller) charakterisiert. Basierend auf der Bevölkerungsstatistik wurde der Anteil an den Gesamttodesfällen ermittelt. Ergebnisse 2016 gab es in Deutschland 58.689 mit explizit codierter Sepsis assoziierte Krankenhaustodesfälle (14,1 % aller Krankenhaustodesfälle). Die Mortalität betrug 73/100.000 Einwohner und variierte 1,8-fach zwischen den Bundesländern und 7,9-fach zwischen den Kreisen. 6,4 % der deutschlandweiten Todesfälle waren sepsisassoziierte Krankenhaustodesfälle. Dieser Anteil war am höchsten in der Altersgruppe der 40- bis 64-Jährigen (9,6 %) und höher bei Männern als bei Frauen (7,7 % vs. 5,2 %). Im Vergleich dazu betrug der Anteil von implizit codierten sepsisassoziierten Krankenhaustodesfällen 47,2 % an allen Krankenhaustodesfällen und 21,6 % an allen Todesfällen. Diskussion Auch wenn die direkte Todesursache nicht sicher ableitbar ist, lässt sich aus dem hohen Anteil sepsisassoziierter Todesfälle an den Krankenhaustodesfällen der Bedarf weiterer Forschung und epidemiologischer Surveillance ableiten, zum Beispiel in Kohortenstudien oder auf Basis von multikausalen Todesursachenstatistiken. Zusatzmaterial online Zusätzliche Informationen sind in der Online-Version dieses Artikels (10.1007/s00103-021-03427-5) enthalten.
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Affiliation(s)
- Carolin Fleischmann-Struzek
- Institut für Infektionsmedizin und Krankenhaushygiene, Universitätsklinikum Jena, Am Klinikum 1, 07740, Jena, Deutschland. .,Center for Sepsis Control and Care, Universitätsklinikum Jena, Jena, Deutschland.
| | - Norman Rose
- Institut für Infektionsmedizin und Krankenhaushygiene, Universitätsklinikum Jena, Am Klinikum 1, 07740, Jena, Deutschland.,Center for Sepsis Control and Care, Universitätsklinikum Jena, Jena, Deutschland
| | - Konrad Reinhart
- Klinik für Anästhesiologie m. S. operative Intensivmedizin, Charité Universitätsmedizin Berlin, Berlin, Deutschland
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Yang R, Miao X, Wong CWY, Wang T, Du M. Assessment on the interaction between technology innovation and eco-environmental systems in China. Environ Sci Pollut Res Int 2021; 28:63127-63149. [PMID: 34227007 DOI: 10.1007/s11356-021-15149-x] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 06/22/2021] [Indexed: 06/13/2023]
Abstract
To investigate the latent relation between technology innovation and eco-environmental systems and promote their coordinated development, we integrated the coupling coordination model and panel vector autoregressive model to examine the evidence from China. The research reveals that the technology innovation benefit and eco-environmental governance and endowment are the prominent factors for optimizing the two systems. Moreover, the findings show that the coupling coordination degree of eco-environment and technology innovation in China presents an upward trend. In terms of the dynamic interaction between technology innovation and eco-environment, the influence of the former on the latter is timely while that of the latter on the former is lagging (except for the central region). The weak coupling coordination degree implies that the mutual promotion of technology innovation and eco-environmental systems has not yet formed. The policy implications are proposed accordingly to promote coordinated development of eco-environment and technology innovation in China.
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Affiliation(s)
- Rui Yang
- School of Management, Harbin Institute of Technology, Harbin, 150001, China
| | - Xin Miao
- School of Management, Harbin Institute of Technology, Harbin, 150001, China.
| | - Christina W Y Wong
- Business Division, The Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hunghom, Kowloon, Hong Kong
| | - Teng Wang
- School of Business Administration, Northeastern University, Shenyang, 110006, China
| | - Mengjin Du
- School of Management, Harbin Institute of Technology, Harbin, 150001, China
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Han KT, Choi DW, Kim S. Regional and income disparities in treatment and drug adherence of patients with dyslipidemia: a retrospective cohort study in South Korea, 2003-2015. BMC Geriatr 2021; 21:585. [PMID: 34674649 PMCID: PMC8529775 DOI: 10.1186/s12877-021-02510-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 10/01/2021] [Indexed: 11/25/2022] Open
Abstract
Backgrounds Health disparities represent a major public health problem that needs to be addressed, and a variety of factors, including geographical location and income, can contribute to these disparities. Although previous studies have suggested that health differs by region and income, evidence on the difference in treatment rate is relatively insufficient. To identify differences in prescription rates by region and income in patients with dyslipidemia. Methods Using data from the National Health Insurance Service senior cohort, we included older adults who were diagnosed with dyslipidemia in Korea from 2003 to 2015. Overall prescription rate was determined for patients with dyslipidemia. In addition, medication possession ratio and a defined daily dose were analyzed in patients who were prescribed statins. A generalized estimating equation Poisson model was used to assess differences in prescription rates. Results Patients living in rural areas (Chungcheong-do, Jeolla-do, and Gyeongsang-do) had a significantly higher prescription rate than those in metropolitan cities. Unlike the prescription rate, the drug adherence was significantly higher in Seoul, Gyeonggi-do, and Gangwon-do but lower in Jeolla-do and Gyeongsang-do than in metropolitan cities. Patients with low income had lower prescription rates than those with high income, but this difference was not statistically significant. Conclusion Our findings demonstrate differences in the treatment rates of patients with dyslipidemia by region and income. Appropriate interventions are needed in vulnerable regions and groups to increase the treatment rate for patients with dyslipidemia. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02510-5.
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Affiliation(s)
- Kyu-Tae Han
- Division of Cancer Control and Policy, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, 10408, Republic of Korea
| | - Dong-Woo Choi
- Cancer Data Center, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, 10408, Republic of Korea
| | - Seungju Kim
- Department of Nursing, College of Nursing, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
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27
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Yan LJ, Yao SY, Meng GX, Liu KX, Li HC, Ding ZN, Dong ZR, Hong JG, Chen ZQ, Li T. Sex and regional disparities in incidence of hepatocellular carcinoma in autoimmune hepatitis: a systematic review and meta-analysis. Hepatol Int 2021; 15:1413-1420. [PMID: 34478116 DOI: 10.1007/s12072-021-10249-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 04/23/2021] [Accepted: 08/19/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Recent studies have identified an increased risk of hepatocellular carcinoma (HCC) in autoimmune hepatitis (AIH). Sex and regional disparities in incidence of HCC in AIH continue to be reported worldwide. Nevertheless, the magnitude of this gap remains unknown. METHOD We searched several databases including PubMed, Embase, Web of Science, Cochrane Library, Wanfang Data, CNKI and SinoMed. Incidence rates of HCC in AIH were combined and analyzed following the EBayes method. Incidence rate ratios were pooled to assess the sex differences. The impact of population difference, sex, age, cirrhotic condition was further analyzed with subgroup analysis and linear regression analysis. RESULT 39 studies meeting our eligibility criteria were chosen for the analysis. The pooled incidence rate of HCC in AIH was 3.54 per 1000 person years (95% CI 2.76-4.55). Pooled IRR for the risk of HCC in male AIH patients compared to female was 2.16 (95% CI 1.25-3.75), with mild heterogeneity among studies. The pooled HCC incidence rate in AIH by continents was as follows: Europe 2.37 per 1000 person-years (95% CI 1.45-3.88), Asia 6.18 per 1000 person-years (95%CI 5.51-6.93), North America 2.97 per 1000 person-years (95%CI 2.40-3.68), Oceania 2.60 (95%CI 0.54-7.58). The pooled HCC incidence rate in AIH-related cirrhosis by continent was as follows: Europe 6.35 per 1000 person-years (95%CI 3.94-10.22), Asia 17.02 per 1000 person-years (95%CI 11.18-25.91), North America 10.89 per 1000 person-years (95%CI 6.69-17.74). CONCLUSION A higher HCC incidence in AIH was observed among male and in Asian populations. Cirrhosis status at AIH diagnosis is significantly associated with an increased incidence rate for HCC, and routine HCC surveillance is recommended for patients with AIH cirrhosis, especially for those in Asia.
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Affiliation(s)
- Lun-Jie Yan
- Department of General Surgery, Qilu Hospital, Shandong University, 107 West Wen Hua Road, Jinan, 250012, People's Republic of China
| | - Sheng-Yu Yao
- Department of General Surgery, Qilu Hospital, Shandong University, 107 West Wen Hua Road, Jinan, 250012, People's Republic of China
| | - Guang-Xiao Meng
- Department of General Surgery, Qilu Hospital, Shandong University, 107 West Wen Hua Road, Jinan, 250012, People's Republic of China
| | - Kai-Xuan Liu
- Department of General Surgery, Qilu Hospital, Shandong University, 107 West Wen Hua Road, Jinan, 250012, People's Republic of China
| | - Hai-Chao Li
- Department of General Surgery, Qilu Hospital, Shandong University, 107 West Wen Hua Road, Jinan, 250012, People's Republic of China
| | - Zi-Niu Ding
- Department of General Surgery, Qilu Hospital, Shandong University, 107 West Wen Hua Road, Jinan, 250012, People's Republic of China
| | - Zhao-Ru Dong
- Department of General Surgery, Qilu Hospital, Shandong University, 107 West Wen Hua Road, Jinan, 250012, People's Republic of China
| | - Jian-Guo Hong
- Department of General Surgery, Qilu Hospital, Shandong University, 107 West Wen Hua Road, Jinan, 250012, People's Republic of China
| | - Zhi-Qiang Chen
- Department of General Surgery, Qilu Hospital, Shandong University, 107 West Wen Hua Road, Jinan, 250012, People's Republic of China
| | - Tao Li
- Department of General Surgery, Qilu Hospital, Shandong University, 107 West Wen Hua Road, Jinan, 250012, People's Republic of China. .,Department of Hepatobiliary Surgery, The Second Hospital of Shandong University, Jinan, 250012, People's Republic of China.
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Karaye KM, Ishaq NA, Sai'du H, Balarabe SA, Ahmed BG, Adamu UG, Mohammed IY, Oboirien I, Umuerri EM, Mankwe AC, Shidali VY, Dodiyi-Manuel S, Njoku P, Olunuga T, Josephs V, Mbakwem AC, Ogah OS, Tukur J, Okeahialam B, Stewart S, Henein M, Sliwa K. Disparities in clinical features and outcomes of peripartum cardiomyopathy in high versus low prevalent regions in Nigeria. ESC Heart Fail 2021; 8:3257-3267. [PMID: 34137499 PMCID: PMC8318483 DOI: 10.1002/ehf2.13463] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/09/2021] [Accepted: 05/23/2021] [Indexed: 12/14/2022] Open
Abstract
Aims The prospective, multicentre Peripartum Cardiomyopathy in Nigeria (PEACE) registry originally demonstrated a high prevalence of peripartum cardiomyopathy (PPCM) among patients originating from Kano, North‐West Nigeria. In a post hoc analysis, we sought to determine if this phenomenon was characterized by a differential case profile and outcome among PPCM cases originating elsewhere. Methods and results Overall, 199 (81.6%) of a total 244 PPCM patients were recruited from three sites in Kano, compared with 45 patients (18.4%) from 11 widely dispersed centres across Nigeria. Presence and extent of ventricular myocardial remodelling during follow‐up, relative to baseline status, were assessed by echocardiography. During median 17 months follow‐up, Kano patients demonstrated significantly better myocardial reverse remodelling than patients from other sites. Overall, 50.6% of patients from Kano versus 28.6% from other regions were asymptomatic (P = 0.029) at study completion, with an accompanying difference in all‐cause mortality (17.6% vs. 22.2% respectively, P = 0.523) not reaching statistical significance. Alternatively, 135/191 (84.9%) of Kano patients had selenium deficiency (<70 μg/L), and 46/135 (34.1%) of them received oral selenium supplementation. Critically, those that received selenium supplementation demonstrated better survival (6.5% vs. 21.2%; P = 0.025), but the supplement did not have significant impact on myocardial remodelling. Conclusions This study has shown important non‐racial regional disparities in the clinical features and outcomes of PPCM patients in Nigeria, that might partly be explained by selenium supplementation.
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Affiliation(s)
- Kamilu M Karaye
- Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria.,Department of Medicine, Bayero University, Kano, Nigeria.,Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden.,Hatter Institute for Cardiovascular Research in Africa & CHI, Cape Town, South Africa
| | - Naser A Ishaq
- Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Hadiza Sai'du
- Department of Medicine, Bayero University, Kano, Nigeria.,Department of Medicine, Murtala Mohammed Specialist Hospital, Kano, Nigeria
| | - Sulaiman A Balarabe
- Department of Medicine, Muhammad Abdullahi Wase Specialist Hospital, Kano, Nigeria
| | - Bashir G Ahmed
- Department of Medicine, Muhammad Abdullahi Wase Specialist Hospital, Kano, Nigeria
| | - Umar G Adamu
- Department of Medicine, Federal Medical Centre, Bidda, Nigeria & Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
| | - Idris Y Mohammed
- Department of Chemical Pathology, Aminu Kano Teaching Hospital, Medicine Bayero University, Kano, Nigeria
| | - Isa Oboirien
- Department of Medicine, Dalhatu Araf Specialist Hospital, Lafia, Nigeria
| | - Ejiroghene M Umuerri
- Department of Medicine, Delta State University Teaching Hospital, Oghara, Nigeria
| | - Abaram C Mankwe
- Department of Medicine, Federal medical centre, Yenagoa, Yenagoa, Nigeria
| | | | - Sotonye Dodiyi-Manuel
- Department of Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
| | - Paschal Njoku
- University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Taiwo Olunuga
- Department of Medicine, Federal Medical centre, Abeokuta, Nigeria
| | - Veronica Josephs
- Department of Medicine, University of Benin Teaching Hospital, Benin, Nigeria
| | - Amam C Mbakwem
- Department of Medicine, University of Lagos, Lagos, Nigeria
| | - Okechukwu S Ogah
- Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - Jamilu Tukur
- Department of Obstetrics and Gynecology, Bayero University, Kano, Nigeria
| | - Basil Okeahialam
- Department of Medicine, Jos University Teaching Hospital, Jos, Nigeria
| | - Simon Stewart
- Torrens University Australia, Adelaide, South Australia, Australia
| | - Michael Henein
- Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden
| | - Karen Sliwa
- Hatter Institute for Cardiovascular Research in Africa & CHI, Cape Town, South Africa
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Dörr M, Riemer U, Christ M, Bauersachs J, Bosch R, Laufs U, Neumann A, Scherer M, Störk S, Wachter R. Hospitalizations for heart failure: still major differences between East and West Germany 30 years after reunification. ESC Heart Fail 2021; 8:2546-2555. [PMID: 33949148 PMCID: PMC8318397 DOI: 10.1002/ehf2.13407] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 03/07/2021] [Accepted: 04/22/2021] [Indexed: 12/31/2022] Open
Abstract
Aims Heart failure (HF) is the most common primary inpatient diagnosis in Germany. We examined temporal trends of HF hospitalization within Germany focusing on regional differences. Methods and results We analysed aggregated data of more than 320 million hospitalizations in Germany from 2000 to 2017. Temporal trends of HF‐related parameters were analysed, focusing on regional differences between the federal states. The absolute number of HF‐related hospitalizations throughout Germany increased continuously and almost doubled (from 239 694 to 464 724 cases, +94%) with the relative increase being higher in East Germany compared with West Germany (119% vs. 88%). These regional differences persisted after age standardization with 609 and 490 cases per 100 000 population, respectively. The length of stay decreased continuously across Germany (from 14.3 to 10.2 days; −29%), while the total number of HF‐related hospital days increased by 51% in East Germany and 35% in West Germany. In 2017, HF remained the leading cause of in‐hospital death (8.9% of all cases), with a markedly higher rate in East vs. West Germany (65 vs. 43 deaths per 100 000 population). Conclusions Heart failure remains the most common cause of hospitalization and in‐hospital death throughout Germany. The increase in HF‐related morbidity and mortality was much higher in East Germany compared with West Germany during the observation period. A more detailed understanding of these striking disparities 30 years after the German reunification requires further investigations. There is an urgent need for action with regard to stronger control of risk factors and improvement of both chronic HF management and healthcare structures.
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Affiliation(s)
- Marcus Dörr
- Department of Internal Medicine B, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
| | - Uwe Riemer
- Medical Department, Novartis Pharma GmbH, Nuremberg, Germany
| | - Michael Christ
- Emergency Department, Luzerner Kantonsspital, Luzern, Switzerland
| | - Johann Bauersachs
- Department of Cardiology and Angiology, Hannover Medical School, Hanover, Germany
| | - Ralph Bosch
- Cardio Centrum Ludwigsburg-Bietigheim, Ludwigsburg, Germany
| | - Ulrich Laufs
- Clinic and Policlinic for Cardiology, University Hospital Leipzig, Leipzig, Germany
| | - Anja Neumann
- Institute for Health Care Management and Research, University of Duisburg-Essen, Duisburg, Germany
| | - Martin Scherer
- Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Störk
- Comprehensive Heart Failure Center Würzburg and Dept. Medicine I, University and University Hospital Würzburg, Würzburg, Germany
| | - Rolf Wachter
- Clinic and Policlinic for Cardiology, University Hospital Leipzig, Leipzig, Germany.,Clinic for Cardiology and Pneumology, University Medicine Göttingen, Göttingen, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Göttingen, Germany
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Alcay A, Montañés A, Simón-Fernández MB. Waste generation in Spain. Do Spanish regions exhibit a similar behavior? Waste Manag 2020; 112:66-73. [PMID: 32471683 DOI: 10.1016/j.wasman.2020.05.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 03/15/2020] [Revised: 05/19/2020] [Accepted: 05/20/2020] [Indexed: 06/11/2023]
Abstract
We analyze waste generation differences across Spanish regions by studying the evolution of two complementary indicators: municipal solid waste per unit of GDP as well as in per capita terms. To that end, we apply the recent statistic developed by Phillips and Sul (2007) which allows us to test for the null hypothesis of convergence. In the present case, this hypothesis is equivalent to admitting that the waste generation follows a similar path across the Spanish regions. Our results lead us to reject this hypothesis, which implies that Spanish regional waste generation is quite heterogenous and exhibits several patterns of behavior. We observe that the northern regions exhibit the lowest waste ratios while the insular and Mediterranean coast regions have the highest waste generation. This different behavior is also explained by some socioeconomic factors. Per capita income, environmental spending and education level are helpful in this regard. The population dispersion and the number of years that a region has been governed by a left-wing party are also associated with lower levels of waste generation. Finally, we can also observe that the regions with the highest levels of waste generation are greatly dependent on the tourism industry. Then, strategies targeting the transit towards a more sustainable economy in Spain should take into account this fact. In particular, the adoption of methods for the reduction of the waste levels generated by tourism activities in these areas can be very useful.
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Asemota AO, Ishii M, Brem H, Gallia GL. Geographic Variation in Costs of Transsphenoidal Pituitary Surgery in the United States. World Neurosurg 2020; 149:e1180-e1198. [PMID: 32145414 DOI: 10.1016/j.wneu.2020.02.145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 02/22/2020] [Indexed: 01/12/2023]
Abstract
BACKGROUND Geographic variations in health care costs have been reported for many surgical specialties. OBJECTIVE In this study, we sought to describe national and regional costs associated with transsphenoidal pituitary surgery (TPS). METHODS Data from the Truven-MarketScan 2010-2014 were analyzed. We examined overall total, hospital/facility, physician, and out-of-pocket payments in patients undergoing TPS including technique-specific costs. Mean payments were obtained after risk adjustment for patient-level and system-level confounders and estimated differences across regions. RESULTS The estimated overall annual burden was $43 million/year in our cohort. The average overall total payment associated with TPS was $35,602.30, hospital/facility payment was $26,980.45, physician payment was $4685.95, and out-of-pocket payment was $2330.78. Overall total and hospital/facility costs were highest in the West and lowest in the South (both P < 0.001), whereas physician reimbursements were highest in the North-east and lowest in the South (P < 0.001). There were no differences in out-of-pocket expenses across regions. On a national level, there were significantly higher overall total and hospital/facility payments associated with endoscopic compared with microscopic procedures (both P < 0.001); there were no significant differences in physician payments or out-of-pocket expenses between techniques. There were also significant within-region cost differences in overall total, hospital/facility, and physician payments in both techniques as well as in out-of-pocket expenses associated with microsurgery. There were no significant regional differences in out-of-pocket expenses associated with endoscopic surgery. CONCLUSIONS Our results show significant geographic cost disparities associated with TPS. Understanding factors behind disparate costs is important for developing cost containment strategies.
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Affiliation(s)
- Anthony O Asemota
- Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Masaru Ishii
- Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Henry Brem
- Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Gary L Gallia
- Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, Maryland, USA.
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Yu X, Zhang W. All-cause mortality rate in China: do residents in economically developed regions have better health? Int J Equity Health 2020; 19:12. [PMID: 31964379 PMCID: PMC6975071 DOI: 10.1186/s12939-020-1128-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 01/13/2020] [Indexed: 02/07/2023] Open
Abstract
Background Urban-rural disparities have been extensively investigated, while most investigators overlooked urban-suburban-rural variations in population health. Although regional disparities in East-West China have been largely discussed, limited attention has been directed to the interaction between regional differences and urban-suburban-rural disparities. This study aims to analyze urban-suburban-rural variations in all-cause mortality rates across four geographic regions in China. Methods Data came from China’s National Census Survey and public statistical yearbooks in 2000 and 2010. Urban districts, county-level cities, and counties were respectively defined as urban, suburban, and rural areas. We obtained 2322 areas, including 2148 areas with two observations and 174 areas with only one observation. Data visualization was performed to depict geographic variations and changes in all-cause mortality rates. Five hierarchical linear regression analyses with generalized estimating equations (GEE) were employed to analyze variations in all-cause mortality rates over time. Demographic and socioeconomic attributes were introduced as covariates. Results Despite an overall decline in all-cause mortality rate, rural residents generally achieved worse health than urban and suburban counterparts. In contrast, urban-suburban disparities could be fully explained by demographic and socioeconomic differences. In addition, Northeastern and Central residents achieved better health than Eastern and Western residents. Last, there existed urban/suburban-rural disparities in all regions, except Northeastern, where urban/suburban-rural disparities were eliminated after controlling for socioeconomic and demographic attributes. Conclusion Even though suburban and rural areas were often merged, there exist urban/suburban-rural disparities in population health. Furthermore, urban/suburban-rural disparities vary across regions.
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Affiliation(s)
- Xuexin Yu
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, 37 Guo Xue Alley, Chengdu, 610040, Sichuan, China
| | - Wei Zhang
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, 37 Guo Xue Alley, Chengdu, 610040, Sichuan, China.
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Guo Y, Zhang B, Chen B, Yang Q, Li J. Disparities in socio-economic drivers behind China's provincial energy-related mercury emission changes. J Environ Manage 2019; 251:109613. [PMID: 31561143 DOI: 10.1016/j.jenvman.2019.109613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 07/29/2019] [Revised: 09/11/2019] [Accepted: 09/19/2019] [Indexed: 06/10/2023]
Abstract
The legally binding Minamata Convention was ratified by the Chinese government in 2017, implying that mercury emission mitigation policy design has become an urgent task ever since. As each provincial region has different energy structures and technology levels, their mercury emission profiles may have heterogeneity, thus requiring targeted regional control polices. Therefore, this study investigates the provincial energy-related mercury emissions and identifies their underlying socioeconomic factors during 2007-2012, by combining structural decomposition analysis (SDA) with the multi-regional input-output analysis (MRIO). Results show that the rising consumption per capita and decreasing emission factor are the largest contributors to emission growth and decline, respectively. However, their contributions vary significantly across regions. The rising consumption per capita leads to nearly 20 t emission increase in Shandong and Jiangsu, but less than 1 t in Qinghai. The decreasing emission factor's negative effect on mercury emission reduction is extremely important in Jiangsu, Shandong and Guangdong, but not so obvious in most western provinces. Energy efficiency is another critical contributor to mercury reduction in all provinces except Guizhou, as the coal consumption in Guizhou nearly doubled during 2007-2010. Moreover, production structure and consumption structure have opposite effects during 2007-2010 and 2010-2012: they first drive energy-related mercury emissions growing in most provinces, then inhibit the emissions especially in Shandong and Guangdong. These findings point to targeted mercury mitigation strategies (for example: improving energy efficiency in Guizhou and Liaoning, optimizing economic structure in Henan and Sichuan) for each province.
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Affiliation(s)
- Yaqin Guo
- School of Energy and Power Engineering, Huazhong University of Science and Technology, Wuhan, 430074, PR China
| | - Bonan Zhang
- School of Software and Microelectronics, Peking University, Beijing, 100871, PR China
| | - Bin Chen
- Laboratory of Systems Ecology and Sustainability Science, College of Engineering, Peking University, Beijing, 100871, PR China
| | - Qing Yang
- School of Energy and Power Engineering, Huazhong University of Science and Technology, Wuhan, 430074, PR China
| | - Jiashuo Li
- Institute of Blue and Green Development, Shandong University, Weihai, 264209, PR China.
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Ye L, Luo J, Shia BC, Fang Y. Heterogeneous health classes for older adults and their regional disparities in China: based on multidimensional health. Public Health 2019; 178:15-22. [PMID: 31605804 DOI: 10.1016/j.puhe.2019.08.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 08/13/2019] [Accepted: 08/24/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES China is currently facing an unprecedented complex health demand from a rapidly aging population. Based on multidimensional health, this study aimed to identify heterogeneous latent health classes for older Chinese people, and assess regional disparities and associated sociodemographic factors. STUDY DESIGN Chinese Longitudinal Healthy Longevity Survey in 2014 was adopted. METHODS For 2886 participants aged 65 years and more without missing health indicators in physical, psychological, and social dimensions, latent class analysis was used to identify heterogeneous health. For 2128 participants with complete information, logistic regressions were used to examine how regional divisions and sociodemographic factors impact each identified class. RESULTS Four classes were identified and labeled as 'Lacking Socialization' (17.4%), 'High Comorbidity' (13.7%), 'Functional Impairment' (7.1%), and 'Relative Health' (61.8%). When the Relative Health class was the reference, the likelihoods of the High Comorbidity and Functional Impairment classes were higher for older adults in eastern and central regions than in western regions. Those in eastern regions also tended to be in the Lacking Socialization class than in western regions. The effects of regional divisions on the different classes were significantly impacted by sociodemographic characteristics. CONCLUSIONS Four health classes identified by multidimensional health have enhanced our understanding of heterogeneity among older Chinese people. By examining regional disparities in China, our study provided evidence for health policies addressing the issue of aging with respect to regional disparities.
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Affiliation(s)
- L Ye
- School of Public Health, Xiamen University, Xiamen, Fujian, 361102, China; School of Economics, Xiamen University, Xiamen, Fujian, 361005, China
| | - J Luo
- School of Public Health, Xiamen University, Xiamen, Fujian, 361102, China
| | - B-C Shia
- School of Management, Taipei Medical University, Taipei, 10675, Taiwan
| | - Y Fang
- School of Public Health, Xiamen University, Xiamen, Fujian, 361102, China.
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Dütsch M, Ganesch F, Struck O. Employment trajectories in heterogeneous regions: Evidence from Germany. Adv Life Course Res 2019; 40:43-84. [PMID: 36694413 DOI: 10.1016/j.alcr.2019.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 11/19/2018] [Accepted: 03/02/2019] [Indexed: 06/17/2023]
Abstract
To what extent do regional characteristics influence employment trajectories? Do regional factors diversely affect the employment careers of different sociodemographic groups? By investigating these questions, we extend current life course research in two ways: First, from a conceptual perspective, we use approaches from regional economics in addition to established sociological labour market theories to gain insights into the effects of regional determinants on individual labour market outcomes. Second, from a methodological point of view, we conduct event history analyses based on a German dataset that contains information on individuals, firms and regions. Our results show that there are considerable regional heterogeneities regarding population density and the amount of human capital endowment, both of which influence working careers differently. Regional agglomeration predominantly offers opportunities in terms of employment trajectories, while regional human capital accumulation increases employment risks. Additionally, our findings indicate that group-specific inequalities with respect to employment careers can be weakened or even strengthened by regional frame conditions. Female and foreign employees benefit most from denser regions and from a higher human capital endowment. By contrast, the unemployment risks of workers who previously experienced unemployment periods during their working lives are increased by both of these regional characteristics. Findings regarding education level are mixed: Workers with occupational qualifications profit from regional agglomeration to a greater extent than do low or even generally qualified workers. However, a high local human capital endowment leads to skill segregation between vocationally trained and highly qualified employees.
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Affiliation(s)
- Matthias Dütsch
- Chair of Labour Studies, Otto-Friedrich University of Bamberg, Feldkirchenstraße 21, 96052 Bamberg, Germany; Federal Institute for Occupational Safety and Health, Nöldnerstraße 40-42, 10317 Berlin, Germany.
| | - Franziska Ganesch
- Chair of Labour Studies, Otto-Friedrich University of Bamberg, Feldkirchenstraße 21, 96052 Bamberg, Germany.
| | - Olaf Struck
- Chair of Labour Studies, Otto-Friedrich University of Bamberg, Feldkirchenstraße 21, 96052 Bamberg, Germany.
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Barry Y, Deneux-Tharaux C, Saucedo M, Goulet V, Guseva-Canu I, Regnault N, Chantry AA. Maternal admissions to intensive care units in France: Trends in rates, causes and severity from 2010 to 2014. Anaesth Crit Care Pain Med 2019; 38:363-9. [PMID: 30583117 DOI: 10.1016/j.accpm.2018.12.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 12/03/2018] [Accepted: 12/16/2018] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Maternal intensive care unit admission is an indicator of severe maternal morbidity. The objective of this study was to estimate rates of maternal intensive care unit admission during or following pregnancy in France, and to describe the characteristics of women concerned, the severity of their condition, associated diagnoses, regional disparities, and temporal trends between 2010 and 2014. METHODS Women hospitalised in France in intensive care units during pregnancy or up to 42 days after pregnancy between January 2010 and December 2014 were identified using the national hospital discharge database (PMSI-MCO). Trends in incidence rates were quantified using percentages of average annual variation based on a Poisson regression model. RESULTS In total, 16,011 women were admitted to intensive care units, representing an overall incidence of 3.97‰ deliveries. This number decreased significantly by 1.7% on average per year. For women who gave birth (60.5% by C-section), 62.5% of admissions occurred during their hospitalisation for delivery. The SAPS II score, an indicator of severity, significantly increased from 18.4 in 2010 to 21.5 in 2014. Obstetrical haemorrhage (39.8%) and hypertensive complications during pregnancy (24.8%) were the most common reasons for admission. In mainland France, the Ile-de-France (i.e., greater Paris) region had the highest rates of intensive care units admission (5.05‰) while the Pays-de-la-Loire region had the lowest (2.69‰). CONCLUSION The rate of maternal intensive care unit admission decreased from 2010 to 2014 in France, with a concomitant increase in case severity. In-depth studies are needed to understand the territorial disparities identified.
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Singh PK, Jasilionis D, Oksuzyan A. Gender difference in cognitive health among older Indian adults: A cross-sectional multilevel analysis. SSM Popul Health 2018; 5:180-187. [PMID: 30073185 PMCID: PMC6068074 DOI: 10.1016/j.ssmph.2018.06.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 05/24/2018] [Accepted: 06/21/2018] [Indexed: 01/21/2023] Open
Abstract
This study assesses the gender gap in cognitive health among older adults in India and examines the extent to which individual, household and state level characteristics contribute to the male-female difference in cognitive health. The study is based on 6548 women and men who participated in the WHO Study on Global AGEing and Adult Health conducted in six states in India during 2007-08. Multilevel ordinary least square regression was used to examine the gender difference in cognitive health, adjusting for individual, household, health behavior and state-level variables. A composite cognitive score (CCS) was calculated by combining z-scores of five individual cognitive tests. Results suggest that CCS is worse among women than among men after adjusting for individual and state level factors. The largest reduction in the gender gap in CCS was observed when adjusting for education, followed by other individual factors such as marital status, individual height, caste, religion, tobacco consumption and chronic health status. Although state level urbanization and female workforce participation rate were significantly associated with CCS, these characteristics did not contribute to the reduction of gender difference in CCS. This study extends the current knowledge of women's disadvantage in cognitive health, demonstrating that individual level characteristics remain key determinants of gender difference in cognition among older adults in India. Importantly, this relationship holds in the context of very large cross-state variations in cognitive health and its determinants.
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Affiliation(s)
- Prashant Kumar Singh
- Department of Policy Studies, TERI School of Advanced Studies, 10 Institutional Area, Vasant Kunj, New Delhi 110070, India
| | - Domantas Jasilionis
- Max Planck Institute for Demographic Research, Konrad-Zuse Str. 1, 18057 Rostock, Germany
- Demographic Research Centre, Vytautas Magnus University, Kaunas, Lithuania
| | - Anna Oksuzyan
- Max Planck Institute for Demographic Research, Konrad-Zuse Str. 1, 18057 Rostock, Germany
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Gavurová B, Kováč V, Vagašová T. Standardised mortality rate for cerebrovascular diseases in the Slovak Republic from 1996 to 2013 in the context of income inequalities and its international comparison. Health Econ Rev 2017; 7:7. [PMID: 28150127 PMCID: PMC5289125 DOI: 10.1186/s13561-016-0140-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 12/16/2016] [Indexed: 06/06/2023]
Abstract
Non-communicable diseases represent one of the greatest challenges for health policymakers. The main objective of this study is to analyse the development of standardised mortality rates for cerebrovascular disease, which is one of the most common causes of deaths, in relation to income inequality in individual regions of the Slovak Republic. Direct standardisation was applied using data from the Slovak mortality database, covering the time period from 1996 to 2013. The standardised mortality rate declined by 4.23% in the Slovak Republic. However, since 1996, the rate has been higher by almost 33% in men than in women. Standardised mortality rates were lower in the northern part of the Slovak Republic than in the southern part. The regression models demonstrated an impact of the observed income-related dimensions on these rates. The income quintile ratio and Gini coefficient appeared to be the most influencing variables. The results of the analysis highlight valuable baseline information for creating new support programmes aimed at eliminating health inequalities in relation to health and social policy.
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