139 research outputs found
AN EVALUATION OF THE ADVANCE DIRECTIVES-LIVE ACTION SIMULATION TRAINING (AD-LAST) PROGRAM
Advance Care Planning (ACP) is a process that captures a patientâs wishes in the case of future circumstances in which they are unable to express them. Studies show that less than one third of the general population has completed some type of formal Advance Directive (AD). There are barriers to completing ADs, and these barriers operate on multiple levels, including, patient, provider and institutional. To improve providersâ capacity to help patients complete ACP, and overcome these barriers, a provider-focused intervention was conducted. The current study is an analysis of archival data collected from the Advance Directives-Live Action Simulation Training (AD-LAST) program developed and implemented at New York Presbyterian-Queens (NYP-Q). The AD-LAST workshop aimed to improve ACP and end-of-life (EOL) conversations by increasing clinician knowledge and self-efficacy in aspects of ACP and EOL. Although the intervention was independently successful in increasing cliniciansâ knowledge and self-efficacy on ACP, we found that these two measures were unrelated to one another, and may represent distinct dimensions of improvements in ACP
Social Support and Mental Health in the Postpartum Period in Times of SARS-CoV-2 Pandemic: Spanish Multicentre Cohort Study
COVID-19; Anxiety; PregnancyCOVID-19; Ansiedad; EmbarazoCOVID-19; Ansietat; EmbarĂ sBackground: To explore the depression and anxiety symptoms in the postpartum period during the SARS-CoV-2 pandemic and to identify potential risk factors. Methods: A multicentre observational cohort study including 536 women was performed at three hospitals in Spain. The Edinburgh Postnatal Depression Scale (EPDS), the State-Trait Anxiety Inventory (STAI) Scale, the Medical Outcomes Study Social Support Survey (MOS-SSS), and the Postpartum Bonding Questionnaire (PBQ) were assessed after birth. Depression (EPDS) and anxiety (STAI) symptoms were measured, and the cut-off scores were set at 10 and 13 for EPDS, and at 40 for STAI. Results: Regarding EPDS, 32.3% (95% CI, 28% to 36.5%) of women had a score â„ 10, and 17.3% (95% CI, 13.9% to 20.7%) had a score â„ 13. Women with an STAI score â„ 40 accounted for 46.8% (95% CI, 42.3% to 51.2%). A lower level of social support (MOS-SSS), a fetal malformation diagnosis and a history of depression (p = 0.000, p = 0.019 and p = 0.043) were independent risk factors for postpartum depression. A lower level of social support and a history of mental health disorders (p = 0.000, p = 0.003) were independent risk factors for postpartum anxiety. Conclusion: During the SARS-CoV-2 pandemic, an increase in symptoms of anxiety and depression were observed during the postpartum period
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Blood transfusion history and risk of non-Hodgkin lymphoma : an InterLymph pooled analysis
PURPOSE: To conduct a pooled analysis assessing the association of blood transfusion with risk of non-Hodgkin lymphoma (NHL). METHODS: We used harmonized data from 13 case-control studies (10,805 cases, 14,026 controls) in the InterLymph Consortium. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using unconditional logistic regression, adjusted for study design variables. RESULTS: Among non-Hispanic whites (NHW), history of any transfusion was inversely associated with NHL risk for men (OR 0.74; 95% CI 0.65-0.83) but not women (OR 0.92; 95% CI 0.83-1.03), pheterogeneityâ=â0.014. Transfusion history was not associated with risk in other racial/ethnic groups. There was no trend with the number of transfusions, time since first transfusion, age at first transfusion, or decade of first transfusion, and further adjustment for socioeconomic status, body mass index, smoking, alcohol use, and HCV seropositivity did not alter the results. Associations for NHW men were stronger in hospital-based (OR 0.56; 95% CI 0.45-0.70) but still apparent in population-based (OR 0.84; 95% CI 0.72-0.98) studies. CONCLUSIONS: In the setting of a literature reporting mainly null and some positive associations, and the lack of a clear methodologic explanation for our inverse association restricted to NHW men, the current body of evidence suggests that there is no association of blood transfusion with risk of NHL
Hepatitis C and Non-Hodgkin Lymphoma Among 4784 Cases and 6269 Controls From the International Lymphoma Epidemiology Consortium
Background & Aims: increasing evidence points towards a role of hepatitis C virus (HCV) infection in causing malignant lymphomas. We pooled case-control study data to provide robust estimates of the risk of non-Hodgkin's lymphoma (NHL) subtypes after HCV infection. Methods: The analysis included 7 member studies from the International Lymphoma Epidemiology Consortium (InterLymph) based in Europe, North America, and Australia. Adult cases of NHL (n = 4784) were diagnosed between 1988 and 2004 and controls (n = 6269) were matched by age, sex, and study center. All studies used third-generation enzyme-linked immunosorbent assays to test for antibodies against HCV in serum samples. Participants who were human immunodeficiency virus positive or were organ-transplant recipients were excluded. Results: HCV infection was detected in 172 NHL cases (3.60%) and in 169 (2.70%) controls (odds ratio [OR], 1.78; 95% confidence interval [CI], 1.40 -2.25). In subtype-specific analyses, HCV prevalence was associated with marginal zone lymphoma (OR, 2.47; 95% CI, 1.44-4.23), diffuse large B-cell lymphoma (OR, 2.24; 95% CI, 1.682.99), and lymphoplasmacytic lymphoma (OR, 2.57; 95% CI, 1.14-5.79). Notably, risk estimates were not increased for follicular lymphoma (OR, 1.02; 95% CI, 0.65-1.60). Conclusions: These results confirm the association between HCV infection and NHL and specific B-NHL subtypes (diffuse large B-cell lymphoma, marginal zone lymphoma, and lymphoplasmacytic lymphoma)
Urban and rural differences in frequency of fruit, vegetable, and soft drink consumption among 6â9âyearâold children from 19 countries from the WHO European region
In order to address the paucity of evidence on the association between childhood eating habits and urbanization, this cross-sectional study describes urbanârural differences in frequency of fruit, vegetable, and soft drink consumption in 123,100 children aged 6â9 years from 19 countries participating in the fourth round (2015-2017) of the WHO European Childhood Obesity Surveillance Initiative (COSI). Children's parents/caregivers completed food-frequency questionnaires. A multivariate multilevel logistic regression analysis was performed and revealed wide variability among countries and within macroregions for all indicators. The percentage of children attending rural schools ranged from 3% in Turkey to 70% in Turkmenistan. The prevalence of less healthy eating habits was high, with between 30â80% and 30â90% children not eating fruit or vegetables daily, respectively, and up to 45% consuming soft drinks on >3 days a week. For less than one third of the countries, children attending rural schools had higher odds (OR-range: 1.1â2.1) for not eating fruit or vegetables daily or consuming soft drinks >3 days a week compared to children attending urban schools. For the remainder of the countries no significant associations were observed. Both population-based interventions and policy strategies are necessary to improve access to healthy foods and increase healthy eating behaviors among children.The authors gratefully acknowledge support from a grant from the
Russian Government in the context of the WHO European Office for
the Prevention and Control of NCDs.
Data collection in the countries was made possible through
funding from Albania: WHO through the Joint Programme on
Children, Food Security and Nutrition âReducing Malnutrition in
Children,â funded by the Millennium Development Goals Achievement Fund, and the Institute of Public Health; Austria: Federal Ministry of Social Affairs, Health, Care and Consumer Protection, Republic
of Austria; Bulgaria: Ministry of Health, National Center of Public
Health and Analyses, WHO Regional Office for Europe; Croatia: Ministry of Health, Croatian Institute of Public Health and WHO
Regional Office for Europe; Ministry of Health of the Czech Republic,
grant nr. AZV MZÄR 17-31670 A and MZÄRâRVO EĂ 00023761;
Denmark: Danish Ministry of Health; Estonia: Ministry of Social
Affairs, Ministry of Education and Research (IUT 42-2), WHO Country
Office, and National Institute for Health Development; Georgia:
WHO; Ireland: Health Service Executive; Italy: Ministry of Health and
Italian National Institute of Health; Kazakhstan: Ministry of Health of
the Republic of Kazakhstan and WHO Country Office; Kyrgyzstan:
World Health Organization; Latvia: Ministry of Health, Centre for
Disease Prevention and Control; Lithuania: Science Foundation of
Lithuanian University of Health Sciences and Lithuanian Science
Council and WHO; Malta: Ministry of Health; Montenegro: WHO and
Institute of Public Health of Montenegro; North Macedonia: COSI in
North Macedonia is funded by the Government of North Macedonia
through National Annual Program of Public Health and implemented
by the Institute of Public Health and Centers of Public Health in the
country. WHO country office provides support for training and data
management; Norway: Ministry of Health and Norwegian Institute of
Public Health; Poland: National Health Programme, Ministry of
Health; Portugal: Ministry of Health Institutions, the National Institute
of Health, Directorate General of Health, Regional Health Directorates and the kind technical support from the Center for Studies and
Research on Social Dynamics and Health (CEIDSS); Romania: Ministry
of Health; Serbia: This study was supported by the World Health
Organization (Ref. File 2015-540940); Slovakia: Biennial Collaborative
Agreement between WHO Regional Office for Europe and Ministry
of Health SR; Spain: Spanish Agency for Food Safety and Nutrition
(AESAN); Tajikistan: WHO Country Office in Tajikistan and Ministry
of Health and Social Protection; Turkmenistan: WHO Country Office
in Turkmenistan and Ministry of Health; Turkey: Turkish Ministry of
Health and World Bank.info:eu-repo/semantics/publishedVersio
Socioeconomic disparities in physical activity, sedentary behavior and sleep patterns among 6- to 9-year-old children from 24 countries in the WHO European region
Physical activity, sedentary behavior, and sleep are important predictors of children's health. This paper aimed to investigate socioeconomic disparities in physical activity, sedentary behavior, and sleep across the WHO European region. This cross-sectional study used data on 124,700 children aged 6 to 9 years from 24 countries participating in the WHO European Childhood Obesity Surveillance Initiative between 2015 and 2017. Socioeconomic status (SES) was measured through parental education, parental employment status, and family perceived wealth. Overall, results showed different patterns in socioeconomic disparities in children's movement behaviors across countries. In general, high SES children were more likely to use motorized transportation. Low SES children were less likely to participate in sports clubs and more likely to have more than 2 h/day of screen time. Children with low parental education had a 2.24 [95% CI 1.94-2.58] times higher risk of practising sports for less than 2 h/week. In the pooled analysis, SES was not significantly related to active play. The relationship between SES and sleep varied by the SES indicator used. Importantly, results showed that low SES is not always associated with a higher prevalence of "less healthy" behaviors. There is a great diversity in SES patterns across countries which supports the need for country-specific, targeted public health interventions.The authors gratefully acknowledge support from a grant from the
Russian Government in the context of the WHO European Office for
the Prevention and Control of NCDs. Data collection in the countries
was made possible through funding from: Croatia: Ministry of Health,
Croatian Institute of Public Health and WHO Regional Office for
Europe. Albania: World Health Organization (WHO) Country Office
Albania and the WHO Regional Office for Europe. Bulgaria: WHO
Regional Office for Europe. Czech Republic: Ministry of Health of the
Czech Republic, grant nr. AZV MZÄR 17-31670 A and MZÄRâRVO
EĂ 00023761. Denmark: The Danish Ministry of Health. France:
Santé publique France, the French Agency for Public Health. Georgia:
WHO. Ireland: Health Service Executive. Italy: Italian Ministry of
Health; Italian National Institute of Health (Istituto Superiore di
SanitĂ ). Kazakhstan: the Ministry of Health of the Republic of
Kazakhstan within the scientific and technical program. Kyrgyzstan:
World Health Organization. Latvia: Centre for Disease Prevention and
Control, Ministry of Health, Latvia. Lithuania: Science Foundation of
Lithuanian University of Health Sciences and Lithuanian Science
Council and WHO. Malta: Ministry of Health. Montenegro: WHO and
Institute of Public Health of Montenegro. Poland: National Health
Programme, Ministry of Health. Portugal: Ministry of Health Institutions, the National Institute of Health, Directorate General of Health,
Regional Health Directorates and the kind technical support from the
Center for Studies and Research on Social Dynamics and Health
(CEIDSS). Romania: Ministry of Health. Russian Federation: WHO. San Marino: Health Ministry. Spain: the Spanish Agency for Food
Safety & Nutrition. Tajikistan: WHO Country Office in Tajikistan and
Ministry of Health and Social Protection; Turkmenistan: WHO
Country Office in Turkmenistan and Ministry of Health. Turkey:
Turkish Ministry of Health and World Bank. Austria: Federal Ministry
of Labor, Social Affairs, Health and Consumer Protection of Austria.info:eu-repo/semantics/publishedVersio
Parental Perceptions of Childrenâs Weight Status in 22 Countries: The WHO European Childhood Obesity Surveillance Initiative: COSI 2015/2017
Introduction: Parents can act as important agents of change
and support for healthy childhood growth and development. Studies have found that parents may not be able to
accurately perceive their childâs weight status. The purpose
of this study was to measure parental perceptions of their
childâs weight status and to identify predictors of potential
parental misperceptions. Methods: We used data from the
World Health Organization (WHO) European Childhood
Obesity Surveillance Initiative and 22 countries. Parents
were asked to identify their perceptions of their childrenâs
weight status as âunderweight,â ânormal weight,â âa little
overweight,â or âextremely overweight.â We categorized
childrenâs (6â9 years; n = 124,296) body mass index (BMI) as
BMI-for-age Z-scores based on the 2007 WHO-recommended growth references. For each country included in the analysis and pooled estimates (country level), we calculated the
distribution of children according to the WHO weight status
classification, distribution by parental perception of childâs
weight status, percentages of accurate, overestimating, or
underestimating perceptions, misclassification levels, and
predictors of parental misperceptions using a multilevel logistic regression analysis that included only children with
overweight (including obesity). Statistical analyses were performed using Stata version 15 1. Results: Overall, 64.1% of
parents categorized their childâs weight status accurately
relative to the WHO growth charts. However, parents were
more likely to underestimate their childâs weight if the child
had overweight (82.3%) or obesity (93.8%). Parents were
more likely to underestimate their childâs weight if the child
was male (adjusted OR [adjOR]: 1.41; 95% confidence intervals [CI]: 1.28â1.55); the parent had a lower educational level
(adjOR: 1.41; 95% CI: 1.26â1.57); the father was asked rather
than the mother (adjOR: 1.14; 95% CI: 0.98â1.33); and the
family lived in a rural area (adjOR: 1.10; 95% CI: 0.99â1.24).
Overall, parentsâ BMI was not strongly associated with the
underestimation of childrenâs weight status, but there was a
stronger association in some countries. Discussion/Conclusion: Our study supplements the current literature on factors
that influence parental perceptions of their childâs weight
status. Public health interventions aimed at promoting
healthy childhood growth and development should consider parentsâ knowledge and perceptions, as well as the sociocultural contexts in which children and families live.The authors gratefully acknowledge support from a grant from
the Russian Government in the context of the WHO European Office for the Prevention and Control of NCDs. Data collection in the
countries was made possible through funding by: Albania: World
Health Organization through the Joint Programme on Children,
Food Security and Nutrition âReducing Malnutrition in Children,â funded by the Millennium Development Goals Achievement Fund, and the Institute of Public Health; Bulgaria: Ministry
of Health, National Center of Public Health and Analyses, World
Health Organization Regional Office for Europe; Croatia: Ministry of Health, Croatian Institute of Public Health and World
Health Organization Regional Office for Europe; Czechia: Grants
AZV MZÄR 17-31670 A and MZÄR â RVO EĂ 00023761; Denmark: Danish Ministry of Health; France: French Public Health
Agency; Georgia: World Health Organization; Ireland: Health
Service Executive; Italy: Ministry of Health; Istituto Superiore di
sanitĂ (National Institute of Health); Kazakhstan: Ministry of Health of the Republic of Kazakhstan and World Health Organization Country Office; Latvia: n/a; Lithuania: Science Foundation of
Lithuanian University of Health Sciences and Lithuanian Science
Council and World Health Organization; Malta: Ministry of
Health; Montenegro: World Health Organization and Institute of
Public Health of Montenegro; Poland: National Health Programme, Ministry of Health; Portugal: Ministry of Health Institutions, the National Institute of Health, Directorate General of
Health, Regional Health Directorates and the kind technical support of Center for Studies and Research on Social Dynamics and
Health (CEIDSS); Romania: Ministry of Health; Russia (Moscow): n/a; San Marino: Health Ministry; Educational Ministry; Social Security Institute; the Health Authority; Spain: Spanish Agency for Food Safety and Nutrition (AESAN); Tajikistan: World
Health Organization Country Office in Tajikistan and Ministry of
Health and Social Protection; and Turkmenistan: World Health
Organization Country Office in Turkmenistan and Ministry of
Health. The authors alone are responsible for the views expressed
in this article and they do not necessarily represent the views, decisions, or policies of the institutions with which they are affiliated.info:eu-repo/semantics/publishedVersio
Methodology and implementation of the WHO European Childhood Obesity Surveillance Initiative (COSI)
Establishment of the WHO European Childhood Obesity Surveillance Initiative (COSI)has resulted in a surveillance system which provides regular, reliable, timely, andaccurate data on children's weight statusâthrough standardized measurement ofbodyweight and heightâin the WHO European Region. Additional data on dietaryintake, physical activity, sedentary behavior, family background, and schoolenvironments are collected in several countries. In total, 45 countries in the EuropeanRegion have participated in COSI. The first five data collection rounds, between 2007and 2021, yielded measured anthropometric data on over 1.3 million children. In COSI,data are collected according to a common protocol, using standardized instrumentsand procedures. The systematic collection and analysis of these data enables inter-country comparisons and reveals differences in the prevalence of childhood thinness,overweight, normal weight, and obesity between and within populations. Furthermore,it facilitates investigation of the relationship between overweight, obesity, and poten-tial risk or protective factors and improves the understanding of the development ofoverweight and obesity in European primary-school children in order to supportappropriate and effective policy responses.The authors gratefully acknowledge support through a grant from
the Russian Government in the context of the WHO European
Office for the Prevention and Control of NCDs. The ministries of
health of Austria, Croatia, Greece, Italy, Malta, Norway, and the
Russian Federation provided financial support for the meetings at
which the protocol, data collection procedures, and analyses were
discussed. Data collection in countries was made possible through
funding from the following: Albania: WHO through the Joint
Programme on Children, Food Security and Nutrition âReducing
Malnutrition in Children,â funded by the Millennium Development
Goals Achievement Fund, and the Institute of Public Health. Austria:
Federal Ministry of Labor, Social Affairs, Health and Consumer
Protection of Austria. Bulgaria: Ministry of Health, National Center
of Public Health and Analyses, and WHO Regional Office for
Europe. Bosnia and Herzegovina: WHO country office support for
training and data management. Croatia: Ministry of Health, Croatian
Institute of Public Health, and WHO Regional Office for Europe.
Czechia: Ministry of Health of the Czech Republic, grant number
17-31670A and MZCRâRVO EU 00023761. Denmark: Danish
Ministry of Health. Estonia: Ministry of Social Affairs, Ministry of
Education and Research (IUT 42-2), WHO Country Office, and
National Institute for Health Development. Finland: Finnish Institute
for Health and Welfare. France: Santé publique France (the French
Agency for Public Health). Georgia: WHO. Greece: International
Hellenic University and Hellenic Medical Association for Obesity.
Hungary: WHO Country Office for Hungary. Ireland: Health Service
Executive. Italy: Ministry of Health. Kazakhstan: Ministry of Health
of the Republic of Kazakhstan, WHO, and UNICEF. Kyrgyzstan:
World Health Organization. Latvia: Ministry of Health and Centre
for Disease Prevention and Control. Lithuania: Science Foundation
of Lithuanian University of Health Sciences and Lithuanian Science
Council and WHO. Malta: Ministry of Health. Montenegro: WHO
and Institute of Public Health of Montenegro. North Macedonia:
Government of North Macedonia through National Annual Program
of Public Health and implemented by the Institute of Public Health
and Centers of Public Health; WHO country office provides support
for training and data management. Norway: the Norwegian Ministry
of Health and Care Services, the Norwegian Directorate of Health,
and the Norwegian Institute of Public Health. Poland: National
Health Programme, Ministry of Health. Portugal: Ministry of Health Institutions, the National Institute of Health, Directorate General of
Health, Regional Health Directorates, and the kind technical support
from the Center for Studies and Research on Social Dynamics and
Health (CEIDSS). Romania: Ministry of Health. Russian Federation:
WHO. San Marino: Health Ministry, Educational Ministry, and Social
Security Institute and Health Authority. Serbia: WHO and the
WHO Country Office (2015-540940 and 2018/873491-0). Slovakia:
Biennial Collaborative Agreement between WHO Regional Office
for Europe and Ministry of Health SR. Slovenia: Ministry of Education, Science and Sport of the Republic of Slovenia within the SLOfit
surveillance system. Spain: Spanish Agency for Food Safety and
Nutrition. Sweden: Public Health Agency of Sweden. Tajikistan:
WHO Country Office in Tajikistan and Ministry of Health and Social
Protection. Turkmenistan: WHO Country Office in Turkmenistan
and Ministry of Health. Turkey: Turkish Ministry of Health and
World Bank.info:eu-repo/semantics/publishedVersio
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