How to make healthy early childhood development more likely in marginalized Roma communities:a concept mapping approach

BACKGROUND: This study aims to assess which measures could improve the healthy early childhood development of children from marginalized Roma communities and to identify priority measures. METHODS: Concept mapping approach was used, using mixed methods. In total 54 professionals, including social workers, educators, health care providers, municipality representatives, and project managers participated in our study. RESULTS: Four distinct clusters of measures targeting living conditions, public resources, healthcare and community interventions, and 27 individual priority measures of highest urgency and feasibility were identified. The cluster ‘Targeting living conditions’, was rated as the most urgent but least feasible, whereas the cluster ‘Targeting health care’, was considered least urgent but most feasible. Among the 27 priority measures, ‘Planning parenthood’ and ‘Scaling up existing projects’ had the highest priority. CONCLUSION: Our results reflect the public and political discourse and indicate significant barriers to implementation. Reducing inequalities in early childhood needs to be addressed through coordinated efforts

Desirable but not feasible:Measures and interventions to promote early childhood health and development in marginalized Roma communities in Slovakia

Roma are the largest and most disadvantaged ethnic minority in Europe often facing generational poverty, and limited access to education, employment, housing, and various types of services. Despite many international and national initiatives, children from marginalized Roma communities face multiple risks and are being disadvantaged as early as from conception onward. We, therefore, aimed to identify measures and/or interventions targeting equity in early childhood health and development in marginalized Roma communities which implementation is considered to be urgent but not feasible. We used a group concept mapping approach-a participatory mixed research method-and involved 40 experts and professionals from research, policy and practice. From 90 measures and interventions proposed to achieve early childhood equity for children from marginalized Roma communities, 23 measures were identified as urgent but not feasible. These concerned particularly measures and interventions targeting living conditions (including access to income, access to housing, and basic infrastructure for families) and public resources for instrumental support (covering mainly topics related to financial and institutional frameworks). Our results reflect the most pressing issues in the area of equality, inclusion and participation of Roma and expose barriers to implementation which are likely to arise from public and political discourses perpetrating a negative image of Roma, constructing them as less deserving. Measures to overcome persistent prejudices against Roma need to be implemented along with the measures targeting equity in early childhood health and development

Socioeconomic inequalities in suicide mortality in European urban areas before and during the economic recession

Few studies have assessed the impact of the financial crisis on inequalities in suicide mortality in European urban areas. The objective of the study was to analyse the trend in area socioeconomic inequalities in suicide mortality in nine European urban areas before and after the beginning of the financial crisis. This ecological study of trends was based on three periods, two before the economic crisis (2000-2003, 2004-2008) and one during the crisis (2009-2014). The units of analysis were the small areas of nine European cities or metropolitan areas, with a median population ranging from 271 (Turin) to 193 630 (Berlin). For each small area and sex, we analysed smoothed standardized mortality ratios of suicide mortality and their relationship with a socioeconomic deprivation index using a hierarchical Bayesian model. Among men, the relative risk (RR) comparing suicide mortality of the 95th percentile value of socioeconomic deprivation (severe deprivation) to its 5th percentile value (low deprivation) were higher than 1 in Stockholm and Lisbon in the three periods. In Barcelona, the RR was 2.06 (95% credible interval: 1.24-3.21) in the first period, decreasing in the other periods. No significant changes were observed across the periods. Among women, a positive significant association was identified only in Stockholm (RR around 2 in the three periods). There were no significant changes across the periods except in London with a RR of 0.49 (95% CI: 0.35-0.68) in the third period. Area socioeconomic inequalities in suicide mortality did not change significantly after the onset of the crisis in the areas studied

Mortality in the Visegrad countries from the perspective of socioeconomic inequalities

OBJECTIVES: Large socioeconomic inequalities in health are still present in the Central Europe. The aim was to explore socioeconomic inequalities in mortality in Visegrad countries-the Czech Republic, Hungary, Poland and Slovakia (V4), by three different socioeconomic indicators (unemployment, risk of poverty/social exclusion, education). The study was conducted within the H2020 Euro-Healthy project. METHODS: The associations between selected socioeconomic indicators and the standardised mortality rates by four main causes (mortality related to cancer, circulatory, respiratory and digestive system) in the economically active population aged 20-64 years in the 35 NUTS 2 level regions of the V4 in the period 2011-2013 were explored, using linear regression models. RESULTS: Lower education level was the most significant predictor of mortality in the V4. The lowest mortality rates by all causes of death were found in the regions of the Czech Republic, the highest in regions of Hungary. CONCLUSIONS: Despite the common origin, the pathways of the V4 countries in employment, poverty and education seem to be different, also having impact on health equity. Therefore, where you live in the V4 can significantly influence your health

Effect of the recent economic crisis on socioeconomic inequalities in mortality in nine urban areas in Europe

To analyse socioeconomic inequalities in all-cause mortality among men and women in nine European urban areas during the recent economic crisis, and to compare the results to those from two periods before the crisis. This is an ecological study of trends based on three time periods (2000-2003, 2004-2008 and 2009-2014). The units of analysis were the small areas of nine European urban areas. We used a composite deprivation index as a socioeconomic indicator, along with other single indicators. As a mortality indicator, we used the smoothed standardized mortality ratio, calculated using the hierarchical Bayesian model proposed by Besag, York and Mollié. To analyse the evolution of socioeconomic inequalities, we fitted an ecological regression model that included the socioeconomic indicator, the period of time, and the interaction between these terms. Results: We observed significant inequalities in mortality among men for almost all the socioeconomic indicators, periods, and urban areas studied. However, no significant changes occurred during the period of the economic crisis. While inequalities among women were less common, there was a statistically significant increase in inequality during the crisis period in terms of unemployment and the deprivation index in Prague and Stockholm, respectively. Future analyses should also consider time-lag in the effect of crises on mortality and specific causes of death, and differential effects between genders

Efecto de la reciente crisis económica en las desigualdades socioeconómicas enla mortalidad en nueve áreas urbanas europeas

Objective: To analyse socioeconomic inequalities in all-cause mortality among men and women in nineEuropean urban areas during the recent economic crisis, and to compare the results to those from twoperiods before the crisis.Method: This is an ecological study of trends based on three time periods (2000-2003, 2004-2008 and2009-2014). The units of analysis were the small areas of nine European urban areas. We used a com-posite deprivation index as a socioeconomic indicator, along with other single indicators. As a mortalityindicator, we used the smoothed standardized mortality ratio, calculated using the hierarchical Bayesianmodel proposed by Besag, York and Mollié. To analyse the evolution of socioeconomic inequalities, wefitted an ecological regression model that included the socioeconomic indicator, the period of time, andthe interaction between these terms.Results: We observed significant inequalities in mortality among men for almost all the socioeconomicindicators, periods, and urban areas studied. However, no significant changes occurred during the periodof the economic crisis. While inequalities among women were less common, there was a statisticallysignificant increase in inequality during the crisis period in terms of unemployment and the deprivationindex in Prague and Stockholm, respectively.Conclusions: Future analyses should also consider time-lag in the effect of crises on mortality and specificcauses of death, and differential effects between genders.Objetivo: Analizar las desigualdades socioeconómicas en la mortalidad por todas las causas en hombres ymujeres de nueve áreas urbanas europeas durante la reciente crisis económica, y comparar los resultadoscon dos periodos previos a la crisis.Método: Estudio ecológico de tendencias basado en tres periodos (2000-2003, 2004-2008 y 2009-2014).Las unidades de análisis fueron las áreas peque˜nas de nueve zonas urbanas europeas. Se utilizaron uníndice compuesto de privación socioeconómica como indicador socioeconómico y otros indicadores sim-ples. Como indicador de mortalidad se usó la razón de mortalidad estandarizada suavizada, calculadautilizando el modelo jerárquico bayesiano propuesto por Besag, York y Mollié. Para analizar la evoluciónde las desigualdades socioeconómicas se utilizó un modelo de regresión ecológico que incluía el indicadorsocioeconómico, el periodo y la interacción de ambos. Resultados: Se observaron desigualdades significativas en la mortalidad en los hombres para casi todoslos indicadores socioeconómicos, periodos y áreas urbanas. Sin embargo, no hubo cambios significativosen las desigualdades en el periodo de crisis. Aunque las desigualdades entre las mujeres fueron menoscomunes, hubo un incremento significativo en las desigualdades en mortalidad en el periodo de crisis entérminos de desempleo y del índice de privación en Praga y Estocolmo, respectivamente.Conclusiones: Futuros análisis deberán tener en cuenta el tiempo transcurrido entre la crisis y su efectoen la mortalidad, así como diferentes causas de mortalidad y el efecto diferencial entre género

Fibroblast growth factor receptor influences primary cilium length through an interaction with intestinal cell kinase

Vertebrate primary cilium is a Hedgehog signaling center but the extent of its involvement in other signaling systems is less well understood. This report delineates a mechanism by which fibroblast growth factor (FGF) controls primary cilia. Employing proteomic approaches to characterize proteins associated with the FGF-receptor, FGFR3, we identified the serine/threonine kinase intestinal cell kinase (ICK) as an FGFR interactor. ICK is involved in ciliogenesis and participates in control of ciliary length. FGF signaling partially abolished ICK's kinase activity, through FGFR-mediated ICK phosphorylation at conserved residue Tyr15, which interfered with optimal ATP binding. Activation of the FGF signaling pathway affected both primary cilia length and function in a manner consistent with cilia effects caused by inhibition of ICK activity. Moreover, knockdown and knockout of ICK rescued the FGF-mediated effect on cilia. We provide conclusive evidence that FGF signaling controls cilia via interaction with ICK