The association between neighborhood characteristics and mental health in old age – register based study of urban areas in three European countries

This study aimed to fill the gap in research regarding the longitudinal studies on the association between urban neighborhood characteristics and mental health of older populations. Individual level register-based data sets from Finland (10 largest cities), Sweden (Stockholm), and Italy (Turin) including satellite based land cover data were used. The data included sociodemographic individual information on population aged 50+, their antidepressant purchases, and socioeconomic and physical characteristics regarding area of residence. We followed individuals for antidepressant purchases for 5 years in 2001-2015, depending on dataset, and used hierarchical negative binomial models to assess whether there was an association between social and physical area characteristics and antidepressant use and to what extent was this association attributable to individual sociodemographic characteristics of the residents and whether the findings were consistent across countries. We found weak and inconsistent evidence of high levels of area characteristics related to dense physical urban structure being predictive of increased antidepressant use in ages above 50. However, generally the extent to which antidepressant use was clustered by areas in the studied contexts was minimal

Difficult tracheal intubation in neonates and infants. NEonate and Children audiT of Anaesthesia pRactice IN Europe (NECTARINE): a prospective European multicentre observational study

International audienceBackground: Neonates and infants are susceptible to hypoxaemia in the perioperative period. The aim of this study was to analyse interventions related to anaesthesia tracheal intubations in this European cohort and identify their clinical consequences.Methods: We performed a secondary analysis of tracheal intubations of the European multicentre observational trial (NEonate and Children audiT of Anaesthesia pRactice IN Europe [NECTARINE]) in neonates and small infants with difficult tracheal intubation. The primary endpoint was the incidence of difficult intubation and the related complications. The secondary endpoints were the risk factors for severe hypoxaemia attributed to difficult airway management, and 30 and 90 day outcomes.Results: Tracheal intubation was planned in 4683 procedures. Difficult tracheal intubation, defined as two failed attempts of direct laryngoscopy, occurred in 266 children (271 procedures) with an incidence (95% confidence interval [CI]) of 5.8% (95% CI, 5.1-6.5). Bradycardia occurred in 8% of the cases with difficult intubation, whereas a significant decrease in oxygen saturation (SpO2<90% for 60 s) was reported in 40%. No associated risk factors could be identified among co-morbidities, surgical, or anaesthesia management. Using propensity scoring to adjust for confounders, difficult anaesthesia tracheal intubation did not lead to an increase in 30 and 90 day morbidity or mortality.Conclusions: The results of the present study demonstrate a high incidence of difficult tracheal intubation in children less than 60 weeks post-conceptual age commonly resulting in severe hypoxaemia. Reassuringly, the morbidity and mortality at 30 and 90 days was not increased by the occurrence of a difficult intubation event