Understanding the value of social networks in life satisfaction of elderly people: a comparative study of 16 European countries using SHARE data

BACKGROUND: Networks of family and friends are a source of support and are generally associated with higher life satisfaction values among older adults. On the other hand, older adults who are satisfied with their life may be more able to develop and maintain a wider social network. For this reason, the causal link between size and composition of the social networks and satisfaction with life is yet to be explored. This paper investigates the effect of the ‘size’, (number of family and friends, and network) and the ‘composition’ (the proportion of friends over total number of persons) of the social network on life satisfaction among older adults (50+). Moreover, we also investigate the patterns of this relation between different European countries. METHOD: Data from the 4(th) wave of Survey of Health, Ageing and Retirement in Europe and an instrumental variable approach are used to estimate the extent of the relation between life satisfaction and size and composition of social networks. RESULTS: Respondents in Western and Northern European (WNE) countries report larger networks than respondents in Eastern and Southern European (ESE) countries. However, the positive relationship between network size and life satisfaction is consistent across countries. On the other hand, the share of friends in the network appears to be generally negatively related to satisfaction with life, though results are not statistically significant for all countries. CONCLUSIONS: Apparently, a larger personal network is important for older adults (50+) to be more satisfied with life. Our results suggest that this relation is particularly positive if the network is comprised of family members. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12877-016-0362-7) contains supplementary material, which is available to authorized users

Informal care and gifts to and from older people in Europe: The interlinks between giving and receiving

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On the relationships between tectonics and volcanism in the offshore Capo Vaticano, SE Tyrrhenian Sea, during the Plio-Pleistocene

High-resolution bathymetry and a grid of single-channel reflection seismic profiles (Sparker and Chirp) were recently recorded in a sector of the upper slope of Capo Vaticano (CV) promontory (Tyrrhenian coast, W Calabria) where forward and inverse modeling of previously acquired aeromagnetic data highlight the presence of a WNW©\ESE elongated, 20 km long and 3¨C5 km wide, magnetized body extending from sea floor to about 3 km below sea level. Magnetic properties of this body are consistent with those of the medium to highly evolved volcanic rocks of the Aeolian Arc (De Ritis et al., 2010). Forthwith offshore promontory, the bathymetry highlights a complex-shape seamount that develops along a WNW direction, orthogonally interrupted by NE-trending ridges (Loreto et al., 2013), the largest of which shows major- and minor-axes of ca. 11 and 2 km, respectively. Summit elevation is ca. 70 m. Several vented fluids points were imaged on top of the seamount by chirp profiles. The largest of which rises from seafloor up to 6/7 m within water column, assuming the acoustic water velocity of 1500 m/s. Two faults systems associated with extensional faults are mainly observed on seismic profiles. High-angle NW-trending normal faults, SW-dipping, formed along the continental slope connecting the south-west continental shelf of the CV promontory to the Gioia Tauro basin (Pepe et al., 2013). These faults generally have small displacements, up to 40 m, and are sealed by Pleistocene deposits. A NE-trending normal fault, SE-dipping, is also observed on both chirp and sparker profiles. Its length is estimate to be more than 30 km, partially borders the NE-trending ridge intersecting the NW-trending fault. Landward, another NE-trending normal fault affects Pliocene and lower Pleistocene, and is sealed by upper Pleistocene. The described new geophysical data lead to a re-examination of the magnetic anomaly field interpretation. In fact, the revealed NE-trending ridge encounters the CV NW-SE ridge just where the peak value of the Reduced-to-the-Pole magnetic anomaly lies. Therefore, the inherent source body is emplaced where the maximum fracturing occurs. This suggests highly magnetized material crystallized in a vertical conduit that fed a volcanic system, likely fault-controlled, surrounded by the almost not magnetized rocks of the Gioia and the Paola sedimentary basins and of the Arco Calabro Peloritano units

Strong and graded associations between level of asthma severity and all-cause hospital care use and costs in the UK.

BACKGROUND: Hospital admissions account for a large share of the healthcare costs incurred by people with asthma. We assessed the hospital care use and costs associated with asthma severity using the UK Biobank cohort and linked healthcare data. METHODS: Adult participants with asthma at recruitment were classified using their prescription data into mild and moderate-to-severe asthma and matched separately to asthma-free controls by age, sex, ethnicity and location. The associations of asthma, by severity, with the annual number of all-cause hospital admissions, days spent in hospital and hospital costs were estimated over a 10-year follow-up period using three specifications of negative binomial regression models that differed according to the sociodemographic and clinical characteristics adjusted for. RESULTS: Of the 25 031 participants with active asthma, 80% had mild asthma and 20% had moderate-to-severe asthma. Compared with participants with mild asthma, those with moderate-to-severe asthma were on average 2.7 years older, more likely to be current (13.7% vs 10.4%) or previous (40.2% vs 35.2%) smokers, to have a higher body mass index (BMI), and to be suffering from a variety of comorbid diseases. Following adjustments for age, sex, ethnicity and location, people with mild asthma experienced on average 36% more admissions (95% CI 28% to 40%), 43% more days in hospital (95% CI 35% to 51%) and 36% higher hospital costs (95% CI 31% to 41%) annually than asthma-free individuals, while people with moderate-to-severe asthma experienced excesses of 93% (95% CI 81% to 107%), 142% (95% CI 124% to 162%) and 98% (95% CI 88% to 108%), respectively. Further adjustments for socioeconomic deprivation, smoking status, BMI and comorbidities resulted in smaller though still highly significant positive associations, graded by severity, between asthma and hospital use and costs. CONCLUSIONS: Strong graded associations are reported between asthma severity and the extent of hospital use and costs in the UK. These findings could inform future assessments of the value of asthma management interventions

In Search of New Imaging For Historical Earthquakes: A New Geophysical Survey Offshore Western Calabria (Southern Tyrrhenian Sea, Italy)

During the summer of 2010 we carried out a survey to acquire a multidisciplinary dataset within the Gulf of Sant'Eufemia (SE Tyrrhenian sea, Italy), with the aim of studying the active tectonics affecting the region, including that potentially responsible for key, elusive earthquakes such as the to-date unexplained 8 September 1905 (Mw 7 - 7.5) earthquake. The data here analysed highlight the presence of several tectonic and morphologic features characterizing the investigated area. We have recognized the Angitola Channel, a deep and wide canyon showing a straight trend in its coastward segment, and a meandering trend in the seaward segment. Based on morpho-structural elements, we maintain that the Angitola Channel could be tectonically controlled. Moreover, several gravitational instabilities as slumps and collapses affect the flanks of the morpho-structural high, detected offshore Capo Vaticano. Very high resolution seismic data have unveiled the presence of numerous fluid escape features and several mud volcanoes straddling the sector from the coastline to seaward.INOGS (RIMA Department) supported the acquisition of the entire dataset.Published385-4013.2. Tettonica attivaJCR Journalrestricte

Rethinking “democratic backsliding” in Central and Eastern Europe – looking beyond Hungary and Poland

This essay introduces contributions to a special issue of East European Politics on “Rethinking democratic backsliding in Central and Eastern Europe”, which seeks to expand the study of democratic regression in CEE beyond the paradigmatic cases of Hungary and Poland. Reviewing these contributions, we identify several directions for research: 1) the need to critique “democratic backsliding”, not simply as a label, but also as an assumed regional trend; 2) a need to better integrate the role of illiberal socio-economic structures such as oligarchical structures or corrupt networks; and 3) a need to (re-)examine the trade-offs between democratic stability and democratic quality. We also note how insights developed researching post-communist regions such as Western Balkans or the post-Soviet space could usefully inform work on CEE backsliding. We conclude by calling for the study of CEE democracy to become more genuinely interdisciplinary, moving beyond some narrowly institutionalist comparative political science assumptions

Informal payments and intra-household allocation of resources for health care in Albania

<p>Abstract</p> <p>Background</p> <p>Informal payments for health care services can impose financial hardship on households. Many studies have found that the position within the household can influence the decision on how much is spent on each household member. This study analyses the intra-household differences in spending on informal payments for health care services by comparing the resources allocated between household heads, spouses and children.</p> <p>Methods</p> <p>Pooled data from two cross sectional surveys, the Albanian Living Standard Measurement Survey 2002 and 2005, are used to analyse both the probability and the amount paid in inpatient and outpatient health care services. A generalised Hausman specification test is used to compare the coefficients of probit and OLS models for nuclear and extended households.</p> <p>Results</p> <p>We find that due to the widespread informal payments there are no significant differences between households in the incidence of informal payments for households' members, but there are more differences in the amount paid informally. Results suggest that households strategically allocate their resources on health care by favouring individuals with higher earning potential who have invested more in human capital. Extended households pay higher amounts for spouses with higher education compared to nuclear households. On the other hand, nuclear households choose to pay higher amounts for children with a higher level of education compared to extended households.</p> <p>Conclusions</p> <p>The differences between households should be taken into account by public policies which should compensate this by redistribution mechanisms targeting disadvantaged groups. Governments should implement effective measures to deal with informal patient payments.</p> <p><b>JEL Codes: </b>I10, I19, D10</p

Magnetic resonance enterography compared with ultrasonography in newly diagnosed and relapsing Crohn's disease patients: the METRIC diagnostic accuracy study

Magnetic resonance enterography and enteric ultrasonography are used to image Crohn's disease patients. Their diagnostic accuracy for presence, extent and activity of enteric Crohn's disease was compared. To compare diagnostic accuracy, observer variability, acceptability, diagnostic impact and cost-effectiveness of magnetic resonance enterography and ultrasonography in newly diagnosed or relapsing Crohn's disease. Prospective multicentre cohort study. Eight NHS hospitals. Consecutive participants aged ≥ 16 years, newly diagnosed with Crohn's disease or with established Crohn's disease and suspected relapse. Magnetic resonance enterography and ultrasonography. The primary outcome was per-participant sensitivity difference between magnetic resonance enterography and ultrasonography for small bowel Crohn's disease extent. Secondary outcomes included sensitivity and specificity for small bowel Crohn's disease and colonic Crohn's disease extent, and sensitivity and specificity for small bowel Crohn's disease and colonic Crohn's disease presence; identification of active disease; interobserver variation; participant acceptability; diagnostic impact; and cost-effectiveness. Out of the 518 participants assessed, 335 entered the trial, with 51 excluded, giving a final cohort of 284 (133 and 151 in new diagnosis and suspected relapse cohorts, respectively). Across the whole cohort, for small bowel Crohn's disease extent, magnetic resonance enterography sensitivity [80%, 95% confidence interval (CI) 72% to 86%] was significantly greater than ultrasonography sensitivity (70%, 95% CI 62% to 78%), with a 10% difference (95% CI 1% to 18%;  = 0.027). For small bowel Crohn's disease extent, magnetic resonance enterography specificity (95%, 95% CI 85% to 98%) was significantly greater than ultrasonography specificity (81%, 95% CI 64% to 91%), with a 14% difference (95% CI 1% to 27%). For small bowel Crohn's disease presence, magnetic resonance enterography sensitivity (97%, 95% CI 91% to 99%) was significantly greater than ultrasonography sensitivity (92%, 95% CI 84% to 96%), with a 5% difference (95% CI 1% to 9%). For small bowel Crohn's disease presence, magnetic resonance enterography specificity was 96% (95% CI 86% to 99%) and ultrasonography specificity was 84% (95% CI 65% to 94%), with a 12% difference (95% CI 0% to 25%). Test sensitivities for small bowel Crohn's disease presence and extent were similar in the two cohorts. For colonic Crohn's disease presence in newly diagnosed participants, ultrasonography sensitivity (67%, 95% CI 49% to 81%) was significantly greater than magnetic resonance enterography sensitivity (47%, 95% CI 31% to 64%), with a 20% difference (95% CI 1% to 39%). For active small bowel Crohn's disease, magnetic resonance enterography sensitivity (96%, 95% CI 92% to 99%) was significantly greater than ultrasonography sensitivity (90%, 95% CI 82% to 95%), with a 6% difference (95% CI 2% to 11%). There was some disagreement between readers for both tests. A total of 88% of participants rated magnetic resonance enterography as very or fairly acceptable, which is significantly lower than the percentage (99%) of participants who did so for ultrasonography. Therapeutic decisions based on magnetic resonance enterography alone and ultrasonography alone agreed with the final decision in 122 out of 158 (77%) cases and 124 out of 158 (78%) cases, respectively. There were no differences in costs or quality-adjusted life-years between tests. Magnetic resonance enterography and ultrasonography scans were interpreted by practitioners blinded to clinical data (but not participant cohort), which does not reflect use in clinical practice. Magnetic resonance enterography has higher accuracy for detecting the presence, extent and activity of small bowel Crohn's disease than ultrasonography does. Both tests have variable interobserver agreement and are broadly acceptable to participants, although ultrasonography produces less participant burden. Diagnostic impact and cost-effectiveness are similar. Recommendations for future work include investigation of the comparative utility of magnetic resonance enterography and ultrasonography for treatment response assessment and investigation of non-specific abdominal symptoms to confirm or refute Crohn's disease. Current Controlled Trials ISRCTN03982913. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in ; Vol. 23, No. 42. See the NIHR Journals Library website for further project information

A review of economic evaluation models for cardiac resynchronization therapy with implantable cardioverter defibrillators in patients with heart failure

Objectives Cardiac resynchronization therapy with a biventricular pacemaker (CRT-P) is an effective treatment for dyssynchronous heart failure (DHF). Adding an implantable cardioverter defibrillator (CRT-D) may further reduce the risk of sudden cardiac death (SCD). However, if the majority of patients do not require shock therapy, the cost-effectiveness ratio of CRT-D compared to CRT-P may be high. The objective of this study was to systematically review decision models evaluating the cost-effectiveness of CRT-D for patients with DHF, compare the structure and inputs of these models and identify the main factors influencing the ICERs for CRT-D. Methods A comprehensive search strategy of Medline (Ovid), Embase (Ovid) and EconLit identified eight cost-effectiveness models evaluating CRT-D against optimal pharmacological therapy (OPT) and/or CRT-P. Results The selected economic studies differed in terms of model structure, treatment path, time horizons, and sources of efficacy data. CRT-D was found cost-effective when compared to OPT but its cost-effectiveness became questionable when compared to CRT-P. Conclusions Cost-effectiveness of CRT-D may increase depending on improvement of all-cause mortality rates and HF mortality rates in patients who receive CRT-D, costs of the device, and battery life. In particular, future studies need to investigate longer-term mortality rates and identify CRT-P patients that will gain the most, in terms of life expectancy, from being treated with a CRT-D.This work was supported by the Center for Translational Molecular Medicine and The Netherlands Heart Foundation under the ‘Biomarkers to predict cardiac failure, arrhythmias and success of treatment’ (COHFAR) projec

Effects of health insurance on labour supply:evidence from the health care fund for the poor in Vietnam

The expansion of health insurance in emerging countries raises concerns about the unintended negative effects of health insurance on labour supply. This article examines the labour supply effects of the Health Care Fund for the Poor (HCFP) in Vietnam in terms of the number of work hours per month and labour force participation (the probability of employment). Employing various matching methods combined with a Difference-in-Differences approach on the Vietnam Household Living Standard Surveys 2002–2006, we show that the HCFP, which aims to provide poor people and disadvantaged minority groups with free health insurance, has a negative effect on labour supply. This is manifested in both the average number of hours worked per month and the probability of employment, suggesting the income effect of the HCFP. Interestingly, the effects are mainly driven by the non-poor recipients living in rural areas, raising the question of the targeting strategy of the programme. © 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group