The relative age effect is larger in Italian soccer top-level youth categories and smaller in Serie A

The relative age effect (RAE; i.e., an asymmetry in the birth distribution) is a bias observed in sport competitions that may favour relatively older athletes in talent identification. Therefore, the aim of this study was to investigate the presence of RAE in elite soccer players competing in the Italian championships, even considering the discriminations of younger and older Serie A players (in relation to the median age of the sample), and different positional roles (i.e., goalkeeper, defender, midfielder, forward) for each observed category. A total of 2051 players competing into the 2017-2018 Italian under-15 (n = 265), under-16 (n = 362), under-17 (n = 403), Primavera (n = 421) and Serie A (n = 600) championships were analysed. The birth-date distributions, grouped in four quartiles (i.e., January-March, Q1; April-June, Q2; July-September, Q3; October-December, Q4), were compared to a uniform distribution using Chi-squared analysis. The week of birth was analysed using Poisson regression. The results showed a large over-representation of players born in Q1 in all soccer player categories. However, the effect size of this trend resulted smaller as age increased. Individuals born in Q1 have about two-folds more chances to become a Serie A player compared to those born in Q4. The Poisson regression analysis showed that RAE was greater for defenders than for forwards among all categories. Therefore, a strongly biased selection emerged among elite soccer players competing in Italian championships, highlighting how young individuals born in the first three months have many more chances to become elite players compared to the others

Effect of depression on mortality and cardiovascular morbidity in type 2 diabetes mellitus after 3 years follow up. The DIADEMA study protocol

<p>Abstract</p> <p>Background</p> <p>Type 2 diabetes mellitus and depression are highly prevalent diseases that are associated with an increased risk of cardiovascular disease and mortality. There is evidence about a bidirectional association between depressive symptoms and type 2 diabetes mellitus. However, prognostic implications of the joint effects of these two diseases on cardiovascular morbidity and mortality are not well-known.</p> <p>Method/design</p> <p>A three-year, observational, prospective, cohort study, carried out in Primary Health Care Centres in Madrid (Spain). The project aims to analyze the effect of depression on cardiovascular events, all-cause and cardiovascular mortality in patients with type 2 diabetes mellitus, and to estimate a clinical predictive model of depression in these patients.</p> <p>The number of patients required is 3255, all them with type 2 diabetes mellitus, older than 18 years, who regularly visit their Primary Health Care Centres and agree to participate. They are chosen by simple random sampling from the list of patients with type 2 diabetes mellitus of each general practitioner.</p> <p>The main outcome measures are all-cause and cardiovascular mortality and cardiovascular morbidity; and exposure variable is the major depressive disorder.</p> <p>There will be a comparison between depressed and not depressed patients in all-cause mortality, cardiovascular mortality, coronary artery disease and stroke using the Chi-squared test. Logistic regression with random effects will be used to adjust for prognostic factors. Confounding factors that might alter the effect recorded will be taken into account in this analysis. To assess the effect of depression on the mortality, a survival analysis will be used comparing the two groups using the log-rank test. The control of potential confounding variables will be performed by the construction of a Cox regression model.</p> <p>Discussion</p> <p>Our study’s main contribution is to evaluate the increase in the risk of cardiovascular morbidity and mortality, in depressed Spanish adults with type 2 diabetes mellitus attended in Primary Health Care Setting. It would also be useful to identify subgroups of patients for which the interventions could be more beneficial.</p

Hispano-Americans in Europe: what do we know about their health status and determinants? A scoping review.

BACKGROUND: Policy makers and health practitioners are in need of guidance to respond to the growing geographic mobility of Hispano-American migrants in Europe. Drawing from contributions from epidemiology, social sciences, demography, psychology, psychiatry and economy, this scoping review provides an up-to-date and comprehensive synthesis of studies addressing the health status and determinants of this population. We describe major research gaps and suggest specific avenues of further inquiry. METHODS: We identified systematically papers that addressed the concepts "health" and "Hispano Americans" indexed in five data bases from Jan 1990 to May 2014 with no language restrictions. We screened the 4,464 citations retrieved against exclusion criteria and classified 193 selected references in 12 thematic folders with the aid of the reference management software ENDNOTE X6. After reviewing the full text of all papers we extracted relevant data systematically into a table template to facilitate the synthesising process. RESULTS: Most studies focused on a particular disease, leaving unexplored the interlinkages between different health conditions and how these relate to legislative, health services, environmental, occupational, and other health determinants. We elucidated some consistent results but there were many heterogeneous findings and several popular beliefs were not fully supported by empirical evidence. Few studies adopted a trans-national perspective and many consisted of cross-sectional descriptions that considered "Hispano-Americans" as a homogeneous category, limiting our analysis. Our results are also constrained by the availability and varying quality of studies reviewed./nCONCLUSIONS:/nBurgeoning research has produced some consistent findings but there are huge gaps in knowledge. To prevent unhelpful generalisations we need a more holistic and nuanced understanding of how mobility, ethnicity, income, gender, legislative status, employment status, working conditions, neighbourhood characteristics and social status intersect with demographic variables and policy contexts to influence the health of the diverse Hispano-American populations present in Europe