Social Capital and Self-rated Health: testing association with longitudinal and multilevel methodologies

Since Durkheim’s seminal work over a century ago, research has repeatedly shown that individuals with higher levels of social integration, social networks and social support have better health status. However, the recent introduction of a contextual phenomenon known as social capital to the field of public health has sparked lively debate as to how it may also influence the health of individuals, if at all. Though critics have raised several points of contention regarding reported association between social capital and health over recent years, one outstanding issue remains: the lack of empirical research focusing on causal relationships, due to paucity of adequate longitudinal social capital data. The overall aim of this thesis is to test association between different social capital proxies and self-rated health (SRH), alongside other well-known health determinants, using multilevel and longitudinal data, whilst employing a variety of study designs and methods. All data used in this thesis come from the United Kingdom’s British Household Panel Survey (BHPS) from years 2000, 03, 05, 07 and 08. The underlying premise of this body of work is to investigate temporal (causal) relationships between social capital and health. All four papers of this thesis demonstrate that generalised trust is the most robust of all social capital proxies tested, it maintaining a positive association with SRH over time. Furthermore, results from paper III imply that prior trust levels can predict future SRH, lending weight to the hypothesis that trust is an independent determinant of health. However, debate remains as to whether generalised trust solely captures social capital or other, more tangible aspects of social cohesion

Social capital and self-rated health – a study of temporal (causal) relationships

Despite the vast amount of research over the past fifteen years, there is still lively debate surrounding the role of social capital on individual health outcomes. This seems to stem from a lack of consistency regarding the definition, measurement and plausible theories linking this contextual phenomenon to health. We have further identified a knowledge gap within this field - a distinct lack of research investigating temporal relationships between social capital and health outcomes. To remedy this shortfall, we use four waves of the British Household Panel Survey to follow the same individuals (N = 8114) between years 2000 and 2007. We investigate temporal relationships and association between our outcome variable self-rated health (SRH) and time-lagged explanatory variables, including three individual-level social capital proxies and other well-known health determinants. Our results suggest that levels of the social capital proxy ‘generalised trust’ at time point (t-1) are positively associated with SRH at subsequent time point (t), even after taking into consideration levels of other well-known health determinants (such as smoking status) at time point (t-1). That we investigate temporal relationships at four separate occasions over the seven year period lends considerable weight to our results and the argument that generalised trust is an independent predictor of individual health. However, lack of consensus across a variety of disciplines as to what generalised trust is believed to measure creates ambiguity when attempting to identify possible pathways from higher trust to better health

Non-permanent GPS data for regional-scale kinematics: reliable deformation rate before the 6 April, 2009, earthquake in the L'Aquila area

A GPS-based geodetic study at a regional scale requires the availability of a dense network that is characterized by 10 km to 30 km spacing, typically followed in a few continuous GPS stations (CGPSs) and several non-permanent GPS stations (NPSs). As short observation times do not allow adequate noise modeling, NPS data need specific processing where the main differences between NPSs and CGPSs are taken into account: primarily time-series length and antenna repositioning error. The GPS data collected in the 1999-2007 time-span from non-permanent measurement campaigns in the central Apennine area (Italy) that was recently hit by the Mw 6.3 L'Aquila earthquake (April 6, 2009) are here further analyzed to compute a reliable strain-rate field at a regional scale. Moreover, areas characterized by different kinematics are recognized, and a complete characterization of the regional-scale kinematics is attempted. These new data can be interpreted as indicators from the viewpoint of seismic risk assessment

The association between cannabis abuse and subsequent schizophrenia: a Swedish national co-relative control study.

Although cannabis abuse (CA) is known to be associated with schizophrenia, the causal nature of this association is unclear, with prodromal effects complicating its interpretation

Efficacy and Tolerability of a Nutraceutical Combination (Red Yeast Rice, Policosanols, and Berberine) in Patients with Low-Moderate Risk Hypercholesterolemia: A Double-Blind, Placebo-Controlled Study

Background: Statins are at the forefront of strategies to manage hypercholesterolemia. However 10% to 15% of patients are intolerant to any statin drugs, even at low daily doses and almost one-third of statin users discontinue therapy within 1 year. Some nutraceuticals are prescribed as lipid-lowering substances, but doubts remain about their efficacy and tolerability. Objectives: We aimed to investigate the efficacy and the safety of a nutraceutical combination consisting mainly of 200 mg red yeast rice extract (equivalent to 3 mg monacolins), 500 mg berberine, and 10 mg policosanols (MBP-NC) in patients with low-moderate risk hypercholesterolemia. Methods: In this single centre, randomized, double-blind, placebo-controlled study 60 consecutive outpatients (29 men and 31 women; age range = 18-60 years), with newly diagnosed primary hypercholesterolemia not previously treated, after a run-in period of 3 weeks on a stable hypolipidic diet, were randomized to receive a pill of MBP-NC (n = 30) or placebo (n = 30) once a day after dinner, in addition to the hypolipidic diet. The efficacy and the tolerability of the proposed nutraceutical treatment were fully assessed after 4, 12, and 24 weeks of treatment. Results: In the MBP-NC group both total cholesterol and LDL-C already showed a significant reduction at Week 4 (-30.3% ± 33.9% and -29.4% ± 35.3%, respectively) that remained substantially unchanged at Week 12 (-26.7% ± 33.1% and -25.6% ± 31.5%, respectively) and at Week 24 (-24.6% ± 32.1% and -23.7% ± 32.6%, respectively). The between-groups differences were significant at all time points for both total cholesterol and LDL-C. There were no significant changes in HDL-C, fasting glucose, and triglyceride serum levels in either group. MBP-NC was also safe and well tolerated. Conclusions: In patients with low- to moderate-risk hypercholesterolemia a nutraceutical combination in association with a hypolipidic diet significantly reduced total cholesterol and LDL-C levels and may favor the reaching the recommended cholesterol targets

Analyzing Virtual Reference Station for GPS surveying: experiments and applications in a test site of the northern Apennine (Italy).

The availability of a GPS network of 10-20 km mean size, provides good topographical support for the measurement of ground displacements, even at a local scale such as a landslide. In particular, a series of multitemporal kinematic or rapid-static GPS acquisitions of a landslide allows a good characterization of its displacements if the measurements are referred to a GPS reference network. Nevertheless, a wider network formed by stations located at long distances, for example at several tens of kilometers, characterized by large spacing, can lead to results affected by high noise, degrading the accuracy of final point positions. In order to obtain an adequate GPS reference network, some virtual reference stations (VRSs) can be introduced, even if a network refinement based on VRS cannot reach the same accuracy of a real local network. Some experiments, including measurements on a real landslide, have been performed in order to evaluate the performance of this technique. The results point out that the standard deviation of the obtained solutions is about two or three times larger than those which can be reached using a real local network

Transcatheter aortic valve implantation with the novel-generation Navitor device. Procedural and early outcomes

Transcatheter aortic valve implantation (TAVI) has proved beneficial in patients with severe aortic stenosis, especially when second-generation devices are used. We aimed at reporting our experience with Navitor, a third-generation device characterized by intrannular, large cell, and cuffed design, as well as high deliverability and minimization of paravalvular leak. Between June and December 2021, a total of 39 patients underwent TAVI with Navitor, representing 20% of all TAVI cases. Mean age was 80.0 +/- 6.7 years, and 14 (36.8%) women were included. Severe aortic stenosis was the most common indication to TAVI (37 [97.4%] cases), whereas 2 (5.3%) individuals were at low surgical risk. Device and procedural success was obtained in all patients, with a total hospital stay of 6.6 +/- 4.5 days. One (2.9%) patient required permanent pacemaker implantation, but no other hospital events occurred. At 1-month follow-up, a cardiac death was adjudicated in an 87-year-old man who had been at high surgical risk. Echocardiographic follow-up showed no case of moderate or severe aortic regurgitation, with mild regurgitation in 18 (47%), and none or trace regurgitation in 20 (53%). The Navitor device, thanks to its unique features, is a very promising technology suitable to further expand indications and risk-benefit profile of TAVI