Underutilization of prescribed drugs use among first generation elderly immigrants in the Netherlands

Background. In developed countries, health care utilization among immigrant groups differs where the dominant interpretation is unjustified overutilization due to lack of acculturation. We investigated utilization of prescribed drugs in native Dutch and various groups of immigrant elderly. Methods. Cross-sectional study using data from the survey "Social Position, Health and Well-being of Elderly Immigrants" (the Netherlands, 2003). Ethnicity-matched interviewers conducted the survey among first generation immigrants aged 55 years and older. Outcome measure is self-reported use of prescribed drugs. Utilization is explained by need, and by enabling and predisposing factors, in particular acculturation; analysis is conducted by multiple logistic regression. Results. The study population consisted of immigrants from Turkey (n = 307), Morocco (n = 284), Surinam (n = 308) and the Netherlands Antilles (n = 300), and a native Dutch reference group (n = 304). Prevalence of diabetes mellitus (DM), COPD and musculoskeletal disorders was relatively high among immigrant elderly. Drug utilization in especially Turkish and Moroccan elderly with DM and COPD was relatively low. Drugs use for non-mental chronic diseases was explained by more chronic conditions (OR 2.64), higher age (OR 1.03), and modern attitudes on male-female roles (OR 0.74) and religiosity (OR 0.89). Ethnicity specific effects remained only among Turkish elderly (OR 0.42). Drugs use for mental health problems was explained by more chronic conditions (OR 1.43), better mental health (OR 0.95) and modern attitudes on family values (OR 0.59). Ethnicity specific effects remained only among Moroccan (OR 0.19) and Antillean elderly (OR 0.31). Explanation of underutilization of drugs among diseased with diabetes and musculoskeletal disorders are found in number of chronic diseases (OR 0.74 and OR 0.78) and regarding diabetes also in language proficiency (OR 0.66) and modern attitudes on male-female roles (OR 1.69). Conclusions. Need and predisposing factors (acculturation) are the strongest determinants for drugs utilization among elderly immigrants. Significant drugs underutilization exists among migrants with diabetes and musculoskeletal disorde

Theories of constitution in the early Soviet State (2)

AIM: To explore whether primary school children of migrant and native Dutch origins differ regarding their sleep duration per night, a risk for overweight and obesity, and to determine to what degree differences in parenting styles contribute to these differences. SUBJECTS AND METHODS: A cross-sectional survey, including 1,943 children aged 8-9 years old and their primary caregivers, was performed. Data were collected from primary schools in cities and adjacent municipalities in The Netherlands: Eindhoven and Rotterdam. The outcome measure was mean sleep duration per night. The main independent variable was migrant background, based on the country of birth of the parents. A possible mediating variable was parenting style (rejecting, neglecting, permissive, authoritarian, authoritative). Age and sex of the child as well as parental socioeconomic status, as indicated by educational level, were added as confounders. RESULTS: Dutch children have the highest sleep duration: more than 11 h (mean = 670.1; SD = 27.7). All migrant children show less than 11 h of sleep per night. Migrant children of non-Western origin, especially Turkish and Moroccan children, show the lowest sleep duration per night. Parenting styles do not contribute to these differences. CONCLUSION: Migrant background is associated with sleep duration. As children of migrant origin are, in general, at higher risk for overweight and obesity and sleep duration is regarded as a risk factor for overweight and obesity, further investigation of this association is needed

The ECLW collaborative study. 2: Patient registration form (PRF) instrument, training and reliability

info:eu-repo/semantics/publishe

The European Consultation-Liaison Workgroup (ECLW) collaborative study.1: General outline

info:eu-repo/semantics/publishe

The matching of experimental polymer processing flows to viscoelastic numerical simulation

International audienceThis paper describes work carried out in order to match experimental processing flows to numerical simulation. The work has brought together a consortium that has developed reliable experimental methods by which processing flows can be achieved in the laboratory and then ranked against numerical simulation. A full rheological characterisation of a selected range of polymers was made and the results compared from different laboratories. The data was fitted to a number of rheological models. Multi-mode parameter fitting was universal for the linear viscoelastic response. Particular attention was paid to the non linear response of the material. Prototype industrial flow experiments were carried out for a number of geometries in different laboratories and the flow birefringence technique was used to map out the experimentally observed stress fields for different polymers in a range of complex flows that contained both extensional and shear flow components. Numerical simulation was carried out using a number of algorithms and a range of constitutive equations. In order to make a quantitative comparison between experiment and simulation, an Advanced Rheological Tool (ART) module was developed that was able in some cases to quantify the level of fit between the numerically predicted and the experimentally observed stress patterns. In addition the ART module was able to optimise certain non-linear parameters in order to improve the quality of fit between experiment and simulation

The matching of experimental polymer processing flows to viscoelastic numerical simulation

International audienceThis paper describes work carried out in order to match experimental processing flows to numerical simulation. The work has brought together a consortium that has developed reliable experimental methods by which processing flows can be achieved in the laboratory and then ranked against numerical simulation. A full rheological characterisation of a selected range of polymers was made and the results compared from different laboratories. The data was fitted to a number of rheological models. Multi-mode parameter fitting was universal for the linear viscoelastic response. Particular attention was paid to the non linear response of the material. Prototype industrial flow experiments were carried out for a number of geometries in different laboratories and the flow birefringence technique was used to map out the experimentally observed stress fields for different polymers in a range of complex flows that contained both extensional and shear flow components. Numerical simulation was carried out using a number of algorithms and a range of constitutive equations. In order to make a quantitative comparison between experiment and simulation, an Advanced Rheological Tool (ART) module was developed that was able in some cases to quantify the level of fit between the numerically predicted and the experimentally observed stress patterns. In addition the ART module was able to optimise certain non-linear parameters in order to improve the quality of fit between experiment and simulation

Reduction of cardiac imaging tests during the COVID-19 pandemic: The case of Italy. Findings from the IAEA Non-invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Background: In early 2020, COVID-19 massively hit Italy, earlier and harder than any other European country. This caused a series of strict containment measures, aimed at blocking the spread of the pandemic. Healthcare delivery was also affected when resources were diverted towards care of COVID-19 patients, including intensive care wards. Aim of the study: The aim is assessing the impact of COVID-19 on cardiac imaging in Italy, compare to the Rest of Europe (RoE) and the World (RoW). Methods: A global survey was conducted in May–June 2020 worldwide, through a questionnaire distributed online. The survey covered three periods: March and April 2020, and March 2019. Data from 52 Italian centres, a subset of the 909 participating centres from 108 countries, were analyzed. Results: In Italy, volumes decreased by 67% in March 2020, compared to March 2019, as opposed to a significantly lower decrease (p < 0.001) in RoE and RoW (41% and 40%, respectively). A further decrease from March 2020 to April 2020 summed up to 76% for the North, 77% for the Centre and 86% for the South. When compared to the RoE and RoW, this further decrease from March 2020 to April 2020 in Italy was significantly less (p = 0.005), most likely reflecting the earlier effects of the containment measures in Italy, taken earlier than anywhere else in the West. Conclusions: The COVID-19 pandemic massively hit Italy and caused a disruption of healthcare services, including cardiac imaging studies. This raises concern about the medium- and long-term consequences for the high number of patients who were denied timely diagnoses and the subsequent lifesaving therapies and procedures