Identification of adverse childhood experiences strongly predicting suicidal behaviour among emerging adults in Montenegro and Romania: A new way to targeted cost-effective prevention

Introduction. Aiming at generating evidence for cost-effective public health (PH) interventions for suicidal behaviour (SB) prevention in South Eastern Europe, the objective was to identify adverse childhood experiences (ACEs) most strongly predicting SB in emerging adults. Methods. Survey data of 3283 students aged 18-29 from Montenegro and Romania were analysed by logistic regression. Based on estimation of risk-for-SB, the profiles with the highest values were identified. Results. The SB odds were the highest in respondents, experienced a suicide attempt in the household (OR: 13.81; p < 0.001), and whose primary family was not complete, in particular in those with the foster family background (OR: 18.30; p = 0.001). Conclusions. Magnitude of impact on emerging adults' mental health vulnerability tends to vary considerably with individual ACEs. This should be considered carefully when developing cost-effective response to SB burden through PH interventions in particular at the times of financial crises and in scarce resources settings

Impact of adverse childhood experiences on alcohol use in emerging adults in Montenegro and Romania

Aiming at generating evidence for formulating targeted and cost-effective public health interventions for the effective control of alcohol use (AU) in emerging adults in South Eastern Europe. The study's objective was to assess if alcohol users experience adverse childhood experiences (ACE) more often than non-users, and to identify which ACE victims are the most vulnerable to AU. The data was collected in 2010-2012 in two cross-sectional studies conducted in university settings in Montenegro and Romania (overall response rate 89.1%). In the present study, 3,283 students were included. The international ACE Study Questionnaires were used as a base for study instruments for collecting information on ACEs, health behaviours, and socio-economic factors. The association between AU and individual ACEs, adjusted to background factors, was assessed by using logistic regression. From the child maltreatment group, three ACEs were included in the final model as statistically significantly associated with AU, all of them from physical neglect/abuse types: frequently being hit so hard to have marks or being injured (OR=1.68; p=0.012), frequently being spanked (OR=1.38; p=0.012), and frequently having no person to take to the doctor if necessary (OR=0.58; p=0.031). From the household dysfunction group, two ACEs were included in the final model: exposure to mental health problems in the household (OR=2.85; p<0.001), and living with a problematic drinker/alcoholic (OR=1.51; p=0.019). The effect of exposure to ACEs on AU persists into emerging adulthood. This should be considered when developing cost-effective response to AU burden through targeted interventions, in particular in settings with scarce resources

Stres i radna sposobnost radnika u naftnoj industriji

This cross-sectional study conducted between March and June 2006 examined stress at work and work ability of 180 people with different workplaces within an oil company. Office, laboratory, and oil-field workers were invited to complete the “Occupational Stress Assessment Questionnaire – the Oil Industry Version and Work Ability Index (WAI) Questionnaire”. The overall response rate was 69.4 %, and the final sample size was 125 workers who completed the questionnaires (57 office, 41 laboratory, 27 oil-field workers). Office, laboratory, and oil-field workers differed significantly with respect to age (P<0.001). The oldest were oil-field workers and the youngest were office workers. The average WAI score for office workers was 44.9, for laboratory workers 43.2 and for field workers 39.7, indicating satisfying work ability. After adjusting for age, the difference in WAI score between the groups of workers was still significant (P<0.001). Over 75 % of all workers believed their job was stressful, but the perception of specific stressors depended on the workplace.Cilj ovog ispitivanja bio je procijeniti doživljaj stresa na radnome mjestu i radnu sposobnost zaposlenih u različitim dijelovima radnog procesa naftne industrije. Presječno istraživanje provedeno je u hrvatskoj naftnoj industriji, u razdoblju od ožujka do lipnja 2006. s uzorkom od 180 prigodno odabranih zaposlenika. Zaposlenici u uredu, laboratoriju za preradu nafte i naftnom pogonu trebali su ispuniti Upitnik o stresu na radu – verzija za naftnu industriju i Upitnik za procjenu indeksa radne sposobnosti (WAI). Ukupni odaziv ispitanika bio je 69,4 % te je obrađeno 125 ispunjenih upitnika (57 radnika iz ureda, 41 iz laboratorija i 27 iz naftnog pogona). Radnici iz ureda, laboratorija i naftnih pogona značajno su se razlikovali u dobi (P<0,001). Najstariji su bili radnici u naftnim pogonima, dok su najmlađi bili radnici u uredu. Prosječni WAI za uredske zaposlenike bio je 44,9, za laboratorijske 43,2, a za zaposlenike u naftnom pogonu 39,7, što upućuje na zadovoljavajuću radnu sposobnost. Uzevši u obzir utjecaj dobi pri testiranju razlika, utvrđeno je kako se WAI promatranih skupina statistički značajno razlikuju (P<0,001). Više od tri četvrtine svih ispitanika procjenjuje svoj posao kao stresan, no vrste stresora koje doživljavaju razlikuju se ovisno o radnome mjestu

Obesity prevalence from a European perspective: a systematic review

<p>Abstract</p> <p>Background</p> <p>Obesity has been recognised as an important contributing factor in the development of various diseases, but comparative data on this condition are limited. We therefore aimed to identify and discuss current epidemiological data on the prevalence of obesity in European countries.</p> <p>Methods</p> <p>We identified relevant published studies by means of a MEDLINE search (1990–2008) supplemented by information obtained from regulatory agencies. We only included surveys that used direct measures of weight and height and were representative of each country's overall population.</p> <p>Results</p> <p>In Europe, the prevalence of obesity (body mass index ≥ 30 kg/m²) in men ranged from 4.0% to 28.3% and in women from 6.2% to 36.5%. We observed considerable geographic variation, with prevalence rates in Central, Eastern, and Southern Europe being higher than those in Western and Northern Europe.</p> <p>Conclusion</p> <p>In Europe, obesity has reached epidemic proportions. The data presented in our review emphasise the need for effective therapeutic and preventive strategies.</p

Functional results of 46 thumb replantations and revascularisations

The functional results of 46 patients with isolated thumb replantations and revascularisations were evaluated in the outpatient clinic. The modified system for evaluation of reattached parts proposed by Burton was used. The system for functional evaluation of hands consisted of three major fields: socioeconomic factors, objective assessment and subjective assessment. Certain potential factors which might have influenced the functional results were analysed using Kruskal-Wallis's and Wilcoxon's sum of ranks tests. Level of amputation (P<0.01) and mechanism of amputation (P<0.05) significantly influenced the functional result. Age of the patients and severity of amputation (total-subtotal) had no effect on the late results. Thirty-nine patients (85%) had the same employment as before injury. All the patients had economically suitable employment and 31 patients (67%) had the same manual work as before the injury. All but 8 patients experienced cold intolerance. Satisfaction with aesthetic appearance of injured hand differed between sexes: women not being pleased with the sight of their hands in 37% (3/8) and men in 8% (3/38). All patients but one would have the operation again

Prevalence and factors associated with unmet needs in post-treatment cancer survivors: A systematic review

Item does not contain fulltextCancer survivors may experience unmet needs beyond the end of their treatment. This paper aimed to explore the prevalence and most frequently found unmet needs and to identify factors associated with higher levels of total unmet needs and with each domain separately. Five databases were searched using the keywords neoplasms, survivors, needs assessment, health services' needs and demands. The results were presented based on the strength of the evidence (strong, moderate and weak association) and the categorisation of the pooled prevalence of at least one unmet need (high, moderate, low). Twenty-six studies were included in the review. A higher prevalence of at least one reported unmet need was observed in survivors with less time since treatment and in women with breast cancer. The most frequently reported unmet needs were fear of cancer recurrence and requesting up to date information. Strong evidence was found for an association between a higher number of unmet needs and younger age, higher anxiety and poorer quality of life. Future studies on unmet needs should report how unmet needs are associated with each domain separately. This might solve the inconclusive evidence found for the stage of the disease at diagnosis and depression

Concurrent gemcitabine and radiotherapy for the treatment of muscle-invasive bladder cancer : a pooled individual data analysis of eight phase I–II trials

Purpose: Although radical cystectomy is still considered the standard of care for most localized muscle-invasive bladder cancer (MIBC) patients, bladder-sparing strategies with chemoradiotherapy have demonstrated comparable local control and survival rates when adjusting for tumor stage. We present a pooled analysis of individual patient data out of published trials with gemcitabine-based chemoradiotherapy for MIBC. Methods and materials: Individual patient data were collected from Institutions that enrolled patients into trials that evaluated gemcitabine-based chemoradiotherapy for MIBC. Results: We identified eight studies published on gemcitabine-based radiochemotherapy and 190 patients were included in this analysis. A complete response (CR) was observed in 166 patients (93%). After a median follow up of 44.5 months, 36 patients (18.9%) presented a bladder recurrence and 14 subsequently underwent cystectomy. The 5-year overall survival (OS), disease-specific survival (DSS), and cystectomy-free survival (CFS) rates were 59%, 80.9%, and 93.3%, respectively. The achievement of CR after chemoradiotherapy was the main prognostic variable which was associated with improved OS, DSS, and CFS. The treatment was well tolerated. Conclusion: This pooled analysis strengthens the evidence that chemoradiotherapy regimens with concurrent gemcitabine are feasible and well tolerated. Prospective randomized controlled trials are on-going to definitively assess the efficacy of gemcitabine-based chemoradiotherapy for MIBC

Characterizing Protein-Protein Interactions Using Solution NMR Spectroscopy

In this chapter, we describe how NMR chemical shift titrations can be used to study the interaction between two proteins with emphasis on mapping the interface of the complex and determining the bind- ing affinity from a quantitative analysis of the experimental data. In particular, we discuss the appearance of NMR spectra in different chemical exchange regimes (fast, intermediate, and slow) and how these regimes affect NMR data analysis