The effect on mental health of retiring during the economic crisis

This paper investigates the causal impact of retirement on late life depression, a growing concern for public health as major depressive disorders are the second leading cause of disability. We shed light on the role of economic conditions in shaping the effect of retirement on mental health by exploiting the time and regional variation in the severity of the economic crisis across ten European countries over the 2004-2013 period. We use data from four waves of the Survey of Health, Ageing and Retirement in Europe (SHARE) and address the potential endogeneity of retirement decision to mental health by applying a fixed-effect instrumental variable approach. Results indicate that retirement improves mental health of men, but not of women. This effect is stronger for those men working in regions that are severely hit by the economic crisis and in blue-collar jobs. These findings may be explained by the worsening of working conditions and the rise in job insecurity stemming from the economic downturn: In these circumstances, the exit from the labor force is perceived as a relief

Measurement error in occupational coding: an analysis on SHARE data

This article studies the potential measurement errors when coding occupational data. The quality of occupational data is important but often neglected. We recoded open-ended questions on occupation for last and current job in the Dutch SHARE data, using the CASCOT ex-post coding software. The disagreement rate, defined as the percentage of observations coded differently in SHARE and CASCOT, is high even when compared at ISCO 1-digit level (33.7% for last job and 40% for current job). This finding is striking, considering our conservative approach to exclude vague and incomplete answers. The level of miscoding should thus be considered as a lower bound of the “true” miscoding. This highlights the complexity of occupational coding and suggests that measurement error due to miscoding should be taken into account when making statistical analysis or writing econometric models. We tested whether the measurement error is random or correlated to individual or job-related characteristics, and we found that the measurement error is indeed more evident in ISCO-88 groups 1 and 3 and is more pronounced for higher educated individuals and males. These groups may be sorted in occupations that are intrinsically more difficult to be classified, or education and gender may affect the way people describe their jobs

Measuring and Detecting Errors in Occupational Coding: an Analysis of SHARE Data

This article studies coding errors in occupational data, as the quality of this data is important but often neglected. In particular, we recoded open-ended questions on occupation for last and current job in the Dutch sample of the “Survey of Health, Ageing and Retirement in Europe” (SHARE) using a high-quality software program for ex-post coding (CASCOT software). Taking CASCOT coding as our benchmark, our results suggest that the incidence of coding errors in SHARE is high, even when the comparison is made at the level of one-digit occupational codes (28% for last job and 30% for current job). This finding highlights the complexity of occupational coding and suggests that processing errors due to miscoding should be taken into account when undertaking statistical analyses or writing econometric models. Our analysis suggests strategies to alleviate such coding errors, and we propose a set of equations that can predict error. These equations may complement coding software and improve the quality of occupational coding.This article studies coding errors in occupational data, as the quality of this data is important but often neglected. In particular, we recoded open-ended questions on occupation for last and current job in the Dutch sample of the "Survey of Health, Ageing and Retirement in Europe" (SHARE) using a high-quality software program for ex-post coding (CASCOT software). Taking CASCOT coding as our benchmark, our results suggest that the incidence of coding errors in SHARE is high, even when the comparison is made at the level of one-digit occupational codes (28% for last job and 30% for current job). This finding highlights the complexity of occupational coding and suggests that processing errors due to miscoding should be taken into account when undertaking statistical analyses or writing econometric models. Our analysis suggests strategies to alleviate such coding errors, and we propose a set of equations that can predict error. These equations may complement coding software and improve the quality of occupational coding

Hypertension and emergency medicine: an update

The objective of this paper is to evaluate the correct management of hypertension in emergency departments. Studies were identified searching PubMed up to April 30, 2012, combining the terms 'HYPERTENSIVE EMERGENCY' and 'HYPERTENSIVE URGENCY'. The search strategy was limited to English and Italian language papers on adult and pediatric patients. Hypertensive crises are commonly found in emergency departments. A range of pharmacological options are available in this setting, but each physician should tailor theoretical principles to the individual patient according to his or her clinical parameters

Il paziente a rischio di nefropatia da mezzi di contrasto iodati

Summary Subjects with hypovolemia and/or dehydration and pre-existing renal failure are considered at highest risk for radiocontrast-medium-induced acute kidney injury (RCI-AKI), and this risk increases in the presence of glomerular filtration rate or creatinine clearance rates lower than 60 mL/min (stage 3-5 chronic kidney disease according to the National Kidney Foundation). The authors critically review the evidence-based literature on RCI-AKI, its diagnosis, epidemiological aspects, predisposing conditions, and markers of risk, including advanced age. Procedures requiring the use of iodinated contrast media are increasingly performed in patients over 70 years of age, and there is no definitive consensus regarding the role of advanced age as a marker of risk for RCI-AKI

Pirfenidone for Idiopathic Pulmonary Fibrosis and Beyond

Pirfenidone (PFD) slows the progression of idiopathic pulmonary fibrosis (IPF) by inhibiting the exaggerated fibrotic response and possibly through additional mechanisms, such as anti-inflammatory effects. PFD has also been evaluated in other fibrosing lung diseases. Myocardial fibrosis is a common feature of several heart diseases and the progressive deposition of extracellular matrix due to a persistent injury to cardiomyocytes may trigger a vicious cycle that leads to persistent structural and functional alterations of the myocardium. No primarily antifibrotic medications are used to treat patients with heart failure. There is some evidence that PFD has antifibrotic actions in various animal models of cardiac disease and a phase II trial on patients with heart failure and preserved ejection fraction has yielded positive results. This review summarises the evidence about the possible mechanisms of IPF and modulation by PFD, the main results about IPF or non-IPF interstitial pneumonias and also data about PFD as a potential protective cardiac drug

Approach to leg edema

Edema is defined as a palpable swelling caused by an increase in interstitial fluid volume. Leg edema is a common problem with a wide range of possible causes and is the result of an imbalance in the filtration system between the capillary and interstitial spaces. Major causes of edema include venous obstruction, increased capillary permeability and increased plasma volume secondary to sodium and water retention. In both hospital and general practice, the patient with a swollen leg presents a common dilemma in diagnosis and treatment. The cause may be trivial or life-threatening and it is often difficult to determine the clinical pathway. The diagnosis can be narrowed by categorizing the edema according to its duration, distribution (unilateral or bilateral) and accompanying symptoms. This work provides clinically oriented recommendations for the management of leg edema in adults