Istraživanjem do zdravlja za svakoga

John F. Kennedy\u27s vision of man on the moon by the year 1970 set a goal for technological research and development. The World Health Organization\u27s vision of health for all by the year 2000 set a similar goal not only for health policy but also for health research. Drawing on the analogy between these goals, this paper first explores what health for all means as a policy goal. It calls for changes in most aspects of the health care system. In the European Region of the World Health Organization, 38 specific targets show how approaches to health problems, lifestyles, environment, health care and various support measures (e.g., planning, management and training) should be changed to reach the over-all goal. These changes should be based on sound scientific knowledge. Health for all therefore also calls for a health research policy and reorientation of research. The second part of the paper looks at the research implications of health for all. Assisted by the Regional Office of the World Health Organization, the European Advisory Committee for Health Research analysed the 38 targets to see what kind of research would help to achieve hem. The result of this analysis were two publications: Research Policies for Health for All·and - Priority Research for Health for All. The first volume explains why a country needs a health research policy. The second one identifies, target by target, research necessary to reach them. Translated into several languages, they have begun to influence national research policies. The third section of the paper describes the research priorities identified in the two research for health for all volumes. It also aims at showing their relevance for the European health research community. It finally discusses the prerequisites that the countries have to set up to make research for health for all possible. They include changes in the incentives for and financing of research, personnel development, research organization and communication between the researchers and decision-makers.Vizija Johna F. Kennedya o čovjeku na Mjesecu do 1970. godine odredila je cilj tehnološkom istraživanju i razvoju. Vizija Svjetske zdravstvene organizacije o zdravlju za svakoga do 2000. godine postavila je sličan cilj ne samo u pogledu zdravstvene politike već i u pogledu istraživanja koja se tiču zdravlja. Polazeći od analogije koja postoji između ova dva cilja autor prvo istražuje što znači zdravlje za svakoga kao cilj politike. Ovaj cilj zahtijeva u velikoj mjeri promjenu sistema zdravstvene zaštite. Primjer 38 točno definiranih ciljeva u evropskoj regiji Svjetske zdravstvene organizacije pokazuje kako je, da bi se ostvario konačni cilj, potrebno mijenjati pristupe zdravstvenim problemima, stilovima života, okolišu, zaštiti zdravlja i raznim popratnim djelatnostima (npr. planiranje, upravljanje, obrazovanje). Ove promjene trebaju počivati na čvrstoj znanstvenoj osnovi. Zdravlje za svakoga zato iziskuje dobro definirana zdravstvena istraživanja i njihovo preusmjeravanje. U članku se nadalje razmatraju implikacije istraživanja čiji je cilj zdravlje za svakoga. Uz pomoć Regionalnog ureda Svjetske zdravstvene organizacije Evropski savjetodavni komitet za istraživanje u vezi sa zdravljem analizirao je 38 ciljeva da bi ustanovio koja bi vrsta istraživanja pridonijela njihovu ostvarenju. Rezultat analize bile su dvije publikacije: Smjernice istraživačke politike u vezi sa zdravljem za svakoga i Prioritetna istraživanja u vezi sa zdravljem za svakoga. Prva publikacija objašnjava zašto je za neku zemlju nužno planirati zdravstvena istraživanja. U drugoj publikaciji navode se istraživanja koja su potrebna za ostvarenje svakog pojedinog cilja. Ove su publikacije prevedene na nekoliko jezika i već su počele utjecati na istraživačku politiku u drugim zemljama. Članak se također bavi opisom prioritetnih istraživanja koja su istaknuta u dvije gornje publikacije. Namjera mu je da pokaze njihovu relevantnost za Evropsku zajednicu zaduženu za istraživanja u vezi sa zdravljem. Također raspravlja o preduvjetima koje svaka zemlja treba ispuniti da bi omogućila istraživanja čiji je cilj zdravlje za svakoga. Oni podrazumijevaju promjene u stimuliranju i financiranju istraživanja, obrazovanju kadrova, organizaciji istraživanja i komunikaciji između onih koji istražuju i onih koji odlučuju

Gender- and age-stratified analyses of gambling disorder in Finland between 2011 and 2020 based on administrative registers

Aim: Prevalence studies on gambling have largely relied on survey samples. Little is known about the diagnosed prevalence of gambling disorder (GD) based on register data. This study examines the annual prevalence rate of GD between 2011 and 2020 among Finns by gender and age. Methods: Aggregated data on the diagnosis of GD (corresponding to pathological gambling, code F63.0 in the ICD-10) were retrieved from the following national registers: Register of Primary Health Care Visits, and Care Register for Health Care, including specialised outpatient and inpatient health care, and inpatient Care Register for Social Welfare. Primary and secondary diagnoses of adults were included. Average population during a calendar year (4,282,714-4,460,177 individuals) was utilised to calculate annual prevalence. Results: The annual prevalence of diagnosed GD in the population increased from 0.005% (n = 196) to 0.018% (n = 804) within nine years. In 2011, the annual prevalence rate was 0.006% for men and 0.003% for women, compared to rates in 2020 of 0.025% and 0.011%. Gender discrepancy was relatively stable across years: 27.2-33.8% of the diagnoses were for women. The prevalence of GD varied between age groups within genders. GD was most prevalent among 18-44-year-olds. The prevalence rates increased the most among 30-44-year-old women. Conclusion: The extremely low prevalence rate of GD implies that the problem remains under-diagnosed, yet, it has increased among all age groups across genders, except for women aged 60 years or older. Active efforts are needed to increase awareness of GD among both primary and specialised healthcare professionals and the public for better recognition and early detection.Peer reviewe

Physical activity monitoring in Europe : the European physical activity surveillance system (EUPASS) approach and indicator testing.

Objectives: The main objective of this paper is to describe the approach and specific findings of the European Physical Activity Surveillance System (EUPASS) research project. In particular, the analysis presented aims at testing the reliability, comparability and predictive power of different sets of physical activity (PA) indicators. Design: First, a panel study based on computer-aided telephone interview (CATI) was designed to report PA data of a representative, selected group of about 100 persons per country at three points in time. Second, a CATI time series survey was carried out with the goal of realising about 100 interviews per month over six consecutive months. Setting: The project was carried out in eight European countries to support the development of the European Union's (EU) Health Monitoring Programme. Subjects: Random population samples (subjects aged 18 years and older) were drawn from each participating country. Results: While many PA indicators used in EU countries to date as well as the psychosocial and environmental measures tested in the present study had acceptable to good reliability coefficients, the test–retest reliability scores of the International Physical Activity Questionnaire (IPAQ) version tested (the short (last 7 days) telephone interview IPAQ; IPAQ-S7T) were rather low. The comparability between extant national PA items and the IPAQ-S7T was low for all countries. The strongest predictors of perceived health were the psychosocial and environmental PA indicators. Conclusions: According to the results of the present study, more research is needed to further investigate and improve the quality of the IPAQ. In addition, the specific predictive power of the tested psychosocial and environmental PA indicators on perceived health should be of particular interest for designing health surveillance activities in the future

Production Technology and Competitiveness In the Hungarian Manufacturing Industry

Following the big transformations of the 1990s, enterprise structure and technological level seem to have become stabilised in Hungary. Under these circumstances it is especially interesting to identify the elements responsible for competitiveness in general, and the role technology plays in development in particular, according to managers experienced in production and marketing. This empirical study – based on in-depth interviews and field research – summarises characteristics of the technological level in the sectors examined, role of technology and labour in production, effects of foreign direct investment, relations between competition and firm-level factors determining competitiveness, and concludes by summing up those most frequently mentioned proposals that should be incorporated into economic policy according to managers. Main findings indicate that more qualified, more intensive and cheaper labour can be substituted for high technology. The competitiveness of an enterprise is not determined by technology alone, but rather by a combination of technology, the parameters of available labour and the costs of investment increasing productivity. The insufficiency of inter-company relations, together with a shortage of available assets necessary for investment constitute the major threat undermining the competitiveness of enterprises in present-day Hungary

Attention deficit hyperactivity and oppositional defiant disorder symptoms in adolescence and risk of substance use disorders - a general population-based birth cohort study

BACKGROUND: Externalizing symptoms are associated with risk of future substance use disorder (SUD). Few longitudinal studies exist using general population-based samples which assess the spectrum of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms. AIMS/OBJECTIVES: We aimed to study the associations between adolescent ADHD symptoms and subsequent SUD and additionally examine whether the risk of SUD is influenced by comorbid oppositional defiant disorder (ODD) symptoms. METHODS: The Northern Finland Birth Cohort 1986 was linked to nationwide health care register data for incident SUD diagnoses until age 33 years (n = 6278, 49.5% male). ADHD/ODD-case status at age 16 years was defined using parent-rated ADHD indicated by Strengths and Weaknesses of ADHD symptoms and Normal Behaviors (SWAN) questionnaire with 95% percentile cut-off. To assess the impact of ODD comorbidity on SUD risk, participants were categorized into four groups based on their ADHD/ODD case status. Cox-regression analysis with hazard ratios (HRs) and 95% confidence intervals (CIs) were used to study associations between adolescent ADHD/ODD case statuses and subsequent SUD. RESULTS: In all, 552 participants (8.8%) presented with ADHD case status at the age of 16 years, and 154/6278 (2.5%) were diagnosed with SUD during the follow-up. ADHD case status was associated with SUD during the follow-up (HR = 3.84, 95% CI 2.69-5.50). After adjustments for sex, family structure, and parental psychiatric disorder and early substance use the association with ADHD case status and SUD remained statistically significant (HR = 2.60, 95% CI 1.70-3.98). The risk of SUD remained elevated in individuals with ADHD case status irrespective of ODD symptoms. CONCLUSIONS: ADHD in adolescence was associated with incident SUD in those with and without symptoms of ODD. The association of ADHD and SUD persisted even after adjustment for a wide range of potential confounds. This emphasizes the need to identify preventative strategies for adolescents with ADHD so as to improve health outcomes

Epidemiología i assistència primària

Amb aquest article pretenem presentar, de forma resumida, els elements més rellevants de la sessió dedicada per la Societat a la relació entre l'Epidemiologia i l'Assistència Primària. Hem refusat d'intentar una transcripciò cronològica per tal d'aconseguiruna síntesis més útil. Així després d'una consideració preliminar sobre què és. d'una banda l'Epidemiologiai, de l'altra, L'assistència Primària, passarem a tractar els aspectes de l'organització de la tasca epidemiològica en el context del primer esglaó dels serveis sanitari

Analysis of pancreas tissue in a child positive for islet cell antibodies

Conclusions/interpretation These observations suggest that positivity for ICA alone, even when lasting for more than 1 year, is not associated with inflammatory changes in the islets. However, it is most likely that the pancreatic islets were infected by an enterovirus in this child

Gender- and age-stratified analyses of gambling disorder in Finland between 2011 and 2020 based on administrative registers

Aim: Prevalence studies on gambling have largely relied on survey samples. Little is known about the diagnosed prevalence of gambling disorder (GD) based on register data. This study examines the annual prevalence rate of GD between 2011 and 2020 among Finns by gender and age. Methods: Aggregated data on the diagnosis of GD (corresponding to pathological gambling, code F63.0 in the ICD-10) were retrieved from the following national registers: Register of Primary Health Care Visits, and Care Register for Health Care, including specialised outpatient and inpatient health care, and inpatient Care Register for Social Welfare. Primary and secondary diagnoses of adults were included. Average population during a calendar year (4,282,714-4,460,177 individuals) was utilised to calculate annual prevalence. Results: The annual prevalence of diagnosed GD in the population increased from 0.005% (n = 196) to 0.018% (n = 804) within nine years. In 2011, the annual prevalence rate was 0.006% for men and 0.003% for women, compared to rates in 2020 of 0.025% and 0.011%. Gender discrepancy was relatively stable across years: 27.2-33.8% of the diagnoses were for women. The prevalence of GD varied between age groups within genders. GD was most prevalent among 18-44-year-olds. The prevalence rates increased the most among 30-44-year-old women. Conclusion: The extremely low prevalence rate of GD implies that the problem remains under-diagnosed, yet, it has increased among all age groups across genders, except for women aged 60 years or older. Active efforts are needed to increase awareness of GD among both primary and specialised healthcare professionals and the public for better recognition and early detection.</p