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Making decisions about colorectal cancer screening. A qualitative study among citizens with lower educational attainment

Date

Source

02.02.2016

Kirkegaard, P., Mortensen, G. L., Mortensen, S. L., Larsen, ...


Background: Few decision aids (DAs) have been developed to support an informed choice to citizens with lower educational attainment about colorectal cancer screening. The aim of this study was to identify information needs and preferences for formats and content in a DA for this group of citizens. Methods: Four focus groups were conducted among Danish men and women aged 50–74 years with lower educational attainment. A semi-structured interview guide was developed to explore participants’ perceptions about colorectal cancer screening and wishes for a DA. The interviews were transcribed and analysed using an ethnographic approach. Results: The participants appreciated information about the causes, symptoms, incidence and mortality of colorectal cancer compared with other common cancers. The majority preferred the information to be presented in a clear and simple way with numbers and figures kept to a minimum. Values clarification exercises were not found useful. Receiving a screening kit to collect a sample of faeces along with the invitation letter was seen by the participants as a clear request from the health authorities to get screened. However, the overall message in the DA was perceived as ambiguous by the participants as it both recommended screening and seemed to disclaim responsibility for it. Conclusion: The results are relevant to a discussion of the delicate balance between participants’ call for a clear recommendation, and the purpose of a DA to present options in a neutral and balanced way. This discussion is relevant beyond the group of citizens with lower educational attainment.


The EUROMED CANCER network: state-of-art of cancer screening programmes in non-EU Mediterranean countries

Date

Source

02.02.2016

Giordano, L., Bisanti, L., Salamina, G., Ancelle Park, R., S...


Background: The EUROMED CANCER Network project aims to support non-EU Mediterranean countries in the development of cancer early detection and screening policies. Methods: Through a structured questionnaire information from 15 countries (Albania, Algeria, Bosnia and Herzegovina (BiH), Croatia, Egypt, Jordan, UN Interim Administration Mission in Kosovo, Lebanon, Montenegro, Morocco, Palestinian National Authority, Serbia, Syria, Tunisia and Turkey) were collected on cancer epidemiology and control. Results: Large differences between countries are evident. Breast cancer (BC) is the commonest cancer among women, though the incidence rate is much lower in non-EU than in EU Mediterranean countries. Conversely, cervical cancer (CC) is much more common in the former than in the latter countries. Colorectal cancer (CRC) is more frequent in Northern than in Eastern and Southern Mediterranean shores. Population-based cancer registries are available in few countries but most of them lack information on disease staging. Opportunistic screening for CC and BC is unevenly spread across and within countries; organised screening programmes are rare and do not meet international recommendations. BC and CC early detection is extensively considered a priority, while a few countries included CRC into their agenda. Conclusions: Collected data witnesses inadequacy of health information system and, in general, of the strategies for cancer control in the involved countries. A uniform approach for strengthening cancer control is not realistic neither feasible. Tailored preventive actions for cancer early detection have to be started concurrently with the development of a reliable health information system and, specifically, with cancer registration.


The 'dark side of social capital: trust and self-rated health in European countries

Date

Source

02.02.2016

Campos-Matos, I., Subramanian, S. V., Kawachi, I.


Background: Generalized interpersonal trust (as an indicator of social capital) has been linked to health status at both the individual and ecological level. We sought to examine how changes in contextual and individual trust are associated with changes in self-rated health in the European Social Surveys 2002–12. Methods: A multilevel analysis using a variance components model was performed on 203 452 individuals nested within 145 country cohorts covering 35 countries. Conditional on sociodemographic covariates, we sought to examine the association between self-rated health and individual trust, country average trust and a cross-level interaction between the two. Results: Although individual trust perceptions were significantly correlated with self-rated health [OR = 0.95, 95% confidence interval (0.94–0.96)], country-level trust was not associated [OR = 1.12, 95% confidence interval (0.95–1.32)]. There was, however, a strong crosslevel interaction between contextual and individual trust (P < 0.001), such that individuals with high interpersonal trust reported better health in contexts in which other individuals expressed high average interpersonal trust. Conversely, low trust individuals reported worse health in high trust contexts. Conclusion: Our findings suggest that contexts with increasing average trust can be harmful for low trust individuals, which might reflect the negative impact that social capital can have in certain groups. These findings suggest that contextual trust has a complex role in explaining health inequalities and individual self-rated health.


Thank you

Date

Source

02.02.2016

Allebeck, P., Delnoij, D., Leyland, A., Ricciardi, W.



Prevalence and burden of osteoarthritis amongst older people in Ireland: findings from The Irish LongituDinal Study on Ageing (TILDA)

Date

Source

02.02.2016

French, H. P., Galvin, R., Horgan, N. F., Kenny, R. A.


Objective: To investigate the prevalence of osteoarthritis (OA) in a population aged ≥50 years in Ireland, and to determine its relationship with demographic and health-related variables. Methods: Cross-sectional data from Wave 1 of The Irish Longitudinal Study on Ageing (TILDA), a population-based study of 8175 people aged ≥50 years were analyzed. Logistic regression was used to determine associations between the presence of OA and a range of demographic and health-related variables. Results: A total of 8175 people ≥50 years in Ireland were identified from the TILDA database of whom 45.7% (n = 2941) were male and 54.3% (n = 4431) were female. The overall prevalence of OA was 12.9% (women-17.3%; men-9.4%). Prevalence increased with age, with prevalence in those aged ≥ 80 years twice that [17.7%; 95% confidence interval (CI) 13.97, 21.54] of those aged 50–60 years (8.23, 95% CI 7.32, 9.13). On multivariable analysis, OA was significantly associated (P < 0.02) with female gender, older age, pain severity, higher body mass index (BMI), fear of falling, greater number of physical limitations and medication use. In particular, there was a strong association between the use of NSAIDS and the presence of OA [adj odd ratio (OR) = 5.88, 95% CI 4.16, 8.31]. A significant association was also found between OA and increasing number of chronic diseases (adj OR = 2.75 9, 95% CI = 2.44, 3.09). Conclusions: OA is a common and multifaceted condition, with comparable prevalence of self-reported OA in Ireland with similar populations. Assessment and management should focus on potentially modifiable factors such as BMI, pain, physical limitations, polypharmacy and fear of falling. More research is required to understand the complex inter-relationships between these and other risk-associated variables.


European Public Health News * EUPHA President's Column * EUPHA Office column * Message from the WHO Regional Director for Europe * Message from Vytenis Andriukaitis, EU Commissioner for Health and Food Safety * 9th European Public Health Conference--'All for Health--Health for All

Date

Source

02.02.2016

McKee, M., Paget, D. Z., Jakab, Z., Andriukaitis, V., Barnho...



Impact of living alone on institutionalization and mortality: a population-based longitudinal study

Date

Source

02.02.2016

Pimouguet, C., Rizzuto, D., Schon, P., Shakersain, B., Angle...


Background: Living alone is common among elderly people in Western countries, and studies on its relationship with institutionalization and all-cause mortality have shown inconsistent results. We investigated that the impact of living alone on institutionalization and mortality in a population-based cohort of elderly people. Methods: Data originate from the Swedish National study on Aging and Care-Kungsholmen. Participants aged ≥66 years and living at home (n = 2404) at baseline underwent interviews and clinical examination. Data on living arrangements were collected in interviews. All participants were followed for 6 years; survival status and admission into institutions were tracked continuously through administrative registers from 2001 to 2007. Data were analysed using Cox proportional hazard models, competing risk regressions and Laplace regressions with adjustment for potential confounders. Results: Of the 2404 participants, 1464 (60.9%) lived alone at baseline. During the follow-up, 711 (29.6%) participants died, and 185 (15.0%) were institutionalized. In the multi-adjusted Cox model, the hazard ratio (HR) of mortality in those living alone was 1.35 (95% confidence interval [CI] 1.18 to 1.54), especially among men (HR = 1.44, 95% CI 1.18 to 1.76). Living alone shortened survival by 0.6 years and was associated with the risk of institutionalization (HR = 1.74, 95% CI 1.10 to 2.77) after taking death into account as a competing risk. Conclusions: Living alone is associated with elevated mortality, especially among men and an increased risk of institutionalization. Over a 6-year period, living alone was related to a half year reduction in survival among elderly people in Sweden.


An exploration of antecedents of positive affect among the elderly: a cross-sectional study

Date

Source

02.02.2016

Lee, S.


Background: Positive affect contributes to the healthy life style, which, in turn, explains life satisfaction and psychological well-being among the elderly. Existent literature has reinforced that physical activity participation influences development of positive affect for the elderly. Because of the increased life constraints and physical problems, however, maintenance of positive affect might be challenging for elderly people. Methods: Data were drawn from a sample of the Survey of Health, Ageing and Retirement in Europe. A total sample of 3845 males and 3912 females aged between 65 and 103 years from 16 European countries was analyzed. Perception of life constraints, health problems, physical activity engagement and positive affect were measured by a structured questionnaire. Confirmatory factor analysis and a technique of structural equation modelling were employed using Amos 18 to examine the hypothesized relationships between study variables. Results: Perceived life constraints and physical problems significantly affected the acquisition of positive affect among the elderly. Physical activity was found to have a significant path coefficient towards the measure of positive attitude and emotion. Physical activity was also a significant mediator between physical problems and positive affect. Conclusions: This study extended our understanding of how the perception of life constraints and health problems influence the elderly’s daily experience. Study finding reinforced the goodness of physical activity participation to enhance positive affect among the elderly. We should administer sustainable and evidence-based physical activity including interventions and infrastructure to improve positive affect and psychological well-bing among the elderly.


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