Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis.

The allergenic content of the atmosphere varies according to climate, geography and vegetation. Data on the presence and prevalence of allergenic airborne pollens, obtained from both aerobiological studies and allergological investigations, make it possible to design pollen calendars with the approximate flowering period of the plants in the sampling area. In this way, even though pollen production and dispersal from year to year depend on the patterns of preseason weather and on the conditions prevailing at the time of anthesis, it is usually possible to forecast the chances of encountering high atmospheric allergenic pollen concentrations in different areas. Aerobiological and allergological studies show that the pollen map of Europe is changing also as a result of cultural factors (for example, importation of plants such as birch and cypress for urban parklands), greater international travel (e.g. colonization by ragweed in France, northern Italy, Austria, Hungary etc.) and climate change. In this regard, the higher frequency of weather extremes, like thunderstorms, and increasing episodes of long range transport of allergenic pollen represent new challenges for researchers. Furthermore, in the last few years, experimental data on pollen and subpollen-particles structure, the pathogenetic role of pollen and the interaction between pollen and air pollutants, gave new insights into the mechanisms of respiratory allergic diseases.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1398-9995.2007.01393.x

Allergenic pollen and pollen allergy in Europe

Objectives To update a 2004 systematic review of health care service use and health outcomes related to differences in health literacy level and interventions designed to improve these outcomes for individuals with low health literacy. Disparities in health outcomes and effectiveness of interventions among different sociodemographic groups were also examined. Data sources We searched MEDLINE®, the Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, PsychINFO, and the Educational Resources Information Center. For health literacy, we searched using a variety of terms, limited to English and studies published from 2003 to May 25, 2010. For numeracy, we searched from 1966 to May 25, 2010. Review methods We used standard Evidence-based Practice Center methods of dual review of abstracts, full-text articles, abstractions, quality ratings, and strength of evidence grading. We resolved disagreements by consensus. We evaluated whether newer literature was available for answering key questions, so we broadened our definition of health literacy to include numeracy and oral (spoken) health literacy. We excluded intervention studies that did not measure health literacy directly and updated our approach to evaluate individual study risk of bias and to grade strength of evidence. Results We included good- and fair-quality studies: 81 studies addressing health outcomes (reported in 95 articles including 86 measuring health literacy and 16 measuring numeracy, of which 7 measure both) and 42 studies (reported in 45 articles) addressing interventions. Differences in health literacy level were consistently associated with increased hospitalizations, greater emergency care use, lower use of mammography, lower receipt of influenza vaccine, poorer ability to demonstrate taking medications appropriately, poorer ability to interpret labels and health messages, and, among seniors, poorer overall health status and higher mortality. Health literacy level potentially mediates disparities between blacks and whites. The strength of evidence of numeracy studies was insufficient to low, limiting conclusions about the influence of numeracy on health care service use or health outcomes. Two studies suggested numeracy may mediate the effect of disparities on health outcomes. We found no evidence concerning oral health literacy and outcomes. Among intervention studies (27 randomized controlled trials [RCTs], 2 cluster RCTs, and 13 quasi-experimental designs), the strength of evidence for specific design features was low or insufficient. However, several specific features seemed to improve comprehension in one or a few studies. The strength of evidence was moderate for the effect of mixed interventions on health care service use; the effect of intensive self-management inventions on behavior; and the effect of disease-management interventions on disease prevalence/severity. The effects of other mixed interventions on other health outcomes, including knowledge, self-efficacy, adherence, and quality of life, and costs were mixed; thus, the strength of evidence was insufficient. Conclusions The field of health literacy has advanced since the 2004 report. Future research priorities include justifying appropriate cutoffs for health literacy levels prior to conducting studies; developing tools that measure additional related skills, particularly oral (spoken) health literacy; and examining mediators and moderators of the effect of health literacy. Priorities in advancing the design features of interventions include testing novel approaches to increase motivation, techniques for delivering information orally or numerically, "work around" interventions such as patient advocates; determining the effective components of already-tested interventions; determining the cost-effectiveness of programs; and determining the effect of policy and practice interventions.

/pdf/health-literacy-interventions-and-outcomes-an-updated-chswt8nilu.pdf

Health literacy interventions and outcomes: an updated systematic review.

Páginas de Salud Pública. Food, nutrition and the prevention of cancer: A global perspective. Conocimientos actuales sobre nutrición

Melanoma and nonmelanoma skin cancer (NMSC) are now the most common types of cancer in white populations. Both tumor entities show an increasing incidence rate worldwide but a stable or decreasing mortality rate.1,2 The rising incidence rates of NMSC are probably caused by a combination of increased sun exposure or exposure to ultraviolet (UV) light, increased outdoor activities, changes in clothing style, increased longevity, ozone depletion, genetics and in some cases, immune suppression. A dose-dependent increase in the risk of squamous cell carcinoma (SCC) of the skin was found associated with exposure to Psoralen and UVA irradiation. An intensive UV exposure in childhood and adolescence was causative for the development of basal cell carcinoma (BCC) whereas for the aetiology of SCC a chronic UV exposure in the earlier decades was accused.

Epidemiology of melanoma and nonmelanoma skin cancer--the role of sunlight.

In order to obtain information regarding the efficacy of healthcare services in the region of Umbria (Italy), trends in mortality due to the main causes of death in this region, between 1994-2004, were analysed. Mortality data was collected from the Nominal Registry of Causes of Death. Standardized mortality and years of potential life lost (YPLL) rates, and cumulative death risk were used as indicators. Joinpoint regression was used to determine whether temporal changes in indicator trends were statistically significant. The joinpoint analysis of mortality trends has shown that general mortality, as well as specific mortality due to malignant tumors, cardiovascular disease, gastrointestinal disease and accidental causes declined over the examined time period. Statistically significant decreases in the indicators used were constant over time: in fact, joinpoints were found only for YPLL and cumulative risk trends for cardiovascular disease-related mortality. These results have provided important information regarding healthcare in the Umbria region.

[Trends in mortality due to the main causes of death in Umbria (Italy), 1994-2004].

Survival statistics of 4135 incident cases of digestive system cancers in the Umbria region of Italy are reported. The original data are derived from an ad hoc survey carried out in the period 1978--1982. Observed and relative rates at 1, 5 and 10 years are presented separately by sex and age (< 60 and ≥ 60 years). In both sexes there are very short survival rates for liver, bile duct and pancreas cancers, whereas about 50% of colon and rectum cancer patients survived at five years. About 20% stomach cancer patients survived at the same time. In males the survival rate for oesophagus cancer is close to 10%. The rates at ten years confirm the trend. Comparisons between sexes show that there is no significant differences in age at first diagnosis. Survival values are higher in females only for rectum cancers. In both sexes, for stomach, colon and rectum sites younger patients had a significantly longer survival than older ones.

Ten-year survival of patients with cancer of the digestive tract in Umbria, Italy.

The aim of the study was to evaluate the quality of hospital-territorial services relationship and community care to ensure continuity of care and to avoid, or reduce, the risk of hospitalization for complications or problems in the Health Districts of Umbria region (Italy) They are considered some of the outcome indicators proposed by the Assessment Document on Determinants of Health and the Strategies of the SSR, sponsored by the Region of Umbria in 2004 and based on Agency for Healthcare Research and Quality Indicators : the rate of unplanned readmission to hospital within 28 days after hospitalization for hip fracture, stroke, acute myocardial infarction, asthma, and the rate of hospitalization for chronic complications of diabetes, pneumonia and influenza The most significant feature is the marked variability between different districts of the region This variability requires careful verification, as well as the quality of intra-hospital, also the quality of the relationship hospital-territorial services and the different skills and ways of taking care of patients by the health district To reduce the risk of rehospitalization/readmission not programmed for specific diseases, even considering that this risk is influenced by various determinants, it is desirable to improve the quality of community services

Evaluation of the healthcare continuity quality in Umbria (Italy)

Background 

Many governments have made commitments to tackle inequalities in healthcare access based on studies which assessed the association between several socio-demographic factors and late initiation or fewer antenatal visits. This study addressed the question of whether socio-demographic determinants were significant in explaining differences in antenatal care in an administrative region of Italy (i.e., Umbria) with specific focus on migrant women, and whether the implementation of regional policies of the integration process …

Access equality to prenatal care in Italy: the effects of socio-demographic determinants

Using incidence, survival and mortality we tried to verify the effectiveness of mass-screening interventions for cervical uterine, breast, and colorectal cancer in females. Mortality data concern the period from 1978-2002. Incident cases derived from an ad hoc survey for 1978-1982 data and from the RTUP from 01/01/1994 to 31/12/2002. Relative survival rates were calculated for 1978-1982, 1994-1997 and 1998-2002 time intervals. All standardized mortality figures showed a steady trend. Incidence rates concerning cervical uterine cancer showed a decrease starting from the 1978-1982 period, whereas those for breast cancer had a constant increasing trend, and those for colorectal cancer increased up to 1997-1999 and later remained constant. For breast cancer the 5-year survival rate increased about 15% compared to the first period, for colon cancer there was less of an increase and the increase for cervical uterine cancer survival was only for the 1998-2002 period compared to the former ones. With constant incidence rates, improvement in survival from cervical uterine cancer may be due to a high number of cancer cases detected at an early stage. The effect of breast cancer screening on incidence is evident, though differences still did not influence mortality and survival. Colorectal cancer epidemiology can be considered as a prescreening pattern. Mortality, incidence and survival data allow a good overview for the effectiveness of screening procedures.

Liliana Minelli

Papers

[Trends in mortality due to the main causes of death in Umbria (Italy), 1994-2004].

Ten-year survival of patients with cancer of the digestive tract in Umbria, Italy.

Evaluation of the healthcare continuity quality in Umbria (Italy)

Access equality to prenatal care in Italy: the effects of socio-demographic determinants

Epidemiological overview on the effectiveness of mass screening for female cancer in Umbria, Italy.