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This study aimed to assess premature mortality due to Diabetes in small areas of Spain between 2016 and 2020, and its relationship with socioeconomic level and the immediate cause of death. As a secondary objective, we evaluated the effect of the Covid 19 pandemic. This was an ecological study of premature mortality due to Diabetes from 2016 to 2020, with a focus on small areas. All deaths in people under 75 years of age due to Diabetes as the underlying cause were included The final sample comprised 7382 premature deaths in 5967 census tracts. Women living in census tracts with an high level of deprivation(RR=2.40) were at a significantly higher risk. Mortality from Diabetes increased with deprivation, especially people aged 0–54(RR=2.40). People with an immediate cause of death related to a circulatory disease, living in census tracts with an high level of deprivation(RR=3.86) was associated with a significantly greater risk of death with underlying Diabetes. When a disease of the circulatory system was recorded as the immediate cause of death, being 65–74 years (RR=71.01) was associated with a significantly higher risk of premature mortality. Living in geographic areas with higher levels of socioeconomic deprivation is associated with a higher risk of premature death from Diabetes in Spain. This relationship has a greater impact on women, people under 54 years, and people at risk of death caused directly by diseases of the circulatory system. Premature mortality due to diabetes saw a modest increase in 2020. • 49,943 died in Spain (2016–2020) from DM; 16.6% (8307) under 75. Study excluded 925 due to unestablished deprivation index. • Deprivation linked to higher DM mortality; women more affected. Most DM deaths (57%) tied to circulatory diseases. • DM mortality increases with deprivation, notably higher when circulatory system is the immediate cause. [ABSTRACT FROM AUTHOR]

Social determinants of health (SDOH) are linked to poor health care outcomes across the different medical specialties. We conducted a scoping review to understand the existing literature and identify further areas of research to address disparities within hand surgery. A systematic search of PubMed, Scopus, and Cochrane was conducted. Inclusion criteria were English studies examining health disparities in hand surgery. The following were assessed: the main SDOH, study design/phase/theme, and main disease/injury/procedure. A previously described health disparities research framework was used to determine study phase: detecting (identifying risk factors), understanding (analyzing risk factors), and reducing (assessing interventions). Studies were categorized according to themes outlined at the National Institute of Health and American College of Surgeons: Summit on Surgical Disparities. The initial search yielded 446 articles, with 49 articles included in final analysis. The majority were detecting-type (31/49, 63%) or understanding-type (12/49, 24%) studies, with few reducing-type studies (6/49, 12%). Patient factors (31/49, 63%) and systemic/access factors (16/49, 33%) were the most frequently studied themes, with few investigating clinical care/quality factors (4/49, 8%), clinician factors (3/49, 6%), and postoperative/rehabilitation factors (1/49, 2%). The most commonly studied SDOH include insurance status (13/49, 27%), health literacy (10/49, 20%), and social deprivation (6/49, 12%). Carpal tunnel syndrome (9/49, 18%), upper extremity trauma (9/49, 18%), and amputations (5/49, 10%) were frequently assessed. Most investigations involved retrospective or database designs (29/49, 59%), while few were prospective, cross-sectional, or mixed-methods. Despite an encouraging upward trend in health disparities research, existing studies are in the early phases of investigation. Most of the literature focuses on patient factors and systemic/access factors in regard to insurance status. Further work with prospective, cross-sectional, and mixed-method studies is needed to better understand health disparities in hand surgery, which will inform future interventions. [ABSTRACT FROM AUTHOR]

Objective: To test the hypotheses that (1) higher neighborhood disadvantage is associated with greater injury-related symptom severity in civilians with mild traumatic brain injury (mTBI) and (2) neighborhood disadvantage remains predictive after controlling for other established predictors. Setting: Level 1 trauma center and affiliated academic medical center. Participants: N = 171 individuals with mTBI. Design: Prospective cohort study. Main Measures: Rivermead Post Concussion Symptoms Questionnaire (RPQ) total score assessed less than 24 hours and at 2 weeks, 3 months, and 6 months postinjury. Linear mixed-effects models were used to assess the relationship between predictor variables and mTBI-related symptom burden (RPQ score). Neighborhood disadvantage was quantified by the Area Deprivation Index (ADI), a composite of 17 markers of socioeconomic position (SEP) scored at the census block group level. Results: Individuals in the upper ADI quartile of the national distribution displayed higher RPQ symptoms than those in the lower 3 quartiles (P <.001), with a nonsignificant ADI × visit interaction (P =.903). In a multivariable model, the effect of ADI remained significant (P =.034) after adjusting for demographics, individual SEP, and injury factors. Other unique predictors in the multivariable model were gender (gender × visit P =.035), health insurance type (P =.017), and injury-related litigation (P =.012). Conclusion: Neighborhood disadvantage as quantified by the ADI is robustly associated with greater mTBI-related symptom burden throughout the first 6 months postinjury. That the effect of ADI remained after controlling for demographics, individual SEP, and injury characteristics implies that neighborhood disadvantage is an important, understudied factor contributing to clinical recovery from mTBI. [ABSTRACT FROM AUTHOR]

To examine the influence of social deprivation and hand therapy attendance on active range of motion (AROM) outcomes following flexor tendon repair. We performed a retrospective analysis of patients who underwent primary zone I–III flexor tendon repair between November 2016 and November 2020. Area deprivation index (ADI) was used to quantify social deprivation. Medical record review determined each patient's demographic characteristics, injury details, total hand therapy visits, and final AROM outcome. Active range of motion was converted to Strickland's percentage for analysis. Spearman correlation and simple and multivariable linear regression models were used to assess relationships between explanatory variables and outcomes. There were a total of 109 patients, with a mean ADI of 53 and mean therapy attendance of 13 visits. Higher ADI and lower therapy attendance were correlated, and each was associated with significantly decreased Strickland's percentage. In the multivariable model, therapy attendance, ADI, zone 2 injury, and age maintained significant associations with Strickland's percentage. Socially deprived patients attend fewer therapy sessions and obtain poorer AROM after flexor tendon repair. Social deprivation is likely to contribute to poor outcomes both by its association with decreased therapy attendance and by other potential pathways that make it difficult for deprived patients to achieve good surgical outcomes. Prognostic IV. [ABSTRACT FROM AUTHOR]

Copyright of Trayectorias is the property of Universidad Autonoma de Nuevo Leon and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background Several meningococcal vaccines have been recently introduced into the infant and adolescent vaccination schedules in Northern Ireland to promote immunity to Neisseria meningitidis, protecting against meningococcal septicaemia and meningococcal meningitis. Maintained vaccination uptake is vital in securing individual protection as well as herd immunity. Several social factors have been described in influencing vaccine uptake and therefore it was the aim of this study to examine possible correlations between meningococcal vaccine uptake rates and indicators of social deprivation in Northern Ireland. Methods Vaccination data was retrieved from the Cover of Vaccination Evaluated Rapidly (COVER) database, for meningococcal vaccines (MenACWY, HiB/MenC & 4CMenB, as well as for MMR vaccine as a non-meningococcal control). Vaccine coverage data assessed included (i). Two doses of MenB by 12 months, (ii). All 3 doses of MenB by 24 months, (iii). HiB/MenC coverage, (iv). MenACWY (Year 12s, for NI) (v). First dose of MMR. Northern Ireland Multiple Deprivation Measures 2017 (NIMDM2017) were examined against 38 indicators in 7 domains. NI HSCT vaccine uptake dataset for each vaccine was correlated with each indicator in the HSCT NIMDM2017 dataset. Regression analysis was performed to determine the relationship between vaccine uptake and deprivation indicators and coefficient of variation (R²) was calculated for each of the indicators. R² values >0.7 were considered significant. Results For 4CMenB (all 3 doses by 24 Months), HiB/MenC, MenACWY and for MMR, correlation of variation (R²) values > 0.7, were obtained for 17, 16, 0 and 17 social deprivation indicators, respectively. Significant deprivation indicators were (i) the proportion of 18-21 year olds, who have not enrolled in higher education courses at higher or further education establishments, (ii) the proportion of domestic dwellings that are unfit, (iii) the proportion of domestic dwellings with Local Area Problem Scores, (iv) rate of burglary, (v) rate of vehicle crime, (vi) rate of antisocial behaviour incidents (per 1,000 population), (vii) absenteeism at primary schools and (viii) the proportion of the population aged 65 and over living in households whose equivalised income is below 60% of the NI median. Conclusions Within the last two decades, incidence of meningococcal disease has been on the decline. The introduction of meningococcal vaccines has contributed to this decrease and uptake of such vaccines should remain a public health priority to maintain the decline in meningococcal disease. Identifying contributing factors to low vaccine uptake, such as, the association between local deprivation and uptake of meningococcal vaccines, should be of public health importance and acknowledged by local governments and policy makers in their efforts to enhance vaccine uptake, both infant and teenage vaccination. There is a clear correlation with educational deprivation measures such as absenteeism and poor educational attainment and reduced vaccine uptake, perhaps through lack of understanding and willingness to vaccinate. This is where the importance of a clear and coherent public health message surrounding meningococcal vaccination should be prioritised, particularly to establish innovative modalities in a multidisciplinary team approach, to reach out to and increase vaccine uptake rates in socially deprived communities in Northern Ireland. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic is an unprecedented global event. Physical distancing and other restrictions imposed by national and local governments all over the world to contain the spread of the virus almost certainly have had a significant impact on young people, who are more sensitive to peer interaction and social stimuli than adults. This article sets out to investigate the lifestyles of young Italians during the first lockdown, with the aim of exploring how leisure becomes the object of a negotiation between social needs, regulatory requirements, and a situation of crisis. To investigate these aspects, we present the results of a quantitative study conducted on a large group of individuals in Italy, focusing on young Italians' lifestyles and leisure activities, together with an overview of prevailing moods. Our findings indicate that young people activated various adaptation strategies in response to the crisis with possible significant effects on lifestyles and well-being. [ABSTRACT FROM AUTHOR]

Social deprivation is associated with a higher prevalence of chronic pain in children and an under-representation in specialist paediatric chronic pain programs. Our primary objective was to determine if there was a relationship between social deprivation and paediatric chronic pain referrals in Ireland. Secondary objectives included analysing for differences between deprivation groups in pain characteristics and function that are recorded at first clinic visit. Families attending the national paediatric complex pain service in Dublin, Ireland, complete questionnaires on pain characteristics, parental pain catastrophizing, and pain-related disability including sleep quality and school attendance. We retrospectively reviewed records from between February 2016 and November 2019 on 288 patients. Social deprivation was assessed using the Pobal HP Deprivation Index, which is based on data from the Irish national census. Referrals followed a normal distribution across deprivation grades. Children in the disadvantaged group had a longer duration of pain, greater use of screens at bedtime, and longer sleep onset latency. Parents in the disadvantaged group had significantly higher levels of parental pain catastrophizing. In Ireland, while paediatric chronic pain referrals were normally distributed across deprivation group, the disadvantaged group was different in several ways that may be clinically significant. Further work will be needed to determine the longitudinal relationship between these factors before and after the referral and initial review. Screening for, and targeting, potential risk factors for pain chronicity may be needed to harmonize treatment outcomes in children from socially disadvantaged families. [ABSTRACT FROM AUTHOR]

Evaluate the impact of social deprivation on morbidity and mortality in surgery for colorectal cancer. The COINCIDE prospective cohort included nearly 2,000 consecutive patients operated on for colorectal cancer at the Assistance Publique-Hospitals of Paris (AP-HP) from 2008 to 2010. The data on these patients were crossed with the PMSI administrative database. The European Social Deprivation Index (EDI) was calculated for each patient and classified into five quintiles (quintiles 4 and 5 being the most disadvantaged patients). Thirty-day post-operative morbidity was determined according to the Dindo-Clavien classification, with a Had®Hoc re-analysis of each file. Statistical analysis was performed using the proprietary Q-finder® algorithm. One thousand two hundred and fifty nine curative colorectal resections were analyzed. Mortality was 2.7% and severe morbidity (Dindo-Clavien ≥ 3) occurred in 16.4%. Mortality was not statistically significantly increased among the most disadvantaged who made up almost two thirds of the population (64.2%). Patients in quintiles 4 and 5 had a statistically significant increase in severe morbidity. The relative risk remained 1.5 even after adjustment for the known risk factors found in the analysis: age > 70 years, ASA score, urgency, and laparotomy. The EDI represents an independent risk factor for severe morbidity after carcinologic colorectal resection. This study suggests that the determinants of health are multidimensional and do not depend solely on the quality and performance of the care system. The inclusion of this index in our surgical databases is therefore necessary, as is its use in health policy for the distribution of resources. [ABSTRACT FROM AUTHOR]

Background: Penile cancer is a rare disease, with approximately 600 cases diagnosed every year in the UK. In this study, we assessed the impact of social deprivation on penile cancer, concentrating on incidence, disease factors, surgical treatment and mortality within our 'Supranetwork' population. Methods: All cases of penile cancer in the West of Scotland were identified from the uro-oncology multidisciplinary team meetings over a 10-year period covering January 2008 to December 2017. Patients underwent treatment within the remit of a centralised service, and social deprivation was determined using the Scottish Index of Multiple Deprivation (SIMD), which is the Scottish government's official tool to identify areas of multiple deprivations. Results: A total of 278 patients were identified, with an age range of 27–97 years (M =64 years). The incidence of penile cancer in SIMD category 1 (most deprived) is 7.2/100,000 population at risk compared to 2.8/100,000 population at risk in SIMD category 5 (least deprived). Histologically, a higher proportion of aggressive grade 3 cancers (45% vs. 16%, p =0.03) and more advanced N2/N3 nodal disease (63% vs. 33%, p =0.04) was found in SIMD category 1 compared to SIMD category 5, suggesting higher incidence of delayed presentation with more advanced and aggressive disease in the most deprived populations. Conclusions: The level of social deprivation shows a significant association with penile cancer incidence, tumour grade and stage at time of diagnosis, with a resulting disproportionate impact on morbidity and mortality in the most deprived cohort of patients. Public awareness and efforts to increase earlier diagnoses of penile cancer in these 'hard to reach' men should be an important step in improving overall outcomes from penile cancer. [ABSTRACT FROM AUTHOR]

BACKGROUND: Patients with type 2 diabetes are at risk of heart failure hospitalization. As social determinants of health are rarely included in risk models, we validated and recalibrated the WATCH-DM score in a diverse patient-group using their social deprivation index (SDI). METHODS: We identified US Veterans with type 2 diabetes without heart failure that received outpatient care during 2010 at Veterans Affairs medical centers nationwide, linked them to their SDI using residential ZIP codes and grouped them as SDI <20%, 21% to 40%, 41% to 60%, 61% to 80%, and >80% (higher values represent increased deprivation). Accounting for all-cause mortality, we obtained the incidence for heart failure hospitalization at 5 years follow-up; overall and in each SDI group. We evaluated the WATCH-DM score using the C statistic, the Greenwood Nam D'Agostino test χ2 test and calibration plots and further recalibrated the WATCH-DM score for each SDI group using a statistical correction factor. RESULTS: In 1 065 691 studied patients (mean age 67 years, 25% Black and 6% Hispanic patients), the 5-year incidence of heart failure hospitalization was 5.39%. In SDI group 1 (least deprived) and 5 (most deprived), the 5-year heart failure hospitalization was 3.18% and 11%, respectively. The score C statistic was 0.62; WATCH-DM systematically overestimated heart failure risk in SDI groups 1 to 2 (expected/observed ratios, 1.38 and 1.36, respectively) and underestimated the heart failure risk in groups 4 to 5 (expected/observed ratios, 0.95 and 0.80, respectively). Graphical evaluation demonstrated that the recalibration of WATCH-DM using an SDI group-based correction factor improved predictive capabilities as supported by reduction in the χ2 test results (801–27 in SDI groups I; 623–23 in SDI group V). CONCLUSIONS: Including social determinants of health to recalibrate the WATCH-DM score improved risk prediction highlighting the importance of including social determinants in future clinical risk prediction models. [ABSTRACT FROM AUTHOR]

First line treatment for Parkinson's disease (PD) is typically either L-dopa or a non-ergot dopamine agonist (DA). However, the options for the treatment of motor symptoms in PD patients have increased in the last thirty years, which have seen several new classes of PD medications introduced onto the market. The purpose of this study is to examine the changes in first line therapy of newly diagnosed Parkinson's patients between 2000 and 2016 in Wales. A population-based study evaluated data from the Secure Anonymised Information Linkage (SAIL) Databank of residents in Wales, aged 40 years or older, newly treated with PD medications between 2000 and 2016. The data was compared across three intervals: 2000–2005, 2006–2011 and 2012–2016. Patients were classified by age at diagnosis into young: 40–60 years; mid, 61–80 years; and older >80 years. Logistic regression was undertaken to determine the predictors of PD medication prescribing. For the whole study period, the profiles of 9142 newly diagnosed PD patients were analysed. L-dopa was the most common first line therapy (80.6%), followed by non-ergot DAs (12.9%) and monoamine oxidase B (MAO-B) inhibitors (7.9%). Odds of L-dopa prescribing were greater in patients >80 years (OR = 20.46 95%CI: 16.25–25.76) and in the period 2012–2016 (OR = 1.98 95% CI: 1.70–2.29). Prescribing of non-ergot DAs significantly declined in 2012–2016 (OR = 0.42 95% CI: 0.35–0.49). Additional factors influencing first line therapy were deprivation, presence of diabetes and prior use of antidepressants. For example, PD patients residing in the least deprived area were less likely to be prescribed L-dopa compared to patients residing in the most deprived area (OR = 0.77 95% CI: 0.65–0.93). First line therapy in PD in Wales has undergone a significant switch towards L-dopa over the last 16 years. The data indicates reasonable compliance with guidelines on efficacy and safety issues related to Parkinson's medications. [ABSTRACT FROM AUTHOR]

Social deprivation, a measure of socioeconomic status, has been shown to negatively affect perceptions of orthopedic conditions and outcomes of treatment. The objective of this study was to assess whether social deprivation correlates with subjective assessment of function in pediatric patients with congenital hand differences. Patients enrolled in the Congenital Upper Limb Differences (CoULD) registry were assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS). The PROMIS scores for Pain Interference, Peer Relations, Anxiety, Depression, and Upper Extremity (UE) function were obtained for all patients 5 years and older at initial presentation. Social deprivation was determined by the Area Deprivation Index (ADI); the index ranges from 0 to 100 with higher scores being the most deprived. The PROMIS scores were correlated with the ADI for all patients. Three hundred seventy-five pediatric patients with congenital UE differences were evaluated. Average age was 11 years, 56% were female, and 55% had bilateral involvement. Overall, PROMIS scores were within 1 SD of normal for Peer Relations, Pain, Depression, and Anxiety. However, child-reported scores for UE function (39) were more than 1 SD below the national average (50). The mean ADI for the cohort was lower than the national average, indicative of less deprivation, with 14% of patients in the most deprived national quartile. Children in the highest ADI quartile reported PROMIS scores that reflected higher Pain Interference (41 vs 45), lower Peer Relations (55 vs 50), higher Anxiety (44 vs 49), and higher Depression (43 vs 47) than children in the lowest ADI quartile. The PROMIS scores were normal for psychosocial measures in children with congenital hand differences when evaluated as an entire cohort. However, child self-reported PROMIS scores for Pain Interference, Peer Relations, Anxiety, and Depression were worse in more socially deprived areas, suggesting more psychosocial challenges in these children. Pediatric patients with congenital upper extremity differences in areas of higher social deprivation report lower psychosocial well-being. The care of these individuals must be considered within the context of their environment because they may be more at risk for negative outcomes secondary to environmental and societal stressors. [ABSTRACT FROM AUTHOR]

• Standardized infection ratios (SIRs) are used for comparing facility performance. • Social deprivation is known to impact infection risk. • Deprivation is not accounted for in the SIR and may bias comparisons of performance. • High hospital area deprivation is associated with reporting worse SIRs. • Use of SIRs for facility comparisons is flawed. Healthcare-associated infections (HAIs) are common and often preventable complications of care, with reduction emphasized in national policy. The Centers for Medicare and Medicaid Services introduced an HAI-focused Hospital Acquired Condition Reduction Program in 2015 to penalize poor-performing hospitals. Standardized infection ratios (SIRs) are used for comparisons between healthcare organizations, though they are not adjusted for socioeconomic risks known to impact infection. The objectives of this study were to assess the relationship between hospital-area deprivation with reported SIRs and reimbursement penalties. This was a cohort study using 2018 Hospital Compare, as well as area deprivation data and other hospital characteristics. Multivariable regression models were used to evaluate associations between hospital-area deprivation and SIR reporting as well as payment reduction, adjusting for case mix index and hospital ownership. Of the 2102 unique hospitals in our study, 12.8% reported at least one worse than national benchmark SIR and 23.7% had a payment reduction. After adjustment, there was a 17% increased risk of reporting worse than benchmarked SIRs with quartile increases in deprivation (95% confidence interval: 5%-30%, P =.004). Despite this, there were no significant relationships between reimbursement penalties and ADI (risk ratio: 1.00, 95% confidence interval: 0.997-1.005, P =.567). This study documented a significant relationship between hospital-area deprivation and the risk of reporting worse than national benchmark SIRs. Though this did not appear to translate to Hospital Acquired Condition Reduction Program penalties in this dataset, it reinforces problems with the current use of SIRs for interhospital comparisons. [ABSTRACT FROM AUTHOR]

Introduction: Inequalities in life expectancy and mortality by social deprivation in the general population of the United Kingdom are widening. For people with dementia, data on potential gradients in life expectancy and mortality by social deprivation are sparse. This study aimed to explore potential differentials in life expectancy and mortality in people with dementia according to social deprivation.Methods: Using The Health Improvement Network (THIN) primary care database, we included people with a diagnosis of dementia in the United Kingdom in 2000 to 2016 and obtained data on age at death and mortality. Comparisons were made according to social deprivation quintiles adjusting for age at diagnosis.Results: Among 166,268 people with dementia there were no differences in life expectancy and mortality in the most deprived compared with the least deprived. This pattern has been stable during the study period, as no increasing inequalities in life expectancy and mortality according to social deprivation were found.Discussion: Contrary to the general population, there were limited inequalities in life expectancy and mortality according to social deprivation for people with dementia. [ABSTRACT FROM AUTHOR]

Copyright of Boletim de Geografia is the property of Universidade Estadual de Maringa and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Speech and Language skill is an essential component of normal child development. Speech, language and communication needs are widespread and are an important determinant of outcomes over the life course. This article discusses the evidence for this relationship and what can be done to improve speech, language and communication capacity for children today. [ABSTRACT FROM AUTHOR]

Objective Population screening for abdominal aortic aneurysm (AAA) in men is currently ongoing in several countries. The aim was to examine the effects of deprivation and ethnicity on uptake of screening for abdominal aortic aneurysm (AAA) and prevalence of AAA. Methods This was a review of outcomes from a population screening programme using data collected contemporaneously on a bespoke national database. Men aged 65 in two annual cohorts (2013/14 and 2014/15) were invited for AAA screening. Attendance and prevalence of AAA (aortic diameter >2.9 cm) were recorded. Results were compared according to measures of social deprivation and recorded ethnicity. Results Some 593,032 men were invited and 461,898 attended for ultrasound screening; uptake 77.9%. Uptake was related to social deprivation: 65.1% in the most deprived decile, 84.1% in the least deprived: OR for least deprived 2.84, 95% CI 2.76-2.92, p <.0001. Men in deprived areas were more likely to actively decline screening: 6% versus 3.8% in the least deprived decile. AAA were twice as common in the most deprived compared with the least deprived decile: OR 2.1, 95% CI 1.77-2.27, p <.0001. AAA were more common in white British men than in black (OR 0.46, 95% CI 0.31-0.71) or Asian (OR 0.18, 95% CI 0.13-0.26) men. There was considerable local variation in all findings. Conclusions Social deprivation affects uptake of AAA screening in 65 year old men. Local factors are the most important determinants of uptake, so solutions to improve uptake must be designed at local, not national level. [ABSTRACT FROM AUTHOR]

Sozial ungleich verteilte Arbeitsbelastungen tragen zu einer höheren Krankheitslast bei sozial benachteiligten Gruppen bei. Im Zuge wirtschaftlicher Globalisierung sind diese Gruppen zunehmend von Belastungen infolge verletzter Tauschgerechtigkeit betroffen. Internationale Forschungsergebnisse zu damit assoziierten stressbedingten Erkrankungsrisiken legen geziel-te verhältnispräventive Aktivitäten auf betrieblicher und überbetrieblicher Ebene nahe. Stressful work is unequally distributed, with more severe impact on burden of disease among socially disadvantaged groups. In times of economic globalization, these groups suffer increasingly from failed reciprocity at work and the adverse effects this takes on their health. International research evidence on these effects in terms of the elevated stress-associated disease risks underlines the need of implementing targeted prevention programs at the corporate level and beyond. [ABSTRACT FROM AUTHOR]

Background: Healthcare-associated infections (HCAIs) endanger safety by increasing morbidity, mortality, and hospital stay. Studies identifying risk factors for HCAI rarely address the wider determinants of health. However, a well-characterized association exists between increasing social deprivation and poor health outcomes. Therefore it is important to determine whether HCAIs are associated with social deprivation.Aim: To determine the association between social deprivation and the prevalence of HCAI, in all inpatients in an acute hospital in Scotland on a single day across September and October 2011.Methods: This study linked Scottish data from the 2011 European Point Prevalence Survey of HCAI and Antimicrobial Prescribing to the Scottish Morbidity Record 01, a national dataset with Scottish Index of Multiple Deprivation (SIMD) included. Multivariate logistic regression was used to model HCAI prevalence against SIMD quintile.Findings: No overall association was found between SIMD quintile and prevalence of HCAI in all inpatients. A significant difference was found between HCAI prevalence across SIMD quintile in patients undergoing surgical procedures, with higher prevalence observed with increasing deprivation (P = 0.0071). Variables associated with HCAI prevalence were: intensive care specialty, psychiatric and medical specialties, minimum invasive surgery, and all categories of length of stay.Conclusion: This study found a significant difference in HCAI prevalence across SIMD quintile in patients undergoing surgery. To our knowledge this was the first study to examine the overall association between HCAI and SIMD. The findings highlight the broad and comprehensive nature of social deprivation in determining health outcomes. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Although it is important to screen women who have had gestational diabetes mellitus (GDM) for abnormal post-partum glucose levels, such testing is rarely performed. The aim of this study was to use data from the first observational phase of the IMPACT study to determine rates of screening within 6 months of delivery in a multiethnic cohort, focusing in particular on the effects of social deprivation and the risk of future diabetes. Patients and methods: To investigate the frequency of post-partum screening, charts were analyzed, and all women attending four centres located in a deprived area who had had GDM between January 2009 and December 2010 were contacted by phone. The Evaluation of Precarity and Inequalities in Health Examination Centres (EPICES) deprivation index and Finnish Diabetes Risk Score (FINDRISK) questionnaire were also evaluated. Results: Data were evaluable for 589 of the 719 women contacted (mean age: 33.4±5.2years; mean body mass index: 27.6±5.4kg/m2), and 196 (33.3%) reported having been screened. On multivariate analysis, factors associated with a lack of screening were smoking [odds ratio (OR): 0.42 (0.20–0.90), P <0.05], low consumption of fruit and vegetables [OR: 0.58 (0.39–0.82), P <0.01] and heavier offspring birth weight (P <0.05), although there were no differences in FINDRISK and EPICES scores between screened and unscreened women. Conclusion: One-third of women who had had GDM reported having been screened for dysglycaemia at 6 months post-partum. However, it is expected that the interventional phase of the IMPACT study will increase screening rates, especially in women with the risk factors associated with lower screening rates during this observational phase. [Copyright &y& Elsevier]

Abstract: We describe contemporaneous changes in environmental quality and social deprivation in English local authority districts over four decades, using secondary source GIS modelled data on environmentally intrusive development. The distribution of this development is described with respect to the Townsend material deprivation score, corroborated against the Breadline Britain index. Spatial patterns of environmental intrusion and material deprivation change markedly over the period, although a clear environmental inequality remains throughout. However, it is not the most deprived who experience the greatest decline in their environmental quality, as most of the increase in environmental intrusion occurs in those districts whose population were amongst the most affluent in the early 1960s. We note that the environmental justice implications of these observations are dependent upon conceptions of justice held, and reflect on the challenge of testing, through empirical longitudinal analysis, the notion that environmental sustainability and social justice are incompatible. [Copyright &y& Elsevier]

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Abstract: Objectives: to establish the incidence of obesity in the pregnant population in a large city in the North West of England, identify links between obesity and social deprivation, and compare outcomes of pregnancy in obese and non-obese women. Design: retrospective cohort study using maternal records. Setting: largest maternity hospital in Europe. Participants: 8176 women who gave birth at the study hospital in 2006. Findings: data showed that 17.7% of women were clinically obese. Obesity rates increased with advancing age. The incidence of pre-eclampsia, gestational diabetes, induction of labour, caesarean section and fetal macrosomia was significantly higher amongst the obese population. No relationship was found between obesity and social deprivation. Conclusions: this study ascertained the exact incidence of maternal obesity in the local area and showed the increased risks associated with obesity and pregnancy. Implications for practice: this study supports the need for a shared-care approach to antenatal care and that obese women should give birth in consultant-led units. The support of a named midwife should be available to these women throughout the childbearing experience, and preconception care advocated. [Copyright &y& Elsevier]

Copyright of Zentralblatt fuer Arbeitsmedizin, Arbeitsschutz und Ergonomie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal for Sociology of Education & Socialization / Zeitschrift für Soziologie der Erziehung & Sozialisation is the property of Julius Beltz GmbH & Co. KG Beltz Juventa and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Background: Increasing concerns regarding the health of men – in particular, the rising prevalence of male-related conditions and men''s suggested poor access and uptake of health services – has focused the minds of health practitioners and policy makers on understanding the role of masculinity in shaping men''s health and on promoting greater gender-sensitivity and equality of access to health services. However, taking a gendered approach to health service delivery necessarily requires the development of effective strategies for accessing and engaging different constituencies of men. While a series of new initiatives and pilots to bridge the gap between men and their service needs has been established throughout the UK, as elsewhere in the world, few of these have been formally evaluated. This paper reports on the qualitative findings from one such initiative in the North of England: the Preston Men''s Health Project. Methods: Taking account of age, ethnicity and sexuality, the Preston Men''s Health Project was established as a response to the diverse health needs of men living in socially marginalised areas of inner-city Preston. Using a combination of focus groups, semi-structured and narrative interviews with project staff and service users, this article focuses on men''s health as an embedded social practice and describes how men''s health is mediated by family and community structures. Results and Conclusions: The Preston men''s Health Project demonstrates how the successful deployment of outreach approaches provides a first-contact for men who wish to gain greater control over their health through a dual focus on formal services and informal supports, thus providing a bridge to healthcare-access for groups who traditionally fall outside the reach of orthodox service delivery. [Copyright &y& Elsevier]

Copyright of Revista de Psicología (1669-2438) is the property of Pontificia Universidad Catolica Argentina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Heritage tourism has attracted attention academically and in the industry. We study how preference for heritage tourism is motivated by individuals' need to belong, which varies as a result of differential impacts of the COVID-19 pandemic. In two studies, we measure this natural manipulation of need to belong and study its impact in a quasi-experimental manner. We find that need to belong affects preference for heritage tourism through its effect on nostalgic feeling. Individuals with higher need to belong have higher state nostalgia and prefer heritage tourism that may help satisfy their nostalgic yearning. In addition, we identify the moderating role of trait nostalgia proneness. Individuals who are more nostalgia-prone are more susceptible to this need-to-belong effect. • Need to belong varies with the degree of social isolation resulting from COVID-19. • Increased need to belong enhances preference for heritage tourism. • Nostalgia mediates the effect of need to belong on preference for heritage tourism. • Trait nostalgia proneness moderates the effect of need to belong on nostalgia state. [ABSTRACT FROM AUTHOR]

Autism spectrum disorders (ASD) are well known to be influenced by various environmental factors. Among these influencers, social experiential deprivation (SED) in infancy is one of them which is not well reported. We explored factors contributing to SED in 11 young children diagnosed to have ASD and compared them to 24 children without SED also having ASD. Intervention mainly addressing factors causing SED for 6 months demonstrated that children with SED had a better outcome at follow up. Could SED be a possible prognostic factor in children with ASD? [ABSTRACT FROM AUTHOR]

Purpose Social, mental, and physical health have a complex interrelationship with each influencing individuals' overall health experience. Social circumstances have been shown to influence symptom intensity and magnitude of disability for a variety of medical conditions. We tested the null hypothesis that social deprivation would not impact Patient-Reported Outcomes Measurement Information System (PROMIS) scores or objective health factors in patients presenting for treatment of carpal tunnel syndrome (CTS). Methods This cross-sectional study analyzed data from 367 patients who presented for evaluation of CTS to 1 of 6 hand surgeons at a tertiary academic center between August 1, 2016, and June 30, 2017. Patients completed PROMIS Physical Function—v1.2, Pain Interference—v1.1, Depression—v1.0, and Anxiety—v1.0 Computer Adaptive Tests. The Area Deprivation Index was used to quantify social deprivation. Medical record review determined duration of symptoms, tobacco and opioid use, and the Charlson Comorbidity Index (CCI) for each patient. Sample demographics, PROMIS scores, and objective health measures were compared in groups defined by national quartiles of social deprivation. Results Patients with CTS living in the most deprived quartile had worse mean scores across all 4 PROMIS domains compared with those living in the least deprived quartile. A higher proportion of individuals from the most deprived quartile had a heightened level of anxiety than those in the least deprived quartile (37.3% vs 12.6%). The mean CCI was higher in the most deprived quartile, as was the proportion of individuals using tobacco. There were no differences in opioid use or symptom duration between patients from each deprivation quartile. Conclusions Social deprivation is associated with worse patient-reported health measures in patients with CTS. Compared with those from the least deprived areas, patients from the most deprived areas also have a greater comorbidity burden and higher rates of tobacco use at presentation to a hand surgeon. Type of study/level of evidence Prognostic II. [ABSTRACT FROM AUTHOR]