Seasonal and pandemic influenza: the role of communication and preventive strategies

Appropriate, timely, and data-driven health information is a very important issue in preventive strategies against influenza. Intui- tively, a link between willingness to be vaccinated against seasonal influenza and against pandemic influenza exists, given the similarities in decision-making for this vaccine. International and national literature reviews suggest that progress has been made in order to incorporate and disseminate crisis risk communication principles into public health practice, as such investments in public health could be important for building capacity and practice which aid in the realization of countermeasures in response to a future pandemic and epidemic situation. This study emphasizes the lack of perception by Health Care Workers (HCWs) of the importance of being immunized against seasonal and pandemic influenza and the doubts concerning safety. In the future, particular efforts are needed during vaccination campaigns, to provide more information to HCWs and the general population regarding role and safety of such vaccines

Guidelines for autopsy investigation of sudden cardiac death: 2017 update from the Association for European Cardiovascular Pathology.

Although sudden cardiac death (SCD) is one of the most important modes of death in Western countries, pathologists and public health physicians have not given this problem the attention it deserves. New methods of preventing potentially fatal arrhythmias have been developed and the accurate diagnosis of the causes of SCD is now of particular importance. Pathologists are responsible for determining the precise cause and mechanism of sudden death but there is still considerable variation in the way in which they approach this increasingly complex task. The Association for European Cardiovascular Pathology has developed these guidelines, which represent the minimum standard that is required in the routine autopsy practice for the adequate investigation of SCD. The present version is an update of our original article, published 10 years ago. This is necessary because of our increased understanding of the genetics of cardiovascular diseases, the availability of new diagnostic methods, and the experience we have gained from the routine use of the original guidelines. The updated guidelines include a detailed protocol for the examination of the heart and recommendations for the selection of histological blocks and appropriate material for toxicology, microbiology, biochemistry, and molecular investigation. Our recommendations apply to university medical centers, regionals hospitals, and all healthcare professionals practicing pathology and forensic medicine. We believe that their adoption throughout Europe will improve the standards of autopsy practice, allow meaningful comparisons between different communities and regions, and permit the identification of emerging patterns of diseases causing SCD. Finally, we recommend the development of regional multidisciplinary networks of cardiologists, geneticists, and pathologists. Their role will be to facilitate the identification of index cases with a genetic basis, to screen appropriate family members, and ensure that appropriate preventive strategies are implemented

Mortality by country of birth in the Nordic countries – a systematic review of the literature

Abstract Background Immigration to the Nordic countries has increased in the last decades and foreign-born inhabitants now constitute a considerable part of the region’s population. Several studies suggest poorer self-reported health among foreign-born compared to natives, while results on mortality and life expectancy are inconclusive. To date, few studies have summarized knowledge on mortality differentials by country of birth. This article aims to systematically review previous results on all-cause and cause-specific mortality by country of birth in the Nordic countries. Methods The methodology was conducted and documented systematically and transparently using a narrative approach. We identified 43 relevant studies out of 6059 potentially relevant studies in August 2016, 35 of which used Swedish data, 8 Danish and 1 Norwegian. Results Our findings from fully-adjusted models on Swedish data support claims of excess mortality risks in specific categories of foreign-born. Most notably, immigrants from other Nordic countries, especially Finland, experience increased risk of mortality from all causes, and specifically by suicide, breast and gynaecological cancers, and circulatory diseases. Increased risks in people from Central and Eastern Europe can also be found. On the contrary, decreased risks for people with Southern European and Middle Eastern origins are found for all-cause, suicide, and breast and gynaecological cancer mortality. The few Danish studies are more difficult to compare, with conflicting results arising in the analysis. Finally, results from the one Norwegian study suggest significantly decreased mortality risks among foreign-born, to be explored in further research. Conclusions With new studies being published on mortality differentials between native and foreign-born populations in the Nordic countries, specific risk patterns have begun to arise. Regardless, data from most Nordic countries remains limited, as does the information on specific causes of death. The literature should be expanded in upcoming years to capture associations between country of birth and mortality more clearly

Mutations with pathogenic potential in proteins located in or at the composite junctions of the intercalated disk connecting mammalian cardiomyocytes: a reference thesaurus for arrhythmogenic cardiomyopathies and for Naxos and Carvajal diseases

In the past decade, an avalanche of findings and reports has correlated arrhythmogenic ventricular cardiomyopathies (ARVC) and Naxos and Carvajal diseases with certain mutations in protein constituents of the special junctions connecting the polar regions (intercalated disks) of mature mammalian cardiomyocytes. These molecules, apparently together with some specific cytoskeletal proteins, are components of (or interact with) composite junctions. Composite junctions contain the amalgamated fusion products of the molecules that, in other cell types and tissues, occur in distinct separate junctions, i.e. desmosomes and adherens junctions. As the pertinent literature is still in an expanding phase and is obviously becoming important for various groups of researchers in basic cell and molecular biology, developmental biology, histology, physiology, cardiology, pathology and genetics, the relevant references so far recognized have been collected and are presented here in the following order: desmocollin-2 (Dsc2, DSC2), desmoglein-2 (Dsg2, DSG2), desmoplakin (DP, DSP), plakoglobin (PG, JUP), plakophilin-2 (Pkp2, PKP2) and some non-desmosomal proteins such as transmembrane protein 43 (TMEM43), ryanodine receptor 2 (RYR2), desmin, lamins A and C, striatin, titin and transforming growth factor-β3 (TGFβ3), followed by a collection of animal models and of reviews, commentaries, collections and comparative studies

Pathways to labour market marginalisation : aspects of common mental disorders, migration status and age [Elektronisk resurs]

Background: Labour market marginalisation (LMM), measured as sickness absence (SA)/disability pension (DP) or unemployment, differs between young immigrants and natives in several countries. The aim of this project was to investigate the risk of LMM among immigrants, second generation immigrants, and refugees and if the risk differed with region/country of birth, age, generation, refugee status and before and after a diagnosis of common mental disorder (CMD). A second aim was to assess psychiatric healthcare utilization before and after DP due to CMD among immigrants and natives, and if it differed before and after changes in social insurance regulations in Sweden in 2008. Methods: Four studies were conducted, all based on Swedish nationwide register data. Study I. a cohort study of all 3 507 055 individuals living in Sweden in 2004 (19-50 years), with a 6-year follow-up. Hazard ratios (HR) and 95% confidence intervals (CI) for DP were estimated by Cox regression for first and second generation immigrants compared to natives, across regions of birth and stratified by age. Study II. individuals with incident DP due to CMD (n=28 354), before or after the introduction of stricter social insurance rules, were included. Patterns of psychiatric in- and specialised outpatient healthcare utilization during a 7-year window before and after being granted DP were assessed by Generalized Estimating Equations. Study III. A total of 28,971 individuals (19-30 years) with an incident CMD in 2007 were included. Groupbased trajectory models were utilised to identify trajectories of annual months of LMM three years before and six years after the diagnosis. Study IV. A prospective cohort study including individuals (19-30 years) with CMDs during 2009 (N=69,515). Cox regression was used to calculate HR for future LMM (2010-2013). Results: In the first generation immigrants compared to natives, HRs for DP were higher (range: 1.17 to 1.74). Also in the second generation immigrants, HRs were higher (range: 1.10 to 1.30) (study I). Prevalence rates of psychiatric inpatient healthcare were comparable among immigrants and natives, lower though in non-Western immigrants. Three years after granted DP, non-Western immigrants in comparison to natives and Western immigrants had a stronger decrease in inpatient psychiatric healthcare. After 2008, a strong reduction in outpatient psychiatric healthcare after granted DP was observed, similarly in immigrants and natives (study II). Young natives and immigrants showed similar trajectories of SA/DP in individuals with CMDs. A higher proportion of non-Western immigrants (21%) followed trajectories of high levels of unemployment compared to Western immigrants (15%) and natives (17%). Educational level and duration of residence in Sweden discriminated trajectories of both SA/DP and unemployment (study III). Regarding subsequent unemployment, both refugees and nonrefugee immigrants with CMDs had a higher risk compared to natives. Regarding subsequent SA, refugees from Africa and Asia showed a lower risk compared to natives (study IV). Conclusions: Immigrants differed in comparison to natives in LMM in terms of a higher level of DP in both generations, in lower levels of inpatient psychiatric healthcare after DP granting, particularly among non-Western immigrants, in higher unemployment trajectories after a CMD and in higher unemployment risk and lower SA risk, particularly among refugees. Educational level, psychiatric comorbidity and duration of residence are relevant factors in discriminating differences in LMM trajectories among immigrants and natives

The project “D.E.A.Th. by Eros to Thanatos AIDS and Sexually Transmitted Diseases”. A multimedia exhibition as a means of prevention of sexually transmitted infections

<p><strong>Background</strong>: An educational intervention on Sexually Transmitted Diseases (STDs) accompanied by a multimedia exhibition was proposed in order to verify the effectiveness of an exhibition as a tool for prevention, to increase awareness in youth and to evaluate whether it yielded changes in the sexual behaviour of its’ visitors. The Target population were high schools and university students.</p><p><strong>Methods</strong>: The Exhibition consisted of a historical overview and four other sections: biological and clinical aspects, epidemiology, prevention and a section called the Red Zone with clear and explicit images relating to STDs. The exhibition was supported by three observational studies carried out on about2000 students of two High Schools and the university in the city of Cassino, Italy. Data collection took place through three different types of “ad hoc” questionnaires. The Statistical analysis carried out was that typical of cross-sectional surveys. We utilized the statistical program Epi-Info 3.5.</p><p><strong>Results</strong>: Regarding survey 1, 48% of 529 students taking part said that the exhibition had contributed “enough” for them to acquire new knowledge, 75.2% had already had sexual intercourse and 37.7% of them did not change their sexual habits. Relative to survey 2, 583 responded to the pre test and 403 posttests returned. Regarding knowledge, data obtained from processing of pre-tests showed how 63.9% of the sample did not know how many STDs existed, whilst this value dropped in post test answers to 49.2% . AIDS was the best known disease (96%) whilst other STDs were little known. The educational intervention partly increased these percentages. With regard to sexual practices although 43% of the sample claimed to have already had sexual intercourse (66% male and 34% female). The family doctor is seen by a high percentage of young people (70% - 68.6%) as the first figure which should address an individual affected by a sexually contracted disease. Only 46% (pre and post tests) recognized at risk groups such as “drug addicts”, homosexuals and heterosexuals. Eight hundred university students participated in Survey 3. The sample had good knowledge about HIV transmission and the AIDS disease and 93% of respondents knew how to avoid infection. They identified drug users and homosexuals as the most prone to infection to HIV, while awareness of infection risk among heterosexuals was less marked. Despite its importance, awareness of condom use was worrying as only 44.2% reported to always one.</p><p><strong>Conclusions</strong>: The exhibition can be considered as an effective prevention tool for new knowledge acquisition but not for the modification of behaviours already present. Even in this study, it looks like the long-term effects, in populations who have had health education interventions with the models of behavioural change, are not sufficiently protective . Therefore, it is necessary to intensify efforts to broadly apply the most effective models of self empowerment in order to change risk behaviours.</p&gt