• Chiara Marinacci1

  1. Ministero della Salute, Dipartimento della programmazione e dell'ordinamento del Servizio sanitario nazionale, Direzione Generale della Programmazione Sanitaria.
Chiara Marinacci -

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Ricerca bibliografica periodo dal 16 novembre 2013 al 31 gennaio 2014

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Stringa: ("socioeconomic factors"[MeSH Terms] OR "social class"[MeSH Terms]) OR "educational status"[MeSH Terms]) OR inequalities[Title/Abstract]) OR inequities[Title/Abstract]) OR socioeconomic[Title/Abstract]) OR socio-economic[Title/Abstract]) OR disparities[Title/Abstract]) AND ("italy"[MeSH Terms] OR "italy"[All Fields]) AND ("2013/11/16"[PDAT] : "2014/01/31"[PDAT])
1. Fraga S(1), Lindert J(2), Barros H(3), Torres-González F(4), Ioannidi-Kapolou E(5), Melchiorre MG(6), Stankunas M(7), Soares JF(8) Elder abuse and socioeconomic inequalities: A multilevel study in 7 European countries. Prev Med. 2014 Jan 15;61C:42-47. doi: 10.1016/j.ypmed.2014.01.008. [Epub ahead of print]
Author information: (1)Institute of Public Health, University of Porto, Porto, Portugal; Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal. Electronic address: (2)Department of Public Health Science, Protestant University of Applied Sciences, Ludwigsburg, Germany. (3)Institute of Public Health, University of Porto, Porto, Portugal; Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal. (4)Centro de Investigación Biomedica en Red de Salud Mental (CIBERSAM), University of Granada, Granada, Spain. (5)Department of Sociology, National School of Public Health, Athens, Greece. (6)Centre of Socio-Economic Research on Ageing, Italian National Institute of Health and Science on Aging, I.N.R.C.A., Ancona, Italy. (7)Department of Health Management, Lithuanian University of Health Sciences, Kaunas, Lithuania. (8)Department of Health Sciences, Section of Public Health Sciences, Mid Sweden University, Sundsvall, Sweden.

Abstract OBJECTIVES: To compare the prevalence of elder abuse using a multilevel approach that takes into account the characteristics of participants as well as socioeconomic indicators at city and country level. METHODS: In 2009, the project on abuse of elderly in Europe (ABUEL) was conducted in seven cities (Stuttgart, Germany; Ancona, Italy; Kaunas, Lithuania, Stockholm, Sweden; Porto, Portugal; Granada, Spain; Athens, Greece) comprising 4467 individuals aged 60-84years. We used a 3-level hierarchical structure of data: 1) characteristics of participants; 2) mean of tertiary education of each city; and 3) country inequality indicator (Gini coefficient). Multilevel logistic regression was used and proportional changes in Intraclass Correlation Coefficient (ICC) were inspected to assert explained variance between models. RESULTS: The prevalence of elder abuse showed large variations across sites. Adding tertiary education to the regression model reduced the country level variance for psychological abuse (ICC=3.4%), with no significant decrease in the explained variance for the other types of abuse. When the Gini coefficient was considered, the highest drop in ICC was observed for financial abuse (from 9.5% to 4.3%). CONCLUSION: There is a societal and community level dimension that adds information to individual variability in explaining country differences in elder abuse, highlighting underlying socioeconomic inequalities leading to such behavior.

2. Béghin L(1), Dauchet L(2), De Vriendt T(3), Cuenca-García M(4), Manios Y(5), Toti E(6), Plada M(7), Widhalm K(8), Repasy J(9), Huybrechts I(3), Kersting M(10), Moreno LA(11), Dallongeville J(12). Influence of parental socio-economic status on diet quality of European adolescents: results from the HELENA study. Br J Nutr. 2013 Dec 13:1-10. [Epub ahead of print]
Author information: (1)CIC-PT-9301-Inserm-CH&U of Lille, CHRU de Lille, F-59037 Lille, France. (2)Service d'épidémiologie régional, CHRU de Lille, F-59037 Lille, France. (3)Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. (4)Department of Medical Physiology, School of Medicine, University of Granada, Granada, Spain. (5)University of Harakopio, Athens, Greece. (6)Instituto Naziolalen di Ricerca per gli Alimenti de la Nutrizione, Roma, Italy. (7)University of Crete School of Medicine, Heraklion, Greece. (8)Department of Pediatrics, Private Medical University Salzburg, Salzburg, Austria. (9)Department of Pediatrics, University of Pecs, Pecs, Hungary. (10)Forschungsinstitut für Kinderernährung, Institut an der Rheinischen Friedrich-Wilhelms-Universität Bonn, Dortmund, Germany. (11)GENUD (Growth, Exercise, Nutrition and Development) Research Group, Escuela Universitaria de Ciencas de la Salud, Universidad de Zaragoza, Zaragoza, Spain. (12)Inserm, U744, Institut Pasteur de Lille, Université Lille Nord de France, Lille, France.

Abstract Diet quality is influenced by socio-economic and geographical factors. The present study sought to assess whether adolescents' diet quality is affected by their parents' socio-economic status and whether the relationship between these factors is similar in northern and southern Europe. Data collected in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study in eight European countries were analysed. Dietary intake data were recorded via repeated 24 h recalls (using specifically developed HELENA Dietary Intake Assessment Tool software) and converted into an adolescent-specific Diet Quality Index (DQI-AM). Socio-economic status was estimated through parental educational level (Par-Educ-Lev) and parental occupation level (Par-Occ-Lev) as reported by the adolescents in a specific questionnaire. The DQI-AM data were then analysed as a function of Par-Educ-Lev and Par-Occ-Lev in northern European countries (Austria, Belgium, France, Germany and Sweden) and southern European countries (Greece, Italy and Spain). We studied a total of 1768 adolescents (age 14•7 (sd 1•3) years; percentage of girls: 52•8 %; 1135 and 633 subjects from northern and southern Europe, respectively). On average, the DQI-AM score was higher in southern Europe than in northern Europe (69•1 (sd 0•1) v. 60•4 (sd 2•8), respectively; P< 0•001; Δ = 12•6 %). The DQI was positively correlated with both paternal and maternal Par-Educ-Lev. However, this association was more pronounced in northern Europe than in southern Europe (P interaction = 0•004 for the mother and 0•06 for the father). The DQI was also positively correlated with Par-Occ-Lev (all P trends < 0•01), but this correlation was independent of the geographical area (P interaction = 0•51 for the mother and 0•50 for the father). In conclusion, Par-Educ-Lev and Par-Occ-Lev are associated with diet quality in adolescents in Europe. However, this association differs between northern Europe and southern Europe.

3. Marinaccio A, Ferrante P, Corfiati M, Di Tecco C, Rondinone BM, Bonafede M, Ronchetti M, Persechino B, Iavicoli S. The relevance of socio-demographic and occupational variables for the assessment of work-related stress risk. BMC Public Health. 2013 Dec 10;13:1157. doi: 10.1186/1471-2458-13-1157.
Author information: Italian Workers' Compensation Authority, Research area, Occupational medicine department, Via di Fontana Candida 1, Rome 00100, Monteporzio Catone, Italy.

Abstract BACKGROUND: Work-related stress is widely recognized as one of the major challenges to occupational health and safety. The correlation between work-related stress risk factors and physical health outcomes is widely acknowledged. This study investigated socio-demographic and occupational variables involved in perceived risk of work-related stress. METHODS: The Italian version of the Health and Safety Executive Management Standards Indicator Tool was used in a large survey to examine the relationship between work-related stress risks and workers' demographic and occupational characteristics. Out of 8,527 questionnaires distributed among workers (from 75 organizations) 6,378 were returned compiled (74.8%); a set of mixed effects models were adopted to test single and combined effects of the variables on work-related stress risk.
RESULTS: Female workers reported lower scores on control and peer support and more negative perceptions of relationships and change at work than male workers, most of them with full-time contracts. Age, job seniority, and educational level appeared positively correlated with control at work, but negatively with job demands. Fixed-term workers had positive perceptions regarding job demands and relationships, but more difficulties about their role at work than permanent workers. A commuting time longer than one hour and shift work appeared to be associated with higher levels of risk factors for work-related stress (except for role), the latter having more negative effects, increasing with age. CONCLUSIONS: The findings suggest that the assessment and management of work-related stress risk should consider specific socio-demographic and occupational risk factors such as gender, age, educational level, job status, shift work, commuting time, job contracts.

4.Valenti M, Masedu F, Mazza M, Tiberti S, Di Giovanni C, Calvarese A, Pirro R, Sconci V. A longitudinal study of quality of life of earthquake survivors in L'Aquila, Italy. BMC Public Health. 2013 Dec 7;13:1143. doi: 10.1186/1471-2458-13-1143.
Author information: Department of Applied Clinical Sciences and Biotechnology, Section of Clinical Epidemiology and Environmental Medicine, University of L'Aquila, Via Vetoio, Coppito 2, 67100 L'Aquila, Italy.

Abstract BACKGROUND: People's well-being after loss resulting from an earthquake is a concern in countries prone to natural disasters. Most studies on post-earthquake subjective quality of life (QOL) have focused on the effects of psychological impairment and post-traumatic stress disorder (PTSD) on the psychological dimension of QOL. However, there is a need for studies focusing on QOL in populations not affected by PTSD or psychological impairment. The aim of this study was to estimate QOL changes over an 18-month period in an adult population sample after the L'Aquila 2009 earthquake. METHODS: The study was designed as a longitudinal survey with four repeated measurements performed at six monthly intervals. The setting was the general population of an urban environment after a disruptive earthquake. Participants included 397 healthy adult subjects. Exclusion criteria were comorbidities such as physical, psychological, psychiatric or neurodegenerative diseases at the beginning of the study. The primary outcome measure was QOL, as assessed by the WHOQOL-BREF instrument. A generalised estimating equation model was run for each WHOQOL-BREF domain. RESULTS: Overall, QOL scores were observed to be significantly higher 18 months after the earthquake in all WHOQOL-BREF domains. The model detected an average increase in the physical QOL scores (from 66.6 ± 5.2 to 69.3 ± 4.7), indicating a better overall physical QOL for men. Psychological domain scores (from 64.9 ± 5.1 to 71.5 ± 6.5) were observed to be worse in men than in women. Levels at the WHOQOL domain for psychological health increased from the second assessment onwards in women, indicating higher resiliency. Men averaged higher scores than women in terms of social relationships and the environmental domain. Regarding the physical, psychological and social domains of QOL, scores in the elderly group (age > 60) were observed to be similar to each other regardless of the significant covariates used. CONCLUSIONS: WHOQOL-BREF scores of the psychological domain displayed trends conditioned by age and education: older subjects experienced less satisfaction with psychological health on average. Less-educated subjects always demonstrated the worst QOL scores. Gender, age and education impacted the variability of QOL in the environmental dimension in the elderly.

Breve commento a cura di Chiara Marinacci
Follow up di 18 mesi su un campione della popolazione maggiorenne residente nelle nuove costruzioni del territorio aquilano, con baseline 7 mesi dopo il terremoto di aprile 2009. Integra i risultati sopra riportati lo specifico andamento temporale nella dimensione psicologica della qualità della vita, con variazioni in relazione all'istruzione dei partecipanti che appaiono evidenti nella fascia d'età 18-60 anni, età in cui mediamente i punteggi registrano i miglioramenti più consistenti durante il follow up: in modo particolare, le persone con istruzione elementare con più di 40 anni evidenziano una scarsa resilienza.

5. Piovani D, Clavenna A, Cartabia M, Bonati M; Interregional Italian Drug Utilisation Group. Antibiotic and anti-asthmatic drug prescriptions in Italy: geographic patterns and socio-economic determinants at the district level. Eur J Clin Pharmacol. 2014 Mar;70(3):331-7. doi: 10.1007/s00228-013-1615-4. Epub 2013 Dec 6.
Author information: Department of Public Health, Laboratory for Mother and Child Health, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Via Giuseppe La Masa 19, 20156, Milan, Italy,

Abstract PURPOSE: To analyse the prevalence rate of antibiotics and anti-asthmatics in children and adolescents at the healthcare district level. METHODS: Data sources were three regional prescription databases. A total of 175 healthcare districts (3.3 million children/adolescents) participated in the study, providing data for the year 2008. Prevalence rate was standardised by age. The ANOVA test was used to compare prevalence rates of districts in the three regions. The standardised prevalence ratio (SPR) was calculated for each district and a map of the index was elaborated. The correlation among latitude, average annual income per inhabitant, hospitalisation rate, number of paediatricians per 1,000 resident children and prevalence rate was evaluated by district (Spearman's test).
RESULTS: The antibiotic prevalence rate was, on average, 47.9 % (34.0 to 67.9 % between districts), while the anti-asthmatic prevalence was 21.4 % (11.7-35.6 %). The prevalence was higher in districts from the southern regions (antibiotics F = 92.1, anti-asthmatics F = 107.5; p < 0.001). There was a significant correlation between the prevalence of antibiotics and anti-asthmatics (rS = 0.77 p < 0.001), and the prevalence of both was inversely related to latitude (respectively rS = -0.71, -0.72; p < 0.001) and average income (rS = -0.77, -0.73; p < 0.001). Children/adolescents living in districts in the lower quintile of average income were more exposed to antibiotic (OR = 1.75; 1.74-1.77) and anti-asthmatic (OR 1.56, 1.55-1.57) prescriptions. CONCLUSIONS: A lower income at the district level is related to higher antibiotic and anti-asthmatic drug prescription rates. Local socio-economic inequities can concur in prescribing distribution and must be considered when planning educational interventions to reduce over-prescription.

6. Grosso G, Marventano S, Buscemi S, Scuderi A, Matalone M, Platania A, Giorgianni G, Rametta S, Nolfo F, Galvano F, Mistretta A. Factors associated with adherence to the mediterranean diet among adolescents living in Sicily, Southern Italy. Nutrients. 2013 Dec 4;5(12):4908-23. doi: 10.3390/nu5124908.
Author information: Department "G.F. Ingrassia", Section of Hygiene and Public Health, University of Catania, Catania 95123, Italy.

Abstract The present study aimed to examine the factors associated with increased Mediterranean diet (MD) adherence among a sample of Italian adolescents. A cross-sectional survey was conducted on 1135 students (13-16 years) attending 13 secondary schools of Sicily, southern Italy. Validated instruments were used for dietary assessment and the KIDMED score to assess adolescents' adherence to the MD. A higher adherence to the MD was associated with high socioeconomic status (Odds Ratio [OR] 1.53, 95% Confidence Interval [CI]: 1.03-2.26) and high physical activity (OR 1.19, 95% CI: 1.02-1.70), whereas lower adherence was associated with living in an urban environment (OR 0.65, 95% CI: 0.44-0.97) and being obese (OR 0.59, 95% CI: 0.37-0.94). The adolescents' KIDMED scores were inversely associated with adolescents' intake of sweets, fast foods, fried foods, and sugary drinks, and directly with fruit, vegetables, pasta, fish, and cheese intakes. Urban-living adolescents were less likely to eat fruit and more prone to consume meat, sugary drinks, and fast food than rural-living adolescents. The latter were more likely to eat sweets and snacks. A general poor quality of food consumption in Italian adolescents away from the MD was reported, especially among those living in urban areas.

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