Due to the enormous migration as the result of war and disasters during the last decades, health systems in Europe are faced with various cultural traditions and both healthcare systems and healthcare professionals are challenged by human rights and values. In order to minimize difficulties in providing healthcare services to patients with different cultural backgrounds, cultural competence healthcare professionals are needed.
Four focus group interviews, were conducted with Kurdish immigrants in Scandinavian countries (N=26). The majority were males (n=18) aged between 33-61 years (M= 51.6 years) and a few were (n=8) females aged 41-63 years (M=50.7 years). The data were analyzed by using qualitative content analysis method.
According to the study results participants experienced that diversities both in culture and healthcare routines create a number of difficulties regarding contact with healthcare services. Though culture related aspects influenced the process of all contact with health care services, the obstacles were more obvious in the case of psychological issues. The results of the study showed that cultural diversities were an obvious reason for immigrants' attitudes regarding healthcare services in resettlement countries.
The results of the study revealed a number of difficulties beyond linguistic problems regarding immigrants' contact with healthcare services in Scandinavian countries. Problems were rooted both in diversities in healthcare services and cultural aspects. Immigrants' views of healthcare systems and healthcare professionals' approach in providing healthcare were some of the problems mentioned.
Cites: Workplace Health Saf. 2015 Dec;63(12):532-8 PMID 26199294
Cites: Br J Community Nurs. 2014 Feb;19(2):91-3 PMID 24514110
Height is regarded as a marker of early-life illness, adversity, nutrition and psychosocial stress, but the extent to which differences in height are determined by early-life socioeconomic circumstances, particularly in contemporary populations, is unclear. This study examined socioeconomic differences in children's height trajectories from birth through to 21 years of age in four European countries.
Data were from six prospective cohort studies-Generation XXI, Growing Up in Ireland (infant and child cohorts), Millennium Cohort Study, EPITeen and Cardiovascular Risk in Young Finns Study-comprising a total of 49?492 children with growth measured repeatedly from 1980 to 2014. We modelled differences in children's growth trajectories over time by maternal educational level using hierarchical models with fixed and random components for each cohort study.
Across most cohorts at practically all ages, children from lower educated mothers were shorter on average. The gradient in height was consistently observed at 3 years of age with the difference in expected height between maternal education groups ranging between -0.55 and -1.53?cm for boys and -0.42 to -1.50?cm for girls across the different studies and widening across childhood. The height deficit persists into adolescence and early adulthood. By age 21, boys from primary educated maternal backgrounds lag the tertiary educated by -0.67?cm (Portugal) and -2.15?cm (Finland). The comparable figures for girls were -2.49?cm (Portugal) and -2.93?cm (Finland).
Significant differences in children's height by maternal education persist in modern child populations in Europe.
Previous studies of infliximab in psoriasis have demonstrated rapid improvement with induction therapy and sustained response with regularly administered maintenance therapy.
The efficacy and safety of continuous (every-8-week) and intermittent (as-needed) maintenance regimens were compared.
Patients with moderate-to-severe psoriasis (n = 835) were randomized to induction therapy (weeks 0, 2, and 6) with infliximab 3 mg/kg or 5 mg/kg or placebo. Infliximab-treated patients were randomized again at week 14 to continuous or intermittent maintenance regimens at their induction dose.
At week 10, 75.5% and 70.3% of patients in the infliximab 5 mg/kg and 3 mg/kg groups, respectively, achieved PASI 75; 45.2% and 37.1% achieved PASI 90 (vs 1.9% [PASI 75] and 0.5% [PASI 90] for placebo; P 1 year) maintenance therapy and further study of infliximab serum concentrations over this period, in both PASI 75 responders and non-responders, would be preferable.
Through week 50, response was best maintained with continuous infliximab therapy. Infliximab was generally well-tolerated in most patients.
Disease-specific measures of quality of life (QoL) for children with haemophilia are now available for use in clinical studies [Haemophilia, 10, 2004, 9-16]. One of these measures, the Canadian Haemophilia Outcomes - Kids' Life Assessment Tool (CHO-KLAT), was developed in Canada with emphasis on the perspectives of children [Pediatr Blood Cancer, 47, 2006, 305-11; Haemophilia, 10, 2004, 34-43]. Another, the Haemo-QoL, was developed in Europe, with emphasis on the perspectives of clinicians [Haemophilia, 8, 2002, 47-54; Haemophilia, 10, 2004, 17-25]. While these two measures are unique and independent, researchers from both studies were collaboratively linked throughout development and testing. This study presents the results of a joint assessment of the two measures with respect to their strengths, limitations and unique contributions. The primary questions addressed were: 1 What is the relationship between the CHO-KLAT and the Haemo-QoL in terms of summary scores and item content? 2 What are the methodological strengths, limitations and unique contributions of each measure? We conducted a retrospective analysis of data from field testing of both measures. The analysis included a comparative assessment of the basic validity, reliability and items used in each measure. Overall, the CHO-KLAT and the Haemo-QoL are promising and valuable measures of QoL for children with haemophilia. Our analyses confirmed the basic psychometric properties of both tools, but identified some discrepancies between them. Additional data will allow for greater understanding of these discrepancies and lend clarity to how the tools should be used in clinical studies (separately or merged). The present recommendation is that the measures be run independently, but preferably concurrently in studies of children with haemophilia.
Disparities in health status between American Indians and other groups in the United States have persisted throughout the 500 years since Europeans arrived in the Americas. Colonists, traders, missionaries, soldiers, physicians, and government officials have struggled to explain these disparities, invoking a wide range of possible causes. American Indians joined these debates, often suggesting different explanations. Europeans and Americans also struggled to respond to the disparities, sometimes working to relieve them, sometimes taking advantage of the ill health of American Indians. Economic and political interests have always affected both explanations of health disparities and responses to them, influencing which explanations were emphasized and which interventions were pursued. Tensions also appear in ongoing debates about the contributions of genetic and socioeconomic forces to the pervasive health disparities. Understanding how these economic and political forces have operated historically can explain both the persistence of the health disparities and the controversies that surround them.
Evidence-based policies have become increasingly accepted in clinical practice. However, policies on many of the non-clinical activities that take place in health care facilities may be less frequently evidence based.
We carried out a review of literature on safety of mobile phones in hospitals and survey of practice in selected European countries.
When first evidence on the dangers of electronic interference associated with mobile phones appeared in the 1990s, hospitals in many countries introduced complete bans on mobile phones. Yet a review of recent evidence suggests that there is no significant risk from using mobile phones in hospitals as long as they are more than a metre away from sensitive equipment, whereas the risk to the most modern equipment is even less. With the technological evolution of mobile phones, the residual risk of interference appears to be minimal and controllable. Although some countries are reluctant to relax regulation, others now limit bans to areas in which sensitive equipment is used and some discourage the use of mobile phones on the grounds of noise exposure.
With new technology on the doorstep, the potential benefits and risks associated with mobile phones should be examined explicitly in the light of the evidence.
We investigated the response times of eight volatile methylsiloxanes (VMSs) in environmental systems at different scales from local to global, with a particular focus on overall loss rates after cessation of emissions. In part, this is driven by proposals to restrict the use of some of these compounds in certain products in Europe. The GloboPOP model estimated low absolute Arctic Contamination Potentials for all VMSs and rapid response times in all media except sediment. VMSs are predicted to be distributed predominantly in air where they react with OH radicals, leading to short response times. After cessation of emissions VMSs concentrations in the environment are expected to decrease rapidly from current levels. Response times in specific water and sediment systems were evaluated using a dynamic QWASI model. Response times were sensitive to both physico-chemical properties and environmental characteristics. Degradation was predicted to play the most important role in determining response times in water and sediment. In the case of the lowest molecular weight VMSs such as L2 and D3, response times were essentially independent of environmental characteristics due to fast hydrolysis in water and sediment. However, response times for the other VMSs are system-specific. They are relatively short in shallow water bodies but increase with depth due to the diminishing role of volatilization on concentration change as volume to surface area ratio increases. In sediment, degradation and resuspension rates also contribute most to the response times. The estimated response times for local environments are useful for planning future monitoring programs.