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Population health segmentation

Ignacio Aznar-Lou, Anton Pottegård, Ana Fernández, María Teresa Peñarrubia-María, Antoni Serrano-Blanco, Ramón Sabés-Figuera, Montserrat Gil-Girbau, Marta Fajó-Pascual, Patricia Moreno-Peral, Maria Rubio-Valera
OBJECTIVE: Copayment policies aim to reduce the burden of medication expenditure but may affect adherence and generate inequities in access to healthcare. The objective was to evaluate the impact of two copayment measures on initial medication non-adherence (IMNA) in several medication groups and by income level. DESIGN: A population-based study was conducted using real-world evidence. SETTING: Primary care in Catalonia (Spain) where two separate copayment measures (fixed copayment and coinsurance) were introduced between 2011 and 2013...
March 15, 2018: BMJ Quality & Safety
Sean C Lucan, Andrew R Maroko, Jason L Seitchik, Don Yoon, Luisa E Sperry, Clyde B Schechter
Local businesses that offer foods may create different 'grazing environments' (characterized by sources of ready-to-consume foods) and 'grocery environments' (characterized by source of foods for later preparation). Such environments may be relevant to different populations at different times and may vary by neighborhood. In neighborhoods within two demographically distinct areas of the Bronx, NY [Area A (higher-poverty, greater minority representation, lesser vehicle ownership) vs. Area B], researchers assessed all storefront businesses for food offerings...
March 14, 2018: Journal of Community Health
Adriano Roberto Tarifa Vicente, Érico Castro-Costa, Josélia de Oliveira Araújo Firmo, Maria Fernanda Lima-Costa, Antônio Ignácio de Loyola Filho
The purpose of the study was to investigate whether religiousness and social support were associated with the use of antidepressants among community-dwelling elders. The research involved 1,606 older adults who make up the cohort of Bambuí Project, a study on ageing and health. The dependent variable was the use of antidepressants in the last 90 days, and the exposures of interest were social support and religiousness. Logistic regression was used to test the associations and to estimate crude and adjusted Odds Ratio and their 95% confidence intervals...
March 2018: Ciência & Saúde Coletiva
Hee-Jung Park, Jun Hyup Lee, Sujin Park, Tae-Il Kim
Purpose: This study utilized a strong quasi-experimental design to test the hypothesis that the implementation of a policy to expand dental care services resulted in an increase in the usage of dental outpatient services. Methods: A total of 45,650,000 subjects with diagnoses of gingivitis or advanced periodontitis who received dental scaling were selected and examined, utilizing National Health Insurance claims data from July 2010 through November 2015. We performed a segmented regression analysis of the interrupted time-series to analyze the time-series trend in dental costs before and after the policy implementation, and assessed immediate changes in dental costs...
February 2018: Journal of Periodontal & Implant Science
Rebecca Burch, Paul Rizzoli, Elizabeth Loder
BACKGROUND AND OBJECTIVES: In this targeted systematic review, we aimed to identify up-to-date prevalence estimates of migraine and severe headache in adults from population-based US government surveys. Our goal was to assess the stability of prevalence estimates over time, and to identify additional information pertinent to the burden and treatment of migraine and other severe headache conditions. METHODS: We searched for the most current publicly available summary statistics from the National Health Interview Survey (NHIS), the National Hospital Ambulatory Medical Care Survey (NHAMCS), and the National Ambulatory Medical Care Survey (NAMCS)...
March 12, 2018: Headache
Isabelle Niedhammer, Allison Milner, Anthony D LaMontagne, Jean-François Chastang
OBJECTIVES: The objectives of the study were to construct a job-exposure matrix (JEM) for psychosocial work factors of the job strain model, to evaluate its validity, and to compare the results over time. METHODS: The study was based on national representative data of the French working population with samples of 46,962 employees (2010 SUMER survey) and 24,486 employees (2003 SUMER survey). Psychosocial work factors included the job strain model factors (Job Content Questionnaire): psychological demands, decision latitude, social support, job strain and iso-strain...
March 8, 2018: International Archives of Occupational and Environmental Health
Alejandra Carrillo Roa
The situation in Venezuela is marked by a profound socioeconomic crisis that raises questions concerning its effects on the health system. The study's aim was to analyze the trends and current situation of the Venezuelan health system, with special emphasis on financing. Based on the World Health Organization's Framework for Action to Strengthen Health Systems, five of the system's six basic components were studied, along with the results in terms of coverage and the population's health. Healthcare financing in Venezuela proved to be primarily private, with a high and growing share of out-of-pocket expenditures, one of the highest in the world...
March 5, 2018: Cadernos de Saúde Pública
Shakeel Ahmad Jadoon, Ashfaq Ahmed, Muhammad Adeel Alam
BACKGROUND: Vitamin D deficiency is becoming a public health problem and involves every segment of the population irrespective of age and gender. This study was conducted to assess its status in patients presenting with generalized body aches and pains.. METHODS: This cross-sectional study was conducted at Ayub Teaching Hospital Abbottabad from March 2015 to October 2016. A sample of 202 patients presenting with generalized body aches and pains were enrolled for the study using convenient sampling technique...
January 2018: Journal of Ayub Medical College, Abbottabad: JAMC
Aaron M Magnuson, Josephine K Fouts, Daniel P Regan, Andrea D Booth, Steve W Dow, Michelle T Foster
Obesity-related adverse health consequences occur predominately in individuals with upper body fat distribution commonly associated with increased central adiposity. Visceral adipose tissue accumulation is described to be the greatest driver of obesity-induced inflammation, however evidence also supports that the intestines fundamentally contribute to the development of obesity-induced metabolic disease. The visceral adipose depot shares the same vasculature and lymph drainage as the small intestine. We hypothesize that the visceral lymph node, which drains adipose tissue and the gastrointestinal tract, is central to the exacerbation of systemic pro-inflammation...
March 1, 2018: Physiology & Behavior
Karen R Siegel, Kai McKeever Bullard, Giuseppina Imperatore, Mohammed K Ali, Ann Albright, Carla I Mercado, Rui Li, Edward W Gregg
OBJECTIVE: We examined the proportion of American adults without type 2 diabetes that engages in lifestyle behaviors known to reduce type 2 diabetes risk. RESEARCH DESIGN AND METHODS: We conducted a cross-sectional analysis of 3,679 nonpregnant, nonlactating individuals aged ≥20 years without diabetes (self-reported diagnosis or glycated hemoglobin ≥6.5% [8 mmol/mol] or fasting plasma glucose ≥126 mg/dL) and who provided 2 days of reliable dietary data in the 2007-2012 National Health and Nutrition Examination Surveys (NHANES)...
March 2, 2018: Diabetes Care
Minyoung Lee, Haeri Baek, Jong Suk Park, Sohee Kim, Chanhee Kyung, Su Jung Baik, Byoung Kwon Lee, Jie-Hyun Kim, Chul Woo Ahn, Kyung Rae Kim, Shinae Kang
Helicobacter pylori is a gastrointestinal pathogen known to be associated with cardiovascular disease (CVD). However, most analyses about the effect of H. pylori infection have been done in patients with a history of CVD but not in healthy subjects. We evaluated the association between H. pylori infection and subclinical atherosclerosis by using cardiac multidetector computed tomography (MDCT) in healthy subjects without previous CVD. From December 2007 to February 2014, 463 subjects who underwent the rapid urease test (CLO test), pulse-wave velocity (PWV) measurement, and MDCT for a self-referred health check-up were enrolled to this study...
2018: PloS One
Luna S Vieira, Ana Paula Gomes, Isabel O Bierhals, Simone Farías-Antúnez, Camila G Ribeiro, Vanessa I A Miranda, Bárbara H Lutz, Thiago G Barbosa-Silva, Natália P Lima, Andréa D Bertoldi, Elaine Tomasi
OBJECTIVE Evaluate the prevalence and the factors associated with the occurrence of falls among older adults. METHODS A cross-sectional study with a representative sample of 1,451 elderly residents in the urban area of Pelotas, RS, in 2014. A descriptive analysis of the data was performed and the prevalence of falls in the last year was presented. The analysis of demographic, socioeconomic, behavioral and health factors associated with the outcome was performed using Poisson regression with adjustment for robust variance according to the hierarchical model...
2018: Revista de Saúde Pública
Koen Bruynseels, Filippo Santoni de Sio, Jeroen van den Hoven
Personalized medicine uses fine grained information on individual persons, to pinpoint deviations from the normal. 'Digital Twins' in engineering provide a conceptual framework to analyze these emerging data-driven health care practices, as well as their conceptual and ethical implications for therapy, preventative care and human enhancement. Digital Twins stand for a specific engineering paradigm, where individual physical artifacts are paired with digital models that dynamically reflects the status of those artifacts...
2018: Frontiers in Genetics
Guang Yang, Xiahai Zhuang, Habib Khan, Shouvik Haldar, Eva Nyktari, Lei Li, Ricardo Wage, Xujiong Ye, Greg Slabaugh, Raad Mohiaddin, Tom Wong, Jennifer Keegan, David Firmin
PURPOSE: Atrial fibrillation (AF) is the most common heart rhythm disorder and causes considerable morbidity and mortality, resulting in a large public health burden that is increasing as the population ages. It is associated with atrial fibrosis, the amount and distribution of which can be used to stratify patients and to guide subsequent electrophysiology ablation treatment. Atrial fibrosis may be assessed non-invasively using late gadolinium-enhanced (LGE) magnetic resonance imaging (MRI) where scar tissue is visualised as a region of signal enhancement...
February 26, 2018: Medical Physics
John P A Ioannidis, Muin J Khoury
Genomic and other related big data (Big Genomic Data, BGD for short) are ushering a new era of precision medicine. This overview discusses whether principles of evidence-based medicine (EBM) hold true for BGD and how they should be operationalized in the current era. Major EBM principles include the systematic identification, description and analysis of the validity and utility of BGD, the combination of individual clinical expertise with individual patient needs and preferences, and the focus on obtaining experimental evidence, whenever possible...
February 20, 2018: Human Molecular Genetics
Yubraj Acharya
There is now a critical threshold of evidence documenting the relationship between one's exposure to shocks in early life and outcomes in adulthood. Using Nepal's vitamin A supplementation program, this study provides additional insights on the mechanisms and differences in effects by the timing of the first exposure and across different groups. The program's sequential rollout between 1993 and 2001 and the age eligibility provide an exogenous variation in exposure to the program. I utilize that variation and data on more than 700,000 individuals from the 2011 census to estimate the program's causal effect on long-term health and educational outcomes...
February 5, 2018: Social Science & Medicine
Jeffrey B Blumberg, Regan L Bailey, Howard D Sesso, Cornelia M Ulrich
Micronutrient deficiencies occur in segments of the adult population in the United States. Multivitamin/multimineral supplements (MVMS) are widely used by this population, which reduces inadequacies in micronutrient intake, but the potential for exceeding tolerable upper intake levels in others should be considered. There are concerns associated with the excessive intake of certain nutrients, particularly folic acid, and potential untoward consequences. The advent of nutrigenomics and the enhanced ability to directly study the interactions between nutrition and genetic variants and expression will allow for the conduct of more targeted studies with specific endpoints and may ultimately lead to progress in the field of personalized nutrition...
February 22, 2018: Nutrients
Patrizia Calella, Giuliana Valerio, Matt Thomas, Helen McCabe, Jake Taylor, Malcolm Brodlie, Mario Siervo
OBJECTIVES: Body mass index (BMI) has significant limitations when assessing nutritional status in pediatric patients with cystic fibrosis (CF). We evaluated whether measurements of lean body mass (LBM) and fat mass (FM) are more sensitive nutritional parameters by testing their association with pulmonary function in adolescent patients with CF. METHODS: Sixty-nine male and female adolescents with CF were studied (age: 14.5 ± 2.3, BMI: 19.5 ± 2.3 kg/m2 )...
December 5, 2017: Nutrition
Emil Nicolae Coman, Helen Zhao Wu
Exposure to adverse environmental and social conditions affects physical and mental health through complex mechanisms. Different racial/ethnic (R/E) groups may be more or less vulnerable to the same conditions, and the resilience mechanisms that can protect them likely operate differently in each population. We investigate how adverse neighborhood conditions (neighborhood disorder, NDis) differentially impact mental health (anxiety, Anx) in a sample of white and Black (African American) young women from Southeast Texas, USA...
February 20, 2018: Healthcare (Basel, Switzerland)
Mauro Tettamanti, Gabriella Marcon
PURPOSE: Centenarians, a segment of the population which some 50 years ago comprised only a few individuals, now count thousands in many countries, and demographic projections forecast that this growth will continue. The study of this new population will give us new information on extreme longevity and help prepare for their health and social needs. The aim of the Centenari a Trieste study is to describe the health and health service use by centenarians, with specific focus on cognitive status...
February 8, 2018: BMJ Open
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