Regional mortality by socioeconomic factors in Slovakia: a comparison of 15 years of changes.

BACKGROUND: Like most Central European countries Slovakia has experienced a period of socioeconomic changes and at the same time a decline in the mortality rate. Therefore, the aim is to study socioeconomic factors that changed over time and simultaneously contributed to regional differences in mortality. METHODS: The associations between selected socioeconomic indicators and the standardised mortality rate in the population aged 20-64 years in the districts of the Slovak Republic in the periods 1997-1998 and 2012-2013 were analysed using linear regression models. RESULTS: A higher proportion of inhabitants in material need, and among males also lower income, significantly contributed to higher standardised mortality in both periods. The unemployment rate did not contribute to this prediction. Between the two periods no significant changes in regional mortality differences by the selected socioeconomic factors were found. CONCLUSIONS: Despite the fact that economic growth combined with investments of European structural funds contributed to the improvement of the socioeconomic situation in many districts of Slovakia, there are still districts which remain "poor" and which maintain regional mortality differences.

How parents can affect excessive spending of time on screen-based activities.

BACKGROUND: The aim of this study is to explore the association between family-related factors and excessive time spent on screen-based activities among school-aged children. METHODS: A cross-sectional survey using the methodology of the Health Behaviour in School-aged Children study was performed in 2013, with data collected from Slovak (n = 258) and Czech (n = 406) 11- and 15-year-old children. The effects of age, gender, availability of a TV or computer in the bedroom, parental rules on time spent watching TV or working on a computer, parental rules on the content of TV programmes and computer work and watching TV together with parents on excessive time spent with screen-based activities were explored using logistic regression models. RESULTS: Two-thirds of respondents watch TV or play computer games at least two hours a day. Older children have a 1.80-times higher chance of excessive TV watching (CI: 1.30-2.51) and a 3.91-times higher chance of excessive computer use (CI: 2.82-5.43) in comparison with younger children. More than half of children have a TV (53%) and a computer (73%) available in their bedroom, which increases the chance of excessive TV watching by 1.59 times (CI: 1.17-2.16) and of computer use by 2.25 times (CI: 1.59-3.20). More than half of parents rarely or never apply rules on the length of TV watching (64%) or time spent on computer work (56%), and their children have a 1.76-times higher chance of excessive TV watching (CI: 1.26-2.46) and a 1.50-times greater chance of excessive computer use (CI: 1.07-2.08). A quarter of children reported that they are used to watching TV together with their parents every day, and these have a 1.84-times higher chance of excessive TV watching (1.25-2.70). CONCLUSIONS: Reducing time spent watching TV by applying parental rules or a parental role model might help prevent excessive time spent on screen-based activities.

Majority of cerebrospinal fluid-contacting neurons in the spinal cord of C57Bl/6N mice is present in ectopic position unlike in other studied experimental mice strains and mammalian species.

Cerebrospinal fluid contacting neurons (CSF-cNs) represent a specific class of neurons located in close vicinity of brain ventricles and central canal. In contrast with knowledge gained from other vertebrate species, we found that vast majority of CSF-cNs in the spinal cord of C57Bl/6N mice is located in ectopic distal ventral position. However, we found that small number of ectopic CSF-cNs is present also in spinal cord of other investigated experimental mice strains (C57Bl/6J, Balb/C) and mammalian species (Wistar rats, New Zealand White rabbits). Similarly, as the proximal populations, ectopic CSF-cNs retain PKD2L1-immunoreactivity and synaptic contacts with other neurons. On the other side, they show rather multipolar morphology lacking thick dendrite contacting central canal lumen. Ectopic CSF-cNs in the spinal cord of C57Bl/6N mice emerge during whole period devoted to production of CSF-cNs and reach their ventral destinations during first postnatal weeks. In order to identify major gene, whose impairment could trigger translocation of CSF-cNs outside the central canal area, we took advantage of close consanguinity of C57Bl/6J substrain with normal CSF-cN distribution and C57Bl/6N substrain with majority of CSF-cNs in ectopic position. Employing in silico analyses, we ranked polymorphisms in C57Bl/6N substrain and selected genes Crb1, Cyfip2, Adamts12, Plk1, and Herpud2 as the most probable candidates, whose product dysfunction might be responsible for the ectopic distribution of CSF-cNs. Furthermore, segregation analysis of F2 progeny of parental C57Bl/6N and Balb/C mice revealed that polymorphic loci of Crb1 and Cyfip2 underlie the ectopic position of CSF-cNs in the spinal cord of C57Bl/6N mice.

Relationship between the MDS-UPDRS and Quality of Life: A large multicenter study of 3206 patients.

BACKGROUND: The relationship between Health-Related Quality of Life (HRQoL) and MDS-UPDRS has not been fully studied so far. The aim of this study was to evaluate the relationship between all MDS-UPDRS components and HRQoL in a representative international cohort of PD patients. METHODS: We collected demographic and disease-related data as well as MDS-UPDRS and PDQ8 scales. Data were analyzed using correlations between PDQ8 and all MDS-UPDRS items, subsequently two hierarchical multiple regressions were performed, first between the scores of the MDS-UPDRS Parts and PDQ8 and second between individual items from those Parts demonstrating significant relationship to PDQ8 scores in the first regression. LASSO regression analyses were performed to evaluate the relationship between PDQ8 and all individual MDS-UPDRS items. RESULTS: A total of 3206 PD patients were included in the study. In the first regression analysis, PDQ8 was significantly related to MDS-UPDRS parts I and II, but not to III and IV. In the second regression model, significant contributions to PDQ8 were found for Part I items Fatigue, Pain, Depressed mood, Apathy; and Part II items Dressing, Doing hobbies, Freezing, Speech and Tremor. In the LASSO analysis, six Part I, seven Part II, three Part III and one Part IV items contributed to PDQ8 scores. The five items most significantly related to the model were Depressed mood, Dressing, Apathy, Pain and Fatigue. CONCLUSIONS: This is so far the largest study related to HRQoL issues in PD. Restrictions in activities of daily living and non-motor symptoms significantly contribute to HRQoL in PD.

Predictors of perceived health status in patients after kidney transplantation.

BACKGROUND: Patients after kidney transplantation have decreased mortality, morbidity and better quality of life compared to people on dialysis. Major efforts are being directed towards research into graft and patient survival. Research into quality of life is less intensive. The aim of this study was to explore the predictors of perceived health status (PHS) in kidney transplant recipients. METHODS: Out of 218 patients after kidney transplantation 138 participated in the study. Linear regression analysis was performed to predict PHS, measured with the SF-36 questionnaire, in three age categories (<40, 40-59, >or=60 years). Independent variables included social support (measured with the Social Support List Discrepancies questionnaire), sociodemographic and medical variables, side effects and compliance. RESULTS: Predictors of better PHS in patients<40 years were better social support (P

Socio-economic differences in health among Slovak adolescents.

OBJECTIVES: To explore socio-economic health differences among Slovak adolescents. METHODS: Socio-economic differences in health (psychological health: GHQ-12, vitality and mental health scale of RAND, experienced health complaints, chronic illness, use of medicines, self-reported health, self-perceived vulnerability to illness) were explored among Slovak adolescents (n = 2,616, 1,370 boys, 1,246 girls; mean age 15 years). RESULTS: Adolescents from lower socio-economic groups (parents' occupation, parents' education, type of school) experienced more health complaints; less frequently experienced their health as excellent or very good, more frequently reported to fall ill easier and less frequently use non-prescribed drugs in comparison with adolescents from higher socio-economic groups. Moreover, adolescents from lower occupational group of parents and lower type of school score significantly lower in mental health and in vitality and used prescribed drugs more frequently. We did not confirm any socio-economic differences in psychological health or prevalence of chronic illness. Our findings confirmed poorer health of girls in comparison to boys. There are no gender differences with regard to socio-economic differences in health. CONCLUSION: There are significant socio-economic health differences among Slovak adolescents.

Is the cardiovascular risk profile of people living in Roma settlements worse in comparison with the majority population in Slovakia?

OBJECTIVES: Roma constitute a large minority in several Central European countries, with a mostly disadvantaged societal and health position. The aim of this study was to assess biological and other cardiovascular diseases (CVD) risk factors in people living in Roma settlements and to compare them with non-Roma. METHODS: We used data from the cross-sectional Hepa-Meta study conducted in Slovakia. The sample consisted of 452 Roma (mean age = 34.7, 35.2 % men) and 403 non-Roma (mean age = 33.5, 45.9 % men). The effect of ethnicity was analysed using logistic regression adjusted for age and stratified by gender. RESULTS: Roma were more likely to have obesity, low HDL cholesterol, normal total cholesterol, and to smoke than non-Roma. Moreover, Roma women were more likely to have abdominal obesity and Roma men to have normal LDL cholesterol than non-Roma. No significant differences by ethnicity were found regarding hypertriglyceridaemia, hyperglycaemia and hypertension. CONCLUSIONS: Our study confirmed higher rates of some CVD risk factors in Roma compared with non-Roma. Our findings call for interventions aiming at decreasing CVD risks and improving health literacy among Roma, to reduce CVD morbidity and premature mortality.

Does social support mediate or moderate socioeconomic differences in self-rated health among adolescents?

OBJECTIVE: Social support is assumed to be a protective social determinant of health. The aim of this cross-sectional study was to explore whether social support from the father, mother and friends mediates or moderates the association between socioeconomic position and self-rated health among adolescents. METHODS: The sample consisted of 1,863 secondary school students from the Kosice region in Slovakia (mean age 16.85; 53.3% females, response rate 98.9%). We assessed the mediation and moderation effects of social support from the mother, father and friends on the relation between socioeconomic position and self-rated health, performing binary logistic regression models. Socioeconomic position was measured by parents' education, the family affluence scale and financial strain. RESULTS: Social support from the father mediated the association between family affluence and self-rated health among both males and females and the association between financial strain and self-rated health among males only. No moderating effect of social support on socioeconomic differences in self-rated health was found. CONCLUSION: Father involvement seems to have the potential to mediate socioeconomic differences in health during adolescence.

Socioeconomic indicators and ethnicity as determinants of regional mortality rates in Slovakia.

OBJECTIVES: Regional differences in mortality might reflect socioeconomic and ethnic differences between regions. The present study examines the relationship between education, unemployment, income, Roma population and regional mortality in the Slovak Republic. METHODS: Separately for males and females, data on standardised mortality in the Slovak population aged 20-64 years in the year 2002 were calculated for each of the 79 districts. Similarly the proportions of respondents with tertiary education, unemployed status, Roma ethnicity and income data were calculated per district. A linear regression model was used to analyse the data. RESULTS: Socioeconomic differences in regional mortality were found among males, but not among females. While education and unemployment rate significantly contributed to mortality differences between regions, income and the proportion of Roma population did not. The model explained 32.9% of the variance in standardised mortality rate among districts for males and 7.6% for females. CONCLUSION: Low education and high unemployment rate seems to be an indicator of regions with high mortality of male and therefore should be targeted by policy measures aimed at decreasing mortality in productive age.