Multigenerational inequalities of opportunity in health outcomes.

This paper studies multigenerational health transmission mechanisms in Australian panel data. Using inequality-of-opportunity (IOP) models, we demonstrate that grandparental socioeconomic status (SES) is an important determinant of personal health, even after controlling for health and SES at the parental level. Our findings hold over a range of health/biomarkers of individuals' physical and mental well-being and appear to be especially sensitive to educational outcomes on the father's side. Since ingrained socioeconomic (dis)advantages that persist over multiple generations may be indicative of social class, our results suggest that subtle attitudinal and behavioural characteristics associated with this variable may be a key factor driving health disparities.

The Medical Outcome Study Social Support Survey (MOS-SSS): A psychometric systematic review.

AIMS: To evaluate and synthesize psychometric properties of the MOS-SSS and to identify quality versions of MOS-SSS for use in future research and practice. DESIGN: A psychometric systematic review. DATA SOURCES: Articles about the translation, adaptation, or validation of the MOS-SSS in Medline, PubMed, CINAHL, and Web of Science and their reference lists published before 11 November 2022. REVIEW METHODS: The review followed the Consensus Standards for the Selection of Health Measurement Instruments guidelines. RESULTS: The review included 35 articles. Eleven versions of MOS-SSS (3, 4, 5, 6, 8, 12, 13, 16, 18, 19, and 22 items) have been validated in various populations and 13 languages. Of 14 studies developing a translated version of MOS-SSS, four studies performed both an experts' evaluation of content validity and a face validity test; two studies reported translation evaluation in the form of a content validity index. Of 35 studies, six performed both exploratory factor analysis and confirmatory factor analysis for structural validity; hypotheses and measurements for construct validity testings were often not clearly stated; two examined criterion validity; and four assessed cross-cultural validity. Internal consistency reliabilities were commonly examined by calculating Cronbach's alpha and reported satisfactory. Five studies analysed test-retest reliabilities using intra correlation coefficient. Methodological concerns exist. CONCLUSION: The English 19-item, Farsi Persian 19-item, and Vietnamese 19-item versions are recommended for future use in research and practice. Italian 19-item and Malaysian 13-item versions are not recommended to be used in future research and practice. All other versions considered in this review have potential use in future research and practice. Proper procedures for developing a translated version of MOS-SSS and validating the scale are recommended. IMPACT: The review identified quality versions of MOS-SSS to measure social support in future research and practice. The study also indicated methodological issues in current validation studies. Application of the study findings and recommendations can be useful to improve outcome measurement quality and maximize the efficiency of resource use in future research and practice. NO PATIENT OR PUBLIC CONTRIBUTION: This systematic review synthesized the evidence from previous research and did not involve any human participation.

Value for Money of CAR-T Cell Therapy for Patients with Diffuse Large B-cell Lymphoma in China: Evidence from a Cost-Effectiveness Analysis.

OBJECTIVE: This research assesses the cost effectiveness of Axicabtagene ciloleucel (Axi-cel), Tisagenlecleucel (Tis-cel), Relmacabtagene autoleucel (Rel-cel) and Lisocabtagene maraleucel (Lis-cel) against standard of care (SOC) for patients with diffuse large B-cell lymphoma (DLBCL) in the first-line setting (1L), second-line setting (2L) and third-line or later setting (3L+). METHODS: Markov modelling based on a flexible survival model was adopted to evaluate four chimeric antigen receptor T-cell (CAR-T) therapies compared with SOC for patients with diffuse large B-cell lymphoma (DLBCL). The clinical inputs and utility values of the model were derived from the most recent clinical trials and the health care costs from a Chinese provincial clinical center. Costs and quality-adjusted life years (QALYs) were used to derive incremental cost-effectiveness ratios (ICERs) from the Chinese health care system perspective. RESULTS: The ICER of Axi-cel (1L) versus SOC was approximately Chinese Yuan (CNY) 2,125,311 per QALY. The ICER for Axi-cel (2L), Tis-cel (2L) and Liso-cel (2L)) versus SOC in transplant-eligible patients were approximately CNY363,977, CNY32,066,781 and CNY347,746 per quality-adjusted life year (QALY), respectively. The ICER for Liso-cel (2L) versus SOC in transplant-ineligible patients was approximately CNY1,233,972 per QALY. The ICERs for Axi-cel (3L+), Tis-cel (3L+), Rel-cel (3L+) and Liso-cel (3L+) versus SOC were approximately CNY346,009, CNY654,344, CNY280,964 and CNY436,858 per QALY, respectively. In the scenario analysis using mixture cure models, the long-term survival benefit for CAR-T and SOC groups was found higher, and only Rel-cel (3L+) was found to be cost effective. CONCLUSION: Our results demonstrated that CAR-T treatments are not cost effective in any-line settings for DLBCL patients at the WHO-recommended willingness-to-pay threshold (CNY257,241 per QALY) in the base-case analysis. Price reduction of CAR-T therapies is the main approach for lowering ICERs and ensuring that the drug costs are proportional to patient health benefits.

Air pollution and health outcomes: Evidence from Black Saturday Bushfires in Australia.

This paper presents new evidence of the causal effect of air pollution on Australian health outcomes, using the Black Saturday bushfires (BSB) in 2009 as a natural experiment. This event was one of the largest bushfires in Australian history and emitted approximately four million tonnes of CO2 into the atmosphere. We use data from the Household Income and Labour Dynamic Australia (HILDA) panel and compare the health status of individuals who were living in affected and unaffected regions before and after the event. Using a triple differences procedure, we further examine whether a difference in vulnerability to bushfire smoke exists comparing people living in urban or regional areas. We find that ambient air pollution had significant negative effects on health and that the magnitudes were actually larger for individuals residing in urban areas.

Molecular characterization and antimicrobial susceptibility of methicillin-resistant staphylococcus aureus isolates from clinical samples and asymptomatic nasal carriers in Istanbul (Turkey).

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) has been a widespread problem in Turkish hospitals. AIMS: The aim of this study was to investigate the staphylococcal toxin genes of the clinical and nasal MRSA isolates, and their antibiotic resistance profiles. MATERIALS AND METHODS: Isolation of nasal and clinical bacteria was done following standard microbiological methods. The presence of antimicrobial resistance genes (mec A, pvl, tsst-1, and SEs genes) was determined using the real-time polymerase chain reaction (PCR) assay. RESULTS: Among nasal MRSA isolates, 66.7% were toxigenic. The distribution of genes was as follows: pvl 26.7%, tsst-1 3.3%, and SEs 36.7%. Therefore, the nasal MRSA isolates had a rate of 23.3% multidrug resistance (MDR) pattern to the non-beta-lactams antibiotics. All (100%) clinical MRSA isolates were found to be toxigenic. The distribution of genes was as follows; pvl 10%, tsst-1 6.7%, and SEs 100%. The clinical MRSA isolates had a rate of 60% MDR. CONCLUSIONS: Following detection of pvl, tsst-1, and SEs among nasal and clinical MRSA isolates, and the presence of high antimicrobial resistance, the spread of these strains may be an additional factor contributing to the emergence of community-acquired (CA)-MRSA and hospital-acquired (HA)-MRSA. This study is the first to determine the resistance to linezolid and tigecycline in both nasal and clinical MRSA isolates, for the first time in Turkey. All nasal and clinical MRSA isolates were uniformly susceptible to vancomycin and quinupristin-dalfopristin. Our findings show that MRSA infections in Turkey can be empirically treated with vancomycin and quinupristin-dalfopristin based on the lack of demonstrable resistance to these drugs.

The intergenerational effects of socioeconomic inequality on unhealthy bodyweight.

We study the effects of inherited socioeconomic characteristics on markers of unhealthy bodyweight. Taking Australian microdata from 2007 to 2013, we show that approximately 4% of the variation in outcomes is determined by factors beyond an individual's control, such as their race, gender, and social class. Paternal socioeconomic status is the primary explanatory factor, with those born to more affluent fathers slightly less likely to be overweight in adulthood. Decompositions reveal that only 20%-25% of this effect is attributable to advantaged families exhibiting better health behaviors, which implies that unobserved factors also play an important role. Since diseases associated with unhealthy weight place a major strain on public healthcare systems, our results have implications for the provision of treatment when resources are constrained.

Should we leave the paper currency? A microbiological examination.

OBJECTIVE: Pathogens can be transmitted to banknotes due to the personal unhygienic habits. The aim of study was to find the possible pathogens on the banknotes circulating in the market and also to present their antibacterial resistance and their various virulence factors using genotypic and phenotypic methods. METHODS: A total of 150 samples of bank-notes were randomly collected between August 2017 and March 2018. VITEK systems were used for identification and antimicrobial susceptibility testing respectively. Antimicrobial resistance genes (mecA, van, extended-spectrum ß-lactamase [ESBL] and carbapenemases) and staphyloccoccal virulence genes (staphyloccoccal enterotoxins [SEs], pvl, and tsst-1) were determined using with real-time PCR. RESULTS: Staphylococcus aureus, coagulase-negative staphylococci (CoNS), Enterococcus spp., Gram-negative enteric bacteria, non-fermentative Gram-negative bacteria and Candida spp. were detected 48%, 54.7%, 56%, 21.3%, 18.7%, and 4%, respectively. Methicillin-resistant S. aureus, vancomycin-resistant enterococci and ESBL producing Gram-negative were found 46.8%, 1.3%, and 28.7%, respectively. Pvl, tsst-1, and SEs genes were found in a 2.8/4.9%, 1.4/1.2%, and 100/ 87.8% of the S. aureus/CoNS strains, respectively. The sea gene was found the most common enterotoxigenic gene. blaTEM, blaSHV, blaCTX-M-2, blaCTX-M-1, blaKPC, and blaOXA-48 were found 55.8%, 46.5%, 41.2%, 18.6%, 18.6%, and 18.6%, respectively in Gram-negative strains. CONCLUSIONS: These results is very important to highlight hygienic status of paper currencies. This can be considered as an indication that banknotes may contribute to the spread of pathogens and antimicrobial resistance. Therefore, we may need to start using alternative products instead of banknotes.

Significant caries index values and related factors in 5-6-year-old children in Istanbul, Turkey.

To evaluate significant caries (SiC) index values and related factors in Turkish children aged 5-6 years old, children from 5 nursery schools in Istanbul were included in a cross-sectional study. Sociodemographic information and data about oral care habits were obtained from the records and from parents. Of 542 students examined, the mean decayed/missing/filled primary teeth (dmft) index was 3.74 (SD 3.49) and the SiC index was 7.75 (SD 2.56). About 76.8% of the children had experienced dental caries. Logistic regression analysis of the SiC index for dmft showed that risk factors for poor dental status were low mother's education (OR 2.04) and irregular toothbrushing versus once-a-day brushing (OR 4.09) or twice-a-day brushing (OR 4.20).

Significant caries index values and related factors in 5-6-year-old children in Istanbul, Turkey

To evaluate significant caries [SiC] index values and related factors in Turkish children aged 5-6 years old, children from 5 nursery schools in Istanbul were included in a cross-sectional study. Sociodemographic information and data about oral care habits were obtained from the records and from parents. Of 542 students examined, the mean decayed/missing/filled primary teeth [dmft] index was 3.74 [SD 3.49] and the SiC index was 7.75 [SD 2.56]. About 76.8% of the children had experienced dental caries. Logistic regression analysis of the SiC index for dmft showed that risk factors for poor dental status were low mother's education [OR 2.04] and irregular toothbrushing versus once-a-day brushing [OR 4.09] or twice-a-day brushing [OR 4.20]

Comparison of ranking dental status using the Significant Caries Index and the Significant Filled and Sound-Teeth Index.

OBJECTIVE: The objective was to test whether the ranking of countries was different using the SFS-T (Significant Filled Sound-Teeth Index) or the Significant Caries Index (SIC). METHOD: This study compared the country rankings using the SiC and the SFS-T indices in 12 year olds in a range of countries. The SFS-T is the one-third of the population with the lowest filled or sound teeth and is a measure of functional status. We used the SiC and DMFT data from the WHO database for 12 year olds. SFS-T index values were estimated for the 12 year olds for 16 countries. RESULTS: The ranking by SiC index scores was lower for developed countries than for developing countries. CONCLUSIONS: These findings suggest that it may be more useful to use the SFS-T index than the SiC index in studies comparing dental status between countries.

Dental health status and risk factors for dental caries in adults in Istanbul, Turkey.

The aim this study was to record the oral health in adults in Istanbul, Turkey, and to evaluate the risk indicators associated with a high significant caries index (SiC). A random sample of 2183 individuals in Bayrampasa district aged between 18 and 74 years were invited for a free dental examination and interview. The mean decayed, missing and filled teeth index (DMFT) was 11.44 and the SiC was 14.00, increasing from 6.00 for the age group 18-19 years to 15.32 at 33-44 years and 28.00 at 65-74 years. Logistic regression analysis showed that older age, female sex and rural origin of birth were the significant risk indicators for a high SiC index.

Dental health status and risk factors for dental caries in adults in Istanbul, Turkey

The aim this study was to record the oral health in adults in Istanbul, Turkey, and to evaluate the risk indicators associated with a high significant caries index [SiC]. A random sample of 2183 individuals in Bayrampasa district aged between 18 and 74 years were invited for a free dental examination and interview. The mean decayed, missing and filled teeth index [DMFT] was 11.44 and the SiC was 14.00, increasing from 6.00 for the age group 18-19 years to 15.32 at 33-44 years and 28.00 at 65-74 years. Logistic regression analysis showed that older age, female sex and rural origin of birth were the significant risk indicators for a high SiC index

Risk factors for dental caries in Turkish preschool children.

The aim of this study was to evaluate risk factors of dental caries in preschool children in Istanbul. Five nursery schools in Istanbul were included and results of 598 students' were collected. Subjects were orally examined. Socio-demographic data were obtained from the records and from parents. Oral examination data were recorded on examination forms in accordance with the WHO criteria. Bivariate analyses were conducted using chi-square test Multivariate analyses were then performed to estimate the simultaneous impact of the independent variables on dft. Logistic regression analysis was performed in stages. In the study, while although the percentage of children had 60% caries and 0 results at the age of 3, this percentage drops to 15.3% at the age 6. 36%Thirty-six percent of the students have insufficient oral hygiene. Statistically meaningful difference was ascertained in chi-square analysis related to age, mother's education level, and father's occupation. When the variables with statistically meaningful difference are estimated with logistic regression analysis, the age and father's father's occupation turned out to be the risk indicators that affect dft level.