Alexandra Cucu - Academia.edu (original) (raw)
Papers by Alexandra Cucu
PubMed, Jun 1, 2022
Objectives: This study compares the utilization of osteoporosis and osteoporosis complication hea... more Objectives: This study compares the utilization of osteoporosis and osteoporosis complication healthcare services before and during the COVID-19 pandemic in Romania. Methods:The descriptive nationwide population study has used secondary data collected from the national health information system. We have calculated and compared the procedures performed for osteoporosis diagnosis and screening, standardized incidence and hospitalization rate for osteoporosis and osteoporosis fractures before and during the COVID-19 pandemic. Results:A 37.84% reduction in the number of DXA scans performed in 2020 have been observed, decreasing from 30,698 in 2019 to 12,064 in 2020. The standardized incidence for osteoporosis was 212.97 cases/100.000 person-years in 2018, 234 cases/100,000 person-years in 2019, and 185.97 cases/100,000 person-years in 2020. The hospitalization rates for osteoporosis have decreased by 68% compared with 2019 and the continuous hospitalization rate for osteoporotic fracture by 48% compared with 2019. Conclusions:The COVID-19 pandemic affected the utilization of healthcare services for osteoporosis management, posing a threat due to a magnified effect on osteoporotic fracture burden. More efforts are further needed to progress and re-engage with osteoporotic fracture prevention in our country and to develop and shape an optimal implementation of prevention and management strategies for all level of health care in Romania.
European journal of public health, Oct 1, 2018
Background: Tobacco is the leading preventable cause of death globally and tobacco taxation is a ... more Background: Tobacco is the leading preventable cause of death globally and tobacco taxation is a cost-effective method of reducing tobacco use in countries and increasing revenue. However, without adequate enforcement some argue the risk of increasing illicit trade in cheap tobacco makes taxation ineffective. We explore this by testing sub-national variations in the impact of tobacco tax increases from 2009 to 2011, on seven smoking-related diseases in adults in Romania, to see if regions that are prone to cigarette smuggling due to bordering other countries see less benefit. Method: We use a pragmatic natural experiment study approach to analyse the study period 2009-15. Findings from hospital episodes data relating to smoking-attributable diseases are analysed for six regional subgroups which are compared according to border characteristics with other countries. Results: At a national level smoking-attributable diseases reduced over the study period especially around the tax increase years, with asthma showing the most significant decline. Sub-nationally there was no statistically significant correlation in variations between central regions and those bordering other countries. Conclusion: There is a reassuring decline in hospitalizations for smoking-related diseases associated with the tax increases, and no sub-national association with smuggling risk measured by variation in the size of this effect and regions that border other countries. More comprehensive and progressive tobacco control in Romania should be implemented in line with the WHO Framework Convention for Tobacco Control.
eLife, 2021
From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesit... more From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory ...
Acta Medica Transilvanica, Jun 1, 2021
The entire environment to provide mental health care was affected by the COVID-19 pandemic, inclu... more The entire environment to provide mental health care was affected by the COVID-19 pandemic, including tertiary health care services. This nationwide population-based observational descriptive study aims to explore the access to tertiary mental health care services in Romania, during the year 2020 compared with the last two years before. The analysis of national patterns of hospital admission due to mental health diseases and for the main causes of morbidity has shown disruption of regular services delivery morbidity during Covid-19 pandemic year, the rate of admission for continuous hospitalization registered in Romania due to mental and behavioural disorders in the year 2020 decreased to approximately 55% of the value of the registered rate for 2019 or 2018. During 2020, a change in hospital admission patterns for other diseases, such as cardiovascular, respiratory, digestive diseases, and neoplasms has been observed in Romania.
Obesity Facts, 2021
Introduction: Parents can act as important agents of change and support for healthy childhood gro... more Introduction: Parents can act as important agents of change and support for healthy childhood growth and development. Studies have found that parents may not be able to accurately perceive their child's weight status. The purpose of this study was to measure parental perceptions of their child's weight status and to identify predictors of potential parental misperceptions. Methods: We used data from the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative and 22 countries. Parents were asked to identify their perceptions of their children's weight status as "underweight," "normal weight," "a little overweight," or "extremely overweight." We categorized children's (6-9 years; n = 124,296) body mass index (BMI) as BMI-forage Z-scores based on the 2007 WHO-recommended growth references. For each country included in the analysis and pooled estimates (country level), we calculated the distribution of children according to the WHO weight status classification, distribution by parental perception of child's weight status, percentages of accurate, overestimating, or underestimating perceptions, misclassification levels, and predictors of parental misperceptions using a multilevel logistic regression analysis that included only children with overweight (including obesity). Statistical analyses were performed using Stata version 15 1. Results: Overall, 64.1% of parents categorized their child's weight status accurately relative to the WHO growth charts. However, parents were more likely to underestimate their child's weight if the child had overweight (82.3%) or obesity (93.8%). Parents were more likely to underestimate their child's weight if the child was male (adjusted OR [adjOR]: 1.41; 95% confidence intervals [CI]: 1.28-1.55); the parent had a lower educational level (adjOR: 1.41; 95% CI: 1.26-1.57); the father was asked rather than the mother (adjOR: 1.14; 95% CI: 0.98-1.33); and the family lived in a rural area (adjOR: 1.10; 95% CI: 0.99-1.24). Overall, parents' BMI was not strongly associated with the underestimation of children's weight status, but there was a stronger association in some countries. Discussion/Conclusion: Our study supplements the current literature on factors that influence parental perceptions of their child's weight status. Public health interventions aimed at promoting healthy childhood growth and development should consider parents' knowledge and perceptions, as well as the sociocultural contexts in which children and families live.
WOS, 2021
Establishment of the WHO European Childhood Obesity Surveillance Initiative (COSI) has resulted i... more Establishment of the WHO European Childhood Obesity Surveillance Initiative (COSI) has resulted in a surveillance system which provides regular, reliable, timely, and accurate data on children's weight status-through standardized measurement of bodyweight and height-in the WHO European Region. Additional data on dietary intake, physical activity, sedentary behavior, family background, and school environments are collected in several countries. In total, 45 countries in the European Region have participated in COSI. The first five data collection rounds, between 2007 and 2021, yielded measured anthropometric data on over 1.3 million children. In COSI, data are collected according to a common protocol, using standardized instruments and procedures. The systematic collection and analysis of these data enables intercountry comparisons and reveals differences in the prevalence of childhood thinness, overweight, normal weight, and obesity between and within populations. Furthermore, it facilitates investigation of the relationship between overweight, obesity, and potential risk or protective factors and improves the understanding of the development of overweight and obesity in European primary-school children in order to support appropriate and effective policy responses.
WOS, 2021
Objective: To explore secular trends in physical activity in relation to socioeconomic position i... more Objective: To explore secular trends in physical activity in relation to socioeconomic position in middle-aged women, with focus on whether the social gaps have become wider, narrower, or remain unchanged. Design: Cohort comparisons between two representative samples of women, recruited in 1980-81 and 2004-05 as a part of the Population Study of Women in Gothenburg. Setting: Gothenburg, the second largest city of Sweden, with % 450 000 inhabitants. Subjects: Population-based cohorts of 38-and 50-year-old women, invited in 1980-81 and 2004-05 to free health examinations. The study population in 1980 was n ¼ 477, 38-and 50-year-old women born in 1930 (n ¼ 355) and 1942 (n ¼ 122), and in 2004 n ¼ 500, 38-and 50-year-old women born in 1966 (n ¼ 207) and 1954 (n ¼ 293). Main outcome measure: Physical activity at work and leisure time. Socioeconomic position was defined based on socio-occupational group and level of education. Physical activity during work and leisure time was based on questionnaires. Results: On average 38-and 50-year-old women were more physically active at work and leisure time in 2004-05 compared to 1980-81; odds ratio (OR) for increase over time for physical activity at work for 38-year-olds: 2.59, (95% confidence interval (CI) 1.65-4.07), and for 50-yearolds: OR 2.09 (1.52-2.88); OR for increase physical activity leisure time in 38-year-olds: 1.93 (1.25-2.98), and in 50-year-olds 2.04 (1.49-2.79). There were no significant differences between socioeconomic groups in physical activity levels changes over time. Conclusion: Women in different socioeconomic groups improved their physical activity at work and leisure time to the same extent from 1980 to 2004, indicating that the socioeconomic gap in physical activity is neither increasing nor decreasing. KEY POINTS The gap in physical activity levels between socioeconomic groups seems to have remained stable for middle-aged women the last 25 years. However, women were more physically active in 2004 at work and during leisure time, independent of socioeconomic position, compared to 1980. It remains a great challenge to create structures that enable these behaviours for all social groups.
European journal of public health, Oct 1, 2015
Acta Medica Transilvanica, Mar 1, 2016
There is an association between smoking and many mental illnesses. Smoking prevalence in all pati... more There is an association between smoking and many mental illnesses. Smoking prevalence in all patients with psychiatric pathology is between 35% and 54%. The prevalence of smoking among patients with schizophrenia is between 74% and 92%, much higher than the one between 22% and 30% concerning the general population. Male patients with schizophrenia are at increased risk for smoking. Smoking is implicated in the pathogenesis of many diseases and it is responsible for 90% of lung cancer deaths, 75% of those in chronic bronchitis and emphysema and around 25% of those involving cardiovascular diseases. Tobacco is a strong inducer of cytochrome P450 enzyme, the metabolizing pathway for many antipsychotics. This leads to decreased levels in plasma concentrations of antipsychotic agents. Higher doses of antipsychotic agents are administered to smoking patients with schizophrenia to achieve similar therapeutic effects as in non-smoking patients with schizophrenia. The higher the doses of antipsychotic agents administered, the greater the risk of adverse events. In case of sudden smoking cessation, the plasma concentrations of antipsychotic agents may exceed the therapeutic range and may cause side effects. Thus, there is an added risk of adverse reactions to antipsychotics to the general health risk of smoking. Patients with schizophrenia smoke because nicotine improves the cognitive symptoms of the disease. Smoking is a habit for patients with schizophrenia and sometimes this activity is the only source of pleasure. Smoking-related concessions are motivating factors that increase compliance in patients with schizophrenia. It is well known that compliance rates are low for this category of patients. It would be preferable to try phasing out smoking in patients with schizophrenia, as well as in any other patient.
Epidemiology, Nov 1, 2006
The aim of the study was to assess the profile of nosocomial infections and antibiotic resistance... more The aim of the study was to assess the profile of nosocomial infections and antibiotic resistance in the Intensive Care Unit (ICU) department versus other departments of the „Dr Victor Babeș” Infectious Diseases Hospital, Bucharest, Romania. The descriptive and documentary study in transversal approach based on analysis information provided by the national and international data bases was completed with the active surveillance results of the Microbiology Laboratory. There was described and identified the profile of nosocomial infections and antibiotic resistance in the intensive care unit (ICU) department in comparison to the global resistance of other departments of the hospital, during December 2011- May 2012. Microorganisms included in the assesment were: Staphylococcus aureus MRSA, Enterobacteriaceae (E. coli, Klebsiella pneumoniae, Enterobacter cloacae), Pseudomonas aeruginosa and Acinetobacter baumannii. For all these microorganisms the resistance was higher in the ICU than the antibioresistance in other compartiments of the hospital, fact that highlights this particular department as a critic point in the control of nosocomial infections. Rezumat Scopul studiului a fost acela de a evalua profilul etiologic al infecțiilor nosocomiale și rezistența la antibiotice in Secția de Anestezie și Terapie Intensivă (ATI) in raport cu rezistența globală in celelalte secții ale Spitalului Clinic de Boli Infecțioase și Tropicale „Dr Victor Babeș”- București, in vederea identificării direcțiilor de intervenție viitoare. Studiul descriptiv și documentar in abordare transversală a fost realizat pe baza informațiilor furnizate de analiza datelor naționale și internaționale, completate cu rezultatele supravegherii active derulate de Laboratorul de Microbiologie al Spitalului. A fost analizată comparativ rezistența la antibiotice in ATI și antibiorezistența globală in celelalte secții ale spitalului, in perioada decembrie 2011 - mai 2012. Microorganismele țintă pentru această analiză au fost: Staphylococcus aureus MRSA, Enterobacteriaceae (E. coli, Klebsiella pneumoniae, Enterobacter cloacae), Pseudomonas aeruginosa și Acinetobacter baumannii. Rezultatele testelor de laborator au evidențiat faptul că pentru toate aceste microorganisme rezistența a fost mai mare in Secția de ATI decât cea de la nivelul celorlalte secții ale spitalului. Concluziile studiului identifică secția de ATI ca un punct critic in controlul infecțiilor nosocomiale.
International Journal of Radiation Biology, Aug 22, 2016
Purpose: To establish a training data set of digital images and to investigate the scoring criter... more Purpose: To establish a training data set of digital images and to investigate the scoring criteria and dose assessment of the dicentric assay within the European network of biodosimetry (RENEB), a web based scoring inter-comparison was undertaken by 17 RENEB partners. Materials and methods: Two sets of 50 high resolution images were uploaded onto the RENEB website. One set included metaphases after a moderate exposure (1.3 Gy) and the other set consisted of metaphases after a high dose exposure (3.5 Gy). The laboratories used their own calibration curves for estimating doses based on observed aberration frequencies. Results: The dose estimations and 95% confidence limits were compared to the actual doses and the corresponding z-values were satisfactory for the majority; only the dose estimations from two laboratories were too low or too high. The coefficients of variation were 17.6% for the moderate and 11.2% for the high dose. Metaphases with controversial results could be identified for training purposes. Conclusions: Overall, the web based scoring of the two galleries by the 17 laboratories produced very good results. Application of web based scoring for the dicentric assay may therefore be a relevant strategy for an operational biodosimetry assistance network.
Nature, Mar 29, 2023
Diminishing benefits of urban living for children and adolescents' growth and development NCD Ris... more Diminishing benefits of urban living for children and adolescents' growth and development NCD Risk Factor Collaboration (NCD-RisC)* Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being 1-6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5-19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m-2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified.
European Journal of Public Health
Background Physical activity is key for preventing obesity and development of noncommunicable dis... more Background Physical activity is key for preventing obesity and development of noncommunicable diseases later in life. Previous research suggests that socioeconomic factors, such as parental education or income, may influence a child’s risk of obesity. However, previous research on this has provided heterogeneity in results. Our aim was to investigate the socioeconomic disparities between physical activity, sedentary behaviour and sleep patterns in school-aged children aged 6 to 9 years in 24 European countries, using a large nationally-representative sample of children from 24 countries (Albania, Bulgaria, Croatia, Czechia, Denmark, France, Georgia, Ireland, Italy, Kazakhstan, Kyrgyzstan, Lithuania, Latvia, Malta, Montenegro, Poland, Portugal, Romania, Russian Federation – only Moscow, San Marino Republic, Spain, Tajikistan, Türkiye and Turkmenistan). Methods COSI collected information on physical activity patterns of children, sedentary behaviour and sleep duration through a questi...
Statistics highlight the increasing number of medical equipments and procedures using ionizing ra... more Statistics highlight the increasing number of medical equipments and procedures using ionizing radiation in Romania. Some of these procedures involve high doses, the exposures may be repeated, and recording and saving information on patient doses are still inadequate, despite the existing legal provisions; in this context, recent studies confirm that practitioners are still reluctant to refuse unjustified examinations, and the issue of radiation protection of the patient becomes an actual public health problem. Public health specialists are confronted with the dilemma of the alternatives to solve existing problems, between a new excessive regulation or better information, assisted by control and the mechanisms of internal and external clinical audit, not as punitive means, but appealing to the professional deontology of the professionals. Cuvinte cheie: expuneri medicale la radiaţii, justificare, protecţie radiologică Rezumat: Cifrele statistice semnalează creşterea numărului de ech...
BJOG: An International Journal of Obstetrics & Gynaecology, 2021
The SARS-CoV-2 pandemic exposed multiple shortcomings in national and international capacity to r... more The SARS-CoV-2 pandemic exposed multiple shortcomings in national and international capacity to respond to an infectious disease outbreak. It is essential to learn from these deficiencies to prepare for future epidemics. One major gap is the limited availability of timely and comprehensive population-based routine data about COVID-19's impact on pregnant women and babies. As part of the Horizon 2020 PHIRI (Population Health Information Research Infrastructure) project on the use of population data for COVID-19 surveillance, the Euro-Peristat research network investigated the extent to which routine information systems could be used to assess the effects of the pandemic by constructing indicators of maternal and child health and of COVID-19 infection. The Euro-Peristat network brings together researchers and statisticians from 31 countries to monitor population indicators of perinatal health in Europe and periodically compiles data on a set of 10 core and 20 recommended indicators1.
Chirurgia (Bucharest, Romania : 1990)
The present study tries to provide an expressive, customized answer to the question in the title.... more The present study tries to provide an expressive, customized answer to the question in the title. The study relies on a ten-year experience (2000-2009), evaluated retrospectively on a group of 488 prosthetic repairs of incisional herniae, out of which 432 were performed in a clean environment and 56 cases in a clean-contaminated one. The two groups are superimposable based on the Apache score. The visceral surgical procedures associated to the surgery of the parietal defect were varied (cholecystectomy, appendectomy, enterectomy enterorrhaphy,colectomy colotomy-colorrhaphy, hysterectomy with adnexectomy). The assessment of postoperative suppurative complications showed no significant differences between the two groups (p 0.001). These results lead us to the idea of defining the indication for parietal prosthetic repair in a contaminated environment. The major factors of this decision are: the nature, the source and the amount of the septicinoculum, the duration of exposure, the inte...
Environmental Health Perspectives, 2007
PubMed, Jun 1, 2022
Objectives: This study compares the utilization of osteoporosis and osteoporosis complication hea... more Objectives: This study compares the utilization of osteoporosis and osteoporosis complication healthcare services before and during the COVID-19 pandemic in Romania. Methods:The descriptive nationwide population study has used secondary data collected from the national health information system. We have calculated and compared the procedures performed for osteoporosis diagnosis and screening, standardized incidence and hospitalization rate for osteoporosis and osteoporosis fractures before and during the COVID-19 pandemic. Results:A 37.84% reduction in the number of DXA scans performed in 2020 have been observed, decreasing from 30,698 in 2019 to 12,064 in 2020. The standardized incidence for osteoporosis was 212.97 cases/100.000 person-years in 2018, 234 cases/100,000 person-years in 2019, and 185.97 cases/100,000 person-years in 2020. The hospitalization rates for osteoporosis have decreased by 68% compared with 2019 and the continuous hospitalization rate for osteoporotic fracture by 48% compared with 2019. Conclusions:The COVID-19 pandemic affected the utilization of healthcare services for osteoporosis management, posing a threat due to a magnified effect on osteoporotic fracture burden. More efforts are further needed to progress and re-engage with osteoporotic fracture prevention in our country and to develop and shape an optimal implementation of prevention and management strategies for all level of health care in Romania.
European journal of public health, Oct 1, 2018
Background: Tobacco is the leading preventable cause of death globally and tobacco taxation is a ... more Background: Tobacco is the leading preventable cause of death globally and tobacco taxation is a cost-effective method of reducing tobacco use in countries and increasing revenue. However, without adequate enforcement some argue the risk of increasing illicit trade in cheap tobacco makes taxation ineffective. We explore this by testing sub-national variations in the impact of tobacco tax increases from 2009 to 2011, on seven smoking-related diseases in adults in Romania, to see if regions that are prone to cigarette smuggling due to bordering other countries see less benefit. Method: We use a pragmatic natural experiment study approach to analyse the study period 2009-15. Findings from hospital episodes data relating to smoking-attributable diseases are analysed for six regional subgroups which are compared according to border characteristics with other countries. Results: At a national level smoking-attributable diseases reduced over the study period especially around the tax increase years, with asthma showing the most significant decline. Sub-nationally there was no statistically significant correlation in variations between central regions and those bordering other countries. Conclusion: There is a reassuring decline in hospitalizations for smoking-related diseases associated with the tax increases, and no sub-national association with smuggling risk measured by variation in the size of this effect and regions that border other countries. More comprehensive and progressive tobacco control in Romania should be implemented in line with the WHO Framework Convention for Tobacco Control.
eLife, 2021
From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesit... more From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory ...
Acta Medica Transilvanica, Jun 1, 2021
The entire environment to provide mental health care was affected by the COVID-19 pandemic, inclu... more The entire environment to provide mental health care was affected by the COVID-19 pandemic, including tertiary health care services. This nationwide population-based observational descriptive study aims to explore the access to tertiary mental health care services in Romania, during the year 2020 compared with the last two years before. The analysis of national patterns of hospital admission due to mental health diseases and for the main causes of morbidity has shown disruption of regular services delivery morbidity during Covid-19 pandemic year, the rate of admission for continuous hospitalization registered in Romania due to mental and behavioural disorders in the year 2020 decreased to approximately 55% of the value of the registered rate for 2019 or 2018. During 2020, a change in hospital admission patterns for other diseases, such as cardiovascular, respiratory, digestive diseases, and neoplasms has been observed in Romania.
Obesity Facts, 2021
Introduction: Parents can act as important agents of change and support for healthy childhood gro... more Introduction: Parents can act as important agents of change and support for healthy childhood growth and development. Studies have found that parents may not be able to accurately perceive their child's weight status. The purpose of this study was to measure parental perceptions of their child's weight status and to identify predictors of potential parental misperceptions. Methods: We used data from the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative and 22 countries. Parents were asked to identify their perceptions of their children's weight status as "underweight," "normal weight," "a little overweight," or "extremely overweight." We categorized children's (6-9 years; n = 124,296) body mass index (BMI) as BMI-forage Z-scores based on the 2007 WHO-recommended growth references. For each country included in the analysis and pooled estimates (country level), we calculated the distribution of children according to the WHO weight status classification, distribution by parental perception of child's weight status, percentages of accurate, overestimating, or underestimating perceptions, misclassification levels, and predictors of parental misperceptions using a multilevel logistic regression analysis that included only children with overweight (including obesity). Statistical analyses were performed using Stata version 15 1. Results: Overall, 64.1% of parents categorized their child's weight status accurately relative to the WHO growth charts. However, parents were more likely to underestimate their child's weight if the child had overweight (82.3%) or obesity (93.8%). Parents were more likely to underestimate their child's weight if the child was male (adjusted OR [adjOR]: 1.41; 95% confidence intervals [CI]: 1.28-1.55); the parent had a lower educational level (adjOR: 1.41; 95% CI: 1.26-1.57); the father was asked rather than the mother (adjOR: 1.14; 95% CI: 0.98-1.33); and the family lived in a rural area (adjOR: 1.10; 95% CI: 0.99-1.24). Overall, parents' BMI was not strongly associated with the underestimation of children's weight status, but there was a stronger association in some countries. Discussion/Conclusion: Our study supplements the current literature on factors that influence parental perceptions of their child's weight status. Public health interventions aimed at promoting healthy childhood growth and development should consider parents' knowledge and perceptions, as well as the sociocultural contexts in which children and families live.
WOS, 2021
Establishment of the WHO European Childhood Obesity Surveillance Initiative (COSI) has resulted i... more Establishment of the WHO European Childhood Obesity Surveillance Initiative (COSI) has resulted in a surveillance system which provides regular, reliable, timely, and accurate data on children's weight status-through standardized measurement of bodyweight and height-in the WHO European Region. Additional data on dietary intake, physical activity, sedentary behavior, family background, and school environments are collected in several countries. In total, 45 countries in the European Region have participated in COSI. The first five data collection rounds, between 2007 and 2021, yielded measured anthropometric data on over 1.3 million children. In COSI, data are collected according to a common protocol, using standardized instruments and procedures. The systematic collection and analysis of these data enables intercountry comparisons and reveals differences in the prevalence of childhood thinness, overweight, normal weight, and obesity between and within populations. Furthermore, it facilitates investigation of the relationship between overweight, obesity, and potential risk or protective factors and improves the understanding of the development of overweight and obesity in European primary-school children in order to support appropriate and effective policy responses.
WOS, 2021
Objective: To explore secular trends in physical activity in relation to socioeconomic position i... more Objective: To explore secular trends in physical activity in relation to socioeconomic position in middle-aged women, with focus on whether the social gaps have become wider, narrower, or remain unchanged. Design: Cohort comparisons between two representative samples of women, recruited in 1980-81 and 2004-05 as a part of the Population Study of Women in Gothenburg. Setting: Gothenburg, the second largest city of Sweden, with % 450 000 inhabitants. Subjects: Population-based cohorts of 38-and 50-year-old women, invited in 1980-81 and 2004-05 to free health examinations. The study population in 1980 was n ¼ 477, 38-and 50-year-old women born in 1930 (n ¼ 355) and 1942 (n ¼ 122), and in 2004 n ¼ 500, 38-and 50-year-old women born in 1966 (n ¼ 207) and 1954 (n ¼ 293). Main outcome measure: Physical activity at work and leisure time. Socioeconomic position was defined based on socio-occupational group and level of education. Physical activity during work and leisure time was based on questionnaires. Results: On average 38-and 50-year-old women were more physically active at work and leisure time in 2004-05 compared to 1980-81; odds ratio (OR) for increase over time for physical activity at work for 38-year-olds: 2.59, (95% confidence interval (CI) 1.65-4.07), and for 50-yearolds: OR 2.09 (1.52-2.88); OR for increase physical activity leisure time in 38-year-olds: 1.93 (1.25-2.98), and in 50-year-olds 2.04 (1.49-2.79). There were no significant differences between socioeconomic groups in physical activity levels changes over time. Conclusion: Women in different socioeconomic groups improved their physical activity at work and leisure time to the same extent from 1980 to 2004, indicating that the socioeconomic gap in physical activity is neither increasing nor decreasing. KEY POINTS The gap in physical activity levels between socioeconomic groups seems to have remained stable for middle-aged women the last 25 years. However, women were more physically active in 2004 at work and during leisure time, independent of socioeconomic position, compared to 1980. It remains a great challenge to create structures that enable these behaviours for all social groups.
European journal of public health, Oct 1, 2015
Acta Medica Transilvanica, Mar 1, 2016
There is an association between smoking and many mental illnesses. Smoking prevalence in all pati... more There is an association between smoking and many mental illnesses. Smoking prevalence in all patients with psychiatric pathology is between 35% and 54%. The prevalence of smoking among patients with schizophrenia is between 74% and 92%, much higher than the one between 22% and 30% concerning the general population. Male patients with schizophrenia are at increased risk for smoking. Smoking is implicated in the pathogenesis of many diseases and it is responsible for 90% of lung cancer deaths, 75% of those in chronic bronchitis and emphysema and around 25% of those involving cardiovascular diseases. Tobacco is a strong inducer of cytochrome P450 enzyme, the metabolizing pathway for many antipsychotics. This leads to decreased levels in plasma concentrations of antipsychotic agents. Higher doses of antipsychotic agents are administered to smoking patients with schizophrenia to achieve similar therapeutic effects as in non-smoking patients with schizophrenia. The higher the doses of antipsychotic agents administered, the greater the risk of adverse events. In case of sudden smoking cessation, the plasma concentrations of antipsychotic agents may exceed the therapeutic range and may cause side effects. Thus, there is an added risk of adverse reactions to antipsychotics to the general health risk of smoking. Patients with schizophrenia smoke because nicotine improves the cognitive symptoms of the disease. Smoking is a habit for patients with schizophrenia and sometimes this activity is the only source of pleasure. Smoking-related concessions are motivating factors that increase compliance in patients with schizophrenia. It is well known that compliance rates are low for this category of patients. It would be preferable to try phasing out smoking in patients with schizophrenia, as well as in any other patient.
Epidemiology, Nov 1, 2006
The aim of the study was to assess the profile of nosocomial infections and antibiotic resistance... more The aim of the study was to assess the profile of nosocomial infections and antibiotic resistance in the Intensive Care Unit (ICU) department versus other departments of the „Dr Victor Babeș” Infectious Diseases Hospital, Bucharest, Romania. The descriptive and documentary study in transversal approach based on analysis information provided by the national and international data bases was completed with the active surveillance results of the Microbiology Laboratory. There was described and identified the profile of nosocomial infections and antibiotic resistance in the intensive care unit (ICU) department in comparison to the global resistance of other departments of the hospital, during December 2011- May 2012. Microorganisms included in the assesment were: Staphylococcus aureus MRSA, Enterobacteriaceae (E. coli, Klebsiella pneumoniae, Enterobacter cloacae), Pseudomonas aeruginosa and Acinetobacter baumannii. For all these microorganisms the resistance was higher in the ICU than the antibioresistance in other compartiments of the hospital, fact that highlights this particular department as a critic point in the control of nosocomial infections. Rezumat Scopul studiului a fost acela de a evalua profilul etiologic al infecțiilor nosocomiale și rezistența la antibiotice in Secția de Anestezie și Terapie Intensivă (ATI) in raport cu rezistența globală in celelalte secții ale Spitalului Clinic de Boli Infecțioase și Tropicale „Dr Victor Babeș”- București, in vederea identificării direcțiilor de intervenție viitoare. Studiul descriptiv și documentar in abordare transversală a fost realizat pe baza informațiilor furnizate de analiza datelor naționale și internaționale, completate cu rezultatele supravegherii active derulate de Laboratorul de Microbiologie al Spitalului. A fost analizată comparativ rezistența la antibiotice in ATI și antibiorezistența globală in celelalte secții ale spitalului, in perioada decembrie 2011 - mai 2012. Microorganismele țintă pentru această analiză au fost: Staphylococcus aureus MRSA, Enterobacteriaceae (E. coli, Klebsiella pneumoniae, Enterobacter cloacae), Pseudomonas aeruginosa și Acinetobacter baumannii. Rezultatele testelor de laborator au evidențiat faptul că pentru toate aceste microorganisme rezistența a fost mai mare in Secția de ATI decât cea de la nivelul celorlalte secții ale spitalului. Concluziile studiului identifică secția de ATI ca un punct critic in controlul infecțiilor nosocomiale.
International Journal of Radiation Biology, Aug 22, 2016
Purpose: To establish a training data set of digital images and to investigate the scoring criter... more Purpose: To establish a training data set of digital images and to investigate the scoring criteria and dose assessment of the dicentric assay within the European network of biodosimetry (RENEB), a web based scoring inter-comparison was undertaken by 17 RENEB partners. Materials and methods: Two sets of 50 high resolution images were uploaded onto the RENEB website. One set included metaphases after a moderate exposure (1.3 Gy) and the other set consisted of metaphases after a high dose exposure (3.5 Gy). The laboratories used their own calibration curves for estimating doses based on observed aberration frequencies. Results: The dose estimations and 95% confidence limits were compared to the actual doses and the corresponding z-values were satisfactory for the majority; only the dose estimations from two laboratories were too low or too high. The coefficients of variation were 17.6% for the moderate and 11.2% for the high dose. Metaphases with controversial results could be identified for training purposes. Conclusions: Overall, the web based scoring of the two galleries by the 17 laboratories produced very good results. Application of web based scoring for the dicentric assay may therefore be a relevant strategy for an operational biodosimetry assistance network.
Nature, Mar 29, 2023
Diminishing benefits of urban living for children and adolescents' growth and development NCD Ris... more Diminishing benefits of urban living for children and adolescents' growth and development NCD Risk Factor Collaboration (NCD-RisC)* Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being 1-6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5-19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m-2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified.
European Journal of Public Health
Background Physical activity is key for preventing obesity and development of noncommunicable dis... more Background Physical activity is key for preventing obesity and development of noncommunicable diseases later in life. Previous research suggests that socioeconomic factors, such as parental education or income, may influence a child’s risk of obesity. However, previous research on this has provided heterogeneity in results. Our aim was to investigate the socioeconomic disparities between physical activity, sedentary behaviour and sleep patterns in school-aged children aged 6 to 9 years in 24 European countries, using a large nationally-representative sample of children from 24 countries (Albania, Bulgaria, Croatia, Czechia, Denmark, France, Georgia, Ireland, Italy, Kazakhstan, Kyrgyzstan, Lithuania, Latvia, Malta, Montenegro, Poland, Portugal, Romania, Russian Federation – only Moscow, San Marino Republic, Spain, Tajikistan, Türkiye and Turkmenistan). Methods COSI collected information on physical activity patterns of children, sedentary behaviour and sleep duration through a questi...
Statistics highlight the increasing number of medical equipments and procedures using ionizing ra... more Statistics highlight the increasing number of medical equipments and procedures using ionizing radiation in Romania. Some of these procedures involve high doses, the exposures may be repeated, and recording and saving information on patient doses are still inadequate, despite the existing legal provisions; in this context, recent studies confirm that practitioners are still reluctant to refuse unjustified examinations, and the issue of radiation protection of the patient becomes an actual public health problem. Public health specialists are confronted with the dilemma of the alternatives to solve existing problems, between a new excessive regulation or better information, assisted by control and the mechanisms of internal and external clinical audit, not as punitive means, but appealing to the professional deontology of the professionals. Cuvinte cheie: expuneri medicale la radiaţii, justificare, protecţie radiologică Rezumat: Cifrele statistice semnalează creşterea numărului de ech...
BJOG: An International Journal of Obstetrics & Gynaecology, 2021
The SARS-CoV-2 pandemic exposed multiple shortcomings in national and international capacity to r... more The SARS-CoV-2 pandemic exposed multiple shortcomings in national and international capacity to respond to an infectious disease outbreak. It is essential to learn from these deficiencies to prepare for future epidemics. One major gap is the limited availability of timely and comprehensive population-based routine data about COVID-19's impact on pregnant women and babies. As part of the Horizon 2020 PHIRI (Population Health Information Research Infrastructure) project on the use of population data for COVID-19 surveillance, the Euro-Peristat research network investigated the extent to which routine information systems could be used to assess the effects of the pandemic by constructing indicators of maternal and child health and of COVID-19 infection. The Euro-Peristat network brings together researchers and statisticians from 31 countries to monitor population indicators of perinatal health in Europe and periodically compiles data on a set of 10 core and 20 recommended indicators1.
Chirurgia (Bucharest, Romania : 1990)
The present study tries to provide an expressive, customized answer to the question in the title.... more The present study tries to provide an expressive, customized answer to the question in the title. The study relies on a ten-year experience (2000-2009), evaluated retrospectively on a group of 488 prosthetic repairs of incisional herniae, out of which 432 were performed in a clean environment and 56 cases in a clean-contaminated one. The two groups are superimposable based on the Apache score. The visceral surgical procedures associated to the surgery of the parietal defect were varied (cholecystectomy, appendectomy, enterectomy enterorrhaphy,colectomy colotomy-colorrhaphy, hysterectomy with adnexectomy). The assessment of postoperative suppurative complications showed no significant differences between the two groups (p 0.001). These results lead us to the idea of defining the indication for parietal prosthetic repair in a contaminated environment. The major factors of this decision are: the nature, the source and the amount of the septicinoculum, the duration of exposure, the inte...
Environmental Health Perspectives, 2007