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Objective: Physician density is a crucial element of a well-functioning health system. Previous research has investigated factors affecting country-level physician supply. To date, however, no evidence has been provided about the patterns of convergence in physician density among countries. This paper thus tested club convergence in physician density in 204 countries worldwide from 1990 to 2019. A nonlinear time-varying factor model was adopted to identify potential clubs, wherein groups of countries tend to converge towards the same level of physician density. Our primary purpose was to document the potential long-lasting disparity in future global physician distribution. Results: Despite physician density increasing in all regions globally from 1990 to 2019, we found no evidence in favor of the hypothesis of global convergence. Conversely, the clustering algorithm successfully identified three main patterns (i.e., three final clubs). With few exceptions, the results indicated an uneven physician distribution between the majority of North and Sub-Saharan African countries (where physician density would remain well below the estimated threshold of at least 70% of the Universal Health Coverage Services Index) and the rest of the world. These findings support the WHO's global strategy to reverse the chronic under-investment in human resources for health. [ABSTRACT FROM AUTHOR]

Background: Understanding how the development of obesogenic food environments and the consumption of ultra-processed foods and beverages influence each other can help policymakers to identify effective ways to curb the current obesity epidemic. This paper was designed to investigate whether, and to what extent, the consumption of soft drinks and the prevalence of obesity are linked through feedback effects.Methods: An ecological study design and a simultaneous equation model were used to investigate the existence of a vicious cycle between the consumption of soft drinks and the prevalence of obesity. The analysis was based on a longitudinal dataset covering per capita sales of soft drinks, the age-standardised prevalence rate of obesity and several demographic and socio-economic control variables in a sample of 98 countries worldwide for the period 2005-2019.Results: Using a Two-Stage Least Squares (2SLS) regression model with fixed effects, we documented a self-reinforcing process that links consumption and obesity. Changes in the spread of obesity were associated with changes in soft drink consumption: a one-unit increase in the age-adjusted prevalence rate of obesity increased consumption by about 2.39 l per person per year. Similarly, as the consumption of soft drinks rose, so did the prevalence of obesity: the age-adjusted rate of obesity increased by 0.07% for every additional litre consumed per capita. Computing the impact multipliers, we found that the outcome of a one-unit decrease in the average price of soft drinks was twofold: a) the prevalence of obesity increased by around 0.17%; and b) consumption increased by around 2.40 l per person, the sum of the increase directly caused by the price reduction (2 l) and the increase due to the interplay between consumption and obesity (0.4 l).Conclusions: This study has identified a feedback loop between unhealthy habits (i.e. the consumption of soft drinks) and health outcomes (i.e. the prevalence of obesity). This interplay amplifies the impact of any exogenous changes in the determinants of consumption and obesity. These feedback effects should be considered and exploited in planning effective strategies to tackle the burden of obesity and the global epidemic of non-​communicable diseases. [ABSTRACT FROM AUTHOR]

In this work, the capability of two commercial high silica zeolites (HSZs), namely ZSM-5 and Y, for the removal of chlorobenzene (CB) from water was investigated by combining chromatographic and diffractometric techniques. The adsorption isotherms and kinetics of CB on ZSM-5 and Y zeolites were determined from batch tests. The adsorption kinetics were very fast; the time to reach equilibrium was less than 10 min. The equilibrium data of CB on the two HSZs showed dissimilarities that are particularly evident in the adsorption data concerning the low concentration range, where Y zeolite is characterized by low adsorption. On the contrary, at higher solution concentrations the adsorption capacity of Y is higher than that of ZSM-5. The crystalline structures of Y and ZSM-5 saturated with CB were investigated by X-ray diffraction (XRD) techniques. Rietveld refinement analyses of XRD data allowed for quantitative probing of the structural modifications of both zeolites after CB adsorption and provided insight into the preferred zeolite adsorption sites in both microporous materials. The refined framework-extraframework bond distances confirm that interactions between the selected organic contaminant and hydrophobic zeolites are mediated via co-adsorbed H2O. The occurrence of H2O -CB-framework oxygen oligomers explains variations in both the unit cell parameters and the shape of the channels, clearly confirming that water plays a very relevant role in controlling the diffusion and adsorption processes in hydrophobic zeolites. [ABSTRACT FROM AUTHOR]

Purpose: During economic recession people with mental health problems have higher risk of losing their job. This paper analyses the issue by considering the Italian rates of unemployment amongst individuals with and without mental health problems in 2005 and 2013, that is prior and during the economic crisis. Methods: We used data from the National surveys on “Health conditions and use of health services” carried out by the Italian National Institute of Statistics (ISTAT) for the years 2005 and 2013. The surveys collected information on the health status and socioeconomic conditions of the Italian population. Self-reported unemployment status was analysed amongst individuals with and without reported mental health problems. In addition, descriptive statistics were performed in order to detect possible differences in the risk of unemployment within different regional contexts characterised by different socio-economic conditions. Results: The recession determined increased disparities in unemployment rates between people with and without mental health problems. Regardless to the presence of mental health problems, young people were more likely to be unemployed. Among people who reported mental health problems, males were more likely to be unemployed than females. People with low education level were more likely to be unemployed, particularly during the recession and in presence of mental health problems. Changes in unemployment rates due to the crisis showed different patterns across different regions of the Country. Conclusions: These analyses confirm that in periods of economic crisis people with mental health problems are at risk of experiencing exclusion from labour market. In addition, the impact is even worse within the group with low education and younger age. These findings emphasise the importance of specific interventions aimed at promoting labour market participation and reintegration for people with mental health problems. [ABSTRACT FROM AUTHOR]

The temperature-induced desorption of methyl tert-butyl ether (MTBE) from aqueous solutions onto hydrophobic ZSM-5 was studied by in situ synchrotron powder diffraction and chromatographic techniques. This kind of information is crucial for designing and optimizing the regeneration treatment of such zeolite. The evolution of the structural features monitored by full profile Rietveld refinements revealed that a monoclinic (P21/n) to orthorhombic (Pnma) phase transition occurred at about 100 °C. The MTBE desorption process caused a remarkable change in the unit-cell parameters. Complete MTBE desorption was achieved upon heating at about 250 °C. Rietveld analysis demonstrated that the desorption process occurred without any significant zeolite crystallinity loss, but with slight deformations in the channel apertures. [ABSTRACT FROM AUTHOR]

The adsorption of toluene from aqueous solutions onto hydrophobic zeolites was studied by combining chromatographic, thermal and structural techniques. Three beta zeolites (notated BEAs, since they belong to BEA framework type), with different SiO2/Al2O3 ratios (i.e., 25, 38 and 360), before and after calcination, were tested as adsorbents of toluene from aqueous media. This was performed by measuring the adsorbed quantities of toluene onto zeolites in a wide concentration range of solute. The adsorption data were fitted with isotherms whose models are based on surface heterogeneity of the adsorbent, according to the defective structure of beta zeolites. The thermal treatment considerably increases the adsorption of toluene, in the low concentration range, on all BEAs, probably due to surface and structural modifications induced by calcination. Among the calcined BEAs, the most hydrophobic zeolite (i.e., that with SiO2/Al2O3 ratio of 360) showed the highest binding constant, probably due to its high affinity for an organophilic solute such as toluene. The high sorption capacity was confirmed by thermogravimetric analyses on BEAs, before and after saturation with toluene. [ABSTRACT FROM AUTHOR]

This paper aims at analysing two relevant dimensions of well-being: living a healthy life and social interaction. A link between the two dimensions of well-being has been highlighted in the literature. The model assumes that both these concepts, i.e. social interaction and healthy life, are latent and manifest themselves through a number of indicators. The indicators adopted are those available in the 2011 ISTAT survey on social inclusion of people with disability in Italy by comparing the well-being attainments with respect to the different levels of functional limitations. In this paper the available indicators are used simultaneously to study the level of social interaction and health through a multiple indicators multiple causes model. This allows us to deal directly with endogeneity issues. Results show that women have a lower achievement in social interaction and in health. Moreover, differences occur in the effect of the observable exogenous variables included in the model with a larger negative effect of ageing for women on their health status and a higher negative effect of ageing for men on social interaction. Education plays a significant role only for women for the healthy life dimension. Finally, the latent variable on social interaction has been found to positively affect, consistently with the literature, the health dimension. [ABSTRACT FROM AUTHOR]

During the last decades, the socio-economic policy agenda has devoted an increasing attention to the inclusion of disabled people into society. It follows that understanding the drivers of life outcomes and conditions of disabled people is essential to analyze the sources of disadvantaged positions. This paper brings evidence on the predictors of life satisfaction of disabled people in Italy, focusing on four specific dimensions (relations with relatives and friends, economic conditions, and leisure time) and analyzing information on people with functional limitations and health problems, as provided by the 2011 ISTAT survey. Estimation results show that household structure, health and disability status affect life satisfaction more significantly than personal and income variables. Education attainments significantly affect satisfaction with the economic conditions. In addition, support in daily activities may increase satisfaction with economic conditions and leisure time, suggesting that providing non-monetary support would be effective in increasing life satisfaction, especially in those domains requiring freedom of movement. Finally, we find that older disabled people are, on average, more satisfied than younger disabled people, while gender is relevant when interacted with the household type. [ABSTRACT FROM AUTHOR]

Background: The Great Recession has caused worldwide tangible costs in terms of cuts in employment and income, which have been widely recognised also as major social determinants of mental health. Italy has not been spared from the financial crisis with severe societal and mental health consequences. In addition, a strong earthquake hit the province of Modena, Italy, in 2012, that is, amid the crisis. Aims: In this study, we explored and investigated the possible additional impact of concurrent events such as economic crisis and a natural disaster. Methods: Our analysis elaborated data from two local surveys, ICESmo2 (2006) and ICESmo3 (2012), and a national survey carried out in 2013 by the Italian National Institute of Statistics (Istituto Nazionale di Statistica (ISTAT)). A regression model was adopted to distinguish the effect of the crisis and the earthquake. Results: Our analysis confirmed the negative effect of the economic crisis on psychological wellbeing, but within the province of Modena such an effect resulted as even stronger compared with the rest of Italy, particularly within those areas struck by the earthquake. Conclusion: Being hit by a combination of two major negative events might have a significantly increased negative effect on psychological health. The higher repercussion observed is not only attributable to the occurrence of a natural disaster but can be reasonably related to the additional effect of unemployment on psychological dimensions. [ABSTRACT FROM AUTHOR]

We present a capillary electrophoresis method for determining two different C8-conjugated deoxyadenosines, and for oligonucleotides containing them, in which a psoralen or an acridine molecule is bonded to the base via a short alkyl chain containing sulfur ethers at both ends. The sensitivity of the micellar electrokinetic chromatography (MEKC) method was increased by using two preconcentration techniques, micro solid-phase extraction (μSPE) followed by reversed-electrode-polarity stacking mode (REPSM). Variables that affect the efficiency of the extraction in μSPE and preconcentration by REPSM, including the type and volume of extraction nanoparticle, concentration, and injection time, were investigated. Under the optimum conditions, enrichment factors obtained were in the range 360-400. The limits of detection (LODs) at a signal-to-noise ratio of 3 ranged from 2 to 5 nmol L. The relative recoveries of labelled adenosines from water samples were 95-103 %. The proposed method provided high enrichment factors and good precision and accuracy with a short analysis time. On the basis of the advantages of simplicity, high selectivity, high sensitivity, and good reproducibility, the proposed method may have great potential for biochemical applications. [Figure not available: see fulltext.] [ABSTRACT FROM AUTHOR]

Removal of perfluorinated alkylated substances (PFAS) such as perfluorooctanoic acid (PFOA) from aqueous solution is an actual topic in light of their widespread diffusion and their persistence in the environment. The process of adsorption has been identified as an effective technique to eliminate PFAS in water, however the process efficiency strongly depends on the adsorbents employed (silica, alumina, activated carbon, layer doubled hydroxides). In this work three nanostructured mesoporous silica materials of similar pore diameter (~4 nm) featuring high surface area (~900 m/g) and high pore volume (0.7-1.0 mL/g) were evaluated in PFOA removal: calcined MCM-41 (MCM-41c), calcined hexagonal mesoporous silica (HMSc) and HMSe obtained after ethanol extraction of the amine templates from HMS. Sorption kinetics and isotherms were performed at PFOA concentrations from 10 µg/L to 10 mg/L. It appeared that HMSe showed much faster and higher adsorption capacity for PFOA than the other tested adsorbents (MCM-41c and HMSc) whatever the pH of the solution (5 < pH < 9). Thermogravimetric analysis of HMSe evidenced that the ethanol extraction of the templating amines was not complete (70 %) and HMSe possessed some remaining hexadecylamine (HDA) (0.08 mol amine per mol SiO) on the surface conferring some hydrophobic properties to the adsorbent and also some probable complex formation between anionic PFOA and protonated HDA. Indeed, the incomplete amine extraction is surely due to the presence of protonated HDA in strong electrostatic interactions with SiO avoiding their removal by simple ethanol extraction as for H-bonding amine with Si-OH groups. Considering both adsorption isotherms and adsorption kinetics, PFOA could be efficiently removed from contaminated water in a wide range of concentration by an environmental friendly adsorbent as HMSe. [ABSTRACT FROM AUTHOR]

The current study was designed to demonstrate the efficiency of selected zeolites in the immobilization of heavy metals and volatile organic compounds from water in the industrial area of Tito Scalo (Basilicata Region in Southern Italy). The efficiency of zeolite materials has been evaluated by analyzing real water samples, by a multi-technique approach. Gas chromatography (GC) and inductively coupled plasma optical emission spectrometry (ICP-OES) were selected for the detection of volatile organic compounds (VOCs) and heavy metals respectively, and then by thermal analysis (TG, DTA) and X-ray powder diffraction (XRD) to verify the presence of contaminants in the structural channels of the adsorbents. ZSM-5 zeolite (MFI topology) was suitable for volatile organic compounds, showing removal efficiencies 87%. 13X (FAU topology) was more selective for in situ abatements of heavy metals, with efficiencies up to 100%. After VOCs and heavy metals removal, structure refinements of loaded zeolites highlighted variations of both lattice parameters and extraframework content confirming the pollutants immobilization in the framework microporosities. The occurrence of these species was also confirmed by DTA curves showing different phenomena explained on the basis of the nature and number of extraframework species hosted in the zeolite micropores. [ABSTRACT FROM AUTHOR]

The present work focused on the use of high-silica commercial zeolites as sorbent media for pharmaceuticals in an aqueous matrix. As drug probes, ketoprofen, hydrochlorothiazide, and atenolol were selected, because of their occurrence in surface waters and effluents from wastewater treatment plants. Pharmaceuticals adsorption was evaluated for two Faujasite topology zeolites with Silica/Alumina Ratio 30 and 200. The selected zeolites were demonstrated to be efficient sorbents towards all investigated pharmaceuticals, thanks to their high saturation capacities (from 12 to 32% w/w) and binding constants. These results were corroborated by thermal and structural analyses, which revealed that adsorption occurred inside zeolite's porosities, causing lattice modifications. Finally, zeolites have been tested as a pre-concentration media in the dispersive-solid phase extraction procedure. Recoveries higher than 95% were gained for ketoprofen and hydrochlorothiazide and approximately 85% for atenolol, at conditions that promoted the dissolution of the neutral solute into a phase mainly organic. The results were obtained by using a short contact time (5 min) and reduced volume of extraction (500 µL), without halogenated solvents. These appealing features make the proposed procedure a cost and time saving method for sample enrichment as well as for the regeneration of exhausted sorbent, rather than the more energetically expensive thermal treatment. [ABSTRACT FROM AUTHOR]