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Evidence of inequality in the utilisation of mental health care (MHC) by adolescents in Nordic countries is mixed. This study aims to investigate if there are socioeconomic differences in the utilisation of MHC, while accounting for adolescents' mental health status. We analysed a cohort of 3517 adolescents, followed from 7 to 9th grade (ages 13–16), to examine the association between parental socioeconomic position (SEP: education and disposable income), adolescents' estimated needs, and the utilisation of MHC (defined as visits to secondary psychiatric care or receipt of psychotropic medication). Logistic and negative binomial regression models, with mental health status as moderator, were used to predict utilisation during each grade. Lower SEP predicted higher odds of utilising MHC in adolescents with no/mild symptoms (e.g., odds ratio, OR = 1.33, 95% CI 1.04–1.72, lower vs highest education), but not in those with moderate-to-severe symptoms (estimates close to one and non-significant). This pattern was largely explained by treatment of attention deficit hyperactivity disorder/autism spectrum disorders (ADHD/ASD) in boys. For girls with severe symptoms, lower SEP predicted reduced odds of utilising MHC for other mental disorders (OR = 0.48, 95% CI 0.25–0.92, lower education), and fewer outpatient visits when in contact with such care, although non-significant (incidence rate ratio, IRR = 0.51, 95% CI 0.25–1.05, lowest vs highest income). Our findings suggest a more equitable use of MHC for treating ADHD/ASD, but not other mental disorders such as depression and anxiety, particularly among girls. [ABSTRACT FROM AUTHOR]

Background: The psychosis continuum implies that subclinical psychotic experiences (PEs) can be differentiated from clinically relevant expressions since they are not accompanied by a 'need for care'. Methods: Using data from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; N = 34 653), the current study examined variation in functioning, symptomology and aetiological risk across the psychosis phenotype [i.e. variation from (i) no PEs, 'No PEs' to (ii) non-distressing PEs, 'PE-Experienced Only' to (iii) distressing PEs, 'PE-Impaired' to (iv) clinically defined psychotic disorder, 'Diagnosed']. Results: A graded trend was present such that, compared to those with no PEs, the Diagnosed group had the poorest functioning, followed by the PE-Impaired then PE-Experienced Only groups. In relation to symptom expression, the PE-Impaired group were more likely than the PE-Experienced Only and the Diagnosed groups to endorse most PEs. Predictors of group membership tended to vary quantitatively rather than qualitatively. Trauma, current mental health diagnoses (anxiety and depression) and drug use variables differentiated between all levels of the continuum, with the exception of the extreme end (PE-Impaired v. Diagnosed). Only a few variables distinguished groups at the upper end of the continuum: female sex, older age, unemployment, parental mental health hospitalisation and lower likelihood of having experienced physical assault. Conclusions: The findings highlight the importance of continuum-based interpretations of the psychosis phenotype and afford valuable opportunities to consider if and how impairment, symptom expression and risk change along the continuum. [ABSTRACT FROM AUTHOR]

Background: Dementia poses a growing challenge for individuals, healthcare, social support, and society amidst the ongoing ageing of populations. To evaluate the care requirements and social implications of dementia in Germany, reliable statistics regarding its current and future occurrence are necessary. Methods: Using existing data sources and recent research results, this paper compiles and analyses relevant statistics on the occurrence of dementia in Germany, presents protective and risk factors, and options for care provision. Results: Recent projections indicate a potential surge in the number of dementia patients in Germany, predicted to rise from 1.7 million at present to up to 3.0 million by the year 2070. Cognitive and motor deterioration and behavioural changes associated with dementia lower the ability to live independently. These changes are often tied to social exclusion and stigma and, particularly in the severe phase of the disease, necessitate extensive medical and care requirements. This contributes to dementia being one of the most costly diseases at old age from an overall societal perspective. Currently, there are no curative treatment options available. Conclusions: To reduce the increase in the number of dementia patients and associated costs in the future, preventive approaches, particularly promoting a healthy lifestyle, may prove effective. Simultaneously, the healthcare system, society, and caregivers must prepare for the increasing number of dementia patients. Improved diagnostics, new forms of therapy, and social innovations that support those who are affected and their relatives can help reduce the burden of dementia and its associated costs.

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Objective: This article aimed to investigate the needs of caregivers of patients with palliative neurological problems and contribute to the solution proposals. Material-method: Phenomenological research design, a qualitative research design, was used in the study. The article was conducted with 16 relatives of patients with palliative neurological problems. The interviews were conducted using face-to-face in-depth semi-structured interview form. Colaizzi's phenomenological analysis method used for the analyse. Results: In the analysis of the data, three categories, eight main themes, and seventeen sub-themes emerged. As a result of the interviews with the participants, the category of the effect of neurological palliative disease on the quality of life of individuals was gathered under three main themes, namely mental, physical, and social effects, and in the process of coping with the disease requiring neurological palliative care, two main themes were identified as emotion-focused coping and problem-focused coping. Conclusion: It was concluded in our study that having a patient in palliative care has psychological, social, and physical effects on the relatives of the patients. The burden of caregiving mostly affects the relatives of patients negatively. Relatives of patients mostly need time for themselves, moral support, and companion support. [ABSTRACT FROM AUTHOR]

Knowledge on determinants of children's psychosocial care use is important to improve their access to care. This study examined the independent contributions of need and predisposing factors to psychosocial care use in 9-year-old children, guided by the Gateway Provider Model. Data of the Generation R Study, a prospective cohort of children born in Rotterdam, the Netherlands, were analysed using multivariable logistic regression (n = 4714). Need (quality of life, presence and type of emotional/behavioural problems) and predisposing factors (sex, ethnic background and maternal educational level) were measured using parent questionnaires at multiple time points between ages 1.5 and 9 years. Psychosocial care use was parent-reported at 9 years old (9.6% among children with Western background, 7.3% among children with non-Western background). Having emotional/behavioural problems at 5 and 9 years old was associated with more care use, while having a higher quality of life, being a girl and having a Moroccan/Turkish or other non-Western background were associated with less care use. Externalising and internalising problems, as well as several types of problems, at 5 and 9 years old were associated with psychosocial care use. Stratified analyses revealed that, in children with non-Western backgrounds, only a poorer psychosocial quality of life was associated with psychosocial care use. To conclude, girls with a Western background and children with a non-Western background were less likely to receive care compared to their peers. Children with parent-reported emotional/behavioural problems at 5 and 9 years old and decreased quality of life at 5 years old were more likely to receive psychosocial care use at 9 years old. Our findings hold relevance for preventive policies. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Health Sciences / Türkiye Klinikleri Sağlık Bilimleri Dergisi is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In the international literature, the principal task of grandparents is generally recognized as helping their children in providing childcare. Most of those studies analyzed grandparental childcare on the whole population, and few have focused on co-resident grandparent(s), which turns out to be an understudied topic in the European context. Further, most of them investigated the effect of childcare on grandparents’ health status. However, the elderly population can both provide and receive care. Using two Italian surveys released by the Italian National Institute of Statistics, the “Social Condition and Integration of Foreign Citizen (2011–2012)” and the “Multiscopo–Aspetti della vita quotidiana (2011)”, the study aims to analyze differences in grandparental childcare provided by co-resident grandparents between Italian and migrant households, considering both the role played by grandparents’ self-rated health (SRH) and gender. We identify four grandparents’ profiles by combining grandparents’ SRH and their attitude towards looking after their grandchild(ren). Subsequently, we apply multinomial logistic regressions, and we compute average marginal effects to facilitate results interpretations. Results display that migrant co-resident grandparents are less likely to declare bad SRH and no-childcare and are more likely to declare good SRH and to provide childcare than Italian grandparents. Moreover, when considering gender differences, the real role is revealed: we find that women have a higher probability to report poor health and care for their grandchild(ren) than men. Such findings illustrate that grandparents’ cohabitation decision is based upon the difference between their need for care and offer to care, and second, in addition to migrant status and SRH, gender is a determinant of grandparents’ childcare: women look after their grandchild(ren) more than men, whatever their health status.

Abstract Background Comorbid depression is common in patients with type 2 diabetes (DM2) and/or coronary heart disease (CHD) and is associated with poor quality of life and adverse health outcomes. However, little is known about patients’ and practice nurses’ (PNs) perceptions of depression. Tailoring care to these perceptions may affect depression detection and patient engagement with treatment and prevention programs. This study aimed to explore patients’ and PNs’ perceptions of depression in patients with DM2/CHD screened for subthreshold depression. Methods A qualitative study was conducted as part of a Dutch stepped-care prevention project. Using a purposive sampling strategy, data were collected through semi-structured interviews with 15 patients and 9 PNs. After consent, all interviews were recorded, transcribed verbatim and analyzed independently by two researchers with Atlas.ti.5.7.1 software. The patient and PN datasets were inspected for commonalities using a constant comparative method, from which a final thematic framework was generated. Results Main themes were: illness perception, need for care and causes of depression. Patients generally considered themselves at least mildly depressed, but perceived severity levels were not always congruent with Patient Health Questionnaire 9 scores at inclusion. Initially recognizing or naming their mental state as a (subthreshold) depression was difficult for some. Having trouble sleeping was frequently experienced as the most burdensome symptom. Most experienced a need for care; psycho-educational advice and talking therapy were preferred. Perceived symptom severity corresponded with perceived need for care, but did not necessarily match help-seeking behaviour. Main named barriers to help-seeking were experienced stigma and lack of awareness of depression and mental health care possibilities. PNs frequently perceived patients as not depressed and with minimal need for specific care except for attention. Participants pointed to a mix of causes of depression, most related to negative life events and circumstances and perceived indirect links with DM2/CHD. Conclusion Data of the interviewed patients and PNs suggest that they have different perceptions about (subthreshold) depressive illness and the need for care, although views on its causes seem to overlap more.

Background: Older adults in Iceland have good access to social services that support them in maintaining an independent life, although receiving informal care is common for community living older adults in Iceland. The aim of this study was to examine whether the need for care as well as receiving formal and informal care is associated with education among older adults in Iceland. Methods: Among a national sample of 782 Icelandic community dwelling old adults (mean age 76.9 ± 7.4 years, 55% women), a telephone survey was conducted. The survey included questions on: socioeconomic status, social network, health status, activities of daily living and formal/informal care. Results: A full data set was available for 720 subjects and among these, 349 (48.5%) had no need for care, 197 (27.4%) received informal care only, 31 (4.3%) received formal care only, and 143 (19.9%) received both type of care. Participants with higher education were significantly less likely to need care (OR 0.67, 95% CI, 0.47–0.97, p = 0.031) when compared with those who had primary education. Categorisation by age showed that this difference was only significant in participants younger than 80 years. Education was not related to formal care, but adults with higher education were less likely to receive informal care compared with older adults who had primary education (OR: 0.65, 95%CI: 0.46, 0.93, p = 0.018). Conclusions: People with higher education were significantly less likely to need care and this association was mainly present among those aged below 80 years. Further, in participants that needed care, the likelihood of receiving informal care was lower in highly educated participants, but no differences in formal care were observed between educational levels. [ABSTRACT FROM AUTHOR]

Abstract Background It is most likely that the need for long-term care increases considerably in the next decades due to demographic shifts. Thus, we aimed at identifying the preferences for characteristics of professional long-term caregivers among old age individuals in Germany. Methods Data were gathered from a population-based survey of the German population aged 65 and above in 2015 (n = 1006). Results It was important for individuals in old age that long-term caregivers were ‘empathetic, kind’ (99.3%), ‘punctual, reliable’ (98.2%), have an ‘orderly appearance’ (96.4%), work in a ‘small team’ (92.5%) and have ‘enough time’ (91.5%). Moreover, while most of the individuals (76.5%) reported high preferences for ‘German language’, the preferences were lower for ‘same cultural background’ (54.2%) and ‘same gender’ (35.7%). In multiple logistic regressions, preferences for ‘same gender’ were positively associated with being female [OR 8.3 (5.6–12.1)], living with partner or spouse [OR 1.4 (1.0–1.9)], and being born abroad [OR 1.8 (1.1–3.1)]. Preferences for ‘German language’ were positively associated with being female [OR: 1.5 (1.1–2.1)]. Preferences for ‘same cultural background’ were positively associated with age [OR 1.0 (1.0–1.1)], living with partner or spouse [OR 1.4 (1.0–1.9)], and East Germany [OR 1.9 (1.3–2.7)]. Preferences for ‘orderly appearance’, ‘empathetic, kind’, ‘punctual, reliable’ and ‘small nursing team’ were all not significantly associated with included independent variables, whereas preferences for ‘enough time’ were positively associated with being female [OR 1.9 (1.1–3.5)], living with partner or spouse [OR 1.9 (1.1–3.4)], education [Apprenticeship, full-time vocational school, OR 3.1 (1.3–7.6)], not providing care for family/friends [OR 1.9 (1.1–3.3)], and involvement in the issue of need for care [OR 1.3 (1.1–1.6)]. Conclusions Our data suggest that it is important to almost every individual aged 65 and above in Germany that professional long-term caregivers are (i) empathetic, kind, and understanding, (ii) punctual and reliable, (iii) have enough time (e.g., for conversation), (iv) and have an orderly appearance. Furthermore, several factors such as gender or region were found to be associated with preferences for characteristics of caregivers. By knowing these factors, nursing services can tailor their activities to the needs of care-recipients.

Background: Steadily increasing numbers of older people and people in need of care represent critical challenges for today's society. In the last years, diverse (health-related) technologies have been developed to facilitate living at home for older people but also to support (professional) care personnel in their daily care efforts. Ambient Assisted Living (AAL) technologies have the potential to enhance safety, support medical therapy, or facilitate everyday chores and social life. With the huge range and variety of technical opportunities, the question arises what influences (potential) users' decisions for the right technology in their individual conditions and situations. In particular with regard to the fragility of the care situation, it is unknown which technologies are desired for different care needs and diverse situations.Objectives: The present study investigates (1) personal care needs as a potential influencing parameter for technology acceptance and (2) the selection of specific technologies.Method: In an online questionnaire (including n = 162 people of all ages), technology acceptance and the selection of specific technologies was assessed, using two scenarios differing in their personal care needs (low care needs vs. moderate care needs) in two situational contexts (emergency detection vs. medical reminders).Results: Personal care needs influence the perception of benefits, barriers, and general acceptance of assisting technologies, independent from situational context. Higher needs for care lead to higher acknowledgements of the technology's benefits, lower agreements or, in parts, higher rejections of potential barriers and higher acceptance. The two care situations differ regarding the participants' preferences for technologies: For emergency detection, smart watches and emergency buttons are clearly accepted. In contrast, cameras are consistently rejected. For situations in which medical reminders are used, smartphone and smartwatches are most wanted, whereas audio assistants and smart TV were rather rejected.Conclusions: The results provide insights into users' preferences for specific technologies for the purpose of emergency detection and medical reminders as well as for the important influence of personal care needs. These insights can be used to derive user-tailored solutions of technology configurations for specific care needs and situations. [ABSTRACT FROM AUTHOR]

Recent research has shown that markers of biological age, such as leukocyte telomere length (LTL), epigenetic clocks and the frailty index (FI) are predictive of mortality and age-related diseases. However, whether these markers associate with the need for care in old age, thereby having utility in reflecting dependency, is unclear. This study was undertaken to analyze whether LTL, two epigenetic clocks—the DNA methylation age (DNAmAge) and DNAm PhenoAge—and the FI are associated with the need for regular care in up to 604 individuals (aged 48–94 years) participating in the Swedish Adoption/Twin Study of Aging. Need for regular care was defined as receiving formal or informal help in daily routines at least once per week. Logistic regression adjusted for age, sex and education was used in the analysis. The predictive accuracies, assessed as the area under the curve (AUC) for the significant biological age measures were further compared to the accuracies of the limitations in activities of daily living (ADL) and instrumental ADL (IADL). Neither LTL nor the epigenetic clocks were associated with the need for care, whereas the FI was; odds ratio for 10% increase in FI 3.54 (95% confidence interval 2.32–5.41). The FI also demonstrated higher predictive accuracy than the ADL score (FI AUC 0.80 vs. ADL score AUC 0.62; p < 0.001 for equality of the AUCs), whereas the difference between FI AUC (0.80) and IADL score AUC (0.75) was not significant (p = 0.238). The FI might thus be a useful marker for the need for care. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to identify correlates of service utilization and perceived need for care among college students with suicidal ideation. Participants: Respondents were recruited from introductory psychology courses at an undergraduate college during the Fall 2014 semester. Methods: Independent correlates of (1) mental health service utilization, (2) self-perceived need, and (3) other-perceived need for mental health services among college students (N = 190) with suicidal ideation were identified. Results: Service utilization was associated with need for care as perceived by others. Perceived need for care by others was associated with suicidal ideation intensity and suicide attempt history. Perceived need by the respondents themselves was correlated with depression severity, sex, and race but was not independently associated with actual service utilization. Conclusions: Perceived need by others was the sole significant correlate of service utilization, suggesting it is an important target for public health interventions aimed at facilitating pathways into mental health treatment. [ABSTRACT FROM AUTHOR]

Background: Dementia poses a growing challenge for individuals, healthcare, social support, and society amidst the ongoing ageing of populations. To evaluate the care requirements and social implications of dementia in Germany, reliable statistics regarding its current and future occurrence are necessary., Methods: Using existing data sources and recent research results, this paper compiles and analyses relevant statistics on the occurrence of dementia in Germany, presents protective and risk factors, and options for care provision., Results: Recent projections indicate a potential surge in the number of dementia patients in Germany, predicted to rise from 1.7 million at present to up to 3.0 million by the year 2070. Cognitive and motor deterioration and behavioural changes associated with dementia lower the ability to live independently. These changes are often tied to social exclusion and stigma and, particularly in the severe phase of the disease, necessitate extensive medical and care requirements. This contributes to dementia being one of the most costly diseases at old age from an overall societal perspective. Currently, there are no curative treatment options available., Conclusions: To reduce the increase in the number of dementia patients and associated costs in the future, preventive approaches, particularly promoting a healthy lifestyle, may prove effective. Simultaneously, the healthcare system, society, and caregivers must prepare for the increasing number of dementia patients. Improved diagnostics, new forms of therapy, and social innovations that support those who are affected and their relatives can help reduce the burden of dementia and its associated costs., Competing Interests: Conflicts of interest The authors declared no conflicts of interest., (© Robert Koch Institute. All rights reserved unless explicitly granted.)

Background: In 2009, statutory regulations on information and counselling regarding nursing care needs, performed by so-called care advisors have been implemented for persons in need of long-term care and their relatives. In order to adequately prepare these care advisors, contemporary needs and requirements must be determined. The aim of the study was to determine the different needs of persons in need of long-term care and their relatives., Method: Care advisors were interviewed via an online survey tool using a standardized questionnaire. A 5-point Likert scale was used to determine the needs regarding information and advice on 16 specific topics. In general, overall needs regarding information and advice of care recipients and relatives were recorded using a 10-point scale (1 low and 10 high). Using classification and regression trees (CRT) and random forest, the correlation between the individual main topics and the general need for advice was analyzed., Results: The participating care advisors (n = 276) rated the general demand for information of people in need of care and their relatives with a mean of 7.8 and 9.2, respectively. For those in need of care, the strongest association of general information needs was the topic of housing advice For the relatives, the topic social law aspects and benefits was the most relevant association., Conclusion: The general demand for information was rated very high. Since differences became obvious between those in need of care and their relatives, it is necessary to adjust care advice for these two groups., (© 2022. The Author(s).)

Background: It is most likely that the need for long-term care increases considerably in the next decades due to demographic shifts. Thus, we aimed at identifying the preferences for characteristics of professional long-term caregivers among old age individuals in Germany. Methods: Data were gathered from a population-based survey of the German population aged 65 and above in 2015 (n = 1006). Results: It was important for individuals in old age that long-term caregivers were 'empathetic, kind' (99.3%), 'punctual, reliable' (98.2%), have an 'orderly appearance' (96.4%), work in a 'small team' (92.5%) and have 'enough time' (91.5%). Moreover, while most of the individuals (76.5%) reported high preferences for 'German language', the preferences were lower for 'same cultural background' (54.2%) and 'same gender' (35.7%). In multiple logistic regressions, preferences for 'same gender' were positively associated with being female [OR 8.3 (5.6-12.1)], living with partner or spouse [OR 1.4 (1.0-1.9)], and being born abroad [OR 1.8 (1.1-3.1)]. Preferences for 'German language' were positively associated with being female [OR: 1.5 (1.1-2.1)]. Preferences for 'same cultural background' were positively associated with age [OR 1.0 (1.0-1.1)], living with partner or spouse [OR 1.4 (1.0-1.9)], and East Germany [OR 1.9 (1.3-2.7)]. Preferences for 'orderly appearance', 'empathetic, kind', 'punctual, reliable' and 'small nursing team' were all not significantly associated with included independent variables, whereas preferences for 'enough time' were positively associated with being female [OR 1.9 (1.1-3.5)], living with partner or spouse [OR 1.9 (1.1-3.4)], education [Apprenticeship, fulltime vocational school, OR 3.1 (1.3-7.6)], not providing care for family/friends [OR 1.9 (1.1-3.3)], and involvement in the issue of need for care [OR 1.3 (1.1-1.6)]. Conclusions: Our data suggest that it is important to almost every individual aged 65 and above in Germany that professional long-term caregivers are (i) empathetic, kind, and understanding, (ii) punctual and reliable, (iii) have enough time (e.g., for conversation), (iv) and have an orderly appearance. Furthermore, several factors such as gender or region were found to be associated with preferences for characteristics of caregivers. By knowing these factors, nursing services can tailor their activities to the needs of care-recipients. [ABSTRACT FROM AUTHOR]

This study explored determinants of perceived need for care among male inmates of general prison wards in Amsterdam (N = 208) with a normative need for care. Also, it assessed the relation between perceived need for care and criminal recidivism. Normative need for care was defined as having a mental health problem, assessed with the Brief Jail Mental Health Screen, or being substance dependent. Perceived need for care was defined as a subjective problem experience and a wish to receive care. Mental health and/or addiction problems were highly prevalent (68%). Of those inmates, only 29% had a perceived need for care. Age and borderline personality disorder were associated with perceived need for care, prior care utilization intermediated these associations. No direct relation between perceived need for care and criminal recidivism was observed. All inmates should be well screened and the benefits of mental health care should be promoted. [ABSTRACT FROM AUTHOR]

Introduction: Illness is a test both for those who are suffering and their families. Patients and their beloved ones are going through several stages until they finally accept the disease and try to deal with it. A series of negative effects could rise from care provision only offered to patients, and hence, ignoring the needs and health problems of their caregivers. Method: The articles of this review were identified by searching the databases of PubMed, Scopus and Google Scholar and specific identified articles. Results: Support to the caregivers should be available during all the stages of the disease: a) during the diagnosis, b) at home after treatments, c) during check-ups and d) in the final stage. The primary needs of informal caregivers should include: a) psychological support, b) financial support, c) spiritual support, d) burden relief and e) communication, education and information. Conclusions: As shown in the collected data, there are many factors that may limit the caregivers" ability to continue providing care to their beloved ones. The caregivers feel responsible for the patients but get tired as the disease progresses. The role of the health care professional is pivotal in all stages of the disease process by supporting both the patient and the caregiver. [ABSTRACT FROM AUTHOR]

Copyright of Zeitschrift für Gerontologie und Geriatrie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Resources for coronary revascularisations have increased substantially since the early 1990s in Finland. At the same time, ischaemic heart disease (IHD) mortality has decreased markedly. This study aims to examine how these changes have influenced trends in absolute and relative differences between socioeconomic groups in revascularisations and age group differences in them using IHD mortality as a proxy for need. Methods: Hospital Discharge Register data on revascularisations among Finns aged 45-84 in 1995-2010 were individually linked to population registers to obtain socio-demographic data. We measured absolute and relative income group differences in revascularisation and IHD mortality with slope index of inequality (SII) and concentration index (C), and relative equity taking need for care into account with horizontal inequity index (HII). Results: The supply of procedures doubled during the years. Socioeconomic distribution of revascularisations was in absolute and relative terms equal in 1995 (Men: SII = -12, C = -0.00; Women, SII = -30, C = -0.03), but differences favouring low-income groups emerged by 2010 (M: SII = -340, C = -0.08; W: SII = -195, C = -0.14). IHD mortality decreased markedly, but absolute and relative differences favouring the better-off existed throughout study years. Absolute differences decreased somewhat (M: SII = -760 in 1995, SII = -681 in 2010; W: SII = -318 in 1995, SII = -211 in 2010), but relative differences increased significantly (M: C = -0.14 in 1995, C = -0.26 in 2010; W: C = -0.15 in 1995, C = -0.25 in 2010). HII was greater than zero in each year indicating inequity favouring the better-off. HII increased from 0.15 to 0.18 among men and from 0.10 to 0.12 among women. We found significant and increasing age group differences in HII. Conclusions: Despite large increase in supply of revascularisations and decrease in IHD mortality, there is still marked socioeconomic inequity in revascularisations in Finland. However, since changes in absolute distributions of both supply and need for coronary care have favoured low-income groups, absolute inequity can be claimed to have decreased although it cannot be quantified numerically. [ABSTRACT FROM AUTHOR]

Background: Long-term care is one of the most pressing health policy issues in Germany. It is expected that the need for long-term care will increase markedly in the next decades due to demographic shifts. The purpose of this study was to investigate the factors associated with preferences for long-term care settings in old age individuals in Germany.Methods: Based on expert interviews and a systematic review, a questionnaire was developed to quantify long-term care preferences. Data were drawn from a population-based survey of the German population aged 65 and over in 2015 (n = 1006).Results: In multiple logistic regressions, preferences for home care were positively associated with providing care for family/friends [OR: 1.6 (1.0-2.5)], lower self-rated health [OR: 1.3 (1.0-1.6)], and no current need of care [OR: 5.5 (1.2-25.7)]. Preferences for care in relatives' homes were positively associated with being male [OR: 2.0 (1.4-2.7)], living with partner or spouse [OR: 1.8 (1.3-2.4)], having children [OR: 1.6 (1.0-2.5)], private health insurance [OR: 1.6 (1.1-2.3)], providing care for family/friends [OR: 1.5 (1.1-2.0)], and higher self-rated health [OR: 1.2 (1.0-1.4)]. Preferences for care in assisted living were positively associated with need of care [OR: 1.9 (1.0-3.5)] and higher education [for example, University, OR: 3.5 (1.9-6.5)]. Preferences for care in nursing home/old age home were positively associated with being born in Germany [OR: 1.8 (1.0-3.1)] and lower self-rated health [OR: 1.2 (1.0-1.4)]. Preferences for care in a foreign country were positively associated with lower age [OR: 1.1 (1.0-1.2)] and being born abroad [OR: 5.5 (2.7-11.2)].Conclusions: Numerous variables used are sporadically significant, underlining the complex nature of long-term care preferences. A better understanding of factors associated with preferences for care settings might contribute to improving long-term care health services. [ABSTRACT FROM AUTHOR]

Copyright of Zeitschrift für Gerontologie und Geriatrie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)