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1.
J R Soc Interface ; 21(214): 20230495, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38715320

RESUMEN

Monitoring urban structure and development requires high-quality data at high spatio-temporal resolution. While traditional censuses have provided foundational insights into demographic and socio-economic aspects of urban life, their pace may not always align with the pace of urban development. To complement these traditional methods, we explore the potential of analysing alternative big-data sources, such as human mobility data. However, these often noisy and unstructured big data pose new challenges. Here, we propose a method to extract meaningful explanatory variables and classifications from such data. Using movement data from Beijing, which are produced as a by-product of mobile communication, we show that meaningful features can be extracted, revealing, for example, the emergence and absorption of subcentres. This method allows the analysis of urban dynamics at a high-spatial resolution (here 500 m) and near real-time frequency, and high computational efficiency, which is especially suitable for tracing event-driven mobility changes and their impact on urban structures.


Asunto(s)
Censos , Humanos , Beijing , Remodelación Urbana , Población Urbana , Dinámica Poblacional
2.
JMIR Res Protoc ; 13: e55470, 2024 May 09.
Artículo en Inglés | MEDLINE | ID: mdl-38722676

RESUMEN

BACKGROUND: Substance use continues to remain a public health issue for youths in the United States. Black youths living in urban communities are at a heightened risk of poor outcomes associated with substance use and misuse due to exposure to stressors in their neighborhoods, racial discrimination, and lack of prevention education programs specifically targeting Black youths. Many Black youths, especially those who live in urban communities, do not have access to culturally tailored interventions, leaving a critical gap in prevention. Since family is a well-known protective factor against substance misuse for Black youths, it is essential to create sustainable and accessible programming that incorporates Black youths' and their families' voices to develop a suitable prevention program for them. OBJECTIVE: We aim to understand the cultural and environmental level factors that influence substance use among Black youths and develop a prevention program to increase parent-child substance use education among Black families. METHODS: This study will take place within urban cities in New Jersey such as Paterson and East Orange, New Jersey, which will be the main study sites. Both cities have a large population of Black youths and this study's team has strong ties with youths-serving organizations there. A formative, qualitative study will be conducted first. Using the first 3 steps of the ADAPT-ITT (Assessment, Decision, Adaptation, Production, Topical Experts, Integration, Training, and Testing) framework we begin the development of an intervention for Black families. Three aims will be described: aim 1, collect qualitative data from Black parents and youths aged 11-17 years from parent-child dyads (N=20) on the challenges, barriers, and facilitators to communicating about substance use; aim 2, adapt a selected evidence-based intervention for Black families and develop a family advisory board to guide the adaptation; and aim 3 assess the feasibility of the intervention through theater testing, involving the family and community advisory board. RESULTS: This study is part of a 2-year research pilot study award from the National Institutes of Drug Abuse. Data collection began in May 2023, and for aim 1, it is 95% complete. All aim 1 data collection is expected to be complete by December 30, 2023. Data analysis will immediately follow. Aim 2 activity will occur in spring 2024. Aim 3 activity may begin in fall 2024 and conclude in 2025. CONCLUSIONS: This study will be one of the few interventions that address substance use among youths and uses parents and families in urban communities as a protective factor within the program. We anticipate that the intervention will benefit Black youths not only in New Jersey but across the nation, working on building culturally appropriate, community-specific prevention education and building on strong families' relationships, resulting in a reduction of or delayed substance use. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/55470.


Asunto(s)
Negro o Afroamericano , Relaciones Padres-Hijo , Trastornos Relacionados con Sustancias , Población Urbana , Humanos , New Jersey , Trastornos Relacionados con Sustancias/prevención & control , Trastornos Relacionados con Sustancias/etnología , Negro o Afroamericano/educación , Adolescente , Femenino , Masculino , Relaciones Padres-Hijo/etnología , Niño , Adulto , Educación en Salud/métodos
3.
Cien Saude Colet ; 29(5): e02662023, 2024 May.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-38747764

RESUMEN

This article aims to describe the geographical distribution of hospital mortality from COVID-19 in children and adolescents during the 2020-2021 pandemic in Brazil. Ecological, census study (SIVEP GRIPE) with individuals up to 19 years of age, hospitalized with SARS due to COVID-19 or SARS not specified in Brazilian municipalities, stratified in two ways: 1) in the five macro-regions and 2) in three urban agglomerations: capital, municipalities of the metropolitan region and non-capital municipalities. There were 44 hospitalizations/100,000 inhabitants due to COVID-19 and 241/100,000 when including unspecified SARS (estimated underreporting of 81.8%). There were 1,888 deaths by COVID-19 and 4,471 deaths if added to unspecified SARS, estimating 57.8% of unreported deaths. Hospital mortality was 2.3 times higher in the macro-regions when considering only the cases of COVID-19, with the exception of the North and Center-West regions. Higher hospital mortality was also recorded in non-capital municipalities. The urban setting was associated with higher SARS hospital mortality during the COVID-19 pandemic in Brazil. Living in the North and Northeast macro-regions, and far from the capitals offered a higher risk of mortality for children and adolescents who required hospitalization.


O objetivo deste artigo é descrever a distribuição geográfica da mortalidade hospitalar por COVID-19 em crianças e adolescentes durante a pandemia de 2020-2021 no Brasil. Estudo ecológico, censitário (SIVEP GRIPE), de indivíduos até 19 anos, internados com SRAG por COVID-19 ou SRAG não especificada, em municípios brasileiros, estratificados de duas formas: 1) nas cinco macrorregiões e 2) em três aglomerados urbanos: capital, municípios da região metropolitana e do interior. Verificou-se 44 internações/100 mil habitantes por COVID-19 e 241/100 mil ao se incluir a SRAG não especificada (subnotificação estimada de 81,8%). Ocorreram1.888 óbitos por COVID-19 e 4.471 óbitos se somados à SRAG não especificada, estimando-se subnotificação de 57,8% dos óbitos. A mortalidade hospitalar foi 2,3 vezes maior nas macrorregiões quando considerados apenas os casos de COVID-19, com exceção das regiões Norte e Centro-Oeste. Registrou-se também maior mortalidade hospitalar em municípios do interior. O contexto urbano esteve associado à maior mortalidade hospitalar por SRAG durante a pandemia de COVID-19 no Brasil. Residir nas macrorregiões Norte e Nordeste, e distante das capitais, ofereceu maior risco de mortalidade para crianças e adolescentes que necessitaram hospitalização.


Asunto(s)
COVID-19 , Mortalidad Hospitalaria , Hospitalización , Humanos , COVID-19/mortalidad , COVID-19/epidemiología , Brasil/epidemiología , Adolescente , Niño , Preescolar , Hospitalización/estadística & datos numéricos , Lactante , Adulto Joven , Índice de Severidad de la Enfermedad , Femenino , Masculino , Población Urbana/estadística & datos numéricos , Recién Nacido , Ciudades/epidemiología
4.
Braz J Biol ; 84: e283001, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38747861

RESUMEN

At present more than 50% of the human population of Planet Earth, live in urban areas. The natural environment is changed considerably by cities: increase of population, productions of tons of waste, daily, change of biodiversity. The relationships human-nature were disrupted in cities due to the artificial construction of infrastructure. In order to protect biodiversity and recover nature in cities, Urban Forest Parks, as part of green infrastructure are a very important action. At the same time the psycology of urban populations can be improved. The use of Urban Forest Parks to improve social relations, education, physical activities in older adults can improve their cognitive ability and performance.


Asunto(s)
Cognición , Bosques , Parques Recreativos , Humanos , Cognición/fisiología , Anciano , Población Urbana , Ciudades , Conservación de los Recursos Naturales
5.
PLoS One ; 19(5): e0293351, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38728317

RESUMEN

INTRODUCTION: While urban areas are often perceived to have better access to healthcare services, including modern family planning (FP) services, urban dwellers including those with better socioeconomic status are faced with multidimensional challenges that shape their access to appropriate FP services. In Uganda's urban spaces, there is currently a lack of understanding among service providers, civil society organizations, and individuals/communities regarding the implementation of interventions that promote informed choice and voluntary use of family planning services. This knowledge gap has profound implications for reproductive rights. This study seeks to enhance existing efforts towards increasing coverage and uptake of Voluntary Family Planning (VFP) in Jinja City and Iganga Municipality, central eastern Uganda. Our primary question is, "What interventions can effectively be packaged and delivered to increase the uptake of VFP among different segments of urban residents?" METHODS: We propose to use the Human-Centered Design (HCD) approach to understand the needs and challenges of users and community capabilities in ensuring access to VFP services. Co-creating with stakeholders' engagement and a data-driven-centric approach will steer design and adaptation that respond to the different population segments within the urban space. As such, the study will be implemented in three phases: formative assessment, design and implementation, and implementation monitoring and evaluation. The implementation process will incorporate robust monitoring, learning, and adaptation mechanisms. The primary focus of these mechanisms will be to utilize gathered information effectively to inform the design of the implementation and facilitate continuous learning throughout the process. The study will apply a process monitoring and evaluation approach to address questions related to what package of FP interventions work, for whom, under what circumstances and why. DISCUSSION: Guided by strong learning and implementation flexibility, we hypothesize that our implementation will provide segmentation-specific high-impact interventions in an urban context. REGISTRATION: This implementation research protocol has been registered on the Open Science Framework (OSF) repository Registries (https://osf.io/vqxu9; DOI: 10.17605/OSF.IO/VQXU9).


Asunto(s)
Servicios de Planificación Familiar , Humanos , Uganda , Ciudades , Femenino , Accesibilidad a los Servicios de Salud , Población Urbana , Masculino
6.
PLoS One ; 19(5): e0303215, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38739597

RESUMEN

Despite improvement over recent decades, childhood vaccination uptake remains a concern across countries. The World Health Organization observed that over 25 million children missed out on one or more vaccines in 2021, with urban poor and other marginalized groups being the most affected. Given the higher risk of disease transmission and vaccine-preventable diseases (VPD) outbreaks across densely populated urban slums, identifying effective interventions to improve childhood vaccination in this vulnerable population is crucial. This study explored the behavioral and social factors influencing childhood vaccination uptake in urban informal settlements in Nairobi, Kenya. A grounded theory approach was employed to develop a theoretical account of the socio-behavioral determinants of childhood vaccination. Five focus group discussions (FGDs) were conducted with purposively sampled caregivers of children under five years of age residing in informal settlements. The Theory of Planned Behavior guided the structuring of the FGD questions. An iterative process was used to analyze and identify emerging themes. Thirty-nine caregivers (median age 29 years) participated in the FGDs. From the analysis, four main thematic categories were derived. These included attitude factors such as perceived vaccine benefits, cultural beliefs, and emotional factors including parental love. Additionally, subjective norms, like fear of social judgment, and perceived behavioral control factors, such as self-control and gender-based influences, were identified. Furthermore, a number of practical factors, including the cost of vaccines and healthcare providers attitude, also affected the uptake of vaccination. Various social, behavioral, cultural, and contextual factors influence caregiver vaccination decisions in urban poor settings. Community-derived and context-specific approaches that address the complex interaction between socio-behavioral and other contextual factors need to be tested and applied to improve the timely uptake of childhood vaccinations among marginalized populations.


Asunto(s)
Población Urbana , Vacunación , Humanos , Femenino , Masculino , Vacunación/psicología , Vacunación/estadística & datos numéricos , Adulto , Población Urbana/estadística & datos numéricos , Kenia , Preescolar , Investigación Cualitativa , Cuidadores/psicología , Lactante , Grupos Focales , Conocimientos, Actitudes y Práctica en Salud , Áreas de Pobreza , Pobreza , Padres/psicología
7.
PLoS One ; 19(5): e0303492, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38739629

RESUMEN

BACKGROUND: Nutritional imbalance is an underlying cause of 2.6million death annually and a third of child's death globally. This study assessed and compared the nutritional status of primary school children and their caregiver's knowledge on malnutrition in rural and urban communities of Ekiti State. METHODS: This is a cross-sectional comparative study carried out among 983 urban and rural primary school children in Ekiti State (495 in urban and 488 in rural) using interviewer-administered semi-structured questionnaire. A multi-stage sampling technique was used and data collected was analyzed using SPSS 23 with level of statistical significance set at p < 0.05. RESULTS: Underweight and stunting were relatively higher in rural (6.5% and 22.7% respectively) than in urban (6.3% and 19.4% respectively) and these differences are not statistically significant (p = 0.898, p = 0.197). However, wasting, overweight and obesity were higher in urban (12.7%, 6.1% and 7.7% respectively) than rural (11.5%, 3.7% and 7.5% respectively) but the difference is not statistically significant. (p = 0.242). Majority of the caregivers in both settings had good knowledge of malnutrition though higher in urban mothers (89.5%) with statistical significance than their rural counterparts (71.5%). However, there is no significant association between caregiver's knowledge and malnutrition in this study. Being in lower primary school class, relationship with caregiver, educational status of caregiver and occupation of caregiver were the common predictors of malnutrition among the school children in both community settings. CONCLUSION: Generally, the prevalence of malnutrition was high in both urban and rural primary school children in this study. However, while underweight and stunting were more prevalent among the children in the rural communities, wasting, overweight and obesity were more prevalent in the urban. The caregivers in both communities had good knowledge of malnutrition (better in the urban) but this is not good enough to bring a significant relationship with the occurrence of malnutrition in the children. Common predictors of malnutrition in both community settings are being in lower primary school class, relationship with caregiver, educational status of caregiver and occupation of caregiver. It is therefore recommended that regular continuous public enlightenment, nutritional education programmes and other programmes targeted at improving the economic power of the caregivers are measures that will improve the nutritional status of the primary school children.


Asunto(s)
Cuidadores , Desnutrición , Estado Nutricional , Población Rural , Población Urbana , Humanos , Femenino , Niño , Masculino , Nigeria/epidemiología , Estudios Transversales , Desnutrición/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Delgadez/epidemiología , Prevalencia , Instituciones Académicas , Adulto
8.
Zhonghua Zhong Liu Za Zhi ; 46(5): 461-470, 2024 May 23.
Artículo en Chino | MEDLINE | ID: mdl-38742360

RESUMEN

Objective: To analyze the effects of changes in the spectrum of deaths from malignant tumors on the life expectancies of residents of different ages, sexes, and regions (urban or rural) in Tianjin from 1999 to 2019. Methods: The Abridged Life Table method and the Arriaga's decomposition method were used to calculate the effects of changes in spectrum of deaths from malignant tumors on the life expectancies of Tianjin residents of different ages, sexes, and regions. Results: During 1999-2019, the life expectancies increased by 4.96 years and 5.69 years for males and females, respectively, in Tianjin. The decreases in the mortalities from malignant neoplasms contributed 0.12 year (3.30%) and 0.03 year (0.77%) for males and females, respectively, to the increase during 1999-2007, and 0.05 year (3.13%) and 0.12 year (6.08%) for males and females, respectively, during 2007-2019. The decreases in the mortality rates of malignant tumors contributed the most to the increase among residents in the 60-69 years group, and the decreases in mortality rates of lung, gastric, esophageal, and liver cancers had relatively larger contribution. Lung cancer had a negative effect on the life expectancies of men and rural residents, but a positive effect on those of women and urban residents. The significant increases in the mortality rates of lung, colorectal, and pancreatic cancers in the ≥85 years group had a large negative effect on the overall life expectancy. Breast and ovarian cancers contributed negatively to the life expectancy of female residents. Conclusion: The overall increase in the life expectancy in Tianjin from 1999 to 2019 was mainly attributed to the elderly and the decreases in the mortality rates of gastric, esophageal, and liver cancers, among other malignancies, while the increases in the mortality rates of lung, colorectal, gallbladder, pancreatic, and breast cancers were the most significant factors hindering the increase of the life expectancy in Tianjin.


Asunto(s)
Esperanza de Vida , Neoplasias , Población Rural , Humanos , Masculino , Femenino , China/epidemiología , Neoplasias/mortalidad , Persona de Mediana Edad , Anciano , Población Rural/estadística & datos numéricos , Adulto , Neoplasias Pulmonares/mortalidad , Neoplasias Pulmonares/patología , Anciano de 80 o más Años , Neoplasias Hepáticas/mortalidad , Población Urbana/estadística & datos numéricos , Adulto Joven , Adolescente , Niño , Neoplasias Esofágicas/mortalidad , Neoplasias Esofágicas/patología , Lactante , Preescolar , Neoplasias Gástricas/mortalidad , Neoplasias Gástricas/patología
9.
J Health Popul Nutr ; 43(1): 71, 2024 May 20.
Artículo en Inglés | MEDLINE | ID: mdl-38769540

RESUMEN

INTRODUCTION: Ethiopia has been implementing community-based health insurance programs since 2011 to improve health care financing system. However, the prevalence of household willingness to join the community-based health insurance (CBHI) program and its associated factors are less explored in urban area. Therefore, this study was aimed to assess the prevalence of willingness to join community-based health insurance program and its associated factors among households in Nekemte City, Ethiopia. METHODS: A community-based cross-sectional study was conducted on 422 randomly selected households in Nekemte City, Ethiopia. Bivariate and multivariable analyses were performed to see the association between the independent and outcome variables using binary logistic regression model. Association was described using an adjusted odd ratio (AOR) and a 95% confidence interval (CI). Finally, p-value < 0.05 was considered the cut-off point for declaring a significant. RESULTS: Among 422 study participants, 320 (75.83%) [95% CI = 71.5-79.8%)] of the households were willing to join community-based health insurance program. The willingness to join for community-based health insurance was 3.11 times more likely among households who were in the richest quintile (AOR = 3.11; 95% CI = 1.08-8.93), 3.4 times more likely among those who were merchants (AOR = 3.40;1.33, 8.69), 2.52 times more likely among those who had history of chronic illness in the household (AOR = 2.52; 95% CI = 1.43-4.45), 4.09 times more likely among those who had the awareness about the scheme (AOR = 4.09; 95% CI = 1.97-8.47) and 3.29 times more likely among those who had the experience of borrow for medical care (AOR = 3.29; 95% CI = 1.48-7.30). CONCLUSION: Nearly three fourth of the households were willing to join community-based health insurance program, however, about one fourth of households were not willing, which is a significant public health problem. Being merchant, having awareness about the scheme, being in the richest wealth quintile, having experience of borrowing for medical care, and having history of chronic illness in the household were factors found to be significantly associated with willingness to join community based health insurance in the study area. Therefore, strengthening awareness creation at community level about the benefit package and principle of the program would increase their demand for the community-based health insurance scheme.


Asunto(s)
Seguros de Salud Comunitarios , Composición Familiar , Humanos , Etiopía , Estudios Transversales , Femenino , Masculino , Seguros de Salud Comunitarios/estadística & datos numéricos , Adulto , Persona de Mediana Edad , Adulto Joven , Factores Socioeconómicos , Modelos Logísticos , Población Urbana/estadística & datos numéricos , Aceptación de la Atención de Salud/estadística & datos numéricos , Adolescente
10.
Nutrients ; 16(9)2024 Apr 24.
Artículo en Inglés | MEDLINE | ID: mdl-38732506

RESUMEN

In the past five decades, global food systems have undergone a notable transition, moving from predominantly rural settings to increasingly urban and industrialized environments, largely driven by processes of globalization and supply chain integration. However, this evolution has not adequately addressed equitable access to nutritious diets and food environments, resulting in adverse health outcomes. This study delves into the spatial and non-spatial barriers that impede the adoption of healthy diets in the Noreste of Mexico, particularly focusing on the challenges associated with accessing and cultivating plant-based foods. Through an examination of suitable areas for urban agriculture and an exploration of the socio-cultural factors influencing the adoption of plant-based diets, the research focuses on interventions aimed at promoting healthier and more sustainable eating practices in Monterrey. The findings of the study reveal significant disparities in food access across the Monterrey metropolitan area, with central urban zones exhibiting superior access to fresh foods compared to suburban and peripheral regions. This inequality disproportionately affects marginalized areas characterized by higher poverty rates, exacerbating issues of food insecurity. Nevertheless, traditional dietary practices could offer promising avenues for creating culturally significant and healthier dietary transitions, even amidst the ongoing process of urbanization.


Asunto(s)
Dieta Saludable , Abastecimiento de Alimentos , México , Humanos , Factores Socioeconómicos , Agricultura , Población Urbana , Inseguridad Alimentaria , Urbanización , Población Rural
11.
Nutrients ; 16(9)2024 Apr 28.
Artículo en Inglés | MEDLINE | ID: mdl-38732580

RESUMEN

The dietary patterns of older adults, particularly in relation to meat, egg, and dairy (MED) consumption, significantly impact frailty, a state of heightened vulnerability to adverse health outcomes. This paper investigates the association between MED consumption and frailty among older Chinese adults, considering rural/urban disparities and gender differences. Analyzing data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) spanning from 2008 to 2018, this study explores how MED consumption influences frailty levels over time. The results show that moderate MED consumption is associated with slower frailty progression, suggesting a protective effect against frailty among older adults. However, excessive MED consumption, particularly among rural residents and females, is linked to accelerated frailty progression. Urban residents and males report higher MED consumption levels, possibly due to their greater access to diverse food options and traditional dietary preferences. The findings underscore the complex interplay between dietary habits, demographic factors, and frailty outcomes. Understanding these dynamics is crucial for developing targeted interventions to mitigate frailty risk factors and promote healthy aging among Chinese older adults.


Asunto(s)
Dieta , Huevos , Fragilidad , Carne , Población Rural , Población Urbana , Humanos , Masculino , Femenino , Anciano , China/epidemiología , Población Rural/estadística & datos numéricos , Fragilidad/epidemiología , Población Urbana/estadística & datos numéricos , Dieta/estadística & datos numéricos , Estudios Longitudinales , Productos Lácteos/estadística & datos numéricos , Anciano de 80 o más Años , Factores Sexuales , Anciano Frágil/estadística & datos numéricos , Conducta Alimentaria , Pueblos del Este de Asia
13.
Sci Rep ; 14(1): 10614, 2024 05 09.
Artículo en Inglés | MEDLINE | ID: mdl-38719922

RESUMEN

Regional population mortality correlates with regional socioeconomic development. This study aimed to identify the key socioeconomic factors influencing mortality patterns in Chinese provinces. Using data from the Seventh Population Census, we analyzed mortality patterns by gender and urban‒rural division in 31 provinces. Using a functional regression model, we assessed the influence of fourteen indicators on mortality patterns. Main findings: (1) China shows notable gender and urban‒rural mortality variations across age groups. Males generally have higher mortality than females, and rural areas experience elevated mortality rates compared to urban areas. Mortality in individuals younger than 40 years is influenced mainly by urban‒rural factors, with gender becoming more noticeable in the 40-84 age group. (2) The substantial marginal impact of socioeconomic factors on mortality patterns generally becomes evident after the age of 45, with less pronounced differences in their impact on early-life mortality patterns. (3) Various factors have age-specific impacts on mortality. Education has a negative effect on mortality in individuals aged 0-29, extending to those aged 30-59 and diminishing in older age groups. Urbanization positively influences the probability of death in individuals aged 45-54 years, while the impact of traffic accidents increases with age. Among elderly people, the effect of socioeconomic variables is smaller, highlighting the intricate and heterogeneous nature of these influences and acknowledging certain limitations.


Asunto(s)
Mortalidad , Población Rural , Factores Socioeconómicos , Humanos , China/epidemiología , Masculino , Femenino , Persona de Mediana Edad , Anciano , Adulto , Población Rural/estadística & datos numéricos , Mortalidad/tendencias , Preescolar , Anciano de 80 o más Años , Adolescente , Adulto Joven , Niño , Lactante , Población Urbana , Recién Nacido , Factores Económicos , Urbanización , Factores de Edad
14.
Front Public Health ; 12: 1338079, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38699418

RESUMEN

Introduction: The association between the residential environment and emotional wellbeing (EWB) in older adults has received extensive attention from gerontologists, especially during the COVID-19 pandemic; however, the mediating mechanism of how residential environment affects emotional wellbeing has not been fully explored. This study examined the effects of the residential environment on EWB and the mediating role of health lifestyle. Methods: This study analyzed the survey data of 493 rural and 515 urban older adults from 2021 Chinese General Social Survey. General linear regression and structural equation models were used to examine the effects of residential environment and health lifestyle. Results: Urban participants exhibited clear advantages in EWB, residential environment, and physical activity. Residential environment significantly affected the EWB of older adults, and health lifestyle played a mediating role in this relationship. The residential environment and health lifestyle did not significantly affect EWB in rural participants. Discussion: This study revealed differences in the effects of health lifestyles and residential environments on EWB among older adults in rural and urban settings in China. This study provided empirical evidence of mental health disparities between older rural and urban Chinese residents.


Asunto(s)
Salud Mental , Población Rural , Población Urbana , Humanos , China/epidemiología , Anciano , Femenino , Masculino , Salud Mental/estadística & datos numéricos , Población Rural/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , COVID-19/psicología , COVID-19/epidemiología , Estilo de Vida Saludable , Encuestas y Cuestionarios , Características de la Residencia/estadística & datos numéricos , Persona de Mediana Edad , Ejercicio Físico/psicología , Anciano de 80 o más Años , Emociones
15.
Health Aff (Millwood) ; 43(5): 659-665, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38709973

RESUMEN

We investigated county-level variation in mRNA COVID-19 vaccine use among Medicare beneficiaries throughout the United States. There was greater use of Pfizer-BioNTech vaccines than Moderna vaccines in urban areas for first and booster doses.


Asunto(s)
Vacunas contra la COVID-19 , COVID-19 , Medicare , Población Rural , Población Urbana , Humanos , Estados Unidos , COVID-19/prevención & control , Población Urbana/estadística & datos numéricos , Medicare/estadística & datos numéricos , Anciano , Femenino , Masculino , Vacuna BNT162 , SARS-CoV-2
16.
BMJ Open ; 14(5): e079415, 2024 May 03.
Artículo en Inglés | MEDLINE | ID: mdl-38702083

RESUMEN

BACKGROUND: Increasing levels of poor glycaemic control among Thai patients with type 2 diabetes mellitus (T2DM) motivated us to compare T2DM care between urban and suburban primary care units (PCUs), to identify gaps in care, and to identify significant factors that may influence strategies to enhance the quality of care and clinical outcomes in this population. METHODS: We conducted a cross-sectional study involving 2160 patients with T2DM treated at four Thai PCUs from 2019 to 2021, comprising one urban and three suburban facilities. Using mixed effects logistic regression, we compared care factors between urban and suburban PCUs. RESULTS: Patients attending suburban PCUs were significantly more likely to undergo eye (adjusted OR (AOR): 1.83, 95% CI 1.35 to 1.72), foot (AOR: 1.61, 95% CI 0.65 to 4.59) and HbA1c (AOR: 1.66, 95% CI 1.09 to 2.30) exams and achieved all ABC (HbA1c, blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C)) goals (AOR: 2.23, 95% CI 1.30 to 3.83). Conversely, those at an urban PCU were more likely to undergo albuminuria exams. Variables significantly associated with good glycaemic control included age (AOR: 1.51, 95% CI 1.31 to 1.79), T2DM duration (AOR: 0.59, 95% CI 0.41 to 0.88), FAACE (foot, HbA1c, albuminuria, LDL-C and eye) goals (AOR: 1.23, 95% CI 1.12 to 1.36) and All8Q (AOR: 1.20, 95% CI 1.05 to 1.41). Chronic kidney disease (CKD) was significantly linked with high triglyceride and HbA1c levels (AOR: 5.23, 95% CI 1.21 to 7.61). Elevated HbA1c levels, longer T2DM duration, insulin use, high systolic BP and high lipid profile levels correlated strongly with diabetic retinopathy (DR) and CKD progression. CONCLUSION: This highlights the necessity for targeted interventions to bridge urban-suburban care gaps, optimise drug prescriptions and implement comprehensive care strategies for improved glycaemic control, DR prevention and CKD progression mitigation among in Thai patients with T2DM. The value of the clinical target aggregate (ABC) and the process of care aggregate (FAACE) was also conclusively demonstrated.


Asunto(s)
Diabetes Mellitus Tipo 2 , Hemoglobina Glucada , Atención Primaria de Salud , Humanos , Diabetes Mellitus Tipo 2/terapia , Masculino , Femenino , Tailandia , Estudios Transversales , Persona de Mediana Edad , Anciano , Hemoglobina Glucada/análisis , Análisis Multinivel , Presión Sanguínea , Retinopatía Diabética/terapia , Retinopatía Diabética/epidemiología , Calidad de la Atención de Salud , Modelos Logísticos , Población Suburbana , Control Glucémico , LDL-Colesterol/sangre , Población Urbana/estadística & datos numéricos , Adulto , Pueblos del Sudeste Asiático
17.
PLoS One ; 19(5): e0297489, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38722852

RESUMEN

BACKGROUND: There are few data reporting the needs and priorities of older adults in Brazil. This hampers the development and/or implementation of policies aimed at older adults to help them age well. The aim of this study was to understand areas of importance, priorities, enablers and obstacles to healthy ageing as identified by older adults and key stakeholders in both urban and rural environments. METHODS: Two locations were selected, one urban and one rural in the municipality of Santo André, in the metropolitan region of São Paulo (SP). Workshops for older adults (>60 y) and stakeholders were conducted separately in each location. The workshops incorporated an iterative process of discussion, prioritisation and ranking of responses, in roundtable groups and in plenary. Areas of commonality and differences between older adult and stakeholder responses were identified by comparing responses between groups as well as mapping obstacles and enablers to healthy ageing identified by older adults, to the priorities identified by stakeholder groups. The socio-ecologic model was used to categorise responses. RESULTS: There were few shared responses between stakeholders and older adults and little overlap between the top ranked responses of urban and rural groups. With respect to areas of importance, both stakeholder groups ranked policies for older people within their top five reponses. Both older adult groups ranked keeping physically and mentally active, and nurturing spirituality. There was a marked lack of congruence between older adults' obstacles and enablers to healthy ageing and stakeholder priorities, in both urban and rural settings. Most responses were located within the Society domain of the socio-ecologic model, although older adults also responded within the Individual/ Relationships domains, particularly in ranking areas of most importance for healthy ageing. CONCLUSIONS: Our results highlight substantial differences between older adults and stakeholders with respect to areas of importance, priorities, enablers and obstacles to healthy ageing, and point to the need for more engagement between those in advocacy and policymaking roles and the older people whose needs they serve.


Asunto(s)
Población Rural , Población Urbana , Humanos , Brasil , Anciano , Masculino , Femenino , Persona de Mediana Edad , Anciano de 80 o más Años , Participación de los Interesados , Prioridades en Salud , Envejecimiento Saludable , Necesidades y Demandas de Servicios de Salud
18.
PLoS One ; 19(5): e0302876, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38722931

RESUMEN

Realizing the common wealth of all people is the essential requirement of socialism with Chinese characteristics. Measuring the process of realizing common wealth and the differences between groups is one of the important issues that need to be addressed urgently. In order to reasonably measure the process of realizing common wealth in China, on the premise of horizontal comparability and vertical consistency, the principles of comparability and consistency are introduced, and a comparative method of opportunity advantage based on income distribution is proposed from the perspective of opportunity equity. Using the 2012-2020 CFPS data to measure and test the opportunity advantages and their differences across regions and groups in China. The study found, firstly, that the opportunity advantage persists but tends to diminish across groups, with the more educated group having a more pronounced opportunity advantage, but that this advantage is diminishing over time. Secondly, the doctoral degree group has a greater probability of earning higher incomes, followed by the master's and bachelor's degree groups, but this opportunity advantage, i.e., the probability of earning higher incomes, is diminishing, i.e., the education dividend is diminishing. Third, the difference in opportunity advantage between urban and rural areas still exists, as evidenced by the greater probability of higher incomes in towns than in rural areas, but this advantage has narrowed further over time, with a clear process of urban-rural integration. Fourthly, in terms of gender, men have a certain opportunity advantage over women, but this difference is not significant. Fifthly, in the context of education levels, gender and urban/rural subgroups, under the framework proposed in this paper, China has achieved some success in the process of realizing the common wealth, and is showing a steady upward trend.


Asunto(s)
Renta , Población Rural , China , Humanos , Femenino , Masculino , Factores Socioeconómicos , Población Urbana , Escolaridad
19.
PLoS One ; 19(5): e0293232, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38722946

RESUMEN

BACKGROUND: Global evidence on psychosis is dominated by studies conducted in Western, high-income countries. The objectives of the Study of Context Of Psychoses to improve outcomes in Ethiopia (SCOPE) are (1) to generate rigorous evidence of psychosis experience, epidemiology and impacts in Ethiopia that will illuminate aetiological understanding and (2) inform development and testing of interventions for earlier identification and improved first contact care that are scalable, inclusive of difficult-to-reach populations and optimise recovery. METHODS: The setting is sub-cities of Addis Ababa and rural districts in south-central Ethiopia covering 1.1 million people and including rural, urban and homeless populations. SCOPE comprises (1) formative work to understand care pathways and community resources (resource mapping); examine family context and communication (ethnography); develop valid measures of family communication and personal recovery; and establish platforms for community engagement and involvement of people with lived experience; (2a) a population-based incidence study, (2b) a case-control study and (2c) a cohort study with 12 months follow-up involving 440 people with psychosis (390 rural/Addis Ababa; 50 who are homeless), 390 relatives and 390 controls. We will test hypotheses about incidence rates in rural vs. urban populations and men vs. women; potential aetiological role of khat (a commonly chewed plant with amphetamine-like properties) and traumatic exposures in psychosis; determine profiles of needs at first contact and predictors of outcome; (3) participatory workshops to develop programme theory and inform co-development of interventions, and (4) evaluation of the impact of early identification strategies on engagement with care (interrupted time series study). Findings will inform development of (5) a protocol for (5a) a feasibility cluster randomised controlled trial of interventions for people with recent-onset psychosis in rural settings and (5b) two uncontrolled pilot studies to test acceptability, feasibility of co-developed interventions in urban and homeless populations.


Asunto(s)
Trastornos Psicóticos , Etiopía/epidemiología , Humanos , Trastornos Psicóticos/epidemiología , Trastornos Psicóticos/terapia , Femenino , Masculino , Población Rural , Adulto , Estudios de Casos y Controles , Población Urbana , Personas con Mala Vivienda/psicología
20.
Int J Qual Stud Health Well-being ; 19(1): 2350729, 2024 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38723243

RESUMEN

PURPOSE: Suburbanization has become a major characteristic of urban development in sub-Saharan Africa, and shifting from agricultural-based areas modus vivendi to urban lifestyles affects subjective wellbeing of the original settlers. While there is lack of evidence in the literature of wellbeing in these areas, this study examines life satisfaction of these populations by means of individuals' own appreciation and evaluation of quality of life. METHODS: The study uses interpretionist and reflexive approaches, and analyses 76 interviews conducted through snowball sampling in two major suburbanized areas. Thematic analysis was used to analyse the data. RESULTS: Generally, the findings show that respondents are satisfied with material living conditions due to improvement of availability of economic opportunities, roads and other transport services, social and community support. However, income inequality and urban poverty result in the inability to afford modern and high-quality urban living conditions, which creates feelings of vulnerability while limiting social relationships. CONCLUSIONS: There is a need to strenghten existing frameworks to fully respond to urban life requirements that relate to transport, education, hygiene, and sanitation services. It is also important to develop support systems that mitigate issues of gender discrimination, human rights, household decision-making, fashion, and cultural norms.


Asunto(s)
Satisfacción Personal , Investigación Cualitativa , Calidad de Vida , Población Suburbana , Humanos , Femenino , Masculino , Adulto , Persona de Mediana Edad , Adulto Joven , Pobreza , Anciano , Población Urbana , Factores Socioeconómicos , Apoyo Social , Ciudades , Adolescente
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