Temporal Trends of Age-Adjusted Mortality Rates for Rheumatic Heart Disease in Brazil From 2000 to 2021.

Background Rheumatic heart disease (RHD) is a chronic cardiovascular condition stemming from an infectious origin, posing a substantial health burden, particularly in economically disadvantaged regions. It starts with acute rheumatic fever (ARF), a complication following group A Streptococcus infection, leading to heart valve damage and, over time, structural heart abnormalities. RHD contributes to premature deaths, especially in low-middle-income countries. Although the incidence and prevalence have generally reduced globally due to antibiotics and improved healthcare, it remains a significant public health concern in Brazil, echoing its prevalence in many developing nations around the world. RHD stands as a poignant testament to the intersection of socio-economic disparities and healthcare challenges within Brazil's diverse population. In Brazil, despite advancements in healthcare, RHD continues to impact communities, highlighting the urgent need for enhanced prevention strategies, access to quality healthcare services, and heightened awareness to combat this preventable, yet persistent, cardiac condition. Understanding the epidemiological landscape and socio-cultural factors influencing RHD in Brazil is crucial for developing targeted interventions aimed at mitigating its burden on individuals, families, and the healthcare system at large. Thus, our study focuses on analyzing age-related mortality rates linked to ARF and chronic RHD (ARHD) in Brazil from 2000 to 2021, particularly examining gender disparities. Materials and methods This retrospective cohort study employed a descriptive time-series approach, utilizing comprehensive nationwide data from Brazil spanning from 2000 to 2021 to assess trends in diverse age groups, among both sexes, enabling a detailed analysis of temporal patterns. Mortality data, extracted and categorized meticulously, were subjected to Joinpoint statistical analyses enabling comparative assessments, with average annual percent change (AAPC) and annual percent change (APC) serving as key metrics to quantify and interpret trends over the analyzed period. Results The acute RHD (ARHD)-related mortality declined over the analyzed years supported by AAPC, with higher mortality reduction in females. The age-adjusted mortality rate for "males and females" decreased from 78 to 67 deaths/100,000 from 2000 to 2021. Female mortality dropped from 85 to 69/100,000, and male mortality decreased from 73 to 63/100,000 over the same period. For ARHD, male age groups (20-29, 60-69, 70-79, 80+) showed declining mortality, while the 30-59 age group exhibited an upward. Females AAMR for chronic RHD (CRHD) decreased across all age groups, with significant reductions in the 80 years and above age group from 2000-2002 (APC: -11.94*) and steadily from 2002 onwards (APC: -1.33). Conclusions Our study revealed an overall decline in mortality rates for both acute and CRHD across both sexes. Females consistently exhibited higher mortality rates and a more pronounced reduction compared to males in both acute and CRHD. In ARHD, males experience the highest mortality in the 50-59 age group, while females have a peak in the 40-49 age group. The 60-69 age group had the highest mortality in CRHD for both sexes. Conversely, the 20-29 age group displayed the lowest mortality in CRHD, and the 80-89 age group had the lowest mortality in ARHD.

Effectiveness of agricultural extension's farmer field schools (FFS) in Pakistan: the case of citrus growers of Punjab province / Eficácia das escolas de extensão agrícola de campo (FFS) no Paquistão: o caso dos produtores de frutas cítricas da província de Punjab

ABSTRACT: Citrus is one of the major exported fruits of Pakistan. Especially Kinnow cultivar is famous across the globe because of its aroma and taste. The overall production of citrus is reported as half of the potential because of the non-adoption of research-based practices and lack of agricultural extension services and training of the citrus growers. In the last few years, the department of agricultural extension has started training programs called Farmer Field Schools (FFS) for citrus growers in the major citrus growing zone of the Punjab province, i.e., Sargodha region. This research was conducted in the Sargodha district to evaluate the knowledge and skills gained by the farmers from the FFS. The interview schedule was designed for the purpose of data collection. The data was collected from 120 farmers randomly selected from 15 FFS in the study area. All the respondents were participants of the FFS. The data was analyzed using Statistical Package for Social Sciences (SPSS). The Results of the study showed that 40% of the farmers learned about citrus verities, one-third of respondents learned about the management of new plants/orchards, 28% of the respondents got knowledge about the cultivation of fruits, and one-fourth of respondents acquired knowledge and skills about layout and management of citrus orchards. These findings conclude that training course has a positive influence on farmers' farm management skills; hence emphasize on its persistence and further improvement by the concerned authorities.

RESUMO: Os citros são as principais frutas exportadas do Paquistão, especialmente, a cultivar Kinnow é famosa em todo o mundo por causa de seu aroma e sabor. A produção geral de citros é relatada como a metade do potencial devido a não adoção de práticas baseadas em pesquisas e a falta de serviços de extensão agrícola e treinamento dos citricultores. Nos últimos anos o departamento de extensão agrícola iniciou programas de treinamento chamados Farmer Field Schools (FFS) para citricultores na maior zona de cultivo de citros da província de Punjab, no distrito de Sargodha. Esta pesquisa é conduzida no distrito de Sargodha para avaliar o conhecimento e as habilidades adquiridas pelos agricultores da FFS. O cronograma de entrevistas foi elaborado para fins de coleta de dados. Os dados foram coletados de 120 agricultores aleatoriamente de 15 FFS na área de estudo. Todos os entrevistados eram participantes da FFS. Os dados foram analisados ​​por meio do programa estatístico "Statistical Package for the Social Sciences (SPSS"). Os resultados do estudo mostraram que 40% dos agricultores aprenderam informações importantes sobre citros, um terço dos entrevistados aprenderam sobre o manejo de novas plantas / pomares, 28% dos entrevistados aprenderam sobre o cultivo de frutas e um quarto dos entrevistados adquiriu os conhecimentos e habilidades sobre layout e manejo de pomares de citros. Essas descobertas concluem que o curso de treinamento tem uma influência positiva nas habilidades de gestão das propriedades; portanto, suporta a necessidade de sua persistência e melhorias adicionais pelas autoridades para alavancar ainda a produtividade essa atividade no futuro.

Effectiveness of agricultural extensions farmer field schools (FFS) in Pakistan: the case of citrus growers of Punjab province / Eficácia das escolas de extensão agrícola de campo (FFS) no Paquistão: o caso dos produtores de frutas cítricas da província de Punjab

Citrus is one of the major exported fruits of Pakistan. Especially Kinnow cultivar is famous across the globe because of its aroma and taste. The overall production of citrus is reported as half of the potential because of the non-adoption of research-based practices and lack of agricultural extension services and training of the citrus growers. In the last few years, the department of agricultural extension has started training programs called Farmer Field Schools (FFS) for citrus growers in the major citrus growing zone of the Punjab province, i.e., Sargodha region. This research was conducted in the Sargodha district to evaluate the knowledge and skills gained by the farmers from the FFS. The interview schedule was designed for the purpose of data collection. The data was collected from 120 farmers randomly selected from 15 FFS in the study area. All the respondents were participants of the FFS. The data was analyzed using Statistical Package for Social Sciences (SPSS). The Results of the study showed that 40% of the farmers learned about citrus verities, one-third of respondents learned about the management of new plants/orchards, 28% of the respondents got knowledge about the cultivation of fruits, and one-fourth of respondents acquired knowledge and skills about layout and management of citrus orchards. These findings conclude that training course has a positive influence on farmers farm management skills; hence emphasize on its persistence and further improvement by the concerned authorities.(AU)

Os citros são as principais frutas exportadas do Paquistão, especialmente, a cultivar Kinnow é famosa em todo o mundo por causa de seu aroma e sabor. A produção geral de citros é relatada como a metade do potencial devido a não adoção de práticas baseadas em pesquisas e a falta de serviços de extensão agrícola e treinamento dos citricultores. Nos últimos anos o departamento de extensão agrícola iniciou programas de treinamento chamados Farmer Field Schools (FFS) para citricultores na maior zona de cultivo de citros da província de Punjab, no distrito de Sargodha. Esta pesquisa é conduzida no distrito de Sargodha para avaliar o conhecimento e as habilidades adquiridas pelos agricultores da FFS. O cronograma de entrevistas foi elaborado para fins de coleta de dados. Os dados foram coletados de 120 agricultores aleatoriamente de 15 FFS na área de estudo. Todos os entrevistados eram participantes da FFS. Os dados foram analisados ​​por meio do programa estatístico “Statistical Package for the Social Sciences (SPSS”). Os resultados do estudo mostraram que 40% dos agricultores aprenderam informações importantes sobre citros, um terço dos entrevistados aprenderam sobre o manejo de novas plantas / pomares, 28% dos entrevistados aprenderam sobre o cultivo de frutas e um quarto dos entrevistados adquiriu os conhecimentos e habilidades sobre layout e manejo de pomares de citros. Essas descobertas concluem que o curso de treinamento tem uma influência positiva nas habilidades de gestão das propriedades; portanto, suporta a necessidade de sua persistência e melhorias adicionais pelas autoridades para alavancar ainda a produtividade essa atividade no futuro.(AU)

Effectiveness of agricultural extension’s farmer field schools (FFS) in Pakistan: the case of citrus growers of Punjab province / Eficácia das escolas de extensão agrícola de campo (FFS) no Paquistão: o caso dos produtores de frutas cítricas da província de Punjab

Citrus is one of the major exported fruits of Pakistan. Especially Kinnow cultivar is famous across the globe because of its aroma and taste. The overall production of citrus is reported as half of the potential because of the non-adoption of research-based practices and lack of agricultural extension services and training of the citrus growers. In the last few years, the department of agricultural extension has started training programs called Farmer Field Schools (FFS) for citrus growers in the major citrus growing zone of the Punjab province, i.e., Sargodha region. This research was conducted in the Sargodha district to evaluate the knowledge and skills gained by the farmers from the FFS. The interview schedule was designed for the purpose of data collection. The data was collected from 120 farmers randomly selected from 15 FFS in the study area. All the respondents were participants of the FFS. The data was analyzed using Statistical Package for Social Sciences (SPSS). The Results of the study showed that 40% of the farmers learned about citrus verities, one-third of respondents learned about the management of new plants/orchards, 28% of the respondents got knowledge about the cultivation of fruits, and one-fourth of respondents acquired knowledge and skills about layout and management of citrus orchards. These findings conclude that training course has a positive influence on farmers’ farm management skills; hence emphasize on its persistence and further improvement by the concerned authorities.

Os citros são as principais frutas exportadas do Paquistão, especialmente, a cultivar Kinnow é famosa em todo o mundo por causa de seu aroma e sabor. A produção geral de citros é relatada como a metade do potencial devido a não adoção de práticas baseadas em pesquisas e a falta de serviços de extensão agrícola e treinamento dos citricultores. Nos últimos anos o departamento de extensão agrícola iniciou programas de treinamento chamados Farmer Field Schools (FFS) para citricultores na maior zona de cultivo de citros da província de Punjab, no distrito de Sargodha. Esta pesquisa é conduzida no distrito de Sargodha para avaliar o conhecimento e as habilidades adquiridas pelos agricultores da FFS. O cronograma de entrevistas foi elaborado para fins de coleta de dados. Os dados foram coletados de 120 agricultores aleatoriamente de 15 FFS na área de estudo. Todos os entrevistados eram participantes da FFS. Os dados foram analisados ​​por meio do programa estatístico “Statistical Package for the Social Sciences (SPSS”). Os resultados do estudo mostraram que 40% dos agricultores aprenderam informações importantes sobre citros, um terço dos entrevistados aprenderam sobre o manejo de novas plantas / pomares, 28% dos entrevistados aprenderam sobre o cultivo de frutas e um quarto dos entrevistados adquiriu os conhecimentos e habilidades sobre layout e manejo de pomares de citros. Essas descobertas concluem que o curso de treinamento tem uma influência positiva nas habilidades de gestão das propriedades; portanto, suporta a necessidade de sua persistência e melhorias adicionais pelas autoridades para alavancar ainda a produtividade essa atividade no futuro.

The dependency analysis between energy consumption, sanitation, forest area, financial development, and greenhouse gas: a continent-wise comparison of lower middle-income countries.

This study explored the long-run association among greenhouse gases (GHGs), financial development, forest area, improved sanitation, renewable energy, urbanization, and trade in 24 lower middle-income countries from Asia, Europe, Africa, and America (South and North) by using panel data from 1990 to 2015. Granger causality was tested by Toda and Yamamoto approach. The bi-directional causality was established among urbanization and GHGs (Asia), financial development and forest (Asia), energy use and renewable energy (Asia), renewable energy and forest (Asia), improved sanitation and forest (Asia, Africa, America), urbanization and forest (Asia), and improved sanitation and financial development (Europe). The GHG emission also shows one-way causality is running from financial development to GHG (America), energy to GHG (Asia), renewable energy to GHG (America), forest area to GHG (America), trade openness to GHG (Africa), urbanization to GHG (Europe), GHG to financial development (Europe), GHG to energy use (Europe, Africa, and America), and GHG to trade openness (Asia). On the basis of fully modified ordinary least square and generalized method of moment, the reciprocal relationship of GHGs was observed due to financial development in Asia and Africa; renewable energy in all panels; forest area in Asia, Europe, and America; improved sanitation in Asia, Africa, and America; trade openness in Africa; and urbanization in Europe and America. Policymakers should concentrate on these variables for the reduction in GHGs. The annual convergence towards long-run equilibrium was 50.5, 31.9, and 20.9% for America, Asia, and Africa, respectively.