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1.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud, LIS-bvsms | ID: lis-LISBR1.1-47122
2.
Zhonghua Er Ke Za Zhi ; 58(3): 194-200, 2020 Mar 02.
Artículo en Chino | MEDLINE | ID: mdl-32135590

RESUMEN

Objective: To survey the children under 7 years of age in nine cities of China for a better understanding of the current situation of childhood stunting. Methods: According to a stratified cluster sampling design, a cross-sectional survey on children under 7 years of age was carried out in 9 cities (Beijing, Harbin and Xi'an in northern China; Shanghai, Nanjing and Wuhan in central China; and Guangzhou, Fuzhou and Kunming in southern China) from June to November in 2016. A total of 110 499 children were recruited. Height of children was evaluated using the growth standards for Chinese children (2009 edition) .Children with height less than the 3rd percentile of the growth standards were considered as stunting, and children with height between the 3rd and 10th percentiles of the growth standards were considered as relatively short stature. Chi-square test was used for comparison between data of boys and girls, urban and suburban, as well as among different ages and regions. Results: Totally 113 084 children under 7 years of age should be investigated and actually 110 499 children were investigated, with a rate of 97.7%. The prevalence of stunting was 1.9% (2 141/110 499) among all the children. The prevalence of stunting in urban children (1.6%, 904/55 524) was lower than that in suburban children (2.3%, 1 237/54 975, χ(2)=56.246, P<0.01). The gender difference in stunting prevalence was not statistically significant (1.9% (1 121/57 921) in boys and 1.9% (1 020/52 578) in girls, χ(2)=0.003, P=0.965). The prevalence of stunting decreased with age for children younger than 3 years, from 1.8% (312/17 080) in 0-<1 year of age group to 1.2% (168/13 740) in 2-<3 years of age group, but increased to 2.2% (240/11 073) at 6-<7 years group. Comparison among different regions showed that the stunting prevalence in southern region was higher than those in the central and northern regions (0.9% (193/20 374) in northern urban, 0.8% (154/18 486) in central urban, and 3.3% (557/16 664) in southern urban children), showing a statistical significance (χ(2)=437.736, P<0.01); 1.1% (241/21 924) in northern suburban, 1.4% (227/16 775) in central suburban and 4.7% (769/16 276) in southern suburban children, showing a statistical significance (χ(2)=646.533, P<0.01). In urban areas, the difference between the central and northern regions showed no statistical significance (χ(2)=1.429, P=0.232) and the stunting prevalence of central Chinese children was slightly higher than that of northern Chinese children in suburban areas (χ(2)=5.130, P=0.024). Among the nine cities, the stunting prevalence of Guangzhou (6.1%, 613/10 019) was higher than those of other cities (χ(2)=1 559.64, P<0.01). Among the stunting children, 78.4% (1 679/2 141) were classified as borderline or mild and only 7.2% (154/2 141) were classified as severe. The prevalence of relatively short stature was 5.2% (5 721/110 499). Conclusions: The prevalence of stunting among children under 7 years of age in nine cities of China is low and most of the stunting children were classified as mild; the prevalence of stunting in suburban children is higher than that in urban children; the gender difference show no statistical significance; and the prevalence of stunting in southern Chinese children is higher than those in central and northern Chinese children.


Asunto(s)
Estatura , Desarrollo Infantil , Trastornos del Crecimiento/epidemiología , Beijing , Estatura/fisiología , Peso Corporal , Niño , Preescolar , China/epidemiología , Ciudades/estadística & datos numéricos , Estudios Transversales , Femenino , Trastornos del Crecimiento/diagnóstico , Humanos , Masculino , Prevalencia , Encuestas y Cuestionarios
3.
BMJ ; 368: m108, 2020 02 10.
Artículo en Inglés | MEDLINE | ID: mdl-32041707

RESUMEN

OBJECTIVE: To assess short term mortality risks and excess mortality associated with exposure to ozone in several cities worldwide. DESIGN: Two stage time series analysis. SETTING: 406 cities in 20 countries, with overlapping periods between 1985 and 2015, collected from the database of Multi-City Multi-Country Collaborative Research Network. POPULATION: Deaths for all causes or for external causes only registered in each city within the study period. MAIN OUTCOME MEASURES: Daily total mortality (all or non-external causes only). RESULTS: A total of 45 165 171 deaths were analysed in the 406 cities. On average, a 10 µg/m3 increase in ozone during the current and previous day was associated with an overall relative risk of mortality of 1.0018 (95% confidence interval 1.0012 to 1.0024). Some heterogeneity was found across countries, with estimates ranging from greater than 1.0020 in the United Kingdom, South Africa, Estonia, and Canada to less than 1.0008 in Mexico and Spain. Short term excess mortality in association with exposure to ozone higher than maximum background levels (70 µg/m3) was 0.26% (95% confidence interval 0.24% to 0.28%), corresponding to 8203 annual excess deaths (95% confidence interval 3525 to 12 840) across the 406 cities studied. The excess remained at 0.20% (0.18% to 0.22%) when restricting to days above the WHO guideline (100 µg/m3), corresponding to 6262 annual excess deaths (1413 to 11 065). Above more lenient thresholds for air quality standards in Europe, America, and China, excess mortality was 0.14%, 0.09%, and 0.05%, respectively. CONCLUSIONS: Results suggest that ozone related mortality could be potentially reduced under stricter air quality standards. These findings have relevance for the implementation of efficient clean air interventions and mitigation strategies designed within national and international climate policies.


Asunto(s)
Contaminación del Aire/efectos adversos , Exposición a Riesgos Ambientales/efectos adversos , Salud Global/estadística & datos numéricos , Mortalidad , Ozono/efectos adversos , Contaminación del Aire/análisis , Ciudades/estadística & datos numéricos , Cambio Climático/mortalidad , Exposición a Riesgos Ambientales/normas , Política Ambiental , Humanos , Cooperación Internacional , Ozono/análisis , Estaciones del Año
4.
BMC Infect Dis ; 20(1): 129, 2020 Feb 11.
Artículo en Inglés | MEDLINE | ID: mdl-32046662

RESUMEN

BACKGROUND: Syphilis is a sexually transmitted infection (STI) transmitted from person to person mainly by sexual intercourse or through vertical transmission during pregnancy. Female sex workers (FSWs) are exposed especially to syphilis infection, and besides all the efforts to control the spread of STIs, syphilis prevalence is still rising, mainly occurring in low-income countries. This study aimed to investigate the syphilis prevalence, demographic characteristics and sexual habits among FSWs in the Amazon region of Brazil. METHODS: A cross-sectional study was carried out including 184 FSWs from 3 countryside cities of the state of Pará, Amazon region of Brazil. A venereal disease research laboratory test and an indirect immunoenzyme assay to test antibodies against Treponema pallidum were used for screening syphilis infection, while sexual habits and demographic data information were collected through a semi-structured questionnaire. Data was analyzed comparing groups with/without syphilis. Poisson regression models were used to estimate the reasons of prevalence (RP). RESULTS: The overall prevalence of syphilis was 14.1% (95% CI = 9.8-17.8). FSWs had between 15 and 56 years of age, most were unmarried (65.7%), had attended less than 8 years of formal education (64.1%), had between 10 and 20 partners per week (64.1%), and reported no previous history of STIs (76.1%) and regular use of condom (52.7%). Low level of education attending up to the primary school (RP adjusted = 3.8; 95% CI = 1.4-9.2) and high frequency of anal sex during the past year (RP adjusted = 9.3; 95% CI = 3.5-28.7) were associated with a higher prevalence of syphilis. CONCLUSIONS: A high prevalence of syphilis among FSWs in the Brazilian Amazon region was identified, showing that syphilis is more likely to be transmitted in FSW working in low-income areas, which is attributed to the low level of education. Anal intercourse was found as a risk factor associated with syphilis. Health programs focused on risk populations appear as a rational way to control syphilis spread, which is a rising problem in Brazil and in other several countries.


Asunto(s)
Trabajadores Sexuales/estadística & datos numéricos , Sífilis/epidemiología , Adolescente , Adulto , Brasil/epidemiología , Ciudades/estadística & datos numéricos , Condones/estadística & datos numéricos , Estudios Transversales , Escolaridad , Femenino , Humanos , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Conducta Sexual/estadística & datos numéricos , Parejas Sexuales , Sífilis/diagnóstico , Serodiagnóstico de la Sífilis , Treponema pallidum/inmunología , Adulto Joven
5.
Nat Hum Behav ; 4(3): 248-254, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-31932688

RESUMEN

Human activities, such as research, innovation and industry, concentrate disproportionately in large cities. The ten most innovative cities in the United States account for 23% of the national population, but for 48% of its patents and 33% of its gross domestic product. But why has human activity become increasingly concentrated? Here we use data on scientific papers, patents, employment and gross domestic product, for 353 metropolitan areas in the United States, to show that the spatial concentration of productive activities increases with their complexity. Complex economic activities, such as biotechnology, neurobiology and semiconductors, concentrate disproportionately in a few large cities compared to less--complex activities, such as apparel or paper manufacturing. We use multiple proxies to measure the complexity of activities, finding that complexity explains from 40% to 80% of the variance in urban concentration of occupations, industries, scientific fields and technologies. Using historical patent data, we show that the spatial concentration of cutting-edge technologies has increased since 1850, suggesting a reinforcing cycle between the increase in the complexity of activities and urbanization. These findings suggest that the growth of spatial inequality may be connected to the increasing complexity of the economy.


Asunto(s)
Biotecnología/estadística & datos numéricos , Mapeo Geográfico , Patentes como Asunto/estadística & datos numéricos , Ciencia/estadística & datos numéricos , Tecnología/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Urbanización , Ciudades/estadística & datos numéricos , Humanos , Estados Unidos
6.
Environ Sci Pollut Res Int ; 27(6): 6375-6388, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31873878

RESUMEN

As a market-based environmental regulation tool, emissions trading scheme for SO2 (SO2 ETS) has been carried out in China for decades, so impacts of SO2 ETS have become a vital issue to the society. Based on the SO2 ETS of China in 2007, this paper attempts to test and verify impacts of the scheme on environment and economy, especially on green total factor productivity (TFP). We firstly combine biennial weight-modified non-radial direction distance function and Luenberger productivity indicator to measure and decompose the green TFP of 280 cities in China over the period 2003 to 2016, and apply a difference-in-differences method (DID) with fixed effect models to investigate whether SO2 ETS achieves a win-win scenario of "emission reducing" and "efficiency increasing." The results show that the scheme significantly may decrease SO2 emissions and SO2 intensity by 12.3% and 11.0%, respectively, in ETS regions while no obvious impact on GDP. In terms of green TFP, we find SO2 ETS inhibits the growth of green TFP, and the negative impact mainly caused by the deterioration in efficiency change. Therefore, we hold that SO2 ETS is effective for improving environment, but it is still difficult to achieve the promotion of green TFP simultaneously.


Asunto(s)
Contaminación del Aire/estadística & datos numéricos , Dióxido de Azufre/análisis , Agricultura , Contaminación del Aire/economía , China , Ciudades/estadística & datos numéricos , Eficiencia
7.
Artículo en Inglés | MEDLINE | ID: mdl-31861677

RESUMEN

The Yangtze River Delta (YRD) is one of the most developed regions in China. This is also a flood-prone area where flood disasters are frequently experienced; the situations between the people-land nexus and the people-water nexus are very complicated. Therefore, the accurate assessment of flood risk is of great significance to regional development. The paper took the YRD urban agglomeration as the research case. The driving force, pressure, state, impact and response (DPSIR) conceptual framework was established to analyze the indexes of flood disasters. The random forest (RF) algorithm was used to screen important indexes of floods risk, and a risk assessment model based on the radial basis function (RBF) neural network was constructed to evaluate the flood risk level in this region from 2009 to 2018. The risk map showed the I-V level of flood risk in the YRD urban agglomeration from 2016 to 2018 by using the geographic information system (GIS). Further analysis indicated that the indexes such as flood season rainfall, urban impervious area ratio, gross domestic product (GDP) per square kilometer of land, water area ratio, population density and emergency rescue capacity of public administration departments have important influence on flood risk. The flood risk has been increasing in the YRD urban agglomeration during the past ten years under the urbanization background, and economic development status showed a significant positive correlation with flood risks. In addition, there were serious differences in the rising rate of flood risks and the status quo among provinces. There are still a few cities that have stabilized at a better flood-risk level through urban flood control measures from 2016 to 2018. These results were basically in line with the actual situation, which validated the effectiveness of the model. Finally, countermeasures and suggestions for reducing the urban flood risk in the YRD region were proposed, in order to provide decision support for flood control, disaster reduction and emergency management in the YRD region.


Asunto(s)
Ecosistema , Inundaciones/estadística & datos numéricos , Bosques , Aprendizaje Automático , Redes Neurales de la Computación , Medición de Riesgo/métodos , Ríos , China , Ciudades/estadística & datos numéricos , Sistemas de Información Geográfica
8.
Int Health ; 11(S1): S64-S71, 2019 10 31.
Artículo en Inglés | MEDLINE | ID: mdl-31670819

RESUMEN

BACKGROUND: We aimed to examine the associations of cognitive and structural social capital with subjective well-being (SWB) and mental health among internal migrants in five cities in China. METHODS: We conducted healthy cities surveys from June 2017 to April 2018. In total, 3038 migrants submitted surveys. Generalized linear regressions for SWB and logistic regressions for mental health were used to examine the associations of social capital, SWB and mental health after controlling for covariates. RESULTS: The median level of SWB was 75.7 (interquartile range 62.9-85.7). Self-rated health and physical activity were positively associated with SWB. The SWB level among migrants who perceived high individual social cohesion was much higher than that of their counterparts (unstandardized coefficients, ß=7.01 [95% confidence interval {CI} 5.82 to 8.21]). The prevalence of poor mental health was 10.0%. High social cohesion (odds ratio [OR] 0.32 [95% CI 0.24 to 0.44]) and high social participation (OR 0.77 [95% CI 0.57 to 0.97]) were significantly associated with a low ratio of poor mental health when compared with their counterparts. CONCLUSIONS: Cognitive social capital is positively associated with SWB, while both cognitive and structural social capitals were negatively associated with poor mental health. It is beneficial to migrants' mental health and SWB to promote social participation and social cohesion.


Asunto(s)
Estado de Salud , Salud Mental/estadística & datos numéricos , Capital Social , Migrantes/psicología , Migrantes/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Adolescente , Adulto , Anciano , China/epidemiología , Ciudades/estadística & datos numéricos , Estudios Transversales , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Encuestas y Cuestionarios , Adulto Joven
9.
Int Health ; 11(S1): S24-S32, 2019 10 31.
Artículo en Inglés | MEDLINE | ID: mdl-31670821

RESUMEN

BACKGROUND: According to the 2017 China National Education Development Statistics Bulletin, there were 14.07 million rural-urban migrant children in the compulsory education stage. The mental health of migrant children in China has drawn increasing attention in research. The objective of this study was to compare subjective well-being, self-esteem, prosocial behaviour and family functioning of migrant children vs local children in Shanghai and to explore their relationship. METHODS: A survey was conducted among 2229 students (9-17 y of age; male 52.0%, female 48.0%) and their parents from grades 4 to 8 in four primary schools and four middle schools in Shanghai in 2016. The sample consisted of 1333 migrant children and 896 urban children in three migrant schools and five public schools. A total of 959 rural-urban migrant children and 374 urban hukou migrant children were recruited. The questionnaire for students included the Personal Well-Being Index - School Children (PWI-SC), Satisfaction with Life Scale (SWLS), Positive and Negative Affect Scale for Children, Rosenberg Self-Esteem Scale, Family APGAR Index and prosocial behaviour domain of the Strengths and Difficulties Questionnaire. In the questionnaire for parents, the Personal Well-Being Index and Social Support Rating Scale were used in addition to the sociodemographic characteristics. These data were analysed using one-way analysis of variance, correlation analysis and multiple linear regression. RESULTS: Rural-urban migrant children reported significantly lower PWI-SC, SWLS, positive affect, prosocial behaviour, self-esteem and Family APGAR Index scores and reported higher negative affect scores than local children (p<0.01). The prevalence rate of abnormal prosocial behaviour among rural-urban migrant children was 10%, which was higher than that of local children (5.9%; p<0.001). Compared with rural-urban migrant children in public schools, the SWLS, prosocial behaviour and Family APGAR Index scores of the children in migrant schools were higher and the prevalence rate of abnormal prosocial behaviour was lower (p<0.01). Multiple linear regression analysis indicated that the self-esteem and Family APGAR Index had predictive effects on subjective well-being and prosocial behaviour scores of rural-urban migrant children. CONCLUSIONS: Rural-urban migrant children are susceptible to mental health problems. Additional public policy and interventions by practitioners are needed to support rural-urban migrant children.


Asunto(s)
Relaciones Familiares/psicología , Salud Mental/estadística & datos numéricos , Población Rural/estadística & datos numéricos , Estudiantes/psicología , Estudiantes/estadística & datos numéricos , Migrantes/psicología , Población Urbana/estadística & datos numéricos , Adolescente , Niño , China/epidemiología , Ciudades/estadística & datos numéricos , Femenino , Humanos , Masculino , Prevalencia , Migrantes/estadística & datos numéricos
10.
Int Health ; 11(S1): S14-S23, 2019 10 31.
Artículo en Inglés | MEDLINE | ID: mdl-31670823

RESUMEN

BACKGROUND: There are very few close-up sociological or anthropological data informing epidemiological and psychiatric research design and/or contributing to our understanding of the relationship between mental health and specific forms of urban life. Furthermore, research on the relationships between urbanicity and mental disorder has paid little attention to the global diversity of urban experience, such as in cities in China, India and Brazil. METHODS: Two innovative methods can be employed to unveil the diversified urban experience of migrants in China, i.e. an ethnography-informed sociological deep surveying instrument and an ecological momentary assessment with a smartphone app. This article introduces the design and pilot survey of these new instruments towards a 'mechanism-rich' epidemiology. RESULTS: The ethnography-informed survey instrument enabled us to include some of the issues from the ethnography and successfully 'dig deeper' into respondents' social experience. The pilot of the smartphone app serves as 'proof of principle' that we can recruit respondents in Shanghai, and that we can receive and use the data. CONCLUSIONS: Both of these pilots have demonstrated good feasibility for studying mobility, urban life and mental health. Our next steps will be to extend the Shanghai sample, to use the app in Sao Paulo and Toronto and then hopefully in India and Africa.


Asunto(s)
Estado de Salud , Trastornos Mentales/epidemiología , Salud Mental/estadística & datos numéricos , Aplicaciones Móviles , Migrantes/psicología , Migrantes/estadística & datos numéricos , Adulto , Anciano , Anciano de 80 o más Años , Antropología Cultural , China/epidemiología , Ciudades/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Adulto Joven
11.
Artículo en Inglés | MEDLINE | ID: mdl-31623353

RESUMEN

Quantitative analysis on decoupling between economic output, carbon emission, and the driving factors behind decoupling states can serve to make the economy grow without increasing carbon emission in China's transport sector. In this work, we investigate the decoupling states and driving factors of decoupling states in the transport sector of China's four municipalities (Beijing, Shanghai, Tianjin, and Chongqing) through combining the Tapio decoupling approach with the decomposition technique. The results show that (i) the decoupling state of Beijing, Shanghai, and Tianjin improved; Beijing stabilized in weak decoupling; Shanghai and Tianjin appeared to have strong decoupling, but the decoupling state of Chongqing deteriorated from decoupling to negative decoupling. (ii) The energy-saving effect was the primary contributor to decoupling in these four municipalities, promoting transport's economic growth strongly decouple from carbon emission. The economic scale effect was not optimized enough in Chongqing, facilitating expansive coupling, and expansive negative decoupling emerged. But it had a rather positive impact on decoupling process in Beijing, Shanghai and Tianjin, promoting economic growth to weakly decouple from carbon emission. (iii) The carbon-reduction effect promoted strong decoupling, which emerged in Shanghai's transport sector, more so than in the other three municipalities, in which weak decoupling emerged. Finally, several relevant policy recommendations were offered to promote the decoupling of carbon emission from economic growth and low-carbon transport.


Asunto(s)
Contaminación del Aire/estadística & datos numéricos , Desarrollo Económico/estadística & datos numéricos , Fuentes Generadoras de Energía/estadística & datos numéricos , Urbanización/tendencias , Carbono/análisis , China/epidemiología , Ciudades/estadística & datos numéricos , Desarrollo Económico/tendencias , Fuentes Generadoras de Energía/economía , Humanos
12.
BMC Med ; 17(1): 184, 2019 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-31570106

RESUMEN

BACKGROUND: The healthcare system can be understood as the dynamic result of the interaction of hospitals, patients, providers, and government configuring a complex network of reciprocal influences. In order to better understand such a complex system, the analysis must include characteristics that are feasible to be studied in order to redesign its functioning. The analysis of the emergent patterns of pregnant women flows crossing municipal borders for birth-related hospitalizations in a region of São Paulo, Brazil, allowed to examine the functionality of the regional division in the state using a complex systems approach and to propose answers to the dilemma of concentration vs. distribution of maternal care regional services in the context of the Brazilian Unified Health System (SUS). METHODS: Cross-sectional research of the areas of influence of hospitals using spatial interaction methods, recording the points of origin and destination of the patients and exploring the emergent patterns of displacement. RESULTS: The resulting functional region is broader than the limits established in the legal provisions, verifying that 85% of patients move to hospitals with high technology to perform normal deliveries and cesarean sections. The region has high independence rates and behaves as a "service exporter." Patients going to centrally located hospitals travel twice as long as patients who receive care in other municipalities even when the patients' conditions do not demand technologically sophisticated services. The effects of regulation and the agents' preferences reinforce the tendency to refer patients to centrally located hospitals. CONCLUSIONS: Displacement of patients during delivery may affect indicators of maternal and perinatal health. The emergent pattern of movements allowed examining the contradiction between wider deployments of services versus concentration of highly specialized resources in a few places. The study shows the potential of this type of analysis applied to other type of patients' flows, such as cancer or specialized surgery, as tools to guide the regionalization of the Brazilian Health System.


Asunto(s)
Vías Clínicas/estadística & datos numéricos , Parto Obstétrico/estadística & datos numéricos , Servicios de Salud Materna/estadística & datos numéricos , Transferencia de Pacientes/estadística & datos numéricos , Adulto , Brasil/epidemiología , Cesárea/estadística & datos numéricos , Ciudades/epidemiología , Ciudades/estadística & datos numéricos , Vías Clínicas/organización & administración , Vías Clínicas/normas , Estudios Transversales , Prestación de Atención de Salud/organización & administración , Prestación de Atención de Salud/normas , Parto Obstétrico/métodos , Parto Obstétrico/normas , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Servicios de Salud Materna/organización & administración , Servicios de Salud Materna/normas , Transferencia de Pacientes/organización & administración , Embarazo , Indicadores de Calidad de la Atención de Salud , Derivación y Consulta/estadística & datos numéricos , Análisis de Sistemas , Transporte de Pacientes/estadística & datos numéricos
13.
Emerg Microbes Infect ; 8(1): 1490-1500, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31631794

RESUMEN

In 2014, the chikungunya virus reached Colombia for the first time, resulting in a nationwide epidemic. The objective of this study was to describe the demographics and clinical characteristics of suspected chikungunya cases. Chikungunya infection was confirmed by enzyme-linked immunosorbent assay and 548 patients where included in the study. Of these patients, 295 were positive for antibodies against chikungunya (53.8%), and 27.6% (151/295) were symptomatic for chikungunya infection, with a symptomatic:asymptomatic ratio of 1.04:1. Factors associated with infection included low income and low socio-economic strata (odds ratio [OR]: 1.8; 95% confidence interval [CI]: 1.0-3.2, p = 0.003 and OR: 2.1; CI: 1.3-3.4, p = 0.002, respectively). Confirmed symptomatic cases were associated with symmetric arthritis (OR: 11.7; CI: 6.0-23.0, p < 0.001) of ankles (OR: 8.5; CI: 3.5-20.9, p < 0.001), hands (OR: 8.5; CI: 3.5-20.9, p < 0.001), feet (OR: 6.5; CI: 2.8-15.3, p < 0.001), and wrists (OR: 17.3; CI: 2.3-130.5, p < 0.001). Our study showed that poverty is associated with chikungunya infection. Public health strategies to prevent and control chikungunya should focus on poorer communities that are more vulnerable to infection. The rate of asymptomatic infections among confirmed cases was 48.8%. However, those with symptoms displayed a characteristic rheumatic clinical picture, which could help differentiate chikungunya infection from other endemic viral diseases.


Asunto(s)
Fiebre Chikungunya/virología , Virus Chikungunya/aislamiento & purificación , Adolescente , Adulto , Anciano , Anticuerpos Antivirales/sangre , Fiebre Chikungunya/sangre , Fiebre Chikungunya/diagnóstico , Fiebre Chikungunya/epidemiología , Virus Chikungunya/genética , Virus Chikungunya/inmunología , Ciudades/estadística & datos numéricos , Estudios de Cohortes , Colombia/epidemiología , Estudios Transversales , Demografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
14.
Bull Soc Pathol Exot ; 112(2): 96-104, 2019.
Artículo en Francés | MEDLINE | ID: mdl-31478619

RESUMEN

Big cities have thrived on all continents, so have domestic and industrial wastes not to mention the often irrational use of agricultural inputs (fertilizers and pesticides) detrimental to plants and animals. One hundred and eighty million tons of fertilizers and 2.4 million tons of pesticides are spread every year worldwide. Such pollutions, whether urban or rural, have a significant impact on the biology of mosquitoes. Today some urban spaces have properly become a land of plenty for mosquitoes. The combined use of fertilizer and pesticides in the country, quite paradoxically also favor their proliferation. Ironically the very reasons that account for the multitudes of mosquitoes are the exact reasons responsible for the depletion of biodiversity.


Asunto(s)
Agricultura , Culicidae/crecimiento & desarrollo , Contaminación Ambiental/efectos adversos , Actividades Humanas , Mosquitos Vectores/crecimiento & desarrollo , Agricultura/estadística & datos numéricos , Animales , Patógenos Transmitidos por la Sangre/aislamiento & purificación , Ciudades/estadística & datos numéricos , Reservorios de Enfermedades/microbiología , Reservorios de Enfermedades/parasitología , Reservorios de Enfermedades/estadística & datos numéricos , Reservorios de Enfermedades/virología , Contaminación Ambiental/estadística & datos numéricos , Fertilizantes/efectos adversos , Actividades Humanas/estadística & datos numéricos , Actividades Humanas/tendencias , Humanos , Plaguicidas/efectos adversos , Población Urbana/estadística & datos numéricos
15.
Cien Saude Colet ; 24(9): 3517-3528, 2019 Sep 09.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31508769

RESUMEN

The relevance of breast cancer for women has driven research about mortality of this disease. However, these studies are affected by problems generated by deaths due to ill-defined causes (IDC). To highlight distortions caused by IDC in studies that evaluate mortality, we calculated the age-standardized mortality rates of breast cancer, with and without adjustment for IDC for the years 1990, 2000, and 2010. Then, panel data regression models were estimated and enabled us to identify that the adjustment for IDC: has elevated breast cancer mortality rate of Brazilian municipalities by 9% in the period considered; has drawn mortality rates of the South, Southeast, Northeast and North regions closer; has reduced the increasing trend of mortality by almost 60%, mainly in the Southeast and South regions; has increased, more sharply, the mortality in cities with less than 5 thousand inhabitants; has curbed the significance of most factors associated with breast cancer; has revealed that the effect of longevity and the public health expenditure may be overestimated. These results highlight the importance of adjustment for IDC in producing reliable mortality indicators.


Asunto(s)
Neoplasias de la Mama/mortalidad , Causas de Muerte/tendencias , Mortalidad/tendencias , Brasil/epidemiología , Ciudades/estadística & datos numéricos , Femenino , Humanos
16.
Int J Public Health ; 64(9): 1335-1344, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31486855

RESUMEN

OBJECTIVES: To determine adolescent-reported visibility of smoking in different public and private spaces in Europe and associations between smoking visibility and beliefs about the benefits of smoking. METHODS: We used SILNE-R cross-sectional survey data (2016/2017) of 10,798 14-16-year-old students from 55 secondary schools in seven European cities. Respondents reported for private and public spaces whether they had seen others smoke there in the last 6 months. Beliefs about the benefits of smoking were measured on a 7-item scale; higher scores indicated more positive beliefs. Multilevel linear regression analyses determined associations while controlling for potential confounders and stratifying by smoking status. RESULTS: Most students reported observing others smoke in public spaces, especially at train/bus stations (84%). Positive beliefs about smoking of never smokers were positively associated with seeing others smoke in train/bus stations and leisure/sports facilities, but not at home, a friend's home, restaurants or bars, when fully adjusted. Associations were of similar magnitude for ever smokers. CONCLUSIONS: Smoking in several public places is highly visible to adolescents. Reducing this visibility might weaken positive beliefs that adolescents have about smoking.


Asunto(s)
Conducta del Adolescente/psicología , Actitud Frente a la Salud , Estudiantes/psicología , Fumar Tabaco/psicología , Adolescente , Ciudades/estadística & datos numéricos , Estudios Transversales , Europa (Continente) , Femenino , Humanos , Masculino
17.
AIDS Behav ; 23(12): 3306-3314, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31512066

RESUMEN

Monitoring distributive syringe sharing (DSS) and syringe services program (SSP) use among persons who inject drugs (PWID) is important for HIV prevention. PWID aged ≥ 18 in 20 US cities were recruited for National HIV Behavioral Surveillance in 2015 using respondent-driven sampling, interviewed and offered HIV testing. Bivariate and multivariable analyses via log-linked Poisson regression with generalized estimating equations were conducted to examine associations between demographic and behavioral variables and DSS. Effect of SSP use on DSS by HIV sero-status was assessed by including an interaction between SSP and sero-status. Analyses were adjusted for sampling design. Among 10,402 PWID, 42% reported DSS. DSS was less likely to be reported among HIV-positive compared to HIV-negative PWID (aPR = 0.51, CI 0.45-0.60), and among those who primarily obtained syringes from SSPs versus those who did not (aPR = 0.82, 95% CI 0.77-0.88). After adjustment, those who primarily used SSPs were less likely to report DSS than those who did not among both HIV-negative PWID (aPR = 0.84, 95% CI 0.78-0.90) and HIV-positive PWID (aPR = 0.54, 95% CI 0.39-0.75). Findings support expansion of SSPs, and referrals to SSPs by providers working with PWID.


Asunto(s)
Infecciones por VIH/prevención & control , Compartición de Agujas/estadística & datos numéricos , Programas de Intercambio de Agujas , Jeringas/provisión & distribución , Adolescente , Adulto , Ciudades/epidemiología , Ciudades/estadística & datos numéricos , Femenino , Humanos , Masculino , Tamizaje Masivo , Persona de Mediana Edad , Vigilancia de la Población/métodos , Abuso de Sustancias por Vía Intravenosa/epidemiología , Estados Unidos/epidemiología , Adulto Joven
18.
Artículo en Inglés | MEDLINE | ID: mdl-31416292

RESUMEN

This systematic review aimed to examine the associations between health-related outcomes and the built environment (BE) characteristics of compact metropolitan cities in Korea using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. Searching the three Korean academic databases and PubMed, two independent reviewers identified 27 empirical articles published between 2011 and 2016. Data extracted for review included the study characteristics, the variables and measurement methods related to the BE and health-related outcomes, and the findings on the associations between the BE characteristics and health-related outcomes. Vote counting was used to assess the consistency of associations and the direction of associations between the BE characteristics and health-related outcomes. All of the reviewed studies used cross-sectional designs. The objective BE qualities were commonly examined. The BE characteristics associated with health-related outcomes in the reviewed articles included land use, street environment, transportation infrastructure, green and open spaces, and neighborhood facilities. Street environment, transportation infrastructure, and green and open spaces had consistent positive associations with physical health. Mixed land use and neighborhood facilities, however, had inconsistent associations with physical health. Generally, insufficient findings were reported in the association between the BE characteristics and mental and social health. The accessibility of the BE in a compact urban environment was the prominent attribute related to health promotion, health challenges, and health equity. An international comparative analysis of compact cities with different urban contexts and scale is required. Interdisciplinary urban health strategies are recommended based on the associations between the BE characteristics and health-related outcomes.


Asunto(s)
Entorno Construido/estadística & datos numéricos , Planificación Ambiental/estadística & datos numéricos , Estado de Salud , Características de la Residencia/estadística & datos numéricos , Ciudades/estadística & datos numéricos , Estudios Transversales , Humanos , República de Corea
19.
Artículo en Inglés | MEDLINE | ID: mdl-31319540

RESUMEN

Using the case of Ulaanbaatar, Erdenet, and Darkhan cities from Mongolia, the study aimed to assess the contamination level and health risk assessment of heavy metals (As, Cr, Pb, Ni, and Zn) in urban soil. A total of 78 samples was collected from a variety of functional areas. The geoaccumulation index (Igeo) and integrated pollution index (IPI) were used in pollution assessment, while the health risk was scored using a hazard quotient (HQ) and health index (HI) for non-carcinogenic heavy metals, as well as a lifetime average daily dose (LADD) for carcinogenic heavy metals. The results show that the concentration of heavy metals in the soil samples taken from Darkhan city, which presented "uncontaminated" values in terms of Igeo for all metals, was relatively lower than other cities within the contamination assessment. Furthermore, the Igeo value signified "uncontimated to heavily contaminated" soil in the Ulaanbaatar and Erdenet cities. Typically, as for the IPI that observed similar trends with Igeo, the mean IPI values in Ulaanbaatar, Erdenet, and Darkhan were 1.33 (moderate level of pollution), 1.83 (moderate level of pollution), and 0.94 (low level of pollution), respectively. In terms of the assessment of potential health risk, there was a particular or different level of ingestion, dermal contact, and inhalation exposure pathway for human health. Among these three different pathways, the ingestion was estimated by the main contributor for health risk. Each value of HQ and HI indicated that soil heavy metals of studied cities were at a safe level (<1) or had the absence of a significant health risk there. In addition, the potential health risk for children was greater than for adults, where heavy metal values of HI for children had a high value compared to adults. We estimated carcinogenic risks through the inhalation exposure, and as a result, there were no significant risks for human health in the studied cities from three elements (As, Cr, and Ni).


Asunto(s)
Carcinógenos/análisis , Contaminación Ambiental/análisis , Metales Pesados/análisis , Contaminantes del Suelo/análisis , Suelo/química , Adulto , Niño , Ciudades/estadística & datos numéricos , Monitoreo del Ambiente , Humanos , Mongolia , Medición de Riesgo
20.
Environ Sci Pollut Res Int ; 26(26): 26472-26487, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31290043

RESUMEN

Environmental regulations affect employment through productivity output and factor substitution. This paper employs a difference-in-differences (DID) method to investigate the effect of China's Two Control Zones (TCZ) policy on the urban employment in 287 cities from 1994 to 2009. We apply the DID method to two time points: 1998 for policy issuance and 2000 for the policy implementation. From the results of analyses on full-sample cities, the TCZ policy did not contribute to increasing total urban employment. Moreover, a negative impact on employment resulted from sulfur dioxide and acid rain controls in secondary and tertiary industries, respectively. In the acid rain control zone, the TCZ policy increased the average wage of urban workers. Negative effects on employment were observed in larger cities. The policy triggered labor migration from larger to smaller cities, resulting in significant increases in primary and tertiary industry employment in smaller cities, although the effects on mid-size cities were insignificant. This study provides important empirical evidence and insight into the impact of the TCZ policy on urban employment.


Asunto(s)
Desarrollo Económico , Emigración e Inmigración/tendencias , Empleo/estadística & datos numéricos , Política Ambiental/legislación & jurisprudencia , Regulación Gubernamental , China , Ciudades/estadística & datos numéricos , Política Ambiental/economía , Humanos
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