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1.
Int J Equity Health ; 19(1): 70, 2020 05 19.
Artículo en Inglés | MEDLINE | ID: mdl-32429948

RESUMEN

COVID-19 has imposed unprecedented challenges to society. As the pandemic evolves, the social distancing measures that have been globally enforced, while essential, are having undesirable socioeconomic side effects particularly among vulnerable populations. In Mexico, families who depend upon informal employment face increased threats to their wellbeing, and households who in addition have young children may face long-term consequences. The Mexican government has not yet taken actions, but a coalition of non-governmental organizations is advocating in partnership with academic institutions for social protection actions such as a cash transfer and basic services subsidies for families with young children, subsisting from the informal sector economy. To facilitate governmental action, we estimated the costs for implementation of these recommendations. The methodology used could be replicated in other countries facing similar challenges.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Composición Familiar , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Poblaciones Vulnerables , Bienestar del Niño , Preescolar , Costos y Análisis de Costo , Humanos , Lactante , Recién Nacido , México , Distancia Social
2.
Waste Manag ; 108: 183-188, 2020 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-32361534

RESUMEN

The distance of recycling bins from households is often considered important by practitioners, but published evidence for this uses only indirect and self-reported data. This study aims to provide such evidence by obtaining a clean test using measured distances in a walled community with 1200 households with the same building types, local governance, recycling and waste arrangements. The number of deposits each month of food waste for recycling at a designated site are logged via smart-cards allocated per household. The number of days per month that each household deposits showed a highly significant - but small - negative correlation with distance of the bin: fewer householders participate if further away, accounting for 3% of the variation. Surprisingly, there is no variation with distance among those who do participate: their recycling frequency does not vary. This second result is not consistent with the first in terms of cost/benefit concepts assumed by government planners, nor with the static theories of behaviour currently used in waste management research. We recommend that recycling practitioners note the smallness of the contribution of distance to recycling performance, and not overrate it. And we recommend that researchers make better use of non-static models (which model different stages towards behaviour change), which our second result appears to call for.


Asunto(s)
Eliminación de Residuos , Administración de Residuos , Composición Familiar , Alimentos , Reciclaje
3.
BMC Infect Dis ; 20(1): 329, 2020 May 07.
Artículo en Inglés | MEDLINE | ID: mdl-32381073

RESUMEN

BACKGROUND: Although people of all ages are susceptible to the novel coronavirus infection, which is presently named "Coronavirus Disease 2019" (COVID-19), there has been relatively few cases reported among children. Therefore, it is necessary to understand the clinical characteristics of COVID-19 in children and the differences from adults. CASE PRESENTATION: We report one pediatric case of COVID-19. A 14-month-old boy was admitted to the hospital with a symptom of fever, and was diagnosed with a mild form of COVID-19. The child's mother and grandmother also tested positive for SARS-CoV-2 RNA. However, the lymphocyte counts were normal. The chest computed tomography (CT) revealed scattered ground glass opacities in the right lower lobe close to the pleura and resorption after the treatment. The patient continued to test positive for SARS-CoV-2 RNA in the nasopharyngeal swabs and stool at 17 days after the disappearance of symptoms. CONCLUSION: The present pediatric case of COVID-19 was acquired through household transmission, and the symptoms were mild. Lymphocyte counts did not significantly decrease. The RNA of SARS-CoV-2 in stool and nasopharyngeal swabs remained positive for an extended period of time after the disappearance of symptoms. This suggests that attention should be given to the potential contagiousness of pediatric COVID-19 cases after clinical recovery.


Asunto(s)
Infecciones por Coronavirus/diagnóstico , Coronavirus , Heces/virología , Fiebre/etiología , Pulmón/diagnóstico por imagen , Nasofaringe/virología , Neumonía Viral/diagnóstico por imagen , Adulto , Betacoronavirus , Técnicas de Laboratorio Clínico , Coronavirus/genética , Coronavirus/aislamiento & purificación , Infecciones por Coronavirus/diagnóstico por imagen , Infecciones por Coronavirus/epidemiología , Composición Familiar , Humanos , Lactante , Recuento de Linfocitos , Masculino , Pandemias , Neumonía Viral/epidemiología , Reacción en Cadena de la Polimerasa , Síndrome Respiratorio Agudo Grave/transmisión , Tomografía Computarizada por Rayos X
4.
BMC Public Health ; 20(1): 445, 2020 Apr 05.
Artículo en Inglés | MEDLINE | ID: mdl-32248812

RESUMEN

BACKGROUND: Acute gastroenteritis (AGE) is a highly transmissible condition spreading rapidly between individuals and within households. Rotavirus vaccination was introduced in the UK in 2013. The study objectives were to investigate how acute gastroenteritis incidence changed over 25 years and household incidence of AGE since 2013. METHODS: Repeated cross-sectional study of Royal College of General Practitioners Research and Surveillance Centre network. We used a negative binomial model to report incidence rate ratio (IRR) using the last 5 years data. We also conducted a retrospective cohort analysis, using a shared gamma frailty model (2013-2017). We explored the impact of child under 5- years, household size, socioeconomic status quintile, and rurality. RESULTS: In the cross-sectional analysis, the IRR of AGE in households with a child of under 5 years was 12.20 (95%CI 11.08-13.45-, p < 0.001) compared with households without; the IRR fell across IMD quintiles, for example there is a 37% decrease in incidence comparing IMD quintile 1 to quintile 5 (95%CI -0.52-0.76, p < 0.001), The cohort study revealed that the presence of an under 5 in the household was associated with a higher risk of household presentation (HR = 6.29, 95% CI 5.61-7.06, p < 0.001). In addition, we observe a reduction in risk of presentation from the most to the least deprived socioeconomic quintile (second quintile: HR = 0.74 (95%CI 0.59-0.92), to least deprived quintile, HR = 0.55 (95%CI 0.41-0.74). We saw a lower association with male gender, white ethnicity and living outside London, but an increased association with increasing household size. CONCLUSIONS: The incidence of AGE has changed over time: pre-school children, larger households, and living in London were associated with higher rates, and male gender and higher economic status associated with lower rates.


Asunto(s)
Composición Familiar , Gastroenteritis/epidemiología , Adolescente , Adulto , Anciano , Niño , Preescolar , Estudios Transversales , Bases de Datos Factuales , Femenino , Humanos , Incidencia , Lactante , Recién Nacido , Londres , Masculino , Persona de Mediana Edad , Atención Primaria de Salud , Estudios Retrospectivos , Factores de Riesgo , Factores Socioeconómicos , Adulto Joven
5.
Medwave ; 20(2): e7833, 2020 Mar 19.
Artículo en Español | MEDLINE | ID: mdl-32225131

RESUMEN

Background: Out-of-pocket spending on medicines and supplies can lead to a heavy financial burden in households. Objective: To determine the out-of-pocket spending on medicines and supplies in Peru and the population groups with the highest out-of-pocket spending on medicines and supplies in 2007 and 2016. Methods: We conducted an analytical cross-sectional study of the Peruvian National Household Survey on Living and Poverty Conditions for the years 2007 and 2016. Mean and median out-of-pocket spending on medicines and supplies are reported in USD for the general population, and according to the presence or not of factors described in the literature as associated with out-of-pocket spending on medicines and supplies. Results: 92 148 and 130 296 participants from 2007 and 2016 were included. In 2007, a median of 3.19 (interquartile range: 0.96 to 7.99) and an average of 8.14 (95% confidence interval: 7.80 to 8.49) were found for the out-of-pocket spending on medicines and supplies. In 2016, the median and mean out-of-pocket spending on medicines and supplies were 3.55 (interquartile range: 1.48 to 8.88) and 9.68 (95% confidence interval: 9.37 to 9.99), respectively. For 2016, higher out-of-pocket spending on medicines and supplies was found in women, children under five and over 60 years of age, people of higher educational level, having private or armed forces insurance, living in the coastal region, and being in one of the highest per capita quintile of expenditure. Between 2007 and 2016, the out-of-pocket spending on medicines and supplies was significantly increased in children under five (p < 0.001), uninsured persons (p < 0.001), insured to the Seguro Integral de Salud (p < 0.001) or the Armed Forces (p = 0.035), for the urban and rural area (both p < 0.001), and in people without chronic diseases (p < 0.001). Conclusions: An increase in out-of-pocket spending on medicines and supplies was found in the study period. There were population groups with significant increases in out-of-pocket spending on medicines and supplies. It is necessary to explore further the factors associated with out-of-pocket spending on medicines and supplies in groups of greater economic vulnerability regarding direct health spending in Peru.


Asunto(s)
Costos de los Medicamentos , Financiación Personal , Gastos en Salud , Adolescente , Adulto , Niño , Estudios Transversales , Composición Familiar , Femenino , Financiación Personal/economía , Gastos en Salud/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Perú , Pobreza , Adulto Joven
6.
Science ; 368(6488): 274-277, 2020 04 17.
Artículo en Inglés | MEDLINE | ID: mdl-32299948

RESUMEN

Drought is a critical stressor that contributes to water insecurity. In the United States, an important pathway by which drought affects households' access to clean, reliable drinking water for basic needs is through the organization and activities of community water systems. Research on the local political economy of drinking water provision reveals the constraints on community water systems that affect their performance when confronting drought hazards. Fragmentation in responsibility for drinking water contributes to disparities in drought vulnerability, preparation, and response across households and across communities. The nature and extent of these disparities require further investigation to identify strategies for expanding water security in the face of drought and other water hazards.


Asunto(s)
Agua Potable , Sequías , Abastecimiento de Agua , Composición Familiar , Humanos , Estados Unidos
7.
J Environ Manage ; 264: 110457, 2020 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-32224292

RESUMEN

In this study, we posit that in determining the underpinnings and attributes of community resilience to disaster-shocks, an analysis of actual and potential disaster victims' emic perspectives, that is the views of cultural insiders, on recovery processes and community resilience is crucial. We argue that community resilience must be framed within a deeper understanding of the subjective views of the actors themselves, their local knowledge and culture, and the historical context of the place or social formation. In this context, the primary goal of this study was to delineate the fundamental elements of community recovery and attributes of resilience to cyclones, storm surges, and other environmental disaster-shocks in Bangladesh's coastal communities, and, recognizing that social actions are pivotal elements of community resilience, we attempt to make a novel contribution by underscoring local emic perspectives. Using the tools of participatory research methods, we collected empirical data from four sources: a household survey of 300 household heads, eight focus group discussions, 20 key informant interviews, and five in-depth, household case studies. Our research findings revealed that the roles of traditional-informal as well as quasi-formal institutions were vital for rapid recovery and transformation to new local economic and livelihood trajectories. Resilience attributes that were deeply embedded in community characteristics assisted in ameliorating immediate impacts as well as in building future adaptive capacities. Out of 12 resilience attributes identified by the respondents, 'knowledge, skills and learning', 'values and beliefs', 'people-place connection', 'social networks and support', 'active institutions', and 'self-organization' capacities were ranked highest. The community resilience attributes and their functionality in the context of the coastal communities studied varied significantly depending on their economic base, occupations, and their respective contexts of vulnerability. Overall, the findings demonstrate that community resilience attributes function interactively rather than independently, and analyses of community attributes therefore require a clear understanding of network functioning and the processes that drive institutional structures, relations, and outcomes.


Asunto(s)
Tormentas Ciclónicas , Planificación en Desastres , Desastres , Bangladesh , Composición Familiar , Grupos Focales , Resiliencia Psicológica
8.
J Glob Health ; 10(1): 010406, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32257154

RESUMEN

Background: There is considerable interest in community organising and activism as a strategy to shift patriarchal gender norms, attitudes and beliefs and thus reduce intimate partner violence (IPV). Yet there is limited insight into how activism actually translates into reduced violence, including how aspects of programme implementation or cultural context may affect impact. This study evaluates the community activism/mobilisation portion of Indashyikirwa, a multi-component, IPV prevention programme implemented in rural Rwanda. The activism part of Indashyikirwa was based on SASA!, a promising program model from Uganda with demonstrated effectiveness. Methods: We implemented two separate cross-sectional surveys as part of a larger community randomised controlled trial to assess the impact of the community portion of Indashyikirwa on preventing physical and/or sexual IPV and other secondary outcomes at a community level. The survey consisted of a random household-based sample of 1400 women and 1400 men at both waves. Surveys were conducted before community-level activities commenced and were repeated 24 months later with a new cross-sectional sample. Longitudinal, qualitative data were collected as part of an embedded process evaluation. Results: There was no evidence of an intervention effect at a community level on any of the trial's primary or secondary outcomes, most notably women's experience of physical and/or sexual IPV from a current male partner in the past 12 months (adjusted odds ratio (aOR) = 1.25; 95% confidence interval (CI) = 0.92-1.70, P = 0.16), or men's perpetration of male-to-female physical and/or sexual IPV (aOR = 1.02; 95% CI = 0.72-1.45, P = 0.89). Process evaluation data suggest that delays due to challenges in adapting and implementing SASA!-style activites in rural Rwanda may account for the trial's failure to measure an effect. Additionally, the intervention strategy of informal activism was not well suited to the Rwandan context and required considerable modification. Conclusions: Failure to reduce violence when implementing an adaptation of SASA! in rural Rwanda highlights the importance of allowing sufficient time for adapting evidence-based programming (EBP) to ensure cultural appropriateness and fidelity. This evaluation held little chance of demonstrating impact since the project timeline forced endline evaluation only months after certain elements of the programme became operational. Donors must anticipate longer time horizons (5 to 7 years) when contemplating evaluations of novel or newly-adapted programmess for reducing IPV at a population level. These findings also reinforce the value of including embedded process evaluations when investing in rigorous trials of complex phenomena such as community activism. Trial registration: ClinicalTrials.gov, NCT03477877.


Asunto(s)
Participación de la Comunidad , Violencia de Pareja/prevención & control , Población Rural , Parejas Sexuales , Adolescente , Adulto , Servicios de Salud Comunitaria , Estudios Transversales , Composición Familiar , Femenino , Humanos , Violencia de Pareja/etnología , Violencia de Pareja/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Rwanda , Maltrato Conyugal/etnología , Maltrato Conyugal/prevención & control , Maltrato Conyugal/estadística & datos numéricos
9.
Acta Med Port ; 33(4): 229-236, 2020 Apr 01.
Artículo en Portugués | MEDLINE | ID: mdl-32238236

RESUMEN

INTRODUCTION: Sao Tome and Principe is an African low-and-middle-income country, where extreme poverty causes major health inequalities. No systematic research has been done on the consumption of alcohol and drugs in Sao Tome and Principe, and only overall statistics are available based on the importation of alcoholic drinks and their distribution among the population. There are also no studies on consumption of alcohol and illicit substances in children and youth and no preventive measures being undertaken. Besides that, manual databases present significant limitations, considering the lack of causes associated with mortality rates (0 - 5 years and > 5), and the difficulty to establish a cause/effect relation between diseases, deaths and life expectancy. No relevant data with burden of life was found in the reports of Centro Nacional de Endemias or the non-governmental, organization Instituto Marques de Valle Flor, a facilitator on healthcare clinical specialties selected on a voluntary basis by doctors from Portuguese hospitals. So, we proposed to provide a first overview of family and housing conditions, and above all, the consumption of alcohol and illegal drugs in young people. Thus, a project, the National Survey on Harmful Consumption of Alcohol and Drugs in Schools of Sao Tome and Principe, will be realized in order to better characterize the situation among children and young students and test public health communication strategies and preventive interventions aimed at this target-population. Interventions were designed taking into consideration local sociocultural realities of target audiences. We considered dialect language, single-parent families (matriarchal structure) and polygamy (mostly) in men and a country and governments led by men (patriarchal structure) and, in which the woman's role, as Food and Agriculture Organization of the United Nations reports, remains overlooked. Subsequently, we will collect traditional alcohols samples from the two main islands for analysis (at Laboratório de Estudos Farmacêuticos and Laboratório Nacional de Engenharia Civil - Portugal) and to determine heavy metals in the production process and impact on burden of life. MATERIAL AND METHODS: In order to characterise the country's situation in terms of alcohol and illicit substances consumption a literature review was carried out through a search in several international electronic databases, such as those of the World Health Organization, World Health Organization Africa, United Nation, The Lancet and Lancet Global Health, etc. Available data of the following institutions of Sao Tome and Príncipe was also analyzed: National Institute of Statistics, Ministry of Education, Culture and Training and Ministry of Health and Social Affairs. Several interviews with community and church leaders as well as with members of catholic missions were carried out to better understand the local situation. Following this, a nationwide cross-sectional survey of a sample of 2064 students will be carried out. This will include a questionnaire on socio-demographic characteristics, lifestyles, health behaviors/attitudes, alcohol and illicit substances consumption. Finally, based on the overall diagnosis obtained, some edutainment health communication preventive interventions will be tested in the primary schools of three districts (EDUCA_TURTLE) and on the radio journalists (EDUCA_PRESS). These were evaluated by primary school teachers and by radio journalists.


Asunto(s)
Consumo de Bebidas Alcohólicas/prevención & control , Trastornos Relacionados con Sustancias/prevención & control , Adolescente , Adulto , Consumo de Bebidas Alcohólicas/epidemiología , Causas de Muerte , Estudios Transversales , Características Culturales , Recolección de Datos , Bases de Datos Factuales/normas , Composición Familiar , Femenino , Encuestas Epidemiológicas , Vivienda/normas , Humanos , Esperanza de Vida , Masculino , Salud Pública , Santo Tomé y Príncipe , Trastornos Relacionados con Sustancias/epidemiología , Adulto Joven
10.
Lancet ; 395(10228): 973-984, 2020 03 21.
Artículo en Inglés | MEDLINE | ID: mdl-32199484

RESUMEN

BACKGROUND: Tens of millions of children are exposed to Mycobacterium tuberculosis globally every year; however, there are no contemporary estimates of the risk of developing tuberculosis in exposed children. The effectiveness of contact investigations and preventive therapy remains poorly understood. METHODS: In this systematic review and meta-analysis, we investigated the development of tuberculosis in children closely exposed to a tuberculosis case and followed for incident disease. We restricted our search to cohort studies published between Jan 1, 1998, and April 6, 2018, in MEDLINE, Web of Science, BIOSIS, and Embase electronic databases. Individual-participant data and a pre-specified list of variables were requested from authors of all eligible studies. These included characteristics of the exposed child, the index case, and environmental characteristics. To be eligible for inclusion in the final analysis, a dataset needed to include: (1) individuals below 19 years of age; (2) follow-up for tuberculosis for a minimum of 6 months; (3) individuals with household or close exposure to an individual with tuberculosis; (4) information on the age and sex of the child; and (5) start and end follow-up dates. Studies assessing incident tuberculosis but without dates or time of follow-up were excluded. Our analysis had two primary aims: (1) estimating the risk of developing tuberculosis by time-period of follow-up, demographics (age, region), and clinical attributes (HIV, tuberculosis infection status, previous tuberculosis); and (2) estimating the effectiveness of preventive therapy and BCG vaccination on the risk of developing tuberculosis. We estimated the odds of prevalent tuberculosis with mixed-effects logistic models and estimated adjusted hazard ratios (HRs) for incident tuberculosis with mixed-effects Poisson regression models. The effectiveness of preventive therapy against incident tuberculosis was estimated through propensity score matching. The study protocol is registered with PROSPERO (CRD42018087022). FINDINGS: In total, study groups from 46 cohort studies in 34 countries-29 (63%) prospective studies and 17 (37%) retrospective-agreed to share their data and were included in the final analysis. 137 647 tuberculosis-exposed children were evaluated at baseline and 130 512 children were followed for 429 538 person-years, during which 1299 prevalent and 999 incident tuberculosis cases were diagnosed. Children not receiving preventive therapy with a positive result for tuberculosis infection had significantly higher 2-year cumulative tuberculosis incidence than children with a negative result for tuberculosis infection, and this incidence was greatest among children below 5 years of age (19·0% [95% CI 8·4-37·4]). The effectiveness of preventive therapy was 63% (adjusted HR 0·37 [95% CI 0·30-0·47]) among all exposed children, and 91% (adjusted HR 0·09 [0·05-0·15]) among those with a positive result for tuberculosis infection. Among all children <5 years of age who developed tuberculosis, 83% were diagnosed within 90 days of the baseline visit. INTERPRETATION: The risk of developing tuberculosis among exposed infants and young children is very high. Most cases occurred within weeks of contact investigation initiation and might not be preventable through prophylaxis. This suggests that alternative strategies for prevention are needed, such as earlier initiation of preventive therapy through rapid diagnosis of adult cases or community-wide screening approaches. FUNDING: National Institutes of Health.


Asunto(s)
Trazado de Contacto/métodos , Transmisión de Enfermedad Infecciosa , Mycobacterium tuberculosis/aislamiento & purificación , Tuberculosis Pulmonar/transmisión , Adolescente , Factores de Edad , Niño , Preescolar , Composición Familiar , Femenino , Salud Global , Humanos , Incidencia , Masculino , Medición de Riesgo , Factores Sexuales , Tuberculosis Pulmonar/diagnóstico , Tuberculosis Pulmonar/epidemiología
11.
J Environ Manage ; 261: 109921, 2020 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-32148251

RESUMEN

Most estimations of residential water demand are based on single-equation models that rely on assumptions that are most often not compatible with the fundamental principles of consumer theory. In this paper, we relax these assumptions by using a more flexible system of demand estimation, the Quadratic Almost Ideal Demand System (QUAIDS) (Banks et al., 1997) and reveal the existence in our sample of substitution and complementary patterns as well as non-linearities in Engel curves for water consumption. Water demand would not be, therefore, linear in income and separable from other goods consumed within the household. In this context the QUAIDS functional specification is expected to be more consistent with observed consumer behavior. Our results seem to confirm this expectation; when compared to the linear, log-linear and double-log models commonly used in water demand estimation, QUAIDS seems to produce a better overall fit and a better fit to the asymmetric shape of the real distribution of water consumption. This has important implications in terms of public policy, as it allows to explore how water policies interact with other goods consumed within the household (e.g. water-energy nexus or efficient household appliances). Furthermore, differential responses to pricing policies and taxes across the income distribution can be considered, thus contributing to avoid undesired redistributive effects and water poverty.


Asunto(s)
Comercio , Agua , Composición Familiar , Renta , Impuestos
12.
Rev Bras Epidemiol ; 23: e200006, 2020.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-32130395

RESUMEN

INTRODUCTION: Systemic arterial hypertension (SAH) has a high prevalence in Brazil and impacts on the use of health services. OBJECTIVE: This study verified the influence of the Family Health Strategy (FHS) on the use of health services by adults ≥ 18 years old who reported SAH in the National Health Survey (Pesquisa Nacional de Saúde - PNS) 2013. METHODS: The Propensity Score (PS) method was used to correct the lack of homogeneity between the groups with SAH under exposed or not to the FHS. PS was estimated using binary logistic regression, which reflected the conditional probability of receiving the household register in the FHS according to socioeconomic, demographic and health covariates of adults and their families. After estimating the PS, the stratification was used to group hypertensive adults into five mutually exclusive strata (pairing them). Prevalence and confidence intervals at 95% were estimated of medical consultations and hospitalizations. The effects of the complex NHS sampling were incorporated into all phases of the analysis. RESULTS: It was verified that hypertensive adults enrolled in FHS had worse socioeconomic, health and health conditions, but similar prevalence of medical consultations and hospitalizations to adults without a FHS registry and with better living and health conditions. The FHS has attenuated individual and contextual inequalities that impact the health of Brazilians by favoring the use of health services. CONCLUSION: The FHS can favor the care and control of SAH in Brazil. Thus, it must receive investments that guarantee its effectiveness.


Asunto(s)
Salud de la Familia , Servicios de Salud/estadística & datos numéricos , Hipertensión/epidemiología , Hipertensión/prevención & control , Programas Nacionales de Salud/estadística & datos numéricos , Anciano , Brasil/epidemiología , Composición Familiar , Femenino , Encuestas de Atención de la Salud , Encuestas Epidemiológicas , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Puntaje de Propensión , Factores Socioeconómicos
13.
Environ Pollut ; 259: 113619, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32191994

RESUMEN

Quantitating the health effects of employment history in factories, especially polluting ones, is essential for understanding the benefits or losses of industrialization in rural areas. Using a traced subset of nationwide panel data from 2005 covering five provinces, 101 villages, and 2026 households (collected recently in 2016) and the econometric models, this study estimated the effect of factory employment history on workers' health. The results showed that: the absolute number of factory workers increased from 1998 to 2015, and the proportion of factory workers was 7.68% in 2015; the absolute number and the proportion of farmers decreased from 63.84% in 1998 to 29.06% in 2015. Given that all the respondents live in rural areas, the HlthPlace (the first place the individual went to for their last illness in 2015) was selected as the main dependent variable of interest, and Hlthexp (Healthcare expenditure per person at last illness in 2015) and self-reported health were used as auxiliary dependent variables. The findings revealed that, after controlling the characteristics of individual, household, hospital and area, a one year increase of factory employment history corresponded to a 0.035 level increase in the probability of people choosing high-level hospital (p < 0.01) and a 237.61 yuan increase in healthcare expenditure (p < 0.1). The results also showed the adverse effect of self-reported health on factory employment history (p < 0.01). In addition, the relationship between the farming history and health was evaluated, and the econometric results showed that compared with factory employment history, farming history had opposite impacts on health (p < 0.01). Finally, the robustness check showed that the empirical results were reliable and that the initial results were robust. Generally, this study revealed the effect of overall factory employment on health, which is a useful research supplement to the studies on the health effects of specific pollution exposure.


Asunto(s)
Agricultura , Empleo , Exposición Profesional/efectos adversos , Salud Rural , Población Rural , China , Composición Familiar , Humanos
15.
Artículo en Inglés | MEDLINE | ID: mdl-32143519

RESUMEN

After the 2019 novel coronavirus (2019-nCoV) outbreak, we estimated the distribution and scale of more than 5 million migrants residing in Wuhan after they returned to their hometown communities in Hubei Province or other provinces at the end of 2019 by using the data from the 2013-2018 China Migrants Dynamic Survey (CMDS). We found that the distribution of Wuhan's migrants is centred in Hubei Province (approximately 75%) at a provincial level, gradually decreasing in the surrounding provinces in layers, with obvious spatial characteristics of circle layers and echelons. The scale of Wuhan's migrants, whose origins in Hubei Province give rise to a gradient reduction from east to west within the province, and account for 66% of Wuhan's total migrants, are from the surrounding prefectural-level cities of Wuhan. The distribution comprises 94 districts and counties in Hubei Province, and the cumulative percentage of the top 30 districts and counties exceeds 80%. Wuhan's migrants have a large proportion of middle-aged and high-risk individuals. Their social characteristics include nuclear family migration (84%), migration with families of 3-4 members (71%), a rural household registration (85%), and working or doing business (84%) as the main reason for migration. Using a quasi-experimental analysis framework, we found that the size of Wuhan's migrants was highly correlated with the daily number of confirmed cases. Furthermore, we compared the epidemic situation in different regions and found that the number of confirmed cases in some provinces and cities in Hubei Province may be underestimated, while the epidemic situation in some regions has increased rapidly. The results are conducive to monitoring the epidemic prevention and control in various regions.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Emigración e Inmigración , Epidemias , Neumonía Viral/epidemiología , Adulto , Anciano , Aniversarios y Eventos Especiales , Betacoronavirus/aislamiento & purificación , Betacoronavirus/patogenicidad , China/epidemiología , Ciudades , Coronavirus , Infecciones por Coronavirus/transmisión , Composición Familiar , Salud de la Familia , Femenino , Predicción , Vacaciones y Feriados , Humanos , Masculino , Persona de Mediana Edad , Neumonía Viral/transmisión , Población Rural , Estaciones del Año , Adulto Joven
17.
PLoS Negl Trop Dis ; 14(1): e0007967, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-32004316

RESUMEN

Oral cholera vaccine (OCV) has increasingly been used as an outbreak control measure, but vaccine shortages limit its application. A two-dose OCV campaign targeting residents aged over 1 year was launched in three rural Communes of Southern Haiti during an outbreak following Hurricane Matthew in October 2016. Door-to-door and fixed-site strategies were employed and mobile teams delivered vaccines to hard-to-reach communities. This was the first campaign to use the recently pre-qualified OCV, Euvichol. The study objective was to estimate post-campaign vaccination coverage in order to evaluate the campaign and guide future outbreak control strategies. We conducted a cluster survey with sampling based on random GPS points. We identified clusters of five households and included all members eligible for vaccination. Local residents collected data through face-to-face interviews. Coverage was estimated, accounting for the clustered sampling, and 95% confidence intervals calculated. 435 clusters, 2,100 households and 9,086 people were included (99% response rate). Across the three communes respectively, coverage by recall was: 80.7% (95% CI:76.8-84.1), 82.6% (78.1-86.4), and 82.3% (79.0-85.2) for two doses and 94.2% (90.8-96.4), 91.8% (87-94.9), and 93.8% (90.8-95.9) for at least one dose. Coverage varied by less than 9% across age groups and was similar among males and females. Participants obtained vaccines from door-to-door vaccinators (53%) and fixed sites (47%). Most participants heard about the campaign through community 'criers' (58%). Despite hard-to-reach communities, high coverage was achieved in all areas through combining different vaccine delivery strategies and extensive community mobilisation. Emergency OCV campaigns are a viable option for outbreak control and where possible multiple strategies should be used in combination. Euvichol will help alleviate the OCV shortage but effectiveness studies in outbreaks should be done.


Asunto(s)
Vacunas contra el Cólera/administración & dosificación , Cólera/prevención & control , Vacunación Masiva/métodos , Cobertura de Vacunación , Adolescente , Adulto , Niño , Preescolar , Cólera/epidemiología , Vacunas contra el Cólera/provisión & distribución , Análisis por Conglomerados , Recolección de Datos , Brotes de Enfermedades , Composición Familiar , Femenino , Haití/epidemiología , Humanos , Lactante , Masculino , Población Rural
18.
BMC Public Health ; 20(1): 149, 2020 Jan 31.
Artículo en Inglés | MEDLINE | ID: mdl-32005220

RESUMEN

BACKGROUND: The global poverty profile shows that Africa and Asia bear the highest burden of multidimensional child poverty. Child survival and development therefore depend on socioeconomic and environmental factors that surround a child.The aim of this paper is to measure multidimensional child poverty and underpin what drives it among children aged 5 to 18 years in a resource poor region of Burkina Faso. METHODS: Using primary data collected from a cross sectional study of 722 households in the Mouhoun region of Burkina Faso, the Alkire-Foster methodology was applied to estimate and decompose child poverty among children aged 5-18 years. Seven broad dimensions guided by the child poverty literature, data availability and the country's SDGs were used. A binary logistic regression model was applied to identify drivers of multidimensional child poverty in the region. RESULTS: The highest prevalence of deprivations were recorded in water and sanitation (91%), information and leisure (89%) followed by education (83%). Interestingly, at k = 3 (the sum of weighted indicators that a child must be deprived to be considered multidimensionally poor), about 97% of children are deprived in at least three of the seven dimensions. At k = 4 to k = 6, between 88.7 and 30.9% of children were equally classified as suffering from multidimensional poverty. The odds of multidimensional poverty were reduced in children who belonged to households with a formally educated mother (OR = 0.49) or stable sources of income (OR = 0.31, OR = 0.33). The results equally revealed that being an adolescent (OR = 0.67), residing in the urban area of Boromo (OR = 0.13) and rural area of Safané (OR = 0.61) reduced the odds of child poverty. On the other hand, child poverty was highest among children from the rural area of Yé (OR = 2.74), polygamous households (OR = 1.47, OR = 5.57 and OR = 1.96), households with an adult head suffering from a longstanding illness (OR = 1.61), households with debts (OR = 1.01) and households with above five number of children/woman (OR = 1.49). CONCLUSION: Child poverty is best determined by using a multidimensional approach that involves an interplay of indicators and dimensions, bearing in mind its causation.


Asunto(s)
Pobreza/estadística & datos numéricos , Adolescente , Burkina Faso , Niño , Preescolar , Estudios Transversales , Composición Familiar , Femenino , Humanos , Masculino , Factores de Riesgo
19.
PLoS One ; 15(2): e0227342, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32074100

RESUMEN

The transition to parenthood (TTP) is a stressful life event for most couples. Therefore, the way both partners jointly cope with stress (i.e., dyadic coping) is important for the prevention of individual adjustment problems (e.g., depression). For dyadic coping to be effective in reducing depressive symptoms, efforts of both partners should be equal. However, many couples experience a decrease of equity in task division within the domestic sphere across the TTP. The current study investigates the equity of a specific skill within the 'relationship sphere', because similarly to a decreased equity in household and childcare, a decreased equity of dyadic coping is likely to be associated with poorer individual adjustment. We collected longitudinal self-report data on dyadic coping and depressive symptoms from 104 mixed-gender first-time parents (n = 208 individuals) from pregnancy until 40 weeks postpartum. We created an equity score for men and women that measured their perceived difference between received and provided dyadic coping. On average, women reported providing more and receiving less dyadic coping than men. While both genders agreed on this distribution, men did perceive a higher equity of dyadic coping than women. Furthermore, the decrease of equity perceived by women across TTP was not visible in men. In line with our assumptions based on the equity theory, perceived equity of dyadic coping was associated with depressive symptoms in a curvilinear manner: Decreases in women's perceived equity in either direction (over- or underbenefit) were associated with more depressive symptoms in women and their male partners. This association was found above and beyond the beneficial effect of dyadic coping itself. This implies that not only how well partners support each other in times of stress, but also how equal both partners' efforts are, is important for their individual adjustment across TTP.


Asunto(s)
Adaptación Psicológica , Depresión/psicología , Relaciones Interpersonales , Padres/psicología , Estrés Psicológico/psicología , Adulto , Composición Familiar , Femenino , Humanos , Masculino , Persona de Mediana Edad
20.
PLoS One ; 15(2): e0229363, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32092129

RESUMEN

Post-marital residence patterns are an important aspect of human social organization. However, identifying such patterns in prehistoric societies is challenging since they leave almost no direct traces in archaeological records. Cross-cultural researchers have attempted to identify correlates of post-marital residence through the statistical analysis of ethnographic data. Several studies have demonstrated that, in agricultural societies, large dwellings (over ca. 65 m2) are associated with matrilocality (spouse resides with or near the wife's family), whereas smaller dwellings are associated with patrilocality (spouse resides with or near the husband's family). In the present study, we tested the association between post-marital residence and dwelling size (average house floor area) using phylogenetic comparative methods and a global sample of 86 pre-industrial societies, 22 of which were matrilocal. Our analysis included the presence of agriculture, sedentism, and durability of house construction material as additional explanatory variables. The results confirm a strong association between matrilocality and dwelling size, although very large dwellings (over ca. 200 m2) were found to be associated with all types of post-marital residence. The best model combined dwelling size, post-marital residence pattern, and sedentism, the latter being the single best predictor of house size. The effect of agriculture on dwelling size becomes insignificant once the fixity of settlement is taken into account. Our results indicate that post-marital residence and house size evolve in a correlated fashion, namely that matrilocality is a predictable response to an increase in dwelling size. As such, we suggest that reliable inferences about the social organization of prehistoric societies can be made from archaeological records.


Asunto(s)
Arqueología , Composición Familiar , Vivienda , Matrimonio , Filogenia , Antropología , Demografía/historia , Composición Familiar/historia , Femenino , Historia Antigua , Vivienda/historia , Humanos , Masculino , Matrimonio/historia , Dinámica Poblacional/historia , Características de la Residencia/historia
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