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1.
J Environ Radioact ; 233: 106618, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-33894497

RESUMEN

The delineation of radon prone areas is one of the central requirements of the European Council Directive 2013/59/EURATOM. It is quite a complex task which usually requires the collection of radon data through an appropriate survey as a first step. This paper presents the design and methodology of the recent Austrian radon survey (ÖNRAP 2, 2013-2019) and its implementation. It details the results of the nationwide survey as well as correlations and dependencies with geology and building characteristics. The paper also discusses the representativeness of the survey as well as advantages and disadvantages of the selected approach. For the purpose of establishing a new delineation of radon prone areas in Austria we distributed approximately 75,000 passive long-term radon detectors. They were offered to selected members of the voluntary fire brigades and this resulted in about 50,000 radon measurements. Thus, a return rate of about 67% was achieved. The distribution of the radon results closely follows a log-normal distribution with a median of 99 Bq/m³, a geometric mean of 109 Bq/m³, and a geometric standard deviation factor of 2.29. 11% of the households show a mean radon concentration above the national reference level of 300 Bq/m³. Important data on building characteristics and the location of the measured rooms were collected by means of a specific questionnaire and a measurement protocol that were handed out together with the radon detectors. We were able to identify significant correlations between the indoor radon concentration and geology, the year of construction, and the coupling of the room to the ground (basement yes/no, floor level). Being a geographically-based and not a population-weighted survey, the comparison of building characteristics with the Austrian census data confirms that rural areas are over-represented in this survey. As a summary, the selected approach of conducting passive long-term radon measurements in selected dwellings of members of the voluntary fire brigades proved to be an efficient method to collect reliable data as a basis for the delineation of radon prone areas. The next step was to eliminate factors that influence the measured radon concentration through appropriate modelling. Based on the results predicted by the model radon areas are then be classified. This will be presented in a subsequent publication.


Asunto(s)
Contaminantes Radiactivos del Aire , Contaminación del Aire Interior , Monitoreo de Radiación , Radón , Contaminantes Radiactivos del Aire/análisis , Contaminación del Aire Interior/análisis , Austria , Vivienda , Radón/análisis , Encuestas y Cuestionarios
2.
Artículo en Inglés | MEDLINE | ID: mdl-33805125

RESUMEN

Housing quality, stability, and affordability have a direct relationship to socioemotional and physical health. Both city planning and public health have long recognized the role of housing in health, but the complexity of this relationship in regard to infant and maternal health is less understood. Focusing on literature specifically relevant to U.S. metropolitan areas, I conduct a multidisciplinary literature review to understand the influence of housing factors and interventions that impact infant and maternal health. The paper seeks to achieve three primary goals. First, to identify the primary "pathways" by which housing influences infant and maternal health. Second, the review focuses on the role and influence of historical housing discrimination on maternal health outcomes. Third, the review identifies emergent practice-based housing interventions in planning and public health practice to support infant and maternal health. The literature suggests that the impact of housing on infant health is complex, multifaceted, and intergenerational. Historical housing discrimination also directly impacts contemporary infant and maternal health outcomes. Policy interventions to support infant health through housing are just emerging but demonstrate promising outcomes. Structural barriers to housing affordability in the United States will require new resources to foster greater collaboration between the housing and the health sectors.


Asunto(s)
Vivienda , Salud del Lactante , Humanos , Lactante , Salud Pública , Estados Unidos
3.
Artículo en Inglés | MEDLINE | ID: mdl-33806987

RESUMEN

Neighborhood greenspace may attract new residents and lead to sociodemographic or housing cost changes. We estimated relationships between greenspace and gentrification-related changes in the 43 largest metropolitan statistical areas (MSAs) of the United States (US). We used the US National Land Cover and Brown University Longitudinal Tracts databases, as well as spatial lag models, to estimate census tract-level associations between percentage greenspace (years 1990, 2000) and subsequent changes (1990-2000, 2000-2010) in percentage college-educated, percentage working professional jobs, race/ethnic composition, household income, percentage living in poverty, household rent, and home value. We also investigated effect modification by racial/ethnic composition. We ran models for each MSA and time period and used random-effects meta-analyses to derive summary estimates for each period. Estimates were modest in magnitude and heterogeneous across MSAs. After adjusting for census-tract level population density in 1990, compared to tracts with low percentage greenspace in 1992 (defined as ≤50th percentile of the MSA-specific distribution in 1992), those with high percentage greenspace (defined as >75th percentile of the MSA-specific distribution) experienced higher 1990-2000 increases in percentage of the employed civilian aged 16+ population working professional jobs (ß: 0.18, 95% confidence interval (CI): 0.11, 0.26) and in median household income (ß: 0.23, 95% CI: 0.15, 0.31). Adjusted estimates for the 2000-2010 period were near the null. We did not observe evidence of effect modification by race/ethnic composition. We observed evidence of modest associations between greenspace and gentrification trends. Further research is needed to explore reasons for heterogeneity and to quantify health implications.


Asunto(s)
Vivienda , Parques Recreativos , Adolescente , Grupos Étnicos , Humanos , Densidad de Población , Características de la Residencia , Estados Unidos
4.
Artículo en Inglés | MEDLINE | ID: mdl-33799678

RESUMEN

Habitability is an essential concept for shelter planning in terms of supporting victims' right to life with dignity and recovering from what they suffered. The study aimed to identify problems and needs in shelter spaces and suggest measures to improve shelter space plans by conducting a case study in South Korea. The temporary disaster shelter in Pohang built right after the earthquake (2018) was selected as a case subject. From the literature review, a framework consisting of four concepts of habitability (safety, health, sociality, comfort) and four shelter zones (entry, residential, service, special needs zone) was developed for the in-depth interviews and analysis. The field study and in-depth interviews with victims, staff, and volunteers were conducted to collect problems and needs regarding shelter space planning. The results showed that the entry zone needed improvements in 'protection', 'prevention', 'sanitation', 'accessibility', 'area', and 'privacy'. The residential zone lacked 'area', 'privacy', and 'indoor environmental quality'. The service zone problems were mainly seen in the categories of 'area' and 'privacy'. The special needs zone was less habitable in the categories of 'protection' and 'area'. To appropriately respond to victims' urgent needs, the temporary shelter planning should secure enough space beyond the legal minimum standards, provide sanitation and indoor environmental quality management, and separate spaces by function and user type.


Asunto(s)
Planificación en Desastres , Desastres , Terremotos , Refugio de Emergencia , Vivienda , Humanos , República de Corea
5.
Artículo en Inglés | MEDLINE | ID: mdl-33799905

RESUMEN

The objective of this pilot study was to gather and analyze data on radon concentrations in workplaces in three buildings of Granada University (Southern Spain) constructed in different centuries. All measurements were made at basement or ground floor level under normal use conditions except for one space (mineral store), in which measurements were compared between the door closed and open. Measurements were conducted during different time periods between October 2013 and March 2019 with a Radon-Scout PLUS portable Radonmonitor. The duration of continuous recordings at different sites ranged between 42 and 1104 h. Mean accumulated radon concentrations ranged between 12 and 95 Bq/m3, below the maximal level of 300 Bq/m3 set by the World Health Organization (WHO). Relatively high values were recorded in the oldest building (15th century), which was also poorly ventilated. Ventilation appeared to be an important factor in reducing radon levels, especially in areas less exposed to radon, such as Southern Spain.


Asunto(s)
Contaminantes Radiactivos del Aire , Contaminación del Aire Interior , Monitoreo de Radiación , Radón , Contaminantes Radiactivos del Aire/análisis , Contaminación del Aire Interior/análisis , Vivienda , Humanos , Proyectos Piloto , Radón/análisis , España
6.
Artículo en Inglés | MEDLINE | ID: mdl-33802036

RESUMEN

Cold, damp and mouldy housing arises from the degradation of the housing stock over time due to weathering and a lack of maintenance. Living in such houses is associated with many adverse impacts on human health, especially for those with existing health issues. This paper presents a systematic review, using the PRISMA protocol, consisting of an exploratory analysis of housing-related risk factors associated with respiratory disease. The review consisted of 360 studies investigating 19 risk factors associated with respiratory conditions. Each fall into one of four categories, namely, (1) outdoor environment-related factors; (2) indoor air pollution-related factors; (3) housing non-structure-related factors; or (4) housing structure-related factors. The results show that effects of poor housing conditions on occupants' respiratory health is a growing research field, where poor indoor air quality, mainly due to a lack of adequate ventilation, was found to be the most influential risk factor. Usage of solid fuel and living in an urban area without a pollutant-free air filtration system are the main risk factors related to inadequate ventilation. Therefore, an adequate and reliable ventilation system with air-infiltration was considered to be the main mitigation solution to improve indoor air quality. It is suggested that government organisations and health practitioners could use the identified risk factors to measure the healthiness of existing dwellings and take measures to improve existing conditions and develop regulations for new housing construction to promote the healthy home concept. Further research is needed for risk mitigation strategies to reduce the respiratory health burden attributed to housing.


Asunto(s)
Contaminación del Aire Interior , Contaminantes Ambientales , Contaminación del Aire Interior/análisis , Vivienda , Humanos , Factores de Riesgo , Ventilación
7.
BMC Geriatr ; 21(1): 259, 2021 04 17.
Artículo en Inglés | MEDLINE | ID: mdl-33865321

RESUMEN

BACKGROUND: Depression is a common mental disorder among older people. This study aimed to assess the association between housing environment factors and depressive symptoms among older people using a multidimensional assessment method. METHODS: The study uses a population-based cross-sectional design. A total of 950 participants aged ≥ 60 years were selected using a complex multistage sampling design from 22 locations in China. All data were collected using questionnaires by face-to-face interviews. A total of 938 participants were included in the analysis, and 17.1% of males and 23.1% of females were identified as having depressive symptoms. The depressive symptoms were assessed using the 15-item Geriatric Depression Scale. The housing environment was assessed on the basis of four dimensions: physical, social, psychological, and cognition and physical function. Cumulative logistic regression analysis was used to evaluate the association between housing environment and depressive symptoms. RESULTS: The Cochran-Armitage trend test showed that the depressive symptom scores were linearly negatively associated with self-assessed housing environment, living arrangement, life satisfaction, and other physical environment factors and linearly positively associated with cognitive and physical function scores. The results of cumulative logistic regression analysis showed that the housing environment was significantly associated with depressive symptoms. The participants' self-assessed housing environment was strongly associated with the levels of depressive symptom scores, and the odds ratio was 3.47 (95% CI, 1.14-10.82, P = 0.003). CONCLUSION: The housing environment was significantly associated with depressive symptoms. Our results suggest that multi-dimensional assessment in the housing environment may be an effective way to develop intervention strategies of depressive symptoms among older people.


Asunto(s)
Depresión , Vivienda , Anciano , Anciano de 80 o más Años , China/epidemiología , Estudios Transversales , Depresión/diagnóstico , Depresión/epidemiología , Femenino , Evaluación Geriátrica , Humanos , Masculino , Encuestas y Cuestionarios
8.
Artículo en Inglés | MEDLINE | ID: mdl-33800209

RESUMEN

Radon (222Rn) and thoron (220Rn) account for almost two-thirds of the annual average radiation dose received by the Irish population. A detailed study of natural radioactivity levels and radon and thoron exhalation rates was carried out in a legislatively designated "high radon" area, as based on existing indoor radon measurements. Indoor radon concentrations, airborne radiometric data and stream sediment geochemistry were collated, and a set of soil samples were taken from the study area. The exhalation rates of radon (E222Rn) and thoron (E220Rn) for collected samples were determined in the laboratory. The resultant data were classified based on geological and soil type parameters. Geological boundaries were found to be robust classifiers for radon exhalation rates and radon-related variables, whilst soil type classification better differentiates thoron exhalation rates and correlated variables. Linear models were developed to predict the radon and thoron exhalation rates of the study area. Distribution maps of radon and thoron exhalation rates (range: E222Rn [0.15-1.84] and E220Rn [475-3029] Bq m-2 h-1) and annual effective dose (with a mean value of 0.84 mSv y-1) are presented. For some parts of the study area, the calculated annual effective dose exceeds the recommended level of 1 mSv y-1, illustrating a significant radiation risk. Airborne radiometric data were found to be a powerful and fast tool for the prediction of geogenic radon and thoron risk. This robust method can be used for other areas where airborne radiometric data are available.


Asunto(s)
Contaminantes Radiactivos del Aire , Contaminación del Aire Interior , Monitoreo de Radiación , Radiactividad , Radón , Contaminantes Radiactivos del Aire/análisis , Contaminación del Aire Interior/análisis , Vivienda , Irlanda , Radón/análisis , Suelo
9.
Artículo en Inglés | MEDLINE | ID: mdl-33800525

RESUMEN

This research investigates the relationships between airborne and depositional industrial lead emission concentrations modeled using Environmental Protection Agency's (EPA's) American Meteorological Society/Environmental Protection Agency Regulatory Model (AERMOD) and childhood blood lead levels (BLL) in the Detroit Metropolitan Area (DMA) 2006-2013. Linear and mediation interaction regression models estimated the effects of older housing and airborne and depositional lead emission concentrations on black and white childhood BLLs, controlling for neighborhood levels of racial isolation and poverty-important social structures in the DMA. The results showed a direct relationship between airborne and depositional lead emissions and higher childhood BLL, after controlling for median housing age. Lead emissions also exacerbated the effect of older housing on black and white children's BLLs (indirect relationship), after controlling for social structures. Findings from this research indicate that black and white children exposed to lead-based paint/pipes in older housing are further impacted by industrial lead pollution that may lead to permanent neurological damage.


Asunto(s)
Intoxicación por Plomo , Plomo , Anciano , Niño , Exposición a Riesgos Ambientales , Vivienda , Humanos , Intoxicación por Plomo/epidemiología , Pobreza , Características de la Residencia
10.
Artículo en Inglés | MEDLINE | ID: mdl-33802321

RESUMEN

Lead is well known for its adverse health effects on children, particularly when exposure occurs at earlier ages. The primary source of lead hazards among young children is paint used in buildings built before 1978. Despite being 100% preventable, some children remain exposed and state and local policies often remain reactive. This study presents a methodology for planners and public health practitioners to proactively address lead risks among young children. Using geospatial analyses, this study examines neighborhood level measurement of lead paint hazard in homes and childcare facilities and the concentration of children aged 0-5. Results highlight areas of potential lead paint hazard hotspots within a county in the Midwestern state studied, which coincides with higher concentration of non-white children. This places lead paint hazard in the context of social determinants of health, where existing disparity in distribution of social and economic resources reinforces health inequity. In addition to being proactive, lead poisoning intervention efforts need to be multi-dimensional and coordinated among multiple parties involved. Identifying children in higher lead paint hazard areas, screening and treating them, and repairing their homes and childcare facilities will require close collaboration of healthcare professionals, local housing and planning authorities, and community members.


Asunto(s)
Intoxicación por Plomo , Niño , Preescolar , Exposición a Riesgos Ambientales/análisis , Vivienda , Humanos , Lactante , Recién Nacido , Plomo , Intoxicación por Plomo/epidemiología , Intoxicación por Plomo/prevención & control , Pintura
11.
Artículo en Inglés | MEDLINE | ID: mdl-33802482

RESUMEN

While the association between general housing and mental health has been well documented, little is known about the mental health outcomes of house sharing. As shared housing has been viewed as an economically and socially viable housing option for young adults, a broader understanding of how shared housing affects the residents' quality of life, including mental health, is needed. In this context, this study aims to provide empirical evidence about the relationship between mental health and house sharing after controlling for residents' self-selection. We conducted a survey of 834 young single adults living in shared housing and non-shared housing in Seoul, Korea. Then, to control for residential self-selection, we applied the residential dissonance framework. The main findings of this study were two-fold: first, house-sharers with a positive attitude toward shared housing were more likely to respond that their mental health status improved after they started residing in shared housing; second, if young adults are forced to live in shared housing, this could increase the potential risk of social dysfunction of house-sharers. Based on these findings, we suggest policy measures for shared housing, including pre-occupancy interviews, resident behavior codes, and fostering a livable dwelling environment to ensure a healthier life in shared living arrangements.


Asunto(s)
Salud Mental , Calidad de Vida , Vivienda , Humanos , República de Corea , Seúl , Adulto Joven
12.
Artículo en Inglés | MEDLINE | ID: mdl-33806740

RESUMEN

To understand fungal contamination in the indoor environment of the disaster region, a field survey was performed to measure the number of fungal counts and identify isolates in the indoor air of prefabricated temporary housing, privately independent-housing, and rented apartments flooded by the East Japan Great Earthquake disaster tsunami. As a result, the period with the highest detected fungal count was from the rainy season to summer in independent-housing and rented apartments. Moreover, in the temporary housing, the fungal number increased further in winter as indicated by the maximum fungal-number throughout the measurement period. The detection frequency of Aspergillus species was relatively higher in the indoor air of temporary housing than in typical housing in the non-disaster area. Since Aspergillus is known as an allergenic genus, it requires careful attention to the health risk for residents. The extremely high level of fungal condensation in indoor air possibly occurred due to high relative humidity and loss of heat insulation in the building attics. It is suggested that this problem commonly happened in the cold region including the entire disaster region of the East Japan Great Earthquake.


Asunto(s)
Desastres , Terremotos , Vivienda , Japón , Tsunamis
13.
J Environ Radioact ; 233: 106594, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-33798813

RESUMEN

Indoor radon poses one of the most significant environmental threats to public health as it is the second leading cause of lung cancer in the United States. Developing a more thorough understanding of the factors that affect radon concentrations is key for developing risk maps, identifying where testing should be a priority, and education about indoor radon exposure. The objectives of this study are to investigate seasonal and annual variation of indoor radon concentrations in Pennsylvania, USA from 1988 to 2018, to explore the hotspot areas for high indoor radon concentrations, and to analyze the association with various factors such as weather conditions, housing types, and floor levels. Based on a total of 1,808,294 radon tests conducted from 1988 to 2018, we found that 61% of the area (by zip codes), 557,869 tests conducted in the basement and 49,141 tests conducted on the ground floor in homes in Pennsylvania had higher radon levels than the U.S. EPA action level concentration of 148 Bq/m3 (equivalent to 4 pCi/L). Winter and fall had significantly higher indoor radon concentrations than summer and spring. Case studies conducted in Pittsburgh, Philadelphia, and Harrisburg showed that there was no significant correlation of daily temperature, precipitation, or relative humidity with indoor radon concentration on the day a radon test occurred.


Asunto(s)
Contaminantes Radiactivos del Aire , Contaminación del Aire Interior , Monitoreo de Radiación , Radón , Contaminantes Radiactivos del Aire/análisis , Contaminación del Aire Interior/análisis , Vivienda , Pennsylvania , Radón/análisis , Estaciones del Año
14.
Nat Commun ; 12(1): 2274, 2021 04 15.
Artículo en Inglés | MEDLINE | ID: mdl-33859196

RESUMEN

Massive unemployment during the COVID-19 pandemic could result in an eviction crisis in US cities. Here we model the effect of evictions on SARS-CoV-2 epidemics, simulating viral transmission within and among households in a theoretical metropolitan area. We recreate a range of urban epidemic trajectories and project the course of the epidemic under two counterfactual scenarios, one in which a strict moratorium on evictions is in place and enforced, and another in which evictions are allowed to resume at baseline or increased rates. We find, across scenarios, that evictions lead to significant increases in infections. Applying our model to Philadelphia using locally-specific parameters shows that the increase is especially profound in models that consider realistically heterogenous cities in which both evictions and contacts occur more frequently in poorer neighborhoods. Our results provide a basis to assess eviction moratoria and show that policies to stem evictions are a warranted and important component of COVID-19 control.


Asunto(s)
/transmisión , Control de Enfermedades Transmisibles/métodos , Vivienda/legislación & jurisprudencia , Pandemias/prevención & control , Políticas , /economía , /virología , Ciudades/legislación & jurisprudencia , Ciudades/estadística & datos numéricos , Control de Enfermedades Transmisibles/legislación & jurisprudencia , Simulación por Computador , Vivienda/economía , Humanos , Modelos Estadísticos , Philadelphia/epidemiología , Desempleo/estadística & datos numéricos , Población Urbana/estadística & datos numéricos
15.
J Environ Radioact ; 233: 106582, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-33848713

RESUMEN

A 2018 estimate indicates that there were 226,057 radon-attributable lung cancer deaths in 66 countries that had representative radon surveys. This is a shocking figure, and as it comes from only 66 countries it underestimates the worldwide death toll. Any research that enables countries to conduct representative radon surveys and to understand better the risk to citizens from radon is surely welcome. We hope this paper provides a useful methodology for estimating population risk. The estimation of population weighted average indoor radon levels requires statistically valid sampling methodologies that use a representative sample of occupied homes throughout the country. A literature review indicates that in many population weighted surveys, the sampling methodology may not have been designed to do this. This paper describes a simple, resource efficient methodology which produces statistically valid and reliable estimates based on a small scale sample that is representative of the population distribution. The resource efficient design of this study enables it to be repeated at frequent intervals providing for a longitudinal analysis of the population risk from indoor radon. This survey was conducted in Ireland using 653 measurements and a representative sampling strategy to provide a baseline population weighted radon exposure for future comparisons. This study estimates the average population weighted indoor radon concentration in Ireland to be 97.83 Bq m-3 (95% Confidence Interval 90.69 Bq m-3 to 105.53 Bq m-3), and that there are an estimated 350 lung cancer cases and 255 deaths per year due to radon exposure. The mortality rate of 5.3 per 100,000 due to indoor radon, demonstrates that radon remains one of the highest preventable causes of death in Ireland.


Asunto(s)
Contaminantes Radiactivos del Aire , Contaminación del Aire Interior , Neoplasias Pulmonares , Monitoreo de Radiación , Radón , Contaminantes Radiactivos del Aire/análisis , Contaminación del Aire Interior/análisis , Vivienda , Humanos , Irlanda/epidemiología , Neoplasias Pulmonares/epidemiología , Radón/análisis
16.
Cien Saude Colet ; 26(3): 1023-1033, 2021 Mar.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-33729356

RESUMEN

Vulnerability is a crucial factor in addressing COVID-19 as it can aggravate the disease. Thus, it should be considered in COVID-19 control and health prevention and promotion. This ecological study aimed to analyze the spatial distribution of the incidence of COVID-19 cases in a Brazilian metropolis and its association with social vulnerability indicators. Spatial scan analysis was used to identify COVID-19 clusters. The variables for identifying the vulnerability were inserted in a Geographically Weighted Regression (GWR) model to identify their spatial relationship with COVID-19 cases. The incidence of COVID-19 in Fortaleza was 74.52/10,000 inhabitants, with 3,554 reported cases and at least one case registered in each neighborhood. The spatial GWR showed a negative relationship between the incidence of COVID-19 and demographic density (ß=-0,0002) and a positive relationship between the incidence of COVID-19 and the percentage of self-employed >18 years (ß=1.40), and maximum per capita household income of the poorest fifth (ß=0.04). The influence of vulnerability indicators on incidence showed areas that can be the target of public policies to impact the incidence of COVID-19.


Asunto(s)
/epidemiología , Análisis Espacio-Temporal , Poblaciones Vulnerables , Adulto , Factores de Edad , Teorema de Bayes , Brasil/epidemiología , Ciudades/epidemiología , Comorbilidad , Escolaridad , Empleo/estadística & datos numéricos , Femenino , Vivienda/normas , Humanos , Incidencia , Renta , Masculino , Persona de Mediana Edad , Densidad de Población , Áreas de Pobreza , Factores Socioeconómicos , Salud Suburbana/estadística & datos numéricos
17.
Artículo en Inglés | MEDLINE | ID: mdl-33668252

RESUMEN

The tourism sector in general and the hotel sector in particular face the challenge of managing appropriate security measures to deal with the COVID-19 pandemic. In this sense, it is useful to know which measures are most demanded by the clientele. This research, through non-parametric statistics tests, concluded that women are more demanding than men in relation to the security measures to be taken in hotels. More specifically, this research concludes that women are more demanding than men in relation to a set of measures including ensuring good hygiene conditions, the use of disinfectants, the existence of health and information checks, adapting the establishment to WHO recommendations, obtaining quality certification, measuring temperature, the need to provide information on protocols and measures, and the elimination of physical contact between people. This, as a practical application, makes it possible to know more accurately about the safety requirements of sex-segmented customers in the face of future health crises, allowing tourist managers to offer safer destinations and the hotel sector better health conditions for their clients.


Asunto(s)
Control de Enfermedades Transmisibles/métodos , Pandemias , /prevención & control , Desinfectantes , Femenino , Vivienda , Humanos , Higiene , Industrias , Masculino , Pandemias/prevención & control , Turismo , Viaje
18.
Lancet Public Health ; 6(5): e309-e323, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33780656

RESUMEN

BACKGROUND: People who inject drugs (PWID) are at increased risk for HIV and hepatitis C virus (HCV) infection and also have high levels of homelessness and unstable housing. We assessed whether homelessness or unstable housing is associated with an increased risk of HIV or HCV acquisition among PWID compared with PWID who are not homeless or are stably housed. METHODS: In this systematic review and meta-analysis, we updated an existing database of HIV and HCV incidence studies published between Jan 1, 2000, and June 13, 2017. Using the same strategy as for this existing database, we searched MEDLINE, Embase, and PsycINFO for studies, including conference abstracts, published between June 13, 2017, and Sept 14, 2020, that estimated HIV or HCV incidence, or both, among community-recruited PWID. We only included studies reporting original results without restrictions to study design or language. We contacted authors of studies that reported HIV or HCV incidence, or both, but did not report on an association with homelessness or unstable housing, to request crude data and, where possible, adjusted effect estimates. We extracted effect estimates and pooled data using random-effects meta-analyses to quantify the associations between recent (current or within the past year) homelessness or unstable housing compared with not recent homelessness or unstable housing, and risk of HIV or HCV acquisition. We assessed risk of bias using the Newcastle-Ottawa Scale and between-study heterogeneity using the I2 statistic and p value for heterogeneity. FINDINGS: We identified 14 351 references in our database search, of which 392 were subjected to full-text review alongside 277 studies from our existing database. Of these studies, 55 studies met inclusion criteria. We contacted the authors of 227 studies that reported HIV or HCV incidence in PWID but did not report association with the exposure of interest and obtained 48 unpublished estimates from 21 studies. After removal of duplicate data, we included 37 studies with 70 estimates (26 for HIV; 44 for HCV). Studies originated from 16 countries including in North America, Europe, Australia, east Africa, and Asia. Pooling unadjusted estimates, recent homelessness or unstable housing was associated with an increased risk of acquiring HIV (crude relative risk [cRR] 1·55 [95% CI 1·23-1·95; p=0·0002]; I2= 62·7%; n=17) and HCV (1·65 [1·44-1·90; p<0·0001]; I2= 44·8%; n=28]) among PWID compared with those who were not homeless or were stably housed. Associations for both HIV and HCV persisted when pooling adjusted estimates (adjusted relative risk for HIV: 1·39 [95% CI 1·06-1·84; p=0·019]; I2= 65·5%; n=9; and for HCV: 1·64 [1·43-1·89; p<0·0001]; I2= 9·6%; n=14). For risk of HIV acquisition, the association for unstable housing (cRR 1·82 [1·13-2·95; p=0·014]; n=5) was higher than for homelessness (1·44 [1·13-1·83; p=0·0036]; n=12), whereas no difference was seen between these outcomes for risk of HCV acquisition (1·72 [1·48-1·99; p<0·0001] for unstable housing, 1·66 [1·37-2·00; p<0·0001] for homelessness). INTERPRETATION: Homelessness and unstable housing are associated with increased risk of HIV and HCV acquisition among PWID. Our findings support the development of interventions that simultaneously address homelessness and unstable housing and HIV and HCV transmission in this population. FUNDING: National Institute for Health Research, National Institute on Drug Abuse, National Institute of Allergy and Infectious Diseases, and Commonwealth Scholarship Commission.


Asunto(s)
Infecciones por VIH/epidemiología , Hepatitis C/epidemiología , Personas sin Hogar/estadística & datos numéricos , Vivienda/estadística & datos numéricos , Abuso de Sustancias por Vía Intravenosa/epidemiología , Salud Global/estadística & datos numéricos , Humanos , Medición de Riesgo
20.
Sensors (Basel) ; 21(4)2021 Feb 11.
Artículo en Inglés | MEDLINE | ID: mdl-33670237

RESUMEN

An integrated smart home system (ISHS) is an effective way to improve the quality of life of the elderly. The elderly's willingness is essential to adopt an ISHS; to the best of our knowledge, no study has investigated the elderly's perception of ISHS. Consequently, this study aims to investigate the elderly's perception of the ISHS by comprehensively evaluating its possible benefits and negative responses. A set of sensors required for an ISHS was determined, and interviews were designed based on four factors: perceived comfort, perceived usability, perceived privacy, and perceived benefit. Subsequently, technological trials of the sensor-set followed by two focus group interviews were conducted on nine independently living elderly participants at a senior welfare center in South Korea. Consistent with previous studies, the results of this investigation indicate that elderly participants elicited negative responses regarding usability complexity, and discomfort to daily activities. Despite such negative responses, after acquiring enough awareness about the ISHS's benefits, the elderly acknowledged its necessity and showed a high level of willingness. Furthermore, these results indicate that for a better adoption of an ISHS, sufficient awareness regarding its benefits and development of elderly-friendly smart home sensors that minimize negative responses are required.


Asunto(s)
Vivienda , Internet de las Cosas , Calidad de Vida , Materiales inteligentes , Anciano , Anciano de 80 o más Años , Femenino , Grupos Focales , Humanos , República de Corea
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