Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 838
Filtrar
1.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 47(5): 619-627, 2022 May 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-35753732

RESUMO

OBJECTIVES: Stroke readmission increases financial burden on the family and the consumption of medical resources, and 30-day readmission rate is an important indicator for quality evaluation on health services. The influential factors for readmission mainly include patient-related factors, hospital factors, and society-related factors, with regional differences. This study aims to explore the spatial distribution and its main relevant factors for 30-day readmission of stroke patients in Hunan Province, and to provide the useful information for the improvement of regional prevention and control of stroke readmission. METHODS: Stroke patients in Hunan Province who were hospitalized in 2018 and readmitted within 30 days were included in the study. The vector map of the county boundary in Hunan Province was used as the basic map since county was the spatial analysis unit. SPSS 26.0 and ArcGIS 10.8 were used for statistical analysis that contains descriptive analysis of the general situation and the distribution map of readmission rate within 30 days of stroke patients. Spatial autocorrelation analysis and spatial regression analysis were further used to find the spatial clusters of the 30-day readmission rate of stroke and the local relationship between the readmission rate and main influential factors. RESULTS: In 2018, a total of 172 800 stroke patients were hospitalized in Hunan Province, of which 6 953 patients were re-hospitalized within 30 days after discharging due to stroke. The 30-day readmission rate was 4.09% in Hunan Province. The clusters of stroke readmission rates were mainly concentrated in the northeast and western regions in Hunan Province. The geographically weighted regression revealed that proportion of patients with complications, number of hospitals per 10 000 population and number of primary medical and health care institution per 10 000 population were the main relevant factors for stroke readmission, and there were differences both in the direction and degree of the effect on readmission in different regions. CONCLUSIONS: The 30-day readmission rate for stroke patients in Hunan province and its main influential factors had spatial heterogeneity. The key prevention and control areas were mainly concentrated in the northeast and western regions. It is recommended that the prevention and treatment of stroke complications and the construction of medical institutions need to be strengthened to improve the quality of medical services, particularly in the western region. The importance to the treatment of stroke complications should be attached in the northern region, and the primary health care should be reinforced in the northeast region. All counties should take prevention and control measures according to local conditions, so as to effectively control the readmission rate of stroke within 30 days.


Assuntos
Readmissão do Paciente , Acidente Vascular Cerebral , China/epidemiologia , Humanos , Análise Espacial , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/terapia
2.
Rev Med Inst Mex Seguro Soc ; 60(2): 156-163, 2022 Mar 01.
Artigo em Espanhol | MEDLINE | ID: mdl-35759426

RESUMO

Background: In a context where the prevalence of Diabetes Mellitus and Hypertension has increased significantly in recent years, kidney diseases become important for the potential demand for specialized health care and resources required. Objective: To analyze the geographical distribution of Diabetic Nephropathy (DN) and Renal Insufficiency (RI) based on the medical consultations given in first-level units of IMSS during 2019, to identify the medical units with the highest burden of care. Material and methods: Ecological-exploratory study in which indicators were estimated for every thousand persons in relation to medical consultations given by ND and RI according to service time, first-level medical unit (UMF) and representation to analyze the magnitude and geographic distribution at the national level. Results: 45% of medical consultations were by ND and 52.4% by RI. The highest burden per DN was registered in UMF No. 50 Cd. Juarez (Chihuahua) and No. 49 Gabino Barreda (Veracruz Sur), with 1.7 first-time medical consultations and 148.3 subsequent medical consultations per 1,000 persons, respectively. While in UMF No. 40 Manlio Fabio Altamirano and No. 25 Cotaxtla, in Veracruz Norte, the highest burden was for RI, with 4.9 first-time medical consultations and 134.2 subsequent medical consultations per 1000 persons, respectively. Conclusions: The results could contribute to strengthening of medical units where it is necessary and the efficient allocation of resources available to meet the demand for health services of ND and RI in IMSS.


Introducción: en un contexto donde la prevalencia de diabetes mellitus e hipertensión arterial ha aumentado significativamente en años recientes, las enfermedades renales adquieren importancia por la potencial demanda de atención especializada y de recursos en salud que requieren. Objetivo: analizar la distribución geográfica de la nefropatía diabética (ND) y la insuficiencia renal (IR) con base en las consultas otorgadas en unidades de primer nivel del Instituto Mexicano del Seguro Social (IMSS) durante 2019, para identificar las unidades médicas con mayor carga de atención. Material y métodos: estudio ecológico-exploratorio en el que se estimaron indicadores por cada mil derechohabientes en relación a las consultas otorgadas por ND e IR según la ocasión de servicio, la unidad médica familiar (UMF) de primer nivel y la representación. Se utilizó estadística espacial para analizar dichos indicadores. Resultados: el 45% de las consultas otorgadas fue por ND y el 52.4% por IR. La mayor carga por ND se registró en la UMF No. 50 de Cd. Juárez (Chihuahua) y en la No. 49 Gabino Barreda (Veracruz Sur), con 1.7 consultas de primera vez y 148.3 subsecuentes por mil derechohabientes, respectivamente. Mientras que en la UMF No. 40 Manlio Fabio Altamirano y No. 25 Cotaxtla, en Veracruz Norte, la mayor carga fue por IR, con 4.9 consultas de primera vez y 134.2 subsecuentes por mil derechohabientes, respectivamente. Conclusiones: los resultados podrían contribuir al fortalecimiento de las unidades médicas que así lo requieran y en la distribución eficiente de los recursos disponibles para atender la demanda de servicios de salud de ND e IR en el IMSS.

3.
BMC Oral Health ; 22(1): 249, 2022 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-35733133

RESUMO

BACKGROUND: It is impossible to attain good general health without maintaining oral health and this becomes problematic when dental services are located far from the population that needs to utilise them. This study aimed to assess the geographic accessibility of dental clinics located in public primary healthcare clinics (PHCs) and hospitals in the Jazan region of Saudi Arabia and how long it takes to reach them by car and on foot. METHODS: The location of clinics and hospitals, maps of road systems, and the governorates' borders (administrative areas) within the Jazan region were downloaded using the QGIS mapping tool. The time taken to travel to the clinics and hospitals, either by driving or walking, was assessed. If the time was 30 min or less, residents in the area were classified as 'serviced'. It was more than 30 min, they were 'underserved'. RESULTS: Only 31% of Jazan residents were found to live in a serviced area if they drove to clinics and hospitals. Residents of Jazan's seven mountainous governorates were more likely to require services. Only 40% could drive less than 30 min to a primary health dental clinic. Only 19% of people could walk to a hospital in less than 30 min. Only two governorates had a majority of residents who lived in serviced areas. CONCLUSION: The study demonstrates an accessibility issue, as many Jazan inhabitants must drive or walk for an extended period (> 30 min) to reach a healthcare facility, whether a primary health care centre or a hospital. This issue may result in many people not receiving necessary health care, compromising their oral health status. Additional research is needed to identify public, private and other health facilities in the region and the prevalence of oral disease.


Assuntos
Acesso aos Serviços de Saúde , Saúde Bucal , Humanos , Prevalência , Arábia Saudita/epidemiologia
4.
Math Biosci Eng ; 19(7): 7032-7054, 2022 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-35730295

RESUMO

This assessment aims at measuring the impact of different location mobility on the COVID-19 pandemic. Data over time and over the 27 Brazilian federations in 5 regions provided by Google's COVID-19 community mobility reports and classified by place categories (retail and recreation, grocery and pharmacy, parks, transit stations, workplaces, and residences) are autoregressed on the COVID-19 incidence in Brazil using generalized linear regressions to measure the aggregate dynamic impact of mobility on each socioeconomic category. The work provides a novel multicriteria approach for selecting the most appropriate estimation model in the context of this application. Estimations for the time gap between contagion and data disclosure for public authorities' decision-making, estimations regarding the propagation rate, and the marginal mobility contribution for each place category are also provided. We report the pandemic evolution on the dimensions of cases and a geostatistical analysis evaluating the most critical cities in Brazil based on optimized hotspots with a brief discussion on the effects of population density and the carnival.


Assuntos
COVID-19 , Brasil/epidemiologia , COVID-19/epidemiologia , Humanos , Incidência , Pandemias , Densidade Demográfica
6.
Local Environ ; 27(6): 728-746, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35757155

RESUMO

A community-integrated geographic information systems (CIGIS) study assimilating qualitative and quantitative information about human exposures and health was conducted in Colfax, Louisiana, which hosts a commercial open burn/open detonation thermal treatment (TT) facility that destroys waste from Superfund sites, explosives, military ordnances, and propellants. Fifty-eight percent of residents identified as Black, and median annual income was $16,318, with 90% of the population living below the poverty line. We conducted oral history interviews of twenty-nine residents and mined public records to document the community's experiences. Interviews focused on themes of Colfax's history, changing community fabric, resident health, and air pollution. The oral histories and public comments by community members provided information about lived experiences, including several health conditions, toleration of noise and vibration, property damage, and resulting changes to activity levels. These statements provided insight into the extent of suffering experienced by the local community. We also ran dispersion models for dates in 2020 when the waste stream composition, mass, and burn/smoldering times were provided in the facility's public records. The dispersion models placed the air pollution at the homes of residents during some of the time, and waste stream records from the TT facility agree with community testimony about health effects based on the known health effects of those compounds. CIGIS integration of our community-based qualitative data and maps with quantitative air pollution dispersion model output illustrated alignment between community complaints of impacts to health and property, known toxicological information about waste stream compounds, and dispersion model output.

7.
BMC Proc ; 16(Suppl 1): 3, 2022 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-35715765

RESUMO

The use of geographic information system (GIS) technologies to improve access to health is gaining momentum in Africa. This has become more pertinent with the increasing penetration of mobile-phone technology and internet use, and calls for innovative strategies to support implementation of the World Health Organization Sustainable Development Goals for universal health coverage on the continent. The huge potential benefits of GIS to advance health service delivery in Africa is, however, yet to be fully harnessed due to critical challenges such as proliferation of pilot projects, poor coordination, inadequate preparedness of the health workforce for GIS, lack of interoperability, and inadequate sustainable financing. To discuss these challenges and propose the way forward for rapid, cost-effective, and sustainable deployment of GIS, the African Regional GIS Summit was held in Brazzaville, Republic of the Congo, on 7-10 October 2019 under the umbrella of the AFRO GIS Centre.

8.
BMC Health Serv Res ; 22(1): 772, 2022 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-35698112

RESUMO

BACKGROUND: Health service areas are essential for planning, policy and managing public health interventions. In this study, we delineate health service areas from routinely collected health data as a robust geographic basis for presenting access to maternal care indicators. METHODS: A zone design algorithm was adapted to delineate health service areas through a cross-sectional, ecological study design. Health sub-districts were merged into health service areas such that patient flows across boundaries were minimised. Delineated zones and existing administrative boundaries were used to provide estimates of access to maternal health services. We analysed secondary data comprising routinely collected health records from 32,921 women attending 27 hospitals to give birth, spatial demographic data, a service provision assessment on the quality of maternal healthcare and health sub-district boundaries from Eastern Region, Ghana. RESULTS: Clear patterns of cross border movement to give birth emerged from the analysis, but more women originated closer to the hospitals. After merging the 250 sub-districts in 33 districts, 11 health service areas were created. The minimum percent of internal flows of women giving birth within any health service area was 97.4%. Because the newly delineated boundaries are more "natural" and sensitive to observed flow patterns, when we calculated areal indicator estimates, they showed a marked improvement over the existing administrative boundaries, with the inclusion of a hospital in every health service area. CONCLUSION: Health planning can be improved by using routine health data to delineate natural catchment health districts. In addition, data-driven geographic boundaries derived from public health events will improve areal health indicator estimates, planning and interventions.


Assuntos
Serviços de Saúde Materna , Dados de Saúde Coletados Rotineiramente , Área Programática de Saúde , Estudos Transversais , Feminino , Gana/epidemiologia , Acesso aos Serviços de Saúde , Humanos , Gravidez
9.
Surg Endosc ; 2022 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-35729404

RESUMO

INTRODUCTION: Screening colonoscopy is one of the few procedures that can prevent cancer. While the majority of colonoscopies in the USA are performed by gastroenterologists, general surgeons play a key role in at-risk, rural populations. The aim of this study was to examine geographic practice patterns in colonoscopy using a nationwide Medicare claims database. METHODS AND PROCEDURES: The 2017 Medicare Provider Utilization and Payment database was used to identify physicians performing colonoscopy. Providers were classified as gastroenterologists, surgeons, ambulatory surgical centers (ASCs), or other. Rural-Urban Commuting Area classification at the zip code level was used to determine whether the practice location for an individual provider was in a rural area/small town (< 10,000 people), micropolitan area (10-50,000 people), or metropolitan area (> 50,000 people). RESULTS: Claims data from 3,861,187 colonoscopy procedures on Medicare patients were included. The majority of procedures were performed by gastroenterologists (57.2%) and ASCs (32.1%). Surgeons performed 6.8% of cases overall. When examined at a zip code level, surgeons performed 51.6% of procedures in small towns/rural areas and 21.7% of procedures in micropolitan areas. Individual surgeons performed fewer annual procedures as compared to gastroenterologists (median 51 vs. 187, p < 0.001). CONCLUSIONS: Surgeons perform the majority of colonoscopies in rural zip codes on Medicare patients. High-quality, surgical training in endoscopy is essential to ensure access to colonoscopy for patients outside of major metropolitan areas.

10.
Data Brief ; 42: 108262, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35647244

RESUMO

This article presents a geolocated dataset of rural home annotations on very high resolution satellite imagery from Uganda, Kenya, and Sierra Leone. This dataset was produced through a citizen science project called "Power to the People", which mapped rural homes for electrical infrastructure planning and computer-vision-based mapping. Additional details on this work are presented in "Power to the People: Applying citizen science to home-level mapping for rural energy access" [1]. 578,010 home annotations were made on approximately 1,267 km2 of imagery over 179 days by over 6,000 volunteers. The bounding-box annotations produced in this work have been anonymized and georeferenced. These raw annotations were found to have a precision of 49% and recall of 93% compared to a researcher-generated set of gold standard annotations. Data on roof colour and shape were also collected and are provided. Metadata about the sensors used to capture the original images and the annotation process are also attached to data records. While this dataset was collected for electrical infrastructure planning research, it can be useful in diverse sectors, including humanitarian assistance and public health.

11.
Healthc Inform Res ; 28(2): 160-169, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35576984

RESUMO

OBJECTIVES: During the coronavirus disease 2019 (COVID-19) pandemic, countries around the world framed specific laws and imposed varying degrees of lockdowns to ensure the maintenance of physical distancing. Understanding changes in temporal and spatial mobility patterns may provide insights into the dynamics of this infectious disease. Therefore, we assessed the efficacy of lockdown measures in 16 countries worldwide by analyzing the relationship between community mobility patterns and the doubling time of COVID-19. METHODS: We performed a retrospective record-based analysis of population-level data on the doubling time for COVID-19 and community mobility. The doubling time for COVID-19 was calculated based on the laboratory-confirmed cases reported daily over the study period (from February 15 to May 2, 2020). Principal component analysis (PCA) of six mobility pattern-related variables was conducted. To explain the magnitude of the effect of mobility on the doubling time, a finite linear distributed lag model was fitted. The k-means clustering approach was employed to identify countries with similar patterns in the significant co-efficient of the mobility index, with the optimal number of clusters derived using Elbow's method. RESULTS: The countries analyzed had reduced mobility in commercial and social places. Reduced mobility had a significant and favorable association with the doubling time of COVID-19-specifically, the greater the mobility reduction, the longer the time taken for the COVID-19 cases to double. CONCLUSIONS: COVID-19 lockdowns achieved the immediate objective of mobility reduction in countries with a high burden of cases.

12.
J Acad Nutr Diet ; 2022 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-35569729

RESUMO

BACKGROUND: Online grocery shopping is a rapidly growing food procurement approach in the United States with the potential to improve food access. Limited research has focused on understanding differential access to online grocery shopping that provides healthier items such as fresh or frozen fruits and vegetables. OBJECTIVE: The study aim was to understand geospatial, socioeconomic, and racial disparities in the availability of healthy online grocery shopping and online Supplemental Nutrition Assistance Program (SNAP) acceptance in North Carolina. DESIGN: A cross-sectional study was conducted in Spring 2021. PARTICIPANTS/SETTING: A listing of grocery stores with online shopping was generated using a systematic search strategy. Stores were geocoded and spatially joined to relevant contextual (rural/urban (based on USDA Rural Urban Continuum codes), broadband internet availability), socioeconomic (percent poverty, Social Vulnerability Index), and demographic (percent racial minority) variables in Geographic Information Systems software. MAIN OUTCOME MEASURES: Prevalence Rate Ratios (PRR) of healthy online grocery shopping (availability of curbside pickup or home delivery of fresh and frozen produce), and online SNAP acceptance (availability of online SNAP), at the census tract level (n=2,162). STATISTICAL ANALYSES PERFORMED: Prevalence Rate Ratios for availability of healthy online grocery shopping and SNAP online acceptance at the census tract level (n= 2,162) were modeled using Poisson regression with robust standard errors. RESULTS: This study found disparities in access to healthy online grocery shopping and SNAP online shopping availability in North Carolina. Healthy online shopping availability rates were higher in urban census tracts (Prevalence Rate Ratio (PRR)=1.68, 95% confidence interval (CI)=1.47-1.92), areas with lower Social Vulnerability Index scores (PRR=0.99, 95% CI=0.98-0.99), higher Internet Availability Index scores (PRR=1.21, 95% CI=1.17-1.25), and lower percent poverty (PRR=0.94, 95% CI=0.90-0.98). SNAP online shopping availability rates were higher in urban census tracts (PRR=1.41, 95% CI=1.16-1.65), areas with higher social vulnerability scores (PRR=1.02, 95% CI=1.01-1.04), higher Internet Availability Index scores (PRR=1.15, 95% CI=1.10-1.20), and higher percent minority (PRR=1.02, 95% CI= 1.0001-1.03). SNAP online shopping availability rates were lower in areas with higher percent poverty (PRR=0.90, 95% CI=0.85-0.95). CONCLUSIONS: This study found disparities in access to healthy online grocery shopping and SNAP online shopping for rural areas, and areas with higher poverty, and lower broadband internet access in North Carolina. Further research is needed to identify effective strategies for addressing these disparities.

13.
Public Health Nurs ; 2022 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-35537106

RESUMO

OBJECTIVE: The purpose of this systematic review was to synthesize the existing global literature examining the relationship between altitude and suicide. METHOD: Using the electronic databases PubMed, CINAHL, EMBASE, and PsychInfo published articles in English that addressed the relationship between altitude and suicide as a primary or secondary aim, and included human subjects, where identified. Studies were assessed for quality based on methodological approach and data relevance on a three-point scale (strong, moderate, or weak). RESULTS: Of the 19 studies related to the purpose and aims, 17 reported evidence of a positive correlation between altitude and increased suicide. Vast design differences were employed within the literature, individual-level suicide data was identified as the preferred level of analysis. DISCUSSION: The relationship between altitude and suicide is an evolving science with a small but growing body of literature suggesting altitude is associated with an increased risk of suicide. This review identifies the need for additional studies examining both individual-level suicide data and improving geographic precision. Public health nurses have a responsibility to carefully examine the quality of studies and the strength of the evidence when addressing variables associated with suicide.

14.
Infect Dis Poverty ; 11(1): 52, 2022 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-35562755

RESUMO

BACKGROUND: Bulinus globosus, the main intermediate snail host of Schistosoma haematobium. The increased contacts between Africa and China could even lead to large-scale dissemination of B. globosus in China. Temperature is the key factor affecting fresh-water snail transmission. This study predicted potential risk of colonization of B. globosus in the mainland of China under climate change. METHODS: We investigated minimum and maximum temperatures for B. globosus eggs, juveniles and adult snails kept under laboratory conditions to find the most suitable range by pinpointing the median effective temperatures (ET50). We also assessed the influence of temperature on spawning and estimated the accumulated temperature (AT). The average air temperatures between 1955 and 2019 in January and July, the coldest and hottest months in China, respectively, were collected from national meteorological monitoring stations and investigated in a geographic information system (GIS) using empirical Bayesian Kriging to evaluate the theoretical possibility for distribution of B. globosus in southern China based on temperature. RESULTS: The effective minimum temperature (ET50min) for eggs, juveniles, adult snails and spawning were 8.5, 7.0, 7.0, 14.9 °C, respectively, with the corresponding maximum values (ET50max) of 36.6, 40.5, 40.2 and 38.1 °C. The AT was calculated at 712.1 ± 64.9 °C·d. In 1955, the potential B. globosus distribution would have had a northern boundary stretching from the coastal areas of Guangdong Province and Guangxi Autonomous Region to southern Yunnan Province. Since then, this line has gradually moved northward. CONCLUSIONS: Annual regeneration of B. globosus can be supported by the current climate conditions in the mainland of China, and a gradual expansion trend from south to north is shown in the study from 2015 to 2019. Thus, there is a potential risk of colonization of B. globosus in the mainland of China under climate change.


Assuntos
Bulinus , Mudança Climática , Animais , Teorema de Bayes , China , Schistosoma haematobium , Caramujos
15.
Public Health Rep ; : 333549221090262, 2022 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-35514159

RESUMO

OBJECTIVE: Vulnerability indices use quantitative indicators and geospatial data to examine the level of vulnerability to morbidity in a community. The Centers for Disease Control and Prevention (CDC) uses 3 indices for the COVID-19 response: the CDC Social Vulnerability Index (CDC-SVI), the US COVID-19 Community Vulnerability Index (CCVI), and the Pandemic Vulnerability Index (PVI). The objective of this review was to describe these tools and explain the similarities and differences between them. METHODS: We described the 3 indices, outlined the underlying data sources and metrics for each, and discussed their use by CDC for the COVID-19 response. We compared the percentile score for each county for each index by calculating Spearman correlation coefficients (Spearman r). RESULTS: These indices have some, but not all, component metrics in common. The CDC-SVI is a validated metric that estimates social vulnerability, which comprises the underlying population-level characteristics that influence differences in health risk among communities. To address risk specific to the COVID-19 pandemic, the CCVI and PVI build on the CDC-SVI and include additional variables. The 3 indices were highly correlated. Spearman r for comparisons between the CDC-SVI score and the CCVI and between the CCVI and the PVI score was 0.83. Spearman r for the comparison between the CDC-SVI score and PVI score was 0.73. CONCLUSION: The indices can empower local and state public health officials with additional information to focus resources and interventions on disproportionately affected populations to combat the ongoing pandemic and plan for future pandemics.

16.
Am J Epidemiol ; 2022 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-35524716

RESUMO

Light exposure at night impedes sleep and shifts the circadian clock. An extensive body of literature has linked sleep deprivation and circadian misalignment with cardiac disease, cancer, mental health disorders, and other chronic illnesses, as well as more immediate risks, such as motor vehicle crashes and occupational injuries. In the current issue of the journal, Zhong et al. build on this literature, finding that in a cohort of 50,000 California teachers, artificial light at night, noise, greenspace, and air pollution were all associated with sleep disturbances. Light, noise, air pollution, and the lack of greenspace are problems inequitably distributed across the population, concentrated among vulnerable populations in inner cities. The current study provides novel data on the manner in which these local environmental exposures drive sleep deprivation. Future research should explore the degree to which place-based disparities in sleep in turn drive disparities in short and long-term health. Addressing home-based sleep disparities could be an avenue to addressing systemic racism and achieving environmental justice.

17.
BMJ Open ; 12(5): e056123, 2022 05 24.
Artigo em Inglês | MEDLINE | ID: mdl-35613799

RESUMO

INTRODUCTION: While travel distance and time are important proxies of physical access to health facilities, obtaining valid measures with an appropriate modelling method remains challenging in many settings. We compared five measures of geographic accessibility in Haiti, producing recommendations that consider available analytic resources and geospatial goals. METHODS: Eight public hospitals within the ministry of public health and population were included. We estimated distance and time between hospitals and geographic centroids of Haiti's section communes and population-level accessibility. Geographic feature data were obtained from public administrative databases, academic research databases and government satellites. We used validated geographic information system methods to produce five geographic access measures: (1) Euclidean distance (ED), (2) network distance (ND), (3) network travel time (NTT), (4) AccessMod 5 (AM5) distance (AM5D) and (5) AM5 travel time (AM5TT). Relative ranking of section communes across the measures was assessed using Pearson correlation coefficients, while mean differences were assessed using analysis of variance (ANOVA) and pairwise t-tests. RESULTS: All five geographic access measures were highly correlated (range: 0.78-0.99). Of the distance measures, ED values were consistently the shortest, followed by AM5D values, while ND values were the longest. ND values were as high as 2.3 times ED values. NTT models generally produced longer travel time estimates compared with AM5TT models. ED consistently overestimated population coverage within a given threshold compared with ND and AM5D. For example, population-level accessibility within 15 km of the nearest studied hospital in the Center department was estimated at 68% for ED, 50% for AM5D and 34% for ND. CONCLUSION: While the access measures were highly correlated, there were significant differences in the absolute measures. Consideration of the benefits and limitations of each geospatial measure together with the intended purpose of the estimates, such as relative proximity of patients or service coverage, are key to guiding appropriate use.


Assuntos
Instalações de Saúde , Acesso aos Serviços de Saúde , Haiti , Humanos , População Rural , Viagem
18.
Artigo em Inglês | MEDLINE | ID: mdl-35627689

RESUMO

Assessing personal exposure risk from PM2.5 air pollution poses challenges due to the limited availability of high spatial resolution data for PM2.5 and population density. This study introduced a seasonal spatial-temporal method of modeling PM2.5 distribution characteristics at a 1-km grid level based on remote sensing data and Geographic Information Systems (GIS). The high-accuracy population density data and the relative exposure risk model were used to assess the relationship between exposure to PM2.5 air pollution and public health. The results indicated that the spatial-temporal PM2.5 concentration could be simulated by MODIS images and GIS method and could provide high spatial resolution data sources for exposure risk assessment. PM2.5 air pollution risks were most serious in spring and winter, and high risks of environmental health hazards were mostly concentrated in densely populated areas in Shanghai-Hangzhou Bay, China. Policies to control the total population and pollution discharge need follow the principle of adaptation to local conditions in high-risk areas. Air quality maintenance and ecological maintenance should be carried out in low-risk areas to reduce exposure risk and improve environmental health.


Assuntos
Sistemas de Informação Geográfica , Tecnologia de Sensoriamento Remoto , China , Material Particulado/análise , Medição de Risco
19.
Sci Total Environ ; 838(Pt 1): 155908, 2022 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-35588849

RESUMO

Critical to identifying the risk of environmentally driven disease is an understanding of the cumulative impact of environmental conditions on human health. Here we describe the methodology used to develop an environmental burden index (EBI). The EBI is calculated at U.S. census tract level, a finer scale than many similar national-level tools. EBI scores are also stratified by tract land cover type as per the National Land Cover Database (NLCD), controlling for urbanicity. The EBI was developed over the course of four stages: 1) literature review to identify potential indicators, 2) data source acquisition and indicator variable construction, 3) index creation, and 4) stratification by land cover type. For each potential indicator, data sources were assessed for completeness, update frequency, and availability. These indicators were: (1) particulate matter (PM2.5), (2) ozone, (3) Superfund National Priority List (NPL) locations, (4) Toxics Release Inventory (TRI) facilities, (5) Treatment, Storage, and Disposal (TSD) facilities, (6) recreational parks, (7) railways, (8) highways, (9) airports, and (10) impaired water sources. Indicators were statistically normalized and checked for collinearity. For each indicator, we computed and summed percentile ranking scores to create an overall ranking for each tract. Tracts having the same plurality of land cover type form a 'peer' group. We re-ranked the tracts into percentiles within each peer group for each indicator. The percentile scores were combined for each tract to obtain a stratified EBI. A higher score reveals a tract with increased environmental burden relative to other tracts of the same peer group. We compared our results to those of related indices, finding good convergent validity between the overall EBI and CalEnviroScreen 4.0. The EBI has many potential applications for research and use as a tool to develop public health interventions at a granular scale.


Assuntos
Ozônio , Material Particulado , Humanos , Material Particulado/análise , Estados Unidos
20.
J Fungi (Basel) ; 8(5)2022 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-35628690

RESUMO

Sporotrichosis is a subacute/chronic subcutaneous mycosis. Since the late 1990s, there has been a hyperendemic zoonotic transmission in the state of Rio de Janeiro, involving Sporothrix brasiliensis, the most virulent causative species, and a "belt" was described along the limits between the capital and its outskirts ("Baixada Fluminense"). This study analyzes the distribution of sporotrichosis using secondary data from the Notifiable Diseases Information System (Sinan) of the Rio de Janeiro State Health Department (SES/RJ) from 2011 to 2015 and from the INI Electronic Patient Record System (Sipec) from 2008 to 2015. Cases diagnosed since the onset of the hyperendemic exceed all previously reported case series of the disease and there is a progressive expansion in the state of Rio de Janeiro. The study suggests the spread of the mycosis to all regions of the state and the expansion of the previously described "belt", despite public health measures and changes in its profile over the years, with great social impact.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...