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1.
J Environ Manage ; 279: 111599, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33189421

RESUMO

Although nitrogen (N) is a limiting factor for food production (FP) in Africa, and African food security is seriously threatened by the phenomenon of soil N depletion, there is a dearth of information that shows the points to focus on throughout the chain of FP and food consumption (FC) in all African countries to minimize N loss while securing food N supply. Food N footprint (NF) is an indicator for tracing the losses of reactive N (Nr) with regard to the FP and FC chain. This is the first study to calculate the food NF for all African countries under fertilized and unfertilized farms, by calculating two sets of virtual N factors (VNFs; kg Nr released to the environment kg-1 N in consumed product): one for unfertilized farms (the unfertilized scenario) and one for fertilized farms (the fertilized scenario). The fertilized and unfertilized VNFs were utilized to calculate a weighted average set of VNFs (the combined scenario). From the percentage of farms that utilize N fertilizer, and the N percentage in production that comes from soil depletion, the proportion used for the combined scenario was determined. Soil N depletion factors (SNDFs; kg N taken from the unfertilized soil kg-1 N in food consumed) were also computed to identify the quantity of N extracted from the soil for food production. We have also provided the changes in N inputs, N outputs, and N use efficiency (NUE) for North Africa and Sub-Saharan Africa (SSA) during the last 57 years. The average total N input to croplands increased from 24 and 19 kg N ha-1 yr-1 in 1961-1965 to 100 and 42 kg N ha-1 yr-1 in 2010-2017 for North Africa and SSA, respectively. The NUE declined from 109% and 67% (1961-1965) to 47% and 63% (2010-2017) for North Africa and SSA, respectively. The total average per-capita food NF was 11 and 5.8 kg N cap-1 yr-1 in unfertilized farms; 21 and 14 kg N cap-1 yr-1 in fertilized farms; and 19 and 7.5 kg N cap-1 yr-1 under the combined scenario for North Africa and SSA, respectively. Vegetable-fruit and beef have the highest SDNFs in Africa. FP in Africa contributes approximately 70% of the total food NF. Therefore, if possible, the best way for Africans to reduce soil N depletion and N emissions is to encourage the production and consumption of livestock and crops products with less VNF and SNDF. However, African people do not have this luxury of choice because of poverty and ignorance. Therefore, African policy-makers must adopt integrated approaches that provide effective tools to control the production of animals and crops in conjunction with the improvement of NUE. Trying to completely change the African agricultural system is impossible, but strategies must be developed to reduce soil depletion in a gradual way, as well as a shift towards low-VNF foods.


Assuntos
Fertilizantes , Nitrogênio , África ao Sul do Saara , África do Norte , Agricultura , Animais , Bovinos , Fazendas , Fertilizantes/análise , Humanos , Nitrogênio/análise , Solo
2.
PLoS One ; 15(12): e0242027, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33264318

RESUMO

The presence of glass beads in West African archaeological sites provides important evidence of long-distance trade between this part of the continent and the rest of the world. Until recently, most of these items came from historical Sub-Saharan urban centers, well known for their role in the medieval trans-Saharan trade. We present here the chemical analysis by Laser Ablation-Inductively Coupled Plasma-Mass Spectrometry (LA-ICP-MS) of 16 glass beads found in three rural sites excavated during the past decade: the funerary site of Dourou-Boro and settlement sites of Sadia, in central Mali, as well as the settlement site of Djoutoubaya, in eastern Senegal, in contexts dated between the 7th-9th and the 11th-13th centuries CE. Results show that the raw materials used to manufacture the majority of the glass most probably originated in Egypt, the Levantine coast and the Middle East. One bead is of uncertain provenance and shows similarities with glass found in the Iberian Peninsula and in South Africa. One bead fragment found inside a tomb is a modern production, probably linked to recent plundering. All of these ancient beads were exchanged along the trans-Saharan trade routes active during the rise of the first Sahelian states, such as the Ghana and the Gao kingdoms, and show strong similarities with the other West African bead assemblages that have been analysed. Despite the remoteness of their location in the Dogon Country and in the Falémé River valley, the beads studied were therefore included in the long-distance trade network, via contacts with the urban commercial centers located at the edge of the Sahara along the Niger River and in current southern Mauretania. These results bring a new light on the relationships between international and regional trade in Africa and highlight the complementarity between centres of political and economic power and their peripheries, important because of resources like gold for eastern Senegal.


Assuntos
Arqueologia , Comércio/história , Vidro/história , África do Norte , Demografia , Egito , Cromatografia Gasosa-Espectrometria de Massas , Gana , Vidro/química , História Antiga , Humanos , Mali , Oriente Médio , Níger , Senegal , África do Sul
3.
PLoS One ; 15(11): e0241510, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33137127

RESUMO

Social axioms or general social beliefs represent people's cognitive map of their social world acquired through social experiences. Empirical research has related the central constructs in the study of psychology and social axioms, establishing a broad nomological network in various cultural settings. This paper studies the validity of the Social Axioms Survey II (SAS-II) short form, Spanish version, on the individual level in Melilla as North Africa´s borderland. Participants were 410 high school students from 14 to 18 years of age. The reliability analysis, the discriminant validity analysis, and the confirmatory factor analysis through the structural model equation, showed similar results to previous studies in other contexts and allowing the use of the survey in Melilla. In addition it is presented a fitted model that improves the psychometric results showing significant differences with the initial model. The confirmatory multi-group analysis of the fitted model shows measurement invariance across educational centers, allowing new research possibilities in the cultural context of Melilla.


Assuntos
Cultura , Instituições Acadêmicas , Comportamento Social , Estudantes , Adolescente , África do Norte , Análise Discriminante , Análise Fatorial , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes
4.
PLoS One ; 15(11): e0242477, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33201909

RESUMO

The duration and intensity of future heat waves are analyzed for 53 cities in the Middle East and the North Africa (MENA) region for the 21st century under two different scenarios (RCP4.5 and RCP8.5). A consistent approach is carried out using data from 13 Regional models within the framework of the Coordinated Regional Climate Downscaling Experiment (CORDEX). By the end of the century, 80% of the most populated MENA cities are expected to be at least 50% of the days under heat wave conditions during the warm season. In addition, the mean and maximum intensity of the heat waves will also increase. Changes in the duration and intensity of heat waves have shown to be negatively correlated. Therefore, the vulnerability of the MENA cities to future heat waves was determined using a cumulative index (CI) that takes into account both duration and intensity. This CI indicates that Middle East and the eastern part of Africa will suffer the most unfavorable temperature conditions in the future. Assuming no intervention trough adaptation/mitigation strategies, these results, together with the particular properties of the MENA region, such as aridity or lack of precipitation, make it likely that the area will be affected by disease or famine.


Assuntos
Mudança Climática/estatística & dados numéricos , Temperatura Alta/efeitos adversos , Aclimatação , Adaptação Fisiológica , África do Norte , Cidades , Previsões , Humanos , Oriente Médio , Estações do Ano , Temperatura
5.
Artigo em Inglês | MEDLINE | ID: mdl-33020437

RESUMO

Issues related to poverty and income inequality in high-income countries have led to food insecurity among some population groups, such as migrants and refugees. While there are some studies on the experience of some migrant groups (and other subpopulations), little is known about food security among Middle Eastern and African migrants and refugees. This systematic review identified the prevalence of food insecurity and its effects among Middle Eastern and North African (MENA) migrants and refugees in high-income countries. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed in this systematic review. Four databases, namely MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCO), and PubMed were searched. Three studies met the inclusion criteria, all of which were conducted in USA: two among Sudanese migrant families, and one among Somali refugee women. The rates of reported food insecurity ranged from 40% to 71% and were significantly higher than for the general population. Food insecurity was associated with acculturation and socio-economic factors. Food insecurity adversely impacts the health of MENA migrants and refugees, creating economic implications for individuals, families, the broader community in which they now live, and for governments.


Assuntos
Aculturação , Abastecimento de Alimentos/estatística & dados numéricos , Refugiados , África do Norte , Feminino , Humanos , Fome/etnologia , Renda , Oriente Médio , Obesidade , Pobreza , Prevalência , Migrantes
6.
Nature ; 587(7832): 42-43, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33057187
7.
East Mediterr Health J ; 26(10): 1148-1150, 2020 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-33103740

RESUMO

The global COVID-19 pandemic has demonstrated the impact of a major public health emergency on mental health, and the ways that individuals, communities, professionals and systems can react positively to such a crisis. The Eastern Mediterranean Region (EMR) has substantial experience in mental health and psychosocial support (MHPSS) in crises, and COVID-19 has driven further innovation to support mental health and well-being.Global and regional guidance has been developed quickly, applying lessons learnt from previous disease outbreaks to respond to the pandemic at a systems level, for different population groups, and for countries of different income levels. Preliminary results from a global rapid assessment survey to assess the impact of COVID-19 on MHPSS services, indicate that 20 of the 22 EMR Member States have MHPSS as integral components of national COVID-19 response plans; one-third have allocated additional funding. However, MHPSS services have been severely impacted by the pandemic, including psychotherapy, psychosocial interventions, community services, and services for children/adolescents. Innovative solutions such as crisis hotlines, tele-consultations, digital self-help platforms, novel approaches to ensure supply of psychotropic medicines, and task sharing/shifting for basic psychosocial support, are being used in many countries to overcome service disruptions and maintain care for those with mental conditions.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Serviços de Saúde Mental/organização & administração , Saúde Mental , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , África do Norte/epidemiologia , Betacoronavirus , Desastres , Saúde Global , Comportamentos Relacionados com a Saúde , Promoção da Saúde/organização & administração , Acesso aos Serviços de Saúde/organização & administração , Humanos , Oriente Médio/epidemiologia , Pandemias , Resiliência Psicológica , Determinantes Sociais da Saúde , Fatores Socioeconômicos
8.
East Mediterr Health J ; 26(9): 992-993, 2020 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-33047787

RESUMO

The COVID-19 pandemic continues to pose multiple health challenges in the Eastern Mediterranean Region. Morbidity and mortality from the disease remain a serious cause for concern. As of 31 August 2020, a total of 1 924 511 laboratory-confirmed cases of SARS-CoV-2 virus infection had been reported in the Region, including 51 019 deaths. Moreover, there are worrying signs that cases are now rising again in some countries after a period of decline and the indirect impact of the pandemic on health care is arguably even more troubling. Access to essential health services is being compromised as scarce resources are diverted to fight the pandemic, social restriction measures such as lockdowns disrupt service provision, while fear and rumor deter people from approaching health facilities. Initial studies indicate that services such as immunization, elective surgery and chronic disease management have been severely affected. The long-term consequences threaten to be grave indeed.


Assuntos
Infecções por Coronavirus/epidemiologia , Saúde Global , Pneumonia Viral/epidemiologia , África do Norte/epidemiologia , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Acesso aos Serviços de Saúde/organização & administração , Humanos , Oriente Médio/epidemiologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/terapia , Vacinas Virais/administração & dosagem , Vacinas Virais/provisão & distribução , Organização Mundial da Saúde
9.
East Mediterr Health J ; 26(9): 1005-1010, 2020 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-33047790

RESUMO

Background: COVID-19 is now well documented in the Eastern Mediterranean Region; however, the incidence, mortality and fatality rates differ by country. Aims: The study aimed to describe the COVID-19 pandemic in the Eastern Mediterranean Region, assessing the incidence, mortality-related and fatality rate in different countries, in comparison with the worldwide mean. Methods: Data were sourced from the Worldometer surveillance page and from governmental reporting channels. Data were exported and analyzed using Statistical Package for Social Sciences (SPSS, version 23.0). Results: In the Eastern Mediterranean Region, the testing frequency is heterogeneous between countries, in addition to the reported cases and death. Very few data are available from countries with political instability and security problems (Yemen, Syrian Arab Republic and Sudan), particularly for the testing frequency. Overall, despite similar rates of testing, there was a significantly lower incidence in the Eastern Mediterranean Region versus the rest of the world, in addition to a lower mortality per million-population, particularly in countries with low to moderate testing rates. However, in countries with higher testing than the world average, there is a higher incidence, a lower mortality, but an unexpected higher fatality rate. Conclusion: The overall testing frequency was similar in the Eastern Mediterranean Region compared to the rest of the world; this would be expected to lead to a similar cumulative incidence and case fatality rate. Nevertheless, the average incidence was 70% lower than the rest of the world, and mortality per million-population was lower (90%). Moreover, in Gulf Cooperation Council high-testing countries, a similar case-fatality rate to other countries in the Region was noted, but was higher than the world average, although expected to be lower. Further studies are necessary to explain discrepancies in incidence, mortality and fatality rates among countries; principally, environmental, genetic and managerial reasons should be investigated.


Assuntos
Técnicas de Laboratório Clínico/estatística & dados numéricos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Vigilância da População/métodos , África do Norte/epidemiologia , Betacoronavirus , Infecções por Coronavirus/mortalidade , Humanos , Incidência , Oriente Médio/epidemiologia , Pandemias , Pneumonia Viral/mortalidade , Organização Mundial da Saúde
10.
J Stroke Cerebrovasc Dis ; 29(11): 105181, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33066945

RESUMO

COVID-19 pandemic has led to a change in the way we manage acute medical illnesses. This pandemic had a negative impact on stroke care worldwide. The World Stroke Organization (WSO) has raised concerns due to the lack of available care and compromised acute stroke services globally. The numbers of thrombolysis and thrombectomy therapies are declining. As well as, the rates and door-to treatment times for thrombolysis and thrombectomy therapies are increasing. The stroke units are being reallocated to serve COVID-19 patients, and stroke teams are being redeployed to COVID-19 centers. Covid 19 confirmed cases and deaths are rising day by day. This pandemic clearly threatened and threatening all stroke care achievements regionally. Managing stroke patients during this pandemic is even more challenging at our region. The Middle East and North Africa Stroke and Interventional Neurotherapies Organization (MENA-SINO) is the main stroke organization regionally. MENA-SINO urges the need to developing new strategies and recommendations for stroke care during this pandemic. This will require multiple channels of interventions and create a protective code stroke with fast triaging path. Developing and expanding the tele-stroke programs are urgently required. There is an urgent need for enhancing collaboration and cooperation between stroke expertise regionally and internationally. Integrating such measures will inevitably lead to an improvement and upgrading of the services to a satisfactory level.


Assuntos
Infecções por Coronavirus/terapia , Prestação Integrada de Cuidados de Saúde/normas , Pneumonia Viral/terapia , Acidente Vascular Cerebral/terapia , Trombectomia/normas , Terapia Trombolítica/normas , África do Norte/epidemiologia , Consenso , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Humanos , Oriente Médio/epidemiologia , Pandemias , Segurança do Paciente , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Padrões de Prática Médica/normas , Quarentena , Medição de Risco , Fatores de Risco , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/epidemiologia , Telemedicina/normas , Fatores de Tempo , Resultado do Tratamento , Triagem/normas
11.
Sci Data ; 7(1): 351, 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-33060594

RESUMO

Trait-based analyses explaining the different responses of species and communities to environmental changes are increasing in frequency. European butterflies are an indicator group that responds rapidly to environmental changes with extensive citizen science contributions to documenting changes of abundance and distribution. Species traits have been used to explain long- and short-term responses to climate, land-use and vegetation changes. Studies are often characterised by limited trait sets being used, with risks that the relative roles of different traits are not fully explored. Butterfly trait information is dispersed amongst various sources and descriptions sometimes differ between sources. We have therefore drawn together multiple information sets to provide a comprehensive trait database covering 542 taxa and 25 traits described by 217 variables and sub-states of the butterflies of Europe and Maghreb (northwest Africa) which should serve for improved trait-based ecological, conservation-related, phylogeographic and evolutionary studies of this group of insects. We provide this data in two forms; the basic data and as processed continuous and multinomial data, to enhance its potential usage.


Assuntos
Borboletas/classificação , África do Norte , Animais , Evolução Biológica , Conservação dos Recursos Naturais , Bases de Dados Factuais , Ecologia , Europa (Continente) , Filogenia
12.
Int J Rheum Dis ; 23(11): 1550-1557, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32892516

RESUMO

AIM: To evaluate the impact of the coronavirus disease 2019 pandemic (COVID-19) on the access to rheumatology care for patients with chronic rheumatic diseases (CRD) in the Arab countries. METHOD: A web-based cross-sectional survey was designed by the Arab Adult Arthritis Awareness group (AAAA) consisting of 16 rheumatologists representing countries from the Arab League of Associations for Rheumatology (ArLAR) and was validated by the ArLAR scientific committee. The survey was disseminated online through social media and patients' association channels between May 8 and May 22, 2020. The steering committee developed recommendations to improve the care of patients with CRD during the COVID-19 pandemic. RESULTS: A total of 2163 patients were included in the analysis; 72% were female; mean age was 40 years (SD 11.9). The Levant, the Gulf, and North Africa contributed almost equally to the sample. The pandemic had a significant negative impact on rheumatology visits in 82% of cases, access to hydroxychloroquine (47%), and chronic medication persistency (28%). The negative impact on rheumatology visits was associated with female gender, country, medication non-persistency, isolation due to COVID-19, and impact on mental health. Sixty-one patients (2.8%) stated that they had COVID-19, 5% said that a close contact was infected, and 47% were in isolation because of COVID-19. CONCLUSION: The current study highlights the deleterious consequences of the COVID-19 pandemic on the continuity of rheumatology care. Therefore, an action plan, including establishing a telemedicine platform, securing drug availability, and promoting medication persistence through the appropriate communication channels, is strongly recommended.


Assuntos
Continuidade da Assistência ao Paciente/tendências , Assistência à Saúde/tendências , Pandemias , Doenças Reumáticas/terapia , Adulto , África do Norte , Árabes , Estudos Transversais , Feminino , Humanos , Internet , Masculino , Saúde Mental , Pessoa de Meia-Idade , Oriente Médio , Reumatologistas , Inquéritos e Questionários
13.
Artigo em Inglês | MEDLINE | ID: mdl-32961850

RESUMO

Breast cancer, the most common cancer among women in the Middle East and North Africa (MENA) region, is associated with social and psychological implications deriving from women's socio-cultural contexts. Examining 74 articles published between 2007 and 2019, this literature/narrative review explores the psychosocial aspects of female breast cancer in the MENA region. It highlights socio-cultural barriers to seeking help and socio-political factors influencing women's experience with the disease. In 17 of 22 Arab countries, common findings emerge which derive from shared cultural values. Findings indicate that women lack knowledge of breast cancer screening (BCS) and breast cancer self-examination (BSE) benefits/techniques due to a lack of physicians' recommendations, fear, embarrassment, cultural beliefs, and a lack of formal and informal support systems. Women in rural areas or with low socioeconomic status further lack access to health services. Women with breast cancer, report low self-esteem due to gender dynamics and a tendency towards fatalism. Collaboration between mass media, health and education systems, and leading social-religious figures plays a major role in overcoming psychological and cultural barriers, including beliefs surrounding pain, fear, embarrassment, and modesty, particularly for women of lower socioeconomic status and women living in crises and conflict zones.


Assuntos
Neoplasias da Mama , Conhecimentos, Atitudes e Prática em Saúde , Acesso à Informação , África do Norte , Neoplasias da Mama/psicologia , Características Culturais , Cultura , Detecção Precoce de Câncer , Medo , Feminino , Humanos , Programas de Rastreamento , Oriente Médio , Apoio Social
14.
Sci Rep ; 10(1): 14948, 2020 09 11.
Artigo em Inglês | MEDLINE | ID: mdl-32917918

RESUMO

Drought and desertification are the major environmental constraints facing the Sahelian agro-ecosystems for decades. Assessing genetic diversity of native tree species is critical to assist ecosystems restoration efforts. Here we describe genetic diversity and structure of seven Balanites aegyptiaca L. natural populations distributed across the Sahelian-Saharan zone of Mauritania using 16 polymorphic ISSR primers. These generated 505 polymorphic bands. Polymorphism information content (PIC) varied from (0.13-0.29) with an average 0.23, marker index (MI) averaged 7.3 (range 3.3-10.3) and resolving power (RP) ranged from (4.53-14.6) with an average 9.9. The number of observed alleles (Na) ranged from (0.62-1.39), Effective number of alleles (Ne) varied from (1.26-1.37), Shannon's information index (I) ranged from (0.25-0.36). AMOVA analysis showed that 80% of the genetic variation was fined within populations, which is supported by a low level of genetic differentiation between population (GST = 0.21) and an overall estimate of gene flow among populations (Nm = 1.9). The dendrogram based on Jaccard's similarity coefficient and the structure analysis divided the seven populations into two main clusters in which two populations from the Saharan zone were grouped. Our results provide baseline data for genetic conservation programs of this Sahelian neglected crop and with an important econ-ecological role.


Assuntos
Balanites/genética , Ecossistema , Repetições de Microssatélites , Polimorfismo Genético , África do Norte , Mauritânia
15.
Saudi Med J ; 41(9): 907-915, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32893272

RESUMO

OBJECTIVES: To summarize the outcomes of the coronavirus disease 2019 infections in the Eastern Mediterranean Region (EMR) in the first 4 months of the pandemic. METHODS: A meta-analysis approach was used in this context. We used the aggregate data from the World Health Organization Regional Office for the EMRO (until 26 May 2020) to generate this report. RESULTS: An analysis of official data from all 22 countries and territories in the Middle East, North Africa, the Horn of Africa, and Central Asia K=22 (a total of 438,717 cases) was performed. The total number of cases, recovered cases were 438,717,228,986,  and deaths was 11,290 in the EMR. Meta-analytic pooling of the point estimates of recovery rate per country in the EMR was 52.5% (95% CI 52.3% - 52.6%). The lowest recovery rates were in Somalia (4.3%), and the highest rates were in Tunisia (87.4%). Meta-analytic pooling of the point estimates of death rate per country in the EMR yielded 3.85% [95% CI 3.80% - 3.9%]. Meta-analytic pooling of the point estimates of recovery rate per country in the Gulf Cooperation Council countries was 46.1% (95% CI 45.8% - 46.3%). Meta-analytic pooling of the point estimates of death rate per country in the Gulf Cooperation Council countries was 0.6% (95% CI 0.50% - 0.65%). CONCLUSION: Wide variability was found between EMR countries in recovery and mortality, implying the possible impact of resource availability, and genetic and environmental factors on the morality and recovery of the COVID-19.


Assuntos
Infecções por Coronavirus/mortalidade , Pneumonia Viral/mortalidade , Taxa de Sobrevida , África do Norte/epidemiologia , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Humanos , Oriente Médio/epidemiologia , Mortalidade , Paquistão/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Somália/epidemiologia
16.
Artigo em Inglês | MEDLINE | ID: mdl-32867287

RESUMO

Public health recommendations and governmental measures during the new coronavirus disease (COVID-19) pandemic have enforced numerous restrictions on daily living including social distancing, isolation, and home confinement. While these measures are imperative to mitigate spreading of COVID-19, the impact of these restrictions on psychosocial health is undefined. Therefore, an international online survey was launched in April 2020 to elucidate the behavioral and lifestyle consequences of COVID-19 restrictions. This report presents the preliminary results from more than one thousand responders on social participation and life satisfaction. METHODS: Thirty-five research organizations from Europe, North-Africa, Western Asia, and the Americas promoted the survey through their networks to the general society, in 7 languages (English, German, French, Arabic, Spanish, Portuguese, and Slovenian). Questions were presented in a differential format with questions related to responses "before" and "during" confinement conditions. RESULTS: 1047 participations (54% women) from Asia (36%), Africa (40%), Europe (21%), and others (3%) were included in the analysis. Findings revealed psychosocial strain during the enforced COVID-19 home confinement. Large decreases (p < 0.001) in the amount of social activity through family (-58%), friends/neighbors (-44.9%), or entertainment (-46.7%) were triggered by the enforced confinement. These negative effects on social participation were also associated with lower life satisfaction (-30.5%) during the confinement period. Conversely, the social contact score through digital technologies significantly increased (p < 0.001) during the confinement period with more individuals (+24.8%) being socially connected through digital technology. CONCLUSION: These preliminary findings elucidate the risk of psychosocial strain during the early COVID-19 home confinement period in 2020. Therefore, in order to mitigate the negative psychosocial effects of home confinement, implementation of national strategies focused on promoting social inclusion through a technology-based solution is strongly suggested.


Assuntos
Infecções por Coronavirus/psicologia , Satisfação Pessoal , Pneumonia Viral/psicologia , Participação Social , África do Norte , América , Ásia Ocidental , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Europa (Continente) , Feminino , Humanos , Masculino , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle
17.
Lancet ; 396(10254): 830-838, 2020 09 19.
Artigo em Inglês | MEDLINE | ID: mdl-32877651

RESUMO

BACKGROUND: Angina might persist or reoccur despite successful revascularisation with percutaneous coronary intervention (PCI) and antianginal therapy. Additionally, PCI in stable patients has not been shown to improve survival compared with optimal medical therapy. Trimetazidine is an antianginal agent that improves energy metabolism of the ischaemic myocardium and might improve outcomes and symptoms of patients who recently had a PCI. In this study, we aimed to assess the long-term potential benefits and safety of trimetazidine added to standard evidence-based medical treatment in patients who had a recent successful PCI. METHODS: We did a randomised, double-blind, placebo-controlled, event-driven trial of trimetazidine added to standard background therapy in patients who had undergone successful PCI at 365 centres in 27 countries across Europe, South America, Asia, and north Africa. Eligible patients were aged 21-85 years and had had either elective PCI for stable angina or urgent PCI for unstable angina or non-ST segment elevation myocardial infarction less than 30 days before randomisation. Patients were randomly assigned by an interactive web response system to oral trimetazidine 35 mg modified-release twice daily or matching placebo. Participants, study investigators, and all study staff were masked to treatment allocation. The primary efficacy endpoint was a composite of cardiac death; hospital admission for a cardiac event; recurrence or persistence of angina requiring an addition, switch, or increase of the dose of at least one antianginal drug; or recurrence or persistence of angina requiring a coronary angiography. Efficacy analyses were done according to the intention-to-treat principle. Safety was assessed in all patients who had at least one dose of study drug. This study is registered with the EU Clinical Trials Register (EudraCT 2010-022134-89). FINDINGS: From Sept 17, 2014, to June 15, 2016, 6007 patients were enrolled and randomly assigned to receive either trimetazidine (n=2998) or placebo (n=3009). After a median follow-up of 47·5 months (IQR 42·3-53·3), incidence of primary endpoint events was not significantly different between the trimetazidine group (700 [23·3%] patients) and the placebo group (714 [23·7%]; hazard ratio 0·98 [95% CI 0·88-1·09], p=0·73). When analysed individually, there were no significant differences in the incidence of the components of the primary endpoint between the treatment groups. Similar results were obtained when patients were categorised according to whether they had an elective or urgent PCI. 1219 (40·9%) of 2983 patients in the trimetazidine group and 1230 (41·1%) of 2990 patients in the placebo group had serious treatment-emergent adverse events. Frequencies of adverse events of interest were similar between the groups. INTERPRETATION: Our results show that the routine use of oral trimetazidine 35 mg twice daily over several years in patients receiving optimal medical therapy, after successful PCI, does not influence the recurrence of angina or the outcome; these findings should be taken into account when considering the place of trimetazidine in clinical practice. However, the long-term prescription of this treatment does not appear to be associated with any statistically significant safety concerns in the population studied. FUNDING: Servier.


Assuntos
Infarto do Miocárdio sem Supradesnível do Segmento ST/terapia , Intervenção Coronária Percutânea/métodos , Trimetazidina/efeitos adversos , Vasodilatadores/efeitos adversos , Administração Oral , África do Norte/epidemiologia , Idoso , Angina Estável/terapia , Angina Instável/terapia , Ásia/epidemiologia , Estudos de Casos e Controles , Angiografia Coronária/métodos , Angiografia Coronária/estatística & dados numéricos , Morte , Europa (Continente)/epidemiologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Intervenção Coronária Percutânea/tendências , Placebos/administração & dosagem , Recidiva , Segurança , América do Sul/epidemiologia , Resultado do Tratamento , Trimetazidina/administração & dosagem , Trimetazidina/uso terapêutico , Vasodilatadores/administração & dosagem , Vasodilatadores/uso terapêutico
18.
J Environ Manage ; 275: 111295, 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-32891008

RESUMO

Following the "Belt and Road" (B&R) initiative, China has significantly increased its outward direct investment (ODI). Although these investments help to boost these countries' productivity, their impacts on the environment are still controversial and deserve careful investigation. This study for the first time examines whether China's ODI has improved the green total factor productivity (GTFP), a comprehensive index for environmental quality and productivity. Moreover, a new data set composed of ICRG, World Bank WDI, Heritage Foundation, and Wind databases is used to match the panel data of 46 B&R countries for the period of 2003-2016. A newly developed dynamic threshold panel model with GMM characteristics is utilized to explore the possible nonlinear relationship with full consideration of heterogeneity. The empirical results indicate that there is no pollution shelter effect on China's ODI. With the increase in China's ODI, the GTFP of the B&R countries has been significantly improved. Additionally, China's ODI has a greater role in promoting GTFP in B&R countries with higher institutional quality. The positive effects of China's ODI on the GTFP of B&R countries depend on the institutional qualities of the countries, and the enhancement effect becomes greater when the countries have better institutions. There is also evidence that China's ODI significantly promoted the GTFP of countries in the East Asia and Pacific region, South Asia, Central Asia and Europe, while China's ODI did not significantly promote the GTFP of countries in the Middle East and North Africa.


Assuntos
África do Norte , Ásia , China , Europa (Continente) , Oriente Médio
20.
Environ Int ; 144: 106056, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32866734

RESUMO

In October 2017, hundreds of wildfires ravaged the forests of the north and centre of Portugal. The fires were fanned by strong winds as tropical storm Ophelia swept the Iberian coast, dragging up smoke (together with Saharan dust from north-western Africa) into higher western European latitudes. Here we analyse the long-range transport of particulate matter (PM10) and study associations between PM10 and short-term mortality in the Portuguese population exposed to PM10 due to the October 2017 wildfires, the worst fire sequence in the country over the last decades. We analysed space- and ground-level observations to track the smoke plume and dust trajectory over Portugal and Europe, and to access PM10 concentrations during the wildfires. The effects of PM10 on mortality were evaluated using satellite data for exposure and Poisson regression models. The smoke plume covered most western European countries (including Spain, France, Belgium and the Netherlands), and reached the United Kingdom, where the population was exposed in average to an additional PM10 level of 11.7 µg/m3 during seven smoky days (three with dust) in relation to the reference days (days without smoke or dust), revealing the impact of the wildfires on distant populations. In Portugal, the population was exposed in average to additional PM10 levels that varied from 16.2 to 120.6 µg/m3 in smoky days with dust and from 6.1 to 20.9 µg/m3 in dust-free smoky days. Results suggest that PM10 had a significant effect on the same day natural and cardiorespiratory mortalities during the month of October 2017. For every additional 10 µg/m3 of PM10, there was a 0.89% (95% confidence interval, CI, 0-1.77%) increase in the number of natural deaths and a 2.34% (95% CI, 0.99-3.66%) increase in the number of cardiorespiratory-related deaths. With rising temperatures and a higher frequency of storms due to climate change, PM from Iberian wildfires together with NW African dust will tend to be more often transported into Northern European countries, which may carry health threats to areas far from the ignition sites.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Doenças Cardiovasculares , Incêndios Florestais , África do Norte , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Bélgica , Poeira , Europa (Continente) , França , Humanos , Países Baixos , Material Particulado/análise , Portugal/epidemiologia , Espanha , Reino Unido
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