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1.
Lancet ; 394(10216): 2255-2262, 2020 12 21.
Artigo em Inglês | MEDLINE | ID: mdl-31862250

RESUMO

BACKGROUND: More than 80% of public-access defibrillation attempts do not result in sustained return of spontaneous circulation in patients who have had an out-of-hospital cardiac arrest (OHCA) and a shockable heart rhythm before arrival of emergency medical service (EMS) personnel. Neurological and survival outcomes in such patients have not been evaluated. We aimed to assess the neurological status and survival outcomes in such patients. METHODS: This is a retropective analysis of a cohort study from a prospective, nationwide, population-based registry of 1 299 784 patients who had an OHCA event between Jan 1, 2005, and Dec 31, 2015 in Japan. The primary outcome was favourable neurological outcome (Cerebral Performance Category of 1 or 2) at 30 days after the OHCA and the secondary outcome was survival at 30 days following the OHCA. This study is registered with the University Hospital Medical Information Network Clinical Trials Registry, UMIN000009918. FINDINGS: We identified 28 019 patients with bystander-witnessed OHCA and shockable heart rhythm who had received CPR from a bystander. Of these, 2242 (8·0%) patients did not achieve return of spontaneous circulation with CPR plus public-access defibrillation, and 25 087 (89·5%) patients did not achieve return of spontaneous circulation with CPR alone before EMS arrival. The proportion of patients with a favourable neurological outcome was significantly higher in those who received public-access defibrillation than those who did not (845 [37·7%] vs 5676 [22·6%]; adjusted odds ratio [OR] after propensity score-matching, 1·45 [95% CI 1·24-1·69], p<0·0001). The proportion of patients who survived at 30 days after the OHCA was also significantly higher in those who received public-access defibrillation than those who did not (987 [44·0%] vs 7976 [31·8%]; adjusted OR after propensity score-matching, 1·31 [95% CI 1·13-1·52], p<0·0001). INTERPRETATION: Our findings support the benefits of public-access defibrillation and greater accessibility and availability of automated external defibrillators in the community. FUNDING: None.


Assuntos
Reanimação Cardiopulmonar/instrumentação , Cardioversão Elétrica/instrumentação , Doenças do Sistema Nervoso/etiologia , Parada Cardíaca Extra-Hospitalar/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Reanimação Cardiopulmonar/métodos , Desfibriladores , Cardioversão Elétrica/métodos , Serviços Médicos de Emergência , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/epidemiologia , Razão de Chances , Parada Cardíaca Extra-Hospitalar/complicações , Parada Cardíaca Extra-Hospitalar/mortalidade , Pontuação de Propensão , Estudos Prospectivos , Logradouros Públicos , Recuperação de Função Fisiológica , Sistema de Registros , Estudos Retrospectivos
2.
Rev Saude Publica ; 53: 112, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31800909

RESUMO

OBJECTIVE: To analyze the association between sociodemographic characteristics of census tracts and the presence/quality of public open spaces and physical activity facilities. METHODS: A cross-sectional study was conducted in 643 census tracts in Florianópolis, Brazil, the presence and quality of public open spaces and physical activity facilities were objectively analyzed and the data by census tracts using Geographic Information Systems was treated. Outcomes were analyzed considering the census tracts as having: ≥ 1 public open spaces; ≥ 1 public open spaces with high quality; ≥ 2 physical activity facilities and high-quality physical activity facilities. Sociodemographic characteristics were the independent variables. Logistic regression analysis was performed. RESULTS: Census tracts with a medium-income (OR = 1.8; 95%CI 1.1-3.0) and high-income (OR = 2.4; 95%CI 1.4-4.0), in those with medium (OR = 1.7; 95%CI 1.0-2.7) and high residential density (OR = 2.0; 95%CI 1,2-3.3), and with higher proportions of older adults (OR = 3.3; 95%CI 1.9-5.7) had a higher proportion of public open spaces. Census tracts with higher proportions of children/adolescents (OR = 0.3; 95%CI 0.2-0.6) and non-white residents (OR= 0.6; 95%CI 0.3-0.9) were less likely to contain public open spaces. The tracts with medium (OR = 4.0; 95%CI 1.4-11.3) and high-income (OR = 3.6; 95%CI 1.2-10.2) were more likely to contain public open spaces with ≥ 2 structures for physical activity, compared with those with low-income. We observed the inverse in sectors with a high proportion of non-white residents (OR = 0.3; 95%CI 0.1-0.9). CONCLUSIONS: Census tracts with higher proportions of children or adolescents, non-white individuals and those in the low-income strata had lower odds of containing public open spaces and physical activity facilities.


Assuntos
Exercício/fisiologia , Logradouros Públicos/estatística & dados numéricos , Instalações Esportivas e Recreacionais/estatística & dados numéricos , Adulto , Fatores Etários , Brasil , Censos , Estudos Transversais , Feminino , Sistemas de Informação Geográfica , Humanos , Masculino , Pessoa de Meia-Idade , Características de Residência , Meio Social , Fatores Socioeconômicos , Adulto Jovem
3.
BMC Public Health ; 19(1): 1269, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533693

RESUMO

BACKGROUND: Several studies have demonstrated that smoke-free legislation is associated with a reduced risk of mortality from acute myocardial infarction (AMI). This study aimed to examine and quantify the potential effect of smoke-free legislation on AMI mortality rate in different countries. METHODS: Studies were identified using a systematic search of the scientific literature from electronic databases, including PubMed, Web of Science, ScienceDirect, Embase, Google Scholar, and China National Knowledge Infrastructure (CNKI), from their inception through September 30, 2017. A random effects model was employed to estimate the overall effects of smoke-free legislation on the AMI mortality rate. Subgroup analysis was performed to explore the possible causes of heterogeneity in risk estimates based on sex and age. The results of meta-analysis after excluding the studies with a high risk of bias were reported in this study. RESULTS: A total of 10 eligible studies with 16 estimates of effect size were included in this meta-analysis. Significant heterogeneity in the risk estimates was identified (overall I2 = 94.6%, p < 0.001). Therefore, a random effects model was utilized to estimate the overall effect of smoke-free legislation. There was an 8% decline in AMI mortality after introducing smoke-free legislation (RR = 0.92, 95% confidence interval (CI): 0.90-0.94). The results of subgroup analyses showed that smoke-free legislation was significantly associated with lower rates of mortality for the following 5 diagnostic subgroups: smoke-free in workplaces, restaurants and bars (RR = 0.92, 95% CI: 0.90-0.95), smaller sample size (RR = 0.92, 95% CI: 0.89-0.95), study location in Europe (RR = 0.90, 95% CI: 0.85-0.94), regional study area (RR = 0.92, 95% CI: 0.89-0.94), and no previous local smoke-free legislation (RR = 0.91, 95% CI: 0.90-0.93). However, there was not much difference in AMI mortality rates after the legislation between the longer (RR = 0.92, 95% CI: 0.86-0.98) and shorter follow-up duration subgroups (RR = 0.92, 95% CI: 0.89-0.94). CONCLUSION: Smoke-free legislation could significantly reduce the AMI mortality rate by 8%. The reduction in the AMI mortality rate was more significant in studies with more comprehensive laws, without prior smoke-free bans, with a smaller sample size, at the regional level, and with a location in Europe.


Assuntos
Infarto do Miocárdio/mortalidade , Logradouros Públicos/legislação & jurisprudência , Saúde Pública/legislação & jurisprudência , Política Antifumo/legislação & jurisprudência , Fumar/legislação & jurisprudência , China , Feminino , Humanos , Masculino , Infarto do Miocárdio/prevenção & controle , Restaurantes/legislação & jurisprudência , Fatores de Tempo , Local de Trabalho/legislação & jurisprudência
4.
J Sci Med Sport ; 22(12): 1335-1343, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31444034

RESUMO

OBJECTIVES: While outdoor gyms are being rapidly installed around the globe, little is known about their implications on physical activity, and fitness and other health-related outcomes. The primary objective of this systematic review was to examine the effects of outdoor gyms on physical activity, fitness and other health-related outcomes. Secondary objectives were to describe outdoor gym characteristics, user characteristics, and outdoor gym usage. DESIGN: Systematic review. METHODS: Peer-reviewed papers published in English were obtained through online database searches of the following databases; EBSCO, SPORTdiscus, Medline, PsycINFO, Web of Science, Scopus and Informit. Searches covered the periods from database inception to January 2019. Studies that reported on the efficacy of outdoor gym use for physical activity, health-related outcomes or descriptive aspects of outdoor gyms and their users were eligible for inclusion. RESULTS: There was some support that outdoor gyms may improve physical activity, fitness and other health-related outcomes, however few experimental studies have been conducted. There was no consistency between outdoor gyms in terms types and number of installed equipment for each facility. Further, this review found discrepancies of whom were the most likely users of outdoor gyms and when they were mainly used. CONCLUSIONS: This review contributes to the limited evidence on the impact and characteristics of outdoor gyms on physical activity and fitness and health-related outcomes.


Assuntos
Exercício , Aptidão Física , Logradouros Públicos , Recreação , Instalações Esportivas e Recreacionais/classificação , Humanos
5.
Artigo em Inglês | MEDLINE | ID: mdl-31426297

RESUMO

Urban Large-scale Public Spaces (ULPS) are important areas of urban culture and economic development, which are also places of the potential safety hazard. ULPS safety assessment has played a crucial role in the theory and practice of urban sustainable development. The primary objective of this study is to explore the interaction between ULPS safety risk and its influencing factors. In the first stage, an index sensitivity analysis method was applied to calculate and identify the safety risk assessment index system. Next, a Delphi method and information entropy method were also applied to collect and calculate the weight of risk assessment indicators. In the second stage, a Dempster-Shafer Theory (DST) method with evidence fusion technique was utilized to analyze the interaction between the ULPS safety risk level and the multiple-index variables, measured by four observed performance indicators, i.e., environmental factor, human factor, equipment factor, and management factor. Finally, an empirical study of DST approach for ULPS safety performance analysis was presented.


Assuntos
Logradouros Públicos , Medição de Risco , Algoritmos , China , Cidades , Técnica Delfos , Pesquisa Empírica , Entropia , Meio Ambiente , Humanos
6.
BMC Pregnancy Childbirth ; 19(1): 220, 2019 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-31266469

RESUMO

BACKGROUND: Low birthweight (LBW) remains the most important risk factor which attributed to mortality of 15-20% of newborns across the globe. An infant with low birthweight is more likely to have stunting in childhood and develop markers of metabolic risk factors at his later age. Furthermore, LBW is a risk for inter-generational assaults of malnutrition as it is the risk for sub optimal growth until adulthood, affecting women's and male's reproductive capabilities. Thus, there is enough concern to study the determinants of LBW across different settings. Accordingly, this study was conducted to assess the determinants of low birthweight s in public health facilities of Nekemte town, West Ethiopia. METHODS: Facility based unmatched case control study was employed from February to April 2017. The data were collected using structured, pretested interviewer administered questionnaire in all public health facilities of Nekemte town. Consecutive live births of less than 2500 g in each of the hospitals and health centres were selected as cases and succeeding babies with weights of at least 2500 g as controls. Data were entered in to Epi-data software version 3.1 and exported to SPSS Version 21 and analyzed using frequency, cross-tabs and percentage. Factors with p-value < 0.25 in Bivariate analysis were entered in to multivariable logistic regression and statistical significance was considered at p-value < 0.05. RESULT: A total 279 (93 cases &186 controls) were included in the study with a mean birthweight of 2138.3 g ± SD 206.87 for cases and 3145.95 g ± SD 415.98 for controls. No iron-folate supplementation (AOR = 2.84, 95% CI, 1.15-7.03), no nutritional counselling (AOR = 4.05, 95%CI, 1.95-8.38), not taking snacks (AOR =3.25, 95%CI, 1.64-6.44), maternal under nutrition (AOR =5.62, 95%CI, 2.64-11.97), anemia (AOR = 3.54, 95%CI, 1.46-8.61) and inadequate minimum dietary diversity score of women MDDS-W (AOR = 6.65, 95%CI, 2.31-19.16) were factors associated with low birthweight . CONCLUSION: Lacking nutrition counselling during pregnancy, lacking iron/folic acid supplementation during pregnancy, not taking snacks during pregnancy, maternal under-nutrition, maternal anemia and inadequate minimum dietary diversity score of women (MDDS-W) were independently associated with LBW. Thus, public health intervention in the field of maternal and child health should address these determinants.


Assuntos
Recém-Nascido de Baixo Peso , Desnutrição/complicações , Complicações na Gravidez/etiologia , Adulto , Peso ao Nascer , Estudos de Casos e Controles , Etiópia , Feminino , Humanos , Recém-Nascido , Modelos Logísticos , Masculino , Fenômenos Fisiológicos da Nutrição Materna , Estado Nutricional , Gravidez , Cuidado Pré-Natal/estatística & dados numéricos , Logradouros Públicos , Fatores de Risco
7.
Artigo em Inglês | MEDLINE | ID: mdl-31284643

RESUMO

Experts in diverse fields have investigated sound in cities throughout the United States. This research aims to examine sound levels and determine its contributors at the transit-oriented development (TOD) station and neighborhood levels by studying selected Dallas Area Rapid Transit (DART) light rail stations. A multilevel analysis was performed to model the likelihood of TOD stations and neighborhoods affecting sound levels, controlling for station amenities, socio-demographics and built environment characteristics. Sound measurements were sampled in three time intervals with 15 min sampling over weekdays and weekends at TOD and non-TOD stations by a type II SPL meter that was mounted on a small camera tripod at a height of 1.5 m, at a distance of 1.5 m from rails and curbs. The research team found that amenities, built environmental characteristics, and neighborhood features have significant implications on sound levels at both the TOD station and the neighborhood level, which affects quality of life (QoL). TOD stations that include more amenities have a greater level of significance on sound levels. Additionally, neighborhoods with a pervasive street grid configuration, public facilities, and built environment densities are significantly associated with a likelihood of high sound levels. Conversely, higher population densities and intersection densities decrease the likelihood of a high sound level environment. These patterns provide an arena for transportation, urban, and environmental planning and policymaking to generate transformative solutions and policies.


Assuntos
Ambiente Construído , Ferrovias , Som , Cidades , Demografia , Feminino , Humanos , Masculino , Densidade Demográfica , Logradouros Públicos , Qualidade de Vida , Características de Residência , Texas
8.
MMWR Morb Mortal Wkly Rep ; 68(28): 627-630, 2019 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-31318854

RESUMO

In October 2017, the Nebraska Department of Health and Human Services (NDHHS) was notified by a local health department of a gastrointestinal illness outbreak among attendees of a wedding reception at facility A, an event center. Shortly thereafter, state and local public health officials began receiving reports of similar gastrointestinal illness among attendees of subsequent facility A events. An investigation was initiated to identify cases, establish the cause, assess possible transmission routes, and provide control recommendations. Overall, 159 cases consistent with norovirus infection (three confirmed and 156 probable) were identified among employees of facility A and attendees of nine facility A events during October 27-November 18, 2017. The investigation revealed a public vomiting episode at the facility on October 27 and at least one employee involved with preparing and serving food who returned to work <24 hours after symptom resolution, suggesting that a combination of contaminated environmental surfaces and infected food handlers likely sustained the outbreak. Recommendations regarding sanitation and excluding ill employees were communicated to facility A management. However, facility A performed minimal environmental cleaning and did not exclude ill employees. Consequently, transmission continued. To prevent persistent norovirus outbreaks in similar settings, public health officials should ensure that involved facilities implement a comprehensive prevention strategy as early as possible that includes extensive sanitation and strict exclusion of ill food handlers for at least 48 hours after symptom resolution (1).


Assuntos
Infecções por Caliciviridae/epidemiologia , Surtos de Doenças/estatística & dados numéricos , Logradouros Públicos , Infecções por Caliciviridae/prevenção & controle , Surtos de Doenças/prevenção & controle , Fezes/virologia , Gastroenterite/epidemiologia , Gastroenterite/prevenção & controle , Gastroenterite/virologia , Genótipo , Humanos , Nebraska/epidemiologia , Norovirus/genética , Norovirus/isolamento & purificação , Prática de Saúde Pública
9.
Salud Publica Mex ; 61(4): 524-531, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31322845

RESUMO

OBJECTIVE: To analyze the possible effect of certification models and healthcare organizations' (HOs) participation incentives in the General Health Council certification process in the 1999-2017 period. MATERIALS AND METHODS: Official printed and online documents about HOs' certification were collected. Information from instances related to the process was requested through transparency mechanisms. Health organizations' participation in political-administrative periods between 1997-2017 was analyzed. RESULTS: The annual average participation in the certification process during the 1999-2000 period was 259.5 HOs; during the 2013-2016 period, the average was 72.5. Public units' participation in this process has been decreasing. In 2017, certified HO were <1%. CONCLUSIONS: No positive effects of adjustments to the certification model or the incentives applied were identified. Conversely, there is decreasing participation in the different political-administrative periods. The National HO Certification System and its possible effect on clinical quality must be thoroughly evaluated.


Assuntos
Acreditação/normas , Certificação/normas , Instalações de Saúde/normas , Instalações de Saúde/estatística & dados numéricos , México , Setor Privado/normas , Setor Privado/estatística & dados numéricos , Logradouros Públicos/normas , Logradouros Públicos/estatística & dados numéricos
10.
Artigo em Inglês | MEDLINE | ID: mdl-31086047

RESUMO

Parks provide an opportunity for children to be physically active, but are rarely fully utilised. A better understanding of which park features attract children of varying ages is needed. This study examined which features are present at parks that children visit most often at different stages throughout childhood. Parents reported the park their child visited most often at three timepoints: T1 = 3-5 years, T2 = 6-8 years, and T3 = 9-11 years. These parks were then audited (using a purposely created audit tool) to capture information relating to access, activity areas and quality. Online mapping tools were also used to determine walking distance to parks and park size. Parks visited at T2 were further from home, larger, and had more road crossings, full courts, other facilities and comfort amenities such as toilets and lights than T1 parks. Parks visited at T3 were larger and had more sports ovals compared to T1 parks, and were significantly less likely to have barbeque facilities than T2 parks. Our findings suggest that as children transition from pre-school (T1), to primary school age (T2 and T3), they visit parks that have more facilities to support sport and active recreation.


Assuntos
Logradouros Públicos , Recreação , Criança , Pré-Escolar , Planejamento Ambiental , Feminino , Humanos , Masculino , Jogos e Brinquedos , Características de Residência , Esportes
11.
Artigo em Inglês | MEDLINE | ID: mdl-31027385

RESUMO

The aim of this study was to support management of airborne bacteria in facilities used by pollution-sensitive individuals (in daycares, medical facilities, elder care facilities, and postnatal care centers). A field survey was conducted on 11 facilities from October 2017 to April 2018. Elder care facilities in industrial, urban, and forested areas were excluded. Two indoor, and one outdoor, measuring points were selected per facility. These points were located in areas most often used by the residents. Measurements were taken at random time-points before February 2018 and at specific times in the morning and afternoon thereafter. The relationships among bacterial counts, carbon dioxide concentrations, dust levels, temperature, relative humidity, and ventilation were examined. The pooled average bacterial counts at the daycares, medical facilities, elder care facilities, and postnatal care centers were 540.25 CFU m-3, 245.49 CFU m-3, 149.63 CFU m-3, and 169.65 CFU m-3, respectively. Considering the upper 95% confidence interval, the bacterial counts in many daycares may in fact be >800 CFU m-3, which is the threshold set by the Korean Ministry of the Environment. The pooled average indoor: outdoor bacterial count ratio was 1.13. Indoor airborne bacterial counts were influenced mainly by their sources. This study found no significant correlations among indoor temperature, relative humidity, carbon dioxide concentration, dust levels, and airborne bacterial counts, unlike previous studies. Airborne bacteria management at daycares should be a top priority. The sources of airborne bacteria must also be identified, and a management plan must be developed to control them.


Assuntos
Poluição do Ar em Ambientes Fechados/análise , Bactérias/isolamento & purificação , Logradouros Públicos , Microbiologia do Ar , Monitoramento Ambiental , Humanos , Ventilação
12.
J Wound Ostomy Continence Nurs ; 46(3): 235-239, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31022127

RESUMO

PURPOSE: The principal aim of this study was to map and describe the availability of parkland public toilets in major US cities per population and area. DESIGN: Observational and descriptive. SUBJECTS AND SETTING: Data were collected from the following cities: Austin, Texas; Minneapolis-St Paul (MSP), Minnesota; Nashville, Tennessee; New York City (NYC), New York; Philadelphia, Pennsylvania; San Francisco, California (SFC); Seattle, Washington; and Tampa, Florida. These cities are located throughout the United States. METHODS: Data from the US Census and cities' parks/recreation departments about publicly owned and operated permanent toilet facilities were analyzed and then mapped using geographic information systems. Toilet density by population and residential area (mi) was calculated, and toilet distribution was visualized. RESULTS: When calculated per 100,000 residents, MSP had the most parkland public toilets with 24; Tampa, Seattle, and Philadelphia had 17 to 22; and Nashville, NYC, and SFC had the fewest, around 7 toilets. Parkland public toilet density per residential area was highest in NYC and Philadelphia (>2/mi), followed by MSP, Seattle, and SFC (1/mi), then Tampa, Austin, and Nashville (<1/mi). The proportion of Census tracts containing parkland public toilets was more than 0.4 in MSP, Seattle, Tampa, and Philadelphia, more than 0.20 in Nashville and Austin, and less than 0.20 in the other cities. Toilet mapping showed fairly even distribution across Census tracts in MSP, Seattle, Tampa, and Philadelphia. CONCLUSIONS: Availability of parkland public toilets was highest in MSP and lowest in SFC. Findings inform WOC nurses for counseling incontinent patients about self-management strategies. Urban planning that provides an adequate number and distribution of parkland public toilets may improve quality of life.


Assuntos
Aparelho Sanitário/estatística & dados numéricos , Parques Recreativos/estatística & dados numéricos , Logradouros Públicos/normas , Humanos , Logradouros Públicos/estatística & dados numéricos , Estados Unidos , População Urbana/estatística & dados numéricos
14.
BMC Public Health ; 19(1): 238, 2019 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-30819121

RESUMO

BACKGROUND: Active travel to and from a transit station may provide significant amounts of physical activity and improve health. The ease with which people can traverse the distance to the transit station may impede or support active travel. Therefore, transit stations that have features that are supportive of utilitarian physical activity would be desirable. This study aimed to characterize the built environment surrounding new light rail transit (LRT) stations in the City of Houston, Texas. METHODS: In 2014, we used a series of systematic protocols and a standardized environmental audit instrument, the Analytic Audit Tool, to collect data on segments (streets) that surround 22 LRT stations that were being newly built. Using Geographic Information System (GIS), we assembled all the segments that intersect a 0.25-mile circular buffer around each station for the audit exercise. Several 3- to 4-member teams of trained auditors completed the audit exercise on a subset of these identified segments. Our analysis were descriptive in nature. We provided the frequency distributions of audited features across the study area. We also followed an original algorithm to produce several composite index scores for our study area. The composite index score is indicative of the prevalence of physical activity friendly/unfriendly features in the study area. RESULTS: In all, we audited a total of 590 segments covering a total of 218 US Census blocks, and eight City of Houston super neighborhoods. Findings suggest the environment around the new LRT stations may not be supportive of physical activity. In general, the audited segments lacked land use integration; had abandoned buildings, had uneven sidewalks; were not bike-friendly, had minimal presence of public-recreational facilities that would support physical activity; and had significant physical disorder. Notably, certain attractive and comfort features were frequently to usually available. CONCLUSIONS: Current findings, which will be compared to follow-up audit data, can be useful for future researchers and practitioners interested in the built environment around LRT stations.


Assuntos
Ciclismo/estatística & dados numéricos , Ambiente Construído/estatística & dados numéricos , Exercício , Logradouros Públicos/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Transportes/estatística & dados numéricos , Caminhada/estatística & dados numéricos , Cidades , Planejamento Ambiental/estatística & dados numéricos , Feminino , Humanos , Masculino , Texas
15.
Artigo em Inglês | MEDLINE | ID: mdl-30857230

RESUMO

Third-hand smoke (THS) causes pathological changes in the liver, lungs, and skin. THS exposure can be ubiquitous, chronic, and unconscious. However, little is known about THS exposure in public facilities and its susceptible population. This paper aimed to identify which public facilities and socio-demographic groups were especially vulnerable to THS. Data from 1360 adults obtained from Korean National Environmental Health Survey I (2009⁻2011) were analyzed. To study the sole effect of THS, we restricted the study population to those participants who had never smoked and who had no exposure to second-hand smoke. The assessed variables included the type and frequency of public transportation, frequency of use of 12 different public facilities, and 8 socio-demographic factors. Urinary cotinine was used as a biomarker. T-tests and analysis of variance were used for univariate analyses, while generalized linear regression was used for multivariate analysis. Frequent use of public transportation, bars, internet cafés, and participants with low levels of education, divorced or bereaved, living in multi-unit houses, and with smokers within the family were associated with significantly high urinary cotinine levels. These findings indicate that the frequent use of public transportation, certain public facilities and certain socio-demographic factors can result in high THS exposure.


Assuntos
Cotinina/urina , Exposição Ambiental , Logradouros Públicos , Poluição por Fumaça de Tabaco , Fumar Tabaco/urina , Adulto , Biomarcadores/urina , Demografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , República da Coreia , Fatores Socioeconômicos
16.
JAMA Netw Open ; 2(3): e191011, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30924892

RESUMO

Importance: Out-of-hospital cardiac arrest (OHCA) is a major public health issue, and in recent years, the number of OHCAs among the elderly population, aged 65 years or older, has significantly increased in developed countries. Objective: To evaluate the demographic and clinical characteristics and outcomes of patients 65 years or older who experienced OHCA based on the location-public, residential, or nursing home-where it occurred in Japan. Design, Setting, and Participants: This prospective, nationwide, population-based cohort study used information collected by the All-Japan Utstein Registry to examine data from 293 615 patients 65 years or older who experienced OHCA during the period from January 2013 to December 2015 in Japan. Data analyses were conducted from June to July 2018. Main Outcomes and Measures: The primary outcome was 1-month survival with a favorable outcome that was defined as a cerebral performance category score of 1 or 2 (1, good cerebral performance; 2, moderate cerebral disability; 3, severe cerebral disability; 4, coma or vegetative state; and 5, death or brain death). Multivariable logistic regression analyses were conducted to examine favorable outcome by location. Results: A total of 233 511 patients with OHCA were included in the final analysis; 29 911 (12.8%) occurred in a public location, 157 087 (67.3%) at a residential location, and 46 513 (19.9%) at a nursing home. The median age of the patients was 83.0 years (interquartile range, 76.0-88.0 years), and the proportion of men was 53.1% (124 108 of 233 511). The proportion of favorable neurologic outcomes was 4.5% (1351 of 29 911) in public locations, 1.0% (1555 of 157 087) in residential locations, and 0.6% (301 of 46 513) in nursing homes. Patients with cardiac arrests in public locations had a significantly higher likelihood of achieving a favorable neurologic outcome than those in residential locations (adjusted odds ratio, 1.36; 95% CI, 1.25-1.48), whereas those in nursing homes were less likely to achieve a favorable neurologic outcome (adjusted odds ratio, 0.62; 95% CI, 0.54-0.72). However, this difference in outcomes among patients based on location decreased with age. Conclusions and Relevance: The outcomes of patients 65 years or older after OHCA differed by the location of the cardiac arrest. These outcomes may be improved by updating existing response measures across all locations.


Assuntos
Parada Cardíaca Extra-Hospitalar , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Japão/epidemiologia , Masculino , Casas de Saúde , Parada Cardíaca Extra-Hospitalar/epidemiologia , Parada Cardíaca Extra-Hospitalar/mortalidade , Estudos Prospectivos , Logradouros Públicos
17.
Artigo em Inglês | MEDLINE | ID: mdl-30704116

RESUMO

Outdoor fitness equipment (OFE) areas have become a popular form of built environment infrastructure in public open spaces as a means to improve public health through increased physical activity. However, the benefits of using OFE are not consistent, and several OFE accidents have been reported. In this study, we videotaped how OFE users operate OFE in parks and selected four types of popular OFE (the waist twister, air walker, ski machine, and waist/back massager) for video content analysis. Furthermore, we established coding schemes and compared results with the instructions provided by OFE manufacturers. The results revealed various usage behaviors for the same OFE types. In addition, we observed that a significant portion of user behaviors did not follow manufacturers' instructions, which might pose potential risks or actually cause injuries. Children are especially prone to act improperly. This study provides empirical evidence indicating the existence of potential safety risks due to inappropriate usage behaviors that might lead to accidents and injuries while using OFE. This study provides crucial information that can be used to evaluate the effectiveness of OFE and to develop future park or open space initiatives.


Assuntos
Planejamento Ambiental , Equipamentos e Provisões , Exercício , Aptidão Física , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Logradouros Públicos , Fatores Sexuais , Gravação de Videoteipe , Adulto Jovem
18.
Int J Health Plann Manage ; 34(2): e1166-e1178, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30762904

RESUMO

BACKGROUND: Hypertension in low- and middle-income countries, including Kenya, is of economic importance due to its increasing prevalence and its potential to present an economic burden to households. In this study, we examined the patient costs associated with obtaining care for hypertension in public health care facilities in Kenya. METHODS: We conducted a cross-sectional study among adult respondents above 18 years of age, with at least 6 months of treatment in two counties. A total of 212 patients seeking hypertension care at five public facilities were interviewed, and information on care seeking and the associated costs was obtained. We computed both annual direct and indirect costs borne by these patients. RESULTS: Overall, the mean annual direct cost to patients was US$ 304.8 (95% CI, 235.7-374.0). Medicines (mean annual cost, US$ 168.9; 95% CI, 132.5-205.4), transport (mean annual cost, US$ 126.7; 95% CI, 77.6-175.9), and user charges (mean annual cost, US$ 57.7; 95% CI, 43.7-71.6) were the highest direct cost categories. Overall mean annual indirect cost was US$ 171.7 (95% CI, 152.8-190.5). The incidence of catastrophic health care costs was 43.3% (95% CI, 36.8-50.2) and increased to 59.0% (95% CI, 52.2-65.4) when transport costs were included. CONCLUSIONS: Hypertensive patients incur substantial direct and indirect costs. High rates of catastrophic costs illustrate the urgency of improving financial risk protection for these patients and strengthening primary care to ensure affordability of hypertension care.


Assuntos
Financiamento Pessoal , Gastos em Saúde , Instalações de Saúde , Hipertensão/economia , Logradouros Públicos , Efeitos Psicossociais da Doença , Estudos Transversais , Feminino , Humanos , Quênia , Masculino , Pessoa de Meia-Idade
19.
PLoS One ; 14(2): e0212004, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30742673

RESUMO

Urban public spaces facilitate social interactions between people, reflecting the shifting functionality of spaces. There is no commonly-held consensus on the quantification methods for the dynamic interplay between spatial geometry, urban movement, and face-to-face encounters. Using anonymized social media check-in records from Shanghai, China, this study proposes pipelines for quantifying physical face-to-face encounter potential patterns through public space networks between local and non-local residents sensed by social media over time from space to space, in which social difference, cognitive cost, and time remoteness are integrated as the physical co-presence intensity index. This illustrates the spatiotemporally different ways in which the built environment binds various groups of space users configurationally via urban streets. The variation in face-to-face interaction patterns captures the fine-resolution patterns of urban flows and a new definition of street hierarchy, illustrating how urban public space systems deliver physical meeting opportunities and shape the spatial rhythms of human behavior from the public to the private. The shifting encounter potentials through streets are recognized as reflections of urban centrality structures with social interactions that are spatiotemporally varying, projected in the configurations of urban forms and functions. The results indicate that the occurrence probability of face-to-face encounters is more geometrically scaled than predicted based on the co-location probability of two people using metric distance alone. By adding temporal and social dimensions to urban morphology studies, and the field of space syntax research in particular, we suggest a new approach of analyzing the temporal urban centrality structures of the physical interaction potentials based on trajectory data, which is sensitive to the transformation of the spatial grid. It sheds light on how to adopt urban design as a social instrument to facilitate the dynamically changing social interaction potential in the new data environment, thereby enhancing spatial functionality and the social well-being.


Assuntos
Relações Interpessoais , Mídias Sociais , China , Planejamento Ambiental , Humanos , Logradouros Públicos , Análise Espaço-Temporal , População Urbana
20.
Environ Sci Pollut Res Int ; 26(18): 17965-17973, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29785607

RESUMO

Increasing population and over-consumption are placing unprecedented demands on agriculture and natural resources. The Earth is suffering from global warning and environmental destruction while our agricultural systems are concurrently degrading land, water, biodiversity, and climate on a global scale. For a sustainable future, green certification, e-commerce, and environment education can boost low-carbon economy with decreasing carbon emissions, but very few researches address them for the hotel industry. This research studies the performance impact of e-commerce, international hotel chain, local hotel chain, and green certification for carbon emission reductions of international tourist hotels of Taiwan. It reveals that, after a sufficiently long time, there is an improvement in the environmental and economic performance of the green-certified hotel group. In addition, it reveals that, as recommended by the operation policy, the international hotel chain group together with e-commerce has better performance than local hotel chain. It is also discussed how to sustain the continuing improvement in low-carbon performance of the hotel industry.


Assuntos
Dióxido de Carbono/economia , Certificação , Comércio , Conservação dos Recursos Naturais/economia , Logradouros Públicos/economia , Indústrias , Taiwan
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