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1.
Rev. enferm. UERJ ; 28: e44289, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1104374

RESUMO

Objetivo: discutir as vivências dos motoristas de ônibus através de suas percepções acerca do trânsito e os impactos à saúde sofridos por eles. Método: estudo qualitativo fenomenológico realizado em uma garagem de ônibus situada no Rio de Janeiro. As entrevistas fenomenológicas foram realizadas com 24 motoristas que responderam perguntas semiestruturadas e foram gravadas em dispositivo mp3, posteriormente, transcritas para obtenção das unidades de significado, a coleta de dados ocorreu entre 2017 e 2018. O projeto foi aprovado por Comitê de Ética e Pesquisa. Resultados: da análise fenomenológica das unidades de significados dos depoimentos emergiram duas categorias: o trânsito é instável e estressante e a falta de educação das pessoas afeta os aspectos psíquicos. O ambiente de trabalho determina, expressivamente, o bem-estar dos trabalhadores que nele atuam. Conclusão: diante de tantos limites impostos pela sociedade contemporânea e pelo sofrimento no trabalho, necessário é motiva-los, e também dar-lhes condições de realizar seu trabalho de forma plena.


Objective: to discuss the experience of bus drivers through their perceptions regarding traffic and the health impacts they suffer. Method: in this qualitative phenomenological study conducted at a bus garage in Rio de Janeiro, data were collected in 2017 and 2018 by way of phenomenological interviews of 24 drivers, who answered semi-structured questions. The resulting mp3 recordings were later transcribed to obtain the units of meaning. The project was approved by the research ethics committee. Results: from phenomenological analysis of the units of meaning in the responses, two categories emerged: traffic is unstable and stressful, and people's lack of education has adverse psychological effects. The work environment substantially determines the well-being of those working in it. Conclusion: given all the many constraints imposed by contemporary society and by their suffering at work, it is necessary to motivate them and also assure them the conditions necessary to carry out their work fully.


Objetivo: discutir la experiencia de los conductores de autobuses a través de sus percepciones sobre el tráfico y los impactos en la salud que sufren. Método: en este estudio fenomenológico cualitativo realizado en un garaje de autobuses en Río de Janeiro, se recopilaron datos en 2017 y 2018 a través de entrevistas fenomenológicas a 24 conductores, que respondieron preguntas semiestructuradas. Las grabaciones mp3 resultantes se transcribieron posteriormente para obtener las unidades de significado. El proyecto fue aprobado por el comité de ética de investigación. Resultados: del análisis fenomenológico de las unidades de significado en las respuestas, surgieron dos categorías: el tráfico es inestable y estresante, y la falta de educación de las personas tiene efectos psicológicos adversos. El ambiente de trabajo determina sustancialmente el bienestar de quienes trabajan en él. Conclusión: dadas las muchas restricciones impuestas por la sociedad contemporánea y por su sufrimiento en el trabajo, es necesario motivarlos y también asegurarles las condiciones necesarias para llevar a cabo su trabajo plenamente.


Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Condução de Veículo , Condições de Trabalho , Saúde do Trabalhador , Estresse Ocupacional , Percepção Social , População Urbana , Brasil , Pesquisa Qualitativa
2.
Global Health ; 16(1): 96, 2020 10 09.
Artigo em Inglês | MEDLINE | ID: mdl-33036622

RESUMO

BACKGROUND: The outbreak of Coronavirus Disease is causing considerable acute risk to public health and might also have an unanticipated impact on the mental health of children and adolescents in the long run. This study collected data during the national lockdown period in China and aims to understand whether there is a clinically significant difference in anxiety, depression, and parental rearing style when comparing adolescents from Wuhan and other cities in China. This study also intends to examine whether gender, grade in school, single child status, online learning participation, parents' involvement in COVID-19 related work, and parents being quarantined or infected due to the disease would lead to clinically significant differences in anxiety and depression. Beyond that, this study explored the pathways among the different variables in order to better understand how these factors play a part in impacting adolescents' mental health condition. RESULTS: Results showed that there was a statistically significant difference in anxiety symptoms between participants who were from Wuhan compared to other urban areas, but not in depressive symptoms. In addition, participants' grade level, gender, relative being infected, and study online have direct positive predictive value for depressive and anxiety symptoms, whereas location and sibling status have indirect predictive value. Having relatives who participated in COVID-19 related work only had positive direct predictive value toward depression, but not anxiety. CONCLUSIONS: This study discovered several risk factors for adolescents' depression and anxiety during the pandemic. It also called for a greater awareness of Wuhan parents' mental wellbeing and recommended a systematic approach for mental health prevention and intervention.


Assuntos
Ansiedade/epidemiologia , Infecções por Coronavirus/psicologia , Depressão/epidemiologia , Pandemias , Pneumonia Viral/psicologia , População Urbana/estatística & dados numéricos , Adolescente , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Feminino , Humanos , Masculino , Pandemias/prevenção & controle , Poder Familiar/psicologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Fatores de Risco
3.
Sci Rep ; 10(1): 16213, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33004925

RESUMO

Italy was the first, among all the European countries, to be strongly hit by the COVID-19 pandemic outbreak caused by the severe acute respiratory syndrome coronavirus 2 (Sars-CoV-2). The virus, proven to be very contagious, infected more than 9 million people worldwide (in June 2020). Nevertheless, it is not clear the role of air pollution and meteorological conditions on virus transmission. In this study, we quantitatively assessed how the meteorological and air quality parameters are correlated to the COVID-19 transmission in two large metropolitan areas in Northern Italy as Milan and Florence and in the autonomous province of Trento. Milan, capital of Lombardy region, it is considered the epicenter of the virus outbreak in Italy. Our main findings highlight that temperature and humidity related variables are negatively correlated to the virus transmission, whereas air pollution (PM2.5) shows a positive correlation (at lesser degree). In other words, COVID-19 pandemic transmission prefers dry and cool environmental conditions, as well as polluted air. For those reasons, the virus might easier spread in unfiltered air-conditioned indoor environments. Those results will be supporting decision makers to contain new possible outbreaks.


Assuntos
Poluição do Ar/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Umidade , Pneumonia Viral/epidemiologia , Temperatura , Cidades/estatística & dados numéricos , Infecções por Coronavirus/transmissão , Humanos , Itália , Pandemias , Pneumonia Viral/transmissão , População Urbana/estatística & dados numéricos
4.
Nutrients ; 12(10)2020 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-33050404

RESUMO

Unexpected isolation, which has not yet been seen on a global scale, has created the conditions for evaluating nutrition in a situation of reduced spatial activity. The study aimed to assess the influence of lockdown on selected eating habits of Polish adults. An anonymous questionnaire was conducted, including questions about eating habits and self-reported anthropometric measurements, referring to "before" and "during" lockdown. We reported the findings of 312 adults (aged 41.12 ± 13.05 years). Overall, 64.1% of the participants were women, 77.7% urban inhabitants and 78.6% employed. The average length of social isolation was 50.79 ± 10.53 days. The majority (51.6%) of the respondents did not eat outside the house during lockdown (p < 0.0001). The number of meals eaten during the day during lockdown increased significantly, 11.2% of the respondents ate 5 and more meals (p < 0.0001). The percentage of people snacking between meals increased by 5.1% during lockdown (p = 0.0001). Eggs, potatoes, sweets, canned meat and alcohol were consumed considerably more commonly during lockdown, while fast-food products, instant soups and energy drinks were eaten or drunk significantly less frequently. A marked decrease in the number of daily servings of the following products was observed: bakery products, red meat, fast food, instant soups, sweet beverages and energy drinks. Conversely, the number of daily servings of sweets and canned meat significantly increased. Two thirds of the respondents reported body weight changes, with 45.86% of the participants being overweight during lockdown. Significant changes in the diet of Polish adults were found during lockdown due to COVID-19.


Assuntos
Infecções por Coronavirus , Dieta , Comportamento Alimentar , Comportamentos Relacionados com a Saúde , Pandemias , Pneumonia Viral , Isolamento Social , Ganho de Peso , Adulto , Betacoronavirus , Índice de Massa Corporal , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Fast Foods , Feminino , Preferências Alimentares , Humanos , Estilo de Vida , Masculino , Refeições , Pessoa de Meia-Idade , Obesidade/etiologia , Sobrepeso/etiologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Polônia/epidemiologia , Lanches , Inquéritos e Questionários , População Urbana
6.
N Z Med J ; 133(1523): 65-75, 2020 10 09.
Artigo em Inglês | MEDLINE | ID: mdl-33032304

RESUMO

AIMS: To investigate changes in general practice consultation patterns in response to reduced face-to-face patient contact during the COVID-19 pandemic. METHODS: A retrospective before and after case notes review study of one urban general practice to investigate patient contact in the first two weeks of New Zealand general practices' COVID-19 response in 2020, compared to the same period in 2019. RESULTS: Twenty percent of patients had contact with the practice in both samples, with similar proportions by age, gender, ethnicity, deprivation and presence of multimorbidity or mental health diagnoses. Similar numbers of acute illness, accident-related and prevention patient contacts occurred in both samples, with more long-term condition-related contact in 2020. While 70% of patient contacts were face-to-face in 2019, 21% were face-to-face in 2020. Most acute illness, accident-related and long-term condition-related contacts were able to be provided through virtual means, but most prevention-related contacts were face-to-face. CONCLUSIONS: This single practice study showed total patient contact was similar over both sample periods, but most contact in 2020 was virtual. Further longitudinal multi-practice studies to confirm these findings and describe future consultation patterns are needed to inform general practice service delivery post-COVID-19.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Medicina Geral/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Encaminhamento e Consulta/organização & administração , População Urbana/estatística & dados numéricos , Adulto , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Masculino , Nova Zelândia , Satisfação do Paciente , Pneumonia Viral/epidemiologia , Estudos Retrospectivos
7.
Artigo em Inglês | MEDLINE | ID: mdl-33050278

RESUMO

At the end of 2019, the first cases of coronavirus disease (COVID-19) were reported in Wuhan, China. Thereafter, the number of infected people increased rapidly, and the outbreak turned into a national crisis, with infected individuals all over the country. The COVID-19 global pandemic produced extreme changes in human behavior that affected air quality. Human mobility and production activities decreased significantly, and many regions recorded significant reductions in air pollution. The goal of our investigation was to evaluate the impact of the COVID-19 lockdown on the concentrations of the main air pollutants in the urban area of Palermo (Italy). In this study, the trends in the average concentrations of CO, NO2, O3, and PM10 in the air from 1 January 2020 to 31 July 2020 were compared with the corresponding average values detected at the same monitoring stations in Palermo during the previous five years (2015-2019). During the lockdown period (10 March-30 April), we observed a decrease in the concentrations of CO, NO2, and particulate matter (PM)10, calculated to be about 51%, 50%, and 45%, respectively. This confirms that air pollution in an urban area is predominantly linked to vehicular traffic.


Assuntos
Poluição do Ar/estatística & dados numéricos , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Quarentena , População Urbana , Infecções por Coronavirus/epidemiologia , Humanos , Itália/epidemiologia , Pneumonia Viral/epidemiologia
8.
BMC Public Health ; 20(1): 1559, 2020 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-33066763

RESUMO

BACKGROUND: Undernutrition among under five children in India is a major public health problem. Despite India's growth in the economy, the child mortality rate due to undernutrition is still high in both urban and rural areas. Studies that focus on urban slums are scarce. Hence the present study was carried out to assess the prevalence and determinants of undernutrition in children under five in Maharashtra, India. METHODS: A community-based cross-sectional study was conducted in 16 randomly selected clusters in two districts of Maharashtra state, India. Data were collected through house to house survey by interviewing mothers of under five children. Total 2929 mothers and their 3671 under five children were covered. Multivariate logistic regression analysis was carried out to identify the determinants of child nutritional status seperately in urban and rural areas. RESULTS: The mean age of the children was 2.38 years (±SD 1.36) and mean age of mothers was 24.25 years (± SD 6.37). Overall prevalence of stunting among children under five was 45.9%, wasting was 17.1 and 35.4% children were underweight. Prevalence of wasting, stunting and underweight were more seen in an urban slum than a rural area. In the rural areas exclusive breast feeding (p < 0.001) and acute diarrhea (p = 0.001) were associated with wasting, children with birth order 2 or less than 2 were associated with stunting and exclusive breast feeding (p < 0.05) and low maternal education were associated with underweight. Whereas in the urban slums exclusive breast feeding (p < 0.05) was associated with wasting, sex of the child (p < 0.05) and type of family (p < 0.05) were associated with stunting,and low income of the family (p < 0.05) was associated with underweight. CONCLUSIONS: Factors like sex of the child, birth order,exclusive breast feeding,economic status of the family, type of family,acute diarrhea and maternal education have influence on nutritional status of the child. Improvement of maternal education will improve the nutritional status of the child. Strategies are needed to improve the economic status of the community. TRIAL REGISTRATION: Trial registration number: CTRI/2017/12/010881 ; Registration date:14/12/2017. Retrospectively registered.


Assuntos
Transtornos da Nutrição Infantil/epidemiologia , Áreas de Pobreza , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adulto , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Índia/epidemiologia , Lactente , Masculino , Mães/estatística & dados numéricos , Prevalência , Fatores de Risco , Fatores Socioeconômicos
9.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(7): 840-848, 2020 Jul 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-32879088

RESUMO

OBJECTIVES: To verify the applicability and extensibility of the satisfaction index of basic medical insurance for rural and urban residents, and to explore the mechanism responsible for the satisfaction index in Kunming and Changsha City, and provide references for effective management and policy making. METHODS: A stratified cluster sampling method was conducted. A total of 560 familial decision makers were randomly selected in 24 classes of 14 schools of Kunming and Changsha City. Model reliability was tested by SPSS18.0. In addition, Smart PLS 3.0 was applied to conduct model validity test, calculate the satisfaction index, and to compare the model path coefficients of Kunming and Changsha by multi-group analysis. RESULTS: In the application of the satisfaction index of basic medical insurance for rural and urban residents in Kunming, Cronbach's α of the model was 0.93, split-half reliability coefficient was 0.90, and the latent variable composite reliability coefficient values were more than 0.86; the latent variable average variance extraction (AVE) values were greater than 0.66, and the square root of the AVE of each latent variable (all greater than 0.66) was larger than the correlation coefficient with other latent variables. The factor loading values were greater than 0.70, with statistical significance. The basic health insurance satisfaction index of Kunming and Changsha was 60.40 and 52.05, respectively. The difference between the path coefficient of Kunming and Changsha was not statistically significant except the path from public satisfaction to public loyalty. Perceived value had the largest direct and total effect on public satisfaction latent variable in Kunming City. While the perceived value had the largest direct effect on public satisfaction, and the perceived quality had the largest total effect on public satisfaction in Changsha City. CONCLUSIONS: The satisfaction index model reflects the satisfaction of pupils' basic medical insurance for urban and rural residents, and it also shows good reliability and validity in Changsha and Kunming. What's more the model can be extended to the national level to evaluate the satisfaction of basic medical insurance for urban and rural residents for primary school students. The basic health insurance satisfaction index of familial decision makers in Kunming is higher than that of Changsha. There are differences between Kunming and Changsha in the influential mechanism of the satisfaction index of for Chinese pupils with basic medical insurance for rural and urban residents, and the measures taken by the government and relevant departments to improve the satisfaction of basic medical insurance should be based on local conditions.


Assuntos
Satisfação Pessoal , População Rural , China , Tomada de Decisões , Humanos , Reprodutibilidade dos Testes , População Urbana
10.
JMIR Public Health Surveill ; 6(3): e19578, 2020 09 04.
Artigo em Inglês | MEDLINE | ID: mdl-32877347

RESUMO

According to the United Nations, about 1 billion persons live in so-called slums. Numerous studies have shown that this population is particularly vulnerable to infectious diseases. The current COVID-19 pandemic, caused by the novel coronavirus SARS-CoV-2, emphatically underlines this problem. The often high-density living quarters coupled with a large number of persons per dwelling and the lack of adequate sanitation are reasons why measures to contain the pandemic only work to a limited extent in slums. Furthermore, assignment to risk groups for severe courses of COVID-19 caused by noncommunicable diseases (eg, cardiovascular diseases) is not possible due to inadequate data availability. Information on people living in slums and their health status is either unavailable or only exists for specific regions (eg, Nairobi). We argue that one of the greatest problems with regard to the COVID-19 pandemic in the context of slums in the Global South is the lack of data on the number of people, their living conditions, and their health status.


Assuntos
Infecções por Coronavirus/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Áreas de Pobreza , Humanos , Pobreza , População Urbana
11.
Glob Health Action ; 13(1): 1810415, 2020 12 31.
Artigo em Inglês | MEDLINE | ID: mdl-32867606

RESUMO

At the time of writing, it is unclear how the COVID-19 pandemic will play out in rapidly urbanising regions of the world. In these regions, the realities of large overcrowded informal settlements, a high burden of infectious and non-communicable diseases, as well as malnutrition and precarity of livelihoods, have raised added concerns about the potential impact of the COVID-19 pandemic in these contexts. COVID-19 infection control measures have been shown to have some effects in slowing down the progress of the pandemic, effectively buying time to prepare the healthcare system. However, there has been less of a focus on the indirect impacts of these measures on health behaviours and the consequent health risks, particularly in the most vulnerable. In this current debate piece, focusing on two of the four risk factors that contribute to >80% of the NCD burden, we consider the possible ways that the restrictions put in place to control the pandemic, have the potential to impact on dietary and physical activity behaviours and their determinants. By considering mitigation responses implemented by governments in several LMIC cities, we identify key lessons that highlight the potential of economic, political, food and built environment sectors, mobilised during the pandemic, to retain health as a priority beyond the context of pandemic response. Such whole-of society approaches are feasible and necessary to support equitable healthy eating and active living required to address other epidemics and to lower the baseline need for healthcare in the long term.


Assuntos
Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/epidemiologia , Dieta , Exercício Físico , Pneumonia Viral/epidemiologia , População Urbana , Urbanização , Betacoronavirus , Ambiente Construído , Abastecimento de Alimentos , Comportamentos Relacionados com a Saúde , Humanos , Pandemias , Fatores de Risco
12.
Nihon Koshu Eisei Zasshi ; 67(8): 509-517, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32879237

RESUMO

Objective To explore health-related and socioeconomic factors that can predict future deterioration in Psychological Distress Scale (K6) scores.Method We conducted a baseline (2010, 2011) self-administered questionnaire survey of the Kobe Orthopedic and Biomedical Epidemiological study (KOBE study) involving 1,117 participants who had no previous history of cancer or cardiovascular diseases and were not under treatment for hypertension, diabetes, or dyslipidemia. We used the Japanese K6 as an indicator of stress and defined K6≧5 points as a high-stress group and K6<5 points as a low-stress group. A four-year follow-up survey (2014, 2015) was conducted on 1,004 people (follow-up rate of 90%). We excluded 39 participants with missing values, and 185 people whose K6 score was higher than 5 points at baseline. A final total of 780 participants' scores were examined for: gender, age, living situation, physical activity level, average sleep time, as well as the K6 score, the Japanese Hearing Handicap Inventory for Elderly (HHIE-S), and the Japanese Oswestry Disability Index (ODI). We conducted a logistic regression analysis using K6≧5 points at the four-year follow-up survey as the dependent variable and each factor at the baseline survey as the independent variable.Results Of the 780 subjects analyzed, 132 (16.9%) were highly stressed (K6≧5 points) at the four-year follow-up point. A logistic regression analysis found age (40s/70s) (odds ratio 3.38, 95% confidence interval 1.45-7.86), living situation (single/living together) (odds ratio 1.98, 95% confidence interval 1.07-3.68), and ODI scores (every 1%) (odds ratio 1.05, 95% confidence interval 1.01-1.09), to all be significantly associated with high stress.Conclusion This study suggests that age, living situation, and ODI scores are related to future stress.


Assuntos
Estresse Psicológico/diagnóstico , População Urbana , Adulto , Fatores Etários , Feminino , Seguimentos , Previsões , Humanos , Japão , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Características de Residência , Fatores Socioeconômicos , Estresse Psicológico/psicologia , Inquéritos e Questionários
13.
S Afr Med J ; 110(6): 505-513, 2020 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-32880563

RESUMO

BACKGROUND: Lephalale Municipality in Limpopo Province, South Africa, has seen significant economic and industrial development owing to expansion of the coal mining and power generation sectors. This development has coincided with substantial population growth of 65% between 2001 and 2016, attributable to largely (migrant) males living in the area who, overall, outnumbered females by ~121:100. The local HIV prevalence is reported to be higher than national rates. OBJECTIVES: Anonymised National Health Laboratory Service CD4+ data were used to document increasing laboratory services workload and to establish the burden of advanced (CD4+ count <200 cells/µL) and very advanced (<100 cells/µL) HIV disease among adult patients accessing public healthcare in Lephalale between 2006 and 2015. METHODS: A cross-sectional design was used to analyse CD4+ laboratory data. CD4+ outcomes were categorised by volumes of tests, year, health facility type, age categories (15 - 19, 20 - 24, 25 - 29, 30 - 34, 35 - 39, 40 - 44, 45 - 49 and >49 years), CD4+ test range (≤50, 51 - 100, 101 - 200, 201 - 350, 351 - 500 and ≥501 cells/µL) and gender. Median CD4+ counts were calculated. RESULTS: Extracted Lephalale data comprised 57 490 CD4+ results, with a mean patient age of 34 years. Considerably fewer male than female patients had CD4+ counts reported (male/female ratio 0.45:1). CD4+ test volumes showed a five-fold escalation over the study period, increasing from 1 458 tests in 2006 to 8 239 in 2015. A considerable burden of advanced and very advanced HIV disease (exceeding 50% of all cases) was noted in 2006/2007; by 2015 the proportion had fallen, but was still high at 27%. The overall median CD4+ count in 2006 (192 cells/µL) confirmed a high burden of advanced disease, with modest improvement to 289 cells/µL by 2015. Between 2006 and 2015, the median CD4+ count for females increased from 204 to 405 cells/µL, while that for males increased from 126 to 285 cells/µL. Age analysis further revealed that men aged <20 years or >25 years, and specifically those aged 30 - 45 years, had up to 44% more advanced HIV disease. CONCLUSIONS: Lower median CD4+ counts and a dramatic increase in volumes of CD4+ tests performed from 2007 onwards revealed a high burden of advanced and very advanced HIV disease in patients accessing care in Lephalale. Viewed together with Statistics South Africa census documentation of a disproportionately high number of males compared with females living in the area, these figures suggest that improved systems are urgently needed to encourage and accommodate access to HIV care for male (migrant worker) patients living and working in emerging industrial centres.


Assuntos
Infecções por HIV/epidemiologia , Acesso aos Serviços de Saúde , Adolescente , Adulto , Contagem de Linfócito CD4 , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores Sexuais , África do Sul/epidemiologia , População Urbana
14.
Ann Agric Environ Med ; 27(3): 448-455, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32955229

RESUMO

INTRODUCTION: Cerebrovascular diseases in Poland constitute a bigger threat to life in men than in women, especially after the age of 60. Death rates indicate higher stroke over-mortality in the rural population rather than the urban. At the same time, stroke is the main cause of long-term disability, since half of the patients are unable to independently perform daily activities, which makes them dependent on other people. MATERIAL AND METHODS: The study was conducted in the Independent Public Healthcare Institution in Krasnik, eastern Poland. It covered the medical records of 1,500 patients, 780 women (52%) and 720 men (48%), aged 20-100, diagnosed with cerebral infarction. The patients were hospitalised between 2011-2016 in the Neurology Ward with a Stroke Unit, the Internal Medicine Ward, and the Anaesthetics and Intensive Care Ward. RESULTS: The stroke patients hospitalised in the Independent Public Healthcare Institution in Krasnik were residents of urban communes (59.1% of subjects) and rural communes (40.9%). The most often diagnosed type of stroke was due to embolism of the cerebral arteries (I63.4) in women (63.48%). In men, the most most often diagnosed type was cerebral infarction due to thrombosis of the cerebral arteries (I63.3; 51.33%). Stroke in 36.15% of the female subjects resulted in death. In male subjects, death occurred in 26.11% of the cases. CONCLUSIONS: Women aged around 78-years-old were the most likely to suffer a stroke. In men, it occurred eight years earlier. Despite residents of urban areas being hospitalised due to stroke more often, deaths caused by this disease were recorded the most frequently among rural residents. It can be concluded that primary stroke prevention is the only effective measure for reducing morbidity and premature mortality in the population.


Assuntos
População Rural/estatística & dados numéricos , Acidente Vascular Cerebral/epidemiologia , População Urbana/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Prevalência , Acidente Vascular Cerebral/classificação , Acidente Vascular Cerebral/etiologia , Adulto Jovem
15.
Ann Agric Environ Med ; 27(3): 469-475, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32955231

RESUMO

INTRODUCTION: Currently, malignancies are the most severe medical problems worldwide. Numerous, already known risk factors in carcinogenesis could be potentially avoided. Some cancer risk factors have been recognized and have become the targets of primary prophylaxis. OBJECTIVE: The aim of the study was to ascertain the state of knowledge about risk factors, primary prevention and early detection of malignancies of gastrointestinal tract (GIT) in the urban and rural population of the Lublin province in Eastern Poland. MATERIAL AND METHODS: The study was cross-sectional. The originally designed questionnaire was applied to the group of 1,352 patients, representatives of both the rural and urban environments of the Lublin province during random appointments with their general practitioner (GP). RESULTS: The study showed low awareness of the issues connected with GIT malignancies within the studied group. The problem was particulary apparent in the rural population. CONCLUSIONS: In order to raise general awareness of cancer, different means should be applied in urban and rural populations. GPs and the media were found to have the leading rols in the promotion of primary prevention.


Assuntos
Detecção Precoce de Câncer/estatística & dados numéricos , Neoplasias Gastrointestinais/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Prevenção Primária/estatística & dados numéricos , Neoplasias Gastrointestinais/diagnóstico , Neoplasias Gastrointestinais/prevenção & controle , Polônia , Fatores de Risco , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos
16.
BMC Public Health ; 20(1): 1472, 2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-32993592

RESUMO

BACKGROUND: Urban-rural disparity in mortality at older ages is well documented in China. However, surprisingly few studies have systemically investigated factors that contribute to such disparity. This study examined the extent to which individual-level socioeconomic conditions, family/social support, health behaviors, and baseline health status contributed to the urban-rural difference in mortality among older adults in China. METHODS: This research used the five waves of the Chinese Longitudinal Healthy Longevity Survey from 2002 to 2014, a nationally representative sample of older adults aged 65 years or older in China (n = 28,235). A series of hazard regression models by gender and age group examined the association between urban-rural residence and mortality and how this association was modified by a wide range of individual-level factors. RESULTS: Older adults in urban areas had 11% (relative hazard ratio (HR) = 0.89, p < 0.01) lower risks of mortality than their rural counterparts when only demographic factors were taken into account. Further adjustments for family/social support, health behaviors, and health-related factors individually or jointly had a limited influence on the mortality differential between urban and rural older adults (HRs = 0.89-0.92, p < 0.05 to p < 0.01). However, we found no urban-rural difference in mortality (HR = 0.97, p > 0.10) after adjusting for individual socioeconomic factors. Similar results were found in women and men, and among the young-old and the oldest-old populations. CONCLUSIONS: The urban-rural disparity in mortality among older adults in China was largely attributable to differences in individual socioeconomic resources (i.e., education, income, and access to healthcare) regardless of gender and age group.


Assuntos
Comportamentos Relacionados com a Saúde , Nível de Saúde , Renda/estatística & dados numéricos , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Feminino , Humanos , Longevidade , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Risco , Percepção Social , Apoio Social , Fatores Socioeconômicos , Adulto Jovem
17.
Am J Clin Oncol ; 43(9): 615-620, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32889830

RESUMO

BACKGROUND: Most patients with stage III non-small cell lung cancer (NSCLC) develop metastases and succumb to their cancer. Approaches to the treatment of stage III disease can be highly variable. Understanding current treatment patterns can inform the optimal integration of emerging therapies. In this study, we describe contemporary treatment patterns and outcomes for a population-based cohort of stage III NSCLC patients from a large Canadian province. METHODS: On the basis of the provincial cancer registry, all adult patients diagnosed with stage III NSCLC from April 1, 2010 to March 31, 2015 were identified. Analyses of these patients' existing electronic medical records and administrative claims data were conducted to describe patient characteristics, treatment patterns, and survival outcomes. RESULTS: In total, we screened 6438 patients diagnosed with NSCLC, of whom 1151 (17.9%) had stage III disease. Among them, 61.2% were stage IIIA, 36.4% were stage IIIB, and 2.4% were unspecified. Median age at diagnosis was 70 (22 to 94) years and 50.2% were men. In this cohort, a significant proportion of patients received only palliative radiotherapy (35.6%), palliative chemotherapy (8.8%), or best supportive care (24.8%) as initial treatment. Conversely, relatively few underwent concurrent chemoradiotherapy (11.7%) or trimodality therapy (1.7%). Surgery±adjuvant treatments were performed in 14.8% of stage III patients. Median overall survival was 13.2 months (95% confidence interval [CI], 12.2-14.0) among stage III patients. Patients who received initial curative treatment had statistically significant better survival compared with those who received noncurative treatment (P<0.001); median overall survival 29.8 months (95% CI, 22.3-34.6) and 8.9 months (95% CI, 7.6-11.6), respectively. CONCLUSIONS: In a population-based setting that includes community, regional, and tertiary cancer centers, use of concurrent chemoradiotherapy and trimodality therapy in stage III NSCLC was low despite evidence supporting the potential benefits of these strategies.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/secundário , Carcinoma Pulmonar de Células não Pequenas/terapia , Terapia Combinada/estatística & dados numéricos , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Alberta , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Quimiorradioterapia/estatística & dados numéricos , Feminino , Humanos , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Cuidados Paliativos/estatística & dados numéricos , Sistema de Registros , População Rural/estatística & dados numéricos , Taxa de Sobrevida , População Urbana/estatística & dados numéricos , Adulto Jovem
18.
PLoS One ; 15(9): e0238320, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32911529

RESUMO

AIM: In view of the current context of poverty and socio-economic inequalities and the high and rising burdens of HIV infection and non-communicable diseases in South Africa, this study aims to describe the distribution of adverse life events (ALEs) by age and gender, and examine the socio-demographic characteristics, psychosocial coping mechanisms, risky lifestyle behaviours and family burden of HIV-related ill-health associated with ALEs in 25-74-year-old black residents of Cape Town. MATERIALS AND METHODS: In a random cross-sectional sample, 12 ALEs, tobacco and alcohol use, sense of coherence (SOC), locus of control (LOC) and impact of HIV in the family were determined by administered questionnaires. Data analyses included descriptive statistics adjusted for the realised sample. Multivariable linear regression models assessed the independent associations of increasing number of ALEs. RESULTS: Among 1099 participants, mean lifetime score of ALE categories examined was 6.1 ±2.1 (range 0-12) with men reporting significantly higher number of events compared with women (p<0.001). The most frequent ALE was the death of a loved one (88.5%) followed by a major financial crisis (81.2%) with no trend across gender or age group. In the multivariable linear regression model, increasing ALEs were significantly associated with male gender, unemployment, having spent >50% of life in urban areas, >7 years of education, problematic alcohol use and poorer psychosocial coping mechanisms defined by low SOC and LOC. All four variables pertaining to HIV-related burden of ill-health in the family were significantly associated with increasing ALEs. CONCLUSIONS: Considering that lower SOC and LOC and problem drinking were significantly linked to ALEs, policymakers need to formulate strategies that improve coping mechanisms and promote problem-solving behaviours, target the high burden of alcohol misuse and address unemployment.


Assuntos
Adaptação Psicológica , Experiências Adversas da Infância/estatística & dados numéricos , Consumo de Bebidas Alcoólicas/epidemiologia , Infecções por HIV/complicações , Acontecimentos que Mudam a Vida , Fumar Tabaco/epidemiologia , População Urbana/estatística & dados numéricos , Adulto , Grupo com Ancestrais do Continente Africano , Idoso , Estudos Transversais , Feminino , HIV/isolamento & purificação , Infecções por HIV/psicologia , Infecções por HIV/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , África do Sul/epidemiologia
19.
Vaccine ; 38(45): 7146-7155, 2020 10 21.
Artigo em Inglês | MEDLINE | ID: mdl-32943265

RESUMO

BACKGROUND: COVID-19 pandemic has affected routine immunization globally. Impact will likely be higher in low and middle-income countries with limited healthcare resources and fragile health systems. We quantified the impact, spatial heterogeneity, and determinants for childhood immunizations of 48 million population affected in the Sindh province of Pakistan. METHODS: We extracted individual immunization records from real-time provincial Electronic Immunization Registry from September 23, 2019, to July 11, 2020. Comparing baseline (6 months preceding the lockdown) and the COVID-19 lockdown period, we analyzed the impact on daily immunization coverage rate for each antigen by geographical area. We used multivariable logistic regression to explore the predictors associated with immunizations during the lockdown. RESULTS: There was a 52.5% decline in the daily average total number of vaccinations administered during lockdown compared to baseline. The highest decline was seen for Bacille Cal-mette Guérin (BCG) (40.6% (958/2360) immunization at fixed sites. Around 8438 children/day were missing immunization during the lockdown. Enrollments declined furthest in rural districts, urban sub-districts with large slums, and polio-endemic super high-risk sub-districts. Pentavalent-3 (penta-3) immunization rates were higher in infants born in hospitals (RR: 1.09; 95% CI: 1.04-1.15) and those with mothers having higher education (RR: 1.19-1.50; 95% CI: 1.13-1.65). Likelihood of penta-3 immunization was reduced by 5% for each week of delayed enrollment into the immunization program. CONCLUSION: One out of every two children in Sindh province has missed their routine vaccinations during the provincial COVID-19 lockdown. The pool of un-immunized children is expanding during lockdown, leaving them susceptible to vaccine-preventable diseases. There is a need for tailored interventions to promote immunization visits and safe service delivery. Higher maternal education, facility-based births, and early enrollment into the immunization program continue to show a positive association with immunization uptake, even during a challenging lockdown.


Assuntos
Infecções por Coronavirus/psicologia , Sarampo/prevenção & controle , Pandemias , Pneumonia Viral/psicologia , Quarentena , Infecções por Rotavirus/prevenção & controle , Tuberculose Pulmonar/prevenção & controle , Vacinação/estatística & dados numéricos , Vacina BCG/administração & dosagem , Betacoronavirus/patogenicidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/imunologia , Processamento Eletrônico de Dados , Feminino , Humanos , Programas de Imunização/estatística & dados numéricos , Lactente , Recém-Nascido , Masculino , Sarampo/epidemiologia , Sarampo/imunologia , Vacina contra Sarampo/administração & dosagem , Paquistão/epidemiologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/imunologia , Sistema de Registros , Infecções por Rotavirus/epidemiologia , Infecções por Rotavirus/imunologia , Vacinas contra Rotavirus/administração & dosagem , População Rural , Tuberculose Pulmonar/epidemiologia , Tuberculose Pulmonar/imunologia , População Urbana , Vacinação/psicologia , Cobertura Vacinal/estatística & dados numéricos , Vacinas Atenuadas/administração & dosagem
20.
Western Pac Surveill Response J ; 11(1): 22-28, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32963888

RESUMO

Objective: To identify individual characteristics related to the development of pulmonary tuberculosis (PTB) among residents in the Airin area (Airin), Osaka City, Japan. Methods: We conducted a retrospective case-control study of individual characteristics potentially related to the development of PTB by comparing PTB patients and residents without tuberculosis (TB) in Airin. The following binominal data of characteristics were compared: age (< 65 or > 65); body mass index (BMI) (< 18.5 or > 18.5); diabetes mellitus (diagnosed or not diagnosed); smoking (currently smoking any amount or not smoking); and alcohol use (currently drinking any amount or not drinking). Results: We compared the individual characteristics of 192 PTB patients notified from January 2015 to December 2018 and 190 residents of supportive houses who attended a health education programme from April 2016 to March 2018.Univariable analysis showed that the following characteristics were significantly related with PTB: BMI < 18.5 (odds ratio [OR]: 6.54, 95% confidence interval [CI]: 3.58-11.97, P < 0.001) and current alcohol use (OR: 1.88; 95% CI: 1.24-2.85, P = 0.003). Multivariable analysis showed similar results: BMI < 18.5 (adjusted odds ratio [aOR]: 6.90, 95% CI: 3.72-12.79, P < 0.001) and current alcohol use (aOR: 2.15, 95% CI: 1.36-3.42, P = 0.001). Discussion: Undernutrition and alcohol use are individual characteristics associated with PTB among residents in Airin, Osaka City. To strengthen the TB control programme further, it is suggested to develop new programmes for primary prevention.


Assuntos
Pobreza/estatística & dados numéricos , Tuberculose Pulmonar/epidemiologia , População Urbana/estatística & dados numéricos , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco
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