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1.
MMWR Morb Mortal Wkly Rep ; 70(22): 818-824, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34081685

RESUMO

Disparities in vaccination coverage by social vulnerability, defined as social and structural factors associated with adverse health outcomes, were noted during the first 2.5 months of the U.S. COVID-19 vaccination campaign, which began during mid-December 2020 (1). As vaccine eligibility and availability continue to expand, assuring equitable coverage for disproportionately affected communities remains a priority. CDC examined COVID-19 vaccine administration and 2018 CDC social vulnerability index (SVI) data to ascertain whether inequities in COVID-19 vaccination coverage with respect to county-level SVI have persisted, overall and by urbanicity. Vaccination coverage was defined as the number of persons aged ≥18 years (adults) who had received ≥1 dose of any Food and Drug Administration (FDA)-authorized COVID-19 vaccine divided by the total adult population in a specified SVI category.† SVI was examined overall and by its four themes (socioeconomic status, household composition and disability, racial/ethnic minority status and language, and housing type and transportation). Counties were categorized into SVI quartiles, in which quartile 1 (Q1) represented the lowest level of vulnerability and quartile 4 (Q4), the highest. Trends in vaccination coverage were assessed by SVI quartile and urbanicity, which was categorized as large central metropolitan, large fringe metropolitan (areas surrounding large cities, e.g., suburban), medium and small metropolitan, and nonmetropolitan counties.§ During December 14, 2020-May 1, 2021, disparities in vaccination coverage by SVI increased, especially in large fringe metropolitan (e.g., suburban) and nonmetropolitan counties. By May 1, 2021, vaccination coverage was lower among adults living in counties with the highest overall SVI; differences were most pronounced in large fringe metropolitan (Q4 coverage = 45.0% versus Q1 coverage = 61.7%) and nonmetropolitan (Q4 = 40.6% versus Q1 = 52.9%) counties. Vaccination coverage disparities were largest for two SVI themes: socioeconomic status (Q4 = 44.3% versus Q1 = 61.0%) and household composition and disability (Q4 = 42.0% versus Q1 = 60.1%). Outreach efforts, including expanding public health messaging tailored to local populations and increasing vaccination access, could help increase vaccination coverage in high-SVI counties.


Assuntos
Vacinas contra COVID-19/administração & dosagem , Disparidades em Assistência à Saúde/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Cobertura Vacinal/estatística & dados numéricos , Populações Vulneráveis/estatística & dados numéricos , Adulto , COVID-19/epidemiologia , COVID-19/prevenção & controle , Cidades/epidemiologia , Humanos , Fatores Socioeconômicos , Estados Unidos/epidemiologia
2.
Pan Afr Med J ; 38: 249, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34104297

RESUMO

Introduction: blood donation (BD) is affected by several factors, among which people's knowledge and attitude are the key determinants. However, the level of knowledge and attitude towards BD in Ethiopia is not yet well studied. Therefore, this study aimed to assess the level and factors associated with knowledge and attitude towards blood donation among health science college students in Southwest Ethiopia. Methods: a cross-sectional study was conducted among 394 health science students from June 1st to 15th 2019. The data were collected using a structured self-administered questionnaire. The data were entered using EPI-data version 4.2.0.0 and analyzed using SPSS version 20. The correlation analysis was done to determine the association between the knowledge sum score and the attitude sum score. A binary logistic regression analysis was done to determine the association between the dependent and independent variables. Results: the proportions of good knowledge and positive attitude towards BD were 69.3%, 95% CI (64.8%-73.4%) and 58.1%, 95% CI (52.3%-63.0%) respectively. The study also found that age ≥23 years (adjusted odds ratio (AOR)=1.67, 95% CI (1.04-2.67)), having a father with primary and secondary school and above (AOR=2.24, 95% CI (1.20-4.17) and AOR=2.26, 95% CI (1.26-4.06) respectively) and ever donated blood (AOR=3.64, 95%CI (2.26-5.85)) were factors associated with good knowledge of blood donation. Being a rural resident (AOR=1.59, 95% CI (1.01-2.40)) and graduating class student (AOR=0.56, 95% CI (0.34-0.96)) were factors associated with a positive attitude towards blood donation. The knowledge-related questions´ sum score value was positively correlated with the attitude-related questions' sum score value (r=0.30, P<0.001). Conclusion: the knowledge and attitude towards BD among the study population are a substantial deficiency. Therefore, more effort is needed to increase the level of knowledge and attitude towards BD by inculcating short training courses for these groups of population in the existing curriculum.


Assuntos
Doadores de Sangue/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Estudantes/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Etiópia , Feminino , Humanos , Masculino , População Rural/estatística & dados numéricos , Inquéritos e Questionários , Universidades , População Urbana/estatística & dados numéricos , Adulto Jovem
3.
BMC Public Health ; 21(1): 939, 2021 05 17.
Artigo em Inglês | MEDLINE | ID: mdl-34001026

RESUMO

BACKGROUND: Population aging poses a demographic burden on a country such as India with inadequate social security systems and very low public investment in health sector. This challenge of accelerated demographic transition is coupled by the rural-urban disparity in access to healthcare services among the elderly people in India. An important objective of India's National Health Policy (2017) is to "progressively achieve universal health coverage" which is posited upon mitigating the sub-national disparity that necessitates identifying the drivers of the disparity for targeted policy intervention. This study, therefore, makes an attempt towards the exploration of the prominent contributory factors behind the rural-urban gap in utilisation of healthcare among the older population in India. METHODS: The analysis has been done by using the unit level data of Social Consumption: Health (Schedule number 25.0) of the 75th round of the National sample Survey conducted during July 2017-June 2018. Two binary logistic models have been proposed to capture the crude and the adjusted association between health seeking behaviour and place of residence (rural/ urban). To compute the group differences (between rural and urban) in the rate of healthcare utilization among the elderly population in India and to decompose these differences into the major contributing factors, Fairlie's decomposition method has been employed. RESULTS: The logistic regression models established a strong association between place of residence and likelihood of healthcare utilisation among the Indian elderly people. The results of the Fairlie's decomposition analysis revealed considerable rural-urban inequality disfavouring the rural residents and health care utilisation was found to be 7 percentage points higher among the older population residing in urban India than their rural counterparts. Level of education and economic status, both of which are indicators of a person's Socio-Economic Status, were the two major determinants of the existing rural-urban differential in healthcare utilisation, together explaining 41% of the existing rural-urban differential. CONCLUSION: Public health care provisions need to be strengthened both in terms of quality and outreach by way of greater public investments in the health sector and by building advanced health infrastructure in the rural areas. Implementation of poverty alleviation programmes and ensuring social-security of the elderly are also indispensable in bringing about equity in healthcare utilisation.


Assuntos
Aceitação pelo Paciente de Cuidados de Saúde , População Rural , Idoso , Humanos , Índia , Fatores Socioeconômicos , Cobertura Universal do Seguro de Saúde , População Urbana
4.
Medicine (Baltimore) ; 100(21): e25975, 2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34032709

RESUMO

ABSTRACT: This study aimed to evaluate the prevalence of low health literacy in Hebei Province of China, and to investigate its socio-demographic risk factors.This study was a community-based, cross-sectional questionnaire survey with a multiple-stage randomization design and a sample size of 10,560. Participants' health literacy status was evaluated by a questionnaire based on the 2012 Chinese Resident Health Literacy Scale. Meanwhile, participants' socio-demographic characteristics were also collected by the questionnaire.A total of 9952 participants provided valid questionnaires and were included in the final analyses. The mean health literacy score was 63.1 ±â€Š17.1 points; for its subscales, the mean basic knowledge and concepts score, lifestyle score, health-related skills score were 31.7 ±â€Š9.0, 17.2 ±â€Š4.8, 14.3 ±â€Š4.1, respectively. Meanwhile, low health literacy prevalence was 81.0%; for its subscales, low basic knowledge and concepts prevalence (70.6%) was numerically reduced compared to low lifestyle prevalence (87.4%) and low health-related skills prevalence (86.1%). Further analyses showed that age, male, and rural area were positively associated, but education level and annual household income were negatively associated with low health literacy prevalence. Further multivariate logistic regression analyses showed that higher age, male, lower education level, lower annual household income, and rural area were closely correlated with the risks of low total health literacy or low health literacy in subscales in Hebei Province.The prevalence of low health literacy is 81.0% in Hebei Province. Meanwhile, higher age, male, lower education level, lower annual household income, and rural area closely associate with low health literacy risk.


Assuntos
Letramento em Saúde/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Idoso , China , Estudos Transversais , Escolaridade , Feminino , Humanos , Renda , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Fatores de Risco , População Rural/estatística & dados numéricos , Fatores Sexuais , População Urbana/estatística & dados numéricos , Adulto Jovem
5.
PLoS One ; 16(5): e0249268, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33956810

RESUMO

AIM: The lockdown of sports infrastructure due to the COVID-19 pandemic has substantially shifted people's physical activity towards public green spaces. With Germany's lockdown as one of the more severe governmentally imposed epidemic-control-decisions, we tested to what extent the frequency of outdoor cycling activities changed from March to June 2020. METHODS: User behaviour and frequency in 15 urban and 7 rural German public green spaces was quantified using cycling data from the fitness application Strava. Changes in cycling activities were analysed with four different generalised linear models, correcting for factors like weather conditions and temporal changes in the user base of the fitness application. RESULTS: We found a clear increase in outdoor cycling sport activities in urban public green spaces in response to epidemic-control decisions (e.g. increase by 81% in April relative to the expected value (95% CI [48%, 110%])). In contrast, biking in rural areas showed no significant change with epidemic-control-decisions in place. CONCLUSION: Fitness App data, e.g. from Strava, can be used to monitor visitor behaviour and frequency. The increase in outdoor cycling activities during epidemic control decisions likely reflects a shift of sport activities from indoor and team sports to outdoor and individual sports. This highlights the importance of accessible green space for maintaining physical fitness and health. Beyond this shift, it is likely that outdoor activities may be of particularly importance for stress relief in times of crisis such as the current COVID-19 pandemic.


Assuntos
Ciclismo , Exercício Físico , Parques Recreativos , /epidemiologia , Controle de Doenças Transmissíveis , Alemanha/epidemiologia , Humanos , Pandemias , População Rural , População Urbana
6.
PLoS One ; 16(5): e0250707, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33956827

RESUMO

Demographic, health, and socioeconomic factors significantly inform COVID-19 outcomes. This article analyzes the association of these factors and outcomes in Chile during the first five months of the pandemic. Using the municipalities Metropolitan Region's municipalities as the unit of analysis, the study looks at the role of time dynamics, space, and place in cases and deaths over a 100-day period between March and July 2020. As a result, common and idiosyncratic elements explain the prevalence and dynamics of infections and mortality. Social determinants of health, particularly multidimensional poverty index and use of public transportation play an important role in explaining differences in outcomes. The article contributes to the understanding of the determinants of COVID-19 highlighting the need to consider time-space dynamics and social determinants as key in the analysis. Structural factors are important to identify at-risk populations and to select policy strategies to prevent and mitigate the effects of COVID-19. The results are especially relevant for similar research in unequal settings.


Assuntos
/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Criança , Chile/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pobreza , Fatores de Risco , Determinantes Sociais da Saúde , Fatores Socioeconômicos , População Urbana
7.
BMJ Open ; 11(4): e042762, 2021 04 30.
Artigo em Inglês | MEDLINE | ID: mdl-33931407

RESUMO

OBJECTIVE: The substantial differences in socioeconomic and lifestyle exposures between urban and rural areas in China may lead to urban-rural disparity in cancer risk. This study aimed to assess the urban-rural disparity in cancer incidence in China. METHODS: Using data from 36 regional cancer registries in China in 2008-2012, we compared the age-standardised incidence rates of cancer by sex and anatomic site between rural and urban areas. We calculated the rate difference and rate ratio comparing rates in rural versus urban areas by sex and cancer type. RESULTS: The incidence rate of all cancers in women was slightly lower in rural areas than in urban areas, but the total cancer rate in men was higher in rural areas than in urban areas. The incidence rates in women were higher in rural areas than in urban areas for cancers of the oesophagus, stomach, and liver and biliary passages, but lower for cancers of thyroid and breast. Men residing in rural areas had higher incidence rates for cancers of the oesophagus, stomach, and liver and biliary passages, but lower rates for prostate cancer, lip, oral cavity and pharynx cancer, and colorectal cancer. CONCLUSIONS: Our findings suggest substantial urban-rural disparity in cancer incidence in China, which varies across cancer types and the sexes. Cancer prevention strategies should be tailored for common cancers in rural and urban areas.


Assuntos
Neoplasias , População Rural , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Incidência , Masculino , Neoplasias/epidemiologia , Sistema de Registros , População Urbana
8.
BMC Gastroenterol ; 21(1): 212, 2021 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-33971822

RESUMO

BACKGROUND: Metabolic associated fatty liver disease (MAFLD) is a new definition for liver disease associated with known metabolic dysfunction. Based on new diagnostic criteria, we aimed to investigate its prevalence and risk factors in Chinese population. METHODS: We conducted this study in a health examination population who underwent abdominal ultrasonography in China. The diagnosis of MAFLD was based on the new diagnostic criteria. The characteristics of the MAFLD population, as well as the associations between MAFLD and metabolic abnormalities, were explored. Mann-Whitney U test and chi-square test were performed to compare different variables. Binary logistic regression was used to determine the risk factors for MAFLD. RESULTS: Among 139,170 subjects, the prevalence of MAFLD was 26.1% (males: 35.4%; females: 14.1%). The prevalence based on female menopausal status, that is, premenopausal, perimenopausal, and postmenopausal, was 6.1%, 16.8%, and 30.2%, respectively. In different BMI groups (underweight, normal, overweight and obese), the prevalence was 0.1%, 4.0%, 27.4% and 59.8%, respectively. The proportions of abnormal metabolic features in the MAFLD group were significantly higher than those in the non-MAFLD group, as was the proportion of elevated alanine aminotransferase (ALT) (42.5% vs. 11%, P < 0.001). In nonobese individuals with MAFLD, the proportions of abnormal metabolic features were also all significantly higher than those in nonobese individuals without MAFLD. The prevalence of metabolic syndrome (MS), dyslipidaemia, and hyperuricaemia, respectively, in the MAFLD group (53.2%, 80.0%, and 45.0%) was significantly higher than that in the non-MAFLD group (10.1%, 41.7%, and 16.8%). Logistic regression revealed that age, BMI, waist circumference, ALT, triglycerides, fasting glucose, uric acid and platelet count were associated with MAFLD. CONCLUSIONS: MAFLD is prevalent in China and varies considerably among different age, sex, BMI, and female menopausal status groups. MAFLD is related to metabolic disorders, especially obesity, while metabolic disorders also play important roles in the occurrence of MAFLD in nonobese individuals. MAFLD patients exhibit a high prevalence of MS, dyslipidaemia, hyperuricaemia, and elevated liver enzymes. MAFLD tends to coexist with systemic metabolic disorders, and a deep inner relationship may exist between MAFLD and MS. Metabolic disorders should be considered to improve the management of MAFLD.


Assuntos
Síndrome Metabólica , Hepatopatia Gordurosa não Alcoólica , Índice de Massa Corporal , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Síndrome Metabólica/epidemiologia , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Prevalência , Fatores de Risco , População Urbana
9.
BMC Health Serv Res ; 21(1): 425, 2021 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-33952266

RESUMO

BACKGROUND: Stroke has always been a severe disease and imposed heavy financial burden on the health system. Equity in patients in regard to healthcare utilization and medical costs are recognized as a significant factor influencing medical quality and health system responsiveness. The aim of this study is to understand the equity in stroke patients concerning medical costs and healthcare utilization, as well as identify potential factors contributing to geographic variation in stroke patients' healthcare utilization and costs. METHODS: Covering 31 provinces in mainland China, our main data were a 5% random sample of stroke claims from Urban Employees Basic Medical Insurance (UEBMI) and Urban Residents Basic Medical Insurance (URBMI) from 2013 to 2016. The Theil index was employed to evaluate the equity in stroke patients in regard to healthcare utilization and medical costs, and the random-effect panel model was used to explore the impact of province-level factors (health resource factors, enabling factors, and economic factors) on medical costs and health care utilization. RESULTS: Stroke patients' healthcare utilization and medical costs showed significant differences both within and between regions. The UEBMI scheme had an overall lower Theil index value than the URBMI scheme. The intra-region Theil index value was higher than the inter-region Theil index, with the Theil index highest within eastern China, China's richest and most developed region. Health resource factors and enabling factors (represented by reimbursement rate and education attainment years) were identified significantly associated with medical costs (P < 0.05), but have no impact on average length of stay. CONCLUSIONS: China's fragmented urban health insurance schemes require further reform to ensure better equity in healthcare utilization and medical costs for stroke patients. Improving education attainment, offering equal access to healthcare, allocating health resources reasonably and balancing health services prices in different regions also count.


Assuntos
Pacientes Internados , Acidente Vascular Cerebral , China/epidemiologia , Humanos , Seguro Saúde , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/terapia , População Urbana
10.
J Prim Care Community Health ; 12: 21501327211017016, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33985374

RESUMO

BACKGROUND: Coronavirus infection (COVID) presents with flu-like symptoms and can cause serious complications. Here, we discuss the presentation and outcomes of COVID in an ambulatory setting along with distribution of positive cases amongst healthcare workers (HCWs). METHOD: Patients who visited the COVID clinic between 03/11/2020 and 06/14/2020 were tested based on the CDC guidelines at the time using PCR-detection methods. Medical records were reviewed and captured on a RedCap database. Statistical analysis was performed using both univariate and bivariate analysis using Fischer's exact test with 2-sided P values. RESULTS: Of the 2471 evaluated patients, 846 (34.2%) tested positive for COVID. Mean age of positivity was 43.4 years (SD ± 15.4), 60.1% were female and 49% were Black. 58.7% of people tested had a known exposure, and amongst those with exposure, 57.3% tested positive. Ninety-four patients were hospitalized (11.1%), of which 22 patients (23.4%) required ICU admission and 10 patients died. The overall death rate of patients presenting to clinic was 0.4%, or 1.2% amongst positive patients. Median length of hospital stay was 6 days (range 1-51). Symptoms significantly associated with COVID included: anosmia, fever, change in taste, anorexia, myalgias, cough, chills, and fatigue. Increased risk of COVID occurred with diabetes, whereas individuals with lung disease or malignancy were not associated with increased risk of COVID. Amongst COVID positive HCWs, the majority were registered nurses (23.4%), most working in general medicine (39.8%) followed by critical care units (14.3%). DISCUSSION/CONCLUSION: Blacks and females had the highest infection rates. There was a broad range in presentation from those who are very ill and require hospitalization and those who remain ambulatory. The above data could assist health care professionals perform a targeted review of systems and co-morbidities, allowing for appropriate patient triage.


Assuntos
Assistência Ambulatorial/estatística & dados numéricos , Guias como Assunto , Pessoal de Saúde/estatística & dados numéricos , Pacientes Ambulatoriais/estatística & dados numéricos , Triagem , Adulto , Idoso , Infecção Hospitalar , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Retrospectivos , População Urbana
11.
Rev Saude Publica ; 55: 26, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34037138

RESUMO

OBJECTIVE: To assess total usual nutrient intakes from foods and dietary supplements by age, sex, physical activity, and nutritional status, and to compare usual nutrient intakes to the Dietary Reference Intakes among non-users and users of dietary supplements in an urban population. METHODS: Cross-sectional population-based survey with 506 adults conducted in the city of Brasília, Brazil, using 24h food recalls. The 24-HR was collected on two nonconsecutive days, for which individuals reported all food, supplements, and beverages consumed in the previous 24 hours. The estimates of mean and the distribution percentiles were adjusted to reflect usual nutrient intake using the Iowa State University method. The prevalence of inadequate micronutrient intake was estimated according to sex using the Estimated Average Requirement (EAR), and values above the Tolerable Upper Intake Level (UL) were also considered. Also, a comparison was made of the total mean usual intake between supplement users and non-users according to BMI and physical activity. RESULTS: The total mean usual dietary intake was significantly higher among users than non-users of dietary supplements (p ≤ 0.02). Dietary supplement use increased intakes of nutrients and decreased prevalence of inadequacy according to sex, with only small (typically < 13%) increases in the population exceeding the Tolerable Upper Intake Level. There was a significant interaction between physical activity and BMI categories with supplement use. CONCLUSIONS: The population that consumes food supplements comprises individuals with more advanced age, female, normal BMI, and physically active. Our findings show that the use of supplements appears beneficial to attain nutrient adequacy. Careful monitoring of intake from food and supplements is recommended, and the statistical methods must be powerful enough to achieve relevant information.


Assuntos
Dieta , Suplementos Nutricionais , Adulto , Brasil , Estudos Transversais , Feminino , Humanos , Inquéritos Nutricionais , Necessidades Nutricionais , População Urbana
13.
MMWR Morb Mortal Wkly Rep ; 70(20): 759-764, 2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34014911

RESUMO

Approximately 60 million persons in the United States live in rural counties, representing almost one fifth (19.3%) of the population.* In September 2020, COVID-19 incidence (cases per 100,000 population) in rural counties surpassed that in urban counties (1). Rural communities often have a higher proportion of residents who lack health insurance, live with comorbidities or disabilities, are aged ≥65 years, and have limited access to health care facilities with intensive care capabilities, which places these residents at increased risk for COVID-19-associated morbidity and mortality (2,3). To better understand COVID-19 vaccination disparities across the urban-rural continuum, CDC analyzed county-level vaccine administration data among adults aged ≥18 years who received their first dose of either the Pfizer-BioNTech or Moderna COVID-19 vaccine, or a single dose of the Janssen COVID-19 vaccine (Johnson & Johnson) during December 14, 2020-April 10, 2021 in 50 U.S. jurisdictions (49 states and the District of Columbia [DC]). Adult COVID-19 vaccination coverage was lower in rural counties (38.9%) than in urban counties (45.7%) overall and among adults aged 18-64 years (29.1% rural, 37.7% urban), those aged ≥65 years (67.6% rural, 76.1% urban), women (41.7% rural, 48.4% urban), and men (35.3% rural, 41.9% urban). Vaccination coverage varied among jurisdictions: 36 jurisdictions had higher coverage in urban counties, five had higher coverage in rural counties, and five had similar coverage (i.e., within 1%) in urban and rural counties; in four jurisdictions with no rural counties, the urban-rural comparison could not be assessed. A larger proportion of persons in the most rural counties (14.6%) traveled for vaccination to nonadjacent counties (i.e., farther from their county of residence) compared with persons in the most urban counties (10.3%). As availability of COVID-19 vaccines expands, public health practitioners should continue collaborating with health care providers, pharmacies, employers, faith leaders, and other community partners to identify and address barriers to COVID-19 vaccination in rural areas (2).


Assuntos
/administração & dosagem , Disparidades em Assistência à Saúde/estatística & dados numéricos , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Cobertura Vacinal/estatística & dados numéricos , Adolescente , Adulto , Idoso , /prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Adulto Jovem
14.
Zhonghua Yu Fang Yi Xue Za Zhi ; 55(5): 640-645, 2021 May 06.
Artigo em Chinês | MEDLINE | ID: mdl-34034405

RESUMO

Objective: To analyze the trend of mortality and incidence of colorectal cancer among urban residents in Guangzhou from 1972 to 2015 and to predict the mortality of colorectal cancer from 2016 to 2025. Methods: The mortality data of colorectal cancer among urban residents in Guangzhou were collected from the death registration of malignant tumors of Guangzhou Health Statistics Bureau (1972-1979), Guangzhou Health Statistics (1980-2001), Guangzhou Cancer Registration Annual Report (2002-2009) and China Cancer Registration Annual Report (2010-2015). The incidence of colorectal cancer was collected from Guangzhou Cancer Registration Annual Report (2002-2009) and China Cancer Registration Annual Report (2010-2015). The incidence and mortality data of colorectal cancer coded as C18-C21 in 10th Edition of International Classification of Diseases (ICD-10) were obtained from the above data, and the demographic data were from the Guangzhou Municipal Bureau of Statistics. Joinpoint model was used to calculate the annual change percentage (APC) and average annual change percentage (AAPC) of colorectal cancer mortality and incidence among urban residents in Guangzhou from 1972 to 2015 and from 2002 to 2015. ARIMA model was used to predict colorectal cancer mortality from 2016 to 2025. Results: There were 19 309 colorectal cancer deaths among urban residents in Guangzhou from 1972 to 2015. The crude mortality rate of colorectal cancer increased from 4.33/100 000 to 24.89/100 000 (AAPC=4.2%, P<0.001). A total of 24 033 new cases of colorectal cancer were reported in Guangzhou from 2002 to 2015. The crude incidence rate of colorectal cancer increased from 22.95/100 000 to 52.81/100 000 (AAPC=6.6%, P<0.001). The mortality rate of colorectal cancer among urban residents of Guangzhou would continuously increase from 2016 to 2025 and reach 29.53/100 000 in 2025. Conclusion: The mortality rate of colorectal cancer among urban residents of Guangzhou from 1972 to 2015 and the incidence rate of colorectal cancer from 2002 to 2015 both show an upward trend. The mortality rate will increase from 2016 to 2025.


Assuntos
Neoplasias Colorretais , População Rural , China/epidemiologia , Neoplasias Colorretais/epidemiologia , Humanos , Incidência , Morbidade , População Urbana
15.
Biomed Res Int ; 2021: 2732983, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33969116

RESUMO

Objectives: To compare the differences of epidemiology analysis in population birth defects (BDs) between the rural and urban areas of Hunan Province in China. Methods: The data of population-based BDs in Liuyang county (rural) and Shifeng district (urban) in Hunan Province for 2014-2018 were analyzed. BD prevalence rates, percentage change, and annual percentage change (APC) by sex and age were calculated to evaluate time trends. Risk factors associated with BDs were assessed using simple and multiple logistic regression analyses. Results: The BD prevalence rate per 10,000 perinatal infants (PIs) was 220.54 (95% CI: 211.26-230.13) in Liuyang and 181.14 (95% CI: 161.18-202.87) in Shifeng. Significant decreasing trends in BD prevalence rates were noted in the female PIs (APC = -9.31, P = 0.044) and the total BD prevalence rate in Shifeng (APC = -14.14, P = 0.039). Risk factors for BDs were as follows: rural area, male PIs, PIs with gestational age < 37 weeks, PIs with birth weight < 2500 g, and migrant pregnancies. Conclusions: We should focus on rural areas, reduce the prevalence of premature and low birth weight infants, and provide maternal healthcare services for migrant pregnancies for BD prevention from the perspective of population-based BD surveillance.


Assuntos
Anormalidades Congênitas/epidemiologia , População Rural , População Urbana , Adulto , China/epidemiologia , Parto Obstétrico , Feminino , Humanos , Recém-Nascido , Modelos Logísticos , Masculino , Idade Materna , Prevalência , Adulto Jovem
16.
J Korean Acad Nurs ; 51(2): 203-216, 2021 Apr.
Artigo em Coreano | MEDLINE | ID: mdl-33993126

RESUMO

PURPOSE: This study analyzed the current status of face mask usage. It also identified factors related to the knowledge and behavior regarding the same among older adults living alone during the COVID-19 pandemic. METHODS: This descriptive study was conducted via a telephone survey involving 283 older adults living alone in S City from March to April 2020. Knowledge and behavior pertaining to face mask usage were measured using Hilda Ho's Face Mask Use Scale; reliability of the measurement was Kuder-Richardson formula-20 = .62, Cronbach's α = .92. Data were analyzed using descriptive analysis, independent t-test, Pearson's correlation coefficient, and multiple linear regression. RESULTS: Older adults used one mask for 3.55 days on an average. The knowledge level was 9.97 (± 1.84) out of 12 and behavior level was 15.49 (± 1.55) out of 16. Level of education (ß = - .31, p < .001), living region (ß = .13, p = .017), personal income (ß = .12, p = .041) significantly affected the face mask usage-related knowledge, and living region (ß = .15, p = .010) significantly affected the face mask usage-related behavior. CONCLUSION: Older adults living alone are aware of the effects of using face masks. However, their mask usage is inappropriate, for example, the prolonged use of the same mask. Considering the low level of face mask usage-related knowledge, it is necessary to develop customized education programs and infectious disease prevention strategies for older adults possessing low educational levels living alone in urban-rural complex areas.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Máscaras , Idoso , Idoso de 80 Anos ou mais , /patologia , Escolaridade , Feminino , Humanos , Renda , Masculino , Máscaras/estatística & dados numéricos , Inquéritos e Questionários , Telefone , População Urbana
17.
BMC Public Health ; 21(1): 966, 2021 05 22.
Artigo em Inglês | MEDLINE | ID: mdl-34020620

RESUMO

BACKGROUND: China is one of the world's fastest-aging countries. Population aging and social-economic development show close relations. This study aims to illustrate the spatial-temporal distribution and movement of gravity centers of population aging and social-economic factors and thier spatial interaction across the provinces in China. METHODS: Factors of elderly population rate (EPR), elderly dependency ratio (EDR), per capita gross regional product (GRPpc), and urban population rate (UPR) were collected. Distribution patterns were detected by using global spatial autocorrelation, Kernel density estimation, and coefficient of variation. Further, Arc GIS software was used to find the gravity centers and their movement trends yearly from 2002 to 2018. The spatial interaction between the variables was investigated based on bivariate spatial autocorrelation analysis. RESULTS: The results showed a larger variety of global spatial autocorrelation indexed by Moran's I and stable trends of dispersion degree without obvious convergence in EPR and EDR. Furthermore, the gravity centers of the proportion of EPR and EDR moved northeastward. In contrast, the economic and urbanization factors showed a southwestward movement, which exhibited an reverse trend compared to population aging indicators. Moreover, the movement rates of EPR and EDR (15.12 and 18.75 km/year, respectively) were higher than that of GRPpc (13.79 km/year) and UPR (6.89 km/year) annually during the study period. Further, the bivariate spatial autocorrelation variation is in line with the movement trends of gravity centers which showed a polarization trend of population aging and social-economic factors that the difference between southwest and northeast directions and exhibited a tendency to expand in China. CONCLUSIONS: In sum, our findings revealed the difference in spatio-temporal distribution and variation between population aging and social-economic factors in China. It further indicates that the opposite movements of gravity centers and the change of the BiLISA in space which may result in the increase of the economic burden of the elderly care in northern China. Hence, future development policy should focus on the social-economic growth and distribution of old-aged supporting resources, especially in northern China.


Assuntos
Envelhecimento , Urbanização , Idoso , China/epidemiologia , Humanos , Pessoa de Meia-Idade , Análise Espacial , População Urbana
18.
Sci Rep ; 11(1): 10795, 2021 05 24.
Artigo em Inglês | MEDLINE | ID: mdl-34031469

RESUMO

This study aimed to determine COVID-19-related awareness, knowledge, impact and preparedness among elderly Asians; and to evaluate their acceptance towards digital health services amidst the pandemic. 523 participants (177 Malays, 171 Indians, 175 Chinese) were recruited and underwent standardised phone interview during Singapore's lockdown period (07 April till 01 June 2020). Multivariable logistic regression models were performed to evaluate the associations between demographic, socio-economic, lifestyle, and systemic factors, with COVID-19 awareness, knowledge, preparedness, well-being and digital health service acceptance. The average perception score on the seriousness of COVID-19 was 7.6 ± 2.4 (out of 10). 75.5% of participants were aware that COVID-19 carriers can be asymptomatic. Nearly all (≥ 90%) were aware of major prevention methods for COVID-19 (i.e. wearing of mask, social distancing). 66.2% felt prepared for the pandemic, and 86.8% felt confident with government's handling and measures. 78.4% felt their daily routine was impacted. 98.1% reported no prior experience in using digital health services, but 52.2% felt these services would be helpful to reduce non-essential contact. 77.8% were uncomfortable with artificial intelligence software interpreting their medical results. In multivariable analyses, Chinese participants felt less prepared, and more likely felt impacted by COVID-19. Older and lower income participants were less likely to use digital health services. In conclusion, we observed a high level of awareness and knowledge on COVID-19. However, acceptance towards digital health service was low. These findings are valuable for examining the effectiveness of COVID-19 communication in Singapore, and the remaining gaps in digital health adoption among elderly.


Assuntos
Conscientização , Conhecimento , Percepção , Telemedicina , Idoso , /virologia , Estudos Transversais , Atenção à Saúde , Grupos Étnicos/psicologia , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Singapura/epidemiologia , Fatores Socioeconômicos , Inquéritos e Questionários , Telefone , População Urbana
19.
BMC Public Health ; 21(1): 992, 2021 05 26.
Artigo em Inglês | MEDLINE | ID: mdl-34039319

RESUMO

BACKGROUND: Country-wide urbanization in Uganda has continued amidst institutional challenges. Previous interventions in the water and sanitation sector have not addressed the underlying issues of a poorly managed urbanization processes. Poor urbanisation is linked to low productivity, urban poverty, unemployment, limited capacity to plan and offer basic services as well as a failure to enforce urban standards. METHODS: This ethnographic study was carried out in three urban centres of Gulu, Mbarara and Kampala. We explored relationships between urban livelihoods and sustainable urban sanitation, using the economic sociology of urban sanitation framework. This framework locates the urbanization narrative within a complex system entailing demand, supply, access, use and sustainability of slum sanitation. We used both inductive and deductive thematic analysis. RESULTS: More than any other city in Uganda, Kampala was plagued with poor sanitation services characterized by a mismatch between demand and the available capacity for service provision. Poor slum sanitation was driven by; the need to escape rural poverty through urban migration, urban governance deficits, corruption and the survival imperative, poor service delivery and lack of capacity, pervasive (urban) informality, lack of standards: 'to whom it may concern' attitudes and the normalization of risk as a way of life. Amidst a general lack of affordability, there was a critical lack of public good conscience. Most urbanites were trapped in poverty, whereby economic survival trumped for the need for meeting desirable sanitation standards. CONCLUSIONS: Providing sustainable urban livelihoods and meeting sanitation demands is nested within sustainable livelihoods. Previous interventions have labored to fix the sanitation problem in slums without considering the drivers of this problem. Sustainable urban livelihoods are critical in reducing slums, improving slum living and curtailing the onset of slumification. Urban authorities need to make urban centres economically vibrant as an integral strategy for attaining better sanitation standards.


Assuntos
Áreas de Pobreza , Saneamento , Cidades , Humanos , Uganda , População Urbana , Urbanização
20.
J Environ Manage ; 292: 112715, 2021 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-33992870

RESUMO

Anthropogenic disruption of the global phosphorus (P) cycle has already pushed it beyond the planetary boundary. Understanding P metabolism at global, regional and local scales is critical to close the loop of P for the safekeeping of mankind. Investigating the effects of urbanization-induced income growth on the natural nutrient (especially P) cycles contribute to that end. Bangladesh, a lower-middle-income agrarian economy seeing rapid urbanization and stunning GDP growth, presents itself as a good case for P-metabolism research. Past efforts to quantify P flows in the country have not addressed the effects of urbanization thereon. This time-series study quantifies the P flows in rural and urban Bangladesh using substance flow analysis after outlining the urbanization indicators (viz. GDP, income per capita, percentage of income spent on food, change in urban population and built-up area) which affects urban metabolism of P. Urbanization caused a dietary transition from cereal-based to animal-based diet resulting in 50% more P consumption from the latter by urban individuals than their rural counterparts in 2010. Comparing the P flows among the 19 expenditure groups of the urban population, an individual belonging to a higher expenditure group (USD 71-82) consumed 38% more P than one of the lower groups (USD 17-21) in 2016. Future forecasting was conducted for (i) future demand of P fertilizer using human appropriation of net primary productivity (HANPP) and (ii) P recovery potential from urban household food waste for the policymakers to get a glimpse of the future demand and recovery potential of P. The projections suggested approximately 145% rise in the national P inflow by 2030. Moreover, the universal adoption of source separation of household food waste in the two largest cities of Bangladesh can cycle back almost 1.2 × 103 tonnes of P to the system by 2030. As Bangladesh poises to faster economic growth in decades ahead, the study provides a basis for policy formulation for an appropriate P management plan to achieve circularity in nutrient use.


Assuntos
Fósforo , Eliminação de Resíduos , Animais , Bangladesh , Cidades , Alimentos , Humanos , Fósforo/análise , Crescimento Demográfico , População Urbana , Urbanização
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