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1.
Sci Eng Ethics ; 30(4): 28, 2024 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-39012561

RESUMO

The rapidly advancing field of brain-computer (BCI) and brain-to-brain interfaces (BBI) is stimulating interest across various sectors including medicine, entertainment, research, and military. The developers of large-scale brain-computer networks, sometimes dubbed 'Mindplexes' or 'Cloudminds', aim to enhance cognitive functions by distributing them across expansive networks. A key technical challenge is the efficient transmission and storage of information. One proposed solution is employing blockchain technology over Web 3.0 to create decentralised cognitive entities. This paper explores the potential of a decentralised web for coordinating large brain-computer constellations, and its associated benefits, focusing in particular on the conceptual and ethical challenges this innovation may pose pertaining to (1) Identity, (2) Sovereignty (encompassing Autonomy, Authenticity, and Ownership), (3) Responsibility and Accountability, and (4) Privacy, Safety, and Security. We suggest that while a decentralised web can address some concerns and mitigate certain risks, underlying ethical issues persist. Fundamental questions about entity definition within these networks, the distinctions between individuals and collectives, and responsibility distribution within and between networks, demand further exploration.


Assuntos
Interfaces Cérebro-Computador , Internet , Autonomia Pessoal , Privacidade , Humanos , Interfaces Cérebro-Computador/ética , Responsabilidade Social , Blockchain/ética , Segurança Computacional/ética , Propriedade/ética , Política , Cognição , Segurança , Tecnologia/ética
4.
PLoS One ; 19(7): e0305178, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38959184

RESUMO

Cryptocurrency is a digital asset secured by cryptography that has become a popular medium of exchange and investment known for its anonymous transactions, unregulated markets, and volatile prices. Given the popular subculture of traders it has created, and its implications for financial markets and monetary policy, scholars have recently begun to examine the political, psychological, and social characteristics of cryptocurrency investors. A review of the existing literature suggests that cryptocurrency owners may possess higher-than-average levels of nonnormative psychological traits and exhibit a range of non-mainstream political identities. However, this extant literature typically employs small nonrepresentative samples of respondents and examines only a small number of independent variables in each given study. This presents the opportunity for both further testing of previous findings as well as broader exploratory analyses including more expansive descriptive investigations of cryptocurrency owners. To that end, we polled 2,001 American adults in 2022 to examine the associations between cryptocurrency ownership and individual level political, psychological, and social characteristics. Analyses revealed that 30% of our sample have owned some form of cryptocurrency and that these individuals exhibit a diversity of political allegiances and identities. We also found that crypto ownership was associated with belief in conspiracy theories, "dark" personality characteristics (e.g., the "Dark Tetrad" of narcissism, Machiavellianism, psychopathy, and sadism), and more frequent use of alternative and fringe social media platforms. When examining a more comprehensive multivariate model, the variables that most strongly predict cryptocurrency ownership are being male, relying on alternative/fringe social media as one's primary news source, argumentativeness, and an aversion to authoritarianism. These findings highlight numerous avenues for future research into the people who buy and trade cryptocurrencies and speak to broader global trends in anti-establishment attitudes and nonnormative behaviors.


Assuntos
Propriedade , Política , Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Comércio
5.
J Surg Res ; 300: 381-388, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38848639

RESUMO

INTRODUCTION: Firearms now represent the leading cause of death in U.S. children. Therefore, this study aimed to determine if state-level rates of gun ownership, guns in circulation, and strictness of firearm-related laws are related to firearm-related mortality among both juveniles and overall populations. MATERIALS AND METHODS: State firearm mortality rates among the juvenile and overall populations were obtained from 2010 to 2020. The number of weapons registered with the Bureau of Alcohol, Tobacco, Firearms, and Explosives (ATF) and federal firearms licensees for each state were also recorded. Giffords Law Center Scorecard Rankings, a relative measure of the restrictiveness of each state's gun laws, were also collected. Unadjusted linear regressions modeled the relationships between firearm-associated mortality and ATF-registered weapons, federal firearm licensees, Giffords Center rankings, and gun ownership rates. Multivariable (adjusted) analyses were performed to control for poverty, unemployment, and poor mental health. RESULTS: Unadjusted analyses demonstrated that higher gun ownership rates and more lenient gun laws were associated with increased firearm-associated mortality among juveniles. Similarly, these measures as well as increased ATF-registered weapons and ATF federal firearm licensees were associated with increased firearm mortality in the overall population. In the adjusted analyses, more ATF-registered weapons, more ATF federal firearm licensees, higher gun ownership rates, and more lenient firearm laws were associated with increased firearm-related mortality in the overall population, while increased gun ownership and higher Giffords Center rankings were associated with increased firearm-associated mortality in the pediatric population. CONCLUSIONS: To reduce the toll of gun violence in the United States, policymakers should focus on implementing more restrictive firearm laws and reducing the prevalence of guns in their communities.


Assuntos
Armas de Fogo , Propriedade , Humanos , Armas de Fogo/legislação & jurisprudência , Armas de Fogo/estatística & dados numéricos , Estados Unidos/epidemiologia , Propriedade/legislação & jurisprudência , Propriedade/estatística & dados numéricos , Adolescente , Ferimentos por Arma de Fogo/mortalidade , Criança , Masculino , Feminino
6.
J Environ Manage ; 364: 121455, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38878577

RESUMO

Building on prior research on managerial ownership and firm performance, this study is the first to link CEO ownership to carbon commitment. We examine if firms led by CEOs with substantial ownership are more or less inclined to prioritise reducing carbon emissions than those without such ownership. We find that higher CEO ownership is associated with a lower carbon commitment, indicating that CEOs with more significant ownership do not prioritise carbon emissions reduction. However, we notice an inverted U-shaped relationship. Particularly, moderate CEO ownership (between 5% and 10% of total shares) has the stronger impact. The results are robust to alternative measures and approaches. The study provides empirical evidence on how CEO ownership can influence corporate carbon commitment and contribute to the global fight against climate change.


Assuntos
Carbono , Mudança Climática , Propriedade , Humanos
7.
BMC Med Educ ; 24(1): 706, 2024 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-38943114

RESUMO

BACKGROUND: Patient care ownership (PCO) among medical students is a growing area in the field of medical education. While PCO has received increasing attention, there are no instruments to assess PCO in the context of Japanese undergraduate medical education. This study aimed to translate, culturally adapt, and validate the PCO Scale - Medical students (PCOS-S) in the Japanese context. METHODS: We collected survey data from fifth- and sixth-grade medical students from five different universities varying in location and type. Structural validity, convergent validity, and internal consistency reliability were examined. RESULTS: Data from 122 respondents were analyzed. Factor analysis of the Japanese PCOS-S revealed three factors with Cronbach's alpha values exceeding the satisfactory criterion (0.70). A positive correlation was observed between the total Japanese PCOS-S scores and the global rating scores for the clinical department as a learning environment (Pearson's correlation coefficient = 0.61). CONCLUSIONS: We conducted the translation of the PCOS-S into Japanese and assessed its psychometric properties. The Japanese version has good reliability and validity. This instrument has potential value in assessing the development of medical students' PCO.


Assuntos
Psicometria , Estudantes de Medicina , Traduções , Humanos , Estudantes de Medicina/psicologia , Japão , Reprodutibilidade dos Testes , Feminino , Masculino , Inquéritos e Questionários , Educação de Graduação em Medicina , Propriedade , Assistência ao Paciente/normas , Tradução , Análise Fatorial
8.
JAMA Netw Open ; 7(6): e2414864, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38865130

RESUMO

Importance: Extreme risk protection orders (ERPOs)-also known as red flag, risk warrant, and gun violence restraining orders-authorize law enforcement, family members, and sometimes others to petition a court to remove firearms from and prevent the acquisition of new firearms by a person judged to pose an immediate danger to themselves or others. Previous estimates suggest that 1 suicide is prevented for every 10 ERPOs issued, a number needed to treat that depends critically on the counterfactual estimate of the proportion of suicidal acts by ERPO respondents that would have involved firearms in the absence of ERPOs. Objective: To empirically inform updated estimates of the number of ERPOs needed to prevent 1 suicide. Design, Setting, and Participants: This cohort study used data from California for method-specific suicides by handgun ownership (October 18, 2004, to December 31, 2015). Handgun-owning suicide decedents in California were identified using individual-level registry data about lawful handgun ownership linked to cause-specific mortality for a cohort of more than 25 million adults. The study also used data from Connecticut for method-specific suicides among ERPO respondents who died by suicide, extracted from published data (October 1999 to June 2013). Data analysis was performed in December 2023. Exposure: Handgun ownership. Main Outcomes and Measures: The primary outcomes were the number and distribution of suicidal acts by handgun owners in California, estimated using method-specific suicide mortality data and published case fatality ratios, and the counterfactual number and distribution of suicidal acts and deaths among ERPO respondents in Connecticut had no ERPOs been issued. Results: A total of 1216 handgun owners (mean [SD] age, 50 [18] years; 1019 male [83.8%]) died by suicide during the study period. Among male handgun owners in California, 28% of suicidal acts involved firearms, 54% involved drug poisoning, 9% involved cutting or piercing, 3% involved hanging or suffocation, 2% involved poisoning with solids and/or liquids, and the remaining 4% involved other methods. Assuming this distribution approximates the counterfactual distribution among ERPO respondents in Connecticut in the absence of ERPOs, 1 suicide death was prevented for every 22 ERPOs issued. Conclusions and Relevance: The estimates produced by this cohort study of California handgun owners suggest that ERPOs can play an important role in averting deaths among high-risk individuals.


Assuntos
Armas de Fogo , Prevenção do Suicídio , Suicídio , Humanos , Armas de Fogo/legislação & jurisprudência , Armas de Fogo/estatística & dados numéricos , California/epidemiologia , Masculino , Feminino , Adulto , Suicídio/estatística & dados numéricos , Pessoa de Meia-Idade , Estudos de Coortes , Violência com Arma de Fogo/prevenção & controle , Violência com Arma de Fogo/estatística & dados numéricos , Propriedade/estatística & dados numéricos , Propriedade/legislação & jurisprudência , Idoso , Aplicação da Lei/métodos
9.
PLoS One ; 19(6): e0306190, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38917198

RESUMO

The inefficiency observed in investment within state-owned enterprises presents a significant practical challenge that can affect the sustainable development of China's economy. To address this issue, this study comprehensively explores the intricate mechanisms underlying the governance implications of mixed ownership on the investment efficiency of listed companies. Drawing on unbalanced panel data encompassing Shanghai and Shenzhen Stock Exchange A-share listed companies in China spanning the period from 2008 to 2022, this study employs a fixed-effects model to unveil the nuanced ways in which mixed ownership influences investment efficiency through the lens of agency costs. This study transcends the boundaries of traditional agency conflicts between managers and shareholders. It delves deeper, illuminating the diverse effects of agency conflicts between significant controlling shareholders and minority shareholders. The results revealed a noteworthy positive correlation between mixed ownership and investment efficiency, and verified the intermediary role of agency costs between mixed ownership and investment efficiency, which is an important result of our research. Heterogeneity analysis indicates that the relationship between the two can be affected by external events, such as during the COVID-19 pandemic, investment efficiency is not the most concerned issue for enterprises. The findings have practical implications for practitioners and policymakers, as they offer avenues for optimizing investment strategies and fostering efficient and effective corporate governance practices.


Assuntos
COVID-19 , Investimentos em Saúde , Propriedade , China , Investimentos em Saúde/economia , Propriedade/economia , Humanos , COVID-19/economia , COVID-19/epidemiologia , SARS-CoV-2 , Pandemias/economia
10.
World Neurosurg ; 186: xvii, 2024 06.
Artigo em Inglês | MEDLINE | ID: mdl-38850009
11.
Sci Rep ; 14(1): 14321, 2024 06 21.
Artigo em Inglês | MEDLINE | ID: mdl-38906904

RESUMO

Increasing levels of physical inactivity is a global burden for mankind and is also an emerging problem in companion dogs. In both humans and dogs, insufficient physical activity is associated with increased risk for noncommunicable diseases and impaired quality of life (QoL). The aim of the current pilot study was to evaluate effects of a joint outdoor exercise program for dog owners (n = 22) and dogs (n = 22) with focus on QoL and body measurements. Results indicate that an eight-week exercise intervention alone, with a target distance of at least 2 km twice a week, may be sufficient to significantly increase self-reported QoL and acceptance of bodily appearance in dog owners despite no reductions in body measurements. In dogs, a significantly reduced body condition score (BCS) was registered, despite no considerable changes in feeding. The increased owner motivation for continued joint exercise suggests potential for lifestyle changes, which could be investigated in future studies including control groups and long-term follow-ups. The importance of the human-animal bond as a success factor for increased mutual physical activity and health benefits in both dog owners and dogs is recommended to be studied in a more in-depth manner.


Assuntos
Exercício Físico , Qualidade de Vida , Cães , Animais , Projetos Piloto , Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Vínculo Humano-Animal , Animais de Estimação/psicologia , Condicionamento Físico Animal , Propriedade
12.
J Urban Health ; 101(3): 571-583, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38831155

RESUMO

Mass shootings (incidents with four or more people shot in a single event, not including the shooter) are becoming more frequent in the United States, posing a significant threat to public health and safety in the country. In the current study, we intended to analyze the impact of state-level prevalence of gun ownership on mass shootings-both the frequency and severity of these events. We applied the negative binomial generalized linear mixed model to investigate the association between gun ownership rate, as measured by a proxy (i.e., the proportion of suicides committed with firearms to total suicides), and population-adjusted rates of mass shooting incidents and fatalities at the state level from 2013 to 2022. Gun ownership was found to be significantly associated with the rate of mass shooting fatalities. Specifically, our model indicated that for every 1-SD increase-that is, for every 12.5% increase-in gun ownership, the rate of mass shooting fatalities increased by 34% (p value < 0.001). However, no significant association was found between gun ownership and rate of mass shooting incidents. These findings suggest that restricting gun ownership (and therefore reducing availability to guns) may not decrease the number of mass shooting events, but it may save lives when these events occur.


Assuntos
Armas de Fogo , Incidentes com Feridos em Massa , Propriedade , Suicídio , Humanos , Armas de Fogo/estatística & dados numéricos , Estados Unidos/epidemiologia , Propriedade/estatística & dados numéricos , Incidentes com Feridos em Massa/estatística & dados numéricos , Suicídio/estatística & dados numéricos , Ferimentos por Arma de Fogo/epidemiologia , Ferimentos por Arma de Fogo/mortalidade , Eventos de Tiroteio em Massa
13.
Sci Eng Ethics ; 30(4): 27, 2024 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-38888795

RESUMO

Artificial intelligence (AI) has long been recognised as a challenge to responsibility. Much of this discourse has been framed around robots, such as autonomous weapons or self-driving cars, where we arguably lack control over a machine's behaviour and therefore struggle to identify an agent that can be held accountable. However, most of today's AI is based on machine-learning technology that does not act on its own, but rather serves as a decision-support tool, automatically analysing data to help human agents make better decisions. I argue that decision-support tools pose a challenge to responsibility that goes beyond the familiar problem of finding someone to blame or punish for the behaviour of agent-like systems. Namely, they pose a problem for what we might call "decision ownership": they make it difficult to identify human agents to whom we can attribute value-judgements that are reflected in decisions. Drawing on recent philosophical literature on responsibility and its various facets, I argue that this is primarily a problem of attributability rather than of accountability. This particular responsibility problem comes in different forms and degrees, most obviously when an AI provides direct recommendations for actions, but also, less obviously, when it provides mere descriptive information on the basis of which a decision is made.


Assuntos
Inteligência Artificial , Tomada de Decisões , Responsabilidade Social , Humanos , Inteligência Artificial/ética , Tomada de Decisões/ética , Técnicas de Apoio para a Decisão , Julgamento , Aprendizado de Máquina/ética , Propriedade , Robótica/ética
14.
J Law Health ; 37(3): 364-386, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38833607

RESUMO

Montana, Alaska, and Wyoming lead the United States in a category coveted by no one: the suicide rate. Firearm ownership drives the rate to the disproportionate level it reaches year after year and the states are left with little recourse. This article argues the usefulness and constitutionality of narrowly tailored red-flag laws aimed exclusively at reducing the rate of suicide in these mountain states. The article follows Supreme Court jurisprudence leading up to New York Rifle and Pistol Association v. Bruen and offers an analysis that complies with the hyper textualist history and tradition test laid out by Scalia in District of Columbia v. Heller and McDonald v. City of Chicago. The analysis demonstrates that narrowly tailored red flag laws are a constitutional means of reducing the suicide rate in these at-risk states and references statutory and cultural avenues for the implementation of the legislation.


Assuntos
Armas de Fogo , Suicídio , Humanos , Suicídio/legislação & jurisprudência , Estados Unidos , Armas de Fogo/legislação & jurisprudência , Prevenção do Suicídio , Decisões da Suprema Corte , Propriedade/legislação & jurisprudência , Populações Vulneráveis/legislação & jurisprudência
16.
Environ Health ; 23(1): 53, 2024 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-38844911

RESUMO

BACKGROUND: Time-varying exposures like pet ownership pose challenges for identifying critical windows due to multicollinearity when modeled simultaneously. The Distributed Lag Model (DLM) estimates critical windows for time-varying exposures, which are mainly continuous variables. However, applying complex functions such as high-order splines and nonlinear functions within DLMs may not be suitable for situations with limited time points or binary exposure, such as in questionnaire surveys. OBJECTIVES: (1) We examined the estimation performance of a simple DLM with fractional polynomial function for time-varying binary exposures through simulation experiments. (2) We evaluated the impact of pet ownership on childhood wheezing onset and estimate critical windows. METHODS: (1) We compared logistic regression including time-varying exposure in separate models, in one model simultaneously, and using DLM. For evaluation, we employed bias, empirical standard error (EmpSE), and mean squared error (MSE). (2) The Japan Environment and Children's Study (JECS) is a prospective birth cohort study of approximately 100,000 parent-child pairs, registered across Japan from 2011 to 2014. We applied DLM to the JECS data up to age 3. The estimated odds ratios (OR) were considered to be within critical windows when they were significant at the 5% level. RESULTS: (1) DLM and the separate model exhibited lower bias compared to the simultaneously model. Additionally, both DLM and the simultaneously model demonstrated lower EmpSEs than the separate model. In all scenarios, DLM had lower MSEs than the other methods. Specifically, where critical windows is clearly present and exposure correlation is high, DLM showed MSEs about 1/2 to 1/200 of those of other models. (2) Application of DLM to the JECS data showed that, unlike other models, a significant exposure effect was observed only between the ages of 0 and 6 months. During that periods, the highest ORs were 1.07 (95% confidence interval, 1.01 to 1.14) , observed between the ages of 2 and 5 months. CONCLUSIONS: (1) A simple DLM improves the accuracy of exposure effect and critical windows estimation. (2) 0-6 months may be the critical windows for the effect of pet ownership on the wheezing onset at 3 years.


Assuntos
Propriedade , Animais de Estimação , Sons Respiratórios , Humanos , Japão/epidemiologia , Pré-Escolar , Feminino , Masculino , Propriedade/estatística & dados numéricos , Animais , Exposição Ambiental/efeitos adversos , Estudos Prospectivos , Lactente , Modelos Estatísticos , Estudos Longitudinais , Modelos Logísticos
17.
J Prim Care Community Health ; 15: 21501319241259685, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38840558

RESUMO

OBJECTIVE: There has been a trend toward hospital systems and insurers acquiring privately owned physician practices and subsequently converting them into vertically integrated practices. The purpose of this study is to observe whether this change in ownership of a medical practice influences adherence to clinical guidelines for the management of type 1 and type 2 diabetes. METHODS: This is an observational study using pooled cross-sectional data (2014-2016 and 2018-2019) from the National Ambulatory Medical Care Survey, a nationally representative probability sample of US office-based physician visits. A total of 7499 chronic routine follow ups and preventative care visits to non-integrated (solo and group physician practices) and integrated practices were analyzed to see whether guideline concordant care was provided. Measures included 7 services that are recommended annually for individuals with type 1 and type 2 diabetes (HbA1c, lipid panel, serum creatinine, depression screening, influenza immunization, foot examination, and BMI). RESULTS: Compared to non-integrated physician practices, vertically integrated practices had higher rates of hemoglobin A1C testing (odds ratio 1.58 [95% CI 1.07-2.33], P < .05), serum creatine testing (odds ratio 1.53 [95% CI 1.02-2.29], P < .05), foot examinations (odds ratio 2.03 [95% CI 0.98-4.22], P = .058), and BMI measuring (odds ratio 1.54 [95% CI 0.99-2.39], P = .054). There was no significant difference in lipid panel testing, depression screenings, or influenza immunizations. CONCLUSIONS: Our results show that integrated medical practices have a higher adherence to diabetes practice guidelines than non-integrated practices. However, rates of services provided regardless of ownership were low.


Assuntos
Diabetes Mellitus Tipo 2 , Fidelidade a Diretrizes , Propriedade , Humanos , Fidelidade a Diretrizes/estatística & dados numéricos , Estudos Transversais , Diabetes Mellitus Tipo 2/terapia , Feminino , Masculino , Pessoa de Meia-Idade , Adulto , Estados Unidos , Prestação Integrada de Cuidados de Saúde/normas , Prestação Integrada de Cuidados de Saúde/organização & administração , Guias de Prática Clínica como Assunto , Hemoglobinas Glicadas/análise , Diabetes Mellitus Tipo 1/terapia , Idoso , Pesquisas sobre Atenção à Saúde
18.
PLoS One ; 19(5): e0300019, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38768137

RESUMO

This paper estimates efficiency measures for the banking system in Chile for the period 2000-2019. In contrast to previous studies, we use input-distance functions, introduce the nonparametric slack-based model, and choose the intermediate inputs approach in determining inputs and outputs. Our results suggest that the Chilean system has achieved relatively high levels of efficiency, although with no significant variation over the sample period. Ownership (government, foreign and public) and size had a positive impact on efficiency. On average, mergers and acquisitions seem to have targeted highly efficient banks in order to improve the overall efficiency of the controlling institution in the short run. Other sources of efficiency gains could be an increase in bond funding or a reduction in expenses and capital holdings. The latter could be induced by deepening the local derivatives market.


Assuntos
Indústrias , Chile , Humanos , Indústrias/economia , Modelos Econômicos , Conta Bancária , Propriedade
19.
Environ Manage ; 73(6): 1121-1133, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38710805

RESUMO

Though the federal government impacts private forest management across the United States through legislation such as the Clean Water Act, state-level regulations applied to private forest landowners vary remarkably. Despite this diversity of policies, little is known about how variations in regulatory intensity (defined here as number of forestry regulations) correlate with state-level political and socioeconomic characteristics. In this study, we use a quantitative approach to explore the intensity of regulation on forest practices impacting private landowners across all 50 states. We quantified intensity by tabulating the number of regulated forest practices, then used a quasi-Poisson regression to estimate the relationship between regulatory intensity and state-level characteristics, including forestland ownership types, the economic importance of the forest industry, and measures of state environmentalism. Results indicated a positive association between regulatory intensity and the percent of private corporate land, environmental voting records of elected officials, and direct democracy. Foresters and landowners may learn from these relationships, consider how to influence different policies, and build or achieve greater levels of public trust. This study starts to help us explain why state-level forestry policies differ, not just how they differ.


Assuntos
Conservação dos Recursos Naturais , Agricultura Florestal , Florestas , Propriedade , Estados Unidos , Agricultura Florestal/legislação & jurisprudência , Conservação dos Recursos Naturais/legislação & jurisprudência , Setor Privado , Regulamentação Governamental , Política Ambiental/legislação & jurisprudência
20.
Malar J ; 23(1): 167, 2024 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-38807175

RESUMO

BACKGROUND: Malaria poses a substantial public health threat in Myanmar, indicating the need for rigorous efforts to achieve elimination of the disease nationwide by 2030. The use of insecticide-treated nets (ITNs) forms part of a pivotal strategy for preventing transmission. This study explored the ownership and use of ITNs in Myanmar and identified factors associated with non-use of ITNs. METHODS: Household datasets from the 2015-2016 Myanmar Demographic and Health Survey were utilised, which encompassed all household members except children under the age of five. Descriptive statistics and inferential tests, including simple and multiple logistics regression models and Pearson correlations, were employed for analysis. All analyses, taking the two-stage stratified cluster sampling design into account, used weighting factors and the "svyset" command in STATA. The ownership and use of bed nets were also visualised in QGIS maps. RESULTS: Among the 46,507 participants, 22.3% (95% CI 20.0%, 24.5%) had access to ITNs, with only 15.3% (95% CI 13.7, 17.1%) sleeping under an ITN the night before the survey. Factors associated with the non-use of ITNs included age category (15-34 years-aOR: 1.17, 95% CI 1.01, 1.30; 50+ years-aOR: 1.19, 95% CI 1.06, 1.33), location (delta or lowland-aOR: 5.39, 95% CI 3.94, 7.38; hills-aOR: 1.80, 95% CI 1.20, 2.71; plains-aOR: 3.89, 95% CI 2.51, 6.03), urban residency (aOR: 1.63, 95% CI 1.22, 2.17), and wealth quintile (third-aOR: 1.38, 95% CI 1.08, 1.75; fourth-aOR: 1.65, 95% CI 1.23, 2.23; fifth-aOR: 1.47, 95% CI 1.02, 2.13). A coherent distribution of the ownership and use of ITNs was seen across all states/regions, and a strong correlation existed between the ownership and use of ITNs (r: 0.9795, 95% CI 0.9377, 0.9933, alpha < 0.001). CONCLUSIONS: This study identified relatively low percentages of ITN ownership and use, indicating the need to increase the distribution of ITNs to achieve the target of at least one ITN per every two people. Strengthening the use of ITNs requires targeted health promotion interventions, especially among relatively affluent individuals residing in delta or lowland areas, hills, and plains.


Assuntos
Mosquiteiros Tratados com Inseticida , Propriedade , Mianmar , Mosquiteiros Tratados com Inseticida/estatística & dados numéricos , Propriedade/estatística & dados numéricos , Adulto , Adolescente , Pessoa de Meia-Idade , Masculino , Adulto Jovem , Feminino , Humanos , Inquéritos Epidemiológicos , Malária/prevenção & controle , Idoso , Controle de Mosquitos/estatística & dados numéricos , Controle de Mosquitos/métodos , Pré-Escolar , Características da Família , Lactente
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