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2.
Nutrients ; 13(10)2021 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-34684547

RESUMO

Peruvian households have experienced one of the most prevalent economic shocks due to COVID-19, significantly increasing their vulnerability to food insecurity (FI). To understand the vulnerability characteristics of these households among the Peruvian young population, including the role of the government's response through emergency cash transfer, we analysed longitudinal data from the Young Lives study (n = 2026), a study that follows the livelihoods of two birth cohorts currently aged 18 to 27 years old. FI was assessed using the Food Insecurity Experience Scale. Household characteristics were collected before and during the COVID-19 outbreak in Peru to characterise participants' vulnerability to FI. Multivariate logistic regression was used to evaluate the association between government support and participants' vulnerability characteristics to FI. During the period under study (March to December 2020), 24% (95% CI: 22.1-25.9%) of the participants experienced FI. Families in the top wealth tercile were 49% less likely to experience FI. Larger families (>5 members) and those with increased household expenses and decreased income due to COVID-19 were more likely to experience FI (by 35%, 39% and 42%, respectively). There was no significant association between government support and FI (p = 0.768). We conclude that pre-pandemic socioeconomic status, family size, and the economic disruption during COVID-19 contribute to the risk of FI among the Peruvian young population, while government support insufficiently curtailed the risk to these households.


Assuntos
COVID-19/economia , Apoio Financeiro , Insegurança Alimentar/economia , Abastecimento de Alimentos/economia , Governo , Pandemias/economia , Adolescente , Adulto , Estudos de Coortes , Feminino , Abastecimento de Alimentos/métodos , Humanos , Renda , Estudos Longitudinais , Masculino , Peru , SARS-CoV-2 , Fatores Socioeconômicos , Adulto Jovem
4.
BMJ Open ; 11(9): e049538, 2021 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-34475170

RESUMO

OBJECTIVES: To explore the mechanisms of reduction of suicide mortality in Japan (from 25.7 to 16.5 per 100 000 population) between 2009 and 2018, the present study determined the effects of execution amounts of regional suicide prevention programmes (Emergency Fund to Enhance Community-Based Suicide Countermeasure: EFECBSC) on gender-specific trends of suicide mortality by disaggregated methods. DESIGN AND SETTING: Stepwise multiple regression analysis was used to determine the effects of execution amounts of 10 subdivisions of execution amounts of financial support for regional suicide prevention programmes (EFECBSC) on suicide methods and gender disaggregated suicide mortalities in Japan between 2009 and 2018 using the statistical data obtained from national governmental database. RESULTS: The suicide mortalities by the most common/frequent suicide methods, hanging, charcoal burning and jumping were significantly decreased between 2009 and 2018. Male hanging suicide was decreased by prefectural enlightenment, municipal development programmes, but female hanging suicide was decreased by municipal personal consultation programmes. Municipal development and enlightenment programmes decreased male and female charcoal-burning suicide mortalities, respectively. Jumping suicide was decreased by prefectural telephone consultation programmes but was unexpectedly increased by municipal personal consultation and enlightenment programmes. CONCLUSIONS: This study revealed the contribution of ECEFBSC on reduction of suicide mortalities, especially hanging, charcoal-burning and jumping suicides, via enhancement of regional suicide prevention programmes in Japan; however, notably, the 'means substitution' from parts of hanging and charcoal burning to jumping is probably generated by EFECBSC. Therefore, these findings provide important aspects for planning evidence-based and cost-effective regional suicide prevention programmes.


Assuntos
Encaminhamento e Consulta , Suicídio , Feminino , Apoio Financeiro , Humanos , Japão/epidemiologia , Masculino , Suicídio/prevenção & controle , Telefone
6.
Lancet Infect Dis ; 21(8): e222-e233, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34331891

RESUMO

For the past 20 years, the notion of bioterror has been a source of considerable fear and panic worldwide. In response to the terror attacks of 2001 in the USA, extensive research funding was awarded to investigate bioterror-related pathogens. The global scientific legacy of this funding has extended into the present day, highlighted by the ongoing COVID-19 pandemic. Unsurprisingly, the surge in biodefence-related research and preparedness has been met with considerable apprehension and opposition. Here, we briefly outline the history of modern bioterror threats and biodefence research, describe the scientific legacy of biodefence research by highlighting advances pertaining to specific bacterial and viral pathogens, and summarise the future of biodefence research and its relevance today. We sought to address the sizeable question: have the past 20 years of investment into biodefence research and preparedness been worth it? The legacy of modern biodefence funding includes advancements in biosecurity, biosurveillence, diagnostics, medical countermeasures, and vaccines. In summary, we feel that these advances justify the substantial biodefence funding trend of the past two decades and set a precedent for future funding.


Assuntos
Pesquisa Biomédica/economia , Bioterrorismo/prevenção & controle , Apoio Financeiro , Humanos , Investimentos em Saúde , Medição de Risco , Vacinas/imunologia
8.
Epidemiol Serv Saude ; 30(3): e2020983, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34287553

RESUMO

OBJECTIVE: To assess vaccination coverage, based on the National Immunization Program schedule, among children receiving financial support from the Family Income Transfer Program, Brazil, according to the family socioeconomic status and maternal characteristics. METHODS: 3,242 children under 12 months old were assessed between August/2018 and April/2019, of whom 3,008 were reassessed between September/2019 and January/2020. The analyses were performed using multilevel models (level 3, Federative Unit; level 2, municipality; level 1, children). RESULTS: Vaccination coverage was 2.5 fold higher in the first follow-up (61.0% - 95% CI 59.3;62.6%), compared to the second follow-up (24.8% - 95% CI 22.8;25.9%) (p<0.001). In the first follow-up, coverage was higher in the richest quintile (67.9%) and in children whose mothers had ≥9 years of schooling (63.3%). In the second follow-up, there were no differences. The highest coverage occurred between 0.5-2.5 (93.5%) and 12.5-15.5 months (34.4%), respectively, first and second follow-ups. CONCLUSION: Low coverage was found, both in the first and second year of life.


Assuntos
Programas de Imunização , Cobertura Vacinal , Brasil , Criança , Feminino , Apoio Financeiro , Humanos , Esquemas de Imunização
9.
BMC Health Serv Res ; 21(1): 556, 2021 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-34092230

RESUMO

BACKGROUND: The share of out-of-pocket payments in Iranian families has the greatest burden on the poor and lead to an impoverishment caused by catastrophic health expenditures. In order to improve access of the poor to public resources, it is necessary to create a better governance system and effective policy-making. The purpose of this study is to improve network effectiveness of the Iranian health system and to design a financial protection network for the poor, based on the network governance theory. METHODS: We are using a quantitative method framework in conjunction with a Social network analysis (SNA) strategy. To draw an optimal network, we conducted interviews with experts by focusing on the arrangement and relationship among different institutions. The research sample was purposefully selected. We used UCINET software for data analysis and NetDraw software to draw networks. RESULTS: In this article, an optimal network was proposed with the following characteristics: First, the problem of the density of relationships among several central institutions and the isolation of the other institutions have been solved. Second, in our model, the relationships have been distributed in a balanced manner among all institutions in the network. Third, the number of participants has been reduced and consensus on poor people support policies has been achieved in this optimal network. Forth, executive organizations keep their central positions and upper institutions are not at the central position, so that the power is distributed in favor of more balanced governance. However, in order to increase efficiency and to have coherent decision-making, it is necessary to establish a "core" for this optimal network. The "core" has to include the organizations with the most relationship with others. CONCLUSION: The result revealed that the usefulness of network analysis as a tool for proposing the effectiveness of governance. By strengthening the relationship among the main actors, an organized system of network management can be achieved. The network has to include all actors from different levels, from policy-making to implementation. The network also has to clarify the tasks from identifying the poor to covering costs. From an academic perspective, this study showed the adequacy of network analysis as a tool for policy sciences. Governance in our optimal health financial protection model follows the shared-governance pattern due to its high density, low centralization and low distance. The model of network governance can be the source of changes in the health governance system. It is a necessary structural condition to provide access to universal health coverage.


Assuntos
Política de Saúde , Formulação de Políticas , Apoio Financeiro , Humanos , Irã (Geográfico) , Rede Social
12.
J Law Med Ethics ; 49(1): 139-151, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33966651

RESUMO

Based on hierarchical classification and logistic regression of early US and French COVID-19 clinical trials we show that despite the registration of a large number of trials, only a minority had characteristics usually associated with providing robust and relevant evidence.


Assuntos
COVID-19/prevenção & controle , Ensaios Clínicos como Assunto , Projetos de Pesquisa/normas , Apoio Financeiro , França/epidemiologia , Humanos , Disseminação de Informação , SARS-CoV-2 , Estados Unidos/epidemiologia
13.
J Evid Based Dent Pract ; 21(1): 101524, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-34051953

RESUMO

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Vegetarian diet and its possible influence on dental health: A systematic literature review. Community Dent Oral Epidemiol. Smits KPJ, Listl S, Jevdjevic M. 2020; 48(1):7-13. SOURCE OF FUNDING: No financial support. TYPE OF STUDY/DESIGN: Systematic review with meta-analysis.


Assuntos
Cárie Dentária , Dieta Vegetariana , Apoio Financeiro , Humanos
16.
Artigo em Inglês | MEDLINE | ID: mdl-33922470

RESUMO

The intentional integration of physical activity in elementary school classrooms-including brief instructional breaks for activity, or integration into lessons-can benefit children's physical activity and education outcomes. Teachers are key implementation agents, but despite physical activity in the classroom being an evidence-informed practice, many teachers do not regularly implement it. The aim of this study was to obtain updated nationally representative prevalence estimates in United States public elementary schools, regarding four key outcomes: (1) school adoption of physically active lessons (PA lessons); (2) school adoption of physical-activity breaks (PA breaks); (3) penetration in the classroom, defined as ≥50% of teachers using PA breaks; and (4) dose, defined as an average of at least 50 min per week of PA breaks. We examined variations in outcomes by school demographic characteristics, and by three factors hypothesized to be implementation facilitators (administrative support, financial resources, and presence of a wellness champion at the school). In the 2019-20 school year, surveys were distributed to a nationally representative sample of 1010 public elementary schools in the US; responses were obtained from 559 (55.3%). The weighted prevalence of schools reporting adoption of PA lessons was 77.9% (95% CI = 73.9% to 81.9%), and adoption of PA breaks was nearly universal at 91.2% (95% CI = 88.4% to 94.1%). Few demographic differences emerged, although adoption of PA lessons was less prevalent at higher-poverty schools (73.9%) and medium-poverty schools (77.0%) as compared to schools with lower poverty levels (87.1%; p < 0.01). Across all four outcomes, associations emerged with facilitators in multivariable logistic regression models. The prevalence of adoption of PA lessons, adoption of PA breaks, and dose of PA breaks were all significantly higher at schools where administrative encouragement occurred more frequently. Financial support was associated with implementation outcomes, including adoption of PA lessons, and penetration and dose of PA breaks. Presence of a champion was associated with higher prevalence of reporting adoption of PA lessons. School leaders can play a crucial role in supporting teachers' implementation of PA breaks and lessons in the classroom, through providing financial resources, encouragement, and supporting champions. Effective school-leadership practices have the potential to positively impact students at a large-scale population level by supporting implementation of PA lessons and breaks.


Assuntos
Exercício Físico , Instituições Acadêmicas , Criança , Apoio Financeiro , Promoção da Saúde , Humanos , Serviços de Saúde Escolar , Estudantes , Inquéritos e Questionários
17.
Artigo em Inglês | MEDLINE | ID: mdl-33806105

RESUMO

To improve and plan regional suicide prevention programmes that utilise more cost-effective governmental financial support compared with previous programmes, the present study determined the effects of the amount of financial support provided for regional suicide prevention programmes, such as the Emergency Fund to Enhance Community-Based Suicide Countermeasures (EFECBSC), on the trends of suicide mortalities caused by six major suicide motives between 2009 and 2018, using forward multiple regression analysis. The ranking order of motives for male suicide was health, economy, family, employment, romance and school (in that order), whereas the ranking order for females was health, family, economy, romance, employment and school. Male suicide mortality caused by economy-related motives was significantly/inversely related to prefectural intervention programmes, whereas mortality caused by health-related motives was also significantly/inversely related to prefectural intervention programmes, but significantly/positively related to prefectural personal consultation support programmes. Contrary to males, female suicide mortality caused by health-related motives was significantly/inversely related to the municipal development programmes of leaders/listeners, whereas mortality caused by family- and school-related motives was significantly/positively related to prefectural and municipal telephone consultation support programmes, respectively. Contrary to our expectations, school-aged female suicide mortality caused by school-related motives was significantly/positively related to prefectural personal consultation support, enlightenment and municipal telephone consultation support programmes. These results indicate that Japanese regional suicide prevention programmes probably affect the suppression of male suicide mortality. However, these programmes are possibly ineffective, or at least partially, have an adverse effect, in regard to the suicide mortalities of female and school-aged populations. Therefore, we should work to improve regional suicide prevention programmes, making them more cost-effective and targeted towards female and school-aged populations in the future.


Assuntos
Motivação , Suicídio , Criança , Feminino , Apoio Financeiro , Governo , Humanos , Japão/epidemiologia , Masculino , Encaminhamento e Consulta , Suicídio/prevenção & controle , Telefone
18.
Med Sci Monit ; 27: e929280, 2021 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-33824264

RESUMO

BACKGROUND In addition to sociodemographic and COVID-19- related factors, the needs of school support, including material, psychological and information support, have seldom been discussed as factors influencing anxiety and depression among college students during the COVID-19 pandemic. MATERIAL AND METHODS In this cross-sectional study, 3351 college students from China were surveyed through questionnaires about their sociodemographic and COVID-19 characteristics, the needs of school support, and their experiences with anxiety and depression. RESULTS Anxiety and depression were reported by 6.88% and 10.50% of students, respectively. Married, higher education, non-medical, and urban students had significantly higher risks of anxiety or depression. Additionally, symptoms such as cough and fever, especially when following a possible contact with suspected individuals, quarantine history of a personal contact, going out 1-3 times a week, not wearing a mask, and spending 2-3 hours browsing COVID-19-related information were significantly associated with the occurrence of anxiety or depression. Those who used methods to regulate their emotional state, used a psychological hotline, and who had visited a psychiatrist showed higher anxiety or depression. Those who used online curricula and books, used preventive methods for COVID-19, and who had real-time information about the epidemic situation of the school showed lower anxiety and depression. CONCLUSIONS In addition to sociodemographic and COVID-19-related aspects, students' needs for psychological assistance and information from schools were also associated with anxiety and depression among college students.


Assuntos
Ansiedade/epidemiologia , COVID-19/psicologia , Depressão/epidemiologia , Instituições Acadêmicas/organização & administração , Estudantes/psicologia , Adolescente , Adulto , Ansiedade/prevenção & controle , Ansiedade/psicologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , China/epidemiologia , Controle de Doenças Transmissíveis/normas , Estudos Transversais , Depressão/prevenção & controle , Depressão/psicologia , Feminino , Apoio Financeiro , Educação em Saúde/organização & administração , Educação em Saúde/estatística & dados numéricos , Linhas Diretas/organização & administração , Linhas Diretas/estatística & dados numéricos , Humanos , Disseminação de Informação , Masculino , Saúde Mental , Pandemias/prevenção & controle , Prevalência , Sistemas de Apoio Psicossocial , Instituições Acadêmicas/economia , Instituições Acadêmicas/normas , Fatores Socioeconômicos , Estudantes/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Adulto Jovem
20.
PLoS One ; 16(4): e0250000, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33909670

RESUMO

A significant body of multi-disciplinary research supports the proposition that women may experience empowerment from microfinance programs. This is based on the assumption that an increase in women's financial contribution to the household helps to transform gender norms and relations which increases their decision-making power. However, the relationship between the strength and persistence of patriarchal gender norms within the household and women's financial empowerment needs further exploration. This paper presents the findings of a mixed-method study comprising 331 surveys and 33 in-depth interviews with women receiving microfinance and their husbands in a southern sub-district of Bangladesh; it draws upon gender socialisation and gender performance theory to understand how patriarchal gender norms influence women's financial empowerment in households receiving microfinance. Findings demonstrate that participation in microfinance programs has not shifted gender norms, nor financially empowered women. Women's loans were largely controlled by men as prescribed by underlying, unchanged patriarchal gender norms. The inter-generational reproduction of patriarchal gender relations continued to reproduce a strict gendered division of labour that reinforced restrictions on women's behaviour, mobility, and decision-making domains, and men's dominance in household and economic decision-making.


Assuntos
Empoderamento , Apoio Financeiro , Cônjuges/psicologia , Adulto , Bangladesh , Tomada de Decisões , Características da Família , Feminino , Identidade de Gênero , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , População Rural , Inquéritos e Questionários
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