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1.
Sci Total Environ ; 802: 149716, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34455272

RESUMO

Fossil fuels have been the major source of electricity supply in the United States of America (USA) for many decades. While a significant shift has occurred from coal-dominated supply to natural gas and renewable source based supplies in recent decades, there is still large potential to improve biomass supported electricity contribution in rural communities, which depend majorly on forest-related activities. Wood waste, an underutilized renewable resource, has the potential for electricity generation in rural areas to reduce the contribution of electricity generated from fossil fuels and assist in greenhouse gas savings. In this study, a life cycle assessment approach was used to estimate the emissions of electricity generated by wood residues in a rural community (Grenada County, Mississippi (MS), USA) and compared with those emissions from the recent electricity mix (2018), a previous electricity mix (2010) supply, along with natural gas (NG) and coal (Bituminous Coal, BC) based electricity generation options. A significant reduction (85.9-94.6%) in global warming impact was observed when compared with BC, NG and grid supplied electricity for years 2010 and 2018. When compared to the current electricity mix at the grid (2018), acidification, eutrophication, respiratory effects and smog formation showed higher emissions ranging from 30.8% to 72.4%. The sensitivity analysis showed an improvement in emissions savings with increased biomass to power conversion efficiency (40%), lower moisture content of the biomass (0%, bone dry biomass), and reduced transportation distance (35 km). This study showed an improvement in the electricity mix supplied to Grenada county, MS, which implies sustainable development opportunities for promoting energy security in rural communities with forest-based industries.


Assuntos
Eletricidade , População Rural , Biomassa , Florestas , Granada , Humanos , Mississippi , Estados Unidos
2.
Chemosphere ; 286(Pt 2): 131833, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34426128

RESUMO

Due to the poor living and healthcare conditions, preterm birth (PTB) in rural population is a pressing health issue. However, PTB studies in rural population are rare. To explore the effects of air pollutants on PTB in rural population, we collected 697,316 medical records during 2014-2016 based on the National Free Preconception Health Examination Project. Logistic regression models were used to estimate the association between air pollutants and PTB and the modifying effects of demographic characteristics. Relative contribution and principal component analysis-generalized linear model (PCA-GLM) analysis were used to explore the most significant air pollutant and gestational period. Our results demonstrated that PTB risk is positively associated with exposure to air pollutants including PM10, PM2.5, SO2, NO2, and CO, while negatively associated with O3 exposure (P < 0.05). In addition, we found that NO2 was the largest contributor to the risk of PTB caused by air pollutants (26.5%). The third trimester of pregnancy was the most sensitive exposure window. PCA-GLM analysis showed that the first component (a combination of PM, SO2, NO2, and CO) increased the risk of PTB. Moreover, we found that rural women who are younger, had higher educated, multi-parity, or smoke appeared to be more sensitive to the association between air pollutants exposure and PTB (P-interaction<0.05). Our findings suggested that increased air pollutants except O3 were associated with elevated PTB risk, especially among vulnerable mothers. Therefore, the effects of air pollutants exposure on PTB should be mitigated by restricting emission sources of NO2 and SO2 in rural population, especially during the third trimester.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Nascimento Prematuro , Efeitos Tardios da Exposição Pré-Natal , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/toxicidade , Poluição do Ar/análise , Poluição do Ar/estatística & dados numéricos , China/epidemiologia , Feminino , Humanos , Recém-Nascido , Exposição Materna/estatística & dados numéricos , Material Particulado/análise , Material Particulado/toxicidade , Gravidez , Nascimento Prematuro/induzido quimicamente , Nascimento Prematuro/epidemiologia , População Rural
3.
Chemosphere ; 286(Pt 1): 131634, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34325266

RESUMO

One contemporary issue is how environmental pollution and climate can affect the dissemination and severity of COVID-19 in humans. We documented the first case of association between particulate matter ≤2.5 µm (PM2.5) and COVID-19 mortality rates that involved rural and medium-sized municipalities in northwestern Mexico, where direct air quality monitoring is absent. Alternatively, anthropogenic PM2.5 emissions were used to estimate the PM2.5 exposure in each municipality using two scenarios: 1) considering the fraction derived from combustion of vehicle fuel; and 2) the one derived from modeled anthropogenic sources. This study provides insights to better understand and face future pandemics by examining the relation between PM2.5 pollution and COVID-19 mortality considering the population density and the wind speed. The main findings are: (i) municipalities with high PM2.5 emissions and high population density have a higher COVID-19 mortality rate; (ii) the exceptionally high COVID-19 mortality rates of the rural municipalities could be associated to dust events, which are common in these regions where soils without vegetation are dominant; and (iii) the influence of wind speed on COVID-19 mortality rate was evidenced only in municipalities with <100 inhabitants per km2. These results confirm the suggestion that high levels of air pollutants associated with high population density and an elevated frequency of dust events may promote an extended prevalence and severity of viral particles in the polluted air of urban, suburban, and rural communities. This supports an additional means of dissemination of the coronavirus SARS-CoV-2, in addition to the direct human-to-human transmission.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , COVID-19 , Poluentes Atmosféricos/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Cidades , Poeira/análise , Monitoramento Ambiental , Humanos , Material Particulado/análise , Densidade Demográfica , População Rural , SARS-CoV-2 , Vento
4.
Ann Ig ; 34(1): 70-78, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34698763

RESUMO

Background: Pregnancy is a unique experience in a woman's life, which comes with physiological, metabolic, social, and psychological changes. The combination of these changes along with migration, may reduce the quality of life of pregnant women and mothers. This study aims to determine the quality of life in rural pregnant women. Methods: A cross-sectional study was conducted. Three hundred pregnant Iranian and Afghan women who attended the public health centers in regional Tehran, Iran, were systematically selected and included in the study. Different dimensions of health status were investigated using the standard health-related quality of life questionnaire (SF-26) through interviews. SPSS version 23 was used for data analysis. Results: The psychological health subscale (38.00) in the Iranian pregnant women and the physical health subscale (38.83) in the Afghan pregnant women had the highest scores. The lowest score was in social functioning subscale in both groups (20.59 in Iranian and 21.22 in Afghans). In general, Iranian mothers had lower scores compared to Afghan mothers. There was a relationship between the quality of life of Iranian pregnant women, their level of education and family's monthly income (P <0.05), and between the quality of life of Afghan pregnant women with the lesser number of pregnancies (P <0.05). Conclusions: In rural Iran, the quality of life score and its subscales is comparably low in both Iranian and Afghan pregnant women. Interventions are needed to improve the quality of life in this vulnerable population.


Assuntos
Gestantes , Qualidade de Vida , Estudos Transversais , Feminino , Humanos , Irã (Geográfico) , Gravidez , População Rural
5.
Philos Trans A Math Phys Eng Sci ; 380(2214): 20210123, 2022 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-34802276

RESUMO

Sociocentric network maps of entire populations, when combined with data on the nature of constituent dyadic relationships, offer the dual promise of advancing understanding of the relevance of networks for disease transmission and of improving epidemic forecasts. Here, using detailed sociocentric data collected over 4 years in a population of 24 702 people in 176 villages in Honduras, along with diarrhoeal and respiratory disease prevalence, we create a social-network-powered transmission model and identify super-spreading nodes as well as the nodes most vulnerable to infection, using agent-based Monte Carlo network simulations. We predict the extent of outbreaks for communicable diseases based on detailed social interaction patterns. Evidence from three waves of population-level surveys of diarrhoeal and respiratory illness indicates a meaningful positive correlation with the computed super-spreading capability and relative vulnerability of individual nodes. Previous research has identified super-spreaders through retrospective contact tracing or simulated networks. By contrast, our simulations predict that a node's super-spreading capability and its vulnerability in real communities are significantly affected by their connections, the nature of the interaction across these connections, individual characteristics (e.g. age and sex) that affect a person's ability to disperse a pathogen, and also the intrinsic characteristics of the pathogen (e.g. infectious period and latency). This article is part of the theme issue 'Data science approach to infectious disease surveillance'.


Assuntos
Portador Sadio , População Rural , Surtos de Doenças , Humanos , Estudos Retrospectivos , Rede Social
6.
Infectio ; 25(4): 256-261, oct.-dic. 2021. tab, graf
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1286719

RESUMO

Resumen Objetivo: Determinar los factores de riesgo en adultos con COVID-19 en población rural andina durante 2020. Métodos: En este estudio de cohorte retrospectivo multicéntrico, incluimos a 184 pacientes adultos (≥18 años) con pruebas serológicas y moleculares para CO VID-19 de tres hospitales de la sierra peruana (Ancash y Apurímac) incluidos con sospecha clínica entre abril y junio. Se utilizó análisis descriptivos y regresión logística univariable para explorar los factores de riesgo asociados a los pacientes con COVID-19. Resultados: Del total de pacientes, 14 (7.6%) tuvieron SARS-CoV-2. En los pacientes infectados 12 (85.7%) fueron varones con promedio de edad de 47.3±21 años. Las comorbilidades estuvieron presentes en cerca de la tercera parte de pacientes, siendo la hipertensión y diabetes las más frecuentes (ambas 14.3%), y la sinto matología más frecuentes fueron fiebre y cefalea (57.2%). La regresión univariable mostró mayores probabilidades de infección con SARS-CoV-2 en la población rural andina asociada con la edad avanzada (OR: 1.1 IC95% 0.7-1.8; p=0,019), comorbilidades previas (OR: 1.7, IC95% 0.32-9.39; p=0,006), y sintomatología previa (OR: 49.8, IC95% 5.6-436.9; p=0,0011). Conclusiones: Los posibles factores de riesgo como la edad avanzada, las comorbilidades y sintomatología previas están relacionados con el desarrollo de CO VID-19 en población rural andina de Perú.


Abstract Objective: To determine the risk factors in adults with COVID-19 in the rural Andean population during 2020. Methods: This multicenter retrospective cohort study included 184 adult patients (≥18 years) with COVID-19's serological and molecular tests from three Hospitals in the Peruvian mountains (Ancash and Apurímac) included with clinical suspicion between April and June. Descriptive analysis and univariate logistic regression were used to explore the risk factors associated with patients with COVID-19. Results: Of total of patients, 14 (7.6%) had a SARS-CoV-2. In infected patients 12 (85.7%) were men with an average age of 47.3±21 years. Comorbidities were present in about a third of patients, with hypertension and diabetes being the most frequent (both 14.3%), and the most frequent symptoms were fever and hea dache (57.2%). Univariate regression showed higher probabilities of infection with SARS-CoV-2 in the rural Andean population associated with advanced age (OR: 1.1 95% CI 0.7 - 1.8; p = 0.019), previous comorbidities (OR: 1.7, 95%CI 0.32 - 9.39; p = 0.006), and previous symptoms (OR: 49.8, 95%CI 5.6 - 436.9; p = 0.0011). Conclusions: Possible risk factors such as advanced age, comorbidities and previous symptoms are related to the development of COVID-19 in the rural Andean population of Peru.


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , COVID-19 , Peru , População Rural , Fatores de Risco , Estudos de Coortes , SARS-CoV-2 , Cefaleia , Hospitais , Hipertensão , Infecções
7.
J Cross Cult Gerontol ; 36(4): 347-368, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34748119

RESUMO

Compared with western countries, research on homelessness among older people in developing nations is minimal. Unlike in Global North nations that offer income security in late-life, in areas like Sub-Saharan Africa abject poverty contributes to older adults migrating from rural areas to urban centers in search of a means of livelihood. The aim of this study was to explore the challenges faced by homeless older rural-urban migrants in Kobo Town, Ethiopia. This cross-sectional study employed a qualitative descriptive case study. Purposive sampling was used to identify ten older adult migrants who had been homeless for more than a year. Data from in-depth interviews was supplemented with key informant interviews, observation, and document review. The narrative data was analyzed using thematic analysis. Study results revealed that homeless elders faced multiple challenges including lack of necessities such as food, shelter, and water, mobility issues, lack of employment access, social exclusion, and psychological struggles. The findings call attention to the need for practical access to social and economic empowerment responses to prevent and curb homelessness among older adults in developing nations.


Assuntos
Pessoas em Situação de Rua , Migrantes , Idoso , Estudos Transversais , Etiópia , Humanos , População Rural
8.
Rural Remote Health ; 21(4): 6770, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34757760

RESUMO

CONTEXT: The COVID-19 pandemic led to several changes to methadone treatment protocols at federal opioid treatment programs in the USA. ISSUE: Protocol changes were designed to reduce transmission of COVID-19 while allowing for continuity of care, but those changes also demonstrated that many policies surrounding opioid use disorder care in the USA cause unnecessary burdens to patients. In this commentary, we describe how current policies create and maintain fatal barriers to methadone treatment for people in rural communities who have opioid use disorder, and highlight how COVID-19 adaptations and more flexible methadone models in other countries can better allow for effective and accessible care. Reasons and ways to address these issues to create lasting solutions for rural communities are discussed. LESSONS LEARNED: We focus on three lessons: (1) methadone dispensing and take-home schedules during COVID-19, (2) telehealth services during COVID-19, and (3) international models in use prior to COVID-19. We then outline recommendations for each lesson to improve access to methadone treatment long term for rural communities in the USA. There is an urgent need to implement recommendations that maintain flexible approaches and address methadone treatment barriers in the rural USA. To achieve lasting health policy change and combat stigma about addiction and methadone treatment, there is a need for advocacy efforts that give voice to rural residents impacted by inequitable access to methadone treatment and rural-tailored educational initiatives that promote the evidence base for methadone. We hope opioid treatment program directors, regulatory authorities, and health policymakers consider our recommendations.


Assuntos
COVID-19/psicologia , Atenção à Saúde/organização & administração , Acesso aos Serviços de Saúde , Metadona/uso terapêutico , Tratamento de Substituição de Opiáceos/estatística & dados numéricos , Transtornos Relacionados ao Uso de Opioides/reabilitação , População Rural , COVID-19/epidemiologia , Humanos , Tratamento de Substituição de Opiáceos/métodos , Transtornos Relacionados ao Uso de Opioides/psicologia , Pandemias , SARS-CoV-2 , Estados Unidos
9.
Environ Monit Assess ; 193(12): 795, 2021 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-34773150

RESUMO

A water safety plan (WSP) has been developed for rural water supply in Dehradun district, Uttarakhand, India. Four public water utilities were chosen to demonstrate the application of WSP in improving the rural drinking water quality along with improved sanitation. Hazard identification and risk assessment carried out identified 10 hazardous events at all four utilities. Intermittent water supply, poor repair and maintenance of the supply channel machinery, and individual household sanitation practices were the potential sources of contamination. The study showed encouraging results, where the evaluated risks decreased substantially after implementing the control measures, along with improved water quality after WSP implementation which showed statistically significant results (p < .05) for all tested parameters, namely, turbidity (p = .000), total dissolved solids (p = .004), residual-free chlorine (p = .004), total coliforms (p = .000), and fecal coliforms (p  = .003). The sanitation condition of water source and households also improved by adopting the suggested measures. The study recommends water safety planning, to empower the rural communities to safeguard their water sources, and for sustainable water supply management.


Assuntos
Água Potável , População Rural , Monitoramento Ambiental , Humanos , Índia , Medição de Risco , Qualidade da Água , Abastecimento de Água
10.
Geospat Health ; 16(2)2021 10 28.
Artigo em Inglês | MEDLINE | ID: mdl-34726036

RESUMO

Pre-hospital care is provided by emergency medical services (EMS) staff, the initial health care providers at the scene of disaster. This study aimed to describe the characteristics of EMS callers and space-time distribution of emergency requests in a large urban area. Descriptive thematic maps of EMS requests were created using an empirical Bayesian smoothing approach. Spatial, temporal and spatio-temporal clustering techniques were applied to EMS data based on Kulldorff scan statistics technique. Almost 225,000 calls were registered in the EMS dispatch centre during the study period. Approximately two-thirds of these calls were associated with an altered level of patient consciousness, and the median response time for rural and urban EMS dispatches was 12.2 and 10.1 minutes, respectively. Spatio-temporal clusters of EMS requests were mostly located in central parts of the city, particularly near the downtown area. However, high-response time clustered areas had a low overlap with these general, spatial clusters. This low convergence shows that some unknown factors, other than EMS requests, influence the high-response times. The findings of this study can help policymakers to better allocate EMS resources and implement tailored interventions to enhance EMS system in urban areas.


Assuntos
Desastres , Serviços Médicos de Emergência , Teorema de Bayes , Humanos , População Rural
11.
PLoS One ; 16(11): e0259538, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34731188

RESUMO

During the COVID-19 pandemic, West Virginia developed an aggressive SARS-CoV-2 testing strategy which included utilizing pop-up mobile testing in locations anticipated to have near-term increases in SARS-CoV-2 infections. This study describes and compares two methods for predicting near-term SARS-CoV-2 incidence in West Virginia counties. The first method, Rt Only, is solely based on producing forecasts for each county using the daily instantaneous reproductive numbers, Rt. The second method, ML+Rt, is a machine learning approach that uses a Long Short-Term Memory network to predict the near-term number of cases for each county using epidemiological statistics such as Rt, county population information, and time series trends including information on major holidays, as well as leveraging statewide COVID-19 trends across counties and county population size. Both approaches used daily county-level SARS-CoV-2 incidence data provided by the West Virginia Department Health and Human Resources beginning April 2020. The methods are compared on the accuracy of near-term SARS-CoV-2 increases predictions by county over 17 weeks from January 1, 2021- April 30, 2021. Both methods performed well (correlation between forecasted number of cases and the actual number of cases week over week is 0.872 for the ML+Rt method and 0.867 for the Rt Only method) but differ in performance at various time points. Over the 17-week assessment period, the ML+Rt method outperforms the Rt Only method in identifying larger spikes. Results show that both methods perform adequately in both rural and non-rural predictions. Finally, a detailed discussion on practical issues regarding implementing forecasting models for public health action based on Rt is provided, and the potential for further development of machine learning methods that are enhanced by Rt.


Assuntos
COVID-19/epidemiologia , Previsões/métodos , Aprendizado de Máquina , Teste para COVID-19/estatística & dados numéricos , Humanos , Incidência , Modelos Estatísticos , Valor Preditivo dos Testes , População Rural , West Virginia/epidemiologia
12.
Int J Public Health ; 66: 592043, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34744561

RESUMO

Objectives: The study aimed to explore the association between Ideal cardiovascular health (ICH) and health-related quality of life (HRQoL) using the European Quality of Life Five Dimension Five Level Scale (EQ-5D-5L) among rural population. Methods: This study included 20,683 participants aged 18-79 years from "the Henan Rural Cohort study". Generalized linear and Tobit regression models were employed to explore the associations of ICH with EQ-5D-5L utility scores and visual analogue scale (VAS) scores, respectively. Results: The mean EQ-5D-5L utility scores and VAS scores were 0.962 ± 0.095 and 79.52 ± 14.02, respectively. Comparing with poor CVH participants (EQ-5D-5L utility scores and VAS scores: 0.954 ± 0.111 and 78.44 ± 14.29), people with intermediate and ideal CVH had higher EQ-5D-5L utility scores (0.969 ± 0.079 and 0.959 ± 0.099) and VAS scores (80.43 ± 13.65 and 79.28 ± 14.14). ICH scores were positively correlated with EQ-5D-5L utility scores (0.007 (0.004, 0.009)) and VAS scores (0.295 (0.143, 0.446)), respectively. Conclusions: Higher ICH scores is positive associated with better HRQoL in rural population, which suggests that improvement of cardiovascular health may help to enhance HRQoL among rural population.


Assuntos
Doenças Cardiovasculares , Qualidade de Vida , Adolescente , Adulto , Idoso , Doenças Cardiovasculares/epidemiologia , China/epidemiologia , Estudos Transversais , Humanos , Pessoa de Meia-Idade , População Rural/estatística & dados numéricos , Adulto Jovem
13.
Pan Afr Med J ; 39: 277, 2021.
Artigo em Francês | MEDLINE | ID: mdl-34754354

RESUMO

Introduction: malnutrition due to inadequate food supply is a major challenge in low- and middle-income countries. The purpose of this study is to identify the sociocultural drivers of malnutrition. Methods: we conducted a qualitative study in the Amoron´I Mania region, Madagascar. The study involved pregnant women, mothers and fathers, grandmothers and health actors such as "matrones", community workers and health workers. A total of 24 semi-structured individual interviews and 6 focus groups were used to collect data. Thematic analysis was used. Results: malnutrition refers to a lack of food and undernourishment. It revolves around the amount of rice consumption, socio-cultural factors and insufficient financial resources. Vulnerable groups were mainly composed of children and pregnant women. Severe malnutrition including signs was reported, but there was evidence for local adaptation. Thus, families were trying by different means to fight against malnutrition. Conclusion: the socio-cultural context modulates knowledge and perception of the causes, the manifestations and the vulnerability or non-vulnerability of an individual as well as the severity of malnutrition.


Assuntos
Abastecimento de Alimentos , Conhecimentos, Atitudes e Prática em Saúde , Desnutrição/epidemiologia , População Rural/estatística & dados numéricos , Adolescente , Adulto , Idoso , Feminino , Grupos Focais , Pessoal de Saúde/estatística & dados numéricos , Humanos , Entrevistas como Assunto , Madagáscar/epidemiologia , Masculino , Desnutrição/fisiopatologia , Pessoa de Meia-Idade , Percepção , Gravidez , Pesquisa Qualitativa , Índice de Gravidade de Doença , Populações Vulneráveis/estatística & dados numéricos , Adulto Jovem
14.
Artigo em Inglês | MEDLINE | ID: mdl-34770111

RESUMO

Differences in economic development, public services, production, and lifestyle between urban and rural areas lead to significant differences in people's attitudes and abilities to cope with environmental pollution. Furthermore, environmental pollution has heterogeneous effects on the health of individuals in urban and rural areas. The article takes the health of left-behind children as an entry point to analyze the impact of haze pollution on the health of urban and rural left-behind children. Using children's survey data from the China Health and Nutrition Survey and the urban and rural raster PM2.5 data from 2000 to 2015, this study applies a logit model to analyze the heterogeneity of the impact of haze pollution on the health of left-behind children. This research finds that, first, the health effects of haze pollution on rural left-behind children are more severe than those on rural children not left behind. Moreover, the same results are not present in the sample of urban left-behind children. Second, the health of left-behind children is more vulnerable to haze pollution than the others when neither parent is at home in rural areas. Third, no evidence proves that haze pollution has more severe health effects on rural children aged 0-6 years with parents away from home. Meanwhile, haze pollution will more easily influence the health status of left-behind children aged 7 years and above in rural areas due to their parents' absence. Fourth, the finding that haze pollution significantly affects the health of left-behind children with parents away from home only applies to the central and western rural samples in China.


Assuntos
Poluição Ambiental , População Rural , Criança , China , Desenvolvimento Econômico , Humanos , Inquéritos e Questionários
15.
Artigo em Inglês | MEDLINE | ID: mdl-34770145

RESUMO

Optimising the layout of garbage bins is a requirement for improving the utilisation efficiency of rural infrastructure and continuously promoting the renovation of rural human settlements in China. This study selects Yuding Village in Chongqing, China, as the study area. The present distribution of garbage bins and the existing problems are analysed on the basis of interview materials and the point on interest data of garbage bins obtained from an on-the-spot investigation. Actor network theory (ANT) is suitable for small-scale micro research, and thus, this study uses ANT to construct a research framework for garbage bin layout optimisation. Then, it designs an optimisation path for the layout of garbage bins in Yuding Village by identifying different actors and their common interests, classifying the transformation of roles amongst various actors and building a stable heterogeneous network that can be used as a guide for determining the optimal spatial layout of garbage bins. This study combines a sociological theory with geospatial phenomena, providing a new idea for studying the optimal layout of infrastructure.


Assuntos
Resíduos de Alimentos , China , Humanos , População Rural
17.
J Pak Med Assoc ; 71(11): 2648-2651, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34783752

RESUMO

A functional referral system for addressing health emergencies requires coordinated efforts by health system's stakeholders and the community. Using the Rural Health Programme (RHP) Thatta as a platform provided by an academic institution, district health system stakeholders and the community of Mirpur Sakro, taluka of Thatta, were engaged to strengthen the referral system for health emergencies through active community engagement. Through consultations with stakeholders, a referral system plan was developed with community volunteers from each village as focal persons for transportation, referring patients to health facilities and maintaining referral documentation. The stakeholders' experience and perceptions about the referral system were assessed through qualitative in-depth interviews. Patients' experiences of referral system improved with enhanced transport availability, but they faced structural challenges, including out of pocket transport expenses, weak back-referral links, lack of trust between the community and healthcare providers and poor availability of medicines.


Assuntos
Emergências , População Rural , Instalações de Saúde , Humanos , Paquistão , Pesquisa Qualitativa , Encaminhamento e Consulta
18.
Acad Pediatr ; 21(8S): S126-S133, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34740419

RESUMO

Nearly 1 in 5 children in the United States live in rural areas. Rural children experience health and health care disparities compared to their urban peers and represent a unique and vulnerable pediatric patient population. Important disparities exist in all-cause mortality, suicide, firearm-related unintentional injury, and obesity. Rural children experience decreased availability and accessibility of primary care and specialty care (especially mental health care) due to a decreased number of health care providers as well as geographical and transportation-related barriers. Other geographic and socioeconomic determinants, especially concerning poverty and substandard housing conditions, are likely important contributors to the observed health disparities. Increased funding for research focused on rural populations is needed to provide innovative solutions for the unique health needs of rural children. Policy changes positioned to correct the trajectory of poor health among children should consider the needs of rural children as an under-researched and under-resourced vulnerable population.


Assuntos
Pobreza , População Rural , Criança , Acesso aos Serviços de Saúde , Disparidades em Assistência à Saúde , Humanos , Fatores Socioeconômicos , Estados Unidos/epidemiologia , População Urbana , Populações Vulneráveis
19.
Reprod Health ; 18(1): 220, 2021 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-34742315

RESUMO

INTRODUCTION: The ministry of health (MOH) of Ethiopia recommends 4 or more focused antenatal care (ANC) visits at health centre (HC) or at a higher level of health facility (HF). In Ethiopia, few studies investigated time dimension of maternal health continuum of care but lack data regarding place dimension and its effect on continuum of care. The aim of this study is to estimate effect of place of ANC-1 visit and adherence to MOH's recommendations of MOH for ANC visits on continuum of care rural in Ethiopia. METHODS: We used data collected from 1431 eligible women included in the National Health Extension Program (HEP) assessment survey that covered 6324 households from 62 woredas in nine regions. The main outcome variable is continuum of care (CoC), which is the uptake of all recommended ANC visits, institutional delivery and postnatal care services. Following descriptive analysis, Propensity Score Matching was used to estimate the effect of place of ANC-1 visit on completion of CoC. Zero inflated Poisson regression was used to model the effect of adherence to MOH recommendation of ANC visits on intensity of maternal health continuum of care. RESULT: Only 13.9% of eligible women completed the continuum of care, and place of first antenatal care (ANC) visit was not significantly associated with the completion of continuum of care (ß = 0.04, 95% CI = -0.02, 0.09). Adherence of ANC visit to the MOH recommendation (at least 4 ANC visits at higher HFs than health posts (HPs)) increased the likelihood of higher intensity of continuum of care (aIRR = 1.29, 95% CI: 1.26, 1.33). Moreover, the intensity of continuum of care was positively associated with being in agrarian areas (aIRR = 1.17, 95% CI: 1.06, 1.29), exposed to HEP (IRR = 1.22, 95% CI: 1.16, 1.28), being informed about danger signs (aIRR = 1.14, 95% CI: 1.11, 1.18) and delivery of second youngest child at HF (IRR = 1.16, 95% CI: 1.13, 1.20). Increasing age of women was negatively associated with use of services (IRR = 0.90, 95% CI: 0.87, 0.94). CONCLUSION: Completion of maternal health continuum of care is very low in Ethiopia, however most of the women use at least one of the services. Completion of continuum of care was not affected by place of first ANC visit. Adherence to MOH recommendation of ANC visit increased the intensity of continuum of care. Intensity of continuum of care was positively associated with residing in agrarian areas, HEP exposure, danger sign told, delivery of second youngest child at health facility. To boost the uptake of all maternal health services, it is crucial to work on quality of health facilities, upgrading the infrastructures of HPs and promoting adherence to MOH recommendations of ANC visit.


Assuntos
Serviços de Saúde Materna , Cuidado Pré-Natal , Etiópia , Feminino , Instalações de Saúde , Humanos , Recém-Nascido , Gravidez , População Rural
20.
Wei Sheng Yan Jiu ; 50(5): 708-715, 2021 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-34749861

RESUMO

OBJECTIVE: To analyze the effects of diabetes mellitus(DM) and pathoglycemia in Chinese children and adolescents in 2016-2017. METHODS: The data originated from Nutrition and Health Survey of Chinese Children and Adolescents in 2016-2017.The multi-stage stratified cluster random sampling method in proportion was used. The subjects were selected from 275 surveillance sites, which were from 31 provinces in nationwide. Dietary survey, medical physical examination and laboratory tests were carried out in 51 902 subjects. Among them, 25 946 subjects were male and 25 956 were female, 26 340 subjects were from urban and 25 596 from rural, there were 23 637, 17 884 and 10 381 subjects in aged 6-10, 11-14 and 15-17, respectively. Factor analysis method was used to obtain the dietary patterns of children and adolescents and two-level Logistic regression model was used to analyze the association of pathoglycemia with dietary patterns, overweight and obesity. RESULTS: The prevalence of pathoglycemia and DM in Chinese children and adolescents were 2.40% and 0.26%, respectively. The prevalence of pathoglycemia(2.83%)and DM(0.32%)in urban areas was higher than that in rural(1.79% and 0.17%)(χ~2=6.90, P<0.01 and χ~2=6.88, P<0.01). The prevalence of pathoglycemia in male(3.00%) higher than that in female(1.71%)(χ~2=78.34, P<0.01). The prevalence of pathoglycemia in 11-14 years old group was the highest(3.35%)while that in 6-10 years old group was the lowest(1.86%)(χ~2=40.85, P<0.01). Two-level Logistic regression model result showed that overweight and obesity, hypertension and dyslipidemia were all associated with pathoglycemia in children and adolescents, with OR values of overweight and obesity were 1.42(95%CI 1.20-1.68) and 1.80(95%CI 1.53-2.13) respectively. The OR values of hypertension and dyslipidemia were 1.74(95%CI 1.53-1.97) and 1.38(95%CI 1.20-1.59), respectively. CONCLUSION: The prevalence of pathoglycemia and DM in Chinese children and adolescents is different in urban and rural, gender and age. Overweight and obesity, hypertension, dyslipidemia is the effects of pathoglycemia in children and adolescents.


Assuntos
Obesidade , Sobrepeso , Adolescente , Criança , China/epidemiologia , Feminino , Humanos , Masculino , Estado Nutricional , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Prevalência , Fatores de Risco , População Rural
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