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1.
Sci Rep ; 11(1): 21368, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34725394

RESUMO

There is a need for wastewater based epidemiological (WBE) methods that integrate multiple, variously sized surveillance sites across geographic areas. We developed a novel indexing method, Melvin's Index, that provides a normalized and standardized metric of wastewater pathogen load for qPCR assays that is resilient to surveillance site variation. To demonstrate the utility of Melvin's Index, we used qRT-PCR to measure SARS-CoV-2 genomic RNA levels in influent wastewater from 19 municipal wastewater treatment facilities (WWTF's) of varying sizes and served populations across the state of Minnesota during the Summer of 2020. SARS-CoV-2 RNA was detected at each WWTF during the 20-week sampling period at a mean concentration of 8.5 × 104 genome copies/L (range 3.2 × 102-1.2 × 109 genome copies/L). Lag analysis of trends in Melvin's Index values and clinical COVID-19 cases showed that increases in indexed wastewater SARS-CoV-2 levels precede new clinical cases by 15-17 days at the statewide level and by up to 25 days at the regional/county level. Melvin's Index is a reliable WBE method and can be applied to both WWTFs that serve a wide range of population sizes and to large regions that are served by multiple WWTFs.


Assuntos
COVID-19/epidemiologia , SARS-CoV-2/genética , População Suburbana , População Urbana , Instalações de Eliminação de Resíduos , Águas Residuárias/virologia , Vigilância Epidemiológica Baseada em Águas Residuárias , Purificação da Água , COVID-19/virologia , Genoma Viral , Humanos , Minnesota/epidemiologia , Prevalência , Prognóstico , RNA Viral/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos , Fatores de Risco
2.
Sci Rep ; 11(1): 21336, 2021 10 29.
Artigo em Inglês | MEDLINE | ID: mdl-34716393

RESUMO

Air quality improvements pollution changes due to COVID-19 restrictions have been reported for many urban developments and large metropolitan areas, but the respective impacts at rural and remote zones are less frequently analysed. This study evaluated air pollution changes across all Portugal (68 stations) considering all urban, suburban and rural zones. PM10, PM2.5, NO2, SO2, ozone was analysed in pre-, during, and post-lockdown period (January-May 2020) and for a comparison also in 2019. NO2 was the most reduced pollutant in 2020, which coincided with decreased traffic. Significant drop (15-71%) of traffic related NO2 was observed specifically during lockdown period, being 55% for the largest and most populated region in country. PM was affected to a lesser degree (with substantial differences found for largely populated areas (Lisbon region ~ 30%; North region, up to 49%); during lockdown traffic-related PM dropped 10-70%. PM10 daily limit was exceeded 50% less in 2020, with 80% of exceedances before lockdown period. SO2 decreased by 35%, due to suspended industrial productions, whereas ozone concentrations slightly (though not significantly) increased (83 vs. 80 µg m-3).


Assuntos
Poluição do Ar/análise , COVID-19/prevenção & controle , Quarentena/métodos , População Rural , SARS-CoV-2 , População Suburbana , População Urbana , Poluentes Atmosféricos/análise , COVID-19/epidemiologia , COVID-19/virologia , Monitoramento Ambiental/métodos , Humanos , Dióxido de Nitrogênio/análise , Ozônio/análise , Material Particulado/análise , Portugal/epidemiologia , Dióxido de Enxofre/análise
3.
Indian J Dent Res ; 32(1): 115-119, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34269248

RESUMO

Background: Grinspan syndrome is characterised by presence of the triad: hypertension, diabetes mellitus (DM) and oral lichen planus (OLP). OLP, seen in hypertension and diabetes mellitus, is caused by drugs used to treat these diseases according to literature, however the incidence of this syndrome in India has not yet been reported anywhere. Hence the present study was conducted with the following objectives: (i) To determine the incidence of Grinspan syndrome amongst tribal and suburban study population of Maharashtra in different gender and age groups (ii) To correlate occurrence of OLP with DM type 2 and hypertension (iii) To find out the number of patients with OLP, DM type 2 and hypertension either alone or in combination. Methods and Material: The present study was conducted on 4681 new patients attending the routine outpatient department (O.P.D.) of the dental hospital between January 2017 and December 2018. Patients with OLP or DM (type-2) or hypertension or any combination of these diseases were included in the present study. Brief case history of each patient was recorded. Data thus collected were analysed using SPSS version 20 for Chi-square test. Results: Grinspan syndrome was found in 1.62% of the study population. Syndrome was seen in 1.02% of female and 0.59% of male. Maximum patient affected by syndrome were in 35-50 years of age group. Conclusions: Incidence of Grinspan syndrome was 1.62%, mainly seen in sub-urban females of 35-50 years and OLP seen in hypertension and diabetes mellitus has different etiology and is not caused by drugs used to treat these diseases.


Assuntos
Líquen Plano Bucal , Estudos Transversais , Feminino , Humanos , Incidência , Índia/epidemiologia , Masculino , População Suburbana
4.
Viruses ; 13(6)2021 06 04.
Artigo em Inglês | MEDLINE | ID: mdl-34200070

RESUMO

The World Health Organisation recommends monitoring the circulation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We investigated anti-SARS-CoV-2 total immunoglobulin (IgT) antibody seroprevalence and in vitro sero-neutralization in Nancy, France, in spring 2020. Individuals were randomly sampled from electoral lists and invited with household members over 5 years old to be tested for anti-SARS-CoV-2 (IgT, i.e., IgA/IgG/IgM) antibodies by ELISA (Bio-rad); the sero-neutralization activity was evaluated on Vero CCL-81 cells. Among 2006 individuals, the raw seroprevalence was 2.1% (95% confidence interval 1.5 to 2.9), was highest for 20- to 34-year-old participants (4.7% (2.3 to 8.4)), within than out of socially deprived area (2.5% vs. 1%, p = 0.02) and with than without intra-family infection (p < 10-6). Moreover, 25% of participants presented at least one COVID-19 symptom associated with SARS-CoV-2 positivity (p < 10-13), with highly discriminant anosmia or ageusia (odds ratio 27.8 [13.9 to 54.5]); 16.3% (6.8 to 30.7) of seropositive individuals were asymptomatic. Positive sero-neutralization was demonstrated in vitro for 31/43 seropositive subjects. Regarding the very low seroprevalence, a preventive effect of the lockdown in March 2020 can be assumed for the summer, but a second COVID-19 wave, as expected, could be subsequently observed in this poorly immunized population.


Assuntos
Anticorpos Antivirais/sangue , COVID-19/epidemiologia , COVID-19/imunologia , SARS-CoV-2/imunologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Teste Sorológico para COVID-19 , Criança , Pré-Escolar , Controle de Doenças Transmissíveis , Estudos Transversais , Feminino , França/epidemiologia , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Masculino , Pessoa de Meia-Idade , Testes de Neutralização , Estudos Soroepidemiológicos , População Suburbana/estatística & dados numéricos , Adulto Jovem
5.
BMC Complement Med Ther ; 21(1): 110, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33794868

RESUMO

BACKGROUND: The use of herbal and dietary supplement (HDS) in health and disease management has gained global attention. HDS are generally accepted by the public and are associated with positive health behaviours. However, several reports have been documented with regards to their potential adverse effects and interaction with conventional medicines. Limited data is currently available on the use of HDS among elderly population in Malaysia. This present study aims to investigate the prevalence of and pattern of HDS use among a sample of community-dwelling elderly in a suburban town in Malaysia. METHODS: A cross-sectional survey was conducted between March and May 2019 among the elderly aged ≥60 years old. The participants with the following criteria were included in the study: aged ≥60 years, residing in Puncak Alam and able to understand Malay or English language. Data were collected using a pre-validated questionnaire. All statistical analysis was conducted using IBM SPSS ver. 23. RESULTS: Overall, 336 out of 400 elderly responded to the survey, achieving a response rate of 84%. This study observed that almost 50% of the respondents were using at least one type of HDS in the past one month of the survey. Among HDS non-users, most of them preferred to use modern medicines (62.6%, 114/182). Among the HDS users, 75.3% (116/154) were using at least one type of modern medicine (prescription or over-the-counter medicine). Multivariate analysis showed that having good to excellent perceived health (adjusted OR = 2.666, 95% CI = 1.592-4.464), having felt sick at least once in the past one month (adjusted OR = 2.500, 95% CI = 1.426-4.383), and lower body mass index (adjusted OR = 0.937, 95% CI = 0.887-0.990) were associated with HDS use. It was noted that only a small percentage of HDS users (16.2%, 25/154) had informed healthcare providers on their HDS use. CONCLUSION: The use of HDS is common among the elderly sampled. Hence, healthcare providers should be more vigilant in seeking information of HDS use for disease management in their elderly patients. Campaigns that provide accurate information regarding the appropriate use of HDS among the elderly are pertinent to prevent misinformation of the products.


Assuntos
Suplementos Nutricionais/estatística & dados numéricos , População Suburbana/estatística & dados numéricos , Idoso , Estudos Transversais , Feminino , Humanos , Vida Independente , Malásia , Masculino , Pessoa de Meia-Idade
6.
BMJ Open ; 11(3): e045427, 2021 03 31.
Artigo em Inglês | MEDLINE | ID: mdl-33789856

RESUMO

OBJECTIVES: This study aimed to determine the lifetime prevalence of male-perpetrated intimate partner violence (IPV), and to assess the association with food insecurity, sociodemographic factors and health risk behaviours in Uganda in the year preceding COVID-19-associated lockdowns. DESIGN: Population-based, cross-sectional household survey. SETTING: Urban, semiurban and rural communities of the Wakiso and Hoima districts in Uganda. PARTICIPANTS: A total of N=2014 males aged 13-80 years participated in the survey. The current study included males who reported having ever been in a sexual union and responded to the IPV questions (N=1314). MEASURES: Data were collected face-to-face from May 2018 to July 2019 using an interviewer-mediated questionnaire. Lifetime IPV perpetration was measured as 'no physical and/or sexual IPV', 'physical' versus 'sexual violence only', and 'physical and sexual violence'. Past-year food insecurity was measured through the Food Insecurity Experience Scale and categorised into 'none', 'low' and 'high'. Multinomial logistic regression was used to determine the crude and adjusted relative risk ratios (aRRRs) of IPV perpetration in relation to self-reported food insecurity, adjusting for sociodemographic and health risk behaviours. RESULTS: The prevalence of self-reported lifetime IPV perpetration was 14.6% for physical and 6.5% for sexual violence, while 5.3% reported to have perpetrated both physical and sexual IPV. Most (75.7%) males reported no food insecurity, followed by low (20.7%) and high (3.6%) food insecurity. In adjusted models, food insecurity was associated with increased risk of having perpetrated both physical and sexual violence (aRRR=2.57, 95% CI 1.52 to 4.32). IPV perpetration was also independently associated with having had more than one lifetime sexual partner and drinking alcohol, but not with education level or religion. CONCLUSION: This study suggests that food insecurity is associated with male IPV perpetration, and more efforts are needed to prevent and mitigate the expected worsening of this situation as a result of the COVID-19 pandemic.


Assuntos
Insegurança Alimentar , Violência por Parceiro Íntimo/estatística & dados numéricos , Parceiros Sexuais/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Humanos , Violência por Parceiro Íntimo/psicologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , População Rural , Autorrelato , População Suburbana , Inquéritos e Questionários , Uganda/epidemiologia , População Urbana , Adulto Jovem
7.
Int J Equity Health ; 20(1): 104, 2021 04 20.
Artigo em Inglês | MEDLINE | ID: mdl-33879174

RESUMO

BACKGROUND: The rising prevalence of type 2 diabetes results in a worldwide public healthcare crisis, especially in low- and middle-income countries (LMICs) with unprepared and overburdened health systems mainly focused on infectious diseases and maternal and child health. Studies regarding type 2 diabetes in LMICs describe specific interventions ignoring a comprehensive analysis of the local factors people see influential to their health. This study aims to meet this research gap by exploring what people with type 2 diabetes in Bolivia need to maintain or improve their health, how important they perceive those identified needs and to what extent these needs are met. METHODS: From March until May 2019, 33 persons with type 2 diabetes from three periurban municipalities of the department of Cochabamba participated in this study. The concept mapping methodology by Trochim, a highly structured qualitative brainstorming method, was used to generate and structure a broad range of perspectives on what the participants considered instrumental for their health. RESULTS: The brainstorming resulted in 156 original statements condensed into 72 conceptually different needs and resources, structured under nine conceptual clusters and four action domains. These domains illustrated with vital needs were: (1) self-management with use of plants and the possibility to measure sugar levels periodically; (2) healthcare providers with the need to trust and receive a uniform diagnosis and treatment plan; (3) health system with opportune access to care and (4) community with community participation in health and safety, including removal of stray dogs. CONCLUSIONS: This study identifies mostly contextual factors like low literacy levels, linguistic problems in care, the need to articulate people's worldview including traditional use of natural remedies with the Bolivian health system and the lack of expertise on type 2 diabetes by primary health care providers. Understanding the needs and structuring them in different areas wherein action is required serves as a foundation for the planning and evaluation of an integrated people centred care program for people with type 2 diabetes. This participative method serves as a tool to implement the often theoretical concept of integrated people centred health care in health policy and program development.


Assuntos
Participação da Comunidade , Atenção à Saúde , Diabetes Mellitus Tipo 2/terapia , Assistência Centrada no Paciente , Bolívia , Feminino , Letramento em Saúde , Pessoal de Saúde , Planejamento em Saúde , Humanos , Masculino , Determinação de Necessidades de Cuidados de Saúde , Autogestão , População Suburbana
8.
Medicine (Baltimore) ; 100(10): e24670, 2021 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-33725826

RESUMO

ABSTRACT: To report the rationale, design, and baseline demographic characteristics of TuYou-County Pediatric Eye study, which mainly aimed to determine the retinal microvascular changes with optical coherence tomography angiography (OCTA) and its association with eye abnormalities in school aged children and adolescents at suburban location in Northern China.TuYou-County Pediatric Eye study was a school-based survey conducted in TuYou-County. Multi-ethnic (Mongol, Han, and Hui) participants will be followed up for 5 years. Standardized ophthalmological examinations include visual acuity, ocular biometry, retinal photography, and OCTA. A questionnaire survey was conducted to collect variables regarding to eye disease such as parental history of eye diseases, near work, outdoor activities, living and eating habits, etc.After sampling, 687 participants were eligible for investigation, and 20 students did not attend the investigation, living 667 (response rate, 97.1%) students completed questionnaires and all ocular examinations. The average age of all participants was 14.9 ±â€Š5.11.TYPE study is the first large-scale school-based multi-ethnic survey in suburban site of Northern China. Continuous identification of retinal microvascular changes with eye diseases will provide new insights into the control related diseases in school-age children and adolescents.


Assuntos
Microvasos/diagnóstico por imagem , Projetos de Pesquisa , Retina/diagnóstico por imagem , Vasos Retinianos/diagnóstico por imagem , Transtornos da Visão/diagnóstico , Adolescente , Angiografia , Criança , China/epidemiologia , Feminino , Humanos , Incidência , Masculino , Prevalência , Instituições Acadêmicas/estatística & dados numéricos , População Suburbana/estatística & dados numéricos , Tomografia de Coerência Óptica , Transtornos da Visão/epidemiologia , Acuidade Visual
9.
PLoS One ; 16(3): e0246502, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33662004

RESUMO

Post-colonial land tenure reforms in emerging countries have partly aimed at poverty reduction through equitable land access. However, the poverty rate keeps rising in rural and peri-urban settings in Sub-Saharan Africa dominated by agricultural activities. This article reviews land tenure reforms in Mali, from the year 2000 to 2017 regarding poverty alleviation and evaluates their impacts on indigenous smallholder farmers, using multiple linear and logistic regression models and local experts' elicitations. The results indicate that the advent of land titles as the only definitive evidence of land ownership, following the reforms, has generally weakened customary land management. Smallholder farmers face several barriers to obtaining land titles, limiting equity in land access and security. This has paved way for land markets marred by irregularities and resulted in colossal loss of agricultural lands, which are the main source of rural livelihood. Thus, the reforms have not yielded the intended poverty reduction outcomes. The study recommends that land transfers must be authorised by a single institution, represented at the various administrative levels, which issues an authentic and incorruptible document using appropriate technology. Moreover, since pro-poor provisions in the reforms usually lack implementing decrees in Mali, political will is key to achieving equitable land access and security.


Assuntos
Agricultura/legislação & jurisprudência , Pobreza/prevenção & controle , Países em Desenvolvimento , Pesquisa Empírica , Feminino , Humanos , Povos Indígenas , Masculino , Mali/etnologia , Pobreza/etnologia , Análise de Regressão , População Rural , Fatores Socioeconômicos , População Suburbana
10.
Drug Alcohol Depend ; 221: 108631, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33647587

RESUMO

BACKGROUND: Despite significant geographical heterogeneity of sociodemographic and clinical characteristics, little is known about potential differences in cannabis use behaviors in U.S. geographic areas. In this study, we examined cannabis use behaviors in large metropolitan, small metropolitan, and nonmetropolitan areas. We focused on interactions between geographic areas and health insurance status and medical cannabis laws (MCL). METHODS: Data came from the 2015-2018 National Survey on Drug Use and Health (NSDUH; N = 171,766 adults; N = 36,175 cannabis users). Weighted chi-squares tests of independence and multivariable Poisson regression models were used to examine study questions. RESULTS: Past-year use was highest in large metropolitan areas (16.08 %). Frequent use was highest among nonmetropolitan area users (48.67 %). Uninsured adults had a higher likelihood of past-year use (RRR = 1.21, 95 % CI = 1.14, 1.29) and frequent use (RRR = 1.27, 95 % CI = 1.14, 1.41), but a lower likelihood of cannabis use disorder (RRR = 0.77, 95 % CI = 0.66, 0.89). Uninsured adults in nonmetropolitan areas had a higher likelihood (RRR = 1.62, 95 % CI = 1.39, 1.88) of past-year use than insured nonmetropolitan area adults. MCL state residency was associated with a higher likelihood of frequent use among nonmetropolitan (RRR = 1.39, 95 % CI = 1.11, 1.74) and small metropolitan users (RRR = 1.30, 95 % CI = 1.15, 1.47). Cannabis use disorder likelihood did not vary by geographic area. CONCLUSIONS: Lack of health insurance and MCL state residency are significant variables affecting cannabis use behaviors in small metropolitan and/or nonmetropolitan areas.


Assuntos
Uso da Maconha/epidemiologia , População Rural/estatística & dados numéricos , População Suburbana/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adolescente , Adulto , Controle de Medicamentos e Entorpecentes/estatística & dados numéricos , Feminino , Geografia , Inquéritos Epidemiológicos , Humanos , Seguro Saúde/estatística & dados numéricos , Masculino , Uso da Maconha/legislação & jurisprudência , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Adulto Jovem
11.
PLoS One ; 16(3): e0248469, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33788827

RESUMO

BACKGROUND: Insulin resistance (IR) has been considered as a therapeutic target in the management of type 2 diabetes mellitus (T2DM). Readily available, simple and low cost measures to identify individuals with IR is of utmost importance for clinicians to plan optimal management strategies. Research on the associations between surrogate markers of IR and routine clinical and lipid parameters have not been carried out in Sri Lanka, a developing country with rising burden of T2DM with inadequate resources. Therefore, we aimed to study the utility of readily available clinical parameters such as age, body mass index (BMI), waist circumference (WC) and triglyceride to high density lipoprotein cholesterol ratio (TG/HDL-C) in the fasting lipid profile in predicting IR in a cohort of patients with newly diagnosed T2DM in Sri Lanka. METHODS AND FINDINGS: We conducted a community based cross sectional study involving of 147 patients (age 30-60 years) with newly diagnosed T2DM in a suburban locality in Galle district, Sri Lanka. Data on age, BMI, WC, fasting plasma glucose (FPG) concentration, fasting insulin concentration and serum lipid profile were collected from each subject. The indirect IR indices namely homeostasis model assessment (HOMA), quantitative insulin sensitivity check index (QUICKI) and McAuley index (MCA) were estimated. Both clinical and biochemical parameters across the lowest and the highest fasting insulin quartiles were compared using independent sample t-test. Linear correlation analysis was performed to assess the correlation between selected clinical parameters and indirect IR indices. The area under the receiver operating characteristic (ROC) curve was obtained to calculate optimal cut-off values for the clinical markers to differentiate IR. BMI (p<0.001) and WC (p = 0.01) were significantly increased whereas age (p = 0.06) was decreased and TG/HDL-C (p = 0.28) was increased across the insulin quartiles. BMI and WC were significantly correlated (p<0.05) with HOMA, QUICKI and MCA. Out of the clinical parameters, age showed a borderline significant correlation with QUICKI and TG/HDL-C showed a significant correlation only with MCA. The area under ROC of BMI was 0.728 (95% CI 0.648-0.809; p<0.001) and for WC, it was 0.646 (95% CI 0.559-0.734; p = 0.003). The optimized cut-off value for BMI and WC were 24.91 kg/m2 and 81.5 cm respectively to differentiate the patients with IR or ID. Study limitations include small sample size due to recruitment of patients only from a limited geographical locality of the country and not totally excluding of the possibility of inclusion of some patients with slowly progressive type 1 DM or Latent onset diabetes of adulthood from the study population. CONCLUSIONS: The results revealed that there was a significant positive correlation between BMI, WC and HOMA while a significant negative correlation with QUICKI and MCA among the cohort of patients with newly diagnosed T2DM. The cut-off values of BMI and WC as 24.91 kg/m2 and 81.5 cm respectively could be used as simple clinical parameters to identify IR in newly diagnosed patients with T2DM. Our results could be beneficial in rational decision making in the management of newly diagnosed patients with T2DM in limited resource settings.


Assuntos
Índice de Massa Corporal , HDL-Colesterol/sangue , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/diagnóstico , Resistência à Insulina , Triglicerídeos/sangue , Circunferência da Cintura , Adulto , Biomarcadores/sangue , Glicemia/análise , Estudos de Coortes , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , Jejum/sangue , Feminino , Humanos , Insulina/sangue , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Sri Lanka/epidemiologia , População Suburbana
12.
Nagoya J Med Sci ; 83(1): 169-182, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33727748

RESUMO

Evaluating the effects of dietary intake on mortality in older populations has become increasingly important in modern aging societies. The objective of the present study was to investigate the associations between food group intakes and all-cause mortality among a young older population. We conducted a prospective study on 1,324 men and 1,338 women aged 64-65 years at baseline who were living in a suburban city from 1996 to 2005. The participants were followed for all-cause mortality from 1996 through 2015 to assess the effects of 17 food group intakes (g) per 1,000 kcal after multivariable adjustments in proportional hazard models. During follow-up (mean: 13.2 years), 339 deaths were registered. In women, total mortality was significantly and inversely associated with the consumption of milk and dairy products and vegetables. The hazard ratios across intake quartiles after multivariable adjustment were 1, 0.70 (95% confidence interval: 0.42-1.17), 0.66 (0.40-1.10), and 0.40 (0.22-0.75) (P for trend = 0.003) for milk and dairy products, and 1, 0.77 (0.46-1.28), 0.83 (0.50-1.38), and 0.42 (0.23-0.78) (P for trend = 0.008) for vegetables. In men, a positive association was found between total mortality and sugar and sweetener consumption (P for trend = 0.038). Higher consumption of milk and dairy products and vegetables was suggested to reduce all-cause mortality in young older women.


Assuntos
Dieta , Alimentos/estatística & dados numéricos , Mortalidade , Agaricales , Idoso , Animais , Açúcares da Dieta , Feminino , Seguimentos , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Leite/estatística & dados numéricos , Modelos de Riscos Proporcionais , Fatores Sexuais , População Suburbana/estatística & dados numéricos , Inquéritos e Questionários , Edulcorantes , Verduras
13.
J Rural Health ; 37(2): 272-277, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33619806

RESUMO

PURPOSE: This report compares COVID-19 incidence and mortality rates in the nonmetropolitan areas of the United States with the metropolitan areas across three 11-week periods from March 1 to October 18, 2020. METHODS: County-level COVID-19 case, death, and population counts were downloaded from USAFacts.org. The 2013 NCHS Urban-Rural Classification Scheme was collapsed into two categories called metropolitan (large central, large fringe, medium, and small metropolitans) and nonmetropolitan (micropolitan/noncore). Daily COVID-19 incidence and mortality rates were computed to show temporal trends for each of these two categories. Maps showing the ratio of nonmetropolitan to metropolitan COVID-19 incidence and mortality rates by state identify states with higher rates in nonmetropolitan areas than in metropolitan areas in each of the three 11-week periods. FINDINGS: In the period between March 1 and October 18, 2020, 13.8% of the 8,085,214 confirmed COVID-19 cases and 10.7% of the 217,510 deaths occurred among people residing in nonmetropolitan counties. The nonmetropolitan incidence and mortality trends steadily increased and surpassed those in metropolitan areas, beginning in early August. CONCLUSIONS: Despite the relatively small size of the US population living in nonmetropolitan areas, these areas have an equal need for testing, health care personnel, and mitigation resources. Having state-specific rural data allow the development of prevention messages that are tailored to the sociocultural context of rural locations.


Assuntos
COVID-19/epidemiologia , População Rural/estatística & dados numéricos , População Suburbana/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Humanos , Incidência , Pandemias , Estados Unidos/epidemiologia
14.
PLoS Negl Trop Dis ; 15(2): e0008995, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33630833

RESUMO

BACKGROUND: Schistosomiasis is a parasitic disease caused by trematode worms of the genus Schistosoma and belongs to the neglected tropical diseases. The disease has been reported in 78 countries, with around 290.8 million people in need of treatment in 2018. Schistosomiasis is predominantly considered a rural disease with a subsequent focus of research and control activities in rural settings. Over the past decades, occurrence and even expansion of schistosomiasis foci in peri-urban and urban settings have increasingly been observed. Rural-urban migration in low- and middle-income countries and subsequent rapid and unplanned urbanization are thought to explain these observations. Fifty-five percent (55%) of the world population is already estimated to live in urban areas, with a projected increase to 68% by 2050. In light of rapid urbanization and the efforts to control morbidity and ultimately achieve elimination of schistosomiasis, it is important to deepen our understanding of the occurrence, prevalence, and transmission of schistosomiasis in urban and peri-urban settings. A systematic literature review looking at urban and peri-urban schistosomiasis was therefore carried out as a first step to address the research and mapping gap. METHODOLOGY: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic computer-aided literature review was carried out using PubMed, ScienceDirect, and the World Health Organization Database in November 2019, which was updated in March 2020. Only papers for which at least the abstract was available in English were used. Relevant publications were screened, duplicates were removed, guidelines for eligibility were applied, and eligible studies were reviewed. Studies looking at human Schistosoma infections, prevalence, and intensity of infection in urban and peri-urban settings were included as well as those focusing on the intermediate host snails. PRINCIPAL FINDINGS: A total of 248 publications met the inclusion criteria. The selected studies confirm that schistosomiasis is prevalent in peri-urban and urban areas in the countries assessed. Earlier studies report higher prevalence levels in urban settings compared to data extracted from more recent publications, yet the challenge of migration, rapid uncontrolled urbanization, and resulting poor living conditions highlight the potential for continuous or even newly established transmission to take place. CONCLUSIONS: The review indicates that schistosomiasis has long existed in urban and peri-urban areas and remains a public health problem. There is, however, a challenge of comparability of settings due to the lack of a clear definition of what constitutes urban and peri-urban. There is a pressing need for improved monitoring of schistosomiasis in urban communities and consideration of treatment strategies.


Assuntos
Schistosoma/isolamento & purificação , Esquistossomose/epidemiologia , Animais , Humanos , Schistosoma/classificação , Esquistossomose/transmissão , Caramujos/parasitologia , População Suburbana , População Urbana
16.
Reprod Health ; 18(1): 11, 2021 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-33468198

RESUMO

BACKGROUND: Research has paid limited attention to understanding factors that are associated with unmet contraceptive needs among female sex workers. In order to fill this knowledge gap, we estimated the prevalence of unmet contraceptive needs and examined associated factors among FSWs in semi urban Blantyre, Malawi. METHODS: We used systematic sampling to recruit 290 female sex workers in semi urban Blantyre between February and March 2019. In this cross sectional study, we used questionnaire interviews to collect quantitative data. We calculated the mean and standard deviation for continuous variables and proportions for categorical variables to describe the data. Logistic regression analysis was used to investigate the association between unmet needs (the outcome variable) and explanatory variables such as: having a steady partner, fear of contraceptives' side effects and having a history of sexually transmitted infections. RESULTS: Out of the 290 study participants 102 (35.2%) reported unmet contraceptive needs. The following factors were significantly associated with unmet contraceptive needs in multivariate analysis: female sex workers' history of physical and sexual violence by clients [OR 3.38, 95% CI (1.10, 10.43)], p < 0.03, participants with a steady partner [OR 3.28, 95% CI (1.89, 5.68)], p < 0.001, and participants who feared side effects of contraceptives [OR 2.99, 95% CI (1.73, 5.20)], p < 0.001. CONCLUSION: Reproductive Health services should address barriers to contraceptives use for instance: violence by female sex workers' clients, fear and misinformation on contraceptives. There is need to improve awareness of contraceptives. Specific health promotion interventions on female sex workers engaged in a steady partnership are recommended. It is important to enhance the knowledge, attitudes, and counseling skills of health care providers in order to address unmet contraceptive needs among female sex workers in semi-urban Blantyre. Unmet contraceptive needs are defined as lack of contraceptives use in heterosexually active women of childbearing age who do not wish to become pregnant. Unmet contraceptive needs are the main cause of short inter-pregnancy intervals, early childbearing, physical abuse, unintended pregnancy, poor maternal and child health outcomes. Several studies have documented low contraceptives use among female sex workers (FSWs), but research has paid limited attention to understanding factors associated with unmet contraceptive needs among this population in semi urban Blantyre Malawi. In order to fill this knowledge gap, we estimated the prevalence of unmet contraceptive needs and examined factors that were associated with unmet contraceptive needs among FSWs in semi urban Blantyre, Malawi. We recruited 290 FSWs and collected quantitative data. These data were analyzed to obtain descriptive statistics. Logistic regression analysis was used to investigate the association between unmet contraceptive needs (the outcome variable) and explanatory variables such as: FSWs with history of physical and sexual violence by clients, having a steady partner, fear of contraceptives' side effects and having a history of sexually transmitted infections. Out of the 290 FSWs, 35% reported unmet contraceptive needs. The following factors were significantly associated with unmet contraceptive needs in multivariate analysis: FSWs' history of physical and sexual violence by clients, participants with a steady partner and participants who feared contraceptive side effects. Sexual and Reproductive Health services should address barriers to contraceptives use, female sex workers exposure to violence, having a steady partners and concerns about side effects. There is also a need to improve the knowledge, attitudes, and counseling skills of health providers in order to address unmet contraceptive needs among FSWs.


Assuntos
Anticoncepcionais Femininos/uso terapêutico , Serviços de Planejamento Familiar , Infecções por HIV/prevenção & controle , Acesso aos Serviços de Saúde , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Determinação de Necessidades de Cuidados de Saúde , Serviços de Saúde Reprodutiva/provisão & distribuição , Trabalho Sexual/estatística & dados numéricos , Profissionais do Sexo , Adulto , Comportamento Contraceptivo , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Humanos , Malaui/epidemiologia , Gravidez , Gravidez não Planejada , População Suburbana
17.
J Emerg Nurs ; 47(2): 239-255, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33317860

RESUMO

The purpose of this facility-level case report was to describe our facility's leadership process of applying the Donabedian model to structure an early response to the coronavirus disease pandemic relative to emergency care. Using the Donabedian model as a guide, both structure and process changes were implemented to maintain high-quality clinical outcomes as well as ED staff safety and engagement. Rapid changes to the model of care, both architecturally and through the expansion of universal precautions through personal protective equipment, created the foundation for what was to follow. Clinical, service quality, and staff safety outcomes were evaluated to demonstrate that the collaborative changes that follow a known process improvement model can be used to address the coronavirus disease pandemic. Further study is needed to compare the outcomes of this facility-level case study with those of others to evaluate the success of the measures outlined.


Assuntos
COVID-19/terapia , Enfermagem em Emergência/métodos , Serviço Hospitalar de Emergência , Avaliação de Processos e Resultados em Cuidados de Saúde/métodos , COVID-19/enfermagem , COVID-19/prevenção & controle , Hospitais , Humanos , Liderança , New York , Pandemias , Equipamento de Proteção Individual , SARS-CoV-2 , População Suburbana
18.
Nurs Res ; 70(1): E1-E10, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32991529

RESUMO

BACKGROUND: Studies focusing on adolescent suicide in Arab countries are particularly scarce, with the few available undertaken from within an epidemiological paradigm. OBJECTIVE: This study aimed to understand Jordanian adolescents' perceptions, beliefs, and attitudes toward suicide. METHODS: A qualitative design using 12 dual-moderator focus group discussions was conducted in public schools. Participants were selected from the three main regions of the country (rural southern, urban central, and suburban northern). Participants included Jordanian adolescent boys and girls, aged 14-17 years, who reported experiencing mild to moderate depressive symptoms. A relational content analysis approach was used for coding data, and a content analysis was used to identify salient thematic categories. Data were analyzed using NVivo software. RESULTS: Four themes emerged, including perceived risk factors, perceived protective factors, active and passive suicidal ideations, and e-games and Internet influences. Main risk factors were depression; anxiety; stigma, shame, and isolation; family issues; life pressures; and guilt. Conversely, religiosity, perceived positive family functioning, and availability of long-term goals seemed to confer resilience to adolescents' suicidal ideation and behavior. Passive suicidality (having death wishes without any plans to complete suicide) was noticed most among participants who feared jeopardizing the family's reputation if they committed suicide. Several boys with active suicidal ideations used the Blue Whale Challenge e-game to learn how to complete suicide and relinquish their problems. DISCUSSION: Suicide is a multifactorial problem requiring multimodal strategies. Evidence from this research suggests that those most passionate about the outcome of interest are encouraged to redouble efforts to reduce modifiable risk factors, enrich protective factors, target the underlying psychiatric illness that informs suicidal ideations and behavior, and research the effect of social media and Internet activity more deeply. Parents are advised to monitor the online activities of their children and familiarize themselves with the digital applications they use.


Assuntos
Comportamento do Adolescente/psicologia , Atitude Frente a Morte , Geografia/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Ideação Suicida , Tentativa de Suicídio/psicologia , Suicídio/psicologia , Adolescente , Feminino , Humanos , Jordânia/epidemiologia , Masculino , Fatores de Risco , População Rural/estatística & dados numéricos , População Suburbana/estatística & dados numéricos , População Urbana/estatística & dados numéricos
19.
Creat Nurs ; 26(4): 267-271, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-33273133

RESUMO

Parent-child relationships have been researched in many ways. This article describes a qualitative study using the concept of reflective functioning (defined by Slade as the parent's capacity to hold and reflect upon her own and her child's internal mental experience) as a framework. The study focused on understanding the experiences of early childhood adversities, social supports, and the reflective functioning capacity of 11 young adult African American mothers and their children in urban and suburban areas of Minnesota. Findings included that the participants did not perceive adversities as bad, but as part of a daily norm; they demonstrated that they have social support and know how to access it; and they showed the ability to reflect on their children's emotions and experiences as well as the parent-child relationship. Participants talked about transmitting good things to their children while simultaneously protecting them from negative experiences. Thus, parents were able to change patterns that could affect their children's well-being.


Assuntos
Experiências Adversas da Infância/psicologia , Afro-Americanos/psicologia , Trauma Histórico/psicologia , Mães/psicologia , Relações Pais-Filho , Poder Familiar/psicologia , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Minnesota , Apoio Social , População Suburbana , População Urbana , Adulto Jovem
20.
Artigo em Inglês | MEDLINE | ID: mdl-33322469

RESUMO

Planning plays a critical role in promoting healthy communities for children. We conducted a national survey of United States (US) cities and counties in 2019 and found only half of the 1312 responding communities report they give attention to the needs of children in their community plans. Those that do, provide more services and have more child-friendly zoning codes. We use a human ecological framework to build structural equation models of child-friendly zoning and services. We find communities with more engagement of families with children and youth and a common vision across generational, race, and ethnic lines report higher levels of child-friendly zoning and services. Collaboration between health providers and schools builds trust and leads to more services. However, child-friendly zoning is lower in communities with higher child poverty, and in suburbs and rural areas. Our results support a dynamic human ecological model where the processes of collaboration, inclusion, and engagement are key to creating healthy places for children. These processes may be especially important in addressing the unique challenges of suburban and rural communities.


Assuntos
Planejamento de Cidades , Planejamento Ambiental , Promoção da Saúde , Adolescente , Criança , Grupos Étnicos , Humanos , Pobreza , População Rural , População Suburbana , Estados Unidos
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