ABSTRACT
Background With the aging of China's population, cognitive impairment in the elderly is receiving increasing public attention. Screening and intervention of people with mild cognitive impairment (MCI) are of great significance to prevent and reduce the occurrence of cognitive impairment. Objective To understand the prevalence and explore potential influencing factors of MCI in the elderly in Songjiang District, Shanghai, and to provide scientific basis for promoting early screening of cognitive impairment and precise intervention of MCI in the elderly in this area. Methods A cross-sectional study design was adopted. From August to October 2022, using multi-stage random sampling, 1800 elderly residents aged 60 years and above were screened for cognitive impairment in 6 neighborhood/village committees in 6 towns in Songjiang District. The survey questionnaires included a sociodemographic questionnaire, a health status and lifestyle questionnaire, the Instrumental Activities of Daily Living (IADL), the Patient Health Questionnaire (PHQ-9), and the Mini-Mental State Examination (MMSE). Prevalence rates of MCI among the elderly by selected social demographic characteristics, health status, and lifestyle were estimated, and potential influencing factors of MCI were evaluated by binary logistic regression. Results A total of 209 elderly residents with MCI and 1591 healthy elderly residents were detected, and the prevalence of MCI in the elderly aged 60 and above was 11.6% in Songjiang District. Being physically active (OR=0.556, 95%CI: 0.399, 0.774) reduced the risk of MCI. Illiteracy (OR=1.810, 95%CI: 1.239, 2.644), primary school education level (OR=3.454, 95%CI: 2.342, 5.092), non-participation in social activities (OR=1.945, 95%CI: 1.360, 2.781), IADL damaged (OR=3.173, 95%CI: 2.137, 4.712), and depression (OR=1.957, 95%CI: 1.112, 3.443) increased the risk of MCI (P＜0.05). Conclusion The prevalence of MCI among the elderly in Songjiang District is lower than the national average. Educational level, physical activity, participation in social activities, IADL, and depression may be the influencing factors of MCI in the elderly. It is recommended to carry out early screening, early detection, and early intervention for cognitive impairment in the elderly. Improving involvement in physical exercise and increasing participation in social activities are encouraged. Special attention should be paid to the needs of vulnerable groups such as low education level and disabled elderly during a community MCI intervention program.
ABSTRACT
ObjectiveTo analyze the clinical and epidemiological characteristics of confirmed cases of human monkeypox infection in Changning District， Shanghai， and to explore their clinical and epidemiological characteristics. MethodsClinical data from 10 reported cases of monkeypox in individuals residing in Changning District or identified by local medical institutions between July 20 and September 30， 2023， were collected. Epidemiological case investigations were conducted， and throat swabs， anal swabs， and rash swabs were collected by the treating medical institutions. Real-time fluorescence quantitative PCR was used for monkeypox virus nucleic acid testing， and descriptive epidemiological analysis was applied to analyze the epidemiological characteristics of the cases. ResultsAll 10 confirmed cases of human monkeypox infection were all young males with an average age of 35.4 years， all of whom belonged to the men who have sex with men （MSM） population， with no occupational clustering. The primary clinical symptoms included fever， rash， enlarged inguinal lymph nodes， and muscle soreness. Nine cases presented with a rash， and seven cases experienced fever symptoms. Among the 10 cases， one experienced fever， rash， enlarged lymph nodes， and muscle soreness； two had fever， rash， and enlarged lymph nodes； two had fever， rash， and systemic soreness； two had only a rash； one had fever or rash； and one was asymptomatic. Among the nine cases with a rash， the rash was mainly localized to the genital or anal area， with fewer cases presenting rashes on the limbs or trunk simultaneously. All cases reported a history of non-exclusive MSM behavior within 21 days before the onset of the disease. The interval between the last suspected high-risk exposure and the onset of symptoms was 4 to 10 days， with an average interval of 6.9 days. The time from the onset of fever to the appearance of a rash was 0 to 5 days， with an average of 1.87 days. ConclusionThe main clinical manifestations of human infection with monkeypox are fever， rash， and enlarged inguinal lymph nodes. The MSM population is a high-risk group for monkeypox infection， and its source of infection may be associated with MSM exposure. Early-stage symptoms are mild， leading to potential underdiagnosis. Additionally， patients may conceal information during the investigation process， which increases the difficulty of epidemic prevention and control.
ABSTRACT
Este texto expone una reflexión académica sobre el proceso de renovación de la política pública de comunitaria en Bogotá (Colombia) realizada durante 2020 y 2022. Inicialmente, se presentan las consideraciones conceptuales sobre las cuales se cimienta el trabajo en relación con las políticas de comunicación, la comunicación comunitaria y el problemático cruce entre estos conceptos. Luego, intenta describir y analizar las tensiones originadas en el interior de la Mesa Distrital de Comunicación Comunitaria en el marco de la fase preparatoria de la política pública. Y finalmente se sugieren algunas ideas o desafíos producto de la experiencia, que bien podrían ser asumidos en las futuras etapas del proyecto político. Entre ellas cabe destacar la urgente necesidad de redefinir la comunicación comunitaria, a partir de las prácticas ejercidas por los medios comunitarios y el actual momento histórico, porque solo así sería posible identificar el carácter de la comunicación y el sentido de la política pública en el actual proceso de reconstrucción.
Summary This text aims to present an academic reflection on the process of renewal of the public community policy in Bogota - Colombia, which will be carried out between 2020 and 2023. Initially, it presents the conceptual considerations on which the work is based in relation to communication policies, community communication, and the problematic crossover between these concepts. Then, it attempts to describe and analyze the tensions originated within the Mesa Distrital de Comunicación Comunitaria, in the framework of the preparatory phase of the public policy. And, finally, it suggests some ideas or challenges resulting from the experience, which could well be assumed in the future stages of the political project. Among them, it is worth highlighting the urgent need to redefine community communication, based on the practices exercised by community media and the current historical moment, because, only in this way, it would be possible to identify the character of communication and the meaning of public policy in the current reconstruction process.
ABSTRACT
Abstract Objective To assess the potential relationship of clinical status upon admission and distance traveled from geographical health district in women with gestational trophoblastic disease (GTD). Methods This is a cross-sectional study including women with GTD from the 17 health districts from the São Paulo state (I-XVII), Brazil, referred to the Botucatu Trophoblastic Disease Center (specialized center, district VI), between 1990 and 2018. At admission, hydatidiform mole was assessed according to the risk score system of Berkowitz et al. Gestational trophoblastic neoplasia was evaluated using the International Federation of Gynecology and Obstetrics / World Health Organization (FIGO/WHO) staging/risk score. Data on demographics, clinical status and distance traveled were collected. Multiple regression analyses were performed. Results This study included 366 women (335 hydatidiform mole, 31 gestational trophoblastic neoplasia). The clinical status at admission and distance traveled significantly differed between the specialized center district and other districts. Patients referred from health districts IX (β = 2.38 [0.87-3.88], p = 0.002) and XVI (β = 0.78 [0.02-1.55], p = 0.045) had higher hydatidiform mole scores than those from the specialized center district. Gestational trophoblastic neoplasia patients from district XVI showed a 3.32 increase in FIGO risk scores compared with those from the specialized center area (β = 3.32, 95% CI = 0.78-5.87, p = 0.010). Distance traveled by patients from districts IX (200km) and XVI (203.5km) was significantly longer than that traveled by patients from the specialized center district (76km). Conclusion Patients from health districts outside the specialized center area had higher risk scores for both hydatidiform mole and gestational trophoblastic neoplasia at admission. Long distances (>80 km) seemed to adversely influence gestational trophoblastic disease clinical status at admission, indicating barriers to accessing specialized centers.
Resumo Objetivo Avaliar a possível relação entre estado clínico na apresentação e distância percorrida a partir do distrito de saúde em mulheres com doença trofoblástica gestacional. Métodos Estudo transversal incluindo mulheres com doença trofoblástica gestacional dos 17 distritos de saúde do estado de São Paulo (I-XVII), Brasil, encaminhadas ao Centro de Doenças Trofoblásticas de Botucatu (distrito VI), entre 1990 e 2018. Na admissão, avaliaram-se mola hidatiforme pelo sistema de pontuação de risco de Berkowitz et al. e neoplasia trofoblástica gestacional pelo escore de risco/estadiamento Federação Internacional de Ginecologia e Obstetrícia / Organização Mundial da Saúde (FIGO/OMS). Coletaram-se dados demográficos, clínicos e distância percorrida e análises de regressão múltipla foram realizadas. Resultados Este estudo incluiu 366 mulheres (335 mola hidatiforme, 31 neoplasia trofoblástica gestacional). O estado clínico na apresentação e distância percorrida diferiram significativamente entre o centro especializado e demais distritos. Nas pacientes encaminhadas pelos distritos IX (β = 2,38 [0,87-3,88], p = 0,002) e XVI (β = 0,78 [0,02-1,55], p = 0,045), os escores de mola hidatiforme foram maiores que no centro especializado. As pacientes com neoplasia trofoblástica gestacional do distrito XVI apresentaram escores FIGO 3,32 vezes maior que no centro especializado (β = 3,32, 95% CI = 0,78-5,87, p = 0,010). A distância percorrida pelas pacientes dos distritos IX (200km) e XVI (203,5km) foi significativamente maior do que a percorrida pelas pacientes do centro especializado (76km). Conclusão Pacientes de distritos de saúde fora da cobertura do centro especializado apresentaram escores de risco mais alto para mola hidatiforme e para neoplasia trofoblástica gestacional na admissão. Longas distâncias (>80 km) pareceram influenciar negativamente o estado clínico da doença trofoblástica gestacional na apresentação, indicando barreiras no acesso a centros especializados.
Subject(s)
Humans , Female , Pregnancy , Gestational Trophoblastic Disease , Tertiary Care CentersABSTRACT
Occurrence, diversity and density of phytoplankton were recorded in five estuaries from Ratnagiri district of Maharashtra during rainy season. A total of 104 phytoplankton species belonging four division, viz, Cyanophyceae (11), Chlorophyceae (7), Dinophyceae (3) and Bacillariophyceae (83) were reported in the present study. Species diversity and density was recorded highest at Ranpar estuary and from Bacillariophyceae it was greater than other divisions. Diversity index is very high due to number of contributing species. He result concluded that the selected estuaries are more fertile with rich phytoplankton productivity.
ABSTRACT
Mental disorders in India form a major public health concern and the efforts to tackle these dates back to four decades, by way of the National Mental Health Programme (NMHP) and its operational arm, the District Mental Health Programme (DMHP). Although the progress of NMHP (and DMHP) was relatively slower till recently, the last 4-5 years have seen rapid strides with several initiatives, including (i) expansion of DMHPs to 90 per cent of the total districts of the country, (ii) the National Mental Health Policy and (iii) strengthening the Mental Health Legislation by way of providing explicit provisions for rights of persons with mental illnesses. Among others, factors responsible for this accelerated growth include the easily accessible digital technology as well as judicial activism. Federal and State cooperation is another notable feature of this expansion. In this review, the authors summarize the available information on the evolution of implementation and research aspects related to India’s NMHP over the years and provide a case for the positive turn of events witnessed in the recent years. However, the authors caution that these are still baby steps and much more remains to be done.
ABSTRACT
Background. Abortion is the termination of a pregnancy before the age of fetal viability which, according to the WHO, is 22 weeks of pregnancy and/or with the fetus weigh less than 500 g. Spontaneous abortion is a public health problem. It's one of the most common complications of pregnancy. In order to contribute to the decrease of the morbidity and mortality linked to spontaneous abortions, we conducted this study, which the general objective was to study risk factors of spontaneous abortion. We carried out a cross-sectional case-control study in the District Hospitals of Biyem Methods. - Assi and Efoulan in Yaoundé. During six months, we collected 3774 records of pregnant women from January 1, 2020 to December 31.,2020. For each case (record of woman who had a spontaneous abortion), two controls (records of those who gave birth spontaneously at term) of the same age, were immediately recruited. Data were analyzed using IBM SPSS Version.23.0 software. Tools used to assess our results were: Fischer's exact test, frequency, odds ratio (OR) and P, with P signicant for any value less than 5%. We recruited 104 cases and 208 controls. Being unmarried, being from the littoral region, having a Results. history of stress, smoking, having started antenatal care and having had prenuptial check-up, independently increased the risk of spontaneous abortion with respectively aOR = 2.8 IC=1.24-6.31 aP= 0.013, aOR=4.31 IC= 1.09-17.02 aP= 0.037, aOR=11.86; CI=3.88-36.19; aP=<0.001, aOR=8.57; CI=3.41-21.54; aP=<0.001, aOR=10.4; CI=1.12-96.82; aP=0.04) and aOR=3.37; CI=1.67-6.79; aP<0.001). These risk factors being mostly modiable, should be sought and prevented Conclusion. in order to improve the prognosis of pregnancies in our context
ABSTRACT
The state Uttarakhand is rich with floral and faunal diversity including plants used by local inhabitance to cure health problems. Himalayan region always has been the treasure of herbs from ancient time. Himalayan herbs are highest in quality and potency. There are numbers of side effect are noted using allopathic medicines which leads towards reuse of medicinal plants available locally. Keeping this in view an attempt has been made to enumerate the common medicinal plants used in traditional therapeutic system of Uttarakhand, India. Results reveal that 29 plant species are used for primary healthcare. Purnagiri hills located in Champavat district of Uttarakhand is reservoir for a large number of medicinal herbs during the field survey large number of medicinal plants like Adina cordifolia (Roxb.) Hook. (Rubiaceae), Asparagus adscendence Roxb. (Liliaceae), Artemesia nilgirica (Clarke) Pamp. (Asteraceae), Berberis aristata DC. (Berberiridaceae), Colebrookea oppositefolia Sm. (Lamiaceae), Elephantopus scaber L (Asreraceae), Pinus longifolia Roxb. (Pinaceae), Tamarix gallica L. (Tamaraceae), Urtica dioica L. (Urtecaceae) and many more with their use in local health traditions by local habitants were recorded. One of the serious challenges to biodiversity and ecological functioning is climate change. Climate change and global warming are well known issue that has had an impact on the biodiversity. Second thing over exploitation of Himalayan forest leads these valuable herbs in endangered category. Some of the plants recorded are critically endangered and rare. We have to pay attention towards the conservation, cultivation of these herbs.
ABSTRACT
Background & objectives: The COVID-19 pandemic exposed the strengths and weaknesses of the healthcare systems across the world. Many directives, guidelines and policies for pandemic control were laid down centrally for its implementation; however, its translation at the periphery needs to be analyzed for future planning and implementation of public health activities. Hence, the objectives of this study were to identify the challenges faced by frontline health managers in selected States in India during the pandemic with regard to implementation of the COVID-19-related policies at the district level and also to assess the challenges faced by the them in adapting the centrally laid down COVID-19 guidelines as per the local needs of the district. Methods: A qualitative study using the grounded theory approach was conducted among frontline district-level managers from eight different States belonging to the north, south, east and west zones of India. The districts across the country were selected based on their vulnerability index, and in-depth interviews were conducted among the frontline managers to assess the challenges faced by them in carrying out COVID-19 related activities. Recorded data were transcribed verbatim, manually coded and thematically analyzed. Results: Challenges faced in implementing quarantine rules were numerous, and it was also compounded by stigma attached with the disease. The need for adapting the guidelines as per local considerations, inclusion of components of financial management at local level, management of tribal and vulnerable populations and migrants in COVID context were strongly suggested. The need to increase human resource in general and specifically data managers and operators was quoted as definite requirement. Interpretation & conclusions: The COVID-19 guidelines provided by the Centre were found to be useful at district levels. However, there was a need to make some operational and administrative modifications in order to implement these guidelines locally and to ensure their acceptability.
ABSTRACT
ObjectiveTo construct an evaluation index system for the development of district-level disease prevention and control centers according to the requirements of the modernization of Shanghai’s disease control system and public health work practices， and to comprehensively assess the construction and development of district-level disease prevention and control institutions. MethodsAccording to the national and municipal requirements for the development of disease prevention and control institutions， an index framework was proposed through literature search and expert interviews. 39 representative experts in the field of public health at the national， provincial， and municipal （district） levels were selected to participate in the consultation and construction of the index system. The authority coefficient， the coefficient of variation， etc. were used to carry out quality control and determination of each index on the Delphi method. ResultsThe questionnaire response rate was 100%， the expert authority coefficient was 0.86，the degree of familiarity was 0.79， and the judgment basis was 0.92. The coefficients of variation of the necessary indicators in the index system were all <0.25 in the dimension of importance， and there were statistical differences in the statistical test of Kendall’s W coordination coefficients at all levels and dimensions （all P<0.001）. After multiple rounds of consultation， experts reached a consensus， forming a development evaluation index system of district-level CDCs with 6 first-level indicators， 24 second-level indicators， and 105 third-level indicators （including 63 necessary indicators and 42 recommended indicators）. ConclusionThe evaluation index system of Shanghai district-level CDCs based on the Delphi method has good authority， reliability， sensitivity and operability. This indicator system can effectively support the development of Shanghai district-level CDCs， and can be used for evaluation at multiple levels and in an all-round way in the future. The evaluation results can provide an evidence-based basis for the modernization of the disease prevention and control system and the continuous and dynamic updating of the development goals in the future.
ABSTRACT
ObjectiveTo investigate the prevalence and risk factors of dental caries and its related influencing factors in 12-year-old children in Yangpu District， Shanghai， and to provide relevant data support for the formulation of oral health policies and measures for children. MethodsIn 2021， 839 12-year-old children were randomly selected from five ordinary junior high schools in Yangpu District. The investigation included an oral health examination and a questionnaire survey on factors related to dental caries. Logistic regression analysis was used to analyze the influencing factors of dental caries. ResultsAmong the 839 participants， data from 830 were included. Among them， 426 were male （51.3%） and 404 were female （48.7%）. Of the 830 children， 203 had dental caries， resulting in a caries prevalence of 24.46%， a caries supplemental filling ratio of 32.6%， and a DMFT of 0.63. Multivariate logistic regression analysis revealed that a mother’s education level of college or above （OR=0.849，95% CI： 0.732‒0.984）， brushing teeth twice a day （OR=0.827，95%CI： 0.703‒0.973）， and the caregiver brushing teeth twice a day （OR=0.843， 95%CI： 0.726‒0.983） were effective factors in reducing the caries rate. Factors associated with childhood dental caries included consuming sweets ≥1 time per day （OR=1.397，95%CI： 1.197‒1.342） and female gender （OR=1.482，95%CI： 1.347‒1.671）. ConclusionThe prevalence of dental caries among 12-year-old children in Yangpu District is 24.46%. Gender， maternal education， the frequency of children's toothbrushing， the frequency of sweet consumption， and the caregiver’s toothbrushing frequency are the main factors affecting the prevalence of dental caries in children.
ABSTRACT
AIM: To explore the characteristics of astigmatism in preschool children before, during and after the COVID-19 epidemic, so as to provide a reference for further prevention and control of children's vision.METHODS: In the consecutive four years from January 2018 to December 2021, a retrospective analysis of vision data was conducted on 2 273 preschool children(4 546 eyes)younger than 4 years old who participated in children's vision screening test in Baiyun district, Guangzhou. They were divided into 1-year old group(ages<1-year old, 420 cases), 2-year old group(1-year ≤ ages <2-year, 543 cases), 3-year old group(2-year ≤ages <3-year, 614 cases), and 4-year old group(3-year ≤ ages<4-year, 696 cases)according to ages. The analysis included astigmatic degrees of children's eyes as well as their conditions of astigmatism.RESULTS: In 2018, the astigmatic degrees of the both eyes of 1-year-old group were higher than those of other groups(P<0.05). The binocular astigmatic degrees of the preschool children in four groups were obviously higher in 2020 than 2019(P<0.05), while they were significantly decreased in 2021 when compared with 2020(P<0.05). From 2019 to 2020, the increase of astigmatic degrees of the right eye is more considerable than the left eye of preschool children in those four groups(P<0.001). Furthermore, the morbidity of astigmatism basically echoes with the changing tendency of astigmatic degrees from 2018 to 2021.CONCLUSIONS: Preschool children in Baiyun district, Guangzhou, have the highest degree of astigmatism and the fastest progression rate within 1 year old. Before COVID-19 epidemic, the changes in astigmatism and prevalence were relatively stable; during COVID-19 epidemic, the astigmatism and prevalence increased significantly and the astigmatic degrees of right eye increased more than that of the left eye; after the normalization of epidemic prevention and control, the astigmatism and prevalence decreased significantly.
ABSTRACT
OBJECTIVE@#To explore the carrier rate, genotype and phenotype of α-thalassemia fusion gene in Huadu district of Guangzhou, Guangdong province of China, and provide data reference for the prevention and control of thalassemia.@*METHODS@#A total of 10 769 samples who were screened for thalassemia in Maternal and Child Health Hospital of Huadu District from July 2019 to November 2020 were analyzed retrospectively. Blood cell analysis and hemoglobin (Hb) electrophoresis were performed. Thalassemia genes were analyzed by gap-PCR and PCR-reverse dot blot hybridization (PCR-RDB).@*RESULTS@#A total of 9 cases with α-thalassemia fusion gene were detected in 10 769 samples (0.08%). There were 7 cases with fusion gene heterozygote, 1 case with compound of α-thalassemia fusion gene and Hb G-Honolulu, 1 case with compound of α-thalassemia fusion gene and Hb QS. The MCV results of 4 samples of blood cell analysis were within the reference range, the Hb A2 value of 1 case was decreased, and there were no other abnormalities found.@*CONCLUSION@#The α-thalassemia fusion gene is common in Huadu district of Guangzhou, and heterozygotes are more common, and current screening methods easily lead to misdiagnosis.
Subject(s)
Humans , alpha-Thalassemia/genetics , Retrospective Studies , beta-Thalassemia/genetics , Genotype , Phenotype , Heterozygote , China , MutationABSTRACT
ObjectiveTo investigate the contamination status and drug resistance of Campylobacter spp. in poultry sold in Jiading District， Shanghai. MethodsFour types of poultry meats （chickens， ducks， geese and pigeons） were sampled from commercial markets， and potential Campylobacter spp. contamination was isolated and identified. Furthermore， resistance of isolated Campylobacter spp. to 15 commonly used antibiotics was tested. ResultsTotally 29 Campylobacter jejuni strains and 34 Campylobacter. coli were isolated from 236 commercial poultry samples. The most severe contamination of Campylobacter spp. was found in chicken samples， with a detection rate of 34.04%， while the lowest detection rate of Campylobacter spp. was found in duck （19.67%）. Contamination status was categorized with different storage conditions. The lowest detection rate of 6.67% was noted under frozen condition， while highest detection rate of 41.27% was noted under cold storage. Campylobacter jejuni was completely resistant to cefazolin， ciprofloxacin， nalidixic acid and tetracycline， and Campylobacter coli was completely resistant to cefazolin， cefoxitin and nalidixic acid； Campylobacter spp. showed the lowest resistance to imipenem. Multi-drug resistant strains accounted for 100.00% of the isolated strains. 96.83% of the strains were resistant to more than 5 drugs， with the highest number reaching 14 kinds of antibiotics. ConclusionThere is a significant difference in the contamination status and drug resistance of Campylobacter spp. isolated from four types of poultry meats sold in Jiading District， Shanghai， and the drug resistance is serious. It is strongly recommended that the use of antibiotics should be strictly controlled. Freezing can effectively reduce Campylobacter spp. pollution.
ABSTRACT
Resumo O financiamento público vem ganhando destaque nos estudos das políticas públicas esportivas, pois permite visualizar de forma mais transparente onde e como são alocados os recursos públicos para o setor. Este artigo tem como objetivo analisar o financiamento das políticas públicas de esporte do Distrito Federal (DF), a partir de matriz e proposta metodológica que possibilitam o levantamento e sistematização de dados referentes à identificação das fontes, magnitude e direcionamento dos gastos públicos orçamentários com o esporte de 2009 a 2019. A pesquisa apontou: (i) falta de legislação efetiva para garantia dos recursos esportivos; (ii) centralidade da execução do orçamento pela Secretaria de Esporte do Distrito Federal; (iii) elevado gasto com a construção do Estádio Nacional de Brasília; e, (iv) hierarquização dos gastos esportivos nos programas oferecidos, com priorização aos Centros Olímpicos e Paralímpicos, ação com gestão terceirizada, além de capilaridade e abrangência reduzidas.
Abstract Public funding has been gaining prominence in studies of sports public policies as it provides a more transparent view of where and how public resources are allocated to the sector. This article aims to analyze the financing of public policies for sports in the Federal District (FD), based on a matrix and methodological proposal that allows the survey and systematization of data referring to the identification of sources, magnitude, and direction of public budget expenditure on sports from 2009 to 2019. The research points out: (i) the lack of effective legislation to guarantee sports resources; (ii) the centrality of budget execution by the Secretariat of Sports of the Federal District; (iii) high expenses with the construction of the Brasília National Stadium; and (iv) the prioritization of sports spending in the offered programs, with priority given to the Olympic and Paralympic Centers, outsourced management, in addition to reduced capillarity and scope.
Resumen La financiación pública ha ido cobrando protagonismo en los estudios de políticas públicas deportivas, ya que permite tener una visión más transparente de dónde y cómo se asignan los recursos públicos al sector. Este artículo tiene como objetivo analizar del financiamiento de las políticas públicas deportivas en el Distrito Federal (DF), a partir de una propuesta matricial y metodológica que permite recolectar y sistematizar datos referentes a la identificación de fuentes, magnitud y dirección del gasto público presupuestario en deportes, de 2009 a 2019. La investigación señaló: (i) la falta de una legislación efectiva para garantizar los recursos deportivos; (ii) la centralidad de la ejecución presupuestaria por parte de la Secretaría de Deportes del Distrito Federal; (iii) altos gastos con la construcción del Estadio Nacional de Brasilia; y (iv) la priorización del gasto deportivo en los programas ofrecidos, con prioridad en los Centros Olímpicos y Paralímpicos, gestión externalizada, además de capilaridad y alcance reducidos.
ABSTRACT
Resumo O Subsistema de Atenção à Saúde Indígena (SasiSUS), como parte do Sistema Único de Saúde (SUS), é responsável pela atenção à saúde dos povos indígenas do Brasil. Em âmbito local, são os Distritos Sanitários Especiais Indígenas (DSEI) os responsáveis pela gestão, planejamento e organização do processo de trabalho das equipes multidisciplinares de saúde indígena (EMSI), que realizam a atenção primária à saúde para essa população. O objetivo do estudo foi analisar como ocorrem o planejamento e a gestão do processo de trabalho das EMSI. Foi realizado um estudo de casos múltiplos holístico, considerando sete DSEI como unidades de análise. A principal fonte de dados utilizada foi a entrevista e, de forma complementar, a observação direta. Os resultados indicaram que, de forma geral, o planejamento está presente na organização do processo de trabalho das equipes, com variações entre os DSEI. A efetivação das ações planejadas foi relacionada à disponibilidade de diferentes recursos: funcionamento adequado do sistema de informação e a articulação intra e intersetorial do SasiSUS. Como conclusão, apontou-se a necessidade de radicalização da participação no planejamento e na gestão, necessária a uma ação coordenada para garantia da atenção diferenciada e dos princípios do SUS.
Abstract The Indigenous Health Care Subsystem (SasiSUS), as part of the Brazilian National Health System (SUS), is responsible for health care for indigenous peoples in Brazil. At the local level, the Special Indigenous Health Districts (DSEI) are responsible for managing, planning, and organizing the work process of the multidisciplinary indigenous health teams (EMSI), which provide primary health care for this population. The objective of the study was to analyze how the planning and the management of the EMSI work process occurs. A holistic multiple-case study was carried out, considering seven DSEI as units of analysis. The main source of data used were interviews and, in a complementary way, direct observation. The results indicated that, in general, planning is present in the organization of the teams' work process, with variations between the DSEI. Carrying out the planned actions was related to the availability of different resources: adequate functioning of the information system and the intra and intersectoral articulation of SasiSUS. As a conclusion, the need to radicalize participation in planning and management, necessary for a coordinated action to guarantee differentiated care and the principles of SUS, was pointed out.
Subject(s)
Unified Health System , Local Health Systems , Health Management , Health Planning , Health Services, IndigenousABSTRACT
Background Severe malaria is a key global public health issue, particularly in Sub-Saharan Africa, which accounts for over 80% of global malaria deaths. Rwanda has experienced about 11-fold annual increase in reported malaria cases since 2012 to 2016. Severe malaria accounted for 13,092 cases in 2015 to 17,248 cases in 2016. Objective To determine factors associated with severe malaria among patients under reference to Gihundwe and Mibilizi Hospitals. Methods A cross-sectional study that included 228 febrile patients diagnosed with malaria at Gihundwe and Mibilizi Hospitals was conducted. Data were collected from patients' files. Logistic regressions were computed to establish determinants of severe anemia. Odds ratio (OR), 95% confidence level (CI) and p-value were reported. Results The proportion of severe malaria was 64.03%. The multivariable logistic regression analysis showed that patients under five years (aOR = 8.169; 95%CI = 3.646- 18.304); being males (aOR = 2.539; 95%CI = 1.299-4.965); farmers (aOR = 2.757; 95%CI = 1.339-5.678) and limited access to health facilities (aOR = 2.740: 95%CI = 1.038-7.232) were the main factors associated with severe malaria. Conclusion Severe malaria was high with various associated factors. There is a need to strengthen malaria control and prevention interventions for young children, men and farmers. Furthermore, beside public health interventions, health facilities should be accessible to people residing in malaria endemic areas.
ABSTRACT
Introduction: Human immunodeficiency virus' (HIV's) threat to food security is highest in areas with high poverty levels. The OR Tambo district in the Eastern Cape province has the highest poverty rate in South Africa (80.4%); HIV prevalence is 11.4%. Objective: The purpose of the study was to describe the threat that HIV poses to farm employment and food security in the Eastern Cape province of South Africa. Methods: A multi-method approach was used. The quantitative component was a cross-sectional design and the qualitative component was a narrative design. The study population comprised approximately 7 000 smallholder farmers from the five local municipalities in the OR Tambo district. Participants for both the qualitative and quantitative aspects of the study were selected using convenience sampling. Quantitative data were collected using questionnaires and qualitative data were collected from face-to-face interviews. Quantitative data were analysed using descriptive statistics and the chi-square test. Qualitative data were analysed using Tesch's eight-step procedure for thematic content analysis. Results: Five hundred and ninety-three farmers completed the questionnaire. Most agreed that HIV affects food security (n = 486, 72.0%), that HIV negatively affects food security (n = 454, 76.6%), that people living with HIV are excluded from farming activities (n = 426, 71.8%), and that HIV affects farming skills (n = 495, 83.5%). A significantly larger proportion of farmworkers older than 60 years than those who were younger perceived the threat to food security. Twenty participants described the effect of HIV on farm workers in interviews, and highlighted that HIV impacts farm skills and labour due to ill health and lost income from farming, which threatens food security. Conclusion: HIV threatens food security among smallholder farmers in the OR Tambo district due to farmworkers' diminished capacity to work and consequent reduced income, which affects their ability to secure food.
Subject(s)
Humans , Male , Female , HIV InfectionsABSTRACT
ObjectiveTo characterize the prevalence and epidemic situation of imported malaria cases in Songjiang District of Shanghai from 2013 to 2022， and to provide evidence for malaria prevention and control. MethodsRelated data were collected and analyzed， including malaria cases， blood testing of febrile patients， and mosquito surveillance in Songjiang from 2013 to 2022. ResultsA total of 13 002 febrile patients in Songjiang were tested for plasmodium parasites from 2013 to 2022， among which 18 malaria cases were confirmed， including 17 cases of falciparum malaria and 1 case of ovale malaria. Moreover， a total of 36 malaria cases were notified in Songjiang through the National Notifiable Disease Reporting System from 2013 to 2022， including cases reported from Songjiang District and other districts or provinces with physical addresses in Songjiang. Of them， there were 31 cases of falciparum malaria， 2 cases of vivax malaria， 2 cases of ovale malaria and 1 case of quartan malaria. The gender ratio of male to female cases was 17∶1， and the majority was young and middle aged. In addition， 35 cases were imported from Africa and 1 case from southeast Asia； 34 cases were migrant workers， and 2 cases were travellers abroad； 17 cases were found and reported in Songjiang， 15 cases were reported from other districts of Shanghai， and 4 cases were reported from other provinces； 27 cases were treated in Shanghai， 3 cases were treated in other provinces and 6 cases were treated with self-provided antimalarial drugs. Mosquito surveillance in Songjiang showed that density of Anopheles sinensis was extremely low. ConclusionNo indigenous malaria case has been notified in Songjiang since 2008. Malaria surveillance on migrant workers remains the focus of malaria prevention and control. Furthermore， achievement of malaria elimination in Songjiang should be continually enhanced to avoid potential further transmission of imported malaria.
ABSTRACT
ObjectiveTo analyze the monitoring data of schistosomiasis from 2004 to 2021 in Suzhou New District， Jiangsu Province， and to provide evidence for improving schistosomiasis elimination strategies. MethodsFollowing the Opinions on Prevention and Control of Schistosomiasis， Parasitic Diseases and Endemic Diseases in Suzhou and the Technical Plan for Prevention and Control of Schistosomiasis， Parasitic Diseases and Endemic Diseases in Suzhou， the monitoring of schistosomiasis in the population and snail habitats from 2004 to 2021 was conducted. The Mann-Kendall method and Joinpoint regression method were employed to analyze the trend of epidemic indicators （such as seropositive rate， prevalence of snail frames， etc.）. Time series analysis （exponential smoothing model） was conducted to predict snail occurrence. ResultsFrom 2004 to 2021， a total of 73 680 people were serologically tested for schistosomiasis， with a positive rate of 0.084%. The seropositivity rate showed statistically significant differences between different years （χ2=70.73， P<0.05）， but there was no significant trend over time. In addition， 3 053 fecal tests were conducted and no positive result was found. The snail habitats covered an area of 70.11 hm2 and showed a decreasing trend （Z=-1.97， P<0.05）. A total of 30 093 frames were surveyed， of which 19.038% contained snails. The difference in the prevalence of snail frames between different years was statistically significant （χ2=7 203.09， P<0.05）， with a decreasing trend in the prevalence of snail frames （Z=-2.05， P<0.05）. A total of 26 296 live snails were seized and density of live snails was 0.874 snails per frame， showing a decreasing trend in the density of live snails （Z=-2.35， P<0.05）. A total of 12 391 snails were dissected and no infected snail was found. The areas treated with molluscicides remained stable at 264.60 hm2. An area of 27.77 hm2 achieved the goal of snail eradication through environmental modification， with a decreasing trend （Z=-2.44， P<0.05）. It is estimated that the prevalence of snail frames and snail density will remain relatively stable from 2022 to 2026， but the snail habitat area will fluctuate significantly， showing an increasing trend. ConclusionNo indigenous cases of schistosomiasis and no infected snails are reported， indicating the successful consolidation of schistosomiasis prevention and control measures. However， the snail habitat area fluctuates greatly with an increasing trend， suggesting the need for long-term Oncomelania snail monitoring in local areas.