Interpretation of the global burden of lung cancer: Current status and future trends / 中国胸心血管外科临床杂志

@#The article titled "The global burden of lung cancer: Current status and future trends" which is recently published in Nature Reviews Cinical Oncology has provided a detailed analysis of the current global status of lung cancer. This article focuses on the global burden of lung cancer, risk factors, related prevention, control measures and treatment progress. Based on the current situation of lung cancer in the world, this paper analyzes the current situation of lung cancer in China, and briefly interprets the key points of prevention as well as control measures in the article.

Tendências na qualidade da atenção à saúde da criança na primeira semana de vida na Atenção Primária no Brasil / Trends in the quality of child health care in the first week of life in primary care services in Brazil

Resumo O objetivo deste estudo foi avaliar a tendência temporal da qualidade da atenção à saúde da criança na consulta da primeira semana de vida no nível da Atenção Primária à Saúde, segundo características dos municípios, do processo de trabalho das equipes e das usuárias responsáveis pelas crianças. Foram realizadas análises transversais com dados dos três ciclos do Programa Nacional de Melhoria do Acesso e da Qualidade (PMAQ) (2012, 2014 e 2018). Usuá­rias adultas com filhos de até dois anos foram entrevistadas. O desfecho foi a "boa qualidade da atenção à saúde na primeira semana de vida". Foram realizadas análises descritivas e de tendência temporal por meio de regressão de mínimos quadrados ponderados por variância. A frequên­cia de boa qualidade na consulta da primeira semana de vida foi 47,9% (IC95% 46,6-49,3) em 2012, 52,5% (IC95% 51,3-53,7) em 2014 e 53,3% (IC95% 52,2-54,4) em 2018, com um aumento anual de 0,73 ponto percentual (p<0,001). O aumento anual foi maior na região Nordeste (2,06 pp) e com IDH muito baixo/baixo (1,48 pp) e com 100% de cobertura de ESF (0,98 pp). Ao longo dos três ciclos do PMAQ-AB houve uma evolução favorável na frequência da boa qualidade na atenção à saúde na primeira semana de vida.

Abstract The aim of this study was to assess temporal trends in the quality of health care during the first-week child check-up in primary care services stratified by municipal, health team and maternal characteristics. We conducted a cross-sectional study using data from the three cycles of the National Program for the Improvement of Access and Quality (PMAQ) (2012, 2014 and 2018). Adult service users with children aged up to 2 were interviewed. The outcome was "good quality health care in the first week of life". Descriptive and time trend analyses were performed using variance-weighted least squares regression. The frequency of good quality care during the first-week check-up was 47.9% (95%CI 46.6-49.3) in 2012, 52.5% (95%CI 51.3-53.7) in 2014 and 53.3% (95%CI 52.2-54.4) in 2018, with an annual increase of 0.73 pp (p<0.001). The annual increase was greater in the Northeast (2.06 pp) and in municipalities with very low/low HDI (1.48 pp) and 100% family health strategy coverage (0.98 pp). Trends in the frequency of good quality health care during the first-week child check-up were favorable.

La Educación Física desde la Educación para el Desarrollo Sostenible

La Educación Física está presente en los currículos de los sistemas educativos en casi todos los países y reporta reconocidos beneficios a la educación integral de los estudiantes, pues en las visiones actuales está al servicio del desarrollo humano; sin embargo, los enfoques de enseñanza-aprendizaje predominantes obvian los postulados fundamentales de la Educación para el Desarrollo Sostenible y enfatizan solo en la dimensión ambiental. De ahí que este artículo tuvo como objetivo realizar una aproximación a la relación entre la Educación Física y la Educación para el Desarrollo Sostenible, desde las diferentes tendencias, las aportaciones a los Objetivos de Desarrollo Sostenible y el vínculo competencial entre ambas. Se empleó el análisis documental, en particular el análisis de contenido, en función de conformar la estructura interna de la información desde la inferencia, a partir de datos no cuantificables y se emplearon métodos complementarios como el análisis, la síntesis, deducción-inducción, el análisis histórico lógico y la educación comparada. Entre los resultados obtenidos estuvieron la determinación de una nueva tendencia de la Educación Física, asociada a la Educación para el Desarrollo Sostenible, se identificó el marco legal que fundamenta la relación entre ambas áreas, se determinaron las concepciones de la Educación Física, desde la Educación para el Desarrollo Sostenible y se encontraron metas específicas, potencialmente pedagógicas de los Objetivos de Desarrollo Sostenible que vinculan las competencias entre ellas.

A Educação Física está presente nos currículos dos sistemas educacionais de quase todos os países e traz benefícios reconhecidos à formação integral dos alunos, pois nas visões atuais está a serviço do desenvolvimento humano; Contudo, as abordagens de ensino-aprendizagem predominantes ignoram os postulados fundamentais da Educação para o Desenvolvimento Sustentável e enfatizam apenas a dimensão ambiental. Assim, este artigo teve como objetivo fazer uma abordagem sobre a relação entre Educação Física e Educação para o Desenvolvimento Sustentável, a partir das diferentes tendências, das contribuições para os Objetivos de Desenvolvimento Sustentável e do vínculo de competências entre ambas. Utilizou-se a análise documental, em especial a análise de conteúdo, para formar a estrutura interna das informações oriundas da inferência, com base em dados não quantificáveis, e foram utilizados métodos complementares como análise, síntese, dedução-indução, análise histórica lógica e comparativa. Educação. Entre os resultados obtidos estiveram a determinação de uma nova tendência na Educação Física, associada à Educação para o Desenvolvimento Sustentável, foi identificado o quadro legal que fundamenta a relação entre ambas as áreas, foram determinadas as concepções de Educação Física, desde a Educação para o Desenvolvimento Sustentável e específicas, foram encontradas metas potencialmente pedagógicas dos Objetivos de Desenvolvimento Sustentável que vinculam as competências entre eles.

Physical Education is present in the curricula of educational systems in almost all countries and brings recognized benefits to the comprehensive education of students, since in current visions it is at the service of human development; however, the predominant teaching-learning approaches ignore the fundamental postulates of Education for Sustainable Development and emphasize only the environmental dimension. Hence, this article aimed to make an approach to the relationship between Physical Education and Education for Sustainable Development, from the different trends, the contributions to the Sustainable Development Goals and the competency link between both. Documentary analysis was applied, in particular content analysis, in order to form the internal structure of the information from inference, based on non-quantifiable data and complementary methods were used such as analysis, synthesis, deduction-induction, historical analysis logic and comparative education. Among the results obtained were the determination of a new trend in Physical Education, associated with Education for Sustainable Development, the legal framework that bases the relationship between both areas was identified, the conceptions of Physical Education were determined, from Education for Sustainable Development and specific, potentially pedagogical goals of the Sustainable Development Goals were found that link the competencies between them.

Análisis tendencial y perspectivas actuales de las tecnologías sanitarias en el sistema de saludcubano

Introducción: El desarrollo de la medicina se favorece activamente con el progreso de la sociedad imperante. Las iniciativas proporcionadas por las diferentes revoluciones industriales han sido significativas para el sector de la salud, es en la tercera revolución industrial, donde se ha logrado una integración activa del desarrollo tecnológico y científico con las ciencias de la salud. Objetivo: Identificar desde diversas aristas las tendencias tecnológicas actuales orientadas en el desarrollo científico para el sector de la salud en Cuba. Métodos: Se realizó un estudio de las diferentes etapas por las que ha transitado el desarrollo médico tecnológico en los últimos cinco años en el mundo y en Cuba, la integración de las Ciencias de la Salud con las tecnologías con una visión histórica-lógica de sus procesos hasta la actualidad; se analizaron sus trayectorias, tendencias y propósitos en los conocimientos, técnicas e impactos más relevantes y principales metas. Conclusiones: En el proceso de informatización del sistema nacional de salud se observa un acelerado impacto del uso de las tecnologías telemáticas en la calidad de las prestaciones de los servicios médicos, lo que se traduce en calidad, efectividad, factibilidad en los servicios de salud y satisfacción social en la excelencia en los servicios médicos asistenciales actuales.

Introduction: The development of medicine is actively favored by the progress of the prevailing society. The initiatives provided by the different industrial revolutions have been significant for the health sector, it is the third industrial revolution, where an active integration of technological and scientific development with the health sciences has been achieved. Objective: To identify from various angles the current technological trends oriented towards scientific development for the health sector in Cuba. Methods: An observational, longitudinal, historical, analytical and synthetic study of the different stages through which technological medical development has passed in the last five years in the world and for Cuba, the integration of Health Sciences with technologies with a historical-logical vision of their processes up to the present; They analyzed their trajectories, trends and purposes in the most relevant knowledge, techniques and impacts and main goals. Conclusions: In the process of computerization of the national health system, an accelerated impact of the use of telematic technologies on the quality of medical services is observed, which translates into quality, effectiveness, feasibility in health services and social satisfaction in excellence in current medical care services.

Asociación entre las tendencias de búsqueda en internet con el número de casos confirmados por la viruela símica: estudio multinacional en diez países

Introducción: La viruela símica es una infección zoonótica que se ha distribuido por todo el mundo. La búsqueda de información en internet refleja el interés y concientización de la población acerca de salud. Objetivo: Determinar la asociación entre el volumen relativo de búsquedas en internet con el número de casos confirmados por la viruela símica en diez países. Métodos: Se realizó un estudio obser- vacional, analítico, retrospectivo, utilizando la herramienta Google Trends (GT™) para encontrar el volumen relativo búsqueda (VRB) sobre viruela símica desde 01 de enero al 31 de agosto del 2022 usando términos de búsqueda en el idioma oficial de los 10 países con mayor número de casos en dichas fechas, registrado por Our World in Data. Para establecer la relación lineal entre el VRB con los nuevos de casos por día se usó el coeficiente de correlación de Pearson con un nivel de significancia (p ≤ 0,05). Resultados: Se encontró un coeficiente de correlación de Pearson fuerte en Brasil (Rp = 0,562,p = 0,001), y débil en países como Alemania (Rp = 0,281, p = 0,004), Estados Unidos de Norteamérica (Rp = 0,255, p = 0,008), España (Rp = 0,122, p = 0,213), Perú (Rp = 0,120, p = 0,333), Canadá (Rp = 0,116, p = 0,238), Francia (Rp = 0,095, p = 0,335), Reino Unido (Rp = 0,085, p = 0,362), Portugal (Rp = 0,024, p = 0,805) y Países Bajos (Rp = 0,067, p = 0,497). Conclusión: Nuestro estudio evidencio que el VRB presento una relación positiva con el número de nuevos casos de viruela símica. Asimismo, se observo un coeficiente de correlación fuerte en Brasil, y en el resto de países fue débil.

Background: Smallpox is a zoonotic infection that has been distributed worldwide. The search for information on the Internet reflects the interest and awareness of the population about health. Aim: To determine the correlation between the relative volume of internet searches and the number of confirmed cases of smallpox in ten countries. Methods: An observational, analytical, retrospective study was conducted using the Google Trends (GT™) tool to find the relative search volume (RSV) on monkeypox from January 1 to August 31, 2022 using search terms in the official language of the 10 countries with the highest number of cases on those dates, as recorded by Our World in Data. To establish the relationship between RSV and new cases per day, Spearman's correlation was used with a significance level (p ≤ 0.05). Results: A. strong Pearson correlation coefficient was found in Brazil (Rp = 0.562, p = 0.001), and weak in countries like Germany (Rp = 0.281, p = 0.004), United States (Rp = 0.255, p = 0.008), Spain (Rp = 0. 122, p = 0.213), Peru (Rp = 0.120, p = 0.333), Canada (Rp = 0.116, p = 0.238), France (Rp = 0.095, p = 0.335), United Kingdom (Rp = 0.085, p = 0.362), Portugal (Rp = 0.024, p = 0.805) and Netherlands (Rp = 0.067, p = 0.497). Conclusion: Our study showed that RSV had a positive relationship with the number of new cases of smallpox. Also, a strong correlation coefficient was observed in Brazil, while the rest of the countries showed a weak correlation coefficient.

Indications and types of keratoplasties: Trends in the past 10 years (2011-2020) in Eastern India

Purpose: To observe the trends of various types of keratoplasties in different etiologies over a period of 10 years (2011?2020) in a tertiary eye care center of eastern India. Methods: A retrospective review of patients undergoing keratoplasties from 2011 to 2020 was performed in a tertiary eye care hospital situated in eastern part of India. Apart from demographic data, primary indication for each surgery and type of procedure carried out was recorded. For comparison, data were divided into two time periods: Group I: Jan 2011 to Dec 2015 and Group II: Jan 2016 to Dec 2020. Results: Over a period of 10 years, a total of 2365 (Group I: 902, Group II: 1463) keratoplasties were performed. The average age of patients was 45.8 � 19.9 and 46.9 � 20.9 years in Group I and Group II, respectively. Among all the corneal grafts, 1747 (74%) surgeries were full?thickness. Although optical penetrating keratoplasty (OPK) was most the common indication for full?thickness keratoplasties, Descemet抯 stripping endothelial keratoplasty (DSEK) remained most performed lamellar keratoplasty. Keratitis, corneal scars, and bullous keratopathies remain to be most common indications in both groups. Number of lamellar keratoplasties increased significantly from Group I to Group II for corneal scars (P = 0.02), bullous keratopathies (P = 0.01), and endothelial dystrophies (P = 0.00). Conclusion: With change in time, the indication and technique of keratoplasty has witnessed a changing trend from full?thickness keratoplasty to lamellar keratoplasty. There is rise in trend of lamellar keratoplasties over the period

Factores sociodemográficos en la dinámica del comportamiento delictivo: análisis descriptivo de criminalidad en Colombia, año 2022 / Socio-demographic factors in the dynamics of criminal behaviour: descriptive analysis of criminality in Colombia, year 2022 / Fatores sociodemográficos na dinâmica do comportamento criminal: análise descritiva da criminalidade na Colômbia, ano de 2022

El presente estudio de carácter descriptivo y analítico tiene como objetivo principal presentar el comportamiento criminal en Colombia para el 2022, desde un enfoque cuantitativo empleado para la extracción, análisis e interpretación de los registros administrativos del Sistema de Información Estadístico, Delincuencial, Contravencional y Operativo (SIEDCO), constituyéndose como un insumo para aquellos interesados en el estudio de la dinámica criminal, así como para quienes se encargan de diseñar estrategias para la contención del delito y la generación de política pública en materia de seguridad. En este sentido y en el marco de las dinámicas sociodemográficas, en una primera parte se aborda de manera general el proceso de homogenización de los registros administrativos llevado a cabo por la Policía Nacional y la Fiscalía General de la Nación. Y en una segunda parte, con especial énfasis en el homicidio intencional, se presenta el análisis de la información que permitió identificar las principales variables que influyen en la comisión del delito, de acuerdo con las cifras contenidas en el SIEDCO, en el periodo comprendido entre el 1 de enero y el 31 de diciembre de 2022, comparado con la misma temporalidad del 2021, en el que se detallan los delitos que afectan la integridad personal y el patrimonio económico de quienes habitan el territorio colombiano; se hallaron incrementos considerables en estos y se resaltan los factores de oportunidad para su comisión, situación contraria a la que se evidenció sobre las afectaciones a la vida y la integridad, conjunto de conductas que, según lo registrado, decrecieron en el periodo analizado. Finalmente, se ofrece un aporte a la contención desde la actividad de policía y una serie de conclusiones que permitan ampliar la visión sobre los diversos fenómenos y enriquecer la generación de conocimiento en el campo de la criminología.

The main objective of this descriptive and analytical study is to present criminal behaviour in Colombia for 2022, from a quantitative approach used for the extraction, analysis and interpretation of the administrative records of the Statistical, Criminal, Contraventional and Operational Information System (SIEDCO), constituting an input for those interested in the study of criminal dynamics, as well as for those responsible for designing strategies for the containment of crime and the generation of public policy on security. In this sense, and within the framework of socio-demographic dynamics, the first part of the paper deals in a general way with the process of homogenisation of administrative records carried out by the National Police and the Attorney General's Office. The second part, with special emphasis on intentional homicide, presents the analysis of the information that made it possible to identify the main variables that influence the commission of the crime, according to the figures contained in SIEDCO, in the period between 1 January and 31 December 2022, compared with the same period in 2021, in which the crimes that affect the personal integrity and economic patrimony of those who live in Colombian territory are detailed; considerable increases were found in these and the factors of opportunity for their commission are highlighted, contrary to the situation that was evidenced in the affectations to life and integrity, a group of conducts that, according to what was recorded, decreased in the period analysed. Finally, we offer a contribution to containment from the police activity and a series of conclusions that allow us to broaden the vision of the diverse phenomena and enrich the generation of knowledge in the field of criminology.

O principal objetivo deste estudo descritivo e analítico é apresentar o comportamento criminal na Colômbia para 2022, a partir de uma abordagem quantitativa utilizada para a extração, análise e interpretação dos registros administrativos do Sistema de Informação Estatística, Criminal, Contravencional e Operacional (SIEDCO), constituindo um insumo para os interessados no estudo da dinâmica criminal, bem como para os responsáveis pela elaboração de estratégias para a contenção do crime e a geração de políticas públicas de segurança. Nesse sentido, e dentro da estrutura da dinâmica sociodemográfica, a primeira parte do artigo trata de forma geral do processo de homogeneização dos registros administrativos realizado pela Polícia Nacional e pela Procuradoria Geral da República. A segunda parte, com ênfase especial no homicídio doloso, apresenta a análise das informações que permitiram identificar as principais variáveis que influenciam o cometimento do crime, de acordo com os números contidos no SIEDCO, no período entre 1º de janeiro e 31 de dezembro de 2022, em comparação com o mesmo período de 2021, no qual são detalhados os crimes que afetam a integridade pessoal e o patrimônio econômico daqueles que vivem em território colombiano; Neles foram encontrados aumentos consideráveis e são destacados os fatores de oportunidade para seu cometimento, ao contrário da situação que se evidenciou nas afetações à vida e à integridade, grupo de condutas que, segundo o que foi registrado, diminuiu no período analisado. Finalmente, oferecemos uma contribuição para a contenção da atividade policial e uma série de conclusões que nos permitem ampliar a visão dos diversos fenômenos e enriquecer a geração de conhecimento no campo da criminologia.

Percutaneous Suspensory Stabilization of Chronic Distal Radioulnar Joint (DRUJ) Dislocation Using an Adjustable Loop Endobutton Construct: Case Report / Fixação suspensiva percutânea de luxação crônica da articulação radioulnar distal (ARUD) usando um dispositivo de endobutton de laço ajustável: Relato de caso

Abstract Chronic distal radioulnar joint (DRUJ) dislocation has been treated historically with complex osteotomies and reconstructive procedures, often resulting in intractable stiffness and loss of function. It is desirable to use a technique of fixation that will not only restore the wrist biomechanics but also be cosmetically appealing to the individual. We present a novel technique of reduction and fixation of a chronically dislocated DRUJ in a 26-year-old male using a minimally invasive approach, with successful restoration of DRUJ function and no postoperative complications.

Resumo Luxação crônica da articulação radioulnar distal (ARUD) foi tratada historicamente com osteotomias complexas e procedimentos reconstrutivos, geralmente resultando em rigidez intratável e perda de função. É desejável usar uma técnica de fixação que não apenas restaure a biomecânica do punho, mas também seja esteticamente atraente para o indivíduo. Apresentamos uma nova técnica de redução e fixação de uma ARUD deslocada cronicamente em um homem de 26 anos, usando uma abordagem minimamente invasiva, com restauração bem-sucedida da função da ARUD e sem complicações pós-operatórias.

Analysis of incidence, mortality and lethality by COVID-19 in the States of Pará and Rio Grande do Sul, Brazil: epidemiological aspects of evolution 2020-2022

Introduction: COVID-19 unfolded differently in Pará and Rio Grande do Sul, Brazil, owing to distinct socioeconomic contexts. From 2020 to 2022, both states implemented diverse measures against the virus SARS-CoV-2, including vaccination and variant monitoring, tailored to their specific challenges. Understanding regional impacts on COVID-19 indicators is crucial for designing effective control strategies. Objective: to analyze the incidence, mortality, and lethality of COVID-19 in Pará and Rio Grande do Sul and the trends of these indicators from 2020 to 2022. Methods: ecological study with time series from public and official data available in the Health Secretariat of Pará and Rio Grande do Sul, including all cases and deaths by COVID-19 from February 2020 to December 2022. Lethality, mortality, and incidence rates were calculated. Prais-Winsten regression analysis was used, and trends were classified as stationary, increasing, or decreasing. Significant differences were considered when the p-value is <0.05. Results: when examining the lethality rates between the states of Para and Rio Grande do Sul, an observable trend emerged during the analyzed period. It became evident that the total lethality rate consistently remained higher in Para. Noteworthy peaks in lethality were mainly observed during the months of April 2020, May 2020, and March 2021. The incidence rates showed increasing trends during 2020, both in Pará with a daily percentage change (DPC) of 1.69% (p <0.05) and in Rio Grande do Sul with a DPC of 1.70% (p<0.05). In 2021, the incidence was decreasing (p <0.05) in both states, with a DPC of 0.60% in Pará and 0.64% in Rio Grande do Sul and continued this trend in Pará in 2022 (DPC of -0.50% p <0.05), becoming stationary in Rio Grande do Sul, with a non-significant p-value (p> 0.05).Conclusion: the positive impact of the vaccination program is reflected in the evolution of the pandemic. During the study period Rio Grande do Sul and Para exhibited a stationary incidence trend, emphasizing the need for continued monitoring of cases and morbidity across various age and demographic groups.

Tendencia de mortalidad hospitalaria por COVID-19 en mujeres y hombres / Trends in COVID-19-related in-hospital mortality in women and men

Resumen Introducción: Todavía no se comprende si el desarrollo político, científico y médico en un país se asocia a mejores resultados clínicos de los pacientes con COVID-19 según el sexo. Objetivo: Determinar las tendencias de mortalidad hospitalaria asociada a COVID-19 en mujeres y hombres entre marzo de 2020 y febrero de 2022. Métodos: Se utilizaron los datos clínicos de todos los pacientes con COVID-19 atendidos en 21 hospitales españoles, tanto de quienes fueron dados de alta como de quienes fallecieron durante el ingreso. La asociación entre la fecha del ingreso y la mortalidad se analizó con modelos de regresión logística. Resultados: Fueron incluidos 7974 pacientes, de los cuales 3234 fueron mujeres y 928 fallecieron. Se encontró una tendencia significativa y decreciente en la mortalidad según avanzaba la fecha del ingreso. Cuando el análisis se realizó por sexos, no se halló una tendencia significativa en las mujeres (RM = 0.96 [0.90-1.03], p = 0.239), pero sí en los hombres (RM = 0.87 [0.82-0.92], p < 0.001). Conclusión: Las políticas de salud, junto con las intervenciones clínicas y preventivas, pueden dar cuenta de los resultados. Diferencias en la respuesta al tratamiento o en los comportamientos pueden explicar por qué la mortalidad no disminuye en las mujeres.

Abstract Introduction: Whether political, scientific and medical development in a country is associated with better clinical results according to gender in patients with COVID-19 has not yet been clearly elucidated. Objective: To determine the trends of COVID-19-related in-hospital mortality in women and men from March 2020 to February 2022. Methods: Clinical data of all patients with COVID-19 cared for at 21 Spanish hospitals were used, both of those who were discharged and of those who died during hospitalization. The association between hospital length of stay and mortality was analyzed with logistic regression models. Results: Out of 7,974 patients that were included, 3,234 were women; 928 patients died. A significant decreasing trend in mortality was identified. When the analysis was carried out by gender, no significant mortality trend was found in women (OR = 0.96 [0.90-1.03], p = 0.239), while in men there was a significant decreasing trend identified (OR = 0.87 [0.82-0.92], p < 0.001). Conclusion: Health policies, together with clinical and preventive interventions, may explain these results. Response to treatment and behavioral differences may explain why mortality does not decrease for women.

Linear trends over 20 years in sexually transmitted infections among patients attending a tertiary care centre in north Kerala, India

Background: Worldwide, a declining trend is observed in sexually transmitted infections of bacterial origin which is reflected as a rise in the proportion of viral sexually transmitted infections. Aims: To find out the clinical referral patterns of sexually transmitted infections among patients who attended the sexually transmitted infection clinic attached to Dermatology and Venereology Department of Government Medical College, Kozhikode from 1.1.1998 to 31.12.2017 and to study the linear trends in the pattern of sexually transmitted infections over 20 years. Methods: After clearance from the institutional ethics committee, a retrospective study was conducted among patients who attended the sexually transmitted infection clinic of Government Medical College, Kozhikode from 1.1.1998 to 31.12.2017 and were diagnosed to have sexually transmitted infections. Results: During the 20 year study period 5227 patients, attended the sexually transmitted infection clinic of our institution. Diagnosis of sexually transmitted infection was made in 2470 (47.3%) cases. Predominant sexually transmitted infections were herpes genitalis (964, 39%), condyloma acuminata (921, 37.9%) and syphilis (418, 17.2%). Viral sexually transmitted infections (1885, 76.3%) outnumbered bacterial sexually transmitted infections (575, 23.3%). A declining trend was noted for both bacterial and viral sexually transmitted infections over the 20 year period, which was more marked for the former. But the latter years of the study documented a rising trend in total sexually transmitted infections including bacterial sexually transmitted infections. Limitations: The study does not reflect the status of sexually transmitted infections in the general population since it was conducted in a tertiary referral center. Conclusion: The disturbing ascending trend recorded in sexually transmitted infections including syphilis during the final years of the 20-year period needs to be watched closely, to plan future strategies

Factors Affecting Under-Five Mortality Rate (U5MR) in India- National Family Health Survey (NFHS) 5 Factsheet What It Speaks?

Introduction: In developing countries various factors lead to Under-5 Mortality and irreversible losses which can be prevented by proper measures take on factors affecting to it. Objective: This study was conducted to analyse the changing trends of Under-5 Mortality in India. The new National Family Health Survey (5th round) which was published recently came up with several new findings, which were both encouraging and disheartening and also one of the major Sustainable Development Goals.Method: A secondary data analysis was conducted of NFHS factsheets to study the U5MR in India. The indica-tors which had a correlation either positive or negative with the Under-five mortality rate were included.Result- When we look at the result, few states' performance is encouraging because they have shown some of the best declines. Correlation was found between dependant variable that is U5MR which is a dependent vari-able and several independent variables which concluded that factors like Women literacy, Men literacy, Breastfeeding, Nutritional insufficiencies, Caesarean delivery, ANC visits and IFA consumptions are negatively associated withU5MR. Conclusion: Various steps have been taken in order to improve our healthcare sector since independence, every government had their fair share of contribution, that’s the reason why we are this stage. Now it’s time to increase efforts with targeted interventions to solve this problem and complete our commitment towards the SDGs.

Trends in Urban Immunization Coverage in India: A Meta-Analysis and Meta-Regression

Objectives To assess the gaps and trends in child immunization coverage among urban and rural areas in India, and compare the success of immunisation program in each. Methods PubMed, Scopus, and Crossref, and Google Scholar electronic databases were searched on October 9, 2019, and March 21, 2020, for studies that measured and reported immunization coverage indicators in India. Random-efects metaanalyses and meta-regressions were conducted. Results The authors' search identifed 545 studies, and 2 were obtained by expert suggestion. Among these 68 studies and 6 surveys were included. They found that full immunization coverage has grown yearly at 2.65% and 0.82% in rural and urban areas, respectively whereas partial immunization coverage declined by ?2.44% and ?0.69%, respectively. Percentage of nonimmunized children did not show a statistically signifcant trend in either. Conclusion While rural immunization coverage has seen a large increase over the past two decades, the progress in urban areas is weak and negligible. This was largely attributable to a focus on minimizing dropouts in rural areas. However, a lack of signifcant reduction in unimmunized children may indicate left-out children or pockets in both rural and urban areas. The poor performance of immunization programs in urban areas, coupled with a larger impact of COVID-19, warrants that India urgently adopts urban-sensitive and urban-focused policies and programs.

Do compromisso ético-político à concepção de projeto profissional na terapia ocupacional: um debate necessário ao trabalho na assistência social / From an ethical and political commitment to the design of a professional occupational therapy project: a debate necessary for social assistance work

Resumo Terapeutas ocupacionais compõem as equipes técnicas da assistência social anteriormente à formalização de sua inserção no Sistema Único de Assistência Social (SUAS), ocorrida em 2011. Com isso, a discussão sobre o trabalho nesse setor e sobre a questão social ganhou relevância na profissão do ponto de vista interventivo e teórico-acadêmico. Neste estudo, refletimos, a partir da perspectiva marxista, sobre a forma como a questão social determina as demandas que requisitam o trabalho na assistência social. Em seguida, apresentamos as concepções de projetos societários - entendidos como projetos coletivos que expressam intencionalidades de classe para a sociedade, e de projetos profissionais - definidos como projetos coletivos relacionados às profissões, constituídos de princípios éticos e políticos, que são referenciais teórico-metodológicos para o exercício profissional e que estabelecem bases para suas relações com os usuários dos serviços, com outras profissões e com organizações e instituições. Finalizamos propondo que a terapia ocupacional social é um referencial teórico-metodológico que pode ser adotado para construir um projeto profissional crítico-transformador: crítico à estrutura e à dinâmica da sociedade capitalista que repõem continuamente as expressões da questão social, tangenciando os cotidianos dos sujeitos; ao modelo neoliberal de gestão do Estado que fragiliza os direitos e precariza a vida das pessoas; às tendências conservadoras do trabalho na assistência social que individualizam, medicalizam, psicologizam e moralizam a leitura das problemáticas que se apresentam como demandas profissionais; e ao papel e função social da terapia ocupacional na sua relação com a sociedade, rompendo com uma visão tecnicista e pretensamente neutra da profissão.

Abstract Occupational therapists compose technical teams in social assistance services before the formalization of their insertion in the Unified Social Assistance System (SUAS), which occurred in 2011. As a result, the discussion about the work in this sector and the social question has gained relevance in the profession from an interventional and theoretical-academic point of view. In this study, from a Marxist perspective, we reflect on how the social question determines the demands observed in social assistance work. Next, we present the concepts of societal projects - understood as collective projects that express class intentions for society, and of professional projects - defined as collective projects related to professions composed of ethical and political principles, which are theoretical and methodological references for professional practice, and that establish bases for their relationships with service users, other professions, and organizations and institutions. We conclude by proposing that social occupational therapy is a theoretical and methodological framework that can be adopted to construct a critical-transformative professional project: critical of the structure and dynamics of capitalist society that continually replace the expressions of the social question, touching the everyday life of subjects; critical of the neoliberal model of State management that weakens rights and makes people's lives precarious; critical of the conservative trends of work in social assistance that individualize, medicalize, psychologize, and moralize the reading of problems presented as professional demands; critical of the role and social function of occupational therapy in its relationship with society, breaking with a technical and supposedly neutral view of the profession.