A Study of Awareness, Knowledge, Attitudes, and Practices Regarding Antibiotic Resistance.

Background Antibiotic resistance is a critical global health concern, intensified by public misconceptions and inconsistent antibiotic use. Misunderstandings about antibiotics and their improper use contribute to the acceleration of resistance, making it harder to treat infections effectively. Previous research has identified knowledge gaps in the public, yet there is limited understanding of how these gaps translate into attitudes and practices across different demographic groups. This study aimed to assess the levels of knowledge, attitudes, and practices regarding antibiotic resistance among various demographic groups and to determine the influence of demographic factors on these variables. Methods A descriptive study was conducted using a structured online questionnaire distributed through social media and health forums. The questionnaire targeted adults aged 18 years and older from diverse socioeconomic backgrounds. Data were analyzed using SPSS version 26 (Armonk, NY: IBM Corp.) for descriptive statistics, chi-square tests, and logistic regression analysis. Results The study included responses from 1,561 participants, revealing that 75.72% had knowledge of antibiotic resistance, but only 68.23% understood its public health implications. Attitudes toward antibiotic use were generally positive, with 90.14% recognizing the importance of completing antibiotic courses. However, 32.16% admitted they would stop taking antibiotics once feeling better, even if the course was not finished, highlighting a significant gap between knowledge and practice. Regression analysis identified awareness of prevention measures (coefficient=2.06) and knowledge of antibiotic resistance (coefficient=1.38) as strong predictors of awareness. The chi-square test showed a significant association between gender and awareness of prevention measures (chi-square value=15.19, p-value=0.000097). Conclusions Despite a high level of knowledge about antibiotic resistance, gaps in attitudes and practices persist. These findings underscore the necessity for tailored educational campaigns that not only inform but also engage and alter behaviors across all demographic groups to combat antibiotic resistance effectively.

A systems approach to multilingual language attitudes: A case study of Montréal, Québec, Canada.

Purpose: People are shaped holistically by dynamic and interrelated individual and social-ecological systems. This perspective has been discussed in the context of varied aspects of bilingual experiences, namely language acquisition and development. Here, we applied a Systems Framework of Bilingualism to language attitudes, which may be especially responsive to social-ecological influences. Methodology: One hundred twenty-three French-English bilingual adults (M age = 21.20, SD = 3.21) completed self-report questionnaires on demographic information and their attitudes toward languages. A subset of these bilinguals (n = 73) completed a social network survey. Data and analysis: We used language-tagged social network analysis and geospatial demographic analysis to examine the role of individual characteristics (i.e., first language), interpersonal language dynamics (i.e., person-to-person interactions), and ecological language dynamics (i.e., neighborhood language exposure). Findings and Conclusions: At an individual level, we found that bilinguals' language background (i.e., first language) predicted attitudes of solidarity toward a language (i.e., whether a language is associated with personal identity and belongingness). When considering sociolinguistic layers of influence, we found that bilinguals' social network and neighborhood-level language exposure jointly predicted their attitudes of solidarity toward a language, as well as their attitudes toward the protection of minority languages. Originality: While most studies have examined language experience in a unidimensional nature, the present study investigated multilingual language attitudes by considering multiple systems within a social-ecological framework. Implications: Taken together, the results suggest that several interrelated interpersonal and ecological systems are associated with language attitudes, which could have important implications for planning future language policies in multilingual societies such as Montréal.

Active Case-Finding: An Effective Solution for Tuberculosis Detection in Vulnerable Groups - The Romanian Experience.

Introduction: Tuberculosis (TB) remains a global health challenge, requiring enhanced active case finding (ACF) through screening strategies. This study assesses the effectiveness of such an approach in locating TB cases among vulnerable groups, such as homeless persons, injecting drug users, those detained in prison, and people living in rural areas. Methods: The study focuses on socio-economic characteristics and TB detection rates across Romanian counties using modern techniques including computer-aided detection of lesions on chest X-ray and GeneXpert tests. Results: The results highlight the disproportionate burden of TB in vulnerable groups, by revealing significant differences in TB detection rates between regions. Notably, the TB detection rates among these vulnerable groups (250.85 per 100,000 population) are five times higher than the national incidence rate (46.1). Discussion: These findings underscore the imperative integration of ACF into National TB Program to provide customized and efficient solutions for diverse vulnerable groups, thereby informing crucial public health initiatives and interventions.

Thripidae pest species community identification and population genetic diversity analyses of 2 dominant thrips in cotton fields of China.

Thrips are devastating pests for various crops, and they can rasp tender leaves, terminal buds, and flowers, which specifically causing huge economic losses to cotton production. However, there is very little knowledge about the species composition of thrips in mainland China, as well as the genetic structure of the thrips populations, particularly in the cotton-producing regions. In this study, thrips were collected from 40 geographical locations at 8 different provinces which representing majority cotton-producing belts in China, and mitochondrial cytochrome oxidase subunit I sequence was used to identify species composition and evaluate the genetic diversity of collected thrips individuals. Based on experimental results proven that overall, 10 and 8 species of thrips were identified in seedling and flowering stage respectively, which is corresponding dominant species are Thrip tabaci (Lindeman) and Frankliniella intonsa (Trybom). Genetically, 24 haplotypes were identified in 310 T. tabaci individuals from 10 locations, and 263 haplotypes were detected in 1,861 F. intonsa individuals from 40 locations. Hap1 (T. tabaci) is the most widely distributed haplotype among all the T. tabaci samples. Likewise, Hap 2 is the most widely distributed and abundant haplotype among all samples of F. intonsa. The genetic differentiation degrees of T. tabaci between SXYC population and other 9 populations were high, but its gene flow in these 10 regions was relatively low, which might be due to geographical barriers. The Mantel tests showed no correlation between genetic distance and geographic distance of the 2 thrip species. Demographic analysis results showed that both T. tabaci and F. intonsa experienced population expansion in China. Taken together, this study identifies the species composition of thrips in major cotton-producing regions at different growth periods and evaluates effects of geomorphology on the geographical distribution of haplotypes of dominant thrips T. tabaci and F. intonsa.

Demography and Genealogical Analysis of Massese Sheep, a Native Breed of Tuscany.

This study investigates the genealogical and demographic trends of the Massese sheep breed in Tuscany from 2001 to 2021. The Herd Book kept by the Italian Sheep and Goat Breeders Association (Asso.Na.Pa) provided the data. The descriptive statistics were analyzed using JMP software. The pedigree parameters of a total of 311,056 animals (whole population-WP) were analyzed using CFC, ENDOG, and Pedigree viewer software. A total of 24,586 animals born in the period 2007-2021 represented the Reference Population (RP), and 18,554 animals the Base Population (BP). The demographic results showed an inconsistent trend of offspring registration. This study showed a short period of productivity for both ewes and rams, with means of 1.47 and 19.2 registered newborn ewes and rams, respectively. The genealogical analysis revealed incomplete data, highlighting inaccurate assessments of the relationships among the animals, and inbreeding with large differences among provinces. The average inbreeding coefficient in the WP was 1.16%, and it was 2.26% in the RP. The total number of inbreds was 2790 in the WP, with an average FPED of 13.56%, and 2713 in the RP, with an average FPED of 12.82%. The use of pedigree data is a key and economical approach to calculating inbreeding and relationship coefficients. It is the primary step in genetic management, playing a crucial role in the preservation of a breed. The regular updating of genealogical data is the first step to ensuring the conservation of animal genetic resources, and this study is compromised by the lack of such updates.

Clinical Characteristics and Outcomes of a High-grade Endometrial Cancer Cohort Treated at Instituto Nacional de Câncer, Brazil / Características clínicas e desfechos de uma coorte de câncer endometrial de alto grau tratada no Instituto Nacional de Câncer, Brasil

Abstract Objective To analyze the outcomes of a cohort of patients with high-risk histologies of endometrial cancer (EC) treated at Instituto Nacional de Câncer (National Cancer Institute, INCA, in Portuguese), in Brazil. Materials and Methods We reviewed the medical records of patients with high-risk histologies of EC in any stage registered at INCA between 2010 and 2016 to perform a clinical and demographic descriptive analysis and to evaluate the outcomes in terms of recurrence and survival. Results From 2010 to 2016, 2,145 EC patients were registered and treated at INCA, and 466 had high-grade histologies that met the inclusion criteria. The mean age of the patients was 65 years, 44.6% were Caucasian, and 90% had a performance status of 0 or 1. The most common histology was high-grade endometrioid (31.1%), followed by serous carcinoma (25.3%), mixed (20.0%), carcinosarcoma (13.5%), and clear cell carcinoma (9.4%). Considering the 2018 Fédération Internationale de Gynécologie et d'Obstétrique (International Federation of Gynecology and Obstetrics, FIGO, in French) staging system, 44.8%, 12.4%, 29.8%, and 12.9% of the patient were in stages I, II, III or IV respectively. Age (> 60 years), more than 50% of myoinvasion, higher stage, poor performance status, serous and carcinosarcoma histologies, and adjuvant treatment were independent factors associated with recurrence-free survival (RFS) and overall survival (OS) in the multivariate analysis. Conclusion The current findings reinforced the international data showing poor outcomes of these tumors, especially for serous and carcinosarcomas and tumors with advanced stages, with shorter survival and high recurrence rates in distant sites, independently of the FIGO stage. Adjuvant therapy was associated with better survival.

Resumo Objetivo Analisar os desfechos de uma coorte de pacientes com câncer de endométrio (CE) e histologias de alto risco atendida no Instituto Nacional do Câncer (INCA) entre 2010 e 2016. Materiais e Métodos Foram revisados prontuários de pacientes com histologias de alto risco de CE em qualquer estágio cadastradas no INCA entre 2010 e 2016 para realizar uma análise descritiva clínica e demográfica e avaliar os resultados em termos de recorrência e sobrevida. Resultados De 2010 a 2016, 2.145 pacientes com CE foram cadastradas e atendidas no INCA, e 466 tinham histologias de alto grau e atendiam aos critérios de inclusão. A média de idade das pacientes foi de 65 anos, 44,6% eram brancas, e 90% tinham performance status de 0 ou 1. A histologia mais comum foi endometrioide de alto grau (31,1%), seguida de carcinoma seroso (25,3%), misto (20,0%), carcinossarcoma (13,5%) e carcinoma de células claras (9,4%). Considerando o estadiamento da Fédération Internationale de Gynécologie et d'Obstétrique (Federação Internacional de Ginecologia e Obstetrícia, FIGO, em francês) de 2018, 44,8%, 12,4%, 29,8% e 12,9% apresentaram estágios I, II, III ou IV, respectivamente. Idade (> 60 anos), mais de 50% de mioinvasão, estágio avançado, performance status ruim, histologias serosas e carcinossarcoma, e tratamento adjuvante foram fatores independentes associados à sobrevida livre de recorrência e sobrevida global na análise multivariada. Conclusão Os achados atuais reforçam os dados internacionais que demonstram o prognóstico ruim desses tumores, principalmente para as histologias serosas e carcinossarcomas e para estágios avançados, com menor sobrevida e altas taxas de recorrência à distância, independentemente do estágio da FIGO. A terapia adjuvante foi associada a melhor sobrevida.

Socio-demographic and Audiological Profile of the Board-Reviewed Applicants for Hearing Handicap Certification in a Tertiary Care Teaching Institute in Eastern India.

To analyze the socio-demographic and audiological profile of the applicants for hearing handicap certification in the Medical Board (henceforth, "Board") of a tertiary care teaching institute. This is a retrospective record review (March 2019-February 2020) from the archival computer database of the institutional Board. The procedure for audiological assessment prior to Board review and thereafter, the evaluation at the Board (computation of hearing impairment) for eligibility for certification was discussed. The socio-demographic profile of the applicants (age, gender, faith) and the types of hearing impairment [HI%; organic (sensorineural, mixed), non-organic (malingering)] were analyzed with relevant statistical parameters. A HI% scale was introduced to classify the severity of the hearing deficit. Of the 163 applicants, 148 had organic hearing loss (average age: 35.4 years; 1.9 times male preponderance) and 15 were malingerers (average age: 35.7 years; 14 times male preponderance). The left ear contributed more to the hearing handicap. Most applicants having sensorineural hearing loss (SNHL; n = 124) were within 10-19 years and 40-49 years (19.35% each), with 12% being ≧ 60 years (age-associated hearing loss). Of the 13 applicants of age ≦ 12 years, eight were diagnosed with brainstem evoked response audiometry, and 10 had HI score of ≥ 70%. Muslim population with SNHL tended to avail certification 1.34 times more than the Hindus. Most of the applicants with mixed hearing loss (MHL; n = 24) were in their fifth and sixth decades (29.2% each), with three times male preponderance. Among the malingerers, the average malingering impairment was 66% (median: 61%; range 44-100%). Among the SNHL population, ~ 30% had HI at 90-100% in contrast to the MHL population of whom 8% had HI at > 90% and 29% had HI at 40- < 55%. Ten applicants among the organic hearing loss group (6.76%) (two with SNHL; eight with MHL) had HI scores of < 40% and were considered ineligible for certification. The outcomes of the review provided a comprehensive account of the socio-demographic profile of the applicants for handicap certification and the type of hearing loss prevailing in a given population. These data, and the severity stratification of the hearing disability through the HI% scale would provide the policymakers and stakeholders with proper directions to work upon.

Demographic Analysis of Shortfin Mako Shark (Isurus oxyrinchus) in the South Pacific Ocean.

The shortfin mako shark (Isurus oxyrinchus) demonstrates low productivity and is thus relatively sensitive to fishing. Natural mortality (M) and fishing mortality (F) data are critical to determine their population dynamics. However, catch and fishing effort data are unavailable for this species in the South Pacific Ocean, making stock assessments difficult. Demographic quantitative methods aid in analyzing species with limited data availability. We used a two-sex stage-structured matrix population model to examine the demographic stock status of mako sharks. However, data-limited models to determine fishery management strategies have limitations. We performed Monte Carlo simulations to evaluate the effects of uncertainty on the estimated mako shark population growth rate. Under unfished conditions, the simulations demonstrated that the mako sharks showed a higher finite population growth rate in the 2-year reproductive cycle compared to the 3-year reproductive cycle. Protecting immature mako sharks led to a higher population growth rate than protecting mature mako sharks. According to the sex-specific data, protecting immature male and female sharks led to a higher population growth rate than protecting mature male and female sharks. In conclusion, sex-specific management measures can facilitate the sustainable mako shark conservation and management.

Whole-genome sequencing revealed different demographic histories among the Korean endemic hill pigeon (Columba rupestris), rock pigeon (Columba livia var. domestica) and oriental turtle dove (Streptopelia orientalis).

BACKGROUND: The family Columbidae is known as the pigeon family and contains approximately 351 species and 50 genera. Compared to the wealth of biological and genomic information on these Columba livia var. domesteca, information on Columba rupestris and Streptopelia orientalis has been rather limited. The C. rupestris population size is decreasing in Korea. OBJECTIVES: Whole-genome sequencing and identification of population characterization of each species based genome variation on 9 Korean pigeon and dove samples, namely, six hill pigeon (C. rupestris), one rock pigeon (C. livia var. domestica) and two oriental turtle dove (S. orientalis) samples. RESULTS: The whole genome of 9 genotypes were sequenced and mapped to the C. livia reference genome. Sequence alignment showed over 96% identity in C. rupestris and 94% identity in S. orientalis to the reference genome (GenBank assembly accession: GCA_001887795.1). Sequence variations, including single nucleotide polymorphisms (SNPs), insertions and deletions (InDels), and structural variations, revealed that intergenus (Columba vs. Streptopelia) variations were approximately four times higher than intragenus variations (C. livia vs. C. rupestris). Of the two Columba species, C. livia var. domestica is closer to S. orientalis than C. rupestris. Pairwise sequentially Markovian coalescent (PSMC) demographic history analysis revealed that the three species underwent a common population bottleneck between 105 and 120 Kya; since then, the effective population sizes of the rock pigeon and oriental turtle dove have increased. CONCLUSION: The effective population size of the hill pigeon, an Endangered Species of Grade II in Korea, has increased slowly from the second severe bottleneck that occurred approximately 0.5-1.4 × 104 years ago. Our results showed no relationship between copy number variation in the Norrie disease protein (NDP) regulatory regions and plumage color patterns. We report the first comparative analysis of three pigeon genomes.

Two Years of Evolutionary Dynamics of SARS-CoV-2 in Mexico, With Emphasis on the Variants of Concern.

Background: The advance of the COVID-19 pandemic and spread of SARS-CoV-2 around the world has generated the emergence of new genomic variants. Those variants with possible clinical and therapeutic implications have been classified as variants of concern (VOCs) and variants of interest (VOIs). Objective: This study aims to describe the COVID-19 pandemic and build the evolutionary and demographic dynamics of SARS-CoV-2 populations in Mexico, with emphasis on VOCs. Methods: 30,645 complete genomes of SARS-CoV-2 from Mexico were obtained from GISAID databases up to January 25, 2022. A lineage assignment and phylogenetic analysis was completed, and demographic history for Alpha, Gamma, Delta and Omicron VOCs, and the Mexican variant (B.1.1.519) was performed. Results: 148 variants were detected among the 30,645 genomes analyzed with the Delta variant being the most prevalent in the country, representing 49.7% of all genomes. Conclusion: The COVID-19 pandemic in Mexico was caused by several introductions of SARS-CoV-2, mainly from the United States of America and Europe, followed by local transmission. Regional molecular epidemiological surveillance must implement to detect emergence, introductions and spread of new variants with biologically important mutations.

Assessing the effects of Bt maize on the non-target pest Rhopalosiphum maidis by demographic and life-history measurement endpoints.

The most commercialized Bt maize plants in Europe were transformed with genes which express a truncated form of the insecticidal delta-endotoxin (Cry1Ab) from the soil bacterium Bacillus thuringiensis (Bt) specifically against Lepidoptera. Studies on the effect of transgenic maize on non-target arthropods have mainly converged on beneficial insects. However, considering the worldwide extensive cultivation of Bt maize, an increased availability of information on their possible impact on non-target pests is also required. In this study, the impact of Bt-maize on the non-target corn leaf aphid, Rhopalosiphum maidis, was examined by comparing biological traits and demographic parameters of two generations of aphids reared on transgenic maize with those on untransformed near-isogenic plants. Furthermore, free and bound phenolics content on transgenic and near-isogenic plants were measured. Here we show an increased performance of the second generation of R. maidis on Bt-maize that could be attributable to indirect effects, such as the reduction of defense against pests due to unintended changes in plant characteristics caused by the insertion of the transgene. Indeed, the comparison of Bt-maize with its corresponding near-isogenic line strongly suggests that the transformation could have induced adverse effects on the biosynthesis and accumulation of free phenolic compounds. In conclusion, even though there is adequate evidence that aphids performed better on Bt-maize than on non-Bt plants, aphid economic damage has not been reported in commercial Bt corn fields in comparison to non-Bt corn fields. Nevertheless, Bt-maize plants can be more easily exploited by R. maidis, possibly due to a lower level of secondary metabolites present in their leaves. The recognition of this mechanism increases our knowledge concerning how insect-resistant genetically modified plants impact on non-target arthropods communities, including tritrophic web interactions, and can help support a sustainable use of genetically modified crops.

Ecological Features and Conservation of Urtica rupestris Guss. (Urticaceae): A Narrow Endemic Species of Sicily.

The conservation actions of endangered plant species require a clear knowledge of their habitats. Urtica rupestris Guss. (Urticaceae) is a rare endemic plant species occurring on shady cliffs in the southern-eastern part of Sicily. In the last century, the extreme anthropogenic alterations of Hyblaean plateau have caused the continuous and unrestrained fragmentation of natural habitats and consequently the reduction and disappearance of some plant species. A total of 52 vegetation plots, of which 34 are unpublished, were analyzed in order to characterize the floristic composition of the U. rupestris community. All the relevés were classified using classification and ordination methods. The species is mainly linked to shady and wet rock habitats, and only secondarily colonizes the undergrowth shrubs. According to IUCN criteria, we propose a new risk status for this species and the establishment of a new habitat (92/43CEE) for correct long-term conservation. Finally, a new association, Urtico rupestris-Adiantetum capilli-veneris, which falls within the Polysticho setiferi-Phyllitidion scolopendrii alliance (Adiantetea capilli-veneris class), was described. This study can provide useful information for the management and conservation of U. rupestris.

Transição da morbimortalidade no Brasil: um desafio aos 30 anos de SUS / Transition of morbidity and mortality in Brazil: a challenge on the thirtieth anniversary of the SUS

Resumo Em 2020, completamos 30 anos desde a publicação das Leis Orgânicas do Sistema Único de Saúde. Desde então, a mudança no perfil de morbimortalidade tem desafiado a gestão, para que o serviço de saúde consiga atender à grande heterogeneidade dos quase seis mil municípios. Para isso, é necessário monitorar os principais indicadores do país. O objetivo do presente estudo foi apresentar uma visão geral das tendências de mortalidade e morbidade no Brasil entre 1990 e 2019. Utilizamos os dados do Estudo de Carga Global de Doenças para descrever a morbimortalidade pelos grandes grupos (doenças infecciosas, doenças crônicas e causas externas), segundo sexo e grupos etários. Há redução da morbimortalidade no período, independente do grupo de causa ou faixa etária, com variada diferença entre sexo de acordo com o grupo de causas. A contribuição das doenças crônicas é crescente com a progressão da idade, com diferença substancial segundo o sexo. As curvas de mortalidade e de anos perdidos por incapacidade possuem padrão típico, com destaque ao padrão diferenciado para curvas de homens por causas externas, com marcada sobremortalidade em idades jovens. A tendência ratifica o declínio dos indicadores de forma linear no período.

Abstract In 2020, the 30th anniversary of the publication of the Organic Laws of the Unified Health System was celebrated. Since then, the change in the profile of morbidity and mortality has been a challenge to management to ensure that the health services can attend the significant heterogeneity of approximately 6,000 municipalities. To achieve this, it is necessary to monitor the leading indicators of the country. The scope of this study was to present an overview of trends in mortality and morbidity in Brazil between 1990 and 2019. Data from the Study on the Global Burden of Disease was used to describe morbidity and mortality by major groupings (infectious diseases, chronic diseases, and external causes), according to gender and age groups. There was a reduction in morbidity and mortality in the period, irrespective of the cause or age group, albeit with a varied difference between the sexes depending on the cause. The contribution of chronic diseases increases with age, with a marked difference according to gender. The curves for mortality and years lost due to disability have a typical profile, with a different pattern of curves for men due to external causes, with marked excess mortality at young ages. The trend confirms the decline of indicators in a linear manner over the period.

Vulnerability Assessment of Pelagic Sharks in the Western North Pacific by Using an Integrated Ecological Risk Assessment.

The vulnerability of 11 pelagic shark species caught by the Taiwanese coastal and offshore longline fisheries in the western North Pacific were assessed by an ecological risk assessment (ERA) and 10 of the 11 species was assessed by using an integrated ERA developed in this study. The intrinsic rate of population growth was used to estimate the productivity of sharks, and the susceptibility of sharks was estimated by the multiplication of the catchability, selectivity, and post-capture mortality. Three indices namely, the IUCN Red List category, the body weight variation trend, and the inflection point of population growth curve coupled with ERA were used to conduct an integrated ERA. The results indicated that the scalloped hammerhead is at the highest risk (group 1), followed by the silky shark, and the spinner shark at high risk (group 2). The bigeye thresher, and sandbar shark fall in group 3, the smooth hammerhead falls in group 4, and the shortfin mako, pelagic thresher, oceanic whitetip, and dusky shark fall in group 5. Rigorous management measures for the species in groups 1 and 2, setting total allowable catch quota for group 3, and consistent monitoring schemes for groups 4 and 5 are recommended.

Morbimortality transition in Brazil: a challenge to 30 years of SUS / Transição da morbimortalidade no Brasil: um desafio aos 30 anos de SUS

In 2020, we celebrated 30 years since the publication of the Organic Laws of the Unified Health System. Since then, the change in the profile of morbidity and mortality has challenged management. The health service can meet the significant heterogeneity of almost 6000 municipalities. For this, it is necessary to monitor the leading indicators of the country. The present study aimed to present an overview of trends in mortality and morbidity in Brazil between 1990 and 2019. We used data from the Global Burden of Disease Study to describe morbidity and mortality by large groups (infectious diseases, chronic diseases, and external causes), according to sex and age groups. There is a reduction in morbidity and mortality in the period, regardless of the cause or age group. Also, there is a varying difference between sex according to the cause group. The contribution of chronic diseases is increasing with age, with a substantial difference according to sex. The mortality and years lost curves due to disability curves have a typical pattern. We emphasize the different patterns for male curves due to external causes, with marked over-mortality at young ages. The trend confirms the decline of indicators in a linear manner in the period. The peculiarities of the health transition and the mortality transition in Brazil need to be seen in the light of the different socio-spatial patterns and demographic profiles.

Em 2020, completamos 30 anos desde a publicação das Leis Orgânicas do Sistema Único de Saúde. Desde então, a mudança no perfil de morbimortalidade tem desafiado a gestão, para que o serviço de saúde consiga atender à grande heterogeneidade dos quase 6000 municípios. Para isso, é necessário monitorar os principais indicadores do país. O objetivo do presente estudo foi apresentar uma visão geral das tendências de mortalidade e morbidade no Brasil entre 1990 e 2019. Utilizamos os dados do Estudo de Carga Global de Doenças para descrever a morbimortalidade pelos grandes grupos (doenças infecciosas, doenças crônicas e causas externas), segundo sexo e grupos etários. Há redução da morbimortalidade no período, independente do grupo de causa ou faixa etária, com variada diferença entre sexo de acordo com o grupo de causas. A contribuição das doenças crônicas é crescente com a progressão da idade, com diferença substancial segundo o sexo. As curvas de mortalidade e de anos perdidos por incapacidade possuem padrão típico, com destaque ao padrão diferenciado para curvas de homens por causas externas, com marcada sobremortalidade em idades jovens. A tendência ratifica o declínio dos indicadores de forma linear no período. As peculiaridades da transição da saúde e da transição da mortalidade no Brasil precisam ser vista à luz dos diferentes padrões socioespaciais e perfis demográficos.  

Statistical Review of the Suicide Attempts Rates Committed on Polish Railway Tracks between the years 2013-2016.

Suicides on railway tracks are one of the most drastic ones. No research concerning this phenomenon has been done to this date in Poland. This article focuses on the connection between suicidal behaviors on Polish railway tracks and sociodemographic traits and presents risk factors. BACKGROUND: The suicide behavior is largely spread among many European countries. Of these, Poland ranks 22nd in terms of suicide attempts. This study aims to highlight the suicide attempts rates on Polish railways lines and their main risk factors. LIMITATIONS: Limited number of available statistical data before 2013. METHOD: Statistical review of the available Central Police headquarters database and analyses of the influence of the risk factors on people's awareness during the suicide attempts and their geographical distribution in Poland during the years 2013 - 2016. The prevalence of railway suicides in individual voivodeships (provinces) in Poland have been indicated in a 3D map. RESULTS: There were 834 cases of railway suicide fatalities across the entire country. Of the total suicide statistics by any means, 3.75% are railway related. The average known age of those committing railway suicides were: 37.9 years for men (n = 627) and 34.6 for women (n = 155). In most cases, suicides were committed by bachelors (54.3%). The largest group of people who committed suicide had a primary level of education (42.0%). Among the suicides, a significant group are unemployed (45.2%). Alcohol intoxication have been established as responsible for a person's lower awareness of his actions in 70.9% of cases. Almost 63.3% of people had a higher propensity for suicidal ideation and behavior, resulting in their being treated for mental health issues. CONCLUSION: Alcohol intoxication, illegal narcotics and psychotropic medication are responsible for a person's lower awareness during his ore her actions, in most of the cases of suicide on Polish railway lines.

Gene flow as a simple cause for an excess of high-frequency-derived alleles.

Most human populations exhibit an excess of high-frequency variants, leading to a U-shaped site-frequency spectrum (uSFS). This pattern has been generally interpreted as a signature of ongoing episodes of positive selection, or as evidence for a mis-assignment of ancestral/derived allelic states, but uSFS has also been observed in populations receiving gene flow from a ghost population, in structured populations, or after range expansions. In order to better explain the prevalence of high-frequency variants in humans and other populations, we describe here which patterns of gene flow and population demography can lead to uSFS by using extensive coalescent simulations. We find that uSFS can often be observed in a population if gene flow brings a few ancestral alleles from a well-differentiated population. Gene flow can either consist in single pulses of admixture or continuous immigration, but different demographic conditions are necessary to observe uSFS in these two scenarios. Indeed, an extremely low and recent gene flow is required in the case of single admixture events, while with continuous immigration, uSFS occurs only if gene flow started recently at a high rate or if it lasted for a long time at a low rate. Overall, we find that a neutral uSFS occurs under more restrictive conditions in populations having received single pulses of gene flow than in populations exposed to continuous gene flow. We also show that the uSFS observed in human populations from the 1000 Genomes Project can easily be explained by gene flow from surrounding populations without requiring past episodes of positive selection. These results imply that uSFS should be common in non-isolated populations, such as most wild or domesticated plants and animals.

Demographic and Comorbidities Data Description of Population in Mexico with SARS-CoV-2 Infected Patients(COVID19): An Online Tool Analysis.

The Word Health Organization (WHO) declared in March 2020 that we are facing a pandemic designated as COVID-19, which is the acronym of coronavirus disease 2019, caused by a new virus know as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In Mexico, the first cases of COVID-19, was reported by the Secretary of Health on 28 February 2020. More than sixteen thousand cases and more than fifteen thousand deaths have been reported in Mexico, and it continues to rise; therefore, this article proposes two online visualization tools (a web platform) that allow the analysis of demographic data and comorbidities of the Mexican population. The objective of these tools is to provide graphic information, fast and updated, based on dataset obtained directly from National Governments Health Secretary (Secretaría de Salud, SSA) which is daily refreshed with the information related to SARS-CoV-2. To allow a dynamical update and friendly interface, and approach with R-project, a well-known Open Source language and environment for statistical computing and Shiny package, were implemented. The dataset is loaded automatically from the latest version released by the federal government of Mexico. Users can choose to study particular groups determined by gender, entity, type of result (positive, negative, pending outcome) and comorbidity. The image results are plots that can be instantly interpreted and supported by the text summary. This tool, in addition to being a consultation for the general public, is useful in Public Health to facilitate the visualization of the data, allowing its timely interpretation due to the changing nature of COVID-19, it can even be used for decision-making by leaders, for the benefit of the health of the community.

Una aproximación al quehacer del personal de salud que trabaja con adultos con discapacidad intelectual / An approach to the work of health personnel working with adults with intellectual disabilities

Objetivo: conocer las percepciones del personal de salud en el contexto institucional motivacional, ocupacional y su nivel de satisfacción laboral en el trabajo con adultos con discapacidad intelectual. Materiales y métodos: estudio con enfoque cuantitativo, alcance descriptivo y diseño no experimental-transaccional. Se utilizó una ficha sociodemográfica y laboral (ad hoc) que incluye hábitos y estilo de vida. Para analizar los resultados se utilizó el SPSS 21. Resultados: participaron 12 trabajadores, el 83% mujeres con promedio de 34,5 años de edad; el 67% trabaja más de 40 horas a la semana. El 50% reportó experimentar inseguridad laboral con distintos niveles de frecuencia. El 66,7% disfruta trabajar con personas con discapacidad. El 42% cree prioritarios cambios en la "conducción" y el 17% "mejorar la comunicación". Conclusiones: estos resultados permiten diseñar propuestas de formación y programas para la promoción de su salud y prevención de la enfermedad..Au

Objectives: to know the perceptions of health personnel in relation to the institutional context, their level of job satisfaction and aspects related to motivational dimension. Materials and methods: study with a quantitative approach, with a descriptive scope, with a non-experimental, transactional design. A sociodemographic and labor file was used, which includes sociodemographic and labor data (ad hoc), as well as aspects related to lifestyle habits. The institutional context, the level of worker satisfaction and other aspects related to the motivational dimension are investigated. SPSS 21 was used for the analysis of the results. Results: 12 employees participated; these were women (83%) with an average age of 34.5 years, 67% work more than 40 hours per week. A 50% reported experiencing a certain level of occupational insecurity with different frequencies. The 66.7% enjoy working with people with disabilities. A 42% believe priority changes are needed in "leadership" and a 17% in the "improvement in communication". Conclusions: it is considered convenient to know the reality of these workers to design training proposals and to plan programs for the promotion of their health..Au

Factors and cost associated with atopic dermatitis in Nevada.

Objectives: Atopic dermatitis, or eczema, is an inflammatory illness that impacts individuals of all ages. The cost of treating AD and the impact on the quality of life have not been well documented in the state of Nevada. This study seeks to fill this gap by identifying factors that impact the cost of AD in the state utilizing clinical and patient demographics. Methods: ANOVA with Bonferroni adjustment was performed using a large hospital utilization database to examine the cost of AD in the state of Nevada across all hospital settings. Results: Several significant factors were associated with the overall cost of AD in Nevada, including hospital setting type (outpatient vs. inpatient), physician type, region, AD diagnosis level, and age (p < 0.05). Stratified analysis was performed by setting type. In the inpatient setting, region, diagnosis level, and records with age listed between 0 and 5 years remained significant (p < 0.05). In the outpatient setting, physician type, region, and African American race remained significant (p < 0.05). Conclusions: Data from this study indicate that the AD cost burden is dependent on both demographic and clinical factors in the state of Nevada. These differences suggest that patients with AD may encounter higher costs depending on age, race, and clinical factors.