Global health journal (Amsterdam, Netherlands)最新文献_第5页

Knowledge acquisition and retention when implementing public health awareness training on common pediatric eye conditions in Thailand 在泰国开展关于常见儿科眼病的公共卫生意识培训时获取和保留知识

Global health journal (Amsterdam, Netherlands)

Pub Date : 2025-03-01 DOI: 10.1016/j.glohj.2025.02.002

Fountane Chan , Mani Woodward , Michael Parappilly , Yichen Fan , Saron Tedla , Ratipark Tamornpark , Jamie Anderson , Chalitar Chomchoei , Manassawin Kampun , Fartima Yeemard , Buathanya Srikua , Elizabeth White , Allison Summers

Background

Low awareness of common pediatric eye conditions, such as amblyopia, conjunctivitis, and myopia in rural Chiang Rai, Thailand, prompted the development of a specialized curriculum. This curriculum aimed to provide individuals serving these areas with resources to educate and disseminate information within their communities.

Methods

A one-hour curriculum covering the causes, signs, diagnosis, treatment, and prevention of amblyopia, conjunctivitis, and myopia was delivered virtually to public health students at a Thai university and in-person to students at this university and rural community members. The in-person seminar included hands-on activities and simulations of these eye conditions. Knowledge acquisition and retention were assessed using pre-tests, immediate post-tests, and one-month post-tests.

Results

The seminar was attended by 87 virtual public health students, 111 in-person public health students, and 40 in-person rural community members. All groups showed significant improvement in test scores from pre-test to immediate post-test (P < 0.001). In-person students had 1.57 times the odds of answering correctly on the immediate post-test compared to virtual students, despite no significant difference in baseline knowledge. However, the subset of in-person students who did not receive bilingual materials showed no significant difference in immediate post-test performance compared to virtual students (P > 0.05). Although public health students had more than twice the odds of answering correctly at pre-test compared to rural community members, there were no significant differences between groups on the immediate post-test (P > 0.05).

Conclusion

A brief seminar significantly improved understanding and retention of pediatric eye conditions, achieving similar levels of understanding among public health students and rural community members, regardless of initial knowledge on this topic. In-person, hands-on seminars with educational materials in participants’ preferred language proved more effective than virtual ones in achieving these improvements.

背景：在泰国清莱农村，人们对弱视、结膜炎和近视等常见儿童眼病的认识不足，促使专门课程的发展。该课程旨在向服务于这些地区的个人提供资源，以便在其社区内进行教育和传播信息。方法对泰国一所大学的公共卫生专业学生进行虚拟授课，并对该大学的学生和农村社区成员进行面对面授课，讲授弱视、结膜炎和近视的病因、体征、诊断、治疗和预防等1小时课程。面对面的研讨会包括动手活动和这些眼睛状况的模拟。通过前测、即时后测和一个月后测来评估知识的获取和保留。结果共有87名虚拟公共卫生学生、111名现场公共卫生学生和40名现场农村社区成员参加了研讨会。从测试前到测试后，所有组的测试成绩都有显著提高(P <；0.001)。与虚拟学生相比，面对面的学生在即时测试中回答正确的几率是虚拟学生的1.57倍，尽管基线知识没有显着差异。然而，与虚拟学生相比，没有接受双语材料的面对面学生在测试后的即时表现没有显着差异(P >；0.05)。虽然公共卫生专业的学生在测试前答对的几率是农村社区学生的两倍多，但在测试后的即时测试中，两组之间没有显著差异(P >；0.05)。结论一个简短的研讨会显著提高了对儿童眼病的理解和保留，在公共卫生专业学生和农村社区成员中达到了相似的理解水平，无论他们最初对这一主题的了解程度如何。事实证明，在实现这些改进方面，用参与者喜欢的语言提供教育材料的亲自动手研讨会比虚拟研讨会更有效。

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引用次数: 0

Vaccine pricing and production capacity in Africa: can Africa move beyond pooled procurement in the face of a future pandemic? 非洲的疫苗定价和生产能力：面对未来的大流行，非洲能否超越集中采购？

Global health journal (Amsterdam, Netherlands)

Pub Date : 2024-12-01 DOI: 10.1016/j.glohj.2024.11.001

Christian Kwaku Osei , Edward Nketiah-Amponsah , Ama Pokuaa Fenny , Frank Otchere

We examine Africa’s vaccine manufacturing potential, spurred by the coronavirus disease 2019 (COVID-19) pandemic, while critically analyzing vaccine price inequities and procurement strategies during the pandemic, with anticipation of future outbreaks. Although Africa consumes approximately 25% of the global vaccine supply, over 99% of these vaccines are produced outside the continent, primarily due to insufficient local investment. Vaccine procurement strategies have relied heavily on pooled procurement mechanisms and tiered-pricing models, predominantly controlled by external organizations. Significant disparities in vaccine pricing have resulted in vaccine price inequities, with evidence suggesting price discrimination, where different prices are charged for the same vaccine across countries and regions. While vaccine prices are only one component of vaccination campaign costs, the inequitable pricing of vaccines poses serious challenges to fair access, especially in low-income countries. Given the inevitability of future pandemics and other outbreaks, the central question remains: Does Africa possess the capacity to strengthen its vaccine production infrastructure and reduce dependency on external suppliers? Our review reveals that, with robust political commitment, enhanced investment in Research and Development, and leveraging the heterogeneous nature of the regional bloc, Africa has made strides toward establishing vaccine manufacturing hubs with the potential for substantial capacity expansion. Furthermore, we argue for a regional campaign based on the principles of the fair priority model as an ethical framework for vaccine procurement, which prioritizes need and ensures equitable distribution, thereby complementing existing pooled procurement arrangements in times of future pandemics. This paper concludes with two key recommendations based on lessons learned from the COVID-19 crisis and future preparedness. First, Africa must push for a transparent and equitable tiered-pricing structure to ensure affordability for all. Second, intentional and sustained investment in R&D is critical to addressing systemic inequities in vaccine supply, not only for COVID-19 but for future outbreaks and routine immunization programs.

在2019年冠状病毒病（COVID-19）大流行的刺激下，我们研究了非洲的疫苗制造潜力，同时批判性地分析了大流行期间的疫苗价格不公平和采购战略，并预测了未来的疫情。虽然非洲消费了全球约25%的疫苗供应，但99%以上的疫苗是在非洲大陆以外生产的，主要原因是当地投资不足。疫苗采购战略严重依赖集中采购机制和分层定价模式，主要由外部组织控制。疫苗定价的巨大差异导致疫苗价格不公平，有证据表明存在价格歧视，同一种疫苗在不同国家和地区收取不同的价格。虽然疫苗价格只是疫苗接种运动成本的一个组成部分，但疫苗定价不公平对公平获取构成严重挑战，特别是在低收入国家。鉴于未来大流行病和其他疫情的不可避免性，核心问题仍然是：非洲是否有能力加强其疫苗生产基础设施并减少对外部供应商的依赖？我们的审查表明，凭借强有力的政治承诺、加大对研发的投资以及利用区域集团的异质性，非洲在建立疫苗制造中心方面取得了长足进展，并有可能大幅扩大产能。此外，我们主张开展一项基于公平优先模式原则的区域运动，作为疫苗采购的道德框架，优先考虑需求并确保公平分配，从而在未来发生大流行病时补充现有的集中采购安排。根据从2019冠状病毒病危机和未来准备中吸取的教训，本文最后提出了两项关键建议。首先，非洲必须推动透明和公平的分级定价结构，以确保所有人都负担得起。第二，有意和持续的研发投资对于解决疫苗供应中的系统性不公平问题至关重要，这不仅适用于COVID-19，也适用于未来的疫情和常规免疫规划。

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引用次数: 0

Scope of public health workforce: an exploratory analysis on World Health Organization policy and the literature 公共卫生人力资源的范围：对世界卫生组织政策和文献的探索性分析

Global health journal (Amsterdam, Netherlands)

Pub Date : 2024-12-01 DOI: 10.1016/j.glohj.2024.11.004

Min Zhang , Rokho Kim

The public health workforce is a key component of public health system. To articulate the scope of public health workforce, we reviewed the relevant World Health Organization (WHO) guidance and peer-reviewed journal articles on this subject. Specifically, we assessed and compared the relevant publications produced by WHO Headquarters and Regional Offices along with other literature on this issue. Our focus was on the “occupation, workplace setting, and employer of public health workforce”. It is noteworthy that WHO has adopted a conceptual framework with an inclusive scope of the public health workforce, while setting out a 5-year vision to strengthen capacity across all WHO Member States for a multidisciplinary workforce to deliver the essential public health functions, including emergency preparedness and response. The importance of public health workforce in global and national responses to the coronavirus disease 2019 (COVID-19) pandemic is recognized. We also observed that there were diverse understandings of the scope of public health workforce worldwide, including macro-, meso‑ and micro-level perspectives. In the post-COVID-19 era, we suggest that policy-makers and practitioners at the national, regional and global level adopt a coordinated approach to expand and strengthen the national workforce as guided by the WHO towards the health-related targets of United Nations Sustainable Development Goals such as health security and Universal Health Coverage.

公共卫生人力是公共卫生系统的重要组成部分。为了阐明公共卫生人力的范围，我们审查了世界卫生组织（世卫组织）关于这一主题的相关指南和同行评议的期刊文章。具体而言，我们评估并比较了世卫组织总部和区域办事处编写的相关出版物以及关于这一问题的其他文献。我们的重点是“职业、工作场所环境和公共卫生工作人员的雇主”。值得注意的是，世卫组织通过了一个涵盖公共卫生人力的概念性框架，同时制定了一个5年愿景，以加强世卫组织所有会员国多学科人力的能力，以履行包括应急准备和应对在内的基本公共卫生职能。认识到公共卫生人力在全球和国家应对2019冠状病毒病（COVID-19）大流行中的重要性。我们还观察到，对全球公共卫生人力资源的范围有不同的理解，包括宏观、中观和微观层面的观点。在后covid -19时代，我们建议国家、区域和全球各级的政策制定者和从业者采取协调一致的方法，在世卫组织的指导下，扩大和加强国家劳动力队伍，以实现卫生安全和全民健康覆盖等联合国可持续发展目标中与卫生相关的具体目标。

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引用次数: 0

Gambling to public health in ageing populations: a life expectancy evaluation perspective 老龄人口中的赌博对公共卫生：从预期寿命评估的角度看问题

Global health journal (Amsterdam, Netherlands)

Pub Date : 2024-12-01 DOI: 10.1016/j.glohj.2024.11.002

Stanley Chi-on Shiu

Objective

Gambling is a complex topic in relation to health systems. It is always unclear how to strike a balance between the gambling economy and the impact of gambling on public health or social wellbeing at any age. There are limited studies considering the association between determinants of gambling and the life expectancy of the ageing population in a country. From an evaluation perspective, this article aims to demonstrate the correlation between life expectancy and gambling and public health systems.

Methods

The approach of analysis has two parts. One is the influence of gambling prevalence in populations on life expectancy among old adults. Another is the association between the effect of changes in legal gambling provisions within public health systems and life expectancy among old adults. Healthy adjusted life expectancy at age 60 from the World Health Organization and gross gambling yield were used. ANOVA was performed with SPSS.

Results

The population groups with HALE at age 60 of 15 years or over are likely more active in gambling than the population groups with smaller HALE at age 60 of 14 years or less. On the other hand, the influence of a health policy may be sidelined when it is implemented for older adult populations because the resource distribution magnitude or number of strategical techniques may not be the same for younger adult populations. The study here is marked as a good practical start, and there is room for further research with big data analysis on additional gambling variables against other life expectancy variables, quality of life variables or public health system variables.

Conclusion

Associations between the determinants of gambling and the life expectancy of the ageing population in a country have not yet been identified. Continuous measurements of policy implementation and effectiveness and assessments of health equity, while gambling policies worldwide continue to change, have not yet been performed. Researchers and policy makers should understand the importance of holistic integration of the gambling economy and policy within a public health and social paradigm with the help of big data insights to achieve sustainability in their cities and health equity in their communities.

目的与卫生系统相关的赌博是一个复杂的话题。人们总是不清楚如何在赌博经济和赌博对任何年龄的公众健康或社会福利的影响之间取得平衡。有有限的研究考虑赌博的决定因素之间的关系和预期寿命的老龄化人口在一个国家。从评估的角度来看，本文旨在证明预期寿命与赌博和公共卫生系统之间的相关性。方法分析方法分为两部分。一是人口中赌博盛行对老年人预期寿命的影响。另一个是公共卫生系统内合法赌博规定变化的影响与老年人预期寿命之间的关系。采用世界卫生组织的60岁健康调整预期寿命和总赌博产量。采用SPSS进行方差分析。结果15岁及以上的60岁HALE人群比14岁及以下的60岁HALE较小人群的赌博活动更活跃。另一方面，保健政策在对老年人实施时，其影响可能被搁置一边，因为战略技术的资源分配规模或数量对较年轻的成年人可能不一样。这里的研究被认为是一个良好的实践开端，还有进一步研究的空间，通过大数据分析额外的赌博变量与其他预期寿命变量、生活质量变量或公共卫生系统变量。结论赌博的决定因素和一个国家老龄化人口的预期寿命之间的联系尚未确定。虽然世界各地的赌博政策在不断变化，但尚未对政策执行和有效性进行持续衡量，并对卫生公平进行评估。研究人员和政策制定者应了解在大数据见解的帮助下，在公共卫生和社会范式内全面整合赌博经济和政策的重要性，以实现其城市的可持续性和社区的卫生公平。

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引用次数: 0

An analysis of inequality in physical health status of women in India: 2015‒2021 2015-2021年印度妇女身体健康状况不平等分析

Global health journal (Amsterdam, Netherlands)

Pub Date : 2024-12-01 DOI: 10.1016/j.glohj.2024.11.003

Debolina Banerjee, Tamal Krishna Kayal

Objective

We examine how inequality in women’s health has changed in India and its major states between 2015 and 2021. We also attempt to identify the sources of any change in this inequality using a decomposition analysis. In order to suggest suitable policies for reducing this inequality, we attempt to identify the factors that are strongly associated with it.

Methods

We construct an index of women’s health from five indicators using the principal component analysis. Based on this index we measure inequality in women’s health using the coefficient of variation and the Theil index. To identify the sources of change in this inequality, we apply Theil decomposition technique.

Results

We find that inequality in women’s health has increased significantly in India between 2015 and 2021. During this period, this inequality has increased significantly in six states, while it has decreased significantly in five states. The decomposition analysis suggests that the increase in this inequality between 2015 and 2021 has been driven by an increase in interstate inequality. We also find a strong positive association between inequality in women’s health and inequality in public health amenities and social development.

Conclusion

We suggest that for reducing inequality in women’s health in developing countries like India, policies should focus on eliminating disparities in income, female education and provision of public health amenities.

我们研究了2015年至2021年间印度及其主要邦妇女健康不平等的变化情况。我们还尝试使用分解分析来确定这种不平等的任何变化的来源。为了提出减少这种不平等的适当政策，我们试图找出与之密切相关的因素。方法采用主成分分析法，从5个指标构建妇女健康指数。根据这一指数，我们使用变异系数和泰尔指数来衡量妇女健康方面的不平等。为了确定这个不等式的变化来源，我们应用了希尔分解技术。结果我们发现，2015年至2021年期间，印度妇女健康方面的不平等现象显著加剧。在此期间，这种不平等在六个州显著增加，而在五个州显著减少。分解分析表明，2015年至2021年间，这种不平等的加剧是由州际不平等加剧造成的。我们还发现，妇女健康方面的不平等与公共卫生设施和社会发展方面的不平等之间存在强烈的正相关关系。结论我们建议，在印度等发展中国家，政策应侧重于消除收入、女性教育和提供公共卫生设施方面的差距，以减少妇女健康不平等。

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引用次数: 0

Burnout and mental distress among community health workers in low- and middle-income countries: a scoping review of studies during the COVID-19 pandemic 低收入和中等收入国家社区卫生工作者的职业倦怠和精神困扰：对COVID-19大流行期间研究的范围审查

Global health journal (Amsterdam, Netherlands)

Pub Date : 2024-12-01 DOI: 10.1016/j.glohj.2024.11.007

Oluchi I. Ndulue , Anand Chukka , John A. Naslund

Community health workers (CHWs) represent the backbone of primary health systems, especially in many low- and middle-income countries (LMICs). The coronavirus disease 2019 (COVID-19) pandemic stretched health systems and increased the workload for CHWs. The objective of this scoping review was to identify the mental health symptoms experienced among CHWs in LMICs during the COVID-19 pandemic. We searched PubMed for published literature, from January 1, 2020 to December 31, 2022 that focused on documenting the experiences of burnout, distress, and mental health symptoms among CHWs in LMICs. The quality of included studies was assessed using the Joanna Briggs Institute Critical Appraisal Tool. Included studies were grouped into the following broad thematic categories: (1) symptoms experienced; (2) drivers of different mental health symptoms; and (3) strategies for coping with different symptoms. We identified 10 cross-sectional, qualitative, and observational studies from 11 LMICs in South and Southeast Asia, South America, and Eastern/Southern Africa that assessed the mental health burden CHWs faced during the pandemic. The studies identified disorders and symptoms such as depression, anxiety, fear, burnout, worsened stress, and fatigue. Contributing factors included increased workload, financial constraints, and an understaffed and underequipped workplace. CHWs reported using different adaptive responses like humor, support from family and colleagues, denial, and substance use, and asked for recommended regular mental health checkups and counseling. More research and policies should be targeted towards promoting the mental wellbeing of CHWs to help ensure responsive and resilient health systems in LMICs in the face of future emerging public health threats.

社区卫生工作者是初级卫生系统的骨干，在许多低收入和中等收入国家尤其如此。2019年冠状病毒病（COVID-19）大流行使卫生系统不堪重负，增加了卫生工作者的工作量。本综述的目的是确定中低收入国家卫生工作者在COVID-19大流行期间经历的心理健康症状。我们在PubMed检索了从2020年1月1日到2022年12月31日的已发表文献，这些文献主要记录了中低收入卫生工作者的倦怠、痛苦和心理健康症状。采用乔安娜布里格斯研究所关键评估工具评估纳入研究的质量。纳入的研究分为以下主题大类：(1)经历的症状；(2)不同心理健康症状的驱动因素；(3)不同症状的应对策略。我们从南亚和东南亚、南美和非洲东部/南部的11个低收入国家中确定了10项横断面、定性和观察性研究，评估了卫生工作者在大流行期间面临的心理健康负担。这些研究确定了障碍和症状，如抑郁、焦虑、恐惧、倦怠、压力加剧和疲劳。造成这种情况的因素包括工作量增加、财政限制以及工作场所人手不足和设备不足。chw报告使用不同的适应性反应，如幽默，家人和同事的支持，否认和物质使用，并要求建议定期进行心理健康检查和咨询。应该针对促进卫生工作者的心理健康开展更多的研究和制定更多的政策，以帮助确保中低收入国家的卫生系统在面对未来新出现的公共卫生威胁时作出反应和具有复原力。

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引用次数: 0

Health system interventions for the cost containment of drugs used for cardiovascular diseases: a systematic review and exploration of how the results could be adapted to the Sri Lankan context 控制心血管疾病药物费用的卫生系统干预措施：系统审查和探索如何使结果适应斯里兰卡的情况

Global health journal (Amsterdam, Netherlands)

Pub Date : 2024-12-01 DOI: 10.1016/j.glohj.2024.11.005

Jayasekara Liyana Patabendige Chaminda , Sanjeewa Kularatna , Dilantha Dharmagunawardene , Reece Hinchcliff , Alexia Rohde , David Brain , Ruvini Manjula Hettiarachchi , Sucharitha Rangi Weerasuriya , Sunil Senarath Yapa , Sameera Senanayake

Objectives

Cardiovascular disease (CVD) in low and middle-income countries (LMICs), accounts for over 80% of global CVD-related deaths. The high cost of drugs is a major concern in not of managing CVD. This study aimed to conduct a comprehensive review to identify interventions for cost containment of CVD drugs and use the intervention scalability assessment tool (ISAT) to examine the acceptability and application of relevant interventions in the Sri Lankan context, that can also be adaptable to other LMICs.

Methods

A systematic search across three databases (Medline, Web of Science and Embase) was completed to identify relevant health system interventions. The ISAT assessed the feasibility of adapting the identified interventions to Sri Lanka, using structured interviews with 25 Sri Lankan stakeholders representing five groups: health managers, cardiologists, pharmacists, nursing officers, and patients.

Results

The search yielded nine publications. Five were conducted on a national scale, while others were conducted at the regional levels. Seven were published in developed countries. The identified interventions were categorised into six intervention themes: Imposing a ceiling price or reference price; introduction of the polypill; introduction of volume price contract initiatives; prescribing generic and essential drugs; one intervention package including generics, essential medicine, 90-day drugs, and free delivery; and a second intervention package including discounts, rebates, cost-free medicine, and bundling. Assessment of six intervention themes revealed that methods of setting ceiling prices and controlling generic drug prescribing were the most popular, while other interventions were least popular.

Conclusions

The study provides a roadmap for future interventions based on successful scaling, emphasizing the importance of understanding contextual variables and encourages stakeholder participation in policy assessments and advocacy. The findings highlighted the potential for enhancing the access to affordable CVD drugs not only in Sri Lanka, but also adaptable to other LMICs. These outcomes can contribute to policy decisions, aimed at reducing the significant global burden of CVD.

在中低收入国家（LMICs），心血管疾病（CVD）占全球心血管疾病相关死亡的80%以上。药物的高成本是控制心血管疾病的一个主要问题。本研究旨在进行全面审查，以确定控制心血管疾病药物成本的干预措施，并使用干预措施可扩展性评估工具（ISAT）检查斯里兰卡背景下相关干预措施的可接受性和应用情况，这些干预措施也可适用于其他中低收入国家。方法通过Medline、Web of Science和Embase三个数据库进行系统检索，确定相关的卫生系统干预措施。ISAT评估了使所确定的干预措施适应斯里兰卡的可行性，对25名斯里兰卡利益攸关方进行了结构化访谈，这些利益攸关方代表五个群体：卫生管理人员、心脏病专家、药剂师、护理人员和患者。结果检索得到9篇论文。其中五项是在国家范围内进行的，其他则是在区域一级进行的。其中七本在发达国家出版。确定的干预措施分为六个干预主题：实施最高限价或参考价；复方药丸的介绍；引入批量价格合同计划；处方非专利药物和基本药物；一套干预措施，包括仿制药、基本药物、90天药物和免费送货；第二个干预方案包括折扣、回扣、免费药品和捆绑销售。对六个干预主题的评估显示，设定最高价格和控制仿制药处方的方法最受欢迎，而其他干预措施最不受欢迎。该研究为未来的干预提供了一个基于成功规模的路线图，强调了理解背景变量的重要性，并鼓励利益相关者参与政策评估和宣传。这些发现强调了不仅在斯里兰卡而且在其他中低收入国家加强可负担得起的心血管疾病药物获取的潜力。这些结果有助于作出旨在减轻心血管疾病重大全球负担的政策决定。

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引用次数: 0

Regional deprivation and cause-specific mortality in Russian adults in 2006–2022 2006-2022年俄罗斯成年人的区域贫困和死因特异性死亡率

Global health journal (Amsterdam, Netherlands)

Pub Date : 2024-12-01 DOI: 10.1016/j.glohj.2024.11.006

Anastasia Zelenina

Objective

The relationship between cause-specific mortality and regional socio-economic and environmental indicators remains poorly studied in Russia. The study first aims to study regional differences in cause-specific mortality among the population aged 20 years and older in Russia, and second to investigate the association between regional deprivation and cause-specific mortality.

Material and methods

Russian deprivation index was used to measure level of deprivation. The index consists of three components: social, economic and environmental. The index measures general deprivation, and its components measure social, economic and environmental deprivation. The mortality data by age (five-year groups) and sex in the subjects of Russia from 2006 to 2022 were extracted from the Russian Fertility and Mortality Database of the Center of Demographic Research of the New Economic School.

Results

In the most general deprived areas, mortality rate from infectious and parasitic diseases increased by more than twice in the total population, women and men as compared to the least deprived quantile (Q1). Fully adjusted negative binomial regression showed an increase in mortality rate from injuries, poisoning and external causes and infectious and parasitic diseases in more social deprived areas as compared to Q1 in the total population, women and men. In men, there was a significantly higher mortality rate from neoplasms and from infectious and parasitic diseases in more economic deprived areas as compared to Q1. Both in total population and in women, there was a trend towards an increase in mortality from neoplasms depending on the level of environmental deprivation.

Conclusions

This is the first study examining the relationship of contextual factors with cause-specific mortality that takes into account sex, age and year of death at the population level in Russia. General, social, economic and environmental deprivation are associated with cause-specific mortality.

目的在俄罗斯，对死因特异性死亡率与区域社会经济和环境指标之间的关系的研究仍然很少。该研究首先旨在研究俄罗斯20岁及以上人口中特定原因死亡率的区域差异，其次调查区域贫困与特定原因死亡率之间的关系。材料与方法采用俄罗斯剥夺指数衡量剥夺程度。该指数由三个部分组成：社会、经济和环境。该指数衡量的是总体剥夺，其组成部分衡量的是社会、经济和环境剥夺。2006 - 2022年俄罗斯按年龄（5岁组）和性别分列的死亡率数据取自新经济学院人口研究中心的俄罗斯生育率和死亡率数据库。结果在最普遍的贫困地区，与最不贫困的分位数相比，传染病和寄生虫病的死亡率在总人口、妇女和男子中增加了两倍多（Q1）。经充分调整的负二项回归显示，与第一季度相比，在社会较为贫困的地区，因受伤、中毒和外因以及传染病和寄生虫病造成的死亡率有所上升，无论男女。与第一季度相比，在经济较为贫困的地区，男性死于肿瘤、传染病和寄生虫病的死亡率要高得多。在总人口和妇女中，肿瘤死亡率都有上升的趋势，这取决于环境匮乏的程度。结论：这是第一个研究背景因素与俄罗斯人口水平上考虑性别、年龄和死亡年份的死因特异性死亡率之间关系的研究。一般的、社会的、经济的和环境的匮乏与特定原因的死亡率有关。

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引用次数: 0

Building a transdisciplinary science of One Health with a global vision 以全球视野构建 "一体健康 "跨学科科学

Global health journal (Amsterdam, Netherlands)

Pub Date : 2024-09-01 DOI: 10.1016/j.glohj.2024.08.004

Xiaonong Zhou , Jinxin Zheng

One Health has been recognized as a cost-effectiveness approach that intricate connections between human health, animal health, and ecosystem health. This holistic perspective is crucial for addressing complex health challenges that arise at the intersection of these domains, such as emerging infectious diseases, antimicrobial resistance, food safety & food security, and environmental degradation. The beneficiaries of the One Health approach have been demonstrated by many case studies worldwide, and summarized by The World Bank that not only support poverty alleviation in developing countries, but also can reduce pandemic risk globally. It is essential for us to understand the means of promoting the initiatives in building the transdisciplinary science of One Health that requires a global vision with integration of various disciplines, stakeholders, and resources. Therefore, we introduce the role of the transdisciplinary science of One Health, and the key steps and strategies necessary to implement One Health approach in the real world. We also propose three research priorities, including emphasizing climate change and health, enhancing global health security, and promoting equity and inclusivity which is crucial for the success of One Health initiatives. Hence, building a transdisciplinary science of One Health will not only improve holistic health between human, animal, and environmental domains, but also contribute to the global health security and sustainable development.

一体健康 "已被公认为是一种成本效益方法，它将人类健康、动物健康和生态系统健康紧密联系在一起。这种全面的视角对于解决这些领域交叉出现的复杂健康挑战至关重要，如新出现的传染病、抗菌素耐药性、食品安全问题、粮食安全和环境退化。世界范围内的许多案例研究已经证明了 "同一健康 "方法的益处，世界银行也对其进行了总结，认为它不仅能支持发展中国家的减贫工作，还能降低全球大流行病的风险。我们有必要了解在建立跨学科的 "一体健康 "科学过程中推动各项倡议的手段，这需要一个整合各学科、利益相关方和资源的全球视野。因此，我们介绍了 "同一健康 "跨学科科学的作用，以及在现实世界中实施 "同一健康 "方法所需的关键步骤和战略。我们还提出了三个研究重点，包括强调气候变化与健康、加强全球健康安全以及促进公平和包容性，这对 "一个健康 "倡议的成功至关重要。因此，建立跨学科的 "同一健康 "科学不仅能改善人类、动物和环境领域之间的整体健康，还能促进全球健康安全和可持续发展。

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引用次数: 0

Demographic and socioeconomic determinants of urinary arsenic concentration for elementary school children in Bangladesh 孟加拉国小学生尿砷浓度的人口和社会经济决定因素

Global health journal (Amsterdam, Netherlands)

Pub Date : 2024-09-01 DOI: 10.1016/j.glohj.2024.08.005

Raisa Sara , Khalid M. Khan , Shelbin Mattathil , Munachimso Nwankwo , Mohammad Aminul Islam , Faruque Parvez

Background

Arsenic (As) is a toxic element that can lead to various health issues in humans. The primary exposure to As is through the consumption of water contaminated with high As levels, particularly in Bangladesh. Previous studies have shown that urinary arsenic (UAs) concentration can reflect As exposure and metabolism in individuals. However, little is known about how other factors, such as age, sex, and socioeconomic status, may affect UAs concentrations in children.

Objective

This study aimed to investigate the influence of factors such as age, sex, and socioeconomic status on UAs concentrations in children, in addition to the impact of drinking water arsenic (WAs) levels.

Methods

We conducted our study on elementary school-going children aged 8‒11 years from rural Araihazar in Bangladesh. We measured UAs (available for a subset of 391 children) and WAs levels and collected information on demographic and socioeconomic characteristics. We employed regression analysis and t-tests to analyze the data.

Results

Our findings revealed that younger children (β = 197.95, 95% confidence interval [CI]: 111.97 to 283.94), female children (β = 93.95, 95% CI: 8.49 to 179.40), and children with less educated fathers (β = 138.03, 95% CI: 26.47 to 249.58) had higher UAs levels, particularly when they consumed water with high As content.

Conclusion

The study concludes that children’s As exposure and UAs concentration may vary depending on their age, sex, and socioeconomic status. Therefore, these factors should be considered when assessing the health risks associated with As.

背景砷（As）是一种有毒元素，可导致人类出现各种健康问题。人们接触砷的主要途径是饮用被高浓度砷污染的水，尤其是在孟加拉国。以往的研究表明，尿砷浓度可以反映个人的砷暴露和新陈代谢情况。本研究旨在调查年龄、性别和社会经济状况等因素对儿童尿砷浓度的影响，以及饮用水砷（WAs）水平的影响。我们测量了 UAs（391 名儿童的子集）和 WAs 水平，并收集了有关人口和社会经济特征的信息。结果我们发现，年龄较小的儿童（β = 197.95，95% 置信区间 [CI]：111.97 至 283.94）、女性儿童（β = 93.95，95% 置信区间 [CI]：8.49 至 179.40）和父亲受教育程度较低的儿童（β = 138.结论本研究得出结论，儿童的砷暴露量和 UAs 浓度可能因其年龄、性别和社会经济地位而异。因此，在评估与砷有关的健康风险时应考虑这些因素。

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引用次数: 0