Universal Access to Sanitation

Abstract Background To estimate median survival time of AIDS patients, with and without tuberculosis (TB), in a cohort in Sao Paulo, Brazil, and to investigate survival predictors. Methods Retrospective cohort study of AIDS patients above 12 years old, registered at the Ministry of Health AIDS surveillance system between 2003-2007, and followed until 2014. Survival analysis used the Kaplan-Meier method and Cox proportional hazards model to estimate hazard ratios (HR), with respective 95% confidence intervals (CI = 95%). Results 35,515 patients were included, being 4,581 (12.9%) co-infected with TB. Among the latter, probability of survival 12 years after AIDS diagnosis was 95.2%, 82.9%, and 21.9%, respectively for patients receiving at least one third line ARV (HAART2), receiving triple therapy (HAART1) and the last one not on ARV. In the same period, the probability of survival for patients without TB, in the same order as for the therapeutic regimens, was 95.2%, 90.5%, and 40.9%, respectively. The main factors associated with survival, adjusted for the year of diagnosis, were: Living in the city of Sao Paulo (HR = 1,16;IC95% 1,01-1,32), living away from the capital city (HR = 1.43; 95%CI 1.25-1.62); or on the coast (HR = 1.49; 95%CI 1.21-1.82); having TB (HR = 1.70; 95%CI 1.49-1.87); above 49 years old (HR = 1.35; 95%CI 1.18-1.54); black (HR = 1.27; 95%CI 1.12-1.45); IV drug use (HR = 1.73; 95%CI 1.49-2.02); CD4+ below 200 cell/mm³ at AIDS diagnosis (HR = 2.31; 95%CI 1.97-2.72); viral load above 500 copies at AIDS diagnosis (HR = 1.99; 95%CI 1.72-2.30); HAART1 scheme (HR = 1.94; 95%CI 1.47-2.55); no ARV (HR = 8.22; 95%CI 2.95-22.87). Conclusions A large proportion of patients did not receive ARVs or were late diagnosed with AIDS, especially those with TB, whose survival was shorter. Survival is heterogeneous in the state, being lower in regions with higher TB rates. The results point to the need for specific strategies for patients with TB-HIV co-infection. Key messages Tuberculosis is the main cause of death among HIV-infected people, being responsible for one third of deaths in this group and causing a great impact on the survival of this population. The Brazilian policy of universal access to ARV and treatment for TB has increased the survival of AIDS-TB from 22% to 95% and in patients without TB from 50% to 95% up to 12 years after diagnosis.

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Integrative and Complementary Health Practices Building a New Health Paradigm

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.443 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

T Gemeli ◽

H Silva ◽

M Kato

Keyword(s):

Cognitive Abilities ◽

Universal Access ◽

Well Being ◽

The Elderly ◽

Professional Service ◽

Health It ◽

Self Confidence ◽

The Social ◽

The Subject ◽

New Perspective

Abstract This work arose from the need to broaden the therapeutic approach and offer a differentiated health intervention proposal based on the understanding that the illness process has repercussions on all integrated systems of Being. Since 2019, the Health Center for the Elderly in Blumenau (SC-Brasil), specialized multi-professional service, offering support for biopsychoenergetic transformation with the practice of Yoga and Meditation, through a holistic and comprehensive view of health. It begins with the Multidimensional Assessment of the Elderly, with a guideline in welcoming and qualified listening, which considers the subject and all subjectivity. From there, the expanded diagnosis and the Singular Therapeutic Project are built and the consultations with the team and the 'Re-Conhecer group' begin. The activity is weekly, aimed at the elderly and their family, takes place in an appropriate place and lasts two hours. Welcoming, pranayama, mantras, kriyas and meditation are made, as well as reflections on free themes. The professionals who conduct the practice are the dentist, trained in yoga, and the social worker, the welcoming process continues individually after the activity. Due to subjectivity, results are routinely collected in a qualitative way from the participants' report. There is a perception on the part of the participants, therapists and members of the multidisciplinary team that this work provides improvement in cognitive abilities, self-care, well-being, self-confidence, creativity, improved sleep, autonomy, balance, strengthening bonds, joy, vitality. Key messages This initiative builds new models of health care, transcending the traditional biomedical model, according to the operational guideline for comprehensiveness, universal access and equity. Provokes reflections and builds a new perspective of life with quality and participation of the elderly as subjects of their health.

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Drivers of sustained sanitation access: social network and demographic predictors of latrine reconstruction after flooding disasters

Environmental Science Water Research & Technology ◽

10.1039/d1ew00263e ◽

2021 ◽

Vol 7 (10) ◽

pp. 1861-1872

Author(s):

Katherine G. Chambers ◽

Amanda R. Carrico ◽

Sherri M. Cook

Keyword(s):

Social Network ◽

Universal Access ◽

Sanitation Services ◽

Demographic Predictors

Flooding disasters pose a threat to sanitation services and can result in loss of access that exacerbates challenges to achieving universal access.

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Clustering Techniques for Secondary Substations Siting

Energies ◽

10.3390/en14041028 ◽

2021 ◽

Vol 14 (4) ◽

pp. 1028

Author(s):

Silvia Corigliano ◽

Federico Rosato ◽

Carla Ortiz Dominguez ◽

Marco Merlo

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Universal Access ◽

Distribution Networks ◽

Industrialized Countries ◽

Agglomerative Clustering ◽

Clustering Techniques ◽

Hierarchical Agglomerative Clustering ◽

Efficient Planning ◽

Target Set

The scientific community is active in developing new models and methods to help reach the ambitious target set by UN SDGs7: universal access to electricity by 2030. Efficient planning of distribution networks is a complex and multivariate task, which is usually split into multiple subproblems to reduce the number of variables. The present work addresses the problem of optimal secondary substation siting, by means of different clustering techniques. In contrast with the majority of approaches found in the literature, which are devoted to the planning of MV grids in already electrified urban areas, this work focuses on greenfield planning in rural areas. K-means algorithm, hierarchical agglomerative clustering, and a method based on optimal weighted tree partitioning are adapted to the problem and run on two real case studies, with different population densities. The algorithms are compared in terms of different indicators useful to assess the feasibility of the solutions found. The algorithms have proven to be effective in addressing some of the crucial aspects of substations siting and to constitute relevant improvements to the classic K-means approach found in the literature. However, it is found that it is very challenging to conjugate an acceptable geographical span of the area served by a single substation with a substation power high enough to justify the installation when the load density is very low. In other words, well known standards adopted in industrialized countries do not fit with developing countries’ requirements.

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