scholarly journals Assessing impacts of redeveloping public housing communities on obesity in low-income minority residents: Rationale, study design, and baseline data from the Watts Neighborhood Health Study

Author(s):  
Ashlesha Datar ◽  
Victoria Shier ◽  
Alexandria Braboy ◽  
Marai Jimenez-Ortiz ◽  
Angelica Hernandez ◽  
...  
Author(s):  
Giorgia Gon ◽  
Abdunoor M. Kabanywanyi ◽  
Petri Blinkhoff ◽  
Simon Cousens ◽  
Stephanie J. Dancer ◽  
...  

Abstract Background Healthcare associated infections (HAI) are estimated to affect up to 15% of hospital inpatients in low-income countries (LICs). A critical but often neglected aspect of HAI prevention is basic environmental hygiene, particularly surface cleaning and linen management. TEACH CLEAN is an educational intervention aimed at improving environmental hygiene. We evaluated the effectiveness of this intervention in a pilot study in three high-volume maternity and newborn units in Dar es Salaam, Tanzania. Methods This study design prospectively evaluated the intervention as a whole, and offered a before-and-after comparison of the impact of the main training. We measured changes in microbiological cleanliness [Aerobic Colony Counts (ACC) and presence of Staphylococcus aureus] using dipslides, and physical cleaning action using gel dots. These were analysed with descriptive statistics and logistic regression models. We used qualitative (focus group discussions, in-depth interviews, and semi-structured observation) and quantitative (observation checklist) tools to measure why and how the intervention worked. We describe these findings across the themes of adaptation, fidelity, dose, reach and context. Results Microbiological cleanliness improved during the study period (ACC pre-training: 19%; post-training: 41%). The odds of cleanliness increased on average by 1.33 weekly during the pre-training period (CI = 1.11–1.60), and by 1.08 (CI = 1.03–1.13) during the post-training period. Cleaning action improved only in the pre-training period. Detection of S. aureus on hospital surfaces did not change substantially. The intervention was well received and considered feasible in this context. The major pitfalls in the implementation were the limited number of training sessions at the hospital level and the lack of supportive supervision. A systems barrier to implementation was lack of regular cleaning supplies. Conclusions The evaluation suggests that improvements in microbiological cleanliness are possible using this intervention and can be sustained. Improved microbiological cleanliness is a key step on the pathway to infection prevention in hospitals. Future research should assess whether this bundle is cost-effective in reducing bacterial and viral transmission and infection using a rigorous study design.


2011 ◽  
Vol 24 (1) ◽  
pp. 74-81 ◽  
Author(s):  
Itamar S. Santos ◽  
Márcia Scazufca ◽  
Paulo A. Lotufo ◽  
Paulo R. Menezes ◽  
Isabela M. Benseñor

ABSTRACTBackground: Anemia and dementia are common diseases among the elderly, but conflicting data are available regarding an association between these two conditions. We analyzed data from the São Paulo Ageing & Health Study to address the relationship between anemia and dementia.Methods: This cross-sectional observational study included participants aged 65 years and older from a deprived area of the borough of Butantan, São Paulo, Brazil. Data about demographics, education, income, and cognitive and daily life function were collected, as well as blood samples. Anemia and dementia were defined according to WHO and DSM-IV criteria, respectively.Results: Of the 2267 subjects meeting the inclusion criteria, 2072 agreed to participate in the study; of whom 1948 had a valid total blood count and were included in the analysis. Anemia was diagnosed in 203 (10.2%) participants and dementia in 99 (5.1%). The frequency of anemia was higher in patients with dementia according to univariate analysis (odds ratio (OR) = 2.00, 95% confidence interval (CI) = 1.17–3.41, p = 0.01), but this association was not present after adjusting for age (OR = 1.33, 95% CI = 0.76–2.33, p = 0.32). Further multivariate adjustment did not change the results.Conclusion: Although anemia and dementia are frequent disorders in older people, we found their relationship to be mediated exclusively by aging in this low-income population from São Paulo.


2021 ◽  
pp. 239965442110411
Author(s):  
Lauro Gonzalez ◽  
Fernanda Lima-Silva ◽  
Marlei Pozzebon

Research on street-level bureaucrats has examined the various ways in which these professionals have implemented public policies in areas such as healthcare, education, and security, often emphasizing the role played by discretion in the implementation process. Despite its importance, the concept of street-level bureaucracy has scarcely been approached by housing studies. This study focuses on the role of street-level workers in the delivery of public housing to the lower-income population. We affirm the value of complementing street-level discretion with the concept of proximity, a premise borrowed from the microfinance literature, to increase the understanding of the interactions and relationships established between street-level workers and policy recipients during the implementation process. Such complementarity may contribute to a more accurate understanding of the housing policy implementation dynamics on the street-level and the possible adjustments to meet local needs. To explore this issue, we used a theoretical lens inspired by Goffman’s frame analysis that points to the importance of relational mechanisms that characterize the interactions between street-level workers and beneficiaries. These lenses were applied to a collective case study of Minha Casa Minha Vida-Entidades, a Brazilian subprogram in which street-level workers linked to social housing movements assume a leading role in the planning and execution of interventions. The results indicate that the combination of proximity and discretion has a positive influence on the implementation of housing policies. Our analysis shows the existence of nonprofit-oriented arrangements that may present different features and nuances at the implementation (micro) level and contribute to the (macro) debate on housing policies.


Author(s):  
Seward B. Rutkove ◽  
Kristin Qi ◽  
Kerisa Shelton ◽  
Julie Liss ◽  
Visar Berisha ◽  
...  

2022 ◽  
Vol 9 ◽  
Author(s):  
Karine Vidal ◽  
Shamima Sultana ◽  
Alberto Prieto Patron ◽  
Irene Salvi ◽  
Maya Shevlyakova ◽  
...  

Objectives: Risk factors for acute respiratory infections (ARIs) in community settings are not fully understood, especially in low-income countries. We examined the incidence and risk factors associated with ARIs in under-two children from the Microbiota and Health study.Methods: Children from a peri-urban area of Dhaka (Bangladesh) were followed from birth to 2 years of age by both active surveillance of ARIs and regular scheduled visits. Nasopharyngeal samples were collected during scheduled visits for detection of bacterial facultative respiratory pathogens. Information on socioeconomic, environmental, and household conditions, and mother and child characteristics were collected. A hierarchical modeling approach was used to identify proximate determinants of ARIs.Results: Of 267 infants, 87.3% experienced at least one ARI episode during the first 2 years of life. The peak incidence of ARIs was 330 infections per 100 infant-years and occurred between 2 and 4 months of age. Season was the main risk factor (rainy monsoon season, incidence rate ratio [IRR] 2.43 [1.92–3.07]; cool dry winter, IRR 2.10 [1.65–2.67] compared with hot dry summer) in the first 2 years of life. In addition, during the first 6 months of life, young maternal age (<22 years; IRR 1.34 [1.01–1.77]) and low birth weight (<2,500 g; IRR 1.39 [1.03–1.89]) were associated with higher ARI incidence.Conclusions: Reminiscent of industrialized settings, cool rainy season rather than socioeconomic and hygiene conditions was a major risk factor for ARIs in peri-urban Bangladesh. Understanding the causal links between seasonally variable factors such as temperature, humidity, crowding, diet, and ARIs will inform prevention measures.


2018 ◽  
Author(s):  
Michele M Ciulla ◽  
Patrizia Vivona

Clinical studies/trials are experiments or observations on human subjects considered by the scientific community the most appropriate instrument to answer specific research questions on interventions on health outcomes. The time-line of the observations might be focused on a single time point or to follow time, backward or forward, in the so called, respectively, retrospective and prospective study design. Since the retrospective approach has been criticized for the possible sources of errors due to bias and confounding, we aimed this study to assess if there is a prevalence of retrospective vs prospective design in the clinical studies/trials by querying MEDLINE. Our results on a sample of 1,438,872 studies/trials, (yrs 1960-2017), support a prevalence of retrospective, respectively 55% vs 45%. To explain this result, arandom sub-sample of studies where the country of origin was reported (n=1576) was categorized in high and low-income based onthe nominal Gross Domestic Product (GDP) and matched with the topic of the research. As expected, the absolute majority of studies/trials are carried on by high-income countries, respectively 86% vs 14%; even if a slight prevalence of retrospective was recorded in both income groups, nonetheless the most part of prospective studies are carried out by high-GDP countries, 85% vs 15%. Finally the differences in the design of the study are understandable when considering the topic of the research.


2021 ◽  
Vol 2006 (1) ◽  
pp. 012026
Author(s):  
Xuewei Ye ◽  
Xufang Ye
Keyword(s):  

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