scholarly journals The public health importance of Ascaris lumbricoides

Parasitology ◽  
2000 ◽  
Vol 121 (S1) ◽  
pp. S51-S71 ◽  
Author(s):  
P. O'LORCAIN ◽  
C.V. HOLLAND

Numerous studies have shown that anthelminthic treatment can be effective in improving growth rates when given to malnourished children with ascariasis. Recent investigations have also indicated that Ascaris infections can affect mental processing in some school children. Poor socio-economic conditions are among the key factors linked with higher prevalences of ascariasis, as are defaecation practices, geophagia, cultural differences relating to personal and food hygiene, occupational necessity, agricultural factors, housing style, social class and gender. Chemotherapy is currently the major tool used for the strategic control of ascariasis as a short-term goal. In the long term, improvements in hygiene and sanitation are thought to aid long-term control considerably. Targeted treatment, especially when aimed at schoolchildren, has been a major focus of recent control efforts in some areas. Universal treatment reaches more people and thus decreases further aggregate morbidity, especially in nutritionally vulnerable preschool-age children. Selective treatment requires technical effort to identify heavily infected individuals; acceptance by the community may vary in less educated populations when some individuals receive treatment and others do not. Child-targeted treatment may be more cost-effective than population treatment in reducing the number of disease cases and, in high transmission areas, expanding coverage of a population can be a more cost-effective strategy than increasing the frequency of treatment.

2021 ◽  
Vol 24 ◽  
Author(s):  
Márcia Mara Corrêa ◽  
Marcela Aparecida de Souza Borges ◽  
Elizabete Regina Araújo de Oliveira

ABSTRACT: Objective: This study aimed to investigate the association between sleep duration and excess weight in Brazilian adolescents. Methods: This is a cross-sectional study conducted with 65,837 adolescents, aged 12 to 17 years, enrolled in the Study of Cardiovascular Risks in Adolescents (ERICA). Sleep duration was assessed by means of a questionnaire focusing on weekday and weekend hours of sleep. Nutritional status was assessed based on body mass index, and participants were classified according to age and gender. The statistical analysis was performed with the Stata 13 software, using the survey command. Poisson regression was used to determine the association of excess weight with sleep duration categories. Results: A decline in sleep duration was associated with advancing age. The prevalence of short and long-term sleep among adolescents was 17.9 and 3.6%, respectively, while overweight was diagnosed in 25.5% of the sample. Adolescents who reported having short sleep had 10% (PR = 1.10; 95%CI 1.06 – 1.15) more overweight, while those who reported sleeping more than 11 hours had approximately 12% (PR = 0.88; 95%CI 0.78 – 0.99) less excess weight. Conclusion: Our findings reinforce the assumption that insufficient sleep poses health risks, and encouraging regular and sufficient sleep may be a cost-effective intervention for the prevention of overweight in adolescence.


2019 ◽  
Vol 2 (2) ◽  
pp. 28
Author(s):  
Roy Carr-Hill ◽  
Shelley Sauerhaft

The rapid growth of Low Cost Private Schools (LCPS) in developing countries has led to increasing interest in the model’s ‘sustainability’. Nearly all the literature is based on the proponents’ claims that the model is more cost-effective than government schools rather than of the implications of the model depending to a large extent on very low paid young women teachers.The article is written against the backdrop of the model of an autonomous, respected, well-prepared teacher and framed in terms of human rights and gender (dis-)empowerment. Drawing on material on literature mainly from India and Pakistan, it documents the educational levels and employment opportunities for women; reviews the arguments for and against the model pointing out the lack of attention to the high rates of profit and the plight of teachers; and demonstrates that the (mostly young women) teachers are not only very low paid but are also poorly qualified with very precarious conditions of employment. Simply put, paying women teachers less than the minimum wage denies their human rights, further disempowering those who are already socially marginalized and excluded. This is not sustainable for gender equality in the long term and, finally, detrimental to education in developing societies as a whole.


2015 ◽  
Vol 20 (4) ◽  
pp. 242-251 ◽  
Author(s):  
Éva Kállay

Abstract. The last several decades have witnessed a substantial increase in the number of individuals suffering from both diagnosable and subsyndromal mental health problems. Consequently, the development of cost-effective treatment methods, accessible to large populations suffering from different forms of mental health problems, became imperative. A very promising intervention is the method of expressive writing (EW), which may be used in both clinically diagnosable cases and subthreshold symptomatology. This method, in which people express their feelings and thoughts related to stressful situations in writing, has been found to improve participants’ long-term psychological, physiological, behavioral, and social functioning. Based on a thorough analysis and synthesis of the published literature (also including most recent meta-analyses), the present paper presents the expressive writing method, its short- and long-term, intra-and interpersonal effects, different situations and conditions in which it has been proven to be effective, the most important mechanisms implied in the process of recovery, advantages, disadvantages, and possible pitfalls of the method, as well as variants of the original technique and future research directions.


1997 ◽  
Vol 17 (03) ◽  
pp. 161-162
Author(s):  
Thomas Hyers

SummaryProblems with unfractionated heparin as an antithrombotic have led to the development of new therapeutic agents. Of these, low molecular weight heparin shows great promise and has led to out-patient therapy of DVT/PE in selected patients. Oral anticoagulants remain the choice for long-term therapy. More cost-effective ways to give oral anticoagulants are needed.


Author(s):  
W.J. Parker ◽  
N.M. Shadbolt ◽  
D.I. Gray

Three levels of planning can be distinguished in grassland farming: strategic, tactical and operational. The purpose of strategic planning is to achieve a sustainable long-term fit of the farm business with its physical, social and financial environment. In pastoral farming, this essentially means developing plans that maximise and best match pasture growth with animal demand, while generating sufficient income to maintain or enhance farm resources and improvements, and attain personal and financial goals. Strategic plans relate to the whole farm business and are focused on the means to achieve future needs. They should be routinely (at least annually) reviewed and monitored for effectiveness through key performance indicators (e.g., Economic Farm Surplus) that enable progress toward goals to be measured in a timely and cost-effective manner. Failure to link strategy with control is likely to result in unfulfilled plans. Keywords: management, performance


2017 ◽  
Author(s):  
Douglas LaBrecque ◽  
◽  
Russell D. Brigham ◽  
Conny Schmidt-Hattenburger ◽  
Evan Um ◽  
...  

Author(s):  
Jill C. Fodstad ◽  
Rebecca Elias ◽  
Shivali Sarawgi

Gender diversity refers to gender expressions and/or gender identity experiences that vary from the common experiences of gender. Gender-diverse people may be gender nonconforming, gender nonbinary, gender fluid, gender exploring, transgender, and so forth. Some gender-diverse individuals experience gender dysphoria and/or gender incongruence and may require gender-affirming supports, including gender-affirming medical interventions. The co-occurrence of autism and gender diversity has been highlighted in a series of studies internationally as well as through rich community expressions. Studies in gender-referred individuals reveal high rates of autism traits as well as high rates of existing autism diagnoses. Studies in autistic populations reveal greater gender diversity characteristics. The long-term course of gender diversity in autistic individuals is poorly understood. Clinical guidelines have been developed for adolescents with the co-occurrence, but much work remains: No gender-related measures have been developed and tested for use in neurodiverse populations, no programs exist to support gender-diverse neurodiverse adults, and little is known about co-occurring mental health profiles, risks, or protective factors for people with the co-occurrence. The inclusion of this chapter on co-occurring autism and gender diversity within a book on “co-occurring psychiatric conditions” is problematic, because gender diversity is not a “psychiatric condition,” but instead a form of human diversity. The diagnosis of Gender Dysphoria is useful only insomuch as it allows individuals to obtain necessary gender-related supports. The authors’ choice to include this chapter in this book reflects a compromise, motivated by the need for educating both autism and gender specialists in this common co-occurrence.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 39-39
Author(s):  
Katie Aubrecht ◽  
Ivy Bourgeault ◽  
Tamara Daly

Abstract Intersectionality is a useful method (Lutz, 2015) for interdisciplinary long-term care (LTC) research to advance a more critical understanding of how experiences of quality are shaped by mutually reproducing social divisions, identities and relations of power that shape LTC. This paper discusses insights from the “Mapping Care Relationships” stream of the Seniors – Adding Life to Years (SALTY) project, a pan-Canadian program of research examining clinical, social and policy perspectives on quality in LTC. “Mapping Care Relationships” mapped how promising approaches to care relationships are organized and experienced in LTC. From January 2018-August 2019 our team of nine researchers conducted rapid ethnographies in eight nursing homes, two in each of four provinces across Canada. We purposively observed and interviewed workers from a wide variety of positions and backgrounds, informed by an intersectionality approach. We traced how promising approaches in person-centred dementia care (PCDC) in particular may reify the subordinated status of care workers (some more than others) and reinforce inequities within LTC systems. In multiple LTC homes, front-line care workers described experiencing physical and emotional harm in care relationships with residents which caused them distress. However, consistent with a PCDC approach, the harm was attributed to ‘behaviours’ clinically symptomatic of dementia. In framing power differentials from a medical perspective, PCDC makes it possible to interpret harmful experiences as 'part of the job’ and something workers should know to expect, prevent, avoid, redirect, or ignore. Lutz, H. (2015). Intersectionality as method. DiGeSt. Journal of diversity and gender studies, 2(1-2), 39-44.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Panatto ◽  
P Landa ◽  
D Amicizia ◽  
P L Lai ◽  
E Lecini ◽  
...  

Abstract Background Invasive disease due to Neisseria meningitidis (Nm) is a serious public health problem even in developed countries, owing to its high lethality rate (8-15%) and the invalidating sequelae suffered by many (up to 60%) survivors. As the microorganism is transmitted via the airborne route, the only available weapon in the fight against Nm invasive disease is vaccination. Our aim was to carry out an HTA to evaluate the costs and benefits of anti-meningococcal B (MenB) vaccination with Trumenba® in adolescents in Italy, while also considering the impact of this new vaccination strategy on organizational and ethics aspects. Methods A lifetime Markov model was developed. MenB vaccination with the two-dose schedule of Trumenba® in adolescents was compared with 'non-vaccination'. Two perspectives were considered: the National Health Service (NHS) and society. Three disease phases were defined: acute, post-acute and long-term. Epidemiological, economic and health utilities data were taken from Italian and international literature. The analysis was conducted by means of Microsoft Excel 2010®. Results Our study indicated that vaccinating adolescents (11th year of life) with Trumenba® was cost-effective with an ICER = € 7,912/QALY from the NHS perspective and € 7,758/QALY from the perspective of society. Vaccinating adolescents reduces the number of cases of disease due to meningococcus B in one of the periods of highest incidence of the disease, resulting in significant economic and health savings. Conclusions This is the first study to evaluate the overall impact of free MenB vaccination in adolescents both in Italy and in the international setting. Although cases of invasive disease due to meningococcus B are few, if the overall impact of the disease is adequately considered, it becomes clear that including anti-meningococcal B vaccination into the immunization program for adolescents is strongly recommended from the health and economic standpoints. Key messages Free, large-scale MenB vaccination is key to strengthening the global fight against invasive meningococcal disease. Anti-meningococcal B vaccination in adolescents is a cost-effective health opportunity.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Takahiro Kinoshita ◽  
Kensuke Moriwaki ◽  
Nao Hanaki ◽  
Tetsuhisa Kitamura ◽  
Kazuma Yamakawa ◽  
...  

Abstract Background Hybrid emergency room (ER) systems, consisting of an angiography-computed tomography (CT) machine in a trauma resuscitation room, are reported to be effective for reducing death from exsanguination in trauma patients. We aimed to investigate the cost-effectiveness of a hybrid ER system in severe trauma patients without severe traumatic brain injury (TBI). Methods We conducted a cost-utility analysis comparing the hybrid ER system to the conventional ER system from the perspective of the third-party healthcare payer in Japan. A short-term decision tree and a long-term Markov model using a lifetime time horizon were constructed to estimate quality-adjusted life years (QALYs) and associated lifetime healthcare costs. Short-term mortality and healthcare costs were derived from medical records and claims data in a tertiary care hospital with a hybrid ER. Long-term mortality and utilities were extrapolated from the literature. The willingness-to-pay threshold was set at $47,619 per QALY gained and the discount rate was 2%. Deterministic and probabilistic sensitivity analyses were conducted. Results The hybrid ER system was associated with a gain of 1.03 QALYs and an increment of $33,591 lifetime costs compared to the conventional ER system, resulting in an ICER of $32,522 per QALY gained. The ICER was lower than the willingness-to-pay threshold if the odds ratio of 28-day mortality was < 0.66. Probabilistic sensitivity analysis indicated that the hybrid ER system was cost-effective with a 79.3% probability. Conclusion The present study suggested that the hybrid ER system is a likely cost-effective strategy for treating severe trauma patients without severe TBI.


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