scholarly journals Zika: An ongoing threat to women and infants

2017 ◽  
Author(s):  
Beatriz Macedo Coimbra ◽  
Flávio Codeço Coelho ◽  
Margaret Armstrong ◽  
Valeria Saraceni ◽  
Cristina Lemos
Keyword(s):  
Sexual Transmission ◽  
Herd Immunity ◽  
Risk Groups ◽  
Older Age ◽  
Age Classes ◽  
Sharp Drop ◽  
Men And Women ◽  
Epidemic Season ◽  
Women And Children ◽  
Previous Summer

AbstractRecent data from Rio de Janeiro shows a sharp drop in the number of notified cases of Zika in the summer of 2016-17, compared to the previous summer. This is probably due to herd immunity built up after the previous year's epidemic. There is still a much higher incidence among women than men, almost certainly due to sexual transmission. An unexpected feature of the new data is that there are proportionally far more cases in children under 15 months than in older age classes. By comparing the incidence for 2016-17 with that of 2015-16, we can deduce the proportion of reported cases for men and women, and also verify that the disparity of incidence between them is still present. Women and children still represent risk groups with regard to Zika infection, even during a non-epidemic season.

scholarly journals Zika: an ongoing threat to women and infants

2018 ◽  
Vol 34 (11) ◽  
Author(s):  
Beatriz Macedo Coimbra dos Santos ◽  
Flavio Codeço Coelho ◽  
Margaret Armstrong ◽  
Valeria Saraceni ◽  
Cristina Lemos
Keyword(s):  
Sexual Transmission ◽  
Risk Groups ◽  
Gender Disparity ◽  
Incidence Rates ◽  
Older Age ◽  
Age Classes ◽  
Sharp Drop ◽  
Men And Women ◽  
Women And Children ◽  
Previous Summer

Recent data from the municipality of Rio de Janeiro, Brazil, shows a sharp drop in the number of reported occurrences of Zika during the summer of 2016/2017, compared to the previous summer. There is still a much higher incidence among women than men, almost certainly due to sexual transmission. An unexpected feature of the new data is that there are proportionally far more cases affecting children under 15 months than older age classes. By comparing incidence rates in 2016/2017 and 2015/2016, we were able to deduce the proportion of reported cases affecting men and women, and verify that gender disparity is still present. Women and children are still risk groups for Zika infection, even during non-epidemic seasons.

scholarly journals Emerging trends in the epidemiology of invasive mycoses in England and Wales (1990–9)

2001 ◽  
Vol 126 (3) ◽  
pp. 397-414 ◽  
Author(s):  
T. L. LAMAGNI ◽  
B. G. EVANS ◽  
M. SHIGEMATSU ◽  
E. M. JOHNSON
Keyword(s):  
Disease Surveillance ◽  
Fungal Infections ◽  
Communicable Disease ◽  
Pneumocystis Carinii ◽  
Age Groups ◽  
Public Health Problem ◽  
Risk Groups ◽  
Older Age ◽  
England And Wales ◽  
Invasive Mycoses

Invasive fungal infections are becoming an increasing public health problem owing to the growth in numbers of susceptible individuals. Despite this, the profile of mycoses remains low and there is no surveillance system specific to fungal infections currently existing in England and Wales. We analysed laboratory reports of deep-seated mycoses made to the Communicable Disease Surveillance Centre between 1990 and 1999 from England and Wales. A substantial rise in candidosis was seen during this period (6·76–13·70 reports per million population/year), particularly in the older age groups. Rates of cryptococcosis in males fluctuated over the decade but fell overall (1·05–0·66 per million population/year), whereas rates of female cases gradually rose up until 1998 (0·04–0·41 per million population/year). Reports of Pneumocystis carinii in men reduced substantially between 1990 and 1999 (2·77–0·42 per million population/year) but showed little change in women. Reports of aspergillosis fluctuated up until 1996, after which reports of male and female cases rose substantially (from 0·08 for both in 1996 to 1·92 and 1·69 per million population/year in 1999 for males and females respectively), largely accounted for by changes in reporting practice from one laboratory. Rates of invasive mycoses were generally higher in males than females, with overall male-to-female rate ratios of 1·32 (95% CI 1·25–1·40) for candidosis, 1·30 (95% CI 1·05–1·60) for aspergillosis, 3·99 (95% CI 2·93–5·53) for cryptococcosis and 4·36 (95% CI 3·47–5·53) for Pneumocystis carinii. The higher male than female rates of reports is likely to be a partial reflection of HIV epidemiology in England and Wales, although this does not fully explain the ratio in infants and older age groups. Lack of information on underlying predisposition prevents further identification of risk groups affected. Whilst substantial under-reporting of Pneumocystis carinii and Cryptococcus species was apparent, considerable numbers of superficial mycoses were mis-reported indicating a need for clarification of reporting guidelines. Efforts to enhance comprehensive laboratory reporting should be undertaken to maximize the utility of this approach for surveillance of deep-seated fungal infections.

scholarly journals Risk factors for cutaneous leishmaniasis in a high-altitude forest region of Peru

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Justin T. Lana ◽  
Andrés Mallipudi ◽  
Ernesto J. Ortiz ◽  
Jairo H. Arevalo ◽  
Alejandro Llanos-Cuentas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cutaneous Leishmaniasis ◽  
Conditional Logistic Regression ◽  
Risk Groups ◽  
Early Morning ◽  
Agricultural Field ◽  
Domestic Spaces ◽  
Field Worker ◽  
Home Interview ◽  
Women And Children

Abstract Background American cutaneous leishmaniasis (CL) is a neglected tropical disease typically associated with men working in remote, sylvatic environments. We sought to identify CL risk factors in a highly deforested region where anecdotal reports suggested an atypical proportion of women and children were infected with CL raising concern among authorities that transmission was shifting towards domestic spaces and population centers. Methods We describe the characteristics of CL patients from four participating clinics after digitizing up to 10 years of patient data from each clinic’s CL registries. We assessed risk factors of CL associated with intradomestic, peridomestic, or non-domestic transmission through a matched case-control study with 63 patients who had visited these same clinics for CL (cases) or other medical reasons (controls) between January 2014 and August 2016. The study consisted of an in-home interview of participants by a trained field worker using a standard questionnaire. Risk factors were identified using bivariable and multivariable conditional logistic regression. Results Between 2007 and 2016, a total of 529 confirmed CL positives were recorded in the available CL registries. Children and working aged women made up 58.6% of the cases. Our final model suggests that the odds of sleeping in or very near an agricultural field were five times greater in cases than controls (p = 0.025). Survey data indicate that women, children, and men have similar propensities to both visit and sleep in or near agricultural fields. Conclusions Women and children may be underappreciated as CL risk groups in agriculturally dependent regions. Despite the age-sex breakdown of clinical CL patients and high rates of deforestation occurring in the study area, transmission is mostly occurring outside of the largest population centers. Curbing transmission in non-domestic spaces may be limited to decreasing exposure to sandflies during the evening, nighttime, and early morning hours. Our paper serves as a cautionary tale for those relying solely on the demographic information obtained from clinic-based data to understand basic epidemiological trends of vector-borne infections.

scholarly journals Gender Roles and Employment Pathways of Older Women and Men in England

SAGE Open ◽  
2017 ◽  
Vol 7 (4) ◽  
pp. 215824401774269 ◽  
Author(s):  
Mariska van der Horst ◽  
David Lain ◽  
Sarah Vickerstaff ◽  
Charlotte Clark ◽  
Ben Baumberg Geiger
Keyword(s):  
Gender Roles ◽  
Marital Status ◽  
Older Women ◽  
Older Age ◽  
Full Time ◽  
Men And Women ◽  
Male Breadwinner ◽  
Time Work ◽  
Part Time ◽  
Part Time Work

In the context of population aging, the U.K. government is encouraging people to work longer and delay retirement, and it is claimed that many people now make “gradual” transitions from full-time to part-time work to retirement. Part-time employment in older age may, however, be largely due to women working part-time before older age, as per a U.K. “modified male breadwinner” model. This article therefore separately examines the extent to which men and women make transitions into part-time work in older age, and whether such transitions are influenced by marital status. Following older men and women over a 10-year period using the English Longitudinal Study of Ageing, this article presents sequence, cluster, and multinomial logistic regression analyses. Little evidence is found for people moving into part-time work in older age. Typically, women did not work at all or they worked part-time (with some remaining in part-time work and some retiring/exiting from this activity). Consistent with a “modified male breadwinner” logic, marriage was positively related to the likelihood of women belonging to typically “female employment pathway clusters,” which mostly consist of part-time work or not being employed. Men were mostly working full-time regardless of marital status. Attempts to extend working lives among older women are therefore likely to be complicated by the influence of traditional gender roles on employment.

scholarly journals COVID-19: Rethinking the Lockdown Groupthink

2021 ◽  
Vol 9 ◽  
Author(s):  
Ari R. Joffe
Keyword(s):  
Public Health ◽  
High Risk ◽  
Cost Benefit Analysis ◽  
Health Care Systems ◽  
Herd Immunity ◽  
Cost Benefit ◽  
Risk Groups ◽  
School Closures ◽  
Trade Offs ◽  
Care Systems

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has caused the Coronavirus Disease 2019 (COVID-19) worldwide pandemic in 2020. In response, most countries in the world implemented lockdowns, restricting their population's movements, work, education, gatherings, and general activities in attempt to “flatten the curve” of COVID-19 cases. The public health goal of lockdowns was to save the population from COVID-19 cases and deaths, and to prevent overwhelming health care systems with COVID-19 patients. In this narrative review I explain why I changed my mind about supporting lockdowns. The initial modeling predictions induced fear and crowd-effects (i.e., groupthink). Over time, important information emerged relevant to the modeling, including the lower infection fatality rate (median 0.23%), clarification of high-risk groups (specifically, those 70 years of age and older), lower herd immunity thresholds (likely 20–40% population immunity), and the difficult exit strategies. In addition, information emerged on significant collateral damage due to the response to the pandemic, adversely affecting many millions of people with poverty, food insecurity, loneliness, unemployment, school closures, and interrupted healthcare. Raw numbers of COVID-19 cases and deaths were difficult to interpret, and may be tempered by information placing the number of COVID-19 deaths in proper context and perspective relative to background rates. Considering this information, a cost-benefit analysis of the response to COVID-19 finds that lockdowns are far more harmful to public health (at least 5–10 times so in terms of wellbeing years) than COVID-19 can be. Controversies and objections about the main points made are considered and addressed. Progress in the response to COVID-19 depends on considering the trade-offs discussed here that determine the wellbeing of populations. I close with some suggestions for moving forward, including focused protection of those truly at high risk, opening of schools, and building back better with a economy.

scholarly journals Prognostic Significance of Reduced BCAS4 expression in Bone Marrow Cells of Patients with Myelodysplastic Syndromes

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4258-4258
Author(s):  
Masayuki Shiseki ◽  
Mayuko Ishii ◽  
Mari Ohwashi ◽  
Kentaro Yoshinaga ◽  
Naoki Mori ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bone Marrow ◽  
Mononuclear Cells ◽  
Bone Marrow Cells ◽  
Risk Groups ◽  
Older Age ◽  
Expression Level ◽  
Expression Of Genes ◽  
Kaplan Meier ◽  
Lysosome Related Organelles

Deletion of long arm of chromosome 20 (del(20q)) is commonly observed in myelodysplastic syndromes (MDS). Reduced expression of genes located within the common deleted region (CDR) of del(20q) due to haploinsufficiency may play a role in molecular pathogenesis of MDS. In the previous study, we examined expression of genes located within the CDR which we determined using array-CGH, in bone marrow mononuclear cells in MDS patients with or without del(20q), indicating that BCAS4 expression was significantly reduced in bone marrow cells in MDS patients with or without del(20q). The BCAS4 gene, which was identified as a fusion transcript expressed in MCF7 cells, encodes 23kD protein. Although function of BCAS4 protein remains unclear, it could be a member of "cappuccino" family, which belong to lysosome-related organelles. Abnormality of genes encoding lysosome-related organelles cause variety of congenital disorders, including the Hermansky-Pudlak syndromes, which is characterized by oculocutaneous albinism and bleeding tendency due to platelet dysfunction as a result of lysosome abnormalities. In the present study we investigated clinical implication of BCAS4 expression level in MDS patients. Mononuclear cells separated from bone marrow samples taken at the time of MDS diagnosis were used for analysis. Written informed consent was obtained from patients before study. To analyze BCAS4 expression, quantitative RT-PCR was performed using cDNA from mononuclear cells as template by the TaqMan probe method (Applied Biosystems) with co-amplification of the endogenous control gene, human GAPDH (Applied Biosystems). Samples from 103 MDS patients, 64 males and 39 females with median age of 67 years (range: 20-91 years), with (n=14) or without (n=89) del(20q), were examined in the present study. Patients were classified as RCUD (n=12), RCMD (n=55), RARS (n=9), RAEB-1 (n=10), and RAEB-2 (n=13), according to WHO 2008 classification, and in RAEB-T (n=4) according to FAB classification. They also were categorized in four IPSS risk groups, low risk (n=30), intermediate-1 risk (n=46), intermediate-2 risk (n=18), and high risk (n=9). There was no significant difference in relative BCAS4 expression level between patients with del(20q) and those without del(20q), and among WHO subtypes. Higher IPSS risk groups (INT-2 and High) showed trend in association with reduced BCAS4 expression compared with lower IPSS risk groups (Low and INT-1) (P=0.104). We analyzed impact of BCAS4 expression on overall survival (OS). Based on BCAS4 expression level, 103 patients were divided into four groups, highest (Q1), intermediate (Q2, Q3), and lowest (Q4) quartiles. The Kaplan-Meier analysis demonstrated that Q4 showed significantly worse OS compared with remaining quartiles (Q1-Q3) (log-rank test, P=0.0031). The estimated 2-year OS rates in Q1-3 group and Q4 group were 75.1% and 48.9%, respectively. According to the COX proportional hazards model, univariate analysis showed lower BCAS4 expression (Q4 vs Q1-Q3) was associated with worse OS (hazard ratio 3.43, 95%CI 1.89-6.11, P=0.0001) as well as older age (65 years or older vs less than 65 years), and higher IPSS risk groups (INT-2 and High vs Low and INT-1). Multivariate analysis indicated that lower BCAS4 expression showed trend for association with worse OS (hazard ratio 1.90, 95%CI 0.96-3.64, P=0.0651) by analyzing with two variables (older age and higher IPSS groups). Next, we investigated whether OS is predicted by combination of three variables, BCAS4 expression level, IPSS risk groups, and age at diagnosis. We defined lower BCAS4 expression (Q4), higher IPSS (INT-2 and High), and older age (65 years or older), as risk factors. The Kaplan-Meier analysis showed that survival curves were well separated according to number of risk factors (0, 1, and 2 or more) (P<0.0001). The estimated 1-year, 2-year, and 5-year survival rates were 100%, 100%, and 86.5% in patients without risk factor, 75%, 70.2%, and 51.7% in patients with one risk factor, and 54%, 34.3%, and 11.4% in patients with two or more risk factors. The present study demonstrated that reduced BCAS4 expression is associated with inferior clinical outcome, indicating that BCAS4 expression level could be a useful prognostic marker in MDS, especially by combination with IPSS risk and patients age at diagnosis. Disclosures Tanaka: Bristol-Myers Squibb: Research Funding.

Secondary post-tonsillectomy haemorrhage and informed consent

2004 ◽  
Vol 118 (12) ◽  
pp. 937-940 ◽  
Author(s):  
R.J. Alexander ◽  
R. Kukreja ◽  
G.R. Ford
Keyword(s):  
Informed Consent ◽  
Incidence Study ◽  
Older Age ◽  
Men And Women ◽  
Significant Difference ◽  
Post Operation ◽  
Secondary Haemorrhage

This is a prospective incidence study of 250 secondary post-tonsillectomy haemorrhages from a population of 2706 tonsillectomies performed over a seven-year period, which aims to ascertain the incidence and character of post-tonsillectomy secondary haemorrhage. Out of 250 post-tonsillectomy secondary bleeds (9.2 per cent of total; 95 per cent CI = 8.2 per cent – 10.4 per cent), 39 patients had a severe bleed (1.4 per cent; 95 per cent CI = 1.2 per cent – 2.1 per cent). The incidence of secondary tonsillectomy haemorrhage increased with age, peaking at 30–34 years in both men and women (p < 0.001), with no statistically significant difference between the two sexes (p = 0.23). The incidence of serious haemorrhage increases in the older age categories (p = 0.005) but is not influenced by gender (p = 0.50). The majority of secondary tonsillectomy haemorrhages presented between the fourth and seventh day post-operation (69.8 per cent). These results now provide the basis for informed consent for a tonsillectomy in our department.

ADDRESSING COVID-19 IN KAZAKHSTAN: WHAT ARE THE EFFORTS AND CHALLENGES?

Vestnik ◽  
2021 ◽  
pp. 289-292
Author(s):  
Л.Ж. Алекешева ◽  
К.К. Тогузбаева ◽  
К.О. Джусупов
Keyword(s):  
Social Services ◽  
Herd Immunity ◽  
Health Indicators ◽  
Risk Groups ◽  
Medical Services ◽  
New Disease ◽  
Optimal Care ◽  
Number Of Patients ◽  
Coronavirus Infection ◽  
The Impact

COVID-19 нанес серьезный удар по системам здравоохранения многих стран мира, включая Республику Казахстан. Чтобы справиться с пандемией, Казахстан разработал план, содержащий три стратегические цели: 1) предотвращение вспышки болезни; 2) Обеспечение оптимального ухода для всех пациентов и 3) Сведение к минимуму воздействия пандемии на системы здравоохранения, социальные услуги и экономическую деятельность. Однако неравномерное распределение финансовых ресурсов по регионам, нерегулярное потребление медицинских услуг и различия в показателях здоровья препятствуют этим усилиям. Другие проблемы - это нехватка медицинских сил, неожиданность ситуации, отсутствие знаний о коронавирусной инфекции и бессилие перед этой новой болезнью. Были трудности с массовым тестированием, поскольку стигма и страх перед карантином вынуждали людей не проходить тестирование. После отмены чрезвычайного положения и строгой изоляции страну охватила эйфория, которая привела к резкому увеличению числа случаев заболевания. Чтобы взять ситуацию под контроль в июне 2020 года был экстренно введен второй локдаун, постепенно стало уменьшаться количество больных и инфицированных. Пандемия показала, насколько хрупка и зависима система: была отложена плановая вакцинация детям до 1 года, временно приостановлено медицинское обследование и оказание медицинских услуг больным хроническими, онкологическими заболеваниями, плановая госпитализация. Многие врачи и медсестры заразились и заболели. На момент написания этой статьи эпидемиологическая ситуация в стране с COVID-19 находится под контролем и надзором, однако давать какие-либо прогнозы относительно его завершения пока рано. Казахстан готовится к вакцинации от коронавирусной инфекции, в первую очередь вакцинации должны подвергаться группы риска, медицинские и социальные работники, а также люди с хроническими заболеваниями. Пока коллективный иммунитет не сформирован, казахстанцы должны проявлять осторожность при снятии ограничений, чтобы предотвратить взрыв новых случаев заболевания. COVID-19 has strained the healthcare systems of many countries worldwide including the Republic of Kazakhstan. To cope with the pandemic, Kazakhstan mounted a plan containing three strategic objectives: 1) Preventing the outbreak of the disease; 2) Ensuring optimal care for all patients, and 3) Minimizing the impact of the pandemic on health systems, social services, and economic activities. However, the uneven distribution of financial resources across regions, irregular consumption of medical services, and inconsistent health indicators hamper these efforts. Other issues are the lack of medical forces, the unexpectedness of the situation, lack of knowledge on coronavirus infection, and powerlessness in front of this new disease. There were difficulties in mass testing as stigma and fear from quarantine forced people not to get tested. The euphoria enveloped the country after abolishing the emergency state after an intense lockdown which resulted in increased cases. A second lockdown was urgently introduced in June 2020 to take control of the situation. The number of patients and those infected gradually began to decline. The pandemic showed the fragility and inter-dependence of the health system- planned vaccinations against many infectious diseases were postponed. Medical examination and provision of medical services to patients with chronic, oncological diseases, planned hospitalization were temporarily halted. Many doctors and nurses became infected and ill. The country's COVID-19 epidemiological situation is somewhat under the control and supervision as of this writing. However, to give any forecasts for its completion is still too early. Kazakhstan is preparing to vaccinate against coronavirus infection. First of all, risk groups, medical and social workers, and people with chronic diseases should be subject to vaccination. Until herd immunity is not formed, Kazakhstanis must keep caution when the restrictions are taken off to prevent an explosion of new disease cases.

scholarly journals Movie as A Medium to Create an Equal Society

2018 ◽  
Vol 73 ◽  
pp. 14009
Author(s):  
Wening Jiwandaru Pradanri
Keyword(s):  
Gender Inequality ◽  
Qualitative Approach ◽  
Audience Reception ◽  
Equal Opportunities ◽  
Film Festivals ◽  
Men And Women ◽  
Active Audience ◽  
Women And Children

Kartini movie may not succeed commercially, but it had 34 nominations and won 3 awards from 3 different film festivals. These different perspectives allowing variety tendencies of active audience reception. In prior researches, shows that Indonesia still facing a gender inequality in the fields of education. This study aims provides overview of the four active audiences reception on Kartini movie, in order to be a medium that creating an equal society using qualitative approach and constructivism paradigm. This study concluded that there are tendencies of dominant meanings acceptance in Kartini movie. All of the four subjects felt that it delivered such powerful messages about creating an equal society. They agreed that the messages delivered in three main scenes of the movie. The first scene is when Kartini persuade her sisters to free their souls and minds by reading books. The second scene is when Kartini was told by a moslem leaders, that both of men and women must have equal opportunities to a proper education. The last scene is when Kartini giving terms and conditions to a man who proposed her to be his wives, it successfully giving a proper education to women and children in needs.

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