Water, Sanitation and Hygiene in Lower-Level Health Care Facilities of Dar es Salaam Region in Tanzania: Status towards Achieving the Sustainable Development Goals and Way Forward

Background: Improving Water, Sanitation and Hygiene in health care settings is a critical prerequisite for achieving national health goals and Sustainable Development Goals (SDGs). The World Health Organization (WHO) has set a target for each United Nations member state to reach by 2030. Each member state is required to reach by 2022, 2025 and 2030 at least 60%, 80% and 100%, respectively of basic level of service of the five elements which are water, sanitation, hygiene, waste management and environmental cleaning. Methods: This study aimed to evaluate and document the current state of basic water, sanitation, and hygiene services in all lower-level health care facilities in the Dar es Salaam region of Tanzania as of July 2022. A cross-sectional study was conducted in 99 public dispensaries in the Dar es Salaam region’s five councils: Ubungo, Kigamboni, Kinondoni and Temeke Municipalities, and Ilala City. The interviewee form and observational checklists were both digitalized using the Kobo tool software. The respondents were health care facility in-charges or nurse in-charges. Data were downloaded, validated, and imported to Stata version 15 for analysis. Results: The basic WASH level per JMP is far below the target in 2022. Each member state by 2022 is required to reach at least 60% of the basic level of service of each element. We found a low coverage of basic WASH in the 99 dispensaries included in this study. The basic WASH coverage was met in only 10 (10.1%) of the dispensaries, while the remaining 89 (89.9%) dispensaries fall on limited WASH services. Conclusion: This study revealed lower coverage of basic WASH services in dispensaries. An urgent need is required to improve the status of WASH in all the dispensaries and facilitate the provision of quality health care services, patient safety and reduce health care associated infections.

Present situation and the countermeasures of health human resources in Guangxi general hospitals at the county - level

[目的] 了解广西县级综合医院卫生人力资源状况,为进一步推进县级医院改革提供建设性意见. [方法]通过问卷调查法、数理统计法等综合分析广西县级综合医院卫生人力资源现状.[结果]广西县级综合 医院在岗人员在编率为41.56%,医护比为1： 1.68, 67.12%的卫生技术人员职称为初级及以下,超七成拥有 大专及以上学历.[结论]广西县级综合医院卫生技术人员在编率较低,医护比、职称及学历结构不合理,整 体年龄偏低,需通过综合措施加以改善.

Assessment of pollution levels and human health risk of heavy metals in dust deposited on Yerevan＇s tree leaves (Armenia)

The total concentrations of Cd,As,Pb,Cr,Ni,Co,Zn,Cu,Ag,Hg,and Mo were determined in the atmospheric dust of the city of Yerevan by atomic absorption spectrometry(AAnalyst PE 800).Heavy metal pollution levels were evaluated by calculating geo-accumulation(I_(geo)) and summary pollution(Z_c) indices.Potential human health risk was assessed using the United States Environmental Protection agency's human health risk assessment model.The results show that mean contents of all elements tested except Ni and Cr were substantially higher than local geochemical background values.According to the I_(geo),Yerevan territory is strongly-to-extremely polluted by As,Ag,Hg,Mo,and Cd.The Z_c assessment indicated that very high pollution was detected in 36%of samples,high in 32%,average in 12%,and low in 20%.The health risk assessment revealed a noncarcinogenic risk(HI >1) for children at 13 samplings sites and for adults at one sampling site.For children the risk was due to elevated levels of Mo,Cd,Co,and As,while for adults,only Mo.Carcinogenic risk(>1:1,000,000) of As and Cr via ingestion pathway was observed in 25 and 14 samples,respectively.This study,therefore,is the base for further detailed investigations to organize problematic site remediation and risk reduction measures.

Practical Experience of Establishing German Standard Level 1 Perinatal Center in Chongqing Health Care for Women and Children

Germany,as a western developed country,has an advanced medical level,especially in the health care of very immature premature infants.We trace the medical history of perinatology to understand the development of perinatal centers in Germany.After analyzing the classification and function,hierarchical management and quality control systems of German perinatal centers,we established a German standard level 1 perinatal center in the Chongqing Health Center for Women and Children(CHCWC).During more than two years of practice,we changed concepts,continuously updated clinical knowledge and skills,developed a series o f high-quality work processes and supervision systems and introduced advanced medical equipment.We believe that the experience of establishing a German standard level 1 perinatal center and perinatal center network in Chongqing is worthy of being promoted to the Chinese maternal and child health care system.

The Effect of Life Skills Training on the Mental Health and Level of Resilience among Teachers of Normal Students and Teachers of Exceptional Students in Zahedan

This is an experimental study conducted on two groups of control and experimental using pretestposttest design, applying psychological intervention on the study sample. The present study aimed to determine the effectiveness of collective education life skills on mental health and resilience of teachers in Zahedan. The population of the study included all teachers at schools with normal students and teachers at schools with exceptional students in Zahedan, among which 60 teachers at normal schools and 20 teachers at exceptional schools were selected and placed in two groups of experimental and control, respectively. Initially, members of the experimental group were taught 10 basic life skills in 10 2-hour sessions. Mental health and resilience questionnaires were distributed and gathered before and after the training sessions. Results indicated the positive effect of life skills training on mental health of teachers at schools with normal students and teachers at schools with exceptional students, which meant that the more the life skills training to teachers at schools with normal students and teachers at schools with exceptional students, the lower their mental health scores would be. Results also indicated the positive effect of life skills training on resilience of teachers at schools with normal students and teachers at schools with exceptional students, which meant that the more the life skills training to teachers at schools with normal students and teachers at schools with exceptional students, the higher their resilience scores would be.

A Theoretical Study on Health Quotient Promotion-based Physical Education Reform at the University Level

This study maintains that university-level physical education does not currently include or implement health education.? As a consequence of this, college and university students have a very weak theoretical understanding of health.? This study maintains that university-level physical education should focus on the state of students’ health, using the principles of the health quotient.? Of particular importance are problems related to mental health, social adaptive ability, and lifestyle.? Physical education should incorporate instruction based on health quotient-related theories and techniques;doing so will lay a strong foundation for students’ lifelong physical education.? In addition to opening up new paths and methods in research related to the all-around health education of college students, this can also enrich and perfect the theoretical system of modern sports science, as well as provide a new line of thinking and perspective to university-level physical education reform.

Health concerns of veterans with high-level lower extremity amputations

Background: To identify health concerns of veterans with high-level lower extremity amputations.Methods: Through a cross-sectional study, general practitioners, an orthopedic specialist, psychologists, psychiatrists,physiotherapist and prosthetists examined 100 veterans using a short-form health-related quality of life questionnaire(SF-36) that assessed their ability to perform activities of daily living(ADL), instrumental activities of daily living(IADL) and life satisfaction(SWLS) after hip disarticulation or hemi-pelvectomy amputations. The assessment tool was designed to gather statistically useful information about their health needs.Results: The means of the Physical Component Summary(PCS), Mental Component Summary(MCS), SWLS, ADL and IADL were 48.58±29.6, 33.33±22.0, 19.30±7.7, 48.10±10.5 and 5.08±1.8, respectively. Somatization, depression, and anxiety were the most prevalent disorders;among the veterans who were visited by psychiatrists, 11.6% had a history of hospitalization in a psychiatry section, and 53.2% had a psychiatric visit. Regardless of their injury in battle, 34% of veterans were hospitalized. Hearing problems were common, and about four-fifths of the participants suffered from at least one orthopedic condition. Neuroma(49%) was the most common stump-related complication during orthopedic evaluations, though the prevalence of phantom pain was 81% during the pain assessment. A total of 87% of the participants had a history of wearing a prosthesis, but only 29% wore a prosthesis at the time of the present study.The Canadian-type of prosthesis was uncomfortable and not useful(27%) and excessively heavy(10%) according to the amputees.Conclusions: Understanding veterans’ characteristics and special needs are important to make sure that enough facilities and services are afforded to them. These findings emphasize the importance of paying close attention to different dimensions of health in veterans and can help health providers identify health needs and make regular assessments.

Physical Activity Level and Adult Saudi Health Related Quality of Life

Purpose: Physical inactivity in Saudi Arabia is a growing challenge to public health. This study aimed to define the relationship between the physical activity level (PAL) and adult Saudi health-related quality of life (HRQoL). Methods: Participants of this study were 100 Saudi adult aged from 18 - 70 years. The 36-Item Short-Form Health Status Survey (SF-36) was used to measure the participant’s HRQoL. The SF-36 is comprised of 8 domains. The electronic version of the General Practice Physical Activity Questionnaire was used to categorize participants in terms of physical activity level into;inactive, moderately inactive, moderately active, and active. Descriptive and inferential statistical tests were used to treat the collected data. Results: Results showed that only 17% of the Saudi adults had active PAL. The PAL had significantly positive relationship with 4 domains of HRQoL including: physical functioning (P = 0.004), role limitations caused by physical health problems (P = 0.048), vitality (P = 0.009), and general health (P = 0.044). Results also confirmed that the younger the subject, the higher the PAL (P = 0.0001) and the better the HRQoL. This is true for all domains except the role limitations caused by emotional problems and emotional wellbeing. Conclusion: The poor physical activity level of adult Saudi negatively impacts their HRQoL.

Addressing the public health concerns of physical inactivity, low levels of fitness, and unhealthy weight among Chinese school-aged children

In China, sports and physical activity （PA） have tradition- ally been an integral part of school curricula to promote fitness and enhance healthy growth among children and ado- lescents. Three decades of economic reforms, however, have brought major changes in social, economic.

Role of medical resource level in iodine deficiency disorder

Background:Iodine deficiency disorders(IDDs)refer to a series of diseases caused by the human body's insufficient iodine intake.Edible salt became iodized in China in 1996,which yielded remarkable results.We have known that IDDs is associated with iodine in the human body,but it is not clear whether IDDs is related to medical resource level.Methods:We collected the number of IDDs cases and an index for the level of medical resource from 31 provinces,autonomous regions and municipalities directly under the central government in China.All data came from the China Statistical Yearbook of Health and Family Planning issued in 2013 by the Peking Union Medical College Publishing House.Data standardization and linear regression analysis were used.Results:The results showed that IDDs correlated with the number of beds in medical and health institutions,number of medical health personnel,number of medical and health institutions,total health expenditure,average health expenditure per capita,medical insurance for urban resident and new rural cooperative medical rural residents(P<0.01).In a multiple linear regression,IDDs was most significantly associated with the number of beds in hospitals,the number of rural health personnel,the number of basic medical and health institutions and government health expenditure for these institutions. Conclusion:Based on the experimental data,we concluded that IDDs had a positive connection with the medical resource level,and basic and rural areas had a more significant association with IDDs.This analysis provides new and explicit ideas for iodine prevention and control work in China.

Primary Health Care-基础医疗卫生服务应该在中国新医改中得到正确理解和全面实施

英文"primary health care"(PHC)-基础(基本)医疗卫生服务这个概念在中国被错误地理解和翻译成"初级卫生保健"已经有半个多世纪。而专科医疗则被认为是"先进的高级医疗服务"。这种对PHC的错误理解渗透到中国政府和医疗卫生各个部门,在国家的医疗卫生服务宗旨和宏观发展战略决策中造成广泛的影响,如政府的卫生政策制定,医疗服务保障制度建立,医疗卫生基础设施布局,以及医疗卫生服务专业人才队伍的培养等。本文全面阐述了PHC的概念在中国是如何被错误地理解并被翻译成中文"初级卫生保健"的,并从多个角度分析为什么这样理解和翻译是不合理的和错误的:"primary"和"health care"英文单词的基本含义,关于综合性PHC的概念,全球PHC的正反历史经验和上述错误理解对中国医疗卫生服务的发展以及对整个社会造成了部分伤害。中国正在进行的以基础医疗卫生服务为中心的新医改已经取得了很大的前期进展,但是也面临着一系列困难和挑战,包括对基础医疗卫生服务这个概念还存在广泛而根深蒂固的错误理解。我们希望医疗卫生领域的学者、医疗卫生专业人员和政府部门的官员能够充分理解和接受PHC-基础医疗卫生服务这个正确概念,消除"初级卫生保健"错误观念在发展中国基础医疗卫生服务事业中的各种影响,促进新医改的健康发展,使广大人民群众能真正享受到新医改的好处。

The status and influence factors of residents＇ health knowledge awarenessin Yizhou district of Hami city

[目的] 了解新疆哈密市伊州区居民健康知识知晓情况及其影响因素.[方法]采用分层整群随机抽样 的方法,抽取哈密市伊州区的丽园街道丽园社区、石油新城街道支油区社区、陶家宫乡和回城乡的居民（ 共 700名）进行问卷调查,利用二元Logistic回归方法分析影响因素.[结果]居民健康知识知晓率为23.5%.具 备健康理解知识知晓、科学健康观知识知晓、传染病知识知晓和职业病知识知晓的比例分别为 55. 0%、 33.4%、27.3%、33. 14%和 52.3%.居民获取健康知识的主要途径占比分别为医生80. 15%、电视38. 10%、 学校或单位22.33%、网络21.02%.居民文化程度与家庭平均月收入及健康知识知晓水平有关（P〈0. 05）. [结论]居民的健康知识知晓水平还有提升空间,影响健康知识知晓水平的主要因素为文化程度和家庭平均月 收入,应有针对性地制定健康教育和健康促进策略,以提高居民健康知识知晓水平.

基于随机森林模型分析共情心理对大学生心理健康的影响

目的运用随机森林算法分析共情心理对大学生心理健康的影响。方法采取方便抽样的方法,以问卷调查的方式于2022年8月对河北省某大学的1383名学生进行在线调查,内容包括调查对象一般情况以及基本共情量表和症状自评量表。使用最小二乘法回归模型分析共情心理是否为大学生心理健康的影响因素,构建随机森林模型分析共情心理对大学生心理健康的重要性。结果共回收问卷1383份,有效问卷1348份,问卷有效率为97.5%。回归模型结果表明,共情心理对大学生心理健康水平的影响具有统计学意义(t=-2.051,P<0.05)。随机森林模型的结果显示,大学生心理健康重要性排名前3位的解释变量分别为共情心理、睡眠质量以及学业压力。结论共情心理是影响大学生心理健康的重要因素。建议合理开展提升共情心理能力的活动,关心学生的睡眠时长,适当减轻学生的学业压力。

The Effect of Cortex Lycii on Rattus norvegicus’ Blood Glucose Level Using a High Glucose Diet

One of the primary problems in the United States is diabetes. Cortex Lycii is an herb from Asia mostly used in traditional Chinese medicine. Although its main purpose is not for lowering blood glucose levels, there are studies on Cortex Lycii with other substances which have proven it can lower glucose level in type 2 diabetes rat. Unlike other experiments, this experiment only used Cortex Lycii as a single unit to see if there was any effect on blood glucose level. Also an observation was done on if Cortex Lycii could reduce blood glucose level after ingesting a high glucose diet. Rattus norvegicus was used in this project and in order for the subject to consume Cortex Lycii, the herb was boiled and the liquid was given for consumption. In order to increase the rats’ glucose levels, corn syrup and white sugar were added to the mixture. The data showed significant decrease of blood glucose when Cortex Lycii liquid was ingested. This research has shown that Cortex Lycii can be a potential treatment for hyperglycemia or diabetes. With further research, there can be an alternative treatment rather than injecting external hormones (Insulin).

Determinants of infant mortality in rural India: A three-level model

Taking into account the hierarchical structure of the data, through two-level analysis on infant mortality available under second round of National family Health Survey, the same group of authors recently reported determinants of infant mortality while examining possible changes in results under traditional regression analysis that ignores hierarchical structure of data. They reported that the community (e.g., state) level characteristics still have a major role regarding infant mortality in India. For better epidemiological understanding, the present study is to assess determinants of infant mortality in rural India, where three level considerations were possible. The results indicate that even after consideration of these covariates, variation in infant mortality remains significant not only between States but also between Districts. Further, as an additional observation, the probability of infant mortality is still high in rural areas of districts having health facility beyond three kilometers than their counterparts.

Immigrants’ Satisfaction from the National Health System in Greece: In the Quest of the Contributing Factors

Immigrants deserve special attention as they constitute a very sensitive social group, facing an increasing risk of social exclusion. The access of immigrants to health services is one of the most important factors, which contributes to their integration into the society of induction. The purpose of this study is to track and assess the immigrants’ satisfaction from the health services provided by the Greek National Health System (NHS). The satisfaction level assessment is examined in conjunction with demographic and socio-economic characteristics of the study participants, as well as with the characteristics that are related to their personal experience with the National Health System in Greece. The research was conducted from March 2012 to May 2013. The sample of the research comprises of 126 “first-generation” immigrants on legal permit of residence in Greece, who lived in the prefecture of Attica. It is panel study based on “snowball sampling” and the statistical analysis was conducted with the use of the Stata (ver. 11), while the statistical analysis used probit estimation techniques. The demographic and social variables—particularly the variables of gender, “understanding the Greek language”, “education”, “participation in the community of origin” and “insurance”—the variables of “health” and specifically “long-term diseases” and the variable of “trust” are found to be highly related with immigrants’ satisfaction degree from the Greek health system. Our research concludes that health is a fundamental, human right and immigrants’ access to health services is essential not only for their instant and effective treatment of their health problems and the improvement of their lives but also for ensuring the public health in Greece. In order to properly incorporate immigrants in Greece in particular, the health policy decision-makers have to pay attention to the contributing factors.

Mental Health Literacy and the Belief in the Supernatural

Objective: Mental health literacy affects treatment seeking. We compare literacy levels of psychiatric outpatients and a control group of outpatients seeking treatment for non-psychiatric disorders in the same hospital. We hypothesized higher levels of mental health literacy among psychiatric patients than controls, with younger age and higher educational levels associated with better literacy. We also hypothesized that there would be an inverse relationship between educational level and the belief in the supernatural causality of mental disorders. Methods: Literacy was estimated by showing psychiatric outpatients and a control group of non-psychiatric patients vignettes depicting a case of major depression and a case of generalised anxiety disorder. Their opinions regarding diagnosis, etiology, treatment, and attitudes towards mental health services were ascertained by structured questionnaires. Results: Psychiatric patients did not demonstrate superior mental health literacy compared to controls, with the exception of knowing where to obtain a psychiatric referral. Lower age and higher education levels of psychiatric patients were associated with better literacy. The higher the education level is, the less likely to attribute the causality of mental disorders to supernatural elements. Conclusion: This study highlights the need for a program of psycho-education targeting patients, their relatives, and the public.

公共服务水平对居民健康的影响研究

本文使用2010—2020年中国家庭追踪调查(CFPS)和中国统计年鉴数据,构建了多层次Logistic回归模型,验证了公共服务水平与居民健康之间的关系。研究发现:公共服务水平提升对居民健康具有明显的促进作用,但在不同群体中,其作用效果有所不同;公共服务可以调节个体属性对居民健康的影响,公共服务削弱了年龄对居民健康的负向影响,并削弱了户籍和收入对居民健康的正向影响,但强化了性别对居民健康的正向影响,有利于促进健康平等;公共服务水平提升有利于居民树立积极健康观,提升健康素养,形成科学的生活方式,合理使用医疗资源做好疾病预防、及时诊治、愈后康复,进而提升居民健康水平。

当代大学生心理健康素养特点及影响因素分析

采用《国民心理健康素养问卷》和《心理健康自评问卷》(SRQ-20)对大学生进行调查。发现以下几点,①大学生心理健康素养总分均值、对心理疾病的知识和观念优于我国社会水平,但是在对待心理疾病的态度、行为和技能、维护心理健康态度方面,大学生群体回答正确率较低;②大学生心理健康素养存在显著的性别、城乡、学历层次、专业类别差异,担任心理骨干、学习课程和参加活动的学生,其心理健康素养均处于较高水平;③有心理困扰的大学生的心理健康认识观念得分高于无困扰学生,但在应对行为因子上显著低于后者;④心理健康低水平组的心理健康素养低于高水平组;心理健康水平越低,其心理健康素养越差;⑤大学生心理健康素养与“心理/精神障碍患者的接触频率”呈负相关,与“对心理健康服务的熟悉程度”呈正相关。

Projecting Health Outcomes for Portuguese Ageing Population: Challenges and Opportunities

Objectives: To project health outcomes for the period 2011-2031, in the Portuguese population aged 65 years and over, considering the expected changes in its demographic and educational structure. Methods: Demographic projections were produced using the multistate cohort component method. Logistic regression models were fitted to estimate current differences in health outcomes, using data from the Portuguese Health Survey. Such differences were applied to the projection results, in order to project the prevalence of “poor” self-reported health status, functional limitations and disability. Results: Our results point to a future improvement in the considered health outcomes. The prevalence of “poor” self-reported health status, functional limitations and disability will decrease in both genders, but will continue to be higher among women than men. Discussion: Beyond age and gender, other determinants of health, like education, should be considered when studying the possible evolution of health outcomes in an ageing population.