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.

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。

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。

2016—2021年四川省地表水体中铀的放射性水平及健康风险评价

为调查四川省地表水体中放射性物质铀(U)的含量,评价居民摄入地表水体中U导致的健康风险,在四川省主要地表水系中共设置23个监测断面,于2016—2021年检测了U的放射性水平,并根据健康风险评价模型对居民的健康风险进行评估。结果表明:四川省地表水体中U的质量浓度为0.16~3.6μg/L,参照《生活饮用水卫生标准》(GB 5749—2022),均合格;不同年份、不同地表水体中U的放射性水平间的差异均无统计学意义(P>0.05);不同水期U的放射性水平间的差异有统计学意义(P<0.05)。各年龄组通过饮水、水体浸没途径摄入U所致总年均待积有效剂量均<0.1mSv;对各年龄段居民的总致癌风险为4.18×10^(-9)~2.24×10^(-8),均低于世界卫生组织(WHO)和国际放射防护委员会(ICRP)发布的最严格控制限值。全省主要地表水体中U对各年龄组都是安全的。

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.

老年结直肠癌高危人群智能语音健康干预效果评价

目的评价60岁及以上结直肠癌高危人群智能语音健康干预效果,为提高该人群知识水平和检查行为依从性提供依据。方法将2020年上海市黄浦区社区60岁及以上居民结直肠癌筛查项目中初筛结果为阳性者782例使用随机数字表法分为干预组和对照组。在1年干预期间,干预组接受2次智能语音电话干预,对照组接受常规健康教育。在干预前后,分别对干预组和对照组进行一次问卷调查,了解其结直肠癌防治的相关知识以及肠镜检查和肛指检查行为改变情况。结果干预组344例,对照组342例,2组对象一般资料比较,差异均无统计学意义(P>0.05)。干预后,干预组较对照组的大肠癌防治知识总分高0.29分,且差异有统计学意义(χ^(2)=5.45,P<0.05),干预组干预后较干预前知识总分提高了0.55分且差异有统计学意义(χ^(2)=60.84,P<0.05)。干预后,干预组的肠镜检查率显著高于对照组(χ^(2)=4.24,P<0.05),干预组干预后较干预前肠镜率显著提高,且差异有统计学意义(χ^(2)=28.25,P<0.05)。结论运用智能语音技术对60岁及以上结直肠癌高危人群进行干预是提高大肠癌防治知识和肠镜检查率的有效手段,可在今后的干预项目中进一步完善和推广。

基于NT的心理调适干预对稳定型心绞痛患者心理健康、希望水平及生存质量的影响

目的探讨基于叙事疗法(NT)的心理调适干预对稳定型心绞痛患者心理健康、希望水平及生存质量的影响。方法选取2020年5月-2022年4月本院收治的200例稳定型心绞痛患者,随机将患者分为NT组和常规干预组,每组各100例,常规干预组患者采用常规基础护理干预,NT组在常规干预组的基础上采用基于NT的心理调适干预,两组患者均持续干预3个月。在干预前后,比较NT组和常规干预组患者的汉密尔顿抑郁量表(HAMD)评分和汉密尔顿焦虑量表(HAMA),比较两组患者的Herth希望量表(HHI)、比较两组患者身体活动受限程度(PL)评分。结果与干预前相比,干预后NT组和常规干预组患者HAMD评分、HAMA评分均降低,干预后,NT组患者HAMD评分、HAMA评分均低于常规干预组(P<0.05);与干预前相比,干预后NT组和常规干预组患者PL评分、HHI评分升高,干预后,NT组PL评分、HHI评分高于对照组(P<0.05)。结论基于NT的心理调适干预能够减轻稳定性心绞痛患者负性情绪,提高患者生活希望和生存质量。

广西边境地区县域卫生资源配置状况研究

目的分析广西边境地区县域卫生资源配置现状及其公平性,为优化县域卫生资源配置提供参考。方法收集广西边境地区8个县域2015—2021年的卫生资源数据,从人口、地理两个维度评价县域卫生资源配置的公平性。结果2015—2021年,广西边境地区8个县域的卫生资源总体呈逐年增加的趋势,但大部分县域千人口床位数、执业(助理)医师数、注册护士数低于广西平均水平;按人口配置的各类卫生资源公平性的基尼系数优于按地理配置的。结论应强化政府在卫生资源配置中的宏观调控功能,进一步提高广西边境地区卫生资源配置水平;加大边境地区县域卫生人力资源投入力度,持续提升卫生人力资源供给能力;多措并举,稳定边境地区村卫生室人员队伍;优化边境地区县域卫生资源空间布局,保障卫生资源配置的公平性。

健康教育在学校结核病防控中的价值研讨

目的研究学校结核病防控中应用健康教育的效果。方法于2021年1月—2022年12月时间段对某高中学校进行调查,选择该校三年级400名进行研究,其中1~5班采用常规校园疾病防控管理(200名),6~10班采用健康教育疾病防控管理模式(200名),观察指标为健康知识水平、防控措施落实情况、新发结核病发生情况。结果6~10班学生结核病防控知识高于1~5班学生,差异有统计学意义(P<0.05);6~10班学生防控措施落实情况高于1~5班学生,差异有统计学意义(P<0.05);6~10班学生新发结核病发生为0,低于1~5班学生3例(1.50%),但差异无统计学意义(P>0.05);6~10班学生结核病主动汇报15例(7.50%),高于1~5班学生4例(2.00%),差异有统计学意义(P<0.05)。结论学校结核病防治过程中采用健康教育模式可以提升学生的健康知识水平,强化结核病防治措施落实效果,有效预防新发结核病发生,并提高其主动汇报率,改善学生预后效果。

高职院校辅导员心理育人路径探索

高职院校的学生面临着学业、职业、人际等多方面的压力。面对学生多样化的心理需求,高职院校辅导员的心理育人工作显得尤为重要。辅导员提升自身专业素养,准确把握学生心理需求,为学生提供专业化的帮助和支持是高职院校心理育人工作的关键路径。文章从辅导员心理育人的内涵和特点出发,结合高职院校学生特点,分析高职院校辅导员心理育人领域的路径探索与实施,旨在为高职院校辅导员提供启示,帮助高职院校辅导员更好地开展心理育人工作。

回授式健康教育干预对上呼吸道感染发热患儿家长心理健康及知信行水平的影响

目的:探讨回授式健康教育干预对上呼吸道感染发热患儿家长心理健康及知信行水平的影响。方法:选取2020年12月-2021年12月某院收治的120例上呼吸道感染发热患儿,随机分为观察组(60例)和对照组(60例),对照组患儿家长予以常规干预,观察组患儿家长除此之外予以回授式健康教育干预。比较两组患儿家长干预前后心理健康状态、知信行水平、生活质量,干预后患儿临床症状消失时间及家长疾病认知程度、干预满意度。结果:观察组干预后SAS、SDS评分与对照组相比下降幅度更明显(t=-3.852,-6.129;P<0.05);观察组患儿咳嗽、发热、鼻塞、充血症状消失时间与对照组相比更短(t=-18.607,-15.745,-19.737,-19.467;P<0.05),家长疾病认知评分与对照组相比更高(t=40.146,P<0.05);观察组干预后预防知识、预防态度、预防行为评分与对照组相比更高(t=14.660,22.476,5.541;P<0.05);观察组干预后生活质量各评分与对照组相比更高(t=4.899,5.528,4.570,2.863;P<0.05);观察组患儿家长干预满意度为96.67%与对照组的77.50%相比更高(χ^(2)=3.930,P<0.05)。结论:回授式健康教育干预有利于改善其心理健康状态,提高知信行水平、生活质量和干预满意度,同时缓解患儿临床症状,增强家长疾病认知。

突发公共卫生事件背景下城市社区韧性水平的影响因素研究——基于ISM-MICMAC的方法

目的:本研究将关注点聚焦于城市社区内部,通过识别突发公共卫生事件中影响社区韧性的关键因素和因素间的相互关系,为如何保证城市社区韧性的持续内驱力、提升社区韧性水平提出建议。方法:运用ISM-MICMAC方法探究影响因素的内在层次性和各因素的驱动力和依赖性,对影响因素进行分类,进一步探究因素间的影响路径。结果与结论:研究发现社会资本、居民参与水平、社区自治能力、社区组织再造是影响突发公共卫生事件中社区韧性水平的根本因素,并且具有较高的驱动力。基于此,本文从组织、物理、技术三个方面提出了提升社区韧性水平的建议。