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.

健康行动过程取向理论指导下的干预措施对下肢骨折患者心理健康水平和疾病认知能力的影响

目的:研究健康行动过程取向(HAPA)理论指导下的干预措施对下肢骨折患者心理健康水平和疾病认知能力的影响。方法:选取某院2023年6月-2024年6月就诊的182例下肢骨折患者,以简单随机法分为对照组(91例)和观察组(91例),对照组采用常规干预措施,观察组在对照组基础上辅以HAPA理论指导下的干预措施。比较两组患者干预前后心理健康水平[症状自评量表(SCL-90)]、疾病认知能力、生活质量SF-36量表和康复情况[Berg平衡量表(BBS)、简式下肢Fungl-Meyer运动功能量表(FMA)]。结果:干预后,观察组患者躯体化、人际敏感、强迫、抑郁、精神病、焦虑、敌对、恐怖、偏执评分均低于对照组(t=18.253,16.763,20.064,19.241,17.361,20.724,17.058,19.475,20.663;P<0.05),观察组疾病基本知识、对待疾病的态度、用药治疗知识、康复知识评分均高于对照组(t=6.727,5.455,7.082,8.155;P<0.05),观察组生理健康和心理健康总评分均高于对照组(t=6.727,5.455;P<0.05),观察组BBS、FMA评分均高于对照组(t=5.087,5.982;P<0.05)。结论:HAPA理论指导下的干预措施应用于下肢骨折患者,能有效提升下肢骨折患者心理健康水平,改善生活质量,提高疾病认知能力。

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.

农村中老年高血压病人受教育程度在健康相关生命质量与卫生服务利用间的调节作用

目的:了解农村中老年高血压病人健康相关生命质量与卫生服务利用的关系,探索受教育程度的调节作用。方法:选取2018年中国健康与养老追踪调查(CHARLS)数据库中的1391例农村中老年高血压病人作为研究对象,提取数据库中农村中老年高血压病人基本信息、健康状况与功能信息,考察其卫生服务利用状况,根据数据库信息及欧洲五维健康量表(EQ-5D)评分结果评价其健康相关生命质量。分析健康相关生命质量对卫生服务利用的影响,探索受教育程度在二者间的调节作用,采用边际效应图对调节作用进行可视化展现。结果:1391例农村中老年高血压病人中,有457例病人利用了卫生服务,卫生服务利用率为32.85%。农村中老年高血压病人EQ-5D的5个维度存在困难者占比分别为行动能力46.59%、自我照顾能力12.94%、日常活动能力19.34%、疼痛或不适68.51%、焦虑或抑郁38.82%,病人健康效用值为(0.952±0.085)。多因素分析结果显示,健康效用值是农村中老年高血压病人门诊服务利用和住院服务利用的影响因素。校正混杂因素后的结果表明,受教育程度较高对健康相关生命质量与卫生服务利用关系中的调节作用较强。边际效应图显示,受教育程度高的农村中老年高血压病人卫生服务利用斜率较受教育程度低者小。结论:健康相关生命质量是影响农村中老年高血压病人卫生服务利用的重要因素,受教育程度在健康相关生命质量和卫生服务利用关系中具有调节作用。

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。

风险护理策略联合健康教育对肺癌患者的影响

目的:探讨风险护理策略联合健康教育对肺癌患者的影响。方法:选取2020年4月—2023年4月徐州医科大学附属医院呼吸与危重症医学科收治的78例肺癌患者。根据随机数表法将其分为对照组与观察组,各39例。两组均接受健康教育,对照组同时给予常规护理,观察组同时给予风险护理策略。比较两组护理前后癌因性疲乏、压力水平、健康信念、希望水平、自护能力。结果:护理后,观察组癌症疲乏量表(CFS)和中文版压力知觉量表(CPSS)评分均低于对照组,差异有统计学意义(P<0.05)。护理后,观察组个人信念感、控制感、资源利用感、威胁感、行动能力评分均高于对照组,差异有统计学意义(P<0.05)。护理后,观察组与他人保持亲密关系、现实与未来积极态度、采取积极行动评分均高于对照组,差异有统计学意义(P<0.05)。护理后,观察组健康知识、自我护理技能、自护责任感评分均高于对照组,差异有统计学意义(P<0.05)。结论:风险护理策略联合健康教育能显著减轻肺癌患者的癌因性疲乏和压力水平,提高其健康信念、希望水平和自护能力。

健康意识理论教育干预对脑血管病患者疾病认知水平及康复行为的影响

目的:探讨健康意识理论教育干预对脑血管病患者疾病认知水平以及康复行为的影响。方法:选取2019年4月至2022年4月期间接受治疗的100例脑血管病患者,按照入院先后顺序将其分为两组:对照组(n=50)和研究组(n=50)。对照组实施常规健康干预,研究组则采取基于健康意识理论的教育干预。对比两组在疾病认知、康复行为(合理饮食、用药规范、作息规律、有氧运动)、自我管理能力、生活质量上的差异,并评估患者对干预的满意度。结果:干预后,研究组在疾病认知方面的表现显著优于对照组(Z=4.378,P<0.05);研究组在合理饮食、药物使用规范、作息规律以及有氧运动等多个方面的比例均显著高于对照组(χ^(2)=4.336,7.162,7.862,7.484;P<0.05)。两组在干预后的自我管理能力评分都比干预前有所上升,且研究小组在各个维度的得分显著超过对照组(t=8.309,5.538,8.141,6.025;P<0.05)。此外,干预后,两组的世界卫生组织生活质量测定量表简表(WHOQOL-BREF)评分相比干预前均有改善,而研究小组在所有维度的得分均显著优于对比组(t=6.529,7.406,12.260,4.569;P<0.05)。同时,干预后两组的世界卫生组织生存质量测定量表简表(WHOQOL-BREF)评分均较干预前有所改善,且研究组的得分在所有维度上均明显优于对照组(t=6.529,7.406,12.260,4.569;P<0.05)。此外,研究组的干预满意度也明显高于对照组(χ^(2)=4.332,P<0.05)。结论:相比常规健康教育,基于健康意识理论的干预在提升脑血管病患者的疾病认知水平和康复行为上有显著效果,有助于提高患者的自我效能感和生活质量,且干预满意度较高。

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.

含储能健康运行域与电压安全约束的配电网重构方法

随着未来各类新能源及用户侧需求互动技术引入配电网,配电网电压安全管理将面临更严峻挑战,带来双向潮流、电压越限等运行问题。在此背景下,该文挖掘网络侧及储能设备的运行灵活性,以限制配电网节点电压波动指数(voltage volatility index,VVI)为目标,提出融合储能能量管理的配电网网络重构方法。同时,为减小储能频繁充放引起的寿命损失,该文基于储能寿命曲面的超空间投影定义储能寿命水平集表征储能健康运行域(health operating area,HOA),并提出水平集凸逼近方法替代非线性储能寿命约束,可在保障储能寿命前提下实现网络重构问题的高效求解。最后,选取IEEE-33节点系统进行分析,验证所提方法的有效性与实用性。

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.