Health: A Necessity for Sustainable Development

Provision of Mental Health Services in U.S. Nursing Homes, 1995–2004

Objective To investigate the clinical characteristics of upper respiratory tract infection in hospita-lized children with mental disorders, and to analyze the risk factors for nosocomial infection, so as to provide reference for clinical treatment and prevention and control of nosocomial infection(NI). Methods The NI of 1 587 hospitalized children at the Second Affiliated Hospital of Xinxiang Medical University from January to December 2016 was investigated and a retrospective study was conducted on 78 hospitalized children with nosocomial upper respiratory tract infection.In a ratio of 12, the patients with mental disorders during the same time at hospital, without the occurrence of hospital infection, with same gender and same age group, were selected as the control group, then the univariate regression analysis and multivariate conditional Logistic regression analysis were carried out. Results Of the 1 587 cases, 86 cases were NI, and the incidence of NI infection was 5.42%.Among them, the upper respiratory tract infection accounted for 83.87%(78 cases). Univariate conditional Logistic regression analysis indicated that the type of disease, hospitalization days, insight, rehabilitation activities, hand hygiene habits, self-support ability, eating habits, management mode, seasonal and environmental conditions were the risk factors for upper respiratory tract infection in hospitalized children with mental disorders (all P<0.05). Multivariate analysis showed that the odds ratio(OR) of autumn and winter, poor self-support ability, no insight, poor hand hygiene habits, longer hospitalization days (over 14 d), severe mental illness were 19.627 (5.391-23.518), 12.835 (3.436-18.715), 5.427 (1.879-16.921), 3.752 (1.743-16.864), 3.618 (1.659-12.671), 3.361 (1.478-10.527), respectively, which were significantly associated with the occurrence of upper respiratory infection, and the differences were statistically significant (all P<0.05). Conclusions The season, self-support ability, insight, hand hygiene habits, days hospitalization, and disease type are the independent risk factors for upper respiratory infection in hospitalized children with mental disorders, positively controlling and eliminating of independent risk factors for upper respiratory tract may reduce its incidence in the inpationt children. Key words: Mental disorder; Hospitalized child; Nosocomial upper respiratory tract infection; Risk factor; Case-control study

Previous analyses demonstrated an elevated occurrence of perceived unmet need for mental health care among persons with co-occurring mental and substance use disorders in comparison with those with either disorder. This study built on previous work to examine these associations and underlying reasons in more detail. Secondary data analyses were performed on a subset of respondents to the 2002 Canadian Community Health Survey (unweighted N=4,052). Diagnostic algorithms classified respondents by past-year substance dependence and selected mood and anxiety disorders. Logistic regressions examined the associations between diagnoses and unmet need in the previous year, accounting for recent service use and potential predisposing, enabling, and need factors often associated with help seeking. Self-reported reasons underlying unmet need were also tabulated across diagnostic groups. Of persons with a disorder, 22% reported a 12-month unmet need for care. With controls for service use and other potential confounders, the odds of unmet need were significantly elevated among persons with co-occurring disorders (adjusted odds ratio=3.25; 95% confidence interval=1.96-5.37). Most commonly, the underlying reason involved a preference to self-manage symptoms or not getting around to seeking care, with some variation by diagnosis. The findings highlight potential problems for individuals with mental and substance use disorders in accessing services. The elevated occurrence of perceived unmet need appeared to be relatively less affected by contact with the health care system than by generalized distress and problem severity. Issues such as stigma, motivation, and satisfaction with past services may influence help-seeking patterns and perceptions of unmet need and should be examined in future work.

Objective To investigate the impact of diet, the way of parenting and living environment on recurrent upper respiratory tract infections (rURTIs) in children, and to discuss risk and protective factors in order to explore new method for taking prevention measures. Methods From December 2008 to May 2009, a total of 230 children aged 3 to 6 years old who were admitted in the Department of Child Health Care, Children Hospital of Shanxi, including 151 boys (65.7%) and 79 girls (34.3%). Among those 230 children, 118 children were diagnosed as recurrent upper respiratory tract infections (case group) according to the diagnostic criteria made by Subspecialty Group of Respiratory Diseases, the Society of Pediatrics, Chinese Medical Association, including 82 boys (69.5%) and 36 girls (30.5%). At the same time, another 112 normal children aged 3 to 6 years old from the same hospital were included into control group, including 69 boys (61.6%) and 43 girls(38.4%). Informed consent was obtained from all participates. The general demographic characteristics, nutritional status, ways of parenting and living environment were analyzed between two groups by single factor and multi-factor non-conditional Logistic regression analysis approach in order to explore risk and protective factors of recurrent upper respiratory tract infections. Results The main influencing factors of recurrent upper respiratory tract infections aged 3 to 6 years old included, ① Risk factors: Vegetable consumption at least third times per week[OR=5.195, 95%CI(1.193, 22.624)], nursery school [OR=5.642, 95%CI(1.149, 27.702)], history of recurrent upper respiratory tract infections[OR=8.129, 95%CI(2.725, 24.256)], outdoor activity less than 30 minutes a day [OR=4.583, 95%CI(0.857, 24.499)] or less than 2 hours a day [OR=5.291, 95%CI(1.576, 17.763)]. ②Protective factors: Education level of father [OR=0.134, 95%CI(0.034, 0.527)], fruit consumption at least six times per week [OR=0.231, 95%CI(0.069, 0.775)], application of antibiotics less than three times per year[OR=0.028, 95%CI(0.003, 0.303)]. ③ Nursery and fruit intake: There had interaction effect between children who had history of recurrent upper respiratory tract infections before nursery and fruit intake. Conclusion The occurrence of recurrent upper respiratory tract infections could affect by rational diet, vegetable intake, fruit intake, and outdoor activity at least 2 hours a day. The education level, especially the father's, is related with the occurrence of recurrent upper respiratory tract infections. Nursery school should strengthen child health care and prevent cross infection, and children with recurrent upper respiratory tract infections should be treated in time. Key words: recurrent upper respiratory tract infections(rURTIs); case control study; child; Logistic regression; multi-factor analysis

Досліджено нормативно-правовий та інституційно-адміністративний механізм державного управління сталим розвитком аграрного сектору та сільських територій. Проаналізовано міжнародний досвід запровадження принципів сталого розвитку. На основі проведеного аналізу запропоновано алгоритм запровадження основ концепції сталого розвитку України, а саме: прийняття національної стратегії сталого розвитку “Україна – 2030”, відповідно до Глобальних цілей сталого розвитку (далі – ЦСР), прийнятих Генеральною Асамблеєю Організації Об’єднаних Націй (далі – ООН) 25 вересня 2015 р. “Перетворення нашого світу: Порядок денний сталого розвитку 2030”, який вміщує 17 Глобальних ЦСР до 2030 р.; Указу Президента України “Цілі сталого розвитку України на період до 2030 року” від 30.09.2019 р. Зазначено, що в рамках національної стратегії повинна бути розроблена програма сталого розвитку аграрного сектору та сільських територій. Адже для досягнення 2-ї Цілі “Подолання голоду, досягнення продовольчої безпеки, поліпшення харчування та сприяння сталому сільському господарству” саме аграрний сектор та сільські громади мають вирішальну роль. Запропоновано удосконалення адміністративно-інституціонального механізму управління сталим розвитком, а саме створення державного комітету із сталого розвитку, підпорядкованого Кабінету Міністрів України, для здійснення координаційної діяльності всіх міністерств та відомств у напрямку запровадження стратегії сталого розвитку. Розглянуто методи побудови механізмів державного управління сталим розвитком, які враховують інтереси усіх зацікавлених сторін, базуються на моделі “державно-приватного” партнерства, а також методах горизонтальної та вертикальної інтеграції, враховуючи альтернативи розвитку держави, специфіку аграрного сектору економіки, потреб сільських територіальних громад у напрямку досягнення ЦСР.

The past decade has seen the rapid spread of market-based approaches to address climate change mitigation, adaptation and poverty alleviation. In the first decade of the 21st century, the enthusiasm for pursuing mitigation through green alternatives to fossil fuels contributed to a spike in global investments in biofuel crops. The tropical plant jatropha (Jatropha curcas Linn.) was promoted as the ideal ‘green’ biofuel because of its multiple qualities. It was a non-food crop that was seen to grow easily in poor soils without requiring fertiliser or heavy demand for water and, most importantly, it could not be diverted from food consumption to biofuel production. Foreign direct investment (FDI) in jatropha cultivation was thus considered a potentially winning strategy for sustainable development and poverty alleviation in poor countries. This thesis investigates how FDI in jatropha has contributed to sustainable regional development in northwest Madagascar. Madagascar was one of the major destinations for FDI in jatropha cultivation in the 2000s and, in particular, the northwest region of Boeny was targeted for large-scale production of the crop and as a node for biofuel-based industrial development. Using the framework of political ecology and global value chain analysis, the thesis examines three critical dimensions of jatropha investments in Boeny: first, the broader political-economic conditions that led Madagascar to become a favoured global destination for jatropha investment; second, the processes by which foreign companies launched into jatropha production in Boeny; and third, the experiences and outcomes of jatropha production and their impact on sustainable regional development in northwest Madagascar. The study uses a combination of field interviews, observations, and secondary data on jatropha investment and government policies to explore these dimensions. The thesis shows that jatropha investment in Madagascar resulted from a convergence of interests of the Madagascar presidency, bilateral aid agencies, global environmental organisations, and investors seeking to profit from an emerging global carbon economy. The expectations were similar to a gold rush, where everyone hoped to reap windfall profits as early-movers in the alternative fuel industry. The reality of jatropha cultivation proved the opposite and companies struggled to meet the targets outlined in their business plans. Poor knowledge of the crop’s agronomy and the regional economy undermined the profit expectations of companies, and a subsequent fall in petroleum prices and financial crisis led many to withdraw from jatropha cultivation altogether. These outcomes provided negligible benefits for sustainable regional development in the Boeny region. This study offers significant insights on the risks associated with market-driven initiatives aimed at climate change mitigation and sustainable development. Its findings indicate that despite vigorous promotion of sustainable development through the emerging global carbon economy, ‘green’ foreign investments in innovative biofuel crops such as jatropha provide negligible economic or ecological benefits to regions in poor countries.

City life takes its toll on São Paulo's residents

Most studies focusing on respiratory infections in immunocompromised children have been addressed to bacterial etiology. However, respiratory virus infections in this population can also lead to severe disease. The objective of this study is to evaluate the clinical significance of respiratory virus infections in children with cancer or human immunodeficiency virus (HIV) infection. Retrospective study conducted in a teaching hospital in Madrid. Medical records from children <or=14 years diagnosed with cancer or with HIV infection were reviewed. We analyzed demographic characteristics, clinical syndromes associated with the infection, need for hospitalization, treatment prescribed, and outcome. Fifty-three respiratory viral infections were identified: 26 (20%) in 129 HIV-infected children and 27 (12%) in 218 children with cancer. Twenty (38%) of the respiratory infections were nosocomial. Causal viruses were: respiratory syncytial virus, 43%; influenza A, 26%; adenovirus, 13%; parainfluenza virus, 13%; and influenza B, 4%. Thirty-three children were hospitalized: 14 (54%) with HIV infection and 19 (70%) receiving anticancer chemotherapy. Pneumonia occurred in 11 (34%) of the 33 hospitalized children. Four (21%) of the 19 hospitalized children with cancer, but none of the HIV-infected children, were admitted to the Pediatric Intensive Care Unit (P=0.096). Two children with cancer died. Common respiratory virus infections in children with cancer or HIV infection have a relevant morbidity. The fact that 40% of these infections are hospital-acquired emphasizes the need for isolation and preventive measures.

In the 1980s, Bangladesh entered the global market by establishing export-oriented industries, the largest of which was the ready-made garment (RMG) industry. This industry has recruited a mainly female workforce consisting of millions of poor women with little formal education. Coming from mainly rural areas, they are drawn to the cities to work in the RMG factories there. This group of women has normally assumed the traditional roles of stay-at home wife, mother or daughter, hence their engagement in paid work as migrant labourers presents a new challenge in the form of their having to fulfill ‘dual roles’. Combined with workplace health and safety issues associated with the RMG industry, this can have significant implications for their physical health and mental wellbeing. Yet, it was not until the 2013 Rana Plaza incident, which killed over a thousand workers, that the world’s attention focused on the issues of health and safety of female garment workers in Bangladesh. Although the RMG industry contributes significantly to Bangladesh’s economic development, helping to raise it to the status of lower-middle-income nation, the benefits to the nation have come at a considerable cost to these women, with consequences for their physical and mental wellbeing. Regrettably, these consequences have not been adequately investigated and little data is available to fully understand their health needs and working conditions. This research aims to fill this gap by offering a more in-depth exploration of the health and safety issues as they are experienced by the women in the RMG industry in Bangladesh. It will do so by focusing on understanding their work, including the tasks, work environment, and the treatment they receive at work. It will also present and discuss women’s voices about their experience at work, incorporating key stakeholders’ views and the researcher’s own observations, in order to examine the health and safety issues of these workers through a gender lens. Using qualitative research methods, the study was conducted in four factories in two industrial areas of Dhaka district during the eight months from December 2015 to July 2016. Data collection included a literature review, 20 in-depth interviews and four focus-group discussions with female garment workers, as well as worksite and household observations. Further, 14 key-informant interviews were conducted with officials from the Ministry of Labour and Employment, health-service providers within the garment factories, factory managers, and representatives of the Bangladesh Garment Manufacturers and Exporters Association. The data collected were analyzed using a framework analysis approach. The women reported that paid work creates an opportunity for them to earn their own income, and hence improve their families’ living standards and education. However, they also reported mental and physical health issues due to the stressful nature of the work (e.g., long work hours with few breaks and sitting in one position for long hours); and the work environment (e.g., heat and dust, noise, plus poor lighting and ventilation) They are also under constant threat of losing their jobs because of their ‘slow’ work habits and in more serious cases, separation from their children, pregnancy, the double burden of work and domestic expectations, as well as the threat of physical and verbal violence in the workplace. Factories provide health services through their clinics, but these lack the proper medical facilities required to manage work-related injuries and other health conditions, especially the workers’ mental health problems caused by stress and anxiety. Workers generally do not access these limited services. In particular, pregnant workers are less likely to do so, for fear that revealing their pregnancy to their supervisors will result in a loss of employment. Further, the workers cannot easily access government hospital services, due to their long work hours. Similarly, they are blocked from using private health services because of the high costs entailed. Their employers seem focused primarily on profit and on meeting quotas in a buyer-driven market, such that the health of workers appears to be a low priority. Furthermore, this study found that the government, despite its obligations under international conventions, lacks the resources and capacity to monitor working conditions or to ensure compliance with existing labour regulations. This study found that female workers participating in paid work in the RMG industry are vulnerable to significant short- and long-term physical and mental health problems. It concludes with three sets of recommendations to (a) address the health and safety of workers, (b) build the capacity of the government’s Occupational Health and Safety (OHS) system, and (c) enlist the support of global buyers in supporting proper OHS in the RMG industry. This is important not only for the government and the industry itself, but for the whole society to recognise the important role that the female garment workers play in the national economy. As such, this study takes the position that there is an urgent necessity to improve these women’s health and safety, not just for their own sake, but also for the sustainable development of the nation.

Globally, mental and substance use disorders are a leading cause of disease burden. In low- and middle-income countries, where there is an extreme shortage of trained mental health specialists, validated, brief screening tools for mental and substance use disorders are required for non-specialists to efficiently identify patients in need of mental health care. Mozambique, one of the poorest countries in the world, has fewer than two mental health specialists for every 100,000 people. In the present study, we evaluated a comprehensive set of seven measures for depression, anxiety, somatization, alcohol use disorder, substance use disorder, psychosis and mania, and suicide risk among N=911 Mozambican adults in general healthcare settings. All instruments demonstrated acceptable internal consistency (α > 0.75). Compared to diagnoses made by the Mini International Neuropsychiatric Interview, all measures showed good criterion validity (AUC > 0.75), except the Psychosis Screening Questionnaire, which showed low sensitivity (0.58) for psychotic disorder. No substantial differences were observed in internal consistency when stratifying by gender, age, education level, primary language, facility-type, and patient status; criterion validity showed some variability when stratified by sub-population, particularly for education, primary language, and whether the participant was seeking care that day. Exploratory factor analyses indicated that the measures best differentiate categories of diagnoses (common mental disorder, severe mental disorders, substance use disorders, and suicide risk) rather than individual diagnoses, suggesting the utility of a transdiagnostic approach. Our findings support the use of these measures in Mozambique to identify common mental disorders, substance use disorders, and suicide risk, but indicate further research is needed to develop an adequate screen for severe mental disorders. Given the limited mental health specialists in this and other LMIC settings, these brief measures can support non-specialist provision of mental health services and promote closure of the treatment gap.

The current education system is still «teaching» society the tasks and goals of sustainable development on a small and insufficient scale. However, the official program document (Resolution) of the UN General Assembly formulates an appropriate global strategy «Transforming our world: the 2030 Agenda for Sustainable Development». Sustainable Development Goals (SDGs) are the key areas for implementing this global integrated multi-level strategy for social, governmental and institutional sustainable development. Education is one of the crucial prerequisites for the implementation of the UN global strategy «Agenda 2030». Therefore, education has a key role to play in seeing a just, peaceful and sustainable society (both global, continental, regional and national). International and European integrated strategy for sustainable social development «Transforming our world: the 2030 Agenda for Sustainable Development» – at the global level of education and science offers a mechanism for achieving and providing inclusive, equitable and quality education and training, promoting all opportunities for education and lifelong learning. The strategy envisages providing and allowing everyone to receive and complete free, fair and quality primary, secondary and higher education, which will lead to appropriate and effective results of sustainable social development of both individual states and the global system. It is also necessary to create preconditions for ensuring access of all, regardless of social, sexual, racial, ethnic origin to quality education at all levels, and to create appropriate conditions for this by 2030, which will allow them to successfully move to the next educational levels and carry out lifelong learning. To do this, all levels, models and systems of education (through the model of «education for sustainable development») must be transformed - to acquire the knowledge and skills necessary for sustainable development: sustainable lifestyles, human rights, gender equality, promoting a culture of peace and non-violence, through global civic education and the recognition of cultural diversity and the contribution of culture to sustainable development. Thus, Agenda 2030 sets practical challenges for governments to ensure, through the transformation of the education system («education for sustainable development»), the maximum conditions for all people to participate (through the acquisition of quality knowledge and skills through education) in society, state and economic and political development.

Introduction ‘Sustainable development’ has been an enormously influential concept in environmental law since at least the early 1980s. The World Commission on Environment and Development published the seminal work on sustainable development, Our Common Future (more commonly known as the ‘Brundtland Report’, after its chair) in 1987. The Brundtland Report has been built on at an international level, most prominently by the United Nations Convention on Environment and Development (the famous Rio Earth Conference) in 1992, and more recently by the 2002 World Summit on Sustainable Development in Johannesburg. Sustainable development is now extraordinarily widely accepted and supported across the world. We begin this chapter by discussing the evolution of sustainable development through international law. The most widely quoted ‘definition’ of sustainable development comes from the Brundtland Report, according to which sustainable development is development that ‘meets the needs of the present without compromising the ability of future generations to meet their own needs’ (pp. 8 and 43). The Johannesburg Declaration on Sustainable Development provides an alternative in its reference to ‘the interdependent and mutually reinforcing pillars of sustainable development – economic development, social development and environmental protection’ (para. 5), although this three-pillared approach is an evolution of earlier approaches, rather than a break with the past. Sustainable development has clearly entered the political and academic mainstream, and those interested in environmental law cannot afford to ignore questions of sustainable development.

A Randomized Controlled Trial of a Supported Employment Program for Persons With Long-Term Mental Illness in Hong Kong

The World Summit on Sustainable Development was held in Johannesburg, South Africa, 26 August‐4 September 2002. The meeting was a follow‐up to the United Nations Conference on Environment and Development (UNCED) that took place in Rio de Janeiro in 1992 but with a mandate broader than that of the Rio conference: the Summit was to consider strategies toward sustainable development in all its dimensions. According to the opening paragraph of the Plan of Implementation adopted by the Johannesburg Summit, the Rio conference “provided the fundamental principles and the programme of action for achieving sustainable development.” But while reaffirming commitment to the Rio principles, the Plan states that it intends to “further build on the achievements made since UNCED and expedite the realization of the remaining goals.”A topic conspicuously missing from the deliberations of the Rio conference was population, even though rapid population growth has a plausible bearing on sustainable development and specifically on the problem of poverty, an issue at the center of the discussions concerning sustainability. It had been expected that Johannesburg would make amends for that omission. In the ten years between the two conferences, the size of the world's population increased by some 790 million persons. Of this growth, 754 million, or 95 percent, occurred in the countries the United Nations classifies as “less developed.” The population of these countries grew by 18 percent between the two conferences, as compared with a 3 percent growth in the more developed countries. The countries classified as “least developed“—a subset of the less developed countries consisting of 48 countries, predominantly African, with a 2002 population of nearly 700 million—grew during the interconference period by 29 percent.This record of population growth since the Rio conference may be supplemented by the projections of the United Nations up to 2050. The medium variant of these projections for the next 48 years envisages a slight population decline in the more developed countries and an addition of some 2 billion persons to the less developed group. For the least developed countries, the UN projects a population of more than 1.8 billion in 2050, some 164 percent larger than the current population size.Although the magnitudes of past population growth and its likely future dynamics are well known, they attracted very little attention at the Johannesburg meeting. The Johannesburg Declaration on Sustainable Development, a concise political document issued at the closing of the conference along with the Plan of Implementation, pledges “to place particular focus on, and give priority attention to, the fight against the worldwide conditions that pose severe threats to the sustainable development of our people.” It then proceeds to specifics: “Among these conditions are: chronic hunger; malnutrition; foreign occupation; armed conflicts; illicit drug problems; organized crime; corruption; natural disasters; illicit arms trafficking; trafficking, in persons; terrorism; intolerance and incitement to racial, ethnic, religious and other hatreds; xenophobia; and endemic, communicable and chronic diseases, in particular HIV/AIDS, malaria and tuberculosis” (Paragraph 19 of the Declaration,).The Plan of Implementation, a 27,000‐word document, was the main product of the Johannesburg meeting. Apart from a mention of the Cairo conference on Population and Development, the Plan's treatment of population issues is confined to health. The relevant section—section VI, titled Health and sustainable development—is reproduced below in full. (Paragraph numbers have been retained.) It presents a statement of goals couched in general exhortative terms (“integrate,”“promote,”“provide,”“improve,”“develop”), and specifies some quantitative targets, notably to reduce “by the year 2015, mortality rates for infants and children under 5 by two thirds, and maternal mortality rates by three quarters,” and “reduction of HIV prevalence among young men and women aged 15–24 by 25 per cent in the most affected countries by 2005 and globally by 2010.” The full text of the Plan can be found at http://www.un.org/jsummitlhtmlldocumentslsummit_docsl21Q9_planfinal.htm

Background:Adenovirus is associated with respiratory tract infections in children worldwide. However, there is insufficient data about adenovirus infections in Egyptian children and the genotypes present in this infection.Objective:The aim of the present study was to investigate the prevalence of adenovirus and its genotypes in respiratory tract infection in children by real-time Polymerase Chain Reaction (PCR).Methods:The study was a cross-sectional study that included 100 children complaining of respiratory tract infections signs and symptoms. Laboratory investigation for adenovirus included real-time polymerase chain reaction and genotypes detection by Multiplex Polymerase Chain Reaction (PCR).Results:Adenovirus was detected by PCR for fiber gene in 11% with genotype 3 in 6 samples (54.5%) and genotype 7 in 5 samples (45.5%) positive for adenovirus by Multiplex PCR. The main presenting symptoms and signs in children with adenovirus detected by PCR were cough, fever, wheezing, and croups (90.9%, 81.1%, 63.6%, and 63.6%, respectively). The diagnosis in children with adenovirus was pneumonia in 72.7% and bronchitis in 27.7%. There were statistically insignificant differences in demographic, clinical, and hematological parameters between children with adenovirus and children negative to adenovirus by PCR.Conclusion:The clinical characteristics of respiratory infections with adenovirus vary upon the age of the patients and the immune status. Therefore, there is a requirement for an extensive study of adenovirus in respiratory infections in children with different ages and immune status.