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Yearly Assessment of Weather and Air Quality Impact on Respiratory Disease Hospitalizations: Faial Island (Azores) Study

Building upon our previous research conducted at weekly and monthly intervals, this study investigates the yearly dynamics of weather conditions and air quality on respiratory diseases, specifically tailored to Faial Island in the Azores. Expanding our analysis to a yearly basis allows for a more comprehensive understanding of long-term trends and seasonal variations in hospital admissions. Drawing upon extensive daily data spanning from 2008 to 2019, sourced from the Statistics Service of Hospital da Horta, the Meteorological Observatory Príncipe Alberto de Mónaco, and the Air Quality Monitoring Network of the Azores, we examined the differentiated relationships between yearly meteorological variables, such as temperature, dew point, and wind direction, and respiratory health outcomes. Additionally, we explored the persistent influence of air quality indicators, including suspended particulate matter with an aerodynamic diameter of 10 micrometers (µm) or less (PM10), sulfur dioxide (SO<sub>2)</sub>, nitrogen dioxide (NO<sub>2)</sub>, and ozone (O<sub>3</sub>), across different seasons and years. By incorporating yearly data into our analysis, this study aims to provide a comprehensive and nuanced understanding of the interplay between environmental factors and respiratory disease hospitalizations, thereby informing targeted interventions and public health strategies in insular regions. The principal component analysis (PCA) applied to the yearly data reveals interesting correlation patterns between meteorological variables and hospitalizations for respiratory diseases such as asthma, pneumonia, and rhinitis. Hospital admissions were found to increase during periods of lower temperatures and smaller temperature amplitudes, suggesting that prolonged cold conditions may exacerbate symptoms of these diseases. Additionally, atmospheric pollutant concentrations, such as suspended particles PM10, SO<sub>2</sub>, NO<sub>2</sub>, and O<sub>3</sub>, significantly varied across seasons, with a notable influence on the exacerbation of respiratory diseases. In insular regions like the Azores, these findings highlight the importance of targeted public health strategies to mitigate the impact of environmental factors on respiratory health.

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Leveraging Pareto Analysis of Outpatient Morbidity for Strategic Drug Procurement and Health Promotion in Resource-Constrained Setting in Ghana

Background: Effective health management in resource-limited settings requires strategic resource allocation and intervention planning. Pareto analysis, based on the 80/20 rule, aids in identifying key health conditions impacting outpatient morbidity, guiding intervention prioritization and resource optimization. This study applied Pareto analysis on outpatient morbidity data from Goaso Government Hospital, Ghana, to identify common health conditions and improve drug procurement and health promotion strategies. The methodology also serves as a guide for applying Pareto chart analysis to enhance decision-making in healthcare delivery. Methods: A cross-sectional study was conducted analyzing outpatient department (OPD) data from January to December 2023. Data were extracted from the Ghana Health Service Monthly Outpatient Morbidity Reports via the District Health Information Management System 2 (DHIMS 2). Data analysis was conducted using SPSS version 20 to estimate the mean and standard deviation. Microsoft Excel 2016 was employed for Pareto analysis and the creation of column charts. Results: The analysis revealed that female patients had a higher average number of outpatient cases (M = 259, SD = 430.7) compared to male patients (M = 156, SD = 282.5). Key conditions contributing to 80% of the cases included Upper Respiratory Tract Infections (URTIs), Pneumonia, Malaria, Acute Urinary Tract Infections (UTIs), Diarrhoeal diseases, Typhoid Fever, Anaemia, Rheumatism/Arthritis, Skin Diseases, and Septicaemia. Notably, young adults (ages 20-34) and children (ages 1-4) were most affected. Conclusions: A strategic approach to drug procurement is essential due to high disease prevalence. Key actions include maintaining a three-month supply of ACTs for malaria, stocking essential antibiotics, and ensuring a two-month supply of ORS. Utilizing data-driven forecasting and establishing strong supplier partnerships are crucial for optimizing drug availability. Simultaneously, targeted health promotion efforts should focus on respiratory health, malaria prevention, UTIs, WASH practices, anaemia, rheumatism, and skin diseases through public education. Additionally, qualitative research, such as patient interviews and provider surveys, is recommended to understand high morbidity rates and evaluate existing interventions.

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A Study on the Correlation Between Sarcopenia and Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is a disease that affects the entire body. Sarcopenia, one of the adverse manifestations of the whole body, can lead to a variety of adverse outcomes. The worldwide studies have shown that sarcopenia was associated with COPD. This article aims to further enrich this research direction by focusing on the relationship between sarcopenia and COPD in Chinese inpatients. The subjects of this study were patients hospitalized in the Department of Respiratory and Critical Care Medicine of Rongchang People's Hospital of Chongqing from July 2022 to May 2024. After bioelectrical impedance analysis (BIA), test of 6 m walking speed, and tests for upper grip strength were accomplished, the sarcopenia can be diagnosed. According to the presence of chronic airflow limitation, which assessed by post-bronchodilator spirometry, we diagnosed COPD. COPD and sarcopenia as two variables, simple correlation analysis was adopted for them. The subjects were classified into sarcopenia group and non-sarcopenia group. And then, the correlation between sarcopenia and COPD was assessed with binary logistic regression analysis. Finally we get the results. Spearman's correlation coefficient for sarcopenia and COPD was 0.166 (p<0.05). While, COPD was not an independent risk factor to sarcopenia in the binary logistic regression analysis. Therefore, this study draws conclusions that COPD and sarcopenia is associated, but not linked independently.

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The Role of Healthcare Administration and Policy in Improving Access to Dialysis for ESRD Patients in CKD: Challenges and Solutions

End-Stage Renal Disease (ESRD) presents a critical challenge within the spectrum of Chronic Kidney Disease (CKD) and represents the final stage of CKD, necessitating timely and consistent access to dialysis for patient survival. However, access to dialysis remains significantly constrained in many regions due to a combination of systemic, financial, and infrastructural barriers. This article explores the pivotal role that healthcare administration and policy play in overcoming these challenges to enhance dialysis accessibility for ESRD patients. Multifaceted barriers are there regarding access to dialysis, including the economic burden of treatment, limited availability of dialysis centers, and disparities in healthcare delivery. The analysis then shifts to the policy landscape, discussing existing healthcare policies aimed at expanding dialysis services, as well as gaps that persist in current frameworks. The role of healthcare administration is also scrutinized, particularly in terms of resource allocation, service delivery optimization, and patient education. Through case studies and comparative analysis, it was identified that successful strategies from various regions that have effectively improved access to dialysis. These include public-private partnerships, subsidies, and advancements in telemedicine. The article concludes by offering policy recommendations and administrative strategies tailored to address the unique challenges faced by ESRD patients, emphasizing the need for a collaborative, patient-centered approach in healthcare planning and implementation. By highlighting these key areas, this article aims to provide actionable insights for policymakers, healthcare administrators, and other stakeholders committed to improving dialysis access and, ultimately, patient outcomes for those suffering from ESRD.

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