85 research outputs found
THE CLIMATE CHANGE IMPACT ON THE GLACIERS OF GEORGIA
The article reviews the changes of the glacier basins characteristics of Georgia glaciers due to the current climate change. Calculations show significant decrease of the area and number of the glaciers in Georgia over the last 50 years. This reduction is more intensive in eastern Georgia in comparison with the western part of the country. At the same time, some large glaciers complete melting dates are determined according to one of the basic scenarios of current climate change, namely the business as usual. Based on the calculations it is concluded that viewed large glaciers complete melting is not expected within this century even in this worst conditions scenario.The article reviews the changes of the glacier basins characteristics of Georgia glaciers due to the current climate change. Calculations show significant decrease of the area and number of the glaciers in Georgia over the last 50 years. This reduction is more intensive in eastern Georgia in comparison with the western part of the country. At the same time, some large glaciers complete melting dates are determined according to one of the basic scenarios of current climate change, namely the business as usual. Based on the calculations it is concluded that viewed large glaciers complete melting is not expected within this century even in this worst conditions scenario
Correlates of Complete Childhood Vaccination in East African Countries.
Despite the benefits of childhood vaccinations, vaccination rates in low-income countries (LICs) vary widely. Increasing coverage of vaccines to 90% in the poorest countries over the next 10 years has been estimated to prevent 426 million cases of illness and avert nearly 6.4 million childhood deaths worldwide. Consequently, we sought to provide a comprehensive examination of contemporary vaccination patterns in East Africa and to identify common and country-specific barriers to complete childhood vaccination. Using data from the Demographic and Health Surveys (DHS) for Burundi, Ethiopia, Kenya, Rwanda, Tanzania, and Uganda, we looked at the prevalence of complete vaccination for polio, measles, Bacillus Calmette-Guérin (BCG) and DTwPHibHep (DTP) as recommended by the WHO among children ages 12 to 23 months. We conducted multivariable logistic regression within each country to estimate associations between complete vaccination status and health care access and sociodemographic variables using backwards stepwise regression. Vaccination varied significantly by country. In all countries, the majority of children received at least one dose of a WHO recommended vaccine; however, in Ethiopia, Tanzania, and Uganda less than 50% of children received a complete schedule of recommended vaccines. Being delivered in a public or private institution compared with being delivered at home was associated with increased odds of complete vaccination status. Sociodemographic covariates were not consistently associated with complete vaccination status across countries. Although no consistent set of predictors accounted for complete vaccination status, we observed differences based on region and the location of delivery. These differences point to the need to examine the historical, political, and economic context of each country in order to maximize vaccination coverage. Vaccination against these childhood diseases is a critical step towards reaching the Millennium Development Goal of reducing under-five mortality by two-thirds by 2015 and thus should be a global priority
Evolution of the Greater Caucasus Basement and Formation of the Main Caucasus Thrust, Georgia
Along the northern margin of the Arabia‐Eurasia collision zone in the western Greater Caucasus, the Main Caucasus Thrust (MCT) juxtaposes Paleozoic crystalline basement to the north against Mesozoic metasedimentary and volcaniclastic rocks to the south. The MCT is commonly assumed to be the trace of an active plate‐boundary scale structure that accommodates Arabia‐Eurasia convergence, but field data supporting this interpretation are equivocal. Here we investigate the deformation history of the rocks juxtaposed across the MCT in Georgia using field observations, microstructural analysis, U‐Pb and 40Ar/39Ar geochronology, and 40Ar/39Ar and (U‐Th)/He thermochronology. Zircon U‐Pb analyses show that Greater Caucasus crystalline rocks formed in the Early Paleozoic on the margin of Gondwana. Low‐pressure/temperature amphibolite‐facies metamorphism of these metasedimentary rocks and associated plutonism likely took place during Carboniferous accretion onto the Laurussian margin, as indicated by igneous and metamorphic zircon U‐Pb ages of ~330–310 Ma. 40Ar/39Ar ages of ~190–135 Ma from muscovite in a greenschist‐facies shear zone indicate that the MCT likely developed during Mesozoic inversion and/or rifting of the Caucasus Basin. A Mesozoic 40Ar/39Ar biotite age with release spectra indicating partial resetting and Cenozoic (<40 Ma) apatite and zircon (U‐Th)/He ages imply at least ~5–8 km of Greater Caucasus basement exhumation since ~10 Ma in response to Arabia‐Eurasia collision. Cenozoic reactivation of the MCT may have accommodated a fraction of this exhumation. However, Cenozoic zircon (U‐Th)/He ages in both the hanging wall and footwall of the MCT require partitioning a substantial component of this deformation onto structures to the south.Plain Language SummaryCollisions between continents cause deformation of the Earth’s crust and the uplift of large mountain ranges like the Himalayas. Large faults often form to accommodate this deformation and may help bring rocks once buried at great depths up to the surface of the Earth. The Greater Caucasus Mountains form the northernmost part of a zone of deformation due to the ongoing collision between the Arabian and Eurasian continents. The Main Caucasus Thrust (MCT) is a fault juxtaposing old igneous and metamorphic (crystalline) rocks against younger rocks that has often been assumed to be a major means of accommodating Arabia‐Eurasia collision. This study examines the history of rocks along the MCT with a combination of field work, study of microscopic deformation in rocks, and dating of rock formation and cooling. The crystalline rocks were added to the margins of present‐day Eurasia about 330–310 million years ago, and the MCT first formed about 190–135 million years ago. The MCT is likely at most one of many structures accommodating present‐day Arabia‐Eurasia collision.Key PointsAmphibolite‐facies metamorphism and plutonism in the Greater Caucasus basement took place ~330–310 MaThe Main Caucasus Thrust formed as a greenschist‐facies shear zone during Caucasus Basin inversion and/or rifting (~190–135 Ma)The Main Caucasus Thrust may have helped facilitate a portion of at least 5–8 km of basement exhumation during Arabia‐Eurasia collisionPeer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154626/1/tect21292-sup-0002-2019TC005828-ts01.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154626/2/tect21292-sup-0006-2019TC005828-ts05.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154626/3/tect21292_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154626/4/tect21292-sup-0003-2019TC005828-ts02.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154626/5/tect21292-sup-0005-2019TC005828-ts04.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154626/6/tect21292.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154626/7/tect21292-sup-0004-2019TC005828-ts03.pd
Cost of TB services in the public and private sectors in Georgia (No 2)
BACKGROUND: Patient-centred care along with optimal financing of inpatient and outpatient services are the main priorities of the Georgia National TB Programme (NTP). This paper presents TB diagnostics and treatment unit cost, their comparison with NTP tariffs and how the study findings informed TB financing policy.METHODS: Top-down (TD) and bottom-up (BU) mean unit costs for TB interventions by episode of care were calculated. TD costs were compared with NTP tariffs, and variations in these and the unit costs cost composition between public and private facilities was assessed.RESULTS: Outpatient interventions costs exceeded NTP tariffs. Unit costs in private facilities were higher compared with public providers. There was very little difference between per-day costs for drug-susceptible treatment and NTP tariffs in case of inpatient services. Treatment day financing exceeded actual costs in the capital (public facility) for drug-resistant TB, and this was lower in the regions.CONCLUSION: Use of reliable unit costs for TB services at policy discussions led to a shift from per-day payment to a diagnosis-related group model in TB inpatient financing in 2020. A next step will be informing policy decisions on outpatient TB care financing to reduce the existing gap between funding and costs
Broader health coverage is good for the nation's health: evidence from country level panel data.
Progress towards universal health coverage involves providing people with access to needed health services without entailing financial hardship and is often advocated on the grounds that it improves population health. The paper offers econometric evidence on the effects of health coverage on mortality outcomes at the national level. We use a large panel data set of countries, examined by using instrumental variable specifications that explicitly allow for potential reverse causality and unobserved country-specific characteristics. We employ various proxies for the coverage level in a health system. Our results indicate that expanded health coverage, particularly through higher levels of publicly funded health spending, results in lower child and adult mortality, with the beneficial effect on child mortality being larger in poorer countries
Determinants of condom uptake among HIV voluntary counselling and testing clients: experiences from a hospital-based study in south India
Clustering of Multiple Energy Balance-Related Behaviors in School Children and Its Association with Overweight and Obesity—WHO European Childhood Obesity Surveillance Initiative (COSI 2015–2017)
It is unclear how dietary, physical activity and sedentary behaviors co-occur in school-aged children. We investigated the clustering of energy balance-related behaviors and whether the identified clusters were associated with weight status. Participants were 6- to 9-year-old children (n = 63,215, 49.9% girls) from 19 countries participating in the fourth round (2015/2017) of the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative. Energy balance-related behaviors were parentally reported. Weight and height were objectively measured. We performed cluster analysis separately per group of countries (North Europe, East Europe, South Europe/Mediterranean countries and West-Central Asia). Seven clusters were identified in each group. Healthier clusters were common across groups. The pattern of distribution of healthy and unhealthy behaviors within each cluster was group specific. Associations between the clustering of energy balance-related behaviors and weight status varied per group. In South Europe/Mediterranean countries and East Europe, all or most of the cluster solutions were associated with higher risk of overweight/obesity when compared with the cluster 'Physically active and healthy diet'. Few or no associations were observed in North Europe and West-Central Asia, respectively. These findings support the hypothesis that unfavorable weight status is associated with a particular combination of energy balance-related behavior patterns, but only in some groups of countries
Methodology and implementation of the WHO European Childhood Obesity Surveillance Initiative (COSI)
Establishment of the WHO European Childhood Obesity Surveillance Initiative (COSI) has resulted in a surveillance system which provides regular, reliable, timely, and accurate data on children's weight status—through standardized measurement of bodyweight and height—in the WHO European Region. Additional data on dietary intake, physical activity, sedentary behavior, family background, and school environments are collected in several countries. In total, 45 countries in the European Region have participated in COSI. The first five data collection rounds, between 2007 and 2021, yielded measured anthropometric data on over 1.3 million children. In COSI, data are collected according to a common protocol, using standardized instruments and procedures. The systematic collection and analysis of these data enables intercountry comparisons and reveals differences in the prevalence of childhood thinness, overweight, normal weight, and obesity between and within populations. Furthermore, it facilitates investigation of the relationship between overweight, obesity, and potential risk or protective factors and improves the understanding of the development of overweight and obesity in European primary-school children in order to support appropriate and effective policy responses
Cobertura efectiva del manejo de la violencia contra mujeres en municipios Mexicanos: límites de la métrica
Physical Activity, Screen Time, and Sleep Duration of Children Aged 6-9 Years in 25 Countries: An Analysis within the WHO European Childhood Obesity Surveillance Initiative (COSI) 2015-2017
Background: Children are becoming less physically active as opportunities for safe active play, recreational activities, and active transport decrease. At the same time, sedentary screen-based activities both during school and leisure time are increasing. Objectives: This study aimed to evaluate physical activity (PA), screen time, and sleep duration of girls and boys aged 6–9 years in Europe using data from the WHO European Childhood Obesity Surveillance Initiative (COSI). Method: The fourth COSI data collection round was conducted in 2015–2017, using a standardized protocol that included a family form completed by parents with specific questions about their children’s PA, screen time, and sleep duration. Results: Nationally representative data from 25 countries was included and information on the PA behaviour, screen time, and sleep duration of 150,651 children was analysed. Pooled analysis showed that: 79.4% were actively playing for >1 h each day, 53.9% were not members of a sport or dancing club, 50.0% walked or cycled to school each day, 60.2% engaged in screen time for 1 h/day, 8.2–85.6% were not members of a sport or dancing club, 17.7–94.0% walked or cycled to school each day, 32.3–80.0% engaged in screen time for <2 h/day, and 50.0–95.8% slept for 9–11 h/night. Conclusions: The prevalence of engagement in PA and the achievement of healthy screen time and sleep duration are heterogenous across the region. Policymakers and other stakeholders, including school administrators and parents, should increase opportunities for young people to participate in daily PA as well as explore solutions to address excessive screen time and short sleep duration to improve the overall physical and mental health and well-being of children.The authors gratefully acknowledge support from a grant from the Russian Government in the context of the WHO European Office for the Prevention and Control of NCDs.
Data collection in the following countries was made possible through funding. Albania: WHO through the Joint Programme on Children, Food Security and Nutrition “Reducing Malnutrition in Children” (the Millennium Development Goals Achievement Fund) and the Institute of Public Health; Bulgaria: Ministry of Health, National Centre of Public Health and Analyses, WHO Regional Office for Europe; Croatia: Ministry of Health, Croatian Institute of Public Health and WHO Regional Office for Europe; Czechia: grants AZV MZČR 17–31670 A and MZČR – RVO EÚ 00023761; Denmark: Danish Ministry of Health; Estonia: Ministry of Social Affairs, Ministry of Education and Research (IUT 42–2), WHO Country Office, and National Institute for Health Development; France: Sante Publique France, the French Agency for Public Health; Georgia: WHO; Ireland: Health Service Executive; Italy: Ministry of Health and Italian National Institute of Health; Kazakhstan: Ministry of Health of the Republic of Kazakhstan and WHO Country Office; Kyrgyzstan: WHO; Latvia: Ministry of Health, Centre for Disease Prevention and Control; Lithuania: Science Foundation of Lithuanian University of Health Sciences and Lithuanian Science Council and WHO; Malta: Ministry of Health; Montenegro: WHO and Institute of Public Health of Montenegro; Poland: National Health Programme, Ministry of Health; Portugal: Ministry of Health Institutions, the National Institute of Health, Directorate General of Health, Regional Health Directorates and the kind technical support from the Center for Studies and Research on Social Dynamics and Health (CEIDSS); Romania: Ministry of Health; San Marino: Health Ministry, Educational Ministry, Social Security Institute and Health Authority; Spain: Spanish Agency for Food Safety and Nutrition (AESAN); Turkmenistan: WHO Country Office in Turkmenistan and Ministry of Health; Turkey: Turkish Ministry of Health and the World Bank
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