Health Needs Assessment: Chronic Kidney Disease Secondary to Type 2 Diabetes Mellitus in a Population without Social Security, Mexico 2016-2032.
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ABSTRACT:
SUBMITTER: Martinez-Valverde S
PROVIDER: S-EPMC9332051 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Labor-force participation among Mexican males in their early retirement years (60 to 64 years of age) has decreased in recent decades, from 94.6 percent in 1960 to 65.2 percent in 2010. Similar trends are evident elsewhere in Latin America, and have occurred in the developed world. Such trends pose challenges to financial sustainability of social security systems as working-age populations decrease and those in retirement increase both because of demographic trends and decisions to take early retirement. In this study, we find that the Mexican social security system provides incentives to retire early. The retirement incentives of the Mexican social security system affect retirement behavior, and may be one of the main contributors to early retirement decisions, particularly for lower-income populations. We simulated the effect of the reform from a Pay-As-You-Go (PAYG) to the new Personal Retirement Accounts (PRA) system and we find that the PRA system also provides incentives to early retirement. Further analysis is needed to assess the financial sustainability of the social security system and financial security in old age for the largest cohorts in Mexico that will begin to retire by 2040.
| S-EPMC4197850 | biostudies-literature
Project description:BackgroundWhile genetic counseling has expanded globally, Mexico has not adopted it as a separate profession. Given the rapid expansion of genetic and genomic services, understanding the current genetic counseling landscape in Mexico is crucial to improving healthcare outcomes.MethodsOur needs assessment strategy has two components. First, we gathered quantitative data about genetics education and medical geneticists' geographic distribution through an exhaustive compilation of available information across several medical schools and public databases. Second, we conducted semi-structured interviews of 19 key-informants from 10 Mexican states remotely with digital recording and transcription.ResultsAcross 32 states, ~54% of enrolled medical students receive no medical genetics training, and only Mexico City averages at least one medical geneticist per 100,000 people. Barriers to genetic counseling services include: geographic distribution of medical geneticists, lack of access to diagnostic tools, patient health literacy and cultural beliefs, and education in medical genetics/genetic counseling. Participants reported generally positive attitudes towards a genetic counseling profession; concerns regarding a current shortage of available jobs for medical geneticists persisted.ConclusionTo create a foundation that can support a genetic counseling profession in Mexico, the clinical significance of medical genetics must be promoted nationwide. Potential approaches include: requiring medical genetics coursework, developing community genetics services, and increasing jobs for medical geneticists.
| S-EPMC6503023 | biostudies-literature
Project description:Computer security incident response teams (CSIRTs) respond to a computer security incident when the need arises. Failure of these teams can have far-reaching effects for the economy and national security. CSIRTs often have to work on an ad hoc basis, in close cooperation with other teams, and in time constrained environments. It could be argued that under these working conditions CSIRTs would be likely to encounter problems. A needs assessment was done to see to which extent this argument holds true. We constructed an incident response needs model to assist in identifying areas that require improvement. We envisioned a model consisting of four assessment categories: Organization, Team, Individual and Instrumental. Central to this is the idea that both problems and needs can have an organizational, team, individual, or technical origin or a combination of these levels. To gather data we conducted a literature review. This resulted in a comprehensive list of challenges and needs that could hinder or improve, respectively, the performance of CSIRTs. Then, semi-structured in depth interviews were held with team coordinators and team members of five public and private sector Dutch CSIRTs to ground these findings in practice and to identify gaps between current and desired incident handling practices. This paper presents the findings of our needs assessment and ends with a discussion of potential solutions to problems with performance in incident response.
| S-EPMC5733042 | biostudies-other
Project description:The increase of insecurity levels in Mexico, as well as the fact that violence is a frequent experience among health personnel, motivated this study whose purpose was to evaluate the perception of security and violence that social service medical interns (SSMI) had on the institutions and localities where they carried out their social work and make visible the main types of violence to which they were exposed. This was a cross-sectional study, based on a perception survey self-administered to 157 SSMI from Zacatecas, in Mexico. A high proportion of the participants (75.8%) stated that they were victims of violence, describing 134 incidents; however, only 33.6% of SSMI made an official report. The reported incidents were related to organized crime (31.9%), verbal violence (20.6%), violence by the authorities (14.7%) and sexual harassment (11.8%). One hundred percent of the victims of sexual harassment were women (p = 0.039). According to the above, it is a priority to generate strategies to prevent and reduce the risk of exposure to the violence generated in the medical units and communities where SSMI carry out their activities as medical graduates, as well as, to efficiently process formal violence reports to promote a safe environment that favors the fulfillment of the practice of SSMIs in Mexico.
| S-EPMC8751139 | biostudies-literature
Project description:We studied food security and biodiversity conservation from a social-ecological perspective in southwestern Ethiopia. Specialist tree, bird, and mammal species required large, undisturbed forest, supporting the notion of 'land sparing' for conservation. However, our findings also suggest that forest areas should be embedded within a multifunctional landscape matrix (i.e. 'land sharing'), because farmland also supported many species and ecosystem services and was the basis of diversified livelihoods. Diversified livelihoods improved smallholder food security, while lack of access to capital assets and crop raiding by wild forest animals negatively influenced food security. Food and biodiversity governance lacked coordination and was strongly hierarchical, with relatively few stakeholders being highly powerful. Our study shows that issues of livelihoods, access to resources, governance and equity are central when resolving challenges around food security and biodiversity. A multi-facetted, social-ecological approach is better able to capture such complexity than the conventional, two-dimensional land sparing versus sharing framework.
| S-EPMC8352376 | biostudies-literature
Project description:Despite global health improvements, substantial challenges in social determinants of health and poverty remain in rural communities in low-income countries. Public health theorists suggest that communities with high social capital are less vulnerable to such challenges and more likely to participate in community development. This research examines levels of social capital amongst rural communities in southern Malawi through data gathered as part of a participatory needs assessment for a Healthy Settings project, and discusses the potential benefits of having access to such data before project implementation. Social capital data was collected during 108 focus group discussions in 18 communities (split by gender, age, status) by adapting an existing mixed methods measurement tool, the Schutte tool. Five indicators were measured: sense of belonging, friendship, reliance, ability to work together and influence. Mean results showed all 18 communities had medium-high levels of social capital. Means from each group in the 18 communities highlighted the lowest social capital among the youth groups and the highest with the leaders. A more detailed breakdown highlighted that all groups had a strong sense of belonging to the community, while youth and women had lower social capital levels in terms of influence over local decisions and ability to rely on other community members. Incorporating social capital tools into community health needs assessments in low-income settings provides a valuable overview of community dynamics before project implementation, and Monitoring & Evaluation indicators which allow changes in social capital to be measured at different stages of the project.
| S-EPMC6195280 | biostudies-literature
Project description:Home gardens are recognised in the literature for their contribution to food security, yet the process by which agrobiodiversity and household characteristics mediate this relationship is less well understood. This paper contributes to fill this research gap by drawing on a multi-site case study in the Yucatán region in Mexico. By applying regression analysis, the significance of the association between home garden diversity and food security is confirmed. Plant diversity is found to have a positive association with food consumption scores and the frequency of vegetable intakes. The number of animals used for food purposes is also found to have positive and significant associations with food consumption scores and frequency of meat intakes. However, the dimension and the significance of these positive associations were found to vary among communities and quantiles of the distribution of food security measures. In the households studied, younger individuals and better-educated people, males and Spanish speakers were more likely to engage in jobs in urban areas. Engagement in urban jobs was found to involve complementarities with the overall plant diversity of home gardens, but also trade-offs with the diversity of vegetables and other herbs used for food purposes and with the abundance of animals raised for food purposes.Supplementary informationThe online version contains supplementary material available at 10.1007/s12571-021-01148-w.
| S-EPMC7881320 | biostudies-literature
Project description:BackgroundThe COVID-19 pandemic revealed large structural inequalities that led to disparities in health outcomes related to socioeconomic status. So far, most of the evidence is based on aggregated data or simulations with individual data, which point to various possible mechanisms behind the association. To date, there have been no studies regarding an income gradient in COVID-19 mortality based on individual-level data and adjusting for comorbidities or access to healthcare.MethodsIn this paper, we use linked employee-patient data for patients tested for COVID-19 at the Mexican Institute of Social Security. We estimate the association of the probability of dying with income centiles, using a probit estimation and adjusting for COVID-19 diagnosis, sociodemographic variables, and comorbidities.FindingsAfter controlling for all these variables, we find that persons in the lowest income decile still had a probability of dying from COVID-19 five times greater than those at the top decile.InterpretationOur results imply that the association between income and COVID outcomes is not explained by the prevalence of comorbidities or by a lack of access to healthcare among the low-income population.FundingThis study was not supported by any external funding source.
| S-EPMC8578731 | biostudies-literature
Project description:Genome-wide DNA methylation profiling of blood of participants from a high CVD risk community-based cohort of African American individuals from Washington D.C. Chronic stress increases the risk of cardiovascular disease (CVD) and amygdalar activity (AmygA), a known marker of chronic stress which has been associated with subclinical CVD. Previous research suggests a plausible connection between AmygA, hematopoietic tissue activity, arterial inflammation, and cardiovascular events. There is a paucity of data on the relationships between AmygA, hematopoietic activity, and epigenomics modifications through deoxyribonucleic acid (DNA) methylation among racial and ethnic minorities. We investigated the association between AmygA and spleen (SpleenA) and bone marrow activity (BMA) as well as DNA methylation at genes previously associated with stress. Participants included in the study were from a high CVD risk community-based cohort of African American individuals from Washington D.C. AmygA was measured by aortic uptake of 18Fluorodeoxyglucose (FDG) on Positron Emission Tomography/Computed Tomography and calculated as standardized uptake values (SUVs). SpleenA and BMA were calculated as SUVs from regions of interest within the spleen and vertebrae, respectively. Standardized beta coefficients (β ) and p-values were calculated from linear regression models adjusted for body mass index and 10-year predicted atherosclerotic CVD risk.
2024-09-06 | GSE241763 | GEO
Project description:BackgroundChildren with medical complexity (CMC) have inter-related health and social needs; however, interventions to identify and respond to social needs have not been adapted for CMC. The objective of this study was to evaluate the feasibility of implementing social needs screening and assessment within pediatric complex care programs.MethodsWe implemented systematic social needs assessment for CMC (SSNAC) at two tertiary care centers in three phases: (1) pre-implementation, (2) implementation, and (3) implementation monitoring. We utilized a multifaceted implementation package consisting of discrete implementation strategies within each phase. In phase 1, we adapted questions from evidence-informed screening tools into a 21-item SSNAC questionnaire, and we used published frameworks to inform implementation readiness and process. In phases 2-3, clinical staff deployed the SSNAC questionnaire to parents of CMC in-person or by phone as part of usual care and adapted to local clinical workflows. Staff used shared decision-making with parents and addressed identified needs by providing information about available resources, offering direct assistance, and making referrals to community agencies. Implementation outcomes included fidelity, feasibility, acceptability, and appropriateness.ResultsObservations from clinical staff characterized fidelity to use of the SSNAC questionnaire, assessment template, and shared decision-making for follow-up on unmet social needs. Levels of agreement (5-point Likert scale; 1 = completely disagree; 5 = completely agree) rated by staff for key implementation outcomes were moderate to high for acceptability (mean = 4.7; range = 3-5), feasibility (mean = 4.2; range = 3-5), and appropriateness (mean = 4.6; range = 4-5). 49 SSNAC questionnaires were completed with a 91% response rate. Among participating parents, 37 (76%) reported ≥ 1 social need, including food/nutrition benefits (41%), housing (18%), and caregiver needs (29%). Staff responses included information provision (41%), direct assistance (30%), and agency referral (30%).ConclusionsIt was feasible for tertiary care center-based pediatric complex care programs to implement a standardized social needs assessment for CMC to identify and address parent-reported unmet social needs.
| S-EPMC8606226 | biostudies-literature