EPIDEMILOGY

Indonesia adalah salah satu negara dengan tingkat keanekaragaman hayati tertinggi di dunia. Hutan dan laut di negara ini, termasuk ekosistem terkaya di dunia, memberikan lapangan kerja dan pendapatan kepada jutaan penduduk Indonesia. Akan tetapi, lingkungan hidup negara ini mengalami tekanan hebat akibat kegiatan-kegiatan manusia. Eksploitasi sumber daya alam merupakan bagian yang penting dari perekonomian negara akibatnya berbagai sektor yang berhubungan dengan pengelolaan sumber daya alam seperti sektor kehutanan berada dalam keadaan yang memprihatinkan karena sumber dayanya terus menipis. Negara ini juga menghadapi berbagai tantangan lingkungan hidup lainnya seperti polusi udara atau sulitnya akses terhadap sumber daya air. Karena berperan penting bagi pembangunan jangka panjang Indonesia, penanganan masalah lingkungan hidup menjadi semakin mendesak dalam kaitannya dengan isu perubahan iklim. Indonesia merupakan penghasil emisi gas rumah kaca yang besar sekaligus negara yang secara khusus, rentan terhadap dampak perubahan iklim seperti misalnya, kenaikan muka air laut atau gangguan terhadap sektor pertanian dan ketahanan pangan.

In December 2019, SARS COV-2 which originated in the Chinese city of Wuhan achieved pandemic proportions and spread rapidly to countries through International air traffic causing acute respiratory infection and deaths. Presence of International airports, demography, health financing and human developments factors were assumed to influence COVID-19 cases burden and case fatality rate (CFR). So, this study was undertaken to find a association between these factors and COVID-19 cases and deaths. The study used 48 districts using purposive sampling as proxy for cities and used secondary data analysis. Data was obtained for various variables like demographic, Health Financing, Indices and Testing infrastructure, COVID cases burden and case fatality from trusted sources. Descriptive statistics correlational statistics using Pearsons coefficient students T was used to describe, correlate and find significant difference in the data. The analysis found a significant difference between COVID cases burden in districts with International Airports (p<0.039) and those without it. Positive correlation of population density (r=0.65) with COVID-19 case burden and negative correlation of case fatality rate with NITI Aayogs health index (r=-0.12), human development index (HDI) (r=-0.18), per-capita expenditure on health (r=-0.072) and a correlation of r=0.16 was observed for gross state domestic product. Decongestion of cities through perspective urban planning is the need of the hour. Stricter quarantine measures in those districts with international airports can help reduce the transmission. Negative correlation of HDI and NITI Aayogs health index with CFR emphasizes the importance of improvements in social determinants of health.

Hypothesis: Cerebrovascular diseases (CVD) are one of the main causes for disability and death, chiefly of aged population in East European countries and especially Bulgaria.
Background: The ratio increment trend of population above 65 in the next decades will multiply the number of people under the risk of CVD. This creates a need for identification of cases under the greatest risk of CVD.
Methods: Standardized by sex and age CVD death rates from almost all European countries until 2001 are included in the study. European Health For All Database, updated June 2003 from WHO was used.
Results: Bulgaria together with Russia, some former Russian republics and Romania occupies one of the first places in Europe regarding CVD death rate.
Conclusion: For Bulgaria was found a significant difference between standardized CVD death rates among men and women for all age groups.

Gompertzian analysis is a statistical technique which has been successfully applied to the analysis of amyotrophic lateral sclerosis (ALS) mortality in England and Wales, Japan and the United States. This paper analyses the consistent trend of rising ALS mortality in France over the years 1968–1990, a period during which crude mortality rose from 400 deaths in 1968 to 950 deaths in 1990. The findings indicate that age-specific mortality rates have risen at ages older than 54 years for men and 53 years for women and decreased slightly at younger ages. The evolving ALS mortality pattern is attributable to changing inter-disease competition resulting from the increased life expectancy of the French population, rather than to changing environmental aetiopathogenic factors or to substantial artefact effects.

Describir y analizar el gasto de la Secretaría de
Salud asociado con iniciativas de comunicación social de
las campañas de prevención de enfermedades transmitidas por vectores (Zika, chikunguña y dengue) y la evaluación de impacto o resultados. Material y métodos. La información se obtuvo de 690 contratos de prestación de servicios de comunicación social (2015-2017), asociados con dos declaraciones de emergencia epidemiológica (EE2-2015 y EE-1-2016). Resultados. Se concluye una débil evaluación de impacto del gasto público. No existe evidencia suficiente que demuestre la correspondencia del gasto en comunicación social con la efectividad y cumplimiento de las campañas. Conclusiones. Los hallazgos permiten definir recomendaciones para vigilar, transparentar y hacer más
eficiente el gasto público. Existe información pública sobre el gasto; sin embargo, es necesario garantizar mecanismos de transparencia, trazabilidad de contratos y evaluación de impacto de las campañas.
To briefly describe and to analyze, the expenditure of the Minister of Health associated with social communication campaigns for the prevention of vector-transmitted
diseases (Zika, chikungunya and dengue). Materials and
methods. The information was obtained through the analysis of 690 contracts for the provision of social communication services (2015-2017). The analyzed contracts are linked with two epidemiological emergency declarations (EE-2-2015, EE-1-2016). Results. The analysis concludes a weak evaluation of the impact of public spending. There is not enough evidence to show the correspondence of social communication spending with the effectiveness and compliance of the campaigns aim goals. Conclusions. Findings allow defining
recommendations to monitor public spending. There are
platforms that provide information on social communication spending; however, it is necessary to guarantee transparency, accountability and the governance of those responsible for social communication and official advertising and strengthen
outcomes evaluation mechanisms.