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1.
Perspect Behav Sci ; 46(3-4): 431-446, 2023 Dec.
Article in English | MEDLINE | ID: mdl-38144552

ABSTRACT

Several barriers may inhibit the growth of behavior analysis as a more integrated and collaborative field. Two such barriers are siloed environments that reinforce a basic-applied distinction, and a lack of translational research pathways. We describe the perils of silos, and elaborate on potential solutions to increase reciprocal relations among subfields in behavior analysis. We promote a five-tiered system to classify research in behavior analysis, and discuss literature on cultivating effective intra and cross-disciplinary collaborations, including using the framework of metacontingencies to understand collaborations. We also propose quantitative and qualitative measures to examine whether the potential solutions increase intra and interdisciplinary interactions. These measures include bibliometric (e.g., citations across fields), sociometric (e.g., social network analysis), and narrative analysis. We apply some of these measures to publications from 2011-2022 from the Journal of the Experimental Analysis of Behavior and Journal of Applied Behavior Analysis, and argue that behavior analysis overall may benefit from a more collaborative approach. Supplementary Information: The online version contains supplementary material available at 10.1007/s40614-023-00386-x.

2.
Front Psychol ; 14: 940961, 2023.
Article in English | MEDLINE | ID: mdl-36936015

ABSTRACT

The Myers-Briggs Type Indicator (MBTI) is a popular tool used by psychologists working as managers' coaches in organizational contexts. Despite its popularity, few studies provide empirical evidence on the role of the MBTI as a predictor of managers' leadership-related behaviors. This article is written based on research that answers the question of how good the MBTI is to prove leadership behavior. It does so by comparing goodness-of-fit indexes of two confirmatory factor analysis models and two structural models on the personality-leadership relationship, following standards of reproducible research principles. We sampled 529 participants who were graduate and undergraduate students enrolled in business administration programs from Colombian universities. Results show conclusive evidence of the psychometric measurement of both MBTI and leadership practices, even though the relationship between MBTI and the leadership practices inventory proved to be weak.

3.
J Stat Theory Appl ; 21(4): 175-185, 2022.
Article in English | MEDLINE | ID: mdl-36160758

ABSTRACT

In The hitchhiker's guide to responsible machine learning, Biecek, Kozak, and Zawada (here BKZ) provide an illustrated and engaging step-by-step guide on how to perform a machine learning (ML) analysis such that the algorithms, the software, and the entire process is interpretable and transparent for both the data scientist and the end user. This review summarises BKZ's book and elaborates on three elements key to ML analyses: inductive inference, causality, and interpretability.

4.
Int J Lang Commun Disord ; 56(5): 892-906, 2021 09.
Article in English | MEDLINE | ID: mdl-34227721

ABSTRACT

BACKGROUND: Imprecise articulation has a negative impact on speech intelligibility. Therefore, treatment of articulation is clinically relevant in patients with dysarthria. In order to be effective and according to the principles of motor learning, articulation therapy needs to be intensive, well organized, with adequate feedback and requires frequent practice. AIMS: The aims of this pilot study are (1) to evaluate the feasibility of a virtual articulation therapy (VAT) to guide patients with dysarthria through a boost articulation therapy (BArT) program; (2) to evaluate the acoustic models' performance used for automatic phonological error detection; and (3) to validate the system by end-users from their perspective. METHODS & PROCEDURES: The VAT provides an extensive and well-structured package of exercises with visual and auditory modelling and adequate feedback on the utterances. The tool incorporates automated methods to detect phonological errors, which are specifically designed to analyse Dutch speech production. A total of 14 subjects with dysarthria evaluated the acceptability, usability and user interaction with the VAT based on two completed therapy sessions using a self-designed questionnaire. OUTCOMES & RESULTS: In general, participants were positive about the new computer-based therapy approach. The algorithm performance for phonological error detection shows it to be accurate, which contributes to adequate feedback of utterance production. The results of the study indicate that the VAT has a user-friendly interface that can be used independently by patients with dysarthria who have sufficient cognitive, linguistic, motoric and sensory skills to benefit from speech therapy. Recommendations were given by the end-users to further optimize the program and to ensure user engagement. CONCLUSIONS & IMPLICATIONS: The initial implementation of an automatic BArT shows it to be feasible and well accepted by end-users. The tool is an appropriate solution to increase the frequency and intensity of articulation training that supports traditional methods. WHAT THIS PAPER ADDS: What is already known on the subject Behavioural interventions to improve articulation in patients with dysarthria demand intensive treatments, repetitive practice and feedback. However, the current treatments are mainly limited in time to the interactive sessions in the presence of speech-language pathology. Automatic systems addressing the needs of individuals with dysarthria are scarce. This study evaluates the feasibility of a VAT program and investigates its acceptability, usability and user interaction. What this paper adds to existing knowledge The computer-based speech therapy approach developed and applied in this study intends to support intensive articulation training of patients with dysarthria. The virtual speech therapy offers the possibility of an individualized and customized therapy programme, with an extensive database of exercises, visual and auditory models of the target utterances, and providing adequate feedback based on automatic acoustic analysis of speech. What are the potential or actual clinical implications of this work? The automatic BArT overcomes the limitation in time of face-to-face traditional speech therapy. It offers patients the opportunity to have access to speech therapy more intensively and frequently in their home environment.


Subject(s)
Dysarthria , Speech Intelligibility , Adult , Dysarthria/psychology , Humans , Pilot Projects , Speech Production Measurement/methods , Speech Therapy/methods
5.
Front Rehabil Sci ; 2: 796074, 2021.
Article in English | MEDLINE | ID: mdl-36188782

ABSTRACT

Background and Objectives: During the Coronavirus disease 19 (COVID-19) pandemic, isolation and prevention measures to reduce COVID-19 contagions are essential for the care of all people; these measures should comply with the principles of inclusion and accessibility for people with disabilities (PWD), with all kinds of deficiencies and levels of dependency. Thereby, the aim of this article is to present the measures adopted for PWD or people with rehabilitation needs, for containment, mitigation, or suppression of the SARS-CoV-2 virus in different countries of all continents and of all income levels. Methods: A narrative approach was used in this article. First, a broad search was carried out in the 193 member states of the UN, and then 98 countries that issued any document, report, or information related to disability and COVID-19 were selected. Finally, 32 countries were included in this article because they presented official information. We considered official sources, the information available in the government, or on the health ministry page of the country. In this way, the countries that presented information which did not correspond to an official source were excluded. The search was conducted in August 2020 and updated in March 2021. Results: First, the non-pharmacological general interventions for PWD included informative measures and general recommendations during the stay at home, isolation, and biosecurity measures, contagion prevention, detection of positive cases, mobilization measures, and measures implemented in institutions or residences of PWD. Second, we identified the economic and social benefits provided to PWD during the pandemic. Finally, we identified the measures taken by countries according to the type of impairment (visual, hearing, physical, mental, and cardiopulmonary impairment) during the COVID-19 pandemic. Conclusion: In response to the COVID-19 pandemic, only 50% of countries from the five world regions created and implemented specific measures for PWD to containment, mitigation, or suppression of the SARS-CoV-2 virus. There is very little specific information available about the measures to continue with the care of people with rehabilitation needs and the long-term follow-up of PWD, and for the prevention and response to violence, especially for women with disabilities.

6.
Prev Med Rep ; 18: 101090, 2020 Jun.
Article in English | MEDLINE | ID: mdl-32322460

ABSTRACT

A common practice among clinical psychologists and other health professionals is the use of school-based sexual health promotion programs as a means for preventing sexually transmitted infections. A fundamental criterion for the designing and adaptation of these programs is the age of their target populations because limited education and language are the most relevant factors that limit the efficacy of these programs. The contribution of this paper consists of assessing both the readability of the written materials that accompany the contents of a Spanish-written school-based sexual health promotion program used in Colombia, as well as the words co-occurrence network structure of its contents. The readability of the evaluated program corresponded to its intended target population aged between 14 and 19, with the schooling of 9-13 years of education. The resulting words co-occurrence network structure of the COMPAS program also mirrored its theoretical content. These results all together are deemed as empirical evidence of the adequacy of the program.

7.
Data Brief ; 25: 104007, 2019 Aug.
Article in English | MEDLINE | ID: mdl-31193950

ABSTRACT

This data article contains data regarding the collaborative consumption that takes place in an Online Food Delivery Platform that connects restaurants owners, and customers who wish to order meals and receive them at home or office. These data are associated with the article "Evaluation of Collaborative consumption of food delivery services through web mining techniques" [1]. These data are stored in a comma separated value format; that can be easily downloaded from a Mendeley data repository (https://data.mendeley.com/datasets/m9z9hw4nsc/1).

8.
PLoS One ; 14(3): e0213651, 2019.
Article in English | MEDLINE | ID: mdl-30897113

ABSTRACT

The accumulation of knowledge required to produce economic value is a process that often relates to nations economic growth. Some decades ago many authors, in the absence of other available indicators, used to rely on certain measures of human capital such as years of schooling, enrollment rates, or literacy. In this paper, we show that the predictive power of years of education as a proxy for human capital started to dwindle in 1990 when the schooling of nations began to be homogenized. We developed a structural equation model that estimates a metric of human capital that is less sensitive than average years of education and remains as a significant predictor of economic growth when tested with both cross-section data and panel data.


Subject(s)
Economic Development , Educational Status , Health Status , Socioeconomic Factors , Algorithms , Child, Preschool , Cross-Sectional Studies , Developing Countries , Education , Humans , Infant , Infant, Newborn , Life Expectancy , Models, Economic , Models, Statistical , Mortality , Regression Analysis
9.
Front Psychol ; 9: 699, 2018.
Article in English | MEDLINE | ID: mdl-29867666

ABSTRACT

We argue that making accept/reject decisions on scientific hypotheses, including a recent call for changing the canonical alpha level from p = 0.05 to p = 0.005, is deleterious for the finding of new discoveries and the progress of science. Given that blanket and variable alpha levels both are problematic, it is sensible to dispense with significance testing altogether. There are alternatives that address study design and sample size much more directly than significance testing does; but none of the statistical tools should be taken as the new magic method giving clear-cut mechanical answers. Inference should not be based on single studies at all, but on cumulative evidence from multiple independent studies. When evaluating the strength of the evidence, we should consider, for example, auxiliary assumptions, the strength of the experimental design, and implications for applications. To boil all this down to a binary decision based on a p-value threshold of 0.05, 0.01, 0.005, or anything else, is not acceptable.

10.
Rev. latinoam. psicol ; 50(1): 61-70, jan.-abr. 2018. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-978645

ABSTRACT

Abstract A peace agreement was recently subjected to a plebiscite as a solution to finish the Colombian armed conflict. With 62.57% of abstention, 18.44% of the Colombian electorate rejected this agreement. This paper aims to propose a methodological approach that shows how to linguistically analyze peace agreements as political products that are acceptable or not according to their text difficulty. Given the socio-political similarities of the armed conflicts of Colombia, Guatemala, and El Salvador, we scrutinized with sufficient computational detail these peace agreements. The results revealed that the text difficulty of these accords was more appropriate for a person with at least 19 years of education, suggesting that these sort of texts are not written for broader and less-educated audiences.


Resumen El gobierno de Colombia sometió recientemente a plebiscito un acuerdo de paz para dar por finalizado su conflicto armado. Para este plebiscito la abstención electoral fue del 62.57% y solo el 18.44% de los votantes rechazó la implementación del acuerdo. El objetivo de este trabajo es proponer una aproximación metodológica que muestre cómo analizar los acuerdos de paz como productos políticos que pueden ser aceptables o no según su dificultad textual. Dadas las semejanzas socio-políticas de los conflictos armados en Colombia, Guatemala y El Salvador, en este trabajo se muestra con suficiente detalle computacional el análisis por minería de texto de los acuerdos de paz celebrados en estos países. Los resultados revelaron que la dificultad textual de estos acuerdos exige un nivel educativo de al menos 19 años de educación formal, lo que sugiere que ese tipo de documentos no suelen redactarse para audiencias más numerosas con menores niveles de educación formal.


Subject(s)
Human Rights , Smog , Communication Barriers , Armed Conflicts , Data Mining
11.
Suma psicol ; 24(2): 129-134, jul.-dic. 2017. tab, graf
Article in English | LILACS | ID: biblio-904068

ABSTRACT

Abstract Snapchat offers a distinctive feature from other social networks in that its users control the visibility of the contents they share with others by defining how long these contents may be available. Snapchat is changing the way men and women perceive online information privacy and content management. This paper aims to illustrate the relevance of social representation theory to evaluate perceived privacy in Snapchat users, with a sample of 268 young adults residing in Bogotá. A survey method was employed for data collection purposes. The results reveal that Snapchat users are concerned about their networks' privacy, with no significant sex differences, although men's perception of Snapchat privacy is safer than that of women. Finally, a discussion is presented as to the limitations and implications of these results for further studies.


Resumen De las redes sociales existentes, Snapchat ofrece a sus usuarios el rasgo distintivo de permitirles controlar el tiempo que será visible el contenido que comparten con otros. Snapchat plantea un cambio en la manera cómo se concibe la privacidad de la información y el manejo de contenidos online por parte de hombres y mujeres. El objetivo de este trabajo es ilustrar la relevancia de la teoría de representaciones sociales para evaluar la privacidad percibida Redes sociales en usuarios de Snapchat a través de una muestra de 268 adultos jóvenes residentes en Bogotá. Con el diseño y aplicación de una encuesta especialmente adaptada se pudo observar que a los usuarios de Snapchat les preocupa la privacidad de sus redes sin que existan diferencias significativas por sexo; aunque, en comparación con sus pares femeninos, los hombres perciben que Snapchat es más segura. El artículo finaliza con una discusión sobre las limitaciones e implicaciones de estos resultados para futuros estudios.

12.
Cyberpsychol Behav Soc Netw ; 20(1): 37-43, 2017 Jan.
Article in English | MEDLINE | ID: mdl-28080152

ABSTRACT

Propagation of political ideologies in social networks has shown a substantial impact on voting behavior. Both the contents of the messages (the ideology) and the politicians' influence on their online audiences (their followers) have been associated with such an impact. In this study we evaluate which of these factors exerted a major role in deciding electoral results of the 2015 Colombian regional elections by evaluating the linguistic similarity of political ideologies and their influence on the Twitter sphere. The electoral results proved to be strongly associated with tweets and retweets and not with the linguistic content of their ideologies or politicians' followers in Twitter. Finally, suggestions for new ways to analyze electoral processes are discussed.


Subject(s)
Internet , Politics , Social Media , Social Networking , Colombia , Humans
13.
Psychol Res ; 81(4): 750-763, 2017 Jul.
Article in English | MEDLINE | ID: mdl-27431389

ABSTRACT

The valence-space metaphor posits that emotion concepts map onto vertical space such that positive concepts are in upper locations and negative in lower locations. Whilst previous studies have demonstrated this pattern for positive and negative emotions e.g. 'joy' and 'sadness', the spatial location of neutral emotions, e.g. 'surprise', has not been investigated, and little is known about the effect of linguistic background. In this study, we first characterised the emotions joy, surprise and sadness via ratings of their concreteness, imageability, context availability and valence before examining the allocation of these emotions in vertical space. Participants from six linguistic groups completed either a rating task used to characterise the emotions or a word allocation task to implicitly assess where these emotions are positioned in vertical space. Our findings suggest that, across languages, gender, handedness, and ages, positive emotions are located in upper spatial locations and negative emotions in lower spatial locations. In addition, we found that the neutral emotional valence of surprise is reflected in this emotion being mapped mid-way between upper and lower locations onto the vertical plane. This novel finding indicates that the location of a concept on the vertical plane mimics the concept's degree of emotional valence.


Subject(s)
Emotions/physiology , Psycholinguistics , Verbal Behavior/physiology , Adult , Female , Humans , Male , Middle Aged , Young Adult
14.
Environ Pollut ; 205: 87-96, 2015 Oct.
Article in English | MEDLINE | ID: mdl-26025261

ABSTRACT

We evaluated the occurrence of 12 veterinary antibiotics and a beta agonist over spatial and temporal scales in Shell Creek, an intensively agricultural watershed in Nebraska, using Polar Organic Chemical Integrative Samplers (POCIS). Twelve pharmaceuticals were detected with concentrations ranging from 0.0003 ng/L to 68 ng/L. The antibiotics measured at the highest time-weighted average concentrations were lincomycin (68 ng/L) and monensin (49 ng/L), and both compounds were detected at increased concentrations in summer months. Analysis of variance indicates that mean concentrations of detected pharmaceuticals have no significant (p > 0.01) spatial variation. However, significant temporal differences (p < 0.01) were observed. This study demonstrates the utility of passive samplers such as POCIS for monitoring ambient levels of pharmaceuticals in surface waters.


Subject(s)
Adrenergic beta-Agonists/analysis , Anti-Bacterial Agents/analysis , Water Pollutants, Chemical/analysis , Agricultural Irrigation , Environmental Monitoring , Nebraska , Organic Chemicals/chemistry , Seasons
15.
Int J Radiat Oncol Biol Phys ; 89(5): 1024-1031, 2014 Aug 01.
Article in English | MEDLINE | ID: mdl-25035205

ABSTRACT

PURPOSE: To propose a random forest normal tissue complication probability (RF-NTCP) model to predict late rectal toxicity following prostate cancer radiation therapy, and to compare its performance to that of classic NTCP models. METHODS AND MATERIALS: Clinical data and dose-volume histograms (DVH) were collected from 261 patients who received 3-dimensional conformal radiation therapy for prostate cancer with at least 5 years of follow-up. The series was split 1000 times into training and validation cohorts. A RF was trained to predict the risk of 5-year overall rectal toxicity and bleeding. Parameters of the Lyman-Kutcher-Burman (LKB) model were identified and a logistic regression model was fit. The performance of all the models was assessed by computing the area under the receiving operating characteristic curve (AUC). RESULTS: The 5-year grade ≥2 overall rectal toxicity and grade ≥1 and grade ≥2 rectal bleeding rates were 16%, 25%, and 10%, respectively. Predictive capabilities were obtained using the RF-NTCP model for all 3 toxicity endpoints, including both the training and validation cohorts. The age and use of anticoagulants were found to be predictors of rectal bleeding. The AUC for RF-NTCP ranged from 0.66 to 0.76, depending on the toxicity endpoint. The AUC values for the LKB-NTCP were statistically significantly inferior, ranging from 0.62 to 0.69. CONCLUSIONS: The RF-NTCP model may be a useful new tool in predicting late rectal toxicity, including variables other than DVH, and thus appears as a strong competitor to classic NTCP models.


Subject(s)
Gastrointestinal Hemorrhage/epidemiology , Models, Statistical , Prostatic Neoplasms/radiotherapy , Radiation Injuries/epidemiology , Radiotherapy, Conformal/statistics & numerical data , Rectum/radiation effects , Age Factors , Aged , Aged, 80 and over , Anticoagulants/administration & dosage , Anticoagulants/adverse effects , Area Under Curve , Gastrointestinal Hemorrhage/etiology , Humans , Male , Middle Aged , Probability , Prospective Studies , ROC Curve , Radiation Injuries/complications , Radiotherapy Dosage , Radiotherapy, Conformal/adverse effects , Radiotherapy, Conformal/methods , Radiotherapy, Image-Guided , Radiotherapy, Intensity-Modulated , Retrospective Studies
16.
Rev. colomb. cir ; 29(2): 131-139, abr.-jun. 2014. tab
Article in Spanish | LILACS | ID: lil-717028

ABSTRACT

Introducción. La cirugía abierta ha sido el abordaje quirúrgico estándar para los tumores del estroma gástrico (Gastrointestinal Stromal Tumors, GIST). En artículos recientes se propone la cirugía laparoscópica como una alternativa segura para su tratamiento. Se hizo una evaluación de las publicaciones disponibles en las que se comparaban la seguridad y la efectividad de la cirugía laparoscópica con las de la cirugía abierta, en aspectos como tiempo quirúrgico, estancia hospitalaria, complicaciones y recurrencia tumoral. Materiales y métodos. Se hizo una búsqueda sistemática de la literatura y se evaluaron los artículos de más alta calidad según los criterios del Journal of the American Medical Association, JAMA. Se siguió la metodología del Best Evidence Topic (BestBET). Resultados Se encontraron tres revisiones sistemáticas de estudios observacionales. No hay a la fecha ensayos clínicos aleatorios. Los pacientes sometidos a laparoscopia presentan menor tiempo de reinicio de la vía oral y de estancia hospitalaria, y menor número de complicaciones globales y complicaciones menores. En comparación con la cirugía abierta, no hay diferencia con respecto a la pérdida sanguínea y el tiempo quirúrgico. Tampoco hay diferencia en tiempo de recurrencia y supervivencia libre de enfermedad. Conclusión. La evidencia a partir de estudios no aleatorios sugiere que la resección laparoscópica de los GIST gástricos es tan segura y efectiva como la vía abierta. La aplicabilidad de las técnicas quirúrgicas laparoscópicas se basa en una serie de factores que comprenden características del paciente, tamaño del tumor, localización, invasión y la experiencia del grupo quirúrgico en el abordaje laparoscópico.


Introduction. Open surgery is considered the surgical gold standard for the treatment of gastric stromal tumors. Some recent studies propose laparoscopic surgery as a safe alternative. We conducted a systematic review of the literature to assess the effectiveness and safety of the laparoscopic approach in comparison with the open approach evaluating operative time, hospital length of stay, complications and tumor recurrence Material and methods. We conducted a systematic review of the literature and evaluated the quality of the available studies, selecting those of higher quality using the JAMA criteria. The Best BETS methodology was followed. Results. Three systematic reviews of observational studies but none randomized controlled trial were found. Patients in the laparoscopic group had shorter time until feeding and hospital length of stay and lower number of minor and severe complications. In comparison with open surgery, there is no difference regarding blood loss and operating time. Recurrence and disease free survival were similar. Conclusion. Evidence form observational non randomized trials suggest that laparoscopic surgery for GIST gastric tumors is as safe and effective as the open approach. Applicability of laparoscopic techniques requires a careful evaluation of factors such as patient conditions, tumor size, location, invasion and experience of surgeons to guarantee a successful outcome.


Subject(s)
Gastrointestinal Stromal Tumors , Stomach , Laparoscopy , Minimally Invasive Surgical Procedures
17.
Chemosphere ; 91(6): 733-9, 2013 May.
Article in English | MEDLINE | ID: mdl-23499217

ABSTRACT

The presence of organochlorine pesticides (OCPs) in biological and environmental samples has been studied for decades in many countries. Nonetheless, studies in Latin American countries like Colombia have been scarce. Determining the presence of OCPs in breast milk will be of relevance to assess exposures, potential health risks, and for surveillance among Latin American populations. Thirty-two breast-feeding mothers were selected to voluntarily participate in the study. Breast milk samples were analyzed for 10 OCPs (α-, ß-, γ-, δ-HCH, Heptachlor, α-, γ-Chlordane, 4,4' DDT, 4,4' DDE, 4,4' DDD). Milk samples were analyzed using liquid-liquid extraction, followed by sulfuric acid clean-up, and quantified using GC/µECD. Results were confirmed by GC/MS. OCPs concentrations were normalized using fat content. In all but one sample, 4,4' DDE was quantified in concentrations ranging between<17 and 14948 ng g(-1) (ng of OCP per g of lipids), with a mean value of 203 ng g(-1). One woman had 4,4' DDE concentrations that were orders of magnitude above the average concentrations observed worldwide. Concentrations of 4,4' DDE in a second breast milk sample collected in a different time period of lactation from a sub-group of 13 women from the original participants, showed no statistically significant difference with the concentrations found in the first sample. Based on the results obtained from the Persistent Organic Pollutants Global Monitoring Plan report of 2009 of the Stockholm Convention, Colombia ranks fourth from bottom to top in terms of 4,4' DDE average concentrations.


Subject(s)
Environmental Monitoring , Environmental Pollutants/analysis , Hydrocarbons, Chlorinated/analysis , Milk, Human/chemistry , Pesticides/analysis , Adolescent , Adult , Colombia , Environmental Pollutants/chemistry , Environmental Pollutants/isolation & purification , Female , Humans , Hydrocarbons, Chlorinated/chemistry , Hydrocarbons, Chlorinated/isolation & purification , Pesticides/chemistry , Pesticides/isolation & purification , Pregnancy , Young Adult
18.
Rev Panam Salud Publica ; 31(6): 476-84, 2012 Jun.
Article in English | MEDLINE | ID: mdl-22858814

ABSTRACT

OBJECTIVE: To evaluate the effectiveness of alcohol-based handrubs (ABH) in reducing acute diarrheal diseases (ADD) and acute respiratory infections (ARI) among children 1-5 years of age in childcare centers with limited tap water. METHODS: This was the first cluster-randomized controlled trial in a developing country. The study took place at 42 childcare centers with sporadic and limited water availability in six towns in Colombia. Participants were randomly assigned to use ABH as a complement to handwashing (intervention arm: 21 centers/794 children); or to continue existing handwashing practices (control arm: 21 centers/933 children). ADD and ARI cases were identified through teacher-reported signs and symptoms of illness. Adverse events were monitored. Hazard ratios (HR) were obtained using Cox proportional hazards multivariate regression shared frailty models. RESULTS: Child-days of surveillance totaled 336 038. Loss to follow up was 14.5%. For both ADD and ARI, there were no differences in hazard ratios during the first trimester of the study. In the second and third trimesters, significant reductions in the risk of ADD were found in the intervention compared to control arm (HR = 0.55, P < 0.001 and HR = 0.44, P < 0.001, respectively). There were also significant risk reductions for ARI in the second trimester (HR = 0.80, P < 0.05) and in the third trimester (HR = 0.69, P < 0.001). No adverse events occurred. CONCLUSIONS: ABH effectively prevent ADD and ARI, and are safe. Colombia's national public health policies for prevention of these diseases should include use of ABH, especially in settings where handwashing with soap and water is limited by water availability.


Subject(s)
Communicable Disease Control , Hand Disinfection , Child , Child, Preschool , Colombia , Female , Humans , Infant , Male
19.
Rev. panam. salud pública ; 31(6): 476-484, jun. 2012. ilus, tab
Article in English | LILACS | ID: lil-644000

ABSTRACT

OBJECTIVE: To evaluate the effectiveness of alcohol-based handrubs (ABH) in reducing acute diarrheal diseases (ADD) and acute respiratory infections (ARI) among children 1-5 years of age in childcare centers with limited tap water. METHODS: This was the first cluster-randomized controlled trial in a developing country. The study took place at 42 childcare centers with sporadic and limited water availability in six towns in Colombia. Participants were randomly assigned to use ABH as a complement to handwashing (intervention arm: 21 centers/794 children); or to continue existing handwashing practices (control arm: 21 centers/933 children). ADD and ARI cases were identified through teacher-reported signs and symptoms of illness. Adverse events were monitored. Hazard ratios (HR) were obtained using Cox proportional hazards multivariate regression shared frailty models. RESULTS: Child-days of surveillance totaled 336 038. Loss to follow up was 14.5%. For both ADD and ARI, there were no differences in hazard ratios during the first trimester of the study. In the second and third trimesters, significant reductions in the risk of ADD were found in the intervention compared to control arm (HR = 0.55, P < 0.001 and HR = 0.44, P < 0.001, respectively). There were also significant risk reductions for ARI in the second trimester (HR = 0.80, P < 0.05) and in the third trimester (HR = 0.69, P < 0.001). No adverse events occurred. CONCLUSIONS: ABH effectively prevent ADD and ARI, and are safe. Colombia's national public health policies for prevention of these diseases should include use of ABH, especially in settings where handwashing with soap and water is limited by water availability.


OBJETIVO: Evaluar la eficacia del uso de antisépticos para las manos a base de alcohol en la disminución de las enfermedades diarreicas agudas y las infecciones respiratorias agudas en niños de 1 a 5 años de edad en los centros de atención infantil donde el lavado de las manos con agua y jabón no es factible. MÉTODOS. El presente fue el primer ensayo controlado y aleatorizado por conglomerados llevado a cabo en un país en desarrollo. El estudio tuvo lugar en 42 centros de atención infantil con disponibilidad de agua esporádica y limitada ubicados en seis ciudades de Colombia. Se asignó aleatoriamente a los participantes a usar antisépticos a base de alcohol como complemento del lavado de las manos (grupo de intervención: 21 centros/794 niños) o a continuar llevando a cabo las prácticas de lavado de las manos habituales (grupo de referencia: 21 centros/933 niños). Los casos de enfermedades diarreicas agudas e infecciones respiratorias agudas fueron identificados mediante la notificación de los signos y síntomas de enfermedad por los maestros. Se efectuó un seguimiento de los acontecimientos adversos. Se obtuvieron las razones de riesgos instantáneos (HR) usando modelos de regresión multivariante de riesgos proporcionales de Cox con fragilidad compartida. RESULTADOS: Se alcanzó un total de 336 038 niño-días de vigilancia. La pérdida de contacto durante el seguimiento fue de 14,5%. Durante el primer trimestre del estudio no hubo diferencias en las razones de riesgo para las enfermedades diarreicas agudas ni para las infecciones respiratorias agudas. En el segundo y tercer trimestres se encontraron disminuciones significativas del riesgo de enfermedades diarreicas agudas en el grupo de intervención en comparación con el grupo de referencia (HR = 0,55, P < 0,001 y HR = 0,44, P < 0,001, respectivamente). Para las infecciones respiratorias agudas se observaron disminuciones significativas del riesgo durante el segundo trimestre (HR = 0,80, P ...


Subject(s)
Humans , Female , Infant , Child, Preschool , Child , Communicable Disease Control , Hand Disinfection , Colombia
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