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1.
Reprod Health ; 18(1): 122, 2021 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-34112194

RESUMEN

BACKGROUND: High fertility rates and unintended pregnancies are public health concerns of lower and middle income countries such as Ethiopia. Long acting contraceptives (LACs) take the lion's share in reducing unintended pregnancies and high fertility rates. Despite their numerous advantages, the utilization of LACs remains low in Ethiopia. This study is aimed to explore the geographic variation and associated factors of long acting contraceptive use among reproductive-age women in Ethiopia. METHODS: This is a secondary data analysis of 2016 Ethiopian Demographic and Health Survey (EDHS) data. A total of weighted sample sizes of 10,439 reproductive-age women were included in the final analysis. To clean and analyze the none-spatial data Stata 14 was used while ArcGIS 10.6 and SaTScanTM version 9.6 software were used for spatial analysis. Multilevel Mixed-effect Logistic regression model was used to identify associated factors of LACs utilization. An Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was reported to identify significant variables. RESULTS: Long acting contraceptive utilization was non-random (Moran's I: 0.30, p-value < 0.01). Statistically, clusters with significant low utilization of LACs were found in Somali, Afar, Gambela, northern Amhara, eastern Oromia and western part of Southern Nations Nationalities and Peoples (SNNP) regions. Adjusting for other factors such as being married (AOR = 2.51, 95% CI: 1.29-4.87), having one to two (AOR = 2.14, 95% CI: 1.43-3.22), and three to four children (AOR = 1.68, 95% CI: 1.02-2.76), urban (AOR = 1.59, 95% CI: 1.16-2.19), want no more children (AOR = 1.40, 95% CI: 1.08-1.83), working status of women (AOR = 1.33, 95% CI: 1.07-1.65) increased the odds of LACs utilization. While previous history of abortion (AOR = 0.56, 95% CI: 0.39-0.80), and living in the pastoralist community (AOR = 0.22, 95% CI: 0.14-0.35) reduced the odds of LACs utilization in Ethiopia CONCLUSIONS: Significant geographic variation of LACs utilization was observed in Ethiopia. Spots with Low LACs utilization were found in the eastern, north eastern and western part of the country. Socio-demographic and pregnancy related factors were significant determinants of LACs utilization. Designing intervention programs targeting the identified hot spot clusters, and variables that can hinder the utilization of LACs is very important to increase the utilization.


Asunto(s)
Conducta Anticonceptiva , Anticonceptivos/uso terapéutico , Anticoncepción Reversible de Larga Duración , Adolescente , Adulto , Estudios Transversales , Etiopía , Femenino , Humanos , Matrimonio , Persona de Mediana Edad , Análisis Multinivel , Embarazo , Población Rural , Factores Socioeconómicos , Análisis Espacial , Población Urbana , Adulto Joven
2.
Rev Bras Epidemiol ; 24: e210037, 2021.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-34133703

RESUMEN

AIM: To investigate the geographical variability and factors associated with hospitalizations for ambulatory care sensitive conditions (ACSC) among older adults living in the state of Minas Gerais. METHODOLOGY: This is an ecological study, based on data from the National Hospital Information System (SIH-SUS). Municipal rates of hospitalization for ACSC were compared to the state's average rate, and analysis of associated factors included sociodemographic characteristics, supply of health services and primary health care (PHC) activities. Data analysis was based on Bayesian spatial modeling. RESULTS: Most municipalities in Minas Gerais (479 or 56.2%) had a rate of hospitalization for ACSC below the state average. After multivariate analysis, income (ß = -0,0008; 95%CI: -0.0014 - -0,0002) and the Family Health Strategy coverage (ß = -0.4269; 95%CI: -0.7988 - -0.1116) were negatively associated with the risk of hospitalization for ACSC, while the availability of hospital beds (ß = 0.0271; 95%CI 0.0211 - 0.0331) was positively associated. The characteristics of PHC did not show any association with the rate of hospitalization for ACSC. CONCLUSION: the rates of hospitalization for ACSC in the elderly population were influenced by the PHC coverage, but also by external factors such as income and structure and provision of health services, indicating that the meeting of population health demands passes through actions that go beyond the health sector, including investment in the reduction of poverty and inequality and expansion of access to PHC.


Asunto(s)
Atención Ambulatoria , Hospitalización , Anciano , Teorema de Bayes , Brasil/epidemiología , Humanos , Análisis Espacial
3.
Science ; 372(6547)2021 06 11.
Artículo en Inglés | MEDLINE | ID: mdl-34112668

RESUMEN

X-inactive specific transcript (Xist) RNA directs the process of X chromosome inactivation in mammals by spreading in cis along the chromosome from which it is transcribed and recruiting chromatin modifiers to silence gene transcription. To elucidate mechanisms of Xist RNA cis-confinement, we established a sequential dual-color labeling, super-resolution imaging approach to trace individual Xist RNA molecules over time, which enabled us to define fundamental parameters of spreading. We demonstrate a feedback mechanism linking Xist RNA synthesis and degradation and an unexpected physical coupling between preceding and newly synthesized Xist RNA molecules. Additionally, we find that the protein SPEN, a key factor for Xist-mediated gene silencing, has a distinct function in Xist RNA localization, stability, and coupling behaviors. Our results provide insights toward understanding the distinct dynamic properties of Xist RNA.


Asunto(s)
Proteínas de Unión al ADN/metabolismo , Proteínas Nucleares/metabolismo , ARN Largo no Codificante/metabolismo , Proteínas de Unión al ARN/metabolismo , Inactivación del Cromosoma X , Animales , Línea Celular , Núcleo Celular/metabolismo , Cromatina/metabolismo , Proteínas de Unión al ADN/genética , Células Madre Embrionarias , Silenciador del Gen , Ratones , Microscopía , Proteínas Nucleares/genética , Estabilidad del ARN , ARN Largo no Codificante/biosíntesis , Proteínas de Unión al ARN/genética , Análisis Espacial , Transcripción Genética , Cromosoma X/metabolismo
4.
Rev Bras Enferm ; 74(2): e20200564, 2021.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-34076221

RESUMEN

OBJECTIVES: to identify risk clusters for the occurrence of tuberculosis and its treatment outcomes. METHODS: ecological study, in a city in Maranhão, using data from the Notifiable Diseases Information System. Point density analysis and isotonic scanning techniques were used to identify areas with the highest occurrence of treatment outcomes and identify risk areas for possible tuberculosis cases. RESULTS: most tuberculosis cases occurred in the male, adult, brown-skinned population. Also, most of the reported cases were classified as pulmonary and as new cases that progressed to a cure. The areas with the highest density of cure, death and abandonment are located in the central region of the city. CONCLUSIONS: the central region of the urban area of the city, with high demographic density and poor sanitary and socioeconomic conditions, presented a greater cluster of tuberculosis cases.


Asunto(s)
Tuberculosis , Adulto , Brasil/epidemiología , Ciudades , Humanos , Masculino , Factores Socioeconómicos , Análisis Espacial , Resultado del Tratamiento , Tuberculosis/epidemiología
5.
Wei Sheng Yan Jiu ; 50(2): 217-222, 2021 Mar.
Artículo en Chino | MEDLINE | ID: mdl-33985624

RESUMEN

OBJECTIVE: The spatial interpolation method was used to estimate the intake of sodium in the areas without dietary sodium intake data. METHODS: The data of dietary sodium consumption in this study are from the 2010-2012 China National Nutrition and Health Surveillance(CNNHS), the CNNHS was carried out on stratified multistage systematic clustered random sampling method with proportional to the population to form a representative sample of China as a whole, including 150 survey site. Dietary data was collected through face-to-face interview, based on a combination of three consecutive days of 24-h recalls combined with a household food weighting method, a total of 48 826 participants aged 20 years old and more were recruited in this study. The average sodium intake among 150 survey sites were calculated according to data of the CNNHS 2010-2012. The accuracy of spatial analysis techniques, such as Inverse Distance Weight, Ordinary Kriging, Cooperative Kriging method and Regression Kriging Interpolation method, was compared in the estimation of dietary sodium intake. The spatial analysis method with the highest accuracy was used to estimate the daily dietary sodium intake of each district and county in China, and then the dietary sodium intake of each province was calculated according to the population weight. RESULTS: The average sodium intake among Chinese adults was 5. 18 g, among which the average intake of men is 5. 33 g and that of women was 5. 03 g. Comparing the accuracy of four spatial analysis method in estimating dietary sodium intake, it was found that the Regression Kriging Interpolation method was superior to the other three methods, with root mean square error and mean absolute error of 0. 54 and 0. 44. The Regression Kriging Interpolation method was used to estimate the dietary sodium intake in different regions of China, the estimated national dietary sodium intake by population weighted calculation was 5. 17 g/d, the estimated national dietary sodium intake was 5. 33 g/d for men and 5. 01 g/d for women. The difference rate between the measured and estimated dietary sodium intake for all age groups was not more than 10%. Shandong Province, Tianjin City and Hebei Province had the highest sodium intake, which was 5. 98 g/d, 5. 83 g/d and 5. 82 g/d, respectively. Guizhou Province had the lowest sodium intake, with an estimated intake value of 4. 27 g/d. CONCLUSION: The spatial interpolation method can be used to estimate the intake of sodium, and the accuracy of Regression Kriging Interpolation method is higher than other spatial interpolation method.


Asunto(s)
Sodio en la Dieta , Sodio , Adulto , China , Dieta , Femenino , Humanos , Masculino , Análisis Espacial , Adulto Joven
6.
Int J Health Geogr ; 20(1): 22, 2021 05 19.
Artículo en Inglés | MEDLINE | ID: mdl-34011390

RESUMEN

BACKGROUND: Healthcare accessibility, a key public health issue, includes potential (spatial accessibility) and realized access (healthcare utilization) dimensions. Moreover, the assessment of healthcare service potential access and utilization should take into account the care provided by primary and secondary services. Previous studies on the relationship between healthcare spatial accessibility and utilization often used conventional statistical methods without addressing the scale effect and spatial processes. This study investigated the impact of spatial accessibility to primary and secondary healthcare services on length of hospital stay (LOS), and the efficiency of using a geospatial approach to model this relationship. METHODS: This study focused on the ≥ 75-year-old population of the Nord administrative region of France. Inpatient hospital spatial accessibility was computed with the E2SFCA method, and then the LOS was calculated from the French national hospital activity and patient discharge database. Ordinary least squares (OLS), spatial autoregressive (SAR), and geographically weighted regression (GWR) were used to analyse the relationship between LOS and spatial accessibility to inpatient hospital care and to three primary care service types (general practitioners, physiotherapists, and home-visiting nurses). Each model performance was assessed with measures of goodness of fit. Spatial statistical methods to reduce or eliminate spatial autocorrelation in the residuals were also explored. RESULTS: GWR performed best (highest R2 and lowest Akaike information criterion). Depending on global model (OLS and SAR), LOS was negatively associated with spatial accessibility to general practitioners and physiotherapists. GWR highlighted local patterns of spatial variation in LOS estimates. The distribution of areas in which LOS was positively or negatively associated with spatial accessibility varied when considering accessibility to general practitioners and physiotherapists. CONCLUSIONS: Our findings suggest that spatial regressions could be useful for analysing the relationship between healthcare spatial accessibility and utilization. In our case study, hospitalization of elderly people was shorter in areas with better accessibility to general practitioners and physiotherapists. This may be related to the presence of effective community healthcare services. GWR performed better than LOS and SAR. The identification by GWR of how these relationships vary spatially could bring important information for public healthcare policies, hospital decision-making, and healthcare resource allocation.


Asunto(s)
Accesibilidad a los Servicios de Salud , Regresión Espacial , Anciano , Francia/epidemiología , Humanos , Análisis de los Mínimos Cuadrados , Análisis Espacial
7.
Geospat Health ; 16(1)2021 05 05.
Artículo en Inglés | MEDLINE | ID: mdl-33969966

RESUMEN

Coronavirus disease 2019 (COVID-19) is the current worldwide pandemic as declared by the World Health Organization (WHO) in March 2020. Being part of the ongoing global pandemic, Malaysia has recorded a total of 8639 COVID-19 cases and 121 deaths as of 30th June 2020. This study aims to detect spatial clusters of COVID-19 in Malaysia using the Spatial Scan Statistic (SaTScan™) to guide control authorities on prioritizing locations for targeted interventions. The spatial analyses were conducted on a monthly basis at the state-level from March to September 2020. The results show that the most likely cluster of COVID-19 occurred in West Malaysia repeatedly from March to June, covering three counties (two federal territories and one neighbouring state) and moved to East Malaysia in July covering two other counties. The most likely cluster shows a tendency of having moved from the western part to the eastern part of the country. These results provide information that can be used for the evidence- based interventions to control the spread of COVID-19 in Malaysia.


Asunto(s)
COVID-19 , Análisis por Conglomerados , Humanos , Malasia/epidemiología , SARS-CoV-2 , Análisis Espacial
8.
BMC Infect Dis ; 21(1): 430, 2021 May 07.
Artículo en Inglés | MEDLINE | ID: mdl-33962557

RESUMEN

BACKGROUND: The upsurge in HIV infections among students is a matter of particular concern. However, few studies have explored the epidemiological characteristics including the risky sexual networking of HIV-infected students in Zhejiang province, China. METHODS: Using the provincial surveillance data of HIV-infected students, we conducted a retrospective epidemiology study to describe the epidemiological characteristics of 628 newly diagnosed cases from 2011 to 2016 and detailed information of 124 cases from 2015 to 2016. Spatial analyses were conducted using ArcGIS software, and statistical analyses were performed using SPSS software. RESULTS: A total of 628 cases of HIV/AIDS were diagnosed among students in Zhejiang Province, China between 2011 and 2016. The cases showed an overall increasing trend over time, while the proportions of students with HIV disease status, cases diagnosed by HIV voluntary counseling and testing (VCT), and cases of homosexual transmission remained stable over time. Significant spatial heterogeneity in the cases was seen at the county level. Detailed data on 124 HIV-positive individuals collected from the local Center for Disease Control and Prevention (CDC) from 2015 and 2016, showed that the majority of them (85.5%,) engaged in homosexual behavior, and 93.4% had sex with casual partners. These partners included not only social members, but also other students. Online dating applications represented the most common means of seeking and communicating with homosexual partners. The level of awareness regarding the risk of HIV infection, and the amount coverage of face-to-face education towards students were both low. CONCLUSIONS: HIV infections among students were characterized by increasing trend and spatial clustering in Zhejiang Province between 2011 and 2016, with homosexual sexual activity being the main mode of infection. Interventions are urgently required to prevent HIV infection in this population by increasing awareness of the disease. HIV testing programs and information regarding disease prevention specifically through online dating applications are needed.


Asunto(s)
Infecciones por VIH/epidemiología , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Adulto , China/epidemiología , Femenino , Seropositividad para VIH , Humanos , Masculino , Estudios Retrospectivos , Conducta Sexual , Minorías Sexuales y de Género , Análisis Espacial , Estudiantes/estadística & datos numéricos , Adulto Joven
9.
Global Health ; 17(1): 56, 2021 05 20.
Artículo en Inglés | MEDLINE | ID: mdl-34016145

RESUMEN

BACKGROUND: COVID-19 is an emergent infectious disease that has spread geographically to become a global pandemic. While much research focuses on the epidemiological and virological aspects of COVID-19 transmission, there remains an important gap in knowledge regarding the drivers of geographical diffusion between places, in particular at the global scale. Here, we use quantile regression to model the roles of globalisation, human settlement and population characteristics as socio-spatial determinants of reported COVID-19 diffusion over a six-week period in March and April 2020. Our exploratory analysis is based on reported COVID-19 data published by Johns Hopkins University which, despite its limitations, serves as the best repository of reported COVID-19 cases across nations. RESULTS: The quantile regression model suggests that globalisation, settlement, and population characteristics related to high human mobility and interaction predict reported disease diffusion. Human development level (HDI) and total population predict COVID-19 diffusion in countries with a high number of total reported cases (per million) whereas larger household size, older populations, and globalisation tied to human interaction predict COVID-19 diffusion in countries with a low number of total reported cases (per million). Population density, and population characteristics such as total population, older populations, and household size are strong predictors in early weeks but have a muted impact over time on reported COVID-19 diffusion. In contrast, the impacts of interpersonal and trade globalisation are enhanced over time, indicating that human mobility may best explain sustained disease diffusion. CONCLUSIONS: Model results confirm that globalisation, settlement and population characteristics, and variables tied to high human mobility lead to greater reported disease diffusion. These outcomes serve to inform suppression strategies, particularly as they are related to anticipated relocation diffusion from more- to less-developed countries and regions, and hierarchical diffusion from countries with higher population and density. It is likely that many of these processes are replicated at smaller geographical scales both within countries and within regions. Epidemiological strategies must therefore be tailored according to human mobility patterns, as well as countries' settlement and population characteristics. We suggest that limiting human mobility to the greatest extent practical will best restrain COVID-19 diffusion, which in the absence of widespread vaccination may be one of the best lines of epidemiological defense.


Asunto(s)
COVID-19/prevención & control , Internacionalidad , Conducta Social , Análisis Espacial , COVID-19/transmisión , Humanos , Pandemias/prevención & control , Pandemias/estadística & datos numéricos
10.
Nat Commun ; 12(1): 2978, 2021 05 20.
Artículo en Inglés | MEDLINE | ID: mdl-34017002

RESUMEN

African lions (Panthera leo) and African savanna (Loxodonta africana) and forest (L. cyclotis) elephants pose threats to people, crops, and livestock, and are themselves threatened with extinction. Here, we map these human-wildlife conflicts across Africa. Eighty-two percent of sites containing lions and elephants are adjacent to areas with considerable human pressure. Areas at severe risk of conflict (defined as high densities of humans, crops, and cattle) comprise 9% of the perimeter of these species' ranges and are found in 18 countries hosting, respectively, ~ 74% and 41% of African lion and elephant populations. Although a variety of alternative conflict-mitigation strategies could be deployed, we focus on assessing the potential of high-quality mitigation fences. Our spatial and economic assessments suggest that investments in the construction and maintenance of strategically located mitigation fences would be a cost-effective strategy to support local communities, protect people from dangerous wildlife, and prevent further declines in lion and elephant populations.


Asunto(s)
Conservación de los Recursos Naturales/métodos , Elefantes , Interacción Humano-Animal , Leones , África , Distribución Animal , Crianza de Animales Domésticos , Migración Animal , Animales , Bovinos , Productos Agrícolas , Bosques , Pradera , Humanos , Dinámica Poblacional , Análisis Espacial
11.
J Environ Manage ; 292: 112773, 2021 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-34022649

RESUMEN

Outdoor recreation decision-making has received significant research interest over the last fifty years. In the context of campsite choice, this previous research has almost exclusively used stated preference data and aspatial methods to understand decision-making. This present research seeks to understand how recreationists reach decisions on the selection of campsites and what aspects of the recreational setting drive demand through an examination of a big dataset of revealed preference data using a spatial regression. Specifically, we examine which managerial, social, and ecological aspects of the setting influence demand for campsites in Zion National Park's (USA) Watchman Campground using reservation data from the Recreation Information Database (RIDB). Results indicate that price, access to electricity, ease of access, and proximity to the Virgin River are significantly predictive of demand. Study implications for park management, including campsite allocation and distributive justice, are provided. Additionally, implications for future research methodology, including the use of transaction-style big data in protected area management research, are discussed.


Asunto(s)
Macrodatos , Recreación , Ríos , Análisis Espacial
12.
Nat Commun ; 12(1): 3199, 2021 05 27.
Artículo en Inglés | MEDLINE | ID: mdl-34045463

RESUMEN

In patients with metastatic cancer, spatial heterogeneity of somatic alterations may lead to incomplete assessment of a cancer's mutational profile when analyzing a single tumor biopsy. In this study, we perform sequencing of cell-free DNA (cfDNA) and distinct metastatic tissue samples from ten rapid autopsy cases with pre-treated metastatic cancer. We show that levels of heterogeneity in genetic biomarkers vary between patients but that gene expression signatures representative of the tumor microenvironment are more consistent. Across nine patients with plasma samples available, we are able to detect 62/62 truncal and 47/121 non-truncal point mutations in cfDNA. We observe that mutation clonality in cfDNA is correlated with the number of metastatic lesions in which the mutation is detected and use this result to derive a clonality threshold to classify truncal and non-truncal driver alterations with reasonable specificity. In contrast, mutation truncality is more often incorrectly assigned when studying single tissue samples. Our results demonstrate the utility of a single cfDNA sample relative to that of single tissue samples when treating patients with metastatic cancer.


Asunto(s)
Autopsia/métodos , ADN Tumoral Circulante/genética , Análisis Mutacional de ADN/métodos , Neoplasias/diagnóstico , Microambiente Tumoral/genética , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Biomarcadores de Tumor/genética , Quimioradioterapia Adyuvante , Estudios de Cohortes , Variaciones en el Número de Copia de ADN , Femenino , Heterogeneidad Genética , Humanos , Masculino , Terapia Neoadyuvante , Neoplasias/sangre , Neoplasias/patología , Neoplasias/terapia , Mutación Puntual , RNA-Seq , Valores de Referencia , Sensibilidad y Especificidad , Análisis Espacial , Factores de Tiempo , Secuenciación del Exoma Completo
13.
Infect Dis Poverty ; 10(1): 74, 2021 May 20.
Artículo en Inglés | MEDLINE | ID: mdl-34011383

RESUMEN

BACKGROUND: Oncomelania hupensis is only intermediate snail host of Schistosoma japonicum, and distribution of O. hupensis is an important indicator for the surveillance of schistosomiasis. This study explored the feasibility of a random forest algorithm weighted by spatial distance for risk prediction of schistosomiasis distribution in the Yangtze River Basin in China, with the aim to produce an improved precision reference for the national schistosomiasis control programme by reducing the number of snail survey sites without losing predictive accuracy. METHODS: The snail presence and absence records were collected from Anhui, Hunan, Hubei, Jiangxi and Jiangsu provinces in 2018. A machine learning of random forest algorithm based on a set of environmental and climatic variables was developed to predict the breeding sites of the O. hupensis intermediated snail host of S. japonicum. Different spatial sizes of a hexagonal grid system were compared to estimate the need for required snail sampling sites. The predictive accuracy related to geographic distances between snail sampling sites was estimated by calculating Kappa and the area under the curve (AUC). RESULTS: The highest accuracy (AUC = 0.889 and Kappa = 0.618) was achieved at the 5 km distance weight. The five factors with the strongest correlation to O. hupensis infestation probability were: (1) distance to lake (48.9%), (2) distance to river (36.6%), (3) isothermality (29.5%), (4) mean daily difference in temperature (28.1%), and (5) altitude (26.0%). The risk map showed that areas characterized by snail infestation were mainly located along the Yangtze River, with the highest probability in the dividing, slow-flowing river arms in the middle and lower reaches of the Yangtze River in Anhui, followed by areas near the shores of China's two main lakes, the Dongting Lake in Hunan and Hubei and the Poyang Lake in Jiangxi. CONCLUSIONS: Applying the machine learning of random forest algorithm made it feasible to precisely predict snail infestation probability, an approach that could improve the sensitivity of the Chinese schistosome surveillance system. Redesign of the snail surveillance system by spatial bias correction of O. hupensis infestation in the Yangtze River Basin to reduce the number of sites required to investigate from 2369 to 1747.


Asunto(s)
Ríos/parasitología , Schistosoma japonicum/aislamiento & purificación , Caracoles/fisiología , Animales , Cruzamiento , China , Monitoreo del Ambiente , Estudios de Factibilidad , Aprendizaje Automático , Modelos Teóricos , Vigilancia de la Población , Caracoles/parasitología , Análisis Espacial
14.
Front Public Health ; 9: 673778, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34017814

RESUMEN

A growing body of research has documented the determinants of healthcare expenditure, but no known empirical research has focused on investigating the spatial effects between economic policy uncertainty (EPU) and healthcare expenditure. This study aims to explore the spatial effects of EPU on healthcare expenditure using the panel data of 29 regions in China from 2007 to 2017. Our findings show that healthcare expenditure in China has the characteristics of spatial clustering and spatial spillover effects. Our study also shows that EPU has positive spatial spillover effects on healthcare expenditure in China; that is, EPU affects not only local healthcare expenditure but also that in other geographically close or economically connected regions. Our study further indicates that the spatial spillover effects of EPU on healthcare expenditure only exist in the eastern area. The findings of this research provide some key implications for policymakers in emerging markets.


Asunto(s)
Atención a la Salud , Gastos en Salud , China , Análisis Espacial , Incertidumbre
15.
Geospat Health ; 16(1)2021 05 14.
Artículo en Inglés | MEDLINE | ID: mdl-34000787

RESUMEN

Exposure to asbestos causes a wide range of diseases, such as asbestosis, malignant mesothelioma (MM) and other types of cancer. Many European countries have reduced production and use of asbestos and some have banned it altogether. Based on data derived from the World Health Organisation (WHO) Cancer Mortality Database, we investigated whether some regions in Europe could have a higher relative risk of MM incidence than others. The data were compared, including the number of MM deaths per million inhabitants and aged-standardized mortality rates. Applying Moran's I and Getis-Ord Gi statistic on the agedstandardized mortality rates of MM cases assisted the spatial analysis of the occurrence of health events leading to an assessment of the heterogeneity of distribution and cluster detection of MM. We found a statistically significant positive autocorrelation for the male population and also the general population, while there was no statistically significant positive one for the female population. Hotspots of relative risk of developing MM were found in northwestern Europe. For the general population, Great Britain and the Netherlands stood out with high levels at the 99% and 95% confidence levels, respectively. For the male population, the results were similar, but with addition of risk also in Belgium and Switzerland. However, in many European countries with high asbestos use per capita, the MM incidence was found to still be low. The reasons for this are not yet clear, but part of the problem is certainly due to incomplete data in registers and databases. The latency time can be longer than 40 years and is related to the intensity and time of exposure (occupational, para-occupational and environmental). In Europe, even though peak production occurred in the 1960s and 1970s, a significant decrease in production did not occur until 25 years later, which means that the impact will continue for as late as The mid 2030s.


Asunto(s)
Asbestos , Neoplasias Pulmonares , Mesotelioma Maligno , Mesotelioma , Anciano , Análisis por Conglomerados , Europa (Continente)/epidemiología , Femenino , Humanos , Neoplasias Pulmonares/epidemiología , Masculino , Mesotelioma/epidemiología , Análisis Espacial , Suiza
16.
Geospat Health ; 16(1)2021 05 11.
Artículo en Inglés | MEDLINE | ID: mdl-34000792

RESUMEN

Cancer is a problem of both global and local concern. We determined the geo-epidemiological and spatial distribution of the 10 most common cancers in Iran. We used the data of the Iranian Cancer Registry for the year 2014 analysing the prevalence of 112,131 registered cancer cases with the aim of detecting potential geographical underlying causes. The geographic distribution of cancers is reported as standardized incidence rates at the provincial level considering risk with respect to sex and age. A geographical information systems (GIS) approach based on Anselin Local Moran's index method was used to map clusters and spatial autocorrelation patterns. The mean age of the patients was 55.6 (±17.8) and 61.7 (±18.2) for females and males, respectively, in the database which showed 46.1% (n=51,665) of all cases to be female. Analysis of the spatial distribution of cancers showed significant differences among the different provinces. Stomach and breast cancers were the most prevalent cancers in men and females, respectively. The highest incidence rates of stomach cancer were found in Ardabil and Zanjan provinces, with 48.38 and 48.08 per 100,000 population, respectively, while Tehran and Yazd provinces had the highest incidences of breast cancer, 51.0 and 47.5 per 100,000 population, respectively. Strong clustering patterns for stomach and breast cancers were identified in the north-western provinces and in Semnan Province, respectively. These patterns indicate a diversity of geo-epidemiological contributing factors to cancer incidence in Iran.


Asunto(s)
Neoplasias , Análisis por Conglomerados , Femenino , Humanos , Incidencia , Irán/epidemiología , Masculino , Neoplasias/epidemiología , Sistema de Registros , Análisis Espacial
17.
Stud Health Technol Inform ; 278: 118-125, 2021 May 24.
Artículo en Inglés | MEDLINE | ID: mdl-34042884

RESUMEN

The main goal of this project was to define and evaluate a new unsupervised deep learning approach that can differentiate between normal and anomalous intervals of signals like the electrical activity of the heart (ECG). Denoising autoencoders based on recurrent neural networks with gated recurrent units were used for the semantic encoding of such time frames. A subsequent cluster analysis conducted in the code space served as the decision mechanism labelling samples as anomalies or normal intervals, respectively. The cluster ensemble method called cluster-based similarity partitioning proved itself well suited for this task when used in combination with density-based spatial clustering of applications with noise. The best performing system reached an adjusted Rand index of 0.11 on real-world ECG signals labelled by medical experts. This corresponds to a precision and recall regarding the detection task of around 0.72. The new general approach outperformed several state-of-the-art outlier recognition methods and can be applied to all kinds of (medical) time series data. It can serve as a basis for more specific detectors that work in an unsupervised fashion or that are partially guided by medical experts.


Asunto(s)
Redes Neurales de la Computación , Semántica , Análisis por Conglomerados , Corazón , Análisis Espacial
18.
BMC Public Health ; 21(1): 966, 2021 05 22.
Artículo en Inglés | MEDLINE | ID: mdl-34020620

RESUMEN

BACKGROUND: China is one of the world's fastest-aging countries. Population aging and social-economic development show close relations. This study aims to illustrate the spatial-temporal distribution and movement of gravity centers of population aging and social-economic factors and thier spatial interaction across the provinces in China. METHODS: Factors of elderly population rate (EPR), elderly dependency ratio (EDR), per capita gross regional product (GRPpc), and urban population rate (UPR) were collected. Distribution patterns were detected by using global spatial autocorrelation, Kernel density estimation, and coefficient of variation. Further, Arc GIS software was used to find the gravity centers and their movement trends yearly from 2002 to 2018. The spatial interaction between the variables was investigated based on bivariate spatial autocorrelation analysis. RESULTS: The results showed a larger variety of global spatial autocorrelation indexed by Moran's I and stable trends of dispersion degree without obvious convergence in EPR and EDR. Furthermore, the gravity centers of the proportion of EPR and EDR moved northeastward. In contrast, the economic and urbanization factors showed a southwestward movement, which exhibited an reverse trend compared to population aging indicators. Moreover, the movement rates of EPR and EDR (15.12 and 18.75 km/year, respectively) were higher than that of GRPpc (13.79 km/year) and UPR (6.89 km/year) annually during the study period. Further, the bivariate spatial autocorrelation variation is in line with the movement trends of gravity centers which showed a polarization trend of population aging and social-economic factors that the difference between southwest and northeast directions and exhibited a tendency to expand in China. CONCLUSIONS: In sum, our findings revealed the difference in spatio-temporal distribution and variation between population aging and social-economic factors in China. It further indicates that the opposite movements of gravity centers and the change of the BiLISA in space which may result in the increase of the economic burden of the elderly care in northern China. Hence, future development policy should focus on the social-economic growth and distribution of old-aged supporting resources, especially in northern China.


Asunto(s)
Envejecimiento , Urbanización , Anciano , China/epidemiología , Humanos , Persona de Mediana Edad , Análisis Espacial , Población Urbana
19.
Pan Afr Med J ; 38: 159, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33995766

RESUMEN

Introduction: the new coronavirus (COVID-19) that emerged from Wuhan, Hubei Province of China in December 2019, causing severe acute respiratory syndrome (SARS) has fast spread across the entire globe, with most countries struggling to slow and reduce the spread of the virus through rapid screening, testing, isolation, case management, contact tracing, implementing social distancing and lockdowns. This has been shown to be a major factor in countries that have been successful in containing COVID-19 transmission. Early detection of cases is important, and the use of geospatial technology can support to detect and easily identify potential hotspots that will require timely response. The use of spatial analysis with geographic information systems (GIS) had proved to be effective in providing timely and effective solutions in supporting epidemic response and pandemics over the years. It has developed and evolved rapidly with a complete technological tool for representing data, model construction, visualization and platform construction among others. Methods: we conducted a geospatial analysis to develop a web mapping application using ArcMap and ArcGIS online to guide and support active case search of potential COVID-19 cases, within 500m radius of COVID-19 confirmed cases to improve detection and testing of suspected cases. Results: the web mapping application tool guides the active case search teams in the field, with clear boundaries on the houses to be visited within 500-meter radius of confirmed positive cases, to conduct active case search of all cases of severe acute respiratory illnesses (SARI), acute respiratory illnesses (ARI), pneumonia etc, to detect and test for COVID-19 towards containing the pandemic. Conclusion: the use of GIS and spatial statistical tools have become an important and valuable tool in decision-making and, more importantly, guiding health care professional and other stakeholders in the response being carried out in a more coherent and easy manner. It has proven to be effective in supporting the active case search process to rapidly detect, test and isolate cases during the process, towards containing the COVID-19 pandemic.


Asunto(s)
COVID-19/epidemiología , Sistemas de Información Geográfica , Salud Pública , COVID-19/diagnóstico , Estudios Transversales , Humanos , Síndrome Respiratorio Agudo Grave/virología , Análisis Espacial , Zimbabwe/epidemiología
20.
Soc Sci Med ; 278: 113952, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-33933801

RESUMEN

Type 1 Diabetes (T1D) poses an increasing threat to public health, as incidence rates continue to rise globally. However, the etiology of T1D is still poorly understood, especially from the perspective of geography. The objective of this research is to examine the incidence of T1D among youth and to identify high-risk clusters and their association with socio-demographic and geographic variables. The study area was the entire state of Utah and included youth with T1D from birth to 19 years of age from 1998 to 2015 (n = 4161). Spatial clustering was measured both globally and locally using the Moran's I statistic and spatial scan statistic. Ordinary least squares (OLS) regression was used to measure the association of high-risk clusters with certain risk factors at the Census Block Group (CBG) level. The mean age at diagnosis was 9.3 years old. The mean incidence rate was 25.67 per 100,000 person-years (95% CI, 24.57-26.75). The incidence rate increased by 14%, from 23.94 per100,000 person-years in 1998 to 27.98 per 100,000 person-years in 2015, with an annual increase of 0.80%. The results of the spatial scan statistic found 42 high-risk clusters throughout the state. OLS regression analysis found a significant association with median household income, population density, and latitude. This study provides evidence that incidence rates of T1D are increasing annually in the state of Utah and that significant geographic high-risk clusters are associated with socio-demographic and geographic factors.


Asunto(s)
Diabetes Mellitus Tipo 1 , Adolescente , Niño , Análisis por Conglomerados , Diabetes Mellitus Tipo 1/epidemiología , Geografía , Humanos , Incidencia , Análisis Espacial , Utah/epidemiología
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