Características demográficas, socioeconômicas e da procura dos usuários em um serviço de reabilitação física de referência estadual, Mato Grosso, 2021 / Demographic, socioeconomic and service demand features of users in a state reference physical rehabilitation service, Mato Grosso, 2021 / Características demográficas, socioeconómicas y de la demanda de los usuarios en un servicio de rehabilitación física de referencia estatal, Mato Grosso, 2021

Introdução: O estudo dos fatores sociodemográficos e socioeconômicos de usuários doSistema Único de Saúde éimportante para o planejamento e a avaliação das ações dos serviços de saúde procurados por esta população. Objetivo:Descrever as características demográficas, socioeconômicas e da procura dos usuários adultos com demanda dereabilitação física ortopédica e neurológica emum Centro Especializado em Reabilitação de referência no Estado de Mato Grosso. Metodologia:Estudo observacional descritivo baseado nos prontuários dosetor de acolhimento de um Centro Especializado em Reabilitação de Mato Grosso,de fevereiro a maio de 2021. Foram analisados dados demográficos e socioeconômicos de usuários adultos de ambos os sexos. Utilizou-se o teste de qui-quadrado de Pearson para as associações entre as variáveis segundo eixo de reabilitação (ortopédica e neurológica). Resultados:Dos196 prontuários analisados,94% dos usuários eram procedentes de Cuiabá, comidade média de 50,3 anos, sendo 52,55% do sexo feminino. Aprocura pelo serviçofoi de 69%pela reabilitação ortopédica (69%) e de 31%reabilitação neurológica. Observaram-se diferenças estatisticamente significantes entre as frequências nos dois eixos dereabilitação física estudados nas variáveis idade (p=0,0005), escolaridade (p=0,0031), principal atividade de trabalho (p=0,0045), doenças concomitantes (p=0,0016), tratamento em outro estabelecimento de saúde (p=0,0041) e motivo da procura pela reabilitação (p<0,0001). Conclusões:Osresultados mostraram que os casos neurológicos possuem maior idade, baixo nível de escolaridadeepequeno percentual de trabalho remuneradoem relação aos casos ortopédicos. Tais resultados sugerem que as necessidades de saúde e de reabilitação dependem da singularidade dos casos e podem subsidiara efetivação depolíticas públicas que favoreçam a reorganização dos serviços e a articulação intersetorial entre saúde, educação emercado de trabalho (AU).

Introduction: Assessing sociodemographic and socioeconomic factors related to Unified Health System's users is essential to plan and evaluate the actions by the health services sought by them.Aim: Describing the demographic and socioeconomic features of adult users, and their search for having their orthopedic and neurological-physical rehabilitation demands fulfilled by a Specialized Center in Orthopedic and Neurological Rehabilitation in Mato Grosso State.Methodology: Observational descriptive study based on medical records collected between February and March 2021, provided by the welcoming sector of a Specialized Center in Rehabilitation in Mato Grosso State. Demographic and socioeconomic records of adult users belonging to both sexes were analyzed. Person's chi-square test was adopted to associate the variables based on the orthopedic and neurological rehabilitation axes.Results: In total, 94% of the 196 analyzed medical records regard patients from Cuiabá, in the mean age group 50.3 years; 52.55% of them belonged to the female sex. The search for orthopedic rehabilitation reached 69% and that for neurological rehabilitation recorded 31%. There were significant statistical differences between frequencies on the two assessed physical rehabilitation axes based on variables such as age (p=0.0005), schooling (p=0.0031), main labor activity (p=0.0045), concomitant diseases (p=0.0016), treatment provided in another health establishment (p=0.0041) and reason for seeking rehabilitation (p<0.0001). Conclusions: Results have shown that neurological cases are linked to older age, low schooling and low rate of paid work in comparison to orthopedic cases. These results have suggested that health and rehabilitation needs depend on cases' particularities; moreover, they can subsidize the process to make public policies to reinforce services'organization, as well as inter-sectoral articulation among health, education and labor market, effective (AU).

Introducción: El estudio de los factores sociodemográficos y socioeconómicos de los usuarios del Sistema Único de Salud es importante para planificar y evaluar las acciones de los servicios de salud buscados por esta población.Objetivo: Describir las características demográficas, socioeconómicas y de demanda de usuarios adultos con demanda de rehabilitación física ortopédica y neurológica en un Centro Especializado de Rehabilitación de Referencia en el Estado de Mato Grosso.Metodología: Estudio observacional descriptivo basado en las historias clínicas del sector de acogimiento de un Centro Especializado de Rehabilitación en Mato Grosso, de febrero a mayo de 2021. Se analizaron datos demográficos y socioeconómicos de usuarios adultos de ambos sexos. Se utilizóla prueba de chi-cuadrado de Pearson para las asociaciones entre las variables según el eje de rehabilitación (ortopédico y neurológico).Resultados: De las 196 historias clínicas analizadas, 94% de los usuarios provenían de Cuiabá, con una edad promedio de 50,3 años, de los cuales 52,55% eran de sexo femenino. La demanda del servicio fue del 69% para la rehabilitación ortopédica (69%) y del 31% para la rehabilitación neurológica. Se observaron diferencias estadísticamente significativas entre las frecuencias en los dos ejes de rehabilitación física estudiados en las variables edad (p=0,0005), escolaridad (p=0,0031), actividad laboral principal (p=0,0045), enfermedades concomitantes (p=0,0016), tratamiento en otro establecimiento de salud (p=0,0041) y motivo de búsqueda de rehabilitación (p <0,0001). Conclusiones:Los resultados mostraron que los casos neurológicos tienen mayor edad, bajo nivel de educación y un pequeño porcentaje de trabajo remunerado en relación con los casos ortopédicos. Estos resultados sugieren que las necesidades de salud y rehabilitación dependen de la singularidad de los casos y pueden apoyar la implementación de políticas públicas que favorezcan la reorganización de los servicios y la articulación intersectorial entre salud, educación y mercado laboral (AU).

The association between child maltreatment and health risk behaviours and conditions throughout life in the Australian Child Maltreatment Study.

OBJECTIVE: To estimate associations between all five types of child maltreatment (emotional abuse, neglect, physical abuse, sexual abuse, and exposure to domestic violence) and health risk behaviours and conditions. DESIGN, SETTING, PARTICIPANTS: Nationally representative survey of Australian residents aged 16 years and older conducted by computer-assisted telephone interviewing. MAIN OUTCOME MEASURES: Associations between child maltreatment and the following health risk behaviours and conditions: current smoker, binge drinking (at least weekly in past 12 months), cannabis dependence (according to the Cannabis Severity of Dependence Scale), obesity (based on body mass index), self-harm in past 12 months, and suicide attempt in past 12 months. RESULTS: A total of 8503 participants completed the survey. All five types of child maltreatment were associated with increased rates of all of the health risk behaviours and conditions that we considered. The strongest associations were in the youngest age group (16-24-year-olds). Sexual abuse and emotional abuse were associated with the highest odds of health risk behaviours and conditions. Cannabis dependence, self-harm and suicide attempts were most strongly associated with child maltreatment. Experiencing more than one type of child maltreatment was associated with higher rates of health risk behaviours and conditions than experiencing one type of child maltreatment. CONCLUSIONS: Child maltreatment is associated with substantially increased rates of health risk behaviours and conditions. Prevention and intervention efforts should be informed by trauma histories, and holistic psychosocial care should be incorporated into programs focusing on behaviour change.

Self-rated health status and associated factors in rural workers.

BACKGROUND: Self-rated health status can be considered a good predictor of morbidity and mortality and has been used due to its easy assessment and applicability. The instrument is efficient for understanding sociodemographic, environmental and clinical conditions that may be related to the self-rated health status. Thus, this study aims to analyze the self-assessment of health status in rural workers and its association with socioeconomic characteristics, lifestyle, clinical condition and work characteristics. METHODS: This is a cross-sectional study carried out with 787 male and female rural reporting agriculture as their main source of income in the municipality of Santa Maria de Jetibá. A simple and direct question was used "In general, compared to people your age, how do you rate your own state of health?" to see how rural workers rate their current health status. The independent variables analyzed were socioeconomic, clinical, health and work conditions. The magnitude of the associations was evaluated by means of hierarchical logistic regression. RESULTS: It was found that 42.1% of rural workers self-rated their health status as regular or poor. Belonging to socioeconomic classes C (OR = 1.937; 95% CI = 1.009-3.720) or D/E (OR = 2.280; 95% CI = 1.178-4.415), being overweight (or having excess weight) (OR = 1.477; 95% CI = 1.086-2.008), multimorbidity (OR = 1.715; 95% CI = 1.201-2.447) and complex multimorbidity (OR = 1.738; 95% CI = 1.097-2.751) were risk factors for worse self-rated health. CONCLUSION: It was concluded that chronic diseases, socioeconomic status and overweight are risk factors for negative self-rated health. The identification of these determinants through self-rated status can support the planning of actions aimed at improving the health of the rural population. TRIAL REGISTRATION: This study was approved by the Research Ethics Committee of the Health Sciences Center of the Federal University of Espírito Santo (Protocol No. 2091172; CAAE No. 52839116.3.0000.5060). All research participants gave their informed consent.

Mixed Signals in Child and Adolescent Mental Health and Well-Being Indicators in the United States: A Call for Improvements to Population Health Monitoring.

Policy Points Social indicators of young peoples' conditions and circumstances, such as high school graduation, food insecurity, and smoking, are improving even as subjective indicators of mental health and well-being have been worsening. This divergence suggests policies targeting the social indicators may not have improved overall mental health and well-being. There are several plausible reasons for this seeming contradiction. Available data suggest the culpability of one or several common exposures poorly captured by existing social indicators. Resolving this disconnect requires significant investments in population-level data systems to support a more holistic, child-centric, and up-to-date understanding of young people's lives.

Health-Related Quality of Life in Osteoporosis Patients with and without Fractures in Tehran, Iran.

BACKGROUND: This study aimed to measure the health-related quality of life (HRQOL) of patients with osteoporosis with and without fractures in Tehran, the capital city of Iran. METHODS: We surveyed a sample of 478 patients with osteoporosis aged over 50 years. Participants with fractures included patients referred to hospitals due to osteoporotic fractures which were alive 6 months after the fracture. Participants without fractures were randomly selected from patients with a definite diagnosis of osteoporosis admitted to 3 outpatient clinics in Tehran. Data were collected using the EuroQol 5-dimensional 5-level questionnaire. Statistical differences between patients with and without fracture were tested with Pearson's χ2 test, Student's t-test, and the Mann-Whitney U-test. The association between HRQOL and other variables was evaluated using a multiple linear regression model. RESULTS: The patients' mean age±standard deviation was 67.3±11.9 years, and 74.1% were women. One hundred and seventeen (23%) patients had hip fractures, 56 (11%) had vertebral fractures, 127 (25%) had forearm fractures, and 178 (40%) had no fractures. The median (interquartile range) values of HRQOL scores of those with hip, vertebral, and forearm fractures and those with no history of fracture were 0.53 (0.22), 0.60 (0.28), 0.64 (0.26), and 0.64 (0.27), respectively. The multiple regression model revealed a significant relationship between the HRQOL scores and sex, marital status, employment status, presence of any chronic illness in addition to osteoporosis, and type of fracture. CONCLUSIONS: Osteoporosis and its related fractures can reduce the HRQOL.

Quality of life in patients with asthma: Medical indicators and psychological variables.

BACKGROUND: Quality of life (QoL) is a widely studied term concerning asthma because it allows the impact of the disease on the patient's life to be assessed through the patient's perception. The study aims to analyze which asthma-related, psychological, and family variables affect the QoL of adolescents with asthma. DESIGN AND METHODS: This cross-sectional design involves 150 patients diagnosed with asthma aged between 12 and 16 years. The patients' emotional symptomatology, the threat of illness, self-esteem, bonds, quality of life, family, and disease variables were assessed. Statistical analyses were performed using QCA models. RESULTS: The results indicate that girls have a poorer QoL, and age is negatively associated. QCA models found that the variables that best explained the quality of life of these patients, in the case of the medical indicators, were control, good compliance, shorter diagnosis times, and improvement. Regarding psychological variables: a lower threat of illness, less emotional distress, and better parental mood explained the high QoL. CONCLUSIONS AND PRACTICAL IMPLICATIONS: Adolescent QoL is affected by variables related to their asthma that are beyond their control and other psychological and family variables that may increase the perception of their QoL.

Influence of sports elective courses on college students' physical health / Influência dos cursos eletivos esportivos sobre a saúde física dos estudantes universitários / Influencia de las asignaturas deportivas optativas en la salud física de los estudiantes universitarios

ABSTRACT Introduction The college sports environment is characterized by breadth, diversity, and personality. This is an important period to develop students' physical ability and improve their personality. Objective Compare the effects of different exercise methods on students' health status. Methods 2991 college students participated in different sports activities. These sports were conducted based on the selection course (PE), all during one semester. The students' physical health status was observed through experiments performed before and after the intervention. Results Activities such as basketball and soccer showed high effectiveness in improving students' vital capacity index, volleyball expressively improved students' performance in the long jump, tennis and table tennis were effective in improving students' strength and adherence index, being lower in other indices. Martial arts also stood out in improving the students' vital capacity index. Conclusion Improving physical health should be an overall process of students' fitness development, and universities should actively encourage college students to participate in long-term sports to improve their health. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução O ambiente do esporte universitário é caracterizado pela abrangência, diversidade e personalidade. Este é um período importante para desenvolver a capacidade física dos estudantes e melhorar a sua personalidade. Objetivo Comparar os efeitos de diferentes métodos de exercício sobre o estado de saúde dos estudantes. Métodos 2991 estudantes universitários participaram de diferentes atividades esportivas. Estes esportes foram conduzidos com base no curso de seleção (PE), todos durante um semestre. O estado de saúde física dos estudantes foi observado através de experimentos executados previa e posteriormente à intervenção. Resultados Atividades como basquetebol e futebol demonstraram alta efetividade para melhorar o índice de capacidade vital dos estudantes, voleibol melhorou expressivamente o desempenho dos alunos no salto em distância, o tênis e o tênis de mesa foram efetivos para aprimorar o índice de força e de adesão dos alunos, sendo inferior noutros índices. Também as artes marciais se destacaram ao melhorar o índice de capacidade vital dos alunos. Conclusão O aprimoramento da saúde física deve ser um processo global de desenvolvimento da aptidão física dos estudantes e as universidades devem encorajar ativamente os estudantes universitários a participar de esportes de longo prazo para melhorar sua saúde. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción El entorno del deporte universitario se caracteriza por su alcance, diversidad y personalidad. Es un periodo importante para desarrollar la capacidad física de los alumnos y mejorar su personalidad. Objetivo Comparar los efectos de diferentes métodos de ejercicio sobre el estado de salud de los estudiantes. Métodos 2991 estudiantes universitarios participaron en diferentes actividades deportivas. Estos deportes se llevaron a cabo basándose en el curso de selección (PE), todo ello durante un semestre. El estado de salud física de los alumnos se observó mediante experimentos realizados antes y después de la intervención. Resultados Actividades como el baloncesto y el fútbol mostraron una alta eficacia para mejorar el índice de capacidad vital de los alumnos, el voleibol mejoró expresivamente el rendimiento de los alumnos en salto de longitud, el tenis y el tenis de mesa fueron eficaces para mejorar el índice de fuerza y adherencia de los alumnos, siendo inferiores en otros índices. También las artes marciales se destacaron en la mejora del índice de capacidad vital de los alumnos. Conclusión La mejora de la salud física debería ser un proceso global del desarrollo de la forma física de los estudiantes y las universidades deberían animar activamente a los universitarios a participar en deportes de larga duración para mejorar su salud. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Indicadores de resultados com pacientes críticos obtidos com o processo de enfermagem: Estudo de coorte prospetivo / Outcome indicators obtained from the nursing process: Prospective cohort study with critically ill patients / Indicadores de resultados con pacientes críticos obtenidos con el proceso de enfermería: estudio de cohorte prospectivo

Resumo Enquadramento: A implementação do processo de enfermagem contribui para a obtenção de indicadores de resultados que demonstram mudanças nos diagnósticos de enfermagem. Objetivo: Analisar indicadores de resultados obtidos a partir da implementação do processo de enfermagem com pacientes críticos. Metodologia: Coorte prospetivo com 109 pacientes críticos em amostra de conveniência. Foram calculadas taxas de prevalência e incidência diagnóstica, de efetividade diagnóstica do risco, efetividade na prevenção de complicações e de modificações positivas no estado dos diagnósticos reais. Resultados: O diagnóstico risco de infeção foi prevalente em 100% dos pacientes e o risco de desequilíbrio na temperatura corporal foi o mais incidente (33,9%). Os diagnósticos risco de infeção, risco de trauma vascular, risco de sangramento e risco de religiosidade prejudicada obtiveram a taxa de efetividade diagnóstica do risco de 100%. A taxa de efetividade na prevenção de quedas foi de 100%. A taxa de modificações positivas no estado do diagnóstico de hipotermia foi de 93,4%. Conclusão: Indicadores obtidos a partir do processo de enfermagem evidenciam resultados sensíveis à prática de enfermagem.

Abstract Background: The implementation of the nursing process contributes to obtaining outcome indicators that demonstrate changes in nursing diagnoses. Objective: To analyze outcome indicators obtained from the implementation of the nursing process with critically ill patients. Methodology: Prospective cohort study with a convenience sample of 109 critically ill patients. Rates of diagnostic prevalence and incidence, risk diagnostic effectiveness, effectiveness in preventing complications, and positive changes in the status of actual diagnoses were calculated. Results: The diagnosis of risk for infection was prevalent in 100% of patients and the diagnosis of risk for imbalanced body temperature had the highest incidence (33.9%). The diagnoses of risk for infection, risk for vascular trauma, risk for bleeding, and risk for impaired religiosity obtained a diagnostic effectiveness rate of 100%. The rate of effectiveness in preventing falls was 100%. The rate of positive changes in the diagnosis of hypothermia was 93.4%. Conclusion: Indicators obtained from the nursing process show nursing-sensitive outcomes.

Resumen Marco contextual: La aplicación del proceso de enfermería contribuye a la obtención de indicadores de resultados que demuestran cambios en los diagnósticos de enfermería. Objetivo: Analizar los indicadores de resultados obtenidos a partir de la aplicación del proceso de enfermería con pacientes críticos. Metodología: Cohorte prospectivo con 109 pacientes críticos en una muestra de conveniencia. Se calcularon las tasas de prevalencia e incidencia de los diagnósticos, de la eficacia de los diagnósticos de riesgo, de la eficacia en la prevención de complicaciones y de los cambios positivos en el estado de los diagnósticos reales. Resultados: El diagnóstico de riesgo de infección prevaleció en el 100% de los pacientes y el riesgo de desequilibrio de la temperatura corporal fue el más incidente (33,9%). Los diagnósticos de riesgo de infección, riesgo de traumatismo vascular, riesgo de sangrado y riesgo de deterioro de la religiosidad obtuvieron una tasa de eficacia diagnóstica del 100%. La tasa de eficacia en la prevención de caídas fue del 100%. La tasa de cambios positivos en el diagnóstico del estado de hipotermia fue del 93,4%. Conclusión: Los indicadores obtenidos del proceso de enfermería muestran resultados sensibles a la práctica enfermera.

Reliability and predictive validity of two scales of self-rated health in China: results from China Health and Retirement Longitudinal Study (CHARLS).

BACKGROUND: Despite the widespread use of the single item self-rated health (SRH) question, its reliability has never been evaluated in Chinese population. METHODS: We used data from the China Health and Retirement Longitudinal Study, waves 1-4 (2011-2019). In wave 1, the same SRH question was asked twice, separated by other questions, on a subset of 4533 subjects, allowing us to examine the test-retest reliability of SRH. In addition, two versions of SRH questions (the WHO and US versions) were asked (n = 11,429). Kappa (κ), weighted kappa ([Formula: see text]), and polychoric correlation coefficient (ρ) were used for reliability assessment. Cox proportional-hazards models were estimated to assess the predictive validity of SRH measurement for mortality over 7 years of follow up. To do so, relative index of inequality (RII) and slope index of inequality (SII) were estimated for each SRH scale. RESULTS: There was moderate to substantial test-retest reliability (κ = 0.54, [Formula: see text]=0.63) of SRH; 31% of respondents who used the same scale twice changed their ratings after answering other questions. There was strong positive association between the two SRH measured by the two scales (ρ > 0.8). Compared with excellent/very good SRH, adjusted hazard ratios (HR) of death are 2.30 (95% CI, 1.70-3.13) for the US version and 1.86 (95% CI, 1.33-2.60) for the WHO version. Using slope indices of inequality, the WHO version estimated slightly larger mortality differences (RII = 3.50, SII = 15.53) than the US version (RII = 3.25, SII = 14.80). CONCLUSIONS: In Chinese middle-aged and older population, the reliability of SRH is generally good, although the two commonly used versions of SRH scales could not be compared directly. Both indices predict mortality, with similar predictive validity.

[Factors associated with hospitalizations for primary care-sensitive conditions in Brazil: an ecological studyFactores asociados a las hospitalizaciones infantiles por afecciones que podrían tratarse en la atención primaria en Brasil: estudio ecológico]. / Fatores associados às internações infantis por condições sensíveis à atenção primária no Brasil: estudo ecológico.

Objective: To investigate whether structural aspects of primary care units (PCUs) and the work processes of primary care teams are associated with the rate of hospitalizations for primary care-sensitive conditions (HPCSC) in children younger than 5 years of age in Brazil. Method: For this longitudinal ecological study, secondary data were obtained from the Brazilian Hospital Information System and from three cycles of the National Program for Access and Quality Improvement in Primary Care (PMAQ-AB) (2012, 2014, 2017/2018). The analysis included 42 916 PCUs. A multilevel random intercept model with fixed slope was used. In the first level, the outcome (HPCSC rates) and explanatory variables (structure and process indicators) aggregated by PCU were analyzed. Social determinants (represented by a stratification criterion combining municipality population and health care management indicators) were entered in the second level. The t test with Bonferroni correction was used to compare indicator means between regions, and multilevel linear regression was used to estimate the correlation coefficients. Results: The HPCSC rate in children younger than 5 years was 62.78/100 thousand population per estimated PCU coverage area. A direct association with the outcome was observed for: participation in one or more PMAQ-AB cycles; team planning; special hours; dedicated pediatric care area; and availability of vaccines. Equipment, materials, supplies, and being a small or medium-size municipality were inversely associated with HPCSC. Conclusions: HPCSC rates in children below 5 years of age may potentially be reduced through improvements in PCU structure and process indicators and in municipal social determinants.

Objetivo: Determinar la asociación de la estructura de las unidades básicas de salud (UBS) y del proceso de trabajo de los equipos de atención primaria con los determinantes sociales y las tasas de hospitalización por afecciones que podrían tratarse en la atención primaria en menores de 5 años en Brasil. Métodos: Estudio longitudinal ecológico, con datos secundarios del Sistema de Informaciones Hospitalarias y los tres ciclos del Programa Nacional de Mejora del Acceso y de la Calidad de la Atención Básica (PMAQ-AB) (2012, 2014, 2017-2018). Se analizaron 42.916 UBS. Se aplicó un modelo multinivel con pendiente fija e intercepción aleatoria. En el primer nivel, se analizaron el desenlace (tasas de hospitalización por afecciones que podrían tratarse en los servicios de atención primaria) y las variables explicativas (indicadores estructurales y procedimentales) consolidados por UBS. En el segundo nivel, se incluyeron determinantes sociales municipales (representados por un criterio de estratificación que combina el tamaño del municipio con indicadores que influyen en la gestión de salud). Se utilizó la prueba de la t con la corrección de Bonferroni para comparar las medias de los indicadores entre las regiones y la regresión lineal multinivel para estimar los coeficientes de correlación. Resultados: La tasa de hospitalización por afecciones que podrían tratarse en los servicios de atención primaria en menores de 5 años fue de 62,78/100 mil habitantes por área estimada de cobertura de UBS. Los siguientes factores presentaron una asociación directa con el desenlace: participación en uno o más ciclos del PMAQ-AB; planificación del equipo; horario especial; dependencias de atención infantil en la unidad; y disponibilidad de vacunas. La variable relativa a equipos, materiales e insumos y la clasificación como municipio pequeño o mediano se asociaron inversamente con las hospitalizaciones por afecciones que podrían tratarse en los servicios de atención primaria. Conclusiones: Las hospitalizaciones de menores de 5 años por afecciones que podrían tratarse en los servicios de atención primaria pueden reducirse mejorando los indicadores estructurales y procedimentales de las UBS y los determinantes sociales municipales.

Digital health transformation in Saudi Arabia: A cross-sectional analysis using Healthcare Information and Management Systems Society' digital health indicators.

Background: The digital revolution has had a huge impact on healthcare around the world. Digital technology could dramatically improve the accuracy of diagnosis, treatment, health outcomes, efficiency of care, and workflow of healthcare operations. Using health information technology will bring major improvements in patient outcomes. Purpose: This study aims to measure the readiness for digital health transformation at different hospitals in the Eastern Province, Saudi Arabia in relation to Saudi Vision 2030 based on the four dimensions adopted by the Healthcare Information and Management Systems Society: person-enabled health, predictive analytics, governance and workforce, and interoperability. Methods: The study was conducted with a cross-sectional design using data collected through an online questionnaire from 10 healthcare settings, the questionnaire consists of the four digital health indicators. The survey was developed by Healthcare Information and Management Systems Society for the purpose of assessing the level of digital maturity in healthcare settings. Results: Ten healthcare facilities in the Eastern Province, both private and governmental, were included in the study. The highest total scores for digital health transformation were reported in private healthcare facilities (median score for private facilities = 77, public facilities = 71). The 'governance and workforce' was the most implemented dimension among the healthcare facilities in the study (median = 80), while the dimension that was least frequently implemented was predictive analytics (median score = 70). In addition, tertiary hospitals scored the least in digital transformation readiness (median = 74) compared to primary and secondary healthcare facilities in the study. Conclusion: The results of the study show that private healthcare facilities scored higher in digital health transformation indicators. These results will be useful for promoting policymakers' understanding of the level of digital health transformation in the Eastern Province and for the creation of a strategic action plan.

Correlations between Physical Fitness and Body Composition among Boys Aged 14-18-Conclusions of a Case Study to Reverse the Worsening Secular Trend in Fitness among Urban Youth Due to Sedentary Lifestyles.

A secular trend can be observed throughout the world with an increase in childhood obesity and a decrease in fitness. The research aimed to examine the results of tests measuring the conditional abilities of young boys aged 14-18 in fitness tests and their correlations with body composition indicators. That was supported by research that has been prepared in Hungary so far. This research focuses on the results of fitness tests conducted on 14- to 18-year-old boys, presented along with body composition data. The authors sought to describe the development of the fitness profiles of males at a Budapest secondary school participating in the research, based on the results of the Hungarian National Student Fitness Test (NETFIT®), and also how their physical characteristics affect the results of NETFIT® tests in the sample measured. A total of 735 male high school students at a Budapest secondary school (14-18 years old) (mean ± SD, 16.05 ± 1.18 years) participated in the survey. The data were collected in the 2018/2019 academic year, and it was compared with the national data. The correlation between the performance indicators of the NETFIT® tests and the physical characteristic indicators was analyzed using the two-block Partial Least Squares method. In the resulting groups, Kruskal-Wallis variance analysis was performed to investigate the differences in performance. In contrast, pairs of group differences were tested with the Mann-Whitney test. Boys with a short physique were at some advantage in trunk-lifts and push-ups, compared to taller boys. It was also obvious that being overweight is a hindrance regarding the PACER test or the standing broad jump. The handgrip in the left and right hand was mostly of similar strength or weakness. Tall-heavy children performed better in this test. The grip strength of tall-thin students was also strong, but not as strong as in the tall-heavy group. Reducing the percentage of body fat (PBF) and creating the optimal BMI index is important for the younger age group, as our results have clearly demonstrated that overweight is a hindrance in the PACER, VO2 max, standing broad jump, back-saver sit-and-reach, and push-up tests.

["Follow up" strategy in the management of hospital stay]. / Estrategia de Follow up en la gestión de la estancia hospitalaria.

Background: In countries with emerging economies, the adequate and efficient management of resources is a priority, through strategies to reduce prolonged stay, increase the availability of beds, maximize profitability and reduce iatrogenic complications. Objective: The purpose of the study was to evaluate the effect of the "Follow up" strategy (FU) on the main indicators of the hospitalization process. Material and methods: A cross-sectional, comparative study was developed to evaluate the impact of the FU strategy on the indicators: hospital admissions and discharges, average days of hospital stay (DEH), percentage of hospital occupancy (OH), bed substitution interval (ISC), bed turnover rate (CRI) and prolonged hospital stay (EHP). Results: The FU was associated with a reduction in DEH [5.7 (5.5-6.1) vs. 6.5 days (6.1-6.9), p = 0.01]; ISC [0.6 (0.4-0.8) vs. 1.2 (0.8-1.3), p = 0.01] and EHP [23.6 (21.6-24.7) vs. 26.3% (24.4-28.7), p = 0.02] compared to the control group, with an increase in existence [1436 (1381-1472) vs. 1347 patient days (1280-1402), p = 0.02], respectively. There was no significant difference in the number of admissions, discharges or in the IRC. Conclusions: The FU reduces the average number of days of hospital stay, the rate of bed substitution and prolonged stay.

Introducción: en los países con economías emergentes es prioritaria la gestión adecuada y eficiente de los recursos hospitalarios. Las estrategias de gestión pueden reducir la estancia prolongada, aumentar la disponibilidad de camas, maximizar la rentabilidad y reducir las complicaciones iatrogénicas. Objetivo: el propósito del estudio fue evaluar el efecto de la estrategia de Follow up (FU) en los principales indicadores del proceso de hospitalización. Material y métodos: se desarrolló un estudio transversal, comparativo, para evaluar el impacto de la estrategia de FU en los indicadores: ingresos y egresos hospitalarios, promedio de días de estancia hospitalaria (DEH), porcentaje de ocupación hospitalaria (OH), intervalo de sustitución de camas (ISC), índice de rotación de camas (IRC) y estancia hospitalaria prolongada (EHP). Resultados: la estrategia de FU se asoció con una reducción de los DEH [5.7 (5.5-6.1) frente a 6.5 días (6.1-6.9), p = 0.01]; ISC [0.6 (0.4-0.8) frente a 1.2 (0.8-1.3), p = 0.01] y EHP [23.6 (21.6-24.7) frente a 26.3% (24.4-28.7), p = 0.02] respecto al grupo control, con incremento de la existencia [1436 (1381-1472) frente a 1347 días paciente (1280-1402), p = 0.02], respectivamente. No hubo diferencia significativa en el número de ingresos, egresos ni en el IRC. Conclusiones: la estrategia de FU disminuyó el promedio de días de estancia hospitalaria, el índice de sustitución de camas y la estancia prolongada.

The Sentiworld project: global mapping of sentinel surveillance networks in general practice.

BACKGROUND: Sentinel networks composed of general practitioners (GPs) represent a powerful tool for epidemiologic surveillance and ad-hoc studies. Globalization necesitates greater international cooperation among sentinel networks. The aim of this study was to inventory GP sentinel networks involved in epidemiological surveillance on a global scale. METHODS: GP sentinel surveillance networks were inventoried globally between July 2016 and December 2019. Each identified network was required to fill out an electronic descriptive survey for inclusion. RESULTS: A total of 148 networks were identified as potential surveillance networks in general practice and were contacted. Among them, 48 were included in the study. Geographically, 33 networks (68.8%) were located in Europe and 38 (79.2%) had national coverage. The number of GPs registered in these networks represented between 0.1 and 100% of the total number of GPs in the network's country or region, with a median of 2.5%. All networks were involved in continuous epidemiologic surveillance and 47 (97.9%) monitored influenza-like illness. Data collection methods were paper-based forms (n = 26, 55.3%), electronic forms on a dedicated website (n = 18, 38.3%), electronic forms on a dedicated software program (n = 14, 29.8%), and direct extraction from electronic medical records (n = 14, 29.8%). Along with this study, a website has been created to share all data collected. CONCLUSIONS: This study represents the first global geographic mapping of GP sentinel surveillance networks. By sharing this information, collaboration between networks will be easier, which can strengthen the quality of international epidemiologic surveillance. In the face of crises like that of COVID-19, this is more imperative than ever before.

COVID-19 Symptoms and Deaths among Healthcare Workers, United States.

We evaluated whether demographics and COVID-19 symptoms predicted COVID-19 deaths among healthcare workers (HCWs) in the United States by comparing COVID-19 deaths in HCWs with 3 control groups (HCW nondeaths, non-HCW deaths, and non-HCW nondeaths) using a case-control design. We obtained patient-level data of 33 variables reported during January 1, 2020-October 12, 2021, in all US states. We used logistic regression analysis while controlling for confounders. We found that persons who were >50 years of age, male, Black, or Asian experienced significantly more deaths than matched controls. In addition, HCWs who died had higher risks for the most severe clinical indicators. We also found that the most indicative symptoms were preexisting medical conditions, shortness of breath, fever, cough, and gastrointestinal symptoms. In summary, minority, male, and older HCWs had greater risk for COVID-19 death. Severe clinical indicators and specific symptoms may predict COVID-19-related deaths among HCWs.

Priority Indicators for Adolescent Health Measurement - Recommendations From the Global Action for Measurement of Adolescent Health (GAMA) Advisory Group.

PURPOSE: This article describes the selection of priority indicators for adolescent (10-19 years) health measurement proposed by the Global Action for Measurement of Adolescent health advisory group and partners, building on previous work identifying 33 core measurement areas and mapping 413 indicators across these areas. METHODS: The indicator selection process considered inputs from a broad range of stakeholders through a structured four-step approach: (1) definition of selection criteria and indicator scoring; (2) development of a draft list of indicators with metadata; (3) collection of public feedback through a survey; and (4) review of the feedback and finalization of the indicator list. As a part of the process, measurement gaps were also identified. RESULTS: Fifty-two priority indicators were identified, including 36 core indicators considered to be most important for measuring the health of all adolescents, one alternative indicator for settings where measuring the core indicator is not feasible, and 15 additional indicators for settings where further detail on a topic would add value. Of these indicators, 17 (33%) measure health behaviors and risks, 16 (31%) health outcomes and conditions, eight (15%) health determinants, five (10%) systems performance and interventions, four (8%) policies, programmes, laws, and two (4%) subjective well-being. DISCUSSION: A consensus list of priority indicators with metadata covering the most important health issues for adolescents was developed with structured inputs from a broad range of stakeholders. This list will now be pilot tested to assess the feasibility of indicator data collection to inform global, regional, national, and sub-national monitoring.

[Functionality and seniors: where are we and where should we be going?Funcionalidade e pessoas idosas: onde estamos e para onde devemos ir?] / Funcionalidad y personas mayores: ¿dónde estamos y hacia dónde ir?

The process of population aging will lead to an increase in health problems in older people, mainly related to their functionality. Accordingly, the countries of the Region of the Americas must begin to act to meet this challenge. One of the fundamental tasks involves the ability to measure and monitor functionality in the population. The tools used to evaluate functionality focus mainly on the basic activities of daily living, which limits their preventive capacity, since instrumental activities provide a better prognosis. Using the case of Chile, challenges for the Region were identified, mainly related to the advantages of adopting new methodologies that not only evaluate functional capacity, as current strategies do, but also detect its deterioration early and monitor its stages throughout the dependence stage in older people. This will also make it possible to evaluate initiatives for the prevention and management of loss of functionality.

O processo de envelhecimento populacional levará a um aumento de problemas de saúde nas pessoas idosas, principalmente relacionados à sua funcionalidade. Nesse sentido, os países da Região das Américas devem começar a agir para enfrentar esse desafio. Uma das tarefas fundamentais está relacionada à capacidade de medir e monitorar a funcionalidade da população. Os instrumentos utilizados para avaliá-la estão voltados principalmente para as atividades básicas da vida diária, o que limita sua capacidade preventiva, já que são as atividades instrumentais que permitem um melhor prognóstico. Utilizando o caso do Chile, identificamos desafios para a Região, principalmente relacionados às vantagens de incorporar novas metodologias de avaliação da capacidade funcional que não só habilitem as estratégias atuais, mas também detectem precocemente a deterioração da funcionalidade e monitorem suas fases ao longo da dependência das pessoas idosas. Isso permitirá, ao mesmo tempo, avaliar as iniciativas de prevenção e manejo da perda de funcionalidade.

Prevalência de indicadores de saúde sexual e reprodutiva dos adolescentes brasileiros: análise comparativa da pesquisa nacional de saúde do escolar 2015 e 2019 / Prevalencia de indicadores de salud sexual y reproductiva de los adolescentes brasileños: análisis comparativo de la encuesta nacional de salud escolar 2015 y 2019 / Prevalence of brazilian adolescents' sexual and reproductive health indicators: a comparative analysis of the 2015 and 2019 national school health survey

RESUMO Objetivo: comparar estimativas de prevalência de indicadores de saúde sexual e reprodutiva dos adolescentes brasileiros que participaram das edições 2015 e 2019 da Pesquisa Nacional de Saúde do Escolar (PeNSE). Método: estudo transversal que analisou dados de adolescentes escolares de 13 a 17 anos de idade respondentes da PeNSE 2015 e 2019. Estimou-se a prevalência dos indicadores com intervalos de 95% de confiança de acordo com o sexo, a faixa etária, a dependência administrativa da escola e a região. Resultados: destaca-se o aumento da prevalência de iniciação sexual precoce entre os mais novos, 171,2% entre os meninos e 425,2% entre as meninas. Também houve aumento da prevalência de gravidez na adolescência nas regiões Nordeste (376,9%) e Sudeste (416,6%), entre as mais jovens. Entre os adolescentes de 16 e 17 anos, houve redução do uso de preservativo na última relação e aumento na prevalência de recebimento de orientações sobre prevenção de gravidez e sobre HIV/Infecções Sexualmente Transmissíveis, entre os estudantes de escolas públicas. Houve redução na prevalência de acesso a essas orientações nas escolas privadas entre os mais jovens. Em 2019, observou-se redução no uso de pílulas anticoncepcionais entre as adolescentes mais novas das regiões Norte, Sudeste e Centro-Oeste. Conclusão: houve piora na prevalência dos comportamentos sexuais de risco em adolescentes brasileiros, incluindo o aumento da gravidez em algumas regiões do país. Ressalta-se a importância da cooperação entre os serviços de saúde e de educação, que devem estar alinhados para promover melhores hábitos de vida, destacando os de saúde sexual e reprodutiva entre os jovens.

RESUMEN Objetivo: comparar las estimaciones de prevalencia de los indicadores de salud sexual y reproductiva de los adolescentes brasileños que participaron en las ediciones 2015 y 2019 de la Encuesta Nacional de Salud Escolar (PeNSE). Método: estudio transversal que analizó los datos de los adolescentes escolares de 13 a 17 años encuestados en la PeNSE 2015 y 2019. La prevalencia de los indicadores se estimó con intervalos de confianza del 95% según el sexo, el grupo de edad, la dependencia administrativa del centro escolar y la región. Resultados: Se distingue el aumento de la prevalencia de la iniciación sexual precoz, entre los más jóvenes, 171,2% entre los chicos y 425,2% entre las chicas. También hubo aumento de la prevalencia de embarazo en la adolescencia en las regiones Nordeste (376,9%) y Sudeste (416,6%), entre los más jóvenes. Entre los adolescentes de 16 y 17 años, hubo reducción del uso del preservativo en la última relación y aumento en la prevalencia de recibir orientación sobre prevención de embarazo y sobre VIH/infecciones sexualmente transmisibles, entre los alumnos de escuelas públicas. La prevalencia del acceso a esta orientación en las escuelas privadas se redujo entre los más jóvenes. En 2019, se redujo el uso de píldoras anticonceptivas entre los adolescentes más jóvenes de las regiones Norte, Sureste y Centro-Oeste. Conclusión: hubo un empeoramiento de la prevalencia de los comportamientos sexuales de riesgo en los adolescentes brasileños, incluyendo un aumento de los embarazos en algunas regiones del país. Se destaca la importancia de la cooperación entre los servicios sanitarios y educativos, que deben estar alineados, para promover mejores hábitos de vida, destacando los de salud sexual y reproductiva entre los jóvenes.

ABSTRACT Objective: to compare prevalence estimates of sexual and reproductive health indicators among Brazilian adolescents who participated in the 2015 and 2019 editions of the National School Health Survey (Pesquisa Nacional de Saúde do Escolar, PeNSE). Method: a cross-sectional study that analyzed data from in-school adolescents aged from 13 to 17 years old who answered the 2015 and 2019 editions of PeNSE. Prevalence of the indicators was estimated with 95% confidence intervals according to gender, age group, the school's administrative system and region. Results: the increase in the prevalence of early initiation of sexual activity stands out among the youngest adolescents: 171.2% in the boys and 452.2% in the girls. An increase in the prevalence of teenage pregnancy was also recorded in the Northeast (376.9%) and Southeast (416.6%) regions in the youngest subjects. Among the in-school adolescents aged 16 and 17 from public institutions there was a reduction in condom use in the last intercourse and an increase in the prevalence of receiving guidelines on pregnancy prevention and about HIV/Sexually Transmitted Infections. There was a reduction in the prevalence of access to these guidelines in private schools among the youngest students. In 2019, a reduction in the use of contraceptive pills was observed among the youngest female adolescents from the North, Southeast and Midwest regions. Conclusion: the prevalence of risk sexual behaviors worsened among Brazilian adolescents, including an increase in the number of pregnancies in some regions of the country. The importance of cooperation between the health and education services is emphasized, which should be aligned to promote better life habits, with those related to sexual and reproductive health among young people standing out.