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1.
Int J Offender Ther Comp Criminol ; 66(1): 84-97, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33478273

RESUMO

Experience Sampling Method (ESM) is a structured diary technique assessing variations in thoughts, mood, and psychiatric symptoms in everyday life. Research has provided ample evidence for the efficacy of the use of ESM in general psychiatry but its use in forensic psychiatry has been limited. Twenty forensic psychiatric patients participated. The PsyMate™ Device emitted a signal 10 times a day on six consecutive days, at unpredictable moments. After each "beep," the patients completed ESM forms assessing current context, thoughts, positive and negative affect, and psychotic experiences. Stress was measured using the average scores of the stress related items. Compliance rate was high (85% beeps responded). Activity stress was related to more negative affect, lower positive affect, and more psychotic symptoms. This finding was restricted to moments when a team member was present; not when patients were alone or with other patients. ESM can be useful in forensic psychiatry and give insights into the relationships between symptoms and mood in different contexts. In this study activity-related stress was contextualized. These findings can be used to personalize interventions.


Assuntos
Avaliação Momentânea Ecológica , Transtornos Psicóticos , Afeto , Psiquiatria Legal , Humanos , Amostragem
2.
PLoS One ; 16(12): e0261015, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34919574

RESUMO

BACKGROUND AND OBJECTIVES: Xinjiang is one of the areas in China with extremely severe iodine deficiency. The health of Xinjiang residents has been endangered for a long time. In order to provide reasonable suggestions for scientific iodine supplementation and improve the health and living standards of the people in Xinjiang, it is necessary to understand the spatial distribution of iodine content in drinking water and explore the influencing factors of spatial heterogeneity of water iodine content distribution. METHODS: The data of iodine in drinking water arrived from the annual water iodine survey in Xinjiang in 2017. The distribution of iodine content in drinking water in Xinjiang is described from three perspectives: sampling points, districts/counties, and townships/streets. ArcGIS was used for spatial auto-correlation analysis, mapping the distribution of iodine content in drinking water and visualizing the distribution of Geographically Weighted Regression (GWR) model parameter. Kriging method is used to predict the iodine content in water at non-sampling points. GWR software was used to build GWR model in order to find the factors affecting the distribution of iodine content in drinking water. RESULTS: There are 3293 sampling points in Xinjiang. The iodine content of drinking water ranges from 0 to 128 µg/L, the median is 4.15 µg/L. The iodine content in 78.6% of total sampling points are less than 10 µg/L, and only that in the 3.4% are more than 40 µg/L. Among 1054 towns' water samples in Xinjiang, 88.9% of the samples' water iodine content is less than 10 µg/L. Among the 94 studied areas, the median iodine content in drinking water in 87 areas was less than 10 µg/L, those values in 7 areas were between 10-40 µg/L, and the distribution of water iodine content in Xinjiang shows clustered. The GWR model established had found that the effects of soil type and precipitation on the distribution of iodine content in drinking water were statistically significant. CONCLUSIONS: The iodine content of drinking water in Xinjiang is generally low, but there are also some areas which their drinking water has high iodine content. Soil type and precipitation are the factors affecting the distribution of drinking water iodine content, and are statistically significant (P<0.05).


Assuntos
Água Potável/química , Iodo/análise , China , Monitoramento Ambiental , Amostragem , Análise Espacial
3.
Nat Commun ; 12(1): 5629, 2021 09 24.
Artigo em Inglês | MEDLINE | ID: mdl-34561445

RESUMO

Severe fever with thrombocytopenia syndrome (SFTS) is a novel tick-borne infectious disease caused by a new type of SFTS virus (SFTSV). Here, a longitudinal sampling study is conducted to explore the differences in transcript levels after SFTSV infection, and to characterize the transcriptomic and epigenetic profiles of hospitalized patients. The results reveal significant changes in the mRNA expression of certain genes from onset to recovery. Moreover, m6A-seq reveals that certain genes related with immune regulation may be regulated by m6A. Besides the routine tests such as platelet counts, serum ALT and AST levels testing, distinct changes in myocardial enzymes, coagulation function, and inflammation are well correlated with the clinical data and sequencing data, suggesting that clinical practitioners should monitor the above indicators to track disease progression and guide personalized treatment. In this study, the transcript changes and RNA modification may lend a fresh perspective to our understanding of the SFTSV and play a significant role in the discovery of drugs for effective treatment of this disease.


Assuntos
Epigênese Genética , Epigenômica/métodos , Perfilação da Expressão Gênica/métodos , Febre Grave com Síndrome de Trombocitopenia/genética , Transcriptoma , Idoso , Alanina Transaminase/sangue , Antivirais/uso terapêutico , Aspartato Aminotransferases/sangue , Creatinina/sangue , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Phlebovirus/efeitos dos fármacos , Phlebovirus/fisiologia , RNA-Seq/métodos , Amostragem , Febre Grave com Síndrome de Trombocitopenia/tratamento farmacológico , Febre Grave com Síndrome de Trombocitopenia/virologia
4.
Rev. colomb. anestesiol ; 49(3): e702, July-Sept. 2021.
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1280188

RESUMO

The SES-Hospital Universitario de Caldas takes care of approximately 210 deliveries per month, with an overall cesarean section rate of 32 %, of which 72 % were conducted with, or had an epidural catheter, as an extension of the analgesia delivered during labor and were therefore excluded from the trial. This may address some of the concerns expressed by Sotelo 1 It is important to consider the observational character of the study discussed; in the discussion paragraph, mention is made of a potential selection bias, based on the convenience sampling and the non-randomized approach which are typical of the design used


el SES-Hospital Universitario de Caldas atiende aproximadamente 210 partos por mes, con una tasa global de cesáreas del 32%, de las cuales el 72% se realizaron con o tenían un catéter epidural, como una extensión de la analgesia administrada durante el trabajo de parto y por lo tanto, fueron excluidos del ensayo. Esto puede abordar algunas de las preocupaciones expresadas por Sotelo 1 Es importante considerar el carácter observacional del estudio discutido; En el párrafo de discusión, se menciona un posible sesgo de selección, basado en el muestreo de conveniencia y el enfoque no aleatorio que son típicos del diseño utilizado.


Assuntos
Humanos , Feminino , Gravidez , Trabalho de Parto , Cesárea , Caráter , Viés de Seleção , Amostragem , Cateteres , Analgesia
5.
PLoS One ; 16(8): e0255256, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34407106

RESUMO

Sampling rare and clustered populations is challenging because of the effort required to find rare units. Heuristically, a practitioner would prefer to discontinue sampling in areas where rare units of interest are apparently extremely sparse or absent. We take advantage of the characteristics of inverse sampling to adaptively inform practitioners when it is efficient to move on to sample new areas. We introduce Adaptive Two-stage Inverse Sampling (ATIS), which is designed to leave a selected area after observation of an a priori number of only non-rare units and to continue sampling in the area when rare units are observed. ATIS is efficient in many cases and yields more rare units than conventional sampling for a rare and clustered population. We derive unbiased estimators of population total and variance. We also introduce an easy-to-compute estimator, which is nearly as efficient as the unbiased estimator. A simulation study on a rare plant population of buttercups (Ranunculus) shows that ATIS even with the easy-to-compute estimator is more efficient than its conventional sampling counterparts and is more efficient than Two-stage Adaptive Cluster Sampling (TACS) for small and moderate final sample sizes. Additional simulations reveal that ATIS is efficient for binary data (e.g., presence or absence) whereas TACS is inefficient for binary data. The overall results indicate that ATIS is consistently efficient compared to conventional sampling and to adaptive cluster sampling in some important cases.


Assuntos
Modelos Estatísticos , Amostragem , Análise por Conglomerados , Simulação por Computador
6.
Transfusion ; 61 Suppl 2: S11-S35, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34337759

RESUMO

INTRODUCTION: Supplemental data from the 2019 National Blood Collection and Utilization Survey (NBCUS) are presented and include findings on donor characteristics, autologous and directed donations and transfusions, platelets (PLTs), plasma and granulocyte transfusions, pediatric transfusions, transfusion-associated adverse events, cost of blood units, hospital policies and practices, and implementation of blood safety measures, including pathogen reduction technology (PRT). METHODS: National estimates were produced using weighting and imputation methods for a number of donors, donations, donor deferrals, autologous and directed donations and transfusions, PLT and plasma collections and transfusions, a number of crossmatch procedures, a number of units irradiated and leukoreduced, pediatric transfusions, and transfusion-associated adverse events. RESULTS: Between 2017 and 2019, there was a slight decrease in successful donations by 1.1%. Donations by persons aged 16-18 decreased by 10.1% while donations among donors >65 years increased by 10.5%. From 2017 to 2019, the median price paid for blood components by hospitals for leukoreduced red blood cell units, leukoreduced apheresis PLT units, and for fresh frozen plasma units continued to decrease. The rate of life-threatening transfusion-related adverse reactions continued to decrease. Most whole blood/red blood cell units (97%) and PLT units (97%) were leukoreduced. CONCLUSION: Blood donations decreased between 2017 and 2019. Donations from younger donors continued to decline while donations among older donors have steadily increased. Prices paid for blood products by hospitals decreased. Implementation of PRT among blood centers and hospitals is slowly expanding.


Assuntos
Doadores de Sangue/estatística & dados numéricos , Pesquisas sobre Serviços de Saúde , Adolescente , Adulto , Distribuição por Idade , Idoso , Bancos de Sangue/estatística & dados numéricos , Remoção de Componentes Sanguíneos/estatística & dados numéricos , Transfusão de Componentes Sanguíneos/estatística & dados numéricos , Transfusão de Componentes Sanguíneos/tendências , Doadores de Sangue/provisão & distribuição , Antígenos de Grupos Sanguíneos/genética , Transfusão de Sangue/estatística & dados numéricos , Transfusão de Sangue/tendências , Transfusão de Sangue Autóloga/estatística & dados numéricos , Transfusão de Sangue Autóloga/tendências , Área Programática de Saúde , Criança , Pré-Escolar , Transmissão de Doença Infecciosa/prevenção & controle , Seleção do Doador/estatística & dados numéricos , Feminino , Custos de Cuidados de Saúde , Hospitais/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Procedimentos de Redução de Leucócitos/economia , Procedimentos de Redução de Leucócitos/métodos , Masculino , Pessoa de Meia-Idade , Política Organizacional , Assunção de Riscos , Amostragem , Procedimentos Cirúrgicos Operatórios/estatística & dados numéricos , Reação Transfusional/epidemiologia , Estados Unidos/epidemiologia , Adulto Jovem
7.
PLoS One ; 16(8): e0256699, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34464414

RESUMO

This paper considers the concomitant-based rank set sampling (CRSS) for estimation of the sensitive proportion. It is shown that CRSS procedure provides an unbiased estimator of the population sensitive proportion, and it is always more precise than corresponding sample sensitive proportion (Warner SL (1965)) that based on simple random sampling (SRS) without increasing sampling cost. Additionally, a new estimator based on ratio method is introduced using CRSS protocol, preserving the respondent's confidentiality through a randomizing device. The numerical results of these estimators are obtained by using numerical integration technique. An application to real data is also given to support the methods.


Assuntos
Amostragem , Estatística como Assunto , Humanos , Modelos Estatísticos , Distribuição Aleatória , Estatística como Assunto/métodos
8.
Sci Rep ; 11(1): 16537, 2021 08 16.
Artigo em Inglês | MEDLINE | ID: mdl-34400678

RESUMO

Evidence indicates that age-related macular degeneration (AMD) is associated with the prior presence of allergic diseases; however, large-scale studies in the literature are limited. A case-control study was conducted to describe the relationship between premorbid allergic diseases and AMD using Taiwan's National Health Insurance database. Eligibility criteria for inclusion of new adult AMD cases from 2000 to 2013 were set up. We defined the year of diagnosis as the index year. Age-, gender-, index year- matched controls who were drawn from the same database. The case control ratio was 1:4. For all participants, all premorbid conditions staring 1996 to index year were documented. Binary logistic regression was used to describe factors related to AMD occurrence. The AMD group consisted of 10,911 patients, and the comparison group consisted of 43,644 individuals. Patients with AMD showed significant associations with premorbid allergic diseases (aOR 1.54, 95% CI 1.47-1.61), specifically with allergic conjunctivitis (aOR 2.07, 95% CI 1.94-2.20), allergic rhinitis (aOR 1.32, 95% CI 1.25-1.39), asthma (aOR 0.99, 95% CI 0.93-1.06), and atopic dermatitis (aOR 1.04, 95% CI 0.94-1.17). Further analyses indicated that patients with more concurrent allergic diseases have higher associations with AMD than those with fewer concurrent diseases. Patients with more annual medical visits for their allergic diseases also showed higher associations with AMD than those with fewer visits. AMD is significantly associated with premorbid allergic diseases. The underlying mechanisms must be further investigated.


Assuntos
Asma/epidemiologia , Conjuntivite Alérgica/epidemiologia , Dermatite Atópica/epidemiologia , Degeneração Macular/epidemiologia , Rinite Alérgica/epidemiologia , Adulto , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Comorbidade , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Hiperlipidemias/epidemiologia , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Visita a Consultório Médico/estatística & dados numéricos , Risco , Amostragem , Taiwan/epidemiologia , Adulto Jovem
9.
Can J Surg ; 64(4): E407-E413, 2021 07 23.
Artigo em Inglês | MEDLINE | ID: mdl-34296768

RESUMO

Background: There has been a continuing trend toward decreasing the length of hospital stay for patients undergoing total hip arthroplasty (THA). We aimed to investigate the impact of timing of discharge on gait and patient-reported outcomes early after THA. Methods: In this prospective observational cohort study conducted from May 2014 to November 2015, we measured gait velocity, stride length, single-limb support and single-limb support symmetry in adults aged 18-75 years before direct anterior THA, at discharge from the hospital, and 2, 6 and 12 weeks postoperatively. All procedures were performed by a single surgeon. Patients were discharged on the same day as surgery (outpatient group) or stayed at least 1 night in hospital (inpatient group). Participants also completed the Timed Up and Go test (all postoperative time points) and a series of questionnaires (Western Ontario and McMaster Universities Osteoarthritis Index [6 and 12 wk], 12-Item Short Form Health Survey [2, 6 and 12 wk], Harris Hip Score [12 wk] and a pain visual analogue scale [all postoperative time points]). Results: Thirty-six participants were enrolled in the study, of whom 16 were outpatients and 20 were inpatients. The mean pain rating at the time of discharge was lower in the outpatient group than in the inpatient group (adjusted mean difference -1.5, 95% confidence interval -3.0 to 0.0). We found no other significant differences between the groups for any gait, patient-reported or surgical outcome. Conclusion: There were no statistically significant differences in gait or patient-reported outcomes after direct anterior THA between patients who stayed overnight and those who were discharged as outpatients. Patients discharged as outpatients were younger than those who stayed overnight. Our results suggest that discharging patients as an outpatient after direct anterior THA may have a similar impact on patient function and outcomes as a standard overnight stay in hospital.


Assuntos
Procedimentos Cirúrgicos Ambulatórios , Artroplastia de Quadril , Análise da Marcha , Hospitalização , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Medidas de Resultados Relatados pelo Paciente , Amostragem
10.
Psychosom Med ; 83(6): 624-630, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34213862

RESUMO

OBJECTIVE: Because of fast-growing interest in the applications of mindfulness to promote well-being and mental health, there are field-wide efforts to better understand how mindfulness training works and thereby to optimize its delivery. Key to these efforts is the role of home practice in mindfulness-based intervention (MBI) outcomes. Despite its centrality in MBIs, recent reviews have documented limited and mixed effects of home practice on MBI outcomes. However, methodological issues regarding monitoring and quantifying home practice and focus on cumulative or additive effects may limit our understanding of it. Temporally proximate, more transient, and contextually circumscribed effects of mindfulness mediation practice have not been examined. METHODS: We applied intensive experience sampling to measure daily practice and levels of targeted proximal outcomes (state mindfulness, decentering, emotional valance, and arousal) of training over the course of a 21-day MBI among a community-based sample of 82 meditation-naive adults. RESULTS: Despite intensive experience sampling, we found no evidence of cumulative or additive effects of total mindfulness meditation practice on outcomes at postintervention for mindfulness, decentering, emotional valence, or emotional arousal. However, we found that that daily dose of mindfulness meditation home practice significantly predicted same-day levels of state mindfulness (B = 0.004, SE = 0.001, t = 3.17, p = .000, f2 = 0.24), decentering (B = 0.004, SE = 0.001, t = 2.757, p = .006, f2 = 0.05), and emotional valence (B = 0.006, SE = 0.003, t = 2.015, p = .044, f2 = 0.01) but not daily levels of emotional arousal. Daily dose-response practice effects did not carry over to next-day levels of monitored outcomes. CONCLUSIONS: Findings show that effects of daily home mindfulness meditation practice dose on state mindfulness, decentering, and positive emotion are reliable but transient and time-limited. Findings are discussed with respect to the proposed daily dose-response hypothesis of mindfulness meditation practice.


Assuntos
Meditação , Atenção Plena , Adulto , Avaliação Momentânea Ecológica , Emoções , Humanos , Amostragem
11.
Transfusion ; 61 Suppl 2: S1-S10, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34165191

RESUMO

INTRODUCTION: Previous iterations of National Blood Collection and Utilization Survey (NBCUS) have demonstrated declines in blood collection and transfusion in the United States since 2008, including declines of 3.0% and 6.1% in red blood cell (RBC) collections and transfusions between 2015 and 2017, respectively. This study describes results of the 2019 NBCUS. METHODS: The survey was distributed to all US blood collection centers, all hospitals performing ≥1000 surgeries annually, and a 40% random sample of hospitals performing 100-999 surgeries annually. Weighting and imputation were used to generate national estimates for units of blood and components collected, distributed, transfused, and outdated. RESULTS: In 2019, 11,590,000 RBC units were collected (95% confidence interval [CI], 11,151,000-12,029,000 units), a 5.1% decrease compared with 2017, while 10,852,000 RBC units were transfused (95% CI, 10,444-11,259 units), a 2.5% increase from 2017. Between 2017 and 2019, platelet distributions (2,508,000 units; 95% CI, 2,375,000-2,641,000 units) decreased by 2.0%, and plasma distributions (2,679,000 units; 95% CI, 2,525,000-2,833,000 units) decreased by 16.5%. During the same time period, platelet transfusions (2,243,000 units; 95% CI, 1,846,000-2,147,000 units) increased by 15.8% and plasma transfusions (2,185,000 units; 95% CI, 2,068,000-2,301,000 units) decreased by 8.0%. CONCLUSION: Utilization of RBC in the United States might have reached a nadir. Between 2017 and 2019, RBC collections declined while RBC transfusions did not significantly change, suggesting a narrowing between blood supply and demand. Monitoring national blood collection and utilization data is integral to understanding trends in blood supply safety and availability.


Assuntos
Transfusão de Sangue/tendências , Pesquisas sobre Serviços de Saúde , Bancos de Sangue/estatística & dados numéricos , Transfusão de Componentes Sanguíneos/estatística & dados numéricos , Transfusão de Componentes Sanguíneos/tendências , Doadores de Sangue/estatística & dados numéricos , Perda Sanguínea Cirúrgica , Transfusão de Sangue/estatística & dados numéricos , Hospitais/estatística & dados numéricos , Humanos , Cuidados Intraoperatórios/estatística & dados numéricos , Amostragem , Procedimentos Cirúrgicos Operatórios/estatística & dados numéricos , Estados Unidos
12.
Neuroimage ; 239: 118262, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34147629

RESUMO

The Adolescent Brain Cognitive Development (ABCD) Study is the largest single-cohort prospective longitudinal study of neurodevelopment and children's health in the United States. A cohort of n = 11,880 children aged 9-10 years (and their parents/guardians) were recruited across 22 sites and are being followed with in-person visits on an annual basis for at least 10 years. The study approximates the US population on several key sociodemographic variables, including sex, race, ethnicity, household income, and parental education. Data collected include assessments of health, mental health, substance use, culture and environment and neurocognition, as well as geocoded exposures, structural and functional magnetic resonance imaging (MRI), and whole-genome genotyping. Here, we describe the ABCD Study aims and design, as well as issues surrounding estimation of meaningful associations using its data, including population inferences, hypothesis testing, power and precision, control of covariates, interpretation of associations, and recommended best practices for reproducible research, analytical procedures and reporting of results.


Assuntos
Desenvolvimento do Adolescente , Psicologia do Adolescente , Adolescente , Alcoolismo/epidemiologia , Encéfalo/anatomia & histologia , Encéfalo/crescimento & desenvolvimento , Encéfalo/fisiologia , Área Programática de Saúde , Criança , Cognição/fisiologia , Feminino , Seguimentos , Interação Gene-Ambiente , Humanos , Masculino , Modelos Neurológicos , Modelos Psicológicos , Tamanho do Órgão , Pais/psicologia , Pontuação de Propensão , Estudos Prospectivos , Reprodutibilidade dos Testes , Projetos de Pesquisa , Tamanho da Amostra , Amostragem , Viés de Seleção , Fatores Socioeconômicos , Estados Unidos
13.
J Womens Health (Larchmt) ; 30(10): 1406-1415, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34129406

RESUMO

Background: Sexual minority women may use contraception for various reasons but face notable barriers to contraceptive care, including stigma and discrimination. However, studies examining sexual orientation disparities in contraceptive care have largely relied on nonprobability samples of predominately White women and may thus not be generalizable to U.S. women overall or Black and Latina women in particular. Materials and Methods: Using data from the 2006 to 2017 National Survey of Family Growth, a large national probability sample of U.S. women 15-44 years of age (N = 25,473), we used multivariable logistic regression to estimate adjusted odds ratios for receiving a contraceptive method or prescription and contraceptive counseling from a health care provider in the past year among sexual orientation identity and racial/ethnic subgroups of heterosexual, bisexual, and lesbian White, Black, and Latina women relative to White heterosexual women. Results: Among women overall, 33.9% had received contraception and 18.3% had obtained contraceptive counseling. Black (odds ratio [OR] = 0.73, 95% confidence interval [CI]: 0.65-0.82) and Latina (OR = 0.73, 95% CI: 0.64-0.82) heterosexual women, White (OR = 0.80, 95% CI: 0.65-0.99) and Black (OR = 0.43, 95% CI: 0.32-0.58) bisexual women, and White (OR = 0.23, 95% CI: 0.13-0.43), Black (OR = 0.19, 95% CI: 0.09-0.40), and Latina (OR = 0.08, 95% CI: 0.03-0.22) lesbian women had significantly lower adjusted odds of receiving contraception compared with White heterosexual women. White (OR = 0.36, 95% CI: 0.15-0.85), Black (OR = 0.42, 95% CI: 0.18-0.98), and Latina (OR = 0.22, 95% CI: 0.09-0.53) lesbian women also had significantly lower adjusted odds of obtaining contraceptive counseling relative to White heterosexual women. Conclusions: Policies, programs, and practices that facilitate access to person-centered contraceptive care among marginalized sexual orientation identity and racial/ethnic subgroups of U.S. women are needed to promote reproductive health equity.


Assuntos
Anticoncepcionais , Minorias Sexuais e de Gênero , Feminino , Humanos , Masculino , Amostragem , Comportamento Sexual
14.
Aggress Behav ; 47(5): 593-602, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34076267

RESUMO

This paper reports findings on men's exposure to extreme pornography, impersonal sexuality, and sexual aggression from the National Survey of Porn Use, Relationships, and Sexual Socialization, a U.S. population-based probability study. Despite Malamuth's confluence model (CM) of sexual aggression positing that an impersonal approach to sex interacts with exposure to pornography to predict the likelihood of committing sexual assault, only a few studies have actually tested this prediction. Additionally, the data from the only previous nationally representative study were gathered more than 30 years ago. Results of the present study generally supported the CM. Extreme pornography exposure and impersonal sexuality were both associated with a higher probability of sexual aggression. Although impersonal sex was a robust predictor in and of itself, men who were more exposed to pornography and impersonal in their approach to sex were more likely to be sexually aggressive than men who were impersonal in their approach to sex but less exposed to pornography. Results maintained when indicators of sex drive were included in analyses. The only finding inconsistent with the CM was that the association between pornography exposure and sexual aggression was stronger among men lower rather than higher in impersonal sex.


Assuntos
Literatura Erótica , Delitos Sexuais , Agressão , Humanos , Masculino , Amostragem , Comportamento Sexual
15.
Int J Equity Health ; 20(1): 113, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33933098

RESUMO

BACKGROUND: Several middle and upper income countries carry out household surveys that seek to trace the profile of access and use of health services. Probably one of the most ambitious examples is Brazil, with its National Health Survey (PNS-2019). We evaluated PNS-2019, presenting in an unprecedented way, one of its innovations, which refer to Starfield and Shi's adult Primary Care Assessment Tool (PCAT). METHODS: Based on a cross-sectional study, we evaluated Module H of the PNS-2019, which interviewed a probabilistic sample of about 10,000 adults in 2019 in all 27 Brazilian states. According to the PCAT methodology, an average score equal to or above 6.6 indicates a greater orientation and quality of the evaluated primary care services. RESULTS: Brazilian overall PCAT score [5, 9] reveals the need to improve primary health care services across the country. There were no statistically significant differences in the scores by sex (men and women, 5.9), and race (whites 5.9 [5.7; 6.0] and brown / black 5.9 [5.8; 6.0]). On the other hand, there was a difference in terms of age. The elderly evaluated the services in a more positive way (score = 6.1 [6.0; 6.2]), when compared to those aged 40-59 years (5.9 [5.7; 6.0]) and 18 to 39 years (5.6 [5.5; 5.8]). First results of PNS-2019 show that the population that most needs primary care services in SUS is the one with the best perception and the most positive evaluation of the actions and procedures offered in health facilities. DISCUSSION: During 2019, Brazil undertook important structural reforms in PHC based on a new financing model with the aim of inducing an improvement in efficiency and strengthening its attributes. It is essential that countries with universal health coverage (UHC) guarantee access to their population and, especially, the most vulnerable, seek better efficiency of these services and regularly assess PHC based on the population's perception, through an independent methodology that monitor the quality of services and the strength of PHC, generating value for public resources applied to health services.


Assuntos
Pesquisa sobre Serviços de Saúde , Atenção Primária à Saúde , Adolescente , Adulto , Idoso , Brasil , Estudos Transversais , Difusão de Inovações , Características da Família , Feminino , Pesquisas sobre Serviços de Saúde , Pesquisa sobre Serviços de Saúde/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Atenção Primária à Saúde/organização & administração , Amostragem , Adulto Jovem
16.
PLoS One ; 16(5): e0251506, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33974654

RESUMO

OBJECTIVE: To assess the rate of glycemic control and associated factors among type 2 diabetes mellitus patients at Dilchora Referral Hospital, Dire Dawa, Eastern Ethiopia. METHODS: A cross-sectional study was conducted from 13 May to 16 August 2019. Type 2 diabetic patients on follow up at Dilchora Referral Hospital who fulfilled the inclusion criteria of the study were included. Systematic random sampling was used to select study participants. Data was collected by a face-to-face interview and review of medical records. The primary outcome was the level of blood glucose during three consecutive visits. Poor glycemic control was defined as a blood sugar level of more than 154 mg/dL based on the average of measurements from three consecutive visits. Multivariate logistic regression analysis was used to identify determinants of glycemic control. RESULT: A total of 394 participants responded to the interview and were included in the final analysis. The overall prevalence of poor glycemic control was 45.2% (95%CI: 40.6%-50.0%). Patients who were on oral anti-diabetic drug plus insulin had more than two times greater chance of poor glycemic control than patients on oral anti-diabetic drug alone: 2.177(95%CI:1.10-4.29). The odds of poor glycemic control in patients who did not understand the pharmacist's instructions was two times higher than patients with good understanding of instructions 1.86(95%CI: 1.10-3.13). Patients who had poor level of practice were found to have poor glycemic control: 1.69(95% CI: 1.13-2.55). CONCLUSION: The overall prevalence of poor glycemic control was high among type 2 diabetes patients. Oral anti-diabetic drugs in combination with insulin, lack of understanding of pharmacist's advice, and poor practice of diabetic patients were significant factors of poor glycemic control. Pharmacists should reassure the understanding of patients before discharge during counseling. Optimization of the dose of antidiabetic medications and combination of oral hypoglycemic agents should be considered.


Assuntos
Diabetes Mellitus Tipo 2/sangue , Controle Glicêmico , Adulto , Idoso , Glicemia/análise , Comorbidade , Compreensão , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/terapia , Quimioterapia Combinada , Etiópia/epidemiologia , Feminino , Humanos , Hiperlipidemias/tratamento farmacológico , Hiperlipidemias/epidemiologia , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Modelos Logísticos , Masculino , Adesão à Medicação , Pessoa de Meia-Idade , Educação de Pacientes como Assunto , Farmacêuticos , Relações Profissional-Paciente , Fatores de Risco , População Rural , Amostragem , Fatores Socioeconômicos , População Urbana , Adulto Jovem
17.
Med Care ; 59(7): 565-571, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-33989247

RESUMO

BACKGROUND: Integrated care that is continuous, coordinated and patient-centered is vital for Medicare beneficiaries, but its relationship to health care expenditures remains unclear. RESEARCH OBJECTIVE: This study explores-for the first time-the relationship between integrated care, as measured from the patient's perspective, and health care expenditures. METHODS: Subjects include a sample of continuously eligible fee-for-service Medicare beneficiaries (n=8807) in 2015. Analyses draw on 7 previously validated measures of patient-perceived integrated care from the 2015 Medicare Current Beneficiary Survey. These data are combined with 2015 administrative utilization data that measure health care expenditures. Relationships between patient-perceived integrated care and costs are assessed using generalized linear models with comprehensive control measures. RESULTS: Patients who perceive more integrated care have higher expenditures for many, but not all, cost categories examined. Aspects of integrated care pertaining to primary provider and specialist care are associated with higher costs in several areas (particularly inpatient costs associated with specialist knowledge of the patient). Office staff members' knowledge of the patient's medical history is associated with lower home health costs. CONCLUSIONS: Patients who experience their care as more integrated may have higher expenditures on average. Thoughtful policy choices, further research, and innovations that enable patients to perceive integrated care at lower or neutral cost are needed.


Assuntos
Prestação Integrada de Cuidados de Saúde , Gastos em Saúde , Medicare/economia , Qualidade da Assistência à Saúde , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Amostragem , Estados Unidos
18.
ScientificWorldJournal ; 2021: 6631860, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33854412

RESUMO

Escherichia coli O157 : H7 (E. coli O157 : H7) has been found to be the major cause of food-borne diseases and a serious public health problem in the world, with an increasing concern for the emergence and spread of antimicrobial-resistant strains. Hitherto, little is known about the carriage of E. coli O157 : H7 and its antimicrobial susceptibility profile in the food of animal origin in Ethiopia. This study aimed to determine the occurrence and multidrug resistance profile of E. coli O157 : H7 from food of animal origin at different catering establishments in the selected study settings of Arsi Zone. One hundred ninety-two animal origin food items, namely, raw/minced meat (locally known as "Kitfo," "Kurt," and "Dulet"), raw milk, egg sandwich, and cream cake samples were collected and processed for microbiological detection of E. coli O157 : H7. Out of 192 samples, 2.1% (4/192) were positive for E. coli O157 : H7. Two E. coli O157 : H7 isolates were obtained from "Dulet" (6.3%) followed by "Kurt" (3.1%, 1/32) and raw milk (3.1%, 1/32), whereas no isolate was obtained from "Kitfo," egg sandwich, and cream cake samples. Of the 4 E. coli O157 : H7 isolates subjected to 10 panels of antimicrobial discs, 3 (75%) were highly resistant to kanamycin, streptomycin, and nitrofurantoin. Besides, all the isolates displayed multidrug resistance phenotypes, 3 to 5 antimicrobial resistance, amid kanamycin, streptomycin, nitrofurantoin, tetracycline, and chloramphenicol. The occurrence of multidrug-resistant E. coli O157 : H7 isolates from foods of animal origin sampled from different catering establishments reveals that the general sanitary condition of the catering establishments, utensils used, and personnel hygienic practices did not comply with the recommended standards. Thus, this finding calls for urgent attention toward appropriate controls and good hygienic practices in different catering establishments dealing with consuming raw/undercooked foods of animal origin.


Assuntos
Ovos/microbiologia , Escherichia coli O157/isolamento & purificação , Microbiologia de Alimentos , Carne/microbiologia , Leite/microbiologia , Restaurantes , Animais , Antibacterianos/farmacologia , Área Programática de Saúde , Farmacorresistência Bacteriana Múltipla , Escherichia coli O157/efeitos dos fármacos , Etiópia , Manipulação de Alimentos/instrumentação , Manipulação de Alimentos/métodos , Testes de Fixação do Látex , Modelos Logísticos , Produtos da Carne/microbiologia , Alimentos Crus/microbiologia , Fatores de Risco , Amostragem
19.
PLoS One ; 16(4): e0249074, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33857165

RESUMO

OBJECTIVE: Respondent driven sampling (RDS) is an important tool for measuring disease prevalence in populations with no sampling frame. We aim to describe key properties of these samples to guide those using this method and to inform methodological research. METHODS: In 2019, authors who published respondent driven sampling studies were contacted with a request to share reported degree and network information. Of 59 author groups identified, 15 (25%) agreed to share data, representing 53 distinct study samples containing 36,547 participants across 12 countries and several target populations including migrants, sex workers and men who have sex with men. Distribution of reported network degree was described for each sample and characteristics of recruitment chains, and their relationship to coupons, were reported. RESULTS: Reported network degree is severely skewed and is best represented by a log normal distribution. For participants connected to more than 15 other people, reported degree is imprecise and frequently rounded to the nearest five or ten. Our results indicate that many samples contain highly connected individuals, who may be connected to at least 1000 other people. CONCLUSION: Because very large reported degrees are common; we caution against treating these reports as outliers. The imprecise and skewed distribution of the reported degree should be incorporated into future RDS methodological studies to better capture real-world performance. Previous results indicating poor performance of regression estimators using RDS weights may be widely generalizable. Fewer recruitment coupons may be associated with longer recruitment chains.


Assuntos
Vigilância da População/métodos , Rede Social , Inquéritos e Questionários/normas , Humanos , Amostragem , Viés de Seleção
20.
Viruses ; 13(3)2021 03 18.
Artigo em Inglês | MEDLINE | ID: mdl-33803868

RESUMO

Haïti is at risk for wild poliovirus (WPV) importation and circulation, as well as vaccine-derived poliovirus (VDPV) emergence. Environmental surveillance (ES) for polioviruses was established in Port au Prince and Gonaïves in 2016. During 2017-2019, initial ES sites were re-evaluated, and ES was expanded into Cap Haïtien and Saint Marc. Wastewater samples and data on weather, hour of collection, and sample temperature and pH were collected every 4 weeks during March 2017-December 2019 (272 sampling events) from 21 sites in Cap Haïtien, Gonaïves, Port au Prince, and Saint Marc. Samples were processed for the detection of polio and non-polio enteroviruses using the two-phase and "Concentration and Filter Elution" methodologies. Polioviruses were serotyped and underwent intra-typic characterization. No WPV or VDPVs were isolated. Sabin-like polioviruses (oral vaccine strain) of serotypes 1 and 3 were sporadically detected. Five of six (83%), one of six (17%), five of six (83%), and two of three (67%) sites evaluated in Cap Haïtien, Gonaïves, Port au Prince, and Saint Marc, respectively, had enterovirus isolation from >50% of sampling events; these results and considerations, such as watershed population size and overlap, influence of sea water, and excessive particulates in samples, were factors in site retention or termination. The evaluation of 21 ES sampling sites in four Haïtian cities led to the termination of 11 sites. Every-four-weekly sampling continues at the remaining 10 sites across the four cities as a core Global Polio Eradication Initiative activity.


Assuntos
Monitoramento Ambiental/métodos , Poliomielite/epidemiologia , Poliovirus/isolamento & purificação , Erradicação de Doenças/métodos , Enterovirus/classificação , Enterovirus/isolamento & purificação , Monitoramento Ambiental/estatística & dados numéricos , Haiti , Humanos , Poliomielite/virologia , Poliovirus/classificação , Poliovirus/genética , Vacina Antipólio Oral/análise , Amostragem , Esgotos/virologia , Águas Residuárias/virologia
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