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Texto & contexto enferm ; 29: e20180399, Jan.-Dec. 2020. tab, graf
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: biblio-1101980


ABSTRACT Objective: to evaluate the effectiveness of educational interventions in improving the quality of life of people with arterial hypertension. Method: an integrative literature review which included studies that conducted educational interventions aimed at the hypertensive public to improve quality of life. The search was performed in the following databases: MEDLINE, LILACS, IBECS, CUMED, BDENF, SciELO and CINAHL, without restriction of language, date and sample size. For this, the following descriptors were crossed: "hipertensão" (hypertension), "educação em saúde" (health education) and "qualidade de vida" (quality of life). 619 articles were retrieved and after the selection and analysis process, a total of 10 made up this review. Data extraction and analysis were performed with the help of validated instruments and the result summarized. Results: Most studies were developed on a quasi-experimental basis, using generic instruments to measure quality of life with significant improvement after educational interventions, with group technology being the most used educational strategy. Just one study used a specific instrument to evaluate hypertensive patients. Conclusion: these results may direct the interventions to be implemented by health professionals in managing arterial hypertension. Further investigations are needed to identify and verify the most effective interventions for hypertensive patients, considering heterogeneous profiles and aiming at improving quality of life.

RESUMO Objetivo: evaluar la eficacia de las intervenciones educativas en el mejoramiento de la calidad de vida de personas con hipertensión arterial. Método: revisión integradora de la literatura que incluyó estudios que han realizado intervenciones educativas direccionadas al público hipertenso con el objetivo de mejorar su calidad de vida. La búsqueda se realizó en las bases de datos MEDLINE, LILACS, IBECS, CUMED, BDENF, SciELO e CINAHL, sin restricción de idioma, fecha ni tamaño de muestra. A tal efecto, se utilizaron los descriptores "hipertensión", "educación en salud" y "calidad de vida". Se tomaron 619 artículos y luego de un proceso de selección y análisis esta revisión se compone de un total de 10. La extracción y el análisis de datos se realizaron con el auxilio de instrumentos validados e se procedió a la síntesis de los resultados. Resultados: la mayor parte de los estudios se desarrolló con carácter casi experimental mediante el uso instrumentos genéricos para medir la calidad de vida, con significativa mejoría después de realizadas las intervenciones educativas, siendo la tecnología grupal la estrategia educacional más utilizada. Apenas un estudio utilizó un instrumento específico para la evaluación de hipertensos. Conclusión: estos resultados pueden direccionar las intervenciones que deben llevarse a cabo por profesionales de la salud en el manejo de la presión arterial. Es necesario profundizar las investigaciones para identificar y verificar las intervenciones más eficientes en pacientes hipertensos, considerando perfiles heterogéneos a fin de mejorar su calidad de vida.

RESUMO Objetivo: avaliar a efetividade de intervenções educativas na melhora da qualidade de vida de pessoas com hipertensão arterial. Método: revisão integrativa da literatura que incluiu estudos que realizaram intervenções educacionais direcionadas ao público hipertenso com vistas à melhora da qualidade de vida. Busca realizada nas bases de dados: MEDLINE, LILACS, IBECS, CUMED, BDENF, SciELO e CINAHL, sem restrição de idioma, data e tamanho amostral. Para tal, cruzaram-se os descritores: "hipertensão", "educação em saúde" e "qualidade de vida". Foram resgatados 619 artigos e após o processo de seleção e análise, um total de 10 compuseram esta revisão. A extração e análise dos dados foram realizadas com auxílio de instrumentos validados e o resultado sumarizado. Resultados: a maioria dos estudos foi desenvolvida em caráter quase experimental, utilizando-se de instrumentos genéricos para mensuração da qualidade de vida com melhora significativa após a realização de intervenções educativas, sendo a tecnologia grupal a estratégia educacional mais utilizada. Apenas um estudo utilizou instrumento específico para avaliação em hipertensos. Conclusão: estes resultados podem direcionar as intervenções a serem implementadas por profissionais de saúde no manejo da hipertensão arterial. Futuras investigações são necessárias para identificar e verificar as intervenções mais eficazes aos pacientes hipertensos, considerando perfis heterogêneos e visando à melhora da qualidade de vida.

Qualidade de Vida , Doença Crônica , Hipertensão , Saúde , Educação em Saúde , Revisão , Pressão Arterial , Análise de Dados
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1497-1502, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018275


Functional magnetic resonance imaging (fMRI) is one of the most popular methods for studying the human brain. It measures brain activity, by detecting local changes of Blood Oxygen Level Dependent (BOLD) signal in the brain, over time, and can be used in both task-related and resting-state studies. In task-related studies, our aim is to determine which brain areas are activated when a specific task is performed. Various unsupervised multivariate statistical methods are being increasingly employed in fMRI data analysis. Their main goal is to extract information from a dataset, often with no prior knowledge of the experimental conditions. Generalized canonical correlation analysis (gCCA) is a well known statistical method that can be considered as a way to estimate a linear subspace, which is "common" to multiple random linear subspaces. We propose a new fMRI data generating model which takes into consideration the existence of common task-related and resting-state components. We estimate the common spatial task-related component via a two-stage gCCA. We test our theoretical results using real-world fMRI data. Our experimental findings corroborate our theoretical results, rendering our approach a very good candidate for multi-subject task-related fMRI processing.Clinical Relevance-This work provides a set of methods for amplifying and recovering commonalities across subjects that appear in data from multi-subject task-related fMRI experiments.

Mapeamento Encefálico , Imagem por Ressonância Magnética , Encéfalo , Análise de Dados , Humanos , Análise Multivariada
Hum Genomics ; 14(1): 35, 2020 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-33008459


Precision medicine aims to empower clinicians to predict the most appropriate course of action for patients with complex diseases like cancer, diabetes, cardiomyopathy, and COVID-19. With a progressive interpretation of the clinical, molecular, and genomic factors at play in diseases, more effective and personalized medical treatments are anticipated for many disorders. Understanding patient's metabolomics and genetic make-up in conjunction with clinical data will significantly lead to determining predisposition, diagnostic, prognostic, and predictive biomarkers and paths ultimately providing optimal and personalized care for diverse, and targeted chronic and acute diseases. In clinical settings, we need to timely model clinical and multi-omics data to find statistical patterns across millions of features to identify underlying biologic pathways, modifiable risk factors, and actionable information that support early detection and prevention of complex disorders, and development of new therapies for better patient care. It is important to calculate quantitative phenotype measurements, evaluate variants in unique genes and interpret using ACMG guidelines, find frequency of pathogenic and likely pathogenic variants without disease indicators, and observe autosomal recessive carriers with a phenotype manifestation in metabolome. Next, ensuring security to reconcile noise, we need to build and train machine-learning prognostic models to meaningfully process multisource heterogeneous data to identify high-risk rare variants and make medically relevant predictions. The goal, today, is to facilitate implementation of mainstream precision medicine to improve the traditional symptom-driven practice of medicine, and allow earlier interventions using predictive diagnostics and tailoring better-personalized treatments. We strongly recommend automated implementation of cutting-edge technologies, utilizing machine learning (ML) and artificial intelligence (AI) approaches for the multimodal data aggregation, multifactor examination, development of knowledgebase of clinical predictors for decision support, and best strategies for dealing with relevant ethical issues.

Infecções por Coronavirus/genética , Diabetes Mellitus/genética , Neoplasias/genética , Pneumonia Viral/genética , Medicina de Precisão/tendências , Cardiomiopatias , Infecções por Coronavirus/epidemiologia , Análise de Dados , Diabetes Mellitus/epidemiologia , Genômica/tendências , Humanos , Metabolômica/tendências , Neoplasias/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Proteômica/tendências
Artigo em Inglês | MEDLINE | ID: mdl-33017937


There is evidence to suggest that changes in kinematics and neuromuscular control in activities that take place over long periods of time lead to increased injury risk. The collection of biometric data over long time periods could provide insight into these injuries. However, it is difficult to analyse long period biometric data for occupations as the analysis depends on the activity being performed, and it is not practical to manually label the amount of data required. A sufficiently accurate human activity recognition algorithm can provide a means to segment the activities and allow this analysis, but the classification must be robust to the inter-individual differences, as well as the intra-individual variations in movement over time that are the target of analysis. This work presents a person-independent human activity recognition algorithm for sheep shearing using a Hidden Markov Model with physical features that are identified to be relevant to spinal movement quality. The classifier achieved an F1 score of 96.47% in identifying the shearing task.

Biometria , Análise de Dados , Algoritmos , Animais , Atividades Humanas , Humanos , Movimento , Ovinos
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 750-753, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018095


In addition to the global parameter- and time-series-based approaches, physiological analyses should constitute a local temporal one, particularly when analyzing data within protocol segments. Hence, we introduce the R package implementing the estimation of temporal orders with a causal vector (CV). It may use linear modeling or time series distance. The algorithm was tested on cardiorespiratory data comprising tidal volume and tachogram curves, obtained from elite athletes (supine and standing, in static conditions) and a control group (different rates and depths of breathing, while supine). We checked the relation between CV and body position or breathing style. The rate of breathing had a greater impact on the CV than does the depth. The tachogram curve preceded the tidal volume relatively more when breathing was slower.

Análise de Dados , Respiração , Postura , Posição Ortostática , Volume de Ventilação Pulmonar
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2451-2454, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018502


A mathematically identical ordinary differential equations (ODEs) model was derived from a multiscale partial differential equations (PDEs) model of hepatitis c virus infection, which helps to overcome the limitations of the PDE model in clinical data analysis. We have discussed about basic properties of the system and found the basic reproduction number of the system. A condition for the local stability of the uninfected and the infected steady states is presented. The local stability analysis of the model shows that the system is asymptotically stable at the disease-free equilibrium point when the basic reproduction number is less than one. When the basic reproduction number is greater than one endemic equilibrium point exists, and the local stability analysis proves that this point is asymptotically stable. Numerical sensitivity analysis based on model parameters is performed and therefore the result describes the influence of each parameter on the basic reproduction number.

Hepacivirus , Hepatite C , Número Básico de Reprodução , Análise de Dados , Humanos
RECIIS (Online) ; 14(3): 656-680, jul.-set. 2020. graf, tab
Artigo em Português | LILACS | ID: biblio-1121855


A pesquisa apresentada neste artigo realizou um balanço quantitativo da taxa de mortalidade materna no Brasil ao longo das últimas duas décadas (2000-2019), sob o recorte de cor/raça com o objetivo de enfatizar a importância da divulgação de informações como demarcadores de mensuração de desigualdades raciais na mortalidade materna de mulheres negras no período gestacional, durante o parto e puerpério. A metodologia compreende a desagregação por cor/raça de dados do Sistema Único de Saúde (MS/DataSUS) derivados do Sistema de Informação de Mortalidade (SIM), a fim de coletar dados referentes a óbitos maternos, e do Sistema de Nascidos Vivos (Sinasc) para os dados relacionados aos nascimentos informados em território nacional. Os resultados obtidos apontam uma tendência de índices de mortalidade materna entre mulheres de cor/raça preta substancialmente maiores do que os que se referem às de cor/raça branca, revelando a falta de informações e políticas que minimizem a condição de vulnerabilidade de alguns grupos étnico-raciais no sistema de atenção à saúde materna.

This article presents a quantitative research examining the color/race-related maternal mortality rate in Brazil over the last two decades (2000-2019), aiming to emphasize the importance of the disclosure of information as indicators of racial inequalities in the black women' maternal mortality in the gestational period, during the childbirth and puerperium. The methodology uses the disaggregation by color/race of data from the Sistema Único de Saúde (DataSUS - Unified Health System) derived from the SIM - Sistema de Informação de Mortalidade (Mortality Information System), in order to collect data related to maternal deaths and from the Sinasc - Sistema de Nascidos Vivos (Live Births System), for the data related to births registered in the national territory. The results obtained point to a trend towards the maternal mortality rates being substantially higher among Black race/color women than among White race/color women, revealing the lack of information and policies that minimize the vulnerability of some ethnic-racial groups in the maternal health care system.

Este artículo presenta una investigación cuantitativa acerca de la tasa de mortalidad materna en Brasil a lo largo de las dos últimas décadas (2000-2019), del punto de vista de color/raza con el objetivo de enfatizar la importancia de la divulgación de informaciones como indicadores de las desigualdades raciales en la mortalidad materna de las mujeres negras en la fase de gestación, en el momento del parto y en el período de puerperio. La metodología utiliza la desagregación por color/raza de los datos del Sistema Único de Saúde (DataSUS - Sistema Unificado de Salud) derivados del SIM - Sistema de Informação de Mortalidade (Sistema de Información sobre Mortalidad), con el fin de recopilar datos relacionados con las muertes maternas, y del Sinasc - Sistema de Nascidos Vivos (Sistema de Nacidos Vivos) para los datos relacionados con los nacimientos documentados en el territorio nacional. Los resultados obtenidos apuntan una tendencia de las tasas de mortalidad materna entre las mujeres de color/raza negra sustancialmente superior a de las mujeres de color/raza blanca, revelando la falta de información y políticas que minimicen la condición de vulnerabilidad de ciertos grupos étnico-raciales en el sistema de atención de salud materna.

Humanos , Morte Materna , Sistemas de Informação em Saúde , Saúde Materna , Análise de Dados , Brasil , Grupos de Populações Continentais , Nascimento Vivo , Racismo
Pharm. pract. (Granada, Internet) ; 18(3): 0-0, jul.-sept. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-194197


BACKGROUND: While pharmacists are well positioned to implement pharmacogenomic testing in healthcare systems, uptake has been limited. OBJECTIVE: The primary objective of this survey was to determine how post-graduate education and training influences pharmacist's knowledge and attitudes of pharmacogenomic testing. METHODS: Survey questions were developed by the study team, and responses were collected electronically using REDCapTM. The electronic survey was sent to all pharmacists (n=161) within a large, multi-state healthcare system by email. RESULTS: A total of 75 (47%) respondents completed all aspects of the survey. The majority of respondents were female (60%), worked in acute care settings (57%), were full-time employees (80%), and worked in an urban area (85%), with many graduating in or after 2010 (43%). For post-graduate education, 36% of respondents completed a Post-Graduate Year One Residency (PGY-1), and 27% had a board certification. Those that completed a PGY-1 residency were significantly more likely to have received formal training or education on pharmacogenomics than those who had not. They also assessed their own knowledge of pharmacogenomic resources and guidelines higher than those without PGY-1 training. More recent graduates were also significantly more likely to have received formal training or education on pharmacogenomics. Additionally, pharmacists who completed a PGY-1 residency were more likely to respond favorably to pharmacogenomics being offered through pharmacy services. Pharmacists with board certification were more comfortable interpreting results of a pharmacogenomic test than those without board certification. CONCLUSIONS: Pharmacists who have completed a PGY-1 residency or received board certification appear more comfortable with interpretation and implementation of pharmacogenomic testing

No disponible

Humanos , Masculino , Feminino , Testes Farmacogenômicos/tendências , Conhecimentos, Atitudes e Prática em Saúde , Farmacogenética/educação , Assistência Farmacêutica/normas , Atitude do Pessoal de Saúde , Assistência Farmacêutica/organização & administração , Inquéritos e Questionários , Análise de Dados
PLoS Med ; 17(9): e1003272, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32976539


BACKGROUND: Prescription opioid misuse is an ongoing crisis and a risk factor for injection drug use (IDU). Few studies have evaluated strategies for preventing opioid or IDU initiation among adolescents. We evaluated changes in the proportion of adolescents reporting IDU before and after prescription drug monitoring program (PDMP) mandates were implemented in 18 states compared to 29 states without such mandates. METHODS AND FINDINGS: This difference-in-differences analysis used biannual Youth Risk Behavioral Surveillance System (YRBSS) data representative of adolescents 17 to 18 years old across 47 states from 1995 to 2017. We compared changes in adolescent IDU in 18 states with and 29 states without PDMP mandates. Among 331,025 adolescents, 51.7% identified as male, 62.1% as non-Hispanic white, 17.4% as non-Hispanic black, and 14.6% as Hispanic. Overall, 3.5% reported IDU during the 2 years prior to PDMP mandates. In the final multivariable difference-in-differences model, we included individual age, sex, and race/ethnicity, as well as state and year as covariates from the YRBSS. We also included state- and year-specific poverty rates based on US Census Bureau data. Additionally, we controlled for state implementation of (non-mandated) PDMPs before states subsequently implemented mandates and pill mill laws. We conducted several sensitivity analyses, including repeating our main analysis using a logistic, rather than linear, model, and with a lead indicator on PDMP mandate implementation, a lag indicator, and alternative policy implementation dates. PDMP mandates were associated with a 1.5 percentage point reduction (95% CI -2.3 to -0.6 percentage points; p = 0.001) in adolescent IDU, on average over the years following mandate implementation, a relative reduction of 42.9% (95% CI -65.7% to -17.1%). The association of PDMP mandates with this reduction persisted at least 4 years beyond implementation. Sensitivity analyses were consistent with the main results. Limitations include the multi-stepped causal pathway from PDMP mandate implementation to changes in IDU and the potential for omitted state-level time-varying confounders. CONCLUSIONS: Our analysis indicated that PDMP mandates were associated with a reduction in adolescent IDU, providing empirical evidence that such mandates may prevent adolescents from initiating IDU. Policymakers might consider PDMP mandates as a potential strategy for preventing adolescent IDU.

Analgésicos Opioides/uso terapêutico , Análise de Dados , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Programas de Monitoramento de Prescrição de Medicamentos/tendências , Adolescente , Feminino , Humanos , Masculino , Abuso de Substâncias por Via Intravenosa/tratamento farmacológico , Estados Unidos
F1000Res ; 9: 570, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32884676


The 2019-2020 global pandemic has been caused by a disease called coronavirus disease 2019 (COVID-19). This disease has been caused by the Severe Acute Respiratory Syndrome coronavirus-2 (SARS-CoV-2). By April 30 2020, the World Health Organization reported 3,096,626 cases and 217,896 deaths, which implies an exponential growth for infection and deaths worldwide. Currently, there are various computer-based approaches that present COVID-19 data through different types of charts, which is very useful to recognise its behavior and trends. Nevertheless, such approaches do not allow for observation of any projection regarding confirmed cases and deaths, which would be useful to understand the trends of COVID-19. In this work, we have designed and developed an online dashboard that presents actual information about COVID-19. Furthermore, based on this information, we have designed a mathematical model in order to make projections about the evolution of cases and deaths worldwide and by country.

Infecções por Coronavirus/mortalidade , Análise de Dados , Pneumonia Viral/mortalidade , Software , Betacoronavirus , Humanos , Internet , Modelos Teóricos , Pandemias
Yakugaku Zasshi ; 140(9): 1107-1117, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32879243


The true central aim of pharmaceutical research and education is to strive for the patient's satisfaction, i.e., "for the sake of the patient". Our research focuses to bridge the gap between the ideal and current situation in pharmaceutical science. We also investigated/questioned the united roles of pharmacists and pharmacies, with the ambition of changing the work culture of pharmacists. This paper reviews the history of our research and discusses the future of pharmaceutical research and education.

Biofarmácia/educação , Educação em Farmácia/tendências , Pesquisa/tendências , Análise de Dados , Humanos , Satisfação do Paciente , Farmacêuticos , Farmácia
Popul Health Manag ; 23(5): 350-360, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32897820


Given the severe and rapid impact of COVID-19, the pace of information sharing has been accelerated. However, traditional methods of disseminating and digesting medical information can be time-consuming and cumbersome. In a pilot study, the authors used social listening to quickly extract information from social media channels to explore what people with COVID-19 are talking about regarding symptoms and disease progression. The goal was to determine whether, by amplifying patient voices, new information could be identified that might have been missed through other sources. Two data sets from social media groups of people with or presumed to have COVID-19 were analyzed: a Facebook group poll, and conversation data from a Reddit group including detailed disease natural history-like posts. Content analysis and a customized analytics engine that incorporates machine learning and natural language processing were used to quickly identify symptoms mentioned. Key findings include more than 20 symptoms in the data sets that were not listed in online lists of symptoms from 4 respected medical information sources. The disease natural history-like posts revealed that people can experience symptoms for many weeks and that some symptoms change over time. This study demonstrates that social media can offer novel insights into patient experiences as a source of real-world data. This inductive research approach can quickly generate descriptive information that can be used to develop hypotheses and new research questions. Also, the method allows rapid assessments of large numbers of social media conversations that could be applied to monitor public health for emerging and rapidly spreading diseases such as COVID-19.

Infecções por Coronavirus/fisiopatologia , Progressão da Doença , Disseminação de Informação/métodos , Informática Médica/estatística & dados numéricos , Pandemias/estatística & dados numéricos , Pneumonia Viral/fisiopatologia , Mídias Sociais/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Análise de Dados , Feminino , Humanos , Masculino , Projetos Piloto , Pneumonia Viral/epidemiologia , Saúde Pública , Índice de Gravidade de Doença , Estados Unidos
Nan Fang Yi Ke Da Xue Xue Bao ; 40(4): 475-482, 2020 Apr 30.
Artigo em Chinês | MEDLINE | ID: mdl-32895141


OBJECTIVE: To explore the application and advantages of conditional inference forest in survival analysis. METHODS: We used simulated experiment and actual data to compare the predictive performance of 4 models, including Coxproportional hazards model, accelerated failure time model, random survival forest model and conditional inference forest model based on their Brier scores. RESULTS: Simulation experiment suggested that both of the two forest models had more accurate and robust predictive performance than the other two regression models. Conditional inference forest model was superior to the other models in analyzing time-to-event data with polytomous covariates, collinearity or interaction, especially for a large sample size and a high censoring rate. The results of actual data analysis demonstrated that conditional inference forest model had the best predictive performance among the 4 models. CONCLUSIONS: Compared with the commonly used survival analysis methods, conditional inference forest model performs better especially when the data contain polytomous covariates with collinearity and interaction.

Análise de Dados , Modelos de Riscos Proporcionais , Tamanho da Amostra , Análise de Sobrevida
Nihon Koshu Eisei Zasshi ; 67(8): 501-508, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32879236


Objectives Medical expenses for diabetes differ between Japan's 47 prefectures. The medical care expenditure regulation plan aims to reduce regional differences in outpatient medical costs through prevention of severe diabetes, promotion of specific health checkups and specific health guidance, promotion of generic drugs, and proper use of medicines. To achieve this goal, we need to conduct an in-depth analysis of inter-prefecture differences in diabetes care expenses. This study analyzed regional differences in prescription fees for dipeptidyl peptidase-4 (DPP-4) inhibitors and the use of generic sulfonylureas (SUs), glinides, biguanides, α-glucosidase inhibitors (α-GIs), and thiazoline derivatives, using the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB). Furthermore, we analyzed regional differences in consultancy fees for dialysis prevention.Methods We analyzed the 2nd NDB Open Data Japan website of the Ministry of Health, Labor, and Welfare. Pearson's correlation coefficient (r) was used to evaluate the relationship between the medical costs of diabetes and each factor. The correlation coefficient was analyzed with Student's t-test, and a P-value<0.05 was considered statistically significant.Results Regarding oral hypoglycemic drugs, prefectures with a large number of DPP-4 inhibitors tended to have higher medical costs of diabetes (r=0.40, P=0.0048). Furthermore, such expenses tended to be low in prefectures where the use of generic SU drugs was high (r=-0.43, P=0.0023).Conclusions In conclusion, the results revealed regional differences in the use of DPP-4 inhibitors and generic SU drugs, which may contribute to the regional differences in medical expenses for diabetes. This study suggests that NDB open data are useful for policy making to reduce regional differences in outpatient medical costs of diabetes.

Serviços de Saúde Comunitária/economia , Efeitos Psicossociais da Doença , Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus/economia , Inibidores Enzimáticos/administração & dosagem , Inibidores Enzimáticos/economia , Custos de Cuidados de Saúde , Hipoglicemiantes/administração & dosagem , Hipoglicemiantes/economia , Compostos de Sulfonilureia/administração & dosagem , Compostos de Sulfonilureia/economia , Análise de Dados , Diabetes Mellitus/prevenção & controle , Dipeptidil Peptidase 4 , Humanos , Japão , Honorários por Prescrição de Medicamentos , Encaminhamento e Consulta/economia
Gesundheitswesen ; 82(8-09): 716-722, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32961567


" There are more and more good reasons for using existing care data, with the focus in particular on the use of register data. The associated, clearly structured methodological procedure has so far been insufficiently combined, prepared and presented transparently. The German Network for Health Services Research (DNVF) has therefore set up an ad hoc commission for the use of routine practice data (RWE/RWD). The rapid report prepared by IQWiG on the scientific development of concepts for "generation of care-related data and their evaluation for the purpose of benefit assessment of medicinal products according to § 35a SGB V" is an essential step for the use of register data for the generation of evidence. The "Memorandum Register - Update 2019" published by DNVF 2020 also describes the requirements and methodological foundations of registers. Best practice examples from oncology, which are based on the uniform oncological basic data set for clinical cancer registration (§ 65c SGB V), show, for example, that guidelines can be checked and recommendations for guidelines and necessary interventions can be derived in the sense of knowledge-generating health services research using register data. At the same time, however, there are no clear quality requirements and structured formal and content-related procedures in the areas of data consolidation, data verification and the use of specific methods depending on the question at hand. The previously inconsistent requirements are to be revised and a method guide for the use of suited data is to be developed and published. The first chapter of the manual on methods of care-related data explains the objective and structure of the manual. It explains why the use of the term "routine practice data" is more effective than the use of the terms Real Word Data (RWD) and Real World Evidence (RWE). By avoiding the term "real world" it should be emphasized in particular that high-quality research can also be based on routine practice data (e. g. register-based comparative studies).

Pesquisa sobre Serviços de Saúde , Projetos de Pesquisa , Análise de Dados , Interpretação Estatística de Dados , Alemanha
Univ. salud ; 22(2): 178-185, mayo-ago. 2020. tab
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1115967


Introducción: Un concepto es una idea acerca de algo o de una acción. Objetivo: Analizar el concepto "Violencia de Género" desde la perspectiva evolutiva de Rodgers. Materiales y métodos: Se utilizó el análisis evolutivo de conceptos mediante revisión de literatura publicada entre los años 2000 y 2018. Criterios de inclusión: Artículos de investigación, de implementación de estrategias, de política, tesis, libros, capítulos de libro y reportes, en las bases de datos Lilacs, Ebsco, SciELO, CINAHL, Web of Science, PubMed, Google Académico; también se incluyeron documentos de organizaciones internacionales, publicados del año 2000 al año 2018, en Español, Inglés o Portugués, y que pertenecieran al contexto iberoamericano. Resultados: La Violencia de género consiste en un fenómeno de orden estructural, social y político; resultado de la discriminación estructural originado por un sistema sexo-género-patriarcado. Se encontraron términos relacionados como inequidad de género, control, relaciones asimétricas y términos subrogados como violencia de pareja, contra la mujer y doméstica. Conclusiones: La violencia de género, constituye una violación a los derechos humanos, afecta la dignidad, la integridad física y moral, la libertad y la autonomía.

Introduction: A concept is an idea about something or an action. Objective: To analyze the concept of "Gender Violence" from the Rodgers' evolutionary perspective. Materials and methods: An evolutionary analysis of this concept was carried out through a review of literature published between 2000 and 2018. The inclusion criteria were: research articles related to implementation of strategies and politics; thesis; books; book chapters; and reports. They were found in the databases of Lilacs, Ebsco, SciELO, CINAHL, Web of Science, PubMed, and Google Scholar. The review also included documents from international organizations published from 2000 to 2018 in Spanish, English or Portuguese, which discussed Ibero-American issues. Results: Gender violence is a phenomenon with structural, social and political dimensions and is caused by the structural discrimination triggered by a sex-gender-patriarchy system. Related terms such as gender inequality, control, asymmetric relationships were found. Likewise, surrogate terms, i.e., violence against intimate partners, women and domestic violence, were also identified. Conclusions: Gender violence constitutes a violation against human rights that affects the dignity, physical and moral integrity, freedom, and autonomy of people.

Humanos , Violência de Gênero , Violência contra a Mulher , Análise de Dados
J Am Acad Orthop Surg ; 28(17): 717-729, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32833390


INTRODUCTION: Although the Patient-reported Outcomes Measurement Information System (PROMIS) is increasingly being used, there are few studies assessing the psychometric properties of PROMIS in minimally invasive spine (MIS) surgery. Thus, the purpose of this study was to perform a psychometric evaluation of PROMIS Physical Function Computer Adaptive Testing (PROMIS-PF CAT) in MIS lumbar surgery. METHODS: The patient-reported outcome measures collected preoperatively and postoperatively of patients undergoing MIS lumbar surgery were retrospectively analyzed to assess responsiveness, coverage, discriminant validity, and concurrent validity of PROMIS-PF CAT. RESULTS: Four hundred twenty-one patients were included. The responsiveness of PROMIS Physical Function (PROMIS-PF) was lower than that of the Oswestry Disability Index (ODI) in the decompression subgroup. Although the ODI had a ceiling effect of 16.7% at 1 year, the Short-Form 12 physical health score and PROMIS-PF did not show floor or ceiling effects. PROMIS-PF demonstrated discriminant validity preoperatively and postoperatively and convergent validity with the ODI, as evidenced by a significant strong negative correlation but not with the Short-Form 12 Physical Health Score, as evidenced by the variability in strength of correlation. CONCLUSIONS: Although the PROMIS-PF showed lower responsiveness than the ODI, particularly in the decompression subgroup, it demonstrated discriminant validity preoperatively and postoperatively, convergent validity with ODI, and better coverage than ODI. These findings suggest that the PROMIS-PF CAT demonstrates reasonable psychometric properties and may be a good surrogate for the ODI.

Vértebras Lombares/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/psicologia , Procedimentos Ortopédicos/psicologia , Medidas de Resultados Relatados pelo Paciente , Psicometria/métodos , Reprodutibilidade dos Testes , Análise de Dados , Avaliação da Deficiência , Feminino , Humanos , Vértebras Lombares/fisiopatologia , Masculino , Recuperação de Função Fisiológica , Estudos Retrospectivos
Pediatr Dent ; 42(4): 288-292, 2020 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-32847668


Purpose: The purpose of this study was to examine if there are differences in the success rate of primary teeth treated with pulpotomies performed by general dentists (GDs) versus pediatric dentists (PDs), using submitted paid insurance dental claims. The extraction time after pulpotomy was examined. Methods: Data for this study were obtained from a private dental insurance claims warehouse. The insurance claims data were retrieved, and a retrospective analysis was performed over seven years (2008 to 2015). The survival rate was estimated using proportional hazard survival analysis. Results: The total number of paid dental claims that used the CDT code for pulpotomy was 401,638. For teeth that received pulpotomy, the average time between pulpotomy and extraction was 1.1 years if the pulpotomies were performed by GDs. The average time was 1.3 years if the pulpotomies were performed by PDs (P<0.0001). GDs had an extraction rate of 7.83 percent after pulpotomies and the placement of stainless steel crowns, while PDs had an extraction rate of 4.09 percent. Conclusions: There is a significant difference in the success rate of teeth treated with pulpotomies performed by pediatric dentists versus general dentists, with pulpotomies performed by the former having a longer survival rate.

Análise de Dados , Pulpotomia , Criança , Coroas , Odontólogos , Humanos , Dente Molar , Estudos Retrospectivos , Dente Decíduo , Resultado do Tratamento
PLoS Pathog ; 16(8): e1008643, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32790776


The current state of much of the Wuhan pneumonia virus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) research shows a regrettable lack of data sharing and considerable analytical obfuscation. This impedes global research cooperation, which is essential for tackling public health emergencies and requires unimpeded access to data, analysis tools, and computational infrastructure. Here, we show that community efforts in developing open analytical software tools over the past 10 years, combined with national investments into scientific computational infrastructure, can overcome these deficiencies and provide an accessible platform for tackling global health emergencies in an open and transparent manner. Specifically, we use all SARS-CoV-2 genomic data available in the public domain so far to (1) underscore the importance of access to raw data and (2) demonstrate that existing community efforts in curation and deployment of biomedical software can reliably support rapid, reproducible research during global health crises. All our analyses are fully documented at

Betacoronavirus/patogenicidade , Infecções por Coronavirus/virologia , Pneumonia Viral/virologia , Saúde Pública , Síndrome Respiratória Aguda Grave/virologia , Análise de Dados , Humanos , Pandemias