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1.
Sci Total Environ ; 804: 150091, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-34517316

RESUMO

BACKGROUND: Ambient air pollution exposure has been associated with higher mortality risk in numerous studies. We assessed potential variability in the magnitude of this association for non-accidental, cardiovascular disease, respiratory disease, and lung cancer mortality in a country-wide administrative cohort by exposure assessment method and by adjustment for geographic subdivisions. METHODS: We used the Belgian 2001 census linked to population and mortality register including nearly 5.5 million adults aged ≥30 (mean follow-up: 9.97 years). Annual mean concentrations for fine particulate matter (PM2.5), nitrogen dioxide (NO2), black carbon (BC) and ozone (O3) were assessed at baseline residential address using two exposure methods; Europe-wide hybrid land use regression (LUR) models [100x100m], and Belgium-wide interpolation-dispersion (RIO-IFDM) models [25x25m]. We used Cox proportional hazards models with age as the underlying time scale and adjusted for various individual and area-level covariates. We further adjusted main models for two different area-levels following the European Nomenclature of Territorial Units for Statistics (NUTS); NUTS-1 (n = 3), or NUTS-3 (n = 43). RESULTS: We found no consistent differences between both exposure methods. We observed most robust associations with lung cancer mortality. Hazard Ratios (HRs) per 10 µg/m3 increase for NO2 were 1.060 (95%CI 1.042-1.078) [hybrid LUR] and 1.040 (95%CI 1.022-1.058) [RIO-IFDM]. Associations with non-accidental, respiratory disease and cardiovascular disease mortality were generally null in main models but were enhanced after further adjustment for NUTS-1 or NUTS-3. HRs for non-accidental mortality per 5 µg/m3 increase for PM2.5 for the main model using hybrid LUR exposure were 1.023 (95%CI 1.011-1.035). After including random effects HRs were 1.044 (95%CI 1.033-1.057) [NUTS-1] and 1.076 (95%CI 1.060-1.092) [NUTS-3]. CONCLUSION: Long-term air pollution exposure was associated with higher lung cancer mortality risk but not consistently with the other studied causes. Magnitude of associations varied by adjustment for geographic subdivisions, area-level socio-economic covariates and less by exposure assessment method.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Adulto , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/toxicidade , Poluição do Ar/análise , Poluição do Ar/estatística & dados numéricos , Censos , Estudos de Coortes , Exposição Ambiental/análise , Exposição Ambiental/estatística & dados numéricos , Humanos , Material Particulado/análise , Material Particulado/toxicidade
2.
Nature ; 598(7879): 33-34, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34616052

Assuntos
Córtex Motor , Censos
3.
Rev Bras Enferm ; 75(2): e20201370, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34705990

RESUMO

OBJECTIVES: to analyze the socioeconomic characteristics of nurses and nursing technicians living in Brazil according to color/race. METHODS: based on the 2010 Demographic Census sample, 62,451 nursing professionals (nurses and technicians) living in Brazil were selected. Differences in monthly income were estimated by multivariate models, stratified by color or race groups (white, brown, and black). RESULTS: the majority were technicians (61.9%) of white color (54.3%). The income of white nurses exceeded that of brown and black nurses by more than a quarter; among technicians, white professionals had an income approximately 11% higher than brown and black nurses. CONCLUSIONS: differences between incomes of nursing workers were associated with ethnic/racial background, revealing situations in which white professionals systematically presented more favorable job and income conditions than black and brown professionals.


Assuntos
Grupos Étnicos , Recursos Humanos de Enfermagem , Brasil , Censos , Humanos , Renda , Fatores Socioeconômicos
4.
BMJ ; 375: n2368, 2021 10 08.
Artigo em Inglês | MEDLINE | ID: mdl-34625469

RESUMO

OBJECTIVE: To investigate the association between changes in long term residential exposure to ambient fine particulate matter (PM2.5) and premature mortality in Canada. DESIGN: Population based quasi-experimental study. SETTING: Canada. PARTICIPANTS: 663 100 respondents to the 1996, 2001, and 2006 Canadian censuses aged 25-89 years who had consistently lived in areas with either high or low PM2.5 levels over five years preceding census day and moved during the ensuing five years. INTERVENTIONS: Changes in long term exposure to PM2.5 arising from residential mobility. MAIN OUTCOME MEASURES: The primary outcome was deaths from natural causes. Secondary outcomes were deaths from any cardiometabolic cause, any respiratory cause, and any cancer cause. All outcomes were obtained from the national vital statistics database. RESULTS: Using a propensity score matching technique with numerous personal, socioeconomic, health, and environment related covariates, each participant who moved to a different PM2.5 area was matched with up to three participants who moved within the same PM2.5 area. In the matched groups that moved from high to intermediate or low PM2.5 areas, residential mobility was associated with a decline in annual PM2.5 exposure from 10.6 µg/m3 to 7.4 and 5.0 µg/m3, respectively. Conversely, in the matched groups that moved from low to intermediate or high PM2.5 areas, annual PM2.5 increased from 4.6 µg/m3 to 6.7 and 9.2 µg/m3. Five years after moving, individuals who experienced a reduction in exposure to PM2.5 from high to intermediate levels showed a 6.8% (95% confidence interval 1.7% to 11.7%) reduction in mortality (2510 deaths in 56 025 v 4925 deaths in 101 960). A greater decline in mortality occurred among those exposed to a larger reduction in PM2.5. Increased mortality was found with exposure to PM2.5 from low to high levels, and to a lesser degree from low to intermediate levels. Furthermore, the decreases in PM2.5 exposure were most strongly associated with reductions in cardiometabolic deaths, whereas the increases in PM2.5 exposure were mostly related to respiratory deaths. No strong evidence was found for the changes in PM2.5 exposure with cancer related deaths. CONCLUSIONS: In Canada, decreases in PM2.5 were associated with lower mortality, whereas increases in PM2.5 were associated with higher mortality. These results were observed at PM2.5 levels considerably lower than many other countries, providing support for continuously improving air quality.


Assuntos
Poluição do Ar/análise , Mortalidade Prematura , Material Particulado/efeitos adversos , Adulto , Idoso , Poluição do Ar/efeitos adversos , Canadá/epidemiologia , Censos , Exposição Ambiental/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados não Aleatórios como Assunto
5.
Rev Saude Publica ; 55: 54, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34614117

RESUMO

OBJECTIVE: To build and validate a logical model for health care in Specialized Rehabilitation Centers (CER) by analyzing the work process and organizational issues of centers in Rio Grande do Norte. METHODS: This is a methodological study developed in three stages: 1) documentary research of legislation and ordinances concerning the healthcare service and the Disability Care Network (RCPD); 2) focus groups with a Census study of the CER in Rio Grande do Norte to understand and assess the daily activities of the service; and 3) systematization of the information collected and, finally, proposition and validation of the evaluative logical model. RESULTS: The model encompassed five central categories of the work and organizational process: "demands", "resources" (inputs, financial and workforce), "processes", "products and results" and "mission, values and external factors". CONCLUSION: The logical model built was suitable for graphical representation of the work process and organizational issues of the SRC. The study showed that the functioning of the services is in line with the regulations. However, there are still organizational gaps that need to be addressed to improve the resolution capacity of the service and the articulation with other points of the network.


Assuntos
Censos , Centros de Reabilitação , Brasil
7.
BMC Musculoskelet Disord ; 22(1): 791, 2021 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-34525989

RESUMO

BACKGROUND: There are different procedures for both, the diagnosis and the therapy of a periprosthetic joint infection (PJI), however, national or international guidelines for a standardised treatment regime are still lacking. The present paper evaluates the use of the predominant treatment protocols for PJI in certified total joint replacement centres (EPZ) in Germany based on an EndoCert questionnaire. MATERIALS AND METHODS: The questionnaire was developed in cooperation with the EndoCert Certification Commission to survey the treatment protocols for septic revision arthroplasties in EPZ. Questions targeted the various treatment options including prosthesis preserving procedures (DAIR - Debridement, antibiotics, irrigation, and retention of the prosthesis), one-stage revision, two-stage revision, removal of the endoprosthesis and diagnostic sampling prior to re-implantation. All certified EPZ participated (n = 504) and the results from the current survey in 2020 were compared to data from a previous analysis in 2015. RESULTS: The number of centres that performed DAIR up to a maximum of 4 weeks and more than 10 weeks after index surgery decreased since 2015, while the number of centres that provided a one-stage revision as a treatment option increased (hip: + 6.3%; knee: + 6.6%). The majority of the centres (73.2%) indicated a 4-8 week period as the preferred interval between prosthesis removal and re-implantation in two-stage revision in hip as well as knee revisions. Centres with a higher number of revision surgeries (> 200 revisions/year), opted even more often for the 4-8 week period (92.3%). In two-stage revision the use of metal-based spacers with/without reinforcement with antibiotic-containing cement as an interim placeholder was significantly reduced in 2020 compared to 2015. There was also a clear preference for cemented anchoring in two-stage revision arthroplasty in the knee in 2020, whereas the majority of hip replacements was cementless. Additionally, in 2020 the number of samples for microbiological testing during the removal of the infected endoprosthesis increased and 72% of the centres took five or more samples. Overall, the number of EPZ with a standardised protocol for the procedure expanded from 2015 to 2020. CONCLUSION: While there was a trend towards standardised therapeutic algorithms for PJI with more uniform choices among the centres in 2020 compared to 2015, the treatment often remains an individual decision. However, since a consistent treatment regime is of vital importance with an expected rise of total numbers of revision arthroplasties, uniform definitions with regard to comparability and standardisation are necessary for the further development of the EndoCert system.


Assuntos
Artroplastia de Quadril , Artroplastia do Joelho , Infecções Relacionadas à Prótese , Antibacterianos/uso terapêutico , Artroplastia de Quadril/efeitos adversos , Artroplastia do Joelho/efeitos adversos , Censos , Desbridamento , Alemanha/epidemiologia , Humanos , Infecções Relacionadas à Prótese/diagnóstico , Infecções Relacionadas à Prótese/epidemiologia , Infecções Relacionadas à Prótese/cirurgia , Reoperação , Estudos Retrospectivos , Resultado do Tratamento
8.
Med Care ; 59(Suppl 5): S413-S419, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34524237

RESUMO

BACKGROUND: The federal government uses multiple definitions for identifying rural communities based on various geographies and different elements of rurality. OBJECTIVES: The objectives of this study were to: (1) assess the degree to which rural definitions identify the same areas as rural; and (2) assess rural-urban disparities identified by each definition across socioeconomic, demographic, and health access and outcome measures. RESEARCH DESIGN: We determined the rural status of each census tract and calculated the rural-urban disparity resulting from each definition, as well as across the number of definitions in which tracts were designated as rural (rurality agreement). SUBJECTS: The population in 72,506 census tracts. MEASURES: We used 8 federal rural definitions. Population characteristics included percent with a bachelor's degree, income below 200% poverty, population density, percent with health insurance and whether various health care services were within 30 minutes driving time of the tract centroid. RESULTS: The rural population varied from slightly < 6.9 million people to >75.5 million across definitions. The largest rural-urban disparities were found using Urban Influence Codes. Urbanized Area and Urbanized Cluster tended to generate smaller disparities. Population characteristics such as population density and percent White had notable discontinuities across levels of rurality, while others such as percent with a bachelor's degree and income below 200% poverty varied continuously. CONCLUSIONS: Rural-urban populations and disparities were sensitive to the specific definition and the relative strength of definitions varied across population characteristics. Researchers and policymakers should carefully consider the choice of outcome and region when deciding the most appropriate rural definition.


Assuntos
População Rural/classificação , População Urbana/classificação , Censos , Disparidades nos Níveis de Saúde , Humanos , Estados Unidos
9.
Epidemiology ; 32(6): 877-885, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34347686

RESUMO

BACKGROUND: Prior studies suggest neighborhood poverty and deprivation are associated with adverse health outcomes including death, but evidence is limited among persons with HIV, particularly women. We estimated changes in mortality risk from improvement in three measures of area-level socioeconomic context among participants of the Women's Interagency HIV Study. METHODS: Starting in October 2013, we linked geocoded residential census block groups to the 2015 Area Deprivation Index (ADI) and two 2012-2016 American Community Survey poverty variables, categorized into national tertiles. We used parametric g-computation to estimate, through March 2018, impacts on mortality of improving each income or poverty measure by one and two tertiles maximum versus no improvement. RESULTS: Of 1596 women with HIV (median age 49), 91 (5.7%) were lost to follow-up and 83 (5.2%) died. Most women (62%) lived in a block group in the tertile with the highest proportions of individuals with income:poverty <1; 13% lived in areas in the tertile with the lowest proportions. Mortality risk differences comparing a one-tertile improvement (for those in the two highest poverty tertiles) in income:poverty <1 versus no improvement increased over time; the risk difference was -2.2% (95% confidence interval [CI] = -3.7, -0.64) at 4 years. Estimates from family income below poverty level (-1.0%; 95% CI = -2.7, 0.62) and ADI (-1.5%; 95% CI = -2.8, -0.21) exposures were similar. CONCLUSIONS: Consistent results from three distinct measures of area-level socioeconomic environment support the hypothesis that interventions to ameliorate neighborhood poverty or deprivation reduce mortality risk for US women with HIV. See video abstract at, http://links.lww.com/EDE/B863.


Assuntos
Infecções por HIV , Pobreza , Censos , Feminino , Humanos , Renda , Pessoa de Meia-Idade , Características de Residência , Fatores Socioeconômicos , Estados Unidos/epidemiologia
10.
Artigo em Inglês | MEDLINE | ID: mdl-34360148

RESUMO

BACKGROUND: This study investigated trends in cancer-related avoidable (preventable and treatable) mortality and its association with area deprivation in Korea. METHODS: Cancer-related avoidable mortality rates per 100,000 population between 2015 and 2019 were measured using the Causes of Death Statistics. Area Deprivation Index (ADI) was measured from the Population and Housing Census and information on other independent variables from the Korea Community Health Survey. The gap in avoidable mortality between the more and less deprived groups was expressed as rate ratios (RR) and absolute differences (ADs) with a 95 percent confidence interval (95% CI). The association between avoidable mortality and ADI was investigated through Poisson regression modelling. RESULTS: The more deprived areas had higher avoidable (RR 1.15, 95% CI 1.13-1.17; AD 6.58, 95% CI 5.59-7.57) and preventable (RR 1.19, 95% CI 1.17-1.21; AD 6.22, 95% CI 5.38-7.06) mortality. The overall cancer-related avoidable mortality decreased but the gap between the more and less deprived groups did not decline significantly during the study period. The association between avoidable and preventable mortality and area deprivation remained significant after adjusting for variables, including area levels of smokers and alcohol drinkers. CONCLUSIONS: The gap in avoidable mortality signifies the importance of addressing related disparities in cancer.


Assuntos
Censos , Neoplasias , Causas de Morte , Humanos , Mortalidade , República da Coreia/epidemiologia , Fatores Socioeconômicos
11.
J Environ Radioact ; 237: 106714, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34428732

RESUMO

The Second Census of Pollution Source in China was conducted from 2017 to 2020, and the radioactive target in this census was Naturally Occurring Radioactive Material (NORM).The census plan for the radioactive component was prepared by the Nuclear and Radiation Safety Centre of the Ministry of Ecology and Environment in accord with the work requirement of the overall census. The work steps involved in performing the census included establishing the organization structure, document formulation, conducting a pilot survey, relevant training, screening of preliminary survey data, quality assurance, detailed data collection and analysis, data verification and reporting, and final summarizing. The survey mainly involved 15 kinds of NORM industries, which include the rare earth, niobium/tantalum, zircon, zirconia and tin industries, etc. Almost 30,000 enterprises were investigated in the screening phase, and nearly 2000 enterprises were determined to satisfy the screening criteriafor the presence of NORM. A total of 3500 samples including discharge water, raw ore, milling ore and solid waste were obtained and measured resulting in about20,000 individual datum. The Nuclear and Radiation Safety Centre of the Ministry of Ecology and Environment had responsibility for the NORM census and has completed a comprehensive statistical analysis of the data including analysis of the characteristics from different perspectives.


Assuntos
Exposição Ocupacional , Monitoramento de Radiação , Resíduos Radioativos , Radiação de Fundo , Censos , China , Resíduos Radioativos/análise
12.
JMIR Public Health Surveill ; 7(8): e28195, 2021 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-34346897

RESUMO

BACKGROUND: COVID-19 has been one of the most serious global health crises in world history. During the pandemic, health care systems require accurate forecasts for key resources to guide preparation for patient surges. Forecasting the COVID-19 hospital census is among the most important planning decisions to ensure adequate staffing, number of beds, intensive care units, and vital equipment. OBJECTIVE: The goal of this study was to explore the potential utility of local COVID-19 infection incidence data in developing a forecasting model for the COVID-19 hospital census. METHODS: The study data comprised aggregated daily COVID-19 hospital census data across 11 Atrium Health hospitals plus a virtual hospital in the greater Charlotte metropolitan area of North Carolina, as well as the total daily infection incidence across the same region during the May 15 to December 5, 2020, period. Cross-correlations between hospital census and local infection incidence lagging up to 21 days were computed. A multivariate time-series framework, called the vector error correction model (VECM), was used to simultaneously incorporate both time series and account for their possible long-run relationship. Hypothesis tests and model diagnostics were performed to test for the long-run relationship and examine model goodness of fit. The 7-days-ahead forecast performance was measured by mean absolute percentage error (MAPE), with time-series cross-validation. The forecast performance was also compared with an autoregressive integrated moving average (ARIMA) model in the same cross-validation time frame. Based on different scenarios of the pandemic, the fitted model was leveraged to produce 60-days-ahead forecasts. RESULTS: The cross-correlations were uniformly high, falling between 0.7 and 0.8. There was sufficient evidence that the two time series have a stable long-run relationship at the .01 significance level. The model had very good fit to the data. The out-of-sample MAPE had a median of 5.9% and a 95th percentile of 13.4%. In comparison, the MAPE of the ARIMA had a median of 6.6% and a 95th percentile of 14.3%. Scenario-based 60-days-ahead forecasts exhibited concave trajectories with peaks lagging 2 to 3 weeks later than the peak infection incidence. In the worst-case scenario, the COVID-19 hospital census can reach a peak over 3 times greater than the peak observed during the second wave. CONCLUSIONS: When used in the VECM framework, the local COVID-19 infection incidence can be an effective leading indicator to predict the COVID-19 hospital census. The VECM model had a very good 7-days-ahead forecast performance and outperformed the traditional ARIMA model. Leveraging the relationship between the two time series, the model can produce realistic 60-days-ahead scenario-based projections, which can inform health care systems about the peak timing and volume of the hospital census for long-term planning purposes.


Assuntos
COVID-19/terapia , Censos , Previsões/métodos , Hospitais , Modelos Teóricos , COVID-19/epidemiologia , Humanos , Incidência , Análise Multivariada , North Carolina/epidemiologia
13.
Am J Public Health ; 111(S2): S141-S148, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34314212

RESUMO

OBJECTIVES: To assess the quality of population-level US mortality data in the US Census Bureau Numerical Identification file (Numident) and describe the details of the mortality information as well as the novel person-level linkages available when using the Census Numident. METHODS: We compared all-cause mortality in the Census Numident to published vital statistics from the Centers for Disease Control and Prevention. We provide detailed information on the linkage of the Census Numident to other Census Bureau survey, administrative, and economic data. RESULTS: Death counts in the Census Numident are similar to those from published mortality vital statistics. Yearly comparisons show that the Census Numident captures more deaths since 1997, and coverage is slightly lower going back in time. Weekly estimates show similar trends from both data sets. CONCLUSIONS: The Census Numident is a high-quality and timely source of data to study all-cause mortality. The Census Bureau makes available a vast and rich set of restricted-use, individual-level data linked to the Census Numident for researchers to use. PUBLIC HEALTH IMPLICATIONS: The Census Numident linked to data available from the Census Bureau provides infrastructure for doing evidence-based public health policy research on mortality.


Assuntos
Causas de Morte/tendências , Censos , Centers for Disease Control and Prevention, U.S./estatística & dados numéricos , Coleta de Dados/métodos , Coleta de Dados/estatística & dados numéricos , Mortalidade/tendências , Estatísticas Vitais , Previsões , Humanos , Estados Unidos
14.
Health Rep ; 32(7): 11-26, 2021 07 21.
Artigo em Inglês | MEDLINE | ID: mdl-34288618

RESUMO

BACKGROUND: The objective of this study was to describe sex-specific hospitalization rates among Indigenous people in Canada (excluding Quebec), separately for First Nations people living on and off reserve, Inuit living in Inuit Nunangat (excluding Nunavik), Métis, and the non-Indigenous population. DATA AND METHODS: The 2006 and 2011 Canadian Census Health and Environment Cohorts (CanCHECs) were used, allowing hospital records to be examined by Indigenous identity as reported on the census. Five years of hospitalization data were used for each CanCHEC. Causes of hospitalization were based on the most responsible diagnosis and coded at the chapter level according to the International Classification of Diseases (ICD-10-CA). Age-standardized hospitalization rates (ASHRs) were calculated per 100,000 population, and rate ratios (RRs) were calculated for each Indigenous group relative to non-Indigenous people. RESULTS: ASHRs were higher among Indigenous people than among non-Indigenous people; this was true for females and males from both the 2006 and the 2011 cohorts. Hospitalization patterns varied by sex and Indigenous group. The greatest disparities with the non-Indigenous population were observed among on-reserve First Nations females and males from both cohorts. Elevated RRs were observed for diseases of the endocrine, nutritional and metabolic system among First Nations females and males living on reserve; hospitalizations for mental health among First Nations females and males living off reserve and Inuit males; and diseases of the respiratory system among Inuit females. For Métis females and males, equally elevated RRs were observed for diseases of the endocrine system and mental health. ASHRs for most causes decreased between the 2006 and 2011 cohorts, with the exception of ASHRs for mental health among First Nations females and males living on reserve, which increased. DISCUSSION: Findings are consistent with recognized health disparities between Indigenous and non-Indigenous people. Further research is warranted to understand reported differences in hospitalization patterns.


Assuntos
Índios Norte-Americanos , Inuítes , Canadá/epidemiologia , Censos , Feminino , Hospitalização , Humanos , Povos Indígenas , Masculino
15.
J Anxiety Disord ; 83: 102455, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34332230

RESUMO

BACKGROUND: Events from spring to fall 2020, including the COVID-19 pandemic, hate crimes, and social unrest, may have impacted mental health, particularly mood and anxiety disorders. This study compares rates of positive screens for anxiety and depressive disorders in separate U.S. national samples from 2019 and April to September 2020. The analysis includes trends within demographic groups, which have received scant attention. METHODS: Nationally representative probability samples of U.S. adults administered by the U.S. Census Bureau (n = 1.3 million) completed the PHQ-2 screening for depressive disorder and the GAD-2 screening for anxiety disorder. RESULTS: U.S. adults in 2020 were four times more likely to screen positive for depressive and anxiety disorders than in 2019, with the largest increases among males, 18- to 29-year-olds (for depression), Asian Americans, and parents with children in the home. Anxiety and depression rose and fell in tandem with the number of COVID-19 cases in the U.S., as well as increasing during the early June weeks of racial justice protests. CONCLUSIONS: Screens for mood and anxiety disorders remained at elevated levels in spring, summer, and fall 2020, especially among certain groups.


Assuntos
COVID-19 , Depressão , Adulto , Ansiedade , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Censos , Criança , Estudos Transversais , Depressão/diagnóstico , Depressão/epidemiologia , Humanos , Masculino , Pandemias , SARS-CoV-2
16.
Crim Behav Ment Health ; 31(4): 262-274, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34302309

RESUMO

BACKGROUND: The level of mental state incidents dealt with by police and the police resource involved is under-researched, often giving rise to un-evidenced claims around demand, response and resources. The 2019 National Police Chiefs' Council and College of Policing definition of such incidents provides a useful basis for more accurate calculation: 'Any police incident thought to relate to someone's mental health where their vulnerability is at the centre of the incident or where the police have had to do something additionally or differently because of it'. AIMS: To establish the nature and frequency of incidents involving the police when mental state is a primary reason for the involvement. METHODS: In this mixed methods study, we first analysed data from records in two mixed inner city/urban/rural forces and one large multi-local authority metropolitan force. Secondly, we made an in-depth analysis of a sample of mental state-related incidents (n = 320) in two of these forces. Thirdly, we took a 24-hour snapshot of all such incidents in England and Wales. RESULTS: Mental state-related incidents accounted for 5.1% of recorded police contacts from the public, rising to just 7.8% when confining attention only to contacts that generated a police response beyond taking the call and recording it. Length of time between an incident being reported and first response was similar between mental state-related and non-mental state-related incidents, but response to closure time was shorter for the former. CONCLUSIONS: While incidents relating to mental state problems do consume police resources, they do not represent disproportionate demand in terms of numbers or time spent. That said, only about a quarter of the police work recorded was related to possible crimes, and the possibility of conflating perception of wider social need with mental state problems may further account for an apparent mismatch between the perceived and actual proportion of the workload spent on these incidents.


Assuntos
Saúde Mental , Polícia , Censos , Inglaterra/epidemiologia , Humanos , País de Gales/epidemiologia
17.
N C Med J ; 82(4): 229-238, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34230171

RESUMO

BACKGROUND: Decision makers face challenges in estimating local risk for child maltreatment and how best to prioritize which factors to intervene upon. METHODS: Using US Census and survey data for all US counties (N = 3141), we derived US county profiles characterized by the severity of child maltreatment risk factors observed at the county level, such as parental health, health care access, and economic distress. We estimated how five child maltreatment outcomes would vary across the profiles for North Carolina counties (n = 100): total maltreatment reports (including unsubstantiated and substantiated), substantiated neglect, substantiated abuse, whether services were received, and reported child's race/ethnicity. RESULTS: We derived three profiles of county-level child maltreatment risk: high, moderate, and low risk, denoting that predicted risk factors means within profiles were all high, moderate, or low levels compared to counties in other profiles. One risk factor did not follow this pattern: the drug overdose death rate. It was highest in the moderate-risk profile instead of the high-risk profile, as would have been consistent with other factor levels. Moderate-risk counties had the highest predicted rate of child maltreatment reports, with over 20 more reports per 10,000 residents compared to low-risk counties (95% CI, 1.38, 38.86). LIMITATIONS: We included only factors for which aggregate, county-level estimates were available, thus limiting inclusion of all relevant factors. CONCLUSIONS: Results suggest the need for increased family-based services and interventions that reduce risk factors such as economic distress and drug overdose deaths. We discuss the implications for tailoring county efforts to prevent child maltreatment.


Assuntos
Maus-Tratos Infantis , Censos , Criança , Grupos Étnicos , Humanos , North Carolina/epidemiologia , Fatores de Risco
18.
Environ Res ; 201: 111573, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34174254

RESUMO

The heatwave is a disastrous hazard having significant impacts on health and society. This study analyses the heatwave hazards and risk for India's current and future scenarios using socioeconomic vulnerability and temperature datasets during the summer (April-June) season. The Census of India (CoI) 2011 datasets were considered to assess current vulnerability and projected from the SocioEconomic Data And Application Center (SEDAC) population at Shared Socioeconomic Pathway (SSP) 4 for future vulnerability. Whereas IMD temperature data used for hazard assessment for the present scenario (1958-2005) while projected temperature data from regional earth system model REMO-OASIS-MPIOM (ROM) were used for the future (2006-2099) scenario. The study exhibited the most hazardous, vulnerable, and risk-prone regions identified as the south-eastern coast and Indo-Gangetic plains and some populous districts with metropolitan regions (Mumbai, Delhi, and Kolkata) under the current scenario. The coupled model ROM has efficiently captured the critical districts with higher and lower risk, showing its future projection capability. The study highlighted that the heatwave hazard-risk would significantly worsen in future scenarios in all districts under enhanced global warming and largely affecting the districts in the eastern and middle Indo-Gangetic plains and Malabar region. The present study will provide sufficient insights into designing mitigation strategies and future adaptive planning for the heatwave risk, which is one of the targets under Sustainable Development Goal 13 (Goal 13: Climate Action).


Assuntos
Censos , Temperatura Alta , Índia/epidemiologia , Modelos Teóricos , Medição de Risco
19.
J Am Med Inform Assoc ; 28(9): 1977-1981, 2021 08 13.
Artigo em Inglês | MEDLINE | ID: mdl-34151986

RESUMO

Hospital census prediction has well-described implications for efficient hospital resource utilization, and recent issues with hospital crowding due to CoVID-19 have emphasized the importance of this task. Our team has been leading an institutional effort to develop machine-learning models that can predict hospital census 12 hours into the future. We describe our efforts at developing accurate empirical models for this task. Ultimately, with limited resources and time, we were able to develop simple yet useful models for 12-hour census prediction and design a dashboard application to display this output to our hospital's decision-makers. Specifically, we found that linear models with ElasticNet regularization performed well for this task with relative 95% error of +/- 3.4% and that this work could be completed in approximately 7 months.


Assuntos
Censos , Hospitais , COVID-19 , Humanos , Aprendizado de Máquina
20.
PLoS One ; 16(6): e0251430, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34101744

RESUMO

Income polarization is a pressing issue which is increasingly discussed by academics and policymakers. The present research examines income polarization in Canada's eight largest Census Metropolitan Areas (CMAs) using data at the census-tract (CT) level between 1971 and 2016. Generally, there are significant decreasing trends in the middle-income population with simultaneously increasing trends in low-income groups. The high-income groups have been relatively stable with fewer significant increasing population trends. Using conventional mapping and cartograms, patterns of the spatial evolution of income inequality are illustrated. Every CMA examined contains an increasing trend of spatial fragmentation at the patch level within each CMA's landscape mosaic. The results of a spatial autocorrelation analysis at the sub-patch, CT level, exhibit significant spatial clustering of high-income CTs as one process that dominates the increasingly fragmented landscape mosaic.


Assuntos
Status Econômico , Renda , Pobreza , Canadá , Censos , Cidades , Características da Família , Feminino , Humanos , Masculino
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