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1.
Public Health Genomics ; 22(1-2): 1-7, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31390644

RESUMO

BACKGROUND: Biomedical research has recently moved through three stages in digital healthcare: (1) data collection; (2) data sharing; and (3) data analytics. With the explosion of stored health data (HD), dental medicine is edging into its fourth stage of digitization using artificial intelligence (AI). This narrative literature review outlines the challenge of managing HD and anticipating the potential of AI in oral healthcare and dental research by summarizing the current literature. SUMMARY: The basis of successful management of HD is the establishment of a generally accepted data standard that will guide its implementation within electronic health records (EHR) and health information technology ecosystems (HIT Eco). Thereby continuously adapted (self-) learning health systems (LHS) can be created. The HIT Eco of the future will combine (i) the front-end utilization of HD in clinical decision-making by providers using supportive diagnostic tools for patient-centered treatment planning, and (ii) back-end algorithms analyzing the standardized collected data to inform population-based policy decisions about resource allocations and research directions. Cryptographic methods in blockchain enable a safe, more efficient, and effective dental care within a global perspective. Key Message: The interoperability of HD with accessible digital health technologies is the key to deliver value-based dental care and exploit the tremendous potential of AI.


Assuntos
Inteligência Artificial , Coleta de Dados , Pesquisa em Odontologia , Coleta de Dados/métodos , Coleta de Dados/tendências , Pesquisa em Odontologia/métodos , Pesquisa em Odontologia/tendências , Humanos , Aplicações da Informática Médica , Saúde Pública/estatística & dados numéricos
2.
Nurs Adm Q ; 43(3): 246-255, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31162343

RESUMO

Nurse leaders are dually responsible for resource stewardship and the delivery of high-quality care. However, methods to identify patient risk for hospital-acquired conditions are often outdated and crude. Although hospitals and health systems have begun to use data science and artificial intelligence in physician-led projects, these innovative methods have not seen adoption in nursing. We propose the Petri dish model, a theoretical hybrid model, which combines population ecology theory and human factors theory to explain the cost/benefit dynamics influencing the slow adoption of data science for hospital-based nursing. The proliferation of nurse-led data science in health systems may be facing several barriers: a scarcity of doctorally prepared nurse scientists with expertise in data science; internal structural inertia; an unaligned national "precision health" strategy; and a federal reimbursement landscape, which constrains-but does not negate the hard dollar business case. Nurse executives have several options: deferring adoption, outsourcing services, and investing in internal infrastructure to develop and implement risk models. The latter offers the best performing models. Progress in nurse-led data science work has been sluggish. Balanced partnerships with physician experts and organizational stakeholders are needed, as is a balanced PhD-DNP research-practice collaboration model.


Assuntos
Inteligência Artificial/tendências , Coleta de Dados/métodos , Assistência à Saúde/métodos , Doença Iatrogênica , Inteligência Artificial/normas , Coleta de Dados/tendências , Ciência de Dados , Humanos , Papel do Profissional de Enfermagem , Garantia da Qualidade dos Cuidados de Saúde/tendências
3.
Clin Neuropsychol ; 33(2): 209-219, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30882285

RESUMO

OBJECTIVE: Computerized tests and use of the internet offer many opportunities for improvement of neuropsychological assessment over traditional paper-and-pencil tests. Nevertheless, many clinical neuropsychologists are conservative in their choice of tests when assessing patients; the majority still seems to prefer using well-established paper-and-pencil tests. METHOD: This deliberately one-sided opinion paper discusses several reasons that may explain the reluctance to embrace modern techniques. These reasons are of a psychometric, technical, theoretical, and strategic nature. CONCLUSIONS: A range of issues regarding each of these reasons need to be solved before digital assessment techniques can fulfill their promises. In the meantime, it seems wise to be cautious, and to be critical in adopting the digital assessment techniques.


Assuntos
Internet/tendências , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Testes Neuropsicológicos , Neuropsicologia/tendências , Atitude , Coleta de Dados/normas , Coleta de Dados/tendências , Emoções/fisiologia , Humanos , Internet/normas , Testes Neuropsicológicos/normas , Neuropsicologia/normas , Psicometria
5.
J Autism Dev Disord ; 49(6): 2258-2267, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30701436

RESUMO

The current study investigated the age of diagnosis (AoD) of autism spectrum disorder (ASD) in Nepal by using de-identified data on 246 children with a diagnosis of ASD registered at AutismCare Nepal Society from 2010 to 2015. The mean AoD in children was 58 months (range 14-187 months). Majority of children were male (76%), lived in the Kathmandu valley (75%), and were from upper caste groups (62%). The mean diagnostic age of ASD in Nepal is much later than the age at which a reliable diagnosis is possible, indicating the need to reduce the gap between the age at which it is possible to diagnose ASD, and the average age at which ASD is currently diagnosed.


Assuntos
Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/etnologia , Classe Social , Idade de Início , Transtorno do Espectro Autista/psicologia , Criança , Pré-Escolar , Coleta de Dados/tendências , Feminino , Humanos , Lactente , Masculino , Nepal/etnologia , Sistema de Registros
6.
J Neurointerv Surg ; 11(8): 785-789, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30655361

RESUMO

BACKGROUND AND PURPOSE: Endovascular thrombectomy (EVT) has revolutionized the management of acute ischemic stroke. Landmark clinical trials have shown EVT to be one of the most efficacious interventions in clinical medicine over the past 5 years. A method of recognition for an article in the scientific community is to use a citation rank list, in order to identify the seminal works in the academic medical literature. The objective of this study was to characterize the 100 most highly cited articles assessing endovascular management of acute ischemic stroke. METHODS: We conducted a retrospective bibliometric analysis using the Web of Science Citation Index Expanded database for the most cited works in the endovascular management of acute ischemic stroke. Citation count was used to rank the top 100 articles, which were then analyzed for authorship, year of publication, subject, study type, level of evidence, and subject. RESULTS: The mean number of citations was 245 (range 65-1726) and 394 on Google Scholar. The top 100 articles were cited an average of 43.9 times per year and published in 21 journals in the past two decades. The majority of papers (62) were classified as constituting levels 1, 2, or 3 evidence, and included 17 randomized controlled trials. Approximately two-thirds of the top 100 articles originated from the USA. CONCLUSIONS: This study details the most cited articles in the endovascular management of acute ischemic stroke, and furthermore shows that a high proportion of level I evidence exists for this intervention.


Assuntos
Bibliometria , Isquemia Encefálica/cirurgia , Gerenciamento Clínico , Procedimentos Endovasculares/tendências , Fator de Impacto de Revistas , Acidente Vascular Cerebral/cirurgia , Isquemia Encefálica/epidemiologia , Coleta de Dados/métodos , Coleta de Dados/tendências , Bases de Dados Factuais/tendências , Procedimentos Endovasculares/métodos , Humanos , Estudos Retrospectivos , Acidente Vascular Cerebral/epidemiologia , Trombectomia/métodos , Trombectomia/tendências
7.
Nicotine Tob Res ; 21(4): 475-480, 2019 03 30.
Artigo em Inglês | MEDLINE | ID: mdl-29394419

RESUMO

INTRODUCTION: Tobacco price increases can generate increased public interest in smoking cessation, but it is not clear how long this interest lasts. Our objective was to evaluate the duration of the impact of cigarette price increase in Japan using Google search data. METHODS: Monthly or daily aggregated Google search volume for smoking cessation in Japan from 2004 to 2016 was collected in terms of relative search volume (RSV) ranging from 0 to 100. Using monthly RSV data, we evaluated possible relationships between the RSVs and tobacco control measures in Japan. Time periods within which the impact of search volume significantly increased were identified by cluster detection test, using daily RSV data. A spike in RSV preceding the enforcement of a cigarette price increase revealed an anticipation effect. RESULTS: Between 2004 and 2016, the three highest monthly RSV spikes were observed in July 2006 (RSV = 66), when cigarette prices increased by 11%, and in September (RSV = 90) and October 2010 (RSV = 100), when cigarette prices increased by 37%. Regarding daily RSV, the detected cluster size around the price increase in 2010 (52 days) was longer than that in 2006 (17 days). In 2010, a cluster period of 25 days before the date of the price increase was observed, suggesting an anticipation effect. After the onset of the price increase, a cluster of 27 days was detected. When the cigarette price increased due to consumption tax in April 2014, almost no anticipation effect was observed. CONCLUSIONS: The population impact of tobacco price increases on smoking cessation may be assessed using Google Trends data. The cluster indicates that a higher cigarette price increase had a higher and longer lasting effect on population interest in cessation, but the impact may continue for a relatively short time. IMPLICATIONS: To examine the duration of the impact of cigarette price increases on population interest in smoking cessation in Japan, Google search data for smoking cessation were analyzed. Between 2004 and 2016, the three highest spikes of monthly RSV were observed in October 2010, when cigarette prices increased by 37%. Analyzing daily RSV data, the detected cluster size around the price increase in 2010 was 52 days, and a cluster period of 25 days before the date of the price increase was observed, suggesting an anticipation effect. The cluster indicates that a higher cigarette price increase had a higher and longer lasting effect, but the population impact continues for a relatively short time. Further increases in the price of cigarettes are necessary.


Assuntos
Comércio/economia , Comércio/tendências , Internet/economia , Internet/tendências , Abandono do Hábito de Fumar/economia , Produtos do Tabaco/economia , Adulto , Fumar Cigarros/economia , Fumar Cigarros/psicologia , Fumar Cigarros/tendências , Coleta de Dados/tendências , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Japão/epidemiologia , Masculino , Abandono do Hábito de Fumar/psicologia , Impostos/tendências , Indústria do Tabaco
8.
IEEE Rev Biomed Eng ; 12: 303-318, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30004887

RESUMO

In this review, the critical parts and milestones for data harmonization, from the biomedical engineering perspective, are outlined. The need for data sharing between heterogeneous sources paves the way for cohort harmonization; thus, fostering data integration and interdisciplinary research. Unmet needs in chronic diseases, as well as in other diseases, can be addressed based on the integration of patient health records and the sharing of information of the clinical picture and outcome. The stratification of patients, the determination of various clinical and outcome features, and the identification of novel biomarkers for the different phenotypes of the disease characterize the impact of cohort harmonization in patient-centered clinical research and in precision medicine. Subsequently, the establishment of matching techniques and ontologies for the creation of data schemas are also presented. The exploitation of web technologies and data-collection tools supports the opportunities to achieve new levels of integration and interoperability. Ethical and legal issues that arise when sharing and harmonizing individual-level data are discussed in order to evaluate the harmonization potential. Use cases that shape and test the harmonization approach are explicitly analyzed along with their significant results on their research objectives. Finally, future trends and directions are discussed and critically reviewed toward a roadmap in cohort harmonization for clinical medicine.


Assuntos
Biomarcadores , Pesquisa Biomédica/tendências , Medicina Clínica/tendências , Estudos de Coortes , Engenharia Biomédica/tendências , Coleta de Dados/tendências , Registros de Saúde Pessoal , Humanos , Pacientes , Fenótipo
9.
Neurol Sci ; 40(1): 155-165, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30426289

RESUMO

The past decade has seen extraordinary increase in worldwide availability of and access to several large multiple sclerosis (MS) databases and registries. MS registries represent powerful tools to provide meaningful information on the burden, natural history, and long-term safety and effectiveness of treatments. Moreover, patients, physicians, industry, and policy makers have an active interest in real-world observational studies based on register data, as they have the potential to answer the questions that are most relevant to daily treatment decision-making. In 2014, the Italian MS Foundation, in collaboration with the Italian MS clinical centers, promoted and funded the creation of the Italian MS Register, a project in continuity with the existing Italian MS Database Network set up from 2001. Main objective of the Italian MS Register is to create an organized multicenter structure to collect data of all MS patients for better defining the disease epidemiology, improving quality of care, and promoting research projects in high-priority areas. The aim of this article is to present the current framework and network of the Italian MS register, including the methodology used to improve the quality of data collection and to facilitate the exchange of data and the collaboration among national and international groups.


Assuntos
Coleta de Dados/tendências , Bases de Dados Factuais/tendências , Esclerose Múltipla/epidemiologia , Sistema de Registros , Adulto , Estudos de Coortes , Coleta de Dados/métodos , Feminino , Humanos , Itália/epidemiologia , Estudos Longitudinais , Masculino , Esclerose Múltipla/diagnóstico
10.
Ethn Dis ; 28(4): 561-564, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30405301

RESUMO

The use of race and ethnicity in biomedical research has been a subject of debate for the past three decades. Initially the two major race categories were: White and Black, leaving other minorities uncounted or inappropriately misclassified. As the science of health disparities evolves, more sophisticated and detailed information has been added to large databases. Despite the addition of new racial classifications, including multi-racial denominations, the quality of the data is limited to the data collection process and other social misconceptions. Although race is viewed as an imposed or ascribed status, ethnicity is an achieved status, making it a more challenging variable to include in biomedical research. Ambiguity between race and ethnicity often exists, ultimately affecting the value of both variables. To better understand specific health outcomes or disparities of groups, it is necessary to collect subgroup-specific data. Cultural perceptions and practices, health experiences, and susceptibility to disease vary greatly among broad racial-ethnic groups and requires the collection of nuanced data to understand. Here, we provide an overview of the classification of race and ethnicity in the United States over time, the existing challenges in using race and ethnicity in biomedical research and future research directions.


Assuntos
Pesquisa Biomédica , Diversidade Cultural , Grupos Étnicos , Disparidades nos Níveis de Saúde , Pesquisa Biomédica/métodos , Pesquisa Biomédica/tendências , Coleta de Dados/tendências , Grupos Étnicos/classificação , Grupos Étnicos/estatística & dados numéricos , Humanos , Estados Unidos/etnologia
11.
Med Sci (Paris) ; 34(10): 849-851, 2018 Oct.
Artigo em Francês | MEDLINE | ID: mdl-30451660

RESUMO

Human biological samples are key resources in unravelling physiopathological factors underlying diseases and influencing their outcome. By making use of these resources, genomics, proteomics and molecular imaging techniques have achieved unprecedented progress in the past decade. The development of genomics platforms, molecular imaging as well as bioinformatics allowed a significant development of the biomarkers field thus realizing significant advances towards personalized medicine. The exponential increase of data, their complexity, the necessity of their integration for analysis require the development of appropriate infrastructures. These latter should integrate experts from different fields as well as an optimal organisation of biobanks including novel access and exchange rules for biological material and data.


Assuntos
Bancos de Espécimes Biológicos/tendências , Medicina de Precisão , Animais , Coleta de Dados/métodos , Coleta de Dados/tendências , Ensaios de Triagem em Larga Escala , Humanos , Medicina de Precisão/métodos , Medicina de Precisão/tendências
12.
Arq. Ciênc. Vet. Zool. UNIPAR (Online) ; 21(1): 1-7, Jan-Mar. 2018. tab, mapas, graf, ilus
Artigo em Português | LILACS, VETINDEX | ID: biblio-915826

RESUMO

Em relação aos anfíbios dos Estados de Goiás e Tocantins, os trabalhos disponíveis tratam de descrições de espécies e de ecologia de anfíbios. Esse trabalho foi realizado em uma área de importância ao ecoturismo, denominada cachoeira da Roncadeira, Tocantins. O presente estudo teve como propósito realizar um levantamento rápido sobre a anurofauna e com bases nestes dados, fazer comentários sobre a qualidade ambiental. No presente levantamento foi aplicada a técnica de busca ativa, que consiste na revirada de troncos, pedras e folhas caídas em locais úmidos, no período compreendido entre as 06h 30 min - 08h 30 min e 19h 30 min - 21h 30 min. Gravação dos registros sonoros, visualização direta e registros fotográficos foram realizados e analisados comparativamente com os guias de identificação visuais. Foram registradas 18 espécies de anuros na área de influência da cachoeira da Roncadeira, distribuídas nas famílias Bufonidae (2), Hylidae (7), Leptodactylidae (6), Microhylidae (3). Pela amostra aqui apresentada ser bem representativa da área de influência da cachoeira, está evidente a existência de boa qualidade ambiental local, sendo um indicador para a necessidade de investimentos em preservação para o ecoturismo com sustentabilidade.(AU)


The studies related to amphibians in the states of Goiás and Tocantins deal with the description of species and the ecology of amphibians. This paper was developed in an area of importance to ecotourism, known as the Roncadeira Waterfall, in the state of Tocantins. It has the purpose of carrying out a quick survey on the anuran fauna and, based on such data, comment on the environmental quality. The active search technique was applied on this survey, consisting in the overturning of trunks, rocks and leaves fallen in humid places, in the period between 6:30-8:30 a.m. and 7:30-9:30 p.m. Sounds were recorded, direct visualization and photographic records were made and analyzed by comparison to the visual identification guides. A total of 18 species of frogs were recorded in the area of influence of the Roncadeira Waterfall, distributed among Bufonidae (2), Hylidae (7), Leptodactylidae (6) and Microhylidae (3) families. The sample presented here is a good representative of the area of influence of the waterfall, providing evidence of the existence of a good local environmental quality, an indicator of the need for investments in preservation for sustainable ecoturism.(AU)


En cuanto a los anfibios de los Estados de Goiás y Tocantins, los trabajos disponibles tratan de descripciones de especies y de ecología de anfibios. Ese trabajo ha sido realizado en un área de importancia para el ecoturismo, denominada Cascada de la Roncadeira, Tocantins. El presente estudio tuvo como propósito realizar un levantamiento rápido sobre la anurofauna y con base en estos datos, hacer comentarios sobre la calidad ambiental. En el presente levantamiento se aplicó la técnica de búsqueda activa, que consiste en la revirada de troncos, piedras y hojas caídas en lugares húmedos, en el período comprendido entre las 06h 30 min - 08h 30 min y 19h 30 min - 21h 30 min. La grabación de los registros sonoros, visualización directa y los registros fotográficos han sido realizados y analizados en comparación con las guías de identificación visual. Se registraron 18 especies de anuros en el área de influencia de la cascada de la Roncadeira, distribuidas en las familias Bufonidae (2), Hylidae (7), Leptodactylidae (6), Microhylidae (3). Por la muestra aquí presentada es muy representativa del área de influencia de la cascada, está evidente la existencia de buena calidad ambiental local, siendo un indicador para la necesidad de inversiones en preservación para el ecoturismo con sustentabilidad.(AU)


Assuntos
Animais , Anuros/classificação , Coleta de Dados/tendências , Coleta de Dados/estatística & dados numéricos
13.
Nurs Outlook ; 66(5): 446-454, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30131168

RESUMO

Pragmatic studies are common in nursing research. These studies range from secondary analysis of large observational datasets to prospective randomized multisite clinical trials. The common elements in pragmatic studies are the real-world settings in which the research occurs: settings that decrease threats to external validity, but may increase threats to internal validity of the research. This manuscript presents a pragmatic study and the methodological considerations in design and analytic approaches that were undertaken to decrease all threats to validity while maintaining study feasibility. A pragmatic study design and analytic choices are presented and evaluated. To increase robustness of the study and internal and external validity of findings, while maintaining feasibility, unique approaches to design and analyses were chosen. Like efficacy studies, pragmatic studies are essential to nursing research and require additional a priori considerations in design and analyses to increase internal validity of findings.


Assuntos
Coleta de Dados/tendências , Ensaios Clínicos Pragmáticos como Assunto/métodos , Projetos de Pesquisa/tendências , Coleta de Dados/métodos , Coleta de Dados/normas , Humanos
15.
Soc Sci Med ; 211: 123-130, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29935402

RESUMO

In anthropology, interest in how values are created, maintained and changed has been reinvigorated. In this case study, we draw on this literature to interrogate concerns about the relationship between data collection and the delivery of patient care within global health. We followed a pilot study conducted in Kayunga, Uganda that aimed to improve the collection of health systems data in five public health centres. We undertook ethnographic research from July 2015 to September 2016 in health centres, at project workshops, meetings and training sessions. This included three months of observations by three fieldworkers; in-depth interviews with health workers (n = 15) and stakeholders (n = 5); and six focus group discussions with health workers. We observed that measurement, calculation and narrative practices could be assigned care-value or data-value and that the attempt to improve data collection within health facilities transferred 'data-value' into health centres with little consideration among project staff for its impact on care. We document acts of acquiescence and resistance to data-value by health workers. We also describe the rare moments when senior health workers reconciled these two forms of value, and care-value and data-value were enacted simultaneously. In contrast to many anthropological accounts, our analysis suggests that data-value and care-value are not necessarily conflicting. Actors seeking to make changes in health systems must, however, take into account local forms of value and devise health systems interventions that reinforce and enrich existing ethically driven practice.


Assuntos
Bases de Dados como Assunto/economia , Bases de Dados como Assunto/normas , Assistência à Saúde/economia , Estudos de Casos e Controles , Coleta de Dados/ética , Coleta de Dados/tendências , Grupos Focais , Sistemas de Informação em Saúde/normas , Sistemas de Informação em Saúde/tendências , Humanos , Programas Nacionais de Saúde/tendências , Projetos Piloto , Pesquisa Qualitativa , Uganda
16.
Acta Crystallogr D Struct Biol ; 74(Pt 5): 433-440, 2018 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-29717714

RESUMO

Macromolecular crystallography is now a mature and widely used technique that is essential in the understanding of biology and medicine. Increases in computing power combined with robotics have not only enabled large numbers of samples to be screened and characterized but have also enabled better decisions to be taken on data collection itself. This led to the development of MASSIF-1 at the ESRF, the first beamline in the world to run fully automatically while making intelligent decisions taking user requirements into account. Since opening in late 2014, the beamline has processed over 42 000 samples. Improvements have been made to the speed of the sample-handling robotics and error management within the software routines. The workflows initially put into place, while highly innovative at the time, have been expanded to include increased complexity and additional intelligence using the information gathered during characterization; this includes adapting the beam diameter dynamically to match the diffraction volume within the crystal. Complex multi-position and multi-crystal data collections have now also been integrated into the selection of experiments available. This has led to increased data quality and throughput, allowing even the most challenging samples to be treated automatically.


Assuntos
Algoritmos , Cristalografia por Raios X/instrumentação , Coleta de Dados/métodos , Cristalografia por Raios X/métodos , Cristalografia por Raios X/tendências , Coleta de Dados/tendências , Substâncias Macromoleculares/química , Receptores Acoplados a Proteínas-G/química , Manejo de Espécimes , Síncrotrons , Fatores de Tempo , Fluxo de Trabalho
17.
Alcohol Alcohol ; 53(5): 578-585, 2018 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-29846496

RESUMO

Background and aims: Given ongoing community concern about high rates of alcohol-related crimes (ARCs) experienced by disadvantaged populations, a more specific and nuanced understanding of factors associated with ARCs would help inform the development of more sophisticated programs and policies aimed at reducing ARCs. This study estimates rates of ARCs across all communities in New South Wales (NSW), Australia, using routinely collected police data; investigates whether there are differences between communities; and identifies individual and community characteristics that are significantly associated with higher rates of ARCs. Short summary: This study analysed routinely collected police data in New South Wales, Australia, to identify individual and community characteristics associated with alcohol-related crimes. Young people, Aboriginal Australians, socio-economically disadvantaged communities, remote and regional communities and communities with higher per capita rate of on-venue liquor licenses are at risk of alcohol-related crimes. Methods: Age standardized rates of ARCs were calculated. A multi-level Poisson regression analysis was conducted to investigate the individual and community factors that were statistically significantly associated with higher rates of ARC, separately for Aboriginal and non-Aboriginal Australians. Results: Rates of ARCs were statistically significantly higher for Aboriginal Australians, young people (aged 13-37 years) and on weekends. ARCs varied significantly across communities, and were significantly higher in remote or regional communities, in communities with a higher per capita rate of on-venue licences, and for socio-economically disadvantaged communities for non-Aboriginal Australians, but not for Aboriginal females. Conclusion: This analysis shows that the impact of national-level and jurisdictional-level legislation and policies is uneven across communities and defined populations, leaving young people, socio-economically disadvantaged communities and Aboriginal Australians at increased risk of ARCs. To more equitably reduce the exposure of all Australians to ARC, mechanisms that effectively engage vulnerable communities and defined populations, need to be developed in consultation with them, implemented and evaluated.


Assuntos
Consumo de Bebidas Alcoólicas/etnologia , Consumo de Bebidas Alcoólicas/tendências , Crime/tendências , Coleta de Dados/tendências , Polícia/tendências , Populações Vulneráveis/etnologia , Adolescente , Adulto , Fatores Etários , Idoso , Crime/estatística & dados numéricos , Coleta de Dados/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , New South Wales/etnologia , Grupo com Ancestrais Oceânicos/etnologia , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Política Pública/tendências , Características de Residência/estatística & dados numéricos , Adulto Jovem
18.
J Public Health (Oxf) ; 40(4): 891-898, 2018 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-29590431

RESUMO

Background: Health systems in the European Union (EU) are being questioned over their effectiveness and sustainability. In pursuing both goals, they have to conciliate coexisting, not always aligned, realities. Methods: This paper originated from a workshop entitled 'Health systems for the future' held at the European Parliament. Experts and decision makers were asked to discuss measures that may increase the effectiveness and sustainability of health systems, namely: (i) increasing citizens' participation; (ii) the importance of primary care in providing integrated services; (iii) improving the governance and (iv) fostering better data collection and information channels to support the decision making process. Results: In the parliamentary debate, was discussed the concept that, in the near future, health systems' effectiveness and sustainability will very much depend on effective access to integrated services where primary care is pivotal, a clearer shift from care-oriented systems to health promotion and prevention, a profound commitment to good governance, particularly to stakeholders participation, and a systematic reuse of data meant to build health data-driven learning systems. Conclusions: Many health issues, such as future health systems in the EU, are potentially transformative and hence an intense political issue. It is policy-making leadership that will mostly determine how well EU health systems are prepared to face future challenges.


Assuntos
Governança Clínica/tendências , Participação da Comunidade/tendências , Coleta de Dados/tendências , Assistência à Saúde/tendências , União Europeia , Atenção Primária à Saúde/tendências , Prestação Integrada de Cuidados de Saúde/tendências , Previsões , Humanos
19.
Epidemics ; 24: 26-33, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29506911

RESUMO

Accurate forecasts could enable more informed public health decisions. Since 2013, CDC has worked with external researchers to improve influenza forecasts by coordinating seasonal challenges for the United States and the 10 Health and Human Service Regions. Forecasted targets for the 2014-15 challenge were the onset week, peak week, and peak intensity of the season and the weekly percent of outpatient visits due to influenza-like illness (ILI) 1-4 weeks in advance. We used a logarithmic scoring rule to score the weekly forecasts, averaged the scores over an evaluation period, and then exponentiated the resulting logarithmic score. Poor forecasts had a score near 0, and perfect forecasts a score of 1. Five teams submitted forecasts from seven different models. At the national level, the team scores for onset week ranged from <0.01 to 0.41, peak week ranged from 0.08 to 0.49, and peak intensity ranged from <0.01 to 0.17. The scores for predictions of ILI 1-4 weeks in advance ranged from 0.02-0.38 and was highest 1 week ahead. Forecast skill varied by HHS region. Forecasts can predict epidemic characteristics that inform public health actions. CDC, state and local health officials, and researchers are working together to improve forecasts.


Assuntos
Influenza Humana/epidemiologia , Estações do Ano , Comportamento Cooperativo , Coleta de Dados/estatística & dados numéricos , Coleta de Dados/tendências , Epidemias/estatística & dados numéricos , Previsões , Humanos , Saúde Pública/estatística & dados numéricos , Saúde Pública/tendências , Estados Unidos/epidemiologia
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