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1.
Science ; 365(6455)2019 08 23.
Artigo em Inglês | MEDLINE | ID: mdl-31439763

RESUMO

Ballard et al argue that our prediction of a 30-year or longer recovery time for Gulf of Mexico water quality is highly uncertain, and that much shorter time lags are equally likely. We demonstrate that their argument, based on the use of a two-component regression model, does not sufficiently consider fundamental watershed processes or multiple lines of evidence suggesting the existence of decadal-scale lags.


Assuntos
Nitrogênio/análise , Qualidade da Água , Metas , Golfo do México
2.
Nurs Educ Perspect ; 40(5): 291-294, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31436692

RESUMO

AIM: The study purpose was to describe current international clinical experience (ICE) practices in RN prelicensure programs in the United States. BACKGROUND: There is interest in ICE to fulfill the goal of preparing global citizens; however, lack of evidence on developing, implementing, and evaluating best practices for ICE limits the enactment of this approach. METHOD: An electronic survey was completed by 900 deans and/or directors of diploma, associate, bachelor's, accelerated bachelor's, and master's-entry RN prelicensure programs. RESULTS: Respondents (n = 241, 27 percent) indicated their programs included ICE. Across programs, ICE occurred most often in community health courses. The predominant reason for offering ICE was alignment with the institutional mission and vision. CONCLUSION: Wide variability exists in methods used to implement ICE for credit toward the nursing major. There is a need to continue to assess and disseminate best practices in implementing ICE to accomplish the goal of global health engagement.


Assuntos
Bacharelado em Enfermagem/organização & administração , Intercâmbio Educacional Internacional , Saúde Global , Metas , Humanos , Pesquisa em Educação de Enfermagem , Pesquisa em Avaliação de Enfermagem , Inquéritos e Questionários , Estados Unidos
3.
Stud Health Technol Inform ; 264: 1012-1016, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438077

RESUMO

Despite similar policy goals, the adoption of eHealth practices took different paths in Austria (AT), Switzerland (CH), and Germany (GER). We seek to provide a rigorous analysis of the current state of hospitals by focusing on three key eHealth areas: electronic patient records (EPR), health information exchange (HIE), electronic patient communication. For validation and in order to gain better contextual insight we applied a mixed method approach by combining survey results from clinical directors with qualitative interview data from eHealth experts of all three countries. Across countries, EPR adoption rates were reported highest (AT: 52%, CH: 78%, GER: 50%), HIE-rates were partly lower (AT: 52%, CH: 14%, GER: 17%), and electronic patient communication was reported lowest overall (AT: 17%, CH: 8%, GER: 19%). Amongst others, results indicate patient awareness about eHealth to be equally weak across countries, which thus may be an important focal point of future policy initiatives.


Assuntos
Metas , Telemedicina , Áustria , Alemanha , Humanos , Suíça
4.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46680

RESUMO

A Organização Mundial da Saúde (OMS) tem metas ambiciosas para 2019. Entre os objetivos da agência da ONU, está a ampliação do acesso e da cobertura de saúde para atender a 1 bilhão a mais de pessoas na comparação com números atuais. A instituição também quer garantir que 1 bilhão de indivíduos estejam protegidos de emergências de saúde. Para tirar essas resoluções do papel, a OMS estipulou dez prioridades para o ano que se inicia.


Assuntos
Metas , Nações Unidas , Organização Mundial da Saúde
5.
Neumol. pediátr. (En línea) ; 14(2): 72-75, jul. 2019.
Artigo em Espanhol | LILACS | ID: biblio-1010417

RESUMO

In the clinical research process, the formulation of a well-founded hypothesis and objectives concordant with the research question are key to the proper conduct of the project. The following article reviews the fundamental principles for the adequate formulation of hypotheses and objectives of clinical research projects, providing practical recommendations and examples.


En el proceso de investigación clínica, la formulación de una hipótesis bien fundamentada y objetivos concordantes con la pregunta de investigación, son claves para la adecuada conducción del proyecto. El siguiente artículo revisa los principios fundamentales para la formulación adecuada de hipótesis y objetivos de proyectos de investigación clínica, proporcionando recomendaciones prácticas y ejemplos.


Assuntos
Humanos , Testes de Hipótese , Pesquisa Biomédica , Metas
6.
MMWR Morb Mortal Wkly Rep ; 68(26): 587-591, 2019 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-31269012

RESUMO

All six World Health Organization (WHO) regions have established measles elimination goals, and three regions have a rubella elimination goal. Each region has established a regional verification commission to monitor progress toward measles elimination, rubella elimination, or both, and to provide verification of elimination* (1,2). To verify elimination, high-quality case-based surveillance is essential, including laboratory confirmation of suspected cases and genotyping of viruses from confirmed cases to track transmission pathways. In 2000, WHO established the Global Measles and Rubella Laboratory Network (GMRLN) to provide high-quality laboratory support for surveillance for measles, rubella, and congenital rubella syndrome (3). GMRLN is the largest globally coordinated laboratory network, with 704 laboratories supporting surveillance in 191 countries (4). This report updates a previous report and describes the genetic characterization of measles and rubella viruses during 2016-2018 (5). The genetic diversity of measles viruses (MeVs) and rubella viruses (RuVs) has decreased globally following implementation of measles and rubella elimination strategies. Among 10,857 MeV sequences reported to the global Measles Nucleotide Surveillance (MeaNS) database during 2016-2018, the number of MeV genotypes detected in ongoing transmission decreased from six in 2016 to four in 2018. Among the 1,296 RuV sequences submitted to the global Rubella Nucleotide Surveillance (RubeNS) database during the same period, the number of RuV genotypes detected decreased from five in 2016 to two in 2018. To strengthen laboratory surveillance for measles and rubella elimination, specimens should be collected from all confirmed cases for genotyping, and sequences from all wild-type measles and rubella viruses should be submitted to MeaNS and RubeNS in a timely manner.


Assuntos
Erradicação de Doenças , Saúde Global/estatística & dados numéricos , Vírus do Sarampo/genética , Sarampo/prevenção & controle , Vigilância da População , Vírus da Rubéola/genética , Rubéola (Sarampo Alemão)/prevenção & controle , Bases de Dados Factuais , Genótipo , Metas , Humanos , Laboratórios , Sarampo/epidemiologia , Vírus do Sarampo/isolamento & purificação , Rubéola (Sarampo Alemão)/epidemiologia , Vírus da Rubéola/isolamento & purificação , Organização Mundial da Saúde
8.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(6): 605-609, 2019 Jun 10.
Artigo em Chinês | MEDLINE | ID: mdl-31238605

RESUMO

In 2016, the WHO proposed the goal for elimination of hepatitis B as public health threat, by 2030. China has the heaviest burden caused by hepatitis B virus (HBV) infection in the world, and serves as the major contributor to the goal of eliminating hepatitis B by 2030, globally. During the past 30 years, great progress has been made towards the implementation on prevention and control programs of HBV infection, in China, that enabling the WHO 2030 target to be fulfilled. However, due to the size of population, the large number of HBV infections and the low coverage of diagnosis and treatment programs, China is still facing the challenge in reaching the 2030 target, on time. This paper elaborates the achievements and gaps regarding the on-going prevention and control programs, including vaccination, prevention of maternal-to-child transmission, blood and injection safety, diagnosis and treatment on HBV infection and putting forward several suggestions on relevant policies for achieving the goal of hepatitis B elimination by 2030, in China.


Assuntos
Antivirais/uso terapêutico , Metas , Vacinas contra Hepatite B/administração & dosagem , Vírus da Hepatite B/efeitos dos fármacos , Hepatite B/prevenção & controle , Programas de Imunização , Vacinação/métodos , Criança , China/epidemiologia , Saúde Global , Acesso aos Serviços de Saúde , Hepatite B/epidemiologia , Hepatite B/virologia , Vírus da Hepatite B/isolamento & purificação , Humanos , Programas de Rastreamento , Saúde Pública
10.
BMJ ; 365: l4223, 2019 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-31221622

RESUMO

The studyClare L, Kudlicka A, Oyebode J R, et al. Goal-oriented cognitive rehabilitation for early-stage Alzheimer's and related dementias: the GREAT RCT. Health Technol Assess 2019;23:1-242.The trial was funded by the NIHR Health Technology Assessment Programme (project number11/15/04).To read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000767/goal-setting-in-early-stage-dementia-can-improve-function.


Assuntos
Disfunção Cognitiva/economia , Disfunção Cognitiva/reabilitação , Demência/psicologia , Atividades Cotidianas , Disfunção Cognitiva/psicologia , Análise Custo-Benefício , Demência/economia , Demência/epidemiologia , Demência/reabilitação , Metas , Humanos , Estudos Multicêntricos como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Autoeficácia , Avaliação da Tecnologia Biomédica , Resultado do Tratamento , Reino Unido
11.
Handchir Mikrochir Plast Chir ; 51(3): 193-198, 2019 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-31167280

RESUMO

BACKGROUND: The national competency-based catalogue of learning objectives in surgery (NKLC) for undergraduate surgical education in Germany consists of 230 objectives and defines competence levels for each objective. These levels range from "competence level 1: factual knowledge" to "competence level 3: independent action". The German second state examination is not based on these objectives, although it is known that assessment drives learning. This study analyses the proportion of hand surgery-based learning objectives in the NKLC and compares the results with the hand surgery questions of the German second medical licensing examination compiled by the Central German Institute for Medical and Pharmaceutical Examinations (IMPP). METHODS: Hand surgery teaching objectives in the NKLC were identified by five hand surgeons. All exam questions addressing these objectives were identified in the German second medical licensing examinations held from autumn 2009 through autumn 2014 (n = 11). The analysis included the number of hand surgery questions for each examination, the number of learning objectives and the different levels of competence. RESULTS: Forty-seven learning objectives of the NKLC were identified as "hand surgery-related" (20.4 % of all NKLC learning objectives). Nine of them were classified as learning objectives that were "only covered by hand surgery" (3.9 % of all NKLC learning objectives). Two hundred and twenty questions (6.3 % of the total number of 3480 questions) addressed hand surgery-related objectives. Per exam, an average of 20 ± 8.2 questions (minimum: 9; maximum: 37) addressed a hand surgery-related learning objective. An average of 0.5 ± 0.7 questions per exam were related to objectives that only covered hand surgery (minimum: 0; maximum: 2). During the study period, 16 learning objectives were not tested at all (13.7 % of all NKLC learning objectives). These untested objectives included 5 objectives of competence level 1 (10.6 % of all NKLC learning objectives). Six of the 9 objectives that are only covered by hand surgery were not assessed at all. CONCLUSIONS: The number of hand surgery-based learning objectives in the NKLC appears to be high. However, many of these learning objectives are not addressed in the second medical licensing examination. We recommend better adjustments between the state examinations and the NKLC.


Assuntos
Currículo , Educação de Graduação em Medicina , Cirurgia Geral , Licenciamento , Competência Clínica , Cirurgia Geral/educação , Alemanha , Metas , Mãos/cirurgia , Humanos
12.
Wiad Lek ; 72(5 cz 2): 1145-1149, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31175761

RESUMO

OBJECTIVE: Introduction: Ukraine has made a commitment to reduce preventable deaths of newborns and children under 5 years of age, within the framework of the relevant task of the Sustainable Development Goals. For a purposeful and effective struggle, it is necessary to realize the scope and structure of losses. The aim: Identify differences in child mortality rates in Ukraine compared to other countries, to calculate and estimate the number of years of potential life lost (YPLL) due to infant mortality. PATIENTS AND METHODS: Materials and methods: The information base of the study was official data of the State Statistics Service of Ukraine on the distribution of the deceased by age and causes of death in 2017 and World Health Statistics 2016 data. The method of potential demography was used to estimate demographic losses. RESULTS: Review: In Ukraine, in 2017 the absolute number of years of potential life lost (YPLL) was estimated to be almost 217,000 person-years due to under-five mortality, most of them - more than 179,000 person-years - due to infant mortality. The rest were losses due to mortality within the interval of 1-4 years - almost 40 thousand person-years. 55.6% of all potential life losses due to infant mortality determined Certain conditions occurring in the perinatal period, Congenital malformations, deformities and chromosomal anomalies - 23.4%. CONCLUSION: Conclusions: Ukraine has significant reserves for reducing under five mortality rates, primarily through minimization of preventable mortality.


Assuntos
Mortalidade da Criança , Mortalidade Infantil , Desenvolvimento Sustentável , Causas de Morte , Pré-Escolar , Metas , Humanos , Lactente , Recém-Nascido , Ucrânia
13.
BMC Public Health ; 19(1): 815, 2019 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-31234831

RESUMO

BACKGROUND: In 2017, the G20 health ministers convened for the first time to discuss global health and issued a communiqué outlining their health priorities, as the BRICS and G7 have done for years. As these political clubs hold considerable political and economic influence, their respective global health agendas may influence both global health priorities and the priorities of other countries and actors. METHODS: Given the rising salience of global health in global summitry, we analyzed the health ministerial communiqués issued by the BRICS, G7 and G20 after the SDGs were adopted in 2015. We compared the stated health priorities of the BRICS, G7 and G20 against one another and against the targets of SDG 3 on health, using a traffic light system to assess the quality of their commitments. RESULTS: With regard to the SDG 3 targets, the BRICS, G7 and G20 priorities overlapped in their focus on emergency preparedness and universal health coverage, but diverged in areas of environmental pollution, mental health, and maternal and child health. Health issues with considerable associated burdens of disease, including substance use, road traffic injuries and sexual health, were missing from the agendas of all three political clubs. In terms of SDG 3 principles and ways of working, the BRICS, G7 and G20 varied in their emphasis on human rights, equity and engagement with non-state actors, but all expressed their explicit commitment to Agenda 2030. CONCLUSIONS: The leadership of BRICS, G7 and G20 on global health is welcome. However, their relatively narrow focus on the potential impact of ill-health primarily in relation to the economy and trade may not be sufficiently comprehensive to achieve the Agenda 2030 vision of promoting health equity and leaving no-one behind. Recommendations for the BRICS, G7 and G20 based on this analysis include: 1) expanding focus to the neglected SDG 3 health targets; 2) placing greater emphasis on upstream determinants of health; 3) greater commitment to equity and leaving no-one behind; 4) adopting explicit commitments to rights-based approaches; and 5) making commitments that are of higher quality and which include time-bound quantitative targets and clear accountability mechanisms.


Assuntos
Saúde Global/tendências , Metas , Equidade em Saúde/tendências , Prioridades em Saúde/tendências , Desenvolvimento Sustentável/tendências , Prioridades em Saúde/organização & administração , Humanos
14.
Behav Processes ; 164: 115-122, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31063789

RESUMO

Intensively housed domestic pigs (Sus scrofa) have little opportunity to perform diverse foraging behaviour though they still seem strongly motivated to do so. Here, we investigated whether the execution of specific behaviours may in itself satisfy their foraging motivation. We elicited the specific foraging behaviours rooting, grazing, and biting & chewing by providing 24 dry sows with three different substrates. Sows visited three pens consecutively. Two of the three substrates were offered one in pen 1 and the other in pen 2, whereas pen 3 provided the three substrates simultaneously. In the control condition, all three materials were provided in all pens. In pen 1 and 2, the sows predominantly showed those foraging behaviours that were to be elicited by the specific substrates. Sows spent less time in pens with a single substrate compared with when all substrates were available. Moreover, durations of the specific behaviours which had not been performed in pen 1 and 2 increased in pen 3. Finally, the lowest proportion of time was spent in pen 3 in the control condition. In conclusion, the results indicate that performing single behaviours of the foraging repertoire did not satisfy the sows' overall foraging motivation.


Assuntos
Comportamento Apetitivo , Metas , Motivação , Sus scrofa , Animais , Feminino , Abrigo para Animais
15.
Vnitr Lek ; 65(4): 248-255, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31091943

RESUMO

Insulin pump therapy represents nowadays the way of insulin administration most similar to the physiological insulin secretion. This form of intensified insulin regime is used mostly (but not exclusively) in type 1 diabetes patients. Insulin pump therapy can be efficiently combined with continuous glucose monitoring. Even there are available insulin pumps which can serve as continuous glucose monitoring signal receiver themselves and are capable to stop automatically basal insulin infusion to prevent hypoglycemia. By this technological combination it is possible to reach near normoglycemia without increasing the risk of severe hypoglycemia. In the Czech Republic this therapy is covered by insurance when defined indication criteria are fulfilled. To reach this therapy full potential the patient as well as the professionals must be trained properly to know all technical aspects of this therapy as well as it is necessary to gain further knowledge. Particularly important is knowledge on food nutrition content and on the glycemic effect of different meals. All these factors are discussed in details in the paper.


Assuntos
Automonitorização da Glicemia , Diabetes Mellitus Tipo 1 , Hipoglicemiantes , Sistemas de Infusão de Insulina , Insulina , Glicemia , República Tcheca , Diabetes Mellitus Tipo 1/tratamento farmacológico , Educação Médica , Metas , Humanos , Hipoglicemiantes/administração & dosagem , Insulina/administração & dosagem , Médicos
16.
Maturitas ; 125: 17-19, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31133211

RESUMO

Our objective was to bridge the gap between gerontechnology developers and hospitalized frail elderly people, in order to promote open gerontechnology innovation in hospitals. We designed a hospital-based living lab that provides reflexive "idea incubator workshops" that gather both the users and the developers of technology, supplemented with an "experimental hospital room" for the testing of devices by older inpatients. The ALLEGRO living lab was delivered in 2018 at the Geriatric Department of Angers University Hospital, France. The workshops and experimental hospital room should help frail older inpatients to participate in the co-design and co-development of new technologies to improve hospital care and promote successful aging.


Assuntos
Atividades Cotidianas , Envelhecimento , Tecnologia Biomédica/métodos , Idoso Fragilizado , Geriatria/métodos , Idoso , Idoso de 80 Anos ou mais , Tecnologia Biomédica/instrumentação , Cuidadores , Difusão de Inovações , Arquitetura de Instituições de Saúde , França , Avaliação Geriátrica , Geriatria/instrumentação , Metas , Serviços de Saúde para Idosos , Hospitais , Humanos , Pacientes Internados , Tecnologia
17.
Neural Netw ; 116: 166-177, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31063926

RESUMO

Recently, L1-norm-based non-greedy linear discriminant analysis (NLDA-L1) for feature extraction has been shown to be effective for dimensionality reduction, which obtains projection vectors by a non-greedy algorithm. However, it usually acquires unsatisfactory performances due to the utilization of L1-norm distance measurement. Therefore, in this brief paper, we propose a flexible non-greedy discriminant subspace feature extraction method, which is an extension of NLDA-L1 by maximizing the ratio of Lp-norm inter-class dispersion to intra-class dispersion. Besides, we put forward a powerful iterative algorithm to solve the resulted objective function and also conduct theoretical analysis on the algorithm. Finally, experimental results on image databases show the effectiveness of our method.


Assuntos
Algoritmos , Reconhecimento Automatizado de Padrão/métodos , Bases de Dados Factuais/normas , Análise Discriminante , Metas , Reconhecimento Automatizado de Padrão/normas
20.
Nat Neurosci ; 22(5): 770-777, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30988523

RESUMO

The ability to sustain goal-directed action is essential for success in many domains, but little is known about the corresponding neural substrates. Using fiber photometry to monitor population neural activity, we demonstrate that engagement in sustained food- or punishment-motivated behavior is associated with suppression of ventral but not dorsal hippocampal activity. Using optogenetic stimulation, we demonstrate that this suppression is required for goal-directed behavior, whereas optogenetic suppression of the ventral hippocampus (vHP) enhances the ability to sustain goal-directed behavior. Suppression of vHP during sustained goal-directed behavior was accompanied by increased activity in median but not dorsal raphe, implicating serotonergic signaling through Htr3a as a mechanism of vHP suppression during successful goal-directed behavior. Sustainment of goal-directed action may require suppression of vHP because of the structure's well-documented role in behavioral inhibition.


Assuntos
Metas , Hipocampo/fisiologia , Neurônios/fisiologia , Serotonina/fisiologia , Animais , Condicionamento Operante , Feminino , Masculino , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Optogenética , Recompensa
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