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1.
Rev Epidemiol Sante Publique ; 67(4): 239-245, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31146902

RESUMO

BACKGROUND: Completeness, timeliness and accuracy are important qualities for registries. The objective was to estimate the completeness of the first two years of full registration (2008/2009) of a new population-based general cancer registry, at the time of national data centralisation. METHODS: Records followed international standards. Numbers of cases missed were estimated from a three-source (pathology labs, healthcare centres, health insurance services) capture-recapture method, using log-linear models for each gender. Age and place of residence were considered as potential variables of heterogeneous catchability. RESULTS: When data were centralized (2011/2012), 4446 cases in men and 3642 in women were recorded for 2008/2009 in the Registry. Overall completeness was estimated at 95.7% (95% CI: 94.3-97.2) for cases in men and 94.8% (95% CI: 92.6-97.0) in women. Completeness appeared higher for younger than for older subjects, with a significant difference of 4.1% (95% CI: 1.4-6.7) for men younger than 65 compared with their older counterparts. Estimates were collated with the number of cases registered in 2014 for the years 2008/2009 (4566 cases for men/3755 for women), when additional structures had notified cases retrospectively to the Registry. These numbers were consistent with the stratified capture-recapture estimates. CONCLUSION: This method appeared useful to estimate the completeness quantitatively. Despite a rather good completeness for the new Registry, the search for cases among older subjects must be improved.


Assuntos
Confiabilidade dos Dados , Coleta de Dados , Neoplasias/epidemiologia , Sistema de Registros/normas , Adulto , Fatores Etários , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Coleta de Dados/métodos , Coleta de Dados/normas , Atestado de Óbito , Feminino , França/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Vigilância da População/métodos , Registros/normas , Registros/estatística & dados numéricos , Sistema de Registros/estatística & dados numéricos , Estudos Retrospectivos
2.
PLoS One ; 14(5): e0216061, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31075119

RESUMO

BACKGROUND: The consequences of armed conflicts impose considerable burdens on the economy and health care services, particularly in countries that are not equipped to deal with them, such as in the Middle-East, and North African countries. Little is known about the burden of mortality and injury resulting from the Libyan armed conflict. This study aimed to determine the trends and patterns of mortality, injury and disabilities directly associated with the Libyan armed conflict and analyze the geographic variation within the country during 2012-2107. METHODS: Data on conflict-related deaths, injuries, and disabilities were obtained from the national registry offices. The information included date, place, and demographic information. A questionnaire was also used to obtain information from the affected individuals and their families. National and regional trends of mortality, injury and disabilities were calculated. Spatial analysis was performed using geographic data available on all documented cases to analyze clustering of mortality and injury. RESULTS: A total of 16,126 deaths and 42,633 injuries were recorded with complete information during the Libyan conflict from 2012 till 2017. The overall mortality rate was 2.7/1000 population and injury rate was 7.1/1000. The overall male-to-female ratio of mortality and injury was 4.4:1; 42.3% were single and aged 20-30 years old, and 26.4% were aged 31-40 years. Moreover, injuries resulted in death in 20.1% of cases and disability in 33.5% of the cases. Most of the disabilities were caused by blasts, while gun shots resulted in more deaths. The overall mortality and injury rates were highest during 2015-2017. These rates were highest in the eastern region. Injuries were most concentrated in Benghazi and Derna in the east, followed by Sert and Musrata in the central region. CONCLUSIONS: Conflict-related mortality, injury and disability has inflicted a heavy burden on the Libyan society that may persist for a long time. The rates of these casualties varied in time and place. National, well-planned efforts are needed to address this serious situation and its consequences.


Assuntos
Conflitos Armados/estatística & dados numéricos , Conflitos Armados/tendências , Causas de Morte/tendências , Pessoas com Deficiência/estatística & dados numéricos , Mortalidade/tendências , Adolescente , Adulto , África do Norte , Análise por Conglomerados , Morte , Demografia/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Oriente Médio , Registros/estatística & dados numéricos , Inquéritos e Questionários , Ferimentos e Lesões , Adulto Jovem
3.
Emergencias (Sant Vicenç dels Horts) ; 31(2): 99-106, abr. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-182526

RESUMO

Objetivos: Estudiar las características de los pacientes que consultan por un episodio de fibrilación auricular (FA) en los servicios de urgencias hospitalarios (SUH), en función de si la FA es de novo o conocida previamente, y la reconsulta relacionada con la FA a los 30 días (R30d). Método: Estudio observacional de cohorte prospectivo y multicéntrico que incluyó a todos los pacientes $ 18 años que consultaron por síntomas relacionados con una FA o el hallazgo de una FA en 5 SUH catalanes. Se recogieron variables demográficas, del episodio agudo, de manejo en urgencias y la R30d. Resultados: De los 1.199 pacientes, 1.052 tuvieron seguimiento a 30 días. La edad media fue de 73 (DE 13) años y 646 (53,9%) eran mujeres. Seiscientos cincuenta y dos pacientes (54,4%) tenían una FA conocida, los cuales tenían mayor edad, presencia de comorbilidades y uso de antiarrítmicos y anticoagulantes orales. Hubo escasas diferencias en el manejo farmacológico en urgencias. La R30d fue de un 7,9%, y fue más frecuente cuando se usó digoxina en urgencias y bloqueadores de los canales del calcio al alta. Conclusiones: Existen diferencias basales entre los pacientes con FA de novo y conocida, pero estas son escasas en el manejo en urgencias. En pacientes atendidos por fibrilación auricular en urgencias, la R30d se relacionó con el uso de digoxina en urgencias y de bloqueadores de los canales del calcio al alta


Objectives: To study the characteristics of patients attending a hospital emergency department (ED) with de novo or previously diagnosed atrial fibrillation (AF), and to determine the rate of revisits for AF within 30 days of discharge. Methods: Prospective multicenter, observational cohort study of patients aged 18 years or older who came to 5 Catalan EDs with symptoms of AF or who were found to have AF on examination. We recorded demographic information and data related to the acute episode and ED management on the first or other visits within 30 days. Results: We had complete follow-up data for 1052 of the 1199 patients initially registered. The mean (SD) age was 73 (13) years, and 646 (53.9%) were women. AF had already been diagnosed in 652 (54.4%). Patients with diagnosed AF were older, had more concomitant conditions, and were more likely to be taking antiarrhythmic and/or anticoagulant drugs. Pharmacologic management in the ED was similar. The 30-day revisiting rate was 7.9% , and revisits were more frequent when digoxin was used in the ED and/or calcium channel blockers were prescribed on discharge. Conclusions: We detected differences between ED patients with de novo FA and previously diagnosed FA, but management of the 2 groups was similar. The 30-day revisiting rate was associated with use of digoxin in the ED and the prescription of calcium channel blockers on discharge


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Registros/estatística & dados numéricos , Fibrilação Atrial/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Readmissão do Paciente/estatística & dados numéricos , Digoxina/administração & dosagem , Canais de Cálcio/administração & dosagem , Readmissão do Paciente/normas , Fatores de Risco
4.
Emergencias (Sant Vicenç dels Horts) ; 31(2): 107-110, abr. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-182527

RESUMO

Objetivo: Análisis de la evolución temporal de las intoxicaciones medicamentosas (IM) atendidas en urgencias hospitalarias. Método: Estudio retrospectivo, con análisis multivariante de variables epidemiológicas y asistenciales de IM, comparando la casuística de los años 2007 con 2017, en un hospital universitario. Resultados: Se incluyeron 750 casos, 58,4% del 2007. En 2017, disminuyeron la causa suicida (p < 0,001), el empleo de descontaminación digestiva (p < 0,001) y antídotos (p = 0,007), y los ingresos (p = 0,004), altas voluntaria o fugas (p = 0,03). Se incrementó por el contrario la intoxicación múltiple (p = 0,001), especialmente en varones y en contexto recreativo. Las benzodiacepinas fueron los fármacos más implicados en las IM (65,1%). Conclusiones: Existe una tendencia al descenso de las IM atendidas, con incremento en varones, menos intencionalidad suicida, menos uso de terapéuticas específicas y menos admisiones hospitalarias


Objective: To review changes occurring over time in cases of medication overdose attended by an emergency department. Methods: Retrospective review of epidemiologic and care variables related to drug poisonings in a university teaching hospital in 2007 and 2017. We used multivariate analysis to compare the 2 years. Results: A total of 750 cases were included; 438 (58.4%) were from 2007. Fewer cases were seen in 2017 even though the total numbers of emergencies and poisonings had risen (P<.001). Fewer cases were suicides or suicide attempts in 2017 (P<.001), and digestive tract decontamination and antidotes were used less often (P<.001 and P=.007, respectively). Admissions (P=.004) and voluntary self-discharges or patient losses were also down in 2017 (P=.03). However, multidrug poisonings increased (P=.001), especially in the context of recreational drug use by men. Benzodiazepine overdoses accounted for most of such cases (65.1%). Conclusions: Medication overdoses seem to be decreasing, although the proportion of men overdosing is rising. Suicide attempts, the abuse of specific medications, and admissions also seem to be decreasing


Assuntos
Humanos , Masculino , Feminino , Adulto , Overdose de Drogas/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Envenenamento/epidemiologia , Registros/estatística & dados numéricos , Estudos Retrospectivos , Análise Multivariada , Hospitais Universitários/estatística & dados numéricos
5.
PLoS One ; 14(3): e0212345, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30870458

RESUMO

Has the maximum human lifespan been reached? The current record stands at 122 years, 164 days and has held for over 20 years and is more than four and three quarter years higher than the previous record. The value and persistence of this record have surprised some researchers, with some even questioning its veracity. There have been previous attempts in the literature to answer questions about how long this record might stand and whether it is truly exceptional but the focus has been mainly on the record ages, using ad hoc tools. This article contributes in two new ways. First we study lifespan records via the (inter-) record times and second we make use of specific tools from statistical Records Theory. We find that the occurrence of the present record was not surprising. We estimate around a 25% chance that the record would have survived until now and around a one in five chance that it will survive until 2050, demonstrating remarkable persistence.


Assuntos
Longevidade/fisiologia , Registros/estatística & dados numéricos , Envelhecimento/fisiologia , Humanos , Reprodutibilidade dos Testes
6.
JMIR Mhealth Uhealth ; 7(1): e11730, 2019 01 16.
Artigo em Inglês | MEDLINE | ID: mdl-30664467

RESUMO

BACKGROUND: Mobile phone call detail records (CDRs) are increasingly being used in health research. The location element in CDRs is used in various health geographic studies, for example, to track population movement and infectious disease transmission. Vast volumes of CDRs are held by multinational organizations, which may make them available for research under various data governance regimes. However, there is an identified lack of public engagement on using CDRs for health research to contribute to an ethically founded framework. OBJECTIVE: This study aimed to explore public views on the use of call detail records in health research. METHODS: Views on using CDRs in health research were gained via a series of three public workshops (N=61) informed by a pilot workshop of 25 people. The workshops included an initial questionnaire to gauge participants' prior views, discussion on health research using CDRs, and a final questionnaire to record workshop outcome views. The resulting data were analyzed for frequencies and emerging themes. RESULTS: At the outset, most participants (66%, 40/61) knew that location data were collected by operators, but only 3% (2/61) knew they were being used for health research. Initially, the majority of the participants (62%, 38/61) was content for their anonymous CDRs to be used, and this increased (80%, 49/61) after the discussion explained that safeguards were in place. Participants highlighted that terms and conditions should be clearer, as should information to phone users on data collection, privacy safeguards, sharing, and uses in research. CONCLUSIONS: This is the first known study exploring public views of using mobile phone CDRs in health research. It revealed a lack of knowledge among the public on uses of CDRs and indicated that people are generally amenable to the use of anonymized data for research, but they want to be properly informed and safeguarded. We recommend that public views be incorporated into an ethically founded framework for the use of CDRs in health research to promote awareness and social acceptability in data use.


Assuntos
Telefone Celular/instrumentação , Privacidade/psicologia , Opinião Pública , Registros/normas , Adolescente , Adulto , Idoso , Telefone Celular/tendências , Educação/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Registros/estatística & dados numéricos , Inquéritos e Questionários
7.
Braz. J. Pharm. Sci. (Online) ; 55: e18481, 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1039078

RESUMO

In general, topical ophthalmic drug products, especially those used for treating infections, present low effectiveness because of various reasons, from unfavorable drug physicochemical properties to physiological protective mechanisms of the eye. The fact is such group of products holds room for improvement, which could mean the development of better drugs or dosage forms. To achieve this, the knowledge of market composition is essential. The present work studied and compared the antimicrobial ophthalmic markets of Brazil and of the United States (US). Official databank of Brazilian Health Regulatory Agency and of US Food and Drug Administration were assessed for registered antimicrobial topical ophthalmic drug products. Brazilian market has registered greater number of drug products (119) than the US (94), but the latter involves more variety of substances and dosage forms. In both countries, non-innovative products registered as solutions of antibacterials, especially fluoroquinolones and aminoglycosides lead the market. Despite the clinical demand, the US has only one group of antimycotics (polyenes) registered, while in Brazil, there is not any ophthalmic antimycotic product marketed. This study evidences there is not only space for development of newer drugs and formulations but also a demand for already existing technologies and products in both countries.


Assuntos
Oftalmologia/classificação , Preparações Farmacêuticas , Lubrificantes Oftálmicos/análise , Estados Unidos/etnologia , Brasil/etnologia , Registros/estatística & dados numéricos , Anti-Infecciosos/efeitos adversos
8.
BMC Med Res Methodol ; 18(1): 106, 2018 10 12.
Artigo em Inglês | MEDLINE | ID: mdl-30314471

RESUMO

BACKGROUND: Health inequalities, worse health associated with social and economic disadvantage, are reported by a minority of research articles. Locating these studies when conducting an equity-focused systematic review is challenging due to a deficit in standardised terminology, indexing, and lack of validated search filters. Current reporting guidelines recommend not applying filters, meaning that increased resources are needed at the screening stage. METHODS: We aimed to design and test search filters to locate studies that reported outcomes by a social determinant of health. We developed and expanded a 'specific terms strategy' using keywords and subject headings compiled from recent systematic reviews that applied an equity filter. A 'non-specific strategy' was compiled from phrases used to describe equity analyses that were reported in titles and abstracts, and related subject headings. Gold standard evaluation and validation sets were compiled. The filters were developed in MEDLINE, adapted for Embase and tested in both. We set a target of 0.90 sensitivity (95% CI; 0.84, 0.94) in retrieving 150 gold standard validation papers. We noted the reduction in the number needed to screen in a proposed equity-focused systematic review and the proportion of equity-focused reviews we assessed in the project that applied an equity filter to their search strategy. RESULTS: The specific terms strategy filtered out 93-95% of all records, and retrieved a validation set of articles with a sensitivity of 0.84 in MEDLINE (0.77, 0.89), and 0.87 (0.81, 0.92) in Embase. When combined (Boolean 'OR') with the non-specific strategy sensitivity was 0.92 (0.86, 0.96) in MEDLINE (Embase 0.94; 0.89, 0.97). The number needed to screen was reduced by 77% by applying the specific terms strategy, and by 59.7% (MEDLINE) and 63.5% (Embase) by applying the combined strategy. Eighty-one per cent of systematic reviews filtered studies by equity. CONCLUSIONS: A combined approach of using specific and non-specific terms is recommended if systematic reviewers wish to filter studies for reporting outcomes by social determinants. Future research should concentrate on the indexing standardisation for equity studies and further development and testing of both specific and non-specific terms for accurate study retrieval.


Assuntos
Bases de Dados Bibliográficas/normas , Equidade em Saúde/normas , Disparidades em Assistência à Saúde/normas , MEDLINE/normas , Ferramenta de Busca/normas , Bases de Dados Bibliográficas/estatística & dados numéricos , Guias como Assunto/normas , Equidade em Saúde/estatística & dados numéricos , Recursos em Saúde/normas , Recursos em Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Humanos , MEDLINE/estatística & dados numéricos , Registros/normas , Registros/estatística & dados numéricos , Padrões de Referência , Ferramenta de Busca/métodos , Ferramenta de Busca/estatística & dados numéricos , Revisão Sistemática como Assunto
9.
PLoS One ; 13(8): e0200655, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30110326

RESUMO

INTRODUCTION: Electronic health care data offers the opportunity to study rare events, although detecting these events in large datasets remains difficult. We aimed to develop a model to identify leukemia patients with major hemorrhages within routinely recorded health records. METHODS: The model was developed using routinely recorded health records of a cohort of leukemia patients admitted to an academic hospital in the Netherlands between June 2011 and December 2015. Major hemorrhage was assessed by chart review. The model comprised CT-brain, hemoglobin drop, and transfusion need within 24 hours for which the best discriminating cut off values were taken. External validation was performed within a cohort of two other academic hospitals. RESULTS: The derivation cohort consisted of 255 patients, 10,638 hospitalization days, of which chart review was performed for 353 days. The incidence of major hemorrhage was 0.22 per 100 days in hospital. The model consisted of CT-brain (yes/no), hemoglobin drop of ≥0.8 g/dl and transfusion of ≥6 units. The C-statistic was 0.988 (CI 0.981-0.995). In the external validation cohort of 436 patients (19,188 days), the incidence of major hemorrhage was 0.46 per 100 hospitalization days and the C-statistic was 0.975 (CI 0.970-0.980). Presence of at least one indicator had a sensitivity of 100% (CI 95.8-100) and a specificity of 90.7% (CI 90.2-91.1). The number of days to screen to find one case decreased from 217.4 to 23.6. INTERPRETATION: A model based on information on CT-brain, hemoglobin drop and need of transfusions can accurately identify cases of major hemorrhage within routinely recorded health records.


Assuntos
Assistência à Saúde/estatística & dados numéricos , Hemorragia/diagnóstico , Hospitalização/estatística & dados numéricos , Leucemia Mieloide Aguda/complicações , Registros/estatística & dados numéricos , Adulto , Idoso , Estudos de Coortes , Feminino , Hemorragia/epidemiologia , Hemorragia/etiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia
10.
Artigo em Inglês | MEDLINE | ID: mdl-30021934

RESUMO

The aims of this study were (i) to evaluate the relationship between official data on invasive meningococcal disease cases in Sardinia and the reporting of the cases by a regional online newspaper and (ii) to identify indicators useful for understanding the community outrage related to health events. Cases of meningococcal disease, selected from articles published between 1999 and 2016 on a regional newspaper database, were compared to those reported to the Infectious Disease Information Service. In order to evaluate the equality of the two distribution records, the Kolgomorov Smirnov test for two samples was applied. A community outrage indicator was obtained by calculating the number of published articles for each case of meningococcal disease identified. The outrage indicator was evaluated in comparison with other phenomena: drinking water supply limitation and domestic accidents. Overall, 2724 articles on meningitis/sepsis referring to 89 cases related to meningococcal disease were considered. Significant differences between the distribution of cases officially reported and those found in the newspaper (combined K-S = 0.39; p = 0.08) were not observed. The meningococcal disease outrage indicator showed an average of seven items per case. Comparing the meningococcal disease outrage indicator with those regarding the limitation of drinking water supplies and domestic accidents, a different risk perception by the reference media was found, with the highest outrage for meningococcal disease. The present study supports the role played by emotional factors as behavioral determinants in emerging threats to public health. The analysis of the data allowed us to highlight that the proposed outrage indicator could be a feasible proxy of emotional epidemiology. Finally, data confirm that meningitis is perceived as a highly outrageous health threat.


Assuntos
Atitude Frente a Saúde , Métodos Epidemiológicos , Infecções Meningocócicas/epidemiologia , Infecções Meningocócicas/psicologia , Humanos , Incidência , Disseminação de Informação , Itália/epidemiologia , Registros/estatística & dados numéricos , Risco
11.
BMC Med Res Methodol ; 18(1): 76, 2018 07 06.
Artigo em Inglês | MEDLINE | ID: mdl-29980173

RESUMO

BACKGROUND: Records pertaining to individuals whose identity cannot be verified with legal documentation may contain errors, or be incorrect by intention of the individual. Probabilistic data linkage, especially in vulnerable populations where the incidence of such records may be higher, must be considerate of the usage of these records. METHODS: A data linkage was conducted between Queensland Youth Justice records and the Australian National Death Index. Links were assessed to determine how often they were made using the unverified (alias) records that would not have been made in their absence (i.e. links that were not also made using solely verified records). Anomalies in the linked records were investigated in order to make evaluations of the sensitivity and specificity of the linkage, compared to the links made using only verified records. RESULTS: From links made using verified records only, 1309 deaths were identified (2.6% of individuals). Using alias records in addition, the number of links increased by 16%. Links made using alias records only were more common in females, and those born after 1985. Different records belonging to the same individual in the justice dataset did not link to different death records, however there were instances of the same death record linking to multiple cohort individuals. CONCLUSIONS: The inclusion of aliases in data linkage in youths involved in the justice system increased mortality ascertainment without any discernible increase in false positive matches. We therefore conclude that alias records should be included in data linkage procedures in order to avoid biased attenuation of ascertainment in vulnerable populations, leading to the concealment of health inequality.


Assuntos
Sistemas de Informação/estatística & dados numéricos , Registros/estatística & dados numéricos , Justiça Social/normas , Populações Vulneráveis/estatística & dados numéricos , Adolescente , Austrália , Declaração de Nascimento , Estudos de Coortes , Atestado de Óbito , Feminino , Humanos , Armazenamento e Recuperação da Informação/métodos , Armazenamento e Recuperação da Informação/estatística & dados numéricos , Masculino , Reprodutibilidade dos Testes
12.
Nat Commun ; 9(1): 2565, 2018 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-29967400

RESUMO

Estimates of recent biodiversity change remain inconsistent, debated, and infrequently assessed for their functional implications. Here, we report that spatial scale and type of biodiversity measurement influence evidence of temporal biodiversity change. We show a pervasive scale dependence of temporal trends in taxonomic (TD) and functional (FD) diversity for an ~50-year record of avian assemblages from North American Breeding Bird Survey and a record of global extinctions. Average TD and FD increased at all but the global scale. Change in TD exceeded change in FD toward large scales, signaling functional resilience. Assemblage temporal dissimilarity and turnover (replacement of species or functions) declined, while nestedness (tendency of assemblages to be subsets of one another) increased with scale. Patterns of FD change varied strongly among diet and foraging guilds. We suggest that monitoring, policy, and conservation require a scale-explicit framework to account for the pervasive effect that scale has on perceived biodiversity change.


Assuntos
Biodiversidade , Aves/fisiologia , Conservação dos Recursos Naturais , Monitorização de Parâmetros Ecológicos , Animais , Aves/classificação , América do Norte , Registros/estatística & dados numéricos
13.
BMC Health Serv Res ; 18(1): 494, 2018 06 26.
Artigo em Inglês | MEDLINE | ID: mdl-29940946

RESUMO

BACKGROUND: The literature suggests that although adult hospitals are establishing population health programs around the country, there is considerable definitional ambiguity regarding whether interventions are aimed at the social determinants of health or the management of existing patient populations. U.S. children's hospitals also undertake population health programs, but less is known about how they define population health. The purpose of this study is to understand how U.S. children's hospitals define population health, and how institutions are adjusting to new preventive health care models. METHODS: We conducted semi-structured interviews with key stakeholders at ten hospitals with the highest amount of staff time dedicated to population health activities as reported in the 2016 Children's Hospital Association's population health survey. Using a semi-structured interview guide, we interviewed representatives from each hospital. Verbatim interview notes were coded and analyzed using the data analysis software Dedoose. Data analysis followed a modified constructivist grounded theory approach. RESULTS: Our results suggest that even population health innovators employ a variety of approaches that span both population health management and public health. We present further evidence that U.S. children's hospitals are actively debating the definition and focus of population health. CONCLUSIONS: Definitional debates are ongoing even within children's hospitals that are dedicating significant resources to population health. Increased clarity on the conceptual boundaries between population health and population health management could help preserve the theoretical differences between the two concepts, especially insofar as they mark two quite different long-term visions for health care. Without agreement about the meaning of population health within and among institutions, hospitals will not be able to know whether projects aimed at addressing the social determinants of health are likely to improve the health of populations.


Assuntos
Hospitais Pediátricos/estatística & dados numéricos , Entrevistas como Assunto , Saúde da População , Pesquisa Qualitativa , Criança , Bases de Dados Factuais , Feminino , Pesquisa sobre Serviços de Saúde , Humanos , Masculino , Saúde da População/classificação , Saúde da População/estatística & dados numéricos , Indicadores de Qualidade em Assistência à Saúde , Registros/estatística & dados numéricos , Software , Estados Unidos
15.
J Safety Res ; 64: 155-162, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29636164

RESUMO

INTRODUCTION: Fatigue is one of the riskiest causes of traffic accidents threatening road safety. Due to lack of proper criteria, the identification of fatigue-related accidents by police officers largely depends on inferential evidence and their own experience. As a result, many fatigue-related accidents are misclassified and the harmfulness of fatigue on road safety is misestimated. METHOD: In this paper, a joint model framework is introduced to analyze factors contributing to misclassification of a fatigue-related accident in police reports. Association rule data mining technique is employed to identify the potential interactions of factors, and logistic regression models are applied to analyze factors that hinder police officers' identification of fatigue-related accidents. Using the fatigue-related crash records from Guangdong Province during 2005-2014, factors contributing to the false positive and false negative detection of the fatigue-related accident have been identified and compared. RESULTS: Some variables and interactions were identified to have significant impacts on fatigue-related accident detection. CONCLUSIONS: Based on the results, it can be inferred that the stereotype of certain groups of drivers, crash types, and roadway conditions affects police officers' judgment on fatigue-related accidents. PRACTICAL APPLICATIONS: This finding can provide useful information for training police officers and build better criteria for fatigue identification.


Assuntos
Acidentes de Trânsito/classificação , Fadiga/epidemiologia , Registros/estatística & dados numéricos , Acidentes de Trânsito/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , China , Fadiga/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , Polícia , Adulto Jovem
16.
Patient Educ Couns ; 101(7): 1283-1290, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29506876

RESUMO

OBJECTIVE: To investigate the use of lebensstil-aendern.de ("lifestyle change"), a website providing peer narratives of experiences with successful lifestyle change, and to analyze whether peer model characteristics, clip content, and media type have an influence on the number of visitors, dwell time, and exit rates. METHODS: An in-depth statistical analysis of website use with multilevel regression analyses. RESULTS: In two years, lebensstil-aendern.de attracted 12,844 visitors. The in-depth statistical analysis of usage rates demonstrated that audio clips were less popular than video or text-only clips, longer clips attracted more visitors, and clips by younger and female interviewees were preferred. User preferences for clip content categories differed between heart and back pain patients. Clips about stress management drew the smallest numbers of visitors in both indication modules. CONCLUSIONS: Patients are interested in the experiences of others. Because the quality of information for user-generated content is generally low, healthcare providers should include quality-assured patient narratives in their interventions. User preferences for content, medium, and peer characteristics need to be taken into account. PRACTICE IMPLICATIONS: If healthcare providers decide to include patient experiences in their websites, they should plan their intervention according to the different needs and preferences of users.


Assuntos
Dor nas Costas/reabilitação , Doença das Coronárias/reabilitação , Internet , Estilo de Vida , Registros/estatística & dados numéricos , Aconselhamento , Feminino , Humanos , Masculino , Narração , Grupo Associado , Inquéritos e Questionários
17.
Epidemiol Serv Saude ; 27(1): e20171493, 2018 02 01.
Artigo em Inglês, Português | MEDLINE | ID: mdl-29412348

RESUMO

OBJECTIVE: to describe the quality of records on cases of sexual violence against women, reported in the Information System for Notifiable Diseases (Sinan), in Santa Catarina State, Brazil, from 2008 to 2013. METHODS: normative assessment with data from records of sexual violence cases against women (≥10 years old); data quality was described according to the dimensions 'non-duplicity' (acceptable when >95%), 'completeness' (good when >75%), and 'consistency' (excellent when >90.0%) of information. RESULTS: 2,010 cases of sexual violence against women were studied, after the exclusion of four duplicate records; the percentage of non-duplicity was 99.9% (acceptable); of completeness was 93.3% (good) and of consistency was 98.9% (excellent). CONCLUSION: the results presented point out the usefulness of Sinan as a source of information for the surveillance of sexual violence against women and for planning actions to tackle this type of aggression.


Assuntos
Confiabilidade dos Dados , Sistemas de Informação/normas , Registros/normas , Delitos Sexuais/estatística & dados numéricos , Adolescente , Brasil/epidemiologia , Criança , Feminino , Humanos , Sistemas de Informação/estatística & dados numéricos , Registros/estatística & dados numéricos , Adulto Jovem
19.
Hernia ; 22(2): 243-248, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29243213

RESUMO

OBJECTIVES: To determine the baseline accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of routinely collected co-morbidity data in patients undergoing abdominal wall hernia repair. METHODS: All patients aged > 18 who underwent umbilical, para-umbilical, inguinal or incisional hernia repair between 1 January 2015 and 1 November 2016 were identified. All parts of the clinical notes were searched for co-morbidities by two authors independently. The following co-morbidities were considered: hypertension, ischaemic heart disease (IHD), diabetes, asthma, chronic obstructive pulmonary disease (COPD), cerebrovascular disease (CVD), chronic kidney disease (CKD), hypercholesterolemia, obesity and smoking. The co-morbidities data from clinical notes were compared with corresponding data in hospital episode statistics (HES) database to calculate accuracy, sensitivity, specificity, PPV and NPV of HES codes for co-morbidities. To assess the agreement between clinical notes and HES data, we also calculated Cohen's Kappa index value as a more robust measure of agreement. RESULTS: Overall, 346 patients comprising 3460 co-morbidity codes were included in the study. The overall accuracy of HES codes for all co-morbidities was 77% (Kappa: 0.13). When calculated separately for each co-morbidity, the accuracy was 72% (Kappa: 0.113) for hypertension, 82% (Kappa: 0.232) for IHD, 85% (Kappa: 0.203) for diabetes, 86% (Kappa: 0.287) for asthma, 91% (Kappa: 0.339) for COPD, 92% (Kappa: 0.374) for CVD, 94% (Kappa: 0.424) for CKD, 74% (Kappa: 0.074) for hypercholesterolemia, 71% (Kappa: 0.66) for obesity and 24% (Kappa: 0.005) for smoking. The overall sensitivity, specificity, PPV and NPV of HES codes were 9, 100, 100, and 77%, respectively. The results were consistent when individual co-morbidities were analyzed separately. CONCLUSIONS: Our results demonstrated that HES co-morbidity codes in patients undergoing abdominal wall hernia repair are specific with good positive predictive value; however, they have substandard accuracy, sensitivity, and negative predictive value. The presence of a relatively large number of false negative or missed cases in HES database explains our findings. Better documentation of co-morbidities in admission clerking proforma may help to improve the quality of source documents for coders, which in turn may improve the accuracy of coding.


Assuntos
Doença Crônica/epidemiologia , Comorbidade , Confiabilidade dos Dados , Hérnia Abdominal , Herniorrafia , Parede Abdominal/cirurgia , Adulto , Idoso , Feminino , Hérnia Abdominal/classificação , Hérnia Abdominal/epidemiologia , Hérnia Abdominal/cirurgia , Herniorrafia/efeitos adversos , Herniorrafia/métodos , Herniorrafia/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Registros/estatística & dados numéricos , Estudos Retrospectivos , Sensibilidade e Especificidade , Reino Unido/epidemiologia
20.
Appl Nurs Res ; 38: 1-4, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-29241500

RESUMO

Background: Although there are many recommendations and guidelines for adequate pain assessment, the quality of postoperative pain documentation does not meet the acceptable standards. Aim: The aim of the study is to review the pain assessment and analgesic records of nurses within the first 48 h in the postoperative period. Methods: This retrospective and descriptive study was conducted in a University Hospital. The records of a total of 421 patients who underwent surgery between January 2014 and January 2015 were analysed. The data of the patients were obtained using the patient files. Results: Pain assessment scale was not used, and the pain records did not include intensity, location, duration and quality of the pain. The analgesic records indicated that the highest percentage (70.8%) of analgesic use was within the first postoperative two hours. Diclofenac sodium was the most commonly administered and recorded analgesic, while pethidine HCl was the least used one. More than half of the all analgesic injections (63.9%) were administered by intramuscular route. No non-pharmacological intervention including massage, hot­cold application, or positioning was reported in the nursing records. Conclusion: The postoperative pain was not assessed properly as recommended in the acute pain guidelines. Therefore, nurses should increase the awareness on the pain assessment records for effective pain management. In addition, the administration of the hospital should support the use of standard pain assessment and recording via electronic patient record system, continue online education courses and give feedback on the records of nurses regarding pain management.


Assuntos
Analgésicos/uso terapêutico , Medição da Dor/estatística & dados numéricos , Medição da Dor/normas , Dor Pós-Operatória/tratamento farmacológico , Registros/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Analgésicos/administração & dosagem , Feminino , Guias como Assunto , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
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