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1.
Evol Anthropol ; 29(3): 117-124, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32472595

RESUMO

The human evolutionary sciences place high value on quantitative data from traditional small-scale societies that are rapidly modernizing. These data often stem from the sustained ethnographic work of anthropologists who are today nearing the end of their careers. Yet many quantitative ethnographic data are preserved only in summary formats that do not reflect the rich and variable ethnographic reality often described in unpublished field notes, nor the deep knowledge of their collectors. In raw disaggregated formats, such data have tremendous scientific value when used in conjunction with modern statistical techniques and as part of comparative analyses. Through a personal example of longitudinal research with Batek hunter-gatherers that involved collaboration across generations of researchers, we argue that quantifiable ethnographic records, just like material artifacts, deserve high-priority preservation efforts. We discuss the benefits, challenges, and possible avenues forward for digitizing, preserving, and archiving ethnographic data before it is too late.


Assuntos
Antropologia Cultural/normas , Povos Indígenas , Registros/normas , Antropologia Cultural/instrumentação , Humanos , Malásia , Registros/estatística & dados numéricos
2.
Int J Public Health ; 65(1): 29-36, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31848636

RESUMO

OBJECTIVES: To analyze the agreement between self-reported race and race reported on death certificates for older (≥ 60 years) residents of São Paulo, Brazil (from 2000 to 2016) and to estimate weights to correct mortality data by race. METHODS: We used data from the Health, Well-Being and Aging Study (SABE) and from Brazil's Mortality Information System. Misclassification was identified by comparing individual self-reported race with the corresponding race on the death certificate (n = 1012). Racial agreement was analyzed by performing sensitivity and Cohen's Kappa tests. Multinomial logistic regressions were adjusted to identify characteristics associated with misclassification. Correction weights were applied to race-specific mortality rates. RESULTS: Total racial misclassification was 17.3% (13.1% corresponded to whitening, and 4.2% to blackening). Racial misclassification was higher for self-reported pardos/mixed (63.5%), followed by blacks (42.6%). Official vital statistics suggest highest elderly mortality rates for whites, but after applying correction weights, black individuals had the highest rate (45.85/1000 population), followed by pardos/mixed (42.30/1000 population) and whites (37.91/1000 population). CONCLUSIONS: Official Brazilian data on race-specific mortality rates may be severely misclassified, resulting in biased estimates of racial inequalities.


Assuntos
Causas de Morte , Grupos de Populações Continentais/classificação , Grupos de Populações Continentais/estatística & dados numéricos , Atestado de Óbito , Mortalidade , Registros/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
3.
Public Health Rep ; 135(1): 40-46, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31835013

RESUMO

OBJECTIVES: Violence due to firearms is a substantial public health problem. Death data from medical examiner and vital records were linked to evaluate the use of medical examiner data to augment routine surveillance and determine any differences in sex, age, manner of death, or race and ethnicity between the 2 data systems. MATERIALS AND METHODS: Medical examiner data were searched for keywords of interest, and vital records data were obtained and linked for deaths occurring in Multnomah County, Oregon, from January 1, 2010, through December 31, 2016. Both data sets were compared for the number and proportion of firearm-related deaths by sex, age, manner of death, and race/ethnicity. Sensitivity and positive predictive values were calculated for variables that had discordant results. RESULTS: A total of 568 firearm-related deaths were identified in the medical examiner data. After matching with manual review, the 2 data systems had 100% case agreement. A reverse match showed that most cases not found in medical examiner data were due to transfer of case jurisdiction. The 2 systems matched nearly perfectly in sex, age, and manner of death but differed in characterization of race and ethnicity. Sensitivity was 62% for Hispanic ethnicity but 93% for white and black race. PRACTICE IMPLICATIONS: Using medical examiner data was a useful way to augment routine surveillance of firearm-related deaths in our jurisdiction in close to real time. However, caution is needed when analyzing data by subgroups because of discordant classifications of race between the data systems.


Assuntos
Médicos Legistas/estatística & dados numéricos , Coleta de Dados/métodos , Registros/estatística & dados numéricos , Ferimentos por Arma de Fogo/mortalidade , Adulto , Distribuição por Idade , Idoso , Grupos de Populações Continentais , Coleta de Dados/normas , Grupos Étnicos , Feminino , Armas de Fogo , Humanos , Masculino , Pessoa de Meia-Idade , Oregon , Vigilância da População , Reprodutibilidade dos Testes , Distribuição por Sexo , Estados Unidos/epidemiologia , Ferimentos por Arma de Fogo/etnologia , Adulto Jovem
4.
Rev. Hosp. Ital. B. Aires (2004) ; 39(4): 108-114, dic. 2019. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1099618

RESUMO

En la Argentina no existen datos epidemiológicos sobre displasia fibromuscular. La realización de un registro nacional puede aportar información que conduzca a una actualización de los consensos y recomendaciones para un correcto diagnóstico, evaluación y tratamiento. El Registro Argentino de Displasia Fibromuscular (SAHARA-DF) inició su actividad de recopilación de datos en octubre de 2015. Al año 2019 se confirmaron 49 pacientes (44 mujeres, 38 hipertensos, edad 45,3 ± 17,2 años, 12 con presentación neurológica). Veintidós pacientes tuvieron lesiones vasculares en más de un sitio, a pesar del sesgo diagnóstico por falta de estudios complementarios en casi la mitad de los casos. El sitio afectado más frecuente fue el renovascular, seguido por el carotídeo y el ilíaco, y las lesiones multifocales fueron más frecuentes que las unifocales (35 versus 14, respectivamente). Se constató la presencia de aneurismas asociados en 13 casos y disección arterial en 4 casos. De las 22 angioplastias renales realizadas, 14 fueron con colocación de stent (endoprótesis). En este estudio preliminar de una población argentina se evidencia el carácter sistémico de la enfermedad y se plantea un llamado a actuar en cuanto a la necesidad de debatir el algoritmo diagnóstico y el método de tratamiento. (AU)


In Argentina there are no epidemiological data regarding fibromuscular dysplasia. Building a National Registry may provide information leading to updated consensus and recommendations for a correct diagnosis, assessment and treatment. Data gathering for the Argentine Registry of Fibromuscular Dysplasia (SAHARA-DF) was initiated in October 2015. By 2019, 49 patients were confirmed (44 women, 38 hypertensives, age 45.3 ± 17.2 years, 12 with a neurological presentation). Twenty-two patients had multi-site vascular lesions, in spite of a diagnosis bias due to lack of supporting studies in almost half of the cases. The renovascular site was the most affected, followed by the carotid and iliac sites, and multifocal lesions were more frequent than unifocal (35 versus 14, respectively). Associated aneurysms were found in 13 cases, and arterial dissection in 4. Twenty-two renal angioplasties were performed, 14 with stent placement. In this preliminary study of an Argentinian population, the systemic nature of the disease is evidenced, and a call for action arises regarding the need for discussing the diagnostic algorithm and treatment method. (AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Registros/estatística & dados numéricos , Displasia Fibromuscular/diagnóstico , Argentina/epidemiologia , Algoritmos , Viés , Fatores Sexuais , Estudos Transversais , Fatores de Risco , Fatores Etários , Angioplastia/métodos , Fatores Antropológicos , Lesões do Sistema Vascular/diagnóstico por imagem , Displasia Fibromuscular/classificação , Displasia Fibromuscular/etiologia , Displasia Fibromuscular/terapia , Displasia Fibromuscular/epidemiologia , Hipertensão/epidemiologia , Aneurisma Dissecante/diagnóstico por imagem
5.
Semin Radiat Oncol ; 29(4): 306-310, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31472730

RESUMO

In oncology, the term "big data" broadly describes the rapid acquisition and generation of massive amounts of information, typically from population cancer registries, electronic health records, or large-scale genetic sequencing studies. The challenge of using big data in cancer research lies in interdisciplinary collaboration and information processing to unify diverse data sources and provide valid analytics to harness meaningful information. This article provides an overview of how big data approaches can be applied in cancer research, and how they can be used to translate information into new ways to ultimately make informed decisions that improve cancer care and delivery.


Assuntos
Big Data , Bases de Dados Factuais/estatística & dados numéricos , Assistência à Saúde/métodos , Oncologia/métodos , Medicina de Precisão/métodos , Registros/estatística & dados numéricos , Registros Eletrônicos de Saúde/estatística & dados numéricos , Humanos , Sistema de Registros/estatística & dados numéricos
6.
Educ. med. (Ed. impr.) ; 20(supl.2): 124-128, sept. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-193074

RESUMO

INTRODUCCIÓN: El expediente final de un graduado puede tener una importante repercusión en su futura carrera profesional, es por ello que también debería ser establecido de la forma más justa posible. Hasta hace unos años los expedientes en la universidad española se calculaban a partir de criterios cualitativos de 4 categorías (1-4). En el año 2003 se propone una calificación decimal (0-10) para calcular los expedientes, hecho que garantizaría más la equidad. El objetivo del estudio consiste en determinar la relación entre los 2 tipos de calificaciones y en observar las posibles diferencias y posibles repercusiones. MATERIAL Y MÉTODOS: Para el estudio se registraron los datos de 6 promociones de la extinta licenciatura de biología, 5 promociones del grado de biología humana y de 3 promociones de medicina de la Facultad de Ciencias de la Salud y de la Vida de la Universidad Pompeu Fabra. RESULTADOS: Se observaron correlaciones muy elevadas (superiores a 0,9) entre las 2 opciones de evaluación, pero se puso de manifiesto que con el sistema decimal existiría un mayor número de egresados con expedientes brillantes. DISCUSIÓN: Dado que el sistema decimal de evaluación era más equitativo se propone que las autoridades responsables utilicen el sistema decimal de evaluación en vez del cualitativo que todavía continúa en vigor


INTRODUCTION: As the final academic record of a graduate can have an important impact on their future professional career, this should be established as fairly as possible. Until a few years ago, the academic grades in Spanish universities were calculated based on qualitative criteria of four categories (1-4). In 2003, a decimal rating (0-10) was proposed to calculate the grades; a fact that would further guarantee fairness. The objective of the study is to determine the relationship between the two types of qualifications and to observe any differences and repercussions. MATERIAL AND METHODS: For the study data was recorder from 6 courses of the former Biology degree, 5 courses of the Human Biology degree, and of 3 Medicine courses of the Faculty of Health and Life Sciences of the Pompeu Fabra University. RESULTS: Very high correlations (higher than 0.9) were observed between the two assessment options, but it was observed that with the decimal system there would be a greater number of graduates with brilliant results. DISCUSSION: Since the decimal evaluation system was more equitable, it is proposed that the responsible authorities use the decimal assessment system instead of the qualitative one that is still in force


Assuntos
Humanos , Registros/estatística & dados numéricos , Desempenho Acadêmico/estatística & dados numéricos , Faculdades de Medicina/normas , Educação Médica/estatística & dados numéricos , Desempenho Acadêmico/normas , Faculdades de Medicina/organização & administração , Faculdades de Medicina/estatística & dados numéricos , Estatísticas não Paramétricas , Estudantes de Ciências da Saúde/estatística & dados numéricos
7.
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
8.
PLoS One ; 14(6): e0217295, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31188838

RESUMO

BACKGROUND: The news media is a key source for health and medical information, and relies to a large degree on material from press releases (PR). Medical universities are key players in the dissemination of PRs. This study aims to 1) explore the relation between the quality of press releases (PRs) from medical universities and their corresponding news stories (NSs) and 2) to identify the likelihood that specific scientific and interest-raising measures appear or are omitted in PRs and NSs. METHODS AND FINDINGS: In this retrospective study using quantitative content analysis, PRs (n = 507) from 21 medical universities in Germany, the Netherlands, Sweden, the USA and the UK were retrieved. Of all PRs, 33% had media coverage, resulting in 496 NSs. With two codebooks, 18 scientific (e.g. reporting the study design of the study correctly) and 7 interest-raising measures (e.g. words like 'ground-breaking') were evaluated in the PRs and NSs. For all measures the percentage of presence in NSs and PRs was calculated, together with a Mean PR Influence Factor. Quality of PRs and NSs was defined as a score, based on 12 of the 18 scientific measures. Mean (SD) NS quality score was 6.5 (1.7) which was significantly lower than the PR score of 8.0 (1.5). The two quality scores were significantly correlated. Quality measures that were frequently omitted included reporting important study limitations (present in 21% of PRs, 21% of NSs), funding (59% of PRs, 7% of NSs) and conflicts of interest (16% of PRs, 3% of NSs). We did not evaluate the quality of the scientific papers (SPs), and can therefore not determine if the quality of PRs and NSs is associated with the quality of SPs. CONCLUSIONS: This large study of medical university press releases and corresponding news stories showed that important measures of a scientific study such as funding and study limitations were omitted to a very large extent. The lay public and health personnel as well as policy makers, politicians and other decision makers may be misled by incomplete and partly inaccurate representations of scientific studies which could negatively affect important health-related behaviours and decisions.


Assuntos
Educação Médica/estatística & dados numéricos , Meios de Comunicação de Massa/estatística & dados numéricos , Indicadores de Qualidade em Assistência à Saúde/estatística & dados numéricos , Universidades/estatística & dados numéricos , Pesquisa Biomédica/estatística & dados numéricos , Comunicação , Alemanha , Humanos , Disseminação de Informação , Países Baixos , Registros/estatística & dados numéricos , Projetos de Pesquisa/estatística & dados numéricos , Estudos Retrospectivos , Suécia
9.
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
10.
BMJ Open ; 9(4): e026271, 2019 04 20.
Artigo em Inglês | MEDLINE | ID: mdl-31005930

RESUMO

OBJECTIVE: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement has been developed as a guideline for reporting systematic reviews and meta-analyses. Despite the prevalent use of the PRISMA statement in medicine and nursing, no studies have examined authors' perception of it. The purpose of this study is to explore the perception of the PRISMA statement of authors who published reviews, meta-analyses, or both in nursing journals. DESIGN: Cross-sectional descriptive study. METHODS: An online survey was conducted among authors who published reviews, meta-analyses, or both in nursing journals between 2011 and 2017. The selected authors' email addresses were extracted from the PUBMED database. A questionnaire-with a 10-point Likert scale (1-not important at all to 10-very important)-was developed to elicit their responses regarding their perception of not only the PRISMA statement as a whole, but also the individual items therein. RESULTS: Invitations were sent to 1960 valid email addresses identified, with 230 responses (response rate: 11.7%) and 181 completed responses (completion rate: 9.2%). The average perceived importance of the PRISMA statement was 8.66 (SD=1.35), while the perceived importance for the individual items ranged from 7.74 to 9.32. Six items were rated significantly higher than the average rating, whereas one item was rated significantly lower. CONCLUSION: Most respondents perceived the PRISMA statement as important. Items related to information sources, selection, search-flow presentation, summary of findings, limitations and interpretation were deemed more important while the registration was deemed less so.


Assuntos
Enfermagem , Publicações Periódicas como Assunto/estatística & dados numéricos , Controle de Qualidade , Registros/estatística & dados numéricos , Literatura de Revisão como Assunto , Bases de Dados Factuais , Medicina Baseada em Evidências , Humanos
11.
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
12.
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
13.
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
14.
Commun Biol ; 2: 64, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30820466

RESUMO

To date, eco-evolutionary dynamics in the ascent of tyrannosauroids to top predator roles have been obscured by a 70-million-year gap in the North American (NA) record. Here we report discovery of the oldest Cretaceous NA tyrannosauroid, extending the lineage by ~15 million years. The new taxon-Moros intrepidus gen. et sp. nov.-is represented by a hind limb from an individual nearing skeletal maturity at 6-7 years. With a ~1.2-m limb length and 78-kg mass, M. intrepidus ranks among the smallest Cretaceous tyrannosauroids, restricting the window for rapid mass increases preceding the appearance of colossal eutyrannosaurs. Phylogenetic affinity with Asian taxa supports transcontinental interchange as the means by which iconic biotas of the terminal Cretaceous were established in NA. The unexpectedly diminutive and highly cursorial bauplan of NA's earliest Cretaceous tyrannosauroids reveals an evolutionary strategy reliant on speed and small size during their prolonged stint as marginal predators.


Assuntos
Evolução Biológica , Dinossauros/anatomia & histologia , Fósseis , Registros/estatística & dados numéricos , Animais , Biota , Dinossauros/classificação , Membro Posterior/anatomia & histologia , Humanos , América do Norte , Paleontologia , Fatores de Tempo
15.
Inj Prev ; 25(5): 444-447, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-30705052

RESUMO

Monitoring levels of alcohol-related harm in populations requires indicators that are robust to extraneous influence. We investigated the validity of an indicator for police-attributed alcohol-related assault. We summarized offence records from Queensland Police, investigated patterns of missing data, and considered the utility of a surrogate for alcohol-related assault. Of 242 107 assaults from 2004-2014, in 35% of cases the drug used by the offender was recorded as 'unknown'. Under various assumptions about non-random missingness the proportion of assaults judged to be alcohol-related varied from 30%-65%. We found a sharp increase in missing data from 2007 suggesting the downward trend from that point is artefactual. Conversely, we found a stable and increasing trend using a time-based surrogate. The volume of missing data and other limitations preclude valid estimation of trends using the police indicator, and demonstrate how misleading results can be produced. Our analysis supports the use of an empirically-based surrogate indicator.


Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Vítimas de Crime/estatística & dados numéricos , Polícia/estatística & dados numéricos , Violência/estatística & dados numéricos , Feminino , Humanos , Masculino , Queensland , Registros/estatística & dados numéricos
16.
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
17.
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
18.
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 , Revisões Sistemáticas como Assunto
19.
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
20.
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
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