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1.
Nature ; 598(7879): 33-34, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34616052

Assuntos
Córtex Motor , Censos
2.
Rev Saude Publica ; 55: 54, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34614117

RESUMO

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


Assuntos
Censos , Centros de Reabilitação , Brasil
3.
BMC Musculoskelet Disord ; 22(1): 791, 2021 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-34525989

RESUMO

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


Assuntos
Artroplastia de Quadril , Artroplastia do Joelho , Infecções Relacionadas à Prótese , Antibacterianos/uso terapêutico , Artroplastia de Quadril/efeitos adversos , Artroplastia do Joelho/efeitos adversos , Censos , Desbridamento , Alemanha/epidemiologia , Humanos , Infecções Relacionadas à Prótese/diagnóstico , Infecções Relacionadas à Prótese/epidemiologia , Infecções Relacionadas à Prótese/cirurgia , Reoperação , Estudos Retrospectivos , Resultado do Tratamento
5.
Artigo em Inglês | MEDLINE | ID: mdl-34360148

RESUMO

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


Assuntos
Censos , Neoplasias , Causas de Morte , Humanos , Mortalidade , República da Coreia/epidemiologia , Fatores Socioeconômicos
6.
JMIR Public Health Surveill ; 7(8): e28195, 2021 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-34346897

RESUMO

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


Assuntos
COVID-19/terapia , Censos , Previsões/métodos , Hospitais , Modelos Teóricos , COVID-19/epidemiologia , Humanos , Incidência , Análise Multivariada , North Carolina/epidemiologia
7.
J Environ Radioact ; 237: 106714, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34428732

RESUMO

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


Assuntos
Exposição Ocupacional , Monitoramento de Radiação , Resíduos Radioativos , Radiação de Fundo , Censos , China , Resíduos Radioativos/análise
8.
J Anxiety Disord ; 83: 102455, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34332230

RESUMO

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


Assuntos
COVID-19 , Depressão , Adulto , Ansiedade , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Censos , Criança , Estudos Transversais , Depressão/diagnóstico , Depressão/epidemiologia , Humanos , Masculino , Pandemias , SARS-CoV-2
9.
Crim Behav Ment Health ; 31(4): 262-274, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34302309

RESUMO

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


Assuntos
Saúde Mental , Polícia , Censos , Inglaterra/epidemiologia , Humanos , País de Gales/epidemiologia
10.
Am J Public Health ; 111(S2): S141-S148, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34314212

RESUMO

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


Assuntos
Causas de Morte/tendências , Censos , Centers for Disease Control and Prevention, U.S./estatística & dados numéricos , Coleta de Dados/métodos , Coleta de Dados/estatística & dados numéricos , Mortalidade/tendências , Estatísticas Vitais , Previsões , Humanos , Estados Unidos
11.
N C Med J ; 82(4): 229-238, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34230171

RESUMO

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


Assuntos
Maus-Tratos Infantis , Censos , Criança , Grupos Étnicos , Humanos , North Carolina/epidemiologia , Fatores de Risco
13.
Artigo em Inglês | MEDLINE | ID: mdl-34069368

RESUMO

Child mortality due to malaria and diarrhea can be reduced if proper treatment is received timely at healthcare facilities, but various factors hinder this. The present study assessed the associations between the use of public healthcare facilities among febrile/diarrheal children in rural Zambia and supply-side factors (i.e., the distance from the village to the nearest facility and the availability of essential human resources and medical equipment at the facility). Data from the Demographic and Health Survey 2018 and the Health Facility Census 2017 were linked. Generalized linear mixed models were used to assess the associations, controlling for clustering and other variables. The median distances to the nearest facility were 4.5 km among 854 febrile children and 4.6 km among 813 diarrheal children. Children who were over 10 km away from the facility were significantly less likely to use it, compared to those within 5 km (fever group: odds ratio (OR) = 0.36, 95% confidence interval (CI) = 0.20-0.66; diarrhea group: OR = 0.30, 95% CI = 0.18-0.51). The availability of human resources and equipment was, however, not significantly associated with facility use. Poor geographic access could be a critical barrier to facility use among children in rural Zambia.


Assuntos
Censos , Instalações de Saúde , Criança , Estudos Transversais , Atenção à Saúde , Humanos , Zâmbia/epidemiologia
14.
JMIR Public Health Surveill ; 7(8): e29205, 2021 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-34081608

RESUMO

BACKGROUND: Previous studies have shown that various social determinants of health (SDOH) may have contributed to the disparities in COVID-19 incidence and mortality among minorities and underserved populations at the county or zip code level. OBJECTIVE: This analysis was carried out at a granular spatial resolution of census tracts to explore the spatial patterns and contextual SDOH associated with COVID-19 incidence from a Hispanic population mostly consisting of a Mexican American population living in Cameron County, Texas on the border of the United States and Mexico. We performed age-stratified analysis to identify different contributing SDOH and quantify their effects by age groups. METHODS: We included all reported COVID-19-positive cases confirmed by reverse transcription-polymerase chain reaction testing between March 18 (first case reported) and December 16, 2020, in Cameron County, Texas. Confirmed COVID-19 cases were aggregated to weekly counts by census tracts. We adopted a Bayesian spatiotemporal negative binomial model to investigate the COVID-19 incidence rate in relation to census tract demographics and SDOH obtained from the American Community Survey. Moreover, we investigated the impact of local mitigation policy on COVID-19 by creating the binary variable "shelter-in-place." The analysis was performed on all COVID-19-confirmed cases and age-stratified subgroups. RESULTS: Our analysis revealed that the relative incidence risk (RR) of COVID-19 was higher among census tracts with a higher percentage of single-parent households (RR=1.016, 95% posterior credible intervals [CIs] 1.005, 1.027) and a higher percentage of the population with limited English proficiency (RR=1.015, 95% CI 1.003, 1.028). Lower RR was associated with lower income (RR=0.972, 95% CI 0.953, 0.993) and the percentage of the population younger than 18 years (RR=0.976, 95% CI 0.959, 0.993). The most significant association was related to the "shelter-in-place" variable, where the incidence risk of COVID-19 was reduced by over 50%, comparing the time periods when the policy was present versus absent (RR=0.506, 95% CI 0.454, 0.563). Moreover, age-stratified analyses identified different significant contributing factors and a varying magnitude of the "shelter-in-place" effect. CONCLUSIONS: In our study, SDOH including social environment and local emergency measures were identified in relation to COVID-19 incidence risk at the census tract level in a highly disadvantaged population with limited health care access and a high prevalence of chronic conditions. Results from our analysis provide key knowledge to design efficient testing strategies and assist local public health departments in COVID-19 control, mitigation, and implementation of vaccine strategies.


Assuntos
COVID-19/epidemiologia , Hispano-Americanos , Determinantes Sociais da Saúde , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Censos , Feminino , Equidade em Saúde , Humanos , Incidência , Masculino , México/etnologia , Pessoa de Meia-Idade , Grupos Minoritários , Distanciamento Físico , SARS-CoV-2 , Fatores Socioeconômicos , Análise Espacial , Texas/epidemiologia , Estados Unidos , Populações Vulneráveis , Adulto Jovem
15.
Environ Pollut ; 287: 117584, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34153607

RESUMO

Previous nationwide studies have reported links between long-term concentrations of fine particulate matter (PM2.5) and COVID-19 infection and mortality rates. In order to translate these results to the state level, we use Bayesian hierarchical models to explore potential links between long-term PM2.5 concentrations and census tract-level rates of COVID-19 outcomes (infections, hospitalizations, and deaths) in Colorado. We explicitly consider how the uncertainty in PM2.5 estimates affects our results by comparing four different PM2.5 surfaces from academic and governmental organizations. After controlling for 20 census tract-level covariates, we find that our results depend heavily on the choice of PM2.5 surface. Using PM2.5 estimates from the United States EPA, we find that a 1 µg/m3 increase in long-term PM2.5 concentrations is associated with a statistically significant 26% increase in the relative risk of hospitalizations and a 34% increase in mortality. Results for all other surfaces and outcomes were not statistically significant. At the same time, we find a clear association between communities of color and COVID-19 outcomes at the Colorado census tract level that is minimally affected by the choice of PM2.5 surface. A per-interquartile range (IQR) increase in the percent of non-African American people of color was associated with a 31%, 43%, and 56% increase in the relative risk of infection, hospitalization, and mortality respectively, while a per-IQR increase in the proportion of non-Hispanic African Americans was associated with a 4% and 7% increase in the relative risk of infections and hospitalizations. The current disagreement among the different PM2.5 estimates is a key factor limiting our ability to link environmental exposures and health outcomes at the census tract level. These results have strong implications for the implementation of an equitable public health response during the crisis and suggest targeted areas for additional air monitoring in Colorado.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , COVID-19 , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Teorema de Bayes , Censos , Colorado , Exposição Ambiental/análise , Humanos , Material Particulado/análise , Fatores de Risco , SARS-CoV-2 , Estados Unidos
16.
Rev Bras Enferm ; 74(3): e20201101, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34161506

RESUMO

OBJECTIVES: to analyze the spatial-temporal distribution of leprosy in a priority municipality for leprosy control. METHODS: ecological study, conducted in a city in the Northeast of Brazil, whose analysis units were census sectors. The study used compulsory notification data for cases registered between 2008 and 2017. TerraView software and the Batch Geocode tool was used for geocoding. The detection of spatial-temporal agglomerations of high relative risks was done by scanning statistics. RESULTS: the spatial-temporal distribution of cases was heterogeneous, creating four agglomerations of high relative risks in the urban area of the municipality between the years 2008 and 2012; and annual prevalence rates classified from high to hyperendemic. CONCLUSIONS: areas of higher risk and concentration of the disease in space-time were linked to the characteristics of high population density and social vulnerability of these spaces, raising the prioritization of health professionals' actions, systems, and services for control, and monitoring the disease.


Assuntos
Hanseníase , Brasil/epidemiologia , Censos , Humanos , Hanseníase/epidemiologia , Hanseníase/prevenção & controle , Prevalência , Risco
17.
Environ Res ; 201: 111573, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34174254

RESUMO

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


Assuntos
Censos , Temperatura Alta , Índia/epidemiologia , Modelos Teóricos , Medição de Risco
18.
J Med Internet Res ; 23(6): e26242, 2021 06 14.
Artigo em Inglês | MEDLINE | ID: mdl-34125071

RESUMO

BACKGROUND: The COVID-19 pandemic has amplified the role of telehealth in health care delivery. Regional variation in internet access and telehealth use are well-documented, but the effect of neighborhood factors, including the pervasiveness of broadband internet, on older adults' telehealth usage in the context of internet access is not known. OBJECTIVE: This study aimed to investigate how individual and neighborhood characteristics, including the pervasiveness of neighborhood broadband internet subscription, are associated with engagement in telehealth among older adults with internet access. METHODS: In this cross-sectional study, we included 5117 community-living older adults aged ≥65 years, who participated in the 2017 National Health and Aging Trends Study with census tract-level data for participants' places of residence from the American Community Survey. RESULTS: Of an estimated 35.3 million community-living older adults, 21.1 million (59.7%) were internet users, and of this group, more than one-third (35.8%) engaged in telehealth. In a multivariable regression model adjusted for individual- and neighborhood-level factors, age, education, income, and the pervasiveness of neighborhood broadband internet subscription were associated with engagement in telehealth, while race, health, county metropolitan status, and neighborhood social deprivation were not. Among internet users, living in a neighborhood at the lowest (versus highest) tertile of broadband internet subscription was associated with being 40% less likely to engage in telehealth (adjusted odds ratio 0.61, 95% CI 0.42-0.87), all else equal. CONCLUSIONS: Neighborhood broadband internet stands out as a mutable characteristic that is consequential to engagement in telehealth.


Assuntos
COVID-19/epidemiologia , Telemedicina/estatística & dados numéricos , Idoso , Censos , Estudos Transversais , Feminino , Humanos , Masculino , Pandemias , SARS-CoV-2/isolamento & purificação , Inquéritos e Questionários , Telemedicina/instrumentação , Estados Unidos
19.
G Ital Nefrol ; 38(3)2021 Jun 24.
Artigo em Italiano | MEDLINE | ID: mdl-34169689

RESUMO

In the last year, the Italian National Health Service as a whole and the Nephrology community have been severely challenged by the pandemic. It has been a dramatic stress test for the entire healthcare system, not only in Italy but worldwide. The general organization of our Nephrology units and our models of care were put under extreme pressure, and we had to quickly adopt unprecedented clinical practice recommendations and organizational models to overcome the impasse caused by the pandemic. The time has come to evaluate these new experiences, ask how we could have been better prepared and look for change. In this editorial, we outline a few proposals and suggestions for the future, weighing the information gathered in the 2018 Nephrology Census against the new organizational requirements imposed by the COVID-19 pandemic.


Assuntos
COVID-19/epidemiologia , Nefrologia/organização & administração , Pandemias , Censos , Humanos , Itália/epidemiologia , Modelos Organizacionais , Nefrologia/tendências , Diálise Peritoneal/estatística & dados numéricos , Diálise Peritoneal Ambulatorial Contínua/estatística & dados numéricos , Médicos/provisão & distribuição , Diálise Renal/estatística & dados numéricos
20.
Salud Publica Mex ; 63(3 May-Jun): 444-451, 2021 May 03.
Artigo em Espanhol | MEDLINE | ID: mdl-34098602

RESUMO

Objetivo. Describir el diseño y los resultados de campo de la Encuesta Nacional de Salud y Nutrición (Ensanut) 2020 so-bre Covid-19. Material y métodos. La Ensanut Covid-19 es una encuesta probabilística de hogares. En este artículo se describen los siguientes elementos del diseño: alcance, muestreo, medición, inferencia y logística. Resultados. Se obtuvieron 10 216 entrevistas de hogar completas y 9 464 resultados sobre seropositividad a SARS-CoV-2. La tasa de respuesta de hogar fue 80% y la de prueba de seropositividad de 44%. Conclusiones. El diseño probabilístico de la Ensa-nut Covid-19 permite hacer inferencias estadísticas válidas sobre parámetros de interés para la salud pública a nivel nacional y regional; en particular, permitirá hacer inferencias de utilidad práctica sobre la prevalencia de seropositividad a SARS-CoV-2 en México. Además, la Ensanut Covid-19 podrá ser comparada con Ensanut previas para identificar potenciales cambios en los estados de salud y nutrición de la población mexicana.


Assuntos
COVID-19/epidemiologia , Indicadores Básicos de Saúde , Inquéritos Nutricionais/métodos , Distribuição por Idade , COVID-19/transmissão , Censos , Humanos , México/epidemiologia , Inquéritos Nutricionais/estatística & dados numéricos , Prevalência , Saúde da População Rural/estatística & dados numéricos , Tamanho da Amostra , Saúde da População Urbana/estatística & dados numéricos
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