Efecto de factores sociodemográficos en la mortalidad del COVID-19 en Costa Rica: un enfoque geográfico

Introducción: La enfermedad por coronavirus (COVID-19) se ha extendido entre la población de todo el país y ha tenido un gran impacto a nivel mundial. Sin embargo, existen diferencias geográficas importantes en la mortalidad de COVID-19 entre las diferentes regiones del mundo y en Costa Rica. Objetivo: Explorar el efecto de algunos de los factores sociodemográficos en la mortalidad de COVID-19 en pequeñas divisiones geográficas o cantones de Costa Rica. Métodos: Usamos registros oficiales y aplicamos un modelo de regresión clásica de Poisson y un modelo de regresión ponderada geográficamente. Resultados: Obtuvimos un criterio de información de Akaike (AIC) más bajo con la regresión ponderada (927.1 en la regresión de Poison versus 358.4 en la regresión ponderada). Los cantones con un mayor riesgo de mortalidad por COVID-19 tuvo una población más densa; bienestar material más alto; menor proporción de cobertura de salud y están ubicadas en el área del Pacífico de Costa Rica. Conclusiones: Una estrategia de intervención de COVID-19 específica debería concentrarse en áreas de la costa pacífica con poblaciones más densas, mayor bienestar material y menor población por unidad de salud.

Introduction: The coronavirus disease (COVID-19) has spread among the population of Costa Rica and has had a great global impact. However, there are important geographic differences in mortality from COVID-19 among world regions and within Costa Rica. Objective: To explore the effect of some sociodemographic factors on COVID-19 mortality in the small geographic divisions or cantons of Costa Rica. Methods: We used official records and applied a classical epidemiological Poisson regression model and a geographically weighted regression model. Results: We obtained a lower Akaike Information Criterion with the weighted regression (927.1 in Poisson regression versus 358.4 in weighted regression). The cantons with higher risk of mortality from COVID-19 had a denser population; higher material well-being; less population by health service units and are located near the Pacific coast. Conclusions: A specific COVID-19 intervention strategy should concentrate on Pacific coast areas with denser population, higher material well-being and less population by health service units.

Application of scheduling model based on linear programming model in human resource allocation of surgical nursing staff / 中国实用护理杂志

Objective:Use linear programming model to predict the allocation of surgical nursing human resources, and optimize the allocation of nursing staff.Methods:This study was a controlled clinical trial. A total of 91 nurses from 5 surgical departments in Affiliated Hospital of Qingdao University were selected by convenience sampling method. The nurses who participated in the scheduling in August and September 2020 were the routine scheduling groups, and in March and April 2021 were the linear scheduling groups. The linear programming model of surgical nursing human resources was established. The LINGO 11.0 software was used to calculate the minimum number of nurses required for the next day operation. According to the predicted results and the requirements of the operation specialty and rank level, the surgical staff was arranged for the next day. The overtime hours of nurses in the routine scheduling groups and the linear scheduling groups were compared and analyzed.Results:The number of on-duty nurses was the same in 4 groups, the overtime hours of the conventional scheduling groups in August and September 2020 and the linear scheduling groups in March and April 2021 were 865 (505, 1 435), 780 (475, 1 355), 650 (460, 910) and 720 (350, 915) min, the difference of overtime hours was statistically significant ( H=13.66, P<0.05). The overtime hours of the routine scheduling group in August 2020 were significantly different from those of the linear scheduling group in March 2021 and April 2021 respectively ( Z=-2.69, -2.55, both P<0.05). The overtime hours of the routine scheduling group in September 2020 were significantly different from those of the linear scheduling group in March 2021 and April 2021 respectively ( Z=-2.62, -2.58, both P<0.05). Conclusions:The linear programming model was used to predict the human resource allocation of surgical nursing staff, optimized the allocation of operating room human resources. It reduced the overtime hours of surgical nursing staff effectively. Indirectly, it accelerated operations, improved operation efficiency and ensured the safety of patients.

A follow up study of body fat distribution and blood pressure among 6-9 years old children in Beijing / 中国学校卫生

Objective@#To explore the association of body fat mass and distribution indices including fat mass percentage (FMP), visceral fat area (VFA) and percentage of trunk fat mass (%TFM) with blood pressure in children to inform early management of blood pressure in children.@*Methods@#Based on the Beijing Child Growth and Health Cohort in Shunyi District, lifestyle questionnaire survey, baseline and follow up physical examination were conducted among children from October to November 2018 and September 2020. Bioelectrical impedance analysis (BIA) was used to measure the body composition, and 1 098 participants with completed data were finally included.@*Results@#Both body fat indices and blood pressure increased with age in boys and girls. For FMP, VFA, and %TFM, no significant differences presented between sex at baseline, while FMP, VFA, and %TFM were significantly higher in boys than girls at follow up ( t=2.73, 3.76, 3.41, P <0.01). Before and after adjusting for age, height and lifestyles or not, linear mixed effect models showed longitudinal associations existing between body fat indices and blood pressure in both boys and girls ( β=0.64-3.48, P <0.05). The association coefficients of body fat indices with systolic blood pressure were ranked as %TFM>FMP>VFA in both boys and girls. The association coefficients of body fat indices with diastolic blood pressure were ranked sequentially as FMP>%TFM>VFA in boys, and VFA>FMP>%TFM in girls.@*Conclusion@#Longitudinal associations are observed between body fat indices and blood pressure in children. Primordial prevention of high pressure should pay attention on body fat distribution.

Mortalidade de professores no estado de Goiás: análise de série temporal / Mortality of teachers in the state of Goiás: a time serie analysis

Análise de perfil epidemiológico e a tendência da mortalidade de professores da educação básica e do ensino superior no Estado de Goiás, no período de 2008 a 2017. Método: série temporal, com dados do Sistema de Informações sobre Mortalidade. Para a análise da tendência da mortalidade utilizou-se modelos de regressão linear e considerou-se p<0,05. Resultados: foram levantados 2.439 óbitos, maior frequência de óbitos no sexo feminino, em indivíduos de cor branca e com idade entre 50 e 69 anos. Entre as mulheres, as neoplasias malignas foram as principais causas de óbito, enquanto entre os homens destacaram-se as doenças do aparelho circulatório. Identificou-se tendência temporal de aumento dos óbitos (0,134 para as neoplasias malignas, 0,132 para as doenças do aparelho circulatório, 0,252 para as causas externas e 0,212 para as doenças do aparelho respiratório). Considerando todas as causas de óbito o incremento foi de 0,040 (p<0,000). Conclusão: há aumento de mortalidade de professores por causas evitáveis

Objective: to analyze the epidemiologic profile and the trends in mortality of teachers from basic education and higher education professors in the state of Goiás, in the period from 2008 to 2017. Method: time series, with data from the Mortality Information System. In order to analyze the trend in mortality, a linear regression model was used, considering p<0.05. Results: 2,439 deaths were recorded, with higher frequency of deaths within female sex, white and aged from 50 to 69 years. Among the women, malignant neoplasms were the main causes of death, whilst among men, circulatory system diseases stood out. It was identified a temporal trend of increase in deaths (0.134 for malignant neoplasms, 0.132 for circulatory system diseases, 0.252 for external causes and 0.212 for respiratory system diseases). Considering all the causes of death, the increase was 0.040 (p<0.000). Conclusion: there is an increase in mortality of teachers and professors due to avoidable causes

Proposal of a non-linear model to adjust in vitro gas production at different incubation times

This work aims to propose a new model named Gompertz-Von Bertalanffy bicompartmental (GVB), a combination of the models Gompertz and Von Bertalanffy. The GVB models is applied to fit the kinetic curve of cumulative gas production (CGP) of four foods (SS ­ sunflower silage; CS ­ corn silage; and the mixtures 340SS ­ 660 gkg-1 of corn silage and 340 gkg-1 of sunflower silage; and 660SS ­ 340 gkg-1 of corn silage and 660 gkg-1 of sunflower silage). The GVB fit is compared to models Logistic-Von Bertalanffy bicompartmental (LVB) and bicompartmental logistic (BL). All the process studied employed the semi-automatic "in vitro" technique of producing gases used in ruminant nutrition. The gas production readout was performed at times 2, 4, 6, 8, 10, 12, 15, 19, 24, 30, 48, 72, and 96 h. The data generated were used to estimate the models' parameters by the least squared method with the iterative Gauss-Newton process. The data fit quality of the models was verified using the adjusted coefficient of determination criterion (), mean residual square (MRS), Akaike information criterion (AIC), and mean absolute deviation (MAD). Among the analyzed models, the LVB model presented the best quality of fit evaluators for CS. In contrast, the GVB model showed better quality of fit to describe CGP over time for 340SS, 660SS, and SS, presenting the highest values of () and the lowest values of MSR, AIC, and MAD.

Relationship between polycyclic aromatic hydrocarbons internal exposure and lung function change among healthy college students / 中国学校卫生

Objective@#To investigate the relationship between urinary monohydroxylated metabolites of hydroxyl polycyclic aromatic hydrocarbons (OH-PAHs) and lung function, as well as the role of oxidative stress in these associations, so as to provide a scientific basis for air pollution control and policy formulation.@*Methods@#A panel study was carried out among 45 young healthy adults. Four follow up surveys and health examinations were conducted from November 2017 to October 2018 to measure lung function parameters [forced vital capacity (FVC), second forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), FEV1/FVC, and forced expiratory flow between 25% and 75% vital capacity (FEF 25%~75% )], markers of exposure to 7OHPAHs [∑ 7OH PAHs], and markers of oxidative stress[8 hydroxy 2 deoxyguanosine (8 OHdG) and 8 isoprostaglandin F 2α (8 iso PGF 2α )]. The relationship between urinary PAH metabolites and lung function was quantified by linear mixed effects models. Mediation analysis was performed to assess the role of oxidative stress in the relationship between OH PAHs and lung function.@*Results@#The median values of FVC, FEV1, FEVI/FVC, PEF, and FEF 25%-75% were 4.37 L, 3.58 L, 83.00%, 4.38 L/s, and 3.32 L/s, respectively. The results showed that each 1 unit increase in log transformed value of 2 Hydroxyfluorene (2 OHFlu) was associated with a 5.05% decrease ( β %=-5.05%，95% CI =-8.85%--1.09%) in FVC, 4.15% decrease ( β %=-4.15%，95% CI =-7.94%- -0.22% ) in FEV1 and 5.87% decrease ( β %=-5.87%，95% CI =-11.35%--0.05%) in FEF 25%-75% , respectively. Each 1 unit increase in log transformed values of 2 OHFlu and 9 Phenanthrol (9 OHPhe) was associated with a 7.03% decrease ( β %=-7.03%，95% CI =-12.60%--1.11%) and a 7.08% decrease ( β%=-7.08%，95% CI =-13.50%--0.17%) in PEF, respectively. Additionally, urinary ∑ 7OH PAHs had a positive correlation with the levels of urinary 8 OHdG and 8 iso PGF 2α ( r =0.64, 0.69, P <0.01). Meanwhile, the levels of 8 OHdG mediated 17.06% and 15.71% of the association between 2 OHFlu with FVC and FEV1.@*Conclusion@#The finding reveales a negative relationship between urinary OH PAHs and lung function among young healthy adults. The 8 OHdG plays a mediated role in the correlation of 2 OHFlu with FVC and FEV1. Active relevant policies are needed to control air pollution and maintain the healthy living conditions of young people.

O efeito das medidas de distanciamento social sobre a incidência de COVID-19 no Brasil: Uma análise multissetorial / The effect of social distancing measures on the incidence of COVID-19 in Brazil: A multisectoral analysis

Objetivo: Este artigo estima o impacto das medidas de distanciamento social sobre a incidência de COVID-19 a partir de uma perspectiva multissetorial. Métodos: O desenho de pesquisa utiliza um modelo de regressão em painel para analisar a relação entre restrições de mobilidade em diferentes setores econômicos e a dinâmica longitudinal da doença nos estados do Brasil. Resultados: Os principais resultados indicam que apenas os coeficientes das variáveis que representam os setores de restaurantes (p-valor < 0,05), compras (p-valor < 0,05) e transporte (p-valor < 0,001) obtiveram significância estatística. Em especial, o transporte (ß= -0,674) é a variável que mais influencia a variação do número de casos de COVID-19. Conclusões: As evidências reportadas nesta pesquisa podem auxiliar o processo de tomada de decisão dos gestores governamentais a respeito da eficácia de intervenções não farmacológicas como instrumento para reduzir a disseminação da COVID-19 (AU)

Objective: This article estimates the impact of social distancing measures on the incidence of COVID-19 from a multisectoral perspective. Methods: The research design uses a panel regression model to analyze the relationship between mobility restrictions in different economic sectors and the longitudinal dynamics of the infection across Brazilian states. Results: The main results indicate that only the coefficients for the restaurant (p-value < 0.05), shopping (p-value < 0.05), and transport sectors (p-value < 0.001) reached statistical significance. In particular, transport (ß = -0.674) is the variable with the strongest impact on the variation in the number of COVID-19 cases. Conclusions: The evidence reported in this research can assist the decision-making process of government managers regarding the effectiveness of non-pharmacological interventions as a tool to reduce the spread of COVID-19

Correlation of Anthropometric Measurements of Proximal Tibia with Its Length for Stature Estimation in Forensic Analysis

Background: Estimation of stature is one of the commonly used methods in forensic analysis to establish identity of individuals. Estimation of stature from fragments of long bones is done by deriving linear regression equations. The objective of the present study was to derive a simple regression equation for estimating length of the tibia using the morphometry of proximal end of tibia. Materials and methods: In this descriptive study carried out in the department of anatomy of a medical college, anthropometric measurements of proximal end of 150 dry human tibiae were collected irrespective of the sex and side. The parameters measured included the mediolateral length of the proximal end, the anteroposterior length of the medial and lateral condyle of tibia, anteroposterior length of the intercondylar area, and the circumference of proximal end of tibia. The measurements were done using Vernier calliper and measuring tape. Length of the tibia was estimated by using simple regression analysis. Results: The following linear regression equations were derived. Length of tibia can be calculated by, 29.2749 + (1.1925 × Mediolateral length) ±1.1926, 27.6418 + (2.333 × Anteroposterior length of lateral condyle) ±1.132, 21.8342+(3.2614 ×Anteroposterior length of medial condyle) ±1.328, 33.542 +(0.8952 × Anteroposterior length of intercondylar region) ±1.474, 23.1902 +(0.76379 × Circumference of proximal end) ± 1.134 Conclusion: The study revealed that there is a positive correlation between the measurements of proximal end of tibia and its length. The equation derived would help in forensic analysis to estimate the stature of an individual.

Estimation of lactation curves of Gyr cattle and some associated production parameters in the Colombian low tropic

Background: The Gyr breed is widely used in Colombian low tropic dairy production systems. During the last 10 years, the Asociación Colombiana de Criadores de Ganado Cebú† ASOCEBU, has been leading a dairy milk control program which led to the creation of a dataset that permits to carry out the first analysis of milk yield in Gyr cattle in the country using records from several herds. Objectives: To study milk production dynamics of Gyr cattle in the Colombian low tropic through the estimation of lactation curves and four derived production parameters: total milk yield between 5 and 305 days (TMY305), peak milk yield (PMY), days at peak (DP) and persistency (P). Methods: 13,798 daily milk yield records from 1,510 cows performing in 103 herds were used; the total number of lactations was 2,480. Four models were considered: Wood, Wiltmink, Papajcsik & Bordero, and a second-degree polynomial. Mean square error, mean absolute error, mean square error of prediction, Akaike and Bayesian information criteria were used to select the model better describing each lactation using the majority rule, that is, the model selected by most criteria was the chosen one. The shape of each fitted lactation curve was checked using basic results from calculus which permitted the classification of the estimated curves into two groups: typical and atypical; only typical functions were used to compute the four aforementioned production parameters. Results: The second-order polynomial was the model most frequently selected, while the Papajcsik & Bordero model had the lowest frequency. Average TMY305, PMY, DP and P were 3,489.86 kg, 17.28 kg, 57.17 days, and 0.83, respectively, with coefficients of variation: 0.27, 0.21, 0.41, and 0.16. Conclusions: This study permitted to identify individuals with outstanding phenotypic performance. To the best of our knowledge, this is the first study of this kind involving thousands of lactations from Gyr cows performing in several regions of Colombian low tropic.

Antecedentes: La raza Gyr es ampliamente utilizada en las lecherías de trópico bajo en Colombia. Durante los últimos 10 años, la Asociación Colombiana de Criadores de Ganado Cebú ASOCEBU, ha liderado un programa de control lechero que generó una base de datos que permite llevar a cabo el primer análisis de producción de leche de la raza Gyr en el país, considerando individuos de varias fincas. Objetivos: Caracterizar la dinámica de producción de leche de ganado Gyr en el trópico bajo colombiano mediante la estimación de curvas de lactancia y cuatro parámetros de producción derivados: producción total entre 5 y 305 días (TMY305), pico de lactancia (PMY), días al pico (DP) y persistencia (P) Métodos: Se utilizaron 13.798 registros de producción diaria de leche de 1.510 vacas provenientes de 103 fincas, el total de lactancias fue 2.480. Se consideraron cuatro modelos: Wood, Wiltmink, Papajcsik & Bordero, y un polinomio de segundo grado. Los criterios usados para elegir el modelo que mejor describió cada lactancia fueron: error cuadrático medio, error absoluto medio, error cuadrático medio de predicción, criterio de información de Akaike y criterio de información Bayesiano. Se utilizó el criterio de mayoría, esto es, el modelo seleccionado fue aquel elegido por más criterios. La forma de cada una de las curvas de lactancia estimadas fue chequeada utilizando resultados básicos del cálculo, esto permitió clasificar las curvas estimadas en dos grupos: típicas y atípicas; solamente las curvas típicas fueron empleadas para calcular los cuatro parámetros antes mencionados. Resultados: El polinomio de segundo grado fue el modelo que se seleccionó con mayor frecuencia, mientras que el modelo Papajcsik & Bordero tuvo la menor frecuencia. Los promedios para TMY305, PMY, DP y P fueron 3.489,86 kg, 17,28 kg, 57,17 días, y 0,83, respectivamente, con coeficientes de variación 0,27, 0,21, 0,41 y 0,16 Conclusiones: Este estudio permitió identificar individuos con desempeño fenotípico sobresaliente. De acuerdo al estado del arte, este es el primer estudio de este tipo que considera miles de lactancias de vacas Gyr provenientes de varias regiones del trópico bajo colombiano.

Antecedentes: Gir é uma raça Bos indicus amplamente utilizada em sistemas de produção leiteira no trópico baixo Colombiano. A Asociación Colombiana de Criadores de Ganado CebúASOCEBU, lidera um programa de controle de leite nos últimos 10 anos, o que permitiu à coleta de um conjunto de dados para realizar a primeira análise de produção de leite em bovinos Gir no país com informações de vários rebanhos. Objetivo: Estudar a dinâmica da produção de leite por meio da estimativa das curvas de lactação e quatro parâmetros de produção derivados: produção total de leite entre 5 e 305 dias (TMY305), produção de leite no pico de lactação (PMY), dias em produção de leite no pico de lactação (DP) e persistência (P). Métodos: Foram utilizados 13.798 registros de produção diária de leite de 1.510 vacas de 103 fazendas , totalizando 2.480 lactações. Foram considerados quatro modelos: Wood, Wiltmink, Papajcsik & Bordero e um polinômio de segundo grau. Para selecionar o modelo que melhor descreve cada lactação foram utilizados os seguintes critérios: erro quadrado médio, erro absoluto médio, e erro quadrado médio de predição. O modelo selecionado pela maioria dos parâmetros, de acordo com os critérios de informação de Akaike e Bayesiano, foi o escolhido. A forma de cada curva de lactação ajustada foi verificada utilizando os resultados básicos do cálculo, isso permitiu classificar as curvas estimadas em dois grupos: típico e atípico, e apenas funções típicas foram utilizadas para calcular os quatro parâmetros de produção acima mencionados Resultados: O polinômio de segunda ordem foi o modelo mais frequentemente selecionado, enquanto o modelo Papajcsik & Bordero apresentou a menor frequência. A média de TMY305, PMY, DP e P foram 3.489,86 kg, 17,28 kg, 57,17 d e 0,83, respectivamente, com coeficientes de variação de 0,27, 0,21, 0,41 e 0,16. Conclusões: Este estudo permitiu identificar indivíduos com excelente desempenho fenotípico. De acordo com a literatura atual, este é o primeiro estudo envolvendo milhares de lactações de vacas Gir em várias regiões do trópico baixo colombiano.

Tendência temporal da leptospirose e sua associação com variáveis climáticas e ambientais em Santa Catarina, Brasil / Temporal trends in leptospirosis incidence and association with climatic and environmental factors in the state of Santa Catarina, Brazil

Resumo A leptospirose é uma zoonose que apresenta potencial epidêmico, principalmente após fortes chuvas que acarretam inundações, alagamentos e enxurradas. Algumas características da região costeira de Santa Catarina, localizada no Sul do Brasil, influenciam nesses processos. Portanto, a partir do estudo da leptospirose nos seis municípios do estado com as maiores incidências e picos epidêmicos de 2000 a 2015, buscou-se conhecer a tendência dessa doença e as variáveis climáticas e ambientais associadas à sua ocorrência, ajustando dois modelos com resposta binomial negativa. As maiores incidências foram encontradas em 2008 e 2011, com picos no mesmo mês ou no posterior aos eventos de desastres. A incidência apresentou forte comportamento sazonal, sendo maior nos meses do verão. Observou-se tendência de queda na incidência dos municípios estudados, estimada em 3,21% ao ano. Os fatores climáticos e ambientais mais fortemente associados foram o número de dias de chuva, a temperatura máxima e a presença de enxurrada e de inundação, com diferentes impactos entre os municípios. Houve interações significativas, indicando que o efeito de inundações na incidência não é o mesmo em todos os municípios e que as diferenças nas incidências entre os municípios dependem da ocorrência ou não de inundações.

Abstract Leptospirosis is a zoonosis with epidemic potential, especially after heavy rainfall causing river, urban and flash floods. Certain features of Santa Catarina's coastal region influence these processes. Using negative binomial regression, we investigated trends in the incidence of leptospirosis in the six municipalities with the highest epidemic peaks between 2000 and 2015 and the climatic and environmental variables associated with the occurrence of the disease. Incidence was highest in 2008 and 2011, and peaks occurred in the same month or month after disasters. Incidence showed a strong seasonal trend, being higher in summer months. There was a decrease trend in incidence across the six municipalities (3.21% per year). The climatic and environmental factors that showed the strongest associations were number of rainy days, maximum temperature, presence of flash floods, and river flooding. The impact of these variables varied across the municipalities. Significant interactions were found, indicating that the effect of river flooding on incidence is not the same across all municipalities and differences in incidence between municipalities depend on the occurrence of river flooding.

Competência de idosos cuidadores informais de pessoas em assistência domiciliar / Competencia de ancianos que se desempeñan como cuidadores informales de personas en cuidados domiciliarios / Competence of aged informal caregivers of people in home care

Resumo Objetivos analisar a estimativa condicional do conhecimento, adaptação e preparo nas competências de idosos que exercem o papel de cuidadores informais de pessoas dependentes de cuidado em assistência domiciliar. Método estudo transversal, realizado com idosos cuidadores informais, residentes no município de Maringá, Paraná, Brasil. A coleta de dados foi realizada entre maio e julho de 2019 com um instrumento que avalia as competências cognitivas, psicomotoras, emocionais e relacionais de cuidadores informais de pessoas dependentes de cuidado em assistência domiciliar. O instrumento é constituído por 14 itens e três construtos: conhecimento, adaptação e preparo, sendo a escala de resposta Likert de cinco pontos. Utilizou-se análise de regressão linear para tratamento das variáveis. Resultados participaram do estudo 101 idosos cuidadores informais, e as estimativas condicionais das competências cognitiva e relacional apresentaram maior correlação com adaptação e o preparo. O melhor conhecimento estima maior desenvolvimento da competência psicomotora e cognitiva nas práticas de cuidado. Conclusão e implicações para a prática os conceitos hipotéticos de conhecimento, adaptação e preparo explicam o melhor desempenho das competências cognitiva, relacional e psicomotora de idosos cuidadores informais. Este resultado possibilita o desenvolvimento de novas intervenções educativas aos idosos que desempenham o papel de cuidador informal.

Resumen Objetivos analizar la estimación condicional del conocimiento, adaptación y preparación en las habilidades de personas mayores que desempeñan el papel de cuidadores informales de personas dependientes de cuidados en el hogar. Método estudio transversal realizado con personas mayores que se desempeñan como cuidadores informales, residentes en la ciudad de Maringá, Paraná, Brasil. La recolección de datos se realizó entre mayo y julio de 2019 a través de un instrumento construido y validado que evalúa las habilidades de los cuidadores informales de personas dependientes de cuidados en el hogar. Se utilizó análisis de regresión lineal para tratar las variables. Resultados participaron del estudio 101 personas mayores, que obran como cuidadores informales y las estimaciones condicionales de las habilidades cognitivas y relacionales de las personas mayores mostraron mayor correlación con la adaptación y preparación. Un mejor conocimiento estima un mayor desarrollo de la competencia psicomotora y cognitiva de las personas mayores en las prácticas asistenciales. Conclusión e implicaciones para la práctica los conceptos hipotéticos de conocimiento, adaptación y preparación explican el mejor desempeño de las habilidades cognitivas, relacionales y psicomotoras de las personas mayores que actúan como cuidadores informales. Este resultado permite el desarrollo de nuevas intervenciones educativas para las personas mayores que desempeñan el papel de cuidadores informales.

Abstract Objectives to analyze the conditional estimate of knowledge, adaptation and preparation in the skills of aged people who play the role of informal caregivers of assistance-dependent individuals in home care. Method a cross-sectional study carried out with aged informal caregivers who live in the city of Maringá, Paraná, Brazil. Data collection was carried out between May and July 2019 through a constructed and validated instrument that assesses the skills of informal caregivers of assistance-dependent individuals in home care. Linear regression analysis was used to treat the variables. Results the study participants were 101 aged informal caregivers, in which the conditional estimates of the cognitive and relational skills of the aged person showed a greater correlation with adaptation and preparation. Better knowledge estimates greater development of the psychomotor and cognitive competence of the elderly in care practices. Conclusion and implications for the practice the hypothetical concepts of knowledge, adaptation and preparation explain the better performance of the cognitive, relational and psychomotor skills of aged informal caregivers. This result enables the development of new educational interventions for the elderly who play the role of informal caregivers.

Influence of birth weight and infancy growth patterns on weight status among first grade primary school pupils / 中国学校卫生

Objective@#To explore the influence of birth weight and growth patterns during infancy on overweight and obesity among first grade primary school pupils, so as to provide a theoretical basis for the formulation of early life prevention and intervention policies.@*Methods@#In 2019, data related to routine physical examinations were collected for primary school pupils in the Minhang District of Shanghai, and information regarding birth and follow ups was collected retrospectively. Physical examination data of 4 434 pupils at 12 months of age were obtained. A multiple linear regression model was used to analyze the relationship between growth patterns during infancy and body mass index (BMI) in the first grade of primary school. A generalized linear model was employed to analyze the relationship between birth weight and growth patterns during infancy and overweight and obesity in the first grade of primary school. A hierarchical analysis was conducted.@*Results@#A linear relationship was observed between growth patterns during infancy and BMI and the BMI Z score of first grade primary school pupils [ β(β 95%CI)=0.30(0.24-0.35),0.12(0.10- 0.15 ), P <0.01]. In addition to subjects classified as small for gestational age (SGA), catch up growth during infancy was identified among subjects who were classified as appropriate for gestational age (AGA) and large for gestational age (LGA). LGA at birth and catch up growth during infancy were independent risk factors for overweight and obesity among first grade primary school children ( RR =1.31-1.55, P <0.05). The hierarchical analysis showed that catch up growth increased the risk of overweight and obesity among first grade primary school pupils classified as AGA [ RR(RR 95%CI )=1.74(1.42-2.14),1.87(1.56-2.26)], and increased the risk of obesity among first grade primary school pupils classified as SGA and LGA [ RR(RR 95%CI )=3.74(1.04-13.49),3.24(1.62-6.46)]( P <0.05). Among those who exhibited catch up growth during infancy, LGA increased the risk of obesity among first grade primary school pupils ( RR= 2.60 , 95%CI=1.35-5.02, P <0.01), but not the risk of being overweight ( P =0.13).@*Conclusion@#Birth weight and growth patterns during infancy have an impact on overweight and obesity among children in the first grade of primary school. It is suggested that attention should be paid to growth and physical development in early life for those classified as LGA and AGA, and catch up growth in children should be closely monitored.

Association between parents health literacy and health risk behaviors of middle school students in northeast Jiangxi Province / 中国学校卫生

Objective@#To explore the association between parents health literacy and health risk behaviors of middle school students, so as to provide theoretical basis for parental health literacy improvement and adolescent health risk behaviors prevention.@*Methods@#A questionnaire survey was conducted among 1 993 middle school students and their parents in northeast Jiangxi Province by multistage stratified random sampling during Jun. to Sept. of 2020. Spearman correlation and generalized linear model were used to explore association between parents health literacy with 5 types of unhealthy behaviors.@*Results@#Generalized linear model analysis showed that after adjusting household economic status and other covariates, parents health literacy was associated with adolescent health risk behaviors, and the scientific health view ( β =-0.05, 95% CI =-0.09--0.01), health information literacy ( β = -0.06 , 95% CI =-0.08--0.05) were associated with substance abuse and violence among middle school students; health information literacy ( β =-0.03, 95% CI =-0.04--0.01) was associated with adolescent healthy eating behavior; health information literacy ( β =-0.03, 95% CI =-0.05--0.02) was associated with breakfast and exercise in middle school students; chronic disease literacy ( β =0.05, 95% CI =0.00-0.09), health information literacy ( β =-0.02, 95% CI =-0.03--0.00) was associated with screen related behavior of middle school students; scientific health view ( β =-0.05, 95% CI =-0.09--0.01), basic medical literacy ( β =-0.08, 95% CI =-0.13--0.04), health information literacy ( β =0.02, 95% CI =0.00-0.03) were associated with middle school students traffic safety behavior( P <0.05). @*Conclusion@#There is a certain cross sectional correlation between parents health literacy and adolescent health risk behaviors. It is necessary to clarify the direction and intensity of the correlation in the cohort study.

Relationship between urinary metals and lung function in college students / 中国学校卫生

Objective@#To explore the association between urinary metals and lung function among college students, and to provide a theoretical basis for related research on metal exposure and lung function injury.@*Methods@#A total of 45 healthy college students were recruited from North China University of Science and Technology in Caofeidian between 2017-2018. During the four seasons, information was obtained from questionnaires and physical examinations, lung function parameters were assessed, including FVC, FEV1, PEF, FEV1/FVC and FEF 25-75 , and morning urine samples were collected simultaneously. The urinary levels of 15 metals were measured by inductively coupled plasma mass spectrometry (ICP/MS); a Kruskal Wallis H test was used to compare differences in urinary metals during the four seasons; and a mixed effect model was used to assess correlations between urinary metals and lung function.@*Results@#There were significant differences in the levels of urinary chromium, iron, nickel, copper, zinc, arsenic, selenium, selenium, molybdenum, cadmium, antimony and lead from 15 metals over the four seasons ( H =9.79- 20.61 , P <0.05). The differences observed in five lung function parameters over the four seasons were statistically significant ( F =61.72, 45.30, 47.61, 25.47, 35.13, P <0.05). The linear mixed effect model analysis showed that urinary concentrations of vanadium, manganese, iron, cobalt, nickel and antimony were negatively correlated with FEV1( B =0.202, 0.192, 0.181, 0.154, 0.131 , 0.283); urinary concentrations of aluminum, vanadium, manganese, iron, cobalt, nickel, zinc, cadmium, and antimony were negatively correlated with FVC ( B =0.252, 0.290, 0.292, 0.271, 0.201, 0.180, 0.171, 0.163, 0.381); urinary concentrations of manganese and antimony were negatively correlated with PEF ( B =0.291, 0.354)( P <0.05).@*Conclusion@#The increase of multiple metal concentrations among college students was related to lung function decline, the long term metal exposure might lead to lung function damage. So environmental metal pollution should be controlled.

Prevalências de doenças crônicas e acesso aos serviços de saúde no Brasil: evidências de três inquéritos domiciliares / Prevalence of chronic diseases and access to health services in Brazil: evidence of three household surveys

Resumo As Doenças Crônicas Não Transmissíveis (DCNT) são as principais causas de morte no mundo, impactando fortemente sobre populações mais vulneráveis. O objetivo deste estudo foi analisar as mudanças nas prevalências dessas doenças, nas condições de saúde, acesso e utilização de serviços de saúde no Brasil, entre 2008 e 2019. Como ferramenta analítica, foram utilizados testes de diferenças de proporções e modelos lineares generalizados, considerando amostragem complexa dos inquéritos da Pesquisa Nacional por Amostra de Domicílios (PNAD) de 2008, e da Pesquisa Nacional de Saúde (PNS), nos anos de 2013 e 2019, para testar mudanças no tempo das prevalências e estimar razões de prevalência, ajustadas por variáveis sociodemográficas. Houve aumento das prevalências de depressão, câncer, diabetes, distúrbios neuropsiquiátricos, problemas pulmonares crônicos e problemas osteomusculares. Houve redução de artrite reumatoide, insuficiência renal crônica e doenças do aparelho circulatório. Entre os brasileiros com pelo menos uma DCNT verificou-se aumento da cobertura da Estratégia de Saúde da Família ao longo do tempo, no entanto verificou-se redução do atendimento médico em tempo oportuno e obtenção de medicamentos prescritos gratuitamente.

Abstract Chronic non-communicable diseases (NCDs) are the leading causes of death globally, impacting heavily on the most vulnerable populations. This study aimed to analyze changes in the prevalence of these diseases, health conditions, access, and health services in Brazil between 2008 and 2019. Tests of differences and generalized linear models were used as analytical tools, considering complex sampling from the PNAD 2008, PNS 2013, and PNS 2019 surveys, to test temporal changes in the prevalence and the prevalence ratio estimates, adjusted by sociodemographic variables. An increase in the prevalence of Depression, Diabetes, Cancers, Neuropsychiatric Disorders, Chronic Pulmonary problems, and Musculoskeletal problems was observed. A decline in rheumatoid arthritis, chronic renal failure, and diseases of the circulatory system was identified. Among Brazilians with at least one NCD, an increase in coverage by the family health strategy over time was observed. However, there was a reduction in timely medical care and obtaining of free prescription drugs.

Elevada proporción de Staphylococcus aureus meticilino resistentes aislados en pacientes atendidos en un servicio ambulatorio dermatológico de referencia nacional: cohorte 2010 a 2019 / High proportion of isolated resistant methicillin-resistant Staphylococcus aureus in patients treated in a national refe rence dermatological outpatient service: cohort 2010 to 2019

Resumen Objetivo: Estimar la resistencia del Staphylococcus aureus frente a diferentes antibióticos usados para el manejo ambulatorio de piodermias. Métodos: Se realizaron análisis descriptivos y de tendencias mediante modelos de regresión segmentada. Resultados: La mayor resistencia se presentó a la oxacilina, con mediana de 54,3% (RIQ: 43 - 58,8), seguido de eritromicina con el 20%, (RIQ: 15,4 - 26,5), clindami cina con el 14% (RIQ: 7,9 - 20), gentamicina con el 7,5% (RIQ: 0 -10), trimetoprima/sulfametoxazol (SXT) con el 5,5% (RIQ: 4 - 11), y ciprofloxacina con 2,1% (RIQ: 2 - 8.4). La tendencia de la resistencia del S. aureus a la oxacilina fue creciente con un cambio anual porcentual no significativo de (0,07) (IC 95%: -3,7; 3,9). Para eritromicina, clindamicina, ciprofloxacina, trimetoprima/sulfametoxazol, y gentamicina hubo decrecimiento. Conclusiones: La resistencia del S. aureus a oxacilina fue ligeramente creciente para el periodo 2010 al 2019 y francamente creciente en los últimos 3 años, superando en promedio a lo reportado a nivel país y Latinoamérica. Los antibióticos con menor resistencia fueron ciprofloxacina, SXT, clindamicina para uso sistémico, y ácido fusídico, mupirocina para manejo tópico y descolonización. Es pertinente articular la vigilancia del S. aureus en la atención ambulatoria a la red de vigilancia nacional.

Abstract Objective: To estimate the resistance trend of Staphylococcus aureus (S. aureus) against different antibiotics in a reference dermatology outpatient center in Colombia. Methods: Descriptive and trend analyzes were performed using segmented regression models for the period 2010 to 2019. Results: The greatest resistance was presented to oxacillin, with a median of 54.3% (RIQ: 43 - 58.8), followed by erythromycin with 20%, (RIQ: 15.4 - 26.5), then clindamycin with 14% (RIQ: 7.9 - 20), gentamicin with 7.5% (RIQ: 0 -10), trimethoprim / sulfamethoxazole (SXT) with 5.5% (RIQ: 4 - 11), and ciprofloxacin with 2.1% (RIQ: 2 - 8.4). The trend of S. aureus resistance to oxacillin from 2010 to 2019 was increasing with a non-significant Annual Percent Change (APC) of (0.07) (95% CI -3.7, 3.9). APC for erythromycin (-1.2) (95% CI: -11.3; 10), clindamycin (-1.7) (95% CI: 11; -12.9), ciprofloxacin (-25.4) (95% CI: -44.6; 0.5) and trimethoprim / sul famethoxazole (-20.7) (95% CI: -43.5; 11.2), were decreasing not significant. For gentamicin the trend was decreasing and significant (-44.2) (95% CI: -19.9; -61.1). Conclusions: The resistance of S. aureus to oxacillin exhibited a slightly increasing trend for the period 2010 to 2019 and increasing in the last 3 years, exceeding on average that reported at the country level and the world average. Antibiotics for outpatient management of skin and soft tissue pyoderma with less resistance were ciprofloxacin, SXT, clindamycin for systemic use, and fusidic acid, mupirocin for topical management and decolonization. It is important to articulate surveillance of S. aureus in outpatient care to the national surveillance network.

Clinical value of inflammatory biomarkers in predicting prognosis of patients with ureteral urothelial carcinoma / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the clinical value of inflammation-related markers in predicting the prognosis of patients with ureteral urothelial carcinoma.@*METHODS@#200 patients with ureteral urothelial carcinoma were randomly divided into two groups by split sample validation: modeling group and validation group. Paraffin embedded pathological specimens of the patients were reviewed. Immunohistochemical method was used to detect tumor-infiltrating neutrophil (TIN) (CD66b+), tumor-associated macrophage (TAM) (CD163+), lymphocyte (CD+, CD4+, CD8+) counts, peripheral blood neutrophil / lymphocyte ratio (NLR) and tumor tissue neutrophil/monocyte ratio (NMR). According to the results of pathological staging, the patients were divided into non-muscle-invasive and muscle-invasive ureteral urothelial carcinoma group. The resolution of the models was evaluated, and the prognostic nomogram models including only peripheral blood parameters and all parameters were established to compare the accuracy of the two models in predicting the prognosis of patients with urothelial carcinoma of the ureter.@*RESULTS@#The median follow-up time was 36 months, the progression-free survival was 40 months, and 42 cases (21.0%) showed tumor progression within 3 years. Tumor size, pathological stage and pathological grade were all single-factor variables predicting the first recurrence of ureteral urothelial carcinoma three years after operation. Tumor size, pathological stage, pathological grade, TIN, TAM, NLR and NMR were multi-factor variables predicting the first recurrence three years after operation. Among 104 cases of non-muscle-invasive ureteral urothelial carcinoma, 10 cases (9.6%) recurred for the first time 3 years after operation, 96 cases (33.3%) of muscle invasive ureteral urothelial carcinoma, and the diffe-rence between the two groups was statistically significant (χ2=15.53, P < 0.05). The predictive nomogram model of progression free survival was established. The concordance index of progression free survi-val was 0.722 (95%CI: 0.70-0.78) in non-muscle-invasion group, and 0.725 (95%CI: 0.71-0.79) in muscle-invasion group, which was in good agreement with the observed 3-year survival rate. The results of discrimination test showed that the concordance index of the whole parameter prediction model of ureteral urothelial carcinoma was 0.726, which was higher than that of peripheral blood parameters (consistency index 0.672). The immune microenvironment of ureteral urothelial carcinoma improved the prediction accuracy of the model.@*CONCLUSION@#The prognosis prediction model based on immune inflammation-related markers was established as a perfection and supplement for the existing pathological grading and staging system, providing a basis for accurate individualized treatment of patients with urete-ral urothelial carcinoma. The prognosis prediction model based on the relevant indicators of peripheral blood samples is established, which is easy to obtain specimens, and the detection method is simple and economical, which is more conducive to clinical application.

Static balance and control strategy in preschool children / 中国学校卫生

Objective@#To explore the age related increases and characteristics of static stance balance and control strategies of 3-6 years old preschool children,and to provide a reference for the research of children s physique and the practice of physical education.@*Methods@#Using a 2×2×3 (proprioceptive×visual×age) three factor experimental design, standing balance was tested among 105 preschool children aged 3-6 years who were subjected to static for 15 s under four standing postures from January to March 2018. Quantitatively examine the static stance balance ability based on changes in the center of pressure (COP), and quantitatively examine the posture control strategy based on COP frequency domain analysis and nonlinear analysis.@*Results@#Among children aged 3-, 4- and 5-6 years old under the condition of open eyes / hard ground AP_ MV and ML_ MV were 18.05, 16.00, 13.40; 13.55, 11.03, 10.12 mm/s respectively; Under the condition of closed eyes/hard ground, children in three age groupsAP_ MV and ML_ MV were 21.01, 19.60, 15.10; 12.20, 10.20, 10.00 mm/s respectively among three age groups of children. The results showed that the sloshing amplitude and average sloshing velocity decrease significantly with age( P <0.01). Under the conditions of open/hard ground and closed/hard ground, the high frequency band in the left-right direction and the low frequency band in the anterior posterior direction increased significantly with age ( P <0.01). Under the condition of open eyes/hard ground, three age groups of AP_ MF and AP_ HF among three age groups of children were 29.00, 28.61, 27.20； 7.45, 7.44 6.01, respectively, indicating that the middle and high frequency bands ( P <0.01) in the anterior posterior direction decreased significantly with age. ML_FD of children aged 3-, 4- and 5-6 years old under the condition of open eyes / hard ground and closed eyes / hard ground was 1.43, 1.44, 1.52; 1.49, 1.48, 1.56/mm, AP_ FD was 1.58, 1.56, 1.52; 1.56, 1.63, 1.61; AP_MSE was 6.81, 6.90, 5.61 ; 7.25 , 7.41,6.60，respectively. The results show that the fractal dimension in the left right direction increases significantly with age, while the fractal dimension and multi scale entropy in the front back direction decrease significantly( P <0.01).@*Conclusion@#The static stance balance ability of 3-6 years old preschool children shows non linear changes with age,the static posture balance ability of 5-6 years old preschool children is significantly better than that of 3-5 years old , and the balance control strategies of 5-6 years old preschool children is different from that of 3-5 years old.

Association between health literacy and health related quality of life among primary and middle school students / 中国学校卫生

Objective@#To investigate the association between health literacy (HL) and health related quality of life (HRQoL) among primary and middle school students in Nanjing,and to provide a reference for improving health literacy and health related quality of life among children.@*Methods@#In this cross sectional study, by using a multi stage rondom duster sampling method,a total of 4 388 primary (4-6), junior (grades 7-9) and senior (grades 10-12) high school students were randomly selected in Nanjing during May and June of 2018. HRQoL was measured as continuous variable with the validated Chinese version of Child Health Utility 9D (CHU9D CHN); the relationship between health literacy level and HRQoL was examined using mixed effect linear regression models and reported as mean difference ( MD ) and 95% confidence interval( CI ).@*Results@#There were 85.8% participants who obtained adequate health literacy level, while the mean score of CHU9D CHN was (0.78±0.17) for overall participants. After control for potential confounding factors and class level clustering effects, participants who self reported adequate HL recorded an increased HRQoL scores of 0.08 (95% CI =0.06-0.10) units relative to those self reporting inadequate HL. According to the stratified analysis of students gender, school type and place of residence, the results show that after adjusting the relevant confounding factors and the aggregation of class level, compared with the students without health literacy, the score of health related quality of life of those with health literacy increased significantly.@*Conclusion@#Health literacy of primary school students in Nanjing is positively related to health related life qualities.Therefore,there is a need to promote student s health related quality of life through health literacy.

A longitudinal study on sex difference in weight growth and systolic blood pressure change among children and adolescents in Beijing / 中国学校卫生

Objective@#To explore sex differences between weight and systolic blood pressure (SBP) changes among school-age children and adolescents in Beijing, and to provide a basis for priority intervention to control the rapid growth of body weight and blood pressure.@*Methods@#Anthropometric measurement data of 70 288 children and adolescents from primary and high schools in Shunyi District were collected from 2009 to 2018, and a longitudinal dataset with complete data related to weight and BP after individual data linkage was compiled. The age-specific weight and SBP growth rates were calculated, and a linear mixed-effects model was used to identify sex differences in chronological growth rates.@*Results@#Weight and SBP increased with age in both boys and girls, and the mean weight and SBP were higher in boys than in girls across all age groups. The result of the linear mixed-effects model indicated apparent sex differences in weight and SBP growth rates, with an age and sex interaction term(β=-0.35, -0.40, P<0.01). The age at peak weight velocity (PWA) was 12 years old and the age at peak SBP velocity was 13 years old in boys, which occurred one and three years later than for girls, respectively. In addition, the peak weight and SBP velocity were higher in boys than in girls. The curves of the SBP growth rate adjusted for the PWA, showed that the peak SBP velocity occurred two years before PWA and the second peak SBP velocity occurred at the PWA, which indicated "double peaks" in both boys and girls. The SBP growth rate was always higher in boys than in girls, and the rates declined after PWA.@*Conclusion@#Sex differences in weight and SBP growth rates were persistent and obvious in school-age children and adolescents in Beijing and the change in SBP was highly time synchronized with the increase in weight.