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1.
Rev. peru. med. exp. salud publica ; 39(3): 362-367, jul.-sep. 2022. tab, graf
Article in Spanish | LILACS | ID: biblio-1410014

ABSTRACT

RESUMEN La distribución geoespacial de la morbilidad por tuberculosis (TB) pulmonar y extrapulmonar en el municipio de Cúcuta en los años 2019 y 2020 se describió utilizando el método de Kulldorff usando la ubicación geográfica y la fecha de reporte de los casos incidentes de TB. La unidad de análisis fue el evento reportado al Sistema Nacional de Vigilancia Epidemiológica (SIVIGILA). Se identificaron 392 barrios distribuidos en diez comunas, donde se ubicaron 607 casos. En la distribución de la TB pulmonar, la comuna norte fue la que más casos reportó, siendo el barrio El Salado el más afectado de manera repetitiva. Los casos incidentes de TB extrapulmonar no mostraron patrones de repetición en la distribución entre las unidades espaciales y temporales. Se debe priorizar la región occidental dentro de las estrategias de mitigación y control de la propagación de la infección pulmonar del territorio.


ABSTRACT The geospatial distribution of pulmonary and extrapulmonary tuberculosis (TB) morbidity in the municipality of Cúcuta in 2019 and 2020 was described by the Kulldorff method using the geographic location and reporting date of incident TB cases. The unit of analysis was the event reported to the National Epidemiological Surveillance System (SIVIGILA). A total of 607 cases were identified in 392 neighborhoods distributed in ten communes. Most cases of pulmonary TB were reported in the northern commune, with the El Salado neighborhood being the most affected repeatedly. Incident cases of extrapulmonary TB did not show patterns of repetition in the distribution between spatial and temporal units. Strategies to mitigate and control the spread of pulmonary infection should prioritize the western region.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Tuberculosis , Morbidity , Geographic Information Systems , Cluster Analysis , Geographic Mapping , Spatial Analysis
2.
Int. j. high dilution res ; 21(1): 2-2, May 6, 2022.
Article in English | LILACS, HomeoIndex | ID: biblio-1396610

ABSTRACT

The Clificol® COVID-19 Support Project is an innovative international data collection project aimed at tackling some of the core questions in homeopathy, including the notion of Genus Epidemicus. Aims:To shed some light on the notion of Genus Epidemicus in the context of this infection. Going beyond that, the project aims to use these data to tackle more fundamental questions, such as the role of symptoms and rubrics in treatment individualisation. Methodology:This online multi-national data-collection project is supported by the ECH, ECCH, ICH, HRI, LMHI, and other professional associations. The collected data includes demographic information, severity, conventional diagnosis and treatment, presenting symptoms as well as the remedies prescribed. The outcome of treatment was tracked using the ORIDL scale. The concept of Genus Epidemicus, including the role of treatment individualisation, was investigated by analysing whether presenting symptoms cluster into distinct groups (K-Means clustering approach). The symptom data originating from China was obtained using a questionnaire. Results and discussion: 20 Chinese practioners collected 359 cases, primarily in the first half of 2020 (766 consultations, 363 prescriptions). The cluster analysis found two to be the optimum number of clusters. These two symptomatic clusters had a high overlap with the two most commonly prescribed remedies in that population: In cluster 1 there were 297 prescriptions, 95.6% of which were Gelsemium sempervirens, incluster 2, there were 61 prescriptions, 95.1% of which were Bryonia alba. Under the assumption of a single genus epidemicuswe would expect to see a single cluster of symptoms. The data from the Chinese population were not compatible with this assumption. Conclusion:This was the first study that investigated the notion of Genus Epidemicus by using modern statistical techniques. These analyses identified at least two distinct symptom pictures. The notion of a single COVID-19 Genus Epidemicus did not apply to this population.


Subject(s)
Medicamentous Diagnosis , COVID-19/epidemiology , Cluster Analysis
3.
Rev. Ciênc. Plur ; 8(2): e27501, mar. 2022. ilus, tab
Article in Portuguese | LILACS, BBO | ID: biblio-1368633

ABSTRACT

Introdução:São poucos os estudos que identificaram os padrões alimentares em adultos sem patologias associadas utilizando metodologias de abordagem a posteriori, o que representa um grande e importante campo de pesquisa na epidemiologia nutricional a ser explorado para melhor entender o hábito alimentar das diferentes populações no mundo e suas relações com demais fatores.Objetivo:Analisar as metodologias deidentificação dos padrões alimentares em adultos saudáveis que utilizaram a abordagem a posteriori.Metodologia:Trata-se de uma revisão integrativa. Foram incluídos somente artigos originais publicados em português ou inglês que identificaram padrão alimentar de adultos saudáveis por meio de abordagem a posteriori, de 2013 a 2018. Os artigos foram selecionados por meio de busca em 4 bases de dados, sendo resgatadas 328 publicações.Resultados:Apenas 9 artigos identificaram padrões alimentares por meio de abordagem a posteriori em adultos, sendo 7 do tipo transversal e 2 longitudinal.O método de abordagem exploratória mais utilizado foi a análise fatorial, abordada em sete estudos. Um artigo utilizou o método de análise de agrupamento, enquanto outros dois utilizaram o método RRR, sendo um deles associado ao método ACP. Conclusões:As metodologias de avaliação do padrão alimentar possuem limitações, o que torna absolutamente importante que os estudos sejam bem delineados, com escolha de inquéritos alimentares mais convenientes, tamanho e seleção da amostra relevantes e testes estatísticos que orientem as decisões do pesquisador da melhor forma possível, para que os resultados retratem padrões e agrupamentos bem fidedignos (AU).


Introduction:There are few studies that have identified dietary patterns in adults without associated pathologies using a posteriori approach methodologies, which represents a large and important field of research in nutritional epidemiology to be explored to better understand the eating habits of different populations in the world and their relationships with other factors. Objective:To analyze the methodologies for identifying dietary patterns in healthy adults who used the a posteriori approach. Methodology:This is an integrative review. Only original articles published in Portuguese or English that identified the dietary pattern of healthy adults through an a posteriori approach, from 2013 to 2018, were included. Results:Only 9 articles identified eating patterns through a posteriori approach in adults, 7 of which were transverse and 2 were longitudinal.The most used exploratory approach method was factor analysis, addressed in seven studies. One article used the cluster analysis method, while two others used the RRR method, one of them associated with the ACP method. Conclusions:The dietary pattern assessment methodologies have limitations, which makes it absolutely important that the studies are well designed, with the choice of more convenient food surveys, relevant sample size and selection, and statistical tests that guide the researcher's decisions in the best possible way, so that the results depict very reliable patterns and groupings (AU).


Introducción: Existen pocos estudios que hayan identificado patrones alimentarios en adultos sin patologías asociadas utilizando metodologías de abordaje a posteriori, lo que representa un amplio e importante campo de investigación en epidemiología nutricional a explorar para comprender mejor los hábitos alimentarios de diferentes poblaciones en el mundo y sus relaciones con otros factores. Objetivo: Analizar las metodologías para la identificación de patrones dietéticos en adultos sanos que utilizaron el enfoque a posteriori.Metodología:Esta es una revisión integradora. Se incluyeron solo artículos originales publicados en portugués o inglés que identificaron el patrón dietético de adultos sanos a través de un enfoque a posteriori, de 2013 a 2018. Resultados: Solo 9 artículos identificaron patrones de alimentación mediante abordaje a posteriori en adultos, 7 de los cuales fueron transversales y 2 longitudinales.El método de abordaje exploratorio más utilizado fue el análisis factorial, abordado en siete estudios. Un artículo utilizó el método de análisis de conglomerados, mientras que otros dos utilizaron el método RRR, uno de ellos asociado al método ACP.Conclusiones: Las metodologías de evaluación del patrón dietético tienen limitaciones, por lo que es absolutamente importante que los estudios estén bien diseñados, con la elección de encuestas alimentarias más convenientes, tamaño y selección de muestras relevantes y pruebas estadísticas que guíen las decisiones del investigador de la mejor maneraposible, para que que los resultados representan patrones y agrupaciones muy fiables (AU).


Subject(s)
Adult , Eating , Feeding Behavior , Habits , Brazil/epidemiology , Cluster Analysis , Surveys and Questionnaires , Factor Analysis, Statistical , Nutritional Epidemiology
4.
Esc. Anna Nery Rev. Enferm ; 26: e20210307, 2022. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1356221

ABSTRACT

Resumo Objetivo Analisar o perfil das pessoas com estomias intestinais e/ou urinárias acompanhadas em serviço de estomaterapia, conforme variáveis sociodemográficas e clínicas. Método Trata-se de um estudo transversal, realizado com 90 usuários do serviço de estomaterapia. A coleta foi realizada de janeiro a fevereiro de 2020, por meio de dois instrumentos: COH-QOL-Ostomy, adaptado e traduzido para o contexto brasileiro; e City of Hope Quality of Life - Ostomy Questionnaire, instrumento original com questionário elaborado pelas próprias pesquisadoras, contemplando os aspectos sociodemográfico e clínico. Esses dados foram transferidos e organizados no Software Statistical Package for the Social Science, versão 22. Resultados Foram identificados quatro grupos distintos. No cluster 1, o grupo possui de duas a três complicações associadas ao estoma e 52,9% possuem colostomia. No cluster 2, 45% não apresentam nenhuma complicação e 70% têm urostomia. Já no cluster 3, a totalidade do grupo apresenta uma complicação e colostomia. E no cluster 4, nenhum participante do grupo apresenta complicação e todos têm colostomia. Conclusão e implicações para a prática O estudo proporcionou a geração de dados que podem auxiliar no planejamento do trabalho desenvolvido pelas equipes de saúde junto aos pacientes estomizados.


Resumen Objetivo Analizar el perfil de las personas con ostomías intestinales y/o urinarias seguidas en un servicio de estomaterapia, según variables sociodemográficas y clínicas. Método Se trata de un estudio transversal, realizado con 90 usuarios del servicio de Estomaterapia. La recolección de datos se realizó de enero a febrero de 2020, utilizando dos instrumentos: COH-QOL-Ostomy, adaptado y traducido al contexto brasileño; y City of Hope Quality of Life - Ostomy Questionnaire, instrumento original con cuestionario elaborado por las propias investigadoras, considerando aspectos sociodemográficos y clínicos. Estos datos se transfirieron y organizaron en Software Statistical Package for the Social Science, versión 22. Resultados Se identificaron cuatro clústeres distintos. En el clúster 1, el grupo tiene de dos a tres complicaciones asociadas con estoma y el 52,9% tiene una colostomía. En el grupo 2, el 45% no presenta complicaciones y el 70% tiene urostomía. En el clúster 3, todo el grupo presenta complicación y colostomía. Y en el clúster 4, ninguno de los participantes del grupo tiene complicaciones y todos tienen una colostomía. Conclusión e implicaciones para la práctica El estudio generó datos que pueden ayudar a planificar el trabajo que desarrollan los equipos de salud con pacientes ostomizados.


Abstract Objective To analyze the profile of people with intestinal and/or urinary ostomies followed up in a stomatherapy service, according to sociodemographic and clinical variables. Method This is a cross-sectional study, carried out with 90 users of the stomatherapy service. Data collection was carried out from January to February 2020, using two instruments: COH-QOL-Ostomy, adapted and translated to the Brazilian context; and City of Hope Quality of Life - Ostomy Questionnaire, an original instrument with a questionnaire prepared by the researchers themselves, considering the sociodemographic and clinical aspects. These data were transferred and organized in the Statistical Package for Social Science Software, version 22. Results Four distinct clusters were identified. In cluster 1, the group has two to three complications associated with the stoma and 52.9% have a colostomy. In cluster 2, 45% have no complications and 70% have urostomy. In cluster 3, the entire group presents a complication and colostomy. And in cluster 4, none of the participants in the group have complications and all have a colostomy. Conclusion and implications for practice The study provided the generation of data that can help in planning the work developed by the health teams with ostomy patients.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Health Profile , Ostomy , Enterostomal Therapy , Quality of Life , Socioeconomic Factors , Cluster Analysis , Cross-Sectional Studies , Surgical Stomas/adverse effects
5.
Esc. Anna Nery Rev. Enferm ; 26: e20210194, 2022. tab, graf
Article in Portuguese | LILACS, BDENF | ID: biblio-1356216

ABSTRACT

Resumo Objetivo analisar o perfil sociodemográfico, laboral e a intensidade das cargas de trabalho de trabalhadores da enfermagem de hospitais universitários. Método quantitativo e transversal, com 361 trabalhadores de enfermagem, entre novembro de 2019 e fevereiro de 2020, por meio da Escala de Cargas de Trabalho nas Atividades de Enfermagem. Realizou-se análise de cluster. Resultados formaram-se quatro clusters com trabalhadores do sexo feminino (2, 3 e 4) e sexo masculino (1). A exposição às cargas de trabalho foi identificada como intensa (1, 2 e 3) e pouco intensa (4). As unidades de trabalho evidenciadas com mais frequência nos clusters 1, 2 e 3 foram a Rede de Urgência e Emergência, Pediátrica e Clínica Médica, e no cluster 4, a Maternidade e Clínica Cirúrgica. Os clusters 1 e 3 identificaram com mais frequência o período de trabalho de 1 a 5 anos, no cluster 2, foi de 15 a 20 anos, e no cluster 4, inferior a um ano. Conclusão e implicações para a prática a identificação dos quatro clusters possibilitou a análise do perfil de trabalhadores de enfermagem, permitindo o planejamento de intervenções direcionadas a minimizar as cargas de trabalho de acordo com as particularidades de cada grupo.


Resumen Objetivo analizar el perfil sociodemográfico, laboral y la intensidad de las cargas de trabajo de trabajadores de enfermería de hospitales universitarios. Método cuantitativo y transversal con 361 trabajadores de enfermería, entre noviembre de 2019 y febrero de 2020, por medio de la Escala de Cargas de Trabajo en las Actividades de Enfermería. Se realizó el análisis de cluster. Resultados se formaron cuatro clusters, con trabajadores del sexo femenino (2, 3 y 4) y sexo masculino (1), la exposición a las cargas de trabajo fue identificada como intensa (1, 2 y 3) y poco intensa (4). Las unidades de trabajo evidenciadas con más frecuencia en los clusters 1, 2 y 3 fueron la Unidad de Cuidados de Emergencia y Urgencia, Pediatría y Clínica Médica y en el cluster 4, los Servicios de Maternidad y de Clínica Quirúrgica. Los clusters 1 y 3 identificaron con más frecuencia el período de trabajo de 1 a 5 años, en el cluster 2 fue de 15 a 20 años y en el cluster 4, inferior a un año. Conclusión e implicaciones para la práctica la identificación de los cuatro clusters posibilitó el análisis del perfil de los trabajadores de enfermería, permitiendo la planificación de intervenciones dirigidas a minimizar las cargas de trabajo de acuerdo con las particularidades de cada grupo.


Abstract Objective to analyze the sociodemographic and occupational profile and intensity of workloads among nursing professionals working in university hospitals. Method This quantitative and cross-sectional study addressed 361 nursing workers from November 2019 to February 2020, using the Escala de Cargas de Trabalho nas Atividades de Enfermagem and cluster analysis. Results Four clusters were identified: with female workers (2, 3, and 4) and male workers (1). Exposure to workload was reported to be intense (1, 2, and 3) and a little intense (4). The work units most frequently identified in clusters 1, 2, and 3 were the Emergency and Urgent Care Unit, Pediatrics, and Medical Clinic, whereas Maternity Services and Surgical Clinics were the units most frequently identified in cluster 4. Most workers in clusters 1 and 3 had from 1 to 5 years of experience, cluster 2 from 15 to 20 years, and the workers in cluster 4 had less than one year of work experience. Conclusion and implications for practice the identification of four clusters enabled analyzing the profile of the nursing workers, which favors the planning of interventions intended to minimize workloads according to the specificities of each group.


Subject(s)
Humans , Male , Female , Adult , Working Conditions , Workload , Licensed Practical Nurses , Hospitals, University , Nurses , Nursing Assistants , Cluster Analysis , Cross-Sectional Studies , Interprofessional Relations
6.
Cad. Saúde Pública (Online) ; 38(supl.1): e00164321, 2022. tab
Article in English | LILACS | ID: biblio-1384289

ABSTRACT

Our objective is to describe the differences in the sampling plans of the two editions of the Brazilian National Health Survey (PNS 2013 and 2019) and to evaluate how the changes affected the coefficient of variation (CV) and the design effect (Deff) of some estimated indicators. Variables from different parts of the questionnaire were analyzed to cover proportions with different magnitudes. The prevalence of obesity was included in the analysis since anthropometry measurement in the 2019 survey was performed in a subsample. The value of the point estimate, CV, and the Deff were calculated for each indicator, considering the stratification of the primary sampling units, the weighting of the sampling units, and the clustering effect. The CV and the Deff were lower in the 2019 estimates for most indicators. Concerning the questionnaire indicators of all household members, the Deffs were high and reached values greater than 18 for having a health insurance plan. Regarding the indicators of the individual questionnaire, for the prevalence of obesity, the Deff ranged from 2.7 to 4.2, in 2013, and from 2.7 to 10.2, in 2019. The prevalence of hypertension and diabetes per Federative Unit had a higher CV and lower Deff. Expanding the sample size to meet the diverse health objectives and the high Deff are significant challenges for developing probabilistic household-based national survey. New probabilistic sampling strategies should be considered to reduce costs and clustering effects.


Nosso objetivo é descrever as diferenças nos desenhos amostrais das duas edições da Pesquisa Nacional de Saúde (PNS 2013 e 2019) e avaliar como suas mudanças afetaram o coeficiente de variação (CV) e o efeito do desenho (Deff) de alguns dos indicadores avaliados. Variáveis de diferentes partes do questionário foram analisadas para avaliar proporções com diferentes magnitudes. A prevalência de obesidade foi incluída na análise uma vez que a medição de antropometria na pesquisa de 2019 foi realizada em uma subamostra. Os valores do estimador pontual, CV e Deff foram calculados para cada indicador considerando a estratificação das unidades amostrais primárias, a ponderação das unidades amostrais, e o efeito do agrupamento. Para a maioria dos indicadores, CV e Deff foram menores nas estimativas de 2019. Em relação aos indicadores para todos os membros familiares, Deffs foram elevados e atingiram valores superiores a 18 para a posse de um plano de saúde. Quanto aos indicadores no questionário individual, Deff variou de 2,7 a 4,2 em 2013 e de 2,7 a 10,2 em 2019 para a prevalência de obesidade. A prevalência de hipertensão arterial e diabetes por Unidade Federativa apresentou CV maior e Deff menor. A expansão do tamanho da amostra para atender aos diversos objetivos de saúde e Deff altos são desafios expressivos para o desenvolvimento de uma pesquisa nacional domiciliar probabilística. Novas estratégias de amostragem probabilística devem ser consideradas para reduzir custos e efeitos do agrupamento.


Nuestro objetivo es describir las diferencias en los diseños muestrales de las dos ediciones de la Encuesta Nacional de Salud (PNS 2013 y 2019) y evaluar cómo sus cambios afectaron el coeficiente de variación (CV) y el efecto de diseño (Deff) de algunos de los indicadores evaluados. Se analizaron variables de diferentes partes del cuestionario para evaluar proporciones con diferentes magnitudes. La prevalencia de obesidad se incluyó en el análisis, ya que la medición de la antropometría en la encuesta de 2019 se realizó en una submuestra. Los valores del estimador puntual, CV y Deff se calcularon para cada indicador considerando la estratificación de las unidades de muestreo primarias, la ponderación de las unidades de muestreo y el efecto de agrupamiento. Para la mayoría de los indicadores, CV y Deff fueron más bajos en las estimaciones de 2019. En cuanto a los indicadores para todos los miembros de la familia, los Deff fueron altos y alcanzaron valores superiores a 18 por tener un plan de salud. En cuanto a los indicadores del cuestionario individual, Deff osciló entre 2,7 y 4,2 en 2013, y entre 2,7 y 10,2 en 2019 para la prevalencia de obesidad. La prevalencia de hipertensión arterial y diabetes por Unidad Federativa tuvo mayor CV y menor Deff. Un mayor tamaño de la muestra para cumplir con los diversos objetivos de salud y un alto valor de Deff son desafíos importantes para el desarrollo de una encuesta nacional domiciliar probabilística. Se deben considerar nuevas estrategias de muestreo probabilístico para reducir los costos y efectos de agrupamiento.


Subject(s)
Humans , Obesity/epidemiology , Brazil/epidemiology , Cluster Analysis , Health Surveys , Sample Size
7.
Rev. bras. estud. popul ; 39: e0190, 2022. tab, graf
Article in Spanish | LILACS | ID: biblio-1365653

ABSTRACT

Los objetivos de este estudio son descubrir la conformación de conglomerados espaciotemporales de los suicidios, homicidios y muertes por lesiones de intención no determinada (MLIND) en Argentina, durante el período 1994-2014, y analizar la asociación espaciotemporal entre conglomerados de suicidios u homicidios y conglomerados de MLIND en Argentina durante el mismo período. Las unidades espaciales fueron los departamentos de Argentina. Se hizo un rastreo estadístico espaciotemporal para la detección de conglomerados por sexo y grupos de edad (10 a 29, 30 a 59 y 60 o más años). Se utilizaron dos modelos espaciotemporales: multinomial y Bernoulli. La emergencia de conglomerados de homicidios en hombres estuvo más asociada a caídas más abruptas en los niveles de empleo, entre 1991 y 2001, en comparación a los suicidios. Las áreas con densidades poblacionales altas y porcentajes más altos de necesidades básicas insatisfechas (NBI) tendieron a estar incluidas en conglomerados de homicidio en hombres en comparación a los suicidios. Hubo un mayor solapamiento espaciotemporal entre MLIND y homicidios. Los resultados obtenidos apoyan las hipótesis de 1) una diferenciación geográfica entre homicidios y suicidios en tiempos de crisis económica y 2) la representación mayoritaria de MLIND en homicidios ocultos.


Os objetivos deste estudo são: conhecer a conformação dos conglomerados espaço-temporais de suicídios, homicídios e óbitos por lesões por intenção indeterminada (MLIND) na Argentina, durante o período 1994-2014; e analisar a associação espaço-temporal entre grupos de suicídio ou homicídio e grupos de MLIND, na Argentina no mesmo período. As unidades espaciais foram os departamentos da Argentina. Uma varredura estatística espaço-temporal foi realizada para detectar clusters por sexo e grupos de idade (10-29, 30-59 e 60 anos ou mais). Dois modelos espaço-temporais foram usados: multinomial e Bernoulli. O surgimento de conglomerados de homicídios em homens esteve mais associado a reduções mais acentuadas nos níveis de emprego, entre 1991 e 2001, em comparação com os suicídios. Áreas com altas densidades populacionais e maiores percentuais de necessidades básicas insatisfeitas (indicador de pobreza) tenderam a ser incluídas em conglomerados de homicídio em homens, em comparação com suicídios. Houve uma maior sobreposição espaço-temporal entre MLIND e homicídios. Os resultados obtidos suportam as hipóteses de uma diferenciação geográfica entre homicídios e suicídios em tempos de crise económica e que os MLINDs representariam principalmente homicídios ocultos.


The objectives of this study are to discover the conformation of spatio-temporal clusters of suicides, homicides and deaths due to injuries of undetermined intention (MLIND) in Argentina, during the period 1994-2014, and to analyze the spatio-temporal association between suicide or homicide clusters and MLIND clusters in Argentina during the same period. The spatial units were the departments of Argentina. Space-time scan statistics were performed to detect clusters by sex and age groups (10-29 years, 30-59 years and 60 or more years). Two space-time models were used: multinomial and Bernoulli. The emergence of homicide clusters in men was more associated with steeper drops in employment levels, between 1991 and 2001, compared to suicide clusters. Areas with the highest population density and with the highest percentage of Unsatisfied Basic Needs (poverty indicator) were more likely to be included in clusters with high proportions of homicide in men, compared to suicide. There was a greater spatio-temporal overlap between MLIND and homicides. The results obtained support the hypotheses of (1) a geographical differentiation between homicides and suicides in times of economic crisis; and (2) MLIND would represent mostly hidden homicides.


Subject(s)
Humans , Argentina , Suicide , Cluster Analysis , Space-Time Clustering , Homicide , Binomial Distribution , Sex Distribution , Age Groups
8.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 14: e10086, 2022. tab, ilus, mapas
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1355011

ABSTRACT

Objetivo: analisar o perfil epidemiológico da leishmaniose tegumentar americana entre 2007 e 2017 na Paraíba, Nordeste Brasileiro. Método: Estudo ecológico dos casos de leishmaniose tegumentar americana registrados no Sistema de Informação de Agravos de Notificação. Utilizou-se o Risco Relativo, Método Scan Espacial e Método Bayesiano Empírico Local para a análise dos conglomerados. Resultados: Foram registrados 671 casos de leishmaniose tegumentar americana na Paraíba entre 2007 e 2017 com maior ocorrência em 2009 e 2010, com 121 e 91 notificações, respectivamente e no sexo masculino (341). A maioria apresentou a forma clínica cutânea e residentes na zona rural. Identificaram-se conglomerados espaciais significativos da leishmaniose tegumentar americana na Paraíba, no Litoral Norte, microrregião do Agreste e no município de Poço Dantas no Alto Sertão. Conclusões: os conglomerados espaciais de risco para a infecção demonstram a importância de ações imediatas de educação em saúde para prevenção do agravo


Objective: to analyze the epidemiological profile of american cutaneous leishmaniasis between 2007 and 2017 in Paraíba, Northeast Brazil. Method: Ecological study of cases of american cutaneous leishmaniasis registered in the Notifiable Diseases Information System. Relative Risk, Spatial Scan Method and Local Empirical Bayesian Method were used for the analysis of conglomerates.Results: 671 cases of american cutaneous leishmaniasis were registered in Paraíba between 2007 and 2017, with the highest occurrence in 2009 and 2010, with 121 and 91 notifications, respectively and among males (341). Most presented the clinical cutaneous form and lived in the rural area. Significant spatial conglomerates of american cutaneous leishmaniasis were identified in Paraíba, on the North Coast, the Agreste micro-region and in the municipality of Poço Dantas in Alto Sertão. Conclusions: thespatial conglomerates at risk for infection demonstrate the importance of immediate health education actions to prevent the disease


Objetivo: analizar el perfil epidemiológico de la leishmniosis cutánea entre 2007 y 2017 en Paraíba, noreste de Brasil. Método: Estudio ecológico de casos de leishmniosis cutánea registrados en el Sistema de Información de Enfermedades de Notificación. El riesgo relativo, el método de exploración espacial y el método bayesiano empírico local se utilizaron para el análisis del conglomerados. Resultados: se registraron 671 casos de leishmaniasis cutánea en Paraíba entre 2007 y 2017, con la mayor incidencia en 2009 y 2010, con 121 y 91 notificaciones, respectivamente, y entre hombres (341). La mayoría presentaba la forma cutánea clínica y vivía en el área rural. Se identificaron importantes conglomerados espaciales de leishmaniasis cutánea en Paraíba, en la costa norte, en la microrregión de Agreste y en el municipio de Poço Dantas en Alto Sertão. Conclusiones: los conglomerados espaciales en riesgo de infección demuestran la importancia de las acciones inmediatas de educación sanitaria para prevenir la enfermedad


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Cluster Analysis , Leishmaniasis, Cutaneous/epidemiology , Spatial Analysis , Health Profile , Epidemiology, Descriptive , Bayes Theorem , Health Information Systems
9.
Article in Chinese | WPRIM | ID: wpr-941044

ABSTRACT

OBJECTIVE@#To propose a new method for mining complexes in dynamic protein network using spatiotemporal convolution neural network.@*METHODS@#The edge strength, node strength and edge existence probability are defined for modeling of the dynamic protein network. Based on the time series information and structure information on the graph, two convolution operators were designed using Hilbert-Huang transform, attention mechanism and residual connection technology to represent and learn the characteristics of the proteins in the network, and the dynamic protein network characteristic map was constructed. Finally, spectral clustering was used to identify the protein complexes.@*RESULTS@#The simulation results on several public biological datasets showed that the F value of the proposed algorithm exceeded 90% on DIP dataset and MIPS dataset. Compared with 4 other recognition algorithms (DPCMNE, GE-CFI, VGAE and NOCD), the proposed algorithm improved the recognition efficiency by 34.5%, 28.7%, 25.4% and 17.6%, respectively.@*CONCLUSION@#The application of deep learning technology can improve the efficiency in analysis of dynamic protein networks.


Subject(s)
Algorithms , Cluster Analysis , Computer Simulation , Neural Networks, Computer , Research Design
10.
Chinese Journal of Epidemiology ; (12): 709-715, 2022.
Article in Chinese | WPRIM | ID: wpr-935448

ABSTRACT

Objective: To understand the spatial characteristics of echinococcosis and associated factors in the pastoral area of Qinghai province, and provide evidence for the effective prevention and control of echinococcosis. Methods: The number of echinococcosis cases in the pastoral areas of Qinghai in 2019 was collected to perform spatial epidemiological analysis. The thematic map of the distribution of echinococcosis cases was generated with software ArcGIS 10.8 for visual analysis and spatial autocorrelation analysis. The spatial autocorrelation and spatial scanning analysis were performed to estimate the clustering of echinococcosis with software SaTScan 9.5. Software GeoDa 1.14 and ArcGIS 10.8 were used to establish spatial lag model and geographical weighted regression model to analyze the related factors of echinococcosis epidemic. Results: In 2019, the echinococcosis surveillance covered 64 741 people in the pastoral area of Qinghai, and 829 echinococcosis cases were found, with a prevalence rate of 1.28%. The distribution of the cases had spatial correlation (Moran's I=0.41, P<0.001). The most possible clustering areas indicated by spatial scanning analysis included Banma, Jiuzhi, Dari and Gande counties of Guoluo Tibetan Autonomous Prefecture (LLR=460.77, RR=9.20, P<0.001). The prevalence of echinococcosis in the pastoral areas was positively associated with the total annual precipitation (β=0.13, P=0.036), and negatively associated with population density (β=-1.36, P=0.019) and doctors/nurse ratio (β=-25.60, P=0.026). Conclusions: The distribution of echinococcosis cases in the pastoral areas of Qinghai in 2019 had spatial correlation, and the prevalence was affected by total annual precipitation, population density, and doctors/nurse ratio.


Subject(s)
China/epidemiology , Cluster Analysis , Echinococcosis/epidemiology , Epidemics , Humans , Prevalence , Spatial Analysis
11.
Article in Chinese | WPRIM | ID: wpr-935308

ABSTRACT

Objective: To analyze the epidemiological characteristics and spatiotemporal clustering of hepatitis A in Zhejiang Province from 2010 to 2019. Methods: The data of hepatitis A incidence in Zhejiang Province from 2010 to 2019 were collected from the infectious disease surveillance system of China Information System for Disease Control and Prevention. ArcGIS 10.7 software was used for spatial autocorrelation analysis. SaTScan 9.6 software was used for spatiotemporal scanning analysis. SPSS 25.0 software was used for additional analysis. Results: Zhejiang Province has reported 5 465 cases of hepatitis A in 2010-2019 years, with an average annual incidence rate of 1.00/100 000, and periodicity and seasonality are not obvious. The incidence of male was higher than that of female (P=0.023), and the highest incidence rate was 50-59 years old. Spatial autocorrelation analysis showed that there was a positive spatial correlation between the incidence of hepatitis A in Zhejiang Province from 2010 to 2017, with the weakest correlation in 2010 (Moran's I =0.103, Z=1.769, P=0.049), and the strongest correlation in 2016 (Moran's I=0.328, Z=4.979, P=0.001). Spatiotemporal scanning analysis showed that there was spatial aggregation of hepatitis A in Zhejiang Province from 2010 to 2019, with a total of three aggregation areas identified. Among them, the mostly aggregation area was concentrated in Xiangshan county of Ningbo city, which covered 10 counties (cities and districts), including Ninghai county and Yinzhou district, and appeared from January 1 to June 30, 2012. Conclusion: The incidence level of hepatitis A in Zhejiang Province shows a stable fluctuation trend from 2010 to 2019, and the seasonal regularity is not obvious. The population group aged 50-59 years old is the key population. There is spatial aggregation in the epidemic situation of hepatitis A. Targeted prevention and control measures of hepatitis A should be done based on the law of spatiotemporal aggregation and local incidence.


Subject(s)
China/epidemiology , Cluster Analysis , Female , Hepatitis A/epidemiology , Humans , Incidence , Male , Middle Aged , Spatial Analysis
12.
Article in Chinese | WPRIM | ID: wpr-928703

ABSTRACT

OBJECTIVE@#To study the expression profiles changes of miRNA in apheresis platelets after 1, 3 and 5 days of storage.@*METHODS@#The apheresis platelets were collected from 20 volunteer blood donors. After mixing fully, the platelets were stored in a shaker with (22±2) ℃ horizontal oscillation. The samples were taken on the 1st, 3rd and 5th day, and used to sequence for miRNAs by DNA nanoball (DNB) sequencing technology, which were named as C_1, C_3 and C_5, respectively. The expression level of platelets miRNA was standardized by transcripts per kilobase million (TPM) algorithm. MiRNAs with P-value < 0.001 and the expression difference of more than two times were considered as significant difference between two groups. The expression of miRNAs was verified by real-time fluorescence quantitative PCR (RT-qPCR).@*RESULTS@#By DNB sequencing, there were 688, 730, and 679 platelet miRNAs expressed in C_1, C_3 and C_5 group, respectively. Cluster analysis showed that the expression profile of miRNAs changed significantly. The expression level of the first 20 high abundance miRNAs was about 4/5 of the total amounts of expressed miRNAs in each group, which the top five miRNAs were miR-21-5p, miR-26a-5p, miR-199a-3p, miR-126-3p, and let-7f-5p. The correlation of high abundance platelet miRNAs among the three groups was high (R2=0.876, R2=0.979, R2=0.937, respectively) and the differences were not statistically significant (P>0.05). Compared with the differential expression of platelet miRNAs with more than 1 000 TPM in the C_3 and C_1 group, there were 6 differentially expressed miRNAs, including 3 up-regulated (miR-146a-5p, miR-379-5p, and miR-486-5p) and 3 down-regulated (miR-652-3p, miR-142-5p, and miR-7-5p). While in the C_5 and C_1 group, there were 4 differentially expressed miRNAs, including 2 up-regulated (miR-146a-5p and let-7b-5p) and 2 down-regulated (miR-30d-5p and miR-142-5p). Compared with the differentially expression of platelet miRNAs between 1-1 000 TPM in the C_3 and C_1 group, there were 133 differentially expressed miRNAs, in which 99 were up-regulated and 34 were down-regulated. While in the C_5 and C_1 group, there were 77 differentially expressed miRNAs, in which 31 were up-regulated and 46 were down-regulated. The six selected differentially expressed miRNAs verified by RT-qPCR were consistent with those of sequencing.@*CONCLUSION@#The expression profiles of platelets miRNAs change significantly among 1, 3, and 5 d of storage in vitro.


Subject(s)
Blood Component Removal , Blood Platelets , Cluster Analysis , Gene Expression Profiling , Humans , MicroRNAs/genetics
13.
Einstein (Säo Paulo) ; 20: eAO6153, 2022. tab
Article in English | LILACS | ID: biblio-1360399

ABSTRACT

ABSTRACT Objective To estimate the prevalence of clustering of behavioral risk factors for chronic non-communicable diseases, as well as the associated factors in climacteric women. Methods This is a cross-sectional, analytical study, with random selection of climacteric women, aged between 40 and 65 years, and registered in Family Health Strategy units. The dependent variable was clustering of three or more behavioral risk factors for chronic non-communicable diseases. The definition of associated variables was made after Poisson multiple regression analysis with robust variance. Results We evaluated 810 women, and 259 (32.0%) had a clustering of risk factors. The main risk behaviors were physical inactivity and low fruit consumption. The variables associated with clustering of behavioral factors were age group 52-65-years, marital status without a partner, overweight/obesity, moderate to severe anxiety and depression symptoms. Conclusion There was a considerable prevalence of women with three or more behavioral risk factors for chronic non-communicable diseases. Demographic variables and those related to health conditions were shown to be associated. Considering the results recorded, health services must provide differentiated care policies to climacteric women, seeking to alleviate high morbidity and mortality of chronic non-communicable diseases.


Subject(s)
Humans , Female , Adult , Aged , Noncommunicable Diseases/epidemiology , Menopause , Cluster Analysis , Prevalence , Cross-Sectional Studies , Risk Factors , Middle Aged
14.
São Paulo; s.n; 2022. 134 p.
Thesis in Portuguese | LILACS | ID: biblio-1393141

ABSTRACT

OBJETIVOS: Avaliar completitude e oportunidade dos dados registrados no Sistema Nacional de Informação de Agravos de Notificação (SINAN) para os casos de febre maculosa (FM) no estado de São Paulo; Analisar as tendências das taxas de incidência e mortalidade por febre maculosa brasileira (FMB) com base na distribuição espacial de cada vetor; Investigar desfechos por locais de internação; Identificar quais as áreas de maior risco de ocorrência de FM, qual a sua distribuição por zona de ocupação humana e se este risco se manteve estável no território ao longo do período estudado; Projetar a provável evolução da ocorrência no tempo e no espaço. MÉTODOS: Esta tese está dividida em três manuscritos. Manuscrito 1: Trata-se de estudo descritivo e ecológico dos casos humanos confirmados de FM, notificados no SINAN de 2007 a 2017 no estado de São Paulo analisando atributos completitude e oportunidade de dez campos da ficha de notificação. Realizou-se regressão linear para avaliar as tendências das séries temporais (p<0,05). Manuscrito 2: Estudo de série temporal utilizando dados secundários de casos humanos confirmados de FMB por carrapato-vetor no estado de São Paulo, utilizando o software Joinpoint. Os dados foram georreferenciados pelos locais de internação. Manuscrito 3: Trata-se de estudo ecológico de varredura espaço-temporal de casos humanos confirmados notificados de FM com análise do risco de ocorrência da doença no local provável de infecção (LPI), por meio do SaTScan. RESULTADOS: Manuscrito 1: Foram analisados 736 registros. Dos campos essenciais, apenas Data da alta demonstrou baixa completitude (68,5%). Investigação e Encerramento tiveram boa oportunidade; demais intervalos não foram adequados. Manuscrito 2: Nas áreas de Amblyomma sculptum, houve tendência de aumento da incidência e mortalidade (ambos p<0,05), entre 2007 e 2015. Nas áreas de Amblyomma aureolatum, houve tendência de redução da incidência (p<0,05), enquanto a tendência de mortalidade permaneceu estável em todo o período estudado. A letalidade nos casos relacionados ao A. aureolatum foi maior do que nos casos de A. sculptum (67,1% contra 55,0%, p=0,037). A maioria dos pacientes foi hospitalizada próximo ao LPI. Manuscrito 3: No presente momento, comportamento predominantemente urbano para A. sculptum, A. aureolatum e Amblyomma ovale foi verificado, explicado pela atual expansão imobiliária e pelo maior contato de cães domésticos com áreas de floresta. Duas novas áreas potenciais de ocorrência da FM associadas a A. sculptum foram identificadas no período analisado; enquanto para A. aureolatum não houve nova área endêmica. CONCLUSÕES: No estado de São Paulo, a completitude dos dados de FM foi boa (80,0%) na maioria das variáveis estudadas, mas a oportunidade estudada não. Isso aponta para a importância de ações de educação e comunicação em saúde sobre FM. As curvas de incidência e mortalidade foram marcadamente diferentes de acordo com o carrapato-vetor, apontando para uma pior taxa de letalidade quando A. aureolatum foi implicado. Esses achados podem orientar ações específicas de vigilância e abordagens assistenciais, considerando os diferentes territórios. O delineamento ecológico com análise espaço-temporal permitiu melhor detecção de aglomerados de alto risco de distribuição da FM em humanos no espaço e no tempo, contribuindo para a estruturação de ações em saúde coletiva específicas para as diferentes áreas do estado.


AIM: To evaluate completeness and timeliness of data registered in the National Information System for Notifiable Diseases (SINAN) for spotted fever (SF) cases in the state of São Paulo; To analyze the trends of incidence and mortality rates caused by Brazilian spotted fever (BSF) based on each vector spatial distribution; To investigate outcomes by hospitalization sites; Identify which areas are most at risk for the occurrence of SF, their distribution by human occupation zone and whether this risk has remained stable in the territory throughout the period studied; Project the probable evolution of the occurrence in time and space. METHODS: This thesis is divided into three manuscripts. Manuscript 1: This is a descriptive and ecological study of confirmed human cases of SF, reported in Sinan from 2007 to 2017 in the state of São Paulo for completeness and timeliness of ten form fields. Linear regression was performed to analyze trends in the time series (p<0.05). Manuscript 2: A time-series study using secondary data of BSF confirmed human cases by tick-vector in the state of São Paulo, using Joinpoint software. Data was georeferenced by hospitalization sites. Manuscript 3: This was an ecological spatiotemporal clustering study of SF confirmed human cases. The risk analysis of disease occurrence by probable site of infection (PSI) was performed through SaTScan. RESULTS: Manuscript 1: A total of 736 registration were analyzed. Among essential fields, only Discharge date showed low completeness (68.5%). Investigation and Closure had good timeliness; other intervals were not adequate. Manuscript 2: In Amblyomma sculptum areas, there were upward incidence and mortality trends (both p<0.05), between 2007 and 2015. In Amblyomma aureolatum areas, there was a downward incidence trend (p<0.05), while the mortality trend remained stable through all studied period. Lethality rate in A. aureolatum related cases was higher than A. sculptum ones (67.1% against 55.0%, p=0.037). The majority of the patients were hospitalized near PSI. Manuscript 3: Currently, it was verified a predominantly urban behavior for A. sculptum, A. aureolatum, and Amblyomma ovale, which can be explained by the existing real estate expansion and by a higher exposure of pet dogs to forest areas. Two new areas with potential A. sculptum-related SF occurrence were identified, while there were no new endemic territories for A. aureolatum. CONCLUSIONS: In São Paulo, the completeness of SF data was good in most of the variables studied (80,0%), but not timeliness, highlighting the importance of education on SF. Incidence and mortality curves were markedly different according to tick-vector, pointing to a worse lethality rate when A. aureolatum was implicated. These findings may orient specific surveillance actions and assistance approaches, considering the different territories. This approach enabled a better quantification of high-risk spatiotemporal clusters of human SF, contributing for the tailoring of specific public health actions towards different state regions.


Subject(s)
Humans , Information Systems , Rocky Mountain Spotted Fever , Cluster Analysis , Risk Assessment , Public Health Surveillance
15.
Dement. neuropsychol ; 15(3): 366-372, Sept. 2021. tab
Article in English | LILACS | ID: biblio-1339788

ABSTRACT

ABSTRACT The ability to perform instrumental activities of daily living (IADLs) is an important marker within the aging process, as it reflects the level of independence to perform in the real world. However, there is a scarcity of studies that investigate the different performance profiles among older adults. Objective: To investigate the heterogeneity present in the community of elderly people, grouping them based on characteristics and patterns observed through an objective performance-based assessment. Methods: Participants were selected according to the following inclusion criteria: fluency in Portuguese, 360 years, regular participation in a social program offered by the government of Rio de Janeiro, and absence of a caregiver. The evaluation of IADLs was determined by the total and brief version of the University of California, San Diego Performance-Based Skills Assessment (UPSA) and the Lawton and Brody IADL scale. The Brief Cognitive Screening Battery and the Mini-Mental State Examination were used to characterize the sample, in addition to the Geriatric Depression Scale. A total of 61 elderly people with an average age of 72.5 years, predominantly females (85.2%), and average education of 11.2 were evaluated and grouped according to their performance at UPSA through clustering analysis. Results: The analysis revealed three grouping patterns, subdividing the sample into subgroups that differed significantly in terms of age, education, global cognition, and all instrumental activities assessed by UPSA — planning, finance, communication, transportation, and household chores. Conclusions: This study was able to identify the heterogeneity present between the elderly people in the different factors that compose the IADLs through a performance-based assessment.


RESUMO A capacidade para realização das atividades instrumentais da vida diária (AIVDs) é um importante marcador no envelhecimento, uma vez que reflete o grau de independência para atuação no mundo real. No entanto, há uma escassez de estudos que se proponham a investigar os diferentes perfis de desempenho entre idosos. Objetivo: Investigar a heterogeneidade presente em idosos da comunidade, agrupando-os a partir de características e padrões observados através de uma avaliação objetiva baseada em desempenho. Métodos: Participantes foram selecionados conforme critérios de inclusão: ter fluência no Português; ter 60 ou mais anos; participar de forma regular no programa de casas de convivência do Rio de Janeiro e não possuir cuidador. A avaliação das AIVDs foi determinada pela versão total e breve do The University of California, San Diego Performance-Based Skills Assessment (UPSA) e pela escala AIVD de Lawton e Brody. A Bateria Breve de Rastreio Cognitivo e o Miniexame do Estado Mental foram utilizados para caracterização da amostra, além da Escala de Depressão Geriátrica. Um total de 61 idosos com idade média de 72,5 anos, predominantemente do sexo feminino (85,2%) e escolaridade média de 11,2 foram avaliados e agrupados de acordo com o seu desempenho no UPSA por meio de uma análise de cluster. Resultados: A análise revelou três padrões de agrupamento, subdividindo a amostra em subgrupos que se diferenciaram significativamente em termos de idade, escolaridade, cognição global e todas as atividades instrumentais avaliadas pelo UPSA — planejamento, finanças, comunicação, transporte e habilidades domésticas. Conclusões: O presente estudo foi capaz de identificar a heterogeneidade presente na população idosa entre os diferentes fatores que compõe as AIVDs por meio de uma avaliação baseada em desempenho.


Subject(s)
Humans , Population Characteristics , Aged , Physical Functional Performance , Cluster Analysis
17.
Rev. adm. pública (Online) ; 55(4): 757-781, jul.-ago. 2021. graf
Article in Portuguese | LILACS | ID: biblio-1340886

ABSTRACT

Resumo O objetivo principal do presente trabalho é verificar como evoluiu o padrão remuneratório das diferentes carreiras com nível superior dentro do Poder Executivo Federal ao longo do período de 1998 a 2015. A justificativa para se estudar esses diferenciais salariais é que, nos últimos anos, se verificou um aumento substancial dos salários do funcionalismo público brasileiro. No entanto, os resultados obtidos pela técnica de análise de agrupamento sugerem que existe um padrão de maior valorização das carreiras chamadas típicas de Estado, em detrimento de outras. Isso revela um padrão de apreciação de salários dentro do Poder Executivo e, principalmente, um conflito distributivo interno, em que aquelas carreiras mais próximas do poder central e com as características de "típicas de Estado" foram sendo gradativamente beneficiadas, estabelecendo uma grande mudança no padrão remuneratório relativo ao longo do período analisado.


Resumen El objetivo principal del presente trabajo es verificar cómo ha evolucionado el patrón retributivo de las distintas carreras con educación superior dentro del Poder Ejecutivo federal durante el período de 1998 a 2015. La justificación para estudiar estos diferenciales salariales es que, en los últimos años, se ha verificado un aumento sustancial de los salarios de los funcionarios públicos brasileños. Sin embargo, los resultados obtenidos por la técnica de análisis de conglomerados sugieren que existe un patrón de mayor apreciación de las carreras denominadas típicas del Estado, en detrimento de otras. Esto revela un patrón de apreciación salarial al interior del Poder Ejecutivo y, principalmente, un conflicto distributivo interno, en que las carreras más cercanas al poder central y con las características de "típicas del Estado" fueron paulatinamente beneficiadas, estableciendo un cambio importante en el patrón de remuneración relativa durante el período analizado.


Abstract This paper verifies the evolution of the remuneration pattern of different higher-level careers within the Brazilian federal executive branch from 1998 to 2015. In recent years, the differences in remuneration have substantially increased in the Brazilian civil service. However, the results obtained through cluster analysis suggest a pattern of greater pay raise for "typical state careers" to the detriment of others. This reveals a pattern of salary appreciation within the executive branch and, especially, an internal distributive conflict, in which those careers closer to the central power and with characteristics of "typical state careers" were gradually benefiting, establishing a major change in the relative remuneration pattern among different careers over the studied period.


Subject(s)
Humans , Male , Female , Salaries and Fringe Benefits , Public Administration , Career Mobility , Cluster Analysis , Public Sector , Executive
18.
Poblac. salud mesoam ; 18(2)jun. 2021.
Article in Spanish | LILACS-Express | LILACS, SaludCR | ID: biblio-1386909

ABSTRACT

Resumen Objetivo: evaluar los resultados de una intervención educativa grupal en diabetes mellitus tipo 2 (DM2) para determinar la capacidad de las personas participantes en el control metabólico de la enfermedad. Metodología: se realizaron diferentes análisis estadísticos; a saber, un análisis de correlación y de conglomerados mediante tres procedimientos (K medias con valores estandarizados de las variables involucradas, análisis jerárquico con variables estandarizadas) y una combinación de análisis factorial con K medias. Además, se llevó a cabo un análisis de normalización para determinar la efectividad del Programa de Intervención Nutricional en Enfermedades Crónicas. Resultados: completaron la intervención educativa 702 personas con diabetes, de las cuales la mayoría son mujeres, con edades entre 40 y 64 años. Las variables que resultaron estadísticamente significativas (p<0,001) para el análisis de conglomerados fueron glicemia posprandial, glicemia en ayunas, hemoglobina glicosilada, colesterol total y triglicéridos, donde los valores promedio disminuyeron en todas las pruebas clínicas después de la intervención educativa. Por medio de la combinación del análisis factorial y el análisis de conglomerados se generaron tres grupos: DM2 control bajo, DM2 control medio y DM2 control alto. En el análisis de normalización, se determinó que la intervención educativa del Programa de Intervención Nutricional en Enfermedades Crónicas fue efectiva. Conclusión: los resultados de estudio permitirán enfocar los objetivos terapéuticos de la intervención educativa mediante acciones propias y de seguimiento del tratamiento de una manera más certera.


Abstract Objective: Evaluate the results of a group educational intervention in type 2 diabetes mellitus (DM2) to determine the capacity of the participants in the metabolic control of the disease. Methodology: Different statistical analyzes were performed: correlation and cluster analysis using three procedures (K means with standardized values of the variables involved, hierarchical analysis with standardized variables) and a combination of factor analysis with K means. In addition, a normalization analysis was carried out to determine the effectiveness of the Nutritional Intervention Program in Chronic Diseases. Results: 702 people with diabetes completed the educational intervention, of which the majority are women, ages between 40 and 64 years old. The variables that were statistically significant (p <0.001) for the cluster analysis were postprandial glycemia, fasting glycemia, glycated hemoglobin, total cholesterol and triglycerides, where the average values decreased in all the clinical tests after the educational intervention. Three groups were generated by combining factorial analysis and cluster analysis: low control DM2, medium control DM2 and high control DM2. In the normalization analysis, it was determined that the educational intervention of the Nutritional Intervention Program in Chronic Diseases was effective. Conclusion: The results of this study will allow us to focus on the therapeutic objectives of the educational intervention through our own actions and by monitoring the treatment in a more accurate way.


Subject(s)
Humans , Diabetes Mellitus, Type 2/prevention & control , Metabolic Equivalent , Cluster Analysis , Costa Rica
19.
Rev. bras. ter. intensiva ; 33(2): 196-205, abr.-jun. 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1289074

ABSTRACT

RESUMO Objetivo: Identificar apresentações mais graves de COVID-19. Métodos: Pacientes consecutivamente admitidos à unidade de terapia intensiva foram submetidos à análise de clusters por meio de método de explorações sequenciais Resultados: Analisamos os dados de 147 pacientes, com média de idade de 56 ± 16 anos e Simplified Acute Physiological Score 3 de 72 ± 18, dos quais 103 (70%) demandaram ventilação mecânica e 46 (31%) morreram na unidade de terapia intensiva. A partir do algoritmo de análise de clusters, identificaram-se dois grupos bem definidos, com base na frequência cardíaca máxima [Grupo A: 104 (IC95% 99 - 109) batimentos por minuto versus Grupo B: 159 (IC95% 155 - 163) batimentos por minuto], frequência respiratória máxima [Grupo A: 33 (IC95% 31 - 35) respirações por minuto versus Grupo B: 50 (IC95% 47 - 53) respirações por minuto] e na temperatura corpórea máxima [Grupo A: 37,4 (IC95% 37,1 - 37,7)ºC versus Grupo B: 39,3 (IC95% 39,1 - 39,5)ºC] durante o tempo de permanência na unidade de terapia intensiva, assim como a proporção entre a pressão parcial de oxigênio no sangue e a fração inspirada de oxigênio quando da admissão à unidade de terapia intensiva [Grupo A: 116 (IC95% 99 - 133) mmHg versus Grupo B: 78 (IC95% 63 - 93) mmHg]. Os subfenótipos foram distintos em termos de perfis inflamatórios, disfunções orgânicas, terapias de suporte, tempo de permanência na unidade de terapia intensiva e mortalidade na unidade de terapia intensiva (com proporção de 4,2 entre os grupos). Conclusão: Nossos achados, baseados em dados clínicos universalmente disponíveis, revelaram dois subfenótipos distintos, com diferentes evoluções de doença. Estes resultados podem ajudar os profissionais de saúde na alocação de recursos e seleção de pacientes para teste de novas terapias.


Abstract Objective: To identify more severe COVID-19 presentations. Methods: Consecutive intensive care unit-admitted patients were subjected to a stepwise clustering method. Results: Data from 147 patients who were on average 56 ± 16 years old with a Simplified Acute Physiological Score 3 of 72 ± 18, of which 103 (70%) needed mechanical ventilation and 46 (31%) died in the intensive care unit, were analyzed. From the clustering algorithm, two well-defined groups were found based on maximal heart rate [Cluster A: 104 (95%CI 99 - 109) beats per minute versus Cluster B: 159 (95%CI 155 - 163) beats per minute], maximal respiratory rate [Cluster A: 33 (95%CI 31 - 35) breaths per minute versus Cluster B: 50 (95%CI 47 - 53) breaths per minute], and maximal body temperature [Cluster A: 37.4 (95%CI 37.1 - 37.7)°C versus Cluster B: 39.3 (95%CI 39.1 - 39.5)°C] during the intensive care unit stay, as well as the oxygen partial pressure in the blood over the oxygen inspiratory fraction at intensive care unit admission [Cluster A: 116 (95%CI 99 - 133) mmHg versus Cluster B: 78 (95%CI 63 - 93) mmHg]. Subphenotypes were distinct in inflammation profiles, organ dysfunction, organ support, intensive care unit length of stay, and intensive care unit mortality (with a ratio of 4.2 between the groups). Conclusion: Our findings, based on common clinical data, revealed two distinct subphenotypes with different disease courses. These results could help health professionals allocate resources and select patients for testing novel therapies.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Respiration, Artificial/statistics & numerical data , Critical Illness/therapy , Critical Care/methods , COVID-19/physiopathology , Intensive Care Units , Phenotype , Severity of Illness Index , Algorithms , Cluster Analysis , Retrospective Studies , Patient Selection , Respiratory Rate/physiology , COVID-19/mortality , COVID-19/therapy , Length of Stay
20.
Rev. cuba. med ; 60(1): e1382, tab
Article in Spanish | LILACS, CUMED | ID: biblio-1156560

ABSTRACT

Introducción: A partir de la aparición de la epidemia COVID-19 se conforma un equipo multidisciplinario en Santiago de Cuba con participación de varias instituciones y activado por el Consejo de defensa provincial. El análisis integrado epidemiológico, la gestión gubernamental y la respuesta social resultarían determinantes en el control de la enfermedad. Objetivos: Identificar posibles grupos de casos con COVID-19 en la provincia Santiago de Cuba y caracterizar su transmisión según variables epidemiológicas. Métodos: Se desarrolló un estudio ecológico, comparándose los clústeres de transmisión de COVID-19. Se resumieron variables de interés y se realizó análisis de redes sociales desde el punto de vista de las relaciones entre casos y contactos, así como análisis espacial. Resultados: Se identificaron cinco grupos espaciales de transmisión en los municipios, uno en Palma Soriano, uno en Contramaestre y tres en Santiago de Cuba. Los antecedentes patológicos personales (hipertensión y procesos respiratorios), el sexo femenino, los casos sintomáticos y el promedio de 22 a 27 contactos por cada confirmado fueron las variables más relevantes. Se identificó fuente de infección introducida en 51 por ciento (25/49). Además, se identificaron redes sociales complejas en la transmisión de la enfermedad. Conclusiones: La transmisión de COVID-19 en la provincia Santiago de Cuba mostró grupos de casos y contactos con redes sociales epidemiológicas características para cada municipio, así como el modo de transmisión de acuerdo a la fuente de infección, relaciones de familiaridad o cercanía social y la relación de distancia espacial entre contactos, aspectos que influyeron en las bajas tasas de incidencia de la enfermedad, con predominio en su forma sintomática, edades jóvenes y en mujeres(AU)


Introduction: From the onset of COVID-19 epidemic, a multidisciplinary team is formed in Santiago de Cuba with the participation of several institutions and activated by the Provincial Defense Council. Integrated epidemiological analysis, government management and social response would be decisive in controlling the disease. Objectives: To identify possible groups of COVID-19 cases in the Santiago de Cuba province and to describe the transmission according to epidemiological variables. Methods: An ecological study was carried out, comparing COVID-19 transmission clusters. Variables of interest were summarized and analysis of social contact networks was carried out from the point of view of the relationships between cases and contacts, as well as spatial analysis. Results: Five spatial transmission groups were identified in the municipalities, one in Palma Soriano, one in Contramaestre and three in Santiago de Cuba. The personal pathological antecedents (hypertension and respiratory processes), female sex, symptomatic cases and the average of 22 to 27 contacts for each confirmed were the most relevant variables. A source of introduced infection was identified in 51 percent (25/49). In addition, complex social networks were identified in the transmission of the disease. Conclusions: The transmission of COVID-19 in Santiago de Cuba province showed groups of cases and contacts with characteristic epidemiological social networks for each municipality, as well as the mode of transmission according to the source of infection, relationships of familiarity or social closeness and the relationship of spatial distance between contacts, which influenced on the low incidence rates of the disease, with predominance of symptomatic form, young ages and in women(AU)


Subject(s)
Humans , Cluster Analysis , Epidemiologic Methods , Coronavirus Infections/epidemiology , Social Networking , Cuba
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