RESUMO
BACKGROUND: Understanding non-epidemiological factors is essential for the surveillance and prevention of infectious diseases, and the factors are likely to vary spatially and temporally as the disease progresses. However, the impacts of these influencing factors were primarily assumed to be stationary over time and space in the existing literature. The spatiotemporal impacts of mobility-related and social-demographic factors on disease dynamics remain to be explored. METHODS: Taking daily cases data during the coronavirus disease 2019 (COVID-19) outbreak in the US as a case study, we develop a mobility-augmented geographically and temporally weighted regression (M-GTWR) model to quantify the spatiotemporal impacts of social-demographic factors and human activities on the COVID-19 dynamics. Different from the base GTWR model, the proposed M-GTWR model incorporates a mobility-adjusted distance weight matrix where travel mobility is used in addition to the spatial adjacency to capture the correlations among local observations. RESULTS: The results reveal that the impacts of social-demographic and human activity variables present significant spatiotemporal heterogeneity. In particular, a 1% increase in population density may lead to 0.63% more daily cases, and a 1% increase in the mean commuting time may result in 0.22% increases in daily cases. Although increased human activities will, in general, intensify the disease outbreak, we report that the effects of grocery and pharmacy-related activities are insignificant in areas with high population density. And activities at the workplace and public transit are found to either increase or decrease the number of cases, depending on particular locations. CONCLUSIONS: Through a mobility-augmented spatiotemporal modeling approach, we could quantify the time and space varying impacts of non-epidemiological factors on COVID-19 cases. The results suggest that the effects of population density, socio-demographic attributes, and travel-related attributes will differ significantly depending on the time of the pandemic and the underlying location. Moreover, policy restrictions on human contact are not universally effective in preventing the spread of diseases.
Assuntos
COVID-19 , COVID-19/epidemiologia , Demografia , Surtos de Doenças/prevenção & controle , Humanos , Viagem , Doença Relacionada a ViagensRESUMO
The department of X-ray diagnostics of the out-patient center was used to carry out a sociological survey with the purpose of studying such social demographic characteristics of patients as level of education, material condition, benefits availability, degree of employment. The patients of advanced age visit the out-patient center most often for X-ray examinations because of diseases of nervous system, neoplasms and diseases of musculoskeletal system. In average, the patients wait their line for examination during up to three days. In both cases of implementing examination by appointment of hospital physician or by initiative of patient oneself (for fee) waiting time decreases. The main causes of using of paid medical care is the queue for free-of-charge examination and lacking of needed physician in polyclinic. The most of patients characterize scope of services provided in out-patient center as inadequate. At that, less than a half of respondents are agreed for broadening of paid diagnostic services. The readiness of patients for broadening of scope of paid services at the pre-hospital stage of treatment depend on their economic condition and employment status. The maximal readiness is expressed by working people with good economic condition. The application of obtained data provides an opportunity of optimizing of diagnostic care optimization.
Assuntos
Assistência Ambulatorial , Avaliação das Necessidades , Pacientes Ambulatoriais , Idoso , Emprego , Humanos , Pessoa de Meia-Idade , Salários e Benefícios , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To determine the prevalence, social demographic characteristics and types of pelvic organ prolapse that patients present with at the Tamale Teaching Hospital (TTH). METHODS: A descriptive study of pelvic organ prolapses at the Tamale Teaching Hospital from 1(st) January 2010 to 31(st) December 2011. RESULTS: The 118 pelvic organ prolapse cases constituted (2.68%) of the 4403 gynaecological out-patient cases seen during the two year study period. The mean age and standard deviation was (45.9± 15.1) and the modal age group was 30-39 years with 32 (27.1%) of cases. There were 112 (94.9%) cases of uterine prolapse, 95 (80.5%) had cystocele, 16 (13.5%) patients had rectoceles and 3 (2.5%) had enterocele. Their main occupations were trading 66 (55.9%) and farming 44 (37.3%), seventy (62.5%) of the patients with uterine prolapse were premenopausal while (10) 14.3% of the premenopausal cases had an ongoing pregnancy. The parity ranged from zero to 13 with mean and standard deviation of (4.4±1.7). Fifty five (46.6%) were from the Tamale metropolis and only 12 (10.5%) had all their deliveries in hospital. The commonest complication was decubitus ulcer present in 20 (16.9%) patients, 16(80%) of it in patients with procedentia. CONCLUSION: Pelvic organ prolapse is not a rare gynaecological condition at the Tamale Teaching Hospital. The patients are relatively young and are from various districts in the northern region. Some occupational, socio-cultural practices and reproductive characteristics may be contributory to severity of pelvic organ prolapse.
Assuntos
Cistocele/epidemiologia , Hérnia/epidemiologia , Retocele/epidemiologia , Prolapso Uterino/epidemiologia , Adulto , Idoso , Cistocele/complicações , Parto Obstétrico/estatística & dados numéricos , Feminino , Gana/epidemiologia , Hérnia/complicações , Parto Domiciliar/estatística & dados numéricos , Humanos , Pessoa de Meia-Idade , Ocupações , Paridade , Pós-Menopausa , Pré-Menopausa , Úlcera por Pressão/etiologia , Prevalência , Retocele/complicações , Prolapso Uterino/complicações , Adulto JovemRESUMO
The health care needs of elderly people were influenced by their heterogeneity. This study aimed to identify the health latent classes of elderly people by using latent class analysis to deal with heterogeneity and examine their socio-demographic characteristics. Data came from the 2005 National Health Interview Survey (NHIS) in Taiwan. In total, 2449 elderly individuals with available health indicators were examined in latent class analysis (LCA), and 2217 elderly community-dwellings with complete socio-demographic data were analyzed by multinomial logistic regression. Four health latent classes were identified which included 1066 (43.5%) people in the High Comorbidity (HC), 152 (6.2%) in the Functional Impairment (FI), 252 (10.3%) in the Frail (FR), and 979 (40.0%) in the Relatively Healthy (RH) group. Multinomial logistic regressions revealed socio-demographic characteristics among health classes. The variables associated with an increased likelihood of being in the FR group were age, female, and living with families. They were also correlated to ethnicity and educations. Apart from age and gender, the Functional Impairment group was less likely to be ethnicity of Hakka, more likely to live with others than were the RH group. The HC group tended to be younger, with higher educations, and more likely to live in urban area than the Functional Impairment group. The correlations between health classes and socio-demographic factors were discussed. The health status of elderly people includes a variety of health indicators. A person-centered approach is critical to identify the health heterogeneity of elderly people and manage their care needs by targeting differential aging.
Assuntos
Envelhecimento , Nível de Saúde , Características de Residência , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Atenção à Saúde , Feminino , Necessidades e Demandas de Serviços de Saúde , Indicadores Básicos de Saúde , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Fatores Socioeconômicos , TaiwanRESUMO
CONTEXT: The multifactorial nature of falls among elderly people is well-known. Identifying the social-demographic characteristics of elderly people who fall would enable us to define the typical profile of the elderly who are at risk of falling. OBJECTIVE: We aimed to isolate studies in which the social-demographic risk factors for falls among the elderly have been evaluated and to carry out a meta-analysis by combining the results of all of these selected studies. METHOD: We did a systematic literature review using the key words "accidental fall / numerical data" and "risk factors." Inclusion criteria entailed the selection of articles with the following characteristics: population of subjects aged 60 years or over, falls that took place in everyday life, and social-demographic risk factors for falls. RESULTS: 3,747 indexed articles published between 1981 and 2007 were identified, and 177 studies with available data were included, of which 129 had data on social-demographic risk factors for falls. Difficulties in activities of daily living (ADL) or in instrumental activities of daily living (IADL) double the risk of falling: The OR and 95 percent Cl were 2.26 (2.09, 2.45) for disturbance ADL and 2.10 (1.68, 2.64) for IADL. The OR and 95 percent Cl for Caucasians were 1.68 (0.98 - 2.88) and 0.64 (0.51 - 0.80) for Hispanics. In the subgroup of patients older than eighty, being married protected people from falling with an OR and 95 percent Cl =0.68 (0.53 - 0.87). CONCLUSION: Defining factors that create a risk of falling and protect elderly people from falls using social-demographic characteristics lets us focus on an "at risk" population for which a specific program could be developed.