946 resultados para Coincident and leading indicators


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The aim of this study was to analyze the association between risk behaviors and adiposity indicators in adolescents and to discuss some methodological aspects related to this relationship. We evaluated 1,321 adolescents (55.2% female) aged 10-16 years. Relative body fat (%fat) by measurement of triceps and subscapular skinfold thickness and waist circumference (WC) were used as total and central adiposity indicators, respectively. Physical inactivity, time spent in front of the TV, the consumption of soda and/or chocolate, alcohol, and tobacco smoking were analyzed as risk behaviors. Information about the socioeconomic status (categorized into three levels) and nutritional status of the mother (overweight or normal weight) were used as adjustment factors in the analyses of prevalence ratio (PR) of the outcomes and their associated 95% confidence intervals (95% CI). The chi-square test and Poisson regression were used for statistical analyses. Low associations were found between risk behaviors and adiposity indicators. Tobacco smoking was the most positively correlated behavior with adiposity in girls (%fat: PR = 1.61; 95% CI = 1.04-2.47; WC: PR = 1.90; 95% CI = 1.17-3.08) and in adolescents whose mothers were normal weight (%fat: PR = 2.31; 95% CI = 1.33-4.03; WC: PR: 2.31; CI: 1.19-4.46). Additionally, as an important methodological issue, we highlighted the assessment of risk behaviors in adolescents as crucial to producing more robust evidence on the subject. Of the investigated behaviors, we concluded that tobacco smoking is the behavior most associated with adiposity indicators.

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Fresh-water diatoms are present in coal, and tonsteins (altered volcanic ash) are interbedded with the coal, in the Miocene Venado Formation on the southwest margin of the Limon Basin, in Provincia Alajuela, northern Costa Rica. The Venado Formation is composed of more than 300 m of mudstone, siltstone, sandstone, limestone, volcaniclastics, and coal beds. The coal beds are of unknown lateral extent and mainly occur in the middle part of the formation. The Pataste coal bed occurs near the middle of the formation and is divided into three parts by two tonstein layers. The abundance of biogenic opaline material (diatoms) in the coal is believed to be a direct response to an influx of silica from volcanic tuffs that Later altered to the tonsteins. Diatoms are a useful microscopic tool for identifying the depositional environments of the Pataste coal deposit. The diatoms identified include Aulacosira ambigua, Pinnularia sp., Eunotia spp., and Achnanthes exigua, among others. The abundance of Aulacosira arnbigua suggests that an open-water lacustrine environment was present locally. Achnanthes exigua and the remaining diatom species are benthic forms that lived in shallow fresh-water to slightly acidic swamp environments. The different types of diatoms found in the coal indicate that swamp environments were intermixed with lacustrine environments during the formation of the peat deposit or that the coal records environmental changes through time.

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The objective of this quantitative, correlational and descriptive study was to analyze the time the nursing staff spends to assist patients in Adult Intensive Care Units, as well as to verify its correlation with quality care indicators. The average length of time spent on care and the quality care indicators were identified by consulting management instruments the nursing head of the Unit employs. The average hours of nursing care delivered to patients remained stable, but lower than official Brazilian agencies' indications. The correlation between time of nursing care and the incidence of accidental extubation indicator indicated that it decreases with increasing nursing care delivered by nurses. The results of this investigation showed the influence of nursing care time, provided by nurses, in the outcome of care delivery.

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Obesity is a chronic disease characterized by increased accumulation of body fat. We evaluated the socioeconomic aspects, body composition, risk of metabolic complications associated with obesity, eating habits and lifestyle in both women and men adults and elderly with body mass index (BMI) 40 kg/m(2). Among the subjects studied, 79% (n = 32) are female, 5% (n = 2) smokers, 39% (n = 16) use alcohol and only 24% (n = 10) are practitioners of physical exercise. The higher food intake was breads, followed by rice. The daily intake of fruits and vegetables is low. Positive correlation between consumption of sugar and BMI and abdominal circumference (AC) was observed. In summary, was found that morbidly obese patients that looking for nutritional counseling presents increased body fat, poor eating habits and sedentary lifestyle.

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Soil is a critically important component of the earth’s biosphere. Developing agricultural production systems able to conserve soil quality is essential to guarantee the current and future capacity of soil to provide goods and services. This study investigates the potential of microbial and biochemical parameters to be used as early and sensitive soil quality indicators. Their ability to differentiate plots under contrasting fertilization regimes is evaluated based also on their sensitivity to seasonal fluctuations of environmental conditions and on their relationship with soil chemical parameters. Further, the study addresses some of the critical methodological aspects of microplate-based fluorimetric enzyme assays, in order to optimize assay conditions and evaluate their suitability to be used as a toll to asses soil quality. The study was based on a long-term field experiment established in 1966 in the Po valley (Italy). The soil was cropped with maize (Z. mays L.) and winter wheat (T. aestivum L.) and received no organic fertilization, crop residue or manure, in combination with increasing levels of mineral N fertilizer. The soil microbiota responded to manure amendment increasing it biomass and activity and changing its community composition. Crop residue effect was much more limited. Mineral N fertilization stimulated crop residue mineralization, shifted microbial community composition and influenced N and P cycling enzyme activities. Seasonal fluctuations of environmental factors affected the soil microbiota. However microbial and biochemical parameters seasonality did not hamper the identification of fertilization-induced effects. Soil microbial community abundance, function and composition appeared to be strongly related to soil organic matter content and composition, confirming the close link existing between these soil quality indicators. Microplate-based fluorimetric enzyme assays showed potential to be used as fast and throughput toll to asses soil quality, but required proper optimization of the assay conditions for a precise estimation of enzymes maximum potential activity.

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BACKGROUND: We have carried out an extensive qualitative research program focused on the barriers and facilitators to successful adoption and use of various features of advanced, state-of-the-art electronic health records (EHRs) within large, academic, teaching facilities with long-standing EHR research and development programs. We have recently begun investigating smaller, community hospitals and out-patient clinics that rely on commercially-available EHRs. We sought to assess whether the current generation of commercially-available EHRs are capable of providing the clinical knowledge management features, functions, tools, and techniques required to deliver and maintain the clinical decision support (CDS) interventions required to support the recently defined "meaningful use" criteria. METHODS: We developed and fielded a 17-question survey to representatives from nine commercially available EHR vendors and four leading internally developed EHRs. The first part of the survey asked basic questions about the vendor's EHR. The second part asked specifically about the CDS-related system tools and capabilities that each vendor provides. The final section asked about clinical content. RESULTS: All of the vendors and institutions have multiple modules capable of providing clinical decision support interventions to clinicians. The majority of the systems were capable of performing almost all of the key knowledge management functions we identified. CONCLUSION: If these well-designed commercially-available systems are coupled with the other key socio-technical concepts required for safe and effective EHR implementation and use, and organizations have access to implementable clinical knowledge, we expect that the transformation of the healthcare enterprise that so many have predicted, is achievable using commercially-available, state-of-the-art EHRs.