1000 resultados para COMPETITIVIDAD – MEDELLIN (ANTIOQUIA, COLOMBIA) – 2007-2011 - ESTUDIO DE CASOS
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OBJECTIVE To analyze if the distribution of specialized care services for HIV/AIDS is associated with AIDS rates. METHODS Ecological study, for which the distribution of 10 specialized care services in the Ceara state, Northeastern Brazil, was obtained, and the mean rates of the disease were estimated per mesoregion. We evaluated 7,896 individuals who had been diagnosed with AIDS, were aged 13 years or older, lived in Ceara, and had been informed of their condition between 2001 and 2011. Maps were constructed to verify the relationship between the distribution of AIDS cases and institutionalized support networks in the 2001-2006 and 2007-2011 periods. BoxMap and LisaMap were used for data analysis. The Voronoi diagram was applied for the distribution of the studied services. RESULTS Specialized care services concentrated in AIDS clusters in the metropolitan area. The Noroeste Cearense and west of the Sertoes Cearenses had high AIDS rates, but a low number of specialized care services over time. Two of these services were implemented where clusters of the disease exist in the second period. The application of the Voronoi diagram showed that the specialized care services located outside the metropolitan area covered a large territory. We identified one polygon that had no services. CONCLUSIONS The scenario of AIDS cases spread away from major urban areas demands the creation of social support services in areas other than the capital and the metropolitan area of the state; this can reduce access barriers to these institutions. It is necessary to create specialized care services for HIV/AIDS in the Noroeste Cearense and north of Jaguaribe.
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RESUMO: Este estudo foi realizado com o objectivo de conhecer os efeitos da desinstitucionalizao dos doentes psiquitricos crnicos durante o processo de encerramento do Hospital Miguel Bombarda (2007-2011). Este processo incluiu a fuso, em 2008, dos dois principais hospitais psiquitricos de Lisboa- Hospital Miguel Bombarda (HMB) e Hospital Jlio de Matos (HJM), no Centro Psiquitrico Hospitalar de Lisboa (CHPL). Foi criado um grupo controlo de pacientes ainda hospitalizados no CHPL (n=166) para comparao com o grupo de casos desinstitucionalizados (n=146). Desta amostra inicial (n=312) apenas 142 (76 casos e 66 controlos) foram includos, sendo as principais causas de excluso: diagnstico (patologia orgnica, demncia ou debilidade mental, como diagnstico primrio) e transferncia entre hospitais. A desinstitucionalizao foi principalmente avaliada em termos de psicopatologia, utilizao de servios, satisfao, crime, condio de sem abrigo ou morte. Os resultados mostraram que a maioria dos doentes crnicos pode sair do hospital psiquitrico para a comunidade sem agravamento da psicopatologia, aumento do crime ou da condio de sem abrigo. A satisfao parece estar aumentada na populao desinstitucionalizada. A mortalidade, por outro lado, revelou-se uma questo problemtica: apesar de no ter sido possvel estabelecer uma comparao entre casos e controlos, a Taxa de Mortalidade Standard encontrada neste estudo foi muito superior ao esperado, de acordo com os resultados encontrados na literatura. Um estudo longitudinal da mesma populao poder ser objecto de futura investigao, possivelmente comparada com outra populao similar de um programa de desinstitucionalizao noutro pas.--------- RSUM: Cette tude a t mene afin de dterminer les effets de la dsinstitutionnalisation des patients chroniques lors de la fermeture de l'hpital Miguel Bombarda (2007-2011). Ce processus comprenait la fusion en 2008 de deux grands hpitaux psychiatriques de Lisbonne: savoir, Hpital Miguel Bombarda (HMB) et Hpital Julio de Matos (HJM), maintenant Centre de l'Hpital Psychiatrique de Lisbonne (CHPL). Il a t cr un groupe contrle des patients toujours hospitaliss CHPL (n = 166) pour comparer avec les cas dsinstitutionnaliss (n = 146). De cet chantillon initial (n= 312) peine 142 (76 cas et 66 contrles) ont t inclus, les principales raisons d'exclusion: diagnostique (maladie organique, dmence ou d'arriration mentale comme diagnostic primaire) et les transferts entre hpitaux. La dsinstitutionnalisation a t principalement value en termes de psychopathologie, de l'utilisation des services, la satisfaction, la criminalit, les sans abri et de la mort. Les rsultats ont montr que la majorit des malades chroniques peuvent quitter l'hpital psychiatrique et sintgrer dans la communaut sans aggravation de la psychopathologie, augmentation de la criminalit ou du nombre de sans-abri. La satisfaction semble tre en hausse dans la population dsinstitutionnalise. Toutefois, la mortalit s'est avr tre une question problmatique, mme si il na pas t possible d'tablir une comparaison entre les cas et les contrles, le Taux de Mortalit Standard estim dans cette tude fut beaucoup plus lev que prvu, en tenant compte des rsultats tablis dans la littrature. Une tude longitudinale de la mme population pourra faire l'objet de futures recherches, peut-tre compar une population similaire d'un programme de dsinstitutionnalisation dans un autre pays. ----------- ABSTRACT:This study was conducted to assess the effects of deinstitutionalization of long-stay patients during the process of closing Hospital Miguel Bombarda (2007-2011). This process included the fusion, in 2008, of the two main psychiatric hospitals in Lisbon- Hospital Miguel Bombarda (HMB) and Hospital Jlio de Matos (HJM), into Centro Psiquitrico Hospitalar de Lisboa (CHPL). A control group of still institutionalized patients in CHPL (n=166) was used as a comparison with the deinstitutionalized population (n=146). Of this 312 initial sample only 142 (76 cases and 66 controls) were included, the main causes of exclusion being diagnoses (organic disease, dementia and mental retardation- as first diagnoses) and transference between hospitals. Deinstitutionalization is mainly evaluated in terms of psychopathology, use of services, satisfaction, crime, vagrancy and deaths. The results show that most long-stay patients can successfully leave psychiatric hospitals and be relocated in the community without an increase in psychopathology, crime or vagrancy. Satisfaction seems to be improved in those patients. On the other hand, mortality remains an issue of concern: Although there was no possibility of comparing it between cases and controls, the Standard Mortality Rate (SMR) in our study was found to be much higher than expected judging by other studies results. A longitudinal further study of this same population will be the matter for a future investigation, possibily compared with another similar population from a desinstitutionalization programme in another country.
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Dissertao apresentada para cumprimento dos requisitos necessrios obteno do grau de Mestre em Gesto do Territrio, rea de especializao em Territrio e Desenvolvimento
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A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics
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This study compared the serum levels of IL-6, TNF-alpha and IFN-gamma, in children under 1 year of age with and without dengue. Sera were collected from a total of 41 children living in the Department of Antioquia, Colombia (27 patients with dengue and 14 controls). The results showed higher cytokine levels in children with dengue than without dengue, with statistically significant differences for IL-6 and IFN-gamma. No statistically significant differences were found between clinical forms, although IL-6 and IFN-gamma levels were higher in dengue fever cases than in dengue hemorrhagic fever cases. On the other hand, TNF-alpha levels were higher in dengue hemorrhagic fever than in dengue fever. The levels of IL-6 and TNF-alpha were higher in secondary infection than in primary infection, although IFN-gamma levels were higher in primary infection. These results suggest that IL-6, TNF-alpha and IFN-gamma are involved in dengue infection independently of the clinical form.
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O objetivo deste trabalho apresentar os aspectos clnicos e epidemiolgicos das crianas acometidas por dengue, em Manaus, AM, no perodo de 2006 a 2007. Foram analisados 482 casos de dengue confirmados laboratorialmente, em 2006, sendo 46,9% nos menores de 15 anos, e 1.538 casos, em 2007, sendo 57,7% nos menores de 15 anos. Os dados foram obtidos do Sistema Nacional de Agravos de Notificao (SINAN) de Manaus. As variveis analisadas foram: idade, gnero, bairro de residncia, ms do inicio dos sintomas, sorotipo e forma clnica da doena. Verificou-se um aumento estatisticamente significativo da proporo de casos em menores de 15 anos, bem como das formas graves entre 2006 e 2007. Apesar de a forma hemorrgica ter sido quase trs vezes mais freqente em 2007, houve uma reduo do coeficiente de letalidade. Os sorotipos identificados foram DEN-3 em 2006 e DEN-1, DEN-2 e DEN-3 em 2007. Em 2007, houve registro de casos em todos os meses do ano.
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O presente trabalho objetivou descrever a epidemiologia e a expanso da leishmaniose visceral no municpio de Vrzea Grande/Mato Grosso/Brasil de 1998 a 2007. Foram notificados 48 casos humanos, com taxa de incidncia de at 11,7 por 100.000 habitantes, preferencialmente em crianas e adolescentes de ambos os sexos, com acentuada expanso geogrfica da doena no municpio.
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Los psicticos presentan mayor riesgo cardiovascular y peor control de sus factores de reisgo segn la bibliografa. Se presenta un estudio de casos y control para comparar psicticos vs no psicticos atendidos en un centro de atencin primaria durante 2010. El tabaquismo es ms prevalente y ms frecuentemente interrogado en psicticos, y el ndice de masa corporal ms medido en no-psicticos, aunque no hay otras diferencias significativas en el registro y control de factores de riesgo cardiovascular, por lo que no se puede concluir que la psicosis y su tratamiento supongan un riesgo cardiovascular aumentado.
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The finding of Panstrongylus geniculatus nymphs inside a house in northeastern Antioquia, Colombia, and the reports related to their increasing presence in homes suggest the need for surveillance methods for monitoring the invasion processes. We analyzed the morphological differences between a wild population and its laboratory descendants, using the techniques of geometric morphometry, with the idea that such differences might parallel those between sylvatic and synanthropic populations. The analyses over five generations showed differences in size but not in shape. Head size and wing size were both reduced from sylvatic to laboratory populations, but the decrease in head size occurred only up to the second generation while the decrease in wing size proceeded up to the fifth generation. In contrast, although a decrease in sexual size dimorphism has been proposed as a marker of colonization in human dwellings, we did not detect any significant loss of dimorphism between sexes of P. geniculatus over the five generations studied. We conclude that size changes may have a physiological origin in response to a change of ecotopes, but more than five generations may be required for the expression of permanent morphological markers of human dwellings colonization.
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Aquest estudi va analitzar la interacci del canvi organitzatiu, els valors culturals i el canvi tecnolgic en el sistema sanitari catal. L'estudi se subdivideix en cinc parts diferents. La primera s una anlisi de contingut de webs relacionats amb la salut a Catalunya. La segona s un estudi dels usos d'Internet en qestions relacionades amb la salut entre la poblaci en general, les associacions de pacients i els professionals de la salut, i es basa en un sondeig per Internet adaptat a cada un d'aquests grups. La tercera part s un estudi de treball de camp dels programes experimentals duts a terme pel Govern catal en diverses rees i hospitals locals per a integrar electrnicament la histria clnica dels pacients. La quarta s un estudi de les implicacions organitzatives de la introducci de sistemes d'informaci en la gesti d'hospitals i centres d'assistncia primria a l'Institut Catal de Salut, el principal provedor de salut pblica a Catalunya, i es basa en un sondeig per Internet i entrevistes en profunditat. La cinquena part s un estudi de cas dels efectes organitzatius i socials de la introducci de les tecnologies de la informaci i la comunicaci en un dels principals hospitals de Catalunya, l'Hospital Clnic de Barcelona. L'estudi es va dur a terme entre el maig del 2005 i el juliol del 2007.
