Patterns of self-care in adults with heart failure and their associations with sociodemographic and clinical characteristics, quality of life, and hospitalizations: A cluster analysis

Background: Self-care is important in heart failure (HF) treatment, but patients may have difficulties and be inconsistent in its performance. Inconsistencies in self-care behaviors may mirror patterns of self-care in HF patients that are worth identifying to provide interventions tailored to patients. Objectives: The aims of this study are to identify clusters of HF patients in relation to self-care behaviors and to examine and compare the profile of each HF patient cluster considering the patient's sociodemographics, clinical variables, quality of life, and hospitalizations. Methods: This was a secondary analysis of data from a cross-sectional study in which we enrolled 1192 HF patients across Italy. A cluster analysis was used to identify clusters of patients based on the European Heart Failure Self-care Behaviour Scale factor scores. Analysis of variance and [chi]2 test were used to examine the characteristics of each cluster. Results: Patients were 72.4 years old on average, and 58% were men. Four clusters of patients were identified: (1) high consistent adherence with high consulting behaviors, characterized by younger patients, with higher formal education and higher income, less clinically compromised, with the best physical and mental quality of life (QOL) and lowest hospitalization rates; (2) low consistent adherence with low consulting behaviors, characterized mainly by male patients, with lower formal education and lowest income, more clinically compromised, and worse mental QOL; (3) inconsistent adherence with low consulting behaviors, characterized by patients who were less likely to have a caregiver, with the longest illness duration, the highest number of prescribed medications, and the best mental QOL; (4) and inconsistent adherence with high consulting behaviors, characterized by patients who were mostly female, with lower formal education, worst cognitive impairment, worst physical and mental QOL, and higher hospitalization rates. Conclusion: The 4 clusters identified in this study and their associated characteristics could be used to tailor interventions aimed at improving self-care behaviors in HF patients

Analysis of the evolution of the Spanish labour market through unsupervised learning

Unemployment in Spain is one of the biggest concerns of its inhabitants. Its unemployment rate is the second highest in the European Union, and in the second quarter of 2018 there is a 15.2% unemployment rate, some 3.4 million unemployed. Construction is one of the activity sectors that have suffered the most from the economic crisis. In addition, the economic crisis affected in different ways to the labour market in terms of occupation level or location. The aim of this paper is to discover how the labour market is organised taking into account the jobs that workers get during two periods: 2011-2013, which corresponds to the economic crisis period, and 2014-2016, which was a period of economic recovery. The data used are official records of the Spanish administration corresponding to 1.9 and 2.4 million job placements, respectively. The labour market was analysed by applying unsupervised machine learning techniques to obtain a clear and structured information on the employment generation process and the underlying labour mobility. We have applied two clustering methods with two different technologies, and the results indicate that there were some movements in the Spanish labour market which have changed the physiognomy of some of the jobs. The analysis reveals the changes in the labour market: the crisis forces greater geographical mobility and favours the subsequent emergence of new job sources. Nevertheless, there still exist some clusters that remain stable despite the crisis. We may conclude that we have achieved a characterisation of some important groups of workers in Spain. The methodology used, being supported by Big Data techniques, would serve to analyse any alternative job market.Ministerio de Economía y Competitividad TIN2014-55894-C2-R y TIN2017-88209-C2-2-R, CO2017-8678

Assessing care

The objective of this report is to summarize progress towards measurement of selected childcare and feeding practices, and to discuss the feasibility and usefulness of these measurements in research and program contexts. This is the third in a series of reports documenting insights regarding care and measurement of care gained from the Accra Urban Food and Nutrition Study (AUFNS). This last report complements the previous two by providing an extensive review of the published literature on experience with the measurement of selected dimensions of care.FCND ,Child Feeding. ,Child care. ,