206 research outputs found
New strategies for finding multiplicative decompositions of probability trees
Probability trees are a powerful data structure for representing probabilistic potentials. However, their complexity can become intractable if they represent a probability distribution over a large set of variables. In this paper, we study the problem of decomposing a probability tree as a product of smaller trees, with the aim of being able to handle bigger probabilistic potentials. We propose exact and approximate approaches and evaluate their behaviour through an extensive set of experiments
Colectivos invisibilizados: las mujeres sin hogar
El objetivo de este trabajo es conocer la situación de las mujeres sin hogar, abordando la interacción de la situación de pobreza desde la variable del género. De forma estudiamos el citado objetivo para ver qué diferencias existen con respecto al masculino. Se trata de conocer las problemáticas, necesidades y violencias sufridas por las mujeres sin hogar además de considerar cómo se interviene desde el Trabajo social con este colectivo. Para la realización del trabajo, utilizaremos una aproximación metodológica mixta, cuantitativamente mediante el uso de fuentes secundarias extraÃdas de fuentes públicas y privadas y cualitativamente a través de entrevistas semiestructuradas realizadas a profesionales de Trabajo Social de Zaragoza. Como primeras conclusiones, quiero señalar cómo el género invisibiliza a las mujeres sin hogar frente a los hombres en similares situaciones.<br /
Eficà cia de l'auto-mesura de pressió arterial com a mètode diagnòstic d'hipertensió en Atenció Primà ria
Prevalence of Post COVID-19 Condition in Primary Care : A Cross Sectional Study
Background: The COVID-19 pandemic is a major challenge for health systems, citizens and policymakers worldwide. It is not known how many people are affected with longer term se-quelae after acute COVID-19 and a wide range of prevalence estimates have been reported with a high heterogeneity between studies. Methods: We designed a cross-sectional study to estimate the prevalence of post COVID-19 conditions in a community setting. We selected a random sample of 579 individuals from three different primary health care centers and collected information on symptoms through a standardized questionnaire. Results: Our main study finding was an overall population prevalence of 14.34% (95% CI 11.58%-17.46%) of post COVID-19. Only 9% of patients were hospitalized in our study. Prevalence was higher in women than men (15.63% versus 13.06%) and the most frequent persistent symptoms were fatigue (44.6%), smell impairment (27.7%) and dysp-nea (24.09%). Conclusions: The prevalence of post COVID-19 condition was lower than expected according to other studies published in the literature. The prevalence was higher in women than men, and the most frequent persistent symptoms were fatigue, smell impairment, and dyspnea
Factorisation of Probability Trees and its Applications
Bayesian networks can be seen as a factorisation of a joint probability distribution over a set of variables, based on the conditional independence relations amongst the variables. In this paper we show how it is possible to achieve a finer factorisation decomposing the origninal factors in which some conditions hols. The new ideas can be applied to algorithms able to deal wih factorised probabilistic potentials, as Lazy Propagation, Lazy-Penniless and Importance Sampling
Effect of a multicomponent exercise program and cognitive stimulation (VIVIFRAIL-COGN) on falls in frail community older persons with high risk of falls: study protocol for a randomized multicenter control trial
Cognitive function; Falls; FracturesFunción cognitiva; CaÃdas; FracturasFunció cognitiva; Caigudes; FracturesBackground
Falls represent important drivers of intrinsic capacity losses, functional limitations and reduced quality of life in the growing older adult’s population, especially among those presenting with frailty. Despite exercise- and cognitive training-based interventions have shown effectiveness for reducing fall rates, evidence around their putative cumulative effects on falls and fall-related complications (such as fractures, reduced quality of life and functional limitations) in frail individuals remains scarce. The main aim of this study is to explore the effectiveness program combining an individualized exercise program and an executive function-based cognitive training (VIVIFRAIL-COGN) compared to usual care in the prevention of falls and fall-related outcomes over a 1-year follow-up.
Methods
This study is designed as a four-center randomized clinical trial with a 12-week intervention period and an additional 1-year follow-up. Three hundred twenty frail or pre-frail (≥ 1 criteria of the Frailty Phenotype) older adults (≥ 75 years) with high risk of falling (defined by fall history and gait performance) will be recruited in the Falls Units of the participating centers. They will be randomized in a 1:1 ratio to the intervention group (IG) or the control group (CG). The IG will participate in a home-based intervention combining the individualized Vivifrail multicomponent (aerobic, resistance, gait and balance and flexibility) exercise program and a personalized executive function-based cognitive training (VIVIFRAIL-COGN). The CG group will receive usual care delivered in the Falls Units, including the Otago Exercise Program. Primary outcome will be the incidence of falls (event rate/year) and will be ascertained by self-report during three visits (at baseline, and 6 and 12 weeks) and telephone-based contacts at 6, 9 and 12 months after randomization. Secondarily, effects on measures of physical and cognitive function, quality of life, nutritional, muscle quality and psychological status will be evaluated.
Discussion
This trial will provide new evidence about the effectiveness of an individualized multidomain intervention by studying the effect of additive effects of cognitive training and physical exercise to prevent falls in older frail persons with high risk of falling. Compared to usual care, the combined intervention is expected to show additive effects in the reduction of the incidence of falls and associated adverse outcomes.The present study is funded by a grant from the Spanish Ministry of Science and Innovation and the Instituto de Salud Carlos III (PI20/01546). Funder Agencies do not play any role in the conducting of the study. Instituto de Salud Carlos III,PI20/01546,Alvaro Casas-Herrer
Promoting social capital, self-management and health literacy in older adults through a group-based intervention delivered in low-income urban areas : results of the randomized trial AEQUALIS
Altres ajuts: Recercaixa (2014ACUP00207)Background: Evidence is scarce on how to promote health and decrease cumulative inequalities for disadvantaged older people. Downstream complex interventions focusing on intermediate factors (self-management, health literacy and social capital) may have the potential to mitigate the inequitable impacts of social determinants in health. The aim of the AEQUALIS study was to assess the effectiveness of a group-based intervention to improve self-perceived health as indicator of health inequality. Methods: Pragmatic randomised clinical trial addressed to older adults (≥ 60 years) living in urban disadvantaged areas with low self-perceived health. The intervention was delivered in primary care settings and community assets between 2015 and 2017 and consisted in 12 weekly sessions. The primary outcome was self-perceived health assessed in two ways: with the first item of the SF-12 questionnaire, and with the EQ-5D visual analog scale. Secondary outcomes were health-related quality of life, social capital, self-management, mental health and use of health services. Outcomes were assessed at baseline, post intervention and follow-up at 9 months after the end of the intervention. Results: 390 people were allocated to the intervention group (IG) or the control group (CG) and 194 participants and 164 were included in the data analysis, respectively. Self perceived health as primary outcome assessed with SF-12-1 was not specifically affected by the intervention, but with the EQ-5D visual analog scale showed a significant increase at one-year follow-up only in the IG (MD=4.80, 95%CI [1.09, 8.52]). IG group improved health literacy in terms of a better understanding of medical information (− 0.62 [− 1.10, − 0.13]). The mental component of SF-12 improved (3.77 [1.82, 5.73]), and depressive symptoms decreased at post-intervention (− 1.26 [− 1.90, − 0.63]), and at follow-up (− 0.95 [− 1.62, − 0.27]). The use of antidepressants increased in CG at the follow-up (1.59 [0.33, 2.86]), while it remained stable in the IG. Conclusions: This study indicates that a group intervention with a strong social component, conducted in primary health care and community assets, shows promising effects on mental health and can be used as a strategy for health promotion among older adults in urban disadvantaged areas. Trial registration: ClinicalTrials.gov, NCT02733523. Registered 11 April 2016 - Retrospectively registere
Adolescentes y jóvenes migrantes no acompañados/as: de la discriminación al reconocimiento de los saberes
El artÃculo presenta una investigación aplicada sobre la realidad de los y las Menores Migrantes No Acompañados/das (MMNA), y los jóvenes que llegan a la mayorÃa de edad. A lo largo de más de 20 años del fenómeno en el Estado Español existen numerosos estudios sobre el tema, no obstante, pocos que cuestionen la representación social de las migraciones de los menores. Se utilizó una metodologÃa cualitativa y participativa, con la utilización de la entrevista como instrumento de recogida de datos y, a la vez, se generaron espacios grupales participativos para promover el diálogo entre los diferentes actores. Se presentan una sÃntesis de las narrativas y de las experiencias de adolescentes y jóvenes que migraron solos; las representaciones, discursos y saberes (co)existentes sobre estos y estas; y finalmente, explicamos cómo una experiencia de auto-orgnización se ha constituido como un espacio de conocimiento y reconocimiento de su realidad y cómo la participación y auto-organización pueden influir en la concienciación polÃtica y en la reivindicación de los derechos de las personas migrantes. Concluimos resaltando la importancia de reflexionar e incidir en un cambio de paradigmas en la investigación aplicada y la intervención en el ámbito social
The ERICE-score: the new native cardiovascular score for the low-risk and aged mediterranean population of Spain
[Abstract] Introduction and objectives. In Spain, data based on large population-based cohorts adequate to provide an accurate prediction of cardiovascular risk have been scarce. Thus, calibration of the EuroSCORE and Framingham scores has been proposed and done for our population. The aim was to develop a native risk prediction score to accurately estimate the individual cardiovascular risk in the Spanish population.
Methods. Seven Spanish population-based cohorts including middle-aged and elderly participants were assembled. There were 11 800 people (6387 women) representing 107 915 person-years of follow-up. A total of 1214 cardiovascular events were identified, of which 633 were fatal. Cox regression analyses were conducted to examine the contributions of the different variables to the 10-year total cardiovascular risk.
Results. Age was the strongest cardiovascular risk factor. High systolic blood pressure, diabetes mellitus and smoking were strong predictive factors. The contribution of serum total cholesterol was small. Antihypertensive treatment also had a significant impact on cardiovascular risk, greater in men than in women. The model showed a good discriminative power (C-statistic = 0.789 in men and C = 0.816 in women). Ten-year risk estimations are displayed graphically in risk charts separately for men and women.
Conclusions. The ERICE is a new native cardiovascular risk score for the Spanish population derived from the background and contemporaneous risk of several Spanish cohorts. The ERICE score offers the direct and reliable estimation of total cardiovascular risk, taking in consideration the effect of diabetes mellitus and cardiovascular risk factor management. The ERICE score is a practical and useful tool for clinicians to estimate the total individual cardiovascular risk in Spain.[Resumen] Introducción y objetivos. En España no existen unas cohortes poblacionales suficientemente grandes para hacer predicciones precisas del riesgo cardiovascular. Las ecuaciones de Framingham y EuroSCORE calibradas son las más utilizadas en España. El objetivo es desarrollar la primera ecuación de predicción autóctona para estimar con precisión el riesgo cardiovascular individual en España.
Métodos. Análisis conjunto de siete cohortes españolas de población de mediana edad y anciana. La población del estudio —11.800 personas (6.387 mujeres)— aportó un total de 107.915 personas-año de seguimiento y 1.214 eventos cardiovasculares (633 de ellos, mortales). Se efectuó un análisis de regresión de Cox para examinar la contribución de los diferentes factores al riesgo de cualquier evento cardiovascular (mortal y no mortal).
Resultados. La edad fue el principal factor de riesgo de eventos cardiovasculares. La presión arterial sistólica, la diabetes mellitus, el tabaquismo y el tratamiento antihipertensivo fueron factores predictivos fuertemente asociados con el riesgo cardiovascular. En cambio, la contribución del colesterol total sérico fue pequeña, especialmente en los mayores de 70 años. El modelo final de riesgo mostró un buen poder discriminatorio (estadÃstico C = 0,789 en varones y C = 0,816 en mujeres).
Conclusiones. ERICE es una nueva ecuación de riesgo cardiovascular genuinamente española obtenida a partir del riesgo concurrente individual de los participantes en varias cohortes. La ecuación ERICE ofrece una estimación directa y fiable del riesgo cardiovascular total teniendo en cuenta factores como la diabetes mellitus y el tratamiento farmacológico de los factores de riesgo cardiovascular, habitualmente no incluidos en otras ecuaciones.Instituto de Salud Carlos III; G03/065Instituto de Salud Carlos III; PI05/1464Instituto de Salud Carlos III; RD06/0014/001
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