scholarly journals Transition Probabilities of Disablement for Malaysian Population in Need of Long-Term Care

2020 ◽  
Vol 13 ◽  
pp. 1-10
Author(s):  
Syazreen Niza Shair

This research aims to estimate the transition probabilities of lives becoming disabled and the extent to which they are disabled using the approach of functional Markov model. The transition probability from one disabled state to a more or less severely disabled state is best estimated using longitudinal data in which the change in the health status of each respondent can be monitored over one or more years. Such data are limited in Malaysia, typically covering only a smaller area of the nation. The functional Markov model overcomes such data limitations, using cross-sectional data which measures the disability status of individuals only at one point in time and build a functional form for the transition probabilities in a multiple state model. Results suggested that multiple state model's prevalence rates replicated the Malaysian prevalence rates quite well, indicating that the parameters of the probability of deterioration had been estimated accurately with sum squared of errors less than 5% for almost all age groups and disability levels. Furthermore, severely disabled elderlies, especially among the oldest age group, have the highest probability to die compared to less severely disabled elderlies.

Author(s):  
Juan Xiong ◽  
Qiyu Fang ◽  
Jialing Chen ◽  
Yingxin Li ◽  
Huiyi Li ◽  
...  

Background: Postpartum depression (PPD) has been recognized as a severe public health problem worldwide due to its high incidence and the detrimental consequences not only for the mother but for the infant and the family. However, the pattern of natural transition trajectories of PPD has rarely been explored. Methods: In this research, a quantitative longitudinal study was conducted to explore the PPD progression process, providing information on the transition probability, hazard ratio, and the mean sojourn time in the three postnatal mental states, namely normal state, mild PPD, and severe PPD. The multi-state Markov model was built based on 912 depression status assessments in 304 Chinese primiparous women over multiple time points of six weeks postpartum, three months postpartum, and six months postpartum. Results: Among the 608 PPD status transitions from one visit to the next visit, 6.2% (38/608) showed deterioration of mental status from the level at the previous visit; while 40.0% (243/608) showed improvement at the next visit. A subject in normal state who does transition then has a probability of 49.8% of worsening to mild PPD, and 50.2% to severe PPD. A subject with mild PPD who does transition has a 20.0% chance of worsening to severe PPD. A subject with severe PPD is more likely to improve to mild PPD than developing to the normal state. On average, the sojourn time in the normal state, mild PPD, and severe PPD was 64.12, 6.29, and 9.37 weeks, respectively. Women in normal state had 6.0%, 8.5%, 8.7%, and 8.8% chances of progress to severe PPD within three months, nine months, one year, and three years, respectively. Increased all kinds of supports were associated with decreased risk of deterioration from normal state to severe PPD (hazard ratio, HR: 0.42–0.65); and increased informational supports, evaluation of support, and maternal age were associated with alleviation from severe PPD to normal state (HR: 1.46–2.27). Conclusions: The PPD state transition probabilities caused more attention and awareness about the regular PPD screening for postnatal women and the timely intervention for women with mild or severe PPD. The preventive actions on PPD should be conducted at the early stages, and three yearly; at least one yearly screening is strongly recommended. Emotional support, material support, informational support, and evaluation of support had significant positive associations with the prevention of PPD progression transitions. The derived transition probabilities and sojourn time can serve as an importance reference for health professionals to make proactive plans and target interventions for PPD.


Author(s):  
Khushbu P. Shah ◽  
Mandakini M. Patel

Background: Parasitic infestation has a worldwide prevalence and it affects almost all age groups and both the sexes. The incidence of these infections is slowly rising in today’s era. Parasites are mainly found in stool samples but due to increase in a immunocompromised state now a days, tissue parasitaemia has increased globally necessitating more such type of studies. Parasite found in surgical pathology either incidentally or in clinically suspicious cases not only improves morbidity but also saves clinician’s time and patient’s money.Methods: A retrospective-cross sectional study is done based on histomorphological and cytomorphological evaluation of 25 cases diagnosed at The Department of pathology, New Civil Hospital Surat from January 2015 to January 2017.Results: Most common parasite seen was Echinococcus presenting as hydatid cyst in liver followed by filariasis. Most common age group affected was 0-20 years of age. Most common intestinal parasite found in our study was Entamoeba histolytica. Patients presented with variety of symptoms.Conclusions: Distribution of parasite in tissue section in relation to frequency, age, sex, various system involvements and its correlation with clinical symptoms are analyzed in our study.


2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Deiviane Aparecida Calegar ◽  
Polyanna Araújo Alves Bacelar ◽  
Brenda Bulsara Costa Evangelista ◽  
Kerla Joeline Lima Monteiro ◽  
Jéssica Pereira dos Santos ◽  
...  

Soil-transmitted helminthiasis (STHs) are poverty-related diseases with high prevalence rates in developing countries. The present study aims to describe the epidemiological scenario of STHs in an urban population in the Brazilian Amazon. A cross-sectional survey (n = 349 children aged 1–15 years) was carried out to obtain faecal samples and sociodemographic and sanitation data. Among the children, 143 (41%) were positive for at least one STH. Prevalence rates of infections by A. lumbricoides, T. trichiura, and hookworms were 24.4%, 42.6%, and 9%, respectively. A logistic regression multivariate model showed that infection with A. lumbricoides is significantly more frequent in children aged 11–15 years (odds ratio [OR] = 2.38; 95% confidence interval [CI] = 1.15–4.94; p = 0.018 ) and the presence of latrines inside houses is a protection factor against ascariasis (OR = 0.38; 95% CI = 0.17–0.85; p = 0.019 ). Positivity for T. trichiura is higher in the 5–10 (OR = 3.31; 95% IC = 1.85–5.89; p = 0.001 ) and 11–15 age groups (OR = 3.16; 95% IC = 1.66–6.00; p = 0.001 ), in children living in poor families (OR = 1.78; 95% IC = 1.01–3.14; p = 0.045 ) and practicing open evacuation (OR = 2.07; 95% IC = 1.07–3.99; p = 0.029 ). Hookworm infection is more frequent in children aged 11–15 years (OR = 6.70; 95% IC = 1.91–23.43; p = 0.002 ), males (OR = 6.35; 95% IC = 2.00–20.14; p = 0.002 ), and those living in stilt houses (OR = 3.52; 95% IC = 1.22–10.12; p = 0.019 ). The use of albendazole in the last six months was a protection factor against hookworm infection (OR = 0.31; 95% IC = 0.10–0.96; p = 0.042 ). The proportion of mild, moderate, and severe infections was 55.2%, 37.8%, and 7%, respectively, for A. lumbricoides, 72.4%, 24.3%, and 3.3% for T. trichiura, and 93.8%, 3.1%, and 3.1% for hookworms. Significantly higher worm burdens in T. trichiura and hookworm infections were associated with practicing open defecation and living in stilt houses. The data points to the need to improve sanitation infrastructure in Amazonian cities with similar sociodemographic and environmental characteristics.


2020 ◽  
Author(s):  
Carola Detring ◽  
Annette Müller ◽  
Lisa Schielicke ◽  
Peter Névir ◽  
Henning W. Rust

Abstract. Stationary, long-lasting blocked weather patterns can lead to extreme conditions such as very high temperatures or heavy rainfall. They are defined by a persistent high pressure system in combination with one or two low pressure systems. The mechanisms for the onset of such weather patterns are still not fully understood. Using a novel method based on the kinematic vorticity number we distinguish between two blocking types, namely High-over-Low and Omega block, in previously-identified blocking periods. Our main goal of this work is to study the temporal evolution of the occurrence probability and the onset, offset, and transition probabilities of blocking on the northern hemisphere. We analyze NCEP-DOE Reanalysis 2 data over the30 year period from 1990 to 2019 in two regions: Euro-Atlantic sector (40° W–30° E) and half northern hemisphere (90° W–90° E). First, we use logistic regression to investigate the temporal development of blocking probabilities depending on years, seasons and months. We find no significant difference in blocking numbers over the 30 year period. But we find large differences in the occurrence probabilities on a monthly basis with strongest increases over the 30 year period in February and March that are compensated by a decrease in December and autumn. Second, we use a Markov model to calculate the transition probabilities for two models: One is composed of two states blocking and no blocking, and another Markov model (three states) that additionally distinguishes between the specific blocking types High-over-Low and Omega blocking as well as of the state no blocking. The description with Markov theory reduces the probability to change from one weather regime to another or to stay within the same regime to a dependency only on the previous time step. Over the 30 year period, we found the largest changes in transition probabilities in the summer season, where the transition probability to Omega blocks increase strongly, while the unblocked state becomes less probable. Hence, Omega blocks become more frequent and stable in summer at the expense of the other states. As a main result, we show that Omega blocking is more likely to occur and more persistent than the High-over-Low blocking pattern.


Medicina ◽  
2018 ◽  
Vol 54 (2) ◽  
pp. 25 ◽  
Author(s):  
Andrius Bleizgys ◽  
Jevgenij Kurovskij

Aim: Data on the prevalence of vitamin D deficiency in Lithuania are scarce. The aim was to assess the reserves of vitamin D in different age groups of out-patients, regarding the season of the year. Methods: Data on serum 25-hydroxyvitamin D (25(OH)D) levels from blood tests made in 2012–2014 were obtained from one laboratory, and a retrospective cross-sectional analysis was performed. Results: A total of 9581 subjects were included. The mean age of the participants was 33 ± 23 years. The mean levels of vitamin D were higher in males than in females (p < 0.001). The highest mean 25(OH)D levels were in 0–9-year-old group, the lowest were in the 10–19-year-old group and in the group of participants that were 70 years and older (p < 0.001). The lowest vitamin D status was found in January, February, March, and April. The highest status was found in August and September. Overall, vitamin D deficiency, sufficiency, and hypervitaminosis were detected in 67%, 21%, and 12% of cases, respectively. Most cases with hypervitaminosis were in the group of children up to 2 years of age. Conclusion: Vitamin D status demonstrated clear seasonality. Significant sex-related differences of vitamin D statuses were also determined. Vitamin D deficiency was very prevalent in almost all age groups. Young children (aged up to 2 years) are of special interest for further research involving other types of 25(OH)D assays, such as those based on high-performance liquid chromatography (HPLC), since the real prevalence of “true” vitamin D hypervitaminosis in Lithuania’s children is still to be determined.


2017 ◽  
Vol 20 (17) ◽  
pp. 3075-3083 ◽  
Author(s):  
Annette Keß ◽  
Ulrike Spielau ◽  
Christoph Beger ◽  
Ruth Gausche ◽  
Mandy Vogel ◽  
...  

AbstractObjectiveRecently several industrialized countries reported a stabilization or even a decrease in childhood overweight and obesity prevalence rates. In Germany, this trend started in 2004. The present study therefore aimed to evaluate whether this trend has continued or even leads in a clear direction.Design/Setting/SubjectsBMI (>90th percentile (overweight), >97th percentile (obesity)) from the CrescNet database was analysed in 326 834 children and adolescents according to three age groups (4–7·99, 8–11·99 and 12–16 years), gender and between time points (2005–2015).ResultsTrend analysis from 2005 to 2010 demonstrated that the prevalence of overweight and obesity decreased significantly in boys and girls in the entire group (4–16 years) and in 4–7·99-year-olds. From 2010 to 2015 there was a significant decrease in boys for overweight and obesity in the entire group and for overweight among 8–11·99-year-olds. Within the cross-sectional analysis, prevalence rates for overweight decreased significantly for both genders in the age groups of 4–7·99 and 8–11·99 years (2005 v. 2015). For obesity, prevalence rates showed a significant decrease for boys (2005 v. 2015) and girls (2005 v. 2010) in 4–7·99-year-olds.ConclusionsWe observed a further stabilization of overweight and obesity prevalence rates for all age groups and even a decrease in the rates for the younger ages (4–7·99 years, 8–11·99 years). As other industrialized countries have also reported similar trends, it seems that the epidemic of childhood overweight and obesity is reaching a turning point in the industrial part of the world.


Author(s):  
Vivian Tallita Pinheiro Santana ◽  
Eliane Aparecida Suchara ◽  
Roberta Carreto ◽  
Phelipe Magalhães Duarte

O conhecimento do perfil epidemiológico das intoxicações medicamentosas é um importante guia para a gestão de recursos destinados ao planejamento e à implementação de ações que previnam a ocorrência desse agravo. O presente trabalho buscou estudar o perfil das intoxicações medicamentosas ocorridas no município de Primavera do Leste-MT, entre 2007 a 2014. Foram avaliados dados secundários registrados no Sistema de Informação de Agravos de Notificação (SINAN), que permitiram a realização de um estudo epidemiológico descritivo e transversal em que se analisaram informações referentes ao perfil das vítimas (idade, sexo) e dos casos (circunstâncias, tipo de exposição e evolução dos casos). Registraram-se 52 casos, destes 73,1% (n=38) são vítimas do gênero feminino e 26,9% (n=14) do masculino. As intoxicações com medicamentos ocorreram em quase todas as faixas etárias (01 a 64 anos), porém a maioria das vítimas possuía entre 20 a 39 anos (n=26; 50%) e 15 a 19 (17,3%; n=9). As circunstâncias relacionadas às intoxicações foram: 73,1% (n=38) por tentativa de suicídio, 15,4% (n=8) por uso acidental e os demais pelo uso habitual, abuso, automedicação e violência/homicídio. Em 82,7% (n= 43) dos casos, as exposições foram agudas e únicas, em 9,6% (n=5) agudas repetidas, não sendo registrada exposição crônica. 84,6% (n= 44) das intoxicações evoluíram para cura sem sequelas. Registrou-se um óbito em função da tentativa de suicídio. As intoxicações por medicamentos são frequentes e representam um importante problema de saúde pública, que necessita de ações preventivas e educativas com foco nas vítimas e circunstâncias mais frequentes. Palavras-chave: Suicídio. Abuso de Medicamentos. Automedicação. AbstractKnowledge of the epidemiological profile of drug intoxications (Notification of Injury Information System) is an important guide for the resources management  intended to the planning and implementation of actions that prevent the occurrence of this outcome. The present study aimed to describe the drug intoxications profile occurring in the municipality of Primavera do Leste -MT, between 2007 and 2014. Secondary data recorded in  SINAN (Information System for Notifiable Diseases) were used to conduct a descriptive and cross - sectional epidemiological study in which information was analyzed regarding the victims’ profile (age, sex) and cases (circumstances, type of exposure and evolution of cases). There were 52 cases, of which 73.1% (n = 38) were females and 26.9% (n = 14) males. Drug intoxications occurred in almost all age groups (01 to 64 years), but the most of the  were between 20 and 39 years (n = 26; 50%) and 15 to 19 (17.3%; n = 9). The circumstances related to intoxication were: 73.1% (n = 38) for attempted suicide, 15.4% (n = 8) for accidental use and the others for habitual use, abuse, self-medication and violence / homicide. In 82.7% (n = 43) of the cases the exposures were acute and single, in 9.6% (n = 5) repeated acute, and chronic exposure was not recorded. 84.6% (n = 44) of intoxications evolved to cure without sequelae. A death was recorded due to suicide attempt. Drugs intoxications are frequent and represent a relevant public health problem that requires preventive and educational actions with a focus on the most frequent victims and circumstances. Keywords: Suicide. Drug Misuse.Self-Medication.


1986 ◽  
Vol 16 (1) ◽  
pp. 130-135 ◽  
Author(s):  
Mark R. Roberts ◽  
Allan J. Hruska

We tested the null hypothesis that diameter class transitions over a 40-year period (1940–1980) in an even-aged mixed Pinusresinosa Ait. – Pinusstrobus L. stand represent a stationary Markov process. Transition probabilities were constructed from growth data on 202 trees ≥ 5.1 cm DBH in a 0.4-ha permanent plot. For each species, a diameter distribution in 1980 was predicted with the stationary Markov model using the 1940–1950 transition probability matrix. The predicted and observed 1980 distributions were significantly different for P. resinosa (χ2 = 31.67, p < 0.01), but not P. strobus (χ2 = 7.86, not significant). In P. resinosa, growth rates of trees in the same diameter class at different points in time declined with increasing stand age. This violates the assumption of stationarity. Growth did not decline in most diameter classes in P. strobus. The model also assumes that differences in the competitive histories of trees of the same size do not affect transition probabilities. The average growth rates of trees in different crown classes within two diameter classes were significantly different for P. resinosa, but not for P. strobus. Both assumptions of the model were violated in the case of P. resinosa. The.model was not rejected for P. strobus because it is a midtolerant species capable of relatively constant growth in the understory. However, this study included only the middle period of stand development when growth rates are relatively constant. These results indicate that more biologically realistic modelling approaches which incorporate growth declines with stand age and past competitive effects should be pursued.


Author(s):  
Zaiton Haron ◽  
David Oldham

Kertas kerja ini menguji kaedah novel, iaitu Markov untuk tujuan simulasi pengorakan bunyi di jalan raya. Kaedah ini menganggap deretan bangunan di tepi jalan menyerap dan memantulkan bunyi secara berserak. Proses simulasi menganggap proses pengorakan bunyi sebagai proses Markov jujukan pertama bercirikan matrix kebarangkalian perpindahan pancaran bunyi di antara permukaan–permukaan. Keputusan simulasi menggunakan kaedah Markov dibandingkan dengan keputusan diperolehi dari model kommersial RAYNOISE dengan menggunakan pilihan pantulan berserak. Hasil keputusan menunjukkan paras tekanan bunyi di jalan raya yang diramal oleh kaedah Markov mempunyai kesepadanan yang baik dengan ramalan diperolehi dari model RAYNOISE. Ini menunjukkan kaedah Markov mempunyai potensi untuk meramal pantulan berganda bagi keadaan sempadan berserak. Kesan agihan serapan permukaan bangunan juga dikaji, dan dengan skop dan anggapan kajian didapati jalan raya yang mempunyai deretan bangunan berpermukaan menyerap bunyi berupaya menghasilkan pengurangan bunyi kurang dari 1 dB. Kata kunci: Pantulan berserak; proses Markov; kebarangkalian perpindahan; pengorakan bunyi; kawalan bunyi bising This paper examined the capability of the novel approach called Markov in the simulation of sound propagation in streets. The approach assumes that the facades lining the streets absorb and reflect sound diffusely. The simulation process treated the sound propagation process as first order Markov process characterised by a matrix of transition probabilities relating to sound radiation between surfaces. The results of simulation using Markov model were compared with the results obtained from a commercial model, RAYNOISE using the diffuse reflection option. The results showed that sound pressure level in a street predicted by the Markov model was in good agreement with predictions obtained using RAYNOISE model. This suggest that the Markov model has the potential to predict multiple reflections for diffuse boundary conditions. The effects of distribution absorption of building facades were also investigated and within the scope and assumptions in this study; it is shown streets with absorbent building facade result in sound reductions typically less than 1 dB. Key words: Diffuse reflection; Markov process; transition probability; sound propagation; noise control


2021 ◽  
Vol 8 (3) ◽  
pp. 78-87
Author(s):  
Khaleel I. Alyahya ◽  

The study aimed to assess the impact of awareness of citizens and residents in Saudi Arabia toward the home isolation and social distancing during lockdown that might decrease the outbreak of COVID-19, to measure the importance of social behavior to maintain the constant decline of COVID-19 cases and to determine if there is a difference in the level of awareness and behavior between citizens and residents in Saudi Arabia toward the governmental measures during the pandemic. We have adopted a cross-sectional survey design to investigate the impact of Saudi lockdown on blockade COVID-19 by using an anonymous online questionnaire. The targeted population of the study was Saudi citizens and non-Saudi residents of different ages. The collected data were entered into Microsoft Excel (version 2011) and analyzed by using the Statistical Package for Social Sciences (SPSS), version 23. The Chi-square test with 95% confidence intervals (CI) was used to examine significant associations between the socio-demographic characteristic of participants, their awareness, and their behavior towards the COVOD-19 pandemic. AP value of <0.05 was considered statistically significant. The total number of the current study participants was 1168. The majority (70.50%) were married males with children (73.50%). Three-quarters of the participants were equally distributed between the age groups of 30-39, 40-49, and 50-59 years old. Almost all (90.90%) of the participants have received higher education, 73.60% living in the central region, and in large and crowded cities (75.30%). More than half (58.50%) of the Saudi respondents know about the coronavirus from media sources, while for the non-Saudis, 54.50% are well informed regarding the virus. The results of the current study revealed that the majority of the population in the country believe in home isolation and social distancing for the COVID-19 blockade. Additionally, they also consider non-compliance to these measures as one the main factor for the disease outbreak. Most of the participants were committed to home isolation, social distancing, and personal protective measures including wearing masks, gloves, and avoiding face contact.


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