1000 resultados para EPIDEMIC MODELLING
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Dissertation submitted in partial fulfillment of the requirements for the Degree of Master of Science in Geospatial Technologies
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Dissertation submitted for obtaining the degree of Master in Environmental Engineering
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Dissertation to obtain the degree of Master in Chemical and Biochemical Engineering
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Dissertação para obtenção do Grau de Doutor em Engenharia Química e Bioquímica, Especialidade em Engenharia Bioquímica
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Dissertação para obtenção do Grau de Doutor em Engenharia Química e Bioquímica
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Dissertação para obtenção do Grau de Doutor em Ambiente
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Dissertation to obtain the degree of Master in Chemical and Biochemical Engineering
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Beriberi, ou cardiopatia e polineuropatia ligada à deficiência de tiamina, foi, antigamente, um flagelo nas populações. Os mais notáveis surtos de beriberi ocorreram após o advento da moagem de massa de arroz, em várias zonas da Ásia, no final do século XIX. Com a descoberta de vitamina B1, "anti-beriberi", e, subsequentemente, o enriquecimento de alimentos e as campanhas de sensibilização de saúde pública, a doença foi esquecida por muitos profissionais de saúde. Contudo, sabe-se que, hoje em dia, em diferentes partes do mundo, muitos casos de beriberi são os focos primários de epidemias de outras deficiências potencialmentes fatais, em comunidades vulneráveis. Determinados alimentos, assim como o álcool, são conhecidos para reduzir a absorção de vitamina B1. A Encefalopatia de Wernicke, a deficiência de tiamina mais conhecida pelos médicos que trabalham em países desenvolvidos, está associada à ingestão de álcool. Estudos recentes demonstraram, por um lado, atrasos significativos do desenvolvimento neurolinguístico em crianças alimentadas com leite sem tiamina, assim como uma possível correlação entre malária grave e deficiencia em Vitamina B1, o que reforça a importância desta vitamina na saúde das populações. A Guiné-Bissau, um país fragilizado pelos conflitos coloniais e pós-coloniais, instabilidade política, tráfico de droga e deficiente acesso à Saúde, continua sendo um dos países mais pobres do mundo. A maioria da população vive da agricultura de subsistência, pesca e colheita de cajú. O Islão é practicado por quase metade da população, e as religiões animistas e cristãs compõem as outras religiões principais do país. De acordo com a fé islâmica, os muçulmanos da Guiné-Bissau praticam o jejum, em função da luz do dia, durante o mês de Ramadão. Existe pouca investigação publicada sobre os efeitos nutricionais e na saúde deste ritual. Este trabalho é o primeiro a relacionar uma deficiência de micronutrientes ao mês sagrado do Ramadão. Esta tese apresenta casos clínicos de beriberi em comunidades rurais muçulmanas, que ocorreram no final da época das chuvas, que coincide com o mês de Ramadão. A análise dos dados mostra que, uma vez que alguns dos doentes apresentavam os mesmos sintomas, repetidamente, todos os anos, estes casos podem refletir a ponta do iceberg da ocorrência de beriberi na Guiné-Bissau. Parte da discussão centra-se na necessidade de mais investigação para confirmar o grau de deficiência na população em geral, efeitos de deficiência de tiamina relacionados com a malária, e consequências possíveis da deficiência marginal, a longo prazo, desta vitamina na saúde. A discussão apresenta ainda sugestões práticas para a redução da incidência da deficiência de vitamina B1 na Guiné-Bissau.
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This work aims to identify and rank a set of Lean and Green practices and supply chain performance measures on which managers should focus to achieve competitiveness and improve the performance of automotive supply chains. The identification of the contextual relationships among the suggested practices and measures, was performed through literature review. Their ranking was done by interviews with professionals from the automotive industry and academics with wide knowledge on the subject. The methodology of interpretive structural modelling (ISM) is a useful methodology to identify inter relationships among Lean and Green practices and supply chain performance measures and to support the evaluation of automotive supply chain performance. Using the ISM methodology, the variables under study were clustered according to their driving power and dependence power. The ISM methodology was proposed to be used in this work. The model intends to provide a better understanding of the variables that have more influence (driving variables), the others and those which are most influenced (dependent variables) by others. The information provided by this model is strategic for managers who can use it to identify which variables they should focus on in order to have competitive supply chains.
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Transport is an essential sector in modern societies. It connects economic sectors and industries. Next to its contribution to economic development and social interconnection, it also causes adverse impacts on the environment and results in health hazards. Transport is a major source of ground air pollution, especially in urban areas, and therefore contributing to the health problems, such as cardiovascular and respiratory diseases, cancer, and physical injuries. This thesis presents the results of a health risk assessment that quantifies the mortality and the diseases associated with particulate matter pollution resulting from urban road transport in Hai Phong City, Vietnam. The focus is on the integration of modelling and GIS approaches in the exposure analysis to increase the accuracy of the assessment and to produce timely and consistent assessment results. The modelling was done to estimate traffic conditions and concentrations of particulate matters based on geo-references data. A simplified health risk assessment was also done for Ha Noi based on monitoring data that allows a comparison of the results between the two cases. The results of the case studies show that health risk assessment based on modelling data can provide a much more detail results and allows assessing health impacts of different mobility development options at micro level. The use of modeling and GIS as a common platform for the integration of different assessments (environmental, health, socio-economic, etc.) provides various strengths, especially in capitalising on the available data stored in different units and forms and allows handling large amount of data. The use of models and GIS in a health risk assessment, from a decision making point of view, can reduce the processing/waiting time while providing a view at different scales: from micro scale (sections of a city) to a macro scale. It also helps visualising the links between air quality and health outcomes which is useful discussing different development options. However, a number of improvements can be made to further advance the integration. An improved integration programme of the data will facilitate the application of integrated models in policy-making. Data on mobility survey, environmental monitoring and measuring must be standardised and legalised. Various traffic models, together with emission and dispersion models, should be tested and more attention should be given to their uncertainty and sensitivity
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INTRODUCTION: The case definition of influenza-like illness (ILI) is a powerful epidemiological tool during influenza epidemics. METHODS: A prospective cohort study was conducted to evaluate the impact of two definitions used as epidemiological tools, in adults and children, during the influenza A H1N1 epidemic. Patients were included if they had upper respiratory samples tested for influenza by real-time reverse transcriptase polymerase chain reaction during two periods, using the ILI definition (coughing + temperature > 38ºC) in period 1, and the definition of severe acute respiratory infection (ARS) (coughing + temperature > 38ºC and dyspnoea) in period 2. RESULTS: The study included 366 adults and 147 children, covering 243 cases of ILI and 270 cases of ARS. Laboratory confirmed cases of influenza were higher in adults (50%) than in children (21.6%) ( p < 0.0001) and influenza infection was more prevalent in the ILI definition (53%) than ARS (24.4%) (p < 0.0001). Adults reported more chills and myalgia than children (p = 0.0001). Oseltamivir was administered in 58% and 46% of adults and children with influenza A H1N1, respectively. The influenza A H1N1 case fatality rate was 7% in adults and 8.3% in children. The mean time from onset of illness until antiviral administration was 4 days. CONCLUSIONS: The modification of ILI to ARS definition resulted in less accuracy in influenza diagnosis and did not improve the appropriate time and use of antiviral medication.
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Fundação para a Ciência e a Tecnologia (FCT) - SFRH/BD/64337/2009 ; projects PTDC/ECM/70652/2006, PTDC/ECM/117660/2010 and RECI/ECM-HID/0371/2012
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INTRODUCTION: The diagnosis of dengue and the differentiation between primary and secondary infections are important for monitoring the spread of the epidemic and identifying the risk of severe forms of the disease. The detection of immunoglobulin (Ig)M and IgG antibodies is the main technique for the laboratory diagnosis of dengue. The present study assessed the application of a rapid test for dengue concerning detection of new cases, reinfection recognition, and estimation of the epidemic attack rate. METHODS: This was a retrospective, cross-sectional, descriptive study on dengue using the Fortaleza Health Municipal Department database. The results from 1,530 tested samples, from 2005-2006, were compared with data from epidemiological studies of dengue outbreaks in 1996, 2003, and 2010. RESULTS: The rapid test confirmed 52% recent infections in the tested patients with clinical suspicion of dengue: 40% detected using IgM and 12% of new cases using IgG in the non-reactive IgM results. The positive IgM plus negative IgG (IgM+ plus IgG-) results showed that 38% of those patients had a recent primary dengue infection, while the positive IgG plus either positive or negative IgM (IgG+ plus IgM+/-) results indicated that 62% had dengue for at least a second time (recent secondary infections). This proportion of reinfections permitted us to estimate the attack rate as >62% of the population sample. CONCLUSIONS: The rapid test for dengue has enhanced our ability to detect new infections and to characterize them into primary and secondary infections, permitting the estimation of the minimal attack rate for a population during an outbreak.
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Digital Businesses have become a major driver for economic growth and have seen an explosion of new startups. At the same time, it also includes mature enterprises that have become global giants in a relatively short period of time. Digital Businesses have unique characteristics that make the running and management of a Digital Business much different from traditional offline businesses. Digital businesses respond to online users who are highly interconnected and networked. This enables a rapid flow of word of mouth, at a pace far greater than ever envisioned when dealing with traditional products and services. The relatively low cost of incremental user addition has led to a variety of innovation in pricing of digital products, including various forms of free and freemium pricing models. This thesis explores the unique characteristics and complexities of Digital Businesses and its implications on the design of Digital Business Models and Revenue Models. The thesis proposes an Agent Based Modeling Framework that can be used to develop Simulation Models that simulate the complex dynamics of Digital Businesses and the user interactions between users of a digital product. Such Simulation models can be used for a variety of purposes such as simple forecasting, analysing the impact of market disturbances, analysing the impact of changes in pricing models and optimising the pricing for maximum revenue generation or a balance between growth in usage and revenue generation. These models can be developed for a mature enterprise with a large historical record of user growth rate as well as for early stage enterprises without much historical data. Through three case studies, the thesis demonstrates the applicability of the Framework and its potential applications.
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Introduction The prognosis of dengue depends on early diagnosis and treatment, which can help prevent severe forms whose characteristics were evaluated here. Methods A cross-sectional study was conducted involving dengue cases in Vitória, State of Espírito Santo, Brazil, in 2011. Results Two health regions registered 56.3% of 371 cases of severe dengue. Of these cases, 21.3% presented with dengue hemorrhagic fever. There were associations between dengue hemorrhagic fever with younger ages and a longer time before receiving care. Conclusions There was a greater involvement of dengue hemorrhagic fever in young people. Delay in care, poor urban quality and high endemicity were identified as possible risk factors for dengue severity.