905 resultados para Causal attribution
Resumo:
Famines are often linked to drought in semi-arid areas of Sub-Saharan Africa where not only pastoralists, but also increasingly agro-pastoralists are affected. This study addresses the interplay between drought and famine in the rural semi-arid areas of Makueni district, Kenya, by examining whether, and how crop production conditions and agro-pastoral strategies predispose smallholder households to drought-triggered food insecurity. If this hypothesis holds, then approaches to deal with drought and famine have to target factors causing household food insecurity during non-drought periods. Data from a longitudinal survey of 127 households, interviews, workshops, and daily rainfall records (1961–2003) were analysed using quantitative and qualitative methods. This integrated approach confirms the above hypothesis and reveals that factors other than rainfall, like asset and labour constraints, inadequate policy enforcement, as well as the poverty-driven inability to adopt risk-averse production systems play a key role. When linking these factors to the high rainfall variability, farmer-relevant definitions and forecasts of drought have to be applied.
Resumo:
In this paper I first discuss some non-causal change constructions which have largely gone unnoticed in the literature, such as The butler bowed the guests in (which is said to code mild causation) and The supporters booed Newcastle off at the interval (which only codes temporal coextension between its two constitutive subevents). Since the same structure (i.e. the transitive object-oriented change construction) can be used to code a wide spectrum of causal and temporal relations, the question arises of what cognitive mechanisms may be involved in such meaning shifts. I argue that variation can be motivated on the basis of the figure/ground segregation which the conceptualiser can impose upon the integrated scene coded by the change construction. The integrated scene depicts a force-dynamic scenario but also evokes a unique temporal setting (i.e. temporal overlap or coextension between the constitutive subevents). Such a “bias” towards temporal overlap can be used by the conceptualiser to background causation and highlight temporal overlap interpretations. It is also shown that figure/ground segregation can be appealed to to account for the causal interpretation of intransitive change constructions, e.g. The kettle boiled dry. If the conceptual distance between the verbal event and the non-verbal event is (relatively) great, causality can be highlighted even in intransitive patterns.
Resumo:
Campylobacteriosis is the most frequent zoonosis in developed countries and various domestic animals can function as reservoir for the main pathogens Campylobacter jejuni and Campylobacter coli. In the present study we compared population structures of 730 C. jejuni and C. coli from human cases, 610 chicken, 159 dog, 360 pig and 23 cattle isolates collected between 2001 and 2012 in Switzerland. All isolates had been typed with multi locus sequence typing (MLST) and flaB-typing and their genotypic resistance to quinolones was determined. We used complementary approaches by testing for differences between isolates from different hosts with the proportion similarity as well as the fixation index and by attributing the source of the human isolates with Bayesian assignment using the software STRUCTURE. Analyses were done with MLST and flaB data in parallel and both typing methods were tested for associations of genotypes with quinolone resistance. Results obtained with MLST and flaB data corresponded remarkably well, both indicating chickens as the main source for human infection for both Campylobacter species. Based on MLST, 70.9% of the human cases were attributed to chickens, 19.3% to cattle, 8.6% to dogs and 1.2% to pigs. Furthermore we found a host independent association between sequence type (ST) and quinolone resistance. The most notable were ST-45, all isolates of which were susceptible, while for ST-464 all were resistant.
Resumo:
BACKGROUND There is limited evidence on the optimal timing of antiretroviral therapy (ART) initiation in children 2-5 y of age. We conducted a causal modelling analysis using the International Epidemiologic Databases to Evaluate AIDS-Southern Africa (IeDEA-SA) collaborative dataset to determine the difference in mortality when starting ART in children aged 2-5 y immediately (irrespective of CD4 criteria), as recommended in the World Health Organization (WHO) 2013 guidelines, compared to deferring to lower CD4 thresholds, for example, the WHO 2010 recommended threshold of CD4 count <750 cells/mm(3) or CD4 percentage (CD4%) <25%. METHODS AND FINDINGS ART-naïve children enrolling in HIV care at IeDEA-SA sites who were between 24 and 59 mo of age at first visit and with ≥1 visit prior to ART initiation and ≥1 follow-up visit were included. We estimated mortality for ART initiation at different CD4 thresholds for up to 3 y using g-computation, adjusting for measured time-dependent confounding of CD4 percent, CD4 count, and weight-for-age z-score. Confidence intervals were constructed using bootstrapping. The median (first; third quartile) age at first visit of 2,934 children (51% male) included in the analysis was 3.3 y (2.6; 4.1), with a median (first; third quartile) CD4 count of 592 cells/mm(3) (356; 895) and median (first; third quartile) CD4% of 16% (10%; 23%). The estimated cumulative mortality after 3 y for ART initiation at different CD4 thresholds ranged from 3.4% (95% CI: 2.1-6.5) (no ART) to 2.1% (95% CI: 1.3%-3.5%) (ART irrespective of CD4 value). Estimated mortality was overall higher when initiating ART at lower CD4 values or not at all. There was no mortality difference between starting ART immediately, irrespective of CD4 value, and ART initiation at the WHO 2010 recommended threshold of CD4 count <750 cells/mm(3) or CD4% <25%, with mortality estimates of 2.1% (95% CI: 1.3%-3.5%) and 2.2% (95% CI: 1.4%-3.5%) after 3 y, respectively. The analysis was limited by loss to follow-up and the unavailability of WHO staging data. CONCLUSIONS The results indicate no mortality difference for up to 3 y between ART initiation irrespective of CD4 value and ART initiation at a threshold of CD4 count <750 cells/mm(3) or CD4% <25%, but there are overall higher point estimates for mortality when ART is initiated at lower CD4 values. Please see later in the article for the Editors' Summary.
Resumo:
OBJECTIVE To expand the limited information on the prognostic impact of quantitatively obtained collateral function in patients with coronary artery disease (CAD) and to estimate causality of such a relation. DESIGN Prospective cohort study with long-term observation of clinical outcome. SETTING University Hospital. PATIENTS One thousand one hundred and eighty-one patients with chronic stable CAD undergoing 1771 quantitative, coronary pressure-derived collateral flow index measurements, as obtained during a 1-min coronary balloon occlusion (CFI is the ratio between mean distal coronary occlusive pressure and mean aortic pressure both subtracted by central venous pressure). Subgroup of 152 patients included in randomised trials on the longitudinal effect of different arteriogenic protocols on CFI. INTERVENTIONS Collection of long-term follow-up information on clinical outcome. MAIN OUTCOME MEASURES All-cause mortality and major adverse cardiac events. RESULTS Cumulative 15-year survival rate was 48% in patients with CFI<0.25 and 65% in the group with CFI≥0.25 (p=0.0057). Cumulative 10-year survival rate was 75% in patients without arteriogenic therapy and 88% (p=0.0482) in the group with arteriogenic therapy and showing a significant increase in CFI at follow-up. By proportional hazard analysis, the following variables predicted increased all-cause mortality: age, low CFI, left ventricular end-diastolic pressure and number of vessels with CAD. CONCLUSIONS A well-functioning coronary collateral circulation independently predicts lowered mortality in patients with chronic CAD. This relation appears to be causal, because augmented collateral function by arteriogenic therapy is associated with prolonged survival.
Resumo:
The European Water Framework Directive (WFD) requires a status assessment of all water bodies. If that status is deteriorated, the WFD urges the identification of its potential causes in order to be able to suggest appropriate management measures. The instrument of investigative monitoring allows for such identification, provided that appropriate tools are available to link the observed effects to causative stressors, while unravelling confounding factors. In this chapter, the state of the art of status and causal pathway assessment is described for the major stressors responsible for the deterioration of European water bodies, i.e. toxicity, acidification, salinisation, eutrophication and oxygen depletion, parasites and pathogens, invasive alien species, hydromorphological degradation, changing water levels as well as sediments and suspended matter. For each stressor, an extensive description of the potential effects on the ecological status is given. Secondly, stressor-specific abiotic and biotic indicators are described that allow for a first indication of probable causes, based on the assessment of available monitoring data. Subsequently, more advanced tools for site-specific confirmation of stressors at hand are discussed. Finally, the local status assessments are put into the perspective of the risk for downstream stretches in order to be able to prioritise stressors and to be able to select appropriate measures for mitigation of the risks resulting from these stressors.
Resumo:
A prerequisite for preventive measures is to diagnose erosive tooth wear and to evaluate the different etiological factors in order to identify persons at risk. No diagnostic device is available for the assessment of erosive defects. Thus, they can only be detected clinically. Consequently, erosion not diagnosed at an early stage may render timely preventive measures difficult. In order to assess the risk factors, patients should record their dietary intake for a distinct period of time. Then a dentist can determine the erosive potential of the diet. A table with common beverages and foodstuffs is presented for judging the erosive potential. Particularly, patients with more than 4 dietary acid intakes have a higher risk for erosion when other risk factors are present. Regurgitation of gastric acids is a further important risk factor for the development of erosion which has to be taken into account. Based on these analyses, an individually tailored preventive program may be suggested to the patients. It may comprise dietary advice, use of calcium-enriched beverages, optimization of prophylactic regimes, stimulation of salivary flow rate, use of buffering medicaments and particular motivation for nondestructive toothbrushing habits with an erosive-protecting toothpaste as well as rinsing solutions. Since erosion and abrasion often occur simultaneously, all of the causative components must be taken into consideration when planning preventive strategies but only those important and feasible for an individual should be communicated to the patient.