Child-care attendance and common morbidity: evidence of association in the literature and questions of design

Papers on child-care attendance as a risk factor for acute respiratory infections and diarrhea were reviewed. There was great variety among the studies with regard to the design, definition of exposure and definition of outcomes. All the traditional epidemiological study designs have been used. The studies varied in terms of how child-care attendance in general was defined, and for different settings. These definitions differed especially in relation to the minimum time of attendance required. The outcomes were also defined and measured in several different ways. The analyses performed were not always appropriate, leading to sets of results of uneven quality, and composed of different measures of association relating different exposures and outcomes, that made summarizing difficult. Despite that, the results reported were remarkably consistent. Only two of the papers reviewed failed to show some association between child-care attendance and increased acute respiratory infections, or diarrhea. On the other hand, the magnitude of the associations reported varied widely, especially for lower respiratory infections. Taken together, the studies so far published provide evidence that children attending child-care centers, especially those under three years of age, are at a higher risk of upper respiratory infections, lower respiratory infections, and diarrhea. The studies were not consistent, however, in relation to attendance at child-care homes. Children in such settings were sometimes similar to those in child-care centers, sometimes similar to those cared for at home, and sometimes presented an intermediate risk.

What drives corporate default risk premia? Evidence from the CDS market

This paper studies the evolution of the default risk premia for European firms during the years surrounding the recent credit crisis. We employ the information embedded in Credit Default Swaps (CDS) and Moody’s KMV EDF default probabilities to analyze the common factors driving this risk premia. The risk premium is characterized in several directions: Firstly, we perform a panel data analysis to capture the relationship between CDS spreads and actual default probabilities. Secondly, we employ the intensity framework of Jarrow et al. (2005) in order to measure the theoretical effect of risk premium on expected bond returns. Thirdly, we carry out a dynamic panel data to identify the macroeconomic sources of risk premium. Finally, a vector autoregressive model analyzes which proportion of the co-movement is attributable to financial or macro variables. Our estimations report coefficients for risk premium substantially higher than previously referred for US firms and a time varying behavior. A dominant factor explains around 60% of the common movements in risk premia. Additionally, empirical evidence suggests a public-to-private risk transfer between the sovereign CDS spreads and corporate risk premia.

Shareholder wealth creation in response to announcements of acquisitions of unlisted firms: Evidence from Spain

We investigate shareholder value creation of Spanish listed firms in response to announcements of acquisitions of unlisted companies and compare this experience to the purchase of listed firms over the period 1991–2006. Similar to foreign markets, acquirers of listed targets earn insignificant average abnormal returns, whereas acquirers of unlisted targets gain significant positive average abnormal returns. When we relate these results to company and transaction characteristics our findings diverge from those reported in the literature for other foreign markets, as our evidence suggests that the listing status effect is mainly associated with the fact that unlisted firms tend to be smaller and lesser–known firms, and thus suffer from a lack of competition in the market for corporate control. Consequently, the payment of lower premiums and the possibility of diversifying shareholders’ portfolios lead to unlisted firm acquisitions being viewed as value–orientated transactions.

Evidence of portuguese stock market abnormal returns

According to the stock market efficiency theory, it is not possible to consistently beat the market. However, technical analysis is more and more spread as an efficient way to achieve abnormal returns. In fact there is evidence that momentum investing strategies provide abnormal returns in different stock markets, Jegadeesh, N. and Titman, S. (1993), George, T. and Hwang, C. (2004) and Du, D. (2009). In this work we study if like other markets, the Portuguese stock market also allows to obtain abnormal returns, using a strategy that consists in picking stocks according to their past performance. Our work confirms the results of Soares, J. and Serra, A. (2005) and Pereira, P. (2009), showing that an investor can get abnormal returns investing in momentum portfolios. The Portuguese stock market evidences momentum returns in short term, exhibiting reversal in long term.

Idiosyncratic risk really drives stock returns; Spanish evidence

Following the theoretical model of Merton (1987), we provide a new perspective of study about the role of idiosyncratic risk in the asset pricing process. More precisely, we analyze whether the idiosyncratic risk premium depends on the idiosyncratic risk level of an asset as well as the vatriation in the market-wide measure of idiosyncratic risk. As expected, we obtain a net positive risk premium for the Spanish stock market over the period 1987-2007. Our results show a positive relation between returns and individual indiosyncratic risk levels and a negative but lower relation with the aggregate measure of idiosyncratic risk. These findings have important implications for portfolio and risk management and contribute to provide a unified and coherent answer for the main and still unsolved question about the idiosyncratic risk puzzle: whether or not there exists a premium associated to this kind of risk and the sign for this risk premium.

Psychiatric assessment in transplantation

The implementation of the presumptive donor law in Brazil is expected to increase the availability of organs for transplantation. As medical management of end-stage organ dysfunction continues to improve, increasing numbers of potential transplant recipients will be available to meet this supply. There is mounting evidence that supports the involvement of skilled psychiatric practitioners in the selection of transplant candidates. Data supporting the influence of psychosocial factors on compliance and therefore medical outcomes continues to grow. The literature review allows delineating the components and rationale for comprehensive psychosocial evaluations as a component of preoperative transplantation evaluation.

Correlation between HIV and HCV in Brazilian prisoners: evidence for parenteral transmission inside prison

OBJECTIVE: It is an accepted fact that confinement conditions increase the risk of some infections related to sexual and/or injecting drugs practices. Mathematical techniques were applied to estimate time-dependent incidence densities of HIV infection among inmates. METHODS: A total of 631 prisoners from a Brazilian prison with 4,900 inmates at that time were interviewed and their blood drawn. Risky behavior for HIV infection was analyzed, and serological tests for HIV, hepatitis C and syphilis were performed, intended as surrogates for parenteral and sexual HIV transmission, respectively. Mathematical techniques were used to estimate the incidence density ratio, as related to the time of imprisonment. RESULTS: Prevalence were: HIV -- 16%; HCV -- 34%; and syphilis -- 18%. The main risk behaviors related to HIV infection were HCV prevalence (OR=10.49) and the acknowledged use of injecting drugs (OR=3.36). Incidence density ratio derivation showed that the risk of acquiring HIV infection increases with the time of imprisonment, peaking around three years after incarceration. CONCLUSIONS: The correlation between HIV and HCV seroprevalence and the results of the mathematical analysis suggest that HIV transmission in this population is predominantly due to parenteral exposure by injecting drug, and that it increases with time of imprisonment.

Performance management in health centres: evidence from a field study

There has been a growing interest in research on performance measurement and management practices, which seems to reflect researchers’ response to calls for the need to increase the relevance of management accounting research. However, despite the development of the new public management literature, studies involving public sector organizations are relatively small compared to those involving business organizations and extremely limited when it comes to public primary health care organizations. Yet, the economic significance of public health care organizations in the economy of developed countries and the criticisms these organizations regularly face from the public suggests there is a need for research. This is particularly true in the case of research that may lead to improvement in performance measurement and management practices and ultimately to improvements in the way health care organizations use their limited resources in the provision of services to the communities. This study reports on a field study involving three public primary health care organisations. The evidence obtained from interviews and archival data suggests a performance management practices in these institutions lacked consistency and coherence, potentially leading to decreased performance. Hierarchical controls seemed to be very weak and accountability limited, leading to a lack of direction, low motivation and, in some circumstances to insufficient managerial abilities and skills. Also, the performance management systems revealed a number of weaknesses, which suggests that there are various opportunities for improvement in performance in the studied organisations.

Palaeomagnetic study of a subaerial volcanic ridge (Sao Jorge Island, Azores) for the past 1.3 Myr: evidence for the Cobb Mountain Subchron, volcano flank instability and tectonomagmatic implications

We present a palaeomagnetic study on 38 lava flows and 20 dykes encompassing the past 1.3 Myr on S. Jorge Island (Azores ArchipelagoNorth Atlantic Ocean). The sections sampled in the southeastern and central/western parts of the island record reversed and normal polarities, respectively. They indicate a mean palaeomagnetic pole (81.3 degrees N, 160.7 degrees E, K= 33 and A95= 3.4 degrees) with a latitude shallower than that expected from Geocentric Axial Dipole assumption, suggesting an effect of non-dipolar components of the Earth magnetic field. Virtual Geomagnetic Poles of eight flows and two dykes closely follow the contemporaneous records of the Cobb Mountain Subchron (ODP/DSDP programs) and constrain the age transition from reversed to normal polarity at ca. 1.207 +/- 0.017 Ma. Volcano flank instabilities, probably related to dyke emplacement along an NNWSSE direction, led to southwestward tilting of the lava pile towards the sea. Two spatially and temporally distinct dyke systems have been recognized on the island. The eastern is dominated by NNWSSE trending dykes emplaced before the end of the Matuyama Chron, whereas in the central/western parts the eruptive fissures oriented WNWESE controlled the westward growth of the S. Jorge Island during the Brunhes Chron. Both directions are consistent with the present-day regional stress conditions deduced from plate kinematics and tectonomorphology and suggest the emplacement of dykes along pre-existing fractures. The distinct timing and location of each dyke system likely results from a slight shift of the magmatic source.

Estudo descritivo da unidade de cuidados intensivos e intermédios respiratórios do Hospital Clínico - Barcelona

Este estudo tem como objectivo descrever a Unidade de cuidados intensivos e intermédios respiratórios do Hospital Clínico em Barcelona de forma a caracterizá-la tanto ao nível de recursos materiais e humanos como em termos de protocolos usados. Esta unidade é considerada uma das melhores da Europa, dispondo da mais alta tecnologia, desenvolvendo protocolos baseados na evidência de forma a reduzir ao máximo a taxa de mortalidade neste local. O staff médico sempre em constante actualização, trabalhando muito no campo da investigação. Por outro lado, a fisioterapia integrante no Instituto Clínico do Tórax realiza menos investigação investindo mais no tratamento de doentes não intubados, tendo como técnicas de eleição posicionamento, mobilização, expiração forçada e hidratação oral. Em relação à VNI, muitos dos estudos referentes a este tema foram realizados pelo staff médico deste Hospital. O staff de fisioterapia é responsável pela adaptação da VNI nos pacientes hipercápnicos. Em conclusão, o número e tempo limitado de fisioterapeutas na unidade não contribuem para a aplicação de novas técnicas que requerem a intervenção de dois fisioterapeutas. Palavras-chave: unidade de cuidados intensivos respiratórios, unidade de cuidados intermédios respiratórios, VNI, papel dos fisioterapeutas respiratórios.

Evaluation of alcohol outlet density and its relation with violence

OBJECTIVES: The current study set out to investigate alcohol availability in a densely populated, residential area of suburban São Paulo associated with high levels of social deprivation and violence. Gun-related deaths and a heavy concentration of alcohol outlets are notable features of the area surveyed. Given the strong evidence for a link between alcohol availability and a number of alcohol-related problems, including violent crime, measures designed to reduce accessibility have become a favored choice for alcohol prevention programs in recent years. METHODS: The interviewers were 24 residents of the area who were trained for the study. It was selected an area of nineteen streets, covering a total distance of 3.7 km. A profile of each alcohol outlet available on the area was recorded. RESULTS: One hundred and seven alcohol outlets were recorded. The number of other properties in the same area was counted at 1,202. Two measures of outlet density may thus be calculated: the number of outlets per kilometer of roadway (29 outlets/km); and the proportion of all properties that sold alcohol (1 in 12). CONCLUSIONS: The results of this study is compared with others which are mainly from developed countries and shown that the area studied have the highest density of alcohol outlet density ever recorded in the medical literature. The implication of this data related to the violence of the region is discussed. By generating a profile of alcohol sales and selling points, it was hoped to gain a better understanding of alcohol access issues within the sample area. Future alcohol prevention policy would be well served by such knowledge.

Definition of MV Load Diagrams via Weighted Evidence Accumulation Clustering using Subsampling

A definition of medium voltage (MV) load diagrams was made, based on the data base knowledge discovery process. Clustering techniques were used as support for the agents of the electric power retail markets to obtain specific knowledge of their customers’ consumption habits. Each customer class resulting from the clustering operation is represented by its load diagram. The Two-step clustering algorithm and the WEACS approach based on evidence accumulation (EAC) were applied to an electricity consumption data from a utility client’s database in order to form the customer’s classes and to find a set of representative consumption patterns. The WEACS approach is a clustering ensemble combination approach that uses subsampling and that weights differently the partitions in the co-association matrix. As a complementary step to the WEACS approach, all the final data partitions produced by the different variations of the method are combined and the Ward Link algorithm is used to obtain the final data partition. Experiment results showed that WEACS approach led to better accuracy than many other clustering approaches. In this paper the WEACS approach separates better the customer’s population than Two-step clustering algorithm.

Determination of electricity consumers’ load profiles via weighted evidence accumulation clustering using subsampling

With the electricity market liberalization, the distribution and retail companies are looking for better market strategies based on adequate information upon the consumption patterns of its electricity consumers. A fair insight on the consumers’ behavior will permit the definition of specific contract aspects based on the different consumption patterns. In order to form the different consumers’ classes, and find a set of representative consumption patterns we use electricity consumption data from a utility client’s database and two approaches: Two-step clustering algorithm and the WEACS approach based on evidence accumulation (EAC) for combining partitions in a clustering ensemble. While EAC uses a voting mechanism to produce a co-association matrix based on the pairwise associations obtained from N partitions and where each partition has equal weight in the combination process, the WEACS approach uses subsampling and weights differently the partitions. As a complementary step to the WEACS approach, we combine the partitions obtained in the WEACS approach with the ALL clustering ensemble construction method and we use the Ward Link algorithm to obtain the final data partition. The characterization of the obtained consumers’ clusters was performed using the C5.0 classification algorithm. Experiment results showed that the WEACS approach leads to better results than many other clustering approaches.

Reactogenicity of yellow fever vaccines in a randomized, placebo-controlled trial

OBJECTIVE: To compare the reactogenicity of three yellow fever (YF) vaccines from WHO-17D and Brazilian 17DD substrains (different seed-lots) and placebo. METHODS: The study involved 1,087 adults eligible for YF vaccine in Rio de Janeiro, Brazil. Vaccines produced by Bio-Manguinhos, Fiocruz (Rio de Janeiro, Brazil) were administered ("day 0") following standardized procedures adapted to allow blinding and blocked randomization of participants to coded vaccine types. Adverse events after immunization were ascertained in an interview and in diary forms filled in by each participant. Liver enzymes were measured on days 0, 4-20 and 30 of the study. Viremia levels were measured on days 4 to 20 of follow-up. The immune response was verified through serologic tests. RESULTS: Participants were mostly young males. The seroconversion rate was above 98% among those seronegative before immunization. Compared to placebo, the excess risk of any local adverse events ranged from 0.9% to 2.5%, whereas for any systemic adverse events it ranged from 3.5% to 7.4% across vaccine groups. The excess risk of events leading to search for medical care or to interruption of work activities ranged from 2% to 4.5%. Viremia was detected in 3%-6% of vaccinees up to 10 days after vaccination. Variations in liver enzyme levels after vaccination were similar in placebo and vaccine recipients. CONCLUSIONS: The frequency of adverse events post-immunization against YF, accounting for the background occurrence of nonspecific signs and symptoms, was shown for the first time to be similar for vaccines from 17D and 17DD substrains. The data also provided evidence against viscerotropism of vaccine virus.

Residential property loans and performance during property price booms: evidence from European banks

Understanding the performance of banks is of the utmost relevance, because of the impact of this sector on economic growth and financial stability. Of all the different assets that make up a bank portfolio, the residential mortgage loans constitute one of its main. Using the dynamic panel data method, we analyse the influence of residential mortgage loans on bank profitability and risk, using a sample of 555 banks in the European Union (EU-15), over the period from 1995 to 2008. We find that banks with larger weights of residential mortgage loans show lower credit risk in good times. This result explains why banks rush to lend on property during booms due to the positive effects it has on credit risk. The results show further that credit risk and profitability are lower during the upturn in the residential property price cycle. The results also reveal the existence of a non-linear relationship (U-shaped marginal effect), as a function of bank’s risk, between profitability and the residential mortgage loans exposure. For those banks that have high credit risk, a large exposure of residential mortgage loans is associated with higher risk-adjusted profitability, through lower risk. For banks with a moderate/low credit risk, the effects of higher residential mortgage loan exposure on its risk-adjusted profitability are also positive or marginally positive.