The potential utility of age, triage score, and disposition data contained in emergency department electronic records for influenza-like illness surveillance in Montreal

La surveillance de l’influenza s’appuie sur un large spectre de données, dont les données de surveillance syndromique provenant des salles d’urgences. De plus en plus de variables sont enregistrées dans les dossiers électroniques des urgences et mises à la disposition des équipes de surveillance. L’objectif principal de ce mémoire est d’évaluer l’utilité potentielle de l’âge, de la catégorie de triage et de l’orientation au départ de l’urgence pour améliorer la surveillance de la morbidité liée aux cas sévères d’influenza. Les données d’un sous-ensemble des hôpitaux de Montréal ont été utilisées, d’avril 2006 à janvier 2011. Les hospitalisations avec diagnostic de pneumonie ou influenza ont été utilisées comme mesure de la morbidité liée aux cas sévères d’influenza, et ont été modélisées par régression binomiale négative, en tenant compte des tendances séculaires et saisonnières. En comparaison avec les visites avec syndrome d’allure grippale (SAG) totales, les visites avec SAG stratifiées par âge, par catégorie de triage et par orientation de départ ont amélioré le modèle prédictif des hospitalisations avec pneumonie ou influenza. Avant d’intégrer ces variables dans le système de surveillance de Montréal, des étapes additionnelles sont suggérées, incluant l’optimisation de la définition du syndrome d’allure grippale à utiliser, la confirmation de la valeur de ces prédicteurs avec de nouvelles données et l’évaluation de leur utilité pratique.

Physical disability, recent illnesses and health self-assessment in a population-based study in Sao Paulo, Brazil

Objectives. To investigate health self-assessment and to estimate the prevalence of chronic diseases and recent illnesses in people with and without physical disabilities (PD) in the state of Sao Paulo, southeastern Brazil. Study design. A Cross-sectional study comprising two population-based health surveys conducted in 2002 and 2003. Methods. A total of 8317 persons (165 with PD) were interviewed in the two studies. Variables concerning to health self-assessment; chronic disease and recent illness were compared in the people with and without PD. Negative binomial regression was used in the analysis. Results. Subjects with PD more often assessed their health as poor/very poor compared to non-disabled ones. They reported more illnesses in the 15 days prior to interview as well as more chronic diseases (skin conditions, anaemia, chronic kidney disease, stroke, depression/anxiety, migraine/headache, pulmonary diseases, hypertension, diabetes, arthritis/arthrosis/rheumatic conditions and heart disease). This higher disease prevalence can be either attributed to disability itself or be associated to gender, age and schooling. Conclusions. Subjects with PD had more recent illnesses and chronic diseases and poorer health self-assessment than non-disabled ones. Age, gender, schooling and disability have individual roles in disease development among disabled people.

Power series generalized nonlinear models

We introduce in this paper a new class of discrete generalized nonlinear models to extend the binomial, Poisson and negative binomial models to cope with count data. This class of models includes some important models such as log-nonlinear models, logit, probit and negative binomial nonlinear models, generalized Poisson and generalized negative binomial regression models, among other models, which enables the fitting of a wide range of models to count data. We derive an iterative process for fitting these models by maximum likelihood and discuss inference on the parameters. The usefulness of the new class of models is illustrated with an application to a real data set. (C) 2008 Elsevier B.V. All rights reserved.

Distribuição Espacial da Lagarta-do-Cartucho, Spodoptera frugiperda (J.E. Smith) (Lepidoptera: Noctuidae), na Cultura do Milho

O estudo da distribuição espacial da lagarta-do-cartucho, Spodoptera frugiperda (J.E. Smith), na cultura do milho é fundamental para garantir a utilização de estratégias de controle, otimização de técnicas de amostragem, determinação de danos econômicos e incorporação da dinâmica espacial dentro do modelo populacional. O experimento foi conduzido em três campos contendo 100 parcelas cada, sendo amostradas 10 plantas ao acaso por parcela, num total de 1000 plantas por campo em cinco datas de amostragem. Foram contados o número de lagartas pequenas (menor que 10 mm) e grandes (maior que 10 mm) por planta. As lagartas pequenas apresentaram um ajuste muito bom à distribuição binomial negativa e não à Poisson, indicando que esta categoria larval encontra-se agregada no campo. Os números de lagartas grandes por planta ajustaram-se razoavelmente à distribuição binomial negativa, com algumas datas ajustando-se à distribuição de Poisson. Portanto, as lagartas pequenas (alta densidade populacional) têm distribuição agregada no campo, enquanto que as lagartas grandes (baixa densidade populacional) podem ser mais dispersas no campo, tendendo à aleatoriedade.

Distribuição espacial de Tenuipalpus heveae Baker (Acari: Tenuipalpidae) na cultura da seringueira

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Physical disability, recent illnesses and health self-assessment in a population-based study in São Paulo, Brazil

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Relação entre desempenho e infecções por nematódeos gastrintestinais em bovinos Nelore em crescimento

Este estudo teve por objetivo verificar a associação entre o desempenho e a carga parasitária de 28 machos inteiros da raça Nelore (a partir de um ano de idade), naturalmente infectados por nematódeos gastrintestinais. de novembro de 1999 a junho de 2000, os animais foram pesados quinzenalmente, período no qual foram colhidas amostras de fezes e de sangue para a realização, respectivamente, de exames coprológicos e sangüíneos. Os dados da contagem de ovos por grama de fezes (OPG) ajustaram-se ao modelo de distribuição binomial negativa, indicando que a distribuição de nematódeos no rebanho é agregada. Não ficou evidenciada associação entre ganho de peso e contagem de OPG, e entre contagem de OPG e volume globular (VG). de 10 coeficientes de correlação entre ganho de peso e VG, oito foram negativos, mas apenas dois significativos (P<0,05). As estimativas de repetibilidade da contagem de OPG, LOG (OPG+1) e VG foram de 0,26, 0,25 e 0,33, respectivamente. Cooperia punctata foi a espécie mais freqüentemente encontrada parasitando os animais. Além dessa espécie, foram detectados os seguintes nematódeos: Haemonchus placei, Haemonchus similis, Trichostrongylus axei, Bunostomum phlebotomum e Oesophagostomum radiatum. O parasitismo por nematódeos gastrintestinais aparentemente não prejudicou o desenvolvimento dos animais estudados.

DISTRIBUTION OF THE NUMBER OF EURYTREMA SP EGGS PER GRAM OF FECES IN NATURALLY INFECTED CATTLE

Eurytrema sp. egg counts (epg) in the feces of naturally infected cattle were performed and the technique employed showed 94.2% probability of detecting positive cases of the infection with a single examination independently of the host parasite burden. It was also demonstrated that the epg of Eurytrema sp. follows a negative binomial distribution model and is characterized by its small magnitude.

Spatial Distribution of Euschistus heros (F.) (Hemiptera: Pentatomidae) in Soybean

Soybean bugs are major crop pests that cause significant reduction in harvest yield and influence grain quality. The aim of this study was to verify the spatial distribution of Euschistus heros (F.) (Hemiptera: Pentatomidae) in conventional and transgenic soybean cultivars. The experiment was conducted during the 2010-2011 crop season in UNESP/FCAV, Jaboticabal, SP, Brazil, in two fields of 10,000-m2 area that were subdivided into 100 plots (10 m × 10 m). The cultivars sown were M 7908 RR and its isoline M-SOY 8001. The number of the first to fifth instars and the number of adults were determined. To evaluate insect dispersion in the area, the following indices were used: variance/mean ratio, Morisita index, Green coefficient, and the k exponent of the negative binomial distribution. To study probabilistic models to describe the spatial distribution of the insects, the adjustments of the Poisson and negative binomial distributions were tested. The first to third instars showed aggregated spatial distribution, whereas the fourth and fifth instars, and adults, isolated or grouped, showed variation in the arrangement, ranging from moderately aggregated to randomly dispersed. During the adjustment of probability distributions, the negative binomial distribution model showed adjustment for the first to third instars, fourth and fifth instars, adults, and fourth and fifth instars plus adults. © 2013 Sociedade Entomológica do Brasil.

Distribuição espacial e plano de amostragem sequencial para Euschistus heros (Fabricius, 1794) (Heteroptera: Pentatomidae) na cultura da soja convencional e transgênica

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Distribuição espacial e plano de amostragem seqüencial de ácaros fitófagos na cultura da seringueira [Hevea brasiliensis (Wild. Ex Adr. de Juss.) Müell.Arg.]

Pós-graduação em Agronomia - FEIS

Homicide and public security indicator trends in the city of Sao Paulo between 1996 and 2008: a time-series ecological study

The scope of this paper was to analyze the association between homicides and public security indicators in Sao Paulo between 1996 and 2008, after monitoring the unemployment rate and the proportion of youths in the population. A time-series ecological study for 1996 and 2008 was conducted with Sao Paulo as the unit of analysis. Dependent variable: number of deaths by homicide per year. Main independent variables: arrest-incarceration rate, access to firearms, police activity. Data analysis was conducted using Stata. IC 10.0 software. Simple and multivariate negative binomial regression models were created. Deaths by homicide and arrest-incarceration, as well as police activity were significantly associated in simple regression analysis. Access to firearms was not significantly associated to the reduction in the number of deaths by homicide (p>0,05). After adjustment, the associations with both the public security indicators were not significant. In Sao Paulo the role of public security indicators are less important as explanatory factors for a reduction in homicide rates, after adjustment for unemployment rate and a reduction in the proportion of youths. The results reinforce the importance of socioeconomic and demographic factors for a change in the public security scenario in Sao Paulo.

Ecological implications on the aggregation of Amblyomma fuscum (Acari: Ixodidae) on Thrichomys laurentius (Rodentia: Echimyidae), in northeastern Brazil

We investigated the Amblyomma fuscum load on a pullulating wild rodent population and the environmental and biological factors influencing the tick load on the hosts. One hundred and three individuals of Thrichomys laurentius were caught in an Atlantic forest fragment in northeastern Brazil, as part of a longitudinal survey on ticks infesting non-volant small mammals. Ticks (n = 342) were found on 45 individuals and the overall mean intensity of infestation was 7.6 ticks per infested rodent. Ticks were highly aggregated in the host population and the negative binomial distribution model provides a statistically satisfactory fit. The aggregated distribution was influenced by sex and age of the host. The microhabitat preference by T. laurentius probably increases contact opportunities between hosts and aggregated infesting stages of the ticks and represents important clues about the habitat suitability for A. fuscum.

Effectiveness of a multifactorial falls prevention program in community-dwelling older people when compared to usual care: study protocol for a randomised controlled trial (Prevquedas Brazil)

Background Falling in older age is a major public health concern due to its costly and disabling consequences. However very few randomised controlled trials (RCTs) have been conducted in developing countries, in which population ageing is expected to be particularly substantial in coming years. This article describes the design of an RCT to evaluate the effectiveness of a multifactorial falls prevention program in reducing the rate of falls in community-dwelling older people. Methods/design Multicentre parallel-group RCT involving 612 community-dwelling men and women aged 60 years and over, who have fallen at least once in the previous year. Participants will be recruited in multiple settings in Sao Paulo, Brazil and will be randomly allocated to a control group or an intervention group. The usual care control group will undergo a fall risk factor assessment and be referred to their clinicians with the risk assessment report so that individual modifiable risk factors can be managed without any specific guidance. The intervention group will receive a 12-week Multifactorial Falls Prevention Program consisting of: an individualised medical management of modifiable risk factors, a group-based, supervised balance training exercise program plus an unsupervised home-based exercise program, an educational/behavioral intervention. Both groups will receive a leaflet containing general information about fall prevention strategies. Primary outcome measures will be the rate of falls and the proportion of fallers recorded by monthly falls diaries and telephone calls over a 12 month period. Secondary outcomes measures will include risk of falling, fall-related self-efficacy score, measures of balance, mobility and strength, fall-related health services use and independence with daily tasks. Data will be analysed using the intention-to-treat principle.The incidence of falls in the intervention and control groups will be calculated and compared using negative binomial regression analysis. Discussion This study is the first trial to be conducted in Brazil to evaluate the effectiveness of an intervention to prevent falls. If proven to reduce falls this study has the potential to benefit older adults and assist health care practitioners and policy makers to implement and promote effective falls prevention interventions. Trial registration ClinicalTrials.gov (NCT01698580)

High-risk drug use and sexual behaviors among out-of-treatment drug users: An aging and life course perspective

High-risk injection drug use and the sexual behaviors that accompany it have large social and financial costs. Tailored treatments have been shown to successfully reduce high-risk behaviors. However, little is known about how age and age at first drug use are related to high-risk injection or sex behaviors. The current study draws on life course theory and hypothesizes that age will have a strong relationship with high-risk behaviors of out-of-treatment drug users. Data from the NIDA Cooperative Agreement was used to analyze the relationship between (1) age, and (2) age at first drug use with seven high-risk injection and sexual behavior variables. Negative binomial regression models revealed that high-risk sexual behavior decreases between 15.8 and 20.9% with each decade of age, while high-risk injection behavior increases between 32 and 67% with each decade of age after the addition of demographic controls. Both high-risk injection and high-risk sex behaviors are significantly reduced with a delayed age at first drug use. Previous research promotes interventions to reduce the high-risk sexual behaviors of older drug users. The current study suggests a refocusing of public health efforts on the high-risk injection habits of older drug users.^