Prevalence and risk factors of Hepatitis C virus infection in Brazil, 2005 through 2009: a cross-sectional study

Abstract Background Hepatitis C chronic liver disease is a major cause of liver transplant in developed countries. This article reports the first nationwide population-based survey conducted to estimate the seroprevalence of HCV antibodies and associated risk factors in the urban population of Brazil. Methods The cross sectional study was conducted in all Brazilian macro-regions from 2005 to 2009, as a stratified multistage cluster sample of 19,503 inhabitants aged between 10 and 69 years, representing individuals living in all 26 State capitals and the Federal District. Hepatitis C antibodies were detected by a third-generation enzyme immunoassay. Seropositive individuals were retested by Polymerase Chain Reaction and genotyped. Adjusted prevalence was estimated by macro-regions. Potential risk factors associated with HCV infection were assessed by calculating the crude and adjusted odds ratios, 95% confidence intervals (95% CI) and p values. Population attributable risk was estimated for multiple factors using a case–control approach. Results The overall weighted prevalence of hepatitis C antibodies was 1.38% (95% CI: 1.12%–1.64%). Prevalence of infection increased in older groups but was similar for both sexes. The multivariate model showed the following to be predictors of HCV infection: age, injected drug use (OR = 6.65), sniffed drug use (OR = 2.59), hospitalization (OR = 1.90), groups socially deprived by the lack of sewage disposal (OR = 2.53), and injection with glass syringe (OR = 1.52, with a borderline p value). The genotypes 1 (subtypes 1a, 1b), 2b and 3a were identified. The estimated population attributable risk for the ensemble of risk factors was 40%. Approximately 1.3 million individuals would be expected to be anti-HCV-positive in the country. Conclusions The large estimated absolute numbers of infected individuals reveals the burden of the disease in the near future, giving rise to costs for the health care system and society at large. The known risk factors explain less than 50% of the infected cases, limiting the prevention strategies. Our findings regarding risk behaviors associated with HCV infection showed that there is still room for improving strategies for reducing transmission among drug users and nosocomial infection, as well as a need for specific prevention and control strategies targeting individuals living in poverty.

Outcome at two years of age in a Swiss national cohort of extremely preterm infants born between 2000 and 2008

Background While survival rates of extremely preterm infants have improved over the last decades, the incidence of neurodevelopmental disability (ND) in survivors remains high. Representative current data on the severity of disability and of risk factors associated with poor outcome in this growing population are necessary for clinical guidance and parent counselling. Methods Prospective longitudinal multicentre cohort study of preterm infants born in Switzerland between 240/7 and 276/7 weeks gestational age during 2000–2008. Mortality, adverse outcome (death or severe ND) at two years, and predictors for poor outcome were analysed using multilevel multivariate logistic regression. Neurodevelopment was assessed using Bayley Scales of Infant Development II. Cerebral palsy was graded after the Gross Motor Function Classification System. Results Of 1266 live born infants, 422 (33%) died. Follow-up information was available for 684 (81%) survivors: 440 (64%) showed favourable outcome, 166 (24%) moderate ND, and 78 (11%) severe ND. At birth, lower gestational age, intrauterine growth restriction and absence of antenatal corticosteroids were associated with mortality and adverse outcome (p < 0.001). At 360/7 weeks postmenstrual age, bronchopulmonary dysplasia, major brain injury and retinopathy of prematurity were the main predictors for adverse outcome (p < 0.05). Survival without moderate or severe ND increased from 27% to 39% during the observation period (p = 0.02). Conclusions In this recent Swiss national cohort study of extremely preterm infants, neonatal mortality was determined by gestational age, birth weight, and antenatal corticosteroids while neurodevelopmental outcome was determined by the major neonatal morbidities. We observed an increase of survival without moderate or severe disability.

Executive Reorganization: Building a State Government That Worked for People -- Tom Harrison, Diana Dowling & Sheena Wilson “In the Crucible of Change”

One of the primary accomplishments of Governor Forrest Anderson in 1969-71 was the reorganization of the Executive Branch of Montana government, something that had been attempted six different times between 1919 and 1962 as state government had grown from twenty agencies to almost 200 uncontrolled boards, bureaus and commissions. The chaotic structure of the executive branch disempowered governors of both parties and empowered the private corporations and organizations that were the power structure of Montana. With remarkable political acumen, Governor Anderson figured out how to get that near impossible job done. Central to his efforts was the creation of an Executive Reorganization Commission, including eight legislators and the Governor, the adoption of a Constitutional Amendment that limited the executive branch to no more than twenty departments under the Governor, and the timely completion of a massive research effort to delineate the actual structure of the twenty departments. That story is told in this episode by three major players in the effort, all involved directly with the Executive Reorganization Commission: Tom Harrison, Diana Dowling and Sheena Wilson. Their recollections reflect an insider’s perspective of this significant accomplishment that helped change Montana “In the Crucible of Change.” Tom Harrison is a former Republican State Representative and State Senator from Helena, who was a member of the Executive Reorganization Commission. As Majority Leader in the Montana House of Representatives in 1971, he was the primary sponsor of the House’s executive reorganization bill and helped shepherd the Senate’s version to passage. Harrison was the Republican candidate for Attorney General in 1976 after which he practiced private law for 3 more decades. He served in the Montana Army National Guard for almost 34 years, rising to the rank of Colonel in the position of Judge Advocate General. He was a founding Director of Federal Defenders of Montana (legal representation for indigents accused within the Federal Judicial System); appointed Chairman of the original Montana State Fund (workers' compensation insurance) by Gov. Stephens; served as President of the Montana Trial Lawyers Association, Helena Kiwanis Club and St. Peter's Community Hospital Foundation, as well as Chairman and Director of AAA MountainWest; and was a founder, first Chairman and Director of the Valley Bank of Helena for over 25 years. Diana Dowling was an attorney for the Executive Reorganization Commission and helped draft the legislation that was passed. She also worked for Governor Forrest Anderson and for the 1972 Constitutional Convention where she prepared and directed publication of official explanation of the new Constitution that was mailed to all Montana voters. Diana was Executive Director of the Montana Bar Association and for 20 years held various legal positions with the Montana Legislative Council. For 12 years she was a commissioner on the National Conference of Commissioners on Uniform State Laws and for 7 years was a member of Montana State Board of Bar Examiners. Diana was the first director of the Montana Lottery, an adjunct professor at both Carroll College and the UM Law School, and an administrative officer for Falcon Press Publishing Co. Diana is currently - and intends to continue being - a perpetual college student. Sheena Wilson came fresh out of the University of Montana to become a Research Assistant for the Executive Reorganization Commission. Later she worked for seven years as a field representative in Idaho and Montana for the Mountain Plains Family Education Program, for thirteen years with Congressman Pat Williams as Executive Assistant in Washington and Field Assistant here in Montana, owned and managed a Helena restaurant for seven years, worked as Executive Assistant for State Auditor John Morrison and was Deputy Chief of Staff for Governor Brian Schweitzer his full 8 years in the Governorship. Though currently “retired”, Sheena serves on the Montana Board of Investments, the Public Employees Retirement Board and the Capitol Complex Advisory Council and is a partner in a dry-land wheat farm in Teton County that was homesteaded by her great uncle.

The Other Side of the Doors: Butte & Beyond -- Congressman Pat Williams “In the Crucible of Change”

Pat Williams emerged from the Mining City of Butte, Montana with a sense of grassroots, people-oriented politics. His inherent belief in the power of ordinary citizens carried him through the Montana Legislature and into Congress for a record-setting period. The accomplishments of his long career partially obscured his innate progressive and populist instinct that is reflective of the period of “in the Crucible of Change.” This film addresses Pat’s early years when his progressive instincts and activities resulted in pushback from the giant Anaconda Company which had held Montana hostage for 75 years. Pat is joined for part of the film by former campaign staffer, and now prominent media consultant, Michael Fenenbock for reflections on Pat’s 1978 “Door-to-Door to Congress” campaign, which demonstrated the power of his belief in the people on the other side of the doors. Pat Williams (b. 1937) rose from teaching grade school in his hometown of Butte, MT, to serving for the longest number of consecutive terms (9 terms, 18 years) in the US House of Representatives of anyone in Montana history. Pat was a member of the National Guard and attended UM in Missoula and William Jewel College, graduating from the University of Denver. Pat also served in the Montana legislature for 2 terms (1966 & 1968 elections). In 1969. Pat helped his legislative seat-mate John Melcher get elected as Montana’s Eastern District Congressman in the Special Election that June. Pat went to Washington DC as Melcher’s Executive Assistant. Upon returning to Montana, Pat headed up the Montana offices of the innovative Mountain Plains Family Education Program. In 1974, Pat ran unsuccessfully for Montana’s Western District Congressional seat in a three-way race with former Congressman Arnold Olsen and state Legislator Max Baucus. After the drafting and passage of the 1972 Montana Constitution, Pat was named a member of Montana’s first-ever Reapportionment Commission. In 1978 he successfully ran for Congress, conducting a massive grass-roots door-to-door campaign of 1½ years, reaching 50,000 doors. In a hotly contested 6-way Democratic primary, Pat won going away and also handily won the general election. Pat served in Congress from January, 1979 until January of 1997, 14 years representing the Western District and 4 years representing the entire state. Upon his retirement from Congress, in 1997 Williams returned to Montana where has been an instructor at the University of Montana and Senior Fellow and Regional Policy Associate at the Center for the Rocky Mountain West. He is a former member of the Montana Board of Regents and serves on a number of national education-related boards. In Congress Pat was a Deputy Whip of the U.S. House of Representatives and sat on committees on: Budget, Natural Resources, Education and Labor, and Agriculture. Pat’s leadership helped pass trailblazing legislation to assist hard-working middle-class families and ensure opportunities for every child. Pat’s fingerprints are on many pieces of important legislation, including the College Middle Income Assistance Act, the Family and Medical Leave Act, the Toddlers and Childhood Disability Act, the Library Services and Construction Act, and the Museum Services Act. Pat successfully sponsored the Lee Metcalf Wilderness Area and the Rattlesnake Wilderness area, helped save the Bob Marshall Wilderness from oil and gas exploration, and helped ban geothermal energy drilling near the borders of Yellowstone National Park. As Chairman of The Post-Secondary Education Committee, he protected the National Endowment for the Arts from elimination, a remarkable undertaking during a very trying time for the Agency. Pat worked tirelessly with Tribal College Leaders to build Montana’s seven Tribal Colleges. He was also responsible for the legislation that created The American Conservation Corps, which became the Corporation for National Service, giving thousands of America’s young people a chance to serve their country and pursue higher education. Pat lives in Missoula with his wife Carol Griffith Williams, former Montana Senate Majority Leader. They have three children and five grandchildren.

Automated soldier medical readiness: Prevalence of " medically not ready" using data from the electronic soldier readiness processing system (ESRP)

Identifying accurate numbers of soldiers determined to be medically not ready after completing soldier readiness processing may help inform Army leadership about ongoing pressures on the military involved in long conflict with regular deployment. In Army soldiers screened using the SRP checklist for deployment, what is the prevalence of soldiers determined to be medically not ready? Study group. 15,289 soldiers screened at all 25 Army deployment platform sites with the eSRP checklist over a 4-month period (June 20, 2009 to October 20, 2009). The data included for analysis included age, rank, component, gender and final deployment medical readiness status from MEDPROS database. Methods.^ This information was compiled and univariate analysis using chi-square was conducted for each of the key variables by medical readiness status. Results. Descriptive epidemiology Of the total sample 1548 (9.7%) were female and 14319 (90.2%) were male. Enlisted soldiers made up 13,543 (88.6%) of the sample and officers 1,746 (11.4%). In the sample, 1533 (10.0%) were soldiers over the age of 40 and 13756 (90.0%) were age 18-40. Reserve, National Guard and Active Duty made up 1,931 (12.6%), 2,942 (19.2%) and 10,416 (68.1%) respectively. Univariate analysis. Overall 1226 (8.0%) of the soldiers screened were determined to be medically not ready for deployment. Biggest predictive factor was female gender OR (2.8; 2.57-3.28) p<0.001. Followed by enlisted rank OR (2.01; 1.60-2.53) p<0.001. Reserve component OR (1.33; 1.16-1.53) p<0.001 and Guard OR (0.37; 0.30-0.46) p<0.001. For age > 40 demonstrated OR (1.2; 1.09-1.50) p<0.003. Overall the results underscore there may be key demographic groups relating to medical readiness that can be targeted with programs and funding to improve overall military medical readiness.^

"Es preciso, pues, regimentar" : La organización de la Guardia Nacional de campaña. Buenos Aires, 1852-1862

En este trabajo estudiamos la organización de la Guardia Nacional en la campaña y la frontera bonaerense, durante los diez años que siguieron a su creación (1852-1862). En ese proceso se destacan dos períodos bien definidos. El primero, 1852-1857, se caracterizó por el predominio de los jueces de paz en el manejo de la institución. El segundo, 1857-1862, se definió por una mayor presencia de los jefes de los regimientos. Nos centraremos en el rol que tuvieron las autoridades civiles y militares que protagonizaron el "arreglo" de la Guardia Nacional de campaña. Procuraremos complejizar la percepción que existe sobre las relaciones de poder que se establecieron entre las jurisdicciones civil y militar, al mismo tiempo entre esta última.

El coronel Don Benito Machado. Un comandante de Guardias Nacionales en la frontera sur bonaerense (1852-1880)

En el presente trabajo, analizamos los regimientos de Guardias Nacionales y las funciones que desempeñaron sus comandantes durante el proceso de organización nacional en la frontera sur bonaerense, desde el estudio de caso del coronel don José Benito Machado. En primer lugar, repasamos las características específicas que adoptaron las Guardias Nacionales en las sociedades de la frontera sur de la provincia de Buenos Aires; mientras que, en segundo lugar, analizamos los diversos mecanismos desarrollados por Benito Machado para construir las bases de poder en la región que posibilitaron el afianzamiento de su liderazgo

"Es preciso, pues, regimentar" : La organización de la Guardia Nacional de campaña. Buenos Aires, 1852-1862

En este trabajo estudiamos la organización de la Guardia Nacional en la campaña y la frontera bonaerense, durante los diez años que siguieron a su creación (1852-1862). En ese proceso se destacan dos períodos bien definidos. El primero, 1852-1857, se caracterizó por el predominio de los jueces de paz en el manejo de la institución. El segundo, 1857-1862, se definió por una mayor presencia de los jefes de los regimientos. Nos centraremos en el rol que tuvieron las autoridades civiles y militares que protagonizaron el "arreglo" de la Guardia Nacional de campaña. Procuraremos complejizar la percepción que existe sobre las relaciones de poder que se establecieron entre las jurisdicciones civil y militar, al mismo tiempo entre esta última.

"Es preciso, pues, regimentar" : La organización de la Guardia Nacional de campaña. Buenos Aires, 1852-1862

En este trabajo estudiamos la organización de la Guardia Nacional en la campaña y la frontera bonaerense, durante los diez años que siguieron a su creación (1852-1862). En ese proceso se destacan dos períodos bien definidos. El primero, 1852-1857, se caracterizó por el predominio de los jueces de paz en el manejo de la institución. El segundo, 1857-1862, se definió por una mayor presencia de los jefes de los regimientos. Nos centraremos en el rol que tuvieron las autoridades civiles y militares que protagonizaron el "arreglo" de la Guardia Nacional de campaña. Procuraremos complejizar la percepción que existe sobre las relaciones de poder que se establecieron entre las jurisdicciones civil y militar, al mismo tiempo entre esta última.

El coronel Don Benito Machado. Un comandante de Guardias Nacionales en la frontera sur bonaerense (1852-1880)

En el presente trabajo, analizamos los regimientos de Guardias Nacionales y las funciones que desempeñaron sus comandantes durante el proceso de organización nacional en la frontera sur bonaerense, desde el estudio de caso del coronel don José Benito Machado. En primer lugar, repasamos las características específicas que adoptaron las Guardias Nacionales en las sociedades de la frontera sur de la provincia de Buenos Aires; mientras que, en segundo lugar, analizamos los diversos mecanismos desarrollados por Benito Machado para construir las bases de poder en la región que posibilitaron el afianzamiento de su liderazgo

El coronel Don Benito Machado. Un comandante de Guardias Nacionales en la frontera sur bonaerense (1852-1880)

En el presente trabajo, analizamos los regimientos de Guardias Nacionales y las funciones que desempeñaron sus comandantes durante el proceso de organización nacional en la frontera sur bonaerense, desde el estudio de caso del coronel don José Benito Machado. En primer lugar, repasamos las características específicas que adoptaron las Guardias Nacionales en las sociedades de la frontera sur de la provincia de Buenos Aires; mientras que, en segundo lugar, analizamos los diversos mecanismos desarrollados por Benito Machado para construir las bases de poder en la región que posibilitaron el afianzamiento de su liderazgo

"Es preciso, pues, regimentar" : La organización de la Guardia Nacional de campaña. Buenos Aires, 1852-1862

En este trabajo estudiamos la organización de la Guardia Nacional en la campaña y la frontera bonaerense, durante los diez años que siguieron a su creación (1852-1862). En ese proceso se destacan dos períodos bien definidos. El primero, 1852-1857, se caracterizó por el predominio de los jueces de paz en el manejo de la institución. El segundo, 1857-1862, se definió por una mayor presencia de los jefes de los regimientos. Nos centraremos en el rol que tuvieron las autoridades civiles y militares que protagonizaron el "arreglo" de la Guardia Nacional de campaña. Procuraremos complejizar la percepción que existe sobre las relaciones de poder que se establecieron entre las jurisdicciones civil y militar, al mismo tiempo entre esta última.

Housing discrimination study : incidence and severity of unfavorable treatment /

"HUD-1327-PDR"--Cover p. 4.