In addition to our main analysis, we conducted four subanalyses. First, we assessed whether the same transformation parameter (c) developed for the 2010– 13 data would be useful for the recalibrated 2013 GFT model by testing our transformation equation with the same parameter value for c on the most recent data available at the time of analysis using this model (weeks 31 to 10 of the 2013– 14 influenza season: July 28, 2013 to March 8, 2014; 32 weeks). Second, we calculated a separate value of c based on weeks 31 to 10 of the 2013–14 influenza season alone. Third, we assessed whether a similar transformation could have been developed before the large overestimation in GFT that occurred during the 2012– 13 season using data for week 39 of 2010 to week 39 of 2012. Fourth, as a supplemental analysis, we reran thetransformation separately for each of the ten UnitedStates Department of Health and Human Services (HHS) regions to examine how the value of c varied across the country. We used the final regional %ILINet values in these regional calculations as the historic preliminary regional values are not made available by CDC. The latter three subanalyses used the same methodology to estimate c as our main transformation analysis.
behavior; however, such pandemic-specific queries are not included in GFT models because they do not correlate well with ILINet data in previous seasons, nor are they necessarily expected to correlate with future seasonal or non-seasonal influenza activity. GoogleFluTrends can provide timely and accurate estimates of the influenza activity in theUnitedStates, especially during peak activity, even in the wake of a novel form of influenza. Although more experience is needed to fully understand GFT performance during smaller waves and off-peak periods, the pH1N1 pandemic allowed us to build a GFT model incorporating both seasonal and pandemic influenza, which gives us added confidence in the ability of GFT to accurately estimate future influenza activity. Validation with surveillance systems monitoring laboratory-confirmed influ- enza disease are needed with nonspecific systems such as the one described here. Two GFT UnitedStates models were compared during the pH1N1 pandemic: an original model trained without pH1N1 data and an updated model trained on data including the initial wave of pH1N1, the summer months of the pandemic. The two models performed well prior to pH1N1 (r.0.9), with the updated model performing slightly better. Although the original model did not perform well during the initial wave of pH1N1, it did perform well during the second wave. Finally, the updated model accounted for the shift in search behavior and ILINet estimates, and performed well over both waves. We will continue to perform annual updates of FluTrends models to account for additional changes in behavior, should they occur.
09/04/09). ILI is not specific to influenza, however. Prospective studies with laboratory sampling of persons with ILI have demonstrated a wide variability in the specificity of ILI for influenza disease, with the proportion of subjects testing positive for influenza ranging from 20% to 70% of those tested during the influenza season [3,4]. ILI may also not be sensitive for influenza, particularly in certain age or risk groups where influenza may have atypical presentations [5,6,7,8,9]. Furthermore, even during peak periods of influenza circulation, a substantial number of cases of febrile respiratory illness may have non-influenza etiologies. In theUnitedStates, during the spring wave of the 2009 H1N1 outbreak from March through August 2009, the proportion of positive influenza laboratory tests did not exceed 45% (http://www.cdc.gov/flu/ weekly, accessed 09/04/09).
The response of the other two wings of the triangle to Beijing’s attempt to expand its sphere of influence was indeed respectful (in the sense that China’s attempts to enforce its claims were not met with greater or equal force), although no one actually agreed with the 9-dash line except Taiwan (who distanced itself from China’s attempts to enforce it). In Southeast Asia, Vietnam and the Philippines were vociferous in their objections, and Manila, after failing to generate support for a Code of Conduct at ASEAN in 2011, took its claims to theUnited Nations Convention on the Law of the Sea (UNCLOS) Court of Arbitrarion in 2012. Vietnam, having lost naval battles with China in 1974 and 1988, tried to find a balance between resistance and negotiation. China’s position was for shelving sovereignty issues and engaging in bilateral joint development, but those who tried to negotiate were told that joint development was premised on concession of sovereignty. Those states whose EEZs were interdicted sought to mobilize joint resistance by ASEAN because Beijing’s joint venture terms were unattractive and they were too weak to contest them bilaterally. But other ASEAN countries, e.g. Cambodia, Laos and Myanmar, had no maritime territorial claims and enjoyed expanding economic relations with the PRC. More importantly, the integration of China into such expanded forums as the ARF and ADMM plus gave Beijing a voice in the question of whether to constrain Beijing, which it used skillfully. Thus Southeast Asia proved unable to concert a united resistance to China’s incremental advances.
The greatest political support today is for incremental expansions of our current programs, which, theoretically, would eventually result in universal coverage. There are innumerable variations of this approach. Most would increase the affordability of insurance premiums for private group and individual plans by providing ﬁ nancial assistance through tax policies and by modifying the beneﬁ ts and coverage of the plans. Some policy analysts recommend that employers be mandated to offer coverage to their employees. Others recommend that individuals be required to purchase their own coverage. Since some individuals would be left without coverage, a public program, such as the existing Medicaid program for low-income individuals, would be used to cover everyone else. Many simulation studies have shown that these approaches could be effective in covering almost everyone, but they are the most expensive models of reform since they leave in place the administrative excesses of the fragmented system of funding care . Also, to keep premiums affordable, these approaches may fall short on comprehensiveness of coverage and on the affordability of the out-of-pocket component, especially for those individuals with greater health care needs.
divorce, but not by an extramarital affair); Copeland, 551 So. 2d at 355 (parties married previously to each other face no special burden to create a common law marriage); Coleman, 531 So. 2d at 882; Aaberg, 512 So. 2d at 1376; Etheridge v. Yeager, 465 So. 2d 378, 379-80 (Ala. 1985) (no formal ceremony or particular words are necessary but words of present assent are required at the time agreement to marriage took effect); Mills v. Bose, 435 So. 2d 1264, 1265 (Ala. 1983) (parties need not know legal effects of common law marriage at time mutual assent is given); Piel, 361 So. 2d 90, 93-4 (agreement can be inferred from circumstances); Skipworth v. Skipworth, 360 So. 2d 975, 976 (Ala. 1978) (lack of agreement cannot be inferred from intention of parties to obtain formal marriage); Krug v. Krug, 292 Ala. 498, 29 So. 2d 715, 718 (19974) (agreement to marriage must be “permanent and exclusive of all others”); Beck v. Beck, 286 Ala. 692, 246 So. 2d 420, 425 (1971).
The kissing bug epidemic had substantial cultural influences across the nation during its two-month reign. Replicas of the kissing bug became a fashion statement, as indicated by an article stating that “the Washington girl might wear the kissing bug on all occasions, and in all forms of her jewelry, from her garter buckles to her tiara” . Advertisements and political cartoons were published about the varying forms of the kissing bug in society, particularly male suitors [22–24]. Professional beggars were noted to have forged emergency room notes of employment deferral in an attempt to appeal to the sympathies of passersby . Even crimi- nals used kissing bug encounters as defenses in their legal arguments [25,26].
This study is limited by its retrospective nature. Thus, the inluence of speciic events, such as outbreaks, on antibiotic susceptibility could not be precisely deined. Otherwise, the long assessment period could dilute the inluence of eventual outbreaks when taking into account the long-term antimicrobial susceptibility tendencies at the institution in this study. The same idea should be considered with regard to the different methods used to assess antibiotic susceptibility. In the last eight years, the automated Vitek TM system became the only method used,
Meanwhile, 53 institutions have published more than fifty articles. Figure 2 shows the ten institutions with the highest number of articles published. The institution with the highest number of articles published on this research field was Universidade Federal de Lavras, with a total of 418 articles. Also, the average growth rate (AGR) during the period 2016 - 2017 was positive for the first and third institution with 5.5 and 4.5 respectively. The Univ Fed Viscosa, Brazil with a total of 339 articles had a decrease of -7 in the number of articles published. The CIRAD institution from France with 135 articles is the highest AGR with 7.0 during this period. The institution’s country was extracted from authors affiliations. According to the institutions rank, Brazil is the country with the highest total number of articles published, where, five from the first ten institutions belong to this country, followed by theUnitedStates and France.
Data for theUnitedStates was the most robust, as many articles analyzed blood samples collected for NHANES, which collects data from a population representative of that of theUnitedStates. However, blood samples for the most recent NHANES were collected between 1988 and 1994 and thus prevalence data may not be representative of the current burden of disease 20 years later. Prevalence estimates for theUnitedStates ranged from 8.6% for ages 1–5 to 15.1% for ages 6–11, with an overall prevalence rate of 13.9% reported for all adults and children ages 6 and older [3,10]. Data for Canada focused mainly on indigenous commu- nities living in rural areas. Prevalence estimates ranged from 0.6% to 13.4%, indicating that for some communities toxocara infection causes a significant burden; however, the overall burden of disease in Canada as a whole is still unknown [11,12]. Reported seroprevalence estimates in Mexico tended to be higher than those reported for theUnitedStates and Canada and the data available focused on comparing prevalence rates in high-risk groups, such as psychiatry patients, waste pickers, and asthmatic children to controls (Table 2) [9,13,14]. Seroprevalence rates in these high-risk groups ranged from 4.7% in inpatient psychiatric patients to 30.8% in children with asthma [9,14].
The current study examines a nationally representative sample of hospital based emergency departments to provide estimates of ED visits attributed to attempted suicides and self inflicted injuries among children ages 18 years and younger in theUnitedStates. The results suggest that a greater proportion of such visits occurred among females (66.4% of the total visits). The frequently reported sources of injuries were attempts to poison themselves. Prior nationwide estimates also suggest that self poisoning is the most common method of self inflicted injuries and attempts to suicide . However, this may be contributed by the higher percentage of female population shown in our study. A recent study by Branco et al. demonstrated a distinct sex differences in the mechanism of self-inflicted injuries in childhood and adolescents (ages 18 years and younger). Among male adolescents, shooting was found to be the most common mechanism, while poisoning was the dominant mechanism in female victims . Fortunately, majority of the incidents tend to be non-fatal among children. Previous studies have shown that use of firearms is the leading cause of fatal self inflicted injuries [9–11]. In the current study, use of firearms was reported in less than 1% of all ED visits and this could explain the low mortality rates observed. Restricting access to firearms has been reported to be an effective approach to prevent suicides [9,10]. The economics associated with treating children with these injuries in ED and hospital settings are also presented and highlight the public health burden of the problem.
Indeed, several conflict and post-conflict countries in the OIC stand out for their high prevalence rates of NTDs. In Sudan, the high endemicity of trachoma, hook- worm and other intestinal helminth infec- tions, and schistosomiasis were already mentioned. In addition, dracunculiasis (guinea worm) is still prevalent, and more cases of guinea worm occur there relative to any other country [11,24]. Some of the world’s highest rates of visceral leishman- iasis also occur in Sudan, particularly along the border with Ethiopia where refugees living under conditions of ex- treme stress are exposed to sandfly vectors [11,25,26]. For similar reasons, visceral leishmaniasis is endemic to Somalia, where extremely high rates of schistoso- miasis are also present [6,26]. War-torn areas of Afghanistan (and much of Paki- stan) and Iraq exhibit a high prevalence of both leishmaniasis (especially cutaneous leishmaniasis) and ascariasis [27–29]. Un- like other intestinal helminths, the eggs of Ascaris lumbricoides are capable of with- standing the cold and dry conditions that can occur in these countries. Ascariasis and other intestinal parasitic infections are also highly prevalent among children living in the Gaza strip . I have suggested previously that the NTDs not only emerge in the setting of conflict, but these infections may also promote conflict through their destabilizing effects on human populations and agriculture .
Quanto à segunda questão, o âmbito foi nacio- nal e distinguiu-se ao mesmo tempo, entre regiões e cidades. A terceira e quarta questão foram realizadas comparando com serviços web "não co- laborativos"como as empresas de autocarros que permitem reservas de bilhetes na internet. A esco- lha destas empresas recaiu sobre aquelas que estão nos primeiros lugares do ranking de buscas no Go- ogle. A quinta e sexta questão foram respondidas com a ajuda da ferramenta GoogleTrends e fo- ram complementadas com o Google Insights for Search.
UnitedStates-Mexico Border, Diagnostic of Healthcare Services, Volume II presents data and information in such a way that facilitates comparative analyses of the distribution of health resources, not only within each border state, but also horizontally, from state to state and county to county across the border. This volume describes demographic factors that impact the supply and demand of services, coverage of services, as well as human, financial and infrastructure resources at both the county and state levels. Special care has been taken to present data in a way that allows comparisons with the data contained in Volume I.
Though libraries continue to struggle with challenges to collected material, the landscape in which they perform their service to the community has changed. The preponderance of multiple formats and information access points via ICT make limiting access through abridging a library collections less effective than it has been historically (Knox 2015). In light of such changes, the role of libraries in responding to book challenges and book banning has become primarily educational. In 1982, the American Library Association through its Office of Intellectual Freedom, instituted Banned Books Week, an annual celebration held in September to promote awareness of frequently challenged materials (American Library Association Office of Intellectual Freedom, 2013). Since its inception, libraries have used Banned Books Week as a platform to educate the public about the impact of censorship to society and promote greater readership of challenged materials, independent of the format.