Monthly Mean Number Research Articles

Timesavers: Clinical Decision Support and Automation of MRSA and VRE Deisolation

Background: Most healthcare facilities in the US apply contact precautions (CP) for patients with methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enterococci (VRE) infection and/or colonization. Most individuals with MRSA or VRE colonization will clear over time; however, frontline clinicians rarely evaluate for discontinuation of CP, resulting in increased burden on infection preventionists (IPs). Automation of time- and test-based evaluation using clinical decision support systems (CDSS) embedded in electronic health records (EHR) may increase evaluation and discontinuation of CP when appropriate, while preserving IP resources. Methods: This quality improvement initiative was implemented at Mass General Brigham (MGB), an integrated healthcare system, where patients with MRSA or VRE infection/colonization are identified in the EHR with a corresponding “infection status” and CP applied. Following MGB policy (Figure 1), CDSS features included: 1) automated time-based resolution from 2/15/2023-11/13/2023 and 2) automated ordering of screening assays for patients eligible for test-based evaluation from 6/20/2023-11/14/2023 (Figure 2). Counts of CP discontinuation and automated ordering were performed. IPs at one MGB facility performing manual review of patients self-recorded the time spent evaluating for CP discontinuation. Using these time reports, the average time to complete these tasks and the projected time savings were calculated over the implementation period. Results: Four IPs recorded the time to review patients for CP discontinuation, including reviewing recent antimicrobial administration, microbiology results, ordering screening test(s), and contacting the primary team. Twenty-five patient encounters were timed with a mean of 4.7 minutes documented per encounter. Over a 9-month period after initiation of the automated time-based resolution, the monthly mean number of patients with CP for MRSA and VRE which were automatically discontinued was 247 and 100, respectively. Projected IP time savings over the same 9-month period for MRSA and VRE were 174.1 and 70.5 hours, respectively. Over a 5-month period after initiation of automated ordering of MRSA polymerase chain reaction (PCR)/culture, as well as VRE culture for test-based evaluation, the monthly mean number of MRSA culture, MRSA PCR, and VRE culture automatically ordered for patients on CP for MRSA and VRE were 176, 24, and 145, respectively. Projected IP time savings over the same 5-month period for MRSA and VRE were 78.3 and 56.8 hours, respectively.Conclusion: Healthcare systems that enhance their EHR with CDSS to automate CP evaluations may improve frontline clinician workflow, patient flow and bed capacity, while optimizing use of IP resources.

Changes in primary care visits for respiratory illness during the COVID-19 pandemic: a multinational study by the International Consortium of Primary Care Big Data Researchers (INTRePID).

The majority of patients with respiratory illness are seen in primary care settings. Given COVID-19 is predominantly a respiratory illness, the INTernational ConsoRtium of Primary Care BIg Data Researchers (INTRePID), assessed the pandemic impact on primary care visits for respiratory illnesses. Definitions for respiratory illness types were agreed on collectively. Monthly visit counts with diagnosis were shared centrally for analysis. Primary care settings in Argentina, Australia, Canada, China, Norway, Peru, Singapore, Sweden and the United States. Over 38 million patients seen in primary care settings in INTRePID countries before and during the pandemic, from January 1st, 2018, to December 31st, 2021. Relative change in the monthly mean number of visits before and after the onset of the pandemic for acute infectious respiratory disease visits including influenza, upper and lower respiratory tract infections and chronic respiratory disease visits including asthma, chronic obstructive pulmonary disease, respiratory allergies, and other respiratory diseases. INTRePID countries reported a marked decrease in the average monthly visits for respiratory illness. Changes in visits varied from -10.9% [95% confidence interval (CI): -33.1 to +11.3%] in Norway to -79.9% (95% CI: -86.4% to -73.4%) in China for acute infectious respiratory disease visits and - 2.1% (95% CI: -12.1 to +7.8%) in Peru to -59.9% (95% CI: -68.6% to -51.3%) in China for chronic respiratory illness visits. While seasonal variation in allergic respiratory illness continued during the pandemic, there was essentially no spike in influenza illness during the first 2 years of the pandemic. The COVID-19 pandemic had a major impact on primary care visits for respiratory presentations. Primary care continued to provide services for respiratory illness, although there was a decrease in infectious illness during the COVID pandemic. Understanding the role of primary care may provide valuable information for COVID-19 recovery efforts and planning for future global emergencies.

ED Visits for Schizophrenia Spectrum Disorders During the COVID-19 Pandemic at 5 Campus Health Systems.

Although substantial research has reported grave population-level psychiatric sequelae of the COVID-19 pandemic, evidence pertaining to temporal changes in schizophrenia spectrum disorders in the US following the pandemic remains limited. To examine the monthly patterns of emergency department (ED) visits for schizophrenia spectrum disorders after the onset of the COVID-19 pandemic. This observational cohort study used time-series analyses to examine whether monthly counts of ED visits for schizophrenia spectrum disorders across 5 University of California (UC) campus health systems increased beyond expected levels during the COVID-19 pandemic. Data included ED visits reported by the 5 UC campuses from 2016 to 2021. Participants included persons who accessed UC Health System EDs had a diagnosis of a psychiatric condition. Data analysis was performed from March to June 2023. The exposures were binary indicators of initial (March to May 2020) and extended (March to December 2020) phases of the COVID-19 pandemic. The primary outcome was monthly counts of ED visits for schizophrenia spectrum disorders. International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnosis codes, categorized within Clinical Classification Software groups, were used to identify ED visits for schizophrenia spectrum disorders and all other psychiatric ED visits, from the University of California Health Data Warehouse database, from January 2016 to December 2021. Time-series analyses controlled for autocorrelation, seasonality, and concurrent trends in ED visits for all other psychiatric conditions. The study data comprised a total of 377 872 psychiatric ED visits, with 37 815 visits for schizophrenia spectrum disorders. The prepandemic monthly mean (SD) number of ED visits for schizophrenia spectrum disorders was 519.9 (38.1), which increased to 558.4 (47.6) following the onset of the COVID-19 pandemic. Results from time series analyses, controlling for monthly counts of ED visits for all other psychiatric conditions, indicated 70.5 additional ED visits (95% CI, 11.7-129.3 additional visits; P = .02) for schizophrenia spectrum disorders at 1 month and 74.9 additional visits (95% CI, 24.0-126.0 visits; P = .005) at 3 months following the initial phase of the COVID-19 pandemic in California. This study found a 15% increase in ED visits for schizophrenia spectrum disorders within 3 months after the initial phase of the pandemic in California across 5 UC campus health systems, underscoring the importance of social policies related to future emergency preparedness and the need to strengthen mental health care systems.

The relationship between PM10 and SO2 exposure and Covid-19 infection rates in Turkey using nomenclature of territorial units for statistics level 1 regions

The Covid-19 pandemic, which has been affecting the world since December 2019, has become one of the biggest problems of the 21st century. There are studies stating that the contagiousness of the Covid-19 pandemic, which is transmitted from person to person, increases more with environmental factors such as air pollution, and accordingly, there is an increase in the number of cases. In this study, a panel regression model to investigate the effect of air pollution concentrations such as PM10 and SO2 as environmental factors and population density on the monthly mean number of Covid-19 cases for 12 regions at the nomenclature of territorial units for statistics (NUTS) level 1 in Turkey between June 2020 and November 2020, and a linear regression model to investigate the effect at the regional level. we used. Based on the model results, we concluded that a small increase in air pollution indicators led to an increase in the number of Covid-19 cases in Turkey and its regions. It is very important to identify preventable environmental factors in order to prevent and minimize the effects of respiratory tract diseases and rapidly spreading pandemic diseases such as Covid-19. Accordingly, we can conclude that countries should take some measures, especially on air pollution, in order to develop public health and pandemic/disease management strategies and to reduce the risk of respiratory diseases.

Evident differences of haze days between December and January in north China and possible relationships with preceding climate factors

AbstractAir pollution of fine particulate matter (PM2.5) is severe in winter and causes vast premature deaths in north China. Many previous studies have concerned winter‐mean haze conditions and identified some useful climate factors. However, obvious differences in the number of haze days also existed between December and January (HDJ‐D) that lacked of understandings. The HDJ‐D maximum was 6.6 days, which occurred between December 2005 and January 2006, accounting for more than 45% of the monthly mean number of haze days in these 2 months. Differences of large‐scale atmospheric circulations were distributed like a Rossby wave pattern in mid‐troposphere, with centres in the west of Europe (+), the north to the Caspian Sea (−) and north China (+). Associated meteorological conditions in north China resulted in more adverse ventilation conditions and stronger chemical productions, and thus larger number of haze days in January than in December. In addition, significant relationships between HDJ‐D and three preceding climate factors during 1979–2018 were also revealed, including August–September–October sea ice over the Laptev Sea and the north of the Kara Sea (correlation coefficient = −0.53), November snow depth in eastern Europe and western Siberia (correlation coefficient = −0.44) and sea surface temperature over the Mid‐Atlantic Ridge (correlation coefficient = −0.48). Abundant analyses, basing on the observation data, large‐ensemble climate simulations and atmospheric chemical simulations, all reproduced the influences of each climate factor on large‐scale atmospheric circulations and local meteorological conditions associated with HDJ‐D changes.

The inception of a hospital-based dental emergency department in a precarious region decreases the incidence of severe cellulitis of odontogenic origin

Introduction: Although most localized odontogenic infections can be managed successfully without complications, some can cause extensive morbidity through the onset of cervicofacial cellulitis. The management of these more severe infections generally requires emergency treatment, including surgical treatment under general anesthesia, and prolonged length of hospital stay. Material & Methods: In this work, we assessed the impact of the provision of a hospital-based dental emergency department on the regional incidence of severe odontogenic cellulitis in a socioeconomically precarious region. Monthly case rates of odontogenic cellulitis treated between January 2010 and December 2019 at the hospital-based dental emergency department of Lille Medical University Hospital were collected. Results: The mean number of monthly severe odontogenic cellulitis cases treated under general anesthesia was significantly higher before than after the inception of the hospital-based dental emergency service [14.07 (5.83) vs 8.79 (4.42); p<0.0001]. Conversely, the monthly mean number of collected odontogenic cellulitis cases treated under local anesthesia was significantly lower before the emergency service was set up [22.42 (12.73) vs 43.32 (23.41); p<0.0001]. Conclusion: The provision of a hospital-based dental emergency department resulted in a decrease in severe dental infections in a region with high indices of socioeconomic precarity, morbidity and mortality. Greater accessibility to dental care allows for the rationalization of care through more precocious and fewer burdensome procedures.

Randomised trial on effect of involving media reporters in salt reduction programme to increase media reports and the public's knowledge, belief and behaviors on salt and health: Changzhi reporters trial.

ObjectiveTo assess the effects of a novel mass media intervention in increasing media reports on salt and health by involving media reporters in a scientifically well designed salt reduction trial.MethodsWe recruited and trained 66 media reporters in Changzhi, Shanxi province, China to conduct a randomized controlled trial on blood pressure lowering effect of salt substitute in Dec, 2012 and Jan 2013 among their own relatives or friends (253 from 129 families in the salt substitute arm and 263 from 133 families in the control arm for two months). We shared trial results and other information on salt and health with the reporters within a month after the trial. We monitored all local newspapers for the number of relevant articles in 3 months before, 3 months during and 3 months after the intervention and at the 6th, 12th, 18th, 24th and 48th months after the intervention. Additionally, we conducted two independent surveys on knowledge, belief and behaviours of salt and health among local citizens before and after the intervention.ResultsAs expected, systolic blood pressure was reduced significantly more in the salt substitute than the control group (-4.7±11.0 mmHg vs -2.6±10.3 mmHg, p<0.001) in the randomized trial. The monthly mean number of relevant articles increased from 0.7 before to 1.7 during (p = 0.263), and further to 6.0 after the intervention (p<0.001), and varied from 2 (p = 0.170) to 4 (p = 0.008) from the 6th to 48th month; the awareness of knowledge on salt and health among local citizens improved significantly after the intervention.ConclusionsMedia reporters’ participation in a well-designed salt reduction trial significantly increased the number of relevant media reports, and the effect was sustained for a prolonged period. Future mass media public health education programs should consider this innovative strategy for better and sustained impacts.

Pediatric asthma exacerbations during the COVID-19 pandemic: Absence of the typical fall seasonal spike in Washington, DC

Pediatric asthma exacerbations during the COVID-19 pandemic: Absence of the typical fall seasonal spike in Washington, DC

Effectiveness of Physical Distancing: Staying 6 Feet Over to Put Respiratory Viruses 6 Feet Under

Community transmission of severe acute respiratory illness Coronavirus-2 (SARS-CoV-2) in Arizona was noted in March 2020. It was our hypothesis that the associated implementation of physical distancing and masking led to a decline in circulation and detection of common respiratory viruses. Nasopharyngeal swabs processed with the Biofire, Film Array respiratory panel at Mayo Clinic Arizona were reviewed from January 1, 2017, to July 31, 2020. A total of 13,324 nasopharyngeal swabs were analyzed. Between April and July 2017- 2019 (Period A) a mean of 262 tests were performed monthly, falling to 128 for the corresponding months of 2020 (Period B). A reduction in the monthly mean number of positive tests (Period A 71.5; Period B 2.8) and mean positivity rate (Period A 25.04%; Period B 2.07%) was observed. Rhinovirus/enterovirus was the most prevalent virus, with a monthly mean of 21.6 cases (30.2% of positives) for Period A and 2 cases (72.7% of positives) for Period B. Positivity for a second virus occurred in a mean of 2.1 positive tests (3.3%) in Period A but was absent in Period B. Implementation of distancing and masking coincides with a marked reduction in respiratory virus detection and likely circulation. Data from the fall/winter of 2020 will help clarify the potential role for distancing and masking as a mitigation strategy, not only for SARS-CoV-2 but also in the seasonal battle against common respiratory viruses.

Patrones espaciotemporales de las observaciones de Sentinel-2 a nivel de imagen y píxel sobre el territorio mexicano entre 2015 y 2019

&lt;p class="p1"&gt;Sentinel-2 imagery has the highest temporal, spectral and spatial resolution to monitor land surface among the freely available multispectral collections. However, the possibility to use these images in different applications is conditioned by the number of cloudless observations available for a certain spatiotemporal window. Thus, the objective of this article is to analyze the number of Sentinel-2 observations available for the Mexican territory at image and pixel level. In the first case, the total number of available images and its cloud cover percentage was calculated; while in the second case, the number of cloudless observations was estimated for each pixel. Additionally, in order to take into account the territory diversity, the monthly mean number of cloudless observations, as well as the proportion of its surface with at least one cloudless observation in monthly, bimonthly, trimonthly and annual intervals, was computed for each one of the seven ecoregions of the country. The results show that annually, the number of valid observations per pixel is between 0 and 121 observations, while in monthly evaluations, between 0 and 6.58 observations. Additionally, in the 2017-2019 period annual observations can be obtained for the entire Mexican land surface, while in 2018-2019, monthly or trimonthly evaluations can be achieved, depending on the ecoregion. We consider that these results will provide useful information for researchers that are interested in using Sentinel-2 imagery for different applications.&lt;/p&gt;

PND57 INFORMAL CARE COST IN NEUROLOGIC DISORDERS WITH THE CONTINGENT VALUATION METHOD

To realize the first estimate of the cost of informal care associated with epilepsy, Parkinson disease (PD), and multiple sclerosis (MS) with the contingent valuation method (CVM). Individuals with MS (n=58), PD (n=96), or epilepsy (n=193) declaring informal caregivers in the French Health and disabilities households survey (Enquête Handicap-Santé) were classified in non-dependent, moderate and severe levels of dependency for the activities in daily living. The mean cost of informal care from the main caregiver per year was calculated with the Proxy Good (PGM), Opportunity Cost (OCM), and CVM methods. The monthly mean (standard deviation, SD) number of informal care hours per care recipients was 142 (201) in PD, 138 (170) in MS, and 151 (180) in epilepsy. It increased with the level of dependency. The PGM and OCM produced similar costs (mean difference [SD] of €243 [440]). The CVM produced greater costs in severely dependent forms- (mean cost [SD] of €187,029 [328,058] versus €25,685 [22,520] for both OCM and PGM in MS; and €41,915 [38,157] with CVM versus €34,627 [25,263] with OCM, and €34,545 [25,308] with PGM in epilepsy). By revealing the preferences of informal caregivers, the CVM could catch intangible effects of informal care related to severe MS and epilepsy, compared to PGM and OCM which consider only the effect on caregivers’ productivity in the labour market. However, numerous methodological questions remain about the calculation of the informal care cost and its implementation in economic evaluations.

New particle formation events observed at the King Sejong Station, Antarctic Peninsula – Part 2: Link with the oceanic biological activities

Abstract. Marine biota is an important source of atmospheric aerosol particles in the remote marine atmosphere. However, the relationship between new particle formation and marine biota is poorly quantified. Long-term observations (from 2009 to 2016) of the physical properties of atmospheric aerosol particles measured at the Antarctic Peninsula (King Sejong Station; 62.2∘ S, 58.8∘ W) and satellite-derived estimates of the biological characteristics were analyzed to identify the link between new particle formation and marine biota. New particle formation events in the Antarctic atmosphere showed distinct seasonal variations, with the highest values occurring when the air mass originated from the ocean domain during the productive austral summer (December, January and February). Interestingly, new particle formation events were more frequent in the air masses that originated from the Bellingshausen Sea than in those that originated from the Weddell Sea. The monthly mean number concentration of nanoparticles (2.5–10 nm in diameter) was &gt;2-fold higher when the air masses passed over the Bellingshausen Sea than the Weddell Sea, whereas the biomass of phytoplankton in the Weddell Sea was more than ∼70 % higher than that of the Bellingshausen Sea during the austral summer period. Dimethyl sulfide (DMS) is of marine origin and its oxidative products are known to be one of the major components in the formation of new particles. Both satellite-derived estimates of the biological characteristics (dimethylsulfoniopropionate, DMSP; precursor of DMS) and phytoplankton taxonomic composition and in situ methanesulfonic acid (84 daily measurements during the summer period in 2013 and 2014) analysis revealed that DMS(P)-rich phytoplankton were more dominant in the Bellingshausen Sea than in the Weddell Sea. Furthermore, the number concentration of nanoparticles was positively correlated with the biomass of phytoplankton during the period when DMS(P)-rich phytoplankton predominate. These results indicate that oceanic DMS emissions could play a key role in the formation of new particles; moreover, the taxonomic composition of phytoplankton could affect the formation of new particles in the Antarctic Ocean.

A4427 Study on the effect of clinical decision support system in the management of cardiovascular disease risk factors for Community Hypertensive Patients in 81388 cases in real world

Objectives: To evaluate the effect of clinical decision support system (CDSS) in the real world on the management of cardiovascular risk factors in community-based hypertensive patients. Methods: The data of 76 community health service centers in Futian district of Shenzhen city from June 1, 2015 to May 31, 2017 were collected based on the real-world data of the community health service center, including general demographic information, diagnostic information, blood pressure / Lipid monitoring information, medication information. Results: A total of 81388 cases of hypertensive patients were collected. There were 4315 CDSS patients with a mean age of (62.13 ± 10.45) years, the proportion of men and women is 1.31:1. There were 77073 non-CDSS patients with an average age of (57.58 ± 11.36) years, and the ratio of male and female is 1.21:1. The number of monthly outpatient visits (t = 3078.18, P < 0.001), the monthly mean number of outpatient lipids (t = 23464.27, P < 0.001), the prevalence of dyslipidemia (=2470.54, P < 0.001), blood pressure control compliance rate (= 10.38, P = 0.002) in the CDSS patients were higher then non-CDSS patients, and in the prevention of cardiovascular disease, antihypertensive drug use rate (= 179.48, P < 0.001), antiplatelet drug use rate (= 247.37, P < 0.001), lipid-lowering drug use rate (= 163.23, P < 0.001) in the CDSS patients were higher than non-CDSS patients. Conclusion: The electronic clinical decision support system can help community doctors to better manage cardiovascular risk factors for hypertensive patients, effectively improve patient compliance with treatment, improve blood pressure and blood lipid control rate, and regulate the use of cardiovascular diseases.

Non-communicable diseases in the Western Area District, Sierra Leone, before and during the Ebola outbreak

Setting: Twenty-seven peripheral health units, five secondary hospitals and one tertiary hospital, Western Area District, Sierra Leone. Objectives: To describe reporting systems, monthly attendances and facility-based patterns of six non-communicable diseases (NCDs) in the pre-Ebola and Ebola virus disease outbreak periods. Design: A cross-sectional study using programme data. Results: Reporting was 89% complete on the six selected NCDs pre-Ebola and 86% during the Ebola outbreak (P < 0.01). Overall, marked declining trends in NCDs were reported during the Ebola period, with a monthly mean of 342 cases pre-Ebola and 164 during the Ebola outbreak. The monthly mean number of cases per disease in the pre-Ebola and Ebola outbreak periods was respectively 228 vs. 85 for hypertension, 43 vs. 27 for cardiovascular diseases, 36 vs. 18 for diabetes and 25 vs. 29 for peptic ulcer disease; this last condition increased during the outbreak. There were higher proportions of NCDs among females during the Ebola outbreak compared with the pre-Ebola period. Except for peptic ulcer disease, the number of patients with NCDs declined by 25% in peripheral health units, 91% in the secondary hospitals and 70% in the tertiary hospital between the pre-Ebola and the Ebola outbreak periods. Conclusion: Comprehensive reporting of NCDs was suboptimal, and declined during the Ebola epidemic. There were decreases in reported attendances for NCDs between the pre-Ebola and the Ebola outbreak periods, which were even more marked in the hospitals. This study has important policy implications.

1% low-fat milk has perks!: An evaluation of a social marketing intervention.

This study evaluated the effect of a 12-week social marketing intervention conducted in 2012 promoting 1% milk use relying on paid advertising. Weekly milk sales data by type of milk (whole, 2%, 1%, and nonfat milk) were collected from 80 supermarkets in the Oklahoma City media market, the intervention market, and 66 supermarkets in the Tulsa media market (TMM), the comparison market. The effect was measured with a paired t-test. A mixed segmented regression model, controlling for the contextual difference between supermarkets and data correlation, identified trends before, during, and after the intervention. Results show the monthly market share of 1% milk sales changed from 10.0% to 11.5%, a 15% increase. Evaluating the volume sold, the monthly mean number of gallons of 1% milk sold increased from 890.5 gal (SD = 769.8) per supermarket from before the intervention to 1070.7 gal (SD = 922.5) following the intervention (t(79) = 9.4, p = 0.000). Moreover, average weekly sales of 1% milk were stable prior to the intervention (b = − 0.2 gal/week, 95% CI [− 0.6 gal/week, 0.3 gal/week]). During each additional week of the intervention, 1% milk sales increased by an average of 4.1 gal in all supermarkets (95% CI [3.5 gal/week, 4.6 gal/week]). Three months later, albeit attenuated, a significant increase in 1% milk sales remained. In the comparison market, no change in the market share of 1% milk occurred. Paid advertising, using the principles of social marketing, can be effective in changing an entrenched and habitual nutrition habit.

A Low-Cost Ultrasound Program Leads to Increased Antenatal Clinic Visits and Attended Deliveries at a Health Care Clinic in Rural Uganda

BackgroundIn June of 2010, an antenatal ultrasound program to perform basic screening for high-risk pregnancies was introduced at a community health care center in rural Uganda. Whether the addition of ultrasound scanning to antenatal visits at the health center would encourage or discourage potential patients was unknown. Our study sought to evaluate trends in the numbers of antenatal visits and deliveries at the clinic, pre- and post-introduction of antenatal ultrasound to determine what effect the presence of ultrasound at the clinic had on these metrics.Methods and FindingsRecords at Nawanyago clinic were reviewed to obtain the number of antenatal visits and deliveries for the 42 months preceding the introduction of ultrasound and the 23 months following. The monthly mean deliveries and antenatal visits by category (first visit through fourth return visit) were compared pre- and post- ultrasound using a Kruskal-Wallis one-way ANOVA. Following the introduction of ultrasound, significant increases were seen in the number of mean monthly deliveries and antenatal visits. The mean number of monthly deliveries at the clinic increased by 17.0 (13.3–20.6, 95% CI) from a pre-ultrasound average of 28.4 to a post-ultrasound monthly average of 45.4. The number of deliveries at a comparison clinic remained flat over this same time period. The monthly mean number of antenatal visits increased by 97.4 (83.3–111.5, 95% CI) from a baseline monthly average of 133.5 to a post-ultrasound monthly mean of 231.0, with increases seen in all categories of antenatal visits.ConclusionsThe availability of a low-cost antenatal ultrasound program may assist progress towards Millennium Development Goal 5 by encouraging women in a rural environment to come to a health care facility for skilled antenatal care and delivery assistance instead of utilizing more traditional methods.

Prevalence and breeding habitats of the dengue vectors Aedes aegypti and Aedes albopictus (Diptera: Culicidae) in the semi-urban areas of two different climatic zones in Sri Lanka

Dengue has become the fastest-growing mosquito-borne disease in Sri Lanka and the control of the vectors, Aedes aegypti Linnaeus and Ae. albopictus Skuse, is the most effective way of controlling the disease. A detailed study on vector prevalence has not been recorded from Sri Lanka. Therefore, the present study was undertaken to study the prevalence of both vectors in four semi-urban study sites in two of the most affected districts, namely Kandy (wet zone) and Kurunegala (intermediate zone), by conducting egg surveys (using ovitraps) and larval surveys from June 2007 to May 2008. A total of 82,524 eggs and 2658 larvae of Ae. aegypti and Ae. albopictus were collected. A total of 3699 potential breeding habitats were examined. Ovitrap and larval indices (house, container and Breteau) showed that all four areas are at epidemic risk, especially due to a high abundance of Ae. albopictus. The highest numbers for both the species were from the Kandy sites where dense vegetation, high rainfall and low temperature prevailed. The results showed a high mortality rate during the egg-to-larva transition, suggesting that conducting an egg survey alone would overestimate the vector abundance and the disease risk. For Ae. albopictus, the monthly mean number of eggs showed positive relationships with relative humidity in both districts and with rainfall in the Kandy District. The number of dengue cases in the area had no positive relationships with the abundance of eggs or larval density indices. Discarded receptacles were the most preferred breeding habitat for these dengue vectors. Since the attractiveness (inferred by the calculated risk factors) of most of the breeding habitats was very high, elimination of these breeding sites is essential for the success of dengue control programmes.

Prevalência e duração dos benefÃcios auxÃlio-doença decorrentes de asma no Brasil em 2008

To determine the prevalence and duration of social security benefits (SSBs) claims to registered workers with asthma in Brazil by the Brazilian National Institute of Social Security in 2008. This was a retrospective, descriptive study, based on information obtained from the Brazilian Unified Benefit System database, on the number of SSB claims granted to registered workers with asthma in 2008. The reference population was the monthly mean number of workers registered in the Brazilian Social Registry Database in 2008. The variables studied were type of economic activity, gender, age, and type/duration of the SSB claim. The relationship between work and asthma was evaluated by the prevalence ratio (PR) between work-related and non-work-related SSB claims for asthma. In 2008, 2,483 SSB claims were granted for asthma, with a prevalence of 7.5 allowances per 100,000 registered workers. The prevalence was higher among females than among males (PR = 2.1 between the sexes). Workers > 40 years of age were 2.5 times more likely to be granted an SSB claim for asthma than were younger workers. The prevalence was highest among workers engaged in the following types of economic activity: sewage, wood and wood product manufacturing, and furniture manufacturing (78.8, 22.4, and 22.2 claims/100,000 registered workers, respectively). The median (interquartile range) duration of SSB claims for asthma was 49 (28-87) days. Asthma is a major cause of sick leave, and its etiology has a strong occupational component. This has a major impact on employers, employees, and the social security system. Being female, being > 40 years of age, and working in the areas of urban sanitation/sewage, wood and wood product manufacturing, and furniture manufacturing increase the chance of sick leave due to asthma.

Precipitation variations in Beijing during 1860–1897 AD revealed by daily weather records from the Weng Tong‐He Diary

AbstractDaily weather records from a historical private diary provide important data for studying historical climate change. We compiled daily weather records from the Weng Tong‐He Diary and counted the number of monthly precipitation days during 1860‐1897 AD for Beijing; then, using the number of monthly precipitation days, we reconstructed the seasonal precipitation using regression models relating the precipitation and precipitation days. The findings show that the monthly mean number of precipitation days for 1860‐1897 was greater than that for 1951‐2009 by about 1 d month−1 and that the summer (June to August, JJA) precipitation for 1860‐1897 was 471.8 mm greater than that for 1951‐2009 by about 15.5%. The JJA precipitation of 1860‐1897 had not only inter‐annual variations but also inter‐decadal variations that were characterized by less precipitation before 1886 (about 421.9 mm) and more precipitation thereafter (about 550.7 mm). As a consequence, the JJA precipitation of 1860‐1897 showed an evident positive trend with a rate of about 57.9 mm per decade. These precipitation variations were confirmed by other datasets. However, it is worth noting that our reconstruction underestimates the historical precipitation values (by about 22.5%) because of rainfall/snowfall events missed in Weng's diary and the poor ability of the regression models to capture extreme years. In the future, new methods of reconstructing precipitation with the consideration of missed rainfall/snowfall events are needed. Copyright © 2012 Royal Meteorological Society

Production, growth and properties of ultrafine atmospheric aerosol particles in an urban environment

Abstract. Number concentrations of atmospheric aerosol particles were measured by a flow-switching type differential mobility particle sizer in an electrical mobility diameter range of 6–1000 nm in 30 channels near central Budapest with a time resolution of 10 min continuously from 3 November 2008 to 2 November 2009. Daily median number concentrations of particles varied from 3.8 × 103 to 29 ×103 cm−3 with a yearly median of 11.8 × 103 cm−3. Contribution of ultrafine particles to the total particle number ranged from 58 to 92% with a mean ratio and standard deviation of (79 ± 6)%. Typical diurnal variation of the particle number concentration was related to the major emission patterns in cities, new particle formation, sinks of particles and meteorology. Shapes of the monthly mean number size distributions were similar to each other. Overall mean for the number median mobility diameter of the Aitken and accumulation modes were 26 and 93 nm, respectively, which are substantially smaller than for rural or background environments. The Aitken and accumulation modes contributed similarly to the total particle number concentrations at the actual measurement location. New particle formation and growth unambiguously occurred on 83 days, which represent 27% of all relevant days. Hence, new particle formation and growth are not rare phenomena in Budapest. Their frequency showed an apparent seasonal variation with a minimum of 7.3% in winter and a maximum of 44% in spring. New particle formation events were linked to increased gas-phase H2SO4 concentrations. In the studied area, new particle formation is mainly affected by condensation sink and solar radiation. The formation process seems to be not sensitive to SO2, which was present in a yearly median concentration of 6.7 μg m−3. This suggests that the precursor gas was always available in excess. Formation rate of particles with a diameter of 6 nm varied between 1.65 and 12.5 cm−3 s−1 with a mean and standard deviation of (4.2 ± 2.5) cm−3 s−1. Seasonal dependency for the formation rate could not be identified. Growth curves of nucleated particles were usually superimposed on the characteristic diurnal pattern of road traffic direct emissions. The growth rate of the nucleation mode with a median diameter of 6 nm varied from 2.0 to 13.3 nm h−1 with a mean and standard deviation of (7.7 ± 2.4) nm h−1. There was an indicative tendency for larger growth rates in summer and for smaller values in winter. New particle formation events increased the total number concentration by a mean factor and standard deviation of 2.3 ± 1.1 relative to the concentration that occurred immediately before the event. Several indirect evidences suggest that the new particle formation events occurred at least over the whole city, and were of regional type. The results and conclusions presented are the first information of this kind for the region over one-year long time period.