Pertussis has substantially increased in Quebec, Canada, since 1990. We estimated pertussis vaccine effectiveness and vaccine coverage in child-care centers and elementary schools.
Two retrospective cohort studies were simultaneously conducted. One included 4482 children attending 88 public child-care centers and the other included 3429 pupils in 14 elementary schools. Cough and pertussis symptoms were assessed through a questionnaire and medical records; immunization status was ascertained by examination of written records.
In child-care centers 95% of children had received at least three vaccine doses at the beginning of the follow-up; in schools more than 98% of pupils had received at least 4 doses. With > or = 4 doses of vaccine and a standard case definition used for surveillance (cough > or = 2 weeks, > or = 1 pertussis symptom and no other apparent cause for cough), vaccine effectiveness was estimated at 61% (95% confidence interval, 44 to 72%) in child-care centers and at 60% (95% confidence interval, 10 to 82%) in schools. With the same number of doses but a case definition requiring a cough > or = 5 weeks, vaccine effectiveness increased to 71% (95% confidence interval, 49 to 83) in child-care centers and to 86% (95% confidence interval, 66 to 94%) in schools.
The increase in pertussis in Quebec is not caused by a low vaccine coverage. A low vaccine effectiveness may contribute to the resurgence of pertussis in the past decade.
Lamb chops inoculated with 2.23-2.83 log cfu/g of E. coli O157:H7 strain NCTC 12900 were packed in air (AP), vacuum (VP), and two modified atmospheres (MAP) consisting of 100% CO2 and a commercial mixture of 35% CO2/35% O2/30% N2. All samples (initial total counts
This paper presents further international comparisons of progressivity of health care financing systems. The paper builds on the work of Wagstaff et al. [Wagstaff, A., van Doorslaer E., et al., 1992. Equity in the finance of health care: some international comparisons, Journal of Health Economics 11, pp. 361-387] but extends it in a number of directions: we modify the methodology used there and achieve a higher degree of cross-country comparability in variable definitions; we update and extend the cross-section of countries; and we present evidence on trends in financing mixes and progressivity.
To determine the prevalence and associated risk factors of non-insulin-dependent diabetes mellitus (NIDDM) in inhabitants of traditional indigenous communities from Durango, Mexico, a transversal descriptive study was conducted. Tepehuano, Huichol and Mexicanero tribe members without racial admixture and a minimal Western influence on lifestyle were studied. One hundred and ninety-three subjects were included, this figure corresponding to approximately 20% of subjects aged from 30 to 64 years of the target population. Glycemia was determined in capillary blood after an overnight fast of 10-12 h, and 2 h after a 75 g oral glucose load using a Glucometer II device; NIDDM diagnosis was established according to the WHO criteria. Personal risk factors of NIDDM were determined. The average glucose level was 87.5 +/- 19.3 mg/dl. There were no NIDDM cases, hence the prevalence was 0.0%. The personal risk factors profile for NIDDM were as follows: 0.0% of cases with family history of NIDDM and with residency in urban areas > 40% of their lifetime, 7.2% of obese subjects and 15.5% of subjects with alcohol intake > or = 8 g/day. The absence of NIDDM suggests that this disease may be rare in traditional indigenous communities of Mexico and may be associated with less exposure to risk factors or genetic differences.
The purpose of this study was to estimate the prevalence and risk factors of hypertension in adults indigenous to their traditional communities from the north of Mexico. The study was based on a cross- sectional survey of inhabitants from Mexicaneros, Huicholes and Tepehuanos communities, which have not been influenced by a western lifestyle. A home interview and clinical examination that included blood pressure and anthropometric measurements of 217 men and 598 non-pregnant women aged between 35 to 64 years was carried out. Eligible indigenous subjects must have had no migratory history to partially or totally urbanised areas. Target population represented approximately 100% of the indigenous people who have spent all their life time in the community of birthplace. Age and body mass index average was 48.9+/-12.9 years and 25.6+/-5.1 kg/m2. Hypertension was identified in 56 individuals, 45 women and 11 men (prevalence 6.87%, 95% confidence interval (CI) 5.1-8.6). Forty-one percent of the hypertensive subjects were aware of being hypertensive. Hypertensive subjects had a higher intake of saturated fats than non-hypertensives. Salt consumption was lower than 6 g per day in subjects with and without hypertension. High intake of saturated fats (odds ratio 6.4, 95% CI 2.1-12.3; P
Institut national de santé publique du Québec, Québec, QC, Canada; Axe santé publique et pratiques optimales en santé, Centre de recherche du Centre Hospitalier Universitaire de Québec, Québec, QC, Canada.
This study was designed to evaluate the epidemiology of severe gastroenteritis in children living in Québec rural areas with intensive livestock activities. From September 2005 through June 2007, 165 cases of gastroenteritis in children aged from 6 months to 5 years, hospitalized or notified to the public health department were enrolled, and 326 eligible controls participated. The parents of cases and controls were asked questions about different gastroenteritis risk factors. The quality of the drinking water used by the participants was investigated for microbial indicators as well as for four zoonotic bacterial pathogens (Campylobacter spp, Escherichia coli, Salmonella spp and Yersinia spp) and two enteric parasites (Cryptosporidium spp and Giardia spp). From 134 stool specimen analysed, viruses were detected in 82 cases (61%), while 28 (21%) were found with at least one of the bacteria investigated, and five cases were infected by parasites. Campylobacteriosis was the main bacterial infection (n = 15), followed by Salmonella sp (n = 7) and E. coli O157:H7 (n = 5) among cases with bacterial gastroenteritis. No significant difference was found between cases and controls regarding the quality of water consumed; the frequency of faecal contamination of private wells was also similar between cases and controls. Considering the total cases (including those with a virus), no link was found between severe gastroenteritis and either being in contact with animals or living in a municipality with the highest animal density (4th quartile). However, when considering only cases with a bacterial or parasite infection (n = 32), there was a weak association with pig density that was not statistically significant after adjusting for potential confounders. Contact with domestic, zoo or farm animals were the only environmental factor associated with the disease.
OBJECTIVE: To describe and compare the consumption of total fish (marine foods) and the fish sub-groups - white fish, fatty fish, very fatty fish, fish products and crustacea, in participants from the European Investigation into Cancer and Nutrition (EPIC) study. DESIGN: Cross-sectional analysis of dietary intake using a computerised standardised 24-hour recall interview. Crude means, means and standard errors adjusted by age, season and day of the week were calculated, stratified by centre and gender. SETTING: Twenty-seven redefined centres in the 10 European countries participating in the EPIC study. SUBJECTS: In total, 35 955 subjects (13 031 men and 22 924 women), aged 35-74 years, selected from the main EPIC cohort. RESULTS: A six- to sevenfold variation in total fish consumption exists in women and men, between the lowest consumption in Germany and the highest in Spain. Overall, white fish represented 49% and 45% of the intake of total fish in women and men, respectively, with the greatest consumption in centres in Spain and Greece and the least in the German and Dutch centres. Consumption of fatty fish reflected that of total fish. However, the greatest intake of very fatty fish was in the coastal areas of northern Europe (Denmark, Sweden and Norway) and in Germany. Consumption of fish products was greater in northern than in southern Europe, with white fish products predominating in centres in France, Italy, Spain, The Netherlands and Norway. Intake of roe and roe products was low. The highest consumption of crustacea was found in the French, Spanish and Italian centres. The number of fish types consumed was greater in southern than in northern Europe. The greatest variability in consumption by day of the week was found in the countries with the lowest fish intake. CONCLUSIONS: Throughout Europe, substantial geographic variation exists in total fish intake, fish sub-groups and the number of types consumed. Day-to-day variability in consumption is also high.
In this study, we hypothesized that dentist' interpersonal resources (good cooperation with one's assistant) together with their personal resources (optimism) buffer the negative effects of emotional dissonance (a demand that occurs when there is a difference between felt and displayed emotions) on job performance (in-role and extra-role performance) over time.
We carried out Hierarchical Regression Modeling on a sample of 1954 Finnish dentists who participated in a two-wave 4-year longitudinal study.
Results showed that good cooperation with dental assistants buffered the negative effects of emotional dissonance on both in-role and extra-role performance among the dentists in the long term. However, unexpectedly, dentists' high optimism did not buffer their in-role nor extra-role performance over time under conditions of experiencing high emotional dissonance.
We conclude that interpersonal job resources such as good cooperation with one's colleagues may buffer the negative effect of emotional dissonance on dentists' job performance even in the long term, whereas the role of personal resources (e.g., optimism) may be less important for maintaining high job performance under conditions of emotional dissonance. The study novelties include the test of the negative effects of emotional dissonance on long-term performance in dentistry and the identification of the job rather than personal resources as the buffers against the negative effects of emotional dissonance on long-term performance.