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A prediction model for polypharmacy: are older, educated women more susceptible to an adverse drug event?

INTRODUCTION: This study attempts to account for variation in the number of prescription medications concurrently consumed in geriatric populations. METHODS: Data were selected from The National Health and Nutrition Examination Survey, III, 1988-1994 (NHANES III), Adult Household Questionnaire, a complex, multistage, clustered sampling of civilian, non-institutionalized populations, which included a volunteer sample of 5,249 individuals aged 65 and older who participated in NHANES III survey, representing four broad geographic regions and twelve states. RESULTS: Age, income, and educational level accounted for nine percent of the variation in the number of prescription medications concurrently taken (p < 0.0001); though non-significant, there were gender differences regarding polypharmacy; in addition, there were significant differences with respect to educational levels by region and age by region (p < 0.05). CONCLUSIONS: Educational level accounted for the most variation in polypharmacy. Women, on average, consumed more prescription medications than men. Older, more educated women may be most likely to engage in polypharmaceutical consumption, suggesting a greater likelihood of an adverse drug event.

Aged↗

[Risk predictive model for damage caused by the spittlebug Aeneolamiapostica (Walker) Fennah (Hemiptera: Cercopidae)].

This paper evaluated the risk that Aenolamia postica (Walker) Fennah populations reach the economic threshold in sugar cane fields in Veracruz, México. A risk deductive model was constructed to include the sequence of events leading to damaging populations, considered the top event or critical failure in the crop. Model events were identified and quantified, and model was validated on field conditions. The model components and their state values were identified as: temperature e" 28 degrees C, precipitation e" 45% during June and July, soil clay content e" 40%, infested adjoining fields, deficient weed control, wind dominance, crop phenology and variety, deficient chemical and biological control, and irrigation. Sensitivity analysis showed that the most important events triggering high densities of A. postica were high temperatures and precipitation, previous field infestation, nymph and weed presence. Event probability estimates were combined using Boolean algebra to compute the minimum, mean and maximum probabilities for the top event, yielding values of 0.417, 0.563, y 0.734 respectively. Model was tested in field, by selecting sugar cane fields having the model properties and compared to fields without these features. Fields were sampled in both conditions during 2004 year and high-risk fields had significantly (F = 13, 4, gl = 1, 18, P = 0,0018) higher densities (2.4 adults m(-1)) than low-risk plots (0.4 adults m(-1)) thus agreeing with the model forecast.

Animals↗

Antilisterial activity by enterococci in a model predicting the temperature evolution of Taleggio, an Italian soft cheese.

Enterococcus ssp. produced broad-spectrum bacteriocins, which were active against Listeria innocua and Listeria monocytogenes. Inhibition of L. innocua in milk by different starter cultures was evaluated. Milk was inoculated with a conventional starter (Streptococcus salivarius ssp. thermophilus and Lactobacillus delbrueckii ssp. bulgaricus mixed cultures) as a sole starter or in combination with inhibitory starter cultures (Enterococcus ssp., bacteriocin-producing strains). Tests were performed under a temperature gradient that reproduced the first 55 h of Taleggio cheese manufacturing and in the presence of rennet. Results indicated that satisfactory inhibition of L. innocua was linked to the combined synergistic antimicrobial effect of pH decrease and bacteriocin production. Overall, data suggested that a potential existed for use of the antagonistic activity from enterococci for protection of Taleggio cheese during ripening, when L. monocytogenes may often reach dangerous concentrations.

Bacteriocins↗

Predictive model of mastitis occurrence in the dairy cow.

Mastitis occurrence within a lactation and times of mastitis onset were studied for about 1000 cows. The number of mastitis cases within a lactation was modeled through overdispersed Poisson regression with individual and herd covariants. The results emphasized the role of the herd variable. Increased production potential increased the number of cases per lactation at a rate of 1.4/10 kg. Calving month also played an important role. The incidence of mastitis was greater when calving took place in early autumn or winter, which led to an expanded housing period. The interval from calving to the first case of mastitis and the intervals between successive cases were modeled for cases occurring during lactation through random selections from fitted gamma distributions, these distributions being truncated to consider the lactation length. The results of both steps can be used to simulate mastitis occurrence in different conditions.

Animals↗

[Prediction model on mother-infant attachment during the early postpartum period].

PURPOSE: The purpose of this study is to identify the influencing factors of mother-infant attachment and construct a descriptive model that explains mother-infant attachment during the early postpartum period. METHOD: The hypothetical model of this study consisted of 8 variables with 23 constructed paths. The subjects of this study were 152 postpartum women. Data was analyzed to test the hypothetical model using covariance structure analysis. RESULT: The final model which is modified from the hypothetical model improved to Chi-Square 41.92, GFI.95, AGFI.89, RMSR.02, RMSEA.06, NFI.94, and NNFI.95. Mother-infant attachment during the early postpartum period was proven to be influenced directly by neonatal perception, maternal sensitivity, and maternal-fetal attachment and also indirectly by social support, maternal-fetal attachment and maternal identity. These variables accounted for 32% of the variance of the mother-infant attachment during the early postpartum period. CONCLUSION: It is necessary that the nurses provide postpartum women with an intervention using social support for improving maternal identity and alleviating maternal role strain. It can be helpful to improve maternal sensitivity and in the end it will facilitate the mother-infant attachment during postpartum period.

Adult↗

A predictive model to describe the effects of temperature, sodium lactate, and sodium diacetate on the inactivation of a serotype 4b strain of Listeria monocytogenes in a frankfurter slurry.

A modified Gompertz equation was used to model the effects of temperature (55, 60, and 65 degrees C), sodium lactate (0, 2.4, and 4.8%), and sodium diacetate (0, 0.125, and 0.25%) on inactivation of Listeria monocytogenes strain MFS 102 (serotype 4b) in frankfurter slurry. The effects of these factors were determined on the shouldering region (parameter A), maximum death rate (parameter B), and tailing region (parameter C) of microbial inactivation curves. Increased temperature or sodium diacetate concentrations increased the death rate, whereas increased sodium lactate concentrations decreased heat resistance. Complex two-way interactive effects were also observed. As both temperature and sodium lactate increased, the death rate decreased; however, as temperature and sodium diacetate increased, the death rate increased. The effect of the interaction between sodium lactate and sodium diacetate on the maximum death rate varied with temperature. Increases in both acidulants at temperatures above 56.7 degrees C decreased the death rate, whereas at temperatures below 56.7 degrees C, increases in both acidulants increased the death rate. To test for significant differences between treatments, D-values were calculated and compared. This comparison revealed that, in general, sodium lactate increased heat resistance and sodium diacetate decreased heat resistance of L. monocytogenes. This information is important for reducing and minimizing contamination during postprocessing thermal treatments.

Animals↗

Trends in hospital unionization and a predictive model for unionizing success.

Between 1976 and 1980, the average annual increase in hospital expenses was 12.7%. Wages for employees accounted for approximately one-half of this increase. Because employee wages have such a great effect on hospital costs, it is important to study those factors that could curtail management's control over these expenses. One such factor is the establishment of labor unions. This study outlines the structural factors that encourage union activity, as well as the factors that contribute to its success. Variables studied include: the types of employees in the bargaining unit; the total number of employees in the bargaining unit; the number of hospitals in the same city; the control of the hospital and the presence of a profit motive; the number of beds in the hospital; the occupancy level of the hospital; and the region of the country in which the hospital is located.

Data Collection↗

Web-based 'early warning' predictive modeling system enhances preventive care.

Shifting the focus of disease management from treatment to prevention. There is nothing new about the concept of health risk assessment. Most of these tools seek to identify people with chronic disease so that interventions can be employed. But a cadre of DM firms think that approach does not go far enough. See how one firm is trying to move the focus from treatment to prevention of disease in the first place.

Evidence-Based Medicine↗