Dengue Fever Seroprevalence and Risk Factors, Texas–Mexico Border, 2004

High seroprevalence of dengue was found on both sides of the border

Assessing the roles of temperature, precipitation, and enso in dengue re-emergence on the Texas-Mexico border region Evaluación del clima y del ENSO en la reemergencia del dengue en la frontera Texas-México

OBJECTIVE: The goal of this study was to assess linkages between microclimate and longer-term ENSO-related weather forcing on the week-to-week changes in dengue prevalence in Matamoros, Tamaulipas, Mexico, over a recent decade of dengue observations. MATERIAL AND METHODS: An auto-regressive model to evaluate the role of climatic factors (sea-surface temperature) and weather (maximum temperature, minimum temperature, precipitation) on dengue incidence over the period 1995-2005, was developed by conducting time-series analysis. RESULTS: Dengue incidence increased by 2.6% (95% CI: 0.2-5.1) one week after every 1ºC increase in weekly maximum temperature and increased 1.9% (95% CI: -0.1-3.9) two weeks after every 1 cm increase in weekly precipitation. Every 1ºC increase in sea surface temperatures (El Niño region 3.4 ) was followed by a 19.4% (95% CI: -4.7-43.5) increase in dengue incidence (18 weeks later). CONCLUSIONS: Climate and weather factors play a small but significant role in dengue transmission in Matamoros, Mexico. This study may provide baseline information for identifying potential longer-term effects of global climate change on dengue expected in the coming decades. To our knowledge, this is the first study to investigate the potential associations between climate and weather events and dengue incidence in this geographical area.OBJETIVO: Evaluar los vínculos entre el microclima, las variables relacionadas al fenómeno de El Niño Oscilación del Sur (ENSO) y los cambios en el reporte semanal de casos de dengue en el área de Matamoros, Tamaulipas, México, a lo largo de una década de observaciones. MATERIAL Y MÉTODOS: Se desarrolló un modelo autorregresivo para evaluar la influencia de factores climáticos (temperatura superficial del mar) y tiempo (temperatura máxima, temperatura mínima y precipitación) sobre la incidencia de dengue, a lo largo de 11 años (1995-2005), empleando análisis de series de tiempo. RESULTADOS: La incidencia de casos de dengue aumentó 2.6% una semana después de cada 1ºC de incremento en la temperatura máxima semanal (95% IC: 0.2, 5.1); observamos también que los casos de dengue aumentaron 1.9% dos semanas después de cada centímetro de incremento en la precipitación semanal (95% IC: -0.1, 3.9). Cada 1ºC de aumento en la temperatura superficial del mar en la región Niño 3.4 fue seguida, 18 semanas después, de un aumento de 19.4% en la incidencia de casos de dengue (95% IC: -4.7, 43.5). CONCLUSIONES: Los factores de clima y tiempo tienen una influencia menor, aunque significativa, sobre la transmisión del dengue en la ciudad fronteriza de Matamoros, México. Este estudio aporta información basal para identificar efectos potenciales de mayor alcance, relacionados con el cambio climático global sobre los casos esperados de dengue en las próximas décadas. Hasta donde sabemos, este es el primer estudio que evalúa las posibles asociaciones entre los eventos climáticos y tiempos y la incidencia de casos de dengue en la frontera de México con Texas

Physician Treatment of Osteoporosis in Response to Heel Ultrasound Bone Mineral Density Reports

Optimal information that should be included in ultrasound (US) heel bone mineral density (BMD) reports is not known. If additional information about further evaluation of patients with low heel BMD were included in reports, would responses for treatment improve? We screened people at health fairs using the Sahara heel US machine. For those with a T-score of ≤–1.0, letters were sent to their primary care physician notifying them of the result. Physicians were randomly assigned to (1) a standard letter, which recommended central bone density screening (dual X-ray absorptiometry [DXA]) and treatment if the BMD was low; or (2) an extended letter, which also outlined treatment strategies based on recommended subsequent central DXA scan results for a T-score of \u3c–1.50 and also if \u3c–2.00. The extended letter only increased the frequency of DXA testing from 30.1 to 37.2% (not a significant increase). Of 88 people with heel BMD ≤–1.00 and not previously on any treatment, 25 of 45 (56%) were treated (calcium, estrogens, bisphosphonates, or calcitonin or a combination) after physicians received a standard letter and 30 of 43 (70%) after an extended letter (one-sided p = 0.084). Of people with T ≤ –1.9, and initially taking nothing more than calcium, 5 of 36 (13.9%) received additional treatment after physicians received a standard letter vs 9 of 41 (22.0%) after an extended letter (one-sided p = 0.180). For those with T ≤ –1.0 because of the screen 25 of 197 (12.7%) received additional treatment. One hundred forty-six of 194 (75%) individuals and received treatment with calcium or other medications, and 74 of 173 (43%) of individuals before screening and 141 of 195 (72%) after physicians received letters took calcium. Physicians regarded calcium alone as adequate treatment in many cases. There was no marked increase in treatment when additional information was provided to physicians regarding evaluation and treatment for low US heel BMD results

Physician Treatment of Osteoporosis in Response to Heel Ultrasound Bone Mineral Density Reports

Optimal information that should be included in ultrasound (US) heel bone mineral density (BMD) reports is not known. If additional information about further evaluation of patients with low heel BMD were included in reports, would responses for treatment improve? We screened people at health fairs using the Sahara heel US machine. For those with a T-score of ≤–1.0, letters were sent to their primary care physician notifying them of the result. Physicians were randomly assigned to (1) a standard letter, which recommended central bone density screening (dual X-ray absorptiometry [DXA]) and treatment if the BMD was low; or (2) an extended letter, which also outlined treatment strategies based on recommended subsequent central DXA scan results for a T-score of \u3c–1.50 and also if \u3c–2.00. The extended letter only increased the frequency of DXA testing from 30.1 to 37.2% (not a significant increase). Of 88 people with heel BMD ≤–1.00 and not previously on any treatment, 25 of 45 (56%) were treated (calcium, estrogens, bisphosphonates, or calcitonin or a combination) after physicians received a standard letter and 30 of 43 (70%) after an extended letter (one-sided p = 0.084). Of people with T ≤ –1.9, and initially taking nothing more than calcium, 5 of 36 (13.9%) received additional treatment after physicians received a standard letter vs 9 of 41 (22.0%) after an extended letter (one-sided p = 0.180). For those with T ≤ –1.0 because of the screen 25 of 197 (12.7%) received additional treatment. One hundred forty-six of 194 (75%) individuals and received treatment with calcium or other medications, and 74 of 173 (43%) of individuals before screening and 141 of 195 (72%) after physicians received letters took calcium. Physicians regarded calcium alone as adequate treatment in many cases. There was no marked increase in treatment when additional information was provided to physicians regarding evaluation and treatment for low US heel BMD results

Obeying organizational 'rules of relevance': Gender analysis of policy

There is considerable research showing that gender is deemed irrelevant to organizations and to policy. This paper examines the results of a research project that sought to reverse those 'rules of relevance'. The project required policy actors in several public sector organizations to undertake a gender analysis of their policies. We found that it was through the collaborative work of doing the gender analysis that policy actors came to see why such an analysis was needed. This necessarily meant seeing the relevance of gender to the policies they dealt with, which could also highlight gender bias in their organizations. Yet, a bureaucratic and gendered division of labour ensured that those who got to do the gender analysis were those in relatively powerless positions, predominantly women. We draw on the 'turn to practice' in organizational studies and feminist strategies of 'sudden seeing' to consider what our results might offer future projects of gender analysis and organizational intervention.Joan Eveline and Carol Bacch