Longitudinal quantile regression in presence of informative drop-out through longitudinal-survival joint modeling

We propose a joint model for a time-to-event outcome and a quantile of a continuous response repeatedly measured over time. The quantile and survival processes are associated via shared latent and manifest variables. Our joint model provides a flexible approach to handle informative drop-out in quantile regression. A general Monte Carlo Expectation Maximization strategy based on importance sampling is proposed, which is directly applicable under any distributional assumption for the longitudinal outcome and random effects, and parametric and non-parametric assumptions for the baseline hazard. Model properties are illustrated through a simulation study and an application to an original data set about dilated cardiomyopathies

PERFIL DA AUTOMEDICAÇÃO EM ESTUDANTES DE ENSINO SUPERIOR: IMPACTO NA RESISTÊNCIA BACTERIANA

A resistência bacteriana, causada pela mutação espontânea e recombinação de genes, além do consequente surgimento das superbactérias, são problemas crescentes de saúde pública na atualidade e estão diretamente relacionados ao uso indevido de antibióticos. A autoadministracão desses fármacos é um fator determinante, considerando a automedicação como problema de saúde pública. Diante disso, o presente estudo trata-se de um estudo transversal descritivo (observacional), a partir da aplicação de um questionário aos estudantes de uma faculdade de ensino superior da região Noroeste do Rio Grande do Sul. O objetivo central foi estabelecer um comparativo entre o uso irracional de antibióticos entre os estudantes da área da saúde e os demais cursos, além de avaliar o comportamento destes futuros profissionais com relação à prática da automedicação. Os sujeitos submetidos a pesquisa foram os acadêmicos dos cursos de Administração, Análises e Desenvolvimento de Sistemas, Biomedicina, Ciências Contábeis, Direito, Estética e Cosmética, Fisioterapia e Odontologia. Através desta pesquisa, entre ambos os cursos, observou-se um alto índice de automedicação e número significativo de compra de antibióticos sem prescrição médica entre os acadêmicos, além de uma grande tendência na prática da automedicação

An Inventory of Occupational Oppertunities in the Columbus Service Area

Purpose To inventory the number of persons presently employed in the various occupational areas in the Columbus, Nebraska service area and to identify the prOjected employment needs due to turnover and expansion for the next year and the following two years in the same occupations. Methods. The inventory was conducted in postal zip code area 686 surrounding Columbus, Nebraska. A 25 percent random sampling of business firms in the area netted 667 businesses to be inventoried. The state-wide computerized model for determining occupational opportunities in Nebraska was used as the data collection instrument and data were collected by questionnaire and personal interview from 92 percent of the businesses. Findings. The inventory showed J8.l percent of the people worked in agriculture; 9.8 percent in distribution; 1.9 percent in health; 1.0 percent in home economics; 7.4 percent in business occupations; 19.4 percent in trades andindustry; and 22.4 percent in other occupations. The total number of persons employed in the area was found to be 27,060. The greatest need for workers was found to be in the trades and industrial occupations area which accounted for 38.8 percent of the total needs for the next year and 35.5 percent of the needs for the following two years. Following the other occupations category was the business occupations area with needs of 8.5 percent in 12 months and 8.7 percent of total needs the following two years. Distribution occupations were found to be next in needs followed by agriculture, health, and home economics

Evaluation of the response to vaccination with hepatitis B vaccine in pediatric patients diagnosed with celiac disease

Background: A gap exists in the literature on celiac disease populations and the response to hepatitis B vaccination. Objective: To identify pediatric patients with celiac disease who received the primary hepatitis B vaccination and investigate their response to vaccine. Design/Methods: Patients underwent blood draw for hepatitis B surface antibody titers. Patients with undetectable or non-protective HBsAb titers were contacted. Study outcome measures and patient characteristics variables were summarized by means, standard deviations, medians, and ranges. A two-sample t-test was used to compare normally distributed continuous variables between responders and non-responders. Results: In all, 58% of patients did not meet the threshold for “protective” antibody titers. The mean time between completion of hepatitis B vaccination and diagnosis of celiac disease was 8.1 years for responders versus 10.5 years for non-responders. In a multivariate analysis, time between completion of vaccine and diagnosis of celiac disease was statistically significant predictor of response with an adjusted odds ratio of 0.69 (95% confidence interval: 0.50–0.95; p = 0.021). Conclusion: Our celiac disease population shows a high hepatitis B vaccine failure. The time between completion of vaccine series and diagnosis of celiac disease is an independent predictor for response