scholarly journals The Epidemiology of COVID 19 in the Amazon and the Guianas: Similarities, Differences, and International Comparisons

2021 ◽  
Vol 9 ◽  
Author(s):  
Mathieu Nacher ◽  
Cyril Rousseau ◽  
Tiphanie Succo ◽  
Audrey Andrieu ◽  
Mélanie Gaillet ◽  
...  
Keyword(s):  
French Guiana ◽  
Scale Up ◽  
International Comparisons ◽  
Case Fatality ◽  
Mortality Data ◽  
Political Factors ◽  
The Usa ◽  
Outcome Differences ◽  
Log Linear ◽  
The Guianas

Background: The COVID 19 epidemic submerged many health systems in the Amazon. The objective of the present study was to focus on the epidemic curves of the COVID 19 epidemic in different centers, and to look at testing and mortality data.Methods: Publicly available datasets were used. The log10 of the daily cumulated number of cases starting from the day the territory reached 100 cumulated cases was plotted to compare the magnitude, shape and slope of the different curves. The maximum daily testing efforts were plotted for each territory in relation to the maximum daily number of diagnoses. The case fatality rate was computed by dividing the number of COVID 19 deaths by the number of confirmed cases.Results: In the Amazonian regions in general the speed of growth was generally lower than in Europe or the USA, or Southern Brazil. Whereas, countries like South Korea or New Zealand “broke” the curve relatively rapidly the log linear trajectory seemed much longer with signs of a decline in growth rate as of early July 2020. After a very slow start, French Guiana had the lowest slope when compared to other Amazonian territories with significant epidemics. The Amazonian states of Roraima, Amazonas, Parà, and Amapà had among the highest number of cases and deaths per million inhabitants in the world. French Guiana had significantly fewer deaths relative to its number of confirmed cases than other Amazonian territories. French Guiana had a late epidemic surge with intense testing scale-up often exceeding 4,000 persons tested daily per million inhabitants. Brazil was an outlier with low daily testing levels in relation to the number of daily diagnoses.Conclusions: There were marked heterogeneities mortality rates suggesting that socioeconomic, political factors, and perhaps ethnic vulnerability led to striking outcome differences in this Amazonian context.

scholarly journals Do Different Models Induce Changes in Mortality Indicators? That Is a Key Question for Extending the Lee-Carter Model

2021 ◽  
Vol 18 (4) ◽  
pp. 2204
Author(s):  
Ana Debón ◽  
Steven Haberman ◽  
Francisco Montes ◽  
Edoardo Otranto
Keyword(s):  
Historical Data ◽  
Mortality Rates ◽  
Parametric Model ◽  
Mortality Data ◽  
Block Bootstrap ◽  
Functional Anova ◽  
Model Block ◽  
The Usa ◽  
Data Constraints ◽  
Carter Model

The parametric model introduced by Lee and Carter in 1992 for modeling mortality rates in the USA was a seminal development in forecasting life expectancies and has been widely used since then. Different extensions of this model, using different hypotheses about the data, constraints on the parameters, and appropriate methods have led to improvements in the model’s fit to historical data and the model’s forecasting of the future. This paper’s main objective is to evaluate if differences between models are reflected in different mortality indicators’ forecasts. To this end, nine sets of indicator predictions were generated by crossing three models and three block-bootstrap samples with each of size fifty. Later the predicted mortality indicators were compared using functional ANOVA. Models and block bootstrap procedures are applied to Spanish mortality data. Results show model, block-bootstrap, and interaction effects for all mortality indicators. Although it was not our main objective, it is essential to point out that the sample effect should not be present since they must be realizations of the same population, and therefore the procedure should lead to samples that do not influence the results. Regarding significant model effect, it follows that, although the addition of terms improves the adjustment of probabilities and translates into an effect on mortality indicators, the model’s predictions must be checked in terms of their probabilities and the mortality indicators of interest.

External Validation of the Cardiac Surgery Score in a Quaternary Hospital in the United States of America

2021 ◽  
pp. 088506662110668
Author(s):  
Asha Singh ◽  
Chen Liang ◽  
Stephanie L. Mick ◽  
Chiedozie Udeh
Keyword(s):  
United States ◽  
Cardiac Surgery ◽  
United States Of America ◽  
Predictive Accuracy ◽  
External Validation ◽  
Cleveland Clinic ◽  
Area Under The Curve ◽  
The United States ◽  
Mortality Data ◽  
The Usa

Background The Cardiac Surgery Score (CASUS) was developed to assist in predicting post-cardiac surgery mortality using parameters measured in the intensive care unit. It is calculated by assigning points to ten physiologic variables and adding them to obtain a score (additive CASUS), or by logistic regression to weight the variables and estimate the probability of mortality (logistic CASUS). Both additive and logistic CASUS have been externally validated elsewhere, but not yet in the United States of America (USA). This study aims to validate CASUS in a quaternary hospital in the USA and compare the predictive performance of additive to logistic CASUS in this setting. Methods Additive and logistic CASUS (postoperative days 1-5) were calculated for 7098 patients at Cleveland Clinic from January 2015 to February 2017. 30-day mortality data were abstracted from institutional records and the Death Registries for Ohio State and the Centers for Disease Control. Given a low event rate, model discrimination was assessed by area under the curve (AUROC), partial AUROC (pAUC), and average precision (AP). Calibration was assessed by curves and quantified using Harrell's Emax, and Integrated Calibration Index (ICI). Results 30-day mortality rate was 1.37%. For additive CASUS, odds ratio for mortality was 1.41 (1.35-1.46, P <0.001). Additive and logistic CASUS had comparable pAUC and AUROC (all >0.83). However, additive CASUS had greater AP, especially on postoperative day 1 (0.22 vs. 0.11). Additive CASUS had better calibration curves, and lower Emax, and ICI on all days. Conclusions Additive and logistic CASUS discriminated well for postoperative 30-day mortality in our quaternary center in the USA, however logistic CASUS under-predicted mortality in our cohort. Given its ease of calculation, and better predictive accuracy, additive CASUS may be the preferred model for postoperative use. Validation in more typical cardiac surgery centers in the USA is recommended.

Automation in Colombia: assessing skills needed for the future of work

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Michael Jones ◽  
Sandra Idrovo-Carlier ◽  
Alfredo J. Rodriguez
Keyword(s):  
Design Methodology ◽  
Interpersonal Relationship ◽  
Political Factors ◽  
Content Type ◽  
Work Activities ◽  
Occupational Information ◽  
Occupational Information Network ◽  
Workforce Skills ◽  
The Usa ◽  
Automation Technology

PurposeThe purpose of this paper is to identify workforce skills that protect an occupation from elimination due to automation technology.Design/methodology/approachThe authors apply a Gaussian process (GP) classifier, based on the level of non-automatable work activities in an occupation, to USA and Colombian occupational datasets.FindingsThe authors find that communication, interpersonal relationship management and decision-making skills are most important in occupations that are resistant to automation.Research limitations/implicationsThe results are based on work activities data from the Occupational Information Network (O*NET) database developed for the USA labor market. This dataset does not capture significant differences in work activities, where they exist, for the same occupation between the two countries. The findings are also limited to Colombia. Readers should be careful to extrapolate the findings outside of this geography.Originality/valueThe authors discover that automation is likely to be a global phenomenon that can only be slightly mitigated by cultural and political factors.

scholarly journals KNOCK! KNOCK! WHO'S THERE? AN ETHNOARCHAEOLOGICAL APPROACH IN FRENCH GUIANA

2017 ◽  
Vol 28 (1) ◽  
pp. 6-27
Author(s):  
Stéphen Rostain
Keyword(s):  
Field Data ◽  
French Guiana ◽  
South American ◽  
Archaeological Preservation ◽  
Ethnographic Data ◽  
Natural Degradation ◽  
Tropical Lowlands ◽  
The Village ◽  
The Guianas ◽  
Cultural Rules

Amazonia and the Guianas possess exceptional potential for ethnoarchaeological studies because of the precolumbian heritage of modern-day Amerindian people. Surprisingly, minimal scholarship of this nature has been conducted in the South American lowlands. On the French Guiana coast, Maillard, a small Palikur village, was abruptly abandoned in 1990. I initiated an ethnoarchaeological study to pinpoint important differences between the interpretation of archaeological and ethnographic data. I recorded the topography of features and remains, compiled an inventory of artifacts and the contents of discard areas, inventoried the cultivated trees present, and described the characteristics of the surroundings. After analyzing the data using classical methods of archaeological inference to obtain a complete reconstruction of the village and the customs of its inhabitants, I invited the chief into his now-abandoned village to describe the settlement as it was while inhabited. In the twenty years since, I have made several visits to track the natural degradation of the site. This ethnoarchaeological approach shows that archaeologists dealing with field data can make many mistakes. Conversely, ethnographic accounts are distorted by the cultural rules and interdictions of interviewees. This experiment suggests the need for prudence in our interpretations and hypotheses, especially in the tropical lowlands, where archaeological preservation is particularly poor.

The cost of consent: why healthcare providers must be compliant with the Montgomery principles

2020 ◽  
Vol 102-B (5) ◽  
pp. 550-555
Author(s):  
Nick Birch ◽  
Nick V. Todd
Keyword(s):  
Positive Impact ◽  
Healthcare Providers ◽  
International Comparisons ◽  
Point Of View ◽  
Public Healthcare ◽  
Health Board ◽  
Malpractice Claim ◽  
The Usa ◽  
The Uk ◽  
The Cost

The cost of clinical negligence in the UK has continued to rise despite no increase in claims numbers from 2016 to 2019. In the US, medical malpractice claim rates have fallen each year since 2001 and the payout rate has stabilized. In Germany, malpractice claim rates for spinal surgery fell yearly from 2012 to 2017, despite the number of spinal operations increasing. In Australia, public healthcare claim rates were largely static from 2008 to 2013, but private claims rose marginally. The cost of claims rose during the period. UK and Australian trends are therefore out of alignment with other international comparisons. Many of the claims in orthopaedics occur as a result of “failure to warn”, i.e. lack of adequately documented and appropriate consent. The UK and USA have similar rates (26% and 24% respectively), but in Germany the rate is 14% and in Australia only 2%. This paper considers the drivers for the increased cost of clinical negligence claims in the UK compared to the USA, Germany and Australia, from a spinal and orthopaedic point of view, with a focus on “failure to warn” and lack of compliance with the principles established in February 2015 in the Supreme Court in the case of Montgomery v Lanarkshire Health Board. The article provides a description of the prevailing medicolegal situation in the UK and also calculates, from publicly available data, the cost to the public purse of the failure to comply with the principles established. It shows that compliance with the Montgomery principles would have an immediate and lasting positive impact on the sums paid by NHS Resolution to settle negligence cases in a way that has already been established in the USA. Cite this article: Bone Joint J 2020;102-B(5):550–555.

scholarly journals Anemopaegma kawense (Bignoniaceae), a new species from the Kaw Mountain (French Guiana), with notes on related species and a key to the genus in the Guianas

2021 ◽  
Vol 154 (2) ◽  
pp. 296-306
Author(s):  
Olivier Lachenaud ◽  
Fabiana Firetti ◽  
Lúcia G. Lohmann
Keyword(s):  
New Species ◽  
French Guiana ◽  
Conservation Status ◽  
Iucn Red List ◽  
Herbarium Specimens ◽  
Similar Species ◽  
Centre Of Diversity ◽  
North Eastern ◽  
The Guianas ◽  
A New Species

Background and aims – The genus Anemopaegma (Bignoniaceae) includes around 47 species and has its centre of diversity in Brazil. Here, we describe and illustrate a new species from French Guiana, Anemopaegma kawense, and compare it to the two most similar species, A. foetidum and A. granvillei. We further assess the conservation status of all three species.Material and methods – Morphological descriptions are based on herbarium specimens deposited at BM, BR, CAY, INPA, K, MO, P, SPF, and U, and, in the case of the newly described species, also on field observations. The conservation status assessments follow the IUCN Red List criteria.Key results – Anemopaegma kawense differs from both A. foetidum and A. granvillei by its densely villose twigs, longitudinally plicate leaflets with secondary veins not or hardly prominent below, and tertiary veins impressed below. It is further separated from A. foetidum by the leaflets that are villose below and the calyx that is entirely pubescent outside. On the other hand, A. kawense differs from A. granvillei by the densely lepidote outer surface of the corolla, shorter petiolules, leaflets with midrib impressed above, shorter bracts and bracteoles, inflorescence peduncle exceeding the rachis, and pedicels densely puberulous, not lepidote or only sparsely so at the apex. This species is endemic to the Kaw Mountain in north-eastern French Guiana, where it grows in low stunted forest on laterite; it is assessed as Endangered according to the IUCN criteria. New descriptions are provided for A. granvillei, which is newly reported from Suriname, and for A. foetidum, which is newly reported from French Guiana; these two species are assessed as Endangered and Least Concern, respectively. Lectotypes are designated for A. maguirei, which is here synonymised with A. foetidum, and for A. umbellatum, another synonym of that species. A key to the 12 species of Anemopaegma occurring in the Guianas is presented.

scholarly journals An Evidence Base for School Health Policy during the COVID-19 Pandemic

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Saif Badran ◽  
Omran Musa ◽  
Somaya Al-maadeed ◽  
Egon Toft ◽  
Suhail Doi
Keyword(s):  
Dose Response ◽  
Case Fatality Rate ◽  
School Health ◽  
Meta Analysis ◽  
Case Fatality ◽  
Evidence Base ◽  
Mortality Data ◽  
Response Analysis ◽  
Fatality Rate ◽  
Epidemiological Characteristics

Objective: Children represent a small fraction of confirmed COVID-19 cases, with a low case fatality rate (CFR). In this paper, we lay out an evidence-based policy for reopening schools. Methods: We gathered age-specific COVID-19 case counts and identified mortality data for 14 countries. Dose-response meta-analysis was used to examine the relationship of the incremental case fatality rate (CFR) to age. In addition, an evidence-to-decision framework (EtD) was used to correlate the dose-response data with other epidemiological characteristics of COVID-19 in childhood. Results: In the dose-response analysis, we found that there was an almost negligible fatality below age 18. CFR rose little between ages 5 to 50 years. The confidence intervals were narrow, suggesting relative homogeneity across countries. Further data suggested decreased childhood transmission from respiratory droplets and a low viral load among children. Conclusions: Opening up schools and kindergartens is unlikely to impact COVID-19 case or mortality rates in both the child and adult populations. We outline a robust plan for schools that recommends that general principles not be micromanaged, with authority left to schools and monitored by public health authorities.

International comparisons of COVID-19 case and mortality data and the effectiveness of non-pharmaceutical interventions: a plea for reconsideration

2021 ◽  
pp. 1-7
Author(s):  
Stephen Thomson ◽  
Eric C. Ip ◽  
Shing Fung Lee
Keyword(s):  
Mental Health ◽  
Economic Development ◽  
Human Rights ◽  
Social Cohesion ◽  
Public Discourse ◽  
Public Support ◽  
International Comparisons ◽  
Mortality Data ◽  
Media Reporting ◽  
Pharmaceutical Interventions

Abstract International comparisons of the effectiveness of coronavirus disease 2019 (COVID-19) non-pharmaceutical interventions (NPIs) based on national case and mortality data are fraught with underestimated complexity. This article calls for stronger attention to just how extensive is the multifactorial nature of national case and mortality data, and argues that, unless a globally consistent benchmark of measurement can be devised, such comparisons are facile, if not misleading. This can lead to policy decisions and public support for the adoption of potentially harmful NPIs that are ineffective in combating the COVID-19 pandemic and damaging to mental health, social cohesion, human rights and economic development. The unscientific use of international comparisons of case and mortality data in public discourse, media reporting and policymaking on NPI effectiveness should be subject to greater scrutiny.

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