Disgust as an emotional driver of vaccine attitudes and uptake? A mediation analysis.

Research on the drivers of vaccine acceptance has expanded but most interventions fall short of coverage targets. We explored whether vaccine uptake is driven directly or indirectly by disgust with attitudes towards vaccines acting as a possible mediator. An online cross-sectional study of 1007 adults of the USA via Amazon's Mechanical Turk was conducted in January 2017. The questionnaire consisted of four sections: (1) items assessing attitudes towards vaccines and vaccine uptake, (2) revised Disgust Scale (DS-R) to measure Disgust Sensitivity, (3) Perceived Vulnerability to Disease scale (PVD) to measure Germ Aversion and Perceived Susceptibility, and (4) socio-demographic information. Using mediation analysis, we assess the direct, the indirect (through Vaccine Attitudes) and the total effect of Disgust Sensitivity, Germ Aversion and Perceived Susceptibility on 2016 self-reported flu vaccine uptake. Mediation analysis showed the effect of Disgust Sensitivity and Germ Aversion on vaccine uptake to be twofold: a direct positive effect on vaccine uptake and an indirect negative effect through Vaccine Attitudes. In contrast, Perceived Susceptibility was found to have only a direct positive effect on vaccine uptake. Nonetheless, these effects were attenuated and small compared to economic, logistic and psychological determinants of vaccine uptake.

Disability adjusted life years lost to dengue in Brazil.

OBJECTIVES: To assess the dengue burden in Brazil, and to compare it over three spatial scales: in the city of Rio de Janeiro, the state of Rio de Janeiro, and in Brazil overall. METHODS: We calculated disability adjusted life years (DALYs) lost to dengue per million individuals annually from 1986 through 2006. To calculate DALYs, we compiled data on the number of dengue cases by age, clinical syndrome and outcome. We evaluated the sensitivity of our results to multiplication factors used to adjust for inaccuracies in reporting using a Monte Carlo method. RESULTS: From 1986 through 2006, a mean of 56, 47 and 22 DALYs per million individuals annually were lost to dengue in the city of Rio de Janeiro, in the state of Rio de Janeiro and in Brazil, respectively. Over 80% of the dengue burden derived from dengue fever cases. The dengue burden was highest at the city-level with a maximum single-year estimate of 560 DALYs per million individuals for 2002. CONCLUSIONS: Assessment of dengue burden requires consideration of all clinical syndromes over multiple years. Our results indicate that the dengue burden is as high as the burden of other major infectious diseases that afflict the Brazilian population, including malaria. These results may prompt policy makers to elevate the prioritization of dengue control, and allocate resources needed to curtail the increasing dengue burden.

Owlet moths (Lepidoptera: Noctuoidea) associated with Bt and non- Bt soybean in the brazilian savanna.

The use of GMO expressing Bt toxin in soybean production has increased significantly in the last years in Brazil in order to manage the damage caused by lepidopteran pests. In this study, we compared the richness and abundance of owlet moths (Noctuoidea) associated with Bt and non-Bt soybean. We determined the temporal variations as a function of phenology, and correlated the population variations of the most common species with meteorological variables. The research was conducted at the experimental area of Embrapa Cerrados. The collection method used was differentiated being suppressive and absolute. A total of 13 species were collected, of which eight occurred on Bt soybeans. The most representative taxa were Chrysodeixis includens (72.87%), Anticarsia gemmatalis (18.17%) and Spodoptera spp (5.22%). The number of larvae belonging to species targeted by the Bt technology was 10 times lower on Bt than on non-Bt soybeans. Utetheisa ornatrix and Elaphria deltoides were recorded on soybean for the first time, observing larvae of both species in non-Bt soybean and those of U. ornatrix also in Bt soybean. Only A. gemmatalis larvae correlated (p <0.05) negatively with precipitation. This study provided field information on the abundance and species richness of owlet moths on non-Bt soybeans, associated with the effects of Bt soybean. When considering the different levels of infestation between cultivars as a criterion, larvae monitoring is of substantial importance in order to develop the lost control program.

Risk assessment of yellow fever urbanization in Rio de Janeiro, Brazil.

Yellow fever (YF), an arthropod-borne viral disease, occurs in regions of tropical America and Africa. Sylvatic YF is endemic in the north and west of Brazil. Urban YF, on the other hand, has not been reported in the country since 1942. However, the widespread presence of the YF urban vector in Brazil has lead to concern about the potential re-emergence of YF in urban centres. Here, we assess the risk of YF emergence in the city of Rio de Janeiro, Brazil, by estimating the probability of infected individuals arriving from YF-endemic areas, and the probability of infective individuals triggering an epidemic. We found that the risk of urban YF emergence may reach values as high as 29% during the epizootic periods but the precision of the estimate is low.

Is pertussis actually reemerging? Insights from an individual-based model.

In this paper, we introduce a spatially explicit, individual-based model developed to simulate the dynamics of pertussis in a small population. With this simulation approach, complex epidemic systems can be built using information on parasite population structure (strain diversity, virulence diversity, etc.), human population structure (individual risk, age structure, interaction matrices, immune response, etc.), as well as mechanisms of evolution and learning. We parameterized our model to describe pertussis in an age-structured community. Pertussis or whooping cough is an acute infection of the respiratory tract caused by Bordetella pertussis. Despite wide-scale vaccination in many countries, this disease is reemerging throughout the world in both adults and children. Emergence has been explained by many factors: wane of vaccine and natural immunity, increase of asymptomatic carriers, and/or natural selection of non-vaccine strains. Here, we model these hypotheses and analyze their potential impact on the observed increase of pertussis notification.

Owlet moths (Lepidoptera: Noctuoidea) associated with Bt and non- Bt soybean in the brazilian savanna / Noctuóides (Lepidoptera: Noctuoidea) associados a soja Bt e não-Bt no Cerrado brasileiro

Abstract The use of GMO expressing Bt toxin in soybean production has increased significantly in the last years in Brazil in order to manage the damage caused by lepidopteran pests. In this study, we compared the richness and abundance of owlet moths (Noctuoidea) associated with Bt and non-Bt soybean. We determined the temporal variations as a function of phenology, and correlated the population variations of the most common species with meteorological variables. The research was conducted at the experimental area of Embrapa Cerrados. The collection method used was differentiated being suppressive and absolute. A total of 13 species were collected, of which eight occurred on Bt soybeans. The most representative taxa were Chrysodeixis includens (72.87%), Anticarsia gemmatalis (18.17%) and Spodoptera spp (5.22%). The number of larvae belonging to species targeted by the Bt technology was 10 times lower on Bt than on non-Bt soybeans. Utetheisa ornatrix and Elaphria deltoides were recorded on soybean for the first time, observing larvae of both species in non-Bt soybean and those of U. ornatrix also in Bt soybean. Only A. gemmatalis larvae correlated (p <0.05) negatively with precipitation. This study provided field information on the abundance and species richness of owlet moths on non-Bt soybeans, associated with the effects of Bt soybean. When considering the different levels of infestation between cultivars as a criterion, larvae monitoring is of substantial importance in order to develop the lost control program.

Resumo O uso de OGM que expressam toxina Bt na produção de soja tem aumentado significativamente nos últimos anos no Brasil e são utilizados para conter os danos causados ​​pelos lepidópteros pragas. Neste estudo comparamos a riqueza e a abundância de Noctuoides (Noctuoidea) associados à soja Bt e não-Bt. Determinamos as variações temporais em função da fenologia e correlacionamos às variações populacionais das espécies mais comuns com variáveis ​​meteorológicas. A pesquisa foi conduzida na área experimental da Embrapa Cerrados. O método de coleta utilizado foi diferenciado sendo supressivo e absoluto. Um total de 13 espécies foram coletadas, das quais oito ocorreram em soja Bt. Os taxa mais representativos foram Chrysodeixis includens, Anticarsia gemmatalis e Spodoptera spp. O número de larvas pertencentes às espécies alvo da tecnologia Bt foram 10 vezes menores na soja Bt do que em soja não-Bt . Utetheisa ornatrix e Elaphria deltoides foram registradas na soja pela primeira vez, observando-se larvas de ambas espécies na soja não-Bt e as de U. ornatrix também na soja Bt. Somente as larvas de A. gemmatalis se correlacionaram (p <0,05) negativamente com a precipitação. Este estudo forneceu informações em campo sobre a abundância e riqueza de espécies na soja não- Bt, associada aos efeitos da soja Bt. A importância do monitoramento das lagartas é substancial, a fim de tomar a melhor decisão de controle, considerando-se os diferentes níveis de infestação entre cultivares como critério.

Cervical cytological abnormalities and factors associated with high-grade squamous intraepithelial lesions among HIV-infected women from Rio de Janeiro, Brazil.

Although cervical cancer remains a major public health problem in Brazil, knowledge of cervical cytological abnormalities among HIV-infected women remains scarce. At baseline evaluation of a cohort followed in Rio de Janeiro, Brazil, 703 HIV-infected women underwent cytology-based cervical cancer screening and human papillomavirus (HPV) DNA testing. Poisson regression analysis was used to evaluate the association of factors with the presence of high-grade squamous intraepithelial lesions (HSIL). Cervical cytology was abnormal in 24.3% of the women; 4.1% had HSIL. Beyond HPV infection, factors independently associated with the presence of HSIL was age (≥25 and ≤40 years, prevalence ratio [PR] 2.60, 95% confidence interval [CI] 1.11-6.10), and more than three pregnancies was protective (PR 0.33, 95% CI 0.11-0.94). High coverage of cervical cancer screening is warranted to prevent morbidity and mortality from cervical cancer in this population.

Impact of insecticide interventions on the abundance and resistance profile of Aedes aegypti.

Insecticide-based vector control is the primary strategy for curtailing dengue transmission. We used a mathematical model of the seasonal population dynamics of the dengue mosquito vector, Aedes aegypti, both to assess the effectiveness of insecticide interventions on reducing adult mosquito abundance and to predict evolutionary trajectories of insecticide resistance. We evaluated interventions that target larvae, adults, or both. We found that larval control and adult control using ultra-low-volume insecticide applications can reduce adult mosquito abundance with effectiveness that depends on the frequency of applications. We also found that year-long continuous larval control and adult control, using either insecticide treatment of surfaces and materials or lethal ovitraps, imposed the greatest selection for resistance. We demonstrated that combined targeting of larvae and adults at the start of the dengue season is optimal. This intervention contrasts with year-long continuous larval control policies adopted in settings in which dengue transmission occurs.

A modelling analysis of pertussis transmission and vaccination in Rio de Janeiro, Brazil.

Pertussis is an infectious respiratory disease for which mass vaccination is an effective preventive strategy. In many developed countries, where high vaccination coverage has been maintained for approximately 50 years, re-emergence of the disease has been observed in all age groups. In the municipality of Rio de Janeiro (RJ), where vaccination started in the 1980s, surveillance data show no sign of disease re-emergence. We developed a mathematical model that incorporates the major demographic aspects of a large urban centre in a developing nation, in addition to the most important epidemiological aspects of disease transmission. Parameter values were estimated based on RJ demographic and vaccine coverage data. Overall, all vaccination strategies determined a major decrease (over 95% decrease when compared to the pre-vaccine era) in the incidence of primary infections (occurring in individuals who have never been immunized through infection or vaccine). On the other hand, the strategies (a) three doses at age 2-11 months, (b) three doses plus booster at age 12-23 months, (c) three doses plus booster at age 4-5 years, and (d) three doses plus both boosters, differently affected the incidence of secondary infections (occurring in previously infected/vaccinated individuals). Given that the immunity against pertussis wanes with time and that the infectious agent has not been eliminated from the population, it is expected that pertussis will continue to be a problem in RJ. Actually, since immunity acquired from vaccine wanes faster than disease-acquired immunity and the possibility of natural boosters has decreased with mass vaccination, an increase in the incidence of secondary infections among older age groups is expected (and predicted by the model). Possible explanations as to why this dynamics is not captured by the RJ surveillance system are discussed. A poorly effective surveillance system and a lack of awareness regarding loss of immunity and the possibility of pertussis infection in older age groups are among them. Finally, we bring attention to the need of (i) field studies for the measurement of pertussis incidence in adolescents and adults; (ii) better understanding of the transmission dynamics currently occurring in RJ, and (iii) re-evaluation of vaccination strategies with the possible introduction of acellular vaccines for the vaccination of older individuals.

Risk of fatal adverse events associated with 17DD yellow fever vaccine.

Yellow fever (YF), an acute infectious disease, is endemic in the north and central-west of Brazil. This disease can be prevented by the use of a vaccine. In Brazil, four fatal adverse events have been associated with the YF vaccine used in the country (17DD vaccine). We briefly describe the last two fatalities, and estimate the risk of 17DD-associated fatal adverse events under different epidemiological scenarios. Controversies regarding the appropriate denominator that enters the estimation of risk serve as a motivation for each proposed scenario. The statistical procedures used show optimum behaviour when assessing the risk of rare events. Risk estimates vary from 0.043 (95 % CI 0.017-0.110) to 2.131 (95 % CI 0.109-12.071) fatalities per million doses administered. The robust estimates of the risk of fatal adverse events we present constitute an important element in future risk-benefit analysis and point to the need for good quality vaccine coverage and adverse-events surveillance data to assess the risk of vaccination. Although vaccination of YF endemic regions is necessary to maintain low disease prevalence, preventive administration of YF vaccine to the entire population should be cautiously analysed.

Calcio/creatinina en orina basal en relación a la ingesta de calcio y al estado nutricional en menores de tres años / Calcium/creatinine ratio, in basal urine, and its interrelationship with calcium intake and calcium nutritional status in children under three years of age

En un grupo de niños se estudió la posibilidad de utilizar la relación calcio/creatinina (Ca/Creat.) en orina basal, como indicador del estado nutricional respecto al calcio. Esta investigación incluyó 24 niños con edades comprendidas entre 3 y 36 meses que, por razones legales, permanecieron 60 días en el Hospital Especializado Noel H. Sbarra, de La Plata. A su ingreso se les dividió en normales y desnutridos de acuerdo a la clasificación de Waterlow y se alimentaron ad libitum con una de las dos fórmulas lácteas comerciales elegidas por el equipo pediátrico, en base a la presencia o ausencia de diarrea. Los mayores de 12 meses recibieron además la dieta habitual del Hospital; en todos los casos se registró diariamente el consumo de alimentos y se calculó la ingesta de calcio. A los 60 días del ingreso se recolectó orina basal, en la cual se determinó calcio y creatinina. Los resultados demonstraron que: a) en los niños normales la relación Ca/Creat. tendía a disminuir con la edad, a un valor mínimo de 0.2 a los 36 meses; con la ingesta de calcio, el índice guardó una relación similar a la observada para las vitaminas hidrosolubles, cambiando bruscamente a partir del momento en que teóricamente se cubren las necesidades, según el NRC (60 mg/kg/día). b) En los niños desnutridos dicha relación no mostró variación con la edad ni con la ingesta de Ca, a pesar de que ésta superaba ampliamente la cifra recomendada por el NRC para niños normales. Es de suponer que esta respuesta se haya debido a que la elevada retención de Ca que tiene lugar durante la recuperación, hizo que no se llegasen a cubrir las necesidades. La similitud de este comportamiento con el observado anteriormente en escolares sugiere la dependência de la relación Ca/Creat en orina basal con la velocidad de recambio del calcio óseo y su futura utilidad para establecer la adecuación nutricional con respecto a este elemento mineral

Interrrelaciones entre ingesta de vitamina D y absorcion y retencion de calcio durante la recuperacion nutricional / Relationship between vitamin D intake and absorption and retention of calcium during nutritional recovery

La velocidad de recuperación del niño desnutrido puede acelerarse utilizando dietas con un percentaje de calorías proteicas mayor que el tradicional; de este modo se alcanzan velocidades de crecimiento elevas que llevan asociadas retenciones de calcio y fósforo varias veces superiores a las normales. Debido a la importancia de la vitamina D en la regulación del metabolismo del calcio, estas observadiones conducen a pensar si durante la terapia de recuperación es necesario incrementar la ingesta de vitamina D administrando suplementos, con potencial riesgo de hipervitaminosis. Por tal motivo se han estudiado, en el presente trabajo, las interrelaciones entre retención y absorción de Ca e ingesta de vitamina D durante la recuperación nutricional comparando nuestros datos con las ingestas recomendadas (IR) para Ca y vitamina D, expresadas por kg/de peso corporal, por 1000 kcal recomendadas (IR) para Ca y vitamina D, expresadas por kg/de peso corporal, por 1000 kcal de alimento y como Ca absorbido/microng de vitamina D. La metodología fue la habitual en los estudios de balance: 29 niños, de 2 a 18 meses, con diferentes grados de desnutrición, fueron alimentados ad libitum con una de dos fórmulas comerciales que contenías respectivamente: Ca: 0,50 y 1,17 g%; Fósforo: 0,37 y 0,50 g%; vitamina D: 350 y 400 UI/100 g. (,87 a 10 micron/100 g); Proteínas: 11,34 y 17,00 kcal proteicas/100 kcal totales de dieta. La ingesta de Ca osciló entre 60 y 413 mg/kg/día y el Ca absorbido entre 40 y 92% con...