A toxocaríase é uma zoonose muito difundida em todo o mundo. Trata-se da infecção humana, em especial pelas larvas de Toxocara canis, um nematóide comum de cães. O objetivo do presente estudo foi levantar a soropositividade a anticorpos anti-Toxocara spp, identificar os fatores de risco em grupos de escolares da cidade de Fernandópolis/SP e avaliar a contaminação do solo por ovos desse e de outros geo-helmintos entre os anos de 2007 e 2008. Foi realizado um estudo transversal utilizando-se amostragem complexa e estratificada, por renda, para a avaliação da toxocaríase humana. O método diagnóstico empregado foi o teste de ELISA para detecção de anticorpos IgG anti-Toxocara spp. O estudo da contaminação do solo deu-se por meio da avaliação de amostras de solo de praças, parques públicos e escolas municipais e pela avaliação de amostras de fezes provenientes de 10 praças públicas. Foram avaliados 252 indivíduos em dois estratos, o primeiro representando baixa renda com 120 (47,6%) crianças e o segundo com 132 (52,4%) representando renda elevada. A frequência geral de positividade ao antígeno TES foi de 15,4% (39), sendo 28,3% (34) para o primeiro estrato contra 3,7% (5) do segundo (p<0,000). A exposição à geofagia (exposto OR ajustado 14,65 - IC95% = 2,14 a 89,25 e muito expostos OR ajustado 19,15 a IC95% = 2,96 a 123,94), o hábito de levar objetos à boca (exposto OR ajustado 9,31 - IC95% = 1,63 a 53,03 e muito expostos OR ajustado 42,29 a IC95% = 5,49 a 326,01) e a presença de mais de dois cães em domicílio (OR ajustado 21,25 = 1,7 a 264,87) foram variáveis associadas à positividade. O hábito de lavar as mãos antes das refeições (OR ajustado 0,01 - IC95% 0,00 a 0,05) representou importante fator de proteção. Foram avaliadas 225 amostras de solo, sendo 71% (160) provenientes de praças e parques públicos e 29% (65), de escolas municipais. Foi observado alto grau de contaminação de praças e parques públicos 28,4% (64), ao passo que nas escolas a positividade foi de 1,7% (6). Os parasitos encontrados com maior frequência foram de Toxocara spp 79,6% (47), Trichuris spp 13,5% (8) e ancilostomídeo 6,4% (4). Foram avaliadas ainda 400 amostras de fezes de cães, e observou-se uma positividade de 23,7% (95). Os parasitos observados com maior frequência nas amostras positivas foram ancilostomídeo símile 74,7% (71) e Toxocara canis, 53,6% (51). A positividade a anticorpos anti-Toxocara spp em indivíduos de 1 a 12 anos de idade, provenientes de cinco escolas do município de Fernandópolis/SP, foi relativamente baixa. Os principais fatores de risco/proteção dizem respeito às questões modificáveis como a geofagia, o hábito de levar objetos à boca, a existência de mais de dois cães em domicílio e o hábito de lavar as mãos antes das refeições. Os solos de praças e parques públicos de Fernandópolis/SP e amostras de fezes recolhidas em ambiente estavam altamente contaminados com geo-helmintos zoonóticos e representam fonte de infecção relevante para a população / Toxocariasis is a zoonosis of worldwide occurrence. It is defined as the human infection by larvae of nematodes, especially Toxocara canis, common intestinal parasite of dogs. The aim of this study was to estimate the frequency of anti-Toxocara spp antibodies, identify risk factors in groups of school children from the city of Fernandópolis/SP and evaluate soil contamination by eggs of this and other geohelminths between 2007 and 2008. It was conducted a cross-sectional study using complex sampling for the assessment of human toxocariasis. The diagnostic method used was the ELISA test for detection of IgG anti-Toxocara spp antibodies. The study of soil contamination was done through evaluation of soil samples from public places, sand boxes of municipal schools and evaluation of dogs stool samples from 10 public places. Two hundred and fifty two children were evaluated in two strata, the first with 120 children (47.6%) from low income families and the second with 132 (52.4%) from high income ones. The overall frequency of antibodies anti-Toxocara spp was 15.4% (39), being 28.3% (34) for the first stratum compared with 3.7% (5) of the second (p <0.000). The exposure to geophagy (exposed: adjusted OR 14.65 - CI 95% = 2.14 to 89.25; very exposed: adjusted OR 19.15 - CI 95%= 2.96 to 123.94), the habit of rising objects up to the mouth (exposed: adjusted OR 9.31 1.63 to 53.03; very exposed: adjusted OR 42.29 - CI 95%= 5.49 to 326.01) and the presence of more than two dogs at home (adjusted OR 21.25 - 1.7 to 264.87) were variables associated with positivity. The habit of washing hands before meals (adjusted OR 0.01 - CI 95% = 0.00 to 0.05) represented an important protective factor. Were evaluated 225 samples of soil: 71% (160) from public places and 29% (65) of municipal schools. It was observed a high contamination of public places with 28.4% (64) being positive, while in school positivity was 1.7% (6). The most frequent parasites eggs found were Toxocara spp 79.6% (47), Trichuris spp 13.5% (8) and Ancylostomatidae 6.4% (4). They were also evaluated 400 fecal samples of dogs and observed a positivity of 23.7% (95). The most frequent parasites observed in positive samples were Ancylostoma simile 74.7% (71) and Toxocara canis 53.6% (51). The anti-Toxocara spp antibodies positivity in school children from Fernandópolis/SP was relatively low. The main factors of risk/protection concern to modifiable issues like geophagy, the habit of rising objects up to the mouth, the existence of more than two dogs at home and the habit of washing hands before meals. The soil of public places of Fernandópolis/SP and feces samples collected from the environment were highly contaminated with zoonotic helminths and represent important source of infection for the population

Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2014-11-19T14:09:47Z No. of bitstreams: 2 Dissertação - Fabiana Carmo Approbato - 2012.pdf: 1717961 bytes, checksum: a9307564863c1765301f00c5f05b6d5f (MD5) license_rdf: 23748 bytes, checksum: b92763cfc0af52c7c868455edfaf3266 (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2014-11-20T14:28:48Z (GMT) No. of bitstreams: 2 Dissertação - Fabiana Carmo Approbato - 2012.pdf: 1717961 bytes, checksum: a9307564863c1765301f00c5f05b6d5f (MD5) license_rdf: 23748 bytes, checksum: b92763cfc0af52c7c868455edfaf3266 (MD5) / Made available in DSpace on 2014-11-20T14:28:48Z (GMT). No. of bitstreams: 2 Dissertação - Fabiana Carmo Approbato - 2012.pdf: 1717961 bytes, checksum: a9307564863c1765301f00c5f05b6d5f (MD5) license_rdf: 23748 bytes, checksum: b92763cfc0af52c7c868455edfaf3266 (MD5) Previous issue date: 2012-04-04 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / The Chlamydia trachomatis is a common factor of sexually transmitted diseases. If not treated it can induce tubal obstruction, ectopic pregnancy and infertility. In adolescent women, the prevalence can reach 30%. When look for infertility treatment, the women are at older age, so they are at a different prevalence of Chlamydia. Objectives: To evaluate the prevalence of Chlamydia trachomatis by PCR, enzyme immunoassay or indirect immuno fluorescence at infertile patients. Methods: Design: Prevalence study. Diagnoses Test. Setting: Reproductive Laboratory (LABREP) - HC / UFG and Mater Clinic of Obstetrics and Gynecology, Goiânia, Brazil. Patients: One hundred and twenty patients attended from 2011 to 2012, from 20 to 48 years old. Main Outcome Measures: Age frequency histogram, exposition to pregnancy time, Chlamydia prevalence, Odds ratio for tubal obstruction, ectopic pregnancy and others STDs (Sexually Transmitted Diseases). It was calculate the age histogram frequency, and pregnancy exposition time. We used Chi Square statistical for Odds risk to tubal obstruction for serum positive patients; the Odds risk to ectopic pregnancy for serum positive patients and Odds risk to others STDs for serum positive patients. The rejection p was 5 % (p = 0.05). The Statistical Software used was BioEstat® and excel®. The study was submitted and approved by ethics committee of Clinical Hospital of Federal University of Goias State, Brazil. Results: The patients average age was 33.2 years, above of adolescent age prevalence, when chlamydia is frequently found. The average of exposition to pregnancy was 48.6 months. The PCR Chlamydia detection was less than 1 % (0.83 %). The Chlamydia PCR prevalence for serum positive was 2.4 % (one patient). We did not found Positive PCR between serum negative patients. The Odds to tubal obstruction for serum positive patients was 2.5. This was statistically significant. The Odds Ratio to ectopic pregnancy for serum positive patients was 1.31. This was not statistically significant. The Odds Ratio to others STDs for serum positive patients was 4.1 (p = 0.024). The Odds Ratio to ectopic pregnancy for tubal obstruction was 19.1. This was highly significant (p = 0.001). The NNT was 42. Conclusions: We conclude that C. trachomatis has a very low frequency at this population ( < 1 %), but heavy sequels of infection stays. The average age of the infertile patients was 33.2 years, above of the age mean of adolescents. We found association of positive serology screening and statistically significant risk for tubal obstruction, ectopic pregnancy and to others STDs. / A Chlamydia trachomatis é fator etiológico comum de doenças sexualmente transmissíveis. Quando não tratada pode provocar sequelas como obstrução tubária, gravidez ectópica e infertilidade. Entre mulheres adolescentes, a taxa de prevalência pode chegar a 30%. Por outro lado, nas mulheres que procuram tratamento para infertilidade a faixa etária é maior, e a prevalência diferente. Objetivos: Avaliar a prevalência de Chlamydia trachomatis pela técnica de PCR, por enzimaimunoensaio ou imunofluorescência indireta em pacientes com esterilidade feminina. Métodos: Desenho: Estudo de prevalência. Teste diagnóstico. Local: Laboratório de Reprodução Humana (LABREP) - HC / UFG e Mater Clínica de Ginecologia e Obstetrícia, Goiânia. Pacientes: Foram estudadas 120 pacientes atendidas entre 2011 a 2012 com idade entre 20 e 48 anos. Principais resultados medidos: Faixa etária, tempo de exposição à gravidez, prevalência da clamídia, risco de Odds para obstrução tubária, gravidez ectópica e outras DSTs. Foram calculados os histogramas de frequência para idade e tempo de exposição. Foi utilizada a estatística de Qui quadrado para cálculo do risco de Odds de obstrução tubária entre as pacientes soro positivas; o risco de Odds de gravidez ectópica em pacientes soro positivas e o risco de Odds das pacientes soropositivas ter outras DSTs. O nível de significância escolhido foi 5 % (p = 0,05). O programa utilizado foi o BioEstat® e a planilha do Excel®. O projeto foi submetido e aprovado pelo Comitê de Ética do Hospital das Clínicas na Universidade Federal de Goiás. Resultados: A média de idade das pacientes foi 33,2 anos, acima da faixa de prevalência nas adolescentes, quando a presença de clamídia é elevada. A média de tempo de exposição (tempo tentativa de gravidez) foi de 48,6 meses. A prevalência de infecção detectada pelo exame de PCR foi menor do que 1 % (0,83 %). A prevalência da infecção por clamídia pelo exame de PCR entre as pacientes soro positivas foi de 2,4 % (uma paciente). Não encontramos PCR positivo entre as soro negativas. O risco de Odds entre as pacientes soro positivas para obstrução tubária foi de 2,5. Este valor foi estatisticamente significativo. O risco de Odds entre as pacientes soro positivas para apresentar gravidez ectópica foi de 1,31. Este valor não atingiu nível estatístico significativo. O risco de Odds entre as pacientes soro positivas foi de 4,1 para apresentar outras DSTs. Este valor foi estatisticamente significativo. O risco de Odds entre as pacientes com obstrução tubária para apresentar gravidez ectópica foi de 19,1. Este valor atingiu nível estatístico significativo (p = 0,001). Encontramos um NNT de 42 neste trabalho. Conclusões: Neste trabalho, a prevalência da clamídia detectada por PCR foi menor do que 1 % permanecendo as sequelas graves da infecção. Encontramos associação entre a sorologia positiva para Chlamydia trachomatis e obstrução tubária, gravidez ectópica e outras DSTs neste estudo. A média de idade das pacientes foi 33,2 anos, acima da faixa de prevalência nas adolescentes, quando a presença de clamídia é elevada.

Background Chronic myeloid leukemia (CML) is a relatively rare hematological malignancy with a constant incidence of approximately 90 new cases each year in Sweden (0.9 cases/100 000 inhabitants). The etiology is largely unknown but high doses of ionizing radiation are a known but rare risk factor. The treatment options were for a long time limited to chemotherapies i.e. hydroxyurea and busulfan, interferon’s and allogeneic hematopoietic stem cell transplantation and the median survival were only about four years. Since the beginning of the 21st century a new way of treating CML has been introduced, the tyrosine kinase inhibitors (TKI), leading to a rapid decrease in leukemic cells and symptoms. Due to the TKIs, the overall 5-year survival is nowadays approximately 85 % and CML patients have time to develop other diseases, including other malignancies. The aims of this thesis was to investigate the present and future prevalence of CML and the prevalence of other malignancies prior and subsequent to the diagnosis of CML, malignancies among first-degree relatives of persons with CML. In addition, the incidence of autoimmune and chronic inflammatory diseases among patients with CML was also investigated.   Methods From the Swedish CML register, data over nearly all Swedish CML patients from 2002 and forward were obtained for paper II-IV. For paper I, the Swedish cancer register was used to identify all Swedish CML patients since 1970 and the Swedish cause of death register was used to identify an eventual date of death for these patients. With a constant incidence and the relative survival rates for CML patients between 2006 and 2012 as a model, the present and future prevalence was calculated. For paper II-IV, data from the Swedish cancer register was used to identify other malignancies than CML. For paper II, information about autoimmune and chronic inflammatory diseases was retrieved from the Swedish national patient register. For paper II and IV, five controls matched for year of birth, gender and county of residence were randomly selected from the Swedish register of the total population. To calculate odds ratio (OR), conditional logistic regression was used. To calculate the risk of a second malignancy for paper III, Standardized incidence ratio (SIR) was used. In paper IV, first-degree relatives (parents, siblings and offsprings) for both cases and controls were retrieved from the Swedish multi-Generation Register, where persons born later than 1932 and registered in Sweden at some time since 1961 are registered.   Results Prevalence and survival As shown in paper I, the 5-year overall survival for CML patients increased remarkably from 0.18 to 0.82 between 1970 and 2012. The prevalence increased from 3.9 to 11.9 per 100 000 inhabitants in Sweden between 1985 and 2012. By assuming no further improvements in relative survival as compared to the survival rates between 2006 and 2012, the prevalence by 2060 is expected to increase to 22.0 per 100 000 inhabitants. This corresponds to 2 587 CML patients as compared to 1 137 CML patients in 2012.   Malignancies, autoimmune and chronic inflammatory diseases prior to CML In study II, more than 45 000 person-years of follow-up were evaluated in 984 CML patients diagnosed between 2002 and 2012. With an OR of 1.47 (95 % CI 1.20–1.82) and 1.55 (95 % CI 1.21–1.98), respectively, the prevalence of prior malignancies and autoimmune diseases were significantly increased as compared to matched controls. On the other hand, no association between CML and chronic inflammatory diseases was shown.   Second malignancies In 868 CML patients, diagnosed between 2002 and 2011, 52 malignancies were observed in the Swedish cancer register, as shown in paper III. When compared to expected rates in the background population, a significantly increased risk of second malignancies with a SIR of 1.52 (95 % CI 1.13–1.99) was shown. When looking at specific cancer types, gastrointestinal as well as nose and throat cancer were significantly increased.   Familial aggregation of malignancies 984 CML patients were identified in paper IV. However, 184 had a birth date prior to 1932, subsequently only 800 patients were analyzed. Among them, 4 287 first-degree relatives were identified, compared to 20 930 first-degree relatives of the matched controls. 611 malignancies were retrieved; no significant increase of malignancies in first-degree relatives of CML patients was shown (OR 1.06; 95 % CI: 0.96–1.16).   Conclusion Since CML patients nowadays have a high survival rate, the calculations in this thesis shows that the prevalence of CML will almost double by 2060. CML patients have an increased risk of developing malignancies prior and subsequent to the diagnosis of CML, suggesting a hereditary or acquired predisposition to develop cancer. Since there is no familial aggregation of malignancies in CML patients, a hereditary predisposition to develop cancer is unlikely to be part of the pathogenesis of CML, leaving an acquired predisposition more likely.

Philosophiae Doctor - PhD / This study extends the existing literature on how social networks enhance the performance and sustainability of small enterprises. More specifically, the study isolates and investigates the mechanisms through which social capital helps with the growth and survival of MSMEs. The evidence presented in this study strongly suggests that an indigenous social network widely practiced in Ethiopia, the "iqqub", contributes significantly to the start-up, survival and development of urban MSMEs. / South Africa

This empirical exploratory study quantitatively analyzed content similarity indices (potential plagiarism) from a corpus consisting of 360 dissertations and 360 published articles. The population was defined using the filtering search criteria human resource development, training and development, organizational development, career development, or HRD. This study described in detail the process of collecting content similarity analysis (CSA) metadata using Turnitin software (www.turnitin.com). This researcher conducted robust descriptive statistics, a Wilcoxon signed-rank statistic between the similarity indices before and after false positives were excluded, and a multinomial logistic regression analysis to predict levels of plagiarism for the dissertations and the published articles. The corpus of dissertations had an adjusted rate of document similarity (potential plagiarism) of M = 9%, (SD = 6%) with 88.1% of the dissertations in the low level of plagiarism, 9.7% in the high and 2.2% in the excessive group. The corpus of published articles had an adjusted rate of document similarity (potential plagiarism) of M = 11%, (SD = 10%) with 79.2% of the published articles in the low level of plagiarism, 12.8% in the high and 8.1% in the excessive group. Most of the difference between the dissertations and published articles were attributed to plagiarism-of-self issues which were absent in the dissertations. Statistics were also conducted which returned a statistically significant justification for employing the investigative process of removing false positives, thereby adjusting the Turnitin results. This study also found two independent variables (reference and word counts) that predicted dissertation membership in the high (.15-.24) and excessive level (.25-1.00) of plagiarism and published article membership in the excessive level (.25-1.00) of plagiarism. I used multinomial logistic regression to establish the optimal prediction model. The multinomial logistic regression results for the dissertations returned a Nagelkerke pseudo R2 of .169 and for the published articles a Nagelkerke pseudo R2 .095.

Das Hauptanliegen dieser Arbeit besteht in der Erweiterung des Kenntnisstandes zur Bedeutung des Berufs im Hinblick auf Prävalenz bzw. Risiko einer Psychischen und Verhaltensstörung (PVS) bei Frauen. Es gibt zahlreiche deskriptive Aussagen von Krankenkassen zum Auftreten verschiedener Diagnosegruppen oder Einzeldiagnosen, die sich bezüglich der Berufe jedoch auf die Gesamtheit der PVS beschränken. Die Analysen im Rahmen dieser Arbeit beruhen auf den Daten der weiblichen Versicherten der AOK PLUS für die Jahre 2007 bis 2011 mit insgesamt 2.113.083 Versichertenjahren. Es werden inferenzstatistische Aussagen getroffen, die auf Ergebnissen explorativer Voranalysen beruhen. Den berufsbezogenen Analysen werden zunächst Auswertungen zum Alter vorangestellt (Abschnitt 4). Erwartungsgemäß sind die Unterschiede zwischen den Altersgruppen für jede betrachtete Diagnosegruppe signifikant, jedoch weisen die Diagnosegruppen nicht dieselbe Altersabhängigkeit auf. Mit zunehmendem Alter zeigen sich zudem längere Erkrankungsdauern. Die Berufe im Datenbestand der AOK PLUS sind mittels der Klassifikation KldB 1988 [1] codiert (ca. 330 3-Steller). Für die berufsbezogenen Analysen wird in Abschnitt 5 zunächst die Frage geklärt, ob sich mittels Aggregationen der 3-Steller eine geeignetere Systematik finden lässt. Bis auf die Zusammenfassung einiger weniger 3-Steller ist das nicht der Fall. Basierend auf diesen Ergebnissen wird in Abschnitt 6 ein zweistufiges Vorgehen gewählt. In einem ersten Schritt werden für jede betrachtete PVS-Diagnose (bzw. Diagnosegruppe) die 21 Berufe mit den größten Quoten (AU-Personen pro 1.000 Versichertenjahre) ermittelt. Dabei werden zusätzlich altersstandardisierte Quoten berechnet. In einem zweiten Schritt werden die Ergebnisse des ersten Schrittes mittels Binärer Logistischer Regression (BLR) mathematisch-statistisch abgesichert. Dabei wird die Gesamtheit der nicht ausgewählten Berufe (also alle außer den 21) als Referenzgruppe verwendet. Für alle 21 ausgewählten Berufe werden dann die Odds Ratios gegenüber der Referenzgruppe in Verbindung mit einer Aussage zur Signifikanz ermittelt. Daraus resultiert schließlich eine Rangreihe der „Risikoberufe“, sortiert nach den unteren Grenzen der Konfidenzintervalle. Das Alter wird in diesem Schritt durch Einbezug als potentielle Einflussgröße berücksichtigt. Die Ergebnisse (Abschnitte 6 und 7) zeigen, dass Frauen besonders von PVS betroffen sind, wenn sie als Schienenfahrzeugführer (711), Soldaten, Grenzschützer, Polizisten, Sicherheitskontrolleure (801, 803), Krankenversicherungsfachleute (693), Telefonisten (734) sowie als Fachschul-, Berufsschul- und Werklehrer (874) arbeiten. Für Einzeldiagnosen und Diagnosegruppen ergibt sich ebenfalls ein differenziertes Bild. Bei den Erkrankungsdauern in Abhängigkeit vom Beruf zeigen sich keine substantiellen Auffälligkeiten.:1 Einleitung 7 2 Problemlage und Fragestellungen 8 2.1 LITERATURÜBERSICHT 8 2.1.1 Allgemeine Aussagen und Kosten 8 2.1.2 Aussagen zu Diagnosegruppen und Einzeldiagnosen der PVS 10 2.1.3 Aussagen zum Alter 12 2.1.4 Aussagen zum Beruf 13 2.1.5 Berufe als Risikofaktor für psychische Fehlbelastung 19 2.1.6 Psychischen Gesundheit von Frauen: Der Beruf als Modulator 21 2.1.7 Gesamteinschätzung zum Kenntnisstand 21 2.2 FRAGESTELLUNGEN 23 2.2.1 Zum Alter 24 2.2.2 Zur Systematik der Berufe 25 2.2.3 Zum Beruf 26 2.2.4 Zur Relation der Frage- und Zielstellungen 26 3 Datenbasis und methodische Aspekte 27 3.1 DATENBASIS 27 3.2 INDIKATOREN, DESKRIPTIVE STATISTIKEN 28 3.3 SYSTEMATIK DER BERUFE 29 3.4 MATHEMATISCH-STATISTISCHE VERFAHREN 30 3.4.1 Altersstandardisierung 30 3.4.2 Chi-Quadrat- und MANTEL-HAENSZEL-Test 31 3.4.3 Binäre Logistische Regression (BLR) 31 3.4.4 Mathematisch-statistische Aussagen zu Erkrankungsdauern 33 3.4.5 Signifikanzniveau und Darstellung von Signifikanzaussagen 35 4 F-Diagnosen und Z73 nach Alter 36 4.1 BETROFFENENQUOTEN 36 4.2 ERKRANKUNGSDAUERN 39 5 Systematiken zum Beruf im Vergleich 43 5.1 BERUFSORDNUNG 44 5.2 SYSTEMATIK NACH BLOSSFELD 45 5.3 ZUSAMMENGEFASSTE BERUFSGRUPPEN NACH SUGA 46 5.4 BERUFSGRUPPEN 47 5.5 PARTIELL AGGREGIERTE BERUFE 48 6 F-Diagnosen und Z73 nach Beruf und Alter 49 6.1 DIAGNOSEHAUPTGRUPPE F00-99 PSYCHISCHE UND VERHALTENSSTÖRUNGEN 49 6.1.1 AU-Personen 49 6.1.2 Erkrankungsdauern 54 6.2 DIAGNOSEGRUPPEN IM VERGLEICH 55 6.3 DIAGNOSEGRUPPE F10-19 PSYCHISCHE UND VERHALTENSSTÖRUNGEN DURCH PSYCHOTROPE SUBSTANZEN 56 6.3.1 Gesamtgruppe F10-19 – AU-Personen 56 6.3.2 Diagnosen F10 und F17 – AU-Personen 59 6.3.3 AU-Personen – die auffälligsten Berufe 60 6.3.4 Erkrankungsdauern 61 6.4 DIAGNOSEGRUPPE F30-39 AFFEKTIVE STÖRUNGEN 62 6.4.1 Gesamtgruppe F30-39 – AU-Personen 62 6.4.2 Diagnosen F32 und F33 – AU-Personen 64 6.4.3 AU-Personen – die auffälligsten Berufe 66 6.4.4 Erkrankungsdauern 66 6.5 DIAGNOSEGRUPPE F40-48 NEUROTISCHE, BELASTUNGS- UND SOMATOFORME STÖRUNGEN 68 6.5.1 Gesamtgruppe F40-48 – AU-Personen 68 6.5.2 Diagnosen F41, F43, F45, F48 – AU-Personen 70 6.5.3 AU-Personen – die auffälligsten Berufe 73 6.5.4 Erkrankungsdauern 74 6.6 DIAGNOSE Z73 PROBLEME BEI DER LEBENSBEWÄLTIGUNG (BURN-OUT) 75 6.6.1 AU-Personen 75 6.6.2 Erkrankungsdauern 76 6.7 AU-PERSONEN – DIE AUFFÄLLIGSTEN BERUFE IM GESAMTKONTEXT 77 7 Diskussion der Ergebnisse 83 7.1 METHODISCHE ASPEKTE 83 7.1.1 Einordnung der Analysen im Sinne der Epidemiologie 83 7.1.2 Bezugsbasis Versichertenjahre versus Versicherte 85 7.1.3 Zur Altersstandardisierung 86 7.1.4 Zur Binären Logistischen Regression 88 7.1.5 Binäre logistische Regression versus MANTEL-HAENSZEL Test und Anmerkungen zum Signifikanzniveau 89 7.1.6 Zur Auswahl der Zielgrößen AU-Personen und Erkrankungsdauern 89 7.2 INHALTLICHE ASPEKTE 91 7.2.1 Zum Alter 91 7.2.1.1 Betroffenenquoten 91 7.2.1.2 Erkrankungsdauern 92 7.2.2 Zu den Berufen 93 7.2.2.1 Zu F00-99 – Gesamtheit der PVS – Erkrankungsrisiko 93 7.2.2.2 Zu F00-99 – Gesamtheit der PVS – Erkrankungsdauern 98 7.2.2.3 Zu den Diagnosegruppen F30-39 Affektive Störungen und F40-48 Neurotische, Belastungs- und somatoforme Störungen – Erkrankungsrisiko 99 7.2.2.4 Zur Diagnose F10 PVS durch Alkohol – Erkrankungsrisiko 103 7.2.2.5 Zur Diagnose F17 – PVS durch Tabak 106 7.2.2.6 Zu Diagnose Z73 – Burn-out-Syndrom 108 7.2.3 Zusammenfassung 109 7.3 AUSBLICK 110 8 Literatur 112 9 Verzeichnis der Abkürzungen 122 10 Verzeichnis der Abbildungen 124 11 Verzeichnis der Tabellen 126 Anlagen 128

The aim of this thesis was to investigate the use of effect sizes to report the results of statistical credit rating models in a more practical way. Rating systems in the form of statistical probability models like logistic regression models are used to forecast the behaviour of clients and guide business in rating clients as “high” or “low” risk borrowers. Therefore, model results were reported in terms of statistical significance as well as business language (practical significance), which business experts can understand and interpret. In this thesis, statistical results were expressed as effect sizes like Cohen‟s d that puts the results into standardised and measurable units, which can be reported practically. These effect sizes indicated strength of correlations between variables, contribution of variables to the odds of defaulting, the overall goodness-of-fit of the models and the models‟ discriminating ability between high and low risk customers. / Statistics / M. Sc. (Statistics)

Abstract Purpose: The United States has the highest rate of teen pregnancy of any industrialized nation. Adolescents who have their first sexual intercourse at a young age are at increased risk for teen pregnancies and acquiring a sexually transmitted disease. This study examines predictors of early onset sexual intercourse in male and female residents of the United States. Methods: A nationally representative sample of N=7,643 females and N=4.928 males ages 15-44 was procured from the 2002 National Survey of Family Growth (NSFG), Cycle 6. Age at first sexual intercourse was used to define early onset of sexual debut(<18 years). Socio-demographic and behavioral characteristics of the respondents, demographic and selected reproductive characteristics of the respondent's parents were examined using multiple logistic regression modeling. Results: Non-fispanic black, being raised without both parents, having a mother less than 18 years old at the age of first birth and age difference between partners were significant predictors of early onset of sexual intercourse for both males and females. Maternal education less than high school was a significant protective factor for female respondents [OR=0.72 (95%CI=0.58- 0.90)] and paternal education completed high school only [OR=1.4 (95% CI=l. 1-1.7)] was a significant risk factor for male respondents. Conclusions: Racelethnicity, age difference between partners, not being raised by both parents, having a mother who had her first birth before the age of 18 and parental education are important predictor variables. Further study should be conducted to investigate the protective effect of lack of maternal education for female respondents. Intervention programs for teen pregnancy and sexually transmitted infection prevention should target these at risk groups.

Um dos estudos observacionais mais difundidos e usados em epidemiologia veterinária é o estudo do tipo transversal. Sua popularidade ocorre por fatores como baixo custo e rapidez comparados com outros tipos de estudos, além de ajudar a estimar a prevalência de uma doença (desfecho) e postular fatores associados com o desfecho, que poderão ser confirmados como fatores causais em outros tipos de estudos epidemiológicos. Porém, este tipo de estudo apresenta dois importantes desafios: a dependência dos dados, muito frequente dada a típica estrutura populacional de animais dentro do mesmo rebanho ou fazenda e a escolha da medida de associação para desfechos binários, tão frequentes neste modelo de estudo. Com o objetivo de contribuir com a compreensão global da epidemiologia do aborto bovino associado à Neospora caninum tendo em conta a estrutura populacional, construiu-se um modelo misto com os dados de um estudo transversal realizado em duas regiões do Rio Grande do Sul. Usaram-se dados de 60 propriedades amostradas em duas regiões (noroeste e sudeste) e 1256 bovinos. A percentagem de aborto dentro de cada rebanho variou entre 1% e 30%. Vacas soropositivas tiveram 6,63 vezes mais chances de ter histórico de aborto (IC 95%: 4,41-13,20). As chances de uma vaca ter histórico de aborto foram 5,18 vezes maiores na região noroeste em relação à região sudeste (IC 95%: 1,83-20,80). Um coeficiente de correlação intraclasse de 16% foi estimado, indicando que 16% da variação da ocorrência de abortamentos não explicados pelos efeitos fixos foram devido as fazendas. Já na segunda parte deste trabalho, uma revisão sistemática foi realizada considerando um conjunto diverso de revistas e jornais com o objetivo de verificar os métodos estatísticos usados e a adequação das interpretações das medidas de associação estimadas em estudos transversais na área de medicina veterinária. Um total de 62 artigos foi avaliado. A revisão mostrou que, independentemente do nível de prevalência relatado no artigo, 96% deles empregou regressão logística e, portanto, estimaram razão de chances (RC). Nos artigos com prevalência superior a 10%, 23 deles fizeram uma interpretação adequada da RC como uma “razão de chances” ou simplesmente não fizeram uma interpretação direta da RC, enquanto 23 artigos interpretaram de forma inadequada a RC, considerando-a como risco ou probabilidade. Entre os artigos com prevalência inferior a 10%, apenas três interpretaram a RC como uma “razão de chances”, cinco interpretaram como risco ou probabilidade e em um, apesar de ter estimado a razão de prevalências (RP), foi interpretado de forma inadequada. Paralelamente, com o objetivo de exemplificar o uso de métodos estatísticos que estimam diretamente a razão de prevalências (RP), medida mais adequada para os estudos transversais, um conjunto de dados obtidos a partir de um estudo transversal sobre a ocorrência de anticorpos (AC) contra o vírus da diarreia viral bovina (BVDV) foi usado. Os AC foram medidos em amostras de tanque de leite de rebanhos leiteiros localizados no estado do Rio Grande do Sul, em que os possíveis fatores associados puderam ser avaliados. Entre os métodos utilizados, as maiores discrepâncias nas medidas de associação estimadas foram observadas com a regressão logística tomando-se como referência a regressão log-binomial. Finalmente, é importante que este tipo de desafio seja atendido pelos pesquisadores que realizam estudos transversais, ou seja, considerar a estrutura das populações nas análises, cuidado ao escolher o tipo de modelo estatístico empregado para desfecho binário e interpretação dos estimadores. / The commonest study design used in veterinary epidemiology is the cross-sectional study. Its popularity lies on the fact of the short time needed and low costs compared with other types of studies; moreover, this type of study estimates prevalence and associated factors, which may be elucidated as causal in another type of epidemiological studies. However, this type of study presents two major challenges: a very common dependence between data given the typical structure of the animal population, i.e., animals within herds or farms and the choice of measure of association for binary outcomes, frequently used in this type of study. In order to contribute to the understanding of the epidemiology of bovine abortion associated with Neospora caninum, a mixed model accounting for the hierarchical structure of cattle population using data from a cross-sectional study conducted in two regions (northwest and southeast) of Rio Grande do Sul was made. Data from 60 dairy herds and 1256 sampled cattle were used. The percentage of abortions in each herd ranged between 1% and 30%. Seropositive cows were 6.63 times more likely to have a history of abortion (95% CI: 4.41 to 13.20). The chances of a cow have a history of abortion were 5.18 times higher in the northwest comparing with the southeast region (95% CI: 1.83 to 20.80). An intraclass correlation coefficient (ICC) of 16% was estimated which means that 16% of the variation in abortion occurrence not explained by the fixed effects is due to farms. In the second part of this work, a systematic review was conducted considering a range of journals and newspapers in order to verify the statistical methods used and the adequacy of the interpretations of the measures of association estimated in cross-sectional studies from the veterinary medicine field. A total of 62 articles were revised. The review showed that, regardless of the reported prevalence, 96% of them employed logistic regression, therefore estimating odds ratio (OR). From the articles that reported prevalence rates above 10%, 23 of them did a proper interpretation of OR as an odds ratio, or simply did not make a direct interpretation of the OR, while 23 articles interpreted improperly the OR as a risk or probability. Among the articles that reported prevalence rates lower than 10%, only three interpreted the OR as an odds ratio, five interpreted as a risk or probability and only one, despite the estimated prevalence ratio (PR), it was improperly interpreted. Meanwhile, in order to exemplify the use of statistical methods to estimate directly the PR, the more appropriate measure of association in cross-sectional studies, a data set obtained from a cross-sectional study to estimate the occurrence of antibodies (AB) against bovine viral diarrhea virus (BVDV) in milk was used; AB were measured in bulk tank samples from dairy herds located in the state of Rio Grande do Sul, Brazil, and also possible associated factors were estimated. Among the methods used, major discrepancies in the measures of association estimated were observed with the logistic regression, comparing with the log-binomial regression. Finally, it is important that such challenges are met by the researchers that undertake cross-sectional studies.

The aim of this thesis was to investigate the use of effect sizes to report the results of statistical credit rating models in a more practical way. Rating systems in the form of statistical probability models like logistic regression models are used to forecast the behaviour of clients and guide business in rating clients as “high” or “low” risk borrowers. Therefore, model results were reported in terms of statistical significance as well as business language (practical significance), which business experts can understand and interpret. In this thesis, statistical results were expressed as effect sizes like Cohen‟s d that puts the results into standardised and measurable units, which can be reported practically. These effect sizes indicated strength of correlations between variables, contribution of variables to the odds of defaulting, the overall goodness-of-fit of the models and the models‟ discriminating ability between high and low risk customers. / Statistics / M. Sc. (Statistics)