Thesis (Ph. D.)--University of Alabama at Birmingham, 2008. / Title from first page of PDF file (viewed Nov. 13, 2008). Includes bibliographical references (p. 67-73).

This thesis was elaborated within the MSM 6007665801 research intention. The objective of the thesis was to create an overview of the distribution of Common Minnow in the basin of upper and middle reaches of the Malše River. Selected stretches of the Malše River, Černá River and Pohořský, Huťský, Tisový and Žďárský Brooks were monitored. These streams correspond to trout waters in their character. The field research was conducted in the years 2005?2008. Estimates of quantity and indexes of diversity and eguitability in the fish communities were calculated. Estimates of biomass in the population of Common Minnow were calculated and the length frequency distributions were determinated. Common Minnow was found in seven out of twenty examined stretches.

Thesis (M.A.)--University of South Florida, 2006. / Title from PDF of title page. Document formatted into pages; contains 86 pages. Includes bibliographical references.

Large woody debris (LWD) was added to North Fork Stony Creek and North Prong Barbours Creek in southwest Virginia to inlprove fish habitat. The purposes of this study were to monitor stream channel response to the addition of LWD at a stream reach scale and at a local scale around individual logs, to evaluate changes in fish population parameters, and to observe microhabitat availability and use before and after L WD additions. In low-gradient Stony Creek, LWD was effective in modifying fish habitat through the formation of pools, the structuring of poo1/riffle sequences, and the enhancement of channel complexity. New pools formed from the break up of continuous rime habitat, increasing the overall number of habitat units and decreasing mean surface areas. Total pool area increased for both treatment sections, while changing little in the reference section where no logs were added. Localized scour and fill was observed for crosssectional transects around individual logs, creating a more heterogenous environment than in areas without logs. In contrast, physical habitat changed little in moderate-gradient Barbours Creek after L WD was added. An increase in the relative weight of brook trout in Barbours Creek suggested that although minimal channel changes were observed, logs may have increased channel complexity and cover, providing resting areas of lower velocities next to food pathways, which may have lead to decreased energy expenditure. Observations of microhabitat use revealed that unlike adult brook trout, juvenile brook trout used a limited range of depths and velocities. Adult brook trout shifted microhabitat use in response to changes in microhabitat available. Low numbers of fish in Stony Creek may have been related to low pH, but numbers of adult brook trout found in each section increased in 1994. With improved water quality, I believe that fish abundance in Stony Creek would increase through time because of the improved habitat. Although few significant changes were observed for available microhabitat in Stony Creek, changes in physical habitat suggest that over time shifts in microhabitat would be apparent. / Master of Science

The European green lizard, Lacerta viridis, is in the Bohemia region stated as critically endangered species. Populations in this region are located beyond the northern border of continuous range of this species and are closely related to the "riverine phenomenon", and deeply engorged river valleys. The chosen locality in Tiché údolí is a subject to a long-term conservational management aimed to strengthen and maintain abundance of the local population. This management is a direct output of a previous study of this population performed in years 1995-1997. Main goal of the presented study is to compare current population characteristics with the older study. The locality has been visited 119 times in years from 2011 to 2014. The studied population now displays higher abundance and inhabits a larger area. The author also performed a spatial analysis of the places with presence of an observed individual in order to determine and evaluate significance of the chosen abiotic factors for habitat discrimination. The results indicate that positive discrimination is based on the presence of a rock debris and a hiding place. Strongest factors towards negative discrimination were high percentages of grass and high vegetation coverage. This study also contains and discusses ecological, ethological and...

O objetivo deste estudo foi a analise das readmissões no Sistema de Serviços Hospitalares no Brasil no ano de 2006, a partir do indivíduo internado. A base de dados foi organizada para analisar as internações em 2006 e as readmissões em até um ano após uma internação em 2006. Os dados iniciais ultrapassaram os 27 milhões de registros, oriundos dos sistemas de internações SUS (SIH), de internações não SUS (CIH) e do cadastro de serviços de saúde (CNES). A localização do indivíduo foi feita pelo método probabilístico de associações de registros (linkage) e, para a composição dos dados da internação, aplicaram-se algoritmos específicos aos dados de cobranças da internação. Foram analisadas 12.391.990 internações com ao menos um dia, no ano de 2006, e selecionados para o estudo 10.332.337 indivíduos, correspondente a 5,5% da população, com uma internação completa em 2006 e suas readmissões no período de 365 dias a contar da data de saída da admissão índice, totalizando 12.878.422 internações. O estudo possibilitou inferências sobre a qualidade dos sistemas de informação da assistência hospitalar no país. Nas internações de 2006, a taxa de internação, financiamento SUS e não SUS foi de 5,6 por 100 habitantes. As internações de financiamento SUS nas categorias analisadas apresentam o perfil semelhante ao do total de internações. Nas internações não SUS notam-se diferenças que delineiam as regiões em dois conjuntos. O primeiro formado pelo Norte, Nordeste e Centro-Oeste com baixa ocorrência de internações não SUS, mais jovens e idosos, e de indivíduos do sexo masculino em maiores proporções que no SUS. No segundo conjunto formado, Sudeste e Sul, verifica-se significativa participação do financiamento não SUS, mais de adultos e idosos. Ainda que com evidência limitada, este achado confirma a distribuição da população com planos de saúde. As internações não SUS com UTI estão ainda mais concentradas na região Sudeste, do que as internações não SUS em geral (80,1% x 67,9%). As internações e indivíduos, na análise das readmissões, de maneira geral apresentaram semelhante perfil com as internações de 2006. A proporção de readmitidos foi de 15,9% e de readmissões foi de 19,8%. O SUS foi responsável por 88,7% das internações selecionadas e foram identificados 3,3% de indivíduos que utilizaram os dois segmentos de financiamento. A natureza do método probabilístico, que encerra certo grau de imprecisão, a adoção de parâmetros conservadores a fim de se evitar a inclusão de falsos positivos, tanto quanto a subnotificação da CIH representam as possíveis limitações do estudo. O Sistema de Serviços Hospitalares no Brasil apresentou relevante taxa de readmissão, independente da fonte de financiamento e local de ocorrência, que aponta para a necessidade de estudos adicionais para se conhecerem os fatores contribuintes. Os dados de internações de financiamento não SUS coletados pelo CIH agregam informações relevantes para análise da assistência hospitalar no país. Os dados administrativos do SIH são válidos para análises de internações e os algoritmos de composição dos dados de internação, a partir da cobrança, aprimoram a análise do Sistema de Serviços Hospitalares no Brasil. / The objective of this study was to analyze readmissions on the System of Hospital Services in Brazil in the year of 2006, starting from the admitted subjects. The data base was organized to analyze the admissions in 2006 and the readmissions up to one year after the admission in 2006. The initial data were over 27 million registrations, from the systems of admissions SUS (SIH), non-SUS (CIH) and from the register of health services (CNES). The choice of the subject individual was by probabilistic method of associations of registrations (linkage) and, for the composition of the admission data, specific algorithms were applied to the data of the admission charging. A total of 12,391,990 admissions were analyzed with at least one day in the year of 2006 and 10,332,337 subjects were selected for the study, corresponding to 5.5% of the population, with a complete admission in 2006 and readmissions in a period of 365 days from the date of discharge of the admission index, a total of 12,878,422 admissions. The study made possible inferences about the quality of the systems of information on the hospital attendance in the country. On the admissions in 2006, the admission rate, SUS and non SUS financing was 5.6 for each 100 inhabitants. The admissions financed by SUS, in the analyzed categories, present a profile similar to the total of admissions. On the non-SUS admissions, we noticed differences that delineate the areas in two groups. The first composed by the North, Northeast and Center-West areas of Brazil, with low occurrence of SUS admissions, more young and elders, and male subjects in proportions higher than in SUS. In the second group, Southeast and South, we verified significant participation of the non- SUS financing, more adults and elders. Although with limited evidence, this discovery confirms the distribution of the population with healthcare plans. The non- SUS admissions with ICU are still more concentrated in the Southeast area than the non-SUS admissions in general (80.1% x 67.9%). The admissions and subjects, under the analysis of the readmissions, in a general way presented a profile similar to the admissions in 2006. The proportion of readmitted subjects was 15.9% and of readmissions was 19.8%. SUS was responsible for 88.7% of the selected admissions and we identified 3.3% of subjects that used both financing segments. The nature of the probabilistic method that contains certain imprecision degree, the adoption of conservative parameters in order to avoid the inclusion of false positive, and the subnotification of CIH represent possible limitations of this study. System of Hospital Services in Brazil presented important readmission rate, independently on the financing source and occurrence place, what points out to the need of additional studies to know the contributory factors. The data of non-SUS financing admissions collected by CIH join important information to the analysis of the hospital attendance in the country. The administrative data of SIH are valid for analyses of admissions and the algorithms of the admission data composition, starting from the charging, perfect the analysis of System of Hospital Services in Brazil.

The very old, aged 80 years and over, is the fastest growing age group today, and the demands for healthcare and services will be even higher in the future. It is, therefore, of great importance to advance our knowledge about this group. The main purpose of this thesis was to describe living conditions and health, with a special focus on physical ability, falls and morale, in women and men in three different age groups of very old people in northern Sweden. Half the population aged 85, and the total population aged 90 and ≥95 (-103) in the municipality of Umeå were selected for participation (n=348) in this population-based cross-sectional study, entitled the Umeå 85+ Study. Structured interviews and assessments were performed with the participants in their homes, and data were also collected from next-of-kins, caregivers and medical charts. Cognition was screened for using the Mini-Mental State Examination (MMSE), depressive symptoms using the Geriatric Depression Scale-15 (GDS-15), and nutritional status using the Mini Nutritional Assessment (MNA). Activities of Daily Living (ADL) were assessed using the Staircase of ADL (including the Katz Index of ADL) and morale using the Philadelphia Geriatric Center Morale Scale (PGCMS). Participants also rated their own health and answered a questionnaire about symptoms. Physical ability was assessed using a gait speed test over 2.4 meters (8 feet), three consecutive chair stands, and the Berg Balance Scale (BBS). A follow-up study for falls was performed during a period of six months with fall calendars and telephone calls. The very old people in this northern population have more depression, hypertension and hip fractures, as well as a higher consumption of drugs than comparable, more southern populations. In general, younger participants had lower rates of diagnoses and prescribed drugs, were less dependent in ADL and other functional variables than older participants, and men had lower rates of diagnoses and reported symptoms than women. However, there were no age or sex differences in self-rated health or morale, which were both rated as good by the majority of the participants. There was a wide range of physical ability among these very old people, especially in women, where an age-related decline was seen. The results also demonstrate that men had greater physical ability than women. The BBS had no floor or ceiling effects in the present sample. In contrast, a large proportion was unable to perform the gait speed and chair stands test, resulting in a floor effect for the timed performances, especially in women. Falling is a major public health problem in very old people. From the results of the present study, it could be predicted that every seventh participant and every third of the people who did fall would suffer a fracture over a period of one year. The independent explanatory risk factors for time to first fall in this sample of very old people were dependency in personal (P-) ADL but not bedridden, thyroid disorders, treatment with Selective Serotonin Reuptake Inhibitors (SSRIs) and occurrence of fall/s in the preceding year. These factors should all be considered in fall prevention programmes. The morale of very old people was found in this study to be rather high, with similar scores among age groups and sexes. The most important factors for high morale were the absence of depressive symptoms, living in ordinary housing, having previously had a stroke and yet still living in ordinary housing, not feeling lonely and having few symptoms. The PGCMS seems applicable in the evaluation of morale in very old people. In conclusion, there were wide variations in health status and physical ability in this northern population of very old people. Women had poorer health and physical ability than men. Falls and fractures were common and serious health problems. Morale seemed to be high, despite the fact that a large proportion of the participants suffered from many diseases and functional decline.

O objetivo deste estudo foi a analise das readmissões no Sistema de Serviços Hospitalares no Brasil no ano de 2006, a partir do indivíduo internado. A base de dados foi organizada para analisar as internações em 2006 e as readmissões em até um ano após uma internação em 2006. Os dados iniciais ultrapassaram os 27 milhões de registros, oriundos dos sistemas de internações SUS (SIH), de internações não SUS (CIH) e do cadastro de serviços de saúde (CNES). A localização do indivíduo foi feita pelo método probabilístico de associações de registros (linkage) e, para a composição dos dados da internação, aplicaram-se algoritmos específicos aos dados de cobranças da internação. Foram analisadas 12.391.990 internações com ao menos um dia, no ano de 2006, e selecionados para o estudo 10.332.337 indivíduos, correspondente a 5,5% da população, com uma internação completa em 2006 e suas readmissões no período de 365 dias a contar da data de saída da admissão índice, totalizando 12.878.422 internações. O estudo possibilitou inferências sobre a qualidade dos sistemas de informação da assistência hospitalar no país. Nas internações de 2006, a taxa de internação, financiamento SUS e não SUS foi de 5,6 por 100 habitantes. As internações de financiamento SUS nas categorias analisadas apresentam o perfil semelhante ao do total de internações. Nas internações não SUS notam-se diferenças que delineiam as regiões em dois conjuntos. O primeiro formado pelo Norte, Nordeste e Centro-Oeste com baixa ocorrência de internações não SUS, mais jovens e idosos, e de indivíduos do sexo masculino em maiores proporções que no SUS. No segundo conjunto formado, Sudeste e Sul, verifica-se significativa participação do financiamento não SUS, mais de adultos e idosos. Ainda que com evidência limitada, este achado confirma a distribuição da população com planos de saúde. As internações não SUS com UTI estão ainda mais concentradas na região Sudeste, do que as internações não SUS em geral (80,1% x 67,9%). As internações e indivíduos, na análise das readmissões, de maneira geral apresentaram semelhante perfil com as internações de 2006. A proporção de readmitidos foi de 15,9% e de readmissões foi de 19,8%. O SUS foi responsável por 88,7% das internações selecionadas e foram identificados 3,3% de indivíduos que utilizaram os dois segmentos de financiamento. A natureza do método probabilístico, que encerra certo grau de imprecisão, a adoção de parâmetros conservadores a fim de se evitar a inclusão de falsos positivos, tanto quanto a subnotificação da CIH representam as possíveis limitações do estudo. O Sistema de Serviços Hospitalares no Brasil apresentou relevante taxa de readmissão, independente da fonte de financiamento e local de ocorrência, que aponta para a necessidade de estudos adicionais para se conhecerem os fatores contribuintes. Os dados de internações de financiamento não SUS coletados pelo CIH agregam informações relevantes para análise da assistência hospitalar no país. Os dados administrativos do SIH são válidos para análises de internações e os algoritmos de composição dos dados de internação, a partir da cobrança, aprimoram a análise do Sistema de Serviços Hospitalares no Brasil. / The objective of this study was to analyze readmissions on the System of Hospital Services in Brazil in the year of 2006, starting from the admitted subjects. The data base was organized to analyze the admissions in 2006 and the readmissions up to one year after the admission in 2006. The initial data were over 27 million registrations, from the systems of admissions SUS (SIH), non-SUS (CIH) and from the register of health services (CNES). The choice of the subject individual was by probabilistic method of associations of registrations (linkage) and, for the composition of the admission data, specific algorithms were applied to the data of the admission charging. A total of 12,391,990 admissions were analyzed with at least one day in the year of 2006 and 10,332,337 subjects were selected for the study, corresponding to 5.5% of the population, with a complete admission in 2006 and readmissions in a period of 365 days from the date of discharge of the admission index, a total of 12,878,422 admissions. The study made possible inferences about the quality of the systems of information on the hospital attendance in the country. On the admissions in 2006, the admission rate, SUS and non SUS financing was 5.6 for each 100 inhabitants. The admissions financed by SUS, in the analyzed categories, present a profile similar to the total of admissions. On the non-SUS admissions, we noticed differences that delineate the areas in two groups. The first composed by the North, Northeast and Center-West areas of Brazil, with low occurrence of SUS admissions, more young and elders, and male subjects in proportions higher than in SUS. In the second group, Southeast and South, we verified significant participation of the non- SUS financing, more adults and elders. Although with limited evidence, this discovery confirms the distribution of the population with healthcare plans. The non- SUS admissions with ICU are still more concentrated in the Southeast area than the non-SUS admissions in general (80.1% x 67.9%). The admissions and subjects, under the analysis of the readmissions, in a general way presented a profile similar to the admissions in 2006. The proportion of readmitted subjects was 15.9% and of readmissions was 19.8%. SUS was responsible for 88.7% of the selected admissions and we identified 3.3% of subjects that used both financing segments. The nature of the probabilistic method that contains certain imprecision degree, the adoption of conservative parameters in order to avoid the inclusion of false positive, and the subnotification of CIH represent possible limitations of this study. System of Hospital Services in Brazil presented important readmission rate, independently on the financing source and occurrence place, what points out to the need of additional studies to know the contributory factors. The data of non-SUS financing admissions collected by CIH join important information to the analysis of the hospital attendance in the country. The administrative data of SIH are valid for analyses of admissions and the algorithms of the admission data composition, starting from the charging, perfect the analysis of System of Hospital Services in Brazil.

The spread of pandemic influenza A (2009 H1N1 influenza) virus resulted in a global influenza pandemic in 2009. During the early stages of the pandemic, population surveillance was crucial. However, officials around the world realized that many of our surveillance and reporting systems were not prepared to respond in a coordinated, integrated way, which made informed public health decision-making very difficult. More accurate estimates of the total number of hospitalized 2009 H1N1 influenza cases were required to calculate population-based 2009 H1N1 influenza-associated mortality, morbidity and hospitalization rates. For instance, how many people were hospitalized with 2009 H1N1 influenza in Massachusetts? Of these, how many were admitted to the ICU and how many died? Compared to seasonal influenza, were some race/ethnic and age groups affected more than others, and what types of characteristics led to more severe manifestations of 2009 H1N1 influenza among these groups in Massachusetts? To address the above questions, I proposed a retrospective cohort study using data from the Hospital Discharge Database (HDD), which contains data for all inpatients discharged from 76 acute care hospitals in Massachusetts, as well as Census information to provide a measure of socioeconomic status (SES). My specific aims are as follows: 1. Develop methods to identify influenza cases precisely and describe characteristics of those hospitalized with ILI in MA between April 26-Sept 30, 2009; 2. Conduct analyses to identify race/ethnicity-related trends in reference to 2009 H1N1 influenza-related hospitalizations; 3. Conduct analyses to identify age-related trends in reference to 2009 H1N1 influenza-related hospitalizations. First, I established influenza case selection criteria using hospital discharge data. I addressed limitations in the published methods on defining cases of influenza using administrative databases, and evaluated ICD-9 codes that correspond with common and relatively serious respiratory infections and influenza using a ‘maximum’ and ‘minimum’ approach. Results confirmed that 2009 H1N1 influenza affected a younger population, and disproportionately affected racial minorities in Massachusetts. There were also higher rates of ICU admission compared to seasonal influenza. I then presented epidemiological data indicating race/ethnic disparity among 2009 H1N1 influenza cases in Massachusetts. I found that Hispanics had significantly lower odds of 2009 H1N1 influenza-related ICU stay. SES gradients calculated using five-digit zip code information did not account for these differences. Within race/ethnic strata, Hispanics Finally, I presented epidemiological data indicating differences among 2009 H1N1 influenza cases by age group in Massachusetts. I calculated measures of Diagnostic Cost Group (DxCG) comorbidity for the study population to provide a comorbidity measure at baseline. Main results indicate that although comorbidity scores were similar between the 2009 H1N1 influenza and seasonal influenza groups, 2009 H1N1 influenza caused more severe disease in younger age groups. This is the first study to report population-based statewide outcomes in all acute care centers in MA. In this dissertation I address challenges surrounding influenza surveillance to create case selection criteria within an administrative database. Using my case selection criteria, I then provide data related to fatality and severity of 2009 H1N1 influenza in Massachusetts in reference to sociodemographic variables such as racial/ethnicity and age groups, and provide evidence for patient-level interventions to those hardest hit by influenza. These findings provide valuable information about using large administrative databases to describe pandemic influenza cases and guide resource allocation to reduce disparities in relation to pandemic influenza preparedness.

Estudo transversal do universo de pré-escolares (1544) de creches filantrópicas de Santo André, SP, Brasil, para estimar por antropometria seu crescimento e estado nutricional. Observou-se que o crescimento alcançado no conjunto está acima do referencial CDC/NCHS. Não se encontrou desnutrição, mas sim sobrepeso e obesidade, respectivamente em 16,8 e 10,8% das crianças, com tendência crescente com a idade. Entre os fatores de risco para esta condição encontrou-se o sexo feminino e o peso de nascimento mais elevado. Estes resultados apontam para a presença de uma etapa adiantada de transição epidemiólogica nutricional inclusive na população de pré-escolares de baixa renda deste Município / Cross sectional study of the universe (n=1544) of preschool children attending to philanthropic daycare centers of Santo André (SP- Brazil), to evaluate by anthropometrics their growth and nutritional status. The attained growth by the whole group was above the CDC/NCHS reference. There was no undernutrition but overweight and obesity with a prevalence of 16,8 and 10,8%, respectively, with a trend to increase with age. Higher birth weight and feminine gender were risk factors for these nutritional problems. The results pointed out an advanced step of nutritional transition, affecting the children between 2 and 6 years of age, of low income families, in this Municipality