In epidemiology it is often useful to monitor disease occurrences prospectively to determine the location and time when clusters of disease are forming. This aids in the prevention of illness and injury of the public and is the reason spatio-temporal disease surveillance methods are implemented. Care must be taken in the design and implementation of these types of surveillance methods so that the methods provide accurate information on the development of clusters. Here two spatio-temporal methods for prospective disease surveillance are considered. These include the local Knox monitoring method and a new wavelet-based prospective monitoring method. The local Knox surveillance method uses a cumulative sum (CUSUM) control chart for monitoring the local Knox statistic, which tests for space-time clustering each time there is an incoming observation. The detection of clusters of events occurring close together both temporally and spatially is important in finding outbreaks of disease within a specified geographic region. The local Knox surveillance method is based on the Knox statistic, which is often used in epidemiology to test for space-time clustering retrospectively. In this method, a local Knox statistic is developed for use with the CUSUM chart for prospective monitoring so that epidemics can be detected more quickly. The design of the CUSUM chart used in this method is considered by determining the in-control average run length (ARL) performance for different space and time closeness thresholds as well as for different control limit values. The effect of nonuniform population density and region shape on the in-control ARL is explained and some issues that should be considered when implementing this method are also discussed. In the wavelet-based prospective monitoring method, a surface of incidence counts is modeled over time in the geographical region of interest. This surface is modeled using Poisson regression where the regressors are wavelet functions from the Haar wavelet basis. The surface is estimated each time new incidence data is obtained using both past and current observations, weighing current observations more heavily. The flexibility of this method allows for the detection of changes in the incidence surface, increases in the overall mean incidence count, and clusters of disease occurrences within individual areas of the region, through the use of control charts. This method is also able to incorporate information on population size and other covariates as they change in the geographical region over time. The control charts developed for use in this method are evaluated based on their in-control and out-of-control ARL performance and recommendations on the most appropriate control chart to use for different monitoring scenarios is provided. / Ph. D.

The objective of the thesis is to provide a better understanding of the safety conditions inurban environments, particularly related to those found in transport nodes, in this case,underground stations, and surrounding areas1. First, the study starts with an analysis of theoverall city, identifying concentrations of crime in the urban fabric and then focusing on thecriminogenic conditions at and around underground stations. The analysis combines the useof Geographical Information Systems (GIS), statistical techniques and data of different typesand sources. Regression models were used to assess the importance of the environmentalattributes of underground stations on crime rates. Findings show that violent and propertycrimes show different hotspots at different times. Crime patterns tend to follow people’sscheduled patterns of routine activity. The socio-economic composition of the surroundingenvironment of the stations has a significant impact on crime at these transport nodes, butmore important were attributes of the physical and social environment at the stations. Forinstance, low guardianship and poor visibility at the stations together with mixed land-usesin the surrounding areas induced crime rates at the stations. It is therefore suggested thatintervention to improve safety conditions at the stations should focus on a holistic approach,taking into account the station and surrounding areas, but also being aware of crimevariation on specific places at specific times. / <p>QC 20130207</p> / Safety in transport nodes: the influence of environmental attributes on crime and perceived safety

Made available in DSpace on 2011-05-04T12:42:00Z (GMT). No. of bitstreams: 0 Previous issue date: 2009 / (...) O objetivo desta tese foi modelar os fatores de risco associados à ocorrência de leptospirose urbana em diferentes contextos, com especial atenção para aspectos espaciais e temporais. Foram utilizadas técnicas de modelagem tais como, modelos generalizados aditivos e mistos. Também explorou-se técnicas de detecção de aglomerados espaço-temporais. (...) / Leptospirosis, a disease caused by pathogenic spirochete of the genus Leptospira, is one of the most widespread zoonoses in the world, considered a major public health problem associated with the lack of sanitation and poverty. It is endemic in Brazil, data from surveillance show that outbreaks of leptospirosis occur as cyclical annual epidemics during rainfalls. The aim of this thesis was modeling the risk factors associated with the occurrence of leptospirosis in di erent urban contexts, with particular attention to spatial and temporal aspects. We used some modeling techniques such as generalized additive and mixed models. Techniques for detection space-time clusters were also explored. This thesis has prioritized the use of free softwares - R, ubuntu linux operating system, LATEX , SatScan (this is not open source but free). This thesis was prepared in the form of three articles. In the rst article is presented a spatio-temporal analysis of leptospirosis cases occurrence in Rio de Janeiro between 1997 and 2002. Using the detection of space-time clusters - \outbreaks" method - were statistically signi cant only cluster ocorred in 1997 and 1998. Generalized Linear Mixed Models were used to evaluate the risk factors associated with the occurrence of cases that belonged to outbreaks in endemic cases. The cases belonging to the outbreaks are associated with the occurrence of rainfall over 4 mm (OR, 3.71; 95% CI, 1.83 - 7.51). There were no signi cant associations with socioeconomic covariates, in other words, being endemic or epidemic leptospirosis occurs in the same population. The second and third articles examined a seroprevalence survey and seroconversion cohort conducted in Pau da Lima community, Salvador, Bahia. In both Generalized Additive Models were used to t the exposure variables both in individuals and peridomicile context, as well as to estimate the spatial area of leptospirosis risk. The signi cant variables were: gender, age, presence of rats in the peridomicile, domicile near a trash collectin or an open sewer and domicile altitude above sea level. Studies show that individual and contextual variables explain much of the spatial variability of leptospirosis, but there are still factors that were not measured in the studies but which should be investigated. The maps of risk of seroprevalence and seroconversion show distinct regions where the spatial e ect is signi cantly di erent from the global average. It is still lack for a more robust integration between the professionals who develop and operate the GIS, epidemiologists and biostatistics. This integration represents an important advance enabling the development and use of these techniques in Public Health support. The study of prevalence and incidence of endemic areas, in the leptospirosis context, it is very complex and still grow up. The reunion of professional specialists from several areas of human knowledge (eg, clinicians, epidemiologists, geographers, biologists, statisticians, engineers, etc.), it is essential to advance the knowledge about the disease and their relationship to social inequality and environmental well to contribute to the creation of efficient and e ective measures to control endemic diseases.