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PubMed2006

Quantitative colorectal cancer perfusion measurement by multidetector-row CT: does greater tumour coverage improve measurement reproducibility?

The purpose of this study was to determine if greater z-axis tumour coverage improves the reproducibility of quantitative colorectal cancer perfusion measurements using CT. A 65 s perfusion study was acquired following intravenous contrast administration in 10 patients with proven colorectal cancer using a four-detector row scanner. This was repeated within 48 h using identical technical parameters to allow reproducibility assessment. Quantitative tumour blood volume, blood flow, mean transit time and permeability measurements were determined using commercially available software (Perfusion 3.0; GE Healthcare, Waukesha, WI) for data obtained from a 5 mm z-axis tumour coverage, and from a 20 mm z-axis tumour coverage. Measurement reproducibility was assessed using Bland-Altman statistics, for a 5 mm z-axis tumour coverage, and 20 mm z-axis tumour coverage, respectively. The mean difference (95% limits of agreement) for blood volume, blood flow, mean transit time and permeability were 0.04 (-2.50 to +2.43) ml/100 g tissue; +8.80 (-50.5 to +68.0) ml/100 g tissue/min; -0.99 (-8.19 to +6.20) seconds; and +1.20 (-5.42 to +7.83) ml/100 g tissue/min, respectively, for a 5 mm coverage, and -0.04 (-2.61 to +2.53) ml/100 g tissue; +7.40 (-50.3 to +65.0) ml/100 g tissue/min; -2.46 (-12.61 to +7.69) seconds; and -0.23 (-8.31 to +7.85) ml/100 g tissue/min, respectively, for a 20 mm coverage, indicating similar levels of agreement. In conclusion, increasing z-axis coverage does not improve reproducibility of quantitative colorectal cancer perfusion measurements.

Adenocarcinoma↗
PubMed1988

Employer-sponsored insurance coverage for alcoholism and drug-abuse treatments.

This article examines the growth in employer-sponsored health insurance coverage for alcoholism and drug-abuse treatments. Data are drawn from the Bureau of Labor Statistics' Employee Benefit Surveys of 1981, 1983 and 1985. The surveys provide information on approximately 20.5 million full-time permanent employees in 43,000 establishments each year. The data are nationally representative. In 1985, 68.5% of employees with medical insurance had coverage for alcoholism treatments and 61.6% had coverage for drug-abuse treatments. Alcoholism coverage increased 89% from 1981 to 1985. The increases were reflected across all regions, firm sizes and occupational groups. Self-insured firms, exempt from mandated coverage laws, had the greatest increase in coverage. HMOs appear to have reduced coverage since 1981. Finally, substance abuse coverages did not appear to be discretionary and, therefore, were unlikely to be eliminated if tax laws on fringe benefits were changed.

Alcoholism↗
PubMed1995

[Assessment of vaccination coverage of the basic schedule for the 1st year of life].

Immunization coverage was evaluated in all 12-23 month-old children living in the area were five years before a Primary Care Practice had been set up. All children were investigated through home visits, checking of the immunization chart and relying on mothers' information. In 1986, a baseline study had identified an immunization coverage of under 60% for each of the scheduled vaccines. The current study confirmed that coverage was of 87% for three doses of DTP, 89% for Sabin, 88% for one dose of measles vaccine and 79% for BCG. Despite the high coverage achieved for each specific vaccine, when the basic schedule for the first year was verified, it was observed that only 75% of the children had received the full scheme. Immunization coverage is uneven in different census tracts, being higher in the poorest and more remote areas, where seam the health was given extra attention. A comparison with the routine administrative evaluation of the immunization coverage showed that this underestimated the real coverage. Maternal immunization uptake was also evaluated (antitetanus vaccine during pregnancy) and only 49% of the women were found to be adequately protected. The information collected led to a reorganization of the whole immunization program in a 100% coverage.

Brazil↗
PubMed2006

[Pentavalent vaccine and vaccination coverage in children aged less than one in Colombia 2000-2003].

OBJECTIVE: Determining the impact of including pentavalent vaccine in third-dose immunisation coverage for children aged less than 1 (2002 and 2003) by geographic cluster. MATERIALS AND METHODS: This was an ecologic study using department, province, municipality and capital city as analysis units. It compared third-dose coverage, desertion index, number of places having more than 80% immunisation coverage and the number of children being immunised before and after vaccination was introduced. Having more than 80% immunisation coverage was compared to the number of children or places having unsatisfied basic needs, the presence of armed conflict or municipal category. RESULTS: Immunisation coverage increased from 23% to 26%, mainly for Hib3. Desertion index was 9.3-31.7% in 2000 and 0.3% in 2003. The number of municipalities having more than 80% immunisation coverage increased from 265 in 2000 to 627 in 2003. 462,000-584,000 third-doses were applied in 2000 and 805,000-813,000 in 2003. More municipalities having more than 80% coverage had high unsatisfied basic needs, low socioeconomic income or conflict. CONCLUSIONS: The introduction of the vaccine affected immunisation coverage. Financing should be sought for the vaccine to ensure its continuity and to implement studies for new vaccines or introducing combination vaccines.

Colombia↗
PubMedDate not supplied

[Evolution of the degrees of influenza vaccine (flu shot) coverage in Spain throughout the 1993-2001 period. Analysis by Autonomous Communities].

BACKGROUND: Influenza (flu) is a disease involving a high morbidity which takes a high toll on healthcare costs for which there is an effective vaccine available. This study is aimed at evaluating the evolution of the different degrees of influenza vaccine (flu shot) coverage in Spain by Autonomous Communities during the 1993-2001 period. METHODS: A total of 42,123 cases from the National Health Survey (NHS) for the years 1993 (n=21,051) and 2001 (n=21,072) were analysed, all of which corresponded to non-institutionalised Spanish adults over 15 years of age. Both surveys are representative at the Autonomous Community level. RESULTS: For the total sample, a vaccine coverage of 17.94% (CI 95% 17.42-18.46) in 1993 and of 19.30% (18.77-19.83) en 2001 was estimated. In the logic regression model, adjusted by age, sex and related chronic disease, significant improvements were found in the degrees of coverage of individuals over 64 years of age (OR = 1.28 CI 95% 1.10-1.50) for Spain as a whole and for five of the seventeen Autonomous Communities between 1993 and 2001. However, no significant changes were found in the degrees of coverage for the group under age 65 with related chronic disease entailing an indication for being administered the vaccine. CONCLUSIONS: A slight yet insufficient improvement in the degrees of coverage among the high-risk groups studied were found to exist both nation-wide in Spain as a whole as well as in the majority of the Autonomous Communities between 1993 and 2001. Degrees of coverage varied greatly among Autonomous Communities. The individual under age 65 with related chronic diseases heightening the risks of suffering from flu-related complications have not improved their degrees of coverage regarding this vaccine during the period studied. The difficulty involved in improving the degrees of coverage among this type of patients might lead us to consider the alternative and potential benefit of lowering the age limit of the current influenza vaccine (flu shot) indication-related recommendations in Spain.

Aged↗
PubMed2004

A short-term and long-term comparison of root coverage with an acellular dermal matrix and a subepithelial graft.

BACKGROUND: Obtaining predictable and esthetic root coverage has become important. Unfortunately, there is only a limited amount of information available on the long-term results of root coverage procedures. The goal of this study was to evaluate the short-term and long-term root coverage results obtained with an acellular dermal matrix and a subepithelial graft. METHODS: An a priori power analysis was done to determine that 25 was an adequate sample size for each group in this study. Twenty-five patients treated with either an acellular dermal matrix or a subepithelial graft for root coverage were included in this study. The short-term (mean 12.3 to 13.2 weeks) and long-term (mean 48.1 to 49.2 months) results were compared. Additionally, various factors were evaluated to determine whether they could affect the results. This study was a retrospective study of patients in a fee-for-service private periodontal practice. The patients were not randomly assigned to treatment groups. RESULTS: The mean root coverages for the short-term acellular dermal matrix (93.4%), short-term subepithelial graft (96.6%), and long-term subepithelial graft (97.0%) were statistically similar. All three were statistically greater than the long-term acellular dermal matrix mean root coverage (65.8%). Similar results were noted in the change in recession. There were smaller probing reductions and less of an increase in keratinized tissue with the acellular dermal matrix than the subepithelial graft. None of the factors evaluated resulted in the acellular dermal graft having a statistically significant better result than the subepithelial graft. However, in long-term cases where multiple defects were treated with an acellular dermal matrix, the mean root coverage (70.8%) was greater than the mean root coverage in long-term cases where a single defect was treated with an acellular dermal matrix (50.0%). CONCLUSIONS: The mean results with the subepithelial graft held up with time better than the mean results with an acellular dermal matrix. However, the results were not universal. In 32.0% of the cases treated with an acellular dermal matrix, the results improved or remained stable with time.

Adult↗
PubMed2000

Vaccine preventable diseases and vaccination coverage in Australia, 1993-1998.

BACKGROUND: Since the introduction of childhood vaccination for diphtheria in 1932 and the widespread use of vaccines to prevent tetanus, pertussis (whooping cough) and poliomyelitis in the 1950s, deaths in Australia from vaccine preventable diseases (VPDs) have declined by more than 99%. It is important, however, that the downward trend in morbidity and mortality from VPDs is maintained and carefully monitored, and that changes are interpreted in relation to vaccination coverage. AIM: This report aimed to bring together three national sources of routinely collected data on the morbidity and mortality (notifications, hospitalisations and deaths) from VPDs during the period 1993-1998 for the 8 diseases then on the routine childhood vaccination schedule, and for 4 other diseases potentially preventable by childhood vaccination. It also examined vaccination coverage for the same period. METHODS: Data sources included notifications from the National Notifiable Diseases Surveillance System (NNDSS), hospitalisation data from the Australian Institute of Health and Welfare (AIHW) National Hospital Morbidity Database, deaths from the Australian Bureau of Statistics (ABS) Causes of Death Collection and vaccination coverage according to the Australian Childhood Immunisation Register (ACIR). All data sources were expected to have some limitations, the most important being under-reporting for notifications and vaccination encounters, and coding errors in the hospital morbidity data. RESULTS: Notifications for the 8 diseases covered by the routine schedule declined by 42%, from an average of 11,537 cases each year in 1993-1997 to 6700 in 1998, and hospitalisations fell by 12%, from an average of 1745 per year to 1536 in 1997/1998, while deaths remained unchanged at 7 each year over the period of review (Table 1). Tetanus caused 1 or 2 of the deaths each year. However, 6 of the 7 deaths in 1997 were in infants during a major outbreak of pertussis. Pertussis caused most of the notifications, hospitalisations and deaths during the review period. While most of these were in children, 46% of the notifications and 13% of the hospitalisations occurred in persons aged 15 years or more. There were notable declines in the numbers of notifications of invasive Haemophilus influenzae type b (Hib) disease in children under 5 years of age (77%), measles (87%) and rubella (75%), and there were no notifications of diphtheria or poliomyelitis. Vaccination coverage estimated using ACIR data increased during the review period. Coverage for the first 3 doses of diphtheria, tetanus, pertussis and Hib vaccines, assessed at 1 year of age, increased from 75% to 85%, while coverage for measles-mumps-rubella (MMR) vaccine, assessed at 2 years of age, increased from 83% to 86%. It is likely that these data underestimated coverage by 5-10%, and that the increase in coverage partly reflected better reporting to the ACIR by providers.

Adolescent↗
PubMed2005

Cost-effectiveness of full medicare coverage of angiotensin-converting enzyme inhibitors for beneficiaries with diabetes.

BACKGROUND: Angiotensin-converting enzyme (ACE) inhibitors slow renal disease progression and reduce cardiac morbidity and mortality in patients with diabetes. Patients' out-of-pocket costs pose a barrier to using this effective therapy. OBJECTIVE: To estimate the cost-effectiveness to Medicare of first-dollar coverage (no cost sharing) of ACE inhibitors for beneficiaries with diabetes. DESIGN: Markov model with costs and benefits discounted at 3%. DATA SOURCES: Published literature and Medicare claims data. TARGET POPULATION: 65-year-old Medicare beneficiary with diabetes. TIME HORIZON: Lifetime. PERSPECTIVE: Medicare and societal. INTERVENTIONS: We evaluated Medicare first-dollar coverage of ACE inhibitors compared with current practice (no coverage) and the new Medicare drug benefit. OUTCOME MEASURES: Costs (2003 U.S. dollars), quality-adjusted life-years (QALYs), life-years, and incremental cost-effectiveness. RESULTS OF BASE-CASE ANALYSIS: Compared with current practice, first-dollar coverage of ACE inhibitors saved both lives and money (0.23 QALYs gained and 1606 USD saved per Medicare beneficiary). Compared with the new Medicare drug benefit, first-dollar coverage remained a dominant strategy (0.15 QALYs gained, 922 USD saved). RESULTS OF SENSITIVITY ANALYSIS: Results were most sensitive to our estimate of increase in ACE inhibitor use; however, if ACE inhibitor use increased by only 7.2% (from 40% to 47.2%), first-dollar coverage would remain life-saving at no net cost to Medicare. In analyses conducted from the societal perspective, benefits were similar and cost savings were larger. LIMITATIONS: Results depend on accuracy of the underlying data and assumptions. The effect of more generous drug coverage on medication adherence is uncertain. CONCLUSIONS: Medicare first-dollar coverage of ACE inhibitors for beneficiaries with diabetes appears to extend life and reduce Medicare program costs. A reduction in program costs may result in more money to spend on other health care needs of the elderly.

Aged↗
PubMed1999

Employment-based health benefits: who is offered coverage vs. who takes it.

This Issue Brief provides data on employment-based health insurance, with a discussion of recent trends and how sponsorship rates, offer rates, coverage rates, and take-up rates vary for different workers. Other sections examine reasons why workers do not participate in employment-based health plans, alternative sources of health insurance, and uninsured workers. In 1997, 83 percent of the 108.1 million wage and salary workers in the United States were employed by a firm that sponsored a health plan. Of those workers, 75 percent were offered coverage, and 62 percent (or 67.5 million workers) were covered by that plan. Of those workers who worked for an employer that offered them a health plan, 83 percent participated in the plan. Sponsorship rates have barely changed in the last 11 years. In 1988, 83 percent of wage and salary workers reported that their employer sponsored a health plan. This declined slightly to 82 percent in 1993 but had increased to 83 percent by 1997. Offer rates significantly changed between 1988 and 1997. In 1988, 82 percent of workers reported that they were eligible for health insurance through their employer. By 1993, the percentage of eligible workers declined to 74 percent, and it has only slightly increased since then to 75 percent in 1997. In 1997, 40.6 million American workers did not have health insurance through their own job. Forty-five percent of the workers without coverage were employed at a firm where the employer did not provide health insurance to any workers. Thirty-three percent of the workers without coverage were offered coverage but declined it. Twenty-two percent of the workers without coverage were employed in a firm that offered health insurance to some of its workers, but certain workers were not eligible for the health plan. The 13.7 million workers who were offered coverage but declined it gave a number of reasons for doing so. In the majority of cases (61 percent), the worker was covered by another health plan. Of the remainder, 20 percent reported that health insurance was just too costly. Overall, 41 percent of the 40.6 million workers who were not participating in an employment-based health plan through their own employer had coverage through a spouse. However, 42 percent of the 40.6 million workers who declined their employers' health plan or who were not offered health insurance from their employer were uninsured.

Adult↗
PubMed2000

Death makes news: the social impact of disease on newspaper coverage.

UNLABELLED: This paper is an integrated analysis of newspaper coverage, epidemiological rates, and recent social history of six prominent diseases. HYPOTHESES: Newspaper coverage of a disease has three developmental stages (emergence, maturation, and decline & death). Trends in newspaper coverage of a disease reflect trends in its mortality, prevalence, and incidence. Magnitudes of newspaper coverage of diseases reflect their differential mortality rates. DATA: Using the LEXIS-NEXIS news archive for major U.S. newspapers, we retrieve articles about cancer, heart disease, AIDS, diabetes, Alzheimer disease, and arthritis for the period 1977-1997. We also obtain mortality, prevalence, and incidence trends for the six diseases. RESULTS: During the two decades, newspaper coverage emerges for AIDS and Alzheimer disease and is in the mature stage for the other diseases; declines begin for heart disease and AIDS. Trends in news coverage closely parallel mortality trends, and less consistently prevalence and incidence trends. Sharp downturns and upturns in mortality are mirrored in news volume. High-mortality diseases prompt both the most news coverage and the largest proportions of articles with death topics. CONCLUSION: Newspaper coverage of diseases is responsive to their mortality levels and trends.

Acquired Immunodeficiency Syndrome↗
PubMed2001

State medicaid coverage for tobacco-dependence treatments--United States, 1998 and 2000.

The Guide to Community Preventive Services recommends reducing the cost of tobacco-dependence treatments because these interventions increase both the use of treatment by smokers during attempts to stop smoking and the number of smokers who actually stop. The Public Health Service (PHS) Clinical Practice Guideline supports insurance coverage for tobacco-dependence treatment (i.e., individual, group, and telephone counseling, and Food and Drug Administration-approved pharmacotherapy. One of the 2010 national health objectives is to provide coverage in the 50 states and District of Columbia (DC) for nicotine-dependence treatment by Medicaid (objective 27.8b). In 2000, approximately 32 million low-income persons in the United States received their health insurance coverage through the federal-state Medicaid program; approximately 11.5 million (36%) of these persons smoked (CDC, unpublished data, 2000). Medicaid recipients have approximately 50% greater smoking prevalence than the overall U.S. population. To assess the amount and type of coverage for tobacco dependence offered by Medicaid, the Center for Health and Public Policy Studies at the University of California, Berkeley, conducted state surveys in 1998 and 2000. In 1998, 24 states and DC offered some coverage for tobacco-dependence treatment; in 2000, nine started offering some coverage. In 1998 and 2000, one state offered coverage for all the counseling and pharmacotherapy treatments recommended by PHS. These findings indicate that states can reduce smoking prevalence among Medicaid recipients by implementing more extensive Medicaid coverage for treatment of tobacco dependence.

Bupropion↗
PubMed2001

National, state, and urban area vaccination coverage levels among children aged 19-35 months--United States, 2000.

Since the early 1970s, childhood vaccination has prevented millions of illnesses and tens of thousands of deaths. For these health benefits to continue, high levels of vaccination coverage must be attained for each new birth cohort and must be monitored to ensure protection from disease, to characterize undervaccinated populations, and to evaluate effortsto increase coverage. The National Immunization Survey (NIS) provides ongoing national estimates of vaccination coverage among preschool-aged children for the 50 states and 28 selected urban areas. For this report, NIS data collected during 2000 were compared with 1999 data; findings indicate that, during 2000, significant increases were reported on the national level of vaccination coverage with varicella and hepatitis B, and small but statistically significant decreases were reported in coverage with diphtheria, and tetanus toxoid, and pertussis vaccine. Coverage with poliovirus vaccine, Haemophilus influenzae type b vaccine, and measles-mumps-rubella vaccine were not significantly different from 1999. As in previous years, coverage varied among states. To maximize coverage among preschool-aged children, vaccination providers should continue to apply such strategies as reminders and recalls.

Child, Preschool↗
PubMed2001

Minority Response to Health Insurance Coverage for Mental Health Services.

BACKGROUND: To promote access to mental health services, policy makers have focused on expanding the availability of insurance and the generosity of mental health benefits. Ethnic minority populations are high priority targets for outreach. However, among persons with private insurance, minorities are less likely than whites to seek outpatient mental health treatment. Among those with Medicaid coverage, minorities continue to be less likely than whites to use services. AIMS OF THE STUDY: The present study sought to determine if public insurance is as effective in promoting outpatient mental healthtreatment as private coverage for ethnic minority groups. METHODS: The analysis uses data from the 1987 National Medical Expenditure Survey to model mental health expenditures as a function of minority status and private insurance coverage. An interaction term between the two highlights any differences in response to private and public insurance coverage. The analysis uses a two stage least squares method to account for endogeneity of insurance coverage in the model. RESULTS: Minorities are less responsive to private insurance than whites in two ways. First, minorities are less responsive to private insurance than to public insurance whereas whites do not show this difference. Second, minorities are less responsive to private insurance than whites are to private insurance. DISCUSSION: Results suggest that there is a difference in the effectiveness of public and private health insurance to encourage use of mental health services. Among minorities but not among whites, those with private coverage used fewer mental health services than those with public coverage. Minorities were not only less responsive to private insurance than public insurance, but among those who were privately insured, minorities used fewer mental health services than whites. These results imply that insurance may not be as effective a mechanism as hoped to encourage self-initiated treatment seeking particularly among minority and other low income populations. IMPLICATIONS FOR HEALTH CARE PROVISION AND USE: These results suggest that increasing private insurance coverage to minority populations will not eliminate racial and ethnic gaps in professional help-seeking for outpatient mental health care. Although the total number of people receiving treatment might increase, these results suggest that whites would seek care in greater numbers than minorities and the size of the minority-white differential might grow. IMPLICATIONS FOR FURTHER RESEARCH: Areas for further research include the impacts of alternative definitions of mental health services, the dynamics of the substitution of inpatient for outpatient mental health care, elucidation of nonfinancial barriers to care for minorities, and determinants of timely help-seeking among minorities.

Journal Article↗
PubMed2002

Parental confidence in measles, mumps and rubella vaccine: evidence from vaccine coverage and attitudinal surveys.

BACKGROUND: The measles, mumps and rubella (MMR) vaccine has been the focus of considerable adverse publicity in recent years. AIM: To describe recent trends in parental attitudes to, and coverage of, MMR vaccine. DESIGN OF STUDY: Routine surveillance of vaccine coverage and cross-sectional surveys of parental attitudes. SETTING: All health authorities in England (vaccine coverage) and 132 enumeration districts in England (attitude survey). METHOD: Quarterly MMR vaccine coverage for all resident children in England at two years of age was requested from computerised child health information systems. Data was also obtained from 26 English health authorities/trusts on MMR coverage at 16 months of age. The proportion of mothers who believed that MMR vaccine was safe or carried only a slight risk, and the proportion who intended to fully vaccinate any future children, was obtained from biannual interviews with a national representative sample of over 1000 mothers of children under three years of age. RESULTS: Vaccine coverage at two years of age fell 8.6% (95% confidence interval [CI] = 8.4 to 8.8) between April and June 1995 and between April and June 2001. In September 2001, 67% of mothers reported that the MMR vaccine was safe or carried only a slight risk and 92% of mothers agreed with the statement: 'If I had another child in the future I would have them fully immunised against all childhood diseases'. CONCLUSIONS: Despite considerable adverse publicity, the fall in MMR coverage has been relatively small, mothers' attitudes to MMR remain positive, and most continue to seek advice on immunisation from health professionals. As the vast majority of mothers are willing to have future children fully immunised, we believe that health professionals should be able to use the available scientific evidence to help to maintain MMR coverage.

Attitude to Health↗
PubMed2004

State medicaid coverage for tobacco-dependence treatments--United States, 1994-2002.

In 2000, of approximately 32 million persons who received health insurance coverage through Medicaid programs, an estimated 11.5 million (36%) smoked. One of the national health objectives for 2010 is to provide coverage by Medicaid in the 50 states and the District of Columbia (DC) for nicotine-dependence treatment. The Guide to Community Preventive Services recommends reducing the cost of tobacco-dependence treatments to increase the number of smokers who successfully quit smoking. The 2000 Public Health Service (PHS) Clinical Practice Guideline also supports expanded insurance coverage for tobacco-dependence treatments. The amount and type of coverage for tobacco-dependence treatment offered by Medicaid has been reported previously for 1998, 2000, and 2001. In 2002, all states and DC were surveyed again about the amount and type of coverage they provided. This report summarizes the results of the survey, which indicate that as of December 31, 2002, 1) 36 Medicaid programs covered some tobacco-dependence counseling or medication for all Medicaid recipients, 2) four states offered coverage only for pregnant women, 3) two states offered coverage for all pharmacotherapy and counseling treatments recommended by the 2000 PHS guideline, and 4) seven states covered all recommended medications and at least one form of counseling. To improve the health of populations with disproportionately high rates of smoking, the 50 states and DC should provide coverage under Medicaid for all recommended tobacco-dependence treatments.

Healthy People Programs↗
PubMed2005

[Forest landscape restoration and its affecting factors in burned area of northern Great Xing'an Mountains--taking forest coverage as an example].

Forest landscape restoration has been an attractive issue since the catastrophic fire took place on the northern slope of Great Xing'an Mountains in 1987. Based on the China forest inventory data and employing Kendall Bivariate and Distances Correlation Analyses, an investigation was made to search for what changes of the forest coverage pattern being happened in this area during the past 13 years after fire, and how the fire severity, foster type and terrain factors influenced the restoration of forest coverage. The results showed that the forest coverage in 2000 changed a lot, in comparing with that in 1987 before fire. The percentage of non-stocked land area and coverage grade declined markedly, with lower coverage grade increased. Among all test factors, fire severity which was inversely correlated with forest coverage grade was the key one. Though the regeneration measures didn't markedly affect forest coverage restoration within a short period, they might shorten the cycle of forest succession and promote the productivity of coniferous forest in the future. Among three terrain factors, slope was the strongest one affecting forest coverage, followed by position and aspect.

Biodiversity↗
PubMed2006

Disparities between white and African-American children in immunization coverage.

INTRODUCTION: A recent study has shown that the national-scale difference in immunization coverage between non-Hispanic white (abbreviated "white") and non-Hispanic African-American (abbreviated "African-American") children aged 19-35 months in the United States has increased by about 1 percentage point annually. We examined how this widening gap differs with geography and income. METHODS: We used data from the National Immunization Survey, 1998-2003, a national telephone survey. We examined differences between white and African-American children in immunization coverage within income groups (at or above versus below the federal poverty level) for each census region (northeast, south, midwest and west). We tested the hypothesis of constant disparity over time. RESULTS: Among households at or above the federal poverty level in the northeast census region, disparity is widening (white coverage minus African-American coverage was -0.5 in 1998 but 15.5 in 2003). Among household at or above the federal poverty level in the midwest census region, disparity is narrowing (white coverage minus African-American coverage was 13.9 in 1998 but 2.5 in 2003). We found no significant evidence of a trend in other groups. CONCLUSIONS: Widening national-level disparity in immunization coverage is primarily attributable to trends in the northeast census region. Addressing the widening disparity in coverage requires new strategies that consider current social and economic contexts.

Black or African American↗
PubMed2006

[Inequity in infant vaccination coverage in Colombia 2000 and 2003].

OBJECTIVE: Identifying inequity in childhood vaccination coverage in towns throughout Colombia for both immunisations scheme and type of vaccine. METHODS: An ecological study using secondary information for 2000 and 2003. Three indicators were measured: (1) gaps in coverage (understood as being the differences between municipal coverage and that at national level), (2) Gini coefficient and (3) Lorenz's curve. RESULTS: Decreasing national vaccination coverage was found, dropping from 78.8% in 2000 to 66.8% in 2003. The number of towns having gaps in their coverage also increased during the two years being studied. Vaccination coverage concentration coefficients and curves showed inequalities between the municipalities during the two years being studied, although Gini coefficients improved from 0.18 to 0.13 for vaccination coverage between 2000 and 2003. The anti-influenza vaccine had the greatest decrease in inequality during the years being studied, followed by the anti-hepatitis B vaccine. The smallest change was recorded for the tuberculosis vaccine (BCG). Poliovirus vaccine estimations lay between those for BCG and hepatitis B. CONCLUSIONS: Action should be focused on municipalities identified as having recurring low coverage and large gaps compared to the national level.

Algorithms↗