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PubMedDate not supplied

Reproductive life of French-Canadians in the 17-18th centuries: a search for a trade-off between early fecundity and longevity.

One of the predictions derived from Williams' (1957) evolutionary theory of senescence is the existence of a trade-off between early fecundity and longevity. The population register of the French immigrants to Québec in the 17th century and of the first Canadians in the 17th and 18th centuries was used to detect such a trade-off in a noncontraceptive human population living at a time when longevity had not been prolonged by medical care and was not artificially shortened by wars, epidemics, or other external causes. No evidence for such a trade-off could be detected in these populations which had not yet reached the demographic transition phase (i.e., the historical period when longevity began to be extended and the progeny began to be reduced). Results are discussed in connection with the various studies aiming to test the Williams' theory.

Canada↗

PubMed2002

Cancer incidence among Sami in Northern Finland, 1979-1998.

The Sami population living in Northern Finland represents a specific genetic background and a way of life that is different from other Finns. A cohort of 2,100 Sami and 4,174 non-Sami people from the 2 northernmost municipalities of Finland on 31 December 1978 was identified from the national Population Register and followed up through the Finnish Cancer Registry for cancer incidence during 1979-1998. There were 111 cancer cases among the Sami, while the expected number based on the average cancer incidence in the Finnish population was 173. Among the non-Sami cohort members, there were 226 cases of cancer vs. 224 expected cases. The Sami had significantly decreased incidence of cancers of the prostate [standardised incidence ratio (SIR) 0.25; 95% confidence interval (CI) 0.08-0.58] and breast (SIR 0.36; 95% CI 0.14-0.73), similarly for both localised and nonlocalised tumours. Low SIRs were also observed for bladder cancer (SIR 0.28; 97% CI 0.03-0.99) basal cell carcinoma of the skin (SIR 0.12; 95% CI 0.03-0.30) and other nonmelanoma skin cancers (SIR 0; 95% CI 0-0.63). In contrast to other subcategories of the Sami, the Skolts, whose lifestyle stems from areas that now belong to Russia, showed a nonreduced overall cancer risk and a significantly elevated risk for stomach cancer (SIR 3.8; 95% CI 1.5-7.8). The low cancer incidence among the other Sami populations in Finland cannot be fully explained by their specific way of life. It seems likely that the Sami ethnicity carries a reduced cancer incidence level. Although many Sami have been exposed to radioactive fallout from the nuclear weapon tests via their reindeer-rich diet, this does not seem to affect their cancer risk.

Feeding Behavior↗

PubMed2000

Hormone-dependent cancer and adverse reproductive outcomes in farmers' families--effects of climatic conditions favoring fungal growth in grain.

OBJECTIVES: The impact of grain farming and climate on late-term abortion among female farmers, male genital birth defects among their sons, and hormone-dependent cancer among male and female farmers and their adult children was investigated. METHODS: National registers were cross-matched in Norway and 246,043 male and female farmers born in 1925-1971 were identified, as were their 264,262 children, born in 1952-1980, in agricultural censuses and in the population register. The subjects were followed in the Cancer Register through 1995. Farmers' births, conceived in 1973-1991, were identified, and the prevalences of late-term abortion in mothers and hypospadias and cryptorchidism in their sons at birth were examined. Exposure, defined as the combination of grain farming and categories of seasonal or cumulative warnings, was based on data in agricultural censuses and on local, seasonal, field fungal warnings. Estimated adjusted rate ratios or prevalence ratios served as the measures of association. RESULTS: Categories of high exposure were associated with reproductive outcomes and cancer among female farmers, the strongest occurring for late-term abortion (ratio 2.6, 95% confidence interval (95% CI) 1.6-4.3). Exposure associations for ovarian and breast cancer, and male genital defects, were more moderate. Endometrial cancer was associated with grain farming (ratio 2.0, 95% CI 1.4-2.8) across all levels of fungal warnings. Exposure associations for cancer were strongest for premenopausal, parous women. Exposure was not associated with cancer among male farmers or children. CONCLUSIONS: Climatic conditions favoring fungal growth in grain were associated with hormone-dependent adverse outcomes among female farmers; the results are consistent with hormonal effects of inhaled mycotoxins during pregnancy.

Abortion, Spontaneous↗

PubMed1995

[Case-control study of epidemic optic neuropathy in Cuba, 1993].

The purpose of this study was to identify the risk factors for epidemic optic neuropathy, which occurred in Cuba in 1992 and 1993, as well as to formulate a hypothesis about its etiology. The study sample consisted of 551 pairs of cases and controls matched for age, sex, and area of residence. The cases were patients aged 15 years and over who were diagnosed in April 1993. Diagnosis was made in accordance with major criteria (diminished visual acuity, alteration in color vision, scotomata, and changes in the papillo-macular tract) and minor criteria (pallor of the optic disk, photophobia, and others). Cases were selected through systematic sampling of all the country's provinces. The controls were selected from the population registers of the primary care districts. By means of a 52-section questionnaire, information was obtained from the cases and controls about their sociodemographic characteristics, drug and food habits, and exposure to toxic environmental substances. The population group most affected was that of persons 25 to 64 years of age who lived in urban areas. No evidence was found to support biological transmission of the disease, nor were any environmental toxins discovered to be causal agents. Construction of logistic models showed an irregular diet (95% confidence interval of the odds ratio [95%CI OR]: 2.43-3.63), smoking (95% CI OR: 2.60-3.13), and elevated ingestion of sugar (95% CI OR: 1.74-2.52) to be risk factors for the disease. Despite the study's limitations, it supports the hypothesis that the epidemic's pathogenesis is toxic-nutritional. According to this hypothesis, nutritional deficiencies could be responsible for a marked alteration in metabolic detoxification mechanisms, which would increase susceptibility to a noxious agent.

Adolescent↗

PubMed1984

An alternative sampling approach to the study of diabetes prevalence.

Sampling methods hitherto used in epidemiological surveys have generally faced two major sorts of potential bias: a latent period between listing and testing of listed individuals which can cause a misrepresentation of the population under study, compared with the population basis; population migration and death during the study period, which may result in a discrepancy between the population selected for study and the part of the population examined. A Central Population Register, found in all Scandinavian countries, permits an evaluation of the size of these problems of bias and makes it possible to use an alternative sampling method based on test samples successively drawn from the actual dynamic population. The feasibility of this new approach was tested in an epidemiological survey of diabetes mellitus among individuals in the age group 60-74 years living in a Danish municipality (Fredericia). It is concluded that this alternative dynamic method produces a more representative study population with less bias, thanks to the smaller number of deaths and migration among non-responders during the study, than do the methods previously used. Furthermore, the length of the study period, the size of the test samples, as well as the intervals between selecting samples may be adjusted to the capacity available, thus reducing the resources required. By using a correction in the computer program for selecting test sample size, the sex and age profile of the whole study population may be chosen in accordance with the incidence of the disease studied. In the Scandinavian countries a unique possibility exists to carry out prevalence studies on all kinds of diseases by the method described and evaluated here.

Aged↗

PubMed2005

Colorectal cancer screening in Finland: details of the national screening programme implemented in Autumn 2004.

Colorectal cancer mortality can be reduced by repeated faecal occult blood (FOB) testing followed by colonoscopy for test positives. The object of this report is to describe how to launch a new screening programme in such a way that its effectiveness can be reliably evaluated. The programme is based on gradual expansion over time with individual-level randomization into screening or control arms among a target population aged 60-69 years in Finland. The target population will be sampled from the population register for invitees and controls by municipality and by birth cohort. The non-invited controls will gradually be screened only after the six-year implementation period. After 10 years, the programme covers the entire target population. The effects of screening will be evaluated, comparing the incidence of and mortality from colorectal cancer in those invited to screening with controls. The primary screening test is a biannual guaiac-based FOB test with three test cards for consecutive samples. In September-December 2004, around 5000 test-kits were sent to 22 piloting municipalities. In 2005, the programme expands both among municipalities and the target population, resulting in nearly 20,000 individual requests. The implementation of colorectal cancer screening in Finland in this way meets the criteria for a randomized controlled trial and the requirements for a public health programme. It allows unbiased research data to be collected while introducing the programme and may set an example for the introduction of all national screening programmes.

Adult↗

PubMed1983

The concentration of population in Finland between 1880 and 1980.

Trends in the spatial distribution of the population of Finland from 1880 to 1980 are examined using official data from population registers and censuses. "Cumulative maps and graphs and concentration indices were applied as methodological tools, and the administrative communes were taken as the areal units for a chorological matrix." The results show an increasing concentration of the population beginning in the latter half of the nineteenth century, although urbanization levels remain low in comparison with most industrialized European countries. Differences in population distribution by occupation are also considered.

Demography↗

PubMed1993

Explaining variations in prescribing costs across England.

OBJECTIVE: To derive a predictive model for national prescribing behaviour in terms of basic morbidity and demographic factors. DESIGN: 24 demographic, morbidity, and practice factors were entered into a multiple regression analysis to determine the net ingredient cost per patient. SETTING: The 90 family health service authorities in England for 1989. RESULTS: For net ingredient cost per patient only two demographic factors (numbers of pensioners and the mobility of the registered population measured by list inflation) and two morbidity related factors (standardised mortality ratios and numbers of prepayment certificates issued) significantly contributed to a multiple regression model. This model explained 81% of the variation in net ingredient cost per registered patient between family health services authorities. The model also enabled a weighting factor of 4.6 (95% confidence interval 3.2 to 6.7) to be derived for the net ingredient cost for elderly patients (compared with the existing prescribing unit factor of 3). CONCLUSIONS: The model shows that variations in prescribing costs essentially reflect demand. It also suggests that the current prescribing unit value of 3 for patients aged 65 or more underestimates the extra costs of prescribing for elderly patients.

Drug Costs↗

PubMedDate not supplied

[Gender differences in alcohol consumption in Mexico City].

OBJECTIVE: The objectives of the present study were: 1) To corroborate the increase in alcohol consumption in the female population registered by results from the National Surveys on Addictions (ENA), 1988 and 1993; and 2) to determine affected age groups, and obtain basic information on age of onset, amount consumed per event and drunkenness frequency in the adult population of Mexico City, as indicators to orient preventive measures. MATERIAL AND METHODS: A multi-stage, stratified household survey was applied. A total of 1,932 interviews was completed, subjects were between 18 and 65 years of age, with a response rate of 60.4%. The instrument was a modified version of the Composite International Psychiatric Interview (CIDI), which is a highly structured instrument, applicable by non-specialized personnel, although limited training is necessary. The alcohol section included questions on the age of the first drink, the frequency and amount consumed during each event and the drunkenness frequency during the last 12 months, among other variables. Median and percentage were obtained by sex and among age-cohorts. RESULTS: Of the total, 96.5% of men and 18.1% of women have consumed at least one drink in their lives. In average, age of onset is 16 years for men, and 18 years for women. Age group comparisons show a clear tendency to begin drinking at an earlier age, particularly in women. The growing trend indicated by ENA with respect to alcohol consumption in the feminine population and at a younger age was corroborated. Results indicated that, in average, 5 years after the age of onset, both men and women reach their highest quantities of alcohol consumption, which tend to be excessive. Additionally, high-risk drinking among women (five or more drinks per event) increased to be four times higher in a period of seven years, and with an apparent tendency to rise. Sixty percent of the drinking population reduced alcohol consumption before the age of 30, however, the remaining 40% continued to drink at the same rate, or even increased consumption, particularly among women. CONCLUSIONS: The age of onset of alcohol consumption has diminished, especially in women, showing tendencies towards abuse. Preventive programs should predominantly focus on young age groups with emphasis on the feminine population.

Adolescent↗

PubMed2006

The demographics of same-sex marriages in Norway and Sweden.

The present study investigates the demographics of same-sex marriages--that is, registered partnerships-in Norway and Sweden. We give an overview of the demographic characteristics of the spouses of these partnerships, study patterns of their divorce risks, and compare the dynamics of same-sex couples with those of heterosexual marriages. We use longitudinal information from the population registers of the two countries that cover all persons in partnerships. Our demographic analyses include information on characteristics such as age, sex, geographic background, experience of previous opposite-sex marriage, parenthood, and educational attainment of the partners involved. The results show that in many respects, the distributions of married populations on these characteristics differ by the sex composition of the couples. Patterns in divorce risks are rather similar in same-sex and opposite-sex marriages, but divorce-risk levels are considerably higher in same-sex marriages. The divorce riskforfemale partnerships is double that for male partnerships.

Adult↗

PubMed2004

Surveillance of the bioterrorist threat: a primary care response.

Threats from bioterrorism are of national and international concern. We outline a system of disease surveillance covering a selection of diseases linked to potential bioterrorist threats, based on the weekly returns service of the Royal College of General Practitioners and covering a surveillance population of 650,000 in England and Wales. Practices record working diagnoses and the episode type (distinguishing new episodes of illness from ongoing consultations) on patients' computerised medical records. These are interrogated twice weekly by using automated routines. The registered population and persons consulting for each Read code (group of codes) are counted in sex and age specific groups and the data forwarded electronically to the Research Unit, where the results are consolidated by region (North, Central, South). Weekly incidence rates between October 2001 and September 2002 were compared with the weekly average over the past seven years for 13 selected conditions. Detailed data are presented for three conditions (asthma, infections of the skin, disorders of the peripheral nervous system). For asthma increased incidence was reported in weeks 31 and 32 of 2002, predominantly in the Central region. For the other two conditions no unusual peaks of incidence were observed in any region. Operational research based on disciplined recording of morbidity in general practice can deliver timely surveillance data on bioterrorist threats.

Asthma↗

PubMed2005

Harmonisation of the acute respiratory infection reporting system in the Czech Republic with the European community networks.

Respiratory virus activity is detected in Europe each winter, yet the precise timing and size of this activity is highly unpredictable. The impact of influenza infection and/or acute respiratory infection in European countries is continuously monitored through a variety of surveillance systems. All of these sources of information are used to assess the nature and extent of activity of influenza and other respiratory viruses, and to offer guidance on the prevention and control of morbidity and mortality due to influenza at a local, national and international level. The early warning system for a forthcoming influenza epidemic is mainly based on the use of a set of thresholds. In the Czech Republic, the acute respiratory infection (ARI) reporting system, with automated data processing, uses a statistical model for the early detection of unusual increased rates of the monitored indicators. The collected data consists of the number of ARI, the number of complications due to ARI and the population registered with the reporting general practitioners and paediatricians, all collected separately in five age groups. To improve the reporting system in the Czech Republic, clinical data on the weekly incidence of influenza-like illness (ILI) within the same population and the same age groups was started in January 2004. These data fit the European Commission's recently adopted ILI case definition and allows a better comparison of data with other countries in Europe, in particular those participating in EISS (European Influenza Surveillance Scheme).

Adolescent↗

PubMed2005

Indicators of mancozeb exposure in relation to thyroid cancer and neural tube defects in farmers' families.

OBJECTIVES: The fungicide mancozeb has been suspected of causing thyroid cancer and neural tube defects. The aim of the study was to investigate associations of indicators of mancozeb exposure with thyroid cancer and neural tube defects in farmers' families. METHODS: National registers in Norway, identifying 105 403 female and 131 243 male farmers, born in 1925-1971, and their 300 805 children available for analyses, born in 1952-1991, were cross-linked with national agricultural censuses, 1969-1989, and the population register. Neural tube defects (ICD-8 740-742) at birth among the 102 703 children conceived between May 1973 and April 1991 were identified in the medical birth register. Likewise thyroid cancer (ICD-7 194) was identified in the cancer register through 2000. Data on farm production and fungal forecasts (humid and temperate weather conditions) in 1973-1990, obtained from agricultural censuses and meteorological measurement stations, respectively, served as the mancozeb exposure indicators. The adjusted rate ratio or prevalence ratio (PR) estimates with 95% confidence intervals (95% CI) were computed in a Poisson regression analysis. RESULTS: Neural tube defects (131 cases, prevalence 12.8/10 000 births) was moderately associated with potato cultivation (PR 1.6, 95% CI 1.1-2.3) and paternal work of > 500 hours/year (PR 1.6, 95% CI 1.1-2.5). Altogether 319 thyroid cancer cases were identified: 141 in female farmers (incidence 10.2/100 000 person-years), 79 in male farmers (incidence 3.2/100 000 person-years), and 99 in offspring (female and male incidence 3.4 and 0.6/100 000 person-years, respectively). Mancozeb exposure was not associated with thyroid cancer. CONCLUSIONS: A moderate association seems to exist between mancozeb exposure and neural tube defects, but not between mancozeb exposure and thyroid cancer.

Agriculture↗

PubMed1998

[The magnitude of fatness: prevalence and type of obesity in people registered at a health center].

OBJECTIVE: To determine prevalence and type of obesity; and, secondarily, to determine the prevalence of factors of cardiovascular risk in obese patients. DESIGN: Descriptive observational study. SETTING: Catchment area of an urban Health Centre. PARTICIPANTS: People over 14 and of both sexes registered at the Health Centre. INTERVENTIONS: 270 people were contacted, of whom 191 (70.7%) were finally studied for weight, size and Quetelet index. When this index was 25 or over, the waist/hip index was studied. RESULTS: The prevalence of obesity for the whole population registered at the Health Centre was 13.5% (15.4% in men, 12.1% in women). Prevalence increased with age, and was highest for both sexes in the 65-74 age-group (28%). The type of obesity prevalence has resulted 84.6% for android type and 15.3% for gynecoid. CONCLUSIONS: Obesity is a first-order problem, not only because of its high prevalence and the greater frequency of the male type, but because of the high prevalence of cardiovascular risk factors in obese people.

Adolescent↗

PubMed2006

Factors affecting postoperative mortality of patients with displaced femoral neck fracture.

Displaced femoral neck fractures are known to be associated with high rates of mortality. The purpose of the present study is to investigate pre- and postoperative factors which influence this mortality in a series of 1186 consecutive Danish patients presenting to one hospital's orthopaedic department with Garden type 3-4 fractures. Subsequent mortality data was obtained from the state population register (224 were still alive). The stepwise Cox proportional hazards model was used for multivariate analysis in order to obtain the predictors of postoperative mortality. The median survival of male subjects fell from 5.2 years in an age-matched control population to 1.6 years in the patients. In women survival time fell from 6.6 to 2.8 years. Almost all excess mortality occurred during the first 3 months following hemiarthroplasty. In order of significance, key factors negatively influencing mortality at 3 months were: cardiac complications, dementia, male sex, age, waiting time before operation, stroke and dislocation of the prosthesis and perioperative fracture. Of these, waiting time for surgery and dislocation of the prosthesis could be modified. A number of other studies have confirmed the importance of optimising these factors.

Aged↗

PubMed2006

Association of age, sex and deprivation with quality indicators for diabetes: population-based cross sectional survey in primary care.

OBJECTIVES: To determine the quality of diabetes management in primary care after the publication of the National Service Framework and examine the impact of age, gender and deprivation on the achievement of established quality indicators. DESIGN: Population-based cross sectional survey using electronic general practice records carried out between June-October 2003. SETTING: Thirty-four practices in Wandsworth, South-West London, UK. PARTICIPANTS: 6035 adult patients (> or =18 years) with diabetes from a total registered population of 201,572 patients. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Success rates for the diabetes quality indicators within the General Medical Services contract for general practitioners. RESULTS: We identified large variations in diabetes management between general practitioner practices with poorer recording of quality care in younger patients (18-44 years). In addition, younger patients had a worse cholesterol and glycaemia profile, although hypertension was more common in older patients. Gender and deprivation did not appear to be important determinants of the quality of care received. CONCLUSIONS: There are large variations in diabetes management between general practitioner practices, with care seemingly worse for younger adults. Longitudinal studies are required to determine whether current UK quality improvement initiatives have been successful in attenuating existing variations in care and treatment outcomes.

Adolescent↗

PubMed2003

Fertility of patients with schizophrenia, their siblings, and the general population: a cohort study from 1950 to 1959 in Finland.

OBJECTIVE: Genetic factors are the most important risk factors for schizophrenia. However, despite the fact that patients with schizophrenia have significantly fewer offspring than the general population, schizophrenia persists. The authors investigated whether the siblings of patients with schizophrenia produce more offspring, thereby compensating for the low fertility of the affected individuals. METHOD: From all 870,093 individuals born in Finland from 1950 to 1959, the authors determined how many had schizophrenia or were siblings of schizophrenia patients and how many offspring they had. The population data were obtained from the Population Register Center of Finland, and the National Hospital Discharge Register was used to identify all persons who had been hospitalized because of schizophrenia. Appropriate regression models were used to model age at the birth of the first child, number of children, and proportion of males among offspring. RESULTS: Of the total population, 1.3% were patients with schizophrenia, and 2.8% were their siblings. The mean number of offspring among female siblings was slightly but significantly higher than among women in the general population (1.89 versus 1.83), while the opposite was true for the male siblings (1.57 versus 1.65 among men in the general population). The mean number of offspring among patients with schizophrenia was 0.83 for women and 0.44 for men. CONCLUSIONS: Lower than average fertility among patients with schizophrenia is not compensated for by higher fertility among their siblings. Thus, the persistence of schizophrenia in the general population is not explained by this simple evolutionary mechanism.

Adult↗

PubMed1992

Protection of mouse oesophageal mucosa against gamma rays injury.

The alterations in the oesophageal epithelium were studied in mice after a single whole-body exposure to 7.5 Gy of Co-60 gamma rays in presence or absence of 2-mercaptopropionyl glycine. The epithelium showed an increase in the thickness which reached a maximum on the third day and then decreased gradually up to seventh day after irradiation in the non-drug treated group. In the 2-mercaptopropionyl glycine treated animals the epithelial thickness remained in the normal range except on the day 7 when it was significantly lower than normal. The total cell population registered a steady decline from one to seven days post-irradiation in both groups, but the number of cells was more in the 2-mercaptopropionyl glycine treated group. The number of pycnotic nuclei showed an inverse relationship to the total cell population, it increased continuously up to seven days in both the protected and non-protected groups. However, pycnotic nuclei were significantly lower in the protected group on days 3, 5 and 7 in non-protected group.

Animals↗